He had very sensible ideas about hand washing a couple of hundred years before it was accepted by most doctors. He was a bit weird though, and ended up being ignored.
Semmelweiss was apparently lacking in social graces, but I wouldn't be able to behave normally if I'd discovered what he discovered.
(Edit for coquilles and spacing)
Doctors used to believe they were such gentlemen their hands could not possibly be dirty and contaminated.
NB, not all men were considered gentlemen.
See also surgeons cuffs on coats (blazers), so as to avoid getting blood on one’s clothes when operating, which are still called the same thing today.
"A gentleman's hands are never dirty" should have meant that he keeps them clean, not that his gentlemanliness somehow keeps them from being dirty.
He's a complicated dude.
The cringeworthy "gentlemen don't wash their hands" culture contradicts that.
> he ended up in a sanatorium because he went crazy (he likely had an advanced case of syphilis)
I see no evidence of this so called "craziness". Even the people who speculated about the cause included "emotional exhaustion from overwork and stress" as a possibility. That's the simplest explanation, probably what happened and it's absolutely to be expected when you discover you've been unwittingly killing your patients due to the ignorance of mankind, successfully devise countermeasures and prove their effectiveness only to have your peers and the scientific community all band together to gaslight you. He ended up in an asylum because he "embarrassed" them.
> the connection he made was that "cadaveric particles" were causing illness in hospitals
Of course. More women died when he and his medical students delivered their children after working with corpses than when they didn't. The connection is there, the fact it did not fully explain the phenomena does not invalidate it. Nor does it invalidate the reduction in mortality after hand sanitization was implemented.
That this was denied despite reproducible statistical evidence is absolutely shameful for all involved and a heavy lesson for all time. Women died because of it.
Similarly, you can just go look up Semmelweis' mental state at the time of his commitment.
The difference between Semmelweis's incorrect theory of what was causing childbed fever and reality is a big part of why his interventions were rejected (that, and the fact that he was apparently an unholy asshole) --- he was trying to convince his colleagues to disinfect their hands from particles that sometimes could not have existed, and the colleagues noticed that. If you're trying to evangelize a new medical intervention, don't get hung up on an explanation that can't possibly be correct, is one lesson to take from this.
Complicated dude. Read more about him than you have. It's interesting stuff. His story is more than just the airport bookstore management parable that it's become.
later
As a quick PS: the "gentleman's hands" thing came up on an AskHistorians thread I just read, and it's apparently a misquote. It's not "gentleman don't wash their hands"; it's "a gentleman's hands are clean". As in, doctors already keep their hands clean. What they didn't do was chlorinate the water they used (or clean all that hard).
That's obviously false! The contagionists and aseptics were right, the spontaneous generation people were wrong, and obviously aseptic procedure before Gordon and later Holmes and later Semmelweis was inadequate. I'm not defending the guy who said that. But he didn't say what you think he said.
Which doesn't invalidate the fact that women provably died less after his methods of combating those particles were implemented and published. Faced with that evidence, they should have accepted the method even if they don't agree simply because you can't argue with results. They could have saved women and followed up with further study on the exact nature of the problem which would only become clear when Pasteur came along. They chose to institutionalize him out of embarrassment.
I'm not "putting you on the other side" of anything. I don't agree with your minimization of the guy's achievements nor with your characterization of him as "crazy".
These points might seem kind of nitpicky, but Semmelweis has become a sort of patron saint for brooding nerds with strong but iconoclastic ideas, a shibboleth for "history will show I was right all along". Semmelweis was not, in fact, right all along, and his evident failure to persuade his peers --- stemming from what was in a sense an opposition to the germ theory of disease --- probably set science back a little bit, on margin. Not by much, though; Semmelweis was in his time one of several people expounding the same intervention.
His results have NOT been refuted. Sanitizing hands saved lives. Not sanitizing hands cost lives.
https://pubmed.ncbi.nlm.nih.gov/17553179/
https://pubmed.ncbi.nlm.nih.gov/35486338/
Whether or not it happened due to "cadaveric particles" is a completely irrelevant detail. People died less. That's enough for public health policy decisions even today. The fact his contemporaries did not accept it would be criminal negligence today.
The "scholarly debate" about his mental state is mere speculation. Here's the first result of looking it up:
> It is impossible to appraise the nature of Semmelweis's disorder.
> It might have been Alzheimer's disease, a type of dementia, which is associated with rapid cognitive decline and mood changes.
> It might have been third-stage syphilis, a then-common disease of obstetricians who examined thousands of women at gratis institutions
> or it might have been emotional exhaustion from overwork and stress.
You clearly believe the first two options. I don't believe that even for a second.
> He was not committed to a sanitarium out of pique over his demands that people chlorinate water.
Here's the second result of looking it up:
> With this etiology, Semmelweis identified childbed fever as purely an iatrogenic disease — that is, one caused by doctors.
> Friedrich Wilhelm Scanzoni von Lichtenfels took personal offense at this, and never forgave Semmelweis for it
> Scanzoni remained one of the most ardent critics of Semmelweis.
The third result of looking it up:
> Semmelweis also angered his conservative medical colleagues — and especially his boss, Johann Klein, who was head of the Department of Obstetrics and Gynecology
> Klein rejected Semmelweis' arguments concerning cleanliness, as did his colleagues.
> He probably felt angry that this precocious Hungarian was making orthodox practices and practitioners look not only ridiculous but also dangerous.
> It was Klein, incidentally, who had insisted that medical students examine cadavers in the first place, and it was he who had relaxed constraints on conducting vaginal examinations during labor.
> Semmelweis seemed to be saying that Klein's policies were the direct cause of the epidemic
> When Semmelweis' temporary appointment came up for renewal in March 1849, Klein blocked his application, despite appeals from senior medical colleagues
> The second part [of his publication] attacked his critics. This was the part that got him into serious trouble. Many leaders in obstetrics in Europe were vilified.
> While the book collected all of Semmelweis' investigations into one volume for the first time, it met with harsh reviews and had little impact in preventing the dreaded puerperal fever.
> Probably as a consequence, Semmelweis' mental state deteriorated.
> He roamed the streets of Budapest muttering to himself and distributing pamphlets directed against those who refused to follow his teachings.
> He seemed to swing from periods of excitement and energy to periods of paralyzed depression. By July 1865, he was clearly deranged.
They clearly hated this guy and found several ways punish him for his insubordination. It's entirely possible and very likely that this was the reason he ended up in the asylum where he was killed.
2. Nobody here disputes aseptic technique.
3. You've misconstrued the point about Semmelweis' commitment. Alzheimers, syphilis, exhaustion: the point is that he was symptomatic, as you yourself just quoted.
I don't think anybody else is reading us at this point.
[1]: https://www.econtalk.org/megan-mcardle-on-the-oedipus-trap/
The point at the beginning of the thread is to do as they do, not to do as they say...
So it is not at all obvious that we should favor RCTs over experience. Because they have very different things they can measure.