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« The Mistake of "Early Intervention" | Main | FIND JACOB ALLEN! »

The Semmelweis Reflex

By Twyla Ramos

Why is it that the biomedical paradigm of autism is so readily dismissed by many doctors and scientists?  Parents tell compelling, credible stories about their children's descent into autism after vaccinations, and recovery through biomedical treatments such as chelation, but the “experts” reject these reports as "anecdotal" and say that parents don't understand science.  I read about scientific studies supporting the biomedical paradigm of autism, only to hear critics lambaste the studies as not real science.

Although I don’t fully understand why this happens, I found a name for this phenomenon:  "The Semmelweis Reflex". 

Per Wikipedia, "The Semmelweis Reflex is the dismissing or rejecting out of hand any information, automatically, without thought, inspection, or experiment. The phrase stems from a number of people's personal experiences with the phenomenon, and denotes the reactions of anyone who engages in such behavior. The expression 'Semmelweis Reflex' has been attributed to author Robert Anton Wilson." (1)

I came across this as I was wondering about historical cases of new science being ignored or repressed, such as when early astronomers believed that the earth revolves around the sun, rather than the sun moving across the earth.

I had a vague memory of reading about a physician in the 19th century who was present when a pregnant woman in labor was being wheeled into an obstetrical ward to deliver her baby.  As she was poor, she would have given birth in the midwive’s clinic, but there were no beds available there so she was assigned to the physicians' clinic.  Instead of being grateful that she would be treated by physicians instead of midwives, the woman was crying and begging to be allowed to give birth in the midwive’s clinic.  Her fears were ignored as irrational, and she was taken to the available bed in the physicians' clinic.

Alas, the doctor later learned that this woman had died after childbirth of an infection known as "puerperal fever".  He then investigated and found that the mortality rate from childbirth was indeed much higher in the physician's clinic than in the midwive's clinic.  It occurred to him that the reason why might be that physicians were going straight from doing autopsies and surgeries to delivering babies, without washing their hands.

Of course, the midwives did not perform surgeries and autopsies.  And, the midwives routinely washed their hands before each delivery.

I did a Google search on the history of germs to find out more about the story that had prompted my vague memory.  This doctor, Ignaz Phillip Semmelweis, was born in Budapest, Hungary in 1818.  He graduated from medical school in Vienna, Austria in 1844. “He then worked in the obstetric wards at the Allegemeines Krankenhaus in Vienna where he was one of a generation of young medical men trained by the anatomical pathologist Karl von Rokitansky who sought to transform traditional but ineffective treatment methods by attacking difficult clinical problems with logic and mathematical precision." (2)

Doctor Semmelweis hypothesized that puerperal fever was caused by "particles" spread to the women from the hands of doctors and students. This idea was considered ludicrous at the time.  Germs had not been discovered yet, and the idea of invisible microbes causing disease was rejected out of hand.

"His observations went against the current scientific opinion of the time, which blamed diseases ... on an imbalance of the basic 'four humours' in the body, a theory known as dyscrasia. It was also argued that even if his findings were correct, washing one's hands each time before treating a pregnant woman, as Semmelweis advised, would be too much work. Nor were doctors eager to admit that they had caused so many deaths.” (1)   

"There were ideological issues at the time that prevented the medical establishment from recognizing and applying the findings of Semmelweis. One was that Semmelweis' claims were thought to lack scientific basis, since no explanation was given to his findings. Such a scientific explanation was only made possible some decades later when the germ theory of disease was developed...” (1)   

Also, in the “post-Enlightenment intellectual environment that dominated scientific circles at the time”, the idea that particles from corpses could cause death was thought to arise from superstition or religious beliefs. (1)

Puerperal fever was traditionally viewed as caused by epidemics.  But Doctor Semmelweis believed that if this were true, both clinics would be equally affected. Overcrowding was suggested; yet the second clinic was ordinarily more crowded than the first.

Doctor Semmelweis ordered that staff wash their hands in a chlorine solution before examining the laboring patients. As a result of this new procedure, by 1848 the mortality rate from puerperal fever in the physicians' clinic had decreased from 18% to 1% (4), less than that of the midwives' clinic.      

But many senior obstetricians regarded his ideas as a personal affront.  "Surprisingly, opposition to Semmelweis's observations was intense, for the paradox of being healer and murderer was intolerable for most. When confronted with Semmelweis's explanations, conscientious obstetricians pleaded 'not guilty.' Semmelweis could not understand these reactions. A few outstanding doctors supported him; nevertheless, the tide of controversy grew to such an extent that Semmelweis was 'retired' from his position as assistant at the first clinic. In 1850 he left Vienna and returned to Budapest." (3)

"In Hungary, Semmelweis took charge of the maternity ward of Pest's St. Rochus Hospital from 1851 to 1857. His hand- and equipment-washing protocols reduced the mortality rate from puerperal fever to 0.85% there, and his ideas were soon accepted throughout Hungary. He married, had five children, and built a large private practice. He became chair of theoretical and practical midwifery at the University of Pest in July 1855...

"Vienna remained quite hostile to him, however. In the autumn of 1860..., long after the dismissal of Semmelweis, in the same ward where he demonstrated how to virtually eradicate childbed fever, 35 of 101 patients died..." (1)

In 1861 he published the book "The Etiology, Concept, and Prophylaxis of Childbed Fever."  He “sent copies to medical societies and also to leading obstetricians in Germany, France, and England. A number of unfavorable foreign reviews of the book prompted Semmelweis to lash out against his critics in series of open letters written in 1861-1862, which did little to advance his ideas. At a conference of German physicians and natural scientists, most of the speakers rejected his doctrine." (1)

"In July 1865 Semmelweis suffered what appeared to be a nervous breakdown, though some modern historians believe his symptoms may have indicated the onset of Alzheimer's disease or senile dementia. After a journey to Vienna imposed by friends and relatives he was committed to a mental asylum, the Niederösterreichische Landesirrenanstalt in Wien Döbling, where he died only two weeks later." (1)

Not until 1883 did the Boston Lying-In Hospital introduce methods of antisepsis, methods similar to those used decades earlier by Semmelweis.  In Boston this was developed by Oliver Wendell Holmes, who encountered much the same hostility and opposition from the Boston medical establishment, despite also demonstrating that personal cleanliness by birth attendants could prevent childbed fever. (3) (2)

"The establishment's failure to recognize his findings earlier led to the tragic and unnecessary death of thousands of young mothers, but he was ultimately vindicated. This case is sometimes put forward as an example of a situation where scientific progress was slowed down by the inertia of established professionals." (1)
 
"The legacy of Ignaz Semmelweis continues in various ways:

•         Only after Dr. Semmelweis's death was the germ theory of disease developed, and Semmelweis is now recognized as a pioneer of antiseptic policy and prevention of nosocomial infection;

•         Semmelweis University, a university for medicine and health-related disciplines (located in Budapest, Hungary), is named after the physician Ignaz Semmelweis; and

•         The Semmelweis Orvostörténeti Múzeum is located in the former home of Ignaz Semmelweis.” (1)

Semmelweis Reflex

"The Semmelweis Reflex is the dismissing or rejecting out of hand any information, automatically, without thought, inspection, or experiment. The phrase stems from a number of people's personal experiences with the phenomenon, and denotes the reactions of anyone who engages in such behavior."  (1)   

Now for the pop quiz:  How many parallels with today can you find in this story?

For sources see: www.answers.com/topic/ignaz-semmelweis?cat=health, where all of these sources are shown together.

(1)  Wikepedia
(2)  Encyclopedia of Public Health
(3)  Biography
(4)  Scientist

A long, long time ago Twyla won the awards for best science student in the sixth grade and best math student in the seventh grade, but her only degree is a B.A. in English.  All her life she has tried not to be a nerd, but she now feels ready to stand up at a meeting of Nerds Anonymous and say proudly, "I am a nerd".  Twyla has three children, a job, and a husband.  Her middle child has both Autism and Williams Syndrome.

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Thank you Dori for commenting on this older article which I had missed. And thank you, Twyla, for writing it!

Your point about physicians not wanting to face up to the consequences I think is right on. I know of a physician who is now on our side who said it took an epiphany, in which she had to acknowledge and accept the harm she had done, before she could see the truth of what was happening with vaccines. While it does explain their behavior, in my opinion, it does not excuse it however.

Awhile back, I created a page with past and present medical errors, which some of you might find interesting: http://www.vaccinationnews.com/scandals/feb_8_02/Fiascos.htm (I actually have copies of the Robin book - he is now, sadly, deceased - if anyone is interested in purchasing it. It is an absolutely remarkable book, which, unfortunately has gotten little attention.)

I also just ran into a fabulous quote which I have just added to the front page of my website and want to share here:

"A foolish faith in authority is the worst enemy of truth."

-- Albert Einstein, letter to a friend, 1901

Many years ago as a nursing student in obstetrics, I was required to read the book, "The Cry and the Covenant" by Morton Thompson (copyright 1949). It is the rivoting, personal story of Semmelweis. Interestingly, I've recently procured a copy of that book and have been re-reading it, captivated by the willful and shameful ignorance of the medical establishment of the day. I've also been keenly aware of the explosion of autism in recent years, and have done some study with regards to vaccines, diet, and other possible factors brought to bear on this problem. The propensity of man to hold to his dogma, even when proven wrong, is part of our plight as humans. (It's called "PRIDE!") And yes, it's SO alive and well in our generation. . . and will be in EVERY generation. There will always be more bends in the road; more things to discover. The more we know, the more we realize how much we DON'T know. The world to be known "out there" is as infinite as the God who made them. Our place within that system is careful thoughtfulness, perseverance, yes, against the odds, and above all, humility. Pride is what is at the base of the "Semmelweis Reflex," and can be seen in countless arenas within our culture and even the greater world. I am reminded of a biblical passage in Proverbs that says, "There is a way that seems right unto a man, but the end, thereof, are the ways of death." The "way of the 'Reflexors' seems right to them," but as in Semmelweis' time, that way brought death to countless women. As for Ignaz Phillip, he didn't live long enough to reap what he'd sown; but we, generations later, are living our thanks to him for his persistence.

With his permission, I am posting a comment from one of my five wonderful siblings, who works with special needs kids --


That is AWESOME!!!!

The one thing that bugs me the MOST, and is the most
suspect, about the response to the biomedical and
neurochemical links to Autism is the outright denial
of the establishment. That is a great article.

My only issue is that you were not in 6th & 7th grade
"a long long time ago." One "long" would have
sufficed.

Peter

Angela & Kathryn -

Thanks so much for your interest and comments!

And, you are certainly welcome to reference this.

Twyla

Hi Twyla,

The information you present regarding childbed fever and Semmelweis is dead on accurate! And your comparison between childbed fever and what is happening with the autism epidemic is also dead on accurate!

I am talking to the choir I know, but it all comes down to money, as well as the conditioning our society has undergone for, I can’t tell you how long. Didn't you know that the “authorites” know more than we do? Especially a nation of parents?

Semmelweis Reflex is alive and well everywhere; including the Midwifery community. I have been working on something that demonstrates this very fact. Those that you believe with all your heart never would, still fall prey to Simmelweis to suit their own agenda. Or their pocketbook’s agenda…

I thank you and commend you wholeheartedly for sharing! And if you don’t mind, I may just have to reference this…

Also, I love your bio! Nerd? I have to question that… Someone who questions authority? That you most certainly do and with good reason!

Thanks again Twyla.

This is fascinating and absolutely relative to the phenomenon going on today with the autism epidemic. I think I will be adding "Semmelweis Reflex" to my vocabulary. Thank you.

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