#38 Dr. Semmelweis And How Being Right Can Cause Conflict

This post and the next are derived from the professional and life circumstance of Dr. Ignaz Philip Semmelweis (1818 – 1865).  Semmelweis’ story illustrates several features of both ideological factors in the development of conflict and the complexity of conflict. By ideology I mean a way of believing that takes on a life of its own and may not be based on high quality evidence. This blog focuses on the ideological force and the next one on the complexity.

Semmelweis was the equivalent of an obstetrician in mid-19th Century, first at the Viennese General Hospital, then in Budapest, Hungary. He is considered the father of antiseptic sterilization practices in medicine. He noticed that in one of his two clinics in the Viennese General Hospital, women were dying at childbirth from “childbed fever” at a much higher rate than the other clinic offering the same service. Through meticulous observation and statistical records he determined the difference between the two clinics.

The one with the higher death rate had an adjacent morgue. Semmelweis hypothesized that doctors were transferring something (“cadaverous particles”) from the morgue to the birthing mothers. By having his doctors wash their hands in a lime solution following work in the morgue, the death rate of the women through infection, which had been as high as 30 percent, plummeted to less than 1 percent.

Dr Semmelweis instructing doctors to wash their hands before touching the birthing women. This image of one of 12 mural panels done by the Italian painter Gregorio Calvi di Bergolo commissioned by the International Museum of Surgical Science, Chicago in 1953. The panels done in oil paint, show the development of surgery through the ages and each is about 80 x 44 inches.

Dr Semmelweis instructing doctors to wash their hands before touching the birthing women. This image is one of 12 mural panels done by the Italian painter Gregorio Calvi di Bergolo and commissioned in 1953 by the International Museum of Surgical Science, Chicago. The panels done in oil paint, show the development of surgery through the ages and each is about 80 x 44 inches.

 

We live in a culture that thoroughly believes that infections are caused by micro-organisms but 170 years ago there was no such understanding available. What can be relevant to conflict is not only what might be true, but what is believed to be true. At the time, ‘child bed fever’ was thought to have as many as 30 different causes. Bowel purges and bloodletting were two of the accepted treatments.

Semmelweis had ongoing conflict with the established medical community, and lost two of his residency positions. In his mid-forties, he was committed to an asylum and died two weeks later following a beating by the guards. It was a tragic end to someone who was a brilliant and courageous pioneer.

 

 

Semmelweis’ story illustrates the general principle that if you propose a view that is ahead of its time and runs counter to the established ideology:

– Your ideas are likely to be opposed

– You will come into conflict with the establishment if you attempt to advance your ideas

– You may suffer detrimental personal consequences

Galileo Galilei (1564 – 1642) is perhaps the most famous figure punished for being ahead of his time. He was held under house arrest for nine years of his life for contending that the earth orbited the sun and other ideas that were foundational to the practice of  today’s science. Although modern societies may have advanced in their capacity to tolerate dissenting perspectives, they are far from immune to harsh responses.

In 2005, Australian Barry Marshall (b. 1951) won the Nobel Prize in medicine for establishing that frequently, stomach ulcers are caused by a bacterial infection. Prior to this, he had been  dismissed in a similar manner to Semmelweis: he was made fun of at scientific conferences and struggled to obtain research grants. For most of the 20th Century, stomach ulcers were thought to be caused by stress and were treated by doctors assisted by pharmaceutical companies on this basis.

Modern medicine claims to proceed on the basis of science, as it also claimed in Semmelweis’ time. In both the Marshall and Semmelweis cases, there was high quality objective evidence of the claims the two men made. In both cases, the views were rejected on an ideological basis ie. the beliefs overruled the evidence.

 

 

Although the germ theory of infectious disease seems irrefutable in our time, if we consider the evolution of knowledge, it is possible that it will be modified in the future and that early advocates of a new way of perceiving will have their ideas attacked and rejected.

In the story I have told Semmelweis’ ideas were rejected because they ran counter to scientific establishment. But, there were additional contributing factors to this rejection. Furthermore, Semmelweis himself was a rational actor at the time and he made choices that contributed to his demise. In the next blog I will add many nuances to this story that illustrate the complexity of conflict.

Tagged , . Bookmark the permalink.

Leave a Comment