Why Dr Semmelweis lost his mind

Thinkers who challenge the status quo are often suppressed and marginalised to protect the Establishment. But although they can be locked away and destroyed, their ideas cannot so easily be contained.

Jade Lennon
6 min readSep 10, 2021
Dr Semmelweis (centre) is depicted in the Vienna General Hospital in Austria supervising doctors washing their hands before examining patients in this painting by Robert Thom. Pic: National Geographic

The case of Ignaz Semmelweis

When the story of Dr Ignaz Semmelweis is taught in university courses they often leave out the sad part: that at the end of July 1865, the man who would later be known as the ‘saviour of mothers’ was taken by a friend under false pretenses to an insane asylum in Pest, Hungary, where he was beaten by the guards to subdue him and forced into a straitjacket before being thrown into a cold, dark cell where, aged just 47, he was found dead 14 days later.

The crisis of conscience that led to the breakdown and premature death of the young doctor Semmelweis started 20 years earlier during the period he worked as a superintendent of the maternal wards at the General Hospital in Vienna.

Semmelweis was appointed to work on a maternity ward at Vienna General Hospital in 1846.

Pregnant women would come to him begging not to be admitted to a certain ward.

He soon became aware of and perplexed by the number of women who died in the most excruciating ways from puerperal (childbed) fever and he was determined to find the cause. He noticed also that women who gave birth on the street or at home did not suffer as many incidents of the dreadful disease.

His work makes for an enduring source of debate among students of scientific method, but in brief, he studied and weighed up possible causes of the disease, including supernatural ones, to explain the discrepancy in the number of women who died after childbirth in the two wards at the hospital. The only main difference was that women in the one ward (with the high number of infections) were attended to by doctors and medical students, whereas the other was staffed by mid-wives and their trainees.

Semmelweis eventually concluded — after the death of a colleague who had cut himself with a scalpel while performing an autopsy — that the doctors and medical students who went directly from performing autopsies on women who had died from childbed fever the previous day, to treating women in the maternity ward, were responsible for transmitting the disease to the patients.

A 19th century doctor is depicted performing an autopsy, by Enrique Simonet. Source: Past Medical history

Semmelweis then famously instituted compulsory handwashing procedures for all doctors, medical students and staff, requiring them to sanitise their hands and equipment with a chlorinated lime-wash before operations.

To his delight — and that of the women — by this simple procedure Semmelweis was able to drastically reduce and even eliminate cases of childbed fever at the hospital within weeks.

The Establishment hits back

But despite the life-saving virtue of his discovery, the established medical view of the time prevailed against the young doctor, as his medical peers continued to use outdated concepts and medieval techniques, such as bloodsucking leeches, cutting and bleeding the mothers to treat the disease.

The revolutions of 1848 intervened and Semmelweis, a Hungarian working in Austria, soon lost his position at the hospital and returned to his native Hungary. In Vienna, the hospital authorities soon abandoned his handwashing procedure, and childbed fever cases started to rise again.

When he presented his findings in 1850 to the Viennese Medical Society, contrary to expectation, his views were not welcomed at all, but widely rejected and ridiculed by his peers. It is said that many doctors simply rejected the idea that they were responsible for infecting their patients. The dire implication of Semmelweis’ theory was that they were indeed killing their patients by not sterilizing their hands and equipment.

For the next 20 years, Semmelweis wrote to doctors across Europe to protest their methods. He was increasingly driven to distraction by the simple truth he had discovered, turning every conversation back to the handwashing procedure, until he was driven somewhat out of his mind by the fact that his advice was universally ignored by the medical profession. At times he ranted furiously and called some doctors “murderers” for not washing their hands. But except for a few enlightened medical practices in Germany he was widely ignored, and mothers continued to die needlessly in great numbers.

What he had discovered weighed heavily on him but nobody would listen.

Condemned as a madman in 1865, the importance of his findings were later verified by the germ theory of Louis Pasteur and the advancement of microbiology. Today, there are universities, hospitals and libraries named after Dr Semmelweis. But in 1865 almost nobody could understand the importance of what he was saying. So, he died alone and dejected in a cold, dark cell.

Up against monstrous stupidity

It is not difficult to see why, in the face of such monstrous and universal stupidity, in the face of so much opposition, humiliation and rejection, even the most reasonable person could be driven out of their mind.

This tragic case in the history of science is interesting for a number of reasons. One, because Semmelweis proved the seminal importance of antiseptic handwashing and basic hygiene in reducing disease transmission, a fact that cannot be disputed today in view of the Covid19 pandemic, as the slightest increase in the rate of transmission can have exponential repercussions and disastrous consequences.

Semmelweis showed how scientific progress is based on careful observation and analysis of data, on inductive and deductive reasoning, by hypothesizing, investigating and experimenting he worked every closer towards the truth. But almost two centuries later, these two crucial lessons are flagrantly ignored by the geniuses in charge of water policy, as in Namibia today.

This story is actually an age-old one, it is really about the struggle of isolated thinkers against the cultural and intellectual hegemony of those in power. It is also about the tragic consequences of official stupidity.

Hegemony

Lastly, and most importantly for our purposes, the tragic case of Dr Semmelweis is a prime example of how ideological hegemony operates in the realm of ideas generally; how those in power or in proximity to power (with access to resources and in control of public institutions) are able to isolate new ideas and frustrate to the point of despair those thinkers who dare challenge the orthodox views of the Establishment.

The agencies and agents of the ruling class in the media, the legal fraternity, ‘civil society’, and academic world tend to suppress new and unorthodox ideas— like the backward-looking hospital authorities in the days of Semmelweis, and like the Pharisees of old — to protect not only their established worldview, but also their corresponding material and political interests. Often with disastrous consequences.

Why is this relevant today?

Over the past few months the Swapo government and its allies have waged a relentless campaign of water cuts against the most needy and indebted households across the country. Their cut-off campaign is aimed at forcing the poor to come up with money to pay their municipal debts.

The problem is that these measures make it increasingly difficult for people to maintain basic household hygiene and regular handwashing, as advised by the Ministry of Health and the WHO. In the period after the resumption of water cuts in March, infection rates shot up to record levels and many lives were lost as a result of the surge of Covid19 cases during winter 2021.

But those who question the logic of this insane policy are blandly ignored, ridiculed, isolated from mainstream public discourse and marginalized. While the poor and homeless are criminalized and arrested for not being able to afford a home or the price of water, those who question the official policy are pathologised and their sanity is brought into question, not unlike the tragic case of Dr Ignaz Semmelweis.

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