RESISTANCE TO CHANGE—THE SEMMELWEIS REFLEX.

RESISTANCE TO CHANGE—THE SEMMELWEIS REFLEX. In 1847, four years after Oliver Wendell Holmes published his article about the contagiousness of childbed fever, Ignaz Semmelweis began his efforts to convince the medical community that childbed fever was contagious and that its incidence could drastically be reduced by appropriate hand washing by medical care-givers. As this wikipedia article recounts, Semmelweis had in his campaign a major advantage and a major disadvantage.The advantage was that he had empirical evidence on his side. He was the equivalent of the chief resident at two maternity clinics at the Vienna General Hospital. Clinic 1 was for women who could afford to pay; Clinic 2 was for charity cases. But Clinic 2 had a much lower rate of deaths from childbed fever (about 4%) than did Clinic 1 (about 10%). Mothers were begging to come to the charity clinic. Semmelweis argued that the difference was that Clinic 1 was served by medical students who regularly attended autopsies; Clinic 2 was served only by midwives. He instituted a practice of hand washing with a chemical in Clinic 1, and the death rate from childhood fever in Clinic 1 dropped to be comparable to be that in Clinic 2.

Semmelweis faced the disadvantage that he had no theory to explain his results. The germ theory had not been formulated. He was never able to persuade other doctors of the importance of hand washing. The sad story in wikipedia ends in Semmelweis breaking down mentally and, 18 years after his discovery, being confined in a mental hospital in 1865, where he died of septicemia after 14 days.

The wikipedia article concludes that Semmelweis lives on in the term “Semmelweis reflex”, which is “a metaphor for a certain type of human behaviour characterized by reflex-like rejection of new knowledge because it contradicts entrenched norms, beliefs or paradigms.”

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