Semmelweis was undeterred. He continued to harangue the other doctors to disinfect their hands with a chlorine solution. Reluctantly, they complied, but they used Semmelweis' hand washing experiment as an opportunity to poke fun at him. The doctors made a show of lathering up, cleaning under their fingernails, joking and mocking Semmelweis's foreign accent. But the dying stopped. Getting doctors to disinfect their hands saved lives.
You might think Semmelweis had the last laugh, honoured by his profession and the people of Vienna for his lifesaving discovery. Alas, this is not what happened. Instead of praise, Semmelweis was forced out of the hospital and could not obtain another position in Austria. He returned to Hungary to take up work in a provincial hospital.
Semmelweis kept trying to convince people of the value of his ideas without success. Eventually, he decided that the only way to prove he was right was to infect himself. In the dissecting room, he stabbed himself in the palm of his hand with a scalpel he previously used on a cadaver. In line with his theory, Semmelweis developed a severe infection, which turned out to be fatal. Even his dramatic demise failed to change expert opinion. Semmelweis' ideas were not generally accepted until twenty years later when Pasteur expounded the germ theory of disease.
Advertisement
The Semmelweis story reminds us that science is an enterprise to which people bring their intellectual strengths and the entire panoply of human flaws-pride, greed, vanity, and self-deception. Anthropologist Marshall Sahlins summarised the scientific process succinctly as "the pursuit of disinterested knowledge by self-interested people."
There is nothing wrong with enlightened self-interest. It works well for the economy, and it usually works well for science. Competition among scientists means that science eventually transcends the imperfections of even its most flawed practitioners. What is troubling is how long it can take to change experts' minds. To quote Poincaré again, we either "doubt everything or believe everything" when nuanced reflection is required. Consider the following story from my former university.
Understanding ulcers
I was once Executive Dean of Medicine at the University of Western Australia in Perth. In the 1980s, one of the pathologists at Royal Perth Hospital, Robin Warren, became interested in unusual bacteria that he claimed live in the stomachs of ulcer patients. He believed these bacteria could be responsible for some duodenal and gastric ulcers. Few doctors or researchers took Warren seriously because the dominant view at the time was that bacteria could not live in the acidic environment of the stomach. Anyway, everyone knew that stress, spicy foods, and aspirin caused ulcers.
One person who did take Warren seriously was a young doctor called Barry Marshall. Barry came from a working-class family and lived in a house with a dirt floor and outdoor toilet. He supported himself through medical school by harvesting wheat. Not an establishment figure himself, Marshall was drawn to Warren's iconoclastic work. He and Warren tried several times to culture stomach bacteria in the laboratory without success. Then, by a happy accident, laboratory staff, anxious to start their long Easter break, neglected to wash the stomach contents from their Petri dishes. After the holiday, Marshall and Warren found bacteria busily multiplying when they returned to work.
They identified the bacteria as a genus called helicobacter pylori. Warren and Marshall believed that helicobacter was responsible for some, perhaps most, ulcers. Hardly anyone agreed. Marshall thought he could sway expert opinion by showing a direct connection between the bacteria and gastric disease. So, like Semmelweis, Marshall decided to infect himself. He swallowed a solution containing helicobacter pylori. About a week later, he developed a severe case of gastritis. (Fortunately, not fatal.)
Advertisement
Marshall's dramatic demonstration failed to move medical opinion, at least not right away. As Semmelweis found, entrenched beliefs are difficult to change. No one likes admitting they are wrong, and there are always vested interests. For example, antacid medications, the most common ulcer treatment, were highly profitable products for pharmaceutical companies. Drug company representatives spent considerable time and money finding flaws in Marshall and Warren's work to protect their market. They argued strongly for the continuation of antacid treatments (which remain big sellers, even today). It took ten years before the American National Institutes of Health agreed that eliminating helicobacter pylori would cure many types of ulcers. In 2005, Marshall and Warren won the Nobel Prize in Medicine for their contribution to science and the alleviation of human suffering.
The stories of childbirth fever and helicobacter pylori illustrates the power of constructive dissent, but they also highlight a crucial point about science. All great discoveries begin as blasphemies, which are resisted by those with something to lose.
Of course, resistance is not always futile or wrong. Sometimes, new "discoveries" turn out not to be discoveries at all. Such was the fate of René Blondlot.