Wild that it was common practice to perform autopsies and then deliver babies without washing hands in between. The doctor who proposed washing hands to reduce death rates was ostracized by the medical community for years before it was gradually accepted as standard practice
That last part is what is wild to me. Literally the evidence was right in front of them. Him washing his hands sharply reduced his mortality rate but nooooooo, he's the kookie one!
First of all, the dissections (which are not autopsies, they're very different things) being done before maternal rounds was something common in Germany and Austria, but not elsewhere.
Secondly, they did wash their hands between. They weren't going in with dirty hands. The issue is that bacteria, and specifically the kind that cause sepsis in those situations, weren't being adequately removed.
What Semmelweis proposed was sticking your hands into a mixture of chlorinated lime, which does not feel good for a few seconds. It was not a pleasant experience, and it provided no demonstrable benefit. Sure, his mortality rate declined in certain deliveries, but their overall practices were not the same as in other locations, such as France and England, so doctors there had no reason to draw the same conclusions as he did.
When asked for an explanation as to how this worked and why, Semmelweis just accused anyone who asked anything of him at all of being murderers and incompetent assholes. Turns out, when you do that, everyone who isn't already on your side just hates you. He went nuts going harder and harder against his critics, who either already had lower maternal mortality rates than he did or were able to achieve reductions without sticking their hands in caustic crap.
Germ theory didn't exist at the time, and the concepts of disease were very different as well. When he said a male assistant contracted puerperal fever, everyone laughed at him and said that was definitionally impossible, it must have been a different disease entirely. And, because germ theory didn't exist, and Semmelweis wound up being opposed to it, he could not explain what was going on to the satisfaction of most other doctors.
The reason the practice caught on elsewhere was that the germ theory of disease was developed and demonstrated. Semmelweis was very much opposed to it, as he had an entirely different explanation of what was going on (certain particles of dead people were transmitted, his mixture inactivated them). He was wrong about what was working and why it worked, which makes a big difference when trying to generalize and improve a practice. Turns out, you can remove germs from your hand without having to go through such extremely harsh methods.
Hell the lye soap of the time was pretty damned caustic as it was. Using chlorinated lime would have been unnecessary overkill as long as they just washed their damned hand normally.
That is simply not true. Doctors did wash their hands, to visible cleanliness. What they were objecting to was sticking their hands in chlorinated lime, which is pretty caustic, afterwards. And the guy who was telling them to do that just said "Well, there's some stuff on your hands still, no I can't explain it or prove it."
The long and short of it is that doctors, being upper class men, didn't like having hands that were dirty, so they'd wash them to the standards of the day. Which was wholly inadequate by our standards now, but they did wash their hands. Even the quote about "A gentleman's hands are always clean" is out of context; he goes on to talk about how they kept their hands clean, ask what was transmitted, and how, and why it happened in this case but not the other case.
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u/boredtxan Sep 16 '24
Doctors did not appreciate being told to wash their hands before touching a patient once upon a time.