The “Semmelweis reflex” is from the real
life experience of Dr Ignaz Philipp Semmelweis (his brief
life story is included below) who is now recognized as a
pioneer of antiseptic policy in medical procedures. From
1847 to 1865 he proved beyond any doubt that basic chlorine
washings of hands and medical instruments in hospitals could
save thousands of lives. Because germs had not yet been
discovered he could prove that medical sanitation worked
but not why it worked therefore even some Drs that saw it
work rejected it.
The “Semmelweis reflex” refers to a problem common in the
medical world. It is the automatic rejection of something
different even if it’s obvious, without giving it serious
thought, inspection, or experiment. It is an outright dismissal
of any information that is radically out of sync with the
status quo even if there is strong empirical evidence to
back it up. (Some modern examples)
The “Semmelweis reflex” is often associated with "Eminence
Based Medicine” where Drs gain confidence over an impressive
number of years by repeating the same mistakes of other
Drs. Medical professionals often do this by using medical
jargon and offering obtuse opinions to perpetuate a belief
system where authority has more power than valid science.
Both “Semmelweis reflex” and "Eminence Based Medicine”
are involved in “Medical Myopia” where the medical world
is so sure of something that they even reject overwhelming
proof to the contrary from their own medical research world.
The following life story is a very condensed version of
what Wiki has but matches what I’ve seen in other sources.
I have added a few comments See Wikipedia
Ignaz Philipp Semmelweis (July 1, 1818 - August 13, 1865)
was a Hungarian physician called the "savior of mothers"
who discovered, by 1847, that the incidence of puerperal
fever, also known as childbed fever could be drastically
cut by use of hand washing standards in obstetrical clinics.
(Mothers and babies were dying from serious infections
picked up because the Drs that delivered them didn’t wash
their hands or instruments after doing autopsies on mothers
or babies that had just dyed from serious infections picked
up the same way)
While working at the Vienna General Hospital in Austria,
Semmelweis discovered in 1847 that hand washing with chlorinated
lime solutions reduced the incidence of fatal puerperal
fever from about 10 percent to about 1-2 percent. During
1848 Ignaz Semmelweis widened the scope of his washing protocol
to include all instruments coming in contact with patients
in labor and used mortality rate time series to document
his success in virtually eliminating puerperal fever from
the hospital ward.
The breakthrough for Ignaz Semmelweis occurred in 1847
with the death of his friend Jakob Kolletschka from an infection
contracted after his finger was accidentally punctured with
a knife while performing a postmortem examination. Kolletschka's
own autopsy showed a pathological situation similar to that
of the women who were dying from puerperal fever. Semmelweis
immediately proposed a connection between cadaveric contamination
and puerperal fever. (At the time many thought that
puerperal fever was a weakness in women and babies and it
didn’t happen in men because they were stronger. Semmelweis
realized that the pus on the knife that cut his friend had
contained the disease and that puerperal fever was not a
weakness in women)
Toward the end of 1847, accounts of Semmelweis's work began
to spread around Europe. Semmelweis and his students wrote
letters to the directors of several prominent maternity
clinics; in these letters they described their recent observations.
Ferdinand von Hebra, Vienna's celebrated dermatologist and
the editor of a leading Austrian medical journal, announced
Semmelweis's discovery in the December 1847 and April 1848
issues of his periodical. Hebra and claimed that Semmelweis's
work had a practical significance comparable to that of
Edward Jenner's introduction of cowpox inoculations to prevent
In late 1848 - a British physician named Routh, who had
been Semmelweis's student when the chlorine washings were
initiated, wrote a lecture explaining Semmelweis's work.
The lecture was presented before the Royal Medical and Surgical
Society in London and was published in a prominent medical
journal. A few months later, another of Semmelweis's former
students, M. F. Wieger, published a similar essay in a French
Accounts of his discovery were being circulated throughout
Europe. He had reason to expect that the chlorine washings
would be widely adopted and that tens of thousands of lives
would be saved.
At the time, diseases were attributed to many different
and unrelated causes. Semmelweis' hypothesis, that there
was only one cause, that all that mattered was cleanliness,
was extreme at the time, and was largely ignored, rejected
or ridiculed. He was dismissed from the hospital and had
difficulty finding employment as a medical doctor.
His observations went against all established scientific
medical opinion of the time. The theory of diseases were
highly influenced by ideas of an imbalance of the basic
"four humours" in the body, a theory known as
dyscrasia for which the main treatment was bloodlettings.
Other more subtle factors may also have played a role.
Some surgeons, for instance, were offended at the suggestion
that they should wash their hands; they felt that their
social status as gentlemen was inconsistent with the idea
that their hands could be unclean.
Specifically, Semmelweis' claims were thought to lack scientific
basis, since he could offer no acceptable explanation for
his findings. Such a scientific explanation was only made
possible some decades later when the germ theory of disease
was developed by Louis Pasteur, Joseph Lister, and others.
On 20 May 1851 Semmelweis assumed the relatively insignificant
position of unpaid, honorary head-physician of the obstetrical
ward of Pest's small St. Rochus Hospital. Childbed fever
was rampant at the clinic. After taking over in 1851, Semmelweis
virtually eliminated the disease. During 1851-1855 only
8 patients died from childbed fever out of 933 births (0.85
He assumed that position for six years until June 1857.
Despite the results, Semmelweis's ideas were not accepted
by the other obstetricians in Budapest.
Semmelweis next instituted chlorine washings at the University
of Pest maternity clinic. Once again he attained impressive
Semmelweis had now achieved dramatic successes at three
obstetrical facilities. Even so, his ideas continued to
be ridiculed and rejected both in Vienna and in Budapest.
Semmelweis's views were much more favorably received in
England than on the continent, but he was more often cited
In 1856, Semmelweis' assistant József Fleishcer reported
the successful results of handwashings at St. Rochus and
Pest maternity institutions in the Viennese Medical Weekly.
The editor remarked sarcastically that it was time people
stopped being misled about the theory of chlorine washings.
A popular translation into English is "it was time
to stop the nonsense of hand washing with chlorine"
In his 1861 book, Semmelweis lamented the slow adoption
of his ideas: "Most medical lecture halls continue
to resound with lectures on epidemic childbed fever and
with discourses against my theories. […] The medical literature
for the last twelve years continues to swell with reports
of puerperal epidemics, and in 1854 in Vienna, the birthplace
of my theory, 400 maternity patients died from childbed
fever. In published medical works my teachings are either
ignored or attacked. The medical faculty at Würzburg awarded
a prize to a monograph written in 1859 in which my teachings
In a textbook, Carl Braun, Semmelweis's successor as assistant
in the first clinic, never accepted Semmelweis' teachings.
The impact of Braun’s views is clearly visible in the rising
mortality rates in the 1850s.
Beginning from 1861 Semmelweis suffered from nervous complaints.
He turned every conversation to the topic of childbed fever.
A number of unfavorable foreign reviews of his 1861 book
prompted Semmelweis to lash out against his critics in series
of open letters written in 1861-1862. He bitterly attacked
various prominent European obstetricians. The open letters
were highly offensive, at times denouncing his critics as
irresponsible murderers or ignoramus. The attacks undermined
his professional credibility.
In mid-1865, his public behavior became irritating and
embarrassing to his associates.
On 30 July 1865 Ferdinand von Hebra lured him to a Viennese
insane asylum located in Lazarettgasse. Semmelweis surmised
what was happening and tried to escape. He was severely
beaten by several guards, secured in a straitjacket and
confined to a darkened cell He died after two weeks, on
13 August 1865, aged 47, from a gangrenous wound, possibly
inflicted by the beating. The autopsy revealed extensive
internal injuries, the cause of death pyemia - blood poisoning.
In maternity clinics this would have been called childbed
(In documentary I watched they indicated that
when Semmelweis realized he would be locked up and never
released he broke free and would not let any one or any
force stop him from making it to a part of the hospital
where he knew he could find pus covered medical instruments
which he used to cut himself. The beating occurred as they
tried to stop him. Then as they dragged him away he told
them that puerperal fever was not a weakness in women but
was in the pus and he told them accurately how he would
die from it. He hoped that if the Drs watched him die from
childbed fever after cutting himself that they would get
the connection, they didn’t but he had described accurately
in advance how he would die)
A few medical periodicals in Vienna and Budapest included
brief announcements of Semmelweis's death. The rules of
the Hungarian Association of Physicians and Natural Scientists
specified that a commemorative address be delivered in honor
of each member who had died in the preceding year. For Semmelweis
there was no address; his death was never even mentioned
Janos Diescher was appointed Semmelweis' successor at the
Pest University maternity clinic. Immediately mortality
rates jumped sixfold to to six percent. But there were no
inquiries and no protests; the physicians of Budapest said
nothing. Almost no one - either in Vienna or in Budapest
- seems to have been willing to acknowledge Semmelweis's
life and work
Semmelweis' advise on chlorine washings was probably more
influential than he realized himself. Many doctors, particularly
in Germany, appeared quite willing to experiment with the
practical handwashing measures that he proposed, but virtually
everyone rejected his basic and ground-breaking theoretical
innovation - that the disease had only one cause, lack of
On a broader scale, to a contemporary reader, Semmelweis
would appear to have demonstrated glaringly evident experimental
evidence, that chlorine washings reduced childbed fever.
Today, it may seem absurd that his claims were rejected,
precisely on the grounds of purported lack of scientific
reasoning, or what today would be called a scientific proof.
It is equally absurd that his unpalatable observational
evidence only became palatable when quite unrelated work
by Louis Pasteur in Paris some 20+ years later suddenly
offered a theoretical explanation for Semmelweis' observations
- the germ theory of disease.
Semmelweis is now recognized as a pioneer of antiseptic
Yet a legacy is the so-called Semmelweis reflex. It is not
a "real" physiological reflex but a metaphor for
a certain type of human behavior characterized by reflex-like
rejection of new knowledge because it contradicts entrenched
norms, beliefs or paradigms - named after Semmelweis whose
perfectly reasonable hand-washing suggestions were ridiculed
and rejected by his contemporaries.