Abstract
Semmelweis’ discovery of the etiology of childbed fever has long attracted the attention of historians of medicine and biographers. In recent years it has also become of increasing interest to philosophers. In this paper I discuss the interpretation of Semmelweis’ methodology from the viewpoint of the inference to the best explanation and argue that Popperian methodology is better at capturing the dynamics of the growth of knowledge. Furthermore, I criticize the attempts to explain the failure of Semmelweis to have his discovery accepted on the basis of the Kuhnian concept of paradigms, and warn that this view may endorse dogmatism as the norm The Kuhnian position also raises the problem of the authoritarian nature of scientific institutions which defend a paradigm against unorthodox, rebellious views, such as in the case of Semmelweis. Popperian philosophy is seen as a challenge to promote a link between an open society and open science with its main aim being to cherish a free critical spirit.
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Notes
I shall stick to the term ‘childbed fever’ since it is most frequently used by Semmelweis; today the terms ‘puerperal fever’ or ‘postpartum sepsis’ are preferred.
For instance the play Doktor Semmelweis by Hans José Rehfisch (1934); the novel The Cry and the Covenant by Morton Thompson (1949); the short Oscar-winning film That Mothers Might Live (1938), in addition to the films Semmelweis: Retter der Mütter (1950), Docteur Semmelweis (1995), and the TV film Arzt der Frauen (1987–1988). A short opera, Semmelweis, composed by Raymond J. Lustig, was premiered in Budapest in 2018.
For details see Lesky (1976).
Women were admitted to individual clinics on different days of the week. Semmelweis witnessed that “patients were kneeling and wringing their hands, begging to be released (from the first clinic) in order to seek admission to the second clinic” (Semmelweis 1983, 70).
Professor Michaelis of Kiel committed suicide after realizing that he had infected his own niece.
They criticize Semmelweis for instance for not having adequately appreciated the contagion theory of his British colleagues, for “spoiling” his work by the hypothesis of self-infection and for not adequately explaining the seasonal fluctuations of CBF in winter months.
As Codell Carter (1985) observes, no microscope of sufficient resolution to detect micro-organisms was available in Vienna Hospital until about 1865.
The problem of the positive support of unfalsified theories – for instance in the context of Popper’s concept of corroboration – is a widely discussed topic that goes far beyond the scope of this paper.
Semmelweis knew about the success of his British and Irish colleagues in reducing the incidence of CBF and about their concept of the contagious nature of the disease yet he did not rethink his narrow conception of contagion; he instead attributed the positive records in the UK and Ireland exclusively to the fact that maternity hospitals there were not associated with general hospitals in which autopsies were performed en masse.This lack of scientific dialogue was probably also due to a language barrier between the German-speaking part of the Continent and the English-speaking part of the world.
Recently, though, the holistic approach to disease has been celebrating a return. A large area of possible predisposition / resistance to disease is considered, linked for instance to psychosomatic, lifestyle, environmental and natural immunity factors.
However, Semmelweis was not the only one whom the authorities in the Vienna hospital treated harshly: insubordination was not tolerated. Skoda, a Czech national, performed an emergency tracheotomy that saved his patient’s life but did not have the permission of the professor in charge. The disciplinary board sent him to serve in a mental asylum in Vienna (the same one in which Semmelweis died) for one year as a punishment. Skoda took it stoically, and developed his techniques of percussion and auscultation on the inmates (Obenchain 2016, 52).
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*This paper was written as part of the research activities of the Department of Analytic Philosophy of the Institute of Philosophy of the Czech Academy of Sciences in Prague.
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Parusniková, Z. Popperian methodology and the Semmelweis case*. Med Health Care and Philos 26, 529–537 (2023). https://doi.org/10.1007/s11019-023-10167-7
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DOI: https://doi.org/10.1007/s11019-023-10167-7