I wash my hands: Pontius Pilate or Dr. Semmelweis?

Two people are known to have practiced hand washing: Pontius Pilate and Dr. Ignatius Semmelweis. The first, Pontius Pilate, is a biblical character well known for saying « I wash my hands of it ». His attitude is like a flight from his responsibilities in the face of a problematic situation, namely « deciding on the life or death of a man ».

Let’s focus on the second one, Dr. Ignatius Semmelweis (1818 — 1865): he was a gynecologist-obstetrician of the 19th century of Hungarian origin who worked first in Vienna, at the time of the Austro-Hungarian Empire, and then in Budapest. This doctor focused on a disease that affected women who were giving birth: puerperal fever. At the time, it was not known that it was an infectious disease. To do this, he was helped by using a means not widely used in his time by his contemporaries, statistics, to interpret reality. One thing led to another and he concluded that, in order to reduce the risk of catching this potentially fatal disease, it was simply necessary to wash one’s hands… with bleach (in 1847). 

While his contemporaries had a 90% mortality rate, Dr. Ignatius Semmelweis had only a 3% mortality rate, or 30 times less. He also sterilized his surgical instruments with bleach, 30 years before Dr. Joseph Lister (1827 — 1912), an English physician who was later known for his work on asepsis in surgery⁽¹⁾ (in 1869). The latter’s work was finally accepted in the 1880s. Dr. Semmelweis even sent, at his own expense, a book explaining his work to all the heads of obstetrics clinics in Europe. For 30 years, no one has applied his preventive treatment for this disease.

The fundamental question that arises is: « Why didn’t his contemporaries listen to him when he had 30 times less mortality than them? » I propose three working hypotheses.

First, he was in opposition to his supervisor, which can be problematic even today. This supervisor did not go down in history…

Secondly, his work was the antithesis of the medical knowledge of the time. The mistake of his contemporaries is not to have wanted to judge his work for its logic, its internal coherence.

Third, and this working hypothesis is the most difficult to accept. It can be summarized in one sentence: « If you, Semmelweis, are right, that means that I am wrong and therefore I am responsible for so many women dying of puerperal fever because I did not apply your protocol. Upon realizing that Semmelweis’ hypothesis was correct, a contemporary of Semmelweis committed suicide by throwing himself under the tracks of a train… . In order not to be confronted with devaluation, suicide, etc., this denial of the treatment and its error is a protective mechanism. In psychology, this is called a denial or even an occultation. This is what allows them to continue to live … .

In conclusion, two questions remain:

- « Do I wash my bloodstained hands or do I wash my hands with bleach? » ;

- Was Semmelweis a conspiracy theorist when he told his contemporaries to wash their hands with bleach?

To go further :

Frank G. SLAUGHTER, That Unknown… Semmelweis, ed. PRESSES POCKET (1973)

Jean THUILLIER, Le paria du Danube, ed. BALLAND (1983)

See the article on Wikipedia: https://fr.wikipedia.org/wiki/Ignace_Philippe_Semmelweis