Psychologists lead the field in helping us to identify, explain and understand irrational thinking. Myth-busting researchers in many other different disciplines and areas, from the philosophy of science to amateur essayists, have authored works on fallacies, myths, conspiracy theories, hoaxes, frauds, downright lies, deliberate and hidden bias. When it comes to seeking to know how to check the veracity of 'knowledge', philosophers, natural and social scientists explain some of the pitfalls to look out for. Researchers are taught how to avoid and spot potential problems when conducting their own research or examining the results of other people's endeavours. All of this contributes to a significant body of knowledge that mankind has amassed about the veracity of evidence, which includes what is known to be harmful, bad or simply weak research practice and how to avoid such mistakes as faulty inference. All of this important work adds up to a body of disparate knowledge from distinct disciplines, different levels of expertise along with a huge mixture of examples and case studies.
This knowledge has never been the subject of comprehensive and systematic scholarly research. Might such a massive endeavour empower the recognition of fallacies and myths? Would it help us to better examine, understand and explain what is behind orthodox knowledge and various beliefs in what and is and is not so? Would it help to reduce belief in pseudoscience?
In 1991 Michael Shermer set out the broadly agreed core principles of science in an incredibly good article in the journal of Science, Technology and Human Values. His work is important. Let me explain.
When examining some pragmatic compromises, on a spectrum ranging from slightly shoddy all the way to down right fraud committed by some scientists, it is important to keep this knowledge of “what some scientists do” separate from that which actually defines science. Shoddy scientists do not turn their own discipline into pseudoscience – they merely run the risk of conducting it themselves. I propose that this distinction between (1) what we know about real world scientific practices and (2) the broadly agreed principles of science is important.
Unless we keep our analysis of scientific practices separate from what we define as the core principles of science then our blending of the two confuses and so allows uninformed social-scientists, sociologists, and criminologists to believe, and widely promote the commonly held misconception, that: ‘Science is a rhetorical and relative concept to be viewed through a rhetorical cultural-lens.’ This type of misconception about science results in a proliferation of ‘made-up’ explanatory rhetoric, with arguments made along the lines that we are all now living in a late-modern world where we can all re-invent ourselves to define who and what we are. Such arguments are supported by assertions that what scientists do varies so greatly between themselves and their disciplines that no scientific authority or orthodoxy agrees on exactly what science is. And this intellectual relativism facilitates anyone who wishes to call themselves a scientist to re-define their identity in order to seek to operate under the radar of real science scrutiny. Arguably, this common failure to distinguish between scientific practices and principles fuels an enabling environment where pseudo-sciences such as, for example, Creation Science can be set up, attract funding, and flourish. I also have some criticisms to make of the more recent Crime Science in that it was launched on what I see to be a falure to clearly distinguish between data and explanations for that data.
I argue that Crime Science – like Creation Science before it – is based (at least at the time of writing) upon the unscientific failure to appreciate the importance of keeping explanations for data separate from the data explained. Keeping these two things separate is, arguably, one of the most important of the core scientific principles outlined by Shermer and agreed by 72 Nobel laureates, because it helps to keep science open-ended and avoids the sort of closed-system dogma worship that stems from confirmation bias and other junk-science practice.
If we wish to keep the growth of pseudoscience at bay, we might be wise to explain that these scientist’s shortcomings do not define what their own scientific discipline is and most importantly they do not define what science is. Real scientists and philosophers of science will continue to debate and seek to re-define what science is, but pseudo scientists are mistaken if they believe this makes real science a mere rhetorically constructed label that will cheaply signal gravitas and safely camouflage their own poor scholarship.
With such a large body of disparate, but important, knowledge about science, bad science, pseudoscience and the scholarly creation of fallacies and myths, do we need to develop a specialist field comprising the study and understanding of veracity? If so, should we work towards developing a multi-disciplinary science named dysology?
Consider the case of the fourth supermyth discovered as a case for why we need to better understand why experts continue to spread myths and fallacies
Until only yesterday I believed in it myself but then, following a little research, I discovered that the famous Semmelweis Story was busted as a myth over a decade ago. There are a number of hypothesis for why known fallacies, myths and other erroneous facts continue to be circulated by credulous experts in the academic press (see Arbesman 2012). In this article I make the claim that the long-busted Semmelweis myth is also a supermyth, for the simple reason that it continues to be credulously believed by expert scientist and other skeptics who continue to credulously disseminate it, albeit with excruciatingly unintended irony, as an example of the need for all of us all to be careful to update knowledge in order to avoid spreading myths and fallacies.
With most exquisite irony
In a long line of scientific writing, the Semmelweis story has most lately been credulously disseminated by Samuel Arbesman (2012) in his book ‘The Half-Life of Facts: Why Everything We Know Has An Expiration Date’. Arbesman re-tells the story in an excruciatingly un-intentional ironic attempt to explain why experts fail to appreciate new evidence that contradicts orthodox ‘knowledge’. Arbesman (who incidentally also credulously spread the Spinach, Popeye, Decimal Error Iron Myth after it had been busted here on Best Thinking) is in esteemed company in his credulous acceptance of the Semmelweis story. Because it is unquestioningly repeated by, for example, the inventors of cognitive dissonance – Tavris and Aronson (2008 – pp. 8, 102), prolific debunker of Bad Science Goldacre (2009 – p. 293), Research Fellow of the James Randi Foundation, Time Farley, (no date), The BBC (2003) and academic pseudoscience debunker Allchin (2004).
A suitable place to begin is with the Semmelweis story is to examine the essential content of the tale, particularly the version that is so often told and credulously believed by those who promote themselves as skeptics and scientific experts.
The Semmelweis Story: A credulously believed apocryphal tale
Arbesman’s (2012 pp. 176-177) account of the Semmelweis story is typical of countless renditions that can be read in peer reviewed papers and elsewhere in the academic press and popular science genre:
‘In the 1840’s Ignaz Semmelweis was a noted physician with a keen eye. While he was a young obstetrician working in the hospitals of Vienna, he noticed a curious difference between mothers who delivered in his division of the hospital and those who delivered at home, or using midwives in the other part of the hospital. Those whose babies were delivered by the physicians at the hospital had a much higher incidence of a disease known as childbed fever, which often causes a woman to die shortly after childbirth, than the women delivering with midwives. Specifically, Semmelweis realized that those parts of the hospital that did not have their obstetricians also perform autopsies had similarly low amounts of childbed fever as home deliveries.
Ignaz Semmelweis argued that the doctors – who weren’t just performing autopsies in addition to deliveries but were actually going directly form the morgue to the delivery room – were somehow spreading something from the cadavers to the women giving birth, leading to their deaths.
Semmelweis made a simple suggestion: Doctors performing deliveries should wash their hands with a solution of chlorinated lime beforehand. And this worked. It lowered the cases of childbed fever to one tenth the original amount.
However, rather than being lauded for an idea that saved lives for essentially no cost, Semmelweis was ostracized. In the mid-nineteenth century, there was no germ theory. Instead, the dominant paradigm was a certain theory of biology that blamed disease upon imbalances of “humors”. If you’ve ever noticed that someone is in “good humor,” this is a vestige of this bygone medical idea. So the medical establishment for the most part ignored Semmelweis. This quite likely drove him mad, and he spent his final years in an asylum.’
A Semmelweis Horror Story
Accounts vary with regard to who had Semmelweis admitted to the asylum and why. Moreover there are different accounts of how he actually died. One particularly severe claim has it that members of the medical establishment ordered his murder to silence him. Consider this one from the pen of Donald (2012 p.112-113), which reads like an old Alfred Hitchcock movie plot:
‘When Semmelweis left the clinic, the death rate returned to its original position. In every subsequent post he took up, Semmelweis instituted the same hand-washing regime and the death rate plummeted, but his old enemies had him manoeuvred out of every position he assumed – and the death rate rose in his wake. And still nobody listened. Unbelievably, the Viennese Medical Council saw Semmelweis as a troublemaker, intent on blaming patient and infant death on some of its more influential members, who felt it their right to poke around inside patients with hands still dripping with germs.
Roundly ridiculed as a crank, Semmelweis was cut out of the medical fraternity and marginalized. But he remained unrepentant. Continuing his campaign in exile, Semmelweis published an open letter to the obstetrics fraternity at large, which was, unfortunately for its sender, a little on the antagonistic side. Feeling that decisive action was needed, Semmelweis’ enemies decided to have him declared insane and locked away where he could create no more waves.
In 1865 a small group of physicians, led by Vienna’s leading dermatologist Ferdinand Ritter von Hebra (1816-80), lured Semmelweis to an asylum under the pretence that his opinion was sought on certain matters. No sooner was Semmelweis through the door, he became suspicious and tried to leave, but von Hebra’s henchmen were prepared and they beat Semmelweis so badly that he died shortly after in one of the asylums dungeons.’
The core components of the Semmelweis Story
The Semmelweis Story then essentially goes like this: In the 1840’s while working as a young doctor in Vienna, Semmelweis noticed a statistical correlation between mothers dying shortly after childbirth due to fever and doctors performing autopsies and using cadavers to demonstrate midwifery techniques prior to attending new born deliveries. Although germ theory was not then known, Semmelweis made the simple but radical suggestion that doctors performing deliveries should thoroughly wash their hands. At his own hospital his idea worked and lowered childbed fever mortality to one tenth of what it had been. However, the orthodox medical establishment ostracized him and ignored his findings because they ran contrary to existing ‘knowledge’. He was less than diplomatic in how he went about disseminating his ‘discovery’ and criticizing those who ignored him, which never helped his cause. The failure of the weirdly stubborn medical establishment to accept his unique yet simple life-saving discovery drove poor Semmelweis literally insane and he died from septicemia of a wound he received in an asylum.
The essential components of the story are as follows:
(1) That Semmelweis made a significant and unique contribution to knowledge about the spread of contagions by doctors and how to prevent such spreading.
(2) That Semmelweis had no theoretical notion regarding what exactly it was that doctors were spreading to their patients because germ theory had not at the time been discovered
(3) That the medical and scientific establishment railed against him simply because his claims went against orthodox ‘knowledge’ about the four humours of medicine and because he was rude in condemning his detractors.
(4) That the failure of others to understand and accept his unique and significant discoveries drove him totally insane.
Mythbusted: Why the Semmelweis story is both myth and supermyth
Contrast the above renditions of the simple and compellingly believable Semmelweis story with Milton Wainwright’s superb busting of it as a myth (Wainwright 2001 p. 173):
‘Semmelweis concluded that childhood fever was spread by a poison found in dead flesh (the so called ‘cadaveric principle’), although the germ theory is mentioned in his book published in 1861 which treated the topic in detail. He boldly stated that, “Puerperal fever is not a contagious disease, but it is conveyable from a sick to a sound puerperal by means of decomposed organic matter.”
By insisting that the cadaveric principle alone caused childbed fever, Semmelweis invoked the wrath of critics. The Dublin-based physician John Denham, for example, pointed out (in 1862) that Semmelweis overlooked the fact that childbed fever frequently appeared in towns there were no lying-in hospitals or dissecting rooms, and in rural districts where medical practitioners were seldom called upon. Many of Semmelweis’ forebears and contemporary critics were also aware of the link between puerperal fever and both erysipelas and scarlet fever. Such observations can now readily explained by the fact that puerperal fever is caused by the haemolytic streptococci which are spread on unwashed hands and on the breath of anyone carrying Streptococcus pyogenis.'
Wainwright (2001) goes further in his expert myth busting (p.174) as to the true reasons for Semmelweis' treatment by the medical establishment to reveal that an article published in the New England Journal of Medicine and Surgery in (Wendell Holmes1843), five years before 1848 - when Semmelweis was credited with the practice - that an un-named doctor had as early as 1843 demonstrated the good sense to change his clothes after each maternity-related visit and to wash his hands in chlorinated lime.
Wainwright (2001) concludes (p. 174):
‘…we are told that he alone realized that puerperal fever was spread by doctors and could be prevented by antiseptic hand washing. As we have seen this is simply not the case. It is noteworthy that when Semmelweis’ work first became known the famous Edinburgh surgeon James Young Simpson fired off vitriolic letters to the medical journals refuting the idea that the Hungarian doctor should receive any priority on his ideas. Despite this intervention the Semmelweis myth grew, and continues to be uncritically propagated – essentially because it is too good a story to miss. It satisfies our need to elevate the underdog to near mythical status. In so doing, we ignore the many pioneers who went before Semmelweis and miss out on a more complex and more fascinating story.’
Clearly Semmelweis’ claimed discovery’ was not his own at all. This fact then pulls the rug out from under the story that he was driven mad by the failure of others to realise that he alone was on to something important and life-saving. Semmelweis was incurring criticism not simply because he was insisting that arrogant doctors should wash their hands but because he refused – or at least failed - to recognise evidence that puerperal fever is a contagious disease. Finally, given his profession as a young doctor in Venice in 19th century, when 30 per cent of its population was infected with syphilis, it is highly likely that the manifestation of his mental illness was a consequence of him having contracted an earlier syphilitic infection.
But the mythbusting does not end there. From Varga (2009), we learn that an in-depth examination of the records of what really happened reveals the extent of Semmelweis’ mental illness, its manifestations, the most likely cause of it being syphilis rather than frustration and rage at his failed attempts to gain credit for the ideas of others.
Varga explains the reasons why Semmelweis was committed to an asylum in Vienna and the reasons for the previously unreported role played by the Hungarian political-medical establishment in creating the myth of Semmelweis as a misunderstood and mistreated genius. You can hear them here on this video of a paper given on the subject at Oxford Brookes University in 2009:
Varga (2009) explains in the above referenced video that Semmelweis was taken to the asylum in Venice by his own family, following a number of occasions where he had acted inappropriately – such as arriving for dinner totally naked. Semmelweis was badly beaten by staff at the asylum soon after his arrival and he consequently died of septicemia a couple of weeks later. Exactly why he was beaten remains the kind mystery that the debunking of the myth reveals is oddly yet ironically beloved of both dot-joining conspiracy theorists and their arch enemies in the skeptical scientific community alike. Here is most certainly an area where more research is needed if we are ever to go beyond rhetoric in understanding why expert skeptics are suckered by supermyths.
By omitting crucial facts in order to simply re-tell a compelling uncomplicated story of Semmelweis’ rejection by influential members of the medical establishment, all of the authors who uncritically re-tell it in order to support their own explanations for why inconvenient facts are often ignored are inadvertently hiding the facts that explain why Semmelweis was treated with indifference by the medical establishment. Quite how these accidental myth spreading ‘skeptics’, including the inventors of the notion of cognitive dissonance (Tavris and Aronson 2008), will deal with this mythbusting remains to be seen. We can only hope that at the very least they will cease spreading the Semmelweis Supermyth.
The Semmelweis Supermyth
The starting point of the phenomenon that I have identified and named the supermyth is when an orthodox expert in their subject area publishes a statement of purported fact that is based upon an error in reasoning (fallacy) or else upon a factual error. That published claim then takes on a life of its own as it is credulously reinforced as veracious by numerous orthodox respected sceptics who each cite it unquestioningly in their own scholarly publications, in news paper articles, on television and websites. The great irony is that, unlike ordinary myths, supermyths are created by respected orthodox scholars and then credulously disseminated by other experts distinctively in the spirit of promoting the need for skeptical thinking in order to understand how myths are spread and to help us overcome our tendency towards credulous bias. You can read about three Supermyths that I discovered on my Supermyths website and at Dysology.org. Alternatively, clicking on each of them here will take you directly to the Best Thinking article that busts each myth: (a) The Popeye Spinach Supermyth, (b) The Zombie Cop Myth, and (c) The Crime Opportunity Myth.
Not knowing it is actually a myth that was busted over a decade ago (Wainwright 2001) and so believing the apocryphal Semmelweis’ story to be a veracious account, Arbesman (2012 p177) arguably the most recent expert to fall for the myth explains what he believes to be the importance of this famous story. Ironically, his explanations for the errors of others appear now to explain his own:
‘The tendency to ignore information simply because it does not fit within one’s worldview is now known as the Semmelweis reflex, or the Semmelweis effect. It is related to its converse, confirmation bias, where you only learn information that adheres to your worldview.
The Semmelweis reflex and confirmation bias are important aspects of our factual inertia. Even if we are confronted with facts that should cause us to update our understanding of the way the world works, we often neglect to do so.’
At page 179 Arbesman again with great unintended irony underlines why he credulously believes the Semmelweis story is important in helping us to understand expert bias:
'…more often we have to go out of our way to learn something new. Our blindness is not a failure to see the new fact; it’s a failure to see that the facts in our minds have the potential to be out-of-date at all. It’s a lot easier to keep on quoting a fact you learned a few years ago, after having read it in a magazine, than to decide its time to take a closer look…'
Had Arbesman actually heeded his own advice and taken a closer look he would have realised that research has revealed that this apocryphal tale of the poor downtrodden hero Semmelweis is in fact a myth. Why he, like so many other skeptical scientists, are suckers for supermyths is the big question that I am on a quest to try to answer.
It is, of course, remotely possible that Arbesman is some kind of sceptically mischievous experimenting genius who has deliberately peppered his book on the half-life of facts with myths in order to see whether they are spotted by others and pointed out by them as I have done so here and in my Amazon review of his book. But, unless he has written down or made a pre-publication dated video recording of such an aim – along with a list of the myths he has deliberately re-told as though they are veracious knowledge – and left it in a sealed container with his lawyer or publisher we should remain highly skeptical of such a possibility. In reality, Arbesman’s Errata and Updates page for The Half-Life of Facts is already pointing the way to a much needed second edition if he is to avoid prolonging the half-life of myths beyond what they would have been had he not written the book in the first place. Most surely that was not his aim.
I am rather interested right now in going back as far as I can to seek to discover who first published the Semmelweis Myth. Starting out on that journey of discovery there’s only one book I’m asking my wife to buy me this year for Christmas and that’s Sherwin Nuland's The Doctor's Plague: Germans, Childbed Fever and the Strange Story of Ignác Semmelweis (W.W. Norton, 2003). I’ve no idea whether Nuland supports or busts the Semmelweis Myth, but I’m looking forward to finding out.
Arbesman, S. (2012) The Half Life of Facts: Why Everything We Know Has an Expiration Date. New York. Current. Penguin Books.
Allchin, D. (2004) Pseudohistory and Pseudoscience. Science & Education 13: 179–195.http://depa.fquim.unam.mx/amyd/archivero/AllchinsobrePseudo_20824.pdf
BBC (2003) H2g2 Ignaz Semmelweis The Guide to Life the Universe and Everything:http://www.bbc.co.uk/dna/hub/A1067663
Donald, G. (2012) When the Earth was Flat: All the Bits of Science we got Wrong. London. Michael O’Mara Books Ltd.
Farley, T. (no date) Skeptic History: A Tale of Two Scientists, Redux. James Randi Educational Foundation.. http://www.randi.org/site/index.php/swift-blog/1757-skeptic-history-a-tale-of-two-scientists-redux.html
Goldacre, B, (2009) Bad Science. London. Fourth Estate.
Holmes, O. W. (1843) The contagiousness of puerperal fever. Reprinted in Medical Classics (1936) pp. 195-268. Taken here from Wainwright, M. (2001) Childbed fever- the Semmelweis myth. Microbiology Today. Vol 28. p. 173.
Tavris, C. and Aronson, E. (2008) Mistakes were made (but not by me), why we justify foolish beliefs, bad decisions and hurtful acts. London. Pinter and Martin
Varga, B (2009) The Myth and Cult of Ignaz Semmelweis: Constructing History of Science during the 20th Century. Paper presented at Oxford Brookes University, History of Medicine Seminar Series. 20 Oct. http://www.pulse-project.org/node/177
Wainwright, M. (2001) Childbed fever- the Semmelweis myth. Microbiology Today. Vol 28. pp. 173-174. http://www.sgm.ac.uk/pubs/micro_today/pdf/110102.pdf
A selection of notes taken during this research from the WWW for further reading and research
Wikipedia: In 1865, Semmelweis was committed to an asylum, where he died, ironically, ofsepticemia at age 47.
In 1865 János Balassa wrote a document referring Semmelweis to a mental institution. On July 30 Ferdinand Ritter von Hebra lured him, under the pretense of visiting one of Hebra's "new Institutes", to a Viennese insane asylum located in Lazarettgasse (Landes-Irren-Anstalt in der Lazarettgasse).:293 Semmelweis surmised what was happening and tried to leave. He was severely beaten by several guards, secured in a straitjacket and confined to a darkened cell. Apart from the straitjacket, treatments at the mental institution included dousing with cold water and administering castor oil, a laxative. He died after two weeks, on August 13, 1865, aged 47, from a gangrenous wound, possibly caused by the beating. The autopsy revealed extensive internal injuries, the cause of death pyemia—blood poisoning.:
At the St. Rochus Hospital in Budapest, Semmelweis was allowed to introduce disinfection in the obstetrical division. In 1855 he became professor of theoretical and practical midwifery at the University of Pest. In 1857 he married. But the deaths of two children during the next few years added personal grief to professional suffering, a suffering that intensified as opposition to his ideas spread throughout Europe.
With much reluctance Semmelweis organized his observations and published his great work on puerperal fever, The Etiology, Concept, and Prophylaxis of Childbed Fever (1861). Even this did not silence his opponents, and Semmelweis, unable to accept this resistance, was committed to an insane asylum in 1865, where he died of blood poisoning. Not until 1883 did the Boston Lying-In Hospital introduce methods of antisepsis, methods similar to those used several decades earlier by Semmelweis.
At last, although acceptance of his principles was gaining ground, the long years of controversy and intense preoccupation with defense of his doctrine affected Semmelweis's mind. Because of increasingly eccentric behaviour, he was admitted to a sanatorium for mental disorders. There an infected wound on his finger, received during a gynecological operation, was discovered. Defying all efforts at control, the infection progressed to gangrene followed by extensive sepsis, leading to his death in 1865 at the age of 47. By a tragic irony Semmelweis died from the same manifestations of pyemia as his friend, Kolletschka, whose death provided the clue to the prevention of puerperal fever.
Sadly, Semmelweiss was committed to an insane asylum when he started to exhibit what was possibly the early onset of Alzheimer’s disease. While there he was beaten by the staff and died from his injuries
In 1865 he suffers a mental breakdown. Friends commit him to a mental institution. There -- as though to close the circle on his brief 47-year life -- he cuts his finger. In days, he dies of the very infection that killed his friend Kolletschka and from which he's saved thousands of mothers.
Semmelweis was outraged by the indifference of the medical profession and began writing open and increasingly angry letters to prominent European obstetricians, at times denouncing them as irresponsible murderers. His contemporaries, including his wife, believed he was losing his mind and he was in 1865 committed to an asylum (mental institution). Semmelweis died there only 14 days later, possibly after being severely beaten by guards.
Semmelweis was slow and reluctant as an author, or no doubt his opinions would have obtained an earlier vogue; moreover, he was not only tender-hearted, but also irascible, impatient and tactless. Thus it cannot be said that the stupidity or malignity of his opponents was wholly to blame for the tragical issue of the conflict which brought this man of genius within the gates of an asylum on 20 July 1865. For over a century it was said that he brought with him into this retreat a dissection wound of the right hand, eventually causing his death, a victim of the very disease for the relief of which he had already sacrificed health and fortune. However, it is much more likely that he died of a beating administered by the asylum's staff.
Was it merely the new age of bacteriology that shed fresh light on his theory that renewed his esteem? Benedek Varga adds a new perspective to the otherwise huge, albeit often romanticised, discussion of Semmelweis. Namely the view of how his achievements were used by the Hungarian medical community to strengthen their international reputation. Varga does not question the originality and importance of Semmelweis’s discovery, but locates his changing reputation within the context of late 19th century Hungarian medical society and medical politics.
The Myth and Cult of Ignaz Semmelweis: Constructing History of Science during the 20th Century Benedek Varga
20 Oct 2009, Oxford Brookes University, History of Medicine Seminar Series