1. Semmelweis and Handwashing: Why Hospitals Did Not Adopt It Despite Fewer Deaths
In 1847, at the Vienna General Hospital’s first maternity clinic, the Hungarian doctor Semmelweis required doctors and students to wash their hands with chlorinated lime solution. This was a ward where many women died from puerperal fever, a disease causing high fever after childbirth. According to the Science History Institute, the death rate in this ward dropped from 18.27% to 1.27% in 1848. This means that out of 100 people, about 18 became about 1.[1]
Even though this was correct, it was not accepted. Many doctors at the time believed the cause of puerperal fever was "bad air." Semmelweis thought that dirt from dissected corpses was carried on hands, but the concept of bacteria causing disease was not yet established. Therefore, he could not provide an explanation that people would accept.[1]
Historians also point out an emotional factor. Asking doctors to wash their hands could be received as an accusation that "doctors’ hands were killing patients."[2] However, colleagues in cities like Paris and London did practice or agree with handwashing, so not everyone rejected it.[2]
2. The 1854 Soho Cholera Outbreak: Who Suspected Water When Doctors Blamed "Bad Air"
On August 31, 1854, a cholera outbreak began in Soho, London. Many doctors at the time believed the disease spread by inhaling foul-smelling air called "miasma."[3] The doctor Snow plotted the addresses of the dead on a map and showed they clustered around the Broad Street pump. He suspected water, not air.[3]
Snow spoke at the parish council on the night of September 7, and the pump handle was removed the next day, September 8.[4] However, Snow himself wrote that patients had started to decrease before the handle was removed.[4] Therefore, it cannot be said definitively that the outbreak stopped just because the handle was removed.
The theory that "water carries cholera" was not widely accepted in Victorian medicine. Edwin Chadwick and others supported the miasma theory.[5]
3. Pacini's 1854 Discovery of Cholera Bacteria Under a Microscope
In 1854, the doctor Pacini in Florence found comma-shaped bacteria in the intestines of cholera patients and published a paper. However, the miasma theory was strong among Italian scholars at the time, so his work received little attention.[6]
Koch succeeded in pure culture, growing only this bacteria, in January 1884. Later, in 1965, the International Committee on Bacteriological Nomenclature officially adopted the scientific name "Vibrio cholerae Pacini 1854."[6] The discoverer’s name and year remained in the scientific name.
Even after the bacteria were found, ideas did not change quickly. At the 1874 International Sanitary Conference, a resolution stated that the main medium carrying the cholera cause was "surrounding air."[6] Even after Koch’s discovery, it took time for the major medical communities in Europe to accept it.[6]
4. Warren's Spiral Bacteria in the Stomach: Why Were They Overlooked?
Around 1979, the pathologist Warren in Perth, Australia, examined stomach tissue and found spiral-shaped bacteria. He noticed inflammation where the bacteria were. The young trainee Marshall joined him, and they examined 100 tissue samples.[7]
In early 1982, Marshall failed many times at culturing the bacteria. This bacteria grew very slowly, so he was discarding the dishes before they could grow.[8] The turning point was the Easter holiday (April 9–12). The petri dishes were left in the incubator, and on April 13, after the holiday, small transparent colonies of bacteria appeared.[8] The failures were due to not waiting long enough.
Still, it was not immediately accepted. The local gastroenterology society rejected their abstract, and journal editors struggled to find favorable reviewers.[8] A letter was published in the medical journal The Lancet in June 1983, and the main paper in June 1984.[8] A 2005 article in the BMJ stated that because no one could isolate and culture the bacteria, previous observations were ignored or considered experimental errors.[9]
5. Marshall Drinks H. pylori: Self-Testing and Treatment Guidelines
Because there was no animal model suitable for the experiment, multiple sources report that Marshall drank a culture of H. pylori himself. Several days later, he had nausea and vomiting, and an endoscopy 10 days later confirmed gastritis and the presence of the bacteria.[10] This is said to have happened in the mid-1980s, though details vary by source.
This act involved great danger and cannot be imitated. Here, we simply note that someone tried to find an answer using their own body when they could not demonstrate it in animals.
In February 1994, a consensus development conference by the US National Institutes of Health (NIH) concluded that patients with ulcers infected with H. pylori needed treatment with antibiotics in addition to drugs that suppress stomach acid.[11] The 2005 Nobel Prize in Physiology or Medicine was awarded to Warren and Marshall for "the discovery of H. pylori and its role in gastritis and peptic ulcer disease."[7]
Safety note: This method involves danger and is not recommended. Do not try this.
6. What the Handwashing, Cholera, and Stomach Bacteria Stories Had in Common
When we line up the three scenes, three things stand out. First, there was a lack of explanation for the mechanism. In Semmelweis’s time, the germ theory was not established[1], and because H. pylori could not be cultured, observations were dismissed as experimental errors.[9] Second, it clashed with the common sense and positions of the time. They suspected water while the airborne theory was strong[3], and handwashing was received as blaming doctors.[2]
Third, someone created a way to verify it. Koch’s pure culture[6], Marshall’s culture that succeeded during the Easter holiday[8], and the NIH consensus conference[11] are examples of this. This is the author’s interpretation from these examples and does not mean there are no other reasons for resistance.
We cannot simply label the resisting doctors as foolish. With the knowledge of the time, there were indeed parts that could not be explained.
7. How You Can Investigate a "Obvious" Belief Yourself
What you can do today is choose one thing that "everyone thinks is obvious" and talk with your family about "why we can say it is true." Considering both the explanation and the method of verification makes the three scenes in this article feel closer to home.
If you want to read more, try opening the pages of the Science History Institute[1] or the Museum of London.[3]