Why You Need To Be A Critical Thinker, Lesson From Ignaz Semmelweis

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We have more information at our fingertips than ever before, which should be a good thing. With so much access to content, you’d think humanity would be pretty smart—and yet that doesn’t prove out.

If there’s anything recent history has taught us, it’s that we’re gullible, pliable, and easy victims to believing misinformation. If we don’t learn critical thinking and utilize it in all aspects of life, we’re susceptible to things like fraud and manipulation.

Critical thinking is a step-by-step process of analyzing an issue or subject fact-by-fact without the influence of personal feelings or opinions. A critical thinker does research, recognizes the biases of sources, and determines the value of information to resolve a question.

More than ever, especially in this time of a pandemic and political unrest, the use of critical thinking is essential to help you be successful and to keep you and others safe.

For a useful example of critical thinking, let’s look at the work of Ignaz Semmelweis, a Hungarian physician from the 19th century considered the pioneer of antiseptic technique. His hypothesis about childbed fever was drawn on unbiased critical thinking.

Bloodletting, 16th century image

THE DARKNESS OF MEDICINE IN THE 1800S

Ignaz was born in 1818, the fifth child to a wealthy family in Budapest. In 1837, he entered the University of Vienna with his sights set on law, but quickly switched over to the study of medicine. He then specialized in obstetrics.

His lifetime came after the Age of Enlightenment in Europe. The great thinkers of the day focused on the ideal of reason by utilizing the senses as a path to knowledge. The era produced philosophers including Voltaire and Descartes and artists such as Mozart and Jean-Jacques Rousseau.

Vienna was a place of science, art, and baroque architecture, and the Hapsburgs there ruled and influenced much of Europe. As enlightened as thinking might have been, however, medicine was still in the dark ages. Pandemics including cholera, smallpox, and typhus decimated the public, and medicine didn’t have the ability to do much to treat the sick.

Physicians addressed disease with tools such as bloodletting, where the goal was to drain enough blood from the patient to pass out. Imagine a person already so weak from illness losing their blood to help fight off infection! Other treatments included the use of leeches (which were then reused on other sick people) and medicines such as arsenic and mercury.

The causes of disease were still largely a mystery. Origins were surmised based on anecdotal information and conjured from personal beliefs. Doctors thought noxious fumes, overeating, and even exuberant dance were factors of illness.

Until the 18th century, medicine didn’t have much interest in the examination of the dead to learn more about anatomy and disease. However, by the mid-1800s, autopsies were routinely done. Often, the same physician who treated the patient would perform an autopsy on the corpse afterward.

By the time Ignaz became a doctor, the study of pathology and the use of cadavers was common practice.

The General Hospital of Vienna, 1700s

MEDICINE IN VIENNA

The poor, primarily women and children, suffered the most in society in this era. In Vienna, for example, by the end of the 18th century there was a population of 250,000 people of which 10,000 women were prostitutes and 4,000 were mistresses.

Many unmarried women supplemented their meager incomes with prostitution, and these activities accounted for half the births in the city. Childbirth was deadly for both mother and child. Eighty percent of the population suffered from vitamin D deficiency, which caused rickets, and most girls were born with deformed pelvises, making childbirth even more of a risk.

These unwed mothers were frequent victims of ridicule and venereal disease. There were no resources to help provide healthcare for delivery or support for the infants born, either.

In 1784, Joseph II, tried to address the issue of rampant disease and lack of medical care in the city by commissioning the construction of the Viennese General Hospital. Designed to serve 2,000 patients, its doors were open to both the poor and those who could afford to pay for care.

Governance of the institution was overseen by a committee of doctors who regulated operations, and the power hierarchy of the medical staff. But, as you can imagine, where there is politics, there is infighting.

The hospital proved a useful institution for facilitating the study of medicine. There were ample patients, and corpses for research. And it was understood that the sick, particularly the indigent, received free care in exchange for helping advance science.

Positions at the hospital were coveted by physicians who wanted to learn and build their career. In 1846, Ignaz was accepted as an assistant in the obstetrics clinic.

THE CHILDBED FEVER MYSTERY

The mortality rate for childbearing women during this time in Europe ranged from 1 to 4%. A primary culprit was a disease called childbed (puerperal) fever which came on shortly after a woman delivered. She would develop a fever and abdominal pain. The fever would spike, delirium would follow, and most women would die.

The hospital had two clinics for obstetrics: the first was specific to training physicians, and the second taught midwifery. While the risk of death was already high outside the hospital, within in the first clinic the rates were significantly higher, averaging 5% or more, but much lower in the clinic for midwives.

Ignaz took a keen interest in the disparity of childbed fever infection rates between the two clinics. Through a process entrenched in critical thinking, he soon discovered that a primary difference in the two clinics was that one was manned by physicians, while the second was operated by midwives—and how they treated patients differed.

The doctors in the first clinic performed more internal examinations on patients and did so only rinsing hands between their work. So, for example, a doctor could have been engaged in an autopsy, rinsed his hands, and then worked with a woman in labor. In contrast, midwives did few internal examinations and had no contact with cadavers.

Ignaz hypothesized that the cause of the fever had something to do with the remnants of tissue left on the hands of the doctors. Even if they washed their hands, the stench remained, and particles of tissue were still under their fingernails. The contamination was then passed on to their patients through examination.

Ignaz proposed an experiment where all physicians were to not only to wash their hands but then disinfect them with a solution of chloride and lime before touching any patient. Within a short time, the numbers of women suffering from childbed fever went down dramatically in the first clinic to below 1%.

The extent of handwashing by a medical professional today. Nowhere near as stringent the times of Ignaz.

NEGATING SCIENCE AND POLITICAL FOLLY

I’d like to say that the rest of Ignaz’s story after his discovery was a happy one. Even though Ignaz enjoyed immediate recognition and women’s lives were saved, the political in-fighting by his contemporaries halted further study.

Those in power at the hospital didn’t want to have their opinions displaced, and so antiseptic technique was not continued for some time in the hospital in Vienna. Thankfully for women in other parts of Europe, particularly Germany, antiseptic technique found favor and was adopted.

Ignaz went on to try and persuade his fellow physicians of the value of antiseptic technique but was largely shunned. By 1865, he fell into poor health and declined mentally. One theory regarding his health suggests Ignaz may have been suffering from syphilis. Doctors frequently contracted the disease from patients and cadavers of those with the disease.

Ignaz was committed into an asylum, and once he realized his situation he tried to escape. The guards beat him mercilessly and then placed him in a straitjacket in a dark cell. Within a couple of weeks, Ignaz died on August 13 from injuries sustained in the beating. He was only 47.

It would be another 20 years before Louis Pasteur discovered germ theory which offered an explanation for the observations of Ignaz. The Semmelweis reflex, a metaphor for the reflexive tendency to deny new information or knowledge was named in his honor.

Ignaz says, “Wear Your Mask!”

THINK CRITICALLY AND PASS IT ON

Today we know the struggle between knowledge and beliefs continues. So much information is available, but without the work of critical thinking we can be fooled.

We see large groups of people who have been persuaded to believe and behave in ways that are detrimental to their health and the future. We must each practice critical thinking and encourage it as important in education and in life.

Can you imagine what Ignaz would think of our lives today? I like to believe he would have been an early adopter of the science of climate change, and I’d bet he would have been an advocate for wearing masks during the pandemic. After all, he understood the principle of infection from his own critical thinking, even before the discovery of germs.

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Enjoying time together in Lima, Peru Mother and Daughter Sherry and Alexandra

Sherry is the founder of Storied Gifts a personal publishing service of family and company histories. She and her team help clients curate and craft their stories into books. When not writing or interviewing, Sherry spends loads of time with her grandchildren and lives in Des Moines, Iowa.

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