19 ms·

A doctor who championed hand-washing and briefly saved lives (2015)

106 points by Anon84 6y ago

4ndrewl 6y ago
Anyone else expecting this to be a Doctor Who story?
- tfitz237 6y ago
  Unnecessary Capitalization Creates Unnecessary Clicks
  - iso1210 6y ago
    Unnecessary Capitalization Creates Necessary Revenue
    - aspenmayer 6y ago
      Necessary to Whom?
- ModernMech 6y ago
  Yeah, I had problems parsing the headline.
- brian_herman 6y ago
  Yes!
moron4hire 6y ago
This underscores something that is going on with the COVID-19 pandemic. There are a lot of complaints about face-mask ordinances that claim there is no "hard science" to show that masks are effective, followed by some sort of statement that public policy should be "based on hard science". For a lot of reasons, hard science isn't all it's cracked up to be, certainly not by the lay public, who seem to treat it as a "final, definitive word" on subjects. First of all, it gives a lot more credit to science than even scientists give. But most importantly, you don't need to know the mechanism of a problem if you have statistical evidence that your actions are having an impact. You might not even know it's the direct result of the actual action you're taking, it might be a knock-on effect from some other action people are taking in response to the mandated action. But that doesn't matter. What matters is that lives are saved. You can figure out the mechanism later. In the meantime, do the superstitious sky-god dance. Especially when it's really not that big of an imposition. We know for a fact that most places that have strict mask ordinances are seeing large reductions in infection rate. Some aren't, but that's actually not an argument for not wearing masks. Indeed, it's the exact opposite. While the "hard science" is supposedly unclear, you absolutely should still wear the mask, so that the confounding variables are easier to discover.
- klenwell 6y ago
  My favorite example of this is Pasteur's revolutionary work in immunology itself: A careful reading of Pasteur’s presentations to the Academy of Sciences reveals that Pasteur was entirely mistaken as to how immunity occurs, in that he reasoned, as a good microbiologist would, that appropriately attenuated microbes would deplete the host of vital trace nutrients absolutely required for their viability and growth, and not an active response on the part of the host. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342039/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342039/
- matz1 6y ago
  >Especially when it's really not that big of an imposition This is my biggest issue, dismissing it as something trivial. Everybody is different, for some people it can be huge inconvenience.
  - amanaplanacanal 6y ago
    And exceptions for those few people are good. But that’s not a good reason for the vast majority.
    - matz1 6y ago
      Good enough reason is subjective, if someone says they don't like mask because its uncomfortable, its obviously significant enough reason for them.
  - moron4hire 6y ago
    If a specific person's respiratory system is really so bad that a mask would have a significant, deleterious effect, then a mask ordinance is of no consequence because that person really should not even be going out in public at all during the pandemic.
    - matz1 6y ago
      Then Its for them to decide that. They may very well knew and accept the what you called "deleterious" effect.
cj 6y ago
Side note: The Knick was a great TV show about a hospital in the early 1900's before standard treatments for common conditions existed. If you liked this article, check out this show.
deckarep 6y ago
I’m just gonna leave this right here on the matter: https://youtu.be/JwzDG_kIq68 https://youtu.be/JwzDG_kIq68
- tingletech 6y ago
  interesting, seems to be a reupload of https://www.youtube.com/watch?v=WKfolJv6Kx8 https://www.youtube.com/watch?v=WKfolJv6Kx8
tptacek 6y ago
I think Semmelweis is interesting for other reasons. From what I understand, hand-washing was routine in Semmelweis' time; what he specifically championed was antiseptic washing (in his case with a solution of lime). And: he was an asshole about it. He had a particular theory of why his particular routine worked, and it was the wrong one: he believed particles from corpses were becoming airborne and landing in the wounds of patients. That theory was tested and falsified by numerous infections occurring in places no corpses had been present. Challenged with countervailing evidence, he doubled down, maintaining that childbed fever was caused by the cadaveric particles generated internally by necrotizing tissue crushed during the birthing process. Through it all, he was outrageously rude, hurled insults at his colleagues, stormed into operating theaters, and generally did everything he could to make sure his life-saving contribution was ignored. The rudeness is a little interesting, I guess, but the big thing for me is the idea that just a little bit of intellectual humility --- stick to the empirical observation and stop yelling at people about corpses! You almost had it! --- would have made him a household name centuries later.
- vezycash 6y ago
  Hindsight bias is coloring your view of the man. The article mentions unwashed hands is STILL a problem with physicians TODAY - with all the years of training, knowledge, books, microscopes that can see germs in action and most importantly, hundreds of years of evidence. Changing people's minds is not easy - then or now. Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution... But even with multiple champions, these causes are struggling, not a runaway success as you'd expect. Compare this man to Richard Stallman - see any similarities? I'm sure Stallman would have been remanded to mental institution if he lived in the 1800s. Even if this doctor was a giant asshole, I applaud his use of scientific-ish methods - methodologically cutting off unlikelies until arriving at the root cause - unwashed hands.
  - IAmEveryone 6y ago
    Not just handwashing... There's a theory popular with jaded biologists that neckties alone may have killed more people than some minor genocides. And the failure to perfect the practice of hand-washing is somewhat easy to understand: it's tedious, especially when done dozens of times per day. Some people suffer skin irritation. The cause of any infection can almost never be traced, making it hard to learn and/or punish the guilty. Banning neckties is a rather binary policy decision, and compliance would be extremely easy to monitor. One would think people with advanced academic degrees would see the upside, and don't need to signal status with superfluous items of clothing in addition to that doctorate.
berbec 6y ago
I missed the "A" at the beginning of the article title, and was wondering how hand-washing helped defeat the Daleks.
deleted 6y ago
[deleted]
ninja3925 6y ago
Looks like this work led the way to Germ Theory (Pasteur). Pretty cool. Thanks Semmelweis and Pasteur. https://hardydiagnostics.com/wp-content/uploads/2016/05/Semmelwise-and-Handwashing-by-Raquel-Kahler.pdf https://hardydiagnostics.com/wp-content/uploads/2016/05/Semm...
99_00 6y ago
>Even today, convincing health care providers to take hand-washing seriously is a challenge. Hundreds of thousands of hospital patients get infections each year, infections that can be deadly and hard to treat. The Centers for Disease Control and Prevention says hand hygiene is one of the most important ways to prevent these infections. When I wash my hands several times a day they become raw. Moisturizer helps a bit. Can't the process be made a bit better?
- Baeocystin 6y ago
  Dawn dish soap works very well- you don't need much at all per wash, and your hands don't get dry and cracked after repeat washings.
  - refurb 6y ago
    Really? Dawn is known for doing a great job at striping oils from things. Better than most detergents. I've washed my hands with Dawn and I can feel how clean they are.
    - Baeocystin 6y ago
      Really really. I tend to get dry skin, and I switched to Dawn some years back for doing dishes because it was better on my skin, while still doing the cleaning job. You can also add a little vegetable glycerin to any alcohol-based sanitizers you use. Use the ratios from the WHO sanitizing hand rub guide: https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf Adding a humectant helps a lot when it comes to preventing dry/cracked skin.
- DanBC 6y ago
  The CDC has "When is clean too clean" which explains some of the problems. Health care professionals may be washing their hands many times a day. https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article
- opan 6y ago
pella 6y ago
related: "The Semmelweis reflex or "Semmelweis effect" is a metaphor for the reflex-like tendency to reject new evidence or new knowledge because it contradicts established norms, beliefs, or paradigms." https://en.wikipedia.org/wiki/Semmelweis_reflex https://en.wikipedia.org/wiki/Semmelweis_reflex ---- Bonus: "Look at yourself objectively" (by Aaron Swartz ) http://www.aaronsw.com/weblog/semmelweis http://www.aaronsw.com/weblog/semmelweis
user_50123890 6y ago
Handwashing is overrated IMO. Yes, it's important for doctors and nurses(who touch dozens of sick humans a day), people who are in contact with animals, and small kids who don't have any concept of hygiene. But for the average adult, they just do not have that many harmful bacteria or viruses randomly on their hands. This caused some major issues with the Coronavirus. Eg. if you googled anything related to it in march, the search results displayed a "wash your hands message" even though the virus is spread by droplets AKA sharing air indoors with an infected person. I can only imagine how many unnecessary infections and deaths this caused when people thought they were safe if they just washed their hands often. To this day, I'd say about half of the population has no clue how respitory diseases spread.
- DanBC 6y ago
  > Eg. if you googled anything related to it in march, the search results displayed a "wash your hands message" even though the virus is spread by droplets AKA sharing air indoors with an infected person. There's a fecal-oral route for covid-19, which is why the protocols for people who share a home with someone infected with covid-19 all mention using a separate (if possible) toilet, or making sure the room is cleaned thoroughly after each use. EG, this from CDC: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/ca... > If possible, have the person who is sick use a separate bedroom and bathroom. If possible, have the person who is sick stay in their own “sick room” or area and away from others. Try to stay at least 6 feet away from the sick person. Handwashing remains a crucial part of the set of protection measures against covid-19 and other respiratory disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446461/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446461/ > Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781206/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781206/ > There was moderate to low‐quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower–middle‐income setting. There was high‐quality evidence of a small reduction in respiratory infection in childcare settings. There was high‐quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low‐income setting. There was moderate‐ to high‐quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.
deleted 6y ago
[deleted]
IG_Semmelweiss 6y ago
Hello, I am Ignaz Semmelweiss. Ask me anything!
michaelkeenan 6y ago
> Semmelweis was not very tactful. He publicly berated people who disagreed with him and made some influential enemies. Eventually the doctors gave up the chlorine hand-washing Something Matthew Benjamin wrote stuck with me: "It is way more important to preserve trust, goodwill and respect than to get what you want, no matter how good what you want seems." It seems like this can't be true - some things are surely more important than trust, goodwill and respect. What could be more important than saving lives? But this is an example of that being more true than I'd naively think.
- joe_the_user 6y ago
  "It is way more important to preserve trust, goodwill and respect than to get what you want, no matter how good what you want seems." That is true if someone is leader of a group. You can't let the thread break because then you can't anything. But someone is pushing an idea, it's a different balance, I think. Maybe people understanding the idea is more important than them liking you.
tropdrop 6y ago
> For one thing, doctors were upset because Semmelweis' hypothesis made it look like they were the ones giving childbed fever to the women. This, I think, is a point that needs amplifying: Doctor hubris causing harm and even death is not an isolated incident to this case. This is alluded to with the line about how difficult it is to convince health care providers to take hand-washing seriously today. One can look to some horrifying practices in medical history to see a track record of "I'm a doctor, so I know better than you" that caused needless deaths and sometimes despicably cruel outcomes. Rosemary Kennedy's case is an example of that happening all throughout her life, with first this: During her birth, the doctor was not immediately available and the nurse ordered Rose Kennedy to keep her legs closed, forcing the baby's head to stay in the birth canal for two hours. (caused Rosemary's intellectual disabilities) And then lobotomy [1]. On a personal note, my close family member is dealing with cancer. His last chemotherapy just about killed him - he lost 40 lbs in a week and went from being in full heath to severely underweight. When he told the doctor that he just could not do another therapy session - he feels that it will kill him - the doctor said exactly the above - "I'm a doctor, so I know better than you." He left that doctor - his tumor was already gone, he continued his last radiotherapy sessions. He was just like the people mentioned in this article [2] - The surprising part was that people who were feeling the best at the start of the therapy ended up feeling the worst. They are the ones most harmed and who had the most to lose... without significant benefit for their cancer. 1 - https://en.wikipedia.org/wiki/Rosemary_Kennedy#Lobotomy https://en.wikipedia.org/wiki/Rosemary_Kennedy#Lobotomy 2 - https://time.com/3968918/when-chemotherapy-does-more-harm-than-good/ https://time.com/3968918/when-chemotherapy-does-more-harm-th...
- lordgrenville 6y ago
  Sorry to hear about your family member's bad experience, but glad to hear they're on the mend. I'd highly recommend Atul Gawande's book Being Mortal which has a lot to say about doctor hubris in treating the terminally ill. He describes how the patient should guide the treatment based on their own preferences, informed by the doctor's expertise.
  - tropdrop 6y ago
dang 6y ago
Discussion from 2015: https://news.ycombinator.com/item?id=8897387 https://news.ycombinator.com/item?id=8897387
sammalloy 6y ago
As much as we like to focus on the past, let’s not forget that we still have a long way to go. On average, nosocomial infections (hospital-acquired) kill 100,000 Americans per year in US hospitals. There are many issues that have yet to be resolved. The problem with adequately cleaning and disinfecting medical scopes, for example, was a recent topic in technology circles (Olympus TJF-Q180V).
8bitsrule 6y ago
From 'The Plight of the Obscure Innovator in Science' (Moti Nissani, 1995) [0] : "Semmelweis was laughed at in part because he was unable to explain the observed effect of soiled hands on childbed fever. So, to be believed, widespread resistance to obscure innovators must be documented and explained.... "Bernard Barber commented [1962] that 'one of the interesting aspects of the social process of discovery--the resistance on the part of scientists themselves to scientific discovery...has been largely neglected as a subject for systematic investigation.' A third of a century later, the subject has not yet received the methodical attention it so richly deserves. Only a time-consuming comprehensive historical survey will help to unravel the extent, nature, causes, consequences, and cures of this resistance." [0] http://drnissani.net/MNISSANI/PAGEPUB/HISTORY.HTM http://drnissani.net/MNISSANI/PAGEPUB/HISTORY.HTM Semmelweis died in an insane asylum in 1865. Joseph Lister = who'd discovered the use of carbolic acid that same year - published Antiseptic Principle of the Practice of Surgery in 1867. He'd read about Louis Pasteur's experiments confirming germ theory.

106 points by Anon84 6y ago

4ndrewl 6y ago

Anyone else expecting this to be a Doctor Who story?

tfitz237 6y ago
Unnecessary Capitalization Creates Unnecessary Clicks
- iso1210 6y ago
  Unnecessary Capitalization Creates Necessary Revenue
  - aspenmayer 6y ago
    Necessary to Whom?
ModernMech 6y ago
Yeah, I had problems parsing the headline.
brian_herman 6y ago
Yes!

moron4hire 6y ago

This underscores something that is going on with the COVID-19 pandemic. There are a lot of complaints about face-mask ordinances that claim there is no "hard science" to show that masks are effective, followed by some sort of statement that public policy should be "based on hard science". For a lot of reasons, hard science isn't all it's cracked up to be, certainly not by the lay public, who seem to treat it as a "final, definitive word" on subjects. First of all, it gives a lot more credit to science than even scientists give. But most importantly, you don't need to know the mechanism of a problem if you have statistical evidence that your actions are having an impact. You might not even know it's the direct result of the actual action you're taking, it might be a knock-on effect from some other action people are taking in response to the mandated action. But that doesn't matter. What matters is that lives are saved. You can figure out the mechanism later. In the meantime, do the superstitious sky-god dance. Especially when it's really not that big of an imposition. We know for a fact that most places that have strict mask ordinances are seeing large reductions in infection rate. Some aren't, but that's actually not an argument for not wearing masks. Indeed, it's the exact opposite. While the "hard science" is supposedly unclear, you absolutely should still wear the mask, so that the confounding variables are easier to discover.

klenwell 6y ago
My favorite example of this is Pasteur's revolutionary work in immunology itself: A careful reading of Pasteur’s presentations to the Academy of Sciences reveals that Pasteur was entirely mistaken as to how immunity occurs, in that he reasoned, as a good microbiologist would, that appropriately attenuated microbes would deplete the host of vital trace nutrients absolutely required for their viability and growth, and not an active response on the part of the host. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342039/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3342039/
matz1 6y ago
>Especially when it's really not that big of an imposition This is my biggest issue, dismissing it as something trivial. Everybody is different, for some people it can be huge inconvenience.
- amanaplanacanal 6y ago
  And exceptions for those few people are good. But that’s not a good reason for the vast majority.
  - matz1 6y ago
    Good enough reason is subjective, if someone says they don't like mask because its uncomfortable, its obviously significant enough reason for them.
- moron4hire 6y ago
  If a specific person's respiratory system is really so bad that a mask would have a significant, deleterious effect, then a mask ordinance is of no consequence because that person really should not even be going out in public at all during the pandemic.
  - matz1 6y ago
    Then Its for them to decide that. They may very well knew and accept the what you called "deleterious" effect.

cj 6y ago

Side note: The Knick was a great TV show about a hospital in the early 1900's before standard treatments for common conditions existed. If you liked this article, check out this show.

deckarep 6y ago

I’m just gonna leave this right here on the matter: https://youtu.be/JwzDG_kIq68 https://youtu.be/JwzDG_kIq68

tingletech 6y ago
interesting, seems to be a reupload of https://www.youtube.com/watch?v=WKfolJv6Kx8 https://www.youtube.com/watch?v=WKfolJv6Kx8

tptacek 6y ago

I think Semmelweis is interesting for other reasons. From what I understand, hand-washing was routine in Semmelweis' time; what he specifically championed was antiseptic washing (in his case with a solution of lime). And: he was an asshole about it. He had a particular theory of why his particular routine worked, and it was the wrong one: he believed particles from corpses were becoming airborne and landing in the wounds of patients. That theory was tested and falsified by numerous infections occurring in places no corpses had been present. Challenged with countervailing evidence, he doubled down, maintaining that childbed fever was caused by the cadaveric particles generated internally by necrotizing tissue crushed during the birthing process. Through it all, he was outrageously rude, hurled insults at his colleagues, stormed into operating theaters, and generally did everything he could to make sure his life-saving contribution was ignored. The rudeness is a little interesting, I guess, but the big thing for me is the idea that just a little bit of intellectual humility --- stick to the empirical observation and stop yelling at people about corpses! You almost had it! --- would have made him a household name centuries later.

vezycash 6y ago
Hindsight bias is coloring your view of the man. The article mentions unwashed hands is STILL a problem with physicians TODAY - with all the years of training, knowledge, books, microscopes that can see germs in action and most importantly, hundreds of years of evidence. Changing people's minds is not easy - then or now. Shaming works way better than just talking. You can see how shaming has helped the cause of open source, black lives matter, pollution... But even with multiple champions, these causes are struggling, not a runaway success as you'd expect. Compare this man to Richard Stallman - see any similarities? I'm sure Stallman would have been remanded to mental institution if he lived in the 1800s. Even if this doctor was a giant asshole, I applaud his use of scientific-ish methods - methodologically cutting off unlikelies until arriving at the root cause - unwashed hands.
- IAmEveryone 6y ago
  Not just handwashing... There's a theory popular with jaded biologists that neckties alone may have killed more people than some minor genocides. And the failure to perfect the practice of hand-washing is somewhat easy to understand: it's tedious, especially when done dozens of times per day. Some people suffer skin irritation. The cause of any infection can almost never be traced, making it hard to learn and/or punish the guilty. Banning neckties is a rather binary policy decision, and compliance would be extremely easy to monitor. One would think people with advanced academic degrees would see the upside, and don't need to signal status with superfluous items of clothing in addition to that doctorate.

berbec 6y ago

I missed the "A" at the beginning of the article title, and was wondering how hand-washing helped defeat the Daleks.

deleted 6y ago

[deleted]

ninja3925 6y ago

Looks like this work led the way to Germ Theory (Pasteur). Pretty cool. Thanks Semmelweis and Pasteur. https://hardydiagnostics.com/wp-content/uploads/2016/05/Semmelwise-and-Handwashing-by-Raquel-Kahler.pdf https://hardydiagnostics.com/wp-content/uploads/2016/05/Semm...

99_00 6y ago

>Even today, convincing health care providers to take hand-washing seriously is a challenge. Hundreds of thousands of hospital patients get infections each year, infections that can be deadly and hard to treat. The Centers for Disease Control and Prevention says hand hygiene is one of the most important ways to prevent these infections. When I wash my hands several times a day they become raw. Moisturizer helps a bit. Can't the process be made a bit better?

Baeocystin 6y ago
Dawn dish soap works very well- you don't need much at all per wash, and your hands don't get dry and cracked after repeat washings.
- refurb 6y ago
  Really? Dawn is known for doing a great job at striping oils from things. Better than most detergents. I've washed my hands with Dawn and I can feel how clean they are.
  - Baeocystin 6y ago
    Really really. I tend to get dry skin, and I switched to Dawn some years back for doing dishes because it was better on my skin, while still doing the cleaning job. You can also add a little vegetable glycerin to any alcohol-based sanitizers you use. Use the ratios from the WHO sanitizing hand rub guide: https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf https://www.who.int/gpsc/5may/Guide_to_Local_Production.pdf Adding a humectant helps a lot when it comes to preventing dry/cracked skin.
DanBC 6y ago
The CDC has "When is clean too clean" which explains some of the problems. Health care professionals may be washing their hands many times a day. https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article https://wwwnc.cdc.gov/eid/article/7/2/70-0225_article
opan 6y ago

pella 6y ago

related: "The Semmelweis reflex or "Semmelweis effect" is a metaphor for the reflex-like tendency to reject new evidence or new knowledge because it contradicts established norms, beliefs, or paradigms." https://en.wikipedia.org/wiki/Semmelweis_reflex https://en.wikipedia.org/wiki/Semmelweis_reflex ---- Bonus: "Look at yourself objectively" (by Aaron Swartz ) http://www.aaronsw.com/weblog/semmelweis http://www.aaronsw.com/weblog/semmelweis

user_50123890 6y ago

Handwashing is overrated IMO. Yes, it's important for doctors and nurses(who touch dozens of sick humans a day), people who are in contact with animals, and small kids who don't have any concept of hygiene. But for the average adult, they just do not have that many harmful bacteria or viruses randomly on their hands. This caused some major issues with the Coronavirus. Eg. if you googled anything related to it in march, the search results displayed a "wash your hands message" even though the virus is spread by droplets AKA sharing air indoors with an infected person. I can only imagine how many unnecessary infections and deaths this caused when people thought they were safe if they just washed their hands often. To this day, I'd say about half of the population has no clue how respitory diseases spread.

DanBC 6y ago
> Eg. if you googled anything related to it in march, the search results displayed a "wash your hands message" even though the virus is spread by droplets AKA sharing air indoors with an infected person. There's a fecal-oral route for covid-19, which is why the protocols for people who share a home with someone infected with covid-19 all mention using a separate (if possible) toilet, or making sure the room is cleaned thoroughly after each use. EG, this from CDC: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for-someone.html https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/ca... > If possible, have the person who is sick use a separate bedroom and bathroom. If possible, have the person who is sick stay in their own “sick room” or area and away from others. Try to stay at least 6 feet away from the sick person. Handwashing remains a crucial part of the set of protection measures against covid-19 and other respiratory disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446461/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2446461/ > Improvements in hand hygiene resulted in reductions in gastrointestinal illness of 31% (95% confidence intervals [CI]=19%, 42%) and reductions in respiratory illness of 21% (95% CI=5%, 34%). The most beneficial intervention was hand-hygiene education with use of nonantibacterial soap. Use of antibacterial soap showed little added benefit compared with use of nonantibacterial soap. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781206/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5781206/ > There was moderate to low‐quality evidence of a reduction in both influenza and respiratory tract infection with hand hygiene interventions in schools, greatest in a lower–middle‐income setting. There was high‐quality evidence of a small reduction in respiratory infection in childcare settings. There was high‐quality evidence for a large reduction in respiratory infection with a hand hygiene intervention in squatter settlements in a low‐income setting. There was moderate‐ to high‐quality evidence of no effect on secondary transmission of influenza in households that had already experienced an index case. While hand hygiene interventions have potential to reduce transmission of influenza and acute respiratory tract infections, their effectiveness varies depending on setting, context and compliance.

deleted 6y ago

[deleted]

IG_Semmelweiss 6y ago

Hello, I am Ignaz Semmelweiss. Ask me anything!

michaelkeenan 6y ago

> Semmelweis was not very tactful. He publicly berated people who disagreed with him and made some influential enemies. Eventually the doctors gave up the chlorine hand-washing Something Matthew Benjamin wrote stuck with me: "It is way more important to preserve trust, goodwill and respect than to get what you want, no matter how good what you want seems." It seems like this can't be true - some things are surely more important than trust, goodwill and respect. What could be more important than saving lives? But this is an example of that being more true than I'd naively think.

joe_the_user 6y ago
"It is way more important to preserve trust, goodwill and respect than to get what you want, no matter how good what you want seems." That is true if someone is leader of a group. You can't let the thread break because then you can't anything. But someone is pushing an idea, it's a different balance, I think. Maybe people understanding the idea is more important than them liking you.

tropdrop 6y ago

> For one thing, doctors were upset because Semmelweis' hypothesis made it look like they were the ones giving childbed fever to the women. This, I think, is a point that needs amplifying: Doctor hubris causing harm and even death is not an isolated incident to this case. This is alluded to with the line about how difficult it is to convince health care providers to take hand-washing seriously today. One can look to some horrifying practices in medical history to see a track record of "I'm a doctor, so I know better than you" that caused needless deaths and sometimes despicably cruel outcomes. Rosemary Kennedy's case is an example of that happening all throughout her life, with first this: During her birth, the doctor was not immediately available and the nurse ordered Rose Kennedy to keep her legs closed, forcing the baby's head to stay in the birth canal for two hours. (caused Rosemary's intellectual disabilities) And then lobotomy [1]. On a personal note, my close family member is dealing with cancer. His last chemotherapy just about killed him - he lost 40 lbs in a week and went from being in full heath to severely underweight. When he told the doctor that he just could not do another therapy session - he feels that it will kill him - the doctor said exactly the above - "I'm a doctor, so I know better than you." He left that doctor - his tumor was already gone, he continued his last radiotherapy sessions. He was just like the people mentioned in this article [2] - The surprising part was that people who were feeling the best at the start of the therapy ended up feeling the worst. They are the ones most harmed and who had the most to lose... without significant benefit for their cancer. 1 - https://en.wikipedia.org/wiki/Rosemary_Kennedy#Lobotomy https://en.wikipedia.org/wiki/Rosemary_Kennedy#Lobotomy 2 - https://time.com/3968918/when-chemotherapy-does-more-harm-than-good/ https://time.com/3968918/when-chemotherapy-does-more-harm-th...

lordgrenville 6y ago
Sorry to hear about your family member's bad experience, but glad to hear they're on the mend. I'd highly recommend Atul Gawande's book Being Mortal which has a lot to say about doctor hubris in treating the terminally ill. He describes how the patient should guide the treatment based on their own preferences, informed by the doctor's expertise.
- tropdrop 6y ago

dang 6y ago

Discussion from 2015: https://news.ycombinator.com/item?id=8897387 https://news.ycombinator.com/item?id=8897387

sammalloy 6y ago

As much as we like to focus on the past, let’s not forget that we still have a long way to go. On average, nosocomial infections (hospital-acquired) kill 100,000 Americans per year in US hospitals. There are many issues that have yet to be resolved. The problem with adequately cleaning and disinfecting medical scopes, for example, was a recent topic in technology circles (Olympus TJF-Q180V).

8bitsrule 6y ago

From 'The Plight of the Obscure Innovator in Science' (Moti Nissani, 1995) [0] : "Semmelweis was laughed at in part because he was unable to explain the observed effect of soiled hands on childbed fever. So, to be believed, widespread resistance to obscure innovators must be documented and explained.... "Bernard Barber commented [1962] that 'one of the interesting aspects of the social process of discovery--the resistance on the part of scientists themselves to scientific discovery...has been largely neglected as a subject for systematic investigation.' A third of a century later, the subject has not yet received the methodical attention it so richly deserves. Only a time-consuming comprehensive historical survey will help to unravel the extent, nature, causes, consequences, and cures of this resistance." [0] http://drnissani.net/MNISSANI/PAGEPUB/HISTORY.HTM http://drnissani.net/MNISSANI/PAGEPUB/HISTORY.HTM Semmelweis died in an insane asylum in 1865. Joseph Lister = who'd discovered the use of carbolic acid that same year - published Antiseptic Principle of the Practice of Surgery in 1867. He'd read about Louis Pasteur's experiments confirming germ theory.