Miasma vs. Germ Theory
Early forms of germ theory, the concept that disease transmission is driven by pathogens, emerged around the world more than 2000 years ago. By the middle ages, Islamic physicians had formally proposed the basics of germ theory. For example, writing about an outbreak of the bubonic plague in 1362, Ibn al-Khatib astutely pointed out:
- “The existence of contagion is established by experience [and] by trustworthy reports on transmission by garments, vessels, ear-rings; by the spread of it by persons from one house, by infection of a healthy sea-port by an arrival from an infected land [and] by the immunity of isolated individuals.”
Yet European physicians clung to the miasma theory which attributed diseases such as cholera to “bad air” for many centuries.
Hand Washing: An Early Case Study
The Vienna Maternity Hospital had two clinics with vastly different maternal mortality rates. Between 1840 and 1846, the maternal mortality rate was 10% at the “First” clinic but only 4% at the “Second” clinic run by midwives.
- The First clinic was run by physicians and medical students who started each day with postmortem examinations. They then proceeded to the maternity, ward without washing their hands, where the students did vaginal examinations as part of their training (Loudon, 2013).
- The Second clinic was run by midwives who generally had more sanitary practices (Varney & Thompson 2015). Midwives did not do postmortems or vaginal examinations (Loudon, 2013).
In 1847, the new chief resident Ignaz Semmelweis suspected contagions from the cadavers were to blame. Semmelweis mandated hand washing and sanitizing instruments with a chlorine solution for both clinics. By 1848, the maternal mortality rate in both clinics fell to 1.3% (Loudon, 2013). Despite the overwhelming evidence in favor of sanitizing, these methods were rejected by the European medical community because they were in conflict with the Miasma theory. Semmelweis’ was replaced in 1849, sanitizing fell out of practice, and death rates began to rise again.
Belief Perseverance
In the face of mounting evidence many doctors and public officials stubbornly refused to acknowledge that basic hygiene and sanitation could save lives for decades because they were attached to the Miasma theory. Some were also offended by the idea that physicians themselves were vectors for disease transmission because “a gentleman’s hands are clean”. Rejection of sanitary practices in the European medical community is an example of belief perseverance. Historically, this is a common issue that has impeded numerous scientific advancements (eg. plate tectonics, climate change, vaccines, etc). Belief perseverance has many causes but it is often exacerbated by misogyny, racism, and ethnocentrism (eg. Rossiter 1993).
Question 7)
In your own words, what is belief perseverance? Give your own example of belief perseverance. This can be a historical example or one from your own personal experience.
References
Loudon, I. (2013). Ignaz Phillip Semmelweis’ studies of death in childbirth. Journal of the Royal Society of Medicine, 106(11), 461–463. https://doi.org/10.1177/0141076813507844
Rossiter, M. W. (1993). The Matthew Matilda Effect in Science. Social Studies of Science, 23(2), 325–341.
Varney, H., & Thompson, J. B. (2015). A History of Midwifery in the United States. Springer Publishing Company. https://connect.springerpub.com/content/book/978-0-8261-2538-5