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Drug Bust Alan Cassels

Briefing Notes on Prescription Drugs


A sanitary revolution in the works


It’s time for healthcare to wash its hands of Big Pharma’s influence

harles Delucena Meigs (1792-1869) was a very well regarded American obstetrician with some very strange ideas. He might be best known for saying anaesthesia was not appropriate for women in labour because, he reasoned, it contravened the laws of God. His enlightened perspective on the sanitary practices of his own profession, however, is what makes him most unforgettable. In the 1840s, he quite famously said, “Doctors are gentlemen and gentlemen’s hands are clean” and he showed a vocal contempt towards anyone who suggested doctors could be hurting patients through slovenly sanitary practices. When childbirth was beginning to be institutionalized, women were encouraged to give birth at newly created maternity hospitals where the finest medical technology of the day could be used to extract the child from the womb. The problem was these new large maternity wards had intolerably high death rates. In fact, puerperal fever (or childbed fever), a bacterial infection that often infected women during or after childbirth, was frequently fatal. This fact was not lost on a young Hungarian obstetrician named Ignaz Semmelweis, who, in 1846, was appointed to the Vienna Maternity Hospital, the world’s largest at the time, with two maternity clinics. Semmelweis discovered the death rate among birthing women was nearly 20 percent in the clinic staffed by doctors and medical residents and about three percent in the clinic staffed by midwives. What was going on? Nobody really knew. Women were assigned at random to either ward as they arrived to give birth so Semmelweis hypothesized it was something the doctors were doing that was leading to such carnage. Since the doctors spent their mornings doing autopsies and their afternoons examining women and delivering babies,


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he thought they must have been carrying something deadly on their hands, which he called “cadaverous particles.” When he instituted a program requiring the physicians to wash their hands in a chlorine solution after performing autopsies, the death rate on the doctors’ ward plummeted to the same level as it was with the midwives. What happened next is the most interesting part of the story. Was Semmelweis embraced as a hero? Celebrated as a medical genius? Promoted and respected amongst his peers? Absolutely not. He was reviled, challenged, ridiculed and, worst of all, ignored. By all accounts, the outspoken obstetrician wasn’t a master of diplomacy, but the reaction of his profession was legendary. They felt it was inconceivable that respectable gentlemen physicians could be responsible for killing their patients. At age 47, Semmelweis died alone and shunned in an insane asylum. It took a long time for the medical profession to adopt Semmelweis’ idea of aseptic measures in medicine even though others, such as famous poet and physician Oliver Wendell Holmes, were coming to similar conclusions at about the same time. With some things, orthodox medicine is notoriously slow to change. Sometimes a slow evolution of medical practice is a good thing; at other times, a revolution is required, especially in cases where it becomes obvious that certain practices are killing patients. Today, medical practice has embraced Semmelweis’ advice. Sanitary measures are part of the bedrock of medical care (even though some research shows it is still a challenge to get doctors and nurses to wash their hands). There is, however, an overwhelming need for another type of revolution in sanitation – not concerning germs, but rather the risks and harms of infected (financially conflicted) medicine.

Common Ground November 2013  
Common Ground November 2013  

Robert Alstead, Alan Cassels, Carolyn Herriot, Bruce Mason, Ralph Maud, Mac McLaughlin, Vesanto Melina, Geoff Olson, Gwen Randall-Young, El...