Scholl, Raphael (2013) Causal inference, mechanisms, and the Semmelweis case. [Published Article]

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Abstract

Semmelweis's discovery of the cause of puerperal fever around the middle of the 19th century counts among the paradigm cases of scientific discovery. For several decades, philosophers of science have used the episode to illustrate, appraise and compare views of proper scientific methodology. Here I argue that the episode can be profitably reexamined in light of two cognate notions: causal reasoning and mechanisms. Semmelweis used several causal reasoning strategies both to support his own and to reject competing hypotheses. However, these strategies have gone unappreciated in the existing literature. I show that a causal reasoning approach makes sense of the multitude of tables in Semmelweis's main text, which in later editions were often abridged because they appeared redundant. Moreoever, the existing literature tends to focus on Semmelweis's clinical intervention and on the extent to which it alone confirms his theoretical conclusions. This neglects Semmelweis's efforts to show by animal experiments that his clinical results are in agreement with a demonstrable mechanism of puerperal fever pathogenesis. I argue that the full evidential force of Semmelweis's argument can only be appreciated if both his clinical and his laboratory investigations are taken into account.

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