Finally, antiseptic surgery: March 16, 1867
Modern medicine makes a big leap forward with the publication in The Lancet of an article titled “New Methods of Treating Compound Fractures, Abscesses.” In it, British surgeon Joseph Lister describes the success he has had in treating compound fractures—in which the bone protrudes through the skin—by using carbolic acid to clean wounds and surgical instruments. Instead of having the broken limbs amputated, which is what usually happened after such injuries, Lister’s patients were recovering without developing gangrene or other serious infections.
Prior to Lister’s discovery, serious and often deadly post-surgical infections had become such a problem – a 40 to 50 percent death rate in most places—that the condition had its own name—“hospital disease”—and there actually was a movement to stop surgeries in hospitals. Lister himself reported that between 1864 and 1866, he lost 46 percent of his surgical patients; but between 1867 and 1870, after he started following antiseptic procedures in the operating room, the fatality rate dropped to 15 percent. By 1877, it had fallen to 5 percent.
Hospitals had long been notoriously unsanitary places where surgeons were known to take a certain pride in not changing surgical gowns between operations and routinely used instruments still bloody from previous operations. Just 20 years before Lister’s paper, in 1847, a Hungarian doctor named Ignaz Semmelweis had been widely ridiculed by the medical establishment when he recommended that doctors wash their hands in a solution of chlorinated lime before they delivered babies.
But Lister had read an article by French scientist Louis Pasteur that living microorganisms cause matter to ferment and rot, and that, in Lister’s mind, was what may have been happening in festering wounds. He also read that authorities in Carlisle, England had found that if they treated sewage with carbolic acid, it not only reduced the smell, but also cut down on disease among cattle and humans exposed to it.
Despite the evidence Lister presented of his own success with antiseptic surgical procedures, his approach was still met with much skepticism within the medical establishment. Experienced surgeons didn’t believe that organisms on the body too small to be seen could be causing infections. They still blamed them on “bad air.” They also didn’t particularly like using the carbolic acid spray because it cracked the skin on their hands and gave the operating room an unpleasant smell.
But Lister kept improving his methods of sterilizing operating rooms, creating a machine that sprayed a fine mist of carbolic acid over the operating table. Soon surgeons in Germany, France and the U.S. started adopting his practices and eventually doctors in Great Britain followed suit. By the 1880s, Lister was the surgeon to Queen Victoria herself, and when King Edward VII came down with appendicitis two days before his planned coronation in 1902, the royal doctors consulted with Lister, then 75.
By then, Lister had already been paid homage through an antiseptic sold as both a floor cleaner and a cure for gonorrhea. But it became famous, years later, as a mouthwash, a product called Listerine.
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