The practice of surgery has been around as early as 10,000 B.C. But it wasn’t until the late 1800s, with the systematic thinking of Joseph Lister, were antiseptics finally introduced and widely used for sterilization of surgical instruments and dressings.
Joseph
Lister was a British surgeon who was among those selected to be a surgeon at
the new surgical building in the Glasgow Royal Infirmary in 1861. Here he was able to study the devastating
effects of sepsis on patients following surgical treatment. In the mid-nineteenth century, the mortality
rate for post-operative cases, such as amputee patients, was as high as 46% prior
to the use of antiseptics. It was in
his Male Accident Ward, in which Lister noted the death rate from
post-operative infection to be between 45-50% during the years 1861 and 1865,
where he began to investigate the causes of sepsis more carefully.
The
predominant cause of sepsis within the medical community was thought at the
time to be “bad air”. Thus, the ward
Lister worked in was constructed with the hope that performing surgeries in
this new unit would prevent sepsis from occurring. This hope was diminished when patients continued to acquire
gangrene and other infections. Through
his observations, Lister knew there had to be more to the story. He speculated that sepsis, was not merely
caused by bad air, but was actually decaying of the flesh brought about by
“pollen-like dust”. He recalled the
1865 work of Louis Pasteur who had determined that fermentation of
microorganisms upon entering the flesh causes putrefaction or flesh
decomposition, and saw the relationship between Pasteur’s finding and the
sepsis seen in his patients. Lister
decided that in order to rid the operation rooms of these harmful living
organisms, he would spray the air with carbolic acid, used at the time as a
sewage treatment to control typhoid disease.
He later treated surgical instruments and wounds and dressings with
carbolic acid for sterilization. With
his new antiseptic techniques, the mortality rate after surgery was reduced to
15%.
Joseph
Lister’s new methods were simple, but were not without some initial opposition
from the medical community. But it was
more his theory of the causes of sepsis that stirred up debate rather than his
antiseptic system. He was able to show
that using carbolic acid as a sterilizer in the surgical wards successfully
prevented sepsis in 1877 and by the 1880s, Lister’s antiseptic practices became
more accepted. Although Lister’s
original carbolic acid spray is no longer used today, other antiseptics and
aseptic techniques have been developed for surgical use.
Questions for Discussion
References
http://web.ukonline.co.uk/b.gardner/Lister.html#gi
http://www.umanitoba.ca/faculties/medicine/history/notes/surgery/
http://www.sciencefinder.co.uk/lister.doc
http://www.medfindnow.com/history.htm