In 1874 there was a high mortality rate from major surgical operations or amputation of limbs. It was around 40%. 60% in French hospitals. The simplest operations carried a high risk of death from infection. No real effective solution could be found. Until Joseph Lister, the doctor who washed his hands, arrived.
Applying Pasteur's ideas
Lister suffered from seeing how many of his cases developed serious postoperative complications. He had noticed a marked difference in outcome between simple fractures, when the skin was intact, and compound fractures. In these the skin surface was broken. They often ended in "hospital gangrene" and amputation. A colleague, Professor Thomas Anderson, mentioned to him that in France the chemist Louis Pasteur demonstrated something interesting. If the fluids susceptible to fermentation and putrefaction were kept free from contact with air, they were kept fresh. It revealed that grape juice was fermented due to tiny living particles (microbes) that could be transported in the air.
Lister came up with it immediately. By interposing an antiseptic shield between a wound and the environment, septic complications could be prevented.
Lister decided to experiment with a patient, James Greenless. He decided to use an antiseptic substance. It was used to clean the sewer in the city of Carlisle. It was available as a 5% carbolic acid solution. He arranged that hands, clothing, surgical instruments, and wounds should be washed with that chemical.
Changing bandages
At the end of the operation, he applied a bandage bathed in carbolic acid. He ordered that the dressing be renewed several times as the days passed. The wound healed very well.
It happens that the usual thing was not to change the bandages. Dirty rags were sometimes used, inclusive. They all circulated freely in the operating rooms. Surgeons rarely cleaned surgical equipment. They did not wash their hands before operations.
Joseph Lister, the doctor who washed his hands, treated 11 other cases. Nine were cured without infection. He then published an article in The Lancet titled "A New Method for Treating Compound Fractures." It marked the birth of modern surgery.
Lister described the positive results for his patients. Extremities "that would certainly have been doomed to amputation" due to the probability of infection "can be retained with the confidence of obtaining the best results."
Changing concepts
With his method, abscesses could be drained. Incisions, heal, and hospitals, become healthier places. At first, Lister's antiseptic approach had a mixed reception.
He was highly praised in Germany and in most other countries, but not so much in the United States or England. By 1890, the entire world had embraced Lister's great innovation. The microbes causing the sepsis had been identified and cultured. At the end of that decade, Lister's antiseptic methods led to aseptic surgery and the introduction of sterile instruments in operating rooms. In 1898 the use of rubber gloves and the surgeon's hand washing were de rigueur.
Joseph Lister, the doctor who washed his hands, was the first to apply Pasteur's principles to humans. He made several other contributions to medical science. For the first time, it isolated bacteria in pure culture (Bacillus lactis). He pioneered the use of catgut and rubber tubes for wound drainage, among other things.
He is remembered primarily as the innovator who revolutionized the history of surgery, dividing it into two eras. The one before and the one after him.
