Surgery 1845 - 1918, Joseph Lister and Carbolic Spray

James Simpson with his use of chloroform as an anaesthetic had overcome one of the major problems of surgery in the 19th century and that was pain. But patients were still becoming infected, their wounds were getting gangrenous or they were getting blood poisons, which was leading to deaths. There had been some doctors like Ignaz Semmelweis who realised that if you wash your hands before you go and help a woman give birth, that actually that woman and the baby had a much greater chance of surviving. But Ignaz was dismissed as a lunatic and it wasn't until Pasteur published his germ theory in 1861 that any real progress was made in this area. Joseph Lister, whose father had been a doctor who had done a lot of work developing microscopes, he was greatly inspired by Pasteur's germ theory and he thought that if all of these invisible bacteria in the air were causing this to make it difficult to deal with, he looked at how sewage was being treated and how they were reducing the smell in sewage with something called carbolic spray and he thought that maybe this carbolic spray could be used to kill these invisible germs and so he introduced this into the operating theatre with amazing results. Practically all of his patients stopped dying of infection. But his ideas met with opposition. What a surprise! First of all there was the smell of the carbolic spray which lots of surgeons objected to and it would dry their hands out and crack their skin which they didn't like either. It also increased the expense of an operation because these surgeons were operating privately weren't they? That was a key factor. There was also the tradition that a skilful surgeon would be quick and a surgeon would be speedy and clearly with introducing the carbolic spray it greatly slowed down procedures. And also surgeons said that it was accepted that many of their patients would die and when Lister's patients weren't dying they just didn't believe his results. So again, Joseph Lister's ideas were slow to catch on. In 1878, a German doctor called Koch, he actually proved that it was bacteria that was causing septicemia, it was causing the blood poisoning and so this research greatly helped Joseph Lister's cause. As were some incredibly successful surgeries happening using antiseptic surgeries such as the first appendix being removed and also being able to operate on the heart. By the 1890s, this antiseptic surgery, so spraying this spray to kill the germs, was turned into aseptic surgery, creating an environment where germs didn't exist and making sure that all tools that were used on the workbenches were sprayed properly to kill germs in the first place. Everything was done thoroughly and the doctors began to wear gloves even as they washed their hands and put their fingernails and so creating a bleeding, germ-free environment.