Operating areas of hospitals were a gory, infectious mess until Joseph Lister thought to take the fight to germs. The only place you’d expect to encounter the “unmistakable smell of rotting flesh” these days would be at a slaughterhouse. In Victorian London, you’d find it in an operating room. A “surgeon, wearing a blood-encrusted apron, rarely washed his hands or his instruments and carried with him … the unmistakable smell of rotting flesh . . . cheerfully referred to as ‘good old hospital stink,’ ” writes Lindsey Fitzharris, author of “The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine,” out now. At the time, the medical community was unaware of the existence of germs and didn’t know how infectious diseases were passed on. As a result, cleanliness was not a factor in surgery, leading to gruesome sights and harrowing results. Surgeons — then regarded as low-status workers and often paid less than the men employed to pick lice off hospital beds — didn’t bother cleaning the blood and guts from surgical tables or their instruments between operations. No one in the operating theater wore gloves, and “it was not uncommon to see a medical student with shreds of flesh, gut or brains stuck to his clothing.” Joseph Lister Hospitals were so deadly that surgeries done at home — usually on one’s kitchen table — had a much greater survival rate than those done in a house of medicine. In 1852, Joseph Lister was the young house surgeon at London’s University College Hospital. While dealing with an outbreak of gangrene, then common in hospitals, he noticed that when he cleaned his patients’ ulcers — an unusual practice at the time — they had a much higher incidence of recovery. Eliminating hospital infections became his obsession. He traveled throughout Europe to see how other hospitals handled the issue and conducted his own research. His breakthrough came when he learned about the work of Louis Pasteur. The year before, Pasteur wrote about how germs affected the human body. At the time, few in the medical community took him seriously, disbelieving that these invisible so-called “germs” existed. For Lister, though, Pasteur’s theories opened a crucial door. “Initially, he focused on the parts of Pasteur’s research that confirmed for him a view he already held: that the danger was present in the air around the patient,” Fitzharris writes. But eventually “Lister took away from Pasteur’s work the idea that it wasn’t the air as such but its constituent of microbial life that was the source of hospital infection.” With this realization, Lister “turned his attention to finding a means of destroying microorganisms within the wound itself before infection set in.” Surgeons had used antiseptics to treat wounds, but only after infection was already present. Lister tried them for prevention. He used several concoctions that were popular with surgeons at the time, such as potassium permanganate, but had little success. The answer came when he read that “engineers at a sewage works in Carlisle had used carbolic acid [a derivative of coal tar] to counteract the smell of rotting garbage.” He secured a large supply of the material and had his first successful test in August 1865. An 11-year-old boy named James Greenlees had one of his legs crushed by a metal-wheeled cart. By the time he was rushed into surgery, with his bone sticking through his skin, the wound had filled with dirt, as the boy had to be carried across town to the hospital. Lister immediately cleaned the boy’s wound with carbolic acid and changed the dressing every few hours for several days. Six weeks later, Greenlees walked out of the hospital, his leg fully repaired and with no infections. Lister tried the same method on numerous patients in the months to come, and none developed infections. His carbolic-acid solution worked. At first, Lister’s cure was met with steep resistance from the medical community. Some doctors claimed his method didn’t work, while to others it required too much effort. But Lister stuck to his guns, perfecting his method over time, and by 1871 his antiseptic regimen had gained acceptance to the point that he was summoned by Queen Victoria to remove a tumor from her arm. In time, he was named the queen’s personal surgeon and even knighted. His method spread across Europe throughout the 1870s. He came to America in 1876 to promote it, and it was soon adopted here as well. Lister died in February 1912 at the age of 84, but his impact today remains as notable as ever. Listerine, named after him, was initially developed for multiple antiseptic uses by Dr. Joseph Joshua Lawrence, who attended one of his lectures in the US. By coincidence, another man who attended the same lecture, Robert Wood Johnson, was equally inspired, and joined with his two brothers to create a company “to manufacture the first sterile surgical dressings and sutures mass-produced according to Lister’s methods.” That company was Johnson & Johnson. Source
