- Education and Science
The True Heroes of Clean Medicine
Before the Medical Revolution
Prior to 1857 very little was known about the origin of different diseases. Simple hygienic practices like hand washing and changing surgical gowns and aprons between patients were oftentimes discarded as unimportant. It was a time when medical professionals considered the idea that diseases could be spread through physical contact and bodily fluids was an irrational belief.
Common sense hygienic practices that many of us take for granted in the 21st century, must be credited to these three historical heroes: Ignaz Semmelweis, Louis Pasteur, and Joseph Lister. For without these great figures in medicine, several of our families would not exist today, having perished to the destructive forces of common, controllable illness.
In 1840 while working in an obstetrics ward (where babies were delivered) of a Vienna hospital, Dr. Ignaz Semmelweis observed that midwives who frequently washed their hands between cases with their patients experienced a significantly lower rate of the transmission of puerperal fever when compared to their colleagues (mostly physicians), who didn't practice hand washing.
Semmelweis correlated his observation of the midwives who washed their hands and the physicians who didn't with infection rates, and devoted many years to convincing his colleagues to raise their standard of practice. This was ineffective for him because during these times people believed that disease was caused by spontaneous generation, which is the belief that sickness just happens, and potentially living particles spring to life without reason.
Unfortunately he was dismissed from his position as a physician, and placed in an institution for the mentally ill, where he remained until the day of his untimely death.
In the 1860s Louis Pasteur decided to conduct an experiment that would test the conditions of microbial growth in a controlled environment. Pasteur filled several flasks with boiled beef broth; some of the flasks were left open and the uncovered flasks were soon contaminated, thriving with bacteria and other germs. Pasteur proceeded with his experiment by using flasks with the necks bent in the shape of an “S”. He boiled the beef broth again, and allowed it to cool in the modified flask. He found that while the airborne microbes became trapped in the groove of the “S” shape, his broth was left free of contamination.
Because of Pasteur’s experiments, science and medicine officially recognized that disease causing microorganisms could not be spontaneously generated, but instead are spread by direct contact from a substance to a surface, or through air pollution.
The first principles of aseptic technique in the surgical environment were developed by Joseph Lister in the late 1860s, a man who understood the significance of the observations of his colleagues and mentors. Aseptic technique is the medical term and practice of preventing the spread of infectious organisms.
Lister used carbolic acid (phenol) to kill microorganisms by placing phenol-soaked dressing directly on patients’ surgical wounds, and used it as an antiseptic by using it to cleanse the patient’s skin with it before surgery. Not only does it kill microorganisms, an antiseptic prevents the growth of pathogens, aka disease causing microbes. In addition to using phenol as a wound dressing, Lister’s surgical team would use a phenol based hand scrub before a procedure, and use the same solution as a sterilant aerosol , spraying it over the surgical field.
Lister’s other contributions to aseptic technique included: wearing gloves during surgery, changing gowns and aprons between cases, and cleaning and disinfecting surgical instruments by boiling them before every new case. He realized that by killing microbes he was effectively reducing the infection rate among his patients, saving their limbs and their lives.
Microbiology For the Surgical Technologist
Price, P. & Frey, K.. "Microbiology for the Surgical Technologist." Text, 2003. Pages 4-9.