At the royal college of Physicians
and surgeons of Glasgow
and surgeons of Glasgow
One of the main dangers of surgical procedures, the infection of wounds, is caused by the presence of contaminating germs in the clinical environment. However, this fact was not discovered until the late 19th century. Up to this point, clinicians and scientists alike had no solid evidence as to why some patients would die after an operation.
Surely influenced by his scientific father, Joseph Jackson Lister (who helped to improve the resolution of microscope lenses), Lister was one of the few surgical men of the time who owned a microscope. Thankfully, Lister had an inquisitive mind and was performing his own experiments into the germ theory to confirm the findings of French chemist, Louis Pasteur.
Lister's first case was that of a young boy by the name of James Greenlees in 1865. James had suffered an injury to his leg after being run over by a cart in the street, and was escorted to the Glasgow Royal Infirmary where Lister was house surgeon. His tibia had been fractured and part of the bone had broken through the skin - this meant that the wound was exposed to the air and germs within the environment.
It was all too clear that Lister had to act fast not only to save this boy's leg, but his life. He had read previously of the use of carbolic acid on sewage in Carlisle, which had reduced the smell of the sewage and had eradicated the worms that usually flowed from the sewage into local pastures. Lister made the decision to experiment with soaking wound dressings in a solution of carbolic acid to prevent suppuration. After setting James' fracture, he dressed and bandaged the wound under antiseptic conditions and had his staff regularly change the dressings.
Lister was convinced that germs that could contaminate the wounds of patients were present in the atmosphere of the surgical theatre and wards. He not only wanted to get rid of the presence of germs in wounds, but also the germs in the air. The carbolic spray was used to pump carbolic acid solution into the atmosphere of the surigcal theatre during an operation. Lister used this device from 1870s-1890s.
The spray would be operated by an assistant to the surgeon. Carbolic solution would be placed in the glass beaker connected to the spray and the water container would be filled. In order to boil the water in the container, the spirit burner at the base of the spray would be lit. As the water boiled, pressure would build in the container, drawing up the acid from the glass beaker through the connecting tube. The assistant would then use the wooden handle to pump the spray solution into the atmosphere.
As well as sterilising the air, Lister wanted the surgical instruments and hands of the practitioners to be clean too. Any surface that could be contaminated had to be covered in antiseptic solution. Practitioners would wash their instruments and their hands with the carbolic solution, which was a corrosive and irritant. As a result, you could tell by the state of a practitioner's hands if they followed Lister's antiseptic principle or not, as their hands would most likely be damaged from the acid.
Lister used this method of sterilisation for some time, but eventually abandoned the instrument.