Joseph Lister

[YankeeSergeant]

When did Dr. Lister's theories on sterilization become widely accepted? I know they were being practice in the U.K. in 1881 when President Garfield was shot, but not widely in the U.S. Would doctors been practicing them as early as 1863? Doing edits on my Jack the Ripper novel and just came across what might be a glaring mistake historically. Thanks in advance!

[Pcdunn]

https://en.m.wikipedia.org/wiki/Joseph_Lister,_1st_Baron_Lister

Lister championed the use of antiseptics as early as 1867 in an article detailing his experience with carbolic acid applied directly to wounds, and the effects of spraying surgical instruments, incisions, and dressings with a solution of carbolic acid. His most notable success had been in August 1865 in Glasgow.
From 1869 on his fame spread, as he lectured and experimented with the design of surgical instruments without porous materials for handles.

Among his surgical advancements was repairing kneecaps with wire.

It looks as if 1863 is too early for doctors to have been widely practicing antiseptic procedures, as instructed by Lister. Carbolic acid had been discovered in the 1830s, but Lister was the first to experiment with its use on wound sites and medical dressings. There was resistance to the "germ theory of disease", supposed since the 16th century, but 19th century doctors prior to Lister's work in the 1870s believed the "miasma" of the air was the source of contamination. Even Lister himself thought the main danger to patients stemmed from the air.

[Errata]

A good rule of thumb might be publication date + 10 years, so that would be 1877 for mainstream use.

[Ginger]

I know that during the American Civil War (1861-65), there was no real effort made to keep surgical instruments clean. There was a quasi-government agency called the Sanitary Commission in charge of military hospitals, but their efforts at sanitation ran more toward making sure that buildings were well ventilated, and that wounded and sick soldiers got wholesome food and were kept clean and comfortable. If there were American doctors in 1863 who knew of and accepted the germ theory of disease, they were thin on the ground.

[Rosella]

Lister's theories travelled very slowly. In the Franco-Prussian war (1870-71) the French amputated some 13,200 limbs, with 10,000 gangrene and fever deaths-a mortality rate of 76%.

In the book 'The Greatest Benefit to Mankind' (a medical history) it states that a convert to sterilisation, Dr Halstead, had to operate in marquees in the gardens of New York's Bellevue Hospital in the 1880's because his colleagues objected to the carbolic fumes! He himself did not wear rubber gloves though his nurse assistants did.

[Ginger]

I just saw this as well, which may be relevant - http://www.smithsonianmag.com/scienc...ine-180955626/

[Errata]

I think battlefield amputations are a bad measure of surgical sterility. Even today in battlefield conditions people get amputations without the surgeon having washed or switched to sterile instruments. If it's a compromised surgical field or death, they go with the compromised surgical field. They didn't have the sterility options and disposables we have now. So a French doctor might practice sterile surgery in the comfort of a hospital, but may not have the option in the field. And remember they had no idea how to treat shock back then, so they had to work quickly, and could not afford to wait for "cleanly".

[GUT]

I think battlefield amputations are a bad measure of surgical sterility. Even today in battlefield conditions people get amputations without the surgeon having washed or switched to sterile instruments. If it's a compromised surgical field or death, they go with the compromised surgical field. They didn't have the sterility options and disposables we have now. So a French doctor might practice sterile surgery in the comfort of a hospital, but may not have the option in the field. And remember they had no idea how to treat shock back then, so they had to work quickly, and could not afford to wait for "cleanly".

So true.

Even now some battlefield surgery is, lets just say in less than optimal conditions. Better to risk infection than face near certain death by waiting.