WEBVTT
00:00:09.919 --> 00:00:14.480
An 11-year-old boy is carried into a ground floor ward in Glasgow.
00:00:14.720 --> 00:00:20.239
The wheel of a cart has crossed over his left leg, and the shin bone has come through the skin.
00:00:20.480 --> 00:00:27.519
In this ward, by the surgeon's own count, close to half of all amputation cases end in death.
00:00:27.760 --> 00:00:30.320
But the surgeon does not send for the saw.
00:00:30.480 --> 00:00:33.520
He sends for a bottle of sewage disinfectant.
00:00:34.560 --> 00:00:37.039
Welcome to Same Day Different Century.
00:00:37.200 --> 00:00:38.159
I'm Zack.
00:00:38.320 --> 00:00:40.320
Today is August 12th.
00:00:41.200 --> 00:00:43.439
The year is 1865.
00:00:43.920 --> 00:00:48.560
The boy is James Greenlease, and the surgeon is Joseph Lister.
00:00:49.039 --> 00:00:58.320
38 years old, an Englishman holding the Regius Chair of Surgery at the University of Glasgow, with charge of two wards at the Royal Infirmary.
00:00:58.640 --> 00:01:09.120
Ward 24 is the male accident ward, and Lister has spent four years there watching patients endure his operations, only to die shortly afterward.
00:01:09.519 --> 00:01:13.040
That was the central fact of surgery in the 1860s.
00:01:13.359 --> 00:01:14.799
Pain had been solved.
00:01:15.040 --> 00:01:25.840
Ether arrived in 1846, chloroform the year after, and the man who introduced chloroform, James Young Simpson, was still practicing in Edinburgh.
00:01:26.159 --> 00:01:30.319
Surgeons no longer had to work in seconds against a conscious patient.
00:01:30.560 --> 00:01:34.159
They could take their time, cut deeper, and attempt more.
00:01:34.400 --> 00:01:36.879
This led to the death of more patients.
00:01:37.519 --> 00:01:46.799
The killers had names paemia, Ericipolis, Hospital Gangrene, and the general blood poisoning they called septicemia.
00:01:47.120 --> 00:01:51.280
Wounds that looked clean on Monday would be discharging by the end of the week.
00:01:51.519 --> 00:02:02.079
Lister later reported that in the years before he changed anything, somewhere between 45 and 50% of the amputation cases in his ward died of sepsis.
00:02:02.400 --> 00:02:07.120
In the largest city hospitals of Europe, the picture was similar or worse.
00:02:07.359 --> 00:02:12.719
Surgery inside a hospital was more lethal than surgery in a farmhouse kitchen.
00:02:13.199 --> 00:02:16.719
Compound fracture was where that danger became a decision.
00:02:16.960 --> 00:02:22.080
A closed fracture, bone broken but skin intact, usually healed.
00:02:22.400 --> 00:02:26.719
Break the same bone so that it pierced the skin, and the odds inverted.
00:02:26.960 --> 00:02:36.639
The standard treatment for a compound fracture of the leg was amputation, on the reasoning that a smaller controlled wound was survivable where the ragged one was not.
00:02:36.879 --> 00:02:44.000
So the realistic choice in front of Lister that August day was to take an 11-year-old's leg and then hope for the best.
00:02:44.479 --> 00:02:48.879
Why open wounds rotted and closed ones didn't was contested.
00:02:49.120 --> 00:02:53.199
Some held it was miasma, a poison in foul air.
00:02:53.439 --> 00:02:59.439
Others argued that oxygen itself decomposed exposed tissue, the way that meat spoils.
00:02:59.919 --> 00:03:01.680
Neither theory was foolish.
00:03:01.919 --> 00:03:05.120
Both fit the observation that air was the variable.
00:03:05.360 --> 00:03:08.960
What neither theory offered was a solution for the surgeons.
00:03:09.439 --> 00:03:14.960
Lister thought he had found something a surgeon could do, and he had been rehearsing it for months.
00:03:15.280 --> 00:03:17.280
The route ran through a chemist.
00:03:17.439 --> 00:03:28.400
Around 1864, Thomas Anderson, Glasgow's professor of chemistry, pointed Lister to the recent work of Louis Pasteur on fermentation and putrefaction.
00:03:28.719 --> 00:03:35.840
Pasteur's argument was that decay was not a chemical property of air, but the work of living organisms carried in it.
00:03:36.159 --> 00:03:38.159
That distinction was everything.
00:03:38.400 --> 00:03:43.840
If oxygen caused wound rot, nothing could be done, because wounds must be exposed.
00:03:44.000 --> 00:03:47.520
But if organisms caused it, they could be killed.
00:03:48.000 --> 00:03:51.199
Lister was unusually prepared to take that literally.
00:03:51.439 --> 00:04:06.719
His father, Joseph Jackson Lister, was a wine merchant and amateur microscopist who in 1830 published a method of combining lenses that stripped color distortion out of the compound microscope, the advance that made serious cell biology possible.
00:04:06.960 --> 00:04:10.879
Lister had grown up around instruments built to resolve the invisible.
00:04:11.120 --> 00:04:18.319
When Pastor described organisms too small to see, Lister of all people was unlikely to doubt they were real.
00:04:18.959 --> 00:04:24.720
Pastor killed his organisms three ways heat, filtration, and chemicals.
00:04:24.959 --> 00:04:28.560
Heat and filtration are no use on a boy's shin bone.
00:04:28.720 --> 00:04:30.399
That left the chemical.
00:04:30.800 --> 00:04:38.000
The town of Carlisle, south of the border, had been treating its sewage with carbolic acid, a coal-tar derivative.
00:04:38.240 --> 00:04:40.399
The reports noted two effects.
00:04:40.639 --> 00:04:48.319
The stench dropped, and cattle, grazing on fields irrigated with the treated waste, stopped picking up parasites.
00:04:48.560 --> 00:04:52.399
Something in the acid was killing living things in organic filth.
00:04:52.639 --> 00:04:54.720
Anderson obtained a supply.
00:04:55.120 --> 00:05:02.560
Lister's first attempt was in March 1865, by most accounts on another compound fracture, which failed.
00:05:02.720 --> 00:05:12.959
He said so plainly in print two years later, blaming the outcome, as he then believed, on improper management, meaning his own technique, not the principle.
00:05:13.600 --> 00:05:15.839
On August 12th, he tried again.
00:05:16.079 --> 00:05:22.079
He cleaned the wound, set the fracture, and applied lint soaked in undiluted carbolic acid.
00:05:22.319 --> 00:05:28.399
Over the lint he placed a sheet of thin tin, to slow evaporation and keep the acid working.
00:05:28.639 --> 00:05:31.199
He then placed a splint and a bandage.
00:05:31.360 --> 00:05:34.160
The logic was not that carbolic healed anything.
00:05:34.399 --> 00:05:36.800
The logic was that the dressing was a barrier.
00:05:37.120 --> 00:05:43.360
Destroy whatever had already entered the wound, then keep the wound sealed against whatever else was in the ward.
00:05:43.920 --> 00:05:46.399
Four days later he lifted the dressing.
00:05:46.560 --> 00:05:48.399
There was no pus or smell.
00:05:48.560 --> 00:05:50.720
There was, however, one problem.
00:05:51.120 --> 00:06:00.959
The undiluted acid had burned the skin around the wound, so he weakened the solution for subsequent dressings, an adjustment he would go on making for the rest of his career.
00:06:01.199 --> 00:06:04.319
The dressings were renewed, the bone knit.
00:06:04.560 --> 00:06:11.920
About six weeks after the cart ran him down, James Greenlease walked out of the Glasgow Royal Infirmary with both legs.
00:06:12.240 --> 00:06:16.240
But one case proves nothing, and Lister did not publish.
00:06:16.480 --> 00:06:27.519
He kept treating compound fractures the same way for nearly two years, and only in the spring of 1867 did he lay out the results in a series of articles in the Lancet.
00:06:27.759 --> 00:06:36.160
11 cases, 9 healed without infection, 1 amputation, and 1 death from a hemorrhage unrelated to sepsis.
00:06:36.480 --> 00:06:42.800
He described carbolic acid as the most powerful antiseptic with which surgeons were at present acquainted.
00:06:43.040 --> 00:06:47.519
A phrase that quietly conceded it might not be the best one forever.
00:06:47.839 --> 00:06:49.839
The chemical was replaceable.
00:06:50.079 --> 00:06:51.920
The claim underneath it was not.
00:06:52.160 --> 00:06:57.439
Wound infection had an external living cause and could therefore be blocked.
00:06:57.839 --> 00:07:02.079
That claim was what the profession spent the next 20 years fighting about.
00:07:02.319 --> 00:07:05.680
The first attack came fast, and from Edinburgh.
00:07:05.920 --> 00:07:12.160
In September 1867, a letter signed Kirurgicus appeared in the Edinburgh Daily Review.
00:07:12.399 --> 00:07:14.800
The author was James Young Simpson.
00:07:14.959 --> 00:07:28.399
Simpson followed it with a signed article arguing that Lister had discovered nothing, that carbolic acid and surgery had already been described by Jules Lemaire, a Paris pharmaceutical chemist in a book published in 1863.
00:07:29.120 --> 00:07:33.360
Simpson was substantially right on the facts and wrong on their meaning.
00:07:33.600 --> 00:07:36.240
Others had used carbolic acid on wounds.
00:07:36.480 --> 00:07:40.160
Lister had never heard of Lemaire and had to hunt down a copy.
00:07:40.399 --> 00:07:50.959
What Lister added was not the substance but the system built on a causal theory, a reason to use it, a way to use it, and a prediction about what would happen if you stopped.
00:07:51.360 --> 00:07:54.560
Simpson had his own explanation and his own remedy.
00:07:54.800 --> 00:08:05.120
He would spend the next two years documenting hospitalism, arguing that large overcrowded hospitals were themselves the danger and that the answer lay in smaller buildings.
00:08:05.519 --> 00:08:11.519
The harder objections came from surgeons who tried Listerism and got worse results than Lister did.
00:08:11.759 --> 00:08:21.839
The regimen was fiddly and Lister revised it constantly, so a surgeon working from a published account was often following a version its author had already abandoned.
00:08:22.160 --> 00:08:30.639
The acid burned tissue, as Greenless's leg showed within four days, and in heavier use it sickened operators as well as patients.
00:08:31.120 --> 00:08:33.279
There was also a rival approach.
00:08:33.519 --> 00:08:33.919
At St.
00:08:34.080 --> 00:08:47.279
Bartholomew's in London, George Callender pursued plain, uncompromising cleanliness without the elaborate carbolic apparatus, and by the late 1870s, his patients had an operative mortality below 4%.
00:08:48.240 --> 00:08:51.919
In 1870, Lister published his comparison.
00:08:52.159 --> 00:08:56.960
Before antisepsis, 16 deaths in 35 amputations.
00:08:57.440 --> 00:09:00.240
After, six deaths in 40.
00:09:00.559 --> 00:09:03.840
Roughly 45% falling to 15.
00:09:04.320 --> 00:09:10.799
Lister himself acknowledged in print that the numbers were too small for a satisfactory statistical comparison.
00:09:11.679 --> 00:09:14.480
Adoption came from outside Britain first.
00:09:14.799 --> 00:09:18.720
German surgeons took up the method in the early 1870s.
00:09:18.960 --> 00:09:27.200
Richard von Volkmann most prominently, working wards crowded with infected wounds, and the results were dramatic enough to travel.
00:09:27.440 --> 00:09:31.360
Notably, they did not all accept the underlying biology.
00:09:31.600 --> 00:09:41.120
Volkmann called germ theory the parasitic hypothesis and observed that microorganisms still turned up in wound secretions under antiseptic treatment.
00:09:41.440 --> 00:09:48.480
Lister argued his case from ward conditions he described in 1870 as some of the most unhealthy in the kingdom.
00:09:48.720 --> 00:09:56.320
Wards were an excavation in 1867, turned up coffins from the cholera epidemic buried inches beneath the surface.
00:09:56.559 --> 00:10:02.960
He was claiming that if you controlled what enter the wound, even that ground could be operated on safely.
00:10:03.519 --> 00:10:07.039
And Lister's own conclusions kept moving with the evidence.
00:10:07.279 --> 00:10:13.120
From 1871, he used a carbolic spray to disinfect the air of the operating theater.
00:10:13.360 --> 00:10:22.799
By 1887 he had dropped it, and at the Berlin Congress in 1890, he told the assembled profession that he felt ashamed to have ever recommended it.
00:10:23.200 --> 00:10:28.799
Robert Koch's work had shown that airborne organisms were not the main route of wound infection.
00:10:29.039 --> 00:10:31.679
Hands, instruments, and dressings were.
00:10:32.000 --> 00:10:46.639
Within a decade, antisepsis was giving way to asepsis, steam sterilized instruments, boiled dressings, gowns, and before long, gloves, an operating field made clean rather than chemically poisoned.
00:10:46.879 --> 00:10:58.000
Every sterile field in every operating room today rests on the proposition he tested on one boy's leg that infection has a cause, and that cause can be shut out.
00:10:58.720 --> 00:11:00.879
That same day, different century.
00:11:01.120 --> 00:11:01.919
I'm Zach.
00:11:02.080 --> 00:11:05.039
We'll be back tomorrow with another date, another story.
00:11:05.279 --> 00:11:06.799
Thanks for listening.
00:00:09.919 --> 00:00:14.480
An 11-year-old boy is carried into a ground floor ward in Glasgow.
00:00:14.720 --> 00:00:20.239
The wheel of a cart has crossed over his left leg, and the shin bone has come through the skin.
00:00:20.480 --> 00:00:27.519
In this ward, by the surgeon's own count, close to half of all amputation cases end in death.
00:00:27.760 --> 00:00:30.320
But the surgeon does not send for the saw.
00:00:30.480 --> 00:00:33.520
He sends for a bottle of sewage disinfectant.
00:00:34.560 --> 00:00:37.039
Welcome to Same Day Different Century.
00:00:37.200 --> 00:00:38.159
I'm Zack.
00:00:38.320 --> 00:00:40.320
Today is August 12th.
00:00:41.200 --> 00:00:43.439
The year is 1865.
00:00:43.920 --> 00:00:48.560
The boy is James Greenlease, and the surgeon is Joseph Lister.
00:00:49.039 --> 00:00:58.320
38 years old, an Englishman holding the Regius Chair of Surgery at the University of Glasgow, with charge of two wards at the Royal Infirmary.
00:00:58.640 --> 00:01:09.120
Ward 24 is the male accident ward, and Lister has spent four years there watching patients endure his operations, only to die shortly afterward.
00:01:09.519 --> 00:01:13.040
That was the central fact of surgery in the 1860s.
00:01:13.359 --> 00:01:14.799
Pain had been solved.
00:01:15.040 --> 00:01:25.840
Ether arrived in 1846, chloroform the year after, and the man who introduced chloroform, James Young Simpson, was still practicing in Edinburgh.
00:01:26.159 --> 00:01:30.319
Surgeons no longer had to work in seconds against a conscious patient.
00:01:30.560 --> 00:01:34.159
They could take their time, cut deeper, and attempt more.
00:01:34.400 --> 00:01:36.879
This led to the death of more patients.
00:01:37.519 --> 00:01:46.799
The killers had names paemia, Ericipolis, Hospital Gangrene, and the general blood poisoning they called septicemia.
00:01:47.120 --> 00:01:51.280
Wounds that looked clean on Monday would be discharging by the end of the week.
00:01:51.519 --> 00:02:02.079
Lister later reported that in the years before he changed anything, somewhere between 45 and 50% of the amputation cases in his ward died of sepsis.
00:02:02.400 --> 00:02:07.120
In the largest city hospitals of Europe, the picture was similar or worse.
00:02:07.359 --> 00:02:12.719
Surgery inside a hospital was more lethal than surgery in a farmhouse kitchen.
00:02:13.199 --> 00:02:16.719
Compound fracture was where that danger became a decision.
00:02:16.960 --> 00:02:22.080
A closed fracture, bone broken but skin intact, usually healed.
00:02:22.400 --> 00:02:26.719
Break the same bone so that it pierced the skin, and the odds inverted.
00:02:26.960 --> 00:02:36.639
The standard treatment for a compound fracture of the leg was amputation, on the reasoning that a smaller controlled wound was survivable where the ragged one was not.
00:02:36.879 --> 00:02:44.000
So the realistic choice in front of Lister that August day was to take an 11-year-old's leg and then hope for the best.
00:02:44.479 --> 00:02:48.879
Why open wounds rotted and closed ones didn't was contested.
00:02:49.120 --> 00:02:53.199
Some held it was miasma, a poison in foul air.
00:02:53.439 --> 00:02:59.439
Others argued that oxygen itself decomposed exposed tissue, the way that meat spoils.
00:02:59.919 --> 00:03:01.680
Neither theory was foolish.
00:03:01.919 --> 00:03:05.120
Both fit the observation that air was the variable.
00:03:05.360 --> 00:03:08.960
What neither theory offered was a solution for the surgeons.
00:03:09.439 --> 00:03:14.960
Lister thought he had found something a surgeon could do, and he had been rehearsing it for months.
00:03:15.280 --> 00:03:17.280
The route ran through a chemist.
00:03:17.439 --> 00:03:28.400
Around 1864, Thomas Anderson, Glasgow's professor of chemistry, pointed Lister to the recent work of Louis Pasteur on fermentation and putrefaction.
00:03:28.719 --> 00:03:35.840
Pasteur's argument was that decay was not a chemical property of air, but the work of living organisms carried in it.
00:03:36.159 --> 00:03:38.159
That distinction was everything.
00:03:38.400 --> 00:03:43.840
If oxygen caused wound rot, nothing could be done, because wounds must be exposed.
00:03:44.000 --> 00:03:47.520
But if organisms caused it, they could be killed.
00:03:48.000 --> 00:03:51.199
Lister was unusually prepared to take that literally.
00:03:51.439 --> 00:04:06.719
His father, Joseph Jackson Lister, was a wine merchant and amateur microscopist who in 1830 published a method of combining lenses that stripped color distortion out of the compound microscope, the advance that made serious cell biology possible.
00:04:06.960 --> 00:04:10.879
Lister had grown up around instruments built to resolve the invisible.
00:04:11.120 --> 00:04:18.319
When Pastor described organisms too small to see, Lister of all people was unlikely to doubt they were real.
00:04:18.959 --> 00:04:24.720
Pastor killed his organisms three ways heat, filtration, and chemicals.
00:04:24.959 --> 00:04:28.560
Heat and filtration are no use on a boy's shin bone.
00:04:28.720 --> 00:04:30.399
That left the chemical.
00:04:30.800 --> 00:04:38.000
The town of Carlisle, south of the border, had been treating its sewage with carbolic acid, a coal-tar derivative.
00:04:38.240 --> 00:04:40.399
The reports noted two effects.
00:04:40.639 --> 00:04:48.319
The stench dropped, and cattle, grazing on fields irrigated with the treated waste, stopped picking up parasites.
00:04:48.560 --> 00:04:52.399
Something in the acid was killing living things in organic filth.
00:04:52.639 --> 00:04:54.720
Anderson obtained a supply.
00:04:55.120 --> 00:05:02.560
Lister's first attempt was in March 1865, by most accounts on another compound fracture, which failed.
00:05:02.720 --> 00:05:12.959
He said so plainly in print two years later, blaming the outcome, as he then believed, on improper management, meaning his own technique, not the principle.
00:05:13.600 --> 00:05:15.839
On August 12th, he tried again.
00:05:16.079 --> 00:05:22.079
He cleaned the wound, set the fracture, and applied lint soaked in undiluted carbolic acid.
00:05:22.319 --> 00:05:28.399
Over the lint he placed a sheet of thin tin, to slow evaporation and keep the acid working.
00:05:28.639 --> 00:05:31.199
He then placed a splint and a bandage.
00:05:31.360 --> 00:05:34.160
The logic was not that carbolic healed anything.
00:05:34.399 --> 00:05:36.800
The logic was that the dressing was a barrier.
00:05:37.120 --> 00:05:43.360
Destroy whatever had already entered the wound, then keep the wound sealed against whatever else was in the ward.
00:05:43.920 --> 00:05:46.399
Four days later he lifted the dressing.
00:05:46.560 --> 00:05:48.399
There was no pus or smell.
00:05:48.560 --> 00:05:50.720
There was, however, one problem.
00:05:51.120 --> 00:06:00.959
The undiluted acid had burned the skin around the wound, so he weakened the solution for subsequent dressings, an adjustment he would go on making for the rest of his career.
00:06:01.199 --> 00:06:04.319
The dressings were renewed, the bone knit.
00:06:04.560 --> 00:06:11.920
About six weeks after the cart ran him down, James Greenlease walked out of the Glasgow Royal Infirmary with both legs.
00:06:12.240 --> 00:06:16.240
But one case proves nothing, and Lister did not publish.
00:06:16.480 --> 00:06:27.519
He kept treating compound fractures the same way for nearly two years, and only in the spring of 1867 did he lay out the results in a series of articles in the Lancet.
00:06:27.759 --> 00:06:36.160
11 cases, 9 healed without infection, 1 amputation, and 1 death from a hemorrhage unrelated to sepsis.
00:06:36.480 --> 00:06:42.800
He described carbolic acid as the most powerful antiseptic with which surgeons were at present acquainted.
00:06:43.040 --> 00:06:47.519
A phrase that quietly conceded it might not be the best one forever.
00:06:47.839 --> 00:06:49.839
The chemical was replaceable.
00:06:50.079 --> 00:06:51.920
The claim underneath it was not.
00:06:52.160 --> 00:06:57.439
Wound infection had an external living cause and could therefore be blocked.
00:06:57.839 --> 00:07:02.079
That claim was what the profession spent the next 20 years fighting about.
00:07:02.319 --> 00:07:05.680
The first attack came fast, and from Edinburgh.
00:07:05.920 --> 00:07:12.160
In September 1867, a letter signed Kirurgicus appeared in the Edinburgh Daily Review.
00:07:12.399 --> 00:07:14.800
The author was James Young Simpson.
00:07:14.959 --> 00:07:28.399
Simpson followed it with a signed article arguing that Lister had discovered nothing, that carbolic acid and surgery had already been described by Jules Lemaire, a Paris pharmaceutical chemist in a book published in 1863.
00:07:29.120 --> 00:07:33.360
Simpson was substantially right on the facts and wrong on their meaning.
00:07:33.600 --> 00:07:36.240
Others had used carbolic acid on wounds.
00:07:36.480 --> 00:07:40.160
Lister had never heard of Lemaire and had to hunt down a copy.
00:07:40.399 --> 00:07:50.959
What Lister added was not the substance but the system built on a causal theory, a reason to use it, a way to use it, and a prediction about what would happen if you stopped.
00:07:51.360 --> 00:07:54.560
Simpson had his own explanation and his own remedy.
00:07:54.800 --> 00:08:05.120
He would spend the next two years documenting hospitalism, arguing that large overcrowded hospitals were themselves the danger and that the answer lay in smaller buildings.
00:08:05.519 --> 00:08:11.519
The harder objections came from surgeons who tried Listerism and got worse results than Lister did.
00:08:11.759 --> 00:08:21.839
The regimen was fiddly and Lister revised it constantly, so a surgeon working from a published account was often following a version its author had already abandoned.
00:08:22.160 --> 00:08:30.639
The acid burned tissue, as Greenless's leg showed within four days, and in heavier use it sickened operators as well as patients.
00:08:31.120 --> 00:08:33.279
There was also a rival approach.
00:08:33.519 --> 00:08:33.919
At St.
00:08:34.080 --> 00:08:47.279
Bartholomew's in London, George Callender pursued plain, uncompromising cleanliness without the elaborate carbolic apparatus, and by the late 1870s, his patients had an operative mortality below 4%.
00:08:48.240 --> 00:08:51.919
In 1870, Lister published his comparison.
00:08:52.159 --> 00:08:56.960
Before antisepsis, 16 deaths in 35 amputations.
00:08:57.440 --> 00:09:00.240
After, six deaths in 40.
00:09:00.559 --> 00:09:03.840
Roughly 45% falling to 15.
00:09:04.320 --> 00:09:10.799
Lister himself acknowledged in print that the numbers were too small for a satisfactory statistical comparison.
00:09:11.679 --> 00:09:14.480
Adoption came from outside Britain first.
00:09:14.799 --> 00:09:18.720
German surgeons took up the method in the early 1870s.
00:09:18.960 --> 00:09:27.200
Richard von Volkmann most prominently, working wards crowded with infected wounds, and the results were dramatic enough to travel.
00:09:27.440 --> 00:09:31.360
Notably, they did not all accept the underlying biology.
00:09:31.600 --> 00:09:41.120
Volkmann called germ theory the parasitic hypothesis and observed that microorganisms still turned up in wound secretions under antiseptic treatment.
00:09:41.440 --> 00:09:48.480
Lister argued his case from ward conditions he described in 1870 as some of the most unhealthy in the kingdom.
00:09:48.720 --> 00:09:56.320
Wards were an excavation in 1867, turned up coffins from the cholera epidemic buried inches beneath the surface.
00:09:56.559 --> 00:10:02.960
He was claiming that if you controlled what enter the wound, even that ground could be operated on safely.
00:10:03.519 --> 00:10:07.039
And Lister's own conclusions kept moving with the evidence.
00:10:07.279 --> 00:10:13.120
From 1871, he used a carbolic spray to disinfect the air of the operating theater.
00:10:13.360 --> 00:10:22.799
By 1887 he had dropped it, and at the Berlin Congress in 1890, he told the assembled profession that he felt ashamed to have ever recommended it.
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Robert Koch's work had shown that airborne organisms were not the main route of wound infection.
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Hands, instruments, and dressings were.
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Within a decade, antisepsis was giving way to asepsis, steam sterilized instruments, boiled dressings, gowns, and before long, gloves, an operating field made clean rather than chemically poisoned.
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Every sterile field in every operating room today rests on the proposition he tested on one boy's leg that infection has a cause, and that cause can be shut out.
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That same day, different century.
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I'm Zach.
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We'll be back tomorrow with another date, another story.
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Thanks for listening.
