The Invention of Antiseptics

An antiseptic is a substance that prevents the growth of germs. Ignaz Semmelweiss was the first modern physician to realize that a simple act, such as doctors washing their hands, could lead to lower infection rates, but Joseph Lister was the one who made the connection between washing hands in chemicals, such as bleach or carbolic acid, and the eradication of germs. The invention of antiseptics was an important moment in the history of medicine, making surgery possible.

Ignaz Semmelweiss's Study of Infection

• Semmelweiss, a Hungarian obstetrician working at Vienna General Hospital, made a study of the outcome of births at his hospital. The study revealed that 20 percent of women who gave birth died from puerperal fever when a doctor performed the delivery. When treated by a midwife, only one out of 30 women died from the infection. Although Louis Pasteur had not yet proposed the germ theory of disease, Semmelweiss realized that one difference between the doctors and midwives was that doctors would treat several patients in a row, while midwives would deliver one baby and then go home. Medical students in particular concerned Semmelweiss, because they would show up for rounds at the hospital after having performed dissections on cadavers for their anatomy class. He feared that the blood and tissue on their hands, not always completely washed off, was contributing to infection.

Semmelweiss and Hand Washing

• Acting on this theory, Semmelweiss asked doctors to wash their hands with a chemical containing bleach, and the fatality rate of women who giving birth dropped to 1 out of 60. When Hungary rebelled against Austrian rule in 1849, sentiment against Hungarians ran high. Semmelweiss was let go and the policy of hand washing ended at the Vienna hospital.

The Role of Lister

• Lister was a surgeon in Glasgow in the 1860s when he read both Semmelweiss's report of the effects of hand washing and an article about Pasteur's germ theory. He apprehended that Semmelweiss's hand washing policy with a chemical such as bleach might have killed the germs that led to infection. Lister began wrapping wounds with a bandage that had been soaked with carbolic acid and discovered that post-treatment fatalities from infections such as sepsis declined. Lister reported his results in an 1867 issue of "The Lancet," and other doctors eventually followed Lister's example and even improved upon Lister's methods.

Subsequent Developments

• A New York doctor named William Halsted began washing his hands with carbolic acid and required his nurse to do the same after reading Lister's report. His nurse complained of the effect of the harsh chemical on her skin, and he asked Goodyear to make her thin rubber gloves. Physicians such as Ernst von Bergmann and Pasteur reported that cleaning surgical instruments with steam or heat from a flame could also lower infection rate.

Significance

• The introduction of antiseptics made surgery a viable method of treatment. Prior to antiseptics, surgeons operated only when no other treatment was possible, because surgery so often led to infection and death.