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The History of Antiseptic Surgery

  • Writer: FibonacciMD
    FibonacciMD
  • 17 minutes ago
  • 3 min read

and the Contributions of Louis Pasteur and Joseph Lister

Explore the groundbreaking work of Louis Pasteur and Joseph Lister, whose pioneering contributions to germ theory and antiseptic surgery transformed medicine and saved countless lives.


Up until the mid-1800s it was believed that living things, such as microbes, could arise from inanimate matter in a process known as spontaneous generation. There was also the miasma theory that stagnant, foul-smelling air carried disease.

Louis Pasteur
Louis Pasteur

Louis Pasteur, a leading French scientist, believed in germ theory and wanted to disprove spontaneous generation and miasma as causes of disease.  He did so with a now famous experiment.


In his first experiment he boiled bacteria-filled broth in a normal shaped flask and saw, when viewed under a microscope, that the boiling had killed off the bacteria.  When the flask was stoppered no bacteria ever grew in the flask.  However, when the plug was removed, bacteria returned to the broth.  He believed he had proven germ theory, but people who believed in miasma theory gave a counter explanation which was that the stopper had not allowed air in and that could explain the lack of organisms in the stoppered flask.


Swan-neck flask used by Louis Pasteur
Swan-neck flask used by Louis Pasteur

It was then that Pasteur invented the swan-neck flask.  The curvature of the neck allowed air in, but the swan-neck prevented any outside materials from entering.  In that flask nothing grew after initially boiling the broth.  In a second flask the swan-neck was broken off which allowed both air and material from the air to enter.  Bacteria grew in that flask.  Thus, with this elegant experiment, Pasteur proved germ theory and reputed miasma and spontaneous generation theories.  Disease prevention transformed from trying to suppress odors in the air to identifying bacteria that could cause disease and working on improving public sanitation.   


Joseph Lister
Joseph Lister

Joseph Lister was a prominent British surgeon who lived from 1827 to 1912.  In the 1800s wound sepsis was a leading cause of death with mortality rates after surgical procedures being as high as 40-50%.  Surgeons frequently did not wash their hands between cases and wore blood-soaked clothes into surgeries.  Lister was interested in decreasing infectious operative complications and was influenced and intrigued by Pasteur’s findings and proof of germ theory.  He hypothesized that wound infections were caused by bacteria in the air.


In 1865, Lister used carbolic acid, also known as creosote, to disinfect compound fractures (fractures open to the skin that have a high likelihood of becoming infected). He first treated an 11-year-old boy by inserting a carbolic acid pad in the wound.  Over the next two years he treated 11 more compound fractures with carbolic acid.  The results were published in The Lancet medical journal.  Only one of the patients got an infection and needed an amputation.  In 1867, he started using carbolic acid lotion in wounds during surgery and applied carbolic acid paste to the outside of the sutured wound.  In 1867, he reported that he had had no sepsis cases for nine months.


Based on his experience he advised surgeons to wear clean gloves, and to wash their hands and surgical instruments using a 5% carbolic acid solution.  He also advised not using porous materials in the handles of surgical instruments as they could carry bacteria.  In 1871, Lister started spraying the operating room with a 1:100 carbolic acid solution in an attempt to kill germs there.  As carbolic acid was later found to damage living tissue, Lister started reducing the strength of carbolic acid he was using.


Between 1864 and 1866, 46% of Lister’s surgical patients died.  From 1867 to 1870, only 15% died.  By 1910, using Lister’s techniques, operative mortality rates at King’s College London, where Lister had previously been the Chair of Clinical Surgery, were reduced to 3%.  Joseph Lister has been called both “the father of modern surgery” and the “father of antiseptic surgery”.


Pasteur and Lister revolutionized the understanding of disease processes and the delivery of health care.  Their contributions have saved countless lives.




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