Surgery

The development of anesthesia cleared the way for more ambitious types of surgery and more careful surgical endeavors. Without the need to operate so quickly, surgeons could focus on operating more carefully. Yet surgery still had not entered the modern era, for infection continued to make recovery treacherous.

Patients who survived surgery in the middle nineteenth century continued to face frightening odds of dying from infection. An 1867 report noted that 60% of patients who received a major amputation in a Paris hospital died. Physicians routinely plunged their unwashed hands inside the body and often wore the same outfit for repeated surgical operating, unknowingly passing one patient's germs on to the next.

Ignorance about the nature of germs lead to drastic surgical measures. For example, individuals with compound fractures, in which the bone protruded through the skin, faced serious risk of infection and death in the early nineteenth century. To avoid infection, surgeons often amputated the limb.

Joseph Lister (1827-1912), the British surgeon who is credited with bringing antiseptic surgery to medicine, drew upon the work of his French contemporary, Louis Pasteur (1822-1895). Pasteur observed that germs could be present in the air and on certain surfaces. Lister was the first to apply Pasteur's observation to surgery.

Lister shook the medical world with his use of carbolic acid on compound fracture wounds after surgery. Because surgery for such fractures had a high rate of infection, Lister's report of success with nine out of 11 patients in 1867 was a dramatic finding. Cheered by the success of this effort, Lister continued his drive to remove germs from surgery. His efforts included immersing surgical instruments in a carbolic acid solution, requiring surgical assistants to wash their hands in soap and water, and careful washing of the area to be operated upon.

The success of the sterile surgical technique transformed surgery, over time, from a risky endeavor to one which carried a low risk for most procedures. The new safety of surgery made the practice more familiar, less risky, and far more open to innovation.

A third discovery helped clear the way for the dramatic surgical developments of the twentieth century. This was the finding by immunologist Karl Landsteiner (1868-1943) that blood varied by blood group types. Landsteiner, who received the Nobel Prize in 1930 for his work, described four different blood groups. Knowledge about the compatibility of certain blood types and the incompatibility of others, enabled the development of safe blood transfusions during surgery.