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Unlock This CourseJoseph Lister's antiseptic method, from the 1860s, worked. Using carbolic acid on wounds, dressings and (from 1870) in a spray cut deaths from infection, and more surgeons began to use it. But it was a clumsy answer to the problem. Carbolic acid is a harsh chemical, and it caused trouble of its own.
Lister himself gave up the spray by about 1890, after deciding it was not needed. But the idea behind his work lived on, and it was taken a step further.
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By the 1880s, the work of Pasteur and Koch had shown how many different germs there were and how they spread. Scientists also knew that heat kills germs. Surgeons began to ask a simple question. Why spray germs with acid when you can stop them getting into the wound at all?
This was the idea of aseptic surgery. Instead of fighting germs in the middle of an operation, everything that touched the patient was made germ-free beforehand. Over about fifteen years, several changes came together.
In 1886 a German surgeon, Ernst von Bergmann, introduced steam sterilisation. Instruments, dressings and towels were heated in a steam steriliser before each operation, so no germs were left on them. Heat does the job without any harsh chemicals.
Many earlier surgeons wore ordinary clothes or an old coat stained with blood from past operations. By about 1900 surgeons wore clean gowns that had been sterilised, and washed their hands and arms carefully before operating.
A surgeon in Breslau, Johann von Mikulicz, began wearing a gauze mask over his nose and mouth in 1897. It helped stop germs from the surgeon's breath and spit landing in the patient's wound.
Around 1890 an American surgeon, William Halsted, had thin rubber gloves made. They protected his nurse's hands from the chemicals, and they also kept germs on the surgeon's skin out of the wound. Gloves spread over the following years.
Together these changes meant that the operating theatre itself became a clean, germ-free place. The patient's skin was cleaned and covered, the instruments were sterile and the team wore sterile clothing.
Aseptic methods made operations safer than ever before. Anaesthetics (which stopped pain) and asepsis (which stopped infection) together meant surgeons could work slowly and carefully, and fewer patients died of infection afterwards. By about 1900 operations deep inside the body, such as on the stomach and the chest, were attempted far more often than before.
Explain TWO causes of the move from antiseptic to aseptic surgery by about 1900. [8 marks]
Remember: one cause alone cannot score more than half marks, so make sure you explain two.
One cause was the problems with carbolic acid. The carbolic spray irritated the skin, eyes and throats of surgeons and nurses, and it could also damage the patient's tissue and slow healing. This made surgeons look for a method that did not rely on harsh chemicals, and Lister himself gave up the spray by about 1890. This led towards aseptic surgery, where germs were kept out rather than sprayed with acid.
A second cause was better scientific knowledge of germs. Pasteur's germ theory and Koch's work on bacteria had shown that germs cause infection and that heat kills them. This gave surgeons like Ernst von Bergmann the confidence to steam-sterilise instruments and dressings from 1886, so that nothing carrying germs touched the wound. Mikulicz's gauze mask in 1897 followed the same logic, and Halsted's rubber gloves from about 1890, begun to protect a nurse's hands, soon also kept germs out of the wound, so operating theatres became germ-free places.
What lifts this to the top level: each cause is supported with precise facts (the spray, 1886, the mask) and the answer explains how each cause led to aseptic surgery.
Start each paragraph with the cause, add a date or name, then finish with a sentence that links back to the question, such as "This led to aseptic surgery because...".