The march of medicine; Joseph Lister: A passion for cleanliness

Yes yes my dear did you see this. I know it is not a wives place to rebuke a husband. Even behind closed doors. But you were simply going to bully DNA. What ever did you say to boil it taking every idiot woman. Oh not you my dear that tanker a woman. She had the audacity to ask me and I dare say you're quite right I was a bomb. But see here you know I was thinking about that boy patient at the hospital because boy of ten comes from a dreadful neighborhood compound fracture of the femur skin punctured run over by a car. She and you think that he has it. Given our splendid record of infections at the hospital I think that he will die. If been a simple fracture Agnes I can set a bone. But where the skin is broken where the skin is broken something enters the wound and kills and I do not know what it is now. Tell that to your Mrs. Tanqueray.

You know American hospital supply Corp presents as a public service. March of Madison. Promises a shoe's of Great Moments in medical history. Our story for today a passion for cleanliness. This is Paul Barnes speaking to go back in imagination to the year 1860 and to the work of Joseph Lister who made modern surgery possible is to take a short step in time. But an unbelievably long one in understanding today for instance we have entered the age of disposable equipment disposable surgical drapes disposable hypodermic for example. In listers day all hospital equipment was permanent and of course one of his missions in life was to see

that it was endlessly scrubbed. Modern developments and hospital equipment have improved the cleanliness but saved much of the effort. Here to tell you about some modern developments and a sepsis and surgery is our guest Dr. Joseph C. Hinsey one of the most revered medical educators in the country formerly director of The New York Hospital Cornell Medical Center. Dr. Hinsey is now a consultant to the center. Dr. Hinsey until about one hundred and twenty five years ago surgery represented a desperate expedient in medicine. Doctors Talk To be sure of the wonders which the healing knife could accomplish but they knew that in practice the dreadful pain of operations the shock the loss of blood could kill as surely as the pathology which prompted the treatment. And then there was a phenomenon a post operative infection which was not understood at all. Anesthesia proved to be the answer to pain and the work of such

men as Pastor Koch and Lister struck at the minute. Living organisms which fad on the surgical wound and caused infection. In Joseph listers lifetime only a handful of people realize the importance of cleanliness. But today thousands of workers fight to keep the hospitals clean. Nurses operating room technicians housekeepers laboratory technicians bacteriological experts doctors ritually everyone in a hospital is involved in the vital task of halting and eliminating contamination. This is essential but often unsung work has created a healthy hospital environment. Joseph Lister would have been proud and further this concern for cleanliness has created a wide

range of meaningful careers. Thank you Dr. Hinsey. When Joseph Lister became Regis professor of surgery at the University of Glasgow in 1860 the surgeons art was being rapidly advanced. Only a few years earlier either had been first used as a general anaesthetic and now surgeons were unable to perform quite painlessly operations which had never before been possible. Some of listers new colleagues were perhaps a little smug in their new knowledge and a little contemptuous of the young Englishman's art ideas. No doubt your ideas are well enough for a laboratory among the scuttlebutt to a practice and surgeon to the practicing surgeon who loses entirely too many of his patients from post-operative infection. You were saying the doctor loses post-operative infection you're better off turning on your young man. But a truthful one I hope we look for wounds to heal by what we call first intention. Do we not know reddening no separation. I

do but in cases of open wounds and compound fractures in injuries and surgery treated here in hospital under our own eyes how many do so heal everyone. Nine in 10. Well I must admit you've pushed me to say it. The ones in fact the patients day. Are you going to go this far. It's more the rule than exception then Doctor why not try my conception that cleanliness may be the answer. Absolute cleanliness. Part of me I shouldn't name is so but I'm older than you. Profess some of us that I have heard about just studies of inflammation of tissue and photogs where you thought that it caused the inflammation. About all. I don't know nor do I much care about patients. Well forgive me if I say so but you English have a passion for the scrub and everything with water and so you must consider a lot of

patients might not be able to stand it. Perhaps it was true the Englishman of listers day did have a passion for cleanliness which was not shared in most other countries on the face of the earth. But whatever the source of his notion Lister demanded strenuously that his hospital wards be kept clean. Gentlemen I believe that I have spoken to all of you individually about cleanliness in the wards and operating rooms very well. Now I speak to you as it were regardless of expense regardless of trouble. We will use soap and water soap and water gentleman in God's own abundant plenty. We would use it daily. We will use it more often when necessary. Gentleman I am aware from what some of you have said to me in private that

you do not wholly agree with this expedient. But I pray you gentleman humor me and yes let us try and see what results. Professor Lister could have a word with you. Of course Dr. Pray be seated. And the where do you wish to have with me. Well it is a hard thing for Scott to apologize and most for an old one like me but you have my apologies sir. And for what. But what. Because I talk like a fool when you spoke of soap and water in the Lord's day like a 4. Then there have been good results I guess infection. If you go to depths I just dumped your soap and water is the whole answer and so do I. What do you think is the answer Doctor.

Where the infection spreads through the air a poisonous miasma as they say you can leave it for yourself in the books. I have I have but what does that tell us. It's a bunny for you as you must admit. Indeed it is but what's the nature of the miasma. What is the poison. Mr Hardman when you're on your own good morning doctor a pleasant day I didn't take the trouble to notice I have a small gift for you a gift. We statement about poisonous miasma and how they have caused how their cause. Don't be impatient. It's just our little article by a Frenchman Louis Pastore going to get my tongue out on the French a bit but its core research is on puter affection or some such. But

make no mistake glad it's about your poisonous miasma is enough and it was indeed and what causes them living photons Foster says. The decomposition of organic matter is caused by living for mins. Now one did he took a curved glass and boil it to destroy the living organisms. Boiled it did he. Well I Then he put food at the bottom of the flask and more food at the neck. The crust was so cooked as to allow it apart to get into the neck but not into the bottom of the flask. What do you think you found was defined by. Why he found after some days that the food in the neck of the flask was decayed but that at the bottom was sound. Am I right. Right right it was precisely so. Oh it is true that the air is filled with poison but in the form of living ferment of microbes. If Pastore is right these creatures are dangerous

only when they have a place to feed such as. Such as an open wound. You are right doctor soap and water is not enough. We must try and a way to destroy these organisms before they reach the world. This is Garda McKay speaking. You know when I was invited to say a few words about careers in the health fields I accepted because I think it's important to let young people know about the wonderful new career opportunities opening up to them. Here are a few things I didn't know. First of all I hadn't realized the variety of careers which are now available in hospitals and the number of special skilled persons wanted as soon as possible to help keep these hospitals the finest in the world. Para medical assistance. Now that's a name I hadn't run across before. They are needed as laboratory technicians operating room nurses are in great demand. Nurses in Gage's in pediatrics. The care of children. Are constantly in demand.

Nursing aides in order to work under the direction of professional nurses to keep patients clean and comfortable and easy. The job requires a high school education. Some on the job training and somebody with a sense of responsibility and an urge to do something important in this world. Why not ask your local hospital. One of these careers could be for you. Paul Byron speaking in the researches of Louis Joseph Lister found a clue which would one day lead him to develop the science of modern surgery. But his work had only begun. How to find a means of killing the organisms which caused infection pesto had used heat build ration and antiseptics in his work. Well he could be used to kill the organisms on surgical instruments and other equipment. But what about the

patient himself. Filtration seemed impractical there remained and ascetics. You look discouraged like I am discouraged my dear fellow I have tested everything imaginable. Nothing works. Everything is a good Underwood to run for our business. Well then I have tested Banzai and alcohol chloride of lime none of them any good. I need something to apply to the wound which will kill the microbes almost instantly and will not harm the tissues. Perhaps it's impossible something to destroy the microbes and yet not harm the living flesh. Have you thought of Phoenix arson. You mean carbolic acid. It's the same it's been used to kill enters or the animal parasite. It's an effective deodorizer. Carbolic I hadn't thought of that. You're right you know everything is a bad word for our business. Carbolic acid was not difficult to obtain and the patients were there in plenty

gashes cuts compound fractures all providing a feeding ground. If Lister and Pastor were alike correct for the invisible microbes in a short time Lister found a patient with a fractured leg. It was a small wound or breaking of the skin. Not dangerous but still there was a real chance of infection. The young surgeon made up his mind. Indeed so it's comfortable or indeed searches and I'm glad to hear it. You've been very good very easy on me. I should try to be better than that. I should try to give you a leg as good as new. I swear I thought to do that. Now this may be a little uncomfortable. I can't say. But it will prevent infection. I shall just cover this wound with the Gars soaked in. Whew. You're right it pains you little sir. It will be easier by and by and remember my friend if I am right. If I am right

this little pain may keep you alive and on your too strong legs. Good morning doctor. And how is our friend today. He looks well and is eating fine but he still complains that his leg hurts. It does indeed. I don't like that. Has he a fever. No no fever and we left him yesterday but the leg pains him. I was to look at the wound. Good morning McAfee. How do you feel today. Good enough for a week or but my leg hurts. Yes yes so I've heard. Now I'm going to take the bandages off and have a look at it. Perhaps we can find the trouble here. I must just have this bandage off. Yes.

I see you have done a lot. You've done it. The wound is healing so it is so it is look it is healing perfectly. No inflammation no separation. Only this irritation of the skin around the edges of the wound. In order to visit the carbolic undoubtedly only the carbonic is too strong. We must find a way to dilute it. But my leg hurts. It will hurt less MacAfee less and less every day you're going to get well my friend and after you. Who knows how many will be saved from suffering or even death. You are. Is patient to be sure went home in good health on his own two legs and the next case which engaged his attention at first seemed to go equally well.

Gen. Joseph mind here's my idea Josie if I only wanted to say well you're positively ease my spirit. You're quite used to Mrs. Tang teeth today. You were an idea I knew would one stick you were distraught. Is your work going well. I say easy going way. My what. Oh my work. It is you are charming. It's no compliment my dear dear girl I even found Mrs. Tanqueray tolerable this afternoon. But you you I wonder if your model is to ask. Yes my work goes where you know my little patient Charles is recovering from a wound which six months ago would have meant his death. Joseph That is true you wonder if his leg was badly injured I thought at first that I would have to amputate but I found that the artery and his word had not been severed. So I tried to save his leg. But three days he was delirious.

How awful for you. Oh how you must why I worried but he might have died if the wound separated but it did not. My antiseptic saved him. When are you to make your discovery known Joseph. That's how many who might die. I know Agnes if it is a difficult matter whether doctors accept my findings will they believe what I say. You will make them believe that your success is in child recovery proof and that I'm sure you will make them believe it. And now you must tell the world of your wonderful discovery. You must make them understand that people need no longer feel the surgeon's knife. Yes yes I dare say but that is still so much to do so many things to be improved. And I write so slowly to say if you must not feel that other doctors will say you know what you have learned and you must tell him you are

discerning my good wife. Yes I know what other doctors have said to other discoveries. However. I suppose you have made out my writing table with a force gap in the ink. And I hope somebody shot him. This is Gardner McKay again. And Joseph Lister and the other great pioneers in medical research did wonders for people who are sick or hurt. But they also are responsible for creating a lot of wonderful careers for young people. All these long years later. I've just been learning about such special jobs out of the medical technologist who makes all sorts of delicate and complicated bacteriological chemical and other tests in the hospital. This is a very important and responsible job. And it's open to men and women alike. They have a strong science background in high school and want to go on for some college

and specialized training. Or there is the bacteriology technician or the bacteriologist or the blood bank technician. All of them important and responsible people with special training and doing work so important that only the next hospital patient can praise it highly enough. And how about you. Wouldn't you like one of these health careers. Thank you. This is Paul Byron speaking. Joseph Lister when he published the reports of his new antiseptic methods in surgery had little to fear from his fellow doctors many of whom had thought earnestly though not as successfully as he about the problem of infection. Experimentally he tried attending professional meetings to solve these problems. Coming Joseph Can you look that it was a tiring journey Agnes.

I wish that the British Medical Association would hold its meetings a little nearer home in future. But this is the first meeting you've attended may well be the last. Me you know me so much of talk and so little of medicine. Did your speech go we have. It is hard to say that a number of compliments on my articles in the medical journal. As for my speech they seem more interested in Dr Simpson speech than mine. He's developed the principle of acupressure which is basically the use of needles instead of a ligature to stop the flow of blood in an artery. Interesting enough I guess. Perhaps a dangerous dangerous Agnus. The needles are supposed to cause a clot at the artery to prevent the flow of blood out. When they are removed only the clot remains to prevent a hemorrhage of blood. Clotting is good if.

And still you may get yours out. How many say 5. Don't they sometimes cause him each I was thinking about that very problem on my way home Agnes and I believe I have the answer. Now we know that microbes cause decay in the living tissues of a wound. We've successfully killed the microbes and stop the decay by the use of carbolic acid. Therefore there are if you use carbolic acid on the ligature it will not rot exactly Agnus Exactly. I want all my colleagues want as perceptive as you. Look at your time I says please. Drink the antiseptic dressings. Carefully. Just cover the whole of the wound. And should do it. I. Think we're finished. May take the patient back to the war. Still another experiment blood still another experiment.

My old friend after that another and another and another creeps in this petty pace from day to day to the last syllable of recorded time you sound like Shakespeare. As a practical Scott let me ask you why do you not leave the ties on the lagoon so long enough so you could pull it away from the tree when the clock is set. Because I don't intend to put it away. You're thinking of the old medicine one ties off the arteries in a wound one waits until the little control corruption has taken place one draws out the ligature a little of what doctors call a laudable POS follows and is that not what you expect. Oh no doubt no doubt. Now with my treatment there will be no corruption no law to pass the league as your will disintegrate the artery will heal and how do you know all of that. Because because. Would you really know. I would know very well. I don't know Doctor. I don't know. I have tried it on animals a horse a sheep is a human artery

so much different. Joseph Lister continued to work with new ligatures with new wonder septics. He experimented with animals. He translated his new knowledge to the treatment of human beings. He had his successes and his failures. But perhaps his greatest good fortune was in his wife Agnes herself the daughter of a distinguished doctor. She was tolerant of the oddities of listers work did me Josephs during Christmas holidays and on your father's farm is where perhaps it was a little eccentric to spend Christmas day operating on a calf. It was important truly Agnes and I know it was my dear and in any case here we are in March and my father has quite forgiven me and the operation a success. A complete success. You see I used to catch up literature soaked in carbolic and would you believe it. Only three months later the ligature had quite disappeared and I found that the living tissues had taken place of it was a triumph.

But of course there are further problems. You will never be satisfied with your success. I hope not my dear. Did you know for a Don't be satisfied. It would be so if you were content. Throughout the world. Surgeons began to adopt listers methods. His visits abroad especially to the United States further encourage their acceptance in 1875. Professor from Munich said in an address list treatment is already greeted by the whole civilized world as an enormous advance. Everything new receives criticism but such proofs can be obtained from it. That one has no use for any birds but those how could I took to it and admiration. Look now at my sick broads recently ravaged by death I can only say

that I and my assistants and my nurses are overwhelmed by joy and undertake all the trouble the treatment entails but the greatest secret in the happiest mood processus us before we went about hanging our heads. What wonders of conservative surgery has the future in store for us. Lister died on February 10th 1912 just before his eighty fifth birthday leaving a great legacy to those who followed him in the field of surgery. His great genius is described by the French surgeon. You can shape your new air gave a scientific basis to surgery. He made it a vest on established truce. He swept away the uncertainty in which the greatest surgeons up to that time had left it. Inspired by the ideas of bus tour he conceived the idea that the infinitely little germs of all kinds store of against the natural efforts of the organism toward

healing. He's genius showed itself in this that starting from a fundamental observation that I fired scientifically. He succeeded in determining the general laws of way back. March of medicine. Promises ations of some great moments in medical history. March of medicine is brought to you as a public service by the American hospital supply corporation. Appearing on today's program where Rush read Money catcher on macadam. Norman Gottschalk. Your narrator was Paul Barnes This is Martin Maloney speaking. And.

Authentication of historical materials used in the script was provided by the research division of Encyclopaedia Britannica. If you would like a copy of the script used in today's program or further information on careers in health and medicine Please send your name and address on a postcard to health careers. Post Office Box four to seven. Evanston Illinois by next week. Dr. Fred Banting and the discovery of insulin. This program was distributed by national educational radio. This is the national educational radio network.