No Time for Statistics: Joseph Lister's Antisepsis and Types of Knowledge in Nineteenth-Century British Surgery.

This article documents Joseph Lister's reluctance to publish numerical material and aims at explaining his skeptical view about statistics through an investigation of his approach in its historical context. In this context, statistics was only one kind of evidence used in surgery, along with case histories and experimental results from the laboratory. They represent different "ways of knowing," anchored in different social, conceptual, and practical contexts. The account looks at Lister's approach to wound disease and analyzes how this relates to his attitude toward different types of evidence about surgical outcomes. For this, it also examines his contemporaries' approaches to fighting wound disease as well as their evaluation of different kinds of evidence. This article is a contribution to the history of Lister's antisepsis, but also to the history of the production and use of therapeutic knowledge in nineteenth- and early twentieth-century surgery more generally.

George Hogarth Pringle and the mystery of the first antiseptic operation in Australia.

EARLY LIFE: George Hogarth Pringle, later an associate of Joseph Lister, was born in Kintail, Scotland in 1830. In 1854, he worked as a dresser at the Royal Infirmary, Edinburgh with Joseph Lister. After serving in the Crimean War, he settled in New South Wales and began practice in Parramatta. PRINGLE AND ANTISEPTIC SURGERY: In October 1867, Pringle performed the first operation in Australia using the antiseptic principles advocated 6 months previously in the first of a series of articles published in The Lancet by Joseph Lister. Mystery surrounds how Pringle was able to adopt Lister's principles so quickly. Lister and Pringle had been friends in Edinburgh and previous writers have hypothesized that the two men corresponded whilst another has suggested Pringle was using antiseptic principles prior to Lister's work being published. Both these scenarios are unlikely. The Lancet appears to have been available in Australia within 4 months of publication. CONCLUSION: The conjunction of an appropriate case and the arrival of a recent copy of The Lancet highlighting Lister's work is the likely source of Pringle's decision to apply antiseptic principles.

[Enrico Bottini (1835-1903), Italian Physician and Politician: A Master of Antisepsis and a Pioneer of Modern Surgery] / Enrico Bottini (1835­1903), medico e politico Italiano: Maestro dell'anti-sepsi e pioniere della chirurgia moderna

Enrico Bottini (Stradella, Pavia, 7 September 1835 - Porto Maurizio, Sanremo, 11 March 1903) was a multifaceted surgeon, who left a strong mark in modern surgery, not only Italian but worldwide. A pupil of Porta and Ribeti, as well as the distinguished French surgeon and anatomist Charles-Marie-Édouard Chassaignac, he has dedicated himself throughout his career to various areas of medicine, ranging from bacteriology and anti-sepsis (use of a derivative of phenic acid) to urological surgery (the so-called "endo-urethral galva-cauterization", also called Bottini's operation, or Perineal incision according to Bottini). He has also successfully dedicated himself to gynecology (trans-vaginal hysterectomy for uterine cancer and surgical treatment of vesicovaginal fistulas), maxillofacial surgery (endo-oral resection of the maxilla, subperiosteal resection of the mandible for the treatment of the stable jaw, total amputation of the larynx and the tongue for carcinomas), the dermosurgery (use of the electrocautery), and the vascular surgery (resection of the inferior vena cava). He was also an important Italian politician, first as a deputy and then as a senator.

Antisepsis and Asepsis and How They Shaped Modern Surgery.

Surgical antisepsis and asepsis established the standard of using scientific evidence to determine surgical practice. The microbiological discoveries of Louis Pasteur (1822-1895) were the inspiration for Joseph Lister's (1827-1912) use of carbolic acid as an antiseptic on surgical wounds. German and Swiss surgeons invented aseptic surgical practice based on the studies of Robert Koch (1843-1910), a life-saving revolution in medicine as profound as anesthesia. Together they changed human history, sparing millions the horrors of hospital gangrene and making the entire body accessible to surgical intervention. In the United States, surgeons followed the lead of their brethren across the Atlantic. Americans, characteristically pragmatic, naturally resisted what they saw as unnecessary complexity in Listerism. Once they accepted germ theory, the undeniable scientific evidence led to the rapid acceptance of asepsis. Among the wide-ranging effects of this transition in practice were the creation of the current model of the academic department of surgery and the modern concept of surgical professionalism.

Desarrollo histórico de la traumatología y de la cirugía ortopédica a partir del siglo XV / Historical development of traumatology and orthopedic surgery from the XV century

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Daniel Mollière (1848-1890), the French anatomist and surgeon, and his encounters with nosocomial infections in the operating theatre.

Daniel Mollière, was a French anatomist and surgeon, born in Lyon, who succeeded in his short life in making his mark in surgery. He was a prolific writer who left a series of medical treatises and a committed surgeon who was responsible for various significant innovative apparatuses in the medical sper. As he lived in an era when the role of microbe had already been recognized, he was among the first to use antisepsis and install extreme measures against microbes, both in the air and on the skin'. Fountains with fresh clean water, carbonic acid, cross ventilation, medical blouses, combined with Valette's apparatus for the dressing of amputations, were some of his precautions to reduce surgical infections and post-operative mortality.

Surgical Hand Antisepsis and Surgical Site Infections.

BACKGROUND: Surgical site infections (SSI) remain a significant problem to both the patients and the healthcare system. Value care and standardized quality measures continue to promote improvement in surgical asepsis, but certain debates remain unresolved in the field of surgical hand antisepsis. METHODS: Review of relevant accounts and literature. RESULTS: Controversy has existed regarding the U.S. Food and Drug Administration (FDA)'s 1994 Tentative Final Monograph (TFM), which defined how surgical hand antisepsis products are assessed. Issues involving neutralizers and demonstration of a cumulative effect were addressed in the FDA's Proposed Rule in 2015. Few studies have used SSI as a primary outcome and instead have used a surrogate marker (colony-forming units [CFU]). Quantitative microbiology studies suggest a minimum bacterial inoculum of 105-107 CFU/mL is necessary to cause a clinical infection. Outcomes of antisepsis likely are driven by both active ingredient(s) and overall product formulation. Povidone-iodine aqueous scrubs are inferior to chlorhexidine gluconate (CHG) 4% aqueous scrubs and alcohol-based rubs (ABR). The SSI and CFU outcomes studies support the equivalence or superiority of ABR over CHG. CONCLUSIONS: Both ABRs and CHG 4% are preferred to povidone-iodine for surgical hand antisepsis. Well-powered randomized controlled trials measuring SSI as a primary outcome, as well as those designed according to either TFM or European methodology, with appropriate controls and neutralizers, are warranted. These trials should incorporate different ABR formulations and CHG 4%, as well as skin tolerance assessments and a cost analysis.

Illustrating microorganisms: Sir William Watson Cheyne (1852-1932) and bacteriology.

Sir William Watson Cheyne is largely known to medical history as Lord Lister's 'trusted assistant'.1 He spent a lifetime defending Joseph Lister's (1827-1912) antiseptic principle in the wake of scepticism and misunderstanding. However, his main contribution to Lister's work was in the embryonic field of bacteriology in the 1870s-1890s, which brought him into contact with continental researchers, particularly Robert Koch (1843-1910). In this field, Cheyne built an independent reputation as an assessor, chronicler and promoter of continental laboratory methodology. He pioneered bacteriological training in British teaching hospitals and incorporated laboratory testing into case notes as standard procedure. This paper reconsiders Cheyne's contribution to the development of bacteriology in British medicine at the end of the 19th century. It examines his motives in promoting new laboratory techniques and the methods he used to embed them in hospital procedure. It also considers how he continued to use bacteriological arguments to keep the Listerian antiseptic principle on the medical agenda well after Lister withdrew from active involvement in the field.

Surgical Skills Beyond Scientific Management.

During the Great War, the French surgeon Alexis Carrel, in collaboration with the English chemist Henry Dakin, devised an antiseptic treatment for infected wounds. This paper focuses on Carrel's attempt to standardise knowledge of infected wounds and their treatment, and looks closely at the vision of surgical skill he espoused and its difference from those associated with the doctrines of scientific management. Examining contemporary claims that the Carrel-Dakin method increased rather than diminished demands on surgical work, this paper further shows how debates about antiseptic wound treatment opened up a critical space for considering the nature of skill as a vital dynamic in surgical innovation and practice.

Bolshevik disease and Stalinist terror: on the historical casuistry of artificial pneumothorax.

From its initial development by Carlo Forlanini at the end of the nineteenth century until the advent of antibiotics in the 1940s, artificial pneumothorax was one of the most widely used treatments for pulmonary tuberculosis. However, there were strongly held reservations about this therapy because of its risks and side effects. In the Soviet Union under Stalin, such uncertainties became instruments of political denunciation. The leading Soviet pulmonary physician Volf S. Kholtsman (1886-1941) was alleged to have used the so-called 'aristocratic therapy' of artificial pneumothorax to kill prominent Bolsheviks. Drawing on documents from Stalin's personal Secretariat, this historical study of the pneumothorax scandal contributes to the cultural history of tuberculosis, showing how it was instrumentalised for political purposes.

Antoni Christian Bryk (1820-1881) - professor of forensic medicine at Jagiellonian University (1852-1860), and director of the surgical clinic of Jagiellonian University in Cracow (1860-1881).

scientific discipline. In the 19th century two milestones revolutionised surgery: the development of narcosis, which enabled painless surgery, and the introduction of antisepsis and asepsis. The author presents the beginnings of academic surgery in Cracow. Its pioneer surgeons are presented. Extensive research was undertaken to collect the literature and documents in Polish, Austrian and German archives and libraries in order to prepare this study. Biographical details of the director of the Surgical Clinic, Prof. Antoni Bryk, are provided. He was the first person in Poland to introduce antisepsis and galvanocautery as routine procedures in the Cracow Clinic. The introduction of antisepsis contributed to a reduction in infection during surgery, and a reduction in postoperative mortality in Cracow Surgical Clinic. In this way Professor Bryk became the first Polish surgeon to apply Lister's antiseptic method in the treatment of wounds. Thus enlarged, the scope of surgery for intracranial, bone and other procedures became routine. Surgery is the oldest discipline in medicine. Poland's first university chair of surgery was established in the 18th century. Surgery, which until then had been the domain of barbers and bath house attendants, became a clinical,