The History of Antiseptic Medicine

by Vignesh Viswanathan

From groundbreaking research to clinical care, the practice of medicine has evolved, and the history of this evolution provides interesting insight into certain health protocols that many of us take for granted. Sanitation, amongst both the general population and healthcare professionals, has only been in use for about 150 years. The history of antisepsis first began with three well- known physicians: Oliver Wendell Holmes, Ignaz Semmelweis and Joseph Lister.

In Boston, 1843, Holmes discovered that a certain fever, known as puerperal fever, passed from patient to patient when the physician’s hands were unclean, a phenomenon with a high mortality rate which he first recognized in pregnant women. As a result of this fever, Holmes published, “The Contagiousness of Puerperal Fever” in the New England Quarterly Journal of Medicine and Surgery, which postulated the theory of contagion, stating that disease could be passed between individuals through contact. However, the development of antisepsis was not initiated because many physicians were not interested in refining their procedures.

Within the year, Semmelweis also remarked on the persistence of puerperal fever in pregnant women in Vienna. This provided him with the great opportunity to point out, like Holmes did, that the fever spread from the infected hands of the physician to the patient, and that the fever would eventually spread from patient to patient. He postulated that there was some “cadaverous material” causing this fever after assessing that the fever originated from the doctor’s hand. To rectify the issue, Semmelweis suggested that the doctors wash their hands with chlorinated lime solutions in order to keep themselves hygienic, and he is now considered the father for the introduction of hand-washing disinfectants. Ironically, Semmelweis died due to mental complications of septicemia, but he is nevertheless a venerated figure in the history of medicine.

Lister was a surgeon from Scotland who played a very important role in developing antiseptic protocols for operating rooms. His first contribution was the use of gloves when operating on a patient. He further added to the antiseptic tradition in 1867 when he initiated the application of carbolic acids on wounds and openings to prevent infections and pathogens from entering the body.

The three predominant figures that contributed to the initiation of antiseptic protocols all made their discoveries around the same time, and who made the discovery first is still a controversial topic. Gerald Weissman, author of “Puerperal Priority” (published in the English journal The Lancet) writes: “England honors Lister for antisepsis, Europeans acclaim Semmelweis for the aetiology and prophylaxis of puerperal fever, and the USA gives priority to Oliver Wendell Holmes.” Although many contemporary historians of science would like to credit one or another specific physician with revolutionizing the way we approach hygienics, each of the three medical giants provided massive contributions. Next time you wash your hands, instead of singing “row, row, row your boat” (a technique taught to many health students as a way of ensuring clean hands), thank Holmes, Semmelweis and Lister once for each clean finger.