On the Antiseptic Principle in the Practice of Surgery

In 1867 a Glasgow surgeon published a few pages that changed the odds of survival on every operating table. Reasoning from Pasteur’s discovery that putrefaction is the work of living organisms, Joseph Lister argued that the deadly infection of surgical wounds was caused by germs the surgeon could destroy with carbolic acid. This facsimile source edition reproduces that foundational paper in full, with apparatus that places it in the lethal world of pre-antiseptic surgery it was written to end. In the middle of the nineteenth century, the operating theatre was among the most dangerous places a sick person could enter. Anesthesia had removed the agony of the knife and emboldened surgeons to attempt more and longer operations, but it had done nothing about what came after. The wound, not the cutting, was what killed. Mortality after major amputation frequently ran between a quarter and a half of all cases. The prevailing explanation was miasma, the idea that disease arose from foul air. The key that unlocked the problem came from outside surgery, from Pasteur’s chemistry of fermentation: decay had a biological cause, and that cause could be excluded or destroyed.