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By Root 1072 0

was alive, self-replicating and that it needed warmth and air in order to thrive. Sealed off from air, subjected to excessive heat, the liquid ceased to ferment. Reproduction obviously depended on the presence of air, or an airborne agent. Pasteur announced the discovery of ‘airborne germs’. Was there also a microscopic airborne agent at work, spreading epidemic in the hospitals and communities of Europe? In 1864 Pasteur announced that he had preserved a sealed glass of boiled milk for several years without fermentation because he had kept it from ‘the germs which float in the air’.

The following year the Professor of Chemistry at Glasgow remarked on the new ‘germ’theory to his surgical colleague, Joseph Lister, who immediately applied it to his work in the operating theatre. Lister was the son of the Joseph Jackson Lister who had developed the achromatic microscope some thirty years before. Joseph Lister had noticed during an epidemic in cattle at Carlisle that when carbolic was added to the town sewage, the cows recovered. Was the carbolic killing germs?

Following Pasteur’s lead, Lister tried cleaning wounds after surgery by applying carbolic-soaked lint dressings, covered with thin tin sheet in order to exclude the air. Of a set of eleven test cases involving compound fractures (the most dangerous kind), only two contracted hospital infection. Lister next treated the general hospital environment with a hand-operated carbolic spray. Surgeons began to work enveloped in a fine carbolic mist. Before an operation began, Lister’s students would say, ‘Let us spray.’The technique revolutionised surgery and medicine in general. As one of Lister’s German disciples wrote:

Mankind looks grateful now on thee,

For what thou did’st in surgery,

And death must often go amiss

By smelling antiseptic bliss.

The evident success of carbolic sterilisation brought medicine closer to the microscopic world of the laboratory and further from the treatment of the patient as an involved individual. The sick person had no personal control over his condition since all efforts were now directed towards the identification of microscopic organisms.

The new antiseptic surgical techniques, illustrated in 1882. Note that for all the care in positioning the spray so that the incisions are made within the vapour, the doctors still wear outdoor clothes.

A drawing of colonies of the tubercle bacillus, grown, in accordance with Koch’s technique, on solid nutrient.

By this time earlier advances in inorganic chemistry were being applied in organic analysis. Most biological tissue and fluids - blood, urine, milk, gastric juices, bile, saliva, tears, sweat, nasal mucus, pus, synovial fluid and semen -had been microscopically examined. Analysis of blood and of urine was particularly advanced.

In 1843 Gabriel Andral in Paris had led the field with his analysis of blood. He examined it for visible, microscopic and chemical characteristics. He established the proportions of ‘globules, fibrous material, solids and water’in sick and healthy patients, averaged out the data using statistical techniques, established the relationship between different diseases and blood conditions, and developed a numerical portrait of blood behaviour.

Andral’s contemporary, Alfred Becquerel, approached urine in exactly the same way. By 1860 thirty-four constituents of urine had been identified. There were also twelve separate tests for the presence of glucose. Then Hermann Fehling produced a reagent which would show the presence of diabetes.

This last development represented a major advance in the chemical analysis of the body through the use of marker agents. It was to achieve world-wide recognition through the activity of a German general practitioner working on the problems of anthrax in animals in Wöllstein, Prussia. His name was Robert Koch, and in 1876 he cultured the anthrax bacillus and came to the conclusion that the bacillus produced spores in animal tissues. These spores needed only warmth and oxygen in order to reproduce bacilli, even when