Louis Pasteur (1822-1895) in 1886.

A new scientific landmark has been reached and from the culture of yeasts to the culture of microbes, there is only a step…  To tell the truth, the study of contagious diseases had preoccupied Pasteur from 1863.  But his slightest incursion onto medical terrain had him deprecatingly referred to as a Chemist, or even a so-called Chemist, poaching on private property.  He would therefore have to wait ten years longer to enter the Academie de medecine, where he would have the pleasure of joining up again with Claude Bernard, the Physiologist, author of the Introduction a l’etude de la medecine experimentale.  Claude Bernard, himself the object of the permanent hostility of the Medical Practitioners, maliciously whispers into the ear of Pasteur, his neighbour on the Academie seats:

“Have you noticed that when a Doctor of Medicine enters a salon or an assembly, he always looks as if he is saying:  ‘I have just been saving my fellow men’?”

Within this noble brotherhood, those entrenched in traditional Medicine, like Doctor Pidoux, in his blue jacket with its gold buttons and his great reputation, perorate in applauded discourses:

“Physiology can be of no use in Medicine, and it is only a luxury Science which we can do without!”;

“Tuberculosis?  It is the common result of many external and internal causes, and not the product of a specific agent that is always the same!”

Sometimes, Doctors, like Villemin who senses the existence of a tuberculosis virus, and Davaine, expose new theories.  Davaine has meditated on Pasteur’s work on fermentations, and connects them to certain parasites that he has been able to observe with the microscope in the blood of animals who have died from anthrax, a plague which was then decimating herds.  By their presence and their rapid multiplication in blood, these parasites that he calls “bacteridies” appear to act like ferments…  The two Doctors are practically accused of disturbing the medical peace, and are violently taken to task.

Meanwhile, in the hospitals, it is possible to die from a simple abcess or from a panaris – without even evoking a surgical operation…  Surgeons are appalled by the terrible aftermath of an operation, gangrene, “hospital rot”, septicaemia, purulent infection.  Hospitals being perceived as places of infection, the Social Services rent, near Paris, an isolated house in a healthy location to practise operations there.  In 1863, ten women are sent there, one after the other.  The inhabitants of the Avenue de Meudon would see each of these sick women enter this house and ten coffins leave it.  In their frightened ignorance, they call this mysterious house “the house of crime”.  A Doctor would go as far as saying that the ablation of the ovaries is to be filed “among the attributions of the executioner”.  The Medical Practitioners, unconscious propagators of viruses, sometimes ask themselves if they are not carrying death with them.

In fact, since the beginning of the XIXth Century, Surgery has taken a step backward.  Before this time, antiseptic practices were used, even if it was not done consciously:  cauterization by fire, boiling liquids, applications of linen dipped in eau-de-vie, disinfectant substances.  However, under the influence of Broussais and his theory of the inflamation and the irritation of the tissues, cauterization is stopped and Surgery retrogrades.  Then one sees appearing basins, packets of dressings made from old hospital sheets only just washed, and pots of cerat, an unguent with an oil and wax base.  In 1868, the mortality after amputations is more than sixty per cent.  Those who traversed a ward of amputees or other wounded during the 1870 War speak in fear of it.  It is perpetual agony.  All the wounds suppurate, infectious septicaemia is everywhere.  A medical student of the time says:

“Pus seemed to germ from everywhere as if it had been sown by the Surgeon.”

Unfortunately, it will be only at the end of the War that Alphonse Guerin would have the idea that

“the cause of the purulent infection could well be due to the germs or ferments that Pasteur had discovered in the air”.

This Surgeon develops a reflection by analogy:

“If the miasms are bacteridies, I could arm the wounded against their disastrous influence by filtering the air, like Pasteur did…  I then imagined the cotton wool dressing and I had the satisfaction of seeing my previsions come true.”

The dressing composed of bands of cotton wool held by bands of new cloth is applied on the wounded of the Commune, from March to June 1871.  Alphonse Guerin’s colleagues are stunned to learn that out of thirty-four operated people bandaged in cotton wool, nineteen have escaped death.  The Chemist Pasteur is invited to come to see Guerin’s Service;  he has conversations with his colleagues in the Academie de medecine and visits hospitals.  A new life begins for him where the hospital would take as much place in his activities as the laboratory.

Another Medical Practitioner, British this time, Joseph Lister, who is the real creator of antiseptic practices in Surgery, writes to him from Edinburgh in February 1874:

“Allow me to take this occasion to address to you my most cordial thanks for having, by your brilliant research, shown me the truth of the theory of germs of putrefaction and for having given me the only principle that could lead the antiseptic system to a good end […] it would be a true reward for you to see in our hospital in what large measure it has benefited from your work…”

In Lister’s Service, the instruments, the sponges, the objects necessary for dressings, are purified with a solution of phenol.  Same treatment for the hands of the operating Surgeon and his assistants.  Throughout the whole operation, a spray filled with phenol water creates an antiseptic atmosphere around the wound, which is washed with the phenol solution.  Finally, a gauze impregnated with the same antiseptic is applied and maintained on the wound, then covered by a waterproof cloth.  From 1867 to 1869, out of forty amputees, Lister saved thirty-four.

To be continued.