Antiseptics

Question 1

1) Fill in the blanks;
The Germ Theory was published in ** by *** ***.
2) What did it say?

Answer 1

1) The Germ Theory was published in 1861 by Louis Pasteur.
2) The germ theory stated that ‘infections’ (moldiness in wine) was caused by microbes also known as ‘germs’. The germs could be killed by heat.

Question 2

Name two deadly infectious diseases present in the 1890s…

Answer 2

Gangrene and Sepsis

Question 3

What were operating conditions like before 1861?

Answer 3

Surgery was carried out at home (not sterile) Whilst wearing old bloodied clothes-status (no hygiene)
Using dirty instruments (infection passed on)

Question 4

What did Ignaz Semmelweis notice in 1846?

Answer 4

That mothers on the midwives maternity ward were 50% less likely to contract sepsis (puerperal/childbed fever) than those on a ward ran by med students.

Question 5

1) What did Semmelweis figure out?

2) What precautions did he implement?

Answer 5

1) Medical students often attended births straight after dissecting cadavers-Semmelweis realised something had going from these dead bodies (by the med students) into the mothers.
2) He put bowls of chlorinated water around the hospital and insisted med students washed their hands before treating the mothers.

Question 6

Even though Semmelweis’s methods worked he was sacked (and later sectioned) and his ideas ignored. Why?

Answer 6

1) He couldn’t explain why it worked (before publication of the germ theory-no idea about microbes)
2) Semmelweis was seen as arrogant for not consulting anyone before ordering people to wash their hands
3) Chlorine smelt horrible
4) Hand washing was unnecessary effort

Question 7

The Germ Theory was published in 1861, why didn’t many people accept it until 1864?

Answer 7

Because although published in 1861 the Germ Theory wasn’t proved until 1864, and because people are naturally suspicious they don’t just take your word for it.

Question 8

Who linked microbes to septicemia (infection). How did he originally propose to stop septicemia?

Answer 8

Joseph Lister.
Started the use of antiseptics-used carbolic acid to soak wound and dressing (first used on a boy that had a compound fracture)

Question 9

After originally using carbolic acid as an antiseptic how did Joseph Lister change his methods?

Answer 9

Moved from antiseptics to aseptic. To prevent microbes from getting into the wounds he said the ‘surgery’ needed to be sterile and free from the microbes. Used a donkey pump to spray carbolic acid everywhere)

Question 10

What is Antiseptic surgery?

Answer 10

Killing germs in/on a wound

Question 11

What is Aseptic surgery?

Answer 11

Creating sterile conditions

Question 12

Where did Joseph Lister get the idea of using carbolic acid from?

Answer 12

Carbolic Acid was used to kill parasites at a sewage works

Question 13

What were the 3 main parts of Lister’s aseptic surgery?

Answer 13

1) Washing hands in carbolic acid
2) Washing equipment in carbolic acid
3) Spray the air (and everything) with C.A spray using a donkey pump

Question 14

How successful was Lister’s antiseptic methods?

Answer 14

Very; in 1867 no-one had died from blood poisoning in Listers ward for 9 months

Between 1864 and 1866 45.7% of amputees died. Between 1867 and 1870 15% of patients died

Question 15

Why did Lister replace silk stitches?

Answer 15

Silk can’t be sterilized so Lister replaced it with catgut, which could absorb carbolic acid and therefore wouldn’t introduce infection into the wound.
He later invented a catgut that dissolved in the body so didn’t have to be removed.

Question 16

Why did Lister’s antiseptic methods succeed but Semmelweiss’s fail?

Answer 16

The publication of the Germn Theory meant people believed and understood his methods

Question 17

Why did Surgeons oppose Lister himself and his theory? (7) (not the use of carbolic acid)

Answer 17

1) Lister was viewed as a fanatic.
2) Didn’t believe in microbes or that they caused infections-Lister was a common joke.
3) Felt Lister was blaming them for their patients’ deaths.
4) Surgeons copied the method wrong which meant it didn’t work successfully-said it didn’t work at all.
5) Some surgeons had good success rates without carbolic acid.
6) Lister constantly changed methods-making improvements-made him seem unsure that they worked.
7) People just don’t like change

Question 18

Why did surgeons oppose the use of carbolic acid? (7)

Answer 18

1) Believed antiseptics would compromise body defense system.
2) Carbolic spray was messy and went everywhere.
3) It was very expensive.
4) The donkey pump was awkward to use.
5) Carbolic acid damaged their hands.
6) Using carbolic acid slowed the operation down lots-had to spray everything.
7) It smelt

[Carbolic acid was originally used to treat sewage-made people unsure]

Question 19

What else (equipment) helped promote the ‘aseptic’ environment?

Answer 19

Robert Koch invented the steam sterilizer in 1878; instruments were free of germs
Invention of rubber gloves; prevent microbes being introduced to wound by surgeons hands
People wore gowns and face masks