Germ Theory Papers (Pasteur and Lister)

Summary

Germ Theory Papers gathers four scientific papers that the Harvard Classics printed together in 1910, in the volume of Scientific Papers that also contains Harvey: one by the Glasgow surgeon Joseph Lister and three by the French chemist Louis Pasteur. Each comes with the series' brief introductory note on its author. Together they show how the study of fermentation in breweries and wine cellars became a theory of infectious disease and a new practice of surgery. Lister's On the Antiseptic Principle of the Practice of Surgery was read to the British Medical Association at Dublin in August 1867. He explains that he had long attributed suppuration in wounds to decomposition, and that Pasteur had shown decomposition to be caused not by oxygen but by minute living organisms floating in the air. It therefore occurred to him to kill those organisms in the wound with carbolic acid instead of trying to exclude air. He describes the treatment of compound fractures, including a boy admitted eight and a half hours after his accident, the use of carbolic paste under tinfoil, and the opening of abscesses without admitting germs. He closes with the change in his wards at the Glasgow Royal Infirmary, which went nine months without a case of pyaemia, hospital gangrene or erysipelas. The longest item is Pasteur's Physiological Theory of Fermentation, a chapter of his studies on beer, prefaced by a dedication to his father, a former soldier of the First Empire. In six sections Pasteur studies yeast with and without oxygen, fruits fermenting in carbonic acid, the fermentation of tartrate and lactate of lime by vibrios that live without air, and his replies to Brefeld, Traube and Liebig. Its thesis is that fermentation is the life of organisms deprived of free oxygen. The Germ Theory and Its Applications to Medicine and Surgery, read to the Academy of Sciences in April 1878 with Joubert and Chamberland, uses serial cultures to prove that anthrax is a bacterial disease, cultivates the septic vibrio in vacuum, and describes the microbe of pus. On the Extension of the Germ Theory (May 1880) reports cultures from boils, from a girl's osteomyelitis operated on by Lannelongue, and from women dying of puerperal fever, and recommends antiseptic compresses of boric acid after childbirth. Pasteur ends by welcoming criticism that has a method in doubting.

Plot or Argument

• Lister: the principle stated

  Lister reasons that if Pasteur is right that putrefaction is caused by living particles in the air, wounds need not be sealed from air but only protected by a dressing that destroys those particles. He chooses carbolic acid as the most powerful antiseptic then known.

• Lister: fractures, abscesses and the wards

  He describes applying the acid into compound fractures, keeping it active with paste and tinfoil, persevering despite some suppuration, and draining abscesses without admitting germs. He reports that his once unhealthy wards have been free of pyaemia, hospital gangrene and erysipelas for nine months.

• Pasteur: dedication and preface

  Pasteur dedicates his studies to his father and explains that he began work on beer after the war of 1870, hoping to help French brewing and suggesting that the same principles may shed light on contagious disease.

• Fermentation I–II: yeast, oxygen and fruits

  Experiments with flasks with and without air show that yeast grows vigorously with oxygen but ferments sugar most efficiently without it; whole fruits kept in carbonic acid produce alcohol from the activity of their own cells.

• Fermentation III–V: life without air

  After replying to Brefeld and Traube, Pasteur shows that the fermentations of tartrate and lactate of lime are carried out by vibrios that live, and are even killed, in the presence of air, and he concludes that fermentation is the result of life without air.

• Fermentation VI: reply to Liebig

  Pasteur answers Justus von Liebig's view that ferments act by a communicated chemical motion from decaying albuminous matter, insisting that the ferment is an organized being whose germ is always present.

• The Germ Theory and Its Applications (1878)

  With Joubert and Chamberland, Pasteur proves by twelve successive cultures that anthrax is caused by its bacterium, grows the septic vibrio in vacuum and carbonic acid, explains how septic dust persists in the world, and shows that pus-forming and septic microbes can be combined to produce mixed infections.

• On the Extension of the Germ Theory (1880)

  Pasteur cultures organisms from furuncles, from the bone of a child with osteomyelitis and from cases of puerperal fever, and advises antiseptic precautions, especially boric acid compresses heated in an oven, for women after confinement. He closes by inviting methodical criticism under the motto 'More light.'

Lessons

• One discovery can serve another field

  Pasteur opens his 1878 paper by saying that the sciences gain by mutual support. Lister read a chemist's papers on fermentation and saw in them the cause of wound infection; Pasteur in turn cited Lister. The papers show how knowledge travels from brewery to laboratory to hospital ward when someone is ready to see the connection.

  • What exactly did Lister take from Pasteur, and what did he add himself?
  • Why would a study of beer and wine shed light on surgery?
  • Can you name a recent discovery in one field that changed another?

• Proof requires more than correlation

  Finding a microbe in a sick animal did not satisfy Pasteur. He grew the anthrax organism through twelve successive cultures until none of the original fluid could remain, and only then produced the disease with it. The lesson is that a cause must be isolated and tested, not merely observed alongside an effect.

  • Why did Pasteur think that serial culture ruled out an independent 'virus' in the original blood?
  • How does his septic vibrio experiment use exposure to air as a control?

• Results speak in the wards

  Lister ends not with theory but with the record of his own wards, which had been among the unhealthiest in the infirmary and became free of the dreaded complications. He also admits that he did not dare use full-strength acid in early cases and that suppuration still sometimes appears. Honest reporting of both success and limitation is part of good medicine.

  • What evidence does Lister give that the change in his wards was caused by the antiseptic treatment?
  • What other explanations might a sceptical surgeon of 1867 have proposed?
  • Why does Lister urge surgeons not to abandon the method at the first sign of pus?

• Welcoming criticism

  Pasteur closes his 1880 paper by admitting that medicine is not his profession and by welcoming any attack that has 'a method in doubting'. Strong conviction and openness to correction belong together in a scientist.

  • What is the difference between criticism that 'doubts on principle' and doubt that has a method?
  • How should a scientist respond when experts in another field resist a new idea?

Context

In the mid-nineteenth century many physicians explained epidemic and wound disease by miasma, foul air arising from decay, and many chemists, led by Justus von Liebig, held that fermentation and putrefaction were purely chemical processes. Surgery, newly freed from pain by anaesthesia after 1846, still lost many patients to pyaemia, erysipelas and hospital gangrene. Ignaz Semmelweis in Vienna (1847) had reduced childbed fever by chlorinated washing, and Casimir Davaine had seen rods in the blood of anthrax-infected sheep, but no general theory connected micro-organisms with disease.

Composition

Pasteur's 1857 memoir on lactic fermentation began the work, and his swan-neck flask experiments against spontaneous generation were published in 1862. The fermentation chapter here comes from his Études sur la bière (1876), translated by Frank Faulkner and D. Constable Robb as Studies on Fermentation (1879). Lister published his method in The Lancet in 1867 and gave the Dublin address that summer. The 1878 and 1880 papers were read to the Academy of Sciences and printed in its Comptes rendus; Harold C. Ernst of Harvard translated them.

Reception

Antiseptic surgery spread unevenly, faster in Germany than in Britain at first, and gradually gave way to aseptic technique (sterilised instruments, gowns and dressings) in the 1880s and 1890s. Robert Koch's work on anthrax (1876) and on tuberculosis (1882) placed bacteriology on firm methods, and Pasteur's vaccines against chicken cholera, anthrax and rabies (1885) made him a national hero in France. Historians have since discussed Pasteur's laboratory notebooks, opened in the 1970s, and the relation between his public accounts and his private procedures.

Comparisons

• hempel-philosophy-of-natural-science

  Hempel's opening case study is Semmelweis and childbed fever; Pasteur's 1880 paper returns to puerperal fever with cultures and recommends antiseptic precautions after confinement.

• bernard-introduction-to-experimental-medicine

  Bernard, Pasteur's contemporary in Paris, set out the method of hypothesis and controlled experiment in physiology that Pasteur's flask and culture experiments carry out in microbiology.

• harvey-on-the-motion-of-the-heart-and-blood

  Printed in the same Harvard Classics volume, Harvey's treatise also overturns an ancient medical consensus by experiment, and his Chapter XVI on contagion carried through the blood anticipates questions Pasteur answered with cultures.

• lavoisier-elements-of-chemistry

  Lavoisier analysed vinous fermentation as a balance of chemical elements; Pasteur shows that the same transformation is the work of living cells deprived of oxygen.

• hippocratic-writings

  Airs, Waters, Places ties disease to climate and air; Lister and Pasteur keep the attention to air but locate the danger in living particles carried by it.

Quotes

For Students

A reading companion for classical Christian high school students. See the student guide.

Reading Guide

Watch for

• Lister's opening argument. Notice that he reasons from Pasteur's discovery to a practical consequence: if germs, not oxygen, cause putrefaction, the air need not be kept out.
• Lister's closing paragraphs on the health of his wards, and the evidence he offers that the antiseptic treatment caused the change.
• Pasteur's dedication to his father and his preface, which ties the study of beer to France after the war of 1870.
• The phrase 'life without air' in the fermentation chapter and how the experiments with flasks, fruits and vibrios support it.
• The twelve successive cultures of anthrax in the 1878 paper, and Pasteur's closing modesty in 1880 about working in a field not his own.

Key terms and names

Germ theory

The teaching that many diseases, and fermentation and putrefaction, are caused by specific living micro-organisms rather than by bad air or spontaneous chemical change.

Spontaneous generation

The old belief that living things such as microbes can arise directly from non-living matter. Pasteur calls it chimerical.

Antiseptic

A substance that kills or checks microbes in or on living tissue. Lister used carbolic acid; Pasteur recommended boric acid.

Suppuration

The formation of pus in a wound or abscess, which Lister attributes to decomposition caused by germs.

Pyaemia, erysipelas and hospital gangrene

Infections that spread through hospital wards in the nineteenth century and killed many surgical patients.

Anaerobe

An organism that lives without free oxygen. Pasteur shows that the butyric and septic vibrios are anaerobes and that air can kill them.

Puerperal fever

Childbed fever, an infection of women after giving birth, which Pasteur cultured from patients at the Lariboisière hospital.

Culture

The growing of micro-organisms in a sterile nutrient fluid outside the body, which allowed Pasteur to isolate and test a single kind of microbe.

Seminar Questions

1. Comprehension What had most surgeons assumed was the cause of putrefaction in wounds, and how did Pasteur's work change Lister's view?
2. Comprehension How did Pasteur show that anthrax is caused by its bacterium and not by some other substance in the blood of the sick animal?
3. Comprehension What precautions does Pasteur recommend for women after childbirth, and why?
4. Interpretation Lister writes that he 'came to welcome simple fractures' because they reduced the number of open sores in his wards. What does this detail reveal about hospital conditions before antisepsis?
5. Interpretation Pasteur began his beer research, he says, because of 'our misfortunes' after 1870. How do national hopes and practical industry shape the science in these papers?
6. Interpretation Why do you think Pasteur, so confident about fermentation, ends his 1880 paper by admitting that medicine is foreign to him and asking for criticism?
7. Big Question Before germ theory, physicians and surgeons spread infection without knowing it. What responsibility do people bear for harm they cause in ignorance, and what changes once the truth is known?

Faith Connections

• Leviticus 13–15 (Scripture)

  The Mosaic law prescribes washing, separation and the cleansing of garments and houses in cases of skin disease and bodily discharge. Readers have long noticed how these rules of purity, given for holiness before God, also guard against contagion in ways Lister's practice made explicit.

• Psalm 104:24 (Scripture)

  'O LORD, how manifold are thy works! in wisdom hast thou made them all.' Pasteur's papers open a world of tiny creatures, yeasts and vibrios living with and without air, that no one before the microscope had seen.

• Matthew 25:36 (Scripture)

  'I was sick, and ye visited me.' Lister's concern for the patients in his wards and Pasteur's for women after childbirth show the care of the sick that Christ counts as done to himself.

• Francis Bacon, Novum Organum (Great Conversation)

  Bacon hoped natural philosophy would relieve the condition of mankind. These papers are a clear case of laboratory knowledge turned to the saving of life.

Logic and Rhetoric

Central argument: Fermentation and putrefaction do not occur in fluids protected from living germs, and each kind is produced by its own organism, some of which live without air; diseases such as anthrax can be reproduced by an organism grown through many successive cultures, so that the organism and nothing else must be their cause; therefore wounds and childbirth infections are caused by germs, and destroying or excluding those germs with antiseptics should prevent them, as Lister's wards confirm.

Rhetorical device: argument from consequences in practice. Lister closes his address not with a further theoretical point but with the record of his wards before and after antisepsis, then states that the importance of the fact can hardly be exaggerated.

Debate: Resolved: A medical practice should be adopted as soon as its results are clear, even before its theory is fully proved.

Memory Work

The Sciences gain by mutual support.

It is characteristic of science to reduce incessantly the number of unexplained phenomena.

Writing Prompts

Essay: Trace the chain of reasoning that runs from Pasteur's studies of fermentation to Lister's carbolic dressings and Pasteur's advice on childbirth. Which link in the chain do you think was hardest to establish, and why?

Comparison with On the Motion of the Heart and Blood in Animals (De Motu Cordis): Harvey and Pasteur both overturned medical teaching that had seemed obvious for centuries. Compare how each uses experiment and calculation, how each addresses opponents, and how each presents himself to the learned bodies he addresses.

Medical Lens

These papers mark the passage from miasmatic and chemical theories of putrefaction to the germ theory of infection. Lister's 1867 address is the founding statement of antiseptic surgery: carbolic acid introduced into compound fractures and abscesses, dressings designed to keep the acid active, and the outcome measure of ward mortality from pyaemia, erysipelas and hospital gangrene. Pasteur's 1878 paper with Joubert and Chamberland applies serial culture to establish the causation of anthrax, identifies an obligate anaerobe (the septic vibrio, associated with malignant oedema or gas gangrene), and describes a pus-forming coccus and mixed infections. The 1880 paper isolates what were later called staphylococci from boils and osteomyelitis and chain-forming cocci (streptococci) from puerperal fever, decades after Semmelweis's clinical observations in Vienna, and proposes boric acid and heated compresses for obstetric care. The translator's notes, written in 1910, record which of Pasteur's predictions had been borne out. Carbolic acid and boric acid also belong to the history of pharmacology as early chemical antiseptics, and Lister's remark that carbolic paste was kept under tinfoil to slow its evaporation shows the practical chemistry involved.

• Lister, On the Antiseptic Principle, opening

  Lister links Pasteur's work on putrefaction to suppuration in wounds and introduces carbolic acid.

  Surgery Fever Infection Pharmacology Poisons
• Lister, On the Antiseptic Principle, compound fractures and abscesses

  Cases at the Glasgow Infirmary, including a boy treated eight and a half hours after injury, and the method of opening abscesses without admitting germs.

  Surgery Physicians Doctors
• Lister, On the Antiseptic Principle, closing

  Ward health before and after antiseptic treatment: nine months without pyaemia, hospital gangrene or erysipelas.

  Public Health Sanitation Fever Infection Death Dying
• The Germ Theory and Its Applications (1878)

  Serial culture of anthrax, the anaerobic septic vibrio, septic dust, and combined infections with the microbe of pus.

  Fever Infection Surgery
• On the Extension of the Germ Theory (1880), sections I–II

  Cultures from recurrent furuncles and from the trephined tibia of a twelve-year-old girl with osteomyelitis.

  Fever Infection Surgery
• On the Extension of the Germ Theory (1880), section III

  Observations of women with puerperal fever at the Lariboisière and recommendations for boric acid compresses after confinement.

  Childbirth Maternal Fever Infection Public Health Sanitation

Creative Prompts

• Classroom

  Recreate the logic of Pasteur's swan-neck flask with a diagram: show what happens to boiled broth in an open flask, a sealed flask and a flask whose curved neck admits air but traps dust.

• Essay

  Write the report a sceptical Glasgow surgeon might have given in 1868 after visiting Lister's wards, weighing his evidence and the alternative explanations then available.

• Classroom

  Calculate Pasteur's claim that twelve successive ten-cubic-centimetre cultures dilute the original drop as if into a volume the size of the earth. Is he right, and what does the dilution prove?

Further Reading

• The Life of Pasteur, René Vallery-Radot

• Lord Lister, Rickman John Godlee

• The Private Science of Louis Pasteur, Gerald L. Geison

• Microbe Hunters, Paul de Kruif

• The Butchering Art, Lindsey Fitzharris