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.

Top 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.

• 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.

• 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.

• 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.

Verified Quotes

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.

• 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.

• Lister, On the Antiseptic Principle, closing

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

• 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.

• 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.

• 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.