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The technical complexity might have been part of the difficulty. But there’s an equally long list of vital innovations that have failed to catch on. Plenty do: think of in-vitro fertilization, genomics, and communications technologies themselves. In our era of electronic communications, we’ve come to expect that important innovations will spread quickly. It was a generation before Lister’s recommendations became routine and the next steps were taken toward the modern standard of asepsis-that is, entirely excluding germs from the surgical field, using heat-sterilized instruments and surgical teams clad in sterile gowns and gloves. Instead of using fresh gauze as sponges, they reused sea sponges without sterilizing them. Surgeons soaked their instruments in carbolic acid, but they continued to operate in black frock coats stiffened with the blood and viscera of previous operations-the badge of a busy practice. Finney recalled that, when he was a trainee at Massachusetts General Hospital two decades later, hand washing was still perfunctory. Maybe it could do the same in surgery.įar from it. Lister had read about the city of Carlisle’s success in using a small amount of carbolic acid to eliminate the odor of sewage, and reasoned that it was destroying germs. Pasteur had observed that, besides filtration and the application of heat, exposure to certain chemicals could eliminate germs. Lister became convinced that the same process accounted for wound sepsis. In the eighteen-sixties, the Edinburgh surgeon Joseph Lister read a paper by Louis Pasteur laying out his evidence that spoiling and fermentation were the consequence of microorganisms. Infection was so prevalent that suppuration-the discharge of pus from a surgical wound-was thought to be a necessary part of healing. It was the single biggest killer of surgical patients, claiming as many as half of those who underwent major operations, such as a repair of an open fracture or the amputation of a limb. Sepsis-infection-was the other great scourge of surgery. They had quite made up their minds that pain was a necessary evil, and must be endured.” Yet soon even the obstructors, “with a run, mounted behind-hurrahing and shouting with the best.” Within seven years, virtually every hospital in America and Britain had adopted the new discovery. James Miller, a nineteenth-century Scottish surgeon who chronicled the advent of anesthesia, observed the opposition of elderly surgeons: “They closed their ears, shut their eyes, and folded their hands. Some people criticized anesthesia as a “needless luxury” clergymen deplored its use to reduce pain during childbirth as a frustration of the Almighty’s designs. There were forces of resistance, to be sure. By February, anesthesia had been used in almost all the capitals of Europe, and by June in most regions of the world. By mid-December, surgeons were administering ether to patients in Paris and London. The idea spread like a contagion, travelling through letters, meetings, and periodicals. But Bigelow reported that he smelled ether in it (ether was used as an ingredient in certain medical preparations), and that seems to have been enough. Morton would not divulge the composition of the gas, which he called Letheon, because he had applied for a patent. When she woke, she said she had experienced nothing at all.įour weeks later, on November 18th, Bigelow published his report on the discovery of “insensibility produced by inhalation” in the Boston Medical and Surgical Journal. The following day, the gas left a woman, undergoing surgery to cut a large tumor from her upper arm, completely silent and motionless. The patient only muttered to himself in a semi-conscious state during the procedure. On October 16, 1846, at Massachusetts General Hospital, Morton administered his gas through an inhaler in the mouth of a young man undergoing the excision of a tumor in his jaw. But people talking to people is still the way that norms and standards change. We yearn for frictionless, technological solutions.