The Butchering Art: Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine

by Lindsey Fitzharris

Lister’s focus on cleanliness was still linked to his belief that outbreaks of hospitalism were due to the poisonous atmosphere on the wards. Others had already started to question this theory. Between 1795 and 1860, three doctors put forward the idea that puerperal (or childbed) fever—which, like sepsis, was accompanied by both localized and systemic inflammation—was caused not by miasma but by materies morbi (morbid substances) transmitted from doctor to patient. Each believed the disease could be prevented by following strict rules of cleanliness in the hospitals. The first of these three doctors was a Scotsman named Alexander Gordon, who was working in Aberdeen when a prolonged outbreak began there in December 1789. Over the course of three years, Gordon treated seventy-seven women who had contracted puerperal fever, twenty-five of whom died in his care. In his report published in 1795, he argued that “the cause of the epidemic Puerperal Fever under consideration was not owing to a noxious constitution of the atmosphere” [that is, miasma] but rather to the medical staff itself, which spread the fever to new patients after attending those afflicted with it. Gordon was convinced that the cause of puerperal fever was something on the practitioners themselves. He claimed he could “foretell what women would be affected with the disease, upon hearing by what midwife they were to be delivered, or by what nurse they were to be attended during their lying-in.” In almost every i...