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Features Departments Information |
 Stanford T. Shulman, MD, Head, Division of Infectious Diseases, collects stamps with medical themes. As a regular Feature of The Child's Doctor, Dr. Shulman provides some of his favorite stamps and a brief commentary on them. |
Concepts in Asepsis and Antisepsis STANFORD T. SHULMAN, MD aSpring 1999 Among the most remarkable achievements in the history of medicine, one that made possible the development of modern surgery, was the development of the concepts of asepsis and antisepsis.  In the late 18th century, Lazaro Spallanzani (1729–1799) of Scandiano, Italy, made a number of important medical discoveries, including the fact that gastric juice can prevent putrefaction. Spallanzani, who also carried out key experiments disproving the concept of spontaneous generation, is shown on the gray and pink Italian stamp, looking rather dyspeptic.  By the mid-19th century, puerperal fever (streptococcal sepsis associated with childbirth) was a distressingly common illness with a high fatality rate. Oliver Wendell Holmes (1809–1894), poet, essayist and professor of anatomy at Harvard Medical School, was impressed by the observations of an English obstetrician and published in 1843 and again in 1855 papers On the Contagiousness of Puerperal Fever. Holmes, who is portrayed on the magenta U.S. stamp, argued (without personal data) that medical personnel appeared to spread contagion from infected women or post-mortem cases to women in labor or post-partum. This suggestion stirred violent opposition from many obstetricians.    Phillip Semmelweis stamps from Hungary (Magyar) As the dispute raged, an Austrian physician on the obstetric wards in Vienna, Ignaz Phillip Semmelweis (1818–1865), observed a relationship between high rates of puerperal fever (with high mortality) and exposure to personnel who had performed dissections on fatal cases or cared for infected women.    From Hungary (Magyar), Austria, and Grenada He was convinced that infection was transmitted by the hands of medical personnel. In 1847 Semmelweis required the thorough washing of hands with calcium chloride (lime) solution prior to patient contact and observed a rapid decline in mortality from 10% to 1%.   From Germany and Transkei Unfortunately, Semmelweis was opposed fiercely, was forced to leave Vienna for Budapest, and died early and insane. (It was several decades later that streptococci were demonstrated to cause puerperal infections and to be highly contagious).   Lord Joseph Lister (1827–1912) became England's greatest surgeon. Early in his career he was impressed by the great post-operative mortality related to infection. Unaware of Semmelweis' work in Vienna, Lister attempted chemical antisepsis for wounds, using carbolic acid dressings in compound fractures, amputations and other clean and dirty surgical wounds. He published his work in the Lancet in 1867 and revolutionized surgical procedures, enabling the development of modern surgery, even before specific bacteria were identified. Lister's fame was so great that he became the first medical person to be raised to the peerage. He is honored by the two British stamps [above], another from Transkei and the fourth from Benin [below left]. Two of the stamps show the apparatus used to vaporize carbolic acid. Benin also celebrated asepsis with the orange-red stamps showing scalpels being flame-sterilized [below right].    For nostalgia buffs, a famous Chicagoan is portrayed on the gold souvenir sheet from St. Vincent and the Grenadines in the Caribbean.  |