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About Historical Medical Art

The Surgeon, circa 1900

By the end of the 19th Century, the development of the American surgeon as a medical specialist had evolved. Medical education was shifting from proprietary schools to university-based schools. William Halsted (1852-1922) of Johns Hopkins Hospital and School of Medicine formalized what is known today as the "sine qua non of modern surgical residencies."

William Morton (1819-1869), a dentist, successfully used sulfuric ether as a general anesthetic agent for surgical procedures in 1846. The following year, Marie Floureus (1794-1867) of Paris authored a paper announcing that chloroform had an effect analogous to ether.

As the use of ether and chloroform became more commonplace, speed during surgery was less important and the surgeon gained greater skill and developed more scientific approaches to surgical procedures.

"Contagion" or "hospital gangrene" took the lives of many patients and thus inhibited the evolution of surgery. As early as 1775, a French surgeon, Claude Pouteau (1724-1775) advocated clean hands in dealing with patients' wounds to prevent "putrescence". In 1843, Oliver Wendall Holmes (1808-1910) suggested hand washing in calcium chloride before attending women in childbirth to prevent the spread of Puerperal Fever.

The individual works of the Frenchman, Louis Pasteur (1809-1894) and the German, Robert Koch (1843-1910) advanced the knowledge that "germs and microbes" caused infectious diseases. Not until the 1867 published works of the English Quaker, Joseph Lister (1827-1912), on systematic antisepsis and the use of carbolic acid in surgery was the evolution complete.

I have chosen the period of 1900 for Anne Crawford in her oil rendering to depict the development of the "modern" surgeon and his operative environment. She has skillfully placed those inventions that were so vital to the outcome of surgical intervention.

Thus Lister's carbolizer, which destroyed many types of bacteria, became part of the operating room equipment and is seen on the table to the right.

Surgeons who previously wore "proper" suits during surgery, exchanged them for freshly-cleaned smocks or coats. Anesthesia was administered via Morton's ether inhaler and was the responsibility of an individual physician or nurse. An assistant, usually a nurse, soaked instruments in mercuric chloride and, using protective rubber gloves, passed them to the surgeon. Most surgeons simply washed their hands before surgery, however some had begun to wear rubber gloves. In this rendering, the surgeon prefers his tactile sense unimpeded by the thick and poorly fitting gloves available at the time.

For educational purposes, operations during this time were often performed in an amphitheater, although many were being moved to smaller and more confined rooms to reduce infection.