Journal of the History of Medicine and Allied Sciences Advance Access originally published online on June 25, 2008
Journal of the History of Medicine and Allied Sciences 2009 64(1):1-37; doi:10.1093/jhmas/jrn043
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Causation and Cleanliness: George Callender, Wounds, and the Debates over Listerism
Correspondence: * Program in the History of Medicine, University of Minnesota, MMC 506 Mayo, 420 Delaware St. SE, Minneapolis, Minnesota 55454. Email: kerna001{at}umn.edu.
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Abstract |
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This article reexamines the surgical and historiographic debate over antisepsis and the germ theory through the work of the prominent London surgeon George W. Callender (1830–1879) and the statistical records of St. Bartholomew's Hospital. Surgeons in the mid-nineteenth century faced a rising incidence of wound infection and its systemic complications. Examining mortality and complication rates by type of wound, however, suggests that the extent of this crisis is often overstated. Callender himself occupied a frequently overlooked middle ground in the debate over Listerism. On the one hand, his program of cleanliness, which antedated Lister's work and extended from the wound to the ward, produced excellent and influential results. On the other, while he was never an explicit critic of the germ theory, his writings demonstrate why Lister's collapse of causation into a single etiologic agent was so difficult for surgeons to accept.
Key Words: antisepsis • asepsis • causation • Callender • germ theory • hospitalism • Lister • surgery (nineteenth century)
The author would like to thank John M. Eyler, Professor of the History of Medicine, University of Minnesota for his support, comments, and advice, Jacob Steere-Williams, University of Minnesota, for his comments on an earlier draft, and Ms. Samantha Farhall, Archivist, St. Bartholomew's Hospital, for her courtesy and help with primary source material. Additional thanks are given to the staff of the Wangensteen Library, University of Minnesota, and for the thoughtful comments of the two anonymous reviewers.