Royal Australasian College of Surgeons, East Melbourne
The spray consists of a steam boiler heated by a wick, a nozzle for the steam to escape, and a glass jar for the carbolic solution. Fuel for the wick is carried in a tank at the base. Valves regulate the pressure of the steam, and the nozzle is adjustable. The boiler is made of cast iron, the fittings are brass, and the handles are of wood. Empty, the apparatus weighs 8 lbs (3.2 kg).
The College’s spray was one of the first pieces of surgical memorabilia to come into the possession of the College. It had been used in the Listerian wards of the Glasgow Royal Infirmary, and was presented , along with some other artefacts, by James Hogarth Pringle in 1930.
Joseph Lister (1827-1912) is known as a father of modern surgery. His methods of preventing infection were controversial in their time, but are today recognized as a major advance in the practice of surgery. Lister’s life and achievements are too well known to be recounted here. The definitive biography was written by his nephew, Sir Rickman Godlee (PRCSE 1911-13), and published in 1917.
Douglas Guthrie gives an glimpse of Lister at work:
“...He never wore a white gown and frequently did not even remove his coat, but simply rolled back his sleeves and turned up his coat collar to protect his starched collar from the cloud of carbolic spray in which he operated...”
From advances in bacteriology, and discoveries by Robert Koch and others, it became increasingly evident that airborne bacteria were not a significant contributor to sepsis in surgical wounds. They also demonstrated that the body had its own defences against invading organisms, which were seriously compromised by the effects of the carbolic spray. Gradually the use of the spray was curtailed, Lister himself finally abandoning it in 1887.
Lister performed the first antiseptic operation, the dressing and splintage of a compound fracture of the lower leg, in 1865. At this time he used carbolic solution by application, and dressings soaked in the solution. The spray was developed later, after many different methods, including carbolic and linseed oil putty, had been tried in order to reduce the harmful side-effects of undiluted carbolic acid.
The steam spray was developed in 1869, and announced to the medical world in 1871. Lister’s purpose in adopting the spray was to kill airborne bacteria in the vicinity of the operation before they could reach the patient. It came to be used all over the world for many years. However, it had serious disadvantages, which even Lister acknowledged. The principal problem was the inhalation of carbolic vapour by everyone in the vicinity, including the patient and the operator. In addition, if the patient had been anæsthetized using chloroform, the gas lights decomposed the vapour into chlorine gas, making any procedure an ordeal of endurance.