Imagine a modern day surgeon walking into an operation room or worse, tent, in the early 1860's, during the Civil War. This time was considered to be the middle ages of medicine. A Civil War general graphically depicted the typical surgery routine like this; "There stood the surgeons, their sleeves rolled up to their elbows, their bare arms as well as their linen aprons smeared with blood, their knives not seldom held between their teeth, while they were helping a patient on or off the table.The surgeon snatched his knife from between his teeth. wiped it rapidly once or twice across his bloodstained apron, and the cutting began."# Picture that in your mind and now wonder why 60% of the 620,000 people who died during that four-year war died from disease after visiting the so-called hospital.
In this time period before Louis Pasteur and his discovery and work with bacteria and viruses. Doctors during this time had inaccurate views about the causes of disease and infection; most blamed toxic "miasma" or "efflura" from wet swamplands or tents with poor ventilation. Some also thought that the ingestion of too much or too little salted meat, heat alternating with cold, battle stress or even the smell from the latrines caused all these diseases. A report in 1864 by the American Medical Association noted that the air was full of "pus corpuscles, floating about as dust," which would settle in the wounds and cause infection. These experts suggested that the need for better ventilation in the operating room was " the great lesson of war."# .
Granted, the last statement was an idea heading in the right direction, but the bloody, dirty, hands and tools of the surgeons were definitely overlooked as a problem. While most surgeons were aware of a relationship between cleanliness and low infection rates, they did not know how to sterilize their equipment. Due to a frequent shortage of water, surgeons often went days without washing their hands or instruments, thereby passing germs from one patient to another.