Germs and governance by Anne Marie Rafferty Marguerite Dupree and Fay Bound Alberti

Author:Anne Marie Rafferty, Marguerite Dupree and Fay Bound Alberti
Language: eng
Format: epub
Publisher: Manchester University Press

Part III

Practice and infection control: Focus on gloves

6

Wax paste and vaccination: alternatives to surgical gloves for infection control, 1880–1945

Thomas Schlich

In this chapter, I discuss the history of various technologies for infection control in surgical operations. My account starts with the uptake of surgical gloves by practitioners in the late nineteenth century, which was a protracted process, and explains the relative disinterest of many surgeons in this particular technology by situating it in the context of other contemporary strategies of infection control. Exploring such alternative innovations shows that technological change in surgery and infection control does not happen in a vacuum. There are always multiple technological solutions to a problem. This chapter explores the alternatives to surgical gloves that were not taken up, arguing that this historical awareness provides a deeper understanding of the evolution of modern surgery and infection control.1

William Halsted and surgical gloves

Today, rubber gloves represent an important part of infection control in hospitals. In surgical operations, it is inconceivable for surgeons and nurses to work with their bare hands. Gloves were first used by operators during surgery in the 1880s. At the time, their introduction caused considerable controversy among surgeons, who only gradually adopted the innovation.2 If we look at the historical literature, we can see that many authors have been quite impatient about surgeons’ hesitation to use surgical gloves. This impatience results from a teleological perspective on the history of medicine. From such a perspective, historians judge events and developments in the past according to whether they lead up to how things are now. In our case, it means that anything that was conducive to the use of surgical gloves is considered rational. Anything that went towards a different solution of the problem is judged to be irrational. For example, Justine Randers-Pehrson, in her historical account for the introduction of gloves, found it ‘curious that it took lively minds so long to come around with the notion of an impermeable glove in surgery’. It was ‘even more curious’, she wrote, that, ‘when the proposal was finally made in the eighteen-nineties, it required more than a decade of passionate argument before final universal acceptance could be achieved’, explaining that ‘the human mind does not always dart straight to the obvious’.3 However, a closer investigation of the discussions at the time can show that surgeons had good reason to be sceptical about wearing gloves, including the loss of manual dexterity against the yet unproven benefits of gloves for infection control.4

There is one example in the history of surgical gloves that demonstrates how historians can benefit from a broader perspective when trying to understand why new techniques for infection control were accepted or rejected. It is the relatively well-known story of the first introduction of rubber gloves into the operating room (OR). This event happened in 1889 at the Johns Hopkins Hospital Department of Surgery, then headed by the famous William Halsted. As Halsted recalled it later, the nurse in charge of his OR ‘complained that the solution of mercuric

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