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Meanwhile, British surgeon Joseph Lister ( [link] ) was trying to determine the causes of postsurgical infections. Many physicians did not give credence to the idea that microbes on their hands, on their clothes, or in the air could infect patients’ surgical wounds, despite the fact that 50% of surgical patients, on average, were dying of postsurgical infections. Alexander, J. Wesley. “The Contributions of Infection Control to a Century of Progress” Annals of Surgery 201:423-428, 1985. Lister, however, was familiar with the work of Semmelweis and Pasteur; therefore, he insisted on handwashing and extreme cleanliness during surgery. In 1867, to further decrease the incidence of postsurgical wound infections, Lister began using carbolic acid (phenol) spray disinfectant/antiseptic during surgery. His extremely successful efforts to reduce postsurgical infection caused his techniques to become a standard medical practice.

A few years later, Robert Koch ( [link] ) proposed a series of postulates (Koch’s postulates) based on the idea that the cause of a specific disease could be attributed to a specific microbe. Using these postulates, Koch and his colleagues were able to definitively identify the causative pathogens of specific diseases, including anthrax, tuberculosis, and cholera. Koch’s “one microbe, one disease” concept was the culmination of the 19th century’s paradigm shift away from miasma theory and toward the germ theory of disease. Koch’s postulates are discussed more thoroughly in How Pathogens Cause Disease .

a) Photo of Joseph Lister b) Photo of Robert Koch
(a) Joseph Lister developed procedures for the proper care of surgical wounds and the sterilization of surgical equipment. (b) Robert Koch established a protocol to determine the cause of infectious disease. Both scientists contributed significantly to the acceptance of the germ theory of disease.
  • Compare and contrast the miasma theory of disease with the germ theory of disease.
  • How did Joseph Lister’s work contribute to the debate between the miasma theory and germ theory and how did this increase the success of medical procedures?

Part 2

After suffering a fever, congestion, cough, and increasing aches and pains for several days, Barbara suspects that she has a case of the flu. She decides to visit the health center at her university. The PA tells Barbara that her symptoms could be due to a range of diseases, such as influenza, bronchitis, pneumonia, or tuberculosis.

During her physical examination, the PA notes that Barbara’s heart rate is slightly elevated. Using a pulse oximeter, a small device that clips on her finger, he finds that Barbara has hypoxemia—a lower-than-normal level of oxygen in the blood. Using a stethoscope, the PA listens for abnormal sounds made by Barbara’s heart, lungs, and digestive system. As Barbara breathes, the PA hears a crackling sound and notes a slight shortness of breath. He collects a sputum sample, noting the greenish color of the mucus, and orders a chest radiograph, which shows a “shadow” in the left lung. All of these signs are suggestive of pneumonia , a condition in which the lungs fill with mucus ( [link] ).

Chest X-rays show ribs and other bones as white and the lungs as black. The left image has significant white cloudiness in the lungs. This lung infiltrate is suggestive of pneumonia. Normal lungs show a smooth, even black color throughout the lungs.
This is a chest radiograph typical of pneumonia. Because X-ray images are negative images, a “shadow” is seen as a white area within the lung that should otherwise be black. In this case, the left lung shows a shadow as a result of pockets in the lung that have become filled with fluid. (credit left: modification of work by “Christaras A”/Wikimedia Commons)
  • What kinds of infectious agents are known to cause pneumonia?

Jump to the next Clinical Focus box. Go back to the previous Clinical Focus box.

A timeline. To the far left are the ancient Greeks who proposed the Miasma Theory. In 1546 Fracastoro begins early version of Germ Theory in De Contagione et Contagiosis Morbis. In 1665 Hooke observes cork cells under a microscope. In 1674 van Leeuwenhoek observes single-celled organisms. In 1847 Semmelweis demonstrates that hand washing reduces puerperal infections. In 1854 Snow demonstrates that cholera bacteria were transmitted in contaminated drinking water. In 1856 Pasteur discovers microbial fermentation while studying the cause of spoilage in beer and wine. In 1862 Pasteur disproves spontaneous generation with swan-neck flask experiment. In 1867 Lister begins using carbolic acid as a disinfectant during surgery. From 1867 – 1906 Koch and his workers determine causative agents for many bacterial infections.
(credit “swan-neck flask”: modification of work by Wellcome Images)

Key concepts and summary

  • Although cells were first observed in the 1660s by Robert Hooke, cell theory was not well accepted for another 200 years. The work of scientists such as Schleiden, Schwann, Remak, and Virchow contributed to its acceptance.
  • Endosymbiotic theory states that mitochondria and chloroplasts, organelles found in many types of organisms, have their origins in bacteria. Significant structural and genetic information support this theory.
  • The miasma theory of disease was widely accepted until the 19th century, when it was replaced by the germ theory of disease thanks to the work of Semmelweis, Snow, Pasteur, Lister, and Koch, and others.

Fill in the blank

John Snow is known as the Father of _____________.

epidemiology

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The ____________ theory states that disease may originate from proximity to decomposing matter and is not due to person-to-person contact.

miasma

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The scientist who first described cells was _____________.

Robert Hooke

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Short answer

How did the explanation of Virchow and Remak for the origin of cells differ from that of Schleiden and Schwann?

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What evidence exists that supports the endosymbiotic theory?

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What were the differences in mortality rates due to puerperal fever that Ignaz Semmelweis observed? How did he propose to reduce the occurrence of puerperal fever? Did it work?

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Source:  OpenStax, Microbiology. OpenStax CNX. Nov 01, 2016 Download for free at http://cnx.org/content/col12087/1.4
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