OLIVER WENDELL HOLMES SENIOR—ANESTHESIA AND ANTISEPSIS. In the early days of this blog, I posted here that in writing the blog I had in mind my father leading the conversation at our dinner table, and comparing himself to the Autocrat of the Breakfast Table, the title character in THE AUTOCRAT OF THE BREAKFAST TABLE, a book by Oliver Wendell Holmes Senior. Gawande’s analysis of the rates of adoption of anesthesia and antisepsis calls to mind Holmes Senior because, although a prominent poet and essayist—known for his conversational style— he played a role, as a medical doctor, in promoting both anesthesia and antisepsis. His role with anesthesia was to name it. This wikipedia article says that Holmes proposed the use of the word “Anaesthesia”, predicting that the term “will be repeated by the tongues of every civilized race of mankind.”

With antisepsis, he published, in 1843, an early article, “The Contagiousness of puerperal fever”, which argued that puerperal fever “childbed fever” was spread to patients by contacts with their physicians. Holmes wrote that a physician who lost a patient to childbed fever, “had a moral obligation to purify his instruments, burn the clothing he had worn while assisting in the fatal delivery, and cease obstetric practice for a period of at least six months.”

Resistance to the theory was great. The wikipedia article cites one of his opponents who wrote that “doctors are gentlemen, and ‘gentlemen’s hands are clean'”.

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