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Today I have two close friends in the hospital with heart problems. One of them had a triple bypass last week which went okay but now has an infection. The other just admitted today had a bypass ten years ago, and is now apparently having chest pains. Another friend had a bypass last year which went okay, and then a severe infection in his leg. Apparently the surgeons now know the mechanics of doing heart surgery, but don’t know how to keep their hands clean enough to prevent infection.

One hundred and thirty years ago, which was long before doctors knew much of anything about infectious microbes, they were able to prevent infections even in much dirtier operating rooms. The microbes are smarter now, because of their being able to evolve biological responses to antibiotics. Back in the 1880s they prevented infection by the use of what some called a puffing billy,  which was a device for spraying carbolic acid (or other antiseptics) over the surgical incision. That sounds primitive but it worked better than what is being done now. Among my personal friends it’s been two for two who got nosocomial (hospital induced) diseases in the last two years which makes me, a total outsider, a bit suspicious of the current medical procedures. Last month this blog discussed how Iatrogenic and nosocomial diseases can be limited using a bio-protective suit. This suit would be put on while the patient was still at home before entering the hospital and would contain all of the necessary operating equipment prepackaged within the suit.

Tyvek coveralls

Tyvek coveralls

The ideal pre-manufactured suit would have built-in surgeon’s gloves and windows, so the medical staff could perform all of the expected operations without ever opening it. Sometimes, of course it would be necessary to open, but that could be kept to the absolute minimum, and while it was opened extraordinary measures could be taken to prevent infections—such as using the puffing billy shown below. The following is from Conan Doyle’s Round the Red Lamp – His First Operation, published 1904.

“Who are the two men at the table?”

“Nobody–dressers. One has charge of the instruments and the other of the puffing Billy. It’s Lister’s antiseptic spray, you know, and Archer’s one of the carbolic-acid men. Hayes is the leader of the cleanliness-and-cold-water school, and they all hate each other like poison.”

Carbolic Acid sprayer.

Carbolic Acid sprayer.

Lord Lister with the puffing billy on a stand.

Lord Lister operating while using the puffing billy mentioned by Conan Doyle.

From the University of Manitoba, Health Sciences Libraries Lord Lister Remembers – Slides .

These guys are apparently operating with very little (if anything) in the way of cleanliness, and are even wearing street cloths, but they are seen using anesthesia and an antiseptic spray. As Lister was world renowned for his success, he must have been successful. Modern surgeons are greatly advanced in their technical ability, but are no longer renowned for their success, and seem to be losing the battle against infections.

The following is from Proba-Heal 1995 – How to Accelerate the healing of cuts, scratches and abrasions.

I have used and refined these techniques for healing cuts and abrasions over the last thirty years—it works well for me. Begin with a standard soap and water cleaning of the wound to remove as many germs and as much foreign material as possible. Next, to prevent any new germs from getting a foothold in it, paint a border of 2% tincture of iodine around the wound, about ¼ inch away from any injured tissue, being careful not to get any iodine on the wound. Not only does it hurt, but it kills the good organisms along with the bad ones. The goal here is to create a toxic cloud of iodine vapor above the surface of the wound, which will preferentially debilitate the nasty germs on and above the injured surface but not greatly annoy the infection fighting organisms just underneath the surface. Also dry out the germs on the surface of the injury. The best way to do this is with a 1200 watt hair dryer set on the high heat setting and blowing its stream of hot air directly onto the injury. Bring the surface temperature of the wound up to but just short of the pain level then remove the heat. The procedure so far is to dry out and otherwise debilitate the infectious germs on the surface of the wound or at least to weaken them to the point where the body’s defense mechanisms can more easily destroy them.

The thing that is different about this direct contact infection fighting procedure, and the current ones, is that the toxic iodine is not placed upon the wound, but around it. Doing this “will preferentially debilitate the nasty germs on and above the injured surface but not greatly annoy the infection fighting organisms just underneath the surface.”

Current medical practice, so far as I know, prevents infections with antibiotic shots to the whole patient and swabs Betadine disinfectant directly upon the various incisions. This procedure fails because the germs have developed immunity to the antibiotics and the Betadine sabotages the patient’s immune system at the exact spot where it is trying to do its work-at the site of the incision.

Far better to avoid the hospital by living a clean life, eating well, exercising daily and never taking stupid risks.