Journal of Investigative Surgery, 22, 82–87, 2009Copyright C© Informa Healthcare USA, Inc.ISSN: 0894-1939 print / 1521-0553 onlineDOI: 10.1080/08941930902794729

HISTORICAL NOTE

Louis Pasteur Surgical RevolutionLuis H. Toledo-Pereyra, MD, PhD

ABSTRACT

Louis Pasteur (1822–1895) is considered the most notable medical scientist of his time and perhapsone of the most distinguished of all times in the history of medicine. From Dole in France to Paris,from a student of crystals to “living ferments,” and from chemistry to biology and medicine, Pasteurchanged the world for the benefit of humanity. The genius of Pasteur dealt with the most pressingissues of his time, basing the germ theory on the effects that microorganisms had on fermentationand putrefaction of organic matter, which gave birth to the science of bacteriology. Many otherdifficult problems in medicine and biology were tackled by Pasteur, culminating in the spectacularresults seen with the treatment of rabies. Surgery was no exception to the scientific conquests ofPasteur. The transformation of the surgical world arose from the antiseptic concepts of Lister thatwere based on the germ theory of the disease, which had been derived from the germ theory offermentation and putrefaction discovered by Pasteur. The acceptance of these principles representedthe surgical revolution brought on by the science of Pasteur, a revolution that is now accepted inour daily care of surgical patients.

Keywords: Louis Pasteur, Germ theory, Fermentation, Surgical revolution

Cette grande et belle intelligence, si simple et si robuste.

(Yourievitch, Emile. Duclaux, p. V, 1920.)

In the overall field of the medical sciences, there isno greater or more dependable figure than the notedFrench chemist Louis Pasteur (1822–1895). He abso-lutely changed the medical world by solving the mostpressing medical puzzles of his time. His discoverieswere so extraordinary that they allowed for a surgicalrevolution to ensue a new way of treating patients.

Specifically, Louis Pasteur opened up the universe ofmedicine and surgery for all practitioners to effectivelyapply his revolutionary principles. Pasteur was always

Received January 15, 2009; accepted February 3, 2009.Address correspondence to Dr. Luis H. Toledo-Pereyra, Michi-gan State University, Kalamazoo Center for Medical Studies,1000 Oakland Drive, Kalamazoo, Michigan 49008, USA. E-mail:toledo@kcms.msu.edu

ready to lend a helpful hand regarding the critical is-sues of the day, whether in understanding crystals, thenature of fermentation, the origin of life, the proposi-tion and verification of the germ theory, or the patho-logical characterization of anthrax, cholera, and rabies.

Our intention is to define some of the works of Pasteurthat permitted him to introduce and sustain a surgicalrevolution worthy of recounting.

PRELIMINARY OBSERVATIONS

In the middle of the nineteenth century, in spite of thou-sands of years of medical knowledge, microbiology orbacteriology had not yet been founded. Louis Pasteurremains the main protagonist in this story [1–10], fol-lowed closely by the equally brilliant German physi-cian Robert Koch (1843–1910). Together they should beconsidered the fathers of this exciting field of medicineand surgery [3–10]. It is well known, of course, that

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medicine or surgery could not have reached the lev-els seen today without the discoveries of Pasteur andKoch. Our concentration here is directed toward Pas-teur and his unique accomplishments. Therefore, hislife will not be emphasized a great deal.

Many more qualified individuals have written exten-sively about Pasteur [1–10]. Several outstanding booksaddress all aspects of his life and scientific deeds. Suf-fice it to say that Emile Duclaux in 1896 [1], ReneVallery-Radot in 1927 [5], Rene Dubos in 1950 [3], andother excellent contemporary works by Geison and De-bre relate the details of Pasteur’s life [5, 7, 10]. Dubos, in1960, gave us another masterpiece, Pasteur and ModernScience [8]. Clearly, Pasteur’s life has been well coveredbefore, and our main intention here is to analyze thisgreat French research scientist from our own personalperspective, and within the development of a new sur-gical revolution.

PASTEUR IS BORN IN FRANCE ANDGOES TO SCHOOL

The city of Dole, near the Swiss border in the mid-eastern part of France, saw the birth of Louis Pasteuron December 27, 1822 [8]. Dole did not know as well asthe rest of the world that this new citizen would shapemedical science to a point never seen before, to a pointnever imagined, to a point of incredible heights!

Years later, Jean-Joseph Pasteur, father of Louis, movedhis family to the close-by town of Arbois, where hefounded a tannery on the banks of the Cuisance River.The Pasteurs remained in this city until the passingof Jean-Joseph. Young Louis completed primary andsecondary schools at Arbois in 1831 and 1839, respec-tively. He continued his college studies at Besancon in1842 [8].

Now, Louis Pasteur, the son of a tanner, the taciturn andserious young man, was ready to leave his immediatesurroundings to explore a professional life. His fatherhad high academic ambitions for Louis, involving somekind of professorship because of its social recognition.Without further consideration, young Pasteur got him-self admitted to the famous Ecole Normale Superieurein Paris in 1843 at the age of 21. Once there, he turnedhis attention to physics and chemistry [8].

His academic work at the Ecole Normale was not espe-cially distinguished and was mainly represented by av-erage or above-average activities. Nothing at this stagedemonstrated the genius inside Pasteur. By 1847, hegraduated with a doctorate in physics and chemistryand turned to research that concentrated on the fieldof crystallography, a popular pursuit in the science of

that day. Thus far Pasteur had been a student, but in hisfuture we recognize Pasteur the discoverer, Pasteur thesolver of practical problems through scientific technol-ogy, and Pasteur the genius of biology, medicine, andsubsequently surgery, as related to the advancement ofthese disciplines.

PASTEUR BEGINS TO DISCOVER

Delafosse, Jean Baptiste Biot, and Mitscherlich calledattention to Pasteur’s inquisitive mind as to the opticalactivity of tartrate crystals. While Mitscherlich claimedchemical equality of various tartrates, Pasteur saw anincompatibility and proceeded to prove it. In 1848, Pas-teur demonstrated his first discoveries on asymmetryof crystals [8]. Details of the experiments that orientedPasteur toward his critical conclusions will not be re-ferred to here; I recommend that interested readersreview the original works of Monsieur Pasteur, excel-lently compiled by his grandson Pasteur Vallery-Radot[2], as well as the lucid presentation by his appreciativedisciple Emile Duclaux [1].

From 1849 to 1857 while outside of Paris, Pasteur be-came professor of chemistry at Strasbourg (1849–1854)(see Figure 1), married Marie Laurent (daughter of therector of the University of Strasbourg), had three chil-dren, became professor of chemistry and Dean of theFaculty of Sciences at Lille (1854–1857), was awardedtwo medals by the Legion of Honor and the Royal Soci-ety for his work on crystallography, and published hisfirst classic paper on fermentation in 1857 [1, 3, 5, 7, 8].

Let’s address for a moment Pasteur’s monumentalwork on fermentation. While at Lille, he was askedto study the problem of alcoholic fermentation and thequestion was, could contamination that occurred dur-ing fermentation possibly prevent the development ofgood alcohol? Pasteur carefully studied the issue, tooksamples, visited factories, and came up with a conclu-sion. Pasteur had determined that yeast found duringalcoholic fermentation was a living thing and that theorganic materials present were the food for the livingthings [8]. Furthermore, the man of Dole completedthis work by publishing his remarkable studies on lac-tic acid fermentation [2].

From 1857 to the end of his scientifically creative life,Pasteur moved back to Paris, where he committed hisheart and soul to important biological and medicalproblems. He was director of scientific studies at theEcole Normale (1857–1867), and director of the lab-oratory of physiological chemistry at the same place(1867–1888), with an interlude as professor of chem-istry at the Sorbonne in Paris (1867–1874). In 1888, the

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Figure 1. Louis Pasteur around 1852 while a professor at theUniversity of Strasbourg (obtained from Dubos R. LouisPasteur: Free Lance of Science, 1950).

Pasteur Institute was opened and, as expected, he oc-cupied a place of honor there [3, 8].

PASTEUR DISMISSES SPONTANEOUSGENERATION

Spontaneous generation postulated the creation of lifefrom nonorganic matter. For centuries, many believedthat life came from inanimate matter [1–10]. Otherscould not accept this dictum, and instead associatedthemselves with Virchow’s beliefs that “only cells arisefrom cells” [8]. For Pasteur it was not difficult to under-stand that life originated from life; he felt compelled todemonstrate the truth with clear and forthright exper-iments (Figure 2).

In his usual manner, Pasteur swiftly moved towardconfidently proving that spontaneous generation didnot exist. Dubos, a well-known student of Pasteur, sum-marized the professor’s considerations regarding thiscontestable phenomenon:

Time and time again, he (Pasteur) asserted that he wasready to believe in spontaneous generation if it couldbe shown . . . experimentally [8].

Figure 2. Device used by Pasteur to study microorganismsunder the microscope in absence of air. Please note the flaskto the left of the viewer depicting the swan-type imageending in the container (a) at the far left (obtained fromDubos R. Pasteur and Modern Science, 1998)

Pasteur did not find spontaneous generation to be realin various experiments, such as the lack of alcoholicyeast fermentation from clusters protected with cotton,or the experiments with swan-neck flasks that trappedall contaminants in the neck while the fluid in the flasksremained sterile [8]. Pasteur, with all his superior ex-periments, repeatedly and completely eliminated thepossibility of spontaneous generation. In fact, Dubossays, “Today after more than a century, the fluids inthese very same flasks stand unaltered, witness to thefact that organic matter can be protected from the de-structive action of living forces . . . ” [8]. The issue wasdecisively settled in favor of Pasteur.

PASTEUR INTRODUCES THE GERMTHEORY

From his studies on fermentation, starting in 1855, andhis pioneering publication of Memoire sur la fermenta-tion appelee lactique in 1857 [1–3], Pasteur began his out-standing road to the development of the germ theoryof fermentation, and later to the germ theory of dis-ease. Again, the same excellent biographer mentionedbefore, Rene Dubos (1901–1993), an acclaimed scientistand bacteriologist himself with important French roots,indicated how Pasteur considered this unique conceptin his 1864 Sorbonne lecture [8]:

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The germ theory is not a philosophical theory of life,but merely a body of factual observations from a se-ries of practical operations. It teaches that fermenta-tion, decomposition, putrefaction were caused by liv-ing micro-organisms, ubiquitous in nature; that thesemicro-organisms are not begotten by the decomposingor fermenting fluid, but come into it from the outside;that sterile liquid exposed to sterile air will remain ster-ile forever.

There was no question in the mind of Pasteur about thedefinitive significance and understanding of the germtheory, “for life is a germ and a germ is life,” as hesaid [8]. The concept had been presented and obvi-ously accepted by the audacious and intrepid geniusof Pasteur. Everything began with fermentation, andthereafter it did not take too long to extrapolate theconcept that germs affected human beings! There wasgreat similarity between biological and chemical andmedical and surgical diseases. They looked practicallythe same, though with a different cover. After Pasteur’sfindings about fermentation, the knowledge was in theopen to be applied to medicine and surgery.

PASTEUR MOVES INTO SILKWORMDISEASE, ANTHRAX, CHOLERA,AND RABIES

Pasteur had many scientific interests, but in several in-stances he responded to the needs of his country aswell. Pasteur was ready to help others, whether thecall came from a nation, a small town, a small groupof concerned citizens, or a large crowd. He always hada positive response. For example, the call regardingthe contamination of alcoholic fermentation came fromMonsieur Bigo immediately after Pasteur arrived inLille in 1854; Pasteur also studied ways to improve thetaste and quality of wine, vinegar, and beer; and in-troduced pasteurization for many fluids, such as milk,wine, beer, etc.

In 1865, central and southern France called once againfor Pasteur’s help, since the production of silk from silk-worms was in ruins! [8]. Pasteur responded without de-lay and from 1865 to 1870 he concentrated on studyingsilkworms. He made considerable contributions to thisfield of knowledge, identified specific parameters, andeducated the public as to various ways to control thedisease, mainly based on hygienic measures with goodventilation and guidelines for disease prevention. Hishelp once more was critical to another region of France(Figure 3). Around this time, in 1868, Pasteur suffered adevastating stroke that paralyzed his left side and im-peded him to participate and do many activities in the

Figure 3. Pasteur at the age of 46 probably before he had thestroke that paralyzed his left side (obtained from Dubos R.Louis Pasteur: Free Lance of Science, 1950).

laboratory with his left extremities. He had to changethe way he did things and did without complaints.

In 1877, the minister of agriculture for the second timerequeseted Pasteur’s help, this time to solve the patho-logical puzzle of anthrax, which was decimating manydomestic animals. Pasteur, in his usual manner, inves-tigated healthy and diseased animals, and came upwith vaccination of living attenuated cultures of an-thrax bacillus as the answer for this medical problem. In1881, on the farm at Pouilly le Forte, Pasteur conducteda public experiment. The results were spectacular—all vaccinated animals survived and all unvaccinatedones died. Pasteur was further recognized for theseresults.

Around the same time, in 1878, Pasteur began his stud-ies of chicken cholera. Here, he found important bio-logical and immunological ideas, which, in many ways,were going to advance the principles delineated byPasteur. By studying cultures of chicken cholera heobserved that virulence could be attenuated throughsubsequent generations [8]. The virulence of attenu-ated cultures could be enhanced by passing the micro-organisms through certain animals [8]. Many more

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Figure 4. Oil painting on canvas of Louis Pasteur completedin 1885 by the Finish artist Albert Edelfelt (1854–1905). Thiswork of art is located in the Musee d’Orsay, Paris.

scientific details were enunciated by Pasteur throughthe completion of these studies [8].

Rabies came next and, in 1881, the experiments on thiscondition occupied Pasteur’s attention. He was at theend of what would be for others the active years oflaboratory work. Not so for Pasteur. He armed himselfwith intense desire and strong scientific determinationto pursue this disease. He began the study of rabid an-imals to understand the disease’s cycle. He recognizedthat spinal cords of dying rabbits with rabies could bekept noninfective by maintaining them in sterile, driedair for 2 weeks [8]. By developing a system of vari-ous concentrations of inoculated material, he was ableto protect animals, even from the most virulent rabiesvirus [8] (Table 1).

It was not hard to proceed from here to the humanbeings infected with rabies. Pasteur developed a vac-cine and determined the timing, method, and length ofadministration. His first patient, Joseph Meister, livedfor more than 50 years after rabies exposure and treat-ment. This was another extraordinary triumph of Pas-teur and his team. Although this success was not believ-able under normal conditions, with Pasteur everythingseemed possible!

Table 1. Brief evolution of Louis Pasteur’s life andaccomplishments

Year Development

1822 Birth, Dole, France1857 First paper on fermentation1861 Anaerobic life experiments1865–1870 Silkworm disease [experiments at Ales]1866 Pasteurization1868 Stroke, paralyzed left side1877, 1881 Studies on anthrax [experiments at Pouilly le

Fort]1879 Work on fowl cholera1881 Study of rabies1885 First human treated for rabies1895 Pasteur dies near Paris

PASTEUR GETS CLOSER TO SURGERYAND BECOMES FRIENDS WITH LISTER

Pasteur performed a large number of studies dealingwith the germ theory of fermentation. The applica-tion of these principles to the germ theory of diseasewas clear and immediate. Joseph Lister (1827–1912),the noted British surgeon–scientist, saw real possibil-ities in the findings of the French chemist. Uninten-tionally, both Pasteur and Lister began circling eachother regarding the role of germs and their effect onfermentation and specifically on surgical, infectiousdiseases.

Since early in his productive surgical career, Lister rec-ognized the pioneering efforts of Pasteur and rapidlysubscribed to the same principles of the harmful effectof microorganisms on biological conditions (fermenta-tion) and/or surgical problems, as clearly seen by Listerin the case of his infected compound fractures [8].

It was unavoidable that Lister and Pasteur would even-tually link their scientific interests during their life-times. The work of Pasteur was a constant reminderto Lister, who followed closely the extraordinary dis-coveries of the French master.

The admiration and appreciation that Lister had forPasteur was evident throughout his studies and publi-cations. Lister recognized in public and in writing thecontributions of this unique French man of science [8].The culmination of Lister’s acknowledgment towardPasteur can perhaps be summarized in a letter sentfrom Edinburgh in February 1874 [8].

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My Dear Sir:

Allow me to beg your acceptance of a pamphlet, whichI sent by the same post, containing an account of someinvestigations into the subject, which you have doneso much to elucidate, the germ theory of fermentativechanges. I flatter myself that you may read with someinterest what I have written on the organisms whichyou were the first to describe in your Study on the lacticfermentation.

I do not know whether the records of British Surgeryever meet your eye. If so, you will have seen from timeto time notices of the antiseptic system of treatment,which I have been labouring for the last nine years tobring to perfection.

Allow me to take this opportunity to tender you mymost cordial thanks for having, by your brilliant re-searches, demonstrated to me the truth of the germtheory of putrefaction, and thus furnished me with theprinciple upon which alone the antiseptic system canbe carried out. Should you at any time visit Edinburghit would, I believe, give you sincere gratification to seeat our hospital how largely mankind is being benefitedby your labours.

I need hardly add that it would afford me the high-est gratification to show you how greatly surgery isindebted to you.

Forgive the freedom with which a common love ofscience inspires me, and believe me, with profoundrespect,

Yours very sincerely,

Joseph Lister

Pasteur, happily surprised by Lister’s letter of recog-nition, responded with pride and gratefulness. In ad-dition, he offered a suggestion to the British surgeonregarding the method of culture utilized in his studies,recommending an enhanced strictness in the cultur-ing techniques [7]. In reality, Pasteur was trying to behelpful rather than critical. This was a way for him todemonstrate his deep appreciation for Lister’s recogni-tion. This correspondence opened widely the doors ofcommunication, friendship, and respect between thesetwo universal scientists.

PASTEUR CREATES A SURGICALREVOLUTION

There is no question in my mind that Pasteur createda surgical revolution as we understand it today, that isa real change in the discipline. The principles that sur-

geons claim to be important today would not have hap-pened in a world deprived of Pasteur’s input and posi-tive influence. He generated concepts that would allowsurgeons like Lister to apply them more directly. Pas-teur defined how germs can be harmful under many bi-ological conditions. He advanced knowledge by char-acterizing the role of air, oxygen, and dirtiness on germgrowth, and disseminated this knowledge.

That Pasteur was not a surgeon is well known. In thesame way, it is well known that not only surgeonsmake contributions to the surgical field. Many otherscientists and professionals can substantially add tothe discipline by developing the tools, methods, ortechniques that surgery so frequently needs. Pasteurwas a primary contributor among this group. Considerthat Pasteur discovered the action of microorganismsin changing organic matter, as in fermentation and pu-trefaction. Lister applied this concept to the suppura-tion of wounds. In this manner, the concept went fromPasteur to Lister to surgery. This surgical revolutiondramatically modified the field of surgery.

CONCLUSION

The contributions of Pasteur to surgery are undeniable.Through the recognition of Lister that germs producedisease in wounds, Pasteur saw his own advances wellaccepted, as Lister applied the germ theory of fermenta-tion originally proclaimed by the noted French chemist.Thus, a surgical revolution evolved from the early find-ings of Pasteur.

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3. Dubos R. Louis Pasteur: Free Lance of Science. New York: CharlesScribner’s Sons; 1950.

4. Kruif De P. Microbe Hunters. New York: Harcourt Brace Jo-vanovich; 1954.

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6. Latour B. The Pasteurization of France. Cambridge, MA: HarvardUniversity Press; 1988.

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9. Roll-Hansen N. Louis Pasteur. In: New Dictionary of Scientific Bi-ography, Vol. 6 Koertge N, ed. Detroit, MI: Thomson/Gale; 2008.

10. Geison GL. The Private Science of Louis Pasteur. Princeton:Princeton University Press; 1995.

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