Jornal de Doenças Infecciosas e Medicina Preventiva
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The Conquest of Pus -- a History of Bitumen, Creosote and Carbolic Acid

Charles T. Ambrose

In the Western world from antiquity on, open wounds were treated topically with petroleum-derived substances, such as bitumen, asphalt, pitch, and tar. The immediate aim was to stifle bleeding and ease pain but a potential benefit was preventing local corruption with pus formation. In the early 19th century, creosote was recovered from bitumen and found to reduce suppuration. Carbolic acid was later isolated from creosote and recognized as an underlying active agent. In the 1860s, carbolic acid was first employed by Jules Lemaire to treat local skin infections and later by Joseph Lister to prevent the suppuration in compound fractures. Based on Pasteur's discovery of bacteria in the air, Lister proposed that microbes invade open lesions and cause local purulent discharges. This knowledge led to a new paradigm in medicine -- aseptic surgery.