In the late nineteenth century, modern surgery was still emerging from an era in which hygiene was, by today’s standards, startlingly poor. Operations were often performed with bare hands, instruments were reused with minimal cleaning, and postoperative infections were common and frequently fatal. Although ideas about germs were gaining ground, everyday medical practice lagged behind theory. It was in this transitional moment that Caroline Hampton, a surgical nurse, played an unexpected role in reshaping operative hygiene.
William Halsted operating in the New Surgical Ampitheatre in 1904. Credit: Wellcome Library, London
Caroline Hampton was born to a prominent Southern family in 1861 near Columbia, South Carolina. She was the niece of Confederate General Wade Hampton III, who was later governor of South Carolina and a US senator. Caroline was only a year old when her mother died of tuberculosis, and soon after, she lost her father in the Battle of Brandy Station in Virginia. In 1865, the family’s fortunes suffered another devastating blow when the Hampton plantation was destroyed by the advancing forces of William Tecumseh Sherman. Orphaned and dispossessed, Caroline was raised by three aunts in a small house built behind the ruins of the former family manor.
Her aunts expected her to follow the conventional path of a Southern belle and eventually marry a plantation owner. Caroline, however, resisted these expectations. Determined to shape her own future, she left for New York City to train as a nurse. After three years of study, she graduated from New York Hospital in 1888. The following year, when Johns Hopkins Hospital opened in Baltimore, she moved south once more and was appointed chief nurse of the operating room by the renowned surgeon Dr. William Stewart Halsted.
Caroline Hampton
William Stewart Halsted was among the most influential surgeons of his era. Trained by leading physicians in Europe, he later settled in New York, where he pioneered new surgical techniques for treating gallstones, diseases of the thyroid, disorders of the blood vessels, and hernias. He was best known to his contemporaries for introducing the radical mastectomy as a treatment for breast cancer—a drastic operation in which the surgeon removed not only the tumour but the entire breast and most of the muscles of the chest wall.
A committed supporter of the germ theory of disease, Halsted was determined to bring scientific discipline to the operating room. At a time when many surgeons still treated cleanliness casually, he imposed an unusually strict regimen of hygiene. To reduce infection, he required everyone entering his operating theatre to scrub their hands meticulously: first with soap, then with a caustic solution of potassium permanganate, followed by immersion in a hot oxalic acid bath. Even this was not enough. After the chemical scrubbing, hands had to be washed once more in a mercury-chloride solution, a final step intended to eliminate any remaining microbes.
These chemicals proved brutal on Caroline’s sensitive skin, causing severe irritation and painful dermatitis that soon threatened her ability to continue working. Faced with the prospect of losing his highly capable chief nurse, Halsted searched for a practical remedy.
William Stewart Halsted
At first, he suggested that Caroline coat her hands with collodion, a thick, gelatinous substance made from nitrocellulose that hardened as it dried, forming a protective film. Unfortunately, the collodion cracked whenever she flexed her fingers. So Halsted came up with another solution: gloves.
Halsted had plaster casts made of Caroline’s hands and commissioned the Goodyear Rubber Company of New York to produce two pairs of custom-fitted rubber gloves. At the time, they were conceived purely as a barrier against chemical damage, not as a measure to prevent infection. When Caroline wore them during surgery, however, the results were immediate and dramatic. Her hands healed, the dermatitis subsided, and she was able to continue her work without pain.
These early gloves bore little resemblance to the disposable latex gloves of today. They were relatively thick and designed for repeated use. Before each operation, they had to be sterilized by boiling and then pulled onto hands still slick with soap. Even so, they proved supple enough to allow fine manual control and did not interfere with delicate surgical tasks.
The wider significance of this innovation soon became apparent. Other members of the surgical team began wearing gloves as well, and it was noticed that infection rates declined. Halsted, already an advocate of meticulous surgical methods, embraced the change. He promoted the routine use of gloves as part of a broader commitment to asepsis—alongside careful handwashing, sterilized instruments, and disciplined operating-room protocols.
An early rubber surgical glove, worn by Johns Hopkins surgeon John M. T. Finney.
The use of gloves and Halsted’s meticulous disinfection routine was controversial for some.
In 1898, Dr Robert Morris said,
I have been much interested in everything that seemed to be in the nature of progress in surgery...but have arrived at the conclusion that the practical disadvantages of gloves counterbalance their theoretical advantages. Surgeons who were doing first class work three years ago seem to me to be doing second or third rate now, on account of the interference made by their gloves. The greatest danger to be feared is that the younger generations of surgeons may fail to develop the sense of touch to the highest degree and we shall have much second rate work done, particularly in abdominal surgery ...to the younger generation of surgeons I say fight with your might against the idea of using a means that will damage your most precious possession—the sense of touch.
Yet there were also early adopters who eagerly embraced Halsted’s approach to hygiene. Among the most influential was Dr. Joseph Bloodgood, one of Halsted’s students and later his colleague at Johns Hopkins. Bloodgood began wearing gloves for all of his operations and carefully documented the results. In a ten-year review of hernia surgeries performed between 1889 and 1899, he reported a striking decline in postoperative infections. Before the routine use of gloves, 38 infections occurred in 220 cases; after gloves were adopted by the entire operating team, infections fell to just 4 in 226 cases.
Other prominent surgeons soon followed. In 1897, Dr. Charles McBurney began using gloves regularly, and a year later he published a detailed paper outlining the advantages of having the entire surgical team wear them during operations. McBurney directly confronted common objections, particularly the belief that gloves dulled the surgeon’s sense of touch. Experience, he argued, proved otherwise.
Dr James Mitchell performing a surgical operation wearing rubber gloves in 1893. Credit: Alan Mason Chesney Medical Archives
This view was echoed by Dr. James Mitchell, a surgeon at Johns Hopkins, who noted that tactile skill could be cultivated through gloved hands from the outset. He wrote, ‘‘When I began to operate, and ever since, I have always worn gloves, and the sense of touch has been developed from the first through gloved hands, as is the case with practically all younger surgeons of today.”
Caroline Hampton’s contribution to medical history was largely indirect, but it was no less important for that. Her need for protection led to an innovation that transformed surgery worldwide. Rubber gloves became standard equipment, protecting both patients from infection and medical staff from injury and contamination. In an age when medical hygiene was still inconsistent and often inadequate, this small adjustment helped push surgery toward the cleaner, safer practice we now take for granted.
References:
# S Robert Lathan. Caroline Hampton Halsted: the first to use rubber gloves in the operating room.
# Kevin Paul Lee. Caroline Hampton Halsted and the origin of surgical gloves
# The Nurse Who Introduced Gloves to the Operating Room. Distillation Magazine
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