Kilmer House

(* “According to the Art of Asepsis”) 

Johnson & Johnson manufactured the first-ever sterile surgical dressings, but what did that really mean?  Let’s take a look… Surgery in the 19th century was risky and dangerous, and patients undergoing even the most routine operations literally took their lives in their hands.  The primary reason surgery was so dangerous was because it was not sterile.  The operating room, the surgeon’s hands, and the surgical instruments were full of germs, which caused extremely high levels of mortality.  Surgeons in the mid-1800’s often operated wearing their street clothes, without washing their hands. 

19th Century Surgeon’s Coat with Needle in Lapel

They frequently used ordinary sewing thread to suture wounds, and stuck the needles in the lapels of their frock coats in between patients.  Surgical dressings were also unsterilized, and were often made up of surplus cotton or jute from the floors of cotton mills.   It was against this background that French scientist Louis Pasteur demonstrated that invisible organisms caused disease. 

 

 Louis Pasteur                                               Sir Joseph Lister

Pasteur’s work influenced the eminent English surgeon Sir Joseph Lister, who applied Pasteur’s germ theory to surgery, thus founding modern antiseptic surgery.  To disinfect, Lister used a solution of carbolic acid, which was sprayed around the operating theater by a handheld sprayer. 

Surgery Using Lister’s Carbolic Acid Sprayer

Although many were slow to adopt Lister’s theory of invisible germs causing surgical infections, it was clear from the greatly increased surgical survival rates that his methods worked.   At the time, Lister’s theories were controversial because many 19th century surgeons were unwilling to accept something they could not see – germs – as the culprit.  Also, perhaps another reason that surgeons were slow to pick up on Lister’s methods was the fact that carbolic acid had a very strong and unpleasant smell.  Sir Joseph Lister was invited to speak at a medical conference during the U.S. Centennial Exposition in Philadelphia in 1876.  This event celebrated the 100th anniversary of the Declaration of Independence and showcased advancements in technology and innovation, among other things.  In the audience was Robert Wood Johnson the first, who immediately grasped the importance of Lister’s work and saw an opportunity to create and market the world’s first sterile surgical dressings.  This site has a good description of the types of exhibits Robert Wood Johnson would have seen there, and this site has photographs from the Exposition, which show some of the sights that Johnson saw. (Just click on “Tour Centennial Sites” to see the photos.)

Robert Wood Johnson

Johnson already was in the medical products business, and his personal experience of having two brothers who fought in the Civil War with its terrible medical conditions also may have spurred him to think about ways to improve surgery.  When he and his brothers started Johnson & Johnson in 1886, sterile surgical dressings were among the Company’s first products, as were sterile sutures. 

Fred Kilmer published a treatise on sterile wound care in 1897 called “Asepsis Secundum Artem,” Latin for “According to the Art of Asepsis.”  Kilmer’s treatise was widely read.  A great deal of the scientific data in it was developed in the Johnson & Johnson Bacteriological Laboratory, which had been built to test and enhance improvements in sterilization techniques.  The advent of the Company’s sterile surgical dressings and sutures in the market, and its ongoing improvements in sterilization methods, greatly reduced surgical mortality rates.

One of the Aseptic Rooms in the Company’s Early Laboratories

An earlier post tells the story of how James Wood Johnson saw a building for rent when he was on a train going through New Brunswick.  It was a four-story former wallpaper factory near the railroad tracks.  Johnson got off the train and rented it for the new company he and his brothers were starting.  The only image we’ve ever had of that first building is this illustration: 

Well, that’s about to change.  For the first time ever, here is what is most likely a photograph of the first Johnson & Johnson building: 

The photo is from this Rutgers University archive, courtesy of the New Brunswick Free Public Library, and is part of the New Brunswick Free Public Library’s postcard collection.  It’s included here as well as linked to from the original site.  The building on the left with the pointed roof is four stories high, right next to the railroad tracks, and says “Ja—– and Carpender, Manufacturers of Wallpaper.” 

New Brunswick Times article, 1886 

This newspaper clipping from 1886 confirms that the name of the wallpaper manufacturer was Janeway and Carpender.  Since it’s highly unlikely that there was more than one four-story former wallpaper factory right next to the railroad tracks in New Brunswick in the late 1800s, that means that the building on the left is the building that James Wood Johnson saw from the train window, causing him to get off his train in New Brunswick…the first-ever building occupied by Johnson & Johnson.  Here’s a zoomed-in view of a map from the Old New Brunswick section of the Rutgers University archives that shows this section of the city in 1886 (section 43 on the map), with a building by the railroad tracks marked “to be Johnson’s Porous Plaster Mfy.”  The building on the map is located right next to a spur of the railroad tracks, just like the building in the above photo.

The Company expanded into other nearby buildings as it grew, including this former button factory. 

Former Novelty Button Factory (with tower) 

These early buildings were close to the Raritan River (where the Company’s world headquarters remains today), which was a necessary source of water and transportation for New Brunswick’s early industries.

Early Employees

In 1907, Johnson & Johnson was growing rapidly.  The Company had about 1000 employees, which would more than double by 1908. (In 1908, the local New Brunswick newspaper, The Home News, would list 2,500 employees.)  By 1907, Johnson & Johnson had expanded from its original building into 35 buildings, which included a cotton mill, plaster-making facilities, laboratories across the river in Highland Park, sterile dressing manufacturing, offices, warehouses and shipping facilities, as well as manufacturing space where other products were made.  Johnson & Johnson had a factory whistle, whose loud blasts were a familiar sound to residents of New Brunswick and Highland Park.  Besides shipping its products by rail, the Company also shipped by water, due to its location on the Raritan River, and actually had steamships to facilitate getting its products to the ports in New York.

In an era when working conditions in many industries were being protested as being unfair and unsafe, Johnson & Johnson stood out for its enlightened approach to caring for its employees, many of whom were women.   Women employees of the Company 100 years ago did everything from working in the cotton mill, packing sterile gauze and dressings, to washing the glassware in the scientific laboratories. 

Cotton Mill Employee Washroom

In 1906, Johnson & Johnson formed a Company Welfare Department, which provided a variety of benefits and help to employees at a time when this was unusual.  Hospital and retiring rooms were set up to take care of employees who fell ill on the job, with doctors and nurses available to treat patients and give advice.  A counseling service helped employees deal with family problems.  A mutual benefit fund was started to provide help to employees during financial or medical crises.  A previous post discussed the fact that Johnson & Johnson organized classes in hygiene, gymnastics, language instruction and more.  Many of these activities were centered on the Laurel Club, which was formed by women employees in 1907 for recreation, education and charity work.   Here’s the Laurel Club’s headquarters:

Laurel Club Headquarters, New Brunswick

The Company’s 1907 women’s basketball team were Laurel Club members.  Since many early Johnson & Johnson employees were Hungarian immigrants, newly-arrived and without a network of resources, organizations like the Employee Welfare Department and the Laurel Club provided a much-needed safety net, support and social network.  The Company ran a night shift to meet production demands and, to make it more appealing, hired a French chef to cook appetizing hot meals that were served at midnight for workers. 

In an effort to improve living conditions, Johnson & Johnson bought three blocks of houses in New Brunswick, fixed them up, and rented them to employees at reasonable rates.  Maintenance costs were covered by the Company.  Here’s a picture of some of those houses. 

Morell Street Houses

And in the days when raw materials were shipped in wooden crates instead of cardboard boxes, the Company broke up the wooden shipping boxes and delivered the pieces by wagon to employees in New Brunswick to use for kindling for their furnaces and stoves.   These efforts to support employees earned the Company tremendous loyalty, and it was not uncommon to find local families with multiple members and generations employed by Johnson & Johnson.