TOEFL Reading Practice Online | Q&A 015

This is an original TOEFL-style academic reading passage with practice comprehension questions, not reproduced from any official test. Try roughly 1.5 minutes per question as a self-practice pace, and see the reading practice hub and more reading practice articles for further sets.

Passage

The Slow Acceptance of Germ Theory in Surgery

[1] Before the middle of the nineteenth century, surgery carried a high risk of death, and much of that risk came not from the operation itself but from infection afterward. Most surgeons of the period did not believe that living microorganisms caused these infections. Instead, many accepted an older explanation, sometimes called the miasma theory, which attributed disease to foul-smelling air or invisible vapors rising from decaying matter, rather than to anything that could be washed away or killed.

[2] One of the earliest and most striking pieces of evidence against this view came from observations in maternity wards rather than surgical theaters. A physician working in a Vienna hospital in the 1840s noticed that women who gave birth in a ward attended by doctors and medical students had a much higher rate of fatal fever than women attended by midwives in a separate ward. He traced the difference to the fact that the doctors and students often moved directly from autopsies to deliveries without washing their hands. When he introduced a strict handwashing routine using a chemical disinfectant, deaths from this fever dropped sharply. Even so, many of his contemporaries dismissed his conclusions, in part because he could not explain, in terms accepted at the time, exactly what was being transferred on unwashed hands.

[3] Broader acceptance of the idea that microorganisms cause infection came gradually over the following decades, aided by laboratory research showing that microscopic organisms were responsible for fermentation and the decay of organic matter. Building on this growing body of evidence, a British surgeon began treating surgical wounds and instruments with carbolic acid, a chemical capable of killing many microorganisms, and reported a marked drop in wound infections among the patients treated with this antiseptic method. Many surgeons remained skeptical, partly because the new procedures were slower and more cumbersome than familiar routines, and partly because the idea that invisible organisms on hands or instruments could cause disease still struck many trained physicians as implausible.

[4] Over the following decades, surgical practice shifted from relying mainly on chemical antiseptics applied during an operation toward a broader approach known as aseptic technique, which aimed to keep microorganisms away from a wound in the first place. This included sterilizing instruments with heat before use, wearing sterilized gowns and gloves, and maintaining consistently clean operating environments, rather than simply treating a wound with disinfectant after contamination had already occurred.

[5] By the early twentieth century, the idea that infections were caused by living microorganisms, rather than bad air, had become firmly established in medical training and practice, and postoperative infection was no longer the routine, expected outcome it had once been. The decades-long resistance to this change, despite mounting evidence, illustrates how difficult it can be for a scientific community to abandon a long-held explanatory framework, even when a new one produces clearly better outcomes.

Questions

1. What does the passage mainly discuss?

• (A) The introduction of anesthesia in the nineteenth century
• (B) The life of a single Vienna physician
• (C) Modern methods of sterilizing surgical instruments
• (D) The gradual, often resisted acceptance that microorganisms cause infection

2. The word "attributed" in paragraph 1 is closest in meaning to

• (A) disproved
• (B) measured
• (C) assigned as the cause of
• (D) ignored

3. The word "He" in the third sentence of paragraph 2 refers to

• (A) the physician working in the Vienna hospital
• (B) a surgical patient
• (C) a midwife
• (D) a British surgeon

4. Why does the author describe the difference in fever rates between the two Vienna maternity wards in paragraph 2?

• (A) To argue that midwives were better trained than doctors
• (B) To describe the layout of nineteenth-century hospitals
• (C) To criticize the use of chemical disinfectants
• (D) To present early evidence linking unwashed hands to the spread of infection

5. According to paragraph 2, what did the Vienna physician introduce, and what was the result?

• (A) He separated doctors from midwives, which had no measurable effect.
• (B) He required handwashing with a chemical disinfectant, and deaths from fever dropped sharply.
• (C) He introduced carbolic acid treatment, and deaths increased.
• (D) He banned medical students from the ward, and nothing changed.

6. According to paragraph 3, why did many surgeons resist the new antiseptic method?

• (A) The chemical was too expensive to obtain.
• (B) It had no effect on infection rates.
• (C) The procedures were slower and more awkward, and the idea of invisible disease-causing organisms seemed unlikely to them.
• (D) Hospital administrators banned its use.

7. The word "cumbersome" in paragraph 3 is closest in meaning to

• (A) awkward and inconvenient
• (B) inexpensive
• (C) dangerous
• (D) popular

8. According to paragraph 4, aseptic technique included all of the following EXCEPT

• (A) sterilizing instruments with heat
• (B) wearing sterilized gowns and gloves
• (C) keeping operating rooms consistently clean
• (D) waiting until infection developed before treating a wound

9. According to paragraph 5, what does the long resistance to germ theory illustrate?

• (A) Scientific communities always adopt new evidence quickly.
• (B) It can be hard for a scientific community to give up a long-held explanation, even when the evidence against it is strong.
• (C) The miasma theory was eventually proved correct.
• (D) Surgical death rates did not improve after germ theory was accepted.

Answers and explanations

1. (D) The passage follows the shift from the miasma theory to germ theory, from the Vienna maternity wards to antiseptic and aseptic surgery, and stresses how slowly it happened. The Vienna physician (B) is only one part of the story.
2. (C) The miasma theory "attributed disease to foul-smelling air": it named bad air as the cause.
3. (A) "He traced the difference…" continues the description of the physician introduced in the previous sentence.
4. (D) The comparison showed that deaths were higher where doctors came straight from autopsies without washing, early evidence that something on unwashed hands spread disease.
5. (B) Paragraph 2 says he "introduced a strict handwashing routine using a chemical disinfectant" and "deaths from this fever dropped sharply." Carbolic acid (C) belongs to the British surgeon in paragraph 3.
6. (C) Paragraph 3 gives both reasons: the procedures were "slower and more cumbersome," and invisible organisms causing disease "still struck many trained physicians as implausible."
7. (A) "Cumbersome" procedures are awkward and inconvenient to carry out.
8. (D) Aseptic technique aimed to keep microorganisms away "in the first place," the opposite of treating a wound after contamination.
9. (B) The last sentence says the resistance "illustrates how difficult it can be for a scientific community to abandon a long-held explanatory framework."