The painting clearly shows that Dr. Gross was not convinced of the efficacy of antisepsis, despite the recent work of Joseph Lister and Louis Pasteur demonstrating the germ theory to explain infections. All participants and onlookers of the depicted surgery in the painting wear normal clothing, not sterilized surgical gowns; there is no sign of gloves or surgical masks; and the presumption is that none of the instruments or hands were sterilized before surgery. Dr. Gross is quoted as saying: "Little if any faith is placed by any enlightened or experienced surgeon on this side of the Atlantic in the so-called carbolic acid treatment of Professor Lister".