Joseph
Lister
Joseph Lister, 1st Baron Lister (April 5, 1827-February
10, 1912) was a famous British surgeon who promoted the idea of
sterile surgery while working at the Glasgow Infirmary. He came
from a prosperous Quaker home in Upton, Essex.
At the age of 25 he became a Bachelor of Medicine and entered the
Royal College of Surgeons. In 1854, Lister became first assistant
surgeon to James Syme (1799-1870), a leader of surgery in England.
The two became close friends and Lister ended up marrying Syme's
daughter Agnes, leaving the Quakers because his religion did not
permit alliances with nonmembers.
After six years he got a professorship of surgery at Glasgow. At
the time the usual explanation for wound infection was that the
exposed tissues were damaged by chemicals in the air or via a stinking
"miasma" in the air. The sick wards actually smelled bad,
not due to a "miasma" but due to the rotting of wounds.
Hospital wards were occasionally aired out at midday but Florence
Nightingale's doctrine of fresh air was still science fiction then.
Facilities for washing hands or the patient's wounds did not exist
and it was even considered unnecessary for the surgeon to wash his
hands before he saw a patient. This was strange because the work
of Ignaz Philipp Semmelweis and Oliver Wendell Holmes were not heeded
even though the parallel should have been obvious.
Lister became aware of a paper published by Louis Pasteur which
showed that rotting and fermentation could occur without any oxygen
if micro-organisms were present. Lister confirmed this with his
own experiments. If micro-organisms were causing gangrene, the problem
was how to get rid of them. Pasteur suggested three methods: to
filter them out, to heat them up, or expose them to chemical solutions.
The first two were inappropriate in a human wound so Lister experimented
with the third.
Carbolic acid (phenol) had been in use as a means of deodorising
sewage, so Lister tested the results of spraying instruments, the
surgical incisions, and dressings with a solution of it. Lister
found that carbolic acid solution swabbed on wounds markedly reduced
the incidence of gangrene and subsequently published a series of
articles on the Antiseptic Principle of the Practice of Surgery
describing this procedure on March 16, 1867 in the journal The Lancet.
He also made surgeons wear clean gloves and wash their hands before
and after operations with 5% carbolic acid solutions. Instruments
were also washed in the same solution and assistants sprayed the
solution in the operating theatre.
Many of his contemporaries laughed at him but Lister was said to
have never bothered to reply and only heaved an occasional sigh
at the world's stupidity. His critics still believed in the theory
of spontaneous generation.
Lister left Glasgow in 1869 returning to Edinburgh as successor
to Syme as Professor of Surgery,at Edinburgh University and continued
to develop improved methods of antisepsis and asepsis,]. His fame
had spread by then and audiences of 400 often came to hear him lecture.
He moved to King's College in London and became the second man in
England to operate on a brain tumour. He also developed a method
of repairing kneecaps with metal wire and improved the technique
of mastectomy. His discoveries were greatly praised and he was made
Baron Lister of Lyme Regis and became one of the twelve original
members of the Order of Merit.
Lister retired from practice after his wife, who had long helped
him in research, died in 1893 during one of the few vacations they
allowed themselves. Studying and writing lost appeal for him and
he sank into religious melancholy. Despite suffering a stroke, he
still came into the public light from time to time. Edward VII came
down with appendicitis two days before his coronation. The surgeons
did not dare operate without consulting England's leading surgical
authority. The king later told Lister "I know that if it had
not been for you and your work, I wouldn't be sitting here today".
A British Institution of Preventive Medicine, previously named after
Edward Jenner was renamed in 1899 in honour of Lister.
Two postage stamps were issued in September 1965 to honour Lister
for his contributions to antiseptic surgery.
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As the germ theory of disease became more widely accepted, it was
realised that infection could be better avoided by preventing bacteria
from getting into wounds in the first place. This led to the rise
of sterile surgery. Some consider Lister the father of modern antisepsis.
Listerine mouthwash is named after him for his work in antisepsis.
He credited Ignaz Semmelweis for earlier work in antiseptic treatment:
"Without Semmelweis, my achievements would be nothing.
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