Joseph Lister
April 5, 1827 - February 10, 1912
 

Joseph Lister, 1st Baron Lister 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.

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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The English surgeon Joseph Lister, 1st Baron Lister of Lyme Regis (1827-1912), discovered the antiseptic technique, which represents the beginning of modern surgery.

Born in Upton, Essex, on April 5, 1827, Joseph Lister was the son of a wealthy wine merchant who developed an achromatic lens for the microscope. As a student Lister did microscopic research, and his acceptance of Louis Pasteur's work later may be related to his familiarity with the process of fermentation since childhood. After graduating from the University of London in 1852, Lister began a surgical career in Edinburgh; in 1860 he became professor of surgery at the Royal Infirmary in Glasgow.

With the introduction of anesthesia in the 1840s operations had become more frequent, but many patients died from infection following surgery. Inflammation and suppuration (pus formation) occurred in almost all accidental wounds and after surgery, and more so when patients were treated at the hospital rather than at home by a visiting surgeon. The reason was unknown, but it was believed to be something in the air. As a result, wounds were heavily dressed or irrigated with water to keep the air out; operations were a last resort. The body's cavities (head, chest, or abdomen) were practically never opened; injured limbs were usually amputated.

Lister's research centred on the microscopic changes in tissue that result in inflammation. When he read Pasteur's work on germs in 1864, Lister immediately applied Pasteur's thinking to the problem he was investigating. He concluded that inflammation was the result of germs entering and developing in the wound. Since Pasteur's sterilization by heat could not be applied to the living organism, Lister sought a chemical to destroy the germs.

That same year Lister read in the newspaper that the treatment of sewage with crude carbolic acid had led to a reduction of diseases among the people of Carlisle and among the cattle grazing on sewage-treated fields. In 1865 he developed a successful method of applying purified carbolic acid to wounds. The technique of spraying the air in the operating room with carbolic acid was only briefly used, as it was recognized that airborne germs were not of primary importance. Lister perfected the technical details of antisepsis and continued his research. He developed the surgical use of sterile catgut and silk and introduced gauze dressings. Antisepsis became a basic principle for the development of surgery; amputations became infrequent, as did death from infections; and new surgical procedures could be planned and safely executed.

In 1869 Lister returned to Edinburgh, and in 1877 he was appointed professor of surgery at King's College in London. He won worldwide acclaim and honours, including honorary doctorates, a baronetcy in 1882, and a peerage in 1897. After he retired in 1893 he became foreign secretary of the Royal Society and then its president from 1895 to 1900. He died at Walmer, Kent, on Feb. 10, 1912. Although Lister's antiseptic method was soon replaced by the use of asepsis, his work represented the first successful application of Pasteur's theory to surgery and marked the beginning of a new era.

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