About the Surgeon

BIOGRAPHY OF JOSEPH LISTER

Joseph Lister

(surgeon and a pioneer of antiseptic surgery, born April 5, 1827, West Ham, United Kingdom; died February 10, 1912, Walmer, United Kingdom)

Joseph Lister, circa 1855
Joseph Lister, circa 1855

Joseph Lister, an English surgeon, was born in Upton, Essex. He was the founder of antiseptic surgery. Joseph was the fourth of seven children of whom four were boys and three girls. His father was a well-known scientist. Joseph Lister was the first to discover the reasons for infection and the way to prevent it. He wrote his famous paper on “The Early Stage of Inflammation.” About that time, he began work on the coagulation of blood, a subject related to the early stages of inflammation. In 1887 Joseph Lister accepted the chair of surgery at King’s College in London, which he held for 15 years. He died in Walmer, Kent, in 1912. The best monument to Joseph Lister is the Lister Institute of Preventive Medicine, in London.

To understand the great work that Joseph Lister did, we must know the conditions in the hospitals in those early days of the nineteenth century. Operating rooms were usually in separate buildings so that the other patients in the hospital could not hear the screams of the unhappy patient who was strapped to the operating table. Because of the terrible pain, the surgeon had to operate as quickly as possible. The operating tables were little better than kitchen tables. Under these tables was placed a tub of sand to catch the blood from the operation. The instruments were often not even washed. At the end of each operation they were put into a drawer ready for the next one. The surgeon set to work in the clothes he wore every day.

Often a barber performed the operation instead of a surgeon. The surgeons were not indifferent or careless. They had simply no understanding at all of the bad effects of dirt. They were very sorry that patients died so often but they did not connect this with dirt. Indeed nearly half the people died from blood poisoning after operations. A day or two after the operation the wound became red and inflamed, the patient had a temperature and often died. When Lister began operating at the Royal Infirmary at Glasgow, he too lost patients from blood poisoning. Lister and all the other surgeons were quite helpless.

Modern surgery was not possible until doctors had learned the importance of cleanliness. One day Lister’s friend, a chemist, brought him papers written by a French scientist, Louis Pasteur. That night when Lister had finished his work, he sat down in front of his fireplace and began to read. Pasteur’s papers were a revolution to him. The French scientist said that gangrene was caused not by air itself but by tiny organisms or microbes, called bacteria or germs, in the air. Not all the bacteria are harmful. There are bacteria that help plants grows, living in soil and making it better for growing crops. Still other bacteria do their work by causing chemical changes.

Of course it was not the air itself that caused the inflammation and the gangrene. It was something in the air, something introduced into the wound from the outside. Could these tiny creatures come from other sources than the air? From the dirty hands of the surgeons? From badly washed instruments? If so, it was the surgeon who was responsible for the death of his patients. It is hard to believe that until less than a hundred years ago people did not know that diseases were caused by microbes. At once Lister set to work to find a way of preventing these microbes from reaching the open wound. An operation cannot be done in a perfect vacuum. There was no way to exclude air from surgical operations. How could the microbes be killed off? How could you kill off something that could not even be seen?

After Lister’s many experiments a visitor from the city of Carlisle told him that the city’s sewerage system had been in need of a disinfectant. Carbolic acid was used and thanks to it the smell had disappeared.

“Can you get me some carbolic acid?” Lister asked the visitor.

“I can let you have some.”

Soon after, a boy who had suffered a bad accident was brought into the hospital. He had broken his leg so badly that broken bone could be seen. Lister ordered a bottle of carbolic acid. Then he went to work. He saturated his hands, instruments and everything that came in contact with the patient with the disinfectant. He put on a white apron. The water in which he and his assistant washed their hands was mixed with acid. He cleaned the wound, set the broken bone, and covered the wound with bandage soaked in carbolic acid. He thought that the carbolic acid would kill any germs in the wound and the bandage would keep more from falling in. The carbolic acid did what Lister had intended: it killed the germs. After four days there were no signs of fever and blood poisoning. At the end of six weeks the little boy was able to walk.

Photo of Surgery

The discover of asepsis (the control of infection) created a new kind of surgery. Lister pioneered in these discoveries and brought about quite a new concept in the practice of medicine. In Lister’s opinion, however, there was much more yet to be done. He wanted to find a milder form of antiseptic that would be less irritating to the skin than carbolic acid. After many experiments he found that boracic acid was a better antiseptic.

Gradually other surgeons began to adopt Lister’s methods. They learned that germs in the air were not the chief danger. The big danger came from germs that might be on the hands or clothes of the surgeons, or on the surgical instruments or bandages. Today the surgeon, his assistant, and the nurses all wear gowns, caps, masks and rubber gloves that have been treated with steam to kill any germs on them. The surgical instruments are similarly treated with steam in a vessel known as a sterilizer. Lister won the battle against germs in the operating wards.