swabbed

Joseph Lister, 1st Baron Lister

Joseph Lister, 1st Baron Lister, OM, FRS (5 April 1827 – 10 February 1912) was an English surgeon who promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary. He successfully introduced carbolic acid (phenol) to sterilize surgical instruments and to clean wounds.

Biography

Early life

Joseph Lister came from a prosperous Quaker home in Upton, Essex, a son of Joseph Jackson Lister, the pioneer of the compound microscope.

At Quaker schools he became fluent in French and German which were, serendipitously, also the leading languages of medical research. He attended the University of London, one of only a few institutions which was open to Quakers at that time. He initially studied the Arts but at the age of 25 he graduated with honours as Bachelor of Medicine and entered the Royal College of Surgeons. In 1854, Lister became both first assistant to and friend of surgeon James Syme at the University of Edinburgh in Scotland. He subsequently left the Quakers, joined the Scottish Episcopal Church and eventually married Syme's daughter Agnes. For their honeymoon they spent 3 months visiting leading medical centres (Hospitals and Universities) in France and Germany, by this time Agnes was enamoured of medical research and partnered him in the laboratory for the rest of his life.

Career

Antiseptics

After six years he earned a professorship of surgery at the University of 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 seen as science fiction. 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. The work of Ignaz Semmelweis and Oliver Wendell Holmes were not heeded.

Lister became aware of a paper published (in French) by the French chemist 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: filter, heat, 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 deodorizing 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 in Volume 90, Issue 2299 of The Lancet published on 21 September 1867.

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. One of his conclusions was to stop using porous natural materials in manufacturing the handles of medical instruments.

Lister left Glasgow in 1869, returning to Edinburgh as successor to Syme as Professor of Surgery at the University of Edinburgh, 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.

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."

In 1879 Listerine mouthwash was named after him for his work in antisepsis. Also named in his honour is the bacterial genus Listeria, typified by the food-borne pathogen Listeria monocytogenes.

Surgical technique

Lister moved from Scotland to King's College Hospital, in London, and became the second man in England to operate on a brain tumor. 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.

Among his students at King's College London was Robert Hamilton Russell who later moved to Australia.

In life Lister was said to be a shy, unassuming man, deeply religious in his beliefs, and uninterested in social success or financial gain.

Later life

Lister retired from practice after his wife, who had long helped him in research, died in 1893 in Italy, during one of the few holidays 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 Britain'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".

Lister died on 10 February, 1912 at his country home in Walmer, Kent at the age of 84. After a funeral service at Westminster Abbey, he was buried at Hampstead Cemetery, Fortune Green, London in a plot to the south-west of central chapel.

Legacy and honours

Lister was president of the Royal Society between 1895 and 1900.

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.

Lister is one of the two surgeons in the United Kingdom who have the honour of having a public monument in London, Lister's stands in Portland Place (the other surgeon is John Hunter). There is a statue of Lister in Kelvingrove Park, Glasgow, celebrating his links with the city.

Bibliography

Lister Ward by Martin Goldman. Contains black and plates of activities at the Royal Infirmary Edinburgh
Lord Lister by Sir Rickman Godlee. Macmillan & Co, London, 1917 - reissued by The Heirs of Hippocrates, Gryphon Editions, 1993
Lister as I knew him by John Ruud Leeson. London, Baillière, Tindall and Cox, 1927.
Joseph, Baron Lister, Centenary Volume. 1827-1927, by A. Logan Turner. Oliver and Boyd, Edinburgh, 1927
Joseph Lister – Father of Modern Surgery, by Rhoda Truax. Bobbs Merrill, Indianapolis and New York, 1944
Joseph Lister (the friend of man), by Hector Charles Cameron. W. Heinemann, 1948
Joseph Lister, by Kenneth Walker. Hutchinson, London, 1956
Master Surgeon - A Biography of Joseph Lister, by Laurence Farmer, M.D. Harper & Brothers Publishers, New York, 1962
Joseph Lister, 1827 - 1912, by Richard B Fisher. Stein and Day, New York, 1977
Joseph Lister and Antiseptics, by A J Harding Rains. Wayland, East Sussex, 1978 (2nd impression).
The Collected Papers of Joseph Lister (Vols 1 and 2) by Joseph Lister. Classics of Medicine Library, Birmingham, 1979 (a facsimile edition of the Collected Papers first published in 1909).
Joseph Lister and the Story of Antiseptics, by John Bankston. Mitchell Lane Publishing Inc, 2004 (hardcover)
Joseph Lister – The Father of Antiseptics, by Peggy J. Parkes. Blackbirch Pr Inc, 2005
Pioneers of Science- Joseph Lister, by Douglas McTavish, New York, 1992