I first heard of Joseph Lister when I was studying ‘A’ level biology, the man who used carbolic acid in surgery. That’s pretty much what I remember, but think about him next time you or someone you know needs to have surgery. Before Lister, there was a terrifyingly high mortality rate.
He became the First Baron Lister, and is known as a pioneer of antiseptic surgery. In the early days of surgery, it was barbers and the like who carried it out, hence, in the UK, surgeons are known as Mr/Mrs/Miss/Ms rather than doctor (not so in the United States, they are all called doctor there, but we like our tradition here in the UK).
Lister was a Quaker, and came from a fairly well off home in West Ham, East London. He was a bright lad, and studied languages, maths and natural sciences. He went onto attend University College London, one of the only colleges to accept Quakers at the time (prejudice and –isms are not new!).
He first studied botany and achieved a Bachelor of Arts, and then registered as a medical student. He achieved an honours degree in his Bachelor of Medicine, and went on to become a member of the Royal College of Surgeons. He was 26 years old, which was no mean feat in the nineteenth century.
As an aside, he left the Quakers and joined the Scottish Episcopal Church, after working with James Syme at the University of Edinburgh, and went on to marry Agnes, Syme’s daughter. They spent their honeymoon visiting hospitals in France and Germany… Ok, she went on to work with him in his lab, so I guess he got away with that, but I have to wonder what that marriage was like.
I have to do a quick re-wind here. I said above that in the early days of surgery, they were carried out by barbers. There was no anaesthetic in those days, and the ‘surgeon’ would stroll in wearing his everyday clothes (actually, scrap that, his dirtiest everyday clothes because he knew they’d get covered in blood). There was no ‘scrubbing in.’ In fact, operating theatres were not even restricted to those involved in the surgery, there was a lot of room for spectators. So, nothing about surgery was sterile. And there was a pretty high mortality rate. Wounds became infected with alarming regularity, infection and death followed. The prescribed wisdom at the time was that infection was spread by bad air. There were no hand washing facilities nor any methods for cleaning patients’ wounds. It was common for surgeons to refer to “the good old surgical stink” and enjoyed the blood stains on their aprons. See below:
Lister learned of Louis Pasteur’s work about food spoilage and how it might be dealt with, and proceeded to experiment with one of these – chemical techniques. He started by spraying the surgical instruments, the incisions and the dressings with carbolic acid. He found that swabbing wounds directly with carbolic acid reduced the incidence of gangrene.
There is the well-known case of the seven year old boy whose leg had been run over by a cart, causing a fracture. No plaster casts in those days, but Lister placed lint dipped in carbolic acid on the wound. Four days later, he renewed the lint and was delighted to find there was no infection. Six weeks later, he found the bone had knitted without any infection.
As a result of this, Lister instructed all his surgeons to wash their hands before and after surgery with 5% carbolic acid solution. The instruments were washed in the same solution and the solution was sprayed over the wound in the operating theatre. (There was a slight downside to this – carbolic acid is mildly acidic and can cause chemical burns. It did cause some problems with healing as a result, but still, it was far better than the earlier situation.).
Lister returned to London, where, as well as being elected President of the Clinical Society of London, he developed a means of repairing kneecaps and improved the method used for mastectomy. We have a lot to thank him for.
Lister’s wife died in 1893, after which he retired. He and is wife had worked together for so long, he lost his appetite for his work. He suffered a stroke however, in 1902, two days before his coronation, Edward VII became ill with appendicitis. This was still a dangerous operation in those days. To put it in perspective, I had mine removed when I was six years old, and my scar is about two inches long (and they probably are smaller than that nowadays). My mum had hers removed forty odd years before me and her scar was all the way across her abdomen. Back to Edward VII. The surgeons of the day were between a rock and a hard place: they had to operate or the soon to be crowned king would die. However, the risks of infection were huge. They went to Lister for advice who told them the latest antiseptic surgical techniques. The king later wrote to Lister and said, “I know that if it had not been for you and your work, I wouldn’t be sitting here today.”
He died on 12 February 1912.
Listerine mouthwash is named after him.
He has the honour of having the bacterial genus Listeria, one of the little beasties that gives us an upset stomach, named after him (yes, I really do mean honour, we might not think so but medics get excited over these things).
Listerella, a slime mound, was also named after him.
The Lister Hospital in Stevenage, Herts, is named after him.
Two postage stamps were issued in honour of his services to antiseptic surgery in September 1965.
© Susan Shirley 2017