A Century Gone – Sir Joseph Lister, Bt. (1827-1912): Antisepsis and the Beginnings of Modern Surgical Medicine

Joseph Lister, c1867

Sir Joseph Lister, Bt. was born 1827 in Essex, England.  He graduated from University College, London, with a Bachelor of Medicine in 1852 and, at age 26, entered the Royal College of Surgeons.  Shortly thereafter, he moved to Edinburgh to pursue his career and practice.  In 1860 he accepted the position of Chair of Clinical Surgery at the University of Glasgow.  In this capacity, Lister found that 45-50% of amputation patients later died of infection.  Spurred by this statistic, he undertook the experiments on the prevention of infection that earned him wide renown.

Drawing on the ideas of Louis Pasteur, Lister’s experiments demonstrated that infection was avoided if a disinfectant barrier – one that would kill micro-organisms – was applied in and onto open wounds.  Throughout much of the nineteenth century it was believed that infections were brought on by miasmas, or bad air; however, the work of scientists came to show that it was not the air itself but rather the micro-organisms in it that were to blame.  This realization incited Lister to find ways to create a barrier between the airborne pathogens and the wound thus diminishing incidents of infection.

In 1867 he presented his findings in a paper to the British Medical Association in Dublin, which was later reprinted in the British Medical Journal. Lister stated:

“To prevent the occurrence of suppuration with all its attendant risks was an object manifestly desirable, but till lately apparently unattainable, since it seemed hopeless to attempt to exclude the oxygen which was universally regarded as the agent by which putrefaction was effected.  But when it had been shown by the researches of Pasteur that the septic properties of the atmosphere depended not on the oxygen, or any gaseous constituent, but on minute organisms suspended in it, which owed their energy to their vitality, it occurred to me that decomposition in the injured part might be avoided without excluding the air, by applying as a dressing some material capable of destroying the life of the floating particles.  […]

The material which I have employed is carbolic or phenic acid, a volatile organic compound which appears to exercise a peculiarly destructive influence upon low forms of life, and hence is the most powerful antiseptic with which we are at present acquainted.”  Joseph Lister, “On the Antiseptic Principle of the Practice of Surgery” (1867)

Sterilizing the operating room. Though the carbolic acid spray acted as an effective antiseptic, this technique was discontinued when it was discovered that many doctors were experiencing damaging side-effects in their lungs. Image source: Medicine-An Illustrated History by A.S. Lyons and R.J. Petrucelli, published by Harry N. Abrams NY 1978.

Through the application of such dressings, as well as flushing the wounds with antiseptics, the mortality rate of Lister’s ward decreased to 15% by 1870.

Carbolic Steam Sprayer, 1879. MHC #1935-12-13

In addition to sterilizing wounds, a carbolic acid spray was employed for a time in the attempt to disinfect the air in the surgical room.  This practice was discontinued, though, because the effects of acid inhalation proved severe.

Lister further advocated for the sterilization of surgical instruments, for the cessation of the use of porous natural materials in surgical instruments, and for surgeons to sterilize their hands. Through his efforts and inventions antisepsis became a basic principle of surgery and medical practice.

Joseph Lister, 1902

In 1877 Lister was appointed professor of surgery at King’s College, London.  Though he retired from medical practice in 1893, he served as the President of the Royal Society from 1895 to 1900 and of the British Association for the Advancement of Science in 1896.  He was also a founding member of the British Institute of Preventative Medicine, now the Lister Institute of Preventative Medicine.  Lister died 10 February, 1912.

Pamela Peacock,
Assistant Curator

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