Joseph Lister, 1st Baron Lister

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Joseph Lister, 1857 (credit: Courtesy of the Wellcome Trustees, London)

(born April 5, 1827, Upton, Essex, Eng. — died Feb. 10, 1912, Walmer, Kent) British surgeon and medical scientist. He received a medical degree from Oxford in 1852 and became an assistant to James Syme, the greatest surgical teacher of the day. In 1861 he was appointed surgeon to the Glasgow Royal Infirmary, where he observed that 45 – 50% of amputation patients died from sepsis (infection). Initially he theorized that airborne dust might cause sepsis, but in 1865 he learned of Louis Pasteur's theory that microorganisms cause infection. Using phenol as an antiseptic, Lister reduced mortality in his ward to 15% within four years. Most surgeons were unconvinced until a widely publicized operation under antiseptic conditions was successful. By the time of his retirement in 1893, he had seen his principle accepted almost universally. He is regarded as the founder of antiseptic medicine.

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British physician (1827–1912)

Lister, the son of Joseph Jackson Lister, was born at Upton in England and educated at Quaker schools before entering University College, London, in 1843. University College was, at the time, the only English university open to religious dissenters. After graduating in arts, Lister studied medicine, obtaining his MB in 1852. He then served as assistant to the leading Scottish surgeon James Syme at the Royal Infirmary, Edinburgh, from 1854 until 1860 when he was appointed professor of surgery at Glasgow University. Lister returned to Edinburgh in 1869 as professor of clinical surgery but in 1877 became professor of surgery at King's College, London, serving there until his retirement in 1892.

In 1867 Lister published two short but revolutionary papers, which introduced the principles of antiseptic surgery into medicine. In 1846 he had been present when Robert Liston had first successfully used ether as an anesthetic in England. Yet this, apart from making surgery tolerable for both patient and surgeon, had not greatly advanced the profession. The full potential of anesthesia did not develop because of the high mortality produced by the infection that inevitably followed major surgery. The inevitable consequence was that a surprisingly small amount of surgery was actually attempted, even in the major centers with ready access to anesthetics.

Lister acknowledged the twin sources of his innovations in his 1867 papers. The first and most important were the writings of Louis Pasteur. These revealed the cause of the widespread surgical sepsis to be the germs present in the air. To control them Lister reported that he had been impressed by an account of the effects produced by carbolic acid on sewage in Carlisle. Carbolic acid (phenol, C₆H₅OH) is a weak acid derived from benzene. Although Lister's first attempt to use it as an antiseptic in March 1865 ended in failure he persisted and in August dressed a compound fracture of the leg, that is one in which the skin has been broken, with a piece of lint dipped in liquid carbolic acid. The wound healed well.

This encouraged Lister to introduce the carbolic acid dressings into his regular surgical procedure. By 1870 he claimed that mortality for amputations had dropped from over 40% to 15%. He later analyzed his figures for his Edinburgh period, reporting that from 1871 to 1877 he performed 725 major operations with a mortality of only 5.1%.

Another of Lister's major innovations was his introduction, in 1869, of cat-gut ligatures to replace the traditional silk thread, which was a major source of infection. Lister's experiments showed that cat-gut ligatures were absorbed by the body and if soaked in carbolic acid could be made sterile. He also attempted to maintain an antiseptic atmosphere in the operating theater by introducing a carbolic spray. This, however, made working conditions very unpleasant and the procedure was abandoned.

The Listerian system appears to have been accepted with little dissent and remarkable speed for by 1880 it had become the standard mode of surgical procedure virtually everywhere. Lister, an intensely shy and reserved man, achieved considerable fame and received many honors. In 1897 he became the first physician to be made a peer and sit in the House of Lords.

Joseph Lister (1827–1912) was an English surgeon. Educated at University College, London, he practiced and taught surgery in Scotland, first in Glasgow and then in Edinburgh, before returning to London in 1877. Lister was concerned about the frequently fatal wound infections that followed surgical operations, and, in search of solutions to this problem, he studied the work of European bacteriologists, notably that of Louis Pasteur. Lister thought that bacteria caused the postoperative infections that were so common, and although the connection between bacteria and infection had not been confirmed beyond doubt at that time, he understood that bacteria could be killed by antiseptics. He came up with the idea of using carbolic acid for this purpose and started the practice of preoperative cleansing of his and his assistants' hands with carbolic acid, as well as spraying carbolic acid liberally in the air in the operating room. The dramatic beneficial results of what amounted to an experimental trial of this regimen were reported in the Lancet in 1867. Lister's methods transformed the practice of surgery from a desperate, life-threatening gamble into a relatively safe procedure for many conditions—including the management of childbirth.

Unlike Ignaz Semmelweiss and Oliver Wendell Holmes, who preceded Lister in recognizing the importance of cleanliness in preventing infection during childbirth, Lister offered a method that did not imply that doctors were dirty, and so his message was heeded rather than rejected. Therefore he, more than Semmelweiss or Holmes, deserves much credit for making childbirth safe, as well as for the concept of antiseptic surgical operations. Lister was showered with honors, including elevation to the peerage, the first medical doctor to achieve this distinction. He was buried in Westminster Abbey with the pomp and ceremony reserved for the greatest national heroes.

(SEE ALSO: Antisepsis and Sterilization; Holmes, Oliver Wendell; Semmelweiss, Ignaz)

Bibliography

Lister, J. (1867). "On a New Method of Treating Compound Fractures, Abscesses, Etc., with Observations on the Conditions of Suppuration." Lancet 1:326–329, 357–359, 387–389, 507–509; 2:95–96.

—— (1867). "On the Antiseptic Principle in the Practice of Surgery." Lancet 2:353–356, 668–669.

— JOHN M. LAST

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 centered 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 honors, 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.

Further Reading

The Collected Papers of Joseph Baron Lister (2 vols., 1909) contains an excellent description and evaluation of Lister's work. The official biography by Lister's nephew, Sir Rickman John Godlee, Lord Lister (1917; 2d ed. 1918), is detailed but dated. Frederick F. Cartwright's popularly written Joseph Lister: The Man Who Made Surgery Safe (1963) gives a well-balanced picture.

Lister, Joseph (1827-1912). Surgeon and pioneer of antisepsis. Having qualified at London, then teaching at Edinburgh, he was appointed (1860) as regius professor of clinical surgery at Glasgow, where he was one of the few to pursue the implications of Pasteur's recent work on fermentation and the beginnings of the germ theory. Recognition led to chairs at Edinburgh and London, the presidency of the Royal Society, and a barony (1897). His work improved public confidence in both hospitals and surgery, and stimulated the infant science of bacteriology.

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For the soldier and Victoria Cross recipient, see Joseph Lister (VC).

For the fictional character, see Raffles (Lord Lister).

Joseph Lister
Born	5 April 1827(1827-04-05) Upton, Essex
Died	10 February 1912 (aged 84) Walmer, Kent
Nationality	United Kingdom
Fields	Medicine
Institutions	University of Glasgow University of Edinburgh University of London
Alma mater	University of London
Known for	Surgical sterile techniques

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 to sterilise surgical instruments and to clean wounds, which led to reduced post-operative infections and made surgery safer for patients.

Contents 1 Biography 1.1 Early life 1.2 Career 1.2.1 Antiseptics 1.2.2 Surgical technique 1.3 Later life 2 Legacy and honours 3 Bibliography 4 See also 5 References 6 External links

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, coincidentally, also the leading languages of medical research.^[1] 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. In 1867 Joseph discovered the use of carbolic acid as an antiseptic, such that it became the first widely used antiseptic in surgery. He subsequently left the Quakers, joined the Scottish Episcopal Church and eventually married Syme's daughter Agnes.^[2] 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 her 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.

Lister at age 69 in 1896

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 remarkably 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 British Medical Journal 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^{[citation needed]}. 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 in 1897 ^[3] and became one of the twelve original members of the Order of Merit and a Privy Councillor in the Coronation Honours in 1902.^[4]

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. Following his death, a Memorial Fund was set up in his name to honour his memory. Several lectures and statues were funded or established in this way. Eventually, in 1924, the Memorial Fund was used to establish the Lister Medal, which became the most prestigious prize that could be awarded to a surgeon.

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.

The popular antiseptic mouthwash, Listerine, is named after Joseph Lister.

Bibliography

• Lister Ward by Martin Goldman. Contains black and plates of activities at the Royal Infirmary Edinburgh ^[5]
• Lord Lister by Sir Rickman Godlee. Macmillan & Co, London, 2003 – 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, 2009
• Joseph Lister – Father of Modern Surgery, by Rhoda Truax. Bobbs Merrill, Indianapolis and New York, 1996
• 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

See also

• Joseph Sampson Gamgee
• Discoveries of anti-bacterial effects of penicillium moulds before Fleming
• Ignaz Semmelweis

References

1. ^ Doctors – The History of Medicine through Biography by Sherwin B. Nuland
2. ^ answersingenesis.org: "Lister married Syme’s daughter Agnes and became a member of the Episcopal church."
3. ^ The Times, Friday, Jan 01, 1897; Issue 35089; pg. 8; col A
4. ^ Coronation Honours. The Times, Thursday, Jun 26, 1902; Issue 36804; pg. 5; col B
5. ^ From a copy of Lister Ward First published by Adam Hilger UK in 1987 with an ISBN 0 85274 562 1

External links

Wikimedia Commons has media related to: Joseph Lister, 1st Baron Lister

Wikisource has original works written by or about: Joseph Lister

• The Lister Institute
• Collection of portraits of Lister at the National Portrait Gallery, London
• Statue of Sir Joseph Lister by Louis Linck at The International Museum of Surgical Science in Chicago
• Commemorative plaque to Lord Lister at the Edinburgh Medical School

Peerage of the United Kingdom
New creation	Baron Lister 1897–1912	Title extinct

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Persondata
NAME	Lister, Joseph
ALTERNATIVE NAMES
SHORT DESCRIPTION	Surgeon
DATE OF BIRTH	5 April 1827(1827-04-05)
PLACE OF BIRTH	Upton, Essex
DATE OF DEATH	10 February 1912
PLACE OF DEATH

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