Joseph Lister

Last updated


The Lord Lister

Joseph Lister 1902.jpg
Lister in 1902
President of the Royal Society
In office
1895–1900
Preceded by The Lord Kelvin
Succeeded by Sir William Huggins
Personal details
Born(1827-04-05)5 April 1827
Upton House, West Ham, England
Died10 February 1912(1912-02-10) (aged 84)
Walmer, Kent, England
NationalityBritish
Spouse(s)Agnes Lister (nee Syme)
Signature Joseph Lister signature.png
Alma mater University College, London
Known forSurgical sterile techniques
Awards Royal Medal (1880)
Albert Medal (1894)
Copley Medal (1902)
Scientific career
Fields Medicine
Institutions King's College London
University of Glasgow
University of Edinburgh
University College, London
Lister's carbolic steam spray apparatus, Hunterian Museum, Glasgow Lister's carbolic steam spray apparatus, Hunterian Museum, Glasgow.jpg
Lister's carbolic steam spray apparatus, Hunterian Museum, Glasgow

Joseph Lister, 1st Baron Lister, OM , PC , PRS (5 April 1827 10 February 1912), [1] known between 1883 and 1897 as Sir Joseph Lister, Bt., was a British surgeon and a pioneer of antiseptic surgery.

Privy Council of the United Kingdom Formal body of advisers to the sovereign in the United Kingdom

Her Majesty's Most Honourable Privy Council, usually known simply as the Privy Council of the United Kingdom or just the Privy Council, is a formal body of advisers to the Sovereign of the United Kingdom. Its membership mainly comprises senior politicians, who are current or former members of either the House of Commons or the House of Lords.

Surgeon physician with surgical specialty

In modern medicine, a surgeon is a physician who performs surgical operations. There are also surgeons in podiatry, dentistry maxillofacial surgeon and the veterinary fields.

Contents

Lister promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary. Lister successfully introduced carbolic acid (now known as phenol) to sterilise surgical instruments and to clean wounds.

Glasgow Royal Infirmary Hospital in Glasgow, Scotland

The Glasgow Royal Infirmary (GRI) is a large teaching hospital. With a capacity of around 1,000 beds, the hospital campus covers an area of around 8 hectares, situated on the north-eastern edge of the city centre of Glasgow, Scotland. It is managed by NHS Greater Glasgow and Clyde.

Phenol chemical compound

Phenol is an aromatic organic compound with the molecular formula C6H5OH. It is a white crystalline solid that is volatile. The molecule consists of a phenyl group (−C6H5) bonded to a hydroxy group (−OH). It is mildly acidic and requires careful handling due to its propensity for causing chemical burns.

Applying Louis Pasteur's advances in microbiology, Lister championed the use of carbolic acid as an antiseptic, so that it became the first widely used antiseptic in surgery. He first suspected it would prove an adequate disinfectant because it was used to ease the stench from fields irrigated with sewage waste. He presumed it was safe because fields treated with carbolic acid produced no apparent ill-effects on the livestock that later grazed upon them.

Louis Pasteur French chemist and microbiologist

Louis Pasteur was a French biologist, microbiologist and chemist renowned for his discoveries of the principles of vaccination, microbial fermentation and pasteurization. He is remembered for his remarkable breakthroughs in the causes and prevention of diseases, and his discoveries have saved many lives ever since. He reduced mortality from puerperal fever, and created the first vaccines for rabies and anthrax.

Microbiology study of microscopic organisms

Microbiology is the study of microorganisms, those being unicellular, multicellular, or acellular. Microbiology encompasses numerous sub-disciplines including virology, parasitology, mycology and bacteriology.

Surgery medical specialty

Surgery is a medical specialty that uses operative manual and instrumental techniques on a patient to investigate or treat a pathological condition such as a disease or injury, to help improve bodily function or appearance or to repair unwanted ruptured areas.

Lister's work led to a reduction in post-operative infections and made surgery safer for patients, distinguishing him as the "father of modern surgery". [2]

Early life and education

The Lord Lister Hotel in Hitchin, formerly Benjamin Abbott's Isaac Brown Academy, where Lister was a student from 1838 to 1841 Lord Lister Hotel Hitchin 2017.jpg
The Lord Lister Hotel in Hitchin, formerly Benjamin Abbott's Isaac Brown Academy, where Lister was a student from 1838 to 1841
Lister with fellow Residents at the Old Royal Infirmary, Edinburgh, c. 1855 (Lister is in the front row with his hands clasped) Residents at the Old Royal Infirmary, Edinburgh, summer Wellcome V0027881.jpg
Lister with fellow Residents at the Old Royal Infirmary, Edinburgh, c. 1855 (Lister is in the front row with his hands clasped)
The widespread introduction of antiseptic surgical methods followed the publishing of Lister's Antiseptic Principle of the Practice of Surgery in 1867 On the Antiseptic Principle of the Practice of Surgery.djvu
The widespread introduction of antiseptic surgical methods followed the publishing of Lister's Antiseptic Principle of the Practice of Surgery in 1867

Lister came from a prosperous Quaker home in West Ham, Essex, England, a son of wine merchant Joseph Jackson Lister, who was also a pioneer of achromatic object lenses for the compound microscope. [3]

West Ham western part of the London Borough of Newham

West Ham is a district in East London, located 6.1 mi (9.8 km) east of Charing Cross.

Essex County of England

Essex is a county in the south-east of England, north-east of London. One of the home counties, it borders Suffolk and Cambridgeshire to the north, Hertfordshire to the west, Kent across the estuary of the River Thames to the south, and London to the south-west. The county town is Chelmsford, the only city in the county. For government statistical purposes Essex is placed in the East of England region.

Joseph Jackson Lister British physicist

Joseph Jackson Lister, FRS was an amateur British opticist and physicist and the father of Joseph Lister.

At school, Lister became a fluent reader of French and German. A young Joseph Lister attended Benjamin Abbott's Isaac Brown Academy, a Quaker school in Hitchin in Hertfordshire (since converted into the "Lord Lister" public house). [4] As a teenager, Lister attended Grove House School in Tottenham, studying mathematics, natural science, and languages.

Hitchin market town in the North Hertfordshire District in Hertfordshire, England

Hitchin is a market town in the North Hertfordshire District in Hertfordshire, England, with an estimated population of 33,350.

Hertfordshire County of England

Hertfordshire is one of the home counties in England. It is bordered by Bedfordshire and Cambridgeshire to the north, Essex to the east, Greater London to the south, and Buckinghamshire to the west. For government statistical purposes, it is placed in the East of England region.

Grove House School was a Quaker school in Tottenham, United Kingdom.

Lister attended University College, London, [5] [6] one of only a few institutions which accepted Quakers at that time. He initially studied botany and obtained a bachelor of Arts degree in 1847. [7] He registered as a medical student and graduated with honours as Bachelor of Medicine, subsequently entering the Royal College of Surgeons at the age of 26. In 1854, Lister became both first assistant to and friend of surgeon James Syme at the University of Edinburgh, Edinburgh Royal Infirmary in Scotland. There he joined the Royal Medical Society and presented two dissertations, in 1855 and 1871, which are still in the possession of the Society today. [8]

Lister subsequently left the Quakers, joined the Scottish Episcopal Church, and eventually married Syme's daughter, Agnes. [9] On their honeymoon, they spent three months visiting leading medical institutes (hospitals and universities) in France and Germany. By this time, Agnes was enamoured of medical research and was Lister's partner in the laboratory for the rest of her life.[ citation needed ]

Career and work

Lister spraying phenol over patient Lister spraying phenol over patient.jpg
Lister spraying phenol over patient
Joseph Lister c. 1855 Joseph Lister c1855.jpg
Joseph Lister c. 1855
Joseph Lister in his youth Joseph Lister, 1st Baron Lister (1827 - 1912) surgeon Wellcome L0002075.jpg
Joseph Lister in his youth

Before Lister's studies of surgery, most people believed that chemical damage from exposure to bad air was responsible for infections in wounds. Hospital wards were occasionally aired out at midday as a precaution against the spread of infection via miasma, but facilities for washing hands or a patient's wounds were not available. A surgeon was not required to wash his hands before seeing a patient because such practices were not considered necessary to avoid infection. Despite the work of Ignaz Semmelweis and Oliver Wendell Holmes Sr., hospitals practised surgery under unsanitary conditions. Surgeons of the time referred to the "good old surgical stink" and took pride in the stains on their unwashed operating gowns as a display of their experience. [10]

While he was a professor of surgery at the University of Glasgow, Lister became aware of a paper published by the French chemist, Louis Pasteur, showing that food spoilage could occur under anaerobic conditions if micro-organisms were present. Pasteur suggested three methods to eliminate the micro-organisms responsible: filtration, exposure to heat, or exposure to solution/chemical solutions. Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop antiseptic techniques for wounds. [11] As the first two methods suggested by Pasteur were dangerous and unsafe for the treatment of human tissue, Lister experimented with the third idea.

In 1834, Friedlieb Ferdinand Runge discovered phenol, also known as carbolic acid, which he derived in an impure form from coal tar. At that time, there was uncertainty between the substance of creosote – a chemical that had been used to treat wood used for railway ties and ships since it protected the wood from rotting – and carbolic acid. [12] Upon hearing that creosote had been used for treating sewage, Lister began to test the efficacy of carbolic acid when applied directly to wounds. [13]

Therefore, Lister tested the results of spraying instruments, the surgical incisions, and dressings with a solution of carbolic acid. Lister found that the solution swabbed on wounds remarkably reduced the incidence of gangrene. [14] In August 1865, Lister applied a piece of lint dipped in carbolic acid solution onto the wound of a seven-year-old boy at Glasgow Infirmary, who had sustained a compound fracture after a cart wheel had passed over his leg. After four days, he renewed the pad and discovered that no infection had developed, and after a total of six weeks he was amazed to discover that the boy's bones had fused back together, without the danger of suppuration. He subsequently published his results in The Lancet in a series of six articles, running from March through July 1867. [15] [16] [3]

He instructed surgeons under his responsibility to 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 additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments. [17]

Lister left Glasgow University in 1869, being succeeded by Prof George Husband Baird MacLeod. [18] Lister then returned 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. Amongst those he worked with there, who helped him and his work, was the senior apothecary and later MD, Dr Alexander Gunn. Lister's fame had spread by then, and audiences of 400 often came to hear him lecture. As the germ theory of disease became more understood, 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 less primitive surgery. On the hundredth anniversary of his death, in 2012, Lister was considered by most in the medical field as "The Father of Modern Surgery". [13]

Criticism

Although Lister was so roundly honored in later life, his ideas about the transmission of infection and the use of antiseptics were widely criticized in his early career. [3] In 1869, at the meetings of the British Association at Leeds, Lister's ideas were mocked; and again, in 1873, the medical journal The Lancet warned the entire medical profession against his progressive ideas. [19] However, Lister did have some supporters including Marcus Beck, a consultant surgeon at University College Hospital, who not only practiced Lister's antiseptic technique, but included it in the next edition of one of the main surgical textbooks of the time. [20] [21]

Lister's use of carbolic acid proved problematic. The spray caused respiratory and visual discomfort, and the soaked bandages are suspected to have had damaged tissue, so his teachings and methods were not always adopted in their entirety. [22] They were also based on germ theory which was in its infancy and made adoption of his ideas slow. [23] Exacerbating general criticism was Lister's poor writing abilities which made his methods seem complicated, unorganized, and impractical. [24]

Surgical technique

Lister moved from Scotland to King's College Hospital, in London. In 1881 he was elected President of the Clinical Society of London. [25] He also developed a method of repairing kneecaps with metal wire and improved the technique of mastectomy. He was also known for being the first surgeon to use catgut ligatures, sutures, rubber drains, and developing an aortic tourniquet. [26] [27] He also introduced a diluted spray of carbolic acid combined with its surgical use, however he abandoned the carbolic acid sprays in the late 1890s after he saw it provided no beneficial change in the outcomes of the surgeries performed with the carbolic acid spray. The only reported reactions were minor symptoms that did not affect the surgical outcome as a whole, like coughing, irritation of the eye, and minor tissue damage among his patients who were exposed to the carbolic acid sprays during the surgery. [28] [29]

Later life

Coast House in Deal, with its blue plaque to Lister. CoastHouseDeal.jpg
Coast House in Deal, with its blue plaque to Lister.
Lister's hearse prior to his funeral service at Westminster Abbey, London Joseph Lister's hearse. Photograph by Topical Press agency. Wellcome V0027889.jpg
Lister's hearse prior to his funeral service at Westminster Abbey, London
Grave of Joseph Lister, West Hampstead Cemetery Grave of Joseph Lister, West Hampstead Cemetery.JPG
Grave of Joseph Lister, West Hampstead Cemetery

Lister's wife had long helped him in research and after her death in Italy in 1893 (during one of the few holidays they allowed themselves) he retired from practice. 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. On 24 August 1902 Edward VII came down with appendicitis two days before his scheduled coronation. Like all internal surgery at the time, the appendectomy needed by the King still posed an extremely high risk of death by post-operational infection, and surgeons did not dare operate without consulting Britain's leading surgical authority. Lister obligingly advised them in the latest antiseptic surgical methods (which they followed to the letter), and the King survived, later telling Lister, "I know that if it had not been for you and your work, I wouldn't be sitting here today." [30]

Death

Lister died on 10 February 1912 at his country home (now known as Coast House [31] [32] ) in Walmer, Kent at the age of 84. After a funeral service at Westminster Abbey, he was buried at West Hampstead Cemetery, London in a plot to the south-east of central chapel. Both the baronetcy and barony became extinct on his death.

Legacy and honours

Memorial to Lister, Portland Place, London Memorial To Lord Lister-Portland Place.jpg
Memorial to Lister, Portland Place, London
Arms of Joseph Lister: Ermine, on a fess invected sable three mullets of six points argent in chief a Staff of Aesculapius erect proper with canton of a baronet, Red Hand of Ulster Achievement of arms (of Baron Lister%3F). Watercolour. Wellcome V0018195.jpg
Arms of Joseph Lister: Ermine, on a fess invected sable three mullets of six points argent in chief a Staff of Aesculapius erect proper with canton of a baronet, Red Hand of Ulster

Lister was president of the Royal Society between 1895 and 1900. Following his death, a memorial fund led to the founding of the Lister Medal, seen as the most prestigious prize that could be awarded to a surgeon.

Lister's discoveries were greatly praised and in 1883 Queen Victoria created him a Baronet, of Park Crescent in the Parish of St Marylebone in the County of Middlesex. [33] In 1897 he was further honoured when Her Majesty raised him to the peerage as Baron Lister, of Lyme Regis in the County of Dorset. [34] [35] In the 1902 Coronation Honours list published on 26 June 1902 (the original day of King Edward VII´s coronation), [36] Lord Lister was appointed a Privy Counsellor and one of the original members of the new Order of Merit (OM). He received the order from the King on 8 August 1902, [37] [38] and was sworn a member of the council at Buckingham Palace on 11 August 1902. [39]

"Without such freedom there would have been no Shakespeare, no Goethe, no Newton, no Faraday, no Pasteur and no Lister."

Albert Einstein's speech on intellectual freedom at the Royal Albert Hall, London after having fled Nazi Germany, 3 October 1933. [40]

Among foreign honours, he received the Pour le Mérite, one of Prussia's highest orders of merit. In 1889 he was elected as Foreign member of the Royal Swedish Academy of Sciences. Two postage stamps were issued in September 1965 to honour Lister for his pioneering work in antiseptic surgery. [41]

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. In 1903, the British Institute of Preventative Medicine was renamed Lister Institute of Preventive Medicine in honour of Lister. [42] The building, along with another adjacent building, forms what is now the Lister Hospital in Chelsea, which opened in 1985. In 2000, it became part of the HCA group of hospitals.

A building at Glasgow Royal Infirmary which houses cytopathology, microbiology and pathology departments was named in Lister's honour to recognise his work at the hospital. Lister Hospital in Stevenage, Hertfordshire, England is named in honour of Lister. The Discovery Expedition of 1901–04 named the highest point in the Royal Society Range, Antarctica, Mount Lister. [43]

In 1879, Listerine antiseptic (developed as a surgical antiseptic but nowadays best known as a mouthwash) was named after Lister. Microorganisms named in his honour include the pathogenic bacterial genus Listeria named by J. H. H. Pirie, typified by the food-borne pathogen Listeria monocytogenes , as well as the slime mould genus Listerella , first described by Eduard Adolf Wilhelm Jahn in 1906.

Lister is depicted in the Academy Award winning 1936 film, The Story of Louis Pasteur , by Halliwell Hobbes. In the film, Lister is one of the beleaguered microbiologist's most noted supporters in the otherwise largely hostile medical community, and is the key speaker in the ceremony in his honour.

Lister's name is one of twenty-three names featured on the Frieze of the London School of Hygiene & Tropical Medicine [44] – although the committee which chose the names to include on the frieze did not provide documentation about why certain names were chosen and others were not. [45]

See also

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  44. "Behind the Frieze – Baron Lister of Lyme Regis (1827–1912)". Archived from the original on 22 November 2016. Retrieved 22 November 2016.
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Further reading

Peerage of the United Kingdom
New creation Baron Lister
1897–1912
Extinct
Baronetage of the United Kingdom
New title Baronet
(of Park Crescent)
1883–1912
Extinct