Joseph Lister

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Joseph Lister

Joseph Lister 1902.jpg
Lister in 1902
Born(1827-04-05)5 April 1827
Died10 February 1912(1912-02-10) (aged 84)
Walmer, Kent, England
NationalityEnglish, British
Spouse(s)Agnes Lister (nee Syme)
Education University College, London
Known forSurgical sterile techniques
Awards Royal Medal (1880)
Cameron Prize for Therapeutics of the University of Edinburgh (1890)
Albert Medal (1894)
Copley Medal (1902)
Scientific career
Fields Medicine
Institutions King's College London
University of Glasgow
University of Edinburgh
University College, London
Influences William Sharpey
Wharton Jones
Louis Pasteur,
Signature
Joseph Lister signature.png
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 KCVO , OM , PC , PRS (5 April 1827 10 February 1912), [1] was a British surgeon and a pioneer of antiseptic surgery. [2] From a technical viewpoint, Lister was not an exceptional surgeon, [2] but his research into bacteriology and infection in wounds raised his operative technique to a new plane where his observations, deductions and practices revolutionised surgery throughout the world. [3]

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.

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.

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". [4]

Early life

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 was born to a prosperous Quaker family in the village of Upton, West Ham, Essex, then near but now in London, [5] England. He was the second son of six siblings to gentleman scientist and port wine merchant Joseph Jackson Lister who was in partnership with Thomas Barton Beck, of Tokenhouse Yard, the grandfather of Marcus Beck. [6] Listers mother was Isabella Lister [7] née Harris, the youngest daughter of master mariner Anthony Harris. [6] Before she was married, Isabella worked at the Ackworth School, a Quaker school for the poor, assisting her widowed mother who was the superintendent of the school. [6]

His father was a pioneer in the design of achromatic object lenses for use in compound microscopes. [5] His father spent 30 years of his life perfecting the microscope, and in the process, discovered the Law of Aplanatic Foci, [8] building a microscope where the image point of one lens coincided with the focal point of another. [5] Up until that point, the best higher magnification lenses produced an excessive secondary aberration known as a coma which interfered with normal use. [5] His work built a reputation sufficient to enable his being elected to the Royal Society in 1832. [9] [10]

Education

A young Joseph Lister attended Benjamin Abbott's Isaac Brown Academy, a private [11] Quaker school in Hitchin in Hertfordshire. [12] When Lister was older he attended Grove House School in Tottenham, also a private Quaker School, [12] studying mathematics, natural science, and languages. His father was insistent that Lister received a good grounding in French and German, in the knowledge he would learn Latin. [13] From an early age, Lister became interested in natural history that led to dissections of small animals and fish, that were examined using his fathers microscope [14] and then be drawn or sketched. [12] His interests developed into a determination to become a surgeon. [14] More than 30 of his early school papers are still preserved. [14]

Lister left school in the spring of 1844 when he was seventeen. [12] He was unable to attend either Oxford or the University of Cambridge owing to the religious tests that effectively barred him. [5] Lister decided to attend the non-sectarian University College, London, one of only a few institutions which accepted Quakers at that time. [15] [16] He initially studied arts, graduating with a Bachelor of Arts degree with honours in classics and botany in 1847. [5] While he was studying, Lister suffered from a bout of smallpox, followed by a nervous breakdown. He decided to take a long holiday in Ireland, [11] to recuperate and this delayed the start of his medical studies at the university until October 1948. [11]

He registered as a medical student and graduated with honours as Bachelor of Medicine in 1852. [17] He 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, that are still in the possession of the Society today. [18]

Lister subsequently left the Quakers to join the Scottish Episcopal Church, and eventually married Syme's daughter, Agnes.[ citation needed ] 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. [19]

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, many people believed that chemical damage from exposure to "bad air", or miasma , 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; in the absence of any theory of bacterial infection, such practices were not considered necessary. 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. [20]

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. [21] As the first two methods suggested by Pasteur were unsuitable 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. [22] Upon hearing that creosote had been used for treating sewage, Lister began to test the efficacy of carbolic acid when applied directly to wounds. [23]

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. [24] In the spring of 1865, Lister read about Louis Pasteur discovery of living things causing fermentation and putrefaction in the magazine Comptes rendus hebdomadaires of the French Academy of Sciences, that was given to him by his friend, the chemist Thomas Anderson. [25]

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 Royal 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 suppuration. He subsequently published his results in The Lancet in a series of six articles, running from March through July 1867. [26] [27] [7]

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. [28]

Lister left Glasgow University in 1869, being succeeded by Prof George Husband Baird MacLeod. [29] 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 aseptic 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". [23]

Diffusion

Although Lister was so roundly honoured in later life, his ideas about the transmission of infection and the use of antiseptics were widely criticised in his early career. [7] 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. [30] 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. [31] [32]

Lister's use of carbolic acid proved problematic, and he eventually repudiated it for superior methods. The spray irritated eyes and respiratory tracts, and the soaked bandages were suspected of damaging tissue, so his teachings and methods were not always adopted in their entirety. [33] Because his ideas were based on germ theory, which was in its infancy, their adoption was slow. [34] General criticism of his methods was exacerbated by the fact that he found it hard to express himself adequately in writing, so they seemed complicated, unorganised, and impractical. [35]

Surgical technique

Lister moved from Scotland to King's College Hospital, in London. He was elected President of the Clinical Society of London. [36] 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, and rubber drains, and developing an aortic tourniquet. [37] [38] 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. [39] [40]

Later life

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. He had for several years been a Surgeon Extraordinary to Queen Victoria, and from March 1900 was appointed the Serjeant Surgeon to the Queen, [41] thus becoming the senior surgeon in the Medical Household of the Royal Household of the sovereign. After her death the following year, he was re-appointed as such to her successor, King Edward VII. [42] On 24 August 1902, the King 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." [43]

Death

Lister died on 10 February 1912 at his country home (now known as Coast House [44] [45] ) in Walmer, Kent at the age of 84. After a funeral service at Westminster Abbey, his body was buried at Hampstead Cemetery in London in a plot to the south-east of central chapel.

Awards and honours

In May 1890, Lister was awarded the Cameron Prize for Therapeutics of the University of Edinburgh, [46] that included the delivery of a short oration or lecture, that was held at the Synod Hall in Edinburgh. [47]


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. [48] 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. [49] [50] In the 1902 Coronation Honours list published on 26 June 1902 (the original day of King Edward VII´s coronation), [51] 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, [52] [53] and was sworn a member of the council at Buckingham Palace on 11 August 1902. [54]

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

Among foreign honours, he received the Pour le Mérite, one of Prussia's highest orders of merit. Two postage stamps were issued in September 1965 to honour Lister for his pioneering work in antiseptic surgery. [55]

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 Preventive Medicine was renamed Lister Institute of Preventive Medicine in honour of Lister. [56] 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 is named after him. The Discovery Expedition of 1901–04 named the highest point in the Royal Society Range, Antarctica, Mount Lister. [57]

In 1879, Listerine antiseptic (developed as a surgical antiseptic but nowadays best known as a mouthwash) was named after Lister. [58] 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. [59] 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 [60] – 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. [61]

Academic societies

In 1889 he was elected as Foreign member of the Royal Swedish Academy of Sciences.

Lister was president of the Royal Society between 1895 and 1900. [62] 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.

Bibliography

These are some of Listers most important papers.

See also

Related Research Articles

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Arthur Ernest Sansom physician and anesthesiologist from Britain

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Marcus Beck

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John Rutherford Ryley was an Irish-born surgeon who studied medicine in Glasgow, where he learned about Listerian antisepsis from Joseph Lister. He emigrated to New Zealand and introduced antiseptic surgery there in January 1868. Most of his career was then spent in Australia. He took his own life at the age of 46.

James Johnston Mason Brown Scottish paediatric surgeon

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References

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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