Joseph Lister

Key Facts & Summary

  • Lister was a British Professor of Surgery who proposed the antiseptic method.
  • He was largely influenced by the discoveries made by Luis Pasteur.
  • Pasteur diffused Lister’s finding in France in order to contribute to the medical advancement.

Biography

Joseph Lister was an English surgeon, the first to provide a solution to the problem of wound infection following surgical operations. His work made possible tremendous advances in surgery.

He was born on April 5, 1827, the fourth of seven children, in Upton, a village near London. His father, Joseph Jackson Lister, was a prosperous Quaker merchant who later was made a Fellow on the Royal Society for his discovery of achromatic lens. Joseph Lister received his B.A., and then in 1852, his medical degree from the University College of London. Subsequently, Lister became assistant to a leading surgeon. Prof. James Syme of the University of Edinburgh. In 1856 he married Syme’s daughter, Agnes, giving up his religion to do so. It was a very happy marriage, although they were disappointed in not having any children.

In 1860, Lister was appointed Regius Professor at the University of Glasgow. Here he found the morality following surgical operations even higher than in Edinburgh. At that time surgery was a last resort because of ‘surgical diseases’ which would frequently kill all the patients in a hospital ward. These diseases were usually blamed on miasmas (gases) which presumably hovered about the hospital and caused wounds to rot.

As a student, Lister had examined dangerous material under a microscope, suspecting that something in the wound rather than in the atmosphere caused the disease. This, along with his subsequent work on the contraction of arteries an on the skin on the frog, was related to the subject of his first important scientific contribution, published in 1857 and entitled ‘An Essay on the Early Stages of Inflammation’. These studies enable him to understand a paper by Louis Pasteur which he read in 1865. It demolished the theory of ‘spontaneous generation’ and proved, among other things that microbes cause decay. Lister applied this theory to wound infection. He used carbolic acid to kill the germs in several cases of compound fractures, which generally became infected and necessities amputation. He was successful. In 1867 he published ‘On the Antiseptic Principle in the Practice of Surgery’. His method was not rapidly adopted, mainly due to opposition to the germ theory. However, despite the controversy, his successes and his perseverance could not be ignored.

Within a few years, antiseptic surgery put an end to surgical diseases; new operations could be performed. Modern scientific surgery was born. Later, the antiseptic method was replaced by the aseptic method, the emphasis being shifted from killing germs to keeping them from wounds.

 

In 1883, Lister was made a baronet by Queen Victoria. The only surgical operation she underwent – the removal of an abscess – was performed by Lister. Scientific honours from all over the world were awarded to him.

He died in Walmers, Kent, on February 10, 1912. After public funeral services in Westminster Abbey, he was buried, as he had requested, by his wife’s side in West Hampstead Cemetery.

How Pasteur’s studies had revolutionised surgical practice

When Louis Pasteur started observing microorganisms, he demonstrated through dramatic experiments that in reality each microbe is derived from a pre-existing microbe, and that spontaneous generation did not occur. Therefore, he discovered that microorganism – called the germs – acting on a specific type of substance to produce another substance. In essence, Pasteur illustrated this revolutionary theory with brilliant studies on the conversion of sugar into lactic acid, butyric acid, or alcohol; of alcohol into acetic acid, etc. His germ theory of fermentation was first presented in 1857 in a short paper which has become a classic, Sur la fermentation appelée lactique (On Lactic Fermentation), in which he claimed that the different types of microbes could be separated from each other by proper techniques, and could be shown to differ in nutritional requirements, and susceptibility to antiseptics. He suggested, furthermore, that just as each type of fermentation was caused by a particular type of germ, so it was with many types of disease.

Lister became interested in Pasteur’s work in 1864 in Glasgow, when he came into contact with the microbiologist’s works ‘On the organised bodies which exist in the atmosphere’, published 1861; and in ‘Investigation into the role attributable to atmospheric gas’ (1863) (De Paolo 2012; citing Fisher).

Such reading came in handy to Lister, who at the time was working at the Glasgow Royal Infirmary and was struck by the amount of people that died following surgical procedures. In fact, people were more susceptible to death because of the ‘cross-infections’ present in the hospitals (De Paolo 2012).

In his essay On the Effects of Antiseptic System of Treatment upon the Salubrity of a Surgical Hospital, Lister indicates the three main reasons of post-surgical death: 1. pyaemia (i.e. blood poisoning, or septicaemia); 2. erysipelas (inflammatory infection due to bacteria); 3. gangrene. Moreover, during the cholera epidemic of 1849, several coffins had been interred below the hospital’s infirmary, which was alarming to Lister.

Lister became more and more interested in Pasteur’s work, and started to carry out experiments in order to find out whether he could cure infections caused by germs with antiseptics. In his successful attempts, Lister realised that the study of microorganisms and surgery go hand in hand, since microorganisms can definitely affect the human body and the immune system.

Thanks to Pasteur’s work ‘On the organised bodies which exist in the atmosphere’, Lister came to the conclusion that air in itself is not poisonous: rather, it is the microscopic particles in the air and the minute germs that give a specific quality to the air. Therefore Lister understood something of paramount importance: ‘In the course of an extended investigation into the nature of inflammation, and the healthy and morbid conditions of the blood in relation to it, I arrived several years ago at the conclusion that the essential cause of suppuration in wounds is decomposition brought about by the influence of the atmosphere upon blood or serum retained within them, and, in the case of contused wounds, upon portions of tissue destroyed by the violence of the injury. […] 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 has been shown by the researches of Pasteur that the septic property 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. Upon this principle I have based a practice’ (Lister 1867).

Moreover, Lister was particularly intrigued by a statement made by Pasteur in the scientific magazine Annales des sciences Naturelles (in March and April 1865), which the French microbiologist drew an analogy between fermentation and the processes of infection and putrefaction. Lister started to investigate whether the action of microbes in fermentation might be the same in the cases of infection of putrescence. Lister came ti the conclusion that germs could definitely affect and poison the human tissue, and in 1867, he published in a scientific journal: ‘Admitting, then, the truth of the germ theory, and proceeding in accordance with it, we must when dealing with any case, destroy in the first instance once [and] for all any septic organisms which may exist in the part concerned; and after this has been done, our efforts must be directed to the prevention of the entrance of others into it. And provided that these indications are really fulfilled, the less the antiseptic agent comes in contact with the living tissues the better, so that unnecessary disturbance from the irritating properties may be avoided. [CP, vol. 2, 47-8]’ (De Paolo 2012).

Throughout his experiments, Lister had carefully reproduced Pasteur’s experiments and had made a contribution that sought to eliminate hospital infections. Lister was introduced to Pasteur by John Tyndall, a British physicist who had become acquainted with the Lister’s work. It was the first time that Pasteur had heard of the English surgeon, and was intrigued by his work and how his personal findings had impacted research on other fronts. Therefore, he deemed necessary to spread Lister’s research in France in order to contribute to the medical community. However, Pasteur was not the first to introduce Lister’s work in France: Dr. Just Lucas-Championnière had written about the Lister’s work in 1876 (De Paolo 2012; citing Letter, Godlee 307-10, 353; Vallery-Radot 239).

Bibliography

[1.] Bankston, J. (2004). Joseph Lister and the Story of Antiseptics (Uncharted, Unexplored, and Unexplained). Bear, Del: Mitchell Lane Publishers.

[2.] Cope, Z. (1967). “Joseph Lister, 1827–1912”. The British Medical Journal.

[3.] De Paolo, C. (2012). Pasteur and Lister: A Chronicle of Scientific Influence. Available from: http://www.victorianweb.org/science/health/depaolo.html

[4.] Lister, J. (1999). “PROFESSOR LISTER ON ANTISEPTIC SURGERY”. The Lancet. 102(2610): 353–354

Image sources:

[1.] https://s0.geograph.org.uk/geophotos/02/51/63/2516358_28f56d70.jpg

[2.] https://upload.wikimedia.org/wikipedia/commons/7/7b/Joseph_Lister_c1855.jpg

[3.] https://daily.jstor.org/wp-content/uploads/2017/03/Lister_spraying_phenol_1050x700.jpg

[4.] https://upload.wikimedia.org/wikipedia/commons/3/3c/Albert_Edelfelt_-_Louis_Pasteur_-_1885.jpg