Joseph Lister

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 on Joseph Lister

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.