Joseph Lister is one of the most important names in the history of surgery. Born into a Quaker family in Essex, he nevertheless completed most of his important work at the Royal Infirmary in Glasgow. As a non-conformist, he was excluded from Oxford and Cambridge universities as well as King's College, London, so he studied medicine at University College. Here, he was influenced by opthalamist Wharton Jones and physiologist William Sharpley.
Extracts from the accompanying The Greatest Scot television programme are being added to these biographical notes as the programme is broadcast between November 9 and 13. If you live outside the UK, you will not be able to see these, but you may enjoy other videos about some of the subjects which are available via links in the text.
Joseph Lister put Louis Pasteur’s ideas about bacteria and his carbolic acid experiments on animals into practice, and in 1865 successfully treated an 11-year-old boy who had a severe leg wound. Pure carbolic acid was applied to all parts of the wound and carefully covered. The wound healed and no amputation was needed – this was a milestone in medical history.
Carbolic acid is a derivative of coal and Lister had seen it being used in Carlisle as an antiseptic for cleaning out the sewers. To begin with, Lister's ideas brought him a great deal of derision from his associates. He was openly mocked for his belief in "invisible" germs. But before long, no one could question Lister and his spray as it markedly contributed to a dramatic drop in post-operation mortality rates.
Presenter Vanessa Collingridge says: "The chances of recovering from surgery in the early 19th century were pretty thin – that is, until Lister invented his carbolic spray and changed medical practice forever."
In 1853, Lister moved to Edinburgh, and in 1860, he took the chair of clinical surgery at the University of Glasgow. It was here - and at the attached Royal Infirmary - that he became deeply involved with antiseptics. His work brought him into regular contact with the atrocious conditions at the Infirmary, where amputations had no more than a 60% survival rate, and operations to the abdomen and cranium were not even attempted because of the enormous risk of infection. Lister experimented with his new techniques on compound fracture victims, because their high mortality rates, and their frequency in an industrial city such as Glasgow made them ideal for repeated experimentation. His work continued when he obtained chairs in the University of Edinburgh in 1869 and University of London in 1877.
The drawback of Lister's early experiments with carbolic acid was the toxicity of the acid. This led to the development of a number of antiseptic wound dressings designed to provide a disinfectant barrier between the wound and the surrounding air, while reducing to a minimum the carbolic acid entering the damaged tissue.
A dressing made of shellac mixed with 25% carbolic acid, spread on calico and coated with gutta-percha dissolved in benzene prevented bacteria from entering the dressing but also prevented the carbolic acid from entering the wound. Lister also introduced the sterilisation of surgical instruments with heat and carbolic acid and the frequent cleaning of the surgeon's hands during an operation with a mild antiseptic solution.
Lister's other innovations were improved ligatures (which, because of disinfection, could be fully embedded in the wound, without worry about infection, and therefore did not need to hang out of the wound as it healed) and the introduction into Britain of drainage tubes - which he used in an operation on Queen Victoria in his role as Surgeon in Ordinary to the monarch.
Despite the widespread academic hostility to and scepticism about his innovations (especially on his return to London), Lister served as president of the Royal Society (1895-1900) and the British Association for the Advancement of Science (1896), as well as being a founding member of the British Institute of Preventative Medicine - which now bears his name. On his death, there was considerable support for a burial in Westminster Abbey, but he had insisted on being buried with his wife.
