From major operations to minor procedures, today we take surgery for granted. But go back a century or two and you were more likely to die than survive a trip to the operating theatre, no matter how simple the surgery.
We owe safe surgery to Joseph Lister. Born in April 1827, Lister was a British surgeon and medical scientist who revolutionised modern surgery.
Through sterilising surgical instruments, Lister solved the problem of surgical infection in the 19th century, and his principle of preventing bacterial infection in surgical wounds has prevented the deaths of surgical patients ever-since.
But how did Joseph Lister leave such a life-saving legacy?
Who was Joseph Lister?
Lister was born into a Quaker family who were dedicated to science. His father, J. J. Lister was elected a fellow of the Royal Society for his research into microbes that led to the development of the modern microscope.
Guided by his parents, Lister therefore had a keen and early interest in natural science. He became interested in comparative anatomy, and by the time of his 16th birthday had decided he was going to be a surgeon.
The problem of infection
Despite incredible development in the area of surgical medicine during the 19th century, patients of successful operations were still dying. Often, the cause of death was from infection, with post-op patients developing sepsis or gangrene.
The introduction of anaesthetics such as ether into surgery earlier in the 19th century had removed pain for patients, allowing surgeons to perform ever-more complex procedures. But as surgery got more popular and daring, the number of surgical infections continued to rise.
There were numerous theories about the cause and spread of these infections, but none of these were proven, and there was little attempt to stem the tide of deaths from surgical infections.
What is Joseph Lister famous for?
As all Victorian surgeons, Lister understood the problem of infection. His first job as a surgical dresser meant he had followed surgeons on their rounds, cleaning and dressing the often pus-filled, infected surgical wounds.
Then, working at Glasgow University as Professor of Surgery in 1874, Lister was introduced to Louis Pasteur’s germ theory of disease. Pasteur speculated that microorganisms spread disease, and these diseases could be stopped by using germ-killing chemicals.
Lister applied Pasteur’s theory to the problem of surgical infections. At the hospital and at home, assisted by his wife Agnes, Lister studied infection, trying to prevent germs from getting into wounds by creating a chemical barrier: antiseptic.
Lister published his trials using carbolic acid to prevent infection. The reaction was mixed. Many surgeons did not believe Pasteur’s Germ Theory, so thought Lister’s insistence on bringing antiseptic into surgical procedure was unnecessary and time-consuming.
To prevent the spread of infection, Lister suggested using weak carbolic washes for surgical staff and carbolic acid baths for the instruments. Carbolic acid spray would be used to reduce the level of airborne germs around the patient.
The number of surgical infections fell. It was soon irrefutable that antisepsis worked, and the procedure was accepted by surgeons around the world, leading to further developments in bacterial science in the 1890s.
Lister’s notable contribution to medical science was celebrated during his lifetime. He was awarded multiple medals and was president of the Royal Society between 1895 and 1900.
He was also honoured by royalty. In 1883 Queen Victoria made him a Baronet and in 1897 she awarded him with full peerage. King Edward VII, Victoria’s eldest son, suffered an appendicitis two days before his coronation. He looked to Lister on having a safe appendectomy and credited the surgeon with saving his life.
As a result, Lister was appointed to the Privy Council and made a member of the Order of Merit, an extremely exclusive honour only gifted by the reigning monarch.
After he died, a memorial fund founded the Lister Medal, which continues to be considered the most prestigious prize a surgeon could be awarded.