Joseph Lister

Signaled the way out of surgery's black period. He discovered bacteria and showed that they were involved in spreading disease. Pasteur's work was described to Joseph Lister, professor of surgery in Glasgow, and he determined to find a way of poisoning these bacteria which it seemed were killing his patients. Well the professor of chemistry in Glasgow was a friend of his and the professor of chemistry in Glasgow said to Lister there's a marvellous new process they're using in the sewage works in Carlisle. They're putting carbolic into the sewage and it cuts down the smell. Now Lister knew very well that the smell of a sewage works was extremely similar to the smell of the operating theatre and the surgical wards. So he got some carbolic and he decided to kill the microbes using carbolic acid. And the crucial experiment was in August 1865. A child, James Greenlees, had broken his leg. Lister should have amputated because this was a compound fracture, the bone had broken through the skin, and a lethal infection was bound to follow. But he didn't amputate. What Lister did was to apply phenol, which is a mild antiseptic in the concentrations he used, directly to the protruding bone and to the tissues around it, and he cut away the tissues that had been damaged, and then he just immobilized it and let the patient's own local inflammation begin to overcome it. Of Lister's first 12 patients treated with carbolic or phenol, 10 survived with limbs intact. Limbs he would before have amputated without hesitation. In Lister's operating theatre, antiseptic technique was carried further. Believing that airborne bacteria were a major source of infection, he performed all his operations in a damp mist of carbolic produced by a spray pump. The system was extremely unpleasant and difficult to use, but Lister's staff suffered in silence. Though one irreverent person was heard to intone, let us spray, at the beginning of an operation. But despite its success in Lister's hands, the carbolic regime was not quick to catch on. Surgeons elsewhere were unconvinced of the need for this troublesome procedure. America was very slow. There was a conservative faction in surgery that said we shouldn't change, and in a way medicine, science, fields of learning always have the conservatives saying let's not change our thinking and the radicals saying let's change. There's always a tension there. It's a healthy tension, and in this country we were slow, but finally of course we did.