Joseph Lister (1827-1912) was a British surgeon who pioneered antiseptic surgical techniques, drastically reducing surgical mortality rates from nearly 50% to 15%. In this lesson, learn about his life, discoveries, and legacy.
Listerine: What’s in a Name?
Ugh. It’s caused by the noxious odors of bacterial waste products in your mouth, and getting rid of it should be as simple as getting rid of the bacteria, right? But what to use? How about Listerine? Who came up with that name anyway? It turns out that Listerine, an antiseptic mouthwash, was named after the person widely considered history’s most important person in the development of antiseptic surgery, Joseph Lister.There was a time when medical authorities were considering banning or severely curtailing surgery. As absurd a notion as that may seem, consider that approximately half of all surgery patients ended up dying from post-surgical infections. Lister’s work changed all that.
Lister’s Early Life
Lister was born in Essex, England to a family that valued and cultivated his education.
His father was a successful merchant, who also made notable contributions to the development of microscope lenses. At age 25, he was admitted to the Royal College of Surgeons and began his professional career.
Surgery in the Mid-19th Century
Death from post-surgical infections was so high in the 19th-century, around 50%, that the condition was commonly referred to as ‘ward fever’ or ‘hospital disease.
‘ Though now known as septicemia or sepsis, surgical incisions and openings provided a horrifically opportune route of infection of the blood by microbes of one kind or another. Doctors of the day recognized that ‘something in the air’ must be a factor in the widespread nature of these infections, and often opened windows to get fresh air or made extra sure to have clean linens. Hospitals would even occasionally build brand new surgical wings in order to get clean air, but those wards would quickly encounter mortality on par with any of the older wards.Ironically, the development of anesthetic, a huge development in surgical technology, may have exacerbated the post-surgical sepsis problem. Since doctors were no longer in as much of a hurry to finish their surgery to spare patients the pain that existed prior to anesthetics, they were more deliberate and less frenetic, keeping surgical wounds open for longer periods of time, and unwittingly exposing them to more prolonged periods for potential bacterial infections.
Formulation of Antiseptic Theory
Lister’s early academic work was in pathology and inflammation, in which he demonstrated his sharp scientific mind.
However, once he read Pasteur’s groundbreaking work of the day, The Germ Theory of Disease, in which Pasteur suggested that tissue and other organic materials rotted because of living germs and that life came only from other life, he made the connection to a possible theory by which blood became infected. Pasteur demonstrated several ways to eradicate the infectious germs, one of which was the use of chemicals. Lister set about finding an ideal such chemical to use in surgeries.
Antiseptic Materials and Techniques
Carbolic acid was a chemical used to deodorize sewage, which was helpful in a time when modern waste processing was not yet widely available. Lister fastidiously applied carbolic acid directly to surgical openings in post-operative recovery.
His results were encouraging, and he expanded the use of carbolic acid beyond direct application to the wounds to include surgical instruments, stitching materials, and wound dressings, e.g., gauze. In just a few years, his work resulted in surgical mortality rates decreasing from 45% to 15% of patients, an absolutely striking result for the time.Lister further innovated techniques that included paying attention to the clothing of doctors and nurses, using a carbolic acid mist to treat the air, a technique that was eventually abandoned because carbolic acid could be damaging to skin and lungs, and having hands washed in carbolic acid solution.
Adoption of Antiseptic Surgical Methods
Other pioneers were successful with antiseptic surgical practices, prior to Lister. For example, Ignaz Semmelweis, a Hungarian doctor, successfully demonstrated antiseptic techniques in the 1840’s.
However, lacking a grounded definition in why his techniques were successful, such as Pasteur’s germ theory, Semmelweis found it difficult to have his ideas gain a foothold in the medical community.While Lister was not the first to experiment successfully with antiseptic techniques, he was the one who was able to broadcast his findings widely enough that they were broadly adopted. However, adoption was not as immediate as his results suggested they ought to be. It wasn’t until about a decade after his groundbreaking discoveries with carbolic acid that he was able to convey his message to the majority of the British medical community. By then, German and French physicians had started to adopt antiseptic techniques. However, a very successful public surgery in London led to widespread acceptance and adoption of antiseptic techniques in Great Britain, and eventually, the rest of the world.
In addition to having Listerine named after him, dozens of different items honor the impact of his work. From a mountain in Antarctica, to institutes, hospitals, and prizes, to even bacterial pathogens, Lister’s name is commemorated in places throughout the world, most commonly in his native Britain.He was made a Baron in 1897, and in 1902, was selected as one of the original 12 members of the Order of Merit. An elite group created to honor the work and service of Great Britain’s realms, it included such giants as Francis Crick, T.S.
Eliot, and Alfred Russel Wallace.
Joseph Lister was a British surgeon credited with developing effective antiseptic surgical techniques that reduced postoperative sepsis deaths from its shockingly high rate of nearly 50%. By publicizing his techniques, he helped to facilitate their widespread adoption.
Additionally, Lister was the first to use carbolic acid in the treatment of wounds, as well as on different items in the surgical theatre, such as surgical instruments and wound dressings, doctors’ and nurses’ clothes and hands, and the air. While other antiseptics remain in use, Lister’s practice of disinfecting everything close to the surgical patient is standard medical practice today and can likely be credited with saving countless numbers of lives during the last century.