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The Modernisers

Joseph Lister 1827-1912

Joseph Lister was born in Upton Essex, England. As Professor of Surgery at Glasgow University, he was very aware that many people survived the trauma of an operation but died afterwards of what was known as ward fever’, its other names were Hospitalism or hospital gangrene.
He was aware of the work done by the Hungarian doctor, Ignaz Semmelweis In 1865, Lister however was reminded of the work done by Louis Pasteur on how wine was soured, by professor John Anderson. It convinced Lister of Pasteur’s germ theory that microbes carried in the air that caused diseases to be spread in wards.


People who had been operated on were especially vulnerable as their bodies were weak and their skin had been cut open so that germs could get into the body with more ease. Lister decided that the wound itself had to be thoroughly cleaned.

In 1865 he treated 11 year old James Greenlee who had been run over by a cart and sustained an open fracture (Compound) of the shin bone. He then covered the wound with a piece of lint covered in carbolic acid. After 6 weeks the lad was discharged able to walk.

Prior to this, amputation would have been the only sensible course to save the life of the patient. Death by gangrene was common after such an accident.

He continued to use this treatment on patients who had a compound fracture. This is where the broken bone had penetrated the skin thus leaving a wound that was open to germs.

 

Lister covered the wound made with lint soaked in carbolic acid. His success rate for survival was very high. 


In 1867, Lister published his study of antiseptics by use of carbolic; it was to become known as the Carbolic Crusade. He used carbolic acid sprays to decontaminate surgical wounds.

The number of patients operated on by Lister who died, fell dramatically. 
This was the beginning of sterilisation and proper asepsis. He experimented and had great success with sutures that he soaked in an aqueous solution of carbolic acid.191

Add to this the nursing crusade set in motion by Florence Nightingale during the Crimean war, these combined had a tremendous effect on the post-operative results for the patients.
“On Anaesthetics” he stressed the need for the stomach to be empty and the need to starve a patient for at least four hours.

He also recommended a cup of tea up to two hours before surgery. 201
Joseph Lister died in 1912 and was accorded in death the rare honour of a funeral service at Westminster Abbey before being interred at Hampstead Cemetery.

 

 

Quote 83

"The frequency of disastrous consequences in compound fracture, contrasted with the complete immunity from danger to life or limb in simple fracture, is one of the most striking as well as melancholy facts in surgical practice." 202

 


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