Joseph Lister (1827-1912) dreamed of becoming a physician. When he entered college in 1846, Lister saw the powerful effect that ether had on people who needed surgery. After this experience, Lister decided to focus specifically on becoming a surgeon.
During this time, surgery was still hazardous. Progress was being made in regards to the problems of pain during surgery. However, the main concern now was with an infection after surgery. Lister removed a simple mole from a man’s face before his wedding only to have the man die from an infection. This led Lister to question the benefits of surgery if death by infection was the result.
Infection at this time had reached almost epidemic proportions. Anywhere from 40-80% of surgery patients died from infections. Infections were so bad that one hospital was threatened with being burned to the ground if things did not improve. Many doctors still believed Galen that infection was good. They even went so far as to encourage the development of pus (a sign of infection).
Lister was seeking a solution, and he received insights from treating broken bones. Broken bones are either simple or compound. Simple fractures are broken bones that do not break through the skin. Compound fractures are broken bones that pierce the skin. Lister observed that people who suffered simple fractures rarely develop infections, while those who suffered compound fractures commonly developed infections.
Lister suspected that simple compound fractures lead to infection because the broken bones are exposed to germs in the air. This idea came from Louis Pasteur’s work in Germ Theory. Lister determined that if he can find a chemical that kills germs, he can save lives from infection.
Lister, with the help of a friend, decided to try carbolic acid to kill germs. Soon, a boy came to his office with a compound fracture of his leg. Lister fixed the leg and applied the carbolic acid to the wound to prevent infection. Fortunately, the boy recovered, and there was no infection.
Carbolic acid was not Lister’s only innovation. He also washed his hands before surgery rather than after. In addition, when tying arteries, he would soak the string in carbolic acid before tying the arteries shut. When performing surgery, Lister never wore old blood-stained clothes but always clean white ones. Lister could even get hospitals to stop using old bandages and donated ones and only use sterile, fresh dressings. Many hospitals hated the cost of clean bandages.
Lister’s success at reducing infections was so impressive that many doctors thought he was lying. In the hospital with a fatality rate of 80%, when they adopted Lister’s method, they reduced the death rate to 0.5%. This naturally saved the hospital from being burned to the ground.
One innovation that was made was boiling surgical tools rather than dipping them in carbolic acid. Lister tried this and stated that it didn’t matter as much the method as long as the germs were killed. Regardless, Lister’s methods created a new form of surgery called antiseptic surgery.
Carbolic acid was terrific, but it still had problems. For example, it was harsh on the skin even though it was a mild acid. Chemists came up with new solutions. Joseph Lawrence developed one antiseptic that killed germs without harming human flesh. He named it Listerine in honor of Joseph Lister.
Lister is considered by many to be one of the most excellent surgeons of all time. His contributions lay in his revolutionary insight into saving human life in a reasonable, cost-effective way. His impact is still felt to this day whenever someone has to face the stress of surgery.