Lister, Joseph (1827–1912)

Joseph Lister was a British surgeon best remembered today for pioneering antiseptic techniques to reduce infection rates, and thus morbidity and mortality, following surgical procedures. Lister was born to a Quaker family in Upton, Essex, England; his father was the physicist Joseph Jackson Lister, who invented the achromatic microscope. Joseph Lister studied medicine at University College, London, and graduated in 1852. He served as a resident in University Hospital, London, and was then appointed as an assistant surgeon at the Edinburgh Royal Infirmary in 1856, where he worked under James Syme. In 1859, Lister was appointed to the Regius Professorship of Surgery at Glasgow University, and in 1861, he became surgeon of the Glasgow Royal Infirmary.

When Lister began his career, the mortality rate for surgery was nearly 50%, and a common complication of surgery was infection. It was commonly believed that wound infections or sepsis were caused by oxidation that could be prevented by not allowing exposure to the air. However, following an idea of Louis Pasteur's, Lister believed that wound infection was caused by microorganisms and if the organisms could be prevented from entering the wound site, the infection could be prevented.

Lister began using carbolic acid (previously demonstrated to kill parasites in sewage) as an antiseptic solution in the wards he supervised at the Glasgow Royal Infirmary; it was used to clean and dress wounds and to disinfect surgical instruments, the air in the operating theatre was sprayed with a mist of carbolic acid, and surgeons were required to wash their hands with a carbolic acid solution before operating. There were some complications, primarily skin irritation, from the carbolic acid, but infection rates plummeted with the adoption of these practices. Lister reported, at a British Medical Association meeting in 1867, that the wards he supervised at the Glasgow Royal Infirmary had remained free of sepsis for 9 months. Despite these obvious successes, Lister's ideas were slow to gain support in England, where many surgeons resented having to perform extra procedures they felt were unnecessary, and who rejected the implication that they might be a cause of infection. His ideas were adopted more readily in Germany, and antiseptic procedures saved many lives during the Franco-Prussian War (1870–1871). Lister's theory that wound infections were caused by microorganisms was further reinforced by the demonstration in 1878 by the German physician Robert Koch that heat sterilization of surgical instruments and dressings dramatically reduced infection rates.

Lister became Chair of Surgery in King's College, London, in 1877, and was knighted by Queen Victoria in 1883. He converted many skeptics to the merits of antiseptic surgery following a successful operation to repair a fractured patella (kneecap), an operation considered inordinately risky at the time. He was also one of the first British surgeons to operate on a brain tumor and developed improved techniques for mastectomy and for the repair of the patella.