LISTER, JOSEPH LISTER, 1ST BARON (1827-1912), Eng lish surgeon and founder of antiseptic surgery, was born at Upton, Essex, on April 5, 1827. His father, Joseph Jackson Lister, F.R.S., became eminent in optical science by perfecting the achro matic lens and improving the compound microscope. Joseph Lis ter was educated at the Quaker schools at Hitchin and at Totten ham, and then at University college, London. He received his M.B. and F.R.C.S. in 1852, having been trained under the two noted physiologists, Wharton Jones and William Sharpey. In the autumn of 1853, Lister went to Edinburgh with an introduction from Sharpey to Syme (q.v.) whose house surgeon he became. In 1856 he married Syme's daughter, and soon afterwards was made assistant surgeon to the Royal infirmary, where he gave his first course of lectures on surgery. In the following year he pro duced his classic paper on "The Early Stages of Inflammation," an investigation in which his interests had already been roused by his contact with gangrene and pyaemia in University college hospital, London. About the same time, he began work on the coagulation of blood, a subject related to the early stages of inflammation. In his Croonian lecture to the Royal Society in 1863 on this topic, he concluded that the real cause of coagulation of the blood is "the influence exerted upon it by ordinary matter, the contact of which for a very brief period effects a change in the blood, inducing a mutual reaction between its solid and fluid constituents, in which the corpuscles impart to the liquor sanguinis a dispo sition to coagulate." On his appointment to the chair of surgery at Glasgow in 186o, Lister at first busied himself with his articles on amputation and on anaesthetics for Holmes' System of Surgery. He then resumed his researches on inflammation, his suspicion that decomposition of the blood in the wound was the main cause of suppuration taking on a new meaning after his attention was drawn in 1865 to the work of Pasteur by his colleague, Dr. Thomas Anderson. Pasteur (q.v.) had shown that putrefaction, like other fermenta tions, was due to microbes growing in the putrescible substance and coming from the air. Lister at once saw that if putrefaction was caused neither by the spontaneous generation of germs nor by the oxygen in the air—two predominating theories of his day —there was some chance of preventing it. But how were the organisms in the air to be destroyed before they entered the wound? Of three possibilities, filtration, heat and chemical agents, he selected the last for experiment.
The first experiment was made in 1865 upon a compound frac ture, the agent used being carbolic acid. It was applied to the
wound undiluted, so as to form with the blood a dense crust, the surface of which was painted daily with acid until all danger had passed. The results, after a first failure, were so satisfactory that Lister wrote his paper, "On a New Method of treating Com pound Fracture, Abscess, etc.," for the Lancet between March and July 1867, and at the British Association in Dublin, in the same year, spoke of the value of his methods. However, the caustic property of undiluted carbolic acid, though insignificant in com parison with the evils to be avoided in compound fracture, made it unsuited for general surgery. It was necessary to mitigate its action by blending it with some inert substance, and the endeavour to find this substance which would provide perfect antiseptic efficiency with the least possible irritation of the tissues formed the subject of experiments continued for many years. Lister found the lac plaster to be most satisfactory. It was a mixture of crystallized carbolic acid and shellac which, when spread on calico and painted with a solution of gutta-percha in benzine, passed through the gutta-percha without adhering to the skin so firmly as to prevent drainage.
Lister now turned his attention to the arrest of haemorrhage in aseptic wounds. It had long been the practice to employ silk or flax for tying arteries, long ends being left to provide escape of the pus together with the portion of the arterial coats included in the knot. Lister hoped that if, by antiseptic means, the thread were deprived of microbes, it would no longer cause suppuration, but might be left with short cut ends to become embedded per manently among the tissues of the wound, which thus would be allowed to heal by first intention. In Dec. 1867 a trial of carbo lized silk ligature was so successful that he applied it in a case of femoral aneurysm in a woman. Here again the results were satis factory. But a year later, the patient having died from other causes, the necropsy showed remnants of the silk incompletely absorbed, with appearances which seemed to indicate that they had been acting as causes of disturbance. Thus he began to seek for a material susceptible of more speedy absorption. He experi mented upon the carotid artery of a calf with carbolized catgut, a substance prepared from the small intestine of a sheep. Here again success warranted its use for human subjects, but the difficulty of ensuring its right preparation led him to adopt ultimately a sulphochromic catgut.