page_title: Joseph Lister
section_title: Career and work
hierarchical_section_title: Joseph Lister / Education / Career and work
caption_attribution_description: Portrait of The Right Honourable Joseph Lister, 1st Baron Lister [1827 &amp;#150; 1912], British surgeon Iconographic Collections
context_page_description: Joseph Lister, 1st Baron Lister KCVO, OM, PC, PRS, FRCSE, FFPS, was a British surgeon and a pioneer of antiseptic surgery. From a technical viewpoint, Lister was not an exceptional surgeon, but his research into bacteriology and infection in wounds raised his operative technique to a new plane where his observations, deductions and practices revolutionised surgery throughout the world.
  Lister promoted the idea of sterile surgery while working at the Glasgow Royal Infirmary. Lister successfully introduced carbolic acid to sterilise surgical instruments and to clean wounds.
  Applying Louis Pasteur's advances in microbiology, Lister championed the use of carbolic acid as an antiseptic, so that it became the first widely used antiseptic in surgery. He first suspected it would prove an adequate disinfectant because it was used to ease the stench from fields irrigated with sewage waste. He presumed it was safe because fields treated with carbolic acid produced no apparent ill-effects on the livestock that later grazed upon them.
  Lister's work led to a reduction in post-operative infections and made surgery safer for patients, distinguishing him as the "father of modern surgery".
context_section_description: Before Lister's studies of surgery, many people believed that chemical damage from exposure to "bad air", or miasma, was responsible for infections in wounds. Hospital wards were occasionally aired out at midday as a precaution against the spread of infection via miasma, but facilities for washing hands or a patient's wounds were not available. A surgeon was not required to wash his hands before seeing a patient; in the absence of any theory of bacterial infection, such practices were not considered necessary. Despite the work of Ignaz Semmelweis and Oliver Wendell Holmes Sr., hospitals practised surgery under unsanitary conditions. Surgeons of the time referred to the "good old surgical stink" and took pride in the stains on their unwashed operating gowns as a display of their experience.
  While he was a professor of surgery at the University of Glasgow, Lister became aware of a paper published by the French chemist, Louis Pasteur, showing that food spoilage could occur under anaerobic conditions if micro-organisms were present. Pasteur suggested three methods to eliminate the micro-organisms responsible: filtration, exposure to heat, or exposure to solution/chemical solutions. Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop antiseptic techniques for wounds. As the first two methods suggested by Pasteur were unsuitable for the treatment of human tissue, Lister experimented with the third idea.
  In 1834, Friedlieb Ferdinand Runge discovered phenol, also known as carbolic acid, which he derived in an impure form from coal tar. At that time, there was uncertainty between the substance of creosote – a chemical that had been used to treat wood used for railway ties and ships since it protected the wood from rotting – and carbolic acid. Upon hearing that creosote had been used for treating sewage, Lister began to test the efficacy of carbolic acid when applied directly to wounds.
  Therefore, Lister tested the results of spraying instruments, the surgical incisions, and dressings with a solution of carbolic acid. Lister found that the solution swabbed on wounds remarkably reduced the incidence of gangrene. In the spring of 1865, Lister read about Louis Pasteur discovery of living things causing fermentation and putrefaction in the magazine Comptes rendus hebdomadaires of the French Academy of Sciences, that was given to him by his friend, the chemist Thomas Anderson.
  In August 1865, Lister applied a piece of lint dipped in carbolic acid solution onto the wound of a seven-year-old boy at Glasgow Royal Infirmary, who had sustained a compound fracture after a cart wheel had passed over his leg. After four days, he renewed the pad and discovered that no infection had developed, and after a total of six weeks he was amazed to discover that the boy's bones had fused back together, without suppuration. He subsequently published his results in The Lancet in a series of six articles, running from March through July 1867.
  He instructed surgeons under his responsibility to wear clean gloves and wash their hands before and after operations with 5% carbolic acid solutions. Instruments were also washed in the same solution and assistants sprayed the solution in the operating theatre. One of his additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments.
  Lister left Glasgow University in 1869, being succeeded by Prof George Husband Baird MacLeod. Lister then returned to Edinburgh as successor to Syme as Professor of Surgery at the University of Edinburgh and continued to develop improved methods of antisepsis and asepsis. Amongst those he worked with there, who helped him and his work, was the senior apothecary and later MD, Dr Alexander Gunn.  Lister's fame had spread by then, and audiences of 400 often came to hear him lecture. As the germ theory of disease became more understood, it was realised that infection could be better avoided by preventing bacteria from getting into wounds in the first place. This led to the rise of a
caption: Joseph Lister in his youth
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