Joseph Lister Performs First Antiseptic Surgical Operation

Joseph Lister Performs First Antiseptic Surgical Operation

Joseph Lister performed the first surgical operation under antiseptic conditions on August 12, 1865. The British surgeon's use of antiseptics greatly reduced surgical mortality.

Surgical procedures, such as cauterizing (burning or searing tissue to prevent infection), splints, sutures, and resetting dislocated or broken bones, had been performed since ancient times as a means of treating people with serious injuries or diseases. The germ theory of disease, however, was unknown until the 19th century, with many tragic results. Doctors, midwives, and others who helped with the delivery of babies accidently infected millions of new mothers with “childbirth fever” simply because they did not know to wash their hands. Operations considered routine today could be fatal because of infections, caught in filthy, germ-ridden operating rooms, that settled in after surgery.

Lister, who would develop a means to improve the survival rate of surgical patients, was born on April 5, 1827, in Upton, Essex, England. His father, Joseph Jackson Lister, was an amateur optical scientist who helped perfect the microscope and was made a fellow of the Royal Society in 1832. Lister was educated by his parents and attended two Quaker institutions. By the time he was 16, he had decided to become a surgeon. He graduated with a bachelor of medicine with honors from the school of medical science at University College in London in 1852 and became a fellow of the Royal College of Surgeons and a house surgeon at University College Hospital.

Lister was appointed as assistant to the noted surgical teacher James Syme in the fall of 1853, then as a surgeon to the Edinburgh Royal Infirmary in 1856. When the Regius Professorship of Surgery at Glasgow University became vacant in 1859, Lister was elected to fill the position and became a surgeon to the Glasgow Royal Infirmary two years later. There, Lister was put in charge of wards at a new surgical block in the infirmary that, it was hoped, would bring about a decrease in postoperative sepsis (infection). However, Lister reported that between the years 1861 and 1865, some 45 to 50 percent of his amputation cases died from sepsis. In 1839 the chemist Justin von Liebig had put forth the theory that sepsis was caused by moist body tissue being exposed to oxygen. His proposed treatment was to keep air from touching wounds by using plasters or other covering materials.

Lister had already done research on the coagulation of blood and the role that blood vessels play in the first stages of infection. He rejected Liebig's theory of “bad air” and hypothesized that infections in wounds might be caused by a pollen-like dust. In 1865 he became aware of Louis Pasteur's experiments on fermentation and putrefaction, from which Pasteur had theorized that microorganisms were the cause of disease. Lister adopted Pasteur's theory and tried various methods to create antiseptic conditions, using, for example, carbolic acid, which had already been recommended as a wound dressing in 1863.

Lister tested his theories for the first time on August 12, 1865. An 11-year-old boy had been run over by a cart which broke his leg, leaving the bone exposed. Lister cleaned the wound and dressed it with a bandage that had been covered with carbolic acid. The boy survived without suffering from any serious infection. Afterward Lister went further, developing a carbolic acid spray to clean operating areas. He also insisted that surgical instruments be disinfected regularly, that surgeons operate in clean clothes, and that the operating room be kept sanitized at all times. In 1869 he could report that the surgical mortality rate in his ward had fallen to just 15 percent.

Though Lister's work was initially questioned, by the 1880s leading surgeons had come to see the validity of his practices. He was made a baronet in 1893, and in 1897 he was made a baron by one of his patients, Queen Victoria. Lister died in Walmer, Kent, on February 12, 1912.