Joseph Lister

In a ward of the Glasgow Royal Infirmary, on a summer day in 1865, a Quaker surgeon dressed a boy’s shattered leg with carbolic acid — and the history of surgery divided into before and after. Joseph Lister, Regius Professor of Surgery at the University of Glasgow, had grasped what no surgeon before him had managed to put into practice: that the invisible germs newly described by Louis Pasteur were what killed so many patients after their operations, and that they could be kept out of the wound. Antiseptic surgery — and with it much of modern medicine — was born in this city.

This page tells his story: his early life and training, his Glasgow chair, the deadly problem he faced, the theory that inspired him, his first great success, the principle he gave the world, and the revolution that followed.

The surgeon from a Quaker family

Joseph Lister was born in 1827 at Upton, in Essex, into a well-to-do Quaker family. His father, Joseph Jackson Lister, was a wine merchant and a distinguished amateur scientist — a Fellow of the Royal Society whose work on the microscope did much to make it a serious instrument — and it was he who kindled his son’s early love of science. The younger Lister studied at University College London, one of the few institutions then open to a Quaker, and qualified as a surgeon. In the early 1850s he moved to Edinburgh to work under the eminent surgeon James Syme, becoming his house surgeon and assistant; in 1856 he married Syme’s daughter, Agnes, who would be his devoted helper and collaborator in his experiments for the rest of her life.

The Glasgow chair

In 1860, at the age of thirty-three, Lister was appointed Regius Professor of Surgery at the University of Glasgow, and was elected a Fellow of the Royal Society in the same year. The following year he became a surgeon to the Glasgow Royal Infirmary, taking charge of its accident and surgical wards. It was here, in the great teaching hospital of Britain’s second city — and in a university where Lord Kelvin was at that very moment remaking the science of physics — that he would do the work that changed the world. He was, by temperament, both a careful scientist — forever experimenting, testing, observing — and a humane and conscientious surgeon, appalled by the suffering and death he saw around him, and determined to find its cause.

The scourge of the wards

For the horror of Victorian surgery lay not so much in the operation as in what followed it. Wounds that should have healed became infected; patients who survived the knife died days later of sepsis — blood poisoning — gangrene and the other forms of what was grimly called ‘hospitalism’. In Lister’s own wards, something approaching half of all amputation patients died of such infections. The great surgical wards were among the unhealthiest places in the hospital, and no one understood why — the prevailing idea blamed poisonous ‘miasmas’ in the air. Surgeons operated in their blood-stiffened old coats, with unwashed hands and instruments, in the honest belief that dirt had nothing to do with death. It was this deadly mystery that Lister set out to solve.

Pasteur’s germs

The key came from France. Lister learned of the work of the chemist Louis Pasteur, who had shown that fermentation and putrefaction were caused not by the air itself but by living micro-organisms — germs — carried in it. In a flash of insight, Lister saw the connection: if it was germs, and not some quality of the air, that made wounds rot, then the way to prevent infection was to destroy those germs before they could take hold. He needed a substance that would kill them without destroying living flesh, and he found it in carbolic acid — phenol, a coal-tar product — which he had read was being used to treat the foul-smelling sewage of the town of Carlisle. If it could purify sewage, he reasoned, it might purify a wound.

The case of James Greenlees

His chance came on 12 August 1865. An eleven-year-old boy named James Greenlees was brought into the Royal Infirmary, having been run over by a cart in the street; his shinbone had broken and pierced the skin — a compound fracture, the very kind of injury that so often ended in fatal infection or amputation. Instead of amputating, Lister cleaned the wound and dressed it with carbolic acid, renewing the dressing over the following days. The result was extraordinary: the wound did not fester but healed cleanly, and after some six weeks the boy walked out of the hospital on both his legs, entirely recovered. For the first time, a compound fracture had been treated as though it were a simple one. It was the first triumph of antiseptic surgery.

The antiseptic principle

Lister did not rush to announce his success. He treated further cases, refining his methods, dressing wounds and later spraying the air of the operating theatre with carbolic acid to kill germs before they could settle. Only when he was sure did he publish, in a series of articles in The Lancet in 1867, setting out the antiseptic principle for the profession. The transformation of his own wards was dramatic: where death had been commonplace, cases of blood poisoning and gangrene all but vanished. Yet acceptance was slow and grudging. Many established surgeons scorned the unseen germs on which his method rested; some, like the celebrated James Young Simpson, attacked him outright. The revolution he had begun would take years to win.

The father of antiseptic surgery

In time, win it did. Lister left Glasgow in 1869 to succeed his old master Syme at Edinburgh, and in 1877 moved to King’s College London, carrying his gospel to the heart of the English surgical establishment; slowly, surgeon by surgeon, the antiseptic method — and later the sterile, or aseptic, surgery it inspired — conquered the world. Honours followed the man who had made surgery safe: he was made Baron Lister, one of the first men of science raised to the peerage, and served as President of the Royal Society. His name lives on in the antiseptic mouthwash Listerine and the bacterium Listeria, both named in his honour. But his truest monument is invisible, in the countless lives saved by every clean operation since — a revolution that began in a Glasgow hospital ward, and was carried on in the city by surgeons such as William Macewen, who turned Lister’s antiseptic method into the fully sterile surgery of the modern age.

A life in dates