Detail from Lister's ward book (left) at the Edinburgh Royal Infirmary and his pocket operating set (right) - both from the collections of the Royal College of Surgeons of Edinburgh.


reputation but because over the course of his career he studied, practised and taught in the UK’s three great surgical centres. He trained at University College London before moving to Edinburgh in 1853 at the age of 26 to become dresser and later house surgeon to James Syme, professor of clinical surgery. He married Syme’s daughter Agnes and the pair moved to Glasgow in 1860, where he had been appointed chair of surgery and where his ‘system’ was conceived. Lister returned to Edinburgh in 1869 to be professor of clinical surgery and finally went back to London, to King’s, in 1877.


Answering his critics Tough Lister was celebrated in his lifetime – he was Britain’s first medical baronet and the Jenner Institute of Preventive Medicine, which he had helped to found, was renamed in his honour in 1898 – it was not so at first. Tere was a mixed reception to his first series of papers, varying from condemnation through tolerance to enthusiastic support. For some opponents, it was the radical nature of his proposals that was the problem. For others, it was sheer animus – in Edinburgh James Young Simpson, who had introduced chloroform in 1847, was no fan of Professor Syme, Lister’s mentor and father-in-law. “Simpson not only criticised Lister verbally, he published fairly abrasive notes in medical journals, saying you shouldn’t believe that chap,” says Professor Gardner. But Lister could give as good as he got and in 1870, aſter leaving


Glasgow, he published a summary of the results of his antiseptic method in Te Lancet, along with a stinging attack on the Glasgow Royal Infirmary, whose wards, he wrote, were converted “from some of the most unhealthy in the kingdom into models of healthiness” thanks to his techniques. Te directors there responded in kind, suggesting that much of


the improvement documented by Lister had, in fact, to do with “better ventilation, the improved diet and the excellent nursing, to which the directors have given so much attention of late years”. Such arguments did not distract Lister from being a constant


experimenter and innovator. As well as developing and adapting his system over the years with less irritative compounds, better dressings and his famous antiseptic spray, with which he attempted to create a protective field over the operative site, he went on to introduce absorbable ligatures and drainage tubes into surgery. In addition, Lister was a prodigious lecturer and writer of scientific papers. He was in touch with the leading scientists of the day, among them Pasteur and Robert Koch, who isolated the tubercle bacillus in 1882, and soon achieved international acclaim.


WINTER 2012


Paradigm change With the long view of history it is possible to see Lister’s ideas on antisepsis as the beginning of a paradigmatic change, but it was really a generation before the whole surgical community were on board. And in fact what they were on board with was the post- Listerian idea of asepsis, which had surpassed his original theories, advocating not the direct application of disinfectant to wounds but the rigorous eradication of germs from the whole operating theatre. Indeed, by 1890, Lister himself had renounced the use of his carbolic spray. But none of this diminishes Lister’s importance, argues Michael


Worboys, professor of the history of medicine, who will be speaking at the King’s College conference. “He represented the modernisation of medicine, technical innovation. To be a London surgeon at that time, the most important thing was to be a gentleman. You could get your hands dirty in the surgery but not outside. So he came from a different ethos. In Glasgow and Edinburgh, the medical schools were closely tied to the universities so he would have hung out with scientists in a way that the clinicians in London, apart from at University College, didn’t. “If you go back to the early 19th century, the cutting edge of medical knowledge was made in the clinic. By the end of the 19th century cutting-edge medicine came from the laboratory. Lister is a clinical figure who makes that transition.” Gus McGrouther, professor of plastic and reconstructive surgery,


who will also be a speaker at the King’s College conference, agrees: “I think Lister’s major contribution was to change thinking rather than any specific one thing he did in terms of antisepsis.” Tere is an additional legacy, too, he adds, which has to do with


the role model Lister offers to doctors everywhere. “He was learning from the microbiologists of his day. Tere wasn’t a eureka moment in the bath where he suddenly thought, ‘Tere are bugs causing this.’ He knew about Pasteur’s work. We need to have doctors who are scholars, not just technicians. Tere’s a great drive to make us all into technicians following guidelines, but if you want to actually move things forward, doctors have got to read, understand and innovate.” For more information on the celebrations go to the King’s


website (www.tinyurl.com/7uonow4) and that of the RCSEd (www.lister2012.com).


nAdam Campbell is a freelance journalist and regular contributor to MDDUS publications


13


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24