For as long as mankind has performed surgery, there have been methods of preventing infection and promoting healing. Ancient civilizations used vinegar and wine to dress wounds, iodine became popular in France, and hand washing was instituted in Austrian maternity wards in the 1800s. But it was the British surgeon Joseph Lister (1827–1912) who made antiseptic practices standard in operating rooms throughout the Western world.

When Lister became chair of surgery at Glasgow University in Scotland, survival rates from operations were abysmal. From reading the works of Louis Pasteur (1822–1895), Lister knew that gangrene—the rotting of organic tissue—was the result of airborne bacteria entering an open wound. He also knew that carbolic acid was effective in reducing infection among cattle on farms fertilized with raw sewage, so he experimented with it as a wound covering. He began dressing surgery sites in carbolic-soaked fabric, spraying the operating room with a carbolic mist, and rinsing his hands with the solution before operating. His postsurgery mortality rates plummeted.

Grim outcomes during the Franco-Prussian War of 1870 further drove home the importance of antisepsis: More than half of the French soldiers who had limbs amputated eventually died of gangrene or fever. Lister’s methods began to spread to other countries. In Munich, one surgeon reduced the rate of infection in his ward from four out of five patients in 1872 to zero in 1875. Many doctors continued to deny the existence of microscopic bacteria, however, and argued that a clean operating room was all they needed. The pioneering surgeon William Halsted (1852–1922) adopted the technique but was forced to operate in the garden of New York City’s Bellevue Hospital because his colleagues complained about carbolic fumes.

Newer ways to reduce infection—such as face masks, surgical gowns, sterilization with heat, and the elimination of large operating theaters—were gaining in popularity, however, while criticism of the irritating carbolic spray mounted. Though “Listerism” succeeded in hammering home the importance of antisepsis during surgery, the practice was largely abandoned by 1900.

ADDITIONAL FACTS

  1. Among the many honors he acquired in his lifetime, Lister became Lord Lister of Lyme Regis in 1897 when he was made a baron by Queen Victoria (1819–1901). He has also been immortalized as the namesake for the mouthwash Listerine—though he played no role in its invention.
  2. To help spray his operating room with carbolic acid, Lister developed a “donkey engine,” a 3-foot-high, steam-driven pump that vaporized the liquid.
  3. Lister’s father, Joseph Jackson Lister (1786–1869), was a well-known optical researcher and played an important role in perfecting complex microscopes by eliminating chromatic and spherical aberration.