constitution of the spray had shown him that the microbes of the dust involved in its vortex could not possibly have their vitality destroyed or even impaired by it. Such being the case, the uniform success obtained when he had trusted the spray implicitly as an aseptic atmosphere, abandoning completely certain other precautions which he had before deemed essential, proved conclusively to his mind that the air might safely be left entirely out of consideration in operating.[1] Thus he learnt that not the spray only, but all antiseptic irrigations or washings of the wound also, with their attendant irritation of the cut surfaces, might be dispensed with—a great simplification, indirectly due to experiments with the spray. The spray had also served a very useful purpose by maintaining a pure condition of the entourage of the operation; not indeed in the way for which it was devised, but as a very mild form of irrigation. And Lister took care to emphasize the necessity for redoubled vigilance on the part of the surgeon and his assistants when this “unconscious caretaker,” as he called it, had been discarded.
The announcement that he had given up the spray was absurdly interpreted in some quarters to mean that he had virtually abandoned his theory and his antiseptic methods. The truth is that the spray was only one of many devices tried for a while in the course of the long-continued endeavour to apply the antiseptic principle to the best advantage, and abandoned in favour of something better. Two main objects were always kept steadily in view by him—during the operation to guard the wound against septic microbes by such means as existing knowledge indicated, and afterwards to protect it against their introduction, avoiding at the same time all needless irritation of the tissues by the antiseptic. Upon the technical methods of attaining these ends this is not the place to enlarge; suffice it to say that the endowments and the industry of the discoverer, as seen in the rapidity and flexibility of mind with which he seized upon and selected the best means, were little less remarkable than the activity of the same faculties in his original ideas.
To illustrate this opinion, his work on the ligature may be taken. It had long been the universal practice of surgeons to employ threads of silk or flax for tying arteries, long ends being left to provide escape of the pus (invariably formed during the tedious process of the separation of the ligature) together with the portion of the arterial coats included in the knot. Lister hoped that if, by antiseptic means, the thread were deprived of living microbes, it would no longer cause suppuration, but might be left with short cut ends to become embedded permanently among the tissues of the wound, which thus would be allowed to heal by primary union throughout. A trial of this method upon the carotid artery of a horse having proved perfectly successful, he applied it in a case of aneurysm in the human subject; and here again the immediate results were all that could be desired. But a year later, the patient having died from other causes, the necropsy showed remnants of the silk thread incompletely absorbed, with appearances around them which seemed to indicate that they had been acting as causes of disturbance. Thus was suggested to him the idea of employing for the ligature some material susceptible of more speedy absorption; and the antiseptic treatment of contused wounds having shown that dead tissue, if protected from putrefaction, is removed by the surrounding structures without the intervention of suppuration, he resolved to try a thread of some such nature. Catgut, which is prepared from one of the constituents of the small intestine of the sheep, after steeping in a solution of carbolic acid, was used in a preliminary trial upon the carotid artery of a calf. The animal was killed a month later, when, on dissection, a very beautiful result was disclosed. The catgut, though removed, had not been simply absorbed; pari passu with its gradual removal, fibrous tissue of new formation had been laid down, so that in place of the dead catgut was seen a living ligature embracing the artery and incorporated with it. The wound meanwhile had healed without a trace of suppuration. This success appeared to justify the use of the catgut ligature in the human subject, and for a while the results were entirely satisfactory. But though this was the case with the old samples of catgut first employed, which, as Lister was afterwards led to believe, had been “seasoned” by long keeping, it was found that when catgut was used fresh as it comes from the makers, it was unsuited in various ways for surgical purposes. The attempt by special preparation to obtain an article in all respects trustworthy engaged his attention from time to time for years afterwards. To quote the words of Sir Hector Cameron, who was for several years assistant to Lord Lister, it required “labour and toilsome investigation and experiment of which few can have any adequate idea.”
In 1869 Lister succeeded his father-in-law, Syme, in the chair of clinical surgery of Edinburgh. In 1877 he accepted an invitation to the chair of surgery at King’s College, London, in the anticipation that here he would be more centrally placed for communication with the surgical world at home and abroad, and might thus exercise his beneficent mission to more immediate advantage. In 1896 Lister retired from practice, but not from scientific study. From 1895 to 1900 he was President of the Royal Society. In 1883 he was created a baronet, and in 1897 he was raised to the peerage as Baron Lister of Lyme Regis. Among the Coronation honours in 1902, he was nominated an original member of the new Order of Merit.
In England Lister’s teaching was slow in making its way. The leading surgeons of Germany were among the first to seize upon the new idea with avidity and practical success; so early as 1875, in the course of a tour he made on the Continent, great festivals were held in his honour in Munich and Leipzig. The countrymen of Pasteur did not lag far behind; and it is no exaggeration to speak of Lister’s appearances in foreign countries at this time as triumphal.
The relation of Semmelweiss to Lister is of historical importance. Lister’s work on the antiseptic system began in 1864; his first publication on the subject was in March 1867. At this date, and for long afterwards, Semmelweiss was unknown, or ignored, not only by French and Germans, but also by his own Hungarian people; and this neglect broke his heart. The French Academy pronounced against his opinions, and so did the highest pathological authority in Germany. In England, till long after his death, probably his name was not so much as mentioned. In the early ’seventies Lister’s method was in full operation in Hungary as elsewhere, yet none of the surgeons of Budapest ever mentioned Semmelweiss; not even when, in 1883, they gave a great banquet to Lister. It was after this occasion that Dr Duka, a Hungarian physician practising in London, wrote a biography of Semmelweiss, which he sent to Lister, and thus brought Semmelweiss before him for the first time. Thenceforth Lister generously regarded Semmelweiss as in some measure his forerunner; though Semmelweiss was not aware of the microbic origin of septic poisons, nor were his methods, magnificent as was their success in lying-in hospitals, suitable for surgical work.
In public Lord Lister’s speeches were simple, clear and graceful, avoiding rhetorical display, earnest for the truth, jealous for his science and art, forgetful of himself. His writings, in like manner plain, lucid and forcible, scarcely betray the labour and thought of their production. With the courtesy and serenity of his carriage he combined a passionate humanity, so often characteristic of those who come of the Society of Friends, and a simple love of truth which showed itself in his generous encouragement of younger workers. (T. C. A.)
LISTER, MARTIN (c. 1638–1712), English naturalist and
physician, was born at Radclive, near Buckingham. He was
nephew of Sir Matthew Lister, physician to Anne, queen of
James I., and to Charles I. He was educated at St John’s
College, Cambridge, 1655, graduated in 1658/9, and was
elected a fellow in 1660. He became F.R.S. in 1671. He
practised medicine at York until 1683, when he removed to
London. In 1684 he received the degree of M.D. at Oxford, and
in 1687 became F.R.C.P. He contributed numerous articles
on natural history, medicine and antiquities to the Philosophical
- ↑ See Verhandlungen des X internationalen Congresses, Bd. i. p. 33.
