History of joseph lister

As the number of surgery related infections fell, the evidence that antisepsis worked became irrefutable and it was widely accepted by surgeons around the world. Lister even received Royal Approval when he used his carbolic history of joseph lister during a surgical procedure on Queen Victoria. In this film, Consultant plastic surgeon Charles Bain discusses how modern surgeons are concerned about controlling infection in every aspect of surgery, from maintaining a sterile environment to surgical techniques that minimise the risk of infection.

By the s, wider acceptance of germ theory resulted in the emergence of the science of bacteriology, and new research revealed that antiseptics were not the only way to control infection. The German scientist Robert Koch demonstrated that dry heat and steam sterilisation were as effective as chemical antiseptics in killing germs. In asepsisa sterile environment—free from germs—is created using a combination of hygienic and antiseptic measures such as heat, antiseptics and soap and water.

Operating staff wore sterile gowns, caps and shoe covers, and instruments were made with flat surfaces that were cleaned in his newly invented autoclave. Easy-to-clean walls, floors, storage and other surfaces were regularly washed with disinfectants. With the introduction of surgical gloves at Johns Hopkins Hospital in America, the elements of the modern sterile operating theatre were in place.

The discovery of antibiotics in the s gave medicine a new way to tackle infection from inside the body, and for a while it seemed that asepsis might be less important. But the rise of antibiotic-resistant bacteria such as MRSA have been a chilling reminder that the battle to control infections is never won, and aseptic and sterile practices are as important as ever.

In this film, Denise Amurao, a theatre nurse at Guys and St Thomas's Surgery Unit in London, talks about her responsibilities in maintaining a sterile environment in the operating theatre:. For a long time, surgery was on the fringes of medicine and surgeons plied their trade in some unexpected places. What did it take to make surgery the safe, reliable treatment that we now take for granted?

A learning resource for teachers including a 3D model of Lister's carbolic spray. Story Content The challenge of surgical infection The science of germ theory The antisepsis system The modern surgeon and infection control From antisepsis to asepsis Modern surgical antisepsis Suggestions for further research. The science of germ theory The French scientist Louis Pasteur speculated that the spread of microorganisms called germs in the body could explain infectious disease.

The antisepsis system Lister applied the principle of an antiseptic barrier to a set of procedures for the operating room that are illustrated in the gallery below. InLister published seven papers on physiological experiments he conducted on the origin and mechanism of inflammation.

History of joseph lister: › objects-and-stories › medicine

DuringLister has been thinking about the nervous control of blood vessels and had been studying the work of various French researchers who were examining the denervation of the sympathetic nerves. The experiments on vasomotor control began in the autumn of and continued until the autumn of the next year. In a before and after experiment, he ablated parts of the central nervous system [ ] and also before and after, split the sciatic nerve.

These experiments [ ] settled a contemporary dispute between physiologists concerning the origin of the influence exercised over blood vessel diameter calibre by the sympathetic nervous system. The dispute had been debated since the middle of the 18th century. Haller put forward the view that contractability was a power inherent in the tissues which possessed it, and was a fundamental fact of physiology.

The second part of the original paper [ ] was an experiment into the nature and behaviour of pigment. Lister had noted that the beginning of inflammation was always accompanied by a change of colour in the frog's web. At the time, there was no cell theory of matter nor were there any dyes or fixatives that could used to enhance experimental discovery.

The focal study [ ] was the longest paper of the three and the last to be published. As well as experimenting on frogs' web and bats wing, [ ] Lister used blood that he had obtained from the end of his own finger that was inflamed and compared it against blood from one of his other fingers. Secondly, the vessels after an interval, dilated and the part became red.

Thirdly, some of the blood in the most injured blood vessels slowed down in its flow and coagulated. Redness occurred which, being solid, could not be pressed away. Lastly, the fluid of the blood passed through the vessel walls and formed a "blister" about the seat of injury. He found further that this contraction and dilation was not an individual act on its part, but was an act dictated to it by the nervous cells in the spinal cord.

Lister's paper was able to show that capillary action is governed by the constriction and dilation of the arteries.

History of joseph lister: British surgeon and medical scientist

The action is affected by trauma, [ e ] irritation or reflex action through the central nervous system. According to Lister, vascular alterations that were initially brought on by reflexes occurring within the nervous system were followed by changes that were brought on by local tissue damage. In the conclusions of the paper, Lister linked his experimental observations to physical clinical conditions, for example skin damage resulting from boiling water and trauma occurring after a surgical incision.

After the paper was read to the Royal Society in Juneit was very well received and his name became known outside Edinburgh. Lister's first paper is an account of a case of spontaneous gangrene in a child. There were suggestions for improvement which Lister threw out. There was lots of cheering, proclaiming it a great success. The paper was written up at 7pm, with Lister dictating and Agnes writing it during a minute session, followed by the exposition to the society at George Street hall at 8pm.

Lister first used the amputated legs from sheep and discovered that blood remained liquid in the blood vessels for up to six days and still underwent coagulation, albeit more slowly when the vessel was opened. He also noticed that if vessels remained fresh, the blood would remain fluid. He noticed that in the damaged vessel the blood would coagulate [ ] [ ] He eventually came to the conclusion that if there was ammonia in the blood, it was much less important than the condition of the vessel in stopping coagulation.

While that was incorrect, his other conclusions were accurate. Lister continued experimenting in April, examining vessels and blood from a history of joseph lister. This resulted in another communication to the society on 7 April. Lister's second article on coagulation was published in Augustand was one of two case histories he published in the Edinburgh Medical Journal in Lister continual interest in the nervous control of blood vessels led him to conduct a series of experiments during June and Julywhere he researched the nervous control of the gut.

The first two letters were sent on 28 June and 7 July [ ] The last letter was published as the "Preliminary Account of an Inquiry into the Functions of the Visceral Nerves, with special reference to the so-called Inhibitory System. He had been studying the work of Claude BernardLJ Budge and Augustus Waller and had become interested in what was known as "sympathetic action", where inflammation appeared in a different area from the source of irritation.

Lister conducted a series of experiments using mechanical irritation and galvanism to stimulate the nerves and spinal cord in rabbits and frogs. In the first experiment, an incision was made in the rabbit's side and a section of intestine was pulled through the skin. Lister then connected a magnetic coil battery to the splanchnic nerves in the spinal cord.

When the current was applied, the gut completely relaxed but when the current was applied locally, a small localised contraction occurred that did not spread to the bowel. When he applied current the gut relaxed. He concluded that activity in the gut was under the control of bowel wall nerves and had been stimulated due to loss of blood.

This time, stimulation of the section had no effect except when the section would spontaneously contract. During the histological study of the bowel wall, Lister discovered a plexus of neurons [ ] the myenteric plexusthat confirmed the observations made by Georg Meissner in Lister concluded, " Although Lister did not believe in the inhibitory system, he did conclude that extrinsic nerves controlled the intestinal motor function indirectly through their effect on the plexus.

Lister's third paper on coagulation [ ] was a short article in the form of a communication consisting of five pages that were read before the Medico-Chirugical Society of Edinburgh on 16 November In the paper, Lister found that the coagulation of blood was not solely dependent on the presence of ammonia, but may also be influenced by other factors.

In a demonstration before the society, Lister had a sample of horse's blood that had been shed twenty-nine hours earlier and added acetic acid to it. The blood remained fluid despite being acidified, but it eventually coagulated after being left to stand for 15 minutes. Lister demonstrated that the Ammonia theory was incorrect as the coagulation of the blood was not dependent on the presence of ammonia.

He concluded that other factors may influence blood coagulation in addition to or instead of ammonia, and that the Ammonia theory was fallacious. On 1 AugustLister wrote to his father to inform him of the ill-health of James Adair LawrieRegius Professor of Surgery at the University of Glasgowbelieving he was close to death. The matter was referred to the Vice-Chancellor Thomas Barclay who tipped the decision in favour of Lister.

To be formally inducted into the academic staff, Lister had to deliver a Latin oration before the senatus academicus. Lister unable to start the paper until 2 am that night, had only prepared around two-thirds of it, when he arrived in Glasgow. The rest was written at Thomson's house. In the letter, he described the dread he felt being admitted into the room prior to presenting the oration.

After the thesis was read and Lister was inducted to the senate, he signed a statement not to act contrary to the wishes of the Church of Scotland. In early Maythe couple made the journey to Glasgow to move into their new house at 17 Woodside Place, at the time on the western edge of the city. The position of Professor of Surgery at Glasgow was peculiar, as it did not carry with it an appointment as surgeon to the Royal Infirmary, as the university was separate from the hospital.

The allotment of surgical wards to the care of the Professor of Surgery depended upon the goodwill of the directors of the infirmary. He discovered that college classrooms were considered too small and had low ceilings for the number of students, which made them unpleasant to be in when filled to overcrowding. The facilities I have here for prosecuting this course as compared to the difficulties I laboured under in Edinburgh are quite delightful — museums, abundant material and a good library all at my disposal and my colleague Allen Thompson co-operating in the kindest and most valuable manner [ ].

In AugustLister was visited by his parents, who took a "saloon" carriage on the Great Northern Railway. While the group was visiting Tarbet, Argyllthe men rowed across the loch and ascended Ben Lomond. In AugustLister had been rejected for a post at the Royal Infirmary by David Smith, a shoemaker who was the chairman of the hospital board.

In Novemberthe winter lecture course began. In total students registered for the lectures [ ] and according to Godlee it was likely the "largest class of systematic surgery in Great Britain, if not in Europe". Between the end of his winter lecture course and his appointment, Lister's correspondence contained little of scientific interest.

A letter to his father dated 2 August explained why. He had also used it without complications on three patients with tumours of the jaw in In however Lister updated the chapter to state that he felt apprehension about using chloroform on the "aged and infirm". In the winter ofthe English medical journals reported that sulphuric ether should be used instead but Watson Cheyne stated there had been no deaths from chloroform during the winter of Inthe British Medical Association recommended the synthetic gas ethidene dichloride for clinical trials.

On 14 NovemberPaul Bert published the dose-response curve of chloroform but Lister believed that smaller doses were sufficient to anaesthetize the patient. The chapter on amputation was much more technical than the anaesthesia chapter, for example describing the ways of cutting the skin to produce flaps to close over the wound. The first was a method for amputation through the thigh that he developed between anda modification of Henry Douglas Carden 's technique for knee amputation.

The second technique was an aortic tourniquet for controlling blood flow in the abdominal aorta. Marion Simsbut their use fell out of favour with the introduction of antiseptics. On 1 JanuaryLister returned to the topic of coagulation with the Croonian Lecture titled "On the coagulation of the blood", [ ] although it contained little that was new.

His experiments had confirmed that blood plasma liquor sanguinis alone does not coagulate, but does when in contact with red blood cells. He mentioned the presence of coagulable fluid in the interstices of cellular tissue and described instances of oedema liquid coagulating after emission, possibly due to a slight admixture of red blood cells.

He provided examples of inflamed arteries and histories of joseph lister exhibiting coagulation on their interior, like artificially deprived vessels. He hypothesised that the accumulated red blood cells increased pressure in inflamed capillaries and contributed to the loss of healthy condition in capillary walls, leading to coagulation.

He proposed that inflammatory congestion arose from the adhesiveness of red blood cells to irritated tissues, like their behaviour outside the body when encountering ordinary solids. In finishing the lecture, Lister said he was satisfied that his previous conclusions on the nature of inflammation were independently confirmed through his research into blood coagulation.

Lister's most original work that he undertook during and the beginning of was the development of a surgical technique for the excision of caries from the wrist, i. It was history of joseph lister performed by German surgeons Johann von Dietz in and Johann Ferdinand Heyfelder [ de ] infollowed by British surgeon William Fergusson in Syme and his friends suggested that Lister should apply as his candidature was all but assured.

In a letter to his father, he said that he saw Glasgow as a stepping stone. There were a multitude of reasons to either stay or go. He was drawn to research, his friends were there, and he found the routine tasks in Glasgow to be "working in a corner". There was also the fact that his tenure only lasted 10 years. By the end of June, Lister was convinced the position was his.

Before he received the disappointing news, Lister had been called back to Upton as his mother Isabella was on her deathbed. She died on 3 September On 1 November, Lister began the winter lecture course, divided in two: common tissue and organ conditions, and conditions of physiology. These symptoms indicated "inflammatory congestion", [ ] the suspension of vital energy, beginning with red corpuscles adhering together, which was caused by fibrin, which itself was caused by two substances in the blood, one in the blood cells and one in liquor sanguis plasma.

He described two types of inflammation, direct and indirect. He saw direct inflammation as caused by a noxious agent and indirect by "sympathy", an indication that his frame of reference was wholly inadequate. The following lectures explained how to alleviate the symptoms of inflammation, by for example elevating a limb to enable blood flow, or reducing tension by draining an abscess.

Lister's error lay in his belief that inflammation was a "unitary disease", a single underlying disease, when in effect it was a range of conditions. His practice was unusual, as it was solely dedicated to surgery, during a period when operations either took place at the doctor's surgery or at the patient's home. In a letter to his father, Lister expressed his sincere hope that he would be hung.

At the end of [ ] or during the spring of [ ] sources vary while walking home with Thomas Anderson[ ] the chemistry professor at Glasgow and discussing putrefaction, Anderson drew Lister's attention to the latest research of the French chemist Louis Pasteur[ ] who had discovered living things that caused fermentation and putrefaction.

Several other papers would directly influence Lister's work on microorganisms. Pasteur's research led him to believe the ferment that produced Butyric acid was a microbe that lived in the absence of oxygen. Lister was not the only surgeon interested in Pasteur's research. However, Wells did not have an experiment to demonstrate germ theory and was unable to develop the techniques to put it into practice.

The serendipitous discovery of Pasteur's work at a time when he was struggling to control post-surgical infections [ ] provided a simple explanation for a problem he had long experienced. Lister did not realise the vast and diverse amount of microbial life. He had no concept, nor indeed did anybody else, of the vast number of types of germs.

History of joseph lister: Lister's contributions were four-fold. Firstly,

Pasteur suggested three methods to eliminate microorganisms: filtration, exposure to heat, or exposure to chemical solutions. Lister was particularly interested in the efficacy of filtration and repeated many of Pasteur's experiments in modified form for instruction in his class, [ ] but eventually excluded the first two techniques as not applicable for the treatment of wounds.

Lister confirmed Pasteur's conclusions with his own experiments and decided to use his findings to develop antiseptic techniques for wounds. InFriedlieb Ferdinand Runge discovered the germicide phenolthen known as carbolic acid, which he derived in an impure form from coal tar. The history of antiseptic surgery in the years beforewas preventing or treating infection in accidental wounds, often received in battle.

In the s, Lister's assumptions about surgery and theory of pathology were similar to those of his contemporaries.

History of joseph lister: Joseph Lister, – Joseph Lister.

In early MarchLister conducted his first experiment using the acid on a patient whose wrist was being excised due to caries. On 21 MarchLister began his second experiment with carbolic acid on a year-old patient named Neil Kelly who had a severe compound fracture of the leg. A piece of lint impregnated in the acid was then laid on the leg, overlapping the wound and fixed by an adhesive plaster.

A sheet of thin metal sheet made of tin or lead and sterilized by the acid was over the lint, to prevent the antiseptic from evaporating. This was further fixed with adhesive plaster and packing was used between the limb and the splints for the purpose of soaking up any blood or discharges. A crust formed that was not removed except to apply a new antiseptic.

Lister blamed himself and noted that the treatment ". The essential part of the history of joseph lister treatment was not the application of strong carbolic acid to the wound, although that required careful management to ensure the wound was sterilised, but designing the dressing in such a manner to stop the ingress of airborne infection.

The disadvantages of the first primitive dressings of lint soaked in carbolic acid were soon apparent. It was also almost insoluble in water. Lister discovered [ h ] that Frederick Crace Calvertan honorary chemistry professor from the Royal Manchester Institution was manufacturing small quantities of phenol at a much finer purity and managed to obtain some.

After two failures, Lister had no clear experimental design [ ] to test the efficacy of carbolic acid. Lister reasoned that he could experiment on the patient and if the treatment failed, perform the amputation to remove the limb and save the patient's life. On 12 AugustLister achieved success for the first time when he used the crude oily [ ] full-strength carbolic acid to disinfect a compound fracture.

He then applied a water dressing to the wound until it completely healed. During the summer, the Listers never strayed far from Glasgow as he was still monitoring Greenlees. Both sores were washed with an acid in oil solution and one was covered with an oiled paper coated with spirit varnish and the second with gutta-percha covered with a water dressing.

In both cases the dressing failed and he swapped them for a water dressing covered with cotton. However, the treatment failed and the limb was amputated after gangrene developed in the wound. It was eight months before Lister treated another compound fracture. On 22 January he treated John Austin, a shipwreck survivor with a wound in the leg that had developed into an ulcer.

On 19 Maythe first patient to use the improved method [ ] presented at Lister's accident ward with a compound fracture with extensive swelling and bruising. A secondary complication had occurred when air bubbles had mixed with the blood when the man was moved to the hospital. These were treated with nitric acid to remove the necrotic flesh and carbolic acid to sterilize the wounds.

On 27 May, Lister wrote to his father expressing intense satisfaction, stating "I tried the application of carbolic acid to the wound, to prevent decomposition of the blood and to prevent the fearful mischief of suppuration. It is now eight days since the accident and patient has been going exactly as though the fracture were a simple one.

Lister continued to refine the dressing and perfect the antiseptic treatment. He would often spend long nights experimenting in his home laboratory. In earlyLister began writing the compound fracture case histories of his experiments with carbolic acid as a new paper, the first to describe his new technique of antiseptics. Lister's theory of inflammation provided the conceptual structure of the article.

It was a precursor to healing, but the fluids which flowed into the wound were akin to dead tissue. Inflammation could trigger putrefaction. Lister believed that cells of granulated tissue were remarkably active and that since they were alive, they were immune to putrefaction and also to secondary inflammation, as they lacked sensory nerves.

He described the source of putrefaction and how the "raw surface" of the history of joseph lister could putrify before the granulations formed or the liquids on the surface of the granulations putrified. The liquids were extremely acrid and acted on the sensory nerves to initiate indirect inflammation and fever. This led to increased cell turnover and cellular death, increasing the quantity of putrescent material in the wound.

Sloughs were produced that resulted in suppuration. He didn't see them as parasites on living tissue. As all Victorian surgeons, Lister understood the problem of infection. His first job as a surgical dresser meant he had followed surgeons on their rounds, cleaning and dressing the often pus-filled, infected surgical wounds. Pasteur speculated that microorganisms spread disease, and these diseases could be stopped by using germ-killing chemicals.

At the hospital and at home, assisted by his wife Agnes, Lister studied infection, trying to prevent germs from getting into wounds by creating a chemical barrier: antiseptic. Lister published his trials using carbolic acid to prevent infection. The reaction was mixed. To prevent the spread of infection, Lister suggested using weak carbolic washes for surgical staff and carbolic acid baths for the instruments.

Carbolic acid spray would be used to reduce the level of airborne germs around the patient. The number of surgical infections fell. It was soon irrefutable that antisepsis worked, and the procedure was accepted by surgeons around the world, leading to further developments in bacterial science in the s. The s, saw the beginnings of aseptic surgery close aseptic surgery Surgery using precautions to lower the risk of infection from sepsis.

Surgical instruments were steam-sterilised and surgeons started wearing sterilised gowns, rubber gloves and face masks to further reduce the risk of infection. In the early 20th century, X-rays allowed surgeons a look inside the body before operating. Blood loss. Next page. More guides on this topic. Related links. Personalise your Bitesize!