Throughout the 19th century, surgeries were a gamble on life or death. Antisepsis was unknown and even despised, as many doctors felt that washing hands or cleaning surgical instruments was unnecessary, even offensive, and asked them to do so.
Fortunately, that has changed, although it would not have been possible without the influence of great figures like Joseph Lister. This English physician realized the great need to sterilize both the operating room and the instruments to be used to avoid the large number of deaths associated with 19th century operations.
In this biography of Joseph Lister we will discover the life of this British surgeon, his main discoveries and the importance of his work.
Brief biography of Joseph Lister
Joseph Lister, first Baron of Lister, was a well-known British surgeon for his discoveries in antiseptic techniques and his awareness of the importance of maintaining good hygiene and sterilization in operating rooms. This English doctor he noticed that surgical wounds would eventually rot if they were not properly disinfected before and after the operation., ensuring the death of the patient by sepsis.
Aware of this, he introduced various antiseptic techniques in operating theaters, as well as the imposition of the now standardized habit of washing hands, an original idea of the Hungarian doctor Ignaz Semmelweiss. While Lister abused part of the phenolic acid, now better known as phenol, a highly toxic substance, it must be said that in his time it was a good sterilant and that he was working to prevent the death of thousands of people, causing a real revolution in the field of surgery.
The first years
Joseph Lister was born April 5, 1827 to a prosperous Quaker family in Upton, Essex, England.. His parents were Joseph Jackson Lister and Isabella Harris. His father was a wine merchant who had a deep knowledge of physics and mathematics and also had a hobby of microscopy and optics, being one of the early builders of achromatic lenses.
Lister studied at University College London, one of the few institutions to admit Quakers at the time. He first studied botany and graduated in 1847. Then he enrolled in the study of medicine, graduated with honors and, at the age of 26, was admitted to the Royal College of Surgeons of England.. In 1854, he trained as an official surgeon in Edinburgh, with Jarnes Syme, with whom he married his daughter. In the Scottish capital he devoted himself to various anatomical, physiological and pathological works.
Beginnings in surgery
In 1860 he left for Glasgow where he replaced Syme and carried out his most important works. When he took over the surgical clinic in that town, Joseph Lister had to deal with what was one of the main problems in surgery at the time: between 30 and 50% of hospitalized patients died of hospital gangrene, erysipelas, pyemia or purulent edema.
Entering an operating room in the 19th century was a gamble of life and death. Whereas with the invention of anesthesia operating theaters had become quieter places without the agonizing cries of patients, postoperative illnesses ended up killing nearly half of those operated on.
The usual procedure to prevent infections was to ventilate hospital rooms to expel miasma., the bad air that was believed to exhale the wounds and spread the disease to other patients. It was the only hygienic habit practiced by surgeons of the day, for, surprising as it may seem to us now, they loved the stench of the hospitals of the day.
Doctors arrive at the operating room in street clothes and, without even washing their hands, put on their gowns covered with the remains of dried blood and pus, considered to be medals testifying to the many operations they have performed.
The success of the operations was quite rare, a fact known to all surgeons, because it was their daily bread. It is for this reason that even the surgeons themselves were reluctant to operate until it was absolutely essential and, in fact, the infection problem was so serious that there was even talk of abolishing surgery in hospitals. It was better for the patient to die alone than to cause him an excruciating and unworthy death caused by the symptoms of sepsis.
But to Joseph Lister the miasma theory did not convince him, since he observed that, cleaning wounds, sometimes he was able to contain infections. The problem was not to be in the air, but rather in the wound itself. Like other surgeons in the past, Lister wanted to rebel against the laudable pus doctrine, that pus was a positive sign of scarring far from being an indicator of infection and health risk. Lister approached this doctrine, but differently. He believed that the infection of the wound and the formation of pus were comparable to the putrefaction.
Lister was familiar with the ideas and work of Louis Pasteur. On the one hand, he knew that the French bacteriologist had shown that putrefaction was due to the arrival of living germs in the putrescible matter, and on the other hand, that this same matter could be kept unchanged if it was kept out of it. air contact or if the same happened filtered. Lister linked these notions to his experience in the field of surgery, particularly in cases of fractures.
Discover the power of antisepsis
Joseph Lister had observed that simple fractures, those in which he had no injuries, healed without too much difficulty., while open or complex ones usually ended in suppuration and infection. He believed that atmospheric air was responsible for this, as it introduced germs into the body of the injured person. The conclusion: it had to be filtered in some way.
Lister experimented with several alternatives: zinc chloride, sulphites … until he came across phenolic acid, now better known under the name of phenol, a substance easily obtained from coal tar and which , since 1859, was sold to fight against rot. Joseph Lister knew that phenolic acid was used in the UK to prevent the stench of sewers and that in the fields where the waters flowed with this substance the entozous which parasitized the cattle have disappeared.
In 1867 he published a work entitled “On a New Method of Treatment of Compound Fractures, Abscesses, etc.” with observations on the conditions of suppuration ”(“ New treatment of open fractures and abscesses; observations on the causes of suppuration ”) which hardly found an echo in the scientific community. He then presented the results of a new study on the subject to the British Medical Association. This material was finally published in book form in 1867 under the title “On the Antiseptic Principle in the Practice of Surgery.”
Between the first publication and the second, he improved the technique. He first applied compresses of phoenix water and then sprayed this substance both on the objects and on the air of the room where he was to perform his procedures, supplementing the sterilization with the use of phoenix ointments. on top of the wound. Each measurement seemed small to him to ensure that no germs infect the patient’s surgical wound..
Success in his medical career
Little by little, he accumulates a series of success stories, the fruit of continuous experience. In 1867, he decided to operate on a patient with a broken tibia using his new antiseptic method. Usually, most cases end in tragedy. However, Lister succeeded with his method in curing the patient without any problem, being the start of what some call “listerism”, a trend that is rapidly gaining followers.
Important figures in surgery and medicine at the time were keenly interested in the antisepsis proposed by Joseph Lister: in Italy Antonio Bottini; in Germany Richard von Volkmann and Karl Thiersch; in France, Lucas Championnière; and in Spain Salvador Cardenal, Antonio Morales Pérez, Miguel Fargas, Nicolás Ferrer and Juan Aguilar i Lara.
However, there were also some great figures of his time who didn’t take him seriously or hang out with him. convince ideas. Among them was R. Lawson Tait, of Birmingham, who went so far as to say that antisepsis was an unnecessary complication for surgeries, although the evidence would eventually change his mind.
Knowing the value of statistics to give strength to his arguments, Lister accumulated data and figures. For the year 1870, he presented the results relating to amputations. Before the use of their antiseptic techniques, mortality was close to 50% of operated patients, while after using them, it fell to 15%. Death
Joseph Lister died on February 10, 1912 at the age of 84, after receiving all kinds of honors, tributes and recognition for his work. Although it sparked all kinds of criticism and skepticism at the start, its antisepsis will end up being one of the three great discoveries that will bring the revolution in surgery, along with anesthesia and hemostasis. His funeral was held at Westminster Abbey, where his effigy was engraved along with those of John Hunter and Francis Willis.
Honors and recognitions
If from our modern point of view hygiene and sterilization are essential aspects before surgery, this was not the case in the 19th century. From then on, Joseph Lister came up with the idea that to ensure successful operations and a safe postoperative period, proper cleaning of hands and surgical instruments was necessary, as well as ensuring that the room was as clean as possible. possible, a visionary idea.
Despite initial skepticism about his proposals, it was only a matter of time before the results supported the method., saving thousands of lives and making Lister worthy of several honors, which we mention below:
- 1883: appointed Baronet of Park Crescent, in Marylebone (Middlesex)
- 1897: he receives the title of Baron of Lyme Regis
- 1902: receives the Order of Merit.
- 1895-1900: President of the Royal Society
- 1910: the Independent National University of Mexico awards him the Honoris Causa
- The genus Listeria is named in his honor.
- The product “Listerine” is so named in his honor.
His surname has been recorded baptizing a kind of microorganism of the family Corynebacteriaceae, order Eubacterials: Listeria. Microorganisms belonging to this genus are gram-positive cocoid and bacillary bacteria, which are usually found in animals and which cause sepsis. It can also infect humans by causing upper respiratory disease with lymphadenitis and conjunctivitis, as well as sepsis which can cause encephalitis.
As a last curiosity, the product Listerine, a well-known mouthwash antiseptic, is named in his honor. Joseph Lister was not the inventor and did not take advantage of it, but it should be mentioned that it could not have been invented if the importance of sterilizing wounds and human tissue to prevent their infection n had not been discovered.
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