Joseph Lister, 1st Baron Lister (5 April 1827 – 10 February 1912) was an English surgeon, medical scientist, experimental pathologist and pioneer of antiseptic surgery and preventive healthcare. Lister revolutionised the craft of surgery by the use of close anatomical observation, in the same manner that John Hunter revolutionised the science of surgery.
Glasgow appointment
On 1 August 1859, Lister wrote to his father to inform him of the ill-health of James Adair Lawrie, Regius Professor of Surgery at the University of Glasgow, believing he was close to death. The anatomist Allen Thomson had written to Syme to inform him of Lawrie's condition and that it was his opinion that Lister was the most suitable person for the position. Lister stated that Syme believed he should become a candidate for the position. He went on to discuss the merits of the post; a higher salary, being able to undertake more surgery and being able to create a bigger private practice. Lawrie died on 23 November 1859. In the following month, Lister received a private communication, although baseless, that confirmed he had received the appointment.
However, it was clear the matter was not settled when a letter appeared in the Glasgow Herald on 18 January 1860 that discussed a rumour that the decision had been handed over to the Lord Advocate and officials in Edinburgh. The letter annoyed the members of the governing body of Glasgow University, the Senatus Academicus. The matter was referred to the Vice-Chancellor Thomas Barclay who tipped the decision in favour of Lister. On 28 January 1860, Lister's appointment was confirmed.
Carbolic acid
In 1834, Friedlieb Ferdinand Runge discovered the germicide phenol, then known as carbolic acid, which he derived in an impure form from coal tar. At that time, there was uncertainty as to the relationship of creosote – a chemical that had been used as a preservative on the wood used for railway sleeper and ships to protect the wood from rotting – and carbolic acid. Upon hearing that creosote had been used for treating sewage in Carlisle, Lister obtained a sample from Anderson. Known as "German creosote", it was a thick, smelly tarry substance.
Antiseptic principle of the practice of surgery
Within a few days of the publishing of the last part of the previous paper, Syme asked Lister to attend the British Medical Association meeting in Dublin on 9 August 1867. Lister had some difficulty preparing a new paper, the seminal "On the Antiseptic Principle in the Practice of Surgery-*" Lister's second paper on antiseptic surgery. It was later published in the British Medical Journal (BMJ) on 21 September 1867.
Lister claimed that based on experiments on inflammation, the essential cause of suppuration in wounds was decomposition. Several aspects of this claim need to be examined. Firstly, it was specific to wounds, as Lister had other views about suppuration elsewhere on the body. Secondly, he stipulated that decomposition was the "essential" cause of suppuration, i.e. not the only cause. Thirdly, decomposition was the cause of pus in wounds. Lister's pronouncement is best described as that he had discovered that the only important cause of suppuration in inflamed wounds is decomposition. Lister was specifically referring to the pathology of pus formation in inflamed tissue, the essential cause of harm in the practice of surgery.
His appeal to the reader, and to surgical consensus, was: "To prevent the occurrence of suppuration, with all its attendant risks, was an object manifestly desirable", and refers to the surgeon's dread of pus appearing in an inflamed wound. Lister then made the wholly inaccurate statement that "...oxygen, which was universally regarded as the agent by which putrefaction was effected" compared to other sources. Lister introduced the work of Pasteur, claiming that decomposition might be avoided by using a dressing that could destroy the minute organisms in the wound. Lister decided to formulate his new surgical technique into a general principle. He termed it the "antiseptic principle", thus linking its nomenclature to carbolic acid.