February 22 19 12] 



NATURE 



557 



experiments where the air was filtered through cotton- 

 wool, or else to destroy their vitality, as in the experi- 

 ments where the air which was admitted to the 

 organic fluids was not filtered, but subjected to great 

 heat. There is no doubt that Lister's first view was 

 that the main organisms which produced this decom- 

 position reached the wound from the air or from dust 

 deposited on surrounding objects, although he very 

 soon modified that view as a result of practical experi- 

 ence. Proceeding, however, on the view that the 

 main contamination came from the air, the question 

 which he put before himself was, what was the best 

 way of dealing with the infective particles ; should they 

 be simply kept out by filtration of any air which came 

 in contact with the wound, or should they be killed 

 before they got into the wound, and if they were 

 killed what would be the best way of doing it? To 

 filter the air did not seem at all a practical plan, and 

 Therefore he at once took up the line of killing the 

 organisms before they got into the wound, and the 

 simplest way of doing so seemed to be by the use of 

 chemical substances which had the power of destroy- 

 ing these minute forms of life, and were termed 

 antiseptics. Curiously enough, the first chemical sub- 

 stance to which his attention was directed was 

 carbolic acid, which still holds its place as one of 

 the most potent and generally most applicable anti- 

 septics. 



His views and methods were constantly undergoing 

 expansion and modification as the result of experience. 

 Starting with the crude notion of bacteria in general, 

 lie very soon found that there must be a great variety 

 of dift'erent species of bacteria, each having its own 

 life-history and producing dift'erent noxious effects or 

 none at all, and that the harm following the entrance 

 of bacteria into wounds was, in the main, not due to 

 those which produced the putrefactive fermentation. 

 However much he modified his views and his methods 

 of dealing with wounds, he held to the leading view 

 that no bacteria should gain admission to wounds in 

 a living state, although it was not long before he 

 recognised that it was an ideal aim and that prac- 

 tically bacteria must gain entrance to wounds to a 

 certain extent in spite of all precautions. This led 

 him to postulate the second factor which had to do 

 with the avoidance of sepsis, namely, the power which 

 tlie tissues themselves possess in preventing the de- 

 velopment of these micro-organisms, and that was 

 the point on which he laid the very greatest stress, 

 and in connection with that he struggled for years to 

 reduce, and, if possible, avoid altogether, irritation of 

 the tissues in the wound, while at the same time, 

 as far as possible, preventing the entrance of bacteria. 

 Hence he was constantly changing his dressings and 

 his methods, much to the perplexity of those who 

 had not grasped the scientific ideas which were at 

 the bottom of his researches. 



These changes had a twofold object : one to obtain 

 a more perfect sterilisation of the air, and the various 

 objects which came in contact with the wounds, and 

 I the other to avoid as far as possible the use of irritat- 

 ing substances, and more especially to prevent them 

 "coming in contact with the wound itself, and thus 

 Interfering with the natural action of the tissues in 

 lestroying any bacteria which might enter them in 

 ppite of the various precautions. 



A study of his colli '01001 works which were published 

 a year or two ago will show I he remarkable persever- 

 mce with which he followed out these aims, and as 

 examples of scientific writing, they are probably un- 

 surpassed. He possessed to a high degree the qualitv 

 ■of genius, in not overlooking what to the ordinary 

 mind would appear minor circumstances. If an 

 experiment did not turn out ns ho oxpoch-d, he pro- 

 ceeded at once to ascertain the cause, and he did 

 NO. 2208, VOL. 88] 



not throw it aside as simply an accident. In this 

 way he was led to a great variety of information 

 which the ordinary observer would have missed 

 altogether. 



But Lister as a surgeon did not direct his attentions 

 solely to the treatment of wounds and the avoidance 

 of septic troubles in connection with them. As soon 

 as he found that he could reckon with reasonable 

 certainty on the avoidance of these troubles, he pro- 

 ceeded to consider in what way he could improve the 

 existing methods of treatment, and naturally the 

 immunity from septic diseases opened up a greatly 

 increased range of operative work. Hence very 

 shortly after the successful application of his 

 theories to practice, we find him suggesting operations 

 and procedures as regards the treatment of diseases 

 which had not previously been attempted, and 

 were looked on by the older surgeons as"almost 

 criminal. Such operations, for example, as osteotomy 

 for deformities, the treatment of recenT: fractures, 

 such as fracture of the patella, by operation, exten- 

 sive operations for the removal of cancerous glands 

 in connection with cancer of the breast, the intro- 

 duction of suprapubic colotomy, and a great many 

 other procedures too numerous to mention. 



Another point which should not be forgotten in 

 connection with Lister is that it was his work which 

 gave the main impulse to the development of the 

 great science of bacteriology, a science which bids 

 fair to occupy the most prominent place in medical 

 work._ It is true that he did not discover bacteria, 

 nor did he take an active part in the bacteriological 

 advances, but nevertheless he, along with Pasteur 

 and Koch, may be looked on as a founder of the 

 science. Until Pasteur's time the existence of bac- 

 teria and their life-history had been looked on as only 

 an interesting but not very important study, and 

 practically the only questit)n asked with regard to 

 them was whether they could arise spontaneously in 

 organic fluids, or whether, like other living things, 

 they must have had a progenitor. In other words, 

 the battle raged for many years on the question of 

 Spontaneous Generation. Pasteur was the observer 

 who finally settled this question absolutely definitely, 

 and showed that there was no such thing as spon- 

 taneous generation of living organisms, and that all 

 organisms were derived from pre-existing ones, and 

 he further showed that organisms were the causes of 

 the ordinary fermentations, including the putrefactive 

 fermentation. 



Until, however, Lister seized on the facts demon- 

 strated by Pasteur, and applied them to the treatment 

 of wounds, practically no one had looked on these 

 organisms as of any importance in disease. As soon 

 as Lister showed that the exclusion of these ori;;niisnis 

 from wounds meant the disappearance of a variety of 

 diseases to which man had been previously subject, 

 the study of these organisms naturally advanced with 

 groat rapidity. Lister, for some years, did work in 

 that direction himself, but comparatively lit lie pio- 

 gr(>ss was made until it w.-is taken up by Tim, ur. 

 who, with his wonderful insight, drew deduolions 

 from his observations of far-reaching value. But the 

 great progress dates from the time when Koch appeared 

 in the field, and demonstrated definitely the r<l,ition of 

 these organisms to disease, and showed how tlioy 

 could be detected and how they could be stained and 

 cultivated. Since that time the science has gone 

 .-ilioad nt n vory rapid pri'-. • ^■■^ without Pastour, 

 Lislt'1% nnd l\ooh, and m < iallv without Iho 



|)raorioal drnimi'^trnf ion nl . . .,;..il inipoiMatioo of 

 those oriL;.uii^ni^ h\- l.i-iir, il is iniiios^^ih!.- In s,i\- 

 whether this soii'inr wmld ha\c htm in i-\i-irin\: at 

 all at the present rn<iin.ni. 



I need not say an\ihing ahoul Lord Lifter as a 



