DISCOVliHY 



23 



I of his great discovery, that the lack of vitality after 

 I an injury' made the wounded flesh a prey to attack 

 from some agent as yet unknown. 



In i860 he was appointed Professor of Clinical 

 I Surgerj^ in the University of Glasgow, but it was not 

 ; till a year later that he became surgeon to the Intirmary 

 in that city. Here again he came into contact with 

 I those terrible conditions pertaining to pubhc hospitals, 

 their fetid odour, the look of suffering, and the fear 

 of death. It was truly said at the time that the victim 

 of a street accident stood a better chance of recovery 

 outside these " houses of death " than in their wards. 

 The discovery of the anaesthetic properties of chloro- 

 form by Sir James Simpson in 1847 had in a sense 

 made matters worse, for it had led to more operations, 

 and consequently more deaths from hospital gangrene. 

 Only about 60 per cent, of the patients of those days 

 ever recovered from an operation. The Glasgow 

 wards were no better than the others, and although 

 Lister introduced both air and cleanliness into them, 

 the death roll was not appreciably diminished. Ac- 

 cordingh- he proceeded to search the literature of three 

 lands, and in 1865 came across Pasteur's work, and 

 the great discovery of the existence of microbes in the 

 dust of the air, with which readers of Discovery ' will 

 be familiar. He immediately connected the results 

 obtained by Pasteur with his own early work on the 

 paralysis of the tissues when injured. He concluded 

 that the tissues, when their protective vitality was 

 temporarily wanting, became the prey of the micro- 

 organisms just as though they were dead and in the 

 proper condition for putrefaction to set in. This 

 explained why it was putrefaction only began in cases 

 of compound fracture where the skin was broken, and 

 not in cases of simple fracture w-here the skin was not 

 cut. Thus it came about that Lister, through his use 

 of the microscope, was the only one w-ho, on hearing of 

 Pasteur's discovery, was able to grasp its full meaning. 

 He had a perfectly clear vision of the microbes attack- 

 ing the apparently dead tissues, which through their 

 temporarj- lack of \'itanty were unable to resist. The 

 problem was now a simple one to be solved by simple 

 methods. Kill the microbe and allow the tissues to 

 regain their vitality and power of resistance. The 

 wounds, whether accidental or the result of surgical 

 interference, would then heal up quickly. This is 

 what Lister set out to do. His attention had been 

 attracted to an experiment made by the City authorities 

 at Carhsle in destroying the odour of their sewage by 

 means of carbolic acid. It struck him that this might 

 be just the agent for his purpose. The carbolic acid 

 of that day, it must be noted, was very impure, being 

 full of tarry matter and very insoluble in water. The 

 first experiment was made in 1866 on a small boy, who 

 ' Discovery, November 1920, p. 330. 



was brought in from a street accident with a compound 

 fracture of his leg. Cleaned and dressed with carbolic, 

 the wound healed, and the boy was soon able to walk 

 again. Having thus found out how to deal with such 

 cases, and having successfully treated many of them. 

 Lister passed on to the consideration of cases of chronic 

 abscess, which more often than not proved fatal on 

 operation. Here again he succeeded, where others 

 had failed, by his firm belief in the germ theory, and 

 by his careful exclusion of all contamination from the 

 wound by his carbolic dressings. It was an age of 

 controversy ; no one could understand why it was that 

 the mortality in hospital was so much greater than in 

 the rural districts ; there was a discussion as to the 



IX3RD LISTER. 

 By kind permission ol Messrs. Elliott & Fry. 



best form of ligature to employ. Lister wisely kept 

 aloof from all contro\'ersy, and set to work to find out 

 these things for himself by means of numerous experi- 

 ments. He reduced the mortahty in his wards at 

 Glasgow by the simple expedient of washing every- 

 thing — the wound, the hands of the operator, and the 

 instruments used — in carbolic solution. He found that 

 catgut sterilised in carbohc acid was by far the best 

 ligature to use, but for twelve years he kept an open 

 mind regarding the merits of the various catguts 

 obtainable. He even paid visits to the factories where 

 they were produced. Finally he fixed upon the one 

 in use to this day. 



