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‘THURSDAY, JANUARY 8, 1014. 
LISTER AND HIS WORK, 
Lord Lister: His Life and Work. By. Dr. 'G. T. 
Wrench. Pp. 384. (London: T. Fisher Unwin, 
n.d.) Price 15s. net. 
APPROACHED Dr. Wrench’s book with 
jealous suspicion. I was unfavourably im- 
pressed by his preface, the final paragraph of 
which contains the statement :—“Between Van 
Helmont and Lister nothing was added to the 
fundamental philosophy of disease.” This over- 
coloration was an unpromising introduction to an 
account of the life and work of one of the greatest 
figures in medicine—Joseph Lister. 
However, as I read I became more and more 
fascinated with the book. In addition to an un- 
bounded enthusiasm for his task, the author has 
a detailed knowledge of the development of the 
antiseptic system, and understands that it was 
because Lister was a scientific investigator of the 
first urder that he was privileged to make so great 
a contribution to the welfare of mankind. Fur- 
ther, Dr. Wrench’s appreciation of the intellec- 
tual and moral greatness of Lister is so sincere 
that one forgives the occasional commission of 
some of the faults of journalism. The book is 
written throughout in an interesting and forcible 
style. Well-chosen anecdotes and extracts from 
Lister’s addresses are interspersed, which recall 
the charm of his personality to those who knew 
him, and assist to present the beauty of his char- 
acter to those who had not this privilege. 
The preliminary chapters are devoted to a 
short account of Lister’s childhood, student days, 
and the first portion of his professional career at 
Edinburgh. The importance of his early scientific 
investigations and their bearing upon the great 
work of his life is made clear. | Then 
follows an account of the condition of the surgical 
wards of a hospital in pre-Listerian days. The 
picture is painted in lurid colours, but, as the 
generation which remembers this condition is 
disappearing, it is necessary to impress upon the 
reader the immense human importance of the 
problem which occupied the attention of Lister. 
The rest of the book is a history of the develop- 
ment and final triumph of the antiseptic method 
in surgery. The antiseptic system was based on 
the germ theory of putrefaction, which had been 
finally established by Pasteur. Pasteur himself 
was fully alive to the possible application of the 
facts he had discovered in the interpretation of 
infectious diseases, and was anxious to put his 
ideas to the test. At that time, however, he had 
neither access to hospitals nor a laboratory where | 
NO. 2306, VOL. 92! 
he could work at infectious diseases of animals. 
His opportunity soon arrived, and, in the same 
year (1866) that Lister was applying the germ 
theory to explain the occurrence of wound infec- 
tion, Pasteur, at the request of the French Govern- 
ment, was occupied with an investigation into the 
causation of pébrine. This disease of silkworms 
he discovered to be caused by infection by a proto- 
zoan parasite, Nosema, which is transmitted 
from the moth through the egg to the next genera- 
tion of worms. 
From his first contact with hospital wards Lister 
had been impressed with the terrible evils of 
wound infection, and sorely perplexed as to’ its 
causation. What most surgeons took as a matter 
of course was to him, even as a student, a pheno- 
menon urgently demanding explanation, and 
whilst house surgeon at University College Hospi- 
tal he searched with his microscope for a possible 
fungus as causal agent. 
In 1865 Lister read the papers of Pasteur deal- 
ing with the necessity of microbes for putrefaction, 
which appeared in the Comptes rendus of the 
Paris Academy of Sciences. The analogy between 
the happenings in a flask of broth exposed to the 
air and a festering wound was obvious to a mind 
so prepared; nevertheless hundreds of doctors 
must have read Pasteur’s papers and failed to see 
that they had any significance for their art. 
All this is well told in the chapter entitled 
“Perplexity and Enlightenment,” and in two 
interesting chapters which follow, a description of 
the first attempts to put the principle into practice, 
and the striking success attained in one of the 
most insanitary hospitals in the kingdom is given. 
Notwithstanding, antiseptic surgery was slow 
in making headway. Many surgeons failed to 
appreciate that antiseptic surgery was a system 
based on a principle, and seemed to think that 
they could neglect the principle and apply plenty 
of carbolic. As a consequence, they obtained 
results little, if at all, better than by their old 
methods. 
The gradual spread of the gospel of “Lister- 
ism” until its final acceptance is dramatically 
told. In order to enhance the effect, the author 
has painted a sombre background representing the 
obstinate stupidity of many of the profession, and, 
to this end, has quoted from the speeches and 
writings of distinguished surgeons criticisms and 
opinions which it seems almost cruel to revive. 
This certainly produces the effect of contrast, but 
the lustre shed by the work of Lister is sufficient 
to render the artifice unnecessary. 
The climax was reached at the International 
Medical Congress at Amsterdam in 1879, when 
Lister’s appearance called forth the greatest ova- 
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