NA TURE 



[May 7, 1896 



Surgery, in which capacity he soon attracted to himself a 

 devoted band of admirers. Whilst in Edinburgh he not 

 only published notes of Mr. Syme's cases, but continued 

 to pursue his physiological and pathological researches. 

 Between 1857 and i860 several papers appeared on a 

 variety of kindred matters, of which the most important 

 are those dealing with the subject of inflammation and 

 that of coagulation of the blood. In 1857 his paper "On 

 the Early Stages of Inflammation" was read before the 

 Royal Society, preceded by two others, one being "An 

 Inquiry regarding the Parts of the Nervous System which 

 regulate the Contractions of the Arteries," and the other 

 " On the Cutaneous Pigmentary System of the Frog." 

 This work remains up to the present time one of the 

 most important contributions to the subject. Various 

 observations on the coagulation of the blood, a much- 

 debated matter at that time, culminated in the Croonian 

 Lecture of 1862, which excited great interest, upsetting as 

 it did most of the accepted notions, and forming the 

 groundwork of much of our modern teaching on the sub- 

 ject. In i860 Lister was appointed Regius Professor of 

 Surgery in the University of Glasgow, and it was there, 

 surrounded by the typical surgery of the old ri'gime, and 

 shocked by the prevalence and fatality of the so-called 

 hospital diseases, that his work in connection with anti- 

 septic surgery was begun. Those, however, who have 

 studied his various writings will not fail to observe how 

 his physiological observations were the precursors of his 

 pathological studies, and these again, as he traced first 

 the appearances and then the causes of inflammation, led 

 on step by step to the association in his mind of the in- 

 flammation occurring in open wounds with the action of 

 micro-organisms introduced from without, and so to the 

 crowning performance by which his name will be princi- 

 pally handed down to posterity. He always acknowledged 

 the influence of Pasteur's work on the evolution of his 

 ideas, as has been pointed out by Prof Tillmanns. 



His writings since that time have been chiefly devoted to 

 one branch or another of the subject of the germ theory of 

 disease. They consist of articles scattered about amongst 

 various periodicals, so that it would be a difficult matter 

 to produce a complete list of them. Some arc elaborate 

 investigations into the processes of fermentation and the 

 life-history of certain micro-organisms, most of which 

 were carried out before the introduction of the plan of 

 cultivating these low forms of life upon solid media, and 

 therefore involved far greater difficulties than are met 

 with at the present day ; others are treatises on the 

 bearing of bacteriology upon surgical treatment. 



The controversy which was raised on the first pro- 

 mulgation of his views was \ery warm, and it took a 

 strangely long time before their acceptance in this 

 country was by any means general. To many educated 

 under the old system, it seemed hard to appreciate, 

 first that there was anything new in the antiseptic 

 system at all, and secondly that the modifications of 

 the details of the treatment in the course of its evolution, 

 did not imply a recession from the principles upon which 

 it was founded. It was a stumbling-block to some that, 

 as knowledge advanced, and as it became recognised 

 that the atmosphere was not, as it had been at first 

 supposed, charged with innumerable particles bearing 

 the germs of putrefaction — the details of the treatment 

 NO. 1384, VOL. 54] 



became simpler. By an unlucky chance, the term 

 " spray-and-gauze-treatment " had by some been substi- 

 tuted for the "antiseptic treatment"; and when our 

 German confreres started the watchword " fort niit dem 

 spray," and it was enthusiastically taken up here, it was 

 assumed that Lister had shifted his ground. The 

 assumption was, it need not be said, absolutely without 

 foundation. The earliest antiseptic dressings were much 

 more cumbrous than those mentioned by Prof Tillmanns. 

 The first attempts consisted in making an antiseptic 

 crust of blood and pure carbolic acid which was pro- 

 tected by a sheet of block tin, then followed the use of 

 carbolic acid and oil, and then that of a layer of putty 

 made with carbolic acid ; after this came a plaister made 

 of shellac and carbolic acid, and all these preceded the 

 carbolic acid gauze, whilst the use of the spray was for 

 a long time unknown. Lister was always aiming at 

 simplifying the details of the treatment ; none regretted 

 more than he did its complications, and no one rejoiced 

 more than he, when he found that he could give up the 

 use of the spray with a clear conscience. His idea, in 

 fact, has always been to make an e.xternal wound behave 

 as much like a subcutaneous injury as possible by the 

 simplest practicable means. 



The antiseptic system was fairly launched about 1867, 

 and in the year 1869 Lister was appointed successor to 

 his father-in-law in the chair of Clinical -Surgery at 

 Edinburgh ; and here he continued the elaboration of 

 his system, lecturing to large and enthusiastic classes, 

 numerically much greater than any which can be met 

 with in London, whilst his clinique acquired a world- 

 wide reputation. 



In 1877, on the death of Sir William Ferguson, he 

 was appointed Professor of Clinical Surgery at King's 

 College, London, a position which he held till three 

 years ago. 



No reference has hitherto been made to the many 

 improvements and modifications in surgical practice 

 with which the name of Lister is associated ; but though 

 they may not be of much interest to the general reader, 

 it would not be right to pass them over altogether. 



Long before Esmarch introduced his method of blood- 

 less operation on the limbs. Lister was in the habit of 

 obtaining the same result in a less objectionable way, 

 by simply elevating the limb, which, as he has shown, 

 empties itself not merely mechanically, but by means of 

 an active contraction of the arteries consequent upon the 

 altered position. He also was the inventor of a tourni- 

 quet for compressing the abdominal aorta, thus diminish- 

 ing hemorrhage in operations in the neighbourhood of 

 the hip-jomt. He has introduced several new operations 

 to the profession, notably an amputation which bears his 

 name, and an operation for excision of the wrist, which, 

 although it is now almost superseded, was for a longtime 

 looked'upon as the orthodo.^ method of treatment. He was 

 the first to undertake osteotomy for the purpose of 

 rectifying deformity of the limbs, and the first to advo- 

 cate a more complete method of operating on cancer of 

 the breast, than had been practised by his predecessors. 

 Another ad\ance associated with his name is that of 

 treating fractures of the patella and other bones com- 

 municating with joints, by means of open incisions and 

 wiring, a procedure which, before the introduction of 



