Lord Lister. 



xvn 



But the results were much more far-reaching than this. The dis- 

 appearance of septic diseases after operations opened up a new and large 

 field of surgical activity Prior to the aseptic period, only operations of 

 urgent necessity were performed, and these chiefly consisted of amputations, 

 strangulated hernia, colostomy, a certain number of excisions, operations 

 for stone in the bladder and for diseases of the urethra, opening abscesses, 

 ovariotomy (just in its infancy) and a number of minor operations, 

 especially such as could be performed subcutaneously. When it was 

 demonstrated that one need no longer fear septic diseases after operation, it 

 became evident to Lister that the whole subject of surgical treatment must be 

 reviewed, and that many conditions might be relieved by operation which 

 were formerly left alone, or that operations might be more thoroughly done 

 than had previously been the case, and that many operations might now be 

 performed which had not been thought of, or, if suggested, had been con- 

 demned as impossible and even criminal. Into this matter Lister threw 

 himself with enthusiasm, and the treatment of every case was carefully 

 considered from the point of view of whether something better might not 

 be done for it under the protection of asepsis than had hitherto been the 

 case. Lister thus not only abolished septic diseases, but was the pioneer 

 of modern operative surgery, and for years surgical work could be seen in 

 his wards which was not done elsewhere. 



Eeverting to the period when the writer began to work under him (1873), 

 we had, on the one hand, the Professor of Surgery and several surgeons 

 at the Edinburgh Infirmary who had not adopted Lister's practice, and 

 ridiculed his views, and on the other, Lister himself. The teaching of the 

 two schools was often diametrically opposite, and those of the anti-Listerian 

 school were not sparing in their scathing and sarcastic denunciation of his 

 work. His teaching was, however, clear and logical, and when we (the 

 students) compared the practice and results of the two schools there was no 

 question in the minds of anyone which was right and which was the surgery 

 of the future. It would take too much space, and might be wearisome, to 

 narrate the many alterations which Lister made in surgical practice, but 

 long before his views on the treatment of wounds had been generally 

 accepted, he had entirely altered the operative treatment of the surgical 

 diseases which came under his notice. We may mention, however, a few 

 points. 



A good deal of his early advances in practical surgical work was carried 

 out in connection with injuries and diseases of bones and joints. Ununited 

 fractures of bone had previously been occasionally treated by operation with 

 the view of obtaining union, but generally with disastrous results. Lister, 

 however, had no hesitation in carrying out operations of this nature and with 

 great success. Even if the operation involved opening a neighbouring joint, 

 as in fractures of the olecranon, he did not hesitate to perform it. Malunited 

 fractures were also operated on, pieces of bone being removed as required and 

 the ends being brought into proper position and fixed by silver wire. Kecent 



e 2 



