Life and legacy
Joseph Lister was born on 5 April 1827 in Upton House, Plaistow, Essex, to Joseph Jackson Lister FRS (1786–1869), wine merchant and microscopist, and Isabella, née Harris (1794?–1864). Joseph was educated at home until the age of eleven, being sent first to the local school at Hitchin and then to Grove House School in Tottenham. Lister entered University College, London, in 1844, and in 1848 he had some form of mental breakdown, but in 1852 he became president of the students' medical society of University College, and in 1852 took his MB degree and became a fellow of the Royal College of Surgeons.
In September 1853 Lister visited Edinburgh to witness the surgical practice of James Syme. After becoming Syme's dresser and acting house surgeon, Lister decided to settle in Edinburgh, and on 23 April 1856 Lister married Agnes Syme (1834–1893), the eldest daughter of the surgeon.
In 1860 Lister was appointed to the chair of surgery at Glasgow University and became a Fellow of the Royal Society. A year later he became surgeon to the Glasgow Infirmary. In 1869 hereturned to Edinburgh as professor of clinical surgery, where he remained until 1877.
In 1867 Lister published a number of papers in The Lancet which announced his system of antiseptic surgery, describing his treatment of compound fractures based upon scientific principles. In these he set out the idea of a chemical barrier interposed between the wound and the air, allowing healthy healing by granulation to occur. He used carbolic acid as the barrier, known to him as a disinfectant for the treatment of sewage. In the first series of Lancet papers Lister described eleven cases of compound fracture, of which nine recovered. His views on the causes of wound sepsis changed, however, from 1867 to 1887; initially Lister did not regard pus formation in wounds as the central problem of healing, and his early idea of germs was more in line with Victorian notions of miasma. Many other surgeons of the period were also experimenting with chemicals and with ways of improving cleanliness and claiming equivalent success rates for operations. Surgical mortality did fall in this period, but other factors played a part in the decline; hospitals installed new sanitation systems, nursing and dressings improved, and the diet of patients got better.
In 1877 Lister succeeded Sir William Fergusson as professor of surgery at King's College, London, a not uncontroversial appointment as Lister had antagonised many London surgeons by his remarks on the un-scientific character of surgery in the capital. Lister brought a number of surgical staff from Edinburgh to King’s, and settled in 12 Park Crescent, Portland Place where he installed a laboratory. Little seems to have been known of Lister's methods at King's and there were conflicts, especially with the nursing staff. Although the King's medical faculty were split in their views of Lister and his techniques, gradually he gained converts, notably among younger men who were proponents of the cause of experimental science in medicine.
With the development of Robert Koch’s germ theory, Lister and his disciples modified their practice to take account of Koch’s views. They tended to take the view that any surgeon achieving good results was practising Listerian antiseptic surgery whatever method was employed. By the late 1880s German germ theory and aseptic surgery (which placed much more stress on the sterility of the whole surgical environment rather than just the wound area) were dominant although in 1882 Cheyne held to the view that aseptic surgery had been ‘introduced by Mr. Lister’ (Cheyne, 123).
Lister the scientist and surgeon was regarded by his opponents as distant and friends found him to be aloof and not greatly given to laughter. In 1902 he was one of the twelve original members of the newly constituted Order of Merit and in 1905 he became President for the Royal Society, a position he held for five years. On the occasion of his eightieth birthday in 1907 he received the freedom of the City of London. He died on 10 February 1912. Burial in Westminster Abbey was offered, but he had left instructions to be buried by the side of his wife. The funeral service was held in Westminster Abbey on 16 February 1912, and the burial took place at the Hampstead graveyard.
(Adapted from the Oxford Dictionary of National Biography by Christopher Lawrence).
Lister’s legacy is in flux. How far did his thinking, experimentation, operative and postoperative technique contribute to safer surgical and hospital practice? What role did nursing and hospital management play in developing better surgery? Does Listerism as a surgical and evidence linked movement speak to us, today, of the role of ‘translational science’ in areas such as healthcare and health policy? Can modern surgery learn anything from study the reception and response to health care innovation of the past? How did Lister, himself, reconcile his changing surgical practice with his own initial claims? Did Lister’s followers depart from Listerian antiseptic tenets? Did they promote or impede development of aseptic practice? How receptive were Lister’s followers to the new sciences of bacteriology and microbiology?
The conference will offer a multidisciplinary, multidimensional opportunity to reassess Lister’s legacy in the light of historical, safety, surgical, nursing and health policy research into the theory and practice of hospital health care globally.