Lister

LISTER Joseph (Joseph Lister, 1827-1912), famous English surgeon who created an entire era in surgery by introducing antiseptics into surgical practice (see). L. graduated from the medical school of University College London in 1853. During this period, the entire surgical world was seeking salvation from the appalling mortality rate that prevailed in hospitals and among operated patients. Persistent discussions were held about surgical infectious diseases transmitted from patient to patient by some living virus, although the traditional opinion, supported by Liebig in Germany, attributed complications of wounds to the action of air and in particular oxygen on open tissues in the wound; others pointed to the harmful effects of gaseous foul-smelling substances, i.e., miasmas. Pasteur, working on the causative agents of fermentation, forever put an end to the theory of spontaneous generation of the simplest organisms known to us through his experiments. At the same time in Austria, Semmelweis was developing his correct view of contagion through contact, Holmes (Oliver Holmes) in Boston recommended washing with chlorinated water and changing clothes, Corne, Desormeaux and Lemaire in France expressed themselves in the same direction, and the latter even published a book on antiseptics in 1860-63, where he recommended carbolic acid for this purpose. After graduating from medical school, L. went to Edinburgh to the famous surgeon Syme, in whose clinic he served as assistant and then as lecturer. At the same time, L. conducted experimental work on frogs and bats on the early stages of inflammation, also working on the structure of involuntary muscles and nerve trunks. In 1860, L. received the chair of surgery at the university in Glasgow. Here he continued his work on blood clotting and the properties of fibrin, necessary for him to explain the symptoms and consequences of arteritis and gangrene. Meanwhile, in the wards of the hospital where the clinic was located, there was high mortality from septic processes. Lister found an explanation for this phenomenon in the fact that the hospital was built on the site of a former cemetery recently used for victims of a cholera epidemic. According to L.'s opinion, miasmas emanated from the infected soil, which were the cause of this mortality. Around this time, Pasteur's research became available. Understanding the full significance of microorganisms in the process of wound infection (microbes come from the air onto the wound and infect it), L. studied the conditions for filtering air and destroying microorganisms by high temperature and chemical substances; in essence, he applied to surgery Pasteur's ideas about the fermentation process. If septic processes in wounds depend on the action of microorganisms that have come from the air, then the conclusion suggests itself: for healing wounds without complications, it is necessary to prevent viable microbes from entering the wound. Gradually, L. established a definite and strict antiseptic system, which he published in the article "On the antiseptic principle in the practice of surgery" (Brit. med. j., v. II, 1867), and then repeatedly presented in various speeches and publications until 1878. L. proposed a new method for treating complicated fractures, abscesses, etc., which made it possible to avoid suppuration. When his method was applied, it became possible to operate on joints without endangering the patient's life. In Glasgow, L. wrote an article on amputation and a clinical work on resection of the wrist joint in tuberculosis. In 1869, L. was invited to the chair of surgery in Edinburgh, and in 1877 in London. The main aspiration and goal of L.'s work during these years consisted almost exclusively in spreading his views and improving his method of antiseptic treatment of wounds with disinfection of the air. Destruction of bacteria in the air according to Lister was achieved by spraying a solution of carbolic acid in the operating room from special sprayers. The area of operation and the surgical wound were washed with the same solution, the wound was covered with an impermeable protective layer of silk taffeta, 8 layers of carbolic wool, an impermeable layer of mackintosh. The bulky dressing was fixed with carbolic bandages. Fascinated by the idea of wound infection from the air, L. paid little attention to infection through contact and at the beginning of developing his method did not attach importance to the dirty conditions in which he performed operations. This sharply distinguished him from Semmelweis, Lawson, Tait and others. Later, L. began to pay more attention to this aspect of the matter. L. developed his method down to details: he demanded changing the dressing under the protection of a sprayer. He tried tamponading wounds with strips of carbolic oil-treated gauze, and also tested rubber drainage tubes, introduced carbolic catgut into use, and finally submerged ligatures. Lister's method brought a brilliant revolution to surgery. Mortality after surgical operations decreased dramatically, and septic complications of wounds almost disappeared from surgical wards. This opened one of the most important chapters in preventive surgery.--The collected works of L. were published in 2 vols. ("Collected papers of Joseph Вагой Lister", Oxford, 1909).