Joseph Lister (1827–1912) held the chair of surgery at the University of Glasgow from 1860. He had been substantively troubled by the Glasgow Royal Infirmary’s catastrophic post-operative mortality — about 46% of major-amputation patients died of sepsis (“hospital gangrene”). The standard mid-19th-century European explanation was miasmatic: bad air carried the disease.
Lister read Louis Pasteur’s 1864 papers on fermentation and microbial life in autumn 1864. He recognised the surgical implication immediately: if living micro-organisms in the air caused fermentation in laboratory flasks, the same organisms entering an open surgical wound could cause the sepsis pattern he was watching kill his patients.
The carbolic procedure
Lister chose carbolic acid (phenol) as his antiseptic agent because it had been used to control sewage stench in Carlisle. The first procedure was a compound-fracture leg operation on the eleven-year-old James Greenlees at the Glasgow Royal Infirmary on 12 August 1865. The wound was dressed with carbolic-soaked lint. Greenlees recovered without infection.
Lister substantively elaborated the technique through the substantial subsequent two years: carbolic-saturated wound dressings, carbolic-soaked instruments, carbolic-misted operating-theatre air (using a fine atomiser later mocked as Lister’s “donkey engine”), and carbolic handwashing before procedures. Post-operative mortality on his ward fell from 46% to about 15% by 1868.
He published the framework in five Lancet papers in 1867. The British medical establishment was substantially hostile. The proposal that surgeons themselves had been carrying invisible agents from corpse to patient was professionally unwelcome — substantively the same dynamic that had destroyed Ignaz Semmelweis in Vienna twenty years earlier.
The acceptance
European continental surgery substantively adopted the Lister method through the late 1870s — German surgeons in particular, who had been substantially exposed to Koch’s parallel bacteriological work. British acceptance came after Lister’s 1877 appointment to the chair of surgery at King’s College London, which gave him institutional standing within the metropolitan medical establishment.
By 1880 antiseptic surgery was the European standard. By 1890 the technique had evolved into aseptic surgery — preventing organisms from entering the wound in the first place rather than killing them after entry — substantively the framework still used in modern operating theatres.
Lister died at his country house in Walmer in February 1912, aged 84. He was the first British surgeon ever made a peer.