On June 17 1867, the British surgeon Joseph Lister was the first person to perform surgery under antiseptic conditions. Lister came from a prosperous Quaker family in Essex and graduated with a degree in medicine from the University of London. In just a few years he became Professor of Surgery at the University of Glasgow. At that time the usual explanation for wound infections was that the exposed tissues were damaged by bad smells in the air which were called “miasma”. Hospital wards usually smelled bad, not due to “miasma” but due to the rotting of infected wounds.
Although anesthesia had been introduced in the preceding decades, post-surgical death rates ran at 40 to 50 percent because of hospital-acquired infections such as septicemia. Scientists were just beginning to make the connection between hygiene and infection. Hungarian physician Ignaz Semmelweis had discovered in 1847 that the simple act of obstetricians washing their hands in a chlorine solution could cut deaths from childbed fever from 10 percent to less than 2 percent. Lister had not heard of Semmelweis, but it is usually believed that his work to reduce mortality rates in British hospitals stemmed from his reading of Louis Pasteur’s research. In 1865, Pasteur reported that microorganisms cause matter to ferment and eventually rot. Lister made the connection between Pasteur’s research and his own profession.
Carbolic acid (phenol) had been used by the authorities in the town of Carlisle to treat smelly sewage, so Lister tested the results of spraying instruments, surgical incisions and dressings with a solution phenol. He also found that phenol solution swabbed on wounds markedly reduced the incidence of gangrene and subsequently published a series of articles on this finding. He also made surgeons wear clean gloves and wash their hands before and after operations with 5% phenol solution. Instruments were also washed in the same solution and assistants sprayed the solution into the air in the operating theatre. Another of his innovations was to stop using porous natural materials in manufacturing the handles of surgical instruments.
Lister reported that his surgical wards remained free of sepsis for nine months. Between 1864 and 1866, Lister lost 46 percent of his surgical patients. From 1867 to 1870, he lost “only” 15 percent. By 1877, he had dropped the death rate to 5 percent. As the germ theory of disease became more widely accepted, it was realised that infection could be better avoided by preventing bacteria from getting into wounds in the first place. This led to the development of sterile surgery. Lister went on to pioneer new surgical techniques, became Baron Lister of Lyme Regis and was made one of the twelve original members of the Order of Merit. The bacterial genus Listeria, including the food-borne pathogen Listeria monocytogenes, was named in his honour.