Contributions of Joseph Lister to the field of Microbiology

 

“Success depends upon attention to detail”- Joseph Lister

Joseph Lister, was a British Surgeon and pioneer in Antiseptic surgery. He is known as the “Father of Modern Surgery”. Lister was born on April 5th, 1827, in England. After finishing his baccalaureate in Medicine in 1852, Lister joined the Royal College of Surgeons, England. In 1859, Lister joined as surgeon in the Glasgow Royal Infirmary, Scotland.

As a surgeon at the Glasgow, Lister observed that he was losing nearly half his amputation cases to sepsis which is due to wound infection.  At that time, people considered ‘miasma’ or ‘bad air’ as the cause of infection. He started experimenting with new ways to prevent wound infection. He started by implementing Florence Nightingale’s most elementary hygienic principles in his hospital. The floors, covered in dirt and mud, were thoroughly cleaned and the windows kept opened for fresh air to circulate. The towels and bed sheets were regularly washed.

He was attracted by Louis Pasteur’s theory that decay and fermentation are results of microbial activity. He concentrated on Pasteur’s theories and experiments and discovered that in the suppuration of wounds as well, micro-organisms play a fundamental role. Lister realised that these microbes had to be destroyed before they enter a wound. This became the basis of his antisepsis doctrine.

Pasteur had recommended filtration, pasteurization and use of antiseptics as the means to remove microorganisms. Motivated by this idea, Lister started trials to find out suitable antiseptic agents that are capable of killing these septic germs and can be safely applied on wounds. At that time, Carbolic acid (phenol) had been used to control putrid sewer stench. Lister experimented with phenol on infected frog legs, and the results were remarkable.

On August 12th, 1865, his first human trial of phenol was carried out on an eleven-year old boy, James Greenlees, brought into the Glasgow Royal Infirmary. Lister treated the wound with phenol and the wound healed without suppuration. Lister recognised the antiseptic properties of phenol and used it during operations as well as for cleaning surgical instruments. Lister started to use carbolic acid to clean hands, clothes and also in operation theatres. Wounds were cleaned and sprayed with phenol before dressing. Lister even invented a carbolic acid spray machine (donkey engine) to produce a mist of carbolic acid in the operating theatre as an attempt to reduce post-operative infections. He noticed that pure phenol is too powerful, and its dilutions up to 1:40 have germicide effect. In his “donkey engine”, he used dilutions up to 1:100 which was effective in air sanitization.

After nine months of experiments, he published his promising data in the International General Medical Journal - Lancet as “Papers on a New Method of Treating Compound Fracture, Abscess, etc., With Observations on the Condition of Suppuration”.  He visited conferences and symposia all over Europe, stating proudly that none of his patients so far have died from sepsis, wound infection or hospital gangrene.

                                                                    “Donkey Engine”

To avoid infection from wound suturing threads, he introduced suturing with catgut instead of the commonly used silver threads. He treated the thread first by prolonged “carbolization”. As an experiment, he sutured deep neck wound in a calf. To his surprise, there was no pus on the suture and also there was no trace of catgut. Catgut suture get naturally degraded by the body's own proteolytic enzymes. Catgut suture threads are derived from strands of purified collagen taken from small intestine of healthy ruminants (cattle, sheep, goats) or from beef tendon.

Honours

·  Chassaignac introduced the use of drainage tubes into surgery. Lister was fascinated by the idea and immediately applied it to the first abscess that came his way. It was not just any abscess; it was located in her Majesty Queen Victoria’s armpit. Using his antiseptic techniques, he treated the abscess so meticulously and he was honoured with “Sir “title.

·       In 1897, Queen Victoria honoured Lister with “Baron” title  

·       First  physician who received the highest noble title of “Lord”

·       In 1899, the “British Institute of Preventive Medicine” was renamed as the “Lister Institute of Preventive Medicine”.

On 10th of February, 1912, Joseph Lister passed away at the age of 85 years.