Chapter 11 : Joseph Lister, the Man Who Made Surgery Safe

Abstract:

The first great American contribution, the discovery of anesthesia, to the field of medicine ended the pain of surgery. More importantly, the discovery of anesthesia did not make surgery safe, only painless. In the 20 years between the introduction of anesthesia and Lister’s innovations, the problem of surgical infection and its associated mortality remained. To fully understand Joseph Lister's contribution, one must consider the state of surgery immediately before his efforts. Infection was the anticipated result of surgery. The postoperative mess was the most desirable result of mid-19th-century surgery and was termed "laudable pus." Today, one can identify this outcome as an infection from Staphylococcus aureus. While British surgeons bickered over the value of antiseptic surgery, the 1870-1871 Franco-Prussian war produced, literally, an army of believers. The first part of Lister's process to disappear was the carbolic acid spray in 1887. Asepsis is the process that does not allow microorganisms access to the wound in the first place. In reality, the processes are complementary, not antagonistic. The initial architects of asepsis were German. Lister focused on antisepsis-killing microorganisms when they got into the wound, initially. But soon, Lister recognized the importance of not allowing the microorganisms access to the wound at all.