together the
evidence and began to realize what was happening to his patients:
they were being killed by germs. So, he surmised, if he could kill the
microscopic organisms or prevent them getting into wounds, there
would be no infection. But Pasteur had sterilized his experiments
using heat (a process that would later become known as pasteurization).
How on earth could Lister sterilize a wound on a living person?
Lister tried a few experiments with various chemicals and
compounds but with little success. The answer was to come from
sewage. A hundred miles south, on the other side of the Scottish
border, the authorities in Carlisle were trying out a new type of
sewage treatment on the drains and cesspools of the city. The chemical
they were using – carbolic acid – removed the terrible smell.
Made from coal tar, carbolic acid had been shown in studies to kill
germs. Lister reasoned that a chemical used to destroy micro-organisms
in sewage might also be used to destroy micro-organisms in
wounds and prevent infection. After all, the septic smell of rotting
flesh pervading the surgical ward was not unlike that of untreated
sewage. In the best traditions of surgery, Lister decided to try out his
new 'antiseptic' principle on a patient.
On 12 August 1865, eleven-year-old James Greenlees was run
over by a cart. He was admitted to the Glasgow Royal Infirmary later
that day with a compound fracture of the left leg. The wheel of the
cart had broken his tibia (the main bone of the lower leg) in two.
The broken bone had punctured the skin, leaving a wound some
one and a half inches long and three-quarters of an inch wide.
When Lister examined the boy, he passed a metal probe into the
wound to feel the broken bone. He observed that there was surprisingly
little blood.
Under normal circumstances, the wound would have been
covered and the boy rested. Splints would have been applied in the
hope that the injury would heal, but Lister knew that eventually he
would have little choice but to amputate. The boy would be left a
cripple, his chances in life appallingly diminished.
Instead, Lister orders his house surgeon, Mr Macfee, to dress
the wound using lint dipped in undiluted carbolic acid. The lint is
laid across the wound and then covered with a sheet of tinfoil. The
foil will prevent the carbolic acid from evaporating. Two wooden
splints are then strapped on either side of James's broken leg.
Four days later, James says the wound is feeling sore, so Lister
decides to take off the dressings to see what is happening. Urging
the boy to keep still, he carefully removes the splints and peels back
the dressings. Lister has never got used to this moment. Normally he
would be forced to step backwards as his nostrils were hit by the
smell of rotting flesh and putrefaction. This would normally be the
time he would have to sit down and calmly tell the patient that
amputation is the only option.
The final piece of lint is removed. He has never seen anything
like it. There are no signs at all of suppuration; the wound is
completely clean. The only smell is from the carbolic. The worst that
could be said about the wound is that the edges are red – probably
burnt, he thinks, by the acid. The soreness the boy has been
complaining of is from the dressing, not, thank God, from disease.
Lister reapplies the lint, this time diluting the carbolic with clean
water. Five days later he looks at the wound again – there is no pus or
other sign of infection. However, the carbolic is still burning the skin,
so Lister tries a mixture of carbolic and olive oil. After another few
days he replaces this with a dressing of lint soaked in water. Six weeks
later the wound is completely healed, the splints are removed and
James walks home. It is, says Lister, 'a most encouraging result'.
By 16 March 1867, when the first results of Lister's work were
published in the Lancet , he had treated a total of eleven patients
using his new antiseptic method. Of those, only
evidence and began to realize what was happening to his patients:
they were being killed by germs. So, he surmised, if he could kill the
microscopic organisms or prevent them getting into wounds, there
would be no infection. But Pasteur had sterilized his experiments
using heat (a process that would later become known as pasteurization).
How on earth could Lister sterilize a wound on a living person?
Lister tried a few experiments with various chemicals and
compounds but with little success. The answer was to come from
sewage. A hundred miles south, on the other side of the Scottish
border, the authorities in Carlisle were trying out a new type of
sewage treatment on the drains and cesspools of the city. The chemical
they were using – carbolic acid – removed the terrible smell.
Made from coal tar, carbolic acid had been shown in studies to kill
germs. Lister reasoned that a chemical used to destroy micro-organisms
in sewage might also be used to destroy micro-organisms in
wounds and prevent infection. After all, the septic smell of rotting
flesh pervading the surgical ward was not unlike that of untreated
sewage. In the best traditions of surgery, Lister decided to try out his
new 'antiseptic' principle on a patient.
On 12 August 1865, eleven-year-old James Greenlees was run
over by a cart. He was admitted to the Glasgow Royal Infirmary later
that day with a compound fracture of the left leg. The wheel of the
cart had broken his tibia (the main bone of the lower leg) in two.
The broken bone had punctured the skin, leaving a wound some
one and a half inches long and three-quarters of an inch wide.
When Lister examined the boy, he passed a metal probe into the
wound to feel the broken bone. He observed that there was surprisingly
little blood.
Under normal circumstances, the wound would have been
covered and the boy rested. Splints would have been applied in the
hope that the injury would heal, but Lister knew that eventually he
would have little choice but to amputate. The boy would be left a
cripple, his chances in life appallingly diminished.
Instead, Lister orders his house surgeon, Mr Macfee, to dress
the wound using lint dipped in undiluted carbolic acid. The lint is
laid across the wound and then covered with a sheet of tinfoil. The
foil will prevent the carbolic acid from evaporating. Two wooden
splints are then strapped on either side of James's broken leg.
Four days later, James says the wound is feeling sore, so Lister
decides to take off the dressings to see what is happening. Urging
the boy to keep still, he carefully removes the splints and peels back
the dressings. Lister has never got used to this moment. Normally he
would be forced to step backwards as his nostrils were hit by the
smell of rotting flesh and putrefaction. This would normally be the
time he would have to sit down and calmly tell the patient that
amputation is the only option.
The final piece of lint is removed. He has never seen anything
like it. There are no signs at all of suppuration; the wound is
completely clean. The only smell is from the carbolic. The worst that
could be said about the wound is that the edges are red – probably
burnt, he thinks, by the acid. The soreness the boy has been
complaining of is from the dressing, not, thank God, from disease.
Lister reapplies the lint, this time diluting the carbolic with clean
water. Five days later he looks at the wound again – there is no pus or
other sign of infection. However, the carbolic is still burning the skin,
so Lister tries a mixture of carbolic and olive oil. After another few
days he replaces this with a dressing of lint soaked in water. Six weeks
later the wound is completely healed, the splints are removed and
James walks home. It is, says Lister, 'a most encouraging result'.
By 16 March 1867, when the first results of Lister's work were
published in the Lancet , he had treated a total of eleven patients
using his new antiseptic method. Of those, only
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