Lister’s Ideas About Hospital Infection and His Suggestions for Dealing With This Problem

Lister’s Ideas About Hospital Infection and His Suggestions for Dealing With This Problem

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Lister’s Ideas About Hospital Infection and His Suggestions for Dealing With This Problem

Throughout most of Lister’s career, his ideas and theories were
mocked. The basis for the majority of his work was the germ theory.
This stated that germs were tiny micro organisms that were the cause
of infection and disease and not the result of it. Because of the
ignorance of the medical professions at this time, Lister’s ideas were
not accepted by most doctors and his was made a mockery. The doctors
could not understand how something that they could not see could
exist. This meant that although Lister’s ideas would save thousands of
people per year, they would not be nationally and globally excepted
until much later in his life. Even the most respectable people in
medical history did not except Lister’s ideas. For example, Florence
Nightingale did not believe Lister’s theories and rejected them.
Lister triumphed in the end, and his theories were adopted into the
medical profession. His revolutionary methods caused him to becoming
known as one of the greatest surgeons in the history of medicine. In
1897 he was made Lord Lister.

Lister’s theory discussed that surgeons passed on germs when they
operated. It also discussed how the instruments and all of the
equipment used also carried germs and they were also to blame. He said
that it was vital to clean all instruments used and the surgeon’s
hands should be clean at all times. The germ theory discussed this and
it is this vital piece of knowledge that the medical profession would
not accept. Because of this, infection carried on to be passed on and
people kept on dieing. When Lister operated, he removed his coat,
rolled up his sleeves and pinned a large towel over his waistcoat and
trousers. He would dip all of the instruments that he was about to use
in carbolic acid, as well as his own hands, to try to keep them
sterile and clean. This meant that there were fewer germs to be passed
on to the patient and they were less likely to catch and infection and

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die. The carbolic acid acted as a disinfectant and killed the germs
that were previously on his hands and on the instruments. These
measures meant that everything was relatively clean and sterile.
Lister’s theory was a basic understanding of cleanliness and it is
this that the doctors would not accept. Lister wanted the doctors to
understand that minute organisms, known as germs, did exist and that
these organisms are the sole cause of decomposition. Once they have
settled on whatever surface, putrefaction and decay will follow.
Lastly he stated that the true remedy against them is carbolic acid.
We now know that carbolic is an antiseptic and there are other
substances that can be used instead of carbolic acid. His methods and
ideas were enthusiastically adopted on the continent and especially in
Germany. They had used his methods in the Franco-l’russian War of 1870
with good results. Britain however was sceptical and held back from
adopting these proven methods. The majority of doctors in England
could not be bothered to study Lister’s methods, but those that did
converted to his ways. It wasn’t until Lister moved to London that his
ideas and methods were more nationally accepted.

Within a month of living in London, Lister had the opportunity to
prove the superiority of his method. Francis Smith, a forty-year-old
billposter, sustained a simple fracture of his right patella on the 12th
October 1877 and was admitted to Lister’s ward. First he attempted to
unite the two fragments by traction but failed to secure the union and
then announced he intended to incise the skin and wire the fractured
bone together. This method would break one of the rules of old
fashioned surgery. A simple fracture might cause disability if it
failed to unite but did not put the patient’s life at risk and did not
risk loosing the limb completely. Compound fractures were more
complicated and were at a high risk of being subject to infection.
This meant that the usual course of treatment was to amputate the
limb. Lister would incise the protective skin and turn the simple
fracture into a compound one. Many surgeons thought that Lister only
wanted to harm the patient for the sake of a quite unjustifiable
experiment. On Friday 26th October Lister carried out the experiment
and cut into the patient. He wired the two fragments together and on
the 11th January 1878, Francis Smith walked out of hospital recovered.

James Greenlees was another patient of Lister’s that received the
experimental methods. He was an 11 year old boy and was admitted to
Lister on the 12th August 1865. James had sustained a compound
fracture of the tibia. Compound fractures were particularly dangerous
because of the open wound as this was liable to infection as the germs
could easily land on the open wound and infect it. Lister covered the
injury with carbolic-impregnated lint and laid sheet metal over the
lint. The lint soaked the blood and serum forming an artificial scab.
Fresh carbolic acid was applied to the wound with the removal of the
metal plate which formed a barrier that the micro organisms could not
get through. He boy recovered and on May 16th 1867, Lister published
the results of his treatment of eleven cases of compound fracture. Of
these eleven, eight made uneventful recoveries. Two had been attacked
by hospital disease but both recovered and one patient died but his
death was caused by the broken bone end piercing an artery and was not
due to sepsis. These results were amazing and were the only of its
kind at this time.

Lister had performed antiseptic surgery. It had never been performed
before but as its popularity grew, it became a vital part of surgery
and later developed into aseptic surgery. This is preventing the germs
from being in the operating theatre as well as off the instruments and
doctors. The germs are all killed outside of the theatre which is
constantly kept clean. Because of Lister’s ideas, we have been able to
make further developments in medicine. The use of these methods meant
that an operation was no longer a likely death sentence.

Lister’s methods made way for the development of modern day surgery.
Because of his work, attitudes towards going to hospital and the
expectations we have of an operation changed forever. He showed people
how germs worked and proved that they existed and how they behaved. He
showed doctors how to treat them after an operation and placed the
foundations for other doctors to work on. It is because of Lister that
we have aseptic surgery, a technique that is used today where by germs
are prevented completely from entering any open wounds. Lister made
the way for modern surgery and it is because of this that he is
considered one of the greatest surgeons in the history of medicine.
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