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Learning from Lister

Inaugural lecture

First page of address, in manuscriptPage 1 from a manuscript transcript of Lister’s inaugural lecture at King’s College London, 1 October 1877. From the Archives of the Royal College of Surgeons of England.

Lister’s inaugural lecture at King’s would have been, for most students in the audience, their first introduction to the theory which, for Lister, was crucial to understanding the practice of antisepsis. It was intended to be a serious scientific disquisition. Although Lister had come to his surgical conclusions through years of observing the inflammation and putrefaction of wounds, he was, unlike most English surgeons, keenly interested in the researches of Louis Pasteur on the fermentation of yeast which touched on the same subject.

Page 31 from address, in manuscriptPage 31 from a manuscript transcript of Lister’s inaugural lecture at King’s College London, 1 October 1877. From the Archives of the Royal College of Surgeons of England. Lister spoke on the fermentation of milk and described putrefaction of wounds as a process caused by the fermentation of the blood. He went on to suggest that all true fermentative processes were the result of what we would now call micro-organisms. For those who still believed in airborne infections, the natural conclusion to draw was that attention to the general cleanliness of a hospital (or ‘aseptic’ surgery) would deal with the problem of post-operative mortality. Therefore, Lister felt that it was incumbent on him to demonstrate the scientific basis for his contention that care of the wound itself was of paramount importance.

However, many surgeons who practised antiseptic surgery on the basis of empirical observation did not necessarily accept Pasteur’s germ theory. Lister’s position was complicated by his own changing views; by the end of his career he had accepted many of the assumptions of ‘aseptic’ surgeons. Although the note-taker has ventured to include the reaction of his audience (‘Applause’) in several places in the text, this contradicts the recollection of other witnesses. It is generally accepted that this lecture was ill-received by an audience which was not generally prepared for it and had expected something more light-hearted.

As St Clair Thomson, who later became Lister’s house-surgeon and friend, recalled:

We showed our boredom, as was the manner of those unregenerate days, by shuffling our feet. Whenever Lister referred to a cow we tried to emit the ‘Boo’ of that animal; each time he mentioned the contaminating hand of the dairy-maid we said ‘tut-tut’; when five o’clock struck we reminded him audibly that it was ‘tea-time’...

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