1827-1912
1827.     Born at West Ham, April 5.
1844-52.     University College, London.
1851.     Acting House Surgeon under Erichsen.
1852.     First research work published.
1853.     Goes to Edinburgh. House Surgeon under Syme.
1855.     Assistant Surgeon and Lecturer at Edinburgh Infirmary.
1856.     Marries Agnes Syme.
1860.     Appointed Professor of Clinical Surgery at Glasgow.
1865.     Makes acquaintance with Pasteur’s work.
1866-7.     Antiseptic treatment of compound fractures and abscesses.
1867.     Papers on antiseptic method in the Lancet.
1869.     Appointed Professor of Surgery at Edinburgh.
1872-5.     Conversion of leading scientists in Germany to Antisepticism.
1875.     Lister’s triumphal reception in Germany.
1877.     Accepts professorship at King’s College, London.
1879.     Medical congress at Amsterdam. Acceptance of Lister’s methods by Paget and others in London.
1882.     von Bergmann develops Asepticism in Berlin.
1883.     Lister created a Baronet.
1891.     British Institute of Preventive Medicine incorporated.
1892.     Lister attends Pasteur celebration in Paris.
1893.     Death of Lady Lister.
1895-1900.     President of Royal Society.
1897.     Created a Peer.
1902.     Order of Merit.
1907.     Freedom of City of London: last public appearance.
1912.     Dies at Walmer, February 10.
Joseph Lister
Surgeon

In a corner of the north transept of Westminster Abbey, almost lost among the colossal statues of our prime ministers, our judges, and our soldiers, will be found a small group of memorials preserving the illustrious names of Darwin, Lister, Stokes, Adams, and Watt, and reminding us of the great place which Science has taken in the progress of the last century. Watt, thanks partly to his successors, may be said to have changed the face of this earth more than any other inhabitant of our isles; but he is of the eighteenth century, and between those who developed his inventions it is not easy to choose a single representative of the age. Stokes and Adams command the admiration of all students of mathematics who can appreciate their genius, but their work makes little appeal to the average man. In Darwin’s case no one would dispute his claim to represent worthily the scientists of the age, and his life is a noble object for study, single-hearted as he was in his devotion to truth, persistent as were his efforts in the face of prolonged ill-health. No better instance could be found to show that the highest intellectual genius may be found united with the most endearing qualities of character. Kindly and genial in his home, warmly attached to his friends, devoid of all jealousy of his fellow scientists, he lived to see his name honoured throughout the civilized world; and many who are incapable of appreciating his originality of mind can find an inspiring example in the record of his life. There is no need to make comparisons either of fame, of mental power, or of character; but the choice of Lister may be justified by the fact that his science, the science of Health and Disease, is one of absorbing interest to all men, and that with his career is bound up the history of a movement fraught with grave issues of life and death from which few families have been exempt.

About these issues bitter controversies have raged; but it is to the lesser men that the bitterness is due. By his family traditions, as well as by his natural disposition, Lister was a man of peace; and though he left the Society of Friends at the time of his marriage, he retained a respect for their views which accorded well with his own nature. When he had to speak or write on behalf of what he believed to be the truth, it was from no motive of self-assertion or combativeness. He had the calm contemplative mind of the student, whereas Bright, the Quaker tribune, the champion of Repeal, had all the fervour of the man of action. Lister’s family had been Quakers since the beginning of the eighteenth century; and at this time too they moved from Yorkshire to London, where his grandfather and father were engaged in business as wine merchants. But Joseph Jackson Lister, who married in 1818, and became in 1827 the father of the famous surgeon, was much more than a merchant. He had taught himself the science of optics, had made improvements in the microscope, and had won his way within the sacred portals of the Royal Society. Letters have been preserved which show us how keen his interest in science always remained, and with what full appreciation he entered into the researches which his son was making as professor at Glasgow in the middle of the century. A father like this was not likely to grudge money on the boy’s education; but for the Friends many avenues to knowledge were still closed, including the Universities of Oxford and Cambridge. He had to be content to go successively to Quaker schools at Hitchin and Tottenham, and from the latter to proceed, at the age of seventeen, to University College, London, which was non-sectarian. There the teaching was good, the atmosphere favourable to industry, and Lister was not conscious of hardship in missing the delights of youth that fell to his more fortunate contemporaries.

His father lived in a comfortable house at Upton, some six miles east of London Bridge, in a district now completely swamped by the growth of the vast borough of West Ham. He kept up close relations with other Quaker families living in the neighbourhood, especially the Gurneys of Plashets. In their circle the most striking figure was Elizabeth Fry, who from 1813 to her death in 1843 devoted herself unsparingly to the cause of prison reform. From his home the father continued to exercise a strong influence over his son, who was industrious and serious beyond his years.

From his father Lister learned as a boy to delight in the use of the microscope. He learned also to use his own power of observation, and to make hand and eye work together to minister to his studies. The power of drawing, which the future surgeon thus early developed, stood him in good stead later in life; and it is interesting to contrast his enjoyment of it with the laments made by his great contemporary Darwin, who felt keenly what he lost through his inability to use a pencil and to preserve the record of what he saw in nature or in the laboratory. Lister’s school-days were over when he was seventeen years old and there is nothing remarkable to tell of them; but his period at University College was unusually prolonged. He was a student there for seven years and continued an eighth year, after he had taken his degree, as Acting House Surgeon. In 1848, half-way through his time, a physical breakdown was brought on by overwork, just as he was finishing his general studies; but a long holiday enabled him to recover his strength, and before the end of the year he had begun the course of medical studies which was to be his life-work.

At school his record had been good but not brilliant, nor did he come quickly to the front in London. His mind was not of the sort which can be forced to produce untimely fruit in the hot-house of examinations. But his education was both extensive and thorough; it formed an excellent general training for the mind and a good basis for the special studies in which he was later to distinguish himself. He had been at University College for two years before he gained his first medal; but by 1850 he had made his name as the best man of his year, capable of upholding the credit of his College against any rival in the metropolis. Among his fellow students the best known in later years was Sir Henry Thompson, whose portrait by Millais hangs in our National Gallery. Among his professors one stands out pre-eminent, alike for his character and for his influence on Lister’s life. This was William Sharpey, Professor of Physiology, an original man with a keen eye for originality in others. In days when most English professors were content with a narrow empirical training, he had trudged with his knapsack over half Europe in quest of knowledge, had studied in France, Switzerland, Italy, and Austria, and had made himself acquainted at first hand with the best that was taught in their schools. He was a first-rate lecturer, clear and simple, and took much pains to get to know his pupils. When Lister had held for a short time the post of Acting House Surgeon at University College Hospital, and needed to make definite plans for his career, it was Sharpey who advised him to go north for a while and attend some classes in Edinburgh before deciding on his course. Thus it was Sharpey who introduced him to Scotland and to Syme.

Before we speak of the latter, a few words must be given to the year 1851, when Lister completed his studentship and became for a time an active member of the hospital staff. This year was important as introducing him to the practice of his art under the direction of Erichsen, an Anglo-Dane and one of the foremost surgeons in London. It also led to a change in his way of living, to his being thrown into closer relations with men of his own age, and to his taking a more lively part in social gatherings. What we hear of the essays that he wrote at school, what we can read of his early letters, all harmonizes with our conception of a Quaker upbringing. There is a staid primness about him, which contrasts strangely with the pictures of medical students presented to us in the pages of Dickens. Capable though he was of enjoying a holiday, or of expanding among congenial associates, Lister was not quick to make friends. He was apt to keep too much to himself; and he seems to have inspired respect and even a certain awe among men of his own age. In his youth men noticed the same grave mien, steadfast eyes, and lofty intellectual forehead which are conspicuous in his later portraits. He was steady in conduct, serious in manner, precise in his way of expressing himself; and while these qualities helped him in the mental application which was so necessary if he was to profit by his student days, he needed a little shaking up in order to adapt himself to the ways of other men in the sphere of active life. This was given him by the constant activities of the hospital, and by the demands which the various societies made upon him; but he did not allow them to interfere with his own researches, for which he could find time when others were overwhelmed by the routine of their daily tasks.

His first bit of original research is of special interest because it connects him with his father’s work. He made special observations with the microscope of the muscular tissue of the iris of the eye, illustrated his paper by delicate drawings of his own, and published it in the leading microscopical journal. This and a subsequent paper on the phenomena of ‘Goose-skin’ attracted some attention among physiologists at home and abroad, and brought him into friendly relations with a German professor of world-wide reputation. They also gave great satisfaction to his father and to his favourite teacher Sharpey.

But Lister’s development henceforth was to take place on Scottish ground, and his visit to Edinburgh in 1853 shaped the whole course of his career. James Syme, under whose influence he thus came, was the most original and brilliant surgeon then living in the British Isles, perhaps in all Europe. His merits as a lecturer were somewhat overshadowed by his extraordinary skill as an operator; but he was a remarkable man in all ways, and the fact that Lister was admitted, first to his lecture-room and operating theatre, and then to his home, was without doubt the happiest accident in his life.

The atmosphere of Edinburgh with its large enthusiastic classes in the hospitals, its cultivated and intellectual society outside, supplied just what was wanted to foster the genius of a young man on the threshold of his career. In London, centres of culture were too widely diffused, indifference and apathy too prevalent, conservatism in principles and methods too strongly entrenched. In his new home in the north Lister could watch the boldest operator in his own profession, and could daily meet men scarcely less distinguished in other sciences, and as a visitor to Syme’s house he was from time to time thrown among able men following widely different lines in life. Above all, here he met one who was peculiarly qualified to be his helper; and three years later, at the age of twenty-nine, he was married to Agnes Syme, the daughter of his chief, to whom he had been attracted, as can be seen from the letters which passed between Edinburgh and Upton, soon after his arrival in the north. Before this event, he had already made his mark as Resident House Surgeon, as assistant operator to Syme, and also as an independent lecturer under the liberal system which gave an opening to all who could establish by merit a claim to be heard. He had also begun those researches into the early stages of inflammation which, ten years later, were to bear such wonderful fruit. It was a full and busy life, and the distraction of courtship must have made it impossible for him at times to meet all demands; but after 1856 his mind was set at rest and his strength doubled by the sympathy which his wife showed in his work, and by the help which she was able to render him in writing to his dictation.

For their honeymoon they took a long journey on the Continent in the summer of 1856; but half, even of this rare holiday, was given to science, and, after some weeks’ enjoyment of the beauties of Italy, husband and wife made the tour of German universities, as he was desirous to see something, if possible, of the leading surgeons and the newest methods. Vienna, Dresden, Berlin, Munich, Frankfort, Heidelberg, and Stuttgart were all included in the tour. They were well received, and at Vienna the most eminent professor of Pathology in the University gave more than three hours of his time to showing his museum to Lister, and also invited the young couple to dine at his house. Though he had not yet made a name for himself, Lister’s earnestness and intelligence always made a favourable impression; and as he had taken pains with foreign languages in his youth, he was able, now and later in life, to address French and German friends, and even public meetings, in their native tongue. He came back to find work waiting for him which would tax his energies to the full. In October 1856 he was elected Assistant Surgeon to the Infirmary, and now, in addition to lecturing, he had to conduct public operations himself, whereas he had hitherto only acted as Syme’s assistant. This was at first a severe trial for his nerves. That it affected him differently from most experienced surgeons is shown by the fact that he used always, all his life, to perspire freely when starting to operate; but he learnt to overcome this nervousness by concentrating his attention on his work. He was not a man who had religious phrases on his lips; but in letters to his family, quoted by Sir Rickman Godlee, he gives us the secret of his confidence and his power. ‘Yesterday’, he says in a letter written to his father on February 26, ‘I made my début at the hospital in operating before the students. I felt very nervous before beginning; but when I had got fairly to work, this feeling went off entirely, and I performed both operations with entire comfort.’ A week later, in a letter to his sister, he returns to the subject. ‘The theatre was again well filled; and though I again felt a good deal before the operation, yet I lost all consciousness of the presence of the spectators during its performance, and did it exactly as if no one had been looking on. Just before the operation began I recollected that there was only one Spectator whom it was important to consider, one present alike in the operating theatre and in the private room; and this consideration gave me increased firmness.’ Interest in the work for its own sake, forgetfulness of himself, these were to be the key-notes of his life-work.

As yet, to a superficial observer, there were not many signs of a brilliant career ahead of him. His private practice was small and did not grow extensively for many years. The attendance at his earlier course of lectures was discouragingly meagre. This would have been more discouraging still, had not his dressers, from personal affection for him, made a point of attending regularly to swell the number of the class. Indeed, in view of the exacting demands made on him by the hospital, Lister might have been content to follow the ordinary routine of his profession. With his wife at his side and friends close at hand, he had every chance of living a useful and happy life. But he still found time to conduct experiments and to think for himself. His researches were continued along the line which he had opened up in 1855, and in 1858 he appeared before an Edinburgh Surgical Society to read a paper on Spontaneous Gangrene.

This gave Mrs. Lister an opportunity to show her value. All his life Lister was prone to unpunctuality and to being late with preparations for his addresses, not because he was indifferent to the convenience of others or careless about the quality of his teaching, but because he became so engrossed in the work of the moment that he could not tear himself away from it so long as any improvement seemed possible. This same quality made him slow over his hospital rounds and often over operations, with the result that his own meal-times were most irregular and his assistants often had trouble to stay the pangs of hunger. This handicapped him in private practice and in some measure as a lecturer. He gave plenty of thought to his subjects, but rarely began to put thoughts in writing sufficiently in advance of his engagement. When he was in time with his written matter the credit was chiefly due to his wife. On the occasion of this paper she wrote for seven hours one day and eight hours the next, and her heroic industry saved the situation.

Towards the end of 1859 Lister decided to be a candidate for the Surgical Professorship at Glasgow, which appointment was in the gift of the Crown; and in spite of some intrigues to secure the patronage for a local man, the post was offered by the Home Secretary, Sir George Lewis, to the young Edinburgh surgeon. Syme’s opinion and influence no doubt counted for much. Lister’s appointment dated from January 1860, but it was not till a year and a half later that his position in Glasgow was assured by his being elected Surgeon to the Royal Infirmary. Before this he could preach his principles in the lecture-room, but he had little influence on the practice of his students and colleagues. Thanks to the reputation which he brought from Edinburgh, his first lecture drew a full room, and his class grew year by year till it reached the unprecedented figure of 182, and each year the enthusiasm seemed to rise. But in the hospital he had an uphill task, as any one will know who has studied the history of these institutions in the first half of the century.

To-day the modern hospital is an object of general admiration, with its high standard of cleanliness and efficiency; and few of us would have any hesitation if a doctor advised us to go into hospital for an operation. Seventy or a hundred years ago the case was very different; and when we read the statistics of the early nineteenth century, gathered by the surgeons who had known its horrors, it is hard to believe that we are not back among the worst abuses of the Middle Ages. Such terrible scourges as pyaemia and hospital gangrene were rife in all of them. In the chief hospital of Paris, which for centuries claimed pre-eminence for its medical faculty, the latter disease raged for 200 years without intermission: 25 per cent. of those entering its doors were found to have died, and the mortality after certain operations was more than double this figure. Erichsen, who published in 1874 the statistics of deaths after operations, quoted 25 per cent. in London as satisfactory, and referred to the 60 per cent. of Paris as not surprising. In military practice the number of deaths might reach the appalling figure of 80 or 90 per cent. What was so tragic about this situation was that it was precisely hospitals, built to be the safeguard of the community, which were the most dangerous places in the case of wounds and amputations. In 1869 Sir James Simpson, the famous discoverer of chloroform, collected statistics of amputations. He took over 2,000 cases treated in hospitals, and the same number treated outside. In the former 855 patients (nearly 43 per cent.) died, as it seemed, from the effects of the operation; in the latter only 266 cases (over 13 per cent.) ended fatally. He went so far as to condemn altogether the system of big hospitals; and under his influence a movement began for breaking them up and substituting a system of small huts, which, whether tending to security or not, was in other ways inconvenient and very expensive. About the same time certain other reforms, obvious as they seem to us since the days of Florence Nightingale, were tried in various places, tending to more careful organization and to greater cleanliness; but till the cause of the mischief could be discovered, only varying results could be obtained, and no real victory could be won. Hence a radical policy like Simpson’s met with considerable support. In days when many surgeons submitted despairingly to what they regarded as inevitable, it was an advantage to have any one boldly advocating a big measure; and Simpson had sufficient prestige in Edinburgh and outside to carry many along with him. But before 1869 another line of attack had been initiated from Glasgow, and Lister was already applying principles which were to win the battle with more certainty of permanent success.

Glasgow was no more free from these troubles than other great towns; in fact it suffered more than most of them. With its rapid industrial development it had already in 1860 a population of 390,000. Its streets were narrow, its houses often insanitary. In the haste to make money its citizens had little time to think of air and open spaces. The science of town-planning was unborn. Its hospital, far from having any special advantage of position, was exposed to peculiar dangers. It lay on the edge of the old cathedral graveyard, where the victims of cholera had received promiscuous pit-burial only ten years before. The uppermost tier of a multitude of coffins reached to within a few inches of the surface. These horrors have long been swept away; but, when Lister took charge of his wards in the Infirmary, they were infected by the poisonous air generated so close at hand, and in consequence they presented a gruesome appearance. The patients came from streets which often were foul with dirt, smoke, and disease, and were admitted to gloomy airless wards, where pyaemia or gangrene were firmly established. In such an environment certain death seemed to await them.

Though his heart must have sunk within him, Lister set himself bravely to the task of fighting these grim adversaries. For two years, indeed, he was chiefly occupied with routine work and practical improvements; but he continued his speculations, and in 1861 an article on amputations which he contributed to the System of Surgery, a large work in four volumes published in London, showed that he had not lost his power of surveying questions broadly and examining them with a fresh and original insight. He was not in danger of letting his mind be swamped with details, but could put them in their place and subordinate them to principles; and his article is chiefly directed to a philosophical survey which would enable his readers to go through the same process of education which he had followed out for himself. Sir Hector Cameron, the most constant of his Glasgow disciples, once illustrated this philosophic spirit from a passage in Cicero contrasting the many scientists who ‘render themselves familiar with the strange’ (not realizing that it is strange or needs explanation) with the few who ‘render themselves strange to the familia............