LISTER'S GREAT WORK.

New Zealand Herald, Volume LXIV, Issue 19608, 9 April 1927, Page 1 (Supplement)

LISTER'S GREAT WORK.

ANTISEPTIC SURGERY.. - BY MATANGA. There was once a horrible thing called hospital gangrene. So horrible was it that it made hospitals places of which even doctors were afraid. It made mock of their cleverest work, dogging every surgical operation with a relentlessness seldom baffled. Skilfully, quickly, they would cut away an injured or diseased part, and bind up the kindly wound, only to find that in a day or two the dreaded discolouration would appear. Another day or two, and all that was mortal of their patient lay inert on a bed, with a sheet drawn right up over the face. " Hospital gangrene," they said, and went sorrowful, perplexed, fearful, to the next task of the kind.

It had as ghoulish a despoiler of life, this horrible scourge, in the lying-in hospitals v.-here poor women entered with fear and trembling. Septicaemia they called it—blood-poisoning—and it turned into hotbeds of pestilence the-places meant to be the porchways of young lives. Sometimes, despairing, the authorities closed these places,- and took such patients as survived to other scenes. It was of no avail. Everywhere, this tjread foe seemed to lie in wait, in league with death. Many surgeons thought it inevitable that so many cases should be lost by " hospital gangrene" after operation, but as many raised their voices in protest. One of the more heroic doubters was John Bell, an Edinburgh surgeon of great repute. It is in his textb'ok, "The Principles of Surgery," that the hospitals of his day, a bare hundred years ago. have their terror of this scourge exposed. " There is no hospital," !he wrote, "'however small, airy, or well-regulated, where this epidemic ulcer is not found at times; and then no operation dare be performed, every cure stands still, and every sore is apt to run into gangrene; but in great hospitcJs, especially, it prevails at all times, and is a real gangrene. He enlarges on its ravages; ho calls, the Hotel Dieu of Paris a " great storehouse of corruption" where the doctors were terrified of this " hospital gangrene," whose naming was so veritably a deathknell to a patient attacked by it that they gave it disguising names; he tells of two hundred years of this continuous horror there, and quotes an early French writer thus—" A young surgeon who is bred in the Hotel Dieu may learn the various forms of incisions, operations too, and the manner of dressing wounds; but the way of curing wounds he cannot learn; every patient he takes in hand! (do what he will) must die of gangrene." A Waste of Soap! John Bell's text book had some strong words of advice for the budding surgeon: " Let him bear in mind that this is a hospital disease, .that without the circle of the infected walls the men are safe; let him therefore hurry them out of this house of death; let him change the wards; let him take possession of some empty house and so carry nis patients into good air; let him lay them in a • school-room, a church, on a dung-hill, or in a stable; let him carry them anywhere but to their grazes.'" Admirably worried about the whole fell business, Bell was groping in the dark, yet in the right direction. It was Joseph Lister, the centenary of whoso birth has just been celebrated, who found the light. At thirty-thi'ee, this clever surgeon became Professor of Clinical Surgery at the University of Glasgow. That meant, for a time, work with students,, but without patients. Then he was appointed to the Glasgow Infirmary, and his first walk through its wards appalled him with their filth. Their record of amputations was two patients carried out dead for every five operated on. He had the place scrubbed. He ordered the doctors and nurses to wash their hands before engaging in operations and dressing wounds. A waste of time, they said, and a waste of soap, for their hands got dirty again fit quickly! The infirmary's directors were aghast at the demand for soap. It cost money. Th'ey carpeted Lister for his extravagance. Unintimidated, he made washed wards and washed hands the order of the day—but cleanliness seemed to make no difference to gangrene. A continuous stream of corpses went out. J Fasteur Supplies the Key.

He ransacked medical tomes in English, and German works in the original, searching for light. None came. Then, on a day in 1865, five years after he got his J , ofessorship, he was turning the pages i of the weekly publications of the Academie des Sciences. In the issue of June 29, 1863, he found a papei 4 on. "Researches in Putrefactions." Reading the French text as rapidly as if it were English, he came to the claim that putrefaction Was caused by living ferments. It was Pasteur's epoch-making thesis. As he read, Lister's excitement grew; his breath came faster; ideas raced through his mind. He had the key! It was the tiny organisms—in the air, on the hands, on clothes, in dust—that had caused the gangrene. To keep the wounds free of these invisible, outside contagions —that was the task. But how to do it'! The, civic authorities of Carlisle were about that time attacking a sewage problem : for miles round their sewage works a disgusting odour prevailed, and they were using carbolic acid—a thick stuff then, like black treacle—to destroy it. Lister Heard, and went off to Carlisle: smell meant floating particles, and what destroyed the smell must sufely so by destroying the particles. He saw everything, came back, treated a compound fracture with carbolic acid, and the patierft died. Sorely disappointed, he was, nevertheless, undismayed. Next, another compound fracture was treated with the crude carbolic on the open wound before the limb was set, and this time—the patient was a boy smashed up in a cab accident—there was recovery. "A favourable case," was Lister's quiet comment when reporting it a couple of years later. 4 Scepticism and Jealousy. In eighteen months' practice his confidence grew. From fractures v/ith broken skin he turned to abscesses, incising them under lint soaked in dilute carbolic and keeping them so covered. Success followed success. He had triumphed. He wrote about his cases. The Lancet cautiously welcomed Professor Lister's "discovery." But practitioners were sceptical—and very rude. Even Simpson, chloroform's discoverer and the leading professional figure of the day, joined the detractors. Oh, you doctors! Wise and wonderful friends of humankind as you are, have you a specific for the mental malady known as odium medicum ? It has slain thousands of helpless unfortunates. " Listerism" was long despised and hated. .The provinces yielded, but London would stiil have none of it, until Lister himself wept there and proved his methods under the very noses of the leading surgeons of the city. To Pasteur, Lister gave full credit.. The two became fast friends. When Lister, by that time honoured everywhere, went to Paris for the celebration of Pasteur's jubilee in 1892 as the delegate of Great Britain, Pasteur led him to the platform and embraced him while the assemblage, moved even to tears, applauded them both. Lister's work for antiseptic, surgery has been continued in the practice of aseptic methods, and his contribution to human welfare has been of incalculable value. At a "-banquet given to the new baronet by the Royal Society, an American ambassador said: "It is not a profession; it is not a nation; it is humanity itself, which, with uncovered head, salutes you."There - speaks the whole world in this centenary year, and the profession that once was untrue to its owe, ideals now makes honourable amends. i