Lister Centenary Exhibition at the Wellcome Historical Medical Museum : Handbook 1927.

  • Wellcome Historical Medical Museum.
Date:
1927]
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Licence: Attribution 4.0 International (CC BY 4.0)

Credit: Lister Centenary Exhibition at the Wellcome Historical Medical Museum : Handbook 1927. Source: Wellcome Collection.

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PIONEER WORK IN ANTISEPTIC SURGERY It was characteristic of Lister's pioneer thoroughness that all operations carried out according to the antiseptic technique with which his name will ever be associated began with the purification of the patient's skin around the site of the incision. Thus epidermis, hair follicles and gland ducts were cleansed from potentially septic matter. Others, notably Jules Lemaire, had washed wounds with antiseptics, including carbolic acid, but it seems not to have occurred to them to use this means to prevent the germs from entering the wound. For the purpose of preparing the skin, a 1 in 20 solution of carbolic acid was used, a lotion of the same strength being employed also for cleansing the surgeon's hands and the instruments required during the operation. From first to last, Lister considered carbolic acid superior to corrosive sublimate or any similar antiseptic for this purpose. While carbolic acid is more trustworthy as a germicide for surgical purposes than corrosive sublimate, he wrote, so late as 1893, it is in other respects also greatly to be preferred. Carbolic acid has a powerful affinity for the epidermis, penetrating deeply into its substance ; and it mingles with fatty materials in any proportion. In cleansing the skin before an operation, Lister dispensed even with a preliminary washing with soap and water, relying solely upon the penetrating power and great affinity for organic substances of carbolic acid. For almost twenty years considerable importance was attached to the use of the carbolic spray, which was arranged to direct on to the field of operation a fine mist of antiseptic solution. The first form of spray to be used was of the type designed by Richardson for applying ether to produce local anaesthesia. Despite the small capacity of this spray, and the limited cloud of vapour it produced, it was fairly satisfactory. Improvements in its construction were made by Lister and others from time to time, the chief of these being the