Scientific worthies : [No.] 29, Sir Joseph Lister / [Hermann Tillmanns].

  • Hermann Tillmanns
Date:
[1896]
Catalogue details

Licence: Public Domain Mark

Credit: Scientific worthies : [No.] 29, Sir Joseph Lister / [Hermann Tillmanns]. Source: Wellcome Collection.

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    Surgery, in which capacity he soon attracted to himself a devoted band of admirers. Whilst in Edinburgh he not only published notes of Mr. Syme’s cases, but continued to pursue his physiological and pathological researches. Between 1857 and i860 several papers appeared on a variety of kindred matters, of which the most important are those dealing with the subject of inflammation and that of coagulation of the blood. In 1857 his paper “ On the Early Stages of Inflammation” was read before- the Royal Society, preceded by two others, one being “An Inquiry regarding the Parts of the Nervous System which regulate the Contractions of the Arteries,” and the other “On the Cutaneous Pigmentary System of the Frog.” This work remains up to the present time one of the most important contributions to the subject. Various observations on the coagulation of the blood, a much- debated matter at that time, culminated in the Croonian Lecture of 1862, which excited great interest, upsetting as it did most of the accepted notions, and forming the groundwork of much of our modern teaching on the sub¬ ject. In i860 Listej- was appointed Regius Professor of Surgery in the University of Glasgow, and it was there, surrounded by the typical surgery of the old regime, and shocked by the prevalence and fatality of the so-called hospital diseases, that his work in connection with anti¬ septic surgery was begun. Those, however, who have studied his various writings will not fail to observe how his physiological observations were the precursors of his pathological studies, and these again, as he traced first the appearances and then the causes of inflammation, led on step by step to the association in his mind of the in¬ flammation occurring in open wounds with the action of micro-organisms introduced from without, and so to the crowning performance by which his name will be princi¬ pally handed down to posterity. He always acknowledged the influence of Pasteur’s work on the evolution of his ideas, as has been pointed out by Prof. Tillmanns. His writings since that time have been chiefly devoted to one branch or another of the subject of the germ theory of disease. They consist of articles scattered about amongst- various periodicals, so that it would be a difficult matter to produce a complete list of them. Some are elaborate investigations into the processes of fermentation and the life-history of certain micro-organisms, most of which were carried out before the introduction of the plan of cultivating these low forms of life upon solid media, and therefore involved far greater difficulties than are met with at the present day ; others are treatises on the bearing of bacteriology upon surgical treatment. The controversy which was raised on the first pro¬ mulgation of his views was very warm, and it took a strangely long time before their acceptance in this country was by any means general. To many educated under the old system, it seemed hard to appreciate, first that there was anything new in the antiseptic system at all, and secondly that the modifications of the details of the treatment in the course of its evolution, did not imply a recession from the principles upon which it was founded. It was a stumbling-block to some that, as knowledge advanced, and as it became recognised that the atmosphere was not, as it had been at first supposed, charged with innumerable particles bearing the germs of putrefaction—the details of the treatment NO. 1384, VOL. 54] became simpler. By an unlucky chance, the term “ spray-and-gauze-treatment ” had by some been substi¬ tuted for the “antiseptic treatment”; and when our German confreres started the watchword “fortmitdem spray,” and it was enthusiastically taken up here, it was assumed that Lister had shifted his ground. The assumption was, it need not be said, absolutely without foundation. The earliest antiseptic dressings were much more cumbrous than those mentioned by Prof. Tillmanns. The first attempts consisted in making an antiseptic crust of blood and pure carbolic acid which was pro¬ tected by a sheet of block tin, then followed the use of carbolic acid and oil, and then that of a layer of putty made with carbolic acid ; after this came a plaister made of shellac and carbolic acid, and all these preceded the carbolic acid gauze, whilst the use of the spray was for a long time unknown. Lister was always aiming at simplifying the details of the treatment ; none regretted more than he did its complications, and no one rejoiced more than he, when he found that he could give up the use of the spray with a clear conscience. His idea, in fact, has always been to make an external wound behave as much like a subcutaneous injury as possible by the simplest practicable means. The antiseptic system was fairly launched about 1867, and in the year 1869 Lister was appointed successor to his father-in-law in the chair of Clinical Surgery at Edinburgh ; and here he continued the elaboration of his system, lecturing to large and enthusiastic classes, numerically much greater than any which can be met with in London, whilst his clinique acquired a workb wide reputation. In 1877, on the death of Sir William Ferguson, he was appointed Professor of Clinical Surgery at King’s College, London, a position which he held till three years ago. No reference has hitherto been made to the many improvements and modifications in surgical practice with which the name of Lister is associated ; but though they may not be of much interest to the general reader, it would not be right to pass them over altogether. Long before Esmarch introduced his method of blood¬ less operation on the limbs, Lister was in the habit of obtaining the same result in a less objectionable way, by simply elevating the limb, which, as he has shown, empties itself not merely mechanically, but by means of an active contraction of the arteries consequent upon the altered position. He also was the inventor of a tourni¬ quet for compressing the abdominal aorta, thus diminish¬ ing^ haemorrhage in operations in the neighbourhood of the hip-joint. He has introduced several new operations to the profession, notably an amputation which bears his name, and an operation for excision of the wrist, which, although it is now almost superseded, was for a long time lookedaipon as the orthodox method of treatment. He was the first to undertake osteotomy for the purpose of rectifying deformity of the limbs, and the first to advo¬ cate a more complete method of operating on cancer of the breast, than had been practised by his predecessors. Another advance associated with his name is that of treating fractures of the patella and other bones com¬ municating with joints, by means of open incisions and wiring, a procedure which, before the introduction of