[Interview with Dr J.C. Warren on the work of Lord Lister].

  • Warren, John Collins, 1842-1927.
Date:
[1912]
Catalogue details

Licence: In copyright

Credit: [Interview with Dr J.C. Warren on the work of Lord Lister]. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    5/12
    dent fresh from the laboratories of Ger- many anti France an appreciation of the studies ami problems in which he was then engaged. Dr. Warren, lie said to n:e, “l do not expect my contemporaries to ac- cept my doctrines, but I look to your gen- eration and to the men of a coming age to carry them out. Lister had to contend with much ciit- ic!sm and rivalry from his contemporaries, who depreciated h s work, or tt led to show that Ills system had no merit or novelty. All this he b re with the great patience native to a man if his simplicity of char- acter. It was to Pasteur that Lister was indebted for tile basis of h’s conception if 1 antisepsis. The bacillus of anthrax hart | been demonstrated by Eavaine, in France. I as early as 1830; but while the association I cf m'.iroorg.in'sms with seme diseases was rc ognized, it was supposed that a'disease ! might b;gin cut cf nothing, and tnat th - associated organ sms might a:ise by spon- taneous gerieraticn. Pasteur, ti e- clie.i.i.-t. workl g on p:oble-ms connected wltli the manufacture cf beer, laid the foundations cf bacteriology in Ids memoirs of 1838 on ! “the preservation of watery solutions of de. Icompcsable ruhstan es. He showed that if a'r were excluded from a decomposa- ble solution, decomposit ion would not o> i cur. Lister accepted. for many years, the assumption that the microorganisms which caused infection of surgical wounds were derived sole'y from the air. His con'.rlhu- t on to science was the idea of treat log the surfaces of a wound with a substance i which would destroy the organisms deposit. cd tiure from t: e a'r. and excluding air i so far as possible from the dis'nfected wound. Lister l ad used carbolic aril as early as 1863 or 1864. as a caustic; but his antiseptic theory was not announce! until ti e publication of a series of papers in the Lancet, beginning March 16, 1807. Lister’s Crude Early Methods By contrast with present-day practice, Lister's procedure was curious enough, its : crudity being inevitable in view of the im- perfect knowledge of bacteria. His first ; method was to wash the surfaces of the ; wound with a one-to-twenty solution of carbolic acid, in order to destroy the germs of putrescence; and then to cover the line of the wound, or the surface, as the case might be, with lint impregnated witli car- bolic acid; outside of the lint was placed a thin sheet of metal. For opening abscesses he directed the use of a small square of rag which had been dipped in a solution consisting of one part of crystallized car- bolic acid to four parts of boiled linseed oil. This rag was laid over the site of the incision to be made. One edge of the rag •being raised for the purpose, the cut was then made with a knife dipped in the same carbolized oil, and the rag dropped back again ’ as an antiseptic curtain from be- neath which the pus flowed out of the ab- scess. Crude as this procedure now appears, it was effective, for Lister records in August, 1S67, that for nine months lie had had no cases of erysipelas, pyemia, or hospital gangrene in his wards. For the dressing of open wounds Lister devised a putty charged with carbolic acid, a thin sheet of the putty being laid direct- ly on the surface of the flesh. When I visited him. Lister had substi- tuted for the earbolated putty a new dress- ing which consisted' of a sort of rougli plaster made of carbolized shellac laid- on cloth. By warming the plaster by holding it against a hot tea-kettle the shellac came loose, and was to be laid over the surface of the wound. T bought some of these preparations of plaster and brought them home with me in large tin cylinders so ns to have them in the shape used by Lister. Carrying Lister’s Ideas to America After returning to Boston I offered to use ‘some of these dressings in the Massachu- setts General Hospital, hut I wars coldly in- formed that the carbolic acid treatment had been discarded. This episode, which concluded a long period of study in Euro- pean centres, seemed to me a rather start- ling close. Here was a student, myself, who had had every opportunity of -acquir- ing the knowledge of the day. About to return, and complacently regarding himsc-lf as an epitome* of all that -wars newest and latest in modern surgery, this student had been obliged to cast aside suddenly all his previous points of view and begin ail over again. It was the end of an old era and the beginning of a new one. which, as Liu- ter had predicted, it would take nearly a generation to work out. The development of antiseptic surgery was slow, laborious and uncertain. Lister's methods were tried in both the Boston hos- pitals, but for most of a decade they were looked at sceptically toy the older surgeons of the city, who at that time controlled the surgical field much more closely than now. Everyone had his own way of treating wounds, though the antiseptic idea was the common basis. In general, the English methods prevailed. Much better procedures were in use on the Continent, where the notion of pergonal cleanliness as a surgical rr easure got an early start. The old sur- geons were, so far from clean in their hab- its and persons that any improvement in that regard was greatly for the better. Light from the Bacteriologists The attention of the scientific world was soon concentrated on the problem of in- fection by microorganisms. Pasteur’s meth- ods were those of a pioneer, unsuited to the minute exploration of the new ter- ritory. He used liquid media—beef broths -from which the different germs cohld not be separated for particular, study. The I I I I i i i i i i I i i