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Lecture 10

HLTH 385W Lecture 10: John Lister

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Human Health Program
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Bob Gaynes

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John Lister Before anesthesia, leg amputations done and patients had to be held down First use of Anesthesia 1846, by Robert Hinkley Before lister, surgery was painless but not safe! Surgery after the discovery of anesthesia but before Lister Postoperative infections were not the same Laudable pus Erysipelas rapidly fatal infection inspired several colorful names; beefy, red look Hospital gangrene called ward fever Joseph Lister Born in 1827 into the Quaker community outside of London His father, joseph jackson Lister, solved the problem of chromatic aberration of compound microscopes He eventually chose Surgery, loved surgery for its own sake Lister and Surgical Infection As a professor of surgery at Glasgow, Lister had become obsessed in determining how to lower the infection rate in the 1860s The explanation for the nearly universal occurrence of post surgical infection They thought that infections happened when the wound was exposed to oxygen A colleague named Thomas Anderson gave Lister a paper by L Pasteur on the problem of wine fermentation and putrefaction Lister read the paper, recognizing that something foreign to the body must be entering the post operative wounds, just like bacteria had entered fermentation vats resulting in putrefaction Lister and Surgical Antisepsis The images under the microscope prompted Lister to consider bacteria as the cause of post srugical infections But how to stop them from causing infection? Pasteur had used heat (pasteurization) but this wasnt an option for patients Lister turned to chemicals He recalled a nearby town, Carlisle, england, had solved its problem with foulsmelling sewage by spraying with carbolic acid On Aug 12, 1865 Lister was called to see an 11yo boy with an open tibial fracture Knowing this would become infected, he tried something new since amputations had a mortality rate of ~45 He tried soaking bandages in carbolic acid, applying them to the wound (changing the dressings every day) After 6 wks, the wound healed! He tried the carbolic acidsoaked dressings on other fractures, local infections, and after drainage, abscesses) Some ppl died, but many who were expected to die of sepsis recovered Statistic significantly From 5015 Published a paper in 1870 on antisepsis
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