LORD LISTER.
WE can thank Heaven for Lord Lister's life and work,. without one touch of regret that he has died. Years ago, his work was done : and he had to bear many slow years. of old age. For all the love and care given to him by his own people, he was very lonely. The death of his wife, in 1893, killed all the brightness of his life: and they had no children. He suffered, body and mind, the infirmities which, coming at the very close of a long, pure, and splendid life-time, are so inexplicable, so seeming cruel and useless. There hi an end of his weariness and his loneliness : and we may well be glad of that.
Those of us who bad the honour of knowing him, remember the habitual sadness of his face. He bad none of that look, which Pasteur sometimes had, of mastery and of vehemence his face was quiet, soft, thoughtful, gentle; not what men call a "strong face." When be had to sit still under praise and applause, he looked a little tired of it all: the present writer has seen him, at a dinner, bearing meekly the nuisance of "He's a jolly good fellow." His voice was singularly quiet, like his face. He seemed to have no room in his heart for anger : not even much room for controversy. Only, now and again, it was possible to see that he was 'unwilling to entrust a. case to So-and-so, lest some little point of the ritual of antiseptics should be overlooked. In what may bo called the spiritual aspect of his work, ne and Pasteur were much alike : the same indomitable humility, the same laborious and self-judging perseverance, the same passionate desire for truth, the same reverence.
Ho lived to see his work made, so far as we can guess, well- nigh perfect. It began in the days when germs might still be culled, by an honest doctor, " mythical fungi." It caught the light, so early as 1857, of Pasteur's discovery of the "bacillus lactis," the germ which turns the milk sour. It advanced,.
from the use of the carbolized putty and other early uses of carbolic acid, to the invention of the carbolic spray. The elaborate use of the spray was a great object-lesson to the young surgeon : it taught to all men the reality of the fight against germs, even to the laziest and most thoughtless medical students. Then came the time when cyanide dress- ings were found more serviceable than carbolic dressings ; and the perchloride of mercury came into use as a good antiseptic lotion, but not good enough to displace the use of carbolic lotion. Then, as time went on, we learned more and more clearly that the germs in the air are too few to be dangerous : the real danger was the germs in all that made the wound, or came in contact with the wound. Therefore, all must be sterilized, made aseptic, by heat: all towels, dressings, sponges, instruments, and so forth, must be boiled or steamed. But one cannot boil and steam the patient, nor the surgeon, nor the nurses. Therefore, the patient's skin, and the surgeon's hands, and so forth, are prepared for the operation by the strict use of antiseptics. There is no gap, between the antiseptic method and the aseptic method : they are, in Aristotle's phrase, as inseparable as the convexity and the concavity of a curve : or, as Sir William Osier said to the Royal Commission on Vivisection, "It is the difference between tweedleduni and tweeclledee : they are both applica- tions of the same principle." In that famous experiment which Lister made (December 12th, 1867), when he tied the larotid artery of a horse with a silk ligature, cutting the ends ghort, he steeped the silk in carbolic lotion. The complete success of the experiment emboldened him to do the same for a case of aneurysm in a human patient (January 29th, 1868), with complete success. It might possibly suffice to boil the silk : but it might be desirable to use catgut, and one cannot boil catgut. The point is, that Lister discovered the safe use of a buried ligature. And, so far as we can guess, we shall never depart, so long as germs are germs, from this conjoint use of the antiseptic and aseptic methods or method of surgery.
Of course, there have been prophets, who desired to see these things, and did not see them. Pasteur and Lister were not the very first men who ever heated a surgical instrument : and the use of antiseptics is as old as the wine and oil used by the Good Samaritan : the wine was the antiseptic : the Good Samaritan had learned that from Hippocrates.
It may be well, to take one of a thousand instances of the world's debt to Pasteur and Lister. Let us take the operation for empyema (abscess inside the chest). It is to-day one of the simplest and safest of all operations : the recoveries, in favourable cases, are 90 or more per cent. The operation is as old as Hippocrates ; and he did it as we do it now, with a free incision. But, somewhere in the Middle Ages, this bit of his wisdom got lost, and was not found again in the Renais- sance. Then came the dreadful time, when empyema was treated by repeated punctures with a hollow needle : and, as the hollow needle was not sterilized, the fluid in the chest was slowly made more and more septic. We read, half-a-century ago, of cases punctured 58, 74, and 122 times : and out of forty-eight patients thus tormented, only six were healed. Even those surgeons who, before Pasteur and Lister, used a free incision, were helpless : Velpeau lost 11 cases out of 12, Dupuytren lost 48 out of 50, and Sir Astley Cooper com- plained that he "could not get a single cure." To-day, it would be impossible to find any major operation more easy, more safe, and more sure, then and there, to save life.
Indeed, by this time, the limbs and the lives saved, thanks to Pasteur and Lister, must be reckoned in millions. The very animals, likewise, enjoy here the benefit of discoveries made by the help of experiments on animals : our pet dogs and cats have operations done on them in accordance with the principles of modern surgery. It might be worth while, or it might not,to try to imagine what change will be wrought in these principles, fifty years hence, by the advance of our knowledge. As things are at present, we cannot guess at anything better than we have. Probably i the change will be in the direction of more simplicity, fewer different ways of attaining the same end. But this is certain, that all modifications and improvements, henceforth, will be founded and built on the knowledge given to us through Pasteur and Lister. This also is certain, that there is none of us who has not good reason to be thankful for the life and the work of that servant of God whose name to-day is honoured and blessed from end to end of the civilized
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