134 THE INDIAN MEDICAL GAZETTE. [March, 1925. " sity College Hospital to Lister in 1853, Why, you must be in a perpetual state of bliss of the most aggra- vated description, operations being to you a foretaste Reviews. of the joys prepared for the good. We saw your name in the papers as an adopted child of Syme's, reporting a case for him." It was a not inaccurate description LORD LISTER.- By Sir Rickman John Godlee, Bt.? of the relationship between the two. K.C.V.O., M.S., F.R.C.S. 3rd edition, 1924. Oxford: Having married Syme's daughter, Agnes, and after a The Clarendon Press. Pp. 686. Illustrations 34- continental tour, Lister settled in Rutland Street in Price 21s. net. Edinburgh in 1856, and at once devoted himself to the remarkable 011 of in- i series of studies the pathology hp; medical man who to a idea of wishes gain clear flammation which preceded those of Metchnikoff, the broad foundations medicine upon which modern chiefly dealing with the vascular changes associated with and surgery are based should read two books great this process. In the same year, he commenced to lec- which are almost twin Radot's classics; Rene Vallery ture to students, his first class consisting of 23 pupils. Life of Pasteur" translation Mrs. Devon- (English by His lectures were entirely different in two ways from shire), and Sir the Rickman Godlee's "Lord Lister," those of his contemporaries; he taught far more patho- re-appearance of which in a third edition we cordially logy than \ surgery, and in place of academic lectures, welcome. Both are written studies of immortal finely had patients' brought into the lecture theatre one by one and deal with that of medical " subjects, splendid period as was also Syme's custom. He impressed us all when the work of the was clear- history great pioneers deeply from the beginning he worked us very hard ing the of the of and tradi- ground jungle empiricism he taught us pathology more than surgery. The and ex- tion, erecting the pillars of rationalism and was that he was a " general impression great thinker, and of perimental enquiry of the present-day temple he was treated as such by all the men," wrote Sir John medicine." Batty Tuke, one of Lister's pupils, in later years. Head and shoulders above them all in Great Britain The experiments on inflammation were succeeded rose the figure of the greatest and noblest of British by of a study of the conditions of blood coagulation and of surgeons, Joseph Lister (1827-1912). Something " spontaneous gangrene." this time he was known his nobility of spirit and glamour of personality may be By as a young surgeon of great promise, and a keen gathered from a quotation from his graduation address pupil of Syme's and in 1860 the chair of surgery at to students in 1876; "If we had nothing but pecuniary Glasgow University was offered to him and he accepted to rewards and worldly honours to look to, our profession it, be followed in 1861 as surgeon to the would not be one to be desired. But in its practice by appointment Here he contributed articles on you will find it to be attended with peculiar privileges; Royal Infirmary. and ana;sthetics to Holme's second to none in intense interest and pure pleasures. amputations System of and contributed technical on new It is our proud office to tend the fleshly tabernacle of Surgery, many papers technique and instruments to the medical journals. All the immortal spirit, and our path, if rightly followed, the his chief interest was in his labora- will be guided by unfettered truth and love unfeigned. time, however, tory and to him surgery rested upon the wide basis of In the pursuit of this noble and holy calling I wish you all God-speed." pathological study. In writes in an emi- The conditions of surgery in that day, however, are these pages Sir Rickman Godlee " nently readable and charming style of that wonderful now almost inconceivable. Any attempt to realise what teachers and students in career of 85 years, whilst the finely executed portraits' taught learned, and, fact, with which the volume abounds give an added interest what all doctors thought about hospital diseases in 1865, like to the state of mind of the to the volume. Lister was the son of a very remark- is trying appreciate inhabitants of this before had to able man, Joseph Jackson Lister a Quaker, a vintner, planet they begun doubt that it was the of the writes a Fellow of the Royal Society, and one who did much centre universe," Rickman was to bring microscopes and optical apparatus to their Sir Godlee. "Hospitalism rampant.... and the wards were dominated present day condition of perfection. Wisely, Sir Rick- surgical by erysipelas, and When a man Godlee allows Lister to tell much of his own story septicemia, gangrene. surgeon operated to was an his to the father to whom in those days, what he hoped obtain open in abstracts from long letters ' wound with laudable he was so devoted. It was customary in Lister's day streaming pusThe mortality rates after of limbs were 43 cent, at for predatory Scotch surgeons to qualify in the North amputation per cent, at and then to seek livelihood and fame in the more Edinburgh Infirmary, 39 per Glasgow Infirmary, and some 75 to 90 cent, in genial and more wealthy atmosphere of the Southern per military practice; Syme had as his reasoned conclusion that in kingdom. Li.=ter reversed this procedure; he qualified indeed given it all fractures of the lower immediate from University College Hospital, took the F.R.C.S. compound limb, to be resorted and no be (England) in 1852, and went to Edinburgh. Here he amputation ought to, attempt made to save the limb. The among women became house surgeon to that remarkable surgeon and mortality in child-birth was like wonderful teacher, James Syme, who welcomed such from puerperal sepsis something 1 in and in the land was a a recruit with open arms. Syme's consulting rooms 7, every lying-in hospital horrible focus of dirt and death. In many were in the city, but he had a charming house at Mill- hospitals or wards had had to be closed on bank, once a pleasant suburb of Edinburgh, but to-day surgical maternity of in frock swamped in the midst of its slums,?a house which account sepsis. Surgeons operated filthy coats encrusted with an accumulation of years of was the meeting place of a distinguished band of blood, and their assistants attempted to secure Edinburgh surgeons and intellectuals and foreign and pus dirt; equal- whilst the for operation were learned distinguished visitors. From the very com- ly filthy coats, ligatures carried, as badges of honour, in the buttonhole of the mencement Syme's influence and his system of clinical " of the coat. reigned supreme; I have teaching exercised the greatest influence upon the lappet Sepsis come to the wrote Cadge of Norwich, a career of Lister. Lister was exceedingly well qualified, conclusion," well known "that if it does not find as far as London standards then went; in Edinburgh, surgeon, pyaemia, its does find its natural home and resting- however, he found established a school of surgery birth-place, in if and although a hospital may not whith was far in advance of London standards, and in place hospitals; be the mother of it is its nurse." Erichsen, a Sir Rickman Godlee's pages we have here presented an pyemia, of the had written a interesting account of that celebrated Edinburgh school; distinguished surgeon day, just book in which he claimed that surgery had reached also indeed of the very acrimonious controversies which it was too to the abdominal abounded between the chief protagonists of the day, finality; dangerous open " or other and all that remained in the way Edinburgh, Syme, super-house-surgeon," wrote body cavity, of future was to the of the Sir George Buchanan, his fellow student, from Univer- progress improve technique March, 1925.] REVIEWS. 135 the limbs. then-existant operations upon Leibig, the wound out with it after operation, and covering it with that in a wound German chemist, taught suppuration a small dressing of lint soaked in the crude acid and access to of the was due to the it oxygen of the air; covered with a sheet of tin or lead foil in order to and matters this could not possibly be excluded, hence keep the volatile acid in contact with the wound. The could All sorts of measures were not be improved. result was to produce a sterile scab, under which the tried; giving a greatly increased space to the beds in wound healed aseptically. the wards, immersing operated-upon limbs in surgical He soon realised, however, that the crude undiluted continuous water baths, testing different drugs and reme- acid was unsuitable, and commenced to use lotions of dies in solution in dressings; nothing succeeded. Con- 1 in 20 and 1 in 40 strength ; strengths which we to-day ditions were such as to appal Lister and every other recognise as still irritant to the tissues. In 1867 he surgeon of the day. Lister was busy with a thinking the first of his famous papers upon the anti- of the exact position of the abdominal, aorta and published study principle, giving the wonderful results obtained the details of excision of the wrist, but his septic thoughts in his first series of 11 cases of compound fracture were continuously upon the subject of inflammation treated with carbolic acid.