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Joseph Lister was very talented with the microscope. Which helped him make new discoveries.

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Not only is she an author but she is also a medical historian. This means she studies how they used to treat patients in other time periods. Her job helped her be able to write such a descriptive story on Joseph Lister.

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Jack the Ripper used this knife during his killing spree in 1888

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"Back in England, the debate continued to rage over the advantages of microscopic pathological anatomy. Lister, however, was his father’s son. At UCL, he showed himself to have a better grasp of the complex instrument’s workings than most of his professors."

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"Some surgeons customized their knives to suit their preferred techniques. Robert Liston—who was said to carry his scalpels up his coat sleeve to keep them warm—designed his very own amputation knife, which was considerably larger than the norm, with a blade fourteen inches long and one and a quarter inches wide... It is little wonder that for Jack the Ripper, the “Liston knife” was the weapon of choice for the gutting of victims during his killing spree in 1888."

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Click on the link below for reviews on the book

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Books of The Times

Books about Victorian medicine are an acquired taste. They're science by way of B-horror movies, tales of progress set amid blood and spatter and gray guts. To enjoy them requires a tolerance for ick, an enthusiasm for the macabre and (ideally) the iron discipline not to read before supper, especially if that supper is a nice steak.

Lindsey Fitzharris's slim, atmospheric "The Butchering Art: Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine" has its share of resplendent gore. (The author, a medical historian, has a charming blog and a YouTube series called "Under the Knife.") The book is an imperfect first effort, stronger at the beginning than at the end, and a bit workaday when it isn't freaky - it floats less on narrative momentum than on an armada of curious details. But the story it tells is one of abiding fascination, in part because it involves a paradigm shift so basic, so seemingly obvious, that one can scarcely believe the paradigm needed shifting in the first place.

Yet it did. What Lister saw, which his colleagues did not, was that doctors in the Victorian era were making people sick. "The Butchering Art" traces his efforts to revolutionize medicine through one deceptively simple notion: Cleanliness.

As hard as it is to fathom now, surgery was once a filthy enterprise. Operating theaters were as dirty as London was, their surgeons as grimy as chimney sweeps. Doctors seldom washed their hands. They used the same instruments in successive procedures without cleaning them. "It was not uncommon," Fitzharris writes, "to see a medical student with shreds of flesh, gut or brains stuck to his clothing after his lessons were over."

Dissection rooms were perhaps the most gruesome environments of all. Hector Berlioz, who briefly studied medicine before becoming a composer, found them so repulsive that he dove out of a window to escape, unable to bear the sight of rats nibbling on vertebrae and sparrows snacking on scraps of lung. Less sensitive students were known to duel with severed legs and arms.

Hospitals probably killed as many people as they saved in those days. When his sister needed a mastectomy, Lister opted to perform the operation on his dining room table, knowing the odds for a safe convalescence were far better at home than at work. (She survived the operation, dying a few years later from a recurrence of cancer in her liver.) Four types of infection - erysipelas, septicemia, pyemia and gangrene - regularly took the lives of hospitalized patients. The idea that the doctors' own squalid hygiene played a role in spreading these infections didn't cross many people's minds. Most medical professionals believed poisonous vapors, or "miasma," were to blame.

Lister was one of the first surgeons outside of continental Europe to question this logic. "It is a common observation that, when some injury is received without the skin being broken, the patient invariably recovers," he once told his medical students. "On the other hand, trouble of the gravest kind is always apt to follow, even in trivial injuries, when a wound of the skin is present. How is this?"

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Lindsey Fitzharris Credit Adrian Teal

"The Butchering Art" tells Lister's story in simple chronological fashion, showing how the doctor came to embrace Louis Pasteur's germ theory, which stipulated that microbes were the cause of disease, and how this belief then guided Lister to establish a series of antiseptic protocols when treating his patients. These protocols would one day become standard and save countless lives.

Lister's patients were blessed with a kindly, generous physician. Fitzharris, on the other hand, was cursed with an amiable subject, which perhaps makes him a less exciting figure than other hothead surgeons of his day. He was shy and gentle and spoke with a stutter. His students adored him; he married a smart, sensible woman; he came from a supportive Quaker family; and he wrote weekly letters to his father after his mother died.

The real drama in Lister's story comes from the resistance he faced to his theories. After he published the last article in a five-part series in the medical journal The Lancet, carefully outlining his system for killing "septic germs," the establishment drew its knives. The inventor of chloroform wrote under a pseudonym to complain that Lister was taking credit for having discovered the miracles of carbolic acid. (He wasn't.) Others accused him of fearmongering, dismissing Pasteur's germ theory as pure hooey. The editor of The Lancet himself refused to use the word "germ."

"It was difficult for many surgeons at the height of their careers," Fitzharris writes, "to face the fact that for the past 15 or 20 years they might have been inadvertently killing patients by allowing wounds to become infected with tiny, invisible creatures."

It's an unhappy reminder that hubris is a terrible impediment to progress.

Lister also had trouble selling his ideas in America, a country that lost tens of thousands of soldiers in the Civil War because field doctors had mismanaged their injuries, letting their suppurating wounds fester for their "laudable pus." (In England, too, many doctors believed that pus and inflammation were signs of healing, not danger.) Unmentioned but also relevant: President James A. Garfield may have survived his assassin's bullet in 1881 if his doctors hadn't probed the wound with dirty fingers and unsterilized instruments.

Yet Lister's ideas eventually prevailed. The fact that he operated on Queen Victoria in 1871 for an abscess in her armpit probably helped; it was useful, too, when his intellectual opponents died off. But a question that tantalizingly lingers at the end of "The Butchering Art" - one the author never fully explores - is: Why did Lister get all the credit for making the connection between hygiene and infection?

There were, after all, others - most famously the Hungarian doctor Ignaz Semmelweis. In 1847, he hypothesized that puerperal fever was spread by doctors carrying "cadaverous particles" from the deadhouse to the obstetrics ward at Vienna's General Hospital. When he set up a basin filled with chlorinated water and enjoined his colleagues to do something radical after autopsies - wash their hands - mortality rates plummeted.

The establishment still rejected Semmelweis's hypothesis when he published it. Over the years, Fitzharris writes, his behavior grew increasingly erratic. He was eventually committed to an asylum.

Lister, meanwhile, lived to a ripe old age and got a mouthwash named after him. Timing, personality and geopolitics always help determine who earns the garlands for innovation. But it's sad to think that Semmelweis never lived to see the vindication of his theory. He died in that asylum, possibly from an infection, believing that his contribution had been bleached from the record.

Follow Jennifer Senior on Twitter: @JenSeniorNY.
The Butchering Art
Joseph Lister's Quest to Transform the Grisly World of Victorian Medicine
By Lindsey Fitzharris
286 pages. Scientific American/Farrar, Straus & Giroux. $27.

A version of this article appears in print on , on Page C5 of the New York edition with the headline: Wash Up, Doc: How Hospitals Became Clean. Order Reprints | Today's Paper | Subscribe

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The Story of How Surgeons Cleaned Up Their Act

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Books of The Times Books about Victorian medicine are an acquired taste. They're science by way of B-horror movies, tales of progress set amid blood and spatter and gray guts. To enjoy them requires a tolerance for ick, an enthusiasm for the macabre and (ideally) the iron discipline not to read before supper, especially if that supper is a nice steak.

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"LITTLE JOSEPH LISTER STOOD ON his toes and put his eye to the ocular lens of his father’s latest compound microscope. Unlike the foldaway versions that tourists tucked in their pockets and carried with them on trips to the seaside, the instrument before him was something altogether grander. It was sleek, handsome, powerful: a symbol of scientific progress."

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Listen to a portion of the book

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Check out this great listen on Audible.com. The gripping story of how Joseph Lister's antiseptic method changed medicine forever In The Butchering Art, the historian Lindsey Fitzharris reveals the shocking world of 19th-century surgery on the eve of profound transformation. She conjures up early...

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Lindsey Fitzharris made a book trailer for her then new book The Butchering Art, on her Youtube channel, Under The Knife.

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Lindsey Fitzharris, the author of The Butchering Art, was born on May 11, 1982 in England. She is a very successful author, known most famous for The Butchering Art. She also started the blog, The Chirurgeon's Apprentice and has hosted the YouTube video series Under the Knife.

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In The Butchering Art, Lindsey Fitzharris explores the unsafe world of 19th-century surgery, showing how Lister struggled to determine the basis of infection and to establish his pioneering antiseptic system. One problem was that hygiene was nonexistent. “The surgeon, wearing a blood-encrusted apron, rarely washed his hands or his instruments and carried with him into the theatre the unmistakable smell of rotting flesh,” writes Fitzharris, who never misses a chance to compound the horror in her writing. The theatre was packed for Liston’s demonstration in 1846 which made it not just stuffy but extremely hot.

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By Lindsey Fitzharris