CoChat
Sign Up
Cited by 75Medical History and InnovationsHistory of Science and MedicineHistory of Medical Practice

Joseph Lister and the performance of antiseptic surgery

Open access
Worboys, Michael·2013·Notes and Records of the Royal Society
DOI 10.1098/rsnr.2013.0028PMC PMC3744349
Open this paper in CoChat — free account

Abstract

This article highlights a neglected feature of Joseph Lister's work, namely how, in addition to promoting germ theories and the principles of the antiseptic system, he also devoted much time and effort to communicating the performative aspects of antisepsis and of the many other surgical innovations that he developed. Attention to ‘detail’ and striving for ‘improvement’ were crucial to Listerian practice, and he sought to convey his credo in three main ways: first, his publications aimed at ‘bringing the subject out in the same sort of way as it had been worked out by himself’; second, he set out strict protocols and information on materials and methods, yet also encouraged surgeons to improvise; and third, he made himself an exemplar of a new form of professionalism, which made constancy and vigilance in practice a moral duty for surgeons.

AI snapshot

Written from the paper’s full text.

TL;DR

Worboys argues that Joseph Lister’s published writings and lectures were not merely programmatic statements of germ theory but also performances that taught surgeons how to do antiseptic surgery. He shows Lister communicated attention to detail, materials, technique, and professional vigilance through detailed case histories, protocols, demonstrations, and exemplars.

Key findings

  • Lister sought to convey the performative aspects of antisepsis in three main ways: publications that recreated how he had worked out the subject; strict protocols on materials and methods while encouraging improvisation; and his own exemplification of a new professionalism in which constancy and vigilance were moral duties.
  • His 1867 *Lancet* series began with James Greenlees and three other patients, followed by four articles describing a further seven cases, plus a fifth article on abscesses in July 1867; over the next decade he described a further 36 cases in detail.
  • The paper challenges the view that Lister’s writings were unhelpful because tedious or confusing, siding instead with contemporary followers who saw them as detailed and precise enough to enable emulation, with later changes representing improvements.
  • Examples of performative communication include Lister’s 1870 Franco-Prussian War plan recommending washing wounds with a 1 in 20 carbolic acid solution, his 1875 Edinburgh demonstrations where surgeons were eye-witnesses to staged operations, and William Watson Cheyne’s 1882 *Antiseptic Surgery* with step-by-step instructions and illustrations.

Methods

  • Historical analysis and rereading of Lister’s published articles and lectures, including the 1867 *Lancet* series, the 1868 Glasgow Medico-Chirurgical Society address, the 1870 war plan, the 1875 Edinburgh address, and the 1883 patella-fracture address.
  • Qualitative interpretive argument using quotations, case examples, and secondary scholarship, including work by Christopher Lawrence and Richard Dixey and by Anne Crowther and Marguerite Dupree.
  • No formal sampling, statistical analysis, or systematic outcome measurement is presented; the paper is an essay in the history of medical practice and communication.

Limitations

  • No limitations section is present; the paper does not state formal limitations.
  • The text makes evident that the argument rests on the author’s rereading of Lister’s published articles and lectures and on cited secondary literature, rather than a comprehensive survey of unpublished records or all contemporary responses.
  • The analysis is interpretive and does not provide a systematic quantitative assessment of the spread, uptake, or outcomes of antiseptic methods.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1098/rsnr.2013.0028

Cites

16 of 16 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 7 cited sources checked · 0 supported · 0 flagged

  • Findingreasoning

    In the programmatic pieces Lister cited groups of cases and statistics, but typically he did not describe performance.

    “in the programmatic pieces Lister cited groups of cases and statistics, but typically he did not describe performance.”
    Quote in the paperSubstantial claim
  • Findingreasoning

    Throughout his career Lister continued his interest in the technical minutiae of wound management.

    “Throughout his career Lister continued his interest in the technical minutiae of wound management.”
    Quote in the paperNot a substantial claim
  • Findingnone given

    When the British Medical Association met in Edinburgh in 1875, Lister gave demonstrations in which surgeons were made eye-witnesses to the performance of antiseptically staged operations from start to finish.

    “When the British Medical Association met in Edinburgh in 1875, Lister gave demonstrations in which surgeons were made eye-witnesses to the performance of antiseptically staged operations from start to finish.”
    Quote in the paperNot a substantial claim
  • Interpretationown data

    Lister's addresses and articles were detailed and precise to enable his practices to be readily emulated.

    “My rereading leads me to side with his contemporary followers and supporters, who maintained that his addresses and articles were detailed and precise to enable his practices to be readily emulated”
    Quote in the paperSubstantial claim
  • Interpretationnone given

    Lister made himself an exemplar of a new form of professionalism, which made constancy and vigilance in practice a moral duty for surgeons.

    “third, he made himself an exemplar of a new form of professionalism, which made constancy and vigilance in practice a moral duty for surgeons.”
    Quote in the paperSubstantial claim
  • May combine two claims. 14
  • Classified as probably not a substantial claim. 9

  • May combine two claims.

    Findingcitation

    Many surgeons were never persuaded by Lister and antisepsis, and others had a 'pick and mix' approach.

    “In the case of Lister and antisepsis, many surgeons were never persuaded, and others had a ‘pick and mix’ approach.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Probably not a substantial claim: may not pass S4 (based).

    Findingnone given

    In all instances, Lister provided step-by-step instructions of what to see and do, when and how to do it, and how to assess outcomes.

    “In all instances, Lister provided step-by-step instructions of what to see and do, when and how to do it, and how to assess outcomes.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingnone given

    Lister published on antisepsis in two modes: clinical studies with case histories, and programmatic statements linked to germ theories.

    “Lister published on antisepsis at this time in two modes: first, clinical studies in which his principles and practices were set out in the context of case histories of individual patients; and second, programmatic statements linked to germ theories”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Findingnone given

    Lister was unusual, especially in the 1860s and 1870s, for publishing lengthy pieces and series.

    “however, Lister was unusual, especially in the 1860s and 1870s, for publishing lengthy pieces and series.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Lister's professionalism was seen not only in his demeanour and character, but also in his operative performance at every level: no detail was too insignificant for his attention, and these myriad details were the basis of his surgical system.

    “Third, Lister's professionalism was seen not only in his demeanour and character, but also in his operative performance at every level: no detail was too insignificant for his attention, and yet these myriad details were the basis of his surgical system.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Thomas Schlich has recently shown that such claims were largely rhetorical, because Lister's antiseptic practices were not based on specific laboratory findings or tests.

    “Thomas Schlich has recently shown that such claims were largely rhetorical, because Lister's antiseptic practices were not based on specific laboratory findings or tests.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [43]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Crowther and Dupree have pointed to the importance of performance in Lister's classes, noting that by the mid-1860s his operations were the main way of teaching his antiseptic technique.

    “Crowther and Dupree have also pointed to the importance of performance in Lister's classes, noting that ‘By the mid-1860s his operations were the main way of teaching his antiseptic technique.’”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [39]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    The many changes over time in Lister's methods were improvements, showing progress in his methods.

    “and that the many changes over time were improvements, showing progress in his methods.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The spread of antiseptic methods was neither easy nor rapid, and exactly how Lister's principles and practices were used varied greatly across medicine.

    “In recent decades, many studies have shown that the spread of antiseptic methods was neither easy nor rapid, and that exactly how Lister's principles and practices were used varied greatly across medicine.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [7]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • Classified as probably not a substantial claim. May combine two claims.

    Interpretationown data

    Lister, as an experienced and effective clinical teacher, was aware of the problems of communicating surgical methods and sought to deal with this by including the performative aspects of antiseptic and other methods in his writings.

    “My reading of Lister's published lectures and articles is that, as an experienced and effective clinical teacher himself, he was only too aware of the problems of communicating surgical methods and that he sought to deal with this by including the performative aspects of antiseptic and other methods in his writings.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The embodied knowledge and skills of Lister's students were important, and Lister was a role model of a gentleman professional.

    “Anne Crowther and Marguerite Dupree's recent exploration of the diaspora of Glasgow and Edinburgh medical schools has shown the importance of the embodied knowledge and skills of his students; not just their technical knowledge, but also the way in which Lister was a role model of a gentleman professional.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [11]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationnone given

    Lister set out strict protocols and information on materials and methods, yet also encouraged surgeons to improvise.

    “second, he set out strict protocols and information on materials and methods, yet also encouraged surgeons to improvise”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Lister stressed that his new methods were based on principles he took from the germ theory of putrefaction, and he changed both his principles and practices from the 1860s to the 1880s.

    “Christopher Lawrence and Richard Dixey have demonstrated the importance to Lister of stressing that his new methods were based on principles he took from the germ theory of putrefaction, and they show how he changed both his principles and practices from the 1860s to the 1880s.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [10]

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • May combine two claims.

    Interpretationreasoning

    Lister's articles consistently advocated the importance of attention to detail in all aspects of surgical practice, not just in antiseptic methods; he also encouraged problem-solving through improvisation and experiment.

    “Second, and at a more general level, his articles consistently advocated the importance of attention to detail in all aspects of surgical practice, not just in antiseptic methods: he also encouraged problem-solving through improvisation and experiment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Interpretationreasoning

    Every aspect of the antiseptic system was contested by Lister's contemporaries, not because his critics were ignorant, prejudiced or wrong, but for very good reasons given the surgical knowledge and methods at the time.

    “Both these claims are, of course, ahistorical and we now understand that every aspect of the antiseptic system was contested by Lister's contemporaries, not because his critics were ignorant, prejudiced or wrong, but for very good reasons given the surgical knowledge and methods at the time.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    Lister's writings were long-winded in comparison with modern style and taste, but such prolixity was typical of his era.

    “Lister's writings were long-winded in comparison with modern style and taste, but such prolixity was typical of his era”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    Many histories of Listerian antisepsis have tended to focus on the programmatic papers and ignore the seemingly mundane and technical clinical articles.

    “Many histories of Listerian antisepsis have tended to focus on the programmatic papers, which tended to prompt the strongest reactions from his critics, and ignore the seemingly mundane and technical clinical articles.”
    Quote in the paperNot a substantial claim
17 of 17

Cites

Flagged first, then by citations

Cited by

Sorted by citations

Related

Authors
Worboys, M.
Affiliations
University of Manchester (GB)
Corresponding author
Worboys, Michael
ORCID
Worboys, Michael
Venue
Notes and Records of the Royal Society
Publisher
The Royal Society
Published
2013-05-22
Volume
67
Issue
3
Pages
199-209
ISSN
  • 0035-9149 (ISSN-L)
  • 1743-0178
DOI
10.1098/rsnr.2013.0028
PMC
PMC3744349
OpenAlex
W1968164807
Cited by
75
References
16
Citations by year
2026: 4 · 2025: 2 · 2024: 29 · 2023: 4 · 2022: 5 · 2021: 5 · 2020: 7 · 2019: 3 · 2018: 6 · 2017: 2 · 2015: 3 · 2014: 2 · 2013: 3
FWCI
57.60
Type
journal article
Language
en
Open access
Licence
Locations
  • Notes and Records the Royal Society Journal of the History of Science (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Explorer (The University of Manchester) (submittedVersion, other-oa)
Funders
Wellcome Trust
Topics
  • Social Sciences › Arts and Humanities › History › Medical History and Innovations
  • Social Sciences › Arts and Humanities › History and Philosophy of Science › History of Science and Medicine
  • Health Sciences › Medicine › Surgery › History of Medical Practice
Keywords
Joseph Lister, antiseptic surgery, germ theory, surgical antisepsis, surgical innovation, medical communication, surgical protocol, history of surgery

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-30.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-30.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review