Books: The Butchering Art: Joseph Lister’s Quest to Transform the Grisly World of Victorian Medicine

From the start, Lindsey Fitzharris’s account of the life and times of surgeon Joseph Lister gleefully evokes the smells, sights, and sounds of mid-nineteenth century medicine. Surgeons in bloodied aprons used instruments still filthy from previous operations to perform amputations in seconds, slicing through testicles and assistants’ fingers in their haste.

Little wonder that operating theatres were known as ‘gateways of death’ as half of those undergoing surgery did not live to tell the tale. A broken leg could lead to amputation and surgeons were still pillaging cemeteries to obtain cadavers.

The advent of anaesthesia in the 1840s offered surgeons the opportunity to undertake longer, more complex operations, but outcomes remained appalling due to the postoperative suppuration that Fitzharris vividly describes. Smells outside hospitals feature prominently too, as Fitzharris relates the career progression of Quaker surgeon Joseph Lister through the reeking Victorian streets of London, Edinburgh, and Glasgow.

Lister developed a technique of antiseptic surgery, using carbolic acid to disinfect wounds during and after surgery. He constantly worked to refine his carbolic spray device, which surrounded the operation site with an antiseptic mist, and his irrigation techniques. Contemporaries were initially sceptical (doctors were mystified why infections kept the death rate so high) but Lister was tireless in promoting his system, which soon became widely accepted and ultimately resulted in Lister’s ennoblement.

Some might find the book’s American spelling a little irksome, and this highly graphic account of the smells of hospital wards, the sounds of agonised patients, and the sights of the ‘Butchering Art’ of surgery might have benefited from a few pictures. Fitzharris occasionally tends towards an uncritical account of Lister, and not all historians would accept her implication that Lister, with his enthusiasm for microscopy, pre-empted the discovery of germ theory. But Fitzharris is a medical historian with a deep knowledge of her subject, and her account is fun, fascinating, easy to read, and assumes no prior historical knowledge. It deserves a place by the bedside of any clinician interested in a glorious pus-and- blood-filled romp through this aspect of the history of their profession.

• © British Journal of General Practice 2018