Editor's Note: Historic Milestones is a new publication that will appear on a periodic basic as supplement to Milestones, the John Templeton Foundation monthly newsletter. Historic Milestones aims to provide context — a point of comparison, if you will — for the research funded by the John Templeton Foundation. "My major aim," Sir John says, "is to help those relatively rare and visionary entrepreneurs who are trying to link spiritual progress with scientific methods."
- Marban M. Sparkman <milestoneseditor@templeton.org>

A boy with a skinned knee limps tearfully into the house. While slicing a tomato, the knife slips and a woman cuts her thumb. What's the first aid in both injuries? Putting a salve on the wound to prevent infection. This is now so ho-hum a medical treatment, we've nearly forgotten what a momentous discovery it was when Sir Joseph Lister discovered antisepsis. By trusting his own instincts, rather than conventional wisdom, Lister showed that progress in science — as in religion — often requires a leap of faith.

Lister's courage still resonates. Indeed, in the current New York Times best-selling book, Complications: A Surgeon's Notes on an Imperfect Science, Dr. Atul Gawande describes attending a forum convened by the American College of Surgeons in Chicago. Dazzled by new techniques for bioengineering the human liver, Dr. Gawande writes, "I experienced a sudden giddiness upon realizing what these doctors had done. And I began to wonder if it was at all like what Joseph Lister's colleagues at the Royal College of Surgeons had felt when he first presented his findings on antisepsis, nearly a century and a half ago."

Joseph Lister was born in Upton, England, on April 5, 1827. As a young man, he learned about the natural sciences from his father, Joseph Jackson Lister, a physicist who made important modifications to the microscope. Lister fils received a medical degree from University College, London. Upon graduation, he became an assistant to surgeon James Syme at the University of Edinburgh, and subsequently married Syme's eldest daughter, Agnes. Their marriage is of note for it was Agnes' command of French that allowed her to translate the works of Louis Pasteur, which would play a key role in her husband's career.

Lister was appointed Regius Professor of Surgery at the University of Glasgow in 1859. However, he was teaching the surgical trade at a time when medicine was practiced very differently than it is today. Surgery was known in ancient times — Egyptian papyrus scrolls from 1600 B.C. describe the use of linen thread and animal sinews to suture battle wounds — but its general practices advanced very slowly. For example, bleeding wounds were cauterized with boiling oil for centuries, and before the discovery of anesthesia, patients were simply lashed to an operating table.

In Lister's time, doctors themselves were held in low esteem and in many of the best homes were required to enter through the servants' doorway. Much of the aversion they provoked was doubtless due to the squalid environment in which doctors, and especially surgeons, worked. Surgeons operated without facial masks or gloves, sanitary devices that wouldn't be used for decades. Often they didn't even wash their hands before beginning to operate. Surgeons went about their work in street clothes or, worse, in smocks stiff with dried blood from past operations. Though it seems unimaginable, doctors would customarily begin their workday performing autopsies and proceed directly to operating on the living.

As a result of infection, nearly half of all surgical patients died and innumerable women succumbed within a few days of childbirth. The cause for such shockingly high morbidity rates was unknown, though it was postulated that there was a poisonous vapor in the air and that infection was a combustion caused by the exposure of moist body tissue to oxygen.

Lister began to doubt this theory.

By reading the translated works of Pasteur, Lister learned that post-operative infection was putrefaction caused not by the air itself, but by air-borne bacteria which appeared under the microscope as tiny moving bodies. Lister advanced this thinking to suggest that suppuration — or the forming of pus in a wound — was actually a form of decomposition caused by bacteria, those same tiny moving bodies. Pasteur's theories were not then widely accepted and Lister's attempts to build on their foundation were scoffed at by contemporary surgeons, unwilling to consider that microscopic elements could significantly affect human life.

"Where are these little beasts?" asked John Hughes Bennett, a contemporary of Lister, and a well-respected professor in Edinburgh. "Show them to us, and we shall believe in them. Has anyone seen them yet?"

Undaunted by such criticism, Lister began to use a carbolic acid treatment to clean wounds. He gradually refined his methods, suggesting that surgeons wash themselves and especially their hands with this disinfectant liquid before and during surgery. He insisted on meticulously clean wards, operating instruments and patients' dressings. Eventually, he realized that the most effective approach combined both antisepsis- killing infective agents in the wound - and asepsis, or preventing infective bacteria from getting into the wound. Though he first published his results in a series of articles in the Lancet in 1867, it wasn't until he successfully treated Queen Victoria for an abscess that Lister's innovative thinking began to be taken seriously. More importantly, during the Franco-Prussian war in 1871, his disciples, the Listerites," reported that antiseptic surgical techniques practically eradicated blood poisoning and gangrene among their patients.

Only by breaking free from the accepted thinking of his day was Lister able to influence the future course of medicine.

He was knighted in 1883 and raised to the peerage in 1897, thus becoming the first doctor to sit in the House of Lords. Nearing retirement in 1891, he became chairman of the newly formed British Institute of Preventive Medicine, later named the Lister Institute.

Even Lister could not have foreseen how transformative his breakthrough would ultimately be. The combined discoveries of sepsis and antisepsis set the stage for modern medicine. Working in scientifically "clean fields", surgeons were free to concentrate on the art of surgery. By 1929, Sir Alexander Fleming, pursuing the study of bacterial infection, had discovered the basis for penicillin which, when commercialized during World War II, became the first miracle drug. Today, Lister's seminal theory of infection is heralded as the basis for epidemiology, which through the years has helped control such scourges as smallpox, AIDS, and, it is to be hoped, will help contain SARS. Finally, there is a clear link from the anatomically-based scientific medicine that Lister pioneered to later developments ranging from vaccinations to antibiotics and anesthesia.

Can the same courage, vision and rigorous methodology exemplified by scientists like Lister that have led over centuries to our present knowledge of the material world also lead to a greater understanding of spirituality? That question underlies the research at the intersection of science and religion that is sponsored by the Templeton Foundation.

Though no one can predict in advance where such scientific inquiry into spirituality will lead, as Sir John writes in his recent book, Possibilities, "The important thing is to get started and begin accumulating insights based on experience."

Stephen Henderson, a writer based in New York City, contributes frequently to the New York Times, The Baltimore Sun, Town & Country, and Religion News Service, as well as other publications.