Joseph Lister
Edinburgh position

In June 1864, the Professor of Systematic Surgery in Edinburgh James Miller, died. The Edinburgh chair was considered the most prestigious within the Scottish medical community and came with an annual stipend of between £700-£800 per year. Syme and his friends suggested that Lister should apply as his candidature was all but assured. A number of reasons have been advanced on why Lister applied. In a letter to his father, he said that he saw Glasgow as a stepping stone. There were a multitude of reasons either to stay or go. He was drawn to research, his friends were there and he found the routine nature in Glasgow, "working in a corner". There was also the fact that his tenure only lasted 10 years. Testimonials from Christison, Paget, Buchanan and Syme followed the application. By the end of June, Lister was convinced the position was his. However, the chair went with James Spence instead. Lister was disappointed and in social settings tended to solipsism in conversation, but by October his father, in a letter said that it was, "very gratifying to learn thy complete reconcilement to remaining at Glasgow".

Before he received the disappointing news, Lister had been called back to Upton as his mother Isabella was on her deathbed. She died on 3 September 1864. His father was now living alone at Upton as the only daughter left at home had married in 1858. Communication with his children became of paramount importance to Joseph Jackson and he started to send Lister a letter every week, stating in October "The thought that thou wilt look for letters from thee weekly, and the letters when they come, are alike gratifying to thy poor father.

On 1 November, Lister began the winter lecture course that was divided into two divisions: Those conditions common with tissue and organs and those conditions of physiology. His first lectures were on blood, then nerves, then detailed special nerves which explained the process of inflammation. In introducing the subject, he stated that any injury that didn't cause death would result in inflammation with the familiar symptoms of redness, swelling and pain. These symptoms were indicative of "inflammatory congestion" that is the suspension of vital energy, which began with red corpuscles adhering together, that are caused by fibrin, which itself was caused by two substances in the blood, one in the blood cell and one in liquor sanguis (plasma). He described two types of inflammation, direct and indirect, direct by a noxious agent and indirect by "sympathy" which was an indication that Lister's frame of references was wholly inadequate. He then provided various examples and examined various types, for example acute, latent or chronic. The following lectures were devoted to explaining how to alleviate the symptoms of inflammation, for example raising a limb to enable blood to flow easier, or reducing tension for example, by draining an abscess. The remarkable aspect of Lister's theory of inflammation was that while the details of the observations were correctly made, the theoretical structure used to explain the observations was completely wrong. Lister's error lay in his belief that inflammation was a "unitary disease", a single underlying disease when in effect it was a range of conditions. The second division of the lecturers focused on the heart, blood vessels, lymphatic system, bones, joints and nerves.

Lister and Agnes spent Christmas 1864 with Joseph Jackson at Upton. In January, Lister attended a quite unusual operation by Syme in Edinburgh, whereby a patient's tongue was removed. A month later, Lister received an interesting letter from Jackson on fees that indicated Lister's growing private practice that he began in 1861. His practice was unusual as it was solely dedicated to surgery, during a period when operations either took place at the doctor's surgery or at the patient's home. In March 1865, Lister along with his colleagues became involved in the case of the murderer Edward William Pritchard who was employed as a doctor in Glasgow. Prichard had broken his oath. In a letter to his father, Lister expressed his sincere hope that he would be hung.
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