What’s the most important advance in surgery of the last 200 years? Until Saturday, I’d probably have said ‘anaesthetics’. Like most people, it’s the thought of pre-anaesthetic operations that disturbs me most.
Now I know that any sensible patient awaiting removal of their gangrenous leg, or painful kidney stones, would have waved away the laudenum bottle in favour of a bar of carbolic soap. It wasn’t the pain, but the infection, that did for the pre-20th century surgical patient.
I’d been planning to visit the Old Operating Theatre and Herb Garret at London Bridge for some years. I finally got there on Saturday, when the snow whirling around Borough Market gave the whole area a Dickens-at-Christmas air. It was well worth the trip.
The museum itself, perched at the top of what was the 17th century St George’s Church, is pretty much all that remains of the original St Thomas’ Hospital, before the move to Lambeth. The visitor ducks into the church doorway, out of the snow, and opens a creaking wooden door. Beyond, a narrow spiral staircase leads upwards, with only a sturdy rope and a few signs to encourage ascent.
At the top, the space opens out into a fragrant wooden-vaulted attic room, the original herb garret, used as a store-room by the apothecary (later the medical officer) who was responsible for diagnosis, prescription and drug manufacture in the hospital.
On the evidence of these displays, it must have been fantastic fun being an apothecary. A handful of lavender blossoms, a few cloves, plenty of horseradish, an infusion of willow bark, and there you go. For the more embarrassing complaints, mercury pills. If you were a medieval apothecary, it was even more fun. A few sniffles? Try kissing this mouse, or grinding up a few snails. Nothing much worked (except probably the willow bark, which yields the basic ingredient for aspirin), but it must have taken your mind off the illness wonderfully.
Fun was probably in short supply in the operating theatre, a cold little room
that leads off from the garret. Right at the top of the building to take advantage of the light from the glass fanlight in the roof, the theatre was surrounded by wooden galleries for medical students to crowd in and watch.
There was precious little room around the little wooden bench for the four ‘assistants’, there to hold the unfortunate patient down. The patient would be stone cold sober, although a glass of brandy was on hand to revive anyone fortunate enough to pass out. The surgeon himself, covering his outdoor clothes with a bloodstained apron, probably prided himself on the speed with which he could lop off a limb. Speed was about the only thing on the patient’s side – not only did it keep the agony to a minimum, it also allowed less time for the wound to become infected.
I hadn’t realised how relatively late in the 19th century germ theory became accepted. It’s a chilling thought that all the operations carried out in this old operating theatre were in pre-antiseptic days, as the theatre itself closed when the hospital was moved in 1862.
The staff give informative and lively talks twice daily in the museum. It’s a fascinating place, highly recommended for anyone curious about how ever we managed before the age of modern medicine.