The History of Surgery in London's Museums - A Tour of The Old Operating Theatre _ 4 others

Did you know that a surgery took place in London in the 19th century that had a 300 percent mortality rate? It's true. I'm Jessica the Museum Guide and today I'm going to visit five different London museums to tell you all about the gruesome and grim history of surgery. But first let me tell you all about that ill-fated surgery that killed three men. Robert Liston, known as the fastest knife in the West End, is said to have once performed a surgery here in London with a 300 percent mortality rate. Surrounded by morbidly eager spectators who were, quote, packed like herrings in a barrel, as was common in the time, Liston amputated the leg of a patient in just two and a half minutes using a sharp knife called a Liston knife to shear off the flesh and skin like he was filleting a fish and then sawing swiftly through the bone with a bone saw. Though not his fastest amputation, he could do the job in less than a minute under the right conditions, he was still working quickly and in his haste he accidentally sliced off three of his assistant's fingers and then he slashed through the coattails of one of the spectators. The spectator was so frightened that he keeled over immediately of a heart attack. Soon after the patient died in the ward of gangrene, as many did in those days, and the poor assistant died of a hospital gangrene himself. Did that operation happen here at the old operating theater? Well, no one is sure. Did it ever even happen at all? Well, it might be apocryphal, but it's a great story and it's the perfect way to start our tour. We'll come back to Liston and his famous student Joseph Lister a little bit later on, but today we're talking about one grisly topic and visiting five museums to do so. The history of surgery in the 18th and 19th centuries and how it is represented and depicted in London's museums. Normally I focus on just one museum but today we're really traversing the capital. We're so lucky in London to have not just these museums but nearly two dozen which document the history of optometry, anesthesia, nursing, mental health and so much more. I've already covered some of these museums in depth, one in my 40-minute video on the Hunterian Surgical Museum which is just linked above and I also visited four of them for my 12 strangest museums in London video. However, there's a lot more to the story and I wanted to do a video that dives deeper into the history of the old operating theatre here on the South Bank near London Bridge. We'll be focusing mostly on this site but we'll also visit the fascinating St Bart's Hospital Museum and the Science Museum in Kensington as well as popping back into the Anesthesia Museum and the Hunterian. If you're new to my channel I'm delighted to have you here and I'd love to have you as a subscriber. If you're interested in a tour of the medical history of London please get in touch, it's one of my favourite topics to guide. I'm also really excited to share that in about three weeks time on June 7th I'll be launching my Patreon or if you're watching this in the future it's already launched. My patrons are going to have access to all kinds of cool bonus content including blind museum walkthroughs, special tours and even free in-person tours so be sure to check that out. I'll be posting another video when it's live. Now let's get started with the history of this unusual building known today as the old operating theatre museum and Herb Garrett. As the name Garrett suggests this is a top floor room museum located in an attic. You can see the way that I'm climbing this very narrow spiral staircase to get up into the museum. From this modest entryway you'd never guess what was upstairs. Once we walk through the charming Herb Garrett that details the medicinal history of the era we have one of the world's best preserved early Victorian operating theatres. We enter this space to see it just as it was back in the 19th century when surgery was on the cusp of respectability. See it in previously being looked down upon by physicians. After all to cut into a patient would lead to infection and near certain death. No we need three things for the advent of modern medicine. We need anatomical knowledge, we need pain relief and we need hygiene and we really need hygiene. Only then could we begin to use this nice hygienic wooden table for more than just amputations and cauterizations and actually begin operating on the abdomen and internal organs and that's the story that we're going to tell today. But we're getting ahead of ourselves. Let me zoom into the history of this building and this operating room before we talk more about the men and women who made modern medicine possible. As you can tell from the exterior of the building we are actually in a church not a hospital but this church was part of the broader old St Thomas Hospital located at the southeast corner of London Bridge. The hospital is one of London's oldest providing shelter and relief sometimes to the sick and needy since the 12th century. I say sometimes because medieval medicine it wasn't great more on that shortly. Now St Thomas Hospital has since moved to Lambeth in 1862 on the advice of Florence Nightingale who didn't approve of the stinky old buildings in this area. See she didn't believe in the germ theory of medicine. She would have scoffed at you for such silly woke ideas. She believed in miasma theory which most medical professionals believed in at the time. This was the belief that bad smells or bad air made you sick and so Nightingale extolled the virtues of long wide corridors big windows and fresh linens which of course had some positive effect because those things also reduced the presence of germs. Speaking of Florence Nightingale she rose to prominence after her battlefield nursing during the Crimean War. My one regret for this video is that I didn't spend enough time talking about battlefield surgery and its contributions to surgical knowledge at large. When I cover the Science Museum's medical wing in depth I'll definitely be sure to include more of it. Now we don't actually have a lot of information about operating theatres at old St Thomas from its foundation until the early 18th century. We know they likely existed because people have been performing surgeries with varying levels of success since ancient times but they have either been lost or forgotten. However in the years just prior to the construction of this room operations would have taken place on the ward and the ward was a germ-ridden putrid place riddled with gangrene and so success rates were low. The church we're standing in right now was built at the end of the 17th century when the hospital and church were mostly rebuilt. In 1822 part of this space previously used for storing medicinal opium poppies was converted into a purpose-built operating theatre to get the surgeries off of the ward and these windows were added to the building to provide light and air into the space as per miasma theory. The female surgical ward was in the adjacent building and we know that the surgeries that took place here were all on women. They would have been poor and expected to contribute to their care if they could afford it. Surgery patients would put up with the audience of men gathered around watching to their great distress because they would receive medical treatment from some of the best surgeons in the land which they otherwise could not afford. Those with more financial means would have minor operations in their own homes where the death rate would be much lower. It's almost like being in a clean space without being surrounded by countless septic wounds would improve your chances of survival. When the hospital moved in 1862 this operating theatre lay dormant and undiscovered until 1957. But before we talk even more about the surgeries that went on here in this old operating theatre we need to go back even further in time to explore monastic medicine and for this we'll head to a different medical museum located at Bart's Hospital which celebrated its 900th anniversary last year in 2023. Yes you heard me correctly 900th anniversary. Just a note people have been attempting to perform surgeries for thousands of years with common procedures including trepanation that is drilling a hole in the skull to relieve swelling and pressure and induce a euphoric state. Don't worry I would never touch it if it wasn't a replica but they've got a replica here of a trepaned skull that you can actually touch and feel the kinds of holes that would have been made. Creepy but fascinating. And people have also been performing cesarean sections for thousands of years which contrary to its name was not performed on Julius Caesar's mother. Until the advent of modern surgery with rare rare exception c-sections would kill the mother and often kill the baby as well. But I'm not focusing on ancient surgery today which was often far more advanced in other countries other than here in England. So if you fell ill in London prior to the 18th century your prospects were pretty grim even if you were wealthy. However if you were poor your odds of survival became even worse. Not only were cities regularly battling the plague, cholera, sweating sickness and tuberculosis even an infected hangnail could be your death. If you did get really sick you'd head to a local wise woman or an apothecary someone experienced in herbs as your first port of call. But if things got really dire you could perhaps rely on the medieval monastic hospitals which arise in the early middle ages. Well-educated monks and nuns had access to historical documents that contained medical information which was sometimes very bizarre but was seen as better than nothing. Of course monks also had a calling to serve God by helping people and as early as the year 500 they combined their knowledge and altruism to create the earliest hospitals in England though they were more like a combination of a hospice and a long-term care facility for some of society's most physically and mentally troubled people. Watch the segment about the Bedlam Hospital Museum in my video on the 12 strangest museums in London to learn even more. In medieval London monks offered treatment to other monks, pilgrims, paupers and even nobility though the wealthy usually had their own physicians and would receive treatments in their home away from the germs of the hospital although they didn't realize the germs were the problem. Monks practiced herbalism and bloodletting and of course they recommended prayer and pure thought but most of their physical treatments were useless at best and downright harmful at worse. For instance they practiced uroscopy that is examining and smelling your urine and often recommending you drink some for good measure. They'd also use a red hot iron up your rear end to treat hemorrhoids, perform cataract surgeries with needles which usually just blinded you and performed enemas with bear bile and other bizarre liquids and we can't forget the aforementioned bloodletting which I'll talk about at length later on in this video. They simply didn't understand the body nor did they know why certain treatments actually had positive effects and they certainly weren't going to cut very deep into you no deeper than blood letting because deep wounds in the body were certain death in the era before germ theory and hygiene which we'll get to. Remember people often went to the hospital at this time expecting to die it was pretty unlikely you would get well in this environment of filthy bedding septic wounds and unwashed hands but the monks did their best but they didn't have those three ever important fundamentals required for modern surgery and that is again of course knowledge hygiene and pain relief. So by the 15th and 16th centuries most of the anatomical knowledge in Britain and throughout Europe was still largely based on manuscripts from classical Greece, Rome and medieval Italy and from great minds such as Galen, Hippocrates and Pliny the Elder. Strict laws and rules were in place about the dissection of cadavers and so to gain better anatomical knowledge medical professionals were limited to the dissection of animals such as pigs and the occasional autopsy or post-mortem of a condemned criminal. But our man King Henry VIII here, here in his only outdoor statue in London above the entrance to St. Bart's Hospital, he changes that. He gave London's company of barber surgeons permission to dissect four corpses a year, hanged criminals of course, and we'll talk a lot more about the barbers a little bit later on. While this annual figure eventually increased to six cadavers under Charles II reign, it just wasn't enough for surgeons and apprentices to progress in their field and so other means of acquisition were sought and that brings us to grave robbers or as they like to be called the resurrection men. I speak about this profession at length in my video about the most macabre things in London's churches as well as in my video about the London Necropolis Railway, both of those linked above. These were men who for their profession dug up freshly buried corpses and sold them to medical students and to private anatomy colleges. Of course these cadavers were very much needed to advance surgical knowledge and so the resurrectionists often fancied themselves a vital part of the medical supply chain which was ghoulish but I mean undeniable. The valuable medical knowledge gleaned from post-mortem examination would be extended and prolonged by placing interesting body parts in jars which brings me back to the Hunterian Museum and also Bart's Pathology Museum. We've been inside the Bart's Hospital History Museum but the Pathology Museum is closed to the public except during special lectures and events for ethical reasons. I used to volunteer there so I will perhaps ask curator Carla Valentine if I can film a cheeky tour there in the future. Let me know in the comments below if you'd be interested. These wet specimens allowed medical students to learn more about the body and the myriad things that can go wrong with a body but of course these wet specimens often have dubious origins as they come from corpses snatched by the resurrectionists and along with potted organs and post-mortems by the 17th century the situation started to change as printed books of anatomical texts from Italy and France became more widely available. In addition judges began recommending anatomical dissection after a criminal's death by hanging. Public autopsy is a court-mandated punishment. I mean that's wild but it became quite common. However a series of parliamentary acts such as the Murder Act of 1752 and the Anatomy Act of 1832 gave the company of surgeons in London far more bodies to work with and body snatching eventually peters out and comes to an end. Of course as we're learning and dissecting to understand medical conditions medical professionals were also still treating maladies with their limited knowledge on a regular basis. In most cases as I mentioned you'd be treated with herbs and plants just like those here at the old operating theatre museum in the herb garret. Often the goal of medicine back then and we're using that term loosely was to cause a change or make you feel different. You don't necessarily need to feel better but they were just looking for some kind of reaction and that brings us back to bloodletting one of the most common medical treatments from ancient Egypt three thousand years ago right up into the late 19th century. Bloodletting was designed to balance the four humors of the body yellow bile phlegm black bile and blood that people believed controlled your health in the body. But we now know that in some rare cases bloodletting is exactly the right treatment. If a person has hemochromatosis a genetic disorder of excessive blood iron or polythycemia vera a blood marrow disorder that my grandmother actually had or porphyria an iron metabolism disorder bloodletting is just the trick and so if it worked for some it must work for all right? Right? So bloodletting became a really common minor surgery that was popular all over Europe and Asia. Women of menstruation age were bled quarterly while everyone else would go for a good bloodletting every month. This was all about trying to balance your humors if you had too much blood in your body you'd feel feverish and potentially even become lustful or full of rage. Traditionally this job was done by monks in monastic hospitals and then by barbers who had razors and coordination and were called upon for numerous tasks ranging from cutting hair to amputating limbs as well as lancing boils and cysts fire cupping pulling teeth and performing enemas. Here of course you can see an image of the spinning barber's pole common all across England. The red and white isn't mimicking a peppermint candy like I thought of as a child. Instead these poles which emerged back in the 14th century the red represents the bloody bandages while the white represents the clean. The rounded edges or balls at the top or bottom represent the bowl that your blood would flow into and even the shape of the pole represents the staff that you would grip to make your veins bulge out. After 1540 an edict was passed that barbers should use red white and blue poles while surgeons should just use red and white. The blue is thought to represent venous blood but probably became more widespread because of patriotic reasons. It resembles the union flag. The fellowship of the surgeons merged with the barber's company in 1540 forming the company of barbers and surgeons but after the rising professionalism of the trade they broke away in 1745 to form what would become the Royal College of Surgeons. As surgeons were getting ready to move into hospitals and a higher level of professionalism they shed their association with the more rough and ready working class barbers. They're ready to move on to more and more surgery and of course postmortems which we've already discussed. The legacy of barber surgeons is still with us today every time we consult with a surgeon here in the UK. That's because it's customary to refer to a surgeon as Mr. or Ms. rather than Doctor even though they've graduated medical school. This is to pay respect to the early history of the profession and evoke a time when posh university trained physicians refused to let the lowly barbers share their esteemed title Doctor. So let's come back to the old operating theatre now. What was surgery really like here? It wasn't pretty. Here I am all the way back in 2014 during my master's degree having Victorian surgery demonstrated on me during a lecture at the old operating theatre. Remember until 1847 surgeons didn't really have any option for anesthetics. Instead their methods were simply speed. Many could perform an amputation in a minute or less and maybe four large men to hold you down and prevent you from thrashing around. You might also be given a piece of leather to bite down upon and prevent you from screaming. You can have a look here at this painting. It's actually a modern painting by a painter called Chris Fisher done in the 2010s but you can see the surgeon here with a mallet ready to break the bone to make his cutting even easier and here an image of the actual amputation taking place. Of course the shock might kill you and if it didn't the infection was almost certain to get you later. Sometimes alcohol, ether or opiates were used to dull a patient's senses but remember these female patients at the old operating theatre were often the poorest of the poor and they just didn't have the resources to pay for such extravagances and also alcohol which was cheap was the worst thing to use because it thins your blood and could make you bleed out during your operation. During the aforementioned lecture where I was the guinea pig the curator recalled a surgery here in the operating room where a patient ran away from the table and had to be dragged kicking and screaming back to their operation. Of course that's darkly funny now but really imagine it it's horrific even if you survived the shock and managed somehow to avoid infection you'd be left with lifelong trauma. But luckily or maybe not so luckily in 1847 James Simpson a professor of midwifery at the University of Edinburgh soon realized the potential of chloroform to ease pain and cause a sort of blacked out state. We're now here at the Museum of Anesthesia in London which featured in my 12 strangest museums video and we can see in this display the importance of chloroform and its use in childbirth. Simpson and some friends were experimenting with different chemical compounds and their ability to manage pain. It must have been a pretty wild night he wrote in his diary I poured some of the fluid into tumblers before sitting down to dinner we all inhaled the fluid and were quote under the mahogany under the table in a trice that means very quickly to my wife's consternation and alarm yeah I can imagine not only are they drinking they're getting hopped up on chloroform. One year later in 1848 John Snow no not that John Snow who also discovered that cholera spread in dirty water invented an inhaler to measure the dosage of chloroform given and as we can see here in 1854 Queen Victoria used chloroform during the birth of one of her children giving the treatment a tacit stamp of approval and leading to its wide acceptance. The problem of surgery was solved right we have anatomical knowledge after the anatomy act of 1832 and we have anesthesia assorted well wrong we're still missing one of the three key blocks of modern surgery and that is hygiene and so for a time fatalities from surgery actually increased yes this is called the black period of surgery but why would anesthetic increase mortality rates during surgery well without a conscious patient gasping and wriggling and screaming some surgeons were tempted to carry out longer and more complex operations including abdominal surgeries they cut deeper therefore increasing the chance of serious blood loss and the longer duration of the operations gave bacteria a better chance to settle in and cause infection remember at the beginning of the 19th century hospitals and operating theaters were still putrid places let's look at this blood-stained surgeon's coat at the operating theater it pales in comparison to the actual garments that surgeons and barber surgeons would wear during their operations their leather aprons and white coats were stiff and crusty with blood and icor and they are said to have had friendly competitions about whose encrusted garments could stand up on their own they spoke cheerfully of the quote good old surgical stink yet hand washing was simply not done because the germ theory of disease wasn't accepted until Louis Pasteur's work in the 1850s and even then it took decades to be widely embraced behind me is Louis Pasteur's actual microscope such an honor to be able to see it here which brings us to a very important gentleman and yet another medical museum this time we're at the medical collection at the science museum in south kensington to look at some artifacts that belonged to joseph lister i'm going to come back here and do a video where i walk through the entire medical collection there's so much more to it than just surgery joseph lister's meticulous research really sounded the death knell for this old type of surgery that is surgery done on a wooden table in a crowded room attached to a stinking hospital in 1867 he was the first surgeon to use antiseptics and in doing so revolutionized medicine as we know it you may recognize his name from a product in your bathroom cupboard yes listerine now joseph lister didn't invent or endorse this product but they cashed in on his good name for their brand i learned a ton about lister from attending lectures by dr lindsay fitzharris and reading her book on the topic the butchering art which i highly recommend lister who extensively researched pester's germ theory went on to discover that carbolic acid killed the bacteria in open wounds blister was a student of robert liston who i mentioned at the beginning of this video he of the 300 fatality fame however i need to give liston some more credit unlike most of his contemporaries he would remove his frock coat his outside coat before surgery put on a clean apron and wash his hands which is likely why about 85 percent of his patients survived amputations compared with 75 percent at the nearby bart's hospital liston was such a successful amputator that a whole style of knives the type that jack the ripper was rumored to have used was named after him and his technique the liston knife also in 1846 back before the chloroform that i was telling you about at the anesthesia museum liston was also the first surgeon in england to use ether during an operation huh but back to joseph lister the son of a quaker family in upton then near london now it's in london he learned a great deal from his teacher liston and would go on to supersede his knowledge see lister not only analyzed specimens with a microscope but he cultured them in these wine glasses here the glass domes would keep the dust and microorganisms out he soon recognized that the putrefaction in wounds was caused by germs and that carbolic acid would kill those germs in addition to using carbolic acid and clean dressings lister also utilized rubber tubes to remove putrefying liquids from wounds in order to help them heal cleaner and without infection you can see those tubes in this case this crucial piece of knowledge led him to sterilize the tools and surfaces he used and to ensure that everything was as clean as possible here is some cat gut which is a surgical thread made from the twisted dried intestines of sheep or horses but oddly enough not from cats prepared in carbolic oil by lister in 1875 he knew that every element of his surgery needed to be sterilized including the stitches he would also have an assistant spray the entire room down with carbolic acid steam that emanated from this steam sprayer dating to 1867 however he soon abandoned this steam technique because carbolic acid is hard on the lungs and he realized that the germs were entering the wounds via hands and less from the actual air in the room in 1867 he performed a radical mastectomy on his own sister in his own home practicing first on corpses and then using his theorized carbolic acid to sterilize the wound though some separation did occur in her breast tissue he kept it under control she beat her cancer and survived he wrote to his father i may say the operation was done at least as well as if she was not my sister but i do not wish to do such a thing again you might think that he was mercilessly mocked even by the lancet medical journal for years but once surgeons tried his methods they were convinced and soon the death rate in operations using carbolic acid fell from 46 down to just 15 and the era of modern medicine and modern surgery was soon to follow and thank god for his innovations they really took us from the grim world of victorian surgery into the modern era well that's the end of our tour i hope that you've enjoyed well enjoyed might be the wrong word learning all about this really fascinating and brutal topic i'll see you the next time i'm at the museum maybe this one