Old Operating Theatre

The Old Operating Theatre Museum is one of London’s most intriguing historic interiors. It is located in the garret (Herb Garret) of St Thomas's Church, Southwark, on the original site of St Thomas' Hospital. It consists of:

* The oldest surviving operating theatre in the country (dating from 1822), used in the days before anaesthetics and antiseptic surgery.
* the herb garret used by the hospital’s apothecary to store and cure herbs used in healing.
* A collection of artefacts revealing the horrors of medicine before the age of science. Includes instruments for cupping, bleeding, trepanning, and childbirth.
* Displays on medieval monastic health care, the history of St Thomas’s, Guy's Hospital and Evelina Children's Hospital, Florence Nightingale and nursing, medical and herbal medicine.

The rebuilding of the hospital and the Herb Garret

At the end of the 17th century, the hospital and church were largely rebuilt by Sir Robert Clayton, president of the hospital and a former Lord Mayor of the City of London. He employed Thomas Cartwright as architect. (Cartwright was master mason to Christopher Wren at St Mary-Le-Bow). The new church was fitted out with a large Garret constructed in the 'aisled-barn' tradition. Very little information exists about the Garret except that it was fitted with wooden storage racks, and was described as 'the Herb Garret' in 1821. Dried heads of opium plants were found in the rafters. It is likely that the Garret was used by the Hospital's resident Apothecary to store and cure medicinal herbs.

The building of the Operating Theatre

In 1822 part of the herb garret was converted into a purpose-built operating theatre. This strange situation resulted from the fact that the female surgical ward abutted the garret. Previously operations took place on the ward. Windows were also provided for the Garret at the same time, suggesting that its function changed from storage to a working environment. It may have been used as a recovery ward.

Florence Nightingale and the removal of St Thomas's to Lambeth

In 1859, Florence Nightingale became involved with St Thomas's, setting up on this site her famous nursing school. It was on her advice that the Hospital agreed to move to a new site when the Charing Cross Railway Company offered to buy the hospital’s land. In 1862, the hospital began the move to its present site at Lambeth and the operating theatre was closed. The theatre lay undiscovered until 1957.

Who were the patients?

The patients were mainly poor people who were expected to contribute to their care if they could afford it. Rich patients were treated and operated on at home rather than in hospital. The patients at the Old Operating Theatre were all women. Those who visit the museum will be relieved to know that the patients did not have to climb the spiral staircase! They came in from the women’s ward through what is now the fire escape.

Operations in the theatre

Until 1847, surgeons had no recourse to anaesthetics and depended on swift technique (surgeons could perform an amputation in a minute or less), the mental preparation of the patient, and alcohol or opiates to dull the patient’s senses. Thereafter, ether or chloroform started to be used. The Operating Theatre had closed down before antiseptic surgery was invented. The majority of cases were for amputations or superficial complaints as, without antiseptic conditions, it was too dangerous to do internal operations.

A description of the students packing the Theatre to witness an operation has been left by a St Thomas surgeon, John Flint South.

:"The first two rows ... were occupied by the other dressers, and behind a second partition stood the pupils, packed like herrings in a barrel, but not so quiet, as those behind them were continually pressing on those before and were continually struggling to relieve themselves of it, and had not infrequently to be got out exhausted. There was also a continual calling out of "Heads, Heads" to those about the table whose heads interfered with the sightseers."

Patients put up with the audience to their distress because they received medical treatment from some of the best surgeons in the land, which otherwise they could not afford. Wealthy patients of the surgeons would have been operated on, by choice, at home, probably on the kitchen table.

The risk of death at the hands of a surgeon was greatly increased by the lack of understanding of the causes of infection. Although cleanliness was a moral virtue, descriptions suggest that a surgeon was as likely to wash his hands after an operation as before. The old frock coats worn by surgeons during operations were, according to a contemporary, 'stiff and stinking with pus and blood'. Beneath the table was a sawdust box for collecting blood. The death rate was further heightened by the shock of the operation, and because operations took place as a last resort, patients tended to have few reserves of strength.

The museum is a member of the London Museums of Health & Medicine.

External links

* [http://www.thegarret.org.uk/ The Old Operating Theatre Museum website]