This old operating theatre of St. Thomas’s is the 2nd oldest surviving in the world and a vivid reminder to the days where anaesthetic and sterile hospital environments were not yet employed.
Built in 1822 as part of the women’s Dorcas ward of St. Thomas’s Hospital above St. Thomas’s Church, this was the female section where the poor came as a very last option. With Guy’s Hospital, across the road, dealing with the incurables and St.Thomas’s with the curables, the patients who came here could not afford private medical treatment and were forced to sign an agreement to give their body over to medical research in case of their death. The mortality rate was roughly 46%. The surgeons knew their limitations, forgoing deep and intrusive surgery that would result in obvious fatality, and concentrated on “near-surface” operations like amputations and lithotomies.
Lithotomies (removal of the bladder stone) were common practise and occurred frequently in the 1800’s as the build up of uric acid deposits was due to bad diet and irregular water drinking. These were the days where drinking gin was safer than Thames water and many health problems stemmed from this fact.
The main causes of death on the operating table were shock/heart failure, blood-loss and infection due to unsterilized instruments and conditions. From lack of knowing better, the instruments were only lightly washed, i.e. not sterilized in boiling water. The operating table was made of absorbent wood and the surgeons wore everyday jackets and cotton aprons. Despite looking more like torture weapons, the instruments were designed for swift and neat surgery. Many amputations were performed in less than a minute. An oilcloth would be laid on the operating table, directing the blood towards the indentures on the sides of the table into the box of sawdust lying beneath. The floorboards were also packed with sawdust to ensure that none of it might leak into the church below. To make matters even worse, the ordeal would have been observed by a jam-packed auditorium full of medical students. The 1815 Apothecary’s Act made it compulsory for students to attend public hospitals and observe operation techniques. It made for quite a rowdy spectacle. Surgeons had no monitors to check their patients were alive so they would keep them alert with a shot of brandy. If the patient survived, the recovery rate was about two to three months.
It was around the 1850’s that a small idea amongst a few surgeons arose that infection spread through dirty conditions in the operating room. In the 1860’s, having observed how effective the use of carbolic acid was in cleaning sewage systems, Joseph Lister started using it to clean surgical instruments and surfaces. He was also the pioneer of the compound microscope that enabled him to understand the spread of infection better. Meticulously recording his results, Lister’s statistics showed a mortality drop from 46% in 1865 to 15% in 1875. Around the same time, in France, Louis Pasteur discovered that boiling water produced the dispersal of bacteria. At St.Thomas’s, having successfully set up her nursing school in 1859, Florence Nightingale brought with her the techniques she had learned in the Crimean War. When a Sanitary Commission came to clean up the sewage and ventilation, Nightingale was able to reduce the death rate from 42% to a mere 2%. On her return to England she dedicated her life to improving the sanitary design of hospitals, a notion that we take for granted today. In 1862 she oversaw the move of St. Thomas’s to its current location near Waterloo in order to make way for railway lines. The operating theatre was closed down in this year, only to be rediscovered in 1956. The male operating theatre did not survive.
Meticulously maintained by its dedicated team of staff, the Old Operating Theatre along with its adjacent Herb Garret is a treasure chest of information waiting to be re-opened. A place, however, certainly not for the faint-hearted.
The Old Operating Theatre and Herb Garret is now open every day from 10.30am – 5pm