I’m so glad I’m alive today and not 200 years ago

I have never broken a bone (touch wood!) but I know plenty of people who have. Until recently I did not appreciate that once upon a time, such an injury commonly resulted in death. Nowadays breaking a bone would not necessarily be fatal; usually we would go to A&E, get a cast put on it and then 6-8 weeks later the broken bone has normally healed. But 200 years ago treatment for broken bones frequently involved amputation. Death would regularly result from wounds caused by broken bones becoming infected before or after amputation or if they were left untreated – something I previously did not realise.

Last weekend I visited London’s Old Operating Theatre. It is located near London Bridge in the herb garret of St. Thomas’ church. The location of the operating theatre seemed a bit strange at first but the museum guide explained that the woman’s ward was once located in an adjacent hospital building. There is a small opening in the wall between the ward and the theatre through which patients were transferred – convenient but probably not a very pleasant experience for the patients. Although that was probably the least of their worries considering what they were about to encounter.

The museum guide described how the operating theatre was used from 1822 for surgical procedures, mainly amputations. Until 1846 there was no such thing as anaesthetic so the procedure had to be performed very quickly to minimise pain and distress. Surgeons adopted a technique involving slicing the skin which was then pealed back revealing the bone which was sawed off. This procedure took less than 1 minute and was known as the ‘swift technique’. It is not surprising that a high number of patients died of shock during the operation.

I was also surprised to learn that the surgeon did not wash his hands before the operation! He would rarely clean his instruments between amputations and patients would lie on a wooden operating table. We now know that this would almost certainly result in infection but due to the lack of knowledge of microbes cleanliness was not a concern 200 years ago.

Prior to the opening of the operating theatre, patients were operated on in the ward which must have been very upsetting for the other patients (especially if your amputation was scheduled next). The theatre provided sound proofing – and privacy, I assumed, but I was wrong. In 1915 a law was passed which allowed apothecary students to observe operations performed in hospitals. In order to maximise the student experience the operating theatre was fitted with 4 viewing platforms which surrounded the operating table which comfortably accommodate about 40 people. I was horrified to learn that 150 students would squeeze into the room to observe each operation. I cannot imagine what the patients much have felt like – aside from the fact that they were about to endure the worst experience of their life, they had an audience of 150 students, like they are about to put on a show. Additionally, there was no operating theatre dress for attendees. They wore their outdoor clothing – another factor contributing to infection.

Thanks to the advances in medical research, today, in the western world, we are lucky that broken bones (and many other ailments) are now regarded as minor injuries/illnesses that are quite easily fixed – perhaps the NHS service isn’t so bad after all! As scientific research progresses I wonder what diseases will be considered trivial in 200 years time? Cancer and heart disease perhaps? I hope so!

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I recommend a visit to the Old Operating Theatre museum to anyone – but particularly those who have a keen interest in science, medicine or history. Especially since adult admission is only £6.50 – bargain! For more information please visit the Old Operating Theatre website: http://www.thegarret.org.uk/