Betwixt The Sheets: The History of Sex, Scandal & Society - Could You Survive Victorian Surgery?

Episode Date: September 3, 2024

What was it really like inside a Victorian operating theatre? Did people really smoke cigars and eat oysters while they watched high risk surgery taking place? And what were the most common procedures?In today's episode Kate joins Dr. Monica in the Old Operating Theatre in London, to find out about the sights, smells and screams you would have heard there in the 19th century.Find out more about the museum here: https://oldoperatingtheatre.com/This episode was edited by Tom Delargy. The producer was Stuart Beckwith. The senior producer was Charlotte Long.Enjoy unlimited access to award-winning original documentaries that are released weekly and AD-FREE podcasts. Sign here for up to 50% for 3 months using code BETWIXTYou can take part in our listener survey here.Betwixt the Sheets: History of Sex, Scandal & Society is a History Hit podcast. Hosted on Acast. See acast.com/privacy for more information.

Do you want even more shocking and scandalous history? Like why the ancient Greek statues had such small manhoods? Or what went on behind closed doors in the Georgian era? We'll sign up to History Hit, where you can see me discover the scandalous side of history, as well as hundreds of hours of original documentaries, plus new releases every week, covering everything from prehistoric Scotland to the Treaty of Versailles.

Sign up to join me in locations around the world and explore the past. just visit historyhit.com forward slash subscribe. Hello, my lovely bit twixters. It's me, Kate Lister. I am here once more to protect you from yourselves. And to be honest, today's show is one that you might need a little bit of protecting from because we're talking about the history of surgery. And not in a roundabout theoretical way.

We're getting up close and very, very grisly with what was going on in 19th century operating theatres. So, I have to tell you, this is an adult podcast, spoken by adults to other adults, about adulty things in an adultery covering a range of adult subjects, including surgery, and you should be an adult too. And if you're all right with that, I'm all right with that. Okay, on with the show. Waiting rooms are not the most pleasant of places at the best of times.

Rubbish magazines, there's a weird smell in the air, usually, constantly wondering what everyone else is in for, but not daring to make eye contact with them. Could you imagine if you were in the waiting room for a 19th century operating theatre? hearing the cries of some poor bugger having their bladder stone removed or a limb sawn off without an aesthetic. Just a wooden stick to bite down on and a can-do attitude. Oh, I told you this wasn't for the squeamish.

If it's any kind of consolation, the surgeons prided themselves on being able to carry out these procedures in record time. So maybe you could be back down the pub in a few minutes if you survived. But what pioneering techniques did they develop? And what was their success rate? Well, scalples at the ready, let's go and find out. What do you look for a man? Oh, money, of course. You're supposed to rise when an adult speaks to you.

I make perfect copies of whatever my boss needs by just turning it up and pushing the funny. Yes, social courtesy does make a difference. Goodness, I feel for them done. Goodness has nothing to do with it, Derry. Hello, and welcome back to Betwixt the Sheets, the history of sex scandal in society with me, Katelyster. The Victorians pioneered a lot of things, the flushing toilet, the telephone, the camera, to name but three.

But how did surgery progress in the 19th century? Today's episode was recorded in real life at the old operating theatre in London, which was originally built in 1822 with historian Dr. Monica Walker. How did surgeons approach their work without hygiene and, well, the anaesthetic that we take for granted today? Well, fancy technique did they develop for the many amputations they can. married out, and just how did body snatching impact their practice? And if you have a taste for more Victorian history, why not listen back to our recent episode on the dark history of bearded ladies with John

Wolf? And now without further ado, let's do this. Hello and welcome to Twix the Sheets. It's Monica Walker. How are you doing? I'm doing great. I'm very excited that you guys are here in a museum. In the old operating theatre.

Yeah. Which is why we might sound a little bit echoy, because we're actually in situ. Can you explain what the old operating theatre is for anyone who's unfamiliar with it? So the All-Operating Theatre Museum, I heard, Garrett, is a small medical museum that it is located in the attic of St. Thomas's Church, which is pretty much between Borough Market and the Shard. If you're familiar with the area, we're pretty much between both of them on St. Thomas's Street. Geist Hospital is also very nearby, but because we are tuck in the attic of the yard, of the yard, if you're familiar. of this 18th century church, people don't get to see us, but we actually hold the oldest operating theater in Europe.

Holy hell, wow. And you really are in the attic, you really are in the rafters, because we haven't realized that the stairs to get here. There's 50-odd stairs of this tiny spiral wooden staircase. Yeah. It's very exciting. I always consider, like, I remember my first time coming to the museum when I got my job here, and it was,

fascinating because I remember going up the spiral staircase not understanding where I was coming to and then suddenly reaching the top of the stairs entering in these absolutely beautiful space full of these wonderful smells of herbs the garage just opened up is quite large all the beans made out of very old wood you could smell the wood you could smell the herbs and I was like I don't understand this can I somebody please give me a ground plan I don't understand where I am Why is there an operating theatre in the attic of an 18th century church? Why is there an operator? To try and describe the location, so we are in, it's a very,

but it's not massive, but it's a pretty large room that's in a sort of a semi-circle, and there are tiered stands that are going up with bars and barrier for people to kind of lean on whether, presumably they would all have been crowd for the gathered to look down. and in the center of this space is a rather ominous looking table. So can you tell us a bit about what happened in this room? Wow, I think that I will have to take that into two different sections

because one of the questions is why. Why is an operating theatre in the attic of a church? Yes. Because that one, I think, is the most crucial one to understand why we exist in the first place. So where we are used to be the original site of all St. Thomas's hospital. So St. Thomas Hospital is still a working hospital. It is located in Lambeth, right in front of the houses of Parliament. It has had a very long history, but its original home was here in Savak. And it has been here, at least that we know of, since about the 12th century.

12th century. Yes. Unfortunately, there was a very big fire in 1212 that destroyed most of our records. So some of the early history of the hospital, we're not that much familiar. But because of the fire, the small hospital had to be relocated where we are today. And even though originally there used to be a 13th century church and buildings around that acted as a hospital, it wasn't until the 18th century, like really early 18th century, that we see this very huge building kind of development happening where St. Thomas went from a very small hospital into like a major hospital where you actually had, It went from Borough Market, if you're familiar with London, all the way to the shard. That's how long it was.

That's really long. I know, right? We had three interconnected court yards with two additional smaller ones at the back, and then the hospital rose three floors up. The church that was built here in the same location as the previous one was literally part of the building of the hospital. Right. Because at that time, they believed in caring for people's souls as well as the church. their bodies. And so the actual church was here. And one of the requests by the governors

was that the actual church had to have an attic. And I always remember this idea where, well, why an attic? And they start thinking about like how like space is a premium, even in the 18th century. Yes. You know, so what would you have in an attic? A matwife. That's very one paper. Yeah, maybe that would some somewhere else. Okay, that's a different story. That's a completely different story. Actually, if you think about it, surplus. Like, somewhere where you can put the surplus of the hospital, anything that you need to store.

Storage. Exactly. Just storage. And I would say that was the most boring reason why this place existed if you weren't because the apothecary of St. Thomas's, the men knew how to do medicines, how to compound them, prescribe them, you know, the medical practitioners at the time as well, requested the use of the garret, which was the name of the attic at the time. to drink your herbs. Do people still call Attic's Garrots? Like is that like what a posh person might call an

attic? It's a very old word. Nobody uses it anymore. So a lot of people, I didn't know what it meant. A lot of people, every time that some people that ask, did you know what a herb Gareth is? And I was like, who thought that it was a person? I did. Yeah. I was like, a lot of people think that it's a person. It's not their fault. This is a word that has fallen off of our vocabulary. A garret is an attic where you can stand up and not hit your head against the ceiling. Did not know that. You know, it's kind of like a livable attic. And that's what it was.

It comes from the French. So at the end of the day, attic became the main word and everybody uses the attic. So we could be the herb attic. But the documents describe it as the herb garret. So historically speaking, that's what this space was called. And that was his original function just to drank your herbs that turned into medicines for the patients of the hospital. And then in 1821, we see a change a little bit in patient care in terms of education on the one side. So we have the rise of the medical schools. St. Thomas has had a

very important one. And if you have a medical school, you need also spaces where you can teach, right? Yes, you do. Yes, that's important. Yeah. I mean, it's not the same thing. I will tell you happened originally. I mean, there wasn't operating theater in the men's wards in 1755. That was the first one. Right. Yeah. And there was a strict separation of the sexes. All of the men were on one side of the hospital, all of the women on the other side of the hospital, and the church pretty much separated both of them. Okay. Okay. So imagine the situation where the men were all on the other side, and then the women originally from the rise of the the school of surgery where students had to learn by observation.

Oh, right. Yeah, okay. They had to see how these things happen. I don't like where this is going. Okay, go on. Well, that's where you need these kind of spaces. You learn by observation, and it's not the same thing to have a space where you can get about, I don't know, 125, 200 students to spaces where you can only get like 15.

So remember that surgeons will charge students for the privilege of, coming to their lectures. I don't know I'm shocked. They still do, really. You're pretty. And that's true. That's usually I'm quite horrible. I was just about to launch into that.

That's outrageous. They still do this. I know. It's just insane. But it is so fascinating because you see them that also from the perspective of the surgeons that are trying to teach a new generation of students' surgery, the more students that they can accommodate, the more money that ends up going. to them. It doesn't go to the hospital, it goes to the surgeons.

Right. Okay. So, a little kind of different economic aspect to it. Yeah. But then the women's wards did not have an operating theatre per se, like this, this comes later. Around 1755, you know, middle of the 18th century, what you did have was one bed at the end of the ward, surrounded by chairs. And that's where women would be operated on it. And then, like, some panels separating that space that they kind of call an operating theater from the rest of the ward where the rest of the women waiting for a surgical procedure will have to wait. Right, so it's screened off, but this is pre-anesthetic and pre-antiseptic. So, like, they've kind of screened it off, but I'm going to guess if you're a woman sat on that ward along with everyone else,

you can hear exactly what's going on. Oh, yeah. You just like it. I'll take my chances. I'm not doing this. That would depend. I suppose that would. That would depend.

Oh, my God. I mean, the question that we have to ask is who were these patients? I mean, we talk about a gender divide. We have men on one side, women and the other, you know. But who are these patients that we're talking about? Every time that I ask this question when we have a talk and I say, well, do you think that the patients in St. Thomas's Hospital were rich or were they poor? And a lot of people with the perception of health and medicine today,

they always say, in a large majority, that this was for rich people. And I always have to burst their bubble and say, not in a wrong baby, because they were not wrong. I mean, we only learn what we perceive today, right? This was always a charitable hospital for the poor. I see. So if you were poor and living around London, of which many, many people were and you desperately needed an operation, this is where you'd come.

Yeah. Yeah, you probably wouldn't have much of a choice. Where did the rich get operated on? Home? In the kitchen table. On that kitchen table. Yeah. It's a lot cleaner. Yes, it is. Yes. This place, I can guarantee you. With an audience. Yeah, it doesn't matter. Exactly. It's like you were rich and you had the ability to get absolutely any one of your medical practitioners, be that a physician, be that a surgeon, even an apothecary, come home and care. for you at home. And this, of course, means that their aftercare will be a lot better. You know, these people had servants that will make sure that they're clean, that everything is kind of nice at home, right? This is not what people had here. What we had are the working poor. We have what we call the serving poor, people that didn't have a lot of money, but they were able to,

you know, have recommendations to come and be able to use the services of the hospital in case they needed to have, you know, some sort of medical intervention, be that because of a disease, be that because of an injury, and be able to support that within the hospital. So I'm kind of thinking, but what kind of illnesses and diseases would have been treated? Because I'm kind of, like, if you know you've got to have an operation today, and you know it's going to be in a pretty safe environment, there's antiseptic and anesthetic, and there's not going to be a crowd of people gathered around and you're not going to be in an open hospital. It's still kind of scary and you still don't want to have it done.

But you must have been really, I'm trying to think how desperate you must have been to have gone to the hospital and gone, yeah, what kind of stuff we're talking about here? So when it comes to surgery, I mean, diseases and surgery can be separate in this case, right? Certical procedures, which will be the reason why the operating theatre existed in the first place, right? Let's just say that there were the miracles of the past. Okay. Yeah. Because you could only do, through many, many, many, many, many centuries of trial and error,

surgeons have come down with three surgical procedures that they knew that could potentially save someone's life. Right. You know, three. That's it. No more. No, there's three. Okay. You know?

And these three surgical procedures, you know, starting from probably top to bottom and everywhere, Trepanation, basically drilling a hole in the head. Okay. Yeah. So you get a head injury and when you have a head injury and it starts swelling, there is a way in which you can actually get that swelling down by drilling a hole in the head. So the trepination is one of the oldest operations known to mankind. There's some remains from near dentals that showed that they were also doing it at that time period.

Nearer dentists were doing trepinations. So it's one of the oldest operations kind of known to mankind, different reasons, but there are a lot of instances that prove that someone that had received a trepination actually survived that injury and continue to live. So this is one of the operations that they were able to do. Second operation that they could do are lithotomies, removal of bladder stones. And now we're not talking about kidney stones, which are like more common today. We're talking about bladder stones. Okay. And not tiny ones. This doesn't sound good. Oh God, no. No, no, no, no. These are like bladder stones the size of chicken eggs are bigger.

How did they do it? Well, think about it. Think about first, these are the working port. Okay, and these are people that do not have access to clean water. Their diet might be quite horrible and poor, you know. And therefore, because of the sediments that are being provided, they end up having these kind of like humongous bladdersstones. We have some examples in the museum.

You can see them and they're cutting half, so you have to think that they were like put to. together, that's how big they were. The thing is, if you can pee, you die. Yeah, okay. You know? So, bladder stones were much more common in men than in women, and the circuit procedure needed for men was a lot more like harsh. What was the surgery for procedure?

I don't know if I want to actually... No, I do want to know. Do you really want to know? Yeah, I do. Okay, so I read this horrifying account by, you know, Mr. Benjamin Travers, one of the surgeons here in St. Thomas's, that basically described how he performed one of these operations. one of these operations. And what he did was, it was on the male's ward, not the female's ward, and what he did was bring the patient in. Now, I forgot to say something very important, you know,

that for this operation, and I'll tell you later on the other one, for any of the three operations that I'm talking about, your choices were certain death or maybe to live. So if you need to have a trepanation, it's because you were already going to die. Yeah. If you needed a lithotomy, is because if that wasn't removed, you're going to die. And with the third operation, which we will discuss, which of course you already guess is going to be amputations, it literally means that if you don't get it done, you're going to die. So when the surgeon will come to your bed and say,

I'm sorry, we believe that we need to operate on you. They're basically telling you you're going to die. Now, we're going to offer you a very, small chance at salvation. How many people with this kind of choices are going to say, I want to die? Some people did actually. Some people refused to get the operations.

So there's this funny thing about consent. You know, they will not actually have the patient just brought in because unless they were already unconscious and they were trying to save their lives. But if they had to operate on them in an operating theater, it pretty much means that they will have the consent of the patient. Now, there's no backseas. You can't change your mind.

Once you say yes, you're going ahead one way or another. There were portraits on the door. And if you try to run away, they will bring them back into the operating table. Oh, my God. There are so many incredible accounts of surgeons saying, oh, yeah, this patient tried to run away. We just brought him back. I mean, I love, but I love because it's so horrifying in so many different ways

about the image of the fear and the anxiety, you know, and the fact that their lives are going to change forever, definitely for the worst in many cases. So, but still, there's this inhuman wish to leave, you know, that automatically makes us say, oh, I'll choose salvation. So imagine for a man that had, you know, this kind of like a chicken egg size kind of a bladder stone, and he's given the choice to have the operation,

which, to be honest, it was quite successful. We had... Oh, God, yes. We had William Cheseldon, who was one of the top surgeons here in St. Thomas's, sorry. He had a 92% success rate. That's impressive. I know, right? That is impressive.

That was in the 18th century. You know, it was so easy for him, and he was actually able to remove bladder stones in under two minutes. I'm not sure speed is quite the quality that you want with this. Yes, you do. Maybe you do. Maybe you do. You do. So go on hard to get it.

So basically what they did was to lay the patient on the table. And because they had to have access, you know, to their genitals. Yeah. They will, in this case study that I read, they tied their wrists to their ankles. And then lay them open in the operating table. Then there is a very small chair. You will see it from here as well. We have a very low chair.

That low chair literally is for the surgeon to be able to sit down on it while the operating table is like a little bit higher so he can actually get between and like behind and then he would use a urethra sound through the penis trying to find the stone ticking it on the stone and then behind through the scrotum they can actually make a cut and there are a couple of additional like gorse and other tools that they will like actually try to find it by tapping sometimes they will try to break it down a bit kind of like hammer chisel situation but the idea was to make that very very fast grabbing it from behind the scrotum and then just removing it directly and then closer the wound. It's not very big wound that is actually, you know, being taken care of.

But just imagine the sheer kind of like position of the body, the fact that you are completely tied your wrists to your ankles. You're having a scrotum cut open. Yeah. And then you have your assistance, you know, usually for just physically, you know, holding them down. Like something like that is it must be quite delicate surgery. Like even at the time, there's no way that somebody could experience that and not move and like twitch and ride. Was there any way to sedate them at all?

No. No. Not at this time. I mean, anesthesia is not introduced in this country until December 1846. Could they get them drunk? Drunk is a little bit of a, there are some things that they did. But I think that there was this belief that pain was part of the process, of the healing process. You know?

And I think that they were kind of understood that. wine could actually have a bad effect or any alcohol could have a bad effect in terms of thinning the blood. So you also have to be aware that blood loss might be a contributing factor for a patient to die in the operating table. So you want your operation to be fast. You want your operation to be precise because the faster and more precise that you actually are capable of doing an operation, the least amount of pain that you're inflicting on your patient. they bigger their chances of survival. Now, if the operation takes too long and they see that the patient is kind of losing a little bit of sight, they will use a mixture of brandy and wine to try to revive them a little bit. And that has been used in the past. But it's more used as a

revival than as a pain inhibitor. I mean, they did have opium. They did have other things that they knew. They even try hypnosis. They try a lot of different things. I mean, pain management has been a real concern of surgeons for a very long time. And partially because of what you said, you know, it's very difficult for someone to stand still while they're digging in your body and trying to figure out what's going on. You just don't have that ability to you. So for the most part, that's why you have also the assistance,

physically restraining you. And many of the patients ended up coming out of the operation, not only with just whatever has happened to you, but also covering bruises. I bet they didn't. From like the forceful kind of like keeping them down as much as possible. Back with Monica after the show break.

So we've spoken a lot about live people being well dissected of all this operating table. But what I know about the history of surgery and anatomy is they certainly weren't always alive. Like dissecting dead bodies was a real thing. Did that happen here as well? Yes. Not in the operating theatre.

St. Thomas actually have anatomy theater and the anatomy theater was pretty much where bodies were publicly dissected. Now in this country up until like the Anatomy Act of 1832, it pretty much meant that the only bodies that were allowed to be publicly dissected were those of condemned criminals, potentially murderers. And that is basically the largest amount that you could actually do, maybe 15 people a year. So in terms of the need to understand human anatomy and the requirements of the profession to learn and understand understand, you know, the surgical...

And you need more than 15 a year. You need more than 15 a year. You need one per student, you know, at least that would allow you to learn by doing. You were required to practice on the dead all of these operations before being able to even get close to the living. And so what we discovered was that St. Thomas's, because the school rose so quickly, it did encourage in the 18th century the rise of the body snows. So we had men that were very familiar with the hospital, sometimes porters, you know, that

understood the need of having these, you know, extra bodies. And of course they will go into the cemeteries around the area. They basically function like mafias. You know, some gangs have like, like this, they control these cemeteries, another gang's control all the cemeteries. And the idea was basically to steal the bodies that were recently diseased so they could sell them to these anatomy schools because it was so important. important for students to be able to learn by actually doing dissections.

Was that quite lucrative then selling a body? It was. I mean, the wages of a, let's just say, a servant in one year would be the price of one body. Oh, a year's wage. Yeah. That is tempting. It is very tempting. Also because stealing bodies, as long as you remove their clothes, it's not considered a felony, it's a misdemeanor.

And of course... Why are the clothes? Because then it would be theft. Oh. The body has no status, no legal status in this country. It's dead. So it's not like it belongs to anybody. The clothes still belongs to the family that bury the dead.

And so if you wanted to make sure that you did not want to get the full extent of the law applied to you, then you will only steal the body and then sell it to the anatomy schools. So the theatre that we're in at the moment, we're on seated chairs, like looking down, presumably that's where the operation would have been. Yeah. Who the hell is watching this? This looks like a concert hole where you would watch... It's the theatre. It's the theatre.

I mean, at the end of the day, the best way to actually teach, you know, the same thing at the same time to a lot of people is the theatre. So this would have been students. These would have been students. There was a hierarchy. I always love picturing how this would have looked like in that time period when we had patients in that operas. 18 table. All of the stands will have filled with men. For starters. It's all men. All men. No girl is at all. Not once that we're not trying to pass themselves as so men or possibly women disguised. Yes. Exactly. You can have one of seven. But what you actually

have in some cases here were there was a hierarchy. So where you stood in in the stands gave you, you know, status. So if you're closer to the patient, you might be a surgeon with other assistants. that you have come to observe a new operation. After that you have like fourth year students, third year students, second year students, first year students, you know, towards the back. And it would have been quite packed. Now, you have to think about it if you start envision in a space like this. You know, we do have a really massive skylight,

but there used to be no ventilation in the space. It would have been very stuff. Imagine having operations in summer. Now, St. Thomas is usually operated on the same day, on the same day at the same time. So usually for the women's wards, it was Fridays at noon. A, more light. B, students know already that this is when it's happening.

So they could just come here. I mean, we don't have emails trying to say, hey, we have updated this operation. It's coming at this day, and you can come and observe and pay us money for it. So they don't have that. So establishing a specific date when you're actually going to have these events

becomes an important aspect of the medical school in many cases. So, you know, they're all here wearing their Victorian stuffy garments. Some of them would have come from, you know, dissecting bodies. And then once they actually are here, some of them will be trying to scribble, taking notes. Others will be eating oysters. You know, others were smoking cigars, pipes. You could smoke here. This is made out of wood in case, you know, listeners, it's all made out of wood.

We do not allow people to smoke here anymore. But you have to imagine that throughout the operation, As the day progresses, because they had patients coming one after the other, after the other, until they were all done. It pretty much meant that the smoke will potentially become like thicker and thicker. In St. Thomas' only students were allowed or friends of the students. So I could bring my best friend to check on an operation. So you did have sometimes guests as well. Other operating theaters in other places did accept and did sell tickets for public view.

So you could have ladies and other gentlemen who were not students to come and observe an operation. And the thing is that what they see here is basically, you know, a quest for understanding the human condition and saving lives. You know, it is a sign of progress. You know, it's the age of reason and enlightenment, you know. It's just being able to see history in the making by having someone come here and say, I'm going to save this man's life, you know. this kind of like, it's a little bit of like a god complex. It is, isn't it? And where we are at the moment, this is where women would have been operated on?

Yes. Wow. Yes. I can't imagine how scary that must have been. If you are some poor woman who needs, let's say amputation, you need something cutting off. Yes. Which was the third one that they know how to do. Yep.

Like you'd come in through those doors over there. You'd be, and this entire room would be packed with students smoking and jeering and talking and all the rest of it. I can't imagine how scary that must have been for them. I think so too. I think that that's one of the things that I always think about when it comes to the patients, because unfortunately, the patient's voices are the ones that we don't usually hear. We don't hear them. We hear them secondhand because we do have reports.

We have like clinical charts that tells you, well, this person told me that this is what happened to them. So you get their name, their age, their profession. You get a little bit of information about their lifestyle, about, what happened that made them have this accident, that ended up making them come to the hospital, and the decision that was made why it needed to have the procedure that it needed to have. So you have all of that on the first clinical kind of like chart, and then you have an explanation of why the surgeons did what they did, why it was a difficult case.

So you can see that they are trying to figure out how the human body works. They're trying to problem solve. It's all about trial and error at that time. The status of the women here on the man pretty much meant that they had a little bit more of a leeway because if you have a patient that is already going to die, sometimes they had the potential of trying new techniques. And one of the things I always think about, this is what happened with flaps. I love this technique from surgery.

So since we talked about surgery. So originally when you think about pre-early 19th century, you know, up until the early 19th century, you need an amputation, the way that it was performed, it was called the Tour de Metre, you know, the turn of the master. And that was basically a circular cut around the member that needed to be cut off. So if my arm needs to be cut off, what are we doing? I would just bring my knife around it, cut through it in a circular motion. Right. Some of the circular knives were curved to help with the circle around it. Through the flesh. Through the flesh, to see the bone. Yeah. And then basically just try to get saw, try to cut it off. And the thing is that,

that after you have done that procedure, and this is the before the flaps, there's a couple of things that happen there. But what happens is that if that member is removed, at the end of the day, what you end up having is a stump that is always open. You have an open wound forever. So even though if it's calterized by using burning oil, what happens is that you still have an open wound forever. And that actually kill a lot of people afterwards,

even though they survived the procedure, many survived the procedure. The problem always is the infection that comes afterwards. And if you have an open wound, the chances of infection just increase exponentially. Then a surgeon just came out with the idea. Don't ask me who he was. I'm very, very bad with names of using flaps, which meant that instead of just cutting, let's just say, circularly, what you do is that you make an oval. So you cut an oval or you basically cut kind of like triangles around it.

And what you do then is that you leave excess meat and skin. And then after you do those cuts, which are more precise, it can be. fast, but it's one of those things that requires a bit more precision. Then with your fingers, you retract the meat in both directions. So you can see the bone. Then you bring in the bones out, you cut through it, you bring the bone neepers in case there's any splinters let behind. You deal with all those, you know, particularly in legs, you have all of, or,

basically we have major arteries running through your body. They need to be dealt with, again, catarization. on my favorite, there's this thing called ligatures, where they had ligature clamps, which looks like tweezers, where you will pull out a bit of the veins out, and you have like a crochet needle, and then you kind of crochet the endings, and then you tie them up with cuts good, pig's good, horses' hair, silk if you're lucky, and then you keep that in the body. And then that flap is there. So instead of having that wound being completely open all the time,

the flap goes over the stump. And pull it back down. and pull the back down. And they can do sticky pulses or they can just like sew it all together so that after the operation is done and it's successful and it heals, you are basically using your mid and skin to heal itself together. It's like making a foreskin, but like on your leg or your arm. Exactly. Except it's not a penis, it's a leg or an arm.

Yeah, exactly. That's why I'm not a surgeon. But you know, we don't need to read. That's what we do. It's the image. It's like trying to figure how that look like. But this is a technique that was tested in an operation. in theater. And what I like to think about when you're doing this trial and error kind of

situations is if it works, awesome! A bunch of students now know that it works. Yeah. So they will go out to do that technique again because it works. Because it's actually saving lives, it's giving the patients a bigger chance of success of going through what they used to call trauma. Yeah, they didn't understand. They were traumatized, right? Well, at the end of the day, you have to always remember that antiseptics are not introduced until 1865, which completely predates our space. Yes. You know, we moved out of here in 1862. That's when St. Thomas had to be relocated. So we never saw antiseptics at all. So all of these operations, imagine, you know, have been without anesthesia, no antiseptics. So every time that there was something, you know,

what killed people the most were the infections. Yeah. Ask me what the mortality rate. No, the survival rate, Monica. What was the survival rate, Monica. Thank you. 70%. Really? Yes. I did not think you were going to say that. I thought it was going to be abysmal. That's, I mean, 70, you'd get in a lot of trouble with that today, but that's, I'm really impressed because we need have the patients wiggling around on the board and no anesthetic and a lot of students just smoking and boozing up. But I did say that these operations were done because they knew that they could say someone's life. Yeah. And operations before anesthesia were done very conservatively. So they would not just be operating willy-nilly.

They will not just be, oh, we're going to test this. So I'm going to bring this person, that's not how it works. You still need to have the consent of your patient, particularly if you're going to be in an operating theatre. And not only that, but you also have to, you know, be aware that the worst will happen to, you know, so it's just trying to bring all of these different things together. It's scary, but it seems like it did a lot of good. It did. It did. It because of the conservative nature of those operations. Now, a lot of people when they said, oh, but anesthesia came in 1846. I mean, we have the first case of a patient going under anesthesia on the 9th of January, 1847.

It was a child, six years old. They needed to be amputated one of his tiny little fingers, and they put him under. And when he woke up, he was like, oh, why is my finger finger finger? I did not even feel a thing, you know? And you think for every success that they had in operating someone, you know, with anesthesia, the reality is that throughout, well, anywhere that we're doing trigger procedures, the death rate increased exponentially. One, they did not have the equivalency table of how much anesthesia to give a patient. So there were a lot of cases of overdoses and people just died before even having the operation.

Some people had bad reactions, so they had heart attacks. when they were given ether or chloroform. And then, because surgeons thought that, oh, my patient is no longer moving in the operating table, then what are we going to do then? Oh, excellent. We can actually have internal surgery. But in a pre-antiseptic world,

internal surgery means that you're opening up more delicate parts of our anatomy to germs, which they don't know anything about yet. You know, they don't have any idea. But that's pretty much what it's happening. the infection rates increase exponentially. And because they started to do more operations instead of being conservative,

they thought that they could do more because people were under anesthesia, then the death rate increased exponentially. Monica, you have been horrifying to talk to it, but absolutely spelled by doing nonetheless. Can I ask you for the final question? Yes. What is your favorite item in this museum of horrors?

It's incredible, but you can't help but go around looking at this stuff going, oh my God, that was really used to saw someone's leg off. Oh my God, that really was a table that somebody lay on to have these things done. It's so real when you're here. What is your favorite item? I'm going to say the operating table itself because a lot of people, when they come, people see it. And I don't know, I can just describe it. It's a wooden table.

It has a wooden headrest. There is a small section that opens up at the bottom. It actually becomes a little bit narrower at the bottom and is very low. The bit that comes out sometimes is close, so it's actually quite short. And we get people's perception of the operating table like, oh, people in the Victorian area were really short. What they don't understand is the operating table is not there to cater to the patient. It's there to aid the surgeon in the surgical procedures, you know. If you need to do an operation, you need to use your body weight.

It's hard to cut a bone. So it is very low to the ground. It's like a lot lower because you need to do. literally need to use your entire body weight to sew something off. And that actually helps you if your table is really high, the amount of strength that you can put into it is very small. And I always sound fascinating because it's not just the amputations that are taking place in there. It's also the dithotum is the trepanations. And for every single one of them, the operating table is literally, you know, so unassuming, so, you know, prosaic in some cases. And yet so well designed

to help the surgeon do his job in this case as easy as possible. And I think that that's why it's my favorite object is because of that moment of realization when you come here and you realize, wow, you know, this is how they used to do it in the past, and this is literally one of my favorite objects. One of the things that we have in the space is the motto of the surgeons of St. Thomas's. It's a Latin inscription.

on the top of the wall. It reads, misceratione non-merkeldim, for mercy, not for gain. The actual surgeons were trying their best to help their patients with the knowledge that they had available to them. If they didn't do what they did,

try the things that they tried, with every success, with every failure, our knowledge of medical practice, medical techniques have just increased. And it's a chain of knowledge that had come all the way. way down to us. When I'm here, I feel so grateful because I thank the people that lift. I thank the people that died in this operating theater, the students, the surgeons, you know,

even the porters, every single one of them that actually tried their best to survive at a time that was really crappy. And yet, the fact that they say, yes, I want to leave. I want the operation. I want the operation. It just talks about the hope that space is like this, this give to people have no hope. Oh, true. You know? Monica, you have been wonderful to talk to you. Thank you.

People want to come to the old operating theatre, and frankly, they should. It's memorable, to say the least. Where can they find you guys, and what kind of opening hours do you have? So our website is all operating theatre.com. We appear on Google, pretty much everywhere that you might think of,

but that's the best place to come and see us. We do open to the public Thursday to Sunday from 1030 till 5. last admission is about 4.15. We also do groups and schools and private tours, but those happen on Monday, Tuesday and Wednesday. So if you want something a bit more special, you know, that's when you get, you have like the museum for yourself, you get a tour, you get a talk, demonstration. It's a great space. Thank you so much, Monica. You've been just marvelous. Thank you so much for coming and letting me share the stories. Thank you for listening. Thank you so much to Monica for joining me.

and if you like what you heard, please don't forget to like review and follow along wherever it is that you get your podcasts. If you'd like us to explore a subject or if you just wanted to say hi, you can email us at betwixt at history hit.com. We have got episodes on everything from ancient Greek bodies to ritual nudity all coming your way. This podcast was edited by Tom Delaggy and produced by Stuart Beckwith. The Senior Producer was Charlotte Long. Join me again, Betwixt the Sheets, the History of Sex, Scandal and Society,

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