The Old Operating Theatre - Museum & Herb Garret
Hospital Admission Certificate from the 18th Century
The Waiting Room
Featured Object: Apothecary Jars
Miseratione non mercede
Anatomy & Dissection
Abraham Solomon, The dissection room of Old St Thomas' Hospital, 1838, gouache on paper.
The Herb Garret
The Apothecary Counter
Physicians & Diagnosis
Women's Health & Domestic Medicine
Care of the Sick & Nursing
Old St Thomas' Hospital
Venetian Plague Doctor's Mask
The Apothecary's Workshop
Opium Poppy Seed Heads
The Apothecary's Rose
Diagnostic Doll
Featured Object: Leech Jar
The "Mechanical Leech"
Featured Object: Macaura's Blood Circulator
Featured Object: Whirling Spray Ladies' Syringe
Featured Object: Domestic Medicine Chest
The "Midwife's Vade Mecum"
Featured Object: A Medieval Pewter Plate
Featured Object: Carbolic Spray
Schimmelbusch Anaesthetic Mask
Horsehair Sutures and Silkworm Gut Ligatures
Surgery in the 1800s
Liston's Amputation Kit
The Operating Table
The Replica Operating Table
Gold-plated Trephine
The Nurse's Chatelaine
Stomach and Enema Syringe
The Alembic
The Beer Bell
Chain Dissecting Hooks
Victorian Prosthesis
Marigold
Surgeon's frock coat, apron and wash station
Wooden Bandage Winder: Double Roll
Bladder Stones
Metacarpal/Metatarsal Amputation Saws
Bistoury Caché
Bismar Scale
Old Op Activities Online
The Garret
Wet Specimen: Tapeworm (Taenia solium)
Mrs Grieve: Anatomical Teaching Skeleton
Paediatric Ophthalmic Set
This compact case from the late 19th century held medicaments used to treat eye conditions in children. It's a specially designed paediatric ophthalmic set originally used at the Evelina Hospital for Sick Children, which opened at Southwark, London, in 1869 (open today as the Evelina London Children’s Hospital). The three glass dropper bottles contained substances commonly employed when treating various eye conditions. The blue bottle contained Homatropine, the black bottle contained Atropine, and the clear glass bottle contained Cocaine. The substances all had similar effects: they dilated the pupils and paralysed accommodation (the natural constriction or dilation of the pupil when focusing on near or far objects). Cocaine also provided a anaesthetic effect upon the superficial structures of the eye. They could be used alone or mixed together. The solutions were made by dissolving the active ingredients in cooled boiled or distilled water before they were carefully dropped into the eyes of Victorian children.
Hospital Admission Certificate from the 18th Century
Certificates of admission were standard practice for hospitals that provided treatment for the large numbers of sick poor in urban areas. This printed certificate admitted patients to St Thomas' Hospital in 1797. It has spaces for the patient's name, the reason for admission, and the signature of the accepting Hospital Governor. This one is handwritten for "John Jones" for the treatment of "Rupture" (a word often used for hernia). Only the poorest patients might receive free treatment, so the standard admission fees for the period were printed on the certificate, which can be seen on the lower left. Charges are listed as 3s 10d (three shillings and tenpence) for "clean" patients, and 10s 6d (ten shillings and sixpence) for "foul" patients (patients admitted for sexually transmitted diseases, like syphilis). The certificate is signed by Governor John Thornton and is undersigned on the left corner by Saml [Samuel] Williams.The Waiting Room
When you enter the museum you will find our Waiting Room, which has an assortment of activities for visitors of all ages! Make a puppet while learning about the names of the major bones in the human skeleton, colour pages from the history of medicine and pharmacy, or complete our word searches and crossword puzzles! In the Waiting Room you can also spend some time reading Herb Garret Remedies for the Mind, Body, and Soul, which have been written by our previous visitors. We invite you to contribute to the project with your own messages!If you're looking for activities to do while you look around the museum, you can follow our Museum Trail and answer questions about all things Old Op and the history of medicine! We also have a fun I Spy game. Look out for our spotter’s guide to the Herb Garret for fun facts and a visual scavenger hunt related to the history of medicine-making. May the best spotter find all the items!
Featured Object: Apothecary Jars
If you’d found yourself suffering with carbuncles in the early 18th century, the treatment recommended by a physician from St Thomas’ Hospital might have been a poultice made with onions, garlic, Spanish flies, mustard seed, treacle, mithridate, pigeon dung, and oil of scorpions. This was one of the many remedies listed in the hospital’s dispensatory of 1741 – a recipe book of the most commonly used medicinal prescriptions. Dispensatories for London hospitals were first published in Latin by the College of Physicians, but the apothecary and physician Nicholas Culpeper believed that the public should have access to such remedies, and he produced an English translation in 1649.When a physician prescribed a remedy for a patient, it was the job of the apothecary to make it, using their stock of herbs, spices, and other ingredients. Apothecaries stored many of their drugs in delftware jars such as these. The motifs of peacocks, flowers, the baskets of fruit, and the head with wings were common on delftware apothecary jars in the 18th century.
Deciphering the Latin abbreviations on them tells us what they would have contained. For example, P. Aloes Ros. tells us that this jar contained pills of powdered aloe mixed with rose juice. C. Alkermes is a confection made with the juice of the kermes insect, rosewater, and oil of cinnamon. It was thought to assist with digestion, and to act as an invigorating restorative. U. Martiat is "Soldier’s ointment", taking its name from the fact that it was intended to help soldiers against injuries in long, cold encampments.
V. Apostolorum was "Ointment of the Apostles", so named because it had twelve ingredients. And E. Mitridat. D. refers to an "Electuary of Mithridate", a complex formula of around 50 ingredients, including opium, thought to act as a general antidote to poison and venom. It takes its name from the ancient King Mithridates, who was said to have built up immunity to poison by regularly taking small doses of it.
Miseratione non mercede
The inscription in the Operating Theatre is in Latin and can be translated as "For compassion, not for gain"Anatomy & Dissection
Anatomy is the scientific study of the internal workings of the human body through dissection. Until the 16th century, the study of anatomy was always secondary to the study of medicine. By the middle of the 18th century, dissection of the dead had become central to surgical education, meaning that one of the most valuable commodities in surgery was the human corpse. Surgeons needed to be thoroughly educated about anatomy, and they needed to be able to rehearse their operations before they performed them on the living. However, the legal supply of corpses remained limited, and the numbers available fell far short of the profession’s requirements. This gave rise to the body snatchers or "resurrection men": criminals who stole recently buried bodies and sold them to anatomy schools, until the Anatomy Act of 1832 gave licence to doctors, teachers of anatomy, and bona fide medical students to dissect donated bodies. At this time, all bodies that had not been claimed within 48 hours of death were dissected by the hospital surgeons. In 1836, 1,332 patients died in St Thomas’ Hospital and 134 were reported as “unclaimed”.The image shows visiting palaeopathologist Hannah Polaski cleaning and examining the Old Op's articulated skeleton named Mrs Grieve.
Abraham Solomon, The dissection room of Old St Thomas' Hospital, 1838, gouache on paper.
This is a painting of the Old St Thomas' Hospital Dissection Room by London-born artist Abraham Solomon (1823–1864) in 1838. The painting shows the set-up of the hospital dissection and training room. The figure of the corpse is shown as having been set in position by the surgeon or demonstrator using a hook and chain system, which holds the legs in a traditional lithotomy position (an operation to remove bladder stones). Small versions of this chain system for holding the material being dissected are seen in contemporary dissection kits.The Herb Garret
The garret (another word for a large attic) of St Thomas' Church was set up in 1703 for the Old St Thomas' Hospital's apothecary to dry and cure medicinal herbs. It is known as the "herb garret" from the Minutes of the Court of Governors of the Hospital in 1821. This section of the museum is dedicated to that function, and it features the raw materials from which medicines were derived: some animals and minerals, but mostly plants.Volunteer Charlie demonstrates Victorian pill making
The Apothecary Counter is the centre for hands-on activities for visitors of all ages! For example, our reproduction pill machine you see here is regularly used by Old Op visitors keen to experience Victorian pill making! Medicines dispensed and taken in pill form grew popular during the 18th and 19th centuries. Swallowing a pill was a more convenient and often more pleasant way of taking medicines than by drinking an infusion or taking a powder. They were also safer for the patient. Pills were a way to administer accurately measured single doses of medicine without placing responsibility on the patient to measure and mix powders at home. The ingredients for the prescribed medicine were mixed using a mortar and pestle and made into a workable "dough" by gradually adding an inert fluid substance (an "excipient"), such as syrup of liquid glucose. The resulting pliable mass was formed into a ball and rolled into an even pipe shape using the flat wooden back of the separate handle. When the pipe was the correct length, the handle was flipped over so the brass grooves corresponded on each part of the machine. The apothecary worked the pipe into the grooves, back and forth, to create accurately dosed and cut spherical pills. Before they were prescribed to a patient, the finished pills were dried and often coated to improve their appearance, for which the apothecary charged additional fees. A coat of talcum powder was used to give them a pearlised finish, or the pills were sometimes rolled in varnish. The most luxurious finish was created by coating pills in gold or silver leaf using a separate tool called a pill silverer.Our reproduction pill machine
Learning the art of pill making
Physicians & Diagnosis
The history of medicine shows how societies have changed their approach to health, illness, and disease from ancient times to the present. The concepts of medical diagnosis and prognosis, that is the description and development of illnesses, were established in the 9th century BCE in the West. A lack of accurate methods of diagnoses meant that until the 19th century doctors mainly relied on their own observations and listening to the patient’s description of their condition in order to form a prognosis of the illness. European universities began systematic training of physicians around 1220 CE, basing much of their training on the classical concept of the four humours.Women's Health & Domestic Medicine
Women's health in the past was usually reduced to reproductive health, as many of the objects in our collection reminds us. From childbirth to child-rearing and the care of family members in domestic spaces, this section explores the activities and objects related to women and medicine in the 18th and 19th centuries.Care of the Sick & Nursing
Rules and hierarchy governed the patients and staff at St Thomas' Hospital throughout its long history as a charitable medical institution. Patients came mainly from those sections of society classed as the working poor and were subject to strict rules on admission to the hospital, particularly those patients suffering from venereal diseases like syphilis. Hospital staff were often from the same sections of society as the patients. However, during the mid-19th century St Thomas' Hospital saw historic changes. Not only did the buildings relocate to their current home in Lambeth, but nursing at the hospital also witnessed reforms that marked the start of the modern era for the profession. Before the arrival of Florence Nightingale (1820–1910) to St Thomas' in 1860, the first “Lady Nurse”, Jane Shaw Stewart, was appointed by matron Sarah Elizabeth Wardroper (1813–1892) in 1856. Efforts were underway to transform nursing into a profession for “respectable” ladies. Contemporary reformers argued that menial duties, low pay, and no formal training only attracted lower-class women who were illiterate and prone to drunkenness. Wardroper supported Florence Nightingale's radical reforms to nursing discipline and hospital ward designs by ensuring those reforms were implemented in the new buildings of St Thomas' Hospital from 1872. This section of the garret explores the history of hospital patients and the staff who cared for them on a daily basis.The photo dates from 1881 and shows the matron, Sarah Elizabeth Wardroper, alongside a group of St Thomas' Hospital nurses (unknown artist, in E. M. McInnes, St Thomas' Hospital, London: George Allen & Unwin, 1963).
Old St Thomas' Hospital
Welcome to the Old Operating Theatre Museum & Herb Garret. Tucked in the attic space of St Thomas’ Church, the museum celebrates the people, stories, and history of medicine from the Old St Thomas’ Hospital. The history of this hospital is a long one, so let us take you through some of the key moments from the roughly 650 years when it was located in its original site near London Bridge.St Thomas’s Hospital has provided shelter and relief for the poor, the sick, and needy since the 12th century, when it was part of the Catholic Priory of St Mary Overie (which is now Southwark Cathedral). After the Great Fire of Southwark in 1212, the hospital relocated to the east side of what is now Borough High Street, where it continued its charitable mission to help those in need. Unfortunately, the establishment of Protestantism by King Henry VIII with his order to dissolve the monasteries put a stop to this mission for 12 years. The hospital had to close its doors until a dispensation by King Edward VI allowed the City of London to take charge of the hospital as a secular space in 1553.
Fast forward about one hundred years. Towards the end of the 17th century, Old St Thomas’ Hospital saw the largest rebuilding campaign in its history. The new three-storeyed buildings were organised around three large interconnected courtyards, with two smaller ones connected on the far east side. As part of the central courtyard, Thomas Cartwright, the architect, rebuilt the old church of St Thomas’ in a more neoclassical style. The governors of the hospital asked Cartwright to include a garret or large attic above the church to store the hospital’s surplus. At some point after 1703, the apothecaries of St Thomas’ took over the space and used it to cure and dry medicinal herbs and store the surplus of the medicinal remedies. From that moment on, the attic was known as the Herb Garret.
Meanwhile, the hospital’s physicians, surgeons, and apothecaries attended to soldiers, sailors, and other working poor, treating diseases and tending to their injuries. In the 18th century, St Thomas’ became a teaching hospital, training new generations of medical practitioners. To accommodate this new educational function, the hospital needed new spaces. First, a new operating theatre was installed on the men’s wards in 1755. Next, an annex was built on the north side of the hospital, complete with an anatomy theatre, a dissecting room, a pathology museum, and a library. Later, in 1822 the herb garret on top of the church was transformed into a new operating theatre connected to the adjacent women’s surgical ward. This is the operating theatre you can visit today, and it was active during some of the most important moments in the history of medicine, including the advent of anaesthesia in 1846, and the establishment of the nursing profession in 1860.
In 1862, the Charing Cross Railway Company built a railway line through the site and the hospital was relocated again – this time to its current site opposite the Houses of Parliament. In the meantime, the old hospital buildings along St Thomas Street, including St Thomas’ Church, were spared and reused for other purposes. The actual attic of the church was boarded up and was forgotten for a hundred years until it was rediscovered in 1956 and then transformed into a museum with its doors opening for the first time in 1962. Today, the Old Operating Theatre Museum & Herb Garret conserves objects and spaces from the hospital’s history, and tells the stories of those who spent their professional lives working within its walls, and those who passed through as patients. Today you can experience this original space and its fascinating medical history when you venture up the bell tower and into the attic of St Thomas’ Church.
Venetian Plague Doctor's Mask
This Venetian plague doctor's mask was made specially for our museum collection. Masks like this were worn by doctors treating plague victims. The end of the beak was stuffed with herbs, which covered unpleasant odours and were thought to purify the air and prevent against infection. Its invention in the 17th century was based on the popular theory that foul airs and vapours, known as miasma, caused disease. The mask would be worn with a leather overcoat, breeches, boots and gloves, and the eyeholes would sometimes be covered with glass. The 17th-century German broadsheet (a large sheet of paper printed on one side with information) shows the familiar image of the plague doctor in full costume, with information about the practitioners in Rome (Nuremberg: Paulus Fürst, 1656, engraving on paper. Courtesy of The Trustees of the British Museum. CC BY-NC-SA 4.0).The Apothecary's Workshop
Apothecaries were medical professionals who could formulate and dispense medicines to physicians, surgeons, and patients. In order to create these remedies they needed a space to work in. An apothecary's workshop would have included things like a mortar and pestle, scales to weigh ingredients, an alembic to distil medicine, manual pill makers, containers to store medicines (including large bottles called carboys), and cork stoppers, among other apparatus.Until Old St Thomas' Hospital vacated Southwark in 1862, the apothecary lived and worked in what is now 15 St Thomas Street. As a permanent resident, he was not supposed to marry or to practise medicine outside of the hospital. In Old St Thomas' Hospital, the daily care of patients was the responsibility of the apothecary and the medical students.
Opium Poppy Seed Heads
These poppy heads were discovered under the floorboards of the Museum during restoration work. Opium, extracted from the opium poppy (Papaver somniferum), is a narcotic with a history dating back to at least 5000 BCE in western Europe. The drug is obtained by cutting the seed capsules of the poppy after the plant’s flower petals have fallen. The slit seedpods exude a milky latex that coagulates and changes to a brown colour upon exposure to air. The raw opium may be ground into a powder, or treated to obtain chemical derivatives such as morphine, codeine, and heroin. Before the use of anaesthetics, some patients were given small doses of opium before they underwent surgery. It was usually administered in the form of a tincture called laudanum, where the opium was dissolved in alcohol. Laudanum was used as an analgesic (a drug used to relieve pain), but it was not an anaesthetic, and surgery remained excruciating.The Apothecary's Rose
One of the first medical papers including rose was written by the Iranian medic Abu Ali Sina, also known as Avicenna (980-1037), who used egg yolk with rose oil as a skin treatment. The French surgeon Ambroise Paré (1509-1590) mixed rose oil with turpentine and egg yolk to make a healing "digestive" dressing that replaced the cauterisation method to close gunshot wounds (cauterisation involved sealing an open wound with hot oil or tar, for example). Roses contain quercitannic acid that is also found in the tannin of oak bark, which was an antibacterial treatment for bronchial infections, gastritis, diarrhoea, dysentery, eye infections, depression, and anxiety. It required 10,000 pounds of roses to produce just one pound of oil. However, Mrs Grieve in A Modern Herbal instructed that a simple rose “confection is to be made by beating 1 lb. of fresh Red Rose petals in a stone mortar with 3 lb. of sugar. It is mostly used in pill making”.The St Thomas’ Hospital Pharmacopoeia of 1772 incorporated rose into many prescriptions: "The Balsamic Bolus" included conserve of rose, the "Eyewash with Vitriol" included rose water and the "Common Gargle" was simply made by mixing eight ounces of rose tincture with one ounce of rose honey (p. 5, p. 10, p. 16).
The infused dried leaves of the dog rose were traditionally used as a substitute for tea. Within the UK during the Second World War, when fruit was scarce, a rose hip syrup loaded with vitamin C was developed which became an important and nutritious children’s health supplement.
Diagnostic Doll
This small porcelain figure of a child with hand-painted face and hair dates from the 1860s. It was used by physicians when they encountered young patients. The doll was presented to the child so they could indicate on the figure where they felt pain or discomfort. This example shows abrasion to the back surface where it was laid flat on a hard surface, such as a physician's desk.Featured Object: Leech Jar
A handblown clear glass leech jar, used for storing leeches between venesections, which are bloodlettings. A muslin cloth, which allowed air to pass through, was attached with string over the particularly large rim to keep the leeches in place.By the 1830s it was apothecaries, not physicians, who generally bought and administered leeches, although they were also sold for personal use. At this time, Europe was gripped by a leech craze; St Thomas’ Hospital went from using 1,607 leeches in 1815, to over 50,000 in 1822, and the following year spent more than an average physician’s annual earnings on leeches, a full 8% of the total expenditure for that year. France imported 42 million leeches in 1833 alone.
Hirudo medicinalis has a three-part jaw, and the saliva includes anticoagulants and vasodilators, which cause the wound to bleed for several hours after the leech is satiated and detached. This makes them a valuable tool for venesection.
18th- and 19th-century humoural theory held that diseases which caused redness, for example fevers and inflammation, were caused by an excess of blood, one of the four humours, and so could be treated by removing that blood, a task which leeches were especially good at. However, with leech costs spiralling due to demand and Pasteur’s germ theory gaining traction, use of leeches gradually fell out of favour throughout the 19th century. Despite this, the jar was made in the 1860s, so we know that leeches were still being used at St Thomas’ at this time.
The "Mechanical Leech"
The scarificator became known as the "mechanical leech" and was introduced to bloodletting procedures in the early 19th century. The small box-like machine held a line of matching blades that could be activated with the flick of the top bar. The blades made multiple small incisions in the patient's skin of about 3mm in depth. Physician and medical writer Henry Clutterbuck (1767–1856) advised on bloodletting and scarification for children during the 1840s, “There is one objection to the use of leeches in children, which deserves attention; namely, the terror they sometimes occasion, while the operation lasts. In such cases, therefore, scarification with cupping is often preferable to leeches; and, still more, venesection, if it be practicable, either in the arm or neck. By this, not only is the irritation here spoken of avoided, but the disease itself more effectually relieved.” Relief might have been given, but the instruments carried infection. It was not until 25 years later that antiseptic sterilisation procedures would be introduced by Joseph Lister (1827–1912) limiting the transfer of bacteria from patient to patient via a blade.Featured Object: Macaura's Blood Circulator
Patented in 1869 by Dr Gerald Macaura, the Blood Circulator was a hand cranked vibrotherapy device which, according to its eponymous creator, could deliver up to 6000 vibrations a minute. Placed on the afflicted body part, it claimed to improve circulation and thus cure all manner of ailments. Its instruction booklet proclaimed it could cure paralysis, deafness, gonorrhoea, and cancer as well as more minor ailments such as rheumatism, constipation, gout, insomnia, and haemorrhoids.With such miraculous declarations it’s no wonder that the device flew off the shelves, with tens of thousands sold in Britain alone. Newspapers and journals abounded with stories of its miraculous powers to make the paralysed walk and the deaf hear. One notable such account saw a bedridden young policeman from Leeds seek Macaura’s help. After just one round of treatment he was promptly found the next day on a brisk country walk!
Ultimately, however, the craze went as quickly as it came. The machine could do none of its claims. Macaura was exposed as a fraud and in 1914 sentenced to three years in a French jail. He was, unsurprisingly, never a real doctor and "Macaura" simply an alias. The machine faded from use.
You may have heard the theory that contraptions like this were used as a treatment for hysteria, but this has recently been revealed to be a myth. It seems appropriate, however, that just like its heyday the machine is still at the centre of debate!
Featured Object: Whirling Spray Ladies' Syringe
This orange rubber syringe dating to the 1900s, has a round bulb at one end, and a long, thin nozzle at the other. The original packaging was in a blue cardboard box, advertised as "Whirling Spray – Ladies’ Syringe". The box with the syringe and matching cone shaped attachment were "found under the floorboards of a terraced house in Clapham".The box claims that it is the “latest and best syringe ever intended to thoroughly cleanse the vagina”. What the box doesn’t say, is that the syringe was also a form of contraception common from the mid-1800s to 1900s.
This syringe would have been used by dipping the nozzle into water or a prepared liquid spermicide, squeezing and releasing the bulb to suck the liquid into the douche, then inserting the nozzle into the vagina and squeezing the bulb to spray the liquid and "clean" the vagina.
The hidden nature of this particular Whirling Spray speaks of secrecy, shame, and the illicit, contraceptive use of this vaginal douche in the user’s Clapham household. From the 1800s onwards, debates about birth control, population size, social morality, and the role of men and women in managing fertility emerged across Europe, America and Australia. Although pregnancy and childbirth were extremely dangerous, many felt that artificial contraception was immoral, and the only way to control population size was through late marriage or abstinence.
We do not know who used this syringe, only that the owner felt compelled to hide it; and in hiding it, they reveal to us the ancient and ongoing human desire to control fertility, and the struggle between pleasure and pain.
Featured Object: Domestic Medicine Chest
Histories of medicine have often focused on the activities of doctors and surgeons, or on innovations made in laboratories and hospitals. This domestic medicine chest, dating to the early 19th century, reminds us of the important role of medical care undertaken in the home. Diagnosing unwell family members, making and administering medicine, and watching over the sick were all activities associated with the domestic duties traditionally assigned to women. A well-stocked medicine chest was a crucial tool used by wives and mothers to provide healthcare for their family without professional assistance.Domestic medicine chests became popular in Britain in the late eighteenth century, but it was not until the 19th century that were commonplace in middle-class homes. Made from wood by highly skilled cabinet makers, the chests were fitted out by druggists and apothecaries before being sold on to customers. The interior is divided into small compartments that accommodate glass bottles containing powders, liquid medicines (tinctures), and ointments. These ingredients would have been made up into medicines using equipment also kept in the box.
The making and administering of medicines from these chests relied on the specialist knowledge of women in the home. In the 19th century, this knowledge was not only imparted through written guides, but passed down through the generations from mother to daughter. The domestic medicine chest stands as a material reminder of the skilled women who administered medical care in the 19th-century home at a time when they were excluded from formally entering the medical profession.
The "Midwife's Vade Mecum"
These well-worn but beautiful pages were separated from “The Midwife’s Vade Mecum” in a 19th-century copy of Aristotle's Complete Works – a small cloth-bound handbook containing text with simple colour images printed in red ink. These handbooks (vade mecum) were designed to be referred to as often as needed. They were cheaply produced and continually reprinted with various publication styles from the 17th to the 19th centuries. Although initially issued for use by midwives, they were acquired by many wealthier households for use as a general directory. Due to the intimate nature of the subject matter, including conception, pregnancy, childbirth, and general marriage advice, Aristotle’s name was likely used to give credibility to the publication. A possible source for the text is Nicholas Culpepper’s A Directory for Midwives (1651), with additional text added later by anonymous authors. These pages are entitled "Conception to Fourth Month and Fifth to Ninth Month", and the condition suggests they were regularly referred to.Featured Object: A Medieval Pewter Plate
A hoard of twenty of these pewter plates was dug up during building work to extend Guy’s Hospital in 1899. The area where they were discovered is thought to have been the graveyard of the old church of St Thomas’ Hospital.The plates date to around 1500, and curiously, they bear a crown and ostrich feather stamp, the mark of the Prince of Wales. This suggests that the dishes probably come from the household of Henry VII’s eldest son, Prince Arthur.
So why were these plates found on the hospital's site in Southwark?
We can’t be certain. But the quality of the pewter, their likely royal owner, and their location within the grounds of the medieval St Thomas’ Hospital, make it very possible that they were given to the hospital as a charitable donation.
Run by the church, hospitals had their origins in providing hospitality for travellers and caring for the destitute. And like other medieval hospitals, St Thomas’ relied heavily on charitable donations and bequests from those with financial means, to be able to offer these services to those in need.
Donations to the hospital might be monetary; they might be items needed in the running of the hospital such as food, fuel, bedding, clothing, vessels or lamps; or they might be on a much larger scale, such as the refuge for women provided for St Thomas’ by Richard Whittington in the early fifteenth century.
Featured Object: Carbolic Spray
This carbolic steam spray machine was used during surgical practice undertaken at Guy’s Hospital by Sir Henry Howse (1841–1914). By filling the dome section with water and lighting a small candle beneath the machine, the steam produced by the heated water drew the carbolic liquid up through the rubber tubing. It then formed a spray that disinfected the air, operating site, and hospital staff, creating an antiseptic environment.Invented by Joseph Lister (1827–1912) in 1867, carbolic acid spray was the first antiseptic used to kill germs during surgery, laying the foundation for modern day asepsis and sterile technique. Following its introduction, the risk of mortality after amputation surgery dropped from 50 to 15%. Howse was a great advocate of this new antiseptic practice and used the procedure in Guy’s Hospital and the local Evelina Hospital for Sick Children (now St Thomas' Hospital, Lambeth).
However, in 1887, Lister renounced the spray machine after realising that the air did not play as important a role in sepsis as the bacteria transferred from skin, instruments, and dressings did. Exposure to high concentrations of carbolic acid also causes serious side effects such as skin irritation, heart problems, and kidney damage. Poisoned by the liquid, the hospital staff often passed dark purple or black urine.
Now known as phenol, an organic compound extracted from coal tar, carbolic acid can be found in small quantities in items such as lotions, polishes, soaps, and can even be used to prevent snake infestation!
Schimmelbusch Anaesthetic Mask
One of the most commonly used anaesthetic masks in the late 19th century was invented by Curt Schimmelbusch (1860–1895). The mask featured a trough-like rim that was designed to stop any excess ether or chloroform anaesthetic dripping onto the patient's face.Horsehair Sutures and Silkworm Gut Ligatures
The ligatures and sutures from our 19th-century collections are made from silkworm gut and horsehair, materials noted for their tensile strength. Other materials recommended by Victorian surgeons included catgut (made from the intestines of cattle, sheep, or goats) and kangaroo tendons! Ligatures are used to tie blood vessels during operations such as amputation to prevent blood loss, while sutures are used for sewing tissues together and closing wounds. Before the development of germ theory and aseptic surgery during the later 19th century, they could be a lethal source of post-operative infection. Horsehair was a more popular material with surgeons because it presented a lower risk of infection. This was because preparation of the sutures involved boiling the hair, which inadvertently sterilised it.Surgery in the 1800s
On this plinth in the Antechamber lies one of the most important practical works on Victorian surgery, Charles Bell's "Illustrations of the Great Operations of Surgery" from 1821. By looking through this work visitors can explore in detail how major surgery was performed in the era before anaesthesia and antiseptics. Speed and accuracy gave patients the best chance of survival, which limited the number of major operations surgeons could perform. During the early 19th century the five "great" or "capital" operations were amputation, trepanation (skull surgery), lithotomy (removal of bladder stones), aneurysm, and strangulated hernia. Three of those operations were more regularly performed in our operating theatre: amputation, trepanation and lithotomy. You can explore some examples from Charles Bell's work right here.John Stevens, Sir Charles Bell (1774–1842), oil on canvas, circa 1821. © National Portrait Gallery, London
Amputation
Despite the high surgical mortality rate of around 30%, amputation was regularly performed in cases of disease, trauma, and accident. Before the introduction of anaesthesia in 1846, amputations were performed as quickly as possible using a knife and a saw. Curved amputation knives were developed for the technique known as the "tour de maitre" (literally, "the master’s turn"), with which a surgeon could slice through the soft tissues of a damaged limb with one sweep of the sharp, curved blade. This cut was followed by the saw to remove the bone. To prevent blood loss, a tourniquet was applied to compress the arteries and the amputation was completed on average in under two minutes. Until the time of Ambrose Paré (1510–1590), bleeding from the surgical wound was stopped by the application of boiling oil or red-hot irons (known as cauterisation). Paré believed this practice to be barbaric and reintroduced the use of a ligature to tie exposed blood vessels and stop the bleeding without subjecting the conscious patient to additional agony (a method first used in the 1st century AD). A further development had occurred by 1679, when James Yonge of Plymouth described a technique of making skin flaps to cover the stump and credited the method to Lowdham, a surgeon from Exeter. This technique, still used today, was possibly first used by the ancient Greeks. But while patients could and did survive the ordeal of the operation itself, they faced a greater risk of dying from a post-operative infection.Charles Bell, "Illustrations of the Great Operations of Surgery" (London: Longman, 1821), Plate IX. Courtesy of the Wellcome Collection
Lithotomy
Lithotomy refers to the surgical removal of bladder stones and was known as “cutting for the stone”. Minerals in urine can crystalise and build up to form stones of varying sizes, causing them to irritate the bladder wall and prevent the flow of urine from the kidneys or out of the bladder. Untreated cases can be life-threatening, and in the era before anaesthesia patients had to undergo excruciating invasive surgery. We can try to understand the profound and lasting emotional effects of the operation on some patients by looking at the famous diaries of Samuel Pepys (1633–1703). Pepys was cut for the stone on 26 March 1658 by St Thomas' surgeon Thomas Hollier (c. 1609–1690). He was lucky enough to survive and celebrated the anniversary of his operation each year with a “stone feast”, with his extracted stone mounted as a trophy. In Pepys's era lithotomy could take as long as 40 minutes. Nearly a century later, another St Thomas’ Hospital surgeon developed a method which reduced the time of the ordeal to under a minute for the retrieval of one stone. William Cheselden (1688–1752) perfected the “lateral perineal method”, a procedure that involved accessing the bladder via the left side of the perineum rather than taking the “high” route (above the pubic bone). In 1741 only 20 deaths were recorded from his 213 public lithotomies – that's just over a 90% survival rate! Cheselden’s lateral lithotomy remained the preferred surgical method until the end of the 19th century.Charles Bell, "Illustrations of the Great Operations of Surgery" (London: Longman, 1821), Plate XIX. Courtesy of the Wellcome Collection
Trepanation
Possibly the oldest known surgical procedure performed in the operating theatre was trepanation (also, trephination). Archaeological evidence dates the practice back to 7000–5000 BC and the procedure is still performed today. We can find out how a Victorian trepanation was set up to be performed (without anaesthetic) from Charles Bell’s Illustrations of the Great Operations of Surgery (1821), “let there be a stout assistant to hold the patient’s head firmly, and let others put their hands on his arms and knees. The surgeon will expect the instruments to be handed to him in this succession – the scalpel; the rasparatory; the trephine; the brush; the quill, and probe, … the elevator, the forceps, the lenticular." Surgeons often developed their own beautifully crafted instruments for trepanation, such as ebony-handled and gold-plated trephines stored in velvet-lined mahogany cases. The surgeon used the trephine, a cylindrical saw, to bore a hole into the patient’s skull to relieve pressure on the brain, remove a blood clot, or treat a skull fracture. Speculation remains whether some trepanations were performed to release “evil spirits” in patients. Victorian commentators theorised that they were used to cure demonic possession, particularly in patients suffering convulsions. A pounding headache or a seizure may have been attributed to spiritual forces, but this may never be proven.Charles Bell, "Illustrations of the Great Operations of Surgery" (London: Longman, 1821), Plate III. Courtesy of the Wellcome Collection
Liston's Amputation Kit
This is an 1835 amputation kit designed by Robert Liston (1794–1847). The kit includes a set of three knives of various lengths, a tourniquet, a bone saw, bone nippers, ligature clamps, and thread. Missing from the box are the scissors and the suturing needle. Liston was a prolific Victorian surgeon and the first to operate in Britain using ether as an anaesthetic in 1846. In a period when surgeons often worked with manufacturers in the design of their instruments, he invented the "Liston knife", a razor-sharp double-edged amputation knife. A Liston knife was apparently the preferred weapon of Jack the Ripper during his murderous rampage in and around Whitechapel, London, in 1888.The Operating Table
This simple wooden operating table dating from the 1830s was the ultimate in function for Victorian surgeons. The narrow design, removable headrest, and extending footplate allowed the surgeon and dressers to manoeuvre swiftly around the patient during different procedures. Before the introduction of anaesthetics in the mid-19th century, speed was key to avoid prolonging the patient's agony. The operating table was donated to the museum by University College Hospital Medical School in 1957. The donation occurred a year after the rediscovery of the operating theatre by Raymond Russell (1922–1964). The table was one of the original fittings acquired by Lord Russell Brock (1903–1980) for the restoration and opening of the Old Operating Theatre Museum in 1962. The saw cuts that can be seen on this table are likely to have been a result of its use as a work bench by University College carpenters. This was a common occurrence during the 1890s, following the development of germ theory and the introduction of antiseptic and aseptic surgery. Hospitals began to dispose of all wooden furniture and equipment and replaced them for metal and glass supplies.The Replica Operating Table
Our replica operating table is fully interactive, which means Old Op visitors can gain a sense of life a Victorian surgical patient in an original setting! Operating theatres were traditionally designed as a literal ‘theatre’, so that medical students could gather in close proximity to the patient to closely observe the operation. Although most patients were blindfolded before entering this theatre, they couldn't be protected from the sounds and smells of 150 medical students, shouting, smoking, and jostling for a better view. The intense atmosphere is described in the memoirs of St Thomas' Hospital surgeon, John Flint South (1797–1882), whose distinguished career spanned the entire period of this operating theatre (1822–1862)."The general arrangement of all the theatres was the same, a semicircular floor and rows of semicircular standings, rising above one another to the large skylight which lighted the theatre. On the floor the surgeon operating, with his dressers, the surgeons and apprentices of both hospitals, and the visitors, stood about the table, upon which the patient lay. The floor was separated by a partition from the rising stand-places, the first two rows of which 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 were continually pressing on those before, often so severely that several could not bear the pressure, and were continually struggling to relieve themselves of it, and had not unfrequently to be got out exhausted. There was also a continual calling out of ‘Heads, heads,’ to those about the table. The confusion and crushing was indeed at all times very great, especially when any operation of importance was performed, and I have often known even the floor so crowded that the surgeon could not operate till it had been partially cleared."
Gold-plated Trephine
This gold-plated trephine dating from the 1870s is a rare object from our collection. A trephine is a drill used to open sections of the skull during the ancient surgical procedure of trephination (also trepanation). The surgeon cut a disc of bone from the skull using the cylindrical saw blade. Sometimes multiple discs were closely cut and the bone between the holes was clipped or chiseled down. The drill section and handle bear the maker’s mark for Down Brothers, a London-based instrument maker founded in the 1870s. Specialist instrument makers established themselves during the 17th century. Practical surgical tools became status symbols, and prominent surgeons often worked with manufacturers in the design of their instruments. Silversmiths replaced blacksmiths, decoration in ivory and tortoiseshell became popular, and instruments were kept in luxurious velvet-lined cases. Trainee surgeons with little money had to borrow what they needed!The Nurse's Chatelaine
This beautiful nurse's chatelaine dates from the 1850s. The French word chatelaine originally meant "mistress of the château". In the 18th and 19th centuries, it came to be applied to an object essential to the lady of every household, and soon it was used by wider society including nurses. Many chatelaines had medallions at the top that hid a metal tongue for hooking over the waistband of the uniform. Suspended from that medallion were the essential tools that a nurse might need while at work. Our set contains a pencil, an ivory notepad, a mirror, a pair of scissors, a measure, and a whistle.Stomach and Enema Syringe
This pump was based on the usual design for an irrigation syringe that was made to administer an enema (a liquid or gas injected into the rectum to either expel its contents or insert a drug). However, by changing the tube placement and reversing the pressure action on the handle, the syringe could also be used to pull fluid from inside the stomach. Although this machine was manufactured by Krohne & Sesemann, the invention was patented by John Read (1760–1847), who had given his name to a brass enema syringe used for the injection of fluids. It is worth noting that this instrument dates from the 1840s, before the development of germ theory and the introduction of sterilisation practices.The Alembic
An alembic is a still which was designed to concentrate and purify the active medicinal ingredients from raw materials by evaporation and condensation. Medicines were normally extracted from plants, minerals or animals by soaking or dissolving the materials in liquids – most commonly water or alcohol. However, extraction by distillation was found to obtain purer and stronger ingredients. The materials were cut and ground down, mixed with liquid, and heated to above boiling point. As the liquid evaporated it turned into steam, which rose up the alembic until the steam condensed on the cold metal or glass of the "spout". The condensed liquid then ran off and was collected in a container. The "essence" of the material was captured and the liquid obtained was referred to as an "essential oil".Alembics could be made from glass, metal, or leather, but metal was normally used for large-scale production. They were normally relatively crudely made copper vessels and handmade to order.
The Beer Bell
Both staff and patients of St Thomas' and Guy's Hospitals were given an allocation of beer for daily consumption as part of the dietary regime. This beer bell dates from the 1840s and it was rung at Guy's Hospital for the distribution of beer and food to the wards. The daily ration at different time periods at Old St Thomas' Hospital varied between two and eight pints of beer. Although this may seem excessive, it must be remembered that weak or "small" beer was the staple drink when a clean water supply was not guaranteed. St Thomas' Hospital's on-site brewery periodically brewed thousands of pints of small beer. It was not until 1860 when tea and sugar were supplied to patients as an alternative to beer.Chain Dissecting Hooks
These chain hooks were used by surgeons and anatomists during post-mortem examinations. The ring was securely pinned to the dissecting bench while the sharp hooks held back layers of tissue. They were widely used from the 19th century with other dissection instruments including post-mortem, cartilage, and brain knives; intestine scissors; scalpels; forceps; probes; elevators; back-saws; rib shears; chisels; mallets; and blowpipes!Victorian Prosthesis
Our operating theatre saw a great number of amputations during its active period (1822–1862). Those patients who managed to survive the procedure and escape a post-operative infection were assured some kind of replacement limb. This artificial leg from our collection has advanced features such as a hinged knee for jointed movement, and more comfortable leather thigh and waist bands. It even sports its own shoe. Only the wealthy could afford a prosthetic limb like this. The best a poor amputee could expect was a wooden peg leg (like a pirate's), which was prone to splintering or rotting.Marigold
The species of marigold that has most medicinal properties is Calendula officinalis. Many plants have officinalis as the second part of their botanical name, and this always indicates that they have been used in medicine for a long period of time. "Calendula" derives from the belief that they bloomed on the calends of each month (the calends were the first day of the month in the ancient Roman calendar). Calendula cream is sold in pharmacies today as a soothing skin cream and contains extract of marigold. In early 20th century rural England, and almost certainly before that, a tincture made from marigold was used to treat sores on the teats of a cow’s udders.Another traditional use for marigold is to treat the pain and swelling caused by a wasp or bee sting. It is something that we could try today if stung in a garden. However, Mrs Grieve wrote in A Modern Herbal of 1931 that this was something that “has been asserted”, so the efficacy of this remedy is not guaranteed!
Surgeon's frock coat, apron and wash station
Before the 1860s there was no understanding about how germs spread. As a result, surgeons did not make an effort to keep themselves, their instruments or the operating theatre clean. Most surgeons washed their hands after the operation rather than before. They also would wear frock coats or aprons that were covered in dried blood from previous operations to show their experience. You can try on our 'bloody' aprons when you visit the museum!Wooden Bandage Winder: Double Roll
This late-Victorian wooden bandage winder is handmade and allowed for two cotton strips to be wound simultaneously into bandage rolls. The width of the rolls could be adjusted by moving the wooden divider between the two sections. After winding, the handle was pulled out to release the tightly rolled bandages. This gadget was particularly useful before the production of prepacked sterile dressings. A visiting retired nurse once told Old Op staff how much she needed one of these during the Second World War, because all bandages had to be wound by hand!Bladder Stones
Bladder stones are formed of hardened minerals from concentrated urine left unemptied in the bladder. A cross-section of these stones reveals how the material built up inside the bladder. A stone builds in size layer by layer, and the diet of a person affects the colour of the stone. For example, if a colourful food is eaten, such as blackberries, the colour can be seen in the stone.Metacarpal/Metatarsal Amputation Saws
These bow-framed saws allowed for the more delicate surgical removal of fingers and toes compared to larger saws used for major limb amputations. The steel frames are attached to ebony handles, while the ornately designed screws were used to adjust the replaceable steel blades. Breakages were common with these finer saws, so a spare blade was essential to have ready during surgery.Bistoury Caché
This curious instrument is a bistoury caché, which translates from French as “hidden knife”. A blunt guard hides a sharp scalpel blade, which was uncovered by turning the screw on the handle when in the correct position. It allowed surgeons to make internal incisions without wreaking havoc due to low visibility inside the body. The design made it ideal for use during the limited number of internal surgeries which 19th-century surgeons could perform, including hernia operations and lithotomies (the removal of bladder stones), which was known as “cutting for the stone”.Bismar Scale
This handmade potable scale came in particularly handy at market for weighing produce quickly and cheaply! The oak rod has a weighted end with a known mass. The merchandise to be weighed was attached via the hook at the opposite end. The fulcrum (missing on our object) was moved until the scales were in equilibrium. Known as a bismar scale or Danish balance, it’s one of the simplest types of weighing scale and thought to have been introduced around 3000 BCE. Its accuracy decreased the heavier the load, but its uncomplicated design and portable nature made the bismar very convenient to use. Perfect for a quick trip to the market for some medicinal herbs!Old Op Activities Online
If you can't make it to the museum, we have some online activites for you to get stuck into! Try our jigsaw and sliding puzzles featuring some of our displays, or get the family involved in some Victorian parlour games! You can even step into the role of surgeon in our interactive game!The Garret
This is the garret of St Thomas’ Church, formerly a part of Old St Thomas' Hospital. The church was completed in 1703. Its architect was Thomas Cartwright, who worked as master mason to the famous architect Sir Christopher Wren (also a governor of Old St Thomas' Hospital) on three of his city churches. While the space was not in the original designs, before the church was completed the hospital governors decided to request the inclusion of a garret (an old word for a livable attic). Originally it was meant to store the hospital's surplus, but at some point the apothecary took over the use of the space to store, dry, and cure medicinal herbs.Today the garret contains most of the museum's collection and forms the core of the Old Op with the Antechamber and the Operating Theatre. To tell the stories of the Old St Thomas' Hospital, the garret has been divided thematically around different aspects or spaces of the hospital. At the entrance we have the Apothecary's Workshop and Shop, then the Waiting Room, the History of Old St Thomas' Hospital, the Herb Garret, the Physicians & Diagnosis area, the Apothecary Counter, and areas labelled Women's Health & Domestic Medicine, Care of the Sick & Nursing, and Anatomy & Dissection. The virtual tour in this space shows highlights from these sections.
Wet Specimen: Tapeworm (Taenia solium)
This is a wet specimen of a species of tapeworm known as Taenia solium or pork tapeworm. Taenia is a genus of large tapeworm, two of which are common parasites of the human intestines, Taenia solium and the beef tapeworm Taenia saginata. Both types of worm are passed to humans through the consumption of raw or undercooked meat. The beef tapeworm can reach a length of between four and ten metres within the intestines, whereas a pork tapeworm is typically between two and seven metres long. A person can live with a tapeworm infection (taeniasis) without any symptoms. However, serious complications may occur if a person ingests the eggs of the pork tapeworm, causing a condition called cysticercosis. Larval cysts form in the muscles, brain or other body tissues. Symptoms include pain, weakness, fever, vomiting and diarrhoea, while infection in the brain can give rise to dementia, paralysis, convulsions and epileptic attacks, which can be fatal. In the early 20th century, pills supposedly containing tapeworm eggs or larval cysts were advertised for weight loss. The theory was that, once swallowed, the tapeworm would mature in the gut and absorb food, allowing the dieter to eat whatever they desired and still lose weight. Once the ideal weight was reached, an anti-parasitic could be used to expel the worm (if it hadn't already found its own way out). Whether or not many people took up such a potentially dangerous diet is a matter of debate, but the theory behind the tapeworm diet proves impossible to dispel to this day. It is ironic that tapeworm infection can actually lead to weight gain through food cravings, particularly for carbohydrates.Mrs Grieve: Anatomical Teaching Skeleton
Hey, I'm Hannah Polasky, and today I'm going to take you through some of my paleo-pathological findings of the resident articulated skeleton at the Old Operating Theatre Museum and Herb Garret. She's been affectionately dubbed Mrs Grieve, and therefore, for the duration of this discussion, I will be referring to her as such. Mrs Grieve had several assumptions made about her in the past, one of which is that she had syphilis, and another of which is that she wore a corset.Now, these are very important facts because they create a narrative that isn't necessarily something that one can create from a skeleton. So today I'm going to take you through observable pathologies, and then I will discuss the ways in which we can interpret these reasonably. So we're going to start at the top of her head. At the top of Mrs Grieve's skull, you will notice that there are some small pits. These tend to be caused by different types of anaemia. There's some debate as to which kinds of anaemia cause it. So reasonably, we can simply say anaemia.
Moving down, if we look at Mrs Grieve's teeth, we'll see that there are horizontal striations on them. These are caused by a child who is growing teeth, not getting enough nutrition, and therefore their teeth genuinely stop developing enamel for a bit. That's what causes those little lines. And if we move a little bit lower, we will notice that Mrs Grieve has some polishing on her upper humerus. Now, polishing happens when a synovial joint, which is your ball and socket joints really, loses its synovial fluid, which cushions the motion. When that happens, you get bone on bone rubbing, which causes polishing. This usually happens with repetitive motion.
If we then move a little bit lower and look at Mrs Grieve's rib cage, this is where older analyses said that it's obvious that corsets were worn. There's one problem with this. Corsets don't actually deform the skeleton unless there are huge other issues, like a really terrible vitamin D deficiency. That's really not the case here, because if it was, Mrs Grieve's legs would be bowed, and they're not. Also, corsets can deform the angle of the spinous process. Those are the bumps on your spine. They get angled a little bit lower. That's about it. That's not even evident on Mrs Grieve. There was no, quote, tight lacing done.
These facts are incredibly important, because if we look at older analysis that was done at the same time as the assertion about corset wearing, we will know that Mrs Grieve's diet was comprised of a lot of fish. This was very common amongst working class folks. If we look at the fact that Mrs Grieve has repetitive motion evident on her arms, which also show some decently large muscle attachments alongside the fact that she had different deficiencies in her diet and that she was eating a working class diet, we can reasonably simply assume that Mrs Grieve was your average working class person whose body was used to teach anatomy after her death.
That's all we can really tell. We don't know the exact types of activities she was doing. We don't know what her occupation was. But we do know that she probably did have an occupation. She probably wasn't super wealthy, and it's really important that we as historians, as people interested in history and in the history of medicine, don't make erroneous assumptions about the past. We cannot overinterpret the evidence before us.
