Before the development of the chemical industry, virtually all medicines were made from natural plants. The use of herbs in St Thomas’ Hospital is first recorded in the Elizabethan period: a time of major advancements in herbal medicine, but also one where earlier superstitious beliefs prevailed. It was recorded that in 1605 that a bath for a woman in Judith ward in the Hospital was prepared with herbs and sheep’s heads.
Storing herbs in the oak beamed roof of the church meant excess moisture could be absorbed in the wood and also offered protection against rodents. During the programme of restoring the space in the 1950s, poppy heads were discovered in the rafters. Hooks and ropes in the roof provided further evidence of its former use.
In 1703, the Hospital appointed royal physician Richard Mead. He regularly published herbal preparations, including Snail Water for venereal disease. Included were ‘Garden Snails cleansed and bruised 6 gallons and Earthworms washed and bruised, 3 gallons’.
Venereal disease was a common ailment at St Thomas’. As well as strict segregation between general male and females, sufferers from venereal diseases would would be further separated from and treated in the ‘foul’ wards.
The Operating Theatre
In 1821 operations were known to have been undertaken on Dorcas ward, part of the ward block for female patients, that was adjacent to the Old Operating Theatre. The Hospital Governors at the time reported this as unsatisfactory and half of the church roof space was converted into a purpose-built theatre to maximise light from above, and provide an ideal teaching area for the demonstration of surgical skills. Over 100 students could be attending an operation.
To enter the museum today, you have to climb 52 spiral stairs in the church’s tower. Of course patients did not have to do this as the theatre was roughly on the same level as the ward.
Anaesthetic and Antiseptic
Anaesthetic was first used at the Hospital in January 1847 - 25
years after the first operation in the Old Operating Theatre. It was in the
male theatre on a patient with a ‘disease of the hand’. The inhalation caused
‘much coughing, quickened circulation and threatened congestion of the brain
and lungs that it was not thought proper to continue the operation’.
The Hospital never benefited from antiseptic (killing or removing germs before they enter a wound) surgery to prevent infection. Hands and surgical equipment were rarely washed before operations and bandages were often reused.
Before the advent of anaesthesia and antiseptic surgery, it was not possible to operate inside the body, with the exception of lithotomy, the extraction of bladder stones. Therefore operations were limited to those where post-operative infection would hopefully not be fatal: amputations, wounds, fractures, hernia and easily accessible cancers of the skin, etc.
In 1823 surgery for the first artificial nose at the Hospital took place on a 34 year old man: his nose destroyed from the vast amounts of mercury taken to treat syphillis.
During the operation he was obliged to often raise himself from the table to spit out the blood which got into his mouth.
Sawdust was used in theatres to absorb blood. In the 1970s, sawdust collected beneath the floorboards of the Old Operating Theatre was so congealed with blood, it needed a cement cutter to get through it.
The medicinal leech has been used for thousands of years in the common practice of bloodletting: the loss of blood was more gradual and less of a shock to a patient.
Leeches continued to be used prodigiously in the nineteenth century.
At St Thomas’ Hospital they were very much in favour with both physicians and surgeons. In 1820, 28,850 were used, escalating to over 50,000 in 1822. In 1823, 54,650 leeches were purchased at a cost of £251 9s 6d (over £10,000 today) which was roughly 8% of the hospital’s expenditure on all medical and surgical supplies.
Treatment for a case of gonorrhea in the 1820’s required the daily application of 12 leeches onto the patient’s penis.
Today leeches are used in restoring venous circulation following reconstructive surgery.
The patients admitted were generally the working poor from all parts of Britain. It was suggested that as the majority of the Hospital’s patients came from
outside the local area, its demolition and relocation in 1862 would have little significant effect.
St Thomas’ in Southwark maintained its ancient policy to exclude anyone classed as “incurable” ie anyone with a contagious disease or a mental or terminal illness.
They refused admission on the basis that their condition may pose as a potential threat to others or were beyond ‘cure’. Almost all hospitals in Britain operated an equally restrictiveregime until the mid-eighteenth century.
Guy’s Hospital opened across the road from St Thomas’ in 1725, and admitted those previously excluded from the latter, uniquely allowed “lunatics” access to one ward. The link between the two hospital’s was severed in 1836 following a riot in when a number of Guy’s students forced their way into the male operating theatre of St Thomas’. The police were called and the perpetrators fined.
Thomas Wakley, founder-editor of the Lancet medical journal, claimed the Guy’s students had been victimised. He had been excluded from St Thomas’ and full of resentment.
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