> I learnt more about the history of medicine and surgery through a visit to the [Old Operating Theatre Museum](https://oldoperatingtheatre.com/). It is housed in the attic of an early eighteenth-century church of the old St Thomas’ Hospital in London. Predating [[anaesthetics]] and [[Antiseptics]], it is the oldest surviving surgical theatre in Europe. ![[Pasted image 20230910235901.png]] # Operating Theatre (1822-1862) Surgery in the Victorian era was rather **rudimentary and limited in its scope.** At the time when the old operating theatre was active, only three surgical procedures could be done in there: 1. [[Amputations]] procedure (including the removal of external tumours); 2. [[Trepanations]] (for head injuries); 3. [[Lithotomies]] (removal of bladder stones). Ideally, these procedures should have been done in under 2 minutes to minimise blood loss and shock, as the patient was awake throughout the surgery. These procedures were done **without anaesthesia** (introduced in Old St Thomas' in 1847) and **without antiseptics** (introduced after the move to the new site after 1865). ![[Pasted image 20230911000057.png]] ### A Space of Hope While today surgery in the Victorian era might seem barbaric, it was rarely performed for its own sake. It was always done as a last resort to save the life of patient. Patients could voiced whether to accept or reject the surgery, although if they chose to reject it, their death was inevitable. The operating theatre provided the working poor their best chance for survival and, as such, it stood as space of hope. ## Pill Making Machines Medicines dispensed and taken in pill form grew popular during the 18th and 19th centuries. Pills presented a way to administer accurately measured single doses of medicine. 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, 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 of the pill-making machine. When the pipe was the correct length, the handle was flipped over so that the brass grooves corresponded to each part of the machine. The apothecary worked the pipe into the grooves, back and forth, to create accurately dosed and spherical cut 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 could be rolled in a varnish. The most luxurious finish was created by coating pills in **gold or liver leaf** using a separate tool called a **pill silverer.**