On our most recent foray into London, I found the Old Operating Theatre and Herb Garret hidden on a street in Southwark across Tower Bridge near Guy's Hospital. As a Master Herbalist from the wise woman tradition, I was curious to see a different kind of London history. (I have paraphrased below, the material from their web site. I won't mark each section with quote marks--only those which are direct quotes--but I will include the citation at the end of my paraphrasing.)
HISTORY OF THE SITE
According to the web page, the site was originally part of Old St. Thomas Hospital, described as "ancient" in 1215. Originally a hospital for the infirm was set up on the site by seven nuns and monks in 1212. Old St. Thomas was an Augustinian order with a mix of monks and nuns who were charged with providing shelter and treatment for the poor, sick and homeless. It is on was on the grounds of the hospital that the first complete English translation of The Bible was completed in 1533 by Miles Coverdale and printed on the premises by James Nicholson.
Dissolved by Henry VIII in 1540 when the hospital had a dubious reputation as a bawdy house. Southwark was London's "red Light" district at the time. The local prostitutes along with some of their clients, sought treatment at Old St. Thomas for venereal diseases. Reopened in 1552, the hospital was eventually moved to Lambeth in 1862.
At the end of the 17th century the hospital and the church were rebuilt and in 1822 "part of the herb garret was converted into a purpose built operating theatre." It was a surgical ward for women patients and had abutted this ward itself until the hospital was moved in 1862.
|A Nurse's châtelaine from Guy's hospital, 1800's.|
The patients were mainly poor people who were expected to contribute something toward their care if they could afford to do so. Rich people were operated on and treated at home! When St. Thomas' was rebuilt in 1703 it had a very large garret under the roof which the hospital Apothecary used to dry and store herbs. His main office and shop was located a short distance away on St. Thomas Street.
LONDON APOTHECARY HISTORY
Until 1617 trade in herbs was controlled by the Grocers Company, at which time London Apothecaries broke away from the Grocers, claiming, "very many empiricks and unskilled and ignorant men .... do abide in our city ... which are not well instructed in the art and mystery of Apothecaries but ... do make and compound many unwholesome, hurtful, deceitful, corrupt dangerous medicines.
"The Chelsea Physic Garden was set up in 1676 and currently the second oldest botanical garden in England. Oxford University's botanical garden was set up in 1621 and had the distinction of being the oldest botanical garden in the country.
Unlike medical doctors, apothecaries and surgeons did not have medical degrees. Rather they served an apprenticeship of seven years and the hospital's pupils trained with the apothecary first before moving on to surgery.
The apothecary at Old St. Thomas was held in higher esteem than present day chemists. "He was the chief resident medical officer of the hospital, responsible for all patients in the physicians' absence and for all prescription for surgical cases.
"As science improved and active ingredients were isolated and synthesized, the apothecary's art was increasingly replaced by the science of the pharmacist. Before the development of the chemical industry, medicinal compounds were virtually all made out of natural plants. Even today 70% of our medicines originate from herbal sources.
Old St. Thomas' apothecary had to pay for all the medicines required by the hospital, out of his own fees which was a means of the hospital's governors controlling the cost of health care. Unfortunately it also led to accusations against the apothecary of using less than ideal materials to keep his own costs to a minimum.
Some of his herbs were obtained from the Hospital garden, some were "brought in by the Herb Woman, (sold by the container full; eg wormwood by the horse load; others by lap full, bundle, bag or basket). Other herbs were purchased from City Apothecaries, many of whom were Hospital Governors.
Old St. Thomas employed its first Apothecary in 1566, and its last in 1871 when the role as senior medical officer was transferred to the Assistant Physician." (Previous section paraphrased from http://thegarret.org.uk/index.htm, accessed online on 05/23/14)
Not only is it worth your time and effort to visit the museum, it is also possible to attend some fascinating ongoing lectures and events linked to them such as The Surgeon's Apprentice, Victorian A and E, Georgian Medicine, and Night of the Body Snatcher, to name a few. Group events for children can also be arranged with hands on activities in the Herb Garret. The web site also has a great page with links to medicine from Ancient Egyptian through to Future medicine beyond the 21st century.
Given the nature of hospitals and the many thousands who die in them, it is no surprise the Old Operating Theatre and Herb Garret are thought to be haunted. Karen Howell, the museum's curator was photographed several decades ago with a Polaroid camera. When the picture developed it showed a bright yellow streak moving off to her right. Another picture of a man standing the same spot in the Garret also has a yellow streak although it is shaped differently and moves across the entire picture. In between the two photos a picture was taken and there are no streaks on it at all.
Footsteps are also heard on the premises although no one is ever seen. Karen still works there and I spoke with her about it. She says in all the years she has been employed there she has never seen anything paranormal take place. She has heard the footsteps but she is not bothered by it. You can view a link on YOUTUBE to a video about these occurrences which was produced for television by a show called The Why Files.
|Looking back down the stairwell, over the entrance to the Herb Garrett. Those monks must have been mighty thin!|
Up the tight, winding stairs, and a large leap from the step onto the doorway of the museum will bring you inside the gift shop where all kinds of fun, zany, and amazing things await you, such as syringe pens, fuzzy stuffed microbes, T-shirts, guide books, science toys and games. We didn't even stop to look as I could easily have parted with £80 in gifts for grandchildren on both sides of the Atlantic.
|Looking down from the entry into the gift shop. Delights for curious children of all ages.|
Everything is carefully labeled, with information about each herb and item provided. It took me back to a long forgotten moment in my early childhood
when I was about four years old. My mother and step father had just moved into a small house on the outskirts of Spenard, Alaska (Joe Spenard's old homestead which eventually was subdivided into housing estates) just minutes from downtown Anchorage.
While rummaging down in the dark basement I came across a box of interesting smelling powders and plant material packaged in small boxes and jars. I have no idea what possessed me, but I found a large stainless steel bowl and a wooden spoon in another box. I took my found treasures outside filled the bowl with water and proceeded to add various and sundry powders and dried pants to my concoction.
My mother was none too pleased to find her smallest child in the yard making witches brew with her precious store of herbs and spices! Apparently, I have always been a Green Witch! Plants have spoken to me since I was a toddler and I spent many a happy hour wandering in the Alaskan wilderness outside my father's homestead, sampling plants and watching wildlife, knowing by touching a plant whether or not it was safe to eat. Even our neighbor's gardens in Spenard ware not safe from my pilfering. I ate rose hips like candy, and I adored the honey sweet--pepper hot taste of Nasturtiums. It is no accident I became a Master herbalist in the Wise Woman tradition.
|Cabinet of animal curiosities used in medicine!|
APOTHECARY'S TOOL KIT
The alembic above, was used to distill precious essential oils and medicinal distillates from plant materials. I would give my eye teeth for a press like the one on the right. Medicinal plant material would soak for weeks or months in olive oil, 80-100 proof alcohol (good brandy or vodka works just as well), or glycerin. When the tincture was judged to have drawn the maximum amount of active principals from the plants, the plant material would be sieved from the liquid and placed in this press where every last drop of medicinal goodness was wrung from the leaves, flowers or roots before discarding. The liquid was sieved again with fine mesh or very fine muslin and stored in dark brown glass jars out of the light.
|Round wooden sieves, tincture bottles, and medicinal plant materials.|
|Apothecary's tools of the trade: weights, herb cutter, Pharmacopoeia, metal pill making form|
DODGY COMPOUNDS AND THE USE OF STRANGE ANIMALS!
During these ignorant and superstitious times compounds employed in medicine were often ill measured hodge podge mixtures, some of which contained several dozen or more ingredients including he excrement of human beings, dogs, mice, geese, bits of other animals, mineral salts, blind puppies, moss from a human skull, etc., etc. (In Egypt during the time of the Pharaohs crocodile dung was considered an effective means of birth control in a suppository!)
The pharmacopoeia edition of 1721, included for the first time, the botanical names of herbal remedies added to the official ones; the simple distilled waters were ordered of a uniform strength; sweetened spirits and cordials were omitted as well as several compounds no longer used in London, although still in vogue elsewhere.
|Red clover (top right) is a source of many nutrients including calcium, chromium, magnesium, niacin, phosphorus, potassium, thiamine, vitamin C. and rich sources of isoflavones. It has been used to treat or help with: cancer, whooping cough, respiratory problems, asthma and bronchitis (because it is an expectorant), antispasmodic, a diuretic, it cleanses the liver and the blood, and helps with cardiovascular health by lowering cholesterol levels. It is also used to treat: psoriasis and eczema, acne, colds, digestion, flatulence, infections, infertility, lymphatic swelling, piles, helps relieve menopausal symptoms, prostate health, and sore throats. There a variety of preparations for red clover such as; tinctures, teas, dried extracts, capsules, tablets, liquid extract, and ointments for topical applications.|
|Pill tins and vials. Beecham's Pills, first marketed in 1842, lower left, were a laxative created by Thomas Beecham containing Aloe, ginger, and soap. This going concern grew into Beecham Health Care, Beecham Pharmaceuticals Ltd. which merged with SmithKline, which merged with Glaxo. The pills were discontinued in 1998|
|Carter's Little Liver Pills--an American product--are made from Biscodyl. They are the precursors of Dulcolax for relief of constipation. First patented in 1868 they are still available in the U.S.|
|After shaping, pills were counted out in a try like the one above and then placed into an envelope or pill tin.|
Beecham entered the lexicon of common British English as Cockney slang: Beecham still (pill). For Americans who are not familiar with Cockney, it is an London dialect within a certain geographic area--those who could hear the bells of St. Mary Le Bow church on London's East side. It is a rhyming slang that plays with British English. For example in Cockney one would ask for a cup of tea by saying, "I could go for a cup of Rosy Lea."
Carter's entered into the American language lexicon in a much less playful and far more direct manner: "She has more S*** than Carter's Liver Pills." And thus we have another wonderful example of they way Brits play with their language while we crass Americans hurl it at one another.
ASPIRIN AND MODERN PAIN RELIEF
In 1758 Reverend Edward Stone of Chipping Norton in Oxfordshire chewed on a twig from a willow tree. Despite the extraordinary bitter taste he noticed a pain relieving quality. Stone dried and cured the bark and presented his draught to friends. Over the course of five years it never failed to cure mild to chronic pain.
In 1826 Italian chemists discovered Salicin--the active ingredient in willow bark and by 1839 a process was in place to extract Salicin from willow and Meadowsweet--a flowering herb used in the time of Elizabeth I to strew on the floor and crush under foot, releasing its lovely scent.
In Germany in 1858 chemists there isolated salicylic acid from Meadowsweet and in 1898 production of Aspirin began by the Bayer company, having further refined the isolation of acetsylic acid and discovered a means of synthesizing the compound which relieves pain, inflammation and fever. Today's NSAIDS (Non-Steroidal Anti Inflammatory Drugs) such as Tylenol and Paracetamol are basically Aspirin with one molecule removed, supposedly to reduce of remove the stomach irritation that comes from using Aspirin. The trade off is liver damage. Health food stores sell willow bark ground up in placed in gel caps which provide the same relief as the modern drugs but without the side effects of stomach irritation and liver damage. Of course, Willow bark cannot be patented and sold to make one family or Pharmaceutical corporation rich so...
|Sweet almonds, Frankincense, Myrrh, Gum Arabic, Cinnamon...|
|and Snail Water!!|
Snail water was developed by Dr. Richard Mead who practiced at St. Thomas Hospital from 1703-1715. Here then is his recipe for the treatment of Venereal Disease:
Take garden snails cleansed and bruised 6 gallons
Earthworms washed and bruised 3 gallons
Of common Wormwood, Ground-Ivy and Cardoons each one pound and a half.
Pennyroyal, Juniper berry, Fennelseeds, Aniseseeds each half a pound.
Cloves and cubebs bruised, each three ounces.
Spirit of wine and Spring water, of each eight gallons.
Digest them together for the space of twenty four hours.
And then draw it off in a common Alembick.
From The Pharamocopea Papium, 1718
One would have thought knowledge of the recipe alone might have led to more judicious intimate relationships!
|Type and model of exam table in use when the garret and operating room closed down in 1868.|
|Scarificators, lancets, cups for use in cupping and bloodletting.|
|For those with hearing issues perhaps a conversation tube might help. No??...|
BIRTH CONTROL AND WANDERING WOMBSPregnancy tests have been around for thousands of years. From the 1930's to the 1960's they involved the use of live animals including frogs, mice and rabbits. Frogs injected with the urine of a pregnant woman laid eggs. For years this was the most reliable method of determining pregnancy and pathology labs had tanks full of frogs.
|A variety of forceps used when delivery needed to be hastened. Metal speculum tubes were used with a light (candles?) to view the inside of a woman's vagina.|
|Those slim metal rods in the far right are called Male Urethral Sounds. Used in the laboratory, they were inserted into the male urethra to locate bladder stones.|
In the picture above is a physician's Stick made of tapered leather washers on a metal rod core with a solid metal round top. Carried like a walking stick buy some physicians and surgeons. In the days before anesthesia it would be held across the mouth as a restraint.It acted as a gag for patient and a biting stick as evidenced by the teeth marks along its length.
POISONS AND HOMEOPATHY
Poisons are also addressed in the Herb Garret as so many of the herbs used in medicine are also deadly poisonous used to extreme. When used in minute amounts judicious healing and pain relief occur, and thus Homeopathy gives birth to the modern pharmaceutical industry. Below are three of the most common plants used in this manner for hundreds and thousands of years.
Opium, derived from poppies is a prime example. Dried poppy was dissolved in a tincture of alcohol to create Laudanum which was highly addictive. It dulled the senses but was not strong enough to be anesthetic. It was not until 1803 that Morphine was extracted from opium resin. Morphine is ten times more powerful than processed opium. It is the most effective drug known for the relief of severe pain and remains the standard against which knew pain medications are measured.
Atropa Belladonna and Henbane are common wayside plants here in the UK. While a single glistening, black berry of Nightshade (Belladonna) can kill you, a minute dose can prevent spasms and act as a sedative and diuretic. Atropica which is derived from deadly nightshade is given prior to general anesthesia or as emergency treatment for extremely slow heartbeat. It is also included in preparations for eye, skin, rectal and gastrointestinal drugs. Scopalamine derived from Henbane paralyzes the nerve endings and is administered during general anesthesia to keep the patient's body perfectly still.
Foxglove works by controlling contraction of the heart muscle--strengthening and slowing it. Deadly in large amounts, small amounts can steady the heartbeat, restoring circulation in those with Congestive Heart Failure. Wood wivs or wise women used to give a careful preparation of foxglove in a tincture with other plant materials for what was then known as dropsy aka CHF.
Until the modern era of anesthetics plant materials were often used to knock patients out for surgery. In the Orient a Japanese surgeon successfully operated on hundreds of patients using a mixture of 16 different plant materials including Datura (Angel Trumpet or Jimson Weed)--a know narcotic hallucinogenic. the other ingredients are now known to contain Scopalamine and atropine amongst others and would indeed have produced unconsciousness and temporary paralysis in a patient.
While the Dark Ages held sway in Europe, in Persia and Arabia narcotic smoke was inhaled prior to surgery--created again from plant materials that were dried and burned or wet into a tincture, soaked up in a sponge which was heated and the resulting vapors were breathed in.
Dwale was the commonly used anesthetic in England from the 12th-16th centuries. It contained Bile, opium, lettuce, bryony and hemlock. Surgeons roused their patients by rubbing vinegar vigorously into their cheekbones.
Meanwhile Nitrous oxide had been discovered by 1775 by Englishman Joseph Priestley who used to sponsor laughing gas parties amongst the gentry.
|Bottles of Chloroform and Aether, masks and surgeon's scalpels.|
MODERN ANESTHESIA AND ASEPSIS
|Chloroform inhaler and masks.|
Ether: Around the same time American physician Crawford Long noticed that his friends staggering around under the influence of ether felt no pain when they injured themselves during "ether frolics." After removing two tumors from a friend under its influence Long promoted ether for use against severe pain during surgery.
If you've ever had surgery under the influence of ether you will never forget it--it smells sickeningly sweet and is very heavy to breathe in. Ether induces strange hallucinations and dreams and also causes vomiting after surgery. Both Chloroform and Ether can kill if to much is ingested and both have been replaced by modern pharmaceuticals for use as anesthetics.
Asepsis: Joseph Lister, (1821-1912) a Quaker surgeon practicing at Glasgow Royal Infirmary, promoted the idea of a sterile operating theatre. In 1867 he discovered a preparation of carbolic acid could sterilize surgical instruments and clean wounds. Lister built his concepts of sterilization upon Louis Pasteur's work in France, using creosote dissolved in alcohol to sterilize implements. Lister also required all surgeons operating under his auspices to wear clean gloves and wash their hands before and after all operation with a 5% solution of carbolic acid. Instruments were sterilized in the same solution and it was sprayed throughout the operating theatre. Deaths from infection, gangrene and sepsis dropped markedly under his care.
In 1879 two American doctors created a specialized surgical antiseptic fluid and named it Listerine after Joseph Lister. It was given to dentists for oral care in 1895 and became the first over-the-counter mouthwash sol din the U.S. in 1915. It was also marketed as floor cleaner and cure for gonorrhea. Not a big seller, some bright light in marketing decided to attempt selling it as a cure for "halitosis" AKA bad breath and a heretofore unknown social malady was born with an instant cure!
THE OLD OPERATING THEATRE
It is important to note that when the operating theatre at Old St. Thomas was last used there was no use of anesthetic or sterilized, clean facilities--or physicians! Consequently many patients opted to die rather than go to hospital and submit to surgery. If they opted for surgery and by some chance survived it then they faced the very real threat of gangrene and blood poisoning.
Ever heard of child bed fever? It was a common "disease" of childbirth and in the 18th and 19th centuries in England and Wales over 250,000 women died from it. In fact nearly ten out of every 1000 women lost their lives to what is now known as Puerperal fever. Today is it extremely rare in most countries except third world areas. The cause of this infection was unsanitary medical implements and filthy dirty doctor's hands. Often they did not wash hands between one patient and the next. It took a woman three very agonizing days to die as her raw womb became infected, swollen, and spread to the rest of her with extremely high fever and sepsis. Surgical instruments have not changed significantly since the 1890's. Most appear to be adaptations of the average man's tool chest. Some newer tools have been patented in the 20th and 21st century to address specific surgical situations that came with advances in technique and delivery.
My son in law is a certified medical technician (those folks who package the tools for each scheduled operation and attend surgery to ensure the surgeons have the correct implements at any given moment.) I perused his medical textbook once. It contained over 300 pages of tools which he had to learn by site along with the uses and specific surgeries in which each item was required. Those tools resembled nothing so much as a modern torture kit.
It is a modern blessing we have the luxury of being put under general anesthesia and so are unaware of exactly how brutal surgery can often be. Surgeons often position our bodies in an extremely unflattering and painful manner to have the best field of site and reach.
Without the use of X-rays or CT scans visions of the interior of the body were extremely limited for physicians in the past. For information medics relied on very simple tests, information form the patient and their own intuition.
In medieval medical practice blood and urine were considered the foremost diagnostics. Often physicians would visit an ill patient, expecting the spouse of mother to bring out a container of the patient's urine for the doctor to examine--from horseback!
Surgeons performed examination of the outside of the body to suss out what was going on inside the patient, tapping the chest and limbs for a response. IN 1816 medical diagnostic science took a leap forward when a Frenchman by the name of Rene Laenec tightly rolled a sheet of paper into a tube, listing to the pulse of a diseased heart, inventing the first stethoscope.
|Another gruesome image of dissection.|
|The general arrangement of all theatres was the same: a semicircular floor and standings rising one above another to a large skylight. On the floor the surgeons operated with their dressers (every surgeon had 4--they dressed the outpatient wounds so the surgeon had more time for surgery) and apprentices of both hospitals with esteemed visitors gathered all about the table upon which the patient lay, fully conscious, tied and/or held down with the Physician's stick in his or her mouth.|
|Pupils stood in the standings, curious and noisy, packed like Herring in a barrel. Chaos and confusion often reigned and frequently the floor was so crowded the surgeon could not begin the operation until some space was cleared.|
|The view a pupil would have had of an operation in progress.|
|Photo of an actual surgery taking place in a similar operating theatre in the late 19th century.|