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On a knife edge

Laurence Alster witnesses gory drama at the Old Operating Theatre Museum. Though never a happy experience, surgery today is at least one from which most people eventually walk away with no more disturbing memories than those of hospital food. It was not always thus. Before the age of pre-med injections, the pre-op injunction was a little more terse.

"Sickness is the forerunner of death. Are you prepared for the great change that is about to overtake you?" hospital chaplains would inquire of patients before the knife descended. With neither anaesthetics nor antiseptics available, praise the Lord and pass the hacksaw was the general style. Visitors to the Old Operating Theatre Museum in Southwark, London, can readily gauge the progress in surgical procedure. Reached by climbing a narrow spiral staircase, the museum is located in the former garret of St Thomas's Church, itself part of the original site of a hospital founded in the 13th century.

Small but absorbing throughout, the museum traces the history not only of the hospital - along with interesting displays on its most famous personnel, notably Florence Nightingale and John Keats - but also of the development of medicine and surgery.

If visitors do show some interest in the display cabinets containing sundry medicinal herbs, they spend most time looking with horror at various vintage surgical instruments. The section on obstetrics, for example, with its crude devices for saving the mother at the expense of the baby, is especially gruesome. And a cabinet devoted to cupping and scarification - both primitive techniques for drawing blood - makes visitors swallow fairly hard.

In the operating theatre itself, five steeply raked, semi-circular terraces look down upon a horseshoe-shaped central area with a wooden operating table in the middle. Underneath the table is a small box containing sawdust.

In one corner of the room, a pitcher and bowl stand on a small table. Rediscovered in 1956, this is a fully-restored version of a mid-19th-century operating theatre. Or, if you prefer, torture chamber. In a performance alone worth the price of admission, museum administator Hugh Jenkins dons period costume to replay scenes from a time when the theatre staged the grimmest dramas.

The stars of the show were, of course, the surgeons. Wearing coats that, according to one contemporary account, were "stiff and stinking with pus and blood", they would attempt to work with speed and accuracy. Throughout the performance, tightly packed and often rowdy spectators, not all of them medical students, would struggle for a better view.

The most elementary principles of hygiene were frequently ignored, with many surgeons neglecting even to wash their hands before they set to work on their patients.

Given with the aid of volunteers - members of the audience play the patient and attendants - Jenkins's is a graphic, spellbinding account, full of fascinating digressions on particular operations, Victorian social conditions, and the history of medicine and its major practitioners.

The Old Operating Theatre Museum and Herb Garret, 9a St Thomas's St, London SE1 9RY. Tel: 0171 955 4791

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