The Terror of the 19th century operating table: No drugs and patients were fully awake

Libby-Jane Charleston
8 min readSep 12, 2019

No drugs. No sedation. Half of those who underwent surgery in the 19th century didn’t survive the experience. WARNING: Graphic

Scottish surgeon Robert Liston was known as the “Fastest Knife in the West End,” amputating a leg in under 30 seconds.

He was so incredibly strong and agile he was able to use his left arm as a tourniquet, while he wielded the knife in his right hand, as the patient writhed around, screaming in fear and agony.

Liston would keep both hands free by clasping a bloody knife between his teeth. He had learned to steel himself against the screams of those strapped to the operating table in the theatre, which was usually packed to the rafters with medical students and curious members of the public, attracted to the gore and sheer horror of the operation.

Once, when Liston brought down his knife to slice off a patient’s leg, he was so focused on being speedy that he sliced off three of his assistant’s fingers. And, as he swung the knife back up, he managed to slice a spectator’s coat — causing him to collapse and die on the spot.

Artery forceps are used as a clamp to stop bleeding during surgery. This type of forceps was invented by Robert Liston (1794–1847), an English surgeon famous for his speed and skill in surgery. They are often referred to as “bulldog” forceps. Credit: Science Museum, London. CC BYSource:Supplied

Half of those who underwent surgery in the 19th century didn’t survive the experience. The operating theatres were no place for the squeamish; once Liston accidentally sliced off a patient’s testicle along with the leg he was amputating.

The biggest problem was that hospitals had absolutely disgusting hygiene and sanitary conditions and most doctors refused to wash their hands — the idea that doctors could spread germs from patient to patient was scoffed at.

In fact, most doctors insisted on wearing their bloodied aprons all day, going from patient to patient, the aprons gathering more blood and muck, as a badge of honour.

But those disastrous times did not last forever and it was 173 years ago this month, a time when surgery was incredibly hazardous, that a young Quaker surgeon named Joseph Lister stepped forward with his theory about germs that would change the course of medical history.

Libby-Jane Charleston

Journalist, ex-ABC TV, HuffPost AU Assoc Editor, ABC TV, author, poet, mother of 3 boys, cancer Survivor, history lover