They pale a little as guide Sue Weir lifts the lid of a wooden box to reveal a set of gleaming knives and hacksaws, used to amputate the limbs of unfortunate Victorian patients in the days before anaesthetic or antiseptic. Speed was then the surgeon's best hope. With only brandy to dull the pain and a blindfold to shut out the scene, some patients died of shock in the tiny operating theatre, while many more of them succumbed to infection when they returned to the wards.
The nurses, on a sightseeing tour during a professional trip to Britain, recover from their shock sufficiently to pose flat out on the wooden operating table for photographs. Some visitors to London are content to take in Big Ben and Buckingham Palace; others cannot resist the lure of leeches, body snatchers and pickled organs. To cater for such appetites, Sue Weir offers half-day and full-day tours in London and the home counties, to unravel the secrets of medical history museums and trace the remnantsof our gory and painful past. Demand, she says, is increasing. As well as nurses and doctors, her groups include ordinary sightseers keen to learn more about how we lived - and died. "I think it is just curiosity," she says. "We don't put up with pain these days. A hundred years ago illness was part of everybody's life. Today it is just an incon-venience and a nuisance."
A former nurse who switched careers to become a tourist guide six years ago, Sue Weir is also the author of the definitive guidebook to our medical heritage, Weir's Guide to Medical Museums in Britain (Royal Society of Medicine Services Ltd, £10). Enthu s iasts can use it to track down Roman surgical instruments, a Victorian dentist's hand-drill and a fleet of antique ambulances, in more than 200 museums, famous homes, spas and herb gardens.
Earlier in the day, the American nurses have toured the archives at the Royal London Hospital, where Dr Barnardo and Edith Cavell once worked, and the Florence Nightingale museum at St Thomas's Hospital, London, which traces the nursing pioneer's life a n d recreates a Victorian hospital ward. At the little museum with the operating theatre - the oldest surviving one in the country, on the original Southwark site of St Thomas's - they have no trouble recreating scenes from the past with the help of Sue We ir's graphic commentary and some lethal-looking props.
Early operations, she explains, were performed on the wards but the victims' screams distressed other patients so much that in 1822 doctors decided to create a purpose-built operating theatre by extend- ing into the roof of St Thomas's church next door, where the hospital apothecary already stored his herbs. Here, for the next 40 years - until the hospital moved to its present site opposite the House of Commons - the surgeons wielded their knives under gas light in front of jostling ranks of medical students.
Such procedures as amputations, bone- setting and removing kidney stones were their main stock in trade. Kidney stones were "cut out'' by inserting a metal instrument directly into the urethra, crushing the stone and withdrawing it. Samuel Pepys underwent such an operation in the 17th century. In his diaries he describes celebrating the anniversary of the procedure, performed by a female surgeon.
Without anaesthesia, internal surgery was too risky to perform, and anyway the doctors had little idea of how the body worked. They had no notion of germs - surgeons stitched up wounds with needles they kept behind their frockcoat lapels - and bedside manners were a thing of the future. As one 19th-century student wrote: "The more the patient did cry out, the more we did laugh.'' Little wonder only the poor and destitute were ever desperate enough to enter a hospital. The rich were treated at home.
After the theatre closed in 1862 it lay forgotten for nearly a century until builders uncovered it in 1956. The museum, which also features a range of blood-letting equipment and apothecaries' wares, has only recently opened.
The visiting nurses have by now developed a taste for gothic horror. They are eager for more. The 18th-century anatomy collection at the Royal College of Surgeons, the next stop, more than satisfies their appetites.
The treasure-trove of specimens - animal and human - in their original alcohol-filled jars were dissected, prepared and preserved by one man, surgeon John Hunter (1728-93), in the days when doctors were limited to dissecting four bodies a year and grave-robbers supplied any further demands. Hunter kept a menagerie for his animal experiments. Nobody really knows, admits Sue Weir, where he obtained all his human corpses.
Mystery aside, Hunter is credited with some of the most important medical discoveries of his time, advances which helped his colleagues finally break with their barber-surgeon rivals. His experiments on living and dead patients, comparing healthy and diseased organs, demonstrated how blood circulates, bones grow and embryos develop.
Not all his experiments were successful. He abandoned hope of discovering the key to immortality (by freezing people towards the end of their lives to be thawed out at convenient intervals), after experiments on rabbits' ears failed. Although he successfully grafted a living human tooth on to a cock's comb (where it continued to grow) he concluded there was no long-term gain in transplanting teeth.
On John Hunter's death, the collection of 13,687 specimens was handed to the Company of Surgeons. A direct hit on their Lincoln's Inn building during the Second World War devastated the museum and it now houses only a quarter of Hunter's original preparations. It is not generally open to the public.
Even the sight of 3,600 assorted human body parts holds no terrors for the nurses. Only Sue Weir has to shield her eyes when we arrive at the display of pickled feet. "I can deal with anything, except feet,'' she says.
We move briskly on to a case containing a fleshy mass the shape and size of a rugby ball. It is a tumour weighing 144 ounces which Hunter removed from a man's neck, without anaesthetic, in 1785. "It lasted 25 minutes,'' Hunter recorded, "and the man did not cry out during the whole operation.'' Hunter also treated wounds inflicted during duels. One case shows the four holes left in the intestine of a lieutenant-colonel after Hunter's unsuccessful attempt to remove the bullets.
Among the more exotic animal specimens is a baby crocodile still attached to its yolk, a dissected camel's hump and an aardvark embryo. Some, like the baby kangaroo and bottled elephant, were sent back to Hunter across the seas by the earliest explorers.
Commentary over, we scuttle out. Nobody is keen to be left behind with the grim collection in the dark. Yet it is not the sinister side of primitive medicine that leaves a lasting impression on the nurses, so much as amazement that their predecessors achieved so much.
"People are always surprised by how little has changed,'' confirms Sue Weir. "Other things have come full circle.'' Although apothecaries no longer grind herbs, about 80 per cent of modern medicines derive their origins from plants. Surgical instruments have changed remarkably little since Victorian days - doctors still use a saw for amputations.
Sue Weir's medical history tours cost £25 for a half day and £52 for a full day for groups of 10 or more, including all transport and admission fees. Both coach and walking tours can be arranged and these can be tailored to individual tastes. Telephone 0
71-928 0765 for further details.Reuse content