MUSEUMS / The doctor will see you now: Joanna Gibbon takes a deep breath and heads for London's Old Operating Theatre

THE OLD Operating Theatre, Museum and Herb Garret is not a place to be visited in a few spare moments.

Once the narrow spiral staircase up to the museum - situated in the attic of a redundant 18th-century church, now the Chapter House for Southwark Cathedral - has been negotiated, it is obvious that more than an hour is necessary for such oddball medical history.

Built in 1821, the operating theatre - for women - of Old St Thomas's Hospital, South London, is this country's oldest surviving example of what appears to be surgery at a rudimentary and blood-curdling stage of development. The reason that this exists at all is because the hospital moved to Lambeth in 1862, and while the old wards which adjoined the theatre were sold off as hospital buildings, the theatre remained part of St Thomas's Church. The church became redundant in 1898; the operating theatre in the attic was closed and forgotten until its rediscovery in 1956.

Another reason for the operating theatre's elevated position was to reap the reward of as much natural light as possible: candlelight was unsatisfactory for such work. Up in the garret with the herbal apothecary and collection of surgeons' instruments on one side, and the operating theatre on the other, Marieta Ryan, the museum's curator, sniffs a little. She says she can smell formaldehyde - caused by the preserved lungs, kidneys and hernias and something else.

'There is no air-flow in here. When you walk in, it hits you,' she says. In the simple, curved, wooden theatre, restrained in its furnishings and as quiet as a morgue, we sniff a little more.

One particularly nasty explanation for Ms Ryan's discomfort might be the existence of old sawdust, which was packed between the floorboards of the theatre and the ceiling of the church, mainly to prevent worshippers hearing the noise above, but also to absorb blood. A box of sawdust was placed underneath the operating table - a surgeon could kick it about to catch the blood dripping from a wound - but no doubt it missed on occasions and blood seeped through the boards.

The sniffing and the ensuing light-headedness brings images of tortured patients, semi-dazed with alcohol, thrashing about on the wooden operating table - no Doctor Kildare touches here - with perhaps a piece of leather to bite on. Surgery in the early 19th century was highly skilled in areas such as amputations - the expertise having been gleaned from wars - but hindered by lack of anaesthesia and knowledge of the existence of bacterial infections.

The museum's collection of surgeon's knives is impressive. They were tailor-made to the surgeon's methods. One of the other visitors commented that one knife looked like her bread knife, and jolly good it was too, while the other instruments looked very similar to those in her husband's toolbox.

However, 150 years ago, no one agreed to an operation lightly - the author Thomas Hardy refused one, preferring the alternative of remaining in bed for six months, says Ms Ryan - and many died of septicaemia afterwards.

The theatre's furniture - some of which might now look rather grand in a drawing room - is made of mahogany and pine which would have harboured bacteria even after cleaning, had the latter been deemed important.

A surgeon of the time, donning a blood-spattered old frock-coat, would be concentrating on speed and accuracy: and also demonstrating his skills to both students and his distinguished guests.

It was not uncommon to be invited to watch an operation and be sat in a chair a few feet from the blood-bath. On a nearby table there is an appalling 18th-century print of a man, wide awake and screaming, having his leg amputated.

'Students would heckle if their view was obstructed and they'd also time the surgeon with their watches: under a minute was quite normal and 27 seconds was the record for an amputation,' Ms Ryan explains.

Apart from limb chopping - usually to stop the spread of gangrene - a surgeon's work during the early 19th century might include surface work, such as the removal of visible growths, hernias and skin cancers; the only fairly successful internal work - because the result was not always certain death - was the removal of bladder stones.

In the museum, various metal contraptions are displayed for a lithotomy, or the breaking down of bladder stones: 'A long needle is passed into the urethra and an attachment on the end breaks down the stones so that they can be passed out of the body. It was a dreadful operation,' says Ms Ryan. The frequent consequence of which was permanent double incontinence.

In 1846, the use of anaesthetics - chloroform and ether - opened up the field of surgery and many more internal operations were made, again with little success. Queen Victoria used chlorofrom twice, and her example helped break down the Church's opposition to its use in childbirth.

It was not until the 1860s, when Joseph Lister pioneered the use of carbolic - sprayed all over the operating theatre and causing the surgeons to pass black-stained urine - as a powerful antiseptic to prevent infections during surgery, that far reaching advances in the science occurred. Even so the concept of aseptic surroundings took time to catch on, says Ms Ryan, as students were stlll allowed into the same room to watch the surgery until the turn of this century.

By this time, however, St Thomas's operating theatre had been closed down. But according to Ms Ryan, it can still have a strange effect on its visitors: the previous curator was telling a group of school children about an amputation when a builder working on the roof above started sawing through a metal rod. Four children promptly keeled over in a faint.

The Old Operating Theatre, Museum and Herb Garret, 9a St Thomas Street, London SE1 9RY.

Telephone: 071-955 4791.

(Photograph omitted)