Tucked away in the attic of the early‑18th‑century St Thomas’s Church near London Bridge station, the Old Operating Theatre Museum & Herb Garret is Europe’s oldest surviving surgical theatre. Originally the hospital apothecary’s herb garret, in 1822 it was converted into a women‑only operating theatre, long before anaesthetics or antiseptics were used. The semi-circular gallery once accommodated up to 150 students who watched swift, often brutal procedures carried out under primitive conditions, with only alcohol, opiates, or chloroform for pain relief. Forgotten under a sealed attic hatch around 1862 when the hospital moved to Lambeth, it lay hidden for nearly a century before being rediscovered in 1956 and transformed into a museum in 1962. Given the nature of this interesting and morbid nature of the museum, I decided to visit and share my journey with you.
To access the museum, visitors have to climb a cramped 52‑step spiral staircase to the entrance, which also doubles up as the shop. Due to the tight nature of this staircase, a traffic light system is employed and if you’re over 6 feet in height like me, watch you head! Originally part of St Thomas’ Hospital, the church’s attic space, known as the Herb Garret, was used by apothecaries to dry and store medicinal herbs. In the days before modern pharmacies, hospitals and apothecaries needed large quantities of dried plants for making remedies, tinctures, and poultices. The garret’s warm, dry environment made it ideal for preserving herbs. In the herb garret, the different herbs and other ingredients often used were highlighted, as well as information as to how these were administered to the patient.
A hospital apothecary in the 18th and 19th centuries would have used a wide variety of herbs to treat ailments, reflecting the medicinal knowledge of the time. Some commonly used herbs and their purposes included willow bark which contains salicin (a precursor to aspirin), it was used to relieve pain and reduce fever, lavender which was valued for its calming properties, it was used to treat anxiety, insomnia, and headaches, chamomile which is known for its soothing effects, it helped with digestive issues and nervous complaints, peppermint which was used to ease stomach pain, nausea, and colds, thanks to its antispasmodic and cooling properties. Other botanical ingredients included thyme which was applied for its antiseptic properties, particularly for respiratory infections and wounds, comfrey which was used externally to help heal bruises, sprains, and broken bones, and finally elderflower which was common in remedies for colds, fever, and sinus infections due to its anti-inflammatory and diuretic effects. All of these and many more were on display at the museum and can be seen photographed above.
One of my favourite displays was of a number of glass bottles, although they were mostly green in colour. This was primarily for both practical and protective reasons as the green glass helped block sunlight, especially ultraviolet (UV) rays, which can degrade light-sensitive compounds like tinctures, essential oils, and herbal extracts. The same practice is still used for red wine today. Protecting the contents extended shelf life and preserved potency. In earlier glassmaking, the green colour often came from natural iron impurities in the sand used to make the glass. Rather than purifying it completely (which was expensive), glassmakers embraced the tint, which conveniently offered some UV protection. This coloured glass also helped distinguish medicinal substances from other solutions, especially when many were stored in similar-looking containers, and some were lethal. Those photographed above are mainly poisonous or toxic chemicals. This visual cue could also help reduce accidental misuse or ingestion.
The theory of miasma (from the Greek word for “pollution”) held that diseases such as cholera, plague, and typhoid were caused by foul-smelling, poisonous air arising from decaying organic matter. Dominant from antiquity through much of the 19th century, miasma theory shaped public health and medical thinking for centuries. In the Victorian era, it influenced how cities tackled sanitation: slums were cleared, sewers built, and streets cleaned, not because germs were understood, but to eliminate bad air thought to spread illness. While incorrect in its cause, the miasma theory’s focus on cleanliness inadvertently laid the groundwork for major improvements in urban hygiene. It wasn’t until the rise of germ theory in the late 1800s, thanks to scientists like Louis Pasteur and Robert Koch, that miasma was scientifically disproven, fundamentally transforming medicine and public health. However, the impact of this incorrect belief can be seen throughout the museum.
In the Victorian era, bloodletting remained a common medical practice, rooted in centuries-old beliefs about balancing the body’s “humours.” Though its popularity had begun to wane by the mid-19th century, many physicians still relied on the procedure to treat a wide range of ailments, from fevers and infections to mental illness and inflammation. It was believed that removing blood could restore internal balance and relieve pressure or congestion in the body. Techniques included using scarification tools, lancets, or leeches, which were often applied behind the ears or to the temples. Despite growing advancements in medical science during the Victorian period, such as the development of germ theory and anaesthesia, bloodletting persisted among conservative doctors. Eventually, the practice fell out of favour as scientific medicine advanced and the dangers of excessive blood loss and infection became better understood.
Medicinal leeches have a long and fascinating history in medicine, dating back thousands of years. Their use became especially widespread in Europe during the 18th and 19th centuries, peaking in the Victorian era, when leech therapy was believed to balance the body’s humours by drawing off excess blood, similar to bloodletting. Leeches were commonly applied to treat everything from headaches and fevers to more serious conditions like inflammation or infection. The medicinal leech (Hirudo medicinalis) was most often used, valued for its ability to pierce the skin painlessly and secrete anticoagulants that kept blood flowing. Apothecaries and hospitals kept live leeches in jars or tanks, and they were sold by the dozen in markets. Though leeching fell out of favour with the rise of scientific medicine and germ theory, it has seen a modern revival in microsurgery, where their natural anticoagulants and ability to stimulate blood circulation aid in tissue healing and graft survival. They are now a rare species in the UK and are undergoing a conservation recovery program, so that this culturally important species isn’t lost.
Childbirth was highly dangerous for both mother and child, with maternal mortality rates far higher than today. Causes of death included postpartum infections (puerperal fever), haemorrhaging, prolonged labour, and obstructed births. The lack of understanding of germ theory until the late 19th century meant that even well-meaning doctors and midwives often spread infections by using unwashed hands and unsterilised instruments between patients. Hospitals could be particularly deadly due to these unsanitary conditions. The tools above look terrifying by today’s standards and can’t have been comfortable for the expectant mother if there were complications. Some of those tools include obstetric hooks or craniotomy tools which in extreme cases, were tragically used to remove a stillborn baby when the mother’s life was at risk. Despite some medical advances, childbirth remained a deeply risky and painful experience throughout much of the 19th century, only improving significantly with better hygiene, antiseptics, and safer obstetric techniques toward the end of the era.
In the Victorian era, the introduction of antiseptics marked a revolutionary turning point in medicine and surgery. Before their use, operations were performed in unsanitary conditions, often leading to deadly infections like sepsis or gangrene. The breakthrough came in the 1860s, when Scottish surgeon Joseph Lister applied Louis Pasteur’s germ theory to surgical practice. Lister began using carbolic acid (phenol) to sterilise instruments, clean wounds, and even spray the air in operating theatres at the Glasgow Royal Infirmary. His methods drastically reduced post-surgical infections and mortality rates, laying the foundation for modern aseptic techniques. Although initially met with scepticism, Lister’s success helped shift medical thinking from the outdated miasma theory to a scientific understanding of infection control, ultimately transforming Victorian medicine and saving countless lives. You may recognise his name from Listerine which was previously sold as a surgical antiseptic before it became a mouthwash.
At the same time, hospitals saw the dramatic introduction of anaesthetics, further revolutionising surgery and childbirth by allowing procedures to be performed without the agony previously endured by patients. Before anaesthesia, surgeries had to be fast and brutal, with patients fully conscious and restrained. This changed in the 1840s with the discovery of ether (and later chloroform) as effective agents for inducing unconsciousness. Chloroform, introduced by James Young Simpson in 1847, quickly became popular for its rapid action and relative ease of use, especially during childbirth, famously used by Queen Victoria during the birth of her eighth child in 1853, which helped ease public scepticism. Despite its benefits, early anaesthetics were risky due to dosage miscalculations and lack of understanding about their effects on the body. Still, their adoption marked a pivotal shift in medical history, making more complex and humane surgeries possible for the first time.
The removing a bladder stone through a procedure called lithotomy was a challenging and risky surgery throughout the lifetime of the operating theatre. Doctors would use a variety of specialised tools designed to access and extract the stone through the urinary tract or via an incision. Key instruments included a lithotomy which is a sharp, knife-like tool used to make an incision into the bladder or urethra to access the stone, stone forceps which are slender instruments designed to grip and pull the bladder stone out once it was exposed, and finally bougie, which were metal rods used to probe and dilate the urethra, helping locate the stone and prepare the passage for removal. A number of these tools can be seen in the photo above along with some bladder stones – how these were removed without killing the patient I will never know. I know what you’re wondering, how do bladder stones form? Bladder stones form when minerals in urine crystallise and clump together inside the bladder, often due to incomplete emptying of the bladder. When urine remains stagnant, the concentrated minerals such as calcium, phosphate, and uric acid can gradually form hard lumps, ranging in size from tiny grains to large stones. They were far more common in the past due to poorer nutrition.
Anatomy models were extremely important to Victorian surgeons and medical students, especially as dissection opportunities were limited and controversial. In the early 19th century, the legal supply of cadavers for dissection was scarce, often restricted to executed criminals, leading to the rise of body-snatching. This shortage made anatomical models, crafted from wax, wood, papier-mâché, or even ivory vital educational tools. These models allowed students to study human anatomy in detail, particularly organs, muscles, nerves, and vascular systems, without needing a fresh cadaver. The most highly detailed wax models were prized for their realism and durability, offering a safe and reusable alternative to dissection. Institutions like hospitals, medical schools, and museums used them extensively to demonstrate procedures, pathology, and surgical techniques.
“Mrs Grieve” is not a historical visitor but their resident articulated teaching skeleton, a long-serving anatomical model used to educate medical students in the 19th century. Researchers, including paleo-pathologist Hannah Polasky, have examined her to uncover clues about past diseases and to explore details of her diet, occupation, and daily life. Far more than just a static exhibit, Mrs Grieve serves as a window into Victorian anatomical teaching, showing how human remains were used to train surgeons in an era before modern imaging and cadaveric preservation. For Victorian surgeons, who often operated without modern imaging or antisepsis, a deep, memorised understanding of anatomy was critical. Anatomy models helped develop this knowledge, enabling safer, more precise surgeries in an era when mistakes could easily be fatal. A number of human pathological specimens were also on display, but like with the Hunterian Museum, I have not shared photos of these in respect of the people they originated from.
The history of the old St Thomas’ Hospital dates back to the 12th century, making it one of the oldest hospitals in London. Originally established around 1106 by Augustinian monks in Southwark, it served the poor, sick, and pilgrims. Named after St Thomas Becket following his canonisation, the hospital was both a religious and medical institution. It was rebuilt several times, most notably after being damaged in the Great Fire of Southwark in 1212. By the 16th century, under Henry VIII’s dissolution of the monasteries, the hospital was closed briefly but refounded by the City of London. It continued to evolve over the centuries, becoming a prominent centre for medical training and innovation. In 1862, the hospital moved from its original site near London Bridge to its current location across the river in Lambeth, allowing space for modern expansion and marking the end of its medieval chapter. It was at this time that the operating theatre was lost and forgotten about.
Now we get to the bit that I know you’ve all been waiting for – the operating theatre. This is the centrepiece of the museum and is a completely restored 19th-century operating theatre, with original wooden operating table and viewing galleries where medical students once observed surgeries performed without anaesthesia or antiseptics. This space was converted into an operating theatre for female patients, providing a separate area for surgical procedures away from the main wards. The main ward would have been through the double-door seen on the back wall. You may also notice the motto Miseratione Non Mercede above the door which translates to ‘For compassion not for gain’. To me, the operating theatre was a lot smaller than I expected and I can’t imagine trying to squeeze 150 people into this cramped space.
A surgeon’s toolkit was simple yet brutal, designed for speed and efficiency in a time before modern anaesthesia or antiseptics. Essential instruments included scalpels for making precise incisions, long curved amputation knives for quickly removing limbs, and bone saws to cut through bone during amputations. Forceps and retractors were used to grip tissue and expose deeper areas, while tourniquets helped to stem blood flow during operations. Surgeons also used probes to locate foreign objects like bullets, and needles with silk or catgut sutures to close wounds. In neurosurgical cases, trepanning tools were employed to drill into the skull. Some of those can be seen photographed below. Supporting materials were just as important. Sponges were used to soak up blood and keep the surgical field clear, but they were often reused without proper sterilisation, contributing to the spread of infection. On the floor, sawdust served a practical but grisly purpose: it absorbed blood and reduced the risk of slipping in the operating theatre.
Wooden dressers like the one below would have been commonplace in operating theatres, to house a number of the objects and materials needed to help undertake a successful surgery. Visible in the dresser are wooden bandage winders used to roll bandages into tight, neat coils for easy storage and use. The device typically consisted of a hand-cranked wheel or spindle onto which the loose, cleaned bandage would be fed. As the crank was turned, the bandage would roll smoothly and evenly, saving time and ensuring the bandage was easy to apply in an emergency. Using a bandage winder also helped avoid tangles or contamination that might occur if bandages were wrapped by hand. How different the days of medicine were back in the 19th century compared to today, I am glad to have been born after almost 200 years of medical and scientific advances.
To me, visiting the Old Operating Theatre Museum and Herb Garret provided a unique and educational experience, offering insight into the medical practices of the past and the evolution of surgical procedures. It is absolutely bonkers to me that this amazing space was almost lost. Rediscovered in 1956 by historian Raymond Russell, the disused attic was restored. This whole space is Europe’s oldest surviving surgical theatre, complete with original tools, the herb store, and period exhibits. While there is a small entry fee, it is a must-visit for biologists, history enthusiasts and those interested in the development of healthcare/medicine. It also stands as a reminder of how far medicine has come, since the brutal pre-anaesthetic days of surgery to the modern techniques we use today. I would highly recommend visiting, although if you’re from further afield you may benefit from this virtual tour. Enjoy!
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