what’s this?
Obviously a chair, but look closer…if this chair could tell you its story it might surprise you.
To investigate our object in a 3D visualisation, please use the Google Chrome browser.
object enquiry - ask some questions….
Q. Does it look comfy? Would you like to curl up on it to read your favourite book?
Q. what’s it made of?
Q. does it look modern? old? very old?
Q. when do you think it was made?
1600s
1700s
1800s
1900s
Take a good look at the chair, use your fingers or mouse to zoom in on the chair, spin it round to see the seat, the legs, the back…
facts
It was found in the very first infirmary in Worcester which opened on Silver Street in 1746. This hospital (or infirmary) was closed in 1765 to make way for a much bigger hospital which could take more patients. The chair is made from mahogany wood, with a back which has been replaced many times. We don’t know if the chair was used at the newer hospital which opened in 1765, but we think it probably was.
object enquiry - ask some questions…
Q. Do you spot any features which are not on the chair you are using right now?
Q. If it was used between 1746-1765 in a hospital, what do you think it was used for?
Waiting - sitting on while waiting to be seen by a physician
Surgery - strap a patient tight so dentistry or amputation could be performed
Birthing - a mother can deliver the baby easier on a low chair
facts
It’s an amputation chair!
Amputation = the action of surgically cutting off a limb
Q. Did you spot the holes in the chair’s back uprights and legs?
If not go back to the 3D object and play around again! These were used to strap a patient tightly to the chair to reduce the chances of them struggling, wriggling free and causing extra damage while dental work or an amputation was completed. The straps were required when this chair was in use (between 1746-1765) because anaesthetics had not yet been invented, and surgery would HURT!
Anaesthetic = a substance that induces insensitivity to pain
Watch these FILMS for some more information
object enquiry - ask some questions…
Q. Do you think you could lift this chair? Does it look heavy?
Actually, it is relatively light for it to be portable. It could easily be taken anywhere in the infirmary or even to a patient’s house if needed for a procedure (although they did like to use kitchen tables, too!).
Q. Can you see how low the seat is to the ground?
After decades of use by eager surgeons, the legs have probably been cut down. Originally it would have been a very tall chair, to ensure a patient’s feet were well off the ground (so there was even less chance of them running away!). With the floors of operating rooms (theatres) liberally covered with sawdust to absorb the blood and gore spilling from the patient, over time the legs will have probably become rotten and shortened on purpose!
Q. What evidence can you see for the use of this chair in surgery?
A close up view of the seat shows fingernail marks/scratches and also some saw marks!
Surgical procedures in the 1700s and early to mid 1800s were limited to removing limbs, kidney stones (lithotomy), dentistry and mainly external surgeries. It’s likely that this chair was used mainly for amputation and dentistry as lithotomy would have required better access to a patient’s genital area - not ideal on this chair!
Q. How does this chair help understand the development of surgery?
We know the stated problems of doing surgery:
Blood loss
Pain
Infection
This chair shows us the best a surgeon could do for blood loss and pain was to strap the patient as TIGHTLY as possible and then execute the surgery as QUICKLY as possible. This would limit the time arteries were open, reduce the time the patient would be in pain, and reduce the chance of shock setting in.
An example of the procedure to amputate an arm before the development of anaesthetics
Offer the patient very simple ‘pain relief’. They could choose between:
alcohol to numb the senses,
stinging nettles rubbed on a different part of the body to confuse the brain,
a punch to temporarily knock them out, or
an apothecary’s plant-based remedy containing opium, belladonna or mandrake to try to relieve them of their senses.
Strap patient tightly into the chair, leaving the arm free.
Reduce blood loss with a tight tourniquet above the planned cut to reduce blood flow for when the artery is cut.
Complete a 360 degree cut around the arm (see the film about the Circular Cut).
From the cut pull back the skin, muscle and sinew to reveal the bone.
Saw through the bone until the damaged arm is dropped into the bucket or to the sawdust-covered floor. An assistant would support the limb until it was fully cut through, to prevent the last bit of bone-breaking or splintering under the weight of the limb.
Tie off the arteries and veins with silk, an old-fashioned surgeon might wish to use a hot cauterising iron.
Leave the wound open to ensure miasma hasn’t got in to cause hospital gangrene!
Finally, pull the flesh back over the stump, and stitch to make it neat.
Operation complete
Find out how long this took on the short video How long to amputate a limb?
robert liston
Robert Liston was known as the fastest surgeon in the West End of London. He had a very good success rate of only 1 in 10 of his patients dying; in general, hospitals operating under different surgeons might see 1 in 4 patients die!
What made Robert Liston famous was his (apocryphal) catchphrase “Time me gentlemen!” because he was known to complete the above steps on legs and arms in around 30 seconds. Thus, a patient would only experience the trauma for a short time, reducing their chances of shock and blood loss. Try counting to 30 seconds and imagine having an amputation as per the first 7 steps in the example above. We bet each second would feel like a minute!
We also know now that reducing the time a wound is open helps to reduce possible infection, but surgeons didn’t know about bacteria until much later, and blamed infection on miasma - or bad smells in the air. Sadly the pain and blood loss remained an issue, even if reduced.
Robert Liston Facts
1794-1847
Famous for an apocryphal operation with 300% fatalities, watch the video for more details!
Known for the phrase “Time me Gentlemen”
Prided himself on his speed of amputation, recorded as <30 seconds
Could remove kidney stones in under two minutes
Trained in Edinburgh and worked in London
Funded by West Midlands Museum Development with Art Fund support