The Operating Theatre

Western Gazette, 21 March 1902 Image © THE BRITISH LIBRARY BOARD. ALL RIGHTS RESERVED. Reproduced with kind permission of The British Newspaper Archive (www.britishnewspaperarchives.co.uk)

Western Gazette, 21 March 1902
Image © THE BRITISH LIBRARY BOARD. ALL RIGHTS RESERVED.
Reproduced with kind permission of The British Newspaper Archive (www.britishnewspaperarchives.co.uk)

On 23 February 1903 Sir Frederick Treves, surgeon to King Edward VII and a native of Dorchester, opened a new operating theatre at Dorset County Hospital.

The need for a new operating room had been identified in 1898, and in 1901 it was estimated that it would cost the relatively small sum of £500. That year the hospital’s surgeons performed just 80 operations.

The old operating room was located at the very top of the hospital building and patients had to be carried up and down several flights of stairs on a stretcher because there was no lift. There were complaints that the room was both badly ventilated and draughty. Gas lighting had been introduced in 1889 – initially the lamp had been put in the wrong place and had to be lowered and moved to the centre of the room, presumably to hang over the operating table. In June 1900 Sir Frederick Treves had donated a new operating table – “the best he could find”, said to cost “not less than £40” – when he returned to Dorchester to receive the freedom of the borough.

On 1 January 1902 a sub-committee was appointed to look into creating a replacement operating theatre. It reported to the management committee just over a month later:

… it was agreed unanimously to recommend that a New Operating Room should be built at the back, or East side, of the Hospital near the centre of the main block of buildings, and adjoining the room now used as the Nurses’ Dining Room. It would be on the level of the first floor of the Hospital, and would be reached by passing through the present Dining Room, which would be given up altogether by the Nurses, and would be used as an Anaesthetic Room.

… it would stand on arches built over the back yard, and would be in a perfect position as regards light. Windows of any size could be placed in the North, East, and South walls, and there would be no risk of draughts, … nor direct communication with the staircase or corridor. A lift would communicate with the main corridors on the ground floor and first floor, and also with the Anaesthetic Room …

In March 1902 architect Walter J. Fletcher advertised the tender for building the new operating facilities. Fletcher, who was the county surveyor, had a practice in Wimborne and had designed the cottage hospital at Swanage, which opened in 1895. In 1898 he was invited to become Surveyor of the Hospital “to superintend and pass all structural works, repairs to Buildings &c”.

Three tenders for constructing the operating room and the walls of the lift enclosure were opened on 2 April. The sub-committee accepted the lowest tender, from Mr. Charles Slade of South Street, Dorchester, for £1,249. Construction began on 8 May. During the building works, one of the female wards was converted into a temporary operating room. The sub-committee made a number of changes to the specification to bring the cost down, including abandoning the parquet flooring for the anaesthetic room and the new covered back entrance.

© Dorset County Museum

Design for the panel listing subscribers to the operating room fund
© Dorset County Museum

Not everything went smoothly. The piers supporting the new operating room were interfering with the position of the drains in the scullery so the sink had to be re-positioned and replaced. The need for other structural repairs came to light during the building, leading to unplanned expenditure of £42, but still the sub-committee had managed to bring Slade’s total bill down from £1,249 to £1,087.

With other costs – including the architect’s fee (£61) and the cost of hiring a Mr. Grey as clerk of works for 20 weeks (£42) – the new operating facilities and lift cost a total of £1,355. The project was entirely funded by public subscription which raised £1,351. The sum was topped up with interest on the money, leaving a small surplus which was used to commission a panel commemorating the subscribers, the design for which is in the Dorset County Museum (see right). The subscription list was headed by a number of peers associated with the hospital: Lord Eldon gave £500, Lord Ilchester £250, Lord Wimborne £100, and Lord Portman £50. Subscriptions also came from the families descended from the hospital’s founders and early supporters: Floyer, Acland, Williams and Bankes. Sir Frederick Treves donated five guineas.

When Captain John Acland, chairman of the management committee, welcomed Treves to the opening ceremony in February 1903 he alluded to his royal connections. Acland thanked Treves for “coming, as it were, straight from the Royal presence to aid in a work that was for the good of his Majesty’s humblest subjects”. In response Treves reflected on how surgery had changed: “Twenty-five years ago that part of surgery which dealt with operations was more or less discredited” because it was “singularly unsuccessful”. Only a small number of operations were carried out – in the very largest surgical hospital there was only one operating theatre, occupied only one afternoon a week. Now, that same hospital had five operating theatres which, with ancillary rooms, extended over a quarter of a mile and were occupied practically every day. This was all due to the introduction by Lord Lister of antiseptic surgery, which had rendered operative treatment possible and safe, resulting in many thousands of lives being saved each year. Treves continued:

It had come about that the operating theatre, which was once the least attractive part of a hospital and the part that every one endeavoured very properly to avoid, had become a chamber of hope. All the hideous horrors of the old systems of the operating rooms had passed away … Operative surgery had spread all over the country, and now nearly every provincial hospital had its own operating theatre.

After his speech a short prayer of dedication was said by the Archdeacon of Dorset.

Sadly we have no pictures of the new facility but we have clues as to its appearance from the hospital’s committee minutes and annual reports. The operating room was 22ft. 6in. long by 14ft. 6in. wide, at the  level of the first floor, standing on solid stone piers and arches, at the back of the hospital, as had been recommended by the sub-committee. The structure was built of Swanage stone to match the rest of the building. Inside it was

reached from the main corridor through an ante-room, to be used for the administration of anaesthetics. The floor is laid with Ebner’s Terrazo pavement, and the walls are lined with Keene’s cement covered with Ripolin enamel, thus avoiding all joints, which are an objectionable feature when tiles and mosaics are used.

The lift was installed by R. Waygood & Co. of London. Waygood’s was originally established in Dorset, at Beaminster, before relocating (the company later installed the lifts on the Titanic). The lift adjoined the anaesthetic room, and was large enough to take a patient lying on a couch. It was hand-powered, and could be worked either from above or below or from within the cage itself.

By 1905 cracks had begun to appear in the arches of the operating room. The surgeons still relied on gas lamps as electric lighting was not fitted until 1912. By 1923 the creaking of the rope attached to the hand-lift had become “very disconcerting” and it was finally replaced by an electrical lift in 1925.

Sources: The Times, 25 February 1903, page 14; Western Gazette, 22 February 1901, page 6; London Daily News, 24 February 1903, page 11; Dorset County Hospital’s management committee minutes 1894-1917 (NG/HH/DO(C)/1/2/8) and annual reports 1895-1909 (NG/HH/DO(C)/2/1/1), both held at the Dorset History Centre.