Good evening everyone. Can anyone hear me well . Good. I am mary mclaughlin, a program coded with the Smithsonian Associates and i like to welcome you to what is promised to be very perfect halloween evening on the crucible of the victorian surgery. Before we begin risley like us everyone to check their cell phones and make sure they are silenced. Im also like to let you know that this program is being filled by cspan to be aired at a later date, so if youve enjoyed tonight program and would like it again, or if you think your friend like to see it, you should check over the next few weeks cspan and see if it is up. Sometimes it takes a couple of weeks for them to run a show and other times it can be one or two months. So its worth checking periodically. It is my pleasure to introduce our speaker doctor lindsey fitzharris. She tells me as a little girl shes to drag her grandmother trump cemetery to cemetery so that she could hunt ghosts. So some thought she was obsessed with death from an early age. Like to think you simply fascinated with the past, and with the people who lived there. Thats beginner lifelong obsession with history. Dr. Fitzharris received her doctorate in history of science, medicine and technology from the university of oxford. In 2010 she granted a Postdoctoral Research fellowship by the Wellcome Trust which is a medical History Collection in london. She is the author and creator of a popular website, the surgeons apprentice which has received over 2 million hits. She is also a writer and present of the youtube series under the knife which takes a humorous look at our medical past. Her articles have appeared in numerous publications both here and in the uk including the garden, new scientist, the huffington post, and medium. She has also appeared on cbs, bbc and national geographic. After debut book, the butchering art which was just publish worldwide on october 17 and a witch tonight program is based follows the surgeon Joseph Lister on his quest to transform the brutal and bloody world of victorian surgery. And we have this book available through the Smithsonian Museum shop at the interest to the lecture hall, and dr. Fitzharris will be happy to sign copies for you at the end of tonight program. So with that said we will get the program underway. Please join me in getting a very warm welcome to dr. Lindsey fitzharris. [applause] thank you for that lovely introduction. Its true, my grandma and i used to come we still go from cemetery to cemetery. I dedicated the book to her and she is my biggest pr campaign or other try to get this book sold. I am so excited to be a tonight at the smithsonian to talk about the brutal and bloody world of the twin surgery, and im so honored that so many of you would come out on halloween night that you give up your halloween night to learn about what it was like to be a patient and the surgeon in the Early Victorian time. Given the fact its halloween, before i get into my talk i want to start with a hollow greendale and its related to what i view as a medical historian. It was halloween 1828 and the one in scotland was murdered, and it turns out that she was the last victim of 16 who were killed i William Burke and william harris. They were bodysnatchers in the 19th century. I use term loosely because they did this to any bodies. They just kill people and they sold those bodies onto the surgeons of the time. There is a great need for bodies because this is a time before people willingly gave over those bodies to medical science. They were apprehended in 1828. At this time theres a a weirdw in britain called murder act unnumbered acts decrease any murder not only be executed for his crimes but also be publicly dissected. In an ironic twist burke in support of a table he had sold his victims onto at that point. This is collect the 19th century and, of course, they have to kick it up a notch. It doesnt end there. Was enough just to execute them pick was enough just to publicly dissected. In fact, they took his skin and the greater all these various trinkets which the then sold on to a bloodthirsty public. One of which itself on display in surgeons hall in edinburgh, a pocketbook bound in the skin of William Burke. I have held a it has been dna tested it feels like leather. It smells like leather and this practice was so, in the 19th century it at the term called anthropogenic bibliography. Its binding books with human skin. It wasnt always related to criminal activity. Sometimes surgeons doctors took the skin from cadavers and the bound medical text with it. If this is something that interests you one of my friends is working with my publisher on this very subject so be looking for that book. I am really excited to see with the book cover will look like for that book coming up. Anyway, i am so excited to talk about the brutal and bloody word of the joint surgery. Im going to run the country right now. I am demolishing any lingering romantic notions that people might have about what it was like to live in the victorian type if you come away from this talk or if you read my book and you think it might even find a live in the 19th century, i have not done my job. Let me tell you we are very, very lucky to live in the 21st century, like you not to have to endure the horrors of preantiseptic surgery, like for 12yearold henry pace. Its going to get bad. I hope cspan is ready for this. For c12 12 euros henry pace was brought in, he was told is going to have to have this leg removed without any anesthetic. When he was told this he asked the surgeon was it would hurt, as children do the assertions that it would hurt no more than having a twofold. Henry pace was there and prepared for what was to come to you was brought into the operating theater, blindfolded, restrained. He was still awake, still loose. He remembered counting strokes of the saw before his leg fell off. We are so lucky not to have to endure at the horse of preantiseptic surgery. I i imagine cspan will blur this one. Like poor stephen in 1820 he had to have a bladder stone removed. Im not going to go into too much detail about how that was done in the 19th century. Theres a lot of detail in the the butchering art, that might be an incentive or deterrent even know who you are but you been fairly warned. Suffice to say you can tell two very important things from this image. Number one, it hurt a lot. Number two, it was really, really embarrassing. Imagine being tied up like this in front of hundreds of spectators. Thats exactly what happened to stephen in 1828. What should of taken five minutes ended up taking over an hour as stephen struggled against a knife and tried out for the surgeon to please, dear god, stop. And the surgeon shouted back at him that he had a weird anatomy. So you can imagine this struggling scene. It was horrific. He pulled through that die 24 hours later of an effect. That is something features very prominently in the the butchering art. Was revealed on his autopsy report that actually he had normal anatomy and it was the surgeons fault. Let us not forget poor lucy who in 1840s had a mastectomy without any anesthetic. Lucy had this operation in her home. Im going to take by these Early Victorian hospitals but a lot of times the wealthy and middleclass were treated in their home. The surgeons didnt tell the windows going to happen. He told her she needed the operation but it wasnt going to tell her the day because he thought she would focus too much on it. To me that would increase my anxiety. I would want to know that i would want to prepare. He just shows up one day. He walks up the stairs into our bedroom. He opens his hand and shows her the night is going to use and he tells her to prepare her soul for death. This is not very confident inspiring. Im really glad surgeons dont tell us to prepare our souls for death anymore. But, of course, that was necessary in the time because many, many people die. She prepared herself for death but she couldnt prepare for the pain that was about to. Lucy ended up surviving operation. She went on to live a very happy and healthy long life but she wrote to her daughter about whar i want to share that in a letter. She said then came a gash long and deep, first of one side of my breast, then on the other. Deep deprive me of my breakfast. This was followed by extreme faintness. My suffering for no longer local. There was a general feeling of agony throughout my whole system. I felt every inch as though my flesh was fairly. On recollection of the clips i happen to have was the doctors right hand completely covered with blood up to the very rest. He afterwards told me of one time the blood from an artery flew into the ice we couldnt see. So just when you thought things couldnt get worse, now the surgeon is blighted. And she into the letter by saying that it was nearly an hour and half that she was under his hand. An hour and half while he cut away at her cancerous breast. We are very, very lucky to live in the 20 and, of course, we always you to get to the medical men and women who came before us to get us to this point which is what this talk is about today. I started my book tour in philadelphia and i was really excited to start there because my focus about a surgeon in Joseph Lister, this man by two. Mr. Is known as the father antiseptic surgery. He took the germ theory and he made it to medical practice the development of antisepsis. He saved thousands of lives in his own time and he continues to say peoples lives today because we operate with the knowledge that germs exist. I was excited to start philadelphia because whipple came out on october 17 it was just 135 years ago to the very day that lister came to america to convince american surgeons the existence of germs and of the need to adopt antisepsis. Im going to get a little later tell you about that trip more but there are a few plantings again out of this trip. If youre familiar with lister, it might be because of this product listerine. There was a man in this when he was in philadelphia and this man was inspired by the lectures and excited great this wonderful product that we all know and love today. Wasnt originally a mouthwash. Was just a cure all antisepsis. Effect is most commonly used to cure gonorrhea. So im just hoping to argue with a bunch of random facts that you can horrify people with lid at cocktail parties. If your into it, you go up and julie to some some and there into the it you know you foundr people. But listerine, gonorrhea, sure listerine today would not likele me telling the story but that man in the audience that night. Another man in the audience was named Robert Wood Johnson and he was inspired by by mr. Indica together with his brother to greet the Company Johnson johnson. The first thing to produce or surgical antiseptic dressings. This pamphlet, if you ever come across with at an antique store do that when. They were produced in the late 19th, only 20 century by Johnson Johnson. They are can liken idiots guide on how to operate on your own kitchen table, and its all perfectly safe as long as you use Johnson Johnson surgical dressings. This was the kind of thing they were trying to promote and teach people. That all came out of listers trip. I was very, very excited to be in philadelphia. When mr. Got to philadelphia he took a train trip around america, and he went all the way to the west coast and is trying to convince americans of the existence of germs. He was very much on a mission. This was a very personal thing to do. Wasnt about money. It was about saving peoples lives. In fact, lister had a knack of kicking off his college because he didnt charge is patience. He let them decide how much you want to pay, which was not a popular with his colleagues, needless to say. This would all about america. He was on a mission and i like to think that i am on a mission, not just to sell books although i hope Everybody Knows where to get them. Looking right at you, cspan. But but i am on a mission. My mission is that Joseph Listers name is just as my two people as the name Charles Darwin and sir isaac get comfortable and i think he is just as important. In order to convince you of that i really need to take you back to the priest listerine era, the Early Victorian hospitals. These hospitals were not places that you went to be treated if youre wealthy or middle class. We already talked about lucy a bit. These are places you went if you are poor. They were grimy, dingy, overcrowded. There were not houses appealing. It were houses of death. The best they can be said about the Early Victorian hospital is that they were slight improvement over there 18th century predecessors, which isnt really saying much when you consider about catch was paid more than the surgeon and doctors at this time. This lovely card from the Wellcome Trust in london which is a great medical History Collection, this is an 18th century calling card. Its for a man named andrew cook. I think they should make a movie about this guy. At this point that he makes this he claims to have read 20,000 beds in hospitals of lice. When you consider the art are t many lice in these hospitals you can understand why andrew cook was paid so well. But it wasnt just the lice. It was overcrowded. Surgeons often had to treat sometimes upwards as many as 200 patients in a single night. It was overwhelming, overcrowded. There was another population explosion. London was going so rapid and there was no way to keep up. In 1825 at st. Thomas hospital, people that were touring the hospital song wriggling maggots and mushrooms growing in the damp soil sheets of the patient with a compound fracture. What was so crazy about that story is that this was so expected. It was so normal that the patient didnt even think to complain about it. Thats what these hospitals were like. Now that i convinced to these hospitals were really awful places, certainly one would not want to end up in one, you might be surprised to find out they actually were very difficult to get into. Early victorian hospital, you need a ticket to get in. They are really hard to find, these images but this is from 1836, a ticket to get into a hospital. In order to get a ticket you had to petition one of the hospital governors. These people didnt have any medical training, and they had no real interest in the patients themselves. These were political positions. Sometimes it takes weeks, sometimes long before he got your ticket into the hospital of course during which time you could die. When i i say this hospitals wee for the poor, they were really for what historians call the deserving poor. That means they still have have some kind of income to cover the room and board. Some hospitals charged you for your inevitable burial. It was still expected youre going to die. Other hospitals charged extra if they deemed you particularly foul pics i dont know how they determined that, but needless to say if you are absolutely destitute you had no medical options which the course might not of been a bad thing because people are dying heavily as a result of being admitted into these grimy and dingy places. Unsurprisingly infections broke out like crazy. Theres a term that pops up called hospitalist in which refers to the fact are more likely to die as result of being admitted into these Early Victorian hospitals. There were four infections particularly that certain forward about. Hospital gangrene is weird. Medical historians we dont like to retrospectively diagnose things when we reading records if someone says if gangrene, we tend to be more interested in the people contextualize their experiences within rather than how we might look at the past through the lens of our own medical explanations. But hospital gangrene tended, i think its more akin to what we would call necrotizing fasciitis at this time. It was a very horrible condition which of course all of these conditions we suffer from today, surgeons and doctors fight today but because of course we know about germs and existence of germs we are able to more proactively prevent them and, of course, nancy and when they do break out. The scottish surgeon wrote about the war of hospital gangrene. He says the cry of the sufferers are the same night as in the daytime. If they survive, they also contend you eat down and destroying the muscles, the great vessels are last exposed and eroded and the bleed to death. This was the kind of experience that many patients had in these hospitals. Interestingly enough one of the worst records i came across was in a hospital record. It was a naval record. The 18th century and early 19th 19th century naval ships had similar conditions as you can imagine, very unhygienic, overcrowded. When these infections broke out they were very difficult for naval surgeons to control. On the hms saturn, also appeared on the tip of the penis and have to add a half i spy for this and you should be very happy. And this is where cspan goes blank for a bit. After several days of agonizing pain during which the wound blackened and festered, the oregon finally fell off. This poor man is totally awake and completely aware of whats happening to his body. The surgeon underreported the whole length of the aretha the scrotum leaving the testes and vessels barely covered. What was so crazy about this record when it came across was the fact that the surgical the need to underline the fact that the patient had died. Of course he dies. Somebody should have killed him before i got to that stage. So this was what people were finding in this time it was absolutely awful. This is the world that Joseph Lister stepped into in the 1840s when he became medical school at University College in 1848. And it was so bad in this hospitals that it was very seriously suggested that the only solution would be to burn these buildings down from time to time and start a new which i love the imagery, the idea of them can imagine if thats we control things today, just burn it down . I was in cleveland recently at the cleveland clinic, that huge hospital, just burn it down and start a new. So things were reaching critical mass. Im only going to do one reading from a book and just to give an idea of my stock of what you can expect in the butchering art, although i think youre starting to see what you can expect from this book. I chose a passage from the dead house, the first time Joseph Lister<