The Operating Theatre Technician
One of the most famous of pre-anaesthetic operations to be undertaken was on a Chinese (Hong Kong) national who travelled all the way to London to have a very large tumour removed from his groin (25kg in weight) His passage was paid by the East India company and he arrived in London in 1831.9
The gentleman had the colourful name of Hoo Loo and he was to be operated on by Aston Key assisted by Ashley Cooper a renowned surgeon at Guys Hospital in London.
Because of the size of the tumour to be removed, the proposed operation attracted a lot of attention, so much so that the operation was moved to a larger anatomical theatre, there were said to be a thousand spectators crammed in to watch the proposed operation.
Key had Cooper and three surgeons to assist him plus the usual array of handlers. Hoo Loo was strapped onto the table and the surgery commenced. The operation lasted about 45 minutes. It was sad that he died through loss of blood, in agony, his final words translated were
"I can bear no more unloose me"
How must the audience, handlers and surgeons have felt when he died.
At the Post Mortem it was written:
Hoo Loo, in "the arms of death," possesses a countenance remarkable for its placidity, and good humour; qualities which the poor fellow possessed, in an eminent degree, when living.
For some days previous to the operation, Hoo Loo appeared to have some fearful forebodings as to the result. The following event; however, tended not only to raise his spirits, but to give him full confidence in the universally acknowledged talents and experienced skill of Mr. Key, and to cause him anxiously to look forward to the day which was to rid him of his unwieldy burden, and transform him into a "perfect man." 10
Key Reported to The Lancet later.
"The poor patient, however, did not only loose his penis, but his life as well, death being ascribed to haemorrhage:
Complete syncope occurred twice, and during the whole of the later steps of the operation he was in a state of fainting. The quantity of blood lost was variously estimated by those who assisted, and though certainly not large, it was the operators own impression that the haemorrhage was the immediate cause of death." 11
The thought of even trying to excise a tumour of that size without an anaesthetic is horrendous, the chances of survival even if there was some form of anaesthetic would have been very little, what with loss of blood and the strongest possibility, because of the size of the audience and the length of time it took, infection would have been certain.
The more I read about this disaster, the more I see two surgeons who wish to highlight their profile by attempting a procedure that brought a (some say) thousand people to watch.
It is also interesting to note that the patient was given some blood from a member of the audience; there is a distinct possibility that a reaction could have taken place.
Today, these surgeons would be arrested and put up on a manslaughter or murder charge, they would have been dismissed from the profession and locked up.
Handlers existed right up to the turn of the 20th century and in countries where Anaesthesia was not commonly available, well into the 20th century. If you look at some of the oldest hospitals in the UK, look out for the bell tower, thanks to anaesthesia you will not hear it ring to summon handlers.
This position of handler is probably the oldest of the surgical assistant positions. There are ancient Egyptian writings and drawings that show the Handlers restraining those being circumcised.