Shocking Evolution of Surgery Throughout History | Full Series

I don't like Joe. I've found him on the battlefield. I've caught him with my

battlefield. I've caught him with my dagger and I've managed to get in a good blow from behind. How are you going to deal with that? Let's say I've come to you off the battlefield with an arrow

stuck in me. Can you treat this? Well,

it depends where the arrow is embedded.

Kevin, I've come across this, which is the wound man, who seems to represent all the kind of medieval battle injuries a surgeon might be expected to face. And

it kind of drives home how brutal a medieval battle must have been that these are the kinds of wounds you might be expecting. Just how scary, how brutal

be expecting. Just how scary, how brutal would it be to be on a medieval battlefield, right? We've got to get

battlefield, right? We've got to get away from this notion of battles. what

we see in computer games or in reenactments that a medieval battle wasn't tap a door down and you're going to get back up. The point of a battle is

to kill people. That's the whole point of it, to maim, to kill. You're not

going to be walking away from a battlefield with a heavy silence.

There's going to be men screaming.

They're going to be screaming for their mothers. They're going to be in agony.

mothers. They're going to be in agony.

There's going to be a stench of the old place. Not just the the iron smell of

place. Not just the the iron smell of blood, but also the smell of feces and urine. Cuz when men die, their bladders

urine. Cuz when men die, their bladders open. It's going to be hell. And I'm

open. It's going to be hell. And I'm

going to give you an example of this.

Now, now that's your size of a medieval arrow. It's not something thin and

arrow. It's not something thin and flimsy. This is coming off 100 plus

flimsy. This is coming off 100 plus pound bow. That is going to do some

pound bow. That is going to do some damage to you. This is not going to be, oh, I'm hitting the shoulder. I can

carry on. This is it's going to knock me on my back and I'm in agony. And a good example of this is what we found a

couple of years ago in ex.

They found the skull and it had just above the right eye an arrow wound.

So that's the entry wound. That's the

exit wound. Wow. That's our causal evidence there. So we know how powerful

evidence there. So we know how powerful these arrows could be. When we think about medieval battles was them again.

These people are out to ma and kill.

This all sounds very scary and daunting.

Is there any way to survive some of these injuries that our wound man is suffering from? Yes, there is.

suffering from? Yes, there is.

It depends on where the injury is. It

depends on surgical help you're going to get and also, believe it or not, how rich you are. It's just not about having

a lot of money and being able to afford the best medical care.

When you're rich, you've lived in the best conditions all your life. So that

means your immune system is pretty robust. You can have a little bit of

robust. You can have a little bit of advantage and that you can fight off some infections.

Somebody who's poor, their immune system is not going to be as tough. So even

before you get to the question of who can afford to pay for what, the elite are already starting from a better position. This takes us on to the

position. This takes us on to the surgeon. If you're rich, if you're a

surgeon. If you're rich, if you're a lord or a prince, when you go off to battle, you're going to have a retinue of surgeons. Henry V, when he went to

of surgeons. Henry V, when he went to his agent campaign, he took with him Morstead, the surgeon who had organized a team of surgeons to look after his

nobles. Your common foot soldier,

nobles. Your common foot soldier, however, who's not part of the retinue, he is going to have to go to the baggage train. There you'll have the surgeons

train. There you'll have the surgeons who have disqualified. They're trying to build up a name for themselves. I mean,

it may well have been that for some basic wounds, some soldiers would have known some basic first aid, even though there's no actual proof. That's always a

possibility. Yeah, I guess you wouldn't

possibility. Yeah, I guess you wouldn't want to go into a situation where you might end up like that without knowing at least roughly what to do if any of those things happened. However, the

thing we have to move away from is this idea that these surgeons are running out onto a battlefield treating the wounded.

That did not happen. Battlefields are

dangerous. They're not getting involved in that.

There's no barber surgeons in the medieval period. You're either barber or

medieval period. You're either barber or a surgeon. Barber surgeons didn't come

a surgeon. Barber surgeons didn't come along until Henry VII brought together the guild of barbers and the guild of surgeons in the 16th century in the 1540s.

If you were rich, then you're going to have a master surgeon. So, you were going to have the

surgeon. So, you were going to have the very best. Oh, even though if the

very best. Oh, even though if the surgeon thought that you weren't going to survive, he could refuse to treat you. It was up to a surgeon to say,

you. It was up to a surgeon to say, "Well, I'm sorry. I can't treat you.

It's beyond my skill. That was okay.

>> Is there also an idea of a reputational risk of failing to save a lord or something like that? It doesn't look good on your CV and could get you into trouble. Oh, yes. Surgeons self-employed

trouble. Oh, yes. Surgeons self-employed

businessmen. They do too many jobs and people die, they're going to get a reputation. This is why often a surgeon

reputation. This is why often a surgeon would back off if he knew he couldn't treat the patient, which I guess isn't the news you want to hear if you're asking for that treatment.

So, assuming I can get a surgeon to treat me because hopefully I'm not going to die. Let's say I've come to you off

to die. Let's say I've come to you off the battlefield with an arrow stuck in me. Can you treat this?

me. Can you treat this?

Well, it depends where the arrow is embedded. Now,

embedded. Now, a pretty easy wound would be this one. You've been struck in

the arm. Everyone has heard about John

the arm. Everyone has heard about John Bradmore and how he removed the arrow head from Prince Howell's skull in 1403

after the battle of Shrewsbury.

But where did that actually come from?

Yeah. So Brad Moore is not creating what he did in a vacuum. He's not just suddenly invented this. No. Bradmore was

basically influenced by the previous surgeons. This is probably the most

surgeons. This is probably the most basic wound you're going to get. You've

been embedded in the arm. You say basic, I still don't want this. This still

looks pretty horrible. The first thing we're not going to do, we're not going to pull the arrow out by the shaft. If

you pull an arrow out by the shaft, the shaft will come away.

And if the head isn't attached, it will leave the head inside the wound and the wound would close. Some arrow heads are quite barbed as well, so there's a danger of causing more injury. That's

why you always probe first.

>> So you get a little metal tool in there and then you have a feel to find out what kind of arrow head it is.

>> But there's another advantage of leaving the shaft in. You know exactly where the arrow head is. So the rule is if the

arrow head is more than halfway through, you push it through. If it's not halfway through, you can withdraw it. So the

first thing we do, >> we have to push it through slightly and then we just got to feel for the point under the skin. We've established where

it is. So we push it through.

it is. So we push it through.

Then we get our knife.

and we make a cut.

And then we push the arrow through. Then we can snap the head off and we can remove the shaft.

You're adding to my injury to make it better. But it's the quickest way to get

better. But it's the quickest way to get an arrow out causing the least amount of damage. Because if the arrowhead had

damage. Because if the arrowhead had been left inside, we'd have had to reopen the wound, widen the wound, go probing.

Then we will treat the wound. We apply

some rosat, which is wine and honey. Now

to them, anything that entered the body would imbalance the four humors and cause a hot abscess. Today we know that to be

hot abscess. Today we know that to be gangri. Honey is an excellent antiseptic

gangri. Honey is an excellent antiseptic even though they didn't realize that. So

if you're going to put honey and wine into a wound, it's going to do some good. Or you might end up having a

good. Or you might end up having a surgeon who been doing a bit of quarterizing and then getting a quarterizing iron, getting it hot in the fire and sticking

it in there and then sanding the wound up. That's just going to stop the

up. That's just going to stop the bleeding. Yeah. In the wound. The

bleeding. Yeah. In the wound. The

trouble is it will trap the infection inside. Another problem that you had

inside. Another problem that you had infection There's no antibiotics. They

don't understand germs. Even a wound like that, even though from a surgical point of view is pretty simple. There

could be ramifications.

And I mean, thinking about our wound man as well, he's coming off the battlefield with lots of what look like crush injuries. So from clubs and things like

injuries. So from clubs and things like that, maybe broken bones, fractures. Is

that the kind of thing a surgeon can treat too? A simple fracture, as long as

treat too? A simple fracture, as long as it's not compound, you can put a splint on it.

If it's a compound fracture, that's another matter. So, you got bits of bone

another matter. So, you got bits of bone sticking out because he's been hit with props a m with probably a mice. The bone

has been totally smashed, been crushed.

Then that gets to be amputation.

The problem is the medieval surgeons really didn't like doing amputations.

Forget the stereotype of a medieval surgeon cutting off arms and legs.

They're self-employed businessmen. If

you do an amputation and someone dies, that's going to go against you. Surgeons of the day always

against you. Surgeons of the day always used to say, "Avoid amputation at all costs."

costs." Battlefield amputations didn't take off until the the English Civil War under Richard Wiseman. And the reason was you

Richard Wiseman. And the reason was you had bullets, gumballs, and they would smashing bones. So, amputation became a

smashing bones. So, amputation became a real necessity. So, amputation really

real necessity. So, amputation really was a last resort, but it did have to happen sometimes.

>> Yes, it did. Uh, we have found evidence of people who' had limbs amputated.

If there was no choice and amputations had to be done, they would always be done below the elbow or below the knee.

What are we using? Roll your sleeve up, Matt. My poor arm. So, the first thing

Matt. My poor arm. So, the first thing we're going to do is put on.

So, that's going to be twisted on. Not

too tight cuz I don't want to cut off blood supply. Just hold that there.

blood supply. Just hold that there.

So that's stopping too much blood getting past there.

>> Now what's going to happen is this. I've

been paid in advance just in case you die. We have a priest present

die. We have a priest present >> just in case I die. This isn't going away.

>> Well, it is a dangerous operation.

>> You're not filling me with confidence.

>> I'm going to use the the uh instrument devised by the Islamic surgeon Albacas or Alzari. We start with the cat lip

or Alzari. We start with the cat lip knife.

Does that look very clean to you?

>> No, that's better. Okay.

that's better. Okay.

We then will cut all the way around.

We're separating the skin or the flesh from the bone.

Once we've exposed the bell, we get the bone saw and we cut through. Can I can I just ask before you start though, Kit?

Do I get any painkillers for this? Any

pain relief?

>> I'm glad you asked that. So am I. Guess

what? Depends on how much you've got.

>> Okay. Deodoruca

in the 13th century did mention the sophorific sponge that had been soaked in dwale. Dwale was a mixture of opium,

in dwale. Dwale was a mixture of opium, henbane, mandre, and wild lettuce held together with alcohol. It's not going to knock you out. Biscuit, stop your mind

in the pain. Is that something like the sponges that magic sponges they use in football? They Yeah. But a bit more

football? They Yeah. But a bit more effective. Ironic because one of the

effective. Ironic because one of the most famous uh Islamic physicians, Ibasina or Avagina, actually killed himself then experimenting with helping.

What a way to go. Back to the amputation.

We got the bouncer and we go through as quickly as we can. And do we know how quick that is? Can you do that really quickly?

>> Yeah, we know that the surgeons in the 19th century could get through there really quickly, perhaps in over a minute. We don't know for the medieval

minute. We don't know for the medieval surgeons. There was no real way of

surgeons. There was no real way of measuring time. So we get through as

measuring time. So we get through as quickly as we can. We then

quarterize any bleeding, apply medic, sell together what we can, and then we put you to bed so you can rest and hopefully survive. If God

wills, I've paid for you to cut the flesh off my arm, saw through the bone on my arm, burn my arm with a hot iron, and then sew it all together and for

your hope that I'll survive. Yeah. But

still, good. Wonderful. Sounds

fantastic. But I'm looking at a fairly spectacular array of horrific, frightening looking tools on your table here. I'm looking at a mallet and

here. I'm looking at a mallet and chisel. Really? What are you doing with

chisel. Really? What are you doing with that? Right. One thing that got mangled

that? Right. One thing that got mangled in battles with fingers. Not everybody

is wearing a nice set of armored gauntlets. If your finger is mashed,

gauntlets. If your finger is mashed, quickest way to take it off. I was

wearing gauntlets, I promise.

Py and me the joint bang off it goes. I feel like health and safety would have something to say about that now. They weren't around. That's

that now. They weren't around. That's

horrifying though. That's horrific.

Yeah, we swear to do this. Okay, what

else can you frighten me with off this table? What does this giant pair of

table? What does this giant pair of tongs do? Right.

tongs do? Right.

Some arrows had barbs as we see.

Now, the problem with a barbed arrow is pulling it out because the barbs will catch on the flesh.

This is a tool invented by Gita Shilak, the French surgeon. It's a wonderful or invention because that goes into the

wound encases the arrowhead and allows you to remove the arrowhead >> without the barbs catching on the flesh.

So, it's like clamshells stop it tearing your flesh on the way out.

>> That's actually quite clever. I feel

like that would be better than pushing the arrow through and chopping my fingers off with a hammer and a chisel.

Again, it depends at the depth the arrow is. We're doing this for your benefit.

is. We're doing this for your benefit.

Oh, thank you.

And I guess the one thing that catches my eye on the table as well that I feel like isn't going to make me feel better in any kind of way is this terrifying looking spiky thing.

This is a trepamine drill or a Trefine used for drilling holes in the skull.

So, it's not an actual drill. Now the

Bryson bit drill didn't come into the 16th century when Ambrose Par the French barber surgeon invented it. This is the medieval version. So what is the purpose

medieval version. So what is the purpose of trapanning? Because I think we do

of trapanning? Because I think we do have this idea. It's for a headache and it's to relieve pressure. We know why they are trapanning in the medieval period. Fractured skulls embedded

period. Fractured skulls embedded weapons. If a piece of skull penetrates

weapons. If a piece of skull penetrates the brain to their mind could lead to a hot absess wherein the tumors become

unbalanced and become dangerous. Today

we know it can lead to menitis or encphilitis.

So it's important to try and ensure that the brain was not damaged even back then.

And part of that included either cutting a piece out or just cutting off one bit of the bone and then leaving the bone out. And you're going

to help me do it. Not to myself hopefully. No. So how are we going to

hopefully. No. So how are we going to trapan this skull then? You are going to trapan it. Okay. So we're going to put

trapan it. Okay. So we're going to put you in the position of apprentice. First

thing we have done, we have cut across and we've peeled the skin back. That is the most painful

part of the operation. There is no nerve endings in the skull. You then insert

the trapper.

We just gently tap it in.

Presumably there is an art form to how far that needs to go in. Yeah. To do its job, but to be safe. Yes. Because we don't want to be penetrating brain. So what I want

you to do, I want you to put the drill between both hands and spin.

Go on, do faster.

And all the time I'm doing this, I'm doing this to a human being's head.

>> Yes, you are. While while they're still conscious.

>> Yes.

Sorry sorry.

We have to work quickly and gently.

But there we go.

Started to make the hole.

So, I'll take over now.

Okay.

Ah, we're through.

There we are.

>> Wow. So, we've got a full hole in somebody's head. I could be looking at

somebody's head. I could be looking at somebody's brain, right? Uh, not quite because you've got to do a series of holes.

So, you might have to do a little circle or even a square and then we lift out the piece of bone. What would medieval people have made of seeing someone's

brain? We don't actually know. There's

brain? We don't actually know. There's

no record of that. But we do know that they were very particular about not penetrating it. So they were aware how

penetrating it. So they were aware how delicate that was and how important it was to be really really careful.

>> And don't forget this is a very very very expensive operation. Not everyone

is having it done. Only the rich.

>> Right. That trapanning demonstration was really practical and visceral and it made me want to try something else. So

we've managed to get this ballistic dummy in here. Um we'll call him Joe for the day, shall we? And we're going to do some terrible things to Joe. Now, I

wonder if you could show us what extracting an arrow from someone's torso might actually look like. I could

certainly try.

So, what we're going to do, we're going to do a wound through the ribs. So, this

will be going into someone's lung potentially >> into someone's lung. Right.

So, we're going to insert the arrow through the ribs and it's going to become lodged in there.

Oh dear, Joe's got trouble breathing right now. I

guess if that's Now, the important thing we do not do is we don't jerk the arrow out.

What will happen is the arrow head could come off and it's going to fall into the lump. We don't want that to happen.

lump. We don't want that to happen.

So the first thing we'll do, we will get our knife and we will just ex

extend the wound.

Just making a bit of space for you to work. Exactly.

work. Exactly.

If we need to, I can insert my dilators and expand expand the wound like so.

But this is the real important bit about removing an arrow from the null.

We have left the shaft in.

That gives us a guide where the arrow head is.

So we feed the hook into the wound of the parishion steady.

We can then hook put the end of the hook around the end of the arrow head that allows us to keep

the arrow head on.

And out it comes. It's incredible that they had come up with ways to do these things. There's some very clever tools

things. There's some very clever tools that clearly do the job very well. Just

shows how skilled the surgeons were with arrogance. They've had centuries of

arrogance. They've had centuries of training.

>> Right? So, you've managed to get an arrow out of Joe's lung and he seems to have survived that. But let's say, for example, I don't like Joe. I've found

him on the battlefield. I've caught him with my dagger and I've managed to get in a good blow from behind.

>> Yeah.

>> How are you going to deal with that?

This is potentially a fatal wound.

Wounds to this area are never never good. This area contains

your organs for processing food and producing feces and urine. So any wound here has the potential to turn nasty

cause peritonitis.

We've gone into the site at the depth you perforated the stomach. The Vikings,

if any wound penetrated the stomach, they would give the victim an onion soup.

>> They would then smelled the wound.

If they could smell the onion soup, they would put the person out of the misery because there was nothing they could do.

You've got peritonitis and you're going to die a very slow, painful, and nasty death. So, what I'm going to look for is what's coming out

of there. The one thing we don't want to

of there. The one thing we don't want to do is pull it out. So, I'm looking as to what's coming out.

If it's gone deep enough, wrong angle, we could have feces coming out. You

could have perforated the bell. You

could have perforated the bladder and have urine coming out. Both are fatal.

Oh dear, I can smell something nasty.

This means you've perforated the stomach. All I can do for this person

stomach. All I can do for this person will remove the the dagger, put on dressings. There's nothing I can do.

dressings. There's nothing I can do.

Sorry, Joe. Even today, wounds in this area, they're still really, really hazardous because of the amount of

bacteria producing organs in there.

However, it's not all bad news. If you

remove the dagger and if you have just slashed.

So, so if I got him in a slash, providing you haven't perforated any internal organs, that's

quite easy to treat. In fact, is the slash might be so deep his intestines might have come tumbling out.

That's okay as long as they haven't been perforated. Because then, as long as

perforated. Because then, as long as they haven't touched the floor, we just scoop the intestines up, place them in, and sew the wound up. It's like the

5-second rule, as long as it hasn't been out for too long. The important thing is as long as internal organs have not been damaged. So, something that could look a

damaged. So, something that could look a lot worse from the outside, your gut being split open and your intestines falling out, might be more survivable than a dagger just stuck in your side.

Yeah, there's no antibiotics.

Got peritonitis.

That's the problem. Peritonitis is a killer and you're going to die a very long, slow, and nasty death. It's been

incredible to think about the kinds of wounds that someone might go to a medieval surgeon with after a battle and the ingenuity of the tools that were available. They look horrible. They look

available. They look horrible. They look

horrific, but clearly they're all perfectly designed to do the job that they're meant to do. I mean, this the idea that you get this in and you you cup it round an arrow head so that you can pull it out without doing any

damage. It's terrifying that someone's

damage. It's terrifying that someone's had to thought of that, but it's ingenious. And and I guess the lesson

ingenious. And and I guess the lesson I've taken away from this and from seeing poor Joe has been the best thing you can do is avoid a medieval

battlefield. That's very wise. Theodoric

battlefield. That's very wise. Theodoric

of Luca says of medieval surgeons, every day a surgeon is creating a new technique or a new tool. And he was

about the 13th century, 13th, 14th century. So even then surgeons were on

century. So even then surgeons were on the cutting edge though developing new tools, new techniques. So we ought to view this as the foundation of modern

medicine. Yep. Certainly modern surgery.

medicine. Yep. Certainly modern surgery.

Yes, the techniques they developed, arrow wound treatment became bullet wound treatment. What they found from

wound treatment. What they found from stab wounds is still used today.

Tannoning is still used today. So, we do actually owe them a debt. I'm just

grateful, I guess, that I'm around in the days of antibiotics and anesthetics.

Oh, yes. Oh, yes.

In the summer of 1403, a rebellion broke out in England that threatened to tear the kingdom apart. There was only one way to resolve it. Battle.

In these fields north of Shrewsbury, two English armies met. One royal, led in part by a young Prince Hal, and one rebel led by Henry Percy known as

Hotspur.

At the Battle of Shrewsbury, England's future was decided.

The lessons learned by how the Prince of Wales from the Battle of Shrewsbury would in no small part lead to his famous triumph at Azinor.

But it was also during the Battle of Shrewsbury that Hal suffered a life-threatening wound. He was struck in

life-threatening wound. He was struck in the face with an arrow.

As the heir to the throne, saving the prince's life was paramount. After the

battle, the alien prince was taken to Kennallorth Castle, the nearest royal seat. It was here that he was looked at

seat. It was here that he was looked at by a number of physicians until finally the royal surgeon, John Bradmore, took over the prince's care.

I'm meeting James Wright, who's extensively researched what happened to Hal after the battle and can show us just how Bradmore went about saving the prince's life.

So, James, Prince Hal takes a massive wound at the Battle of Shrewsbury.

>> He does. He gets an arrow in the face.

>> What do we know about it?

>> Uh, quite a lot, actually, because the surgeon that Treat him afterwards, John Bradmore, was kind enough to leave a full account of the operation. So, he

takes us through the entire journey step by step.

>> So, what do we know about the depth of this one?

>> We know that it was 6 in deep. Bradmo

makes that very, very clear. There has

been a little bit of debate whether it was on the left or the right hand side of his face.

>> Okay, >> Bradmore says on his left side. However,

if you were to look at later portraits, it does show his left side very very clearly. There is no scar. Now you could

clearly. There is no scar. Now you could argue is that just you know the artist flattering the king or is it possible that he is hiding the sky and it's actually on the other side and simply

when Bradmore describes it he's saying his left rather than the prince's >> so 6 in deep that is a horrific horrific one >> it is indeed he was phenomenally lucky

everything about that strike was perfect you if somebody said to me I'm going to shoot you in the face with an arrow you've got no choice in the matter I'd want to be hit the way he Everything was right about it. The angle

was right. It was coming in at not too high a speed that it didn't go straight through the back of his head. The type

of arrowhead that was being used. And if

you look at uh the types of things that he might have got, you know, he could have got something like that which would have been pretty horrific.

>> Very broad. Really going to make a huge wide.

>> Absolutely. Instead, he gets one of these.

>> I see.

>> Which it's not great, but it is going to mean it's going to be a little bit easier to get out.

>> So, it's a little bit narrower of a wound. a little bit narrower. Yeah. Now,

wound. a little bit narrower. Yeah. Now,

he knows he's going to have a problem because the normally these are only fixed onto the shaft using beeswax. The

idea being if you try just yanking the arrow out, you're going to leave the head behind. And it's for that reason

head behind. And it's for that reason that most surgeons, if they were faced with a penetrating wound like that, they would push the arrow all the way through, take the head off, and pull it back again, and just sew at both ends.

You're actually doing less damage that way, >> right?

>> With this pushing against the prince's spine, that's not an option.

>> That's not an option at all. We have

reports from Bradmore about him worried about seizures which helps us know how close that is to >> very close. Yeah.

>> So any mistake any this way that way in further the prince is gone >> and I think that's why he he didn't leave it there. Another surgeon might have left the arrowhead in place and just allow it to heal up around him. He

was aware that all that had to happen was the arrowhead shift ever so slightly. The prince could drop dead a

slightly. The prince could drop dead a month, a year, 10 years from now. So now

Shakespeare says this is a shallow scratch is what he has. So this is not a shallow scratch.

>> This is not a shallow scratch. Uh we can demonstrate exactly how not shallow this is.

>> Okay.

>> So this is going to be the prince for the day.

>> Okay.

>> Uh so apologies your highness.

And if we can just get a nice demonstration of just roughly about there. And we're just going to give that

there. And we're just going to give that a nice shove in going down about 6 in.

Oh, >> that feels about right. Ah.

>> Oh, the poor man.

>> And to his credit, this kid, he was 16 years old, kept fighting for nearly half an hour with this thing sticking out of his face.

>> Do you think there's any chance maybe he just in the shock of it pulled?

>> Quite possibly. Uh, it doesn't say exactly at what point the shaft was removed, but we do know that when it was removed, Oh god.

>> He's going to leave something behind.

>> Yeah, that's a problem. That's a

problem. And this is Bradmore's problem.

Pulled the shaft. The arrow head is still left in there and lodged against his spine.

>> Yeah.

>> All right. Well, let's talk about what he came up with because he realizes I've got to what? First widen this wound.

>> Absolutely. Part of the problem he's got is that the flesh will be closing in around the arrow head. So, he has to give himself more room to work >> because the tissues have all just gone in.

>> Absolutely. Now, I think probably one of the best ways to demonstrate this would be to use a little sample of ballistic gel here.

>> All right.

>> So, I'm just going to take another arrow head and we're just going to push this in about the same distance there.

>> You can see the force that you're having to use to get this in. You you can just imagine just like the speed that these arrows will be moving at about right there. So, I'm just going to

give that a yank. And sure enough, there we go. We left the head behind.

we go. We left the head behind.

>> And you can see so clearly here how the ballistics gel has sucked in around that wound. It's it's closed it, which is

wound. It's it's closed it, which is what the body's supposed to do, right?

We want to close off so we don't bleed out.

>> But that's what Bradmore's problem is.

>> That's Bradmore's problem. So his

approach to this was to create what he called tents.

>> Tents.

>> Uh so >> I've camped in a tent. This doesn't look like a tent.

>> No, it's not. This was his word for it.

And it's essentially pithldder, which does have some antibiotic properties.

Wrapped very tightly in linen >> and then he would have dipped it in honey and rose water, which would have been an antiseptic. He wouldn't

necessarily understand the mechanism, but he knows that that works. It

prevents infections. So he's going to start off with quite a thin one. And

what he's going to do is just very carefully ease that down. And he's you imagine he's doing this all by feel course and we can see through the ballistic gel. He can't.

ballistic gel. He can't.

>> And this is several days after he's taken the womb. So it's this much more important that he open it up again.

>> Absolutely. So brings that out. And then

we're just going to continue using wider ones.

>> And he would put these in and leave them in there for a little while and then pull them out.

>> Yeah. Just widening it a little bit.

He's just giving himself that little bit more room to work with without doing much collateral damage around the area.

>> Now, as this whole time that he's doing this, the prince has got to be in agony.

>> I think the prince had an incredibly high pain threshold.

>> He had to. The fact that he kept fighting for something like half an hour with the arrows still sticking out of his face before he'd allow his men to drag him off the field. You know, that is a serious tolerance to pain. When

Bradmore's performing this entire procedure, Hal has to stay so incredibly still so he doesn't aggravate the wound.

>> Now, do we think he's got some medications?

>> It's probable. Uh Bradmore doesn't specify. He doesn't say that he puts the

specify. He doesn't say that he puts the prince under anything. I think the most likely I think they would have done is something akin to dwell. They wouldn't

have used alcohol. Okay.

>> So, the trouble with using alcohol is while it may knock you out, it also thins the blood down, which means if you're performing surgery, your patient bleeds out quicker.

>> We don't want that. We don't want that.

No.

>> What you're going to get is a mixture of white wine vinegar, lettuce juice, henbane, hemlock, opium, and betany.

>> That sounds hideous.

>> If it doesn't kill you, it is a really effective anesthetic.

>> So, Bradmore is balancing a lot of things here. He's balancing the wound.

things here. He's balancing the wound.

He's also balancing this medication. If

he gets that wrong, he kills him.

>> If if anything goes wrong here, >> his patient is going to die. And that's

not good for Bradmore.

>> This is a constitutional crisis. He is

feeling an awful lot of pressure on him to get this right.

>> And is he alone in the room when he's doing this? Is it is this kind of like

doing this? Is it is this kind of like we imagine a surgical space?

>> No. I mean, it probably would have been the prince's bedroom or a similar sort of nice sort of soft space, but certainly not, you know, totally clean.

And there would have been plenty of people watching. What Bradmore was doing

people watching. What Bradmore was doing was very, very unique. People hadn't

really seen this type of medical intervention before, so they were naturally curious.

>> And the curiosity of those in attendance would have been peaked further when Bradmore, after days of attending to the wound, would attempt his extraction of the arrowhead. Amazingly though, in

the arrowhead. Amazingly though, in order to attempt the surgery, he would first need to invent the tool for the job. Luckily for us, Bradmore not only

job. Luckily for us, Bradmore not only left his incredibly detailed account, he also sketched the tool for us, too.

meaning we can have a go at an extraction ourselves today.

>> So essentially he describes uh long smooth tongs, >> okay, >> that have a screw mechanism of some kind inside that would work down the shaft

and grip the arrowhead from the inside.

>> So you need to move the tongs outward to grip from the inside.

>> Exactly. And I do, as it happens, have a replica that has been made. So,

>> look, I've read about these, but I've not seen one like this.

>> So, this works remarkably like a wall plug. So, this central shaft, as you can

plug. So, this central shaft, as you can see, it's running down between the tongs. So, as you tighten it down, it

tongs. So, as you tighten it down, it pushes the tongs apart and allows you to grip the arrowhead from the inside.

>> And that's part of why you have these grooves on the end is to have that grip.

>> Yes. Just increase that friction. Yes.

>> Do you think this is actually going to work?

>> Can give it a go.

>> Let's give it a go. See if it works.

>> Okay.

So, I'm just going to feed that down.

And if you actually read Brad's accounts, he says he's doing it entirely by feel. You know, there's no little

by feel. You know, there's no little electric microscopes or anything like that to sort of eat his way. He's got to just feel his way down there. And he

says by his imagination, he's hit that point, which feels about right now. That

feels like I'm hitting something solid.

And then I'm just going to slowly, and >> you can see as you're doing that, that is getting wider and it's getting that grip on the arrow head in there.

Just hoping the prince doesn't sneeze.

>> Okay.

And then Bradmore describes that once it was in there, he then moved it slightly back and forth.

>> Oh, you can see it in there. I can't

imagine the pain.

>> And very carefully.

Oh, >> and there we are.

>> Saved the life of the Prince of Wales.

>> We're not out the woods yet.

>> Oh, we're not.

>> We've got the arrow out.

>> Okay. But our biggest enemy now is infection.

>> Ah, of course. Of course.

>> So, >> so what does he do to take care of infection?

>> So, he does not sew the whole thing up as you might be tempted to do. He

performs a very interesting technique which is still used today, which is to allow the wound to heal from the bottom up. He cleans it out daily over several

up. He cleans it out daily over several weeks, putting in rose water, tarpentine. He's cleaning the wound out,

tarpentine. He's cleaning the wound out, but every time he feeds it down, he's not going quite as far, and he's just allowing the whole thing to heal as it rises to the surface >> and using smaller and smaller tents as

he did does so. So, it's just all coming up.

>> Quite brilliant. Must have taken a lot of time.

>> Yes, this would have taken several weeks to heal properly.

>> Hard to imagine. What does he get in return for this great duty?

>> In return for this, he gets a royal pardon. So, he's not he needed it. He

pardon. So, he's not he needed it. He

also gets 10 marks a year for the rest of his life, which would be about4,000 today. £4,000. That's not a bad earner.

today. £4,000. That's not a bad earner.

>> Not bad at all. Not bad at all. And gets

his name into history for having done that.

>> Does indeed.

The incredible operation performed by John Bradmore on the future king of England is not only a reminder of the horrific damage inflicted by arrows in battle and the bravery of those who were

wounded, but also the ingenuity of surgeons throughout what we often deem an unenlightened age.

King Henry V would go on to achieve one of the most famous of English triumphs, a decisive victory at the Battle of Azenor in 1415.

Ironically, it would be neither sword nor arrow that eventually ended the king's life, but an illness contracted on the battlefield. For surgeons and doctors to get to the bottom of this, it

would take roughly half a millennium and millions of deaths.

The transition from the medieval period into tuna times and on into the civil wars saw advancing technologies. One of

those technologies really did change the battlefield. Gunpowder.

battlefield. Gunpowder.

It revolutionized warfare and it also caused all sorts of wounds that hadn't really been seen before.

I've come to the commandry in Worcester.

This was a medieval hospital that was one of the royalist headquarters during the Civil War. It's the perfect place to come and learn about these deadly new weapons, the carnage they caused, and

where the surgery was able to keep up with the horrifying new wounds.

So, last time you were with Matt, you're talking about medieval battlefield surgery. That blew my mind. But we've

surgery. That blew my mind. But we've

now moved forward into the TUDA era.

What's happening? What's changing?

>> Well, we've got a growth in firearms. Look at that. The musket

>> indeed. Firearms did emerge in the 15th century and at the back of Bosworth, there were probably more firearms than there were bows and arrows. However, in

the 16th century, these are now taking precedence.

>> What kind of damage does one of those do to the human body?

>> Basically, it's going to smash bone.

It's going to penetrate the human body.

It's going to get into organs. And

what's worse is it's not just going to go like an arrow and go in the one place. This can end up going all around the body.

>> So it pinballs down your chest.

>> Exactly. Similar with arrow wounds. It's

going to take in bits of material. It

can take in uh little bits of armor, bone.

>> How does medical science evolve to try and heal people? Things really from a philosophical point of view haven't

moved on. We are still in the era of the

moved on. We are still in the era of the four humors. Blood, flem, yellow bile

four humors. Blood, flem, yellow bile and black bile. If your humors are equal, you are healthy. If you've got too much of a particular humor or not

enough, then you're in a state of disease. Disease, you're ill. So,

disease. Disease, you're ill. So,

anything penetrating the human body is going to imbalance the humorus.

>> You bet it is.

>> But there is one area things are moving on. Technology. And this was due to one

on. Technology. And this was due to one man, Ambrose Parrot. A brilliant

technologist, brilliant innovator, still a man of his time. However, he made some fantastic discoveries and some brilliant inventions.

>> I'm not surprised. A lot of Frenchmen needed bullets taken out of them in this period.

>> So if you're trying to detect a musk ball, you actually use the same technique as you did when searching for an arrow. You probed.

an arrow. You probed.

>> Okay. For that, I need a subject.

>> Not me, I hope.

>> Oh, no, no, no. One I prepared earlier.

>> This poor guy.

>> Yeah. This is Joe.

>> Right. He's been hit by a basketball, has he? He has. We've got some damage at

has he? He has. We've got some damage at the side. The first thing we have to do

the side. The first thing we have to do using the knife and we're just going to reopen the wound a bit.

>> And obviously no anesthetic here, right?

You're just Joe's awake and you're just opening up the wound, working on him like that.

>> Par doesn't record any anesthetic being used.

So we must assume no. And then we're going to probe the wound. Oh,

>> what we're doing is wait and see if you can feel the bullet and I can.

>> So, >> so you're doing it by touch.

>> Yeah.

>> You can.

>> So, you have to tell the difference between bone and lead musket.

>> Oh, yes.

>> I think that's it there.

>> Yeah, you've got it. Yeah.

>> Now, we've got to be careful because the one thing we don't want to do is to push that ball further into the chest. So, I

get the least invasive piece of equipment.

I'll go with this one.

>> Let's have a look at these. Pair of snip nose pliers.

>> Yeah, but the only problem is I've got to make the wound a little bit wider again to get to fit these in.

>> Yeah.

>> Joseph seriously regretting his decision to join the Spanish Armada here.

>> You're just digging it out, aren't you?

>> Oh, basically. Yes.

Oh >> yes.

>> Now >> that is quite satisfying actually, isn't it?

>> Joe probably thinks so too.

>> Yeah, I bet he does.

>> Now, next thing we're going to do, we're going to probe a bit more because we want to make sure that the ribs are intact, >> still springy with a little less bigger,

if I might uh >> less bigger.

>> Less bigger. So you can tell from a rib when you're touching it, you can tell if it's still connected to all the right bits.

>> Yeah. You can feel it how smooth it is.

It's not fractured in any way. What

we'll then do is we'll apply a little roll of bandage soaked in tarpentine.

>> So a bit of disinfectant.

>> Yeah.

>> So without knowing why, they were starting to understand they had to somehow keep that wound clean. They did

recognize come the 16th century that wounds could turn gangarous but to them it was an imbalance of the humorus. So

it really was you know make sure there was no unpleasant smells coming from it.

Most important and if he's got a robust enough immune system you should pull through.

>> Joe lives to fight again another day.

>> That's providing he's got a surgeon who is well up on the latest techniques.

Otherwise, it might be a case of just pulling the musk ball out and applying a red hot quartery.

The one thing that Par was most famous for was it discovery during a battle.

The standard treatment for wounds was cauterizing.

You heat it up in the fire, stick it in the wound and stops the wound bleeding.

>> You had cauterizing irons matched for any wound with this one. A slice. Stick

it in.

>> Oh, that Okay. This that's for that's if you get a sword blow.

>> Yeah. Okay.

>> The other way you could do it would by uh applying uh a hot oil, hot elder oil and tree.

>> You heat that up and just douse it on someone's >> Exactly. And that stops it bleeding.

>> Exactly. And that stops it bleeding.

Does it also stop infection?

>> Yes, but you could also trap the infection inside.

>> However, this is what Par discovered.

This was a game changer. In this bowl, I've got egg yolk, tarpentine oil, and rose oil.

>> How did he discover that? because he'd

run out of the elder oil and the tree cup.

>> Imagine the other stuff he must have used to get to that though.

>> So, this is a it's a cold oil. So,

there's only one way to find out if it works. I

works. I >> think I know where this is going.

>> Would you like to roll up uh the sleeve?

>> Would you like me to shoot myself as well?

>> We're just going to put some of that on.

>> So, this is cold oil. So, previously

it's been super hot trile. Now, it goes to cold egg yolk.

>> Yeah. So we've got egg yolk, turppentine and oil of roses.

>> That is so that is unbelievable that smell.

>> Yes. But

>> turpentine does have antiseptic qualities.

>> Does it?

>> So do roses. But what happened was par discovered that the men he applied this to their wounds healed far more quicker than those who had had the hot oil treatment.

>> I'm not surprised. If I was an infection, I'd run a mile. So he didn't know why, but what was actually going on? Because it's a it's an it's a

on? Because it's a it's an it's a disinfectant.

>> Yeah, in a way. Yes. But what's

happening is he has got no idea of this.

He's still a man who deals with the four humors. But this was a major move

humors. But this was a major move forward. What he did influenced surgeons

forward. What he did influenced surgeons throughout history. And I say surgeons

throughout history. And I say surgeons in this country. Thanks to Henry VII, we've now got the Guild of Barber surgeons.

>> So it's not just a wild west. You're a

surgeon. You're part of the guild.

you're registered with the king and you can practice.

>> In some ways, it's a it's a good time to be a surgeon because you got these wonderful books available. In the 16th century, we've got Aselius, we've got Dainci, massive exploration into the

human body and you got guys like Par making these new discoveries.

>> You got plenty of people shooting each other as well. So, they got lots to practice on.

>> Indeed.

>> So, Joe has had the bullet removed.

>> Yeah. He's found himself a ship. They've

limped back to Spain. What are his chances of surviving though? Because his

his troubles are only really just beginning, aren't they? Lots of this can still kill him.

>> The most important thing is is how robust his immune system is. The better

nourished you were, the more robust your immune system was, >> which of course in armies famously they're always lacking food. They got

bad water. So a lot of the time I'm sure that would be a huge problem.

>> Yeah, it was a big problem. In this

case, we'll imagine that, you know, he's been looked after. So, his immune system is robust. We haven't had any problems

is robust. We haven't had any problems with a fracturing of ribs. Didn't appear

to be any clothing pushed into the wound. What we're going to look at now

wound. What we're going to look at now is if there's been any gunpowder burns.

Now, Par really didn't like gunpowder burns. He saw gunpowder as poisonous. We

burns. He saw gunpowder as poisonous. We

know that's not necessarily true, but paray that had to be dealt with.

>> Those are burns caused by gunpowder igniting close to you. Okay,

>> I've got a treatment for that.

>> Oh, good.

>> Onion paste.

>> Oh, that doesn't sound too bad.

>> The things he must have smeared over his patients before he found stuff that worked. And with modern science, is

worked. And with modern science, is there actually any benefit of this?

>> There is. Onions contain sulfites.

Sulfates are excellent for killing bacteria. So yeah, there is a sound

bacteria. So yeah, there is a sound science behind it. Not that Parry understood that.

>> This is a very basic antibiotic.

>> Very, very basic. To him is balancing the humorus.

>> So smearing this all over a wound wouldn't do any harm. In fact, it might help.

>> Yeah.

>> There's so many different types of wounds, aren't there? So many different weapons, so many different things that can happen to you on a battlefield. So

presumably there's all sorts of different tools appropriate to each wound. Mainly we see a growth when it

wound. Mainly we see a growth when it comes to musk balls. They're getting

really common on battlefields. There's

one thing about a lead musket ball. It's

soft. If the ball is lodged somewhere and you need a bit more force to get it out, then you can use a contraption like

this. You would place that against the

this. You would place that against the ball. That would then be twisted down

ball. That would then be twisted down and as it goes down bores >> into the ball.

>> Yeah. Into the ball, >> but all the time pressing against whatever it's >> exactly. So that's going to be agony.

>> exactly. So that's going to be agony.

Another kind of instrument we've got are forps which allow the surgeon to go in catch the ball and easily withdraw it.

One of Par's famous ones is this one which some wags have called the hungry hippo. If you're opening those jaws

hippo. If you're opening those jaws inside the body, that surely is doing quite a lot of damage when you're in there, isn't it?

>> Yes. There's no way around that. If they

need to get the ball out, sometimes they may leave the ball in if they didn't think it was going to do any damage.

>> So, is it is it all right to walk around with a musk ball left in you?

>> Well, it's best if you get them out because lead antimony in them that can be poisonous.

But if you couldn't, sometimes they may work themselves out a bit like uh arrows did. It's a process of sloing. And if

did. It's a process of sloing. And if

it's close enough to the surface, >> body forces out the ball.

>> Yeah. Wow.

>> And if you couldn't get the bullet out at all, there was always the nuclear option, right? That's just sared off.

option, right? That's just sared off.

Amputation becomes more common once we get into the English Civil War.

One of the people who really in favor of amputations during the English Civil War was Richard Wisman. He was the Royalist

surgeon. Of course, one thing that's

surgeon. Of course, one thing that's going to happen with musket balls is they can shatter bones.

If a bone gets shattered, the limb has got to come off.

>> Is that right? It's not just going to heal itself.

>> It's not going to heal. A shattered bone will not heal itself. Well, we've got a very, very good example of what happens when you don't treat a wound. And that

happened here at the Commandra in 1651 at the Battle of Worcester. Hamilton,

the commander of the Royalist forces, was wounded in his leg. The attending

surgeon at the time was Richard Wisman.

However, Wiseman decided he was going to accompany Charles II and leave Hamilton to the tender mercies of a couple of

apprentices. Things did not go well.

apprentices. Things did not go well.

Hamilton's condition deteriorated. Even Cromwell

condition deteriorated. Even Cromwell offered to send his surgeon to help Hamilton. Hamilton refused and

Hamilton. Hamilton refused and eventually died.

So should they have amputated Hamilton's leg?

>> Probably yes. Because once Gangarine had set in either you practiced debridement, cutting away the flesh, but if the bone had been shattered, the leg had to come off.

>> So if I'm shot in the arm here, Yeah.

>> you'd have had that arm off in a flash.

>> If the bone shattered, if the infection had set in. Yes.

This is where par again came to the four. In the last documentary that we

four. In the last documentary that we did uh looking at trapanning, it was a hand drill.

>> Trapanning. So going into the brain >> into the skull >> into the skull.

>> Into the skull. We don't go into the brain.

>> Of course. Don't touch the brain.

>> Don't touch the brain. They knew that in medieval period. Don't touch the brain.

medieval period. Don't touch the brain.

>> So this is head wounds now.

>> Head wounds. Yeah.

>> Can you give me a demonstration how this was done?

>> I certainly can. Uh, do we have a willing subject?

>> Well, actually, luckily, I have just been out of the garden bludgeoning a skull with a musket. So, here's one I prepared earlier.

>> Excellent.

>> What do you reckon, Kev? Is it Is it survivable?

>> Probably not, because as we can see, there's been a couple of blows here.

Basically, that is going to liquefy the brain, which just demonstrates how vicious even the butt end of a musky could be. If there wasn't a gaping hole

could be. If there wasn't a gaping hole there, then I would be suggesting we drill a hole.

>> Look at that.

>> Par's design for a drill still used even today in hospitals. It's a bracen bit.

Anybody who's into woodwork would recognize it.

>> One second. Why are you drilling a big hole in someone's head in the first place?

>> It might be a depressed fracture, maybe an embedded weapon.

>> Okay. So, if I hadn't hit it as hard, if it just sort of pushed the skull in a bit, you you drill out the bits.

>> We need to get that bone out. We need to get the pressure off the brain. To the

17th century mind, we've disrupted the humorus, >> right? You bet you have.

>> right? You bet you have.

So if you are going to drill into somebody's skull, >> just don't try this at home.

>> We go back to the knife. We would cut across and then we would lever the skin back.

So we expose the skull.

>> Oh my god.

>> Then get a little we put that in there and we just make a little hole.

Now, in that little hole we've made, we will place that spike. And then we cut round.

>> Goodness gracious me.

>> Yeah.

>> And that chops a nice little round circle out the center.

>> Indeed, it does because we've got the cutting edge there. But don't forget, there's a problem. You've got a great big spike there. If you carry on going down, that spike's going to pierce the brain. So, this is where Par was really

brain. So, this is where Par was really clever.

>> Retractable.

>> Okay. Remove the spike. You fix the hood to the depth you want. Replace the

cutting edge in the groove you've made and carry on drilling through >> drilling through the skull.

>> Okay.

>> I would have to be so ill for to let you do that to my head. I mean, I just there is I I think I'd take death over that.

Oh, >> we can't do that. However, not with this one >> because there's a big hole in the sky.

>> There's a big hole already.

>> So, what are we using? Okay, first thing we're going to do, cut the skin away.

We got some loose pieces of bone in there.

We don't want those pieces of bone penetrating the brain.

So, what I'm going to do, poking around inside the skull.

>> There we go.

>> Oh, got it. There we go. Now, we've got a couple more pieces in there. There's

another little piece coming out.

>> Yeah.

>> Okay.

>> Now, we've got the pieces of skull out.

We didn't want any pieces being left in >> and penetrating the brain. There's

something else I've got to do now. And

I've got to use another instrument that was invented by Par, the elevator.

Because I just want to make sure that all the pieces around the hole are still secure. We place that on the skull and

secure. We place that on the skull and we just go around making sure none are loose.

>> So it's like an egg, like a boiled egg.

You don't want another piece just to break off.

>> And thankfully they're all secure.

>> Could that heal over?

>> Not really. No. Uh but in the 17th century, we started applying silver coins.

>> Well, they plug the gap with a silver coin. Yeah. But we haven't quite

coin. Yeah. But we haven't quite finished because there's still some sharp edges.

>> Yes, I was going to say >> what we need is the lenticular. So that

goes into the hole. And then what we do is we just go around >> shaving off the edges.

>> Shaving off the edges.

>> And the the guy is conscious while you're doing this.

>> Yeah. But don't forget there's no nerve endings in the skull.

>> That makes me feel better.

>> Yeah. So you're not going to feel it.

And even today when we do operations on the brain, people are still awake. So

the surgeons know uh if they hit anyway and there's a problem, how the patient responds.

However, wise men did make a complaint about some surgeons doing trapanic.

He said all too often they take off with pieces of the skull and use them as amulets >> like charms. >> Yeah. He didn't like that. So what would

>> Yeah. He didn't like that. So what would happen is cover the wound up, make sure the the puss is flowing and then bed rest. But this is an expensive

rest. But this is an expensive operation.

>> Could only the richest people in society afford to have their their head traped?

>> Yeah. They could afford the treatment in the English Civil War. A lot of the soldiers, the foot soldiers would have to deal with whoever's in the baggage train, often surgeons getting practice,

the journeymen. Those are part of

the journeymen. Those are part of regiments would have their own surgeons paid for by the commanders, the lords.

>> I'd pay someone a lot of money not to have my head drilled into.

>> So, it's amazing that as military technology is advancing on the battlefield, the medical technology is is keeping pace with it or trying to.

>> And it's always been that way. The

daughter of war is surgery. New weapons,

you need to develop new ways of dealing with the results of those weapons. For

example, super glue was originally developed to uh shut wounds.

>> So, they're getting better at treating the wounds with better equipment. But is

their understanding of the basic human biology changing as well? They are

getting an understanding of how the muscles work, the anatomy, but it is frozen in what causes disease and what

causes illnesses and sepsis and gangarine. That's frozen and that

gangarine. That's frozen and that remains for some centuries to come.

Today I'm diving deep into London's grizzly past. We'll be going under the

grizzly past. We'll be going under the knife and taking a forensic look at the horrors of Victorian medicine. And

there's no better place to do so than by exploring one of London's hidden gems, the old operating theater museum and Herb Garrett. So, if you're someone

Herb Garrett. So, if you're someone who's fascinated by the gory, the gruesome, and the downright bizarre, this will be just what the doctor ordered. Stick around to see if I

ordered. Stick around to see if I survive the operating table, and don't forget to subscribe and click that notification button. Wish me luck.

notification button. Wish me luck.

>> You're going to die.

This is all that remains of what was once one of London's most important centers of medicine, the old site of St.

Thomas's Hospital.

When it was in use, it was a vast complex. However, in 1862, the land was

complex. However, in 1862, the land was purchased to make way for the construction of the Charing Cross Railway vioaduct from London Bridge Station. Now, the hospital is located in

Station. Now, the hospital is located in a modern building opposite the Houses of Parliament. And this garrett, part of

Parliament. And this garrett, part of St. Thomas's Church, is one of the only

St. Thomas's Church, is one of the only surviving parts of the original structure. And at the top of a very

structure. And at the top of a very windy staircase, is the original apothecary and herb garrett for old St.

Thomas's Hospital. The apothecary was the medical professional whose main role was to produce and dispense herbal remedies, picuses or even potions. And

the word garrett comes from the old French which means watchtower or a sentry box. But today it simply means a

sentry box. But today it simply means a little room at the top of the building, a type of attic. Whilst the apothecary had his laboratory, shop and store rooms

down at street level, this garrett was used to dry and store herbs which would be used for medicine. Today, it's been transformed into this brilliant museum.

At the start of the 19th century, our understanding of the human body and how it worked hadn't developed much for centuries, and so medical treatments were pretty medieval. It was a high-risisk combination of chance and

quackery. Doctors might recommend

quackery. Doctors might recommend treatments such as a change of air or even leeches. Medicines were made of old

even leeches. Medicines were made of old recipes generally using botanicals, whilst preparations of mercury, arsenic, iron, and phosphorus were also popular

and probably quite dangerous. We've got

all sorts of herbs here that the apothecary would have found pretty useful. We've got parsley that was used

useful. We've got parsley that was used to clean the blood. We've got some meadow which was something which was sacred to the Druids. It became a medieval meat herb. And actually, Queen

Elizabeth the first used it as a kind of pain relief. We've got some raspberry

pain relief. We've got some raspberry leaf. Well, this would have been used

leaf. Well, this would have been used for stomach ache. Sage

used for typhoid. Maragold used to fight scruffula in children. And bay leaves.

This would have been used to soothe your bruises.

Not sure how effective that would have been. We've got some hops here. Now,

been. We've got some hops here. Now,

these would have been used to treat insomnia, hysteria, and tension. And hot

tea is said to improve digestion. We've

got some myrrh. Now, this was the medicine of the ancients, and that stimulates the body against septasemia and strengthens the immune system. And

we've got some frankincense. Now, this

is an ancient aromatic. Actually, Plenny

mentions its use in Rome as an antidote to hemlock. And it was also used in

to hemlock. And it was also used in China for leprosy. And apparently along with gold, these two make quite good Christmas gifts.

But this is the most dangerous cabinet in the whole Garrett because this is the poison cabinet. The bottles are

poison cabinet. The bottles are colorcoded green. They've got this

colorcoded green. They've got this corrugated surface. That's so that you

corrugated surface. That's so that you can have extra grip on the bottles because you don't want to be dropping these. And even on the neck of some of

these. And even on the neck of some of the bottles, we've got a bell. That's an

extra alarm system to alert everyone around that these poisons are being handled. Ding dong. I love this display

handled. Ding dong. I love this display which gives you a sense of what the old apothecary shops would have been like.

Today I'm being served by Dr. Monica Walker. Monica, it's good to be back

Walker. Monica, it's good to be back here at the apothecary shop.

>> Hi Ellis. I'm glad that you're here.

What else you today?

>> Well, I'm sorry to say that I have been suffering from a bit of a stomach ache.

Is there anything you could do for me?

Oh, well, if I was in the Victorian era and I was, you know, an apothecary, I would definitely have something for you.

Um, at that time period, obviously, you have, um, the idea that every single disease was, um, connected with the four humors. Um, and you know, that pretty

humors. Um, and you know, that pretty much meant that the your body is a little bit out of balance.

>> Okay. So, we've got the four humors is blood, black b, yellow bile, and flem.

>> Yes, you've got them all right. So, you

have both of them.

>> I'm all on balance. I'm all on balance.

>> You're all on balance. you are

absolutely out of balance, which means that we have to put you back into balance. And the best ways that we can

balance. And the best ways that we can actually do that is by either giving you something um that is going to make your >> belly feel better by basically emptying

it as much as possible. That pretty much mean that I'm going to give you either animeic or a laxative, okay?

>> You know, or something cathartic, you know, something, you know, a purgative in that case. Um so in the Victorian era they would have gotten a couple of different um kind of like herbs that

have these kind of like um properties.

Um and what they would have done first would be they will have grinded them as as fine as possible. Just make sure that they you had quite a lot of that really fine like active ingredient first. After

that, they would have um put together a little bit of like a mass that would have um actually being done with um glucose syrup or something that will allow you later on to kind of like be

able to knead it um kind of like this.

Um and of course by then um this kind of like little bar we have contained um some of these active ingredients that we actually have here. Uh what that means now is that I want to make sure that I'm

going to give you the right amount um instead of giving you way too much or not enough. So it's a kind of

not enough. So it's a kind of measurement.

>> So it's a kind of measurement. What we

have here is a pill making uh machine and it's all about a standard standardizing um basically the um the quantities that are going to be um given to the patients. Um then of course I

already have my um my little mat with my active ingredient here and I'm going to place it at the center of um of the peelmaking machine. After that I'm going

peelmaking machine. After that I'm going to grab my pillm maker um section. And

what I'm going to do is that I am physically going to go down here and then let's see if we can do this. Um

right have to really like anchor myself to do this as well because now basically is that we're going to be doing this.

>> Oh yeah.

>> One, two, three. One, two, three. One,

two, three. And then uh we actually see that we are starting to make um little balls, rolls of peels. After this was kind of like finalized, what you actually do is

you burnish them. Um and after varnishing them, you can either um use um talcum powder. Okay.

talcum powder. Okay.

>> Um or in some cases, if you are very fancy and you have enough money, you can also use silver. At which point, you just put all of your tiny little balls in here. Hang on. Silver doesn't sound

in here. Hang on. Silver doesn't sound very good to you. Is that a >> So, um it's just a coat. It's just the external coating. Today, we actually use

external coating. Today, we actually use sugar um to coat them so that it doesn't like the first like time that you taste a medicine um it doesn't like, oh my god, it's disgusting. Um so, in the

past, you actually had a talum powder, but you also could have in some in sometimes um you could have silver or gold if you were very fancy. That just

mean that you could actually charge more for the medicine. Um but it actually did the same kind of um um function as um as

having um the tokum or the sugar nowadays. So this is your peel. Take it.

nowadays. So this is your peel. Take it.

And now >> So do I just eat have that straight? Any

water?

>> You can. Yeah, you can have that straight. It's just that you better make

straight. It's just that you better make sure that you have a toilet nearby when you do that.

>> Okay. You ready?

M.

Thank you. You're welcome.

A happy customer.

But over the course of the Victorian period, a revolution took place. The

outdated treatments based on superstition or quackery were replaced.

By the end of the century, there were modern hospitals with stethoscopes, operating tables, white coats, and X-rays. But what caused this

X-rays. But what caused this transformation? Well, the industrial

transformation? Well, the industrial revolution pushed thousands into cities to work in the new factories where many people lived in poverty in spaces which

were overcrowded and unsanitary.

Smallpox, typhus, tuberculosis and cholera spread like wildfire through the tenement blocks. It was so bad that the

tenement blocks. It was so bad that the government was forced to investigate.

And these investigations helped us establish links between poverty and disease about how disease spreads and brought in poor laws and reform acts.

So it was a real time of experimentation of making mistakes and learning from them too. And St. Thomas's was no

them too. And St. Thomas's was no different. In 1822, part of the Herb

different. In 1822, part of the Herb Garrett was converted into a purpose-built operating theater. Instead

of the operations taking place in the women's wards in front of all the other patients, they could be performed here by leading experts where medical

students could watch and learn.

One of the surgeons described the scene here. The first two rows, he said, were

here. The first two rows, he said, were occupied by the dressers and behind a second partition stood the pupils packed like herrings in a barrel, but not so

quiet. There was a continual calling out

quiet. There was a continual calling out of heads, heads to those about the table whose heads interfered with the sightseers.

And now it's my turn to go under the doctor's knife. Wish me luck.

doctor's knife. Wish me luck.

Good morning. Today's operation is going to take place in the operating theater, the women's wards. Uh our patient Alice um had just been run over by a cart in

Boro market. Um and um she has suffered

Boro market. Um and um she has suffered a compound fracture which pretty much means that the bone has broken and basically broken through the skin. So I

can still see your bone coming out of your leg.

>> Ouch. And then um I'm actually going to be ready to uh prep um Alice for the operation. Um I'm wearing my amazing

operation. Um I'm wearing my amazing apron. I wear all the time to my

apron. I wear all the time to my operations. The amount of blood in it

operations. The amount of blood in it indicates how skilled I am. And as you can tell, it's so bloody. It shows that I am a really really good surgeon. Now,

of course, I am going to open my uh fantastic um surgical kit from 1835. Um

and the first thing that we want to do is ensure that you do not lose any additional blood. Therefore, first thing

additional blood. Therefore, first thing that is going to happen is that um Alice is going to get a tourniquet around her leg. So, if you can please raise your

leg. So, if you can please raise your leg slightly. I will place a tourniquet.

leg slightly. I will place a tourniquet.

Um this is just so that you do not die of blood loss um during the operation.

It will be tight um very very tight at the time. Um of course once this has

the time. Um of course once this has happened um the surgeon is not here alone. Um I am actually here with

alone. Um I am actually here with imaginary assistants called dressers. um

four of them they will be helping me throughout the operation and amongst their performance is going to be to hold you down with their physical body so that you do not move throughout the

throughout the entire procedure. So now

that we actually have you um in the operating table, you must know that chances are you were blindfolded in the past. Um so you didn't have to worry

past. Um so you didn't have to worry about the 150 students that would have been in this space with me trying to learn by observation. um how surgical

procedures were done in the past. Um

some of them will be smoking. So the

space will actually have a cloud of smoke above me. Um and of course there'll be sawdust all over the operating table to ensure that no blood um is going to make me slip while I have

a knife in my hand. Um health and safety people that's important. Okay. Now that

I am ready.

>> Is there no anesthetic coming?

>> What is 1823? No. you know there is no anesthetics coming that they don't come into existence until the end of 1846 beginnings of 1847. So yeah you actually

have a little bit um of time left. So

now that I am ready for the operation I make sure that a blood box is placed underneath your leg because we again don't want any extra blood to be actually spilled. Um we want to make

actually spilled. Um we want to make sure that this is done as efficiently and as fast as possible. So now that I am ready, my assistants are around here holding you down, making sure that

nothing is going to happen. We are

basically ready now to uh begin the operation. Because your uh compound

operation. Because your uh compound fracture has happened somewhere around your tibia, we are going to cut right underneath your um uh knee because we always want to try to save the knee. Um

that pretty much means that I'm going to grab one of my knives um which is quite a beautiful knife. Obviously, we has a beautiful wooden um handle um which of

course at that time period we have had lots and lots of germs. Uh but hey, it's fascinating. But now I have the knife.

fascinating. But now I have the knife.

Now I am ready to amputate. And of

course the first thing that I'm going to do is that I actually need to figure out where the bone is. And for that I need to be able to see it. So I actually need

to cut through. So I'm going to get into very, you know, stable horseback riding stance. I'm going to bring my hand

stance. I'm going to bring my hand through here. Grab the knife and cut in

through here. Grab the knife and cut in an oval shape around your leg.

Important.

I'm done. I'm going to do this for the next one in my operating table. So, they

see that it it's kind of clean, right?

After that, I still need to be able to physically see the bone. So, that pretty much means that we're going to have to retract the meat. And to do that, we're going to use our hands. So, you're going

to pull the meat down in one direction.

Remember that little oval? It means that there is a flap on the top. So, I'm

going to pull all of that in the opposite direction. So, I get to see

opposite direction. So, I get to see about this much of your bone. Um because

I need to see what I'm doing, right?

Maybe one of my assistants that was around here will be holding the top of that meat with um their um apron, which will also be blood. I filled with blood

and puss from previous operations. And

now I actually get to see the bone.

Therefore, I am ready to use my bone saw and amputate. And all of my students

and amputate. And all of my students need to be very aware that this is what's happening. I am grabbing my bones

what's happening. I am grabbing my bones saw. Um the operating table, as you can

saw. Um the operating table, as you can see, has an extension for the good leg, you know, and of course that pretty much means that um it doesn't really matter how tall you are. We can always accommodate someone who is tall taller

or someone that is shorter. Also, the

operating table is meant to actually be used for several types of operations.

And for that purpose, you don't have to have an extension all the time. Now that

I have my bones on and I'm ready to go, I'm just again need to be very stable.

And uh what I'm going to do is basically use my body weight to go all the way through.

Now, there is two indentations at the bottom of the operating table, which pretty much means that I'm giving myself somewhere to go because if it stops the

motion halfway through, it means that I'm going to have to do this a lot more times. And that's not what you want. You

times. And that's not what you want. You

want to go all the way through as you as few times as possible. And of course, the fact that the operating table is so low is allows me to use that body weight

to give that sort to go. And at the same time, I can use the strength that I need to actually do this. I've done this in a couple of strikes. Um, the leg has come off. My assistant has grabbed it, put it

off. My assistant has grabbed it, put it in the block box, and kicked it underneath the operating table. Now,

unfortunately, I have left a couple of um splinters there, which means that I'm going to use my bone nippers, and I'm going to try to cut through, you know,

whatever bits and pieces of bone are left. You know, at this stage, I may

left. You know, at this stage, I may actually look at your face to see how you're doing, because that, you know, fabulous headrest is not there for my patients comfort. It's actually there so

patients comfort. It's actually there so I can see whether up until this point, have you died of shock? Have you passed out or are you still holding and biting

down the pain as you are suffering through this with no anesthesia? Also no

antiseptics. And then of course we have to continue um because obviously we have a lot of major you know veins and arteries in your legs um that are kind

of crucial um that we need to deal with so that you do not die of blood loss.

Um, and of course that pretty much means that in the past sometimes they were celerized meant that you burn the endings. And if not, then you get

endings. And if not, then you get something like this, which are called they got your clamps. And what they do is that allows you to grab the endings

of those veins, the main ones, main arteries, pull them out. So you will literally pull some of those veins out of your body. Um, they used to have something like a crochet needle to tie

the endings. And once that's done, you

the endings. And once that's done, you will get a piece of thread that has been leaving um in that box uh which could have been made of cat's gut, pig's gut,

horses hair, silk if you're lucky. And

then I will tie those endings, push them back into your body, put this back where it belongs. And after that, of course,

it belongs. And after that, of course, I'm the surgeon. I am done. But my

assistants still have something to do.

The job of the assistant um at that time called dressers was basically to grab that excess meat. Yeah. And put it over the wound because then you know chances

of infection are less even though they didn't know that it was infection. It

was one of the main reasons that they discovered that having an open wound all the time if you do a circular might not be a great idea. Having a cover on the other hand might give you a better chance also for comfort. So they will

just sew it back together. You may

actually get some dressings and then you are actually done. Amputation has been completed. Um best ones would have been

completed. Um best ones would have been completed in under two minutes. Uh

patient is alive and breathing. Um it

will be u quite natural to give my patient now about um half a pint of brandy.

>> Yes. You actually get into a drunken stouper to deal with the pain and then sent into the uh women's warts to deal with the aftermath um which probably

involve infection and then whether you survive or not it's up to you and your body.

>> Despite the gruesome nature of these procedures, the female patients who made it onto the operating table here would have considered themselves lucky. Most

of them were poor and were prepared to put up with the distress of a live audience in order to receive treatment from the best surgeons in London. In

fact, the trial and error of these operations led to major breakthroughs in surgical practice, paving the way for the huge advances in medicine in the 20th century.

So, there you have it. Those are the delights, or should I say the horrors of the old operating theater, museum, and Herb Garrett. I'd really recommend a

Herb Garrett. I'd really recommend a visit if you're ever in London. Of

course, I made it out okay, but you might not be quite so lucky. If you did enjoy this video, check out our other video on the SS Great Britain where you can find out all about how the

Victorians did cruising. See you next time.

Sir, first day of the SO 19,000 dead, 40,000 casualties just on the British side alone. Tell me, what

were the conditions like in these casualty clearing stations after those first few hours?

It's horrific, isn't it? 40,000

casualties, but we have got a clear system to evacuation of the wounded back to to the casualty clearing stations, back to safety behind. We often hear about the trenches not moving very

often, but it means you can build up your medical services behind. So, if

you're wounded, first thing you do, use your use your first field dressing. If

you can get yourself back off the battlefield, you do that yourself.

>> Yes, got that here.

>> Good. Otherwise, you're reliant on the stretcher bearers coming to get you.

Yeah. 16 stretcher bearers per battalion. That's every thousand men.

battalion. That's every thousand men.

They may double that up with extra bandsmen, etc. Um during the back big battle, the stretcher bearers will bring you off the battlefield and straight down to the regimental aid post which is

in or around the front lines. Okay.

Basic system here. First thing, stop bleeding. That's the highest priority.

bleeding. That's the highest priority.

What we'll do, use direct pressure. So, say you've been injured here. get some pressure on

injured here. get some pressure on there, stop bleeding. If that doesn't work, we're going to have to use indirect pressure. And what we use here

indirect pressure. And what we use here is the British Army's to the pad. You

find a pressure point in there, get it in there, buckle it off around there, and then you twist the top. And as you twist, it gets tighter and tighter.

Okay?

>> That will stop the bleeding. That's the

highest priority.

>> After that, things like pain relief.

What we have is morphine using lord them in the in in the 19th century but at the moment we're using morphine. This is the army's tablet tin. This is what's issued to the doctors. It contains a variety of

medicines and drugs. Um and the one we're using here would be this one here which is morphine like that. If you if you've had morphine it's vitally important to write a big M on your

forehead so you can see who's had morphine and so you don't overdose your casualties.

>> Awesome. Of course. And speaking of wounds, what kind of wounds are we seeing from the first day of the summer offensive?

>> So, by and large, the biggest injury is artillery. So, we're talking shrapnel,

artillery. So, we're talking shrapnel, which are ball bearings, an anti-personal weapon fired by fired by artillery over and explodes like a big sort of almost like a what's called a

claymore mine these days, but in the air. We've also got shell splinters.

air. We've also got shell splinters.

Again, the shells detonate in the air to form an anti-personnel weapon. That's

the highest wounding agent. 58 and a half% of all wounded soldiers seen at the casualty clearing stations have that injury.

>> The next highest is bullet wounds.

Right?

>> When you're in the trench, you're very much protected from bullet wounds. When

you get out of the trench and you go into no man's land, that's when those injuries occur. 38% of all injuries are

injuries occur. 38% of all injuries are caused by bullet wounds. 2% are called by grenades.

>> Okay.

>> And 0.32% so the official statistics say are caused by bayonets, >> right?

>> Tiny proportion. You compare that to the 58% caused by artillery.

>> So we always think sometimes people think, oh, it's going to be the the machine gun bullets that causing absolute devastation. It's actually

absolute devastation. It's actually these these big artillery shells that are just fired in their in their millions, shrapnel, bits of metal flying off and you're getting these sometimes

gaping wounds, right? What are those like to treat?

>> The big big problem in the first world war is wound infection. We don't have antibiotics yet. Penicellin hasn't been

antibiotics yet. Penicellin hasn't been discovered. It won't be discovered for

discovered. It won't be discovered for another 10 years after the end of the first world war. So, but we do have antiseptics. We have things like iodine.

antiseptics. We have things like iodine.

Um there's a very famous film called the battle of the som where uh a cameraman called Jeffrey Mins is filming the buildup to the battle the battle itself and the aftermath and one of the things

he's doing is he's filming at a place called Minden Post which is where there's an advanced dressing station and you can see the medical officers literally with the wounds painting on iodine with paint brushes.

>> Yeah.

>> To try and stop the infection. Every

wounded soldier will get a shot of this stuff here. And this is anti-tan serum.

stuff here. And this is anti-tan serum.

>> Tetanus block jaw. You don't want soldiers to get it. So every single wounded soldier would get an injection of this stuff here.

>> With so many casualties to contend with, a stringent system of orderly triage was essential to effectively treating those with minor and major wounds. A priority

of evacuation was established before transportation.

Major, even minor surgery was to be avoided at these early stages of engagement. In the presence of major

engagement. In the presence of major bleeding or wounds of the thorax or abdomen, the soldier was immediately placed in a cart and wheeled to the nearest safe area that would allow the

approach of an ambulance.

The moderately injured were offered transport at night.

Essentially what happens is you go to a dressing station, advanced dressing station or main dressing station and you're triaged very much like today. If

you go to A&E today, you get triaged or separated into different groups.

>> Yeah.

>> If you're severe but survivable, and that's the key, survivable, you're taken back to a casualty clearing station for further treatment.

>> Right.

>> Down there, these casualty clearing stations are the lynch pin of the whole medical system. They're a big mobile

medical system. They're a big mobile hospital, 500 beds at a minimum, teams of surgeons, x-ray machines, teams of nurses, blood transfusion equipment.

You're in safe hands if you get back to a casualty clearing station.

>> And that's like you said as at the start, there's a huge amount of casualties, but the British do have the infrastructure. It's not like these sort

infrastructure. It's not like these sort of you imagine from the Crimean War, these makeshift hospitals and there's dirt and rats everywhere and just blood and gore. There's an efficient process

and gore. There's an efficient process for the soldiers.

>> Absolutely. Yes. So, you know, it's 40,000 casualties on the first day of the Psalm in the morning of the first day of the Psalm um on the 1st of July

1916. You imagine any medical system in

1916. You imagine any medical system in the world that could have to cope with 40,000 casualties coming streaming through. The official statistics say if

through. The official statistics say if you get back to the safety of one of these casualty clearing stations, 97% survive. Wow. Okay.

survive. Wow. Okay.

>> So, they're doing something incredibly well at these these these casualty clearing stations. Um, and it's a

clearing stations. Um, and it's a tribute to the men of the Royal Army Medical Corp and the nursing professions, the Queen Alexandre's Imperial Military Nursing Service, the VADS and so forth.

>> And so, the fact that there are almost 19,000 dead just shows you the scale of devastation during the Battle of the S.

You know, these are wounds that are irreparable. Now, if I was to come here,

irreparable. Now, if I was to come here, let's say with a bullet wound or a piece of shrapnel in my leg, what are the sort of tools and medicines you'd be using to treat me?

>> Right. Firstly, I mean, that's something for the casualty clearing stations. So,

you'd end up down there. Um, you'd end up these these these big hospitals. Uh,

some of the kit they'd be using would be >> There you go. This is um this is one of the operating sets that they would have used back then. Um, this has all been

redesigned. This is all state-of-the-art

redesigned. This is all state-of-the-art technology here. All of the kit can be

technology here. All of the kit can be sterilized before use. You sterilize it in boiling water or in antiseptic fluids. And so if you compare this set

fluids. And so if you compare this set to a Victorian set of equipment, all the uh the Victorian equipment would have bone or wooden handles. You can't

sterilize that, >> right?

>> You can sterilize all of this sort of stuff. This is a, as I say, a general

stuff. This is a, as I say, a general operating set tool for all sorts of operations. amputations, neurosurgery,

operations. amputations, neurosurgery, tracheosttomies, you name it, it's there.

>> Brain surgery, there would be brain surgery happening.

>> Uh, one of the things they were using is magnets, >> right?

>> German shrapnel balls are made of um steel. If you use an electromagnet and a

steel. If you use an electromagnet and a blunted nail, you can put that into the brain and bring it out.

>> Wow.

>> So, that's one of the things they're using. Um, it sounds a bit barbaric, but

using. Um, it sounds a bit barbaric, but it works. And of course with battlefield

it works. And of course with battlefield injuries, some are more lucky than others. You might have a foot blown off

others. You might have a foot blown off or something. You might have shrapnel on

or something. You might have shrapnel on your leg and you need potential surgery.

Talk to me about the different sorts of operations that would have would have been done on the front.

>> Okay. So an amputation would be quite a common thing uh in a casualty clearing station. Okay. What we've got here is

station. Okay. What we've got here is the the army issue amputation saw. It's

for capital amputations. What I mean by that is a capital amputation is removing arms or legs, >> right?

>> Not decapitation.

>> It's a big thing. It's not very good for you. Um, you'd have to obviously knock

you. Um, you'd have to obviously knock them out first. You'd have to anetize them. This is something called the

them. This is something called the shimmer bush mask. And to anetize your patient, what they do is they place the mask over the patient's face and then drop chloroform or epha directly onto

the mask and then you inhale it. So

that's good to know that if they are going to go through amputations, they're not going to have to bite down on a bit of pencil or something.

>> Yes.

>> With no access to antibiotics, which would be discovered a decade after the war had ended, it is easy to conjure up scenes of chaotic and horrifying conditions within the medical clearing

stations and hospitals.

The reality was to the contrary.

Treatment facilities in this period were ironically far less archaic than the tactics employed on the battlefield.

Portable X-ray machines brought to the front by Mary Cury were available to scan soldiers and aid in diagnosis whilst blood banks had also been set up

behind the front lines ready for transfusions.

Moreover, those who were unfortunate enough to suffer major facial disfigurement now had a source of hope.

>> Many people came back with facial injuries from the First World War.

>> And it's a devastating thing to have. If

your if your whole face has been smashed up by a gunshot wound or um artillery explosion, then you need to have your face rebuilt. Plastic surgery doesn't

face rebuilt. Plastic surgery doesn't really exist before the war.

Enter somebody called Harold Gillis who's a New Zealand surgeon and he develops systems of rebuilding people's faces. He's not just rebuilding people's

faces. He's not just rebuilding people's faces. He's also given their lives back

faces. He's also given their lives back as well.

>> Wow. So an early form of sort of facial reconstruction.

>> Yes.

>> That's incredible. And would these soldiers then be sent back to the front line? I guess it depends on their

line? I guess it depends on their injury. If it's a small shrapnel wound,

injury. If it's a small shrapnel wound, they might be sent away for a bit. But

>> yes, it sent back.

>> Absolutely. It depends on your injury.

depends on if you can serve again. You

could be medically downgraded and so if you're not frontline material anymore, maybe you could work behind the lines in the warehouses or whatever behind the lines. Um but if you're well enough,

lines. Um but if you're well enough, you'd go back into action and back back to the front >> non-stop. Never stops, does it?

>> non-stop. Never stops, does it?