‘As sickness is the usual forerunner of death, it should therefore lead you seriously to consider, and reflect on your behaviour in life, and carefully to examine yourselves ho far you are prepared for that great change.”
From “Directions and prayers for the use of the Patients” by the Chaplain of St Thomas’ Hospital
A major rebuilding programme began at St Thomas’ in the early 19th century. Although most of the programme was never completed, before the move to Lambeth in 1862, much of the work from this period still survives. The most interesting new development was the construction of the Operating Theatre in this Herb Garret. Until it was built, operations took place behind a screen on Dorcas Ward in Frederick’s Block which adjoined the Church. Prior to operations the other patients may have been temporarily removed from their beds to avoid witnessing the proceedings. In 1821 it was : ‘‘Ordered, that the Herb Garret over the Church be fitted up and be in future used as a Theatre for such operations instead of the present Theatre“, according to the Minute book of the Grand Committee of St Thomas’ for October.
Originally, there was a entrance directly into the centre of the theatre from the Dorcas Ward. Around 1840 Guy’s and Frederick’s blocks, the two main buildings fronting onto Borough High Street, were rebuilt. The old entrance to the theatre was then bricked up and the present door on the side constructed. The ante-chamber outside the theatre was also then constructed to receive patients awaiting operation.
Running St Thomas’
The senior resident member of staff was the Treasurer. He was responsible for the running of St Thomas’ and reported to the Hospital Governors. He lived in the fine Queen Anne House adjacent to the Church (now occupied by The Chapter Group).
The senior medical officer was the Apothecary, with premises in Clayton Square. There was a laboratory, dispensing shop, store rooms and an office. The Apothecary also continued to use the Herb Garret to cure the herbs. Each morning, ward sisters brought lists of the drugs needed to his office and picked them up at lunchtime. He had two apprentices and two assistants, and received a salary of £643 15s 1d p.a. For this salary he was required to see all medical patients five days a week. On the other two days patients were visited by their physicians (average salary £239 9s 0d p.a.) or surgeons (average salary £488 3s 6d p.a.). The Apothecary also had to prescribe medicines for surgery and treat emergency cases. Between 1745 and 1877 the Apothecary was in the hands of three generations of the Whitfield family.
Admissions to the hospital were governed by similar procedures to the 18th Century and in 1801 the hospitals statistics were:
Looking After the Patients
The nurses were under the control of the Matron, who was an administrator and had no medical duties. Each ward had a sister (salary £32 p.a. for clean wards and £45 for venereal wards) with 2 assistant nurses (salary £20 or £22 p.a.). Nursing staff were on duty from 6am to lights out, after which a Night Sitter took over. Nurses normally lost their jobs on getting married. But widowed and unmarried women were often employed as sisters or matrons.
In 1801 it was reported that the patients food at St Thomas’ was cooked by one Phoebe Newton in two large coppers. The diet was still monotonous, repeating the same menu each week, with no mention of fresh fruit or vegetables. The major innovation was a dramatic reduction in the quantity of beer given to patients!