A description of the students packing the Theatre to witness an operation has been left by a St Thomas’s surgeon, John Flint South.
'the first two rows … were occupied by the other dressers, and behind a second partition stood the pupils, packed like herrings in a barrel, but not so quiet, as those behind them were continually pressing on those before and were continually struggling to relieve themselves of it, and had not infrequently to be got out exhausted. There was also a continual calling out of “Heads, Heads” to those about the table whose heads interfered with the sightseers.'
Patients put up with the audience to their distress because they received medical treatment from some of the best surgeons in the land, which otherwise they could not afford. Wealthy patients of the surgeons would have been operated on, by choice, at home probably on the kitchen table. The risk of death at the hands of a surgeon was greatly increased by the lack of understanding of the causes of infection. Although cleanliness was a moral virtue, descriptions suggest that a surgeon was as likely to wash his hands after an operation as before. The old frock coats surgeons wore during operations were, according to a contemporary, ‘stiff and stinking with pus and blood’. Beneath the table was a sawdust box for collecting blood. The death rate was further heightened by the shock of the operation, and because operations took place as a last resort, so patients tended to have few reserves of strength.