Search Surgeons' Case Books, University College London, 1836-1851

You will find information including -

First name

Last name

Age

Date of admission

Disease

Case number

Outcome

Date of dismissal

Occupation

Victorian surgery developed during a period of remarkable medical change, moving from a practice shaped largely by speed and endurance to one increasingly influenced by scientific innovation and hospital-based training. In the early nineteenth century, surgeons still worked in conditions that modern observers would recognise as harsh: operations were carried out in crowded theatres, instruments were reused without sterilisation, and patients remained fully conscious during procedures. Because severe pain and shock could be fatal, surgeons prized speed above all else, especially in amputations and other major operations. Hospitals in rapidly expanding cities such as London became important centres for surgical instruction, where students observed procedures and copied case notes to build practical knowledge.

The introduction of ether in 1846 and chloroform soon afterwards transformed surgery by allowing patients to undergo longer and more complex procedures without pain. This did not immediately remove danger, however, because post-operative infection remained one of the greatest causes of death. Surgical wards frequently saw cases of erysipelas, gangrene, and blood poisoning, particularly where overcrowding and poor ventilation were common. Surgeons increasingly treated injuries linked to industrial labour, railway accidents, and urban life, alongside chronic diseases such as tumours, ulcers, and bone disorders. These changing patterns meant that Victorian surgery was shaped not only by medical discovery but also by the realities of poverty, industry, and rapid urban growth.

By the middle of the nineteenth century, surgery had become more closely tied to professional identity and medical reform. Institutions such as University College Hospital helped establish surgery as a discipline grounded in observation, record keeping, and formal teaching. Surgeons published case reports, debated new techniques, and increasingly relied on hospital records to compare outcomes. Although antiseptic methods would only emerge later in the century through the work of Joseph Lister, the decades before 1850 laid much of the groundwork for modern operative practice, with surgical case books offering an important record of how medicine was adapting to a new scientific age.

Among the most famous surgeons associated with early Victorian London was Robert Liston, who became professor of clinical surgery at University College London and surgeon at University College Hospital. Known for his extraordinary speed in the operating theatre, Liston built a reputation as one of Britain’s leading surgeons at a time when rapid amputations could reduce suffering and improve survival chances. He also became famous for performing one of the first operations in Britain using ether anesthesia in 1846, marking a major turning point in surgical history. His work reflects the transition from older forms of operative skill toward a more modern surgical practice shaped by new scientific developments.

From the case notes, we find more details about this pioneering surgery. 36 year old Frederick Churchill, a butler, came to the hospital with a diseased knee and was admitted on 23 November 1846. His notes state that he lived at 37 Upper Harley Street and slept in a rather confined room. He had lived in London for 25 years. He was 5ft8, had a fair complexion, unmarried, and had a 'cheerful state of mind'. Frederick's father died 10 years ago, but his mother, and his siblings, were still alive. It is also noted in his case notes that he had had several cases of gonorrhea and a skin condition, possibly eczema. The diseased knee is inspected and the patient's condition closely monitored, recording fitful sleep and a worsening of the knee. Lister decided on 9 December that the leg needed to be amputated. The details of the procedure and Frederick's recovery are recorded, including reports that Frederick felt no pain during the amputation and had no memory of it happening. It was deemed that the first use of ether in Europe for an amputation was a success.

You can find this case in volume SCB_1845-1847.