Victorian Amputation Saw

“Time me gentlemen.” – Robert Liston

In the 19th century if you needed surgery, the pace at which the surgery could be performed was paramount to the patient. The reason being, anaesthetic, antibiotics, anti-sceptics had all not yet been invented. Therefore, if you needed an operation such as, amputation, mastectomy, lithotomy etcetera the speed at which the operation could be performed was the single greatest pre requisite for the patient. Surgeons that could perfume surgeries the quickest were the most popular as this meant the patient was under the knife for least amount of time without anaesthetic as possible.

Obviously, mortality rates were appalling and even if the patient made it through the initial procedure, they usually died from complications post-surgery. Gangrene, infection, sepsis were all common as not only was there no anaesthetic for the surgeries, there was also no education or knowledge of germ theory. The same knives, saws and blades that were used on one patient would be used on the next patient, without disinfectant, as this had also not been invented yet. It was also common for surgeons when swapping surgical tools to hold the bloody ones in their mouths while transition equipment. Infections were rampant and hospitals were disgusting. So much so that in the Victorian era, the hospital bug catcher that would try rid the hospital of the visible insects and maggots was paid considerably more than the surgeon.

In the Victorian era, hospitals were for the poor. If you were very wealthy or middle class and needed an operation, you paid extra for the surgeon to perform that specific operation in your home. There are records of women receiving mastectomies and people having limbs amputated in their kitchen and dining rooms from Victorian records. As strange as this sounds it was considerably more hygienic than having your operation performed in the hospital.

In a previous article I spoke about “The Fastest Knife in the West End” Robert Liston. He was able to perform an amputation in 30 seconds. Other surgeons could take as long as 90 minutes. Robert Liston became so popular that he began to charge an entry fee to his operations and would fill the room with spectators. It is also recorded that he had queues of people outside his operation theatre to see him, many would wait in line for days and weeks. This was more preferential than getting seen by an inept surgeon immediately, being under the knife for an hour or longer without anaesthetic. Makes sense. When he would walk into the operating theatre he would shout to the audience ‘Time me gentlemen…!’ and the audience would time the operation on their pocket watches as a sport. The audience would sit and watch while he performed amputations on a conveyor belt of patients for hours. It wasn’t until 1876 that a British surgeon named Joseph Lister came to the United States and spoke about the idea of germs playing a part in people dying post-surgery that hygiene during surgery and post-surgery became a common topic. He was the first person to realise there was an invisible element affecting the wounds of people and it was Mr. Lister that proposed this idea to one of his audiences.

One of the spectators in his audience became fascinated with this topic and he was the first person to invent anti-septic. It was created in 1879. His name was Joseph Lawrence and he was an American chemist. He named his product ‘Listerine’ after Joseph Lister. This product changed the course of surgery, and items began to be disinfected and wounds were treated better etcetera. Meaning the mortality rate of Victorian surgery plummeted. But prior to 1879 there was none of the above. A speedy surgery became the single most important aspect of surgery and therefore, the fastest surgeons became celebrities and the best and sharpest tools became incredibly expensive and in demand. This is how the Victorian Amputation Saw came to prominence. However, despite the best efforts of the inventor it was a huge failure.

The Victorian Amputation Saw or The Clockwork Saw as it is sometimes known was a circular saw that had a crank that you would wind. Once the saw was wound up to maximum you would release it and the blade would spin. The idea was that this would make the operation faster but it was a complete disaster. It was invented by a man named W.H.B Winchester in the 19th century, he was a surgeon and fixated on reducing his surgery time. All surgeons at this time were as it was a matter of life and death for the patient. Winchester wanted to make an instrument that would speed up the process of taking of a human leg and he created the Victorian Amputation saw.

The main pitfall of the Clockwork saw was what Winchester gained in speed he lost in precision. It was an extremely difficult tool to manoeuvre after the crank was wound up and left go. He had trouble handling the saw. The first and only time it was used by Winchester he accidentally took off his assistant’s fingers. It was such a failure that it never made it out of prototype phase. The only Clockwork Saw in existence is on display at the Huntarian Museum at the Royal College of Surgeons in London.

It wasn’t just Winchester that was unlucky in his exploits and it wasn’t all glory for Joseph Liston had his fair share of failure as well. Once during an operation, he removed a person’s testicle whilst attempting to remove his leg. In a separate surgery, Liston accidentally sliced off one his assistant’s fingers and while changing instruments during the same operation he slashed the jacket of a spectator that got too close to the procedure. As a result, the patient died of post-operative infection, the assistant died of gangrene from the severed finger and the spectator died of a heart attack from the shock of his jacket being cut. It is the only surgical case in history that has a 300% mortality rate.