 Pennsylvania
Hospital is home to the oldest existing surgical amphitheatre
in the United States. It was constructed in 1804 and is located
in the center portion of the Pine Building. The initial portion
of the hospital, the East Wing, had been completed earlier in
1755 but had no provision for surgical operations; all available
space was designated for housing patients and staff of the hospital.
Forty-nine years after the initial construction project, when
all other parts of the hospital were finished, a large circular
amphitheatre opened on the third floor.
The amphitheatre is approximately 30 feet high and 28 feet in
diameter. The upper gallery has rows of wooden benches that hold
approximately 130 students and observers, but it was often over-crowded
when an unusual operation or particularly popular lecturer was
scheduled. Since the skylight was initially the only source of
lighting, operations were scheduled for mid-day and preferably
during clear weather. Procedures were performed in an unsterile
environment, since the sterile technique was not mandatory in
American hospitals until the turn of the century (1900). In addition,
until about 1840, operations were performed without the benefit
of anesthesia; patients were given a choice of opium, liquor
or a knock on the head with a mallet to render them unconscious.
The surgical amphitheatre helped to inaugurate American clinical
teaching by bringing the patient into the lecture room with the
students. Dr. Benjamin Coates initiated the practice of demonstrating
with patients in 1834. This approach followed the earlier example
of Dr. Thomas Bond's bedside clinical teaching, which had been
carried on in the wards since the earliest days of the Hospital.
Several other distinguished physicians made use of the amphitheatre
over the years, such as Dr. Phillip Syng Physick, Dr. George
W. Norris, Dr. Joseph Pancoast, Dr. D. Hayes Agnew and Dr. Thomas
G. Morton.
In the early 19th century, Philadelphia became known as the "Athens
of America." The city had begun to attract students seeking
medical education and clinical instruction not available anywhere
else in the United States. The opening of the amphitheatre marked
the establishment of surgery as a recognized discipline. Prior
to its inception, what little surgery had been taught was done
so as a practical aspect of anatomy classes. The amphitheatre
filled a long-held desire of the University of Pennsylvania's
faculty for a place in which a large class of students could
receive formal lectures as well as witness surgical operations.
The surgical amphitheatre has been continually used for a variety
of purposes since it ceased to function as a clinical amphitheatre
in 1868. Immediately after a larger amphitheatre opened in another
wing, the room served as a dining room for nurses and patients.
It later served as a lounge for the house staff. In 1976, funds
were raised to renovate the space, and the amphitheatre was returned
to its original state; visitors are now welcome to visit this "time
capsule of surgery."
Information for portions of this essay was gleaned from the
article, "A Note on the 'Circular Room' of the Pennsylvania
Hospital" by Alfred R. Henderson, Journal of the History
of Medicine and Allied Sciences, 1964, Volume XIX, Number
2.
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