In the early 1800s, an operating theater was quite literally that—a combination of surgical operating room and theater stage, complete with an unruly audience of young doctors and nervous “performers.” Students crowded into the seats to see how a particular surgery was performed, or just for an afternoon show.

Antiseptics and anesthesia had yet to be invented. Before the hospital started using anesthesia in 1846, the primary tool of the surgeon was speed. Patients were generously given a choice of opium, liquor, or a knock on the head with a mallet to render them unconscious.

Within the walls of Philadelphia’s expanded, modern Pennsylvania Hospital is the original hospital, founded in 1751 by Ben Franklin and Dr. Thomas Bond. The Pine building, in addition to having a beautiful medical library (featuring 13,000 books and a series of plaster anatomical casts) holds the original surgery amphitheater. 

Built in 1804 and used until 1868, the operating theater is the oldest in the United States. The building of the amphitheater helped formalize surgery and turn it into a recognized medical discipline. Of course, you still wouldn’t want to have been the one on the table in 1804: “Opium, rum, or mallet?”