Lectures, Surgeries Occurred in Amphitheaters
Physicians trained during the late 1800s and early 1900s experienced the golden era for the
anatomical or surgical amphitheater – the principal facility then used to educate medical students.
Oval or circular in nature, the amphitheater consisted of rising tiers of seats arranged about an
open space. This unique configuration enabled physicians not only to perform autopsies or
surgeries but also to simultaneously demonstrate those procedures to numerous medical students.
Medical amphitheaters developed in the 1500s when physicians and laymen expressed a keen
interest in witnessing anatomical knowledge. Although temporary facilities existed, the first
permanent anatomical amphitheater was constructed in 1594 for surgeon-anatomist Fabricius ab
Aquapendente of Padua.
In the 1600s and 1700s, surgeons, especially in France, began to use large amphitheaters in order
to demonstrate operative procedures on cadavers to medical students. As a result, teaching
hospitals gradually adopted amphitheaters as the primary arena in which surgeons could not only
lecture to students but also perform operations on patients.
Large surgical amphitheaters became more commonplace in metropolitan medical centers during
the 1800s. This trend continued as the medical profession’s and the public’s fascination with
surgery grew and as the introduction of anesthesia increased the number of elective surgeries.
The amphitheaters constructed during the late 1800s and early 1900s often accommodated
between 100 and 400 people. From elevated tiers, professional colleagues and medical students
watched as the surgeons demonstrated their proficiency in performing various procedures.
In an article published in 1919 that recounted this earlier period. Dr. Stephen Smith, a New York
surgeon, described the intense fascination with surgery and the prominent role afforded the
surgeon. “The Catlin [double-edged, pointed knife], glittering for a moment above the head of
the operator, was plunged through the limb and with one artistic sweep made the flaps or
completed the circular amputation,” wrote Dr. Smith about a surgical procedure performed in the
1870s at Bellevue Hospital in New York City. “The fall of the amputated part was greeted with
tumultuous applause by the excited students. The operator acknowledged the compliment with a
formal bow.”
This increased interest that the medical profession maintained in surgery and the heightened
confidence the public expressed in this field prompted hospital authorities to upgrade operating
arenas. As a result, elegant new surgical amphitheaters constructed of iron, marble and glass
replaced the wooden structures built previously.
As advances in microbiology dictated the adoption of aseptic practices, the risk element and
excitement often associated with surgery decreased. As the fascination with the field declined,
hospitals began to replace surgical amphitheaters with operating rooms which only
accommodated the surgeons and assistants needed to perform the procedures.
As with the rise of the medical amphitheater, the decline of these structures began to occur in
Europe before the trend occurred in America. As early as 1886, German surgeon Albert Christian
Theodor Billroth lamented that few of the 50 to 60 students who attended lectures in his 450-seat
amphitheater remained to witness the operations. By 1917, surgical amphitheaters had
disappeared completely from hospitals in London.
In America, surgeons continued to perform operations in large amphitheaters until the 1920s. By
the end of that decade, increased incidence of wound infection supported the general conviction
that surgeons and hospitals should discontinue the use of these facilities.
Surgical amphitheaters did experience a fleeting revival when physicians began to perform openheart surgeries in the 1950s. Unlike their predecessors, the amphitheaters built during this decade
used overhead glass domes to screen the operative arenas from interested spectators. Today,
these viewing domes remain empty except for occasional surgical procedures.
[Source: The Rise of Surgery: From Empiric Craft to Scientific Discipline (1978) by Owen H.
Wangensteen, M.D., Ph.D. and Sarah D. Wangensteen, B.A.]