Before the mid-nineteenth century, the vast majority of those who underwent surgery died. Death rates of about 80% were frequent in London hospitals.
Surgeons worked with bare hands and non-sterile instruments while dressed in black, filthy frock coats. Dried blood stains were considered a sign of maturity. Nobody realised at the time that bacteria and other organisms caused a high death rate. According to most sources, the treatment was effective, but the patient died. As the linkages between microorganisms and illnesses were discovered, surgeons began washing their hands, sterilising their instruments, and wearing gowns over their street clothes.