First, Dave has all those points correct. As a Certified Surgical Technologist of 15 years, a few additional points.

Clamps are used to grasp and hold tissues, such as bleeding vessels so they can be either tied off with sutures, or cauterized, to stop the bleeding. Not to hold incisions open. Retractors are used for that purpose.

That's the wrong side of the abdomen for a liver, also too low.

The "restraints" are meant to make sure no part of the patient falls off the bed at any time. A dangling leg is hard to see under the surgical drapes, and can cause nerve damage if left too long. Same with compression against a hard edge, if it just gets shifted to one side.

Anesthesiologists for whatever reason, seem to feel (or have felt in the past, anyway) that they don't have germs, or that their breath cannot reach to the sterile surgical area. I cannot count the number of them I have politely scolded for walking into my OR when sterile setups are open and exposed. No such conversations took place in the presence of any patient, however. I let the Circulating nurses deal with them at that point. Buy if I am the only other person in the room scrubbed in and setting up my supplies and equipment, I am responsible for the safety of that setup.

Gloves were not worn on a regular basis as they are today by anyone, including nurses. Gloves were not disposable, and had to be washed, disinfected, checked for defects, patched if required, matched up by size, wrapped and run through the autoclave to make them sterile. It was a laborious process, and they weren't brought out and used cavalierly. If you got blood, or other body fluids on your hands, you washed them. Unless the patient was in isolation, being operated on, or a very few other procedures requiring the patient be protected from exposure to bacteria.

The first use of gloves in surgery came about when the scrub nurse of a particular surgeon developed a skin sensitivity to the carbolic acid used to "sterilize" the patient's skin where the incision was to be made. He required they furnish her with gloves for that reason. He did not use them.

Surgery has changed in many good ways by leaps and bounds in the last century or so, but like so many other things, the more they change, the more they stay the same. You would be amazed to see how many surgical instruments are still exactly like they were 100 years ago. Fortunately, surgical procedures have been vastly improved in that time as well.

As an anesthesiologist, I can't even imagine having such lack of monitors on a patient, let alone using something so volatile and dangerous as ether!

Look at the eyes on the guy on the left side of the picture, notice that they are pointed in different directions.

[Her eyes are pointed in the same direction. - Dave]

I'm guessing that if those overhead lights were on they would heat up that room in a jiffy! They do not appear to be on to me at all. There is no way to aim the lights either I notice. And the anesthesiologist looks way too close to the ether!

I'm voting with Dave on this one, too. 30+ years of shooting professionally and that nice, broad soft light likes indirect window lighting to me, too. Even the highlights on the glassware over in the back of the room have nice long reflections on them unlike the hotspot left by a flashbulb.

I had all sorts of boo boos that were "treated" with Mercurochrome up through the 1960's. My grandparents must have purchased it by the vat. How much time do I have left, Doc?

The anesthesiologist looks like he is pouring rubber cement to seal the guy's lips so his screaming won't scare the other patients.

Dave is correct, the light from the left is from a large window and there may be some smaller windows behind the photographer. The light bulbs above aren't even on. I speak as a photographer with 30 years of location and studio experience.

Call it what you like, a flash or a lamp, there is a light on the left that illuminates the scene and overpowers the overhead lamps. Dave doesn't know anymore than anyone else about whether there was flash or not. The evidence is in the photo.

[It's a hydrogen lamp, positioned 93 million miles to the left. - Dave]

What's your definitive evidence? Looks like flash to me. What else could cause the light to move from left to right with a higher level on the left. And also overpowering the incandescent lights overhead?

In the forceps is an iodine swab.

The hands and arms tied with narrow tapes against the hard edge - just asking for nerve damage. The straps holding the knees down.
Well, that still happens, but with padding and something to raise the knees - easier on the low back.

Yeah, looks like he's prepping the sterile (ha!) area with an iodine based antiseptic.

Anesthesiologists were known to succumb to the ether and other gasses. There are stories of the whole surgical team dropping.

(I have been a surgical nurse for over ten years, and love the stories from anesthesiologist of the Time Before Pulse Oximetry.)

So many differences from now. Interesting that the anesthesiologist doesn't wear gloves or a face mask. How does he prevent himself from being affected by the ether fumes? Surgery is frightening enough today, but imagine having no monitors of any kind. The varying shapes of the light shades direct the angle of light from above. Yet I bet the operation turned out well.

The restraints aren't a particularly reassuring sign.

This says "staged" all over it. They wouldn't let a flash go off that close to ether, and the patient's abdomen looks a lot like that of a mannequin. The thing in the forceps looks a lot like calves liver from the cafeteria. No clamps to hold the incision open visible, either.

[There was no flash, and there is no incision. That's a sponge in the forceps applying iodine or mercurochrome, Dr. Kildare. - Dave]