He employed Thomas Cartwright, master mason to Christopher Wren[4] at St Mary-Le-Bow, as architect.

Windows were provided for the garret at the same time, suggesting that its function changed from storage to a working environment.

In 1859, Florence Nightingale became involved with St Thomas's, setting up on this site her famous nursing school.

In 1862, the hospital began the move to its present site at Lambeth, and the operating theatre was closed,[5] lying undiscovered until 1957.

The majority of cases were for amputations or superficial complaints as, without antiseptic conditions, it was too dangerous to do internal operations.

A description of the students packing the theatre to witness an operation was left by a St Thomas surgeon, John Flint South: The first two rows ... were occupied by the other dressers, and behind a second partition stood the pupils, packed like herrings in a barrel, but not so quiet, as those behind them were continually pressing on those before and were continually struggling to relieve themselves of it, and had not infrequently to be got out exhausted.