But how did they do it before that time, when they had to operate on someone?
Simple. The patient was kneeled with his head stuck inside a pot and placed on an anvil.
At that point an employee hit the pot with a mallet, an action that made the unfortunate person lose consciousness for the duration of the operation.
Of course it wasn't infallible, because either he didn't faint right away or they woke up during the operation.
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