Unlocking A Civil War-era Surgeon’s Kit

In April 2015, Brooklyn Historical Society opened a new exhibition, “Personal Correspondents: Photography and Letter Writing in Civil War Brooklyn”. The exhibition uses BHS’s evocative 19^th century photography and correspondence collections to reveal the personal, funny, moving, and tragic stories of wartime Brooklynites at home and on the battlefield. As a research assistant on the exhibition, I was charged with researching many of the artifacts featured in the exhibition.  The objects – from sewing kits to cannonballs to broadside posters – allowed me to experience the dramatic changes in Brooklynites’ everyday life during wartime.

Fig 1. Civil War Surgeon's Kit, M1985.385, Brooklyn Historical Society.

One haunting object in the exhibition is a surgeon’s kit, which evokes the gruesome medical experiences many soldiers faced during the war. The kit is a rectangular wooden case covered with textured black leather. Its interior is contoured to fit the shape of a series of instruments: one tourniquet, a saw with a curved wooden handle, a pair of forceps which have curved blades, a bow saw, three different sized knives, a tortoise-shell handled scalpel, a cautery (used to cauterize a wound), and a serrated-edged blade. It is scary to think that such a simple medical kit could be used to perform complex surgeries directly on people’s bodies in unsanitary and crowded military camps. On the other hand, it is also amazing to imagine that a surgeon or a physician could have carried it to the battlefields and saved numerous lives.

One of the questions I sought to answer about this surgeon’s kit was whether it might have been used by military surgeons during the Civil War. During the Civil War, surgeons for the Union troops were either regular Army Medical staff or certified volunteer militia surgeons.  The former carried Army-issued surgical sets, but volunteer militia surgeons often brought their own sets to the war.

Scholars identify Army-issued surgical sets based on the design of the case. Military-issue cases were wooden and included a brass plate, plaque, or cartouche on top of the case, usually engraved with “U.S.A Hosp'l Dept.” or “U.S.A. Medical Department.” Unfortunately, our case did not fit this description.

Fig.2. A 1860’s Civil War Amputation Set, Issued U.S.A Hospital Department. Source: http://www.medicalantiques.com/civilwar/Surgical_ Set_ Displays/ Surgical_amputation_set_photos7.htm

But after reading Elisabeth Bennion’s book Antique Medical Instruments, it became clear that while this case might not have been issued by the Army, it might well have been used in the war – or at least, during the 1860s. The cross-legged forceps in the BHS case were not introduced until the 1840s, and were used throughout the Civil War. Also, many of the tools in the kit have smooth handles. Older tools often had a criss-cross pattern on the handles, but sterilization techniques developed in the mid-19^th century deemed smooth handles to be healthier. And the provenance records related to this artifact indicated that it was a Civil War-era case. Thus our team concluded that it might have been used during the war, possibly by a volunteer surgeon using his own tools.

How were these tools used during the Civil War – and how were the people wielding them trained? The Army offered formal and informal surgical training programs, and special courses on treating gunshot wounds were given. But wartime surgery was difficult and complex; amputation involved much more than whacking off an arm or leg. Basic amputation sets like this one did not include all the tools that would have been necessary for delicate surgery by a trained surgeon during the war years. Civil War surgeons constantly reevaluated their amputation policies and procedures. Both Union and Confederate armies formed army medical societies, and their meetings focused primarily on amputation.

Surgery during the Civil War was a dangerous and unpleasant experience – but doctors and scientists were working hard to make it less so. Anesthesia like ether, developed in the 1840s, came into wider use during the war. In fact, much of the ether used in the Civil War came from factories like that of E.W. Squibb on the Brooklyn waterfront.

Fig.3. The Civil -War Surgeon’s Kit (M1985.385) is shown in the current exhibition “Personal Correspondents: Photography and Letter Writing in Civil War Brooklyn", on view now at Brooklyn Historical Society

When they had it, Civil War surgeons used ether when treating painful wounds. Once the patient lost consciousness, an amputation was carried out quickly. Even though the patient had no awareness of what was happening and felt no pain, he might be agitated, moaning or crying out, even thrashing about during the operation. He sometimes had to be held by assistants so the surgeon could continue.

During the Civil Wwar, nurses, surgeons, and physicians were challenged to mobilize the nation, and they advanced medicine into the modern age. Modern hospital practices methods today owe much to the legacy of Civil War medical treatments, as does  anesthesia and medicine. Combating disease as well as treating wounded soldiers pushed the nation to rethink theories on health and to develop professional practices to care for the sick and wounded.

I used the below sources to piece together the history of this surgeon’s kit.

1. Bennion, Elisabeth. 1979. Antique medical instruments. London: Sotheby Parke Bernet.
2. Edmonson, James M. 1997. American surgical instruments: the history of their manufacture and a directory of instrument makers to 1900. San Francisco: Norman Pub.
3. http://www.medicalantiques.com/civilwar/