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Otolaryngology

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Otolaryngology, or the study of diseases of the ear, nose, and throat, became a recognized branch of medicine at the end of the nineteenth century with the discovery of anesthesia though physicians had always been called upon to do their share of surgery on the head and neck because of trauma that had accompanied ongoing conflicts throughout history. 

votive ears from the British Science Museum
the external and internal ear
cTraité complet d’anatomie de l’homme, 2nd ed. (1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
the external and internal ear
Mid nineteenth century hearing devices
(left) faux tortoiseshell Miss Martineau’s Trumpet; (middle) silver-plated dome by Rein and Son; (right) conversation tube with silk and ebony mounts (bottom) banjo-type ear trumpet
albumin print of a woman holding a hearing horn (ca. 1860)
Duplay brass nasal speculum by Klein, Gund (ca. 1870)
The Principles of Surgery (1812) by John Bell
This is an illustration of nasal packing for the treatment of nose bleeds, a problem recorded as far back as in the time of Hippocrates.
Anatomia humani corporis (1685) by Govard Bidloo
Traité complet d’anatomie de l’homme, 2nd ed.(1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
an illustrated saggital section of the neck
small cased sets of instruments used by ENT physicians in the nineteenth century
mouth gags by Mellier Drug Co.; silver cased otoscope; head mirror by Tiemann
eighteenth century mouth gag from the Paris School of Medicine medical museum
nineteenth century tongue blades
folding silver tongue blade, ivory folding tongue blade by Tiemann
tonsillar snare by Mayep & Meltzer, late eighteenth centiury
for the removal of polyps
exhibition ivory and gold plated tonsillotome by Luer
cased tonsillotome (ca. 1870) by Charriére
Throat Scarificator
A 7" long instrument used for lancing abcesses in the throat and scarificating the amygdalae. It is spring-loaded and made by DOWN BROS LONDON/SILVER".
cased quinsy set by Down
Quinsey was the term used for a peritonsillar abscess, and may have been the cause of George Washington's death.
Diphtheria Trying to Strangle a Small Child (ca. 1910)
All diseases affecting children are tragic, though one of the most devastating is diphtheria because of the fact that the treatment has been so dreadful, and the suffering so heartbreaking. This watercolor is by Richard Tennant Cooper.
O’Dwyer tracheotomy set by Tiemann (ca. 1880)
Tracheotomy was the only available treatment for diphtheria, and only temporized until hopefully the child recovered.
eighteenth century ivory tracheotomy set by Maw, Son, and Thompson

Ophthalmology

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The removal of cataracts was popular in sixth century India and continued by barber-surgeons as they traveled throughout Europe, remaining the only procedure routinely performed on the eye prior to the nineteenth century. 

Exposition anatomique des organs des sens . . . (1color mezzotint of the Circle of Willis775) by Jacques Fabien Gautier D’Agoty-description">
Traité complet d’anatomie de l’homme, 2nd ed.(1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
facial anatomy
Traité complet d’anatomie de l’homme, 2nd ed.(1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
muscles of the eye
Das ist Augendienst (1583) by Georg Bartisch
This is an illustration of cataract surgery and use of the couching needle. Many patients suffered at the hands of incompetent physicians, including composers George Frederic Handel who lost his eyesight, and Johann Sebastian Bach who lost his life to British quack oculist John Taylor.
A General System of Surgery (1743) by Laurence Heister
Cataract surgery continued in use for many centuries through Asia and Europe.
Traité complet d’anatomie de l’homme, 2nd ed.(1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
another illustration of cataract surgery
Cataract Surgery: Teaching a Student How to Make a Superior Incision (1870) by Edouard Meyer
an albumin print
exhibition ophthalmologic surgical set by Aubry (ca. 1880)
This cased set contained polished steel, silver, gilt brass, and horn handled instruments in burl wood case, and was probably manufactured for competition at a World's Fair.
lachrimal syringe by Charriere, Collin
This is a nineteenth century instrument for irrigation of the lacrimal ducts.
Liebrichs ophthalmic trephine
This gruesome instrument was used for corneal surgery.
ophthalmophantome by Luer (ca. 1870)
Young physicians learned about surgery by practicing on pigs’ eyes that were placed in surrealistic appearing ophthalmophantomes.
Herman von Helmholtz ophthalmoscope by Otto & Raynders (ca. 1860)
In 1851, Herman von Helmholtz (1821-1894) invented of the ophthalmoscope, a device that enabled him to be the first to visualize the retina, and ophthalmology was on its was to becoming a specialized branch of medicine.
late nineteenth century Morton’s chain of lenses ophthalmoscope by Maw, Son, and Thompson
Loring ’s ophthmalmoscope by Luer (ca. 1880)
Das ist Augendienst (1583) by Georg Bartisch
The specific origin of spectacles remains unclear, though the first reference to a device for the refraction of light was by the Roman philosopher and statesman Lucius Annaeus Seneca, the Younger (4 B.C.- 65 A.D.) when he said that he had “read all the books in Rome” through a glass globe of water. The Chinese are generally given credit for the invention of spectacles, though they probably used the lenses to protect themselves from “evil forces” rather than for reading. The use of ground glass for reading probably was invented in Venice at the end of the seventeenth century.
examples of early eye glasses
(top) leather Nuremberg spectacles (ca. 1500); (Top left) folding Chinese spectacles of brass and tortoiseshell with forehead rest (ribbons replaced) (ca. 1700), silver horn-rimmed Benjamin Martin type (“Martin’s margins”) with fish skin case (ca. 1770); (bottom) quizzer with case (ca. 1800) and silver folding lorgnette (ca. 1860)
cased set of trial lenses by Nachet and Fils (ca. 1880) distributed by James W. Queen and Co.
Mid to late nineteenth century hand-painted glass artificial eyes
a number of blown glass eyes above a prosthesis resting on a blown opalescent eye cup
silver and ivory eye cup (unmarked)

Other Urologic Instruments

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Because of the high mortality of surgical intervention, all sought a simple medical cure for urinary tract obstruction.

an easy and quick cure for gonorrhea
Syphilis and gonorrhea have been much more common causes of urinary blockage than kidney stones. A number medical treatments were available to an anxious and very demanding public.
hard rubber female and male catheters for the bladder instillation of medications
nineteenth century devices for infusion and irrigation
(left to right) female glass treen cased and ivory syringes, cased urethral syringe, male ivory and glass treen cased syringes
Sage's Urethral Powder Applier
This device was used for the intraurethral injection of any number of medications and powders which were tamped down much like powder and ball was in early muskets.
neurasthenia
This catheter was used for the threatment of "neurasthenia," which was an overall weakeness of all systems not attributable to any other condition. The prostate was irrigated with either hot or cold water, depending on the preference of the physician.
mid eighteenth-century urinals
One of the earliest urinals became popular in early French churches. A Jesuit priest named Louis Bordeloue (1632-1704) gave a most beautiful and lengthy sermon, so lengthy in fact that young ladies passed around a female urinal, now called a “bordeloue” in his honor, so that they might not miss his oratory. Some believe that this is the origin for the term "loo". (left): floral ceramic for males, (right): Bordeloue for females

Stones and Obstruction

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For centuries the practice of removing stones, or lithotomy, was looked down upon by the medical profession as a trade best left to traveling barber-surgeons, who included in their resume other minor surgical procedures such as dental extractions, bloodletting, abscess drainage, and fracture repair. Death was certain without intervention and the chance of survival from lithotomy was about 10 per cent, so physicians avoided taking on this challenge. Dr. Sydenham commented, “The patient suffers until he is finally consumed by both age and illness, and the poor man is happy to die.” 

Short-robed Surgeon Catheterizes a Patient (ca. 1510) by Heinrich Kullmaurer and Albrecht Meher
A Compleat Treatise of the Stone and Gravel (1710) by John Greenfield, MD
eighteenth century surgical treatment of kidney stones
lithotomy forceps (sixteenth century) with a large bladder stone
Bladder stones were much more common prior to the nineteenth century than they are now, perhaps because of increased food and water impurities.
Traité complet d'anatomie de l'homme (1866-1871), 2nd ed. by Bourgery, Bernard, and Jacob
This instrument (used prior to the discovery of anesthesia), initially caught the stone with a claw, drilled it to smaller pieces, and then removed the smaller fragments by the same claw.
cased bow Civiale lithotriptor (ca. 1825) by Samson
cased bow Civiale lithotriptor (ca. 1825) by Samson
bow from the cased Civiale lithotriptor
lithotrite by Bergamini ca. 1840
another instrument which caught and drilled large bladder stones to fragments before removal
Heurteloup's percussion lithotrite with staghorn calculus (ca. 1840)
This lithortrite was held by the handle and struck with a hammer to break up the stone before removal. In this set, the lithotrite was by Charriere, the hammer by Collin, and the handle by Cazaran.
cased lithotomy set (ca. 1840) by George Tiemann
This cased set contains numerous instruments for the relief of urinary tract obstruction, including urinary catheters, gorgets, stone forceps, and Ferguson’s lithotrites for crushing stones.
Traité complet d'anatomie de l'homme (1866-1871), 2nd ed. by Bourgery, Bernard, and Jacob
the use of Depuytren’s double bistoury caché for stone removal
an ivory Depuytren’s double bistoury caché by J.J. Teufel
other instruments used for the relief of urinary tract obstruction
(top) cased set of Bougie á boule, (below) Otis Dilating urethrotome with dissecting blade, internal dilating urethrotome
exhibition urethretome by Luer
This instrument contained a small blade which slid down the urethra to enlarge the passage.
Illustrated Manuel of Operative Surgery (1855) by Bernard & Huette
A cock's trocar was inserted by way of the rectum into the bladder to give relief for acute urinary obstruction. It could be worn by the user chronically to divert the urinary stream until healing took place or a more permanent repair could take palce (if possible).
Cock's trocar, nineteenth century
Though a gruesome instrument, this catheter was welcomed by the sufferer of a lower urinary tract obstruction since its introduction directly into to bladder gave instant lifesaving relief.
silver urinary catheters with oil (ca. 1860)
Kelly's graduated meatus dilator, 1904

Anatomy

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Beautiful anatomic representations of the female anatomy well preceded the attention that physicians paid to the diagnosis and treatment of women's diseases. 

sketch of a gravid uterus (ca. 1500) by Leonardo da Vinci
sketch of procreation (ca. 1500) by Leonardo da Vinci
Leonardo da Vinci perpetuated a passive female role in reproduction in the sixteenth century when he sketched a direct anatomic relationship between the male reproductive organs and his brain and heart. In reality, there is no such connection. Da Vinci’s drawing reflects a pervasive view that the child was made up only of elements from the male’s heart and soul, the woman acting only as an incubator.
Anatomie des parties de la génération de l’homme et de la femme (1773) by Jacques Fabien Gautier D’Agoty
female with child
Anatomia Uteri Humani Gravidi (1774) by Dr. William Hunter
a famous illustration of the gravid uterus
paper mache embryo models, mid nineteenth century (by Dr. Auzoux?)
wax model of twins (ca.1780)
wax model from La Specola

Civil War Medicine and the Battle of Cold Harbor

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The Civil War was a seminal event in American history as combatants decided whether or not the United States would ultimately become a great nation. The death and destruction was horrific, a large part of the problem being that very few physicians had any surgical training at the beginning of the war. The Union had only 30 surgeons and 83 assistant surgeons, and when the war started, 3 surgeons and 21 assistants resigned to join the South.  

Carte-de-visite (CDV) of a Union formal dress (ca. 1865)
This is the typical dress of a Union Civil War surgeon.
elements of a Union Civil War medical officer's uniform
(from left) belt, medical green sash, and dress sword by the Ames Manufacturing Company of Chicopee, Massachusetts
Civil War bullet removers
(top to bottom) 2 canister shot, unfired .58-caliber Minie ball, deformed Minie ball after impact, porcelain tipped Nelaton bullet probe by Tiemann, bullet forceps with .69-caliber musket ball, Coexter bullet remover with Colt’s army pistol bullet, bullet screw with sheath (ca. 1860)
A Morning's Work
This is a Civil War albumin print (CDV) named by Reed Brockway Bontecou, MD, surgeon in charge of the Harewood United States Army General Hospital in Washington, DC. It represents the massive trauma that attended many ferocious battles that took place during the Civil War.
Private John D. Parmenter, 67th Pennsylvania Volunteers prior to an amputation of his gangrenous left foot on June 21, 1865
This and the following CDV clearly demonstrate the traumatic circumstanes endured by soldiers undergoing amputation during the Civil War.
Private Parmenter after his surgery
amputation performed by Dr. James Calhoon on Maj. Gen. Daniel Sickles in Camp Letterman, Gettysburg, July 2, 1863
General Sickles presented his amputated leg to the newly established Army Medical Museum in Washington, DC, where he later visited it and where it now resides.
Major General Daniel Sickles after his amputation
Before the war on February 27, 1859, Sickles had shot and killed the son of Francis Scott Key, Philip Barton Key, because Key had been having an affair with his wife. Sickles pleaded temporary insanity. He was the first person to successfully use that defense for murder in a US court. Sickles was later appointed general in the Union Army.
General Sickles' Leg
General Sickles' leg as it now is on display at the National Museum of Health and Medicine just outside of Washington, DC
CDV of Private L. Coombs, 4th US Infantry seated with his prosthesis (ca. 1865)
Seventy-five percent of all operations in the Civil War were amputations as surgeons soon discovered that the quick removal of a traumatized limb was the most effective way to save lives. Civil War survivors with limb prostheses became a common sight throughout the latter part of the nineteenth century.
Bone-excision procedure performed on Pvt. Porubsky from the Reed Bontecou Civil War surgical album (ca. 1865)
An excision was a specialized procedure employed during the Civil War in order to save limbs by removing only affected joints or parts of bone, thereby avoiding amputation to retain at least some function.
an excision performed on Capt. Tracey
Capt. Tracey was wounded at Chancellorsville, May 2, 1863 by musket-ball to the right humerus. Surgeon HE Goodman excised the joint, removing 4 1/2 inches.
The Medical and Surgical History of the War of the Rebellion (1870–1888)
Private Milton E. Wallen, age 41, of the 1st Kentucky Cavalry was hospitalized Aug. 3, 1863 and while a prisoner in Richmond, was shot by guards. He developed “hospital gangrene,” and required an amputation on Aug. 24.
The Medical and Surgical History of the War of the Rebellion (1870–1888)
Cpt. “S” of the 29th New York volunteers was wounded by a musket ball on May 2, 1863 at Chancellorsville. With his lung collapsed, he walked 1 1/2 miles to a field hospital where physicians unsuccessfully attempted to reduce the hernea, which contained lung and “some portion of the alimentary canal.” The following day, hostilities forced Cpt S to be evacuated and he subsequently had to walk another 1 1/2 miles. The musket ball passed in his stool on May 7th, and the wound, which contained lung and stomach, eventually granulated in.
The Medical and Surgical History of the War of the Rebellion (1870–1888)
Private Charles Betts of the 26th New Jersey Volunteers was wounded by a three ounce grapeshot in 1863 as he charged Fredericksburg. At one point, his aortic arch was outwardly visible, though Betts eventually recovered.
ambulance train at Harewood Hospital, Washington,DC, ca. 1863
Jonathan Letterman, while medical director of the Army of the Potomac, developed the Letterman Ambulance Plan in which the ambulances of a division moved together with two stretcher-bearers and one driver per ambulance to move wounded from the field to dressing stations, and then on to the field hospital. This plan was implemented in August 1862 when McClellan issued General Orders No. 147 creating the Ambulance Corps for the Army of the Potomac.
Armory Square Hospital, Washington, DC, ca. 1863
color print by Kurz and Allison of Chicago (1888) showing Grant “triumphantly” advancing on Lee at Cold Harbor, Virginia
The Battle of Cold Harbor was a devistating defeat for Grant and the North with about 7,000 soldiers slaughtered in the first 20 minutes of an ill-fated charge of Southern embankments. By reviewing this one battle in detail, one can get an understanding of trauma surgery during the latter part of the nineteenth century.
depiction of the Battle of Cold Harbor by Currier and Ives, 1864
Burial Party
This is one of the most famous images of the Civil War. John Reekie took this daguerreotype about a year after the Battle of Cold Harbor, Virginia (June 1864) when the dead, who had been hastily buried after the battle were dug up to be sent home to a proper resting place.
skull of a Union soldier with Minie ball lodged under the right orbit, Cold Harbor, June 1864
Diary kept by Sgt. Joseph Hume of Massachusetts, expired June 3, 1964
This diary was kept by Sgt. Joseph Hume of Massachusetts, killed on the bloodiest day of the battle on June 3, 1864. He was a twenty-year-old mill hand who was born in Ashburnham, Massachusetts, and entered the “A Company”—MA 36th infantry—as a private on July 28, 1862. Hume was promoted to sergeant major as he traveled south to fight at the Battle of Cold Harbor. A compatriot completed his diary on June 3 with the words, “Joseph received his death wound,” and the following day “Died in consequence of the above.” The diary was apparently on Hume’s person at the time of his death in light of the bloody stain in the corner.
wedding ring recovered at the battlefield of Cold Horbor
letter from Merari Bunajah Stevens
Merari was an eighteen year old farmer who participated in the fateful charge by Union forces at Cold Harbor. In a moving letter, he recounted the death of his father in his arms the following morning after he had removed the bullet from his side.
Dr. Merari Stevens' letter
Dear friend Ezra, I take pen in hand to let you know that I yet live. We are camped near Petersburg and we are havng tolerable good times now. However, that was not the case last summer during the "killing season." We left Baltimore on May 15th...then we went on to Coal (sic) Harbor getting ready for the grand assault on the 3rd. The rebs had all the advantages of position and they were all well protected by breastworks and rifle pits. When the order was given we charged across the open plain into a hail storm of rebel balls and shells. Men were struck down as if by a great sythe like grass in haying time, and it was here that Father was struck...The bullet exited near the right hip...and then with my bowie knife took the ball out...Then I helped carry Father off the field and I stayed with him until he died...Father must have suffered greatly before he died..and he was very brave and calm. Father said that he was prepared to die and that he had done his duty...He bade me farewell and then died in my arms...So much blood shed on both sides so as to be beyond description...If we could only live in peace with our Southern brothers...
Harvey Stevens
This is a CDV of Merari's father Harvey Stevens and the bullet that took his life.
Dr. Merari Bunajah Stevens and his five sons
Merari subsequently became a surgeon in Ohio, and two of his sons became physicians.
National Cemetary at Cold Harbor, Virginia
National Cemetary at Cold Harbor, Virginia

Orthopedic Surgery

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Prehistoric skeletons have commonly demonstrated evidence of healed fractures, and certainly physicians have always been faced with the need to address broken bones and displaced joints.  Some of the finest early illustrations were those of the skeletal system, and orthopedic repair was a subject of some of the earliest medical texts.  

Feldtbüch der Wundartzney (1517) by Hans von Gersdorff
This is an illustration of some of the many types of wounds inflicted during battle for thousands of years and the challenges they presented to military physicians.
Armamentarium Chiruigicum (1655) by Joannis Scultetus
multiple early trauma sustained in battle
arrow remover (ca. 1540)
The blades were sharpened on the outside. The operator would insert the device by following the tract of the arrow in with the instrument closed, and then widen to create a tract for the arrow to be removed.
bullet screw, sixteenth century
This instrument followed the path of the bullet and then screwed into the projectile for removal.
exhibition bullet screw by Luer (ca. 1860)
Feldtbüch der Wundartzney (1517) by Hans von Gersdorff
This is an early device for repair of a fractured leg.
seventeenth century fracture or dislocation repair
several early and simple approaches to an orthopedic procedure
seventeenth century fracture or dislocation repair
Armamentarium Chiruigicum (1655) by Joannis
repair of a fracture or dislocation
Anatomia Pathologique du corps Humain, book 2 (1835–1842) by J. Cruveilhier
a representation of a dislocated femur
Anatomia Pathologique du corps Humain, book 2 (1835–1842) by J. Cruveilhier
a fractured femur
wooden leg splint (ca. 1850) by A.M. Day of Bennington, Vermont
Similar devices were employed during the Civil War.
Cased orthopedic set (1877) by Lindenmaier
This surgical set was specifically taylored to patients with orthopedic injuries.
unmarked bone drilling set (ca. 1880)
The Graphic Feb. 5, 1887
This is a scene from a typical orthopedic ward in the latter part of the nineteenth century.

Neurosurgery

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Head trauma resulting in the development of a subdural hematoma, or a blood clot around the brain, was not an uncommon medical problem faced by physicians after large confrontations. These clots needed to be removed and made trepanning (the excision of a section of skull) a fairly common practice throughout early medical history.

Peruvian skull demonstrating a partially healed trephine surgery (age unknown)
This early Peruvian skull was elongated by early headbanding as a mark of beauty. There is new bone growth at the margins of the trepanned skull demonstrating that the patient survived the surgery and may have died of other causes.
Inca tumi knife (recent?)
Puma and snakes (gods of the earth and the underworld) are noted. This is probably a recent reproduction.
Feldtbüch der Wundartzney (1517) by Hans von Gersdorff
an early representation of trepanning
Paré triploides (ca. 1700)
This rare instrument was used to lift the plate of the skull during trepanning.
Traité complet d’anatomie de l’homme, 2nd ed. (1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
trepanning carried into the nineteenth century
trepanning set with trephine brace and Galt’s trephine, raspatories, lenticulars, and elevator (ca. 1760)
This set is seen on the cover of the landmark text on medical antique collecting, Antique Medical Instruments by Elisabeth Bennion
Trepanning set (ca. 1780) by Grangeret
This fine surgical set was manufactured by one of the preeminent medical instrument manufacturers of the eighteenth century.
Launey trephine
This is a small but complete eighteenth century trephine set.
combination trepan and rowel saw (ca. 1860) by Charriére
This combination instrument was likely manufactured for exhibition.

The Control of Bleeding

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The most dangerous peri-operative complication related to surgery was uncontrolled bleeding, so that hemostasis has always been an critical and challenging problem. There were a number of inventive ways in which surgeons attempted to control the loss of blood.  

Traité complet d’anatomie de l’homme, 2nd ed. (1866–1871) by J.M. Bourgery, Claude Bernard, and N.H. Jacob
Certainly no device in the history of medicine has been more popular for the control of bleeding than the tourniquet. The application of pressure to control blood loss is a natural reaction, though it was not until 1674 that Morell reported the use of a field tourniquet when he attached a cord to a wooden rod, and twisted it to achieve hemostasis. Here illustrated are the two most common methods of controlling blood loss in the nineteenth century.
Petit tourniquet
Jean-Louis Petit invented this very screw device as as way of managing bleeding in 1718; similar devices are still in use today.
arterial tourniquet by Both (ca. 1830)
This large tourniquet would have been used to control abdominal bleeding or following the amputation of a lower extremity.
arterial tourniquet by Fli Loollini (ca. 1860)
This is a smaller tourniquet to be used on the upper extremity.
Feldtbüch der Wundartzney (1517) by Hans von Gersdorff
One of the earliest and one of the most feared techniques of hemostasis was the cautery. While there was almost instant hemostasis, this technique also provided the patient with a degree of wound sterilization.
cased set of cauteries by Mariaud (ca. 1860)
This is a cased set of mid eighteenth century cauteries by Mariaud, each to be used for a different part of the body.
bullet cautery (ca. 1860)
This instrument was to be used specifically to cauterize a gunshot wound.
Illustrated Manuel of Operative Surgery by Bernard & Huette (1855)
Another of the many contributions by the great sixteenth century French surgeon Ambroise Pare was his use of the ligature for the control of bleeding. Here are a number of early suturing techniques.
assorted sizes of catgut
Catgut was one of several animal materials that has been used as suture material through the nineteenth century.

Cased Surgical Sets

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The manufacture of surgical instruments was primarily left to tradesmen prior to the eighteenth century.  Armourers, blacksmiths, and cutlers made instruments that were used for crude surgery, and later, silversmiths were responsible for finer work.  A dramatic increase in the complexity of surgical procedures occurred in the nineteenth century as the development of technology provided physicians with a new class of therapeutic instrumentation.   

cased set by Pietro Fugini (ca. 1650)
This Italian amputation set is one of the earliest to survive with digital amputation forceps and chisels not found in sets after 1700.
Armamenterium Chirurgicum (1655) by J. Scultetus
Use of the early amputation hammer and chisel is illustrated in this classic text.
Tibetan surgical set, closed (late nineteenth century?)
Oriental surgical sets are quite rare and contained instruments that were not found in those made in Europe. Note the importance of pulse examination appreciated by all Asian physicians.
Tibetan surgical set, open
surgical etui with instruments (ca. 1750) by Savigny
This is another type of small portable surgical set from the eighteent century. (top) folding thumb lancet and scalpel: (from left) tongue blade, ear scoop, probes, shagreen case, tweezers, and scissors
circular amputation set by Savigny
This is an exceptional late 18th century amputation set by Savigny of London. Savigny was the premier British instrument manufacturer at the time and the maker of instruments for the King.
flap amputation set by Spencer & Crocker
This a complete mid 19th century amputation set by Spencer & Crocker of Cincinnati, Ohio in pristine condition. This set is very similar to the one pictured in the below daguerreotype.
daguerreotype of a surgeon with his instruments (ca. 1860)
Surgeons were proud of their cased sets and regarded them as a status symbol. They displayed intricately carved ebony and ivory handeled instruments (which could not be adequately steralized) to their patients long after the principles of asepsis had been well established.
exhibition ivory general surgery set, closed (ca. 1880) by A. Aubry
Aubrey was one of the finest French instrument makers of the nineteenth century. This set likely was manufactured only for exhibition and competition at a World's Fair. It contained the finest instruments made of ivory, plated gold, and blued steel.
exhibition ivory general surgery set, open (ca. 1880) by A. Aubry
George Tiemann's New York office during the Civil War
G. Tiemann & Co. was one of the major manufacturer's of medical equipment in the United States during the nineteenth century and continues to be in operation. They were located at 63 Chatham Street in New York 1833 -1864, at 67 Chatham Street 1864-1886, and at 107 Park Row 1886-1921
G. Tiemann's New York office 1886-1921
cased Parker’s surgical set by George Tiemann (late nineteenth century)
This four layered Tiemann surgical set represented the finest American medical manufacturing of the nineteenth century.
Charriere Marine Set
This is a large marine set that is fairly complete (surgery, urology, dentistry) as required for the demands of an ocean voyage. Ironically this marine set was paid for in New Orleans just before hurricane Katrina hit and it was months before it was clear that it had survived the storm.
Excision Set by John Weiss & Son
During the Civil War, surgeons devised an excision procedure to reduce the number of amputations. The surgeon would simply remove the elbow joint rather than the entire upper extremity. The "Butcher's Saw" (invented by Dr. Butcher) was unique to this procedure.
large pocket surgical set with various forceps and scalpel blades fitting universal handles (ca. 1870) by Tiemann
Folding surgical sets like this one gave physicians the capability of performing almost all the procedures done with larger cased sets. Thus set has a universal handle that fits several blades.
large folding surgery set by Aubry with strop
This is another large nineteenth century folding surgical set, this one one by one of the premier French makers, Aubry. There are numerous folding lancets and a strop to sharped the blades.
all-metal general operating set (ca. 1900) by Evans & Wormull
Physicians began to appreciate the concept of asepsis at the turn of the century and this was reflected by the transition to all-metal instruments that could be easily steralized.
metal pocket surgical set (ca. 1900) by George Frye
This is a portable folding surgical set manufactured in the all-metal era.

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