One of the biggest
problems I confront on a regular basis is dealers or individuals saying they
own a surgical set of someone who served as a surgeon during the Civil War.
Okay, but there were basically two kinds of Union 'surgeons' during the War: Army
surgeons and Civilian 'contract' surgeons. We need to define who and
what these two groups did during the War. To be fair, there were
medical school surgeons or private surgeons who volunteered during the War
and were among the most competent surgeons on record. Many of those
surgeon's also served on both sides during the War as officers.
There is an excellent reference by Dr.
Jay Bollet, Civil War Medicine:
Challenges and Triumphs, which is a well documented book where he makes
the point that contract surgeons were relegated to working in the rear area
hospitals changing dressings and attending to the general health of
patients, not doing complicated, amputations, or field surgery. The
qualified surgeons were admitted to the Union and Confederate Armies and
reviewed for their competence or lack there of, and eliminated from doing
surgery if they did not pass muster. The point here is contract surgeons were not in the field or
rear hospitals using their surgery kits to amputate limbs or resect
fragments from bullet fractured bones. It just didn't happen often if
at all.
The real surgeons were in the regular Army, were supplied by the Army with Army
owned and purchased surgical sets, not the sets found in some closet one hundred
plus years after the fact, no matter how much some collectors or families
would like to romance that idea.
Contract surgeons are a
major source of problems in relating any existing or pre-existing surgical
set to the Civil War. Everyone wants to think their surgery set was a
part of the Civil War. But the surgery performed during the Civil War
is greatly misunderstood or exaggerated. A part of those
misconceptions is the misunderstood role of the 'contract' surgeons.
During the early days of
the War, there were only 200 medical officers in the Union Army and some of
those left to join the Confederate Army and form the medical service for the
Confederacy. Of those remaining only a very few had any experience
doing actual surgery necessary for treating battle wounds. Until the
Union could recruit and verify the abilities of new surgeons, they used
'contract' surgeons who may never have actually done any surgery other than
minor procedures. These 'contract' surgeons were paid by the day, and came and
went as needed in areas where battles took place. They would have been
the local doctors who came to help. (Yes, they would have brought and
used their own surgery sets) During this time (pre-1861) it was
rare for any kind of major surgery to be performed unless it was thought to
be the absolutely last resort. There were a few teaching centers at
medical hospitals where major surgery was done, but it was not even part of the
teaching experience for most medical students. (That said, there are
many medical textbooks which show and teach extensive invasive surgery as
practice in teaching hospitals in both America and Europe in 1850 and
earlier.) Most American medical students only went to medical school
for only two years and then generally worked as an apprentice afterwards.
Physician/surgeons in major cities like New York, Boston, or Philadelphia,
would have had extensive surgical experience,
but not by the type of doctor found across much of America at the time of the
Civil War. If you wish to read more on this area of medical surgical
history, there is a fine book about medical schools prior to the Civil War:
"Medical Education Before the
Civil War", by Wm. F. Norwood.
Below: Taken from A
History of the Army Medical Department: Civil War Medicine 1861-1865 by
Mary C. Gilletty
"The quality of
the Army's
contract physicians was important, since during the course of the
war more than 5,500 civilian doctors assisted the Medical Department. Many
routinely staffed general hospitals while others provided help only in
emergencies when it was necessary to locate more physicians quickly. In the
last group were some of the nation's most prominent doctors. When a battle
resulted in overwhelming numbers of casualties, those who flocked to the
scene might include quacks, cultists, and practitioners of questionable
ethics, men who were not under military discipline and who could, therefore,
come and go as they liked, taking assignments that pleased them and
rejecting all others. They often performed unnecessary operations or wrought
havoc as they dug about for bullets. As a result of the problems experienced
with doctors so casually assembled, the Medical Department decided to call
only upon members of a reserve surgeons corps formed by the governors of
various states. These gentlemen were paid the salary of contract surgeons
and came in if called. They served under Medical Department orders and were
required to remain at their assigned posts at least fifteen days, unless
officially released sooner."
Civil War Surgery: The
truth about what surgeons did and did not do during the War
(Source
of the following: "The
Medical and Surgical History of the War of the Rebellion. (1861-65.) Part
III, Volume II, Chapter XIV.--The Medical Staff and Materia Chirugica")
"Beside the medical
officers of the regular and volunteer staff, and the medical officers of
regiments, there was a class designated as Acting Assistant Surgeons,
who were private physicians, uncommissioned, serving under contract to do duty
with the forces in the field or in general hospitals. This class was very
large and embraced in its number some of the most eminent surgeons and
physicians of the country. The Medical Cadets were generally young men,
students of medicine, who were assigned to duty in general hospitals as
dressers and assistants. The Medical Department was still further increased
by a number of Hospital Stewards, who were enlisted as needed, and who
performed the duties of druggists, clerks, and storekeepers."
"During the years of the war the organization of the Regular Staff
had been increased so as to number one Surgeon General, one Assistant
Surgeon General, one Medical Inspector General, sixteen Medical Inspectors,
and one hundred and seventy Surgeons and Assistant Surgeons; there had been
appointed five hundred and forty-seven (547) Surgeons and Assistant Surgeons
of Volunteers; there were mustered into service between April, 1861, and the
close of the war, two thousand one hundred and nine (2,109) regimental
Surgeons, three thousand eight hundred and eighty-two (3,882) regimental
Assistant Surgeons. During the same period there were employed eighty-five
(85) Acting Staff Surgeons and five thousand five hundred and thirty-two
Acting Assistant Surgeons."
As the War progressed, it
quickly became apparent many of the doctors were not competent to do any
kind of surgery, so the Surgeon General's Office developed testing
procedures and 'boards' for admitting surgeons to the Army Medical Department and further
qualified those who had varying degrees of skill to actually do the day to
day surgery on the troops. As the more qualified doctors were
recruited and processed the less qualified doctors and especially the
'contract' doctors were relegated to the rear areas to tend to the troops in
ways that we would expect skilled nurses to do today.
It is essential for you
to understand how little surgical experience existed prior to the War
pre01860 Surgery we take for granted today just did not exist.
Medicine was primitive at best by today's standards in most areas of the
country. For all the amputation sets made, it was a rare surgery and
often done by inexperienced doctors who had never done one before. Not
all doctors were trained the same as there were no national standards.
(See medical education
and the Civil War)
As the War progressed,
the more skilled surgeons and assistant surgeons were moved forward into the
field. Assistant surgeons triaged in the forward areas and the full
surgeons operated behind the lines on the more seriously wounded. As
soon as possible the post surgical and seriously wounded would be
transported to field hospitals for continued care and this would
have been where 'contract' doctors would have been employed. It would
not have been in the field with a saw in knife in hand as some would like to
believe. Only the most experienced surgeons were doing amputations or
complicated surgery.
So, the odds of a surgery
set belonging to a 'contract' surgeon being used during the War is pretty
slim. Contract surgeons were not in the Army, they were hired hands to
help in the rear areas and they were not hired to do major surgery.
And anything where cutting was involved was 'major'. Most likely a
pocket roll-up surgical kit was the most any doctor ever needed given the
minor nature of the 'surgery' they did. Certainly only the most
experienced doctors/surgeons drew an amputation knife or bone saw.
The surgery sets used by
the regular uniformed Union surgeons were bought and paid for by the Union Army. They
were not the personal property of the surgeon and were maintained by
assistants, not the surgeons. Surgeon's didn't walk around with large
and heavy sets. These were transported by wagon and set up by
assistants in field or rear area hospitals, which were merely tents in more
protected areas behind the lines. Some well meaning local doctor may
have given a hand or observed at times, but more than likely the uniformed
Army surgeons ruled the scene and kept total control of the situation.
Being a military surgeon was serious business and not to be taken lightly by
allowing some unknown visiting doctor to take over or do a major operation
with a limited use surgery set he brought along for the day.
There may have been European
and English sets used by northern doctors who served in the early days of
the War as 'contract' surgeons after local battles. The Union
and certainly the Confederate contract surgeon's may have (and the emphasis
is on 'May have") brought their existing sets
or pocket kits with them. The source of
these sets would have been both European, English, and American in origin.
The trick is proving they were actually owned by the doctor and the set
existed before or during the War. This is extremely difficult,
but not impossible.
A few more thoughts about
'provenance' supported sets. Just because someone shows up with a lot
of written information about a great set, you have to prove the set belonged
to the owner/surgeon. The set has to be from the right time frame, and
to be something the owner 'could' have owned. This boils down to
documenting the dates of manufacture, the source of the set, then connecting
the set to the owner during the Civil War. (See an example of such a
set owned by a Union surgeon.)
One of the big problems
with European sets is dating the set to a specific time frame because there
is almost no information available about specific European or English sets, with which you can date the sets to five or ten year
time frames. There are a couple of books on European and English
topics (Bennion, Kickup), but nothing to match Edmonson's work on American
sets.
Research notes of:
Dr. Michael Echols
Ft. Myers, Florida
