Civil War Era Surgical Forceps: Design and
by Dr. Michael Echols
If one looks at the progression of
instrument design through the 1700's down to 1900, the major changes are in how
the two halves of a forceps or scissor are joined as well as the position and
shapes of the finger and thumb holes. Prior to 1870 instruments were
typically joined with a screw, which precluded cleaning and sterilization we
would expect today. At that time they didn't sterilize, so a screw
attachment made the most sense. Since my focus is on the pre-1865 Civil
until about 1820, I'll show examples of the forceps one would expect in the type
of surgical sets shown on this site. At the bottom of the page are several
examples of what is not to be expected during this era.
The point in all this minutiae is to point
out a method that may help to date a given set of instruments to a given era and
thus eliminate other examples by comparison. It's something done while
examining a set to determine if an instrument is out of place, replaced, or in
fact...correct. It's also how one determines if an isolated instrument
would be correct for a given era. As an example, if you are looking at a
forceps on eBay, this is how you know it is or isn't right for your set.
If a forceps has an disarticulating joint for sterilization and a
it's post 1880. (There were single step rachet bullet forceps available from
France during the Civil War, but not the three or more step type we see after
1880. If it is chrome plated, it is post 1900. If the
metal is unplated, it's early and most likely pre-1870, but if nickel plated, it
is later, most likely post 1870. The position of the finger and thumb
holes vary greatly from one era and maker to the next. European designs
are much different than designs used by American makers, but much copying of
design and imports cloud the issue in every era. European instruments were
imported by American makers and placed in sets under the maker label name.
There are various instruments referred to
as 'forceps': tissue, lithotomy, bullet, sequestrum, bone, artery, etc.
The word seems to indicate opposing arms of an instrument, which is joined by a
screw or other mechanism to allow movement and approximation of the ends by
means of moving the handles.
As you look through the examples,
note there is a screw holding the two halves together, there is no locking
or ratchet device between the handles, which tells you they are all pre-1890.
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Click on all images to enlarge
Typical 1800's forceps joint and screw mechanism
None of the instruments on
this page are chrome plated or made of stainless steel
|An example of a c. 1840 H. Schively
lithotomy set of bladder or lithotomy forceps with screw
joints, with open
finger space and closed thumb hole. This is after a typical
English design seen in the early part of the 1800's.
|In this group is shown a c. 1846, (second
from the bottom) forceps
by Goulding for bullet or bone fragment removal, the joint is screw
type, and the finger holes are off center, but round. Earlier
types tend to have ovoid finger holes. This
forceps design is pretty common down through the 1860's. By
comparison, the tissue forceps at the top of the photo are highly
unique with a curved tip.
|These examples are from an 1850 Martin
set. The scissors (basically another type of 'double knife
forceps') above, display a cross handle design which
allows for power cutting on closure. The tissue forceps below
are screw jointed and typical of the 1850's from many American
|A set of c. 1850 instruments from an ivory
Tiemann set. Again, compared to the Marten instruments
immediately above, the designs are somewhat different, but still
have a screw joint, but the arms of the large lithotomy forceps
(second from the top) are
more flowing than the angular arms of the Martin scissor. The
tissue forceps at the bottom are typical. The bone cutting
forceps at the top are typical of the from found during the Civil
War and later.
|This tissue forceps (top) is from a Civil War major
bone resection surgery set, c. 1861 by Kolbe. The length is
very short, more like what would be expected in a pocket surgical
set, but was correct to the set. Note the comparative size of
the small locking tissue forceps (tweezers type)
|An earlier style Hernstein bullet forceps
from a c. 1860 set. The open arm is not typical of the 1860's,
and may be due to European influence or importation by Hernstein.
The bone cutting forceps are much different than the other types
seen as they have a round opposing set of cutting edges(bottom
|A bullet forceps from a Civil War surgery
set by Tiemann, c.1865
Note the tip
of the forceps are curved and pointed for gaining purchase of the
bullet. There is a screw type joint and the finger holes are
rotated away from the center line of the instrument. The
position of the joint is about two inches from the tip of the
instrument to allow for opening deep in a cavity.
A Civil War era bullet forceps by Wade and
Ford, screw joint. Photo below is from Frank
Hamilton's text book
,Treatise on Military Surgery, 1861:
|Another example of a lithotomy forceps
(top) with the cross handle design. This from an 1880 Sharp and
Smith set. Still with the screw joint. The bone forceps
(bottom) are typical of later types with the spring between the
handles. Most of the early springs are blued, not plated as
are later, post 1890 bone forceps.
|Another bullet forceps (top), typical post
1860's design, the handles on the scissors scissors are off-set on
the upper handle (reversed) to allow keeping the hand away from the
cutting surface. Below, is a set of artery forceps with
crossed arms to maintain pressure on the jaws of the instrument.
|Tissue forceps (top) with a grabbing type
tip and (bottom) with typical serrated jaws and both with screw joints.
These are from an 1886 Helmond set. Well into the era of
sterilization and the joint is still non-sterilization design.
Note the finger holes are ovoid, not round.
Below are examples of
with multi-step ratchet locking
disarticulating or open joints for sterilization. They are not and
never have been pre-1895. Pay attention to the details when
evaluating pre-1900 instruments. If you see multiple ratchet locks
and dis-articulating joints, it is later, and not Civil War era! Also look at
the maker names. German makers took over the instrument trade in
the 1880's and most of the names from that period and later will be
'German' or have European connections. You need to read
extensively to figure this out. Just remember, if it's simple,
most likely it's earlier.