American Civil War Medicine & Surgical Antiques

Surgical Set collection from 1860 to 1865 - Civilian and Military

Civil War:  Medicine, Surgeon Education & Medical Textbooks

 Dr. Michael Echols  &  Dr. Doug Arbittier


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American Civil War Surgical Antiques

Research and Identification

Civil War Era Surgical Sets, Surgeon's Images

Civil War Surgeon Education & Medical Textbooks

Established 1995    .     Dr. Michael Echols Collection


As seen in:  Warman's Civil War Collectibles, Antique Week, Northeast Antiques, and various TV programs, Antiques & Collecting publications


Trephine, Neurosurgery, Trepanation

By Dr. Michael Echols

Drawings from Bourgery & Jacob

Trepanning is the medical process of drilling or cutting a hole into the skull in order to relieve pressure on the brain tissue, lift a compression fracture of the skull, or remove a blood clot on the brain.  If a person had a concussion with depression of the skull bone, that depressed area would need to be lifted or removed and then the clot under the concussion removed to alleviate trauma induced symptoms.  

The process is documented to have been performed as far back as 4000 years ago by the Inca Indians of Peru.  If you would like more information on this procedure and the history, please do a search for the words: trephine, Inca, neurosurgery, trepanning, trepan on

Trepanning (pronounced: tree-panning), as was frequently practiced in America during the 1800's, was performed with an instrument called a trephine (pronounced: tray-feene or tree-fine) which actually is a saw that cuts a circular hole in the scull.

The scalp over the skull is first incised with a scalpel, a flap laid back, and the hole bored or saw cut by a twisting motion of the trephine.  In some types of trephines, there is a center drill which holds and guides the outer cutting edge of the saw.  There are two main types of trephine saws, the earlier crown type and the later Galt type.



Case study citations of trepanning performed during the Civil War from the Medical and Surgical History of the War of Revolution

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Scalpel for tissue incision



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Trephine with 'Galt' style saw (assembled) c. 1870


An all 'metal' trephine, post 1900

Another instrument used for this procedure is the Hey saw, which has both a straight and curved tooth edge for cutting into the skull.

mvc-097s.jpg (14885 bytes)

Hey saw used to cut into the skull bone

The circular piece of bone, about the size of a nickel is then removed by using one end of a  lenticular or bone rasp to lift out the bone, then the edges of the bone would be smoothed with the rasp. 

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Bone file for smoothing edges and lifting out parts of bone.

Any bone dust could then be removed with the bone brush before cutting into the dura, which is the outer covering of the brain.

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Bone brush to remove bone sawdust from the cutting site.

Examples of American cased trepanning sets

Wiegand & Snowden, c. 1830



Pre-1860 removable handles, (center is turned wood), (left is carved ebonized wood), (right is heat molded)




Pre-1860 Crown type cutting heads, typical of the 1830-50 era


Variations on Hey saw designs



Fig. 1: Cased Trepanning set                                 Fig. 2: Trepanning instruments

In figure 1, is a cased trepanning set by Wade and Ford.  The set contains a lenticular bone rasp, scalpel, Hey saw, crown type trephine, wood handle for the trephine, and both a crown and a Galt type trephine (disassembled). 

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Fig. 3: Trephanning cased set                  Fig. 4: instruments from case

The set in figure 3 contains a bone brush and is missing the scalpel.  Figure 4 shows the individual instruments from the Gemrig set.  The trephine is assembled with a crown type trephine saw.


These type of cased sets were issued to the Union surgeons during the Civil War and made by makers like Gemrig, Tiemann, and Hernstein.  For additional information see trepanning during the Civil War.  Display of multiple trepanning sets in all the multiple Displays on this site.



The set is engraved on the cartouche with " U S A"  and the label indicates the last year Hernstein would have used this label, which is the first year of the War.  The label also indicates the set was produced under contract for the U. S. Army Hosp. Dept. 





"H. Hernstein, N. Y, Surgical Instruments, 393 Broadway, U. S. ARMY, Hosp. Dept."




The partition with trade label and sales list is present on the front and back of the embossed partition.






Medical Antiques Index

American Civil War Medicine & Surgical Antiques Index

Contact Dr. Arbittier or Dr. Echols



Civil War Medical Collections 


Direct links to all medical & Civil War collections on this site                         

American Surgical Sets:

Pre-Civil War:  1 | 2  -   Post-Civil War:  3  -  Civil War 1861-1865:  4 | 5 | 6 | 7 | 8   INDEX

Medical Text-Books:

1 | 1a | 2 | 2a | 3 | 3a | 4 | 4a | 5 | 5a | 6 | 7 | 8 | 9 | 9a | 10 | 11 | 12    INDEX

Surgeon General's Office Library printed catalogues: 1840 | 1864 | 1865
Medical Lecture Cards: 1 | 2 | 34 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | 13 | 14 | 15 | 16 | 17 | 18 | 19 | 20 | 21    INDEX

Medical Faculty and Authors:


Navy Surgeon Exams:

1863 Navy Surgeon Applicant Exams with Biographies   INDEX ONE | INDEX TWO

Surgeon CDVs, Images:

Army: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8    INDEX

Navy: 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8   

Hosp Dep't Bottles, Tins, 

U.S. Army Pannier:

1 | 2 | 3 | 4 | 5 | 6

American Civil War Medicine & Surgical Antiques

Please request permission before commercial use or publication of any content or photos on this site and credit any use with:  "American Civil War Surgical Antiques"   All content and all original photography on this Web Site is copyrighted 1995 - 2015 and may not be used on any other web site or in commercial print without the expressed e-mail permission from Dr. Arbittier:  Contact   All rights reserved. 


Students doing reports or projects are welcome to use the content of this site without permission, but credits would be appreciated.


Please note: information on this site may not be normally referenced as this is an active and long-term educational research project.  Personal notes may not be properly cited for publication.  Various articles are digitally reproduced under the 'fair-use act' of the copyright laws and are intended for educational purposes only.  Many citations are from Google digital 'books' and can be traced backwards via a search of a unique string in the citation.


 Arbittier Museum of Medical History Tour:   1 | 2 | 3


Last update: Monday, December 12, 2016