Advice: Evaluating Civil War surgical sets

Buying a 'Real' Civil War Military Surgical Set

Updated: 12/08/2024 12:41 PM

Also see:  How to identify Civil War military surgery sets

Objective:

Every medical or Civil War collector I know wants to buy a 'real' Civil War surgical set.  So, what do you have to do to get one?  (In the case of myself and other collectors we are preserving our American history.  We are buying sets and other medical artifacts to make sure these historical treasures are not discarded to the dustbin of our history as they were right after the Civil War or when sterilization came into vogue.)  Please understand what we are discussing here is not every surgical item that existed during the Civil War...just the ones one can prove were used in the Civil War.  If you enjoy buying old medical instruments or non-American maker sets, have fun, but that is not what this website is about.  The objective here is to discuss proven authentic Civil War sets or those likely to have been owned or used by uniformed military surgeons during the War.  The sets wanted to buy or for study will only consist of, at most, twenty percent of what is out there.  This project does not study or collect European or English sets, even though they existed during the Civil War.

Set Descriptions:

To obtain a 'real' or 'authentic' Civil War military surgical set, first and foremost, you will have to be extremely lucky and knowledgeable.  The safest set to buy, in my opinion, is one marked 'U.S. Army Medical or Hospital Dept.' with military latches on the case and contracted for production by famous American makers for the Union Army.   (See the various articles about these sets on this site.)  (Note: the Confederate Army never contracted for surgical sets and none will be marked as such to my knowledge (2009).  The confederate States Army Medical Department used existing American, English, or European made sets and purchased sets from Europe and the English during the War.  There were many existing American-made sets as most of the CSA surgeons were trained in the North prior to the Civil War.)

Rarity:

There were over 4,000 contracted military sets made just for the Union Army, so you would think the odds of finding one are good if you know where to look.  However, not many of these surgery sets survived.  Many were destroyed during the War or were sold at the end of the War as war surplus.  One maker in particular, Hernstein, N.Y., sold many un-used sets at the end of the War and his company went bankrupt due to the over-production.  At the end of the War many military sets which were not bought by the government, were sold at auction to distributors and doctors or re-packaged for the civilian trade.   (This seems to be especially true for Tiemann sets and perhaps the reason we see a mixture of (pre-, during-,  post- War) instruments in wood cases which were produced before and during the War from this maker.)  

When sterilization began in the 1870-80's, most of the earlier non-sterilization working sets were discarded in favor of instruments that could be heated and cleaned for sterilization, thus creating a greater scarcity factor to consider.  No one knows how many of these non-sterilization military sets survived.  Unfortunately great numbers of the sets created for use during the War were not preserved and were of little or no value as sterilization came into use.  (No, I do not believe there are 'troves' of surgical sets stored in some musty warehouse.  They were simply discarded as the detritus of war or unusable after sterilization made them obsolete.)

Where to look for surgical sets:

The place to look for Civil War era sets is in existing Civil War collections or in the hall closet of a Civil War surgeon's family.  How do you find this elusive owner...well, that's the trick.   You could try your hand buying at auctions or eBay and hope you don't buy something that was put-together to sell to unsuspecting doctors.  Or, how about a Civil War antiques show?   Unfortunately, many of the sets sold at Civil War shows are suspect for a multitude of reasons: replaced parts, put-together pieces, European origins, out-right fraud, fake engraving, etc.  There are always going to be dealers and auction houses who, from time to time, have authentic sets and you just need to learn which ones are reliable and which are not.

Federal government purchased surgical sets for the U.S. Army:

See: Identify Civil War era sets.   Also, there are several resources on this site to help you identify the earliest sets used during the War via the 1861 Army Supply Table. 

It is possible any given military group could have contracted with any given instrument maker to provide a set of instruments for their group with military latches and military dedicated instruments.  The markings or lack there-of on the brass plates or instruments would be the telling point.  Only the official Union ordered sets would be engraved and marked as U.S.A. Hosp. Dept or Medical Dept.  All others would be either unmarked or otherwise marked depending on the owner.  This may account for some un-marked  or inconsistently marked brass plates on military 'style' sets during or prior to the War years.

Before the War started, there were state militias and each militia had 'medical' staff of some sort.  Unfortunately the state militias did not necessarily qualify their medical officers and some if not many were simply medical wannabes: druggists, preceptors, and individuals who 'attended' a medical lecture or two.  Yes, some were qualified surgeons as the literature proves, but there were qualifying boards which vetted these individuals before they were allowed to be designated as military surgeons in the Union Army and most likely by the Confederate medical staff.  The boards who qualified these doctors as surgeons were often staffed by teaching faculty at leading medical colleges.  Among the famous surgeons and faculty who performed this vetting service were: Alexander Mott, M.D. and Joseph Janvier Woodward, M.D.

See a discussion of the State Volunteer Militia, by Major Charles Smart, Surgeon U. S. A.

There are surgical sets, military and civilian issue (as previously discussed), which were provided to and/or owned by surgeons who were part of State Volunteer Regiments or some division, and who may have brought their own surgical sets when they were mustered into the Regular Army.  As mentioned above, these sets would not be marked for the U.S.A. Hospital Department because the sets were provided to or owned by a state militia or surgeon and not by the Federal Government.  Of course it would be difficult to prove unequivocally if a given set belonged to the surgeon unless engraved or heavily documented.  This is a very difficult area to prove or disprove.  But there are two or three sets in this collection in this category.  See a Tiemann military set, which belonged to Norman Smith, M.D. with the 6th. Mass. Volunteers.

Ownership of sets:

If there is any question in your mind about the Army regulations regarding surgeons returning government issued military surgical sets to the Army when they left the service, please read the adjacent two pages from William Grace's: The Army Surgeon's Manual.  The Manual covers this topic in detail as specified by the Surgeon-General...bottom-line: the surgeon had to sign-out for the instruments and kits, and they were expected to return same after their service.  The surgeons were held personally responsible for the return of the surgical sets to the government.  There is nothing in the regulations or history to suggest a surgeon was allowed to retain his 'personal' set, nor would they have been allowed to engrave their name on a government-owned set if they were serving in the Union Army.   Here again is the 1861 Army Supply Table with this point spelled out early in the War, as well as what instruments were specified during the first year of the War.  We do see military sets, usually with the brass name place removed, that were sold after the War to the public and it is possible a given surgeon bought a set after the War, but it is impossible to determine if it was the same set he used during the War.  As much as we would all like to romanticize that ownership, it cannot be proven beyond doubt for government supplied sets.

CSA sets:

Unmarked sets purchased and used by the Confederate forces are very difficult to prove to have been used during the War unless there is believable documentation or evidence associated with the owner and a chain of ownership.  Again, the set itself must be verified and dated as being made pre-War or made during the War.  Confederate sets may be of American, English or French origin.  As previously mentioned, most CSA surgeon's were trained in the north and they would most likely have purchased sets at the time and place of their training and most likely those sets would have been American-made, but not necessarily.  Another source of sets would have been English sets brought back from an English medical college where many surgeons of the time went for training.  Otherwise, it is at most 'difficult' to say any given set is Confederate owned or used.  The Confederate sources were often pre-War American or European sets in existence before the War or European sets obtained from blockade runners during the War.  

From time to time Civil War items are shown to us marked 'CSA' and are out-and-out fakes.  Confederate sets are the most difficult to prove to have been used during the War because they were not issued by the CSA Medical Department or labeled as such.   Even if a given set has been in a family for many years, unless there are original hand-written documents or period engraving showing ownership on the top of the set cartouche, proof is extremely difficult because there were no 'official' surgery sets made specifically for Confederate surgeons to my knowledge.   With all the surplus military sets floating around immediately after the War, it would not be unusual for a doctor to purchase one for his use and if marked for the U.S. Army, to remove or obliterate the marking on the set.

Early sets:

When you see a basic early (1820-1855) amputation set, no bullet forceps, no trepanning instruments, just a tourniquet, a couple of  knives, and a saw, think twice about that set having been used during the War.  War-time surgery was not just basically whacking off an arm or leg.  Basic amputation sets are grossly deficient for even a 'simple' amputation.  Those early small amputation sets were for 'heroic' intervention, not delicate surgery by a trained surgeon during the War years.   Yes, the small military amputation sets existed, but in most cases they were a part of a larger complement of instruments or reserved for minor surgery.  The more you read about the procedures which were reported in the six volumes of the Medical and Surgical History of the War, the more you will understand just how special the military surgeons were and how much they knew.  To get a good feel for the extensive procedures taught even in the mid 1850's, see the drawings from Dr. Henry Smith's 'A System of Operative Surgery', a copy of which is in this collection.

Post-War and gift surplus military sets

Many Civil War era doctors purchased or received 'testimony gift" surplus military sets after the War, so those sets could be in the family of the surgeon and passed on to this day.  In this case, it takes knowledge to determine when the given set was made and thus determine when or if it was ever used during the War. I have seen more than a few War-years production sets that have had the cartouche (brass name plate) removed, turned over, or the engraving buffed off.  The theory, as mentioned above, is a surgeon bought the set and didn't want the marking on it for the Union Army. 

Non-government and contract doctor sets:

As previously discussed, there would definitely have been European and English sets used by both southern and northern doctors who served in the early days of the War as 'contract' or state volunteer militia surgeons after local battles.  Surgeons in leading medical schools and hospitals also treated soldiers in the first and following years of the conflict.  Many of these teaching or practicing surgeon would have had their own extensive surgical sets.  The Union army and certainly the Confederate part-time contract surgeons may have (and the emphasis is on 'May Have") brought their existing sets or pocket kits with them to a given battle. 

Medical supplies were in short supply in the first years of the War.  The source of these sets would have been both European, English, and American in origin.  The challenge is proving they were actually owned by the doctor and the set existed before or during the War.  This is extremely difficult, but not always impossible.  Again, accurately dating a surgical set is essential to matching up the dates the set existed and when the surgeon could have owned it.  If a set was not made until after the War, obviously it could not have been used during the War.  If a particular set was not made until after the War and was purportedly owned by a Civil War surgeon/doctor there is no way the set can be labeled as 'Civil War'.   See additional information on contract doctors.

Contract doctors:

Regarding 'contract' surgeons, there is an excellent reference by Dr. Bollet, Civil War Medicine: Challenges and Triumphs, a well documented book where he makes the point that (after some initial confusion about doctor abilities by the Army Medical Department) contract surgeons to the Union Army 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 regular Union and Confederate Armies or were part of the Army volunteer militia and were reviewed for their competence, or lack there of, and eliminated from doing surgery if they did not pass muster.  In general, the Union Army's less experienced surgeons were assistant surgeons, not full surgeons.  In state militias, politics could have intervened and allowed an inexperienced or improperly trained surgeon to practice.

My point here is once again that 'contract' part-time surgeons were not in the field or rear hospitals using some little pocket surgery kit or minor amputation set to amputate limbs or resect fragments from bullet fractured bones.  It just didn't happen often if at all after the War was underway during the first year.  The real 'surgeons' for the Union were the regular Army Medical staff or certified volunteer militia surgeons who 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.  There is ample evidence the 'working' surgeons in the CSA were also well-trained doctors who chose to fight on the side of their birth and produced results similar to those of the Union surgeons.  I make this statement based on my research of the history of the various doctors in the education part of this collection.

No matter how much some dealers, collectors, or families would like to romance the idea their set was used during the War, be suspicious and ask lots of questions.  I am belaboring this point because every military collector wants to own a 'real' Civil War set and there are dealers and auction houses who are more than willing to fulfill the desire to own a piece of this history.  Unfortunately 'real authentic' provable Civil War sets are extremely rare and the odds of you finding one 'cheap' at a gun or Civil War show are slim to none!  Of course there are fake or put-together sets and you can find these sets on-line being displayed as 'authentic' Civil War sets, but close expert inspection will show they are 'mistakes' and the owners were unknowingly 'taken'.  This is especially true with 'engraved' cartouches.  Buyer beware, especially those who have more money than research time to spend!

Great stories and questions:

Someone telling you 'my great grand daddy was a surgeon in the Civil War and this was his set' is a story I've heard way too many times.  If you have one, and want to sell it, then be prepared to prove it with provenance such as: letters, a government Form 18,  photos, or direct proof in the Roster of Regimental Surgeons or citation in the Medical and Surgical History of the Rebellion, that your great grand daddy really was an active surgeon and really did own 'that particular' set DURING or BEFORE the War.  Such a set in the hands of most dealers is reason to demand and get total proof of the provenance as well as a written guarantee of ability to return the set if it isn't as described.  The other problem is proving the dates during which a given set existed from that maker.  Do not let some dealer bully you into believing what he says is gospel because you most likely don't know enough to even ask the right questions.  The price of a real Civil War set is divided between the set itself and the extent of the provenance.  Simply saying the set belonged to so-and-so is not adequate.  Show me the provenance, or else we are just talking about the value of the set, which may be considerable depending on the configuration, markings, and complexity.

Civil War medical experts: 

 Never forget: "Wide acceptance of an idea is not proof of its validity"

Some Civil War 'experts' have been selling 'Civil War' information and sets for many years. Their reputations were built on sometimes incorrect or limited information available to only a select few with access to information shared among dealers and other experts who prowl Civil War or Gun Shows.  Every piece of information was colored by their desire to prove what may have been a self-serving opinion in the past.  When one sells themselves as 'the expert' you have to ask yourself if there is some motivation to take a given position?  Do they have 'artifacts' for sale?  What are they selling?  Did they buy into an idea in the past and have not changed that position over the years?  Experts must continuously improve and expand their knowledge otherwise they are just fooling themselves and their collector customers.

Documentation and thinking is constantly improving with the discovery of new information or with access to previously unseen documents unearthed by internet sources such as Google Digital Books.  There is a vast amount of digitized historical data now available on-line that was not even accessible a year ago, much less twenty years ago.  Civil War knowledge has expanded immensely over the past five years and many of the older 'experts' have not kept up, being self-satisfied with long-held opinions or beliefs, and not knowing for sure if they are right or wrong.  (Note: this problem is not just about Civil War medical...it applies to ALL high-priced antiques, no matter what the topic.)

Some of the worst offenders are the very people who wrote 'the book' on their subject in the past and now refuse to 're-write or update' anything they believed in the past, which was based on inaccurate information.  One particular set of medical antiques books comes to mind, which have had the same set of mistakes reprinted over and over and the author(s) know it, but to correct the mistakes would somehow diminish their authority I guess.  At least with web-based media and websites like this one, corrections can be made instantaneously, cross referenced, and updated as new information is found.  If in doubt, look it up on the internet or read a digitally stored document.  Don't take my word for it.

Documented ownership and 'gift' sets:

If you are fortunate enough to find a U. S. Army Medical Department or U. S. Army Hospital Department set, do not make the mistake of saying a given set 'belonged' to a given surgeon, unless you have hard evidence (provenance) to prove otherwise.  The Federal government-issued surgical sets were not given to a specific surgeon and as mentioned above, the Federal government sets were formally recalled at the end of the War by published special orders.  Yes, some of those sets were sold after the War, but they will not have the name of the surgeon maker-engraved (and certainly not machine impressed, lasered, or stuck with individual block letters!) in the cartouche or brass plate on the top of the set unless that set was purchased by the surgeon or someone bought one and had it engraved after-the-fact as a gift. 

If you find a government issued military set with the name of a doctor engraved in the cartouche, you need to ask yourself if it is either faked or created after the War when the government released or sold the set.  That said, some troops bought civilian issued sets as presentation gifts to respected surgeons.  These sets come up from time to time and should be approached for purchase with great caution as it would be too easy to fake such a 'gift' set.  Get an expert opinion before you buy one and research the heck out of the provenance for any mistakes. 

Example of a military set of a famous surgeon that is well documented.

Example of a documented set owned by a famous Union surgeon.

Example of a civilian set owned by a Civil War Navy surgeon during the Civil War.

(Note: When the War was 'over' for a given doctor or surgeon would depend on when he left the military.  These doctors were not conscripts and could leave or return as they saw fit.  Many stayed until the end of the War in 1865, but many left to return to their communities or other duties at any point during the War.)  The point of the 'end of the War' statement is to illustrate that a 'gift' surgery set could have been presented after the surgeon left the military, not necessarily after 1865 when the War officially ended.  So a set with engraved dates that are during the War may be correct. 

The other major problem is with surgical sets that 'belonged' to a documented Civil War surgeon.  There can be extensive provenance about the owner (surgeon), but the set will be post-Civil War issue and simply 'owned by' or 'presented to' the Civil War doctor after the War.  (I see this kind of material all the time.)   In that case, the surgical set is not 'Civil War', but merely was owned after the War, or after the surgeon left the military, by a Civil War doctor, assuming some enterprising dealer didn't have it engraved.   It could be a set just 'associated' with the doctor.  Even with engraved names, you can't believe all you see.  (Check out the following story about engraved brass cartouches or plaques.)  With the kind of money real Civil War sets bring, you can't believe everything you see or hear.   Prove it or convince me why I should believe what you say.

Pieced together sets:

Another 'gotcha' problem is during the War, makers like Hernstein and Tiemann of New York and Gemrig of Philadelphia were so busy producing for the Union War effort, apparently their production for the civilian trade was reduced.  After the War or during the last years of the War, they started piecing together wood cases and instruments from before and during the War to sell to the civilian trade.  For that reason, we see sets that contain War-time saws and bullet forceps, labels from during the War, but cases made before the War.  From a 'dating' standpoint, sometimes it's a nightmare to figure out who did what and when, but experience is the great teacher and having seen hundreds of sets teaches one what to look for and what to reject as being 'Civil War' issue.

See: Instrument sets specified by the U.S. Army Medical Department during the Civil War 1861-1865

See: Instruments sets specified the first year of the War in the Army Supply Table, 1861

See: Identification of leather pocket surgical kits/sets/cases used during the Civil War

Outright fraud:

To prove the point about being careful what you believe and buy, I'll relate a story of one particular 'surgeons' set.  Five or six years ago, a woman contacted me via this web site about a surgical set in her family.  The set supposedly belonged to a relative who was apparently in the Civil War and was a doctor.  Documentation was not readily available when I talked to the owner, but she thought it existed.  I saw photos of the set and determined the set was indeed American-made, but was civilian issue and unfortunately post-1870, so it could not have been used during the Civil War.  I never heard back from the seller.

Now fast forward six years to a gun show in my hometown in 2007.  I stopped to talk to a Civil War dealer from the town of the woman I had spoken to earlier and in the discussion I find out he had bought the set in question I had evaluated.  He proceeds to tell me they subsequently found all the documentation for the relative and 'proved' the man was indeed a Civil War surgeon.  Based on this knowledge, the dealer tells me how he removed the blank brass plaque on top of the set and had it engraved for $100 by someone in Texas, and then replaced it on the set top.  He said he did this because he was satisfied this set belonged to the Civil War surgeon and rightfully should have the owner's name on it!!!!!   Only problem was... he still didn't know the set was missing a number of the correct instruments and was made by Hernstein in c.1870's.   Is that scary or what?  (The same dealer contacted me in 2008 to protest this story having been posted on this site!  (Me thinks 'he' duth protest too much!)  There is no end to what some people will do to scam the public.

As previously mentioned, other examples of outright fraud can be found, but faked mechanically 'engraved' cartouches on the set tops is testimony to someone being unknowingly 'taken' by an enterprising forger.  Early period engraving by-hand has a distinct 'look', patina, and upon examination with a microscope it is easy to determine what is fake and what is not.  Block lettering mechanically impressed or burned into brass or leather is not consistent with mid 1800's hand-engraving used by Civil War makers.  If you have any doubt about what can be done see this web site on engraving and stamping.

See: Engraving on the brass cartouche of Civil War surgical sets

Was he really a 'doctor'?

Another issue is proving a Civil War doctor really was a 'doctor'.  You can access the American Medical Association records for some (less than 50%) deceased physicians and find their name in some cases, but certainly not always.  There were also 'doctors' who attended 'less than acceptable' medical school lectures before the War and may never have been officially certified 'graduated'  before, during, or after the War.  Some 'attended' lectures at a reputable medical college, but did not graduate.  These individuals could easily obtain some type of amputation surgical set and call themselves a 'surgeon'.  There was little enforcement to stop these individuals from committing the ultimate fraud on the public, but during the Civil War boards were formed to interview these individuals and remove them if they were found to be deficient.  This is why identification and creating a chain of provenance for both the set and doctor is essential and takes a lot of research. 

Many students attended some medical school lectures at a young age, but few actually graduated.  Check out the number of students registered for the current year 1850-1851 at Albany Medical College, verses how many actually graduated in previous years.  Many just attended, but very few made it through or were simply taking 'refresher' courses.  Many of the famous medical colleges also served as 'refresher' courses for existing practicing doctors.  Again, these non-degree-seeking students would fill the school's rolls, but only those few who completed the courses are listed as graduates.  The reason for qualifying boards in the early months of the War was to weed out the 'wantabes' and 'charletons' to provide real, trained surgeons to the soldiers.

Identification of a Civil War military set sold post-1870's

Buying eBay, European, or English sets:

One of the big problems with buying any European set is dating the set to a specific time frame because there is very little information available about specific European and in most cases English sets, with which you can accurately 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 instruments, makers, or sets.  I guess one could buy a European military set made immediately before the War and romance about it being used in the War.  European sets are much more extensive than American sets prior to the Civil War and the French sets are most impressive in particular, many of these well-made and techincally advanced sets were imported to the United States before the Civil War begain, but were most likely found in larger cities among well-trained physician/surgeons practicing or teaching in leading medical colleges or hospitals such as Bellevue Hospital in New York.

If you are a real gambler, go play the game on eBay.  Roll the dice and make a bid on a 'True Civil War' set offered almost nightly.  Typically they are listed by the seller as "Civil War Era" to be safe.  Documented Civil War sets are extremely rare.  Finding one on eBay or at any auction is going to be pure speculation on your part unless you possess a great deal of knowledge, but they do surface from time to time, so do your homework first if you spot one.

Dealer problems:

Be very, very careful of certain dealers who actively sell misrepresented sets to unsuspecting new collectors and especially doctors of any ilk.  There is a well-known high-dollar antiques dealer in New Orleans who sold a number of surgical sets purported to be 'Civil War', at very inflated prices, over the years to doctors who were attending professional courses or meetings in New Orleans.  In 2008, one of those doctors ended up in a divorce and was forced by the wife's attorney to sell his collection.  At auction, the doctor found out, much to his and his ex-wife's dismay, most of the sets he bought from the unscrupulous dealer were either fakes, over-valued, or mis-represented and he took a major financial beating.  It happens all the time and I could relate multiple examples, including one story about a faked leech jar, which was returned to the New Orleans dealer for a $10,000 refund after discovery of its faked origins.  Know what you are buying.  Get third party advice and read.  (If you are a medical collector and might get a divorce...well, this isn't the place to discuss that problem, but you would not believe the stories I have heard in the past few years.)

Collector knowledge:

The big advantage I have, as a researcher/collector, is I have seen many, many hundreds of surgical sets from the 1800's and I know how to differentiate between certain years of production from a given maker.  Knowledge and knowing what questions to ask is your only defense in the antiques and collecting business.  Having an extensive library is a big help as well as having friends with whom you can consult.  There are 1800's examples of surgical sets from this collection in the display area to use as comparisons.

Sometimes it is helpful to attend Civil War or gun shows and get to know as many collectors as possible and ask a lot of questions.  Read every single page in Edmonson's book on the History of American Surgical Instruments and know it cold before you buy.  Read everything on this web site too, because I've already invented the wheel and when you think you know enough to jump in, then go right ahead and spend to your hearts content.  (The reason for this article and this web site is to prevent anyone who wants to collect medical antiques from making heart stopping mistakes like I did at one time.  Medical or surgical sets, and especially Civil War medical material, is every expensive when real 'authentic' and certifiable.)

Final words:

Again, keep in mind, some, not all, dealers hype their sets as being "Civil War" because those sets bring a premium.   Some are not above generating provenance to prove a fake.  The same follows for dealers who 'plant' instruments in sets to fill them out.  You have to know what is correct and what is not or you are going to end up with a set which is less valuable than what you paid for, or a sore point in your collection. 

You are not likely to get a serious Civil War set unless you study and get out there to associate with other Civil War and especially medical collectors with deep knowledge.  If you go to just any internet sales site, auction, or local antique shop, and think you are going to get an honest representation on a 'real' Civil War set... well, there's that bridge in Brooklyn for you too.

Identification of Civil War Military surgical sets: USA Hosp. and Medical Dept.

A fake, put-together, Civil War set on eBay