Sources of Military Surgical Sets
By Dr. Michael Echols
Created: September 4, 2009
Last Update: Wednesday, September 21, 2016 09:08 AM
There is very little actual documentation regarding who or which government agency ordered all the military-style surgical sets in circulation today, but points of origin can be made based on associated facts and research drawn from multiple resources. Parts of the story are simply logical deduction. What follows is an effort to better understand why we see military-style sets which are obviously not part of the Union Army contract orders during the Civil War, but are similar.
The Northern medical service numbers organized by categories:
1. Surgeons and Assistant Surgeons of the United States Army. This was the regular Medical Corps and consisted of men in the service when the war began. The War began with only 90 medical officers.
2. Surgeons and Assistant Surgeons of Volunteers. These were former "brigade surgeons" created by Congress to supplement the work of the regular staff surgeons. A total of 547 commissions were issued.
3. Regimental Surgeons and Assistant Surgeons, commissioned by state governors rather than congress or the President. There were 2,109 Surgeons and 3,882 Assistant Surgeons. (Note: these are the best documented surgeons and a list of their names is found in the "List of Battles and Roster of Regimental Surgeons")
4. Acting Assistant Surgeons, United States Army. These physicians were known as the 'contract' surgeons. They held no commission but received pay as first lieutenants. There were a total of 5,532 Acting Assistant Surgeons; most of which worked in the general hospitals in the North. They also continued their civilian practice at the same time.
Federal government purchased surgical sets for the U.S. Army:
There are two major sources of Federal government contract-purchased military surgery sets and one minor source of state militia purchased surgical sets used during the Civil War:
First, there were those sets ordered for the Army Hospital Department, which was a subdivision of the Army Medical Department. From 1861 to 1865, the U.S. Army Hospital Department sets, were specifically made for use during the Civil War. Yes, there were a few Hospital Department marked sets which existed outside the War years, but they are easily identified and dated prior to the Civil War by the contents and are very few in number.
(Note: There are U. S. A. Hosp. Dept. marked sets used during the Mexican War of 1846, which can easily be identified by the maker and instrument production dates. The Army Medical Department immediately before the Civil War was a small bureaucracy, which consisted of less than 100 doctors, most of whom were not performing surgery on a regular basis, so not that many surgical sets were needed.)
Second, there are U. S. Army Medical Department sets, which were used by Army surgeons before, during, and after the Civil War. With Medical Dept. marked sets you have to figure out when the set was made via the maker address or style of the case and instruments, but based on the age distribution of the Medical Department sets seen today, I believe the vast majority of these sets were purchased immediately before or during the first year of the War. Yes, there are some U.S. Army Medical Department instrument sets which may have been purchased and marked during the War. The U.S. Army Medical Department engraved sets may have just been a matter of the Medical Department ordering military surgical sets out of a different budget than the budget approved by congress to run the whole War effort and then assigned to the Hospital Department purveyor bureaucracy.
At the start of the Civil War the number of surgical sets would have been limited as there was not the need that occurred with the start of the War. In 1861, the U.S. Army Medical Department consisted of only one surgeon-general (colonel), thirty surgeons (major), and eighty-three assistants (lieutenant). Three of these surgeons and twenty-one assistants resigned "to go South," and three assistants were dismissed for disloyalty. In August, 1861, ten additional surgeons and twenty assistants were authorized, and a corps of medical cadets was formed, not to exceed fifty in number, to be employed under the direction of medical officers as dressers in hospital. (Refer to: 'The Medical Department' By Major Charles Smart, Surgeon U. S. A. for further details.)
Assuming the Medical Department owned enough surgical sets for each surgeon, they may have only had 100 'U.S.A Medical Department purchased and thus marked surgical sets in the whole Army when the War started. We know the Army ordered something over 4,900 surgery sets during the War, which would have been attributed to the Hospital Department purveyor budget, and some of those sets were unused and sold for surplus at the the end of the War.
Dr. Richard Satterlee, in his role as Medical Purveyor of the United States Army, placed contracts with numerous instrument makers for the fabrication of cased instrument sets and related military surgical equipment. During his tenure, Satterlee requisitioned over 4,900 amputation and general operating cases, 1,150 cases of trephining, exsecting, post-mortem, and "personal" instruments, 12,700 minor surgery, and pocket operating sets. (Rutkow, p. 120, Civil War, American Surgery, an Illustrated History)
State Volunteer Militia purchased surgical sets:
Prior to the Civil War, in addition to the regular army, there were hundreds of organized state volunteer militias, most of which had a system of surgeons, all of whom may have purchased military style surgical sets for their personal use, or they could have simply used existing civilian style surgical sets. There was no organized state government procurement of medical supplies for each volunteer militia unit, thus we have a varied source of surgical sets in each state.
This third and minor source of 'government', but not 'Federal', military-style sets are those purchased by the state volunteer militias. These sets are a minor source of possible military-style sets purchased for or by various state voluntary militias existing prior to and during the first year or so of the Civil War. The state militias were later mustered into the Regular Union Army and would have used Regular Army purchased equipment as needed from that point on.
The various American and non-American instrument makers of the time could have made sets for any of the state militia groups before the War or during the first year before the Med. or Hosp. Dept. purveyors ordered the 4,900 sets for the Federal Union Army and Navy. This would account for the small number of military sets we see from regional makers like Rees, Brinkerhoff, Goulding, Otto, Shurtleff, etc early in the War. These regional makers could have provided military-style sets for their local militia volunteers, but were never under contract to supply the main-stream military sets ordered and used by the Union Army during the War due to their inability to supply the large numbers of instruments ordered from major manufacturers in New York (Tiemann, Hernstein) or Philadelphia (Kolbe', Kern, Gemrig).
The vast majority of instrument makers in 1861, other than someone like Tiemann, were not geared for large scale production, but rather crafted individual hand-made instruments which were custom ordered by the surgeon or put-up in cases for sale as a design by 'doctor so-and-so'. Other 'makers' imported instruments from England and France to assemble sets as requested by a given doctor or retail outlet such as a pharmacy or apothecary dealer.
It is possible any given military group could have contracted with any 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 Federal Union Army 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 would account for some un-marked or inconsistently marked brass plates on military 'style' sets during or prior to the War years.
(Note: the Confederate Army never contracted for American-made surgical sets and none will be marked as such to my knowledge (2013). Recently, (2013) an English-made surgical set turned up in Canada and the cartouche (brass plate) was engraved with 'CSA Medical Dept.' Personally I would be very suspicious of this set and it's engraving because no such marked set has ever turned up in the past 150 years. 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 and smuggled them into the country by the blockade runners. There were many existing American-made sets as most of the CSA surgeons were trained in the North prior to the Civil War.)
If you have a military style or other set you think may be from the Civil War and want it evaluated, please contact Dr. Echols and he will help you figure it out correctly, especially before you buy or sell one!
Now that we have a better idea of who produced the military sets, how did those government sets get into the hands of surgeons after the war ended. One answer is they were sold as military surplus to the public and surgeons. Evidence of this sale can be seen in the following document from the Medical Store Surplus Office, in Washington, D.C., 9/1865. See: Receipt for sale of post-war surplus inventory to a Civil War surgeon There is no way to know what happened to the government military sets distributed to the various state militias, but those sets or medical books would have been marked for the Med. or Hosp. Dept.
Sources of military style surgical sets before and during the Civil War
U.S. Army Medical Department
U.S. Army Hospital Department
State Volunteer Militias
Army Medical Dept. had @100 sets on hand in 1861 and may have continued to order some specialized sets during the War
Army Purveyor orders @4,900 new sets for the Regular Army in 1861- 62, which were also used by volunteer militia groups mustered into the regular army
Unknown number of military-style sets purchased prior to or during the first year of the War
Statement of finances and general transactions of the Medical Department for the fiscal year ending June 30, 1865:
Value of books and surgical instruments sold to medical officers and private physicians $8,311.30 . Which would not account for large numbers of sets or books. Most likely the bulk was sold at public auctions after the war.
"Wide acceptance of an idea is not proof of its validity"
Contact Dr. Arbittier or Dr. Echols
Last update: Monday, December 12, 2016