We’re going to take a short break from looking at the fort’s construction and history at Castillo de San Marcos in
Jacksonville St. Augustine, and look at another angle, if a slightly queasy-making one: what the modern surgeon was using in the 18th Century or so. When OTR visited, a volunteer reenactor had a display of surgical instruments. Later, we’ll return to the mechanics of fort and firearm, we promise, but for now we are going to divert ourselves with a look at the instruments that might have been applied to you if you had the poor fortune to catch a musket ball, met the pointy end of a bayonet or edge of a sword, or had your butterfingered buddy drop an iron cannonball on your foot during, say, the siege of 1702.
If you need to catch up, the first part of the story covers much of the history and the approaches to the Castillo de San Marcos (later known as Fort Francis Marion in American Army hands, before reverting to its original Spanish name).
In normal circumstances, pre-1821, the Spanish military wouldn’t have treated its sick and wounded in the castle. They’d have been removed to the military hospital in town (which has also been well restored, equipped and staffed with interpreters). It’s surprising to most people, but Spanish medicine and surgery was advanced — for its day.
Bear in mind that medical science was ignorant of the germ theory of disease, of the importance of sterile conditions, and had no anesthetics (except alcohol) and no antibiotics. They had nothing to do for gas gangrene, which was a death sentence unless it was in an amputatable extremity. And no weapons, neither preventive nor curative, were at hand against endemic malaria. Yet the claim has been made that while the language, tools and skillsets of the 18th and 21st century internal-medicine physician have very few points of congruence, the historical and modern surgeons would have more common ground for discussion.
Not being surgeons, we have our doubts about that.
This is not somebody’s table at the Acme County Gun and Knife Show. These are a military surgeon’s tools; do they pass the “Common ground” test?
Either the surgeons of 1720 were much concerned with one’s fundamental orifice, or the guy who collected all this gear has some kind of anal fixation. An enema set (appears to be British origin):
And the next to those: suppositories. Eh, we’ll take our chances with the mange, the grunge, the itch, the twitch, the thrush, the scroff, the rot. To borrow a line. We’ll get to the sutures in a bit, what are those “…etal Scrapers?” “Metal Scrapers?” Wait, that’s a “c”. They can’t be fractal scrapers, can they?
Uh, no. They can’t. Yeah, this guy has issues… or maybe 18th Century surgeons did.
Arrgggh. Can we move on to some other region of diseased anatomy, please?
Thank you. The stitch kit doesn’t seem too archaic, although sterile and disposable it isn’t.
Next we’ll move on to stuff for excavating the Brain Housing Group. The thing that looks like a heavy-duty Forstner bit on the upper left in the image below isn’t too far off — it’s a trepanning saw, for making holes in the cranium. That was usually done as a last ditch attempt to reduce brain swelling and save an otherwise doomed patient. If it didn’t work, well, the guy was standing in the door anyway. Maybe there will be a better view of this tool below.
Cautery Irons were used to burn blood vessels shut during surgery. They’d be heated red hot, then jammed into the wound.
Now this is a piece of lifesaving gear that is recognizable. It uses a thumbscrew to apply pressure and it seems probable that the 18th-Century surgeon used it, primarily, during deliberate amputations.
After the jump you can see more grim instruments from bygone days, when the promise that “to cut is to cure” was much less certain than today’s well-informed surgeons can offer. Click “more” if you dare.
Here’s the promised better view of the trepanning saw, or “trephine” as the display calls it (it was also called a “trepan.” The reason a surgeon would do this might be to excise foreign matter and dead brain tissue, or more commonly to relieve pressure on the brain from any kind of traumatic brain injury. Contained in the cranium, the brain has nowhere to go if an injury makes it swell, and rising intracranial pressure can do bad things to the brain and the central nervous system — fatal things.
While cranial trepanation is normally something only used when a patient is already seriously injured, there are nut jobs out there that swear that doing it voluntarily has expanded their consciousness. (Medical science thinks these characters have a hole in their heads).
Bleeding was a cutting-edge technique, once. The next picture shows two fleams (it sounds like something from Mad Magazine, but it’s really what these bloodletting instruments were called), one apparently factory-made, and another blacksmith made (just above it). The thing that looks like a pestle is probably a fleam stick, used to hammer the fleam into one of the patient’s superficial blood vessels. The bowl is a blood bowl. Bleeding doesn’t seem to have cured anything, but it usually didn’t harm the patient much, and it gave the patient, the family and not least the surgeon a warm feeling that something was being done.
Alternative medicine? In 1702, the only alternative to natural herbal painkillers was sucking it up and dealing with the pain. It takes hard men to fight over a new continent.
Some of these next instruments appear to be spoons for giving medicine — made of various materials including silver, bone (or ivory?) and tortoise shell.
How you would use a “crotchét” to help birth babies is beyond us. Hey, we’re just weapons men around here, we hold the mother’s head while the 18D works on the messy end.
Look at those scalpels, in the next image, and it’s easy to see that the professional divergence of surgeon and barber was not long past.
And if you’re going to have scalpels, you had better have forceps:
We’ll close with the
torture kit dental instruments. Hand forged and frightening-looking.
And, an exercise for the reader: which medical procedures and which tools that are in use today will look as primitive as bleeding and the “trephin,” two or three hundred years from now?