Object Record

Object Name Kit, Surgical
Catalog Number 2013.003.001.a-x
Description Pre-Civil War general surgeon's kit that was used during the Civil War. It was owned by Dr. Charles Edward Bellamy, a Confederate surgeon, born 1833. He was an 1854 graduate of the University of Pennsylvania Medical College. The surgeon's kit was a gift from his father-in-law, William Whitfield Croom, based on the inscription on the top of the box in a brass embedded plate (see images). The kit was likely produced prior to the Civil War and is suspected to have been a wedding present. Dr. Bellamy married Elizabeth Whitfield Croom on May 12, 1858.
(Source: Alabama State Archives from a catalog description of a collection of his wife's papers.)
For additional information on Elizabeth as well as an image, please refer to this website:University of Southern Alabama.

Dr. Bellamy felt a patriotic duty to his native South and enlisted in the Confederate Army in July 1862. He became an assistant surgeon and was assigned to duty with the 38th Alabama Regiment. Thanks to the influence of Elizabeth's brother, Major Stephens Croom, Dr. Bellamy was assigned to a unit in Mobile for a while.

After passing an exam, Captain Edward Bellamy was promoted to surgeon, received the rank of major, and was ordered to report to Ringgold, Georgia, with the 38th Alabama Regiment, which would become part of the Army of Tennessee. While serving in hospitals behind Confederate lines, he was relatively safe from enemy gun fire. Unfortunately, he was not safe from the various diseases that struck soldiers in both armies during the Civil War, and he died from typhoid fever on July 27, 1863, before the Chickamauga campaign. The Ringgold hospital under Samuel H. Stout, was the same hospital that Kate Cumming worked at; however, it does not appear that they were there at the same time and likely did not know each other. There is additional biographical information available in Notes.

There are some pieces missing from the set, such as the surgical knives, two pairs of scissors, etc. (there are impressions for the pieces but no instrument). Many of the pieces were made by George Tiemann & Co., which has been suppling surgical instruments since 1826 when the company was founded in New York. They were one of the major manufacturer's of medical equipment in the United States during the nineteenth century and they are still in business as of 2013. By the end of the Civil War, the company had become renowned internationally. George Tiemann (1795-1868) was a German immigrant.

While many surgeries during the Civil War were amputations, this is not solely an amputation set as it does not contain the necessary types of saws. This also may not have the type of kit carried by the doctor on a regular basis outside of wartime. Operations were very rare in small town practice which is perhaps the type of practice Dr. Bellamy participated in prior to the war. Most likely he had another medical bag or physicians leather pocket case with the more common instruments and which he would have taken on his house calls. The sort of surgery he might have performed would have been suturing of wounds, drainage of abscesses, and minor superficial wounds.

"Many of the surgical procedures done in the civil war were complicated by infection as they were done without the knowledge of the role that bacteria played or the benefits of antisepsis and asepsis. Hospitals of the time were characterised by the stench of the ubiquitous puss and infection. The overcrowded and unhygienic conditions made the situation worse." More can be read here: Source.

Here is a listing of the different pieces: (see also diagram images under image management).
a) The wooden box. It has a locking mechanism on the front (no key) and the brass plates embedded decoratively in the wood, as well as the brass plate with inscription as mentioned above.
b) Tourniquet, used to limit blood supply to a limb, often during amputation. This tourniquet is not original to the kit - it was Army issued during the Civil War. This was verified through the National Museum of Civil War Medicine.
c) A tong-like instrument that a surgeon would perhaps use to hold a bone or limb in place during an amputation. The teeth on the inside of the ends of the instrument indicate this, made by G. Tiemann & Co. It has been suggested that the teeth contain remnants of bone and flesh but this has not been authenticated.
d,e) Two surgical retractors, surgeons would use these to hold the two sides of an incision back while conducting surgery. made by G. Tiemann & Co.
f) An 19th century perforator (unmarked) similar in style but probably earlier than the Simpson’s perforator. It has scissor handles with no locking mechanism and shorter blades which are convex in shape. A perforator was a destructive tool used to pierce the skull of a dead fetus. This was done to remove the fetus from the womb in pieces to save the mother's life. Prior to the Caesarean section was a lifesaving procedure for a mother in obstructed labour.
g) Some type of a pair of snips, illegible marking.
h,i) Two trocars, may have been used either for abdominal paracentesis or suprapubic catheterisation. Both have ivory handles and are unmarked.
j) A trephine or part of a trepanning set. "Trepanation is the procedure of drilling a hole in the skull. The two main reasons for doing this would be to drain a collection of blood which had accumulated between the skull and the surface of the brain, or to elevate a depressed bone fracture. The former, often referred to as a subdural haematoma would raise the pressure within the skull and cause brain damage, and in a depressed fracture it was the bone of the skull pushing on the brain (like a collapsed ping-pong ball) which would damage the brain or causes it to swell. When done correctly for the right indications trepanation is a relatively simple procedure which is life saving. This set contains two drills with different sized crowns (“drill bits”), either of which can be attached with a screw to the horizontal crosshatched ebony handle. This forms a drill which is used in a similar way to a cork screw. A flap of scalp would first have been raised to clear the area of the skull to be tapped. In order to anchor the circular drill and prevent slippage a central spike is moved forward and fixed in place to start the drilling (see here). The drill is turned through the cranium until a disk of bone can be removed. This may have been pried out with a lever like ‘elevator’ and the edges of bone trimmed with a sharp knife or ‘lenticular’ and filed down with a ‘raspatory’. The instrument on the top right hand side of the case would probably have been used as a combination of an elevator and raspatory. Sometimes one hole would be enough to drain a collection of blood. Other times a larger plate of skull would need to be removed and this was done by drilling three or more holes and passing a small abrasive wire (a Gigli saw) between two holes at a time to saw through the intersection." More can be read here: Source. Tool marked with "27."
k) was likely part of the trepanning set. Unmarked.
l) Likely a toothpick or other type of pick, metal, marked "Nichol."
m) Unmarked tool, perhaps a surgical probe, ivory handle.
n) An exploring director, which was likely used to explore the bladder.
o) Unmarked scalpel, metal handle. Also called a bistoury.
p) Scalpel marked "Graf-Apsco, Germany," wooden handle. Also called a bistoury.
q) Likely a gum lancet, unmarked, ivory handle. This was likely lancet used for incising the gum over the crown of an erupting tooth or for general bloodletting.
r) Likely a tenaculum, marked "G. Tiemann," ivory handle. A tenaculum is a slender sharp-pointed hook attached to a handle and used mainly in surgery for seizing and holding parts, such as blood vessels.
s) Unmarked tool, perhaps a surgical probe, ivory handle.
t-x) Five sounds for dilating and probing the urinary tract; these are also referred to as catheters. Identified by the National Museum of Civil War Medicine. See also: Source.
t) marked with "13, Marconi Wien." x) marked "Tiemann & Co." Others unmarked.
y) likely an elevator, which were used to pull up the bone from around depressed skull fractures. This instrument also doubled as a rasp to scrape soft tissue from the bone.
Date 1858-1863
Dimensions H-3.25 W-5.75 L-13.25 inches
Accession number 2013.003