Many museum visitors who spy some interesting old relics under glass go home wishing they could have seen how they worked.

A complete Civil War surgeon’s kit is on display at the Indiana State Museum in Indianapolis. Krystle Buschner and other staffers use the next best thing to show how the still-shiny, 150-year-old medical instruments were used to remove limbs to save lives in America’s bloodiest war.

“We have an exact replica of a complete Civil War army surgical kit,” said Buschner, museum gallery programming supervisor. “Our demonstrations are definitely eye-catching, and maybe make some people a little squeamish.”

 

 

In the amputation demonstration, Buschner sometimes plays the role of a Union army “sawbones,” the nickname soldiers gave to surgeons. She ties on a white apron that is anything but pristine. It is spattered and stained red and brown with fake blood.

Next, she spreads an assortment of shiny instruments on a table. They include probes, an amputating saw, large blade scalpel, amputating knife, lifter/tenaculum, cuter/rasper, bone file, iris scissors, curved mosquito hemostats, large tissue forceps, silk thread and artery tie thread.

She uses the tools of the surgeon’s trade on gruesome-looking “amputated limbs” — rubber, bullet-holed arms and legs smeared with the requisite blood and gore.

“They definitely attract attention,” Buschner said with a smile.

Surgeon’s kit

The real surgeon’s kit stays locked behind glass. It belonged to Dr. Albert G. Preston of Greencastle, surgeon of the 55th Indiana Volunteer Infantry Regiment. He treated wounded soldiers at the battles of Shiloh, Tenn., in 1862 and in the Vicksburg, Miss., campaign in 1862-1863.

Preston also was “special surgeon” to Hoosier Gov. Oliver Morton, a friend of President Abraham Lincoln. Preston’s duties included providing medical aid to hundreds of Confederate prisoners of war confined at Camp Morton in Indianapolis.

Buschner’s program focuses on how surgeons like Preston went about the grisly business of removing arms and legs. “How much detail I go into depends on the reaction of the people when they come up to the table,” she said.

Buschner explained that amputees went through three stages of treatment. “First, they would be taken to a dressing station on the battlefield, where their wounds would be dressed.

“From there, they would be taken by horse-drawn ambulance to a field hospital where the surgeon would perform the amputation. From the field hospital, the patient would be taken to a general hospital to recover.”

Of course, Civil War surgeons could not see inside a wounded soldier to determine the extent of his wound. X-ray would not be available until the late 19th century.

“So he would use a probe (a long, slender metal rod) to see if he could locate the bullet,” Buschner said. “Or he might stick his finger in the bullet hole and feel for it. One can only imagine how painful that would have been.”

Civil War bullets were large — rifle rounds generally ranged from .54 to .69 caliber — and made of soft lead. Buschner’s display includes a replica rifle ball and a Minie ball, both of which often tore gaping wounds.

Minie balls were conical shaped rounds with hollow bases. They were especially prone to shattering when they struck bone.

In addition to splintering bones, bullets drove bits of the soldier’s dirty clothing into the wound. Hence, amputation was necessary to prevent almost certain death from gangrene or other forms of infection.

Contrary to Civil War movies, Union and Confederate surgeons nearly always had anesthesia. “They used ether and chloroform, but sometimes didn’t know how much to give a patient. They would sometimes overdose or not give the soldier enough and he would wake up during the procedure.”

Amputation in a hurry

The procedure started with the surgeon cutting out a flap of skin and peeling it back. It would be used later to cover the residual limb.

Next, the surgeon would slice through muscle, clip tendons and suture arteries. He would cut the bone with a sharp-toothed metal saw, hence the “sawbones” handle.

“The surgeon would use a file to smooth off the end of the bone, then make the stump, folding over the flap of skin and sewing it up,” Buschner said.

Surgeons operated bare-handed. “The germ theory was around in Europe but really hadn’t spread to America,” Buschner said.

“The entire amputation took about 15 minutes. Surgeons had to work quickly because they had lots of patients. So they just wiped their hands and moved on to the next man.”

Buschner’s public demonstrations are real-life in a way museum visitors might not imagine. During the Civil War, “amputations were performed in full view of the assembled,” Ira Rutkow wrote in Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine.

On the other hand, Buschner’s demonstrations are bloodless. But Rutkow added that in real amputations, blood splattered on “those too near, including the next victim of the surgeon’s scalpel.”

Rutkow also wrote that 19th century surgery, especially the removal of a limb, “had forever been a speed event in which a surgeon’s ego and a patient’s suffering were intimately bound up with how fast the former could relieve the latter of his extremity.

“Tissues were incised, bones sawed, and blood vessels tied all in a few minutes to minimize blood loss and lessen a patient’s anguish and pain. Despite the introduction of general anesthesia a decade and a half earlier, surgical expediency was a hallmark of Civil War amputations,” Rutkow wrote.