"18th Century Surgery During War"....

The following passage is from the book, "Then...A Patriot I'll Be". It recounts the experience of a Continental Soldier, as he painfully endures a surgical procedure following a musket ball wound to his arm, suffered during the Battle of Monmouth....

I had awoken to the sounds of horrific screaming, and found myself on a small bed in the surgeon’s dimly lit tent. Apparently, I must have passed out during my carriage ride off the field, and stayed in that manner until now. My arm was as it was when I was carried from the battlefield, except that the original tourniquet had been replaced with a different piece of cloth.

Still half dazed and weak, I opened my eyes and looked about for the cause of the unpleasant noise. Not far from where I was lying, there was a wooden surgeon’s table resting on top of two stood up barrels as legs. Lying upon this table was a young man writhing in pain. I could see that his left leg was soaked with blood, and looked badly mangled. This poor man’s wound appeared to be far worse than mine. To the eye, it was very unpleasant to behold, and I could only imagine the pain that man was going through. He was obviously a wounded soldier, brought in from the battle we had just fought. To both his left and right, there were strong men holding the young victim fast to the table, as to prevent his movement as much as possible. “Mind that man’s limbs”, a deep calm voice was overheard approaching the table. This voice belonged to a rather plump man dressed in his small clothes; his sleeves were rolled up, leaving his blood stained arms visible. He had what appeared to be a white apron (soaked with blood) draped from his neck to his knees. I took this man to be the surgeon of the unit. He was walking toward the poor injured young man with what appeared to be a wooden case. Once arriving to the young man’s side, he placed the case on the table next to him, and opened it up; revealing its contents to be full of medical devices.

The surgeon got to work examining the wounded soldier right away. This must have been rather difficult to do thoroughly, as it was still evening, and the darkened inside of the tent was only illuminated by a lantern hanging from the ceiling of the tent above the patient, and a few open candles placed as close to the table as they could get without impeding the surgeon’s business. The man on the table continued to move about against the strong men holding him down on the table. It was evident that his freedom of movement was causing the surgeon hardship in his examination, and this was angering him. “I said hold him down”, he belted out! This time however, his voice was much louder than before. The two men didn’t reply back to him, but went back to their positions of grabbing this poor man still on the table. The surgeon went into his case, took out what appeared to be a long metal probe and pulled the length of it across his blood stained apron in a manner as if to wipe it clean of any residual debris from recent operations. He then placed the recently “cleaned” probe onto the table, and reach into the case once again. This time, he produced a fine pair of spectacles, to which he promptly placed them in their intended position on his face. He picked up the probe once again, and bent over toward the soldier’s mangled leg. “Keep him steady now”, he once again reminded his two assistants, as he gripped the leg just above the wound with his empty hand.

He unceremoniously pushed the metal probe into the soldier’s injury, and began moving it about inside of the leg. The soldier screamed out in agony as the probe dug into the inner flesh of his leg, but the surgeon’s assistants did a good job in holding him down this time. I continued to lie in the bed looking over at this act with both anxiety and terror. I felt greatly for this poor man, and hated to see and hear him go through this ordeal. More importantly, I must admit; I was getting deeply concerned that once his turn was through, I would be the next one to occupy the table and endure the surgeon’s barbarities. I began to wonder if I could actually live with my wound, rather than have it looked at by the surgeon.

After a few moments of using the probe to explore the soldier’s leg, the surgeon finally slid it out from the poor man’s wound; of course his patient winced from the pain of removing it just as much as he did from the insertion of the instrument. He once again wiped it on his bloody apron and placed it back into his case. Immediately after, he used his forearm to wipe away the sweat from his brow, and then rubbed his hands on his gruesome apron again, before removing his spectacles and placing them in the case as well. The surgeon took a breath and turned to the patient stretched out in pain on the operating table. He them solemnly gave him the prognosis of his condition. “I’m afraid your thigh bone has been shattered beyond repair”, he grimly informed the young man. That leg is going to have to come off”. The young man burst into tears as soon as the surgeon informed him of his necessary intentions. Admittedly, I almost cried for him as well, upon hearing the course of action that would be taken.

“Hold him down firmly”, the surgeon ordered his assistants; not two minutes after informing the patient of his miserable fate. Once again, the soldier tried his hardest to escape from the table before the amputation could take place, but it was to no avail. The two strong men on either side held him down, severely limiting his movement. Next, the surgeon took a proper tourniquet from his case, and applied it tightly to the man’s thigh, just above the area that he would remove. Along with the tourniquet, he produced a saw and placed it on the table next to the patient. The blade of that saw appeared to me in the dim light, to have been just as caked with a previous man’s blood as his probe had been. This instrument however, he didn’t bother to wipe on his apron. The surgeon then pulled a wooden spoon out of his case, and placed the handle in front of the riving man’s mouth. “Bite down on this lad; it will help you with the pain”, he coldly instructed the panicking soldier, as he jammed the object between his teeth.

Now with saw in hand, and his spectacles back on his face, the surgeon gave the command to hold the man down firmly once more, and took a breath. He then immediately descended upon the poor man’s leg; sawing back and forth through the tender flesh of the poor victim violently, until he was forced to suddenly stop. All the while, his patient’s muffled cries and screams could be heard through the wooden handle in his mouth. I was terrified at what I had been witnessing.

The amputation wasn’t over. From the case, the surgeon pulled out another, wider saw. “This one’s to get through what’s left of the bone”, he informed the two men holding the patient down. Once again, he went straight to work sawing back and forth through the fragments of bone holding the man’s upper and lower leg together. It sounded much the same as a sawyer’s blade does, while cutting a piece of wood from a tree. The poor wounded man continued to scream in agony from behind the spoon handle, so much, that I was nearly sure that he was about to die. From this point, thankfully it was over rather quickly. As the blade of the saw made its way completely through the thigh and hit the table, both severed section’s of the poor man’s leg seemed to bounce up, only to flop back down on the bloody table. The man’s screams turned to whimpers and cries, as the cutting was finally completed. Unfortunately, he was soon to realize that his suffering however, was far from finished.

Go out and get the pan, the surgeon instructed one of his assistants, as he removed the amputated limb from the table and placed it in a nearby open barrel. Hordes of insects buzzed up from the container in a dark cloud as the leg dropped into the cask; disrupting their meal. As the patient lied sweating on the table with the spoon still firmly held between his teeth, the man had returned back to the tent with the pan. Apparently, there had been a small fire constructed outside the surgeon’s tent solely to be used for the business of heating up metal skillet pans during amputations. The man presented the surgeon with the red hot pan, to which the surgeon received it wearing thick artillery style gloves wrapped in extra protective layers of cloth. “This may hurt a bit”, he smugly informed the crying man on the table. One last time, he ordered his assistants to hold the man down firmly. Suddenly, with one fluid movement, the surgeon swung the steaming pan brutally into the exposed stump of the recently severed thigh. The skin sizzled like a strip of bacon being cooked over an open fire, and smoke bellowed up from the stump like the end of a recently fired artillery piece. The poor victim bit down on the wooden spoon so hard that he snapped it clear in half; enabling the full sound of his screams to resonate thought the tent, and I’m sure outside through camp as well. As the rancid smell of seared flesh continued to waft through the room, the surgeon continued applying firm pressure to the stump with the scolding pan, until finally, he felt that the limb had been sufficiently cauterized.

He pulled the hot pan from the poor soldier’s stump, ripping off strands of burnt and bloody skin along with it. Handing the pan to one of his assistants, he examined the stump. The smell of burnt flesh occupied the whole of the tent, to the point that I felt close to vomiting. All the while, the surgeon had bent further down toward the limb, inspecting his handy work up close. I could not understand how he could have gotten so close to that smell of roasted flesh without suffering from bouts of sickness as well. I supposed however, that if one does this duty enough, he might as well get used to the less desirable affects of his work.

“I think it might heal nicely”, he proudly exclaimed, and went to work dressing the cauterized limb with strands of linen. The man on the table had stopped his screaming, and looked as peeked as one could expect to look after such an ordeal. “You did good son”, the surgeon said to his patient, as he completed dressing his limb. He then walked over and patted him softly on top of his head. “You did very well indeed”. He then looked to his two assistants standing next to the table. “Now get him out of here, and let’s bring on the next one.

Looking around the room, and seeing no other men in as sickly a condition as I was; I knew that my turn was next.

I was promptly lifted onto the surgeon’s table, and I could attest that the two assistants that helped me on to it didn’t do so in a gentle manner. Just as roughly as they handled me during their previous task, my coat and shirt was removed in the same barbarous fashion; causing me more unbearable pain. I could see the surgeon near the table preparing for my examination. He was hunched over a small bucket of water that had been placed on a near-by table. My anxiety continued to grow with each passing moment; as I greatly feared that my arm would be the next victim of the surgeon’s “bone saw”. I glanced about the room nervously, and then brought my gaze back to the surgeon. By now, he had dipped his hands in the bucket of water, and was shaking the excess off of them and onto the floor. Walking toward me, he proceeded to dry them more thoroughly on his blood stained apron. I turned my head to the opposite of his direction, as I was nervous to make eye contact with the man that was soon to come at me with a saw. “Hold him down”! The surgeon had uttered the same words to his “henchmen” that I recall him ordering during the last patient’s unpleasant procedure. His assistants immediately positioned themselves to hold me secure to the table. I didn’t struggle, as I understood that there was no way I could escape the inevitable. The surgeon was to put into practice his trade whether I tried to withstand it or not.

I turned to the doctor, and he was now putting on his spectacles again, and adjusting them to his face. “Let’s take a look at this arm”, he calmly said. I held my breath, as I knew the pain was soon to follow. Without waiting, he hunched over me and aggressively grabbed my arm. I gritted my teeth to fight off the urge to scream as he pushed his finger into the wound and dug around for a bit. I was now at the point where I was squirming about the table, and the surgeon’s assistants had to now employ their services of holding me still. All the while, the doctor continued to explore the inside of my arm with his finger. “Ah huh”, he coolly exclaimed. “I think I might have found it”! “Found it”, I asked silently to myself? “What had he found? Whatever he found, was it good that he had found it? With this find, what does it hold in store for my suffering”? These questions began to run through my thoughts. Surely however, my questions would soon be satisfied, although I wasn’t sure if I would be pleased with the answers.

Much to my relief, he finally removed his finger from my wound. “Oh thank heavens”, I mumbled quietly to myself, under my breath. “I need more light”, the surgeon yelled out! Nearly on cue, one of his helpers quickly went to the corner of the tent and returned with a small lantern.  “Very good”, the doctor replied. “Now hold it steady near the wound”! The man holding the lantern replied with a nervous “Yes Sir”. Once again, the surgeon wiped his hands on the stained apron; this time however, adding my precious blood to its collection. Next, he went into the bucket of water that he had washed his hands in. From within, he produced a balled up piece of cloth that was soaked with water. He employed this cloth to wash the blood away from my wound, as to get a better look inside.

He then turned toward his infernal box of torturous devices and produced the same dastardly probe that was used on the previous man that had held my position on the table. Performing his same routine, he ran the probe against his apron and adjusted his spectacles. “Hold him tightly”, he ordered to his minions. I had learned that once he had spoken those words, an onslaught of pain was soon to follow. True to form, he didn’t disappoint me, as once he jammed the probe into my arm and began wiggling it around furiously, I screamed out in horror; once again, forcing his assistants to better perform their duty of holding me still.

Thankfully, this action didn’t take long, and within a few excruciating moments he had removed the probe; to which I relaxed my body and let out a deep sigh. The surgeon rested the probe on my chest, and wiped the sweat from his brow with the back of his forearm.  He re-positioned his spectacles and hunched slightly toward my face. I turned to look at him. This man had now possessed my full attention. “Today must be your lucky day young man”, the surgeon said to me. Being in a bit of a daze and not sure what he meant by his statement, I didn’t reply back to him. Noticing my state, the doctor hunched down lower toward me and pulled his spectacles down to the tip of his nose, so we were now looking at each other eye to eye. He had a bit of a smirk on his face as he addressed me once again. “I think we are going to be able to save the arm”, he told me as his smirk turned into a full smile.

Being in such a weakened state, I still didn’t respond to him, but I was sure he was able to see my relief at hearing his statement; as a smile slowly crept across my face. Once again, I breathed a weak sigh of relief.

“The musket ball that hit you was kind enough to avoid fracturing any bones on the way into your arm”, the surgeon said to me. “In fact”, he added, “The only reason why you are still alive now is that the ball was so hot from the musket fire, that it cauterized most of the wound as it entered; causing you to avoid excessively bleeding out”. This was all great news, much to my relief, but I was still a bit nervous at how he intended to proceed with my remaining treatment. The surgeon stood up erect, and pushed his spectacles back up to the bridge of his nose. “Using my probe, I was able to locate the projectile in your arm”, he informed me. “I think it can be removed without incident”, he continued. Going back to his box of instruments, he produced a long pair of forceps and placed them on my chest, next to his probe. I had still not uttered a word in response to his statements, but continued to focus my attention on the doctor. “Removing the musket ball will be a painful procedure, but I will do everything that I can to expedite the process”. I knew that there was more pain to be had, but didn’t expect the doctor to tell me so as frankly as he did.

He looked about the contents of his case again, as I continued to lie still on the table. “I had a wooden spoon for you to bite down on to help withstand the pain, but the last patient I had unfortunately snapped it in half”, the surgeon informed me. Of course, I remembered the spoon snap, as I had watched the entire procedure from across the tent. The surgeon must have not been aware that I had witnessed his handy work earlier. Once again, I said nothing to the man. “How about this”, one of the surgeon’s assistants interrupted the doctor? I looked to the soldier, and he had in his hand, a lead musket ball, that he was presenting to the surgeon. The surgeon looked at the object for a moment, and ultimately agreed with his underling. “Yes……….Yes, that would do nicely”, he said to the man as he took up the musket ball in his own blood stained hand. “Bite down on this, son”, the surgeon turned to me and placed the lead musket ball between my teeth. The time for pleasantries was clearly over, and the surgeon was ready to get back to work. I did as I was advised, and bit down on the lead projectile; closing my eyes tightly in preparation of the pain. I didn’t want to see what was being done. I just wanted it finished quickly.

Again, I heard him rattling around in his instrument box. The next thing I remember was an intense cinching feeling around my upper arm, just above my wound. I bit down hard on the musket ball and grunted in pain quite deeply, as the doctor tightened the tourniquet as much as it would tighten around my arm. The next thing I heard was the dreaded words that I had heard from him throughout the entire night. “Hold him down firmly”! No sooner had he uttered those infernal words to his underlings, I knew well enough to prepare for the pain that was sure to follow.

I thought that I was sure to jump right off the surgeon’s table in anguish; and I would have if his two brawny assistants hadn’t been holding me down so securely. The pain was nearly unbearable as the doctor burrowed through my arm in search of the expelled projectile. I struggled and fought against the assistants’ grasps wildly. I bit down upon the musket ball so hard that I was quite confident I would bite it in half. Regardless of my actions, there was no way of gaining comfort in my predicament. I had to do all I could to take the pain, and pray for a quick end to the procedure.

What seemed like an eternity had finally passed, when I overheard the surgeon declare triumphantly that he had pulled the spent musket ball from my arm. Much to my relief, I opened my eyes to see the surgeon holding the blood stained, misshapen musket ball before my face; still gripped between the vice of his forceps.

Physically spent from my ordeal, I lazily spit the musket ball from my mouth and dropped my head back down with a sigh. All that was left was for the surgeon to dress my wounds, and I could finally begin the (hopefully less painful) healing process. As he cleaned out the gaping hole in my arm, stitched it tightly closed, and dressed it with fresh cloth, the doctor showed me both the musket ball that was stuck in my arm, as well as the one that I had been biting on. The one that caused all my discomfort had been distorted from a once perfect ball, and pulled into a jagged oval shape between the violent process of firing and seconds later, entering my arm. The one that I had bitten to reduce my discomfort was also now distorted. Pressed deep into the hardened lead was now permanent tooth marks; as a testament to the ordeal I had endured.



Patient Being Held Down For 18th Century Surgical Procedure





Set of 18th Century Surgical Instruments