Surgical Items:

Surgical Sets

An ivory surgical presentation set. The cartouche on the brass bound mahogany box reads: "The Middlesex Hospital" Governor's Prize. Awarded to Mr. Robert Harry Lords. Session 1868 to 1869" The top tray contains a full complement of ivory handled  scalpels, bistouries, needle threaders and tenaculum hooks all signed Meyer and Meltzer. The lid compartment contains two scissors (one a contemporaneous replacement) one pair of scissor handled and two hand forceps. The lower tray contains a crosshatched ivory metacarpal saw, a director, two silver tracheotomy tubes, a crosshatched ivory and silver trocar and a pair of bone forceps.

A 19th Century French post mortem set enclosed in a brass inlaid wooden case. All the major pieces are engraved Collin. One of the latches on the box is missing. Otherwise the set appears complete and given the virtually mint condition it seems unlikely that the instruments have ever been used. 

A fine German fitted neurosurgical set dating to the early 19th century. The velvet lined leather case is decorated with embossed surrounds. It contain 17 compartments which accommodate a full set of instruments made from unplated polished steel, brass and horn. They are signed by Zitier, Heine and Sandill and it is likely that the boxed set was made specifically to accommodate these instruments. There are no empty spaces and the set is complete and original. Around the central trepanning brace there are two fixed hand held trephines, two detachable handles and trephines attachments, a scalpel, Hey saw, elevator, brush, scissor handled spreaders, a starter trephine and two raspatories. Just under the handle of the trepanning brace is a small instrument with detachable screws which connect to the handle by means of an oblong shaped loop. The small screw would have been turned into a section of cranium and then left in place, allowing it to be easily removed with the handle.

A circa 1880 Dutch tracheotomy set by J C Aalders, a renowned maker of medical and dental instruments. The set consists of a crosshatched ebony double ended tracheotomy knife / probe and and forceps, both signed Aalders. Two ebony handled tenaculae hooks. Two blunt wound retractors, and two solid silver tracheotomy tubes with cannulae and locking mechanisms. All beautifully fitted in the original leather, velvet and silk lined case which is embossed in gold letters within an emblem "J C Aalders Amsterdam"

A cased set of quality Liston knives made by the French instrument maker W. Carter who was in business in the late 18th and early early 19th century. Liston knives were used in limb amputation and were renowned for their sharp steel. One of the knives is double edged and is marked "W Carter No 24 Rue de l'Odéon" the second knife is single edged and is unmarked but is unquestionable a pair. The knives are made from polished steel with crosshatched ebony handles and have been manufactured to the highest quality. They are still razor sharp. Housed in a fitted velvet lined embossed leather case secured by two catches.

General

A 19th century "Charriere" tourniquet signed by Charriere. Skilled craftsmanship went into making this superb example which is of the highest quality. It has been used and I think that there is a tiny blood stain on the brass of the upper pad. Perhaps at a future time, if such tests are more readily available this would make an interesting analysis.

This instrument was designed to remove swallowed foreign bodies. The patient would be asked to swallow the tip and the flexible stem would be passed along the length of the oesophagus below the FB. The thumb ring and finger hold would then be pushed together causing flattening of the bristle (see photo). The instrument would then be removed, hopefully pulling out the FB with it. Unused instrument in its original wrapper as marked F1728 in Feix catalogue. Feix was founded in 1894 and the probang is probably early 20th century.

A nice example of a mid 19th century chainsaw. The instrument was used "chainsaw" style for cutting through bone. One such procedure was division of the pubic bone during labour which was intended to aid delivery. The saw is in excellent condition with fine crosshatched handles in ebony (noting a barely discernable 1mm chip as shown).

This 19th C Miles' variation of the chain Ecraseur is harder to find than the more common Chassaignac's pattern. It comes with a fine crosshatched ebony handle, the original chain, and it is in perfect working order. It was used for treatment of haemorrhoids when the chain was looped over the offending tissue and tightened using the screw mechanism, hence stopping the circulation by strangulation. It was also used to removed uterine tumours or polyps and was preferred in these cases because the process of crushing with a chain produced less bleeding than excisions made with with a scalpel.

A two piece cautery iron and lamp with its original wick, signed by Maw. The set comes in a leather case lined with purple blue velvet and silk.  The handle is made of rosewood. Maw started business in 1807 and became Maw and Son in 1826. The set is in pristine condition.

A 1902 French veterinary cautery set by Graillot with instruments marked "Brevete SGDG". The red felt lined mahogany case is in perfect condition. The silk lined lift out tray contains the main cautery equipment with a full complement of attachments and heads. The bunson burner is particularly attractive with a spiral design. The lower section houses a steam canister, rubber inflator, steel cup and a full set of instructions in French (the latter have minor burn damage). A superb and complete set. I have not seen better.

A quality surgical suture holder with fashioned securing latch and decorated ebony handles. The instrument is in perfect working order and is signed Down Brothers St Thomas St Borough London who were in business from 1897.

A fine crosshatched ebony needle thread holder of Italian origin from the late 1800s. The hollow needle would be passed under an organ or blood vessel allowing the easy passage of a catgut suture through otherwise difficult terrain.

A pair of Assalini forceps made from steel with a crosshatched ivory handle. The instrument is signed Ferguson 21 Giltspur Street London. Ferguson was an instrument maker trading in London at this address from 1826 to 1869

A small semicircular shagreen case containing six surgical needles of various sizes and dating to the 18th century. The inside of the case is lined with green silk on the lid and velvet in the base and is bordered with material decorated in a floral design. The hinge is solid, the shagreen in very good condition and the case closes securely with an intact latch mechanism.

Urological Surgery

A beautifully constructed lithotrite invented and made by Charrière (Paris) which is referred to in Henry Thompson's 1863 paper on Lithotomy and Lithotrity as "The modern French Screw lithotrite". The particular advantage of this instrument was the ability to apply crushing force on a stone using both a screw mechanism, and by rotating the brass release mechanism also by percussion. "The desideratum referred to has however been supplied by M Charrière, the well know surgical mechanist of Paris in the very ingeniously devised lithotrite ..."

This instrument was used to crush and remove the stones in the bladder and urogenital tract which were commonplace in Victorian times. By turning the end wheel, the jaws of the lithotrite clamp down on the stone and crush it. When the ring on the main handle is be moved backwards this frees the mechanism allowing the central rod to be removed from its cannula for cleaning. The instrument is in good condition with minimal wear to the brass plating and is in perfect working order. Engraved 'Arnold & Sons London B.M. ' 390 x 58 mm

A 19th C Thomson's lithotrite signed Walter London made from brass and steel. The instrument was used to trap and crush bladder stones. This was inserted into the bladder via the urethra and by adjusting the male central blade with the handle, the jaws could be moved freely up and down to find and secure the stone. Once trapped, greater force could be applied to the stone through the screw mechanism which was engaged by sliding the spring loaded steel button on the body of the instrument. 

A circa 1850 double lithotome cache used to remove bladder stones. Made from polished and blued steel with a horn handle in a crosshatched harlequin design. Two blades with blunt ends lie within and are concealed by the body of the lithotome, protecting any unplanned trauma to the urethral canal. The instrument was not introduced per urethra but via a lateral perineal incision and would be aligned with a grooved catheter (inserted beforehand) at the distal urethra. When in place the handle was depressed, opening the two blades which when pulled back would divide the neck of the bladder and both lateral lobes of the prostate. This would also cause part of the membranous urethra to be cut "after the fashion of a pen" allowing the stone to be removed with forceps.

Ivory Bistoury Cache by Bonnels

A remarkable bistoury cache of presentation quality, this instrument was used for the removal of bladder stones. The handle is finely carved in ivory and signed by Bonnels, a renowned European medical instrument maker from the mid 19th century. There is a graduated blue steeled mechanism on the handle which limits the opening of the blade. Both the handle and the tip of the instrument are ornately engraved. In quite beautiful condition throughout.

Dating to the late 1700s this is superb example of a bistoury cache by Savigny used for the extraction of bladder stones. The instrument has been well protected and remains pristine. The polished steel lever which opens the blade is attractively crosshatched as is the spring loaded release button which secures the lever within the ebony handle allowing the blade to be fixed in an open position. There is a second adjustment possible using the pivot screw which allows the blade to be moved forwards and backwards a few mm within a steel loop. The stem is signed "Zavigny". The beautifully fitted case is remarkable in its own right being made from sharkskin which is also perfect throughout. It is lined with red velvet and silk and the hinges and catches are original and in good working order.

A beautiful 18th century bistoury cache (literally hidden knife), first used in the mid 18th century for lithotomy (cutting into the bladder to remove stones). The asymmetrical polyfaceted ebony handle when rotated would variably limit the extension of the blade. Each face of the handle is numbered. This instrument as shown in Bennion p 64 is the same as Frère Côme's Bistoury held in the Royal College of Surgeons. There is a similar instrument in display in the Wellcome Museum.

A bistoury cache (literally "hidden knife") used in the days before anaesthetic for urology procedures such as opening the bladder to remove stones. They were not the exclusive remit of urologists and some (of varying design) were also used for opening anal fistulae and doing hernia operations. This is a fine example in pristine condition. The blade and handle spring are made from high quality steel and are secured to the ebony handle with gilt mounts. There is an adjustment screw with graduated markings to control the depth to which the blade can open. Engraved "Charriere" on the metal arm of the handle.

Unusual mechanical urological bistoury scalpel with a crosshatched ebony handle. The curved angle of the blade is adjustable with an ingenious mechanism. It was invented by the renowned Prof Pietro Loreta (1831-1889) of the Bologna University. Two factories in Bologna, Fratelli Lollini first, and Ditta Enrico Bergamini after, manufactured those items, starting in 1870 circa. The same instrument can be seen on the right hand side of the picture **here** as part of a remarkably surgical rare set used for "cistotomia perineale". (With thanks to Andrea Menarini for his kind help in identifying the maker and the dates)

A Holt's Divulsor as described in Tiemann's American Armamentarium Chirurgicum page 358 which is in effect a urethral dilator designed to stretch and release a stricture or narrowing of the urethra. The cannula without the bougie would be inserted through the tip of the penis up to or through the point of narrowing. The hollow bougie is then introduced over a central conducting rod, dilating the bore of the cannula as it passes, so releasing any stricture. The plates securing either side of the protective cannula are made from crosshatched ivory as is the end of the introducing rod. The ivory plate on one side is marked 'Maw London'

A lovely example of a l9th century Jewish circumcision knife with a typical straight blade and a raised central spine. The blade is polished steel and the handles are made from ivory. It is housed in a fitted velvet and silk lined leather case and is signed on the handle Grunewald.

Neurosurgery

A 19th century hand held trephine made from ebony, brass and blued steel. The two different sized drill bits and stems are detachable and interchangeable. A central pin can be adjusted so that after anchoring the drill bit they can be subsequently retracted so as not to cause damage to the cerebral cortex. In excellent condition noting a superficial small superficial chip at one end of the handle. The instruments are not signed but are of excellent build quality.

Elevators 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. Made from high quality steel and with an ebony handle secured with studs. Signed by Strange who was an instrument maker to Bartholomew's Hospital from 1815 to 1820 and worked at 44 West Smithfield in  London from 1820 to 1826 when he was taken over by Ferguson.

Hey Neurosurgical Craniotomy Saw

19th C Trepanning Drill by Mathieu

19th century Hey saw which was used to saw through the skull and which has become synonymous with craniotomy procedures. The unsigned instrument has a steel blade and shaft and finely crosshatched ebony handle.

Used for neurosurgical procedures which required drilling through the skull. For example aspiration of subdural blood clots after head injury, or the elevation of depressed skull fractures. The centre piece of the bit allow the drill to be centered and once the outer teeth had engaged it would be withdrawn so as to prevent further intracranial injury. The high quality brass and steel bit is in mint condition and is detachable. It had it own separate guard which is an unusual feature. The wing of the trepanne has age related loss of plating with early pitting. Signed Mathieu.

Early 20th century saw used for craniotomy. Three holes were drilled in the skull with the trephine and the flexible Gigli wire saw was passed under the skull and sawn through to remove a triangle of bone. I am told that similar instruments are still being used in Brazil for amputation.

A 19th century lenticular which was used to scrape away adherent scalp, but were also doubled up as an elevator to pull up the bone from around depressed skull fractures. Cross- hatched ebony handle.

Double Rachitome by Wilhelm Walb

Predominantly a post mortem instrument. The single rachitome was used to cut through the lamina of the spine. The double rachitome was used to cut sections through the cord. The width of the sections could be varied with the screw and nut mechanism shown. A heavy instrument with solid crosshatch ebony handles and very sharp blades. Signed Wilmh. Walb Heidelberg.

Anaesthetics

Ombredanne Ether Inhaler

Bennett's Portable Anaesthetic Inhaler

A beautifully made Ombredanne inhaler with its original rubber mask and caecum bladder. Professor Louis Ombredanne (1871-1956), the inventor of the apparatus, was a French Surgeon who introduced his ether breathing apparatus in 1908 and it was subsequently widely used throughout Europe. They were made by various makers in the early 1900s. This fine example is signed "Aesculap"

A rare  early 20th Century Bennett's portable anaesthetic inhaler. The central body of the inhaler is filled with an absorbent cotton into which the ether or anaesthetic agent would be poured. The screw on cap would then be replaced. The agent was then administered to the patient by holding the nasal prongs (the tips of which are made from some form of gutta percha) to the nares. Later versions were made from all metal.

Trocars

A fine late 18th or early 19th century set of three ebony handled trocars with their silver sheathed cannulae. These would have been used for abdominal paracentesis (drainage of ascitic fluid from the abdominal cavity).

A fine 19th C ivory and silver trocar. The top of this delicately carved piece unscrews to reveal a silver cannula sheath which is inserted over the central needle.  The ivory body of the trocar is marked with the number "2". The ivory is in excellent condition throughout with no cracks or marks (A similar instrument can be seen on page 178 of Elisabeth Bennion's Antique Medical Instruments). These instruments were used to drain hydroceles.

Invented by Henry Herbert Southey (1783 -1865) sometimes referred to as Southey tubes this trocar contains 4 silver perforated cannulae in the handle compartment so that another was readily available when it was needed to leave one inserted in the body for drainage purposes. (Seen on page 178 of Elisabeth Bennion's Antique Medical Instruments) One such purpose would have been for the drainage of peripheral oedema in the ankle, leg or even the vulva.

This elegant instrument contains three trocars of reducing size sheathed within each other and their respective cannulae and stored in the handle compartment. The oval handle is decoratively grooved and the nickel plated brass is in excellent condition throughout.