Throwback Thursday: Medical Tools of the Revolution
As We Explore the Medicine of the 18th Century, The Uses of these Tools Intrigued Us
Tools of the Trade
The Moore Archives is getting ready for our new exhibitions about the Revolutionary War and the medical tools that saved soldiers’ lives at Washington Hall. We want to tell you about some of the medical instruments on display. For several years, we have shown a collection of replica 18th-century tools in a display case in the Brick Room of the Lincoln Building on our campus. These tools are copies of the medical kit used by Dr. Bodo Otto.
At first glance, these instruments might seem scary and remind you of horror stories. Today, it’s easy to think they look like tools for torture or weapons. But in the 18th century, people thought these tools were very advanced and modern for their time. The image of a bone saw being used on a dying patriot may bring to mind horror stories about old hospitals. However, we should remember that medical advancements have come from many talented, dedicated people.
As we look back, we should think about how we reached our current place in medical history. This includes recognizing the tools that doctors used to make the “Age of Agony” a little bit easier.
We must add, though, that without modern anesthesia and pain relief, these surgeries and treatments would still probably have hurt a lot.
Tooth Key
The tooth key, also called a dental key, was a tool used in dentistry to pull out diseased teeth. Before the invention of antibiotics, doctors often chose tooth extraction to treat dental infections. People have used extraction tools like the tooth key for many centuries.
Also known as the Clef de Garengeot, Fothergill Key, English Key, or Dimppel Extractor, Alexander Monro first mentioned the tooth key in his book “Medical Essays and Observations” in 1742. However, it likely had been used since around 1730.
Dentists and other medical men of the times continued to use the dental key well into the 20th century, but they eventually replaced it with modern dental forceps.
Cupping Glass
These hand-blown glass tools were used- as their name would imply- for the practice of cupping.
The history of cupping as a healing practice goes back a long time, but not much has been documented.
In ancient Greece, Hippocrates (460–370 BCE) used cupping to treat internal diseases and structural problems. Roman surgeons also used it for bloodletting. Additionally, the Islamic Prophet Muhammad supported this method, which helped it spread among cultures in Asia and Europe.
In China, Ge Hong (281–341 CE), a Taoist alchemist and herbalist, recorded one of the earliest uses of cupping. Maimonides also mentioned cupping in his health writings, and the Eastern European Jewish community used it as well. In the early 1900s, William Osler recommended cupping for conditions like pneumonia and acute myelitis.
During the 1770s in colonial America, doctors used cupping to “draw out” illnesses, especially those believed to be caused by excess fluids. They handled issues like inflammation, fevers, chest congestion, headaches, and joint pain by pulling blood toward the skin to relieve pressure inside the body.
Moreover, practitioners followed a straightforward cupping process, though it wasn’t a very relaxing experience.
A practitioner would place a small glass cup on the skin and create suction. They typically heated the air inside the cup with a flame before applying it to the skin. As the air cooled, it pulled the skin upward and left a raised, dark mark.
Additionally, practitioners could perform cupping “dry,” using only suction, or “wet,” where they lightly cut the skin to draw blood into the cup. At that time, people saw cupping as a practical way to ease pain and “rebalance” the body. Today, we appreciate modern clinics and sterile equipment even more.
Mug
In the 1770s, people did not consider redware mugs (simple pottery made from local reddish clay) as “true” medical equipment. They were more common in typical household supplies, and would not have been as hard to get a hold of as some of our more specialized instruments. However, these mugs still played an important role in caregiving, especially at hospitals like Washington Hall.
Caregivers used these mugs to serve warm drinks and soft foods like broth, tea, or thin gruel to sick individuals.
This practice mattered because colonial medicine focused heavily on basic supportive care. Supportive care aimed to keep patients hydrated, comfortable, and strong enough to recover. Warm liquids made it easier to swallow, treated weak stomachs gently, and comforted patients with fevers or chest problems. Plus, redware mugs held heat better than thin metal cups.
Caregivers kept their process simple: they heated broth or an herbal drink at the hearth, poured it into a redware mug, and brought it to the bedside. They offered small sips or spoonfuls in vessels like this one throughout the day.
Without modern hospitals, IV fluids, or insulated containers, people depended on these ordinary mugs to ensure patients remained nourished and stable.
Trephine
This tool, called a trephine, was used to cut a precise circular hole in bone– especially in the skull. The trephine had a short metal cylinder with a sharp edge and a turning handle that allowed it to “core” out a round piece of bone.
Surgeons performed a procedure called trepanning (or trepanation) with this tool, or through other cutting methods, to open the skull. They often did this after severe head injuries or when they suspected that pressure or trapped blood inside the skull caused dangerous symptoms.
Surgeons handled this blunt and physical process by first cutting the scalp and pulling it back. Then, they carefully rotated the trephine to remove a small disc of skull, exposing the tissue beneath. Without modern imaging technology, antibiotics, or safe anesthesia, surgeons considered this operation risky. However, they believed it was one of the few ways to relieve pressure and prevent death after severe trauma to the skull.
Interestingly, trepanation is one of the earliest surgeries for which we have archaeological evidence. By the 1770s, surgeons had improved the tools used in the process, but they kept the procedure itself mostly the same.
Metacarpal Saw
A metacarpal saw is a special surgical tool with a narrow, serrated blade that helps surgeons cut small bones, especially the metacarpals, which are the “middle knuckle” bones in the hand.
Surgeons often use this instrument during surgeries like fixing broken bones or amputations.
Craftsmen make metacarpal saws from durable steel, allowing surgeons to sterilize and reuse them.
These saws enable surgeons to make clean cuts on delicate hand bones, which reduces damage to surrounding tissue. The design of the saw fits perfectly into a surgeon’s toolset, and its fine teeth allow cutting bone without needing a larger “capital” saw used for arms or legs.
When using the metacarpal saw, surgeons follow several steps.
First, they make an incision through the skin and muscle to reach the bone and expose the injured metacarpals. Then, the surgeon carefully uses the saw to cut through the bones, which helps remove broken pieces or perform a partial amputation. Speed and precision are crucial during this process, as quicker cutting lessens the time a patient feels pain and bleeds. At that time, doctors had no modern anesthesia and used minimal infection control, so efficient operations were essential.
Although techniques and tools have improved today, metacarpal saws were vital for treating severe hand injuries in the 18th century. And if a bone needs to be sawed, modern surgeons still use a fairly similar process.
Tourniquet
In the 1770s, colonial medicine often relied on a tourniquet as a simple but important tool to control bleeding during serious injuries or amputations.
Surgeons used a basic method by wrapping a band or strap around a limb, either an arm or a leg, and tightening it until blood flow slowed or stopped. This approach gave surgeons a clearer view of the area and helped prevent patients from bleeding to death during surgery or after a traumatic injury.
The word “tourniquet” comes from the French word “tourner,” which means “to turn.” This connects to early devices that often used a stick or rod to twist and tighten the band around the limb.
Surgeons included these tools in surgical kits from the late 17th and 18th centuries, primarily for battlefield and amputation medicine when wounds from muskets, swords, and accidents frequently caused heavy bleeding.
To apply a tourniquet, a surgeon or assistant would take a strip of linen, leather, or cloth and wrap it several times around the upper part of the injured limb. They would then insert a stick or rod into the knot and twist it to tighten the band, applying pressure to slow blood flow. Once bleeding slowed, surgeons could work on the wound or perform an amputation with better control over blood loss.
Because doctors had not developed anesthesia and sterile techniques yet, speed and control were vital. The tourniquet offered a basic way to manage the risk of uncontrollable bleeding in surgery.
Double Retractor
This tool featured two ends or blades designed to hold back skin, muscle, or other tissues during surgery. By using the double retractor, surgeons could see and operate more efficiently while working on a patient.
Retractors are instruments used to separate the edges of a wound or incision, keeping tissues out of the way and giving surgeons clear access to the area being treated. While most of the retractors we recognize today, like the Senn or Army-Navy retractors, were developed later, surgeons understood the basic idea of retractors long before the 19th century.
Surgeons needed tools that could mimic the action of human hands pulling tissue aside after making an incision, especially for deeper wounds where fingers alone were not enough.
Early retractors were often simple, made of hooked pieces of metal or shaped blades attached to handles. A “double” retractor provided symmetry, with blades on both ends, allowing surgeons to flip it and retract tissue in different directions without needing multiple tools.
To use a double retractor, the surgeon or an assistant would insert one end into the incision and gently pull back the edges of the tissue. This action kept the wound open, allowing the surgeon to see the underlying structures like bone or organs and operate more precisely.
Maintaining a clear view was important in an era without anesthesia or modern lighting since reducing the operation’s time and complexity could help lessen pain and decrease complications.
Bullet Probe
The bullet probe was a long, thin, needle-like tool.
Surgeons and doctors used this tool to locate a musket ball or other debris stuck deep inside a wound. During the Revolutionary Period, musket balls were the most common type of projectile wound. Because of this, the bullet probe became very important for fast and effective medical treatment for soldiers and unlucky civilians alike.
Additionally, gunshots often left foreign objects in injuries. As a result, doctors needed to find and remove these objects first before they could start proper treatment.
Ball Forceps
In the 1770s, colonial medicine used ball forceps, also known as bullet forceps, to retrieve musket balls from wounds.
These tools looked like long metal tongs with narrow jaws that could grip the smooth, rounded lead balls without slipping.
This was important because musket balls could carry dirt, cloth, and bone fragments into the body. If surgeons did not remove the ball, it could cause more pain, swelling, and a higher risk of infection.
Surgeons followed a straightforward procedure. First, they examined the wound and used a probe to locate the musket ball. Next, they would insert the ball forceps into the wound, grip the ball, and carefully pull it out in a steady motion.
If the ball was too deeply embedded or removing it could cause more damage, the surgeons sometimes decided to leave it inside. However, they often relied on ball forceps to extract the entire musket ball when possible.
Scalpel
The scalpel is a small and very sharp knife, and was used to make precise cuts in the skin and tissues during the 18th century, much like it is today.
At the time, people considered the scalpel the most important tool for surgeons. A medical man without his scalpel was like an artist without her paints.
They relied on it to perform almost any surgical procedure, including opening wounds, making them larger for better visibility, removing diseased tissue, and extracting embedded objects.
The term “scalpel” comes from the Latin word “scalpere,” which means “to cut.” Makers produced the blades from metal meant for repeated use.
Even though colonial medicine had limited knowledge of infection and pain control, the scalpel remained essential for giving surgeons greater control over their cuts and helping them finish procedures faster and with less trauma.
Trocar
In the 1700s, doctors used a trocar, a sharp, pointed instrument inside a hollow tube called a cannula. This odd-looking device created an access point into the body.
Although healthcare practitioners developed the trocar before the 19th century, they primarily designed early trocars to drain excess fluid or gas, especially when patients had dangerous buildups in their chest or abdomen due to injury or illness.
The surgeon pressed the pointed tip through the skin and underlying tissue, allowing trapped fluid to escape and relieving pressure.
Over time, similar designs evolved to introduce other surgical instruments, but the main purpose stayed the same: to create a controlled opening that safely provided access to the body during surgical procedures.
Fleam
A fleam, also known as a flem or flew, was an old instrument used for bloodletting during the 17th and 18th centuries. At that time, doctors considered bloodletting crucial for balancing a person’s health. They believed in the four humors theory and treated bloodletting as a necessary part of many treatment plans.
The fleam was designed to puncture a vein and remove blood easily.
It had a flat handle and a sharp, angled blade, sometimes with multiple blades. When a practitioner pressed or struck it with a small stick, the fleam quickly opened the vein while minimizing damage to nearby tissue. Doctors commonly used bloodletting to treat various conditions, believing that removing “bad blood” would restore balance to the body.
Although people later associated the fleam more with veterinary use, it still appeared in medical kits for human patients, often alongside simpler tools called lancets– small, sharp devices used to puncture the skin and obtain tiny blood samples for testing.
Capital Knife
The capital knife, a large and sturdy surgical knife, was designed mainly for amputations.
The term “capital” referred to major surgical operations, and surgeons intended this knife for one main purpose: to cut through the body’s outer layers quickly and cleanly to reach the bone. For smaller surgeries, surgeons used smaller tools, like the metatarsal saw we discussed earlier.
To begin, the surgeon tried to control bleeding using a tourniquet. Next, they would use the capital knife to slice through the skin and underlying tissue, opening the limb to access deeper structures.
Speed was crucial in these procedures due to the lack of effective anesthesia and the constant danger of heavy bleeding. This made a sharp and reliable knife essential for surgeons to work quickly and efficiently.
Mortar and Pestle
During the Revolutionary era, caregivers of all types relied on the mortar and pestle as essential tools to prepare many remedies.
The mortar is a heavy bowl, while the pestle is a tool used to crush and mix different ingredients, like herbs, roots, seeds, resins, and minerals, into powders or pastes.
This process was important because colonial medicine focused heavily on plant-based treatments. Caregivers or apothecaries would grind dried herbs and blend them into drinks, syrups, poultices, or salves.
Doctors kept the preparation hands-on by grinding both dried and fresh ingredients to create a consistent texture. Then, they mixed these with water, alcohol, vinegar, honey, or fat.
This allowed people to swallow the medicine, apply it to their skin, or pack it into cloth to treat wounds.
In a time without factory-made pills, the mortar and pestle transformed raw medicinal plants into usable medicine.
To Us, Today
As we think about medical practices during the Revolutionary War and the tools used at Washington Hall, we understand that learning about these instruments goes beyond just seeing them on display.
Recognizing what each tool was used for helps us see the 18th century differently. Instead of viewing it as a time of cruelty, we can see it as an era of problem-solving, improvisation, and skill in dealing with injury, infection, and uncertainty.
For the people who relied on these tools, they did not represent barbarism; rather, they stood for the best available answers to urgent medical questions. Practitioners used them while doing everything they could with the knowledge and resources they had.
Today, modern medicine may seem effortless with sterile rooms, anesthesia, antibiotics, and precise imaging. Because of that, it’s easy to overlook the long history of trial, experience, and courage that led to these advancements. These tools remind us that medical progress did not happen overnight. Generations built on observation and necessity, often in conditions we would find hard to imagine today.
When we remember this era, we honor both the medical professionals who worked under great limitations and the patients (both soldiers and civilians) who endured painful and risky treatments, sometimes their only chance at survival. While these instruments may make us uncomfortable, that reaction carries an important message.
The “Age of Agony” deserves our remembrance not for shock value, but because it shows how far we’ve come and highlights the incredible human determination that made progress possible.
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