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July 10, 2009

BehindTheMedspeak: Old School Surgical Instruments

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Above, an amputation knife from the 1700s.

"Knives used for amputations during the 18th century were typically curved, because surgeons tended to make a circular cut through the skin and muscle before the bone was cut with a saw. By the 1800s, straight knives became more popular because they made it easier to leave a flap of skin that could be used to cover the exposed stump."

Below, a skull saw (1830s-1860s).

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"This hand-cranked saw's blades were used to cut through sections of the skull, allowing for access by other instruments."

Next, an arrow remover.

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"Not much is known about this tool, but it is hypothesized that it was inserted into the wound in a contracted position, with the central shaft used to grasp the arrow. The blades, which appear to have their sharp edges facing outward, were then expanded using the scissor-like handles, thus expanding the flesh around the arrow to prevent the arrowhead from ripping through the meat as it was pulled out."

Below, a circumcision knife from the 1770s.

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"Ritual circumcision is performed around the world to varying extents and for varying reasons, but few instruments used in the process are as intimidating as this European knife from the 18th century."

Here's an artificial leech from the 1800s.

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"Bloodletting with leeches was such a popular treatment for a range of medical conditions that an artificial leech was invented in 1840 and was used frequently in eye and ear surgery. The rotating blades would cut a wound in the patient's skin, while the cylinder would be used to produce a vacuum that sucked up the blood."

Finally, a mouth gag (1880s-1910s).

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"This wooden, screw-shaped mouth gag would be inserted into an anesthetized patient's mouth to keep the airway open."

FunFact: Believe it or not, there were a couple plastic versions of the mouth gag above in the utility cabinet of the anesthesia workroom โ€” where we got our drugs and tubes and whatnot for the day's cases each morning โ€” back when I was resident at UCLA.

You didn't know I was that old, did you?

I asked Dr. Katz, our chairman, what the devices were for and he told me that if a patient clamped their mouth shut and bit the endotracheal tube at the end of a case when they got light, it was useful for opening the jaws and providing an entry for a conventional oral airway.

Who knew?

I thought it was kind of cool so I put one in my tackle box.

Never used it.

But I still have it.

You never know....

[via Vital Signs, Milena and RM]

July 10, 2009 at 02:01 PM | Permalink


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Comments

Those old things are strangely beautiful in a creepy and terrifying way. It's kind of like when you're a kid and while you're over at a friend's house you have to pee, and in their parents' bathroom there's this big old rubber douche bag and hose hanging up in the shower. THAT kind of creepy and terrifying, except without the beauty part. Hey -- steampunk surgical instruments! I can't stop looking at that skull saw... very Cronenberg. The circumcision knife looks like a pie server, and until I read that it was a mouth gag, I just knew that wooden screw was going to be some kind of rectum-dilating constipation reliever. Eew.

Posted by: Flautist | Jul 10, 2009 4:30:52 PM

very cool info, thanks!

Posted by: teg | Jul 10, 2009 2:56:58 PM

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