The 12 Instruments of Deathmas (Fa-la-la-la-la!)


The holidays rarely afford me an opportunity to engage with others about my favourite subjects. Try opening a conversation at a festive party with: “So, did you know that a decapitated head may retain consciousness for 6 seconds after death?”

Trust me, it usually doesn’t go down well.

But that got me thinking – surely you, my devoted readers, expect a bit of gore this holiday season. After all, you are a rare bunch who appreciates the deathly things in life…even in the midst of joyous fa-la-la-ing and chestnut roasting. Who am I to disappoint?

So without further ado, here is my gift to you this Deathmas: 12 of the strangest (and most dangerous) medical instruments from yesteryear!

L0057778 Brass scarificator, Italy, 16691)   The Scarificator (17th century)

And kicking us off is a bloodletting instrument with a very scary name! This particular example dates from the late 17th century and has 14 blades hidden beneath its lower surface. When placed against the skin, and released by the trigger, these metal blades emerged and slashed rapidly into the patient’s skin. Skill was needed to make sure that the blades did not go too deep into the body, which would not only be painful, but dangerous as well.

A bullet extractor2)   The Bullet Extractor (16th century)

Many surgeons in the 16th century believed gunpowder was poisonous and that bullets needed to be extracted even when embedded deep inside the body’s tissues. The bullet extractor was just the instrument for this job! This particular example has a hollow rod which contains a screw that could be lengthened or shortened by turning the handles. The instrument was placed directly inside the wound; the screw was then lengthened to pierce the bullet thus removing it from the body.

Lister-type tourniquet, London, England, 1866-19273)    Lister-Type Tourniquet (19th century)

Invented by Joseph Lister (1827-1912)—the father of antiseptic surgery and for whom the mouthwash, Listerine, was named after—this tourniquet was used to compress the abdominal aorta, the largest artery in the abdomen. One of the pads is fixed while the other is moveable. Far from saving lives, this instrument likely caused many deaths. Lister eventually abandoned it after discovering it often damaged other internal organs during the course of the operation.

Double bladed bistoury caché, Europe, 1501-15304)   Double Bladed Bistoury Caché (16th century)

In French, bistoury caché translates as ‘hidden knife.’ The device was used to cut internal organs or to open cavities, particularly during the surgical removal of a bladder or kidney stone – a practice known as lithotomy [click here for more on this terrible surgery].

Trephine with bit attached, Strasbourg, Austria, 1780-18205)   Trephine (18th century)

Attached to the trephine is a bit for drilling into the skull during trephination. The bit can be removed and replaced by unlocking the clip on the handle. The brace has an ornate handle which is characteristic of the 18th century. It is made of ebony and steel, both hardwearing materials suitable for the difficult job of drilling through bone. Trephination is an age-old practice dating back thousands of years and was often used to relieve pressure in the skull.

Artery forceps, Paris, France, 1831-1870

6)   Artery Forceps (19th century)

Just as the name implies, artery forceps were used to seal off small blood vessels or to hold the artery out of the way during surgery. Although a version of this instrument is still used today, we can imagine it was a lot more dangerous in the past when these forceps would have been plunged into a person’s open cavity without being sterilized first.

Clover's lithotomy crutch, London, England, 1860-19047) Lithotomy Crutch (19th century)

This device was used to hold a patient in position during a cringe-inducing lithotomy operation during which kidney or bladder stones were removed. The patient would lie face up with their buttocks positioned at the end of the operating table [see illustration]. The hips and knees were fully bent and the feet were locked in position using a crutch. This example was invented by Joseph Clover (1825-1885), a surgeon and anaesthetist. Clover became an expert at lithotomy procedures and also invented a number of other instruments to aid his work.

Skull saw, London, England, 1831-18708)  Skull Saw (19th century)

It doesn’t get any more terrifying with a name like ‘skull saw!’ The chainsaw-like blade of this unusual instrument is moved by turning the handle in a clockwise or anticlockwise direction and is designed to saw through sections of the skull. Skull saws were used to remove fragments of bone in order to provide access for other instruments. They were commonly used in the 19th century, although some surgeons preferred to use chisels or gouging forceps. What a lovely alternative!

 Mallam's vaccinators9) Mallam’s Vaccinators (19th century)

The 1853 Vaccination Act required that every child between the ages of 3 and 4 months be vaccinated against smallpox. Consequently, a large number of different types of vaccinator were developed by medical men and manufactured by surgical instrument companies. Mallam’s model adapts the principle of the mechanical scarificator [above], but employs gilded steel teeth in the place of blades. The surface is concave so that it can fit the arm of a child.

Four double blades are triggered from the base using the lever on top. All of the blades would have been prepared by being dipped in lymph material from the pustule of a person already vaccinated. Pustules are skin blisters filled with pus that appear approximately five to eight days after vaccination. Vaccination did not give life-long immunity.

Part of male anti-masturbation apparatus10) Anti-Masturbation Apparatus (19th century)

This is pretty self-explanatory…and utterly ridiculous! It is part of a male anti-masturbation apparatus dating from the late 19th (possibly early 20th) century. The device attaches to a belt and was worn by boys to prevent them from committing the ‘sin’ of masturbation.

Enough said.

Amputation knife, Germany, 1701-180011) The Falciform Amputation Knife (18th century)

The falciform amputation knife is the official symbol of The Chirurgeon’s Apprentice and thus warrants revisiting here, especially given its terrifying purpose. It was the popular tool of choice by 18th-century surgeons who preferred to cut through the skin and muscle before amputating the bone. To do this, the surgeon would take the falciform knife, hook it around the injured or infected limb, and cut in a circle to separate the flesh and muscle from the bone. After this had been completed, the surgeon would then use a surgical saw to cut off the remaining appendage. A good surgeon could do all this in under 2 minutes.

Unfortunately, very few people survived such trauma.

Watts-Freeman lobotomy instruments.12) Leucotome (20th century)

I like to save the most terrifying for last, and even more shocking about this instrument is that it was invented in fairly recent times by Walter Freeman—the father of the ‘lobotomy.’ The leucotome was inserted into the patient’s tear duct and then lightly hammered into the thin layer of bone with a surgical mallet. Next, it was pushed into the frontal lobe of the patient’s brain about 1.5 inches and moved back and forth. This process was then repeated in the other eye to complete the frontal lobotomy. Freeman performed nearly 3,500 lobotomies over the course of his career using this method before his medical license was revoked in 1967.

*Some of the above descriptions have been adapted and expanded upon from the Science Museum’s website.

By | 2012-12-05T15:17:01+00:00 December 5th, 2012|Casebooks|19 Comments


  1. nightsmusic December 5, 2012 at 5:38 pm - Reply

    I often think I was born centuries too late. Then I read your blog and am reminded that really, I wasn’t…


    On another note, how’s mom?

    • The Chirurgeon's Apprentice December 5, 2012 at 5:39 pm - Reply

      So true… medical history has a way of shattering the romance of the past 🙂 My mom is doing well – thanks for asking. Slow healing but right now, she is cancer free. Still waiting to hear of she needs chemo but it looks promising!

  2. altheapreston December 6, 2012 at 1:35 am - Reply

    Fabulous news! I’m so glad to hear that. You’ve both been in my thoughts since the surgery.

    And aren’t you so glad it was done in this day and age?

  3. altheapreston December 6, 2012 at 1:36 am - Reply

    Oh, this is my alter-ego to the first post as nightsmusic, btw…

  4. Fiona Orr December 6, 2012 at 6:27 pm - Reply

    It would be nice if we could shudder and then move on, but seeing the last, which was used in the 20th century, I cannot do that. All of those “instruments” are grim in the extreme!

  5. Emily December 7, 2012 at 12:29 pm - Reply

    Just wanted to say that the title of your post gave me a good chuckle. And yes – number 12 is absolutely horrifying!

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  7. E. C. Ambrose December 10, 2012 at 2:44 pm - Reply

    Yeah, I love it when people ask if I’d want to live in the Middle Ages. My usual reply is one word: penicillin. But now, I can point them to your blog–and this stuff is recent compared to the tools I write about!

  8. […] Lindsey Fitzharris of The Chirurgeon’s Apprentice got ready for the holiday season by picking 12 (medical) instruments of Deathmas; most are sure to make you squirm. Caro of The Quack Doctor writes about the fun and games at […]

  9. Jack El-Hai (@Jack_ElHai) December 19, 2012 at 3:43 pm - Reply

    What a collection! A minor correction: Walter Freeman’s medical license was never revoked. But he did eventually lose operating room privileges at the last hospital (Herrick Memorial in Berkeley) that had allowed him in.

    • The Chirurgeon's Apprentice December 19, 2012 at 4:50 pm - Reply

      Thanks for this! I had read in three separate sources that his license had been revoked in 1967 – perhaps they were confusing this with the lose of the operating room privileges?

  10. […] of the strangest surgical instruments in history. Number one is “The Scarificator”. No, […]

  11. Doc. Kick ass January 15, 2013 at 11:36 pm - Reply

    I feel bad for the sons of bitches who had to go through this shit.

  12. kitchenmudge February 17, 2013 at 6:35 am - Reply

    Nice collection. Mention of lithotomies reminded me of a story L.R.C. Agnew once told me about surgery before anaesthetic: that in the 19th century there was a surgeon who advertised that he could remove a bladder stone in something like 23 seconds flat. Don’t know whether Agnew wrote about this or read it in someone else’s work.

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    • The Chirurgeon's Apprentice March 11, 2013 at 1:38 pm - Reply

      Thank you so much for your kind comments! I started The Chirurgeon’s Apprentice a little over 2 years ago… still surprised by the level of interest in it after all this time! It’s great to hear positive feedback x

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  16. vadocdoc December 14, 2013 at 11:55 am - Reply

    Charming. And about the leucotome, I had patients in the beginning of my career (1980s) who had undergone that procedure and still showed the scars around the orbits. So we’re not far removed from the barbaric, methinks.

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