Repro. Nelaton Bullet Probe Extractor Set Surg. Instrument Abe Lincoln Civil War

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Seller: elixir172n28 (290) 100%, Location: Rochester, New York, Ships to: Americas & many other countries, Item: 332877811676 Very interesting combination Nelaton style bullet probe & screw type bullet extractor, plus a straight bullet probe, both reproductions. Combination Nelaton probe and screw bullet extractor is 18.0 cm long, 4.5 mm wide handle, a 9 mm long screw and a 7 mm diam. sphere. In my opinion, especially because of the aged appearance of the wooden shaft, this looks more realistic than some Nelaton probes commercially available for re-enactors. The sphere looks realistic enough to be old white unglazed porcelain; the only way that I could tell this was not porcelain was by administering (gently) the "bite test." The sphere appears to be fashioned from very hard white plastic, not apparent even when holding it. Please see photos 10 & 11 for drawings of an original Nelaton bullet probe, for comparison. Both of these items were carefully made by a medical re-enactor who recently died. Screw-type bullet extractors were always more popular in Europe than the U.S., but they were available. Erichsen's 1869 surgical text does not discount their use and pictures two different styles of screw. Photo 9 shows part of page 83 from American Armamentarium Chirurgicum (Tiemann 1889 catalog reprinted), with an ebony-handled screw extractor. Photo 12 shows part of page 214 from the 1903 Collin catalog from Paris (screw extractor is the 2nd of the 4 items shown there). Screw extractors sometimes spun the bullet rather than remove it; because of this, an advanced Charriere version from around 1880 was made with a hollow guide having a serrated end, meant to stabilize the bullet in position with one hand while the dominant hand turned the screw into the lead. The straight metal bullet probe was the most commonly used bullet probe in the Civil War (see the quote from the 1869 Erichsen at the end of the material below). The Nelaton style probe had been just been invented in Europe late in 1862, during our Civil War, & would not have been purchased by or supplied to all field surgeons by the war's end in 1865. The straight metal probe, however, had been available for years. Look carefully at photos 8 & 11, which picture originals of this type of probe. Photo 8 is part of page 82 from American Armamentarium Chirurgicum, which is an 1989 reprint of the 1889 Tiemann catalog, not included (photo 10 is another part of that same page). Photo 11 is part of page 46 from C. Keith Wilbur's Civil War Medicine, also not included. The re-enactor who made this did a really nice job of duplicating this in appearance, I think. It appears to be made from steel. Length is 18.0 cm, width of spade end is 4 mm, diameter of shaft is 2 mm, & the bulbous tip is 4 mm. Nelaton bullet probes were extremely popular in the late 19th century for locating bullets; it was a brilliant idea by a genius surgeon with a famous patient (see below). The first human X ray picture by Rontgen was not until 1895...Nelaton's idea became part of a useful medico-cultural "techno-fascination," along with over-emphasis of the importance of slug removal (see your favorite cowboy movie for the "clink" in the pan). A Nelaton probe was sent for (and used) by the physicians caring for President Abraham Lincoln immediately after his April 14, 1865 assassination (see case report of A.L. below). Original Nelaton bullet probes have an unglazed porcelain ball at the tip. Rotating the probe against the concealed lead slug deep in a wound would confirm that the bullet was still in the wound tract by leaving telltale greyish color on the rough porcelain surface (whereas bone shards would not leave color on the sphere). The maker of this reproduction has skillfully made the sphere out of very hard white plastic, very difficult to tell from porcelain without the bite test. In fact, this reproduction looks much more realistic than the real probe that was used on Lincoln, preserved in the National Museum of Health & Medicine (NMHM) in Silver Springs, Maryland, because the porcelain tip has been lost from that famous artifact (as recounted below)! See below for additional historic information about this important historical surgical instrument (source credited below): Nelaton Bullet ProbeCase---A.L.----, aged 56 years, was shot in the head, at Washington, on the evening of April 14th, 1865, by a large round ball, from a Derringer pistol, in the hands of an assassin. Dr. Charles A. Leale being close at hand, went instantly to the wounded man, whom he found "in a profoundly comatose condition," * * the breathing "exceedingly stertorous." (These and other quotations in the first part of this abstract, are taken from a report compiled by Dr. Leale, from notes made at the time.) No pulsation was perceptible at the right wrist. When the head was examined, "I passed my fingers over a large firm clot of blood, situated about one inch below the superior curved line of the occipital bone and an inch and a half to the left of the median line of the same bone. The coagulum, I easily removed, and passed the little finger of my left hand through the perfectly smooth opening made by the ball, and found that it had entered the encephalon. As soon as I removed my finger, a slight oozing of blood followed, and his breathing became more regular and less stertorous." After the administration of a small quantity of brandy and water, of which a mouthful appeared to have passed into the stomach, the patient was removed to a neighboring house, with the assistance of Acting Assistant Surgeons C.S. Taft and A.F.A. King, and others. His clothing was removed and he was placed in bed. His extremities were cold. He was covered with warm blankets, and bottles of hot water were applied to the lower extremities. It was now about eleven o'clock at night, the wound having been inflicted about half past ten. His family physician, Dr. Robert H. Stone, and Surgeon General Barnes, and Assistant Surgeon General Crane, arrived presently, and assuming charge of the case, proceeded to examine the patient and the wound. The pulse was very feeble and vacillating, from 40 to 48; the respiration was oppressed and labored; the surface was cold. Over the left eye-lid there was slight ecchymosis. "The pupil of that eye was slightly dilated, the left pupil was contracted;" both were irresponsive to light. Sinapisms were applied to the surface. A few drops of brandy and water placed into the fauces was not swallowed, and the attempt to administer internal stimulants was not insisted on. It was observed that when blood and cerebral matter oozed unimpededly from the wound the condition of the pulse and respiration improved. The Surgeon General accordingly kept the external wound open by means of a silver probe, until, a Nelaton's probe being brought, he made an exploration of the course of the ball. A splinter obstructed the track at the depth of about two and a half inches. An inch and a half further on the bulb came in contact with a foreign body, which proved to be the disk from the occipital forced out by the ball; passing beyond this the ball was detected, at a distance over six inches from the entrance wound. Drs. Stone and Crane having also distinctly felt the ball at this depth in contact with the bulb of the probe, it was decided that no attempt should be made to remove it or the foreign bodies, further than "to keep the opening free from coagula, which when allowed to form and remain for a very short time, would produce signs of increased compression, the breathing becoming profoundly stertorous and intermittent, and the pulse more feeble and irregular." Notwithstanding the free oozing from the external orifice, there was evidently much bleeding going on, as was indicated by the excessive extravasation into the orbits, accompanied by great ecchymosis of the eyelids. The protracted death-struggle ceased at twenty minutes past seven o'clock on the morning of April 15th, 1865. At noon, an autopsy was made in the presence of the Surgeon General and others, by Assistant Surgeon J.J. Woodward, U.S.A., aided by Assistant Surgeon Edward Curtis, U.S.A. The following is an extract from the official report to the Surgeon General by Dr. Woodward, compiled the same day from notes taken at the time of the post-mortem examination: "The eyelids and surrounding parts of the face were greatly ecchymosed and the eyes somewhat protuberant from effusion of blood into the orbits. There was a gunshot wound of the head, around which the scalp was greatly thickened by hemorrhage into its tissues. The ball entered through the occipital bone about an inch to the left of the median line and just above the left lateral sinus, which it opened. It then penetrated the dura mater, passed through the left posterior lobe of the cerebrum, entered the left lateral ventricle, and lodged in the white matter of the cerebrum just above the left corpus striatum, where it was found. The wound in the occipital bone was quite smooth, circular in shape, with beveled edges, the opening in the internal table being larger than that through the external table. The track of the ball was full of clotted blood and contained several little fragments of bone, with a small piece of the ball near its external orifice. The brain around the track was pultaceous and livid from capillary hemorrhage into its substance. The ventricles of the brain were full of clotted blood. A thick clot beneath the dura mater coated the right cerebral lobe. There was a smaller clot under the dura mater of the left side. But little blood was found at the base of the brain. Both the orbital plates of the frontal lobe were fractured, and the fragments pushed up toward the brain. The dura mater over these fractures was uninjured. The orbits gorged with blood." * * * Basing his remarks on an account of this case and of the post-mortem examination published by Acting Assistant Surgeon C.S. Taft,* Professor T. Longmore, of Netley, observes: The autopsy showed that the projectile had penetrated the occipital bone one inch to the left of the longitudinal sinus; had driven before it, for about three inches, the piece of bone which it had punched out, as it were; and that, leaving this fragment behind, it had itself then passed on obliquely across, from left to right, through the brain substance to the anterior lobe of the right hemisphere, in which it lodged, immediately over the right orbit. The ball did not strike the anterior part of the cranium, its force having been expended before reaching so far; yet at the autopsy, according to the report of the post-mortem appearances furnished by Assistant Surgeon C.S. Taft, U.S.A., to the Philadelphia Medical Reporter, "the orbital plates of both orbits were found to be the seats of comminuted fracture, the fragments being forced inward, and the dura-mater covering them remaining uninjured. This double fracture is decided to have been caused by contre-coup. If the term 'contre-coup' be limited to its precise signification of 'counter-stroke'--i.e., the impression made by the stroke on the part of the cranium opposite to that directly struck by the ball--will the force of contre-coup explain the fractures in this instance? It seems very difficult to conceive that the orbital plates could be fractured by such a counter-stroke, while the portion of the cranial arch opposite to that which received the primary blow, including the expanse of the frontal bone and the several processes within which the orbital plates are held, and by which they are so strongly protected in all directions laterally remained entire and unchanged. I am inclined rather to attribute the lesions mentioned to a transmitted undulatory stroke or sudden impulse of the brain-substance itself, against the thin bony layers constituting the orbital plates. I am in possession of the notes of a case in which a similar fracture took place in one orbital plate, from a ball passing along, only grooving, the upper surface of the hemisphere lying over the plate broken. In this instance there was no reason to doubt that the impulse communicated to the brain substance by the passage of the projectile had been continued on with sufficient force to the orbital plate to effect its fracture." Case report of President Abraham Lincoln's assassination & medical care, including specific remarks on the use of the Nelaton probe. Pgs 305-6, Surgical Volume, Part First, The Medical and Surgical History of the War of the Rebellion, U.S. Government Printing Office, 1870. Artifact History: Nélaton probe The collection of the National Museum of Health and Medicine (NMHM) contains several objects relating to Presidential health and care. In regards to the Lincoln assassination, the museum contains items extracted from both the President and his assassin during their subsequent autopsies. Booth’s vertebrae and a piece of his spinal cord, through which Boston Corbett’s bullet passed, are housed in this collection. From Lincoln’s autopsy, the museum has pieces of Lincoln’s skull, the bullet that took his life, and some hair clippings taken by the doctors and surgeons as mementoes. The collection was once housed at Ford’s Theatre from 1865 – 1887 when it was called the Army Medical Museum. During that time at Ford’s however, the Lincoln relics were not part of the collection, only Booth’s pieces were there. In fact, the bullet that killed Lincoln was entered as an official exhibit during the Conspiracy Trial and it, along with the skull pieces, were housed with the other evidence in the office of the Judge Advocate General. In 1940, the exhibits were donated to the Lincoln Museum (Ford’s) who then gave the bullet and pieces of Lincoln to the Medical Museum. So while pieces of Lincoln and Booth both returned to the venue of their last living meeting, it was not at the same time. In addition to the bullet and the skull fragments, the National Museum of Health and Medicine also has a rather unassuming instrument housed with these Lincoln relics: a long, medical probe: Lincoln’s skull fragments and Nélaton probe (NMHM) This probe has a specific name and a specific function. Called a Nélaton probe (or Nélaton’s probe) it was used by the doctors during Lincoln’s final night to ascertain the depth and path of the bullet in Lincoln’s head. Before delving into that, however, let’s look at the history behind this medical tool. In 1862, Italian general Giuseppe Garibaldi, was shot while trying to take control over the city of Rome. At that time, Italy had just completed a massive unification to create one kingdom. This kingdom of Italy later became the republic of Italy as we know it now. However, as of 1862, several cities in Italy did not accept unification and Rome was one of them. Tired of waiting for them to come around, General Garibaldi decided to raise a volunteer force to take the city of Rome. The Battle of Aspromonte, as it was called was fought between Garibaldi’s men and the Royal Army of Italy on August 29th, 1862. Both sides were hesitant to harm the other as they were countrymen and Garibaldi was well liked and supported by the people of Italy. When the Royal Army “attacked” Garibaldi’s forces, he ordered his forces not to fire on their brothers. One part of his army did attack though, and during the fire fight, Garibaldi was hit three times. The battle lasted less than ten minutes with only 15 combined casualties. Garibaldi and the rest of his volunteers were arrested and imprisoned. While imprisoned, Garbaldi was still given the respect and medical treatment he deserved. Two of the three shots Garibaldi received were to the hip and proved easily treatable. The third shot hit Garibaldi’s right ankle, just a little above and in front of what we would consider the “ankle bone” (scientifically, it was his internal malleolus). This wound pained him greatly. When he was on the battlefield, a surgeon had made an incision on the opposite side of the wound when he felt swelling but found nothing inside of it. A few days after the battle, Garibaldi was re-examined by more than half a dozen doctors who all believed, save one, that the bullet was no longer in his ankle. Meanwhile, in England, supporters of Garibaldi in the medical field took it upon themselves to see if they could help the general. In an extremely presumptuous way, the English doctors elected that Dr. Richard Partridge, professor at King’s college, should travel to England and check on Garibaldi’s wound and treatment. When Dr. Partridge arrived on September 16th, he examined Garibaldi himself, and came to the same conclusion of the Italian physicians: the ball was no longer in his ankle. He returned back to England and guaranteed his colleagues and the press that, while Garibaldi was still in considerable pain, it was not caused by a bullet being lodged in his ankle. Dr. Partridge believed his condition would improve in time. After five weeks, though, no improvement was noted and Garibaldi was still in quite a deal of pain. This time, the Italian doctors reached out. They sent for Auguste Nélaton, a Parisian professor of surgery. He arrived on October 28th and examined Garibaldi himself. After inserting a normal probe into the wound, he was convinced that the bullet was still in there. The Italian doctors did not concur, citing Dr. Partridge’s agreement of their initial assessment. So, Dr. Partridge returned. Soon, Garibaldi’s sick room became an international conference with the Italian doctors, the Frenchman Nélaton, the Englishman Partridge, and even a Russian physician all prodding and poking General Garibaldi. Dr. Partridge actually changed his mind and started believing that the bullet was still in the general’s ankle. Nélaton, believing amputation to be unnecessary, ordered that the wound entrance be widen with sponges so that the bullet could be removed in time. While the Italian doctors followed this idea, they were still unconvinced that there was a bullet in Garibaldi, and were getting sick of all these foreigners going back and forth on the matter. Auguste Nélaton attending to General Giuseppe Garibaldi in 1862 (National Library of Medicine) When Nélaton returned to France, he started working on a way to prove that there was a bullet in Garibaldi. The problem was that it was impossible for a physician of the time to identify the hard substance met by a probe in a wound. It could be normal bone or a foreign substance like a bullet. The bulk of the Italian doctors believed their probes continually hit the normal bone structure of the ankle, while Nélaton thought it was a bullet. Nélaton began constructing a new probe for his purposes. In the end, his probe was ingenious in its simplicity. At the tip of a normal medical probe he attached an unglazed porcelain tip. When the porcelain touched bone inside a wound, the probe would be unaffected. When it rubbed against the lead of a bullet however, the tip would become marked identifying it as a foreign substance. Nélaton quickly sent his new instrument to the doctors in Italy. After using it to confirm Nélaton’s diagnosis that the bullet was, in fact, still in Garibaldi’s ankle, the Italian physicians were able to successfully remove it on November 22nd. Shortly thereafter General Garibaldi sent a letter to Auguste Nélaton offering his love, gratitude, and thanks. Nélaton’s probes proved wonderfully efficient. They started to be produced on mass and were shipped all over the world. They quickly became an instrument of necessity for any military surgeon and found a market in the surgeons fighting on both sides of the American Civil War. They continued to be used into the 1900’s before they were essentially replaced by the advent of less intrusive devices like the X-ray. Let’s return now to the night of April 14th, 1865. Lincoln was taken to the Petersen House across the street from Ford’s after being shot. There, he was attended to by several doctors including the Surgeon General Joseph Barnes and the first responder, Dr. Charles Leale. At first, the doctors introduced regular, silver probes into Lincoln’s wound. However, like in Garibaldi’s case, they were unsure if the solid mass they encountered was the bullet or a piece of Lincoln’s skull. A steward was then sent for a Nélaton probe. From Dr. Leale’s account we can learn how they used the device: “About 2 AM the Hospital Steward who had been sent for a Nelatons probe, arrived and an examination was made by the Surgeon General, who introduced it to a distance of about 2 ½ inches, when it came in contact with a foreign substance, which laid across the track of the ball. This being easily passed the probe was introduced several inches further, when it again touched a hard substance, which was at first supposed to be the ball, but as the bulb of the probe on its withdrawal did not indicate the mark of lead, it was generally thought to be another piece of loose bone. The probe was introduced a second time and the ball was supposed to be distinctively felt by the Surgeon General, Surgeon Crane and Dr. Stone.” Using Nélaton’s probe, the doctors established that the bullet was above and behind Lincoln’s right eye. Between its use in the early hours of April 15th and today, the Nélaton probe used by the doctors on Lincoln has lost the porcelain tip that marked the bullet. While the first person to utilize Auguste Nélaton’s invention made a full recovery because of it, it was well established before the probe was introduced in Lincoln’s case that he was beyond help. The Nélaton probe did not change Lincoln’s medical prognosis as it did for Garibaldi, but it is still a historically relevant artifact. Its inclusion in the collection of the National Museum of Health and Medicine is so that it can be a testament to the devotion of the doctors who cared for President Lincoln. Despite the hopelessness of his situation, doctors like Barnes, Leale, Taft, and others, did all in their power to aid and comfort the fallen President. The above section excerpted from boothiebarn dot c o m (a great website, take a look) Various instruments are used for the detection and removal of bullets and other foreign bodies. There is usually no material difficulty in detecting the presence of a bullet, by means of an ordinary steel probe of sufficient length. In some cases of peculiar and exceptional difficulty, where the bullet is ledged deeply in the cancellous structure of a bone, or amongst swollen and infiltrated tissues, its presence may be detected by the ingenious device adopted by Nelaton in the case of Garibaldi, of passing a probe armed with a piece of unglazed porcelain down to the suspected site of the bullet, and seeing if a streak of lead was left on the rough surface of the china. -J.E. Erichsen, The Science and Art of Surgery, Gunshot Wounds, p 146, 1869. Condition: Good condition for reproduction Nelaton/extractor...see photos. Realistic antique appearance.Very good condition for straight probe. 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