Michael Mauer reached to the shelf across from his desk and picked up a varnished walnut case with a small brass plaque attached to its lid. It looked like it might contain a family's good silver.
He ran his finger along the edge of its red velvet lining until he came to a large double-edged knife with an ebony handle. It was not made to carve turkeys.
"Most field surgery was amputation," Mauer said, looking at the still-sharp cutting edge.
The walnut box contains a field surgery kit from the Civil War, Union side. According to the inscription on the brass plaque, it belonged to Andrew B. Chapin, MD, of Flint, Mich.
It is just one example of the artifacts spanning more than 2,000 years of the practice of medicine that are on display at the Los Angeles County Medical Assn. Library. The library, which also contains 125,000 contemporary and antiquarian books of medical interest, is open to the public by appointment.
As the curator of the medical artifact collection, Mauer has an office that is more museum than workspace. It is a monument to surgical instruments, circa 1850 to 1950. They are lined up along shelves, some in cracked and weathered black medical bags. Others, like the Civil War surgical instruments, are in kits. Stethoscopes, scalpels, syringes, non-disposable tongue depressors and other instruments line the shelves as though it were the bargain basement of a medical surplus supply house.
Serrated Cutting Edge
Continuing to poke through the Civil War kit, Mauer lifted out a trephine. It is a hollow tube with a serrated cutting edge and a bone screw-on knob that looks like it might fit on a fancy water faucet. It was used to cut into the skull to work on head wounds.
Alongside it is a skull saw. Then, Mauer lifted out a delicate-looking bone brush for removing bone chips from the tools after use.
"Basic medical instruments are very constant, evolving slowly," he said. "They hardly changed from 1600 to the discovery of antiseptic surgery. Then the change was in materials, not function."
To provide an example, he unrolled a canvas bag that holds a World War I American field surgery kit. Many of the instruments are unused. Others--those that Mauer said were most likely to be used in general practice--are missing.
He withdrew the large knife, called a catling. It looks similar to its Civil War counterpart, except for the handle. The ebony handle on the earlier one was crosshatched to improve the surgeon's grip. The later one was cold steel.
Picking up the earlier knife, Mauer said, "It looked good and it felt good to hold, but this handle was impossible to sterilize." He said that while the advantage of operating in a sterile environment was discovered by the time of the American Civil War, the practice had not yet been adopted by most American doctors.
Trend to Disposability
Other common medical tools have met the need for sterilization by becoming disposable. Mauer gestured toward a World War I syringe. It is metal and--unlike its plastic counterparts today--was meant to be permanent. From both a health and convenience standpoint, the plastic instrument is an improvement, Mauer said.
An anthropologist by training, Mauer, who admits to a fascination with old medical instruments, uses a large collection of medical supply catalogues to pin down exactly how old a given medical instrument may be.
His catalogues range from around 1850 to the present. From examining the catalogues, he said he is struck by how long obsolete instruments continued to be sold. For example, he said monaural (single-ear) stethoscopes were catalogued until 1951. Bloodletting instruments survived into the early 1940s.
"Physicians, like everyone else, tend to use what they are used to using," he said. "Even in the face of improvements."
The library owns two examples of the "Wilshire Belt." Gaylord Wilshire believed that the Wilshire Belt (called the Ionaco Belt to the more scientifically minded) would cure arthritis when applied to the affected part of the body by magnetizing the iron in the bloodstream.
The belt, which was marketed around the turn of the century and looks something like an old-fashioned horse collar, plugged into a wall socket. It had an inner ring that lit up.
Wilshire Believed in the Belt
According to Mauer, Wilshire (the entrepreneur for whom Wilshire Boulevard is named) apparently believed in the belt: "He wasn't an out-and-out quack," he said. "They probably worked to some extent because people thought it would work."
Another variation on the theme were the "Violetta Rays," an instrument that supposedly shot electrical current through open-ended glass bulbs. Mauer said the makers claimed the product created ozone, which was thought at the time to be a healthy thing to inhale. Said the advertising of the period: "Good for relieving conditions from alcohol and drug addiction to writer's cramp."
Elizabeth Crahan, director of library services, gestured toward a display case of medical instruments that date back to the Roman Empire. There is a crude pair of shears, pitted and corroded, but still operational, she said. Near it is a bronze cucurbital, or cupping device.
She said a piece of burning material, often linen, was placed into the cup. The heated cup was placed on the skin, raising a blister. If the skin had been broken by a scarring instrument, called a scarificator, it would draw blood.
"It is a very ancient form of therapy," Crahan said. "It was thought to remove evil from the body."
She said the Romans used cupping devices to cure fever, rheumatism and a number of other maladies.
"It has been done up to fairly recent times," she said. Some older people remember having it done to them."
There are other Roman instruments, such as sutures, that are still used in updated forms today. Mauer said the Romans engaged in a few basic surgical techniques. "They dealt with wounds, abscesses, infections."
Away From Center of Empire
Some of the Roman instruments were found thousands of miles away from the center of the empire. "The Romans probably took some things with them wherever they went," Mauer said. "It was standard medical gear--things they considered essential at the time."
Some of the instruments on display even predate the Romans. There is an unguents, or ointment, jar found from the Mesopotamian area. A horse's head acts as a cork on the applicator.
"That indicates that these people were a nomadic tribe," Crahan said. "They used the horse a lot.
"If there were salves and things they wanted to apply, they kept those jars for that purpose."
The library can be contacted at (213) 483-4555.