The Navy Surgeon's Chest: Surgical Instruments of the Royal Navy during the Napoleonic War

The surgeons of the Royal Navy in the late eighteenth and early nineteenth centuries were obliged to procure their own instruments before taking up post on ship. The Company of Surgeons (Royal College after 1800), as well as examining surgeons for their fitness to practise in the Royal Navy, was granted the privilege of examining the surgeons' instrument chests. This privilege was originally bestowed by Charter of Charles I1 and it was an honour that was jealously guarded by the Surgeons. They fought off an attempt to hand this duty over to the Surgeon and Physician of Greenwich Hospital in 1715 and once again in 1795. When the Company became the Royal College of Surgeons in 1800, they retained this ancient honour; but the Navy Regulations of 1805 no longer mention it, and when the College ceased this practice is not clear.2 Royal Navy Regulations of 1731 stated that, after examination, the chest was to be locked ‘and the seals of the Physician and of the Surgeons' Company to be affixed thereto in such a manner, as to prevent its being afterwards opened, before it comes on board; nor is the Captain to admit any Chest into the Ship without these marks upon it’.1 The purpose of this examination was twofold. First, it ensured that the surgeon had the correct instruments and these were of sufficient standard to cope with the variety of procedures encountered during a long sea voyage. Second, the seals prevented the surgeon from selling or pawning any of the instruments to recoup some of his capital before boarding the ship. The pay of the Navy surgeons was meagre and they were unlikely to be able to afford fine sets of matching instruments. A capital set of instruments, sufficient for most procedures, cost between 18 and 25 guineas at this time (Crumplin MKH, Personal communication). Full surgeons were paid £5 a month2 and the pay for assistant surgeons and surgeons' mates was between £2 and £3 a month.3 Since the time of Charles I, an allowance was granted to the surgeon to buy instruments and medicines; in 1781 the allowance for a senior surgeon was £62. This was hardly sufficient to provide the instruments and adequate medicines for the whole crew on a long sea voyage. The poorly paid surgeon would fulfil his duty as cheaply as possible, gathering together instruments of varying makes and quality. After 1805, the medicines were provided by the Navy but the surgeon still had to buy his own instruments.2 This was not the case for Army surgeons during this period; each company purchased an instrument chest for its surgeon. The list of instruments in Box 1 dates from 1812.1 It was provided by Messrs Evans and Co, Old Change, London, and was presented to the College of Surgeons for approval. The College suggested removal of the lenticular and the tobacco from the apparatus for restoring suspended animation, and also the ‘probe scissors’ since they were ‘improper to be used in any operation of surgery’.2 Box 1 List of surgical instruments which were to be included in the naval surgeon's chest (Supplied by Messrs Evans & Co, c. 1812) Using this list as a guide, I attempt in this article to bring together the instruments carried on board ship by surgeons in the era of Nelson. These instruments are not all from a single matching set but are by a variety of makers and of varying dates and quality and therefore mirror those bought and used by the surgeons. The instrument list of Evans and Co falls easily into distinct parts according to purpose—amputation, trephining, drainage of fluid, dentistry, probing of wounds and other minor procedures, bleeding and cupping, and miscellaneous. Although this classification is to some extent my own, complete instrument sets, particularly from a little later, in the mid-nineteenth century, are often arranged and described by operation.