Lot 1: Dr. John Warren's Revolutionary War Amputation Kits
12th July 2017
Two amputation kits personally-owned and used in the Revolutionary War by Continental Army surgeon Dr. John Warren, a founder of Harvard Medical School; one kit given to him by his famous brother, the patriot Dr. General Joseph Warren, who was killed at the Battle of Bunker Hill. One kit is covered in shark or ray skin (shagreen) and measures 19.5 x 7.75 x 3. The kit contains: bullet forceps with scissor handles; tissue forceps; a grooved director; a Petit-style tourniquet; bow-framed metacarpal saw; and an extra blade for a large amputation saw. Attached inside the hinged top cover is a 19th-century hand- written card tracing the provenance, reading: “Revolutionary Instruments given by Joseph Warren to John Warren to John C. Warren to Henry J. Bigelow. Copy of letter describing them in possession of J. Collins Warren.” A typed early 20th-century card reads, “Instruments. Revolutionary War. Surgical instruments used by Dr. John Warren in the war, and presented to him by his brother, General Joseph Warren. Dr. J. Collins Warren.” The second kit is mahogany and measures 18.75 x 7 x 2. The kit contains: a capital amputation saw, with a wooden-handled instrument with hexagonal nut to adjust the blade; a curved amputation knife; surgical scissors; and tissue forceps (possibly non-original). The interior is fitted for the instruments, and one (a scalpel) is absent. Nailed to the front edge is a very faint handwritten 19th-century identification label that is extremely difficult to read, but with enhanced contrast can be deciphered: “Used during the Revolutionary War by Dr. John Warren.” This second kit was exhibited in a 1906 Harvard exhibition of surgical instruments, which was organized by Dr. J. Collins Warren (also known as John Collins Warren, Jr.), the son of John Collins Warren and grandson of John Warren. A newspaper clipping from the Boston Herald of June 3rd, 1906, shows this second kit in the Harvard exhibition. These remarkable Revolutionary War amputation kits hail to a time before doctors understood the importance of sterilization, and the instruments show heavy signs of use. Wounds from musket balls were rarely superficial, and amputation was fairly common—even though as few as 35% of men survived the procedure. Amputation kits were therefore essential on the battlefield and in very high demand. The Continental Army had little in the way of surgical instruments to provide their doctors, and surgeons were forced to rely on their own personal property to make it through the war. Dr. John Warren carried these kits with him throughout his patriotic service. Additional provenance materials include: * A transcript of an entry in John Collins Warren’s day book, dated February 19, 1850, in part: “Sent to Dr. H. J. Bigelow as a present an ancient tourniquet belonging to my father which went through the Revolutionary War. And also an amputating case which had gone through the war most of the important instruments remaining, but some having lost and replaced.” * A transcript of a letter from John Collins Warren to Henry J. Bigelow, dated October 2, 1850, in part: “Sometime since you desired me to give a history of the old surgical instruments which I had sent to you. This history is simplified and comprised in few words. The old case was received by me from my late father, and was employed by him in the army of the American Revolution, during the first years of the war, and during the remaining years in the American Continental Hospital in Boston. The case was probably given to him by his brother General Joseph Warren, when he served as a medical pupil. The tourniquet is a French instrument from a model of great antiquity. It is, perhaps, the best instrument of the kind which has been invented. This, as well as the other instruments, was employed in the public service during the whole of the Revolutionary War. These instruments I have taken great pleasure in transmitting to you, under the impression that they will receive additional honor, by being in the possession of one whose talents and industry will, I doubt not, reflect new lustre on the character of him who was the original possessor and your first predecessor in office.” This is the letter referenced in the handwritten card inside the lid of the shagreen kit. In 1849, Bigelow was appointed as Professor of Surgery at the Harvard Medical School, a position first held by John Warren. Bigelow’s donations form much of the collection of Harvard’s Warren Anatomical Museum. * A photocopy of an article from the Boston Herald of June 3, 1906, concerning the ‘Historical Loan Exhibition of Medical and Surgical Instruments’ held at Harvard as a part of the 1906 American Medical Association Annual Meeting. These kits were featured in the exhibition and described at length in the article, which reads, in part: “The oldest set of amputation instruments in the collection is that which was originally used by Dr. John Warren, the brother of Gen. Joseph Warren, who was killed at the Battle of Bunker Hill. These instruments seem like the coarse and blundering tools of a carpenter to the modern surgeon, in comparison with the instruments used today. They are in a mahogany box with an old-fashioned brass handle on the back, by which it was carried. The instruments are set into sockets in the inside of the box, these sockets being covered with plush which is now a dull snuff color. The large knife in this set is one of the most curious instruments, as it has a blade shaped like a scimitar, while the modern knives are almost straight. This set of instruments is one of the most highly prized of all those that are now in the Harvard medical school collection. They were handed down from Dr. John Warren to Dr. Henry J. Bigelow, who gave them to the medical school museum.” The article also ran with a photo of the medical instruments from the second set, captioned: “These instruments were used by Dr. Warren of Boston in the revolutionary war. This is the oldest set in America and the first photograph of these instruments ever published.” NOTE: These were sold by Harvard University in a warehouse auction sale to William Held; then sold by Held to the present owner through Webber Antiques in 2002. Also includes a 2014 letter from Harvard’s Countway Library of Medicine warranting that Harvard and its affiliated entities make no claim of ownership interest in these kits. Accompanying the lot are two additional medical kits which were included in the 2002 purchase of the John Warren kits: a late 19th century urological set owned by Henry J. Bigelow (with engraved brass plate, “Henry J. Bigelow,” inlaid on the top cover), and an early 20th century set of urethral sounds owned by John Collins Warren, Jr. (with “J. Collins Warren” nameplate affixed to the bottom). Some implements are missing from both kits. Dr. John Warren’s Service in the War Born July 27, 1753, John Warren was the youngest of four children. He followed in the footsteps of his famous brother Joseph, older by twelve years, attending the Roxbury Latin School before enrolling in Harvard College at age 14 in July 1767. John became a good classical scholar with an interest in anatomy, and upon graduating in 1771 he commenced the study of medicine under Joseph, who had become one of the most successful physicians practicing in Boston. It is most probable that Joseph Warren gifted the shagreen amputation kit to John while his brother was under his tutelage. Having completed a two-year course of study with Joseph, John was officially allowed to practice medicine in 1773 and he moved to Salem, Massachusetts. In that same year, he joined Colonel Timothy Pickering’s militia regiment as a volunteer and was elected as an army surgeon. With Pickering’s regiment, John Warren was summoned to the Battles of Lexington and Concord on April 19, 1775. Joseph Warren and another brother, Ebenezer, were also present at the battle, and Joseph was nearly killed by a musket ball that grazed his wig. John remained encamped in Cambridge with Pickering for two weeks before returning to Salem. On June 17th, John Warren was in Salem when news of a bloody fight at Bunker Hill began to come in. In his diary, Warren wrote, “I was very anxious, as I was informed that great numbers had fallen on both sides, and that my brother was in all probability in the engagement. I however went home with the determination to take a few hours’ sleep, and then go immediately for Cambridge, with my arms. Accordingly, in the morning about two o’clock, I prepared myself, and went off on horseback, and when I arrived at Medford, received the melancholy and distressing tidings that my brother was missing. Upon this dreadful intelligence I went immediately to Cambridge, and inquired of almost every person I saw whether they could give me any information of him. Some told me he was undoubtedly alive and well, others, that he was wounded; and others, that he fell on the field. This perplexed me almost to distraction. I went on inquiring, with a solicitude which was such a mixture of hope and fear, as none but one who has felt it can form any conception of. In this manner I passed several days, every day’s information diminishing the probability of his safety.” During this chaotic period, the overzealous Warren attempted to cross into British-occupied Charlestown in search of his brother and was bayonetted by a British sentinel. It would take several days for Warren to ascertain the fact of his brother’s death. Moved by the loss of his brother, John Warren, just 22 years old, left his growing Salem practice and entered into full-time service as senior surgeon of the army hospital at Cambridge. Here he tended to the army’s sick and wounded, and ensured the hospital was properly stocked with medicine. On November 22, 1775, Warren was ordered to report to Israel Putnam’s detachment on Cobble Hill in Somerville, where an outbreak of fighting was expected. The order specified that he was to bring amputation kits: “The Orderly Surgeon is hereby directed to repair immediately but with all secrecy to Cobble Hill, with five Orderly Mates, a case of amputating instruments to each person, plenty of lint, tow, and bandages, for a brisk action.” Putnam took Cobble Hill without incident and began erecting fortifications which proved integral to the defense of the Charles River. Warren returned to Salem for much of the British occupation of Boston, returning to the city to observe the enemy’s evacuation in March 1776. The next month, he was able to claim the body of his late brother, who had been mutilated by British troops after his death and hastily buried. The identification of Joseph Warren’s body was aided by Paul Revere, who recognized a false tooth he had crafted for the doctor. While George Washington left Boston for New York immediately after the evacuation, Warren remained and tended to the wounded for a month before following on to New York. Both Washington and Warren were in New York when the Declaration of Independence was read on July 9, 1776. Warren became surgeon of the general hospital on Long Island, where he helped to deal with the carnage of the Battle of Long Island in August 1776, in which approximately 300 Americans were killed and 800 were wounded. Washington then made his celebrated retreat to Manhattan, and Warren evacuated north to East Chester, where he was stationed after the retreat. Fighting raged on through 1776. Warren became head surgeon at the general hospital in Hackensack, New Jersey, which was expected to become the army’s hospital headquarters in the region. However, Washington received word of an eminent British attack in November, and the whole of the Continental Army—Dr. John Warren included—was forced to leave Hackensack, retreating across New Jersey. Warren traveled toward Philadelphia, where he was to help organize a ‘flying hospital,’ or mobile surgical unit to tend to anticipated casualties. After Washington’s heroic crossing of the Delaware on Christmas Day, the army pushed on to Princeton. Warren had not been notified of the movement, but upon learning of it he and his hospital staff raced to Princeton to take care of the wounded. The American troops suffered fewer than a hundred casualties, and this positive conclusion of Washington’s New Jersey campaign proved to be a decisive turning point in the Revolution. Warren soon left active combat, returning to Boston where he was named the senior surgeon of the city’s general hospital. He became widely respected and helped to fill the void in the medical community left by the loss of his brother and defection of Loyalist doctors. He helped to found the Boston Medical Society in 1780, and he began to teach a course of anatomical lectures. Paul Revere engraved a certificate for graduates of the course, which featured an image of Warren at the dissecting table, scalpel in hand. In 1781 Warren was elected a fellow of the American Academy of Arts and Sciences and became a founding member of the Massachusetts Medical Society. He then became a founder of Harvard Medical School in 1782, and he was elected as the new school’s first Professor of Anatomy and Surgery. He was known as an excellent teacher and eloquent lecturer, and continued his professorship at Harvard until his death in 1815.
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