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An 1868 surgical kit at Harvard Medical School's Warren Museum. Photograph by Carl Tremblay.
An 1868 surgical kit at Harvard Medical School's Warren Museum.

Ancient Scalpels

Not long ago, a knife collector showed a small, attractive-looking bowie knife to cutlery authority Bernard Levine '69. The knife was allegedly made in Connecticut in the 1850s by Lyman Bradley, the first recorded manufacturer of pocket knives in the United States. If genuine, such an item would be worth about $2,000. "The mark on the blade reading 'lbradley' was in an old letter style," says Levine. "But the hand guard [between handle and blade] was made of 303 stainless steel. Stainless steel wasn't invented until 1914 and the 300-series alloys didn't come into use until 10 or more years later. The piece turned out to be a forgery made in the 1970s. A lot of knife authentication is essentially looking for anachronisms. It takes a familiarity with technology, materials, and design."

Since 1971, Levine has been accumulating such familiarity. Today he is among the world's foremost authorities on knives, cutlery, and their history. Levine's Guide to Knives and Their Values, now in its third edition, is the standard reference in the field. He has also published four other books and hundreds of articles on knives. Although he is interested in blades of all eras, he deals mostly with European and American knives from the seventeenth to twentieth centuries. "Some antique knives sell in the six-figure range," he reports.

Levine is also an adviser on cutlery for the California Academy of Sciences and the Smithsonian Institution's National Museum of American History. Museum holdings sometimes include historic surgical instruments; some fine examples reside, for example, in Harvard Medical School's Warren Museum, founded in 1847. "Instrument collections like that of the Warren Museum show us where medicine and surgery have been, and help us appreciate the painful process of development in medicine," Levine says.

The museum displays a number of lancets, which physicians once used to pierce veins for bloodletting. "The standard lancet...consisted of a small, flat, spear-pointed, double-edged steel blade with two flat pieces of tortoise shell pinned to its blunt end so as to fold over and cover the blade when not in use," writes Levine in "Lancets on the Frontier," an article about their use on the Lewis and Clark expedition. Lancet blades were made of hard-tempered steel that was quite brittle, but could be sharpened to a very keen edge. A practitioner held the lancet not by a handle but by the base of the blade, which attached to the cover by a single rivet.

One lancet on display at the Warren Museum was made by Henry Harrington (1796-1876), a cutler of Southbridge, Massachusetts, who began making knives in 1818. Levine calls Harrington's firm "one of the first American manufacturers of industrial knives and pen knives," and adds that the company is still in business.

Lancets, however, are passé. "Phlebotomy [bloodletting] was a good source of secondary infection when you were already sick. The lancet had gone out of use by the late eighteenth century," Levine explains. "But then there was a cholera outbreak, and a prominent surgeon lanced a patient who survived. He became an advocate of lancets and they returned to popular use until after the Civil War." The prestigious British medical journal The Lancet, published since 1823, keeps the instrument's name alive.

The Warren Museum displays several grand kits of surgical instruments dating from the mid-nineteenth century. The surgical knives, arrayed from small to large, often had showy handles of ivory, exotic woods, or tortoise shell. But these kits quickly became obsolete after 1865, when Joseph Lister demonstrated the effectiveness of asepsis in surgery. The nonmetallic materials simply couldn't survive the high temperatures required for sterilization.

Basic surgical tools have changed little over the centuries. "The hardware aspects of surgery were well refined by Roman times," Levine says. "Any eighteenth-century cutler could have made a modern scalpel or retractor without difficulty." Surgeons could enshrine their own names via medical hardware. "In the past, surgical and dental instrument makers were also custom knife makers," Levine notes. "If you were an innovative surgeon you could go to a cutler and say, 'Make me an instrument to this design,' and it would be named after you." The real innovations in surgical implements today involve high technology, such as the use of laser beams.

Modern communications also speed up certain supply-and-demand cycles. Levine recounts how surgical instrument maker Bernard Kalman once had a surgeon talk to him via speakerphone during an operation. The surgeon was developing a new procedure and described to Kalman a specific kind of retractor he needed-one that did not yet exist. Kalman fabricated the retractor on the spot and had it delivered to the operating room while the surgery was still in progress!

~ Craig Lambert
Bernard Levine may be e-mailed at [email protected]

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