A tourniquet (to prevent bleeding)

1. Instructions:Print the following slides and cut off the descriptions. Hand out to students as ISM. Take guesses as to what the items were for. Answers are animated for feedback.

2. Two tough leather retractors – these were used to pass around the limb bone(s), which had not yet been divided and keep the soft tissues (skin, fat and muscle) out of the way during the sawing of the bone – so protecting these from snagging in the saw teeth.

3. Silk Ligatures for tying off (ligating) blood vessels. The vessels first had to be secured with forceps.

4. Bullet extracting forceps. After the wound was explored with the finger (to ascertain where the bullet was and if it could be retrieved), the forceps were slid in and opened slightly allowing the roughened tips to grip and remove the missile.

5. These are rather like pliers and are ‘bone nippers’ to trim (with sharp blades), for example, jagged ends of bone.

6. A tourniquet (to prevent bleeding) • As the canvas strap was tightened, the limb was gripped and constricted so that, eventually no blood could flow out of the wound or down the limb – allowing surgery to be carried out. It could be controlled by an assistant and tightened or loosened as needed, eg to check all the blood vessels had been secured after amputation.

7. Brace and hand-held trephine – • circular saws to cut out a disc of skull to gain better access to in-driven impacted bone fragments and remove blood and foreign material. • Before the twisting action began, to remove a disc of bone, a central spike could be pulled out to centre the saw and prevent it skiting across the bone.

8. A Lenticular • This is a tricky, but ingenious instrument. Used after the trephine hole had been cut in the skull, (it has a blunt button-end, so as not to damage the brain), it cut and trimmed the edge of a skull cutting with the sharp blade on the side of the shaft.

9. A probe • This is a malleable silver probe for the exploration of wounds and deciding on the length and direction of bullet tracks.

10. A set of capital knives. • These were used in amputations to slice through skin, and flesh to allow access to the bone with a saw. • The curve of the top knife would allow a nice circular motion, much like cutting an apple in half against your thumb.