Civil War Army Hospital Microscopes by Joseph Zentmayer,
or Grunow
By Dr. Michael Echols
There are articles or books which
question the use of certain diagnostic instruments during the Civil War.
An example of a Zentmayer Army Hospital microscope is used for illustration
of this type diagnostic instrument used during the War. By examining the cases in the Medical and
Surgical History of the War of the Rebellion, it can be shown by case
documents that indeed the microscope was used during the War. And
further more that books, such as
Virchow's Pathology,
(published by the Army Medical Department during the War for use by the
Union medical staff), addresses microscopic pathology.
The Pillischer microscope below is one such
microscope which would have been available during the War and is an
example of the type and size used at the time. There were on a very
few microscope makers in Ameria at the time of the Civil War, but many
microscopes had been imported from England and Europe.
Microscopes being the
unwieldy instruments they are, would have been available in the rear
hospital areas,
not in the field. An autopsy would have been done in a hospital and
any microscopic examination would have been conducted under a controlled
situation, not out of the back of a wagon or in a tent.
Above, An M. Pillischer claw-foot
monocular microscope, London, c. 1860's from Echols' collection
 
Earlier 1873
version on left, later version on right (from an ad in 1881
'Compendium of Microscopical Technology'. The 1873 example of the 'Army
Hospital Microscope' by Zentmayer, was introduced in 1862.
In 1862, Zentmayer began building the U.S. Army
Hospital microscope to meet the needs of the Civil War. This model was
produced for over 30 years, undergoing many gradual modifications, until
finally it had incorporated the swinging substage and redesigned limb and
long lever fine focus patented by Zentmayer, and eventually even a horseshoe
foot. Unlike the larger stand, the Army Hospital stand is commonly
encountered today and must have been made in fairly large numbers. The cost
of the basic Army Hospital stand in 1879 was $90, with the fully equipped
binocular version going for $173.
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The following ad was on
the last page of: The Army Surgeon's Manual, by Wm. Grace, 1864
Examples of microscope
usage during the Civil War from the Medical and Surgical History of the War of Rebellion
CASE.--Private Julius McKnight, Co. D, 27th U. S. Colored Troops, aged 23
years, received, on July 30th, 1864, at the siege of Petersburg, Virginia, a
gunshot wound of the scalp. He was sent to the hospital for Colored Troops,
a few miles in the rear, at City Point. Here little importance was attached
to the wound of the bead, and the patient was entered on the register as
suffering from remittent fever. On August 14th, he was sent to Philadelphia,
to the Summit House Hospital, where the scalp wound was regarded as serious.
As it was progressing favorably, light, simple dressings were applied. In
September, symptoms of diphtheria were manifested, and the disease making
very rapid progress, the patient died, on September 20th, 1864. At the
autopsy, the mucous coat of the fauces and trachea appeared to be ulcerated
and disorganized. A tough tubular membrane lined the larynx, trachea, and
bronchi, even to the smaller ramifications; and in the larger air passages,
this pseudo-membrane was detached. It was of a yellowish gray or ash colored
tree. The lungs were much engorged. An abscess containing half an ounce of
pus was found in the right lung. Entangled among the columnae carneae of the
right ventricle of the heart was a concretion, half an ounce in weight, very
similar in appearance to the membranous exudation in the lung. It was very
unlike the ordinary fibrinous coagula or heart clots so frequently observed
in autopsies, and tinder the microscope,
presented the same histological elements as the
exudations in the air passages. Surgeon J. H. Taylor, U. S. V.
CASE.--Private William Rogers, Co.
G, 7th Ohio Volunteers, aged 23 years, was wounded at the battle of Port
Republic, Virginia, June 9th, 1862, by a conoidal ball, which struck the os
frontis, one inch above the edge of the right orbit, and about half an inch
from the median line. He was rendered insensible for a few moments, but soon
recovered sufficiently to walk from the field. He was admitted to Cliffburne
Hospital, Washington, on the 15th. The wound was healthy in appearance, and
discharged a thin, sere-purulent fluid; the pulsation of the brain was
distinctly visible, and splinters and loose fragments of bone could be felt.
Absolute quiet was enjoined, and light diet and simple dressing, with aperients,
ordered. On the 17th he complained of increasing pains. Assistant Surgeon John
S. Billings, U. S. A., enlarged the wound of entrance, and removed the fragments
of bone with forceps. The ball could not be found, it having evidently entered
the brain. The wound was left open, and lightly dressed with wet lint. The
patient felt better the next day. The second day after operation, he complained
of slight, persistent pain in the back of the head, which continued until the
20th, when a small fungus growth made its appearance in the wound. Suppuration,
which had previously been profuse and healthy, was much diminished, and the pain
increased. The fungus was readily detached with the handle of the scalpel, and
its removal gave exit to an ounce of pus, which somewhat relieved the pain.
Hernia cerebri again appeared on the 27th, and death took place on the evening
of the 28th. The patient was never delirious, and could answer questions
correctly up to an hour before his death. The autopsy revealed the ball, much
fissured and twisted upon itself, lying in a sac of false membrane, about one
inch beneath the dura mater. The whole anterior lobe was broken down, and of a
pultaceous consistence, dark sanious pus filling the ventricular cavity. The
adventitious tissue, which formed the bulk of the hernia and the cyst containing
the ball, was soft, and under the microscope was
seen to be composed of interlacing fibres, containing large cells in its meshes.
The history of the case was contributed by Assistant Surgeon John S. Billings,
U. S. A.
CASE.--Sergeant James D. Hogan,
Co. C, 1st New York Volunteers, was wounded at Manassas, Virginia, August 30th,
1862, by a conoidal ball, which entered two and one-half incites to the right
of, and on a level with, the second lumbar vertebra, and lodged. He also
received a gunshot wound of the right thigh. He was treated in the field, and,
on September 3d, sent to Wolfe Street Hospital, Alexandria. No search was made
for the ball as the patient assured the attending surgeon that it had been
removed on the field. The wound seemed to heal, though very slowly until
November 17th, when a small tent-like protrusion of exuberant granulations
appeared, such as are usually seen at the orifice of a sinus leading to dead
bone. The patient was unable to stand erect or lie on his back. The surrounding
parts being considerably inflamed and the partially cicatrized wound reopening,
a careful search was made for foreign matter. The ball was found about three
inches from the point of entrance and removed by Acting Assistant Surgeon S. E.
Fuller. The track of the missile was carefully explored and found to extend four
inches in a direction forward and a little inward, where the point of the probe
came in contact with spiculae of bone. There was considerable tenderness over
the whole of the lumbar vertebrae, but no paralysis or other symptoms indicative
of injury to the spinal cord. This man was discharged from service on December
29th, 1862, at which time he was improving rapidly, although he was still unable
to stand erect. The specimen is No. 4486, Section I, A. M. M., and consists of
an elongated smooth-bore musket ball, much roughened on one side. The
incrustation on the missile exhibits,
under the microscope,
spongy bone. It was contributed by the operator. Pension Examiners Craig and
Porter, of Albany, report that this pensioner's disability may be rated as
"one-half and permanent." He had "much pain and weakness of the back" in July,
1871.
CASE 133.--Private Charles
Caloney, company B, 34th New York volunteers; admitted July 7, 1862. Debility
and diabetes. Died, August 21st. Autopsy next day: The lungs were
healthy, except a few old adhesions attaching them to the costal pleura. The
heart also appeared healthy, except that there existed an old pseudomembrane,
about the size of a dime, adherent to the left ventricle near its apex. The
pseudomembrane was fringed, the processes being about one-third of an inch in
length. The liver appeared of the usual size and consistence, but was livid
purple above arid slate colored below. The spleen appeared healthy. The stomach
was moderately distended with air and liquid food; its mucous membrane was red
in small spots, and there was a patch of inflammation about two inches square
near the pylorus. The mucous membrane of the ileum was inflamed in patches; its
solitary glands were prominent, and the agminated glands were red and inflamed,
or were thickened and opaque white. The colon was distended with air; its mucous
membrane presented small patches more than usually injected, arid its solitary
glands were inconspicuous. The kidneys were below the average size, and their
cortical substance was much paler than usual, the tint being pinkish cream
colored. The
microscope presented the usual condition of the granular cells,
(i. e., there was no obvious fatty degeneration.) --Acting Assistant
Surgeon Joseph Leidy.
Carditis and
Pericarditis.--The
comparative immunity from inflammation after injury, that we have observed
in the parenchyma of the lung, when contrasted with the effects of wounds of
its membrane, is yet more conspicuously displayed in the effects of
mechanical lesions upon the heart and its serous envelope. Enough examples
of wounds of the heart, in which the fatal issue was sufficiently delayed to
afford time for the development of inflammatory phenomena, have been
observed to warrant the conclusion that parenchymatous inflammation of this
organ is as infrequently the result of injury as of disease.(3) I have
examined two cases where patients survived a fortnight or more after shot
wounds grazing the heart, in which the pericardium was thickened and the
visceral as well as the reflected layer of the pericardium was thickly
coated with shaggy exudations; but the muscular structure presented no
alterations
discernible by the microscope.(4)
If an analogy might be instituted between the effect of tension on inflamed
striated muscle in the trunk or extremities, it would be inferred that the
slightest degree of inflammation of the muscular structure of the heart
would cause unendurable anguish in its movements
CASE 810.--Private John W.
Gardener, Co. F, 24th North Carolina, aged 25 years, was wounded at the battle
of Fredericksburg, December 13, 1862. A conoidal musket ball entered just above
the pubis and passed out through the body of the ischium. He was sent to a
hospital at Richmond, and, a week subsequently, was sent to his home in
Cumberland County, North Carolina. He was admitted to the Fayetteville Hospital,
November 1, 1863. Urine passed through the orifices of entrance and exit; there
were bed-sores, with extreme emaciation, debility, and pain. With careful
treatment the general condition
(1) The specimen is one-half of
a nearly globular vesical calculus an inch in diameter. It weighs fifty grains
Troy; the original weight of the entire calculus is unknown. Its exterior is of
a slightly reddish gray, soft, porous, and granular. It is seen to be composed
of a homogeneous structureless mass, presenting to one side of the centre a
comparatively large irregular cavity, which wag originally filled with a soft
pasty mass forming the nucleus of the calculus. It is of a muddy gray color,
soft, granular, porous, and structureless throughout. A small quantity of the
dust from the calculus heated on platinum blackened and cleared up with some
loss, and dissolved in hydrochloric acid without effervescence; the solution
neutralized with ammonia and treated with oxalate of ammonia gave no
precipitate. A fresh portion was soluble in boiling water to the extent of about
one-third of the quantity used; the residue was insoluble in liquor ammoniae,
but readily dissolved on acetic acid, from which it was precipitated by ammonia
as a gelatinous deposit containing numerous crystals of triple phosphate. The
solution in boiling water gave a deposit on cooling; boiled with liquor potassae
it gave off ammoniacal vapors; treated with hydrochloric acid it gave a
precipitate which,
under the microscope,
was found to consist of crystals of uric acid. It may be inferred that about
two-thirds of the calculus consisted of triple phosphate, and one-third of urate
of ammonia.
(2) CHISOLM (J. J.), A Manual
of Military Surgery, 3d ed., 1864, p 352.
There are dozens of examples, like those above, in the
documents of the Medical and Surgical History texts which show repeated use
of the microscope during the Civil War. This information was
repeatedly found via a digital search for the word 'microscope'.
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