Hooks, handsaws and forceps: The grisly photos that show how soldiers gritted their teeth for surgery in the American Civil War

Gruesome: Private George W. Lemon, who was shot in the leg at the 1864 Battle of the Wilderness 1864. Captured by Confederates, treatment of his wounds was delayed and he suffered repeated infections. His leg was finally amputated

Photographic record: Here is Private George W. Lemon after his successful amputation

But rather than being comfortably anaesthetised, the soldiers had to grit their teeth through the pain of having their limbs amputated.  

The images from the National Museum of Civil War Medicine show how fallen fighters often faced the kind of slipshod treatment more likely to be found in horror films.

Their treatment is a far cry from the kind of high-tech care such as flying-helicopters and battlefield operating theatres that injured soldiers can receive in modern warfare. 

The museum's pictures show how fallen troops even underwent the gruelling procedures without antibiotics, which often led to more life-threatening infections. 

Low tech: This large single-edged amputation knife was used to cut through skin and muscle in circular amputations

Heavy duty: After skin and muscle had been were severed, this amputation saw – made with a steel blade and an ebony wooden handle – cut through bones

A tenaculum was used in amputations for pulling the arteries out from the stump so that they could be tied off

Pain control was limited to doses of opium while surgeons seemed more intent on hacking off limbs than actually trying to save them.

One soldier, private George W. Lemon, was shot in the leg at the 1864 Battle of the Wilderness in 1864 but after the wound became infected he had to have his limb amputated.

A primitive amputation saw similar to one used by carpenters would have been used to hack through Mr Lemon's flesh and bone.

The agonising surgery would finally have been completed with a tenaculum hook which was used for pulling the arteries out from the stump so that they could be tied off.

In this sepia photo, a group of medical students and professors dissect a cadaver. In the civil war era, most advances in medical knowledge came through the examination of dead bodies, of which there were plenty

In this July 1863 photo, an amputation is being performed in front of a hospital tent in Gettysburg. About three quarters of all operations performed during the war – roughly 60,000 surgeries – were amputations

A hospital ward in a convalescent camp in Alexandria, Virginia, pictured in the 1860s. In crowded camp conditions, infectious diseases spread rampantly and took more lives than battlefield injuries

Another sepia photograph from the era shows a group of medical students practising on a corpse the kind of manoeuvres they would used in the battlefield.

A black and white image from July 1863 shows an amputation being performed in front of a hospital tent in Gettysburg.

Many of the 60,000 operations performed during the civil war were amputations. Surgeons would use different knives, saws and even forceps for the procedures.

The patients would be knocked out with heavy doses of opium so that they did not feel the pain.

Left is a page from 'A Manual of Military Surgery' from the Surgeon General's Office, 1863. Right, chloroform in a medicine tin found in a hospital knapsack. It was used as an anesthetic during many surgeries

Surgeons carried around kits like this one, equipped with an amputation saw, knives, forceps and other surgical equipment

Invalid feeder: Porcelain cups like these were used in hospitals to feed liquids to helpless patients

Open wide: This instrument is called a tooth key and was used for pulling teeth

The American Civil began in 1861 when 11 southern states declared their independence from the U.S. and called themselves the 'the Confederacy'.

Bloody fighting with 21 northern states where slavery had been abolished continued for four years until the Confederacy finally surrounded in 1865.

The war was the first industrial scale conflict and led to the deaths of over half a million men, with another half million wounded.

This prosthetic leg made of wood is a full left leg, articulated at the knee, with a leather shoe covering the foot. It still retains some of the original flesh-colored paint

This apothecary chest contains medicines in paper envelopes and glass medicine bottles

This canteen held quinine, which was essential in treating malaria

Civil War ambulances were typically equipped with two of these water kegs, issued by the U.S. Medical Dept

This instrument, a fleam, was used for bloodletting. The U-shaped blade is spring-loaded and activated by the trigger above it. The depth of the cut can be regulated by a screw at the base of the lever

Spiral tourniquets were used during amputations to stem bleeding. The cloth strap would be wrapped around the limb, and the metal screw tightened until the blood flow slowed

Left, this bottle contains Dover's Powder, a mix of opium and ipecac used to relieve pain and induce sweating. Right, opium was often used as a medication for pain, coughs, and diarrhea

This carved wooden leg splint was used to stabilise a broken lower leg

This metacarpal saw was used for cutting through smaller bones like fingers, toes, hands, wrists, and ribs

This is a wooden stethoscope – the flat end was placed on the patient's back or chest and the cupped end is the ear-piece

This coffin was designed to keep dead bodies fresh. The lower portion was designed to hold ice. The small door at the head of the coffin could be lifted to identify the body inside

An admission ticket to a class at Jefferson Medical College in Philadelphia in 1853, for an anatomy class. These tickets were purchased by medical students

Calomel was used as a remedy for diarrhea and dysentary. Its only drawback was that it contained highly poisonous mercury

'Spiritus Frumenti' was medicinal alcohol. This tin was part of a hospital knapsack made by the U.S. Medical Dept. which was carried onto the battlefield

An ivory tongue depressor. Though today's are disposable, tongue depressors were reused in the Civil War era

This February 1964 photo shows the entrance to the field hospital at Brandy Station, Virginia. The white structures on each side are the hospital tents.

This picture shows a prosthetics factory in the late 1800s. Almost 150 patents were issued for artificial limb designs between 1861 and 1873

These illustrations are titled 'Hospital Train from Chattanooga to Nashville' and 'The Interior of a Hospital Car' from Harper's Weekly, February 27, 1864. Many wounded soldiers were transported by trains

This April 1862 print shows the 'Interior of a Sanitary Steamer'. Where transportation by train was not practical, medical evacuations were done by boat

This June 7, 1862, print shows the surgical ward at the general hospital in Fort Monroe, Virginia

This photograph was made from an 1888 glass plate negative and shows a Civil War veteran's wound. The subject is Sergeant George Ekert, colour bearer, 74th Reg. Pa. Volunteers