ITEM No. 24FILE No. XXV11-2

THE GERMAN SURGICAL INSTRUMENTINDUSTRY IN THE TUTTLINGEN AREA

“This report is issued with the warning that, if the subjectmatter should be protected by British Patents or Patent applica-tions, this publication cannot be held to give any protection againstaction for infringement.”

COMBINED INTELLIGENCE OBJECTIVESSUB-COMMITTEE

LONDON—H.M. STATIONERY OFFICEPrice is. cnaf

TIE GERMAN SURGICAL INSTRUMENTINDUSTRY IN TEH' TUTTLINGEN AREA,

Reported by

1st Lt. George M. Waller!ch SN C,%*»

Office of the Chief Surgeon, Hq.USB’ST,

CIOS ITEM 24Medical

COMBINED INTELLIGENCB OBJECTIVES SUB-COMMITTEEG-2 Division SHADE (Rear) APO 413,

T .able 0 ■ CO N T 72 N T S *

Subject. .No •

Introduction 3 .

I Factory of C,Bruno Bayha 5II Factory of letter & Scheerer 6III Factory: Chiron Werke 7IV Factory of Albert Heise,

G-eorg Hae nice 8V Factory of G-ebrb.der Martin 8VI Summary of Vehrmacht Instrument

Procurement Methods 8VII letter cc Scheerer List 9

INTRODUCTION.

Nor more than one hundred and fifty years, the majority ofthe world’s surgical instruments were manufactured in and aroundthe village of Tuttlingen on the outskirts of Germany’s BlackForest, With generations of skilled instrument makers behind them,Tuttlingen draftsmen learned and developed the precise techniquesrequired in the making of fine surgical instruments.

During the past seventy-five years, many of these instrumentmakers migrated to the United States* where they set up their ownshops, continued in the practice of their trade, and aidedmaterially in the building of what was, prior to the war, the onlyserious contender for Germany’s position in the field.

Not having enough skilled mechanics in the trade, however,.American industry has been forced to limit itself to the manu-facture of a comparatively small variety of patterns which couldbe produced in quantities sufficient to meet the expanding require-ments of the -Army and Navy, As a result, American manufacturers,while not as versatile as their German counterparts, now produceinstruments of excellent quality and have developed -new machines,and new uses for old machines to replace some of the skilled menwho were lacking.

In the final analysis, however, no machine or combinationof machines can replace the vast amount of skill and practicewhich goes into the making of delicate, perfectly made instruments.

This majr be better understood a general knowledge of thesteps involved in the manufacture of an instrument.

1. SELECTION OF THE PROPER PATTERN., This, in many ways, isthe. most important step because even though all the subsequent stepsand workmanship may be correctly performed, a poorly designedinstrument would be of little or no use for the purpose for whichit is intended.

2, SELECTION OF THE APPROPRIATE TYPE OF MATERIAL. Cuttinginstruments demand hardness without brittleness and the abilityto retain a keen cutting edge; clamps and forceps must have

_ ■resiliency and toughness. The desirability of using stainless steel,carbon steel, or non-ferrous metals must, be considered,

3, FORGING, The steel is heated to.a specified temperatureand struck into a die, either by hand or in a drop-forge.

4, TRIMMING, Excess metal is removed by means of a punch-ing die. 'This may involve one or more different dies and there-fore an equal number of punching operations*

5* CLEANING, Scale, or oxidized metal must be removed,cither by sand blasting, tumbling, or by acid.

6. ROUGE GRINDING. This is the initial hand operation*The instrument is held by hand, against a stone grin-ding wheel,and just the "right 1 amount of metal must bo ground off; toolittle may make the instrument heavy and clumsy, too much will leaveit flimsy and subject to. early failure.

7, a* MILLING. Serrations, ratchets, and joints (inthe case, of forceps) are milled by machine to extremely closetolerances.

b, GRINDING, Cutting edges receive their first grindinga hand operation.

8, ASSEMBLY, Box-lock forceps are assembled by hand, drilled,riveted and adjusted. Scissors are often assembled after heattreatment or tempering*

9, GRINDING, The assembled instrument is ground again, thistime with a slightly finer grade of wheel,

10, HEAT TREATING (tempering). Usually performed by meansof electric furnaces, this operation j, s extremely important andmust be closelir controlled. Thermocouples are used to giveaccurate temperature readings, as too low a temperature will leavean instrument soft, while too high a temperature makes it brittle.Following the hardening, an instrument must be ‘‘ drawn', orsubjected to a lower temperature for a specified length of time inorder to relieve the stresses and strains set up within it by thehardening operation.

11, FINAL GRINDING, At this point an instrument begins,to have a definite v! feer* or balance - it may be stiff or weak,light or heavy.

12, POLISHING, Using high speed cloth polishing wheels andcompounds made specially for the purpose, experienced polishersmay proceed with three or more polishing operations, each one ofwhich is critical as the operator must know exactly at what pointenough metal has been removed.

13. CLEANING, Each instrument is degreased.

14, a, PLATING, If the instrument is not made of corrosionresisting steel, successive electro-plating of nickel and chromiumis desirable, although for many years prior to 1929 nickel alonewas used.

b. PASSIVATING- If corrosion resisting steel isused, the instrument is immersed in an acid bath \ihich impartsadditional rust resistant qualities-

15, FINAL BUFFING, The final high lustre is gained throughthe use of soft, dry cloth buffing wheels. Care must be exercisedin the buffing of plated instruments so that too much plating isnot removed.

16, FINAL INDUCTION AND ADJTBTMENT, Although inspectionis usually performed at various points throughout the processesoutlined above, final inspection is a ''must'* because it is herethat adjustment by an experienced hand must be made, A smallamount of acid-free anhydrous lubricating oil is applied, and thefinished instrument is packaged.

These steps may vary slightly in sequence and form betweendifferent manufacturers, but in general they represent standardpractice in the industry. When non-ferrous metals are used theyare stamped, cast, or hand-worked and are never heat treated asdescribed above. The more delicate an instrument is, the morehand work replaces machine operations (fine teeth are hand-filedinstead of milled, fine cutting edges are hand-honed instead ofground, etc)^

It is hoped that the above summary will provide an understandingof the steps involved in the making of an instrument, and also makeclear the reason why no particularly unusual innovations wereobserved during the survey covered by this report.

1, Plant visited; 0,Bruno Bayha, Tuttlingen, Germany,Date of visit; 14 - 15 June 1945,Persons interviewed: Mr,Carl Bayha, Mr,Bruno Bayha,Items manufactured during the war: Plaster shears,traction bows, general purpose scissors, surgicalknives.

General Information: Prior to the war, this plant manufactureda large variety of high quality surgical instruments, whichwere exported to other parts of L’urope and to North and SouthAmerica, The limited variety manufactured during the war was due, .

it was stated, to the fact that neither of the partners in the

firm :were members of the. Nazi party and were therefore not granted,enough orders to utilize their full capacity. At the present timethe plant is intact but not operating, due to the lack of coal. Itwas stated that the occupying troops have confiscated practicallyall servicable stocks of instruments. .

Technical Information: Instruments manufactured during thewar were made of nickel plated carbon'steel of a quality approxi-mately equal to pre-war standards. No chromium- was available to theindustry, which accounts for the absence of any stainless steel orchrome plated steel. Most machinery and production methods arebelieved to be antiquated although a jig was noted vHiich is used tosecure certain types of scissors during the rough grinding operation.This type of attachment is not entirely new, and its use is extreme-ly limited. It was stated by Mr, Carl Bayha that, in general,machine grinding of scissors has not been successful.. An interestinginnovation,was. ; .also noted in the plating department, namely, an,electrolytic degreasing; apparatus, which, in addition to cleaningan instrument, deposits a very light coating, or 'flash - ’ of copperon the instrument, thus forming an excellent base for the subsequentelectroplate of nickel. This procedure is not, it is believed,generally followed by industry in the'United States although it isknown.

II. Plant visited: letter & Scheerer» Tuttlingen, Germany.Date of visit: 15 June 1945,Persons interviewed: Mr. Fritz Scheerer, Mr*Hans

- Hans Scheerer b

Items manufactured during the war; (See attachedlist) (plus-) a large variety of individualinstruments.

General Information: This plant,...formerly employing about1800 people, was the largest si.pgle surgical instrument factory inthe Y/orld. A huge variety of extremely High quality stocks vjereshipped from here to all parts of the world, and the name is oneof the best-known in the trade. Hie factories suffered littleas a result of enemy action, and were it not for the lack of coaland window^glass,'could resume production in a relatively shorttime. Occupying troops have, confiscated practically all finishedstocks, some semi-finished stocks, and many precision tools, itwas said. Prior to and during the war, the firm aided in and attimes contracted for the development of sets of instruments to beused by the Army and Navy, Every effort was made to utilizestandard patterns which provided for the utmost economy inmanufacturing costs. Forceps, for example, were all of the screw-lock or ”aesculap” - lock variety - patterns which have for thepast ten years been considered inferior, to the box-lock type

currently used by the UiS,Array Medical Department. It wasestimated by Mr*Fritz Schooner that during the last year of thewar, this firm supplied about sixty percent of the G-orraan Army’srequirements for all the basic instrument sets as well asquantities of individual pieces. Quantities of castings, forgings,and stampings wore, also produced for the automotive and aircraftindustries.

Technical Information: This investigator was taken through thefactories which, in general, seemed intact. Machinery and equipmentwore in good condition,' and dies had not been disturbed by theoccupying troops, although, as stated above, some precision toolshad been removed. Aluminium was used in place of brass in themanufacture of various racks, trays, and' containers, for brass whichwas formerly used for this purpose, was not available during thewar, and also because of the additional reduction in weight providedby aluminium. No new methods or innovations'll! the manufacture ofinstruments wore noted, although it is difficult to confirm the factas the factory was at a complete standstill and therefore certainoperations could only bo visualized.

Ill, Plant visited: Chiron Works. Tuttlingon, Germany.Date Of visit: 15 Juno 1945,Persons interviewed: Mr.Staoblor, Mr.von Sochaczowski,Items manufactured during the war: Principal instrumentsets, large variety of individual instruments.

General Information: Occupying the newest instrument factoryin Germany, this firm has long been one of the largest producersalthough the quality of the products has not always been as good asthose of such firms as Jotter. Schecrcr, Martin or Bayha, It isbelieved that Chiron has utilized machines to a greater extentthan other■comparable factories, and that the management has beenmore aware of modern trends in working conditions. For example, tiledshowers, attractive dining facilities and daily musical programsarc provided for employees, as well as pleasant appearing, orderlyshops such as have not been seen in other factories in this region,Par production was concerned largely with the manufacture of thevarious basic instrument set. as well as quantities of individualitems.

Technical Information: Such new procedures, as the machine-cutting of dies, machino-trueing of grinding wheels, and electro-polishing, while not now to American industry, wore not observed inother German instrument plants. As in the factories of nearbyinstrument manufacturers', no chromium was used during th ; war, andaluminium was used in many cqsos to replace brass. Approximatelythirty percent of the Wehrmacht’s needs for basic instrument setswore supplied by Chiron,

IV. . Plants visitedt Albert Heise, G-eorg'Haenice ,

Tuttlingen, Germany,Date of visit: 15 June 1945,Items manufactured during the war: Syringes,

eye and ear Instruments,

Both of these plants are extremely small, and manufacturelargely for prime contractors. Both methods and products are ofordinary nature, and no unusual features were noted.

V, Plant visited: Gebmid er Mart in.Date of visit: 15 June 1945,Offices and showroom v;ere completely destroyed. No one

was available for questioning.

VI, The following information concerning the purchasingand development, of instruments and instrument sets represents acomposite of details given by all the plants visited.

In 1939, a Sanitatsoffizier Doctor Gropler was in charge ofthe procurement of surgical instruments for the Wehrmacht, Throughthe firm of Medici, in Berlin,- a retail chain store type of surgicalsupply house, initial purchases and development of Army instrumentsets were begun. Soon it was found that the actual manufacturerswere far more useful in the- field because of their long experience,and they were therefore consulted. In an effort to establish aseries of cheap and efficient patterns for the Army, an instrumentmaker named Hilzinger from Tuttlingen was summoned to the BerlinHauptsanitatepark as consultant in the development of these sets.At about this time, Dr,Gropler became involved in some difficulty,was discharged from the Army, was placed in a concentration camp,and has not been heard of since. Thereafter, all procurement ofinstruments which are standard with the Array was done through theBerlin Hauptsanitatspark. At times contracts were let for thedevelopment of specific sets, and the manufacturers played theleading role in designing and constructing the first samples. Uponacceptance by the Army, manufacturers were forced to work togetherto produce the sets in the shortest possible time. With theexception of the ’’Fachhrztliches Besteck zur ?ehandlung von Hals-Nason-und Ohrenkranken, NeurochirUrgisches Zusatzbosteck, Fachslrz-tliches Besteck zur Behandlung von Augenkranken, Facharztlich.esBesteck zur Behandlung von Goschlechtskfanken', which woreassembled at Berlin, sets were assembled at the factories in andaround Tuttlingen,

VII. JFTTRR & SCHB33KSH LIST.

HauptbesteckSammelbesteckTruppenbe s te ckSezierbesteckNikroskopisches BesteckTaschenbe-steck fdr Sanitdts OffiziereSanitdts-VerbandtascheZahndrztliches Gerdt, Modell 1941Amagnetisciies Besteck zum SplittersuchgerdtFachdrztlich.es Besteck f. Hals,‘Nasen-u. ChrenkrankeFacharztliches Besteck zur Behandlung von AugenkrankheitenNour ochirurgisches BesteckFachdrzt lie lies Besteck zur Behandlung von Eaut-und G-eschlechts-krankheitenG-eburtshilfliches Besteck (Heichswehrmodell)

und Abortusbesteck (Helchswehxmodell)OofassnahtbesteckBesteck zur SchenkelhalsnagelungMarine - Instrumentsnbesteck No. 1 zur Amputation u. ResektionMarine - Instrumentenbesteck No*II zu verschiedenen OperationenMarine - Instrumentenbesteck No.Ill zu Augon-, Ohren-und Nasen-OperationenMarino - Instrumentenbesteck No.IV zur Tracheotomie,Marine - Instrumentenbesteck No* VMarine - Instrumentenbesteck No,VI zur Wundnaht usw.Marine - Instrumentenbesteck No,VII zur ObduktionMarina - Instrumentenbesteck No.VIII zur ZahnbehandlungMarine - Instrumentenbesteck No, IX zur G-eburtshilfc Dto.BordraodellMarine - Instrumentenbesteck No, X zur Gyndkologie BormodellLandungskoffer

VIII This report is essentially a preliminary one. More detailedinformation will be presented in later reports by TIIC investigators.

(53355)5393/36628. 750, 12,45. S.L.S.T.G.

(53357)5393/36628 750. 1/46. S.L.S.T.C