A sawbones is a slang term used to describe a physician, and more specifically a surgeon, especially one who would have served in battle. The term is often tied to the Civil War, but in fact predates it. Dickens uses it to refer to a doctor in the 1837 novel Pickwick Papers which suggests common use of the expression at least 20 years prior to usage during the American Civil War.

The path from surgeon to sawbones is an easy one to follow. One of the principal means of treating infected wounds, large or small, was through amputation. Long before the advent of antibiotics, the danger of gangrene developing from even the very slightest cuts often had surgeons lopping of extremities or limbs in order to avoid blood poisoning. Wounds were then often cauterized (burned) with heated pokers.

In order to cut through a limb or extremity, you had to literally saw through bones. Thus the term sawbones makes a great deal of sense. It’s a quite grisly nickname when you come to realize its origin. Those who ascribe the term’s origin to the American Civil War are at least partially correct. Since battlefield amputation was so common, the term sawbones was in daily use. There are descriptions of field hospitals with amputated limbs piled up that are enough to give a person with the strongest stomach nightmares.

Though the term is sometimes considered derogatory, this isn’t always the case, and physicians may call themselves by this name, particularly if they are surgeons. For instance, cardiac surgeons, in many surgeries must use a sternal saw in a procedure called cracking the chest. They must literally saw through the sternum in order to get to the heart for open-heart repairs. Orthopedic surgeons, who specifically work with the skeletal system, may most refer to themselves as sawbones, though the term is certainly not used with the frequency that it once was.

While sawbones may not be used so much in present day, there’s an interesting, still fairly modern allusion to the term in the first Star Trek series. Dr. Leonard McCoy is affectionately called “Bones” by Captain Kirk. This is an obvious reference to sawbones, shortened simply to bones. It matters little that in the Star Trek universe, especially as evidenced by the film Star Trek IV: The Voyage Home, that cutting into people and needing to be a sawbones is considered a barbaric vestige of the past and relatively unnecessary.