Civil War Medicine
Soldiers Faced Disease as Well as Bullets
In many respects the Civil War was the first modern war, using such innovations as the railroad, the machine gun, and the submarine. But when it came to medicine, the world of the 1860s was still in the Dark Ages. Surgeons used techniques to treat the sick and wounded that were hardly removed from George Washington’s day.
Medical Knowledge in the Civil War
By twenty-first century standards medical knowledge was rudimentary. There were breakthroughs, but most of them came too late to help Civil war soldiers. In 1864 the great chemist Louis Pasteur introduced the “germ theory”- the idea that disease was spread through microscopic infectious organisms. But it took time for this theory to disseminate and be accepted by the medical community at large.
British surgeon Joseph Lister helped cured a patient by using antiseptic techniques that he pioneered. Unfortunately, this was in the summer of 1865, and by then the war was over for several months.
Disease in the Civil War
Battlefields were deadly, but both Union and Confederate soldiers had a greater risk of dying from disease. Many thousands of Americans were farm boys, raised in rural isolation. Once they joined the army, they found themselves in crowded barracks or cramped tents, where infections easily spread from man to man. There were the “common” sicknesses, ills that we think of today as “childhood” diseases. These include measles, mumps, and chicken pox. They were bad enough, but there were also such maladies as typhoid fever, malaria, and chronic diarrhea. All were killers on occasion.
Civil War Surgery
The average Civil War weapon—like the 1861 model Springfield rifle-musket—had low muzzle velocity. That meant that the bullet or ball would not go through flesh like modern jacketed bullets. They tended to smash into bones, breaking and splintering them. Statistics gathered for the Union army show that about 71% of wounds were in the extremities, perhaps because of fighting from behind breastworks and other cover.
During a battle the field hospitals were often swamped with wounded. In order to save lives, doctors tended to ignore the slightly wounded and obviously mortally wounded. When a limb was ripped and the bone shattered, the only way to give the patient a chance of life was amputation. A surgeon and one or two assistants would work as speedily as possible, cutting, sawing, making repairs, typing ligatures on arteries, etc. There are horror stories, usually true, of piles of amputated arms and legs collecting near field hospitals—sometimes to the height of five feet.
Surgical conditions were primitive, and very septic. Operating tables were washed down again and again with the same sponge—a sponge that was merely rinsed in a bucket of water. Surgeons were often covered in blood and pus after a few hours work. Wounds were packed with unsterilized lint or raw cotton, and covered in wet bandages. It was often common for wounds to be probed with fingers.
Civil War Improvements in Medical Care
The picture was not all bad. In fact, in some respects the Civil War soldier had a greater chance of survival than any pervious conflict. Dr. Jonathan Letterman, medical director of the Union’s Army of the Potomac, devised a system for the efficient evacuation of the wounded. He organized ambulances, medical supplies, and field hospitals. Ambulance drivers and stretcher bearers, for example, were carefully chosen and trained. Special uniform insignia instilled a sense of pride.
For the first time in U.S. military history special hospital ships were created for the evacuation of the wounded. The J.K. Barnes was the first U.S. army hospital ship that was specifically built and designed for the purpose. Dr. Alexander Henry Hull supervised its construction. Trains were also used to transport the wounded.
Thanks to advances made in the 1840s, most of the wounded were given anesthesia before an operation. Chloroform and either were usually available, though if supplies ran out the old fashioned “bite the bullet” might be employed.
Sources:
James McPherson, Battle Cry of Freedom:The Civil War Era (Oxford University Press, 1988)
George Washington Adams, Doctors in Blue:The Medical History of the Union Army in the Civil War (Henry Schuman, 1952)
Civil War hospital
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