Tuesday, September 28, 2021

Beyond the Book: Civil War Medicine

Ten years ago I did a series of posts on my blog about the Civil War. I came across them in a folder while I was looking for something else. I decided to share them with you. This one is kind of gruesome, but I have many more that aren’t. Periodically I think I’ll share some of them with you. So, here goes.

If you think medical procedures are unpleasant today, you’d better thank your lucky stars you weren’t born in the Civil War Era.  And you’d really better be grateful that you weren’t a Civil War soldier.

During the 1860’s doctors didn’t know about germs or what caused diseases, and they had very little medical training.  Harvard Medical School didn’t even own a stethoscope or microscope until after the war.  Most Civil War surgeons had never treated a gunshot wound, and many had never performed surgery.  Still, they did the best they could with what they had to work with.  

The Union Army had about 10,000 doctors and the Confederate army had about 4,000.  The doctors used bloody fingers as probes.  Bloody knives were used over and over without washing or sterilizing.  Doctors operated in pus stained clothes or sometimes shirtless.  Blood poisoning, sepsis or Pyemia-pus in the blood-was quite common and often deadly.  Surgical fever and gangrene were constant threats.  This is the way one witness described amputation, the most common surgery:

“Tables about breast high had been erected upon which the screaming victims were having legs and arms cut off.  The surgeons and assistants, stripped to the waist and bespattered with blood, stood around, some holding the poor fellows while others, armed with long bloody knives and saws, cut and sawed away with frightful rapidity, throwing the mangled limbs on a pile nearby as soon as removed.”

A good surgeon could remove a limb in ten minutes or less.  If it took much longer the man would probably go into shock and die.  Most of the time the doctors used chloroform as an anesthetic.  They soaked a cloth in the chloroform and held it across the man’s face until he fell unconscious.  Surprisingly enough, 75% of amputees did survive.  Have you heard the term “sawbones?”  The surgeons bone saw is where the term came from.

Why was amputation the most common surgical procedure?  Because so many people were wounded or killed!  More men were killed in the Civil War than in all previous American Wars combined! More men died at the Battle of Antietam than any other day in American History.  The casualties at Antietam were twice the casualties suffered at D-Day.  

Why were so many people wounded or killed?  It was because the armies still were using Napoleonic tactics.  They were still using frontal assaults where the men would run across open ground to engage the enemy, but during the Civil War the soldiers used guns with rifled barrels.  This meant they were more accurate at longer distances.  As men raced across the field it was easier to pick them off.  

When the wounded were brought to the field hospital a triage system sent only those wounded in the extremities to the surgeon.  A torso or head wound was considered a fatal wound, and the doctor didn’t have time to spend on men whom he couldn’t save.  He didn’t have time to try to save splintered arms and legs either-too many men to see to.  Therefore, amputation was the only real treatment.

Surprisingly, though, for every soldier who died in battle, two died of disease.  Diarrhea and dysentery alone claimed more men than battlefield wounds.  Measles, smallpox, malaria, pneumonia, or camp itch claimed many more.  You’d have thought the camps were safe, so what was the problem?  A heck of a lot!  

First, new recruits weren’t given thorough physical exams.  Men went to fight who weren’t healthy enough to do it, and of course they were more susceptible to disease than healthy men.  Second, troops from rural areas were in the same units as men from cities.  Often the rural men had never been exposed to come of the germs carried by the men from the cities, so they got sick.

Third, camp hygiene was dreadful.  One federal army inspector who visited a camp said the camps were: “littered with refuse, food, and other rubbish, sometimes in an offensive state of decomposition; slops deposited in pits within the camp limits or thrown out with heaps of manure and offal close to the camp.”

Fourth, soldiers suffered from exposure and the lack of protective clothing.  Colds often turned into pneumonia, the third leading killer disease after typhoid and dysentery.  And fifth, poor food and water often weakened a soldier and made him susceptible to disease.  

Sometimes the cures the doctors offered sound almost as bad as the disease itself.  For open bowels the patient was treated with a plug of opium.  For closed bowels the doctor prescribed a mixture of mercury and chalk.  Respiratory problems were treated with opium or sometimes quinine and muster plasters.  Bleeding was also used.  That’s when doctors nick a vein and let blood flow from the patient.

It was easier for the Union army to get medicines than it was the Confederate army.  A large percentage of the medicine used by the Confederates was captured from Union supplies.

The picture below is of an original Civil War amputation kit.   

Information for this post came from the following sources:

http://www.sonofthesouth.net/leefoundation/civil-war-medicine.htm

http://ehistory.osu.edu/uscw/features/medicine/cwsurgeon/


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