Civil War Medicine

At the beginning of the war, knowledge of health care was very limited, and not may of the nurses and doctors knew how to treat certain things, or how to do surgery. Although Civil War medicine began very primitively, through many obstacles and hardships with the assistance of strong individuals it progressed with important developments for future medicine.

Surgeons, doctors, and nurses, were not aware of sanitation, and were not familiar with cures for diseases and wounds. At the time no one knew about bacteriology. Their working conditions were very unsanitary. They used bloody tools on the same people, didn’t wash their clothes or hands, and used dirty, bloody sponges to clean the wounds. Surgeons had little supplies to work with. Their medicine supply was low, and had nowhere to set up hospitals. There was lack of water, basic supplies, drugs, and most of all, time. For operating tables, doctors had to use kitchen tables, doors, and any other flat surface they could find. Surgeon’s tools were also very limited.

Surgeons used a variety of medical tools. Each surgeon basically had the same tool. Each kit would have two surgical saws, a curved probe, retractor, cutting pliers, clamps, brush, and trepanning instruments carried in a plush wooden case. Since surgeons had nowhere to set up hospitals, they used farms, schools, homes and churches. Doctors only cure sometimes for wounds were amputations.

Every three out of four operations were amputations. The Minie Ball, which was one of the most harmful bullets, was usually the main cause for an amputation case. A soldier would have to wait one to two days until a doctor could see them. After they were seen, then they would have to get medicine for their disease. Most diseases had small cures, but the main cure was time and rest. Yet, for severe wounds doctors would have to amputate.

For the typical amputation case the doctor would make an incision in through the muscle and skin down to the bone with his scalpel. He would make incisions above and below, and leave a flap of skin on one side. Then, he would take his bone saw and saw through the bone. Then the flap of skin would be pulled across and sewed with horsehair, silk, or cotton threads, and the surgeon would leave a drainage hole. The stump would be covered with isinglass plaster, and bandaged. Medicine at the beginning of the war was very primitive.

At the beginning of the war there were no ambulances, and very few supplies. To every surgeon there were one thousand men. Doctors did not know anything about bone reconstruction, so if they needed to fix a bone, they would have to amputate. Doctors were also unable to perform internal surgery. Twice as many men died from diseases than they did in battle. If doctors would have known how to perform internal surgery, they could have saved many soldiers lives. Six hundred and twenty thousand men died, and most of them died from disease.

One of the main causes for disease was the unsanitary hospital conditions, and the dirty conditions that the soldiers had to live in. Doctors were unaware of sanitation, and that played a major part in disease. Also, the army let under-age and over-age men into the army with bad health. There were many diseases during the war.

Diarrhea and dysentery killed more soldiers than a battle wound. Many other common diseases were measles, small pox, malaria, typhoid, pneumonia, or camp itch. Insects or a skin disease caused camp itch. Eating food or water that was contaminated by salmonella bacteria caused typhoid. Although doctors were unaware of most causes for disease, they did know some.

The large number of cause for diseases were un-accurate physicals before joining the Army, the fact that many troops came from rural areas, neglect of hygiene, insects and vermin, exposure to other diseases, lack of clothing and shoes, and poor food and water. Also, soldiers got about one to two hours of sleep, so they were not well rested, which was another cause of sickness. Many men were rural farmers that had not been around other people very much, and they had not been exposed to childhood diseases like the measles. Disease was everywhere during the War.

The Civil War was known as a “Field day for bacteria”. Pneumonia was the third leading killer diseases of the war, and then typhoid and dysentery. A soldier’s chance of not surviving was about one in four. Doctors had many cures for diseases, yet they didn’t know cures for some.

For bowel complaints, open bowels were treated with a plug of opium. Closed bowels were treated with “blue mass”, which was a mixture of mercury and chalk. Also, for scurvy doctors prescribed green vegetables, and for respiratory problems, like pneumonia and bronchitis were treated with opium or sometimes quinine and muster plasters. Yellow fever was one of the many diseases during the war.

Mosquitoes spread yellow fever. When the mosquito bit a person, the disease began within a few days. The patient had head and body aches, high fever and nausea. Damage to the liver caused yellowing of the skin and eyes. More than half of the people who had yellow fever died within a few days. People who survived got immunity towards the disease. Yellow fever was most common in swamps around the Mississippi River and Southern ports. Yellow fever spread throughout the war just like small pox.

Small Pox was mostly present in dirty conditions. People from the Union and Confederacy died of disease. The first Confederate army infection was after contacting Yankees at Sharpsburg. The disease spread, so the Confederates had to be vaccinated.

Soldiers in the northern area were more likely to get pneumonia. Sick or injured soldiers, whose immune systems were not very good, were most likely to get pneumonia. In Union prisons, many southerners died from pneumonia. Many doctors thought that pneumonia was an inflammation and that the patient needed to be bled or “cupped.” After many patients were bled, they later died. Some treatments for pneumonia were liquor, opium, and quinine.

Measles was also a very common disease, especially in rural areas. The measles infected 4,000 out of 10,000 Confederate troops in one of their camps. Surgeons treated the measles with whiskey, and rest, yet time was the best treatment for the disease.

Caused by poisonous vapors coming from ponds and swamps, was another deadly disease known as malaria. Surgeons called malaria “ague”, “shakes” or “intermittent fever”. Malaria started with shivering down the spine and a fluctuating fever. Whiskey and quinine were the main treatments used for malaria, and some Yankee patients were given too much quinine that their teeth became loose, and they could not even eat. When the stock of drugs in the south became low, doctors substituted tonics made from whiskey mixed with barks of dogwood, tulip, and willow trees. Malaria was caused by poisonous vapors coming from ponds and swamps. Diarrhea and dysentery were also two major diseases during the Civil War.

Diarrhea and dysentery were called “quickstep” and “alvine flux”. Doctors did not know a cause for these diseases, and 57, 265 Yankees died dysentery or diarrhea, and 44, 238 men died in battle. At Chimborazo Hospital in Richmond, one out of every ten diarrhea or dysentery patients died. Many doctors used opium to treat dysentery, and used “blue mass”, a mixture of chalk and mercury to treat diarrhea. Other treatments used were strychnine, castor oil, laudanum, camphor, turpentine, calomel, lead acetate, silver nitrate, quinine, whiskey, and ipecac. Diarrhea and dysentery were very harmful to the soldiers.

During the war, sometimes both sides suffered from medicine shortages, and they had to be smuggled in. Medicines were smuggled into the South, and were sometimes even sewn into petticoats. The South also had manufacturing capabilities, and worked with herbal remedies. Many of the Southern Medical supplies though, came from captured Union soldiers. Medicines were very scarce at certain times in the War.

Chloroform was used about seventy five percent of the time. Out of eight thousand nine hundred cases of use of anesthesia, only forty-three deaths were attributed to the anesthetic, with a mortality rate of .4%. Chloroform was applied to a cloth held over the patient’s mouth and nose and was withdrawn after the patient was unconscious. For anesthesia doctors used morphine, opiates, and chloroform. The doctors could not do surgery if they did not have hospitals, although sometimes they were very limited.

Civil War hospital conditions were very unsanitary. They used dirty tools, and had few medicines. One hospital was the Regimental Hospital. The Regimental Hospital was allowed four tents. Two of the tents were used for the officers and the medicines. Another tent was used for the injured and wounded patients, and the other was used for supplies, and the kitchen. Each tent could hold eight patients, which were usually in a cot. The hospitals ran smoother with the help of individuals that affected future medicine.

Clara Barton, Dorothea Dix, Mary Bickerdyke, William Hammond, and Dr. Isachar Zacharie were only a few of the many people that helped changed medicine. Without these people, and the help of others, medicine would not be like it is today, and we would not have the American Red Cross. Also, all of the nurses were volunteers, and if no one volunteered then the soldiers would have just been left to die.

Clara Barton was born in Oxford, Massachusetts in 1821. She was the youngest of five children. At age fifteen she started an eighteen year teaching career. She worked at Washington Patent Office at age thirty-nine when the Civil War broke out. When she heard about how many men were wounded from First Bull Run she advertised for donations of medical supplies, since she saw how little supplies they had for the wounded or sick soldiers. She organized relief programs for the union troops stationed nearby. In 1862, she was told by Surgeon General William Hammond to travel with the army, for the purpose of helping the sick and wounded. For the next three years she worked her hardest to help the soldiers, and earned a title as angel of the battlefield. At Abraham Lincoln’s request, she led the search at the end of the war for the missing soldiers. Also, she traveled to Andersonville, Georgia to identify the graves of Union soldiers. In 1881 Clara Barton established the U.S. Sanitary Commission, which is now known as the American Red Cross. Unfortunately, on April 12, 1912 Clara Barton died. She lived a long and successful life that was very influential on future medicine.

Dorothea Dix was a very successful Civil War nurse. She was the Union’s Superintendent of Female Nurses during the War. She had spent more than twenty years trying to improve mentally ill prisons, and trying to find the treatment for the mentally ill. At age fifty-nine, a week after the attack on Fort Sumter, Dix volunteered for the Union and in June 1861 was appointed to be in charge of all women nurses working in army hospitals. She convinced military officials that women could do the job effectively, since the military officials were not used to females working. Dorothea Dix formed a dress code of black or brown skirts, and hoops and jewelry were not allowed. She was named “Dragon Dix” because of how strict she was with other nurses. At the end of the War, Dix returned to trying to find a cure for the mentally ill, and trying to improve their prisons. Mary Bickerdyke also helped organize hospitals during the war.

Mary Ann Ball Bickerdyke was born in Knox County, Ohio. She was known as the most colorful and resourceful Civil War nurse. She worked as a botanic physician in Galesburg, Illinois, and organized many hospitals in Cairo. By the end of the war, with the help of the U.S. Sanitary Commission, Bickerdyke had built about three hundred hospitals and helped the wounded on nineteen battlefields.

William Alexander Hammond graduated from New York University’s Medical College in 1848 and joined the U.S. Army the next year as an assistant surgeon. During his ten-year term he served in the West and at the Military Academy at West Point. At the beginning of the war, he was assigned to inspect the hospitals and army camps. The U.S. Sanitary Commission recognized Hammond’s work of inspecting the hospitals and camps. In April 1862, the U.S. Sanitary Commission pressured Hammond to be appointed surgeon general with the rank of brigadier general. He created the general hospital service, provided assistance to surgeons on the battlefield, and helped with the establishment of the ambulance corps. Also, he created two large government operated drug laboratories to make high quality medicines for the army. Stanton had Hammond court-martialed on a small charge and dismissed from the army in August 1864. Hammond’s court-martial was overturned after the war, and he was brought back the rank of brigadier general, and retired in 1879.

One of the major doctors of the war was Dr. Isachar Zacharie. Dr.Zacharie operated with foot, and was known as the foot doctor to Lincoln. He treated foot problems of thousands of Union soldiers. After the war, he submitted a bill for $45,000 to the War Department for treating the feet of 15,000 Union soldiers. The bill was never paid, and Zacharie returned to England.

Many volunteers, nurses, surgeons and doctors helped to change medicine for the better by the end of the war. The U.S. Sanitary Commission was formed, and the Ambulance Corps was formed. Letterman formed the Ambulance Corps, and Clara Barton formed the U.S. Sanitary Commission, which is now known as the American Red Cross. Barton, Letterman, and many others greatly changed medicine.

One major problem of the Civil War was how to transport the wounded. The low amount of supplies for moving the wounded soldiers was a major problem. On July 4, 1862 Dr. Jonathan Letterman replaced Surgeon General Charles S. Tripler, commander of the Army of the Potomac Medical Department. The Ambulance Corps was formed in time for Antietam, and was formed by the director of the Army of the Potomac, under its medical director Jonathan Letterman. Then, the Corps was known as the Letterman Ambulance Plan. In the system, the ambulance of a division moved together, under a mounted line sergeant, with two stretcher-bearers and one division per ambulance, to collect the wounded from the field, bring them to the dressing stations, and then take them to the field hospital. Drills were repeated frequently in the corps. They had a normal schedule and regular stops on a route. After trying many times, the Ambulance Corps was passed on March 11, 1864. It established the corps as a normal army unit and gave the Medical Department the right to train the men.

In April 1861, Reverend Henry Bellow from New York organized separate women’s aid organizations into the Women’s Central Association of Relief. On May 18, Bellows and three other medical men proposed to the secretary of war that a group of civilians, medical men, and military officers organize the country’s soldiers’ aid activities. On June 7, the administration agreed to the naming of a “commission of Inquiry and Advice in Respect to the Sanitary Interests of the United States Forces” which became known as U.S. Sanitary Commission, which is now known as the American Red Cross. Clara Barton was a major founder of the U.S. Sanitary Commission.

Medical knowledge was very primitive at the beginning of the war, yet with the help of volunteers, nurses, doctors, and surgeons it progressed. People discovered more things about medicine after the war. The Civil War was a major turning point in medical knowledge.

Bibliography

1. “.” Clara Barton. April 23, 2002.

http://www.civilwarhome.com/bartonbio.htm

2. “.” Civil War Interactive. April 1, 2002.

http://www.civilwarinteractive.com/anesthetic_in_field_and_general.htm

3. “.” The Sanitary Commission. 1 March, 2002.

http://www.civilwarhome.com/sanitarycommission.htm

4. Garrison, Webb. 2,000 Questions and Answers About the Civil War.

New York: Gramercy Books, 1992

5. “.” The Union Army Ambulance Corps. 3 March, 2002.

http://members.aol.com/weaver300/grayson/vacwhp.htm

6. “.” Dorothea Dix. 20 April, 2002.

http://www.webster.edu/~woolfm/dorotheadix.html