Hira Hasnain

Social Studies, per. 5

March 19, 2001

 

Civil War Medicine

 

           

More people died in the Civil War, than in all of America’s other wars combined. The main reasons for these deaths were diseases and battle wounds. The doctors and surgeons of the time had little knowledge of medicine. It was expected that the war would last a few months, so during the first couple of years, there wasn’t much preparation for the war, either. Due to the doctors little knowledge of medicine, and little preparation for the war, 2/3 of the 600,000 men who died during the war, died from diseases and battle wounds. Of these men, 360,000 were from the North, and 258,000 were from the South. Many soldiers believed that the doctors “killed more people than they cured”, but in reality the doctors tried their best to save their patients’ lives, and helped them as much as they could.

          During this time, there was a great demand for surgeons. This is why many of them had little or no training in the medical field. The education and training that the surgeons of this time received was very poor, since there wasn’t much knowledge of medicine. Most of the surgeons attended medical schools, which were mostly just diploma factories, providing very little real training. At this time, there was no medical licensing board, so these diploma factories were allowed to continue. Doctors only attended three semesters of thirteen weeks of these medical schools.

The good medical schools, located at the best colleges of the time, had programs which were only one year programs, although two years was recommended. During the first year, the students mostly learned book instructions. During the second year, the first year was repeated, just in case someone missed something the first time around.

               Many of the people during the war became surgeons without ever attending medical schools. These people would first start off as litter bearers, who would carry wounded men off the battlefield. Then, if they were interested in medicine, they could be promoted to a Steward. The Steward took care of patients with minor wounds, and would carry a firearm to guard the medicinal stores. If the Steward did his job well, he could be allowed to help a surgeon in an operation. He could then be promoted to an assistant surgeon. This way many people in the war became surgeons without much knowledge of the basic concepts of surgery.

               The Civil War surgeons not only had little training, they also had very little knowledge of medicine. They didn’t know much of sterilization, sanitation, or bacteriology. They didn’t know that cleanliness had anything to do with their operations. This is why they rarely cleaned their instruments, or themselves. Most of the time, the surgeons would shine their instruments on their bloody shirts, a dirty rag, the sole of their shoes, or pretty much anything they could find. If they had known what terrible mistakes they made, they might have been able to save many lives.

“We operated in old blood-stained and often pus-stained coats, we used undisinfected instruments from undisinfected plush lined cases. If a sponge or instrument fell on the floor it was washed and squeezed in a basin of water and used as if it were clean.” Here, a Civil War surgeon describes the usual working conditions of the doctors during the war. He describes just a few of the horrible conditions, these doctors had to work in. They lacked water, basic supplies, drugs, knowledge, and time. Civil War surgeons are considered to be dirty, horrible people who killed many soldiers, but they actually tried to help their patients as much as possible. They did the best they could, considering how much they knew of surgery and medicine. Most of the time, these surgeons had to perform operations with very little light, usually from a lantern. They had to use farms, schoolhouses, homes, churches, and many other such places, as operating rooms. Sometimes, they even had to use doors, or kitchen tables to operate on. They had such little knowledge that a surgeon sewing up a man’s wound would lick the thread to get it into the needle. This meant that if the surgeon were sick, he would pass it on to his patient. Most of the time, the surgeons would go from one patient to another without even washing their hands. Sometimes the surgeons gave up their health to help their patients survive, but they always tried to do what they could. Below is a picture of a couple of doctors performing surgery.

Those who survived disease and battle wounds during the Civil War survived not only  because  of  the  doctor’s  help,  but  also  because  of  the  nurses’ help.  The  nurses   cared for their patients so much, that the patients considered them their mothers. From both the North and the South, there were about two thousand volunteer nurses in military hospitals.

One of the most famous nurses was Clara Barton, known as “The Angel of the Battlefield”. She was very committed to helping the sick and wounded soldiers. Sometimes, she even helped soldiers while they were out on a field during a battle. Clara Barton did not care what side a soldier was on, but if he was sick or wounded, Clara would   be   there   to   help.  She    began  her  services  in  April  1861,  when  the  Sixth Massachusetts Regiment arrived in Washington. This regiment had lost its baggage in battle, so Clara Barton provided towels and handkerchiefs by tearing up old sheets, and cooked for these troops. After the battle of Bull Run, Clara found out that there were shortages of supplies in the field.   So,  she  advertised  for  provisions  in  a newspaper, and when the public sent huge amounts, she established a distributing agency. Above is a picture of this heroic lady. Clara Barton showed that she cared for the sick and wounded soldiers. She believed that all soldiers should get the best possible treatment, no matter what side they were on.  Clara was so committed to helping others that in 1881, she helped organized the National Society of the Red Cross. She was its first president, and directed its relief activities for the next 23 years. She had a big hand in helping many Civil War soldiers survive.

Along with Clara Barton, there were many other nurses who were dedicated to helping the sick and wounded soldiers. In the North, many women worked for the U.S. Sanitary Commission. This was an organization of men and women who supported the war effort in the North. It consisted of men too old to fight, and hundreds of women volunteers. The Sanitary Commission also helped with medicine, and sometimes even worked in hospitals. These Civil War nurses treated their patients very well, and helped them as much as possible.

Deadly diseases threatened the lives of many soldiers in the war. The main reason that so many soldiers had diseases was because many of them had never been around so many people, before. Also, many of the soldiers were rural farm people, who had never had any childhood diseases such as the measles, mumps, chickenpox, or whooping cough. Now, as adults, these soldiers were getting sick with childhood diseases, resulting in deadly situations. Other diseases were fever, cold, typhoid, dysentery, intestinal disorders, and pneumonia. The doctors didn’t know how they were caused, and couldn’t treat them.

Of all the soldiers that got injured during the war, many had internal wounds. Having internal wounds at this time meant that the soldier had a very rare chance of survival. The surgeons had no knowledge of internal surgery, so they could not deal with internal wounds. Some of these wounds were so bad, that the surgeons had never seen them before, and therefore did not know what to do. Sometimes, when the surgeon did not know how to treat a certain wound, he would take his patient, and leave him lying in the shade of a tree. This tree would be called “the dying tree”. Also, many times, after an operation, the doctors thought it a good thing if pus formed. This was called, “laudable pus”. In reality, the pus was a sign of massive bacterial infection, which would usually kill the soldiers.

The deadliest injury of this time was one caused by a minie ball. Many soldiers had guns that used minie balls, which were big, heavy, lead balls that went very slowly. Minie balls were so heavy that an abdominal or head wound was almost always fatal.

 These minie balls also carried dirt and germs into the wound, which would cause infection. The worst thing about a minie ball was that if it hit a soldier’s bone, the bone would be shattered. There was no technology for bone reconstruction, so the arm or leg, where the bone was shattered, would get amputated.

The most common operation during the Civil War was amputation. Three out of four operations were amputations. An amputation was performed on a board supported between two barrels. The surgeon would first have to cut off the blood flow with a tourniquet. He would then take a scalpel and cut through the flesh and tissue to the bone. Then, the surgeon would have to cut through the bone, using a tool called a capitol saw. Last of all, the surgeon would sew up the arteries, and veins with silk or cotton thread. Amazingly, many soldiers survived amputations, considering the fact that they had a 50% mortality rate, if the operation was done within 24 hours of the injury.

One of the main reasons why so many soldiers died during this war was that the medical technology at this time was not half as proficient as it is today. The doctors did not understand what drugs to give their patients, and how much of it they needed. They mostly used wrong kinds of drugs, which led to terrible results. Most of the time, during operations, patients were given an anesthetic, such as chloroform. The only problem was that the surgeons would accidentally overdose the patients, which would result in the patients getting addicted to the drugs. Many surgeons gave their patients morphine as a painkiller, and again, they would overdose the patients, and they would get addicted. Sometimes, the surgeons gave arsenic, strychnine, or calomel to patients with diarrhea. Later, it was discovered that all three were poisons, and calomel was mercury. The doctors of today would never do such things, but due to the inadequate medical technology during the Civil War, the doctors during this time did.

For the first few years of the war, everything was very disorganized, including hospitals and medical departments. This was mainly because no one had thought that the war would last so long. Fortunately, as the war resumed, hospitals and medical departments became more organized, as there was a greater need for them.

 

 

 

A field dressing station was like a clinic, out on the battlefield. This would be located  50-100  yards behind the main battle line, and consisted of a surgeon, an assistant surgeon, and sometimes a hospital steward. The wounded soldiers would come back here, and the surgeons would do basic first aid. For major wounds, the surgeons would shut off the bleeding, and call for stretcher-bearers. These stretcher-bearers would take the patient to an ambulance, which would then drive him to a field hospital.

Patients that needed more medical attention than basic first aid were brought to a field hospital. The field hospitals were a mile, or two behind the battle line. Railway stations, barns, or any such decent place was set up as a field hospital.  The doctors would use anyplace they could find. They basically just needed water, light, and a flat surface for operations. There would be a surgeon outside which would check to see what kind of treatment the patients needed, and would send them to different rooms. Near the hospital, there would usually be a pile of arms and legs, which had been amputated from recent patients. These hospitals would be very dirty and unclean causing many patients to get infections.

There were many soldiers who survived injuries, and diseases, but that wasn’t all they would have to survive. If a soldier lived through injuries and diseases, he would then face the obstacle of overcoming infection. The main reason for infection was dirt, filth, and germs. Since surgeons didn’t know how to sterilize equipment, and didn’t stay very clean, many of their patients got infections. In fact, due to the shortage of water, doctors went days without ever washing their hands, or equipment. This way they would pass germs from one patient to another. “Surgical fevers” was the name given to the horrible infections, caused by bacterial cells which generate pus, destroy tissue, and release deadly toxins into the bloodstream. The rotting away of flesh caused by the obstruction of blood flow, called gangrene, was also very common after surgery.

When a soldier was wounded during a battle, and needed to get to a hospital, he would have gotten there, using a Civil War ambulance. Civil War ambulances were two and four-wheeled horse drawn wagons, used to transport wounded soldiers. In an ambulance, there would be a mounted line sergeant, two stretcher-bearers, and one driver per ambulance, to collect the wounded from the field. This medical transportation system was suggested by Jonathon Letterman, so it became known as the Letterman Ambulance Plan.

Before this ambulance plan, the job of getting wounded soldiers to a hospital, was given to unfit soldiers, not capable of fighting in the war. Since they hadn’t been good as fighters, they were terrible as medical assistants. They mostly got drunk, and ignored the wounded. By doing so, they’d be able to hide from the enemy fire.   Due   to   these    soldiers’   behavior,    the

Letterman Ambulance Plan was proposed.

A wounded soldier about to ride an ambulance, would get a choice of either a two or four-wheeled wagon. Both of these wagons had very bumpy rides, but the four-wheeled wagon was much better than the two-wheeled one. The two-wheeled wagon, shown below, swayed and tossed the wounded inside, from side to side. Some unfortunate soldiers even slid out of the wagon. The four-wheeled wagon was a little better, but the problem with this was that over half a dozen men were squeezed into it. One way or another, the soldier could not reach the hospital with peace and comfort.

 

 

 

 

 

 

The surgeons and nurses during the Civil War had a very tough and frustrating job, but they still tried their best to help save lives. Many people think that the surgeons were “butchers”, but in reality they did try their hardest to help their patients. Their only problem was that they lacked time, knowledge, and supplies, and so they couldn’t save many. Although many patients didn’t survive, those who did were grateful, and relieved that their lives were saved thanks to the doctors and nurses during the Civil War.

 

 

Works Cited

 

1)     “Battlefield Medicine”, VHS. This was a very good source for my project. It provided   

          lots of useful information.

2)   Catton, Bruce. The American Heritage Picture History of the Civil War. New York,         

American Heritage Publishing Co., 1960. This was also a very good source, but I didn’t get very much good information from it.

3)     “Civil War Amputation”, http://members.aol.com/CWSurgeon0/Amp.html, 3/3/01.

          This site was a good source, but had only a little bit of information on amputations.

4)     “The Civil War Homepage”, http://www.civilwarhome.com, 2/28/01. This was the    

best source out of all the sources I used. It had lots of information on all of my major topics of Civil War Medicine. 

5) “Civil War Medicine”, http://www.powerweb.net/bbock/war.html, 2/28/01. This didn’t   

           help me very much, but provided a few good facts.

6) “Clara Barton”, http://www.rootswev.com/~nwa/barton.html, 3/3/01. I thought that 

          this site was a very good source, even though it wasn’t very detailed.

7) Wright, Mike. What They Didn’t Teach You About the Civil War. California, Presidio  

          Press, 1996. This source didn’t help me very much.