Jamie Vessels

3-19-01

4^th Period

Ms. Newmark

Medicine and the Civil War

Many people don’t have a clear understanding of what medicine and medical procedures were like during the period of the Civil War. That is, they don’t understand how horrendous all of it actually was. Men got sent to the hospitals for many reasons, not just for war wounds. Anesthetics were also rarely used. Most patients and hospitals just went without. Hospitals didn’t have guidelines for sanitary conditions of living quarters, or even the tools to operate with. Dentistry was also needed widely throughout the hospitals and camps because of the neglect the soldiers’ teeth suffered without the proper care. Many women also came out of the Civil War as heroes or just well known people. Many things, some good, some bad, occurred because of the Civil War.

Men were sent to the hospital because of many occurrences on and off the battlefield. Wounds from battle were only some of the main causes of men being sent to the hospitals in their camps. In fact, deaths from wounds in a hospital were as numerous as the deaths on a battlefield. About 67,000 men were killed in action, and 43,000 died from wounds on each side, the Confederacy and the Union (Civil War Hospitals, Surgeons, and Nurses, 2). Bullet wounds were numerous, in which 14% caused death, and 71% were the causes of so many amputations. The bullets would get lodged in the legs or arms, and if they couldn’t be removed, resulted in an amputation. 18% of the bullet wounds experienced were in the torso, and 11% of them were in the head or neck (Civil War Medicine, 53 & 54). The rifled musket balls that were popular to use back then could also cause great damage inside and outside the body. Since they were lead, they were soft, and upon entering the body, would flatten. These deformed bullets would rip through organs and also shatter bones. These internal wounds would cause great damage, and would lead to much more serious situations. Internal wounds were almost always worse than wounds from bullets in the arms or legs. Most of the wounds, if in the small intestine, were always considered fatal. But if they were in the large intestine, they were only 40% fatal. If the wounds happened to be in the stomach or the liver, it would be 100% fatal. Lung wounds would be 62% fatal, and wounds to the pelvis and hip area almost always killed the wounded man- 80% of the time they died (Civil War Medicine, 54). On the battlefield, the causes of most deaths were blood loss or hemorrhage. There were no cures for lost blood, because blood transfusions didn’t exist then. Therefore the blood you lost was irreplaceable. There were also many stages of hemorrhage if the bleeding could not be stopped or the wound was not fixable. First, primary hemorrhage would occur in 24 hours of receiving the wound. Next, Intermediary hemorrhage was between the first and sixth days of receiving the wound. Secondary hemorrhage occurred between days four and ten. The tenth day was almost always the worst risk day for hemorrhage and/or death. This was because infection attacked the body’s blood vessels until they weaken and leak. There was no cure or medical procedure for that kind of wound or infection.

There are worse things than battlefield wounds and hemorrhage, though. Disease and infection sent men to the hospital twice as much as battlefield wounds. Many diseases spread throughout the hospital and soldier camps. What didn’t help was that doctors knew nothing about germs and the connection of germs to infection. Some of the diseases that spread through the camps were dysentery and diarrhea, malaria, typhoid, pneumonia, and scurvy. All of these can or are deadly if not properly treated soon after contracting it, and medicine during this time was scarce because of the demand for it and the lack of doctors they had in the hospitals. Infections also claimed the lives of many. After surgery, the use of the contaminated tools helped to spread the germs of many others into the bloodstream of another. This is one way people contracted diseases and became infected. After surgery, sometimes pussing occurred. Staphylococcus aureus bacteria caused this pussing, and it was unknown to doctors at the time. Back then they thought it good, and were glad to have it happening, but it signaled infection, not healing. The deadliest hospital infection, though, was pyemia, which is pus in the blood stream. It killed 97% of those infected. Tetanus killed 89% infected from soil getting into open wounds (Civil War Medicine, 57). Gangrene was also a very common infection that occurred in the Civil War period. Scientists today still don’t know what bacteria might’ve caused hospital gangrene, though. Gangrene would cause limbs to turn rotten and useless, and thus, the limb would hang loosely, or have to be amputated. Amputation was a very common solution to a wide variety of problems in the war hospitals, but what was used to cover up all of the pain?

Anesthetics were not common among many regiment hospitals or in the Prisoner of War (POW) camps. To help ease some of the pain in the procedures undergone by soldiers, though, doctors would use many different forms of anesthetics. Liquor was always readily available back in this time period, and it was sometimes given to the men if no other form of anesthetic was available. Morphine was also used. It was the leading painkiller of the time. Sometimes, it was rubbed into wounds or dusted into them directly. This helped to ease the pain somewhat. It was also sometimes administered in the form of opium pills. Since it was not known that this drug was addictive, when the soldiers got home from the treatment they received, they would have to keep taking the drugs. It would be available at any respectable corner market store. Ether and chloroform were also used as anesthesia. The opium and morphine just deadened the pain before and after the surgery. The reason that many patients needed anesthetics was because of the type of treatment they were receiving, whether it was amputation or simply removal of a foreign object. Surgery or amputation called for the most anesthesia. In a regular amputation kit, there was a scalpel to scrape off skin and hair in some situations, pliers for those stubborn bones, and a bone saw and hacksaw for the initial “chopping.” There were some other smaller instruments, but those were mainly for smaller jobs. Amputation and surgery were dirty jobs back then, and the more anesthesia the better.

Hospitals in the North and South were not very sanitary. These conditions led to many deaths among the soldiers and infections after almost every operation. The living quarters for the soldiers were often unsanitary and riddled with germs and disease. Most hospitals were on site and in the outdoors. Only in the indoor hospitals did the conditions get only a little better. But even so, in both environments, beds were often not plentiful enough for all of the soldiers. The hospitals were also very inadequate. Most operations and other medical procedures were done outdoors. To solve some of the bed- lacking problems, some beds were made out of hay. If the soldiers were not given beds, they would sleep on these hay beds, but they were often full of human excrements. This led to more disease and infection, as flies and maggots swarmed over the waste. Places to properly defecate were often too shallow anyway, and sometimes the waste even fed back into the hospital’s water supply. Human waste was often everywhere, and piles of the soldiers’ limbs would be in certain places around the camp. On one account, one pile of human limbs was greater than man- high. The methods to proceed in these types of surgeries were not often sanitary either, though. Doctors that were called to work in the hospital camps had little experience with these conditions, let alone sanitation. Doctors were in such high demand that they left for the battlefield from school with hardly an understanding of what should really be going on. They would take whatever doctors they could, though, so most of the doctors that were at the battle sites were not properly trained. Therefore, doctors didn’t know much about sanitation, and antiseptic methods were not known at this time. Before a surgical procedure, the doctors would examine the wound and then they would decide on which medical procedure to perform. The doctors would then remove the knives from their mouths, where they were storing them for the time being, and would merely wipe then off hastily on their blood-stained aprons. They would then continue with the operation. Though medical procedures often differed greatly, the result was often tragically the same: infection.

Dentistry was also a big issue of the day, because many soldiers neglected to take proper care of their teeth. Toothbrushes were scarce, and so was the money for appointments with the dentist because of the high prices of the day, especially when inflation set in in the Confederacy. Because of the neglect to their teeth, some unlucky soldiers could not properly serve on the battlefield. Some people would be missing six opposing teeth that inhibited them from tearing off the end of the powder cartridges used with the muzzle loading rifles of the time. In a normal day, dentist would sometimes have to do twenty to thirty fillings, along with pulling fifteen to twenty teeth, prepare cavities, and do removal of tartar ad libitum, which is the same thing as tartar (Civil War Dentistry, 1). Dentistry was a busy job in that day because of all of the problems caused from soldiers ignoring a tooth- ache or two.

Famous women also emerged from the Civil War because of the roles that they played in the care- taking of the men in the war. All of these women wanted to help serve the country the best and one of the only ways that they could: nursing. Clara Barton was one of those women. Strong- minded, she often thought the worst of her superiors and associates. She was deeply moved by the reports of the First Bull Run and wrote to the Worcester Spy asking for supplies to help out the soldiers of the war. She took care of the men that were both riddled with war wounds and diagnosed with disease. She eventually founded the American Red Cross, and was the director of it for twenty years. Dorothea Dix was also a well known woman to emerge from the war. She is mostly recognized for improving living for the insane. She began to recruit nurses for the Army Medical Bureau when the war began. Some traditionalists opposed her, but her stubbornness helped her to prevail. She, along with Clara Barton, was called “The Angel of the Battlefield.” Mary Ann Bickerdyke was an Agent of the Sanitary Commission. She set up Union hospitals and nursed tirelessly at nineteen different battles. Her efforts were successful, but people often complained that her manner was brittle. When complained to about Bickerdyke, General Sherman told the soldier, “If it was Bickerdyke, I can’t do anything for you. She ranks me” (When This Cruel War is Over, 60). Louisa May Alcott was also one to volunteer to help nurse the soldiers of the war. She reported for duty to Washington hospital in late 1862. She was soon invalided home with typhoid fever, though. She wrote about her experiences later, along with Little Women. These brave women all worked for the Union, mostly in Washington hospitals. The next couple women worked for the Confederacy. Kate Cumming was an avid southerner. She was born in Scotland, and came to Alabama as a girl. She was devoted to the South, and was “delirious with joy” when Virginia seceded. When the war started, she offered her services as a nurse, and said that it was more a social affair than a medical one. Cornelia Hancock was also a southerner, and was twenty- three when she started to nurse in the war. After the war, she worked with Southern Negroes and also with the Philadelphia poor. All of these women wanted to help their men and serve their country with good intentions.

Medicine in the late 1800’s was cruel and men often chose death over the tortures of having to be treated. Amputation was the most painful procedure, yet the most common. Proper sanitation was almost always disregarded and led to many diseases, which even more men died from. Dental hygiene was not taken care of, and so some men were not able to properly serve in the army. Women also emerged as national figures of courage. Many men died in the war, not only because of the battles being fought, but also because of the terrible medicine and diseases of the Civil War.