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Civil War Medicine

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Sarah B

on 2 April 2014

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Transcript of Civil War Medicine

- The first substantial medical advances in prosthetics occurred during the Civil War
- The Union's "Great Civil War Benefaction"
-Confederacy followed the Union and also began insuring artificial limbs to their soldiers (North Carolina being the first to do so)
-Prosthetic Industry and Competition
-1861-1873: 150 patents for limbs issued
(3x the increase than previous 15 years)
-James Edward Hanger (Confederate)
First amputee and launcher of J.E. Hanger, Inc.
-Men like Hanger, characterized themselves as humanitarians not businessmen
-The Civil War marked the end of the era of wooden peg legs and simple hooks.
-Artificial limbs advanced to look life-like and have attachable and removable parts such as swords, knives, hooks, and other instruments and utensils
Doctors and Nurses
Many wounded and injured soldiers in the war
Needed a way to sedate and calm down those in shock and those preparing for amputation
Infection, Bullet shell injuries
First introduced in the late 1840's during the Mexican- American War
Limited Usage
1849 Sulfuric Ether becomes issued by US Army
Made popular in field surgery
Evacuating the Wounded
Two pioneers in this field, Jonathan Letterman and Samuel Stout
Letterman, Union surgeon, established regimental aid stations and field hospitals
Also authorized training for ambulance companies that moved men from the battlefield to hospitals
Stout, a confederate doctor, devised mobile field and general hospitals
Campaigned for hospitals with larger, open wards. Organized effective evacuation system for wounded
Both men made similar yet monumental changes
Rapid evacuation, field assessment, transportation to areas far from battle lines
Transport in trains and ships, like DA January
Civil War Medicine
Field Hospitals
Pavilion Hospital
Maggot Therapy
Debate on Substance
First, people were unsure which to use
Ether had more precedent, chloroform was more potent
Ether was somewhat more difficult to administer and more easily adulterated
Chloroform only took 9 minutes to anesthetize whereas ether took 16
Chloroform was not flammable as opposed to the highly flammable ether
By the end of the war, chloroform was the anesthetic of choice
Sarah Breckinridge
Whitney Smith
Elizabeth Weathers
Sam Wilson

Why are Civil War Medical advancements important?
Amputation and Prothstetics:

Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine
, Ira M. Rutkow

Prisons and Hospitals: The Photographic History of The Civil War
, Francis Trevelyan Miller










Prosthetic Devices
• Slimy, slithery, fly larva, primarily blowflies
• Eat dead and infected tissue of wounded soldiers
• Clean the infection locally without causing harm to other parts of the body
• Very effective because they stop eating once the dead tissue is gone
• Excrete sterilizing chemicals while digesting dead flesh
• Pain free except for a tingling sensation of maggots wriggling around

• Happened upon the treatment in Confederate hospitals where sanitation was not first priority.

• Union doctors had supposedly more sanitary conditions
- Would inject chloroform onto the stumps of amputee patients to help rid infections of flies.
– Many Union soldiers died of gangrene from infected wounds

-30,000 to 40,000 soldiers lost limbs
-While the new invention of the Minié Ball bullet allowed for accuracy and larger shooting range it also caused extreme damage on impact
-Limited experience of doctors
-Amputation was the easiest and safest procedure for large wounds
-Also used when wounds of various size were infected
-28% mortality rate (death rate)
-Doctors were known to quickly resort to amputation and were termed "butchers" by many soldiers, however in many ways amputation was practical
-70% of wounds were to extremities therefore explaining why amputation was such a go-to procedure to save a soldier's life
-Sooner performed the better the chance of survival
The chance of survival also varied based on injury placement
-Process of cutting quickly and healing by granulation and the "fish-mouth" method
-Crude conditions of amputations, often performed outside and discarded parts were often left in heaps

Why Civil War Medical Advancements are important
Surgeons operating, attendants holding lights, the smell of ether,
the odor of blood;
The crowd, O the crown of the bloody forms -
the yard outside also fill'd
Some on the bare ground some on the planks or stretchers,
some in the death-spasm sweating;
An occasional scream or a cry, the doctor's shouted orders
or calls;
The glisten of the little steel instruments catching the glint
of the torches;
These I resume as I chant - I see again the forms,
I smell the odor;
Then hear outside the orders given, Fall in, my men,
Fall in...
Lines from "A March in the Ranks,Hard-Prest, and the Road Unknown," a poem in
, a collection of verse published in 1865 by Walt Whitman:
Inexperience of doctors and nurses
Only 500 out of 11,000 physicians in the Union had previously done surgery and only 27 out of 3,000 physicians in the Confederacy had previously done surgery
Doctors and nurses of the Civil war required very little training compared to the standards in place today
Role of Women
Clara Barton
Mary Edwards Walker
















• Introduced by Clara Barton later in the war
• Originally set up in preexisting buildings
• Later set up in larger pavilion-style hospitals
• Well ventilated, clean, efficient
• Became discrete, well maintained communities
• Run by surgeons, hospital stewards, male and female nurses, matrons, laundresses, and volunteers
• Patient care quality dramatically improved as war progressed
• General hospitals had 8% mortality rate

Architectural make up of pavilion hospitals
• Long, separate, wards
• Benefits of a tent with added protection of a solid structure
• Lighter, warmer, better ventilated
• Shutters on roof allowed air flow but also protection from elements
Doctors and Nurses

Soldiers were usually taken to a field dressing station where their immediate injuries were taken care of and in case of injuries too sever to continue fighting soldiers were then taken to field hospitals. Field hospitals were makeshift medical centers made out of anything from tents to barns near the battlefield. Soldiers were usually separated into categories depending on the severity of their injuries and whether they would need surgery. These hospitals were furnished with improvised equipment such as a surgical table made up of a barn door propped on two barrels and were very unsanitary. The temporary operating table was often covered with blood from previous occupants and doctors did not know that sterilization of instruments was necessary to prevent infection or spread of disease. The most common operation at a field hospital was an amputation.
Field Hospitals
Field Hospital in Virginia
US Army Manufactured Chloroform
Careful steps and precautions to procedure
Can't be sitting up, must be laying and relaxed
Be on empty stomach to prevent vomiting
Wear loose, comfortable clothing
Gradual inhalation, not rushed.
Going Under
Chloroform Success and Decline
Despite the claims of its unsafe nature, only few died
only 54 deaths in nearly 7,000 cases
stats skewed because it was the use in dire situations too
Following the war, its use declined as its need did
more safe anesthetics were developed and rendered it obsolete
still used today in cold medicine, cough drops, toothpaste, mouthwash, and more
People were still skeptical of chloroform use
Many deaths due to it early on
dosing had to be extremely careful as too little wouldn't work and too much would kill the patient
Deaths were highly publicized
some wounded even declined anesthesia due to fears from media
Some doctors loved it, some detested it
"wonderful in mitigating the suffering of the wounded'






The end of the "Medical Middle Ages"
Numerous Advancements in Medicine
Increase in knowledge about anesthesia, surgery, prosthetics, and sanitation
Increased participation of women
• In Union army, 4 men died from sickness for every 1 man killed in battle
• Deaths from disease were twice the amount of those resulting from other causes
• Most disease related deaths happened at the beginning of the war when sanitation and hospital conditions were at their worst.

• The most common maladies were:
Dysentery, Typhoid, Ague, Yellow fever, Malaria, Scurvy, Pneumonia, Tuberculosis, Smallpox

• The spread of most diseases was the result of poor hygiene, garbage in camp, fifth from camp sinks and toilets, overcrowding, weather exposure, spoiled food, impure water, lack of surgeons and doctors that used aseptic techniques.

• At the time, there was little knowledge of sanitation and antibacterial procedures
from http://www.utoledo.edu/library/canaday/exhibits/quackery/quack8.html
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