Medical Practices in the Civil War

1. Medical Practices in the Civil War

2. Union: 2 &1/2 million soldiers fought with 360,00 soldiers killed. • Confederate: 1 million + fought with 250,000 soldiers killed. • Of 618,000 deaths only 200,000 were the result of being killed or wounded in battle. (Down from 88% of deaths in Mexican War.) Statistics:

4. 2 out of 3 died from disease. (Ex: Measles, mumps, diarrhea, pneumonia, & typhoid fever) WHY? a. Dirty, overcrowded camps (Rural soldiers got childhood diseases; worse for you as an adult.) b. Lack of modern medicine (ex: vaccines, antibiotics) c. Bad food (Army sold bad food, starvation then gorging by soldiers, no food available) d. Lack of personal cleanliness (Most people thought taking a bath too often could kill you) • Medical knowledge during the Civil War = a mix of good advice & ignorance.

5. Examples: “Laudable Pus” thought it was a sign of healing instead of a bacterial infection. • Reuse bandages from patient to patient. • Quote: “Of all instruments for conducting an examination of a gunshot wound, the finger of the surgeon is most appropriate.” T. Longmore, Surgeon.

6. Most doctors prior to the Civil War had never seen a surgery being performed. • Battle Wounds: New guns and type of bullet (Minnie ball) cause far worse injuries than in previous wars. • 7 out of 10 soldiers hit were hit in the arm or leg – need more amputations. • 2 out of 10 hit in body itself • 1 out of 10 hit in head or face • 94% of those wounded were wounded by Minnie ball; 6% by artillery; only 56 soldiers died from swords or bayonets in the whole war.

7. Surgeons (They worked under dangerous conditions, lack of supplies, long hours, diseases to catch themselves, sometimes disdain of soldiers who were afraid of them.) • 13,000 Union doctors treated 5.8 million cases. • 3,500 Confederate doctors • Few women doctors-One was forced to work with only the 54th Mass-African-American regiment. • Steward: (Under the surgeon, he was pharmacist, responsible for dressing, kept hospitals clean, & was Union dentist.) • Nurses (1st nuns, then relatives of soldiers. Besides medical duties they cooked, read & sang songs to patients, write letters home for them & prayed with them. Salary $11 per month.) People of Medicine

8. Dorothea Dix: Superintendent of Nurses said she wanted women over 30, healthy, plain looking, dressed in black or brown only, no hoop skirts or ribbons on skirts. • Quote from Kate Cumming, Confederate nurse: After finding a soldier who died during the night with no one noticing, “These are terrible things, and, what is more heart rending, no one seems to mind them.” • Another quote from her about enemy soldiers: “Seeing an enemy wounded and helpless is a different thing from seeing him in health and in power. The first time I saw one in this condition every feeling of enmity vanished at once.” • U.S. Sanitary Commission: Inspection agency to act for the soldiers, whom it felt the army leaders were neglecting.

9. Soldiers went through several different hospitals after they were wounded. • Primary Station: behind the lines for 1st aid. Soldier “nurses” helped the wounded- those fighting could NOT help out. Usually picked the “shirkers” for this duty; stretcher barriers, etc. • Field Hospital: 2 miles back from the front behind the lines- you walked it if you were only slightly wounded; those with severe wounds got an ambulance ride. Most dirty and deadly; lack of supplies. Not enough help to go around. Took over a barn or house and used the door for a surgeon’s table. Decisions about amputations made here. • Regimental Hospital: To be stabilized • General Hospital: Transferred by railroad or boat • Convalescent Hospital: Soldiers would go to learn how to take care of themselves in spite of their permanent disabilities. Hospitals

11. Amputation case, trephining set for head surgery (Drill holes in the head to relieve pressure on the brain), an exsecting case, a general operating kit, & a pocket medical kit, leather trunk, 3-month supply of 80 different medicines. • Amputating knives and saws, tourniquet, scalpels, forceps. • 3 out of every 4 operations were amputations in the Union army. (More arms & legs cut off in this war than in any other war is history. Amputation was based on if the bone was shattered w/damage to other tissues or muscles; whether main blood supply or nerves were damaged ;whether joint was part of the wound. Knee = amputation.) Medical Instruments & Medicines

13. Soldiers stood a better chance of surviving if his gunshot arm or leg was amputated immediately • New Technique: Resection or exsection. • Anesthesia- Used 80, 000 times in the war. • Other Medicines: Quinine for Malaria; Chloroform, Morphine & other opiates for pain. • Recovery Problems included infections, lockjaw, & gangrene. • Improvements in Prosthetics due to large number of amputations. Medical Instruments & Medicines Continued

17. 90% of soldiers wounded in this war survive. • This leaves a large number of individuals with permanent disabilities. War in Iraq and Afghanistan