.

Civil War Hospital Ship

The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.

Evolution of Civil War Nursing

The evolution of the nursing profession in America was accelerated by the Civil War.

The Practice of Surgery

Amputations were the most common surgery performed during the Civil War.

Army Medical Museum and Library

Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.

Civil War Amputation Kit

Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.

Sunday, July 24, 2016

Famously Fiery First Lady Gets Modern-Day Medical Diagnosis

By Jonathan Lapook, 7-16-16

Mary Todd Lincoln had a lot of tragedy in her life. She lost two young children -- and, of course, was sitting next to President Lincoln when he was assassinated.

All of that contributed to years of depression, but now a medical expert believes there was a physical cause for her mental struggles.

History has not been kind to the wife of our 16th president. She was known to be a tempestuous, unpredictable force, and her son eventually had her committed. Sally Field's 2012 portrayal of Mary Todd showed a fierce and sharp-tongued first lady.

"You think I'm ignorant of what you're up to because you haven't discussed this scheme with me as you ought to have done," she said in one scene. "When have I ever been so easily bamboozled?"

But Dr. John Sotos, a physician and medical historian, says the famously fiery first lady was not only misunderstood - but misdiagnosed. Sotos puts forth a new theory about Mary Todd Lincoln -- her erratic behavior was caused by a condition called pernicious anemia.

"Pernicious anemia is an autoimmune disease that starts in the stomach and that impairs the body's ability to absorb food efficiently," Sotos said. "And as a result, the person becomes B12 deficient eventually, and that causes lots of problems in every organ of the body."

It was a fatal illness until treatment was discovered decades after her death. The disease can lead to many of the symptoms exhibited by Mary Todd Lincoln: a sore mouth, pale skin, difficulty walking and psychiatric problems. It can also cause swelling.

"The puffiness is not in a way that would occur with just an accumulation of fat," Sotos said.

Today, the disease can be picked up on a simple blood test and easily treated with B12 supplements.

"She had a sick brain and was doing the best that she could in a very complicated, relentlessly demanding environment," Sotos said. "And I think to have done as well as she did with the kind of handicaps that she had, I think that deserves admiration."

Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News.

From: cbsnews.com

Learn more about the health of Mary Todd Lincoln at www.CivilWarRx.com

What are Civil War Sinks? (Latrines)

From: civilwartalk.com

Some data on sinks in the Civil War that I collected, without doing a precise study.

Sinks in the Civil War are what we would call latrines. It probably is more afield than what the normal Civil War student studies, but it sure killed a lot of soldiers. Sometimes the captured prisoner contributed to his own bad health by undisiplined use of sinks, and was not entirely due to the prison system.

As a result of both historical documentation and field research, the prison stockade, Fort Johnson, the remains of Fort Hill, and the dock have been located. Archaeological excavations have been carried out in several sinks (latrines) dating from 1862 to 1865, a prison well, the powder magazine from Fort Hill, and portions of two prison blocks

HEADQUARTERS ARMY OF THE POTOMAC,
Near Cold Harbor, Va., June 5,1864.
Major-General MEADE, U. S. Volunteers,
Commanding Army of the Potomac:

... Very few regiments provided sinks for the men, and
their excreta are deposited upon hill sides to be washed from thence into the streams, thus furnishing an additional source bf contamination to the water. As is to be expected, under such circumstances, sickness is increasing in the army, diar-rhea being especially prevalent...

THS. A. McPARLIN,
Surgeon U. S. Army, Medical Director, Army of the Potomac.

In fact, no attention seemed to be paid to cleaning up the grounds immediately in and about the hospital, nor was proper atten-tion bestowed upon the sinks. The ground between the hospital and the sinks had been used for uncleanly purposes by the patients, mak-ing it offensive to the sight as well as the smell.

H. B. PEYTON,
Lieutenant- Colonel, Assistant Adjutant and Inspector General.

OFFICE COMMISSARY-GENERAL OF PRISONERS,
July 1, 1862.
General M. C. MEIGS,
Quartermaster-General U. S. Army, Washington, D.C.

...The camp is in a very foul condition from want of drainage, and this can only be remedied by construction of a sewer sufficiently below the surface to guard against frost around the sides of the camp and leading into the lake. With this must be connected water pipes to furnish an abundant supply of water for the use of the camp and to float out the filth of all kinds through the sewer.
The sinks should be connected with the sewers so that during the summer the camp and neighborhood would be relieved from the stench which now pollutes the air.
The cost of erecting new barracks and repairing the old ones will be $5,000 to $8,000 and for introducing the system of pipes and drainage about as much more.
If a suitable camp-ground could be found and there was yet time for the work it would perhaps be best to abandon Camp Douglas, but there seems now no alternative but to make the best of what we have.
I have ordered a thorough system of police to be put in force at once, but your immediate attention is earnestly called to the matter of the above report.
The hot weather of summer is just upon us and if something is not done speedily there must be much sickness in the camp and neighbor-hood if not a pestilence.
Very respectfully, your obedient servant,
W. HOFFMAN,
Colonel Third Infantry, Commissary- General of Prisoners

WASHINGTON, November 13, 1863.
Dr. J. H. DOUGLAS,
Associate Secretary, Sanitary Commission:
SIR: In compliance with orders received from the central office to proceed to Point Lookout, Md., and inquire into the condition, &c., of the rebel prisoners there confined, also the sanitary condition of the encampment and its inmates, I hereby submit the following report:

It is within this that there are confined about 8,000 pris-oners. With so many men and no one to take charge of them, it is not at all to be wondered at that the camp is in any but a desirable condition. The sinks, which should have special consideration, especially in a camp of this size, and where so many men are congregated, are entirely neglected, and it is a perfect mystery that there is not more sickness than they have, and God knows they have enough, for they live, eat, and sleep in their own filth. Sinks have been prepared for them, but little or no attention is paid to them, unless they should be in close proximity when they desire to answer the calls of nature. The holes dug in getting out clay for bricks are used as sinks. You will find them by the side and in front of their tents, in various portions of the encampment, and are the receptacles of their filth. Refuse matter from the tents or what not right under their very noses, yet they heed them not. Others, again, have no particular place, but will void their excrement anywhere on the surface that is most convenient to them, heedless of the convenience of others. Have no drainage around the tents, but there has been an attempt to drain the streets. Ditches were dug, but they are worse than useless, constantly filled with water, and afford another place to throw filth. With this state of affairs and so many men (by the by, over 1,300 more came in the camp on the afternoon of November 10, making nearly 10,000 men) the camp would soon become in an impassable condition. The men themselves complain and hope that some severe punishment, even shooting, will be the penalty to any one who will so outrage decency and lose respect due themselves. Some of the sinks are filled and not been covered and not a particle of chloride of lime has been used in the encampment for a long time. After stating the above facts, giving the condition of the camp arid its inmates, some might say that it is not our fault that they are in this condition. As far as clothing, it is not; but it is our fault when they neglect to enforce those sanitary rules which keep camps and inmates in a cleanly condition and thus try to prevent disease. It is our fault when the officer in command fails to place in charge some one of good executive ability, capable of giving commands and seeing that they are enforced, one who will have the camp regularly policed amid severely punish any offender of the sanitary rules. It is beneficial otherwise, for it will give employment to a certain number of men every (lay. As regards medicine and clothing, they are sadly in want of both and would suggest that the commission send them, place them in the hand of Mr. Fairchild, and I know they will be judiciously distributed.
I know that they are our enemies, and bitter ones, and what we give them they will use against us, but now they are within our power and are suffering. Have no doubt that to compare their situation with that of our men words would hardly be adequate to express our indignation.
I merely gave this suggestion because I think you would be doing right and that it might prove beneficial to us.

Very respectfully, your obedient servant,
W. F. SWALM.

Herbalism

From: mnwelldir.org

The use of foods to heal is as old as the human spirit; it is as natural as breathing. Even today, when we get a cold or flu, we also get a bowl of hot chicken soup. However, the chicken soup we get from a can is hardly related to the chicken soup grandma made from scratch.

Herbs are food. Our medicines of the early 1800s were mostly herbal. What we did not bring from Europe we learned from the Natives, who were far more sophisticated than many give them credit. While surgeons theorized why some patients died of infections and others did not, our natives were very familiar with the role of pathogens in infection (sepsis) and created salves to clean wounds and kill off the pathogens that could cause infections.

The two great names in the early American herbal movement were, Samuel Thomson and Constantine Rafinesque. Rafinesque came to America as a young man, studied botany and herbalism and became a professor of botany. Around 1830 Rafinesque published his book, Medical Flora of the United States, which became the chief reference for herbalists of that period. In his book he described in detail the healing properties of a New World herb, goldenseal. For its immune stimulating properties, the goldenseal was highly prized, and the European communities were soon cultivating seeds they’d received from America. Nothing in the pharmacopoeia could compete with goldenseal, that is until the Natives introduced us to echinacea, the purple coneflower.

Thomson, on the other hand, was not a scholar. He created nothing new, but to his credit, he brought herbal and Native medicines to the common people. He was attacked by the regulars, even found himself facing murder charges for losing a few patients, but was acquitted and went on to publish his New Guide to Health. He is even, according to Ingrid Naiman’s book, Cancer Salves, “credited with the development of a cancer plaster made from red clover blossoms.” Most likely, he learned this too from the Natives, though he was the first to get this procedure on paper. Herbalists today still use this and many other preparations Thomson passed onto us.

At the time of his death, in 1843, his followers numbered around three million. The latter part of his life was spent deflecting criticism from the regulars, though many a regular physician adopted much of Thomsonian medicine as they did Hahnemann’s homeopathy. One constant in history is that when something works, the more liberal minded have a tendency to examine it and eventually incorporate it.

Mixing “pharmaceuticals,” as noted already, is dangerous. However, herbalists, on the other hand, mixed many herbs together, since herbal medicines, for the most part, did not contradict each other, and worked in harmony. Herbs are food. Together, many herbs act to potentiate [make stronger, better] each other. For instance, adding cayenne pepper to any herbal medicine makes the action of the preparation stronger and faster acting. This is just one example of synergy, where the answer to 2 + 2 is actually greater than four.

Image 1: Constantine Rafinesque

Image 2: Notebook kept by Constantine Samuel Rafinesque on a trip from Philadelphia to Kentucky, 1818

The AMA Is Formed

From: mnwelldir.og

Many attempts were made to create medical societies. There is strength in numbers. Most fell by the wayside as competition ate away at their structure, and even forbidding members to consult with, cohort with, purchase from, or even befriend an “irregular” didn’t stop a huge wave of physicians from going over to the other side.

The main purpose of a medical society/association is to provide political pressure to adopt laws that would kill the competition. They also provide entertainment, fellowship, and a safe place to whine about the midwife down the block who makes more money in a week than your average physician in two months.

Another purpose of the American Medical Association was to raise the standards of medical education in the land. Dr Nathan Smith Davis, a graduate of the Rush Medical College in Chicago, became a driving force in the creation of the American Medical Association. His regard for the general educational standards of the day is clear in the following statement:

All the young man has to do is gain admittance in the office of some physician, where he can have access to a series of ordinary medical text-books, and see a patient perhaps once a month, with perhaps a hasty post-mortem examination once a year; and in the course of three years thus spent, one or two courses of lectures in the medical colleges, where the whole science of medicine, including anatomy, physiology, chemistry, materia medica, pathology, practice of medicine, medical jurisprudence, surgery, and midwivery are all crowded upon his mind in the short space of sixteen weeks...and his education, both primary and medical, is deemed complete. [New York Journal of Medicine, V, 1845, 418]

All in all, the main reasons underpinning the formation of the AMA was that doctors simply could not compete in a free market, and they made little money. A report submitted to the 1847 convention that kicked off the formation of the AMA, stated:

The very large number of physicians in the United States has frequently been the subject of remark.... No wonder that the merest pittance in the way of remuneration is scantily doled out even to the most industrious in our ranks. [Healing the Health-Care System]

 The AMA’s first course of action was to lobby the government for strict licensing laws that would limit the number of doctors practicing medicine. Banning any form of medicine not practiced by the regulars was one sure way to limit the number of practicing physicians.

Historically, all laws pertaining to the practice of medicine have been enacted out of intense pressure by the medical lobbyists, not the public.

But as hard as they tried, their efforts often blew up in their face. This young country was not about to give up the freedoms they’d fought to attain. And when given free choice, most Americans in mid century chose the least toxic options of the Eclectics or homeopaths.

The Sad State of the Art

When the AMA got established, the form of medicine practiced by its members had not yet cured a single disorder, and most of the time sent patients to an early death. Surgery showed promise, but sepsis was not yet understood and doctors with a 50% success rate or higher were rare, in deed.

Scurvy had been cured, but by nutrition, not by medicine. Iodine cured goiters, but again, iodine is an essential nutritional factor.

By 1850, the jury on inoculations is still out, for there were safer homeopathic inoculations being developed, and plagues had a life cycle of their own. They came in spite of everything we did to avoid them, and the usually petered out and went away on their own in spite of heroic medicine claiming victory.

In France, a study on cancer, begun in 1843, had just been published. A physician of the French Academy of Science, Dr Leroy d’Etoilles, gathered together as many statistics as possible at that time from some 170 practitioners who had treated cancer. The reason for the study was to compare survival rates of those who elected to undergo the standard treatments for cancer against those who refused these treatments. According to Dr Naiman in her book Cancer Salves, the standard treatments consisted of surgery, caustics “such as nitric acid; sulfuric acid mixed with saffron; poisonous minerals such as lead, mercury, or arsenic nitrate; or alkaline caustics such as sulfate of zinc. Copper sulfate [mixed with borax], quicklime, or potassium permanganate were also used, evidently with mixed success.”

The conclusion of the study showed that those who avoided traditional cancer therapies outlived those who underwent them. Did this stop anyone from practicing these therapies? Perhaps, but for the most part, these treatment protocols continued on till the advent of Radium therapy that proved to be even more deadly than any previous protocol, but was highly recommended because it was a great money maker.

History, we are told, often repeats itself. A study presented to the American Cancer Society in the nineteen-eighties, concluded much the same as that study in France over a century earlier. Ellen Brown’s book, Forbidden Medicine gives us the following:

One of the few studies ... was conducted by Dr. Hardin Jones, professor of medical physics and physiology at the University of California, Berkeley. He told an ACS panel, "My studies have proven conclusively that untreated cancer victims actually live up to four times longer than treated individuals. For a typical type of cancer, people who refused treatment lived for an average of 12-1/2 years. Those who accepted surgery or other kinds of treatment [chemotherapy, radiation, cobalt] lived an average of only three years. . . . I attribute this to the traumatic effect of surgery on the body's natural defense mechanism. The body has a natural defense against every type of cancer.

Ulrich Able, a German epidemiologist and biostatistician, concluded the same in what can be considered the largest statistical analysis ever conducted on cancer. Irwin Bross, biostatistician for the National Cancer Institute, would have to agree. In a paper on Radiation we already published one of his famous quotations: “Radiation therapy does not improve the survival of patients with breast cancer. Did you know that the mortality rate for breast cancer in women over 55 was about 20% higher in 1995 than in 1970 (so much for mammograms)?”

Sadly, the one lesson we have all learned from history is that we do not learn anything from history. We are condemned to make the same mistakes again and again. As long as the primary focus of medicine is on profits, real healing will always take a back seat.

Horace Wells Discovers Pain-free Dentistry

By Emily E. Gifford

In the early 19th century Hartford dentists Horace Wells and William Morton played instrumental roles in the development of anesthesia for dental and other medical applications. Horace Wells, born in Hartford, Vermont, and educated in Boston, began his practice in Hartford, Connecticut, in 1836 and quickly rose to prominence. He married Elizabeth Wales in 1838 and continued to write about dentistry and invent various devices, such as a foot-powered shower.

Wells Sees Potential in Laughing Gas
In 1842, Wells took Morton, first, as his student and then as his partner. Morton, who was born in Massachusetts and trained for dentistry in Baltimore, Maryland, married Elizabeth Whitman, daughter of Lemuel Whitman, on her father’s condition that he quit dentistry and study to practice medicine instead. In 1844, Morton began (but never completed) his studies at Harvard Medical College.

Although Wells tried to form a dentistry practice with Morton in Massachusetts, the new partnership lasted less than two weeks, and Wells returned to Connecticut. In December of 1844, Wells and his wife attended a demonstration at Union Hall in Hartford of “laughing gas” (nitrous oxide) put on by showman Gardner Colton, who had briefly studied medicine. Wells noticed that one of the volunteers, while ingesting the gas to the amusement of the audience, had injured his leg during the demonstration. Wells later talked to the man and found he was unaware he had suffered an injury.

Since Wells had long been concerned about the amount of pain suffered by his patients during dental procedures, he immediately enlisted Colton’s help. The day after the demonstration, Colton came to Wells’s practice and administered nitrous oxide while Wells’s associate, John Riggs, extracted one of Wells’s own troublesome wisdom teeth. Feeling not “so much as the prick of a pin” in the course of this usually painful procedure, Wells believed that he, with the help of Colton and Riggs, had invented painless dentistry.

Experiments with Anesthesia
After Colton taught Wells how to administer the gas, Wells performed a dozen painless procedures over the next few weeks. Always intense, Wells became more excited with each successful procedure. He decided to demonstrate painless dentistry in Boston and did so in January of 1845 at Massachusetts General Hospital for the benefit of Harvard Medical School students and faculty members. The demonstration did not go well. The patient moaned as if in pain, and the audience drove Wells from the lecture hall with cries of “Humbug” and “Swindler,” even though the patient tried to explain that he was not, in fact, in pain.

Despite his setback in Boston, Wells continued to use nitrous oxide in his practice in Hartford and freely shared his discovery area dentists. While dental patients elsewhere continued to suffer, many throughout Hartford were enjoying painless dentistry by the middle of 1845. Wells’s apparent failure in Boston, however, temporarily deterred him from any further attempts to publicize his innovation nationally.

Meanwhile, in Boston, Wells’s former partner Morton was experimenting with the use of ether as an anesthetic. In 1846, Morton demonstrated the use of ether to perform a painless tooth extraction. He did not, however, identify his anesthetic as being ether. Instead, Morton called it “letheon” and applied for a patent for his “substance.” He established a monopoly on painless dentistry in the Boston area and soon got positive publicity for his discovery of ether’s medical applications. Morton also tried to make a profit from his discovery, but his attempts to claim sole discovery of anesthesia in general and ether in particular were denied.

Both Horace Wells and Charles Jackson, who had been Morton’s chemistry professor at Harvard and originally introduced him to ether, stepped forward to challenge Morton’s claim that he had discovered anesthesia. Wells, for his part, sought to strengthen his claims by publishing History of the Discovery of the Application of Nitrous Oxide, Ether, and Other Vapors, to Surgical Operations (1847). Morton and Jackson entered into protracted legal battles in their attempts to prove their claims.

Wells Seeks Fortune in NYC
Wells was also trying to find a way to gain fame and fortune as an anesthetist. By the end of 1847, he had participated in dental and other surgical procedures in Hartford, but decided that he should relocate to New York City to achieve greater recognition and success.

He moved there in January of 1848, intending to establish himself before sending for his wife and their young son, Charles Wells. Loneliness and homesickness overcame him, however, and Wells began using ether and chloroform in an attempt to ease his depression. Wells spent several days intoxicated on the combination of drugs, eventually becoming so confused that he could not distinguish sleep, dreams, and reality.

On the night of his 33rd birthday, Wells went out and threw acid on a pair of women in the street. Fortunately, the acid only burned their clothing and did not permanently injure the women. The police responded to their cries for help and arrested Wells, who they incarcerated in the Tombs Prison. He continued to ingest chloroform and ether while in jail, but in moments of clarity realized the depths to which he had sunk.

Believing that he had disgraced himself and his family beyond repair, Wells took a large dose of chloroform and used a razor to slash a major artery on his thigh. He quickly bled to death, and his body was released to his family for burial at Old North Burying Ground in Hartford. In 1908, Charles Wells re-buried his father and mother (who had died in 1889 and been buried alongside her husband) at Cedar Hill Cemetery. Wells’s tombstone identifies him as the “discoverer of anesthesia.” (In like fashion, Morton’s stone acclaims him as the “Inventor and Revealer of Inhalation Anesthesia.”)

The Nature of Discovery
In 1864, the American Dental Association, followed by the American Medical Association in 1870, recognized Horace Wells as the discoverer of anesthesia. Morton was never able to gain the fortune he sought for his own contributions to the field, including a $100,000 prize which was contested by Jackson and Wells’s survivors.

Although claims to singular discovery reinforce society’s fascination with individual genius, historians of science note that it is not unusual for innovations to occur at a moment when several individuals—sometimes with knowledge of each others’ efforts and sometimes not—are working along similar lines. Discovery, they emphasize, is not typically an event but a process. Wells, then, is rightly recognized for his pioneering role in pain-free dentistry and the field of medical anesthesia.

Emily E. Gifford is an independent historian specializing in the history of religion and social movements in the United States.

Image: Miniature Portrait of Horace Wells

Union Soldier Turns Medic at Gettysburg, 1863

A primary source by Elbert Corbin

Pvt. Elbert Corbin to his wife, July 6, 1863. (GLC)

After three days of fierce fighting on July 1–3, 1863, nearly 40,000 battered soldiers lay scattered across the blood-soaked fields of Gettysburg, Pennsylvania. As the torrential summer rain poured down on the wounded, Private Elbert Corbin of the 1st New York Light Artillery was thrust into an unexpected role when he was ordered to remain behind and take care of his fallen comrades.

In this rare letter, Corbin detailed the quick training that enabled him to assist his wounded compatriots. He also writes of helping wounded enemies: “dressed our Boys wounds then . . . assisting to cut out Balls and dress the wounded Rebels.” He resignedly noted the paradox of having to “Help to wound & Kill men then Patch them up.”

Corbin describes operations and procedures he performed, saying that he now “can do up wounds from shot or shell or Bullits quite like an M.D.” But he also reported that he is troubled by having become numb to the gruesome tasks of rudimentary surgery: “I can see an Arm or Leg taken off and it has no more affect on my feelings, than cutting so much Beef.” Though he claimed that he was no longer disturbed by his work, it is clear that Corbin’s experiences stayed with him, as he wrote of Gettysburg, “more suffering here in one second than you will see in a Leife.”

A full transcript is available.

EXCERPT
Monday Eve July 6th.  10.O’Clock – Em I have passed another busy day – Lieut Shelden was fixed up by me and made as comfortable and sent off with some other officers I am left here in Care of the Boys – Several of the boys who had very slight wounds are with the Battery. We have Patched up just so as to man 4 guns all told and the Battery is ready for the front . . . After getting off Lt[?] S. I dressed our Boys wounds then 15 or 20 of the Boys of other Batteries then I was sent to work assisting to cut out Balls and dress the wounded Rebels and we now have an quantity of them and I shall have to help tomorrow I can do up wounds from shot or shell or Bullits quite like an M.D. – I have had quite a Dicipline I do it for that – I can see an Arm or Leg taken off and it has no more affect on my feelings, than cutting so much Beef – Dead men are plenty here – and I saw plenty of them in all shapes on the field – Help to wound & Kill men then Patch them up I could show more suffering here in one second than you will see in a Leife– at home It is strange how I have diciplined my feelings to see Dying and suffering men and have no feelings only a passing thought, I have some [illegible] that were cut out of men I have had quite a chat to day with Rebels . . . such a Sabbath I shall long remember and these days work here among the wounded & dying –

* The Gilder Lehrman Institute thanks the following people in helping to identify Corbin as the author of this letter: Thomas E. Corbin (great grandson of Private Elbert Corbin); Greg Goodell and Scott Hartwig at the Gettysburg National Military Park; and Stephen J. Dreher, historian for Pettit’s Battery B.

Image: Pvt. Elbert Corbin, 1st New York Artillery, to his wife, July 6, 1863. (Gilder Lehrman Collection)

From: gilderlehrman.org

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