.

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.

Wednesday, April 15, 2015

Medicaments

From: acws.co.uk

Medical supplies were transported to the battle areas as part of the general field train, and carried to the front lines in ambulances, or on pack mules, or on the shoulders of the regimental hospital stewards.

The major effective drugs in use were quinine and morphine. Whiskey was frequently administered to the wounded to induce "reaction", and as the solvent for quinine sometimes administered daily as a suppressant of malaria. Chloroform, sometimes mixed with small amounts of ether, served as an anaesthetic. Among other drugs used were opium, pepsin, various emetics and cathartics, iodine, and calomel.

Dysentery, one of the most important diseases from the viewpoint of both high morbidity and mortality, was treated with oil of turpentine, among many other substances, and ipecac was administered for enteritis; probably neither of these was very effective.

The paratyphoid fevers were not separately recognised and diagnosed; the term "typhomalarial fever" was used to describe debatable cases of prevalent remittent fever.

The lack of preventive measures and specific therapy for treatment of the various diseases became a major factor in the outcome of some battles, and at times, of entire campaigns.

Image: Replica of a circa 1864 army whiskey barrel



Surgery in the Field

From: acws.co.uk

The wounded soldier who received medical attention in the field (and base hospital) had still to run the considerable risk of surgery. After ambulance facilities were available, field hospitals were sometimes overwhelmed by major battle casualties. The limited number of surgeons worked around the clock and haste and neglect were unavoidable under such circumstances.

Anaesthetics, generally chloroform, were available, but there was no notion of aseptic procedure. As W W Keen recalled some years later:

"We operated in old blood-stained and often pus-stained coats with undisinfected hands we used undisinfected instruments and marine sponges which had been used in prior pus cases and only washed in tap water."

Nearly all wounds became infected. In the case of chest or abdominal wounds, surgeons probed with their fingers, prescribed morphine and tried to stop external bleeding. Otherwise there was little that could be done. Death within three days from haemorrhage and/or infection was the normal result. The average Union mortality from gunshot wounds of the chest was 62 percent of cases and from wounds of the abdomen, no less than 87 percent. By way of contrast, only about 3 percent of all American wounded failed to survive in World War II.

The chances for survival following an injury to the extremities were better though not good. Joints were resected and limbs amputated with alarming frequency, often in an attempt to prevent the spread of infection. It was usually the ensuing infection, which caused death. The so-called "surgical fevers" included tetanus, erysipelas, hospital gangrene, and septicaemia.

Image: A medical kit during the Civil War, with scissors, gauze and needles


Civil War Surgery

By Pvt. Hugh R Martyr, 20th Maine

The War broke out during a transition period in medical knowledge. Anaesthesia had been used since the 1840's and thus allowed operations to be performed that hitherto would have been impossible. However there was no knowledge or understanding about the spread of infection until the 1870's. Thus, able to carry out major surgery, medical staff unwittingly caused serious problems with infection.

By far, the most common of wounds to be dealt with, were caused by gunshot. The Minié Ball made a hideous wound, often changing shape as it entered the body and dragging in dirty clothing; upon hitting bone it caused shattering which in turn increased the severity of the damage. Approximately 71 per cent of gunshot wounds were on arms, legs, hands or feet.
There was a difference of opinion amongst Union surgeons about the need to amputate damaged limbs or attempt to repair and try to save them, however, for the staff at the field hospitals time was short. If in doubt the limb was removed. Abdominal wounds were far more serious and the percentage of soldiers surviving them was far less than those losing a limb; bowel and stomach wounds being the most serious.

One of the problems for the wounded was that the transportation from the primary care station to a general hospital was crude and unsanitary; if the wound had not been infected on the battlefield it was almost certainly contaminated en route in ambulance, train or boat. The transportation personnel were more interested in speed of delivery than the comfort of the soldiers in their care.

The officers in charge of advance field hospitals confined the treatment of the wounded to stopping haemorrhage and to bandaging. Tourniquets or compresses were applied, liquor in the form of whiskey or brandy given to counteract shock, and the patient was usually given an opium pill or a dose of morphine. Bandaging of wounds became less common as the war progressed as it was found that they became soiled and contaminated and were causing problems as they were cut away. Splints to be used on fractured limbs were usually cobbled together using fence rails or board, ambulances were furnished with "Smith's Anterior" a suspended splint in ambulances but many staff did not know how to use it correctly. One contribution to medical science was the Hodgen Splint, invented in 1863 by Surgeon J Hodgen. This was a splint that provided room for examination, prevented contraction and allowed drainage of the wounds without disturbing the break. The basic design is still in use today.

The wounded were brought to the field hospital and laid out on straw; the less serious cases would be dealt with by a "dressing surgeon" who together with a medical orderly would operate a triage system passing over the mortally wounded and getting the most needy to the operating table. Pressure of the work load and the primitive conditions of the field units often meant that recommended procedures often were by-passed. It was thought that it was important to operate before infection could set in, but to avoid work whilst the patient was in deep shock. However, there was not the luxury of time available to the surgeons, the operating table had hardly been swilled down after one case before the next was brought in.

The management of the cases after surgery was relatively simple and consisted of rest, the relief of pain by opiates, doses of liquor or quinine to "support the system" and the application of cold compresses to keep down inflammation.

These quick operations broke all the rules of modern asepsis, cleanliness was almost impossible and the field stations soon became a gruesome spectacle as the surgeons worked through the hundreds of cases brought to them. From a Spotsylvania hospital a surgeon wrote home to his wife that he had been steadily operating for four days and that his feet were badly swollen. "It does not seem as though I could take a knife in my hand today. Yet there are a hundred more cases waiting for me. The poor fellows beg for the chance to have an arm or leg taken off. It is a scene of horror as I ever saw."

Pain relief came in the form of opiates; in the state of shock and under the influence of the anaesthetic the pain of the initial surgery was mitigated. It was as shock subsided and infections took hold that the misery of pain was suffered. The poor handling and rough transportation did not help in any way to ease the wounded soldiers plight. Opium was administered in tablet form and often morphine was rubbed into the wound. The hypodermic syringe became more common in the later years of the war and morphine was then injected.

The problem of infection was never really solved; surgeons had little understanding of the healing process and thought that the pus-producing infections were the normal process of tissue repair. When wounds healed without this action as it is now expected to do so, it was thought unusual. Thus large amounts of fatalities occurred due to Septicaemia, Pyaemia and the now unknown "hospital gangrene". The doctors at the time expected this as they were common in the civilian hospitals at the time.

Surgeons reports and letters tell a dreadfully gruesome account of the work that they had to do, the lack of water, the untrained orderlies and the work load are all mentioned time and time again.

I would be wrong to dismiss the efforts of the doctors and medical staff as being poor, throughout the whole of the war huge resources and improvements were made. The medical budget of 1864 exceeded the total amount of money spent on the pre-war army. Medical knowledge was on the verge of major breakthroughs and I consider the numbers of wounded that survived horrific injuries that would even now cause major concern, a testament to the efforts of the Medical Staff and the Sanitary Commission.

From: acws.co.uk

Learn more about Civil War surgery at www.CivilWarRx.com.

Private Bruce Shipman and the Ambulance Corps of the 76th New York

By Robert Moore, Jr.

I take great pride in writing this story of my great-great grandfather, Bruce Shipman, for your journal, and I know that he would be very pleased to be included. He considered his service in the Civil War with the 76th New York as the greatest single event of his life. I literally would not exist if not for certain twists of fate involving the Civil War, foremost among them Shipman's capture at the Battle of Gettysburg in 1863 — more about that later. But I think the most compelling aspect of the story is that Bruce was such an ordinary guy. He was of average height and build, came from obscurity, did his duty during the war and went back to obscurity afterwards, like thousands of other men. The most unusual thing about his Civil War experience was his participation in the ambulance corps, a very small group of men who had an affect on nearly every man in the regiment at one time or another.

Bruce Shipman was born in 1839 in Springfield, New York, not far from Cooperstown and Cherry Valley. By the age of 16, he was living with a family named Cooper, working for them as a hired hand on their farm. In 1860, he married Nancy Keller, the daughter of a lockkeeper on the Erie Canal, and soon their first child, Ruby, was born.

In April 1861, South Carolina forces fired on Federal Fort Sumter in Charleston Harbor, but as far as I can tell, Bruce Shipman knew little of politics. He lived with his wife and baby daughter on another man's land, tending fields and livestock which were not his own. He probably read about slavery, states' rights and secession, but what impact these issues made on him remain unknown. Life in Springfield, New York, went on, as a nation was split in two and went to war.

The Union loss at Manassas, Virginia in July 1861 signaled the beginning of a much longer war than anyone had expected. The people of Bruce Shipman's community began to raise a group of soldiers to go and fight. However, the community was small, and as related in the official history of the 76th New York, the Cherry Valley recruits were consolidated with a much larger group of soldiers from the Cortland area into the 76th. The Cherry Valley group composed companies H,I and K; Bruce Shipman served in Company K.

It would be difficult to discover why Shipman decided to join the army. Patriotism, perhaps. It is doubtful that he was an abolitionist or felt strongly about the slavery issue. He enlisted on November 1, 1861, for a period of three years. He was 22 years old, stood 5' 8 1/2" tall, and listed his profession as "farmer." As of November 6, he put on the uniform of a private in the 76th New York Regiment.

Bruce Shipman drilled throughout November and December. On January 17, 1862, the regiment marched to Albany, where they presented their colors before the state Assembly. The troops were then marched across the frozen Hudson River to the Railroad depot at Renssalaer. They arrived in New York City the following day at noon. By the end of January they were on their way to Washington, D.C., where they served in Fort Massachusetts. During the peninsula campaign in the spring of 1862, the 76th stayed in Fredericksburg, Virginia, repairing railroads.

Bruce Shipman got his first taste of battle with the regiment on August 21st, as the unit was held in reserve while an artillery duel was waged over their heads. A week later, the 76th came under heavy shell fire for the first time at Gainesville, Virginia. Shipman fought as a line soldier at Gainesville and South Mountain, Maryland. But by September 17, 1862, at Antietam, Shipman had been detailed to serve in the newly created ambulance corps. It is difficult to imagine today, but at the onset of the Civil War, there was no system in place for the evacuation of the wounded from the battlefield. Ambulances and their hired drivers were under the command of the Quartermaster's Department; stretcher-bearers, consisting of the regimental band and misfit soldiers, were answerable to the regimental surgeons, with no coordination between the two groups.

Union surgeon Jonathan Letterman, Medical Director of the Army of the Potomac, changed this by establishing an ambulance corps in an order dated August 2, 1862. Under the Letterman system, three ambulances under the command of a sergeant were assigned to each regiment of infantry, two to a troop of cavalry, and one to each artillery battery. Ideally, each ambulance was a four wheeled wagon pulled by four horses, attended by a driver and two privates to act as stretcher-bearers. Each ambulance could carry four wounded men at a time. A second Lieutenant commanded the ambulances of the brigade. By the time of the battle of Antietam, the 76th New York had a sergeant and nine responsible privates detailed to man its three regimental ambulances. Each of these men carried a colt army revolver as a sidearm. The ambulances were gathered and parked by brigade; since the 76th New York was in the Second Brigade, First Corps (composed of six regiments), the brigade ambulance park would have had 18 ambulances attended by 180 men. A medicine wagon and driver, two medical officers, and a hospital steward accompanied each division (composed of two brigades). The Army of the Potomac had an average total of 650 medical officers. Letterman insisted on daily inspections of the ambulances, horses, stretchers, water kegs and other equipment.

The men selected for duty in the ambulance corps were detached from their regiments as a result of their interest, efficiency, and good moral character. No man could be removed from this duty unless relieved by the medical director of his corps. A man found to be unfit for ambulance corps duty would be put back into the ranks immediately. Ambulance corpsman were distinguished in the field by a 2" green stripe around the hat, and a 2" green half-chevron on each sleeve. Soldiers not in the ambulance corps were forbidden to leave the ranks of their units to carry wounded men to the rear. No officer or enlisted man was allowed to use the ambulances for transportation, for themselves or their belongings (this is one reason why the ambulance corpsmen carried sidearms).

Letterman's system was first tested at Antietam, where it functioned well. In battle after battle thereafter, the efficient ambulance corps evacuated thousands of wounded men from harm's way. Sometimes the wounded men were moved while still under enemy fire, but most of the time a lull, truce, nightfall, or the end of a battle was when the bulk of the evacuations were performed. The battles became progressively more brutal each time the armies clashed. Bruce Shipman picked barely living men up off the fields of Fredericksburg and Chancellorsville. By the end of 1862 just 225 of the original 1,000 men of the 76th New York were still in the ranks.

On July 1, 1863, the 348 men and 27 officers of the 76th New York entered the little town of Gettysburg, Pennsylvania, along with the First Army Corps under General Reynolds. Within a half hour of fighting, 27 men were dead, including Major Grover, and 124 were wounded. The work of the ambulance corps was interrupted, however, as Confederate forces overwhelmed the Union troops, driving them back through the town. Many men were captured, including Bruce Shipman. Held prisoner during the remainder of the battle, Shipman was lucky, for he was not taken south with the retreating army of General Lee on July 4. Instead, he went along with the other prisoners captured on July 1 to a "parole camp" in Baltimore, Maryland. Most Union soldiers taken on subsequent days of the Gettysburg battle were forced to accompany the Confederate Army in their retreat, and eventually ended up at Andersonville.

Bruce Shipman, however, was somehow able to get a furlough from the Baltimore parole camp before his exchange came through, and in August 1863, he went home to upstate New York. His reunion with his wife Nancy and daughter Ruby must have been bittersweet, for his duty would be to return to the army and complete his three-year enlistment, only about half over. The importance of this visit home to me is inestimable, however, since my great grandmother was conceived during the autumn of 1863. In early October, Bruce Shipman returned to the parole camp, was exchanged, and returned to the 76th New York, encamped at Culpepper, Virginia. He witnessed the battle of Mine Run, and the execution of Private Winslow Allen for desertion in December 1863. Pvt. Shipman was given several special duties when active fighting tapered off each winter. At various times he served as the regimental mail carrier, pioneer, and the Major's orderly. Perhaps he was good with horses due to his years as a farm laborer.

On May 5, 1864, Bruce Shipman was lucky once more, as the armies clashed in the Battle of the Wilderness. Because he was detailed to the ambulance corps, he was not in the advanced position of the 76th, which was surrounded by Confederate forces. Nearly half the regiment was captured and sent to southern prisons; enlisted men went to Andersonville.

As Lee's troops dug in for the final act of the war at Petersburg, members of the ambulance corps, including Bruce Shipman, were assigned to the stationary hospitals constructed at City Point, Virginia. An efficient evacuation system for the wounded was instituted, with trains bringing casualties to the James River, where they were loaded on steam hospital vessels for the short trip to City Point. As soon as the army had settled into the routine of Petersburg, Bruce Shipman went AWOL. I believe that he somehow made his way home to Springfield, New York to see his new baby daughter, Jennie, my great grandmother. Perhaps there were complications with the birth, or trouble on the farm. Perhaps his commanding officers even turned a blind eye, or gave him a pass. Officially, he was listed as being AWOL, the only instance of this serious infraction in his entire war record. Within a month he returned to camp at City Point, now with only six months left to go on his enlistment.

The wounded continued to pour into the hospitals. The 76th N.Y. lost 341 men during the war; 175 in combat, 166 of disease. During the course of the war, 110,070 Union troops died in battle, and 94,000 Confederates. The total number of deaths from all causes was approximately 258,000, or 1/10th of the U.S. population at that time.

On November 5, 1864, after three years of service, Bruce Shipman's tour of duty was legally over. He had done his duty to his country, and the end of the war was in sight. He was at home in Springfield, New York when Lee surrendered to Grant five months later. He left the army to return to his family in New York State, and was given his $100 bounty. Perhaps he used it to move his family from the Cooper farm to a farm of their own. By 1865, state census records show that the Shipmans owned their own 200 acre spread. Bruce and Nancy Shipman went on to have five more children, for a total of seven.

Bruce Shipman was returned to obscurity. He died in 1927 at age 88 in Richfield Springs, 20 miles from where he was born. The Civil War, and his role in it, would remain the single most exciting event of his life. The same was true for literally thousands of men, north and south. All returned to the struggles of day to day life after the war. Bruce was luckier than many. He survived the war without a serious mishap, unwounded, un-mutilated, and able to work until the day he died.

I have spent many years researching this story, which was compiled from the official history of the 76th New York, Bruce Shipman's war record and pension papers from the National Archives, census data, the family Bible, and books and articles about the U.S. Army medical department and Civil War ambulance corps. It was my privilege in the late 1980s to work for the National Park Service at the Gettysburg battlefield, and live in a pre-Civil War home in the town. Although my major historical interest is not the Civil War, my ancestor's participation in that conflict makes the war seem very real, and not so distant, to me.

Image: Ambulance corps of the 57th New York - National Archives photo

From: bpmlegal.com

Civil War Hospital Wooden Lower Leg Splint

From: joshuasattic.com

This is a factory molded piece of walnut used by physicians during the Civil War period to splint broken or injured lower legs (tibia-fibula). Soldiers would wear these for weeks or months while healing in larger hospitals in Washington and Philadelphia. Made by various manufacturers, they have a wonderfully smooth & exact construction that suits the natural curve of anatomy to the area where they are intended. These came in different sizes, as did soldiers, so there are 3, 4, 5, etc, getting progressively longer and wider. This is a number 6, as we find marked on its backside along with the manufacturer's marking: DAY, Bennington, VT." Such items were made for wrists and knees too.

Civil War Amputation Knife Set

From: joshuasattic.com

Three bright, shiny, razor-sharp blades from Charriere of Paris in a custom-fit wooden case. Such blades were imported from both France and England during the Civil War. They were used to quickly slice through muscle, tendon, fascia and flesh to get to the bone during limb amputations. A very neat and well preserved set. These are the types of instruments that Jack-the-Ripper used in England later in the century...


Share

Facebook Twitter Delicious Stumbleupon Favorites