Founding the United States Sanitary Commission

by Carole Adrienne /

The United States Sanitary Commission was a model of reform for the medical services, inspiring the Federal War Department to reorganize its medical policies. When the Civil War began, supplies presented a major problem. No quality controls existed. Uniforms were poorly made. There was extensive profiteering in food and horses. Surgeons and the wounded sometimes waited for days after a battle before supplies arrived, if they arrived at all.

The Sanitary Commission inspected the conditions at camps and hospitals and published reports, pamphlets, and circulars written by Commission Agents and physicians. They published a hospital directory with the names of over 600,000 hospitalized men, including the black soldiers, who were sometimes treated in segregated hospitals. The Commission advocated the adoption of sanitary principles by the United States Army.

By late 1863, the work of the Sanitary Commission had made remarkable improvements in the evacuation and treatment of the wounded, demonstrated at the Battle of Chattanooga.

The United States Sanitary Commission laid a foundation for discoveries that would be revealed after the war. They knew that cleanliness mattered, although they weren’t sure why. They knew that sanitary conditions led to fewer infections and slowed the spread of disease.

Louis Pasteur would later point out that living organisms did not arise spontaneously, but only from previous organisms. Joseph Lister provided the link to infection, and the Commission’s work paved the way for the acceptance of these discoveries.

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Daughters of Charity Nursed Wounded Civil War Soldiers at West Philadelphia Hospital

by Christine McCullough-Friend /

Women’s religious orders have served both Catholics and non-Catholics within the Philadelphia community since the establishment of the Diocese of Philadelphia two centuries ago. These women, who have and who continue to devote their lives to the betterment of society have played a pivotal role in social work, education and medicine.

As we begin to commemorate the 150th anniversary of the start of the Civil War, one example of this service that should be highlighted is the work of the Daughters of Charity (formerly Sisters of Charity) at Satterlee Military Hospital. The sisters ministered to thousands of wounded and dying Civil War soldiers from 1862 until the hospital closed in 1865.

Nurses and staff

The 12-acre site where the Satterlee Hospital was located in West Philadelphia, bounded roughly by 40th to 44th Streets, from Spruce to Pine Streets, was at that time very rural, far removed from the cramped and crowded conditions of urban Philadelphia. The ‘pure country air’ afforded the soldiers an opportunity to rest and recover from their wounds.

The hospital, initially called West Philadelphia Hospital, was renamed Satterlee Military Hospital in honor of Richard Smith Satterlee, a distinguished army surgeon. The surgeon in charge was Dr. Isaac Hayes, an Artic explorer before he joined the army. The hastily constructed buildings were completed in just over 40 days. The 2,500-bed facility was not quite finished when 22 Daughters of Charity arrived on June 9, 1862.

Initially, the hospital was fairly ill equipped, especially with regard to the accommodations for the sisters. Beverages were served in wash pitchers and the food in basins. The sisters ate their meals earlier than the officers, sharing just four eating utensils reserved for officers’ use. The chapel was so small that some sisters had to exit the room so others could enter and receive Holy Communion.

Satterlee Hospital became a self-contained city when a tent city was built on the grounds in 1863. The hospital increased its capacity to accommodate 4,500 wounded soldiers. A 14-foot high fence surrounded the property, which now sprawled south to Baltimore Avenue and west to 46th Street. On the grounds there was a post office, clothing store, laundry facility, carpenter shop, printing shop, dispensary, library, and three kitchens referred to as restaurants.

Although the official capacity of Satterlee was 4,500, the actual capacity exceeded this number. After the Battle of Bull Run, the wounded arrived by the hundreds. After the Battle of Gettysburg, they arrived by the thousands, swelling the hospital population to more than 6,000. During the Battle of Gettysburg which occurred during July 1863, the greatest number of wounded were admitted to the hospital in a single month. The following month of August saw the greatest number of deaths in any one month, averaging at least one per day. In just one year, patients consumed more than 800,000 pounds of bread, 16,000 pounds of butter and 334,000 quarts of milk.

During the war, more than 100 Daughters of Charity passed through the doors of Satterlee Hospital, ministering to the wounded soldiers’ spiritual and medical needs. The tiny chapel was soon expanded to seat 400 worshippers. Many soldiers often arrived several hours before mass to obtain a seat. Several wounded soldiers contributed generously to outfit the chapel properly, purchasing a set of stations of the cross and taking great pains to decorate the chapel for feasts and special occasions.

The hospital’s chaplain was Father Peter McGrane who was stationed at St. Patrick’s at 20th and Locust Streets. Every day, Father McGrane traveled from St. Patrick’s to Satterlee to say mass, hear confessions, instruct and baptize and frequently arrange for burial. He labored throughout the war ministering to the wounded and dying. Archbishop James Wood also visited Satterlee several times to confirm many adult converts.

Father Peter McGrane, no date

The practice of military medicine during the war was an eye-opening experience. The wounds caused by the new and improved artillery met the outdated medical practices of understaffed field hospitals, resulting in an epidemic of needless deaths. Conditions began to improve with the advent of permanent army hospitals like Sattelee, staffed by experiences surgeons and dedicated sisters.

During its four-year existence, more than 50,000 wounded soldiers were treated at Satterlee. The contributions made by the medical professionals and the Daughters of Charity who staffed the hospital are immeasurable.

PAHRC holds a copy of a diary kept by a Daughter of Charity at the hospital from 1862 to 1865.

Credit: Philadelphia Archdiocesan Historical Research Center

References:

Smith, Sara Trainer, ed. “Notes on Satterlee Military Hospital…from the journal kept at the hospital by a Sister of Charity.” Records of the American Catholic Historical Society of Philadelphia (Volume 8), no. 4 (December 1897): 399-449.

West, Nathaniel. History of the Satterlee U. S. A. Gen. Hospital, at West Philadelphia, Pa., from October 8, 1862, to October 8, 1863. The Hosptial Press, 1863. (Call# IC0135)

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The First Women Nurses

The first women carried as nurses aboard a U.S. Vessel were Sister Mary Adela and Sister Veronica, nuns of the Order of the Holy Cross. They served throughout the war on the U.S.S. Red Rover, a captured Confederate vessel that was refitted as a hospital ship.

The health care challenges of the war changed the role of American women in medicine and in the military. For the first time in the United States, female personnel held responsible positions in traditionally male environments.

Thousands of women, North and South, volunteered as nurses in the hospitals and at the front. Many “Angels of the Battlefield” served throughout the war, lay women as well as Catholic nuns from orders including the Sisters of Charity, Sisters of St. Joseph, Sisters of Mercy and Sisters of the Holy Cross.

Unknown numbers of women simply showed up on the battlefields and helped to relieve the work load of the medical staff.

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Civil War Dentists

The treatment of dental problems raised separate health issues. By 1860, there were about 5,500 dental practitioners in the United States. Most dentists trained by apprenticeship, but about 400 dentists had graduated from three American dental schools.

The Confederacy required that every soldier have a dental exam. The shortage of men in the South meant that no one could be exempted from service because of problems with his teeth. Dentists were routinely assigned to the larger Confederate military hospitals.

The Federal government provided no official dental surgeons for its troops during the Civil War. Toothbrushes were not provided for troops.
Many dentists served in the Union Army, but any dental treatment they performed wasn’t in an official capacity. Most dentists simply enlisted in their state regiments as privates.

Confederate dentist James Baxter Bean and Union dentist Dr. Thomas Gunning developed almost identical and revolutionary methods of treating jaw fractures caused by gunshot. Imperfect healing of these wounds could be life-threatening and earlier treatments had proven uncomfortable and ineffective. Bean and Gunning used intraoral splints to preserve the alignment of the teeth and minimize any deformity. These new techniques were major advancements in the treatment of jaw fractures.

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Civil War Veterinary Medicine

by Carole Adrienne /

The first veterinary facility in Europe was established at Lyon, France, in 1762, after centuries of wars, disease epidemics, livestock plagues and food shortages.

The United States, with a lower density of animals, had not faced any of the major animal epidemics that had periodically swept Europe. The first veterinary college in the country was established in 1862 in Philadelphia.

At the start of the Civil War, dozens of cavalry units were formed, requiring thousands of horses. A War Department General Order in May 1861 provided for one “veterinary sergeant” for every Union cavalry regiment, but listed no qualifications for the post. Only six veterinarians were on the rolls of the Union army.

In the course of the war, thousands of horses, mules, pigs and cows died of disease, battle wounds and overuse.

By mid-1863 both forces began to centralize the collection and distribution of horses. The largest Union depot was at Giesboro Point, in Washington, D.C., with 32 stables and 6,000 stalls. It had a veterinary hospital that could hold 2,650 animals.

Disease among animals could have a devastating effect on the course of a campaign, limiting transportation for food, supplies and artillery. Battles are thought to be won or lost because of numbers, weapons, tactics or courage; not because horses are sick.

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The Civil War Medicine Story

Civil War Medicine: The Documentary Series, is the story of remarkable American heroism and ingenuity at a time when the technology of warfare exceeded the science of medicine.

Operating in the smoky fog of a brutal war, thousands of doctors began their practice of medicine overwhelmed and ill-equipped. They had no antibiotics, no sterilization, and sometimes, no supplies. But by the end of their war service, they had not only helped to heal a nation, they had established revolutionary systems for effective healthcare.

Those medical personnel and volunteers had created a legacy that extends not just to modern war zones, but to every medical school, emergency room and hospital in the world today. Civil War Medicine, a new documentary series now in production, brings a fresh perspective to one of the most revolutionary periods in war and in medicine.

In 1861, medical care in the United States was very limited:

• Most American physicians had never performed surgery or even seen gunshot wounds before.
• The Army had no ambulance corps, no nursing corps and no dedicated medical supply transport.
• Women were refused admittance to most medical schools.
• The health of the individual soldier was not regarded as the responsibility of government.

Civil War Medicine illustrates how remarkable leadership, innovative government policy and a huge volunteer effort changed the quality and nature of health care in America. By the end of the war, systems were in place for ambulances, supply transport, case histories and follow-up. Women appeared on battlefields, in hospitals and in business. The hospitals themselves were redesigned and specialty hospitals designated, including one for the new study of neurology.

Advancements in medicine during the Civil War were not all clinical. The true medical legacy of the war developed from a changing culture of health care: medical administration, record-keeping and governance. It came from the recognition of the importance of sanitation, hygiene and diet, evacuation systems and skilled nursing care. It came in the emergence of women in administrative roles, and in the form of the Geneva Convention and the International Red Cross.

The legacy of the war includes research and educational facilities. The compiled data, published in the six-volume Medical Surgical History of the War of the Rebellion, was regarded as America’s most important contribution to medicine in the 19th century.

Today, any American who has made a trip to the emergency room, been transported by ambulance or been attended to by a skilled nursing staff, has benefited from the legacy of Civil War medicine. Our modern health care systems evolved from this last great conflict fought without knowledge of the causes of disease or infection.

Graphic: Lisa Bollinger

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About the Civil War Medicine Documentary Series

Civil War Medicine is the story of our once-divided country’s massive health crisis, its heroic relief efforts and the resulting revolution in the culture of health care in America.

Targeted for national television broadcast, four one-hour programs will feature 3,000 visual images and compelling dialogue from original letters, diaries, newspapers and rare memorabilia. More than 80 men and women who lived the medical and relief efforts of the terrible war lend their memories through voiceover roles.

Seven years of intense research has yielded valuable information, artifacts and perspectives contributed by scores of experts from across the country.
Civil War Medicine provides high-resolution access to beautiful, shocking and unusual art, photography, prose and ephemera from dozens of American museums, archives, libraries and private collections.

A music soundtrack including military, popular, classical, folk and children’s songs will be recorded from original sheet music. The instruments used will be a combination of authentic 1860’s instruments and meticulous reproductions, tuned and played in period fashion.

Civil War Medicine: The Documentary Series is sponsored by the Abraham Lincoln Foundation of the Union League of Philadelphia, a 501(c)(3) institution. The series has been endorsed by the Abraham Lincoln Bicentennial Commission of the Library of Congress, The Society of Civil War Surgeons and the Military Order of the Loyal Legion of the United States.

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Mutter Minute: Blue Mass and Dover Powder

This week Robert showcases two medicines. Blue Mass was made in the late 1800's and was used during the Civil War and it's active ingredients are opium and mercury. Blue was used for a variety of things from venereal disease to gastrointestinal problems. Dover Powder was also used in the Civil War with active ingredients opium and ipecac and was used for fevers.

To learn more about the Mütter Museum or The College of Physicians of Philadelphia, visit - www.collegeofphysicians.org

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Mutter Minute: Civil War Survey

Every Monday The Director of the Mütter Museum takes a minute to showcase an item from our collection. This week Robert showcases a Civil War survey from our historical medical library collection.

To learn more about the Mütter Museum or The College of Physicians of Philadelphia, visit - www.collegeofphysicians.org

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Medical Advances Timeline: 1866-1899

1866
- 14th Amendment to the U.S. Constitution prohibits voting discrimination, denies government office to certain Civil War rebels and repudiates Confederate war debts.
- February 11: The United States Christian Commission, which raised and spent more than $6 to support its war relief work, goes out of existence.
- March 21: Mrs. Mary Ann “Mother” Bickerdyke submits her resignation to the U.S. Sanitary Commission.
- May: Official termination of the United States Sanitary Commission, and the formation of the American Association for the Relief of Misery on the Battlefield.
- September 29: George A. Otis, M.D. is breveted Captain and Major for faithful and meritorious service in the Medical Department and Lieutenant Colonel for faithful and meritorious service during the war.
- Alfred Nobel invents dynamite.
- Ernst Haeckel publishes his General Morphology, describing the law of biogenetics.
- Robert Whitehead, an English engineer, invents the underwater torpedo.

1867
- Federal Medical Department authorizes the purchase of 4,095 prosthetic legs, 2,391 arms, 61 hands and 14 feet. In the budgets of many former Confederate states, the largest single expenditure was for artificial limbs.
- Nebraska becomes a state of the U.S.
- Russia sells Alaska to the U.S. for $7,200,000.
- German professor of medicine Carl Wunderlich introduces thermometry to bedside medicine.
- June: The Autenrieth Wagon, adopted by the U.S. Army for the transport of drugs, surgical tools and supplies, is displayed in Paris, France, at the World’s Fair

1868
- Ulysses S. Grant is elected President of the United States.
- The Harvard Medical School catalogue first mentions the stethoscope, 30 years after its invention.
- Led by Dr. Elizabeth Blackwell, the New York Medical College for Women at New York Infirmary is started.
- A bill proposing to appoint dental surgeons to the Army and Navy fails, but dental surgeons were subsequently appointed to West Point Military College and the Naval Academy.
- The first teaching clinics on diseases of the eye were held in Baltimore. They were conducted by Dr. Russell Murdock, considered the first surgeon to perform unassisted surgical cataract removal. Dr. Murdock was also known for inventing new surgical instruments for eye surgery.

1869
- General Ulysses S. Grant is inaugurated as 18th President of the United States.
- The first state board of health established in Massachusetts.
- The Harvard Medical School catalogue first mentions the microscope, two centuries after its invention.
- First transcontinental railway is completed in America.
- The body of President Lincoln’s assassin, John Wilkes Booth, was exhumed from a temporary grave under the floor of a warehouse at the Washington Arsenal. Undertaker John H. Weaver staged an informal inquest with Booth’s family and friends. An effort was made to identify the body through its dental work, although the results were inconclusive.

1870
- Four medical colleges for women now exist in America.
- At a meeting of the Aid Society in Berlin, the use of American ambulance trains is described as a model for European armies.

1871
- Former U.S. Surgeon General William Hammond publishes Treatise on Diseases of the Nervous System, the first textbook on nerve diseases to be published in the U.S.
- G.A. Hansen discovers the leprosy bacillus.
- The Baltimore Eye and Ear Hospital is founded by Dr. Julian J. Chisolm.
- Population figures in millions:
German 41
U.S. 39
France 36
Japan 33
Great Britain 26
Ireland 5.4
Italy 26.8

1872
- Grant is re-elected President of the U.S.
- U.S. General Amnesty Act pardons most ex-Confederates.
- Billroth makes the first surgical resection of the esophagus.
- Brooklyn Bridge opens in New York.
- The first nursing school in the United States is established at Bellevue Hospital. Louisa Lee Schuyler, a passionate war volunteer from New York society, was instrumental in starting the school.

1874
- Billroth discovers streptococci and staphylococci.
- A.T. Still founds osteopathy in Kansas.

1875
- The London School of Medicine for Women is founded.
- American artist Thomas Eakins paints The Gross Clinic, portraying famous surgeon Dr. Samuel Gross.
- A Marine Hospital is built in San Francisco’s Presidio area.

1876
- Robert Koch discovers the anthrax bacillus.
- Philadelphia hosts an International Congress of Medicine. Reports were given on the state of American medicine. Foreign physicians praised the publications of the Surgeon General’s office and pointed out that France and Prussia had already adopted the “American ambulance” system.
- German medical journal Berliner Klinische Wochenschrift publishes a paper suggesting that salsalate could help control blood sugar in diabetics. The accuracy of the studies were confirmed by Harvard researchers in the 1990s.
- Alexander Graham Bell patents the telephone.
- Colorado becomes a state of the U.S.

1877
- Rutherford B. Hayes inaugurated as 19th President of the U.S.
- Robert Koch develops a technique that allows bacteria to be stained and identified.
- J. Friedrich A. von Esmarch introduces the antiseptic bandage.
- The Presbyterian Charity Eye, Ear and Throat Hospital in Baltimore is founded by Dr. Julian J. Chisolm.

1878
- First use of iodoform as an antiseptic.
- Researchers noted that “the most frequent cause of the opium-eating habit in females is the taking of opiates to relieve painful menstruation and diseases of female organs of generation.”
- Mannlicher produces a repeater rifle.
- An Act of Congress on March 15 restores William A. Hammond, as Brigadier General on the retired list, without pay or allowances.

1879
- William A. Hammond, M.D. is restored as Brigadier General on the retired list, without pay or allowances, by an Act of Congress in March 1878.
- Pheobe Yates Pember publishes A Southern Woman’s Story: Life in Confederate Richmond, detailing much of her work at Chimborazo Hospital.
- Louis Pasteur’s studies of cholera bacteria in chickens paves the way for the development of vaccines against many diseases.
- Thomas Edison invents the electric lightbulb.

1880
- Thomas Alva Edison and J.W. Swan independently devise the first practical electric lights.
- French army surgeon Charles Louis Alphonse Laveran identifies parasites in the blood of a malaria patient.
- Typhoid bacillus is discovered.
- Pasteur discovers a chicken cholera vaccine.
- New York streets are first lit by electricity.
- Railroad mileage in operation:
U.S. 87,800
Great Britain 17,900
France 16,400
Russia 12,200

1881
- Relief worker Clara Barton succeeds in her efforts to establish the American Red Cross and begins her service as its first president.
- Louis Pasteur and Robert Koch prove the germ theory of disease.
- The first vaccine for anthrax is created by Louis Pasteur.
- City population in millions:
London 3.3
Paris 2.2
New York 1.2
Berlin 1.1
Tokyo 0.8
St. Petersburg 0.6

1882
- The first organized veterinary group in Pennsylvania, the Keystone Veterinary Medical Association, is formed.
- The first vaccine for rabies is created by Louis Pasteur.
- Viennese physician Joseph Breuer uses hypnosis to treat hysteria.
- Thomas Edison designs the first hydroelectric plant in Appleton, Wisconsin.
- English engineer Hiram S. Maxim patents the recoil-operated machine gun.

1883
- The first skyscraper—10 stories—is built in Chicago.
- August 22: A group of twenty-two veterinarians formed the Pennsylvania Veterinary Medical Association. Their meeting focused on continuing education and the legislative actions of veterinary associations that had been successful in other states.

1884
- Grover Cleveland is elected U.S. President.
- German physician Arthur Nicolaier discovers the tetanus bacillus.
- Sir Charles Parson invents the first practical steam turbine engine.

1885
- Grover Cleveland is inaugurated as 22nd U.S. President.
- Louis Pasteur devises a successful rabies vaccine. Due to his vaccine, the death rate from rabies dropped to almost zero in three years.
- Sir Francis Galton proves the individuality of fingerprints.
- Dr. George E. Holtzapple of Pennsylvania treats a pneumonia patient with pure oxygen. Oxygen therapy became the only effective treatment for pneumonia until antibiotics became available in the 1940s.

1886
- Opium demand in the U.S. peaks, during a period from 1880 to 1889, when demand and import increased nine-fold.
- Ernst von Bergmann uses steam to sterilize surgical instruments.

1887
- Dr. William Williams Keen is the first surgeon in the Americas to successfully remove a benign brain tumor.
- The analgesic drug Phenacetin is discovered.

1888
- An English pediatrician identifies a gastrointestinal disorder, later known as celiac disease.

1889
- North Dakota, South Dakota, Montana and Washington become states of the U.S.
- Oklahoma is opened to non-Indian settlement.
- Benjamin Harrison inaugurated as 23d President of the U.S.
- Frederick Abel invents cordite.
- Von Mahring and Minkowski prove that the pancreas secretes insulin to prevent diabetes.

1890
- Idaho and Wyoming become states of the U.S.
- Rubber gloves are used for the first time in surgery by surgeon William Halsted at Johns Hopkins Hospital in Baltimore, MD.
- Emil von Behring announces the discovery of antitoxins and uses them to develop vaccines for tetanus and diptheria.
- Global influenza epidemics.

1893
- African-American surgeon Daniel Williams performs the first open-heart surgery on a patient in Chicago.

1894
- Yersin and Kitasato independently discover the plague bacillus.

1895
- November 8: German physicist Wilhelm Conrad Roentgen discovers X-rays and finds that they pass through matter. This property leads immediately to their use in diagnostic medicine.
- Marconi invents wireless telegraphy.

1896
- Johannes von Mikulisz-Radecki invents the gauze mask to be worn by surgeons when performing surgery.
- Michael I. Pupin of Columbia University takes the first diagnostic X-ray photograph in the U.S. to set a broken arm.
- The first vaccine for typhoid fever is developed.
- Utah becomes a state of the U.S.
- Niagara Falls hydroelectric plant opens.
- French physicist A.H. Becquerel discovers radioactivity.
- First modern Olympics held in Athens.

1897
- William McKinley is inaugurated as 25th President of the U.S.
- Ronald Ross discovers the malaria bacillus.
- Aspirin is invented in Germany.

1898
- Pierre and Marie Curie discover radium and polonium.
- Japanese bacteriologist Shiga discovers the dysentery bacillus.
- Bayer chemist Heinrich Dreser prepares diacetylmorphine and names it “heroin”. It was intended as a faster-acting and shorter-lasting pain reliever than morphine, producing less nausea and vomiting.
- A British officer in the Indian Medical Service, Ronald Ross, demonstrates that malaria parasites are transmitted via mosquitoes.

1898
- The mineral Thorium is found to be radioactive. It had been used by dentists to fill teeth for almost 60 years.

1899
- First Peace Conference held at The Hague.
- The cause of “progressive pernicious anemia”, common in the southern United States, is identified by Dr. Charles Wardell Stiles, a zoologist from Hartford, Connecticut. Dr. Stiles proved that a hookworm species, not a germ, was responsible for the condition.
- The Bayer company registers “Aspirin” as a trademark.
- Rutherford discovers alpha and beta rays in radioactive atoms.
- First magnetic recording of sound.

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Medical Advances Timeline: 1861-1865

1861
- Dr. Samuel D. Gross, prominent Philadelphia surgeon, teacher and author, publishes A Manual of Military Surgery for use by the young surgeons flocking into the army. A copy is later captured by Confederate troops and reprinted for the Southern physicians.
- French neurologist Paul Broca publishes a paper detailing the relationship of damage in the brain’s left temporal lobe to loss of speech.
- January 29: Kansas becomes a state of the U.S.
- February: The Washington Peace Convention tries to preserve the Union, but the Congress of Montgomery forms the Confederate States of America with South Carolina, Georgia, Alabama, Mississippi, Louisiana and Florida.
- February 25: Samuel Preston Moore a physician from South Carolina, resigns from the US Army. He will become Surgeon General of the Confederacy.
- March 4: Abraham Lincoln is inaugurated as the 16th President of the United States.
- April: John J. Chisolm, M.D. receives the first commission granted to a medical officer by the Confederacy. He attended the wounded at Fort Sumter.
- April 12: The flag is fired upon at Fort Sumter. Outbreak of the Civil War.
- Lincoln calls for the militia to suppress Confederacy.
- April 13: Fort Sumter surrenders.
- April 15: The women of Bridgeport, Connecticut organize the first Ladies Aid Society.
- April 15: President Lincoln calls out 75,000 state militia for assistance in retaking U.S. property that had been seized by Confederates.
- April 17: The State of Virginia votes for secession; President Lincoln calls for 90-day volunteers.
- April 19: Union blockades Southern ports; Confederate sympathizers in Baltimore attack the 6th Massachusetts Volunteers as they are en route to defend Washington, D.C.
- April 29: Dr. Elizabeth Blackwell organizes a meeting of socially prominent women in New York to form the Women’s Central Association of Relief of New York City. The Association soon established a program to train nurses for the Army.
- May: The U.S. Sanitary Commission is formed in New York City. The Women’s Central Association of Relief becomes a part of the larger organization.
- May 6: The Physicians and Surgeons of the Hospitals of New York and the New York Medical Association for Furnishing Hospital Supplies was organized in New York City.
- May 15: Dr. Clement A. Finley is appointed Federal Surgeon-General by President Lincoln. Robert C. Wood becomes his assistant.
- May 16: Four New York representatives of the newly formed United States Sanitary Commission met with the acting surgeon-general, Dr. Robert Wood. Wood refused to allow any formal relationship between the army and the Sanitary Commission.
- May 25: The War Department issues General Orders No.25, which directs state governors to appoint a surgeon and assistant surgeon for each regiment of volunteers.
- June 5: Confederate Dr. Gibson requests aid from the Sisters of Charity in Emmitsburg, Maryland, to help with the sick and wounded in Richmond, Virginia.
- June 9: The U.S. Sanitary Commission is approved by Federal Secretary of War Simon Cameron, who appoints nine men to serve as the first USSC commissioners.
- June 10: Dorothea Dix is appointed Superintendent of Female Nurses in the North.
- June 10: Surgeon William A. Spottswood is designated as head of the Office of Medicine and Surgery by the Confederate Navy Department.
- June 30: In Washington, D.C., Miss Lydia English’s Female Seminary is transformed into the “Seminary Hospital”, remaining in operation until June 14, 1865.
- July 3: A “Committee on Military Surgery” reported to the Surgical Section of the New York Academy of Medicine on “matters of practical interest which are not discussed in the ordinary books on surgery”. They noted that, historically during war, deaths from disease far outnumbered deaths from battle wounds.
- July 11: Union General George B. McClellan engages Confederate General Robert E. Lee at Rich Mountain, Virginia (now West Virginia).
- July 21: Confederate Victory at Bull Run, VA (First Battle of Bull Run—First Manassas). The Union surgeon-general chose to wait until the actual fighting began before preparing for casualties.
- July 27: General George B. McClellan is appointed commander of the Union Army, later renamed the Army of the Potomac.
- July 27: The New York Times publishes an editorial protesting the “inadequate provisions” for the care of the war wounded due to the “ancient and fossilized arrangements of the Medical Department”.
- July 30: Confederate President Jefferson Davis names a former U.S. Army physician from Charleston, Samuel Preston Moore, as Surgeon-General.
- August: General Robert E. Lee fails to recapture Virginia’s western counties, hindered in part by an epidemic of measles among the troops.
- August: Confederate Surgeon Julian John Chisolm publishes his book, A Manual of Military Surgery For the Use of Surgeons in the Confederate Army. The book went through three editions.
- August 3: John H. Brinton, M.D. and Frank H. Hamilton, M.D. are appointed Surgeon of Volunteers, U.S.A.
- August 5: Joseph J. Woodward, M.D. is appointed Assistant Surgeon, U.S.A.
- August 10: Joseph K. Barnes, M.D. is appointed Colonel/Medical Inspector, U.S.A.
- August 12: Dr. Charles Tripler is appointed medical director of the Army of the Potomac by Major General George Brinton McClellan.
- August 28-29: Union forces capture Forts Hatteras and Clark, North Carolina.
- September 6: Federal gunboats capture Paducah, Kentucky.
- September 11-16: Cheat Mountain campaign, western Virginia.
- September 16: The United States Sanitary Commission establishes its offices in the Treasury Building.
- September 12-20: Siege of Lexington, Missouri
- October: A wing of the U.S. Patent Office in Washington, D.C. is transformed into the “Patent Office Hospital” and operates there until March, 1963. Patient facilities were created within the walls of the Capitol and the “Reynolds Barracks Hospital” was erected on what is now the South Lawn of the White House.
- October 16: The United States Sanitary Commission establishes its central office in the U.S. Treasury Building, Washington, D.C.
- October 21: Battle of Ball’s Bluff, Virginia
- November 1: General George McClellan is appointed general-in-chief, relieving General Winfield Scott.
- November 7: Battle of Port Royal Sound, South Carolina, occupation of Hilton Head Island and Beaufort, South Carolina. Battle of Belmont, Missouri, the first engagement for General Ulysses S. Grant.
- November 14: Volunteer relief organization the U.S. Christian Commission is formed at a convention of the YMCA’s of the Union states.
- December: Frederick Law Olmstead, Executive Secretary of the U.S. Sanitary Commission, reports that upon inspection of 200 regimental hospitals, 105 were considered good, 52 were tolerable and 26 were bad.

1862
- Auguste Nelaton of Paris, a French physician and surgeon, invents his “probe”, a device to determine the location of a lead bullet or other hard body in a wound.
- R.J. Gatling patents a ten-barrel rapid-fire gun.
- Joseph Janvier Woodward, M.D., of the U.S. Surgeon General’s Office, publishes The Hospital Steward’s Manual: For the Instruction of Hospital Stewards, Ward-Masters, and Attendants, in Their Several Duties.
- The Confederate Congress passes a bill allowing for the enlistment of women into the Confederate Army as army nurses.
- Florence Nightingale opens a nurses’ training program at St. Thomas Hospital in London.
- Union Major Jonathan Letterman devises new ambulance and hospital supply systems. They will become the basis of modern rescue and health care services.
- Swiss humanist Jean Henri Dunant proposes the foundation of an international voluntary relief organization in his book “Souvenir de Solferino”. The International Red Cross would be the result.
- President Lincoln brings his own supply of the anesthetic chloroform to a dental appointment.
- February 6: Surrender of Fort Henry, Tennessee, to General Grant.
- February 8: Union forces win Battle of Roanoke Island, North Carolina.
- February 11: Union and Confederate soldiers wounded at the Battle of Fort Henry, Tennessee are sent north on the Union Army’s hospital ship City of Memphis.
- February 13-16: General Grant lays siege to and accepts surrender of Fort Donelson, Tennessee.
- February 15: Mary Ann “Mother” Bickerdyke assists in the removal of the wounded after the battle at Fort Donelson.
- February 21: Battle of Valverde, New Mexico Territory.
- February 25: Union troops occupy Nashville, Tennessee.
- March: General McClellan lands the Army of the Potomac on York Peninsula, Virginia.
- March 6-8: Battle of Pea Ridge (Elkhorn Tavern), Arkansas.
- March 9: Battle of the ship CSS Virginia (formerly USS Merrimac) with USS Monitor.
- March 12: The Western Sanitary Commission establishes the first Soldiers’ Home in St. Louis, Missouri.
- March 14: Union troops capture Newbern, North Carolina and New Madrid, Missouri.
- March 23: Battle of Kernstown, Virginia.
- March 26: Battles of Apache Canyon and Glorieta Pass, New Mexico Territory.
- April 6: Siege of Yorktown, Virginia begins.
- April 6-7: At the Battle of Shiloh (Pittsburg Landing), the first huge battle of the war, large 8-patient tents are issued to the U.S. Army Medical Corps for the first time, proving to be a successful installation for field hospitals. General Grant captures Island No. 10 in the Mississippi River in Tennessee.
- April 7: The U.S. Army hospital ship R.C. Wood, named for the Assistant Surgeon General, begins removing the wounded from the Battle of Shiloh.
- April 14: Colonel Clement A. Finley resigns as Surgeon General, U.S. Army.
- April 16: Jonathan Letterman is appointed Surgeon/Major, USA.
- April 25: U.S. Secretary of War Edwin Stanton appoints 33-year-old physician William A. Hammond Surgeon-General.
- April 27: Union field nurse Emma Edmonds visits soldiers in the temporary hospitals in Washington, D.C.
- May: The Army Medical Museum is established by Union Surgeon-General William Hammond.
- May: The first edition of Stephen Smith’s Handbook of Surgical Operations is published for the benefit of surgeons in the field.
- May 2: The New York City Ladies’ Home for Sick and Wounded Soldiers opens.
- May 3: Confederates evacuate Yorktown, Virginia.
- May 5: Battle of Williamsburg, Virginia. There were 1,866 Union and 1,570 Confederate casualties.
- May 21: Union Surgeon-General Hammond takes measures to secure more detailed and exact reports of sick and wounded, an important modification in the orders of medical officers.
- May 24: General “Stonewall” Jackson’s cavalry captures a Union supply train near Winchester, Virginia. They seized the medical stores, including 1,500 cases of chloroform.
- May 25: Battle of Winchester, Virginia. General “Stonewall” Jackson releases captured Union surgeons as “non-combatants”.
- May 30: Confederate General Pierre Beauregard commands Confederate forces to evacuate Corinth, Mississippi, due to disease. Union General Henry Halleck enters with troops and faces the same diseases.
- May 31-June 1: Battle of Fair Oaks (Seven Pines), Virginia; General Robert E. Lee assumes command of the Confederate army in Virginia.
- June: Federal authorities telegraphed the Order of the sisters of Charity at Emmitsburg, Maryland, to ask the nuns to provide sisters to work as nurses in Frederick City.
- June 6: Battle of Memphis, Tennessee.
- June 9: Battle of Port Republic, Virginia. The Union Surgeon-General’s Office announces its intent to prepare for publication the Medical-Surgical History of the War of the Rebellion.
- June 10: Union General George McClellan proposes to Confederate General Robert E. Lee that medical officers be viewed as “non-combatants” and that they not be held as prisoners of war.
- June 17: Confederate General Robert E. Lee agrees to McClellan’s plan for the neutrality of medical personnel.
- June 19: McClellan sends Lee a copy of General Order No. 60. It included the statement that all medical officers held by the Federal government would immediately be released.
- June 19: Jonathan Letterman, M.D. is appointed Medical Director of the Army of the Potomac. He replaces Surgeon Charles S. Tripler, who becomes Medical Inspector General of the U.S. Army.
- June 25: Peninsula campaign: Seven Days’ Battles begins.
- June 26: Peninsula campaign: Battle of Mechanicsville, Virginia.
- June 26: Confederate General Robert E. Lee issues a General Order that all imprisoned Federal medical officers be released.
- June 27: Peninsula campaign: Battle of Gaines’s Mill (First Cold Harbor), Virginia.
- June 29: Peninsula campaign: Battle of Savage Station, Virginia.
- June 30: Peninsula campaign: Battle of White Oak Swamp (Frayer’s Farm), Virginia.
- July: The Federal surgeon-general requests the Order of the Sisters of Charity of Emmitsburg, Maryland to provide 100 sisters to work as nurses in White House, Virginia, during the Peninsula campaign.
- July 1: Union Dr. Jonathan Letterman replaces Dr. Charles Tripler as medical director of the Army of the Potomac. Battle of Malvern Hill, Virginia.
- July 12: The Red Rover, a captured Confederate steamer that was refitted as a hospital ship in St. Louis, is put into service at Cairo, Illinois. It carried female nurses, nuns from the order of the Sisters of the Holy Cross.
- July 14: Federal Union General William Hammond issues a directive regarding the confrontational and difficult Superintendent of Nurses, Dorothea Dix. She was to retain the authority to choose and assign nurses, but the “control and direction” of all nurses, male and female, was put under the medical officer in charge. Throughout the war, 3,214 women would serve in Dix’s corps.
- August 2: Special Orders No. 147 is issued by General George B. McClellan, putting Jonathan Letterman’s ambulance plan into effect in the Army of the Potomac.
- August 9: Battle of Cedar Mountain, Virginia.
- August 26: Confederate victory at the Battle of Second Bull Run (Second Manassas).
- August 29: Secretary of War Edwin M. Stanton rejects Jonathan Letterman’s ambulance plan for adoption throughout the Union Army.
- September 1: The abandoned naval hospital at Norfolk, Virginia was reoccupied for the primary use of sailors from the North Atlantic Blockading Squadron.
- September 7: U.S. Surgeon General Hammond writes to Secretary of State Stanton, lamenting “the scarcity of ambulances, the want of organization, the drunkenness and incompetency of the drivers, [and] the total absence of ambulance attendants.”
- September 14: Battles of South Mountain and Crampton’s Gap, Maryland.
- September 17: Battle of Antietam (Sharpsburg), Virginia is the single bloodiest day of the war, with 23,000 casualties in 10 hours of fighting.
- September 22: Lincoln’s “Emancipation Proclamation” (effective January 1, 1863) declares all slaves held in the rebelling territories to be free.
- October 4: Union Major Jonathan Letterman institutes a system of “brigade supplies” in the Union armies. It specifies medical supplies and transport to be issued monthly for active field service.
- October 8: Battle of Perryville, Kentucky.
- October 27: U.S. General Order No. 357 is issued. It emphasized that all nurses were under the control of the senior medical officers in the hospitals where they served. The order was intended to emphasize that female nurses were no longer exclusively under the control of Dorothea Dix, Superintendent of Nurses.
- October 30: Jonathan Letterman, Medical Director of the Army of the Potomac, issued an order that required only the most experienced surgeons to make decisions about whether surgery should be performed on a given patient, and that only the most able surgeons assigned to perform it.
- December: Union Surgeon General William Hammond writes to the heads of American medical schools to request that students be taught hygiene and military surgery.
- December 1: Widow Phoebe Yates Pember, 39, became the chief matron of the Second Division at Chimborazo Hospital outside Richmond, Virginia. It was one of five divisions of what was thought to be the largest military hospital in the world.
- December 13: Union forces are defeated at the Battle of Fredericksburg, Virginia.
- December 31: Battle of Stones River (Murfreesboro), Tennessee.
- By late in the year, both Union and Confederate armies favored the construction of the new “pavilion hospitals”, a type of construction that continued to be used during both World Wars and the Vietnam era for temporary military hospitals.

1863
- New York and Philadelphia leaders in the field of veterinary medicine meet to establish the United States Veterinary Medical Association.
- A major pandemic of smallpox sweeps both armies.
- Almost all troops, North and South, are now armed with rifles.
- January 1: Lincoln issues his Emancipation Proclamation.
- January 2: Second day of the Battle of Stones River (Murfreesboro), Tennessee.
- January 2: Volunteer Mrs. Mary Ann “Mother” Bickerdyke reports to the Medical Director of Memphis, Tennessee.
- January 8: Mary Ann Bickerdyke organizes laundry services for the hospitals in Memphis, Tennessee.
- January 9: Confederate medical services take over the Exchange Hotel in Gordonsville, Virginia, as a receiving hospital.
- January 11: Union troops capture Fort Hindman, Arkansas.
- February 9: Joseph K. Barnes is appointed Lieutenant Colonel/Medical Inspector, USA.
- February 9: In Geneva, Switzerland, the International Committee of the Red Cross is formed. Influenced by his witness of the horrors of the Solferino battlefield, businessman Henri Dunant addressed the Geneva Society for Public Welfare and asked the members to form a volunteer society to aid wounded soldiers.
- February 10: The United States Sanitary Commission establishes a Free Pension Agency to handle the pension claims of wounded soldiers. It was later renamed the Army and Navy Claim Agency.
- February 13: The Western Sanitary Commission opens a Soldiers’ Home in Memphis, Tennessee.
- February 24: Arizona becomes a US. Territory.
- February 25: The Federal Congress passes the Conscription Act.
- February 29: The Western Sanitary Commission is authorized by Major General Grant in Special Orders No. 88, Department of Tennessee, to be provided with a government-furnished steamboat to provide transportation for Sanitary Commission materials and supplies.
- March 3: The National Academy of Science is founded in Washington, D.C. with the endorsement of President Lincoln.
- March 4: Idaho becomes a U.S. territory.
- April: The Federal Army establishes the Invalid Corps, providing less demanding roles for soldiers who were too injured or ill to return to active duty. More than 60,000 men served in the Corps.
- April 3: Bread riots in Richmond, Virginia.
- April 17: Union Colonel Benjamin Grierson begins a cavalry raid into Mississippi as a diversion from Major General Ulysses Grant’s main attack plan on Vicksburg, Mississippi.
- May 1-4: Confederate victory at Chancellorsville, VA. General Thomas Jonathan “Stonewall” Jackson is accidentally wounded by Confederate pickets and loses an arm to amputation.
- May 3: Second Battle of Fredericksburg, Virginia and Battle of Salem Church, Virginia.
- May 10: General Thomas Jonathan “Stonewall” Jackson dies of complications from pneumonia.
- May 12: General Ulysses Grant attacks Raymond, Mississippi as part of the Vicksburg campaign.
- May 14: The Federal Vicksburg campaign engages at Jackson, Mississippi.
- May 16: Battle of Champion’s Hill, Mississippi (Vicksburg campaign).
- May 17: Vicksburg campaign engages at Big Black River, Mississippi.
- May 18: Siege of Vicksburg, Mississippi begins.
- May 21: Siege of Port Hudson, Mississippi begins.
- June 9: Cavalry Battle at Brandy Station, Virginia.
- June 14-15: Second Battle of Winchester, Virginia.
- June 19: Despite the written and verbal protests of Medical Director Jonathan Letterman, the transportation of the Army of the Potomac’s Medical Department is reduced to two wagons per brigade.
- June 20: West Virginia becomes a state of the Union.
- July 1-3: Union victory at Gettysburg, PA. Improved medical transport and organization was apparent. All of the wounded from both sides were gathered from the field each night and taken to field hospitals.
- July 4: Confederate defeat at Vicksburg, Mississippi.
- July 7: U.S. Medical Inspector Edward P. Vollum arrives at Gettysburg and finds the need for drugs so urgent that he purchases supplies at local drugstores and sends the bills to the quartermaster.
- July 8: Confederate surrender of Port Hudson, Mississippi.
- August: The Confederate Association of Army and Navy Surgeons is established.
- August 24: General George Meade issues General Orders No. 85 putting Jonathan Letterman’s revised regulations for the Ambulance Corps into effect in the Army of the Potomac.
- September 20: Confederate victory at Chickamauga, Georgia.
- October 22: Union army defeats the Confederates at Chattanooga, Tennessee.
- October 27: The City of Chicago demonstrated support for the U.S. Sanitary Commission by closing, so that all its citizens could attend the huge Sanitary Fair. The purpose of the Fair was to raise funds to support the Commission’s work and send vegetables to the troops. Spearheading the organization of this first Sanitary Fair was volunteer Mary A. Livermore, a Chicago journalist.
- November: Joseph Janvier Woodward, M.D. of the U.S. Surgeon General’s office, publishes Outline on the Chief Camp Diseases of the United States Army as Observed during the Present War.
- November 5: Federal Army establishes Desmarres Hospital for the treatment of eye injuries, in Washington, D.C.
- November 19: President Abraham Lincoln delivers his “Gettysburg Address” at the dedication of a military cemetery.
- November 20: President Lincoln is diagnosed with a mild case of smallpox and is ill until mid-December.
- November 23-25: Battles for Chattanooga, Tennessee, including Lookout Mountain and Missionary Ridge.
- November 26: Mine Run campaign in Virginia begins.
- November 29: Confederate attack on Fort Sanders at Knoxville, Tennessee.

1864
- A special hospital ward for soldiers with eye injuries is set up in Forsythe, Georgia.
- “In God We Trust” first appears on U.S. coins.
- In France, Louis Pasteur develops his germ theory of disease.
- January: The first issue of the Confederate States Medical and Surgical Journal is printed and continues to be issued monthly in Richmond through March 1865.
- January 11: Assistant Surgeon John Shaw Billings presents his analysis of medical department operations to the Medical Director of the Army of the Potomac.
- January 14: Jonathan Letterman resigns as Medical Director of the Army of the Potomac. His replacement is Surgeon Thomas A. McParlin, U.S. Army.
- January 24: Volunteer nurse Louisa May Alcott returns to her home in New England to recover from typhoid fever.
- February 4: The Union Medical Director of the Department of the South was ordered to send his sick patients to the general hospital, turn in all excess medical supplies, and prepare to board steamers for the attack on Jacksonville, Florida.
- February 14: Federal troops capture Meridian, Mississippi.
- February 20: Battle of Olustee, Florida.
- February 24: The prison at Andersonville, Georgia, called Camp Sumter, opens. It was designed for 10,000 prisoners, but by July, 1864 it held 29,998.
- March 1: Congress passes a reorganization bill, making ambulance service fully operational.
- March 1: Union cavalrymen attempt to assault Richmond in the Kilpatrick-Dahlgren cavalry raid, which fails.
- March 3: An English branch of the United States Sanitary Commission is organized in a British tavern. Its purpose was to solicit relief funds from Americans living abroad.
- March 9: Ulysses S. Grant is commissioned lieutenant general and commander of all U.S. armies.
- March 11: U.S. Congress passes the Ambulance Corps Act in which Jonathan Letterman’s system is adopted throughout all the Union armies.
- March 11: Congress passes a bill reorganizing the medical department and creating an Ambulance Corps.
- March 12: Beginning of the Union’s Red River campaign in Louisiana.
- March 18: The United States Sanitary Commission holds a Sanitary Fair in Washington, D.C.
- April 9: A medical purveying depot is established in Alexandria, Virginia, by Medical Purveyor Thomas G. McKenzie of the Army of the Potomac.
- April 12: General George Meade issues Special Orders No. 197, placing the medical department of the Army of the Potomac on the same level as other staff corps.
- May 4: The 1864 campaign of the Army of the Potomac begins.
- May 5-6: In the Battle of the Wilderness, VA, 21,463 Union troops are wounded. The newly organized ambulance system is able to remove all of the wounded by 9pm on May 6th.
- May 7: Union General W.T. Sherman begins his Atlanta campaign against Confederate General Joseph Johnston.
- May 8-12: Battle of Spotsylvania Court House, Virginia.
- May 12: Confederates evacuate Dalton, Georgia in the Atlanta campaign.
- May 14-15: Battle of Resaca, Georgia of the Atlanta campaign.
- May 15: Battle of New Market, Virginia.
- May 15: Federal orders are given to establish a prison camp at Elmira, New York. In all, 12,123 Confederate prisoners were sent to Elmira. Of those, 2,963 died there.
- May 16: Battle of Dewry’s Bluff, Virginia.
- May 18-19: Spotsylvania Court House, Virginia experiences more fighting.
- May 23-26: Battle of North Anna River, Virginia.
- May 31-June 3: Battle of Cold Harbor, Virginia.
- May 31: The Ambulance Corps of the Army of the Potomac consists of 620 ambulances, 40 medicine wagons, 174 army wagons, 15 forges, 1,882 horses, 870 mules, 767 stretchers, 57 officers and 2,092 enlisted men.
- June: The U.S. Army adopts the “Autenrieth Wagon” for the transport of drugs, surgical tools and supplies. The Autenrieth Wagon was displayed in Paris, France, at the 1867 World’s Fair.
- The Union Naval blockade creates severe medical supply shortages for the South. Jefferson Davis has the Confederate Congress pass a law requiring that blockade runners’ cargoes consist of at least 50% government supplies.
- June 3: By orders of Acting Surgeon General Joseph K. Barnes, Lincoln General Hospital in Washington, D.C. is designated for the care of wounded Confederate soldiers.
- June 14: In a U.S. Sanitary Commission sponsored-lecture at the Smithsonian Institution, Parisian physician Dr. Charles Edouard Brown-Sequard introduced his experience with the revolutionary technique of blood transfusion.
- June 14: Battle of Pine Mountain, Georgia. The Army of the Potomac crosses the James River.
- June 16-18: Siege of Petersburg, Virginia begins.
- June 23: Siege of Petersburg: Engagement at Weldon Railroad.
- June 27: Battle of Kennesaw Mountain, Georgia in the Atlanta campaign.
- July 9: Battle of Monocacy, Maryland.
- July 11: Confederate General Jubal Early is stopped at Fort Stevens in the Washington suburbs.
- July 13: Confederate agents torch Barnum American Museum and Astor House in an unsuccessful attempt to burn New York City.
- July 14: Battle of Tupelo (Harrisburg), Mississippi.
- July 17: General John Bell Hood replaces General Joseph E. Johnston as commander of the Confederate Army in Tennessee
- July 20: Atlanta campaign: Battle of Peachtree Creek, Georgia.
- July 22: Atlanta campaign: Battle of Atlanta, Georgia.
- July 28: Atlanta campaign: Battle of Ezra Church, Georgia.
- July 30: Siege of Pettersburg: Battle of the Crater (mine explosion).
- August 18: William A. Hammond is convicted in a court-martial and removed as Federal surgeon-general.
- August 18-19: Siege of Petersburg: Battle of Weldon Railroad, Virginia.
- August 22: Dr. Joseph K. Barnes is officially appointed Surgeon General, U.S. Army, with the rank of Brigadier General.
- August 22: In Geneva, Switzerland, the representatives of 12 nations agreed to sign the First Geneva Contention “for the Amelioration of the Condition of the Wounded in Armies in the Field”. Twenty countries had signed by 1866.
- August 23: Desmarres Hospital, the Federal specialty Eye and Ear Hospital is moved from Washington, D.C. to Chicago, Illinois. It had 150 beds.
- August 25: Siege of Petersburg: Battle of Reams Station, Virginia.
- August 30: William A. Hammond, M.D., Surgeon General, is dismissed from the U.S. Army.
- August 30: George A. Otis, M.D. is appointed Surgeon of Volunteers, U.S.A.
- August 31: Atlanta campaign: Battle of Jonesboro, Georgia.
- September: Yellow fever epidemic in New Bern, North Carolina.
- September 1: Confederates evacuate Atlanta, Union forces occupy the city.
- September 19: Third Battle of Winchester (Opequon Creek), Virginia.
- September 23: Battle of Fisher’s Hill, Virginia.
- September 29-October 2: Battle of Peeble’s Farm and Chaffin’s Bluff (Fort Harrison), Virginia.
- October 5: Engagement at Altoona, Georgia.
- October 9: Engagement at Tom’s Brook, Virginia.
- October 19: Battle of Cedar Creek, Virginia; Confederate raid on St. Albans, Vermont.
- October 23: Battle of Westport, Missouri.
- October 27: Engagement at Burgess Mill (Boydton Plank Road), Virginia.
- October 26-29: The Convention for the Amelioration of the Condition of the Wounded Soldiers of Armies in the Field, commonly known as The Geneva Convention, in Switzerland, establishes the neutrality of battlefield medical facilities.
- November 8: Abraham Lincoln is re-elected President of the United States. Soldiers in the Army gave him 70 percent of their vote.
- November 16: Union General William Tecumseh Sherman begins his “March to the Sea”.
- November 21: General John Bell Hood’s Army of Tennessee begins a march north to Tennessee.
- November 30: General Hood attacks General George Henry Thomas in the Battle of Franklin, Tennessee.
- December 13: Sherman’s forces capture Fort McAllister, near Savannah, Georgia.
- December 15-16: General Hood attacks General Thomas in Battle of Nashville, Tennessee.
- December 20: Sherman captures Savannah, Georgia.
- December 24-25: Federal attacks on Fort Fisher, near Wilmington, North Carolina.
- Near the end of the war, the Confederate Army establishes a hospital for the treatment of eye injuries at Athens, Georgia, under the command of Surgeon Bolling A. Pope.

1865
- Joseph Lister of Scotland initiates antiseptic surgery by using carbolic acid on a compound wound and introduces phenol as a disinfectant in surgery, reducing the surgical death rate from 45 to 15 percent
- Austrian Gregor Mendel publishes his first experiments in genetics.
- January 13-15: Union troops capture Fort Fisher, North Carolina.
- January 19: General Sherman begins a march north into the Carolinas.
- January 24: Prisoner exchanges between the two armies resume.
- February 3: Clara Barton wrote a letter to President Lincoln requesting the authority and endorsement for her to act as temporary general correspondent for letters to and from recently exchanged prisoners of war.
- February 5-7: Siege of Petersburg: Battle of Hatcher’s Run, Virginia
- February 6: Confederate President Jefferson Davis appoints General Robert E. Lee General-in-Chief of Confederate Army.
- February 17: General Sherman’s forces capture and burn Columbia, South Carolina, Confederate forces evacuate Charleston.
- February 17: The Confederate submarine H.L. Hunley makes a daring and successful night attack on the USS Housatonic. The Hunley survived the attack, although she foundered and sank on the return from the mission.
- February 18: The mayor of Charleston, South Carolina surrenders the city to Union general Alexander Schimmelfennig. Union troops retake control of the United States Arsenal.
- March 3: An Act of Congress creates the National Asylum.
- March 4: President Lincoln delivers his second inaugural address at his second inauguration.
- March 11: President Lincoln appoints Clara Barton to the post she had requested: of temporary general correspondent for letters to and from recently exchanged prisoners of war.
- April 2: Extensive Confederate medical records gathered during the war are destroyed in the Richmond, Virginia fire that destroyed many government offices.
- Siege of Petersburg ends as General Lee removes troops; Richmond is evacuated.
- April 3: Fire begins in Richmond around 3a.m.; Federal troops enter the city later in the day.
- April 3: Richmond, VA surrenders to General Grant.
- April 5: President Lincoln’s Secretary of State, William H. Seward sustained multiple injuries in a carriage accident. One of his most serious injuries was a broken jaw. Unsuccessful attempts to hold the jaw together were made by the attending surgeons.
- April 9: Confederate States of America formally surrender. General Robert E. Lee surrenders the Army of Northern Virginia to General Ulysses S. Grant at Appomattox Court House.
- April 12: Surrender of Mobile, Alabama.
- April 14: President Abraham Lincoln is shot in the head at close range by John Wilkes Booth in Ford’s Theater, Washington, D.C.
- April 15: President Lincoln dies at 7:22 a.m. He is succeeded as president by Andrew Johnson.
- April 26: The Army of Tennessee surrenders to General Sherman near Durham, North Carolina.
- April 29: Secretary of State William Seward’s broken jaw is attended by dentist Dr. Thomas Bryan Gunning. Gunning’s innovative interdental splint was used to treat the injury. Ann almost identical vulcanite splint was developed at the same time by another dentist, Confederate Dr. James Baxter Bean.
- May 4: General Richard Taylor’s forces surrender at Citronelle, Alabama.
- May 10: Confederate President Jefferson Davis is captured at Irwinsville, Georgia, by the Fourth Michigan cavalry and imprisoned.
- May 12: Engagement near Palmito Ranch, Brownsville, Texas
- May 23-24: Grand Review of the Army of the Potomac and Sherman’s army, Washington, D.C.
- May 23: Volunteer Mary Ann (“Mother”) Bickerdyke, was famous during the war for her work procuring equipment and supplies, and the establishment of camp and hospital kitchens and laundries. Her beloved troops insisted that she accompany them during the Army’s Grand Review, and she rode in the parade in an ambulance wagon.
- May 26: U.S. Civil War ends with the surrender of the last Confederate Army, the Army of Trans-Mississippi at Shrevesport, Louisiana.
- July 5: Elmira Prison in New York was closed. It was demolished in August.
- September 27: The last patient left Elmira Prison hospital and the facility closed.
- December 18: The 13th Amendment to the Constitution is officially ratified, abolishing slavery.
- December 24: The Ku Klux Klan is founded in Pulaski, Tennessee.
- Elizabeth Garrett Anderson began her practice as Britain’s first female doctor. She was refused admittance to medical schools and qualified via the Society of Apothecaries.

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Medical Advances Timeline: 1850-1860

1850
- The Female Medical College of Pennsylvania, the world’s first women’s medical school, opens in Philadelphia.
- German physician Carl Reinhold Wunderlich introduces the practice of taking accurate temperature with a thermometer as a regular part of diagnosis.
- California becomes a state of the U.S.
- R.W. Bunsen produces the gas burner.

1851
- German physician Hermann von Helmholz, who was originally trained as a military surgeon, describes the ophthalmoscope for seeing inside the eye.
- The New Orleans Monthly Medical Register begins publication. It later merged with the New Orleans Medical News and Hospital Gazette.
- Isaac Singer invents the continuous-stitch sewing machine.
- The New York Times appears in September.
- World Population statistics in millions:
China 430
Germany 34
France 33
Great Britain 20.8
U.S. 23

1852
- Dutch surgeon Mathysen impregnates bandages with plaster to create rigid casts.
- Wells Fargo & Co. is founded.

1853
- Samuel Colt revolutionizes the manufacture of small arms.
- The hollow needle is developed by Alexander Wood and the hypodermic syringe by Charles Gabriel Pravaz.
- Alexander Wood uses hypodermic syringe for subcutaneous injections.
- Queen Victoria allows chloroform to be administered to her for the birth of her seventh child. This ensures the place of chloroform as an anesthetic in England.
- Vaccination against smallpox is made mandatory in England.
- Between 8,000 and 9,000 people in New Orleans, Louisiana died of yellow fever. For many years the city suffered an almost annual outbreak of the disease in late summer.

1854
- The “War for Bleeding Kansas” escalates between American free and slave states.
- The Republican Party is formed in the U.S.

1855
- Florence Nightingale (1820-1910) introduces hygienic standards into military hospitals during Crimean War.

1856
- May 24-25: Massacre of Pottawatomie Creek, Kansas: slavers are murdered by free-slavers led by abolitionist John Brown. It was one of a series of violent incidents leading to the Civil War, and known as “Bloody Kansas”.
- August 29: Joseph K. Barnes, M.D. is appointed Surgeon/Major, U.S. Army.

1857
- In France, Louis Pasteur proves that fermentation is caused by living organisms.
- The New York College of Veterinary Surgeons is chartered at New York University.
- The British establish a military medical school in the wake of the disaster of the Crimean War.
- Dr. Elizabeth Blackwell establishes the New York Infirmary for Women and Children on Bleeker Street.
- French neurologist Paul Broca discovers that specific areas of the brain are specialized for particular functions.

1858
- Minnesota becomes a state of the U.S.
- John Snow, an early English expert on anesthesia, publishes a book on chloroform and other anesthetics.
- English anatomist and surgeon Henry Gray publishes his classic textbook, Gray’s Anatomy.

1859
- More than 1200 medical students resided in Philadelphia to study medicine at Jefferson Medical College or the University of Pennsylvania; 650 of them were from the South.
- January 25-27: The Battle of Solferino, northern Italy. Approximately 140 doctors were available to treat the 40,000 casualties. The devastation was witnessed by Jean Henri Dunant, a wealthy businessman. Dunant was so deeply affected that he later became one of the founders of the International Red Cross and the primary force behind the meeting of diplomats that became known as the Geneva Convention.
- October: Upon receiving news of abolitionist John Brown’s raid on Harper’s Ferry, a mass exodus of about 200 Southern medical students left Philadelphia.
- Florence Nightingale’s influential book, Notes on Nursing, is published.
- Dr. Elizabeth Blackwell estimates that 300 women had managed to “graduate somewhere” in medicine.
- First oil well is drilled at Titusville, Pennsylvania.
- Oregon becomes a state of the U.S.

1860
- Abraham Lincoln is elected 16th President of the United States; the state of South Carolina secedes from the Union in protest.
- Five medical schools existed in the South, 27 in the North and three in the border states.
- The first hospital-based medical school in the U.S., Bellevue Hospital Medical College, is established in New York.
- The U.S. has about 400 dentist graduates from three dental schools, and about 5,500 dental practitioners, most trained by apprentices.
- Lenoir constructs the first practical internal-combustion engine.

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Medical Advances Timeline: 1800-1849

1800
- The Royal College of Surgeons is founded in London.
- Eli Whitney invents muskets with interchangeable parts.

1802
- German naturalist Gottfried Treviranus coins the term “biology”.

1803
- German pharmacist F.W.A. Serturner isolates morphine, an opium alkaloid. It was named for Morpheus, the Greek god of dreams.
- Ohio becomes a state of the U.S.
- American Robert Fulton propels a boat by steam power.
- English inventor Henry Shrapnel invents the shell.

1805
- Rockets, which were originally created by William Congreve, are reintroduced as weapons in the British Army.

1807
- The medicinal pill-making machine is invented
- Charles Bell publishes his System of Comparative Surgery.

1810
- Homeopathy is introduced by Christian Friedrich Samuel Hahnemann in Germany in his Organon of Therapeutics.

1815
- After the battle of Waterloo, in present-day Belgium, it takes ten days to gather and treat the wounded. It is Napoleon’s last battle.

1816
- Physician Rene Theophile Hyacinthe Laennec of France invents the stethoscope to examine the sounds made by the heart and lungs.
- Indiana becomes a state of the U.S.

1817
- In New Orleans, Louisiana, the Creole Societe Medicale de la Nouvelle-New Orleans is founded. All transactions were in French.

1820
- John Hall is manufacturing breech-loading rifles at Harpers Ferry, VA
- In New Orleans, Louisiana, an English-speaking medical society, the Physio-Medical Society, is established

1823
- A building with an apothecary is erected in New Orleans by Louis Joseph Dufilho, Jr., America’s first licensed pharmacist. It houses today’s Historical Pharmacy Museum.
- “The Lancet”, the British medical journal, is founded.

1824
- The Medical College of South Carolina is founded in Charleston.
- A Treatise on the Diseases of the Eye is published by Dr. George Frick, the leading oculist in Baltimore, Maryland. This was the first American book on ophthalmology.
- The forerunner of the ophthalmoscope was created by Dr. E.G. Loring of Baltimore. It had sixteen lenses mounted on a rotating dist. Concave and plane mirrors were attached.

1826-1837
- First North American cholera epidemic.

1828
- The mineral Thorium is discovered and subsequently used for dental fillings. -In 1898 it was found to be radioactive.
- A Medical Department is established at the University of Virginia in Charlottesville.

1829
- The breechloading needle gun is invented by J.N, von Drayse.
- British chemist James Smithson bequeaths L100,000 to found the Smithsonian Institution in Washington, D.C.
- William Burke is hanged in Scotland for murder. He was found to have provided very fresh corpses for anatomy schools in Edinburgh.

1831
- Chloroform is introduced into medical practice. It was invented simultaneously by American Samuel Guthrie and German Justus von Liebig. It was administered by inhalation in a solution with spirits of wine called Chloric Ether.

1832
- The Anatomy Act is passed in the United Kingdom. This allowed hospitals and workhouses to hand over for dissection bodies that were unclaimed for two days.

1835
- Samuel Colt takes out an English patent for his single-barreled pistol and rifle.

1836
- The first medical periodical in the South, The Southern Medical and Surgical Journal, begins publication.
- The Patent Arms Manufacturing Company of Paterson, New York is established to manufacture and market revolvers and rifles.

1839
- Charles Goodyear devises a process to heat India rubber with sulfur, creating vulcanite. The material was used to make denture bases, replacing gold.
- The first medical journal in Louisiana, Journal de la Societe Medicale de la Nouvelle-New Orleans is published in French.

1840
- Baltimore College of Dentistry in Maryland opens with five students.

1842
- Crawford W. Long, an American physician, produces surgical anesthesia using ether.

1843
- A machine for making pills containing more than one ingredient, or “compound tablets” is invented.
- Oliver Wendell Holmes publishes The Contagiousness of Puerperal Fever.
- American social reformer Dorothea Dix reports to the Massachusetts Legislature on the shockingly bad conditions in prisons and asylums.

1844
- U.S. dental surgeon Horace Wells, a pioneer in the use of anesthetics, has nitrous oxide administered to himself for a tooth extraction.

1845
- The hypodermic syringe is introduced.

1846
- October 16: Successful demonstration of diethyl ether as an anesthetic at Massachusetts General Hospital by dentist William Thomas Green Morton. The substance had been known since about 1200 A.D.
- The Smithsonian Institution in Washington, D.C. is founded.

1847
- Elizabeth Blackwell is the first woman to enter medical school at Geneva (New York) Medical College.
- The American Medical Association is formed by a group of medical school professors who wanted to reform medical education.
- January 19: Scottish physician James Simpson, head of obstetrics at Edinburgh, introduces the use of chloroform as an anesthetic.
- Ignac Semmelweis develops his theory of puerperal sepsis in Vienna. His observations were not taken seriously by a large audience. It would be another 10 years before Louis Pasteur published his discoveries and even longer before surgeons realized that their ungloved, unwashed hands carried blood, soil, pus, excrement and germs into open wounds.
- A report on surgery to the College of Physicians of Philadelphia focused on the uses, power and safety of ether as an anesthetic.

1849
- Elizabeth Blackwell receives her medical degree in New York, prompting international media coverage. She then went to Paris to study midwifery at La Maternite.

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Medical Advances Timeline: 1746-1799

When was the stethoscope invented? Did Civil War doctors have hypodermic needles? When did surgeons first begin to use anesthesia for operations? What were the origins of Neurology? When were the first nursing schools established? Did mid-19th century physicians perform blood transfusions? When was an ambulance corps approved by Congress? See the progression as medicine transformed from an “art” to a “science” . . .

1746
- The compressive bandage to stop bleeding from wounds is introduced.

1747
- Primae lineae physiologiae by Albrecht von Haller, Switzerland, is the first textbook on physiology.
- Benjamin Robins, an English military engineer, addresses the Royal Society on the physics of a spinning projectile.

1749
- The Philadelphia Academy is founded. It will later evolve to become the University of Pennsylvania.
- Sign language for deaf-mutes is invented by Portuguese Giacobbo Rodriguez.

1751
- The first mental asylums are established in London.

1752
- Philadelphian Benjamin Franklin invents the lightning conductor.

1753
- James Lind, British naval surgeon, publishes his classic work on the treatment and prevention of scurvy by the use of citrus fruits.

1754
- The first female M.D. is graduated from the University of Halle, Germany.

1761
- Medical doctor B.G. Morgagni publishes On the Causes of Diseases in Bologna. It is regarded as the beginning of pathological anatomy.

1762
- First veterinary facility in Europe is established after centuries of wars, disease epidemics, livestock plagues and food shortages.

1765
- The first medical school in America opens at the College of Pennsylvania.

1766
- English surveyors Charles Mason and Jeremiah Dixon draw the boundary between Pennsylvania and Maryland, the Mason-Dixon Line. It later separates the slave and free regions.

1767
- English theologian and philosopher Joseph Priestly publishes The History and Present State of Electricity.

1771
- Italian physician and physicist Luigi Galvani performs the first experiments with bioelectricity: the relationship of electrical patterns and the nervous system.
- New York Hospital is founded.

1772
- The Paris Faculty of Medicine declares potatoes to be an edible food.

1777
- American engineer David Bushnell invents the torpedo.
- The American Continental Congress adopts the Stars and Stripes as its flag.

1779
- The first Children’s Clinic is established in London.

1780
- The American Academy of Sciences is established in Boston. Medicine is still considered to be an “art”.

1788
- New York is declared the federal capital of the United States.

1790
- Philadelphia, Pennsylvania becomes the federal capital of the United States.
Washington, D.C. is founded.

1791
- Vermont becomes a state of the U.S.

1792
- Kentucky becomes a state of the U.S.
- The world’s first chemical society is founded in Philadelphia.

1794
- The United States Navy is founded.

1795
- The first elite military medical schools are established in Paris and Berlin.
- Based on James Lind’s 1753 findings, lemon and lime water for the prevention and treatment of scurvey, was stocked aboard all British naval vessels.

1796
- Tennessee becomes a state of the U.S.
- English physician Edward Jenner introduces a vaccination against smallpox.

1798
- The Department of the Treasury establishes The Marine Hospital Service, authorizing marine hospitals for the care of American merchant seamen.

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Top Ten Surprising Things About Civil War Medicine

1) There wasn’t an ambulance to be found. The American Civil War spurred a revolution in emergency rescue and evacuation. Union Major Jonathan Letterman devised the first dedicated ambulance system with trained personnel. Our 21st century emergency rescue systems are still based on his concepts.

2) Most doctors had never performed surgery or seen a gunshot wound. Of the estimated 16,000 physicians who served in the Civil War, only 5% had ever seen or performed surgery. They would learn from hasty training, field manuals and the experience of working with hundreds of thousands of casualties.

3) Anesthesia was used for most wartime surgeries. Despite widespread tales of soldiers biting on bullets while undergoing surgery, almost all Civil War surgeries were performed with the use of ether or chloroform. Dentists in the United States had been using anesthesia since the 1840’s and Northern and Southern surgeons quickly embraced its use. Both armies maintained a steady supply throughout most of the war.

4) Operating conditions were filthy by modern standards. Nothing was sterile. News of European research on sterilization of wounds had not reached America. Surgeons were known to sharpen their scalpels on the soles of their boots. Silk for sutures was wetted with the doctor’s saliva. President Lincoln’s fatal head wound was probed with the unsterilized fingers of some of the most respected physicians of the period.

5) You couldn’t find a trained nurse to save your life. Before the Civil War, family members usually provided care for ailing relatives. The 1,000,000 wartime casualties required a rapid organization and training of volunteer nurses to aid in the massive relief effort. Their work would lead to the establishment of formal schools and associations for skilled nurses.

6) Nerve injuries were identified and addressed for the first time. Dr. Silas Weir-Mitchell of Philadelphia, worked with many post-surgical amputee patients. He noticed some common phenomena, including “phantom limb”. Dr. Mitchell’s observations and treatments formed the basis for our modern medical area of specialty known as neurology.

7) Civil War medicine brought a new perspective to the lives of American women. In a passionate outpouring of support, women emerged from the parlors and plantations onto the battlefields, the hospitals, and prisons to nurse the wounded. They appeared publicly in business for the first time and took on the task of fundraising for the relief effort.

8) The concept of Medical record-keeping on a large scale before was born. From meticulous records kept throughout the war, The Medical-Surgical History of the War of the Rebellion, a massive six-volume compendium, was published. It included case histories, autopsy reports, disease records, post-surgical photographs and follow-ups. It was the first comprehensive study and analysis of its kind and was considered by the European medical community to be America’s finest contribution to the future of medicine.

9) The largest post-war budget expenditures of some Confederate states were for prosthetic limbs. Despite the non-sterile conditions of Civil War surgery, a surprising 75% of amputees survived. Their needs spurred the makers of artificial limbs to improve the comfort and effectiveness of their products.

10) The elements of “triage”, or sorting of the wounded, appeared during the Civil War. Amputation of a wounded limb was the quickest way to save a life. Chest, abdominal and head surgeries were rarely attempted, and those patients were usually left to die.

Related Articles:
Ten Common Myths about Women in the Civil War and How to Dispel Them
How Civil War Photography Changed War
10 Surprising Civil War Facts

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Improved Civil War Ambulances

The Civil War was a landmark in the evacuation and treatment of battlefield casualties. It was the first mass evacuation of wounded troops and its lessons and innovations were quickly adopted in Europe. “The American War” had introduced a trained ambulance corps, improved and designated ambulance vehicles and the use of field hospitals near the battlefield. These systems became standards of battlefield and disaster medicine.

Early in the war, the wounded lay on some battlefields for as long as three days. No designated vehicles were assigned to ambulance duty. There were no trained attendants to carry stretchers. Men deployed to the task were usually those too weak, sick, drunk or frightened to fight.

Major Jonathan Letterman, Medical Director of the Army of the Potomac, instituted a plan. Letterman’s design was a model of organization for medical support. The elements of his concept are still used in modern wars.

Major Letterman’s plan called for transporting the wounded to the hospital in dedicated vehicles, dropping them off with their bedding, picking up new supplies at the hospital and returning to the front. The ambulances of a division would move together with specified personnel to collect the wounded from the field, bring them to dressing stations, then to the field hospital. The plan was implemented in August of 1862 with regulations for the organization of the ambulance corps and the management of ambulance trains.

Jonathan Letterman’s Ambulance Corps was a huge improvement over the previous methods of evacuating casualties. The new system was partially tested at Antietam on September 17, 1862, the single bloodiest day of the war. The field was cleared of its 23,000 casualties within twenty-four hours.

In March, 1864, Congress published General Orders No. 106, an act (Public 22) to create an Ambulance Corps for all the Union Armies. By this time, the Corps was in general use throughout the Union Army. The Confederates had adopted a similar program, although they never put their ambulances under the medical service, keeping them under the quartermaster.

The Americans also pioneered specially designed trains and boats to transport the wounded. The Civil War ambulance-to-field hospital system remained in use by Americans and Europeans during all large wars for almost a hundred years, until the introduction of helicopter evacuation.

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Civil War Pharmaceuticals

Army physicians treated their patients with the most advanced care available, but those treatments were frequently ineffective and sometimes harmful.

They applied preparations like croton oil, which burned the skin, in the belief that a “counter irritant” would increase blood flow. It didn’t work. Soldiers weak from diarrhea were dosed with emetics to induce vomiting in the belief that “cleaning out one’s insides” was beneficial. It wasn’t.

A few effective drugs were available to Civil War physicians. Ether and chloroform, the anesthetics, were routinely administered. Belladonna was helpful in the treatment of intestinal cramps.

The narcotics opium and morphine were used to treat pain and diarrhea. The liberal use of these drugs was criticized after the war for the proliferation of addition, often called “Old Soldier’s Disease.” The rising consumption of opium in the United States peaked in the 1880’s, with commercial opium preparations that were available without a prescription. More women than men were classified as opium addicts in the post-war period.

Quinine, known since the 16th century, was one of the most effective medicines available. It was used to treat fevers of all kinds but was especially helpful in treating the chills and fever of malaria. Powers and Weightman, a Philadelphia-based firm, was the nation’s largest supplier of quinine.

Turpentine was routinely prescribed for oral and topical use in America and Europe. When quinine wasn’t available, Confederate surgeons substituted turpentine.

”Blue Mass”, a claylike compound, and “blue pills” both contained the toxin mercurous chloride. They were used to treat many ailments, sometimes causing severe reactions. President Abraham Lincoln used “blue pills” to combat chronic constipation.

Before the Civil War, the U.S. Army had purchased medicines on the open market. During the course of the conflict, the Union army began to rely heavily o a few large domestic drug companies for stable prices and inventories.

Fueled by the demand for medicines during the Revolutionary War, a North American pharmaceutical industry had sprung up from Baltimore to Boston, with several firms based in Philadelphia. Many of these companies were founded by pharmacists and physicians with names like Wyeth, Warner, Upjohn and Dohme. As the Civil War progressed, existing companies including Powers and Weightman and the Pfizer Company increased their production of drugs like iodine, morphine, chloroform, tartaric acid and camphor.

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Infections in the Civil War

If a soldier survived his wound and subsequent surgery, he wasn’t necessarily healed. He still faced the looming specter of infection.
Infection can develop when a great amount of tissue damage and necrosis, or, death of the tissue, exist. Civil War doctors didn’t know the causes of infections and weren’t able to treat them. Frequently, the infections reached a stage where amputation of the infected limb became the best option.

Although surgeons were aware of a correlation between cleanliness and a low infection rate, most battlefield conditions didn’t permit even a cursory attempt at cleanliness. Sterilization of wounds and surgical tools was unknown.

Almost every soldier who underwent surgery during the war suffered post-operative infections known as “surgical fevers”. Most of these were actually caused by Staphylococcus aureus and Streptococcus phyogenes, bacterial cells that generate pus, destroy tissue and release deadly toxins into the bloodstream.

Surgeons unwittingly passed these germs from one patient to another as they reused bloodied instruments with unwashed hands. Bullets were also responsible for carrying dirt and germs into the wounds.

Nothing about the surgeries was sterile or antiseptic. After probing a wound with unsterilized instruments or fingers to remove pieces of bullet, shell or bone, doctors sprinkled morphine powder into the wound, packed it with moist lint or unsterilized cotton and bandaged it with wet, unsterilized bandages.

Alcohol, bromine and iodine were in use, but not recognized for their antiseptic properties. Inflammation and quantities of pus—known as “laudable pus” were expected as part of the “healing” process.

Ironically, it was just at this time that Louis Pasteur of France was demonstrating his “germ theory”—the concept that invisible organisms caused the infection of surgical wounds. Joseph Lister of Scotland was basing his own work on that theory.

In 1865, Lister, who would become known as “the father of antiseptic surgery”, successfully used carbolic acid to prevent wound infection. If the work of Lister and Pasteur had been known and accepted during the Civil War, the use of even simple vinegar as an antiseptic would have dramatically reduced the number of deadly infections.

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