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.

Posted in: Civil War Wounds,Infection