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Wednesday, August 7, 2013

Civil War Medicine (Part II)

By Jenny Goellnitz


Battlefield surgery (see separate web page describing an amputation) was also at best archaic. Doctors often took over houses, churches, schools, even barns for hospitals. The field hospital was located near the front lines -- sometimes only a mile behind the lines -- and was marked with (in the Federal Army from 1862 on) with a yellow flag with a green "H".
Anesthesia's first recorded use was in 1846 and was commonly in use during the Civil War. In fact, there are 800,000 recorded cases of its use. Chloroform was the most common anesthetic, used in 75% of operations. In a sample of 8,900 uses of anesthesia, only 43 deaths were attributed to the anesthetic, a remarkable mortality rate of 0.4%. Anesthesia was usually administered by the open-drop technique. The anesthetic was applied to a cloth held over the patient's mouth and nose and was withdrawn after the patient was unconscious.
A capable surgeon could amputate a limb in 10 minutes. Surgeons worked all night, with piles of limbs reaching four or five feet. Lack of water and time meant they did not wash off hands or instruments.
Bloody fingers often were used as probes. Bloody knives were used as scalpels. Doctors operated in pus stained coats. Everything about Civil War surgery was septic. The antiseptic era and Lister's pioneering works in medicine were in the future. Blood poisoning, sepsis or Pyemia (Pyemia meaning literally pus in the blood) was common and often very deadly. Surgical fevers and gangrene were constant threats. One witness described surgery as such: "Tables about breast high had been erected upon which the screaming victims were having legs and arms cut off. The surgeons and their assistants, stripped to the waist and bespattered with blood, stood around, some holding the poor fellows while others, armed with long, bloody knives and saws, cut and sawed away with frightful rapidity, throwing the mangled limbs on a pile nearby as soon as removed." If a soldier survived the table, he faced the awful surgical fevers. However, about 75% of amputees did survive.
The numbers killed and wounded in the Civil War were far greater than any previous American war. As the lists of the maimed grew, both North and South built "general" military hospitals. These hospitals were usually located in big cities. They were usually single storied, of wood construction, and well-ventilated and heated. The largest of these hospitals was Chimborazo in Richmond, Virginia. By the end of the War, Chimborazo had 150 wards and was capable of housing a total of 4,500 patients. Some 76,000 soldiers were treated at this hospital.
There were some advances, mainly in the field of military medicine. Jonathan Letterman, revolutionized the Ambulance Corps system. With the use of anesthesia, more complicated surgeries could be performed. Better and more complete records were kept during this period than they had been before. The Union even set up a medical museum where visitors can still see the shattered leg of flamboyant General Daniel Sickles who lost his leg at the Trostle Farm at the battle of Gettysburg when a cannon ball literally left it hanging by shreds of flesh.
The Civil War "sawbones" was doing the best he could. Sadly when American decided to kill American from 1861 to 1865, the medical field was not yet capable of dealing with the disease and the massive injuries caused by industrial warfare.

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