Thursday, September 12, 2013

Civil War Medicine Chest

Contributed by T. A. Wheat

Some advances in medicine were made in the decades before the war, which proved to be very beneficial to both sides. Opium and its derivatives, laudanum and paregoric, were still used for pain, but the decades before the war saw the manufacture of morphine sulfate, which proved to be a much more effective pain reliever. Ether, a common solvent, was accidentally found to have painkilling properties when its vapors were inhaled. It was adopted by the dental profession in the decades before the war and was found to be safe and effective. Other volatile fluids were tested to see if they had a similar effect and this led to the discovery of the anesthetic properties of chloroform. Chloroform was used many thousands of times by the British during the Crimean War (1853–1856), and was also quite successful. During the Civil War, chloroform was the anesthetic agent of choice because it was less volatile (making it easier to transport and store) and less likely to explode in the presence of a lantern or candle.

Another significant advance, in the decades before the war, was the extraction of the active ingredient quinine sulfate from the bark of the Peruvian cinchona tree. The Peruvian bark had been used for centuries to treat "intermittent fever," or malaria. The availability of quinine sulfate provided a safe, predictable, and reliable method of both preventing and treating intermittent fever. Since most of the Atlantic and Gulf coasts in America were areas where malaria was prevalent, the use of quinine sulfate saved many thousands of lives.

The last significant development to occur prior to the Civil War was vaccination for smallpox. Prior to the work of the English physician Edward Jenner with cowpox, the actual smallpox virus was used to inoculate patients, producing a mild form of the disease and conferring a natural immunity. With Jenner's research, first published in 1798, this could be done more safely with the cowpox virus. The success of vaccination and the isolation of smallpox cases prevented this ancient scourge from becoming a significant problem for Civil War soldiers. Most other contagious diseases, especially erysipelas (a streptococcal infection) and gangrene, were also controlled to a great extent with isolation techniques.

Still, at the time of the Civil War, most medical treatment was not only unhelpful but could actually be harmful. This was partially mitigated by the fact that certain inappropriate treatments were applied much less vigorously than in the seventeenth and eighteenth centuries. For instance, physicians considered "blood letting" to be a proper course of treatment only under a few specific conditions associated with congestion; it was not used at all in treating wounded men, who frequently had already lost a great deal of blood. Harsh laxatives, sometimes called "drastics," were often used and included heavy-metal salts such as mercury chloride (calomel and "Blue Mass"). Ironically, an effective treatment for chronic diarrhea—consisting of a diet limited to clear liquids and the use of opiates to slow intestinal contractions—was available and sometimes used in conjunction with other, inappropriate measures. Some surgeons appear to have learned from personal experience and gradually shifted to regimens favoring the more appropriate treatments.

In addition, soldiers faced other natural hazards. These included other insect- and parasite-related diseases, electrocution by lightning, snakebites, and drowning. Certainly the most common natural hazards were the extremes of temperature associated with the change of seasons. During the hottest months, when campaigning was most active, soldiers frequently were incapacitated and occasionally died from heatstroke. During the coldest months, cold-related injuries and even death by freezing were not uncommon. This can be attributed primarily to inadequate clothing and shelter. Although this was most common in the Confederate army, there were times in both armies when the supply system proved inadequate.


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