.

Civil War Hospital Ship

The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.

Evolution of Civil War Nursing

The evolution of the nursing profession in America was accelerated by the Civil War.

The Practice of Surgery

Amputations were the most common surgery performed during the Civil War.

Army Medical Museum and Library

Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.

Civil War Amputation Kit

Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.

Thursday, March 14, 2013

Venereal Disease

Venereal diseases were common among mid-nineteenth century troops. It has been known for hundreds of years that syphilis and gonorrhea were transmitted by sexual contact, although the term “gonorrhea” was applied to all forms of urethral discharge during the Civil War.
As the devastating complications frequently don’t appear for many years, it’s impossible to estimate the number of post-war deaths from these diseases. 102,893 soldiers were diagnosed with gonorrhea during the war and 79,589 with syphilis, but very few wartime deaths were listed as a direct result of these diseases.
The military created some successful public health programs in its effort to rid camp areas of diseased prostitutes. The women were rounded up, inspected, treated and released when their symptoms receded.

Civil War Medications

Information for this section was contributed by The College of Physicians of Philadelphia, in particular Jane E. Boyd, Ph.D., Wood Institute Research Associate, and Robert D. Hicks, Ph.D., Measey Chair for the History of Medicine and Director of the Mütter Museum & Historical Medical Library. For more information about The College of Physicians and the Mütter Museum, visit www.collphyphil.org.

In the Civil War era, many of the medications we now take for granted did not exist. There were no antibiotics and hardly any vaccines, as no one knew that germs (microorganisms) caused many diseases. Nevertheless, pharmaceuticals played an important role in Civil War medical care.

In 1861, before the start of the war, there were only six colleges of pharmacy in the United States. The first, the Philadelphia College of Pharmacy, had been founded in 1821. The pharmacy school curriculum included chemistry and medical botany, as many medicines of the time were derived from plants and taken in liquid or pill form. Formal training in pharmacy, however, was relatively rare. There were no licensing or state board exams for pharmacists. Rather than a profession, pharmacy was usually seen as a trade, with most training gained during a two- or three-year apprenticeship. Of the 11,000 pharmacists in the country in 1860, fewer than 5 percent had any formal course work.

The war spurred the expansion and industrialization of the field. In 1860, there were 84 manufacturers of pharmaceuticals in the United States; just 10 years later, there were 300. Philadelphia was an important manufacturing center for all war materials, and medications were no exception. For instance, the firm of John Wyeth & Brother was founded in 1860 by two graduates of the Philadelphia College of Pharmacy. Their drugstore and small research lab grew quickly during the war to become a large wholesale business, selling beef extract and a range of medicines to the army.

Another Philadelphia company, Powers & Weightman, had introduced quinine sulfate (cinchona bark extract) for malaria treatment to the United States in the 1820s. Rosengarten & Sons was also a quinine supplier. Together, the two firms served most of the Union Army’s quinine needs. Civilian firms, though, could not give the army all the medications it required. Two Army Medical Laboratories were begun in 1863, one in New York and one in Philadelphia, to produce dozens of medicines in large quantities. Even though medications were being manufactured on an industrial scale, there was little quality control and regulation was uneven.

Army Quartermasters were originally responsible for drug supplies. Later, however, this work was transferred to the Surgeon General’s office. Medications were distributed through a network of depots and subdepots, with New York and Philadelphia serving as main depots. Volunteer organizations, most notably the United States Sanitary Commission, also aided with distribution of medical supplies. Surgeons carried small amounts of drugs in satchels for use in the field, and special medicine wagons transported larger quantities of supplies. Hospital stewards were administrators as well as pharmacists, overseeing many aspects of hospital operations in addition to compounding and distributing medications.

Some common medications included chloroform and ether used as anesthetics for surgery. Contrary to popular belief, virtually all Civil War surgical operations were performed with the patient rendered unconscious by anesthetics. Post-operation pain was often treated with morphine, a derivative of opium. Morphine was perhaps the most widely used painkiller during the war, despite its addictive qualities. Alcohol, particularly whiskey, was frequently employed as a base for liquid medicines and as a tonic. It was also the main ingredient in many popular over-the-counter patent medicines.

A nearly universal but perilous drug was calomel, a mercury-based compound, used for constipation as well as diarrhea and dysentery. Since mercury is poisonous, calomel was dangerous in large quantities. Union Surgeon General Dr. William A. Hammond banned its use in 1863, causing much controversy among army physicians.


Image: Man in Uniform of Hospital Steward with Medications. Hand-colored photograph, 1866. Courtesy of The Army Quartermaster Museum, Fort Lee, Va.

 FROM: http://www.pacivilwar150.com/ThenNow/Medicine/Medications

Wednesday, March 13, 2013

The Bullet in Lincoln's Brain

After the President's death, Lincoln's body was removed to the White House. Dr. Joseph J. Woodward performed the autopsy on the bed in the room now known as the "Lincoln bedroom". Dr. Woodward was assisted by Dr. Edward Curtis. Dr. Curtis remembered:
"The Surgeon General detailed me the history of the case. . . Dr. Woodward and I proceeded to open the head and remove the brain down to the track of the ball. The latter had entered a little to the left of the median line at the back of the head, had passed almost directly forwards through the center of the brain and lodged. Not finding it readily, we proceeded to remove the entire brain, when, as I was lifting the latter from the cavity of the skull, suddenly the bullet dropped out through my fingers and fell, breaking the solemn silence of the room with its clatter, into an empty basin that was standing beneath.
"There it lay upon the white china, a little black mass no bigger than the end of my finger--dull, motionless and harmless, yet the cause of such mighty changes in the world's history as we may perhaps never realize."

The Slaves of Chimborazo Hospital

From: The U.S. National Library of Medicine
 
African Americans, free and enslaved, provided care for wounded soldiers in Union and some Confederate hospitals. The survival of the military hospital was dependent upon their work. Employed in white-only and black-only facilities, African Americans were able to move beyond the confines of private employment to a more public environment. Hospital work represented change and opportunity for many African Americans
 
Chimborazo Hospital in Richmond, Virginia, the largest Confederate hospital, relied on the slaves of local plantation owners and hospital surgeons to fill positions such as nurses, cooks, and laundresses. With over 5000 beds in 150 buildings and tents, Chimborazo treated over 77,000 patients during the war. After the fall of Richmond in 1865, it became a hospital for black Union soldiers
 
James Brown McCaw was the chief administrator and surgeon-in-charge of Chimborazo Hospital during the Civil War. McCaw recognized the necessity of employing blacks at the hospital for the hospital's own survival.
 
Hundreds of African Americans, mostly male and enslaved, served as nurses at Chimborazo Hospital. George Cox, and a woman known only as Candis were among the few free blacks that worked there. Their wages were paid directly to them while slave owners received the wages for the work of their slaves. Enslaved African Americans working in Chimborazo had a chance to move from a private to a public work environment where they worked alongside free blacks.
 

"I have at this time only two hundred and fifty-six cooks and nurses [slaves] in my Hospitals, to take care of nearly 4,000 sick soldiers.  . .it will be entirely impossible to continue the hospital without them." James Brown McCaw.

A Medical Doctor Treats Sick Horses

Horses were an essential part of the Civil War military. They were responsible for transporting food, supplies and artillery. Sickness among horses could have a devastating effect on the course of a campaign.
 
Confederate surgeon Herbert M, Nash was treating soldiers with malaria, when the unit's horses began to stumble and tremble.
 
"While the men were thus suffering with malaria, the horses became affected with blind staggers and many died. Without horses the artillery could not be moved, and they could not be replaced.
 
"I made autopsies and became convinced that the same or a similar poison was acting on both men and horses, and rode to Richmond, reported the facts to the Surgeon-General and appealed to him for an issue of a dozen ounces of quinine to treat the horses.
 
"He at first declined to issue the quinine for horses when he could not issue it for the men. I replied very earnestly that this was a most extraordinary condition which should be combated with every possible available means, and that I should be obliged to report to army headquarters the object of my visit and its results.
 
"Seeing the intensity of my conviction he finally relented and gave me the quinine, with which I speedily returned to the bottoms, to drench each horse as soon as the symptoms appeared with one ounce of quinine to the quart of water.
 
But one such dose was given to each sick horse. I am glad to relate that not another horse died, and I subsequently had them removed a mile back from the river to the pines, when the cases of staggers ceased to occur."

Saturday, March 9, 2013

Socks for Sore Feet

BUSY FINGERS: KNITTING STOCKINGS IN THE CIVIL WAR

By Lynne Zacek Bassett, from Knitting Traditions, Spring 2012
South Carolina resident Mary Chesnut commented in her diary late in the summer of 1861, "I do not know when I have seen a woman without knitting in her hand." In the North as well as in the South, knitting needles clicked incessantly during the Civil War years (1861-1865).

Although machine-knitted stockings were widely available, they were considered inferior to handknit stockings and wore out quickly from the rigors of long marches and insufficient washing.

The call for handknitted stockings went out throughout the country. Stories of soldiers going barefoot or suffering from blistered, swollen, and infected feet from wearing their boots without stockings spurred females young and old to take up their knitting needles.

Winslow Homer's engraving "Christmas Boxes in Camp—Christmas 1861," which appeared on the cover of the January 4, 1862, Harper's Weekly, depicts a group of soldiers joyfully receiving a crate of gifts, including new stockings. John L. Hayes, a wool lobbyist, called stockings" . . . the class of clothing the most indispensable for the health and comfort of our soldiers."

Women and girls often enclosed notes offering Christian instruction, encouragement, or even jokes along with their stockings to the military camps and hospitals. Teenage girls, finding the idea of corresponding with a soldier romantic, wrote notes such as this one published in Mary A. Livermore's My Story of the War:

"MY BRAVE FRIEND,—I have learned to knit on purpose to knit socks for the soldiers. This is my fourth pair. My name is—and I live in—. Write to me, and tell me how you like the foot-gear and what we can do for you. Keep up good courage, and by and by you will come home to us. Won't that be a grand time, though? And won't we turn out to meet you, with flowers and music, and cheers and embraces? 'There's a good time coming, boys!'"

Beyond the practical accomplishment of supplying seemingly endless quantities of stockings, knitting answered the emotional need of women and girls who were desperate to participate in the struggle for their country. Woman's Work in the Civil War: A Record of Heroism, Patriotism, and Patience (1867), states, "Men did not take to the musket, more commonly than women took to the needle. . . ."—the sewing or the knitting needle."

Monday, March 4, 2013

A Confederate Shortage of Splints

Southern doctors were particularly hard pressed to obtain sufficient medical supplies. They tried to procure reserves from Europe, but Union Naval blockades, prevalent later in the war, complicated the already desperate situation.
 
Dr. William H. Taylor recounted his experiences:
 
"Normally we were scant of medicines, and generally they were of the commoner kinds. At times, however, we were well supplied, and with excellent preparations. These times would be when captures had been made, or medicines of Northern or European manufacture had come through the blockade. The Confederate pharmaceutical laboratories worked industriously, but under great disadvantages, and their output was not surpassingly excellent.
 
"On the battlefield our stock of medical and surgical supplies was particularly condensed. Bandages were plentiful, but we seldom had splints. On one occasion I used a whole fence-rail for a broken arm, being unable to do any better. I had just finished making the rail secure when a turn in affairs forced us to take flight.
 
"My patient started to run with the rest, but the distal end of the heavy rail tilted downward, stuck in the ground, and jerked him up short at every step. I do not precisely know what became of him, but unless he had the sagacity to turn around and retreat backward I fear I was instrumental in delivering him into the hands of the enemy."
 
PHOTO: Civil War hinged splint

Death by Diarrhea

During the Civil War, diarrhea and dysentery were known as the prevailing diseases in army camps. Union Major and Surgeon S.C. Gordon observed:
 
"The death list from disease was a fearful one in the Department of the Gulf. Fever and diarrhea, the former disabling and the latter killing, were worse foes than bullets, ten to one.
 
"It was estimated that at least ten thousand soldiers died and were buried in the Department of the Gulf, from disease of the bowels alone. It was a standing joke in our department that to be a good soldier here bowels are of more consequence than brains.
 
"The slang phrase in regard to the soldier who was discharged, was "He hasn't got the guts to stand it." The marches were long, the water poor, the weather torrid, and the rations oftentimes of poor quality. Fatigue duty under such circumstances was deadly. The bones of the best Young men of new England lie in unknown graves all over Louisiana."

Yellow Fever Epidemic in North Carolina

Yellow Fever was a highly contagious and deadly disease. In 1864, it ravaged the town of Newbern, North Carolina.
 
The Union publication, "Medical and Surgical Reporter" of September, 1864, published the following:
 
"Yellow fever is prevailing to an alarming extent.
 
"Never before in the history of the place has any epidemic been known to rage so violently and so fatally. One account says the citizens have more than they can do to attend to the sick and bury the dead. In a number of houses when entered, corpses have been found, dead probably a day or two, remaining there in a state of decomposition, for want of persons to remove them.
 
"The disease usually appears with a chill, followed by a fever, which increases in violence until the patient dies with black vomit, often in less than twenty-four hours. Children and Negroes very generally escape. It is mainly confined to the native white citizens."

General Thomas J. "Stonewall" Jackson's Death Wounds

(Attended by his personal physician, Dr. Hunter H. McGuire)

From the Richmond, Virginia "Dispatch" of September 20, 1900
At the battle of Chancellorsville, May, 1863, General Jackson received his death wounds, and being placed upon a litter, was passed on as rapidly as the thick woods and rough ground would permit, when, unfortunately, one of the bearers was struck down, and the General was thrown to the ground, but was again placed on the litter, when he was met by Surgeon McGuire, to whom he said: "I am badly injured, Doctor; I fear I am dying."
His clothes were saturated with blood, his skin cold and clammy, his face pale, fixed and rigid, and his lips compressed and bloodless, showed that his sufferings were intense. His iron will controlled all evidence of emotion.
On reaching the hospital he was placed in bed, and was told that amputation would probably be required. He was asked whether if it was found necessary it should be done at once, he replied promptly: "Yes, certainly, Dr. McGuire. Do for me whatever you think best."
Chloroform was administered, and as he began to feel its effects and its relief to the pain he was suffering, he exclaimed: "What an infinite blessing!" and continued to repeat, "blessing," until he became insensible.
The round ball (such as used for the smooth-bore Springfield musket), which had lodged under the skin, on the back of the right hand, was extracted first; it had entered the palm about the middle of the hand, and had fractured two of the bones. The left arm was then amputated about two inches below the shoulder. There were two wounds in this arm, the most serious dividing the main artery and fracturing the bone. Throughout the whole operation, and until all the dressings were applied, the patient continued insensible.
As there was some danger of capture by Federal troops, it was decided to remove him, and Dr. McGuire was directed to accompany and remain with him, and his duties as medical director were transferred to the surgeon next in rank, although General Jackson had previously declined to allow the Doctor to accompany him, as complaints had been so frequently made of general officers when wounded carrying off with them the surgeons belonging to their commands.
Whilst Dr. McGuire was asleep, he directed his servant, Jim, to apply a wet towel to his stomach, to relieve nausea. The servant asked permission to first consult the Doctor, but the General refused to allow him to be disturbed.
About daylight the Doctor was aroused, and found him suffering great pain, and examination disclosed pleuro-pneumonia of the right side, which the Doctor believed was attributable to the fall from the litter the night he was wounded, and thought the disease came on too soon after the application of the wet cloths to admit of the supposition, once believed, that it was induced by them. Dr. McGuire continued, in conjunction with other physicians summoned to assist him, to minister assiduously to his beloved leader until his death.

Sunday, March 3, 2013

The Sisters of Charity Nurse Smallpox Patients

American Civil War nurse and poet Walt Whitman observed the new social phenomenon of seeing nuns and lay women in hospitals in Washington:
 
"There are many women in one position or another, among the Hospitals, mostly as nurses here in Washington, and among the military stations; quite a number of them young ladies acting as volunteers. They are a great help in certain ways, and deserve to be mention'd with praise and respect."
 
Men weren't accustomed to encountering women in the hospitals, and some of the soldiers had never seen Catholic nuns before. A Sister of Charity in Pennsylvania wrote in her journal:
 
"Our small-pox patients appeared to think that the Sisters were not like other human beings, or they would not attend such loathsome contagious diseases, which everyone else shunned. One day I was advising an application to a man's face for poison--and I told him this remedy had cured a Sister who was poisoned. The man looked at me in perfect astonishment.
 
"'Why!' said he, 'I didn't know the Sisters ever got anything like that.' I told him 'To be sure they did. They are liable to take disease as well as any one else.' 'To be sure NOT!' he said, 'For the boys often say they must be different from other people, for they do for us what no other person would do. They are not afraid of fevers, small-pox or anything else.'"
 
PAINTING: "The Death of a Sister of Charity", 1850, by Isidore Augustin Pils

Catholic Nuns as Civil War Nurses

by Kristine Ashton Gunnell, Ph.D.
 
Approximately 600 Catholic sisters served as nurses during the civil war, both Union and Confederate. Some religious communities, like the Daughters of Charity, had nurses on both sides.
 
The battle of Gettysburg occurred only 8 miles from the headquarters of the Daughters of Charity in Maryland, and they were the first nurses on the scene. Records indicate that they operated 21 field hospitals for several months after the battle.
 
Surgeons often commented that they preferred the discipline of the religious sisters over the volunteer nurses. Catholic sisters shaped the development of military nursing during the civil war, and their service did much to soften anti-Catholic prejudice in the United States.
 
A good book to read on the subject is "To Bind Up the Wounds: Catholic Sister Nurses during the U.S. Civil War" by Mary Denis Maher. "Enlightened Charity" by Martha Libster and Betty Ann McNeil is an overview of the Daughters of Charity's approach to nursing and their extensive experience as trained nurses. My research is on the Daughters of Charity in Los Angeles.

Civil War Hospital Flags


The organization of the Confederate Medical Department/Medical Service was identical to that of the United States Medical Department in 1861. It is probable that the same system, use of yellow flags to mark the location of hospitals. (The Army Medical Department 1818-1865). Confederate Veteran XIX, reunion announcement "Medical Officers Army and Navy, C.S.A. - Our place of meeting will be the chapel of the First Presbyterian Church, centrally located and easily accessible by the display from the front of a yellow flag, the hospital insignia of the Confederate Army". Confederate Veteran XXII " Dr. Simon Baruch, remembers the day of His capture at the Black Horse Tavern Field Hospital on the Hagerstown Road, "I directed the Union Adjutant General's attention to the yellow rag on the lightning rod and said; you fired five shells after that hospital flag was hoisted"

The use of the yellow flag in the U.S. dates back to 1700's. The flag was used as a quarantine flag for ships suspected of carrying contagious disease. "An act to prevent Sickly Vessels from Coming into this Government" City of Philadelphia 1699. A yellow flag was also used to mark the location of hospitals in the "Marine Hospital Service" July 16, 1798 Federal Public Health Law "An act for the relief of sick and disabled seamen" signed by President John Adams. 
 
FROM: www.crwflags.com/fotw/flags/us%5Ehosp.html

American Medical Education in the 1860s

American medical students frequently trained through an apprenticeship to an older practicing physician, who passed along his own fund of knowledge, good and bad. Sometimes the mentor, or "preceptor", sponsored the student's admission to a formal medical college.
 
The country had more than 80 medical schools that operated independently. Most hospitals were institutions that had evolved from almshouse infirmaries. Very little surgery was performed.
 
The average medical student in the United States trained for two years rather than the European requisite of four, and received little clinical and laboratory experience. In 1861, several states still prohibited dissection by medical students.
 
American medical schools weren't prepared to take an organized part in the war effort. Most schools were merely faculties of professors who delivered lectures for which they sold tickets. Fees ranged from $10 to $25 per course, and a popular professor could earn several thousand dollars a semester.
 
Most medical schools conducted lectures for only four to five months of the year. Second-semester lectures were a repeat of the first semester. Courses in anatomy, surgery, midwifery and other subjects were available, but optional.
 
Many independent schools had sprung up in the Untied States, and the mere possession of a diploma conferred the right to practice. Even medical schools like those at Harvard and Dartmouth relied solely on the personal standards and experience of the physicians who made up the faculty. State licensing could be brought about only by public action through state legislatures, and reform of the licensing system occurred many years after the war.
 
Although women were barred admission to most medical schools, by 1859, an estimated 200-300 American women possessed diplomas in medicine. Some were graduates of The Female Medical College of Pennsylvania, the world's first medical school for women, founded in 1850.
 
America's first Medical School at the University of Pennsylvania sent more surgeons to both the Union and Confederate Armies than any other collegiate institution in the country. It was typical of other teaching facilities: there were no laboratories in which to conduct tests or prepare medications. The School had no hospital of its own, but it did conduct a dissecting room and gave clinical instruction in a neighboring hospital.
 
During the Civil War man medical schools in America were forced to cut back their services, or close their doors. Of the Southern schools operating at the start of the conflict, only the Medical College of Virginia continued to train physicians throughout the war.

Dr. Thomas Martin Palmer, CSA

By Robert Sonntag


Among Florida doctors serving with distinction during the war was T. M. Palmer MD.  All three Palmer family doctors have been outstanding practicing physicians, leaders in the state, and presidents of the FMA. 

Young Tom came to Monticello in Jefferson County in 1829, eight years old and eight years after Florida became a United States territory. 

After graduating from the University of Maryland, he returned to Monticello where he spent his life in practice except for the Civil War.  He served in the Constitutional Convention of 1861, which passed the Ordinance of Secession.  During the war he served as a surgeon in the Confederate Army, chiefly in Virginia near Richmond. 

It was Dr. Tom who discovered Confederate officers looking over a site for headquarters that he had already chosen for a field hospital.  Approaching the leader, he urged him to seek another location for battle purposes so that he could retain the shaded area for the wounded.  Complying promptly with his request, the officers galloped away to another site. 

On the next day, Dr. Palmer was introduced to that leader, General Robert E. Lee.  Undaunted even by the presence of Lee, it is not surprising that Dr. Tom later during the stormy reconstruction caused a Republican governor to yield to his demand, in a face to face confrontation, for Democratic representation in Jefferson County government.  Dr. Tom Palmer was president of the FMA in 1876.

Turpentine in Civil War Medicine

At the time of the Civil War, turpentine was routinely prescribed for oral and topical use in America and Europe. During the war, when quinine wasn't available to them, Confederate surgeons substituted turpentine.
 
After the war, Confederate surgeon Herbert M. Nash remembered:
 
"During the siege of Petersburg, in July and August, 1864, malarial fevers of every type attacked our men, so that scarcely enough of the whole number could be had to man the two mortar batteries in use upon the banks of the river. There was no quinine issued at that time, and the men were treated with decoctions internally and friction of turpentine to the spine and twenty drop doses internally. These cases all recovered."
 
IMAGE: Collecting turpentine in North Carolina

Chimborazo Hospital Remembered

By late 1864 there were 154 hospitals in the Confederacy and 204 in the Union. Chimborazo Hospital outside Richmond Virginia had 8,000 beds and may have been the largest military hospital in the world.
 
Chimborazo was exceptional, as well, in appointing to one of its large units Phoebe Pember, known as an outstanding woman hospital administrator.
 
Confederate Surgeon Herbert M. Nash remembered:
 
"In Chimborazo Hospital between 40,000 and 50,000 cases of wounds were treated during its existence. In it there was never a case of gangrene and not a case of smallpox ever developed in its divisions. It had a system of force-pump baths accommodating 300 men at the same time. It also had hot sulphur baths for skin diseases, in which the camp-itch was successfully treated. Vaccination was constantly practiced in all hospitals. Out of the number of wounds treated at Chimborazo eight thousand died, during its existence--a moderate mortality."

The Citizens' Volunteer Hospital

In the North, Philadelphia served as a railway hub, and thousands of the wounded passed through. Volunteers operated a hospital at a main depot.
 
In his history of Philadelphia during the Civil War, author Frank H. Taylor wrote:
 
"This beneficent establishment was located opposite the depot of the Philadelphia, Wilmington and Baltimore Railroad. It was especially intended for the reception of the more serious cases of the sick and wounded constantly arriving from the army by train. It was a clearing house from which the patients were gradually distributed to other hospitals. Humane citizens of both sexes maintained volunteer committees at all incoming trains not only to give instant help to those in need of it, but to protect the soldiers from thieves and harpies, who were ever ready to mislead and rob them. The capacity of this hospital was 400 beds, but at times room was made for 700 men."

Pain Control

By T.A. Wheat, from "Medicine in Virginia During the Civil War"
 
Almost from the moment of injury, efforts were made to ensure that the wounded soldier felt as little pain as possible. Unfortunately, the first substance administered to a wounded man was usually alcohol because it was felt to be a stimulant. But alcohol actually suppresses the nervous system and dilates the blood vessels, neither of which is helpful, especially in cases involving major blood loss.
 
The assistant surgeon, at the aid station, also used an oral narcotic, usually morphine sulfate, and might allow the patient to inhale the vapors of chloroform for additional pain relief. At the division hospital, usually prior to examination of the wound and certainly prior to any surgery, the patient was given additional alcohol, narcotic, and enough chloroform to render him insensible to pain.
 
Many soldiers wrote that they remembered their surgery, but felt no pain. Confederate general Thomas J. "Stonewall" Jackson, who had his left arm amputated, was said to have stated that the sound of the saw on the bone was the sweetest music he had ever heard. He also described chloroform as "an infinite blessing."
 

Saturday, March 2, 2013

The Surgical Tenaculum

Deep wounds of the chest and abdomen presented often insurmountable problems. One of the only instruments available for seizing and holding displaced or severed arteries was the sharp, slender hook called a tenaculum.
 
The surgeon would hook and hold the blood vessels with the instrument as an assistant or second surgeon tied them off to control the bleeding.
 
Union surgeon William Williams Keen explained: 
 
    "The surgery of the chest lagged far behind that of the head and the abdomen because when the chest was opened the lung collapsed and breathing became embarrassed, or impossible, if both sides were opened.
 
    "In the depths of a wound the tissues could not be seized and drawn up to the light and the bleeding vessel quickly clamped. Our only resource was to try to pass a tenaculum through the vessel and tie it with silk. Usually we were only successful after several attempts. Meanwhile that vessel and others were all bleeding; the others had to wait their turn. We had no retractors by which we could get a good view of the depth of such a wound."

Dr. John van Surly DeGrasse

African American Union Doctor

 
By Robert G. Slawson, M.D., F.A.C.R.
 
Dr. John van Surly DeGrasse is the third man known to have received a commission. Dr. DeGrasse was the second African American to be graduated from an American medical school. He was graduated from Maine Medical School, affiliated with Bowdoin College, in Brunswick, Maine, in 1849..
 
Following graduation, he went to Paris and there was Assistant Dresser to the famous French surgeon, Velpeau, for two years. He returned to the United States and first practiced in New York. Later he moved to Boston and did very well there; he became a member of the Massachusetts Medical Society.
 
After the war started and regiments of Colored Troops were formed, he applied for a medical commission. He was commissioned "Assistant Surgeon" with the Thirty-fifth Infantry Regiment, United States Colored Troops.
 
After the war, Dr. DeGrasse returned to Boston and resumed his practice. The Governor of Massachusetts presented Dr. DeGrasse with a ceremonial surgeon's sword to show appreciation for his service in the Civil War.
 
 
Reprinted from: "The Journal of Civil War Medicine", Vol. 7, No. 2, April/May/June 2003
 

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.
IMAGE: Civil War Dental Drill and Forceps

Pavilion Hospitals

At the beginning of the war, available buildings were converted and used as hospitals, but later, both sides came to favor the newly designed pavilion hospital.
These facilities featured long, narrow, well-ventilated wooden buildings, frequently built like spokes on a hub. Specialized areas of the hub included operating rooms, kitchens, offices, supply rooms and "dead house".
Although overall sanitation was still poor, pavilion hospitals were usually equipped with rudimentary toilet facilities. Medications, food, laundry and supplies moved much more efficiently through the pavilion hospitals and the quality of convalescent care improved.

Quinine

Quinine was one of the most effective medicines available to Civil War doctors. Quinine is a drug made from cinchona tree bark, whose active ingredient is the alkaloid “quinine.” Spanish missionaries observed its use in South America in the 1500’s.

 
It was used to treat fevers of all kinds but was especially useful in treating the chills and fever of malaria.
 
Powers and Weightman, a Philadelphia-based firm, was the nation's largest supplier of quinine during the war.
 
When quinine wasn't available, Confederate surgeons substituted turpentine.Turpentine was routinely prescribed for oral and topical use in America and Europe.

The Nelaton Probe

French physician and surgeon Auuste Nelaton invented a porcelain-tipped probe for locating bullets inside a wound. Union surgeon William Williams Keen described using the tool:
 
"We had the ordinary and dangerous probe. This may be described as a slender flexible silver finger to detect the course, and, if possible, the presence of a bullet, but in our ignorance of bacteriology, not being sterilized, it was also a means of carrying infection deep into the wound.
 
"In 1862 Nelaton of Paris invented his celebrated probe. This wa a rather stout but flexible wire tipped with a bulb of unglazed porcelain and therefore rough. When the probe met with any hard body, such as a bone or a lead bullet (the only kind of bullet then used), by rotating the probe, if the hard body were of lead, the rough porcelain would show a dark spot of lead, but if of bone so such spot would be produced."

Civil War Optometrists

The practice of optometry began with the invention and subsequent refinement of eyeglasses in the early nineteenth century. Optometry guilds were formed at this time, and the practice eventually was regulated under statutory law. Jewelers were actually some of the first professionals to use eye charts and sell glasses to the public.
 
The industry in the United States expanded during the Civil War when the government purchased large quantities of binoculars and microscopes for the war effort. Eyeglasses became plentiful and, by the end of the nineteenth century, schools were teaching the science of optics, often in combination with instruction in watch repair.
 
Door-to-door peddlers, jewelers, and optometrists all sold eyeglasses in the late 1800s. At the beginning of the twentieth century, however, physicians conducted most of the eye examinations.
 

Civil War Stretchers and Stretcher Bearers

Civil War Union veteran surgeon Richard Swanton Vickery, born and educated in Ireland, wrote "Duties of the Surgeon in Action". He detailed the importance of, and directions for stretchers and the men who carried them. Dr. Vickery's instructions were directed to the Surgeon in charge on the battlefield.
 
"We will suppose his Regiment is formed in line of battle, expecting soon to be engaged; he has been notified that the Division Depot or Hospital is at some farm-house or other building, a mile or two to the rear, and during the few minutes quiet that he has left, he reviews his arrangements to see that they are as perfect as may be.
 
"He wants to have the wounded as they fall, picked up as rapidly as possible and brought to the Depot which he shall select, there to be cared for and dressed, and forwarded quickly to the Division Hospital in the rear. To ensure that his arrangements to that end are complete, he has to consider first his means of transportation, his stretchers, and stretcher bearers.
 
"For a Regiment of five or six hundred men he should have at least four stretchers--those generally issued now with light canvas bottoms, and with transverse iron bars at the head and foot, the side poles being stout enough to be firm, are the best. They have not so much of that springing motion to every step of the bearers which is so disagreeable and sometimes torturing to the wounded man. A horse-litter has sometimes been furnished to Regiments, but it was both unwieldy and inconvenient, and seldom if ever used. If it should happen that there are no stretchers, blankets or shelter tents stretched between two p9oles will make a good substitute. Failing even these a man can be carried, though not so comfortably or so easily, on a blanket held by four men at the corners, or seated on the crossed arms of two stout men.
 
"Then the stretcher bearers must be looked to, of whom there should be four to each stretcher. After reserving one or two of his Hospital attendants for other duties, he [the surgeon] will have three or four of them to act in this capacity. The Drum corps and the Regimental Band, if there is one, are always on the eve of a battle ordered to report to the Surgeon for duty, but the less he calculates on aid from them the better. With a few exceptions they are generally worthless as stretcher bearers, many of them being young lads physically incapable of such fatiguing duty.
 
"These may be sufficient while the wounded are few and come in slowly, but more help will soon be required when the combat thickens and some dashing charge or close firing brings them to the rear by dozens. In that case the Surgeon will find the Pioneers [construction troops] the best and most reliable aid. Generally numbering about ten under charge of an experienced sergeant [and] all able-bodied men accustomed to stand fire, they form a really effective corps of stretcher bearers, and can generally be procured for that purpose if required on application to the Commanding Officer of the Regiment."

Research on Civil War Eye Glasses

By Johan Steele
My own research included talking to a local fella and present day optometrist who collects eye glasses and was rather enlightening. Surprisingly prices are about the same today, when compared to inflation.

The frame curving around the ear glasses are definitely a post war invention. Most typical had the lenses very small when compared to those of today, the pair I have were originally a set of sample/display glasses. The lenses aren't much larger than my eyes, you are forced to look straight at whoever you are talking to. There is NO peripheral vision with these. Some of the others I was shown that dated to the 1860's and prior were square or hex shaped. There was also a set that were designed to be folded up, those were surprisingly beefy.

Construction was from Brass, braided copper as well as steel. He also had a pair of 1860's glasses that had been coated with gutta percha.

An Optometrist was one of the most highly paid in the medical profession at the time and often traveled quite a bit. He would able to often put together a pair of glasses while you waited from the stock he carried. The collector owned an 1880's Optometrists tool chest which was rather large but still portable. When full he would have been able to both figure out & fill the needed prescription for well over a hundred people. The tools were very similar to a watchmakers or jewelers set and many an eye doctor hand made the frames as well as he could do so more cheaply than sending off for them and it was almost 100% pure profit for him. Needless to say the quality might vary rather dramatically.

Original eye glass frames didn't usually have screws but were fastened with a molten lead plug, which makes it almost impossible to put new lenses in an original set and is a way to date them. As I recall tt was actually during the ACW, in the US, that screws started to be commonly used.

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