The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.
The evolution of the nursing profession in America was accelerated by the Civil War.
Amputations were the most common surgery performed during the Civil War.
Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.
Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.
Tuesday, April 30, 2013
The railroads were most useful to the Confederates in Virginia, where good service existed from Manassas Junction south to Gordonsville, and then on to Richmond. There was good east-west service from Richmond across the mountains to the Shenandoah Valley. From Staunton, in the Valley, there was service to Tennessee at Knoxville and then on to Chattanooga, but that segment was often cut and service was irregular. After the battles fought in northern Virginia, such as First and Second Manassas, the wounded were transported quickly by rail to Gordonsville and then to hospitals in Richmond or Charlottesville.
After Antietam and Gettysburg, wounded were taken by ambulance to Winchester and then down the Valley Turnpike (which had a macadam surface) to Staunton; once there, they could be sent south to Lynchburg or east to Charlottesville, Gordonsville, and Richmond, Depot hospitals, known as "receiving and forwarding hospitals", were set up at key points, such as Gordonsville and Staunton, to provide care en route and to serve as distribution centers.
Excerpted from: Civil War Medicine: Challenges and Triumphs by Alfred Jay Bollet, M.D.
IMAGE: From Confederate States $50 bill
See more about Civil War hospital trains at www.CivilWarRx.com.
Later in the war, hospital cars were specifically designed for use in ambulance trains. The Sanitary Commission's official history describes these improvements:
"A very slight description of these hospital cards will give some idea of the increased comfort provided for the patients conveyed in them. The ordinary field and hospital litter or stretcher was used in loading, unloading, and carrying the patients. These simple litter-beds, with pillows, mattresses, and comforts attached, were then ingeniously and securely swung, in tiers three high, and end to end upon light stanchions, and there suspended by stout tugs of India rubber, which gave sufficient elasticity to obviate all jar to the bed and its patient.
"Thirty of these beds were thus swung along the side of each Hospital car. A number of invalid chairs and a broad couch filled the remainder of the available space. A pantry furnished with medicines, utensils, beverages, and substantial food, ready for serving to the patients hot or cold, made up the sum of creature comforts, while nurses, abundantly provided with towels, socks, blankets, sponges, etc., kept every man clear and warm, however long the trip of stormy the weather. All the usual appliances and skill of a well-regulated Hospital were at hand."
In addition to the hospital cars, these trains included cars for cooking and dining and for use as sleeping quarters for medical staff assigned to accompany the wounded. The trains were clearly identified by a bight red smokestack, engine, and tender and by the markings "U.S. HOSPITAL TRAIN" in enormous red letters, and they carried three red lanterns at night. There is no record that enemy forces ever molested any hospital train.
Excerpted from: Civil War Medicine: Challenges and Triumphs by Alfred Jay Bollet, M.D.
Monday, April 29, 2013
Heart Disease in Civil War SoldiersBy Alfred Jay Bollet, M.D.
Heart symptoms often accompany anxiety, but the physical stresses of a soldier's life can also reveal underlying heart abnormalities. Given the limited diagnostic tools available (no electrocardiograms or radiographs) during the Civil War, the true cause of many soldiers' cardiac ailments baffled their physicians.
During the war, 10,516 white and 100 black soldiers were discharged due to heart disease. Discharges due to valvular disease or "soldier's heart" were not separated out, but available records show that physicians did recognize various types of cardiac pathology. Valvular heart disease was diagnosed in 3,574 whites and 325 blacks; most undoubtedly resulted from rheumatic fever. Civil War physicians clearly were skilled at using a stethoscope to detect this form of heart disease.
Excerpted From: Civil War Medicine: Challenges and Triumphs by Alfred Jay Bollet, M.D.
IMAGE: Civil War era monaural stethoscope
Friday, April 26, 2013
FROM: "Recovery From Insanity Produced by Different Causes", 1844, "The Boston Medical and Surgical Journal", Vol. XXIX, No. 26.
IMAGE: Tennessee Asylum for the Insane
Excerpted from: "Recovery From Insanity Produced by Different Causes", 1844, The Boston Medical and Surgical Journal, Vol. XXIX, No, 26
IMAGE: The First Ohio Lunatic Asylum
Wednesday, April 24, 2013
President Abraham Lincoln's health has been a topic of debate among scholars and physicians. In addition to known illnesses such as smallpox and constipation, at times it has been argued that he also suffered from depression and cancer. The fascination continues: the U.S. National Museum of Health and Medicine held a Symposium on President Lincoln's Health on April 18-19, 2009.
One of the more enduring theories about President Lincoln's health arose in the early 1960s. A physician published a paper in 1964 in the Journal of the American Medical Association which stated that President Abraham Lincoln had Marfan syndrome, a connective tissue disorder. The diagnosis was based on physical observations of Lincoln:
At a scientific workshop held in October 2001 in Cairo, Egypt, the scientists gathered there felt that there was not enough scientific evidence available to definitely diagnose President Lincoln with the disorder.
Marfan syndrome is an inherited disorder of connective tissue, although about one-quarter of all cases occur without any family history of the syndrome. It affects both men and women of all ethnic background. About 1 in 5,000 people have Marfan syndrome.
Tuesday, April 23, 2013
The Nashville Female Academy Hospital had 350 iron cots, well furnished with bedding and 191 patients. There were five surgeons in attendance at this hospital; Major Frederick Seymour was Surgeon-in-Charge. The yardmaster, steward, clerks and apothecary took care of all the other details. The nursing and care of the patients was superintended by ten Catholic Sisters of Charity from Cincinnati. Besides the Sisters, there were twenty-six male nurses, two white male servants, sixteen colored female servants, and twenty-six colored males.
Excerpted from: "Federal Military Hospitals in Nashville, May and June, 1863", The Journal of Civil War Medicine Vol. 12, No, 4.
IMAGE: Sketched by A.E. Matthews, member of the 31st Ohio Infantry. Besides being used as a hospital (No. 14), it was also used by the Provost Marshal and as a shelter for refugees.
When a large, heavy bullet (like the Civil War era minié ball) hits the head, spine or lower skeletal structures, human beings quite obviously crumple to the ground. However, when shot in other locations in the torso or even limbs, people quite often lose leg function and fall to the ground immediately (within a couple of seconds). When this occurs, they may be unconscious, conscious, or initially unconscious--returning to consciousness in a few seconds.
The Permanent Crush Cavity (PCC) is the area or amount of tissue actually touched, crushed or pulped by the bullet. The severing of blood vessels and rupture of hollow viscera (major organs such as the liver, pancreas, etc.) induces neural shock and loss of motor control from damage to the nervous system. The PCC is enhanced when the bullet strikes bone, splintering it and sending these fragments through the body as secondary missiles. The PCC has a direct impact on the vestibulospinal tract causing collapse. This is the primary wound and incapacitation predictor where heavy, slow moving projectiles are concerned.
No doubt about it, a minié ball is a big, hard-hitting slug Nevertheless, being hit by one produces no more push than say a ten-pound weight being dropped about two inches. The impact will not push you backwards unless you were already off balance.
You might spin around to some degree if hit in the shoulder where bone and muscle is being struck and most of the bullet's energy (force) is being expended in you, rather than passing on out the other side. Yet most, if not all of that "spin" would likely be a reactionary move by you to the blunt force trauma you are receiving rather than the bullet actually causing you to spin.
Excerpted from: "The Dynamics of Taking a Hit" reprinted from The Civil War Courier in
The Journal of Civil War Medicine, Vol. 7, No. 2
Learn more about Civil War wounds at www.CivilWarRx.com.
The prognosis was grim. Civil War surgeons were adept at removing limbs for extremity wounds but "gut wound" soldiers were left to die. Word of the injury reached his brother Tom who was still in the 20th Maine regiment. Tom recruited Drs. A.O.Shaw and M.W.Townsend, and through the night they searched field hospitals until they found his brother.
The surgeons embarked on an unprecedented open wound exploration in the field hospital with Chamberlain receiving morphine and chloroform sedation, Halfway through the operation the pain became sheet torture and the surgeons laid down the instruments, thinking that the agony had gone on long enough.
However, the patient himself encouraged them to continue and they did, reconnecting severed urinary organs and removing the minie ball that had done so much damage. Hope for recovery was nonexistent as shortly after finishing, the exhausted surgeons noted urine exiting the lower wound.
Miraculously, Chamberlain began to recover and by the end of July the surgeons started to admit that the danger of death was passing and recovery was certain. Ironically he would ultimately die of this wound but not until he was 85 years old.
Joshua Lawrence Chamberlain survived smallpox, heat stroke, malaria, typhoid and tuberculosis. His horse was shot from under him 5 times and 6 times he was hit with rebel lead causing his obituary to be sent to the New York papers on 2 occasions. The most devastating injury was the pelvic wound, the complications of which he endured for almost 50 years. Despite this medical history, he engaged in innumerable skirmishes and 24 battles, capturing 2,700 prisoners and 8 battle flags. He won the Congressional Medal of Honor for his effort at Gettysburg and was subsequently promoted to Major General. This former theology professor is not only among the most remarkable soldiers ever to serve, but also one of America's greatest heroes.
Excerpted from: "The Lion of the Union: The Pelvic Wound of Joshua Lawrence Chamberlain", The Journal of Civil War Medicine, Vol..6, No. 2
At 2:00 PM on April 27, 1865, [Surgeon General Joseph K.] Barnes and Assistant Surgeon General Dr. Joseph Janvier Woodward conducted a postmortem examination of the body. A letter to Secretary of War Edwin M. Stanton reported their autopsy findings:
"Left leg had a fracture of the fibula 3 inches above the ankle joint . . cause of death was a gun-shot wound in the neck--the ball entering just behind the sterno-cleido muscle--2-1/2 inches above the clavicle--passing through the bony bridge of fourth and fifth cervical vertebrae--severing the spinal cord and passing out through the body of the sterno-ceido of right side--3 inches above the clavicle. Paralysis of the entire body was immediate, and all the horrors of consciousness of suffering and death must have been present to the assassin during the two hours he lingered."
Excerpted from: "J. Wilkes Booth as a Patient, as a Corpse to be Identified and Diagnosed as a Monomaniac", The Journal of Civil War Medicine, Vol. 5, No. 3
In the 1800s, as America became less of a collection of religious colonies and more of a secular nation, a new prophet arose, who redefined masturbation as a medical problem, rather than a purely religious issue. Sylvester Graham, inventor of the graham cracker, published his magnum opus, Lectures to Young Men, in 1834. In this tome, Graham warned that the solitary vice would lead to physical decay, insanity, and death.
The intrepid researcher, Edward S. Milligan, has called to my attention the records of St. Elizabeth's Hospital at Washington, DC, which was for decades the nation's only Federal psychiatric institution. In the six years before the Civil War, twelve men were admitted to the hospital with a mental disorder "caused by masturbation". Their average age was twenty-five. During the war itself, thirty-eight men were admitted with conditions attributed to masturbation. In the decade following the war, fifty-five men were admitted as insane secondary to masturbation. Thus from 1855 to 1875 a total of 108 psychiatric patients at St. Elizabeth's had their mental illness attributed to The Solitary Vice.
Excerpted from: "Onan's Revenge: Death From Masturbation", published in The Journal of Civil War Medicine, Vol. 11, No, 2.
Overwhelmed with patients, hospitals transferred many debilitated soldiers from Richmond to other cities. The nearby university town of Charlottesville, with its medical school, became a major medical center to which patient over-flow could be sent throughout the war.
Maupin, Chairman of the Faculty, noted in his diary:
". . . about 300 soldiers wounded in the battle of the 8th near Port Republic arrived at the University on the evening of the 9th June and were placed in the chapel, Public Hall and Moot Court room. On the 14th, the number of the sick and wounded at the University had increased to 600 and on the 24th, to about 1400. They were provided for in Dawson Row, East and West Ranges of dormitories and in tents in the Gymnasium field and elsewhere."
The military hospitals in Charlottesville were similar to Confederate hospitals throughout the South in that little preparation had been made for the nursing care of mass casualties. The South believed the war would be short and the soldiers assigned to serve as hospital personnel, plus the slaves, should provide whatever nursing care that was needed. Southern women quickly recognized that more nurses were needed, and they became involved in caring for the soldiers.
Excerpted from: "Women Providing Nursing Care in Charlottesville During The American Civil War, 1861-1865"
Visit more Civil War hospitals at www.CivilWarRx.com.
For the purpose of suture, long white tail hairs are the best. Before being used they should be soaked for a minute or two in water, or they may be drawn once or twice through the moistened finger-ends. The suture may be fastened off in a double knot, but if the hair is stiff, a third knot if often required. It may be removed in the ordinary manner, seizing the knot with the forceps, and dividing the suture just aside of it. It is scarcely necessary to remark, that horsehair, as a suture, is not suitable for wounds where there is much tension between the edges.
Excerpted from an article appearing in the March 1866 issue of The Richmond Medical Journal, Vol. 1, No. 3, from where it had been reprinted from an issue of The Lancet.
PHOTO: Pocket surgical kit carried by surgeons during the Civil War
Thursday, April 18, 2013
The disease was at its peak during the first full year of the war (July 1, 1861, to June 30, 1862). During that period, 5.9% of Union soldiers (based on the army's mean strength that year) were diagnosed with typhoid fever; 2% of the entire army died from it.
. . . Many brave women during the Civil War, including those in Charlottesville, defied initial objections against "refined ladies" taking care of strangrs and nursing in military hospitals. They braved the frowns of those around them to volunteer their nursing services despite risk of disease and physical harm to themselves. . . In doing this they overcsme prejudices of many who initially opposed their presence among the wounded and ill.
(Excerpted from: "Women Providing Nursing Care in Charlottesville during The American Civil War, 1861-1865") "The Journal of Civil War Medicine, Vol. 12, No. 4
African American Acting Assistant SurgeonBy Reg Pitts
Alpheus William Tucker was born in Detroit sometime in 1844 or the next year; he grew up in Toledo, Ohio and attended Oberlin from 1861 to 1863 (with Charles Burleigh Purvis) before enrolling in the Iowa School of Medicine, from where he graduated, class of 1865.
His widow and orphan returned to Washington where Martha moved in with her parents (George W. and Mary E. Ferguson Wood; he was a messenger for the US Dept. of the Interior), and taught school in the DC school system. Her daughter followed in her footsteps, and the resided in the LeDroit Park section of Washington. Martha Wood died on March 14, 1921, aged seventy-two (her death cert said sixty-two).
Sources: census records through ancestry.com; city directories through ancestry.com; his middle name and the names of his inlaws from the listing for Martha's death cert at familysearch.com.
Dr. Thomas was appointed as a Surgeon on Staff with 2nd Florida Infantry on October 16, 1861 and was paroled at Appomattox, VA on April 9, 1865. He was born in Baltimore, MD on January 3, 1830. After graduating a course of medical study at the University of Maryland at Baltimore, he practiced medicine in the Shenandoah Valley, VA for two years. In 1856 he came to Kansas and settled in Leavenworth.
"The insertion of morphine into wounds of the chest, attended by pain and dyspnoea, has been of the utmost advantage. I made the insertion of morphine into all painful wounds standing order of the medical department, and it has acted so admirably as to enlist every surgeon in favor of the practice. Its good effects are especially remarkable in painful wounds of the joints, abdomen, and chest. From one to three grains are inserted on the point of the finger. I desire especially to call the attention of the profession to this practice, which is simply a generalization of the well recognized application of morphine hypodermically."
Studies conducted in the early 1900s erroneously suggested that putting opium or morphine directly into a wound was useless, since the drugs worked only after reaching the brain. More recent studies, however, have demonstrated that there are opiate receptors in peripheral tissues which makes topical applications effective. In addition, some of the morphine applied to bleeding wounds probably enters the bloodstream and reaches the brain.
FROM: "Civil War Medicine: Challenges and Triumphs"
Tuesday, April 16, 2013
First African American to Receive a Commission as a Major in a Combat Unit
By Robert Slawson, M.D., F.A.C.R.
Martin Delany became interested in medicine later in life. After an apprenticeship, he applied for medical school without acceptance. After an apprenticeship as a dentist and subsequent practice, he applied again to a medical school.
This time, at age 38, he was accepted at Harvard Medical School. Because of student objections when a woman was admitted as well, he and two other African American men were allowed to attend for only that one year.He then opened a medical practice.
From age 19, Delany had been active in the abolitionist movement and he resumed this activity as well. After an abortive effort at colonization in Nicaragua, Delany organized an exploration of the Niger River.
By his return, the Civil War had begun and he campaigned to have African American troops used by the Union. When this was finally begun, Delany was very active in the recruitment of troops for both Massachusetts and Rhode Island.
Eventually Delany succeeded in obtaining a meeting with President Lincoln. This was followed by a meeting with Secretary of War Stanton, at Lincoln's request, and a Commission of Major of Infantry, United States Colored Troops in March 1865. At the end of the war, Dr. Delany was appointed a Sub-Assistant Commissioner of South Carolina and stayed there for several years.,
Dr. Delany was the first African American to receive a commission as Major in a combat unit. Although his commission was not in the Medical Service, he did practice as a physician on several occasions both before and after the war and must be included in any discussion of African American physicians of this period.
FROM: "The Journal of Civil War Medicine", Vol. 7, No, 2
Clarissa Jones: Union or Confederate, Nurse Cared for All
In 1863, just after the Battle of Gettysburg, she was stationed in a field hospital of the Second Division Union Army with 600 patients, 100 of whom were Confederate captives. Foard says Jones aided injured Union soldiers as well as dying Confederate soldiers in squalid conditions. At one point, she read the burial service for a dead Confederate officer because no chaplain was available. Battlefield hospitals were filthy, without antiseptics and sometimes without bandages. At times, Jones was the only female nurse.
According to Foard, Jones galvanized the Germantown community where she lived to send supplies to wounded soldiers. She wrote letters and returned to update townspeople on the war’s progress and the needs of hospitals for food and supplies. Jones kept her job as principal while she volunteered. According to Foard, she served at several hospitals and a hospital steamer ship, which meant leaving family and her job for longer periods.
According to information from the Germantown Historical Society, Jones accompanied wagons loaded with supplies across nearly impassable roads to reach hospitals. A news report said she personally knew President Abraham Lincoln. Another article indicated she met the president during a White House reception.
In 1872, she married John Dye of Germantown. Her activism did not end as she served two terms as president of the National Association of Army Nurses of the Civil War and chaired a committee that sought pensions for volunteer Army nurses. The National Archives has a 1907 card Jones filed seeking a pension, but it wasn’t until years later that a bill was passed granting pensions to surviving nurses, Foard said.
The Johnstown, Pa., flood of 1888 claimed more than 2,000 lives. Jones responded by organizing the Women’s Permanent Emergency Association of Germantown to aid those in need. That group was active in the Spanish-American War and World War I, Foard said.
Her efforts to win pensions for volunteer nurses, as well as her care of wounded soldiers, made her a pioneer and forerunner of today’s nurses, he said.