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Wednesday, April 15, 2015

Surgery in the Field

From: acws.co.uk


The wounded soldier who received medical attention in the field (and base hospital) had still to run the considerable risk of surgery. After ambulance facilities were available, field hospitals were sometimes overwhelmed by major battle casualties. The limited number of surgeons worked around the clock and haste and neglect were unavoidable under such circumstances.

Anaesthetics, generally chloroform, were available, but there was no notion of aseptic procedure. As W W Keen recalled some years later:

"We operated in old blood-stained and often pus-stained coats with undisinfected hands we used undisinfected instruments and marine sponges which had been used in prior pus cases and only washed in tap water."

Nearly all wounds became infected. In the case of chest or abdominal wounds, surgeons probed with their fingers, prescribed morphine and tried to stop external bleeding. Otherwise there was little that could be done. Death within three days from haemorrhage and/or infection was the normal result. The average Union mortality from gunshot wounds of the chest was 62 percent of cases and from wounds of the abdomen, no less than 87 percent. By way of contrast, only about 3 percent of all American wounded failed to survive in World War II.

The chances for survival following an injury to the extremities were better though not good. Joints were resected and limbs amputated with alarming frequency, often in an attempt to prevent the spread of infection. It was usually the ensuing infection, which caused death. The so-called "surgical fevers" included tetanus, erysipelas, hospital gangrene, and septicaemia.

Image: A medical kit during the Civil War, with scissors, gauze and needles


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