.

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.

Sunday, July 24, 2016

Famously Fiery First Lady Gets Modern-Day Medical Diagnosis

By Jonathan Lapook, 7-16-16

Mary Todd Lincoln had a lot of tragedy in her life. She lost two young children -- and, of course, was sitting next to President Lincoln when he was assassinated.

All of that contributed to years of depression, but now a medical expert believes there was a physical cause for her mental struggles.

History has not been kind to the wife of our 16th president. She was known to be a tempestuous, unpredictable force, and her son eventually had her committed. Sally Field's 2012 portrayal of Mary Todd showed a fierce and sharp-tongued first lady.

"You think I'm ignorant of what you're up to because you haven't discussed this scheme with me as you ought to have done," she said in one scene. "When have I ever been so easily bamboozled?"

But Dr. John Sotos, a physician and medical historian, says the famously fiery first lady was not only misunderstood - but misdiagnosed. Sotos puts forth a new theory about Mary Todd Lincoln -- her erratic behavior was caused by a condition called pernicious anemia.

"Pernicious anemia is an autoimmune disease that starts in the stomach and that impairs the body's ability to absorb food efficiently," Sotos said. "And as a result, the person becomes B12 deficient eventually, and that causes lots of problems in every organ of the body."

It was a fatal illness until treatment was discovered decades after her death. The disease can lead to many of the symptoms exhibited by Mary Todd Lincoln: a sore mouth, pale skin, difficulty walking and psychiatric problems. It can also cause swelling.

"The puffiness is not in a way that would occur with just an accumulation of fat," Sotos said.

Today, the disease can be picked up on a simple blood test and easily treated with B12 supplements.

"She had a sick brain and was doing the best that she could in a very complicated, relentlessly demanding environment," Sotos said. "And I think to have done as well as she did with the kind of handicaps that she had, I think that deserves admiration."

Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News.

From: cbsnews.com

Learn more about the health of Mary Todd Lincoln at www.CivilWarRx.com

What are Civil War Sinks? (Latrines)

From: civilwartalk.com

Some data on sinks in the Civil War that I collected, without doing a precise study.

Sinks in the Civil War are what we would call latrines. It probably is more afield than what the normal Civil War student studies, but it sure killed a lot of soldiers. Sometimes the captured prisoner contributed to his own bad health by undisiplined use of sinks, and was not entirely due to the prison system.

As a result of both historical documentation and field research, the prison stockade, Fort Johnson, the remains of Fort Hill, and the dock have been located. Archaeological excavations have been carried out in several sinks (latrines) dating from 1862 to 1865, a prison well, the powder magazine from Fort Hill, and portions of two prison blocks

HEADQUARTERS ARMY OF THE POTOMAC,
Near Cold Harbor, Va., June 5,1864.
Major-General MEADE, U. S. Volunteers,
Commanding Army of the Potomac:

... Very few regiments provided sinks for the men, and
their excreta are deposited upon hill sides to be washed from thence into the streams, thus furnishing an additional source bf contamination to the water. As is to be expected, under such circumstances, sickness is increasing in the army, diar-rhea being especially prevalent...

THS. A. McPARLIN,
Surgeon U. S. Army, Medical Director, Army of the Potomac.

In fact, no attention seemed to be paid to cleaning up the grounds immediately in and about the hospital, nor was proper atten-tion bestowed upon the sinks. The ground between the hospital and the sinks had been used for uncleanly purposes by the patients, mak-ing it offensive to the sight as well as the smell.

H. B. PEYTON,
Lieutenant- Colonel, Assistant Adjutant and Inspector General.

OFFICE COMMISSARY-GENERAL OF PRISONERS,
July 1, 1862.
General M. C. MEIGS,
Quartermaster-General U. S. Army, Washington, D.C.

...The camp is in a very foul condition from want of drainage, and this can only be remedied by construction of a sewer sufficiently below the surface to guard against frost around the sides of the camp and leading into the lake. With this must be connected water pipes to furnish an abundant supply of water for the use of the camp and to float out the filth of all kinds through the sewer.
The sinks should be connected with the sewers so that during the summer the camp and neighborhood would be relieved from the stench which now pollutes the air.
The cost of erecting new barracks and repairing the old ones will be $5,000 to $8,000 and for introducing the system of pipes and drainage about as much more.
If a suitable camp-ground could be found and there was yet time for the work it would perhaps be best to abandon Camp Douglas, but there seems now no alternative but to make the best of what we have.
I have ordered a thorough system of police to be put in force at once, but your immediate attention is earnestly called to the matter of the above report.
The hot weather of summer is just upon us and if something is not done speedily there must be much sickness in the camp and neighbor-hood if not a pestilence.
Very respectfully, your obedient servant,
W. HOFFMAN,
Colonel Third Infantry, Commissary- General of Prisoners

WASHINGTON, November 13, 1863.
Dr. J. H. DOUGLAS,
Associate Secretary, Sanitary Commission:
SIR: In compliance with orders received from the central office to proceed to Point Lookout, Md., and inquire into the condition, &c., of the rebel prisoners there confined, also the sanitary condition of the encampment and its inmates, I hereby submit the following report:

It is within this that there are confined about 8,000 pris-oners. With so many men and no one to take charge of them, it is not at all to be wondered at that the camp is in any but a desirable condition. The sinks, which should have special consideration, especially in a camp of this size, and where so many men are congregated, are entirely neglected, and it is a perfect mystery that there is not more sickness than they have, and God knows they have enough, for they live, eat, and sleep in their own filth. Sinks have been prepared for them, but little or no attention is paid to them, unless they should be in close proximity when they desire to answer the calls of nature. The holes dug in getting out clay for bricks are used as sinks. You will find them by the side and in front of their tents, in various portions of the encampment, and are the receptacles of their filth. Refuse matter from the tents or what not right under their very noses, yet they heed them not. Others, again, have no particular place, but will void their excrement anywhere on the surface that is most convenient to them, heedless of the convenience of others. Have no drainage around the tents, but there has been an attempt to drain the streets. Ditches were dug, but they are worse than useless, constantly filled with water, and afford another place to throw filth. With this state of affairs and so many men (by the by, over 1,300 more came in the camp on the afternoon of November 10, making nearly 10,000 men) the camp would soon become in an impassable condition. The men themselves complain and hope that some severe punishment, even shooting, will be the penalty to any one who will so outrage decency and lose respect due themselves. Some of the sinks are filled and not been covered and not a particle of chloride of lime has been used in the encampment for a long time. After stating the above facts, giving the condition of the camp arid its inmates, some might say that it is not our fault that they are in this condition. As far as clothing, it is not; but it is our fault when they neglect to enforce those sanitary rules which keep camps and inmates in a cleanly condition and thus try to prevent disease. It is our fault when the officer in command fails to place in charge some one of good executive ability, capable of giving commands and seeing that they are enforced, one who will have the camp regularly policed amid severely punish any offender of the sanitary rules. It is beneficial otherwise, for it will give employment to a certain number of men every (lay. As regards medicine and clothing, they are sadly in want of both and would suggest that the commission send them, place them in the hand of Mr. Fairchild, and I know they will be judiciously distributed.
I know that they are our enemies, and bitter ones, and what we give them they will use against us, but now they are within our power and are suffering. Have no doubt that to compare their situation with that of our men words would hardly be adequate to express our indignation.
I merely gave this suggestion because I think you would be doing right and that it might prove beneficial to us.

Very respectfully, your obedient servant,
W. F. SWALM.

Herbalism

From: mnwelldir.org

The use of foods to heal is as old as the human spirit; it is as natural as breathing. Even today, when we get a cold or flu, we also get a bowl of hot chicken soup. However, the chicken soup we get from a can is hardly related to the chicken soup grandma made from scratch.

Herbs are food. Our medicines of the early 1800s were mostly herbal. What we did not bring from Europe we learned from the Natives, who were far more sophisticated than many give them credit. While surgeons theorized why some patients died of infections and others did not, our natives were very familiar with the role of pathogens in infection (sepsis) and created salves to clean wounds and kill off the pathogens that could cause infections.

The two great names in the early American herbal movement were, Samuel Thomson and Constantine Rafinesque. Rafinesque came to America as a young man, studied botany and herbalism and became a professor of botany. Around 1830 Rafinesque published his book, Medical Flora of the United States, which became the chief reference for herbalists of that period. In his book he described in detail the healing properties of a New World herb, goldenseal. For its immune stimulating properties, the goldenseal was highly prized, and the European communities were soon cultivating seeds they’d received from America. Nothing in the pharmacopoeia could compete with goldenseal, that is until the Natives introduced us to echinacea, the purple coneflower.

Thomson, on the other hand, was not a scholar. He created nothing new, but to his credit, he brought herbal and Native medicines to the common people. He was attacked by the regulars, even found himself facing murder charges for losing a few patients, but was acquitted and went on to publish his New Guide to Health. He is even, according to Ingrid Naiman’s book, Cancer Salves, “credited with the development of a cancer plaster made from red clover blossoms.” Most likely, he learned this too from the Natives, though he was the first to get this procedure on paper. Herbalists today still use this and many other preparations Thomson passed onto us.

At the time of his death, in 1843, his followers numbered around three million. The latter part of his life was spent deflecting criticism from the regulars, though many a regular physician adopted much of Thomsonian medicine as they did Hahnemann’s homeopathy. One constant in history is that when something works, the more liberal minded have a tendency to examine it and eventually incorporate it.

Mixing “pharmaceuticals,” as noted already, is dangerous. However, herbalists, on the other hand, mixed many herbs together, since herbal medicines, for the most part, did not contradict each other, and worked in harmony. Herbs are food. Together, many herbs act to potentiate [make stronger, better] each other. For instance, adding cayenne pepper to any herbal medicine makes the action of the preparation stronger and faster acting. This is just one example of synergy, where the answer to 2 + 2 is actually greater than four.

Image 1: Constantine Rafinesque

Image 2: Notebook kept by Constantine Samuel Rafinesque on a trip from Philadelphia to Kentucky, 1818

The AMA Is Formed

From: mnwelldir.og

Many attempts were made to create medical societies. There is strength in numbers. Most fell by the wayside as competition ate away at their structure, and even forbidding members to consult with, cohort with, purchase from, or even befriend an “irregular” didn’t stop a huge wave of physicians from going over to the other side.

The main purpose of a medical society/association is to provide political pressure to adopt laws that would kill the competition. They also provide entertainment, fellowship, and a safe place to whine about the midwife down the block who makes more money in a week than your average physician in two months.

Another purpose of the American Medical Association was to raise the standards of medical education in the land. Dr Nathan Smith Davis, a graduate of the Rush Medical College in Chicago, became a driving force in the creation of the American Medical Association. His regard for the general educational standards of the day is clear in the following statement:

All the young man has to do is gain admittance in the office of some physician, where he can have access to a series of ordinary medical text-books, and see a patient perhaps once a month, with perhaps a hasty post-mortem examination once a year; and in the course of three years thus spent, one or two courses of lectures in the medical colleges, where the whole science of medicine, including anatomy, physiology, chemistry, materia medica, pathology, practice of medicine, medical jurisprudence, surgery, and midwivery are all crowded upon his mind in the short space of sixteen weeks...and his education, both primary and medical, is deemed complete. [New York Journal of Medicine, V, 1845, 418]

All in all, the main reasons underpinning the formation of the AMA was that doctors simply could not compete in a free market, and they made little money. A report submitted to the 1847 convention that kicked off the formation of the AMA, stated:

The very large number of physicians in the United States has frequently been the subject of remark.... No wonder that the merest pittance in the way of remuneration is scantily doled out even to the most industrious in our ranks. [Healing the Health-Care System]

 The AMA’s first course of action was to lobby the government for strict licensing laws that would limit the number of doctors practicing medicine. Banning any form of medicine not practiced by the regulars was one sure way to limit the number of practicing physicians.

Historically, all laws pertaining to the practice of medicine have been enacted out of intense pressure by the medical lobbyists, not the public.

But as hard as they tried, their efforts often blew up in their face. This young country was not about to give up the freedoms they’d fought to attain. And when given free choice, most Americans in mid century chose the least toxic options of the Eclectics or homeopaths.

The Sad State of the Art

When the AMA got established, the form of medicine practiced by its members had not yet cured a single disorder, and most of the time sent patients to an early death. Surgery showed promise, but sepsis was not yet understood and doctors with a 50% success rate or higher were rare, in deed.

Scurvy had been cured, but by nutrition, not by medicine. Iodine cured goiters, but again, iodine is an essential nutritional factor.

By 1850, the jury on inoculations is still out, for there were safer homeopathic inoculations being developed, and plagues had a life cycle of their own. They came in spite of everything we did to avoid them, and the usually petered out and went away on their own in spite of heroic medicine claiming victory.

In France, a study on cancer, begun in 1843, had just been published. A physician of the French Academy of Science, Dr Leroy d’Etoilles, gathered together as many statistics as possible at that time from some 170 practitioners who had treated cancer. The reason for the study was to compare survival rates of those who elected to undergo the standard treatments for cancer against those who refused these treatments. According to Dr Naiman in her book Cancer Salves, the standard treatments consisted of surgery, caustics “such as nitric acid; sulfuric acid mixed with saffron; poisonous minerals such as lead, mercury, or arsenic nitrate; or alkaline caustics such as sulfate of zinc. Copper sulfate [mixed with borax], quicklime, or potassium permanganate were also used, evidently with mixed success.”

The conclusion of the study showed that those who avoided traditional cancer therapies outlived those who underwent them. Did this stop anyone from practicing these therapies? Perhaps, but for the most part, these treatment protocols continued on till the advent of Radium therapy that proved to be even more deadly than any previous protocol, but was highly recommended because it was a great money maker.

History, we are told, often repeats itself. A study presented to the American Cancer Society in the nineteen-eighties, concluded much the same as that study in France over a century earlier. Ellen Brown’s book, Forbidden Medicine gives us the following:

One of the few studies ... was conducted by Dr. Hardin Jones, professor of medical physics and physiology at the University of California, Berkeley. He told an ACS panel, "My studies have proven conclusively that untreated cancer victims actually live up to four times longer than treated individuals. For a typical type of cancer, people who refused treatment lived for an average of 12-1/2 years. Those who accepted surgery or other kinds of treatment [chemotherapy, radiation, cobalt] lived an average of only three years. . . . I attribute this to the traumatic effect of surgery on the body's natural defense mechanism. The body has a natural defense against every type of cancer.

Ulrich Able, a German epidemiologist and biostatistician, concluded the same in what can be considered the largest statistical analysis ever conducted on cancer. Irwin Bross, biostatistician for the National Cancer Institute, would have to agree. In a paper on Radiation we already published one of his famous quotations: “Radiation therapy does not improve the survival of patients with breast cancer. Did you know that the mortality rate for breast cancer in women over 55 was about 20% higher in 1995 than in 1970 (so much for mammograms)?”

Sadly, the one lesson we have all learned from history is that we do not learn anything from history. We are condemned to make the same mistakes again and again. As long as the primary focus of medicine is on profits, real healing will always take a back seat.

Horace Wells Discovers Pain-free Dentistry

By Emily E. Gifford

In the early 19th century Hartford dentists Horace Wells and William Morton played instrumental roles in the development of anesthesia for dental and other medical applications. Horace Wells, born in Hartford, Vermont, and educated in Boston, began his practice in Hartford, Connecticut, in 1836 and quickly rose to prominence. He married Elizabeth Wales in 1838 and continued to write about dentistry and invent various devices, such as a foot-powered shower.

Wells Sees Potential in Laughing Gas
In 1842, Wells took Morton, first, as his student and then as his partner. Morton, who was born in Massachusetts and trained for dentistry in Baltimore, Maryland, married Elizabeth Whitman, daughter of Lemuel Whitman, on her father’s condition that he quit dentistry and study to practice medicine instead. In 1844, Morton began (but never completed) his studies at Harvard Medical College.

Although Wells tried to form a dentistry practice with Morton in Massachusetts, the new partnership lasted less than two weeks, and Wells returned to Connecticut. In December of 1844, Wells and his wife attended a demonstration at Union Hall in Hartford of “laughing gas” (nitrous oxide) put on by showman Gardner Colton, who had briefly studied medicine. Wells noticed that one of the volunteers, while ingesting the gas to the amusement of the audience, had injured his leg during the demonstration. Wells later talked to the man and found he was unaware he had suffered an injury.

Since Wells had long been concerned about the amount of pain suffered by his patients during dental procedures, he immediately enlisted Colton’s help. The day after the demonstration, Colton came to Wells’s practice and administered nitrous oxide while Wells’s associate, John Riggs, extracted one of Wells’s own troublesome wisdom teeth. Feeling not “so much as the prick of a pin” in the course of this usually painful procedure, Wells believed that he, with the help of Colton and Riggs, had invented painless dentistry.

Experiments with Anesthesia
After Colton taught Wells how to administer the gas, Wells performed a dozen painless procedures over the next few weeks. Always intense, Wells became more excited with each successful procedure. He decided to demonstrate painless dentistry in Boston and did so in January of 1845 at Massachusetts General Hospital for the benefit of Harvard Medical School students and faculty members. The demonstration did not go well. The patient moaned as if in pain, and the audience drove Wells from the lecture hall with cries of “Humbug” and “Swindler,” even though the patient tried to explain that he was not, in fact, in pain.

Despite his setback in Boston, Wells continued to use nitrous oxide in his practice in Hartford and freely shared his discovery area dentists. While dental patients elsewhere continued to suffer, many throughout Hartford were enjoying painless dentistry by the middle of 1845. Wells’s apparent failure in Boston, however, temporarily deterred him from any further attempts to publicize his innovation nationally.

Meanwhile, in Boston, Wells’s former partner Morton was experimenting with the use of ether as an anesthetic. In 1846, Morton demonstrated the use of ether to perform a painless tooth extraction. He did not, however, identify his anesthetic as being ether. Instead, Morton called it “letheon” and applied for a patent for his “substance.” He established a monopoly on painless dentistry in the Boston area and soon got positive publicity for his discovery of ether’s medical applications. Morton also tried to make a profit from his discovery, but his attempts to claim sole discovery of anesthesia in general and ether in particular were denied.

Both Horace Wells and Charles Jackson, who had been Morton’s chemistry professor at Harvard and originally introduced him to ether, stepped forward to challenge Morton’s claim that he had discovered anesthesia. Wells, for his part, sought to strengthen his claims by publishing History of the Discovery of the Application of Nitrous Oxide, Ether, and Other Vapors, to Surgical Operations (1847). Morton and Jackson entered into protracted legal battles in their attempts to prove their claims.

Wells Seeks Fortune in NYC
Wells was also trying to find a way to gain fame and fortune as an anesthetist. By the end of 1847, he had participated in dental and other surgical procedures in Hartford, but decided that he should relocate to New York City to achieve greater recognition and success.

He moved there in January of 1848, intending to establish himself before sending for his wife and their young son, Charles Wells. Loneliness and homesickness overcame him, however, and Wells began using ether and chloroform in an attempt to ease his depression. Wells spent several days intoxicated on the combination of drugs, eventually becoming so confused that he could not distinguish sleep, dreams, and reality.

On the night of his 33rd birthday, Wells went out and threw acid on a pair of women in the street. Fortunately, the acid only burned their clothing and did not permanently injure the women. The police responded to their cries for help and arrested Wells, who they incarcerated in the Tombs Prison. He continued to ingest chloroform and ether while in jail, but in moments of clarity realized the depths to which he had sunk.

Believing that he had disgraced himself and his family beyond repair, Wells took a large dose of chloroform and used a razor to slash a major artery on his thigh. He quickly bled to death, and his body was released to his family for burial at Old North Burying Ground in Hartford. In 1908, Charles Wells re-buried his father and mother (who had died in 1889 and been buried alongside her husband) at Cedar Hill Cemetery. Wells’s tombstone identifies him as the “discoverer of anesthesia.” (In like fashion, Morton’s stone acclaims him as the “Inventor and Revealer of Inhalation Anesthesia.”)

The Nature of Discovery
In 1864, the American Dental Association, followed by the American Medical Association in 1870, recognized Horace Wells as the discoverer of anesthesia. Morton was never able to gain the fortune he sought for his own contributions to the field, including a $100,000 prize which was contested by Jackson and Wells’s survivors.

Although claims to singular discovery reinforce society’s fascination with individual genius, historians of science note that it is not unusual for innovations to occur at a moment when several individuals—sometimes with knowledge of each others’ efforts and sometimes not—are working along similar lines. Discovery, they emphasize, is not typically an event but a process. Wells, then, is rightly recognized for his pioneering role in pain-free dentistry and the field of medical anesthesia.

Emily E. Gifford is an independent historian specializing in the history of religion and social movements in the United States.

Image: Miniature Portrait of Horace Wells

Union Soldier Turns Medic at Gettysburg, 1863

A primary source by Elbert Corbin

Pvt. Elbert Corbin to his wife, July 6, 1863. (GLC)

After three days of fierce fighting on July 1–3, 1863, nearly 40,000 battered soldiers lay scattered across the blood-soaked fields of Gettysburg, Pennsylvania. As the torrential summer rain poured down on the wounded, Private Elbert Corbin of the 1st New York Light Artillery was thrust into an unexpected role when he was ordered to remain behind and take care of his fallen comrades.

In this rare letter, Corbin detailed the quick training that enabled him to assist his wounded compatriots. He also writes of helping wounded enemies: “dressed our Boys wounds then . . . assisting to cut out Balls and dress the wounded Rebels.” He resignedly noted the paradox of having to “Help to wound & Kill men then Patch them up.”

Corbin describes operations and procedures he performed, saying that he now “can do up wounds from shot or shell or Bullits quite like an M.D.” But he also reported that he is troubled by having become numb to the gruesome tasks of rudimentary surgery: “I can see an Arm or Leg taken off and it has no more affect on my feelings, than cutting so much Beef.” Though he claimed that he was no longer disturbed by his work, it is clear that Corbin’s experiences stayed with him, as he wrote of Gettysburg, “more suffering here in one second than you will see in a Leife.”

A full transcript is available.

EXCERPT
Monday Eve July 6th.  10.O’Clock – Em I have passed another busy day – Lieut Shelden was fixed up by me and made as comfortable and sent off with some other officers I am left here in Care of the Boys – Several of the boys who had very slight wounds are with the Battery. We have Patched up just so as to man 4 guns all told and the Battery is ready for the front . . . After getting off Lt[?] S. I dressed our Boys wounds then 15 or 20 of the Boys of other Batteries then I was sent to work assisting to cut out Balls and dress the wounded Rebels and we now have an quantity of them and I shall have to help tomorrow I can do up wounds from shot or shell or Bullits quite like an M.D. – I have had quite a Dicipline I do it for that – I can see an Arm or Leg taken off and it has no more affect on my feelings, than cutting so much Beef – Dead men are plenty here – and I saw plenty of them in all shapes on the field – Help to wound & Kill men then Patch them up I could show more suffering here in one second than you will see in a Leife– at home It is strange how I have diciplined my feelings to see Dying and suffering men and have no feelings only a passing thought, I have some [illegible] that were cut out of men I have had quite a chat to day with Rebels . . . such a Sabbath I shall long remember and these days work here among the wounded & dying –

* The Gilder Lehrman Institute thanks the following people in helping to identify Corbin as the author of this letter: Thomas E. Corbin (great grandson of Private Elbert Corbin); Greg Goodell and Scott Hartwig at the Gettysburg National Military Park; and Stephen J. Dreher, historian for Pettit’s Battery B.

Image: Pvt. Elbert Corbin, 1st New York Artillery, to his wife, July 6, 1863. (Gilder Lehrman Collection)

From: gilderlehrman.org

Women and Medicine

From: mnwelldir.org

Surgery during this period killed as many as it cured, mostly due to sepsis. It was in Europe, where the surgical arts were being perfected, at this time, specifically France, and new techniques flourished there and were quickly disseminated among European medical schools. However, even in Europe, sepsis [infection] was still a problem.

Most surgeries in the US involved the treating of wounds, as well as battle wounds. Amputation was most probably the leading surgical procedure performed.

In 1809, Jane Todd Crawford (Lincoln’s wife’s—Mary Todd— cousin) was diagnosed with a very large ovarian cyst which had originally been diagnosed as a pregnancy. At the time, no tumor had ever been removed successfully. However, there was a visiting surgeon from Edinburgh who agreed to do the surgery. According to Gail Collins, he gave her opium and alcohol to ease the pain, and a month later she returned home cured.

Legend has it that an angry crowd surrounded the doctor’s home while he was treating Mrs. Crawford, threatening to kill him for his outrageous assault on a female body. [Collins]

It was not until mid century that anesthesia was being used, as is outlined in our tongue in cheek article, The History of Anesthesia. At this time Dr J Marion Sims began experimenting with his female slaves.

Females of this period had a rough time where medicine was involved, for doctors were determined to treat every facet of female passage, from puberty through menopause as a disease.

Many doctors believed that during their periods, women were deprived of blood to the brain, leaving them “idiotic” or temporarily insane. [Collins]

During childbirth, regulars bled women into unconsciousness, mainly to relieve their own anxiety at hearing the screams and moans accompanying most births. How woman handled menstruation at this time will remain a mystery because it was something that no one mentioned in private or public. Even diaries have no mention of this monthly visitor, though many have theories on the subject, with some guessing that the use of multiple skirts and petticoats was to hide the great variety of “napkins” women had developed and used at the time.

What we do know for sure is that personal hygiene was extremely poor. Diapers were not even washed till just prior to the Civil War. Bathing was considered unhealthy. Magazine articles exhorted people to brush their teeth, but again, accounts of visitors returning to Europe spoke volumes of the poor dental care in Americans of that time. Much of our tooth loss and gum disease, though, was attributable to mercury poisoning from traditional medicine.

Because of modesty, and no regular female physicians, doctors were not allowed to look upon the naked bodies of their female patients. Many palpated (felt around) under the skirts, while others examined women with the aid of a mirror (to avoid looking directly). Collins points out that one of the best obstetricians of that period, a Dr Degorges, was blind. Many a physician exhorted medical students in their care to avoid viewing a half naked woman (even giving birth) under their care for it could result in sexual perversion leading them to adultery and madness. Students had to learn from textbooks and manikins.

Things sexual were strictly taboo, leading to much ignorance on the subject of birth control and sexually transmitted diseases, though an efficient mail system supported our young entrepreneurial spirit in the trade of sexual goods:

… Americans could send away for birth control pamphlets, medical devices like diaphragms and syringes, condoms, spermicides for douching, and pills that promised to induce abortions. Ads for condoms, cures for venereal disease, aphrodisiacs, and abortion services were an economic mainstay of the urban newspapers. Agents distributed ads for birth control devices on street corners and mailed them to newlyweds. “French” was a code for a contraceptive, and “Portuguese” for something that induced abortion . . . .  [Collins]

Abortions, performed early, were a socially accepted form of birth control. Even the Catholic Church looked the other way, as the fetus was not considered human till movement was perceived. Midwives hung flags out their windows signifying that they performed abortions. [Collins]

Infant mortality was high, even though, as Collins points out, “Americans were more likely to live to adulthood than ever before.” With husbands gone most of the time and no easy way to call for help, young wives were left alone to their superstitions. Everyone knew a handful of stories of a happy, bouncing baby struck by a sudden fever and dead before morning.

Traditional medicines at this time did more harm than good (history seems to repeat itself, e.g. Vioxx) and parents began to drug their children.

An 1833 guide used by southern women suggested daily doses of laudanum, an opium derivative—four drops for a nine-month-old and five to six drops for a toddler. [Collins]

American women, according to the European visitors, aged rapidly. Be it due to the ravages of raising a family or poor nutrition or poor medical care, one visitor penned this maxim:

"… charming and adorable at fifteen . . . faded at twenty-three, old at thirty-five and decrepit at forty." [Collins]

It was right around the mid 19th century that our personal hygiene habits began to improve. It became genteel to have a fresh water basin awaiting one’s morning ablutions. Babies where no longer swaddled (very tightly fitting clothing) in unwashed linens, but were loosely clothed and their diapers washed regularly, and not allowed to dry while the baby still wore them. The belief that children were born unsullied sprouted at this time, and since the mother was a child’s main influence, she often took all the blame should her child go astray. Women’s magazines, physicians, clergy, and neighbors offered plenty of unsolicited advice to raising the perfect child, but the perfect child was only to be found in books. The story of young George Washington still finds life in many an elementary school today.

Women were not allowed in medical schools, period. The reasons for this were varied, and today, quite comical. It took the Blackwell sisters to finally breach this barrier, though the barrier still remained sturdy for many, many years.

Elizabeth Blackwell was inspired to go into medicine because women had a hard time discussing their issues with male doctors. She’d had a close friend dying of uterine cancer who told her of her troubles communicating with her physician. Elizabeth applied at nearly every medical school available at that time, and was turned down time after time, with some faculty members even suggesting she disguise herself as a man and try Paris. [Collins]

As luck would have it, the faculty of a small medical school in upstate New York decided to ask the student body about admitting women, and boys being boys, particularly rowdy that day, cheered and hollered and yipped their approval (most assuredly along with gratuitous lewd gestures) and that was that. Wouldn’t you like to have been a fly on the wall the day Elizabeth Blackwell showed up for her first day of class? The student body thought it had been a joke, but, as the saying goes, the joke was on them. “A hush fell over the class as if each member had been stricken by paralysis.” [Jordan Brown, Elizabeth Blackwell, Physician (p.52)].

Learn more about 19th century women doctors and women's health at www.CivilWarRx.com

Civil War, U.S.: Death and Dying

From: deathreference.com

Between the years 1861 and 1865, the United States engaged in a civil war, one of the most significant military confrontations in the young republic's life. The conflict dramatically altered the course of American society, eradicating the institution of slavery from the land and accelerating a number of social, economic, and political trends originating in other regions of the country. It also made lasting cultural impressions across imaginative and material American landscapes, including the gradual growth of a complex tourist industry built upon memory, patriotism, and consumerism, and the immediate expression of a deeply rooted, though politically sensitive, religious attachment to a distinctly southern way of life.

The Civil War, however, was a major turning point in American history for another reason as well: it transformed attitudes toward death and practices surrounding the corpse in the United States. While antebellum America demonstrated marked preoccupations with the reality of death in literature, material culture, religion, diaries and letters, and early medicine, the war led to the extreme escalation of certain tendencies emerging on the social scene, as well as to the production of entirely new views on death and the dead. The incredible numbers of young men who died during the war, the problems associated with disposal of their bodies, and the rhetorical and symbolic efforts to make sense of the lives lost had profound consequences for American sensibilities and institutional structures.

The Presence of Death

During the war years, death was a pervasive element of social life in both the northern and southern sections of the country. Up until the war, Americans were quite familiar with the presence of death, intimate with its consequences in their own homes and local communities. Some estimates suggest that in the North, where more accurate records of the period are available, the crude death rate in the antebellum period was around 15 per 1,000 in rural areas, and between 20 and 40 per 1,000 in more populated cities. Most people lived into their late thirties if they survived the exceedingly dangerous early years of life. Chances of dying in childhood were also quite high, according to many studies. Infant mortality hovered around 200 per 1,000 live births, and roughly 10 percent of individuals between one year and twenty-one years died from a wide range of causes.

Despite this close and personal awareness of human mortality, Americans during the Civil War had a radically different set of experiences with death than previously. First and foremost, this conflict produced more deaths than any other war in U.S. history. The total number of deaths for both the North and the South, in the four-year period, was over 600,000. World War II is the only other major conflict that comes close to this number, when over 400,000 individuals died in battles across the ocean.

More demographic information is available for the Northern armies than for the Confederacy, which did not have the resources to keep accurate records on soldiers. According to some historians, roughly one out of sixteen white males in the North between the ages of sixteen and forty-three lost his life during the war. Even more astonishing than the overall mortality rates for the entire conflict are the number for particular battles: During the three-day battle at Gettysburg, for example, 3,155 Union soldiers died; at Antietam, during one day of fighting, the Union lost over 2,000 young men.

The carnage left on these and other sites, for both sides, boggles the mind, and must have been overwhelming to Americans viewing photographs, visiting battlefields, or reading detailed accounts in newspapers. Another significant difference between this war and other wars after the Revolution is the proximity of the battles to American communities. The Civil War not only took place on American soil, it pitted neighbor against neighbor, family against family, countrymen against countrymen.

More threatening to American soldiers during the war than mortal wounds on the battlefield was the presence of disease and infection, which had the potential to seriously reduce the number of fighters on both sides. Nearly twice as many men died as a result of poor health in camps and hospitals than from wounds inflicted during combat. What did soldiers die from? Afflictions such as diarrhea, malaria, smallpox, typhoid fever, pneumonia, and measles wiped out large numbers of men on both sides of the conflict. The deadly power of disease swept through the ranks because of the incredibly poor conditions in camps, resulting from inadequate shelter, contaminated water supplies, unhealthy diet, and a limited knowledge about proper sanitation and safe hygienic practices. As the war progressed, the Union forces worked especially hard to improve the living conditions of soldiers and patients—death became an urgent public health issue that could be combated with sound, rational decisions about such simple things as clean water, healthy food, and adequate sanitation.

Under wartime conditions, Americans in general, and soldiers in particular, acquired a unique familiarity with human mortality. Regardless of the formidable presence of death in life during the antebellum years, the Civil War posed a series of new challenges for those affected by the carnage— which is to say nearly every American at the time— and produced new attitudes that reflected distinct modifications in how these Americans made sense of death and disposed of their dead. In the midst of war, unorthodox views on death and the dead body emerged out of the entirely unparalleled experience with human violence, suffering, and mortality in U.S. history. On the other hand, some perspectives demonstrated a degree of continuity with more traditional views on the meaning of death, and reinforced deeply rooted religious sensibilities circulating before the onset of the conflict.

Disposing of the Dead

The Civil War forced Americans to reconsider what counts as appropriate treatment of the dead, as well as to reconceptualize the symbolic meanings of the dead body. The confrontation, with brutally slaughtered masses of bodies or hopelessly diseased soldiers dying in hospitals or camps, upset conventional patterns of disposal, as well as established attitudes about communal duties, religious rituals, and personal respect in the face of death. What counted as proper and appropriate action to usher the dead from the land of the living in an earlier time often proved impossible during the conflict, though in some cases efforts were made to treat the dead with a dignity that evoked prewar sensibilities.

In both the Union and Confederate armies, soldiers attempted to provide some kind of burial for fallen comrades who perished during a battle, even if this meant simply covering bodies with dirt, or placing the dead in common graves. The details of burial depended on a variety of circumstances, including which side won a particular battle, and which unit was assigned burial duty. Victors had the luxury of attending to their own dead with more care and attention, if time permitted. On the other hand, the losing side had to retreat from the battlefield, which meant leaving the fate of the dead and wounded to the winning side, who treated them as most enemies are treated, with indifference and disrespect.

If the Union forces controlled the field after a fight, for example, the dead were often buried without ceremony somewhere on or near the site, either individually in separate graves or collectively in common graves. In many cases, those assigned to burial duty—often African Americans, who performed a variety of noxious duties for the Union army—left the dead in their uniforms or placed a blanket around them before interment. If such resources as pine coffins or burial containers were available, and time permitted, soldiers would be placed in them before being put in the ground, a procedure that rarely occurred in the early years of the war. Many soldiers on both sides expressed a great deal of fear that their bodies would be left to the enemy, which was understood as a fate worse than death.

The federal government and Union soldiers themselves tried to ensure that bodies were identified with at least a name, a desire that led some soldiers to go into battle with their names and positions pinned onto their uniform (foreshadowing the popular use of dog tags in subsequent wars). Again, when time allowed and when burial units were available, Union forces made an effort to avoid anonymous burial, identify graves, and keep records of who died during a battle, an effort that grew increasingly more sophisticated as the war dragged on.

In contrast to the lack of ceremony surrounding the disposition of the dead on or near fields of battle, conditions in Union camps and hospitals allowed for more conventional burial practices that maintained older traditions. Reasons for this difference had nothing to do with smaller numbers of dying soldiers in these settings. More men died from disease than wounds inflicted in battle, so there were ample corpses in these locations. Camps and hospitals simply had more resources, personnel, and time to take care of these matters. Many also had space singled out for use as cemeteries, which provided a readily available and organized location for disposal.

General hospitals in larger towns seemed to be settings where more formal funeral observances could be carried out, especially for the Union. In addition to the presence of hospital nurses in these locations, members of the Sanitary Commission and the Christian Commission made burial of the dead more humane, respectful, and ritually satisfying. According to some firsthand accounts of Union hospitals in Virginia and elsewhere, the dead were given proper burials, which included religious services, the use of a coffin, a military escort from the hospital, the firing of arms, and an individual headboard with information about the deceased.

Regimental hospitals much closer to battlefields, on the other hand, could not offer the kind of attention that larger hospitals provided the dead. Descriptions of death and dying in these locations can be found in a number of soldiers' letters and diaries, anticipating the shifting scenery of expiration from home to hospital. The presence of corpses, as well as other reminders of human mortality like piles of amputated limbs, did not evoke images of order and solemnity. Instead, death and burial had many of the same characteristics as found on fields of battle, though a rudimentary graveyard next to these hospitals allowed for a slightly more organized space for disposing of remains.

In addition to hospitals and battlefields, another location where Civil War dead could be buried included prisons. According to one account of prison burials by a Union soldier incarcerated in Georgia's Andersonville Prison, treatment of the dead followed a fairly regimented set of procedures. These procedures included pinning the name of the deceased on his shirt, transportation to the prison "dead-house," placement on a wagon with twenty to thirty other bodies, and then transferal to the cemetery, where a superintendent overseeing the burial ground would assume responsibilities for ensuring as adequate a burial as possible. Dead prisoners were placed in trenches, usually without any covering, and buried under prison dirt. The location of each body was then marked with a stake at the head identifying the soldier and the date of death.

For family members and friends in the North, the prospect of loved ones dying far away from home, and being interred in what most considered to be profane Southern soil, led to a great deal of anguish and outrage. Indeed, many Northerners were deeply disturbed by this prospect because it upset normal social scripts ingrained in American culture when a family experienced a death. In normal times, death occurred in the home, people had a chance to view the body before it disappeared forever, and burial took place in a familiar space, which usually included previously deceased family members and neighbors. These were not normal times for sure, so some families, particularly the more affluent families in the North, would do whatever they could to bring the body of a loved family member's home, either by making the trip south on their own, or paying someone to locate, retrieve, and ship the body north.

As a result of these desires—to maintain familial control over the final resting place and, if possible, to have one last look before the body vanished—a new form of treating the dead appeared on the social scene, and paved the way for the birth of an entirely modern funeral industry. Undertakers who contracted with Northern families began to experiment with innovative means to preserve bodies that had to be shipped long distances on train cars, often during the hot summer months. The revolutionary practice that emerged in this context, embalming, provided both the military and Northern communities with a scientific, sanitary, and sensible way to move bodies across the land.

Making Sense of Death

In peaceful times, death is often experienced as a painful, disruptive, and confusing moment that requires individuals to draw on strongly held religious convictions about the meaning of life, the fate of the soul, and the stability of an ordered cosmos. During war, when individuals are called to sacrifice their lives for the good of the nation and prepare for an early, violent end, the religion of nationalism makes a distinctive mark on meaningmaking efforts circulating throughout public culture. Indeed, the religion of nationalism becomes an integral frame of reference when war breaks out, setting earthly, political conflicts in a cosmic realm of ultimate good battling ultimate evil. In the Civil War, two conflicting visions of American national life came into sharp relief against the backdrop of fields of bloodied bodies and widespread social anguish over the loss of sons, brothers, fathers, and husbands fighting for God and country.

Both Northerners and the Southerners believed God was on their side, and the nation envisioned by each a fulfillment of distinctive Christian commitments and values. Indeed, the blood of martyrs dying in the fight over slavery, and their sacrifices for the preservation of a sacred moral order ordained by God, had curative powers in the mind of many leading figures precisely because the nationalist ideologies of each side relied on Christian imagery and doctrine to justify killing, and being killed, in the service of a higher good. Although certain dead heroic figures had been intimately linked to the destiny of the nation from the Revolutionary War to the attack on Fort Sumter, the U.S. Civil War dramatically altered that linkage, and established a context for imagining innovative ways of making sense of death in American culture.

One concrete example of this innovation was the creation of military cemeteries, a new form of sacred space that gave material expression to religious sensibilities tied to both Christianity and nationalism. First established during the war by the federal government, military cemeteries gave order to death by placing bodies of fallen soldiers in a tidy, permanent, and sacrosanct space that glorified both the war effort and the Christian virtues associated with it. In the midst of the war and in the immediate aftermath these cemeteries made profoundly political statements about Northern power, resources, and determination.

After Congress approved the purchase of land by the government in 1862, twelve new cemeteries located on or near major battlefields, Union camps and hospitals, and other military sites were authorized. Most of them, including Robert E. Lee's estate near the Potomac, were on Southern soil, thereby enhancing the political and sacral weight of each. President Abraham Lincoln articulated the essential meanings undergirding these cemeteries during his dedication speech at Gettysburg. Here Lincoln transformed the bloodied ground and buried lifeless bodies into the rich symbolic soil nourishing Union ideology and American traditions. In the brief speech, Lincoln successfully integrated the fallen soldiers into American mythology, giving them a permanent, holy spot in the physical landscape and assigning them a pivotal, transcendent role in the unfolding of American history. He also gave voice to the incalculable national debt living American citizens owed to the dead.

After the war, the victorious federal government began to ensure that as many Union soldiers as possible were identified and interred in the sacred space of national cemeteries. One of the first postwar national cemeteries was established on the grounds of Andersonville, a site that held profound symbolic meaning for Northerners who, by the end of the war, were outraged by the treatment of federal soldiers there. More than sixty cemeteries owned and operated by the government appeared across the North and South, and within the next decade nearly 300,000 bodies were reinterred. Trumpeting republican values and Christian morality, these cemeteries provided American citizens with an accessible space—in time, many became popular tourist destinations— that imposed a victorious national identity and promoted collective revitalization.

Northern and Southern leaders also gave meaning to the war dead through public pronouncements, in religious services, and by glorifying individual stories of heroism and sacrifice during and after the conflict. Unprecedented levels of social grief and mourning throughout American communities required extraordinary efforts at meaning-making that spoke to the profound emotional pain of individual citizens as well as created a shared sense of loss that could only be overcome through ultimate victory.

Many saw the battle in apocalyptic terms, with the very salvation of American society, and indeed the entire world, at stake. Millennial notions about the impending return of Christ, the role of the nation in this momentous event, and the demonization of the enemy transformed the blood of fallen soldiers into a potent source of social regeneration that would eventually purify the sins of the nation. Leaders on both sides, for example, publicly encouraged citizens to keep the cosmic implications of the war in mind, rather than stay focused on the tragedy of individual deaths on the battlefield. In this rhetorical context, mass death became meaningful because it forcefully brought home a critical realization about the life and destiny of the nation: It occasionally requires the blood of its citizens to fertilize the life-sustaining spirit of patriotism.

On the other hand, however, Northerners committed to democratic ideals and individual rights also took great pains to glorify, and sentimentalize, the deaths of certain soldiers who embodied at the time of their death national virtues like courage in the face of injustice, spiritual preparedness with an eye toward heavenly rewards, and concern about stability at home with one foot in the grave. Numerous accounts of individuals dying a heroic death on the battlefield or in hospitals were anchored with abundantly rich symbol systems relating to Jesus Christ, America, and home. Indeed, whether death became meaningful in collective or personal terms, a reinterpretation of what it meant to die triumphantly and heroically took place over the course of the war, and was animated by one, two, or all three of these symbolic systems.

Both Northerners and Southerners kept certain deaths in mind and used them as a symbolic and inspirational resource throughout the fighting. For the Confederacy, one of the critical figures in the pantheon of heroic leaders was Stonewall Jackson. A paragon of Christian virtue and piety, Southern honor and pride, Jackson died after being accidentally wounded by one of his own men at the battle of Chancellorsville in 1863. The example of his death, with a chaplain close at hand, his wife singing hymns, and a calm, peaceful demeanor during his last hours, aroused many downhearted Confederates and, in time, attained mythological standing in Southern culture. After the war, Jackson, along with other venerated Southern heroes who eventually passed on like Robert E. Lee and Jefferson Davis, played an important role in the creation of a cultural system of meaning that transformed defeat into the basis for a regionally distinctive southern identity. The southern historian Charles Reagan Wilson argues that this identity embodies a peculiar religious system, the religion of the Lost Cause. This cultural religion, still vital and strong in the twenty-first century, can be characterized as a cult of the dead since much of its mythological and ritual dimensions focus on deceased Southern martyrs who died during the war.

While many responses to the Civil War conveyed a belief in the regenerative powers of violent death, and that redemption of both the individual and society followed in the wake of mass sacrifices by young men, some grew hardened to the savagery and suffering taking place on American soil. For these people, including soldiers themselves who witnessed fighting firsthand, the meaning of death had nothing to do with religious notions like regeneration or redemption. Rather than being swept away by the emotional resonance of responses that glorified the dead and focused on the life of the spirit, certain individuals grew more and more disenchanted with the symbolism of death. Soldiers on the battlefield, military and political leaders guiding the troops, and citizens back home reading eyewitness accounts or seeing visual depictions of the fighting assumed a more pragmatic, disengaged posture, and became indifferent to scenes of human carnage and the deaths of individual men. The question first raised by these attitudes—Does overexposure to death and violence lead to desensitization?—continues to plague twenty-first-century American society.

Advances in Weaponry

Finally, one of the more long-lasting social changes associated with American experiences in the Civil War has to do with the emergence of a particularly strong cultural and political obsession with guns. During the war, technological advances in weaponry, and the wide distribution of rifles and pistols among the male population, transformed the way Americans related to their guns. After the war, a gun culture took shape that to this day remains anchored by both the mythic and social power of owning a weapon, threatening to use it in the face of perceived danger (a danger often understood as jeopardizing the three symbol systems mentioned earlier, Christian virtues, national security, or more commonly, home life), and using it as an expression of power. This fascination with guns, coupled with an ingrained historical tendency to experience violence as a form of social and religious regeneration, has contributed to making violent death in America a common feature of daily life.

Bibliography

Adams, George Washington. Doctors in Blue: The Medical History of the Union Army in the Civil War. New York: Henry Schuman, 1952.

Farrell, James J. Inventing the American Way of Death, 1830–1920. Philadelphia: Temple University Press, 1980.

Faust, Drew Gilpin. "The Civil War Soldier and the Art of Dying." The Journal of Southern History 67, no. 1 (2001):3–40.

Fredrickson, George M. The Inner Civil War: Northern Intellectuals and the Crisis of the Union. New York: Harper and Row, 1965.

Jackson, Charles O., ed. Passing: The Vision of Death in America. Westport, CT: Greenwood, 1977.

Laderman, Gary. The Sacred Remains: American Attitudes toward Death, 1799–1883. New Haven, CT: Yale University Press, 1996.

Linderman, Gerald F. Embattled Courage: The Experience of Combat in the American Civil War. New York: Free Press, 1987.

Linenthal, Edward. Sacred Ground: Americans and Their Battlefields. Urbana: University of Illinois Press, 1991.

MacCloskey, Monro. Hallowed Ground: Our National Cemeteries. New York: Richards Rosen, 1969.

Mayer, Robert G. Embalming: History, Theory, and Practice. Norwalk, CT: Appleton and Lange, 1990.

McPherson, James M. Battle Cry of Freedom: The Civil War Era. New York: Ballantine, 1989.

Miller, Randall M., Harry S. Stout, and Charles Reagan Wilson, eds. Religion and the American Civil War. New York: Oxford University Press, 1998.

Moorhead, James H. American Apocalypse: Yankee Protestants and the Civil War, 1860 –1869. New Haven, CT: Yale University Press, 1978.

Paluden, Phillip Shaw. "A People's Contest": The Union and the Civil War, 1861–1865. New York: Harper and Row, 1988.

Saum, Lewis O. The Popular Mood of America, 1860 –1890. Lincoln: University of Nebraska Press, 1990.

Shattuck, Gardiner H., Jr. A Shield and a Hiding Place: The Religious Life of the Civil War Armies. Macon, GA: Mercer University Press, 1987.

Sloane, David Charles. The Last Great Necessity: Cemeteries in American History. Baltimore, MD: Johns Hopkins University Press, 1991.

Slotkin, Richard. Regeneration through Violence: The Mythology of the American Frontier, 1600 –1860. Middletown, CT: Wesleyan University Press, 1973.

Steiner, Peter E. Disease in the Civil War: Natural Biological Warfare, 1861–1865. Springfield, IL: C. C. Thomas, 1968.

Vinovskis, Maris A., ed. Toward a Social History of the American Civil War: Exploratory Essays. Cambridge: Cambridge University Press, 1990.

Wells, Robert V. Revolutions in Americans' Lives: A Demographic Perspective on the History of Americans, Their Families, and Their Society. Westport, CT: Greenwood, 1982.

Wilson, Charles Reagan. Baptized in Blood: The Religion of the Lost Cause, 1865–1920. Athens: University of Georgia Press, 1980.

Image: Union soldiers prepare to bury dead soldiers that are underneath tarps. Excluding the Vietnam War, Civil War deaths nearly equaled the number of deaths in all otherwars in U.S. history combined.



The History of Medicine: 1800 – 1850

From: mnwelldir.org

“Nearly all men die of their medicines, not of their diseases.” Moliere

The Revolutionary war is ended, a new century is begun, our first president has passed away and we are the freest society in the modern world. So, what are your options if you become ill?

If you lived in the cities your first choice is probably conventional medicine, which we will refer to as "regular medicine" in this article. As to physicians practicing this form of medicine, we shall call them "regulars." Regular medicine at that time was based upon the theory of the Four Humors. We’ve touched this theory in our first article on the history of medicine, The Settlers Arrive. At the turn of the century, many regulars began flirting with some of the newer theories of medicine imported from Europe, and still, none of these were based upon science. Regular medicine of this time, though deemed the best science of the age, was more a philosophy or art than a true science. One movement to which Dr Benjamin Rush  was a leader, attempted to refine all diseases into one disease, while other movements categorized diseases in hot and cold, acid and alkaline categories. Many of the papers published by physicians from this period were philosophical in nature, promulgating theories, which like most theories, easily found both proponents and evidence to back them up while ignoring all evidence to the contrary; that is, until another theory came along.

This same critique of medicine in 1800 being top heavy with theory was made by contemporaries. In a widely quoted excerpt, Thomas Jefferson criticizes basing treatment of disease on "some fanciful theory of corpuscular attraction, of chemical agency, of mechanical powers, of stimuli, of irritability accumulated or exhausted, of depletion by the lancet and repletion by mercury, or some other ingenious dream, which lets him into all nature's secrets at shorthand." He specifically scored the disciples of "Hoffman, Boerhaave, Stahl, Cullen, (and) Brown...." Historians suggest that Rush was omitted only because he was a personal friend. [Barnebeck, B, Destroying Angel: Benjamin Rush, Yellow Fever and the Birth of Modern Medicine http://www.geocities.com/bobarnebeck/ch18.html]

The number of medicines available to regular physicians of the period was just starting to grow. There were probably fewer than 100 medicines used; a firm number is hard to pin down since the first American pharmacopoeia was not published until 1820. However, Rush was of the opinion that large number of medicines was due to “nosology;” or giving names to diseases; the more diseases, the more names.

Today there are some 13,000 drugs in our pharmacopoeia, though a physician will normally administer no more than 100 different pharmaceuticals in her/his lifetime. Most physicians stick to right around 30 different drugs prescribed during their entire career.

The Pharmacopoeia of 1820 consisted mainly of herbal medicines, with few inorganic compounds, such as calomel (mercury), a favorite among regulars. Though herbs have been dropped from today’s Pharmacopoeia, approximately 40% of those drugs listed today are related to herbs in some way, whether synthetics or derivatives.

According to some historians, the regulars’ main focus was on making a living and monopolizing medicine. In the early 1800s, this plan almost worked.

Despite the push of the regulars to monopolize, you still had options during at the start of the 19th century. One option, which is egregiously overlooked in most history books, was to attend a midwife. Midwives of the time did a lot more than just help deliver babies. They practiced a form of medicine that had been handed down for centuries from mother to daughter, family to family.

Midwifery thrived during times of war because doctors were conscripted into military service. In fact, were you to take a course in women’s studies today, you’d learn how women have always progressed during times of war when the men are off fighting. World War II brought many women into the workforce; some of them even became pilots who ferried planes about the country. It was during the Vietnam War that women moved into management positions for the first time. It was during the Civil War that women were first allowed to nurse the sick and wounded. It was after the Civil War that one female physician was decorated with the Medal of Honor.

Nursing during this period, for the most part, was a male vocation. An interesting historical side note is that during the Yellow Fever epidemic in the late 1700s, black slaves were hired out as nurses, because those who had lived in Africa were immune to the disease. [http://www.geocities.com/bobarnebeck/children.html ]

One learned midwifery either from her mother or as an apprentice to a midwife. During the Revolutionary War, midwives performed every service any physician of the period could offer, and though the end of the war reined in many midwifery practices, it wouldn’t be long before England attacked the US in the War of 1812 and again their services would be required throughout the cities and countryside. However, Gail Collins, in her book America's Women: Four Hundred Years of Dolls, Drudges, Helpmates, and Heroines, points out that with the end of conflict, the influx of doctors back into society left midwives with little to do beyond delivering babies. Doctors set out to build up their practices, and offered new life saving techniques, such as delivering babies with the help of forceps that had been popularized in England. As the population of doctors grew, so did their desire to put midwives out of business and take over their practices. Collins tells us that in, “Philadelphia, twenty-one women listed their professions as midwife in the 1815 city directory; by 1824 there were only six.” [In our References and Further Reading section at the end of this article is a link to a superb paper on women in medicine.]

Ironically, if you read up on midwifery, you’ll hear that doctors and modern hospitals could guarantee a sterile environment where babies could be successfully delivered with little chance of infection to the mother. However, it was midwives of this period whose personal hygiene and habits of washing before a delivery that separated their practices from those of the physicians.

Anytime a hand or instrument was inserted into a woman’s body, she was in danger of becoming infected, with fatal results. Childbed, or puerperal, fever became epidemic at times in the nineteenth century, particularly in hospitals, where a single doctor could carry infection from one patient to the next. Hospitals were the delivery rooms of the urban poor, and in 1840 at Bellevue in New York, almost half the women giving birth during the first six months of the year contracted the fever. Eighty percent of them died. [Collins]

Another option of the period were the Indian Doctors, or as they were also known, botanical practitioners; herbalists, to be exact. Regular physicians referred to them as “irregulars." Though the name, Indian Doctor would imply that they picked up their knowledge from the natives, much of what they knew had been brought with them from the Old World. It is an interesting historical fact that herbalism in the old world and in the new world among our natives grew and flourished at approximately the same time.

Two other options of this period were hydropathy and the Thomsonians. Hydropaths believed in the curative powers of water, which, in retrospect, we realize brought a needed bit of personal hygiene into the picture, while the Thomsonian movement put medicine into the hands of the common man. The movement was founded by Samuel Thomson “after six doctors called in to help his seriously ill wife prescribed six different treatments.” [Collins] Thomsonians believed that laypeople could treat themselves better than any physician with a little help from nature’s botanicals.

Farmington’s Hospital Rock Dates Back to 18th-Century Smallpox Inoculation

From: connecticuthistory.org

Deep within the woods of Rattlesnake Mountain in Farmington are the remains of a late-18th-century smallpox inoculation hospital. A long stone ledge known as Hospital Rock is all that is left of the structures that once sheltered those seeking protection from the deadly smallpox virus. Carved into Hospital Rock are names of 66 of the hospital’s patients that testify to the realities of life in 18th-century Connecticut.

Evidence suggests the hospital consisted of several wooden structures set back from Settlement Road, which carried travelers from Farmington to New Britain. The hospital was the brainchild of Eli Todd, a Farmington physician and one of the founders of the Hartford County and Connecticut Medical societies, and Theodore Wadsworth of Southington, who treated smallpox while serving in the Continental Army. Both men apprenticed themselves in medicine at an early age and were established physicians when founding the smallpox inoculation hospital in 1792.

Isolated Rattlesnake Mountain Serves as Hospital Site
Smallpox was a deadly virus that reappeared regularly throughout Connecticut for much of the 17th and 18th centuries. By the time Todd and Wadsworth opened their hospital, inoculations for the disease consisted of infecting patients with trace amounts of the virus in order to allow them to build up an immunity to it. While infected, the patients needed to be isolated from the general population for 3 to 4 weeks. Rattlesnake Mountain proved to be an ideal location for providing the required isolation.

While patients convalesced, there was ample opportunity for socialization on the hospital grounds. One popular spot where this occurred was a sunny, flat ledge where relatives of patients came, often by stagecoach, to leave food and clothing for their loved ones staying in the hospital. This ledge eventually became known as Hospital Rock.

The hospital ceased operations in 1794 when Dr. Edward Jenner developed a vaccine for the treatment of smallpox. In the years that followed, nature reclaimed much of the surrounding area. In 2002, however, the Connecticut Historical Commission declared Hospital Rock an Historic Archeological Site. It is now part of a popular hiking and recreation area in the town of Farmington.

Image 1: Farmington Rock

Image 2: An etching from the Anti-Vaccine Society illustrating the fear of the new method of vaccination with the cowpox virus introduced in 1796

Sunday, July 10, 2016

Life In A Civil War Army Camp

From: civilwarhome.com

       "If there is any place on God's fair earth where wickedness 'stalketh abroad in daylight' it is in the army," wrote a Confederate soldier in a letter to his family back home. Indeed, life in the army camps of the Civil War was fraught with boredom, mischief, fear, disease, and death.

        Army regulations called for the camps to be laid out in a fixed grid pattern, with officers' quarters at the front end of each street and enlisted men's quarters aligned to the rear. The camp was set up roughly along the lines the unit would draw up in a line of battle and each company displayed its colors on the outside of its tents. Regulations also defined where the mess tents, medical cabins, and baggage trains should be located. Often, however, lack of time or a particularly hilly or narrow terrain made it impossible to meet army regulations. The campgrounds themselves were often abysmal, especially in the South where wet weather produced thick mud for extended periods in the spring and summer; in the winter and fall, the mud turned to dust.

        In summer, troops slept in canvas tents. At the beginning of the war, both sides used the Sibley tent, named for its inventor, Henry H. Sibley, who later became a Confederate brigadier general. A large cone of canvas, 18 feet in diameter, 12 feet tall, and supported by a center pole, the tent had a circular opening at the top for ventilation, and a cone-shaped stove for heat. Although designed to fit a dozen men comfortably, army regulations assigned about 20 men to each tent, leading to cramped, uncomfortable quarters. When ventilation flaps were closed on cold or rainy days, the air inside the tent became fetid with the odors of men who had scarce access to clean water in which to bathe.

        As the war dragged on, the Sibley was replaced with smaller tents. The Federal armies favored the wedge tent, a six-foot length of canvas draped over a horizontal ridgepole and staked to the ground at the sides with flaps that closed. off one end. When canvas became scarce in the South, many Confederates were forced to rig open-air beds by heaping straw or leaves between two logs. In autumn and winter, those units that were able to find wood built crude huts, laying split logs on the earth floor and fashioning bunks with mattresses of pine needles.

        When not in battle, which was at least three quarters of the time, the average soldier's day began at 5 A.M. in the summer and 6 A.M. in the winter, when he was awakened by reveille. After the first sergeant took the roll call, the men ate breakfast then prepared for their first of as many as five drill sessions during the day. Here the men would learn how to shoot their weapons and perform various maneuvers. Drill sessions lasted approximately two hours each and, for most men, were exceptional exercises in tedium. One soldier described his days in the army like this: "The first thing in the morning is drill. Then drill, then drill again. Then drill, drill, a little more drill. Then drill, and lastly drill."

        In the few intervals between drill, soldiers cleaned the camp, built roads, dug trenches for latrines, and gathered wood for cooking and heating. Finding clean water was a constant goal: the lack of potable water was a problem that led to widespread disease in both armies. At the outset of the war, the soldiers on both sides were relatively well-fed: the mandated daily ration for a Federal soldier in 1861 included at least 20 ounces of fresh or salt beef, or 12 ounces of salt pork; more than a pound of flour, and a vegetable, usually beans. Coffee, salt, vinegar, and sugar were provided as well. Supplies became limited when armies were moving fast and supply trains could not reach them in the field.

        When in the field, soldiers saw little beef and few vegetables; they subsisted for the most part on salt pork, dried beans, corn bread, and hardtack-a flour-and-water biscuit often infested with maggots and weevils after storage. Outbreaks of scurvy were common due to a frequent lack of fresh fruits and vegetables.

        By far, the most important staple in the minds of the soldiers was coffee. Men pounded the beans between rocks or crushed them with the butts of their rifles to obtain grounds with which to brew the strong drink. Although most Federals were well-supplied with coffee, the Confederates were often forced to make do with substitutes made from peanuts, potatoes, peas, and chicory.

        Most armies were forced at some point to live off the land. The Confederates, who fought mostly on home ground, tried harder to curb pillaging, preferring to request donations from townspeople rather than steal supplies or take them by force. Attached to most armies was the sutler, a purveyor of all goods not issued by the army, including tobacco, candy, tinned meats, shoelaces, patent medicines, fried pies, and newspapers. Sutlers were known for their steep prices and shoddy goods, but soldiers desperate for cigarettes, sweets, and news from home were willing to use their pay for these treats.

        Boredom stalked both armies almost as often as did hunger. When not faced with the sheer terror of battle, the days in camp tended to drag endlessly. The sheer tedium of camp life led the men to find recreational outlets. "There is some of the onerest men here that I ever saw," wrote a new recruit, "and the most swearing and card playing and fitin [fighting] and drunkenness that I ever saw at any place."

        When not drilling or standing guard, the troops read, wrote letters to their loved ones, and played any game they could devise, including baseball, cards, boxing matches, and cockfights. One competition involved racing lice or cockroaches across a strip of canvas. As hard as most commanders attempted to control vice in camp, both gambling and drinking were rampant, especially after payday. Confederate General Braxton Bragg concurred: "We have lost more valuable lives at the hands of whiskey sellers than by the balls of our enemies."

        Army regulations prohibited the purchase of alcohol by enlisted men, and soldiers who violated the rule were punished, but men on both sides found ways around it. Members of a Mississippi company got a half a gallon of whisky past the camp guards by concealing it in a hollowed-out watermelon; they then buried the melon beneath the floor of their tent and drank from it with a long straw. If they could not buy liquor, they made it. One Union recipe called for "bark juice, tar-water, turpentine, brown sugar, lamp oil, and alcohol."

        When not drinking or gambling, some men escaped the tedium of daily army life by enjoying "horizontal refreshments," as visiting prostitutes became known. Thousands of prostitutes thronged the cities in the war zones and clustered about the camps. By 1862, for instance, Washington, D.C., had 450 bordellos and at least 7,500 full-time prostitutes; Richmond, as the center of prostitution in the Confederacy, had about an equal number. Venereal disease among soldiers was prevalent and largely uncontrolled. About eight percent of the soldiers in the Union army were treated for venereal disease during the war and a great many cases were unreported; figures for the Confederacy are unavailable, but assumed to be about equal in proportion. With the invention of penicillin more than 70 years away, treating venereal disease with herbs and minerals such as pokeweed, elderberries, mercury, and zinc sulfate may have eased symptoms but did nothing to cure the disease.

        Even more pervasive than boredom, gambling, or venereal disease was homesickness. Men spent more time writing letters and hoping to receive them than any other leisure activity. Furloughs were rarely granted, and most soldiers had few opportunities to spend extended periods of time away from the army. Federal troops were often stationed too far from home to have time to get home, while Southern armies, short of manpower, needed every available soldier to fight. For better or worse, Civil War soldiers were forced to call camp home for the duration of their terms of service.

Source: The Civil War Society's "Encyclopedia of the Civil War"

African American Nurses in the Civil War

By Maggie MacLean, 11-14-14

Nursing was not a woman's job before the Civil War, but by 1865, there were over 3,000 nurses serving the Union and Confederacy. In the North, most women nurses worked in military hospitals.

Image: Black nurses with the 13th Massachusetts Infantry
The 13th Mass fought in numerous battles, from the Shenandoah Valley to Bull Run to Antietam

So many women volunteered as Union nurses that the U.S. government hired Dorothea Dix to serve as the superintendent of women nurses. African American nurses were not included in those numbers, nor were they recognized for their service for decades to come. Some were paid; many volunteered.

During the Civil War, black women did serve as nurses - in convalescent homes and U.S. government hospitals. The United States Navy also enlisted several African American women as first class boys, five of whom served as nurses on the hospital ship USS Red Rover: Alice Kennedy, Sarah Kinno, Ellen Campbell, Betsy Young and Ann Bradford Stokes.

Ann Bradford Stokes
Ann Bradford Stokes is the best known of the African American women who served as nurses on the hospital ship USS Red Rover, the first Union Naval hospital ship. She was enlisted in the Navy in January 1863 and served until October 1864, during which time she was paid regular wages. Stokes became the first African American woman to serve on board a U.S. military vessel, and she was among the first women to serve as a nurse in the Navy.

The USS Red Rover, a converted former Confederate paddle wheel steamer, was the first U.S. Navy hospital ship, and nearly 3000 patients were treated on board during the Civil War. Ann worked under the direction of the Sisters of the Holy Cross nuns aboard the USS Red Rover. After leaving the Navy, Ann married Gilbert Stokes.

In 1890 Ann Bradford Stokes applied for a disability pension for her service during the Civil War and was certified by the Navy as having served on active duty for eighteen months. She was awarded a pension that same year and is the first woman in the United States to receive a pension for her own military service. Stokes died in Illinois in 1903.

Harriet Tubman
Born into slavery, in eastern Maryland, Harriet Tubman received a severe head wound by an overseer when she was fifteen. From this injury she suffered disabling epileptic-type seizures, headaches, and powerful visionary experiences throughout her life. As a young woman, Tubman escaped from slavery in eastern Maryland with the help of conductors on the Underground Railroad.

Tubman then bravely returned to the South nineteen times and escorted more than three hundred slaves to freedom, becoming the most famous Underground Railroad conductor of all. She expressed her philosophy:

"There was one of two things I had a right to, liberty or death; if I could not have one, I would have the other; for no man should take me alive...."

During the Civil War, Tubman served in numerous military hospitals. In 1865 she was appointed matron of the Colored Hospital at Fort Monroe in Virginia in 1865, and began caring for sick and wounded black soldiers there. Tubman worked tirelessly, trying to heal the sick. Many in the hospital were dying from dysentery, a disease associated with fever, severe abdominal pain and terrible diarrhea.

Tubman remembered home remedies from her childhood, and she was sure she could help these men if she could find some of the same roots and herbs that grew in Maryland. One night she searched the woods until she found water lilies and crane's bill (geranium). She boiled the water lily roots and the herbs and made a bitter-tasting brew that she gave to a man who was dying, and he slowly recovered.

Living past ninety, Harriet Tubman continued to serve mankind in numerous capacities throughout her long life. In 1896, she took up the suffragist cause and was a delegate to the National Association of Colored Women's first annual convention, believing that the right to vote was vital to preserving their freedom. In 1944, Eleanor Roosevelt christened the Liberty Ship Harriet Tubman.

Sojourner Truth
Isabella Baumfree, better known by her self-given name Sojourner Truth, was born into slavery in Ulster County, New York in 1797. Although she would later gain fame as an abolitionist and women's rights activist, Truth was originally a nurse who served a family named the Dumonts. She was promised her freedom a year before the 1827 Emancipation Act, but when her owner changed his mind, she fled with her young daughter Sophia in 1826.

During the Civil War, Sojourner Truth walked the roads of Michigan, where she had settled, collecting food and clothing for black regiments. Moving to Washington, DC in 1863, she worked in Union hospitals nursing the sick and wounded and teaching domestic skills to freed slaves, and immersed herself in relief work for the freed people. During this time, Truth also protested and brought about congressional action in banning segregation on streetcars in Washington, DC.

With the passage in 1867 of the Fourteenth Amendment giving black men the vote, white suffragists were outraged at the lack of reference to women, and most black activists believed that the suffering of black male slaves entitled them to receive the vote first. Again, Truth was the only voice for black women, and for recognizing the link between racism and sexism:

"There is a great deal of stir about colored men getting their rights but not a word about the colored women's theirs, you see, the colored man will be masters over the women, and it will be just as bad as it was before. So I am for keeping the thing going while things are stirring, because if we wait 'till it is still, it will take a great while to get it going again."

Susie King Taylor
A slave raised on an island off the coast of Georgia, Susie King Taylor became famous for her volunteer service during the Civil War. In April 1861, General David Hunter assaulted Fort Pulaski and freed all of the slaves in the area, including Susie. As a young slave girl, Susie had been secretly taught to read and write, and those abilities proved invaluable to the Union Army as they began to form regiments of African American soldiers.

When Union officers raised the First South Carolina Volunteers of African American soldiers, Susie King Taylor signed on as a nurse, and soon started a school for black children and soldiers. She married Sergeant Edward King of the First South Carolina Volunteers and served for more than three years traveling with her husband's unit, the 33rd U.S. Colored Troops.

King's experiences as a black employee of the Union Army are recounted in her diary. She describes numerous battles and intersperses these accounts with personal stories and commentary on life in the South, and the unequal treatment of the African American soldiers:

"The first colored troops did not receive any pay for 18 months and the men had to depend wholly on what they received from the commissary... their wives were obliged to support themselves and their children by washing for the officers and making cakes and pies which they sold to the boys in the camp. Finally in 1863, the government decided to give them half pay, but the men would accept none of this. They preferred rather to give their services to the state, which they did until 1864, when the government granted them full pay, with all back due pay."

Though she was never paid for her service, King wrote:

"I was very happy to know my efforts were successful in camp, and also felt grateful for the appreciation of my service. I gave my services willingly for four years and three months without receiving a dollar. I was glad, however, to be allowed to go with the regiment to care for the sick and afflicted comrades."

Following the Civil War, King established a school for freed slaves. When her husband Sergeant Edward King of the First South Carolina Volunteers died in 1866, she collected a widow's pension. She then settled in Savannah, Georgia with her husband, who was killed in an accident shortly before the birth of their son. Taylor spent much of the remainder of her life in the North, serving as a teacher, domestic servant and cook. In 1879, Taylor married Russell L. Taylor; he died in 1901.

Susie King Taylor's memoirs, "Reminiscences of My Life in Camp with the 33rd United States Colored Troops Late 1st S.C. Volunteers (1902)", is the only known published recollection of the experiences of an African American nurse during the Civil War. Despite her work during the Civil War and her subsequent dedication to political and social reform, Taylor died in relative obscurity in 1912.

In the South, many upper class women refused to lower themselves by working in hospitals, but they did open up their homes to wounded soldiers and nursed them there. A few put aside their distaste for hospitals and went to work. Lower class women, both black and white, were not so fortunate. They spent hours, weeks, months and even years nursing patients, cleaning and preparing food in southern hospitals.

Image: African American Civil War Nurses

From: civilwarwomenblog.com

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