Medical Advances Timeline: 1850-1860

1850
- The Female Medical College of Pennsylvania, the world’s first women’s medical school, opens in Philadelphia.
- German physician Carl Reinhold Wunderlich introduces the practice of taking accurate temperature with a thermometer as a regular part of diagnosis.
- California becomes a state of the U.S.
- R.W. Bunsen produces the gas burner.

1851
- German physician Hermann von Helmholz, who was originally trained as a military surgeon, describes the ophthalmoscope for seeing inside the eye.
- The New Orleans Monthly Medical Register begins publication. It later merged with the New Orleans Medical News and Hospital Gazette.
- Isaac Singer invents the continuous-stitch sewing machine.
- The New York Times appears in September.
- World Population statistics in millions:
China 430
Germany 34
France 33
Great Britain 20.8
U.S. 23

1852
- Dutch surgeon Mathysen impregnates bandages with plaster to create rigid casts.
- Wells Fargo & Co. is founded.

1853
- Samuel Colt revolutionizes the manufacture of small arms.
- The hollow needle is developed by Alexander Wood and the hypodermic syringe by Charles Gabriel Pravaz.
- Alexander Wood uses hypodermic syringe for subcutaneous injections.
- Queen Victoria allows chloroform to be administered to her for the birth of her seventh child. This ensures the place of chloroform as an anesthetic in England.
- Vaccination against smallpox is made mandatory in England.
- Between 8,000 and 9,000 people in New Orleans, Louisiana died of yellow fever. For many years the city suffered an almost annual outbreak of the disease in late summer.

1854
- The “War for Bleeding Kansas” escalates between American free and slave states.
- The Republican Party is formed in the U.S.

1855
- Florence Nightingale (1820-1910) introduces hygienic standards into military hospitals during Crimean War.

1856
- May 24-25: Massacre of Pottawatomie Creek, Kansas: slavers are murdered by free-slavers led by abolitionist John Brown. It was one of a series of violent incidents leading to the Civil War, and known as “Bloody Kansas”.
- August 29: Joseph K. Barnes, M.D. is appointed Surgeon/Major, U.S. Army.

1857
- In France, Louis Pasteur proves that fermentation is caused by living organisms.
- The New York College of Veterinary Surgeons is chartered at New York University.
- The British establish a military medical school in the wake of the disaster of the Crimean War.
- Dr. Elizabeth Blackwell establishes the New York Infirmary for Women and Children on Bleeker Street.
- French neurologist Paul Broca discovers that specific areas of the brain are specialized for particular functions.

1858
- Minnesota becomes a state of the U.S.
- John Snow, an early English expert on anesthesia, publishes a book on chloroform and other anesthetics.
- English anatomist and surgeon Henry Gray publishes his classic textbook, Gray’s Anatomy.

1859
- More than 1200 medical students resided in Philadelphia to study medicine at Jefferson Medical College or the University of Pennsylvania; 650 of them were from the South.
- January 25-27: The Battle of Solferino, northern Italy. Approximately 140 doctors were available to treat the 40,000 casualties. The devastation was witnessed by Jean Henri Dunant, a wealthy businessman. Dunant was so deeply affected that he later became one of the founders of the International Red Cross and the primary force behind the meeting of diplomats that became known as the Geneva Convention.
- October: Upon receiving news of abolitionist John Brown’s raid on Harper’s Ferry, a mass exodus of about 200 Southern medical students left Philadelphia.
- Florence Nightingale’s influential book, Notes on Nursing, is published.
- Dr. Elizabeth Blackwell estimates that 300 women had managed to “graduate somewhere” in medicine.
- First oil well is drilled at Titusville, Pennsylvania.
- Oregon becomes a state of the U.S.

1860
- Abraham Lincoln is elected 16th President of the United States; the state of South Carolina secedes from the Union in protest.
- Five medical schools existed in the South, 27 in the North and three in the border states.
- The first hospital-based medical school in the U.S., Bellevue Hospital Medical College, is established in New York.
- The U.S. has about 400 dentist graduates from three dental schools, and about 5,500 dental practitioners, most trained by apprentices.
- Lenoir constructs the first practical internal-combustion engine.

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Medical Advances Timeline: 1800-1849

1800
- The Royal College of Surgeons is founded in London.
- Eli Whitney invents muskets with interchangeable parts.

1802
- German naturalist Gottfried Treviranus coins the term “biology”.

1803
- German pharmacist F.W.A. Serturner isolates morphine, an opium alkaloid. It was named for Morpheus, the Greek god of dreams.
- Ohio becomes a state of the U.S.
- American Robert Fulton propels a boat by steam power.
- English inventor Henry Shrapnel invents the shell.

1805
- Rockets, which were originally created by William Congreve, are reintroduced as weapons in the British Army.

1807
- The medicinal pill-making machine is invented
- Charles Bell publishes his System of Comparative Surgery.

1810
- Homeopathy is introduced by Christian Friedrich Samuel Hahnemann in Germany in his Organon of Therapeutics.

1815
- After the battle of Waterloo, in present-day Belgium, it takes ten days to gather and treat the wounded. It is Napoleon’s last battle.

1816
- Physician Rene Theophile Hyacinthe Laennec of France invents the stethoscope to examine the sounds made by the heart and lungs.
- Indiana becomes a state of the U.S.

1817
- In New Orleans, Louisiana, the Creole Societe Medicale de la Nouvelle-New Orleans is founded. All transactions were in French.

1820
- John Hall is manufacturing breech-loading rifles at Harpers Ferry, VA
- In New Orleans, Louisiana, an English-speaking medical society, the Physio-Medical Society, is established

1823
- A building with an apothecary is erected in New Orleans by Louis Joseph Dufilho, Jr., America’s first licensed pharmacist. It houses today’s Historical Pharmacy Museum.
- “The Lancet”, the British medical journal, is founded.

1824
- The Medical College of South Carolina is founded in Charleston.
- A Treatise on the Diseases of the Eye is published by Dr. George Frick, the leading oculist in Baltimore, Maryland. This was the first American book on ophthalmology.
- The forerunner of the ophthalmoscope was created by Dr. E.G. Loring of Baltimore. It had sixteen lenses mounted on a rotating dist. Concave and plane mirrors were attached.

1826-1837
- First North American cholera epidemic.

1828
- The mineral Thorium is discovered and subsequently used for dental fillings. -In 1898 it was found to be radioactive.
- A Medical Department is established at the University of Virginia in Charlottesville.

1829
- The breechloading needle gun is invented by J.N, von Drayse.
- British chemist James Smithson bequeaths L100,000 to found the Smithsonian Institution in Washington, D.C.
- William Burke is hanged in Scotland for murder. He was found to have provided very fresh corpses for anatomy schools in Edinburgh.

1831
- Chloroform is introduced into medical practice. It was invented simultaneously by American Samuel Guthrie and German Justus von Liebig. It was administered by inhalation in a solution with spirits of wine called Chloric Ether.

1832
- The Anatomy Act is passed in the United Kingdom. This allowed hospitals and workhouses to hand over for dissection bodies that were unclaimed for two days.

1835
- Samuel Colt takes out an English patent for his single-barreled pistol and rifle.

1836
- The first medical periodical in the South, The Southern Medical and Surgical Journal, begins publication.
- The Patent Arms Manufacturing Company of Paterson, New York is established to manufacture and market revolvers and rifles.

1839
- Charles Goodyear devises a process to heat India rubber with sulfur, creating vulcanite. The material was used to make denture bases, replacing gold.
- The first medical journal in Louisiana, Journal de la Societe Medicale de la Nouvelle-New Orleans is published in French.

1840
- Baltimore College of Dentistry in Maryland opens with five students.

1842
- Crawford W. Long, an American physician, produces surgical anesthesia using ether.

1843
- A machine for making pills containing more than one ingredient, or “compound tablets” is invented.
- Oliver Wendell Holmes publishes The Contagiousness of Puerperal Fever.
- American social reformer Dorothea Dix reports to the Massachusetts Legislature on the shockingly bad conditions in prisons and asylums.

1844
- U.S. dental surgeon Horace Wells, a pioneer in the use of anesthetics, has nitrous oxide administered to himself for a tooth extraction.

1845
- The hypodermic syringe is introduced.

1846
- October 16: Successful demonstration of diethyl ether as an anesthetic at Massachusetts General Hospital by dentist William Thomas Green Morton. The substance had been known since about 1200 A.D.
- The Smithsonian Institution in Washington, D.C. is founded.

1847
- Elizabeth Blackwell is the first woman to enter medical school at Geneva (New York) Medical College.
- The American Medical Association is formed by a group of medical school professors who wanted to reform medical education.
- January 19: Scottish physician James Simpson, head of obstetrics at Edinburgh, introduces the use of chloroform as an anesthetic.
- Ignac Semmelweis develops his theory of puerperal sepsis in Vienna. His observations were not taken seriously by a large audience. It would be another 10 years before Louis Pasteur published his discoveries and even longer before surgeons realized that their ungloved, unwashed hands carried blood, soil, pus, excrement and germs into open wounds.
- A report on surgery to the College of Physicians of Philadelphia focused on the uses, power and safety of ether as an anesthetic.

1849
- Elizabeth Blackwell receives her medical degree in New York, prompting international media coverage. She then went to Paris to study midwifery at La Maternite.

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Medical Advances Timeline: 1746-1799

When was the stethoscope invented? Did Civil War doctors have hypodermic needles? When did surgeons first begin to use anesthesia for operations? What were the origins of Neurology? When were the first nursing schools established? Did mid-19th century physicians perform blood transfusions? When was an ambulance corps approved by Congress? See the progression as medicine transformed from an “art” to a “science” . . .

1746
- The compressive bandage to stop bleeding from wounds is introduced.

1747
- Primae lineae physiologiae by Albrecht von Haller, Switzerland, is the first textbook on physiology.
- Benjamin Robins, an English military engineer, addresses the Royal Society on the physics of a spinning projectile.

1749
- The Philadelphia Academy is founded. It will later evolve to become the University of Pennsylvania.
- Sign language for deaf-mutes is invented by Portuguese Giacobbo Rodriguez.

1751
- The first mental asylums are established in London.

1752
- Philadelphian Benjamin Franklin invents the lightning conductor.

1753
- James Lind, British naval surgeon, publishes his classic work on the treatment and prevention of scurvy by the use of citrus fruits.

1754
- The first female M.D. is graduated from the University of Halle, Germany.

1761
- Medical doctor B.G. Morgagni publishes On the Causes of Diseases in Bologna. It is regarded as the beginning of pathological anatomy.

1762
- First veterinary facility in Europe is established after centuries of wars, disease epidemics, livestock plagues and food shortages.

1765
- The first medical school in America opens at the College of Pennsylvania.

1766
- English surveyors Charles Mason and Jeremiah Dixon draw the boundary between Pennsylvania and Maryland, the Mason-Dixon Line. It later separates the slave and free regions.

1767
- English theologian and philosopher Joseph Priestly publishes The History and Present State of Electricity.

1771
- Italian physician and physicist Luigi Galvani performs the first experiments with bioelectricity: the relationship of electrical patterns and the nervous system.
- New York Hospital is founded.

1772
- The Paris Faculty of Medicine declares potatoes to be an edible food.

1777
- American engineer David Bushnell invents the torpedo.
- The American Continental Congress adopts the Stars and Stripes as its flag.

1779
- The first Children’s Clinic is established in London.

1780
- The American Academy of Sciences is established in Boston. Medicine is still considered to be an “art”.

1788
- New York is declared the federal capital of the United States.

1790
- Philadelphia, Pennsylvania becomes the federal capital of the United States.
Washington, D.C. is founded.

1791
- Vermont becomes a state of the U.S.

1792
- Kentucky becomes a state of the U.S.
- The world’s first chemical society is founded in Philadelphia.

1794
- The United States Navy is founded.

1795
- The first elite military medical schools are established in Paris and Berlin.
- Based on James Lind’s 1753 findings, lemon and lime water for the prevention and treatment of scurvey, was stocked aboard all British naval vessels.

1796
- Tennessee becomes a state of the U.S.
- English physician Edward Jenner introduces a vaccination against smallpox.

1798
- The Department of the Treasury establishes The Marine Hospital Service, authorizing marine hospitals for the care of American merchant seamen.

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Top Ten Surprising Things About Civil War Medicine

1) There wasn’t an ambulance to be found. The American Civil War spurred a revolution in emergency rescue and evacuation. Union Major Jonathan Letterman devised the first dedicated ambulance system with trained personnel. Our 21st century emergency rescue systems are still based on his concepts.

2) Most doctors had never performed surgery or seen a gunshot wound. Of the estimated 16,000 physicians who served in the Civil War, only 5% had ever seen or performed surgery. They would learn from hasty training, field manuals and the experience of working with hundreds of thousands of casualties.

3) Anesthesia was used for most wartime surgeries. Despite widespread tales of soldiers biting on bullets while undergoing surgery, almost all Civil War surgeries were performed with the use of ether or chloroform. Dentists in the United States had been using anesthesia since the 1840’s and Northern and Southern surgeons quickly embraced its use. Both armies maintained a steady supply throughout most of the war.

4) Operating conditions were filthy by modern standards. Nothing was sterile. News of European research on sterilization of wounds had not reached America. Surgeons were known to sharpen their scalpels on the soles of their boots. Silk for sutures was wetted with the doctor’s saliva. President Lincoln’s fatal head wound was probed with the unsterilized fingers of some of the most respected physicians of the period.

5) You couldn’t find a trained nurse to save your life. Before the Civil War, family members usually provided care for ailing relatives. The 1,000,000 wartime casualties required a rapid organization and training of volunteer nurses to aid in the massive relief effort. Their work would lead to the establishment of formal schools and associations for skilled nurses.

6) Nerve injuries were identified and addressed for the first time. Dr. Silas Weir-Mitchell of Philadelphia, worked with many post-surgical amputee patients. He noticed some common phenomena, including “phantom limb”. Dr. Mitchell’s observations and treatments formed the basis for our modern medical area of specialty known as neurology.

7) Civil War medicine brought a new perspective to the lives of American women. In a passionate outpouring of support, women emerged from the parlors and plantations onto the battlefields, the hospitals, and prisons to nurse the wounded. They appeared publicly in business for the first time and took on the task of fundraising for the relief effort.

8) The concept of Medical record-keeping on a large scale before was born. From meticulous records kept throughout the war, The Medical-Surgical History of the War of the Rebellion, a massive six-volume compendium, was published. It included case histories, autopsy reports, disease records, post-surgical photographs and follow-ups. It was the first comprehensive study and analysis of its kind and was considered by the European medical community to be America’s finest contribution to the future of medicine.

9) The largest post-war budget expenditures of some Confederate states were for prosthetic limbs. Despite the non-sterile conditions of Civil War surgery, a surprising 75% of amputees survived. Their needs spurred the makers of artificial limbs to improve the comfort and effectiveness of their products.

10) The elements of “triage”, or sorting of the wounded, appeared during the Civil War. Amputation of a wounded limb was the quickest way to save a life. Chest, abdominal and head surgeries were rarely attempted, and those patients were usually left to die.

Related Articles:
Ten Common Myths about Women in the Civil War and How to Dispel Them
How Civil War Photography Changed War
10 Surprising Civil War Facts

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Improved Civil War Ambulances

The Civil War was a landmark in the evacuation and treatment of battlefield casualties. It was the first mass evacuation of wounded troops and its lessons and innovations were quickly adopted in Europe. “The American War” had introduced a trained ambulance corps, improved and designated ambulance vehicles and the use of field hospitals near the battlefield. These systems became standards of battlefield and disaster medicine.

Early in the war, the wounded lay on some battlefields for as long as three days. No designated vehicles were assigned to ambulance duty. There were no trained attendants to carry stretchers. Men deployed to the task were usually those too weak, sick, drunk or frightened to fight.

Major Jonathan Letterman, Medical Director of the Army of the Potomac, instituted a plan. Letterman’s design was a model of organization for medical support. The elements of his concept are still used in modern wars.

Major Letterman’s plan called for transporting the wounded to the hospital in dedicated vehicles, dropping them off with their bedding, picking up new supplies at the hospital and returning to the front. The ambulances of a division would move together with specified personnel to collect the wounded from the field, bring them to dressing stations, then to the field hospital. The plan was implemented in August of 1862 with regulations for the organization of the ambulance corps and the management of ambulance trains.

Jonathan Letterman’s Ambulance Corps was a huge improvement over the previous methods of evacuating casualties. The new system was partially tested at Antietam on September 17, 1862, the single bloodiest day of the war. The field was cleared of its 23,000 casualties within twenty-four hours.

In March, 1864, Congress published General Orders No. 106, an act (Public 22) to create an Ambulance Corps for all the Union Armies. By this time, the Corps was in general use throughout the Union Army. The Confederates had adopted a similar program, although they never put their ambulances under the medical service, keeping them under the quartermaster.

The Americans also pioneered specially designed trains and boats to transport the wounded. The Civil War ambulance-to-field hospital system remained in use by Americans and Europeans during all large wars for almost a hundred years, until the introduction of helicopter evacuation.

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Civil War Pharmaceuticals

Army physicians treated their patients with the most advanced care available, but those treatments were frequently ineffective and sometimes harmful.

They applied preparations like croton oil, which burned the skin, in the belief that a “counter irritant” would increase blood flow. It didn’t work. Soldiers weak from diarrhea were dosed with emetics to induce vomiting in the belief that “cleaning out one’s insides” was beneficial. It wasn’t.

A few effective drugs were available to Civil War physicians. Ether and chloroform, the anesthetics, were routinely administered. Belladonna was helpful in the treatment of intestinal cramps.

The narcotics opium and morphine were used to treat pain and diarrhea. The liberal use of these drugs was criticized after the war for the proliferation of addition, often called “Old Soldier’s Disease.” The rising consumption of opium in the United States peaked in the 1880’s, with commercial opium preparations that were available without a prescription. More women than men were classified as opium addicts in the post-war period.

Quinine, known since the 16th century, was one of the most effective medicines available. It was used to treat fevers of all kinds but was especially helpful in treating the chills and fever of malaria. Powers and Weightman, a Philadelphia-based firm, was the nation’s largest supplier of quinine.

Turpentine was routinely prescribed for oral and topical use in America and Europe. When quinine wasn’t available, Confederate surgeons substituted turpentine.

”Blue Mass”, a claylike compound, and “blue pills” both contained the toxin mercurous chloride. They were used to treat many ailments, sometimes causing severe reactions. President Abraham Lincoln used “blue pills” to combat chronic constipation.

Before the Civil War, the U.S. Army had purchased medicines on the open market. During the course of the conflict, the Union army began to rely heavily o a few large domestic drug companies for stable prices and inventories.

Fueled by the demand for medicines during the Revolutionary War, a North American pharmaceutical industry had sprung up from Baltimore to Boston, with several firms based in Philadelphia. Many of these companies were founded by pharmacists and physicians with names like Wyeth, Warner, Upjohn and Dohme. As the Civil War progressed, existing companies including Powers and Weightman and the Pfizer Company increased their production of drugs like iodine, morphine, chloroform, tartaric acid and camphor.

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Infections in the Civil War

If a soldier survived his wound and subsequent surgery, he wasn’t necessarily healed. He still faced the looming specter of infection.
Infection can develop when a great amount of tissue damage and necrosis, or, death of the tissue, exist. Civil War doctors didn’t know the causes of infections and weren’t able to treat them. Frequently, the infections reached a stage where amputation of the infected limb became the best option.

Although surgeons were aware of a correlation between cleanliness and a low infection rate, most battlefield conditions didn’t permit even a cursory attempt at cleanliness. Sterilization of wounds and surgical tools was unknown.

Almost every soldier who underwent surgery during the war suffered post-operative infections known as “surgical fevers”. Most of these were actually caused by Staphylococcus aureus and Streptococcus phyogenes, bacterial cells that generate pus, destroy tissue and release deadly toxins into the bloodstream.

Surgeons unwittingly passed these germs from one patient to another as they reused bloodied instruments with unwashed hands. Bullets were also responsible for carrying dirt and germs into the wounds.

Nothing about the surgeries was sterile or antiseptic. After probing a wound with unsterilized instruments or fingers to remove pieces of bullet, shell or bone, doctors sprinkled morphine powder into the wound, packed it with moist lint or unsterilized cotton and bandaged it with wet, unsterilized bandages.

Alcohol, bromine and iodine were in use, but not recognized for their antiseptic properties. Inflammation and quantities of pus—known as “laudable pus” were expected as part of the “healing” process.

Ironically, it was just at this time that Louis Pasteur of France was demonstrating his “germ theory”—the concept that invisible organisms caused the infection of surgical wounds. Joseph Lister of Scotland was basing his own work on that theory.

In 1865, Lister, who would become known as “the father of antiseptic surgery”, successfully used carbolic acid to prevent wound infection. If the work of Lister and Pasteur had been known and accepted during the Civil War, the use of even simple vinegar as an antiseptic would have dramatically reduced the number of deadly infections.

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Treatment of Burns During the Civil War

Civil War soldiers faced serious problems from burns. These injuries were produced by ordinary fire or by the explosion of gunpowder. They varied from the trivial to the most serious lesions. The treatments offered were the most advanced then available, and doctors did have some satisfactory results.

The famous Dr. Samuel Gross recommended the use of white-lead paint, the type used in the arts. The paint was mixed with linseed oil to the consistency of heavy cream. It was applied directly to the burns to cover them completely. A dressing of lint or cloth was then applied.

The application of wheat-lead paint to burns was a precursor to some of today’s treatments. Many burn patients were successfully treated with paint during the Civil War. The paint was soothing, and it diminished fluid loss from the burn surfaces. There was a danger of lead toxicity when the burned surface was very large, and a susceptibility to infection as none of the ointments or dressings were sterilized.

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