Wednesday, August 5, 2015

Civil War Medicine Ushered in Some Modern-Day Techniques

By Angie Mason, 7-3-2013

Triage medicine was first used during the Civil War, and Gettysburg was one of the first places it was put into play.

The first of the wounded staggered onto the Daniel Lady Farm just outside Gettysburg, moaning and clutching his bloody midsection. He went straight to the operating table, an old barn door supported by bales of hay.

Moments later, as more wounded Confederates streamed in, someone pulled a sheet over the soldier's face.

The event, sponsored by the Gettysburg Battlefield Preservation Association, kicked off living history events that will be held Sunday through Thursday at the farm. Re-enactors will demonstrate Civil War-era medical procedures, such as pill-making and amputations.

Brian Butcher, a 48-year-old East New Market, Md. resident, acted as surgeon for the first wounded soldier. A former police officer and paramedic, he now teaches for the University of Maryland's Maryland Fire and Rescue Institute.

"It's really not much different," he said, comparing working in emergency medicine then and now. "You see the wounds and you treat them."

George Wunderlich, executive director of the National Museum of Civil War Medicine, in Frederick, Md., said that before the Civil War, there was no real organization of emergency medicine.

Medical triage before then was ineffective, he said. There was no one assigned to assess wounds, and if anyone did, it was inconsistent. Gettysburg was one of the first times the system known as the Letterman plan, named after Civil War surgeon Jonathan Letterman, was widely used.

According to the Civil War Trust, Letterman, named medical director for the Union in 1862, revamped medical services because it took so long to help the wounded. He developed an ambulance system and evacuation system consisting of field dressing stations, field hospitals and large hospitals, plus an efficient way to distribute medical supplies.

Scott McGaugh, author of a book on Letterman, told Time magazine that the surgeon "made battlefield survival possible by professionalizing combat medicine."

Wunderlich said seeing an ambulance or emergency room in action today is "seeing Civil War Medicine as it exists in the 21st Century." "I'm an old EMT," he said. "The way we do it today is really similar."

Neely, executive director of the Adams County Historical Society, a partner in the new Gettysburg Seminary Ridge Museum, said the war led to advancements in prosthetics, since men who had lost limbs needed to go back to work.

As medicine was still advancing, many soldiers underwent surgeries after the war, and some died of their wounds years later, he said. Wunderlich said that the Civil War led to many other developments, such as the idea of specialized hospitals and doctors, and a method of putting someone's leg in traction.

His museum trains medical professionals for the military, who still report learning lessons they say are helping them in the field. "There's a lot still to be learned from Civil War medicine," he said.

Butcher said that even some of the tools used in the Civil War haven't changed much, in terms of their design and purpose. But materials have changed, he said, citing an amputation saw having a handle of steel instead of wood.

Next week, he'll be involved in a re-enactment in a dual role, serving with the unit but also providing any modern day medicine that might be needed.

His roles collided a bit on Friday, when he grabbed a modern medical bag to help when some re-enactors suffered the effects of the heat.

When John Ream, of East Berlin, Pa., participates in a re-enactment this week, he'll have a blood pressure cuff, stethoscope and other first-aid supplies in his haversack. He'll be dressed in uniform but will act as EMT for his regiment.

The 73-year-old, who retired as assistant chief psychologist with the state corrections department, said that since he is an EMT, he thought it would be nice to get into medical re-enacting instead of doing infantry. On Friday, he portrayed a hospital steward, which he described as a sort of modern-day paramedic.

He researched and found the diary of someone who set up a field hospital during the war, so "I can follow actual traditions of what went on," he said. If he was an EMT on a mass casualty incident, he said, he'd be thinking about the same triage procedures as those used in the Civil War, he said.

Drew McDonald, from Santee, S.C., has a collection of both reproduction and original Civil War medical tools, as well as medical books from the time period, including an 1862 edition of Gray's Anatomy.

"I'm not a doctor," he said. He's a car parts salesman. But he's determined to correct misinformation that goes around about Civil War medicine. Movies sometimes show doctors grabbing the amputation saw first, he said, but that wouldn't be the first tool used in such a procedure.

"We try to get information out that the movies have so badly distorted," he said.

Image: Re-enactors from the 2nd Florida Volunteer Infantry recreated the July 2, 1863 assault of the 1st North Carolina Infantry on Culp's Hill Friday, retreating back to the farm - which was a Confederate field hospital during the Civil War - where they moved through medical triage. The Florida Regimental Medical Department provided simulated medical treatment.


Civil War Medicine is a four-part series that honors the unsung heroes of the Civil War and celebrates our breakthrough period of medical advancement.

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