Monday, December 28, 2015

The Civil War: Medicine, Wounds and Diseases


The Civil War. Many nations and countries had one. But there was a lot more riding on the American Civil War than just political disagreement. Brave men fought each other for what they believed was right; there were many reasons to choose sides. There were just as many reasons to die for that side. In fact, approximately one out of every four Civil War soldiers died during the conflict.

The Civil War is ranked number one in total number of deaths in any war fought by our nation. There were more deaths in this war alone than in World War I, World War II, the Vietnam War and the Korean War combined. These wars are in the top five total number of deaths, and combined
they are still less than the Civil War. And even with all this death, a soldier was far more likely to die from an illness, such as typhoid fever, than he was from getting shot.

There were nearly 625,000 deaths in the war and 388,580 (well over half) of them were due to this lurking predator. In the final count, disease was the unrivaled contributor of Civil War deaths.
So why were over half the deaths in America’s bloodiest clash due to disease?

Well, at that point in time medical progress was just nearing the end of “the medical Middle Ages.” There was little understanding of the cause of diseases, how to cure them or prevent them. Medical training for doctors, surgeons or physicians was barely adequate, and even medical school graduates had very little experience. Two years of book-learning and a few weeks of training was all that was required to become a doctor. There was also a huge hygiene issue. Many diseases could have been taken care of by doing something as easy as taking showers, clearing the waste away from camp or isolating the sick. Regulations that had been in practice since before George Washington’s time were needlessly ignored.

The top three killing diseases of the war were dysentery, typhoid fever and pneumonia. These diseases often started off as something simple and easily treated, like a cold, but grew into something fatal, like pneumonia. Other diseases were caused by poor diet and exposure to the elements, also something that was being ignored and could have saved lives.

Nevertheless the brave doctors and surgeons of the time did the best they could with what they had. Primarily on the Confederate side, whenever medicine was unavailable they would use nature’s “substitutes,” using American hemlock for opium, dogwood for chamomile, wild jalap for ipecac, hops for laudanum and even dandelion for calomel!

Amputation was also a huge source for disease and infection. And with the sanitary conditions at that time, or lack thereof, fighting infections proved to be a very difficult task. Surgeons rarely cleaned their instruments, because they didn’t have time or didn’t think it important. Diseases and infections were then quickly spread from patient to patient. Despite this, 75% of the amputation patients survived. And believe it or not, these surgeries actually saved more lives than they didn’t.

Surprisingly, almost all of the gruesome stories of going through an amputation without anesthetic
aren’t true. The biting down on a bullet to ease the pain was, more often than not, a myth.

Chloroform and ether had already been in use for years before the war. The surgeons would generally use chloroform before-hand, so the sounds of screaming usually came from soldiers that were watching or the soldiers that were just informed that they were going to lose a limb.

Chloroform was preferred over ether because it worked faster and didn’t explode. It was from amputations that surgeons got the nickname “butchers”. This isn’t at all shocking when you consider that three out of four surgeries on the battlefield were amputations.

So what about afterwards? What happened when all these wounded soldiers came home? As a matter of fact many of them didn’t. There were so many deaths and so much destruction that many of the soldiers that did return had no home to return to. The entire nation was in debt, and some states had to spend a part of what little money they had just on prosthetic limbs. So even if the soldiers, now veterans, had a home to come to, many of them couldn’t enjoy it. They weren’t of much use on the farm or business with an arm or leg missing. That is, if the farm or business wasn’t destroyed from the warfare. Also many of them had chronic illnesses. For some poor soldiers, the diarrhea or fever that they caught at camp during the war haunted them for the rest of their lives. Some of them even came home as opium or morphine addicts from what was supposed to help, but now hindered. The veterans that were fortunate enough to survive the bullets, diseases, infections and amputations now came home to devastation, destruction and emotional turmoil.

However, there is at least one bright light in this cloud of gloom. Even though it took the Civil War to make a change, America’s medical field was finally progressing. Doctors and surgeons now knew the best ways to treat a patient, the right amount of chloroform for an amputation, and the most important, the necessity for cleanliness. During the war many surgeons realized that infection and disease were caused by the unsanitary conditions of the average battle camp. Although they still didn’t think it as important as other things, both sides benefited from this new information.

“Throughout the war, both the South and the North struggled to improve the level of medical care given to their men. In many ways, their efforts assisted in the birth of modern medicine in the United States. More complete records on medical and surgical activities were kept than ever before, doctors became more adept at surgery and at the use of anesthesia, and perhaps most importantly, a greater understanding of the relationship between cleanliness, diet and disease was gained not only by the medical establishment but by the public at large.”

Even though there were so many obstacles to overcome during and after the war, at least there
was medical progression, possibly one of the greatest achievements of the Great American Civil War.


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