Tuesday, November 22, 2016

Diagnosing the Civil War

By Margaret Humphreys, 11-11-13

Germs, not guns, were the Civil War's deadliest killer. Far from the drama on the battlefield, hundreds of thousands of young men died from infectious diseases.

Margaret Humphreys, Trent Professor of the History of Medicine, discusses the challenges of fighting infectious disease on the battlefield in her latest book "Marrow of Tragedy: The Health Crisis of the American Civil War."

Humphreys, who has also written about yellow fever and malaria outbreaks in the American South, will discuss her research at noon Tuesday, Nov. 19, in 2002 Duke Hospital.

Humphreys spoke with Ezgi Ustundag of Duke Today to discuss her research on disease and the Civil War.

Q: How did you come to take an interest in the history of infectious disease in the U.S., particularly in the South?

HUMPHREYS: It all began with picking up one book, Charles Rosenberg's monograph on cholera in the 19th Century United States.  Then it was amplified by courses on the history of medicine at my undergrad school, Notre Dame, and in graduate school.

Q: How did you research the history of infectious disease in the American Civil War for your latest book?

HUMPHREYS: My interest in the Civil War goes back to childhood, as I grew up near Fort Donelson in Tennessee and Civil War historical markers were all around me. By the time I began this book I had completed two projects on the history of disease (on yellow fever and malaria) and it was natural to put my fascination with the Civil War together with my enthusiasm for disease and its historical impact. I began the research for Marrow of Tragedy in the late 1990s, and dove into the vast literature on the Civil War by reading the papers of the United States Sanitary Commission (USSC), which are available on microfilm.

The USSC was a Red Cross-like humanitarian NGO in the North that particularly focused on the health and disease of soldiers. Other sources, aside from published books and articles, were the wonderful manuscript collections at Duke, UNC, the South Carolina State Archives, the Massachusetts Historical Society and the Museum of the Confederacy. Manuscript collections preserve letters, one-of-a-kind sources that reveal much about health and disease.

Q: What are some common misconceptions related to infectious diseases that people hold about the Civil War? How does your book address those misconceptions?

HUMPHREYS: The most common misconception about Civil War medicine in general is that they had to "bite the bullet." Wrong! Anesthesia with ether and chloroform had been introduced by 1860 and was available for operations throughout the war. They also had opium compounds.

Also common, in regard to infectious disease, is the assumption that antibiotics (20th century drugs) are necessary for survival, so that health care made no difference in the Civil War. But I found that there were degrees of good and bad health care, and understanding that led me to emphasize the factors that increase or decrease immune function in the absence of antibiotics. These factors seem mundane, but were crucial--abundant, nutritious food; cleanliness of person and environment; opportunities for sufficient rest and warmth; and hydration. You can see the difference in comparing Northern and Southern disease outcomes, as food and care were ample in the North and sorely lacking in the South.

Q: Why is the story of infectious disease in the Civil War one that the general public -- not just individuals interested in disease pathology -- should be aware of?

HUMPHREYS: I hope my readers will reconsider what matters in the sick room and the key aspects of healing. Many medical lessons were learned and applied in the Civil War that are not irrelevant to the modern day. If interested in the Civil War, I hope they can also learn to see the war as not just a glorious account of battles and victory/defeat, but as a health crisis that killed more than a million Americans and was a great tragedy for the nation.

Image: The United States Sanitary Commission helped track health and disease during the Civil War.


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