Middleton Goldsmith and the Use of Bromine to Treat Gangrene

From: library.uthscsa.edu

The P. I. Nixon Medical Historical Library owns a report to the Surgeon General of the United States by Civil War surgeon Middleton Goldsmith on the use of bromine to treat hospital gangrene in wounded soldiers. Published in 1863, the report is entitled A Report on Hospital Gangrene, Erysipelas and Pyaemia as Observed in the Departments of the Ohio and the Cumberland, with Cases Appended. It contains detailed case reports, a foldout table containing all of Goldsmith’s research data, and his correspondence with other surgeons on the treatment of gangrene. The overall mortality of hospital gangrene cases from the Civil War has been reported as 45.6% (The Medical and Surgical History of the Civil War, Washington, U.S. Government Printing Office, 1875-1888). However, only 8 of Goldsmith’s 304 patients receiving bromine-based therapy for gangrene died, a mortality rate of only 2.6 per cent.

Goldsmith’s work predated Joseph Lister’s 1867 paper linking microbes and surgical infections and Louis Pasteur’s groundbreaking work on microbes, also published after the Civil War. Goldsmith did not know what agent caused the gangrene, erysipelas and pyaemia he observed in the wards of his hospitals, but he theorized that they were related to each other and sought a curative agent to cure the infections and prevent the spread between patients.  Goldsmith’s data was so meticulously documented that it was easy to prove his bromine treatment had cured his gangrene patients. By the conclusion of the Civil War, surgeons throughout the country applied variations of Goldsmith’s bromine therapy regimen in the treatment and prevention of gangrene.