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Civil War Medicine

There were many medical advances made during the American Civil War. When the Civil War began in April 1861, medicine was approaching what Surgeon General William Hammond called "the end of the medical Middle Ages." American physicians had little knowledge of the cause and prevention of disease and infection. (Maher, pg. 1)

The Army Medical Department, which was responsible for the care of the sick and wounded in the North, was unprepared. The staff of 90 doctors was experienced in dealing with the health problems of small military outposts, but had no idea of how to deal with large scale medical and logistical problems.

Unfortunately, the war occurred just a few years before Louis Pasteur discovered the role of germs in infection; doctors dug bullet fragments out with unwashed fingers and operated with bloody

instruments for lack of clean water (Thomas, pg92). A surgeon recalled: "We operated in old blood-stained and often pus-stained coats, we used undisinfected instruments from undisinfected plush lined cases. If a sponge (if they had sponges) or instrument fell on the floor it was washed and squeezed in a basin of water and used as if it was clean." Civil War surgeons actually thought pus in a wound was good (Maher


Second to disease as a cause of death was battlefield injuries, totaling some 200,000 casualties. The overwhelming number of wounded created problems in removing them from the battlefield. As late as 1862 there was no ambulance corps on either side. In August of that year, however, Union General George B. McClellan authorized the creation of a trained ambulance corps for the Army of the Potomac, and other armies, both Union and Confederate, soon did the same.

The field hospital was hell on earth. The surgeon would stand over the operating table for hours without a let up. Men screamed in delirium, calling for loved ones, while others laid pale and quiet with the effect of shock. Only the division's best surgeons did the operating and they were called "operators". The ones wounded through the head, belly, or chest were left to one side because they would most likely die. This may sound somewhat cruel or heartless, but it allowed the doctors to not waste precious time and to save those that could be saved.

Risks from surgery were great. Doctors in the field hospitals had no notion of antiseptic surgery, resulting in extremely high death rates from post-operative infection. Some surgeons ignored anesthesia, instead relying on the "surgical shock" of battle, when the patient's heart rate was greatest, to amputate.

The slow-moving Minie bullet used during the American Civil War caused catastophic injuries. Amputation of a wounded arm or leg was the most common operation, due largely to the .58 caliber Mini ball ammunition used during the war. The old, round bullets fired from a smooth-bore musket bounced off bone and were accurate to less than a hundred yards. The new, pointed projectile spun through a rifled bore, the spin producing a bullet accurate to 300 yards. The heavy, conical bullet tore into the skin, carrying dirt and clothing with it and smashing the bone, often not exiting because of its large caliber and low velocity. Because of the severity of the wounds and the overwhelming case load, surgeons usually elected for fast and easy amputation over trying to remove the bullet and save the limb. The closer to

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Approximate Word count = 1444
Approximate Pages = 6 (250 words per page double spaced)


  

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