Medicine in the Civil War
by Lori Austin
Most of us think of the American Civil War as a brutal time, with few medical innovations—and it was. The casualties of this war were the greatest in our history. Most estimates put the death toll at 620,000, though some go as high as 700,000. For the Union, over twice as many died of disease as died in battle. The Confederate disease toll wasn't quite that high but near enough. If one takes into consideration that the Confederacy had less men in the first place, and their records weren't as good, the loss is no doubt comparable.
However, the concept of "biting the bullet" as the only anesthetic is far from the truth. Certainly the conditions in the field were not ideal, and near the end of the war supplies were short. Still, most operations were performed after the administration of ether or chloroform. Reports of screaming from the operating tents were most likely the screams of men who'd just learned they would lose a limb rather than their screams as they were losing it.
Chloroform and ether was administered by dripping the liquid onto cloth then holding the cloth over the patient's nose. When he went limp, the operation commenced. Not the best technique, but better than the alternative. Many soldiers were only half asleep when the operation began. Stonewall Jackson was said to have remembered the sound of the saw cutting off his arm. In the Civil War, speed was often a surgeon's best technique.
Most physicians were aware of the connection between filth and infection, however they had no idea how to sterilize equipment. Because of the conditions—an overabundance of wounded, tents and barns used as field hospitals, a lack of any water, let alone clean water—doctors often went days without washing their hands, thus transferring bacteria from one man to another. A small cut on a hand could result in a "surgical fever" for the doctor himself. And penicillin wouldn't be discovered for another seventy-odd years.
If a soldier survived surgery and escaped fever, his pain might be alleviated by laudanum or morphine, which was made from the opium poppy. Often the drug was rubbed directly onto the wound in powder form. The liquid form could also be injected. As laudanum, the drug could be added to water and made more palatable with sugar. The drug in either form was highly addictive.
Though penicillin was not available to cure infection, quinine could offset malaria. However, the concoction had to be taken daily and the drug was so bitter most soldiers refused to take it all. When mixed with brandy, quinine became more palatable but brandy was soon in short supply. Luckily, malaria was not one of the most rampant diseases of the period.
Smallpox could ravage an army. A vaccination was available, but it was impossible to determine if the vaccination contained enough of the live virus to produce immunity. Nevertheless, most of the soldiers were vaccinated.
Dysentery, typhoid, yellow fever, scurvy, tuberculosis were common. Though we now know poor hygiene, contaminated water and food, overcrowding, poor diets and insects caused these diseases, at the time there was little understanding of such things. Physicians treated the ailments as best they could, though sometimes the cure could kill. For instance dysentery, characterized by intense diarrhea, was treated with "blue mass" a mixture of chalk and mercury. Then again, some physicians treated dysentery with the cure-all of laudanum, a side effect of which was constipation.
Though the Civil War period is considered by many to be lacking in medical treatment, in truth there were many brilliant doctors who applied appropriate cures. Nevertheless, the sheer amount of the afflicted, combined with horrific conditions assured an incredible rate of casualties.
I'm giving away a $25 Amazon gift certificate to one random commenter today so you can purchase your choice of new books along with Beauty and the Bounty Hunter, released October 2.
Small print: Drawing will be held Saturday, October 13, 2012, at 9pm Pacific Time. Be sure to include your email address with your comment or we'll have to choose another winner.
Thanks for being with us this week, Lori!