Civil War Medicine

To be a wounded solider during the Civil War was not a pleasant experience. The medicinal and medical practices that were used were not innovative under any circumstances, and were only slightly more advanced than medieval times. It is a great calamity that the medical knowledge of this time had not yet comprehended the importance of sanitation, sterility, or the practical use of medications. The barbaric and immoral practices used during this time period caused much hysteria and misery for the poor patients. During surgeries and procedures, without the pain-reducing effects of anesthetics, patients suffered long-lasting mental trauma. Many also would submit to cardiac arrest and would perish; some soldiers would scream out in disorientation, while many other men lay silent, pale, or even unconscious from shock. Medicinal practices during the time frame of the Civil War were repulsive, immoral, and medieval in nature. Thousands of soldiers lost their lives not only on the battlefield, but under the attention of inexperienced doctors and surgeons. An average doctor during the mid-nineteenth century took two years of non-formal schooling, normally in a general four-year university.

This lack of medical training was in direct proportion to the absence of accurate knowledge during this time period. These men were inaccurately informed, because the teachers and professors that they were educated by were inexperienced and uninformed themselves. The overtone of cleanliness and of health was not commonly understood. During the 1860’s, doctors had not yet perceived the idea of bacteriology, and all citizens were commonly ignorant of the spread of disease and how it was caused. Most surgeons and doctors on duty during the Civil War had never conducted a procedure in relation to a gunshot wound, and many had never executed a surgical procedure whatsoever. Several doctors were presented to perform surgery for the first time on the battlefields during the Civil War, and had to respond and perform by adjusting and adapting. Armies belonging to both the Union and the Confederacy during the war assigned only one surgeon and one or two assistant surgeons per regiment.

These surgeons would perform operations rapidly and they were normally conducted on the battlefield under a tent, or in available schoolrooms, warehouses or barns. Inexperienced surgeons performed poorly during this period and consequently caused many of the soldiers’ deaths during the Civil War. The medication that the doctors prescribed during the Civil War, for the most part, accomplished the opposite of the intended affect. During the 19th Century, some patients were given a concoction of chalk, honey, (sometimes licorice) and an extreme amount of mercury. This was prescribed by doctors for anything from a simple headache to a dangerous case of syphilis, but turned out to be a poisonous mixture. Another substance that was used as a medicine during the Civil War was alcohol. Alcoholic beverages were used to help treat a wide variety of maladies, and patients received high amounts of doses to prepare them for surgery or to prevent them from going into shock. Alcohol was used as a depressant to lower the patient’s acuity of pain, consequently making it appear to be healing. In actuality, this form of remedy was proven to be of little use.

Wards and their doctors also commonly used quinine for malaria and fevers, ipecac to induce vomiting, and opium as a general painkiller. Confederate doctors, who were denied imported medicines by the Federal blockade, had to rely on creating their own remedies from native plants, with only the use of a mortar and pestle. These men who were trained with little medical experience were given a list of approximately 410 local plants with therapeutic or beneficial value, and were sent into forests and fields to locate them. These medical alternatives were normally proved worthless, but were commonly seen as being better than nothing. The tools that doctors and surgeons used during the Civil War were the exact opposite of progressive, in terms of the technological field. One of the main tools used was a scalpel, which was used to open skin, cut bandages, scrape bones, slice muscle, and lance boils. These practices were considered very dangerous, especially when dealing with older wounds where infection was prominent. Another tool frequently used was the bone saw, and surgeons who used this instrument were given the names “butchers” or “sawbones.”

It was used to amputate soldiers who had been injured on an arm or a leg. An average amputation procedure normally took approximately ten to fifteen minutes to cut through the flesh of the appendage, and then surgeons would proceed to saw through the bone. After this chore was accomplished, the surgeons would simply wipe the blood off of their bone saw, and continue on to their next patient. The doctors and surgeons on the field during the Civil War paid no attention to cleaning or washing their hands or tools before operating, or before finger probing the bullet wound of a patient; as a result, these men unsuspectingly spread infection rapidly. When doctors were examining President Abraham Lincoln’s head wound after he was shot, they dug their fingers into the open wound to retrieve the bullet, which was a very common practice during this time. In addition to the dirt and infection that doctors would spread on their hands, their instruments and surgery tools were just as repulsive.

When something was dropped onto the filthy ground, it would merely be wetted or rinsed into water, which was often bloodied. Doctors also used sponges to help clean open gashes and wounds; these sponges would merely be dipped in water before continuing to be used on the next soldier. The medical tools used during the Civil War were unproductive, and not unlike utensils used in medieval, barbaric times. As it were, Harvard Medical School did not see the use of a microscope or a stethoscope until the conclusion of the war. The lack of sterilization of tools used in surgery caused disease and infection to spread rapidly, causing a sick and miserable environment for the injured soldiers. The physical procedures that doctors practiced on their patients were placed under preposterous and nonsensical circumstances. Diagnostics and treatment of these men by inexperienced doctors, was very little more than guesswork. Of all field surgeries that were performed, seventy-five percent were amputations. There were two basic means of amputation at this time: circular amputation, and single-flap amputation. Circular amputation consisted of firstly, perpendicularly slicing the skin where the bone was to be sawed; and secondly, cutting away a cone of muscles and tendons.

While an assistant pulled the flesh away to reveal the bone, the doctor would proceed to saw through the bone of the injured limb. Single-flap amputation consisted of first diagonally cutting across said limb and closing off blood vessels. The doctor would then pile the flesh and extra skin over the bone and the open wound to create a more even and seamless closure than that of a circular amputation procedure. A surgeon in practice during the Civil War could do away with a mangled limb in just over fifteen minutes. These surgeons were taught through experience that when bones were cracked, fractured, or broken, an amputation was the only way to save a man’s life. However, many men died from cardiac arrest or from shock during the procedure, and most died afterwards due to infection. Most of the soldiers had no form of sedation during these surgical procedures; they simply had but a small object, such as a rolled up piece of cloth, to bite down on to try and cope with the pain. The first recorded use of anesthesia by chloroform was in 1846 and began to be commonly used throughout the Civil War. In truth, there were 800,000 recorded circumstances of its use during the war.

Chloroform was the main anesthetic and was used in seventy-five percent of operations during the Civil War. Doctors and/or assistants would douse a cloth with the liquid and would place it over the nose and mouth of the patient to send them into a state of unconsciousness. This procedure was the main component to a soldiers operation, and many of the poor men did not get the pleasure of an anesthetic. The procedures that doctors and surgeons practiced on their patients during the Civil War were downright brutal, repulsive, and barbaric. In addition to the revolting procedures performed on injured soldiers, many if not all men fell victim to illness during the war. Disease was the number one concern for doctors; nevertheless, infection and sickness ran rampant throughout the soldiers. The number one cause of death after injury was dying of blood poisoning or of other deadly infections.

Surgeons and doctors during this time were unwittingly responsible for the spread of disease and infection. They would wear blood splattered clothes, and would ‘clean’ their surgical utensils with little more than a swipe on their apron, or a rinse in bloody water. When the men in the war had experienced an open wound the surgeons and doctors would wrap the flesh in a bandage; usually made from raw cotton or, in desperate times, horse hair. These bandages were never sterile and the wards would insist upon keeping them moist. This may have granted the patient a short sense of comfort, but was overall a fatal tactic as the wet environment was ideal for the growth of bacteria. In the pressing times of a shortage, bandages were to be removed from deceased patients, given an infantile rinse, and positioned onto the next injured solider.

The wounds of these injured men were expected to be infected, and the festering pus in the injury was considered, by doctors, to be a part of the healing process. Doctors during this time period were unaware of the dangers of spreading infection, and it was a major cause of death during the Civil War. The injured soldiers who fought in the Civil War were deprived the benefits of modern medicine. The idea of Civil War medicine was rooted in a medieval ideology that risked the lives of all it was practiced on. It is a travesty and misfortune that surgeons and doctors during the Civil War had not yet comprehended the importance of sanitation or sterility in their medical knowledge. The inhumane methods of treatment caused the injured soldiers a great deal of agony. If a soldier did survive a serious injury during battle, they would have waited on the field for 48 hours or more before receiving medical attention. By then infection, blood poisoning, or disease would have already started to weaken and/or kill the poor soldier. For some, the pain and agony resulting from these archaic procedures would make them wish their lives had been taken on the battlefield.