Allow me to shift back about one hundred and fifty years to our nation’s Civil War. With all the talk of health care today, and what might or might not happen if HR 3200 is passed by the House of Representatives, I thought I would take a respite from the current woes and look at what were real advances in medicine circa the 1860s.
The numbers of men lost during the Civil War are staggering by any standard. All together there were about 620,000 losses due to battle deaths and disease. The Union forces lost 360,222, while the Confederate forces lost 258,000, although many records were lost by the Confederates. This total number of losses has been placed at nearly 700,000 by some historians. In any event, this is more deaths than any other war the United States has ever engaged in. It is because of this war that so many advances were made in the field of medicine.
The losses combined for the two armies reveals some interesting numbers. By a little more than 2 to 1 disease killed more men than bullets. There were a number of reasons for this. First, we simply had not developed medicines, or had sufficient knowledge in medicines then to save lives. Those medicines that were available were usually in short supply. Most medicines at that time were home remedies. Among the items found in a doctor’s medicine bag included: condensed milk, sugar and black tea. Having a patient bite down on a stick or a bullet while setting bones or hacking off a limb was not created in Hollywood for special effects in the movies – it was the only thing that could be done. In fact, this is where the expression, “Bite the bullet” came from. Second, any respectable conditions for hygiene were nearly impossible to maintain in the battlefield conditions of that time. Cleanliness was a luxury – impossible to attain. Third, surgical tools were brutal, leaving men with enormously grotesque scars, limb loss, and disfigurement. To their credit, many of these battlefield doctors kept journals of their patients, including photos (something quite new) so they and others later could learn from these experiences. The chilling facts are that three out of every four surgical procedures were amputations. Fourth, early in the war, wounded soldiers would be taken to railroad depots where they would have to wait for a train to come to transport them to the nearest city with a hospital. Depending on how the battle went, the wounded might have to wait hours or days before a train could safely be brought to the depot – if at all. Many died lying beside the tracks. There is a scene from “Gone With the Wind” which depicts this problem. What looks like hundreds of litters stretched out in rows by a train station are the wounded waiting for the train. It is a horrific scene. Men are crying out in pain, plus they are thirsty due to dehydration from loss of blood.
It was at the Battle of Corinth (Mississippi) in 1862 that the idea of setting up a field tent to care for the wounded right there where the fighting was taking place was first tried. Earlier on my great grandfather worked as a nurse in the makeshift hospital in the town of Corinth. This hospital was actually the Tishomingo Hotel. Because the hotel was only a hundred yards from the train station, it was logical to use the hotel as a temporary hospital. Even then, it was more of a way of making the wounded comfortable while they waited to be taken by train to a hospital in a safe city. When the doctors proposed using medical field tents to treat the wounded they quickly became part of the army wherever it went from that time forward. Doctors knew that the sooner they could have their patients treated, the greater chance that patient had of surviving. This may well be the reason my great grandfather, who was seriously wounded a couple of months later in that same area, survived. Not only did he survive, but his wounded right arm was not hacked off. Granted, his use of that arm was limited from that time on, and was a prime reason he was discharged, but he was alive.
The design of hospitals was forever changed because of the requirements of the Civil War. The “pavilion design,” which is any of a number of separate or attached buildings forming a hospital or the like, became the format by which hospitals are built even today.
Anesthesia was first introduced in the United States in 1846. However, very few surgeries were performed in those days. The Civil War would change all that! Chloroform was routinely used which allowed doctors to work on patients who were no longer squirming, thrashing or crying out. It also lessened the shock to the patient, saving yet more lives.
Because women were called upon to assist in caring for the wounded and dying, a whole new area of work opened for women. Clara Barton, founder of the Red Cross during the war, was a trail blazer for women moving into the workplace following the war.
Though war is ugly at best, there are those who chose to see some good come from it. Many of these people served in the field of medicine. Perhaps it was best said by Union nurse, Mary Livermore, in caring for others: “People of all conditions and circumstances, wise and unwise, rich and poor, women and men, went thither for inspiration and direction. Scenes were there enacted and deeds performed which transfigured human nature, and made it divine.” (Medical Practices in the Civil War, by Susan Provost Beller, 1992).
Here’s to your health!