Civil War Medical Notes: adapted from http://www.civilwarhome.com/medicinehistory.htm
Civil War SoldierŐs chance of not surviving the war was 1 in 4
four year medical schools in the USA at that time
University didnŐt get itŐs first microscope or stethoscope until after
the war began, the Federal Army had 98 medical officers (for 16,000 men)
and the Confederate Army had just 24. By the end of the war, more than 11,000 men had served
in the Union medical corps, and more than 4,000 for the Confederacy.
medicos treated over 10 million cases of injury and illness over the span
of four years—talk about overwork!
were bad. But despite that
the medical care was improved over previous wars. 90% of Mexican War deaths were non-battle
related; only about 55-60% in the
of the approximately 620,000 deaths in the war, 388,000 died from disease.
were, however, lots of wounds. There, lying on
clumps of hay or bare ground, the wounded awaited their turn on the
operating table. Contrary to legend, there was usually little shouting,
groaning, or clamor because the wounded were quieted by shock and the
combination of liquor and opiate. It
was an eerie scene, with a mounting pile of amputated limbs, perhaps five
feet high, the surgeon and the assistant surgeon-after a few months both
Union and Confederate authorities decided that two assistant surgeons were
necessary in a regiment -cutting, sawing, making repairs, and tying
ligatures on arteries. The scene was especially awesome at night, with the
surgeons working by candlelight on an assignment that might sometimes go
on for three or four days with hardly a respite. And there was always the
smell of gore.
wounds to the head, neck and abdomen were nearly always fatal, surgeons
did not often treat those patients.
Instead, the focused on wounds to the extremities (legs and arms). Of the approximately 175,000 wounds to the extremities
received among Federal troops, about 30,000 led to amputation; roughly the
same proportion occurred in the Confederacy. One witness described a
common surgeon's tent this way: "Tables about breast high had been
erected upon which the screaming victims were having legs and arms cut
off. The surgeons and their assistants, stripped to the waist and
bespattered with blood, stood around, some holding the poor fellows while
others, armed with long, bloody knives and saws, cut and sawed away with
frightful rapidity, throwing the mangled limbs on a pile nearby as soon as
- Everything about the operation was septic. The surgeon
operated in a blood- and often pus-stained coat. He might hold his lancet
in his mouth. If he dropped an instrument or sponge, he picked it up,
rinsed it in cold water, and continue work. When loose pieces of bone and
tissue had been removed, the wound would be packed with moist lint or raw
cotton, unsterilized, and bandaged with wet, unsterilized bandages. The
bandages were to be kept wet, the patient was to be kept as quiet as
possible, and he was to be given small but frequent doses of whiskey and
were largely unaware of the germ theory of disease, and anyway had little
means of providing antiseptic conditions or sterile equipment.
to a frequent shortage of water, surgeons often went days without washing
their hands or instruments, thereby passing germs from one patient to
another as he treated them.
half of the deaths from disease during the Civil War were caused by
intestinal disorders, mainly typhoid fever, diarrhea, and dysentery. The
remainder died from pneumonia and tuberculosis. Camps populated by young
soldiers who had never before been exposed to a large variety of common
contagious diseases were plagued by outbreaks of measles, chickenpox,
mumps, and whooping cough.
- The culprit in most cases of wartime illness, however,
was the shocking filth of the army camp itself. An inspector in late 1861
found most Federal camps 'littered with refuse, food, and other rubbish,
sometimes in an offensive state of decomposition; slops deposited in pits
within the camp limits or thrown out of broadcast; heaps of manure and
offal close to the camp." As a result, bacteria and viruses spread
through the camp like wildfire. Bowel disorders constituted the soldiers'
most common complaint. The Union army reported that more than 995 out of every
1,000 men eventually contracted chronic diarrhea or dysentery during the
war; the Confederates fared no better.
- Typhoid fever was even more devastating. Perhaps
one-quarter of noncombat deaths in the Confederacy resulted from this
disease, caused by the consumption of food or water contaminated by
salmonella bacteria. Epidemics of malaria spread through camps located
next to stagnant swamps teeming with anopheles mosquito. Although
treatment with quinine reduced fatalities, malaria nevertheless struck
approximately one quarter of all servicemen; the Union army alone reported
one million cases of it during the course of the war. Poor diet and
exposure to the elements only added to the burden. A simple cold often
developed into pneumonia, which was the third leading killer disease of
the war, after typhoid and dysentery.
- The diets of both armies did not help and were
deplorably high in calories and low in vitamins. Fruits and fresh
vegetables were notable by their absence, and especially so when the army
was in the field. The food part of the ration was fresh or preserved beef,
salt pork, navy beans, coffee, and hardtack, large, thick crackers,
usually stale and often inhabited by weevils. When troops were not
fighting, many created funds to buy fruits and vegetables in the open
market. More often they foraged in the countryside, with fresh food a
valuable part of the booty. In late 1864, when Major General W. T. Sherman
made foraging his official policy on his march from Atlanta to Savannah,
his army was never healthier. As the war went on, Confederate soldiers
were increasingly asked to subsist on field corn and peas. And the
preparation of the food was as bad as the food itself, hasty, undercooked,
and almost always fried.