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Reflections on Civil War Medicine
continued from page 29

or shredded viscus open to the elements some 23,000 casualties (counting both sides)
and almost guaranteeing a severe wound occurred including those killed (>3600),
infection. The older, smooth bore musket wounded (>17,000), or missing, in one day.
fired a round lead ball, with a slower muzzle As bad, if not worse, were the three days of
velocity, which tended to flatten on impact Gettysburg, when 51,000 casualties, including
and tear a larger entry hole, tumbling and nearly 8,000 KIAs, occurred in the hot days
meandering about inside the body, wreaking of early July. One tour guide told us that
unpredictable havoc and did not necessarily "after the battle of Round Top one could
find its way out of the body.
walk across the battlefield stepping on dead
Surgeons frequently operated non-stop, bodies, without ever touching the ground."
wearing ordinary uniform clothes, wiping
their bloody hands on their aprons and
perhaps rinsing and re-using their equipment
and sponges in whatever water was available
between cases. For amputations, their principle tool was the bonesaw, a hacksaw-like
instrument, which gave rise to the name
of "sawbones." Amazingly, some 75% of
amputees survived the operation, but due
to unsanitary conditions, contamination of
wounds, blood and fluid losses and lack of
antisepsis or antibiotics, many sickened and
died from infections. Much more surgery
was done under anesthesia than generally
acknowledged. Chloroform was used mostly,
as was some ether, and of course, when little
else was available, as in the movies, whiskey
was poured into the patient to put him under.

History records that General William
Tecumseh Sherman said, "It is only those who
have never fired a shot nor heard the shriek
and groan of the wounded, who cry aloud
for blood, for vengeance, for desolation. War
is hell!" He may well have been thinking of
these numbers when he said it.

and for the training of the ambulance crews,
improved medical supply and logistics systems,
bringing them forward from their base to
the battlefield treatment areas, instituted
a basic triage and field evacuation system,
and reorganization of military hospitals. His
changes "remain in place today, and constitute
(the basis of) our military's modern network
of emergency treatment and hospitals for
wounded warriors."

Dr. Maher is a retired Public Health
Physician, a Vietnam War Veteran,
and a long time member of the CCMS
Board of Directors. He gratefully
acknowledges free and widespread
use of information about all these
If there is such a thing as a "silver lining" Civil War topics and statistics, which
to all this, it would have to be the system can be found by Googling each topic
of improvements put into place as the War by name. Special thanks go to these
proceeded. A new Surgeon General, Dr. sites: National Museum of Civil War
William A. Hammond, was appointed in
Medicine, US Army Medical Depart1862, and one of the most important things
ment Center for Medical History,
he did was to appoint Dr. (Major) Jonathan
CivilWarAcademy.com, Battlefields.
Letterman, who had distinguished himself as
org,
American Battlefield Trust, Hisan Army Surgeon and oversaw the medical
toryNet,
the Congressional Research
organization and response at Antietam, as
Service,
National
Library of Medicine/
Medical Director of the Army of the Potomac.
NIH/PMC
(Baylor
Univ.), Wikipedia,
Just try to imagine the field surgeon's Letterman's revolutionary ideas helped to
essentialcivilwarcurriculum.com,
workload! It staggers one's imagination to improve several aspects of military medicine
try to imagine working under such battlefield from that point on. An 1849 graduate of E-History (OSU), AmericanCivilWar.
conditions, say for example, at Antietam, Jefferson Medical College, Letterman created com, National Park Service, National
"the bloodiest single day of the war," where new designs for the military ambulances Archives, inter alia.

30 CHESTER COUNT Y Medicine | SUMMER 2019

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