Medicine - A Perspective

Casualties during the Civil War are often reported in terms of trauma and death which resulted from battlefield wounds and accidents. More accurately, the major killer during the War was sudden and uncontrollable disease. We know that among Northern soldiers, deaths from disease (infectious and non-infectious) were about twice those resulting from wounds. Since many record of the Confederate Medical Corps were destroyed in a Richmond fire, statistics for Southern soldiers are less reliable, but from data that remains, it seems safe to assume that the ratio would be comparable. In almost every unit, Union and Confederate, there were cases of dysentery, malaria, measles, smallpox, tuberculosis and typhoid.

Early in the War, some wounded men were left on the battlefield for as long as two days before being transported for treatment. The walking wounded often carried the more disabled to the rear. Movement of the wounded progressed from early make-shift litters (gates, ladders, doors) to the more efficient and regulated ambulance trains which took the wounded to field hospitals or larger general hospitals.

Those wounded who received medical attention in the field often had to run the considerable risk of surgery. Surgeons, limited in number, typically worked round the clock after battles, and were frequently overwhelmed. Haste and neglect were unavoidable in such circumstances. Sometimes anesthetics were available, but there was no concept of aseptic procedure, so nearly all wounds became infected. Where chest or abdominal wounds were involved, surgeons probed with their finger, prescribed morphine and tried to stop external bleeding. Beyond this, there was little that could be done. To give you an idea by way of contrast: only about 3% of all American wounded failed to survive WWII. During the Civil War, 62% of soldiers wounded in the chest died and no fewer than 87% of those wounded in the abdomen died.

Drugs, as they were available, were shipped via the general supply train. Quinine and morphia were used. Chloroform, sometimes mixed with ether, served as an anesthetic. Opium, iodine and calomel were also in use. Oil of turpentine was administered for dysentery, but was probably not very effective. Often when battle casualties were high, the medicine supply ran out and soldiers were left to swigging whiskey or "biting the bullet" to endure the pain of amputation.

Hospitals varied from crude, quickly constructed regimental receiving stations near the battle lines to well-staffed and fully equipped general hospitals at the rear. At the war's onset, a mere handful of surgeons was available and public schools, factories, churches and private homes were all utilized as medical care facilities. The South's largest hospital was the Chimborazo Hospital in Richmond, completed in early 1862. It was a 6,000 bed hospital under the direction of Dr. James B. McCaw and treated more than 76,000 patients. The North had far more numerous facilities in or near Washington and scattered from New York and Boston to St. Louis and Cincinnati.

Women played a key role in running hospitals and the overall effort to care for the sick and wounded. In the North, the United States Sanitary Commission was organized by women in 1861. This organization provided temporary shelter, clean bedding and other services for the disabled troops. The South had organizations like the Sanitary Commission, but none quite so large or so effective in achieving their goals. Clara Barton, founder of the Red Cross and noted author Louisa May Alcott served as nurses during the Civil War. On the Southern side, Sally Louise Tompkins was the only woman ever commissioned by the Confederacy. She was commissioned as a captain and charged with running Robertson Hospital in Richmond, VA.