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 * Civil War Medicine**

**Introduction**
 Medicine during the Civil War was primitive compared to the medicine today. Our understanding of disease, surgery and sanitation was limited. Anesthesia was a recent discovery. Most doctors did not go through medical school. More people died from disease than from battle injuries. Surgery was the most common solution to bullet wounds. Field hospitals were cramped and dirty, making all soldiers prone to infection. Experiences during the Civil War, led doctors to many medical advances.

[[image:civilwar.jpg width="181" height="232" align="left" caption="A Civil War Amputee"]]Amputations
The job of a surgeon during the Civil War was dismal. Three out of every four surgeries were amputations, the art of surgically removing a major limb of the body. Over thirty thousand surgeries were documented by the end of the Civil War. The main cause of amputation was the impact of a special bullet called the Minié ball. The Minié ball was a .58 caliber lead bullet most commonly used in the Civil War. Being made out of soft lead caused the bullet to flatten out on impact with the body, usually smashing bones apart and tearing through soft organs. In 1861, the only fix to splintered bones was to amputate them. If the soldier was operated on in the first twenty-four hours after his injury, there was a twenty-five percent chance he would die. If the operation was after the first twenty-four hours, only half of the soldiers would survive. A normal surgery would last fifteen minutes, and the amputated limbs would be thrown in a pit nearby the surgeon.

Here is a video about Civil War amputations and prosthetic limbs. media type="youtube" key="3T5v_QbFZDU" height="344" width="419" align="center"

Anesthetics
A common misunderstanding about the civil war is that soldiers were denied anesthetics. Anesthetics such as Chloroform and Ether were used on soldiers just before they were operated on. These were new chemicals that knocked the patient out and took away most of the pain. Chloroform was used most of the operations as it took the little amount needed for it to knock the patient out. However, applying the anesthetics was difficult and anesthetics were only used at the absolute necessary times. The anesthetic temporarily prevented the flow of oxygen through the body and could kill people. There were different techniques on how to administer the anesthetic safely. The most common way was that the doctor would take a paper cloth and fold it into a cone shop. Then he would take a sponge soaked with the anesthetic and place it on the apex of the cone. He would place the cone with the sponge far away from the soldier and slowly move it forwards until the desired effect was achieved. He would do this so the anesthetic was diluted with air in the beginning, making the operation safer. A surgeon in the south, J.J. Chisolm made another device that would have two nose pieces to insert into the patient. In the South, there was a shortage of anesthetics, so Chisolm was forced to think of a device that conserved the most chemical. He made a cylindrical tube with a small grated plate where he would drop the anesthetic in. It looked roughly like the image on the right. On average, ten people per every thousand would die because of the anesthetic. On the rare case anesthetics were not available to the people, they would be given liquor and had to go through all the pain of amputation. When this happened, it was rare that the person would survive.

**Transportation of the Wounded**
The importance of how wounded came back to field hospitals became extremely important in the Civil War. In the beginning of the war, the Union and the Confederacy did not prepare for this. Wounded were left out in the battlefield for days, usually dying in that time. After one of the early battles of the war, The Battle of Bull Run, transportation of the wounded became more widespread. There were two main types of transportation, hand litters and ambulance wagons.

Hand Litters
Hand litters were stretchers that soldiers used to carry the wounded back to field hospitals.These devices were small and compact, making them easy for transport, and could also be assembled very quickly. It was made of canvas with two loops on both sides. Two ash wood sticks would be placed through the loops and two soldier would place the wounded soldier on the canvas. Then they would both grab hold of the poles and be able to carry the wounded soldier to safety. The main hand litter at the beginning of the war was the Satterlee litter. It weighed twenty-five pounds and by the end of the war, there were over fifty-thousand hand litters issued.

After the Battle of Gettysburg finished, the medical director of the Union Army bragged that all the wounded were picked up in the first twelve hours. This was unlike the Battle of Bull Run where soldiers were not picked up for days. Throughout the Civil War, different types of hand litters were made, some even could be folded out into a bedstead. In one type, people could be placed into a litter and put on a horse. All the different variations of hand litters and ambulance wagons can be found in my video below:

media type="youtube" key="mSG9_s866yE" height="267" width="443" align="left"

Ambulance Wagons
Ambulance wagons were a transport vehicle led by horses that would carry people to field hospitals. These were not as commonly used as hand litters because they were big and inconvenient. They were not used seriously in wars before the Civil War. Just before the war in 1858, Dr. I. Moses from New York proposed a wagon that could adapt to the needs of wounded people. It could fit eighteen people sitting down. The seats could be folded out into beds and could fit six people lying down. The downside to these wagons were that they required six horses to move. Throughout the entire Battle of Gettysburg, 1100 wagons were used . = =

**Diseases During the Civil War**
Throughout the entire Civil War, death from battle was the main fear of all common soldiers. In the Civil War, around 605,000 soldiers died, but only one third of them died because of battle wounds. The real enemy of all the soldiers was disease. The soldiers did not understand the importance of hygiene. Diseases such as dysentery and typhoid fever came from the lack of hygiene. Over 400,000 men were killed by diseases. Another reason why so many people died was because doctors did not know what caused disease, how to stop it from spreading, and lastly, how to cure them. Sometimes by luck, doctors would find a natural substance that would cure diseases. For example it was discovered that the bark of a small tree called Cinchona contained a chemical named Quinine. Quinine is used to treat malaria and is still used all over the world today. Below is a list of all the common diseases and how many people they killed:

Dysentery - This illness was by far the greatest killer during the Civil War. It killed around 90,000 people. It killed so many because of the poor sanitation of the people and of the war camps. Trash was littered throughout the camp and latrines were usually dug near the water supply. The water was contaminated and diseases spread quickly due to the large amount of men put into one camp.

Typhoid Fever - This was another disease like dysentery, but did not kill as many people. Typhoid fever killed 70,000 soldiers. One third of all people who got it passed away.

Pneumonia - This lung disease attacked the wounded. Many people recovering from a surgery or bullet wound caught pneumonia. It ended up killing 50,000 people throughout the Civil War.

These were the main diseases in the civil war, others were: measles, tuberculosis and malaria. In total all these diseases killed 60,000 men.

[[image:Hospital-Field-Civil-War.jpg width="438" height="323" align="left" caption="A Field Hospital In a Barn"]]

 * Collaborative portion of project.**

Field Hospitals (jbrudnick)
Field hospitals in the Civil War did not even remotely resemble a real hospital. "Hospitals" were placed wherever space could be found, and often were located in barns, churches and warehouses. An average operating room was outside, where there was much light for the surgeon to operate by. The buildings that were called field hospitals were often used simply to hold wounded, with the actual work being done outdoors. The tools the Union used were, while archaic by modern standards, highly superior to Southern tools and were highly coveted by Confederate doctors. A typical operating table was a large door removed from its hinges and laid across two sawhorses. Surgeons often had merely a rag for cleanliness, leading to a large number of deaths not from actual wounds, but from the care they received after their injuries.

Doctors
Doctors in the Civil War knew close to nothing compared to doctors today. To begin with doctors only needed to go to medical school for two years. Most surgeons in field camps did not even have that much training. Apprentices only learned surgery by watching experienced surgeons operate. Before the war, the Union had 122 field doctors and 24 split off to join the Confederate army when the war began. After the war, the Union had 13,000 field doctors, while the Confederacy had only 4,000. Back then, doctors did not know about sterilization. Doctors worked in blood covered coats and operated with puss-coated gloves. If they dropped a surgical instrument on the dirt, they would pick it up, briefly drop it in a water basin, then use it for the surgery. This caused infection such as gangrene, the death of tissue in a part of the body.

** Diet During Civil War **
In the most basic level, all men were served salted meat and bread, but due to constrictions placed on each side, the food the men had was different. Each field camp had several common cooks that made the food for the soldiers. However, there were times when the soldiers were only given raw food and had to cook their own meals. Soldiers knowledge of cooking was minimal. When soldiers had to cook their own meals, many times they would unintentionally burn their food to such a degree they could not eat it.

The soldiers in the Union had a much different diet than that of the soldiers in the Confederacy.T he North had access to flour and made crackers called hardtack. Hardtack was extremely hard and could not be eaten on its own, so soldiers made different meals using it. The most known dishes were skillygalee, hellfire stew, and lobscouse. Skillygalee was hardtack soaked in water, then fried in pork grease to give it flavor. Hellfire stew was when soldiers broke up hardtack into small pieces and mixed that with their meat, making a stew-like substance. Lastly, the men in the Union Army had lobscouse, a soup made from pork, hardtack and other things the soldier wanted to add in. Hardtack usually was infested with worms and maggots, making soldiers frequently sick.

The South did not have access to wheat flour, so instead they used cornmeal. Cornbread was made out of low quality cornmeal and continually got worse as the war progressed. A soldier in the Stonewall brigade remarked, “the corn bread would get so hard and moldy that when we broke it looked like it had cobwebs in it.”. The poor quality of food in the North and South led to malnutrition and diseases, such as diarrhea and dysentery.

**Medical Advances From the Civil War**
The Civil War was the birthplace for numerous medical advances all throughout the United States. First, the doctors in the Civil War made medical records of what happened, such as deaths, amputations and procedures. This gave a complete medical history of the Civil War and from then onwards, doctors created medical records. Before the Civil War, there was no system that could handle a large amount of extreme injuries. This was installed in the Civil War with the creation of field hospitals and other aid stations. Another piece of information learned from the Civil War was the significance of sanitation and hygiene. Doctors found out these caused diseases and this provided a foundation for research on diseases. Surgeons discovered in the Civil War that if men were not operated on in the first twenty-four hours, they would have a smaller chance of surviving. This showed the importance of treating severe wounds immediately. Lastly, during the Civil War, a group called the Sanitary Commission formed. This organization was devoted to improving the health systems in America, and later it became the American Red Cross.

**Bibliography**

 * Images **

Field Hospital. Digital image. Old-pictures. Web. 22 May 2011. 

Hardtack. Digital image. Civilianmilitaryintelligencegroup. Web. 22 May 2011. .

//Fig424inhaler//. Digital image. Civil War Home. Web. 19 May 2011. .

//Fig453mosesrear//. Digital image. Civil War Home. Web. 19 May 2011. .

Civil War Camp Dinner. Digital image. Niahd. Web. 19 May 2011. .


 * Videos**

"Amputations and Artificial Limbs in the Civil War ." 24 March 2011. YouTube. 22 May 2011. 

Civil War Transportation of the Wounded Video - Self Created. 

Brennan, Matthew. "The Civil War Diet." Thesis. Virginia Polytechnic Institute, 2005. //The Civil War Diet//. 20 May 2005. Web. 19 May 2011. .
 * Information - Thesis Paper **

Weeks, Richard. "Civil War Medicine." //The American Civil War Home Page//. Shotgun, 24 Nov. 2006. Web. 17 May 2011. .
 * Information - Websites **

"Civil War Medicine, Civil War Doctors, Civil War Nurses." //Civil War, American Civil War, Reconstruction//. 2007. Web. 17 May 2011. .

"American Civil War Medical and Surgical History." //American Civil War History Timelines Battle Map Pictures//. Web. 19 May 2011..