Medicine in the American Civil War

[1] The advent of railroads, industrial production, and canned food allowed for much larger armies, and the Minié ball rifle brought about much higher casualty rates.

[2] The work of Florence Nightingale in the Crimean War brought the deplorable situation of military hospitals to the public attention, although reforms were often slow in coming.

The hygiene of the camps was poor, especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers.

Operations in the South meant a dangerous and new disease environment, bringing diarrhea, dysentery, typhoid fever, and malaria.

After the Battle of Bull Run, the United States government took possession of several private hospitals in Washington, D.C., Alexandria, Virginia, and surrounding towns.

Tripler created plans to enlist regimental surgeons to travel with armies in the field, and the creation of general hospitals for the badly wounded to be taken to for recovery and further treatment.

Frederick Law Olmsted, a famous landscape architect, was the highly efficient executive director of the Sanitary Commission.

Following the unexpected carnage at the battle of Shiloh in April 1862, the Ohio state government sent three steamboats to the scene as floating hospitals with doctors, nurses and medical supplies.

The state also set up 12 local offices in main transportation nodes to help Ohio soldiers moving back and forth.

[14] The first permanent general hospitals were ordered constructed during December 1861 in the major hubs of military activity in the eastern and western United States.

The situation became apparent to military leaders in the Peninsular Campaign in June 1862 when several thousand soldiers died for lack of medical treatment.

[16] Dr. Jonathan Letterman was appointed to succeed Tripler as the second medical director of the army in 1862 and completed the process of putting together a new ambulance corps.

Several divisional hospitals were lost to Confederates during the war, but in almost all occasions their patients and doctors were immediately paroled if they would swear to no longer bear arms in the conflict.

The Sanitary Commission collected enormous amounts of statistical data, and improved the means of storing and accessing information for research.

[21] DeLeon had little experience with military medicine, and he and his staff of twenty-five began creating plans to implement army-wide medical standards.

[22] The Confederate government appropriated money to purchase hospitals to serve the army, and the development of field services began after the First Battle of Manassas.

In August 1861, the army began the construction of new larger hospitals in several southern cities and the furloughing policy was gradually halted.

Field hospitals were set up at the regimental level and located in an open area behind the lines of battle and staffed by two surgeons, one being senior.

[29] In some of the lengthier battles, buildings were seized to serve as a temporary secondary hospital at a divisional level where the severely wounded could be held.

[30] Before the formation of any organized ambulance system, a significant number of Union and Confederate soldiers lost their lives on the battlefield in wait for medical aid.

[32] With an insufficient number of ambulances performing assigned tasks, the wounded looked to their comrades to carry them to safety and in essence this removed many soldiers from the battlefield.

With new designs the common Union ambulance was now composed of a 750 lb wagon that was powered by 2–4 horses and was made to carry 2–6 wounded soldiers.

Other accessories that were standard for the improved ambulances included compartments to store medical supplies, stretchers, water, and even removable benches and seats to adapt to the number of passengers.

A post-war review by the U.S. Army Medical Department found that over 99.6% of surgeries performed by their staff were conducted under some form of general anesthesia.

[44] The most popular anesthetic agent was chloroform, accounting for more than 70% of all surgeries in the North according to a study in the Medical and Surgical History of the War of the Rebellion.

[50] "It was a conflict that prefigured our own time in its unanticipated scale and scope, in its incorporation of rapidly advancing technologies of firepower, transportation, and communication.

[citation needed] A 2016 research paper found that Civil War surgery was effective at improving patient health outcomes.

[58] The middle-class women North and South who volunteered provided vitally needed nursing services and were rewarded with a sense of patriotism and civic duty in addition to the opportunity to demonstrate their skills and gain new ones, while receiving wages and sharing the hardships of the men.

[63][64][65] Historian Leon Litwack has noted, "Neither white nor black Southerners were unaffected by the physical and emotional demands of the war.

Jim Downs states: Based on their experiences in the war, many veterans went on to develop high standards for medical care and new medicines.