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| Photo: Ileana Johnson 2019 |
The museum is important in so many ways because the Civil War was described as a “watershed” in the history of medicine in regards to medical school education, recruiting and enlisting of soldiers, camp life, treatments, drugs, evacuation of the wounded, field dressing stations, field hospitals, and pavilion hospitals.
American medicine prior to the Civil War struggled with the general idea that disease was caused by a bodily poison triggered by a nervous constriction of the small blood vessels. Doctors used sweating, bleeding, cupping, blistering of the skin, and drugs to induce vomiting in order to purge the poison from the body. Bleeding was even used to stop internal hemorrhaging or to fix wounds to the chest.
Few really believed in sterilization to stop the spread of disease from patient to patient. The [Henry] Craig Microscope was sold as a novelty through the mail, a single-fused lens in a tube mounting. But few understood microorganisms and the spread of disease through contact.
Battlefield first aid kit
Surgical instruments and tools
Battlefield medicine chest, Museum
Medicines found in care packages from home
Autenrieth medical wagon
It was not uncommon for military surgeons to use their private amputation kits such as the surgical instruments manufactured by Edward F. Snyder of Philadelphia who produced instruments from 1841-1855.
Middleton Goldsmith experimented with bromine to treat hospital gangrene after a severe outbreak in Memphis in 1863. He discovered that the survival rate improved dramatically with the use of bromine. The U.S. Sanitary Commission endorsed the use of bromine immediately and cases diminished in the last years of the war.
Despite the general belief that doctors were simple butchers, the reality is that most Civil War surgeons went to medical school and were trained with an established doctor. They had to pass an exam to serve as a war surgeon.
Wounds were quite severe due to the new rifle musket technology and the French Minié ball which made repairing the damage impossible due to time constraints and potential deadly infections. For this reason, three out of four surgeries performed were amputation which resulted in nearly half a million soldiers coming out of the Civil War disabled.
Surgeons were often spoken of as “sawbones” due to the large number of amputations performed. Soldiers often reached for their weapons when they saw a surgeon approach. The damage done by the musket balls called Minié was so devastating that they had no choice but to amputate.
Not all broken limbs were amputated during the war. A fracture box was used to align the broken bones as well as various sizes and shapes of splints on display.
The .58 caliber rifled musket used in the Civil War was different from the Revolutionary War musket. The cone-shaped bullet had a hollow grooved base that expanded and spun with full force when fired. The accuracy and velocity of these Minié lead bullets did more damage, shattered the bones into many splinters, destroyed the surrounding soft tissue, and the lead remained inside the body. “Approximately 94 percent of all recorded injuries were caused by the new Minié ball. Seven out of ten injured soldiers were wounded in the arm or leg; two out of ten in the body; and one out of ten in the head or neck.”
Hospital cot - Museum
Field hospitals were usually a barn or a tent, with the barn doors removed to serve as surgical tables. Casualties were triaged into three categories: mortally wounded (abdomen, chest, head), slightly wounded, and surgery candidates.
Surgeon Z. Boylston Adams of the 32nd Massachusetts Infantry describes the battle: “The front was filled with the sulfurous odor of smoke. There was a constant rattle of musketry mixed with the blood curdling yells and shouts. Artillery shells were exploding in the treetops. Leaves and branches fell about … Minié balls could be heard thudding into the surrounding trees. And so, the field hospital went into operation.”
One famous Confederate surgeon was John Julian Chisolm from Charleston, S.C. “In April 1861, Chisolm treated Union soldiers wounded at Fort Sumter.” He worked during the war in the military hospitals in Richmond.
According to the museum archives, prior to the Civil War, the U.S. Army had a 40-bed infirmary in Kansas. A hospital was a poor house where the poor went to die. However, by 1865 the Union Medical Department had 181,000 beds in 187 pavilion style hospitals and the Confederates had a similar number of beds to treat the wounded and the sick.
U.S. hospital railroad cars were retrofitted and used as early as August 1861 to transport the wounded from the battlefield to metropolitan hospital centers. Stretchers were suspended in railroad cars with vulcanized rubber rings in order to provide shock absorbers for a smoother ride and to be able to suspend more stretchers inside a car.
“River boats and later steamships were leased or purchased and refitted as hospital ships at first in the West and later in the East. The City of Memphis carried 11,024 sick and wounded in 33 trips up and down the Mississippi. The D.A. January transported and cared for 23,738 patients during the last 3 years of the war.” They were floating hospitals.
Nursing care was provided at first by convalescent or non-combatant soldiers until such a time that they were able to return to their regiments. Since 1863 the Union Veteran Reserve Corps supplied nurses, clerks, ward masters, guards and cooks to the general hospital. A famous male nurse, L.A. Thorpe, head nurse at Foster Hospital in New Bern, NC, died of yellow fever in 1864. John C. Sinclair was nurse at Trinity Hospital in Washington, D.C.
Museum Archives Photo
Civil War nurse - Museum photo
President Lincoln invited to the White House one famous nurse, Caroline Johnson, a former slave who nursed in Washington hospitals.
Black slaves built hospitals, cooked in hospital kitchens, and served as laundresses. Richmond, Virginia’s Chimborazo Hospital was built almost entirely by black labor. Often blacks were assigned the task of burying the dead. Three-quarters of the women who nursed at Chimborazo hospital in Virginia were black. “The use of black women in Northern hospital wards was not authorized until 1864.”
“Susie King Taylor was the best known of the thousands of black Civil War nurses. Her memoir, Reminiscences of My Life in Camp, is the only surviving account of the Civil War experiences of a black nurse.”
Army chaplains assisted with surgeries and comforted the dying. “Of the approximately 165 regiments of the U.S. Colored Troops, only 14 had black chaplains.” Union Army regulations required that regimental officers elected chaplains.
“Mrs. D. H. Hastings, a hospital matron with the 30th U.S. Colored Troops is listed as non-commissioned officer on the regimental muster roll – an extremely rare honor for a woman.”
The Chimborazo hospital in Richmond was like a small city that could serve “more than 8,000 patients in 150 wards, a bakery that produced 10,000 loaves of bread a day, a 400 keg brewery, a newspaper, five ice houses, a soap factory, cultivated fields, and a large herd of livestock.”
Benevolent societies raised money and donated to the U.S. Sanitary Commission for soldiers’ relief - $70 million in four years through contributions from every state and territory in the Union including almost $18,000 from the Sandwich Islands (now Hawaii). In 1861 the U.S. Christian Commission came up with the idea of “coffee wagons” in camp to compete with the “liquor sellers,” the sutlers.
Hospitals provided bands for the entertainment of the wounded, held lectures, concerts, and theatrical performances in addition to medical care.
One of the Civil War doctors, Lewis Henry Steiner (1827-1892), was a fifth generation of the Steiner family to reside in Frederick, MD. He earned his medical degree from the University of Pennsylvania in 1849. Dr. Steiner was an inspector for the U.S. Sanitary Commission and was present when the Confederate troops entered Frederick. He remained there until the Union troops arrived. He described the Confederate troops on September 8, 1862:
“How the rebels manage to get along no one can tell. They are badly clad. Many of them without shoes. Uncleanliness and vermin are universal. The odor of clothes worn for months, saturated with perspiration and dirt, is intense and all-pervading. They look stout and sturdy, able to endure fatigue, and anxious to fight in the cause they have espoused.”
The Union Army of the Potomac counted 1500 days of service but only 45 were spent in battle. The rest of the time they fought diseases of the camp caused by contaminated water supply, refuse and excrement from humans and animals, fleas, lice, and flies which carried bacteria and viruses to the soldiers and their rations. “Of the nearly 620,000 soldiers who died during the Civil War, two-thirds died of disease and only one third died of wounds,” diarrhea being the number one killer.
Civil War stretcher
According to the Museum, the 65th U.S. Colored Troops (U.S.C.T.) had the most deaths from disease (755) of all Union regiments. The 49th U.S.C.T. lost 465 men to disease compared to 62 killed in action. Ten thousand black sailors served in the Union Navy and 179,000 black soldiers enlisted in the Union Army.
As ghastly as the Civil War was, forcing brother to fight against brother, in the end, a lot of the measures developed to deal with casualties of war became the basis for modern military medicine. For example, the ambulance system developed by Jonathan Letterman is still part of the present-day military evacuation plans.
Medical personnel, just like today, treated the wounded from both sides of the war. A field dressing station, the precursor of our modern first responders, bandaged wounds and administered whiskey for shock and morphine for pain.
Triage was first developed during the Civil War in order to set priorities for treatment of the wounded based on the severity of the injury.
The Civil War used embalming to send home soldiers killed in battle. It was a chemical process that had not been used prior to the Civil War.
The physical and mental impact of 60,000 amputees forced the reunited country to deal with the casualties and establish mental hospitals and care for the veterans.
The condition first diagnosed as nostalgia and irritable heart during the Civil War, shell shock during WWI, became PTSD (Post Traumatic Stress Disorder) today.
Apothecary wagons developed during the Civil War to ensure medication was available to soldiers for treatment.
Water and sewer systems used in pavilion hospitals during the Civil War paved the way for our modern hospitals. Wards were self-contained to minimize the spread of disease.
Modern military medicine has roots in these advancements made during the Civil War and in turn, civilians today benefit from continuing medical developments made in military medicine.
In 1863, the first veterans’ organizations were established in both the North (Grand Army of the Republic) and the South (United Confederate Veterans), with the goal to care for veterans, honor the dead, preserve friendships of those who survived, honor the dead, and provide for widows and orphans.
Soldiers were not the only enlisted in the fight, horses and mules were unwilling beasts of burden and victims in the war. Every cannon and its attached limber (two-wheeled ammunition chest) was pulled by six horses. Six-horse teams also pulled each of the six four-wheeled caissons that carried additional ammunition. An artillery battery consisted of six guns which means that 72 horses were necessary to move the battery. Additional horses were necessary to pull the forge, carry the officers, and be replacements.
The Army of the Potomac used in 1864 more than 4,000 six-mule team wagons in the Wilderness Campaign, with a total of 56,499 horses and mules that moved the war machine. Veterinary surgeons tended to the animal injuries and tried to maintain the health of their charges. “Large infirmaries were developed to treat horses and mules which were too sick or worn-down to serve the armies.”
A soldier spent most of his day in camp or marching rather than in battle. Marching means that they had to carry extra clothing, personal hygiene items, blankets, tin utensils, a “soldier’s housewife” (items necessary to mend clothing and darning socks: scissors, needles, thread, patches, pins, buttons, and yarn), items from home, and their weapons. And some also carried items such as pressed flowers, homemade identification tags, business cards (carte de visite), the New Testament, the Book of Common Prayer, and the daguerreotype photo of a loved one.
Most soldiers marched 13 miles daily, carrying 30-50 lbs. of equipment, and such strenuous outlay of energy caused many health problems: “dehydration, malnutrition, hypothermia, sunstroke, headaches, nerve damage, bone spurs, bone degeneration, muscle soreness and tearing, torn or early loss of cartilage in knees and hips, leaking fluid sacks in knees, joint and back pain, blisters, bruises, lacerations, infections, and chronic cough.”
“War is an organized bore,” one said. But Private Wilbur Fisk of 2nd Vermont wrote, “If a man wants to know what it is to have every bone in his body to ache with fatigue, every muscle sore and exhausted, and his whole body ready to sink to the ground, let him … shoulder his knapsack, haversack, gun and equipment, and make one of our forced marches, and I will warrant him to be satisfied that the duties of war are stern and severe.”
Food focused on “hard-tack” (a hard wheat flour cracker) and salt-cured pork. Fresh meat and vegetables were issued sometimes in camp and canned food, meat and seafood. Confederate letters describe meals of canned food captured from Union supply trains. The deficient diet caused major nutritional diseases such as scurvy (vitamin C), night blindness (vitamin A) and malnutrition. There were 46,000 cases of scurvy in Union records.
Coffee, tea, birch beer, and sarsaparilla were available. The soldier had to grind the beans included in their rations in order to make coffee. Alcohol was not allowed in camp, but officers were not restricted. Sutlers made alcohol available to anyone though just outside the camp.
Tallow and lard were used to make candles for illumination. The “Betty Lamp,” a simple pot filled with oil and a wick, provided light at night. Soldiers entertained themselves in camp with cards, dice, and playing baseball.
After the bombardment at Fort Sumter in Charleston, S.C. in April 1861, President Lincoln called for 75,000 ninety-day volunteers to squash the rebellion. Companies were organized with 100 volunteers; ten companies formed a regiment; the volunteers chose officers, one regimental surgeon, and two assistant surgeons.
Johnny Clem, Museum photo
The average volunteer soldier was 25
years old, but Curtis King of 37th Iowa Infantry was 80 years old.
Boys younger than 18 served as musicians, stretcher-bearers, nurses, ships
boys, and even soldiers. Avery Brown of the 31st Ohio Infantry and
Edward Black of the 21st Indian Infantry were 8 years old. At the
age of 10, Johnny Clem ran away from home and became a drummer in the Union
Army. He enlisted at 12, fought in several battles, was captured and briefly
jailed by Confederate soldiers.Women served in the Civil War, with a documented number of over 300 Union and Confederate females serving disguised as men. This happened because physical examination was often superficial or nonexistent in the rush to gain more recruits for the war. Many joined the army already seriously sick with bronchitis, fevers, TB, STDs, etc.
Soldier’s clothing was made of rough-hewn wool in the North and a mixture of cotton, linen, and wool in the South. The material was itchy and of poor quality and did not last long. Soldiers wore softer underwear to prevent itching. When uniforms wore out, they put on civilian shirts and clothes, even in battle. Shoes did not last long due to long marches.
The Medical and Surgical History of the War of the Rebellion recorded the staggering numbers of enlistment and the final tally of combatants who were killed, injured, and died from their wounds and disease:
Union Army Enlistment 2,893,304 Confederate Army Enlistment 1,317,035
Battlefield deaths 110,070 Battlefield deaths 94,000
Death from Disease 224,586 Death from Disease 164,000
Death from Accidents in the Union Army 24,872 (suicides were also included in this number)
A high percentage of soldiers on both sides died from gunshot wounds (94%). Artillery fire killed 5.5% of them and 0.4% of men perished from sabre or bayonet.
The final death toll percentage of soldiers fighting their own countrymen in the Civil War was 12.4% (Union) and 19.6% (Confederates).
The museum was a somber place to reflect on our country’s history forgotten by so many.
