Our meeting this month “Civil War Weapons Pt. 1,” will be presented by Phil Binks. Phil will be speaking on the many types of long arms used in the Civil War. Phil will be bringing a dozen long arms from his own collection. These will include rifles, muskets and carbines.

Phil being the clubs expert on weapons of the Civil War is encouraging anyone having any questions about a rifle, musket or carbine, they might have, to bring it to the meeting. Phil will most likely be able to answer their queries. This should be a very interesting demonstration of what the Troops on both sides used during “The Great Unpleasantness.”

            On February 17, 2010, the SDCWRT was honored to have Joseph Wagner, M.D. present on Medicine in the Civil War. Dr. Wagner was an assistant clinical professor in the department of orthopedic surgery at the University of California Los Angeles and is a member of the Los Angeles Civil War Round Table.

Dr. Wagner Beginning His Presentation

            Another common procedure in the nineteenth century was amputation. What would constitute repairable injuries today such as shattered bones, amputation was seen as the only option. The focus was to amputate as quickly as possible, because there was no anesthesia and a quick operation would save the patient pain and facilitate recovery. There was a Scottish surgeon by the name of Sir Robert Liston (1794-1847) who was famed for the rapidity of his amputations, some only taking a half minute. In one case, there was a man with an injury on his upper thigh near the hip. Liston was so quick at his amputation that he cut the fingers off his assistant, the coat tails off a spectator, and more things than that poor man’s leg. The amputees died of gangrene and the spectator died of fright—perhaps the only operation with a 300 per cent mortality rate.

            By the second third of the nineteenth century, medicine made a great leap forward with the advent of anesthesia. For centuries, man had endeavored for a solution to pain. In 1845, a Harvard dentist by the name of Gardner Q. Colton (1814-1898) gave a public demonstration in which he used nitrous oxide (laughing gas). At this demonstration, he noticed one of the participants had a leg injury, but did not feel the pain because of the gas. Another doctor, Horace Wells (1815-1848), was present and saw the effects of the nitrous oxide. He later had Dr. Colton use nitrous oxide to remove his tooth later that year and he felt nothing. Wells was convinced he had discovered the solution to pain and convinced another doctor, John Collins Warren (1778-1856) to try it at a medical demonstration at Massachusetts General Hospital. On January 20, 1845, Wells gave nitrous oxide to one of Warren’s students who needed a tooth extracted, but when Warren went to extract the tooth, the student felt every part and cried out in pain. The experiment was a failure and Wells was discredited. Although nitrous oxide does have some strength, it makes for weak anesthetic. 

            A former associate of Wells by the name of William Thomas Green Morton (1819-1868) was also working on an anesthetic and discovered the effects of ether. In September 1846, Morton performed a painless tooth extraction using ether. A Boston doctor named Henry Jacob Bigelow (1818-1890), a leader in hip anatomy and for whom the “ligament of Bigelow” is named, was impressed with Morton’s work and invited him to use his either in another demonstration by Dr. Warren at the Massachusetts General Hospital. On October 16, 1846, Morton used his ether and Warren removed a tumor of the unconscious patient in the first demonstration of general anesthesia in history. From that point on, anesthesia spread throughout the western world. In Great Britain, the infamous Dr. Liston immediately began using ether. A Scottish obstetric doctor by the name of Sir James Young Simpson (1811-1870) soon discovered chloroform’s use as an anesthetic and used it in childbirth. The Church of England objected stating that it was against the will of God, but this question was solved when Her Majesty, Queen Victoria used chloroform given by Dr, John Snow in the delivery of her eighth child, Prince Leopold in April of 1853. In the next year, Dr. Snow discovered the connection between polluted water and the cholera further adding to medical science.

            Another advancement made before the Civil War was the concept of hygiene and antiseptics. Although it was conceived in the 1840s and was likely one of the most important medical advancements in history, the concept of hygiene was not yet accepted in the 1860s. In 1847, an Austrian obstetric doctor in Vienna by the name of Ignaz Semmelweis (1818-1865) made the connection between the doctor’s dirty hands and childbed fever. He noted how the midwives washed their hands and few women died under their care, but the doctors did not wash their hands and childbed fever was common amongst women in their care. When he suggested to his colleagues that they should wash their hands in a chlorinated lime solution, they were insulted for they did not believe that as doctors and gentlemen they could not carry disease with them. Semmelweis began to have those in his clinic wash their hands and the mortality rates dramatically fell. Semmelweis did not know why dirty hands caused childbed fever for Louis Pasteur’s work on the germ theory did not come out until after the Civil War.

            By the time of the Civil War in the 1860s, medical science at least had the benefit of anesthesia. Chloroform and ether were in common use by both armies where it was available and in 15,000 surgeries in the Confederacy made with anesthesia, there were no deaths and is comparable to modern standards. Chloroform was preferred over weaker ether. At the beginning of the war at First Bull Run, General “Stonewall” Jackson was shot in the middle finger and it was fractured (perhaps he was being impolite). When he was taken to the field hospital, the doctor wanted to amputate the finger which was unacceptable to Jackson. He went to a second doctor, Hunter Holmes McGuire, who placed the finger in a splint and it later healed. Also early in the war, it was decided between the two sides not to take doctors prisoner as their services were too important.

            In 1862, the medical director of the Army of the Potomac, Dr. Jonathan Letterman, introduced the modern army medical corps. He later became known as the “Father of Battlefield Medicine”, although many of his efforts were begun by D.-J. Larrey a half century before. Ambulances, which had only recently been fitted with springs, were removed from the quartermaster and placed under the medical director. In addition, officers were forbidden under penalty of punishment, from using ambulances for their own use—ambulances were for the sick and for medical goods only.

Dr. Wagner Explaining Civil War Medicine

            Although pain was no longer a concern in the medicine of the Civil War, hygiene was a major problem and many soldiers still died of disease. Although disease was not as great a concern as in the Mexican War, it was still prevalent, but would continue to decrease over time. Bacteria had been known since the seventeenth century, but knowledge of their potentially harmful nature remained a couple of decades away. During the Civil War, the best explanation for the spread of disease was “bad air”, but sometimes this was true in the case of malaria. The only treatment for malaria was quinine, of which nineteen tons were used in the war. During the war, doctors found that dressings for amputees made from horsehair seemed to have fewer infections than those of cotton. This was because the cotton was not usually washed, but the stiff horsehair was boiled to soften it and unbeknownst to the doctors it was also sterilized.

            Vaccination proved to be useful during the war, especially the vaccine for smallpox. The smallpox vaccine had been invented by the English doctor, Edward Jenner (1749-1823) in 1796. Jenner discovered that milkmaids who had the less fatal cowpox did not catch smallpox and thus he came up with the idea to inoculate people with cowpox. Vaccination against smallpox was dangerous, however, as the needles used were not cleaned. By the time of the Civil War, a great majority of the white population was immune to the pox and it was mandatory in both armies, but blacks were not immune and many died of the disease as well as the measles. In addition, President Lincoln was not immune either as he caught smallpox after Gettysburg. When the office seekers would not leave him alone even in sickness, he said that he finally had something to give all of them. Tetanus was also a problem during the war as it was found in horse manure (which was more than plentiful) and was a very painful disease. Vaccines for these diseases were some years away. Cholera and dysentery were common as soldiers often got their water from the same place into which their latrines emptied.

            Amputations were still very common during the war and several limbs were amputated when the bones were shattered or mangled as the lack of hygiene would cause gangrene and death. Thus, the only solution was amputation. Luckily, most of these were done with anesthesia. The amputations of the war also led to the introduction of blood transfusions. Scientists were not to discover the blood types and the troubles arising from mismatched blood types until the early twentieth century. In one case, a private was injured in the leg and it as amputated. He received a pint of blood through a gutta percha syringe and survived. Another private was injured at Petersburg in 1864 and the blood of a “strong, healthy German” was used and the private went from his deathbed to recovery.

            Surprisingly, 95 per cent of soldiers in Federal hospitals survived. Thus medicine in the Civil War was both modern and ancient—where modern techniques of anesthesia and modern knowledge of anatomy were beginning to come into use, but ancient ideas of bad air and the rejection of antiseptics and hygiene still hindered the care of the wounded. It would not be until World War II that soldiers would have most modern benefits—anesthesia, antiseptics, and antibiotics, but the Civil War was indeed a significant beginning stage for the advancement of medical science.