Quinine, Morphine And Whiskey: Tools Of The Civil War Battlefield Doctor

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Quinine, Morphine And Whiskey: Tools Of The Civil War Battlefield Doctor
Civil War field hospital. (NARA )​
December 29, 2012|By DAVID DRURY, Special to the Courant, The Hartford Courant
From his post with the 16th Connecticut Volunteer Regiment, Dr. Nathan Mayer watched as wave after wave of blue-clad infantry fell beneath the Confederate guns massed atop Marye's Heights.
"All day long I had seen the troops, in brigade lines, marched up a wide slope against stone walls, defended by confederates. And line after line was received by deadly volleys, broken and driven back, while batteries from the top of the slope threw shrieking shells at them,'' wrote Mayer, a regimental surgeon from Hartford, as he recalled the Battle of Fredericksburg, one of the worst Union defeats of the Civil War.
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That night in mid-December 1862, "we surgeons labored in a large freight depot till morning. The carnage had been terrible." Nearly 500 amputations were performed, with severed limbs piled into "a heap of feet, arms, legs, etc. under a tree in front of the hospital,'' the poet Walt Whitman wrote.
The German-born Mayer spent more than three years in service with the Union Army. He treated typhoid, malaria, smallpox and the many other infectious diseases that decimated the soldiers' camps. He was once taken prisoner and briefly incarcerated in Richmond's notorious Libby Prison. He survived a bout of yellow fever during an outbreak that struck down his entire surgical staff, and risked court martial by employing an unauthorized treatment to save his patients.
Mayer's wartime experiences, which he related in a lively memoir composed 40 years later, belies the stereotypical image of an ill-trained, ill-equipped, whiskey-swigging sawbones drowning in the catastrophic suffering of the times.
As battlefield losses mounted, and disease riddled the camps, Mayer and others like him worked tirelessly to tend to the legions of wounded and sick.
In an era when the benefits of hygiene and causes of disease were, at best, dimly understood, they relied upon the best tools at their disposal: recently developed anesthesia for surgeries, opiates to relieve pain, and quinine — the ground, liquefied bark of the Peruvian cinchona tree — to treat tropical fevers.
"In one pocket I carried quinine, in the other morphine and whiskey in my canteen,'' he wrote, describing a daylong march in which he trailed his regiment, examining stragglers and treating the sick and injured.
Civil War Medicine
Every Connecticut infantry regiment was assigned a head surgeon and one or two assistants. They were medical doctors who were also commissioned officers. They were assisted by stewards, enlisted personnel or non-commissioned officers who may have had some prior medical or pharmaceutical training.
The job of the regimental surgeon was to keep the soldiers under his charge fit for duty. "They were like the family doctors of — on paper —a thousand men'' said Dr. Robert "Mick" Bedard, a West Hartford allergist who has written and lectured about Civil War medicine and performs the role of regimental surgeon during historical re-enactments.
The doctors were of mixed quality. Not until the Flexner Report of 1910 were requirements for medical education standardized. The most highly trained attended leading medical schools like Yale or Harvard College or, in Mayer's case, Ohio Medical College, and received additional training abroad in anatomy and surgical technique. Even the best mid-18th century medical education was primitive by today's standards.
The Civil War was waged in the generation just prior to the discoveries of Koch and Pasteur, when the link between bacteria and disease was conclusively established, and at a time when Lister was just beginning experiments proving the benefits of sterilization.

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Doctors in the 1860s shared an understanding formulated by Galen and the ancient Greeks "that disease was the product of an imbalance of humours,'' Bedard said.
The miasma theory – that deadly diseases were transmitted through "bad air' from rotting vegetation – remained accepted theory. Troops were coached to protect themselves against the vapors of swampy, humid regions by not venturing out at night without caps and coats, even so leaving them helpless against the disease-carrying mosquitoes or microbial organisms in the drinking water that were the real culprits.
Not surprisingly, two-thirds of the 625,000 deaths during the Civil War resulted from sickness and disease.
The best regimental surgeons — like Mayer, "a cut above,'' according to Bedard — were brave, energetic, resourceful, compassionate and pragmatic. Experience taught that well-supplied, well-fed troops in sanitary living quarters were healthier; that some medicines, treatments and techniques worked better than others; and that those stricken by disease or recovering from battlefield wounds had a better chance of survival with fresh air, regular changes of dressings and active nursing care.

The Civil War battlefield was no place for the faint of heart. Amputation was performed routinely to remove limbs shattered by artillery and rifled lead shot to reduce the risk of gangrene.
The use of chloroform, ether and nitrous oxide for anesthesia had been well-established by the Civil War, thanks to pioneers like Hartford dentist Horace Wells. Chloroform was preferred for field use, being less flammable than ether and easy to administer. So easy, Mayer discovered that it could be dispensed by untrained soldiers called in to assist in the care of wounded comrades.
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For pain relief, doctors relied on morphine and opiates. And, of course, there was whiskey, which for some surgeons became an occupational hazard, as evidence by court marshal records of Army surgeons.
A system developed during the war to manage battlefield casualties — triage — remains in use today, Bedard said. At field-aid stations close to the front, doctors made preliminary assessments of who was unlikely to survive, who could be sent back to fight and who needed to be sent to the rear. They dressed wounds and performed emergency surgery. The seriously wounded were then moved to corps hospitals for major surgeries, and later transported by rail, ship or carriage to centralized hospitals in cities, including Knight Hospital in New Haven.
Dr. Mayer's War
The oldest of four children, Nathan Mayer was born in Bavaria on Dec. 25, 1838, the son of a rabbi. The family moved to the U.S. when Nathan was 11 and he attended schools in Cincinnati, Ohio, graduating from medical school there in 1854.
Two years later, the Mayers moved to Hartford where Nathan's father, Isaac, became the first rabbi of Congregation Beth Israel.
In 1859, Nathan Mayer left the states for further medical study in Munich and Paris, returning in Jan. 1862.
Eager to serve his adopted land, Mayer was interviewed by Gov. William A. Buckingham and in March 1862 was commissioned an assistant surgeon. He was assigned to the 11th Connecticut Volunteer Infantry regiment, based in New Bern, N.C.
In his memoir, Mayer described with good humor how he lost his service trunk in transit and had to rely on the kindness of strangers to meet most needs. He was assigned 30 typhoid patients and scoured the area for fresh milk and kegs of beer "and stimulated my patients Munich fashion." All but two survived.
His smallpox patients were kept in isolation under the care of Negroes. "I was the only white person who went to the smallpox tent. Remember I had only my uniform — my trunk was lost — so you saw me in a scarlet, much beflowered calico morning robe, my head tied up in a bandana, stalking across the field and into woods to see my patients."
Through that spring and summer, Mayer learned to ride a horse, not very well by his account. After his unit moved north into Virginia and Maryland, he performed his first amputations and treated Confederate prisoners.
He arrived at Antietam the evening before the battle and spent the next day, Sept. 17, under heavy fire, treating the badly wounded of his regiment, before relocating to a farmhouse that had been converted to a field hospital. "Every room was soon filled; the barnyard and garden were crowded with wounded, and I should not have known where to place more," he wrote.

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In late 1862, Mayer was transferred to the 16th Connecticut Volunteer Infantry and in January 1863 was promoted to regimental surgeon. In April 1864, he was taken prisoner following the Union defeat at Plymouth, N.C. Following a brief incarceration, he was exchanged and was assigned to Foster General Hospital in New Bern.
There in the summer of 1864 he performed heroic service in combating a yellow fever outbreak. When the accepted method of treatment, large doses of quinine, proved ineffective, he defied an order by the U.S. Surgeon General, and the objections of his own staff, and prescribed Calomel (mercury chloride), successfully saving many lives. Mayer himself barely survived the fever, which struck down all 18 of his surgical staff, killing nine.
By the end of the war, Mayer was the hospital's chief doctor, its chief administrator, the medical purveyor for Gen. William Sherman's Army and in charge of inventory and storage of captured Confederate stores.
The 16th's regimental historian, Lt. B. F. Blakeslee, wrote of Mayer: "He was a good physician, and as a surgeon could not be surpassed in the Army of the Potomac. He commenced immediately to make improvements in and out of the hospital, and to look to the cleanliness of the tents, company streets and cooking utensils. He also saw that the food issued was properly prepared by the cooks; and when he gave cough syrup, it was not stuff that men would use on their food for molasses."

Mayer returned to Hartford after the war, becoming one of the city's most respected physicians. He was appointed Surgeon General of Connecticut in 1872 and was a founding staff member of St. Francis Hospital. He sat on the Board of United States Pension Examiners and served as its president at the time of his death. His long association with the Hartford Medical Society saw his election to the presidency of the organization in 1906, and culminated with the award of the Society's Loving Cup on New Year's Day 1912.
In addition to his professional accomplishments, the good doctor found time to indulge his lifelong passion for literature and music. A published poet and novelist, with five novels about Jewish life to his credit, he spent 41 years as chief theater and music reviewer for the Hartford Times. His wartime experiences would remain close to his heart until his death, July 10, 1912, as evidenced by the poem he wrote and recited in 1894 at the dedication of the memorial to the 16th Connecticut at Antietam.
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He dedicated the work "to my brave and faithful comrades whose individual history, endurance, sufferings and loyal devotion in campaigns, in hospital and in prison, no one had better opportunities to know."

http://articles.courant.com/2012-12...20121223_1_surgeon-civil-war-medicine-doctors
 
I'm in the middle of a project about a soldier from the 21st MA who transferred to the 1st U.S. Arty. He was on Stafford Heights watching what is described above.
 
I found this interesting article... He argues the opiates were the caused a few famous Civil War Generals inability to perform their duties... http://www.4thus.com/opium

Some excerpts....

Some critics and historians offer stupidity, incompetence or cowardice as reasons for Bragg's failures. But his blunders may have resulted from his health and the rudimentary, even primitive level of medicine prevalent during the war. Bragg's behavior showed signs of opiate use. In the field, he appeared to withdraw as battle developed, to lose track of where he was. He became unable to adapt his plans to changing situations on the battlefield. But Bragg certainly was not stupid, as evidenced by the swiftness of his September 1862 movement from Tennessee into Kentucky, to wrest the Bluegrass State from Union Major General Don Carlos Buell. He was not a coward, as his record during the Mexican War and the Battle of Shiloh demonstrated. But, as he was promoted to higher command, Bragg became more distant from the troops, appearing to avoid active command during battle. His behavior could have been the result of a combination of poor health and the use of opiates.

An excerpt...

The gallant John Bell Hood, aggressive, vigorous and effective while with the Army of Northern Virginia, became a victim of delusions after a series of shattering wounds struck him. He left his finest attributes and his common sense on the surgeon's table. The pain from the stump of his right leg must have been horrendous when he rode strapped to his saddle. The bouncing and jolting, the abrasive rubbing of the stump against the rough cloth of a dressing or pad could not have been endured without some sort of pain-reliever.. An opiate was the standard prescription. The drug would have made Hood sleep at Spring Hill while the Federals escaped his trap. The pain was a terrible burden to inflict on Hood, but it was even worse to inflict Hood on the Army of Tennessee.

An excerpt...

Union Major General Joseph "Fighting Joe" Hooker's affinity for spirituous liquors and spirited women was a matter of record by the time he led the Army of the
Potomac to battle at Chancellorsville, Virginia, in May 1863. If Hooker was truly an alcoholic, and if he kept his pledge not to drink while commanding the army, it is highly likely he was treated with opiates to help him through withdrawal (opiates were commonly used to treat delirium tremens). This medical scenario may account may account for his poor battlefield performance. Or, there may have been another. Hooker's plans for the Battle of Chancellorsville were excellent. It was his leadership that faltered as he became more and more lethargic. The general admitted this much himself. Then, on May 3, Hooker claimed that, while he stood on the porch of a house, he was hit on the head by a column that was knocked loose by a cannon shot. He claimed he was in great pain. The Medical Director of the Army of the Potomac, Doctor Johnathan Letterman, later substantiated Hooker's claim, but failed to mention the extent of the injury, the amount of pain and whether any alcohol or morphine
was administered.. But Hooker's behavior the rest of that day indicates he may have received an intoxicating prescription, for he abandoned control of his army to sleep in his tent. Opium, in smaller doses than whiskey, is an effective soporific.


Best for the last excerpt on Grant...

Ulysses S. Grant was certainly known as a two-fisted drinker, but liquor did not keep him from forging victories. Perhaps a more important observation about Grant is that he was never forced by poor health torely on the services of a surgeon. That fact alone may have been a blessing for the Union. Due to the state of medical arts and sciences during the Civil War, some officers, tenuously steadied with alcohol or opiates, managed to hold positions of great responsibility even though they were unfit for any military service.

I hope you read the article and give you s new way of looking at these men performance in the field...
 
Like always, I bring a point a view that goes against conventional history ideas and everyone runs away. Gen. Hood is oblivious that opiates cause him to be unable to do his duty with vigor.

Gen. Bragg, I have heard stuff like he had some mental disorder but in truth he was a opiate user. IF you keep that in mind he acted like a drug addict... Around his men..

GEN. Hooker seems may have be an opiate user at least at Chancellorsville...

Like I say people do not like new ideas of history. ..
 
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Hood's use of opiates I believe has been largely debunked.

I am very glad I live with this century's medicine.
 
Hood's use of opiates I believe has been largely debunked

I have not read that what I have ever read he drank that liquid laced with opium, like water. He was missing body parts...

I glad to living with our modern medicine.

It seems no one wants to think that command officers were using opiates. Or great battles were won and lost do to drug use...
 
Well... General Halleck was a long-term opium user. He abused everything...

Halleck’s problems were personal as well as political. Marszalek observed:”The stress of command had broken down his physical health and with it his will, long under siege by the psychological pressures of his earlier life.”12 Halleck was afflicted with a variety of ills. “His medicinal use of opium to deal with his hemorrhoids or diarrhea may have caught up with him, or he may have been overusing alcohol to compensate for drug withdrawal or mental anxiety. He also smoked incessantly and the habitual scratching of his elbow continued. The physical and psychological stress on Halleck was becoming all too obvious,” wrote Marszalek. “He did not look healthy or alert.”13 Halleck was further handicapped by his political limitations and personal sense of superiority. Like McClellan, he failed to appreciate that war is not fought in a political vacuum. Marszalek wrote that Halleck was “severely limited in his relationships. Since he looked down on politicians, as he did on Grant and anyone whose conduct he disapproved of, there was no reason to expect him to make any effort to draw close to the Washington politicians.”14 He conscientiously evaded responsibility and command. Furthermore, he was no diplomat. He had a talent for alienating generals, congressmen and Cabinet members. He was abrasive – an intellectual in a general’s uniform.

The link... http://www.abrahamlincolnsclassroom...poraries/abraham-lincoln-and-henry-w-halleck/

Here an excerpt of AG Bates committing on Halleck and opium... link

https://books.google.com/books?id=2...#v=onepage&q=General Halleck on opium&f=false
 
President Lincoln a coke head... ?



In 1860 president Lincoln walked into Corneau & Diller drug store in Springfield, Illinois and purchased 50 cents worth of Cocaine. The alkaloid had only been isolated from the cocoa plant 5 years earlier and had just been named “Cocaine,” by Albert Nieman a year before. Lincoln was one of the first Americans to use the new drug.

Harry E. Pratt found this fact when researching for his book, The Personal Finances of Abraham Lincolnpublished in 1943. Pratt studied Corneau & Diller’s order books and found that on October 12, 1860 an order was filled for Lincoln in the amount of 50 cents for Cocaine. In fact, other historians found in earlier order books from the same drug company, that the Lincoln family had bought other powerful drugs in 1853, and 1854. The drugs they purchased in 1853 and 1854 were camphorated opium tincture used at the time for its anti-diarrheal and pain relief properties. The main ingredient in this drug was Morphine, a highly addictive and dangerous drug. But one must understand that little was known about drugs and their side effects at the time. Mary Lincoln experienced depression, mood swings, and hallucinations due to the drug use.


A link to the sight,,,, http://www.historyconfidential.com/2008/08/president-lincoln-used-cocaine/
 
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Hood's use of opiates I believe has been largely debunked.

I am very glad I live with this century's medicine.

I found this on Hood and Ewell... I think this is the info that concludes Hood was not addicted to morphine but he did need morphine to get to sleep for a few months. His doctor kept very detail notes of his care for Hood... Poor Ewell he kept losing bone.. pages 265 and 266 a line of two on page 267...

https://books.google.com/books?id=h_CZBgAAQBAJ&pg=PA266&lpg=PA266&dq=General+Ewell+use+of+opium&source=bl&ots=qUBcK1oFrc&sig=gecMI4H_royncoj6LUIEwGYrqpE&hl=en&sa=X&ved=0ahUKEwi82trc54nQAhVM5CYKHWXQAZcQ6AEIIzAB#v=onepage&q=General Ewell use of opium&f=false
 
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One reason General Rosencrans was removed from command was the excisive use of opium.... here is link to a NY times article from back then 1863...

excerpt...

The statement acquiring growth that he(Rosencrans) had an attack of epilepsy during the battle, and that he was subject to that disease, is untrue; but that he was constitutionally and by education subject to fits of religious depression of the profoundest character, is correct, though he was an austere Roman Catholic, as is well known. In connection with this it may not be unsuitable to add that it is understood that the fourth specification of the preferred charge is an excessive use of opium.

link... http://www.nytimes.com/1863/10/22/n...of-the-government-s-reasons-for-the-step.html
 
President Lincoln a coke head... ?

In 1860 president Lincoln walked into Corneau & Diller drug store in Springfield, Illinois and purchased 50 cents worth of Cocaine. The alkaloid had only been isolated from the cocoa plant 5 years earlier and had just been named “Cocaine,” by Albert Nieman a year before. Lincoln was one of the first Americans to use the new drug.

Harry E. Pratt found this fact when researching for his book, The Personal Finances of Abraham Lincolnpublished in 1943. Pratt studied Corneau & Diller’s order books and found that on October 12, 1860 an order was filled for Lincoln in the amount of 50 cents for Cocaine. In fact, other historians found in earlier order books from the same drug company, that the Lincoln family had bought other powerful drugs in 1853, and 1854. The drugs they purchased in 1853 and 1854 were camphorated opium tincture used at the time for its anti-diarrheal and pain relief properties. The main ingredient in this drug was Morphine, a highly addictive and dangerous drug. But one must understand that little was known about drugs and their side effects at the time. Mary Lincoln experienced depression, mood swings, and hallucinations due to the drug use.


A link to the sight,,,, http://www.historyconfidential.com/2008/08/president-lincoln-used-cocaine/

Sigh. That story goes around. Shows how having a knowledge about the modern world more than the period world causes dramatic mistakes in understanding. It's cocoaine, hair oil.

https://books.google.com/books?id=Os6n80YZ0PIC&pg=PA14
"Instead she found that the Lincolns had purchased Burnett's Cocoaine, a hair tonic made from 'cocoanut oil' and advertised in the Illinois State Register."

And everywhere else, it seems. Extremely common. It's hard to look at period newspapers for very long without finding an ad.

Also, here's a longer article: http://articles.chicagotribune.com/...ily-abraham-lincoln-association-cocaine-abuse
There's just one problem: For all his scholarship, Harry Pratt was wrong.

It's right there in the drugstore's original ledgers, which are fragile, old volumes painstakingly wrapped and stored at the Abraham Lincoln Presidential Library in Springfield.

In flowery handwriting, the ledger attributes several credit purchases to the family of "Abraham Lincoln" on Oct. 12, 1860, including one for "cocoaine." Two other Springfield residents also bought "cocoaine" that year, according to the record.

Of course, many words were spelled differently 150 years ago, a fact that has caused problems periodically with historical interpretation. For instance, the same ledgers misspell "cigars" as "segars." Pratt must have taken this into account in assuming that the ledger's "cocoaine" notation meant Lincoln bought cocaine.

But it's not very likely, says drug historian Dr. David Musto.

Musto, who has written four books about the history of drug regulation, is a Yale Medical School faculty member and a former White House adviser on drug policy.

"It's virtually impossible that Lincoln purchased cocaine in 1860," he says. "Cocaine wasn't even isolated from coca leaves until 1860 by a scientist named Albert Niemann in Germany."

Niemann experimented with 60 pounds of coca leaves until he found a way to isolate the cocaine, according to Steven Karch's "A Brief History of Cocaine" (CRC Press, 1997).

......

Hair tonic, it turns out--a boost for his follicles, not his neurons. Perhaps Honest Abe had a vain streak we didn't know about.

"Cocoaine," a short investigation has disclosed, was a remedy for dandruff and baldness in the latter 1800s and went by the brand name Burnett's Cocoaine.

It was made by Joseph Burnett in Boston from the oil of cocoanuts (an alternative spelling of coconuts), hence its drug-like name. The Jan. 23, 1862, Chicago Daily Tribune even advertised "cocoaine soap" for chapped hands.

Burnett's hair tonic was popular nationwide. "I have used the contents of one bottle, and my bald pate is covered all over with young hair, about three-eighths of an inch long, which appears strong and healthy, and determined to grow," said a customer testimonial in a Nov. 21, 1863, Harper's Weekly ad.

Did Corneau and Diller's sell the product at the time of Lincoln's purchase?

The answer is in a front-page ad in the Springfield paper, the Illinois State Register, on Oct. 11, 1860, the day before Lincoln's purchase. It says:

"Cocoaine--Burnett's, for the hair
At Corneau & Diller"

The hair tonic must have been in demand, because another Springfield store also advertised it.

So, all evidence shows that Lincoln didn't buy cocaine; he bought hair tonic. After all, he often commented on his unruly hair.
 
I found this because someone else must ahve been looking into it and found this where Rosencrans tells and audience to "refer to his druggist" over the charges of opium use... not much of a defense... pages 142 and 143...

https://books.google.com/books?id=BlXxEVcAzQYC&pg=PA142&lpg=PA142&dq=general+rosecrans+use+of+opium&source=bl&ots=Bvd-OX6ltT&sig=VDNDCjI7GYknbZL0gpxZzD_v8kY&hl=en&sa=X&ved=0ahUKEwj46O2A7InQAhUJSCYKHci2BskQ6AEIJzAD#v=onepage&q=general rosecrans use of opium&f=false
Rosecrans' comments about his druggist were made in jest as can be seen in this excerpt: One of my New-York friends has published to the world that Gens. MCCOOK and CRITTENDEN have conspired against me. Now, I have the assurance from them to-day, that they regret the use of their names in any such dishonorable connection. [Cheers.] As to the quantity of opium I have taken, you will have to excuse me -- I refer you to my druggist. [Laughter.]

The entire account of his speech in Cincinnati can be found via this link: http://www.nytimes.com/1863/10/29/n...riotic-speeches-speech-gen-rosecrans-gen.html
 
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