The Ghastly Work Of The Field Surgeons

JohnW.

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Here are three descriptions of the work of the surgeons, all of them tending to bear out the complaints of the Baroness von Oinhausen. These descriptions of heartlessness could be matched in letter after letter, diary after diary, North and South. One Kentucky editor charged that the doctors had " slain more of our troops than all of Lincoln's minions " and a Richmond one characterized the Medical Department as "unfeeling,'shameful and brutal." We must remember however that it is the exceptionally bad conduct that gets recorded; routine work is taken for granted. On the whole the surgeons and nurses did about as well as they could. Certainly many of those who worked all through the war, at great peril to themselves, were distinguished members of a distinguished profession.

The first of these critics, Samuel Nichols, was an Amherst College student who enlisted in the 37th Massachusetts Volunteers; served through the war; and later edited the Pittsfield (Massachusetts) Sun. The second is the famous politician and reformer Carl Schurz, who commanded the XI Corps at Gettysburg. The third is Augustus Brown, Captain in the 4th New York Heavy Artillery.

Want to read the rest of the article????? Click here: http://civilwarrx.blogspot.com/2016/05/the-ghastly-work-of-field-surgeons.html

Courtesy of Civil War Rx
 
Thanks for posting this article @JohnW.

The surgeons did receive a lot of criticism for being seemingly eager to amputate. Unfortunately it was usually the only option - no specialized orthopedic surgery; no pins or plates. And such a shortage if medical officers on both sides! So many wounded and sick men and so few doctors to care for them. :nah disagree:
 
Yes, as lelliott said, the surgeons and nurses did what was sterling work for facilities and the time? The newspapers could afford to be critical, you know? It was so bizarre! The leaders held a war, huge armies collided.... and no one brought the bandaids. Surgeons brought a surgical saw. They had to.

The few surgeons there at the beginning were so overwhelmed, they worked the clock around. Men, with mud packed wounds and no time to clean it much less debride could only be saved by amputation- then there was no one to properly care for them afterwards or supplies to dress wounds. Barbaric? Wounded from Bull Run crawled into the streets of DC where citizen took them in.

Army nurses began to be mustered, in a slow trickle, working around the clock also, but it was a massive groundswell we've never seen before and will never see again of private citizens who financed, organized and glued together medical relief for an entire war. Crazy times.

You see the old photos or records and one says ' surgeon ' and just kind of gasp. How they did it you cannot imagine.
 
Those War times were the worst possible conditions, no antibiotics, no sanitation, and many times no basic supplies. Doctors and nurses (I speak from experience), temporarily harden emotions, from seeing all the gore. It is a mental coping mechanism, but still does not excuse inhumane, unfeeling treatment of patients.

On the other hand, when the doctors finally see those men, whose legs are nearly severed from shrapnel, who had likely packed wounds with dirty rags, moss or mud, gangrene likely had set in. Many lives were saved by removal of limbs.
 
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Thanks for posting this article @JohnW.

The surgeons did receive a lot of criticism for being seemingly eager to amputate. Unfortunately it was usually the only option - no specialized orthopedic surgery; no pins or plates. And such a shortage if medical officers on both sides! So many wounded and sick men and so few doctors to care for them. :nah disagree:

I'm reminded of a line from a M*A*S*H episode, when they're dealing with a mass influx of casualties, one of the doctors, I think Hawkeye, says "If I save this leg, I could lose that life". That was the kind of choice they faced.
 
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Here are three descriptions of the work of the surgeons, all of them tending to bear out the complaints of the Baroness von Oinhausen. These descriptions of heartlessness could be matched in letter after letter, diary after diary, North and South. One Kentucky editor charged that the doctors had " slain more of our troops than all of Lincoln's minions " and a Richmond one characterized the Medical Department as "unfeeling,'shameful and brutal." We must remember however that it is the exceptionally bad conduct that gets recorded; routine work is taken for granted. On the whole the surgeons and nurses did about as well as they could. Certainly many of those who worked all through the war, at great peril to themselves, were distinguished members of a distinguished profession.

The first of these critics, Samuel Nichols, was an Amherst College student who enlisted in the 37th Massachusetts Volunteers; served through the war; and later edited the Pittsfield (Massachusetts) Sun. The second is the famous politician and reformer Carl Schurz, who commanded the XI Corps at Gettysburg. The third is Augustus Brown, Captain in the 4th New York Heavy Artillery.

Want to read the rest of the article????? Click here: http://civilwarrx.blogspot.com/2016/05/the-ghastly-work-of-field-surgeocomplaints of the Baroness von Oinhausen.ns.html

Courtesy of Civil War Rx
I strongly disagree with the blog writer that the three descriptions he/she offers shows civil war surgeons' "heartlessness". On the contrary, what they show is the Uniopn medical department's valiant efforts to perform as best as possible in overwhelming situations. Surgeons, doctors, hospital stewards, nurses, and other assistants were courageous people during the Civil War. Let's not forget these were the 1860's when medical knowledge and practice in the U.S. was very limited.
Also, this questionable article cites the complaints against Union surgeons by the Baroness von Oinhausen. Who is she anyway?!?
 
Yes, as lelliott said, the surgeons and nurses did what was sterling work for facilities and the time? The newspapers could afford to be critical, you know? It was so bizarre! The leaders held a war, huge armies collided.... and no one brought the bandaids. Surgeons brought a surgical saw. They had to.

The few surgeons there at the beginning were so overwhelmed, they worked the clock around. Men, with mud packed wounds and no time to clean it much less debride could only be saved by amputation- then there was no one to properly care for them afterwards or supplies to dress wounds. Barbaric? Wounded from Bull Run crawled into the streets of DC where citizen took them in.

Army nurses began to be mustered, in a slow trickle, working around the clock also, but it was a massive groundswell we've never seen before and will never see again of private citizens who financed, organized and glued together medical relief for an entire war. Crazy times.

You see the old photos or records and one says ' surgeon ' and just kind of gasp. How they did it you cannot imagine.
Couple that with the casualty stats too. Last figures I recall seeing said that 200K+ soldiers more died in the ACW than WW2. Medical science and the Medical Corps had made huge strides in 80 years too.
 
Important to point out that amputation was not simply a matter of brutally hacking a limb. A competent CW field surgeon understood the importance of administering choloform, tieing off blood vessels, peeling back appropriate layers of skin and muscle, carefully selecting point of removal, and suturing the wound. Given the level of medical science at the time, there was a great deal of care given in these type of operations.
 
Couple that with the casualty stats too. Last figures I recall seeing said that 200K+ soldiers more died in the ACW than WW2. Medical science and the Medical Corps had made huge strides in 80 years too.
November 29 1863 after the failed assault on Fort Sanders, Knoxville, Dr Myers (Asst Surgeon 16th GA) wrote:

Before day light we were in line between the R.R. & fort Loudon the latter on out skirts of Knoxville – as soon as there was light enough our Artillery open’d - at 6 am our Infantry commenced firing & charged the works with severe loss on our side – Col Ruff killd in first charge at the ditch wh[ich]: surrounded the fort – Col Thomas killd & fell in ditch his own coat pierced with 19 holes (bullet) Adjt Cumming taken prisoner in the fort which tis said he entered through port hole – Capt Nash Co A killed – my regt’s (16th GA) loss in killed, wounded & prisoners 85 as far as known – Maj Hamilton Comdg Phillips Legion wounded in arm above elbow – Adjt Porter of Cobb Legion [severely wounded] thigh – the fight was soon over – the weather was intensely cold & the wounded sufferd much – I had large fires built on the field to keep them warm – my hands became so cold while dressing the wounded I had to heat water to warm them after the attack we fell back – Capt B.E. Stiles not in the battle, & I was the only medical officer of Woffords Brig'd on the field

Wofford's brigade had five regiments plus the sharpshooters. I have found 81 of the 85 casualties Dr. Myers claimed the 16th GA had. I show 16 killed; 31 wounded; and 34 missing/captured. If each regiment of the brigade had 30 men wounded (which is pretty reasonable to assume under the circumstances), then that was 150 +/- wounded for ONE surgeon to attend!!!!!
@Podad @Chattahooch33
 
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Dr. Stevenson of the 22nd Kentucky wrote a letter to his wife about the conditions at Chickasaw Bayou. He assisted another surgeon in the exsection of the elbow joint of one man then that doctor assisted in the amputation of an arm at the shoulder of one of Stevenson's men. He talks of being on his feet continuously for 18-20 hours each of the three days the troops fought. He discussed wounds of all sorts and then the weather and drinking from the bayou causing much more illness as well. Some men had to lay on the cold field during a night rain with temperatures barely above 40 degrees.

He does not paint a very glamorous picture of honorable warfare.
 
Even a small battle such as at Kirksville, Mo., in August 1862, could produce a number of limbs. After that battle, there is a story of the surgeons or rather enlisted men who tossed the amputated limbs into a wagon from the different floors of a building used as a hospital. The wagon was located by the side of the building. I at least hope they buried them in the nearby cemetery. The building was still standing in the town square when I graduated from the college.
 
Those men and women who had no choice but to perform those brutal surgeries to save lives were heroes of the highest order IMHO, anyone can have an opinion on what they did especially from the comfort of your warm and well provided home far away from the reality of the battlefield.
 
Also, this questionable article cites the complaints against Union surgeons by the Baroness von Oinhausen. Who is she anyway?!?

Mary Phinney, Baroness von Olnhausen, was the American-born widow of a German refugee and served as a nurse in Alexandria during the Civil War. Her biography is here: https://ia801400.us.archive.org/23/items/armynurse00olnhrich/armynurse00olnhrich.pdf

If you're familiar with the PBS series Mercy Street, the main character in that series was very loosely based on the Baroness' biography.
 
I have to highly recommend this series of lectures by former National Museum of Civil War Medicine director George Wunderlich. He has worked diligently to dispel many of the myths of Civil War medicine. One of the most striking: civil war doctors could have saved more lives had they conducted more amputations. Amputations were in fact the single greatest life saving medical technique in the war.

He also worked hard to increase public knowledge about Jonathan Letterman, one of the great unsung heroes of the American Civil War. From the Civil War Trust:
"With the beginning of the Civil War in 1861, Letterman was assigned to the Army of the Potomac and was eventually named medical director of the entire army in June 1862, with the rank of major. After it took over a week to remove the wounded from the battlefield at Second Manassas, Letterman was given free range by General George McClellan to do whatever was needed to revamp the poor medical services that the men received in the field.

Before Letterman’s innovations, wounded men were often left to fend for themselves. Unless carried off the field by a comrade, or one of the regimental musicians doubling as a stretcher bearer, a wounded soldier could lie for days suffering from exposure and thirst. Letterman started the very first Ambulance Corps, training men to act as stretcher bearers and operate wagons to pick up the wounded and bring them to field dressing stations. He also instituted the concept of triage for treatment of the casualties.

Letterman developed an evacuation system that consisted of three stations:

1) A Field Dressing Station - located on or next to the battlefield where medical personnel would apply the initial dressings and tourniquets to wounds.

2) A Field Hospital – located close to the battlefield, usually in homes or barns, where emergency surgery could be performed and additional treatment given.

3) A Large Hospital – Located away from the battlefield and providing facilities for the long term treatment of patients.

In addition to these improvements, Letterman arranged for an efficient distribution system for medical supplies.

The success of the Ambulance Corps was proven at the battle of Antietam on September 17, 1862. While there were over 23,000 casualties, medical personnel were able to remove all of the wounded from the field in just 24 hours. The battle of Fredericksburg, where the Union suffered an additional 12,000 casualties, and the battle of Gettysburg, with 14,000 Union wounded, both tested Letterman’s system to the extreme, but again, it proved a great success, saving thousands of soldiers’ lives. In March of 1864, the system was officially adopted for the U.S. Army by an Act of Congress."
https://www.civilwar.org/learn/biographies/jonathan-letterman

One fact I found particularly interesting is how the nature of chloroform/ether led to myths about anesthesia not being used. In fact, anesthesia was used for nearly all Civil War surgeries. However, anesthetics have different effects as they begin to work.

Stage I (stage of analgesia or disorientation): from beginning of induction of general anesthesia to loss of consciousness.

Stage II (stage of excitement or delirium): from loss of consciousness to onset of automatic breathing. Eyelash reflex disappear but other reflexes remain intact and coughing, vomiting and struggling may occur; respiration can be irregular with breath-holding.

Stage III (stage of surgical anesthesia): from onset of automatic respiration to respiratory paralysis.

Stage IV: from stoppage of respiration till death. Anesthetic overdose cause medullary paralysis with respiratory arrest and vasomotor collapse. Pupils are widely dilated and muscles are relaxed.

During stage 2, the patient is unconscious and not experiencing any physical sensations. However, they are also thrashing about and calling out, often for their mother or some other loved one. Soldiers passing by the hospital would witness this stage and conclude that the barbaric doctors were hacking off limbs without anesthetic, when in fact exactly the opposite was the case.

Furthermore, biting the bullet was almost never done, as inserting a small object into someone's mouth before conducting surgery is very likely to result in the person choking to death.

Finally, alcohol was not provided to soldiers before surgeries as it was understood that alcohol in the bloodstream could have a detrimental effect on patient survival during surgeries. After surgeries; well, that was another story.

For those with a STRONG STRONG stomach, I recommend this video:

While very gruesome and describing surgery during the Napoleonic Wars, the incredible attention to detail and relative similarity between Napoleonic and Civil War surgeries (the key difference being that Civil War soldiers had anesthetics) make this a worthwhile watch for those with, again, a strong stomach.

And now, I really should be finishing my advertising essay due tomorrow....
 
What's so astonishing is this concept that no one thought to let Letterman ( or anyone ) loose on the topic during the long, long windup towards war. During the battle of Second Manassas, bones of the dead from the first battle were still just out in the open, or imperfectly buried. Not enough ambulances, no one dedicated to remove wounded, much less care for them.

Read the list of hospitals, in era papers, in DC, post Bull Run. It's similar to Gettysburg, with 'public houses ', private homes and hotels opening doors to wounded. There are lists of complaints about them, too, about not enough supplies and care. Nothing to do with surgeons or anyone who was frantically trying to help. The lack of foresight with ' War ' on the horizon was criminal.
 
I agree with you JPK. There was no planning on both sides on how to deal with the wounded before the war. Because of this thousands lay on the battlefields suffering and dying needlessly for days or more before help arrived. The people did the best they could with the circumstances.
 
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