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....