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Civil War medicine is notorious for being gruesome.
It’s an odd topic for the squeamish, like Springfield author Glenna
Schroeder-Lein, whose book, The Encyclopedia
of Civil War Medicine, was just published. “I’m the sort of person who feels faint
at the sight of blood,” she says, laughing. This was the third book and second encyclopedia for
Schroeder-Lein, who is manuscripts librarian at the Abraham Lincoln
Presidential Library (which has a copy of the book). She wrote it because
“it’s the kind of thing that I wish I had had when I started
studying Civil War medicine.” (She studied the topic while
researching her doctoral dissertation.)
Medical issues were an important facet of the war
— historians estimate that two-thirds of the soldiers who perished
died of disease, according to Schroeder-Lein — yet the medical terms
from the time are often outdated or the issues are difficult to understand
today. As a result, she writes in the book’s introduction,
“many [Civil War] researchers simply ignore medical issues or are
frustrated by an inability to clarify the problem.”
The 211 short articles in Schroeder-Lein’s
encyclopedia explain those terms and issues in everyday language. The book
covers a variety of related topics, such as women’s contributions to
soldiers’ care, generals who sustained especially bad wounds, and
battles that had significant medical consequences. The minutiae are
included, too: We learn about “vermin fairs” — informal
contests held by soldiers to see who had the most “graybacks,”
or body lice. (And here we thought the soldiers never had fun.) “Many soldiers had less than a rudimentary idea
of sanitation,” Schroeder-Lein writes. “Coming from a rural
background where they relieved themselves outside whenever nature called,
these men continued their habits in camp rather than using the latrines.
When these soldiers entered a hospital with an indoor water closet, they
did not know how to use it, plugging it up with sticks, paper, and other
debris.” This practice contributed to outbreaks of contagious —
and sometimes deadly — diseases. Typhoid and diarrhea were common. Dr. Silas Thompson Trowbridge, a Civil War surgeon
from Decatur, treated a now well-known soldier for battle wounds and severe
diarrhea. The soldier was Col. John A. Logan, of southern Illinois, who
later helped establish Memorial Day and became a congressman and U.S.
senator. Trowbridge’s Civil War experiences are recorded in the Autobiography of Silas Thompson Trowbridge M.D. (Southern Illinois University Press, 2004).
Logan’s previous surgeon had treated him with
two common anti-diarrheal medications of the time: calomel (which contained
the toxic element mercury) and opium (which was addictive). They
didn’t work. “On arriving at the bedside of the gallant
officer I found him unconscious, pulseless at the wrist, speechless, with a
cold clamy [sic] sweat . . . indicating death within an hour,”
Trowbridge wrote. His solution? Turpentine.
Logan got better, but it probably wasn’t due to
the sticky tree sap. Schroeder-Lein’s book says turpentine and other
secondary Civil War treatments for diarrhea “were either useless or
further cleaned out the system.”
Another problem with Civil War medicine was the lack
of knowledge about germs. Back then, common thinking held that
“miasms,” or poisonous airs and bad odors (Civil War camps had
plenty), as well as “animaliculae” caused disease. Medical
personnel, as a consequence of this faulty thinking, didn’t wash
their hands or instruments frequently. Antiseptics and disinfectants were
used, but usually inappropriately, according to the encyclopedia.
Physicians often wouldn’t put antiseptic on a wound until after it
became infected.
In 1911, Dr. William J. Chenoweth, a Decatur Civil
War surgeon, recalled how this affected one soldier’s outcome. (His
comments are included in an online paper from Quincy University’s
Brenner Library — see
www.alliancelibrarysystem.com/IllinoisWomen/files/qu/htm2/quessay.html.) The soldier was in a desperate condition, his knee was
crushed by a bullet. “In a case like this today [1911] we could
probably have saved his life by antiseptic treatment. He was treated with a
solution of bromine, but we had no definite idea of how it should be used
and knew absolutely nothing of germs as causing disease, or of germicides
as preventing surgical fever.”
While the war’s unsanitary conditions are
documented, many people have a misperception about the quality of its
medical care, Schroeder-Lein says. We laugh at it today, considering it
extremely primitive, but we have to put it in perspective, she says:
“If you’re comparing it to the 21st century, yes, it was, in
many respects. But in other respects not.”
“A lot of the guys who were doctors during the
Civil War were pretty cutting-edge,” she says; many were
medical-school professors or were supervised by them. “These were
guys who knew their stuff. . . . Some of the treatments they used
aren’t necessarily that far off [from what we’d use
today].”
For example, contradicting our modern perception,
anesthesia was used amply and effectively.
“Doctors would give [soldiers] just enough
anesthesia so they weren’t feeling pain but not enough that they were
completely relaxed, so they would thrash and moan and people would have to
hold them down,” Schroeder-Lein says. “It would look like they
were having their amputation without anesthesia, but in fact they woke up
not remembering anything. “There were certainly some operations performed
without anesthesia, but the vast majority, in the North and South, were
performed with chloroform or ether, in sufficient doses so the soldier
wouldn’t feel pain.”
One of the biggest medical problems of the war was
disease, especially childhood diseases, Schroeder-Lein says. Soldiers from
rural areas “who’d never been exposed to the measles, mumps, or
chickenpox” would eagerly volunteer to serve, show up at camp and
promptly get sick. “All these [diseases] are more serious when you
get them as an adult,” she notes, but measles was especially serious
because it often led to secondary illnesses. “It was easy for
[soldiers] to catch something after measles, so a lot of people suffered
from bronchitis, pneumonia, eye problems, or all sorts of other things
because they’d been weakened by measles. “It was tough for the commanders, too, because
there were regiments where three-quarters of the soldiers were sick. That
was common in both the North and South.”
The treatment often made the soldier even sicker or
killed him. Calomel not only was used to treat diarrhea, it also was
paradoxically given to prevent constipation; in any case, it could cause
excessive salivation, the death of oral tissues, loose teeth, facial
deformities, and death resulting from mercury poisoning. Opiates, the most effective painkiller at that time,
were used to sedate soldiers and treat diarrhea, according to the
encyclopedia. However, they could be addictive, especially in a soldier
with chronic pain or illness who used them frequently. “Historians
have suggested that several Civil War generals who had serious health
problems may have made poor military choices because they were under the
influence of painkilling opiates,” Schroeder-Lein writes. Doctors didn’t realize that opiates were
addictive. As a result, some veterans ended up with a lingering reminder of
the war: opiate addiction, or “old soldier’s
disease.”
As Schroeder-Lein’s research demonstrates,
Civil War medical practices were more advanced than we thought, but they
still left a lot to be desired.
Tara McClellan
McAndrew is the history columnist for Illinois
Times.
Contact her at TMcand22@aol.com.
This article appears in May 8-14, 2008.
