Transcript Pavilion Hospital - WLWV Staff Blogs

Civil War: Medicine
Doctors
• Beginning of war: 30 surgeons, 83 assistants.
• End of war: 11,000 surgeons/assistant surgeons.
• Most civil war doctors got their diploma in 13
weeks.
• The most prestigious schools had 2 year doctor
programs. The programs were a series of lectures
that a “student” attended two times.
• If a surgeon was unavailable, anyone with a knife,
saw, and tough stomach would perform surgery.
Level of Care:
Field Dressing Station
• Set up behind the
fighting lines.
• Wounded soldiers were
evaluated, given
morphine or liquor, and
bandaged.
• If they couldn’t return
to battle, they were
taken to a field
hospital.
Field Hospitals
•
•
•
•
•
Located in barn or tent 1-2
miles from the battle.
Wounded soldiers
were triaged into 3
categories:
mortally wounded
(Soldiers wounded
through the head,
belly, or chest were
left to one side
because they would
most likely die)
slightly wounded
surgical cases
(amputations)
A surgeon recalled: "We operated in old blood-stained
and often pus-stained coats, we used undisinfected
instruments from undisinfected plush lined cases. If a
sponge (if they had sponges) or instrument fell on the
floor it was washed and squeezed in a basin of water
and used as if it was clean."
Pavilion Hospital
-Prior to the war, no real hospital systems exist in the US.
- By the end of the war, hospitals in the North and South average an 8% mortality rate.
Medication
• Chloroform was used in
most operations.
– Liquid form in the north.
– The South invented an
inhaler to stretch their
limited amounts.
-Morphine was known, but only available in small doses.
- Opium was the drug most commonly used to relieve pain.
HOWEVER, the surgeons did not know that opium was
addictive.
- Alcohol was used as a substitute for any of the above
medications if they were unavailable.
Amputations
•
Total number for both sides
is over 50,000.
• If performed within 24 hours,
the victim had a 75% chance
of survival.
• A good surgeon could
amputate a limb in under 10
minutes. If the soldier was
lucky, he would recover
without one of the horrible
so-called "Surgical Fevers.”
• There was no
knowledge of disease
causing bacteria, so
antiseptics were not
used during surgery.
• Due to a frequent
shortage of water,
surgeons often went
days without washing
their hands or
instruments, thereby
passing germs from
one patient to another
as he treated them.
Complications
Complications Continued:
• Doctors believed that “laudable pus”
meant that the wound was healing
correctly. We now know that visible pus
means an infection.
• Infections set in after a surgical
procedure, most commonly:
• Gangrene, the rotting away of flesh caused
by the obstruction of blood flow.
• Pyemia- blood poisoning with a 90% mortality
rate.
• Antiseptics were provided only after a
fever was visible. At that point it was often
too late.
•
Disease was the biggest killer of the
war.
– Federals: three out of five died of disease
– Confederates: two out of three died of
disease
• Camps were unsanitary, and
garbage, waste, and other refuse
often polluted water sources and
mixed with living conditions.
• Close living quarters caused
disease to spread from man to
man very quickly.
• Poor diet and exposure to the
elements only added to the
burden. A simple cold often
developed into pneumonia.
Disease
Diseases
•
NUMBER 1 KILLER: Typhoid fever (camp fever). Perhaps onequarter of noncombat deaths resulted from this disease, caused by
the consumption of food or water contaminated by salmonella
bacteria.
• NUMBER 2 KILLER: Bowel disorders constituted the soldiers' most
common complaint. The Union army reported that more than 995
out of every 1,000 men eventually contracted chronic diarrhea or
dysentery during the war; the Confederates fared no better.
• NUMBER 3 KILLER: Colds turning into lung diseases like
pneumonia and tuberculosis.
• Malaria spread through camps located next to stagnant swamps
teeming with mosquito. Although treatment with quinine reduced
fatalities, malaria nevertheless struck approximately one quarter of
all servicemen.
Advancements- Chest wounds
• At the onset of the war, a sucking chest
wound (punctured lung) was almost certainly
a death sentence.
• Dr. Howard found that if he closed the wound
with metal sutures, followed by alternating
layers of lint or linen bandages and a few
drops of collodion (a syrupy solution that
forms an adhesive film when it dries), he
could create an airtight seal.
• Survival rates quadrupled, and Howard’s
innovation soon became standard treatment.
Advancements
The Plastic Surgery Revolution
• Carleton Burgan of Maryland was in terrible shape. The 20-year-old
private had survived pneumonia, but the mercury pills he took as a
treatment led to gangrene, which quickly spread from his mouth to
his eye and led to the removal of his right cheekbone
• In a pioneering series of operations in 1862, a surgeon from City
Hospital in New York used dental and facial fixtures to fill in the
missing bone until Burgan’s face regained its shape.
• To some, it seemed pretty wacky, like sci-fi for the 19th century.
Advancements:
Ambulances
- At Bull Run, the Union had hired civilian carriage drivers to
take the wounded back to DC.
- Not surprisingly, they saw the battle and fled.
- The wounded from Bull Run walked the 30 miles back to DC.
Ambulances
- Jonathan Letterman, medical director of the Army of the Potomac,
established caravans of 50 ambulances, each with a driver and
two stretcher bearers, to ferry the injured to field hospitals.
- On September 17, 1862, the Battle of Antietam left 2,108 Union
soldiers dead and nearly 10,000 wounded. The Ambulance Corps
moved all 10,000 wounded Union Soldiers from the battlefield to field
hospitals in twenty-four hours. For this success Letterman earned the
title of “Father of Battlefield Medicine.”
Battlefield Angels!!!
DORTHEA DIX
A week after the attack on Fort
Sumter, Dix, at age 59,
volunteered her services to the
Union and received the
appointment in June 1861,
placing her in charge of all
women nurses working in army
hospitals.
CLARA BARTON
“I went in while the battle raged," she
recalled with pride. After the war, she was
instrumental in the creation of an
American branch of the International Red
Cross.
•3,200 women served as nurses
•Lived in tents or hospital wagons
•Risked their reputation- targets of
gossip
•Paid $12 month
End Results…
• Nearly 3 million men fought in the Civil War.
• Approximately 618,000 lost their lives, and nearly 400,000
of these to disease.
• The death toll was nearly 2% of the entire US population.
• Of the men lucky enough to be in the 79% who survived
the war, nearly half a million returned home permanently
maimed or disabled.
• * One million horses also died in the war.