Advances during Civil War

There were some important advances in medicine and medical technology during the Civil War. As often the case, most medical advances in medicine come about exactly because of war. War can bring out the very worst in mankind, and the very worst of diseases and the most unique of injuries.

Although there were important tangible medical advances, an open mind toward change was the most critical to life saving techniques during the war. The real lasting impact was the change in the mindset of both the doctors and the people who they were treating. (Koyle by Thompson, Six Ways the Civil War Changed American Medicine) Keeping an open mind is one of the reasons why medicine and medicine technology has advanced so quickly from the days of the Civil War an into modern times. Today, physicians most are willing to search for better ways to fight disease, rather than to just stick with one solution. Too, because of the internet, patients also have a similar option. After all, in medicine, there is no one size fits all.

Keeping an open mind was not so much the norm in the beginning of the war. Most physicians still held to the belief that it was best to treat patients diseases via the Humoral theory, which mainly consisted of treating disease through diet and exercise, or in worse cases, through bloodletting. However, the U.S. Surgeon General, William Hammond, was influential in changing with way military physicians treated patients. Two of the most important things he did was he instituted training in public health, hygiene and surgery for all Union Army medical officers. His call for specimens also provided a textbook of case studies to train doctors after the war (Thompson, Six Ways the Civil War Changed American Medicine) Because war often brings about such unique damage and disease to a body; by saving case notes, body parts and bodily fluids for future study, Hammond ensured later practitioners understanding of disease and grievous and at times.

In the beginning of the war, the military hired civilian drivers to carry the wounded off the battlefield. These drivers were unaccustomed to war and not medically trained. They were often shell-shocked and confused, sometimes running away when attempting to pick up wounded soldiers on the battlefield. The wounded could be left where they fell for days before being removed to a hospital, and most died.

Dr. Johnathan Letterman, a surgeon, recognized this and started the first Ambulance Corps. Men were trained to bring the wounded to the field dressing stations on stretchers and by wagon as quickly as possible. Time was essential in saving a wounded soldiers life, and surgeons had to act quickly. The Ambulance Corps would quickly remove the wounded to a Field Dressing Station, very near the battlefield, for assessment and application of dressings to the wounds. Next, they were moved to a makeshift Field Hospital, usually a home or barn also near the battlefield to perform emergency surgery (usually amputations). They would be taken to a Large Hospital later, which would be located much further away from the battlefield for long-term needs. Lettermans efficient removal and triaging of the wounded saved lives as documented in the battle of Antietam, where there were over 20,000 casualties, but all the wounded were removed from the field within 24 hours or less. This practice is still in use today in military warfare as well within the general population. An interesting example of this modern triaging actually happened to me after my horse-riding accident at my farm. After the 911 call, an ambulance came. The medics quickly assessed by wounds and requested a helicopter. The helicopter was en route to UAMS at Little Rock, but diverted to Hot Springs, to stabilize and give me blood and then I was flown to UAMS for surgery and days later to an inpatient rehab facility. One can only imagine what terrible suffering soldiers must have gone through before Lettermans lifesaving innovations.

Before the Civil War broke out, physicians might attend a medical school for two years. If they attended at all. Some would apprentice with another physician and some might not have had any official medical training at all. If they did happen to attend medical school, they would attend a years worth of courses and then repeat the same courses the very next year. Unfortunately, working on cadavers for study in most of America was considered unethical, and therefore most new graduates had very little understanding of the human body. That changed during the course of the Civil War. With thousands of dead and dying men, physicians were granted a great deal of hands-on experience. They learned what medicines worked best for treating some ailments or what worked best for pain. They learned how much anesthesia was needed to put a patient under. They learned how to amputate limbs and how far they needed to cut and to do so quickly. But most importantly, they gained experience and knowledge they needed to become good at what they did, allowing them to teach another generation of physicians all they had learned.

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