The Civil War’s Biggest Killer? Lack of Good Medical Care

Family History
21 August 2014

Civil war
[Photo credit: dfbphotos on Flickr]
When the U.S. Civil War started in 1861, medical knowledge was still primitive. Battlefield doctors didn’t understand infection or the importance of sterile conditions during surgery. In fact, the country was just coming out of a period when doctors used bloodletting, purging, and blistering to cure ailments. So it’s no wonder Civil War soldiers were more likely to die from disease than combat.

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The numbers are staggering: Some estimates say 750,000 soldiers died during the Civil War, about two-thirds of them from disease. That included three in five on the Union side and perhaps two out of every three Confederates.

When thousands of new Civil War soldiers came together for training, epidemics of chicken pox, mumps, whooping cough, measles, malaria, and tuberculosis, among others, tore through the camps with their poor sanitation and bad hygiene. Along with “killed in battle” and “vulnus sclopeticum” (a Latin term for a gunshot wound), Civil War death registers are full of men who died of typhoid, dysentery, pneumonia, and chronic diarrhea.

Doctors often prescribed coffee, whiskey, and quinine in situations where today they would prescribe antibiotics. Of course, antibiotics hadn’t yet been discovered, and when a minor war wound became infected, it often led to death.

Wounds to limbs were common, which often led to the limb being amputated because there were no other techniques to prevent gangrene. Civil War surgeons performed a tremendous number of amputations, and many had it down to a 10-minute procedure. With the enormous number of patients, and often a lack of water, hands and instruments were seldom washed between amputations, which led to high rates of infection. However, it’s estimated that 75 percent of amputation patients survived.

American Poet Walt Whitman was a nurse in the war and wrote about seeing “a heap of amputated feet, legs, arms, hands, &c, a full load for a one-horse cart” at a Virginia camp hospital in 1862.

Surgeons used chloroform or alcohol to partially sedate their patients, who often didn’t feel pain during an operation but were not totally unconscious, either. Confederate General Stonewall Jackson reported that he heard the sound of the saw cutting through his arm bone but did not feel any pain.

The enormous numbers of casualties from disease and wounds in the early years of the war led to much improved and advanced procedures by the end of it. The Union Army implemented standard equipment, division hospitals, and detailed medical records.

The Confederates had far fewer resources and initially sent wounded soldiers home on furlough to recover because of the lack of field hospitals, though that ended gradually when the army began building hospitals in Southern cities. Their first surgeons were required to bring their own supplies.

Clara Barton nursed soldiers on the front lines of the Civil War and was called the “Angel of the Battlefield.” After the war, as a result of what she’d seen, she founded the American Red Cross.

You can find medical and burial records among the searchable Civil War records on Ancestry

— Leslie Lang

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