Page givens bacchus. Weve been talking about the war in means, but we cannot forget about the aftermath as well. Is a public historian with Prince William county, virginia. About here today to talk the medical field in the civil war. Thank you for having me and thank you for listening and watching these videos. What i will be talking to you about, i will be talking about the fight for life and death in the aftermath of these battles in the american civil war. We have heard a lot of talk about different battles, prison camps, and the aftermath of the in the years and months and days following was, in a sense, a whole other battle. It was a war against disease. Wrote thattorian heroes ofe the unsung and they were treating the dying and wounded after these heroes horrific battles. So it cost over 700,000 casualties. Ultimately we will talk about the good that came out of this battle for life and death. So, i could be talking to you all day about anything and everything with civil war medicine, but for the purposes of our conversation, i have pulled examples mainly focusing on the war in the east. But before we can Start Talking about different challenges we have faced in the medical field, we need to talk about where the medical field was at the beginning of the civil war. ,t the time of the civil war there has been significant medical advancement. We have gone beyond the four humors, which are essentially yellow bile, black while, meaning if one of those were out ounce, you were sick and they had to put those back inbounds. This isown fact one of the reasons that George Washington died when he had pneumonia. You had the study of anatomy and there were. Hings such as body snatching but you have different studies of the medical field like epidemiology that are not taken place and now it all comes into place by the time the civil war began. However you do have medical schools that have been around since the 1700s. Betterknown schools, europe was much more advanced at this point than the United States. However, you do start having medical schools in new york, philadelphia, that are starting to take hold. However theres not much clinical. Its more learning from books and all from cadavers. At this point in time, they are trying to catch up. Establishing the American Medical Association and to reform with journals and medical societies. But by the time the civil war departmentsedical thought that they were well prepared for what they were going to experience. However, at the very first major , at thef the civil war battle of first manassas, you have 36,000 troops engaged in a battle that lasted about 24 hours. At the end of that 34 hours, you soldiers wounded or missing. And these challenges immediately started to reveal themselves. In the medical field you had two foreons in each regimen about 1000 men. For the union armies, there were no hospitals established because they had marched from. Enterville there were no hospitals up close to the front lines. Additionally there is no centralized ambulance corps. There would not be ambulance corps federalized until august of 1862. This meant that the ambulances were regimental and some soldiers were picked up with priority over others. Poor organization resulted in slower action, which resulted in more debt. Just to give you an idea. One soldier described a scene at one Field Hospital and he writes, there were piles of legs, feet, hands, arms thrown together and at a distance they acornled piles of corn at shocking. Surgeons were butchering away while the poor devils yelled with pain. Lost. Ives were theres another group of confederate soldiers that came across the Union Soldiers made famous by the battle of manassas and one of them remarked, there were 32 soldiers. But one single surgeon and he was young and apparently inefficient. With their the floor clotted dress. Some had died and not yet been removed. This was the first time many of them had actually had any practical experience, and so there were mistakes that cost lives. There were mistakes that saved lives. At the battle of first manassas, it was not a fight for life or death, and at this point the lines were still divided between north and south and this would create issues because when hospitals were captured, this meant you had surgeons that were taken away from their wounded patients. Began theiron army route back to centerville, decisions had to be made. Do they stay with soldiers and risk imprisonment or leave their patients behind . Left a soldier on the operating table and ran. And theycided to stay leavingen away, confederate troops in need of treatment. But a lot of these confederate soldiers did not receive the treatment they need it. As a result of this, not a year later this gentleman, dr. Hunter maguire enters into an agreement stating that we surgeons and assistant surgeons who are prisoners of war to give the role of honor of being unconditionally relieved to report in person to the secretary of war in Washington City and we will use our best with prisoners who will be taken and really and relieved. Essentially, this makes medical personnel neutral and at this point it did turn into a fight where medicalth personnel were trying to save as many lives as possible. But this point you have several other challenges that illuminate themselves over the civil war and one of the biggest is the casualties. You have 3500 casualties in one single day. In antietam, the number of wounded in the battle of antietam in one single day would reach over 17,000. For fredericksburg it would reach over 13,000. For gettysburg it would create over 33,000 soldiers. Creates issues with medical supply and now they are overwhelmed to try to save as many lives as possible. In one example in the battle of many of these men were intense in tents without floors or blankets. So, one soldier from the state of texas remarked that if there was ever a hell on earth, this was that hell. Another soldier remarked, with the weather 1015 degrees below zero, 100 men were trying to keep warm by one stove. Each morning, men crawled out of their bunks and would get into fights, frequently, for a place by the fire. God help the sick and the week as they were literally left out in the cold. And by december, mostly everyone was in these overcrowded barracks. But with the summer drought, high temperatures, and with many of these armies traveling especially throughout the south, this led another problem food shortages. An observer from the Christian Commission in gettysburg remembered after the battle of gettysburg, at a Field Hospital in rock creek, and he reflected on the typical state of hospitals in town. And she writes, the men were in a terrible condition. They lay upon the damp ground, many of them with nothing under them. In the hospitals, there was usually a large number of amputations. The amputated stumps lying directly on the ground, except when now and then elevated a little on a handful of straw or on old rags. Many of these men were in unwanted clothing. Suitable food was not to be had. The surgeons were overworked. There was an insufficient number of attendance. Nearby were quite a thousand rebels, most of them severely wounded, streaking and crying for assistance. Destitute of clothing, many nearly of them were naked and covered with filth, without tents, lying in the mud, cursing, praying, begging for their attendance or visitors to put an end to their suffering. Another identified soldier from the 47th North Carolina identified soldier from the 47th North Carolina remembered that he was at the hospital in gettysburg in the years after the war ended, and he writes that as a consequence of a small number of surgeons left with us, our men suffered much. For the first two weeks, there were no nurses, no medicines, no kinds of food for men in our condition, our supply being only two or three hard crackers a day with a small piece of fat pork. And now and then, a cup of poor coffee. And for the men reduced to mere skeletons from severe wounds and loss of blood, the floor was a hard bed with only a blanket on it. And each day, we became weaker, thinner until a certain point was reached. If our wounds were curable, nature began to revive the wasted frame. If they were not, there was a little struggle, a moan, and the poor emaciated skeleton of what was once a man was wrapped in a blanket and born from our site forever. And so, not only would you find this struggle with the weather in these Field Hospitals after these battles all throughout the war, you would find them in the camps, as well. The fifth alabama that was at the point in the winter of 1861, all throughout the winter, remarked we being from alabama, where the winters are not so severe, considered this winter of 18611852, to be one of the coldest 18611862, to be one of the coldest of our lives. It seems we never got enough food, and we came here freezing and starving to death that winter. It is the first time in our lives that rations became a part of our wartime life. And so having this lack of food created one of the most dangerous challenges that the medical personnel were forced to face, and that was disease. Over the course of the civil war, two thirds of soldiers, of that 700,000, died of disease rather than battle goods. There are several issues that caused this, even when you had soldier starting to enlist. Many of these soldiers were coming from all walks of life, coming from cities, coming from farms, coming from north, south, coming from the countryside. And so they were all exposed to different kinds of diseases and had different kinds of immunity. When you put hundreds of soldiers together in camps, all of a sudden you have all of these soldiers grouped together, living in close quarters with poor sanitation, and so diseases started spreading rampantly. And some of the most common diseases that wouldve been found over the civil war were diseases such as dysentery, diseases such as malaria and yellow fever caused by mosquito. You have measles that spread through all of these hospitals, as well as typhoid fever. But there were some things that surgeons could do to help spread the curb of these diseases, one of which for malaria and yellow fever was to actually provide cyanide, which was one of the few effective medicines used over the course of the civil war, and was actually given into the soldiers rations, where they would actually drink it with a little bit of water, though it taste terrible, so they prepared to drink it with rum or alcohol. But this was one of the few medicines that was actually provided for these soldiers to curb some of these diseases. For measles and for typhoid fever, which came from being in close quarters, as well as having poor drinking water, there was really no cure. And so for a lot of these diseases, like typhoid fever, was one of the more dangerous diseases that we found over the course of the civil war. Approximately 36 of soldiers became sick with typhoid fever over the course of the civil war. If they survived, they would have immunity. However, that caused about a quarter of the deaths of the diseases found over the course of the civil war. And so, in these hospitals, fighting with these diseases and fighting against these infections, such as gangrene, and diseases such as scurvy, created these different challenges. But it also created successes, as well. Now, before even getting into talking about some of the successes that were found over the was of the civil war that a lot of us take for granted today, we need to discuss the difference between the medical in the north and the south. And so, the medical department in the north was of the more equipped. They had more staffing, as well as better supplies in terms of medicine and food, and so theres a little bit more freedom in the general hospitals than throughout the north and washington, d. C. To be able to treat these soldiers. Throughout the south, however, the medical department was shaped by a lack of resources and shortages in terms of food, medicine, beds, blankets, and staffing. As a result of that, the medical department was solely focused on trying to save as many lives as possible with as few resources as they had available. And so because of this, a lot of the medical advancements that we take for granted today, we learn a lot of that from the Union Medical department. And one of the biggest successes that came out of the course of the civil war was this volume of books here. And so, the surgical and medical history of the war of the rebellion became out of two circulars. Circular number two past in may of 1862. And circular number five past in june of 1862 by the Union Medical department and dr. William alexander hammond. Now, these circulars were orders, in a sense, were passed out throughout the medical personnel throughout the north, directing medical personnel to collect specimens and illustrate the injury and diseases that produce death or disability during the war, and thus affording the materials for the precise method of study or problems regarding that did munition of morality and alleviation of suffering in armies. And so all of these were passed by dr. William alexander hammond, who is a military physician and Surgeon General of the United States from 18621864. And not only did this circular establish the necessity to collect these specimens and collect these cases, it also created the Army Medical Museum as a place to store all of these specimens and store all of this information. And so, in directing all of these collections, anything that was considered of value to a surgeon was sent to the medical medium, including projectiles, reports, images, on a scale that had never before been seen in American History, and in the american medical field. And as these circulars spread, more surgeons wanted to get involved. More medical personnel wanted to get involved, because not only did it create an opportunity for them to advance, they created an opportunity for surgeons to learn. For example, a civilian doctor who is treating ill patients in philadelphia, was able to submit his studies using new techniques to diagnose illnesses. Additionally, chair of the surgery at the jefferson medical college, was able to use the circular to study the effects of his diseases on surgery. And just and so, these are just a few examples of what you would find in the medical and surgical history of the war of the rebellion. Now, i do want to warn you its not for the faint of heart. There are some graphic images in their and there are some graphic studies in there, including this study here, these images which youll see, which is the effects of gangrene on the arm. In addition to this, with circular number two, circular number five is the circular that actually created the Army Medical Museum. And so, sanitary, topographical, medical and surgical reports, details of cases, essays, the results of investigations, inquiries, anything considered of value was sent here in washington, d. C. And a lot of the times, they were sent in barrels full of alcohol to preserve these specimens sent from the fields. And so excuse me eventually, all of these studies, all of these circulars would have been published in about 15 different volumes over the course of the next 20 years after the war had ended. And a lot of these studies and a lot of the specimens were housed in the Army Medical Museum, now known as the National Museum of health and medicines today, just outside of washington, d. C. And so, before all of these medical journals in a lot of these cases and a lot of these specimens provided a wealth of knowledge for future generations. And edward smith, who was a physician who wrote to dr. Hammond, congratulating him on these circulars, wrote that if there was any benefit from the sad struggle of this age, it is that the medical officers can fully justify looking for information and present the information for the world future youth. And even 150 years later, we can still go and visit the National Museum of health and medicine today. And again, i would highly suggest if you go and visit, it is an Amazing Museum to go and see, however you do need to have a strong stomach for you are seeing specimens, including a leg, several civil war soldiers there, as well. And so, within these circulars, there are a few different pieces of civil war medicine and a few pieces of medical advancement that a lot of us take for granted today that we would find, and one of them is bacteriology. And so, bacteriology is essentially the study of germs and what causes diseases. And over the course of the civil war, surgeons and all the medical personnel didnt know what caused these diseases and what made people sick. They didnt understand how germs spread. And as a result, they violated almost every rule about the sterilization of the tools and sterilization of the body that surgeons use today. One soldier remarked at the beginning of the civil war it was common to see a doctor with his sleeves rolled up to his elbows, his bare arms, as well as his apron smeared with blood, and his knife held between his teeth. In addition to this, doctors were practicing some different antique methods that we now know to be completely out of date. One of which was laudable puss. Laudable puss was a sign of infection, as we know today, but puss then meant it was praiseworthy, meant it was healing. The used cups to help keep a wound damp, keep it moist, and when that puss appeared, they would transfer it from one soldier to another, when in fact we now know they were passing on infection. In addition to this, they started to experiment with different kinds of sutures, especially with shortages of supplies. And one of the common sutures was actually horsehair. And when using this horsehair, horsehair is very course, and its tough, and surgeon started to boil it to soften it, make it easier to work with, make it more pliable. But when they did that, they started to realize soldiers who were being sutured with the horsehair rather than the silk or the wire spread were not becoming as ill, and the wounds not becoming as infected. And so this helped lead to the invention of the germ theory and to the idea that boiling things, boiling water, washing your hands starts to kill germs. And so, one surgeon also remarked after the war, into the specifics of the type of horsehair that should be used. He wrote that for the purpose of the suture, a long, white tail is actually the best horsehair to use. He writes it should be soaked for a minute or two in boiling water, or it may be drawn once or twice through the hands, through your fingers with moistened ends if the hair is dried out. The next thing that we use a lot today that a lot of people take granted is Reconstructive Surgery, now known today more commonly as plastic surgery. Over the course of the civil war, with the advanced majority of operations taking part in the hospitals for mp tatians, you have amputations, you have several Soldiers Left with deformities. And for those who are not able to have any kind of prosthetics or any kind of reconstruction, previously were forced to live a doomed life where some soldiers could not be seen in public anymore. They could not function. They could not support their families. And it had a terrible impact on these soldiers mental state. Well, with the creation of Reconstructive Surgery, this started to change and about the 1830s. It started with pulling skin, twisting skin. But over the course of the civil war, it actually started to grow and increase into a much more prominent practice. And one of the surgeons who was most commonly known for his Reconstructive Surgery was a doctor from new york, who was one of the most active and one of the most successful practitioners of the Reconstructive Surgery, using rotation, transposition, which is cutting different pieces of skin and replacing it, as well as shifting things around in order to try and help these soldiers live the easiest and most normal lives that they possibly could. And this is one of the most common cases he would find, or one of the most wellknown cases you would find. And this is private roland ward. And these images that you see here actually included in the surgical history of the war of the rebellion for numbers 167,168, 169, and 170. And the case of this says one fourth of any gin diameter, only remaining and consequence of constant secretion of saliva, he is able to articulate, quite plainly, which he has hitherto been unable to since his injury. Until the completion of his operations, the patient was compelled to resume an incumbent position to receive nourishment and even a swallow of water. It can now take his food and drink standing up. He also has the use of a metal rubber button, excuse me properly adjusted, so that he can actually have his food and drink, and stop the description the secretion of saliva. And so you can see, by the use of this button, and by the use of this Reconstructive Surgery, his face, almost quite literally, is reconstructed to where he can have a normal life, where he can talk, where he can eat, and where he can drink, and he can rejoin society. But for a lot of these soldiers, for these reconstructive surgeries, its not quite so simple when youre losing an arm or losing a leg. And so the vast majority of operations that took place over the civil war were amputations. In fact, there were over 60,000 amputations over the course of the civil war. And so prosthetics became a an important part of civil war medicine, not just for mobility, but for being able to become inconspicuous and rejoin civilian society, as well. Now, for soldiers who had amputations, having a prosthetic limb was a lot easier to have if you had a leg amputation. For soldiers who had our meditations, a lot of common prosthetics given to the soldiers, we could see with the arm prosthetic, in which the hand was a hook. And for a lot of these soldiers, having a hook for a hand was incredibly uncomfortable. It was not very inconspicuous. And so many of these soldiers rather preferred to have the empty sleeve rather than have the arm prosthetic. But for a lot of these prosthetics, you had a lot more common prosthetics being seen from 18611873 for leg prosthetics. Between 18451861, you had 34 patents that were issued for different leg prosthetics. By 1873, you had 133 patents that were issued for prosthetic limbs. And they were uncomfortable to function. They were uncomfortable to walk around in. But for many cases, a lot of these soldiers were able to stand and they were able to stumble around and rejoin society. And one of almost one of the first soldiers to undergo amputations was this soldier here, whose name is james hanger from churchill, virginia. He lost his leg in june 3 of 1861 and he found the prosthetic that was given to him incredibly uncomfortable, and so he designed his own, called the hanger limb. And the hanger limb actually became so popular that by midpoint through the war, he actually started to distribute it among other soldiers who needed it. And by 1871, he had actually created his own company. And so, by 1888, he actually had several businesses with several offices from washington, d. C. , offices from washington, d. C. , st. Louis, philadelphia, pittsburgh, baltimore, and atlanta, to which he actually was able to merge it into a larger company, called the ge Anger Company. And now that je Anger Company is one of the leading prosthetic companies in the United States today. And so, for the prosthetics that soldiers had to use over the course of the civil war like i said, they were uncomfortable. They werent quite as functional. But they were just functional enough for these soldiers to stand, to be able to stumble, to be able to rejoin society in terms of socialization, maybe even working in some of the shops and working throughout the towns. But by now today, with the prosthetics we have available, we can have prosthetics that actually have functioning fingers. We have prosthetics that we can actually run with and can actually perform all the regular duties that we would if we had two legs. And for a lot of these soldiers who had to have Reconstructive Surgery, like i said, it was just enough for them to be able to function comfortably. But with many of these faces, they would not be the same as they had been before the war. But today, for Reconstructive Surgery, we take a lot of that for granted and we can have feet, arm, faces, entire body parts reconstructed for both medical purposes, for necessity, as well as for beauty, as well. And so, with this civil war, over four years of civil war, you had over 700,000 casualties that, again, created this life and death fight that was full of challenges, from the weather, from the shortage of personnel and food, to being out in the fields. But with war, and all of the sacrifice and all of this carnage, all of that had not been in vain, for we were able to use their ultimate sacrifice to be able to learn and to be able to study and grow our medical professionals so that we can take the medicine that they did not have, and that we can use it today to live longer, healthier, fuller lives. Thank you so much for having me here for this symposium discussion today. I hope you guys enjoyed my conversation. And if youre interested in learning more information or checking out these medical and surgical histories of the war of the rebellion, theyve all been digitized and they are all online for you to peruse through. So, thank you very much for having me. [captions Copyright National cable satellite corp. 2020] [captioning performed by the national captioning institute, which is responsible for its caption content and accuracy. Visit ncicap. Org] covering history cspan style, with event coverage, eyewitness accounts, archival films, lectures, visits to museums and historic places. All weekend, every weekend, on cspan3. If you like American History tv, keep of keep up with us during the week. Learn about what happened on this day in history and see preview clips of upcoming programs. Follow us at cspan history. The president s, presenting biographies of every president. Inspired by conversations with noted historians about the leadership skills that make for a successful presidency. 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