Symposium cocoordinators whose hard work has made todays event possible and thank you to our friends at cspan for sharing American History, a very important task in these days. Our final speaker for today is Paige Gibbons backus. Weve been talking a lot today about the war in the east. But we cant forget about the aftermath of battle as well. And one of the most compelling portions about Civil War History and the civil war story. Paige is a historian. Shes the social media manager for emerging civil war and shes here today to talk about the carnage in the medical field of the civil war. Thank you, so much, chris for having me, and thank you for listening in and watching these videos and joining us for the virtual emerging civil war symposium for history at home. Today what im going to be talking to you about, im going to be talking about the life the fight for the life and death in the aftermath of these battles over the american civil war. And weve heard a lot of talks today about different battles, we learned about prison camps, learned about raids, and the aftermath of the battle and in the years and days and months following was in a sense a whole other war in itself. It was a fight for life and death. It was a war against battle wounds and a war against disease. And one historian who wrote a book called learning with the wounded wrote that doctors were actually the Unsung Heroes of the civil war. And that the civil war was overwhelming in its scope and the physicians that were forced to practice tirelessly in the general hospitals and temporary Field Hospitals were treating the dying and wounded after these horrific battles. And so what ended up being four years of war cost over 700,000 casualties. And so over the course of our discussion today, were going to be discussing some of the challenges that this created and some of the different fights that had to take place in this war of life and death and what ultimately resulted and what good came out of this fight for life and death that a lot of us today take for granted in the medical field. And so for the purpose of our conversation today, i could be talking to you all all day about anything and everything with civil war medicine, but for the purpose of our conversation today in our 45 minutes that i have allotted, ive pulled examples mainly focusing on the war in the east, which was the theme of the emerging civil war virtual symposium today. Before we can Start Talking about some of the different challenges that were faced in the medical field over the course of the civil war, we need to talk a little bit about where the medical field was at the beginning of the civil war. And so at the time of the civil war in the 1850s and 1860s, there has been significant medical advancement since the 18th century. We have far gone beyond the four humors which are especially yellow bile, black bile, phlegm meaning if one of those were out of balance, you were sick. This is one of the reasons George Washington died when he had pneumonia because they took too much blood to try to rebalance the humors. By the time of the civil war, this was coming out of fashion. You had the study of anatomy that was taking place with the use of cadavers, both legally and illegally with things such as body snatching that started coming around in the 1830s. But you have different studies of the medical field like bacteriology, ep determinology that are not taking place at this point in time and that would come into place by the time that the civil war began in 1861. However, by the time of the 1850s and 1860s, you do have medical schools that have been around since the 1700s. Some of the better known schools were in paris such as you see here, you see the medical school in scotland. Europe was much more advanced at this point in time than the United States. You do start having medical schools in major schools like boston, new york, philadelphia, that are starting to take that are starting to take hold and students are starting to attend. However, for a lot of these schools, there is not very much clinicals like were used to today with the medical schools that students attend. Its more learning from books and more observations from these cadavers. But by this point in time in the 1850s, the United States was trying to catch up with europe, establishing the american medical association, trying to reform the medical field through journals, medical societies as well as experiments and investigations. But by the time that the civil war began, the medical departments, both for the Northern Army and the Confederate Army thought they were well prepared for what they were going to experience. However, at the very first major battle of the civil war on july 21st, 1861 at the battle of ma nas is a would illuminate how much challenges they were going to experience over the course of the civil war. After the battle of first manassas, you have troops that were engaged in a battle that lasted 24 hours. Before the end of 24 hours, you have 3,500 soldiers who were wounded or missing. At the beginning of the battle, these challenges immediately started to reveal themselves to the medical departments. Now, in the medical field, you had two surgeons to each regiment. That meant you had an surgeon and assistant surgeon for about 1,000 men. For the union armies, there were no hospitals established there on the battlefield because they had marched that morning from centerville and for the Confederate Army, it was four miles to the south and the manassas junction. There were no hospitals set up close to the front lines. Additionally at this point in time, there was no centralized ambulance corps. The regiments had their own ambulances and there would not be an ambulance corps that is federalized until august of 1862. This meant that the ambulances were regimental and some soldiers were picked up with priority over others. It meant that there was very Poor Organization which resulted in slower action which resulted in more deaths. And just to kind of give you an idea of some of the scenes that were found, one soldier from the fifth virginia infantry described the scene at one Field Hospital in the hours after the battle and he writes, there were piles of legs, feet, hands, arms, all thrown together and at a distance resembled piles at a corn shucking. Many of the feet still retained a boot or shoe. Surgeons were carving away, like farmers at butchering season. While the poor devils under the knife yelled with pain. Many limbs were lost that should have been saved and many lives were lost trying to save the limbs that should have been amputated. There was another group of confederate soldiers that came across a few Union Soldiers in the stone house. And one of them remarked that in ma building, there were 32 soldiers, many of them that were dreadfully mangled by cannon shot. There was one surgeon and he was young and inefficient. Men lay on the floor with their clotted wounds still undressed. Some had died and not yet been removed. And so for a lot of these surgeons and a lot of the medical personnel that was operating at the battle of first manassas, this was the first time of them seeing warfare and the first time that many of them had any practical experience. There were mistakes that cost soldiers lives. There were mistakes that also saved soldiers lives. But at the battle of first manassas it was not a battle for life and death. This would create issues for the surgical field because when hospitals were captured, this meant that you had surgeons that were taken away from their wounded patients. One including at this hospital here. When the union army began their route to head back to centerville, decisions had to be made by the surgeons, do they stay with their soldiers and risk imprisonment or do they leave their patients behind. One surgeon left a soldier on the operating table and ran. Others decided to stay and they were taken away and sent to richmond for the prison of war camps leaving federal troops in need and treatment. For a lot of the surgeons who were overwhelmed with their own wounded, a lot of the confederate soldiers did not receive the treatment that they needed costing many lives. As a result of this, not a year later in may and june of 1862, this gentleman here, dr. Hunter mcguire, and several other surgeons who were captured enter into an agreement in may stating that we, surgeons, and assistant surgeons of the United States army who are now prisoners of war in this place do give our parole of honor of being released to report in person, singly or collectively to the secretary of war in Washington City as such and that we will use our best efforts in the same number of medical officers of the Confederate States army now prisoners or may be taken and released on the same terms. Since may of 1862 creating order number 60, it made medical personnel neutral over the course of the rest of the war. At this point, it turned into a fight of life or death where medical personnel both for the union and confederate soldiers were trying to save as many lives as possible. But at this point, you have several other challenges that illuminate themselves over the course of the civil war. And one of the biggest ones is the increase in casualties. Remember, for the battle of first manassas you have 3,500 casualties in one day. Antietam in 1862, 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 Wounded Soldiers and this creates several issues in terms of food supply, medical supply, staffing that now the medical department for both the north and the south are overwhelmed to try and save as many lives as possible. And one example in the battle of antietam, a reporter making his way to the battlefield on september 18th remarked what he saw. He said that the wounded are coming in by the thousands, around and in a large barn. I counted more than 1,200 wounded. Along the same road and in the distance are more than three hospitals, each having from 600 to 700 in them and long trains of ambulances standing in the road waiting to discharge their bloody loads. Surgeons with hands, arms and garments covered with blood amputating limbs from every part of the body. After the battle of gettysburg, the entire town was turned into a hospital and one reporter on july 15th, 1836 remarked that this town and the vicinity around it is one vast and overcrowded hospital. In the town itself, every Available Space has been freely given up by the citizens to the sufferers and on this, the ninth day after the battle, several thousand are lying with arms and legs amputated and every other wound in tents, open fields, woods, stables, barns and some of them even on the bar ground without any cover or any shelter. This leads us to another challenge that had a huge impact on this fight for life and death and that was the weather. The weather is one of the most impactful things on the memories of these soldiers and civilians that took that were here over the course of the civil war. And its actually one of the most recorded events in letters and primary documents. The weather impacted military tactics, for example, jacksons famous flanking march would not have been made possible without the days rains that would block the dust of the moving armies. We learn about burnsides mud march in january of 1863 forcing troops to march through some of the worst weather that anyone has ever experienced. It also had a Significant Impact on the treatment of the wounded. Men who were exposed to the elements in the Field Hospitals were much more susceptible to disease and to illnesses and conditions that impacted the way they were able to heal their wounds. And so, for example, after the battle of gettysburg, that was a severe thunderstorm that raged through the area causing flooding in the fields. During a violent thunder gust, accompanied with the heavy wind and heavy rain, on saturday july 5th after the battle, some would have drowned had not the extraordinary efforts been put forth to prevent it. In addition to this in fredericksburg, the average temperature was a recorded low of the 20s and a high of the 40s or 50s. And in the days before the battle of fredericksburg, one soldier remarked, rain, hail, snow, all day and far into the night and two days later he remarked that on december 6th and 7th had to be one of the coldest that i had experienced since joining the army. There were men who were frozen to death on the picket. The Field Hospitals faired much of the same way after the battle of first manassas. But for many of these soldiers, those in the camps had it the worst. Many of these men were forced to live outside in scrap shelters to shield themselves from the rain and from the heat as well as to have little protection for their skin for clothing as well as little food to sustain themselves. This is one of the prisons in the south in georgia. But from our discussion earlier today, i did pull examples from elmira. They had 5,100 soldiers camped outside. With the onset of winter, there were orders made for barracks to be built for many of these men or in tents without floors or with blankets. And so one soldier who was from the state of texas who was in elmira in the winter remarked if there was ever a hell on earth, elmira was that hell. But it was not a hot one. Another soldier remarked, with the weather 10, 15 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 for a place by the fire. In december, mostly everyone was in these overcrowded barracks. But with the summer drought, high temperatures and many of the armies traveling, especially throughout the south, this led another problem, food shortages. An observer from the Christian Commission remembered after the battle of gettysburg, she reflected on the state of the hospital and town. 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 a large number of amputations, the amputated stumps lined directly on the ground. Accept when now and then elevated a little upon a handful of straw or a bunch of old rags. Many of these men were in wanted of clothing. Suitable food was not to be had. The surgeons were overworked. There was an insufficient number of attendants. Nearby were nearly quite 1,000 rebels, most of them severely wounded. Destitute of clothing, many nearly of them were naked and covered with filth, without tents, cursing, praying or begging to be put to an end of their suffering. Another soldier from the 47th North Carolina remembered that he was at College Hospital at gettysburg and he writes that as a correspond as a consequence of a small number of surgeons, the men suffered much. There were no nurses, medicines, no kinds of food for men in our condition. Our supply being two or three hard crackers a day with a small piece of fat pork and a cup of poor coffee. To the men who were reduced to mere skeletons, the floor was a hard bed with only a blanket on it. And each day we became weaker and thinner until a certain point was reached. If our wounds were curable, nature began to rearrivived the wasted frame. If there was not, there was the poor skeleton of a man was wrapped in a blanket and removed from our sight forever. Not only would you find the 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, alabam alabama that camped all throughout the winter remarked, we being from alabama where the winters are not so severe, considered this winter to be one of the coldest of our lives and at this high point of the pa tome mick, the coldest in america. We never got enough food and we came near freezing and starving to death at winter. Its the first time in our lives that rations became a part of our regular wartime life. Having this lack of food, having this exposure to the elements created one of the most dangerous challenges that the medical personnel were forced to face over the civil war and that was disease. Over the course of the civil war, twothirds of soldiers of that 700,000 died of disease rather than from their battle wounds. And there were several issues that caused this. Even from the wars beginning, even when you had soldiers starting to enlist. Many of these soldiers were coming from all walks of life, coming from cities, coming from farms, coming fre from north, s and they were exposed to different kinds of diseases and had different kinds of immunities. When you put soldiers together in camps, you have all of these soldiers grouped together living in close quarters with poor sanitation and diseases started spreading. Some of the most common diseases were diseases such as dysentery, malaria and yellow fever caused by mosquitos. You have measles that spread through all of the hospitals as well as typhoid fever. There were some things that surgeons could do to help curb the spread of these diseases, one of which for malaria and yellow fever was to provide quinine, one of the effective medicines that was used over the course of the civil war and was given into the soldiers rations where they would drink it with a little bit of water, or they preferred to drink it with a little bit of rum or alcohol. This was one of the few medicines that was provided for the soldiers to try and help curve some of these diseases. For measles and 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, it 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. If they survived, they would have immunity. However, it caused about a quarter of the deaths of these diseases that were 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 course of the civil war that a lot of us take for granted today, we need to discuss a little bit the difference between the medical corps in the north and the south. And so the medical department in the north was a little bit 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 there and throughout the north and in washington, d. C. , to be able to treat these soldiers. Throughout the south, however, the medical department was shaped by its lack of resources and the shortages in terms of food, medicine, beds, blankets and staffing. And so as a result of that, the medical department for the confederacy 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 known as the medical and surgical history of the war of the rebellion. And so the surgical and medical history of the war of the rebellion came out of two circulars. Circumstance number two passed in may of 1862 and circular number five passed in union of 1862 by the medical department and dr. William alexander hamilton. The orders were passed out throughout the north directing medical personnel to collect specimens and illustrate the injuries that produce death and disability during the war and affording the materials for studies or problems regarding the diminution 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 1862 to 1864. And not only did this circular establish the necessity to collect the 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 Army Medical Museum including specimens, projectiles, reports, images, on a scale that had never before been seen on in American History. And so in the american medical field. As these circulars spread, more surgeons wanted to get involved, more medical personnel wanted to get involved because not only did it create the opportunity for them to advance, it created the 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 diagnosis illnesses. Dr. Samuel gross was able to use the circular to study the effects of camp diseases on surgeon. And just a few 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 warn you, its not for the faint of heart. There are graphic images in there and graphic studies in there, including this study, these images here 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, topographic cal, medical and surgical reports, details of cases, the results of investigations, inquiries, anything that could be considered of value was sent here in washington, d. C. And a lot of the times they were sent in barrels full of alcohol in order to preserve the specimens that were being sent from the fields. Eventually all of these studies, all of these circulars would have been established 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 these specimens were housed in the Army Medical Museum now known as the National Museum of health and medicine today just outside of washington, d. C. And so for all of these medical journals and 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 wrote if theres any benefit from this sad struggle of this age, its that the medical officers can fully justify looking for information and present the information for the worlds future use. Even 150 years later, we can still go and visit the National Museum of health and medicine today. Again, i would highly suggest if you go and visit, its an Amazing Museum to see. You do need a strong stomachs, youre seeing specimens and several civil war soldiers there as well. Within these circulars, there are a few different pieces of civil war medicine and a few different pieces of medical advancements 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 of 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 tools and sterilization of the body that surgeons use today. One soldier remarked that 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. Doctors were practicing some different antique methods that we now know to be completely out of date. One of which was laudable puss. It was a sign of infection that we know today, but puss they thought back then was praise worthy. It meant that a wound was healing. So what they actually did, they used cups to keep a wound damp, keep it moist and when this pus aappeared, they thought it was healing properly. We know they were passing on infections. In addition to this, they started to experiment with different kinds of sutures with these shortages of supplies. And one of the common sutures used over the course of the civil war was actually horse hair. And when using the horse hair, horse hair is very coarse and its tough to work with. Surgeons actually started to boil it to soften it, make it easier to work with, but when they did that, they started to realize that soldiers who were being sutured with the horse hair were not becoming as ill. And so this helped lead to the invention of the germ theory and to they that boiling things, boiling water, washing your hands, started to kill germs. And so one surgeon also remarked after the war into the specifics of the type of horse hair that should be used and he wrote for the purpose of a suture, a long, white tail is actually the best horse hair to use and he writes before being used, it should be soaked for a minute or two in boiling water so that it may be or it may be drawn once or twice through your fingers with moistened ends if that hair had dried out. The next thing that we use a lot today that a lot of people take for granted is Reconstructive Surgery known as plastic surgery. Over the course of the civil war with the vast majority of these operations taking place in the hospitals were amputations you had soldiers and several soldiers who are left with deformities and for those who are not able to have any kind of prosthetic 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 states. With the creation of Reconstructive Surgery, it started to change. It was pulling skin, twisting skin, but over the course of the civil war, it actually started to grow and increase into a much more predominant practice. And one of the surgeons who was most commonly known for his reconstructive surgeon was this doctor of new york who is one of the most active and successful practitioners of the Reconstructive Surgery using rotation, trans position, cutting different pieces of skin and replacing it as well as and this here is one of the most common cases you would find, or one of the most wellknown cases you would find of Reconstructive Surgery. This is private roland ward. And these images that you see here are actually included in the surgical history of the war of the rebellion for numbers 167, 168, 169 and 170. The case for this says a fistula orifice, 1 4 inch in diameter, with the collection of saliva he has been able to use. Before the completion of his operation, the patient is to reach a sitting position to receive his nourishment and food and water. He can take his food and drink standing up. He also has the use of a rubber button properly adjusted in the fistula so that he can actually have this food and drink and stop the discretion of saliva from making its exit externally. So you can see that 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, where he can drink as sitting up and rejoins society. But for a lot of these soldiers, for these reconstructive surgeries, its not quite so simple when youre losing an arm or when youre losing a leg. So the vast majority of operations that took place during the civil war were amputations. In fact, there were over 60,000 amputations over the course of the civil war. And so prosthetics became an important part of civil war medicine, not only 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 an arm amputation, a lot of prosthetics that were given to soldiers was an arm prosthetic where the hand was solely a hook. For a lot of these soldiers, having a hook for a hand was incredibly uncomfortable. It was also not very inconspicuous, 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 1861 to 1873 for leg prosthetics. Between 1845 and 1861, 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. Almost one of the first soldiers to undergo an amputation was this soldier here. His name was james hanger from churchville, virginia. He lost his leg on june 3, 1861. He found the prosthetic given to him incredibly uncomfortable, so he designed his own called the hanger limb. It became so popular that midpoint through the war, he actually began to distribute it for other soldiers who needed it. 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. , st. Louis, philadelphia, pittsburgh, baltimore and atlanta to which he actually was able to merge it into a Larger Company called the j. E. Hanger company. And now the j. E. Hanger company is one of the leading prosthetic companies in the United States today. So for the prosthetics that soldiers had to use over the course of the civil war, like i said, they were uncomfortable, they werent that functional, but they were just functional enough to be able to stand, 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 that 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 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, arms, faces, entire body parts reconstructed for both medical purposes, for necessity, as well as for beauty as well. And so with the civil war, with over four years of civil war, you have 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 field, 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 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 theyre all online for you to peruse through. Thank you so much for having me. Weeknights this month were featuring American History tv programs as a preview of whats available every weekend on cspan3. Following more than four years of world war, 51 founding members signed the United Nations charter in the hopes of preventing future war and promoting peace and justice. On october 4, 1945, the u. N. Was officially established. We feature five films beginning with the signing of the u. N. s charter. Thats tonight at 8 00 eastern. Enjoy American History tv this week and every weekend on cspan3. During the battle of Gettysburg Union commander called for reinforcements. Next, dan welch describes how that brigade repulsed confederate attacks. This talk was part of the symposium on the war in the east. Our next speaker i call professor henry hill. By day he is a music teacher. He is the coauthor of the book the last road north a guide to the Gettysburg Campaign and he works as a historian at