The Cost of Medical Ignorance

Even if a soldier made it through the training camp epidemics and went into battle healthy, the lack of medical knowledge and resources reduced his chances of survival if he was wounded.

A major battle such as Cold Harbor or Antietam simply overwhelmed the system. Wounded soldiers might wait as long as four days before treatment. Those with head or abdominal wounds were usually laid to the side since it was assumed they would die.

When a soldier was brought in to the field hospital, assistants sponged the wound with water to wash away blood and mud. The sponge had already been used on dozens of other soldiers. Then the wounded man was lifted onto a table so the surgeon could begin work. To see if the bullet or other debris such as fragments of clothing were still in the wound, the surgeon probed with his unwashed and ungloved finger.

If the bullet had passed through the body and no bones were broken, the wound was simply bandaged. Surgeons knew that when a bullet had broken a bone so that the bone pierced the skin, the injury was unlikely to heal. The limb would have to be cut off. According to official estimates shortly after the war, Union doctors performed at least 60,000 amputations. About a quarter of these patients died. A soldier’s chance pf surviving improved the farther the cut was from the torso. An experienced surgeon could amputate a limb in less than ten minutes. After a major battle, discarded arms and legs piled up on the floor around his operating table.

For the best chance of survival, the amputations should be done as soon after the wounding as possible. Those done two or more days after the battle had a reduced chance for survival.

In an earlier blog, I wrote about Theophilus Perry of the 28th Texas. Letters between Theophilus and his wife, Harriet, are the subject of the book, Widows by the Thousands. Theophilus was wounded in a battle in Louisiana in April 1864 and his leg was amputated in a field hospital. A week later, he died.

Presumably, his wound became infected which was common. Neither surgeons’ hands, their scalpels nor bandages were sterile. Doctors did not know about bacteria and believed the odor—miasma—from wounds or contaminated air was the cause of infection. Hospital gangrene caused the tissue around a wound to die and rot and could expand at a half an inch an hour. The bloodstream carried the gangrene to other parts of the body and the soldier could be dead in less than a day.

Elizabeth McCartney expressed a common view when she wrote to her husband, “Mr McCartney I want you to take good care of yourself and not git sick this sommer for if you do git sick come home at once for if you go to the hospitle you will be all most sure to dey if you are not able to come alone send me word and I will go after you 0 but be sure that you do not go to the hospitle then remember you promised me before you left that you would never go to the hospitle and if you do it will brake your promis besides dying