Appalachia Civil War Letters

Civil War Surgery

Civil War Surgery
Top Ten Surprising Things About Civil War Medicine written by Carole Adrienne

1) There wasn’t an ambulance to be found. The American Civil War spurred a revolution in emergency rescue and evacuation. Union Major Jonathan Letterman devised the first dedicated ambulance system with trained personnel. Our 21st century emergency rescue systems are still based on his concepts.

2) Most doctors had never performed surgery or seen a gunshot wound. Of the estimated 16,000 physicians who served in the Civil War, only 5% had ever seen or performed surgery. They would learn from hasty training, field manuals and the experience of working with hundreds of thousands of casualties.

3) Anesthesia was used for most wartime surgeries. Despite widespread tales of soldiers biting on bullets while undergoing surgery, almost all Civil War surgeries were performed with the use of ether or chloroform. Dentists in the United States had been using anesthesia since the 1840’s and Northern and Southern surgeons quickly embraced its use. Both armies maintained a steady supply throughout most of the war.

4) Operating conditions were filthy by modern standards. Nothing was sterile. News of European research on sterilization of wounds had not reached America. Surgeons were known to sharpen their scalpels on the soles of their boots. Silk for sutures was wetted with the doctor’s saliva. President Lincoln’s fatal head wound was probed with the unsterilized fingers of some of the most respected physicians of the period.

5) You couldn’t find a trained nurse to save your life. Before the Civil War, family members usually provided care for ailing relatives. The wartime casualties required a rapid organization and training of volunteer nurses to aid in the massive relief effort. Their work would lead to the establishment of formal schools and associations for skilled nurses.

6) Nerve injuries were identified and addressed for the first time. Dr. Silas Weir-Mitchell of Philadelphia, worked with many post-surgical amputee patients. He noticed some common phenomena, including “phantom limb”. Dr. Mitchell’s observations and treatments formed the basis for our modern medical area of specialty known as neurology.

7) Civil War medicine brought a new perspective to the lives of American women. In a passionate outpouring of support, women emerged from the parlors and plantations onto the battlefields, the hospitals, and prisons to nurse the wounded. They appeared publicly in business for the first time and took on the task of fundraising for the relief effort.

8) The concept of Medical record-keeping on a large scale was born. From meticulous records kept throughout the war, The Medical-Surgical History of the War of the Rebellion, a massive six-volume compendium, was published. It included case histories, autopsy reports, disease records, post-surgical photographs and follow-ups. It was the first comprehensive study and analysis of its kind and was considered by the European medical community to be America’s finest contribution to the future of medicine.

9) The largest post-war budget expenditures of some Confederate states were for prosthetic limbs. Despite the non-sterile conditions of Civil War surgery, a surprising 75% of amputees survived. Their needs spurred the makers of artificial limbs to improve the comfort and effectiveness of their products.

10) The elements of “triage”, or sorting of the wounded, appeared during the Civil War. Amputation of a wounded limb was the quickest way to save a life. Chest, abdominal and head surgeries were rarely attempted, and those patients were usually left to die.

*Source: Post from Civil War RX The Source Guide to Civil War Medicine.




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  • Reply
    Bobby Title
    April 26, 2015 at 8:15 pm

    Drew Gilpin Faust wrote an excellent book in 2008 entitled “This Republic of Suffering: Death and the American Civil War” – surprisingly readable for being about such a difficult subject, and full of things that most people have never even thought about as pertains to this particular war. It’s highly recommended.

  • Reply
    April 25, 2015 at 7:46 pm

    An interesting and informative report on Civil War hospitals and wound treatment. Thank you for sharing the information. Although crude by modern standards, they were doing the best they knew how and at least attempting to save lives and help with the suffering. We can be grateful for what they passed on in the area of medical progress.

  • Reply
    George Pettie
    April 25, 2015 at 6:29 pm

    Fascinating, including the comments. Thank you for this interesting post.
    So many countries in the world have had, or are having, civil wars because they’re not and will never be real nations. But I can’t conceive of the U.S. being two countries. I guess that would have made me a Unionist, despite my southern origins.
    I spent the same 4 year time span in another bad war, but I’m sure I would have had a worse time of it had it been the Civil War rather than Viet Nam. After 150 years and 40 years, respectively, the national wounds have healed, but the scars remain.

  • Reply
    C. Ronald Perry, Sr.
    April 25, 2015 at 5:54 pm

    The Civil War Museum is located here in Frederick, Md. where we live. Look online at for more info.

  • Reply
    Rev. RB
    April 25, 2015 at 5:11 pm

    Very interesting to know all this.
    Had no idea.
    God bless.

  • Reply
    Ed Ammons
    April 25, 2015 at 2:08 pm

    I had an experience similar to the “phanthom limb” mentioned in the article. An automobile accident left me with no feeling in part of my upper lip and one side of my nose. When my nose itched it did no good to scratch it. The doctor said the nerves would eventually grow back. When I asked him how long it would take, he told me that nerves grow about as fast as fingernails. It was several years before all the feeling returned to my face and my pucker still don’t work right after twenty some years.
    I can imagine losing an arm or leg but experiencing sensations as if it were still there. Feeling pain, itching, heat and cold with little remedy other than alcohol or morphine. And no hope of recovery.
    The Civil War officially ended on 2-Jun-1865 but many soldiers and their loved ones endured it for the rest of their lives.

  • Reply
    April 25, 2015 at 1:44 pm

    This article is a real interesting piece of information about the Civil War and the medical care provided. Thank you, to all of those people who passed this on to those of us that previously had never learned this history. Please keep the information coming.

  • Reply
    April 25, 2015 at 12:09 pm

    Colt manufactured a pocket-sized black powder revolver starting in 1849; it was .31 caliber and was about as powerful as today’s .22 magnum. It was too small to be of use in battle but the tale goes that many officers carried them “as a deterrent to the hospital doctors’ performing unnecessary amputations”.

  • Reply
    Mary Lou McKillip
    April 25, 2015 at 10:59 am

    Horror of Horrors, these were the men of valor and the hand of God’s angels protecting. My question why and how could so much hate divide the North and South at that time.Brothers against brothers and families divided through out their life time.
    Let us pray history doesn’t repeat itself. Medicine has come a long way in a little over 150 years, but more research is needed. Thanks for the info post

  • Reply
    b. Ruth
    April 25, 2015 at 10:11 am

    In Georgia alone there were 39 general hospitals behind the lines. There were two types of hospitals Field hospitals and General hospitals where the patient that needed lengthy care was sent, hopefully to recover. There were many makeshift hospitals that only lasted during the Civil War…A lot of the times large homes or inns were converted temporarily…The rumor was of one here in our area. I was told that is where ghostly moaning noises have been heard, some think comes from the land where the temporary hospital used to be located??
    Kate Cumming traveled with the Army of Tennessee into Georgia as a hospital matron and nurse during the Civil War…
    She kept a journal that was published in 1866..
    Kate: A Journal of Hospital Life in the Confederate Army…
    The book is available in hard copy or paperback…I want it for my Kindle…waiting…
    She was another woman from Scotland arriving to America doing good deeds….
    Thanks Tipper

  • Reply
    April 25, 2015 at 9:44 am

    Amazing how man learns to survive despite the lack of current medical knowledge. Man is so inventive when needed to preserve life. These war medical treatments were very interesting.

  • Reply
    Ron Stephens
    April 25, 2015 at 8:34 am

    My wife’s g-g-g-grandfather deposed after the war that when he was sick in camp he ‘would rather die than go to the hospital’ I expect there was a much different attitude than ours about death, injury and medicine. I believe in the Civil War series there is one or more soldiers quoted to the effect that to go to the hospital was to die.

  • Reply
    Miss Cindy
    April 25, 2015 at 7:39 am

    It’s hard to imagine good coming from war and destruction but it seems that is just what happened.

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