Medical care in the Civil War and contemporary conflicts

Medical Care Influenced by Civil War and Crimean Italian Unification Wars that Immediately Preceded the U.S. Civil War

The objective of this study is to examine how medical care influenced the Civil War and Crimean Italian Unification Wars that Immediately Preceded the U.S. Civil War. The work of Lieutenant Colonel Robert L. Pearce (2002) reports that the Napoleonic wars at the start of the19th century "introduced some important developments in the military medicine. Most significant was the work of the military surgeon Dominique Jean Larrey, who with courage, skill and determination, evolved a system to immediate treatment in the field." (Pearce, 2002, p.89)

Reports on Medicine During the Crimean War

Pearce states that Larrey wrote in his 'Memories de Dhirurgie Militaire et Campagnes as follows:

"…at Aboukir there were 1900 wounded, and many amputations were performed in the field of battle amid a shower of bullets." (2002, p.88)

Pearce reports that Larrey "instituted early evacuation of the wounded by means of 'ambulances volantes' reported as "light, two-wheeled well-sprung vehicles, each drawn by two horses, although of course, Ambroise Pare had used carts and wagons n 1552 to evacuate the wounded after the retreat from Metz."(Pearce, 2002, p.88) Larrey, who was surgeon-in-chief to the Imperial Guard, is reported to have nearly convinced Napoleon that military medicine "was an essential part of warfare." (Pearce, 2002, p.88)

It is reported that as the British army left Varna for the Crimea that 30,000 men were crammed into the inadequate transports to cross the Black Sea, while pack animals, tents, cooking equipment, hospital marquees, regimental medicine chests, bedding and stores all had to be abandoned." (Pearce, 2002, p.89) This was followed a week later by the battle of the Alma in which those who were wounded had not bedding, shelter, bandages or splints and as well, they suffered for lack of chloroform and morphia. Pearce reports that no anesthetics were used in amputations and those surgeons did their work by the light of the moon since they had no lamps or candles. (Pearce, 2002, paraphrased)

II. The Use of Chloroform

It is reported that Chief of the Medical Staff of the British Expeditionary Army, had successfully used chloroform before the war but did not actually support its use or the use of the knife. The winter of 1854-55 was a hard one, the army lost many of its clothing stores, this combined with high casualties for the British Army, and the incompetence of medical service care resulted in a fatal outcome for many individuals. Pearce reports that the medical department was "a ramshackle affair, which, despite being responsible to three distinct ministers in London, was not responsible for its own supplies" and the supplies were instead controlled by two sections of the Treasury generally at odds with one another.

III. U.S. Civil War and Medical Service Provision

The U.S. Civil War (1861-1964) is reported by Pearce (2002) to have "once again focused attention in the lack of preparation of medical support." (p.90) George Worthington Adams wrote, in his Union Army medical history accounts as follows:

'The Army Medical Department Chief, Colonel Thomas Lawson, a veteran of the (Mexican) War of 1812, was over eighty & #8230; and concerned principally with pruning the budget. He considered the purchase of medical books an extravagance and is reported to have flown into a rage on learning that one army post owned two sets of surgical instruments." (cited in Pearce, 2002, p.91) Pearce reports that during the U.S. Civil War "the inadequate standards of medical care are evidenced by reports of prescribing liquor and quinine, even laudanum, for pneumonia; of slashing wrists for bloodletting; and of pouring burning alcohol on the chest. For intestinal disorders, in addition to salts, calomel, turpentine, mercury, chalk, and even strychnine -- any combination of which could be expected to aggravate rather than relieve most conditions -- surgeons often applied hot bricks to the feet and oil cloths to the abdomen." (p.92)