Civil War Medicine: It’s Not All Hacking and Whacking!

The popular image of a blood-soaked apron and soiled hand wielding a monstrous amputation saw was reality. It was also a relatively modest part of the challenges encountered by Union and Confederate surgeons (all physicians were called surgeons then). Despite a pronounced lack of formal classroom instruction in the subject, disease was the major player in the horrific casualty count over the entire course of the American Civil War. On more than one occasion entire campaigns, months in the planning and involving scores of thousands of potential combatants were decided, not by force of arms but by disease, before those campaigns could even get off the ground.

Two professionally-written publications speak to this issue, though they are by no means the only books on the3 topic. The first to come to my attention is Disease in the Civil War, by Paul E. Steiner, Phd, M.D., Thomas Books 1968. The second is of much more recent vintage; Death is in the Breeze, by Bonnie Brice Dorwart, M.D. and published by the National Museum of Civil War Medicine (of which I am a member) in 2009.

It’s reasonable to ask where surgeons learned about disease if not during medical school. And it must be admitted that some knowledge was passed on in such venues from time to time. A noteworthy lecturer might possibly possess a good bit of awareness regarding a given disease and decide to offer that information in a formal lecture for a fee. Medical students and licensed medical doctors alike could purchase tickets to the lecture though in most cases this was entirely voluntary.

There was a substantial body of literature regarding illness and disease, some of it literally hundreds of years old. Many medical schools had substantial collections of this literature, but many of the smaller proprietary schools had little, or nothing beyond a few, often ratty and book-wormy texts in the possession of faculty - of whom there might be as few as one and who might - or might not - make them available to students. Also worth noting is that the American Medical association was formed pre-war and even then published their journal wherein articles on disease and suggested treatments might be found…but many a physician/surgeon chose to forgo this resource.

As you might expect, then, knowledge and understanding of disease and disease processes could vary widely among the nation’s medical professionals. The practical result for military endeavors from 1861 to 1865 could be, and often was, haphazard and even disastrous.

In the political division of 1861, the western counties of Virginia refused to secede. A military struggle for the region ensued, with Gen. Robert E. Lee sending Generals John B. Floyd and Henry Wise to wrest control of the area. This campaign was aborted without battle by a combination of four natural contagious diseases summating their combined effects with other factors. This Confederate defeat gave the North a sizeable political, military and psychological victory. Measles, diarrhea and dysentery, and later, typhoid fever and pneumonia were the chief problems.

The military consequences of disease have long had major impact on operations. At one point, Constantinople dreaded the news of the advance of none other than Atilla the Hun, moving with thousands of warriors intent upon slaughter and subjugation. But this once, Atilla was thwarted, and not by arms. Disease so severely decimated his ranks that year that he was compelled to head for home without the mountains of loot he’d envisioned.

More recently, Guadalcanal with its malaria, dysentery, and tsutsu-gamushi fever became a sensitive memory in Marine Corps and Army medicine. Vietnam certainly wasn’t free of serious disease. But except for the short term, none of these diseases seriously retarded military operations as happened during our Civil War.
Not to take up too much space on this page, but here is another example of the impact of disease on Johnny and Billy…the first Union endeavor to conquer Vicksburg. In ten weeks during May to July of 1862, some 3500 Union troops under Brig. Gen. Thomas Williams and a fleet under Admiral David Farragut attempted, at first unsuccessfully, to compel the surrender of the town. Ordered to make a second attempt, Williams, greatly reinforced, and Farragut, now with a second fleet under Flag Officer Charles Davis, returned upriver to besiege Vicksburg. It was a disaster. Disease, primarily malaria, compounded by scurvy, dysentery, ague, dengue and strength-devouring heat and humidity, laid ‘em out wholesale. The conditions under which the Union force labored were not much kinder to the opposing Confederates, but many of these were positioned far enough in-land to be beyond the flight range of the anophelese mosquitoes that carried the malaria parasite.

The Ninth Connecticut, by mid-July, had nearly a hundred percent morbidity - 153 men died and there were not enough men well enough for a funeral escort. The Second Vermont arrived to join the action on June 25 with some 800 men; by mid-July, fewer than 100 were able for duty. So it went: by July 25th Gen. Williams admitted defeat. The naval forces conceded the next day.
Poor planning and inefficiency led to this Union debacle. Enough was known about malaria that its worst effects could have been avoided by holding off the attempt to subjugate Vicksburg until after the first frost and with an adequate supply of quinine, which was in short supply. Decent rations could have greatly reduced the incidence of scurvy, and drinking well water rather than sewerage-contaminated Mississippi water could likewise have had beneficial impact on the rate of diarrhea.

It’s sometimes difficult in the 21st Century to grasp the idea of disease being so serious a problem. There were six million documented cases of illness among Federal troops during the Civil War, which means that every soldier was sick at least twice - and they were very sick; a man didn’t attend Surgeon’s Call for every runny nose and sore throat. It was considered un-manly to be sick, and of course many a soldier, with some justification, preferred not to visit the surgeon’s tent at all.

These are but a few examples of the health challenges encountered in the Civil War. For greater elaboration on the topic, see the two texts referred to above, or visit the surgeon’s tent, where I’ve plenty of poisons *ahem* * I mean, remedies - to go around!

Last Updated on 8/11/10

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