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The Medical History of the American Civil War V

Friday, September 4th, 2015

This series is a slightly annotated version of a lecture I have given in several places. One of them was at the Royal Army Medical Corps Museum in the Salisbury Plain.

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Two major diseases at the time of the war were Smallpox and Malaria. Both affected large bodies of men in close quarters. Both were infectious but not water borne. Vaccination had been discovered by Edward Jenner in 1796.

In the years following 1770, at least five investigators in England and Germany (Sevel, Jensen, Jesty 1774, Rendell, Plett 1791) successfully tested a cowpox vaccine in humans against smallpox.[20] For example, Dorset farmer Benjamin Jesty[21] successfully vaccinated and presumably induced immunity with cowpox in his wife and two children during a smallpox epidemic in 1774, but it was not until Jenner’s work some 20 years later that the procedure became widely understood. Indeed, Jenner may have been aware of Jesty’s procedures and success.

By the early years of the Napoleonic Wars, Larrey had vaccinated the French Grand Army. By 1870, the French army had forgotten Larry’s work and they were decimated by smallpox while the Prussian army had been vaccinated by Billroth.

Malaria could be treated with Quinine, an extract of Cinchona bark.

Quinine occurs naturally in the bark of the cinchona tree, though it has also been synthesized in the laboratory. The medicinal properties of the cinchona tree were originally discovered by the Quechua, who are indigenous to Peru and Bolivia; later, the Jesuits were the first to bring cinchona to Europe.

The Union Army used 19 tons of cinchona bark to treat malaria in the troops. The Confederates were blockaded and had little to use. The Germans were blockaded in World War I and used their new organic chemistry industry to find alternatives, chiefly from organic dyes, like Methylene Blue.

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There obviously was some understanding of the role of mosquitoes in transmission of malaria as we see with the use of mosquito nets in hospitals.

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Other infectious disease were scourges although nothing was known about the cause. Tonsillitis was seasonal and diphtheria was treated with tracheostomy although I don’t know how many were done. The story of diphtheria is the story of the great triumph of bacteriology in the late 19th century. In the Civil War the only treatment was tracheostomy.

Wounds were always assumed to be infected and treated accordingly.

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The treatment of extremity wounds was almost always amputation as there was no understanding of infection.

Here is an amputation tent with a pile of amputated limbs nearby. Baron Larrey, Napoleon;s surgeon personally amputated 200 limbs in 24 hours at the battle of Borodino. That was one amputation every seven minutes and was prior to the discovery of anesthesia.

There was little treatment available for wounds of the head or the body.

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The wounds from a small battle are listed in The History. Head wounds were mostly fatal although a few survived.

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Early wound care was mostly in the open as the dressing stations were overwhelmed easily.

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Saber wounds, inflicted by mounted cavalry were survivable if the skull was not penetrated and they did not become infected.

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The Battle of Chancellorsville was a success for Lee but a great loss resulted as Jackson was lost.

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Many believe that all chance of success in the war died with Jackson.

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Jackson was shot by his own men as he reconnoitered the battlefield. His left arm was amputated but he did not survive. His wife was with him when he died.

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Gunshot wounds of the extremities were most of the survivors. The mortality rate of amputation was 27%. In the Franco-Prussion War, the incompetent French military surgeons had a 50% mortality rate even though antisepsis had been described three years before by Joseph Lister. Lister was treating tuberculosis of the joints, which was a common condition at the time. He found that infection was prevented by carbolic acid.

In August 1865, Lister applied a piece of lint dipped in carbolic acid solution onto the wound of a seven-year-old boy at Glasgow Infirmary, who had sustained a compound fracture after a cart wheel had passed over his leg. After four days, he renewed the pad and discovered that no infection had developed, and after a total of six weeks he was amazed to discover that the boy’s bones had fused back together, without the danger of suppuration. He subsequently published his results in The Lancet[8][9] in a series of 6 articles, running from March through July 1867.

He instructed surgeons under his responsibility to wear clean gloves and wash their hands before and after operations with 5% carbolic acid solutions. Instruments were also washed in the same solution and assistants sprayed the solution in the operating theatre. One of his additional suggestions was to stop using porous natural materials in manufacturing the handles of medical instruments.

The Germans adopted “Listerism” and the French did not. His reports were after the American Civil War although Semmelweis had tried to introduce hand washing in 1846.

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Vascular injuries were untreatable and would remain so until Vietnam, when new techniques resulted in salvage of most arterial injuries.

To be continued.

Muslim Lives Matter

Tuesday, May 19th, 2015

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The current trope on the left is that “Black Lives Matter.”

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The Democrats have an impressive record of genocide, beginning with the abandonment of South Vietnam. The Vietnam War was begun by Democrats, specifically John F Kennedy, who agreed to the assassination of South Vietnam leader Ngo Dinh Diem, who was killed by Vietnamese generals with Kennedy’s agreement.

Now we are faced with a somewhat similar situation in the Middle East. To quote Richard Fernandez, who I have always found reliable,

The collapse in the Middle East feels like Black April, 1975, the month South Vietnam fell. And it should, because just as the collapse of Saigon did not happen in Black April, but in a political American decision to allow South Vietnam to fall after a “decent interval”, so also is the ongoing collapse rooted, not in the recent tactical mistakes of the White House, but in the grand strategic decision president Obama made when he assumed office.

We are about to witness the total collapse of any American influence in the Middle East.

The reason the press has been trying to corner interviewees into “admitting” that George Bush made an error in toppling Saddam Hussein is the need to reassure themselves that catastrophe in the Middle East isn’t really their fault. The constant need to be told it’s not their doing is a form of denial. The more certain they are of their blunder the more they will need to tell themselves that the sounds they hear aren’t the footfalls of doom.

Because the alternative is to admit the truth and accept that to reverse the tide, 20th century Western liberalism has to die or radically reform itself. None of the people who have built political and establishment media credentials want to hear that, but all the same …

We are on the verge of a massive human catastrophe, one that the world has not seen since the fall of the Soviet Union or, in terms of percentage, since the fall of Rome.

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Conspiracy Theories.

Sunday, January 18th, 2015

conspiracy

Global Warming and Cooling.

Sunday, October 20th, 2013

I have been frustrated by the antics of the AGW alarmists. Scientific American, for example, has lost whatever reputation it once had for objective science. In an another example, the actions of Michael Mann should make for an interesting discovery in his suit against Mark Steyn.

Today, I find a nice discussion of global warming and cooling over the past epoch. The Greenland ice cores are, or should be, the gold standard of temperature measurement. For example.

Summary:
Records of past temperature, precipitation, atmospheric trace gases, and other aspects of climate and environment derived from ice cores drilled on glaciers and ice caps around the world. Parameter keywords describe what was measured in this data set. Additional summary information can be found in the abstracts of papers listed in the data set citations.

Now, to the data.

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Who are they protecting us from ?

Thursday, June 13th, 2013

The latest word on the NSA scandal, and it is a scandal, is that they are not allowed to snoop on mosques.

Since October 2011, mosques have been off-limits to FBI agents. No more surveillance or undercover string operations without high-level approval from a special oversight body at the Justice Department dubbed the Sensitive Operations Review Committee.

Who makes up this body, and how do they decide requests? Nobody knows; the names of the chairman, members and staff are kept secret.

We do know the panel was set up under pressure from Islamist groups who complained about FBI stings at mosques. Just months before the panel’s formation, the Council on American-Islamic Relations teamed up with the ACLU to sue the FBI for allegedly violating the civil rights of Muslims in Los Angeles by hiring an undercover agent to infiltrate and monitor mosques there.

After all, all terrorists thus far have been fundamentalist Christians. Oh wait.

Before mosques were excluded from the otherwise wide domestic spy net the administration has cast, the FBI launched dozens of successful sting operations against homegrown jihadists — inside mosques — and disrupted dozens of plots against the homeland.

If only they were allowed to continue, perhaps the many victims of the Boston Marathon bombings would not have lost their lives and limbs. The FBI never canvassed Boston mosques until four days after the April 15 attacks, and it did not check out the radical Boston mosque where the Muslim bombers worshiped.

We have empowered CAIR, a group linked to Muslim extremists like The Holy Land Foundation, which:

In its earliest days, HLF received a $200,000 cash infusion from Ghassan Elashi’s brother-in-law Musa Abu Marzook, the Hamas senior political leader and Virginia resident who would be deported in 1997 for his involvement in six terror attacks in Israel that killed 47 people. By 1989, HLF had already sent nearly $1 million to Marzook and Hamas co-founder Ahmed Yassin (to the latter through an account called the Islamic Center of Gaza — another ostensibly charitable entity used by Yassin to finance Hamas activities).

Major Hassan, who is now representing himself, was an obvious suspect for jihad before he acted out.

At a hearing last week at the Army base here, Major Hasan told a judge that he was protecting Taliban leaders in Afghanistan from danger when he opened fire on Nov. 5, 2009. In describing his new defense — known in legal terms as a “defense of others” — he told the judge that he had been defending Mullah Muhammad Omar, the founder of the Islamic insurgent group, and its other leaders, from Fort Hood soldiers deploying to Afghanistan.

Oh well, that explains it. Can we be any more clueless with these dangers ?

Memorial Day

Monday, May 27th, 2013

Here are a few photos from a visit to World War II sites in 2006. I’ve posted some of these before.

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This is my daughter, Annie, and her cousins at the American cemetery Omaha Beach. Annie is the farthest from the camera.

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This is the theme building at the cemetery. The statue is called “The Spirit of American Youth.” The web site for the cemetery has a nice video. We walked around the cemetery and spent a week visiting battle sites as I wanted my daughter to know about this and remember.

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The view of the bluffs from the top shows the magnitude of the problem of getting from that beach to the land above under hostile fire. This was completely different from the situation at Utah Beach where the transition from beach to the land behind it was almost level. Note the people climbing the path from the beach. It gives a scale of the size.

Utah

Here is Utah Beach and it is nearly level with the land inland. The problem at Utah was inland where the land was low and had been flooded by the Germans. The Airborne divisions were tasked with capturing and holding the inland end of the causeways from the beach to beyond the flooded fields.

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The inland side of the beach was no obstacle to tanks or men.

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Ponte du hoc was a point of land between Omaha and Utah that was believed to hold big guns that could command both beaches. The climb the Rangers made is almost unbelievable. Rangers at the 1984 ceremony for the 40th anniversary said they could not imagine how they did it. The guns had been shifted a mile inland to avoid naval gunfire but the casements still needed to be taken.

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A view of Omaha Beach from the bottom of the bluffs show German gun emplacements which were turned to avoid naval gunfire and allow them to sweep the beach. Fortunately, the German guns were zeroed at the high tide line and the troops landed at low tide. This provided some shelter as they left the Higgins boats.

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This is a reconstructed Higgins boat.

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This is a famous photo from Omaha Beach on D-Day showing troops leaving the Higgins boat and wading ashore.

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The Omaha bluffs are just as impressive from the bottom as from the top.

Micro Aerial Vehicles

Sunday, March 10th, 2013

This may be the future of drone technology.

I have previously posted on full size UAVs like the Grumman carrier landing vehicle. There are also intermediate sized UAVs that infantry can launch like model airplanes. And we are not the only military interested.

Rye Bread

Monday, March 4th, 2013

I am in Tucson spending a few days fixing a few things in the house here. A post of Chicago Boyz got me interested in the idea of making bread again. I had a bread machine for years and even made some French bread according to a Julia Child’s recipe years ago. I had a bread stone but it has been lost in my moves the last several years.

The progress of my effort will be recorded here. I used partly the recipe given in that post and partly another that I found on the internet. We’ll see how it turns out.

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Here is the first illustration from the post with the ingredients.

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Here is the second, which specifies 350 degrees for 50 minutes.

In the mean time, I have repaired the drip irrigation system, cleaned up some areas of the yard and helped my daughter move out of a house near the campus that she shared with another girl who has gotten rather difficult the past several months.

The first day was spent making the “sponge” which is rye flour, and water and yeast.

First

The sponge this morning had risen to about twice its size yesterday. I altered the recipe to add sugar and white flour to the sponge, as recommended by the second article. For that reason it is larger than the view in the second post of the rye bread series.

Rising

Here it is a little larger and is rising this morning.

SEcond rise with spoon

Here is has risen to the max and has been squished down again. I shaped it as a square as the second article suggested. A spoon is added for scale.

Loaves prerise

Now, after the second rise, it has been divided into two loaves, as per the first article. The recipe from Chicago Boyz suggests baking at 300 to 350. The second article recommends 15 minutes at 450, then the rest of the time at 300. This is what I will try to see if we can get a good crust.

The oven is preheating and taking forever.

risen loaves

The two loaves have about doubled in size while we are waiting for the oven. I finally gave up on the oven reaching 450 so the loaves have gone in at the max temp, probably about 400. I’ll turn the thermostat down to 350 at 3:15, Tucson time. The loaves went in at 3:00 PM.

While doing all this, aside from some garage cleaning, I’ve been reading Genius, The life of Richard Feynmann. It has gnawed at me that I never had the chance to see him at CalTech. I actually applied before he was there and was accepted but did not have the money for tuition. I was a National Merit Scholarship finalist but my father refused to cooperate and did not send in some material on financial need so, I got a letter congratulating me that I did not need money.

Anyway, back to the baking. More to come as they bake.

Now, it is 3:58 and the loaves are out of the oven.

Finished baking

Here are the baked loaves. Still too hot to cut.

Baked closeup

Here is a closeup of the loaf with the cuts showing how they have expanded.

Tonight we will have brats and sauerkraut with beer and this bread. A final report will follow after eating.

I had the first slice of the bread while waiting for my daughter to arrive and it is great ! The crust is very crusty and the inside is delicious.

My daughter and I just finished a dinner of sausages, sauerkraut and beans with the fresh bread. We ate most of one loaf and washed it down with Guinness beer. The next loaf is for tomorrow. I already have some pastrami.

The Sequester day three.

Sunday, March 3rd, 2013

This is the story of the sequester.

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And so it goes. That is the magnitude of this national disaster that Obama sees.

The Sequester

Friday, February 22nd, 2013

As we count down to March 1, we are hearing more and more about the dreaded sequester. The left is confused about its history.

How did this become Obama’s fault? It started with Mitt Romney, a once-influential Republican Party politician and its 2012 nominee for president. In the third debate with President Obama, Romney fretted that “a trillion dollars in cuts through sequestration and budget cuts to the military” would weaken America’s defenses. The president literally dismissed this with a wave of his hand. “The sequester is not something that I proposed,” he said. “It’s something that Congress has proposed. It will not happen.”

How did this get to be the story ?

The accidental Bible of Sequestration is The Price of Politics, Bob Woodward’s history of the debt-limit wars, and one of the least flattering portrayals of the president this side of Breitbart.com. In it, Woodward recounts a July 27, 2011, afternoon meeting between Senate Majority Leader Harry Reid and White House negotiators. Reid wanted a “trigger” as part of a debt deal, some way to force more cuts in the future without defaulting on the debt that summer. Chief of Staff Jack Lew and adviser Rob Nabors proposed sequestration, as a threat that could be averted if/when Congress passed a better deal.

OK. The White House staff suggested it. Why ? Because they assumed that Republicans would cave in rather than accept cuts in the defense budget.

Republicans have “twice passed legislation” to replace the sequestration cuts. Who told you that? It’s a common Republican talking point, but it’s misleading in two ways. The House passed two bills related to sequestration replacement, but the first one, in May 2012, didn’t offer specific cuts. It moved the total amount of defense cuts over into the non-defense budget, like a croupier moving chips into the winner’s pile. The actual replacement cuts were only spelled out in the Spending Reduction Act of 2012, passed by a razor-thin, Republicans-only vote on Dec. 20, 2012. The Congress that passed it expired on Jan. 3 of this year, so the bill is dead.

Oh, OK. The House bill passed with “Republican only” votes so it doesn’t matter ? The real story is the Obama and Democrats’ gamesmanship. What is their position?

The Senate plan would replace the $85 billion of cuts this year with $110 billion of cuts and taxes, reducing the defense cuts to $27.5 billion and raising (hopefully) $54 billion with the “Buffet rule,” the new millionaire income tax.

I thought we passed a “millionaire tax” last January 1 ? Well, that was only the first “millionaire tax” which affected those with incomes above $200,000. Now they want another one. Why ? Because that’s what Democrats do.

To reduce the deficit in a weak economy, new taxes on high-income Americans are a matter of necessity and fairness; they are also a necessary precondition to what in time will have to be tax increases on the middle class. Contrary to Mr. Boehner’s “spending problem” claim, much of the deficit in the next 10 years can be chalked up to chronic revenue shortfalls from the Bush-era tax cuts, which were only partly undone in the fiscal-cliff deal earlier this year. (Wars and a recession also contributed.) It stands to reason that a deficit caused partly by inadequate revenue must be corrected in part by new taxes. And the only way to raise taxes now without harming the recovery is to impose them on high-income filers, for whom a tax increase is unlikely to cut into spending.

Even the New York Times people have to know that tax increases on high income people adds to unemployment and causes the really rich to flee to other countries. Unless, of course, they have bought favors from Obama. As for “revenue” the government’s share of the GDP is the highest since World War II and well above historic norms, no matter what the tax rates were

As for entitlements, Republicans mainly want to cut those that mostly go to the middle class and the poor, while ignoring nearly $1.1 trillion in annual deductions, credits and other tax breaks that flow disproportionately to the highest income Americans and that cost more, each year, than Medicare and Medicaid combined. Clearly then, there is both ample room and justification to reduce the deficit by curbing tax breaks at the high end, as Mr. Obama has proposed and Republicans have rejected.

Those “tax breaks” are the home mortgage deduction and other deductions that are of long standing (like state and local taxes and tax exempt municipal bonds). What the Democrats want is to have no limits on spending. I don’t believe that the Times’ people are so stupid and ignorant that they do not realize we are asking for the situation of Japan, which used Keynesian spending twenty years ago to deal with a real estate bubble collapse. They are still mired in a stagflation economy after a generation.

I will be very disappointed but not particularly surprised if the GOP caves in once again to the old tax now and cut spending later routine that we have seen before. It might be enough to get a third party started if it happens again. The Whigs got too far from their base in 1854. It could happen again.

For an important and entertaining history of the Whigs, read this.

The three most important components of that political culture were the Whig commitment to “improvement” (including both self-transformation as well as national economic improvement), to morality and duty rather than equality and rights, and to national Page [End Page 74] unity rather than local diversity.[4] Their opposition to Andrew Jackson and Jacksonian Democracy did not follow the lines of Schlesinger, which pitted progressives who wanted to use an expansive government to help farmers and the victims of robber-baron capitalism against monied exploiters who wanted to keep government small and impotent against their greed. Instead, it was the Whigs who advocated an expansive federal government—but it was a government that would seek to promote a general liberal, middle-class national welfare, promoting norms of Protestant morality and underwriting the expansion of industrial capitalism by means of government-funded transportation projects (to connect people and markets), high protective tariffs for American manufacturing, and a national banking system to regulate and standardize the American economy. Howe’s Whigs were the embodiment of Horatio Alger, of upward striving, of the triumph of reason over passion, of the positive liberal state, [5] and the counterparts of Disraeli’s “one nation” conservatism.

Arthur Schlesinger libeled more than just Calvin Coolidge.