The Medical History of the American Civil War IV

More of the series on my lecture on the Civil War.

Slide30

The Ambulance Corps were organized and the photo shows one group during the war.

Slide31

The next Army Surgeon General was Letterman who changed Tripler’s organization and built larger hospitals and worked on sanitation projects that had been ignored by the early medical services. Disease was a greater risk to soldiers than wounds and had been since Classical Greece. When large numbers often were accumulated without proper sanitation, disease was rampant. Florence Nightingale was one of the first to realize the importance of cleanliness.

Slide32

One of the greatest medical pioneers of the Civil War was John Shaw Billings who designed hospitals, including The Johns Hopkins Medical Center. He was never Surgeon General but he did organize what became the Public Health Service.

Slide33

One of Letterman’s new hospitals was this one which was constructed in time for the battle of Gettysburg.

Slide34

One of the brilliant surgeons who joined up and contributed was this man, John H. Brinton. Typically, he was dismissed by the politicians around Lincoln because McClellan had appointed him.

Slide35

The most common medical problem was chronic diarrhea.

27,558 Union soldiers died of chronic diarrhea. Without bacteriology, still unknown in 1865, it is impossible to trace the causes.

Typhoid fever killed another 27,056 soldiers.

In the Boer War, in 1899 to 1902, typhoid fever killed thousands of British troops.

of the British Force of 556 653 men who served in the Anglo-Boer War, 57 684 contracted typhoid, 8 225 of whom died, while 7 582 were killed in action.(11) As had been the experience in America, the disease was found to be one which occurred in static camps.

This occurred years after infectious diseases had been identified and the cause of illnesses had been described.

The First Word War was the first war in which more men died of wounds than of disease.

Slide36

This slide, from the “Medical and Surgical History of the War of the Rebellion, shows the seasonal nature of the disease. The nutritional aspects are seen in the incidence during the siege of Atlanta.

Slide37

One example of another page of the History. There were over a million cases of acute diarrhea during the war. “Colored Troops” only appeared after 1863.

Slide38

Diseases were classified according to the medical knowledge of the time. “Miasma” were those which we now know to be infectious. Malaria, for example, mean “Bad Air” in Latin.

Slide39

Tuberculosis was a severe chronic disease which would not be curable until Streptomycin came along in 1946. There were two forms, “consumption” which was the pulmonary form, was not known to be contagious. “Scrofula” is the cervical lymph node form and is associated with milk from infected cows. This was the form studied by Louis Pasteur who recognized that it was transmissible and that heating milk prevented it.

Slide40

Treatment of disease was as primitive as one might expect although quinine was known and used by the Union Army. The blockade of the South prevented its use there. Vaccination was widely practiced and opium was used for pain. There was anesthesia since 1846 and chloroform was more common than ether.

Slide41

Malaria was widespread in the US at the time. Mosquitoes were vaguely known to be associated. Mosquito nets were used although the mechanism was not well understood.

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