From the Battles of Olustee and Brooksville, to the Partisan band known as the Ocklawaha Rangers who sank a Union Gunboat along the Ocklawaha River with explosive musket balls they captured from “those damn Yankees”, Florida is steeped in Civil War history. When efforts are made to show the Civil War in movies, we often see surgical hospitals where the only medication that is given is a stick or a bullet to bite upon, while the surgeon takes a bloody and rusty saw to hack off limbs.
While these nightmarish visions may make for great movies, they do a great disservice to the wonders of the medical world that were introduced during the Civil War, by doctors and nurses on both sides of the Mason Dixon line. Despite popular misconceptions, the occasional amputation without any anesthetics was very much the exception and never the rule, even during the heat of battle.
Why Were Wounds so Devastating During the Civil War?
Any warfare is devastating, but the American Civil War saw more American casualties than all of the American soldiers killed and wounded in every other war before or since, combined. Nearly six hundred thousand soldiers lost their lives in the Civil War, with more than one hundred thousand civilian deaths also occurring during the conflict.
In lessons that should have been taken to heart by the time we reached World War One, the Civil War was all about amassing the greater number of troops and firepower into a single spot. As a result, it was not uncommon for entire cities to lose a large portion of their male population in a single volley. As formations of hundreds of troops, both deep and wide would advance, equally large numbers of troops would be firing thousands of ball rounds into their ranks.
Add to that chaos the use of airburst mortar rounds, cannons loaded with explosive ball and grapeshot, and the resulting mayhem created casualties in numbers never seen before or since, save a very few battles in the first world war. The weaponry of the day was also particularly devastating, in part because it was made of lead, but largely because of the massive size of the rounds being used, and the damage created when they hit flesh and blood targets.
Though relatively rare, there were some Brown Bess muskets that were converted and used, firing a ball that was .75 caliber, or three-quarters of an inch around. Far more common were the .69 caliber lead ball, often fronted with a few pieces of .33 caliber buckshot. The most common calibers for muskets were the .50 caliber, .54 caliber and .58 caliber muskets, all firing projectiles well over 200 grains and one-half inch in diameter or more.
Many cannonballs would not explode, but drive through the massed soldiers whole, taking out entire lines of troops. The cannons would also fire what was known as grapeshot in front of the cannon balls, generally a few pieces anywhere from fractions of an inch to two to three inches in diameter.
While old and slow in comparison to modern firearms, the weapons of the Civil War were far more devastating and created much larger entry and exit wounds, generally taking everything they hit in between with them as they exited. It was not uncommon for large segments of bone to be removed as a bullet passed through someone, so as you can imagine, the field hospitals must have been places of abject horror, even without the thought of operating without any anesthesia or other support.
Prior to the War Between the States, the military doctors were more limited, and there was little in the way of military medical units. This should be understandable as the largest skirmishes before the war were generally with poorly equipped bands of Indians, and the numbers of casualties and their wounds were comparatively light.
Casualties during single battles in the Civil War were often in the tens of thousands, the most deadly being the Wilderness Wars, and the three day affair at Gettysburg that resulted in over fifty thousand killed and wounded. The mass murder and maiming that took place during the civil war literally revolutionized not only the military approach to medical care, but hospital care in general.
What was Chloroform Used for in Civil War Hospitals?
Chloroform can be seen in many horror movies, as a means by which the victim is quickly and easily overwhelmed, incapacitated, and subject to the whims of their torturer, or in this case, the doctor (or nurse) in the house. Chloroform was the most common form of anesthetic to be used during the civil war, knocking the soldiers out before limbs were amputated.
Despite yet more Hollywood misconceptions, it takes a surprisingly long time to knock someone out with chloroform, requiring about five minutes of constantly breathing it in to render the average person unconscious. One of the reasons it is no longer used is because of its potential for causing damage to the heart and liver.
Chloroform also must be constantly applied in order to keep someone unconscious for any length of time. Upon awakening, in addition to the pain resulting from the operation, there would have been shivering, nausea and vomiting, and an intense hangover. It must have been very unpleasant waking up with a chloroform hangover, a missing limb, and no pain pills in site, but even at its worst, it beats biting down on a stick or a tooth-breaking bullet like we see in so many movies.
Was Morphine Invented During the Civil War?
Morphine was originally extracted and separated in 1805 in Germany, though commonly used as a pain reliever. While it was not invented during the civil war, it was used extensively, especially for patients who had to wait for care.
The method by which it was introduced into the system remains questionable, and very few soldiers were given routine doses of painkillers of any kind after surgery, but there can be no doubt that morphine was used extensively, and did help many soldiers survive until they could receive treatment.
Somewhere along the line, someone got the bright idea to mix the morphine into a wax-like substance that could then be easily molded in traditional bullet molds. When someone was “lucky” enough to have a single entry wound that had not removed large chunks throughout, the molded morphine was matched up to the size of the entry would and the morphine “bullets” would be packed into the wound.
Morphine is an opiate and generally does not cause severe side effects requiring medical attention from its use in controlled environments. Those that develop an addiction to morphine may experience severe withdrawal symptoms including DTs or Delerium Tremens (uncontrollable shaking), nausea, vomiting, and even psychological and mental issues as a result of the addiction. Morphine should only be ingested on the advice of your personal physician and only through legal prescription use as it is considered to be a controlled substance.
What Was Care Like for Wounded Soldiers During the Civil War?
Once the role of medical military units was started, things began to move quickly, and both sides established a very similar means of caring for wounded soldiers beginning right at the battlefield. Field Hospitals would generally be marked with a solid red flag, so as not to be fired upon, and to help wounded soldiers find the aid they needed.
Soldiers that were helped or could make the journey would seek out these field stations first. Those who could not be helped were generally provided with a sufficient level of narcotics to help them rest in peace as they passed. Other soldiers who could be saved, were triaged or sorted based on the severity of their wounds. The second phase of battlefield care was the field hospital, a step up from the field stations often situated literally on the field of battle.
The walking wounded were generally given directions to the areas where ambulances would be coming and going, and make their way towards the ambulances, no matter which side of the battlefield they had ended up on after their fighting was interrupted by their wounds. Those who could not walk would either be put in line waiting for a ride to the ambulance stations, or receive immediate care and attention if it was needed.
Open wounds that were bleeding profusely would be filled with lint, what we would call pocket lint today. At the time, this lint had to be scraped and manually removed from whatever materials could be found, generally cotton curtains and sheets. Tourniquets were discouraged, but may have been used if the bleeding continued. Today, it is common knowledge that improperly placed or tied tourniquets can result in limb loss, but it was not common knowledge at the time.
Wounds that had resulted in opening major cavities would see the soldiers being sent immediately via wagon trains to the ambulance stations, as these types of wounds were beyond the capacity of the field hospitals of the day. Broken bones, if they were merely broken and not missing large portions, would be splinted, and supported as well as was possible, and generally opiates in some form would be given to the wounded.
Soldiers who were missing large sections of bones would be knocked out with chloroform and have their limbs amputated. After they had an opportunity to stabilize and recover very briefly from the amputation and the effects of the chloroform, they too would be sent to the ambulance stations for transport to larger, more permanent hospitals.
Ultimately, soldiers would be moved into prisoner of war camps if they landed on the wrong side of the battlefield. Amputated limbs were generally discarded at the field hospitals, and buried or burned after the battles were over, and before the hospitals would move on to the next scene for wholesale carnage.
How Did Medical Care Change During the Civil War?
Before the civil war, most of the casualties of battle were relatively small in number, and civilian doctors were routinely used for their care. During the first battle of Manassas, more than 2700 Union troops were killed or wounded, and nearly 1900 Confederate troops suffering the same fate. Many of the soldiers from both side remained injured, lying on the battlefields for as long as 3 days as there was no organized military structure providing ambulance service, or any way to evacuate the wounded.
As a direct result of the first battle, the Civil War saw the introduction of the military field hospital. Often located in whatever buildings happened to be nearby, these field hospitals on either side would care for the wounded of both sides from the battle. Both Northern and Southern military commanders saw the need to organize the logistics and support for a medical staff to accompany the soldiers.
This radically changed how the military structured its medical specialists, and many of these changes moved into the civilian world as well, especially in big city hospitals where major tragedies could result in large numbers of injured people being admitted in short order. Before the civil war, there had been no organized hospital structure throughout the nation.
Today, not only is hospital care much better in no small part due to advancements made during hospital operations during the civil war, but also by modern technology and the increasing number of alternative medical care centers like Advanced Health Care MD in Boca Raton.