Civil War Surgery

Battle was not the only horror of the Civil War.

The American Civil War remains the bloodiest war Americans have ever fought. By most accounts, 625,000 died and 476,000 were wounded from both North and South. One out of every four soldiers who fought in the Civil War never made it home. War records indicate that about 75% of all surgeries were amputations and an astronomical number—more than 60,000 men, about one out of every 12 surviving soldiers—went home missing one or more limbs. Why? Because the Civil War saw huge technological changes in weapons and munitions that not only made them more lethal but caused far more tissue damage along the way.

The Gatling gun, the slow-moving Minnie ball, the landmine, torpedoes, shrapnel shells, cannisters, and better designed rifles were just some of the new developments that increased the power to kill and wound.

The Minnie ball was especially damaging because it was grooved to stabilize its trajectory, thereby increasing its distance, speed and deadliness, but the grooves also collected bacteria that infected a wound.

Shrapnel shells were made of many small bits of metal, including nails, ball bearings, needles, and sharp metal fragments that exploded in mid-air. The projectiles raggedly ripped through flesh and rendered devastating damage. Cannisters were even more deadly because they dispersed as soon as discharged, whereas shrapnel exploded closer to a target. Cannisters were used heavily in Union combat against the Confederates.

While war weapons during the Civil War had advanced in destructiveness, medical technology had not kept pace. Because of the change in weaponry and munitions, the types of wounds suffered on Civil War battlefields were often more devastating and killed or wounded greater numbers of troops than in past wars.

The devastation was such that both the Union and Confederate forces found themselves very poorly equipped to treat the staggering numbers of wounded. Both Armies realized the terrible need for more organized medical treatment of their wounded and both established medical corps. In fact, the Confederate Army was quicker to authorize a special medical corps of doctors, nurses, aides, and ambulance drivers. But the Confederate Army would soon become hamstrung by dwindling medical supplies and personnel. Consequently, Confederate wounded and Union prisoners of war fared far worse than Union wounded and their prisoners. About 16% of Union soldiers taken prisoner by the Confederacy died in prison as opposed to 12% of Confederates captured by the Union.

Medical knowledge was still relatively primitive. Medical knowledge did not include an understanding of infection, bacteria, or the need for sterile conditions. Two of the miracles of medicine—antiseptics and antibiotics—had not yet been developed. Because of the horrifically unsanitary conditions on the battlefield, as well as the surgical tents set up near the battlefields, even minor wounds often became infected and lethal.

Gangrene was also a huge danger. The recommended cure for gangrene and infection was amputation, which held its own considerable dangers, infection and bleeding to death, among them. Wounds with lead shot and metal shrapnel were often treated with amputation, as well, because it was too difficult and time-consuming to try to remove all fragments. If they remained in the flesh, they would cause infection. Amputation was the most efficient way to increase a soldier’s chances of survival and avoid deadly complications later.

In place of antibiotics, whiskey, coffee and quinine were prescribed. And iodine or bromine were used to clean wounds. Surgeons and medical assistants never washed their hands; blood was assumed to be pure and free of disease. Germs and bacteria were not understood, so surgical instruments were simply rinsed in used, bloody water so the surgeon could see what he was doing.

In the gallows humor vernacular of the battlefield, soldiers referred to doctors as “sawbones,” since amputations seemed to be their primary procedure for treating the wounded, and mountains of limbs were piled like cordwood outside the tents.

Many types of amputation saws were available, but the most effective was the two-man saw, since leg and arm bones took great strength to saw through. Surgeons became so experienced at amputations, they could be performed in only five minutes.

When the war began, the Union government had not made plans for collecting or treating the wounded, burying the dead or notifying kin. There also were no provisions and virtually no medical knowledge about therapeutic care for physically or psychologically damaged soldiers in the aftermath. But, after the first Battle of Bull Run in July 1861, the government took over several hospitals in Washington D.C. and Virginia to house the wounded and appointed the first medical director of the Army in August 1861, then the first Surgeon General in May 1862. The new staff created the first Army Medical Corps.

In addition, many private medical agencies stepped up to treat the wounded as well, especially the U.S. Sanitary Commission, the U.S. Christian Commission, and the Women’s Central Association of Relief for Sick and Wounded. Many states sent their own medical teams, too, to provide medical support for their own state regiments.

Union medical care improved immeasurably in 1862. One of the greatest advancements was the establishment of the ambulance corps. Before its creation, many thousands of troops died agonizing deaths languishing on battlefields untreated. But, there was one silver living in the dark cloud of the War’s catastrophic losses: medical knowledge and research saw spectacular leaps nationwide. And the development of prosthetic devises and technology to aid the handicapped experienced a watershed.

For all the medical advances after the War Between the States, there was one intriguing Civil War medical mystery that was not solved until nearly 140 years later.

At the Battle of Shiloh in southwestern Tennessee in early April 1862—one of the bloodiest conflicts of the War—over 20,000 casualties were left on the battlefield between the two sides. On the night of April 7, many wounded lay in the swampy fields, covered in blood and mud and shrapnel. During the night, across the vast battlefield, soldier’s wounds began to glow an unearthly, phosphorescent blue.

The vast expanse of carnage lay in darkness, but for thousands of blue glowing orbs, like fairies or lightning bugs, in an eerie swamp mist, emanating from the wounds of the fallen soldiers. A chorus of whispers rose across the dark battlefield. The men were awestruck even in their misery and pain. Soldiers began to pray and whisper the only possible explanation: angels had visited them and blessed them with a miracle. They called the blue light “Angel’s Glow.”

It wasn’t until 139 years later, after a 17-year-old high school boy named Bill Martin toured the Shiloh Battlefield in 2001 and learned about the magical “Angel’s Glow” that the spectacular mystery was solved.

The boy and his mother, Phyllis, a microbiologist, decided to investigate types of bacteria that glow in the dark as part of Bill’s high school science project.

They discovered that the swampy land of the Shiloh battlefield was very hospitable for a certain bioluminescent bacterium that lived inside tiny parasitic worms called nematodes. The nematodes would vomit up the bacteria, called “Photorhabdus luminescens,” producing the “Angel’s Glow.” The bacteria also produced chemicals that ate dangerous bacteria and pathogens that caused infection, thereby cleaning the soldiers’ wounds.

Nature had indeed sent the tiniest “angels” to many of the wounded soldiers at Shiloh that night. When the soldiers on the battlefield were retrieved and taken to medical tents, then later hospitals, those who had been “blessed” by the “Angel’s Glow” survived. Those whose wounds were not candescent, did not.

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"Civil War Surgery" was first posted on Facebook on December 17, 2019.

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