Civil War Medicine

By Brenna Burlile:

The Civil War period was a period of great and lasting change in the field of medicine and nursing in the United States. Medical schools were founded, and doctors were required to be better trained for their jobs. Knowledge of disease transmission and prevention advanced. The United States Sanitary Commission was founded to improve conditions in the field. Nursing became a recognized profession, and women were allowed to enter the field. Women, and the families of soldiers who were at home became involved in the war effort through their volunteer activities in support of the troops. Newspapers, such as the Sandusky Register, were vital communication links between those at home and the troops in the field.

At the beginning of the Civil War, medicine was in a transitional period. Before this time people did not have to go to medical school to become a doctor. They simply had to be a doctor’s apprentice for a period of time. In the 1860’s, medical schools were being founded. Doctors had to attend these schools and then be an apprentice for a time with an already practicing doctor in order to practice medicine. There were several Sandusky residents who were in the medical field during the Civil War. One of these was Dr. Richard R. McMeenes. He kept up a correspondence with the Sandusky Register describing battles and camp life until his death in late 1862, while serving in a Military hospital.

Shortly after the war started in 1861, Bellevue Hospital Medical College created a chair devoted to military surgery. The medical establishment knew that disease was the main culprit in war deaths. They wanted to create more qualified surgeons to prevent needless deaths. A handbook for military surgeons also came out around this time. The book was 120 pages long. However, people who wanted to become military surgeons still needed more training than the book offered. In an effort to recruit more surgeons, the Sandusky Register often published the location and times when the Military Surgeon Exam was offered. The paper also printed the requirements. The candidate had to be certified, in good standing, and have five years experience for a surgeon’s mate, and ten years of experience for a surgeon.

Union surgeons captured by Confederate forces were treated well and let soon released. This was because the Confederate forces did not have the necessary accommodations to take care of the surgeons. The surgeons usually had their boots taken if they were in good shape. The Confederate army was not well supplied and usually took uniform parts from prisoners or the dead. When the war first started there was one surgeon in a regiment of twelve hundred men on both sides. There were female doctors in the Union Army, including Dr. Mary Edwards Walker. The Confederate Army had no female doctors.

The knowledge of microbes and germs had not been accepted in 1861. Operations were done the same way they had been for the last fifty years. Surgical instruments were dipped into well water and that was all the sanitizing they received. Wounds were sewn up with unsterilized silk. Sometimes surgeons would moisten the thread with saliva when threading the needle. Doctors would stick their bare hand in a battle wound to feel around for shrapnel or bullets. Because of these practices, death rates were high. For example, 87% of soldiers with an abdominal wound died, 60% with a skull wound died, and 62.6% with a chest wound died. Shoulder wounds were less often fatal, with a 33% mortality rate, and wounds that involved a broken bone usually lead to an amputation. There was no anesthesia as we know it today. Whiskey was used to sedate people and help take away pain. It was also thought to help people get their senses back. Another problem was that disease transmission and prevention was not well understood, and many patients in the hospitals were there because they were sick, and not because they were wounded during a battle. Diseases swept through camps and killed soldiers who saw little fighting.

Unsanitary conditions in camps led to the spread of disease. In a letter from Dr. McMeenes in 1862, he discussed what happened to dead horses after a battle. They would lie on the ground for days. This would cause diseases to spread. Getting water was also a problem. Water sources would have dead horses or cattle from fighting laying in them. This made the water undrinkable.

The United States Sanitary Commission was founded in 1861. It had doctors who would inspect Union camps and mess tents. The commission also produced eighteen pamphlets on proper sanitation in camp. This included everything from personal hygiene to where the best place to put a latrine was. Primitive conditions in camp were a problem. Sanitation did not exist, and camps were pitched on military strategy, not caring about good water or drainage. Camps had no garbage dumps, and had animal parts from slaughtering everywhere. Then flies came and spread disease. This changed with the Sanitary Commission being founded.

Right after the Sanitary Commission was founded, it ordered supplies for the troops from the Quartermaster’s Department. The Commission ordered three million yards of flannel, eight hundred thousand pairs of boots, eight hundred thousand pairs of wool socks, two hundred thousand felt hats, and two hundred thousand haversacks (which are bags with straps that soldiers can use to carry supplies). These supplies were given to soldiers who had lost their own supplies they had brought from home. Unfortunately, this did not stop a shortage from occurring altogether. Soldiers often had to wear the same clothes for weeks on end. In a letter to the Sandusky Register in 1862, Dr. McMeenes states he has worn the same pair of socks and shirt for three weeks.

Carriage ambulances were another problem during the Civil War. While at war with Mexico, between 1846 and 1848, it was discovered that four wheel units were the best for ambulances. However, during the Civil War, the army insisted on two wheel units, which did not make travel easy. Soldiers also had the problem of going unnoticed while lying wounded on the battlefield and not receiving attention for days. This occurred to local resident Jay Caldwell Butler at the Battle of Nashville.

At the beginning of the War, the Union medical division lacked the capability and staff to cope with a war. It had no hospitals in the District of Columbia or anywhere else. There were a few hospitals on Army bases, and the largest hospital was in Kansas, and it only had forty beds. Hospitals were considered too expensive.

Additionally, hospitals were short of supplies. In the field, medical staff would get so desperate that corn leaves were used as bandages. Field hospitals were a canvas tent in an open field. The floor would be dirt, and patient beds were straw piles and blankets on the ground. At field hospitals, soldiers who were ready to leave were sometimes put outside and exposed to the weather to make room for those needing treatment.

If a soldier was so severely injured that he could no longer serve, in order to be discharged from the Union Army, he had to visit the medical board, which traveled to the camps. The medical board did not adapt their procedures to see the sickest first. Soldiers who wanted or needed to be discharged had to wait in line outside a tent to be examined. This sometimes meant waiting for weeks.

Carriage ambulances were another important factor in the War. While at war with Mexico, between 1846 and 1848, during the Mexican-American War, it was discovered that four wheel units were the best for ambulances. However, during the Civil War, the army insisted on two wheel units, which did not make travel easy. Soldiers also had the problem of going unnoticed while lying wounded on the battlefield and not receiving attention for days. This occurred to local resident Jay Caldwell Butler at the Battle of Nashville.

Dorothea Dix was working as a copy clerk for the U.S. government in Washington D.C. in1862, when she noticed how bad the military hospitals were. She took it upon herself to march into the office of Acting Surgeon General R. C. Wood and she told him that the War Department did not have adequate resources to treat its soldiers. There were only a few surgeons; and not enough nurses, which meant that soldiers were filling the nursing role; and no permanent hospitals. She asked to put together a female nursing corps of volunteers under the War Department. She sought the help of Dr. Elizabeth Blackwell to do this. She hoped to keep romance out of the army so her requirements for nurses were very strict. Her requirements, which were published as an article in the Sandusky Register, included: only plain looking women over the age of thirty could apply, married ladies preferred; dresses must be brown or black; women’s clothing could not have any jewelry, and their hair could not have bows or curls; women could not wear hoop skirts. This was because hoops were cumbersome, and made movement in narrow wards difficult. The ban on hoop skirts was even published in the Sandusky Register as an order from the government.

Nursing was not yet a profession and most who took the role learned as they worked. Convalescent soldiers usually filled the role, before women were allowed to work as nurses. Ill soldiers were expected to take care of each other. Only wounded had special treatment from medical staff at the beginning of the war. Many women followed their male family members into service, and then by accident became nurses. Nuns were also nurses. Some doctors liked them the best because they did not question the doctor’s authority. Women nurses were also sought out when it was discovered that a soldier was a woman and she needed treatment.

Female nurses were new in the military. The position was open to any women no matter their class, although upper class women were looked down on if they became nurses. Nursing duties included administering medicine, distributing special diets ordered by the doctor, writing letters, and attending to visitors. In cases where a soldier was dying and he was alone, they would sometimes pretend to be the dying soldier’s relative to make him feel better. Another thing nurses did to make things easier was to fill out a card with the patient’s information and attached it to the head of the patient’s bed for staff to read.

Opponents to female nurses said that they were too weak to help. The strongest of these critics were male doctors. Nurses had to care for wounded not just in hospitals, but in tents, caves, under trees, in fields and in barns. Nurses would go out while the battle was still occurring to take care of the men. After battles the wounded would lie close together for miles. Clara Barton said, “The wounded laid so close it was impossible to move about in the dark. The slightest misstep brought a torrent of groans from some poor mangled fellow in your path.” This was her experience, and men thought that at the sight of such things women would faint. They were wrong.

Female nurses received twelve dollars a month while their male counterparts received twenty. Female nurses were well aware of the difference. Pay was not just an issue for nurses. Doctors had problems receiving their pay also. It would sometimes take months. In June of 1861, Dr. McMeenes wrote a letter to the Register. In the letter, he stated that he had been in the Army for two months and had not been paid yet. He then went on to ask his patients who owed him money to pay his wife. They could pay the entire bill or only part of it.

Nurses, because they were so close to patients, could often discover things about the patient that the doctor had missed. This occurred to one local soldier who had received a scalp wound in battle. He said, “She (the nurse) had been engaged in washing the blood from my head and face when she discovered that what had seemed on a superficial view to be the most desperate wound of the head, including the skull was but a mere scalp wound which bled profusely and doubtless made a most unpromising case for surgery at first view.” Cases like this were common. Sometimes because of the circumstances of the war and the way medicine was practiced at the time, things were overlooked and people were not treated properly.

Nurses also served an important function in letter writing. They would write for soldiers who could not. They would also write letters trying to find information about soldiers. One such letter appeared in the Sandusky Register in June of 1863. Sarah L. Porter wrote a letter about a soldier named Joseph Cramer who was in her care at a hospital in Washington D.C. She could not get much information from him before he died, except that he was from Sandusky. After his death, she wrote a letter to the Postmaster of Sandusky, and it was published in the paper. She asked that his friends and family contact her. Medical professionals did this so that personal belongings of soldiers could be sent home, and so people could get closure.

The author Louisa May Alcott was a nurse during the War. Not only did she recount her experiences in a book, she also wrote for newspapers. One article that appeared in the Boston Commonwealth was reprinted in the Sandusky paper. It recounted the story of a soldier who was sick and dying. He had her write a letter to his mother for him, and the article also talked about how his comrades who were in the hospital could not stand to see him die. This article also gave an impression about how female nurses were treated.

As stated before, a lot of soldiers in the hospital were sick, not wounded. Louisa May Alcott noted in her book Hospital Sketches, “I spent my shining hours washing faces, serving rations, giving medicine and sitting in a very hard chair with pneumonia on one side, diphtheria on the other, two typhoid’s opposite.” Typhoid was one of the more prominent illnesses. Treatment for it was quinine, whiskey, and turpentine. Sometimes all nurses could do was comfort the patient.

Many hospital workers would contract the illnesses of their patients. Louisa May Alcott caught an illness this way, and Dr. McMeenes caught dysentery while working in a hospital. Workers also suffered from exhaustion and could be hospitalized. Dr. McMeenes died in October of 1862. Originally attributed to heart disease, later it was believed that his death was caused by exhaustion. He as well as other doctors were known to work through the night treating battle wounded soldiers by candlelight. After his death, his wife continued on the mission of helping soldiers and became deeply involved in aid societies.

Before female nurses were allowed in hospitals, young women who lived near the hospitals would visit to help care for and entertain the wounded. They would bring food, alcohol, and flowers. They would also play the piano, sing, and read poetry. This was frequently done on Sunday. After the war had been going on for a while female nurses were more accepted, and recruited so male nurses could return to fight in the War. The nursing service had women from all parts of society.

Women who could not leave home collected and made supplies. This included bandages, candles, and cooking. Relief associations were established to bring women together to make these items. In the April 27th, 1861, Sandusky Register, Captain H.G. Depuy of the Sandusky Guards wrote a letter thanking a Mrs. Wilkinson for a donation of 100 rolls of linen strip bandages. “Should we be called upon to meet the enemy in the field of battle many a youth will be saved to bless the donor.” Letters such as this appeared in the Sandusky Register throughout the war, as well as appeals for supplies such as fish or fruit, and appeals for donation drives.

There were also articles in the newspaper instructing women on how to make different medical supplies for the front. The most important one was cloth bandages for soldiers to carry with them to use when wounded and trying to get to a hospital. The instructions said that the cloth should be washed, boiled and ironed without starch; and that there should be no hem. There were three types of bandages that were used the most. The first was a “roller” that was two and a half inches in width, and made of cotton. It could be used for anything. This type of bandage had to be tightly rolled up for easy application. There was another cotton bandage that was larger and referred to as a “many tailed bandage”. It was typically 20 by 20 inches and was used for gunshot wounds. The last bandage was made of muslin, not cotton like the others. It was one square yard and could be used to bandage anything and make arm slings.

In addition to problems with medical supplies, and conditions in the camps, food was a constant problem for the Union forces in the Civil War. Northern rations were hardtack, beans, salt pork, and coffee. Everything was fried in bacon fat over a fire. Fresh local vegetables were rarely available because of price gouging by local farmers. Diet was something that was not always considered, so both sick and healthy people got the same rations. Union hospital staff would go out into the community to find donations of the proper nutritious food for the patients. Sometimes they would encounter Confederate sympathizers and be in danger of being shot at. People back home would be appealed to for supplies. Food problems accompanied by diseases spreading prompted Dr. McMeenes to write this in a letter in 1862 “ Young volunteers who left home in robust health, who had comfortable homes surrounded by relations and friends, now on their way back mere skeletons of their former selves.”

To help with rations, notices were put in the Sandusky Register, asking community members to donate food to soldiers. They could drop them off with a member of a unit who happened to be in town. Potatoes, onions, sauerkraut, chicken, butter, and dried or canned fruit were all wanted. Doctors would ration these out to troops, and the soldiers who were in the worst shape received more rations. Dr. Sexton also put a notice in the paper requesting specific items. When rations were cut short the soldiers and hospital staff would hunt in nearby fields. Sometimes local people would come in and sell produce.

In April of 1861, Captain DePuy’s company from Sandusky was so disgusted by the food at Camp Taylor, in Cleveland, that they sent to town for lunch. Complaints about the health of food there continued for some time. There also were letters to the newspaper saying army food was not bad including one from a veteran of the war with Mexico. Eventually the camp did clean up and take better care of the food.

Near the end of the Civil War, medicine had changed. While amputation was still the answer to many wounds, other aspects were different. With the women’s relief societies coming and military regulations changing conditions improved. Hospitals were buildings with floors, and doctors had to have gone to school and have experience. The government realized that regulations such as these would enable more men to survive and live after the war. These improvements were applied to the practice of medicine and nursing long after the end of the War.