Casualties of war

September 09, 2002|by KATE COLEMAN

War stinks.

More men died from diarrhea, dysentery and typhoid than in battle during the Civil War, a conflict in which more than 500,000 perished.

Consider this: Some 94,000 Confederate soldiers killed in action; 164,000 deaths from disease. On the Union side, more than 110,000 federal soldiers died in battle; disease caused more than double that number of deaths.

This according to George Wunderlich, director of education at the National Museum of Civil War Medicine in Frederick, Md..

There was no sanitation - no waste removal on the Civil War battlefield. There was a shortage of running water, Wunderlich says. Soldiers camped in swampy areas were susceptible to malaria and yellow fever, spread by mosquitoes.


Battlefield "bathroom" facilities - latrines - were slits dug in the ground.

"Where do 50,000 guys take a bath?" Wunderlich asks.

"What bath?" he answers with another question.

There were 120,000 soldiers and more than 60,000 horses at Antietam, Wunderlich says. Think about it and "you have some idea of what the Civil War smelled like," he says.

There were 23,110 casualties at Antietam.

Some of those men were treated on the battlefield.

Contrary to dramatic scenes depicted in novels and on the silver screen, anesthesia was available during the Civil War, Wunderlich says. Chloroform and ether were used during surgery. An exhibit at the National Museum of Civil War Medicine shows how it was done.

The liquid preparation was dripped through a funnel onto a rag placed over the mouth of the patient, who would breathe the consciousness-altering fumes.

"It worked very well," Wunderlich says.

A Civil War bullet in the sternum would kill a soldier outright, Wunderlich says. There was greater hope of survival from an injury in an extremity, and amputations were frequently done to try to prevent the spread of infection.

"Amputation was probably the most common surgery during the Civil War," Wunderlich says.

But there was no understanding of aseptic procedures or that there were microorganisms that caused infection. More than 7,000 Union soldiers undergoing amputations - from fingers to hip joints - died.

Compared to modern standards, Civil War Medicine is primitive and horrific. But advances made during the Civil War were the beginnings of practices still used today.

At the start of the war there was no system for evacuating wounded from the battlefield.

The Union's Dr. Jonathan Letterman, medical director, Army of the Potomac, took control of ambulances away from the army's quartermaster so that they could be used to transport the wounded away from the battlefield instead of carrying supplies, Wunderlich says.

Letterman implemented "revolutionary changes" a few weeks prior to Antietam - establishing an ambulance corps to remove the wounded from the front, according to "One Vast Hospital," by Ted Alexander, historian at Antietam National Battlefield. Letterman's system of prioritizing treatment - triage - still operates in emergency rooms today.

Another great medical development of the Civil War was the practice of keeping medical journals, Wunderlich says. Physician's recorded observations were distributed via "circular letters" among army doctors.

It was the first true application of the scientific method, Wunderlich adds. Case studies were later collected in book form, the knowledge able to be passed to the next generation.

Civil War medicine looks medieval in contrast to modern-day practices. But it seems the compassion showed by those who faced its horrors is unsurpassed.

A passage in Robert E. Denney's "Civil War Medicine, Care and Comfort of the Wounded," illustrates.

The book includes the story of Sam Bloomer, color-bearer of the 1st Minnesota Regiment, wounded and caught in the line of fire between Union and Confederate soldiers at Antietam Sept. 17.

Confederate soldiers piled cordwood around him, protecting him from the more than 100 bullets that hit the barricade.

Later in the evening, Gen. Stonewall Jackson rode by and spoke kindly to the Yankee. He ordered his men to make the prisoner as comfortable as possible.

Changing medicine

"Every war has changed medicine," says Dr. Tom Gilbert, chairman of Washington County Hospital's Emergency Department.

The Civil War was no exception.

Vietnam taught a lot about trauma, amputations and resuscitation, he says. A physician with 20 years of military service, Gilbert was stationed at sea, on naval bases, and spent 9 months in the Persian Gulf.

Gilbert will be in charge of emergency services at the site of the re-enactment during the 140th Anniversary Commemoration of the Battle of Antietam, Sept. 13 - 15.

He expects no gunshot wounds, of course, and diseases that killed so many Civil War soldiers won't be a problem on a 21st-century weekend.

Gilbert anticipates that people will need care for conditions similar to those people experienced five years ago during the 135th anniversary re-enactment.

Gilbert and his staff treated 200 patients. Dehydration was the most common affliction, treated in the field with IV fluids. They also took care of people with breathing problems, remedied in the world of modern medicine with aerosol nebulizers that open breathing passages. Sprains and strains also can be treated on site.

Gilbert's field hospital will be a large white medical tent and 20 stretcher stations. His staff will include a physician, physician's assistant and nurses.

Emergency medical technicians and ambulances will also be on location, he says.

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