The Civil War was a seminal event in American history as combatants decided whether or not the United States would ultimately become a great nation. The death and destruction was horrific, a large part of the problem being that very few physicians had any surgical training at the beginning of the war. The Union had only 30 surgeons and 83 assistant surgeons, and when the war started, 3 surgeons and 21 assistants resigned to join the South.
Civil War bullet removers
(top to bottom) 2 canister shot, unfired .58-caliber Minie ball, deformed Minie ball after impact, porcelain tipped Nelaton bullet probe by Tiemann, bullet forceps with .69-caliber musket ball, Coexter bullet remover with Colt’s army pistol bullet, bullet screw with sheath (ca. 1860)
Major General Daniel Sickles after his amputation
Before the war on February 27, 1859, Sickles had shot and killed the son of Francis Scott Key, Philip Barton Key, because Key had been having an affair with his wife. Sickles pleaded temporary insanity. He was the first person to successfully use that defense for murder in a US court. Sickles was later appointed general in the Union Army.
CDV of Private L. Coombs, 4th US Infantry seated with his prosthesis (ca. 1865)
Seventy-five percent of all operations in the Civil War were amputations as surgeons soon discovered that the quick removal of a traumatized limb was the most effective way to save lives. Civil War survivors with limb prostheses became a common sight throughout the latter part of the nineteenth century.
Bone-excision procedure performed on Pvt. Porubsky from the Reed Bontecou Civil War surgical album (ca. 1865)
An excision was a specialized procedure employed during the Civil War in order to save limbs by removing only affected joints or parts of bone, thereby avoiding amputation to retain at least some function.
The Medical and Surgical History of the War of the Rebellion (1870–1888)
Cpt. “S” of the 29th New York volunteers was wounded by a musket ball on May 2, 1863 at Chancellorsville. With his lung collapsed, he walked 1 1/2 miles to a field hospital where physicians unsuccessfully attempted to reduce the hernea, which contained lung and “some portion of the alimentary canal.” The following day, hostilities forced Cpt S to be evacuated and he subsequently had to walk another 1 1/2 miles. The musket ball passed in his stool on May 7th, and the wound, which contained lung and stomach, eventually granulated in.
ambulance train at Harewood Hospital, Washington,DC, ca. 1863
Jonathan Letterman, while medical director of the Army of the Potomac, developed the Letterman Ambulance Plan in which the ambulances of a division moved together with two stretcher-bearers and one driver per ambulance to move wounded from the field to dressing stations, and then on to the field hospital. This plan was implemented in August 1862 when McClellan issued General Orders No. 147 creating the Ambulance Corps for the Army of the Potomac.
color print by Kurz and Allison of Chicago (1888) showing Grant “triumphantly” advancing on Lee at Cold Harbor, Virginia
The Battle of Cold Harbor was a devistating defeat for Grant and the North with about 7,000 soldiers slaughtered in the first 20 minutes of an ill-fated charge of Southern embankments. By reviewing this one battle in detail, one can get an understanding of trauma surgery during the latter part of the nineteenth century.
Diary kept by Sgt. Joseph Hume of Massachusetts, expired June 3, 1964
This diary was kept by Sgt. Joseph Hume of Massachusetts, killed on the bloodiest day of the battle on June 3, 1864. He was a twenty-year-old mill hand who was born in Ashburnham, Massachusetts, and entered the “A Company”—MA 36th infantry—as a private on July 28, 1862. Hume was promoted to sergeant major as he traveled south to fight at the Battle of Cold Harbor. A compatriot completed his diary on June 3 with the words, “Joseph received his death wound,” and the following day “Died in consequence of the above.” The diary was apparently on Hume’s person at the time of his death in light of the bloody stain in the corner.
Dr. Merari Stevens' letter
Dear friend Ezra, I take pen in hand to let you know that I yet live. We are camped near Petersburg and we are havng tolerable good times now. However, that was not the case last summer during the "killing season." We left Baltimore on May 15th...then we went on to Coal (sic) Harbor getting ready for the grand assault on the 3rd. The rebs had all the advantages of position and they were all well protected by breastworks and rifle pits. When the order was given we charged across the open plain into a hail storm of rebel balls and shells. Men were struck down as if by a great sythe like grass in haying time, and it was here that Father was struck...The bullet exited near the right hip...and then with my bowie knife took the ball out...Then I helped carry Father off the field and I stayed with him until he died...Father must have suffered greatly before he died..and he was very brave and calm. Father said that he was prepared to die and that he had done his duty...He bade me farewell and then died in my arms...So much blood shed on both sides so as to be beyond description...If we could only live in peace with our Southern brothers...