NOTE: Free essay sample provided on this page should be used for references or sample purposes only. The sample essay is available to anyone, so any direct quoting without mentioning the source will be considered plagiarism by schools, colleges and universities that use plagiarism detection software. To get a completely brand-new, plagiarism-free essay, please use our essay writing service.
One click instant price quote
... loans fried. No wonder, then, that at sick call, shortly after reveille, many men who claimed to be sick were marched by the first sergeant to the regimental hospital, usually a wall tent. There the assistant surgeon examined them, then assigned some to cots in the hospital tent, instructed others to be sick in quarters, and restored a few to light duty or to full duty. The less sick and slightly wounded would be expected to nurse, clean, and feed the patients and to see to the disposal of bedpans and urinals.
In the event of an engagement, the assistant surgeon and one or more detailed men, laden with lint, bandages, opium pills and morphine, whiskey and brandy, would establish an "advance" or dressing station just beyond musket fire from the battle. Stretcher-bearers went forward to find the wounded and, if the latter could not walk, to carry them to the dressing station. The assistant surgeon gave the wounded man a stout drink of liquor, expecting it to counteract shock, and then perhaps gave him an opium pill or dust or rubbed morphine into the wound. Later in the war the advantages of a syringe to inject morphine became apparent. The assistant surgeon examined the wound, with special attention to staunching or diminishing bleeding.
After removing foreign bodies, he packed the wound with lint, bandaged it, and applied a splint if it seemed advisable. The walking wounded then started for the field hospital, officially the regiment hospital tent, although in 1862 and onward there was an increasing tendency to take over a farmhouse, school, or church if such was available. The recumbent went by ambulances, if there were any, for the ride to the field hospital, usually anywhere from three to five miles from enemy artillery and sometimes much farther. There, lying on clumps of hay or bare ground, the wounded awaited their turn on the operating table. There was usually little shouting, groaning, or clamor because the wounded were quieted by shock and the combination of liquor and opiate. It was an eerie scene, with a mounting pile of amputated limbs, perhaps five feet high, the surgeon and the assistant surgeon-after a few months both Union and Confederate authorities decided that two assistant surgeons were necessary in a regiment -cutting, sawing, making repairs, and tying ligatures on arteries.
The scene was especially awesome at night, with the surgeons working by candlelight on an assignment that might sometimes go on for three or four days with hardly a respite. And there was always the smell of gore. The surgeons tried to ignore both the slightly wounded and the mortally wounded in the interest of saving as many lives as possible. This meant special attention to arm and leg wounds. Union statistics showed that 71 percent of all gunshot wounds were in the extremities, probably because of fighting from cover behind trees and breastworks. Wounds of the head, neck, chest, and abdomen were most likely to be mortal, so the amputation cases went first on the operating table.
The bullet or piece of shell had to be removed, often with the operator using his fingers for a probe. Between the extensive damage done by the Minnie bullets used to inflict wounds, and the haste and frequent ignorance in treating them, amputation was all too often the "treatment" prescribed. Everything about the operation was septic. The surgeon operated in a blood- and often pus-stained coat.
He might hold his lancet in his mouth. If he dropped an instrument or sponge, he picked it up, rinsed it in cold water, and continue work. When loose pieces of bone and tissue had been removed, the wound would be packed with moist lint or raw cotton, unsterilized, and bandaged with wet, unsterilized bandages. The bandages were to be kept wet, the patient was to be kept as quiet as possible, and he was to be given small but frequent doses of whiskey and possibly quinine. This was a supportive regime. The urgency of operating during the primary period-the first twenty-four hours-was to avoid the irritative period, when infection showed itself.
The surgeon seldom had to wait more than three or four days for "laudable pus" to appear. This was believed to be the lining of the wound, being expelled so that clean tissue could replace it and the wound could heal. In the rare cases when no pus appeared, it was called "healing by first intention" and was a complete mystery. Actually the pus was the sign that Staphylococcus aureus had invaded and was destroying tissue.
As to technique, the amputating surgeons had a choice of the "flap" operation or the "circular, " both quite old. The former was quicker but enlarged the wound; the latter, when properly done, opened up a small area to infection. By the end of the war a small majority preferred the flap. The frequency of amputations was much questioned at the time. Yet, considering the condition of the patients, the difficulties of transportation, and the septic condition of the hospitals, amputations probably saved lives rather than limbs.
Men wounded in the abdomen by gunshot frequently died of peritonitis if they had not already bled to death from serious arterial injuries. Wounds of the head and the neck were frequently mortal. Some surgeons in both armies experimented for a while in sealing chest wounds. They would plug the wound with collodion, relieving the dreadful dyspnea-breathlessness-of the patient, but sealing in such infections as entered with the bullet. These cases were likely to be mortal, but the operator seldom knew because the patient was soon evacuated to a general hospital. As for the frightful-looking sabers and bayonets, they inflicted barely 2 percent of the wounds, most of which usually healed.
Surgical fevers disheartened the doctors. Four or five days after a wound operation, the patient would be recovering well, producing copious pus. Then suddenly the pus stopped, the wound dried, and the patient ran a terrific fever. Despite drugs, the patient would very likely be dead in three or four days.
The diagnosis was blood poisoning. Erysipelas also affected both armies. With a case mortality Of 40 percent, it received serious attention. It was recognized by a characteristic rash, and it was thought by some to be airborne, with the result that both Unionists and Confederates took steps to isolate erysipelas patients in separated tents or wards. The surgeons were in the dark as to how to treat this affliction, but it was noted that if iodine was painted on the edges of a wound, its further extension was stopped.
Civil War surgeons had not only iodine but carbolic acid as well, and a long list of "disinfectants" such as bichloride of mercury, sodium hypochlorite, and other agents. The trouble was that the wound was allowed to become a raging inferno before disinfectants were tried. However, one of the good features of Civil War surgery was that anesthetics were almost always used in operations or the dressing of painful wounds. It was practically universal in the Union, and despite mythology, anesthetics were very seldom unavailable in the Confederacy.
The almost universal favorite was chloroform, probably because ether's explosive quality made it dangerous at a field hospital operating table, where there was always the possibility of enemy gunfire. With the coming of the big battles of 1862, both armies more or less simultaneously evolved larger and better field hospitals. First, regimental hospitals clustered together as brigade hospitals with some differentiation of duty for the various medical officers and with the chief surgeon of the brigade in charge. Soon brigade hospitals clustered into division hospitals, and by 1864 in most field armies there were corps hospitals. There the best surgeons would operate; one surgeon would be in charge of records, another of drugs, another of supplies, and yet another would direct and treat the sick and lightly wounded who were the nurses. In time for Antietam, the Army of the Potomac, under its medical director Jonathan Letterman, developed the Letterman Ambulance Plan.
In this system the ambulances of a division moved together, under a mounted line sergeant, with two stretcher-bearers and one driver per ambulance, to collect the wounded from the field, bring them to the dressing stations, and then take them to the field hospital. It was a vast improvement over the earlier "system, " wherein bandsmen in the Union command, and men randomly specified in the Confederacy, were simply appointed to drive the ambulances and carry the litters. Frequently the most unfit soldiers were detailed, which often meant that, not being good fighters, they were little better as medical assistants. Often in the first year of the war they got drunk on medicinal liquor and ignored their wounded comrades in order to hide themselves from enemy fire. Such improved organization was copied or approximated in the other field armies despite loud opposition from the Quartermaster Corps, which wanted to keep control of ambulances and drivers, and from some field commanders, of whom Major General Don Carlos Buell of the Army of the Ohio was notable for non-cooperation. In general, the Union forces in the...
Free research essays on topics related to: special attention, wounded, three or four, four days, civil war
Research essay sample on Three Or Four Civil War
