Disease In The American Civil War

The American Civil War proved to be the United States deadliest war, with more casualties than World War I and World War II combined.1 The greatest fear of the Union soldier, however, may not have been a quick death by the gun, but rather a slow one caused by the presence of disease. While terrifying for the soldiers, the physicians found themselves with seemingly endless opportunities to study disease, leading to an evolution in the treatment of multiple diseases. The American Civil War’s production of multiple corpses, unsanitary camps, and unsanitary medical equipment lead to this medical revolution. The battle environment allowed physicians the opportunity to study the etiology of disease, its effects on the human body, and prevention strategies,
Of the 750,000 soldiers that died, approximately ⅔ of these were caused by disease;2 in example, for every 2 soldiers that died of disease, only 1 died in battle.3 This would be beneficial for the physicians who came from a variety of different backgrounds with varying degrees of education; even physicians with formal training learned from a weak curriculum.4 Surgeon Charles S. Tripler noted that medical officers were taken from “all grades… [of] civil life, and necessarily without military experience.”5 Though postmortems had been used minimally before the war, as medical students had had limited legal access to cadavers, they became a crucial practice for overwhelmed physicians, and this practice was maintained after the war. Joseph Woodward observed that the study of anatomy “and of specimens allowed some doctors to see the pathological alterations of disease for the very first time.”6 Woodward himself chose to focus on the specimens, creating a shift in focus “from gross to microscopial anatomy in the pathological field.”7 One of the most prevalent diseases throughout the Union army was cholera, and this became the focus of many physicians as the death toll from cholera rose. Using these new tactics of postmortems and microscopy of specimens, along with the study of patients in different stages of the disease, an overview of cholera was sent to other physicians, boards of health, and the
Outnumbered by the alarming number of soldiers sent to their care, physicians had little time to react, let alone maintain sanitary conditions if they were to save as many lives as possible. A competent surgeon could amputate within 10 minutes, leaving behind a pile of limbs with little time to even consider washing their hands or surgical instruments.15 Bandages were often reused, and sanitation seemed to never be considered, however some physicians refused to reuse bandages because they believed it disrupted the healing process.16 These physicians had the right idea, nevertheless it wouldn’t be until 1865 that Joseph Lister would begin to investigate antiseptic surgery.17 Like Lister, other physicians began to note that disease was something that could be eliminated or destroyed, and thus were soon advised to clean wounds and apply remedies as soon as soldiers showed signs of disease.18 Some physicians discovered the use of bromine as a sanitizing agent. William Hammond found that bromine “prevented sloughing”19 after amputations; Middleton Goldsmith placed bottles of bromine in each of the wards, and noted that “within 24 hours [he] saw a marked change for the better in all the patients since not one had died in the barracks from this disease except the one who was in the last stages of