Civil War Part II

By Peter Galvin, MD

More Americans died in the Civil War than all our other wars combined. It is estimated that about 750,000 people died in the war, and about 2/3, or 400,000 died from diseases. What medical records we have from the war are almost exclusively from the North, as the South destroyed their records just prior to the fall of Richmond. Gunshot wounds to the chest or abdomen were usually fatal. Limb wounds necessitated amputation of the limb above the wound, otherwise infection or gangrene would set in and cause death. The Union recorded about 30,000 amputations, and the survival rate was 75%. Unlike what you see in movies, at least for Union soldiers, surgery was rarely performed without anesthesia. Both ether and chloroform were available, but surgeons preferred chloroform for several reasons. First, ether is both flammable and explosive, so using it around candles is not a great idea. Plus, anesthesia with ether requires a much greater volume of anesthetic and those anesthetized with ether still move and may shout out, leading to the mistaken assumption that the surgery is being done without anesthesia. Nothing was cleaned or sterilized between patients, and the surgeons often held the bone saw in their teeth so they would have two free hands.

By far the most common disease was dysentery, or diarrhea. The terms were used interchangeably. The Union had 1.6 million cases, with 27,000 deaths. It was caused by poor sanitary conditions which created contaminated food and water. Soldiers called it “death by frying pan.” In some cases, for unknown reasons, diarrhea persisted for the rest of a soldier’s life. Treatments included fresh fruits and vegetables, opium dissolved in alcohol (tincture of opium or laudanum), and oil of turpentine or glycerin. Malaria (which means bad air) is a parasitic disease caused by the bite of the Anopheles mosquito, found in tropical and subtropical regions. They called it “swamp miasma”. The Union recorded one million cases with 4,800 deaths. The treatment was quinine, derived from the bark of the cinchona tree, which is found in Central and South America. The Union provided 19 tons of powdered bark and 9 ½ tons of quinine sulfate.

Dietary diseases like scurvy (vitamin C deficiency) and night blindness (vitamin A deficiency) were common, as was malnutrition. It was known that these diseases were caused by poor nutrition, but the logistics to get the food to the soldiers didn’t exist, despite railroads. The North reported 76,000 cases of scurvy with 771 deaths. They also reported 76,318 cases of measles with 5,177 deaths and 117,000 cases of “rheumatism,” of which 12,000 were discharged. They also reported 75,148 cases of typhoid fever and 27,058 deaths along with 13,500 cases of tuberculosis with 5,300 deaths. There were no cures for most of these diseases, but the soldiers’ favorite remedy for anything was alcohol. The Union purchased or produced 3.7 million quarts of pure alcohol, whiskey, brandy, and sherry. A North Carolina distillery produced 200 to 500 gallons of alcohol daily for Confederate troops.

Finally, one unfortunate soldier was admitted to Douglas Hospital in Washington, DC, with “typhoid dysentery.” He was given lead acetate, opium, and mercury pills. Not surprisingly, he died the next day.

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