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From: "Ray and Joan Rogers" <>
Subject: [AR-CIVIL-WAR] Medicine in Civil War
Date: Sun, 31 Mar 2002 21:16:39 -0700


This article was printed in the Journal North section of the 3/31
Albuquerque Journal. I clicked for permission to send it, but you
must not use it for any commercial purpose. The article is extremely
graphic, but it gives us an insight into how lucky we are that our
forbears survived.

Ray
Los Alamos, NM

Medicine in Civil War Was Crude

By Diana Heil
Journal Staff Writer

Oh, to remember the days of "laudable pus." Pus forming on the body
after an operation was a sign of health - or so Civil War surgeons
mistakenly thought - rather than a bacterial infection that could kill
the soldier.

Had Civil War medicine understood the nature of germs, disposable
dressings and rags could have saved thousands of lives, speculates Dr.
Robert E. Mallin.
"The surprising part was how bad things can be without the germ
theory," he said, referring to his research into Civil War medicine,
as a small group gathered at the Pecos National Historical Park
visitors center Saturday.
Of the estimated 650,000 soldiers who died, most were struck down by
disease and infection, Mallin said. Only one-third died as a result of
combat wounds.
Pecos National Historical Park is hosting Mallin's talks and other
activities this weekend in recognition of the 140th anniversary of the
Civil War Battle at Glorieta Pass.
A retired plastic surgeon with no family connections to the war,
Mallin's fascination for historical medicine deepened on his 50th
birthday when he unwrapped a cherry wood box of Civil War surgical
instruments. Today, the kit, which a veteran passed down through an
Albuquerque family, is valued at $10,000.
Amputation
Mallin is a 62-year-old New York native who lives in Eldorado. If he
can get his hands on ground-penetrating X-ray technology, he would
like to search the Pecos area for a cache of amputated arms and legs.
Some 43 amputations occurred in this region alone, where a couple of
thousand soldiers fought on both sides. The March 26-28, 1862, battle
left more than 300 dead. The Confederate force of Texans retreated to
the south after Union soldiers destroyed their supply train.
The odds of surviving an amputation were far greater if the limb was
removed the day an injury was sustained. Sometimes doctors waited as
long as 10 days for pus to bubble around the wound, then sliced
through it to the bone. From this delayed method, two-thirds of
amputees died, Mallin said.
Amputations required four people: one to hold down the soldier and
another to anesthetize the soldier with ether or chloroform. Still
another was needed to peel back the skin and muscle and expose the
bone. Then there was the surgeon, who whacked off the limb.
"It wasn't bite the bullet or take a shot of whiskey," Mallin said.
Mallin brandished a variety of amputation knives. One was
nickel-plated and dated to 1864. Another looked like a hack saw with
an ebony wooden handle. Smaller knives were designed for fingers and
wrists.
"In the Civil War, 70 percent of the operations were amputations,"
Mallin said.
In those days, all physicians were called surgeons. They studied two
years of medicine at the most, then obtained practical experience in
the field when drafted. It stands to reason that many a surgeon was
court-martialed for malpractice, he said.
"Then there were some flat-out quacks. The West was good at that,"
Mallin added.
Few of the U.S. Army surgeons who died in the Civil War were shot.
Instead, malaria and the soldiers' infectious diseases caused their
deaths.
A veteran himself, Mallin spent 1966-1967 as a squadron surgeon during
the Vietnam War. He was drafted fresh from his medical internship. In
the field, he patched wounds and shipped soldiers to a board-certified
surgeon. Mallin was shot in the leg and returned to the United States
with a Purple Heart.
19th century medicine
During the Civil War, "bleed, purge and puke" was the procedure of
choice, he said.
Mallin held up a bleeding knife with three blades for different-size
veins.
"That's a real bleeding knife," he said. "You'd puff up a vein and
give it a slice."
A racing heart and fever meant a soldier had too much blood, or so
physicians believed. The doctor would open a vein and let out 16
ounces or so of blood.
For stitches, Northern doctors used silk, whereas Southern doctors
used cotton or horse hair.
When soldiers swung sabers, they chopped from the enemy's head down.
Skull, shoulder and collarbone injuries often resulted.
Surgeons pulled the scalp apart with a retractor, cut around the
fracture with a tomahawk-shaped tool called a Hays saw, drilled
through the bone with a corkscrew called a trephine and then elevated
the bone to relieve the pressure.
The procedure was considered a success if blood - and no brains -
rushed out, Mallin said.
Bullets often pulled bacteria into a soldier's body. Mind you, troops
changed their wool uniforms every two to four weeks and took a full
bath only once a month.
But the war did produce some medical progress, Mallin said.
"By mid-Civil War, they decided to treat diseases and not symptoms,"
he said. "The germ theory was ebbing in."
Vast numbers of soldiers came home addicted to pain-killers such as
opium, heroine, cocaine and alcohol. Yet somehow they managed to
rebuild this country, noted Mallin.





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