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WWHHYY??Poor Hygiene Civil War soldiers didn’t get a daily shower.

Also, they used the same few pots to cookfood and to boil lice-infested clothing.Yummy!

Garbage in Camp You couldn’t put the trash on the curb everyweek, could you?

Filth from Camp Sinks Latrines were often dug too close tostreams, which contaminated the water sup-ply. Imagine drinking from the school toi-lets every day.

Overcrowding Close contact with other people caused dis-eases to spread rapidly.

Exposure to all types of weather Extreme hot and cold; rain, sleet, snow;dust and mud…. Exposure to the elementslowers your body’s ability to resist disease.

Improper and inadequate diet, spoiled food Staple foods were hardtack for Union sol-diers and cornbread for Confederates. Freshfruit and vegetables were rare. Soldiersreceived some meat, but, often, it spoiled ortoo full of preservatives to eat. More later.

“Bugs” Flies, mosquitoes, ticks, lice, maggots, andfleas were abundant and carried disease.Lack of medical knowledge People didn’tknow about “germs” and how they werespread. Doctors didn’t wash their handsbefore operating, or clean tools after eachpatient.

Lack of surgeons There were too few surgeons to handle thehuge numbers of sick and wounded. Lack ofimmunity to diseases Many rural soldiersbecame sick because for the first time theywere in a large group of people and had noimmunity to diseases such as chickenpox,smallpox, scarlet fever, measles, mumps, andwhooping cough. These epidemics ran ram-pant through many regiments.

Impure water If a stream looked and smelled good, it wasassumed that the water was good. Notalways true!

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From National Museum ofCivil War Medicine

Wood tick illustration fromHardtack and Coffee: TheUnwritten Story of ArmyLife by John D. Billings.Illustrated by Charles W.Reed

176 TWO WEEK CURRICULUM FOR TEACHING THE CIVIL WAR

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WWhhaatt ddiisseeaasseess ddiidd ssoollddiieerrss ggeett??Dysentery Number one killer during the Civil War.

Victims get severe diarrhea with passage ofmucous and blood.

Typhoid fever “Camp Fever” – Number two killer, at ¼ ofdisease deaths. This disease is caused by anyof several bacteria. It is very severe, andcauses a high fever, intense headache,intense rash, and delirium. Body lice trans-mit it.

Ague Pronounced “AY-gyu”. A bad fever with acycle of chills and sweating. Also, “swampfever.”

Yellow Fever Caused by a virus, this disease is carried by aspecific mosquito and can be fatal.

Malaria “Shakes” – spread by mosquitoes.

Scurvy Disease caused by a lack of vitamin C. Thegums get spongy; teeth become loose, andmucous membranes begin to bleed.

Pneumonia Disease causing inflammation of the lungs.

Tuberculosis A very contagious disease that is caused by abacteria. It mainly affects the lungs.

Smallpox An extremely dangerous, contagious diseasecaused by a specific virus. It causes a feverand “bumps” similar to chickenpox.Supposedly, in the 20th century, this diseasewas wiped out by global vaccinations.However, during the Cold War, both theUnited States and the former Soviet Unioncultivated the smallpox virus for possible usein “germ warfare.”

Other chicken pox, scarlet fever, measles, mumps,and whooping cough

The chart above doesn’t even count the infections and gangrene thatwere common with wounded soldiers!

Pediculus Vestimenti.Illustration from Hardtack andCoffee: The Unwritten Story ofArmy Life by John D. Billings.Illustrated by Charles W. Reed

How many ofthese diseaseshave YOU had?

Have you everknown anyonewith any of thesediseases? Why orwhy not?

✔✔ SOME TTHINGSTO CONSIDER

Hospitals and Medical KnowledgeImagine you’re in gym class. You and your friend are running the 100-meter dash. Suddenlyyou both trip and skin your knees – badly. You roll around in the dirt, and then you don’twash your wounds. Obviously, your knees get really, really infected and they start to ooze.Next day you both go to the school nurse. She determines that your oozing wounds aren’tthat bad. In fact, she takes a cotton swab and transfers some of the “ooze” from your knee toyour friend’s knee so it will get better faster.

Wait a minute! Yuck! Why would she do that?

During the Civil War, the experience and training ofdoctors wasn’t well regulated. The Union Army onlyhad 98 doctors registered and the Confederacy hadonly 24 (Tenting Tonight, 79). Therefore, both armieswere willing to take anyone who considered himself aphysician. Most of these new doctors carried around acopy of a military surgery manual that had been writtenby Dr. Samuel Gress. Can you imagine being operatedon by a man who had just read the directions?

Infection was a huge problem. And, to make mattersworse, doctors thought pus was a good sign (they calledit laudable pus), and they transferred it from patientswho had it to those who didn’t. So, they infected anoth-er patient (Tenting Tonight, 79).

Doctors didn’t understand germs or how they were carried and spread. As a result, they vio-lated nearly every rule of sterile technique that doctors use today. A doctor’s assistant wrote,It was common to see a doctor with his sleeves rolled up to his elbows, his bare arms as well as hislinen apron smeared with blood and his knife…held between his teeth (Sabiston and Lyerly, 6).

Infection and disease was so widespread that soldiers didn’t have much faith in doctors.Sometimes soldiers felt that limbs were amputated needlessly – or they simply didn’t want tohave their arm or leg cut off (why not?). One such corporal drew his revolver on a doctor,saying, The man that puts a hand on me dies (Hardtack and Coffee, 310)!

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Surgeons operating in a Federal hospital tentduring the siege of Charleston, 1863.Massachusetts Commandery, Military Orderof the Loyal Legion and the US armyMilitary History Institute.

178 TWO WEEK CURRICULUM FOR TEACHING THE CIVIL WAR

MEDICAL 4

AAmmppuuttaattiioonnAt the field or tent hospitals (which were close to battle lines and in range of bullets andshells) surgeons used their fingers to search for bullets and tried their best to control bleed-ing. And, believe it or not, three-fourths of a surgeon’s time was spent amputating limbs(Tenting Tonight, 33). Most wounds suffered by Civil War soldiers were to the arms and legs.An Army of Tennessee surgeon wrote that the shattering, splintering and splitting of a long boneby the impact of the Minie? or Enfield ball were, in many instances, both remarkable and frightful,and early experience taught surgeons that amputation was the only means of saving life (TentingTonight, 92).

Amputation was the wounded soldier’s best chance of survival. Union soldiers suffered174,000 extremity wounds (arms and legs). Of these, 30,000 resulted in amputations.(Tenting Tonight, 92) Three-fourths of the amputees survived (Tenting Tonight, 92). The soon-er the amputation was performed, the better the chance of survival. If amputation wasdelayed more than 48 hours, blood poisoning, bone infection, or gangrene would set in, andthe death rate would double (Tenting Tonight, 92). This was a very painful way to die. It wasactually best to amputate within 24 hours (Museum of the Confederacy). Many doctors usedanesthesia in the forms of chloroform and ether when they operated, especially near the endof the war.

A patient’s chance of survival depended onhow far the wound was from the trunk ofthe body.

When soldiers were wounded in battle, the Infirmary Corps carried the wounded to a for-ward aid station located within the lines of battle (Museum of the Confederacy). There, anassistant surgeon would give the soldier alcohol and painkillers and would try to stop thebleeding by packing the wound with lint and bandaging it. (Lint was obtained by scrapinglinen fabric. Think of the junk that collects on the filter of your clothes dryer.) If the bleed-ing would not stop, a tourniquet would be applied. This would stop the flow of blood to thelimb, which meant that the limb would have to be amputated. Next, the wounded soldierswould be transported by ambulance to a field hospital, which was a short distance behind thelines.

Location Fatality RRateForearm 14%Hip Joint 88%

Museum of the Confederacy

Douglas Hospital,Washington D.C. withhospital tents outside toaccommodate the over-flow of the wounded. Massachusetts

Commandery, MilitaryOrder of the LoyalLegion and the US armyMilitary HistoryInstitute.

At the field hospital, the operatingtable was often a barn door sup-ported by two barrels or similarobjects. Doctors wore no masksor caps to tuck their hair under.There were no gowns – just anapron. The “operating table” wasprobably not cleaned after eachpatient – so it would be coveredwith blood and filth.

What was it like to havea limb amputated?

T.D. Kingsley, a Union colonel:The surgeons used a large cotton pressas their butchering room & when Iwas carried into the building andlooked about I could not help compar-ing the surgeons to fiends. It wasdark & the building lighted partiallywith candles: all around on theground lay the wounded men; some of them were shrieking, some cursing & swearing & some pray-ing…(Tenting Tonight, 92).

William Blackford of the 1st Virginia Cavalry: Tables about breast high had been erected uponwhich screaming victims were having legs and arms cut off…the surgeons and their assistants,stripped to the waist and bespattered with blood, stood around, some holding the poor fellows whileothers, armed with long, bloody knives and saws, cut and sawed away with frightful rapidity, throw-ing the mangled limbs on a pile nearby as soon as removed…his men were soon overwhelmed by theprayers, the curses, the screams, the blood, the flies, the sickening stench of this horrible little valley(Tenting Tonight, 94).

What happened after the amputation?

The solider was moved, by ambulance, to a hospital further fromthe fighting. This was a bumpy ride, and the soldier was already inhorrible pain. From this point, the soldier was often moved by rail.In the winter, the rail car was freezing cold. On the long, horribletrip, there was no water and nothing to kill the pain.

Infection was the number one cause of death after surgery. It was caused by tetanus (lock-jaw), erysipelas (intense swelling of tissues caused by bacteria), gangrene (death of soft tis-sue), and pyaemia (blood poisoning caused by bacteria). That’s one reason for the creation offield hospitals; some surgeons performed amputations on the field of battle to try to increasethe chance of survival.

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Two-WheeledAmbulance.Illustration fromHardtack and Coffee:The Unwritten Story ofArmy Life by John D. Billings.Illustrated by CharlesW. Reed.

A nurse tending to two Union soldiers in a hospital in Nashville, TN.Massachusetts Commandery, Military Order of the Loyal Legion and the USarmy Military History Institute.

180 TWO WEEK CURRICULUM FOR TEACHING THE CIVIL WAR

MEDICAL 5

BBeeaatt tthhee OOddddss:: CCiivviill WWaarr WWoouunnddssHere are three different situations. Using what you know about chances of survival, rank thewounded soldiers from “best” to “worst”. How will each soldier be treated for his wounds?

1. Colonel Abner Morgan is a wounded Confederate cavalry officer. He was shotthrough the left leg, wounding his horse as well. The wounded leg was shot throughthe calf. He is bleeding very heavily.

2. Private Frank Weaver is from the 129th Pennsylvania. He was wounded with abullet piercing his abdomen. It entered the left front and shot through to the back.

3. Private Clark Hannah is from the 87th Indiana. He was wounded in the right leg,in the thigh, just below the hip.

Wounded soldiers in a crowd-ed hospital. Courtesy of theNational Archives,NWDNS-111-B-286