of the Potomac, recognized the need
for speedy evacuation of the wounded,
and to that end created a Federal
Ambulance Corps composed of specially
selected and trained litter bearers,
ambulance drivers and horses, and
specifically constructed ambulances.
These reforms succeeded insaving thousands of Union soldiers’ lives.
The Confederates experimented with
similar ideas, but failed to create an
efficient, army-wide field evacuation
apparatus. Both armies utilized a tripartite
system: regimental dressing stations
directly behind the front lines, divisional
field hospitals (often set up in local barns,
houses, or churches), and formal military
hospitals in the cities (such as Richmond’s
famous Chimborazo) for those wounded
who required long convalescences.chain of command. All their doctors
had to pass a special examination
administered by a military medical
board, except when civilian doctors
were recruited after large battles. The
United States Colored Troops had a
separate medical department that
mirrored the overall Union model, but
with less stringent requirements for
doctors and nurses. Consequently,
death rates for wounded or ill African-
American soldiers were much higher
than for their white counterparts.
Infectious diseases
Disease killed twice as many troops as
battlefield injuries. Sometimes entire
campaigns were called off because of
sickness. In May 1862, Confederate
general P. G. T. Beauregard abandoned
Corinth, Mississippi, to advancing
Federals under General Henry Halleck
because one-third of his force was
incapacitated. When the Union
Army took the city in June,
Halleck called off his invasion for
the same reason.
Dysentery, diarrhea, typhoid,
and malaria—all caused by poor
sanitation—were rampant in the
camps. Measles, smallpox, and
common colds were passed around
by the men, and pneumonia
developed quickly among green
troops exposed to the elements.
Quinine was available to treat
malaria and most armies routinely
inoculated against smallpox, but
outbreaks of both diseases occurred
regularly. Opium, castor oil, and
Epsom salts were prescribed to
combat diarrhea and dysentery.
In most cases, the cure was
bed rest, but rest was
difficult for campaigning
soldiers or those in the
rigors of initial
training. Many came to call the first few
months of service “the hardening,” as
they struggled to condition themselves
and their immune systems to army life.
Thousands could not and died before
they ever left camp.
Union surgeon W. W. Keen described
caring for the wounded: “We operated
in old blood-stained and often pus-
stained coats [with] disinfected hands
... We used undisinfected instruments
from undisinfected plush-lined cases ...
and used marine sponges which had
been used in prior pus cases and had
been only washed in tap water.”Staying alive
Although chloroform or whiskey
deadened the pain of major surgery,
secondary infections caused by ignorance
often killed those who had initially lived
through the trauma of an operation.
Almost one in four amputations resulted
in death. Much depended
on how quickly the
wounded could be
evacuated from the field.
Soldiers’ immune systems
and physical strength could
better handle the shock of
surgery if rapidly treated.
After some battles, such
as Second Bull Run and
Chancellorsville, the injured
lay in agony on the field for
days, or in some cases, more
than a week, and thus were
far less likely to survive.
Jonathan W. Letterman,
medical director of the ArmyLife for a veteran
Congress granted pensions to those soldiers wounded
on the battlefield—but first they had to prove their claim.
Veterans without obvious injuries had to track down
their comrades to write a statement on their behalf.Prosthetic limb
Nearly two-thirds of battlefield wounds
occurred in the extremities, and amputation
under anesthesia was the typical remedy.
Lucky amputees were given prosthetic
devices—this one replaced a severed foot.MEDICINE AND MEDICAL SERVICESAfter the war, the combination of scientific
discoveries and practical battlefield
experience set the stage for greater
survival rates in future wars.PIONEERS OF MEDICINE
Medical practitioners during the Civil War
could only do so much. Bad sanitation often
got the better of them, and infections were
difficult to combat. But the world of
medicine was changing. In France during the
1860s, the chemist and microbiologist Louis
Pasteur proved his germ theory—that bacteria
from the environment caused disease—and
discovered vaccines against rabies and anthrax.
In 1865, Englishman Joseph Lister used
carbolic acid to prevent infection in the
wound of an 11-year-old boy with a compound
fracture of his tibia.ANTIBIOTICS DISCOVERED
Alexander Fleming’s accidental discovery
of the antibiotic penicillin in 1928 changed
the course of medical practice forever. In World
War II, thousands of soldiers were saved
from disease and postoperative complications.AFTER
Union hospital in Washington, D.C.
Field hospitals were hastily put together and inadequate.
As the poet Walt Whitman wrote: “I suppose you know
that what we call hospital here in the field, is nothing but
a collection of tents, on the bare ground for a floor,
rather hard accommodations for a sick man.”
Born in Hampden, Maine, Dorothea Dix
was a reformer on behalf of the mentally
ill prior to the Civil War, but immediately
volunteered her services after the
bombardment of Fort Sumter. In June
1861, Dix was made superintendent of
female nurses for the Union Army, a
position she held until the end of the
war. Under her firm and judicious
leadership, a team of 3,000 nurses
treated thousands of wounded soldiers
in army hospitals. Neither friend nor
enemy were neglected. When Lee
withdrew from Gettysburg, he abandoned
his Confederate wounded—these men
were cared for by Dix’s nurses.DOROTHEA DIX
REFORMER AND NURSE 1802–87“[The war] was fought at the end
of the medical Middle Ages.”
UNION SURGEON GENERAL WILLIAM A. HAMMOND