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Wednesday, May 14, 2008 12:55 pm

Cutting-edge

Springfield researcher takes a revealing look at Civil War medical practices

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An embalming surgeon works on a soldier’s body, location and date unknown
PHOTO FROM THE LIBRARY OF CONGRESS/PRINTS & PHOTOGRAPHS DIVISION/CIVIL WAR PHOTOGRAPHS

Civil War medicine is notorious for being gruesome. It’s an odd topic for the squeamish, like Springfield author Glenna Schroeder-Lein, whose book, The Encyclopedia of Civil War Medicine, was just published. “I’m the sort of person who feels faint at the sight of blood,” she says, laughing. This was the third book and second encyclopedia for Schroeder-Lein, who is manuscripts librarian at the Abraham Lincoln Presidential Library (which has a copy of the book). She wrote it because “it’s the kind of thing that I wish I had had when I started studying Civil War medicine.” (She studied the topic while researching her doctoral dissertation.)
Medical issues were an important facet of the war — historians estimate that two-thirds of the soldiers who perished died of disease, according to Schroeder-Lein — yet the medical terms from the time are often outdated or the issues are difficult to understand today. As a result, she writes in the book’s introduction, “many [Civil War] researchers simply ignore medical issues or are frustrated by an inability to clarify the problem.”
Springfield author Glenna chroeder-Lein, whose book, The ncyclopedia of Civil War Medicine, was just published
PHOTO BY DAVE JANES
The 211 short articles in Schroeder-Lein’s encyclopedia explain those terms and issues in everyday language. The book covers a variety of related topics, such as women’s contributions to soldiers’ care, generals who sustained especially bad wounds, and battles that had significant medical consequences. The minutiae are included, too: We learn about “vermin fairs” — informal contests held by soldiers to see who had the most “graybacks,” or body lice. (And here we thought the soldiers never had fun.) “Many soldiers had less than a rudimentary idea of sanitation,” Schroeder-Lein writes. “Coming from a rural background where they relieved themselves outside whenever nature called, these men continued their habits in camp rather than using the latrines. When these soldiers entered a hospital with an indoor water closet, they did not know how to use it, plugging it up with sticks, paper, and other debris.” This practice contributed to outbreaks of contagious — and sometimes deadly — diseases. Typhoid and diarrhea were common. Dr. Silas Thompson Trowbridge, a Civil War surgeon from Decatur, treated a now well-known soldier for battle wounds and severe diarrhea. The soldier was Col. John A. Logan, of southern Illinois, who later helped establish Memorial Day and became a congressman and U.S. senator. Trowbridge’s Civil War experiences are recorded in the Autobiography of Silas Thompson Trowbridge M.D. (Southern Illinois University Press, 2004).
Logan’s previous surgeon had treated him with two common anti-diarrheal medications of the time: calomel (which contained the toxic element mercury) and opium (which was addictive). They didn’t work. “On arriving at the bedside of the gallant officer I found him unconscious, pulseless at the wrist, speechless, with a cold clamy [sic] sweat . . . indicating death within an hour,” Trowbridge wrote. His solution? Turpentine.
Wounded soldiers from the battles in the “Wilderness” at redericksburg, Va., May 1864
PHOTO FROM THE LIBRARY OF CONGRESS/PRINTS & PHOTOGRAPHS DIVISION/CIVIL WAR PHOTOGRAPHS

Logan got better, but it probably wasn’t due to the sticky tree sap. Schroeder-Lein’s book says turpentine and other secondary Civil War treatments for diarrhea “were either useless or further cleaned out the system.”
Another problem with Civil War medicine was the lack of knowledge about germs. Back then, common thinking held that “miasms,” or poisonous airs and bad odors (Civil War camps had plenty), as well as “animaliculae” caused disease. Medical personnel, as a consequence of this faulty thinking, didn’t wash their hands or instruments frequently. Antiseptics and disinfectants were used, but usually inappropriately, according to the encyclopedia. Physicians often wouldn’t put antiseptic on a wound until after it became infected.
In 1911, Dr. William J. Chenoweth, a Decatur Civil War surgeon, recalled how this affected one soldier’s outcome. (His comments are included in an online paper from Quincy University’s Brenner Library — see www.alliancelibrarysystem.com/IllinoisWomen/files/qu/htm2/quessay.html.) The soldier was in a desperate condition, his knee was crushed by a bullet. “In a case like this today [1911] we could probably have saved his life by antiseptic treatment. He was treated with a solution of bromine, but we had no definite idea of how it should be used and knew absolutely nothing of germs as causing disease, or of germicides as preventing surgical fever.”
While the war’s unsanitary conditions are documented, many people have a misperception about the quality of its medical care, Schroeder-Lein says. We laugh at it today, considering it extremely primitive, but we have to put it in perspective, she says: “If you’re comparing it to the 21st century, yes, it was, in many respects. But in other respects not.”
The Encyclopedia of Civil War Medicine By Glenna Schroeder-Lein, M.E. Sharpe Inc., 2008, 419 pages, $95.
“A lot of the guys who were doctors during the Civil War were pretty cutting-edge,” she says; many were medical-school professors or were supervised by them. “These were guys who knew their stuff. . . . Some of the treatments they used aren’t necessarily that far off [from what we’d use today].”
For example, contradicting our modern perception, anesthesia was used amply and effectively.
“Doctors would give [soldiers] just enough anesthesia so they weren’t feeling pain but not enough that they were completely relaxed, so they would thrash and moan and people would have to hold them down,” Schroeder-Lein says. “It would look like they were having their amputation without anesthesia, but in fact they woke up not remembering anything. “There were certainly some operations performed without anesthesia, but the vast majority, in the North and South, were performed with chloroform or ether, in sufficient doses so the soldier wouldn’t feel pain.”
One of the biggest medical problems of the war was disease, especially childhood diseases, Schroeder-Lein says. Soldiers from rural areas “who’d never been exposed to the measles, mumps, or chickenpox” would eagerly volunteer to serve, show up at camp and promptly get sick. “All these [diseases] are more serious when you get them as an adult,” she notes, but measles was especially serious because it often led to secondary illnesses. “It was easy for [soldiers] to catch something after measles, so a lot of people suffered from bronchitis, pneumonia, eye problems, or all sorts of other things because they’d been weakened by measles. “It was tough for the commanders, too, because there were regiments where three-quarters of the soldiers were sick. That was common in both the North and South.”
The treatment often made the soldier even sicker or killed him. Calomel not only was used to treat diarrhea, it also was paradoxically given to prevent constipation; in any case, it could cause excessive salivation, the death of oral tissues, loose teeth, facial deformities, and death resulting from mercury poisoning. Opiates, the most effective painkiller at that time, were used to sedate soldiers and treat diarrhea, according to the encyclopedia. However, they could be addictive, especially in a soldier with chronic pain or illness who used them frequently. “Historians have suggested that several Civil War generals who had serious health problems may have made poor military choices because they were under the influence of painkilling opiates,” Schroeder-Lein writes. Doctors didn’t realize that opiates were addictive. As a result, some veterans ended up with a lingering reminder of the war: opiate addiction, or “old soldier’s disease.”
As Schroeder-Lein’s research demonstrates, Civil War medical practices were more advanced than we thought, but they still left a lot to be desired.
 Tara McClellan McAndrew is the history columnist for Illinois Times. 
Contact her at TMcand22@aol.com.
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