12/19/2023 0 Comments Cicil war hospitalIt could take days and even up to a week for the wounded to reach a field hospital. ( National Museum of Health and Medicine/Flickr)Īt the beginning of the war, the business of getting injured soldiers off the battlefield was arduous and time consuming. Buck used dental and facial implants to help Buck’s face regain its shape. Burgan had taken mercury pills to treat his pneumonia, but the pills had instigated a bout of gangrene that had taken out his right cheekbone. New York surgeon Gurdon Buck famously photo-documented a series of facial reconstructive surgeries on a Union private named Carlton Burgan in 1862. The war also saw the emergence of distinct fields of surgery, with the development of plastic surgery in particular. Later on, when physicians became aware of the concept of germs, this served as the basis for modern closed amputation techniques. The second option was more aesthetically pleasing but came with the potential for painful infection, because it sealed pathogens inside the body-though doctors might not have realized the cause at the time. “It was effective, but it was brutal.” Working in the field, surgeons learned two key techniques: Leave the wound open and clean it regularly until new skin formed, or close the wound with a flap of skin. “The hallmark of a good surgeon was one who could remove a limb in less than three minutes,” says Koyle. Perhaps unsurprisingly, one of the most common surgeries conducted during the war was amputation. Some even received a more formal crash course in medicine. As casualties mounted, attendants and nurses took on more responsibilities, especially triaging patients-noting who needed to be treated and who could wait. Although these men received some first-aid training, there was really one main requirement: “They had to be able to read doctors’ notes,” says Reznick. Instead, enlisted men were pulled from the ranks to serve as “hospital stewards”. The term “combat medic” didn’t exist during the Civil War or for decades afterward. (Today, the collection of body parts, fluids, case notes and imaging slides is housed at the National Museum of Health and Medicine in Maryland.) His call for specimens also provided a textbook of case studies to train doctors after the war. Hammond instituted mandatory training in public health, hygiene and surgery for all Union Army medical officers. At the beginning of the war, the requirements for becoming an army physician or surgeon were minimal at best. When Hammond became surgeon general of the Union Army in 1862, he shook things up. Writing this week in the New England Journal of Medicine, Koyle and Reznick argue that the war instigated these lasting changes in mentality that forever altered the American medical profession: “The real lasting impact was the change in mindset of both doctors and the people who they were treating,” says NLM historian Ken Koyle. Together, they treated patients in the millions, and sometimes they had to get creative and veer off from the teachings of classical physicians. More than 12,000 physicians served during the Civil War on both sides. The idea of a germ wasn’t even on physicians’ radar. Prior to the war, humoral theory-where an imbalance between the body’s “humours” caused illness-still formed the basis of medical practice. Medicine in the United States did some significant evolving during the Civil War. “When there’s a war, there are evolutionary changes, not necessarily revolutionary changes,” says Jeff Reznick, a historian at the National Library of Medicine in Bethesda, Maryland. It might seem like a strange request, but the medical profession was in the midst of change-from a system based on tradition to one based on evidence. Surgeon General William Hammond put out a call to medical field officers in the Union Army: Send any specimens of morbid anatomy that might be valuable to military medicine and surgery.
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