Video
Civil War Battlefield Medicine
Transcript
[audio description] Against a black backdrop the National Park Service Arrowhead logo stands above the words Kennesaw Mountain National Battlefield Park. Against a dark gray backdrop are the words the 157th Commemoration of the Battle of Kennesaw Mountain. Civil War Battlefield Medicine presented by volunteer David Furukawa. Hello and welcome to Kennesaw Mountain National Battlefield Park.
I’m Ranger Amanda and today I’m coming to you from an open field. And directly behind me is a field medical tent. So, you're going to learn about Civil War medicine and what it was like on the battlefield. Underneath that canvas tent is actually various medical equipment that you would have seen during the Civil War time period. As well as a stretcher and some of the field kits and different types of equipment that would have been used. We also have our surgeon with his assistant behind me and they're going to introduce themselves and give you a little bit more information about what happened here at Kennesaw Mountain, but just in the Civil War as well if you were injured on the field of battle.
Hello everyone, my name is David Furukawa. I’m the surgeon of the 21st Ohio Volunteer Infantry. My assistant here, the hospital steward, is my son William. And we are tasked with discussing a little bit about...
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we're tasked with speaking to you a little bit about battlefield medicine. Medicine in the 19th century has got a quite a bit of mystery and misnomer associated with it. In that we were very well trained. We had supplies, we did use anesthesia, and we did everything in our power to preserve life. That's first and foremost. Now here at Kennesaw, close to the 24-gun battery, a field hospital would be set up roughly a mile or so behind the lines where the ambulance trains would bring the wounded to us. And we would assess what types of injuries that they would have. Now before coming to the field hospital, the wounded would be, would be dispatched to a field dressing station, which would be right off the battle lines. And an assisted surgeon, one of my assistants, and my hospital steward would carry this. This medicine case right here. This is called a hospital knapsack. Basically it would have everything you would need to carry on the battlefield with you to perform minor procedures, stop the flow of blood. We have bandaging material, we have suturing material, It's all... this is all portable, like a portable backpack that you can carry with you. You can carry medicines, anodyne medicines, like opium. We'd have ether and chloroform, which would be used to anesthetize them. However, on the field of battle, we wouldn't have really anesthetized people because of time constraints. We did use tourniquets to stop the flow of blood, which, of course, was the most necessary, first step in treating a wound. The second would be to determine what type of injury you had. I.e. is, is the bone broken? So, let's say you take a wound to the arm, you would take this Nelaton’s probe, stick it into the wound and you would feel the trajectory of the bullet, until the porcelain tip touched the bullet. And then you'd know you're at the right spot. Then you take the bullet forceps, follow the trajectory of the bullet probe until you got to the bullet or projectile, and you pull it out. Now this would all be done sans anesthesia. So, of course, the soldier wouldn't be very happy. But once you got the projectile out, then you take your finger and you stick it in the hole. And you dig around to try to remove any other particulate, which for purposes of fabric and the like, you could use a tenaculum, which is a hook-like device. Pull out foreign material, but this would also be used to pull out blood vessels like veins and arteries. The Grey's Anatomy, first edition came out in 1850. So, if you ever get a chance to look at a copy of Grey's Anatomy, the templates and the actual descriptions and the plates are just incredibly detailed in terms of the anatomy. So, it just shows you that we did have a very good understanding of the body, of disease processes, and also how to treat said disease processes. So here at, here at the field hospital, once the soldier was brought here, we would assess. Do you need immediate treatment? Is it something that can be treated minorly and you can be set aside? Or is it something that, unfortunately, it's considered moral and we can't really do anything about? So that would be an early case of triage. So essentially at a field hospital, that's where we would perform major procedures. So like I said on earlier, at a field dressing station you would basically do first aid to assess the wound, stop the bleeding, give pain medicine. But when you came here to the field hospital, that's where we would actually decide whether or not you needed a surgical procedure. Now, of course, the most common surgical procedure during the Civil War was, of course, amputation. And, of course, we get the bad reputation or sobriquet of being called “Dr. Saw Bones” because we "indiscriminately" cut off limbs at the drop of a hat. But in fact, the necessity for treating battle wounds was such that if you, if you did a surgical procedure on someone who's wound, wounding was on a limb of the upper arm or lower leg, within the first 24 to 48 hours you had a better than 75 percent likelihood of survival. Now, of course, the problem on battlefields is that a lot of, a lot of the soldiers wouldn't get transported off in that timely manner. In which case, you'd lay out on the battlefield for you know longer than a day or two. In which case, the mortality rate goes way down from 75 down to 10 or 15 percent depending on how long you stayed out in the hostile elements. But because of this, because of the necessity to perform surgery so, so quickly our infection rates were fairly low. Now, of course, that being said, 100 percent of patients developed infection. So, it wasn't a case of, oh well, we did perfect, we did a perfect procedure and there was no, you know complications. No, everyone developed infection. In fact, there was a term that was called laudable puss. That laudable puss talks about a creamy colored non-odorous discharge, which you wanted to see. And, in fact, if you didn't see that type of discharge coming out of the wound, then you started getting worried. And you wonder, well where's the puss pocket? In which case, you would take a scalpel and start digging into the wound, looking for the puss pocket, thereby draining the wound, and thereby reducing the amount of potential for infection and resulting gangrene. So, I think that's one reason why Civil War surgeons had such a high success rate with their surgical procedures is because they let wounds heal from the inside out. In fact, when we did a procedure whether it was an amputation or a bone resection, we would actually leave the wound open just a tiny little bit, maybe about a half an inch to a quarter of an inch and that allowed drainage to escape instead of accumulating. Where if you tight, if you sutured it up tight as a drum, then the wound would bloat up, eventually the sutures would pop, and the wound would get infected. So, I definitely credit the medical staff of that time period for allowing wounds to heal from the inside out.
Now one thing that we as surgeons had to deal with outside of combat wounds or battlefield wounds was disease. Out of the quote 800,000 men that died during the Civil War, they say two-thirds died of disease, not of wounds. And these were things that were the result of infections from things like smallpox, measles, rubella, typhus, dysentery, cholera. A whole host of communicable diseases that people would contract. Both from being in close quarters, i.e. in camps, but also from poor hygiene. You know we try to get these soldiers to wash and bathe regularly, which was not necessarily, always the easiest thing. The potential for clean water and good food supplies was often an issue. So you can understand that probably the biggest enemy, that we as surgeons had, was the “dreaded germ.” Which the germ theory was not actually understood in 18, in the 1860s. Louis Pasteur was working on the theory of bacteriology in France as early as the late 1850s. But here in the United States, it was not considered, you know cutting edge medicine. So, we just thought that well, infections are the result of dirt and the result of the injury and self-inflammation. So, if you kept things clean and you kept things bandaged properly, that it would, you would heal yourself basically.
The last thing that I want to talk about is the different types of medications that we had. Back behind here is a Squibb medicine pannier. And it was invented by a doctor named Edward R. Squibb who was a doctor from Rochester, Minnesota. He actually was a physician who was an astute businessman as well and he figured out there was a distinct deficiency in, in quality medicines that could be obtained in bulk. So, what he did was he drew up a formulary of 52 different medicines, which he packaged in 52 little pins, which we can show you in just a bit in that chest. And he marketed it to the military for $100, which $100 in 1864 money is quite a bit of money. But the government loved it because it was portable, it was disposable, and it had everything the surgeons wanted from opium, which opium could be used for pain, it could be used for diarrhea, it'd be used for a whole host of different types of ailments. But we also had medicines, like quinine. Quinine sulfate, was used for malaria, which malaria is very endemic in these southern parts. We know malaria, as the intermittent fever in the shaking chills, which basically is the symptomatology. We did not; however, know what the vector was for malaria, which, of course, is the mosquito. It wasn't until Walter Reed and a doctor by the name of Samuel Mudd, who you know might be sound familiar. He was the man who set John Wilkes Booth's leg and ultimately ended up being incarcerated in Fort Jefferson in the Dry Tortugas. But Mudd and Reed were the ones that discovered that it was in fact a mosquito that was infecting people with yellow fever and malaria. So.. But, we knew that using quinine sulfate stopped the progression of the symptoms. So, in short, we were very good at treating disease from the symptomatic perspective. We just didn't necessarily know the ideology or the root cause of said diseases.
Well we want to thank you for coming to us today, virtually for our 157th Battle Anniversary. We look forward to seeing you again in the future. Please like us on social media and subscribe to our pages. And continue to check us out on our various programs for not only the anniversary but other topics about Kennesaw Mountain. Thank you and have a good one. Bye!
[audio description] Against a dark gray backdrop are the words Thank you for joining us for the 157th Battle of Kennesaw Mountain. For more programs please like and subscribe to our social media sites.
Description
[Sun 3:00 pm ET] The story of Civil War Medicine is a complex one. Through the dedication, innovation, and devotion of surgeons and medical support staff, the foundations for today’s modern military medicine was laid. Please join volunteer David Furukawa, 21st Ohio Volunteer Infantry, and his son William, as they discuss battlefield medicine and what medical treatments were like on the field of battle.
Duration
14 minutes, 14 seconds
Credit
NPS/ D. Furukawa
Date Created
06/27/2021
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