Learning from the Wounded

Learning from the Wounded: The Civil War and the Rise of American Medical Science

SHAUNA DEVINE
Copyright Date: 2014
Pages: 392
https://www.jstor.org/stable/10.5149/9781469611563_devine
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  • Book Info
    Learning from the Wounded
    Book Description:

    Nearly two-thirds of the Civil War's approximately 750,000 fatalities were caused by disease--a staggering fact for which the American medical profession was profoundly unprepared. In the years before the war, training for physicians in the United States was mostly unregulated, and medical schools' access to cadavers for teaching purposes was highly restricted. Shauna Devine argues that in spite of these limitations, Union army physicians rose to the challenges of the war, undertaking methods of study and experimentation that would have a lasting influence on the scientific practice of medicine.Though the war's human toll was tragic, conducting postmortems on the dead and caring for the wounded gave physicians ample opportunity to study and develop new methods of treatment and analysis, from dissection and microscopy to new research into infectious disease processes. Examining the work of doctors who served in the Union Medical Department, Devine sheds new light on how their innovations in the midst of crisis transformed northern medical education and gave rise to the healing power of modern health science.

    eISBN: 978-1-4696-1548-6
    Subjects: History, Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-viii)
  3. Acknowledgments
    (pp. ix-xii)
  4. INTRODUCTION Medical Education and the American Civil War
    (pp. 1-12)

    In popular conceptions of the American Civil War, such a story, told by war physician W. W. Keen years after the conflict, seems to confirm the impression of Civil War medicine. It has become commonplace to associate this war with inexperienced physicians and surgeons hacking off limbs with unsanitized medical equipment while patients clamped down on bullets trying to suppress the pain. New estimates of the Civil War death toll, and how those men died, seem to support this impression. As many as 750,000 soldiers died as a result of the war, a number that would be proportional to 7.5...

  5. CHAPTER ONE Circular No. 2 and the Army Medical Museum
    (pp. 13-52)

    The Union Medical Department was ill-prepared when the Confederate batteries fired on Fort Sumter, April 12, 1861. The department initially had a tremendously difficult time organizing both the volunteer and regular physicians and was inept at managing the new hospitals and training camps. Endemic and epidemic diseases were a part of life in antebellum America, and Americans were used to living with illness to some extent.¹ However, the war brought thousands of men together from all parts of the North, who were then housed in new training camps. Within these camps, overcrowding, exposure, unsanitary sewage disposal, and a lack of...

  6. CHAPTER TWO The Limits of Morbid Anatomy and the Development of New Medical Techniques
    (pp. 53-93)

    The war provided an abundance of bodies, and physicians eagerly dissected them. Before the war, dissection was largely “conducted on the margins of legality.”¹ The practice was sometimes a contentious and volatile issue, as discussed in chapter 5. However, the context of anatomical study changed within the army during the war. It was no longer unsavory or associated with grave robbing under the cover of darkness; rather the Union’s program of dissection was about advancing medical knowledge and learning and developing techniques that might translate into better care for the living. Rank-and-file physicians learned firsthand the methods of the Paris...

  7. CHAPTER THREE Civil War Bodies and the Development of Experimental Method Erysipelas and Hospital Gangrene during the American Civil War, 1861–1865
    (pp. 94-131)

    The men are sometimes placed in wards already affected with hospital gangrene or with erysipelas and cases have come to our knowledge in which they have thus contracted these maladies . . . we fear that a good many have thus lost their limbs and their lives.”¹ So noted Medical Inspector Frank Hamilton of the increasing incidence of gangrene and erysipelas as the war progressed. The Civil War saw both an unprecedented number of wartime amputations and the development of hospitals in which to treat and manage soldiers. These hospitals became a new source for septic infections like pyemia, gangrene,...

  8. CHAPTER FOUR Medical Specialization and Specialized Research
    (pp. 132-172)

    The Civil War provided unparalleled opportunities for a physician to develop an expertise in a specialized area of medicine. Physicians were often challenged by the patients under their care, particularly since the range of unfamiliar diseases and cases manifested peculiar and often devastating symptoms, thus allowing physicians seeking the distinction of specialist a chance to develop specialized knowledge. Medical specialization, once associated with anti-intellectualism and quackery,¹ now had a new intellectual dimension: becoming an expert could save lives, conferring a measure of status and identity on the physician who could successfully diagnose, manage, and treat these challenging cases. Indeed, Silas...

  9. CHAPTER FIVE Whose Bodies? Military Bodies and Control during the American Civil War
    (pp. 173-214)

    The relationship between the physician and the “dead body” was contested in nineteenth-century America. Although most states allowed criminals to be dissected, not enough people were executed to meet the increasing demands of the medical profession.¹ Medical training, of which anatomy was the cornerstone at the time, was consequently severely hindered, forcing medical students to go abroad for their training or to resort to grave robbing, which was both illegal and socially unacceptable. Indeed, the public feared dissection, which was manifested in at least seventeen anatomy riots in America between the years 1785 and 1855.² Although states increasingly passed anatomy...

  10. CHAPTER SIX Cholera and the Civil War Medical Model in the Postwar Period
    (pp. 215-248)

    In 1871 the physician Joseph Woodward observed that the “science of medicine is essentially progressive: with increasing knowledge comes more subtle skill, and the advances already made warrant hopefulness as to the future.”¹ He was referring to the new ideas and direction for American medicine that took shape with the Civil War. By 1866 the many wartime experiences, challenges, innovative research ideas, and management strategies were gradually being adapted in the postwar period to manage new crises and health threats. Nowhere was the impact of the war more apparent than on the management, understanding, and investigation of infectious disease. It...

  11. CHAPTER SEVEN Postwar Reflections
    (pp. 249-272)

    In 1867, an editorial in theRichmond Medical and Surgical Journalreflected on the history of medicine in the United States. The author noted that “until the last ten years, American teaching and American practice of medicine has been conspicuously devoid of individuality.”¹ Part of the problem, as the editor explained, was the lack of American identity in the production of knowledge; thus “the most dogmatic aphorisms of the lecture-room, and the chief lessons from the library have, as a rule been confessedly obtained from foreign authorities.” Indeed, “listeners and readers have been educated to believe, that, in professional circulation,...

  12. Appendix
    (pp. 273-276)
  13. Notes
    (pp. 277-338)
  14. Bibliography
    (pp. 339-360)
  15. Index
    (pp. 361-372)