Table of contents for Civil War medicine : challenges and triumphs / Alfred Jay Bollet.


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Introduction: The Evolution of Battlefield Surgery during
the Civil War ............................................... 1
Treatment of the Wounded Early in the War ................... 2
Treatment of the Wounded after the First Year of the War ........ 3
Treatment of the Wounded at the End of the War ............... 5
Abbreviations Used in Text .................................. 6
1. In The Beginning: Ill-Prepared and Overwhelmed .............. 7
The Influence of the Crimean War ............................ 8
The U.S. Sanitary Commission ............................... 9
The Union Surgeons General .......... ...................  13
The Confederate Medical Department ....................... 15
Tripler and the Army of the Potomac ............ ........ 16
Reforms in the Union Medical Bureau ....................... 19
Medical Records of the Civil War ......... .................. . 22
Medical Care in the Federal and Confederate Navies ............ 26
The Army  Surgeons  ...........   ......................... . 27
The Examining Boards  ...........  ......................  32
2. Sects and Science: Civil War Medicine in Context ............ 37
Medical Science in the Mid-1800s ........................... 39
The Beginnings of Clinical Science .................... 42
The Paris Connection  ................................... 43
Other Notable Teachers of American Physicians ............ 46
Civil War Medical Research Societies ........................ 47
Concepts of Epidemic Disease in the Mid-1800s .............. 49
Contagion ..................................... ...... 50
Miasmas, Fomites, and Civil War Sanitation ................ 51
Did American Physicians Have Up-to-Date Information? ....... 55
U.S. Medical Education in the Mid-1800s ........  ....... 57
Medical Education in Europe .................. .......... 62
Use of Stethoscopes and Thermometers ...................... 64
Use of the Microscope  ..................................... 67
Use of the Ophthalmoscope  ................................ 69



3. Civil War Surgery: Desperate Measures for Desperate Wounds .. 75
Anesthesia during the Civil War ............................. 76
Surgery before the Civil War .......... ...................... 81
The Weapons: Mini6 Balls, Sabers, and Artillery Shells .......... 84
Wounds in Different Sites ................................ 86
Understanding Casualty Statistics ........................... 90
Surgery during the Civil War .............................   92
4. 'Thank God For Jonathan Letterman": Field Surgeons,
Field Hospitals, and Ambulances ............................. 97
The New Ambulance and Field Hospital System ............ ....98
Initial Wound Treatment  ................................ 99
Ambulances ......................................... 103
Field Hospitals  ........................................  106
Medical Transportation Systems ......................... 108
Hospital Trains  ....................................... 109
Hospital Ships  ....................................... 112
The Big Picture: Evolution of the Union Ambulance and
Field Medical Systems ................................ 115
First Bull Run  (July 21, 1861)  .......................... 117
Peninsula Campaign (March-July 1862) .................. 117
Second Bull Run (August 29-30, 1862) .................. 121
Battle of Antietam (September 17, 1862) ................. 123
Battle of Fredericksburg (December 13, 1862) ............. 124
Battle of Gettysburg (July 1-3, 1863) ...................... 125
The Great Battles in Virginia (1864) ..................... 129
Siege of Petersburg and the Appomattox Campaign
(June 1864 to April 1865) ............................. 134
Imitation: The Sincerest Compliment ....................... 136
5. Amputations and Excisions: "Experience Teaches" ........... 143
Amputation Techniques ................................... 149
Primary versus Secondary Amputations ...................... 151
Attitudes toward Disfigurement ......................... ...156
6. Learning to Treat Wounds: The Surgeons, the Operations,
and the Results ........................................... 161
Surgical Innovations  ..................................... 165
Arterial Ligation  ...................................... 166
Early Neurosurgery ...................................  168



Treating Abdominal Wounds ............................ 173
Chest Wounds: A "Clinical Trial" ......................... 174
Origin of Plastic Surgery .........................  177
Dentistry during the Civil War  ............................. 180
Confederate Dentistry  ............. .................. . 181
Dental Splints for Jaw Fractures ............ ......... 182
Treating  Eye Injuries  ..................................... 184
Blood Transfusions  ...................................... 185
Survival Rates during the War ............................ 186
Scurvy and the Mortality Rate from Gunshot Wounds ....... 189
Did Civil War Surgeons Do As Well As Their European
Counterparts?  .........................................   191
7. Wound Infections: Laudable and Not-So-Laudable Pus ........ 197
"Laudable Pus" and Pyemia ............................... 200
Hospital Gangrene and Erysipelas ........................ 201
Bromine: An Experimental Treatment for
Hospital Gangrene  .................................. 204
Controlling the Spread of Hospital Gangrene .............. 207
Antisepsis  .............................................  211
Tetanus ...............................................213
8. Civil War Hospitals ..............   ................................ 217
The Evolution of General Hospitals ........................ 218
Confederate Hospitals  ................................... 221
Hospital Inspections  ..................................... 225
Specialty  Hospitals  ...................................... 227
9. Treating Disease: Questionable Drugs and
"Heroic" Therapies ........................................ 231
The "Physiological Approach" to Medical Therapy ............ 231
Commonly Used Drugs  ................................... 233
Quinine: A  Real Cure .................................. 236
Opium and Morphine .................. .............. 238
Union  Medical Supplies  .................................. 242
Confederate Medical Supplies ............................. 245
Diet as Therapy  .........................................  248
"Heroic"  Therapies  .................. ................... 250



10. Epidemic Diseases in Recruits ............................. 257
"Everything Except Teething, Nettle-Rash, and
Whooping Cough" .................................... 257
Recruits  ............................. 260
Medical Screening .......  ......  ................... 262
Farm Boys and City Slickers ............................ 265
Children .......................... ................266
The Epidemics ............................              . 269
Measles and Mumps ................................. 269
Acute Respiratory Tract Infections ....................... 271
Typhoid Fever  ........................................ 272
Remittent, Continued, and Typhomalarial Fevers ........... 276
Typhus  .......................................       277
Meningitis and Meningococcemia ............................ 278
Sunstroke ....    ................................. 279
11. Nature's Scourges: Epidemic Diseases on Parade ............ 283
Diarrhea and Dysentery .................                 283
Use of the Term "Cholera"  ............    ........... 286
Jaundice .............................................. 287
Tuberculosis and Scrofula ................................. 287
Malaria  .......................        .....         ... 289
Smallpox  ............................................... 290
Smallpox Vaccination .....  .......................... 291
Smallpox in the Prisons ........... .................. 294
Treating Smallpox          ..................          296
Yellow Fever ........................................... 296
New Orleans and Yellow Fever ......................... 298
Outbreaks in Other Cities ............................. 301
The Federal and Confederate Navies ..................... 302
12. Disease Among the Troops: Real, Imagined, and Imitated .... 307
Acute Rheumatism (Acute Rheumatic Fever) ................. 307
Chronic Rheumatism  ...................... 309
Tonsillitis ........................................... 312
Scarlet Fever and Bright's Disease .............. ....... 312
Sexually Transmitted Diseases ............................. 313
Safe Sex in Tennessee ................................. 315
Psychiatric Problems ..................................... 317
Malingering ........................................... 318



"Soldier's Heart"      ..      .............................. .... 321
Alcoholism  ..................................... 323
Skin   Diseases  ......        ...................................... 324
Comparison of Disease in Black and White Troops  .......... 325
Variations in Death  Rates  .............................. 327
Case-Fatality Rates of Major Diseases  ... ...   ....... 329
13. Scurvy and Other "Dietic Diseases": Desiccated Vegetables
and Deteriorating Health: ................................ 337
Union Troops' Diet ................        ..................  338
Confederate Food Supplies ...............................  341
Scurvy  . . .......... ...................................  34 3
Scurvy's Manifestations  ................................ 346
Scurvy during the Peninsula Campaign ................... 349
Foraging  . .....    .................................... 352
Scurvy in the Navy ... ........    ...................  354
Night Blindness  ......................................... 356
Variations in the Incidence of Scurvy and Night Blindness ..... 357
Women  Fight Scurvy  ..................................... 359
Scurvy in European Military Units during the 1860s
and  1870s                   ............................................. 361
14. Chronic Diarrhea: It Takes Good Guts to Be a Good Soldier .. 365
Causes of Chronic Diarrhea  ..................... ......... 366
Amebiasis    ....  ..   ....................................   367
Immune Deficiency ................................... 368
Chronic Diarrhea and Malnutrition ......................... 369
Treatment of Chronic Diarrhea  .....   ......      ................. 372
15. Prison Camps: The Most Appalling Story  ............... 377
Andersonville: The Most Disease-Ridden Confederate Prison ... 380
Inadequate Rations  ................................... 381
Vermin  and Disease  ..................... ............. 382
Andersonville's "Hospital" ............................. 383
Deaths at Andersonville ..................   .............. 385
The Trial of Captain Wirz  .............................. 388
Elmira: The Most Disease-Ridden Federal Prison ............. 390
Care of Wounded Prisoners .......................... 394
Captured Physicians .................................. 397
Physicians and the Prisons  ................................ 400



16: Women of the Civil War: Soldiers, Sisters, and Socialites ..... 405
The Beginning of Nursing ................................ 405
Dorothea Dix  ........................................ 408
Other Union Women Who Served ........................ 411
Nuns as Nurses ......................................... 413
Women Physicians  ....................................... 417
Acceptance of Women as Nurses and Supervisors ........... .. 419
Southern Women Who Served ............................. 425
Nursing Care of Prisoners ............................... 428
The Invalid Corps  ....................................... 430
17: Re-Evaluating Civil War Medical Care: Shattering the Myths . .435
Oft-Quoted Negative Comments ........................... 436
Forgotten Favorable Observations ..........................438
Later Evaluations .   ......................................441
Civil War Medicine: A Reassessment ........................442
A Final Note ...................................... ......444








Library of Congress subject headings for this publication: United States History Civil War, 1861-1865 Medical care, United States History Civil War, 1861-1865 Health aspects