The date was July 21, 1861; the date on which the First Battle of Bull Run was commenced.  35,000 Union troops met 20,000 Confederate troops near Manassas Junction, Virginia to fight what would be known as the first land battle of the Civil War (History.com Staff, para. 1).  Bullets flew and orders were yelled as both sides were locked in combat.  Soldier after soldier succumbed to death or injury, inevitably concluding the battle with a total of roughly 4,750 casualties: 3,000 Union and 1,750 Confederate (History.com Staff, para. 7).  In the Civil War, casualties were as commonplace as cellular device especially are today.  Unfortunately, the medical practices in the Civil War were quite the opposite of hygienic.  Soldier after soldier often opted to be taken to the residence of whosoever happened to live nearest to the battlefield instead, so that they might avoid these conditions.  From unsanitary hospitals, dysentery, and infection, to amputations and anesthesia, medical practices of the Civil War have paved the way for modern medical advancements.

Recall that numerous soldiers were appalled by the condition of many hospitals in the war.  "As quickly as Civil War soldiers learnt of the probabilities of death and wounding in action, however, they learnt to avoid, as far as possible, treatment by the regimental doctors, who acquired a reputation early on for incompetence and laziness.  It was not understated; the staff of the pre-war medical department was ill-trained, rule-bound, and rarely abreast of modern methods.  They were also poorly supplied with drugs or equipment.  The first hospitals were improvised, often simply a few tents pitched on the outskirts of camp, attended by untrained men who acquired the reputation of shirkers...It was often preferable to remain in a barn or private house, as many did, than to be taken to hospital, which were frequently sinks of infection, dirty, untidy, and overrun with parasites.  Most soldiers were infected with lice but, while fit, were able to make some effort to rid themselves of the creepy-crawlies.  In hospital they were dependent on others to delouse them, a duty not often undertaken." (Keegan, p. 313-314)  Civil War physicians often possessed a tremendously limited knowledge of how or what caused diseases and infections, along with how or why they seemed to spread.  Maladies such as dysentery, malaria, typhoid, and diarrhea were fatal; the kill rate was a staggering two soldiers for every one soldier killed on the battlefield (Floyd, para. 2).  All the worse, early hospitals were overcrowded with soldiers and possessed such a poor quality of hygiene, supplies, and "sanitation facilities" that they were as much of a breeding ground for disease as were the stagnant waters and warm temperatures for the yellow fever.  "To remedy this, the U.S. government created the U.S. Sanitary Commission in June 1861.  The commission was directed by Frederick Law Olmstead.  Preaching the virtues of clean water, good food, and fresh air, the commission pressured the Army Medical Department to improve sanitation, build large well-ventilated hospitals, and encourage women to join the newly-created nursing corps.  Despite the efforts of the Sanitary Commission, some 560,000 soldiers died from disease during the war." (Floyd, para. 1-2)

Infection was another impactful ailment in the lives of Civil War soldiers and their treatment in hospitals.  Doctors had little to no knowledge of antiseptic and sterilization of wound dressings and instruments.  Habitually, physicians would move from patient to patient without rinsing their tools or their arms, meaning that a pathway was being paved for soldiers to contract bloodborne illnesses such as hepatitis B, hepatitis C, and several others (Government of British Columbia, para. 1).  "Few medical men then knew why wounds become infected or what causes disease; the treatment of wounds and disease, consequently, ranged from the inadequate through the useless to the downright harmful.  When a man was wounded and the wound was dressed, doctors expected it to suppurate; they spoke of 'laudable pus' and supposed that it's appearance was a good sign.  The idea that a surgical dressing ought to be sterilized never entered anyone's head; for that matter, no physician would have known what the word 'sterilized' meant in such a connection.  If a surgeon's instruments were so much as rinsed off between operations at a field hospitals, the case was an exception." (Catton, p. 154)  Physicians of the Civil War were ignorant to the fact that pus was a sign of infection in wounds, thus numerous injuries became gangrenous, resulting in one of the most popular forms of treatment used: amputations.

For soldiers in the Civil War, amputation was an all too real solution to several of their injuries. "Many soldiers were brought in with their wounds crawling with maggots, stinking, and all too often gangrenous.  Because of the prevalence of gangrene, amputation was the preferred surgical procedure.  Many eyewitnesses recorded the sight of piles of severed arms and legs outside, and sometimes inside hospitals." (Keegan, p. 314)  One reason that amputation was primarily chosen as a form of treatment for wounds was that it was quick and efficient.  With the sheer number of wounded, it was easier for surgeons to remove injured limbs and save the rest of the appendage.  "Due to the enormous number of wounded, the Civil War Surgeons became proficient at performing amputations.  In many cases the amputation would be performed in 10 minutes.  Surgeons, along with their assistants, would work round the clock, ending up with stacks of amputated limbs up to five feet high.  The number of wounded needed attention, and the relative lack of water meant that there was no attempt to wash hands or instruments between procedures.  This lack of hygiene and sterility did create a large chance of infection.  However, it has been estimated that as many as 75% of the amputees did recover." (Paul, para. 7)  In order to perform these amputations, anesthesia was used.  Rags were soaked with chloroform and placed over the soldiers' mouths until they passed out.  "Most of the amputations performed at field hospitals were indeed horrible scenes, but the surgery itself was not as crude as popular memory makes it out to have been.  Anesthetics were readily available to surgeons, who administered chloroform or ether to patients before the procedure.  Though gruesome, amputation was a life saving procedure that swiftly halted the devastating effects of wounds from Minié balls (which, by the way, not many 'bit' to fight the pain--the chloroform usually did the trick)." (Dixon, para. 11)  Whiskey and morphine would be given to the soldiers ahead of time, and in the instance that chloroform was unavailable, physicians relied on shock to carry the soldier through the operation.  "Risks from surgery were great.  Doctors in the field hospitals had no notion of antiseptic surgery, resulting in extremely high death rates from post-operative infection.  Surgeons ignored anesthesia, instead relying on the 'surgical shock' of battle, when the patient's heart rate was greatest, to amputate." (Floyd, para. 5)  Even though medical procedures in the Civil War were unsophisticated, they allowed for scientists to understand and advance medicine into what would become modern medicine.

Several modern medical advancements came out of the Civil War, along with certain organizations being formed.  As aforementioned, the U.S. Sanitary Commission was formed in 1861 as a way to improve the quality of the hospitals and equipment.  It was this organization that set the foundation for the American Red Cross.  Another advancement was in the design of the hospitals.  Updated hospitals of the Civil War were much like pavilions, meaning that they were more open and more ventilated.  These designs would become the model for hospitals throughout the country.  Some other advancements include: the adequate record keeping, which led to the Medical and Surgical History of the War of the Rebellion being published, a system being created to handle mass casualties, which was used in both World Wars and the Korean War, the understanding of the importance of immediately treating wounds and maintaining good hygiene, female nurses and "Catholic orders" being integrated into hospitals, and lastly, modernizing the training of thousands of physicians (Department of Surgery, para. 1)

Civil War medicine was very unsophisticated, yet, due to its existence, modern medicine has progressed and developed into the miracle it is today.  Several early hospitals were unsanitary and were a breeding ground for diseases such as dysentery, malaria, and typhoid.  Doctors possessed a primitive knowledge of antiseptic and sterilization; it was exceedingly rare for them to be seen cleaning their tools.  This practice often led to infections wounds, which turned gangrenous.  When a wound was gangrenous, as it often was, or a soldier's limb needed to be saved, physicians turned to amputation, which was a quick and efficient treatment in the Civil War.  Contrary to popular belief, chloroform was equipped as a form of anesthesia, and surgeons were know to complete operations in ten minutes, allotting them more time to treat other patients. (Paul, para. 7).  All of these early forms of battlefield medicine have helped to shape the medical community in one way or another.  Without the rudimentary medical practices displayed above, modern medicine could not have developed into what it is today.