Medicine and the Battle of Gettysburg

"After that bloody 1st of July, 1863, at Gettysburg, the little town (population of 2,400) was rapidly filled to its utmost capacity with shattered and shot-torn men. All the churches, school buildings, warehouses, halls and public edifices were crowded with the wounded who lay in rows on the floor or on trestles hastily constructed with boards from adjacent lumber yards. They were in tailor shops, doctors' offices, coach factories, dismantled groceries, photography rooms, print shops, smithies, everywhere," recanted J. Howard Wert, author of Gettyshurg and Its Monuments, in the January 8, 1908 edition of the "Gettysburg Compiler," in his narrative series, "The Littles Stories of Gettysburg."

During those first three days in July, 1863, 150,000 men clashed in one of the bloodiest battles in the history of the world. As General Robert E. Lee, defeated and desolated, led his troops from Gettysburg, a caravan of Confederate wounded, 12-miles long, headed for the sanctuary of the South; 6,800 seriously wounded men were left to the care and compassion of the enemy.

The battle claimed nearly 50,000 killed and wounded. There were 10,000 men killed outright and 14,529 Union soldiers were taken to field hospitals in around Gettysburg. At the height of the battle there were 650 Union physicians and about 400 Confederate doctors, but when the Army retreated only about 105 doctors remained to take care of the 21,000 wounded.

Dr. John Shaw Billings, a surgeon with the Army of the Potomac, 2nd Division, 1st Corps, in a letter to his wife penned on July 6 gave this grim account of the cost of the battle, "I have been operating all day long and have got the chief part of the butchering done in a satisfactory manner. I am utterly exhausted mentally and physically, having been operating night and day and am still hard at work. I have been left here in charge of 700 wounded with no supplies and have my hands full. Our division lost terribly. Over 30-percent were killed and wounded."

On July 10, Capt. Billings, again wrote to his wife, saying, "the orderly has just scrubbed all the blood out of my hair with castile soap and bay-rum and my scalp feels as if a steam plow had been passed through it."

The Battle of Gettysburg is one of the most heavily researched conflicts in history, yet there is scant knowledge or records of the medical practices of the day. Capt. Billings' account is one of the few that remains. Confederate medical records were destroyed when Richmond burned near the end of the war.

Capt. Billings was considered one of the outstanding young physicians of the Civil War. Following the war, he spent 30 years as Deputy U.S. Surgeon General. He founded the Surgeon General's Library, which later became the National Library of Medicine at Bethesda, Maryland. He was also a consultant on plans for Johns Hopkins Hospital in 1875 and was responsible for planning isolation wards, because of his war experience with the hazards of post-operative infections .

Local physician, Dr Harrison F. Harbach, has spent the last four years researching the practice of medicine during the Civil War.

"There were some good things in medicine to come out of the Civil War. First of all, they learned how to handle mass casualties; they learned organization; they learned the value of ambulance corps; and they learned the value of postoperative care.

"During the first Battle of Bull Run, early in the War, they had no means for caring for the wounded, they had to take care of themselves. The wounded literally crawled from Bull Run back to Washington for medical care. As the war evolved they organized medical care, mainly through the help of the U.S. Sanitary Commission," Dr. Harbach explained.

The Sanitary Commission was formed from the many Ladies' Auxiliary groups that existed at the time. Its main function was to provide food and medical supplies to the medical corps. Clara Barton, famous for founding the American Red Cross, was one of the main figures involved in the Commission.

Dr. Jonathan Letterman, medical director of the Army of the Potomac, in a report to the Surgeon General, discussed the efficiency and the problems encountered by the medical corps at Gettysburg;

"The greater portion of the surgical labor was performed before the Army left. The time for primary operations had passed, and what remained to be done was attending to comfort of the men, dressing their wounds and performing such secondary operations as might be necessary."

In his report, Letterman added that, Surgeon John McNulty, medical director of the 12th Corps, noted, "it is with extreme satisfaction that I can assure you that the wounded were removed from the field, sheltered, fed, and dressed their wounds within six hours after the battle ended, and to have every capital operation performed within 24 hours after injury was received."

His report went on to praise the 1,100 ambulance corps for carefully removing all the wounded men from the field of battle, often under enemy fire. Letterman noted, however, that local physicians were of "little use" because they expected too many creature comforts and did not operate well under drastic field conditions.

The Sanitary Commission, according to Dr. Harbach, was primarily responsible for the improvements in controlling infection because of the care they took in cleaning the hospitals and dressing the wounds.

A description of the state of the art of medicine given in an account by two historians, Richard and Janet Stark, highlights the lack of medical knowledge of the day:

"Pre-operatively, the patient was given a light, nutritious meal in the hope that the stomach would then be empty and the patient strong. Brandy was the premedication of choice. The patient was placed in a supine position and chloroform was poured upon a cloth cone."

"Treatment of the ordinary wound of battle consisted of shaving the patient, a sponging with warm water, probing the wound, and removing foreign bodies. Wounds were dressed with lint - the scrappings from cotton. Wet dressings were applied often, using cotton dipped in cold water. These were routinely used in large wounds, amputations, resections, and extreme lacerations. Flaxseed or bread poultices were often employed. Raw cotton, baked and charred in the oven, was used and rendered relatively aseptic by this method. Cotton flax thread silk, and horsehair were used as ligatures (sutures). The horsehair was boiled to make it more pliable and soft, thus accidentally it was rendered sterile," the Starks explained in their article on surgical care.

There was a 62 percent mortality rate from chest wounds and 87 percent mortality associated with abdominal wounds. In fact, during triage on the field, men with abdominal wounds were usually set-aside to die.

Early in the war, a general rule was established of amputating extremities if there were serious injuries. Especially if a bone was fractured. This rule caused the needless amputation of thousands of limbs that could have been saved. Dr. Harbach noted that the physicians' views of healing were totally the opposite of medical views today.

"It was the thinking at that time that pus had to form before the wound would heal, it was called laudable pus. We know now that pus indicates an infection, but they knew nothing about bacteriology and of course they had no antibiotics. The wounds of the amputees never completely healed and had to be drained periodically for the rest of their lives," Dr. Harbach said. He added that the average amputation on the field, performed with surgical knives that were extremely dull, took about 12 minutes.

Another practice that has long since been discarded was the use of whiskey as a medication to prevent shock. Dr. Harbach said that 2.4 million quarts of whiskey were brought to Gettysburg to be used for the treatment of the wounded. He said the whiskey accentuated shock and in many cases contributed to the death toll.

The physicians, orderlies and nurses at Gettysburg did an outstanding job of taking care of the wounded, Dr. Harbach believes. The wounded were evacuated by train to hospitals in Washington, Baltimore, and Philadelphia, with the last trainload of wounded leaving Gettysburg by November 17, four months after the battle.

Of the 1,300 monuments dedicated to the valiant deeds of the men who fought and died at Gettysburg, only one exists to attest to the work of the surgeons. It is located on the side of a granite boulder near the Wheatfield, the scene of the second day's battle when 65 percent of all the casualties occurred. It was dedicated to Zebulon Boylston Adams, a surgeon, and bears this inscription:

"Behind this group of rocks, on the afternoon of uly 2, 1863, Surgeon Z. Boylston Adams placed a field hospital of the 32nd Massachusetts Infantry, 2nd Brigade, 1st Division, 5th Army Corp, established so near the line of battle, many of our wounded escaped capture or death by its timely aid."

 

Visitor Finds Human Bones At Gettysburg National Battlefield

From The Civil War News, June 1996, by Deborah Fitts
GETTYSBURG, Pa -- Human bones found on the Gettysburg battlefield are causing a ripple of excitement among federal officials and students of the battle alike. The dozen bones and pieces of bone were discovered on Gettysburg national Military Park March 19 by a visitor from Oregon, who spotted them on the surface where they had eroded out a wash. At first mistaken for animal bones, they weren't positively identified as human until April 24, when the curator of the Smithsonian Institution's National Museum of Natural History identified them as belonging to" a young adult human male who died long ago."

Park spokesman Katie Lawhorm said the park is considering options to conduct an archaeological dig of the site, which is being kept secret The park does not have the estimated $35,000 to $40,000 to fund the project, however, and would investigate low-cost or no-cost options, she said.

The archeology would recover the rest of the remains, "identified their context," and assess the need to stabilize the area against further erosion, Lawhorn said. Superintendent John Latschar said the park was "giving this very careful thought before we proceed because archaeology is, by its nature, destructive to the site."

Lawhorn said the park "will do something to follow up if only to protect the site. It's pretty vulnerable right now." Word of the discovery prompted a flurry of excitement and queries from individuals "dying to know where it is," she said.

Besides the Cumberland Township police chief and the Adams County coroner, who were brought to the park to assess the possibility of foul play, only,"a limited number of park staff" know the location of the find, Lawhon said. "It has been emphasized and re-emphasized that those who do know have an ethical responsibility to keep the site private."

The Oregon visitor alerted park ranger, who in turn notified Jill Halchin, a National Park Service (NPS) archaeologist assigned to Gettysburg.

Smithsonian Curator D.H. Ubelaker list portions of a left humerus and ulna, a left femur, a right tibia, a portion of the jaw and pieces of the skull, as well as other, smaller bone pieces.

Ubelaker said the size of the femur indicates a male, and the maturity of the bones and the progress of cranial sutures places the age at between 20 and 40. As for how long the bones had been in the ground, Ubelaker said in the statement of his findings that fragmentation and erosion of the bone suggest "the post-mortem interval might be measured in decades"

If the remains indeed prove to be a battle casualty, they are the first unearthed at Gettysburg since the late 1930's, according to park historian Kathy Georg Harrison. Around 1939 the bones of a solider from Confederate General Cadmus Wilcox's brigade, which supported Pickett's Charge, were found on the Klingel Farm On the Emmistburg Road during drainage installation, she said.

With the number of soldiers who were never unearthed from temporary graves On the battlefield and near hospital sites, "It was only a matter of time till they would find some bones, author Gregoru Coco said. Coco, whose 1995 book A Strange and Blighted Land Lists the skeletons uncovered over the years at Gettysburg, said the number of dead never retrieved from the battlefield "could be hundreds; by their comrades and their graves were not marked, or poorly marked, or they were "pitched in a hole," or "left to rot."

By April and May of 1864 all Union soldiers' remains that could be found were removed to the national cemetery on the battlefield or to their homes. From 1870 to the fall of 1873, Confederate remains were removed for reburial, many at Hollywood Cemetery in Richmond. A tally of the dead a Gettysburg totaled 5300 Federals and 5400 to 5500 Confederates, Coco said.

Supervisory Park Ranger Scott Hartwig said his "hunch" is that the bones are of a Confederates, particular in individual graves, might vanish without a trace.

As many as 1200 to 1500 Union and Confederate bodies were unaccounted for, Harrison said. "They're somewhere in the 22 square miles" of the battlefield and hospital sites around Gettysburg, Harrison Said. "A lot of old veterans referred to the ground here as a cemetery, because their comrades were still buried here. They knew that better than we do."

BACK