How the Civil War Changed Modern Medicine

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THE GIST

- Despite its barbaric reputation, medical care during the Civil War helped dawn a new era of modern medicine.

- Techniques developed in response to sick and wounded soldiers led to advances in pain management.

- The Civil War saw the birth of organized triage, which directly influenced the modern ambulance system.

The American Civil War often gets credit for ending slavery and reshaping the federal government in this country. But the War Between the States has another, often overlooked legacy: It may have started a new era in modern medicine.

As soldiers fell in unprecedented numbers from both injuries and disease, anesthesia became a specialty. The fields of plastic and reconstructive surgery exploded. And doctors developed new ways to treat a surge in nerve injuries and chronic pain, marking the beginning of contemporary neurology.

At the same time, a visionary surgeon named Jonathan Letterman forever altered the flow of medical treatment from battlefield to hospital, said George Wunderlich, executive director of the National Museum of Civil War Medicine in Frederick, Md.

Now, 150 years later, Letterman's basic principles continue to affect medical care in a wide range of situations, from bombings in Afghanistan to heart attacks in American grocery stores.

"Civil War medicine was every bit as barbaric as it's made out to be, and surgeons weren't washing their hands," Wunderlich said. "But it was a million times more modern than almost anyone thinks. And there are a lot of lessons we can still learn from today."

Medically, the United States was woefully prepared when the Civil War began in the spring of 1861, said Michael Rhode, an archivist at the National Museum of Health and Medicine in Washington, D.C. Nearly 80 years had passed since the end of the American Revolution, the country's last major war. And the new conflict was happening on a much bigger scale.

Scientists, meanwhile, had yet to come up with the theory that germs cause diseases. Doctors didn't know that they should wash their hands before amputating limbs. As soldiers from small towns came together in large groups, they became newly exposed to pathogens that their bodies had never encountered before. But there were no antibiotics and no antiseptics.