Civil War medicine conference will include program on prosthetic limbs

Civil War enthusiasts and some in the medical profession are expected in the Frederick, Md., area late next month for the 28th Conference on Civil War Medicine. The event is hosted by the National Museum of Civil War Medicine. John Lustrea, director of education for the museum, says, “We recently had some prosthetic limbs restored in our collection, and we’re going bring those out for people to get a close up look at. We’re to have the conservator on hand as well to answer questions and say a little piece of the process in preserving the limbs.” -- Article

Plant-based medicines used by a resource-challenged Confederacy are effective against modern drug-resistant bacteria, researchers say

White oak was among remedies tested in study (Photo by Stephen Nowland, Emory University)

The resourcefulness of the Confederacy – hampered by a blockade that limited access to medicines – led to plant-based wound treatments that appeared to be effective, researchers said this week.

A team from Emory University in Atlanta found that white oak, tulip poplar and the devil’s walking stick had an antiseptic effect on three species of drug-resistant bacteria. They’re hopeful such remedies could help in modern treatment of injuries, once experts identify the active ingredients in the plants.

"Our findings suggest that the use of these topical therapies may have saved some limbs, and maybe even lives, during the Civil War," Cassandra Quave, senior author of the paper, said in a university article.

The study was published this week in Scientific Reports.

Germ theory was in its developmental stages at the time of the war and physicians utilized iodine, bromine, quinine and other medicines. But Confederate forces rarely had enough of any of these, and they turned to the botanical world for some treatments. Amputation was common as a medical treatment for an infected wound.

David Price, executive director of the National Museum of Civil War Medicine in Frederick, Md., called the study “fantastic.” He said physicians at the time used the knowledge that they had from every source in order to treat the symptoms with which they were presented.

Francis Porcher wrote a guide used by Confederacy (Photo by Stephen Nowland, Emory University)

“When looking at medicine during the time of the Civil War you cannot use present-day standards,” Price told the Picket. “The reason we have such incredible medicine today is because of the work Civil War doctors did. It's the beginning of the modern health care system.  It was the largest health care crisis in American history; two-thirds died of disease. Camp life was deadlier than the battlefield.”

Confederate Surgeon General Samuel Moore asked botanist Francis Porcher to compile a book of medicinal plants in the South. Some were remedies used by Native Americans and enslaved Africans. “Resources of Southern Fields and Forests” was published in 1863, during the height of the war.

The book featured 37 plant species that were used as antiseptics to treat gangrene and other infections.

From there, the Confederacy devised what is called a standard supply table for using indigenous remedies for field service. A chart listed the remedy, its medical properties and recommended doses.

In his introduction to the guide, Moore advised: “It is hoped that Medical Officers will lay aside all prejudice which may exist in their minds against their use, and will give them a fair opportunity for the exhibition of those remedial virtues which they certainly possess.”

The Emory researchers used bark and leaf extracts from the plants they collected on three species of bacteria often found in wound infections today. The extracts inhibited growth or certain pathogens.

 Researcher Micah Dettweiler with devil’s walking stick (Photo by Stephen Nowland, Emory University)

The researchers said plant extracts provide another weapon against antibiotic-resistant bacteria – in this study Acinetobacter baumannii, Staphylococcus aureus and Klebsiella pneumonie.

“The significance of the study is that it offers another proof-of-concept case that some of our solutions for the post-antibiotic era may be found in the medical traditions of the pre-antibiotic era,” Quave told Gizmodo.

Price pointed out that doctors for both the Federal and Confederate armies used plant-based medicines.

“There are so many lessons to be learned by studying Civil War medicine,” he said. “Water quality, nutrition and how to care for mass populations so they don't get sick. These are lessons that are at the forefront of the world today -- be it poor populations or refugee camps.”

Six ways Civil War changed medicine

Writing this week in the New England Journal of Medicine, two historians argue that the war lasting changes in mentality that forever altered the American medical profession. • Article

Learn how to give programs on CW medicine

The National Museum of Civil War Medicine will host its annual Civil War Medicine Living Historians Workshop on March 14 in Frederick, Md. The workshop is an all-day symposium featuring some of the skills, knowledge and resources necessary to provide quality living history programs to the public. • Details

Fresh insights into the Civil War

Civil War medicine, diplomacy and the Emancipation Proclamation will be discussed at an October 13 symposium entitled “1862: Following the Path to  Freedom” at Kennesaw State University in Georgia.

The 9 a.m. to noon event is sponsored by the school’s Civil War Center in partnership with Kennesaw Mountain National Battlefield Park. Speakers include:

-- George Wunderlich, executive director of the National Museum of Civil War Medicine in Frederick, Md., will share insights on Civil War medical practices.

--  Howard Jones, research professor at the University of Alabama, and author of numerous publications, will lecture on diplomacy efforts.

-- Craig L. Symonds, professor emeritus at the U.S.  Naval Academy where he taught naval history and Civil War history for 30 years, will discuss Abraham Lincoln's issuance of the Emancipation Proclamation and the president's efforts toward colonization.

The free symposium is at Kennesaw State University, 1000 Chastain Rd., Kennesaw, Ga 30144, Social Sciences Building, auditorium room 1021. Free parking will be available in the West Parking Deck, on Campus Loop Drive. More details on the center.

Medicine museum partners with businesses

A century and a half ago, many of Frederick’s downtown buildings served as hospitals to care for wounded soldiers from both sides of the Civil War. Merchants in the Maryland city were urged recently to use that connection to bring in tourists. • Article
• Picket profile of Civil War medicine museum

Lessons we've learned from Civil War medicine

John Dunbar had to make a decision -- quickly.

Lying in a field hospital where treatment decisions are made in moments or on a whim, Dunbar surveyed a pile of military boots. In the background, surgeons talked while preparing for yet another amputation: His bloodied right leg.

The Union lieutenant painfully pulled his boot back on and hobbled away to a fence on the Tennessee battlefield. Spying a horse, he climbed aboard and made his famous ride between Union and Confederate lines, arms lifted and a serene expression on his face. He awaited a bullet that would end the misery.

A bullet, of course, never found the mark. Dunbar, better known as actor Kevin Costner, eventually got medical attention from a general’s doctor and rode on to other adventures in the 1990s film “Dances With Wolves.”

Books and movies have often depicted a trip to the Civil War field hospital as a lesson in futility.

The reality, however, was a little more on the positive side, argues the executive director of the National Museum of Civil War Medicine in Frederick, Md., which has trained 4,000 members of the military in aspects of treating casualties.

“The idea that all hospitals look like the one in ‘Gone With the Wind’ is inaccurate,” argues George Wunderlich.

Wunderlich says that the Civil War actually brought huge advancements in the treatment of soldiers, notably at the September 1862 Battle of Antietam.

Ninety-five percent of Union doctors used anesthesia. And although there were no antibiotics such as penicillin, medical staff understood the importance of sanitation. Some hospitals had mortality rates as low as 7 percent-10 percent.

Still, having enough supplies and cleaning materials was difficult, especially at the front. “They never were able to manufacture all the necessary ambulances and conveniences,” Wunderlich (below, at Antietam) says of the Confederacy.

The mortality numbers are frightening enough, even without the tales of men terrified about going to a military hospital.

Death by disease led deaths by wounds 2-1. Statistics for the Union armies list 67,000 killed in action, 43,000 deaths from wounds and 224,000 lost to disease. The numbers were probably worse in Southern armies.

Wunderlich argues soldiers, even through World War II, had a high risk of infection. Couple that with the fact that medicine was years away from advancements in treating gut wounds, severe head injuries and damage to the thorax.

Lifestyle and conditions in the field had the deadliest consequences.

“The biggest killer of the Civil War was the fact that Boy Scouts had not been invented yet,” he says.

Troops had very poor personal hygiene and drank from polluted water often used as a latrine. Wunderlich contends 100,000 lives would have been saved with a concerted hygiene push.

The wounds were also horrific. The .50-caliber minie balls that smashed there way through the body left shards of bones that brought sure infection and, likely, death. “The best way to save a life was amputation.”

The museum has two principal missions. One is to educate the public about advancements brought by the war, including plastic surgery, anesthesia and reconstructive surgery. An Atlanta hospital, for example, specialized in maxillofacial surgery and Turner’s Lane Hospital in Philadelphia had a neurological focus.

The 7,000, three-story building consists of five immersion exhibits that recreate aspects of Civil War medical issues: life in an army camp, evacuation of the wounded from the battlefront, a field dressing station, a field hospital and a military hospital ward.

“Our most surprising audience is the U.S. military,” says Wunderlich.

His 17 full- and part-time staff, augmented by about 30 volunteers – most with medical backgrounds – teach Army corpsmen and general alike about field hospitals and surgery fundamentals, such as evacuation and triage. “We want corpsmen to know how to read terrain to find good aid stations.”

The center accomplishes this both at Frederick and at Pry House Field Hospital Museum (right) at Antietam National Battlefield in western Maryland. Through an arrangement with the National Park Service, the museum runs the Pry house and re-creates fundamentals of war medicine that are as common in Afghanistan today as they were at Gettysburg.

The house and barn served as Gen. George B. McClellan’s headquarters during the battle. But it also was a hospital for 400 wounded soldiers, including Major Gen. Joseph Hooker.

“We tell soldiers today, ‘We’re going to put you on the Antietam battlefield. You are going to work on problems Letterman worked on,’” Wunderlich says.

Letterman was Maj. Jonathan Letterman, who McClellan brought to the Army of the Potomac to to fix a “broken system” and is now regarded as the father of modern battlefield medicine.

Letterman (left) fired bad surgeons, emphasized sanitation, implemented command and control and increased the medical staff. His contributions included staffing and training men to operate horse teams and wagons to pick up wounded soldiers from the field and to bring them back to field dressing stations for initial treatment. This was the nation's first Ambulance Corps.

He developed the three-tiered system still in use: Field dressing stations, field hospitals (M*A*S*H) and larger hospitals away from the battlefield.

“Our modern medical system was developed into a unified system here in 1862,” Wunderlich says.

• Click here for more information on the National Museum of Civil War Medicine.

Coming soon in Picket: Civil War medicine

I'll be posting in the next few days an item on the National Museum of Civil War Medicine. One major battle led to changes that saved many more soldiers' lives since.