Doctors as Historians: The Medical Reports of the Post-Civil War Era

Civil War battlefield hospitals in film strike up vivid imagery.  Examples include Confederate General James Longstreet meeting a wounded General John Bell Hood in Gettysburg (1993), Union officer Robert Gould Shaw witnessing an amputation in Glory (1989), and the shock of Scarlett O’Hara witnessing an amputation in Gone with the Wind (1939).  The doctors in these films seem to have a great deal of medical knowledge.  Retired orthodontist Dr. Michael Echols, having made something of a hobby collecting surgical tools from the Civil War and extensively researching education of doctors during the Civil War writes, “The perception that ‘doctors’ or ‘surgeons’ knew how to do amputations or any other kind of surgery is just wrong.”[1]  Part of the reason for this, as Dr. Echols points out, is that medical students in the United States “trained for two years or less.”[2]  A war resulting in an upwards of 800,000[3] deaths is staggering, what is even more so is the fact that the number was in some measure due to the responsibility of incompetent doctors.  As early as 1865, doctors were moved to explain the phenomenon of the Civil War and the actions taken by doctors.  Helping to create a Civil War memory of hospitals during the conflict, doctors became in essence early historians of the Civil War.  As a result, it is important to look upon the works of doctors following the conflict as not only works dedicated to medical research, but additions to the historical narrative.  It is possible to study these works and chart an evolution of memory regarding medical research and practices during the Civil War.

The earliest work from the Surgeon General’s office on the Civil War, Reports on the Extent and Nature of Materials Available for the Preparation of a Medical and Surgical History of the Rebellion (1865), set the precedence of medical researchers holding a largely Northern perspective on battlefield medical practices.  The work comes up with some interesting statistics regarding injuries,although most assuredly inacurate, including a mortality rate of solders with surgeries to the upper extremities as 13-70% while the lower extremity surgical mortality rate is stated to have been 24-57%.[4]  The next set of works that ought to be mentioned addressed surgeries specifically.   A Report on Excisions of the Head and Femur for Gunshot Injury (1869), A Report of Surgical Cases Treated in the United States from 1865-1871 (1871), and A Report on Amputations at the Hip-Joint in Military Surgery (1867) dealt with various methods of extraction of bullets and post-operation follow-ups.

Edson D. Bemis displaying wounds sustained during Civil War. Found at: http://bottledmonsters.blogspot.com/2011/05/national-archives-article-on-edson.html

Perhaps the most important work came from the 12th Surgeon General of the United States, Major General Joseph K. Barnes.  Ordered by Congress and published in three parts with two volumes per part over an eighteen year period, Congress essentially charged Barnes with counting the dead and detailing the means by which they died in Medical and Surgical History of the War of Rebellion 1861-1865 (1870-1888).  It is an extremely fascinating work, and mixes a great deal of historical analysis regarding procedures performed before and during the war.  Barnes in the work states, “In the first year of the War, it became evident that the form of Returns of Sick and Wounded, then in use, were insufficient and defective…”[5], and attempts to get an accurate count of the dead and in doing so, creates a wonderful record for historians to draw conclusions from.

While the reports following the war show an application of medical knowledge on the battlefield, Echols is correct to point out that doctors were too inexperienced and schools in Europe offered far more advance schooling in the medical profession.[6]   In one of the most interesting accounts in the work, Barnes does a post-operation follow-up on Union solder Edson D. Bemis.  Wounded in the head and abdomen, Barnes notes that when asked about his health after the surgery Bemis told him, “I am still in the land of the living.”[7]

Medical reports following the war sought to detail the manner in which many died in the hopes to determine the effectiveness of medical practices.  For all intents and purposes, the Civil War was a learning experience for the medical field.  To explain their actions and better understand what could be done in the future, the details compiled by doctors in medical reports following the war are invaluable.  By producing these reports, doctors added to the interpretation of memory regarding doctors and as such, can be considered as early historians of the Civil War.


[1] Michael Echols, “American Civil War Medicine,” Civil War Medical Books & Surgeon Education, http://www.braceface.com/medical/Civil_War_Articles/Medical_education_during_the_Civil_War.htm (accessed June 21, 2012).

[2] Ibid.

[3] J. David Hacker, “Recounting the Dead,” New York Times, September 20, 2011.

[4] George Alexander Otis, Reports On the Extent and Nature of the Materials Available For the Preparation of a Medical and Surgical History of the Rebellion (Philadelphia: J. B. Lippincott & Co., 1865), 45.

[5] Joesph Barnes, Medical and Surgical History of the War of Rebellion, Part 1 (Washington D.C.: Government Printing Office, 1870-1888), 1:iii.

[6] Michael Echols, “American Civil War Medicine,” Civil War Medical Books & Surgeon Education, http://www.braceface.com/medical/Civil_War_Articles/Medical_education_during_the_Civil_War.htm (accessed June 21, 2012).

[7] Joesph Barnes, Medical and Surgical History of the War of Rebellion, Part 2 (Washington D.C.: Government Printing Office, 1870-1888), 2:162.

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3 comments
  1. catymark said:

    Great points! The Civil war definitely gave “doctors” more opportunities to learn about their profession and refine it. The idea that doctors were only professionally trained for about two years is scary to think of. Doctors probably had more in field training than anything (especially after the war started). The statics of surviving amputations is amazing, mortality rates of upper extremity amputations upwards of 70% and lower extremities near 60%??? The thing that amazes me the most about those numbers is that the doctors had to be aware of them and yet they still did not try to refine the trait until after the war ended. Amazing information!

  2. charlesanselmo said:

    This is a very interesting article about battlefield surgeons. I too am shocked by the high mortality numbers. As the article conveys – these were not doctors at all and had a most basic understanding of surgical procedures. It is no surprise that such a large number of Civil War dead were the result of disease and infection.

  3. Kristen Epps said:

    If you ever get to go to Gettysburg, one of the antique shops there (I don’t remember which) is absolutely full of medical paraphernalia, including literally hundreds of glass eyes in every shade that could occur in nature. They are all laid out in a display case. It was a little creepy, actually!

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