Tuesday, March 03, 2020

Anesthesia in the American Civil War

A Civil War Operation

In 1846, Dr. William T.G. Morton, a dentist, introduced the first anesthetic ether.  Ether was first administered by rubbing it on the inside of the patient’s mouth or putting it on a cloth and having the patient breathe through it.  Morton found that ether was more effective when it was inhaled and when on to develop an inhaler.

Morton's first successful public demonstration of ether as an anesthetic was such a historic and widely publicized event that many consider him to be the "inventor and revealer" of anesthesia. However, Morton's work was preceded by that of Georgia surgeon Crawford Williamson Long, who employed ether as an anesthetic on March 30, 1842. Long demonstrated its use to physicians in Georgia, but did not publish his findings until 1849.

Between 1849 and the start of the Civil War, thirty different types of inhalers had been developed for ether and chloroform, another form of anesthesia. One of the thirty inhalers being the one Morton developed and the one he used during his 1846 demonstration. 

Anesthesia had to quickly adapt to the demands of the Civil War.  The most common battlefield operation was the amputation of arms and legs.  Amputation was a quick and reliable answer to the severe wounds created by the .58 caliber Minie ball used during the war.  This heavy bullet of soft lead caused large gaping wounds that filled with dirt and pieces of clothing.  It shattered bone.  Surgeons usually chose amputation over trying to save the limb.  Heavy doses of chloroform were administered and some seventy five percent of all soldiers survived the operation.  The poet Walt Whitman, who served as a nurse in the Union army at the Battle of Fredericksburg in 1862, recounted seeing, “a heap of amputated feet, legs, arms, hands, etc, a full load for a one-horse cart.” 

Anesthesia was administered using cloth instead of inhalers because of the lack of resources and the need for speedy operations. However, fortunately for the wounded soldiers, 95% of the time anesthesia was used in Civil War surgeries although in small quantities, just enough to get the job done. It was quite rare when anesthesia was not used. Morton himself became a military anesthesiologist at the Battle of Fredericksburg in 1862, attending many patients and sharing his knowledge with other surgeons.   A Civil War surgeon remembered many years later, “How much have the horrors of the battlefield and the hospital been diminished by the use of ether and chloroform!”

A quick look at women doctors and medicine in the Civil War for the general reader. Technologically, the American Civil War was the first “modern” war, but medically it still had its roots in the Middle Ages. In both the North and the South, thousands of women served as nurses to help wounded and suffering soldiers and civilians. A few women served as doctors, a remarkable feat in an era when sex discrimination prevented women from pursuing medical education, and those few who did were often obstructed by their male colleagues at every turn.

In 1860, disgruntled secessionists in the deep North rebel against the central government and plunge America into Civil War. Will the Kingdom survive? The land will run red with blood before peace comes again.

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