Doctors in Gray: The Confederate Medical Service, and: A Texas Surgeon in the C.S.A. (review)

458civil war history tance," the author states: "After much deliberation they [the policemen] agreed to ask for, and got, a salary increase of seventy-five dollars per month." Did this raise increase their pay to $75.00 or did it add $75.00 to their former stipend? If the latter, what was their original salary, and what difference in their standard of living did the raise effect? Such ambiguities and incomplete information detract from the historicity of this work All in all, this is a "pleasant" picture-book which rates far below David Donald 's Divided We Fought, James Horan's Mathew Brady, and Fletcher Pratt's Civil War in Pictures. And its appeal is even more limited when it is compared with the scholarly, monumental ten-volume Photographic History of the Civil War, which Thomas Yoseloff has recendy reissued in a five-volume format. Samuel R. Rosenthal Chicago, Illinois. Doctors in Gray: The Confederate Medical Service. By H. H. Cunningham. (Baton Rouge: Louisiana State University Press. 1958. Pp. xi, 339. $6.00.) A Texas Surgeon in the C.S.A. By John Q. Anderson. ("Confederate Centennial Studies," No. 6; Tuscaloosa, Alabama: Confederate Publishing Company. 1957. Pp. 123. $4.00.) the usual account of a battle concludes with a statement of the casualties sustained by each side; the reader of military history compares the scores and passes to the next episode in the campaign. Unless he has had personal experience , he does not realize that at this point in the narrative a long drama for the wounded began behind the scene. Seldom does the historian lift the curtain on these events. It is ironic that civilization has so far been unable to prevent wars with their attendant casualties; yet, once a man is wounded, the humane achievements of the ages are applied to assist in his survival. The physician has the unique privilege to practice a profession equally applicable in peace and war. When he makes the transition from civilian to military problems he does not change his ethics concerning the preservation of human life or his techniques in caring for patients. Military medicine differs from its civilian counterpart chiefly in the number of patients to be treated. An understanding of the medical history of the Civil War requires cognizance of the contemporary knowledge of infectious disease and the resultant surgical practices. Modern surgery, with its low mortality, is heavily dependent upon general anesthesia, the science of bacteriology, and the practicability of blood transfusion. Ether and chloroform had been introduced as anesthetic agents in the 1850's, and their use enabled surgeons to operate upon unconscious patients. But the work of Pasteur, Kochrand many others who established principles of bacteriology, did not come to fruition until the last quarter of the nineteenth century, and thus the cause and prevention of infected wounds were unknown to the military surgeons of 1861. To be sure, the first blood transfusions had been given to man in 1667, but the procedure did not become practical until Book Reviews459 the development of aseptic techniques from bacteriology, the discovery of incompatible human blood groups in 1900, and the introduction of sodium citrate as an anticoagulant in 1914. Lacking transfusions in the 1860's, many wounded men died of hemorrhage. Civil War surgeons recognized that practically all wounds became infected, and that infected wounds of the head and the abdominal cavity were nearly always fatal. Military strategists had already realized the modern principle that a wounded soldier was a greater handicap to the enemy than a dead one; hence infantrymen were ordered to aim their muskets low to produce wounds of the extremities. The huge conical Minié balls, shot from Civil War muskets, caused compound fractures of the long bones with much shattering. In the absence of methods to control the subsequent infection, early amputation was a necessity, and thus huge piles of severed arms and legs accumulated around field hospitals during and after a battle. The assembling of armies has always prompted the spread of contagious diseases. The first World War was the first engagement in history in which deaths from weapons exceeded the mortality from disease; this fact is ascribed to the application of bact...