Years of Change and Suffering: Modern Perspectives on Civil War Medicine (review)

Taking their title from Emily Brontē's poem "Remembrance," James Schmidt and Guy Hasegawa have collected eight essays that indeed recall the horrors and the triumphs that characterized medicine in the American Civil War. Jodi Koste leads off, with a useful and informative paper on Richmond's Medical College of Virginia (MCV) and its extraordinary growth during the war. With all other southern medical schools either closed or in cities under Union control, MCV remained the only school producing the physicians so urgently needed by the Confederate army. Only in Richmond did the Confederacy achieve the sort of medical system more common in northern cities, wherein professors offered sage advice on the wards and medical students acquired firsthand experience of disease and surgical experience.

James Schmidt's essay offers something completely different, a look at Yankee ingenuity as reflected in the pages of Scientific American during the war. He finds all sorts of implements fashioned to maim the enemy and in turn to respond to war injuries, including prosthetic limbs. Most memorable was a device for the filtration of drinking water, so the thirsty soldier would not gulp tadpoles along with his stream water.

Jay Bollet takes up the subject of Civil War amputations and refutes the charge that surgeons were too quick to amputate. He makes the cogent point that while successful amputees were visible everywhere in postbellum society, those men who had died because their fractured limbs were not severed became invisible. Most surgeries were done under anesthesia, and teams of experienced surgeons oversaw the decisions about when it was proper to amputate.

Terry Hambrecht explicates two newly discovered letter books written by major Confederate surgeon J. J. Chisolm. In addition to providing much detail regarding Confederate medical practice, these letters reveal that Chisolm acquired much of his knowledge from observation of European military surgeons in the decade leading up to the Civil War. Harry Herr describes the horrors of urological injuries that resulted from minié balls tearing through the perineum and damaging the urethra, genitals, and rectum. While admitting that surgeons at the time had little to offer such men, he does find that twice as many men recovered from gunshot wounds to the pelvis in the last two years of the war as in the first two and attributes this to surgeons learning the proper use of catheters in such cases.

Guy Hasegawa explores the southern fascination with indigenous remedies, a research plan promoted strongly by Surgeon General S. P. Moore. Hasegawa points out the tension in promoting such botanic drugs at a time when regular medicine was waging sectarian fights against botanic practitioners but recognizes that Moore's campaign grew out of desperation in facing a shortage of drugs, especially quinine. Hasegawa concludes that in spite of Moore's effort and extensive testing, no new, effective medications emerged from the wartime research.

D. J. Canale reviews the story of neurology and the war, one specialty that clearly benefited from a specialized hospital and an unfortunately large number of cases with every imaginable nerve injury available for study. He notes that concepts such as phantom limb pain originated from the war and that one of the chief difficulties for physicians treating neurological conditions was to distinguish the truly injured from those who were faking it. The last essay, by Judith Andersen, adds to the growing literature on the emotional toll the war took on some men. Dubbed posttraumatic stress disorder most recently, this syndrome reflects the psychological trauma that years of exposure to death and disease could have on men who otherwise emerged from the war with bodies intact.

A useful bibliography ends the text, revealing how rich the body of literature about the war and medicine has become.