Medical Care in the Civil War

Carver Gen. Hospital in Washington, September 1864

The Civil War was an epic struggle of great national tragedy and triumph. Unprecedented logistical challenges had to be overcome: vast armies were organized, trained, deployed, supplied, and provided with medical care. Nearly three million men served between 1861 and 1865; at one time or another most of them suffered from serious illness, battle injuries, or both. Approximately 620,000 soldiers died for one reason or another, and it would be only natural to assume that mortal wounds were the main cause of death. In fact, twice as many men died from disease than from injuries sustained in combat. It has been estimated that at least 700,000 men were injured in battle, but most wounds were not mortal (204,000 men died from combat). Indeed, one of the greatest tragedies of the conflict is that most of the deaths were incidental to the bloody business of waging war. Various types of deadly viruses, bacteria and parasites killed more men within the armies than all the fighting between them. When the war began, the medical services of the Union and Confederate armies were woefully unprepared for the amount of sickness, injury and death.

Initially there were about 90 physicians (called “surgeons”) in the Union army and 24 in the Confederate army. Medical school consisted of six months of lectures (mainly anatomy and physiology, no microbiology), repeated for the second year, and no clinical training other than apprenticeships. Inadequate medical screening of volunteers and bad sanitation practices resulted in frightful epidemics of diseases such as typhoid, tuberculosis, pneumonia, and the main killer of the war: dysentery. As the numbers of sick and wounded soldiers soon demonstrated, there was a critical need for medical personnel, hospitals, and an organized system for transporting casualties.

Medical care evolved quickly after the first year, as both the North and South commissioned thousands of medical officers (while weeding out many through examinations). By 1865 about 13,000 Union and 6,000 Confederate doctors had served. Hundreds of buildings were converted into hospitals and dozens of new general hospitals were built. In total there were 400,000 hospital beds and 1,000,000 patients, North and South, between 1862 and 1865. Out of 204 Federal hospitals, the largest was Lincoln General in Washington with 2,600 beds treating 46,000 patients over this 3-year period; out of 154 Confederate hospitals, the largest was Chimborazo in Richmond with 8,000 beds treating 75,000 patients.

Continued