Civil War Medicine – Advances and the Rise of the Amputee

The Civil War saw a great number of casualties and as doctors struggled to keep up with the number of wounded soldiers they slowly learned better ways to deal with injuries from experience and need.  The Civil War saw the beginnings of reconstructive and plastic surgery as well as advances in the treatment of chest wounds which became standard medical practice.  Battlefield surgeons learned the hard way and many advances came out of the horrors of war.

According to Chip Rowe in an article entitled 5 Medical Innovations of the Civil War, it was the shortage of supplies for the Confederates that led to the invention of an anaesthetic inhaler that allowed surgeons to use much less chloroform per patient.

Battlefield wounds were often very complex with canons and Minnie balls fragmenting bones and leaving irregular wounds in flesh that were subject to infection.  And lying unattended, sometimes for hours, on a dirty battlefield was not conducive to keeping wounds clean.  This is where amputations came in.

A soldier with a leg mangled by a canon shot had a much better chance of surviving if his leg was amputated right away before infection set in.  Battlefield surgeons did not have time to deal with complex injuries in mangled limbs and even if they performed what was termed a resection the risk of infection for this sort of injury was very high.  If infection set in and they were forced to amputate later the risk of the infection spreading was much higher.  According to Terry L. Jones in his article on Civil War medicine, Under the Knife, amputations performed right away, or primary amputations, had a mortality rate of only 25% whereas amputating later when a limb became infected had mortality rates twice as high.

So, amputation became a life-saving procedure on Civil War battlefields with experienced surgeons learning the best way to perform an amputation.  They made the cut as far from the heart as possible. The lower on a limb the amputation was made the more likely the patient was to survive.  Surgeons then tried to remove the nerves as high up as possible to avoid pain in the remaining portion of the limb.  This meant that transportation of the wounded patient was less torturous and the amputee had a better chance of feeling less pain wearing a prosthetic.

Due to the large increase in amputees during and after the war, better prosthetics became a huge concern.  From generals to poor foot soldiers nobody was safe from wounds or amputations.  Major General Richard S. Ewell lost his leg at the Battle of Groveton and after his recovery he returned to command with a wooden leg.  For others the loss of a leg changed their lives.

Major General Daniel E. Sickles lost his leg to a canon at Gettysburg in a fierce assault by the Confederates on his line.  Although there is some controversy over the strategy of Sickles who disobeyed orders in his placement of troops at Gettysburg, many Union generals with worse track records were kept around.  Civil War Historian, Craig Wilson, expressed in an interview his belief that the loss of Sickles’ leg, and the other injuries sustained, helped him avoid a court martial for his controversial tactics.  It is impossible to tell what the outcome of such a court martial would have been, whether he would have been branded insubordinate or exonerated for his actions.  What is certain is that Grant would not allow Sickles to return to command and some combination of the controversial tactics and serious injuries saw the end of his military career.  Sickles entered the world of politics and among a number of fascinating exploits he decided to donate his leg to a museum.  For several years after the donation he would return to visit his leg there on the anniversary of the amputation.

Less well-known than Sickles, yet equally important is the first amputee of the Civil War, James E. Hanger.  It would seem that James was simply not destined to fight.  He was too young to join the Confederate Army when the war started so he joined an ambulance group to follow a unit and try to join later.  He enlisted at Phillipi on June 2, 1861 and according to an article by Martha M. Boltz in the Washington Times, he was injured the very next day in his first skirmish.  He lost his leg on June 3 becoming the first amputee of the Civil War.  That in itself is interesting but James is even more remarkable because of his response to the amputation.

James was given a wooden leg but since his amputation had been above the knee he had very limited mobility with the wooden prosthetic.  After a stint as a prisoner he was exchanged and allowed to return home.  There he locked himself in his room and refused to come out.  His patient and worried mother brought him food and the materials he occasionally asked for and he left empty plates and wood shavings outside of his door.  As the weeks passed James’ family worried that he was falling into a deep depression.  However, James was not depressed; he was single-mindedly fashioning a more workable prosthetic.  He shaved barrel staves and willow wood to form a double jointed prosthetic.  It took about three months but when he was finished he opened the door to his room, walked down the stairs and amazed his family with a workable leg that restored both his balance and movement.

James filed for a number of patents for his first prosthetic leg as well as his subsequently improved models.  The boy who was not destined to fight in the Civil War spent the rest of the war dedicated to creating better and better prosthetics.  Thanks to James E. Hanger and many other talented and dedicated inventors the Civil War saw great advancements towards the first truly functioning prosthetics.

Now with technology continuing to advance in leaps and bounds there are some amazing possibilities for prosthetics for modern wounded soldiers.  As soldiers continue to return home from recent wars with missing limbs the need for advanced prosthetics is only growing.  With recent technology it is now possible to have a prosthetic leg 3-d printed for you.  Bespoke Innovations is a company that custom prints legs for amputees out of any material they wish and in a variety of custom designs.  You can take a look at their amazing gallery here.

Technology seems to be moving us closer and closer to having truly bionic body parts.  Computer technology has allowed us to create The Michelangelo Microprocessor Hand.  It uses a microprocessor chip that picks up the electrical impulses from your muscles and translates it into motion working very similarly to a real hand.  It allows people missing a hand to use a knife and fork, turn pages, and pick up small objects again.  Recently bionics have been all over the news with Rex, the bionic man, who is made entirely of bionic organ systems and parts.  The hope is that Rex will be the model for creating such systems to help people with failing organs.

Modern scientists and inventors are following in James E. Hanger’s footsteps and trying to restore as much movement and ability to amputees as possible.  While learning to adjust to a missing limb is always going to be difficult hopefully the modern advances in prosthetics will help.  There was nothing nice about losing a limb during the Civil War but modern technology has made some of the bionic parts and prosthetic replacements exciting in their own right.  Hopefully these and further advancements will restore a dignity and pride to amputees that previous prosthetics could not.

3 thoughts on “Civil War Medicine – Advances and the Rise of the Amputee

  1. I recall several pictures of veterans at the 50th reunion of the battle of Gettysburg that showed many who were missing arms and legs. Were those battlefield hospitals sites excavated and the limbs re-interred ?

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