An Opinion of the Civil War Surgeon

"The surgery of these battle-fields has been pronounced butchery. Gross misrepresentations of the conduct of medical officers have been made and scattered broadcast over the country, causing deep and heart-rending anxiety to those who had friends or relatives in the army, who might at any moment require the services of a surgeon. It is not to be supposed that there were no incompetent surgeons in the army. It is certainly true that there were; but these sweeping denunciations against a class of men who will favorably compare with the military surgeons of any country, because of the incompetency and short-comings of a few, are wrong, and do injustice to a body of men who have labored faithfully and well. It is easy to magnify an existing evil until it is beyond the bounds of truth. It is equally easy to pass by the good that has been done on the other side. Some medical officers lost their lives in their devotion to duty in the battle of Antietam, and others sickened from excessive labor which they conscientiously and skillfully performed. If any objection could be urged against the surgery of those fields, it would be the efforts on the part of surgeons to practice "conservative surgery" to too great an extent."

---Dr. Jonathan Letterman

Obviously, even at the time of the Civil War, the surgeon was coming under attack for his actions.

The Civil War surgeon worked in conditions that today would be completely unthinkable. Doors were often used as operating tables. There was a lack of water, basic supplies, drugs, and most of all: time. Take as an example the best-known battle of the Civil War, Gettysburg. There were approximately 50,000 casualties at Gettysburg in three days of savage fighting. All of this descended down on the heads of the medical men. For the most part, they measured up admirably. Many of them worked until they dropped. With a lack of time, knowledge, and basic supplies, the best bet for saving life was usually an amputation as soon as possible. Thus, Letterman said if any complaint could be lodged against his surgeons after Antietam, it was that they had been too conservative in cutting off limbs.

The Civil War doctor was not a quack, he does not deserve to be labeled a "butcher" or a "barber" or some other equally derisive term. The Civil War surgeon was the most part a hard working, competent, and compassionate individual. Though obviously hardened by the sights, sounds, and smells of War, they still did what they thought best. Really, given the medical knowledge of the time and the hideous destructive powers of the Minie ball, they had no chance but to amputate in most cases.

While modern operating rooms are sterilized and clean, with efficient lighting, gloves, many complicated and specialized instruments, the Civil War surgeon had little to work with. Lighting, even for general officers, was often a held lantern. Farms, school houses, homes, churches were the operating rooms. The operating table could be a door, sometimes a kitchen table. At the basics, the Civil War surgeon's kit consisted of two surgical saws, a curved probe, retractor, cutting pliers, clamps, brush, and trepanning instruments carried in a plush lined wooden chest.

The Civil War surgeon could often be wounded or even killed. Hospitals sites were chosen close to the line and where water was available. Improvisation, particularly for the Confederate surgeon, was the name of the game. Hunter McGuire on the adaptability of the Confederate surgeon:

The pliant bark of a tree made for him a good tourniquet; the juice of the green persimmon, a styptic; a knitting needle, with its point sharply bent a tenaculum; and a pen knife, in his hand, a scalpel and bistoury. I have seen him break off one prong of a common table fork, bend the point of the other prong and with it elevate the bone in a depressed fracture of the skull and save life

The Civil War came at the end of the medical middle ages. Little was known of bacteriology for example. Surgery was septic. Yet, to label the Civil War surgeon in derisive terms does him a great injustice. Forty Union doctors lost their lives in battle. Dr. J.B. Fontaine, of the cavalry corps of the ANV, was killed in the line of treating a wounded soldier, Dr. E.S. Galliard had to have his arm amputated after being wounded treating Joe Johnston. Many medical officers, including Jonathan Letterman, died young. The Civil War surgeon often sacrificed his health to do what he could to save life.

USCivilWar.Net wants to thank Jenny Goellnitz for compiling this information.