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The Human Spirit Endures

Of the treatment for the wounded available even in the last months of the War , Adams had little praise. He was taken to another part of the field where he lay without shelter, almost unnoticed among the hundreds of other wounded collected there. So diligent was the North in certain aspects of the blockade that medicines and drugs were “countraband.” The “Anaconda” systematically prevented shipments of drugs and surgical instruments to the South, a “measure which did not shorten the conflict by a day, but cost the Southern troops untold agony,” as Allen Nevins observes in his essay “The Glorious and the Terrible” Saturday Review, September 2, 1961 . Adams had been among the lucky; he had been operated on under benefit of chloroform anesthetic. When he came to, “Of what happened about me during this ten or eleven days that I lay on this part of the Wilderness battlefield, I have but a vague rememberance. It seems like a horrid nightmare. The groans and complaints of the wounded suffere...
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Head Injuries

Dr. Paul Steiner, writing in Military Medicine, May, 1956 , gives some interesting notes on head injuries, evidently at relatively low velocities. “Was it worth while having men with head wounds carried from the field?” was a topic of interest to surgeons in the spring of 1864 . Brigadier General Alexander S. Webb and Brigadier General James S. Wadsworth discussed the matter; both were to fall victim of head wounds, Wadsworth to die, Webb to remember and to write about it. Matthew Brady’s ubiquitous bright rifle musket adds incongruous note to grim lesson of  War : the silent brutality of  death which the living too soon forget. Bounding lazily like  a ball, spent 12-pounder shell has disembowled Federal soldier.
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Bone Damage

Howard noticed that round balls made a seemingly more severe wound, greater comminution of bone. The word describes bone made small or fine as by grinding. What was overlooked by Howard but not ignored in the official histories of Civil War medicine was the shattering effect sometimes found in Minie wounds which caused a wound much more severe than the neat entrance-exit holes other times observed. For when the round ball hit, it sheared and chopped its way through the leg; when the Minie hit with enough speed, the bone might be split and shattered into large fragments, each one of which proceeded off in a direction roughly spherical to the point of impact, causing severe secondary lacerations. Howard’s views are interesting; they were not authoritative for diagnosis. If the word is not challenged as inappropriate, the subject of death had its wryly humorous aspect. One was in the oft-repeated “accident” of getting one’s foot knocked off by a cannon ball. Though slow moving, less th...
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Some Ignorance Persisted Until Very Recently

Such confusion over gunshot injuries remained a part of Army medical gospel and was shared by some surgeons even as late as the 1950 ’s. During the Korean War the small-caliber high velocity (1,300 f.p.s. M/v) Russian PPSH-41 submachine guns were in great use by the Chinese Communist Forces. It was not uncommon for an American soldier to be brought in by medical corpsmen with five or six bullet holes across his body, from the small .30 caliber Mauser pistol bullets the Russian burp gun fired. The relatively undamaged area about the holes, often appearing to be nothing more than little blue punctures, entrance and exit, caused a great many men to be given only temporary aid, when they needed a complete opening up and repair of the very extensive internal damage done by what was discovered experimentally to be the temporary cavity effect.
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Internal Repairs not Attempted

How many gallant North Carolinians Surgeon Howard killed with his bungling analysis of gunshot wounds is a toll of death no rolls record. But he should perhaps be forgiven his faulty diagnosis of high velocity wounds and their supposedly slight bone damage between those neat holes of entrance and exit, for little exploratory surgery was ever resorted to on the battlefield dressing table. Surgeon Howard preferred in his practice of the inexact science to draw exact inferences and make generalizations good for all cases. That such an approach to medicine is impossible was not revealed to him in his study of gunshot wounds, because he overlooked one branch of preservative surgery to which more modern medicos have, often broken heartedly, devoted their career. This is repairs of gunshots within the body cavity itself.
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Contemporary Studies of Bullet Wounds

Considerable brain power was spent in studying this new aspect of medicine on the battlefield. At best an inexact science, medicine had no quick answers for the changed diagnosis and prognosis for Minie wounds, but doctors North and South were probing the problem. Surgeon E. Lloyd Howard, 27th Regiment North Carolina, Cooke’s Brigade, published a thought-provoking if not entirely correct study of the matter in the Confederate States Medical and Surgical Journal, June, 1864 : Art. VI—The Effects of Minie Balls on Bone.
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Medical Techniques of the Civil War

A few of the Regular Army medical officers had some experience in the Mexican War and Indian border incidents. Others had observed combat casualties or served as volunteers in the Crimea. City surgeons knew gunshot wounds from the police clientele, or gentleman duellists. But prompt diagnosis of the extent of injury, skillful surgery, the initiative and ingenuity to use poor instruments or ill-adapted apparatus, and the techniques of dressing in the prospect of long delays before bandages could be renewed—in all these skills the new Army medics were weak. Fortunately (for the less-severely wounded) the wellinformed military surgeons were often in positions where they could help instruct the volunteers, and the current works of medical literature were relied upon. The most valuable instruction was a series of pocket manuals issued by the Sanitary Commission on the more important operations, camp and field diseases. Indeed, except for the Bull Run casualties and a few injuries from oc...
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