Sickness and Disease in the Field
Civil War military doctors treated many times more cases of sickness and disease than battle wounds. Soldiers were dirty and croded together in camps that were ill supplied with food and clothes. Every morning at sick call, men would drop out of the ranks and make their way to the regimental hospital. There the army doctor would walk down the line of sick men, stopping to prescribe medicine for each complaint.
Diarrhea, often caused by the contaminated water or poor sanitation, was the most common complaint of soldiers and killed more of them than any other illness. The regimental surgeon's standard treatment for all open bowel complaints would be a plug of opium or a tree bark substitute. For closed bowels the doctor would prescribe a dose of blue mass -- a concoction of chalk and mercury.
When an epidemic of such communicable diseases as measles or smallpox swept through the camps, the sick men would be quarantined and cared for at the hospital. Doctors also vaccinated many soldiers in an effort to prevent smallpox, but there was no effective treatment for measles. Doctors would collect human scabs to use as vaccine.
Cold weather brought colds, bronchitis, and pneumonia, which the doctors treated with bleeding and opium. Warm weather brought cases of malaria and yellow fever.
Medicines such as quinine, which was the only effective cure for malaria, were often hard to get in the South and doctors were forced to find and make subsistute home remedies from local plants. To help doctors, Francis P. Porcher wrote a field guide that explained which trees and herbs could provide medical subsistutes and how to prepare the medicine from the plants' roots, leaves, bark, or fruit. Vinegar was always on hand to be given to scurvy victims. Alcohol in the form of whiskey or brandy was prescribed for more complaints than any other medicine.
Organization of Field Hospitals
Under the leadership of U.S. Medical Director Dr. Jonathan Letterman, field hospitals were becoming efficient by 1862, at least in the Army of the Potomac. Extra regimental hospitals were being merged first into larger brigade-wide and then division-wide field organizations, cutting waste and making productive use of medical personnel.
Each hospital was meant to serve 7,000 to 8,000 men. A surgeon in chief selected a regimental surgeon to head each hospital, working with two assistants. One assistant would see to commandeering buildings, setting up tents, supplying straw and fuel, and supervising stewards and nurses; the other took care of record keeping. Three surgeons performed major operations for the entire division; three others assisted. Other medical officers were on hand for such procedures as dressing wounds, with one officer always permanently assigned to each regiment for first aid duty. The regimental commander then assigned 30 to 40 men to nursing duty, which included doubling as stretchermen in the field.
A forward station as close to the lines as possible served as the first stop for wounded men brought from the field. Each station was supposed to have basins, bandages, chloroform, opium, and whiskey, while each medic had a canteen of water, a tin cup, some medicine, and, of course, more whiskey. The lightly wounded had to walk to the main field hospital, but those more seriously injured waited, sometimes for days, to be found.
Twenty wagons were needed to transport a properly equipped field hospital, but often the Confederates did not have enough wagons or horses. They also lacked proper organization, and the field hospitals were left to the ingenuity of the unit. On both sides, however, after doing what they could with bandages, opiates, and whiskey, surgeons had to decide who they could save. A head or spine would mean being laid out and left to die; limb injuries often meant amputation and transfer to a larger base hospital for recuperation, or death from infection.