Gangrene and Glory: Medical Care during the American Civil War

HAVE YOU EVER RETURNED FROM A LONG TRIP TO find that your freezer went haywire during your absence? As you stand on your front step, you notice just the whiff of a strange odor. When you open the door, you are frightened by the unpleasant smell of rotting meat. You make your way to the freezer, but each step is more difficult because of the growing assault upon your nostrils. You throw open the freezer and almost swoon because of the overwhelming stench. You quickly shut the freezer and stagger away, gagging.

If you had visited a Civil War hospital, you might have suffered a similarly unpleasant experience. But you could not stagger away, wondering who would clean up this mess. During the American Civil War, the rotting flesh was attached to real, living human beings. You had to suppress your nausea and press forward to visit the sick. If you were a doctor or nurse, you had to steel yourself to treat the unfortunate victim.

If this book fulfills its mission, the reader will see the same gore and smell the same putrefaction as the doctors in blue and gray saw and smelled. Take home this message: the American Civil War involved suffering. The degree of suffering overwhelms all military glory. The exhilaration of battle dissipates under the load of fever, diarrhea, maggots, blood, dysentery, blindness, pain, pus, and putrefaction.¹

If the reader has a medical background, he or she can appreciate this work as a series of medical mysteries. How could the pus from a patient's wound transfer its virulence to a cut on the surgeon's finger? How does yellow fever spread from a ship in the harbor to afflict people on shore, when no person ever leaves the ship? What is this horrible new disease, never seen by any doctor in the area before, which takes a man from normal at breakfast, to feverish at noon, to prostrate with spots all over his body at supper, to dead by nightfall? What is causing the strange epidemics that afflict and paralyze armies? The text only gives information available to the doctors of the era, thereby attempting to avoid the most common defect of medical history: judging historical individuals by later standards. The author will not afflict the reader with modern medical concepts (don't peek at the endnotes). In this way, the present work adopts the method of Thomas Connelly, whose works on Confederate military leadership give to the reader only information known to the Confederate commander.²

The structure of this work intersperses narrative with a series of anecdotes. In this respect, the book is modeled after James Michener's Tales of the South Pacific; the author doubts, however, whether any Broadway mogul will be able to adapt this story into a musical stage play. Each chapter is written from a different viewpoint; things happen in parallel rather than in a linear fashion. Gettysburg is described from the viewpoint of the wounded soldier lying on the ground, looking at the sun through a haze of gunsmoke. He only knows the actions of his own regiment and where upon his body is the wound. That is all the information the reader possesses. The Vicksburg campaign, on the other hand, is written as if it were a scientific paper, analyzing the causes of illness, but using only contemporary medical knowledge. When Confederate activities are described, the Northern forces are the enemy, the invading

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