Gangrene and Glory: Medical Care during the American Civil War

By Frank R. Freemon | Go to book overview

1
American Medicine in the 1850s

THE EXHAUSTED HORSEMAN RODE INTO THE ISOlated post at Fort Buchanan, New Mexico Territory, with terrifying news. Cochise and six hundred braves had surrounded the fortified mail station at Apache Pass and threatened to massacre its defenders. The post surgeon, Dr. Bernard J. D. Irwin, was the only officer on hand to respond to this startling information. He dispersed messengers to the other small forts nearby with orders to concentrate the regiment. In the meantime, Dr. Irwin determined to take all available military force to reinforce the defenders of the mail station and cheer them with the news that relief was on the way. Leading fourteen volunteer soldiers and one civilian, he rode two hundred miles without rest, part of the way through a blinding snowstorm. This group fought their way into the isolated mail station; the reinforced garrison held out until the full regiment arrived and drove away the Indians.1

This is an unusual-almost a unique-incident, for doctors in the U.S. Army in the 1850s seldom led troops. They treated the minor illnesses of soldiers, bound the occasional wound, and made observations about the conditions around them. A medical career in the army involved many years at the entry rank of assistant surgeon, equal in pay to a lieutenant. Eventually, the assistant surgeon could undergo examination to rise to the rank of surgeon, sometimes called major surgeon because it was equal in pay to a major. The U.S. Navy had so few places for doctors that a third rank was formed, that of passed assistant surgeon. The doctor holding this rank was an assistant surgeon who had passed his examination for the rank of surgeon but had not yet been promoted; he had to wait for someone bearing the higher rank to die or to retire.2

Army physicians encountered different diseases depending on the part of the nation where they were stationed. Malaria occurred frequently in the military forts located along the coastal areas of the South, but was also prevalent in many other locations. In one year, Fort Buchanan in New Mexico Territory experienced 450 episodes of malaria in its garrison of 243 soldiers. The disease showed a marked seasonal variation, from a low of 3 new cases in May to highs of 95 in September and 139 in October (autumn was the sickly season). Dr. Irwin thought that the high rate of malaria was caused by the proximity of the fort to swamps and quagmires. He further noted that one group of fort residents had been entirely free from malaria because they were “protected from the influence of the marsh by a small knoll, which acted as a kind of screen to shelter them from the carrying influence of the southwest wind.”3

The chief army doctor, Surgeon General Thomas Lawson, asked all U.S. Army doctors to report their experiences with the new drug quinine. He had read European medical reports concerning this agent, obtained from the bark of South American cinchona trees, suggesting that it might be able to ameliorate the symptoms of malaria. Their responses confirmed the value of quinine, saying that it often had to be given in high dosage, up to thirty grains per day. Assistant Surgeon David C. DeLeon thought that quinine was especially

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