As br'er Bunni and I prepare for our little trip next week, which will include the National Museum of Civil War Medicine, I have been trying to streamline and systematize some of my research into Civil War Medicine. This research has led me into some very broad reading, including humoral pathology (the system of medicine derived from Hippocrates and Galen which was still the norm into the 19th century) and the history of American medicine, particularly surgery. Here then is my outline for the pre-Civil war phases of the history of American Surgery (which is taken from Ira Rutkow's Surgery: An Illustrated History).
Civil War Surgery: The 19th c. context: several distinct surgical eras
A. Pre-Civil War
1. 1800-25:
"in most respects an extenstion of medicine as it had developed in the 13 colonies." (Rutkow 433). No systematic education generally available in the US, a medical education required study in Europe, which most could not afford. Apprenticeships with practicing physicians were the norm. The practice of surgery was unscientific and standards were nonexistent. There were positive developments however. Those who had the means were studying in Great Britain and they became the leading surgeons in America. Most surgery was skeletal or vascular, and American surgeons developed "an almost unlimited variety of vascular ligations and bone and joint operations." (Rutkow 433).
2. mid 1820's- 1846:
notable for the introduction of the use of ether as anesthesia and the proliferation of medical schools. British influence begins to fade and more students head to Paris for further medical education. These developments did little to improve medical care, however, for there were no uniform standards for licensing physicians.
3. 1847-1860:
the increasing use of surgical anesthesia was offset by the continued inability to control infection. Anesthesia allowed the surgeon to focus more on technical precision rather than completing the operation as quickly as possible. Oversight of the medical field was still haphazard at best. "During the 1840's and 1850's the American practice of medicine and surgery was essentially open to all who cared to call themselves doctors." (Rutkow 438). This led to the development of the American Medical Association in 1847, but the AMA and its recommendations were initially viewed with suspicion.
B. The Civil War 1861-65: "The Civil War proved to be the single greates influence in the development of American surgery after the founding of the nation." (Rutkow 447)
to be continued...
