WI: More Advanced Medicine in Civil War

What if medicine were more advanced during the American Civil War? Say by even just a decade, because the things you would see in just the last few years of the 1860s and the 1870s included cleanliness and antiseptic surgery, and germ theory.
 

Delta Force

Banned
I'm not sure how much of a difference it would make seeing as blood transfusions and antibiotics were still several decades away, as well as x-ray technology. The weapons and tactics would also complicate matters due to the extreme injuries and the inability to evacuate casualties during formation battles.

Also, most casualties were from disease and other non-combat related causes.
 
I'm not sure how much of a difference it would make seeing as blood transfusions and antibiotics were still several decades away, as well as x-ray technology. The weapons and tactics would also complicate matters due to the extreme injuries and the inability to evacuate casualties during formation battles.

Also, most casualties were from disease and other non-combat related causes.

True, however there were still a LOT of combat related injuries many of which got infected. Antiseptics would have saved a lot of limbs and lives.
 

Delta Force

Banned
True, however there were still a LOT of combat related injuries many of which got infected. Antiseptics would have saved a lot of limbs and lives.

Subsonic minie balls and cannon shrapnel tended to get all kinds of things into wounds such as rust, dirt, and even the soldier's own uniform. Minie balls also tended to cause horrific exploding injuries when they hit, and with the state of medicine at the time any bones that were hit by such a round would likely force an amputation because it would be impossible to put them back together.

The supersonic rounds that were introduced later on create much cleaner injuries, both in terms of debris and in terms of pathways. That's with respect to the full metal jacket rounds that are legal for use in international conflict, the various semi-jacketed and hollow point rounds that are used for hunting, police, and self-defense leave exit wounds even more horrific than minie balls.
 
Subsonic minie balls and cannon shrapnel tended to get all kinds of things into wounds such as rust, dirt, and even the soldier's own uniform. Minie balls also tended to cause horrific exploding injuries when they hit, and with the state of medicine at the time any bones that were hit by such a round would likely force an amputation because it would be impossible to put them back together.

The supersonic rounds that were introduced later on create much cleaner injuries, both in terms of debris and in terms of pathways. That's with respect to the full metal jacket rounds that are legal for use in international conflict, the various semi-jacketed and hollow point rounds that are used for hunting, police, and self-defense leave exit wounds even more horrific than minie balls.

Still with literally hundreds of thousands of wounds and deaths I would think antiseptics would help in at least thousands of instances, maybe even as high as 20,000.
 
Just getting surgeons and doctors to sanitise were they operated and clean their hands and tools. would've saved a lot more patients to .
 
As said above, the one big and plausible advance would be improved and systematic antiseptic treatment. That would save the lives of thousands of people. Most of them after having a limb amputated or some other horribly disfiguring injury.

I wonder if this would have an impact on the perception of war, having so many more veterans return crippled and disabled. And whether it might nudge contemporary attitudes on elements of a welfare state. After all, there is no way anyonew could rightly claim these people are to blame for their fate, and it doesn't help a one-legged, blind man much if the government gives him a parcel of farmland in Arkansas as his demobilisation reward.
 
Subsonic minie balls and cannon shrapnel tended to get all kinds of things into wounds such as rust, dirt, and even the soldier's own uniform. Minie balls also tended to cause horrific exploding injuries when they hit, and with the state of medicine at the time any bones that were hit by such a round would likely force an amputation because it would be impossible to put them back together.

The supersonic rounds that were introduced later on create much cleaner injuries, both in terms of debris and in terms of pathways. That's with respect to the full metal jacket rounds that are legal for use in international conflict, the various semi-jacketed and hollow point rounds that are used for hunting, police, and self-defense leave exit wounds even more horrific than minie balls.

Just off topic for a little while. Are you saying that the (US?) armed forces has rules/laws that those who may confront the public do not have to obey?
If so that is very F ed up, so you could have more chance of living if you are shot by someone, say from, ISIS than a cop???

This should go in chat as a new subject!
 

Delta Force

Banned
Just off topic for a little while. Are you saying that the (US?) armed forces has rules/laws that those who may confront the public do not have to obey?
If so that is very F ed up, so you could have more chance of living if you are shot by someone, say from, ISIS than a cop???

This should go in chat as a new subject!

There are international conventions that regulate warfare, and they legally apply to all signatories. The international conventions generally don't apply within nations unless they involve combatants (not necessarily nations, recognized or unrecognized), so they don't apply to police and civilians, or military forces under certain circumstances.

One of the international laws deals with projectiles, and it bans anything but the full metal jacket round for small arms. This was in response to the development of exploding and expanding bullets in the 1880s, which caused horrific injuries. They weren't banned entirely at the time because they were useful in the colonies. That's why militaries have rounds that are less deadly than what hunters, police, and many people with self-defense weapons can use.
 
yes, I knew there were laws, for armed forces, but thought why the hell they aren't the same for law enforcement.
 

TFSmith121

Banned
Antiseptics, anesthesia, sanitation generally (water purification)

Antiseptics, anesthesia, sanitation generally (water purification), all would have made a tremendous difference.

The 1860s were just about a decade before what we would consider modern medicine; there's a really great quote that I literally read in the past week and now can't recall where, but something like "the civil war was the last major conflict where medicine was still in the dark ages..."

Having said that, it wasn't like the conflicts later in the century were medical perfection; about twice as many British & Imperial soldiers died of disease in the 2nd South African War than from battle-related injuries and wounds (and the rates were even worse in other conflicts), but that is still significantly better than the rates in the Civil War.

See the link below for the Army's Medical History of the War:

https://archive.org/details/MSHWRMedical1

Best,
 
Wasn't anesthesia available in the Civil War? I distinctly recall reading that Thomas Jackson was put under with chloroform prior to having his arm amputated. If I recall correctly, the Confederacy suffered appalling shortages of anesthesia and other medical supplies throughout the war. The Union, of course, had no such shortages, but tended to neglect using them due to doctors being poorly educated (by our standards) and being too conservative to try new approaches.
 
If you move up medical technology/knowledge by 15-20 years you get the germ theory of medicine (knowing that infections are caused by micro-organisms) pretty well established and the beginnings of clinical bacteriology. Using antiseptic techniques in wound care, nursing, and surgery (not aseptic which comes a little later) will reduce the almost 100% rate of wound infections, and other conditions such as hospital gangrene. Rules about sanitation were in place in CW Army Regulations, but were beefed up later on - the key thing is to get them enforced (OTL the US had massive deaths from disease in training camps in the USA during the Spanish-American War due to ignoring sanitation rules by volunteer units in spite of exact knowledge about what caused typhoid & how to prevent it).

You will see better surgical techniques (over & above reduction in infection) but you'll still see a lot of amputations as techniques for limb salvage of CW weapon wounds was not there in 1880 although reduced infections will save a fair number of limbs.

Anesthesia was in widespread use during the CW (85% chloroform in the Union Army) and except for very minor procedures, only the lack of supplies (chloroform, ether) primarily on the CSA side led to surgery without anesthesia. Very few deaths were listed as due to anesthetic complications - reasons are medical/technical. Antibiotics were a 20th century item - salvarsan (aresenical for syphilis) early 20th century, sulfa drugs 20s/30s, penicillin early 1940s.

Remember ~ 2/3 of CW deaths were due to disease not wounding including post wound infection. There is lots of data on all this.

disclaimer: retired military/academic MD currently getting history PhD with research topic history of military medicine.
 
If you move up medical technology/knowledge by 15-20 years you get the germ theory of medicine (knowing that infections are caused by micro-organisms) pretty well established and the beginnings of clinical bacteriology. Using antiseptic techniques in wound care, nursing, and surgery (not aseptic which comes a little later) will reduce the almost 100% rate of wound infections, and other conditions such as hospital gangrene. Rules about sanitation were in place in CW Army Regulations, but were beefed up later on - the key thing is to get them enforced (OTL the US had massive deaths from disease in training camps in the USA during the Spanish-American War due to ignoring sanitation rules by volunteer units in spite of exact knowledge about what caused typhoid & how to prevent it).

You will see better surgical techniques (over & above reduction in infection) but you'll still see a lot of amputations as techniques for limb salvage of CW weapon wounds was not there in 1880 although reduced infections will save a fair number of limbs.

Anesthesia was in widespread use during the CW (85% chloroform in the Union Army) and except for very minor procedures, only the lack of supplies (chloroform, ether) primarily on the CSA side led to surgery without anesthesia. Very few deaths were listed as due to anesthetic complications - reasons are medical/technical. Antibiotics were a 20th century item - salvarsan (aresenical for syphilis) early 20th century, sulfa drugs 20s/30s, penicillin early 1940s.

Remember ~ 2/3 of CW deaths were due to disease not wounding including post wound infection. There is lots of data on all this.

disclaimer: retired military/academic MD currently getting history PhD with research topic history of military medicine.

That sounds fascinating. Would this be the history of American military medicine, or just military medicine in general?
 
yes, I knew there were laws, for armed forces, but thought why the hell they aren't the same for law enforcement.
Partly because the sort of rounds to which the military is restricted are more likely to pass through obstacles (including their targets) and harm innocent bystanders than bullets that fragment as soon as they hit something reasonably solid are...
 
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