Medical Treatments of the Revolutionary War

During the American Revolutionary War, more soldiers died from illness than from combat. What do you know about medicine during the 18th and 19th century that may have allowed for this?

Medicine in Colonial America Much of the common information we know today about germs, cleanliness, stopping the spread of disease, and treating illnesses was not yet discovered during the 18th and 19th centuries.

Revolutionary Medical Care What factors do you think influenced the quality of medical care during the Revolutionary War? Skill of Physicians Disease Treatments Hospitals Health Conditions Surgical Procedures

Revolutionary Medical Care There was no medical college in the colonies before the Revolution, what does this tell you about the skill of colonial doctors? The practice of bloodletting for treating almost any disease was common; and if the doctor was not at hand, this was done by the barber. Hardly any drugs or anesthetics were used. Bloodletting was a popular medical practice that involved removing considerable amounts of blood from a patient in an effort to cure a disease or illness.

Bloodletting Bloodletting is the removal or large amounts of blood from a patient’s body. The practice of bloodletting began in the ancient world. Ancient Greeks, Aztecs, and Egyptians used bloodletting because they believed that many diseases were caused by having too much blood.

Physicians At the beginning of the war, little carefulness was used when determining who could and could not practice medicine on the battlefield. Why do you think this was so? The high amount of casualties increased the demand for doctors, so there were practically no qualifications one had to meet in order to work as a physician during the war.

Physicians Army physicians, like most physicians at the time, were uneducated. Each doctor had their own way of treating injuries and illnesses, which led to very unusual medical care. As the reigning government at the time of the Revolution, it was the Continental Congress’ responsibility to set up regulations regarding medical treatment. They could have fixed the problem by regulating who could practice medicine, standardize medical treatments, etc… If you were a member of the Continental Congress, what would you do to fix this problem of inadequate medical treatment?

Hospital Department for the Army The Continental Congress created the Hospital Department for the Army. This department established acceptable treatments of injuries and illnesses. In addition, it created a detailed list of appropriate qualifications of physicians to ensure that all physicians were educated. In order to ensure that all physicians were qualified and to regulate and standardize medical treatment, the Continental Congress created the Hospital Department for the Army.

Health Conditions Poor health conditions posed even more problems to medical treatment during the Revolutionary War. What were the living and working conditions of soldiers living in camps? Living in close quarters, often outside Malnutrition Fatigue The immune system is affected by all of these factors because they increase stress levels. High stress levels can greatly increase your chance of getting a virus. Living close together allows disease to spread faster; living outside exposes the soldiers to an increased amount of germs; malnutrition and poor diet weaken the immune system due to the lack of important nutrients and lack of energy; fatigue puts additional stress on your body that can further weaken your immune system What effect could these conditions have on their immune system?

Health Conditions The military tried desperately to regulate cleanliness of camps and bedding as well as provide what was considered a “balanced diet” in the form of rations.

Health Conditions But keeping the camps supplied with a proper diet and clean and substantial clothing was difficult throughout the course of the War. Soldiers often went weeks without changing clothes. In this environment, diseases ran through the camps at a rapid pace.

Hospitals Many types of hospitals were used during the Revolutionary War. This hospital environment was usually set up in a local home or community near the army's camp. Although many local citizens and volunteers offered care for the injured soldiers, these hospitals were still viewed as “sewers of impurities.” Picture: The Yellow Springs Revolutionary War hospital. Abigail Hartman, a mother of 22, worked at the hospital as a nurse, as did many other women during the War. Without proper sanitation practices these hospitals often were not very helpful . They were mainly beneficial as places of rest for sick soldiers, allowing them to escape the stress of the battlefield. Do you think these hospitals would have been very effective at treating wounded or injured soldiers?

Hospitals Other soldiers were sent to a general hospital. This type of hospital treated all soldiers with all illnesses and was set up for longer term care. These types of hospitals could be horrible places to recover. Over crowding, lack of supplies, and often lack of cleanliness made the death rate very high in these hospitals. These hospitals were not heated, not properly supplied with equipment or doctors, and extremely unclean. What would have been some effective ways to lower the death rate in these hospitals?

Treatments Blood Letting Amputation Bullet excision Burn treatment Smallpox & Typhus Setting broken bones Wound Treatment Burns were also a common wound on the battle field. Burns were treated with applications of wine or hog’s lard. Burns were often not covered, which led to severe infection. If a bullet could not be easily located, surgeons were advised to let it remain in the patient. Most of these surgeries were performed while the patient was still awake! Bloodletting was a common practice used in the 18th and 19th centuries. It involved removing considerable amounts of blood from a patient in order to cure diseases or illnesses. Bloodletting was often done prior to performing surgeries or treating burns. Amputation, the removal of a limb, was a very common practice during the Revolutionary War. These surgeries were often performed with no anesthetic. Not only were extensively wounded limbs amputated, but also limbs with wounds that were highly infected. Wounds containing “foreign matter” like dirt or small pieces of metal were left open so that the pus could bring the debris to the surface. Unfortunately, this also allowed more dirt to enter the wound. To stop bleeding, turpentine was used. Which also proved to be antibacterial. Wounds were also treated with rum or wine to prevent infection. Early in the War, as many soldiers left their homes for the first time, they were highly sensitive to diseases they had never before encountered, such as smallpox and typhus. As the war continued, soldiers began to naturally increase their immune systems and build-up a tolerance to some of the diseases that had earlier put the army in danger. During the Revolutionary War, bullets were made out of lead. The owner of the gun made their own bullets using a bullet mold, molten lead, and gunpowder Simple fractures were usually set with simple slings. Compound fractures, however, were much harder to set. As with other serious wounds, surgeons often chose to amputate the arm or leg rather than risking infection

A surgeon’s amputation and general surgery tool kit. The most common type of surgery performed was the removal of bullets from gunshot wounds. A surgeon’s amputation and general surgery tool kit.

Surgery Since no drugs or anesthetics had been developed, surgeons had to work fast! Surgery was extremely painful for the patient.

Infection Unfortunately, because of poor sanitation, most surgical wounds eventually became infected. To avoid infection, doctors often resorted to amputation. What were some of the health conditions at the time that increased the risk of infection, how could infection have been avoided? Cleanliness, knowledge of medicine/germs, poor wound treatment, poor hospitals

Infection It was not until the mid 1800’s that sterile surgical procedures, such as wearing gloves, were recommended in order to prevent infections. In 1867, Joseph Lister discovered that spraying surgical tools, surfaces, and surgical incisions with carbolic acid drastically reduced the chance of the patient getting an infection.

Stopping the Spread Unfortunately, these discoveries were made well after the Revolutionary War, but they have helped shape the field of medical and disease treatment during later wars, and have helped to significantly reduced the number of deaths due to disease and infection. Sources: http://www.ushistory.org/washingtoncrossing/history/hospitals.htm http://www.ushistory.org/brandywine/special/art06.htm http://www.mnwelldir.org/docs/history/history02.htm http://cip.cornell.edu/DPubS/Repository/1.0/Disseminate/psu.ph/1129135213/body/pdf#page=22 http://www.stratfordhall.org/ed-med.html http://www.braceface.com/medical/Pages/Fossbrook_surgical_set.htm http://www.cr.nps.gov/museum/exhibits/revwar/guco/gucoweapons.html http://www.tombstoneantiques.com/revolutionary_war.htm http://www.surgery.uthscsa.edu/faculty/pubs/2006-pres-pruitt.pdf http://click.americanrevolution.com/www.ushistory.org/valleyforge/served/surgeons.html Click to see the advancement of medical treatment through some of America’s Wars.