 1. Wounded soldiers
were brought to the Regimental Field Hospital by litter bearers
called the "Ambulance Corps" |
 2. The soldier is
brought into the operating area and his wound is examined. In
this case a deep wound to right upper arm is noted. |
 3.
Wounded soldiers are given alcohol to stiffen them against shock.
The alcohol provides some pain relief and also acts as a sedative." |
 4.
The surgeon will often stiffen his own constitution by imbibing
of the spirits before an operation. |
 5.
As soon as possible, the wound was cleaned, or debrided, with
a wet cloth or sponge. This allowed the surgeons to see
the extent of the tissue damage. Unfortunately, the sponge
was not cleaned between patients and became a deadly source of
cross-infection. |
6.
Once a decision was made to operate to remove the bullet, the
soldier was anesthetized with  ether
or chloroform. Here we see an ether cone being placed over the
patient's face as the surgeon prepares to drop ether onto a piece
of gauze inside the ether cone. |
 7.
Here we see the surgeon holding an ether can. Contrary to popular
belief, anesthesia was nearly universally given to soldiers undergoing
major operations. This widespread use of anesthesia was, in fact,
the primary contribution of Civil War medicine to posterity. |
 8. As a patient began to drift off to
sleep, he entered into a phase of euphoria where he may become
talkative and quite jolly. Gradually his anesthetic level becomes
deeper and he enters the "excitement" phase of anesthesia.
Here we see the operating crew restraining the patient from getting
up or thrashing about during this phase. The notion that
we have from Hollywood of patients being held down for surgery
as they "bite the bullet" is a misnomer. They were
actually held down for the induction of anesthesia, not for the
surgery. |
 9.
Here we see the Hospital Steward preparing the instruments for
surgery. The steward was a combination administrator, pharmacist
and surgical assistant. He accompanied the assistant surgeon
onto the battlefield to treat the wounded, oversaw the ambulance
corps and cooking personnel,and was responsible for transporting
the patients and the hospital as need be. |
 10.
After the patient becomes deeply anesthetized and is lagely insensitive
to pain, the touniquet is applied to the limb to prevent massive
bleeding. After the bullet is found and removed, bleeding will
be controlled before the tourniquet is released. |
 11.
Here we see a bullet probe being used to locate the bullet inside
the wound. Generally the finger was used first (with disasterous
results for infection) but a longer probe was necessary if the
bullet couln't be felt manually. This probe has a porcelin tip
because porcelin made a characteristic sound when it hit a bullet
versus bone. The white coating was also marred with a tell-tale
gray scratch when it was rubbed against a bullet. |
 12.
Various types of bullet forceps were used to extract the bullet.
Often, if the bullet could be extracted, and the tissue damage
was not too severe, then the limb could be saved from amputation.
Therefore, a great deal of experimentation reulted in a number
of interesting instruments for this purpose. This surgeon uses
an "othropedic extractor" to remove this bullet. So
called because it was felt to be the best for pulling bullets
out of bone. |
 13. Once the bullet
was successfully located and extracted, control of bleeding
was necessary. An instrument called a tenaculum is used by the
surgeon on the left to hold up the ends of arteries and veins
so that the surgeon on the right can ligate or tie off the blood
vessels with suture material. |
 14.
Having completed the operation, cotton is packed into the wound
to help with pus formation. Remember that Civil War surgeons
had never seen a wound heal without pus formation, therefore
they believed that "laudable pus" was part of the normal
healing process. Bandaging is then applied to the affected
limb, the patient is stimulated with ammonia salts to awaken,
and he is taken to another area to begin recovery. |