The "Steward's Kit" on the left was carried into battle by the steward himself or another soldier who accompanied the assistant surgeon on the field or at the forward dressing station. It contained supplies for bandaging wounds, splinting fractures, administering stimulants or anodynes (painkillers) and other emergency treatments.
The Regimental Hospital .........from the "Civil War Medicine Website"
Although Charles Johnson wrote this many years after the war, it is one of the best of the comparatively few accounts of military field hospitals. Johnson had enlisted as a boy of eighteen, and was assigned to hospital duty in the West; he was with Grant in the siege of Vicksburg and later took part in the expedition into the Bayou Teche country. His account goes far to explain the failure of medical services in the war and to place responsibility not on the medical officers but on the state of medical science at the time.
In the field the Regimental Hospital department was allowed two
small tents for the officers, medicines, etc.; another small tent
for the kitchen department and supplies, and a larger one for
the sick. This last, known as the hospital tent, was about fourteen
feet square and was capable of containing eight cots with as many
patients.
In the field we almost
never had sheets and white pillow cases, but made use of army
blankets that were made of the coarsest, roughest fiber imaginable.
In warm weather the walls of the tent were raised, which made
it much more pleasant for the occupants.
However, the policy
that obtained was to send those who were not likely to recover
quickly to the base hospitals, though this was not always to the
patient's best interests, for these larger hospitals were oftentimes
centers of infection of one kind or another, especially of hospital
gangrene, which seldom attacked the wounded in the field.
During a campaign our
stock of medicines was necessarily limited to standard remedies,
among which could be named opium, morphine, Dover's powder, quinine,
rhubarb, Rochelle salts, castor oil, sugar of lead, tannin, sulphate
of copper, sulphate of zinc, camphor, tincture of opium, tincture
of iron, tincture opii, camphorate, syrup of squills, simple syrup,
alcohol, whiskey, brandy, port wine, sherry wine, etc. Upon going
into camp, where we were likely to remain a few days, these articles
were unpacked and put On temporary shelves made from box-lids;
and, on the other . hand, when marching orders came, the medicines
were again packed in boxes, the bottles protected from breaking
by old papers, etc.
Practically all the
medicines were administered in powder form or in the liquid state.
Tablets had not yet come into use, and pills were very far from
being as plentiful as they are today. The result was that most
powders- were stirred in water and swallowed. In the case of such
medicine as quinine, Dover's powder, tannin, etc., the dose, thus
prepared, was a bitter one. The bromides, sulfonal, trional and
similar soporifices and sedatives, had not come in use, and asafetida,
valerian and opium and its derivatives were about all the Civil
War surgeon had to relieve nervousness and induce sleep.
Among the surgical
supplies were chloroform, ether, brandy, aromatic spirits of ammonia,
bandages, adhesive plaster, needles, silk thread for ligatures,
etc. There were, also, amputating cases well supplied with catlins,
artery forceps, bone forceps, scalpels, scissors, bullet probes,
a tourniquet, etc. But while all the instruments were washed in
water and wiped dry to keep from rusting, such an idea as making
them aseptic never entered the head of the most advanced surgeon.
There was an emergency
case, about the size of a soldier's knapsack, and, indeed, intended
to be carried on an attendant's back like a knapsack. In this
emergency case were bandages, adhesive plaster, needles, artery
forceps, scalpels, spirits of ammonia, brandy, chloroform, ether,
etc. This emergency case, or hospital knapsack, was always taken
with the regiment when the firing-line was about to be approached,
and where the First Assistant Surgeon was in charge and was ready
to render first aid to any who might be wounded.
This first aid, however,
never went further than staunching bleeding vessels and applying
temporary dressings. Thus attended to, the wounded were taken
to an ambulance, and in this conveyed to the field hospital in
the rear, generally out of musket range, but almost never beyond
the reach of shells and cannon balls.
Arrived at the larger
field hospital the patient was cared for by the surgeons and male
nurses. The wounds were examined and dressed, but never antiseptically,
for no one knew the importance of antisepsis or how to put it
in practice; consequently, every wound suppurated, and so-called
laudable pus was welcomed by those in charge as
an indication that the patient had reached one of the mile-posts
that had to be passed on his road to recovery. Careful hand washing
and nail scrubbing was never practiced before operations or in
dressing recent wounds. And yet, for the most part, the wounds
in the end healed satisfactorily. The fact that those receiving
them were, in the great majority of cases, vigorous young men
had much to do with the good results. Here it may be proper to
say that in the Civil War by far the largest proportion of wounds
were made with bullets from what were called minie balls. These
were fired, in most instances, from single-shooters and muzzle-loaders,
such as the Springfield rifled musket, the Enfield rifled musket,
the Austrian rifled musket, etc. These bullets weighed an ounce
or more, and the guns from which they were fired would kill a
man nearly a mile away, and that they produced large, ugly wounds
goes without saying.
When a minie ball struck
a bone it almost never failed to fracture and shatter the contiguous
bony structure, and it was rarely that only a round perforation,
the size of the bullet, resulted. When a joint was the part the
bullet struck, the results were especially serious in Civil War
days. Of course, the same was true of wounds of the abdomen and
head, though to a much greater degree. Indeed, recovery from wounds
of the abdomen and brain almost never occurred. One of the prime
objects of the Civil War surgeon was to remove the missile, and,
in doing this, he practically never failed to infect the part
with his dirty hands and instrument.
When Captain William
M. Colby of my company was brought from the firing-line to our
Division Hospital he was in a comatose state from a bullet that
had penetrated his brain through the upper portion of the occipital
bone. The first thing our surgeon did was to run his index finger
its full length into the wound; and this without even ordinary
washing. Next he introduced a dirty bullet probe. The patient
died a day or two later.... These facts arc narrated to show the
frightful handicap Civil War surgery was under from a lack of
knowledge of asepsis and antisepsis; and it is needless to say
that no reflection is intended to be made on our surgeon, for
he was making use of the very best lights of his day, dangerous
as some of these were....
I think wounds from
bullets were five times as frequent as those from all other sources.
Shell wounds were next in frequency, and then came those from
grape and canister. I never saw a wound from a bayonet thrust,
and but one made by a sword in the hands of an enemy. In another
chapter a reference is made to a man who received a deep wound
in the upper part of his thigh, which, after some days, proved
fatal. Not long after the wound was received the parts began to
assume a greenish tinge and this became of a deeper hue, and when
after death the parts were cut down upon, a copper tap from an
exploding Shell was found to be the ugly missile which had inflicted
the injury that, in the end, proved fatal.
Where so many men are
grouped together accidents of greater or less gravity are liable
to occur. On the whole, however, our regiment was fortunate. We
lost two or three by drowning and one by a steamboat explosion
.... and I can recall but three who received accidental bullet
wounds. One of these was a pistol shot of small caliber . . .
, and the other was from one of the Springfield guns that was
supposed not to be loaded. Looking back, I can but regard our
record in this direction as especially fortunate, when the handling
of so many loaded guns through so long a period is taken into
account.
The only light vehicle
in the regiment was our hospital ambulance, a four-wheeled vehicle
with bed on springs and covered with strong ducking. The rear
end-gate opened with hinges at its lower part for the convenience
of putting in and taking out very sick or severely injured patients.
The driver of our hospital ambulance was a soldier by the name
of Throgmorton, who knew his business, and attended to it. He
was an expert horseman, and kept the pair of bays under his care
well-groomed and properly attended to in every way. They were,
to a degree, spirited, and when the occasion called for it, were
good steppers. Besides serving its purpose in conveying sick and
wounded, our ambulance proved useful as a sort of family carriage,
upon several occasions taking certain of us well ones "here-and-yon."
For service about the
hospital men were detailed from the regiment to serve in the several
capacities of nurses, cooks, and ambulance drivers, etc. Service
of this kind was known as. "special duty," and not a
few came to have duties. Especially was this true of the men who
no little aptness in their new cared for the sick, some of whom
developed quite a little insight into disease, and were frequently
able to make tolerable diagnoses and prognoses.
-JOHNSON, Muskets and Medicine