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Class 3: Challenges in Civil War Medicine


The American Civil War created vast numbers of casualties both from battlefield injuries as well as cases of infectious disease such as measles, malaria, diarrheal illnesses of all sorts, smallpox, and pneumonia. The Army medical force on Union side was tiny at start of the war; in the Confederacy it was almost non-existent. So both sides had to start from scratch. Major challenges included designing a system for removing wounded from battlefields, learning and enforcing the importance of camp hygiene, and dealing with the epidemics that erupted as men from rural areas met not only diseases due to poor sanitation, but diseases of childhood like measles and smallpox that they had been spared in their former isolation. Both governments had to build hospitals, because if they let men go home who were sick, they might not come back. They had to manufacture and distribute drugs on a large scale, and create enough vaccine to protect all the men against smallpox. In the Confederacy health care suffered due to the inadequacy of medications and the scarcity of all varieties of medical labor.


Evans, Bruce A. "Effects of Battle: Wounds, Death, and Medical Care in the Civil War." In Battle: The Nature and Consequences of Civil War Combat. Edited by Kent Gramm. Tuscaloosa: The University of Alabama Press, 2008, 67-91.

Shryock, Richard. "A Medical Perspective on the Civil War." American Quarterly 14 (1962): 161-173.

Tripler, Charles S. "Report of the Medical Director of the Army of the Potomac of the Operations of the Medical Department of that Army from August 12, 1861, to March 17, 1862." In The War of the Rebellion: a compilation of the official records of the Union and Confederate armies. series 1, vol. 5. Washington D.C.: OP, 1881, 76-113. Available online at (accessed on 10/01/2010).

Discussion Questions:

  • Imagine you have been suddenly charged with setting up a hospital in the Civil War. What do you need? What are your problems? What are your most important interventions for healing patients? Assume you are starting from scratch—say, an open field. Try to use the readings to recreate the mindset of the army surgeon who was thrust into this very position, often with little to no training in the administration of a hospital.

  • What challenges faced the officers trying to establish a hygienic camp and govern their soldiers’ behavior to prevent disease? Draw on your own experience with camping or group young adult behavior in considering the difficulties of food preparation and camp cleanliness.

  • Can you say that the war was a learning experience for military medical leaders? What did they learn as the war went on?

  • Why was measles so important in the war? Who do you think survived camp life better, the city dweller or the farm boy?