 | By the end of the war, the U.S. Army had developed a well-organized medical corps comprising a system of levels of treatment starting at Regimental Dressing Stations where minor wounds were treated and triage was performed before transfer to Division hospitals. Depending on the severity of the wounds, patients were transferred to Division and Corps Hospitals for surgery or treatment for disease. Casualties requiring extended treatment were evacuated to theater based Army Depot Evacuation Hospitals or to larger Army General Hospitals. To make room for new casualties, many patients were furloughed back to their homes for recuperation or prolonged treatment in civilian General hospitals such as St. Mary’s and the Rochester City hospital. The great majority of Civil War deaths were the result of disease rather than combat wounds.
Union Colonel Thomas Reynolds lay in a hospital bed after the July 1864 Battle of Peachtree Creek, Georgia. Gathered around him, surgeons discussed the possibility of amputating his wounded leg. The Irish-born Reynolds, hoping to sway the debate toward a conservative decision, pointed out that his wasn't any old leg, but an 'imported leg.' Whether or not this indisputable claim influenced the doctors, Reynolds did get to keep his body intact. Compared to the many men who died because limbs should have been removed but weren't, Reynolds was lucky: he survived. 'I have no hesitation in saying that far more lives were lost in refusal to amputate than by amputation,' wrote William Williams Keen, a medical student with the military status of a West Point cadet. Like many Civil War medical workers, Keen learned his trade on the job, under extreme duress, as Civil War battles churned out thousands of wounded men. After treating casualties of the September 1862 Battle of Antietam, Maryland, Keen went to work in Philadelphia at the Turner's Lane Hospital, a facility famous for making discoveries about nerve injuries. Later he became professor of surgery at the city's Jefferson Medical College and a leader in American surgery.
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In his Reminiscences (1905), he commented on the persistent practice of blaming Civil War surgeons for performing unnecessary amputations. Many other Civil War surgeons made the same point: amputations saved lives and failure to perform necessary ones sometimes resulted in fatal infections The image that surgery during the Civil War consisted of amputations, amputations, and more amputations, many done unnecessarily, developed early in the war. Soldiers' letters and hometown newspapers were filled with such accusations, and the notion stuck. True, more than 30,000 amputations were done on Union soldiers, and probably a similar number on Confederates, but most were necessary. British and American civilian surgeons who visited battlefield hospitals as observers and committed their opinions to paper agreed with Keen that Civil War surgeons were often too hesitant about amputating. Those experts felt that too few amputations were done, and that the accusations that surgeons were too quick too amputate led them to second-guess themselves, often incorrectly.
The introduction of anaesthesia in October 1846 allowed surgeons to operate more deliberately. But because infection almost always followed, very little surgery was done. Then came the Civil War and the need for an astounding number of operations to be performed by doctors without any prior surgical experience. Statistics for the Massachusetts General Hospital, one of the premier hospitals of the era, illustrate the state of surgery in the first half of the 19th century. Between 1836 and 1846, a total of 39 surgical procedures were performed at that hospital annually. In the first 10 years after the introduction of anaesthesia, 1847 through 1857, the annual average was 189 procedures, about 60 percent of which were amputations. Opening the abdomen or chest was rare. About two decades after the Civil War, the volume of surgery in civilian hospitals increased enormously with the introduction of antiseptic and, later, aseptic techniques. Between 1894 and 1904, for example, an average of 2,427 procedures were done annually at the Massachusetts General Hospital and, by 1914, more than 4,000.
| Officers | | Surgeon | | Srg |  | | Assistant Surgeon | | ASrg |  |
| | NCOs | | Medical Cadet | | MCdt |  |
| | Enlisted | | Hospital Steward | | HStd |  | | Ambulance Private | | APvt |  | | Nurse | | Nse |
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With thanks to the 3ci Uhlans for allowing us to use this table.
Tags - *UMC*_Rank_Name
Surgeon Joris
Assistant Surgeon Matthew
Nurse Duuring
Nurse MaHuD
Nurse Randolph
Nurse Rydog
Spoiler
| Field Steward | | FStd |  |
