The Civil War surgeon went to work immediately, hoping to finish before the drug wore off.

Surgeons and amputations during the Civil War

“At the time of the Civil War, ether or chloroform or a mixture of the two was administered by an assistant, who placed a loose cloth over the patient’s face and dripped some anesthetic onto it while the patient breathed deeply. When given this way, the initial effects are a loss of consciousness accompanied by a stage of excitement . . . . The Civil War surgeon went to work immediately, hoping to finish before the drug wore off. Although the excited patient was unaware of what was happening and felt no pain, he would be agitated, moaning or crying out, and thrashing about during the operation. He had to be held still by assistants so the surgeon could continue.” Bollet, (p. 32).

Surgeons operatingIt is commonly believed that most Civil War surgeons were simply butchers, amputating arms and legs unnecessarily oftentimes. This popular misconception is partially due to movies and film depicting gross scenes of amputations performed by rogue surgeons against the screaming wishes of his patient as the doctor amputates a bleeding leg. Though grotesque scenes such as these make for good cinema, it was hardly the typical experience during the Civil War.

Dr. Alfred Bollet dispels several myths about surgery during the Civil War in his fine article (The Truth about Civil War Surgery) in the October 2004 issue of Civil War Times. Bollet explains how surgeons had other procedures they could use besides amputation, how surgery was almost always done with anesthesia, that most wounds were not just to arms and legs, and that not every surgeon had the authority to amputate. Amputation kit

To be sure, there were some isolated incidences of surgery done without anesthesia (for example at Iuka, Mississippi on September 17, 1862) and/or cases where an amputation was not necessary. But medical scholars and historians attest that the surgical care provided by doctors to soldiers during the Civil War was very good for its time. This is all the more remarkable when we realize that little was known about germs, and the spread of infection, and drugs were nearly non-existent in the 1860s. Perhaps a major reason why it was commonly believed, especially by soldiers, is because of how little soldiers knew about anesthesia back then. Bollet writes:

“At the time of the Civil War, ether or chloroform or a mixture of the two was administered by an assistant, who placed a loose cloth over the patient’s face and dripped some anesthetic onto it while the patient breathed deeply. When given this way, the initial effects are a loss of consciousness accompanied by a stage of excitement . . . . The Civil War surgeon went to work imediately, hoping to finish before the drug wore off. Although the excited patient was unaware of what was happening and felt no pain, he would be agitated, moaning or crying out, and thrashing about during the operation. He had to be held still by assistants so the surgeon could continue.” Bollet, (p. 32).

Most amputations performed during the Civil War were necessary to save the life of the soldier. Wounds caused by bullets and artillery normally shattered the bone. The only recourse for most soldiers, if they wanted to live, would be to have the shattered bone or limb removed. The closer the amputation occurred to the trunk of the soldier the more likely it was for a soldier to not survive the operation. The fatality rate for soldiers who received an amputation was around 25% overall. Those who did die after amputation often did so because of infection, complications or because the wound was too severe to be able to survive.

Recommended reads:

Civil War Medicine: Triumphs and Challenges. Alfred J. Bollet.

Gangrene and Glory: Medical Care during the American Civil War. Frank R. Freemon.