Today we are excited to welcome Eric Scott Fischl to The Speculative Herald. His book Dr Potter’s Medicine Show, released February 7, 2017. Be sure to check out the details below, it’s a post-cival war featuring quite an interesting cast of characters!
Tents, Saws, and Ether: Civil War Medicine
by Eric Scott Fischl
The eponymous protagonist of my novel DR POTTER’S MEDICINE SHOW, Dr Alexander Potter, is a former Civil War surgeon. A haunted man, he’s the self-professed “fastest man with a bone-saw in the Hospital Corps”. As a history aficionado, I went into the book thinking I had a fairly reasonable understanding of what medicine and surgery was like during the war; namely, I had visions of filth-caked surgeons hacking limbs off with saws, while the unfortunate patient was held down by burly men, a Minié ball jammed into his mouth to bite on. When I started researching the book, though, I learned that that image, while having some veracity, was only partly true. I’m a fiction writer, and not a historian, and there were a few items that were not quite as historically accurate that I chose to keep in the book for purposes of story. The real details of Civil War medicine are fascinating enough in their own right.
First, while there is no before/after line to draw, instead being a continuum drawing on a number of factors, there’s a marked difference between the quality of medical care in the early years of the war versus the latter. Indeed, there’s much that modern medicine directly owes to lessons learned during the war. While, of course, the mechanics and techniques of surgery was advanced, as in all wars, by virtue of the sheer availability of patients and the ability of medical staff to innovate by necessity, the most profound benefits to medicine were gained via more prosaic improvements to logistics, administration and, most importantly – directly affected by the two previous items – hygiene.
Of the 620,000 soldiers who died in the war, two-thirds of them were killed by disease. During the early war years, hygiene and sanitation as we know it now were almost unheard of, and diseases like typhoid fever, tuberculosis, dysentery, and pneumonia were rampant in the hospital camps of both the Union and Confederacy. The camps themselves were largely the culprits: they were ramshackle, disorganized, and unsanitary; patients were put wherever they could be put, however they could be gotten there.
As the war progressed then, one of the greatest advances in medicine was simply the creation and implementation of well-planned, standardized layouts for field and pavilion hospitals, the logistics of getting patients to them (namely, the training and improvement of an ambulance system, including evacuation plans for wounded soldiers as well as efficiencies in-field care), and clearer guidelines for hospital sanitation and hygiene. The image of amputated limbs thrown randomly into festering piles, dogs running about them, and the like, was largely a fiction by the end of the war; field hospitals had become as orderly, clean, and efficient as they could be made given the time and circumstance, with an incredible mortality rate of only 8% by the time hostilities finally ceased.
The amputations, the piles of limbs … it of course happened, unfortunately; this image isn’t fiction. What is often misstated, though, is that these procedures weren’t quite as crude as imagined. Surgeons, particularly as the war progressed and logistics and organization improved, had access to anesthetics such as ether and chloroform. The patient was generally not required to be forcibly subdued until they passed out from the pain, then: a pad of ether over the face would do the trick. As administration and efficiency improved at the hospital level, so did the standards of care. Doctors became more qualified and better-trained and surgical techniques became more refined. The simple fact that patients were more likely to survive a field amputation contributed to their usage. The effects of the Minié ball and other weaponry was devastating to the human body and a quick amputation was oftentimes a lifesaving measure. After surgery, morphine was available for a patient’s pain, including via administration by the then relatively new hypodermic syringe. Sanitation and hygiene improvements meant that fewer soldiers died after surgical procedures, from infection or disease, all of which helped the mortality rate creep down until it eventually reached that 8%.
By and large, then, the state of medicine was vastly different at the end of the war than it had been at the beginning. The military, the medical establishment, and private organizations built on the foundations laid during the war years to set the pattern for future development. The Red Cross, for example, founded in 1881, was in part modeled on the work of the United States Sanitary Commission, an early relief agency that provided field care for wounded soldiers as early as 1861. While the state of care in the 1860’s was in no way what we would now call advanced, the horrors of the war helped the progression of medical practice that still persist today.
Eric Scott Fischl writes novels of speculative historical fiction and the supernatural. He lives in Montana’s Bitterroot mountains.
Dr. Alexander Potter, disgraced Civil War surgeon, now huckster and seller of snake-oil, travels the wet roads of the Pacific Northwest with a disheartened company of strongmen, illusionists, fortunetellers, and musical whores. Under the quiet command of the mysterious, merciless, and murderous Lyman Rhoades, they entertain the masses while hawking the Chock-a-saw Sagwa Tonic, a vital elixir touted to cure all ills both physical and spiritual… although, for a few unfortunate customers, the Sagwa offers something much, much worse.
For drunken dentist Josiah McDaniel, the Sagwa has taken everything from him; in the hired company of two accidental outlaws, the bickering brothers Solomon Parker and Agamemnon Rideout, he looks to revenge himself on the Elixir’s creator: Dr. Morrison Hedwith, businessman, body-thief, and secret alchemist, a man who is running out of time.