Students did not have any clinical experience prior to graduation. The second year was a repetition of the first. In the first year, lectures were given in two 4-month semesters. There was no prerequisite preparation for admission, no entrance exam, and no state medical licensing boards. The first medical school was established in the United States in Philadelphia in 1765. To better comprehend medical care delivered during this period, it is important to understand the medical infrastructure at the time. The quality of physical exams improved with the Civil War Military Draft Act of 1863, when fines and prison sentences were put in place for physicians who were derelict in their duties, resulting in many more recruits being rejected from service. The system was so poor that it is estimated that about 250 women served as soldiers during the war ( 5). It was the origin of the term 4F (missing 4 front teeth).
Dental care was poor in the 1860s, and this was a frequent cause of rejecting a recruit. Front teeth were needed in order to tear open the cartridge containing gunpowder and the bullet. If you could walk, carry a gun, and had front teeth and a trigger finger, you could enlist. Governors needed to fill quotas, and examining physicians were paid per recruit. That was the requirement however, the reality was that many exams early in the war were of poor quality.
War hospital perscriptions free#
In passing a recruit the medical officer is to examine him stripped to see that he has free use of all his limbs that his chest is ample that his hearing, vision and speech are perfect that he has no tumors, or ulcerated or extensively cicatrized legs no rupture or chronic cutaneous affection that he has not received any contusion, or wound of the head, that may impair his faculties that he is not a drunkard is not subject to convulsions and has no infectious disorder nor any other that may unfit him for military service ( 4). Contributing factors to disease-related deaths included poor sanitation and overcrowded camps the ignoring of sanitation by line officers inadequate pre-enlistment screening of recruits poor diet lack of immunity to childhood diseases and few specific treatments for disease.Īrmy Regulation 1297 set out criteria for preinduction physical exams: Contributing factors to combat-related deaths were inexperienced surgeons the lack of a coordinated system to get the injured off the battlefield quickly wound infections, since sterile technique was not yet recognized as important and battlefield tactics that did not keep pace with advances in weaponry. Soldiers died from two general causes: battlefield injuries and disease. Actually, during the Civil War, there were many medical advances and discoveries ( Table 1). It was stated that surgery was often done without anesthesia, many unnecessary amputations were done, and that care was not state of the art for the times. Medical care was heavily criticized in the press throughout the war. Many misconceptions exist regarding medicine during the Civil War era, and this period is commonly referred to as the Middle Ages of American medicine. The year after the war ended, the state of Mississippi spent 20% of its annual budget on artificial limbs for its veterans ( 3). Countless other soldiers were left disabled.
More recent estimates based on comparative census data put the figure closer to 752,000 ( 2). As hard as it is to believe, these numbers may actually be an underestimate of the death toll, given that much of the data regarding deaths of Confederate soldiers was destroyed when Richmond burned on April 2, 1865.
More Americans died in the Civil War than in all other wars combined. Two percent of the population at the time (approximately 620,000) died during the conflict ( 1). The Civil War was fought in over 10,000 places and was the bloodiest war in the history of the United States.
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