Popular but generally incorrect images of Civil War medicine involve surgery-amputations without anesthesia, piles of arms and legs, the surgeon as a butcher. By modern standards, wartime surgery was limited. Despite the lack of both surgical experience and sanitary conditions, the survival rate among those who underwent the knife was better than in previous wars. Amputation was not the only surgical recourse available. Surgeons also extracted bullets, operated on fractured skulls, reconstructed damaged facial structures, and removed sections of broken bones.
As bullets hit their victims, shattered bone and shredded flesh became the calling cards of the minie ball. Most of the surgeons who had come from civilian practices had little or no experience in dealing with such wounds. They quickly became aware of the surgical options: remove the limb, remove the fractured portions of bone, or clean the wound and apply a dressing. Union surgeons documented nearly 250,000 wounds from bullets, shrapnel, and other missiles. Fewer than 1,000 cases of wounds from sabers and bayonets were reported.
The Case of Major General Daniel E. Sickles
Major General Daniel E. Sickles, Union Third Army Corps commander, was struck by a cannonball during the battle of Gettysburg. Sickles was on horseback when the 12-pound ball severely fractured his lower right leg. Sickles quieted his horse, dismounted, and was taken to a shelter where Surgeon Thomas Sims amputated the leg just above the knee. Shortly after the operation, the Army Medical Museum received Sickles' leg in a small box bearing a visiting card with the message "With the compliments of Major General D.E.S." The amputation healed rapidly and by September of 1863 Sickles returned to military service. For many years on the anniversary of the amputation, Sickles visited his leg at the museum.
Sickles' exploits extended beyond the Civil War. He was the first defendant to successfully use the temporary insanity defense in the United States. In 1859, Sickles was found not guilty of the murder of his wife's lover, Philip Barton Key, the son of the composer of the national anthem. Sickles had shot Key in Lafayette Square in Washington in a jealous rage after learning of the affair. Sickles served as a secret agent for President Lincoln and was appointed Ambassador to Spain by President Grant.
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