At the beginning of the war the Union Army provided one assistant surgeon to every regiment of 1,200 men. These were not always qualified men and there were many examples of people who had previously earned their living by selling quack medicines being appointed. Individual states later took over the responsibility of employing doctors for their volunteer armies. Some appointments were based on political factors, but some states such as Ohio, Massachusetts and Vermont, developed a reputation for recruiting good doctors.
Soon after the war started Dorothea Dix was appointed as superintendent of women nurses for the federal government. Over the next four years she was responsible for the recruitment, training and placement of 2,000 nurses treating members of the Union Army. Later Elizabeth Blackwell organized the Women's Central Association of Relief. This involved the selection and training of nurses for service in the war. Blackwell, along with Emily Blackwell and Mary Livermore, played an important role in the development of the United States Sanitary Commission. Other important nurses during the war included Clara Barton, Mary Stafford, and Mary Ann Bickerdyke.
The Confederate Army was slow to organize a system of medical treatment. In 1861 the Confederate Congress decided to allocate only $50,000 for the establishment and operation of military hospitals. This sum was increased and by the end of 1863 they had a large network of hospitals in Virginia (39), North Carolina (21), South Carolina (12), Georgia (50), Alabama (23), Mississippi (3), Florida (4) and Tennessee (2).
The South had a real problem with obtaining medicine after the U.S. naval blockade began to work successfully in 1862. The Confederacy published a pamphlet giving a list of herbs and plants that could be used to treat patients when manufactured medicines were not available. This included snakeroot, partridgeberry, sassafras, lavender, tulip tree, dogwood, and the leaves and bark of white oak.
The greatest danger facing soldiers during the war was not bullets but disease. It is believed that 186,216 soldiers died of a variety of different illnesses during the conflict. Large numbers of the soldiers came from rural areas and had not been exposed to common diseases such as chicken pox and mumps. Living in unhealthy conditions and often denied properly medical treatment, soldiers sometimes died of the these diseases. For example, 5,177 soldiers in the Union Army died of measles during the war.
The main killer diseases were those that resulted from living in unsanitary conditions. In 1861 typhoid caused 17 per cent of all military deaths, whereas dysentery and diarrhea caused a sick rate of 64 per cent of all the troops in the first year of the war. The following year this figure reached 99.5 per cent.
Union Army records show that a large number of its soldiers died from diseases caused by contaminated food and water. This included diarrhea (35,127), typhoid (29,336) and dysentery
A mixture of mercury and chalk called blue powder was given to soldiers with intestinal complaints. Opium, morphine, and quinine were also used by camp doctors and nurses to deal with a wide variety of different medical problems. It was commonly believed that wearing a flannel bans around the waist under the shirt would prevent disease. Large numbers of soldiers died from tuberculosis (consumption). Official records show 6,497 soldiers died of the disease in the Union Army. However, a much larger number were discharged because of poor health and died later.
It is estimated that smallpox killed 7,058 Union Soldiers. Another 14,379 died of malaria. Although the exact number of Confederate Army deaths from malaria is not known, there were 41,539 cases in an 18 month period (January, 1862-July, 1863) in South Carolina, Georgia and Florida. The cause of the disease was not known and soldiers often slept without the protection of mosquito nets. Once contracted, doctors and nurses often prescribed whiskey and the bark of dogwood, poplar and willow. Other substances used to combat fever included cod-liver oil, cinnamon and the syrup of wild cherry.
Large numbers of soldiers suffered from combat fatigue. Caused by extreme stress, symptoms include muteness, deafness and difficulty in controlling movement of the limbs. Unrecognized as an illness in the 19th century, soldiers were often diagnosed as suffering from mania or dementia, and sent home to recover. During the First World War combat fatigue was known as shellshock. (9,431). Drinking from streams occupied by by dead bodies or human waste and eating uncooked meat were the cause of large numbers of deaths. Regular soldiers who had been trained to be more careful about the food and water they consumed, were far less likely to suffer from intestinal disease that volunteer soldiers.
