A surgeon, up to his elbows in blood, picks up a crimson-stained saw and moves toward a waiting patient. A stricken soldier is held down by numerous stewards, a mangled leg awaiting amputation. He clenches his teeth and lets out pain-infused groans of suffering. We all know what comes next… Or do we?
Hollywood has honed a popular myth about Civil War Medicine and the hospitals in which sick and wounded soldiers were treated during the American Civil War. The notion that Civil War surgeons were merely butchers who callously removed arms and legs without anesthesia has been repeated countless times. These misconceptions cloud modern understanding of the Civil War’s influence on medicine. Hardly the butchery depicted in popular culture and memory, Civil War medicine was an advanced trade and helped drive innovations in medicine that continue to impact our lives today.
Mercy Street helps to clear the picture, depicting the surgeon’s trade with more nuance than most programs about the Civil War-era. Among its strongest elements is the depiction of a general army hospital. The Mansion House Hotel in Alexandria, Virginia (the setting for much of Mercy Street) was occupied by the Union Army and turned into the city’s largest hospital that could treat several hundred patients.
General hospitals became one of the more established Civil War medical innovations, something that is taken for granted by most Americans today. Prior to the outbreak of war in 1861, the concept of a hospital as somewhere sick and wounded people recovered did not exist. The closest approximation at that time would have been sanatoriums, where those with deadly and contagious diseases were left to languish and ultimately perish.
Instead, Americans largely recovered from illnesses and injuries at home, under the watchful eye of a local doctor and with family members acting as nurses. For women like Clara Barton or Mary Phinney (Mercy Street’s protagonist), their only pre-war medical training was tending to ill relatives. If the ill failed to recover, the stricken would die at home surrounded by loved ones. The maelstrom of war would destroy this system.
When two massive (by 1861 standards) armies met on the plains of Manassas, Virginia in July 1861, there were few medical preparations made for the casualties. When the Union Army came running back from the banks of Bull Run to Washington, DC, no hospitals were waiting to treat more than 1,000 wounded men. Instead, churches, hotels, even government buildings, became makeshift hospital wards. Lack of supplies, poor organization, and a broken ambulance system resulted in purposeless suffering among the soldiers.
Over the following months, the bloodletting of war continued. Battles escalated as the armies became more experienced, leading to an increase in the carnage. Civilians, politicians, and medical officials upset with the Army’s poor treatment of the wounded called for a system to be put in place to ease the suffering of the men.
The United States Army began identifying buildings that could be temporarily turned into general hospital wards for the wounded. These would be places that could easily be adapted to the needs of wounded men during the course of their recovery. In Alexandria, this how the opulent Mansion House Hotel became Mansion House Hospital.
Women like Dorothea Dix and others pushed hard for women to be included as nurses in the hospitals scattered around the Union capital. They were fighting against a military bureaucracy and inherent bias against women, but succeeded in gaining entrance as nurses into the army hospitals. Their entrance onto the medical scene during the Civil War helped to open up the medical field for more women.
Life in these hospital wards was not easy for surgeons, nurses, nor the patients. The Civil War took place just prior to the development of germ theory by numerous doctors working in Europe, so Civil War medical professionals lacked knowledge about sterilizing instruments and properly cleaning wounds. Infection ran rampant through the wards, as did contagious diseases like typhoid fever. The spread of disease in the Army both inside and outside of hospital wards led to 2/3 of the deaths caused by the Civil War.
This brings us back to where we began, with the surgeon preparing to operate on a wounded soldier. In reality, anesthesia (chloroform or ether) was used in 95% of major operations conducted by the Union Army. Percentages were likely similar in the Confederate Army as well, as chloroform could be relatively easily manufactured, even with the Union blockade. Amputations readily occurred because it was the safest form of procedure for desperately wounded men. Those shot in the extremities were most likely to be hit by the powerful Minié ball, which splintered bone beyond repair. Amputation allowed for a faster, safer recovery and could lessen the chances of death by serious infection.
Mercy Street is a good introduction into the world of Civil War medicine. As someone who has worked within the field as a public historian, it is incredible to watch a Civil War hospital ward come to life. The authenticity they achieved in crafting the world of Mansion House Hospital shines through, and the medicine you will see in the series won’t disappoint either.
About the Author
Jake Wynn is the Programming Coordinator for the National Museum of Civil War Medicine. Jake has worked for the Fredericksburg and Spotsylvania National Park and at a variety of Frederick historical sites, and would enthusiastically describe himself as a “history nerd.”
