5 ms·

Grim look at Civil War surgery unearthed by new pit of limbs, bodies

63 points by curtis 8y ago

rco8786 8y ago
The title is kind of clickbaity. TLDR they found some dead bodies and amputated limbs at the site of a field hospital where a major civil war battle took place. It’s an incredible find, but doesn’t paint any real picture of civil war era surgery, much less a “grim” one beyond what we already knew (that amputation was common). Interesting fact contrary to popular belief: the vast majority of civil war surgeries involved some form of anesthesia. The notion that doctors were going around lopping off limbs of wide awake soldiers is a myth. http://www.civilwarmed.org/anesthesia/ http://www.civilwarmed.org/anesthesia/
- ryanianian 8y ago
  Thanks for the summary and addendum - not sure why you're getting downvotes. > the vast majority of civil war surgeries involved some form of anesthesia I can't find the article at the moment but I recall seeing somewhere that it was pretty common for incorrect amounts of anesthesia to be administered and many patients waking up (or worse, being aware of their surroundings and able to feel pain but being unable to move or scream; a personal nightmare of mine). Even if this was a small minority of cases it's still haunting enough to leave a legend that roughly corresponds to the myth you cite.
  - sandworm101 8y ago
    >> common for incorrect amounts of anesthesia to be administered and many patients waking up It is a thing, but not during the civil war. The horror story happens when using drugs meant to paralyze internal organs. Those drugs don't make you sleep, just paralyze you and your organs so your intestines aren't squirming around as the doc tries to fix something. So if they give you that, but not the actual anesthetic, things go bad. Modern hospitals have devices to pick up on this situation. (In the extreme situation of full consciousness, anyone monitoring heart rate will notice something is very wrong.) In civil war days this didn't happen as they didn't have the artificial respiration necessary to support such drugs. You could easily have been given not enough, but the paralysis-but-awake thing (true "anesthesia awareness") wouldn't happen.
    - srean 8y ago
      In addition surgery, another place where this has chances of happening is in execution by lethal injection. One key ingredient, Pancuronium bromide, is a potent muscle relaxant. It paralyzes all voluntary muscles. You would have quite a bit of agony in store, if the pentothal dose was not adequate.
      - rscho 8y ago
        The main use of neuromuscular blockers is making it cheaper and faster. You can kill someone just as well with hypnotic drugs alone using a much higher dose, and using neuromuscular blockers as a reason to decrease hypnosis is IMO f*ing TORTURE. That a developed country cannot even find a way to kill people in a proper manner is beyond me.
    - madengr 8y ago
      There was a French movie about that. Some thug killed a surgeons family, so he uses that paralysis drug to perform a colostomy, amongst other tortures.
      - sandworm101 8y ago
        There was also a hollywood movie, iirc starting Mila Kunis, called "Awake". Not something I would ever watch but I remember the commercials.
    - rscho 8y ago
      I'd like to respectfully make you aware of some imprecisions in your statements. https://en.wikipedia.org/wiki/Neuromuscular-blocking_drug https://en.wikipedia.org/wiki/Neuromuscular-blocking_drug https://en.wikipedia.org/wiki/Anesthesia_awareness https://en.wikipedia.org/wiki/Anesthesia_awareness Specifically, neuromuscular blockers is what you seem to be referring to. Those paralyze only muscle, not other organs, and therefore have little influence on intestines. They are of multiple uses to both the anesthesiologist (intubation) and surgeons (easier to reach places normally crammed up by active muscle). There are ways to reduce intestinal activity specifically, but those are not very efficient (glucagon). As for awareness situations, you are right in that they are more likely with neuromuscular blockers on board. However, research shows that the surgical context is of great importance, and situations where: - the patient is perceived as most fragile (cardiac surgery) - or where things go too fast (emergency C-section) are most at risk, due respectively to fear of overdose in fragile patients and immediate threat to life to the unborn child. Detection of true awareness is difficult, since many people will tell you they woke up during surgery while it was in fact the end of surgery (from personal experience). It is not known how frequent true awareness really is, but it is commonly accepted to be quite rare, and this goes along with my personal experience. If you are reasonably healthy, the chance of true awareness during surgery is IMO vanishingly small. Civil war soldiers did indeed not have neuromuscular blockers, but since efficient sleep medication did not exist, true awareness was far more frequent (probably the norm, in fact).
- rhapsodic 8y ago
  Yep, the Civil War-era lyrics to the song "Soldier's Joy" make a reference to morphine. https://en.wikipedia.org/wiki/Soldier%27s_Joy_(fiddle_tune) https://en.wikipedia.org/wiki/Soldier%27s_Joy_(fiddle_tune)
  - djsumdog 8y ago
    Huh. I was gonna say I thought the Civil War predated morphine, but then I looked it up and it was discovered and packaged/sold a few decades before the war started. TIL
clarkmoody 8y ago
One of the more disturbing angles of the Civil War is the number of child soldiers on both sides. https://en.wikipedia.org/wiki/Child_soldiers_in_the_American_Civil_War https://en.wikipedia.org/wiki/Child_soldiers_in_the_American...
- jobu 8y ago
  Thanks! That was more interesting than the Ars Technica article.
- onetimemanytime 8y ago
  I don't think we should define a "child" in the 1800's by today's standards, 18+ year old. Life expectancy, they way they were raised and all...means that life starts much earlier if you want a chance to get married and have your children http://www.legacy.com/life-and-death/the-antebellum-era.html http://www.legacy.com/life-and-death/the-antebellum-era.html
  - newest_user_ 8y ago
    Average life expectancy is a notoriously bad measurement because it skews way down because of childhood deaths. For example, Roman life expectancy was only 21, but if you made it to age 5 it jumped to 42. Even then the laws at the time was 18 to enlist -- so they already viewed child soilders the same way we do now. The big difference is age verification was a lot harder because there was little in the way of a paper trail.
    - onetimemanytime 8y ago
      if you are lucky and lived to 42, you're a child at 16? Please
ewams 8y ago
Read about the Carnton Plantation, https://en.m.wikipedia.org/wiki/Carnton https://en.m.wikipedia.org/wiki/Carnton It was a temporary field hospital for the Battle of Franklin in Tennessee. It doesn't talk about it in the wiki page but if you search for "Carnton house blood stains" or go on a tour yourself you can see how horrific it was. Quite literally you can see the blood stained floorboards today from the civil war. You can still walk on them. There is a place on the second floor where one of the surgeons had a bucket on the floor to hold his tools and the entire floor around it is stained with blood except for a small ring from the bucket which is unstained. Highly recommend a tour of the house, grounds, and small museum especially if you like history. Plus let me know if you are in town. ;)
- LyndsySimon 8y ago
  Wow. My wife has ancestors that fought in the Battle of Franklin, and we’ve toured the house a couple of times. We’re planning on making it to the descendants gathering at some point. The idea of my kids’ great-great-...-grandfather marching across that valley into the Union lines and near-certain defeat is haunting. They knew it was a lost cause, without question. We make it a point to play “The Bonnie Blue Flag” every time we drive through that area.

63 points by curtis 8y ago

The title is kind of clickbaity. TLDR they found some dead bodies and amputated limbs at the site of a field hospital where a major civil war battle took place. It’s an incredible find, but doesn’t paint any real picture of civil war era surgery, much less a “grim” one beyond what we already knew (that amputation was common). Interesting fact contrary to popular belief: the vast majority of civil war surgeries involved some form of anesthesia. The notion that doctors were going around lopping off limbs of wide awake soldiers is a myth. http://www.civilwarmed.org/anesthesia/ http://www.civilwarmed.org/anesthesia/

ryanianian 8y ago
Thanks for the summary and addendum - not sure why you're getting downvotes. > the vast majority of civil war surgeries involved some form of anesthesia I can't find the article at the moment but I recall seeing somewhere that it was pretty common for incorrect amounts of anesthesia to be administered and many patients waking up (or worse, being aware of their surroundings and able to feel pain but being unable to move or scream; a personal nightmare of mine). Even if this was a small minority of cases it's still haunting enough to leave a legend that roughly corresponds to the myth you cite.
- sandworm101 8y ago
  >> common for incorrect amounts of anesthesia to be administered and many patients waking up It is a thing, but not during the civil war. The horror story happens when using drugs meant to paralyze internal organs. Those drugs don't make you sleep, just paralyze you and your organs so your intestines aren't squirming around as the doc tries to fix something. So if they give you that, but not the actual anesthetic, things go bad. Modern hospitals have devices to pick up on this situation. (In the extreme situation of full consciousness, anyone monitoring heart rate will notice something is very wrong.) In civil war days this didn't happen as they didn't have the artificial respiration necessary to support such drugs. You could easily have been given not enough, but the paralysis-but-awake thing (true "anesthesia awareness") wouldn't happen.
  - srean 8y ago
    In addition surgery, another place where this has chances of happening is in execution by lethal injection. One key ingredient, Pancuronium bromide, is a potent muscle relaxant. It paralyzes all voluntary muscles. You would have quite a bit of agony in store, if the pentothal dose was not adequate.
    - rscho 8y ago
      The main use of neuromuscular blockers is making it cheaper and faster. You can kill someone just as well with hypnotic drugs alone using a much higher dose, and using neuromuscular blockers as a reason to decrease hypnosis is IMO f*ing TORTURE. That a developed country cannot even find a way to kill people in a proper manner is beyond me.
  - madengr 8y ago
    There was a French movie about that. Some thug killed a surgeons family, so he uses that paralysis drug to perform a colostomy, amongst other tortures.
    - sandworm101 8y ago
      There was also a hollywood movie, iirc starting Mila Kunis, called "Awake". Not something I would ever watch but I remember the commercials.
  - rscho 8y ago
    I'd like to respectfully make you aware of some imprecisions in your statements. https://en.wikipedia.org/wiki/Neuromuscular-blocking_drug https://en.wikipedia.org/wiki/Neuromuscular-blocking_drug https://en.wikipedia.org/wiki/Anesthesia_awareness https://en.wikipedia.org/wiki/Anesthesia_awareness Specifically, neuromuscular blockers is what you seem to be referring to. Those paralyze only muscle, not other organs, and therefore have little influence on intestines. They are of multiple uses to both the anesthesiologist (intubation) and surgeons (easier to reach places normally crammed up by active muscle). There are ways to reduce intestinal activity specifically, but those are not very efficient (glucagon). As for awareness situations, you are right in that they are more likely with neuromuscular blockers on board. However, research shows that the surgical context is of great importance, and situations where: - the patient is perceived as most fragile (cardiac surgery) - or where things go too fast (emergency C-section) are most at risk, due respectively to fear of overdose in fragile patients and immediate threat to life to the unborn child. Detection of true awareness is difficult, since many people will tell you they woke up during surgery while it was in fact the end of surgery (from personal experience). It is not known how frequent true awareness really is, but it is commonly accepted to be quite rare, and this goes along with my personal experience. If you are reasonably healthy, the chance of true awareness during surgery is IMO vanishingly small. Civil war soldiers did indeed not have neuromuscular blockers, but since efficient sleep medication did not exist, true awareness was far more frequent (probably the norm, in fact).
rhapsodic 8y ago
Yep, the Civil War-era lyrics to the song "Soldier's Joy" make a reference to morphine. https://en.wikipedia.org/wiki/Soldier%27s_Joy_(fiddle_tune) https://en.wikipedia.org/wiki/Soldier%27s_Joy_(fiddle_tune)
- djsumdog 8y ago
  Huh. I was gonna say I thought the Civil War predated morphine, but then I looked it up and it was discovered and packaged/sold a few decades before the war started. TIL

clarkmoody 8y ago

One of the more disturbing angles of the Civil War is the number of child soldiers on both sides. https://en.wikipedia.org/wiki/Child_soldiers_in_the_American_Civil_War https://en.wikipedia.org/wiki/Child_soldiers_in_the_American...

jobu 8y ago
Thanks! That was more interesting than the Ars Technica article.
onetimemanytime 8y ago
I don't think we should define a "child" in the 1800's by today's standards, 18+ year old. Life expectancy, they way they were raised and all...means that life starts much earlier if you want a chance to get married and have your children http://www.legacy.com/life-and-death/the-antebellum-era.html http://www.legacy.com/life-and-death/the-antebellum-era.html
- newest_user_ 8y ago
  Average life expectancy is a notoriously bad measurement because it skews way down because of childhood deaths. For example, Roman life expectancy was only 21, but if you made it to age 5 it jumped to 42. Even then the laws at the time was 18 to enlist -- so they already viewed child soilders the same way we do now. The big difference is age verification was a lot harder because there was little in the way of a paper trail.
  - onetimemanytime 8y ago
    if you are lucky and lived to 42, you're a child at 16? Please

ewams 8y ago

Read about the Carnton Plantation, https://en.m.wikipedia.org/wiki/Carnton https://en.m.wikipedia.org/wiki/Carnton It was a temporary field hospital for the Battle of Franklin in Tennessee. It doesn't talk about it in the wiki page but if you search for "Carnton house blood stains" or go on a tour yourself you can see how horrific it was. Quite literally you can see the blood stained floorboards today from the civil war. You can still walk on them. There is a place on the second floor where one of the surgeons had a bucket on the floor to hold his tools and the entire floor around it is stained with blood except for a small ring from the bucket which is unstained. Highly recommend a tour of the house, grounds, and small museum especially if you like history. Plus let me know if you are in town. ;)

LyndsySimon 8y ago
Wow. My wife has ancestors that fought in the Battle of Franklin, and we’ve toured the house a couple of times. We’re planning on making it to the descendants gathering at some point. The idea of my kids’ great-great-...-grandfather marching across that valley into the Union lines and near-certain defeat is haunting. They knew it was a lost cause, without question. We make it a point to play “The Bonnie Blue Flag” every time we drive through that area.