Posts tagged: military medicine

MHL highlight: Civil War photography from the Army Medical Museum

By , June 26, 2012

Photograph and case history of Private Samuel Decker. He posed for this portrait at the Army Medical Museum along with the prostheses he developed after losing both hands to an artillery accident during the battle of Perryville. — vol. 5, image 5 (Click on image to enlarge.)

The Center for the History of Medicine recently digitized a remarkable collection of Civil War-era images titled Photographs of surgical cases and specimens. Nearly 150 years after it was first published, this six-volume set provides a sobering look at the state of the art in surgery during and after the war. The imagery in the collection is vivid, starkly illustrating the terrible effects of developing warfare technology on the human body, while the detailed case histories that accompany each photograph — recording the names and ranks of soldiers, specific battles, dates of injury, treatment narratives, and final outcomes — provide a wealth of medical and biographical information to scholars and casual readers alike.

Though versions of many of the individual images in the collection have been widely circulated, complete sets in bound volumes are extremely rare, and this is the first time that the entire collection, in its original form, has been made freely available to the public online.

Background & history

At the outset of the Civil War in 1861, the lack of experienced surgeons in the ranks of both the Union and Confederate armies represented a looming medical crisis. In 1862 the United States Army Medical Museum was formed, in part to advance practical research into new ways of treating and diagnosing the types of trauma that had become commonplace on the modern battlefield. Almost immediately after it was established, the museum’s first curator, Dr. John Hill Brinton, began collecting specimens from field hospitals and military grave sites. In the years that followed, individual portraits along with photographs of these specimens and accompanying case histories were disseminated to hospitals and medical institutions around the country.

(top) “Group of officers who have undergone amputation for gunshot injuries” from vol. 3, image 1. (Bottom) Minié ball embedded in skull at the Battle of the Wilderness — vol. 2, image 28.

In 1865, Lieutenant William Bell, who would later gain fame for his photographs of the American West, was appointed Chief Photographer of the museum. The artistic composition and quality of Bell’s work often bore greater resemblance to the celebrated portraiture of Matthew Brady than to standard, utilitarian medical photography. Under the direction of Brinton’s successor, Dr. George Alexander Otis, Bell photographed the portrait sitters and anatomical specimens in a studio at the museum, and was ultimately responsible for the majority of the images that comprise this collection.

Contents

The most common and deadly threat on the battlefield at the time was the gunshot wound, which was more prevalent and vastly more traumatic than in previous wars owing to the development of the “Minié ball.” A type of conical musket round, it could be rapidly loaded, then fired accurately and at a velocity high enough to cause devastating flesh wounds and shatter bone at great distances. Surgical cases and specimens includes an exhaustive variety of these types of wounds, illustrated through morbid specimens and portraits of surviving patients, with amputation or excision of joints comprising the majority of surgeries depicted.

This particular edition, which was sent from the museum to John Collins Warren, Jr., was likely assembled and published in the 1870s, and thus it also includes a number of civilian trauma cases from during and after the war that were considered relevant.

A word of caution to readers who wish to browse these books: many of the cases depicted involve extremely gruesome injuries that can, at times, be shocking to look at. Also, when reading the books online, it is important to note that each case history will appear on the page directly following the photograph it describes.

Volumes I-VI of Surgical cases and specimens were digitized by the Center for the History of Medicine as part of our ongoing contributions to the Medical Heritage Library.  A collaborative online collection of primary source materials held by some of the world’s leading medical libraries, the Medical Heritage Library presently contains over 35,000 individual volumes that cover a broad range of topics within the domain of medical history, including hundreds of items relating to various aspects of Civil War medicine. To read more about the MHL and its contributing partners, or to browse the collection, visit www.medicalheritage.org.

Report on the remarkable case of Captain Robert Stolpe, shot through the abdomen at the battle of Chancellorsville. After being wounded, Stolpe was forced to walk 1.5 miles back to a field hospital. A day later, the field hospital came under fire, and he had to walk another half mile with a portion of his lung protruding from the wound. Shortly after being admitted to a base hospital, he passed the musket ball in his stool and was found “walking about the ward smoking a cigar,” apparently having suffered no long-term, adverse health effects. — vol. 1, image 33.

An American Surgeon in Paris

Inscription by Dr. Elliott C. Cutler to President Emeritus Eliot on flyleaf of journal.

In spring 1915, a deputation of surgeons and nurses from the Harvard Medical School travelled to Paris to join the service at the American Ambulance Hospital, giving medical aid to injured soldiers from battles taking place across Europe. The unit had been invited by Dr. Joseph Blake, one of the surgeons already working in Paris.

One of the surgeons who came from Harvard was Dr. Elliott Carr Cutler. In 1916, he put together a journal of the expedition, publishing it as A Journal of the Harvard Medical School Unit to The American Ambulance Hospital in Paris. The unit totalled 17, including surgeons, medical staff, and four nurses to work at the Hospital at Neuilly.

The Journal starts with the departure of the unit from Boston in March 1915 and concludes with an epilogue written in Canada in July of the same year, after the unit had taken over the hospital service for the intervening three months.

Cutler describes the trip, the difficulties the unit had even in getting into France through Spain (customs officers insisted on opening some boxes of chocolates that had been given as gifts and the Harvard unit only retained them with difficulty), and the final arrival and work at the Hospital. The unit took over all aspects of the Hospital work, including devising a filing system to record and store patient information. Some of the doctors took opportunity of their time in France to make tours, some to historical sites, including Versailles, but often visiting other hospitals and medical services, some very close to the front, or the front itself, under appropriate supervision from armed services.

The day-to-day medical services given to wounded soldiers receive attention, too. Cutler is dispassionate in recording what cases are brought in and what can be done for them, even saying once when discussing some discharged soldiers who were returning for further work on old wounds, “It was a considerable blow to our hopes for more cranial work, though to be sure they were wounded in the head.” (32) Despite this early breeziness, as time goes by Cutler is clearly affected by what he is seeing. As the major “season” for battles over the spring and summer advances as the weather improves, Cutler notes that the wounds become worse and the number of patients higher. Long days in the surgery are mentioned and Cutler sometimes waxes philosophical about what the overall “point” of the war might be, when the major outcome seems to be shattered bodies.

The Journal was digitized for the Medical Heritage Library.  Visit the full collection here.

Staff Finds: A Boer War Hospital Ship Diary

Annotated envelope and photograph.

Annotated envelope and photograph of three unidentified men. The writer of the diary may be one of them.

While conducting a Boston Medical Library-funded preservation survey, Center staff discovered a diary volume dating from the end of the nineteenth century.

The writer – his name may have been Otto Rinstrom or Renstrom – was on the hospital ship Maine, which sailed from New York to London and then on to Cape Town and Durban in South Africa to take part in the nursing of wounded British soldiers from the second Boer War. Most likely the writer was a male nurse or orderly, since the diary begins with the Maine leaving the New York docks, and female nurses did not come on board at the American end of the voyage.1

The writer notes life on board ship between New York and London and, later, London and South Africa, including the celebration of the birthday of Lady Randolph Churchill, one of the sponsors of the expedition and a fellow sailor. He also records, briefly, life in an Army barracks near London where the ship paused on its southward journey, noting the weather and any special events. During his time in London, the writer was an almost daily habitue of the theatre, although he does not mention which shows he saw. When on board ship, the writer almost invariably makes a daily notation of a distance he has run; presumably he was an onboard jogger, making so many circuits of the deck per day and wishing to record his progress. About midway through the volume, a small envelope containing a black-and-white photograph of three unidentified men, all in white coats, has been laid in. The envelope itself is covered in notes for diary entries.

The writer does not include much about his work with the wounded – upon its arrival in South Africa, the Maine almost immediately received injured soldiers from the fighting around Spion Kop, including Lady Churchill’s youngest son, John. He notes that wounded are on board, but seems more concerned to record his impressions of South Africa, the celebrities who visit the ship, including many of the English military commanders in South Africa, and the ship’s movement from port to port. Unfortunately, it seems that the writer did not survive to return to America; the last entry in the journal reads: “Here ends abruptly the diary of [Otto Rinstrom]. On Saturday morning May 18th he was suddenly seized with a violent apoplectiform meningitis and died…” Despite the abrupt ending and the possible fate of the writer, the journal is a fascinating personal record of the South African war from the perspective of a non-combatant.

1. M. Eugenie Hibbard, “With the Maine to South Africa,” American Journal of Nursing, (1) 1900, 1, http://www.jstor.org/stable/i277779. Additional sections of the article were printed in later issues.

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