Civil War Surgeons - A Prized Possession

A lifetime interest in military history has become a passion about the history of surgery for Paul M. Johnson, M.D., a Harvard-trained vascular, thoracic and general surgeon practicing at Chester River Hospital Center. Civil War era medicine particularly fascinates him and it is solving the myths about that era's surgery that consumes his appetite.

During the Civil War, an estimated 620,000 Americans died, more than in all other wars which Americans have fought, combined. Two thirds of these deaths were caused by disease; the other third died from injuries sustained on the battlefields. The war turned thousands of rural family physicians into civil war surgeons. "They were ahead of their time, 'operating' without any knowledge of shock, infection control or proper trauma care," said Dr. Johnson. "During the Battle of Gettysburg, massive casualties were suffered; 52,000 people were injured or killed. Yet it was at this time that doctors first attempted to save limbs rather than amputate, which was the standard of care." Although fifty thousand amputations were performed throughout the war according to the Library of Congress, "resection procedures and conservative treatment of gunshot fractures did preserve limbs," Dr. Johnson reports.

Contrary to popular belief, Dr. Johnson insists there was plenty of anesthesia during the Civil War. "I've researched it. Either ether or chloroform was used, but ether was the preferred anesthesia," Dr. Johnson said. "It was safer because it stimulated breathing and therefore, could be administered by non-physicians, which gave birth to nurse anesthetists. To this day, England does not have any nurse anesthetists because at one time, the country's preferred anesthesia was chloroform. It is dangerous to administer and therefore only doctors could give it," Johnson said.

According to Dr. Johnson, each regiment had a full surgeon and two assistant surgeons. Because of their skills, surgeons were ranked Major. "The only perk to being a surgeon was that both sides respected you," Dr. Johnson said. "When captured, surgeons were well-treated but were expected to treat casualties from both sides. A particularly dangerous time for a surgeon was after a battle when doctors stayed behind to set up field hospitals. They were most vulnerable to being captured."

There was a formal exchange system through which doctors were traded back to their respective sides. "But if you were a northern surgeon, many times your surgical instruments were confiscated by the South because they had fewer medical supplies," Dr. Johnson said. "Also, nearly 250 surgeons were killed during the war because surgeons treated casualties very close to the battlefield."

For more than 20 years, Dr. Johnson has researched and reported on these myths and has collected a wealth of artifacts from the war. He is a founding member of the Museum of Civil War Medicine in Frederick, Maryland, and considered an expert by members of the Civil War Round Table Association, a national, non-profit educational society. Dr. Johnson is a contributing editor to Military Images magazine, through which he helps solve mysteries surrounding the method of injury infliction using surgical-pathological evidence. In a recent issue, Dr. Johnson's evidence about an injury sustained at Gettysburg is featured on a two- page article. Also, Dr. Johnson has written articles for Civil War Times Illustrated and recently has been asked to edit a chapter on Civil War gunshot wounds for a soon-to-be-published textbook entitled The Healing Hand, Volume II, by Guido Manjo, M.D., a professor of pathology at the University of Massachusetts' Medical Center.

Dr. Johnson has created a fascinating presentation for community groups and is available to speak about his research through the hospital's Speakers Bureau. For more information, call the hospital's public relations office at 410-778-3300, ex. 4010.

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