Historian redeems Civil War era medical science

History has not been kind to the physicians of the U.S. Civil War.

With a toll of more than 750,000 deaths between 1861-65, the Civil War’s casualties far outnumber those of any other war the United States has taken part in. And with roughly two thirds of the war’s deaths being a result of disease, it’s no surprise historians have traditionally regarded the Civil War as a medical disaster.

DEVINE

DEVINE

But Shauna Devine is among the first to look at medicine during the Civil War period through a more contextual – and, as such, forgiving – lens.

“I thought it might be counter-intuitive to suggest the war was, in fact, a stimulus to more superior scientific standards in medicine. When I read the books, all of the existing literature in the field said doctors inadvertently spread disease, and patients died, and it was a medical disaster,” said Devine, a visiting research fellow at the Schulich School of Medicine & Dentistry, who also teaches in the Department of History at Western.

Her most recent book, Learning From the Wounded: The Civil War and the Rise of American Medical Science, argues Union Army physicians, despite challenges and lack of preparedness, tackled the war head on, learning new methods of practice and experimentation which would leave an impact on modern medicine.

“My book is a new interpretation of Civil War medicine. It asks, ‘In what ways did the actual practice and study of medicine develop through the war, and in what ways do we see this in the medical marketplace after the war?’ Nobody has asked that question before, or looked at the war in that way,” Devine continued.

Learning from the Wounded was named a Choice Outstanding Academic Title for 2015 and a recipient of the Tom Watson Brown book award, one of the highest honours in the field of Civil War history.

To understand how the conditions of war led to more scientific standards and to the rise of modern medicine, Devine noted historiographical context is key.

America’s worst conflict ended 150 years ago last month, when Confederate Gen. Robert E. Lee surrendered the Army of Northern Virginia to Union commander Ulysses S. Grant at Appomattox on April 9, 1865. Today, many scholars consider the conflict the central event in American history when it comes to defining that nation.

“The standards for doctors and medicine at the time were very low. There were no licensing laws. But the top medical physicians at the time in America served in the Civil War. Just prior to the war, the elite physicians went to Paris to study medicine because there were very few hospitals (in America),” Devine explained.

“Not a lot of them went – just under 1,000 – but they came home and wrote about reforming American medicine along more scientific guidelines – they talked about the need for cadaver bodies, licensing, hospitals, equipment. At this time, a hospital could have consisted of an attic with a bed. There were too few of them to make any kind of difference on a national basis. But I was interested in this. There were pushes for reform,” she continued.

Germ theory emerged soon after the war. As it was disseminated, American physicians headed to Germany to study with leaders in the field, she added. Around the same time, the American Medical Association had a meeting in Philadelphia putting forward specific ideas for reforming medicine, suggesting some of the emerging practices become standard. The organization also asked for more training and dissection of bodies as ways to improve treatment.

“What I noticed in the historiography was, all the same physicians who went to Paris and then went to Germany were being written about. They all served in the war. This was a national emergency and many talk about the opportunity to do work on domestic soil they were previously only able to do abroad,” Devine said.

“Nobody had asked the question, to what extent did the conditions of war lead to more scientific standards or the rise of modern medicine? It’s easy to look at the bad – a lot of soldiers died. But if you look at other things – what happened, did new hospitals develop, did physicians change some things as a result of what they were seeing, did they see new diseases, did they start using more technical equipment to manage disease environment – it’s not so bad,” she added.

“It might not have resulted in cures for disease, but you see much better approaches to the study of medicine develop. I think the story previously had been too focused on the number of soldiers that died, but not enough on the process of change that began to occur. I think my book is the first one to make that statement.”