Thursday, October 29, 2009
When we left off yesterday we were getting into the subject of medicine, a subject that holds a special fascination for you as it pertains to the Civil War. In fact you have a blog called "Civil War Medicine." For those who haven't visited yet, what can they expect when they check it out?
JS: I started my “Civil War Medicine (and Writing)” blog a few years back as a more flexible – and hopefully interactive - alternative to a traditional website. It serves as an easy means to post and archive the “Medical Department” columns that I write for The Civil War News and especially too include supplemental hyperlinks and material that don’t appear in the printed column; provide updates on my other research, writing, and speaking projects; post book reviews, etc. Recently, I’ve been making even more use of Facebook as an opportunity to post shorter “bits” of interesting information, photographs, etc. In fact, I get a lot more “interaction” through FB than my blog, but I’ll continue to give attention to both.
Of all the posts you've done, do you have a favorite?
JS: Well, I have two basic kinds of “Medical Department” columns for The Civil War News. Some of them are based on my own research and the others are interviews with doctors, nurses, and historians who have published interesting work in the medical literature. That is, I look out for interesting Civil War articles in the Journal of Urology! Of my own work, I really enjoyed putting together a 4-part series on “patent medicines” and the Civil War soldier in the past year, and of those parts my favorite was how quack medicine firms continued to rely on veteran testimonials and marketed their nostrums specifically to veterans, well after the war.
Of the interview format columns, one of my favorites is a discussion with Dr. Margaret Humphreys regarding her excellent book Intensely Human which described the medical care that African-American soldiers received during the Civil War, which was decidedly sub-par. Another favorite had to do with the interesting mystery of “glowing wounds” during the Civil War. Plus, anytime I get to interview my good friend Guy Hasegawa for a column, it’s always a treat. His work has been the subject of several columns and they are always interesting because he has a real talent for finding tremendous – and often unexplored – primary material in the National Archives to support his research and writing.
You've just had a new book release. Tell us a little about it.
JS: My new book is entitled "Years of Change and Suffering: Modern Perspectives on Civil War Medicine." The fact is, though, it really isn’t “my” book at all. It is co-edited with Guy Hasegawa and a collection of invited expert essays on various aspects of Civil War medicine. In many ways it is an extension of my “Medical Department” column as several of the contributing authors were interview subjects, but we also were able to add a few more.
To borrow a phrase from an old Oldsmobile ad: “this isn’t your father’s Civil War medicine book”! While some excellent general survey books exist, especially Dr. Alfred Jay Bollet’s "Civil War Medicine: Challenges and Triumphs," we wanted to give some folks a chance to publish some outstanding Civil War medical history that may not be long enough to warrant a book-length treatment on its own, but deserves a wider audience.
There are chapters on medical education, amputation, medical invention, neurology, the use of native plants in military medicine, urological wounds and surgery, mental health of soldiers and veterans, and more. Dan Hoisington – the publisher at Edinborough Press – always puts out a beautiful book, and Years of Change is no exception.
Guy and I were very pleased with the contributions tio the book. These are not re-hashes of your typical topics but rather in-depth treatments that don’t often get the attention they deserve. What’s more, the scholarship is top notch and much of it is previously unpublished.. For example, Dr. Terry Hambrecht presents for the first time some important letters of Confederate surgeon J. J. Chisolm; Terry transcribed the letters and the result is that we now know that Chisolm’s influence on Confederate medicine was much wider than conventional wisdom held.
The best part is that all the contributors have agreed that the royalties will be donated to Civil War medical heritage preservation causes. Pending the success of the book, Guy and I would really like to follow up with another collection of more essays on different topics.
Can you comment on the state of the American medical profession before the war.
JS: Well, that’s two questions really: one, the state of the profession itself and the other, whether the military medical establishment was prepared to deal with the scale of the conflict. The second is easier to answer, and it’s decidedly “no.” The peacetime army was small and the peacetime medical department was even smaller. The number of sick, wounded, and dead in the first few months’ battles demonstrated that the challenge would be unprecedented. That said, some very able administrators and others of real genius prevented a disaster by implementing some important policies that improved the evacuation and care of the wounded as the war went on.
The state of the profession itself really deserves a longer answer than I can give. An important consideration, though, is to avoid the historical “sin” or fallacy of “presentism” which leads to a conceit based on what we know now and what technologies we have now. The physicians and surgeons really should be judged on what they knew at the time and what they had in the way of surgical technique and diagnostic tools. The flip side of that coin is not to under-estimate the sophistication of some of the medical practices of the day. A lot of myths persist and need to be corrected.
One oft-repeated canard is that microscopes, stethoscopes, and thermometers were not widely used in the mid-19th century or during the war. The supposed evidence of this is that few or none of these tools appeared in the inventory of medical schools at that time (Harvard’s medical school is often used an example). The fact is, that during that era (and for another century in fact), medical students were required to supply their own diagnostic instruments (which is why they don’t appear in school inventories), and they were very much in use during the war.
When we look back at medical care during the War, we seem to think it was pretty barbaric. And it didn't help that soldiers thought surgeons were a bunch of quacks and too quick to amputate limbs.
JS: I guess it depends what you mean by “barbaric.” If you mean the horror of a typical post-battle hospital scene, I’d agree. It was bloody, exhausting, noisy, etc. But consider the similar scene after a modern car accident, terrorist incident, or natural disaster: it is bloody, exhausting, noisy, etc. The point is, you can hardly blame the surgeons for the scene; you have to blame the folks shooting at each other.
The public’s – and soldiers’ – perception of the surgeon as too-quick-to-amputate was simply incorrect. Dr. Bollet addresses this in a chapter in Years of Change and Suffering. In fact, there was a post-war consensus that too few amputations were performed. That’s not meant to excuse incompetence, though, and there was some to be sure.
What do you think was the greatest advancement in the treatment, first in disease and, secondly trauma was?
JS: I really don’t think there were a lot of advancements in the actual treatment or cure of disease. The modern era of synthetic chemistry and rational drug design was more than a half-century off. That said, the routine administration of quinine as a prophylactic against malaria and other “fevers” certainly helped, and Surgeon General Hammond also did great good by removing calomel from the approved supply list. They rewarded him with a court martial.
In terms of trauma, I’d have to say that the routine use of anesthesia with ether or chloroform (or sometimes combinations of the two) was – as Stonewall Jackson declared – “an infinite blessing.” We owe a lot of that to Dr. Squibb: he perfected the safe manufacture of pure anesthetics in advance of the war, thus making them more reliable in the surgical setting. Indeed, most people have no idea that the vast majority of surgeries and procedures during the war were done under anesthesia.
In terms of surgical technique, there are a number of examples of improvements such that once certainly-fatal wounds were repairable. Of course, that survival also resulted in disfigurement and incapacity so that the healing and rehabilitation was a life-long burden and process.
Women played a significant role in treating and caring for the sick and wounded. Can you talk a little about the Sisters of Mercy? Both you and the soldiers themselves seem to have had a soft spot in their hearts for them.
TS: I guess the first thing to realize is that many people use “Sisters of Mercy” or “Sisters of Charity” as a kind of generic term when describing the interesting and important role of Catholic sister-nurses in the Civil War. In fact, they are only two of no less than a dozen orders from all over the country – North and South – that served as nurses during the war. In fact, even “Sisters of Charity” is a bit of a misnomer as different communities of the sisters – for example in Emmitsburg, Maryland or Nazareth, Kentucky – served in hospitals in different theaters of the war. Despite a significant amount of period anti-Catholic sentiment, soldiers did indeed have a soft spot for the sister-nurses, but so did the doctors, as the sisters proved to be very able, efficient, and brave.
For someone interested in learning more about medical treatment during the war, what's the single best source?
JS: As I mentioned before, I highly recommend Dr. Bollet’s Civil War Medicine: Challenges and Triumphs as a survey. His book was one of the first to really begin to correct some of the persisting myths and misinformation. There are a lot of great specialized studies out there as well.
The websites of the National Museum of Civil War Medicine and the Society of Civil War Surgeons are also very helpful. Even better, I’d recommend attending their annual conferences. I had the great privilege this past year of attending and speaking at both conferences. The people are just terrific and generous with their knowledge and the lectures and tours are wonderful.
Any new projects you're working on?
JS: There’s always something new! First, I have a lot of great material for future “Medical Department” columns. Second, I recently completed a chapter on “Civilian Medicine” that I was invited to submit for The Civil War in American Life and Culture, a collection of about 40 essays. In addition to 3000-4000 words of text we were required to also supplement it with a similar amount of supporting primary material. I was able to use some period medical correspondence from my personal collection, which was great.
I’m most excited about my next book project, though. I recently signed a contract with The History Press for “Notre Dame in the Civil War: Marching Onward to Victory,” which will describe the interesting and important role that the university played during the Civil War.
What's the fascination with Notre Dame?
JS: Although I happily attended Catholic schools most of my life, I didn’t attend Notre Dame. Nevertheless, I guess I’ve always been among what they refer to as “subway alumni”; that is, folks who didn’t attend but do have an affinity for the university, either because of sports or tradition or both.
As for the Civil War connection, like most people I became acquainted with the school’s role in the war through personalities like the justly celebrated Fr. Corby, chaplain to the Irish Brigade, and – as we discussed earlier – the school community also supplied sister-nurses.
The more I looked, though, I realized there was a LOT more to the story: other chaplains every bit as brave as Fr. Corby (they sent seven in all), the fact that the Sherman family sent their kids there during the war, wartime fisticuffs and political pressure on campus, a unique Grand Army of the Republic chapter, and some real heroes among the student-soldiers, including two brevet generals and a Medal of Honor recipient!
I think it makes a pretty good story. I’ve given presentations on the subject to Civil War Round tables in Illinois, Missouri, and Ohio. I’m hoping the book will appeal to Civil War enthusiasts as well as that group of “subway alumni” I referred to earlier.
It will be published in Fall 2010, just in time for football season!
So the University's nickname isn't referring to a bunch of liquored up Irishmen climbing into a boxing ring? I'm Irish by the way.
JS: In fact, a more proper name would have been the “Fighting French”! Fr. Edward Sorin, the founder of Notre Dame, actually came to Indiana from France and intended to set up the college modeled after the French boarding school system. As it turns out, the school took on its character from a student body which was mostly from Indiana and Michigan with an Irish heritage. The school was a safe haven for Southern students during the war, though, and actually managed to increase enrollment during the war while other institutions were closing their doors.
What's the most obscure or strangest Civil War site you've ever been to?
JS: That’s easy: the world’s largest ball of yarn in Minnesota. Oh, you mean Civil War site? I’ve been to Wilson’s Creek several times, which is a favorite of mine…Vicksburg…Richmond…all the battlefields around Fredericksburg…Chickamauga…still a lot to see though, of course. I suppose the most out-of-the-way spot I’ve been is the Baxter Springs site in Kansas. I had the great pleasure of visiting many of those places with my lifelong friend Curtis Fears, who is also a Civil War enthusiast and past-president of the St. Louis Civil War Round Table, and that made it even more fun.
Any places of Civil War interest close to Houston?
JS: Well, Galveston has some great history and I want to learn more about that. It’s not far from here, of course, and when I’ve been in the old section, it’s well-marked with some areas relative to the Civil War, especially sites associated with the “Battle of Galveston.” Liendo Plantation, which is also not far from me, has an interesting war story and is host to a great living history event every year.
Although it’s not a historic site in its own right, one of the best kept secrets here in Texas has to be the Pearce Civil War collection in Corsicana. It’s a great museum and they have an amazing collection of correspondence.
Well, Jim, it's really been good having you stop by. Besides urging people to buy and read "Lincoln's Labels," any final thoughts?
JS: Urging them to also buy Years of Change and Suffering and Marching Onward to Victory? Did I mention Lincoln’s Labels is now available in softcover, on Kindle, and as PDF!
Seriously, though, I have received so much support, advice, and encouragement over the years that I’m eager and happy to share as well. If anyone has questions about writing, publishing, Civil War corporate history, Civil War medicine, or other topics, please visit my blog, “friend” me on Facebook, or just shoot me an e-mail (jschmidt at lexpharma dot com) and I’ll do my very best to help!
Thanks again Jim.
JS: It’s been my pleasure and a lot of fun. Thank You!