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Civil War Medicine: Challenges and Triumphs

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Few works on Civil War medicine have been published to as many positive pre-publication reviews as Dr. Alfred Jay Bollet's new book, **Civil War Medicine: Challenges and Triumphs**. ...

Dr. Bollet spells out his goal in the introduction to the book: dispelling the many enduring myths about surgeons on both sides during the war, and detailing the extraordinary contributions of this long-maligned group. He especially decries the lack of context that previous historical works, even classics such as Doctors in Blue and Doctors in Gray, provide when discussing Civil War medicine:

Dr. Bollet was born in New York City, graduated from New York University, and spent his professional career in academic medicine, serving as a professor of internal medicine at the University of Virginia, the Medical College of Georgia and State University of New York at Brooklyn. Dr. Bollet is a lifelong student of all aspects of the Civil War. He had always fascinated by history, as was his wife, who had a Masters degree in history. The Civil War was always a subject that he wanted to know more about, when he could devote more time to it.

Since retiring from academic medicine about seven years ago, Dr. Bollet has studied the medical history of the war extensively. Curiously, he first came to the topic with the same conventional wisdom that his book dispels: he expected to find a lot to criticize, but was greatly surprised by what he found, and just kept going further into the subject.

Dr. Bollet has presented lectures on various aspects of Civil War medicine at many medical schools, Civil War round tables, and the Smithsonian Institution. He is the author of more than four-dozen medical journal articles, including several on medical history. Dr. Bollet serves on the Honorary Board of Advisors of the Museum of Civil War Medicine in Frederick, MD, and is on the Board of Directors of the Society of Civil War Surgeons (SOCWS).

In the opening chapter, Dr. Bollet acknowledges the first year of the Civil War "was a medical disaster." He also asserts, however, that all of the military departments were unprepared for the war; a fact often missed by critics pointing to early failures of the medical profession. His brief review of lessons learned by European armies during the Crimean War helps set the stage for describing improvements made during the Civil War.
In his chapter "Sects and Science," Dr. Bollet describes the state of medical science in the early and mid-19th century. His premise is that to "accurately evaluate the quality of Civil War medical care, it is necessary to review the actual state of medical science at that time." The chapter includes biographies of prominent physicians and the state of medical education in Europe and the United States.

Most interesting is Dr. Bollet's excellent rebuttal of the conventional wisdom that Civil War-era physicians lagged behind their European counterparts in the use of medical instruments. He points out that historians who criticize the infrequent use of thermometers fail to recognize that "bedside thermometry" was not an established practice until after the war. Dr. Bollet also supplies evidence that the stethoscope was in wide use among surgeons, and that microscopes were skillfully used for the diagnosis of diseases.

Indeed, Dr. Bollet greatly admires one of the war's microscope experts, Dr. Joseph Woodward, feeling that he is an unsung hero who deserves to be remembered. Woodward worked in the Surgeon General's office where he penned two important manuals, one for hospital stewards and another about camp diseases. He also compiled the data and wrote most of the medical sections of the Medical and Surgical History. The end of Woodward's life was marked by tragedy: he was the main physician in attendance when President James Garfield was assassinated, and was widely criticized for not appreciating the importance of avoiding contamination of Garfield's wound. That criticism lead to Woodward's depression, hospitalization, and perhaps his suicide, leaving his work on the Medical and Surgical History undone.

Other chapters in the book discuss surgery, field and general hospitals, the evolution of the "Letterman system," therapeutic drugs, medical treatment in prisoner of war camps, and the contributions made by women during the war. A good third of the book is devoted to an excellent discussion of the diagnosis and treatment of diseases.

In each chapter Dr. Bollet discusses the challenge faced by the surgeon, provides context by describing the knowledge available at the time, debunks longstanding myths when necessary, and addresses the advances and triumphs that are often missed by critics. The book is well documented and amply illustrated, with many photographs and drawings from period texts and newspapers.

In my opinion, the best aspect of the book is that Dr. Bollet provides "multiple points of entry": a quick flip through the pages reveals dozens of short and interesting sidebars giving medical anecdotes, biographies, and other items of historical interest that can be read in a few minutes time.

I would like to add my voice to the chorus of enthusiastic reviews: in the humble opinion of this reviewer, the book is an excellent read and is a worthy replacement of classics such as Doctors in Blue and Doctors in Gray.

In the book's conclusion, Dr. Bollet notes that our country's landscape is dotted with any number of statues commemorating hometown soldiers and favorite generals, yet perhaps due to longstanding misconceptions, no village has a monument to a Civil War surgeon. His new book, Civil War Medicine: Challenges and Triumphs, will go a long way towards correcting some of these myths.

My own point of view is shaped by forty years as a physician, and being a clinical faculty member at two medical schools. You'll find my name on two Civil War medical books: Swamp Doctor and Tarnished Scalpels. I've read all the standard texts on Civil War medicine. Bollet's is free of the usual misapprehensions, and presents a very balanced view of every subject. I learned something new in every chapter. The writing and editing is excellent. For a general text on the subject, none is finer.

Bollet has written a first rate book on the practice of military medicine in the Civil War. "Civil War Medicine: Challenges and Triumphs" is well-organized, approachable to the non-Civil War History buff or those lacking in a medical background, addresses both Confederate as well as Union history (a standard failing in many Civil War works), and dispells many myths about the standards of Civil War medical practices.

At the onset of the War, the American medical community faced a problem no less difficult than that of their military counterparts: mobilizing to handle the vast numbers of diseased and injured men that a major war would confront them with. They confronted many of the same difficulties as well: political meddling, hidebound regular Army leadership, and having to learn by doing. Bollet does an excellent job of describing how the combatants (the Union in particular) produced excellent military medical establishments, but only after learning from their own numerous mistakes.

He also examines the state of medical practice at the time, with an eye towards dispelling the many myths that have grown up around Civil War surgery (and continue to be espoused by historians today - historians who ought to know better). After laying down the facts (and the state of medicine at the time makes a fascinating study), he takes the very necessary next step of comparing American medical practice during the war to the two next best yardsticks: the Crimean War preceeding the conflict, and the Franco-German War which followed it. With those comparisons in mind, even at some of their absolute worst moments, American military medicine was doing far better than their European counterparts in saving lives.

It is a good book and will be an engaging read for any Civil War buff.

After reading this book it is easy to understand the tremendous task in gathering the amount of information author Alfred Jay Bollet had to assemble on the subject. With 444 pages of material and also quite a lot of references to back up the chapters this book is exceptional. Bollet covers a multitude of areas in the world of the medical care featuring early war ill-preparation, being overwhelmed, medical science, surgery, amputations, wounds, hospitals, drugs, diseases, prison camps and important individuals of the time. Every chapter offers added insight featuring biographies on people that may have had influence on the subject being written about that adds more intrigue to this book. This book is very comprehensive and fair to all parties involved often bringing to light the importance of doctors and nurses through out the entire war and it's aftermath. Another interesting aspect of this book is that it discourages the myths and stereotypes of doctors during the Civil War that have survived to this day. I recommend this book to anyone who studies medicine or the Civil War as much insight can be gained from this very thorough book.

I'm a master docent ... and I love this book. The book does a terrific job of blasting the stereotypes which often portray doctors of the time as either incompetent or uncaring. Civil War surgeons were not "saw happy" and, with rare exceptions, soldiers on the edge of the battlefield were sufficiently anesthetized during all surgical procedures. Dr. Bollet establishes both of these facts right up front. Bollet's book does a wonderful job of clearing up the picture of medicine during this American conflict. In the decade before the war, surgeons at Massachusett's General Hospital performed, on average, fewer than 200 operations each year; during the war, surgeons would perform in excess of 40,000 operations. A great deal was learned in the process, and Bollet recounts it all. As a museum docent, I am reading this book with highlighter in hand. ...

Bollet's effort attempts to give civil war physicians their day in court in this 400+ page endeavor. He provides a more balanced account of the medical field as it existed in that time period. Nothing is left unstudied. Numerous sidebar articles appear throughout the text to embellish points of interest. A nice appendix is provided, as well as countless charts offering statistical data of note. Bollet's style is very reader friendly - you don't have to be a med student to enjoy it! Doctors in Grey by Cunningham, and Doctors in Blue by Adams now have a worthy successor.

I collect Civil War medical and surgical antiques and needed back ground on this area. I found Civil War Medicine: Challenges and Triumphs to be an excellent book, well researched and documented. I highly recommend it to anyone who wants to know what the doctors during the Civil War really knew and how their treatments were performed.

Dr. Michael Echols

American Surgical Antiques

Dr. Bollet has scored an Olympic gold medal with a work that is a perfect "10." He has done a superlative job of setting the record straight about the medical professionals who served in the armies of the North and South during the American Civil War. In one volume, Dr. Bollet has dispelled many, if not all, of the erroneous "facts" that have been perpeturated since the conflict, some attributed to renowned historians. He has presented a balanced narrative of the extraordinary efforts of the Civil War doctors and nurses, who are largely unsung. The volume is well written, easy to read, and contains much new information. Dr. Bollet's work is sure to become THE standard reference on Civil War medicine and should be the foundation of any Civil War medical library.

I just reread this work after an absence of four years. This book is probably the most encyclopedic single volume work on the subject of the title. Any reader who needs a background on an aspect of Civil War medicine (e.g., typhoid fever) will find exactly what he needs in these pages.

From the professional credits of the author I expected great things. I was impressed by the topics which were listed. However, I found the book greatly disappointing for the following reasons:
1. The references, when checked, very often failed to contain the material cited
2. The statistical charts were often redrawn and were inaccurate
3. The serious questions about mortality figures with amputations were not explained when the presented data suggested that the premise that surgery was better was not supported by the facts
4. The referencecing to the major reference:The Medical and Surgical HIstory of the Civil War , was inaccurate in many instances.