A new kind of surgery for a new kind of war: gunshot wounds and their treatment in the British Civil Wars

Abstract

This chapter examines the medical challenges posed by the increased number of gunshot wounds during the civil wars, and sets out the changes in the way these wounds were treated. The treatment of battlefield wounds expounded in surgeons’ manuals, is placed in context with what we now understand about the biology, pathology and effective treatment methods for wounds. The techniques used by the civil-war surgeon are compared with those of later periods. Despite a lack of understanding of microbiology, physiology and, in many cases, anatomy, many methods employed by civil-war military surgeons reflect good contemporary surgical practice. Despite the lack of antibiotics, anaesthetics, hygienic environments and high-quality surgical implements, survival rates from injuries on the field arrear to have been considerable, if treated. In developing treatments for the problems posed by gunshot wounds, some civil-war surgeons used an evidence-based approach, and laid the foundations for much modern surgical practice.