FRII-12 UROLOGIC DISEASE DURING THE AMERICAN CIVIL WAR

Abstract

You have accessJournal of UrologyHistory of Urology: History Forum1 Apr 2017FRII-12 UROLOGIC DISEASE DURING THE AMERICAN CIVIL WAR Patrick Fisher Patrick FisherPatrick Fisher More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2461AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The Civil War marked a major turning point in American epidemiology and medicine. Regulations at the start of the Civil War required the senior medical officer of each hospital, post, regiment, or detachment, to make monthly reports to the Surgeon General of the sick and wounded, deaths, and discharges. Urologic infectious, benign and traumatic diagnoses were documented along with other diseases across geographic and racial divides. Using primary documents and epidemiologic data, we attempt to reconstruct the state of urologic disease among soldiers during the War. METHODS Primary documents from the UC Davis Blaisdell Civil War Medicine Collection including the epidemiological tables of sickness and mortality from the Medical and Surgical History of the War of the Rebellion by Surgeon General Joseph K. Barnes were analyzed. A non-systematic review of Pub Med was also conducted. RESULTS In addition to ushering in new paradigms for the military hospital system, trauma surgery, and anesthesia, the Civil War also brought about major improvements in the way diseases were categorized and recorded. Data from the Medical and Surgical History of the War of the Rebellion demonstrates a small but significant burden of genitourinary pathology in the troops across the Atlantic, Central and Pacific Regions. Among GU diagnoses, sexually transmitted infections including syphilis, gonorrhea and orchitis had the highest incidence, averaging 33, 43 and 6 annual cases per 1000 white troops. The incidence of GU pathology was similar between white and non-white troops, with the exception of venereal disease, which was reported more frequently in whites. Venereal disease had a higher incidence at the start and end of the war. Prostitution, which has been well documented, was a likely contributor to the spread of venereal disease. The incidence of stones, benign scrotal disease, testis tumors and urethral strictures was relatively low and stable over the course of the war; surprisingly, of all GU diagnoses, varicoceles were associated with the highest rates of discharge from service. In this pre-penicillin era, the most fatal diagnoses were syphilis and infectious nephritis and cystitis. As previously described by Herr, traumatic GU injuries were relatively uncommon, representing <1% of all battle wounds; however, about half of injuries to the bladder and kidney were fatal and these injuries were fraught with complications such as fistulae. CONCLUSIONS Urologic pathology played a small but significant role in the lives of soldiers during the Civil War. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1071 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Patrick Fisher More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...