A Briefing on Civil War Amputations
[GORE WARNING: This article contains graphic details about detaching limbs from bodies between 1860 and 1863 along the eastsernish and southernish areas of the United States, especially in fields and stuff. Scroll with caution.]
Amputations are probably one of the more infamous medical procedures. I fast forward past them all the time in movies.
Especially Civil War films, which seem to always include someone losing a leg.
Maybe because it was really that common.
An especially damaging bullet called the Minié ball entered the scene in the 1840s and played a big part in the American Civil War through the early 1860s.
This devilish little thing pulverized any body part it hit.
When you’re a soldier with a giant hole in your leg in the heat of battle, with no other resources around, that leg is coming right the hell off.
“The effects are truly terrible; bones are ground almost to powder, muscles, ligaments, and tendons torn away, and the parts otherwise so mutilated, that loss of life, certainly of limb, is almost an inevitable consequence.” A System of Surgery by William Todd Helmuth
About three quarters of operations during the civil war were amputations. That’s roughly 60,000 severed hands, feet, arms, and legs.
The mortality rate for major limb amputation was about 28 percent, which made it preferable to other, more risky approaches — like not doing anything at all.
The Procedure
Both the Union and Confederate soldiers are said to have relied on amputations equally, and surgeons usually chose one of two popular approaches when it came time to cast off that pesky ol’ limb.
The circular method was perhaps most common in the battlefield because it was efficient and quick.
The surgeon sliced around the limb in a circular cut, pulled the flesh up, and sawed through the bone. The medic then sewed the flesh back over the wound.
A second, more time-consuming method was the flap technique.
In this surgery, the doc sliced two flaps of flesh before cutting the bone. He’d then sew those flaps up after the amputation.
The flap technique was said to yield a more visually appealing result than the circular method, but it was often reserved for hospitals, where the surgeon had the luxury of time and access to anesthesia.
Reviews from the Battlefield
There was a healthy fear in the battlefield of trigger-happy surgeons who just wanted the practice of a good, solid amputation.
Soldiers and their relatives were getting word of surgeons cutting off people’s limbs all willy-nilly, and battlefield surgeons were being called “butchers.”
One surgeon complained that medics were getting a bad name.
This man, medical director Jonathan Letterman, wrote that while there were some incompetent or vindictive surgeons, “It is easy to magnify an existing evil until it is beyond the bounds of truth.”
Battlefield doctors had a rough time for sure.
Surgeon William Child wrote his wife, “… dressed the wounds of 64 different men — some having two or three each. Yesterday I was at work from daylight till dark — today I am completely exhausted — but shall soon be able to go at it again.”
So, he would wake up, attend about 60 dying and wounded traumatized men, and then go directly back to sleep just to wake up and do it again. I am someone who appreciates a good hour or four of Netflix after a rough day (or any day), so I can only imagine.
I don’t doubt that the Civil War saw a percentage of quacks (or madmen), but it sounds like a rough few years for the country’s surgeons.
Prosthetic Limbs
Artificial arms and legs became fairly common around the civil war period, and the prosthetics industry flourished.
By 1862, both the Federal government and Confederacy were offering soldiers stipends to purchase artificial limbs.
Designers strove for realism and utility, and nearly 150 patents popped up between 1861 and 1873.
Prosthetics could include joints at the knee and ankle and a spring in the heel. They could be made from aluminum, wood, or steel.
Artificial limbs gave veterans the potential to ditch the crutches and walk with little to no limp. That was pretty important to many people, especially those who felt ashamed of their disability or what it represented and longed to fit in
Designs have been evolving rapidly ever since. Like, in a Terminator kinda way.
The Next Leg (sorry) of the Prosthetics Journey
Nowadays, options for prosthetics include 3D-printed limbs with moving digits and glowing forearms.
It’s a whole universe of technological design, and it’s too vast an industry to cover in this one article. So, here’s a short documentary about an awesome guy doing awesome things.
Parts & Poultices is a dive into the unique and interesting specifics of medical past and present. The writers (all one of them) thank the reporters and researchers of the source articles that inform its content.
