In 1862, U.S. Surgeon General William Hammond put out a call to medical field officers in the Union Army: Send any specimens of morbid anatomy that might be valuable to military medicine and surgery. It might seem like a strange request, but the medical profession was in the midst of change—from a system based on tradition to one based on evidence.
“When there’s a war, there are evolutionary changes, not necessarily revolutionary changes,” says Jeff Reznick, a historian at the National Library of Medicine in Bethesda, Maryland. Medicine in the United States did some significant evolving during the Civil War. Prior to the war, humoral theory—where an imbalance between the body’s “humours” caused illness—still formed the basis of medical practice. The idea of a germ wasn’t even on physicians’ radar. More than 12,000 physicians served during the Civil War on both sides. Together, they treated patients in the millions, and sometimes they had to get creative and veer off from the teachings of classical physicians.
“The real lasting impact was the change in mindset of both doctors and the people who they were treating,” says NLM historian Ken Koyle. Writing this week in the New England Journal of Medicine, Koyle and Reznick argue that the war instigated these lasting changes in mentality that forever altered the American medical profession:
With amputations becoming increasingly common, the Civil War added to a growing population of people in need of prosthetics, and more patients demanded greater variety. “Prosthetics during this time were created out of experience,” says Reznick. While craftsmen constructed most prosthetics, veterans began trying their hand at designing for specific injuries. For example, a Confederate soldier named James Hanger lost his leg at the battle of Philippi, West Virginia, in 1861. After returning home to Virginia, he designed a prosthetic leg with rubber bumpers on the ankle, and he later added a rubber foot. The design presaged modern prosthetic legs with a soft heel and solid ankle.
Hanger patented the designed and dubbed it the “Hanger limb”—one example among a flood of patents for new prosthetics. In the 12 years following the war, 133 patents were filed for prosthetics compared to just 34 in the 15 years prior.