Medical Advancements of the Civil War

Dr. Peter D’Onofrio in dress Union colonel uniform
On Wednesday evening, Dr. Peter D’Onofrio spoke to a full-capacity crowd about the many medical advancements made during the Civil War. Most of the improvements had to do with the organization of the military and provisions for wounded soldiers and veterans:

  • The Army organized an effective method to evacuate wounded soldiers which included an Ambulance Corp with professional wagon drivers with stretcher carriers and specially designed trains to transport soldiers to major hospitals for long term care and treatment.
  • The Army also developed a tiered system of care involving First Aid field stations, local hospitals, and finally large military hospitals with ample space and ventilation. This system allowed doctors to practice a simple form of modern triage and treat serious injuries within 24 hours.

The carnage of the Civil War also led to several discoveries that benefited the general medical community, especially in the area of cleanliness and surgery.

  • The first use of women nurses, which provided a home-like atmosphere during recovery
  • The wide use of anesthesia during amputations with a high success rate
  • The importance of cooking food properly to avoid disease and sickness
  • The identification of wounds requiring or benefiting from amputation
  • Surgeries done within 24 hours of wounding heal better than those done later
  • Developed method to seal sucking chest wounds
  • Although the discovery and acceptance of the germ theory is a few years away, doctors observed the benefits of boiling stitches, covering wounds with clean cloths, and proper hospital ventilation.

American doctors who served in the Civil War were able to contribute their discoveries and document specific medical cases in the Medical and Surgical History of the War of the Rebellion, 1861- 1865. It was published in six volumes from 1870 to 1888 and contained many statistics and medical reports from Union and Confederate doctors. The volumes include information on a wide variety of subjects such as diseases, injuries, surgical procedures and instruments, transportation, and individual medical cases. These reports allowed doctors to share their observations and newly developed practices. It was considered a major contribution from American doctors to the medical profession and read widely by doctors in Europe.

Listen to a mp3 recording of his 45 minute lecture here : Civil War Medicine

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Medicinal alcohol and prohibition

The Eighteenth Amendment to the Constitution, which banned the “manufacture, sale, or transportation of intoxicating liquors,” took effect on January 16, 1920. It became known as the National Prohibition or Volstead Act. This new law required physicians to obtain a special permit from the prohibition commissioner in order to write prescriptions for liquor. The patient could then legally buy liquor from the pharmacy or the physician. However, the law also regulated how much liquor could be prescribed to each patient. There were no provisions for the prescription of beer.

official prescription tablet for medicinal alcohol, 1933
official prescription tablet for medicinal alcohol, 1933

prescription forms for medicinal alcohol, 1933

In the 1920s, alcohol was known as an ancient therapy that still held medical value with some physicians. It was widely used through the 19th century, although its scientific value was beginning to be questioned by the turn of the 20th century. Part of its popularity was due to its low cost and availability. It was used as a tonic, stimulant, preventive measure, and even as a cure for acute illnesses. Whiskey and brandy were used most often, but use generally varied considerably from physician to physician. Alcohol was prescribed for a variety of ailments including anemia, high blood pressure, heart disease, typhoid, pneumonia, and tuberculosis. Physicians believed it stimulated digestion, conserved tissue, was helpful for the heart, and increased energy. Patients of all ages used alcohol. A common adult dose was about 1 ounce every 2-3 hours. Child doses ranged from 1/2 to 2 teaspoons every three hours.

prescription book of Dr. Dykes, 1928

In addition to their right to prescribe alcohol for its therapeutic value, American physicians also united to protest the encroachment of Congress on their right as doctors to treat their patients with whatever means they deemed necessary. They were not fighting against prohibition, but against the government’s growing jurisdiction over their practice of medicine.

Although the medical community tried to win back their autonomy through numerous court cases, appeals, and resolutions, none of them were successful. Prohibition was finally repealed by the 21st Amendment on December 5, 1933.

This struggle over the Volstead Act marked the first time that the medical community had taken a stance against federal legislation. Previous laws concerning health and medicine had been largely supported by the nation’s medical community. The unsuccessful protest of physicians during prohibition began a new phase in government regulation of medical practice. Modern parallels can be seen in the debate about medicinal marijuana and mandatory health insurance. These laws, like the National Prohibition Act, will affect the interaction of physicians with their patients.

Sources:

Appel, Jacob. 2008. Physicians are not Bootleggers: The short, particular life of the medicinal alcohol movement. Bulletin of the History of Medicine 82: 355-386.

Rothstein, William G. 1972. American Physicians of the Nineteenth Century. Baltimore: Johns Hopkins University Press.

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2010 Nursing Symposium

The Rose Melnick Medical Museum and William F. Maag Library are pleased to host the

2010 Nursing Symposium on Friday, April 2nd.

nursing uniforms

The theme for this year’s symposium is evidenced-based medicine in nursing practice.

9:00 am– “Implementing EBM policies at a community hospital” by Cindy Wetzel from Salem Community Hospital

10:00 am- “Safe medication administration” by Lora Leonard from Kent State Univeristy

11:00 am- “Using evidence-based practice for managing clinical outcomes in advanced practice nursing” by Dr. Irene Glanville from the University of Akron

12:00 noon– break for refreshments and to view the museum exhibits

12:30 pm– “Building an evidence-based practice infrastructure and culture: a model for rural and community hospitals” by Dr. Linda Dudjak from the University of Pittsburgh

The symposium will be held at the Melnick Medical Museum (655 Wick Avenue, Youngstown, OH).

All presentations are free and open to the public.

Hope to see you there!

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Lake to River Science Day

Lake to River Science Day logo

Saturday, March 27th 2010

8am – 5pm

Beeghley Arena, Youngstown State University

Youngstown State University is proud to host the Ohio Academy of Sciences District 15 Lake to River Science Day again this year. Although the Rose Melnick Medical Museum is not usually open on Saturdays, we will be open this particular Saturday for students participating in the Science Day.

Participants, family, and the general public are welcome to stop by anytime between noon and 3:00 to check us out!

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Medieval sunglasses?

Although the first documented discussion of eyeglasses dates from the late 13th century in Italy, many cultures had discovered the magnifying property of convex glass lenses much earlier. English friar Roger Bacon (1214-1292) wrote about his observations of convex glass and noted that it would be useful for those with weak eyes. There is evidence that by 1591, tinted lenses were used as protection from bright sunlight! In the 17th and 18th centuries, tinted lenses were often used a second set of lenses and attached to spectacles by a hinge.

eyeglasses with tinted lenses, 1840-1880

The first eyeglasses consisted of one lens on a handle. Later, two lenses were strapped around the head using leather or silk bands. The modern, hinged temple was not introduced until the late 1700s. Before lightweight plastic and metal alloys were invented, frames were made of brass, iron, nickel, horn, bone, gold, silver, or leather.

hook templed spectacles, 1870-1900

In America during the 1700s, ready-made glasses were imported from Europe. They were expensive and unaffordable for most colonists. In the early 1800s, eye glasses were manufactured in the United States with glass lenses that were still imported from Europe. These ready-made glasses were sold by peddlers or jewelers and customers fit themselves. It was not until the 1870s that Americans learned to make optical-quality glass and to grind the lenses to specific standards that could be prescribed by optometrists. These new skills developed at a time when literacy rates were rising and more people required glasses. By the turn of the century, American-made lenses were being exported to Europe!

The first bifocal lenses were made by Benjamin Franklin around 1784. He made them by cutting two lenses in half and fitting them in one frame.

bifocals with curled temples, c1900

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Hear the Iron Lung at work!

The Melnick Museum has digitized a recording of a March of Dimes fund raising drive from 1952. The drive was held to replenish funds after a recent polio epidemic. During the 20 minute radio program, the announcer Mr. Caldwell interviews three families who were affected by polio. (One of the interviewed children, Judy Shakley, donated the phonograph recordings to the Museum in 2002.) The recording also features the sound of the iron lung while in operation. The three children (ages 7 to 11) talk about what it was like to be inside of iron lung.

Download the mp3 recording here.

The iron lung respirator provides artificial respiration for patients who have a temporary condition that weakens or prohibits their natural breathing capabilities. It is often associated with polio victims, but it can be used to treat many other diseases and conditions.

At the time of this recording in 1952, a vaccine for polio was right around the corner. Jonas Salk performed a trial of his killed vaccine that same year, and it was approved for mass immunizations by 1955. The Sabin vaccine, which provided protection against all three strains of polio, was developed by 1962.

To see an Iron Lung respirator used for polio patients and to learn more about polio, visit the Rose Melnick Medical Museum’s online exhibit “Life in the Iron Lung: Polio and the modern respirator.”

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Child birth in America

For centuries, child birth occurred naturally with help of trained or experienced women. Midwives were often well trained women with children of their own. Midwives usually practiced within ethnic and class-based communities. In addition to helping with the birth, their fee often included check-up visits and assistance with household work for about a week. Although the use of midwives remained strong through the 1800s, trained male physicians began helping with normal births in the 1760s. These men were usually hired for wealthy women. For the average American, a trained physician was only called in an emergency. Doctors were a luxury because they could use tools such as a vectis or forceps and administer drugs such as opium and morphine.

obstetrical vectis, c1830-1850

obstetrical vectis, c1830-1850

In the 1850s, physicians began using anesthetics to help with difficult labors. In spite of medical advances, postpartum hemorraghes and infection were common and often fatal for the mother. The urbanization of early 20th century allowed birth to move from private homes to hospitals which were equipped with penicillin and blood banks. This shift happened rapidly. Before World War II, only half of the births in the United States occurred in hospitals. By 1955, 99% were women were delivered in a hospital.

The invention of obstetrical forceps was a great advance in obstetrical tools for physicians. They were invented in England by the Chamerlin family in late 16th century. Shaped like a pair of hands, these curved metal blades were inserted into the pelvis separately then locked together. Forceps could be used to turn the baby in the womb or guide it through the birth canal. Turning babies so that their head or feet faced the birth canal was best method in difficult births since cesarean surgery was very risky. (The first successful cesarean section was recorded in the United States in 1827, but the procedure was not common until use of anesthetics, antiseptic surgical practices, and penicillin are widespread in early 20th century.) By mid-1700s, several models of forceps had been invented by physicians and their use became more common.

Davis' obstetrical forceps

Davis' obstetrical forceps, 1890

Although forceps saved the lives of many woman and children, physicians untrained in their use could cause damage to the woman or child. Woman experienced tears, infection, and permanent damage. Children could be deformed or disabled by the metal blades of the instrument.

Simpson's obstetrical forceps

Simpson's obstetrical forceps, c1915-1932

See more obstetrical tools in our “Tools of the Trade” exhibit opening this spring!

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A short history of stethoscopes

Today stethoscopes are a typical fixture around doctors’ necks. They are commonly used to listen to the sounds of the heart and lungs as well as the flow of blood during blood pressure readings.

The practice of percussion and immediate auscultation were popular in physical examinations by the early 1800s. In immediate auscultation, physicians placed their ear directly on the patient to observe internal sounds. A French physician named Rene Laennec (1781-1826) was a firm believer in this method of diagnosis. He worked to refine the auscultation procedure and link the sounds with specific physiological changes in the chest.

Immediate auscultation could be an awkward procedure, particularly for female patients.  In 1816, Laennec found himself in one of these situations. He rolled a few sheets of thick paper into a tube shape and applied the tube to the woman’s chest instead of his ear. Later, he made a more durable instrument out of wood and called it the stethoscope. It was a monaural model that consisted of one tube and was used on one ear.

monaural stethoscope, c1890

The first practical bi-aural stethoscope was made in 1851. Flexible tubing is required to make a stethoscope that allowed physicians to use both ears. While many physicians readily adopted monaural stethoscopes, the bi-aural stethoscopes were met with some skepticism. Doctors worried about hearing imbalances caused by using both ears instead of one. For this reason, many doctors continued to use monaural stethoscopes into the early 1900s.

Camman's biaural stethoscope, c1890-1900

Camman's biaural stethoscope, c1890-1900

The stethoscopes used today are very similar to the ones used in the 1930s. New materials such as flexible rubber, stainless steel, and tygon make them lighter and easier to use. The bells (the end of the instrument applied to patient’s body) have also become flatter. The application of electronic amplifiers to the stethoscope provided the next major modification. These stethoscopes amplified the sound heard by the physician and were capable of filtering high pitched tones in order to make faint tones louder. Some electronic models could provide visual or audio recordings that could be used in training or consultation as well.

Maico Stethetron, c1948

Maico Stethetron, c1948

The stethoscope is one of the medical instruments whose development has been dependent on the invention of new materials such as rubber and stainless steel. The sounds the stethoscope produces has been aided by the better understanding of the relationship between anatomy and the laws of physics. Not only did doctors need to understand how to efficiently transmit sound through tubes, they also need to understand how sound waves reacted in the various tissues of the body. These are some of the issues explored in our upcoming exhibit “Tools of the Trade: The history of medical instrumentation.”

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Light the Wick

The Rose Melnick Medical Museum has been featured on “Light The Wick,” a weekly video newsletter about people and events on Wick Avenue, Youngstown State University’s (YSU) arts corridor. The show typically includes profiles of students, staff, faculty, visiting artists, and administrators in the YSU arts scene as well as coverage of noteworthy events. The Museum was included in the episode that aired on November 13, 2009.

Click here to see the video.

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Old photographs found

While cleaning out a room in the museum, I found a shelf full of old photographs and negatives. Many of these photographs depicted local physicians and hospitals. I thought others might be interested in the images and decided that enlargements would be great decoration for the museum. I had 28 of the photographs scanned at a high resolution and then enlarged them to 11 x 14. They are now hanging in the library, conference room, and hallways of the museum. Here’s a sampling of what you’ll find:

An outing of local physicans, c1910

An outing of local physicans, c1910

Nursing students at Youngstown Hospital, c1960

Nursing students at Youngstown Hospital, c1960

Women's Board of the Youngstown Hospital Association, 1930

Women's Board of the Youngstown Hospital Association, 1930

Staff members of the Youngstown Hospital, c1912

Staff members of the Youngstown Hospital, c1912

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