The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery

Western armies have relied on surgical field manuals to help physicians deal with unfamiliar combat medical conditions from the Napoleonic wars to the present day, but there has been little discussion of whether these handbooks have been used or improved outcomes. Recent research shows that the Unio...

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Main Author: John M. Harris, Jr., MD
Format: Article
Language:English
Published: Wolters Kluwer Health 2024-06-01
Series:Annals of Surgery Open
Online Access:http://journals.lww.com/10.1097/AS9.0000000000000419
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author John M. Harris, Jr., MD
author_facet John M. Harris, Jr., MD
author_sort John M. Harris, Jr., MD
collection DOAJ
description Western armies have relied on surgical field manuals to help physicians deal with unfamiliar combat medical conditions from the Napoleonic wars to the present day, but there has been little discussion of whether these handbooks have been used or improved outcomes. Recent research shows that the Union Army’s American Civil War (1861–1865) surgical case fatality rates improved as the war progressed, much like the US Army’s experience in later wars, and were generally superior to comparable European results. These positive Civil War outcomes have been attributed to field experience, adoption of best practices, and enhanced communication, without consideration of New York surgeon Stephen Smith’s widely-used Hand-Book of Surgical Operations. The Army of the Potomac added Smith’s pocket-sized Hand-Book to its supply table in 1862. Northern medical journals applauded it, and Smith’s contemporaries documented its wide use. Smith’s handbook explained and demonstrated surgical techniques that were adopted as the war progressed, such as the use of general anesthesia and limb-sparing resection (debridement) of gunshot wounds. It offered pithy, well-documented advice from recognized experts along with numerous illustrations, which allowed untrained physicians to visualize anatomical relationships and see contemporary best practices in a way that no other wartime publication provided, making it an exemplar of a mass-media surgical improvement change agent.
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spelling doaj-art-2e121e9bd5ec4cdf8b3a79f5d4fcb2602025-01-24T09:18:39ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-06-0152e41910.1097/AS9.0000000000000419202406000-00026The Union Army’s Surgical Handbook and the Positive Story of Civil War SurgeryJohn M. Harris, Jr., MDWestern armies have relied on surgical field manuals to help physicians deal with unfamiliar combat medical conditions from the Napoleonic wars to the present day, but there has been little discussion of whether these handbooks have been used or improved outcomes. Recent research shows that the Union Army’s American Civil War (1861–1865) surgical case fatality rates improved as the war progressed, much like the US Army’s experience in later wars, and were generally superior to comparable European results. These positive Civil War outcomes have been attributed to field experience, adoption of best practices, and enhanced communication, without consideration of New York surgeon Stephen Smith’s widely-used Hand-Book of Surgical Operations. The Army of the Potomac added Smith’s pocket-sized Hand-Book to its supply table in 1862. Northern medical journals applauded it, and Smith’s contemporaries documented its wide use. Smith’s handbook explained and demonstrated surgical techniques that were adopted as the war progressed, such as the use of general anesthesia and limb-sparing resection (debridement) of gunshot wounds. It offered pithy, well-documented advice from recognized experts along with numerous illustrations, which allowed untrained physicians to visualize anatomical relationships and see contemporary best practices in a way that no other wartime publication provided, making it an exemplar of a mass-media surgical improvement change agent.http://journals.lww.com/10.1097/AS9.0000000000000419
spellingShingle John M. Harris, Jr., MD
The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
Annals of Surgery Open
title The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
title_full The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
title_fullStr The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
title_full_unstemmed The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
title_short The Union Army’s Surgical Handbook and the Positive Story of Civil War Surgery
title_sort union army s surgical handbook and the positive story of civil war surgery
url http://journals.lww.com/10.1097/AS9.0000000000000419
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