Learning from the Wounded: The Civil War and the Rise of American Medical Science Shauna Devine. University of North Carolina Press, 2014.

Learning from the Wounded: The Civil War and the Rise of American Medical Science Shauna Devine. University of North Carolina Press, 2014.Learning from the Wounded: The Civil War and the Rise of American Medical Science, by Shauna Devine, is a must-read for anyone interested in the American Civil War and the birth of modern medicine in the United States. I was especially interested in reading this book as I have colleagues who are specialists in the history of medicine during this era. As a matter of fact, during the summer of 2015, these colleagues and I visited the National Museum of Health and Medicine (NMHM) during a conference held in Washington, DC. [I encourage everyone interested in this subject to visit the museum as well.] Using primary sources from NMHM, Dixon traces how the medical profession in general and medical education in particular in the US evolved as a result of the challenges presented in treating the vast numbers of men wounded in battle or the even larger numbers falling victim to the diseases that ran rampart through both field and military hospitals.In her introduction, Devine describes the American medical profession prior to the Civil War. Practitioners had vastly different training experiences. The "elite" few attended medical schools, and many studied abroad in order to further their knowledge of diagnosis and treatment with real patients in hospitals using "stethoscopes and other medical equipment" (4). However, many practitioners, especially in rural areas, learned their profession by apprenticing to someone; these people had little or no formal training. This was the state of medicine at the start of the war.Chapter One describes how and why the "Union Medical Department was ill-prepared when the Confederate batteries fired on Fort Sumter.... The first major challenge... was finding a way to both understand and control the considerable amount of illness" (13) in the new hospitals and training camps. Many practitioners noted that large numbers of men were dying due to the lack of education and training among medical staff and the lack of knowledge about the wounds and/or diseases that were running rampant through the ranks. One important factor that contributed to changes was the appointment of William Hammond to surgeon general of the US Army. Hammond used his appointment to affect changes by "formal restructuring of the medical department; the development of a national military hospital system; the creation of chemical laboratories; improved record keeping; the hiring of female nurses, storekeepers, washerwomen, and medical cadets to meet the demands of the war; and the introduction of specialty hospitals" (15). Hammond also issued Circular No. 2 which led to the establishment of the Army Medical Museum. Physicians were encouraged to submit specimens and case notes on injuries and diseases resulting in death or disability. These specimens could then be used for teaching and training purposes (and indeed many are still available for study at the NMHH).In Chapter Two, Devine examines the state of medicine prior to the war, noting that "knowledge of anatomy was the hallmark of a well-trained physician in 1860" (53). However, it became increasingly clear that such knowledge would be of little help in treating the wounded and in keeping them alive. Concern for patients' suffering led to the development of new medical techniques, including the standardization of specimen collection and the preservation as well as the use of photomicrography to record results. These specimens could then aid in training the next generation of physicians and in contributing to the well-being of their future patients. …