Medicine in the American Civil War In the war , both armies researched advancement in the development of battlefield recovery techniques . In the Union , a new medicinal wing was created under the jurisdiction of a “ Medical Director of the Army ” , the first field hospitals , small tents with a few tables or beds for the wounded , were developed , and a system of transport of the wounded to general hospitals was created , the first wooden ambulances which could hold up to around 4 wounded laying down , 1 or 2 medical officials , and a driver for the horses . The Confederacy advanced mainly by learning from Union camps they overtook , but generally had a less established medical service largely as a result of its more limited resources , vast rural areas , limited medicinal knowledge , and fewer medical professionals . The most common battle injuries were simple flesh wounds that led to amputations of limbs due to lack of better techniques for preventing the fatal spread of gangrene . Background . Before the Civil War , the armies tended to be small , largely because of the logistics of supply and training . Musket fire , renowned for its inaccuracy , kept casualty rates lower than they might have been . The advent of railroads , industrial production , and canned food allowed for much larger armies , and the Minié ball rifle brought about much higher casualty rates . The work of Florence Nightingale in the Crimean War brought the deplorable situation of military hospitals to the public attention , although reforms were often slow in coming . Union . The hygiene of the camps was poor , especially at the beginning of the war when men who had seldom been far from home were brought together for training with thousands of strangers . First came epidemics of the childhood diseases of chicken pox , mumps , whooping cough , and , especially , measles . Operations in the South meant a dangerous and new disease environment , bringing diarrhea , dysentery , typhoid fever , and malaria . There were no antibiotics , so the surgeons prescribed coffee , whiskey , and quinine . Harsh weather , bad water , inadequate shelter in winter quarters , poor policing of camps and dirty camp hospitals took their toll . This was a common scenario in wars from time immemorial , and conditions faced by the Confederate army were even worse . When the war began , there were no plans in place to treat wounded or sick Union soldiers . After the Battle of Bull Run , the United States government took possession of several private hospitals in Washington , D . C . , Alexandria , Virginia , and surrounding towns . Union commanders believed the war would be short and there would be no need create a long standing source of care for the armies medical needs . This view changed after the appointment of General George B . McClellan and the organization of the Army of the Potomac . McClellan appointed the first medical director of the army , surgeon Charles S . Tripler , on August 12 , 1861 . Tripler created plans to enlist regimental surgeons to travel with armies in the field , and the creation of general hospitals for the badly wounded to be taken to for recovery and further treatment . To implement the plan , orders were issued on May 25 that each regiment must recruit one surgeon and one assistant surgeon to serve before they could be deployed for duty . These men served in the initial makeshift regimental hospitals . In 1862 William A . Hammond became surgeon general and launched a series of reforms . He founded the Army Medical Museum , and had plans for a hospital and a medical school in Washington ; a central laboratory for chemical and pharmaceutical preparations was created ; much more extensive recording was required from the hospitals and the surgeons . Hammond raised the requirements for admission into the Army Medical Corps . The number of hospitals was greatly increased and he paid close attention to aeration . New surgeons were promoted to serving at the brigade level with the rank of Major . The Surgeon Majors were assigned staffs and were charged with overseeing a new brigade level hospital that could serve as an intermediary level between the regimental and general hospitals . Surgeon Majors were also charged with ensuring that regimental surgeons were in compliance with the orders issued by the Medical Director of the Army . In the Union skilled , well - funded medical organizers took proactive action , especially in the much enlarged United States Army Medical Department , and the United States Sanitary Commission , a new private agency . Numerous other new agencies also targeted the medical and morale needs of soldiers , including the United States Christian Commission as well as smaller private agencies such as the Women ' s Central Association of Relief for Sick and Wounded in the Army ( WCAR ) founded in 1861 by Henry Whitney Bellows , and Dorothea Dix . Systematic funding appeals raised public consciousness , as well as millions of dollars . Many thousands of volunteers worked in the hospitals and rest homes , most famously poet Walt Whitman . Frederick Law Olmstead , a famous landscape architect , was the highly efficient executive director of the Sanitary Commission . States could use their own tax money to support their troops as Ohio did . Following the unexpected carnage at the battle of Shiloh in April 1862 , the Ohio state government sent 3 steamboats to the scene as floating hospitals with doctors , nurses and medical supplies . The state fleet expanded to eleven hospital ships . The state also set up 12 local offices in main transportation nodes to help Ohio soldiers moving back and forth . Field hospitals were initially in the open air , with tent hospitals that could hold only six patients first being used in 1862 ; after many major battles the injured had to receive their care in the open . As the war progressed , nurses were enlisted , generally two per regiment . In the general hospitals one nurse was employed for about every ten patients . The first permanent general hospitals were ordered constructed during December 1861 in the major hubs of military activity in the eastern and western United States . An elaborate system of ferrying wounded and sick soldiers from the brigade hospitals to the general hospitals was set up . At first the system proved to be insufficient and many soldiers were dying in mobile hospitals at the front and could not be transported to the general hospitals for needed care . The situation became apparent to military leaders in the Peninsular Campaign in June 1862 when several thousand soldiers died for lack of medical treatment . Dr . Jonathan Letterman was appointed to succeed Tripler as the second Medical Director of the Army in 1862 and completed the process of putting together a new ambulance corps . Each regiment was assigned two wagons , one carrying medical supplies , and a second to serve as a transport for wounded soldiers . The ambulance corps was placed under the command of Surgeon Majors of the various brigades . In August 1863 the number of transport wagons was increased to three per regiment . Union medical care improved dramatically during 1862 . By the end of the year each regiment was being regularly supplied with a standard set of medical supplies included medical books , supplies of medicine , small hospital furniture like bed - pans , containers for mixing medicines , spoons , vials , bedding , lanterns , and numerous other implements . A new layer of medical treatment was added in January 1863 . A division level hospital was established under the command of a Surgeon - in - Chief . The new divisional hospitals took over the role of the brigade hospitals as a rendezvous point for transports to the general hospitals . The wagons transported the wounded to nearby railroad depots where they could be quickly transported to the general hospitals at the military supply hubs . The divisional hospitals were given large staffs , nurses , cooks , several doctors , and large tents to accommodate up to one hundred soldiers each . The new division hospitals began keeping detailed medical records of patients . The divisional hospitals were established at a safe distance from battlefields where patients could be safely helped after transport from the regimental or brigade hospitals . Although the divisional hospitals were placed in safe locations , because of their size they could not be quickly packed in the event of a retreat . Several divisional hospitals were lost to Confederates during the war , but in almost all occasions their patients and doctors were immediately paroled if they would swear to no longer bear arms in the conflict . On a few occasions , the hospitals and patients were held several days and exchanged for Confederate prisoners of war . The U . S . Army learned many lessons and in 1886 , it established the Hospital Corps . The Sanitary Commission collected enormous amounts of statistical data , and opened up the problems of storing information for fast access and mechanically searching for data patterns . Confederacy . The Confederacy was quicker to authorize the establishment of a medical corps than the Union , but the Confederate medical corp was at a considerable disadvantage throughout the war primarily due to the lesser resources of the Confederate government . A Medical Department was created with the initial army structure by the provisional Confederate government on February 26 , 1861 . President Jefferson Davis appointed David C . DeLeon Surgeon General . Although a leadership for a medical corp was created , an error by the copyist in the creation of the military regulations of the Confederacy omitted the section for medical officers , and none were mustered into their initial regiments . Many physicians enlisted in the army as privates , and when the error was discovered in April , many of the physicians were pressed into serving as regimental surgeons . DeLeon had little experience with military medicine , and he and his staff of twenty - five began creating plans to implement army - wide medical standards . The Confederate government appropriated money to purchase hospitals to serve the army , and the development of field services began after the First Battle of Manassas . The early hospitals were quickly overrun by wounded , and hundreds had to be sent by train to other southern cities for care following the battle . As a result of the poor planning , Davis demoted DeLeon and replaced him with Samuel Preston Moore . Moore had more experience than DeLeon and quickly moved to speed the implementation of medical standards . Because many of the surgeons in the regiments had been pressed into service , some were not qualified to be surgeons . Moore began reviewing the surgeons and replacing those found to be inadequate for their duties . Initially the Confederacy employed a policy of furloughing wounded soldiers to return home for recovery . This was a result of their lack of field hospitals and limited capacity in their general hospitals . In August 1861 , the army began the construction of new larger hospitals in several southern cities and the furloughing policy was gradually halted . The earliest recruits for surgeons were required to bring their own supplies , a practice that was ended during 1862 . The government began providing each regiment with a pack with medical supplies including medicines and surgical instruments . The Confederacy , however , had limited access to medicinal supplies and relied on their blockade - running ships to import needed medicines from Europe , supplies captured from the North or traded with the North through Memphis . Anesthetics were not in as short supply as medical instruments , something highly prized . Field hospitals were set up at the regimental level and located in an open area behind the lines of battle and staffed by two surgeons , one being senior . It was the responsibility of the regimental surgeons to determine which soldiers could return to duty and which should be sent to the general hospitals . There were no intermediary hospitals , and each regiment was responsible for transporting its wounded to the nearest rail depot , where the injured were transported to the general hospitals for longer term care . In some of the lengthier battles , buildings were seized to serve as a temporary secondary hospital at a divisional level where the severely wounded could be held . The secondary facilities were staffed by the regimental surgeons , who pooled their resources to care for the wounded and were oversaw by a divisional surgeon . Care . The most common battlefield injury was being wounded by enemy fire . Unless the wounds were minor , this often led to amputation of limbs to prevent infection from setting in ; anti - biotics had not yet been discovered . Amputations had to be made at the point where the wound occurred , often leaving men with stub limbs . Skin was taken from the amputated limb to cover the wound and stitched to the stump . Men were generally partially sedated with chloroform or alcohol before surgeries . When properly done , the patient would feel no pain during their surgery , but would not be totally unconscious . Stonewall Jackson , for example , recalled the sound of the saw cutting through the bone of his arm , but recalled no pain . Infection was the most common cause of death of injured soldiers . It has been said that the American Civil War was the first " modern war " in terms of technology and lethality of weapons , but that it was simultaneously fought " at the end of the medical Middle Ages . " Very little was known about the causes of disease , and so a minor wound could easily become infected and take a life . Battlefield surgeons were under qualified and hospitals were generally poorly supplied and staffed . The most common battlefield operation was amputation . If a soldier was badly wounded in the arm or leg , amputation was usually the only solution . Surprisingly , about 75 % of amputees survived the operation . Contrary to popular belief , few soldiers experienced amputation without any anesthetic . Heavy doses of chloroform were administered ; in fact , a few soldiers died of chloroform poisoning , rather than their wounds . If a wound produced pus , it was thought that it meant the wound was healing , when in fact it meant the injury was infected . Roughly three in five Union casualties and two in three Confederate casualties died of disease . Women . North and South , over 20 , 000 women volunteered to work in hospitals , usually in nursing care . They assisted surgeons during procedures , gave medicines , supervised the feedings and cleaned the bedding and clothes . They gave good cheer , wrote letters the men dictated , and comforted the dying . The Union Army nurse superintendent was Dorothea Lynde Dix , while Clara Barton , Mary Livermore , Mary Ann Bickerdyke , and Annie Wittenmeyer played leadership roles . Aftermath . Based on their experiences in the war , many veterans went on to develop high standards for medical care and new medicines . The modern pharmaceutical industry began developing in the decades after the war . Colonel Eli Lilly had been a pharmacist ; he built a pharmaceutical empire after the war . Clara Barton founded the American Red Cross to provide civilian nursing services in wartime .