There is one word that can best describe the surgical procedure most used during the Civil War – amputation. Some surgeons tried to preserve limbs by resection, but amputation was the preferred method. Since the Civil War some historians, educators and others have complained vehemently about the overuse of the “knife.” Butchers, savages, drunken boy surgeons, and many more, were some of the words used to describe and rail against Civil War surgeons. The soldiers also held a low opinion of surgeons, one stating: “it has ever been my opinion that a man is no better than a dead man when placed under the hands of almost any of our surgeons.” Battlefield nurses even chimed in, “it grieves me to think of how many men are ruined for life by surgeons who with savage glee hurry to chop off arms, legs, ad libitum, who might by a slower and more skillful process have been saved such humiliation.” Others have referred to the surgeons as murderers and drunken murderers. Not so fast! It could be argued that the conditions of war demanded simple surgical procedures. A surgeons work needed to be without complications, since the majority of them had little or no medical training.
Amputation was a simple answer. It was fast and uncomplicated, taking less than ten minutes to remove a limb and it required only a few instruments. The knives and saws were tools that were familiar even to the untrained. The medical corps were overwhelmed, sometimes facing as many as 35,000 casualties in one battle. Additionally, even if the surgeon tried to save a limb, instead of amputating, it would have been very risky. Let’s remember that antibiotics did not exist at that time and conservative surgery would have increased the chance of infection and the patient would certainly die.
Battlefield surgeons also had to consider the time element. Conservative surgery would have taken far longer than ten minutes. Decisions were made quickly. Most successful surgeries were performed within 24 hours of the wounding. The last to be seen were usually those shot in the head, chest, or stomach and nearly always left to die. Surgeons focused on those who had a chance of surviving.
There is little doubt that many of the complaints made against Civil War surgeons were true. There were others who were good, even excellent, and continued as surgeons after the war. Despite the high number of complaints about Civil War surgeons, there was a 75% survival rate of all surgeries. The battlefield was the training ground for Civil War surgeons.