[ Years of Change and Suffering: Modern Perspectives on Civil War Medicine edited by James M. Schmidt and Guy R. Hasegawa (Edinborough Press, 2009). Photos, drawings, notes, bibliography, index. 192 pages.]
It's a shame that the general reading public's perception of Civil War surgeons as callous incompetents will probably never change, no matter how many quality corrective volumes have been or will be published. One of these is Years of Change and Suffering (with contributors James M. Schmidt and Guy Hasegawa also serving as general editors), a useful and very readable collection of original essays covering a variety of important figures and topics associated with Civil War medicine.
With a single exception, the articles, all well documented scholarly essays, are written by physicians and/or scientists. It's quite a distinguished assemblage. The book begins with archivist Jodi Koste's 1860-1865 history of the Medical College of Virginia. She traces the institution's sudden increase in attendance and prestige, due in large part to the mass exodus of southern students from the best medical colleges of the North, as well as the many difficulties that needed to be overcome in order for the school to remain in operation during the war years. Co-editor James Schmidt drew his article from the pages of Scientific American magazine, a rather underappreciated publication that both advocated scientific progress in general and directly advised the fighting man in the field.
Perhaps no Civil War medicine book goes to publication without an article of some sort dealing with amputations, and Alfred Jay Bollet's brief essay demonstrates that the reputation Civil War surgeons had and have for a cavalier attitude toward the sawing off of injured limbs is substantially undeserved. Retrospective research has shown that Union and Confederate amputation operations were significantly more successful in terms of death rates than those performed during foreign conflicts immediately before and after the Civil War years. Also, the consensus of opinion appears (then and now) to be that surgeons actually tended to adopt too much of a conservative approach when it came to amputation, attempting to save limbs that should have been removed immediately in order to provide the best chance for patient survival.
F. Terry Hambrecht's article is a biographical summary of the life and career of Charlestonian physician and innovator J.J. Chisolm. Chisolm was a skilled hospital organizer and medical purveyor. He prepared an immensely influential surgical manual for Confederate surgeons, and also designed medical equipment. It's a fine sketch of the professional life of a major figure in Confederate medicine.
In my mind, the most fascinating contribution is Harry Herr's detailed examination of the wartime diagnosis and treatment of urological wounds (i.e. penetrating injuries to the bladder, ureters, urethra, penis, and testes). By focusing on a single, and difficult, category of injury, the essay serves as a wonderful illustration of a level of anatomical knowledge, diagnostic acumen, ingenuity of equipment design, and practical treatment methodology on the part of Civil War physicians that would surprise most Civil War readers. The precision of the language in the case reports reproduced in the article is very comparable to that found in current documentation in the modern hospital setting.
Co-editor Guy Hasegawa's article investigates the collection and processing of southern natural resources in the production of medicines. Following that, the foundations of the field of neurology are traced by D.J. Canale, with an emphasis on the efforts of a talented triad of physicians (S. Weir Mitchell, George R. Morehouse, and W.W. Keen) to identify and treat the consequences to the nervous system of gunshot wounds. The final chapter is Judith Andersen's look at the psychological consequences of sustained combat.
A number of typos crept their way into the text, but there is precious little else that would give cause for complaint. Containing scholarly essays that explore in some depth a mixture of general and specialized medical and scientific topics (yet can be for the most part readily comprehended by a general reading audience), Years of Change and Suffering is a highly recommended contribution to the effort at furthering a more accurate popular reassessment of Civil War medicine.