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Criminal Mischief: The Art and Science of Crime Fiction: Episode 11: Civil War “Limb Pit” and the History of Infectious Diseases

22 Jan

surgery tent

Criminal Mischief: The Art and Science of Crime Fiction Podcast:https://soundcloud.com/authorsontheair/limb-pits-and-germ-theory

Past Criminal Mischief Podcasts: http://www.dplylemd.com/criminal-mischief.html

Here in the 21st century we know a great deal about infectious diseases. We can treat bacterial infections with antibiotics, immunize people against numerous diseases, understand how viruses work, and have a huge fund of knowledge about surgical sterility and disease prevention. This was not always the case. In fact, in the history of medicine, all of this is fairly new.

During the 14th century, Europeans didn’t understand infectious diseases so when the Bubonic Plague, also known as the Black Death, struck, they had no understanding of what was going on, how to prevent it, and, more importantly, how to treat it. They were at the mercy of a bacterium that currently is easily treatable. The Black Death killed between a third and a half of the population of Europe and dramatically altered the trajectory of world history.

germ-theory-2-728

The transition from ignorance to enlightenment concerning infectious processes was a long process and involved some of the giants of medicine. Names like Ignaz Semmelweis, John Snow, Louis Pasteur, Joseph Lister, and Robert Koch. The observations of these famous scientists were ultimately distilled into Robert Koch’s famous Koch’s Postulates, which proved the Germ Theory of disease. These postulates served as the foundation for our understanding of infectious diseases, and still do today. Simply put they say:

koch_s postulates(1884)

!-If an organism is causing a disease, it must be present in those who suffer from the disease and not in those who are healthy.

2-The suspected organism must be isolated from the diseased individual and grown in culture.

3-The cultured organism must then be given to a healthy individual and reproduce the disease.

4-The organism must then be isolated from this newly diseased individual and identified.

Each of these steps is necessary to show that a particular organism causes a particular disease and is transmissible from one person to another. Basically, this is how infectious diseases work.

Unfortunately, Koch’s Postulates were not put forward until the 1880s, a couple of decades after the Civil War.

During the Civil War, almost any battlefield injury could lead to death, most often from a secondary wound infection. A gunshot to the leg, or arm, or really anywhere could become infected quite easily and this infection could spread through the entire body causing sepsis, which would ultimately lead to death. More soldiers died from infection than from their injuries. Surgeons at that time understood the danger of infections, even though they didn’t know what caused it, and had no clue how to prevent or treat them. This meant that serious limb injuries were treated with amputation. Get rid of the injured limb and hopefully lessen the possibility of a secondary infection. Of course, post-surgical infections were also common and also lead to death.

Not only were sterile techniques and antibiotics unavailable at that time, but also any form of anesthesia was not to be found on most battlefields. Ether was around, having been first demonstrated by William T. G. Morton in 1846, but it’s use and availability wasn’t widespread. This means that a battlefield surgeon’s best skill was speed. Sort of the surgical equivalent of “ripping off the Band-Aid.” Any surgery was agony and the quicker it was done, and the sooner it was over, the better for the victim. And the amputated limbs piled up.

It seems that Virginia’s Manassas National Battlefield Park has yielded what can only be called a “limb pit.” It is a place where surgeons deposited removed limbs. This discovery underlines the state of surgical treatment and its brutal nature during the 1860s.

http://www.newser.com/story/260874/first-civil-war-limb-pit-is-excavated.html

Germ Theory: https://en.wikipedia.org/wiki/Germ_theory_of_disease

Koch’s Postulates: https://en.wikipedia.org/wiki/Koch%27s_postulates

Joseph Lister: https://en.wikipedia.org/wiki/Joseph_Lister

Ignaz Semmelseis: https://en.wikipedia.org/wiki/Ignaz_Semmelweis

John Snow: https://en.wikipedia.org/wiki/John_Snow

Louis Pasteur: https://en.wikipedia.org/wiki/Louis_Pasteur

William T.G. Morton: https://en.wikipedia.org/wiki/William_T._G._Morton

History of General Anesthesia: https://en.wikipedia.org/wiki/History_of_general_anesthesia

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3 responses to “Criminal Mischief: The Art and Science of Crime Fiction: Episode 11: Civil War “Limb Pit” and the History of Infectious Diseases

  1. Chris Norbury

    January 22, 2019 at 12:25 pm

    Interesting post. I got hooked on the Civil War as a kid and was always shocked at the idea of sawing off a limb so readily, but I do remember reading about the primitive medical treatments that were available at the time. I often wondered if the Civil War would have turned out differently if it had been fought in the 1960s instead of the 1860s–with all else being the same as in 1860. Certainly less loss of life, but would the South have had a better chance to win since they were undermanned in nearly all battles? They certainly had the better generals and superior fighters.

    Chris

    Like

     
  2. excessivelyperky

    February 3, 2019 at 10:00 pm

    Don’t forget Rudolph Virchow, who once suggested a duel with sausages, one with botulism, and one without, to make his point. (Note that the offended party suddenly remembered his root canal appointment and backed down).

    Like

     
    • D.P. Lyle, MD

      February 4, 2019 at 7:17 am

      Reply–I would rather have the root canal, too.

      Like

       

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