One of the volumes I studied a few years back, to help me get a better sense of 19th century medicine, was a field surgery training booklet written near the start of the Civil War. Hostilities had seemed imminent for some time, and the Army must have thought it was staying ahead of the curve by compiling some tips from the experts. Several versions of such manuals were printed for Union surgeons, and a few with a slightly Southern flavor were produced for the Confederacy.
The Civil War not only racked up a staggering death toll, its a tally that continues to climb. Historians long accepted two-thirds of a million as a roughly accurate measure of Civil War deaths, but have recently suggested that the true figure might be closer to three-quarters of a million. It was no secret to military surgeons of the day that bullets and bayonets had always been much less deadly than everyday life in an army camp. Perhaps only a third of all deaths resulted from battlefield wounds. The bulk stemmed from common diseases, haphazard sanitation, and poor diet. Thus, it was heartening to see the training booklet open, sensibly enough, with a chapter on the importance of hygiene.
I had read only the first page before I frowned and began to flip through the rest. It was immediately clear that by "hygiene," the author meant something other than hand-washing, frequent laundering, and adequate sewerage. While he did want the boys in blue to keep their uniforms tidy, he seemed to be much less concerned with clean linens than with tucked-in shirttails. Seeing the men lounging about in those woolen coats with a few buttonholes left open was a sure harbinger of storm clouds on the horizon. Playing card games or tossing dice was to be avoided, along with chewing tobacco, and, above all else, using foul language.
Since more deaths occurred during periods of inactivity than in actual battles, it surely could not hurt to go looking for a scrap when things were slow. Marching, throwing up redoubts, chopping wood, parading, and storming enemy lines all were preferable to those deadly twins, indolence and sloth.
While I did not make a survey of such manuals, I found the first one to be a sharp contrast to one I leafed through later, an 1863 publication from Richmond. This one was rich with details, percentages of men who had been lost to, say, typhoid vs. dysentery and, what diets and procedures had been found effective in minimizing both. It was wisdom that had been won in the War with Mexico and the more recent and much deadlier international conflict in the Crimean peninsula.
Americans showed a keen interest in the bloodbath in the southern Ukraine, where as many as a million had died during the war, mostly from starvation and disease. An American delegation visiting Crimean battlefields at the end of the conflict produced a report in 1861 that might have served as a playbook for the American Civil War, or at least a preview of what was about to happen on American soil. The Crimean War began a few years after the invention of the Minié rifle, and the powerful, large-caliber weapon demonstrated its bone-shattering effectiveness on Crimean battlefields. When new French ironclad vessels steamed up close to level a Russian fort at Kinburn, the navies of the world took notice, and the world had a ringside seat to the action, because this was also the first media war.
Dispatches were conveyed by electric telegraphy. Images of soldiers and army camps were captured by photographer Roger Fenton and others, and press reports were filed by William Howard Russell, who is sometimes known as the first war correspondent. The one incident from the Crimean War most of us can cite, “The Charge of the Light Brigade,” at Balaclava, may have been immortalized by Tennyson’s poem, but only because Russell’s thrilling eyewitness report had made it front-page news.
Yet, despite the lessons of Crimea, in 1861 there were still a few starry-eyed optimists who believed that if the young men in uniform would only abstain from games of chance and swearing, avoid intoxicating liquors and chewing tobacco, and keep their coats properly buttoned, casualty figures could be kept low and the American Civil War might be brought to a swift end.