Better preventive health in ACW

[Derek Jackson]

As I understand it deaths from disease overwhelmingly outnumbered actual combat deaths in the American Civil War.

Could anything have happened to drastically reduce those deaths?

If so what would be the consequences?

 

[David S Poepoe]

Widespread earlier acceptance of the work of Ignaz Semmelweis and Joseph Lister.

 

[Bob D]

No Andersonville and no Fort Douglas.

Or at least have more suitable conditions in those two places.

 

[carlton_bach]

Infection would have been fairly easy at this point if the innovations had been adopted wholesale. The drop once the basic antiseptic procedures were in place was staggering.

But disease - as opposed to wound infection - would be much harder. Some hygienic procedure could have been improved, but I think the biggest single effect could have been created by rigorously enforcing the measures that were already understood. The problem here is, of course, that many things you can do to reduce the risk of disease also reduce the fighting effectiveness of troops (heatable tents and a sufficient supply of fuel reduces respiratory infection, but cuts down on ammunition and marching distances, sufficient varied food increases overall immune status, but reduces the tooth to tail ratio etc.)

Obviously, the CS Army would have immeasurably benefited from clothes, shoes and food period.

 

[67th Tigers]

Obviously, the CS Army would have immeasurably benefited from clothes, shoes and food period.

The Union Army too. The commisariat was woeful in their duty of care, failing to pay men (sometimes for over a year!), and supply boots and clothes to replace old ones. Lonn reckons these are the major factor in absenteeism in both armies. As early as summer 62 half the men enlisted in the Union Army had deserted.

 

[State of Norrissippi]

Not to mention a greater confidence in the medical services by the frontline. Most doctors, surgeons and 'medics' of back then were very poorly trained or completely ignorant of the medical practice. Sort of just 'well my daddy was a pretty good healer-' 'You're in!' and so had to use a lot of 'common sense' to help the poor souls. So if you were on the front line and got a shot anywhere crucial, you were as sure as dead. So to improve the medical services:

-a greater number of experienced doctors and surgeons (for rural areas this would be hard because a lot of towns and villages only had one doctor to rely on)

-a greater number of experienced 'medics'. For a week after First Manassas you had wounded still unattended on the battlefield and this was repeated constantly. Most of these guys didn't understand that it was essential to treat the wound ASAP and just took them back to the tents to die or the long bumpy road to Richmond/Washington.

-More hospitals. Except for some truly magnificent hospitals in some places (CS I know had huge ones in Atlanta and Richmond that were excellent by 1860's standards: heating, food, etc.). Authorities usually largely underestimated battle casaulties: in Washington '64 wounded Yankees were found lying in the streets, bars and even Congress because the hospitals couldn't cope. More staff at these hospitals too: most had only 1 doctor and a dozen nurses to care for 1000's.

-more proper tools, equipment and medicine. Alot of surgeons followed 'common sense' and home remedies when renowned medicine and treatments ran out. A better knowledge of cleanliness would drastically reduce deaths.

-better food, more of it and better cooking knowledge. Early in the war alot of soldiers had heaps of food - but didn't know how to cook it properly, most suffering from food poisoning. As the war dragged on, the men got wiser but the food got worse. The US had HEAPS of food...but it was mainly just pickled pork, hardtack, bacon and coffee. This bland diet with no vitamins or healthy stuff made soldiers weaker and have a greater chance of infection. (In Georgia '64 there were often battles just for berry bushes such was the crave for better food).


So what would this mean? You probably wouldn't have the insane 1/4 dead to disease rate. More vigorous armies, a greater confidence in those behind the line perhaps. Armies may become slower in the first years of the war (some POD's there maybe) but by the grinding years of late 63-65 this wouldn't have been a problem. Maybe the best thing to come out of it would be not as many good young men dying and a greater start for medical services for wars in the 20th century.

 

[alt_historian]

Infection would have been fairly easy at this point if the innovations had been adopted wholesale. The drop once the basic antiseptic procedures were in place was staggering.

But disease - as opposed to wound infection - would be much harder. Some hygienic procedure could have been improved, but I think the biggest single effect could have been created by rigorously enforcing the measures that were already understood. The problem here is, of course, that many things you can do to reduce the risk of disease also reduce the fighting effectiveness of troops (heatable tents and a sufficient supply of fuel reduces respiratory infection, but cuts down on ammunition and marching distances, sufficient varied food increases overall immune status, but reduces the tooth to tail ratio etc.)

Obviously, the CS Army would have immeasurably benefited from clothes, shoes and food period.

"Tooth to tail"?

 

[ZaphodBeeblebrox]

"Tooth to tail"?

Soldiers Actually in The Fighting, vs. The Service Corps ...

WWII was Probably The Low Point for that Ratio ...

Armed Forces Today are Generally Pretty Self-Sufficient, at Least in The Short-Term, Anyway!

 

[Johnrankins]

Infection would have been fairly easy at this point if the innovations had been adopted wholesale. The drop once the basic antiseptic procedures were in place was staggering.

But disease - as opposed to wound infection - would be much harder. Some hygienic procedure could have been improved, but I think the biggest single effect could have been created by rigorously enforcing the measures that were already understood. The problem here is, of course, that many things you can do to reduce the risk of disease also reduce the fighting effectiveness of troops (heatable tents and a sufficient supply of fuel reduces respiratory infection, but cuts down on ammunition and marching distances, sufficient varied food increases overall immune status, but reduces the tooth to tail ratio etc.)

Obviously, the CS Army would have immeasurably benefited from clothes, shoes and food period.

The CSA didn't have enough clothes, shoes and food. Unless you hand wave that away the Confederacy can't do a damn thing about it.

 

[MrP]

The CSA didn't have enough clothes, shoes and food. Unless you hand wave that away the Confederacy can't do a damn thing about it.

IIRC, someone's mentioned before that at one point N Carolina was holding a stock of about 40,000 shoes, which it never released to the Confederate government.

 

[67th Tigers]

IIRC, someone's mentioned before that at one point N Carolina was holding a stock of about 40,000 shoes, which it never released to the Confederate government.

The same happened in the North. States had large surpluses of materials, and used them to equip new regiments. However, the Federal government had shortages of shoes, uniforms etc., and so couldn't replace worn out uniforms etc.

Lonn points to it as a major source of desertion (along with the lack of pay).

The individual states did quite good jobs of raising units, but they cut them free afterwards as the Federal governments responsibility. The one exception is Wisconsin, who continued to support and reinforce existing regiments in Federal service. The upshot was that Wisconsin seems to have raised fewer regiments than would be expected, but as Sherman's memoirs put it, each Wisconsin Regiment was the size of a Brigade (by 1864, the Bayonet strength of a Brigade was about 8-900)

 

[Johnrankins]

IIRC, someone's mentioned before that at one point N Carolina was holding a stock of about 40,000 shoes, which it never released to the Confederate government.

Considering the size of the armies and how fast shoes wore out, it would have helped some but it wasn't enough by itself.

 

[Paul Spring]

The same happened in the North. States had large surpluses of materials, and used them to equip new regiments. However, the Federal government had shortages of shoes, uniforms etc., and so couldn't replace worn out uniforms etc.

Lonn points to it as a major source of desertion (along with the lack of pay).

The individual states did quite good jobs of raising units, but they cut them free afterwards as the Federal governments responsibility. The one exception is Wisconsin, who continued to support and reinforce existing regiments in Federal service. The upshot was that Wisconsin seems to have raised fewer regiments than would be expected, but as Sherman's memoirs put it, each Wisconsin Regiment was the size of a Brigade (by 1864, the Bayonet strength of a Brigade was about 8-900)

Yes - most of the northern states followed the practice of putting most or all new recruits (or conscripts later in the war) in new regiments, while letting their older veteran regiments gradually dwindle away without receiving new men. This resulted in new regiments of almost 1000 men, but without experience, while there were veteran regiments of only 150 or 200 (in a few cases, less than 100). The general consensus is that the system followed by the confederate states (and apparently Wisconsin) was much better - send new recruits to join existing regiments so that they can keep the regiments at decent strength while serving along with veterans.

 

[Fellatio Nelson]

You'd probably need early widespread vaccination against cholera, typhus etc.

Re. casualties: You'd still have the dangers posed by battlefield wounds becoming infected with dirt, clothing scraps and other debris. Especially if the fighting took place in agricultural land. IIRC, antiseptic was liberally applied during WW1 to such injuries and in many cases proved little better - or even worse - than simple debridement and washing the wound before suturing. Even then, infections could flare up years later and prove fatal.

 

[Thande]

You'd probably need early widespread vaccination against cholera, typhus etc.

Unfortunately, I don't think that's feasible. OTL even the first (and not very effective) vaccine against typhus took several German chemical advances in the 1890s, and the improvements in sanitation that did for cholera won't affect an army in the field.

 

[alephh]

Considering the size of the armies and how fast shoes wore out, it would have helped some but it wasn't enough by itself.

Smaller armies ;-D

It would have been easier to supply and upkeep smaller armies, they may have been more mobile and more hygienic.

_

 

[Prinz Richard Eugen]

Less deaths from disease might have ben possible if the best medical practices, along with proper food and clothing had all been available. But there will always be problems when large groups of people from diverse areas get together. One group carries a couple of diseases while the next group carries another few. And the natural protection of one group against their disease strains will not protect the other group.

But the death and dehabilitation rate could have been reduced. If this occurs from the beginning, it would mean larger armies and more casualties when they did fight. This would place more strain on the supply services and the medical staffs. And what side had more problems with supply and obtaining medicines? The Union, able to supply almost all items better, could support these larger forces. The South would face even greater odds and I foresee a swifter Union victory.

 

[State of Norrissippi]

The CSA didn't have enough clothes, shoes and food. Unless you hand wave that away the Confederacy can't do a damn thing about it.

This report of the Confederate quartermasters and sometimes the superabundance of clothing in the Confederate army.

 

[M79]

Germ theory was not widley accepted until later and people still dumped their biological refuse into the same places they drank from. Medicine was still in the 18th century in many respects though the weaponry was advancing into the 20th century. Effective antibiotics or even WWI medicine/increased basic sanitation would have saved countless amuptations, but remember that many people used to avoid the hospital because they feared the sick people there might only make them worse.

 

[Johnrankins]

Germ theory was not widley accepted until later and people still dumped their biological refuse into the same places they drank from. Medicine was still in the 18th century in many respects though the weaponry was advancing into the 20th century. Effective antibiotics or even WWI medicine/increased basic sanitation would have saved countless amuptations, but remember that many people used to avoid the hospital because they feared the sick people there might only make them worse.

For very good reasons.