In praise of anesthesia: Two case studies of pain and suffering during major surgical procedures with and without anesthesia in the United States Civil War-1861-65

摘要

Background: The United States Civil War (1861-1865) pitted the more populous industrialized North (Union) against the mainly agricultural slave-holding South (Confederacy). This conflict cost an enormous number of lives, with recent estimates me'ntioning a total mortality greater than 700,000 combatants [1]. Although sulfuric ether (ETH) and chloroform (CHL) were available since Morton's use of the former in 1846 and the employment of the latter in 1847, and even though inhalational agents were used in Crimean war (1853-1856) and the Mexican-American War (1846-1848), the United States Civil War gave military surgeons on both sides the opportunity to experience the use of these two agents because of the large number of casualties.Methods: Research of historic archives illustrates the dramatic control of surgical pain made possible with introduction of two general anesthetic and analgesic drugs in 1846 and 1847.Results: An appreciation of the importance of anesthesia during surgical procedures can be noted in the poignant and at times hair raising cases of two left arm amputations carried out under appalling circumstances during the United States Civil War. In the first-case the amputation was delayed for nearly five days after the wounding of Private Winchell who served in an elite sharpshooter brigade and was captured by the Confederate Army during battle. The amputation was performed without anesthesia and the voice of the Private himself narrates his dreadful experience. The postoperative course was incredible as he received no analgesia and survived a delirious comatose state lying on the ground in the intense summer heat.