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Moments in Surgical History |

The Medical and Surgical History of the War of the Rebellion, 1861-1865

Ira M. Rutkow, MD, MPH, DrPH
Arch Surg. 1998;133(7):783. doi:10-1001/pubs.Arch Surg.-ISSN-0004-0010-133-7-ssh0798.
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Of the numerous contributions to American health care that developed out of the horrors of the Civil War, one of the most significant, but least appreciated, was the accumulation of untold clinical records and detailed medical and surgical reports. For the first time in the history of the world, a complete profile of wartime medical activities was available for professional purview. The largest assemblage of these chronicles were published during a 2-decade period (1870-1888) as the 6-volume Medical and Surgical History of the War of the Rebellion, 1861-1865. Considered among the most remarkable works ever composed on military medicine and surgery, the text itself has been described accurately as the country's earliest comprehensive medical monograph. Containing thousands of pages of densely printed type, the 3 medical and 3 surgical volumes present a detailed overview of the health care conditions encountered by the Civil War physician/surgeon and his patients. As a statistical reservoir it is unmatched while its extensive discussions of clinical minutiae highlight the viewpoint of the technical medical mind of the mid 19th century.

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CPT Robert Stolpe of the 29th New York Volunteers was wounded by a musket ball on May 2, 1863, at Chancellorsville, Va. The shot pierced his thoracic cavity, fracturing the ninth rib, and without injuring the pulmonary parenchyma passed through the diaphragm and entered an unknown portion of his alimentary canal. The captain walked 1½ miles to a field hospital, where surgeons unsuccessfully attempted to reduce a herniated lung. The next day, CPT Stolpe walked half a mile farther to the rear, where he was finally placed in a horse-drawn ambulance and brought to a base hospital. Seemingly in good health, the patient passed the musket ball in his stool on May 7th. Three days later the protruding portion of the lung was "carnified" and granulations began to appear as seen in this chromolithograph. After a 2-month furlough, the wound was found to contain a slight hernia of the lung, but the patient was pronounced healed. A 4-year follow-up showed that the hernia had increased considerably in dimension and contained not only the lung but also portions of the alimentary tract, including the stomach. By 1872, the hernia had stabilized in size, measuring 4½ in in its longest diameter. CPT Stolpe "could take food often, but not much at a time," and continued to "enjoy good health."

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