Battlefield Heroism and Cringeworthy 1800s Medical Treatment
Common battlefield injuries in the 18th and 19th centuries included laceration wounds from bayonets, bullet wounds from grapeshot, and shrapnel wounds from cannon fire. Sailors suffered the same kinds of wounds on ships and sometimes much worse.
Horrible Wounds
Often, the force of cannonballs hitting oak and pine wood ships produced horrible splinter wounds. Ships’ rigging, sails, and masts could fall and crush those below. The raking fire of cannon canister loads, which consisted of metal shrapnel, nails, cans, and chains was designed for the purpose of shredding sails and rigging that would disable the ship’s mobility. The flying projectiles also dismembered bodies.
Lieutenant Robert Henley was the commander of U.S. Navy ship The Eagle, with 150 officers and men, during the Battle of Plattsburgh Bay on September 11, 1814. In his account of the battle, Henley noted that by the end of the horrific fighting, the chaotic destruction had been so fierce, few of the surviving crew had clothing left on their bodies.
On another ship, the Saratoga, American Commodore Thomas MacDonough was knocked unconscious twice. Captain Downie, the Commander of the British fleet was killed when he was crushed by a cannon that had suffered a direct hit from an American cannonball.
Blood Pouring From Scuppers
Recounting the battle in the book, The Proudest Day, historian Charles Mueller wrote of the 137-foot long British ship, the Confiance, firing double cannonball loads at the American fleet:
“Directed at Saratoga principally from twenty-four-pound double-slotted British guns leveled at point-blank range and cooly sighted, almost eight hundred pounds of iron smashed into the American flagship with a blow that seemed to lift her out of the water. Saratoga writhed like a stricken whale. Splinters flew over her decks like matchwood. Shrieks and cries rose into the rigging as torn bodies fell beside their guns in pools of blood.
“From the quarterdeck, the Commodore made out nearly half his ship’s complement lying dead, wounded, stunned. He watched dazed men slowly pick themselves up. Then he counted forty wounded and dead by Confiance’s single broadside.”
“While midshipmen directed the lowering of the wounded to the cockpit, the disposal of dead away from the guns, and the remounting where possible of dismounted cannons, the Commodore saw blood pour from the gundeck’s scuppers like rain off a roof. Midshipman Montgomery brought him word of Peter Gamble, killed without a scratch while sighting a gun, dead from the force of a split quoin driven against his chest.”
The Field Hospital and Graves on Crab Island
Not far away, a surgeon worked on the wounded. We know quite a bit about first aid and medical treatment during the War of 1812 period because of accounts from Dr. James Mann, who was a heroic U.S. Army surgeon during the battle. Dr. Mann kept thorough notes published in a book about the fray that includes case studies of his patients during and after the 1814 battle. Once it was over, Mann continued to treat them in Burlington Hospital during their convalescence.
Dr. Mann had set up a field hospital a week before the Battle of Plattsburgh Bay on September 6th at Crab Island, a small island two miles from the fortifications at Plattsburgh. The island sat on the south end of the bay near the battle site on September 11th. We know from Mann’s account that he had moved 500 sick men from Plattsburgh on the nearby mainland. Eventually the tent hospital sheltered over 800 patients, most of whom were disabled with dysentery and typhoid.
Hospital tents to cover the patients and some wooden platforms had been furnished by the Army but Mann’s assistant, Doctor Purcell was sick. Many patients lay on the damp rain-soaked ground for a few nights without straw. During the battle, row galleys transported the dead, wounded, and body parts to the north end of the small island. Dr. Mann administered medicine and performed surgeries as the battle raged.
Mann recounted that during the two-hour battle, the cannon thunder and gunfire were unceasing, with over 200 cannons on the ships and more on the shore. “The whole exhibition on water and land, in addition to the uninterrupted cracks of musketry, in the forests south of the fortifications, to a spectator in full view of the fleets and batteries, was awfully grand.” (Mann)
American and British row galleys continually brought wounded and dead bodies from the ships over to the island during the two and a half-hour battle. During the battle Mann performed over 30 amputations. Of the hundreds of patients in the field hospital, 79 from Crab Island (50 wounded) were transported to the Burlington Hospital, which was located on land that is now Battery Park once the battle ended.
After the British surrender, 149 American and British seamen were buried together in unmarked shallow trenches on Crab Island, along with arms, legs, and entrails that were said to have been pulled from the water on that day.
State of the Art Surgery
Dr. Mann was trained in surgery at Harvard and had plenty of surgical experience before his tour at Plattsburgh and Burlington. He had been captured and imprisoned as a prisoner of war, and upon his release, retired from the service. He experienced a professional renaissance as a researcher, author, and subsequently was recruited back into the Army.
Unfortunately for patients, anesthesiology during surgery was not what it is today. According to historian Gillett, patients were fortified with opium and rum, with their ears filled with lambs wool to deaden the sound during amputations and other major surgeries. When opium wasn’t available, doctors prescribed alcohol to numb the pain, or gave patients lead shot balls to chew during surgery.
The surgeon’s kit included various cutting tools that ranged from a curved amputation knife to small scalpels, probes to search for an embedded shot, retractors to draw back the lips of a wound, tenaculum hook to pull an artery, surgical scissors, shot removal forceps, and a saw. Screw tourniquets were made with straps that compressed the limb to close off blood flow above the amputation site so arteries could be sutured with a curved needle and waxed shoe thread.
When limbs needed to be removed the flesh was cut to the bone and it retracted and receded. The bone was sawed squarely with care to avoid a point, using a leather strap as a guide. Once the arteries were sutured the tourniquet could be removed and the open wound covered in flour. The stump was then wrapped in bandages.
Regarding convalescence, the medical profession had not adopted aseptic techniques as of 1814. Awareness of pathogenic germs was a thing of the future so even if a surgeon’s tools were clean, they were not free of microbes. Gillet reports that tetanus was sometimes contracted following surgeries, among other infections. There was a 45% to 65% mortality rate for amputations at mid-thigh and probably a higher rate for shoulder amputees.
Stories of American Heroism
In one case, Dr. Mann produced documents describing the the heroism of Lieutenant Silas Duncan, who had been ordered to board a disabled British ship. Duncan was in the process of doing so when he was hit in the shoulder with a cannon ball, which destroyed his shoulder blade, collar bone, and the use of his arm. Once on Crab Island, Dr. Mann advised Duncan that in order to survive the mortal wound he would surely need to remove his arm.
Duncan strongly objected to an amputation, saying he would rather die than live the rest of his life without his arm. For safety, Duncan was sent to nearby Peru, NY, farther away from the battle scene, then later to the Burlington Hospital. It took 16 delirious and excruciating months and heroic perseverance for Duncan’s wounds to heal and he never regained use of his arm. Duncan, who would become a Master Commandant, continued to serve in active duty during historic Navy battles all over the world with a long Navy career until his death in 1834. The USS Duncan Navy destroyer was christened in Duncan’s honor in 1942.
In the amputation cases, Mann observed that the skin would heal around the bone with scar tissue, leaving a protruding stump of bone. Periodically, the patient was given fresh bandages, laudanum (an opiate), when available, alcohol cordials, mercury calomel as an emetic, and lead apatite as a purgative. Sometimes an infection would ensue and subsequently heal, and other times the patient would not survive.
Although in 1814 doctors didn’t sterilize instruments or use antiseptics on wounds yet, Mann observed that diseases spread more quickly in confined spaces with poor ventilation instead of isolation. He was concerned that many of the injured were in closed spaces with many others with dysentery and other diseases that seemed to be spreading in the hospital. Instead of using crowded tents and buildings to house the sick and injured, he concluded that hospitals should be large and open with high ceilings with good ventilation from west to east, to facilitate air movement.
Treating Inflammation and Fevers
Historian Dr. C. Keith Wilbur described the healing process after surgery. Following the third or fourth day after an injury to the skin, doctors would expect to see inflammation. If “laudable pus” was emitted from a wound it was seen as the body eliminating unhealthy humors from the body. This was considered a good sign.
Often the wound would become hot, swollen, and painful. Physicians believed that inflammation could be prevented if pain could be prevented. According to C. K. Wilbur, in general, sedation reduced excitability and this could be accomplished by administering opium, cooling medications, copious evacuations, and bloodletting. drugs and supplies were not always available, especially on the battlefield or field hospitals.
Unfortunately, medical supplies and equipment were often in short supply from the Revolutionary War times through the early 1800s. Although historian Mary Gillett shows bountiful lists of drugs, supplies, and instruments present at Fort Meigs in Ohio in 1812, shortages were prevalent at times in remote reaches of Vermont and New York but also with Washington’s Army at Valley Forge, Virginia.
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Gillett, Mary, The Army Medical Department 1175–1818, University Press of the Pacific, 2002.
Mann, James, Medical Sketches of the Campaigns of 1812, 13, 14: To Which Are Added, Surgical Cases, Observations on Military Hospitals, And Flying Hospitals Attached to a Moving Army, Mann & Co., 1816.
Wilbur, C.K., Revolutionary Medicine: 1700–1800, 1980, Globe Pequot Press.
