Civil War Medicine: Sound Medical Advice…Or Not

Antebellum medicine has an established reputation as being backwards and entrenched in archaic medical practices that often caused more harm than good. This is certainly true when considering “heroic medicine” and its use of blood-letting, leeches, and dangerous poisons like arsenic and mercury. However, there were some parts that early nineteenth century people did get right… or at least partially right. And those beneficial practices helped to save the lives of Civil War soldiers as women, some independently trained in domestic styles of nursing, volunteered their time and talents in the hospitals.

In her book, The Family Nurse or Companion of the American Frugal Housewife, published in 1837, Lydia Maria Child compiled a collection of tips and useful guides for housewives and mothers to combat disease and illness within their homes. In some rural communities, access to a professional physician may not have been realistic or affordable. Circuit doctors may have only come around to their community once every few weeks at best, or several months at worst. That wasn’t helpful when mothers had to nurse a child with a severe cough or a husband with a cold. Her book was intended as a “household friend, which the inexperienced may consult on common occasions, or sudden emergencies, when medical advice is either unnecessary, or cannot be obtained.”[1] In her preface, she references the assistance of other doctors and physicians whom she solicited advice or confirmation for the safety of certain procedures or medicines, sourcing them several times throughout the book.

In her first chapter covering the preservation of health, Child reinforces the idea to “Never meddle with medicines, unless some disorder of the system renders them really necessary” before continuing with some rather sound advice on how to maintain one’s health. Advice such as “Regularity in food and sleep is a great preservation of health” and “clean your teeth with a brush and cold water” is paired with common sense that we take for granted today like “if stockings and shoes get wet, change them” and “metals attract lightning.” Other pieces of advice suggests that nineteenth century Americans may have understood more than we realize. Child writes, “After exposure to severe cold, do not suddenly approach a fire, or drink hot drinks; but acquire warmth very gradually” which is the typical medical advice for those recovering from hypothermia.[2]

However, quite a bit of Child’s book leans upon the principles of heroic medicines, which suggests that the body functions on materials called “humors.” When these humors are out of balance, disease and sickness occurs. She had some of the right idea when she wrote, “Very many humors and diseases originate in a want of personal cleanliness,” which we understand as basic personal hygiene, but she missed the mark when she suggested that everyone should wash their whole bodies “at least once or twice a week,” when in reality we should bathe much more often.[3] Many of the medicines for various common illnesses are also anchored in heroic medicine, prescribing cathartic, diaphoretic, diuretic, emetic, and sudorific chemicals or herbal concoctions to induce vomiting, profuse sweating, and purging of the bowels of the patient to expel the bad humors that were causing the illness.[4] Today, we understand that it’s germs and viruses that cause illness and some of these solutions can exacerbate the patient’s condition rather than help it.

Still many more medicines listed by Child throughout the book seem to make a heap of sense, and some of these common household and kitchen items, readily available at the fingertips of housewives, can provide temporary relief to a variety of ails. Chicken broth and beef tea can have positive benefits for the casually ill (think back to when you were sick as a child and chicken noodle soup made your stomach feel better). Common medicines she recommends includes castor oil as a laxative (still used today), vinegar (used for multiple things but proven as an anti-bacterial), and lime water (the citrus in this mix can help boost the immune system and has antioxidants). Some teas she suggests are teas enjoyed today, either casually or for its health benefits like chamomile, sage, peppermint, and saffron.[5] Some of her medicinal ingredients are things we use nearly every day like ginger, cinnamon, horse radish, lettuce, common mustard, and onions, each with their own beneficial properties for maintaining a healthy disposition. Remember, she was writing to mothers and wives who needed to use what they had in their kitchens if they couldn’t go to town for proper patent medicines.

Yet, for all her good advice, Child’s recipes include some of the strangest and likely dangerous concoctions. Her recommendations for the proper use of opium, turpentine, and laudanum are rivaled by her odd meal suggestions for invalids such as Irish Moss Blanc-Mange and Calf’s Foot Jelly (yes, made by boiling the feet of calves). I was surprised to also find a recipe for “Milk of Almonds” which is certainly nothing like our modern day almond milk.[6] Thankfully, she dedicates a section toward the back of her book that explains what to do in the case of an overdose or if a treatment is not agreeing with a patient.

Perhaps the most important section of her book is the chapter on the proper conduct and practices of nurses. Addressing the women who would be following her advice, Child equipped the women of the pre-war era with many excellent tips that would come in handy when entering the medical field as volunteers between 1861 and 1865. While her first tip, “to follow scrupulously and exactly the directions of the physician” may have created tension between Civil War nurses and their doctors (who sometimes did not want women nurses in their wards), Child’s other points made the difference between life and death in army medical hospitals – if they were followed. She advised that all nurses “Frequently wash up the glass, crockery, and spoons that are used in a sick chamber” and that food be prepared in “perfectly clean vessels.” Food was to be made fresh and nurses were to “use your fingers as little as possible in preparation of food or medicine.” She admonished caretakers to “wash your hands frequently,” and that if they tried any food themselves before administering it to the patient, to “put away the spoon you use, without dipping it in a second time.” In today’s world, this is common sense practice to mitigate the spread of germs, though nineteenth century physicians must have solely observed the positive results of cleanliness, since the idea of germ theory hadn’t been widely accepted or studied until after the war.[7]

Above all, Child warned nurses to always “Keep a cheerful countenance” and maintain “a tender conscience as well as a feeling heart.”[8] Given the gentle and nurturing personalities among many women of the Victorian era, they made ideal replacements for the invalid soldiers who were given the task of nursing in the hospital wards during the war.[9] While it may be inconclusive whether it was their gentling influence or any knowledge of home nursing they carried with them into the hospitals, it was observed that “When males have charge, the mortality averages ten percent; when females manage, it is only five percent.”[10] In Southern society at least, the care and nurturing of the family unit was a “fundamental aspect of female duty and self-sacrifice” which made them welcome by soldiers who preferred to be looked after by a motherly or sisterly nurse figure rather than a masculine peer.[11] After the Civil War, the profession of nursing and doctoring became more open to women, especially to those who now had a wealth of experience under their belt, both at home and in the military hospitals.

Whether they dreamed of becoming doctors or simply wanted to faithfully take care of their family, Child’s book, along with many others published in the first half of the nineteenth century, were invaluable resources to those women who aspired to join the field of nursing and medical care.

Endnotes

[1] Lydia Maria Child, The Family Nurse or Companion of the American Frugal Housewife, (Boston, C.J. Hendee, 1837), p. 3

[2] Ibid, p. 5-7

[3] Ibid, p. 7

[4] Alfred Jay Bollet, M.D., Civil War Medicine, Challenges and Triumphs, (Arizona, Galen Press, 2002), p. 250

[5] Child, pp. 81, 97, 100, 103, 107, 115

[6] Ibid, pp. 94-95, 20-21, 29

[7] Ibid, p. 8-9

[8] Ibid, p. 10, 12

[9] Nina Silva, Daughters of the Union: Northern Women Fight the Civil War, (Harvard University Press, 2005), p. 204

[10] Quoted in Libra R. Hilde, Worth a Dozen Men: Women and Nursing in the Civil War South, (Charlottesville, VA, 2012), p. 24-25

[11] Ibid, p. 135