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Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine

by Rutkow, M.D., Ira M.
Publisher: Random House
Retail Price: $27.95 hardcover
Issue: Summer 2005
ISBN: 0375503153

Military medicine


Hospitals shaped the creation of a public health system

The American Civil War is one of the most widely written about periods of America's history. The combat, suffering, and death are glorified through the written accounts of the participants and historians. Yet, as the author states in the Preface, if a description of armed conflict is ever to be considered faithful, then the brutality of combat as well as the painful physical and mental restoration of maimed bodies should be spoken of. The reader must gain a surgeon's perspective of the aggression of war.

Author Ira M. Rutkow accomplishes this in his latest book, Bleeding Blue and Gray. Dr. Rutkow is a clinical professor of surgery at the University of Medicine and Dentistry of New Jersey. He holds a doctorate of public health from Johns Hopkins University and is the author of three previously published books on the history of surgery. In his new book, he focuses on the medical care in the North because there was no great difference in the practice of medicine between the North and South, the preponderance of existing military medical records pertains to the Northern armies, and the institutions that most affected the maturation of American medicine following the Civil War were largely outgrowths of Northern military medicine.

The author takes us from the dismal beginnings of the North's attempt to provide medical care in 1861 to the unprecedented system of evacuation, treatment, and convalescence that emerged by the end of the conflict. The U.S. Army Medical Department, led in the beginning of the war by totally inept and ossified Surgeon Generals, was not at all prepared for the hundreds and thousands of sick and wounded soldiers that they had to care for. Gradually, through the farsightedness and leadership of such people as Jonathan Letterman, Medical Director of the Army of the Potomac, and Surgeon General William A. Hammond, the North developed a system of medical care that was copied by armies around the world into World War I. Letterman's ambulance corps, evacuation and hospital systems saved thousands of lives and are the basis of the system used in today's conflicts. Hammond's innovations led to the first published American medical work recognized by the European medical community, The Medical and Surgical History of the War of the Rebellion. He initiated the Army Medical Museum, the Surgeon General's Library, and many other projects that were completed after his tenure as head of the Army Medical Department.

This volume also delves into the origin and development of the United States Sanitary Commission without whose existence thousands and thousands of sick and wounded would have suffered even more. More than one Union doctor had stated that if it were not for the Sanitary Commission, the soldiers not would have received the medicines, foods, and other supplies in a timely manner.

The author also discusses the tumultuous relationship between Surgeon General Hammond and Secretary of War Edwin Stanton (which eventually led to Hammond's demise), the nursing situation, and the efforts of both civilian and military personnel to improve the Army's medical department.

Dr. Rutkow names three advancements that resulted from the Civil War: the start of specialty hospitals, specialized skills within the field of surgery as a prerequisite to formal recognition of proficiency, and beginnings of the public health system in the United States.

Bleeding Blue and Gray is exceptionally well written, easy to read, and very educational. The author is able to weave the various topics in this subject matter into a cohesive volume that should be in the library of every person interested in Civil War medicine. On a scale of one to ten, this reviewer gives this book a rating of 8.75 scalpels.

Peter J. D'Onofrio, Ph.D. is the president of the Society of Civil War Surgeons, Inc., an international organization dedicated to the study of Civil War era medicine. He received his doctorate in 1998, with a specialization in the American Civil War. Dr. D'Onofrio is the editor of the Society's quarterly publication, The Journal of Civil War Medicine. For more information on the Society, contact Dr. D'Onofrio at socwsurgeons@earthlink.net or visit the Society's website at www.civilwarsurgeons.org.

D'Onofrio, Peter J., review of Bleeding Blue and Gray: Civil War Surgery and the Evolution of American Medicine, by Rutkow, M.D., Ira M., Civil War Book Review, (Summer 2005).