“And I will use regiments for the benefit of the ill in accordance with my ability and my judgment, but from (what is) to their harm or injustice I will keep (them)”
The Hippocratic oath is an ancient greek document that is simply entitled “Oath.” Its age is debated; 400 BC is a reasonable estimate for when it was written. We do not know its stature in its own time; how widely or how long it was used. The oath is neither a sacred scripture nor a legal code. Through the years, although the words have changed, the meaning remains the same. Change is inevitable in all aspects of life, especially medicine. The question at hand is why does it take catastrophic events, such as the Civil War, to inspire change?
At the start of the civil war most physicians were male and there were no specialties. Many chose to treat only eye or leg patients, receiving no more education that of a chosen surgeon. Not only did the physicians receive no specialty training there were few knowledgeable personnel to instruct medical recruits to the military code of behavior. Difficulties soon arose due to a fundamental failure to grasp the different between civilian practice and the military way of life.
From the wretched state of the wounded to the disorganized scattering of surgeons over the rolling battlefield, bull run became a tragic lesson in military medical hubris. With few available surgical supplies and no plans in place to evacuate the casualties the injured lay for days on the ground where the fell; suffocating in their own vomit and delirious from infection. Many received neither medical treatment nor so much as a mouthful of water. As for the injured whom did make it to the hospitals conditions were not much better. That is until the “cyclone in calico” arrived.
Sunday May 26, 1861 began as any other Sunday for Sister Mary Ann Bickerdyke. Sitting in the church after prayer the minister read a letter from Dr. Benjamin Woodward. The letter explained the sparse, or lack or, medical supplies to treat the injured soldiers. The congregation decided to act to aid the suffering but were unsure how. After more prayer Sister Mary Ann rose to speak. Offering herself as the representative from the church her mission was simple; she would go to Cairo, Ill and “clean things up down there,” calling it “the Lord’s work.”
During the early years of war sanitation was so poor that disease quickly outnumbered injuries and wounds. The causation, transmission, and/or treatment of disease such as cholera, gonorrhea, measles, mumps, tuberculosis, and yellow fever was not understood. This was evident by the findings of Sister Mary Ann. Upon arrival in Ciaro soldiers were bundled in tents, some on cots, others on hay thrown on the ground. There were so many injured and so few tents that it was difficult to move between the men. The first order of business for Sister Mary Ann came from bribery. With no support from the Army she was forced to bribe the few able bodied men around. Bribery was also used on the injured, to entice them to move and take a bath.
All clothes and straw was removed and burned. The hair from their heads and faces were removed and skin scrubbed until red. Sister Mary took a shovel and removed the dirt from the first tent until there was a clean floor where fresh straw could be laid. The soldiers were given fresh clothes and once in bed, fed chicken. All felt much better but Sister Mary didn’t stop there. Each tent was given two barrels, one with drinking water and the other with lyme to be used as a latrine. TO the amazement of Dr. Woodward the entire hospital, tents included, were cleaned by nightfall. Even after begging her to leave for fear she would miss the train Sister Mary refused. Civilians were not permitted quarters on base after nightfall and Sister Mary only left to find quarters in town. After discovering that Dr. Woodward was in charge of 5 different hospitals in the Ciaro...