FREDERICK -- A bullet ripped into Richard Brown's left thigh, and as the 21-year-old Confederate cavalryman struggled to stay mounted, his horse fell on him, snapping the same leg's thigh bone.
Medically, even with the compound fracture, the bullet wound would not likely be life-threatening today.
But this was a hot, muggy Friday on East Patrick Street in September 1862. For nearly two months, Brown suffered in a nearby Union hospital in the old Hessian barracks that still stand at the Maryland School for the Deaf. On Nov. 7, he died.
Private Brown's black and white photograph stares out at visitors from a wall in the new National Museum of Civil War Medicine here. His story is a newly recognized footnote in American medical history, told in a Civil War museum unlike any you've visited.
For rather than concentrating on battles, or slavery, or Blue and Gray, this museum is about an unheralded result of that war that former Surgeon General C. Everett Koop calls "a watershed in the history of medicine."
Many museums focus on the Civil War and its battles, but what happened to its 620,000 dead and even more wounded gets only passing mention.
"What we take for granted in medicine today started then," says Dr. Gordon E. Dammann, a dentist in Lena, Ill., who came up with the idea for the museum. "Before the war, American medicine was looked down on by the rest of the world. After the war, we quickly became the leader."
Forced to cope with rampant illness and horrible wounds numbering in the tens of thousands, doctors with little in the way of modern knowledge or technology experimented, improvised, and invented. The list of advances taken for granted today is impressive:
Better sanitation practices, modern hospitals, nursing as a profession, wide use of anesthetics, the triage system of treating the injured, mobile surgical units -- all have Civil War roots.
In the process, doctors saved many like Carlton Burgan, whose photograph hangs next to Richard Brown's on the museum wall.
Burgan was a Union foot soldier, just 18, when a bad cold turned into pneumonia in Winchester, Va. Today, antibiotics, nourishment and rest would quickly return him to normal. But he survived this Civil War-reality: For every soldier that bullets and shrapnel killed on the Civil War battlefields, two died of disease -- ranging from childhood maladies such as measles to the more serious malaria, diphtheria and typhoid.
Burgan's well-intentioned doctor, who knew nothing about germs or antibiotics, treated him with "calomel," a mercury-based potion intended to make him salivate and, thus, flush his body of "bad humors."
It was common practice 134 years ago. No one knew that mercury was a toxin. So the "remedy" ate away much of the soft tissue inside the young soldier's mouth, not to mention his jawbone, right cheekbone and eye, and part of his nose.
A "before" photo of Burgan's disease-eroded face reminds you of a grotesque Popeye in extremis. "After" is where his story surprises.
His face has been restored to near-normal dimensions and features, though thickly scarred with Frankensteinesque seams where live tissue was stitched to cover a reconstructed jaw, cheek and nose. Gurdon Buck, the New York doctor who did the work, is regarded as the father of modern plastic surgery.
Add a happy ending: Burgan was discharged from the army, married, and had "many" children before dying at age 71 in 1915.
Stories that personalize the war this way -- for soldiers and doctors alike -- accompany many of the 3,000 medical tools, devices, kits, packages, medicines, accouterments, and rare documents collected by Gordon Dammann. This material constitutes the private, non-profit museum's starting point.
Frederick was chosen for its location because the city actually was a major wartime medical center -- central to major battles at Gettysburg, Antietam, Harper's Ferry, on the Monocacy, all along South Mountain, and south into the Shenandoah Valley. No fewer than 29 churches, schools and other buildings in Frederick, many near today's museum, served as hospitals at some point during the war.
Go ahead, cynics, call a positive spin on a time better known for medical practices bordering on the barbaric reconstructive history. Because everyone has read about and in movies has seen the Civil War's "surgeons," who left behind more than 50,000 legs and arms amputated at various battlegrounds. But even with only a few of Dammann's items on display now, the museum's exhibits reshape such skepticism without sugarcoating the obvious. The museum's goriest element, discretely played over-and-over on videotape next to a reconstructed field hospital, is a chillingly realistic leg amputation concocted by Civil War re-enactors.
But, you learn that even under the best of conditions, those so-called "sawbones" doctors could not beat infections, including deadly gangrene. Europeans such as Joseph Lister were only on the verge of discovering germs. So amputation was quick -- three to five minutes in many cases -- and while not without risk, a much better wager on life than leaving the patient to die, almost certainly, from infection or blood loss.
You also learn quickly in touring just the one floor (out of three planned) what other medical changes that are taken for granted in the 1990s grew out of the war.
Not least was public sanitation -- systematized cleanliness, separating latrines from water and food in campsites, for example. Early in the war, chronic diarrhea was a major killer as well as spreader of disease.
A new image
"The concept of hospitals as places to cure patients, not to just let them die, was another major development," points out Burton K. Kummerow, the museum's executive director. "We've given that gift to the world."
Before the war, the only hospitals had been "pest houses," charitably run places where people with contagious diseases such as tuberculosis, pneumonia, and smallpox were isolated to die. Critically ill indigent ended life warehoused in comparable "poorhouses."
Because of the war's overwhelming numbers of wounded and ill, "pavilion" hospitals -- airy, easy-to-clean, designed with central nursing stations and common corridors used today -- evolved.
By war's end, the Confederate Chimborazo Hospital just east of Richmond, Va., was the reunited nation's largest, with some 8,000 beds. The Union, which began the war with only one 40-bed military infirmary, that in Kansas, ended it with 181,000 hospital beds.
Nursing emerged as a profession, too. While throughout history women have treated some of war's wounded, they became indispensable -- and in fact, were eventually recruited to help by both sides -- during the Civil War.
The best-known nurses included the iron-willed, if somewhat eccentric Clara Barton, who narrowly escaped death while operating her private ambulance service at Antietam. Dorothea Dix became chief of the Union's nursing corps.
One no-nonsense Pennsylvania physician, Dr. Jonathan Letterman, made a particularly unsung difference within months of being appointed in 1862 to head the Union's medical units.
So crushing were the numbers of wounded that soldiers sometimes lay in fields, critically wounded, for up to a week after a battle before aid arrived. The battle of Shiloh, for example, generated 27,000 casualties -- equivalent to more than half those seated in Oriole Park at Camden Yards on a sold-out night.
Bloody Antietam, where for 12 hours 32 casualties fell per minute during the war's single deadliest day, sent more than 8,000 soldiers to Frederick hospital beds alone.
Letterman established what has become known as the triage system of treating casualties in relation to the severity of their wounds. The system is used today. Field hospitals became better organized, as well. He quickly replaced bouncy, two-wheel "gut-buster" ambulances with gentler and larger four-wheel wagons.
Dr. F. Terry Hambrecht, of Rockville, a neurosurgeon who is the museum's vice president when he's not researching technology for use in brain operations at the National Institutes of Health, credits the Confederate army with perfecting what are known today as mobile Army surgical hospitals -- M.A.S.H. units.
Southern doctors, Dr. Hambrecht says, became adroit at boxing equipment and transporting staff and patients while retreating before Union Gen. William Tecumseh Sherman's relentless "March to the Sea." He also notes that contrary to popular thought, anesthesia -- mainly ether and chloroform -- was widely used on battlefields for the first time.
"They had good painkillers and anesthetics," Hambrecht says. "I get kind of mad at the movies which show Civil War soldiers biting the bullet during surgery. We've never been able to find a documented case of that happening. I have found, though, examples of soldiers refusing to take anesthetics for an NTC amputation. They didn't always trust them."
As Hambrecht says, "It's a fascinating period."
A work in progress
Since its mid-June opening, more than 3,500 people have toured the museum. For now, admission is free, but donations are sought at the tour's end.
Dammann and Kummerow say about $5 million is needed to bring the old brick building up to modern museum standards for safety, security and public access.
That will make the museum's message even more powerful, no doubt. But the sketchy story today is still compelling. Certainly, part of its spirit reflects an observation writer Louisa May Alcott -- a Union nurse -- made:
"The sight of several stretchers, each with its legless, armless, or desperately wounded occupant, entering my ward, admonished
me that I was there to work, not to wonder or weep."
To which Dammann adds: "It's not going to be a static guns and bullets museum. We're going to tell an aspect of the Civil War that hasn't been told before."
If you go
What: National Museum of Civil War Medicine
Where: 48 E. Patrick St., Frederick
Hours: 10 a.m.-5 p.m. Tuesdays through Fridays, noon-5 p.m. Saturdays and Sundays
Call: (301) 695-1864
Pub Date: 8/22/96