November 2014 CE

| The Surgical Technologist | NOVEMBER 2014 498 M E D I C A L T R A I N I N G Medical training during the 19th century consisted of stu- dents attending a two-year program. In the first year, stu- dents attended lectures. The second year also consisted of lectures, and in many cases, the lectures were the same as the year before. Medical students received no laboratory training and had no hands-on clinical experience with patients. Once they graduated they had to find jobs working with a practicing surgeon who would agree to take them on as his apprentice. They were exposed to patients during this time and began assisting the surgeon with surgeries. Once they acquired an adequate number of years working with a surgeon, they were able set up their own medical practice. The 19th century has been described as the “medical dark ages.” Surgeons during this time had no standards for what caused infections, effective sterilization techniques and proper sanitary conditions. Before the start of the Civil War many surgeons never had treated a gunshot wound. When the war started, surgeons were immediately faced with a lack of supplies, a lack of proper shelter and clothing and over- crowded conditions. “Hospitals were sometimes overwhelmed by the major battle casualties. The limited number of surgeons worked around the clock.” F I E L D H O S P I T A L C O N D I T I O N S To further compound the dire situation, many of those who were wounded on the battlefield remained there long after hostilities ended. This unfortunate condition was docu- mented in a communication in August 1862 after the Sec- ond Battle of Manassas from the Surgeon General William Hammond to the Secretary of War Edwin Stanton: “Up to this date, 600 wounded still remain on the battlefield … . Many have died of starvation; many more will die in consequence Of exhaustion, and all have endured torments which might have been avoided.” To try to rectify this deplorable situation, Hammond selected Jonathan Letterman as the new medical director of the Army of the Potomac. Letterman established the Ambu- lance Corps. This service consisted of able-bodies soldiers who were assigned to three ambulances for a regiment of approximately 1,000 soldiers. The horse-drawn ambulanc- es could carry a total of four soldiers on stretchers to field hospitals. The field hospitals were established in any avail- able building and/or field that were considered to be a safe distance from the battlefield. The ride, though sometimes only a few miles, was extremely bumpy and painful for the wounded individuals. However, the wounded soldiers were not any better than 1 Dr John Collins Warren, (1778-1856) who co-founded Mass General Hospital with Dr James Jackson in 1811, was the surgeon at the first public demonstration of surgical anesthesia in 1846. The 19th century has been described as the “medical dark ages.” Surgeons dur- ing this time had no standards for what caused infections, effective steriliza- tion techniques and proper sanitary conditions.