KILLED BY THE CURE: CIVIL WAR MEDICINE, PT. VIII

XXII. Amputations

The most commonly employed surgical technique during the Civil War was the amputation. Union Army medical records list 29,980 amputations. When amputations performed early in the war that went unrecorded, and Confederate Army amputation estimates are added to the total, it is reasonable to assume that Union and Confederate Army surgeons performed somewhere between 50,000-55,000 amputations during the war.

XXIII. Amputations- Categories

Amputations were placed in one of three categories, depending on how soon after the injury the procedure was performed:

1. Primary- Within 48 hours of the injury (23.9% mortality rate)
2. Intermediary- Three to thirty days after the injury (34.8% mortality rate)
3. Secondary- Thirty-one or more days after the injury (28.8% mortality rate)

XXIV. Amputations- Bodily Area of Injury

Injuries in the Civil War requiring amputation involved these sites on the body:

1. Hand (26.4% of total)
2. Thigh (21.2%)
3. Lower leg (18.4%)
4. Upper arm (18.4%)
5. Forearm (5.9%)
6. Foot (5.1%)
7. Shoulder (2.9%)
8. Knee (0.7%)
9. Ankle (0.5%)
10. Hip (0.2%)
11. Wrist (0.2%)
12. Elbow (0.1%)

XXV. Amputations- Mortality Rates by Type of Procedure

The fatality rate of amputations increased the closer the procedure was performed to the trunk of the victim. The mortality rate of various procedures was as follows:

1. Hip (88% fatalities)
2. Knee (58%)
3. Mid-Thigh (54%)
4. Lower leg (38%)
5. Shoulder (28%)
6. Ankle (24%)
7. Upper arm (24%)
8. Forearm (14%)
9. Wrist (10%)
10. Elbow (7%)
11. Toes (6%)
12. Foot (5%)
13. Fingers (3%)
14. Hand (2%)

XXVI. Artificial Limbs Furnished to Maimed Soldiers

After the war, the federal government and most Confederate states had programs to pay for (or to reimburse maimed veterans for) the purchase of artificial limbs and eyes. These programs could be very expensive- Mississippi in 1866 spent more than 1/3 of its entire state budget for these items. Some state archives have retained records of these purchases (South Carolina, for example, has published a printed record of such purchases).

Tom Pearson, Reference Librarian
Special Collections Department
St. Louis Public Library
1301 Olive Street
St. Louis, MO 63103