Wednesday, November 23, 2022



 - the medicine and surgery of yesteryear

By Keith Souter aka CLAY MORE

During the Civil War surgeons had to deal with a huge array of wounds. According to the National Museum of Civil War Medicine the vast majority of documented wounds were caused by the Minié ball, while the rest were caused by grapeshot, canister or other exploding shells. Few men were treated for sabre or bayonet wounds and even fewer for cannon ball wounds.

More documentation of cases seems to have been recorded by the Union Army than the Confederate States Army. 

When one thinks of hand to hand fighting the sabre and the bayonet come very much to mind, but the following figures of cases recorded during the American Civil War 1861-1865 put things into perspective.


522 cases  

488 recovered

26 fatal


400 cases

357 recovered

30 fatal


245,790 cases 

201,962 recovered 

31,922 fatal

Of the sabre wounds the most common site of injuries were the head, followed by the upper limbs.

Of the bayonet wounds the most common site of injuries were the abdomen.

Of shot wounds the most common site of injuries was the chest, followed by the limbs.

So, let us look at the treatment of sabre and bayonet wounds by looking at one of the major textbooks of surgery written for surgeons during the Civil War. It was written by one of the great medical and surgical innovators of the era, Dr JJ Chisolm. You will, if you care to delve back in the blog find that I have written many articles referencing him. 

Dr Julian John Chisolm (1830-1903)
Julian John Chisolm, often referred to as john Julian Chisolm or as J.J. Chisolm was born in Charleston, South Carolina in 1830. He obtained his MD medical degree from the Medical College of South Carolina in 1850 then travelled to Europe to study medicine and surgery in Paris and London.

He returned to Charleston in 1860 and took up the post of Professor of Surgery at the Medical College. He  kept the position throughout the War and in 1861 published the first edition of his textbook A Manual of Military Surgery for the Use of Surgeons in the Confederate States Army.

He was one of the few competent surgeons at the start of the War (it was the steepest of learning curves for surgeons on both sides), but his book gave detailed instructions. His experience was based on personal observations of many wounds  treated in both civilian and military hospitals admitted form the battlefields of Europe. The book was updated twice during the War.

I quote from the book.

PUNCTURED WOUNDS, MADE BY THE BAYONET OR SABRE, require similar treatment to gunshot wounds. If the history and appearances clearly indicate the character of the wound, there will be no need of probing for imaginary foreign bodies. Such wounds usually bleed more freely than gunshot wounds, but the haemorrhage is susceptible of control by similar means - pressure being preferred to ligation of arteries. The treatment should be cold water dressings - irrigation preferred. Protect the wound from air, if possible, by covering it with adhesive plaster or collodion, and dress it a seldom as possible, compatible with cleanliness. Once, probing such a wound should satisfy the curiosity of any surgeon. A frequent repetition of this meddlesome surgery, besides the needless pain inflicted upon the wounded man, must end in mischief. 

Simple incised wounds, as sabre cuts, will be closed by adhesive plaster (or sutures, which are preferable, should there be any tendency to gaping), to be followed by the cold water dressing. Should the wound be not of a serious character, it may be left even without after-dressing - the little oozing from its edges, when drawn together by straps or sutures, dries into a scab along the line of the wound, and excludes air with its pernicious influences. This permits of the remodelling process and cicatrisation is effected without suppuration. 

Should a bayonet or sabre wound transfix one of the natural cavities, the internal injury may be rapidly fatal from hemorrhage , or the injury inflicted upon the contained organs may, sooner or later, lead to the destruction of the patient by visceral inflammation. Under ordinary conditions, when such wounds exist in the extremities, where no large vessels are implicated, they require no special treatment. It is a class of wounds not as frequently met with in military surgery as one would suppose. The sabre-bayonet, when plunged into the body among the viscera, leaves but little work for the surgeon. Such cases seldom leave the battlefield alive.

When the ordinary bayonet has buried itself deeply in a limb, suppuration may appear in the course of the wound. Should pus b suspected, and fears exist that it may be pent up under a fascia, it would be necessary to dilate the wound t permit of its free escape. Under no other condition should a punctured wound , made by either a sword or bayonet, be dilated, except to remove foreign bodies or to control serious haemorrhage, where it is necessary to ligate the open mouths of the bleeding vessel. 

[It should, of course, be noted that the book was written before Lord Lister developed the practice of aseptic surgery in the 1870s]

John Sith Pemberton (1831-1888) and the creation of  Coca Cola
We come now to another Confederate veteran, the pharmacist John Sith Pemberton.

Pemberton was born in Knoxville, Georgia and qualified as a pharmacist at the Reform Medical College of Georgia. He eventually set up a drug store in Columbus. 

Doing the Civil War he served in the Third Cavalry Battalion of the Georgia State Guard, part of the Confederate Army. He rose to the rank of lieutenant colonel. 

During the Battle of Columbus he sustained a sabre wound to the chest and survived. He was, however, left with chronic pain and became addicted to morphine.  As a pharmacist he experimented with various ingredients as a substitute for the opiate. 

At first this medicine he came up with contained coca, from which cocaine is derived. He produced Pemberton's French Wine Coca. When a temperance act was imposed the alcohol content had to be removed and so he developed another formula for his medicine. This was in the form of a syrup, which after experimentation he mixed with soda which he sold as a fountain drink rather than a medicine.  This eventually became Coca Cola.

Sadly, due to ill health and the threat of bankruptcy he sold the complete rights to his drink for  what would nowadays be considered a paltry sum. The drink is now iconic around the world. 


My latest novel, written under my crime and historical writing name of Keith Moray is an historical crime novel. It is entitled DEATH OF A POET and  is the first in the Ancient Egypt  Murder Mysteries series set in Alexandria in the Ptolemaic era. It introduces Overseer Hanufer of Crocodilopolis 

And for more medicine and surgery of yesteryear, The Doctor's Bag published by Sundown Press.



  1. I am Charlie Steel---locked in this anonymous thing.

    Dr. Keith,
    Read every word. There will be no piercing or bayonets around here. At least I hope not.

    You forgot to add that COCAINE was the addictive medicine used when Coca-Cola was first sold. I assume by now they took it out. (I think to this day it disappoints a lot of people.)

    Doctors & Hospitals---can't live without them but it is not always pleasant to live with them and their procedures and prescribed medicines. I say that as an old man and for the majority of writers who are reading your post---MOST OF THEM BEING OLD!

    Dr. Keith, hope you have good times during the coming holidays.

    In the U.S., happy Thanksgiving everyone!

    Charlie Steel

  2. Thanks for reading and pointing that out, Charlie. I should have made it clear that cocaine is derived from coca, so I have added it now.

    Yes, best to stay well and avoid us! And keep writing!

  3. Read this with great interest. I knew the Coca Cola story, but had not really delved into Dr. Chisolm and his work. Thank you for the excerpt and all the best on your new series. (I made the local library add 'The Doctor's Bag' to their Special Collections.) Doris

    1. Oh, thank you for your support, Doris. That is kind of you. Much appreciated. Keith

  4. I'm late to the party, Keith, but as always, I enjoyed this fascinating post. So interesting, especially the origins of Coca-Cola, which I dearly love and always have. LOL Congratulations on your new book!

    1. And I'm even later, Cheryl! Thank you for dropping in. And thank you about the book.