The Growing Research into the History of Drugs Used During the Civil War

The pain started for Confederate Gen. Thomas Jonathan "Stonewall" Jackson as darkness fell May 2, 1863, when he was mistakenly shot twice by his own men during the Battle of Chancellorsville.

Jackson's horse bolted, and an overhanging branch knocked him in the head.

Terribly wounded in the left arm and right hand, he was dragged to a litter. He was dropped three times, once when a litter-bearer was killed by artillery fire. Eight hours later, while being prepared for an amputation, he described the pain's end as the chloroform anesthesia took hold.

"What an infinite blessing," he said, and continued uttering " . . . blessing, blessing, blessing . . . " as he slipped from consciousness. Later, he died.

Though the incident occurred more than 140 years ago, its details were published in the Bulletin of Anesthesia History in 2001 by Dr. Maurice Albin, an anesthesiologist, historian and professor at the University of Alabama at Birmingham.

UAB has one of the nation's best collections of Civil War medical records.

Research into Jackson's death is part of a growing body of work delving into the drugs used during the Civil War. Amid the faded pages of diaries, casualty reports and hospital records, historians have found many of the roots of anesthesiology, the U.S. pharmaceutical industry and even the nation's chronic problem with drug addiction.

The merciful, pain-killing properties of ether and chloroform were discovered about 15 years before the Civil War. Contrary to popular belief, they were widely used by doctors for both the North and South to treat battlefield casualties, Albin said.

His research indicates that up to 130,000 soldiers, about one in every four wounded, were likely to have received anesthesia during the Civil War.

For instance, records indicate chloroform -- the anesthesia of preference because ether is so flammable -- was used 28,000 times just in the Stonewall Brigade of the Confederate Army.

Meanwhile, Union doctors used anesthesia much of the time as they performed about 30,000 amputations during the Civil War, according to Albin's research. Still, only 20,000 of the patients survived, which is not surprising since sterile techniques were not developed until shortly after the war.

But few deaths were caused by anesthesia, which was usually administered by dropping chloroform on a cloth placed over a patient's face, Albin said. Operations were generally speedy, with one surgeon claiming an ability to amputate a limb in 32 seconds.

Before the war, there was resistance to anesthesia. Some believed there was moral value in excruciating pain. In his research, Albin found a Civil War doctor who wrote, "There's nothing like hearing the lusty bawling of the wounded as the knife goes in."

By the end of the war, doctors' attitudes had changed, and anesthesia had become widely accepted because of its effective use in humanely treating battlefield wounds, Albin said.

Michael Flannery, associate director for historical collections at UAB, said many other drugs were used in addition to anesthesia. The Civil War sparked a huge demand for pharmaceuticals not only for battlefield injuries, but to treat an epidemic of diseases that ravaged unsanitary military camps.

In fact, two of three casualties in the Civil War were caused by illnesses such as dysentery and malaria, said Flannery, who has written a 369-page book, "Civil War Pharmacy," scheduled for release this spring.

Flannery said the U.S. pharmaceutical industry was nearly nonexistent when the war began, but it boomed after the government began purchasing large quantities of medical supplies and drugs, which were often based on herbal remedies.

Perhaps the most effective and popular drug was quinine. Soldiers were routinely given the bitter drug mixed with whiskey to treat symptoms of malaria.

"Most soldiers considered it an assault to otherwise good whiskey," Flannery said.

The government bought tons of quinine, making it a kind of Civil War blockbuster drug that had a huge impact on the pharmaceutical industry.

Dr. Edward Squibb, for one, found himself in a lucrative position after starting a small pharmacy operation in 1858, three years before the war. Since Squibb's business was well established, the military awarded it big contracts.

Decades later E.R. Squibb & Sons merged with Bristol Myers to form Bristol-Myers, Squibb Co., a global pharmaceutical company....