Morbid Fact Du Jour for December 25, 2015

Today’s Infected Yet Truly Morbid Fact!

During the American Civil War, much was written on wound care, and the information provided during the war showed physicians adhered to the miasmatic rather than bacterial theory of infection. Nearly all wounds were “probed,” not only to find the projectile but to define the extent of the injury. Clothing, bullets, or shell fragments were removed from wounds. Secondary to this probing, contamination of all wounds occurred. This makes it impossible to compare infection rates and mortality between various treatment techniques. Sometimes wounds were cleaned with solutions that had mild antiseptic qualities such as bromine. The use of ligatures, rather than tourniquets, to stop major vessel hemorrhage was soon practiced by all surgeons and was a major advancement during the war. Nearly all wounds became infected, and white, creamy “laudable” pus was felt to be a good prognostic sign and part of the normal healing process. Wounds that healed without suppuration were essentially considered abnormal and were reported as curiosities.

Dressings were usually kept wet. Unfortunately, some dressings were reused and infrequently washed, which led to a dramatic spread of infections. Ice was a valuable adjuvant to the cold water dressings and was even supplied in the heat of July following Gettysburg by the United States Sanitary Commission. Suppurating wounds were sometimes treated with a dilute chlorinated soda called Labarraque’s solution, a forerunner of Dakin’s solution, a commonly used antiseptic.

Surgical infections were the leading cause of death after surgery. Tetanus, pyemia, erysipelas, and especially gangrene were feared by patient and doctor alike. Various antiseptic agents were tried. Middleton Goldsmith’s study of washing wounds with bromine instead of nitric acid in cases of gangrene was a major achievement in the treatment of gangrene during the war. The number of cases of erysipelas were reduced in a Louisville hospital by spraying bromine vapor in the hospital wards. Other antiseptic agents used included potassium permanganate, sodium hypochlorite (Dakin’s solution), iodine, and creosote. Carbolic acid was sporadically employed but with mixed results. The problem with the use of these agents was that they were utilized at the wrong time, usually when an infection was in full bloom. Men were further ravaged by disease and malnutrition. J.S. Billings, writing on the operation of excising a hip joint, conceded: “Operating, as I did, upon men whose vital force had been diminished by scorbutus and malaria, and exhausted by transfer from a distance, I had little hope of successful results.”

“My vital force is diminished.”
Culled from: Orthopaedic Injuries of the Civil War: An Atlas of Orthopaedic Injuries and Treatments During the Civil War


Garretdom: Asphyxiation Edition

On this Christmas Day, let us all reflect on a dark time when literally everything could kill you. 

December 12, 1887




Mother and Children Asphyxiated by Coal Gas Through Carelessness.

CHICAGO, Dec. 12.–Mrs. McClure and her grown daughter and son were asphyxiated by coal gas last night at their residence in the suburbs of the town of Maplewood. They closed all doors and windows tightly on retiring and forgot to replace a stove-lid after replenishing the parlor fire. Mrs. McClure appeared to have fallen senseless while trying to get out to the open air. Her daughter was lying lifeless across a chair a few feet from her bed. The son was on his knees before the door and evidently had become unconscious during a stupefied search for the knob of the door.

From the Collection of The Comtesse DeSpair
The 1887 Morbid Scrapbook

More tales of asphyxiation and woe can be devoured at Garretdom.

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