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The Empty Sleeve: Amputees and the Civil War

Editor’s Note: WSKG has asked faculty and graduate students in the History Department at Binghamton University to explore the history behind PBS’s new drama Mercy Street. In today’s blog post, graduate student Erika M. Grimminger discusses the causes and effects of amputations during the Civil War.Note: this post contains a graphic illustration of gangrene.

The Empty Sleeve: Amputees and the Civil War

In Episode 4 of Mercy Street, Ezra Foster , the brother of Union Doctor Jed Foster and a Confederate soldier, comes to Mansion House Hospital with a serious leg wound that requires amputating.

Ezra Foster’s story represents the stories of thousands of soldiers who suffered though amputations during the American Civil War and returned home missing body parts. While these Union and Confederate soldiers luckily survived serious trauma, their reintegration into society and with their families after the war was, at best, a hard process of readjustment and, at worst, an almost impossible struggle. 

The Need to Amputate

The Civil War took place during an era in which doctors lacked the medical knowledge of germ theory and that saw the introduction of new means of inflicting pain and death on the battlefield, including the minié ball. In combination, these factors often led to amputation for soldiers shot in one of their extremities.Historians estimate that around 60,000 soldiers from both sides endured the removal of a body part during the Civil War. Only an estimated 45,000 of those men survived the procedure.

The extreme levels of injury caused by the soft lead minié ball bullets were the most common reason for amputation. These bullets shattered bones and ripped apart muscles, nerves, and arteries. Often the damage was so severe that doctors had no option but to remove the afflicted limb.

Many surgeons of the time argued that speed was key when it came to amputations. The faster a surgeon could remove an arm or leg, both in terms of operation time and in relation to when the wound occurred, the better the odds that the soldier would survive the ordeal.As Dr. Foster notes when examining his brother’s leg, the field surgeon who had originally tended Ezra should have acted quickly to remove the limb. This would have reduced the chances of bone or bullet fragments causing infection. Due to Ezra’s mother’s objections, the field surgeon failed to act and Ezra contracted hospital gangrene.Gangrene is a painful infection that turns a wound deep purple or black. It eats away at the surrounding tissue causing the skin around the wound to collapse. Surgeons had to act quickly to stop the infection from spreading to the rest of the soldier's body and amputation was considered the best method.Army doctors worried not only about the infection spreading throughout the injured soldier’s body, but also that it would spread to the other patients in the ward. Therefore, doctors had to deal with gangrene quickly. The few methods available included sanitation of the ward and isolation of the patient. 

The Empty Sleeve

As Jonathan Jones noted in his blog post “Invisible Wounds: PTSD, the Civil War and Those Who ‘Remained and Suffered’”, missing arms and legs became symbols of the Civil War. But what did these symbols mean? The answer to this question varied depending on the soldier.

Historians who study Union amputees, such as Frances Clarke and Jalynn Padilla, have suggested that civilians often saw the wounded veterans who returned to the North as heroes and viewed their amputations as “honorable scars.” For Union veterans, an empty sleeve affirmed their manhood and courage because they lost their limb in the most masculine of 19th-century activities - war.In contrast, historians who study the South have argued that Confederate amputees, and the people to whom they returned, did not readily see their missing appendages as a mark of manly sacrifice.As Brian Craig Miller has suggested, these men often had to come to terms with the fact that their maimed body no longer fit the ideal white male physique of the time. Their wounded bodies no longer allowed these men to participate in masculine pursuits, such as horseback riding or hunting. They also could not always provide strong support for their wives and families.Self-sufficient men before the war became dependent on their wives, charitable organizations, or the government for financial support, artificial limbs, and often basic day-to-day tasks like getting dressed. Depending on what their pre-war occupation had been, amputees had to find other employment that did not require manual labor. In addition, many of these men suffered from constant pain or complications arising from their wounds that hindered their ability to hold a steady job.

Burden or Valor

All in all, the loss of a leg or an arm was (and still is) a deeply personal experience, one that greatly affected the way a veteran lived his life once the war ended.Whether or not he saw his amputation as a burden or a mark of valor depended on how well he readjusted to the life he lead before the war and on the amount of support that he received from his family, friends, and community. Read our other blog posts about Mercy Street.Main Image: Library of Congress.

Sources:Clarke, Frances. “‘Honorable Scars’: Northern Amputees and the Meaning of Civil War Injuries,” In Union Soldiers and the Northern Home Front: Wartime Experiences, Postwar Adjustments, edited by Paul A. Cimbala and Randall M. Miller, 361-394. New York: Fordham University Press, 2002.Hasegawa, Guy R. Mending Broken Soldiers: The Union and Confederate Programs to Supply Artificial Limbs. Carbondale: Southern Illinois University Press, 2012.Humphreys, Margaret. Marrow of Tragedy: The Health Crisis of the American Civil War. Baltimore: The Johns Hopkins University Press, 2013.Marten, James. Sing Not War: The Lives of Union & Confederate Veterans in Gilded Age America. Chapel Hill: University of North Carolina Press, 2011.Padilla, Jalynn Olsen. “Army of ‘Cripples’: Northern Civil War Amputees, Disability, and Manhood in Victorian America.” PhD diss., University of Delaware, 2007.

Erika M. Grimminger is a second year Ph.D. student at Binghamton University. She studies the history of medicine with a focus on perceptions of disability found in the 19th-century U.S. and in Medieval Europe. Her current research project deals with the Union Army’s Invalid Corps/Veteran Reserve Corps, in particular she is attempting to understand how disabled soldiers, who were still actively serving their country, were viewed by civilians and fellow comrades.