Of Bullets and Bone Saws

The adoption of new, deadlier weaponry during the American Civil War inevitably led to the mass infliction of atrocious wounds. One of these new weapons was the Minié ball, a French-designed bullet that greatly increased the accuracy, rate of fire, and wounding power of the commonly issued rifle musket. Up to 90 percent of injuries sustained during the War were administered by the Minié ball.

In the aftermath of a battle, surgeons were responsible for tending to thousands of grievously injured soldiers. Their wounds were often untreatable because of the tendency for the large, lead Minié ball to “mushroom” upon contact with the body, tearing muscle, shredding organs, and splintering bone. Wounds to the body were considered mortal, but wounds to the extremities could be dealt with by amputation.

Tools of the trade. From the top: a petit tourniquet, bone saw, two amputation knives, and a catlin. Aside: two dressing forceps, a tenaculum, and a catheter. (Records of the American National Red Cross)

Amputations accounted for approximately 3/4 of all surgeries performed during the Civil War. Contrary to popular myth, most Civil War surgeons were not uneducated butchers who hacked off limbs without the use of anesthesia. Most had either been to medical school, or had apprenticed with a practicing medical doctor. Amputations were carried out hurriedly, but efficiently. After administering chloroform or ether, the surgeon would use a specialized set of tools including a scalpel to slice through muscle, clamps to hold arteries closed, and a saw to cut through bones. Flaps of skin left behind by the surgeon were sewn together to close the wound after the limb had been removed. The procedure could take as little as fifteen minutes.

An amputation being performed in a field hospital in Gettysburg, PA. Note the evergreen boughs hung above the tent as an air freshener.

The patient would be set aside to either recover or succumb to subsequent infection. Amputations had a varying rate of mortality, depending on which part of the body was taken. For instance, arms which were removed above the elbow caused a mortality rate of about 24 percent, whereas leg amputations at the hip joint would be much deadlier at 84 percent. Despite these high rates of death, the practice of amputation was recognized by surgeons of the day as the only way to increase the chances of a wounded soldier’s survival. Furthermore, many of the limbs that were amputated duri