This Book Review originally appeared in Post & Courier, June 26, 2005

BLEEDING BLUE AND GRAY: Civil War Surgery and the Evolution of American Medicine. By Ira M. Rutkow. 394 pages. Random House. $27.95.

Manassas provided battlefield surgeons with an abundance of limbs to sever on July 21, 1861. With limited medical knowledge and supplies at their disposal, little else could be done. Sudley Church, commandeered as a field hospital for Union troops, was packed so tightly with the wounded that blood from patients being operated on splattered on those next in line for surgery. Antisepsis was unknown and anesthesia unavailable. Teams of assistants fought to hold patients still as surgeons cut their way through skin, muscle, and bone. As daylight fell away, the surgeons continued to saw and sew by the dim light of a few tallow candles.

Much of “Bleeding Blue and Gray” reflects a grim portrait of the medical care available to soldiers who fought in the Civil War. American medicine stood on the cusp of its scientific era. Bleed, blister, and purge were the orthodox remedies of the day. The American Medical Association, established barely more than a decade earlier, fought for unification and standardization among those calling themselves physicians. Apprenticed-based trainings and proprietary medical colleges more interested in an applicant’s ability to pay tuition than their competence boded ill for the organization of medicine as a professional practice.

Rutkow argues effectively that the horrors of the war did much to awaken the American people to the sad state of medicine at the time. Post-bellum public sentiment, coupled with a strengthened federal government, pushed for advances in medical education and licensure laws. Subsequent advances in public health initiatives and medical science achieved far greater success as a result. While the text occasionally digresses overmuch into military strategy and administrative back story, it remains a compelling account of an often overlooked, but essential, part of our history.

Reviewer Jason A. Zwiker is a freelance writer in Charleston.

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