Contributing factors to combat-related deaths were inexperienced surgeons the lack of a coordinated system to get the injured off the battlefield quickly wound infections, since sterile technique was not yet recognized as important and battlefield tactics that did not keep pace with advances in weaponry. Soldiers died from two general causes: battlefield injuries and disease. Actually, during the Civil War, there were many medical advances and discoveries ( Table 1). It was stated that surgery was often done without anesthesia, many unnecessary amputations were done, and that care was not state of the art for the times. Medical care was heavily criticized in the press throughout the war. Many misconceptions exist regarding medicine during the Civil War era, and this period is commonly referred to as the Middle Ages of American medicine. The year after the war ended, the state of Mississippi spent 20% of its annual budget on artificial limbs for its veterans ( 3). Countless other soldiers were left disabled. More recent estimates based on comparative census data put the figure closer to 752,000 ( 2). As hard as it is to believe, these numbers may actually be an underestimate of the death toll, given that much of the data regarding deaths of Confederate soldiers was destroyed when Richmond burned on April 2, 1865. More Americans died in the Civil War than in all other wars combined. Two percent of the population at the time (approximately 620,000) died during the conflict ( 1). The Civil War was fought in over 10,000 places and was the bloodiest war in the history of the United States.
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