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Friday, May 21, 2010

Today is the Medical Museum's 148th birthday



148 years ago, a forward-looking medical man in a position of authority authorized the creation of the Army Medical Museum. Here's something I wrote about the creation of the Museum-

Like much of the rest of the country, the Army Medical Department was unprepared when the war began on April 12, 1861. As J.J. Chisolm wrote in his preface to the Confederate Manual of Military Surgery, "Most of those who now compose the surgical staff were general practitioners whose country circuit gave them but little surgery, and very seldom presented a gunshot wound. Moreover, as our country had been enjoying an uninterrupted state of peace, the collecting of large bodies of men, and retaining them in health, or the hygiene of armies had been a study without an object, and therefore without interest". America's last major war had been the much smaller conflict with Mexico thirteen years earlier which began in 1846 and lasted until 1848. As a result, most doctors, whether career military officers or newly-enlisted civilians, had almost no experience with gunshot wounds, especially those made by the newly-developed MiniƩ ball. MiniƩ had developed a conical bullet that came out of a rifled barrel; this high-speed bullet caused a significantly worse wound than the older soft lead ball.

Although, contrary to popular belief, physicians did use anesthesia during the war, medicine had not yet made the great advances now taken for granted. Since germ theory did not exist, bacteria and viruses were not recognized as the cause of disease. Anti-sepsis would not be practiced until the decade after the war. Blood typing did not exist and so transfusions were extremely rare. William Roentgen would not discover x-rays for another 30 years. Penicillin and antibiotics were 80 years in the future. Medical education was extremely simplistic, and the familiar modern hospital-based training would not be instituted until after the turn of the century. Amputation was a common treatment for a wound of a limb, although surgeons tried excision (removal of the damaged bone) more frequently - sometimes causing more problems than if they had amputated. The Department had no ambulance corps. It was not until the second year of the war that Dr. Jonathan Letterman developed a standard procedure for removing the wounded from the battlefield. To address some of these problems, Drs. William Alexander Hammond and John Hill Brinton created the Army Medical Museum.

Surgeon General William Hammond

By the end of the spring of 1862, Surgeon General William Hammond's plans for revising the Union Army's Medical Department were beginning to get underway. Secretary of War Stanton had not liked Hammond's aged predecessor, Clement Finley, and had forced him to retire. Hammond had then been appointed, regardless of seniority, to head the Medical Department on April 25, 1862. His appointment was due to the Sanitary Commission's pressure on Stanton for an younger, energetic Surgeon General who could revitalize the department.

At the height of his authority in May of 1862, the newly appointed Hammond had begun making changes in the Medical Department. Most importantly for the study of medicine and eventually its history, Hammond committed the resources of the Department to forming a museum, which would use its collections and the records of the Surgeon General's Office to compile a medical history of the war. Only a few weeks after taking over the Medical Department, Hammond established the Army Medical Museum, the first federal medical research facility. By creating the Museum, Hammond essentially began government-funded medical research which is now seen as such a basic part of the role of government. As Dr. J. J. Woodward, whom Hammond assigned to the Museum, pointed out years after the war:

The establishment of the Army Medical Museum was undoubtedly
suggested by a most pressing need experienced at the
commencement of the late war. There were at that time but
few persons in the United States who had any experience
whatever of military surgery, and there was no place in he
country to which the surgeon about to devote himself to the
military service could turn for definite information or
guidance beyond what he could obtain from foreign works. It
was natural that conscientious men, many of whom had never
seen a gunshot fracture in their lives, should feel a grave
regret that there was no place where, before assuming their
new responsibilities, they could obtain a more realistic
knowledge of the details of military surgery than they could
possibly gather from books and pictures alone." (Woodward,
Lippincott, p. 241)

Hammond issued several orders to implement his ideas. These were published in the form of "circular letters" which were intended to be passed through the Department until everyone had seen them. In Circular No. 2, issued on May 21, 1862, Hammond specifically stated "Medical Directors will furnish one copy of this circular to every medical officer in the department in which they are serving."

This circular established the Museum, stating:

As it is proposed to establish in Washington, an Army
Medical Museum, Medical officers are directed diligently
to collect, and to forward to the office of the Surgeon
General, all specimens of morbid anatomy, surgical or
medical, which may be regarded as valuable; together with
projectiles and foreign bodies removed, and such other
matters as may prove of interest in the study of military
medicine or surgery.

These objects should be accompanied by short
explanatory notes.

Each specimen in the collection will have appended
the name of the medical officer by whom it was prepared.


Shortly after the initial circular letter was issued, Hammond recalled Dr. John Hill Brinton from duty on the western battlefields. Brinton's orders were extremely laconic, telling him only to report to Washington for special duty. Brinton arrived hoping to receive one of the newly-created medical inspectorships, a job for which he felt well-qualified. Instead, he was assigned to the examining board for surgeons, placed in charge of the Museum, and told to prepare the surgical history of the war. Hammond's Circular No. 5, issued on June 9th, formally created The Medical and Surgical History of the War of the Rebellion and placed the responsibility for accomplishing it on Brinton and Dr. J.J. Woodward. Brinton was assigned the Surgical part and Woodward the Medical.


Staff of the Army Surgeon General's Office after Hammond and Brinton's departure.

Now, almost a century and a half later, the Museum's fortunes have ebbed and swelled, a great pathology institute grew out of it as did the foundations of the National Library of Medicine, and we're about to embark on yet another move, this time to Forest Glen, MD where a new building is about to be started for us.

1 comment:

Mage said...

Congratulations to all of you on staff. I hope this move isn't a banishment but an improvement.