There were many medical advances made during the American Civil War. When the Civil War began in April 1861, medicine was approaching what Surgeon General William Hammond called "the end of the medical Middle Ages." American physicians had little knowledge of the cause and prevention of disease and infection. (Maher, pg. 1)
             The Army Medical Department, which was responsible for the care of the sick and wounded in the North, was unprepared. The staff of 90 doctors was experienced in dealing with the health problems of small military outposts, but had no idea of how to deal with large scale medical and logistical problems.
             Unfortunately, the war occurred just a few years before Louis Pasteur discovered the role of germs in infection; doctors dug bullet fragments out with unwashed fingers and operated with bloody
             instruments for lack of clean water (Thomas, pg92). A surgeon recalled: "We operated in old blood-stained and often pus-stained coats, we used undisinfected instruments from undisinfected plush lined cases. If a sponge (if they had sponges) or instrument fell on the floor it was washed and squeezed in a basin of water and used as if it was clean." Civil War surgeons actually thought pus in a wound was good (Maher, pg. 48).
             Early in the war it became obvious that disease would be the greatest killer. Two soldiers died of disease (dysentery, diarrhea, typhoid, and malaria) for every one killed in battle. Soldiers from small rural areas suffered from childhood diseases such as measles and mumps because they lacked immunity. Outbreaks of these diseases were caused by overcrowded and unsanitary conditions in the field. To remedy this, the U.S. government created the U.S. Sanitary Commission in June 1861.
             The commission was directed by Frederick Law Olmstead. Preaching the virtues of clean water, good food, and fresh air, the commission pressured the Army Medical Department to improve sanitation, build large wel...