Medicine of the Civil War
By Jim Long
The years of the Civil War were a cauldron of convoluted medical experimentation and improvisation. Not intentionally, of course, but as the war progressed and expanded across the states, elements of diverse American life were thrown together in volatile ways, testing the methods and practices used by folk healers, physicians and old guard military doctors. By the end of the War Between the States, American medicine was forever changed and plants played a major part.
The physicians from the period of the Santa Fe Trail, 1820 to 1847, laid the groundwork for medical practices and ideas that would become common during the war. Most physicians were self-taught, or apprenticed themselves to an older physician. Fewer attended one of the small, for-profit medical schools on the East Coast. For those, the usual period of study lasted six to nine months, most of it spent listening to lectures in a classroom. Upon graduation, most physicians had experienced no hands-on practice with patients. Physicians of the time were looked upon little differently than carpenters, plumbers or other tradesmen.
In 1847 the American Medical Association was formed with the specific purpose of elevating physicians above tradesmen, and establishing a set of teaching guidelines and basic requirements for graduation. However by the time of the Civil War, the majority of physicians had learned their trade as apprentices to older doctors and had extensive experience using traditional plant medicines.
The treatment for malaria is a good example of how divergent the methods of the day were. At the beginning of the War, old-guard Union military doctors still regularly followed the useless practice of bleeding (also known as blood-letting) and purging as the only official treatment for malaria. Even though Dr. John Sappington, a physician from Arrow Rock, Missouri, had been manufacturing and selling anti-malaria quinine pills (made from the bark of the Cinchona tree) since the 1820s to people setting out on the Santa Fe and Oregon Trails, and had demonstrated its effectiveness as a specific in treating malaria, it wasn’t until well into the war that military doctors stubbornly accepted quinine as a proven cure for malaria.
Confederate doctors during the “War of Northern Aggression,” were more schooled in the use of plants as medicine than were their counterparts in the Union Army. So much respect was given to plant medicines that the Confederate Army commissioned a comprehensive study of herbal medicines. The result was “Resources of the Southern Fields and Forests,” by Francis Porcher (1863). This book so thoroughly described the indigenous herbs, their uses and dosages, that it was used as reference for decades to come.
At the beginning of the Civil War, the Union Army listed only 98 physicians and the Confederate Army showed just 24. But by the end of the war, the Union Army had recorded the services of 11,000 doctors and the Confederate Army had 3,000. The influx of physicians pressed into service included many experienced folk doctors who had served on the Santa Fe Trail, as well as young, newly-educated physicians from some of the early medical schools. That influx of new methods and ideas set the stage for the great experiment in healing.
During this time, simple acts of washing medical instruments, clean bandages and coverings over windows in hospitals, was demonstrated to create conditions for more predictable recovery. It is estimated the simple change from blood-letting and purging to treat malaria, to the use of quinine saved thousands of lives.
Dr. Sappington’s “Little Pills,” made from quinine bark, licorice and myrrh, were shown to be effective treatment for malaria, due to the high recovery rates in soldiers. Other plants used during this time included the following:
- Aloe, both imported varieties, as well as our native aloe vera from the American Southwest, was used as a purgative and poultice. We know it today as a helpful plant for treating sunburns as well as more serious burns.
- Allium (Allium spp.), both onions and garlic, were important in the treatment of serious wounds, skin infections and insect bites. According to Sylvia Windle Humphrey, in “A Matter of Taste” (1965), onions were so important in battlefield medicine that in 1864, General Ulysses S. Grant said, “I will not move my army without onions.” Two days later he reportedly received three train-car loads of onions! Because of the antibacterial properties of onions and garlic, these plant treatments were still in use in World War I.
- Bee Balm (Monarda fistulosa & related spp.) was considered a treatment for colic, upset stomach, to induce sweating, and the leaves were poulticed and applied to the head for headaches. This widely-grown herb is still valued today as a pleasant tea and soother of upset stomachs.
- Burdock (Artium lappa & A. minus), thought of as a weed today, was once valued for its use in treating acne, psoriasis, burns, wounds and swellings. Better known today as a vegetable in Asian cooking and available at farmers markets and specialty stores, it also continues to be used medicinally.
- Calendula (Calendula officinalis), was used as an anti-inflammatory, eyewash, poultice, lotion and salve. The bright-orange flowers are the parts used and calendulated lotions, oils and salves can be found in pharmacies everywhere. Calendula was, and still is, considered specific for various skin ailments.
- Catnip (Nepeta cataria) was a popular folk remedy for bronchitis, colds, diarrhea, fevers and headaches, as well as tea used for inducing sleep. Little bags of dried catnip leaves were put in cribs of colicky babies to help them sleep. The fragrance of the dried herb is a soothing sleep pillow ingredient still in use today. Catnip is related to mint, therefore the plant also has current use in easing upset stomachs.
- Cayenne Pepper (Capsicum spp.), known in medical journals of the period as Pulveris capsicum, or pulverized pepper), was used as a topical rubefacient — to raise blisters or cause reddening on the skin. It was also combined with other medications to speed absorption into the bloodstream. Folk uses today include cayenne’s use as a treatment for some stomach ulcers, and still used in combination with other herbs for faster absorption.
- Chamomile (Chamomilla recutita), the flowers of which were, and still are, used for upset stomach and as a sleep aid. Remember the children’s story about Peter Rabbit, who, after having eaten so many carrots his stomach ached? Peter’s mother gave him chamomile tea and sent him to bed. That folk tale illustrates the excellent healing properties of chamomile for both soothing indigestion and helping one sleep.
- Chicory (Cichoorium intybus) was used, especially in the South, as a treatment for jaundice, laxative, diuretic, lowering blood sugar and for liver and gall bladder ailments. It was a common substitute for coffee in the Southern Army, often combined with dandelion roots, both of which were roasted, ground and brewed like coffee beans. Today we find chicory in specialty coffee blends.
- Echinacea (Echinacea spp.), also known as cone flower, this highly-esteemed plant is even more popular today than it was during the 1860s. Back then it was used for infections, chronic inflammations, on wounds, canker sores and spider bites. We know it today as a helpful immune system booster at the first signs of colds or flu.
- Elderberry (Sambucus canadensis), our native roadside berry and herb, had traditional uses as a diuretic, laxative and poultice on sores and cuts. Both the leaves and bark were used in healing salves, historically, and those products can still be found today.
- Gentian (Gentiana spp.), was considered one of the best plants for bitters — that concoction used for encouraging digestion and appetite. When wounded soldiers were slow to heal and had no appetite but needing to ingest food to speed up the healing process, bitters were very often prescribed. There has been a strong resurgence of using bitters for those healing from cancer treatments to boost appetite and strengthen the nerves, and gentian is still considered effective.
- Ginger (Zingiber spp.) was in use throughout the 1800s in the treatment of stomach problems, indigestion and motion sickness and sea sickness. Ginger root is still in use today for those ailments and is especially useful for people traveling across multiple time zones by air.
- Hops (Humulus lupulus), while better known today as an ingredient in fermented beverages, hops have a long and respected use as a sedative, as well as a treatment for boils, fevers, coughs and bruises. Hops is another of the excellent herbs used in aiding sleep by placing dried hop flowers in a bag, then inside the pillowcase.
- Horehound (Marrubium vulgare) has been used to treat sore throats and coughing, usually in tea or throat lozenges, for many centuries. Fresh leaves were sometimes poulticed on wounds and cuts and it was once thought to be useful in treating gall bladder problems. Although the horehound cough drops often found in stores today contain no actual horehound, the authentic item can be found in health food stores and remains a soothing treatment for sore throats and coughing.
- Jewelweed (Impatiens capensis) has been associated with the treatment of poison ivy throughout history. It was, and still is, rubbed on the skin immediately after exposure to poison ivy to prevent blistering. It is also used as a treatment after blistering occurs to soothe the itching. During the war the juicy, crushed stems were applied to insect bites and rashes as well as to poison ivy exposure.
- Lavender (Lavandula spp.) was best known as a flavoring agent to make other medicines more palatable. We know it today as a relaxing fragrance to help children and adults sleep better. Lavender oil, applied directly to the forehead, speeds healing of headaches. Some brands of baby shampoo contain lavender oil, which has been proven to help babies relax.
- Lemon balm (Melissa officinalis) may be one of the most over-looked plant medicines from the past with current applications. The highly acclaimed Swiss physician, Theophrastus Paracelsus (1493-1541) included lemon balm as a primary ingredient in his famous regenerating elixir to restore health to the sick. Today, lemon balm is used as a flavoring ingredient and as an herb in desserts and teas. The website Webmd lists lemon balm as useful in digestive problems, upset stomach, bloating, colic, pain, menstrual cramps, insomnia and headaches. Recent research suggests that topical ointments containing concentrated lemon balm oil helps heal cold sores caused by the herpes simplex virus.
- Marshmallow (Althea officinalis) was used to treat inflammations of the throat, stomach, vaginal, rectal and urinary tract. It was also used in the treatment of skin eruptions. The roots were the part used, boiled into a slimy mass that was used to coat the throat or stomach. To make the herb more pleasant to administer, doctors in the 1800s extracted the juice from the marshmallow plant, cooked it with egg white and sugar then whipped it into a puffy meringue. When the meringue hardened into a candy, it was administered to the patient. It was one of the more pleasant medicines used as a cough suppressant and soothing agent for sore throats. Today, however, commercial marshmallows contain no marshmallow root at all, that ingredient having been replaced by gelatin.
- Oxalis, Wood Sorrel (Oxalis acetosella & O. violacea) is better known today as a so-called, “weed” in our lawns and gardens. Sometimes called, “sheep sorrel” or “pickles” by children, this common plant was used as a tea and flavoring agent. Long known for its action as a refrigerant, meaning cooling of the skin, it was sometimes given, diluted in water, as a beverage for the sick. Today we know it as a fine addition in salads, and the flavor is similar to rhubarb when cooked into a pie or tart.
- Pennyroyal, American (Hedoma pulegiodes) was used historically to treat colds, coughs, fevers, headaches and as an insect repellant. Soldiers during the war (and many people still, today) simply rub the fresh plant on the skin to ward off insects. Current medical research warns against taking pennyroyal tea or oil internally due to the possibility of damage to the liver, or with prolonged use, even death. However, rubbing in on the skin to ward off mosquitoes and ticks, is still the best use of the plant.
- Peppermint (Mentha piperita) has been used as an appetite stimulant, for upset stomach, vomiting and other digestive problems since the time of the ancient Greeks. During the Civil War it was used for those purposes as well as a flavoring in food, beverages and candies. Even today peppermint is highly valued and effective in those same ways.
- Plantain (Plantago major & P. lanceolata) are plants brought to the Americas in grain feeds imported from Europe in the 1700s. Both plants quickly took root along the trails West and were common across most of the United States by the 1800s. Leaves were used in treating blisters, wounds, sores, swellings and insect bites. While the plant remains effective for many of those same uses, it is better known today as a “noxious weed” in our lawns and some people spray weed killers to remove it, not knowing what a valuable plant it is.
- Poppy (Papaver somniferum) was one of the most important pain relievers for many centuries. Opium and morphine were extracted from the poppy resin and every doctor carried it in either powder or tincture form. Poppy seeds were also cooked, ground and mixed with sugar and cardamom seeds to treat diarrhea, coughs and asthma. Papaver somniferum remains a vitally important plant in the manufacture of pain-killing drugs used in medicine today.
- Sage (Salvia officianlis) may have been better known as the flavoring agent in sausage, but it had a reputation of being used to treat headache, skin eruptions and occasionally sore throats. Syrup made with sage, as well as throat lozenges, was a common medicine of the period. While mostly seen today as a culinary herb, the plant still has usefulness in easing sore throats and coughs.
- Slippery Elm (Ulmus rubra) was a specific in the physician’s medical bag for a sore, inflamed throat and laryngitis. It comes from the inner bark of the indigenous slippery elm tree and was made into lozenges to be dissolved in the mouth and throat. Slippery elm tablets can be found in health foods stores today and are used for the same purpose as they were historically.
- Spearmint (Mentha spicata) was used interchangeably with peppermint, although the latter is consider the stronger herb. Used in the treatment of fevers, upset stomach, as an appetite stimulant in the sickroom and as an agreeable tea. Neither mint is native to the United States but both were taken with settlers moving westward and by the 1800s could be found growing around springs and creeks throughout many states.
- Thyme (Thymus spp.) is thought of as a culinary herb today, but historically it had an important part to play in medicines. The plant is highly antiseptic and therefore a good wound herb, often applied as a decoction (strong tea) or tincture in alcohol. Uses included: nervous disorders, flu, coughing, expectorant, blood purifier and easing the pain of toothaches. Today, because of the antiseptic properties, oil of thyme (thymol) can be found in mouthwashes and first-aid salves.
- Valerian (Valeriana officianalis) was native to Europe and Asia but was being imported into the United States as early as colonial times, and its uses date at least as far back as ancient Greece and Rome. It was prescribed for insomnia, depression, nervous headaches and relaxation of muscle spasms. Valerian remains a popular alternative today for sleep problems because it is considered to be gentle and safe to use and can be purchased wherever herbal supplements are sold.
- Yarrow (Achillea millefolium) is one of the most important wound herbs throughout the history of war. Known by the various names of old man’s pepper, soldier’s woundwort and thousand-seal, this highly effective blood-stopping agent was found in every physician’s arsenal of remedies. Named for Achilles, the hero of the Greek Trojan War, who, legend has it, was killed by an arrow in the heel. Achilles mother is said to have held him by the heel as a baby and dunked him in the river Styx to make him immortal. Elements of that tale were likely concocted to pass on the importance of this vital herb of war. When yarrow leaves or flowers, fresh or dry, are applied to a bleeding wound, the wound seals and stops the bleeding in seconds. The only danger in this predictable action comes if the wound has dirt or debris in it. Otherwise, if the wound is washed or clean, the historical herb works as well in stopping bleeding today as it did in the first century A.D.
The Great Experiment
This “great experiment” in medicine that took place during the Civil War, out of necessity, by the bringing together of disparate, often contradicting ideas of healing methods, broadened and condensed ideas and practices. These early healers who were forced to deal with large numbers of sick and wounded, developed an appreciation for what was effective and what wasn’t. Healers of the day are often thought of by people today, in (sometimes distorted) retrospect, as only surgeons who had no alternatives other than the sawing off of limbs. The reality is that most healers during the Civil War period were from rural backgrounds, had extensive experience using plant medicines and only resorted to the “cut and saw” methods as a last resort. Many of the plant medicines used during that terrible time still find uses today.
Note: As is true when using any plant to treat yourself, always consult a knowledgeable health professional. Herbs, while appearing friendly and benign, are also medicines and should always be treated with caution and respect. Caution should also be advised for expectant mothers.
For resources for more information about plant medicines, see Jim Long’s books: Herbal Medicines of the Civil War, It Will Do No Harm to Try It (the Diary of Elias Slagle, 1859) and Herbal Medicines of the Civil War, on his website: www.LongCreekHerbs.com.
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