Blaisdell F W
Department of Surgery, University of California, Davis, Sacramento 95817.
Arch Surg. 1988 Sep;123(9):1045-50. doi: 10.1001/archsurg.1988.01400330021001.
The contributions to medical care that developed during the Civil War have not been fully appreciated, probably because the quality of care administered was compared against modern standards rather than the standards of the time. The specific accomplishments that constituted major advances were as follows. 1. Accumulation of adequate records and detailed reports for the first time permitted a complete military medical history. This led to the publication of the Medical and Surgical History of the War of the Rebellion, which was identified in Europe as the first major academic accomplishment by US medicine. 2. Development of a system of managing mass casualties, including aid stations, field hospitals, and general hospitals, set the pattern for management of the wounded in World War I, World War II, and the Korean War. 3. The pavilion-style general hospitals, which were well ventilated and clean, were copied in the design of large civilian hospitals over the next 75 years. 4. The importance of immediate, definitive treatment of wounds and fractures was demonstrated and it was shown that major operative procedures, such as amputation, were optimally carried out in the first 24 hours after wounding. 5. The importance of sanitation and hygiene in preventing infection, disease, and death among the troops in the field was demonstrated. 6. Female nurses were introduced to hospital care and Catholic orders entered the hospital business. 7. The experience and training of thousands of physicians were upgraded and they were introduced to new ideas and standards of care. These included familiarity with prevention and treatment of infectious disease, with anesthetic agents, and with surgical principles that rapidly advanced the overall quality of American medical practice. 8. The Sanitary Commission was formed, a civilian-organized soldier's relief society that set the pattern for the development of the American Red Cross.
美国内战期间在医疗护理方面取得的成就尚未得到充分认可,这可能是因为当时所提供护理的质量是与现代标准而非当时的标准相比较。构成重大进步的具体成就如下:1. 首次积累了充足的记录和详细报告,从而能够编写完整的军事医疗史。这促成了《叛乱战争的医疗与外科史》的出版,该书在欧洲被视为美国医学的首个重大学术成果。2. 发展了一套管理大批伤员的体系,包括救护站、野战医院和综合医院,为第一次世界大战、第二次世界大战及朝鲜战争中伤员的管理树立了典范。3. 通风良好且干净的 pavilion 式综合医院,在接下来的 75 年里被用于大型民用医院的设计。4. 证明了对伤口和骨折进行即时、确定性治疗的重要性,还表明诸如截肢等大型手术在受伤后的头 24 小时内进行最为适宜。5. 证明了卫生与清洁对于预防战场上部队感染、疾病和死亡的重要性。6. 女性护士被引入医院护理工作,天主教修会也涉足医院事务。7. 数千名医生的经验和培训得到提升,他们接触到了新的护理理念和标准。这些包括对传染病预防与治疗、麻醉剂以及外科原则的熟悉,这些迅速提升了美国医疗实践的整体质量。8. 卫生委员会成立,这是一个由民间组织的士兵救济协会,为美国红十字会的发展树立了典范。