Authentic pocket field kit for a Civil War medic.

With 51,000 casualties to tend to, the civil war surgeon's weapon of choice was often an amputation saw.

Civil War surgeons learned fast, and many of their MacGyver-like solutions have had a lasting impact.

It is thought Nina and Lucy Ann had their hollowed out heads stuffed with medicine for wounded Confederate troops as a way to beat Union blockades of the South.

It was America's bloodiest military day

John Dunbar had to make a decision -- quickly. Lying in a field hospital where treatment decisions are made in moments or on a whim, Dunbar surveyed a pile of military boots. In the background, surgeons talked while preparing for yet another amputation: His bloodied right leg. The Union lieutenant painfully pulled his boot back on and hobbled away to a fence on the Tennessee battlefield. Spying a horse, he climbed aboard and made his famous ride between Union and Confederate lines, arms lifted and a serene expression on his face. He awaited a bullet that would end the misery. A bullet, of course, never found the mark. Dunbar, better known as actor Kevin Costner, eventually got medical attention from a general’s doctor and rode on to other adventures in the 1990s film “Dances With Wolves.” Books and movies have often depicted a trip to the Civil War field hospital as a lesson in futility. The reality, however, was a little more on the positive side, argues the executive director of the National Museum of Civil War Medicine in Frederick, Md., which has trained 4,000 members of the military in aspects of treating casualties. “The idea that all hospitals look like the one in ‘Gone With the Wind’ is inaccurate,” argues George Wunderlich. Wunderlich says that the Civil War actually brought huge advancements in the treatment of soldiers, notably at the September 1862 Battle of Antietam. Ninety-five percent of Union doctors used anesthesia. And although there were no antibiotics such as penicillin, medical staff understood the importance of sanitation. Some hospitals had mortality rates as low as 7 percent-10 percent. Still, having enough supplies and cleaning materials was difficult, especially at the front. “They never were able to manufacture all the necessary ambulances and conveniences,” Wunderlich (below, at Antietam) says of the Confederacy. The mortality numbers are frightening enough, even without the tales of men terrified about going to a military hospital. Death by disease led deaths by wounds 2-1. Statistics for the Union armies list 67,000 killed in action, 43,000 deaths from wounds and 224,000 lost to disease. The numbers were probably worse in Southern armies. Wunderlich argues soldiers, even through World War II, had a high risk of infection. Couple that with the fact that medicine was years away from advancements in treating gut wounds, severe head injuries and damage to the thorax. Lifestyle and conditions in the field had the deadliest consequences. “The biggest killer of the Civil War was the fact that Boy Scouts had not been invented yet,” he says. Troops had very poor personal hygiene and drank from polluted water often used as a latrine. Wunderlich contends 100,000 lives would have been saved with a concerted hygiene push. The wounds were also horrific. The .50-caliber minie balls that smashed there way through the body left shards of bones that brought sure infection and, likely, death. “The best way to save a life was amputation.” The museum has two principal missions. One is to educate the public about advancements brought by the war, including plastic surgery, anesthesia and reconstructive surgery. An Atlanta hospital, for example, specialized in maxillofacial surgery and Turner’s Lane Hospital in Philadelphia had a neurological focus. The 7,000, three-story building consists of five immersion exhibits that recreate aspects of Civil War medical issues: life in an army camp, evacuation of the wounded from the battlefront, a field dressing station, a field hospital and a military hospital ward. “Our most surprising audience is the U.S. military,” says Wunderlich. His 17 full- and part-time staff, augmented by about 30 volunteers – most with medical backgrounds – teach Army corpsmen and general alike about field hospitals and surgery fundamentals, such as evacuation and triage. “We want corpsmen to know how to read terrain to find good aid stations.” The center accomplishes this both at Frederick and at Pry House Field Hospital Museum (right) at Antietam National Battlefield in western Maryland. Through an arrangement with the National Park Service, the museum runs the Pry house and re-creates fundamentals of war medicine that are as common in Afghanistan today as they were at Gettysburg. The house and barn served as Gen. George B. McClellan’s headquarters during the battle. But it also was a hospital for 400 wounded soldiers, including Major Gen. Joseph Hooker. “We tell soldiers today, ‘We’re going to put you on the Antietam battlefield. You are going to work on problems Letterman worked on,’” Wunderlich says. Letterman was Maj. Jonathan Letterman, who McClellan brought to the Army of the Potomac to to fix a “broken system” and is now regarded as the father of modern battlefield medicine. Letterman (left) fired bad surgeons, emphasized sanitation, implemented command and control and increased the medical staff. His contributions included staffing and training men to operate horse teams and wagons to pick up wounded soldiers from the field and to bring them back to field dressing stations for initial treatment. This was the nation's first Ambulance Corps. He developed the three-tiered system still in use: Field dressing stations, field hospitals (M*A*S*H) and larger hospitals away from the battlefield. “Our modern medical system was developed into a unified system here in 1862,” Wunderlich says. • Click here for more information on the National Museum of Civil War Medicine.

Medical Supplies at a Civil War Reenactment Camp in Gettysburg.

Portrait of three unidentified Sanitary Commission nurses during the Civil War. From Miller's Photographic History of the Civil War.

150 years ago, the historic conflict forced doctors to get creative and to reframe the way they thought about medicine

The founder of the Red Cross dedicated her life to helping others and fighting for equality.

hdl.loc.gov/loc.pnp/ppmsca.39811

War is brutal. War is just. The American Civil War (1861–1865) was no exception. For many men that bloody war meant giving a lib. Amputations were the order of the day:

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One hundred and fifty years later, historians are discovering some of the earliest known cases of post-traumatic stress disorder

The Egyptians were the early pioneers of prosthetic technology. Their rudimentary, prosthetic limbs were made of fiber and i...

In WWI more than 10,000 nurses served near the Western Front, many at front-line medical stations. But they served without rank or commission.

Hospital Sketches Block # 3 Love Apple by Becky Brown Our third block recalling Civil War hospitals focuses on Union hospital ships...

Nurse Amelia Mazzara (1831 - 1897) Collection of the California Historical Society Photos of Civil War nurses are rare. Nurse Mazzara's picture was published in the California Historical Society Quarterly with a caption dating it to about 1862. She seems to be wearing a uniform. The bodice has triple rows of soutache or braid on the collar, cuffs and running down the the front. She has an arm band like one we'd see today on a Red Cross nurse. Her white, almost floor-length apron is pinned onto the bodice and perhaps buttoned at the waist. She may be wearing a cap that doesn't show in the photo. See the article with the photo here: http://www.militarymuseum.org/CAandtheCW.pdf But, I'm becoming suspicious that it's not an 1862 photograph and she is not wearing a Civil War nurse outfit. The caption says it is a Bradley & Rulofson photo. These San Francisco photographers did not travel to any battle fronts so the photo was probably taken in their studio after their partnership began in 1861. Amelia's husband, sculptor Pietro Mezzara worked on the premises of the Bradley & Rulofson Studio in the 1860s and '70s. Amelia Mezzara was indeed a Civil War nurse but one wonders why a Civil War nurse was photographed in San Francisco, so far from any battlefields. Amelia Victorien Foulon du Groudre Mezzara was born in France. Husband Pietro, inspired by the Gold Rush, came to California in 1850. He found some success as a sculptor, particularly in cutting life-like cameos. Pietro Mezzara's bronze statue of Abraham Lincoln, 1865, melted in the great San Francisco fire of 1906. At the end of the century a San Francisco newspaper article explained Amelia's service as a nurse with the Union Army. She was in New York in 1861 hoping to join her husband in California but had to wait three months for a sailing date. Believing (like many optimists) that the Civil War would last three months she volunteered to join Dorothy Dix's corps of nurses and went South with Hooker's Division. "Mme. Mezzara remained faithfully at her post until Richmond came down." Amelia finally made it to California after the war. When the Franco-Prussian War broke out in 1870 she bravely traveled to France to use her nursing skills in her native country. Railroad cars as hospitals in the Franco-Prussian War She received a medal in France and another from French women back in San Francisco. Mezzara sculpture on the state capitol in Sacramento Pietro Mezzara returned to Europe about the same time Amelia sailed and never came back to the U.S. After the war was over in 1871 Amelia supported herself by teaching French in San Francisco. Newspaper portrait from the 1890s. In 1896 she was awarded a Union Nurse's Pension after becoming disabled in a fall from a streetcar. At the time an article in the San Francisco Call included an interview: " 'I do not care to see myself written up as anything of a heroine,' said the gentlewoman yesterday. 'The world has many women who did as much and more than I have accomplished among the wounded soldiers, and their names have never been mentioned in the newspapers. The work of nursing was hard always, as nurses in the hospitals fared like the troops, but I have ever received the utmost kindness and courtesy from foes as well as friends. The graceful commendation of the two great republics and those who honored me with their approving testimonials, is recompense far above my deserts.' " She died the following year of "paralysis of the brain," probably a stroke. After reading Amelia's story and trying to figure out when the photo was taken, I believe that uniform with a red cross arm band is her French uniform from the Franco-Prussian war. Detail of a field hospital during the French-German War of 1870-1871. See the rest of the photo in the collection of the Oregon Health & Science University Library here: http://ohsu-hca.blogspot.com/2011/03/franco-prussian-war-photograph.html The red cross as an identifier was developed in 1863 when international signers to the Geneva Convention agreed that medical personnel should easily be distinguished by a simple badge. The red cross on the white background was a reverse of the Swiss flag, a nation that prided itself on its neutrality. Is that a red cross on the nurse's apron in this Swiss hospital? https://www.icrc.org/eng/resources/documents/misc/57jnvw.htm During our Civil War field hospitals were identified with a yellow and green H. See a post on the flags with the H here: http://civilwarquilts.blogspot.com/2011/10/42-h-is-for-hospital.html There's really no evidence I've seen that Amelia's photo was taken in 1863. P.S. Many captions will tell you this photo is of Civil War nurses in outlandish caps. Not true. They are women dressed in regional French headgear at New York's Sanitary Fair. I found this photo floating around the internet. "Nurses Hospital No 9. Summer '63' " I don't think there were any uniforms as such for nurses during the Civil War other than a discreet dark dress and a pinned apron. UPDATE: See Harriet Douglas Whetten's photo at the Wisconsin Historical Society here: https://www.wisconsinhistory.org/Records/Image/IM1882