Anesthesia Advances During the Civil War

The advent of general inhalation anesthesia, in the form of ether (1846) or chloroform (1847), revolutionized medicine for surgeons and patients. Its efficacy in wartime was quickly tested in the Civil War, establishing that painless surgery on the battlefield might be possible (Fig. 1). Despite prior, widespread use of ether by American doctors, chloroform became the anesthetic agent of choice by Union and Confederate Army surgeons, due primarily to its nonflammability and the “rapidity of its effects […] and from the small quantity required.” Army Surgeon B. B. Breed, United States Volunteers wrote that while he personally preferred ether, “on the field of battle […] chloroform is the safe and preferable agent.” As the war progressed, authors of the “Medical and Surgical History of the War of Rebellion (MSHWR)” determined that gathering statistics on the use of anesthesia was “impracticable.” Indeed it may be the only instances in the creation of “MSHWR's” six volumes that the gathering of data was considered unfeasible—a notable distinction in its own right. They determined that chloroform was used at least 80,000 times and individual testimonies from field surgeons noted that they “invariably,” “universally,” or “in every painful operation” used chloroform. Only 37 deaths (5.4 deaths per thousand cases) were attributed to chloroform as surgeons repeatedly emphasized the importance of dosage and the risks of overusing chloroform.