The Pelvic Wound of Joshua Lawrence Chamberlain Revisited

In Brief Objectives: Joshua Lawrence Chamberlain, a hero of the Union during the American Civil War, suffered a major urologic injury in battle. Because of his recent resurgence of fame, there has been interest in his survival from a devastating pelvic wound. The literature has described his treatment as involving a possibly unprecedented repair of the proximal urethra and/or bladder neck. We have reexamined the primary and secondary literature to define, as far as we can determine for the first time, exactly what was done at the time of his injury. Methods: We reviewed available primary and secondary sources, including Chamberlain's letters and writings, regarding the time of his wounding and subsequent care, comparing these documents with current urologic management of such injuries. Results: Chamberlain's treatment was determined by the then current principles of treatment of urethral and bladder injuries. An invasive reconstruction would have been inconsistent with the abilities and practice of the times. The life-saving procedure referred to by many sources was both crucial and simple: an ultimately successful catheterization of a badly damaged proximal urethra and/or bladder neck. Conclusions: The treatment of Chamberlain's wound was difficult but in principal straightforward. Given the technical limitations of the time, this treatment is fully consistent with both modern and urologic principles of 150 years ago. Colonel Joshua Lawrence Chamberlain, a Civil War hero, received a devastating pelvic wound in 1984. The field hospital treatment that saved his life was not an innovative reconstructive procedure, as previously suggested, but a difficult bladder catheterization. The consequences of the wound and its treatment plagued him throughout his long life.