Surgical Procedures in the American Revolution
Surgeries during the time period of the American Revolution were a series of trial and error as surgeons attempted to heal injured soldiers from injuries they faced during battle. Fact took second place over theory1, and as surgeons gained new and valuable knowledge through their trials, it was not only surgeons from the Colonies who recorded their findings. Dominique-Jean Larrey, a French surgeon during the war, recorded his experiences in his journal Memoirs of Military Surgery. He recorded his work performing surgeries on injured soldiers during the war. In one of his entries, Larrey intricately recounted how he performed abdominal surgeries on two French soldiers who were shot in battle. Their injuries required amputations at the hip joint, and both soldiers passed away shortly after, despite their insistence on having the operation performed. Larrey stated in his journal, “I am of the opinion, that if this operation were instantly performed by an expert surgeon, when the wound required it, as in these two cases, it would succeed as well as amputation at the shoulder joint, but few successful cases of which were formally recorded”.2
Despite countless amputations being performed during the American Revolution, surgeons did not yet have the necessary knowledge to ensure the success of these procedures, and soldiers often died shortly after amputation, which was typically performed on the battlefield rather than in a more sterile environment. From the article Emergency Medicine in Colonial America, "The operation was conducted without anesthesia or analgesia of any kind. The amputation was guillotine-type, with no closure of the stump other than by bandages"3. Jelenko, Matthews, and Matthews argue that there was no reliable emergency medicine during the period we have today, such as hospitals, modern medicine, or more reliable surgical techniques. The lack of valuable resources only increased the death toll of soldiers. Even when performing surgeries during the war, surgeons had to find unusual ways to operate. In The Meeting House, which served as a hospital during the war, Benjamin Rush and his colleague Dr. Lewis Howell improvised a method for conducting surgery on wounded soldiers by placing them on wooden benches and an unhinged door as operating tables. 4
Despite the challenges, the knowledge surrounding surgeries steadily began to improve. In the second half of the 18th century, it became a requirement that surgeons and surgeons’ mates had to pass an army surgical exam, administered by the London Corporation of Surgeons5. Once surgeons were better educated, the knowledge they gained helped prevent disease outbreaks in hospitals. This change in the amount of knowledge that surgeons and surgeons’ mates had before performing a procedure during battle marked significant progress in medical practice that would impact the future of medicine. Requiring surgeons to pass an army surgical exam helped reduce the number of soldiers' lives at risk in battle and ensured that surgeons possessed critical medical knowledge. The improvement of surgical techniques during the American Revolution not only saved lives but also laid a crucial foundation for future advancements in the medical field. The knowledge gained by Revolutionary War surgeons influenced medical strategies in later wars and as well as modern healthcare.
1Gillett, Mary C. The Army Medical Department, 1775-1818. Center of Military History, United States Army. Center of Military History, 1981.
2 Larray, Dominique-Jean. 1814. Memoirs of Military Surgery, and Campaigns of the French Armies, on the Rhine, in Corsica, Catalonia, Egypt, and Syria; at Boulogne, Ulm, and Austerlitz; in Saxony, Prussia, Poland, Spain, and Austria. https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-2561003RX2-mvpart. " target="_blank" rel="noreferrer noopener">https://collections.nlm.nih.gov/bookviewer?PID=nlm:nlmuid-2561003RX2-mvpart.
3Jelenko, Carl, Judith B. Matthews, and John Carter Matthews. 1982. “Emergency Medicine in Colonial America: Revolutionary War Casualties.” Annals of Emergency Medicine 11 https://doi.org/10.1016/s0196-0644(82)80012-7.
4 Howard, Martin R. 2023. The Fevered Fight, a medical history of the American Revolution, 1775-1783 https://eds-p-ebscohost-com.proxy1.cl.msu.edu/eds/pdfviewer/pdfviewer?vid=1&sid=819b94fa-a791-4c7e-bf0e-44de055bea69%40redis
5Marshall, Tabitha 2010. “Surgeons Reconsidered: Military Medical Men of the American Revolution.” Msu.edu. 2010. https://www.utpjournals.press/doi/pdf/10.3138/cbmh.27.2.299