The Revolutionary War began on April 19, 1775, with the battles of Lexington and Concord. Combat relied on firearms, but because single-shot muskets required time to reload, soldiers often fought at close range with swords and bayonets.
This resulted in a wide range of injuries. Army surgeons treated wounded soldiers while also managing disease and poor sanitation in military camps.
If a bullet passed cleanly through a limb, surgeons could cauterize the wound. Even in such cases, the risk of death remained high because there was no understanding of infection and no antiseptic treatment.
If a bullet remained lodged in the body, surgeons attempted to remove it using probes. Patients endured the pain without effective anesthesia.
More severe injuries occurred when bullets shattered bones. These fractures were difficult to treat, and controlling blood loss was critical. Field amputations were performed when necessary, though less frequently than during the Civil War.
Surgeons used a tourniquet to restrict blood flow, cut through tissue with a large knife and sawed through bone. The remaining tissue was then repositioned and sutured over the stump. Major blood vessels were tied off to reduce bleeding.
This procedure carried a high risk of death. About half of patients died from infection or shock following amputation.
Earlier treatments were even more harmful. Some surgeons believed gunpowder toxins caused injury and poured boiling oil into wounds to neutralize them.
A 16th-century French surgeon, Ambroise Paré, developed a better method after running short of supplies. He applied a mixture of egg whites, honey and turpentine to wounds. Patients treated this way recovered more often than those treated with boiling oil.
Paré also reintroduced the practice of tying off blood vessels rather than cauterizing entire wounds. Although battlefield medicine remained limited during the Revolutionary War, it benefited from these earlier advances.
Head and neck wounds were often fatal. In some cases, surgeons treated skull fractures by removing bone fragments pressing on the brain. They also performed trepanation, cutting an opening in the skull to relieve pressure or remove accumulated blood.
Although these injuries were severe, disease and poor sanitation caused even more deaths. About 6,800 soldiers died from combat wounds, while disease accounted for between 17,000 and 20,000 deaths.
— Peter J. Ward is a professor of neuroscience at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, W.Va. He earned a Ph.D. degree in anatomy education at Purdue University. Ward joined the WVSOM faculty in 2005 and has taught gross anatomy, neuroscience, embryology, histology and the history of medicine. He has received numerous teaching awards, including the WVSOM Golden Key Award and the American Association of Anatomists’ Basmajian Award, and has been a three-time finalist for the West Virginia Merit Foundation’s Professor of the Year selection. Ward has served as a council member and association secretary for the American Association of Clinical Anatomists. He has also served as a consulting editor, senior associate editor, lead editor and contributor for multiple medical publications, including the Netter Atlas of Human Anatomy.
