This is an interesting period because anesthesia had been in use for 14 years when the war began but the concept of antisepsis would only appear two years after its end. At the beginning of the war, the US Army was tiny and scattered and the medical corps was in the hands of incompetents. For example, they had provided no textbooks to save funds. As the war began, Samuel Gross, a professor of surgery in Philadelphia, wrote his own textbook of military medicine in nine days. It was copied by the Confederates in 1863 and became their medical “bible” as well.
This painting of Gross in his surgery clinic is one of the most famous of American medical paintings. The procedure was one of draining an infected femur. Surgery in America, or anywhere else, in 1860 was very basic and few sophisticated procedures were even contemplated. You might also note the absence of any attempt at antiseptic practice. There are no gowns or gloves and the thought that contamination of the wound was a hazard was unknown.
Admired for its uncompromising realism, the Gross Clinic has an important place documenting the history of medicine—both because it honors the emergence of surgery as a healing profession (previously, surgery was associated primarily with amputation), and because it shows us what the surgical theater looked like in the nineteenth century. The painting is based on a surgery witnessed by Eakins, in which Gross treated a young man for osteomyelitis of the femur. Gross is pictured here performing a conservative operation as opposed to an amputation (which is how the patient would normally have been treated in previous decades). Here, surgeons crowd around the anesthetized patient in their frock coats. This is just prior to the adoption of a hygienic surgical environment (see asepsis). The Gross Clinic is thus often contrasted with Eakins's later painting The Agnew Clinic (1889), which depicts a cleaner, brighter, surgical theater. In comparing the two, we see the advancement in our understanding of the prevention of infection.
Another tragedy is the loss of 1,000 years of potential scientific progress due to the Dark Ages. During the 2nd Century A.D., while the mystic Christian cults via Platonism were beginning their spread through Rome and laying the groundwork for the eventual end of the classical Greek and Roman tradition - the great Roman physician Galen (pictured below) was researching and writing texts which would dominate the field for over a thousand years. As the West descended into the Dark Ages, Galen's texts were kept alive by Muslims and translated into Arabic. However, due to religious prohibitions on dissection, the Muslim's lacked interest in anatomy and did not advance his work significantly. It wasn't until the twelfth and thirteenth centuries, at the dawn of the Renaissance, that interest in anatomy was revived and Galen's works once again translated. However, as Marie Boas in The Scientific Renaissance 1450-1630 writes:
The real worship of Galen begins with the rediscovery of the Anatomical Procedures, and its commentary by Guinther (in 1531).
those who are now dedicated to the ancient study of medicine, almost restored to its pristine splendour in many schools, are beginning to learn to their satisfaction how little and how feebly men have laboured in the field of Anatomy from the time of Galen to the present day."
More than 50 years ago, a Michigan-based pharmaceutical company commissioned a Michigan painter to depict dozens of great moments in medical history, from ancient Egypt to the United States in the 20th century.A link to some of the paintings is here.
Within a few years, the entire nation knew the paintings by Robert A. Thom. Reproductions appeared in magazines and doctors’ offices, and a book of them was given to thousands of new physicians. With a Norman Rockwell-style realism, the works epitomized the optimism of the time in which they were painted, and the nation’s faith in post-World War II medical and scientific triumphs.