When the Civil War began in April 1861, American medicine was approaching what Union Surgeon General William Hammond called "the end of the medical Middle Ages." The Civil War was the last great armed conflict in the world fought without knowledge of the germ theory, which would in subsequent wars allow doctors to understand the cause and prevention of disease. Yet the war, despite its unparalleled death and destruction, revolutionized American medicine and improved medical care and public health in the postwar era.

Antebellum Medicine and Health

Before the Civil War began, most Americans were skeptical of doctors' ability to heal them. Inadequate medical training accounts for some of this skepticism. In sharp contrast to today's high academic entrance standards, admission to medical school was based only on students' ability to pay tuition. Medical school curriculum consisted of a series of lectures delivered by the...