Wounded by bayonet, ball, and bacteria: medicine and neurosurgery in the American Civil War

The American Civil War was a holocaust that illustrated the mid-19th century's unpreparedness for the delivery of medical care to the mass casualties due to both wounds and disease. Several major considerations are offered to explain the soldiers' morbidity. Incomplete understanding of pathophysiology and its management is exemplified by the treatment of the battlefield head injury. Accepting these concepts and the extent of the knowledge of the time, that higher mortality did not occur is in part testimony to the admirable care that was rendered and human resilience in an effort to survive.     

War and conflict

Conflict has existed throughout recorded history and has become a perennial factor in the process of human relations. It has evolved to accommodate cultural, economic, political and technological aspects. As a result it is a multi-faceted process with distinctive differences between peoples and countries. Whether it is the cause of instability or the product of it is a difficult question that would require a detailed case-by-case analysis. Probably, the truth lies somewhere between the extremes with an acceptance that conflict may exacerbate instability, but is more usually the manifestation of it.