Medical History Moment
By Jerry Reves
Julian J. Chisolm, M.D. was born in Charleston on April 16, 1830. After receiving his medical degree from the Medical College of the State of South Carolina, he went to Paris where he studied surgery. He returned to Charleston, but several years later on another visit to Europe he witnessed the treatment of wounded during the Second Italian War of Independence (also called the Italian War of 1859). It was this experience that would become useful to the South’s war effort to which he made major contributions.
Most physicians on both sides in the War Between the States had little experience with the medical horrors of war. To fill this knowledge gap, Dr. Chisolm wrote the first American field textbook on military medicine, “A Manual of Military Surgery: For the Use of the Surgeons in the Confederate Army With an Appendix of the Rules and Regulations of the Medical Department.”
The first edition of this manual was published in 1861 by Evans and Cogswell and described how to treat specific types of wounds, construct field hospitals and manage food, clothing, hygiene and non-surgical diseases. It had everything a physician or line officer needed to know about caring for the “volunteer army … saving the lives and preventing the mutilation of many friends and countrymen.” The book was in continuous use in the field and Confederate hospitals throughout the war.
During the war, Dr. Chisolm was in charge of supplying hospitals and field armies with medical equipment and medicines. Since the South had no pharmaceutical or medical instrumentation facilities prior to the war, the enemy blockade of Southern ports and the declaration by both combatant nations that medicine was contraband and could not be traded between the North and South created severe shortages. Among the most acute shortages was that of anesthesia. With the thousands of wounded men, most requiring surgery, anesthesia was deemed essential. The general anesthetic of choice for the South (unlike the North) was chloroform. The only source was either blockade runners, illicit trade with the North, or confiscation when Confederates captured Union supplies in battle. None of these sources could be relied upon and thus the necessity to conserve chloroform was clear to Dr. Chisolm.
The common method of administering chloroform was enormously wasteful as it involved pouring the liquid on a cloth held six inches or so away from the patient. Chisolm invented a way to deliver the drug economically. This ingenious invention, known to us as the Chisolm inhaler, was probably first made in Charleston. Retractable metal tubes were inserted into the nostrils of the patient who was instructed to breathe only through the nose. Chloroform was placed on a small piece of cotton cloth in the device and a reasonably safe dilute concentration was delivered until the patient was unconscious. This markedly reduced the waste of chloroform into the air and when expertly administered was very safe for the many surgeries conducted during the war. In a twist of irony, after the war the Chisolm inhaler became a mainstay in the United States Army for many years.
Few physicians on either side of the conflict played as important a role as Julian John Chisolm. Charleston can be proud of this medical pioneering son whose enormous talent and ingenuity helped thousands of soldiers who never even met the man.
The Waring Library Society is a “friends of the library” organization that supports the mission of the Waring Historical Library. Named for Joseph I. Waring, Jr., its first director, the Waring Historical Library preserves rare books, manuscripts and museum artifacts documenting the history of the health sciences in South Carolina and the Southeast. To learn more about the Waring's programs and events or to become a member of the Society, please visit waring.library.musc.edu