Blood and Germs: The Civil War Battle Against Wounds and Disease

by Gail Jarrow

Acclaimed author Gail Jarrow, recipient of a 2019 Robert F. Sibert Honor Award, explores the science and grisly history of U.S. Civil War medicine, using actual medical cases and first-person accounts by soldiers, doctors, and nurses.

The Civil War took the lives of hundreds of thousands of Americans and left countless others with disabling wounds and chronic illnesses. Bullets and artillery shells shattered soldiers' bodies, while microbes and parasites killed twice as many men as did the battles. Yet from this tragic four-year conflict came innovations that enhanced medical care in the United States. With striking detail, this nonfiction book reveals battlefield rescues, surgical techniques, medicines, and patient care, celebrating the men and women of both the North and South who volunteered to save lives.

Genres: Nonfiction, History, Middle Grade, Science, Civil War, Historical, War

176 pages, Hardcover

Published October 13, 2020

About the author

Gail Jarrow is the award-winning author of nonfiction books and novels for readers 8-18. Latest book: WHITE HOUSE SECRETS: MEDICAL LIES AND COVER-UPS. Visit GailJarrow.com.

Reviews

[Josiah · Rating 2 out of 5]

More nonfiction books for kids and teens about the U.S. Civil War have been published than anyone could count, but Gail Jarrow manages a fresh take on the subject in Blood and Germs: The Civil War Battle Against Wounds and Disease. The book clues us in to a surprising fact: twice as many soldiers succumbed to disease as died from being shot or stabbed on the battlefield, and this eventually led the U.S. to reexamine and improve healthcare standards. Three months after war began in early 1861, the First Battle of Bull Run yielded a huge casualty count, previewing the carnage of the next four years. The Northern army had every resource advantage in its fight to preserve the U.S. and end slavery, but the Confederate South was determined to hold on to their legal right to own slaves. Both sides required that soldiers be at least eighteen years old, but as the war progressed and the number of able-bodied men dwindled, clerics were willing to overlook the age of younger volunteers. For non-combat roles, even kids signed up; Johnny Clem joined a Northern regiment when he was only ten, and once had to kill a man in battle. The Union and Confederate armies wanted to put their best foot forward, but that's not always possible in war.

In the 1860s, it was believed that miasma caused disease. Germ theory was years from being commonly accepted. Measles, smallpox, and other coronaviruses spread like wildfire in military encampments, causing bronchitis, pneumonia, and other conditions that killed weakened soldiers. Insects and parasites could be a death sentence too, transmitting malaria and typhoid fever. Faced with a shortage of qualified medical help, especially on the Confederate side, medical men relied on quinine, camphor, and opium to stave off a variety of ailments, but these had limited effect. Blood and Germs introduces us to many individual soldiers who took sick between 1861 and '65, most of whom died, though some became well again and went on to lead long lives. Before the war, nursing was not a profession in the U.S., but advocates such as Elizabeth Blackwell lobbied for women to act as nurses for sick and injured soldiers. A bit of comfort from a sympathetic woman could restore the will to live of men ravaged by injury and disease.

Military innovations made war more efficient, but increased the potential for catastrophic damage. The "Minié ball", a type of musket bullet developed by Claude-Étienne Minié in 1849, was calculated to do maximal damage once it entered the human body, demolishing blood vessels, bone, and muscle. Most bullets extracted from Civil War soldiers were Minié balls, and keeping up with the destruction was nearly impossible. Union medical director Jonathan Letterman invented the triage system to sort which patients should be attended first, an innovation that brought him little acclaim during the war but eventually became the international standard. How ghastly was it to be a doctor or attendant at a Civil War battle? Under-qualified surgeons spent days in mobile tent hospitals after a major battle, amputating feet, hands, legs, and arms amidst a sea of delirious soldiers screaming and moaning. Some surgeons broke under the pressure, the psychological strain too much to handle. Piles of dead, bloody human limbs lay everywhere, and most patients died even after amputation; erysipelas, tetanus, and hospital gangrene often set in and killed a man after an operation. Women such as Sally Tompkins, Dorothea Dix, Susie King Taylor, and Kate Cumming took it as their calling to improve the quality of care at these hospitals, and their activism caused America to rethink its dismissive attitude toward nursing as a profession. Devastating as the war was, it helped usher in an era of better healthcare outcomes.

Blood and Germs is closer to being a fact book than a straightforward narrative, but there are a couple of consistent themes. Many of the war's medical horrors persisted because of blind trust in the healthcare establishment; people figured that doctors knew their profession and shouldn't be challenged, but that's not a smart philosophy. Doctors in the 1860s knew almost nothing of germs, infection, and treatment risks, yet actively opposed colleagues who dissented from prevailing opinion. Surgeon general William Hammond lost his job because of his independence of thought. "He told the army's surgeons to stop using calomel, because he believed mercury harmed the body. Today, we know that he was correct. But his decision was unpopular with the doctors who relied on the medicine. With political pressure against him, Hammond was forced from his position in 1864." The lesson? Doctors aren't infallible, and their opinions should constantly be challenged. Society shouldn't follow what anyone in the medical field proclaims based on credentials or reputation; we should demand they show their work and prove their claims, or we fall into the same old pattern that led to many unnecessary deaths in the Civil War. This takes us to the book's second main theme: even a horrifying experience like war can yield some good if we determine to learn from it. Pinpoint your mistakes, decide how to neutralize them, and do better next time. On a societal or individual level, this is the blueprint for wise living that serves as an example to others.

Gail Jarrow wrote books about medical history and mysteries before Blood and Germs came out in 2020, so this brand of storytelling was old hat for her. I appreciate her insight into how doctors dealt with germs, disease, and injuries during the Civil War, but overall this book feels uneven; at times the writing feels distant and clinical, unlikely to intrigue young readers. At other times the descriptions and photos are almost too gruesome, showing piles of severed limbs and dead, decomposing soldiers on the battlefield. I'd rate Blood and Germs two and a half stars, and probably go for three if the central themes were emphasized more. This is a good book for kids already interested at an above average level in the Civil War, but reluctant readers won't likely get far past the blood-soaked front cover.

[Monica Willyard Moen · Rating 4 out of 5]

This is a book about heroes and heartbreak, stories of real men and women who fought for what they believed. These people fought disability and disease in a time when there was very little that a doctor could do to help them. I found myself really understanding for the first time how many men lived after the Civil War with amputation of one or more of their limbs or with Bobby’s weekened by horrible bouts of disease that ended their lives prematurely. Back then, there was no Safetynet of Social Security to help them, and there were no neurosurgeons to help them with a practical prosthesis for a missing arm or leg. In spite of this, many of them went on to marry, have children, and earn a living to support their families. I have a deep respect for how these people dealt with their tragedies.

[jenna · Rating 3 out of 5]

Full of fun facts but never felt like a coherent story, more like a casual medical textbook.

[Samantha · Rating 4 out of 5]

This was a fascinating book filled with startling facts and photographs. As if war wasn't terrifying enough, the threat of illness and infection ran rampant. The good and medical improvements that came from this period were interesting to read about. I appreciated Jarrow's research into the people mentioned and their backgrounds. This was a great read from start to finish that left me with a lot of takeaways.

[C.S. Poe · Rating 5 out of 5]

Make no mistake, while this incredible piece of nonfiction is geared toward a young adult audience (high school, I assume), adults of any age would enjoy and benefit from reading this title, especially if you have an interest in medical history, U.S. history, or to be more exact, the lack thereof of practiced medicine during the Civil War.

Gail Jarrow's writing is very accommodating for a younger audience—she keeps it simple, straightforward, provides statistics, and an extremely comprehensive glossary and bibliography that would undoubtedly be invaluable for any students using Blood and Germs to write papers or study for tests. Her facts and data comes from multiple well-researched sources and experts in their fields, including various museums and institutions, libraries, online resources (that students can utilize), as well as personal journals, newspapers, and letters written by soldiers and non-combative alike between 1861 - 1865. And again, while this book is intended to make an incredibly complex and heartbreaking time period in history more approachable for younger minds, I used it for research into my own projects and found it to be worth every penny and then some.

The layout of the book is astounding. It's absolutely beautiful and full of period photographs featuring battlegrounds, soldiers, ambulance crews, surgeons and their teams, nurses, and more. Gail includes photographic examples of what now-vaccinated diseases looked like (again, these are mostly dated photographs, and thusly in black and white) so that student or adult alike can understand the true horror of smallpox, for example. There's also pictures of prison camps, doctor's surgery kits, and some more graphic photos, especially in the chapter on field hospital amputations. (By graphic, I do mean the brutal reality of the war. Gail does not sugarcoat the truth, which I find to be incredibly important.) But in those pages, she also touches on the history of prostheses, and shows these designs in action for survivors of the war.

One of my favorite parts of the book is that she takes extra care to humanize the statistics, and says in the final pages, that it was important to her that readers see these names as people. She wanted to include where they were from, how old they were, where/what they did if they survived the war, and she went above and beyond to research their lives for this added element. Gail includes several biographies on women who served in secret, as well as those who took on nursing—so many later dedicating their lives to the empowerment of women through education, dress reform, and the right to vote, which I think is a great way to encourage readers to delve into another important time in history. She also includes information (and sadly, obviously, it was not as well documented) on the black men and women who served freely on the Union side, or those kept as slaves on the Confederate side. It is vital to stop and read these biographies amongst the pages of disease, famine, war, and death.

I wish this book had been published when I was in high school. I think it's truly a gift to current students and should be assigned reading in a US history classroom. It's informative, truthful, insightful, and I think a door-opening book for those who might one day go on to become historians or work in the field of medicine.

[Jerry Smith · Rating 3 out of 5]

As many have mentioned here in reviews, this book is aimed at a younger audience or is perhaps pitched as an introduction to the topic and as such, I think it succeeds pretty well. I didn't realize that was the intended audience when I picked it up which is on me of course. It is a slightly disjointed, though interesting series of fairly superficially covered aspects of the US Civil War soldiers cause of demise or injury. In other words injuries in action and, most importantly, the impact of disease on the common soldiery.

When I write “superficial” that is probably somewhat insulting, which is not my intent. Rather, it makes the point that there were numerous diseases liable to carry off an injured combatant in the days before germ theory or the medicines to fight infection. It is hard to imagine today, how grim it was to be at risk from dysentery, diarrhea, typhoid, malaria, parasitic infection before even suffering infections from wounds and/or amputations.

Medicine did benefit from the lessons learned in the conflict and some persist to this day - infection control, anti-septics, triage etc. but it came at a great cost, especially the suffering and death of countless troops over the course of the war.

There is not a lot of depth here but I don’t think that was the goal. By that I mean that there is no lengthy discussion about the diseases beyond a basic outlining of spread and symptoms. It is still interesting and gruesome to be honest. One is thankful to live in an age where medical science has at least advanced significantly in understanding.

As someone who is fascinated by the American Civil war, I was pretty much aware of the scourge of disease and it’s toll on those fighting this horrible but justified, at least from the Union point of view, conflict. Disease killed far more people than the fighting, although the latter was clearly a horrible way to go as well.

I enjoyed this book and it is an easy read, something that can be consumed in a couple of hours. It is tightly focused on the chosen topic and doesn’t stray into comment on how despicable the Confederacy was or talk about the details of the battles. It was clearly a horrible time for all involved and whilst we should be glad the Union prevailed over the racist and slavery promoting Confederates, it was from indeed for soldiers on both sides.

[Stephanie Bange · Rating 5 out of 5]

As she has done in her other books about how sickness and disease affected daily life of people in the past, this time Jarrow explains and humanizes how and why so many soldiers and sailors lost their lives during the American Civil War.

Jarrow does an outstanding job of balancing stories about both the North and the South, even though most of the records kept by the Confederate Surgeon General were burned in Richmond. Heavy use of primary source photos of specific people and battlefields and illustrations from publications of the time, bring the stories down to a very personal level. Sidebars with more detail about the diseases, medications and medical treatments, the role of women and young boys on/off the battlefield, and the rise in importance of nursing as a result add great depth.

A timeline of the war, glossary of terms, suggested websites for more information, extensive research notes, and an index round out the backmatter. Jarrow mentions in her author's note that this is the first of her "Medical Fiasco" series. I can hardly wait to read the others!

Having visited many Civil War sites, there is always a display about this topic - usually displaying a surgeon's kit and/or wagon with medications. The clear explanations and photographs serve to deepen one's knowledge of this area of war. A must to include on reading lists for units of study on the Civil War.

Highly Recommended for grades 7-adult.

[Sandy · Rating 5 out of 5]

I wish I could give more stars than the five. What an amazing book!! By far the best book I've read by this author. We all know how important the Civil War has been to our country's history but WOW I learned a lot from this book.

Trigger warning - it is a pretty graphic and gory book. There are pictures of damage done to men's bodies from bullets, cannonballs and disease. And descriptions of battles and aftermaths. But the amount of information doctors, nurses, and others learned from trial and error made such advances in medical practices. Because of things learned during the Civil War we have ambulances and EMTs, and we have trained nurses. Not to say we wouldn't eventually have had these things but we had them during the war and because of the war.

I read at the end of the book that this will be part of a series and I can't wait to see what other books I will be reading and the events that took place in our history. Read these books by Gail Jarrow, you will love them and learn so much.

I put this book in the I've been here in a previous life shelf because, like Mt. Everest, I feel I've been here. I have such a pull to certain places and times and the Civil War is one of those times. I can't look at pictures of soldiers without feeling the sadness and being a part of it.

[Alicia · Rating 4 out of 5]

Jarrow doesn't pull any punches about what the book is about, the book is literally all about the battle wounds and disease from the Civil War-- specifically from blood and germs.

With a lot of pictures that are fairly standard Civil War photos from the likes of men like Brady, there are additional pictures with the raw experiences of the soldiers including gangrenous wounds, women who pretended to be men, the surgeons (also known as the doctors) who worked on them, how the primitive ambulance wagons pulled by horses were added with additional springs to help avoid more pain for the soldiers.

Jarrow works through many diseases that have been eradicated since the Civil War and explains what the symptoms were, what they thought it was caused by before they realized what it was really caused by which is super helpful to understand from the perspective we have in 2021, including soldiers heart, now known as PTSD.

She's a straight shooting author who gets to the point and I respect her craft for that reason. The book is eye-catching from the cover to the internal layout.

[Yapha · Rating 4 out of 5]

This was a fascinating look at the role played by both illness and injury during the Civil War. I was surprised to learn both what an awful state medicine was in at the start of the Civil War and how many medical advances were made during it. Jarrow looks at treatment and spread of diseases due to a lack of understanding of how they spread, especially the important role that hygiene plays. She also looked at common wounds and the prevalence of amputation. Meticulously researched with photographs throughout, this is an important look at both the Civil War and the history of medical practices. For grades 5 & up.

[Savannah · Rating 3 out of 5]

This is a book I chose to read for my children’s literature class and it was gnarly lol. I would say as a non fiction, this had less of a narrative and was mostly just explaining how fucked medicine was in the mid 1800s and it made me so thankful to be alive during the age of modern medicine lol.

3⭐️ primarily because there wasn’t really a narrative to follow, and it was just giving medical facts and explaining why people were dying at rate they were with gruesome pictures attached. I enjoyed it though!

[Edward Sullivan · Rating 4 out of 5]

In another story from the history of medicine, Jarrow focuses on the horrific death rates, diseases, and medical procedures of the American Civil War. Complementing the vivid narrative are ghastly photos of amputated limbs, gangrenous sores, and corpses. Jarrow makes excellent use of primary sources, including quotes from diaries and memoirs of soldiers, doctors, and nurses from both the Confederate and Union sides. Gruesome and fascinating.

[Rubi · Rating 3 out of 5]

Reads like a text book

Very educational. Very informational. Not the biology insight on blood and germs I thought it'd be because it focuses on diseases that were prominent during the Civil War.
It was a bit dull because it read like a text book, but it wasn't long and it was still interesting. Also includes photos of real soliders who dealt with these illnesses.

[Joan · Rating 5 out of 5]

Well documented and illustrated narrative account of the Civil War from a medical perspective.

[Emily · Rating 4 out of 5]

Since I live in Virginia right now near multiple Civil War battle fields, I decided it was time to study the Civil War in more detail. It's always felt like a distant war to me. I don't know of any of my direct ancestors that fought, though I'm going to look deeper into that and see. Growing up in Idaho, it felt so far away.

This text was interesting. I just finished reading a biography of Elizabeth Blackwell and recognized a lot of people. I'm so grateful that medical care has improved since the Civil War and was interested to learn that many advancements came because of what they learned during the Civil War. I'm now planning a trip to visit the National Museum of Civil War Medicine.

This is not a great book to read if you are squeamish. There are plenty of graphic photos. I would recommend it to kids age 12+.

[Auryn · Rating 4 out of 5]

I learned a lot more about the Civil War and liked reading more detail about what it was like for the people fighting in the war regarding medicine and the science available to them about disease and germs. It reminded me of another book I recently read when the author talked about the advancements in science and medicine due to the Civil War and how it may have taken much longer for those ideas to be discovered without the hardships those in the war faced. Some things were put into place that we still use today, and now I know. Good book with photographs and personal accounts.

[Wendy · Rating 4 out of 5]

This was a very informative book, though repetitive in areas. I read it cover to cover in 2 sittings and felt that it might be better as a reference for middle school or high school readers.

I liked the fact it had many primary source images, though some may be disturbing to sensitive readers. I found the pile of amputated limbs a bit shocking, though necessary to illustrate the reality of the war.

I will be using this book when teaching the Civil War.

[Emma James · Rating 4 out of 5]

I have recently been interested in the Civil War and this book helped me see just how gruesome war can be when you don't have adequate health care. It makes me thankful that through the Civil War came a lot of the things and programs we have in healthcare today. As a nurse myself I enjoyed reading about how nursing came to fruition during this time. 4 stars because it was a little statistic-heavy at times, but would recommend.

[Preston · Rating 4 out of 5]

The book Blood and Germs: The Civil War Battle Against Wounds and Disease by Gail Jarrow in my opinion is a really good book. If you like history this book is for you. The book has an informative feel, meant to teach you medical practices from the Civil War. Though, if you can not handle blood or gorey stuff, I wouldn't read this book. One thing I did not really like about it, was the repetitiveness found later in the book, but other than that, it was an amazing book.

[Darla Baker · Rating 4 out of 5]

This was a junior nonfiction book and it did a great job using words and actual photos to teach about blood and germs and mini balls and maggots and infection and washing you hands and the people who served so valorously helping the wounded. If that is the sort of thing you enjoy learning about this is a good one.

[Maria · Rating 4 out of 5]

"Blood and Germs" by Gail Jarrow is an interesting look at the Civil War from the hospitals and camps. More soldiers died from disease and infections than from actual fighting. The book breaks down what medicine was like back then with real stories. It's written for middle grade readers, so it's clear without being too heavy, and it gives a whole new perspective on history.

[Cecile · Rating 5 out of 5]

I went on a Gettysburg tour, and bought this book. The author did an excellent job of describing the medical and surgical nightmares during the American Civil War. The book was inclusive: it had vignettes of soldiers, doctors, nurses and concerned citizens from both the Union and Confederate sides. Warning: the book has multiple very graphic photographs of injured or dying soldiers.

[Remy · Rating 4 out of 5]

This is an interesting book (I would have LOVED it as a kid, since I was interesting in medical science, etc.), but it's pretty gruesome. Photographs of injuries are shown, including a pile of amputated legs. This is def. not something to hand over to the younger or squeamish crowd.

[Audrey · Rating 4 out of 5]

For such a short book, it contains great information on the diseases of the field hospital and the importance of women in the Civil War.

[Doug · Rating 2 out of 5]

Unfortunately not what was expected. Read like a series of Wikipedia articles. Stories were interesting but lacked details. The period quotes were the best part.

[Tayler Loudermill · Rating 4 out of 5]

A nice quick read about the history of medicine and disease in the civil war era

[Patti Sabik · Rating 4 out of 5]

Incredibly well-researched account of the horrific medical conditions of the civil war.

[Kate Whitaker · Rating 5 out of 5]

While this is technically a kids' book, it was incredibly well-written and engaging and I learned a ton. Currently digging through the bibliography for things I want to know more about!

[Grace Brock · Rating 3 out of 5]

There were some informative and interesting stories, but the book didn't really tie them all together.

[Bobbi Marble · Rating 4 out of 5]

Hearing this side of the civil war that we never talk about was very informative. Crazy how so much changed in the medical field because of the war