In the Civil War era, many of the medications we now take for granted did not exist. There were no antibiotics and hardly any vaccines, as no one knew that germs (microorganisms) caused many diseases. Nevertheless, pharmaceuticals played an important role in Civil War medical care.
In 1861, before the start of the war, there were only six colleges of pharmacy in the United States. The first, the Philadelphia College of Pharmacy, had been founded in 1821. The pharmacy school curriculum included chemistry and medical botany, as many medicines of the time were derived from plants and taken in liquid or pill form. Formal training in pharmacy, however, was relatively rare. There were no licensing or state board exams for pharmacists. Rather than a profession, pharmacy was usually seen as a trade, with most training gained during a two- or three-year apprenticeship. Of the 11,000 pharmacists in the country in 1860, fewer than 5 percent had any formal course work.
The war spurred the expansion and industrialization of the field. In 1860, there were 84 manufacturers of pharmaceuticals in the United States; just 10 years later, there were 300. Philadelphia was an important manufacturing center for all war materials, and medications were no exception. For instance, the firm of John Wyeth & Brother was founded in 1860 by two graduates of the Philadelphia College of Pharmacy. Their drugstore and small research lab grew quickly during the war to become a large wholesale business, selling beef extract and a range of medicines to the army.
Another Philadelphia company, Powers & Weightman, had introduced quinine sulfate (cinchona bark extract) for malaria treatment to the United States in the 1820s. Rosengarten & Sons was also a quinine supplier. Together, the two firms served most of the Union Army’s quinine needs. Civilian firms, though, could not give the army all the medications it required. Two Army Medical Laboratories were begun in 1863, one in New York and one in Philadelphia, to produce dozens of medicines in large quantities. Even though medications were being manufactured on an industrial scale, there was little quality control and regulation was uneven.
Army Quartermasters were originally responsible for drug supplies. Later, however, this work was transferred to the Surgeon General’s office. Medications were distributed through a network of depots and subdepots, with New York and Philadelphia serving as main depots. Volunteer organizations, most notably the United States Sanitary Commission, also aided with distribution of medical supplies. Surgeons carried small amounts of drugs in satchels for use in the field, and special medicine wagons transported larger quantities of supplies. Hospital stewards were administrators as well as pharmacists, overseeing many aspects of hospital operations in addition to compounding and distributing medications.
Some common medications included chloroform and ether used as anesthetics for surgery. Contrary to popular belief, virtually all Civil War surgical operations were performed with the patient rendered unconscious by anesthetics. Post-operation pain was often treated with morphine, a derivative of opium. Morphine was perhaps the most widely used painkiller during the war, despite its addictive qualities. Alcohol, particularly whiskey, was frequently employed as a base for liquid medicines and as a tonic. It was also the main ingredient in many popular over-the-counter patent medicines. A nearly universal but perilous drug was calomel, a mercury-based compound, used for constipation as well as diarrhea and dysentery. Since mercury is poisonous, calomel was dangerous in large quantities. Union Surgeon General Dr. William A. Hammond banned its use in 1863, causing much controversy among army physicians.