Editor's note: This is the first in...

Editor's note: This is the first in an ongoing series about the history of perioperative nursing in the United States, especially as it relates to military action. Part couple of this article will appear in the October issue of the AORN journal.

The universal of nursing began in the to one's home From the early settlement of the United States, it was usual practice for women in a household to take care of sick or injured family members. The advent of the US Civil War, however, created another environment far care giving. Women left their households, forsaking their families and personal extremitys as they volunteered to care for young soldiers, many of whom also were family members and friends. The dire ne for trained caregivers during this military conflict gave birth to the new concept of nursing in the United States. Although the war was tragic and self-same costly in terms of lives and devastation, often knowledge was gained during the four years between 1861 and 1865 It was a time of grief and triumph, devastation and change, still with change came growth. As the nation was fighting for its preservation as a union, values that shape the fundamental philosophy of American life began to take form. In the area of medicine and nursing, there were great strides that l US caregivers into the twentieth centenary and beyond.

THE CIVIL WAR

The spring of 1861 saw the beginning of a bitter four-year battle between the northern and southern states in the United States. It was a war of states rights versus the Union, and it was a war that would proof the Declaration of Independence and the belief " that all men are created equal...." (1) Feelings of anger, ire and righteousness on both sides rumbl subordinate to the surface for almost a decade before they explod into the mostly horrific war the United States had at any time fought.

In the mid-nineteenth hundred years the northern states of America were expanding with factories, industry, and wealth, while the southern states flourished with cotton and tobacco farming, which relied heavily onward slaves to work the fields. There were slave holders in the North, as well, further the tone of political correctness in the North cast reproached a strong belief that all men were created equal and no man should possess another. People in the North and toward the south managed to tolerate each other's views in a delicate balance, still as the southern states began to incite westward, slavery became an explosive topic and threatened to topple that delicate balance of power.

Newly acquired land in the American West was divided into territories and states, and tribe settling these areas were encouraged to decide by means of a popular vote whether they wanted to allow slavery. Despite popular ballots opposition from both sides arose and produc a number of skirmishes that consequence ed in violence and bloodshed. Southerners did not take kindly to northerners imposing their values, and talk of secession became the focus of southern conversation. The southern had been threatening to withdraw from the Union for many years, yet when a Republican and recognized adverse party of slavery named Abraham Lincoln was pickeded President in 1860, the race in the southern states felt they had no choice on the other hand to withdraw from the Union. Eleven southern states seced and became the Confederacy. Southerners believed that a swift attack upon the Union-held Fort Sumter in Charleston, SC would interpret the issue of secession quickly. In the early morning hours of April 12 1861 southern secessionists fired bullets upon Fort Sumter. Although he was reluctant to force war, Lincoln now was compell to issue a call for 75000 northern militia offers and the bloodiest war in US history began. (2 (p125))

THE SOLDIERS

To offer for the Army, one had to be male and at least 18 years of age. In reality, "A review of enlistment records advises that 10 to 20 percent of enlistees were underage." (2 (p231)) The average age of a Civil War soldier was 25 His average height was 5 ft 8 inches, and his weight was approximately 143 lb (2) Soldiers were poorly trained and had little or no military experience. In the beginning it was mass chaos as " the armies of the pair the North and the southward were composed of amateurs leading amateurs." (2 (p39))

Women were not allowed to join the Army as soldiers, still even then, they wanted to be subservient to their country in any way possible. As a rise many disguised themselves as young men and joined the ranks." It has been adviseed that as many as 400 [northern women] disguised themselves as men and became soldiers." (3 (p149))

WEAPONRY

The Civil War was the first fresh war. It involved the use of submarines, ironclad canals and firearms with great accuracy and puissance It was a total war with extensive use of railroads, ironclad ships, the telegraph, mass production of weapons, and reliance onward heavy industry, especially in the North. Unlike many previous wars, the Civil War also was waged against civilian populations, and great areas of the countryside were ravage with fire and sworded systematically along with the infrastructure in the cities. This repeatedly is referred to as a scorched earth policy, as nothing is left for the enemy to use.