In 1863, when Rhode Island Hospital was chartered, no one knew
what caused disease or how it spread. Many American physicians
bled patients for both physical and mental ailments, ascribing
to a 1,600-year-old theory that bleeding restored the balance of
“humors” in the body. Surgery was a brutal affair: surgeons had
recently discovered the anesthetizing properties of ether, but
they performed surgery without gloves, without cleaning their
instruments, and in an environment that was anything but
sterile. By 1863, two years of Civil War had taught America’s
physicians that it was better to amputate a shattered limb than
to try to save it and risk a life-threatening infection. Some
attempts were made to model field hospitals after those
established by Britain’s Florence Nightingale, who introduced
hygienic practices to field hospitals during the Crimean War,
saving the lives of thousands who otherwise may have died of
cholera and other infectious diseases. Nevertheless, more
soldiers died of disease in the Civil