Medics on the Battlefield.
It is often claimed that the practice of sending medics and battlefield ambulances forward with the troops was an innovation of the American Civil War. This is untrue, though there were innovations in the field of caring for the wounded during that war. An organized medical unit was an innovation of the French Army during the wars of the Revolution, developed by a French surgeon named Dominique Jean Larrey. Larrey was a classically trained surgeon who accompanied the French armies during the War of the First Coalition. During the Battle of Mainz he observed the speed with which French artillery caissons and carriages could be moved around the battlefield, and suggested that they be used for the purpose of transporting wounded men from the battlefield to field hospitals to be set up behind the lines, but as near to the fighting as was reasonably safe.
Larrey established a standard crew for what he called his flying ambulances including trained emergency medical specialists and stretcher bearers. His plans were demonstrated at the battle of Metz in 1793, and they proved to be so successful that the French government called for new ambulances to be built, designed specifically for the purpose. At his field hospitals he established written rules of triage, which determined the order in which casualties were treated based on need, rather than rank. He insisted that the field hospitals be as mobile as possible, and that the arriving wounded be triaged by trained medical personnel.
Larrey eventually became Chief Surgeon of Napoleon’s armies, and his medical units were a distinct part of each of the Corps’ of the French Armies. He was wounded in Egypt at the Battle of Acre, sent back to France, and continued his work. A favorite of the Emperor, he took part in the disastrous invasion of Russia in 1812. He was present at the Battle of Waterloo, where Wellington took note of his work with approval, but the Prussians who captured him wanted to summarily execute him. Spared through the intervention of Marshal Blucher, he returned to France, and after the end of the Napoleonic Wars concentrated on medical writing.
Larrey also insisted that the wounded men of the enemy be given the same quality of care as those of France and its allies, and that they be considered during triage as if they were members of the French Army. Army life being as it was and is, how often these admonitions were followed in actual battle conditions is impossible to determine. The likelihood of a wounded French Colonel waiting while an injured Austrian or Russian soldier was treated was probably slim. Other nation’s adopted some or all of Larrey’s innovations as time went on, depending on their own resources and national attitudes towards caring for the wounded.
In the American Civil War Surgeon and Major Jonathan Letterman created a similar system in the early years of the conflict. It was first used following the Battle of Antietam in 1862 where Letterman established forward aid stations connected by ambulances to field hospitals. The actual ability to treat many wounds had not changed much since the time of Napoleon, and one of the most common treatments for wounds involving shatteres bones was amputation. Confederate wounded encountered on the battlefield were also treated. After the battle of Gettysburg more than 6,000 Confederate wounded were treated by Union medics and surgeons.