Was Civil War Surgery Effective?

During the U. S. Civil War (1861-65) surgeons performed a vast number of surgical procedures. The efficacy of surgery has been continually debated since the war began, in part because of lack of evidence for the (in)effectiveness of surgery. I analyze data gathered by Dr. Edmund Andrews, a surgeon with the 1st Illinois Light Artillery. The data can be arranged as observational data on surgery and recovery, with controls for wound location and severity, and with instruments for surgery. Analysis of the data using bivariate probit and a switching regression suggests that surgery was effective, was applied selectively by surgeons, and increased the probability of survival with an average treatment effect of 0.06-0.25 points. Results also suggest that surgeons applied surgery selectively and in situations in which it was likely to be beneficial; among those receiving surgery, I find an average treatment effect of 0.25-0.28 points. Department of Economics, Hunter College and the Graduate Center, CUNY. Email: [email protected]. I would like to thank Jonathan Conning, Partha Deb, and Jessica Van Parys for helpful comments and suggestions. I am faithful, I do not give out, The fractur’d thigh, the knee, the wound in the abdomen, These and more I dress with impassive hand (yet deep in my breast a fire, a burning flame) Walt Whitman, The Wound Dresser