WI: Delayed American civil war with different medical history

[Roger II]

WARNING: I DO NOT WANT TO HEAR ANYTHING ABOUT DIFFERENT MILITARY ANYTHING, PLEASE BUTTERFLY NET THE MILITARY STUFF AND ASSUME THAT THE ACW IN THIS SCENARIO IS VERY ROUGHLY SIMILAR AS A MULTIYEAR CONFLICT ENDING IN NORTHERN VICTORY AND EMANCIPATION

Ok onto the meat of the question: The ACW came at kind of a weird time for medicine and norms of war, shortly before the formation of the Red Cross and the first Geneva Conventions and just on the (relative) brink of germ theory and asepsis. It also came right before the demise of muzzleloaders and with them the Minie ball. So the question to pose is: Suppose the Civil War happens somewhat later without major ramifications for other conflicts and this delay combines with maybe slightly more interest in the US in innovations in European medicine/sanitary practice and phaseout of the Minie ball. How does that affect soldier's health on campaign and combat injuries? Does an *ACW where there are much lower rates of camp diseases and epidemics and possibly somewhat fewer especially bad traumatic injuries, but without the kind of mass devastation of true WWI era industrial warfare,** have a substantially different cultural and socioeconomic impact?

*I am operating under the assumption that whatever replaces the Minie ball is going to be less prone to roll through the body and deform/fragment in ways that are especially uh...nasty.

**Yes I know people cite Petersburg as comparable to trench warfare, but it's not exactly like they had Maxim guns, breechloading artillery shells, or barbed wire there.

 

[Coiler]

FWIW, the "died of wounds rate" (quotations because the statistics are very hard to quantify and cataloguers will admit it) OTL apparently dropped from around 30% in the ACW to around 20% in the Spanish American War and World War I.

A similar study of the "case fatality rate" was about 14% in the ACW (for the north), 6.7% for the Spanish American, and 8% for WWI. Now given that the Spanish-American War was a conventional squash with most of the losses being by disease, I'd take it with a grain of salt. Still, there is a noticeable improvement in wounded survivability.

 

[Roger II]

FWIW, the "died of wounds rate" (quotations because the statistics are very hard to quantify and cataloguers will admit it) OTL apparently dropped from around 30% in the ACW to around 20% in the Spanish American War and World War I.

A similar study of the "case fatality rate" was about 14% in the ACW (for the north), 6.7% for the Spanish American, and 8% for WWI. Now given that the Spanish-American War was a conventional squash with most of the losses being by disease, I'd take it with a grain of salt. Still, there is a noticeable improvement in wounded survivability.

Yea, I'd be curious about a deep dive about what pushed this down and when those things started changing. Be kind of grimly hilarious if high artillery in WWI pushed it down by either 1) ensuring that all wounds were fatal or 2) blowing stuff clean off instead of giving people effectively puncture wounds packed with dirty cloth.