Technological developments are often prompted by military needs during war or war planning. History shows that there have been instances where the U.S. has had to face adversaries who have made advances in the development of weapons, aircraft, naval forces, defensive measures and troop support.

Troop support measures are important, because morale and confidence affect the effectiveness of combat units. The knowledge that a wounded soldier will receive effective medical care means the soldier may be more willing to place themselves "in harm's way." During the Civil War, field medical facilities were manned by a staff including nurses and doctors. However, many of the "doctors" were often untrained with no formal medical education, and many of these "doctors" had observed surgeries without actually performing the procedures. Adding to the surgical risks was the lack of knowledge about the causes and prevention of infection.

Surgeries often were done outdoors because of the better light than lamps available in tents or in captured and damaged buildings. Amputations were common with over 60,000 performed during the war. When available, chloroform was the only anesthesia used. Overall post-surgical survival from amputation was 75 percent, but the closer the amputation was to the trunk the lower the survival rate was.

The primary reason for amputations was the destructive nature of the weapons being used. The "Minnie ball" projectile was often .50 caliber, meaning the lead bullet was a half-inch in diameter. The Minnie ball was highly destructive, and it would cause major tissue damage as well as shattering a large section of bone rather than simply breaking the bone. Repair of the damage was beyond the capabilities of the medical staff.

As the need for prosthetics grew so did the number attempting to develop and manufacture. One issue for confederate soldiers was that prior to the war there were few if any manufacturers in the south. Designs for prosthetics had to include ease of use, comfort, appearance, and functionality. Many different materials were used, and designers tried to incorporate hinges to simulate functional joints.

Post war improvements in prosthetics were slow to come but new technology has made major improvements in restoring function to military amputees since 2000.

Jack Dragoni attended Boston College and served in the U.S. Army in Berlin and Vietnam. He lives in Chaffee, Missouri.