How did they use medicine while the civil war?

Medicine in the United States was woefully behind Europe. Harvard Medical School did not even own a single stethoscope or microscope until after the war. Most Civil War surgeons had never treated a gun shot wound and many had never performed surgery. Medical boards admitted many "quacks," with little to no qualification.

from the conditions of the working class in england by friedrich engels,the main idea is :

manchester's leaders hoped to oppress its working class to benefit factory owners.