Amputation was the most common type of surgery performed on battlefields in the Civil War.
More than 60,000 people lost limbs, and James Edward Hanger was the first.
Hanger, an 18-year-old from Churchville, Va., had enlisted in the Confederate Army two days before the Battle of Philippi on June 3, 1861 - the first land battle of the Civil War that used organized troops.
At that battle, the Union Army set up its artillery on top of a hill and at daybreak fired at the town, where Confederate soldiers were still in tents and barns.
Hanger was in a barn when a 6-pound cannonball tore through his leg.
"This was quite a surprise," said historian James Robison, a Sesquicentennial Commission member. "There were probably only a few cannonballs fired into the town, probably no more than 10 - and one happened to hit in the leg."
The Confederates ran out of town immediately, leaving Hanger behind.
Union soldiers eventually discovered him bleeding on the floor of the barn and took him into custody as a prisoner of war.
A union soldier eventually operated on Hanger and had no choice but to remove his leg - the first amputation of the Civil War.
That war saw a lot of amputations because of the type of weapons used and the state of medicine at the time.
"They were using rifled weapons with an ounce of lead," Robison said. "They would strike the bone and shatter it, and at that time there wasn't any other way of repairing a wound like that except an amputation."