"If he had been dropped and had a pulmonary contusion, or bruise of the lung, it creates an area of the lung that doesn't clear secretions real well, and it can be a focus that pneumonia can start in," DuBose said. "That's probably what happened in this particular instance."
DuBose, a U.S. Air Force veteran, said pulmonary embolism — a blockage of the major blood vessel in the lung — still occurs in nearly 6 percent of combat casualties in Iraq and Afghanistan. It is even more common among those who have amputations, as Jackson did.
Still, the debate will continue over Jackson's death.
Dr. Philip Mackowiak, an internist who organizes the conference each year, said he differs with DuBose on the Jackson case. He reviewed the records and said he believes a recurrent pulmonary emboli destroyed Jackson's lung over time, leading to his death. The medical records don't describe Jackson coughing, as one would expect with pneumonia, Mackowiak said.
It's impossible to know for sure what killed Jackson. But DuBose said modern medicine could have saved him. Jackson's doctor didn't have the tools or knowledge to treat the complications after the shooting.
Robertson, a former Virginia Tech historian and professor who wrote Jackson's biography, said he has been persuaded that sepsis, caused by severe infection, killed Jackson, due to his chaotic rescue and unsanitary conditions. He noted, though, doctors at the time agreed Jackson had pneumonia.
"Unfortunately, medicine in the mid-19th century was still in the dark ages," he said. "Obviously, I'm not overly concerned with how he died. I'm terribly concerned that he died."
Jackson was a pivotal figure and perhaps the most esteemed soldier in the war, Robertson said. He was known for secrecy and speed to execute surprise flank attacks for Gen. Robert E. Lee's strategy.
"He was killed in what may be the high-water mark of the Confederacy," Robertson said. "You can make a case that after Chancellorsville, it's just a question of time for Lee."
Historical Clinicopathological Conference: http://medicalalumni.org/historicalcpc/home
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