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Confederate surgeons.

An address before the Association of the survivors of the Confederate surgeons of South Carolina, at the annual meeting held at Columbia, S. C., November, 1889.


by F. Peyre Porcher, A. B., M. D.,
Surgeon to the Holcombe Legion, to the Confederate Hospital, Fort Nelson, Norfolk Harbor, and the South Carolina Hospital, Petersburg, Virginia.
Fellow Survivors of the Medical Departments of the Army and Navy of South Carolina:

Mr. President,—It was a happy inspiration which prompted us to gather in this capital of South Carolina three years since to organize an association of the surviving surgeons of the separate departments of the army and navy. It partakes of the character of a Medical Cincinnati Society, which is right and proper, as it proposes to transmit to those of immediate descent, certain rights and privileges which have been dearly purchased.

If men were born free and equal, they did not long remain so— for distinctions very soon arose based on difference of conduct, of character, or talents. If your ancestors fought and bled, and gave their property or their lives freely for their country, whilst ours remained at home in inglorious ease, or were money-changers, and wholly devoid of patriotism, we must naturally expect that superior respect and position—other things being equal—should be accorded you, and, by virtue of a more honorable past, you should receive a [13] fuller recognition from society and the world. As Pinckney and Rutledge, Moultrie and Marion, Pickens, Gadsden, Sumter, Richardson, and Bratton left to their descendants a record of good birth, character and capacity, there was presumptive evidence that such superior hereditary qualities would be maintained. Can there be any doubt, also, that Hampton, Butler, Anderson and Kershaw; Gregg, Hagood, Evans, Bratton and Jenkins; McGowan, Elliott, Conner, Manigault, Aiken and Capers; Barker and Gaillard, McMaster and Haskell; the Wallaces, and—

Hundred others whom we fear to name,
More than from Argos or Mycenae came,—

must justly transmit to their descendants some of the fame which they so dearly acquired, and that the halo which surrounded their brows will not entirely disappear in the lapse of time.

So we hope to transmit to the descendants of the survivors, testimonials to the conduct and behavior of their proavi.

It is becoming and necessary that a record should be kept of what was accomplished in those four years of a most bloody and disastrous war, when responsible acts, often requiring the greatest personal coolness and courage, were performed by men of our profession, who had been wholly untrained in the art and requirements of actual warfare. It must be noted, also, that they quietly fulfilled the most arduous, delicate and responsible duties unaccompanied by the ordinary expedients which are resorted to to incite and cheer the soldier; they were men who it was not deemed necessary to stimulate by adventitious aids, by mention in the gazettes, by brevet ranks conferred, by commendations read at the head of regiments, or reports sent up to headquarters—when the battle ended and the records of victory or defeat were recited.

They stood in need of no such aids, artificial or natural. These were the men who would only be referred to—if fate so willed it—in the list of casualties; and even in grave official histories of the campaigns, it is seldom that the presence, acts or the self-sacrifices of the medical staff would be recorded. In proof of which, since the war, we have seen no statement regarding the position, the conduct or the services of the medical department of the army in the great contest in which they played a most essential, if not the most conspicuous part.

Nor did they ask or expect fame, either present or posthumous. For conscious that, as members of a noble profession, the special [14] duties they were called upon to execute were of a high and exalted order, the approval of their immediate commander, the confidence of the sick or wounded—these, with the support of their own conscience, must be their supreme and only ambition.

With a sphere so limited, with reward so meagre and inadequate in comparison with those bestowed upon their military associates of similar or superior rank, we are now entitled to award them the highest credit for the unselfish performance of duty—whether done within the walls of a hospital, to the sick or wounded soldier in his quarters, or, as was often the case, in the face of the enemy, surrounded by danger and death, and equally exposed with the private soldier to shot and shell and to death-dealing missiles from those ‘instruments of precision’—as they were called—which sped with ‘damnable iteration,’ the

leaden messengers
     That ride upon the violent speed of fire.

And your speaker is fully warranted in rendering this tardy justice, as he cannot claim to have fully participated in the special exposures which you encountered.

To prove the devotion and the heroism of the surgeon and his youthful assistants, we would briefly recall some scenes which occurred at Petersburg, Va., near the close of that period when the beleaguered town was being shut in by a cordon of earthworks, crowned with batteries belching forth their bolted thunders,—the lines of the enemy were being pressed in closer and closer, the fire of every species of armament was converging upon that devoted centre, and the roar of cannon and the detonation of small arms ‘would deafen you to hear.’ So incessant was the cannonading from some quarter of the heavens, and so great the roar of artillery, that it seemed to the doomed city that a battle was almost constantly in progress.

The surgeons and assistant surgeons, the generals and the officers lived with their men in the open fields, in trenches swept by the fire of the enemy, literally in ditches and holes burrowed in the earth, half filled with water—from which they were sometimes in the rainy season driven out like rats. Half starved, upon the coarsest food, in cold and storm and rain, exposed to every hazard—these, our brethren of the medical department, quailed not; they patiently submitted to every hardship, often with systems shattered by privation and ill-health, whilst they performed services which required skill, care and serene courage.

No extended reference can be made here to privations endured in [15] prisons; and more than one example exists of voluntary surrender by surgeons in order that they might not be separated from their sick and wounded.

Even those in the comparative shelter of hospitals—especially those placed near to the immediate theatre of the war, had by no means light duties to perform, nor were unexposed to the dangers of the battlefield whilst in attendance upon the sick and wounded. They also were quite within range of shot and shell. Shells passed frequently over the South Carolina hospital at Petersburg. One struck within a few feet of the fourth ward, another entered the ninth, and a third passed through one of the tents provided to relieve the hospital—over—crowded with the sick and wounded. Before it became no longer tenable and was evacuated, the surgeon had to distribute the amputations—including also two resections of the shoulder—among his five assistants; and the whole of three entire days and nights, without cessation, were required to complete the work.

Batteries like Wagner, it is no exaggeration to say—were ofttimes wrapped in a gloom more sulphurous and fiery than that of Phlegethon or of Tartarus—made more terrible by the crash of those bolts of steel, impelled with vengeful fury, which rained upon them by day and by night. The defence was so desperate and destructive that the troops and their medical attendants had to be frequently relieved. Sumter, Mobile and Vicksburg were scarcely more endurable.

These facts are mentioned to show some of the reasons which justify us in recalling at our annual meeting the events of the past; that our associates and those who come after, may know how the medical department comported itself in the trials of that great and bloody war, which to many of us in memory seems now but a dream of the past.

In our opinion no sufficient tribute has ever been paid to the matchless organization of the medical department of the Confederate army as presented by the surgeon-general's office; and we regret that more has not been said and earlier, in order that before the death of that incomparable officer, Surgeon Samuel Preston Moore, he may have learned how much his services were esteemed. A native of Charleston and a man trained in the army, with all its ideas of discipline, its rigidity and its formality, he may have contracted certain habitudes which deprived his manners—not of the repose ‘which stamps the caste of Vere de Vere,’ for of that he had enough and to spare—but of that softness and suavity which are used in representative democracies and in all non-military communities. [16]

Within his domain, which was a very extensive one, he had absolute power and the fiat of an autocrat; the Emperor of the Russias was not more autocratic. He commanded and it was done. He stood in terrorem over the surgeon, whatever his rank or wherever he might be — from Richmond to the trans Mississippi, and to the extremest verge of the Confederate States. And though appearing to be cold and forbidding, we do not think that Surgeon Moore was cruel, arbitrary, or insensible to conviction. We have ourselves experienced some of his stern rulings, which were afterwards fully compensated for.

But where, or under what government so complicated and extensive as this, was there ever a department of the public service characterized by such order and precision? Every paper emanating from that office was a model of despatch and neatness; and the chief introduced various measures for the relief of the medical department when the country was suffering privations, and in want of the ordinary necessaries of life. It will be remembered, also, that included in the sphere of his duties was the providing the medical supplies needed for the entire army—which had to be imported in great measure; and the hospitals and other branches of the service were fairly supplied with quinia, morphia, iron, chloroform and surgical appliances.

If the writer is permitted to say it here, the hospitals at Norfolk and Petersburg under his care were never allowed to be without these essential articles—which were purchased when needed by private contributions from friends in Charleston.

But that we may avoid the imputation of being indiscriminately a laudator temporis acti, we think there were some grave mistakes committed. One of the most serious was the failure to send surgeons of known skill and experience into positions where they might do most good—into the field or into large hospitals—in place of permitting them to remain in high cathedral places as medical examiners, medical directors, in charge of stations for purveying and distributing medical supplies, etc. Surgeons of the first ability were appointed to these offices—doubtless of importance—but which could have been filled by others fully competent who had not devoted their lives to surgery. It seems strange that men, just at the period when their special capacities could be applied to the greatest advantage, were indeed absolutely demanded by the exigency, were diverted from the branch in which they were particularly proficient to such peaceful pursuits, whilst the assistant surgeon, sometimes the full [17] surgeon, was sent to the front and had the most responsible work in any army to perform; the care of the desperately wounded and the sick of every description, who required immediate attention, were often thrust upon them when they may have had little or no opportunities for acquiring practical skill.

The surgeon-general issued some valuable and useful publications, but we had no ‘Medical and Surgical History of the Confederate States’; we had scarcely a journal; we had no Army Medical Museum; we had no men of science with leisure to produce original work, or to record, classify and arrange the rich and abundant material gathered in the departments of either medicine or surgery. We did what we could; but we were working on a semi-starvation basis, pressed down with the cares of the war and of the family; and whilst we admire the genius and enterprise of our then enemy in their admirable illustrations of the records of the war, we could not expect to compete with the highly-organized and lavishly-supplied medical and surgical departments of the United States of the North.

Your speaker would be very remiss if on an occasion like this, and whilst commenting favorably on our own department, he should forget the tribute we owe the Confederate soldier. The surgeon knows the soldier better than any one else; he has occupied peculiar relations to him, and he should freely express what deserves to be said in his behalf.

But first permit us to say that in a paper1 prepared for Surgeon Moore near the close of the war, never issued by that officer—as Richmond was soon abandoned—occasion was taken to refer to the diseases from which the Confederate soldier suffered. Prominent among these were chronic relaxing diseases, and the following statement was emphasized, the accuracy of which some of our colleagues may justify: ‘The dominant fact which must impress and modify the whole course of treatment to which any judicious surgeon would subject him, unquestionably was prostration.’ Exhaustion was the great characteristic, as well as the essential element to be considered and combatted; and the natural corollary was that he was to be nourished and stimulated as far as the resources of the service permitted; [18] and the treatment was of course to be modified in view of the prevalent condition just stated, with the studious avoidance of all pertubative, depressing measures, drastics, ptyalism, etc.

What was applicable to well-nourished civilians would not apply to the soldier with his gastric irritability, his colliquative disease, his gastralgia, and more especially his nostalgia.

The fact being determined it was acted upon practically; the promise of a furlough was found to be superior to the whole pharmacopoea, and would literally rescue a sick or wounded soldier from the jaws of death. We have seen them turn to the wall to die, and yet leave for their homes a few days after under the revivifying influence of hope and a return to their families and all which it implied. When it was averred that one or two died on the road, the question was asked, But how many were saved?

From this brief and imperfect description of the depressing effects produced by the circumstances which surrounded the Confederate soldier, the modification in his management became of the first importance.

The ‘pathology of Shakespeare,’ as the learned and elegant Watson has called it, when he speaks of ‘rasing out the written troubles of the brain’ and ‘ministering to a mind diseased,’ was therefore required to be observed by the surgeon with the greatest advantage. For, superadded to the prostration and general asthenic state which we have asserted to be the dominant feature of our sick soldiers; there was, also, very generally extreme apathy as to results, however sombre might be their complexion, or even fatal to their hopes, wishes or lives.

The Confederate soldier resigned himself to his fate. Once that it was decided that a return home was impossible for him and he must remain in hospital, the physiognomy of his condition was admirably expressed by the phrase poco curante, which he carried in every feature of his face, in his gait and in his bearing. When he entered the service, whether from compulsion or, as in nearly every instance, urged by a noble patriotism, his mind was prepared for any fate; and he went forth, having adopted the desperate maxim of Mezentius— ‘Jam venio moriturus.’ The scenes of danger, also, through which he had passed had strung his nerves to so high a pitch of tension—so much higher than mere illness, which is far below the battlefield in the stirring intensity or the elevation of the emotion it excites—that he was not impressed by his present peril, however imminent might be the fate which it threatened. He was therefore languid, [19] careless and indifferent, and his mind needed to be aroused and stimulated.

As a striking proof of the apathy of the soldier when he takes asylum in hospital, it may be stated that on the occasion of a visit by General Lee to the farm, near Petersburg, to which the sick and wounded had been removed, he visited many of the tents. There was not the slightest excitement or enthusiasm manifested—no exclamation or apparent recognition of their beloved leader by a single individual. Politeness compelled us to occupy a singular role, and in every instance to announce the presence of their commanderin-chief and to introduce him to his soldiers.

What a contrast to their reception on every other occasion, as when surrounded by his generals he rode in review; or when all life and energy and courage they were ready for any enterprise—and meeting the same man in the fore-front of the hottest battle—with a wild cheer of recognition, they would turn his horse aside that he might not encounter the danger which menaced them.

There was no one so uncomplaining as the Confederate soldier. Every surgeon who has seen active service will confirm the truth and accuracy of a picture drawn without exaggeration. In your daily rounds to offer him relief he gazes upon you, but does not complain that you pass him by, asks for nothing, does not bemoan his fate, nor murmur at the insufficiency of either food or attendance. He may lay sick under a broiling sun, in a heated tent; or wounded, he may languish in the hospital amid the dying and the dead, surrounded by everything to appal even well men

crudelis,
Ubique luctus, ubique pavor,
Et plurima mortis imago;
yet the mere stripling possessed his soul unterrified, and uttered neither cry nor groan. There was always a courage and a resolution mingled with his apparent indifference, which has extorted our admiration and has compelled us involuntarily to recall the noble description of the invincible Cato: ‘The whole world was subdued, save the intrepid soul of Cato.’
Omne terrarum subacta,
Preter atrocem animum Catonis.

In this display of his courage there was an inexorable sternness almost amounting to atrocity.

When the soldier, leaving friends, kindred and home, delivers up [20] his life for his country, he has paid the dearest tribute which men can offer, and there is a moral sublimity in the act which ennobles the very poorest. In every age the sacrifice has been immortalized in verse and song, and the divine Dante says of him:

He goes in quest of libertywhich is so dear,
As he knew best who gave his life for it.

Liberta va cercando, ch'e si cara,
Come sa chi per lei vita rifiuta.

It was a great error to confound the Confederate soldier, as some of our surgeons did, with those of a standing army, or with mercenary troops, and treat them with harshness or disdain. The great majority did not require to be drafted into the army; honor and patriotism carried and kept them there. They were our brethren and our friends—sometimes our superiors; and though only privates, often the social equals of the best and highest in the army. Nor was his bearing that of an inferior. We all know the free, unconcerned air and carriage of the soldier, and how he would chaff his colonel or his general as readily as his comrades, whenever he could do so with impunity.

Many noble youths who were killed in battle or who perished by disease were after the pattern of

Little Giffen, of Tennessee,

ill-clad, ill-fed, humble heroes—the peers of any major-general or surgeon-general in the army. There were others more delicately reared, but not more true and loyal than these—high bred, gentle, keenly sensitive youths—who felt a stain as they would a blow—but brave as lions—who freely gave their lives, with only a tear for those at home, in obedience to the demands of that in-born nobility which sent them forth at the call of their bleeding country.
Lycidas is dead, dead ere his prime,
Young Lycidas, and hath not left his peer.

Finally, brethren, in looking around us now on the ‘survivors,’ we see no men like the militia colonels of the dear old ante-bellum days—decked in gay apparel, the ‘cynosure of neighboring eyes,’ as when, decorated and bedizened for a fourth of July celebration, they were surrounded by applauding multitudes and accompanied by bands of music—

Sonorous metal blowing martial sounds.

But, on the contrary, we gaze—not without emotion—upon real [21] veterans—men advanced in years, and of somewhat grave aspect, who are not without the marks of care and anxiety, oppressed, doubtless, by the troublous times through which themselves and those dependent upon them have passed in the struggle for life, and during a period of waste and misrule unexampled in the history of the world. Yet we feel sure that trained as you have been, and nurtured in the school of adversity, these difficulties were confronted with brave hearts, made strong by the experiences of the past.

Some of us, even at the beginning of the contest, had reached what the poet of the Inferno calls ‘the middle of the journey of life’; and now, when near a quarter of a century has elapsed, and we are still spared, we might recall with profit the sad but beautiful allegory, ‘The Vision of Mirza,’ and remember the bridge with the swiftly moving tide that flowed underneath, with the innumerable trap doors that lay concealed, and through which the passengers were falling one by one, some dropping in unexpectedly; and it was observed that the greater number fell near the beginning and at the ending of life. Or we may well be admonished, each of us, that we must soon join the great army which has gone before; and it will surely be esteemed a privilege and an honor that we, also, were of the number of those who went to the defence of their State and country, and did what in them lay to protect, uphold and preserve, by land and sea, ‘A Lost Cause.’

1 ‘Suggestions made to the Medical Department, with Modifications of Treatment required in the Management of the Confederate Soldier, dependent upon his peculiar moral and physical condition, with reference to certain points in practice.’

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