The Photographic History of The Civil War: in ten volumes, Thousands of Scenes Photographed 1861-65, with Text by many Special Authorities, Volume 7: Prisons and Hospitals.
Francis Trevelyan Miller, Ed.

Part 2. hospitals

Medical and surgical supplies: the army surgeon and his work

Edward L. Munson, M. D., Major, Medical Department, United States Army

Guarding supplies for the surgeons with the armies Washington 1863

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Hospitals.

This type of hospital was highly recommended by the United States medical department, though it was not often built complete as shown here. The wards radiate like the spokes of a wheel from a covered passageway which extends completely around the hospitals. Inside this circle was a bakery, laundry, offices, and rooms for the surgeons. Notable are the roof ventilation and the large number of windows. Camp Nelson, shown below, was originally organized by Major-General George H. Thomas in 1861, for the purpose of bringing together the first Kentucky troops to go to the war. It was an open question that year whether Kentucky would espouse the cause of the North or the South. The Southern sympathizers, led by Simon B. Buckner, organized a State Guard, and the Union sympathizers organized an opposition force to which they gave the name of the Home Guard. When Fort Sumter was fired on, the Home Guard organized itself into Union regiments under such leaders as Thomas L. Crittenden and Lovell H. Rousseau. In 1861 Ohio and Indiana regiments crossed the State to Camp Nelson, and the men gathered there were the men that fought the famous battle of Mill Springs, one of the first Union victories. One of the reasons for the location of Camp Nelson was its proximity to the water. A large pumping-station was erected there on the banks of the Kentucky River. It was always a busy place during the war. No old soldier connected with the Camp will ever forget the charming view of the old-style wood-covered Hickman Bridge.

United States General hospital by the river at Jeffersonville, Indiana: a good type of hospital construction developed during the war

A mountain convalescent Camp at Camp Nelson, Kentucky: where the Kentucky recruits of 1861 were gathered.

 

Medical directors and officers.

The hardest task for a soldier is to remain quiet under fire without replying. Add to this the concentrated thought and delicate nicety of touch necessary to the treatment of mortal and agonizing wounds, and you have the task which confronted the army surgeon on the field of battle. During the first year of the war, before General Jackson had established a precedent to the contrary, they were also liable to capture and imprisonment. In war-time, army medical officers have many things to do beyond the mere treatment of the sick and wounded. Far-reaching health measures are in their hands. Vast hospitals must be organized, equipped, supplied, and administered, to which sick and wounded by the hundreds of thousands must be transported and distributed. There are subordinates to be enlisted, equipped, cared for, trained, and disciplined. No less than ten thousand medical men gave direct assistance to the Northern forces during the war. Under the agreement of the Geneva Convention, medical officers are now officially neutralized. This status cannot free them from the dangers of battle, but it exempts them from retention as prisoners of war.

Medical directors, army of the Cumberland, June, 1863

Dr. Blackwood (center) and medical officers in 1864 first division, ninth corps, army of the Potomac

 

Surgeons.

During the war forty surgeons were killed and seventy-three wounded while attending to their duties on the battlefield. Without the excitement of actually taking part in the fight, with no hope of high promotion, seeking no approval but that of their own consciences, these men performed their task actuated and sustained by no other impulse than the sense of duty. William James Hamilton White, of the District of Columbia, became assistant-surgeon in the regular Army March 12, 1850. He was appointed major-surgeon April 16, 1862, and met his fate five months later on the battlefield of Antietam. On this same day E. H. R. Revere, assistant-surgeon of the Twentieth Massachusetts Infantry, was killed on the battlefield. Other surgeons became ill from the excessive labor which they conscientiously and skilfully performed. Surgeon-General Hammond, accompanied by Brigadier-General Muir, deputy medicalinspector-general of the British army, visited the field, inspected the hospitals, and gave the sufferers the benefit of their professional skill soon after the close of the long and terrific battle.

William James Hamilton white Federal major-surgeon killed at the battle of Antietam

Surgeons and hospital stewards in Washington the Mercurian double-snake on the sleeve identifies the latter

 

however brilliant the tactics and strategy, it should be remembered that an essential factor in all warfare must be the physical efficiency of the man behind the gun. Despite this fact, historians give but slight attention to the medical men whose ability and self-sacrifice largely make possible the military reputation of others. Although the surgeons are regarded as non-combatants, their efficiency must always have a powerful influence upon military tactics. The Nation selects its popular heroes wholly for service on the battlefield. But it should not be forgotten that it is only through the unwearying and unobtrusive efforts of the surgeons that men and armies are kept in fighting trim and physically able to execute the will of the commanders. In any critical inquiry into battles and campaigns, the careful student will not overlook the fact that the conflict under consideration might not have occurred at all, nor in the place where it actually did occur, nor might the military tactics have been the same, had not one or the other force been weakened by preventable diseases or rendered more or less immobile by the crippling incubus of the wounded, for whose removal and care no adequate provision had been made before the conflict occurred.

At the outbreak of the war, the national army was inadequate to meet military needs, especially those relating to the critical Indian situations west of the Mississippi, which had been developed in large part by the influx of gold-seekers and colonizers into that territory. It is not to be wondered at, then, that the war should have found the military establishment of [219]

Medical directors of the Army.

Dr. Charles S. Tripler was General Mc-Clellan's first medical director. Although he had accomplished an immense amount of work, his machinery was not flexible enough to care for 100,000 men, and during the Peninsula campaign there was much confusion and an immense amount of suffering. But for the Sanitary Commission, which had charge of the hospital-boats near White House Landing and which cared for many thousands wounded and carried away hundreds, the distress might have been much greater. Dr. Jonathan Letterman became medical director of the Army of the Potomac July 1, 1862, succeeding Dr. Tripler. Dr. Letterman was a man of great ability; he organized the ambulance corps, improved the field-hospital service, and instituted a method of furnishing medical supplies by brigades instead of by regiments. Many of his innovations continued throughout the war. After the larger part of the Army of the Potomac had returned with General Pope, Dr. Letterman found much difficulty in again organizing it properly. He was successful, however, and the care of the wounded after Antietam marks a distinct advance on anything before this time. During the first year of the Civil War it became evident that many of the forms then in use, especially the report of sick and wounded, were highly defective and unsatisfactory when applied to the new and broader conditions of war; and on May 21, 1862, measures were taken by the surgeon-general to secure much more detailed information in regard to cases of illness and injury, and in respect to other matters of record controlled by the medical department. Some years after the Civil War, however, the mass of records in the surgeon-general's and other offices became so great as to bring about the organization of a record division to take them over and provide for their preservation and care. On these records is founded the national pension system.

Dr. Charles S. Tripler first medical director for General McClellan

Dr. Jonathan Letterman with his staff Dr. Letterman succeeded Dr. Tripler as medical director of the army of the Potomac, November, 1862

 

At the opening of hostilities between the States the personnel of the Medical Department of the regular army was composed of one surgeon-general with the rank of colonel, thirty surgeons with the rank of major, and eighty-four assistant surgeons with the rank of first lieutenant for the first five years of service, and thereafter with the rank of captain, until promoted to the grade of major. There was no hospital corps, but the necessary nursing and other hospital assistance were performed by soldiers temporarily detailed to hospital duty from organizations of the line of the army, and here it may be parenthetically remarked that the qualifications and character of the soldiers so detailed were usually far from satisfactory.

The Medical Department, with the above personnel, formed one of the coordinate branches of the general staff of the army as it existed in 1861. Its members were not permanently attached to any regiment or command, but their services were utilized whenever required. Although a separate regimental medical service still existed in many foreign armies, as it did in our militia, experience had demonstrated that our national system of a separate department was better adapted to the needs of troops when scattered over an immense area, and usually serving in small and isolated commands. The latter requirements explained the unusually large proportion of surgeons necessary at the time, amounting to about one per cent. of the total strength.