THF:ARMY 

MEDICAL DEPARTMENT 

1818-1865 

Mary C. Gillett 

Center of Military History. United States Army 

ARMY HISTORICAL SERIES 

THE ARMY MEDICAL 

DEPARTMENT 

1818-1865 

by 

Mary C. Gillett 

I\111IIi\RY' INSTRVCTXJN 

CENTER OF MILITARY HISTORY 

UNITED STATES ARMY 

WASHINGTON, D.C. , 1987 
Library of Congress Cataloging in Publication Data 

Gillett, Mary C. 

The Army Medical Department, 1818- 1865. 

(Army historical series) 

Bibliography: p. 

Includes index. 

Supt. of Docs. no.: D 11 4.1 9:M46/818-865 

I. United States. Army Medical Dept.- History19th century. 2. Medi cine, Military-United StatesHistory- 19th century. I. Title. II. Series. 

UH223.G543 1987 355.3'45'0973 87-600095 

First Printing-cMH Pub 30-8 

For sale by the Superintendent of Documents, U.S. Government Printing Office 

Washington, D.C. 20402 
ARMY HISTORICAL SERIES 

David F. Trask, General Editor 

Advisory Committee 

(As or September 1986) 

Dr. Charles P. Roland (Chairman) 

University of Kentucky 

Maj. Gen. Robert H. Buker 

Deputy Surgeon General 

Col. Robert A. Doughty 

U.S. Military Academy 

Col. Louis D. F. Frasche 

U.S. Army Command and General 

Staff College 

Dr. John H. Hatcher 

The Adjutant General Center 

L. Eugene Hedberg 

American Enterprise Institute for 

Public Research 

Dr. Archer Jones 

North Dakota State University 

Maj. Gen. Carl H. McNair, Jr. 

U.S. Army Training and Doctrine 

Command 

Dr. Jami e W. Moore 

The Citadel 

Dr. James O'Neill 

National Archives and Records 

Service 

Brig. Gen. Richard L. Reynard 

U.S. Army War College 

Donald W. Smythe, SJ. 

John Carroll University 

u.s. Army Center of Military HistOlY 

Brig. Gen. William A. Stofft, Chief of Military History 

Chief Historian 

Chief, Histories Division 

Editor in Chief 

ttt 

David F. Trask 

Lt. Col. Richard O. Perry 

John W. Elsberg 

Foreword 

The second in a projected fo ur-volume series that will cover the history of 

the Army Medical Department from 1775 to 194 1, this volume traces the development of the department from its establishment on a permanent basis in 

1818 through the final days of the Civil War in 1865. The uninterrupted existence 

of the Medical Department after 1818 made possible the gradual transformation 

of its staff from a collection of physicians of varying skills and attitudes into a 

group of highly trained a nd disciplined medical offi cers, proud of their organizati on and of their roles in it. Although the state of the art of medicine before 

1865 gave the military surgeon few effective weapons against illness and infection, after 1818, as this most recent volume in the series demonstrates, the length 

of the military career of the average medical officer and his professiona l attitude 

towa rd the challenges he met led him to concentrate his efforts on the Army's 

health problems and to work persistently to improvise ways in which to meet 

them. 

The Army Medical Department, 1818- 1865 is, like its predecessor, a significant 

and long-needed contribution to the history of military medicine. 

Washington, D.C. 

6 November 1986 

v 

WILLIAM A. STOFFT 

Brigadier General, USA 

Chief of Military History 
The Author 

Mary C. Gillett attended Wellesley College from 1946 through 1949 and 

received a B.A. degree in history from The American Uni versity in 1966. She 

received M.A. and Ph.D. degrees in modern European history from The American Uni versity in 197 1 and 1978, respecti vely. Before entering graduate school, 

she worked from 1966 through 1969 for the Naval History Di vision of th e Offi ce 

of the Chief of Naval Operations. In 1972 she joined The Historical Unit of the 

Army Medi cal Department, which was absorbed by the Center of Milita ry History in 1976, and is now a member of the General History Branch of the Center's 

Histo ri es Di visio n. She is th e author of The Army Medical Department, 

1775-1818, published by the Center of Military History, and of articles concerning the history of military medicine in the United States. 

VI 
Preface 

When the first volume of this series was started, no plans had been made to 

carry the history of the Army Medical Depa rtment beyond 1818, when that 

organization was first established on a permanent basis. Nevertheless, some of 

the precedents set in Volume I have been followed in Volume 2. Thus the 

coverage of military operations is limited to that necessary for an understanding 

of the work of the Medical Department, and the efforts of medical officers are 

evaluated according to the standards of their time. 

Since the permanent establishment of the Army Medical Department favored 

the systematic maintenance of records by the Surgeon General's Office, the 

research involved in the writing of this volume has in volved a challenge far 

different from that of the preceding volume. Indeed, the wealth of records deri ving from a multiplicity of sources made the task of dealing with the Civil 

War quite complicated. The author has attempted, however, to focus primarily 

upon the history of the Medical Department rather than upon the medical history of the Civil War. 

In dealing with the period from 1818 to 1865, the author has received invaluable assistance from too many sources for it to be possible to name them 

all. She is once again, however, particularly indebted to Dorothy Hanks and the 

staff of the History of Medi cine Division of the National Library of Medicine, 

including Lucinda Keister of the Arts Section, and to Elaine C. Everly of the 

National Archives and Records Service, as well as to William A. Deiss of the 

Smithsonian Institution and to Carol Anderson, former Librarian of the Center 

of Military History, for their help in obtaining the books and documents necessary to the research phase of her work. The author is also indebted to those 

who helped in the search for illustrations, particularly William Straight, M.D. , 

Stanley B. Burns, M.D., and Michael J. Winey of the U.S. Army Military History 

Institute at the Carlisle Barracks, Pennsylvani a. 

Many scholars have reviewed the manuscri pt of this vol ume in whole or in 

part and enriched the author's understanding of her subject by their comments 

and suggestions. Among them are Maj. Gen. James A. Weir, MC (Ret.); Col. 

Robert J. T. Joy, MC (Ret.), and Peter Oleh, M.D., both of the Uniformed 

Services University of the Health Sciences; Jack D. Welsh, M.D., of the College 

of Medicine of the University of Oklahoma; professors Edward M. Coffman of 

the University of Wisconsin, K. Jack Bauer of Rensselaer Polytechnic Institute, 

and Joh n Duffy of the Uni versity of Maryland; and Dr. Straight, who shared 

his considerable expertise concerning the Second Seminole War as well as his 

photographs. 

VII 
Members of the staff of the U.S. Army Center of Military History have also 

contributed significantly to the current vol ume. Albert E. Cowdrey, Chief of the 

Special History Branch, reviewed all drafts of the manuscript and assisted materially in their refinement. Dav id F. Trask, Chief Historian, Col. James W. Dunn 

(Ret.), then Chief of the Histories Division, and John W. Elsberg, Chief of the 

Editorial Branch, joined Dr. Cowdrey, Dr. Duffy, and Colonel Joy on the advisory panel that was responsible for the volume's final review before its acceptance for publication. Roger D. Clinton was responsible for the maps, which 

were prepared under the supervision of Arthu r S. Hardyman, Chief of the Cartographic Branch, who assisted in the selection and preparation of the illustrations for this volume as he did for the first. The author is also grateful to her 

editor, Marilee S. Morgan, for the patience wi th which she gave the manuscri pt 

a final polishing as she prepared it for the printer. 

Others of the author's colleagues at the U.S. Army Center of Military History 

have also contributed significantly to this volume. Paul J. Scheips offered helpfu l 

advice concerning Army surgeons in the West, while Kim B. Holien and Dwight 

D. Oland shared their Civil War expertise. Graham A. Cosmas repeatedly made 

his profound understanding of the history of the U.S. Army available so that 

the medical picture could be accurately placed into the overall military context. 

The author wou ld like to add one fina l word of gratitude- to R. Clark Gillett, 

Jr., M.D., for the patience and forbea rance with which he has always answered 

those medical questions with which the author hesitated to bedevil anyone else. 

As always, the responsibility for all errors is entirely that of the author. 

WaShington, D.C. 

6 November 1986 

Vlll 

MARY C. G ILLETT 
Contents 

CIlllfJ/er 

1. THE STATE OF THE ART 

Medicine. . . . 

Surgery . . . . 

Medical Education 

Conclusion . . . 

2. LAYING THE FOUNDATION, 1818- 1835 

Organization and Administration 

Surgeons in the Field 

The Black. HalVk War 

Conclusion . . . . 

3. INDIA N REMOVAL IN THE SOUTHEAST: THE SECOND 

SEM INOLE WAR . . . . . . . . . . . . 

Nell' Leadership jor the Medical Department . 

Removal of the Creeks. . . . . . . 

Character of the Second Seminole War. 

Assignment of Swgeons. 

Supply. . . . . . . . . 

General Hospitals. . . . . 

Care Q{ tlie Sick and Wounded at a Temporary Fort 

An Army Swgeon in the Field 

Conclusion . . . . . . . . . . . . . . . 

4. LAWSON 'S FIRST YEARS AS SURGEON GENERAL, 

1836- 1845. . . . . . . . . . . 

Administration in Washington . . 

Problems of Swgeons in the Field. 

Conclusion. ...... . 

5. THE WAR WITH MEXICO: TH E TAYLOR AND KEAR NY 

CAMPAIGNS . . .......... . 

Administration of the Medical Department. 

Surgeons in the Field 

Conclusion . . . . . . . . . . . . 

6. THE WAR WITH MEX ICO: SCOTT'S CA MPAIGN 

Preparing for Invasion . 

IX 

Page' 

3 

3 

17 

22 

25 

27 

27 

37 

50 

52 

53 

53 

54 

56 

59 

61 

63 

66 

68 

72 

73 

73 

84 

93 

95 

96 

98 

110 

III 

11 2 
Chapter 

Establishing a Base: Vera Cmz. 

The Drive on Mexico City. 

After the Victory 

Conclusion . . . . . . 

7. LAWSON'S LAST YEARS, 1846- 186 1 . . . . 

Administration . . . . . . . . . . . . 

The Work of the Army Surgeon as a Physician 

SlIIgeons as Soldiers and Scientists 

Conclusion . . . . . . . . . . . . 

8. THE CIVIL WAR, 1861: MANY PROBLEMS, FEW 

SOLUTIONS ............... . 

Administrative Problems of the Medical Department 

Care of the Sick and Wounded in the East. 

Care of the Sick and Wounded in the West 

Conclusion . . . . . . . . . . . . 

9. THE CIVIL WAR IN 1862: LEARNING ON THE JOB 

Care of the Sick and Wounded in the East. 

Care of the Sick and Wounded in the West 

Conclusion . . . . . . . . . . . . 

10. THE CIV IL WAR IN 1863: HAMMOND'S LAST YEAR. 

Administration of the Medical Department. 

Care of the Sick and Wounded in the East. 

Care of the Sick and Wounded in the West 

Conclusion . . . . . . . . . . . . 

II. THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 

Hammond's Trial. . . . . . . 

Barnes' Administration. . . . . 

Medical Care of Forces in Vilginia 

Sherman's Campaign in GeOlgia 

Trans·Mississippi Campaign. 

Conclusion . . . . . . . . 

12. THE END . . 

Administration. . . . . . . . . . 

Grant's Campaign in Northern Virginia. 

Sherman's Campaign 

Prisoners of War 

Conclusion . . . . 

x 

Page 

11 3 

11 8 

12 1 

124 

127 

127 

133 

143 

148 

151 

153 

162 

17 1 

176 

177 

184 

195 

200 

20 1 

20 1 

208 

216 

223 

225 

225 

226 

232 

243 

248 

249 

25 1 

25 1 

253 

257 

263 

273 
Chapter 

13. ACHIEVEMENTS AND FA ILURES DURI NG THE 

CIVIL WAR .. . .. 

Disease . . . . . . . . . 

Injeelion and WOl/nds . . . . 

Organization and Adminislration 

Epilogue 

BIBLIOGRAPHY . 

INDEX .. . .. 

Maps 

No. 

I. The Frontier, 18 18- 1835 . . ... . 

2. The Seminole Wa r, 1835- 1842 

3. The Mexican War, Taylor's Campaign, 1846-1 847 

4. The Mexican War, Scott's Campaign, 1847 . 

5. The Civil War, 1861 - 1865 

6. The Civil Wa r, Virginia . . . . . 

Illustrations 

Ophthalmoscope . . . . . . . . . . 

Advertisement for Achromatic Microscopes 

Advertisement for Stethoscope 

Willi am Wood Gerhard . 

Circular Amputation. . . . 

Flap Amputation . .. . . . 

Wound Closure: Methods and Materials 

Will iam Beaumont. . .. . . .. 

Beaumont's Ill ustration of St. Martin's Wound 

Beaumont's Illustration of St. Martin's Wound 

Joseph Lovell. . . . 

Benj amin Waterhouse . . 

Thomas Lawson. . . . . 

Hospital at Fort Mackinac. 

Sketch of Fort Snell i ng 

Cantonment Missouri 

Nathan Jarv is 

Eugene Abadie . 

Dade Masssacre. 

Lyman Foot . . 

William S. King . 

xi 

Page 

275 

275 

279 

288 

298 

301 

363 

Page 

41 

57 

100 

11 2 

152 

187 

Page 

4 

5 

6 

9 

18 

19 

20 

24 

25 

25 

28 

29 

33 

39 

43 

44 

46 

54 

58 

59 

61 
Benjamin King. . . . . . . . . . 

Richard H. Coolidge. . . . . . . . 

Instructions for Keeping Weather Diary. 

Thomas Mower . . . . . . . . . . 

Madison Barracks Hospital . . . . . 

Page of Letter From Nathan Jarvis to " Ben" . 

Samuel De Camp . 

Robert Murray . . 

Richard S. Satter

lee 

John B. Porter . . Charles H. Laub 

Charles McCormick 

Glover Perin . . . 

Roberts Bartholow. 

Bernard J. D. Irwin 

George Suckley. . 

Samuel Woodhouse 

Samuel W. Crawford. 

Clement Alexander Finley. 

Finley Ambulance, Front View 

Finley Ambulance, Side View 

John Cuyler . . . 

Charles Tripier . . 

Joseph J. B. Wright 

John H. Brinton. . 

William A. Hammond Jonathan Letterman and Ass

istants 

Thomas A. McParlin . 

James Simons 

Henry Hewit . 

Eben Swift. . Joseph Barnes 

Tripier Ambulance. 

Ambulance Drill 

General Sickles' Leg 

General Hospital at Gettysburg. 

John Craven Operating. 

Former Slave. . 

Edward Vollum . . 

Madison Mills . . 

Joseph J. Woodward John Shaw Billings. John Brinton and Hospit

al Attendants 

General Hospital for Army of the Potomac 

General Hospital at Point of Rocks, Virginia. 

James T. Ghiselin. . . . . . . 

XII 

Page 

74 

74 

77 

82 

85 

104 108 

110 

11 3 

11 4 

11 5 123 

136 

142 

143 147 148 153 154 158 158 162 

167 

17 1 176 178 185 193 

197 

197 

199 

203 

205 

206 212 

214 

215 217 

218 

219 

227 

233 

238 

239 

242 

243 
George Cooper. . . . . . . . . . 

John Moore . . . . . . . . . . . 

Field Hospital Near Petersburg, Virginia 

Meredith Clymer . . . . . . . . . 

Condition of Returnees From Southern Prisons. 

Union Army Prisoner of War Camp. . . . . 

Hospital and Prisoner of War Depot . . . . . 

Probe and Bullet Fragments From Lincoln's Brai n. 

Hospital Gangrene. . . . . . . . 

Hospital Gangrene. . . . . . . . 

Casualties of Battle: Amputated Limbs 

William W. Keen . . . . . . . . 

Mower General Hospital . . . . . 

Floor Plan of Mower General Hospital 

Design for Ventilation of Hospital Stove 

Rucker Ambulance. . . . . . . . . 

Kitchen and Dispensary Car for Hospital Train . 

U.S. Army Hospital Steamer, D. A. Jan1lary 

Lower Boiler Deck of D. A. Jan1l{IIY 

Middle Deck of D. A. Jan1lary 

Upper Deck of D. A. Jan1lary . 

Cabin Deck of D. A. Jan1lary . 

XIII 

Page 

244 

247 

254 

260 

265 

270 

272 

273 

28 1 

282 

284 

285 

290 

29 1 

292 

293 

294 

295 

296 

296 

297 

297 

THE ARMY MEDICAL DEPARTMENT 

1818-1865 

CHAPTER 1 

The State of the Art 

The years betwee n 18 18 and the start of 

the Civil Wa r were in many ways the darkest in the history of medici ne in the United 

States. Doubts as to the validity of timehonored medical practi ces were growing. 

Licensing requirements fell victim to egalita ri anism, and medi cal ed ucation became 

a profit-making ve ntu re. In a ny a rmy, disease sti ll caused more deaths than wounds, 

even during wartime. A few significa nt new 

developments, however, stood in sta rk contrast to the generall y stagna nt state of the 

art, a nd disillusionment with old ways was 

already beginning to stimulate a search for 

more scientific methods. Before the start 

of the Civil War in 186 1, a n increasing 

awareness of th e need fo r research and critical observation was emphasizing the Army 

Medica l Department's potential for major 

contributions to medi ca l science. 

Medicine 

Earl y in the nineteenth century, elaborate th eoretical systems th at used one or 

two pri nciples to expl ain all disease and its 

cure bega n to lose popularity among orth odox ph ysicians, who came to regard 

th ose who devised and supported such simplisti c explanations as quacks and cultists. 

The public's distrust for conventional medicine led to increased success for homeopa th s, hyd ro pa th s, th o mso ni a ns, a nd 

eclectics, some of whom had their own 

medi cal schools and journals, and many of 

whom had a common distrust for the traditi onal massive dosing with mercurials.' 

The decline of their faith in rigid theoretical systems left many orthodox doctors 

co nfused or uncertai n. Fact did not always 

substanti ate the newer theo ries concerning 

the causes, nature, and spread of disease, 

but suggestions that minuscule animals or 

fun gi might cause disease were generally 

ridiculed. The possibility of insect vectors 

was ra rely menti oned. Vigo rous debate 

raged over the question of contagion, but 

th e most popular theory on the cause of 

disease attributed much sickness to malignant fumes or miasmas arising from de-

'M uch of the background materi al in this chapter 

is based upon the works of Richard Harri son Shryock, 

especially l\4etiicil/e alit! SocielY ill America, /660- 1860 

(Ithaca , N.Y., and London: Cornell Paperbacks, 

1960). Medicine ill America: His/orical Ess(lJls (Baltimore: Johns Hopkins Press, 1966), and The Deve!-

0plllem 0/ Modem l'dedicine: All / lIIerprelaliOIl oj tlte 

Social and Sciemijic F(lefOrS Im'o/I'ed (Philadelphia: 

Uni versity of PCllnsylv,lI1ia Press. 1936), and the 

works of Erwin Heinz Ackerkncchl , including History 

alld Geography 0/ the MOSI Imponalll Diseases (New 

Yo rk: Hafner Publishing Co., 1965), Malaria in Ihe 

Upper Mississippi V(llley. /760-/900 (Baltimore: Johns 

Hopkins Press. 1945), and II Shorl HislOryo/l\tfedicilie 

(New York: Ronald Press Co .. 1955). See also George 

H. Dani els, American Science ill (he Age of Jackson 

(New Yo rk: Columbia Uni ve rsity Press, 1968); John 

Duffy, The Healers: The Rise 0/ the Medical EstabIislmwlIl (New Yo rk: McGraw-Hili Book Co., 1976); 

and Martin Kaufman, American Medical Education: 

The Fomwtire Years. 1765- /9/0 (Westport, Conn: 

Greenwood Press, 1976). 
4 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

"-

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OPHTHALMOSCOPE, as illllstrated in Medical and Surgical Reporter 4 (1860):323. (Collrtesy of National Library of lvledicine.j 

cay in g vege t ab le or an im a l matt er. 

Altho ugh some regarded fever as a symptom of disease, many still believed that 

conditions invol ving fever were a ll merely 

outward manifesta tio ns of a single underlying ailment whose symptoms varied with 

the climate and weathe r, the passage of 

time, the medici nes and treatments used , 

or the condition of the patient' 

2Charl cs Caldwell, AlI(lIysis oj Fever(Lcx ington, Ky.: 

Pri vately printed. 1825), p. 15; sec also William N. 

Bispham, MilIaria: Its TrelllmclII {Illd Prophylaxis (Baltimore: Wi lliams & Wilkins Co., 1944): and Mark 

Frederick Boyd, ed .. Malariology: A Comprehensil'e 

Sun'e)' of All Aspecrs a/ This Group 0/ Diseases From 

Their loss o f fa ith left many physicians 

uncertain not onl y abou t the ca use of disease but a lso abou t its treatment. Critics of 

preva lent practice inveighed agai nst "the 

tendency to self-del usion, which seems inseparable from the practice of the a rt of 

healing" a nd also against the tendency " to 

a ffl ict" t he pati ent "with unnecessary practice" while ignoring the fact that " some diseases a re co ntrolled by nature alone." An 

increasing numbe r of doctors were aware 

tha t overmedicatio n co uld cause harm, but 

a Global Standpoint. 2 vols. (Philadelphia: W. 8. Saunders Co .. 1949). 
THE STATE OF THE ART 

the pressure upon physicia ns to prescribe 

active treatment was great, partially because the pati ent himself might insist " on 

being poisoned." As a result, in the preCivil War period, practice did not quickly 

reflect the discoveri es of researchers and 

statisti cians.) 

Nevertheless, as the nineteenth century 

progressed, many of the most prominent 

physicians in both the United States and 

Europe turned hopefully to the careful, detailed statistical studies bei ng undertaken 

in the new and highly respected clinics of 

the Paris Medical School. Since Army surgeons were stationed at posts scattered over 

the entire nation and were subj ect to an 

overall discipline, their experience as a 

group was readily available to those gathering data for statistical studi es in the 

United States. With the support and encouragement of civili an physicians, the 

Army Medi ca l Department collected information co ncerning the influence of meteorological factors on healt h from post 

surgeons, who recorded the details of the 

weather, climate, and geographical features 

at the various forts and of the nature of the 

diseases affecting the men under their care. 

The science of gathering and using such 

data in the study of disease, however, was 

in its infancy. More effort continued to be 

expended in collecting this information 

than in forming valid conclusions based on 

it, a nd speculations based o n personal 

}Quotes from Oliver Wendell Holmes, "Currents 

and Counter-currents in Medical Sc ience," and Jacob 

Bigelow, "Self-limited Diseases," both in i'll/et/ical 

Conllllllllicaliolls oI,IIe l\;jassac/lllsells Medical Society, 

2d ser., 9 (1860):318, 319 and 5 (1836):338, 343. respecti vely; John Harl ey Warner, "The NatureTrusting Heresy: American Physicians and the Concept of the Healing Power of Nature in the 1850s and 

18605," Pers pec tives ill American Hislory 11 

(1977- 78):299-300: see also "Review of A Practical 

Essay 01/ Typholls Fe\'er by Nathan Smith," Nell' EIIg/alld JOllrn(1/ of Med icine alld SlIrgery 13 

( 1824):409- 10. 

JAMES W. QUEEN & CO., 

OP"'t101.,a,n..S . 

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5 

ADVERTI SEMENT FOR A CHROMATIC M ICROSCO PES, 1859. (COllrlesy oj National Library oj Medicine.) 

impressions still pl ayed an important role 

in ostensibly scientifi c discussions. 

The break with the old medical theories 

and their one- or two-cause explanations 

for disease placed an increased emphasis 

upon finding ways to differentiate between 

various diseases. The new instruments and 

techniques that physicians began to use 

added to their understanding of disease as 

well as to the accuracy of their diagnoses. 

The la ryngosco pe and ophthalmosco pe 

were of recent introduction and had not 

become popular tools by the time of the 

Civil War, but the mi croscope, while still 

ava ilable only to a few doctors, permitted 
6 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

DR. S. A. SJdNNER'S DOUBLE FLEXIBLE STETHOSCOPE, 

WITH 

Dr. C. C. Tafton's Improvements. 

A A arc two ivory ea r- A wha t passes through the intips, that spring into each strument, whilc the physical' when appl ied, by means cian has both hands at libof a spring in the tube erty for exposing the chest 

H; C, an ivory mouth· " or using the other elld of 

piece, taken between the .' the instrtllnent. D is a flexi· 

teeth. The instrument is ble tube, and is long enough 

thus held to the ears firm to be used whi le sitting by 

and steady, having a sol id the bedside in an erect poconnection between the re- 0 sition, thus "voiding the 

ccivi ng tube and teeth, and rush of blood to the head, 

huts out a II sound except which in some obstructs that 

acuteness of hearing so important ill many cases. This instrument is very 

port"ble, boin;:; put up in ell es that will go into the coat pocket, and arc sold 

for half the price of' other Double StetlLOscopes, while it is adm itted by those 

who usc thCIll, to be of more practical usc to the coun try practitioner than 

any other 11 0 11' before the profession. 

ADVERTISEM ENT FOR STETHOSCOPE, 1858. (Collrtesy oj National Library oJMedicine.) 

the study of cells whose very existence was 

unknown at the start of the century. The 

stethoscope was growi ng in popularity, 

while the thermometer came into ils own 

in the great medical centers of Europe with 

the realization that fever was a symptom, 

not a disease. The old procedure of examining the urine to detect disease received new life with the growth of interest 

in pathological anatomy and the discovery 

of the relationship of albumin found in 

urine to disease. Following the lead of 

Pa ris-train ed ph ysic ia ns, d oc tors attempted to correlate symptoms and test 

findings with abnormal changes fo und in 

the body's organs and tissues after death. 

New medicines were also used in the 

trea tment of disease. Most impo rta nt 

among them was quinine, long used in the 

treatment of fevers bUI before 1820, always 

in the form of the bark of the ci nchona tree. 

Not long after quinine sulfate was first extracted from cinchona bark, those using it 

began 10 comment on the ways in which its 

operation differed from that of the bark 

itself; reports maintained that quinine was 

more consistently retained in the stomach 

than bark and that it could be used in larger 

amounts, thu s increasing its effecti veness. 

In the South, where malaria posed a particularly formidabl e problem, some physicians began to realize that as many as 

twenty or thirty grains of quinine at a time, 

a dose much larger than had been custom-
THE STATE OF THE ART 

ary, were exceptionally effecti ve. They also 

learned that administering this drug while 

the patient was in the midst of a fever paroxysm did not trigger the dire consequences that had been expected. 

As a result, in 1843, shortly after the end 

of the Second Seminole War in Florida, the 

surgeon ge neral of the Army Medi cal Department sent a qu estionnaire to the surgeons serving under him inquiring about 

their experiences with quinine sulfate. He 

asked about the exact nature of the drug 

they were using, the impurities present in 

their supply, the size a nd timing of the 

doses administered, and any adverse effects that might have resulted from its use. 

Although the fift y-seven repli es that he received conta ined many subjecti ve impressions and conclusions, they revealed that, 

in the case of malari a, the use ofa few la rge 

doses of quinine instead of many small 

ones was a relati vely well-accepted practice 

in the Army. Most Army surgeo ns did not 

blame the increase in bowel disorders 

among soldiers on heavy dosing with quinine. In spite of its relati ve scarcity a nd the 

resultant high cost, they were using the new 

drug almost indiscriminately for many diseases other than malaria. Its ability to reduce fever and relieve physical discomfort 

may well have given it an undeserved reputation for aiding the treatment of typhus 

and typhoid fever, cholera, pneumonia, 

and other illnesses.' 

4Charlcs McCorm ick, "On the Usc and Action o f 

the Sulphate of Qui nine in Large Doses," Nell' Orleans 

Medical and Swgica/ JOl/mal 2 ( 1845-46):290; Richard 1-1 . Coolidge, "On the Medical Topography and 

Discases of Fort Gibson , Arkansas," SOli/hem Medical 

Repol'fs 2 ( 1850):45 1; Surgeo n General's Office 

(SGO), Sialislical Report oil/he Sickness alld MOrla/ify 

ill file Army From Jallllary, 1839. 10 JamwrJ', /855 

(Washi ngton: A. O. P. N icholson, 1856), pp. 644-90, 

passim (hereafte r cited as Stalislical Nepol'(, /839-55); 

see also Dale C. Smith . "Quinine and Fever: The Development of the EITective Dosage," JOl/mal oj the 

7 

In the earl y years of the nineteenth century, opium was prescribed mainly for dysentery or extreme pain, many physicians 

deploring its constipating effects and regard ing it as harmful if used alone for a 

fever. Nevertheless, a wider use of narcotics in general followed the refinement of 

morphine and codeine from opium in the 

first half of the century. By the Civil War 

era, tincture of opium, or laudanum, was 

a familiar household remedy. The addiction that sometimes resulted was not always condemned, even when the addict 

was an Army offi cer on acti ve duty who 

spoke openly of his problem. Doctors experimented with the dosages of narcotics 

in an effort to obtai n a maximum of benefit 

with a minimum of unpleasant side effects. 

Both new opiates were, like opium itself, 

given by mouth. Doctors also made attempts to administer morphine by scraping 

away the top layer of the skin and applyi ng 

the drug to the surface thus revealed. By 

midcentury, a few also admin istered morphine by injecti on, initially by cutting open 

a vein and using a regular syringe and, after 

1860, with the newly developed hypodermic. Physicians favored the new approach 

because it enabled them to use drugs that 

otherwise would be adversely affected by 

their passage through the digesti ve system. 

By the 1850s doctors were also resorting 

increasingly to alcohol, long also used to 

du ll pain, as a stimulant for the weak and 

debilitated.' 

H istory of J\;/edicille and Allied Sciellces 31 

(1976):343-67. 

sWarner," Heresy." p. 308; William W. Gerhard, 

"Observa tions on the Endermic Application of Med~ 

icine," North Americal/ Medical and Sw gica! Journal 

3 (1851):459; " Injection or Opium Into the Veins," 

Philadelphia Journal of Ihe Medical al/d Physical Sci~ 

ellces 8 ( 1824):456; Ltr, Thomas Lawson to Henry A. 

St innecke (31 Mar 1845), Textual Records orthe or~ 

rice or the Su rgeon General (Army), record group 

(RG) 112, Leiters and Endorsements Sent, entry 2, 

15:437, National Archi ves (NA), Wash ington. 
8 THE ARMY MEDICA L DEPARTMENT, 1818- 1865 

As far as drugs were concerned, purges 

and emetics were still trad itional standbys. 

The mercurials remained th e favorite 

purges. Calomel, in particular, had enthusiastic proponents, but as time passed, a 

growi ng number of physicians expressed 

reservations concerning its use. Impressed 

by the havoc that mercury could wreak 

upon the body, some began to seek ways to 

eliminate its horrible side effects by either 

reducing the dosage or eliminating its use. 

Some physicians also recognized the need 

to avoid constant irritation to the digestive 

system, and although emetics remained 

popular because of the belief that they relieved inflammation and fever, the profession in general used greater restraint in 

prescribing both th ese dru gs and 

purgatives. 

Although faith in emetics and purgati ves 

was still strong in 1818, venesection, once 

the mainstay of any course of treatment, 

had already become somewhat co ntroversial. Physicians used it with increasing caution as a generalized treatment for disease. 

By 1825, even those who favored its use 

against fevers and inflammatio ns questioned the desirability of venesection in hot 

climates and for old, weak patients. A 

growing number of doctors preferred local 

bleeding to venesection, usi ng for the purpose leeches or vacuum cups placed over 

cuts made in the skin. A controversial but 

influential book published in 1830, Researches Principally Relative to the Morbid 

and Curative Effects of Loss of Blood by 

Marshall Hall, emphasized the unfavorable 

short-term reactions that could follow excessive blood loss from any cause. It emphasized that very little had been done to 

determine the long-range effects of bleeding. In 1836 Pierre Louis, the father of the 

use of statistical studi es in medicine a nd a 

teacher of American students in Paris, 

pointed out that bleeding as therapy for 

inflammatory disease, although possibly 

helpful, had been overrated. The lise of 

venesection declined slowly throughout the 

l840s and 1850s, but by the time of the 

start of the Civil War, many surgeons resorted to bleeding only when the desired 

relaxati o n of the body co uld not be 

achi eved by cathartics or changes in the 

diet. 6 

T he principal diseases aga in st whi ch 

Army surgeo ns used their remedies in the 

period 1818 to 186 1 were those then classified as fevers. Of these, malaria represented 

perhaps the greatest continui ng health 

problem facing the Army Medical Department. Although it was receding from the 

eastern seaboa rd , malaria remained to 

va rying degrees a threat throughout the entire nation, posing a surprisingly severe 

problem in the Midwest. It was generall y 

regarded as a disease of the countryside, 

where mosquitoes could abound in numbers almost inconceivable today, but it appeared occasionally in la rge towns and 

cities as well. The fact that a so-called 

animalcule-bea ring mosquito (Anopheles) 

rather than evil vapors spread the disease 

was not definitely established, however, 

until near the end of the centu ry. 

In the mid-nineteenth century, malaria 

in its various forms had many names. It 

appeared in the records of the time as, 

among other things, remittent, intermittent, marsh, miasmatic, and autumnal feve r, as we ll as th e ag ue. Classi fied as 

intermitten t fevers were those that followed a regular pattern of fever alternating 

6James Jackson, Prerace to Researches 01/ Ihe E.Dects 

of Blood-felling . .. , by P. C. A. Lou is, trans. C. G. 

Putnam (Boston: Hilliard , Gray & Co., 1836), p. vi; 

B. M. Randolph. "The Blood Letting Controversy in 

the Nineteenth Century," Allnals 0/ Medical HiSforv, 

n.S., 7 (1935): 180-8 1; Marshall Hall, Researches Prillcipal/y Re/afil't! to Ihe l\llorbid alld CUf(lfil'e Effects 0/ 

Loss of Blood (Philadelphia: E. L. Carey & A. H art, 

1830). 
THE STATE OF TH E ART 

with a return to normal temperatures. The 

remittent form, in whi ch the fever flu ctuated but never quite reached norma l, was 

presumably either typhoid fever or today's 

falciparum ma laria, always dangerous if 

not treated promptly, capable of mimicking many ot her diseases, and most prevalent in warmer climates. Patients who were 

infected wi th malaria on separate occasions might experi ence symptoms that fo llowed different cycles. Once infected by 

malari a, a soldier's hea lth might be permanently threatened. The enlarged spleen 

and liver could be accompanied by a slight 

j aundice resembling that of yellow fe ver. A 

scarlatina-type rash could be present, or 

th e patient's flushed face , reddened eyes, 

hot, dry sk in, agonizing headaches, and 

ac hing muscles might suggest typhoid . 

Bronchitis or even pneumonia could develop to further compli cate the diagnosis. 

The presence of diarrhea might be misleadi ng; diarrhea accompanied by nausea, 

vomiting, and stomach pain mimicked 

chol era. The difTiculty of distinguishing 

malaria from other diseases made credible 

a theory that malarial fevers were antagonistic to typhus and typhoid fever and that 

the prevalence of malaria and the typhoidtyp hus types of fe ve r va ried in verse ly. 

Some authors applied this theory of antagonism also to tuberculosis, but it has been 

since noted th at tuberculosis as a complication of mala ria leads to a quick death .' 

Relapses were frequent in all forms of 

10ale C. Sm ith, "The Rise and Fall of Typhomalarial Fever. I: Origins," lUI/mal Q(lite HislOry a/Medicine and Allied Sciences 37 ( 1982): 191; R. La Roche. 

Pnellmonia: . .. IlIellldillg (llIllIqlliry iwo Ihe f.'·xis/cllee 

and ll'lorbid Agency of Ma/aria (Philadelphia: Blanchard & Lea, 1854), pp. 310. 3 14-15; Bispham, Ma-

!aria, p. 85; Charles Franklin Craig and Ern es t Carroll 

Fausl. Clinical Parasitology, 2d cd. , rev. (Philade lphia: 

Lea & Febigcr. 1940). p. 199; Maxwell Wintrobc ct 

al.. Harrison's Principles o/Imema! Medicille, 7th cd. 

(New York : McGraw-Hi li Bo ok Co., 19 74). 

pp. 1020-2 1. 

9 

W ILLIAM WOOD GER HARD. (Courtesy 0/ 

The College 0/ Physicians 0/ Philadelphia.) 

ma lari a, even after treatment, as is typ ical 

even today in patients treated excl usively 

with quinine, and could be triggered by surgery. At least one Army surgeon blamed 

relapses on the effects of drafts when the 

victim was hot, overexposure to the sun , 

overeating, and constipation. In patients 

weakened by poor diet, overwork, stress, 

or disease, moreover, any form of malaria 

coul d be fata l. Although spontaneous recovery was possible, when chronic, malaria 

co uld lead to varying degrees of anemia, 

even to permanentl y impaired healt h. ' 

Before quinine sulfate became available, 

the treatment of choice for malaria involved vari ous combinations of bleeding, 

' Richard P. Strong, Slill'5 Diagnosis, Prl."I'elllioll and 

Trealmelll of Tropical Disease, 7th ed. , 2 vols. (Philadelphia: BJakiston Co., 1944). I :98; Craig and Faust, 

ParasilOfogy, p. 208. 
10 THE ARMY MEDICAL DEPARTMENT. 1818-1865 

purging, and vomiting, 10 addition to the 

administration of cinchona bark. Some 

physicians believed that causing the patient 

to perspire heavi ly was a lso helpful. Cathartics and emetics continued to be administered with the quinine, but as quinine 

sulfate gained in popularity, bleeding became less popular. Opiates were used for 

pain. Army Assistan t Surgeon Jonat han 

Letterman recorded that he believed ten to 

thirty drops of chloroform taken with a little water could be helpful in soothing the 

irritable stomach of the malaria patient, although he somewhat paradoxica lly warned 

against the use of chloroform when the patient's digestive system was innamed9 

Unlike malaria, true typhus was apparently rarely seen in the United States, but 

the diagnosis was not uncommon because 

in the earliest decades of the nineteenth 

century, when typhoid fever was very common, the term typhus/ever was used almost 

interchangeably with the term /yphoid. Occasionally typhus fever was actua lly used 

to denote any type of fever believed to originate in miasmas. By 1837, research by 

William Gerhard, an American physician 

who was a former student of Louis' in 

Paris, had made it possible to distinguish 

between the two diseases. Even after this 

point, the cause of typhoid remained unclear and its treatment debatable, but the 

disease was probably widespread. The use 

of large doses of quinine was urged in 1851 

in the belief that this drug had not been 

9'fhomas Neville Bonner, The Kansas Doclor: A Cel/-

tury oj Pioneering (Lawrence: University o f Kansas 

Press, 1959), p. 27; John Estcn Cooke, II Tre(J/ise 0/ 

Pathology and Therapelllics, 2 vo ls. (Lexington, Ky. , 

1828),2: 127-28; Stal;sliclIl Report (/839-55), pp. 77, 

33 1-32; Thomas Lawson, quoted in Percy M. Ashburn, "One Centu ry Ago," A4i1irary Surgeon 59 (July 

1926):38; Bernard M. Byrne, Proceedings 0/ a Coul'! 

Marfial for the Trial oj Surgeon 8. lvf. Byrne . 

(Charleston, W. Va.: Walker, Evans & Co., 1859), 

p.82. 

given a fair tri al aga inst typho id, but it was 

suggested that the quinine be accompanied 

by opium and possibly a mercuria l as 

wel1. 1o 

A fourth disease descri bed severa l times 

in Army records from the decades before 

the Civil War was dengue, spread by two 

different mosquitoes, one of which, the 

Aedes aegypli, might also carry yellow fever. In its initial stages, de ngue was characterized by fever a n d n ausea. 

Con tempora ry descriptions noted that, in 

this disease, vomiti ng generally began several days after the fever broke for the first 

time a nd that a rash th en followed the nausea. The rash suggested scarlet fever rather 

than measles and consisted of " minute papulae of a norid red, slightly elevated, and 

distributed in irregularly shaped patches," 

appearing first on the face and trunk. After 

the rash was fu ll y developed, the fever generally reappeared. The swollen glands and 

painful joints that also characterized dengue co ul d persist for weeks or month s. The 

disease tended to cause great suffering but 

few, if any, deaths. In the late 1820s, the 

recommended treatment called for antimonials in the earli est stage, bleeding in the 

so-called innammatory stage, diaphoretics 

such as Dover's powder, wh ich co ntained 

opium a nd ipeca c, and o f c ourse , 

cathartics, I I 

'OCooke, Trealise I :507: William S. Middleton,"William Wood Gerhard," AIII/als o/MedicaillislOry. n.s., 7 ( 1935):11 - 12; William W. Gerhard, "On 

the Typhus Fever Which Occurred at Philadelphia in 

the Spring and Summer of 1836," Americall )011/"1/0/ 

0/ the Medical Sciellces 19 (1837):289-91. 294, 307. 

322; "Review of 01/ the Idelllity or NOIl-idelltity o/TypllOid Fel'er. Typhus F{.'1'er. alld RelapSing Fever. By W. 

Jen ner, M.D .. " Ohio Jllledica/ alld SlIrgical JOllmal 3 

(1851):361. The probabi lity that typhoid was widespread in the United States but often misdiagnosed 

is suggested in Dale Smith, ''The Ri se and Fall of 

Typhomalari al Fever. II: Decline and Fall," JOllmal 0/ 

the History 0/ Medicil/e and Allied Sciences 37 

( 1982):287-321. 

"Samuel Forry. The Climate o/Ihe United Stales alld 
TH E STAT E OF T H E ART 

Yell ow fever was yet another mosq uitospred d isease, dread ed in northern ports as 

well as in the South , where it was a relati vely regul a r visito r a long the coast. Du ring this pe ri od, through the ir stud y of 

pathologica l anatomy, scientists first bega n 

to suspect tha t ye ll ow feve r was a d istinct 

d isease. Altho ugh it was not found end emicall y where the temperature dropped below 7 1

0 F., it co uld be imported into a reas 

o f mode rate temperatures du ring the summer by ships from tropica l ports ca rrying 

infected Aedes aegypti mosqu itoes, which 

were capable o f spreading the d isease fo r 

up to sixty days. T he role of th e mosq uito 

was suggested as ea rly as 1848, but auth orities genera lly bla med yellow feve r o n 

the combined e ffects of heat, moisture, and 

decaying anima l and vegetable matter. Altho ugh they recogn ized the fact tha t few 

ever had the d isease twice, they debated its 

contagio usness and the va lue o f q ua ra ntines aga in st it. Writers urged t hat treatment be started earl y in the cou rse of an 

a ttack of yellow feve r. In additi on to the 

usual purges, doctors might use quini ne to 

treat it. Some a lso ad vocated the ra ising of 

blisters on the spine and upper abdomen. 

A number of less devastating diseases 

a lso bo re the na me chole ra in the nineteenth century, but o nl y the disease known 

as Asiatic cho le ra inspired mo re terror than 

yellow fever. At their worst, the symptoms 

of this disease were dreadful to witness, a lthough th ey could actually vary consi derably in intensit y. A patient with a slight 

case might suffer o nl y a diarrhea so mild 

that, without modern techni q ues, th e diagnosis was uncertain. 

T he victim o f severe chole ra, however, 

often died in hideo us agony. His su nken 

lis Endemic influences . .. . 2d cd. (New Yo rk: J. & H. 

G. Langley, 1842), pp. 343-45, 347, quote from 

p.345. 

II 

face might be " rendered peculi a rl y ghastly 

by the removal o f a ll th e so ft soli ds," accord ing to a surgeon stationed a t Fort Armstro ng d u rin g th e 1832 epide mi c. His 

ha nds and feet we re " bluish white, wrinkled as whe n long m ace ra t ed in co ld 

water," and his eyes "fallen to the bottom 

of their orbs," with a "gla ring vita lity, but 

withou t mobility." His blood was reduced 

by d ehydra ti on to a sludge his heart could 

not pump, his viscera were congested, his 

skin and limbs chilled and bloodless. Such 

a case might begin with a profuse but pa inless di a rrh ea th a t became progressively 

mo re liquid until it reached a stage where 

the stools resemb led rice wate r. Vomiti ng, 

oft en proj ectile, foll owed and continu ed 

even if the patient too k nothing by mouth. 

Mu scle cramps appeared, fi rst in the calves 

of the legs, then in the toes, spreadi ng to 

the thighs and th e a rms and hand s. Bowel 

movements might become involunta ry. As 

the dehydra tion continued, the heart bega n 

to fa lter and c irculato ry fa ilure fo llowed. 

T he fl ow ofurine decreased or stopped. Exhausti on deepened; the eyes san k into the 

head and the ski n shri veled. T he tempe rature drop ped below no rma l, the respiration became ever more rapid, and, in the 

fi nal moments befo re death, the victim's 

dehydrati on might be so complete that 

even his di a rrhea ceased at last. " 

IlLlr. Samuel B. Smith to Capt W ilson, Niles' 

Weekly Register 43 (24 Nov 1832):20 3. Unless otherwise indicated, the background information on cholera in this chapt er is based on Oscar Felscnfeld, The 

Cholera Problem (S1. Loui s: Warren H . G reen, 1967); 

Ahmed Mohamed Kamal, Epidemiology of Comlllunicable Diseases (Cairo: Anglo-Egyptian Bookshop, 

1958); R. Po11itzer, Cholera, World H ealth Organization (WH O) Monograph Series, no. 43 (Geneva: 

W HO, 1959); Charles Rosenberg, n,e Cholera Years: 

The Vnited States ill 1832. 1849, alit! 1866 (Chicago: 

U ni versity of Chicago Press, [962); and G. F. Pyle, 

"The D iffusion of Cholera in tile U nited States in the 

Ni netee nth Cen tury," Geographical Analysis [ 

( 1969): 59-75 . 
12 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Modern methods of restoring body fluids 

make the chance of survivi ng cholera today 

excellent for those fortunate enough to li ve 

where they are ava ilable. Because of the 

present understanding of the way in which 

it is transmitted and because modern sanitation methods limit a population's exposure to cholera, deaths from this disease 

now usually occur only in areas that are 

both extremely backward and crowded. A 

water-borne bacterium (Vibrio cJ/O/erae) 

causes cholera, entering the body through 

the mouth, usuall y in drinking water, in 

fish or shellfish, or on vegetables and similar foods. The organisms may also be 

spread by fli es or by healthy human carriers and can li ve in moist earth one to two 

weeks, in shallow well water three to fifteen 

days, and as long as four months in ice. 

Heat, sunlight, or an acid medium kills the 

vibrio quickly. The incubation period varies, but rarely exceeds fi ve to ten days and 

averages about three. 

Endemic in parts of India, cholera first 

brought widespread fear in 1814 to 1815, 

when it struck Asia, the Near East, and 

Russia, bringing with it a death rate offrom 

40 to 75 percent. It began to inspire terror 

on a worldwide scale only a fter 1830, reappearing periodicall y in the United States 

from 1832 until the time of the Civil War, 

and striking with particular frequency in 

the years 1848 to 1852. The overall death 

rate of the first epidemic in the 1830s varied between 10 and 15 percent, although 

during its initial appearance in New York 

City in 1832, the death rate among those 

co ntractin g th e disease reportedly approached a fri ghtening 50 percent. In the 

1840 epidemic the national mortality rate 

dropped below 10 percent. " 

IlJohn Duffy, "The History of Asiatic Cholera in 

the United States," Billie/in o/Ihe New York Academjl 

of Medicine 47 ( 197 1); 11 53-54, 1158; A. Lave ran, 

Traile des maladies el epic/elllies des orm(!{!s (Pari s: G. 

Before the Civil War, Asiatic cholera was 

most commonl y blamed on miasmas or 

meteorological conditions, but even in the 

1830s a few scientists theorized that sma ll 

li vi ng creatures played a role in this disease. Very few physicians thought that it 

was actuall y contagious, but some beli eved 

that its spread must in some way be related 

to its human victims rather than to the atmosphere. Others, however, doubted that 

Asiatic cholera ex isted as an entity separate 

from ordinary digesti ve upsets with simil ar 

symptoms or from feve rs such as typhus or 

malari a. Excessive nervous strain as well as 

intemperance, debauchery, and filth were 

beli eved to predispose to the disease." 

Steps suggested to protect the population 

from cholera varied. Cleanliness and temperance and the avo idance of dampness, 

chills, and fear were often urged upon the 

populace as were regular exercise and a 

proper diet. The most popular approaches 

to the treatment of the disease resembled 

those fOll owed for other illnesses. Many authorities undertook bleeding at the slightest 

sign of a fever and administered calomel 

and opium early in the course of an illness. 

Less popular remedies included cupping 

the temples and abdomen, giving ice internall y, and administering enemas composed of such ingredients as hot water and 

brandy, which a ided in warmi ng the patient, or a tobacco infusion, which stimulated the circulati on, eased cramps, and 

stopped vomiting and diarrhea. T he possibility of giving intravenous treatmen t was 

Masson, 1875), pp. 700-70 1; James Joseph Walsh, 

t-lislOfY oj l'vIedicilll! ill New York: Three Cenfuries of 

lv/edica! Progress, 5 vols. (New York: National Amc ~ 

icana Society, 1919), 1:109. 

14Danie l Drake, ;I Practical Treatise 01/ 'he History. 

Prel'elllioll and TrealllJ(!lI/ 0/ Epidemic Cho/era 

(Cincinnati: Corey & Fa irbank. 1832), pp. 9, 34-50: 

John Bell and David Francis Condie, IIlIlhe Material 

Facfs ill Ihe Hislory of Epidemic Cholera (Philadelph ia: 

Thomas De Sil ve r, Jun., 18 32), pp. 48-49, 56-57. 
THE STATE OF TH E ART 

considered during the 1832 epidemic, and 

the injection of a saline solution was actually tried. Although the new technique 

was used severa l times on moribund patients, whose demise it failed to prevent, 

several a ll eged s uccesses were a lso 

reported. " 

By 1849 cholera was once again sweeping 

the United States. In SI. Louis it caused 

almost 68 percent of the deaths recorded 

in the period from 23 April to 6 August 

1849. In 1852 it struck with force once 

aga in, only to fade ou t two years later. During this epidemic a British scientist, noting 

the relationship of cases of cholera to water 

drawn from a particular well, began to suspect that cholera was a water-borne disease, but animalcules and fungi were still 

genera lly dismissed as possible ca uses. In 

the United States, treatment during the 

second and third nationwide epidemics 

varied, but did not differ appreciably from 

that favored in 1832. The inj ecti on of a 

saline solution into a victim's vems remained ex perimentaL" 

'SBcrnard M. Byrne, All Essay /0 Prove fhe COlllagivlIs Nature 0/ Malign(llll Cholera. (Baltimore: 

Ca ry, Hart & Co., 1833), pp. 128-29. 131, 138, 

140-4 1, 14 3: Niles' Weekly Register 42 ( 18 Aug 

1832):439; Elam Stimson, 711l! Cholera BeaCOII ... 

(Dundas, Ontario: Hackstaff, 1835), pp. 25-26; "Saline Injecti ons in Cholera," 1\lledical IHagazine I 

(J 933): 192-93; J. Mauran. "Case of Cholera Treated 

With Saline Injections With Observations Thereon." 

Medical Magazine 1 (1933):254-56; Drake, Practical 

Trefllise, pp. 123- 24, 144-47; Floyd T. Ferris,;J Trearise 011 Epidemic Cholera . .. (New York: Harpe r & 

Bros .. 1835), pp. 35-36. 

I~ Sam l A. Cartwright, The Pathology and Treatmellf of CllOlera. . (New Orleans: Spencer & Middlcton. 1849), pp. 30-3 1; Horatio Gates Jameson, A 

Treatise 01/ Epidemic Cholera (Philadelphia: Lindsay 

& Blakiston, 1855), pp. 133-34; Zimri Hussey, A 

COl1lprehensh'(' alld Practical 7iwuise all ... Cholera 

(Cincinnati: Gazette O ffi ce, Wright, Fisher & Co. , 

1949). p. I I: DulTy. "Chole ra," pp. 11 59, 11 62-63: 

Ed mund Charles Wendt , A Treatise 011 Asiatic Cholera 

(Ncw York: William Wood & Co., 1885), pp. 28, 30; 

John Snow, Snail' all Cholera (Reprint. New York: 

Commonwealth Fund, 1936), pp. 40,51 , 56. 

13 

Milder cases of cholera were someti mes 

mista ken for dysentery or diarrhea, both 

common ailments in the period preced ing 

the Ci vii War. As with other diseases, the 

question of whether either was contagious 

continued to be a topic for debate. Little 

distincti on was made between the two; an 

Army surgeon stated in 1852 that the principa l difference between diarrhea and dysentery lay in the fact that th e former 

affected the small intestine and the latter 

the large . Theories attributed the cause of 

this form of illness to bad air, in appropriate 

food, too much purging with harsh medicines, meteorological factors, espec ia ll y 

high temperatures, and alcohol, when appli ed internally and too li bera lly. Bot h 

diarrhea and dysentery had been known as 

camp diseases for centuries, but it was onl y 

in 1859 that the ameba causing one form 

of dysentery was actually iden tified." 

The treatment for dysentery and dia rrhea in many ways resembled that for other 

d iseases: bleeding, emetics, purgati ves, 

quinine, opium, blisters, and occasionally 

less common remedies such as combin ations of alum with either white vitriol (zinc 

sulfate) or sulfate of iron, or of acetate of 

lead with opium and ipecac. At least one 

physician stated that there was no proof 

that mercuri als were helpful in cases of dysentery. Doctors cast doubt on th e possibility that a patient with either dysentery 

or diarrhea could be cured while rema ining 

in a tropical climate; they suggested sea 

voyages, visits to minera l springs, and 

t rave l to a coole r climate for chroni c 

cases,l S 

'7Forry, Climate, p. 298; Austin Fl int, Clinical Report 01/ Dyseflferp . , . (Buffalo: Jewett, T homas & Co., 

18 53). p. 88; Nathaniel Chapman, " Remarks on the 

Chronic Fluxes or the Bowels." in Gert H . Bri eger, 

Medical America ill the Nineteell/h Cef/fUl')I: Readings 

From Litera/lire ( Baltimore: Johns Hopkins Press , 

1972). p. 108. 

18Chapman, " Remarks," in Brieger, /Hedical A mer-
14 T HE ARMY MEDICAL DEPARTMENT, 181 8- 1865 

Scurvy had by no means been eliminated 

in the decades immedi ately preceding the 

Civil War, although in the Army, the incidence of the disease and the number of 

deaths varied considerably from year to 

year. In 1819, for example, the Army recorded 7 cases with no deaths, but in 1820 

there were 734 cases wi th 190 deaths. In 

most years during the period from 18 19 to 

1838, no deaths were recorded. Factors 

that contributed to scurvy's appearance 

were recognized, but the unique importance of fruits and vegetables as both preventi ves and cu res only grad ually came to 

be understood. Such factors as fatigue , 

cold, anx iety, dampness, overwork, and the 

excessive use of salt continued to be implicated as causes rather than merely cond itions that diminished ascorbic ac id 

reserves. The disease appeared at widely 

differing posts from Florida to Texas and 

New Mexico to Wyoming, wherever climate and isolation made an adeq uate di et 

difficult to achi eve. " 

Mercury had particularly destructive effects upon patients suffering from scurvy, 

ica, pp. 111 - 14; Flint, Clinical Report, pp. 84-85, 

89-90; George Johnson, "Remarks on the Medical 

Topography of Texas, and on the Diseases of the Army 

of In vasion," Saillf LOllis Medical alld SlIrgical JOllrnal 

4 (1846- 47):437; William H. Richardson, Journal 0/ 

Wm. H. Richardson. a PriwueSoldier . .. , 3d ed. (New 

York: Wi lliam H. Richardson, 1849), p. 51; John B. 

Porler, "Medical and Surgical Notes of Campaigns in 

the War With Mexico ... ," ilmerican JOl/mal o/Ihe 

Medica! Sciences, n.S. , 26 ( 1853):33!' 

19Forry, Climate, pp. 332-33; John Russell Bartlett, 

Personal Narralive oj 1:::xp/Or{Jliolls and IlIeidellts ill 

Texas, 2 vols. (New York: Rio Grande Press, 18 54), 

I :237; leroy R. Hafen and Francis Marion Young, 

Fort Laramie and the Pageallf ojthe West, 1834-1890 

(Glendale, Calif.: Arthu r H. Clark Co., 1938), p. 157; 

M.l. Crimmins, ed., "Colonel J. K. F. Mansfi eld 's 

Report of the Inspection of the Department of Texas 

in 1856," Southwestern Historical Quarterfy 42 

(1938- 39): 138; John Norris, "The 'Scurvy Disposi~ 

tion': Heavy Exertion as an Exace rbating Influence on 

Scurvy in Modern Times," Bulletin of the His/ory oj 

Medicine 57 (1983):325, 338. 

but physicians of the period were beginning 

to recogni ze this fact and to seek better 

methods of prevention and treatment of 

the disease. They still placed much unwa rranted faith in th e a ntisco rbutic effects of 

vinegar, but more co rrectl y inferred that 

potatoes relieved the symptoms of scurvy. 

Many posts were relati vely isolated, especially during the win ter, and the diffi culty 

of bringing in antiscorbutics caused surgeons to look for native plants with such 

properties. In the Southwest, med ical officers discovered that the plant called the 

maguey proved eve n more effecti ve in 

treating scurvy than lime juice, while pokeweed, prickly pear, a nd wild onions were 

also effecti ve antisco rbutics easily found 

near many forts. :

w 

Among other health problems affli cting 

soldi ers in the 1818 to 186 1 period were 

rh eumatic and respiratory conditions and 

venereal diseases. The number of cases of 

venereal disease reported in this period 

dropped considerably. As a result, Army 

records devote little space to this problem, 

although it appears that, withou t the benefit of blood tests to prove them wrong, 

physi cians assumed that they could easil y 

cure syphilis in its earli est stages. They still 

relied heav ily on mercury as a treatment 

not merely for syphilis but for a ll forms of 

ve nereal disease and applied both internall y and externall y. A new refinement of 

an almost abandoned technique was introduced in this period, however, to treat respiratory disease. When a patien t's pleura l 

cavity filled with Ouid, relief was provided 

by means of thoracentesis, a surgica l puncture of the chest, which eliminated the need 

2°Glover Perin, "Maguey, or Agave Ame ricana: A 

Remedy for Scorbutus," New York Journal ojMedicine 

and the Collateral Sciences, n.s. , 7 (1851):179-83: 

Thomas l. Nichols, Fony Years of American L~re. 

1821-186/ , 2 vols. (London: John Maxwe ll & Co., 

1864; New York: Stackpole Sons, 1937),2:336. 
THE STATE OF THE ART 

for an incision to achieve drainage. The 

pneumonia pati ent would probably still be 

bled, as wou ld the patient with rheumatism 

or simila r problems. The victim of go ut 

mi ght also be afni cted with blisters or 

dosed with colchicum, guaiacum, iodide of 

potash , op ium , o r turpentine. Ano ther 

problem th a t was far fr o m rare was 

oph thalmi a, which might be treated with 

si lver nitrate in the form of a solution 

ca lled " lunar ca usti c in distilled water."" 

A more unexpected health problem that 

also appeared in the Army during this peri od was lead poisoning. On one post the 

source of the problem was traced to drinking water collected aft er it had run down 

the surface of a lead-covered roof. At another, sheet lead covering kitchen equipment was held respo nsible, while at a third, 

white lead used to clean soldiers' gloves 

and boots had caused illness. Lead poisoning was treated with bleedings, purgatives, 

including ca lomel, and blisters, but some 

patients remained partly palsied despite all 

that could be done for them. " 

Preventive medicine in the pre-Civil War 

period was a relati vely unsophisticated art, 

and few American physicians displayed an 

interest in the growing public hea lth movement in Europe. Outside the Army, attempts to prevent disease in the United 

States we re handled on a local or even an 

l'Quote from George R. Mclin, "Report of Ocular 

Diseases at the General Hospital at Fort Pitt, From 

2 1st Dec 1822 to 20 Dec 1823," America" lvledical 

Recorder 8 ( 1825): 193; Owen H . Wangenstcen and 

Sarah D. Wangenstccn, The Rise q{ Surgery: Froll/ the 

Empire Craji 10 Scielll{/ic Discipline (Minneapolis: 

Uni ve rsity of Minnesota Press, [978), pp. 188- 89; Edgar Erskine Hume, ViClOries of IIrmy Medicine. 

(Philadelphia: J. B. Lippincott Co., 1943), p. 12 1; 

Byrne, COllrt Martial, pp. 7- 14, 25; Elisha Bartlett , 

"An Inquiry Into the Degree of Certainty in Med icine; 

and Into the Nature and Ex tent of Its Power Ove r 

Disease," in Brieger, Medical IImerica, pp. 123-25; 

Ltr, Lawson to W. V. Wheaton (9 Sep 1843), RG 112, 

entry 2, 14:4 17. 

l!Forry, Clilllare, p. 342. 

15 

indi vidual basis a nd were generally ineffective. In both civi li an and military life, 

emphasis was placed on the need for increased cleanl iness and improved ventilation and water supplies. 

Medical offi cers, like their civilian counterparts, also recogni zed intemperance as 

a n important cause of ill health. Surgeons 

often wo rked closely with temperance societies to reduce the consumption of alcohol by soldiers. Post commanders tried 

va rying app roaches to the problem. In 

Florida in 1837, for example, double rations of sugar and coffee were substituted 

for liquor and, although it was impossible 

to prevent the soldier from purchasing liquor on his own, drunkenness was severely 

punished,23 

More successful than the temperance 

movement was the Army's requirement 

that all sold iers be vacci nated. The Medica l 

Department usuall y shipped material for 

vaccinati on in the form of crusts, the scabs 

from a cowpox pustule, although in 1849 

the department also tried shipping the virus in liquid form in glass tu bes. A departmental regulation issued in September 

1818 specifi ed that every soldi er not already immune to smallpox be vacci nated 

at once and that su rgeons keep the necessary materi al for vaccinatio n on hand and 

in good condition. The regulation was rigoro usly enforced; in 1847 an Army surgeon 

maintained that he had never seen a single 

case of sma llpox among regular troops. Epidemics among th e civ il ian popu lat io n 

proved, however, that vaccination did not 

a lways protect completely against this disD" Recoltcctions of a Campaign in Florida," Yale 

VIera,,), Maga zille II (1846):76; Forry, Climale, 

p. 327; Charles W. Ayars, "Some Notes on the Medical Service of the Army, 181 2- 1839," Mililary Surgeoll 50 (1922):520; S. D. Gross, II Mallllaloj'Mililary 

SlII'gery . .. (Phi ladelphia: J. B. Lippincott Co .. 1861), 

p. 14 1; Robley Dungl ison, /-fllllltlli Heallh . .. , new ed. 

(Philadelphia: Lea & Blanchard, 1844), pp. 342, 344. 
16 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

ease. The apparent failures of the procedures led to speculation that some vaccine 

had been improperl y obtained, perhaps 

from an immature vesicle, or that failure 

to become immuni zed might be related in 

some way to the temperament of the patient. Also considered was the possibility 

that lymph obtained from a human patient 

who had himself been recently vaccinated 

was weaker than that obtained directly 

from the cow or that the passage of time 

might reduce the effectiveness of vaccination. Suggestions were made that the process be repeated at intervals, although at 

least one ph ysician insisted that the effect 

of the initial vaccination was as strong after 

twenty-fi ve years as after one. In the 1840s 

the surgeon general began urging that his 

surgeons time their vaccinations so that a 

continuous supply of fresh vaccine was always available, but requests for crusts continued to come into Washington from the 

field. 24 

Diet as a factor in the maintenance of 

health was a problem of particular concern 

to the Army and a matter to which Surgeon 

General Joseph Lovell devoted considerable thought from the beginning of his tenure in 1818. He was concerned with the 

state of the culinary art as practiced by the 

average soldi er who, unaccustomed to 

cooking for himself, would eat salt pork 

raw and, when confronted with fresh meat, 

broil it " to a cinder." Instead of tea, the 

soldier "warms his stomach with a gill of 

diluted, corroding whiskey; and, after li vHarvey E. Brown, 711e Medical Departmelll o/lhe 

United Siales Army From 177510 1873 (Washington: 

SGO, 1873), p. 12 1; POrler, "Noles," p.323; Ltrs, 

Lawson to Charles McCormick and to Samuel De 

Camp (both 10 Jun 1843) and to other surgeons, RG 

11 2, enlry 2, 14: 309, 325, 331 , 337; Henry Heiskell 

to Benjamin King (20 Aug 1849), RG 11 2, entry 2, 

20:216. Immunity rrom vaccination varies from two 

to tcn years or occasionally longer, and revaccination 

ex tends the immunity indefinite ly. 

ing a few weeks in this way, is sent to the 

surgeon, worn down with dysentery, diarrhea, and other complaints of the stomach 

and bowels." Lovell urged that the American soldi er be gi ven less meat and more 

bread. Beli eving that man was naturall y 

herbivoro us, he thought a vegetable diet 

best for the maintenance of health and 

vigor. He commented unhappily upon the 

fact that, although the Army allowed each 

man, as part of his regular rations, twent y 

ounces of beef, twel ve ounces of pork, and 

a gill of whiskey a day, it made no allowances for vegetables. 25 

Lovell 's specific recommendations for a 

soldier's diet included a warm beverage 

with morning and evening meals; peas, 

beans, and rice as dietary staples; kilndried cornmeal instead of fl our; and as high 

a proportion as possible of fresh in preference to salted meat. Beer or molasses and 

water should be substituted for hard liquor, 

and a plentiful supply of pi ckles should be 

available to aid the digestion and correct 

any superabundance of bile. Ideally, a large 

proportion of the soldi er's rations should 

be served in the form of soup. The need 

for fresh vegetables and ripe fruit in the 

diet was being emphasized by 186 1, and the 

use of fresh fish and meat was still encouraged. By 1847 the notion that those 

sick with fever should be starved to reduce 

it and the accompanying tension had apparently been abandoned. 26 

Lovell's successor as surgeon general, 

Thomas Lawson, believed that most people 

in the United States ate more than was 

good for them, and certainl y more than 

they needed to. When asked to give his 

opinion on decreasing the size of the Army's food allowance, he suggested that the 

2sJoseph Lovell , " Report to H on. J. C. Calhoun, 

Secretary of War," Naliollallnle/figencer, 16 Nov 18 18. 

26 Ibid.: Gross, lHallual, pp. 120, 143-44; Porle r, 

"NOles" 26:320. 
THE STATE OF THE ART 

amount of food as well as the amount of 

clothing issued could well be reduced. The 

adv ice on diet given by Lawson and Lovell 

has a very modern sou nd, but it does not 

appear to have been acted upon. " 

Surgery 

The sick formed a majority of the Army 

surgeo n's patients, but even in peacetime 

he occasionall y cared for an injured man. 

In either situation he was handicapped. He 

did not understand the cause of the infections th at so often frustrated his attempts 

to save li ves, and in the first half of the 

cen tury, he had no way to complete ly 

deaden the suffering of his patients on the 

operating table. As a result, for the tormented and struggling patient as well as for 

the surgeon, speed was of the essence and 

elaborate or time-consuming procedures 

were impossible. With its horrors and uncertain results, surgery before the era of 

anesthesia tended to be a procedure of last 

resort and a specialty to which few doctors 

ca red to restrict themselves. Specialization 

with in the fi eld was only in its infancy at 

the outbreak of the Civil War. Nevertheless, since major surgery required skills that 

the quack could not pretend to possess, the 

surgeon's prestige did not suffer from the 

competition of cults." 

!'Ltr, Lawson to Sec War (5 May 184 1). RG 11 2. 

entry 2, 12:441 - 43. 

~8 Unlcss otherwise indi cated, material in this scc~ 

ti on is based on Gross. Manual; Joh n Hennen. Prillciples of lvli/ita!'Y Surgery (London: John W ilson, 

1829); Allen O. Whipple, The £i'o/lIlivn o!Swgery ill 

the Unired Sfllfes (Springfield , Ill.: Charles C Thomas. 

1963); and Courtney Robert Hall . "The Rise or 

Prore ssional Surge ry in th e United Slale s, 

1800- 1865," /Jllllelill of lite His/Dry of /\4etlicil/C' 26 

(1 952):23 1- 62. Sec also Josiah Charles Trent, "Surgical Anesthesia, 1846- 1946:' Journal Q( lhe lIistory 

o/ Medic:illt! alld Ill/ied Scil'IICl'S I (1946): 510; Henry 

Burnell Shafer, The American i14edical Pro/essiol/ 1783 

to 1850(New York: Col umbia Universit y Press, 1936), 

p. 242; Walter G. Stuck. " H istoric Backgrounds of Or17 

When ether was first formall y and publicly used as an anesthetic in 1846, it was 

pronounced a success. Not all surgeons, 

however, recognized its introduction as a 

critica l milestone in the history of medicine. Enthusiasm spread with time, but 

some surgeo ns remained ske pti ca l and 

complained of its poisonous side effects. 

Chloroform was introduced not long after 

ether and qu ickly became popular, especially in the South. Those who preferred it 

to ether ma inta ined that less of it was necessary to achi eve the same result, that it 

acted more quickly, that its stage of excitation was shorter, that it was easier and 

more pleasant to take, and that its odor 

disappeared more quickly. " 

T he device initially used for the administration of ether was a somewhat complex 

glass container with two openings, one for 

the insertion of an ether-soaked sponge, the 

other for the admission of air. Opposite the 

hole for air was a glass tube fitted with a 

mou thpiece containing a valve that permitted the patient to draw ether vapors 

into his lungs from the inhaler and th en 

exhal e into the room. Authorities initially 

suggested that no one inhale ether vapors 

for longer than ten minutes at a time and, 

if it were to be readministered, th at it be 

onl y after a fi ve- to ten-minute rest. Some 

surgeons discovered that it was possible to 

keep a patient anesthetized as long as fortyfi ve minutes, but ex perts believed that onl y 

th ose experienced with the procedure 

lhoped ic Su rgery," Allnals 0/ /'vledical H istory, n .S .. 7 

(1935):47; Austin Flint, "Conservati ve Medicine," in 

Brieger, Medical America, p. 135; and William G. 

Rothstein, American Physicians in the 19th Cef/fUry: 

From Sects 10 Science (Baltimore and London: Johns 

Hopk ins U ni versity Press, 1972), p. 250. 

19Barbara M. Duncum, The Del'elopment o/In/Illl· 

arion Anaesthesia (London: Oxford University Press, 

1947); M. A. Reasoner, "The Development of the 

M edi ca l Supp ly Serv ice ," Military SlIrgeoll 63 

( 1928): 16; Trent. "Surgical Anesthesia," p. 5 10. 
18 TH E ARMY MEDICAL DEPARTM ENT, 1818- 1865 

1;) 

CiRCULAR AMPUTATION as illllstrated in 

Richard Upton Piper's Operati ve Surge ry 

(Boston: Tichnor, Reed and Fie/ds, 1852). 

(Courtesy of National Library q/ Medicine.) 

should attempt to do so. When the in ventor 

of this device attempted to patent his creation, many physicians substituted a billor cone-shaped sponge over the pati ent's 

mouth and nose. Surgeons soon discovered 

that anesthetics were best administered by 

enclosing the sponge in a cone made of a 

fold ed towel or c ut from cardboa rd, 

leather, or a similar material. Experts recommended that the patient be carefu ll y obse rved while under anesthesia so that if he 

began to snore or his pulse became weak 

or slow, the sponge could be removed until 

he returned to a more normal state.'o 

The Army used anesthetic agents only 

very briefl y during the Mex ican War ( 1846-

1848), trying ether but qui ckl y abandoning 

it as too dangerous. One ph ysician serving 

with U.S. troops in Mex ico even commented that " anesthetics poison the blood 

and depress the nervous system, and, in 

consequence, hemorrhage is more apt to 

occ ur, and uni o n by ad hesion is prevented." Ether was first used in the Army 

with offi cial sanction in 1849 to detect a 

malinge rer whose supposedl y im mo bile 

knee flexed read ily when he was anestheti zed. The standard supply table allowed 

two pounds of sulfuric ether for every 100 

men by 1849, at whi ch time chloroform 

was also added to the list of regularly used 

drugs, and by 1852 medica l officers at 

many and perhaps all posts administered 

anesthetics during operations." 

Reports of deaths reSUlting from anesth etics, especially from chloroform, bega n 

to appear early in the history of their usc, 

although a physician who had administered one or the other to 600 patients reco rd ed no fata li t ies. Chl oroform wa s 

blamed for occasional sudden con vulsions 

and deaths. Although no way had been 

.IO Hcnry Jacob Bigelow, Surgical Anesthesia, Addresses ami Other Papers (Boston: Little, Brown & Co., 

1900), p. 76 . 

. IIQuote from Po rter, "Notes" 24:30; Louis C. Duncan, " M ed ical History of General Scott's Campaign 

to the Cit y of Mexico in 1847," l'vtilital'Y SlIrgeon 47 

( 1920):439; W. T. G. M orton, Anaesthetic Agenls . 

(Washington: G ideon, 1854), pp. 19- 2 1, 25; Ltrs, LawSOil to Morton ( I M ar 1852), in Ben Perley Poore, 

Historical lvlaleriafs!or the Biography Q(W T G. ,\1/0/., 

101/ , M .D. (Washington: Gideon, 1856), p.78; 

Heiskell to LewisA. Edwards (27 Jan and 9 Feb 1849), 

both in RG 11 2, enlry 2, 19:380- 81 and 398, rcspec· 

lively; Lawson to Morton (I Mar 1852), RG 11 2, 

entry 2, 22:276- 77. 
THE STATE OF THE ART 

fou nd to prevent these tragedies, some surgeons still used this anesthetic at the time 

of the Civil War, and it became popular 

during th at connict because, unlike ether, 

it was not nammable and it put th e pati ent 

under qui ckl y and peacefully. Chloroform 

rema ined the anest hetic of choice for eye 

surgery until the introduction of cocaine as 

a loca l anesthetic after the Civil War. Sulfuri c ether, howeve r, was regarded with less 

suspicion. Some saw its odor as its onl y 

significa nt drawback, and poorl y trained 

doctors tended to prefer it because of its 

supposedly foolproof cha racter. Statistics 

on deaths associated with the use of ether 

became available at midcentury. They revealed that, whatever the reason, death 

rates during and after surgery without anesthesia were higher than those for operation s co ndu c t ed up on a n et he ri zed 

patient. 32 

In the period before 186 1, sulfuri c ether 

and chloroform (or a combin at ion of the 

two) were the two most popular anestheti cs, but other forms were tri ed. Most 

often mentioned was a product misleadingly call ed chloric eth er, wh ich was actually chloroform dissolved in alcohol in 

va rious proport ions. Many surgeons at 

Boston's Massachusetts Genera l Hospital 

preferred chloric ether to either sulfuric 

ether or chloroform in its regu la r form. 

Also mentioned in the literature of the period were amylene, eth ylene, and a prod uct 

called " th e vapor of Benzid."" 

j~ Edwa d Treachcr Coll ins, The History and 'nat/iliOI1S of fhe Moorjields E)'e Hospital . .. (London: H. 

K. Lewis & Co" 1929). p. 85; " Influence of Etherization on the Mortality of Surgical Operations," 

CharleS/Oil Medical Journal {l/u/ Review 3 (1848):464; 

Morton , linaesrheric Age/lis, p. 15. 

3lQuotc from "A New Anesthetic Agent," l'vlissollri 

Medical {/nd Surgical Journal 3 (1847- 48):288; Trent, 

"Surgical Anesthesia," p. 5 13; J. C. Warren, E./ftJC.'ls 0/ 

Chlorofo rm lind oj Strong Chloric Elher as Narcotic 

Agel/Is (Boston: William D. Ticknor & Co., 1849), 

p.43. 

19 

f 

/ 

~ ') 

( 

I 

. -

FLAP AMPUTATION as illustrated ill Richard 

UplOl1 Piper's Operative Surgery (BasIOn: 

Tichnor, Reed and Fields, 1852). (Courtesy 

of Nmiollal Library of Medicine.) 

Yet as late as 1860, some su rgeons still 

had rese rva ti ons th a t extended beyond 

chloroform to include all anesthetic agents. 

One such ph ysician wrote that "if my patients will have an anestheti c agent [I] will 

give them as much good whiskey as they 

will drink," add ing that if he had his way, 

he wo uld have all anestheti c agents aban-
20 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

) 

(, """"= >=\ 

I 

-

-' 

, 

WOU ND CLOSURE: METHODS AND MATE· 

RIALS as illllstrated in Richard Upton Piper's 

Operative Surgery (Boston: Tichnor, Reed 

and Fields, 1852). (COlIl'lesy of National Library of Medicine.) 

do ned except for alcohol and opium. Other 

surgeons also relied heavily upon opium, 

believing that it had an added advantage 

over other drugs intended for the reli ef of 

pain because it prevented inflammation by 

lowering irritability." 

)4Joseph N. McDowell, " Report on the Improvements in the Art and Science of Surgery in the Last 

Fifty Years," Transactions a/the American J\;/edical AsBecause the danger of infection was not 

reduced by the introduction of anesthesia, 

advances in the field of surgery remained 

modest. Despite the willingness of younger 

surgeons to be more adventurous, as late 

as 1861 severe compound fractures or extensive damage to a joint, blood vessels, or 

nerves still dictated immediate amputation, particularl y for a soldi er wou nded in 

the field. Each instance of compound fracture was usually considered individuall y, 

however, before a decision for or against 

amputation was made. The mortality rate 

appeared to vary wit h the amount of limb 

removed. 3S 

Other types of surgery performed before 

the Civil War included the removal of large 

portions of bone from shattered limbs, a 

procedure used in an attempt to avoid amputation; ear and eye surgery; restorative 

surgery, which included the rebuilding of 

damaged lips and checks and the relief of 

the binding of burn scars; and abdominal 

surgery. Successful abdominal surgery to 

deal with intussusception (prolapse of a 

length of the intestine into itself) and obstructions, though rare, was reported as 

early as the 1830s. Doctors often dosed the 

victim of a penetrating abdominal wound 

with opium to quiet the bowel and then left 

him to nature's mercy, but at least one surgeon, Samuel Gross, had ex perimented 

soci(JI iOfi 13 ( 1860):436- 37, quote from p. 436; J. N. 

McDowell, "The Effects of Opium in the Treatment 

of Wounds; or, the Usc of Narcotics in Surgical Operations," ,\llissollri J\4edica/ and Surgical Journal I 

(1845- 46): 11 - 12, 16. 

JSJulian John Chisolm, Mallllal 0/ Military Surgery 

(Richmond: Confederate States of Ameri ca [CSA) 

War Department, 1861), pp. 339. 363, 369- 71 , 374; 

Robley Dunglison, All Address Delil'ered to fhe Grad· 

tUlles ill M edicille . . . (Baltimore: Pri vately printed, 

1834), p. 12; O. H. Wangensteen, J. Smith, and S. D . 

Wangensteen, "Some Highlightsofthe History of Amputation," Bul/elill 0/ the H istory 0/ IHedicille 41 

( 1967):109-10; Henry E. Sigerist. "Surgery at the 

Time of the Introduction of Antisepsis," Joumal 0/ 

fhe Missouri Medical As.wcialioll 32 (1935):172. 

l 

1 

• 

J 
THE STATE OF THE ART 

wi th animals in an attempt to determine 

the best way in which to handle such injuries. Venesection was customary for th e 

victim of an abdominal wound although 

this practice was losing popularit y by 

1861. 36 

By the outbreak of the Civil War, the 

instruments regularl y used by the military 

surgeon might well include at least three 

tourniquets, two saws of d ifferent sizes, 

seve ral bone-cutters, sil ver catheters of 

varying diameters, a stomach pump, and 

small and large syringes. Artery forceps 

were used to clamp off arteries during surgery, and the tenaculum, a hookli ke instrume nt , pl ayed a progressive ly more 

important role in surgery as greater care 

came to be taken in isolating blood vessels. 

Surgeons were beginning to use catgut for 

ligatures because it could be left in place 

and sil ver wire for sutures and ligatures because it seemed to promote healing and 

lessen the danger of hemorrhage. A new 

splint had been developed in 1858 that 

proved simpler to use and less expensi ve 

to make than its predecessors." 

Although the role played by germs in 

wound infection was not generally recognized before the Civil War, a few surgeons 

appear to have at least suspected the role 

of heat in preventing the spread of infecti on and took the precaution of boiling 

their instruments. Chlorine vapors were 

sometimes used to disinfect the sickroom, 

despite the inconvenience caused by the 

need to remove the patient while the room 

was treated. Physicians used such antisepti cs as chlorine or creosote in alcohol, io-

\~Samllc l D. Gross, /III Experimellla/ and Critical 

Inquiry IlIfo 'he Nalllre and Tre(f(melll oj Woul/ds 0/ 

the IlIles/illes. IlIlIstrated by Engl'm'illgs (louisville, 

Ky.: Prentice & Weissinger. 1843). pp. 12, 34-35. 

37-38.42- 44.46-47.50-51. 73, \56. 

Jl$amll cl Clark Harvey, The History oj He"lOstasis 

(Ncw York: Paul B. Hoeber, 1929). pp. 87-88,97, 100. 

2 1 

dine, or even whiskey to prevent the spread 

of infection, without necessaril y understanding how these substances worked. It 

was more probable, however, that wounds 

would be dressed with warm water, to 

which might be added a small amount of 

spirits of camphor. Regard less of the precauti o ns taken , infection was a lways 

ex pected." 

The ignorance of physicians concerning 

the cause of infection and the ways in 

wh ich it could spread led to compli cations 

not oft en seen today. With hospitals bot h 

few and small, hospital gangrene, an infection probably caused by streptococci, was 

not common in the United States before 

the Civil War. Septicemia was frequent and 

the outcome generally fatal despite bleedings, blisterings, and purgings. Erysipelas 

was a lso often seen during the entire period , especially in hospitals. In 18 18 its 

treatment called for purging and the application of warm, weak mineral water to 

the inflamed area, but by 186 1, dilute tincture of iodine and soothing lotions were 

favored as local applications, and quinine, 

tincture of iron, and nutritious food and 

drink were also recommended." 

Surgeons of the pre-Civil War period 

were fam iliar with tetanus, or lockjaw, although they did not understand its cause, 

and the various approaches they suggested 

JlMadgc E. Pickard and R. Carl yle Buley, The Midwest Pioneer: /-lis Ills. Cures. and Doc/ors (Crawfordsvi lle. Ind.: R. E. Banta , 1945). p. 11 7; Roble y 

Dunglison, General Therapelllics. or PrinCiples olMedo 

ica/ Practice. (Philadelphia: Carey, Lea & Blanchard, \836), pp. 506, 508-09, 511 ; G. W. H. Kemper, 

Medical History ojlhe SWfe o/Indiana (Indianapolis: 

Ameri can Medical Association Press, 19 11), p. 46. 

JQ(Wi lliam M. Hand), House Surgeon and Physician 

(Hartford: Peter B. Gleason & Co., 18 18), p. 36; Percy 

Moreau Ashburn, The Ranks of Death . . . , cd. Frank 

D. Ashbu rn (New York: Cowar Mc ann. 11 947]), 

p. 97; August H irsch. !-Iandbook of Geographical alld 

/-/islOrical Palhology, trans. Charles Creighton, 3 vols. 

(London: New Sydcn ham Society, 1883),2:394.398. 
22 THE ARMY MEDICAL DEPARTMENT. 18 18- 1865 

to its treatment were ineffecti ve. Opium 

was popular throughout the period, applied 

externally or given internally. Tincture of 

Cannabis, a blister along the spine, and croton oil were also considered for this purpose. The inhaling of chloroform was 

suggested, as was the use of morphine with 

camphor and antimony.'o 

Eve n before th e wo unded could be 

treated, however, Army surgeons faced the 

problems of moving them from battlefield 

to hospital. In a n era when the ill and injured were for the most part cared for at 

home, the problem of transporting these 

patients was essentially a military one, one 

that the Army did not face on a large scale 

until the war with Mexico. During the Seminole wars in Florida, there was no organized system for moving the wounded to 

safe and conveni ent pl aces where th ey 

could be treated. During the conflict in the 

swamps and jungles, wagons or horse litters 

were used to carry those unable to walk, 

with the latter favored for particularly difficult terrain. Since ready-made litters were 

not issued to Army units, it was necessary 

to construct them on the battlefield. The 

litter was ge nerall y slung between two 

horses, which also req uired both a large 

number of horses and a considerable period of time to fashi on the litters from blankets and rawhide; the desirability of hav ing 

litters made up before the need for them 

arose soon became obvious. The two-horse 

litter was used to move the wounded a fter 

clashes with the Indi ans in the West and 

on at least one occasion in the Mexican 

War, but wheeled vehicles were more popular for this purpose. Until the Civil War, 

however, efforts to have the Army obtain 

4OHand, House Surgeon, p. 33; Chisolm, Mallllal, pp. 

230-3 1; Eugene Hillhouse Pool and Frank J. McGowan, Surgeryallhe Nell' York H ospiralOne Hundred 

Years Ago (New York: Paul B. Hocbcr, 1930), 

pp. 19-20. 

the proper eq uipment and animals for the 

evacuation of the wounded were in va in.

41 

Medical Educalion 

Growing unce rtainty abo ut the common 

assumptions of accepted medical practice 

and a legacy of con tempt fo r intellectualism bequeath ed by Andrew Jackson and his 

followers accompani ed a rapid westwa rd 

dispersal of the population, leadi ng to a deterioration in the quality of the medical education available in the United States. The 

number of medical schools increased in response to the need fo r physicia ns to care 

for an increasingly scattered population. 

Most schools were designed to bri ng ina 

profit, and since licensing requirements 

were ge nera ll y a bse nt, th e co mpetiti on 

among them resulted in a general lowering 

of the demands made upon their students. 

Although a few in stitutions stood o ut 

above the others, most were, as medica l 

historian Richard Harrison Shryock concluded, " mediocre schools ministering to 

mediocre personnel." Even the best schools 

fell short of th e standard set by the best 

European teaChing institutions, and the 

conscientious physician who did not go 

abroad fo r his training might be forced to 

attempt to complete his professiona l ed ucati on on his own initiative after he had 

received his medical degree. If he wished 

to expand the bounds of medical knowledge through research, he would find himself almost alone." 

~IGeo rge A. Oti s, A Reporl /0 the Surgeon Gel/era! 

ollihe Transport a/Sick and Woullded by Pack Animals 

(Washington: Government Printing Office, 1877), pp. 

2n. 3-5, 9. lin. 42Quotc from Shryock, Medicine and Society, p. 137; 

sec also William Frederick Norwood, " Medical Education in the United Slates Before 1900," and John 

Fie ld, "Medical Education in the United States: Late 

Nineteenth and Twentieth Centuri es," both in C. D. 

O'Mall ey. ed., The History of IHedical Edllcmiol1 
THE STATE OF THE ART 

The relati vely low caliber of many of 

those admitted to medical schools as well 

as that of the schools themselves tended to 

give a bad reputation to all who attended 

them. A prominent physician of the time, 

Dani el Drake, maintained that students 

" too stupid for the bar, or too immoral for 

the Pulpit chose to study medi cine." Another commented that beca use of the defici encies in his premedica l education, such 

a student might be "so ignorant and illiterate as to be unable to write his own language." Although propri etary med ica l 

schools often required a three-year apprenticeship in addition to attendance at two 

sessions of lectures, the knowledge ga ined 

during the apprenticeship varied widely, 

according to the interest and competence 

of the preceptor. Work as an apprentice 

might, nevertheless, offer the future physician his only opportunity for training at 

the patient's bedside. Clinical instruction 

did not rece ive the emphasis in the United 

States that it did in Europe; as late as 1849 

onl y nine medical schools in this country 

made hospital attendance a requirement, 

while only sixteen schools so much as offered th eir students an opportunity for 

clinica l training. Few students were likely 

ever to have seen a stethoscope, clinical 

thermometer, ophthalmoscope, or microscope, since most schools did not own such 

instruments. Medi ca l co ll ege li braries 

tended to be quite small. The training offered in anatomy was likely to be weak 

since cadavers were difficult to obta in, and 

rumors of grave robbing could still precipitate scandals." 

(Berkeley, Los Angeles, and London: UCLA Press, 

1970), pp. 476, 483, 486, 501. 

4JQuotcs from Daniel Drake, Praclical Essays all 

Medica! Educmioll. and fhe J\lled/cal Professioll, ill the 

Vniled Siales (Cincinnati, Roff & Young, 1832), pp. 

6-7, and F. Campbell Stewart, "A n Anni versary Address Deli ve red Before the New York Medical and 

Surgical Society," in Brieger, lv/edical America, p. 66; 

23 

In the decades before the Civil War, increasing numbers of American med ical students went abroad for some part of their 

training, and efforts were made throughout 

the period to upgrade the training available 

in the United States. The U.S. Army, which 

after 1832 accepted physicians only after 

they had passed an examination, found 

that, as late as 1860, 50 percent of the applica nts were unqualifi ed, many being defec tiv e in the areas of preparatory 

education, practical anatomy, pathology, 

and clinical medicine. The fact that these 

candidates had fail ed the Army's examination did not, of course, prevent them 

from practicing medicine as civilians wherever they chose, no matter how slight their 

skill, since very few states retained licensing requirements. 

Wh en a ph ysician co nce rn ed by th e 

weakness of his own professional training 

wished to remedy its deficiencies by private study, he often turned to medica l soc ie ti es and pro fessio nal publi ca ti o ns. 

Although their number grew with time, 

medi cal societies during the first half of th e 

century were few and were usually located 

in large cities. The number of medical publications available also grew, although some 

journals were very short-li ved. By 185 1 

eighteen were being published within the 

United States. These journals, as well as 

books, many from abroad, enabled the 

American physician to keep abreast of 

medical developments in the United States 

and in Europe." 

Many Army surgeons in the period conAndrew Boardman, "An Essay on the Means of Improving Medical Education and Elevating Medical 

C hara cte r," in Brieger, Medical America , 

pp. 25-26, 34. 

44Edward B. Krumbhaar, "The Early Days of the 

American JOllmal of tile Medical Sciences," ,'.tledical 

Life 36 (1929):587- 88; Nathan Smith Davis, History 

q/ Medical Edllcatioll and Illstitutions ill tile United 

Slates (Ch icago: S. C. Griggs & Co., 1851), p. 167. 
24 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

WILLIAM BEAUMONT. (CollrLesyofNGlional 

Library of Medicine.) 

tributed to the medical literature. Their articles covered such disparate topics as cures 

for scurvy, medical topography, or anatomy, erysipelas of the head, amputation at 

joints, inflammation and fever, and vaccination. Among books by Army surgeons 

were Samuel Forry's The Climate of the 

United States and lls Epidemic Influences 

and several volumes replete with detailed 

statistics and other data concerning meteorology and disease published by the Medical Department. Army surgeons were also 

caught up in what has been called a "compulsive obsession" to learn more about natural science and anthropology and worked 

to catalogue or record their observations 

and co ll ections made on th e nation 's 

frontiers.45 

Edward Lurie, "An Interpretation of Science in 

American physicians of the period preceding the Civil War devoted little time or 

interest to learning through research. One 

of the few exceptions to this ru le was an 

Army surgeon, Willi am Beaumont. Beaumont took advantage of the opportunity 

presented him in the form of a permanent 

fistula in the abdomen ofa pri vate pati ent, 

Alexis St. Martin, who was suffering from 

the effects of a shotgun wound. From 1822 

to 1834, whenever his reluctant patient 

could be persuaded to remain with him 

long enough, the Army surgeon performed 

ex periments aimed at discovering the secrets of human digestion." 

The book Beaumont published in 1833 

on his experiments described how he inserted various morsels of food by means of 

a silk string into St. Martin's stomach and 

observed their fate in order to study the 

process of digestion. In one series of experiments Beaumont recorded the temperature of that organ during the process. It is 

interesting to note that he was intrigued by 

the possible effects of weather and soil conditions upon the digestion. He enrolled St. 

Ma rtin in the Army as an orderly in 1832 

to ease the burden of supporting him, but 

early in 1834 the unenthusiastic patient 

crossed the Canadian border in the general 

direction of his former home. On this occasion, Beaumont was able to persuade St. 

Martin to return to him so that he could 

resume his research. 

the Nineteenth Century: A Study in History and Histo riograph y," Calliers d' his/ori e l1Iofldiale 8 

( 1964- 65):684. 

·~Jo eph Lovell, "A Case of Wounded Stomach," 

American JI,;/edica! Recorder 8 ( 1825): 14; Harvey Cushing, "William Beaumont's Rendezvous With Fame," 

Yale Journal oj Biology and Medicine 8 ( 1938): 11 3-26. 

Unless otherwise indicat ed, all mater ial on Beaumont 

in this chapter is based on his Experiments and Obserl'{uiolls 011 fhe Gasrric Juice and the Physiology 0/ 

Digestioll (Plaltsburgh, N.Y. , 1833) and Jesse S. 

Myer's Life and Lellers 0/ Dr. William Beaumoflt (St. 

Lou is: C. V. Mosby Co., 1939). 
THE STATE OF THE ART 

B EAUMONT'S I LLUSTRATION OF ST. MAR· 

T IN'S WOUND as ordinarily seell. (Collrtesy 

of National Library of Medicine.) 

Beaumont's efforts to learn the exact 

composition of the gastric juice he obtained from St. Martin's stomach, however, 

met with repeated failure. None of the experts he consulted could add much to what 

he was able to ascertain for himself. Even 

the great Swedish biochemist Jacob Berzelius disappointed Beaumont, blaming his 

inability to determine its exact chemical 

composition on the age and small quantity 

of the nu id sent to him. The final blow fe ll 

in the spring of 1834 when, after accompanying him on a series of visits to medical 

societies, Beaumont's sole source of the vital nuid left again on what was to have been 

a short visit to his family in Ca nada , but 

this time never returned. Repeated a ttempts over a period of many years to get 

him to do so fai led, and thus Beaumont's 

ex periments came to an end. 

Beaumont was among a very few American physicians conducting research of real 

signifi cance in the first half of the nineteenth century, a nd his work received favo r ab le in terna tional a tt ention. The 

attitude toward such endeavors prevalent 

in medical circles in the United States, 

25 

BEAUMONT'S I LLUSTRATION OF ST. MAR· 

T IN'S WOUND IVilh the stomach prolapsed. 

(Collrlesy of National Library a/Medicine.) 

however, was perhaps accurately renected 

in the opinion of Lawson, the second surgeon general of the Army Medical Department, that Lovell's efforts to encou rage and 

aid Beaumont's research constituted unwarranted favorit ism. 

Conclusion 

In the period from 1818 to 1861 , medicine and surgery were slowly approaching 

a new era. These four decades, however, 

were for many doctors a time of increased 

confusion a nd uncertainty. The grad ual 

death of the dogmatic, unscientific medicine of centuries past brought both physicians a nd their patients face to face with 

the profession's ignorance and helplessness 

in the face of infecti on and disease.The use 

of anesthesia brought some relief from suffering in the 1850s, but it was not accompanied by a significant saving of li ves. 

Although the life- and health-saving properties of Quinine sulfate were recognized, 

they were not understood. The drive for the 

refo rm of medical education and the search 

for fact rather than theory would gain 
26 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

strength in the generation after 1870 and 

lead to rapid progress in medical science. 

Only in the next century, however, would 

the United States assume a position of 

leadership in th e medical wo rld. For the 

patient, military or civilian, who was concerned with his health and his life, the period from 1818 to 1861 was a blea k one. 
CHAPTER 2 

Laying the Foundation, 1818-1835 

The War of 1812 did not dispel traditional Ameri can distrust of a strong permanent military organi zation. At the war's 

conclusion, the U.S. Army was allowed for 

a few years to revert to its previous peacetime character as a sma ll collection of regiments without either an ove rall command 

or a central organization. When, however, 

in the spring of 1818, the reform efforts of 

such men as Secretary of War John C. Calhoun finall y bore fruit, one of the first three 

permanent staff departments Congress 

c reat ed for th e Arm y wa s a Medi ca l 

Department. 

Organization and Administration 

As formed in 18 18, th e new Army Medical Department strongly resembled the organi zation th at had bee n c rea ted as a 

temporary ex ped ient during the War of 

1812. Medi cal offi cers, although commissioned, had no rank and thu s remained outside the military hi erarchy and without 

status. The principal departure from the 

previous pattern in vol ved eliminating the 

posit ions of hospita l surgeon and hospital 

surgeon's mate, changes apparentl y dictated by a beli ef that the general hospitals 

th ey staffed would not be necessary for a 

scattered peacetime army of 7,000 men. 

The head of the new department, who reported directly to the secretary of wa r, was 

given the title of surgeon general. A subordinate Apothecary Department, ma nage d b y an apo th eca r y gen e ral , wa s 

reestablished to handle the purchasing as 

we ll as the compounding of medicines. 

Francis LeBaron, the same physician who 

had served as apothecary general during 

the Wa r of 1812, was reappointed to the 

position. Although at this time Congress 

all owed the apothecary general only one assistant, during the three years that his department existed he actu ally had two, just 

as he had had during the War of 18 12.' 

The classifications of post surgeon, regimental surgeon, and regimental surgeon's 

mate were reta ined. Men serving as hospital surgeon s a nd hos pit a l su rgeo n's 

mates, among them some of the ablest ph ysicia ns in the Army, were offered commissions as post surgeons, despite the fact that 

they would thereby be reduced to a position inferior to that of regimental surgeons. 

Congress retained the ratio of one surgeon 

and two mates to a regi ment and placed a 

ce iling of fort y on the number of post 

surgeons. 

The responsibility for setting up the new 

medical department was given to Joseph 

I Unless otherwise indica ted, material in this section 

is based on SGO, !lilli/wi Reports, 18 18- 6 1; John F. 

Callan, Tlte Military Laws of fhe VI/ired Slates . . 

(Philadelphia: G eorge W. Childs, 1863); War D epartment, Genera/ Regll/miol1sjor file Army . .. (Philadelphia: M. Cary & Sons, 182 1) and Genera/ Regulatiolls 

for rhe Army Q( fhe Unifed Slales ... (Washington, 

1835); War Depanrncnt. SGO, Regulariolls ./or 'he 

Medical DeparlmC!lIf, 18 18; and Brown, Medical Department, pp. 107-2 14. 
28 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

JOSEPH LOVELL. (Courtesy of National Library of Medicine.) 

Lovell, a conscientious and level-headed 

thirt y-year-o ld s urgeo n then serv ing as 

medical director for the Army's Northe rn 

Division. A graduate of Harvard and the 

Harvard Medical Schoo l, Lovell had occupied increasingly responsible positions 

during the War of 1812. The respect his 

colleagues held for him appears to have 

eased any resentment that the selection of 

so young a man fo r so great a challenge, 

over more experienced surgeons, might 

otherwise have caused. His appointment as 

the first surgeon genera l proved a wise 

one. 2 

In eliminating the positions of hospital 

Ltr, Calhoun to Brown (25 Apr 18 18), in The Papers 

oj 10/111 C. Calhollll, ed. Robert L. Meriwether and W. 

Edwin Hemphill, 10 vols. (Columbia: University of 

South Carolina Press for the South Carolina Society, 

1963),2:2 59 (hereafter cited as Ca/ho/lll Papers). 

surgeon and hospital su rgeon's mate, while 

at the same time giving specific assignments to each member of the Med ical Department, Congress had placed the new 

surgeon general in a potentia lly difficult 

position. If he adhered strictly to the letter 

of the law and a war were to e rupt, a possibility the legislature perhaps did not wa nt 

to consider, Lovell would have no one 

ready to staff the genera l hospita ls that 

wou ld rece ive the seriously ill or wounded 

toget her with the overnow of smaller faciliti es. Lovell appears to have been well 

aware of the problems this arrangement 

co uld cause. In the regulations he issued 

fo r the department, he o utli ned an organizational framewo rk different from that 

created by Congress, deta iling the d uti es to 

be undertaken by hosp ital surgeons and 

mates and other staff members. He introduced the positio n of the medica l d irecto r, 

who wou ld be responsible for the medica l 

care of the sick and wou nded of an entire 

army or of a la rge geographical area. And 

for greater efficiency in the management of 

his staff, Lovell insisted that all surgeons, 

regard less of their d uti es, report directl y to 

him in Washington. 

In 182 1 Congre ss aba nd o ned its attempts to d ictate the structure of th e Medical Department and classified all med ica l 

officers as either surgeons or assistant su rgeons. In so doi ng, the new legislation eliminated th e Apot h eca r y Depart m e nt 

entirely, all owing Lovell to assign whomever he wished to handle purchasing. Although the physician appointed to serve as 

th e chi ef medical purveyor in New York 

City conti nued for the remai nder of his career in that post, the surgeon general was 

free to change the assignmen ts of all of his 

purveyors as he wished. 

T he result of the reorganizati on was a 

med ical department still too sma ll to care 

fo r a n Army divided in to small units func-
LAYING THE FOUNDATION, 18 18- 1835 

tioning independentl y yet fl ex ible enough 

to minimi ze the effects of its inadequate 

size. The complete solution to the problem 

of understaffing was not within the surgeon 

general's power. Alread y the law of 18 18 

had reduced by fi ve the number of ph ysicians serving in th e Army. Although Love ll 

admilled that a suffi c ient number remained at that time to give each post one 

doctor, he emphasized that a single physician could not adequatel y se rve the needs 

of either the very large or the very unhea lth y post. Unimpressed, in the course 

of cutting back the size of the Army in general, Congress in 182 1 again reduced the 

authorized size of the staff, from 64 to 53, 

of whom 4 5 were a ssistant surgeon s. 

Among those th e surgeon ge ne ral dismissed was the once widely respected Benjamin Waterhouse, who had introduced 

vaccination to the United States but who 

had also acquired a reputation of being vi trioli c and greed y, "a man of talents and 

sciences [who) has not made himselfa good 

practical ph ysician ." Anot her physician of 

mu c h milit a r y expe ri e n ce who was 

dropped was one whose "conduct for intemperance" had become " a matter of 

some notori ety," and whose mind was " too 

much affected to a llend regularl y to 

business." ) 

As the nation expanded westward and 

the number of posts increased, Lovell continued to ma ke temperate but insistent protests aga inst th e in adequate size of his 

department. He pointed out that th e stan -

dards of medi cal care offered to th e nation's soldiers would deteriorate if the ratio 

of surgeons to posts and men as established 

in 1821 was not maintained. He emphasized to the secretary of war that, because 

lFirst quote. Ltf, Calhoun to Monroe ([8 Jun 182 1), 

in Calhol/II Papers 6: 198: remaining quotes, Ltf. Foster 

Swift to Lovell (9 Jan 1821), RG 11 2. entry 12. 

29 

B ENJAM IN W ATE RHOUSE. (Callrlesy a/Naliollal Library Q( Medicille.) 

of the small number of ph ysicians in the 

department, the unrelieved d uty time of an 

Army surgeon exceeded that of any other 

Army officer; some su rgeo ns had served as 

long as ten years without a furlough. Lovell 

reminded the secretary that the shortage of 

Regular Army surgeons made it necessary 

at times to pay pri vate ph ysicians to handle 

department duties and that in some areas 

doctors willing to do so were hard to find . 

Furthermore, they were neither as careful 

in their use of supplies nor as capable of 

supervising the sick and wounded as their 

military co unterpa rts. Lovell maintained 

that a Regular Army surgeon sho uld perform the physical examination of recruits 

beca use it was more likely that an Army 

physician rather than a pri vate physician 

would spot defects that wo uld cause a man 

to be unfit for milita ry duty. Despite Lovell 's argumen ts, it was not until June 1832 
30 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

that Congress authori zed the president to 

name four more surgeons and ten more 

assist ant surgeons t o the Med ical 

Department.' 

Nevertheless, the law of June 1832 only 

partiall y alleviated the shortage of ph ysicians in the Army. To guarantee care for 

the Army's sick and injured, further restrictions on the leave taken by Army surgeons soon became necessary. Afte r 1835, 

granting any leave longer than seven days 

required approval of the secretary of war. 

Ironically, in the early 1830s, at the very 

time that Lovell was urging the appoi ntment of more med ical officers to the department, a new secretary of war, operating 

under the mistaken impression that the position of surgeon general was superOuous, 

proposed to abolish it, thus endi ng the 

Medical Department's existence as a separate entity. Secretary John H. Eaton concluded that the surgeon general's duties 

involved only supply and that these responsibilities were actually being hand led 

by the Quartermaster's Department. Lovell 

countered by pointing out that regulati ons 

prohibited the Qua rtermaster's Department from buyi ng medi cines and hospital 

supplies, wh ich since 182 1 had been pu rchased by a Medica l Department surgeon 

stationed in New York City. He also emphasized that the administrati ve responsibilities of the Surgeon General's Office 

were broad and included "securing the 

professiona l re s ponsibility o f [th e 

department's] several offi cers, a strict accountability for publi c property and a ma-

~L trs. Lovell to Sec War (I Aug 1830 and 13 Jan 

1832), both in U.S. Congress, Americall Stale Pa· 

pers . . , V. Military Affairs, 7 vols. (Washington: Gales 

& Seaton, 1832- 61), 4:644- 45 and 826- 27, ,especti vely (hereafte r cited as American SUlle Papers: lHil· 

itar), Affairs); sec also other Ltrs. surgeon general (SG) 

to various recipients (1823-33), RG 112. entry 2. vols. 

5 and 6. 

teria l reduction of its expenses." Love ll's 

argument prevai led, and the position of the 

surgeon general remained at the top of the 

Medi ca l Department hierarchy.' 

The ca li ber of th e surgeons servi ng under 

him was another of Lovell's conce rns. He 

sought both to attract promising you ng 

ph ysicians by increasing their salaries and 

to weed ou t incompetents by means of examinations for entry and promotion. His 

campa ign for higher salaries was lau nched 

in the fall of 1818, when he poi nted ou t to 

Secretary of War Calhoun that competent 

surgeons would be reluctant to join the 

Army or to remain long in it if th eir compensation was not increased above the $40 

to $45 a mont h then offered. a sum less 

than that paid line officers with simi lar 

lengths of service. Ca lhoun's initia l efforts 

to have th e sa la ries of Army surgeo ns 

raised were not successful. The surgeon 

general was himself paid $2,500 a year, a 

sa lary lower than that of many comparable 

officers in other branches of the se rvice. 

Urged on by the pleas of his subordinates, 

however, he continued to emphasize the 

need for higher salaries. In 1828, for example, he commented that, except fo r the 

forage allowances for their horses, the most 

senior assistant su rgeons received onl y $3 

a month more than the greenest second 

lieutenants' 

At last, in 1834, the Medical Department's en tire pay sca le, except for the sala ry of the surgeon general, was raised and 

the principle of greater pay for longer service established fo r its members. Congress 

a llowed the most experienced surgeons the 

SQuotc from War Department, SGO. AIIIIIW/ Report 

( I Aug 1830), 183 1, p. 3: Ltrs, Lovell to Calhoun 

(6 Feb and 2 1 Dec 1821). both in Call/ol/II Papers 

5:597 and 6:579, respectively. 

6Ltrs, Squie r Lea to Lovell (2 OCl 1820) and William 

Turner to Lovell ( I Jan 1828). both in RG J 12. 

entry 12. 
LAYI NG THE FOUNDATION , 1818- 1835 

pay of majors, $50 a month plus eight rations and forage for three horses, assistant 

su rgeons with at least five years of service 

that of captains, and th e Icast expe rienced 

assistant surgeons that of first lieutenants. 

Those who served in eithcr rank more than 

ten years were to receive dou ble rati ons. 

Nevertheless, although their pay was keyed 

to that of Regular Army officers, Army surgeons still had not been given rank.' 

The shortage of Army surgeons forced 

Lovell to sign contracts from time to time 

wi th civilian physicians, who were paid by 

the depa rtmen t on the basis of the size of 

th e units to which they we rc assigncd. 

Those caring for the sick and wounded of 

a unit of 100 or more men recei ved $40 a 

month. For 50 to 100 men, the fee was $30 

a month; for 50 or less, $20 a month. The 

doctor providing his own medi cines or supplies might receive 25 to 50 percent above 

these rates, 

Although higher pay might encourage 

able physicians to enter the Medi cal Department, it obviously wou ld neither disco urage incompetents from applying nor 

cause those already in the departmcnt to 

resign. Lovell emphasized the problem he 

faced in this regard when he described one 

physician in his department as "so illiterate 

that he cannot spell his own name," so old 

that he had no intention of ever joining his 

regiment, and so uneq ual to the responsibilities of an Army surgeon that hc had 

been forced to resign an earlier appointment as regimenta l mate " to avo id a n arrcst for in co mpet e nce ." Ne ith e r th e 

legislation of 1818 nor the dcpartment's 

regulations, however, made provision for 

weedi ng out such men. Appoi ntments were 

7Llrs. Calhoun to Johnson (21 Dec 1818), in Ca/-

houn Papers 3:4 13: Lovell to Sec War (8 Nov 1828) 

and to Thomas H. Benton ( 18 Dcc 1828), both in 

American Siale Papers: Military IIffilirs 4:32. 64-66. 

respective ly. 

3 1 

made from each state according to the 

number of representati ves it se nt to Co ngress, bu t the regulations themselves required only th at new members have a 

diploma of some type from a " respectable 

medical school, college, or society" or pass 

an examination administered by an Army 

medical board. Si nce the examination was 

rarely given, on ly Lovell's vigilance co uld 

bar entry to incompetent surgeo ns or el iminate those already there. Nevertheless, th e 

department's physicians soon acq uired an 

enviable reputation among those most familiar with their work. In 1827, for example, the inspector gene ral of the Army, 

George Croghan, commented that "The 

army is trul y fortunate in hav ing such a 

medical corps ... More than once I have 

questioned myself, how it could be that the 

government were enabled to employ such 

professiona l worth and talents at so paltry 

a price."8 

Some question ex ists as to exactly when 

Lovell modified his regulati ons to include 

the requirement that all candidates for appointment to the department or for promotion with in it pass an examination by 

an Army medical board. This req uirement 

was first acti vated in 1832, at a time when 

states were beginning to eliminate licensing 

exams for pri vate ph ysicians and exams 

were not required for other Army officers. 

From that time onward , no one joining the 

Medica l Depa rtment was spared these 

tests. Even former Army surgeo ns desiring 

to return to the department were req uired 

to take them. The examining board, com8QUOICS rrom Llf, Lovell to Calhoun (18 Jun 18 18). 

in Calhollll Papers 2:344, " Regulations of the Medical 

Department, September 18 18," in Brown. Medical Depal'llllelll. p. 120, and George Croghan, Army Life 011 

fhe Weslem Frolltier: Sl'lecliolls n"Olll OJ}icial Reports 

Made Be/IlW!1I 1826 alld 1845, ed. Francis Paul Prucha 

(Norman: Uni vcrsi ty orOklahoma Press, 1958), p. 70; 

Ltr. Francis LeBaron to Lovell (21 Scp 18 18), RG 112, 

entry 12. 
32 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

posed of three surgeons or assistant surgeons, was prepared to travel from post to 

post and city to city, if necessary, to administer the three-day examination. Physicians appointed to the department 

between the time when the new regulation 

was issued and that of the first examination 

a year later received conditional appointments and either took the tests when offered or left the Army. Assistant surgeons 

who had served five years in the department were required to take th e promotion 

test in order to remain in the Army. They 

were not required to take a promotion 

should they pass; since assignments were 

based on seniority within grade, and transition from senior assistant surgeon to junior full surgeon might bring with it an 

undesirable change of post, refusa l of promotion was not unusual. Those who fai led 

might try the exam again after two years, 

but a third attempt was not permitted. To 

retain eligibility, any candidate who passed 

the examination but did not receive an appointment within two years had to repeat 

the process' 

Lovell's campaign to upgrade the department still faced serious obstacles. The 

relativel y low salaries and the specter of 

months of constant exposure to disease in 

desolate surroundings undoubtedl y discouraged many able young doctors. One 

department physician pointed out, "The 

9Thc two preceding paragraphs dealing with Medical Department examinations are based upon Rodney Glisan, Journal oj Army Life (San Franc isco: A. 

L. Bancroft & Co., 1874; Washington, Library oreon- gress [LC), microfilm 35155), pp. 3-4; Fayette Robinson, All ACCOWIf 01 the Orgafliz(tlioll oj the Army oj 

Ihe VI/ired Sw(es, 2 vols. (Philadelphia: E. H. Butler 

& Co., 1848), 1:42-43; Ltrs, Loveil lo various reci pients (18 3 1-36), RG 11 2. entry 2, vois. 5-7; Records 

of the Adjutant General's Office. [7805- 191 7. RG 94. 

Letters Sent by the Office of the Adjutant General, 

1800- 1890, microfilm publi cati on M565 , roll 8, 

10: 343, 395. NA; Ur, Lovell to Samuel Beekman 

(24 Mar 1828), RG 11 2, entry 2, 4:226-27. 

Surgeon is more confined, than any of the 

ot her officers, and Without the prospect of 

promotion, rank, or military Honors; performs the most important, Laborious, alld 

Dangerous dillies: for a consideration less 

than a Waggon Mast er." Another wrote 

Lovell of the deaths of two of his children, 

the illness of his wife, and the destroyed 

health of his remaining child, add ing that 

his " mind was too much fatigued, to attempt the drudgery of maki ng out returns" 

and that the only deaths at his post were 

those of his own children. Nevertheless, 

Lovell could offer intangibl e rewards to the 

ambitious. He encouraged his surgeons to 

send geological, zoological, and bota nical 

specimens back to interested scientific institutions. His open and unselfish support 

of Army surgeon William Beaumont's pioneering work in the fi eld of human digestion suggested that, despite the hardships, 

the Army Medical Department could offer 

opportunities to men of talent. ,. 

Lovell's concern for the welfare of the 

department's surgeons also led him to attempt to consider the preferences of indiv idu al ph ys ician s w hen mak ing 

assignments. The alternatives for full surgeons were few; in mid- 1826, for example, 

Fortress Monroe, Virginia , and West Point 

were the only posts open to them, and the 

remainder were assigned to regiments. The 

choices available to assistant surgeons were 

more numerous and some medica l officers 

remained at one post fo r as long as twenty 

years, but both surgeons and assistant surgeons, as a rule, were quick to request 

transfers if their assignments were not entirely to the ir liking. In 1825 the department initiated a req ui rement that Army 

physicians remain at least two years at th eir 

IOFirst quote, Ltr, Lea to Lovell (2 Oct 1820). and 

second, Ur, T. J. C. Monroe to Lovell (12 Nov 1829), 

both in RG 11 2, entry 12. 
LAYING THE FOUNDATION, 18 18- 1835 

posts before requesting transfers. But the 

problem was still not entirely solved, and 

Lovell was irritated to learn that some medical officers, including Thomas Lawson, 

who wou ld be his successor as surgeon general, were ru shing to request changes of assignment as soon as the two-year period 

had passed." 

Lovell's attempts to please everyone actuall y led to discontent among some members of th e department. Lawso n, who 

responded to Lovell's suggestion that he 

was too " pugnacious" with a fourteen-page 

letter of 16 October 1825 reciting his superior's fai lings, accused the surgeon genera l of, among other things, favoritism in 

the gra nting of appointments. "Some of the 

Surgeons," Lawson wrote, were "about to 

apply for a Reorgani zation of the Medical 

Staff" and unless prevented from doing so 

by difficulty in agreeing abou t how to proceed, they would formall y try to "effect a 

new organization, or to produce a change 

in the present system of government under 

the existing organization of th e Medical 

Staff." In 1830 the secretary of war assumed the final responsibility for assignments, but some relaxation in this rul e was 

allowed in 1834, when those with three 

years or more of service within grade were 

granted their choice of vacant posts." 

Despite their many duties, some surgeons, particularly those assigned to small 

posts, had free time. With sa laries less than 

generous, the temptation to take on private 

patients must have been strong. Although 

for many years the department's regula-

"ltrs, Lovell to Calhoun (26 Nov 18 18), in CalholiN 

Papers 3:301; Love ll 10 Thomas J. Jesup (\ Sep 1818) 

i.lnd to Lawson (28 Apr 1827), both in RG 1 [2, entry 

2. 2:7 and 4: 144, respectively: sec also other Ltrs 

(18 18-1822. 1826- 1829). RG 112. entry 2. vols. 2 

and 4. 

Ltr. Lawson to l ovell (16 Oct 1825). RG 112. Lawson Letters, entry 226. 

33 

THOMAS LAWSON. (COllrlesyq{Nalional Library oj Medicine.) 

tions categorically forbade private practice, 

exceptions to the rule, wh ile not always 

granted, were frequent. Early in October 

1818, for example, Lovell wrote Calhoun 

that a surgeon at Norfolk, Virginia, was 

being permitted to continu e treating patients who had no con nection with the 

Army. In 1820 Beaumont mentioned see king permission to care for sick and injured 

civilians at Mackinac Island, where no 

other physician was available for 300 miles; 

fortunately for American medicine, his request was gran ted. In 1834, although the 

prohibition against private practice had 

been reiterated, the adjutant genera l ruled 

that several military surgeons who had 

raised the question had permission to treat 

civi li ans as long as their doing so did not 

interfere with the performance of their assigned duties. T his ruling appears to have 
34 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

represented the offi cial attitude toward private practice. I J 

In the course of his private practice, th e 

Army surgeon also often cared for civilia n 

workers and milita ry fami lies on the base. 

T he extent to whi ch he was officially responsible for civilians in these categories, 

however, was not always clear, even to 

members of the depa rtment. By the time 

of Lovell's death , it was apparently understood that the surgeon was not required to 

care for anyo ne who was not in the Army, 

although it appears tha t he was permitted, 

as a rule, to supply med icines for the famili es of the soldiers at their posts and to 

provide hospital stores for ci vilian workers. 

In unusual circumsta nces, surgeons could 

also supply medicines to anyone in desperate need who was unable to pay for his 

own.14 

Lovell's ambitions for his surgeons extended beyond the prov ision of the best 

possible medical care for the Army's so ldi ers. His appreciation of the new depa rtment's unique opportunity fo r signifi can t 

contributi ons to med ical science led to a 

requirement that department physic ians 

participate in a ttempts to establish the relationship of me teo ro logica l facto rs to 

hea lth, a step he had urged before he became surgeon general and one proposed 

during the War of 18 12 by James Tilton, 

then head of the U.S. Army's medical services. Earl y in the cou rse of his service as 

surgeo n gene ral, th e refore, Lovell ruled 

that the surgeons und er him must submit 

reports on the diseases they treated and on 

the weather and climate, as well as on landscape features, such as elevation , drainage, 

IlLtrs, Lovell to Calhoun (2 Oct 1818), in Calholln 

Papers 3: 185; Adjutant General (AG) to J. Manney 

(17 Jul 1834), RG 94. M565, roll 8, II :49: Henry Stevenson to Lovell (19 Mar 1835), RG 112. entry 12. 

I~ Ltr , Benjamin King to J. M. Foltz (17 Nov 1836), 

RG 11 2, entry 2. 8:1 12- 13. 

and vegeta tion , tha t might a ffect th e health 

of the men. Lovell did no t initiall y receive 

the cooperation he wished from his su rgeons, who appea r to have reta ined the 

nonchalant attitude toward reports tha t 

cha racterized their predecessors. Within 

two years, however, he was able to comment that his orders we re being obeyed. " 

With the aid of these detailed reports, it 

is possible to achieve some understanding 

of the sick rate with which the Med ical Depa rtmen t had to contend more than 150 

years ago. One author has determined that 

the ra te of hospital adm issio ns, largely as 

a resu lt of fevers, digestive ills, and respiratory diseases, was on the average li ve 

times higher from 18 19 to 1829 than, for 

example, it was in 1949 and that the morta lity rate was fifteen times higher. Since 

no separate reporting category listed th e 

number of men suffering from alco holism 

and the effects of intempe rance, even Lovell himself cou ld only assume that this 

problem played an important ro le in much 

illness and death a ttributed to other causes. 

Although these morbidity and mortality 

rates seem shocking in the late twentieth 

century, they did not seem so to Lovell , 

who commented in 1822 that the death rate 

in th e Army was less than that among 

young men in civilian JifeY' 

Lovell's inte rest in the way in wh ich his 

surgeons performed their du ti es di d not 

blind him to the impo rtant role tha t nonprofessionals, such as nurses, cooks, wardmasters, and stewards, played in the care 

of the sick a nd wo unded . In the earliest 

IS Ltrs. Lovell to Calhoun ( I Nov 18 18 and I Aug 

1819) and Calhoun to Jackson (10 Aug 1819), al l in 

Ca/hol/II Papers 3:248 and 4:224-25. respectively. 

'''Ltrs. Love ll to Calhoun (3 OCI and I Nov 1818), 

botll in Calho/lll Papers 3: 186, 249. respecti vel y: Edwin Sherfield Marsh II , "The U nited States Army and 

It s Hea ltll , 18 19- 1829," Military SlIrgeol/ 10 8 

(1951):505. 
LAYI NG THE FOUNDATION , 1818- 1835 

yea rs, civilians co uld be hired to fill th ese 

positions, but in 1822 the adjutant genera l 

dec ided , de spit e criti c isms of th e poor 

work performcd by soldiers in hospitals, 

that on ly enlisted mcn selccted by th e su rgeons for whom they wou ld work should 

be assigned thcse responsibilities. Although 

the permission of the enlisted man's commanding officer was necessary for his assignm e n t to ho sp ital dut y, o nce th e 

appointment had been made, the attendant 

was subject onl y to the com mand of the 

surgcon, except in cascs of great emergency. 

This system did not work as well as the 

adjutant general had assumcd it would. In 

1833 the secretary of wa r gave doctors in 

charge of Army hospita ls permission, when 

absolutely necessary to obta in suitable attendants, to enlist into the Army directly 

from civilian life men who appeared parti cularly well qualifi ed. " 

Guidelines co ncerning the size of staffs 

required by Army surgeons to man their 

hospitals were set forth in the department 

reg ulations. Initi a ll y, th ese reg ulations 

statcd that a gcneral hospital wo uld need 

a steward and a wardmaster, one nurse to 

eve ry ten patients, one matron to every 

twen ty, and a cook for every thirty. A regimental hospital staff might consist of a 

noncommissioned officer who served as 

both steward and ward master, two matrons, a cook, and four nurscs, chosen from 

among the pri vates in thc regiment. A hospital for a post garrisoned by a single compan y wo uld probably have a private serving 

as wardmaster and steward and either two 

nurses or a nurse and a matron. A post of 

I1Ltrs. Lovell to King (I I Oct 1821), RG 112, entry 

2,2:241 : John H . Eaton to Lovell (4 Feb 1822), RG 

112, entry 12; Lovell to Calhoun (18 Jan [822), in 

Calhol/II Papers 6:627: Su rgeon a1 Ft. Gadsden, Fla., 

to Lovell (n.d.), in Ayars, "Notes: Med ical Service," 

p. 51 I. 

35 

more than one company was assigned an 

extra nurse for every added company. 

The pay of civilians work ing in Army 

hospitals varied from $ I 0 to $ I 6 a month 

for hospital attendants to $5 for matrons, 

while enlisted received onl y their regular 

pay for hospital work. Whether the matron 

at this time was still a superviso r of nurses 

as she was in the Continental Army is not 

c1car, but she apparently was responsible 

for cooking, nursing, washing, and cleaning. The worth of an intelligent and dedica te d ste ward or a tt endant was well 

recognized, but shortages of funds and th e 

absence of a legislati ve or regulatory provision permitting an additiona l allowance 

often fru strated attempts to give enlisted 

men and noncommissioned officers extra 

pay. Nevertheless, despite the low pay, at 

least one stewa rd in the Army in 1835 was 

himself a highl y respected ph ysician." 

The administrative staff assisting Lovell 

in his Washington office consisted of a single clerk, a lso a physician. He was paid 

$ 1,150 a year, and his responsibilities apparentl y included a small but growing colIcction of books and journals started by 

Lovell and continued by his successors, the 

first volumes in what wou ld eventually become a vast medical library. T he initial intention was that cach post or regiment have 

texts on, among other things, anatomy, surgery, and medical practice, and it appears 

that whenever a book was sent out to su rI~ Ltr , love ll to Benjamin Harney (3 Jun 1824 and 

15 Nov 1828) and Henry Heiskell to A. Cox, Jr. (30 

Sep 1830). all in RG 112. entry 2, 3: 147, 4:305, and 

5:2 10, respecti vely; Thomas Mower to Lovell (2 Jun 

and I Nov 1818, and 2 Sep 1822), Swift to Lovell (5 

Jan 1822), James Mann to Lovell (3 Feb 1822), Samuel 

Smith to Lovell (5 May and 29 Nov 1822), Edward 

Purcell to Love ll (6 Aug 1822), W. V. Wheaton to 

Love ll (24 Jan 1835), and Philip Maxwe ll to Lovell (8 

Oct [835), all in RG 11 2, entry 12. 
36 THE ARMY MEDICAL DEPARTM ENT, 1818-1865 

geons in the fi eld, a copy was retained for 

the Surgeon General's Office. " 

Although Love ll 's accomplishmen ts 

while he was surgeon general were many, 

he appears to have regarded as most significant his success in the management of 

the department's finances. He believed that 

his close supervision of the work of his surgeo ns and , in pa rti cul a r, his in sistence 

upon regular and systematic reports concerning their use of all forms of department 

property were responsible for important 

savings. In the autumn of 1822 he commented that he had succeeded in creating 

" a perfect system of responsibility fo r a ll 

public property fro m the period of its purchase to that of its expend iture" and that 

there was no longe r any " possibility of 

fraud, extravaga nce o r undue ex pend iture." The fi gures he cited to prove his 

point appear not to have incl uded the salaries of either regular or contract surgeons 

but to have been limited strictly to suppl y 

and housing costs. They showed that from 

1816 to 18 18, $7 was paid out per man per 

year for medical ca re, but that by 1820 the 

fi gure had dropped to $3. It reached a low 

of $ 1.72 in 1824 before starting to rise 

again to $4.60 in both 1827 and 1828; it 

then dropped again to below $3.20 

The overall annual expenses of the department during the 1820s apparently ran 

between $23,000 and $30,000, including 

the costs of hiring pri vate physicians. (Exact fi gures are not easily obtained because 

Lovell often reported in the fall only fo r 

the preceding eight months of the calendar 

19Ltrs, Lovell to Calhoun (24 Jan 182 1) and to Sec 

Wa r (9 Oct 1833), both in RG 11 2, entry 2, 2: II I and 

6:252, respecti vely; Dorothy M. Schullian and Frank 

B. Rogers, "The National Library of Medici ne," Library Quarterly 28 ( 1958):2. 5; Hume, ViclOries, 

pp. 12, 46. 

Quo e from Ltr, Lovell to Calhoun (28 Nov 1822), 

in Calhoull Papers 7:358; Reasoner, "Medical Supply 

Service," p. 14. 

year, addi ng an estimate for the rema ini ng 

four months.) As Army units were sent ever 

further west and the need for more surgeons grew, the department's ann ual expenses grew also, approaching $34,000 in 

1834. Of these sums, a large proportion 

went to pay private physicians, an expense 

the surgeon ge neral had not included in his 

figure for the average cost per man. In th e 

first eight months of 1824, for example, 

$5, 152.30 was paid out to civilian doctors, 

while by 30 September 1829, the fi gure averaged more than $ 1,500 a month." 

Until 182 1 the Apotheca ry General's Office managed actual purchasing fo r the 

Medical Department. Aft er the abolition of 

that office, suppl y responsibiliti es we re 

given to a few surgeons and assistant surgeons. Items such as cooking utensils, hospital furn ishings, and the food used for a 

regular diet were obta ined through the 

commissa ry of purchases, th e mi lita ry 

storekeeper, or the Quartermaster's Department, as appropri ate. But medicines, 

instruments, and special diet items were, 

as a rule, obtained by medi cal purveyors 

directly from merchants. In 1820 Calhoun 

required that the Medical Departme nt be 

guided in its ordering of medicines by the 

"General Pharmacopoeia" then being prepared by a medical convention" 

The role of the Quartermaster's Departmen t in supplying the Medical Department 

varied. In 1819, fo r example, Lovell urged 

that supplies be obtai ned through the quartermaster onl y when absolutely necessary, 

but su rgeons continued to ignore th is in21Amel'icall Stale Papers: Military Ajjairs 2: 125, 711 ; 

4:32, 20 1- 02; and 5:445. 

uQuotc from Ltr, Lovell to Calhoun ( 12 Jan 1820). 

in Ca/hollli Papers 4:568; Ltrs, Lovell to Lawson 

( 14 Feb 1823) and to O. Tiffany (16 Ap r 183 1), both 

in RG 112, entry 2. 3: 17 and 5:212- 13. respecti vel y; 

Lovell to Calhoun (13 Jan 1820), in Calholill PaperJ 

4:569. 
LAYING THE FOUNDATION, 1818-1835 

struction, even during the short period 

when the Office of the Apothecary General 

existed to handle such purchases. With the 

abolition of the Apothecary Department, 

surgeons were told specifically to turn to 

the quartermaster for emergency or casual 

needs. Regardless of how supplies were obtained, howeve r, shortages co uld res ult 

from problems created by distance, shipwrecks, and confusion over troop movements. Items were damaged in shipment, 

and delays of as much as a yea r between 

requisition and delivery occurred. Because 

of such difficu lties, surgeons were occasionally permitted to buy what they needed 

directly" 

Lovell proved to be a talented administrator, skilled in the management of both 

men and supplies; one of his surgeons 

wrote of the surgeon general's " undeviating 

ki ndness" toward his subordinates and 

their problems. Nevertheless, since Lovell 

could exert bu t little control over the situations his subordinates faced in the field, 

the Army's physicians were to a large degree on their own in handling the varying 

difficulties that they encountered at their 

posts or whil e accompanying detachments 

on the move.24 

SUigeons in the Field 

The life of the Army surgeon and the 

problems he encountered varied considBLtrs. Lovell to Richard Weightman (28 Apr 1819), 

to all surgeons and mates (27 Mar 1820), to Lea 

(27 Aug 1828), to James H. Sargent and to Mann 

(both II Feb 1823), to Sec War (3 Feb 183 1), and to 

Jesup (3 Sep 1833), all in RG 11 2, entry 2, 2:59, 191, 

and 237, 3: 12 and 13.5: 185-87, and 6:223, respectively; Alfred Elwcs to T. M. Glassc ll (15 l ui 1827), 

John Thurston to Lovell (1 JuI1829), and S. Shannon 

to 1-1 . Stanton (coPY. 18 Feb 1833), all in RG 112, 

entry 12. 

HLtr, W. L. Wharton to Lovell (22 Dec 1829), RG 

11 2, entry 12. 

37 

erably according to his assignment. In the 

East, a relati vely civilized life was possible, 

but in the West, isolation and an unfamiliar 

environment often gave rise to situations 

for which the eastern-raised and trained 

young physician was not prepared. In the 

Northeast, many of the d iseases he was 

call ed upon to treat were the fam iliar ones 

of the respiratory system, but in the West, 

he often encou ntered malaria and, in the 

wi nter and early spring, scurvy as well. In 

the deep South he fought not only malaria 

but also diarrhea-li ke diseases and quite 

possibly yellow fever. Moreover, the garrison of the fort to which he had been sent 

mi ght have its own peculiar problems, 

those that resulted, for example, from bad 

water, lead poisoning, or alcoholism, all 

factors that might be included among the 

"morbific agents ... which it fa lls to the 

lot of [the military doctor) to encounter."" 

Wherever he was stationed, east or west, 

the Army surgeon, unli ke his civilian counterpart, had to deal with men li ving closely 

toge th er, amo ng whom disease could 

spread rapidly. Once enlisted men fell ill, 

th ey would be gathered together in one 

place and, being subject to military discipline, were easier to treat than civilians, 

each in his own home. On the other hand, 

in the military hospital, and especially in 

wartime, soldiers would be exposed to 

cross infection, a problem that was essentially nonexistent in private homes. 

Unfortunately, the facilities available for 

the accommodation of the Army's sick 

often left much to be desired, even by the 

standards of the time. In one instance, a 

"small, but conveniant [sic) Hospital ... 

comfortably arranged and very well sup-

!SQuole from SGO, Sw/is/iea! Report 0 1/ the Sickness 

alld }\;/orf(llily ill fhe Army 0/ fhe United Slales From 

Janllary 1819 10 Jalll/ary 1839 (Washington: Jacob 

Gideon, Jr., 1840). p. 62 (hereafter c ited as Statistical 

Repol"I. 1819-39). 
38 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

plied" and managed by "a competent, intelligent and faithful Steward" lacked an 

attending surgeon . In man y mo re instances, the reverse was true; the surgeon 

was present at the post, but no hospital facilities awaited his patients. The housing 

that sheltered the sick and injured at such 

posts was often so damp, poorly ventilated, 

and crowded as to further threaten their 

health. In late 1835, of the thirty-one posts 

in states along the East and Gulf coasts and 

in the District of Columbia from which 

surgeons reported, twelve had no hospitals, 

and those at three more were rated as 

poor.26 

One of the eastern posts without hospital 

facilities was Fort Hamilton in New York 

Harbor. Here the sick were housed in casemates that lacked adequate ventilation and 

heal. Even in moderate weather the rooms 

might become unbearabl y hoI. In cold 

weather, the wind often drove the smoke 

back down the chimney; the surgeon there 

reported that on such occasions sulfurous 

clouds filled the air and only the opening 

of doors, which let in cold, damp drafts, 

could dissipate them. The dampness contributed to rheumatism and related conditions. The need for a hospital at Fort 

Hamilton was recogni zed, but none was 

built while Lovell was surgeon genera!. " 

The hospital at Fort McHenry in Maryland, on the other hand, was described as 

~6 Quote from Ltr, William Beaumont to Lovell 

(30 Sep 1835), RG 11 2, enlry 12; Ltr, Lovell 10 Sec 

War(28 Dec 1835), RG 11 2, enlry 2, 7:339- 4 1. Unless 

otherwise indicated, statisti cs concerning morbidity 

and mortality rates at the posts discussed in this chapter are based on Statistical Report /8/9-39. 

27Ltrs, Elwcs to Lovell (28 Nov and 10 Dec 1832) 

and Eaton to Heiskell (7 Jut 1842), all in RG 112, entry 12; Lovell to Elwcs (29 Dec 1832) and to Lawson 

(13 Dec 1833), bolh in RG 112, enlry 2, 6:35 and 238, 

respectively; Surgeon's Quarterly Rpt, Ft. Ham ilton 

(30 lun 1833), and Rpl, Elwes 10 Lovell (6 Nov 1835), 

both in RG 94, Reports of Sick and Wounded, 

1820-1860, enlry 634. 

"passable." This was fortun ate, since the 

elderly surgeon assigned to this post in 

18 18, William Stewa rt, had tocontend wi th 

a disease rate that was the highest in th e 

enti re Northern Di vision. Initially, Stewart 

blamed the most common ailment, " an 

cons/ipGliol1 oj/he il1leSlines" accompanied 

by fever, o n th e water, which tasted 

strongly of iron, but he later suggested that 

the cause was rather a steady diet of salt 

pork. A surgeon sent to inspect the post 

disagreed, stating that he believed the constipation to be "merely symptomatic, produced by a peculiar state of the bile, and 

of course referable to all those causes whi ch 

affect the bilious secretion. At Fort McHenry these natural causes," he added, 

were "aided by habits of in veterate dnlllkenness; for I never, among the same number of men, hea rd of so many addicted to 

intemperance,"28 

The disease afni cting the men at Fort 

McHenry and nea rby Fort Severn apparently grew worse with time, and by 1819 

its victims were being stricken by " frequent 

attacks of inflammation of the brain, ending in delirium, apoplexy, and death." In 

the year from March 18 19 to March 1820, 

thirty-nine men at Fort McHenry were afflicted in this manner, and sixteen died 

from convulsions. The number of cases 

dropped when a unit camped at some distance from the fort (and possibl y also at 

some distance from the suppliers of ha rd 

liquor), and spec ulation arose that th e 

cause of the illness lay in the atmosphere 

at Fort McHenry. The problem continued 

throughout the early 1820s, causing one or 

two deaths each year in the fift y-man gar-

!~ I-Iar ld Well ington Jones, cd .. "A Hospital In· 

spector's Diary," Bul/elill oIlhe History of Medicille 7 

( 1939):231-33, quotes from pp. 231- 32: Surgeon's 

Quarterly Rpts, Ft. McHenry (31 Dec 1818 and 

31 Mar 1819), both in RG 94, entry 634; Ltf, Stewart 

10 Love ll (16 Sep 1819), RG 112, entry 12. 
LAYI NG THE FOUNDATION , 1818- 1835 39 

- -

B[ I 

H OSPITAL AT F ORT M ACKI NAC, as restored in 1960. (Courtesy of Mackinac Is/and Suue 

Park Commission.) 

rison. By 1826 it had become customa ry to 

send the troops from the fort to camp at 

Huntington, Maryland, in late June. " 

Although meningitis could have caused 

some of the illness at Fort McHenry, it is 

entirely possible that chronic alcoholism 

was a basic part of the health problems 

there, accompa ni ed, perhaps, by malaria 

during the summer and early fa ll months. 

Man y symptoms could have resulted from 

lead in the chea p whiskey the men drank, 

since in 1829 the formation of a tempera nce society at the post was followed by an 

improvement in the health of the garrison. 

~'J Quotc from War Department, SGO. Allllual Report ( I Aug 18 19). 1819. p. 2; Surgeon 's Q uarterl y 

Rpts, Ft. McHenry (30 Jun, 30 Sep. and 31 Dec 1819. 

31 Dec 1820, and 30 Sep 1822), all in RG 94, 

entry 634. 

After they began to drink coffee instead of 

whiskey, the men also seemed to live together more amicably and to work more 

effi cie ntl y. Reports on th e accomplishments of the temperance society were so 

glowing that the secreta ry of war himself 

ex pressed an interest in this experiment in 

sobriety. ,. 

Surgeo ns stationed a t Baton Rou ge 

found health problems more serious than 

those at Fort McHenry. Until 1825, this 

post, the most disease-ridden in the enti re 

.lOUrs, Love ll to Robert French (3 Mar 1830), RG 

11 2. entry 2, 5:98; French to Lovell (31 Dec 1829 and 

I Apr 1830), both in RG 112, entry 12; George N. 

Thompson, ed .. Alcoholism (Springfield, III.: Charles 

C Thomas, 1956), pp. 253. 413, 476; Aspects of II {coholism 1 (Phil ade lphi a: 1. B. Lipp in co tt Co .. 

1963): 14- 15. 
40 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

nation, might record in the course of any 

given year over 20 percent of the total 

deaths in the Army. In the second quarter 

of 1822, for example, twenty-eight of the 

Army's total of forty-one deaths took place 

there. Dysentery, diarrhea, and malaria, all 

complicated by intemperance, took a high 

toll at Baton Rouge, where, in 1819, 1822, 

1827, and 1830, the threat of yellow fever 

also added to the sufferings of the garrison. 

Despite the post's notorious reputation, 

its hospital facilities were entire ly 

inadequate." 

The surgeons who struggled to deal with 

the problems at Baton Rouge blamed the 

poor health of the garrison on the lack of 

acclimatization of the recruits, the intemperance of the men, their long work in the 

hot sun, their poorly constructed barracks, 

and even, in June 1822, on the " entire absence of rain." Lovell, on the other hand, 

eventually concluded that the presence of 

ponds, old buildings, and a graveyard located south of the barracks was responsible 

for the high rate of disease, apparently because of the miasmas they engendered." 

The problem of inadequate housing for 

the men at Baton Rouge was solved in 1824 

with the construction of a new barracks, 

and it appears that by 1825 the health of 

the men was improving. Whether the improvement resulted from the new barracks, 

a final acclimatization of the men, an easing of their workload in hot weather, or 

l'John DufTy, ed., Tlte RlIdo/ph Matas History 0/ 

Medicine ill Louisiana, 2 vols. (Baton Rouge: Louisiana State Universit y Press, 1958), 1:484; Surgeon's 

Quarterly Rpts, Baton Rouge (1 821 - 36), RG 94, entry 

634; Records of the Office of the Inspector General , 

RG 159, Report on Condition of Troops and Posts, 

1823, M624, roll I, p. 10. 

12Quotc from Surgeon 's Quarterly Rpt , Baton 

Rouge (30 Jun 1822), RG 94, entry 634; Rpt, Lovell 

to Calhoun (1 Nov 1822), in Calhoull Papers 7:325 ; 

Ltr, Lovell to Harney (1 2 Apr 1823), RG 11 2, entry 

2, 3:42; SGO, AI/lll1a! Reports (Aug 182 1, Nov 1822, 

and Nov 1823), pp. 3, I, and 1-2, respecti vel y. 

possibly a combination of these three factors is unknown. It would appear, however, 

that by the time the hospital was completed 

in 1839, the need for such a facility was no 

longer as great as it had been in the 1820s 

when Lovell first urged that it be built." 

In contrast to Baton Rouge and Fo rt 

McHenry, Fort Mackinac, on Mackinac Island in Lake Michigan, was representati ve 

of the healthiest posts in the nation. 

(Map /) In a cool climate and cut off from 

th e re st of the world from No vembe r 

through the winter, the fort shared the island with 500 French Canadians and halfbreeds who lived in the village of Mackinac, one of a chain of trading posts that lay 

along the Mississippi River and the shores 

of Lakes Michigan, Superior, and Huron. 

From Ma ckinac each fall , vo yageurs, 

among them at one time Beaumont's famous pati ent, Alexis St. Martin, set out in 

boats laden with goods to trade with the 

Indians for furs, returning in June and Jul y 

of each year. Indians also came to Mackinac to trade, and the population fluctuated 

by severa l thousand , according to the 

season . ) 4 

In 1821 Fort Mackinac consisted of three 

intersecting lines of blockhouses and a wall 

of ten-foot-high pickets, placed at the top 

of a steep hill. The earliest hospital at the 

fort, like the faciliti es at so many other 

JJ LtTS, Lovell to Calhoun and to Harney (both 

11 Ju11 82 1), both in RG 11 2, entry 2, 2:229; SGO, 

Slli/is/ieaf Report Oil the Sickness and lvlortalit)1 in the 

Army o/the United States/rom January /839 10 Jal/llary 

/ 855 (Washington: A. O. P. N icholson, 1856), p. 254. 

.l Willard B. Robinson, American Forts, Architectllral Form and Functioll (Urbana: University of illinois Press, 1977), p, 61 ; M yer, Beaumollt, pp. 94- 95; 

John Reed Bailey, "Army Surgeon," Physician alld 

Surgeoll 22 ( 1900):574-75; Keith R. Widder, Reveille Till Taps . . , (Mackinac Island, Mich.: Mackinac Island State Park Commiss ion, 1972), p, 69; Ltr. Beaumont to Mrs. Lucretia Beaumont ( 16 Jun 1836). 

Papers ofWm . Bcaumont, M .D. , M s. Collection, doc. 

36, folder 2. microfilm reel 1, Washington U ni vcrsity, 

School of M edicine Library, St. Louis, M o, 
LAKE SUPERIOR 

MICHIGAN TERRITORY 

Fort Snelling 

Fort 

W innebago 

• 

Fort Crawford 

• 

UNORGANIZED TERRITORY -----

Fort Atkinson A 

~ r--------- o~. I 

" 1 

Fort • l eavenworth 

I 

1 

I 

1 

I 

1 M ISSOURI 

.6. Fort Armstrong 

ILLINOIS 

.",~ 

I _____ -., \----- / ~"'J'~ -.,. 

Fort Gibso .6. 

MAP J 

I ARKANSAS TERRITORY L 

\ 

ith 

MICHIGAN TERRITORY 

Detroit 

---II 

\ 

I OHIO 

INDIANA \ 

I 

\ 

• Louisville 

KENTUCKY 

-------- r"--

THE FRONTIER 

1818-1835 

o 200 

cl--------,M,fulle~'C--------"1 

Note: Boundaries 8S they existed in 1830. 
42 THE ARMY MED ICAL DEPARTMENT. 18 18- 1865 

posts, left much to be desired. It was located in an old, one-story storehouse, divided into two wards and a small kitchen, 

where in the summer the roof leaked and 

in the wi nter the rooms fi lled with smoke. 

The surgeon Ii ved in a stone house built 

into the side of the hill. The fort's isolation 

made supply particularly difficult, the post 

medical officer occasionally having to provide medical services as long as eighteen 

months without receiving new stocks of 

medicine. Surgeons ensured a proper diet 

for their patients by establishing a hospital 

garden on part of the post's open ground, 

growing vegetab les as we ll as opium 

poppies. " 

Its best known Army su rgeon, William 

Beaumont, a rri ved at Fort Mackinac in 

1820, shortly after he was commissioned 

in the Army for the second time. Because 

Fort Mackinac was a healthy post, much of 

Beaumont's work involved maintaining the 

health of the 50- to 100-man garrison and 

treating the victims of various mishaps. 

These responsibilities were not overly demanding, and Beaumont, like his predecessor, was able to gain permission to 

conduct a private practice, since no other 

physician li ved nearby. J6 

From the outset, Beaumont's concern 

that the post should have a garden to ensure 

the continued hea lth of the garrison antagonized both the Indian age ncy on the island 

and the fort's commanding officer, who 

had given the agency permission to erect a 

)sLtr, Beaumont to Lovell (I Nov 1820), RG 11 2. 

entl)' 12; Surgeon's Quarterly Rpt, Fe Mackinac 

(30 Jun 1820), RG 94, entry 634; Bailey, "Army Surgeon," p. 574. Unless otherwise indi cated, material 

on Ft. Mackinac is based on Mycr, 8eo1l11101ll; Widder, 

Reveille; and Ella Hoes Neville, Sara Greene Martin, 

and Deborah Beaumont Martin, Historic Green Bay, 

1634-1840 (Green Bay, Wis.: Privately printed, 1893). 

16Surgco n's Quarterly Rpts, Ft. Mackinac 

( 1820-2 1), all in RG 94, entry 634; Ltr, Richard Satterlee to Lovell (3 Sep 1835), RG 112, entry 12. 

bui lding in the middle of the garden plot. 

But because Beaumont beli eved so strongly 

in the importance of the ga rden for the 

health of the men, he wrote the War Department to complain; his plea was apparently heeded, and the garden rema ined. " 

Partiall y as a result of his concern for the 

prevention of disease, many of Beaumont's 

patients were the vict ims of mishap rather 

than illness. Among those he trea ted was 

an artillery private who had been clubbed 

in a brawl. Although th e surgeo n trephined 

the victim's skull in an attempt to relieve 

the pressure on the brain and to remove 

bone fragments, he was unable to save this 

patient's life. He was more successful with 

a would-be deserter who had survived a 

week wandering without food , drink , shelter, or a source of warmt h at a time when 

the nighttime temperatures ranged from 

200 to _140 F. A visitor who had experienced 

a relapse of what he reported as " lake fever" (presumably malaria) while traveling 

from Detroit to Mackinac was one of Beaumont's few patients suffering from disease. 

Although he had initially appeared to be 

hopelessly ill, under Beaumont's care the 

newcomer recovered. 38 

Although the demand placed on the hospita l at Fort Mackinac did not equa l that 

at such posts as Baton Rouge and Fort 

McHenry, Lovell , Beaumont, and Beaumont's successor at Fo rt Mackinac in 1825 

all urged the construction of a new hospital. Lovell pointed out that the old structure was not fit for the use of health y men, 

much less for the sick, who, because of the 

leaky roof, occasiona lly had to abandon 

their beds during heavy storms. In 1827 a 

new hospital was fina lly erected, on ly to 

l1Ltr, Beaumont to Lovell (I Nov 1820), RG 112, 

entry 12. 

liAlbert G. Ell is, "Fifty-Four Years' Recollections 

of Men and Events in Wisconsin ," Wisconsin /-listoriut! Collections 7 (1873-76):2 13. 
LAY ING THE FOUNDATION. 1818- 1835 

burn down shortly after its comp lction. 

When rebuilt on the same founda tion, this 

facility was capable of sheltering up to fourteen pati ents and remained in use as a post 

hospita l until 18 59."1 

The li fe of the surgeon whose assignment 

se nt him to the fart hest reaches of the western fronti er coul d be particularly grim. 

Many posts were even more isolated than 

Fort Mackinac and yet they suffered disease rates th at at one time or another riva led th ose at Baton Rouge and Fort 

Mc Hen ry. Isolated garriso ns mi ght be 

spared the inroads of such diseases as cholera or typhoid feve r but suffer terribl y from 

scurvy during the winter and early spring, 

when fres h vegetables a nd fruits were 

unobtainable, and from malaria in the 

summer and earl y fall. Disease often decimated ex peditions sent out from Western 

forts to explore unfamili ar territory, escort 

traders, or contact Ind ian tribes. Although 

some surgeons might regard an assignment 

to a fronti er post as a challenge, at least 

one mourned the necessity of spending " his 

best yea rs ... on a pestilenti al fron ti er. 

with no incenti ves to honorable ambition, 

& no society save th at of drinking, swearing, tobacco chewing compani ons."·o 

Among th e fronti er posts established 

ea rly in the period when Lovell was surgeon general was Fo rt Snelling, located in 

present-day Minnesota at the confluence of 

th e Mississippi and Min nesota rivers. One 

ofa chain of forts designed to guard aga inst 

the inroads of both Indians and British fu r 

traders, Fort Snelling occupied a site of 

great natural beauty and, initially, of great 

isolation. Isolation during the winter, howl~ Lt , Lovell to Sec War ( 14 Jul 1826), RG t 12, 

entry 2, 4:82; Satterlee to Lovell (5 Jun 1826), RG 

112. entry 12; Erastus Wolcott to Lovell (15 Nov 

1835), RG 94, entry 634. 

4°Ltr, Richard N. Duggan to Lawson ( 18 Feb [832), 

RG 11 2. entry 12. 

43 

SKETCH OF FORT SNELLI NG by Nathan Jarvis. (Collrtesy oI Nell' York' Academy of 

J'vfedicine.) 

ever, could lead to d isaster, and in the winter of 1819- 1820, disease took a frightful 

toll at two new posts, Cantonment Missouri, soon to become Fort Atkinson, and 

Fort Snell ing. Suppli es intended for the 

men who were to build Fort Snelling were 

damaged in transit, and the fort itself had 

not yet been bui lt when, despite the efforts 

of the Army surgeon who accompan ied the 

men, disease struck th e 228-man garriso n. 

It appeared "in almost malignant form, 

and raged so violent that, for a few days, 

garrison duty was suspended, there being 

barely well men enough in the command 

to attend to the sick, and to the interment 

of the dead." Symptoms appeared so sudden ly that a man who went to sleep apparentl y health y might never awa ken. The 

surgeon general, assuming the problem to 

be scurvy, blamed the absence of vegetables, but he conside red hard work and 

sleeping in wet clothes to be add itional factors contributing to the sickness that swept 

the camp. Others, however, blamed the 

lack of fresh food and bread covered with 

mold. From the suddenness with whi ch the 

disease produced fa ta li ti es, so met h ing 

other than scurvy may have also been affli cting the garrison. Given the inadequate 
44 THE ARMY MEDICAL DEPARTMENT, 181 8- 1865 

~ '. 

, - , .; . 

-.." ~r ~. i.(, ;' .. I ",,, 

." ;~ , , I , )., , , " 

, , , 

"- , : " . : , 1 , ~ :'- " t: , . i ; 

• 

• , • ~ 1 ~ , .; . l> , • ~ \~ it • ... ~ ~ '; i • • q~ t • ", ! , 

• ; I" 

''''l 

CANTONMENT MISSOURI: Sketch dated 23 November /8/ 9, (Courlesyo!Western Americana 

Collection, The Beinecke Rare Book and Manuscript Library, Yale Un iversily.) 

diet, it is possible that the sudden deaths 

were related to a thiamine defici ency, But 

surgeons of the period were too familiar 

with scurvy and its causes to have entirely 

misdiagnosed the problem, and sudden 

death can result from scurvy after any sudden and marked fall in blood pressure, Reports on the number of deaths vary, but it 

appears that as many as 40 or more out of 

the 100 men in the 5th Infantry died in the 

cold of 181 9 to 1820, before the use of remedies such as "strong decoctions of hemlock boughs" and the arrival of supplies 

from the South brought the problem to an 

end. 41 

4(First quote, H. H. Sibley, " Reminiscences, Historica l and Personal," Minnesota Historical Collecriolls 

1 (1872):473; second quote, James Duane Daty, "Offi cial Journal, 1820," Wisconsin Historical Collec/iolls 

13 (1895):214; Norris, .. 'Scurvy Disposition :" pp. 

325-26; Wintrobc C1 aI. , Harrison's Principles, pp. 

430-3 1; Ltr, Purcell 10 Lovell (29 Apr 1820), RG 11 2, 

entry 12. Unless otherwise indicated . mater ial on FI. 

Snell ing is based on Daty, Sibley, and John M. Armstrong, "An Introduction to the History of Medicine 

in Minnesota ," Mil/lIl'SOUl Medicine 2 1 ( 1938):41-43; 

Marcus L. Hansen. Old ForI Snelling. 1819-1858( lowa 

City: The State Historical Society or Iowa, 1918); and 
LAYING THE FOUNDATION, 1818- 1835 

With the arrival of warmer weather, the 

ten-foot walls of Fort Snelling finally began 

to rise. Six of the ten rooms in a stone barracks became the home of the hospital. The 

lesson of the preceding winter had not been 

forgotten, however, and the soldiers took 

time off from the construction work to 

plant ninety acres to corn, potatoes, wheat, 

peas, and other crops. The avai lability of 

fresh vegetables no doubt played a role in 

the fact that the annual death rate from 

1822 through 1825 was I to 4 in a garrison 

of 250 to 300 men, and that most of these 

deaths resulted from respiratory diseases 

rather than dieta ry deficiencies." 

The physicians assigned to Fort Snelling 

during the 1820s and 1830s included several who gained distinction for reasons not 

directly related to their professional talents. The first officer to die while on duty 

at Fort Snelling, for example, was the post 

surgeon, Assistant Surgeon Edward Purcell, who fell victim to an unspecifi ed illness in 1825. A second surgeon, Robert C. 

Wood, gained a small amount of fame by 

marrying a daughter of the future president 

of the United States, Zachary Taylor, the 

colonel commanding Fort Snelling in 1828. 

In so doing, Wood also became for a brief 

time brother-in-law to the future president 

of the Confederate States, Jefferson Davis, 

whose first wife was also a daughter of 

Zachary Taylor. Anot her doctor, John 

Emerson, assigned to Fort Snelling in the 

Evan Jones, Citadel ill lite Wilderness: Tlte Slory oj 

Fori Snelling alld Ille Old Norrhwesf Frall/ier (New 

York: Coward-McCann , 1966). At Ft. Atki nson, 15 

miles north of Omaha, Nebr., on the Missouri River, 

160 men died of scurvy and many of the survivors 

were permanently mutilated in the winter of 18 19-20: 

John Gale, The ,Hissouri Expedition, 18 /8- 1820: The 

JOllmal of Surgeol/ John Gale. Willi Related DoclImews, cd. Roger L. N ichols (Norman: University of 

Oklahoma Press, (1 969]). 

42Ltr, Nathan Jarv is to Love ll ( 16 Jan 1836), RG 

94, entry 634. 

45 

late 1830s, brought with him from an earli er assignment in slave territory a slave, 

Dred Scott, who later cla imed before the 

Supreme Court that his sojourn at Fort 

Snelling had made him a free man. 

The surgeon was often the best-educated 

man at a post; hence it is not surprising 

that one of the finest accounts oflife at Fort 

Snelling came from the pen of yet another 

medical officer there, Nathan Jarvis. Jarvis 

was also reputed to be a gifted caricaturist 

as well as an artist with pencil and sketch 

pad. To his responsibilities as post surgeon 

he added those of teacher of the fort's children and librarian for a garrison library of 

over 400 volumes, newspapers, and periodicals. He was also, it would seem, a musician; he once wrote his brother requesting 

that he be sent an accord ian, "for amusement," which, Jarvis was confident, could 

be purchased for "$3 or 4."43 

Jarv is' letters to his family suggest that, 

despite the fort's isolation, life was not entirely unpleasant at Fort Snelling in the 

1830s. One Christmas Eve, for example, a 

major entertained "with a splendid supper 

consisting among other delicacies of the 

season of venison, roast pig sausages, 

mince & pumpkin pies ... and many other 

kickshaws too numerous to mention." On 

Christmas Day, after an "excellent dejeuner [a]la fourchette [substantial breakfast 

with eggs, meat, etc.] at II o'clock," the 

company went in sleighs to the nearby waterfalls. Upon their return, Jarvis and his 

fellow officers had a supper "which was superb," while " Music & Songs c1os'd the 

amusement of the day." Also during the 

holiday season, Jarvis "for the first time 

rode in a dog train. It was drawn by 4 dogs 

harnes'd ahead of each other the leader 

4.lLtr, Jarvis to Wi ll iam Jarvis (2 Oct 1834), Papers 

of Nathan Jarvis, New York Academy of Medicine, 

New York, N .Y. (herea fter cited as Jarvis Papers). 
46 THE ARMY MEDICAL DEPARTM ENT, 1818-1865 

NATHAN J ARV IS. (Courtesy of National Library of Medicine.) 

having a string of small si lver bells around 

his neck ... The body of the train is made 

of deer skin something in the shape of a 

shoe large enough to stretch yourself at 

length [sic]."" 

Almost a year later, in a cold November 

1835, Jarvis, his sense of isolation heightened by the infrequency with whi ch he 

heard from his famil y, was still able to 

write his brother a vivid description of 

a most beautiful displ ay of th e Aurora Borealis .. . Broad sheets of light shot from 

the zenith directly overhead to the edge of 

the horizon in every direction like radii 

from a centre illuminating the heavens like 

noonday and affording one of the most 

beautiful displays I have ever witnessed. To 

increase the beauty of the spectacle the 

44Ltr, Jarvis to William Jarvis (31 Dec 1834). in 

Jarvis Papers. 

light of the Aurora was ting'd of a most 

beautiful orange color." 

Jarv is' record of his expenses throws 

some light on the finances ofa post surgeon 

in this period. His pay may have been defi cient in relation to his responsibilities, 

but at a time when a physician trying to 

establish a new civilian practice might contract with an entire fami ly for a year's care 

for $ 10, Jarvis reported that his total income from the Army, which presumably 

included both pay and allowances, was a 

relatively munifi cent $82 a month. In addition, he received $ 100 a yea r from the 

Indian agen cy for caring fo r Indian 

pat ients-his predecessor had a lso received 25 cents an Indi an for vaccinating 

500 against smallpox. Another medica l offi cer estimated that $ 100 a year came from 

his private practi ce, giving him an income 

of approximately $ 1,200 a year. Of this total he paid out about $25 a month for food , 

his se rvant, laundry, the maintenance of a 

horse, and similar expenses. His income 

may appear modest, but when Purce ll 

wrote his brother about his own assignment 

to Fort Snelling, he confessed that although 

"You may think it strange that I have consented to go with the Regi ment out of the 

world, as you may call it, the fact is that I 

go, not because I like it, but because of 

thinking that I can make money."" 

At Fort Snelling, as at other earl y posts 

established in the winter, scu rvy was the 

principal hea lth threat, and the greening of 

the vegetable garden spelled an end to 

4)Ltr, Jarvis to William Jarvis (30 Nov 1835), in 

Jarvis Papers. 

4f>Quotc from Ltf. Purcell to his brother (20 Mar 

18 19), in John M. A rmstrong, "Edward Purcell. First 

Physician of Minnesota," AlIllals ojlvlediell/ 11;,\'(Or)' 7 

(1935): 169; David S. Wiggins. Service;1/ "Siberia " (St. 

Paul: Minnesota Historical Society. 1977), p. 4; N. S. 

Jarvis, "An Army Surgeon's Notes on Frontier Service. 1833-1 848," JOllrna/ of Mililani Service Institute! 

39 ( 1906):132; Shryock, M odem M(!(/icille, p. 258. 
LAYING THE FOUNDATION, 18 18- 1835 

bleeding gums, loosened teeth, and multiple bruises. Even cholera. striking in 1833, 

caused no deaths. Fo r many ot her fo rts in 

the West, where malari a was endemic, the 

tri al was unending, repealed every sumrncr 

and fal l. Such a post was Fort Leavenworth, 

established in 1827 to protect the Santa Fe 

Trail and to serve as a base in what is now 

Kansas fo r exped itio ns a lo ng both th e 

Santa Fe and Oregon Trails. The Medical 

Department qui ckly established a hospital 

at the new fort , but, li ke many other post 

hospitals, it left somet hing to be desired, 

si nce it was badl y arranged and its chimneys smoked. A minimum of two surgeo ns 

was assigned to Fort Leavenwort h at all 

times, a step made doubl y necessa ry by the 

repeated ill ness of the surgeons themselves. 

So seve re were the hea lth problems, howeve r, espec iall y those ca used by fevers, that 

the inspector general recommended the 

post's abandonment. Although its garrison 

was at times drastica lly reduced to protect 

the hea lth of the men, Fort Leavenworth 

remained in use. In an attempt to minimi ze 

the onslaught of disease, an "admi rab le poli ce [was] ma intained, [and much] attention paid to the health of the men," bu t 

heavy drinking complicated efforts to improve the command 's hea lth." 

"7Quote from Surgeon's Quarterly Rpt (30 Jun 

1830). RG 94. entry 634; Su rgeon's Quarterly 

Rpts. Ft. Leavenworth ( 1827-36. esp. 30 Jun , 30 SC I', 

and 31 Dec 1830. 30 Sep 1831. and 30 Scp 1833). and 

Ltrs, Edward Macomb to Lovell ( I Dec 1835) and 

Gale to Lovell (\ Oct 1828). all in RG 94. entry 634: 

Ltrs. Lovell to P. G. Randolph (27 Dec 1827), to T. 

S. Bryant(9 Feb 1828). and to Macomb (29 Jul 1832), 

all in RG 112, entry 2. 4: 198 and 211 and 7:527, respective ly; David S. Wiggins. "Minnesota's First Hospita l ... ," Mil/I/esora M edicine 59 (1976):871 ; 

Croghan, tinny Life, p. 10; Robert W. Frazer, FOl"!s of 

the West: Military Forls alld Presidios and Posts COIII1II01l/.V Called Forts West of the Mississippi Ri\'er 10 

1898 (Norman: University of Oklahoma Press, 1965), 

pp. 56- 57: Francis Paul Prucha. The SII·ord of the Republic: The United Stales tlrmy all 'he Fro/llier 

47 

The men of Fort Smith, founded late in 

18 17 on the right bank of the Poteau River, 

near its union with the Arkansas, a lso suffered from a disease th at apparently was 

mala ria. Although the men were spared 

sc urv y despite th ei r re lative iso lation 

(probably because of their successful garden), fevers of one kind or another so severely afflicted them that, in a bad season, 

one to five in each company might die. In 

August 1822, ma laria sent half of one company to the post hospita l, and the year as 

a whole saw 47 of the 206-man garrison 

d ie. Many men, trusting neither the surgeon, T homas Lawson, nor the post hospital, attempted to treat themselves; some 

of those who blamed the water for their 

problems undertook to pu rify it with rye 

whiskey. Colonel Matthew Arbuck le, commander of the post in the early 1820s, 

blamed the purifying age nt for the health 

problem at Fort Smith. Calomel was used 

as a preventive du ring the sickly season, 

but medicines disappeared rapidl y because 

of disease's heavy onsla ught and supply 

was a problem. In the period from 183 1 to 

1833 a lone, eight privates and an assistant 

surgeon died at Fort Smith, a nd the survivors were weakened by repeated bo uts of 

fever and possibl y by heavy dosing with 

ca lomel as well. As a co nseq uence, in 1834 

the fort was abandoned, only to be reoccupied four years later. " 

Surgeon Lawson appeared to have added 

considerably to the troubles at Fort Smith, 

/ 783- /846 (New York: Macmillan Co., 1969), pp. 179. 

224. 236-37. 

4~Edwin C. Bearss and Arrell M. Gibson, FOI"! Smilh: 

LillIe Gibra/rar all Ihe tlrk(llls(ls (Norman: University 

orOklohoma Press, 1969), pp. 28-29. 37, 83-84,136, 

160; Frazer, Forls oflhe West, pp. 16-18: Kent Ruth. 

Great Dml ill the West: Forts, Posts, al/d Relldezl'ous 

8e,l'ol/d die Mississippi (Norman: University of Oklahoma Press. 1963). p. 14; Ltrs, O. Holt to Lovell 

(12 Oct 1833), Thomas O'Dwyer to Lovell (25 Jul 

1833), o"d c. B. Welch to Lovell ( 13 Feb 1834), all 

in RG 11 2, entry 12. 
48 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

both through his failure to ga in the confidence of the men and through his quarrelsome disposition. Even before his arrival, 

he was in volved in a wide-ranging feud 

with his colonel. Highlights of this feud included the trouncing of Lawson in a fistfight by a lieut e na nt who support ed 

Arbuckle, the bringing of charges against 

Arbuckle by Lawson and Lt. Col. Zachary 

Taylor, the placing of charges against Lawson by Arbuckle, and the filing of countercharges against Arbuckle by Lawson. At 

least one modern authority on the subj ect 

believes that Lawson resented Arbuckle's 

popularity with the women at the post. In 

the final analysis, all parties concerned survived the charges with their careers intact, 

including Taylor, who later became president, and Lawson, who succeeded Lovell 

as surgeon general." 

Men from Fort Smith were among those 

who established Fort Gibson, Oklahoma, 

in the 1820s. This post was yet another 

where health problems were frequent and 

severe, but it could not easily be abandoned. It was a base from which important 

expeditions set out and to which came 

many refugees, including Indi an women 

and children seeking shelter from tribal 

warfare engendered by the federal government's removal policy. From 1824 through 

1835, 561 enlisted men and 9 officers died 

at Fort Gibson, described by one surgeon 

as " the charnel house of the Army." More 

than half of the deaths occurred in 1834 

and 1835 alone, years when the more dangerous form of malaria, remittent fever, 

was more prevalent than usual, a nd tuberculosis was also causing deaths. Although 

cholera did appear at the fort, it was prob49Bearss and Gibson, ForI Smith, pp. 55-56, 70, 

74- 75; Ltrs, AG to Lawson (27 Aug 1823), RG 94, 

M565, roll 6, 6:374; Lawson to Love ll (3 1 Mar 182 1) 

and to Edmund R. Gaines ( 12 Oct 1823), both in 

RG 112, entry 12. 

ably not a major factor in the mortality 

rate; most of the patients at the post hospital seem to have been the victims of malarial fevers. The surgeons also cared for 

the victims of respiratory diseases, drunkenness, and the harsh physical punishments meted out to enlisted men. So great 

was the rate of sickness and disability that 

in 1831 an addition was ordered for the log 

hospital that had been completed only four 

years ea rli er. The commandi ng officer, 

Colonel Arbuckle, apparently had little enthusiasm for the hospital addition, and its 

completion was long delayed. '0 

Disease and the remedies used to combat 

it also plagued the many expeditions that 

set out from Fort Gibson. Among the most 

unfortunate of these undertakings was one 

led by Brig. Gen. Henry Leavenworth, who 

in the spring of 1834 joined dragoon units 

that had already arrived there from Jefferson Barracks. Assigned to the newly formed 

Regiment of Dragoons were a surgeon, 

Clement A. Finley, who later served briefly 

as surgeon general in the early months of 

the Civil War, and two assistant surgeons. 

The men under their ca re were already 

sickly, and at least one soldier blamed an 

unnamed medical attendant at the fort for 

their condition . It may have been this medical officer who had fallen into the habit of 

treating almost every complaint with calomel, his favorite mercurial remedy, with-

~OQuote from Leonard C. M cPhailjournal, M s C88, 

National Library of Medicine (N LM), Bethesda, Md. , 

p. 19; Philip St. George Cooke, Scenes and Adl'ell/ures 

ill fhe Army (Philadelphi a: Lindsay & Blaki ston, 

1857), p. 227; Ltrs, Lovell to Zilla Pitcher (21 Oct 

183 1 and 2 Sep 1833), both in RG 11 2, entry 2, 5:26 1 

and 6:221, respecti vel y; AG to Mrs. Eli za Shaw(4 Dec 

1834), RG 94, M565, roll 9, II : I 57: Pit cherto Lovell 

(7 Jan 1830 and 3 Sep 1831), both in RG 11 2, entry 

12; Rpt, Samuel DeCamp (30 Sep 1835), RG 94, entry 

634; Statistical Repol'f /839-55, p. 267. Unless th er~ 

wise ind icated, material on Ft. Gibson is based on the 

journals of Hugh Evans and on books and arti cles by 

Frazer, Prucha, James Hildreth, and Louis Pelzer. 
LAYI NG T HE FO UN DATION, 18 18- 1835 

out being ca reful of the dosage. Soldiers 

might come to him with a minor compla in t, but, aft er repeated visits, the merc ury wo uld beg in to ta ke its to ll. His 

patients would 

gra du a ll y dec line , th e ir co unt e na nces 

merging from the rosy hue of healthfulness 

into the sallow and ghastl y likeness of disease, their firm step giving way to the totter 

of decrepitude; their strong arms shaking 

with a nervous tremour; their bright eyes 

become sun ken an d dilated, and, in fact, 

th rough a cause of either willfu l neglect or 

gross mal-practice, brought down within a 

short period of time from the hea lth, and 

buoyancy, and joyousness of youth, to a 

premature grave,SI 

T he dragoons were already six weeks behind schedule when they fin ally set out 

from Fort G ibson on 15 June to bring peace 

treati es ready for signing to the villages of 

the Pawnee and Comanche Indians near 

the headwaters of the Red Ri ver. Sickness 

caused 68 of the expedition's 588 men to 

be left behind at Fort Gibson. As the dragoons left th e post , tempera tures were 

climbing toward lOS' F. even in the shade. 

As an offi cer descri bed it, 

Nature would seem to have conspired with 

an imbecile military administration for the 

destructi on of the regiment. On, on they 

marched, ove r the parched pla ins whence 

all moisture had shrun k, as from the touch 

of fi re; thei r martial pomp and show dwin- dled to a dusty speck in the midst of a 

boundless plain; disease and death struck 

them as they moved; with the false mirage 

ever in view, with glassy eyes, a nd parched 

tongues, th ey seemed upon a sea of fire . 

They marched on, leav ing three-fourths of 

their number stretched by disease in many 

sick camps; then, not only destitute of 

every comfort, but exposed with burning 

$I Jamcs Hildreth . Dragoon Campaigns to Ihe Rocky 

M Ollntains: Being a H islOry o/Ilte Ellfisfmelll. Organization. al/d First Campaigns o/the Regimel1l o/Unired 

SlaleJ IJragoons (Wiley & Long, 1836. Reprint. New 

York: Arno Press. 1973), pp. 11 5- 16. 

49 

fevers to the horrors of unnatural heat-it 

was the death of hope. 

In the heat even the horses and mules fell 

sick and died. General Leavenworth himself was fatally injured when his horse fell 

during a buffalo hunt. Fewer than 200 men 

actually reached their goal at the Indian 

villages and one of the assistant surgeons 

left behind with patients at a sick camp was 

extremely ill himself by the time the returning troops reached him" 

In early August, as the dragoons began 

thei r return to Fort Gibson, the sick list 

continued to grow. One soldier wrote, "The 

sickness is now becoming verry [sic] alarmi ng as we have a great many deaths every 

day." Four or five died daily, and the mortality rate averaged 21 percent. The cause 

of th e ir sufferings, according to artist 

George Catlin, who accompanied the expedition, was fevers " of a bilious nature, 

and contracted by exposure to the sun, and 

the impurity of the water," among which 

could have been hepatitis and typhoid fever 

as well as mala ria ' ) 

The dragoons were ordered out from 

Fort Gibson on another expedition shortly 

aft er their return, but from 140 to 150 men 

were still too sick to march; 3 to 4 died 

each day. It was hard to say which was 

worse, the fort or the road , since a high rate 

of disease characterized both. In the summer of 1835, Fort Gi bson was described as 

" the worst and without doubt the hottest 

and most unhealthy in the U. States," 

where the families of the men were constantly sick and the quarters of the men 

themselves rotten, leaking, and crowded. 

nphilip St. George Cooke, Scenes, p. 225. 

HFirsl Quote, "The Journal of Hugh Evans. Covering the First and Second Campaigns of the United 

States Dragoon Regiment in 1834 and 1835: Campaign of 1834," Chronicles of Oklahoma 3 ( 1925):2 15; 

second from "Lett ers of Geo Catlin, 13 June and Sept 

1834," in Hildreth, Dragoon Campaigns, p. 187. 
50 T HE ARMY MEDICA L DEPARTMENT. 18 18- 1865 

From 18 25 to 1835, accord ing to o ne 

source at the time, 500 men died at Fort 

Gibson, and in the fall of 1835, 4 of every 

6 orticers were sick, as was the assistant 

surgeon. The surgeon had repo rtedl y been 

overheard to state that there had been 600 

cases of illness at the fort in the quarter 

ending 30 September 1835. By the earl y 

months of 1836, the commanding general 

of the Army was strongly urging the abandonment of the fort. In th e summer of 

1836, howeve r, it was still in use, too sickly 

to occupy yet too strategic to desert." 

The Black Hawk War 

In 1832 men and surgeons from many 

Army posts joined the successful campaign 

to prevent the return of members of the Sac 

and Fox tribes led by Black Hawk to their 

former la nds east of the Mississippi. To 

meet this threat, the secretary of war ordered 200 men from Jefferson Barracks, 

near 51. Louis, M issouri , to move north, 

and 1,000 men stationed in the east to 

move west via the G reat Lakes under Maj. 

Gen. Winfield Scott. Still more men came 

in from Fort Leavenworth and were joined 

by others from Forts Winnebago and Crawford in modern Wisconsin. 

Surgeon General Lovell ordered one of 

his surgeons, Josiah Everett, to leave his 

post at Fort Monroe, Virginia, to serve as 

medical director for General Scott's men 

and sent other Army physicians to join him 

from such posts as New Orleans, Baton 

Rouge, and Forts Niagara and Gratiot. 

Ot hers were called back from furloughs to 

meet the need. Surgeon Thomas Mower, 

handling medical supply in New York Cit y, 

was warned to be ready to supply the needs 

of surgeons ordered to the front and to preS4Army and NallY Chronicle 1 (1835):279.357, 397, 

quote from 279. 

pare, in additi on, "a full supply of med icines. Hospital Stores Dressings and Bedding for 1,000 men acco rding to th e supply 

table, with such addition to the essential 

medicines and to the dressings as yo u thi nk 

adv isable for acti ve service." By 20 June 

sixteen Army surgeons had bee n ordered 

to the Northwest fronti er, their specific assignments being left in the hand s of the 

commanders in the fi eld ." 

The rea l e nemy th ese surgeons soo n 

fa ced, howeve r, was not Black Hawk and 

his warriors, but cholera. In the two battles 

fou ght with the Indians, regular troops suffered onl y minor losses, but cholera, moving west, first with General Scott's men and 

then with those who came into co ntact with 

them, overwhelmed the su rgeons and decimated the forces they served. " 

The first man reported to have contracted cholera in the Army appea rs to have 

been a passenger on the transport /-Iellry 

Clay. After he became ill on 4 Jul y when 

the ship was near Detroit, because of the 

disease on board, city authorities refu sed 

to permit the men on the Henry Clay to 

la nd. Two men from an eighty-man arti llery unit that had landed a day earli er came 

brieny on board, however, and both men 

died three days later of cholera. By the evening of the same day, fi ve more cases had 

appea red among the artillerymen. 

T he /-I en ry Clay anchored two miles 

above the city, and Surgeon Everett. who 

had traveled with General Scott on th e 

Sheldon Thompson, a vessel that had previously ca rried cholera-infected immiHQUOIC from Ltr, Lovell to Thomas Mower ( 16 Jun 

1832), RG 112, entry 2. 5:378: LLrs, Lovell to Sec War 

(10 and 20 JUIl 1832) and to J. Everett (22 lun 1832), 

all in RG 112. entr y 2. 5:375. 38 1, and 382, 

respec ti vely. 

Unlcss otherwise indicated. mat erial on the effects 

of cholera in the Black Hawk War is based on John 

Sharpe Chambers. Tlte COllqlles/ of Cllolera .. . (New 

York: Macmi llan Co .. 1938). 
LAYING THE FOUN DATION , 1818-1835 

grants from Montreal to Niaga ra, joined 

Robert Kerr, th e assistant su rgeon on the 

Henry Clay. The number of cases rapi dly 

multiplied. and Everett warned that all on 

board might die if they we re not landed. 

At last the men were put ashore near Fo rt 

Gratiot and tents and beds set up, and a 

large barn was ta ken over for use as a hospital. Some men ned the camp in total terror not long after landing, onl y to die in 

the nearby woods, where wo lves waited to 

devour their bodies. Thirty-nine perished 

in camp, Everett among them. Despite 

Kerr's unnagging efforts, by 10 Jul y, between disease and desertion, a detachment 

of 400 men had been reduced to 150. Although Scott's men had not been taken into 

Fort Gratiot itself, cholera began to appear 

among the men of th e garrison, and by 14 

Jul y, despite the best efforts of assistant 

surgeon Hen ry Steinecke, 21 inhabitants of 

the fort had died." 

On boa rd the She/doli ThompsolI, cholera 

did not appear until after a stop at Fort 

Gratiot, where some of her passengers were 

put ashore because of seriou s overcrowdi ng 

on board. On 8 July she stopped at Fort 

Mackinac and left off four more who were 

sick. She then proceeded to Fort Dearborn, 

at Chicago, where three passengers died , 

their illness not immediately recognized as 

cholera. The day after th e ship left Fort 

Mackinac, more passengers fe ll ill, and the 

diagnosis of cholera became unavo idable. 

By the time th e ship reached Chicago on 

10 July, seventy-seven cases of cholera had 

been identifi ed. Fo rt Dearborn was quickl y 

!7Jamcs M. Phalen, "The Cholera Epidemic During 

the Black Hawk War," MilifllrySlIIgeoll 83 ( 1938):454. 

456: Niles' Weekly J?egis/el' 42 (1832):391: Ltrs .. John 

Norvell to Robert Morris (1 2 Jul 1832), in Niles ' 

Weekl.v Register 42 (28 Jul [832):390-9 1: A. Walker 

to R. C. Bri stal (30 Oct 1860). in John Wentworth. 

Early Chicago: ForI Dearbom (Chi cago: George 1-1 . 

Fergus, 188 1), p. 12. 

51 

conve rted into a hospital and its ga rrison 

ordered to pitch camp several mil es away. 

While his men we re being ca red for by two 

assistant su rgeons, General Scott warned 

all comers away from the fort in order to 

preven t the spread of the disease to troops 

actuall y engaged in fi ghting. At the fort , 

however, 200 men had been taken into the 

hospital in the space of a week, and 58 

died s, 

An increasing number of men from the 

artillery unit that arri ved at Detroit earl y 

in Jul y were becom ing ill, and the city authorities finall y insisted that they, too , 

leave the immediate area. On 9 July these 

men were moved to a site about thirteen 

miles from Fort Gratiot. The vessel that 

had brought them pi cked up the men General Scott had left behind, all of whom still 

appeared hea lth y, and continued on toward 

Fort Mackinac. The artillerymen, meanwhile, were moved once again to a spot 

three miles from Detroit. By 12 Jul y, 17 or 

18 of them were dead, and before the epiderr.ic abated, 21 had died and 4 dese rted. 

I n August 1832 a newspaper reported that 

of a total of 850 men who had left Buffalo 

to join the fight against Black Hawk, only 

200 remained strong enough to participate 

in military operations. 59 

General Scott fin ally arrived at Fort 

Crawford , at Pra iri e du Chien in Wisconsin, fi ve days aft er the last successful battle 

aga inst Black Hawk, to assume command. 

The wounded from the campaign were left 

at Fort Crawford while, in late Jul y, the rest 

of the army moved on to Fort Armstrong, 

at Rock Island in present-day Michigan, 

with cholera following in their footsteps. 

Within fi ve days in late August, the dread 

For )', C lill/(I/(', pp. 32 1- 22; Ltr, Robert McMillan 

10 Lovell (24 Jul 1832), RG 112. entry 12. 

!"Ltr. Norvell to Morris (12 Jul 1832), in Niles' 

Week!.)1 Register 42 (28 lui 1832):390- 91 ; see also 

Niles' Weekly Regisrer 42 (II Aug 1832):423. 
52 THE ARMY MEDICA L DEPARTMENT, 1818- 1865 

disease struck; 146 of about 300 men at 

Fort Armstrong fell ill, and 26 died. Among 

the dead was another Army doctor, but 

Surgeon Clement Finley and two assistant 

surgeons continued to care for those who 

fell ill.'" 

The entire fort at Rock Island soon resembled a hospital; deaths occurred so rapidly that no time was available to dig 

indi vidual graves. Bodies were " thrown 

co nfused ly-just as they died , with or 

without the usual dress-into trenches, 

where a worki ng party was in consta nt attendance; and it is a fact that an offi cer in 

charge of it, making inquiry as to some delay on one occasion, was answered that 

there was a man who was moving, and they 

were waiting for him to die."61 

Sometimes with the unwitting aid of the 

veterans of the Black Hawk War, cholera 

then spread to other forts across the nation 

in 1832 and 1833. Baton Rouge was spared 

until 1833, when 8 died from this disease. 

In the third quarter of 1833 there were 150 

cholera cases at Fo rt G ibson , with 16 

deaths. The to ll taken in the Army in 1832 

6OPhalen, "Cholera Epidemic:' p. 455; Mililllry and 

NaI'al Magazine 1 :332. 

61Cookc, Scenes. p. 193. 

alone, however, was 686 cases with 19 1 

deaths; and there was a possibility that 

some cases had not been reported or were 

misdi agnosed. 

The impact of chole ra was far greater 

than that of the Black Hawk War that had 

helped to spread it. The best efforts of both 

Lovell and the Army's surgeons were of no 

ava il in the face of a devastating disease 

that the ph ysicians of the peri od were powerless to prevent or cure and of the widespread panic it caused. 

Conclusion 

Nevertheless, Lovell's unceasing effort to 

improve the number and caliber of the surgeons in his Department, to regulate the 

Department's expenditures, and to gua rd 

the health of the nati on's soldi ers had begun to show positi ve results. Although preve nti o n and c ur e remai ned often 

impossible, better care brought a death rate 

among the nati on's soldiers that compared 

favorabl y wi th that among young men in 

the civilian population . The consequences 

of Lovell's work became clearer when the 

Army was called upon to meet its first prolonged challenge since the War of 1812, the 

Second Seminole War of 1835- 1842. 
CHAPTER 3 

Indian Removal in the Southeast: 

The Second Seminole War 

The growing determination of both state 

and federal governments to remove the 

Creeks, Cherokees, Choctaws, Chickasaws, 

and Seminoles to new lands west of the 

Mississippi encountered varyi ng degrees of 

resistance from the members of these Five 

Civi li zed Tribes. Eve n before 1818 th e 

pressures brought to bear upon them had 

induced some groups to undertake the long 

journey to a land inhabited by unfamiliar 

and hostile Indians. Others had delayed, 

hoping that they would never actually have 

to leave, but by December 1835 representatives of all five tribes had officially committed their peoples to the move west, and 

the Choctaws had already completed their 

emigration to lands beyond the Mississi ppi . In the years that followed , except for 

many members of the Seminole tribe and, 

to a lesser degree, of the Creek, even the 

most reluctant of the forced migrants left 

the lands of their forefathers without viole nt resista nce to follow th e long and 

wretched trai l to th e western territories.' 

New Leadership for the Medical 

Department 

The struggle to remove the Cree ks and, 

above all , the Seminoles, from their eastern 

lGracc Steele Woodward, The Cherokees (Norman: 

Uni versit y or Ok lahoma Press, 196 3), pp. 13 1, 

158-59, 161 , 174-75, 190, 195; Prucha, Sword, p. 258. 

homes brought large numbers of soldiers 

into an area where malaria would prove to 

be the most dangerous enemy. Its inroads 

placed a great strain on the Medical Department, but just as the magnitude of the 

problem was becoming obvious and when 

the conflict was less than a year old, Surgeon General Lovell died. His successor, 

the Department's senior su rgeon, Thomas 

Lawson, was neither as talented a physician 

nor as level-headed an administrator. 

Lawson was already familiar with the situati on in the southeast, however. " More 

soldier than doctor," he had served as a 

li eutenant colonel with a Louisiana volunteer unit in the early months of the war, 

resuming his medical duties as the department's seni or surgeon in March 1836. He 

had served as temporary head of the general hospital at Tampa Bay, Florida, in 

April, in May joining the troops at Fort 

Mitchell, Alabama, who would be sent to 

Florida when they were no longer needed 

to enforce Creek emigration. When Lovell 

died in the fall of 1836, Lawson was serving 

as medical director for the units fighting 

the Seminoles. Not eager to take up his duti es as surgeon general, he remained in 

Florida for several months before traveling 

to Washington to escort retiring President 

Andrew Jackson to his home in Tennessee. 

He remained in Tennessee a short while 

before returning to Washington, but soon 

left once again for Florida, abandon ing his 
54 THE ARMY MEDICAL DEPARTMENT, 1818-1 865 

EUGENE ABADIE. (Collrtesy of National Library of Medicine.) 

medical responsibilities in favor of the 

command of a volunteer unit late in 1837 

or early in 1838. 2 

Lawson reta ined the overall organization 

of the Medical Department that Lovell had 

created, but his direction of the Department's work in Florida soo n demonstrated 

that he was a different man from his pred2Quote from Percy Moreau Ashburn, If History of 

lite II;Jedica/ Department of the United Stales Army 

(Boston: Houghton Mimin Co., 1929). p. 66; U.S. War 

Department, Proceedings 0/ fhe l'vlilirar.l' COllrl of 111-

quiry ill fhe Case of lvlajor Gel/era! SCOIl alld Major 

General Gaines (n.p. , n.d.), pp. 224, 469; Ltrs, Lovell 

to Lawson (26 May and 23 Sep 1836) and Benjamin 

King to Lawson (3 Nov 1836) and to Thomas Lee 

(28 Feb 1837), all in RG 112, entry 2, 7:460 and 8:53. 

89, and 243, respecti vely; Macomb to Lawson (20 Sep 

1837) and Smith to Lawson (6 Mar 1838), both in 

Lawson Papers, LC; Lawson to King (28 Mar 1837). 

in Benjamin King Papers. LC. 

ecessor. Throughout his years as su rgeo n 

general , Lawson's occasional temperamenta l outbursts suggested that time had 

neither thickened his skin nor lengthened 

his temper si nce his days on the frontier. 

Apparently convinced that the best defense 

was a strong offense and ever jealous of his 

own authority, he did not suffer criticism 

or frustration lightly. 

Removal oj lhe Creeks 

Lovell was still surgeo n genera l, however, 

when President Jackson decided that it was 

necessa ry to move Army units into Georgia, Alabama , and Florida to force the removal of the Seminoles and Creeks, a step 

that had the added effect of intimidating 

the most reluctant members of the other 

three tribes. Although the Creeks put up 

less resistance to removal than the Seminoles, the possibility of wholesale acti ve resistance caused the Army to order sixteen 

companies of regular troops from a rtillery 

and infantry regiments, more than 1,000 

men, south by mid- 1836 to assist over 

9,000 state troops in rounding up the reluctant members of this tribe in preparation for their removal. In the co urse of the 

following six months, over 14,000 Cree ks 

left the area under Army escort.' 

The Medical Department provided medical supplies for some of those go ing west, 

including the Cherokees, Choctaws, and 

Chickasaws, for which it was reimbursed 

from a specia l fund by the " Indian department," and medical officers also vaccinated la rge groups from the various tribes 

for smallpox. At least one Army surgeo n, 

Eugene Abadie, was sent with the Creeks 

and specifically designated " Surgeon to 

Emigrating Indians" although, except for 

JAmericall Slale Papers: Military A.Dl/irs 7: 115: Prucha, Sword, p. 260. 
INDIA N REMOVAL IN THE SOUTHEAST 55 

surgeo ns assigned to Army escorts, ph ysicians accompanying groups of migrating 

Indians were apparently usually civilians. 

Abadie reported that many Indians fell sick 

during their march, fevers, dysentery, and 

diarrhea being the most common ills, and 

that many died , especially the very old and 

th e very young. Abadie appears to have left 

the Creeks shortly after their arrival in the 

West, for he was at Fort Brooke, Florida, 

in August 1837.' 

Some of those whose dut y it was to assist 

in the removal of the members of these 

tribes were well aware of the traged y involved. Although he was not assigned to 

accompany the Creeks as they moved west, 

Assistant Surgeon Jacob Rhett Motte, who 

was then attached to one of the artillery 

units in the territory of the Creeks, st udied 

their language and learned to respect them 

as a people. He watched at least 500 Creeks 

being brought in chains to Fort Mitchell , 

Alabama, and deplored the 

melanchoiy spectacle as these proud monarchs of the soil were marched off from 

their native land to a distant country, 

which to their anticipations presented all 

the horrors of the infernal regions. There 

were several who committed suicide rather 

than endure the so rrow of leaving the spot 

4QUotcs from Ltrs, Lawson to T. H . Crawford 

(24 Jan 1839), RG I [2, entry 2, 10: 107, and Eugene 

Abadie to (George?] Gi bson (20 Oct 1836), in Grant 

Foreman, Indial/ Remol'Q/: The £l1Iigralioll oflhe Five 

C;I'ilized 1i'ibes of Indians (Norman: Universit y of 

Oklahoma Press, 1932), p. 156; Ltrs, Lawson to Aba~ 

die (3 Aug 1837) and Benjamin King to Joel Martin 

(26 Apr 1838), both in RG 112, entry 2, 8:432 and 

9:238 , re spective ly; Craw ford to Lawson (26 Jan 

1837), Martin to Lawson (4 Jan and 21 Oct 1838). and 

J. Walker to Lawson ( 18 and 31 Dec 184 1), all in RG 

11 2, entry 12; Foreman, Remol'(t/, p. lOOn; Prucha, 

Sword, pp.260-6 1; R. Palmer Howard, "Cherokee 

History to 1840; A M edical View," }OItrlwl oflhe OklaIwow lvledical Associatioll 63 ( 1970):77; Americal/ 

State Papers: IHililar), A.Ullirs 7: 15; Woodward, Cherokees. pp. 196, 200, 208. 

where rested the bones of their ancestors. 

The failure of his attempt to escape 

the round-up drove one wa rrior to self- destruction; the fact that the only weapon 

at his disposal was an extremely dull knife 

did not deter him. With it he made several 

ineffectual efforts to cut his throat, but it 

not proving sharp enough, he with both 

hands forced it into his chest over the 

breast bone, and his successive violent 

thrusts succeeded in dividing the ma in artery, when he bled to death.' 

The troops based at Fort Mitchell during 

the Creek removal suffered primarily from 

dy se nt e ry and diarrhea , which Motte 

blamed on " the rotten limestone water of 

the country." The sick were sheltered in 

two small buildings, each with a ten-footwide piazza shading it from the summer's 

sun. Both structures were in poor condition, with split Ooor boards a nd rooms 

without ce ilings. Neither had bee n intended to serve as a hospital, but the building constructed for this purpose was on 

private land and had been taken over as a 

home, apparently by the family owning the 

land. The diseases endured by the men who 

came to the fac ility were, for the most part, 

fev e rs, probably malarial , and , in hot 

weather, diarrhea and dysentery. An epidemic of measles broke out in the fall of 

1836, and the surgeon was occasionally 

called upon to treat the victims of delirium 

tremens or even of poison ivy. By the summer of 1836 the facility was serving as a 

general hospital, taking in both Regular 

Army patients from the garrison and men 

from the Alabama volunteers, recently 

sJacob Rhett Motte, JOl/rney II/to Wilderness: All 

Army SlIrgeol/'s Accol/I/{ of Ufe ill Camp alld Field 

During the Creek and Seminole H"ars 1836-1838, ed. 

Janus F. Sunderman (Gainesville: University of Florida Press, 1953), pp. 4, 19- 20, 27, quote from p. 20. 
56 TH E ARMY MEDICAL DEPARTMENT, 1818- 1865 

back from Florida and the war against the 

Seminoles.

6 

Character oj the Second Seminole War 

A brief show of strength served to eliminate Creek resistance, but an increasing 

number of attacks on white famili es and 

ambushes of small Army units emphasized 

the determination of the Seminoles never 

to leave thei r homes. I n the last weeks of 

1835, the contli ct erupted into open warfare. In the guerrilla struggle that fo llowed, 

Army regulars and members of various 

state units sent to subdue the Seminoles 

fought in an unfamiliar and da ngerous 

land, " healthy in winter but sickly in summer; . . . a most hideous region," where insec ts a nd bac te ri a a like throve a nd 

multiplied.' 

The growing threat from the Seminoles 

caused the Army to establish two new posts 

in peninsular Florida, Fort King nea r today's Ocala and Fo rt Brooke on Tampa 

Bay. (M ap 2) In 1834 both were reinforced. 

By late 1835 six companies of regulars were 

stati o ned at Fort Kin g, th ree a t Fort 

Brooke, one at SI. Augustine, and one at 

Key West, for a total of over 500 men and 

offi cers. No Regular Army surgeon was 

available for Key West, where a contract 

with a civilian doctor had already become 

6Quote from Motte, Journey, p. 34; Surgeon's Quarterly Rpts, Ft. Mitchell (30 Sep, 31 Dec 1836 and 

3 1 Mar, 30 1un, and 30 Sep 1837), and Ltrs. Madison 

Mills to Love ll (6 Nov 1835), all in RG 94, entry 634; 

Llrt Leonard McPhail to Lawson (2 Jul 1847), RG 

11 2, entry 12. 

'Quote from M otte, Journey, p. 199; Ltrs, Benjamin 

Ki ng to J. Martin (26 Apr 1838) and Lawson to Crawford (24 Jan 1839), both in RG 11 2, entry 2, 9:236 

and 10 : 107, respec tive ly; Crawfo rd to Lawso n 

(26 June 1837), Martin to Lawson (4 Jan, 30 Mar, and 

21 Oct 1838), and J. Walker to Lawson ( 18 and 31 

Dec 1841), all in RG 112, entry 12; War Department, 

Seminole Hostilities: lvlessage From Ihe Presidelll o/Ihe United Siaies (n.p., n.d.), p. 234. 

necessary, and a second assistant surgeon 

had been ordered to Fo rt Brooke.' 

The open hostility of the Seminoles who 

resisted removal came to a head on 28 

December 1835, when all but 3 of a 11 0-

m a n d e t a c hm e nt le d b y Bv!. Maj. 

Francis L. Dade were kill ed in an ambush 

not fa r from Fort King. Among the dead 

was the medical offi cer with the detachment, Assistant Surgeon John S. Gatlin, 

who thereby became the Medical Department's first casualty in the Semi nole War, 

and the only surgeon lost to enemy action. 

The Army's response to the Dade Massacre developed into a full-scale military 

campa ign to force the Seminoles to cease 

their violence and agree once agai n to removal. For the first fi ve years of a struggle 

described by one surgeon as an " inglorious, 

unthankful and hopeless war," the high incidence of feve rs and di arrhea-like diseases 

necessitated an end to active campaigning 

during the summer months. The Semi noles 

were thus able to devote the hottest months 

to planting and harvesting the crops that 

susta ined them and their famili es through 

the balance of the year. Since each of the 

four generals who came and went as overall 

commanders in Florida adopted this policy 

in turn, Seminole resistance continued. In 

1841, however, the Army placed Col. William J. Worth in command of the troops 

in Florida. Refu sing to be intimidated by 

the disease rate, Colonel Worth waged war 

throughout the summer aga inst Seminole 

homes, crops, and warriors and in a year 

'Lt rs, Lovell to Heiske ll (25 Sep 1835) and to B. 

Alvord (29 Dec 1835), both in RG 112, entry 2, 7:264 

and 334, respecti vely; Woodward, Cherokees. p. 16 1; 

Prucha, SlI'ord. pp. 273- 74. U nless o therwise indicated, all mate ri al o n the Seminoles and the Second 

Semino le War is based upon Jo hn K. Mahon, History 

0/ the Second Seminole War, 1835- 1842 (Gainesville: 

Universit y o f Flo rida Press, 1967), and Jo hn T. Sprague, The Origin, Progress. and COllc/usion a/the Florida 

War (Gainesville: Uni versit y of Flo rida Press. 1964), 
MAP 2 

I 

~ Camp Townshend ... 

---- ~ ----~o. 

Newnansville • 

Micanopy 

• 

. Cedar Key·O, 

Fort Drane ... 

Fort 

Clinch ..... ... ~ I"orl King 

S 

.-

'6 

o 

Fort ~ Dade <II 

.. " 

ou\} .------- -'P 

00' y..i\\S "'Fort Foster 

"'Fort 

Brooke 

Charlotte 

THE SEMINOLE WAR 

1835-1842 

a 100 , 

Miles 

Fort 

Jupiter'" 

Fort 

Lauderdale 

ey Biscayne 
58 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

D ADE M ASSACRE by James Hlilchinson. (Ph olOgraph by Mark Driscoll, courtesy of the 

Museum of Florida I-lislOry, Tallahassee, Florida.) 

brought the survivors of that tribe to the 

point where they could no longer continue 

their struggle.' 

The connict with the Seminoles was responsible for almost 1,200 of the 1,500 

deaths occurring in the Army between mid1835 and the summer of 1842. More than 

75 percent of the military deaths in Florida, an average of 15 each month, resulted 

from disease. From 1835 through 1839, an 

average of almost 19 percent were sick at 

anyone time. The disease rate increased 

when campaigning was continued through9Quote from Llr, Nathan Jarvis to Benjamin Jarvis 

(6 Sep 1839), in Jarv is Papers; Thomas Sidney Jesup. 

Seminole Saga; The Jesllp Report (FI. Myers Beach, 

Fla.: Island Press, 1973). p. 12. 

out the summer. From I June 184 1 to 28 

February 1842, for example, 5,000 men 

suffered almost 16,000 cases of d isease, 

nearl y 2,200 in June alone. Army surgeo ns 

treated an additional 2,428 in July, over 

2,000 in August, and more than 1,800 in 

September 184 1. An average of 26 men 

died each month during the nine months 

beginning in June 1841 , a rate almost twice 

that for the entire war. Ten of the medica l 

officers who served in Florida lost their 

li ves as a result or the war, but onl y Gatlin 's 

death came at the hands orthe Semino les.1O 

I°Ltrs. Hciskel to R. Jones ( 15 lun (842), RG 11 2. 

ent ry 2, 13:415; Benjamin Harney to Lawson (2 lUll 

184 1), RG 11 2. entry 12: SUlfislical Report 1819-39. 

pp. 306, 315. 
INDIAN REMOVAL IN THE SOUTHEAST 59 

Assignmel1l 0/ SlIIgeons 

Despite the ~1c t that many tribes were 

being disp laced by the whi te man in decades that preceded th e Civil War, only the 

struggle against the Seminoles developed 

into a major war. Since it was, even so, a 

guerri ll a war, the requirement fo r physicians was greater than it would have been 

had a simila r number of men been engaged 

in conventiona l wa rfare. The many small 

units co ndu cting operations in Florida 

could not easily share surgeons, isolated as 

they often were by distance, the primitive 

terrain , and the enemy's skill at attack from 

ambush. The high rate of disease made it 

difficu lt for a unit to go long without a physician. Alt hough th e organization of the 

Medical Department was basicall y suited 

to this type of wa rfare , its size was not; the 

number of available surgeons was not ul~ 

fi cient to permit one to accompany each 

separate detachmen t at a ll times. In the attempt to meet the need , some medica l offi cers were called upon not only to move 

abo ut wi th one detachment but also to 

change from one unit or post to another at 

short interva ls. 

To gain maximum advantage from the 

nex ibility he had introduced into the department's structure in 1818, Surgeon General Lovell decided that the senior surgeon 

assigned to Florida should serve as med ical 

director. This officer could move the surgeo ns under him from one position to another at the direction of the commanding 

general without prior consultat ion with th e 

surgeon general and req uire th e surgeon or 

assistant surgeon at a supp ly depot to serve 

as purveyor. As a result, the more routine 

requirements of the war co uld be ma naged 

qu ickly and efficiently. II 

"Llr. Lawson to Edward Macomb (19 Oct 1840), 

RG 11 2. entry 2. 12:86. 

LYMAN FOOT. (Collrtesy of National Library of Medicine.) 

Nevertheless the shortage of physicians 

was increasingly irritating to Lawson when 

he became surgeo n general. To the secretary of war in 1839 he bristled, "Nowa days 

an officer cannot march eight miles with a 

Sergeants Guard without having a Surgeon 

attached to his Command, in other words 

witho ut his own special staff." In 1840 he 

lashed out at Lyman Foot, then the medical 

d irector in Florida, apparen tl y because 

Foot, in letting surgeons leave after only 

two years of service, was add ing to Lawso n's difficulties in providing adequate 

medica l support. Lawson brushed aside 

Foot's statement that he understood that 

two-year assignments were official policy, 

and accused Foot of being concerned only 

with popUlarity. When, a few months later, 

the general then commanding in Florida 
60 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

publicly and wholeheartedly praised Foot's 

work, Lawson raged at what he said was 

interference with his management of his 

department." 

Although well aware of the difficulti es he 

faced, Lawson, like Lovell, used every resource at his command to bring adequate 

ca re to all who fell ill or were wounded. As 

early as April 1836, Lovell was able to state 

that "every disposable offi cer of the Department" had been assigned to duty in 

Florida, but more were almost conti nually 

being requested. When, early in 1837, Maj. 

Gen. Thomas S. Jesup, then commanding 

the effort against the Seminoles, added 

crewmen from a naval squadron to his 

force, he made a Navy surgeon his medical 

director, apparently because not enough 

Army medical offi cers in Florida had the 

rank of full surgeon. In this capacity, John 

A. Kearney was stationed at Fo rt Brooke 

much of the spring of 1837." 

Even with help from the U.S. Navy, the 

shortage of medi cal offi cers rema ined 

acute. In May 1837 a surgeon wrote Lawson that Jesup had ordered that the surgeon 

general be informed of the " destitute cond ition of the Medical Department in this 

country," where half the nation's army was 

being cared for by only a sixth of the department's surgeons, many of whom were 

IlQuote fro m Ur, Lawson to Sec War (9 Mar 1839), 

RG 112, entry 2, 10:197; Ltrs, Benjamin Ki ng to J. 

H. Chambers (26 Nov 1836) and Lawson to Dc Camp 

(23 Aug 1838), to Lyman Foot (5 Dec 1840), and to 

Jones (6 May 184 1), all in RG 112, entry 2, 8:120, 

9:408, and 12: 196 and 4 16- 17, respectively; Foot to 

Lawson (8 Sep 1840), RG 11 2, entry 12. 

llQuote from Ltr, Lovell to Edwa rd Wo rrell (4 Apr 

1836), RG 112, entry 2, 7:410; Ltrs, Lovell to Joseph 

Eaton (17 Aug 1836), Benjamin King to John Kearney 

(24 Mar 1837), and Lawson to Kearney ( 16 May and 

2 Jun 1837), all in RG 112, entry 2, 8:16, 276,347, 

and 370-7 1, respective ly; Kearney to AG (9 May 

1837), RG 112, entry 12; Thomas Jesup to R. Jones 

(7 Feb 1837), in Sprague, Florida War, p. 173. 

themselves ill. According to Lawson, Kearney added his complaint that there was 

" not a medical offi cer of the fi rst grade in 

Florida." In December 1839, by which time 

disease had already ki lled three of his physicians, Lawson confessed that he could not 

meet the demands for Regular Army surgeons. By late 1839, although at least nineteen surgeons were serving in Florida, some 

were responsible fo r two or more posts. 

From the outset, therefore, the Med ical 

Department was forced to hire contract 

physicians to serve as acting assistant surgeons in Florida. Some were assigned to 

militia units there and one was orde red by 

the War Department to accompany a small 

group of Seminoles emigrating to the West 

in 1836." 

Lawson's frustration at his impotence in 

the face of the lack of manpower caused 

him to turn imperi ously upon any surgeon 

who so much as appea red to be avo iding 

duty in Florida, where little but " Pri vati ons, ha rd ships, sickness a nd murder" 

awa ited. To a surgeon who complained that 

service in Florida was bad for his "constituti on," Lawson wrote, " it will not do for 

offi cers to talk about conSlill/lions or climales . .. you have received your orders 

and must obey." To another, who had left 

Florida ma intaining that he was ill and di d 

not hasten to return, Lawson stated, " If you 

possess not the exalted sentiments of a soldi er whose pride it is to perform his duty 

with alacrity and cheerfulness, then you 

may as well un dersta nd, once for all , that 

'~Q es rrom Ltrs, Cha rl es S. Tri pIer to Lawson 

(31 May 1837), RG 112, entry 12, and Lawson to 

Kearney (2 Jun 1837), RG [ 12, entry 2, 8:370-71; 

Ltrs, Lawson to R. M. Kirby ( II Dec 1838), RG 112. 

entry 2, 10:3 1, Kea rney to AG (9 May 1837) and to 

Lawso n (3 Ju t 1837) and De Camp to Lawso n (2 Ma r 

1839), a ll in RG 112, entry 12; Wa r Depa rt ment , Seminole Hostilities, pp. 271-72; SGO, Wa r Department. 

Af/flual Reporr (6 Nov 1839), p. 14. 
INDIAN REMOVAL IN THE SOUTHEAST 61 

you will be made to do it." To assistant 

surgeon William S. King, whom he had 

accused-as he was later forced to admit, 

unjustly-of scheming to sneak out of 

Florida, Lawson's apology was princi pally 

a defense of his own conduct. The facts as 

they were known at the time, he maintained, amply justified his conclusions." 

Lawson wan ted his subordinates to see 

the war against the Seminoles not as a privation but as a golden opportunity since, 

if assignments were properly rotated, a su rgeon could gain valuable ex perience in the 

field. He wrote both the medical director 

and the commanding ge neral there, urging 

rotation. The frequent illness of surgeons 

in Florida made systematic rotation impossible, but Lawson became furious when 

they appea red to ignore his wishes. The 

medical director's suggestion that matters 

of assignment, as well as those of supply 

and the establishment of hospitals, were 

better managed by someone on the scene 

further irritated the surgeon genera l. The 

war was almost over, but the spring of 1842 

found him once again raging, this time to 

the adjutant genera l, beca use Colo nel 

Worth, then commanding in Florida, had 

ordered nine more medical officers out of 

Florida than Lawson believed wise, and 

had granted leaves of absence to othe r surgeo ns, all without consulting Lawson. " 

(lQuotes from Ltrs, Nathan Jarvis to Nathaniel Jarvis ( I Aug 1839), in Jarvis Papers, and Lawson to Stinncdc (12 Jun 183 6) and to Will iam W. Hox ton 

(29 Jan 1841), both in RG 11 2, ent ry 2, 8:376 and 

12:279, respectivel y; Ltrs, Lawson to William King 

(19 Jul and 4 Sep 1839), both in RG 11 2, entry 2, 

10:38 and 461 , respectively. It should be noted, however, that when Lawson was bUI a surgeon himself, 

he, too, complained about the effects of an unfriendly 

clime upon his constitution. Ltr, Lawson to Lovell 

(5 Oct 1824), RG 112, entry 12. 

16Ltrs, lawson to Dc Camp ( 15 May 1839), to 

Wa lker K. Armistead (20 Aug 1840), to Edward Macomb (19 Oct 1840). and to Benjamin Harney (8 Jun 

1841) and Heiskell to Sec War (21 Jun 1842), all in 

RG 11 2, entry 2, 10:211 , 11 :48 5. 12:86 and 462- 63, 

WILLIAM S. KING. (Courtesy of Nalional Library of Medicine.) 

Supply 

Except for the heavy demand for quinine, supply problems do not appear to 

have triggered Lawsonian rage. The medicines and other items that surgeons in 

Florida needed came from as far away as 

New York City, New Orleans, Charleston, 

and Savannah. The extensi ve use of steamboats in support of operations against the 

Seminoles red uced the likelihood of severe 

or prolonged shortages in spite of the unusually heavy demand caused by the high 

disease rate. But transportation problems 

within some parts of Florida slowed deliveri es inland from the principal supply 

and 13:427. respectively; Rpt, Lawson to AG (I Apr 

1842), RG 11 2, entry 12. 
62 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

depots at Palatka, SL Augustine, Tampa 

Bay, Garey's Ferry, and Cedar Key, 17 

Some minor shortages stemmed from the 

unpred ictability of the need for certai n 

med icines or stores, In the spring of 184 1, 

inroads of disease upon the men in Florida 

were apparently greater than anticipated, 

The prevalence of a mild form of scurvy in 

the Tampa Bay area in a season when the 

Subsistence Department did not issue lime 

juice mad e it necessary for the Medical Department purveyor there to order this antiscorb uti c on his ow n, Additiona l 

probl ems stemmed from th e fact th a t 

dampness spoiled many of the med icines 

packaged in paper rather than in bottles or 

canisters, On at least one occasion, surgeons discovered that a shipment of olive 

oil was polluted with linseed oiL Localized 

shortages might oblige a surgeon to try one 

depot after another. Still further minor difficu lties were caused by the discovery that 

in the climate of Florida, "comfort and 

cleanliness" di ctated that hospitals use bed 

sheets, wh ich apparently were not generally 

provided, Despite the greater demand th e 

war created for hospital supplies and medicines, however, no significant increase in 

the Department's cost per man resulted," 

Perhaps the greatest supply problem ocI7Ltrs, Lovell to Heiskell (29 Jun 1836), to Lawson 

(26 May 1836), to Richard Clark (30 Jun 1836), and 

to Hamilton Hawkins (9 Jul 1836), all in RG 11 2. en· 

try 2, 7:374, 460, 495, and 507, respectively; Lovell 

to Lawson and to Worrell (both 16 Jul 1836), both in 

RG 112, entry 2, 7:576; Benjamin King to J. P. Russell 

( 19 Jan 1837), to W. H, Shelton (23 Nov 1837), and 

to Thomas Henderson ( 11 Apr 1838) and Lawson to 

Zachary Taylor ( 18 Nov 1839) and to A. K. Parris 

( 17 Nov 1843), all in RG 112, entry 2, 8: 135, 9:57 and 

2 10, 11:73, and 14:474, respectively; Worrell to Lawson (14 Jun 1836), Dc Camp to Lawson (26 Dec 1838) 

and to D. E. Twiggs ( 15 Jan 1839), Foot to Lawson 

( 17 Aug 1840), and W. T. Leonard to Lawson (2 Aug 

1841), all in RG 11 2, entry 12. 

'IQuote from Ltr, B. M. Byrne to Lawson (2 1 May 

1841), RG 112. entry 12; Ltr, Benjamin King to Sec 

War (1 7 Ap r 1838), RG 112, entry 2, 9:219, 

curred beca use some su rgeo ns in Florida 

were begin ning to discover that quinine in 

large doses was effecti ve aga inst the paroxysms of malaria, The demand for this expensive drug was so great as to trigger 

another belligerent reaction from Lawson, 

who appa rentl y concluded that surgeons 

had become soft and frivolous, To Brig, 

Gen, Zacha ry Taylor he wrote in 1839: 

A Physician never shows to greater ad vantage than when he is operating successfull y 

with a few materials, we do not want men 

in the Army who cannot combat disease 

with success unless surrounded by every article in the materia medica ,-Our surgeons 

must learn to substitute in ex treme cases 

one medicine for a nother; finery or furbelows [ruffles] at any rate can not be tolerated in Field Hosp itals or other sick 

Station in the theatre of Wa r. " 

Lawson's attitude toward qu inine surfaced again with characteristi c vigor in 

1840, when the med ical purveyo r at Fort 

Brooke made the error of ordering a second 

supply of quinine before he had received 

the first. Lawson stated authoritatively that 

ot her " tonics" wou ld serve quite as well; 

perhaps his fai lure to reali ze that this was 

not so may again be attributed to the fact 

that he was not on the scene, He informed 

the purveyor that "the reckless use of that 

medicine to the exclusion almost of eve ry 

other Tonic" was prohibited, There is no 

indication that the problem was ever resolved, Lawson was still complaining in 

184 1, when he commented to the medical 

director: "Some years ago when the Army 

was as efficient, or had at least as high a 

character as now, the Soldiers could ", 

take Peru vian Bark , , , but nowadays they 

have become so refined and delicate of 

''1Quotc from Ltr, Lawson to Taylor (18 Nov 1839), 

RG 1 [2, entry 2, 11 :73; see also Smith, "Quinine," 

pp. 361 , 363, and Ltrs, Lawson to Sec War ( 18 lui 

1837) and to R, C. Wood (II Jul 1838), both in RG 

11 2, entry 2, 8:4 18 and 9:949, respectivel y. 
INDIAN REMOVAL IN THE SOUTHEAST 63 

stomach, that th ey can ta ke down nothing 

but ... Sulphate of Quinine as a Toni c."'o 

General l-/ospiUlls 

The locati on of man y of the general hospitals that cared for the sick and wo unded 

of the war in Florida at or near major depots to some degree eased transportati on 

problems. In these institutions, men with 

chronic ill nesses and severe wo unds, toge th e r with th e pati ent ove rOow from 

crowded post hospitals, could be cared for. 

Not long after the start of the war, this type 

of fac ility was established at Fort Brooke, 

on Tampa Bay, and in St. Augustine. At 

about the same time, a conva lescent hospital was set up at Mullet Key, southwest 

of Tampa. 

The general hospital at Fort Brooke was 

located on a hill above the Hillsborough 

River a nd surrou nded by a grove of live 

oak. It could easi ly shelter 100 patients, bu t 

it was occasionall y called on to ca re for 

twice that number. Hospital attendants 

were chosen from the units represen ted 

among the patients: a unit with 12 to 24 

patients at this faci lity wou ld provide 2 att e nd a nts; o ne with ove r 24 wo ul d 

provide 3. Men who were only slightly d isabled but not well enough to march were 

sometimes assigned to remain at the hospital to ca re fo r the more seriously ill. The 

Fort Brooke unit continued in operati on 

until 1840, when it was closed in favor of 

general hosp itals establ ished at Picolata 

and Cedar Key. Supplies that could not be 

used at Fort Brooke's post hospita l were 

20Quotes from Ltrs, lawson to John B. Porter (15 

and 2 1 A ug 1840) and Lawson to Benjamin H arney 

(8 Jun 184 1), all in RG 112, entry 2, 11 :470 and 486 

and 12:465. respectively. 

then se nt to Cedar Key if that facility could 

use them .2 1 

The sites of the genera l hospitals at Picolata and Cedar Key were considered to 

be health y and conveni ent to the line of 

forts as it existed in 1840. The medical director in Florida hoped Ihal, because of the 

good reputation of these sites, the opening 

of the two new genera l hospitals there 

would bring about a saving in expenses for 

the Medical Deparlment. The hospilal al 

Picolata on the St. Johns Ri ver was sel up, 

appa rentl y in 1837, in the upper pa rt of the 

former hOlel where troops used the basement as a barracks. The unit at Cedar Key 

opened in the summer of 1840 at a "beal/-

liji" locatio n," initia lly in a temporary 

building and some hospital lents, while the 

constructi on of the permanent buildi ng, 

160 by 30 feet and shaded by a 10-foot piazza, was underway. In Ihe aulumn of 

1842, however, a severe storm blew the new 

hospital from its fou ndations and caused 

so much destruction that the Army abandoned the island." 

The Picolata general hospital was apparen tly moved to St. Joh n's Bluff, fi ve miles 

from the mouth of the St. Johns River, 

sometime in the summer of 1841 , where it 

remained until it was closed in Ihe spring 

of 1842. The St. John 's Bluff hospital may 

have been slightl y larger Ihan the one at 

!ISurgcon's Quarterl y Rpts, Ft. Brooke (30 Jun and 

30 Sep 1837 and 31 Dec 1839), all in RG 94, entry 

634: Orders (no. 23, 9 Apr 1836), in American Stale 

Papers: Miliwry ;l.ffairs 7:267: Order (no. 21. 22 Jun 

1840): ril ed with Llr. Foot to Lawson. (16 Aug 1840) 

and Llr. Fool to Lawson (22 Ju n 1840), both in RG 

112. entry 12: Ltrs. Lawson to Lee (3 Aug 1837) and 

to A. T. Suter (30 Aug 1837), both in RG 11 2, entry 

2, 8:433 and 474, respectively; SlatisIieal Report, 

1819- 39. pp. 299, 304- 05. 

n Quotc from Ltr, Foot to Lawson ( 16 Aug 1840), 

RG 112, entry 12; Ltrs, Benjamin King to Tripier 

(17 Jan 1838), RG 11 2, entry 2, 9: 118; Foot to Lawson 

(22 Jun 1840), RG 112, entry 12; "Cam paign in Florida," Yale Literary Magazine 11 (1846):77. 
64 THE ARMY MEDICAL DEPARTMENT, 18 18-1865 

Cedar Key, although neither unit cared 

routinely for more than fifty pati ents at a 

time, 2) 

The general hospital at St. Augusti ne was 

established in the summer of 1836, initially 

in two buildings, one near the barracks a nd 

the other near the center of town, and later 

in three more. To this facility shortly after 

its opening came the sick from several 

posts in that section of Florida, particularl y 

Fort Mellon and Volusia, both temporarily 

abandoned because of the high disease rate 

that amicted their garrisons. The sick from 

Mi canopy, ma ny o ri gina ll y fro m Fort 

Drane, were also moved to St. Augusti ne 

in the belief that their chances for recovery 

at Micanopy were poor. As many as 150 

sick were gathered at the St. Augustine genera l hospita l sho rtl y a ft er its open ing, 

among them one of the survivors of the 

Dade Massacre, a man whose eventual 

death evidently resulted more from his 

heavy drinking than from wounds suffered 

in the massacre. By September 1836, 225 

pati ents shared th e hospit a l, and three 

Army physicians, assisted by a civilian acting as assistant surgeon, were busy caring 

for them. After 1836, however, the largest 

number there at anyone time apparently 

rarely exceeded 65. The facility evidently 

closed sometime during the second half of 

1838, torn in its closing weeks by controversy between surgeons and line officers 

over the acceptab ility of removing experienced men from positions as hospital stewards in order to return them to their units." 

l.ISurgeon's Quarterly Rpts (31· Mar and 30 Jun 

1841) and Consolidated Monthly Rpts, Army or Florida (Apr and Jul 184 1), all in RG 94, entry 634; sec 

also other Rpts, St. John 's Hospital ( 184 1- 42), RG 

94, entry 634. 

l4Ltrs, Lovell to Russell (20 Aug 1836), RG 112, 

entry 2, 8: 18; H. S. Hawk ins to Lovell (27 Jul and 

8 Aug 1836 and 7 Sep 1836), G. F. Turner to Hawkins 

(6 Sep 1836), and Richard Weightman to Benjamin 

King (7 Jun 1838), all in RG 112, entry 12; Surgeon's 

Not all of the seriously sick or wounded 

from the wa r were reta ined in Florida's 

ge nera l hospita ls. The Army evacuated 

many to such East Coast posts as Fort 

Monroe in Virginia or Fort Hamilton in 

New York Harbor, in the belief that a 

cha nge of climate would be particularly 

helpful for those with dysentery and recurrent fever. In the fall of 1840, patients 

whose recovery was supposedl y being retarded by the effects of the Florida climate 

were also sent to Fort Columbus, a second 

New York Harbor post. There was a risk 

that some patients who were sen t north 

might die along the way, but Medical Director Foot believed that these were men 

who would have died even if they had been 

reta ined in Florida. " 

Not all those who were evacuated were 

acti vely ill. The Florida climate was considered to be so unhealthy that in 1841 an 

entire regi ment was sent north because of 

its poor health and lack of vigor. The unit 

was dispersed a mong northern posts, 

where it was hoped that its overall hea lth 

would improve. 

Although the chronically ill and the seriously disabled were eventually sen t on to 

general hospitals or even evacuated, those 

with lesser health problems often remained 

at post hospitals until they were ready to 

rejoin their un its. At the time the Second 

Seminole War began, permanent post facilities existed at Forts Broo ke, Marion (at 

Rpts, S1. Augustine General Hospital, RG 94, ent ry 

634; N. S. Jarvis, "Notes" 39:276, 279. There are no 

reports that can definitely be attributed to the general 

hospital at 51. Augustine held in RG 94 for dates later 

than June 1838 and apparently no mention of a gen· 

eral hospital there after that date in other collections. 

lSLtrs, Lawson to Robert A rcher(27 Jul 1837), T ripIer to Russell (26 Aug 1837), and Lawson to L. R. 

Arnold (12 Sep 1837), all in RG 112, entry 2, 8:425, 

469, and 486. respecti vely; 50s, Brig Gen Armistead 

(no. 60. 18 Sep 1840) and Ltrs, Harney to Lawson 

(2 Jun 1841) and Foot to Lawson (30 Jul 184 1), all in 

RG 112, enlry 12. 
INDIAN REMOVAL IN THE SOUTHEAST 65 

St. Augustine), and King. Reports from 

Forts Marion and King at the end of 1835 

described their hospitals as satisfactory, 

and it wo uld appear that the condition of 

the Fo rt Brooke unit was also acceptable." 

The site chosen for Fort Brooke itself was 

initially reported to be healthy, and vegetables and fish were ava ilable in sufficient 

quantity for a good d iet. By the spring of 

1836, diarrhea, blamed on the water and 

its high sulfur content, and respiratory ills 

were appearing in the garrison, and among 

the volunteers, measles and mumps as well. 

At the end of April of that year, 80 of the 

802 men there were reported to be hospita lized, and the qua rterly report dated 

30 June 1836 listed 516 treated in the 

co urse of the April through June quarter, 

a time of much illness at Fort BrookeY 

In the first quarter of 1839, the garrison 

at Fort Brooke was moved to an "elevated" 

ridge where the water was considered to be 

good and the quarters comfortable. The 

hospital here would comfortably hold only 

twelve patients, but fortunately, diarrhea 

disappeared as a se rious problem after the 

move. In November, however, the water 

was aga in causing comment, and the surgeon observed that it was "either saturated 

with rotten limestone or the brackish water 

of the ri ver." Fever was the most common 

compla int, a nd he noted that " an offensive 

and most deleterious ma laria" appeared to 

characte ri ze th e a rea. Overcrowding 

quickly reappeared as a problem, and the 

" Rpt. Lovell to Sec War (28 Dec 1835). RG 112, 

entry 2. 7:340. 

u lbid.; John K . Mahon, cd., "T he Journal of A. B. 

Meek and t;.c Second Seminole War, 1836," Florida 

His/orical Quarferly 38 (1960): 309; James W. Covington, cd .. "Life at Fort Brooke, 1824- 1836." Florida 

His/orical Quarterly 36 (1957-58):32 1, 323: War Dcpartment. Proceedings, p. 339; Surgeon's Quarterly 

Rp •. Ft. Brooke (30 Jun 1836). and other quart erl y 

and monthl y Rpts, Ft. Brooke (1 835-36), RG 94, entry 634. 

surgeon had to treat many patients in their 

quarters. Although the coming of cooler 

weather caused a drop in the number of 

sick from the Fort Brooke garrison, troops 

marching north in Jan uary 1840 left twenty 

of their sick there, and the hospital remained crowded" 

The area in which Fort Marion was located was also reported to be relati vely 

health y by comparison with other southern 

posts. Since the disease rate varied widely, 

and the number of men assigned to this 

post changed often, the number hospitalized also fluctuated. Yellow feve r struck 

Fort Marion in the fall of 1839, causing 12 

deaths in the 24 cases reported in November alone, and aga in in 1841 , when 25 of 

56 cases were fata l. 29 

The site of Fort King was not as health y 

as those of Forts Brooke a nd Marion, despite its apparent beauty. "The li ve oak, 

with other species of the same genus, the 

cypress, magnolia, cabbage-tree, and several varieties of hickory, (carya), all united 

by a cordage of vines and brambles, extending from trunk to trunk and from limb 

to limb, constituting an immense net-work 

of vegetation" surrounded the post. Malaria was th e principal health problem and 

led to th e temporary evacuation of the fort 

sometime in the late spring or summer of 

1836.'0 

ir t quote. Su rgeon's Quarterly Rpt, Ft. Brooke 

(3 1 Mar 1839). RG 94, entry 634; second and third 

quotes, Surgeon's Monthl y Rpt, FI. Brooke (30 Nov 

1839), en try 634; Su rgeon's Monthl y Rpt , FI. Brooke 

(Feb 1840), RG 94, entry 634. 

Stali ical Report , 1839-55, p. 309; Su rgeo n's 

Mo nthl y Rpt, Ft. Mario n (30 Nov 1839), and Surgeon's Quarte rl y Rpts, Ft. Marion (Jun 1840 and Jun 

184 1), all in RG 94, entry 634; Rogers W. Yo ung, 

"Fort Marion During the Sem ino le War, 1835- 1842, 

.. Florida Historical Quarterly 13 (193 5): 205, 2 18. 

* Slalislica/ Report. /8 19-39, pp. 293-94, quote 

rrom p. 29 1; John Bemrose, Reminiscences o/Ihe Sec- ol/d Semil/ole War, cd. John K. Mahon (Gainesville: 

Un iversit y of Florida Press, 1966), pp. 103, 103n; 

John W. Churchman, "The Use of Quinine During 
66 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

At the start of th e Second Semi nole War, 

the hospital at Fort King was located on 

the " decli vity of a hammock abou t 40 

yards from the ba rracks and otTicers Quarters," and was constructed of "hewn logs, 

chin ked and plastered; one storey high, 35 

feet long by 20 wide." The largest of the 

building's two rooms coul d hold as many 

as six patients, and the other was used as 

a dispensary. T he entire hospital was surrounded by a piazza eight feet wide, but 

half of it had been recen tly enclosed and 

the facilit y could shelter a maximum of 

twenty patients. Attac hed to th e main 

building was a small ki tchen made of logs." 

The patient load of this fac ility was 

larger than one might expect from a garrison whose size rarely rose above 2 10. Volunteers, camp followers, and occasional 

Indians found shelter at the fort, as did the 

sick and wounded from smaller posts. In 

1840 and 184 1, patients at the Fort King 

post hospital suffering from repeated "attacks of d isease & ... ent ire ly broken 

down" were peri odicall y se nt on to the general hospital at Picolata. Although from 

October through March in the years 1838 

through 1841, their number tended to be 

less th a n six in a quart e r, from April 

through September, when diarrhea and mala ri a were common, the quarterly average 

might approach fift y. " 

Care of Ihe Sick and Wounded al a 

Temporary ForI 

T he problems posed by the sick and 

wounded at the relati vely short-li ved warthe Civil War," Jolins Hopkins Hospiw/ Bulletill 17 

( 1906):1 77; S urgeo n's Q uarte rl y Rpts, FI. Kin g 

(1837- 41), all in RG 94, entry 634. 

JI Ltr, Archer to Lovell (17 Nov 1835), RG 94, 

entry 634. 

)~ Quote fro m Surgeon's Quarterl y Rpt, Ft. King 

(JUIl 184 1), RG 94, entry 634; Surgeon's Quarte rl y 

Rpts, Ft. King (1838-41), all in RG 94, entry 634. 

time forts that appeared and disappea red 

during the course of the Second Scminole 

War (t hirty-one in 1838- 1839 a lone) were 

greater than those at the few permanent 

posts. It appea rs that when therc was a surgeon at such posts, he oft en managed wit hout the services of anything resembling a 

hospital. Eve n a t the majo r temp ora ry 

posts, facilities for the sick and wound ed 

were likely to be makeshift and less th an 

satisfactory. 

One temporary post, Fort Drane, was a 

base of ope rations for Regular Army effo rts 

aga inst the Seminoles until the summer of 

1836, when the unhealthiness of the site, 

in an area of many small ponds, forced its 

aba ndonment by regula r troops. A high 

rate of sickness characteri zed the garrison 

here from the beginning. On 28 December 

1835, whe n 250 men left the fort for th e 

battle of With lacoochee, the first major engagement of the wa r, 100 more men were 

too ill to accompany them. O n 31 December, six surgeons, two of them Regular 

Army physicians, accompanied the troops 

into action, leav ing a hosp ital surgeon behind in camp with fi ve more men, victims 

of malaria. H 

Since caring fo r the 100 casualti es at or 

near the site of the battle wo uld have been 

imprudent, as soon as their wounds had 

been dressed, the most seriously inj ured 

were placed on stretchers made of blankets 

fa stened to pine saplings. T hese litters were 

then suspended between two horses for the 

return to the relati ve safety of Fort Drane. 

Men with lesser wou nds who were unable 

to walk were moved in springless wagons 

and their "shrieks told of the great anguish" their journey caused them. T he convoy spent several nights on the road , and 

each night the able-bodied had to cut bru sh 

llBcmrosc, Reminiscences, pp. 2, 4, 35-36. 40. 43. 

48, 104n. 
IND IAN REMOVAL IN THE SOUTHEAST 67 

for beds. One night six attendan ts went off 

withou t leave, increasing the burden on 

those who remained. Wounds bega n to 

stiffen as the journey progressed, so th at 

before thc sufferers reached Fort Drane, 

their "cri es and shri eks" had become almost constanLJ-I 

The tents set up at Fort Dra ne to shelter 

the sick and wounded from the elements 

were scarcely better accommodations than 

if they had been set up in the forest. Patients lay two to a bed. Two nurses plus one 

attendant cared for every ten wounded 

while twelve coo ks prepared the di et believed necessary for proper healing. As 

soon as th e patients were settled, su rgeons 

began to probe wo und s. In recalling the 

five-ho ur ordea l, steward Joh n Bemrose, 

an Englishman of some education who left 

a va lua bl e account of his ex pe ri ences, 

wrote later that "The grinding of the knife 

through the sound nesh edged on" his 

teeth. Since Indi an rines had small bores, 

only one wound proved fatal. One patient, 

however, became obsessed with a desire for 

vengeance and begged to be shown an Ind ian sca lp. At last the desired treasu re was 

brought to him, and he burst into "antics 

of delight ... over this small portion of 

nesh belonging to a poor dead Indi an." " 

Although the number of physicians caring for the patients at Fort Drane in the 

spring of 1836 appears to have been adequate (Be rn ro se menti o ns fou r Regu lar 

Army surgeons by name and refers to a fifth 

as " the pragmatical assistant surgeon"), the 

accommodations still were not. Of the shelters ava ilable for the sick and wounded, one 

tent and a lean-to shed we re actuall y outside th e protective pickets of the fort , at 

sites considered more hea lthful than those 

.I bid. , pp. 47- 48, 51. 54, 57- 58, quotes from 

PD. 54-55. 

Hlbid" PI'. 51, 58, 61- 62, quotes frolll pp. 58, 6 1. 

ava ilable inside. Du ring a Seminole attack, 

however, musket balls pierced the walls of 

the tent, and surgeo ns had to move it to a 

safer location, even th ough it was " neither 

so pleasa nt nor so health y." Pati ents in the 

shed, which was open along one side to 

both sun and rain, were " in a deplorable 

condition."36 

As spring progressed toward summer, the 

rate of d isease increased. Half of the 274-

man garri son was sick in June, and in time 

a tota l of seven bu ildings withi n the bounds 

of Fort Drane were filled with patients. 

Conditions became deplorable for everyone. "All suffered from the malignancy of 

disease and the comfortless state in the 

fort ," wrote Bemrose. "Some were filth y in 

the extreme, others without th e necessary 

clothing." Insects of all sorts and descriptions joined them, undeterred by either 

pickets or guards. " Sand nies and mosquitoes were innumerab le .. .. Centipedes, 

cockroaches, scorpions, with immense spiders, were daily tenants of the place . . .. 

The sand of the fort was full of chigoes 

[chiggers], and a sort of black nea. This 

latter was the greatest [pest] to all of US."37 

Some of the men stationed at Fort Drane 

(where, in Bemrose's words, " the mise ry of 

so ldiering was ce rt a inly ve ry grea t") 

developed emotional problems. The everpresent fear of Indian s, who " had a 

co nstant habit of prowling around our sentinels for the purpose of picking them off," 

the exhaustion brought on by guard duty 

under these circumstances, the equall y constant danger of disease, the isolation, all 

added to the stra in on the occupants of the 

fort in the sp ring and early summer of 

1836." 

lttlbid" pp. 94- 96, quotes from p. 95. 

l7Quotes from ibid., pp. 96, 103, 104n; Ltr, Weight· 

man to Lovell (3 Jul 1836), RG 112, entry 12. 

J8Bcm rosc, Remilliscences, p. 103. 
68 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Among those for whom the pressures became intolerable was a West Point-trained 

officer who escaped what he could not endure by placing the muzzle of his pistol in 

his mouth and pulling the trigger. He "thus 

blew out his brains, hurrying his soul into 

perdition." An enlisted man was led in 

from his post, shrieking " Indi ans, Indians," to die, raving mad, " the dread of Indians being so great upon him as to affect 

his brain ." One of the fort's surgeons withstood the strain with difficulty. He became 

increasingly irritable, erupting into threats 

of physical violence, including an offer to 

"give th e stupid mortals a drubbing," 

whenever a patient gave him the smallest 

diffi culty. Although he survi ved his tour at 

Fort Drane, by the time he left, his depression had become so deep that "A conti nual 

dark hour seemed to be upon him. He ... 

passed through his multifarious cases with 

scarcely cognizance of his duty."" 

The principal health problems at Fort 

Drane, however, were not mental but physical. Surgeons used great quantiti es of quinine daily to combat the fever that afflicted 

many within the fort, often causi ng delirium and even death. Up to five might di e 

from it in the space of twenty-four hours; 

some bled from the nose in the hours immediately before their deaths. The implied 

ineffecti ve ness of quinine suggests the 

problem may have been typhoid fever. 

Among those disease killed in May was the 

fort's commanding officer, Col. Julius F. 

Heilman.,Q 

Overcrowding exacerbated the hea lth 

problems at Fort Drane in the last months 

before its evacuation in Jul y 1836 . In 

March men from voluntee r and regular 

units that had barely escaped annihilation 

)9I bid ., pp . 93-9 4 , 10 2-0 3, Qu o t es from 

pp. 93, 94, 102. 

" Ibid., pp. 94, 96-99. 

at the hands of the Seminoles in the course 

of a brief and unfortunate campaign arrived, all in poor cond ition, half starved, 

some barely able to stand, many sick or 

wounded. By the middle of that mont h, 

over 3,000 shared the protection of the 

post. The expa nsion of the fort in April and 

the repeated evacution of patients whose 

prompt recovery could not be expected alleviated some of the crowding. But for 

those leaving the fort, danger wa ited. In 

June a convoy of the sick and wou nded was 

twice attacked, ten to twelve were wounded 

and two killed. The surgeon accompanying 

the group was wounded." 

An Army Surgeon in the Field 

A majority of the Medical Department's 

surgeo ns in Florid a during the Second 

Seminole War worked without the advantages offered by general and permanent 

post hospitals. Many moved about repeatedly from temporary forts to even more 

temporary camps that rarely had facilities 

of a ny kind in whi ch patients co uld be segregated from their healthy comrades and 

kept both comfortable and safe. In Florida 

the surgeon's 

post was always th at of danger too; during 

winter, in the fi eld sharing ali ke wi th all his 

brother offi cers their fatigues, privations, 

and perils. In summer, while his fellow 

campaigners were resting from their past 

toils and dangers, in anti cipation of new 

ones the com ing win ter, ... he was pressing 

the pulse oflanguid sickness, and breathing 

the pestiferous ex halations of crowded hos- pita ls in some unhealthy "Ultima Thule" 

of the wilderness. He had but one consolation; the consciousness of doing good." 

" Ibid., pp. 77-78. 83, 96- 97. 99. 103- 04; ur, Hawkins to Lovell (27 Jul 1836), RG 112, entry 12. 

tt , JOllflley, pp. 106-08. Unless otherwise indicated, all materi al concern ing Motte's work in Florida is based on this work. 
INDIA N REMOVAL IN THE SOUTHEAST 69 

Assistant Surgeon Jacob Rhett Motte's 

expe ri ences and peregrinations in th e 

Southeast from 1836 to 1838 suggest the 

nature of the challenge faced by the Army 

surgeon assigned to that part of the country 

during the Second Seminole War. Motte 

was at Fort Mitchell , Alabama, in the early 

summer of 1836. In Jul y he was sent to 

Tuskegee to care for the men of an artillery 

battalion. Scarcely had he arrived there, 

however, when he was ordered to a camp 

fifteen miles from Tuskegee to cover for 

Surgeon Elwes, who was once agai n ill . 

Here Motte treated the victims of what he 

called typhoid fever as well as sufferers 

from dysentery. In September he was ordered to join an arti llery unit on its way to 

Fort Mitchell where forces were gathering 

to join the fight against the Seminoles. 

Here he encountered Lawson, who as medical director for the Army in the South 

prompt ly ord ered Motte to accompany 

units going to the south ern counties of 

Georgia, "a low, swampy part of the country ... [wi th] the worst possible reputation 

for health."'.! 

On the way to his new assignment, Motte 

came down with fever. When he fina ll y became too ill to ride his horse, he was placed 

in a wagon whose " thick covering," he later 

recalled, "afforded my burning brain no 

protection against the heat of the vertical 

sun in this latitude ... the constant jolting 

over rugged road s and roots of trees was 

fast driving me into a dreadful tempest of 

deliri um." At last he could go no further. 

The convoy left him at a log house ten 

miles from the Florida border, to be cared 

for by its owner. By the end of October he 

had recovered sufficiently to rejoin his unit 

in Lowndes County, Georgia, and to camp 

4J lbid .. p. 34. 

with them in a pine barren, at Camp Townshend, Georgia. 44 

Camp Townshend appears to have made 

a strong impression upon Motte; although 

he did not remain there long, he described 

it in li vely detail in his memoirs. The scenery consisted of "burned and decaying 

trees, pig-pens, pine-flats, and log-huts." By 

day he enjoyed watching " the little tadpoles and polywogs as they frisked and frolicked in the muddy pools." At night his 

"attentive neighbours the screech-owls and 

whooping cranes would commence entertain ing us in the most delicate manner, at 

the expe nse of th eir melodious voices. 

These flattering attentions, however, were 

not properly appreciated by us, owing no 

doubt to our not possessing a correct taste 

for music." The nightly forays of the pigs 

of the area, however, particularly appealed 

to Motte's dry sense of humor. 

In their comings they displayed the wisdom 

of Solomon. Not a snou t was visible before 

tatoo (tattoo) [sic]; but as soon as that signal for an exit into retiracy was completed, on they came, gr unting, snorting, and 

squeaking,-old boars, little pigs, and all; 

forming a concert of sweet sounds .... Their serenades were met on our part with 

base ingratitude; by the shade of Mozart! 

instead of listen ing to their dulcet tones 

with marked applause, and inviting them 

to partake of refreshments after such exertions, as is usual among a refined and 

serenaded people, we impolitely and ungratefull y gave the sentinels peremptory orders to expel them at the point of the 

bayonet." 

For several months after his stay at 

Camp Townshend, Motte accompanied expeditions seeking out Creek troublemakers 

in southern Georgia and northern Florida. 

In May 1837 he briefly came to rest at the 

town of Newnansville, Florida. His enjoy44Jbid., p. 40. 

4sIbid., p. 44. 
70 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

ment of the fine airs affected by th e populace of this town was not to last long, however, for in June he was ordered to Fort 

Mellon, Florida, to replace yet another sick 

su rgeon, but the health of the men at Fort 

Mellon was so bad that he could see no 

alternati ve to its abandonment, which took 

place a week after his arrival there. So 

Motte was once more on the move-but 

before he could reach his destination at 

St. Augustine, he was again sick. Leaving 

the boat that was taking the men from Fort 

Mellon north, down the St. Johns Ri ve r, 

Motte recuperated for a week on shore before resuming his journey. When he finall y 

did arrive at St. Augustine, he was immediately given orders for Fort Harlee, where 

the surgeon had fallen ill. In August, when 

he left Fort Harlee, Motte was sent to Fort 

Peyton, near St. Augustine. 

In September, an expedition was formed 

to capture some of the Indians near Fort 

Peyton, and Motte was assigned to accompany the 170-man detachment, which included two dragoon companies, an artillery 

company, and two companies of Florida 

volunteers. No casualties resulted from this 

operation, but a second shortly therea fter 

resulted in the death of an officer. By the 

time a third such foray was undertaken, 

Motte was once again sick, and another assistant surgeon at the post took his place 

with the men. 

In November Motte accompanied a detachment going south on U.S. Navy vessels 

to New Smyrna, on the east coast. While 

on the journey, Motte served as fl eet su rgeon for the crews of ten to twelve " Mackinac boats" and a sloop-rigged flagship. In 

January 1838 he was again moving south, 

this time to Fort Pierce, located on the west 

bank of the Indian River, with a dense palmetto forest at its back. When an expedition was sent up the Indian River shortly 

after his arrival, Motte was left behind. He 

was not idl e , however, for twen t y-two 

wounded from a combined Army-Navy expedition were brought in and he joi ned the 

dragoon surgeon at the post in ca ring for 

them. " 

In late January, since the dragoon surgeon was still exhausted from the long 

march from Missouri's Jefferson Barracks, 

Motte accompanied the cavalry into the 

field. He was present at a skirmish with the 

Seminoles on the shores of the Loxahatchee 

River in which Maj. Gen. Thomas S. Jesup, 

then in command of the army in Florida, 

was wounded in the face. Seven men were 

killed in this engagement a nd thirt y 

wou nded. The casualties were ca rried 

to the foot of a spreading oak, beneath 

whose widely-flung branches we re strewn 

a score of dead and dying. There before us 

lay death in his most horrible forms; bodies 

pierced with ghastly wounds, and locks begrimed with gore . In one direction, lea ning 

against a tree, there reclined a soldier of 

the Arti llery; his face pa le, and o'ersp read 

with an expression of anguish; one hand 

pressed to his side, from which the blood 

slowl y oozed . In another direction lay 

stretc hed up o n th e ground , with face 

turned upwards, and glazed eyes wide 

open, one whose marble cheek too plainly 

told that the ri fle ball which had entered 

his temple had truly done its mission; ... In one spot sat a party of wounded upon 

the ground , a surgeon binding up their 

bleeding wound s, with hasty but skilful 

hands; a little farther off, reclined one upon 

a cloak; his closed eyes, and calm smiling 

expression of features li ke that of a sleeping 

man, indicated an exemption from pain; 

true, his sufferings were over; he had go ne 

to th a t place whe re ph ysical pain is 

unknown. 47 

After the battle, Motte apparentl y returned to Fort Pierce with the wounded, 

but the rest of the force pushed southward 

~6 d .• p. 155. 

Hlbid., p. 197. 
INDIAN REMOVAL IN THE SOUTHEAST 71 

to establish Fort Jupiter in "a most hideous 

region, in which nothing but serpents and 

frogs can ex ist. The Indians themselves say 

they ca nnot li ve there after March." In February, however, Motte was also on his way 

to Fort Jupiter. He felt ill even before starting out but remained silent for fear that he 

would be left behind. Before long he again 

found himse lf suffering the tortures of 

travel in an Army ambulance wagon. When 

he reached the new post on II February 

1838, he was forced to take to his bed, one 

that consisted of a single "blanket beneath 

separating me from the bare ground, my 

saddle for a pillow to my aching head," 

with nothing " but a thin and threadbare 

old tent, of the smallest dimension to protect me from the maddening rays of the sun 

above,"48 

After two weeks of suffering, Motte was 

on the way to recovery and by the end of 

March was able to join a fifty-man dragoon 

detachment moving further south in an attempt to capture the Seminole chief known 

as Abiaka or Sam Jones. The men on this 

ex pedition reached Fort Lauderda le in 

April. Joined there by several companies 

from the artillery regiment, they proceeded 

by boat to Key Biscayne. 

For several weeks the sea rch for Abiaka 

continued, both among the islands and on 

the mainland at its sou thern tip. At last, 

however, Motte had found a part of Florida 

that appealed to him. One camp was located, for example, in an area that could, 

in Motte's opinion, 

with very little trouble be converted into a 

perfect Eden. The cocoanut, the banana, 

48First quote, Ltr, from an A rm y officer at Jupiter 

Inlet (Jan 1838), in Theodore Francis Rodenbough 

and William L. Hask in, The Army a/rhe United Slates: 

Historical Studies of SrajJ and Lille ( 1896. Reprint , 

New York: Argonaut Press for Uni versity Mi crofilms, 

1966), p. 30; second quote , Motte , JO/(I'f/ey, p. 206. 

the orange, the lime, and tamarind fl ourished around us, the spontaneous growth 

of the soil. Swarms of deer abounded in the 

forests close by; and most delicious spring 

water flowed from the rock under the bluff 

of the shore. This was indeed the land of 

flowers, and no wonder that the Seminoles 

desired to remain in a country where food 

was as plentiful, and as easily procured as 

manna by the Israelites." 

By the end of the month the food supply 

was running out, and the expedition's leaders were co nsid e rin g abandoning the 

search. One company of artillerymen was 

sent back to Tampa Bay while the dragoons 

and a regiment of artillerymen remai ned 

for one last search. Although this attempt 

to capture Abiaka also fa iled, the Army 

mistakenly believed the war to be drawing 

to an end at this time and several regiments 

were ordered north to Cherokee territory. 

Motte accompanied the I st Artillery regiment on its journey to St. Augustine and 

thence to Charleston, South Carolina. On 

16 May 1838, ajoyous Motte arrived safe ly 

at Charleston, the town of his birth. 

Motte was, of course, but one of many 

surgeons the Medical Department sent to 

Florida in the period 1835 to 1842. By June 

1842, however, Colonel Worth's relentless 

campaign was obviously bearing fruit, and 

by August the war would be officially over. 

Most of the twenty-six surgeons still in 

Florida in June were soon reassigned to 

other parts of the country, since only two 

regiments were required to watch over the 

less than 300 Seminoles who remained east 

of the Mississippi .'o 

49 lbid. , p. 229. 

S{) Ltrs, Benj. King to Martin ( 14 Apr 1838) and 

Heiskell to Jones (25 Jun 1842), both in RG 112, entry 

2, 9:214 and 13:434-35, respectivel y; Prucha, SlI'ord, 

p. 300. 
72 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

Conclusion 

The basic problems the Medical Department had encou ntered in the Southeast 

during the period from late 1835 to the 

summer of 1842 originated in factors beyond its control. The nature of the confli ct, 

whi ch in vo lved many sma ll units frequently on the move and often isolated in 

primitive terrain, and the climate, wh ich 

favored the development of both fevers and 

diseases of the digestive system, placed demands upon the small medical staff that it 

could not completely meet, especially when 

surgeons themselves were falling ill again 

and again. " 

In spite of the stress that the Second 

Seminole War placed on the Medica l Department, the confusion, the feuds, the 

shortages, and the serious inadequacies 

that had haunted both the Continenta l Army 's Hospital Department during th e 

American Revolution and the short-li ved 

U.S. Army Medical Department during the 

War of 1812 did not reappear. The permanent but fl ex ible nature of the Medical 

SlEven in Wo rld War II, after weeks of treatment 

with sizable doses of either quinine or Atabrinc, 30 

to morc than 80 percent of the victims of Plasmodium 

,,;vax suffered the relapses characteristic of chro ni c 

malari a within four months of the end of the course 

of medication: W. Paul Havens, Jr., ed.,lnfectiolls Diseases, vol. 2 of /memaf Medicine ill World War II 

(Washington: Office of the Surgeon General, Department of the Army, t963), pp. 513- 14, 532, 534, 

568-69, 583-84, 590. 

Department's organi zation made it possible to assign and quickly reassign all surgeo ns and to establish without delay or 

difficulty a chain of command that eliminated serious conflicts of authority a nd 

permitted swift reactions to changi ng needs 

and circumstances. Although some surgeons sought excuses to avoid service in 

Florida, most, as career military surgeons, 

accepted Lawson's insistence upon discipline. Their caliber was such that few, if 

any, major complaints arose abou t their 

professional abilities or their devotion to 

duty while in Florida. The requ irement for 

a strict accounting of the use of supplies 

and medicines together with systematic 

planning for thei r fu ture use prevented the 

development of significant shortages, despite the fact that medicines and stores 

often had to be moved over long distances 

and the needs of individual posts could not 

always be precisely predicted . 

Even in the hands of others, the Medical 

Department created by Lovell fun ctioned 

well. Medical science was still unable to 

deal effectively wit h the diseases that afflicted armi es in hot climates, but the department's success as an o rga ni zation 

during the course of the Second Seminole 

War justified the fai th of those who had 

supported its establishment as a permanent 

staff department and had favored the appointment of the young Lovell as its first 

surgeon general. 
CHAPTER 4 

Lawson's First Years as 

Surgeon General, 1836-1845 

Although the Second Seminole War in 

Florida was Lawso n's greatest concern during most of his first decade as surgeon general, he could not ignore the needs of the 

men stati oned at the posts scattered about 

the rest of the nation. As increasing numbers of Indians from the Southeast as well 

as white settlers moved west of the Mississippi, the Army's responsibilities in that 

part of the country grew. T he need to protect white traders and settlers and Indians 

from one another and the newly arri ved 

Indians from those indigenous to the area 

dictated the ma intenance of distant posts, 

even in the most unhealth y areas of Arkansas and the Oklahoma Territory. 

Administration in Washington 

In the early yea rs of Lawson's service as 

surgeon general, the need for surgeons was 

great west of the Mississippi, and until 

1842 the demands of the Second Seminole 

War were even greater. Under these circumstances, the Army Medical Department mo re th an ever needed a stro ng 

central administration to assign its small 

staff as effecti vely as possible, to manage 

the purchase and distribution of medicines 

and other suppli es to posts from the Atlantic to Oklahoma, and to anticipate future needs. 

Lawson, however, was not enthusiastic 

about office wo rk. In 1839 he complained: 

I am continuously engaged in answering 

calls from Congress and the Secretary of 

War, and in disposing of references made 

to the department, by any body and every 

body and so incessantly annoyed with the 

trumped up accounts coming in upon the 

offi ce from every section of the Country 

and every di vision of the Army that I can- not bestow that attention upon the general 

interests of the Medical department which 

I desire to do and ought to do. 

He had one or more surgeons assisting him 

in his offi ce at vari ous times, and on occasion, despite his usual resentment for 

those who might seem to be encroaching 

upon his prerogati ves, he willingly delegated his authority in the central offi ce to 

such men as Benjamin King, Richard Coolidge, and Henry Heiskell in order to go out 

into the fi eld or to free himself from the 

more tedious demands of his position. ' 

In other ways, however, Lawson made 

the most of his Washington assignment. He 

did not let his eagerness for more active 

life blind him to th e sedentary joys of verbal " tilts" or his scorn for " fi nery and furlQuote from Ltf, Lawson to Mower (2 1 Mar 1839), 

RG 112. entry 2, 15:75. Unless otherwise indicated, 

materi al in this chapter is based on War Department, 

SGO, AI/llual Reports; Brown, lvledical Department: 

Callan, l\;Ji/ilary Laws; War Department, Generaf Regulaliolls , 184 1 and 1847; and Ayars, ·'Notes." 
74 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

BENJAMI N KI NG. (Courtesy oj National Library oj Medicine.) 

belows" inhibit his enjoymen t for the refinements of the capital's sociely. A young 

lieutenant whom Lawson had in vited to 

dinner and who shared his bachelor host's 

hospitality wi th, among others, the commander in chief of the Army, Lt. Gen. Winfield Scott, reported that " the Doctor had 

a dinner of thirteen courses, provided by 

the prince of restaurant caterers. The wines 

were old a nd rare.'" 

Except for the problems arising directly 

from the Seminole wars, most of those 

Lawson faced in his first years at his WashlFirst quote, Ltr, Lawson to AG (copy, 17 Aug 

1841), RG 112, entry 12; second quote, Ltf, Lawson 

to Taylor (18 Nov 1839), RG 11 2, entry 2, 11: 73; third 

quote, Samuel Gibbs French, Two Wars. lUI Jlllfobiograp/iy of Gen. Samuel G. French (Nashville. Tenn.: 

Confederate Ve teran, 190 I ), p. 28; sec also invitations 

to Lawson in Lawson Papers, LC. 

RICHARD H. COOLIDGE. (Courtesy oj National Library oj Medicine.) 

ington desk had been faced by Lovell before hi m: the inadequate size of the depa rtme nt , th e need to estab lish hi gh 

standards for the staff and to improve its 

statu s, the inadeq uate number and qua lit y 

of hospita ls and attendants, and the difficulti es in volved in maintaining the hea lth 

of the Army at a time when recruits were 

oft en in poor conditi on and the art of medicine was almost primitive. Lawson genera ll y followed his predecessor's approach 

to these common problems, but his style of 

management was radically different from 

that of the quiet-spoken and unassuming 

Lovell . 

When Lawson became surgeon general, 

the Medical Department co nsisted of fifteen surgeons and sixty assistant surgeons, 

in add ition to a clerk who worked in the 

Washington offi ce. In 1838 the demands of 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 75 

the Second Seminole War led Congress to 

allow the appointment of seve n more surgeons. In 1841 a second clerk joined the 

Washi ngton office, but in 1842, despite the 

fact that th e Army then manned seventyfi ve posts, Congress ordered the dismissal 

of two surgeons and ten assistant surgeons, 

reducing the total number of Regular Army 

ph ysicians to seventy. A wise provision of 

thi s law, however, required that each man 

who left the department be indi viduall y selected out on th e basis of his value to th e 

Army, regardless of his seniority] 

The shortage of surgeo ns fo rced Lawso n 

to restrict the granting of leave, generall y 

to medi cal officers who were ill. Even then, 

he granted leave onl y to those who had long 

bee n in the fi eld on active duty. This policy 

did not condemn a surgeon to rema in fo rever at one post, however. Lawson believed 

th a t medica l o ffi cers should be moved 

about so as to become fa mili ar with the 

climate and " d iseases of every section of 

the Country.'" 

Under the circumstances, the low allriti on in th e Medi cal Department might appea r surprising. Many graduates of West 

Point, faced with low sala ries, slow promotions. and ass ignments in primiti ve locati ons that were scarcely suited to the 

raising of a fa mil y, resigned their commissions. Most surgeons, however, apparentl y 

found the limited opportun ities available 

to them in civili an life, where the ratio of 

doctors was high, less lucrative than those 

avail able to West Poi nt-trai ned engineers 

and stayed in the Army. From 1841 th rough 

JLtr. Lawson to J. K. Spaulding (15 Apr 1845), RG 

11 2. ent ry 2, 15:457-58. 

~Q e from Llf, Lawson to D . C. M. Arbuckle 

(22 Oct 1840). RG 112, entry 2, 12: 107; Ltrs, Lawson 

to Satterlee (27 Mar 1839) and King to Charles 

McDougal (7 Jun 1839), both in RG 112, entry 2, 

10:223 and 337. respectively. 

1842, of seven department vacancies, onl y 

th ree resul ted from resignat ions and the remaining four from disease contracted in 

Florida. From 1843 through 1845, there 

were but six vacancies, two of them ca used 

by deaths, in a department of seventy men' 

Ironicall y, at a time when the shortage 

of surgeons in the Army was acute, the indi vidua l medi cal offi cer was not necessarily overworked, and Lawson permilled his 

subordinates to concern themselves with 

mailers that did not directl y in volve sick 

or injured soldi ers. The variety of duti es 

and professional oppo rtunities that continued to be available may, indeed, have been 

part of the allraction of the hard, isolated 

Army life for young physicians. During the 

1836 to 1845 peri od, when the Army made 

it clea r that surgeons we re not required to 

care fo r anyone bu t soldiers, it was customary fo r medical offi cers to offer their services to wives, children, and other civili ans 

at their posts. In additi on, three Medical 

Department doctors were wo rking, appa rentl y fu ll time, on th e problem of choosing 

and buying sites for two hospitals that were 

to serve disabled merchant seamen, at the 

direction of the surgeo n general in response 

to a request from the adjutant general' 

T he professional and military pride that 

j"Thc Requirements of the United States Army and 

Navy Boards of Medical Examiners. Also those of the 

British Army and Navy," TrallS(wiolls o/fhe America" 

Medical AssocialiOIl 2 ( 1849):317; Sprague, Florida 

War. p. 548; DufTy. The Healers. p.9. 

rs . K ing to J. M. Foltz (17 Nov 1836) and Lawson 

to AG (1 May 1837), both in RG 11 2, entry 2, 

8: 11 2- 13 and 328, respecti vely; K ing 10 Sec War 

(28 Nov 1837 and 5 Jan 1838), both in RG 112. entry 

2,9:65 and 103. respectively; Lawson to E. B. Birdsall 

(3 1 Dee 1838). to Burton Randa ll (2 Feb 1839), to 

W illiam M aynadier (25 May 1840), to Lyman Foot 

(27 Jul 1840). to J. Martin (9 Jul 1841 ), and to R. S. 

Baker (7 Aug 184 1), all in RG 11 2, entry 2, 10:62 and 

133, 11 :351 and 429. and 13:7 and 54, respectively; 

H eiskell to M. E. Tyler and to D . S. Kimball (both 

4 Jun 1845), both in RG 112, entry 2, 16:33 and 34, 

respectively. 
76 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Lawson inculcated in his subordinates were 

also inducements to remain in the Army. 

The surgeon general expected his surgeons, 

however heavil y burdened, to work without 

complaining and to exhibit great resourcefulness and unfailing energy under all circumstances. He also insisted that they bear 

themselves proudly and not submit to indignities or encroachments upon th eir 

rights and privileges. "Although in the eye 

of the law and regulations," Lawson maintained, surgeons were " noncombatants," 

they were obliged to " prove themselves to 

possess the ambition and the feelings of the 

proudest officers & soldiers.'" 

The surgeons' basic responsibilities toward the soldier had changed little. In war 

and in peace, they continued to ca re for the 

sick and wounded and attempted to prevent disease by ensuring that a soldier's 

water was good and that the food was both 

good and properly prepared. They also co nsulted with the commanding officer on the 

location of posts and camps, and when 

troops were to be moved by water, lllspected the transports' 

The medical officer's preinduction examination of the Army recruit, in volving 

principally a visual inspection of the disrobed candidate, might appear to have 

been one of his least demanding duties, but 

failure to take this responsibility seriously 

could bring the surgeon to grief. When it 

could be proved that an unfit man had been 

accepted as a recruit, those responsible for 

an injudicious acceptance were apparently 

required to reimburse the Army for the expense of clothing and equipping him. In 

one such instance, an assistant surgeon and 

7Quote from Ltr, Lawson to Foot (1 7 Dec 1840), 

RG 112, entry 2, 15:295; Ltrs, Lawson to Wheaton 

(20Sep 1841) and to Clement Finley ( 18Sep 1844), 

both in RG 11 2, en try 2, 12:207 and 13: 103 , 

respectively. 

8Robinson, All ACCOIlIII 1:4 1. 

)-'0101 ~. 

lJI.iI/l" ~J fit. ""(Jlltll'. 

T ho TI"-'lIlmnMrr w;!! I .. k" pi in • ";'''3';'''' ,, 10o.,· tlo .... · t.. 

f".., i"'ul 1 or . ir, ,,,,,L .. liN" ;1 ",~ "Ot I., ,,0;..,1 ... 1 ,·;.1.... I,." 

11", .li"",1 u' ",II<..,U'..] "'Y ~ "r ,1>,. ."", ,,,. t.)' ,.,Ii.li"" "r 1,,...1 

(,"'" ,.i~hbori"lf ho,li .... ; M I", ~ . ",1 .1.y ,. •• 111, """,I, gr.' .... I. ~, 

J"'W"'''''I, ,,,,n., Or ",1 ... , ."' ... 100 ..... of. tigl., «>!o.. II •. h.",M 

ul ... be ]" ..... ,1 co".;,l".,hl)" "'..,,,,,' f", .. , ,,, ... )" ... "11,,, ",hi.-I, .k,,,-J}, 

,,,.Lit... Or I'''' willi ,..J<Mk. 

'J'J ... Ito,,, 'U ~" will I.· ~q'l "'''0(1(' ' r",,,, oil ,·k,., .... 1 ......... ,"" .•. 

,<> • ,Ii ol",o<' ul 1" .. ( "1,,"1 '" i. hr' I" , "",I .. ill f''''h~. 0)11: 

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• " I., . "'I",,,J,,I in • ,.; .... ·"1.,, ol",,,i"l;: ,,,,,,Ie i" " lo()""I, whi"h ;. 

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wo"I •• 10 """"ell' """1", .. ",1011. .h" .. IJ ,I,,' ""'~' '''' ''"'''I I", ,,, .. i. "",,,,,Iy ,Id .• y ... !. Thr. In ........... ,,,,,,,, i. "",,I,· loy '''ll ,,~ Ih .. ",.1,· 

'" Ih ~ '10''''''' of ~ V'uS", "".1 'i"g 'hr .Ii .. ·" ..... 10 11.0 .... 10· .... 

,,~,k . 'I' h~ g .... III>'i"" "r ,I,r .. ·.Ie ;,. Io~' 1"""I,,,lth. "r "" i""h 

r~r Ih~ n .. , 01'''''''',0",10_ .,f on ;"01,, .,,,1 "I.,,·c ,hot r". 10''''1,. 

"",l h.lf·IN"h.. Tho i"' rrn""li~I" ,li4." ....... "'"Y boo ""· ... lI,,,1 I ..• · 

01> ... '''''';0''' loy ,10" 'I'h ~rll''''' ''',"r will be " ... 1 .. f"". ,i"" ... " 

.by, ; 01 . ,tn.'; ... , 2 I'. M., "''''· .... 1, .,,,1 9 I'. ,\I. 'l"h.· ."''' 

a recruiting officer were fo rced to sha re this 

cost for each of th ree recruits who, according to an inspecting board, could not meet 

the Army's physical quali ficatio ns. The 

physician's fine, half the total, was $26. 11 , 

more than $23 of wh ich was for clothing. 

The medical officer defended himself by 

saying that the supposedly preex isting conditions in all three men could be faked by 

someone anxious to get out of the Army, 

that it had not been proved that any of the 

problems ex isted at the time of the recruitment, that he had not had the opportunity 

of cross-examining the men in question, 

and that he was being deprived of his property without due process. The surgeon general backed his su bordinate in an appea l to 

the secretary of war, but one of the mem-
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 77 

lo'UII 'J"II H .II!.IIL a l\1 

uf ,hf'" r.~" Ibi'.,· '~ .... r ... \;'\n " ,li,i,',,1 h)' (,~" " it! ~i,,' " ... 

" .. ~" r." ,1.< ,by. 'l'h ~ "'"" .,f .. II 'h,' ,bil)' ""'I,," ,li,iM.l I." 

Ihe ",,,nl,... ,..f ,1"",0 ill ,h~ """,," ,,111 ~i"< ')'0 ''',-;0 " or I";' 

"",,,,h. n,.. ''''''~'I "",I ",',I ~'I ,by i •• ,"",." loy lh,· "' .... 11 .0( 

01,.· .... ";0". I,.'" II ... Jh .... ,,~~<r II ill 1,0.- III",'"~ ,I .• ir.· ., 1100" ",h~1I 

I~ "~,, ,ti .. ",.'l",i~hl i. i",'ie,,'''1. . 

'rh" . "", of .11 Ihe .t.ll.,· ,,10"''''''';''''0 loy II", 1),,,,,,, ... I~r •• Ii"i. 

,I ... , loy ,I", "",,,I,.,, or ,I.y ~ ill Ihe "",,,,I., will sh'e the ""."" 

fur 111<1 "",,,d .. 

Ol .... " 'ati .. ,,. ")" ,10., n.i".~u.!C~ will lA' on.",' j"''' .... I,.''·". :Ill." 

<"~I)' .Ioo,,'tr <>r ',11 uf •• i". If ~ •• i" ... ,"''''" .. Ii" .IIY"<"8110 

of ,im" lh ~ <>I .... "·.'i .. ,, will ..... ",>oJ" ., ."llable inl~""'., brf .. ". 

110" ,,'O 'e, ,i..,. hi~h in ,I" lPug.' . In f'c",'ng ,,"~"Ih~ •• wh~n h~ 

flain-g'''se ~.""Ot I,., " ... 1 00,1 or .100" , it " ',U be- ~hn '"'" U.., 

roo",; and, ",,'1"0<1 or ; •. a I." '-........ 1 ,100111,1 I ... 1""..' ...... 1 r", n"_ 

«';I'''1t Ihe '"hl\", 11I'n, 0' "'~' " Ih •• '"~y ,hell {,U. 'r h;. ~_ I 

n,,,l l 1""'0 ,10 oI""OIi", (;J:tltll!l " 1".1 to ,1o,U or 'hr. n.i"·g.,,I1", "",I 

'~ I"" ,iownw.rJ., 1<) It ."ffi~jc III 'Iq~h, w,,1t • "",,.,,I~,,,IoI,· 0101"'. 

Ii .'ooul,1 he 1'1 • ....:1 wlK"ro IIOthlng ('3n lobolfllCI tI,o ,t.-... ,-,I11'"& 

' ''Ow (rom "n'ering i" a,"1 "I",. " "" ,IdA II"W m.y t.I: t.oI"\\'1I 

;11'0 il. Dllrillg 3 «<m'nu"" "OW"IO,,~ Ih" . ,,"". "'.Y 10" """, . 

• 'o"oU)" 1»"""") .1,.",,, ;11 il. The """t~nt. or Ihe .' ...... 1 "",. , I •. 

" ""u',!, ntld 'h ~ w"or I"''' ' '''' ;"'" ,h. g"wge, ,~ ..... erla;" i,_ ,."". I""'", wh, h mil" then , •• ell II''''''] itt ,],~ K:Il'J:e 'olm"" of 'he 

'l'l,e n·",.r"" w.ll e"' .' ~;n opp"'pr;"e ol .... ()II" 011 "<'gr,,,,,,,,.: ... whrn ,he 11<>IrW_I, («<n .... nori.l~,) II... .....1 Or .... A ,,1>1'1 ••• 

.r~r ,ubru,n.) ,he ju"ebr .... )", .h""U""h or "'il.1 I""ar. ("",,,ia ..... 

If)'O r'''''',) II", ,bl~ld'o . (10."'"'011<)11 I,nu" ·"'''') '" ,I .. ). ...,,,,..1 

";I"",i .. n. ~ . he J'I"I"'h. ",'pic •• 'M' 1""'" ''''' .. in 'he "l"''' Iid,Lo, 

a", ill Iolonm: h~I i .. wI,,'" .100,,' on,··h"1f ,h .. Iot""",n .. "y~ "._ 

p.n,I ... I. \\',,,.,, Iho .,n""'. n .... ,k',,,, o( ,Ite .... ""'''''' a iM., (ot. 

"'" ... n"I., •• ) 'ho wh"e ""k, (.l' ..... ~ .11",) ,lIa d" .. ,,,,,. ("" ',nu 

' " .... ~. ) 'h~ 101~<k birch, (l",n,l. kll'.,) the Atl1t' i,·~" .'1';11. (1"'1'''' 

bers of the board of inspectors investigating th e matt e r was a n Army surgeo n. 

Assuming, apparently, th at th e board's 

ph ysician would have been able to detect 

a faked contracti on of the last two fingers 

on the right hand or a feigned lameness 

supposedly caused by a leg two inches 

shorter than its mate, the Army refused to 

back down. In any case, the protesting surgeon finally abandoned his case and paid 

up' 

The collecti on of meteorological data 

9Rpt, Board or Inspcctors (2 1 May 1839) and Ltrs, 

Treasury to Hawkins (29 Dec 1840), Hawkins to B. 

Lewis ( 13 Jan 184 1) and to Lawson (10 May 1841), 

Lawson to Sec Wa r (3 lun 1841), Asst AG 10 Sec War 

(5 lUll 184 1), and Hawkins to Lawson (18 lUll 1841 ), 

all in RG 112, entry 12. 

3'20 "EX~; II \L IIIWIi I •. \T'O."''' 

lu. Lr ",ul oi.' ... ) 1" ,It;Il '" ,\r"p. \\']1('" .;.'" t;~~I· 'r w"".ri,·~ al'" 

I""" ,II 'IU''''i,)". "lid ... h." thu ... h,·~t It,,,· ... , ""","".,,,..... Wh." 

'hu I ... kitli"t (,.,.1 «<:"'" ;n , he """liS-. ""J ,10" liM '" th~ 

.",u",n, ••• It~ ... " hy ,h." ,.0:."" ... " ''''~' r 1>".1 •. ~UI" : (,"31 .... , 

.or g",,,,. of rfl,i, I ..... "". Or .,.hrr ,,'"S •• ~\ol.>., Ih" "" •• ,,( cu,·",,,. 

I,..r., "",1o" •. I .... ~"., &... ·I't ... )" II ,II ~I ... Il o,e Ihu Ilr. , npl"' ''' 

.11 .... or b.",·."",u",,-• • ",1 ",,,,,,,,, ,I" ..... ""'·m.., o{ thu,,~tr o"d ligh'n'''g. h. it .to",,,, hurri .. " ... , 11",1< ......... hi,. o • . h,,", (......,; 'he 

ci ... , , no,,', , ... ~q~h ...... ..; .. ,"'11)". R.MI ,t< ,]i""I'I""r."".,. 

Ihlf tltc llllll,t..-r .. r " '''''' ,h., R"l I"'''' of ,10,· c""'I ..... al'l~·~ .. 

in 'he A. )1. ~n,1 I'. ~1. ""lUll"", ""II g" 'e 'hc "un,I"" of ,by. 

;n ... h,,·h 'he """~ . 1'1" .. ~wl r",,,, ,h", , .... ,,\ ,h",n; ,10" ",o",h. 

'C'I, o ]",,,.,.;11ng w~ ,h", will b" r .... ,,,1 in ,lte "'"Q .... y. i""!,,,I· 

in, ~')" 'I~)" of ""tt . "J '''''''', •• d,,",ly: .,,~ llo,i"g ,hu , .. II'" 

''''. of ,h.".. ,II ",hieh il ... ',,1'Il o • • "0"'''] "'1"""..1)". 'r lto Il~ ". 

pUl:~ ... ,11 be nlll...J ill '" d,." . ,"1 ,I,,,,,,, .. l •. 

I NSTRUCTIONS FOR KEEPING W EATHER 

D IARY. (Co urtesy of Library of Congress.) 

also remained among the duties of the 

Army surgeon. The observations and reports on weather and similar matters that 

the surgeon general required of his subordinates was becoming even more complex 

with time. The physician responsible for 

reports from Governors Island in New 

York Harbor, for example, was required to 

lise not only a barometer and thermometer 

but also a rain gauge, hygrometer, and wet 

bulb, and to record cloud formations and 

the direction and rorce of the winds. All 

surgeons became responsible for recording 

sudden changes in the wind and temperature, th e moment when the baromete r 

reached its lowest point during a storm, 

and even the passage of flocks of migratory 

birds. Although these responsibilities were 
78 TH E ARMY MEDICA L DEPARTM ENT, 1818- 1865 

no doubt an unwelcome burden to some 

medical officers, others appa rently came to 

enjoy this particular aspect of their work.'o 

The enormous quantity of reports on 

meteorological observations that poured 

into the Washington offi ce only added to 

Lawson 's problems with paperwo rk. In 

1841 he finall y decided that he would no 

longer acknowledge the arrival of each report and that he would instead write a surgeon in the fi eld onl y when a report fa iled 

to arri ve on time. Questions apparentl y 

also arose concerning these reports because 

in 1842 Lawson ordered the formati on of 

a medi cal board to design accurate and uniform instructions. L I 

The importance of the Medical Depa rtment's information gathering was apparentl y widely recognized by the 1840s. In 

1842 the Army requested that colleges, scientific instituti ons, and private citizens cooperate in the collection of data. When an 

earthquake shook parts of the Southwest 

on 4 January 1843, inquiries came in to the 

department from pri vate citizens interested in learning the details of the event, 

asking that information on the quake be 

obtained from surgeons in the fi eld. The 

surgeon genera l appears to have sent such 

a questionnaire to his surgeons onl y a few 

days after receiving the request. J2 

Locating young doctors with the ability 

to perform satisfactorily all the many duIOTho mas A. Mower, "Meteorological Obse rvations," New York Journal ojl'vfedicille alld the Collateral 

Sciences 2 ( 1844): 134, 137; Edgar Erkskinc H ume. Ornithologists of the United States Army Medical Corps 

(Baltimore: Johns Hopkins Press, 1942). 

"Cir (14JuI1 841 ), RG 11 2, enlry2, 13: 15- 56. 

12Mower, "M eteorological Observations," p. 137; 

Ltrs, Lawson to Tho mas C. Madison (30 May 1843) 

and to Henry D. Rogers (3 1 May 1843), both in RG 

11 2, entry 2, 14:207- 08 and 2 10- 11 , respectively; 

Rogers to Sec War (27 Mar and 7 Apr 1843), both in 

RG 11 2, entry 12. 

ti es required of them by the Army Medica l 

Department was diffi cult even th ough ph ysicians we re so numerous that establishing 

a profita ble practice was diffi cult. Doctors 

with the education necessa ry to pass the 

De pa rtmen t's tests we re pres um a bl y 

among those whose chances for establishing a lucrati ve practi ce appear to have been 

the best. An average of 50 percent or more 

of those examined fai led, but the tests were 

never waived, even when administering 

them required the temporary removal of an 

assistant surgeon from duty in Florida during the Second Seminole War. The depa rtment was apparentl y unwill ing to take 

chances in its search for doctors of good 

background who might find that the excitement and challenge of military life and 

the possible difficulties of pri vate practice 

outweighed the danger and isolation that 

could face the Army su rgeon. J3 

The entrance examinations were apparently given without favor to anyone, and 

the age limit of twenty-one to twenty-eight 

for the examinees was never waived. Unsuccessful candidates occasiona lly lashed 

out with accusations such as " damned 

favoritism-because I did not have influenti al friends to intercede for me." In this 

particula r instance, the young applicant 

may have tried to co ncea l the fact that he 

was not yet of age, but Lawson was able to 

calm the troubled waters. Less than two 

months aft er he had accused Lawson of 

" damned favoritism," the proud Dr. James 

L. Peacocke wrote Lawson to express his 

gratitude " for the kind words and gentlemanly treatment" he had rece ived from the 

URichard H . Shryock, " Public Relations of the 

Medical Profession in Great Britain and the United 

States, 1600- 1870," Allnals o/Medical History. n.s., 2 

( 1930):3 18- 19: Llr. AG 10 Taylor (15 Oel 1839), RG 

94. M 565, roll I I , 15:435-36; John Duffy, The Healers 

(New Yor k: McGraw· H ill Book Co. , 1976), 

pp. 177-81. 
LAWSON'S FIRST YEARS AS SU RGEON GENERAL. 1836- 1845 79 

su rgeon general and his assista nt when he 

visited Washington. " 

As a result of the req uirements laid down 

by the Medical Department for entry and 

promotion, th e reputation of Army su rgeons improved. A civilia n physician, writing in 1848, pointed out that the Medical 

Department's entra nce examinations had 

always been strict and that incompeten ts 

had never been known to pass them. The 

department's system, he stated, " has saved 

thousands of brave men from the knives 

a nd nostrums [dubi o us remedies] of 

professional bunglers." Although they did 

not ex plain the ir reaso ning, authoriti es 

ma inta ined that the age limit was second 

onl y to the exam inations themselves as a 

promoter of the effi ciency of the med ical 

service,ls 

Men so rigorou sly selected descrved, in 

Lawson's opinion, more adequate sa lari es. 

Some of his su rgeo ns had written in early 

1838 to express their belief that their pay 

did not reflect the importance of their services. That same yea r, however, Co ngress 

fina lly raised their pay to equal that given 

those cavalry officers ranking from first 

lieutenant through major and also granted 

an extra rati on for every five years of service. This step gave assistant surgeons wi th 

less than fi ve years of ex perience $3.33 

more a month and all other department 

physicians $10 more a month. " 

The rank and status of Army surgeons in 

I~Q cs from Ltrs, Peacocke to Lawson (5 Oct and 

23 Nov 1842). both in RG 11 2, entry 12: Ltr. G. M. 

Willing to Lawson (30 Aug 1842), RG 112. entry 12. 

uRobinson. All AccouI/I I :40-41. quote from p. 43: 

Ltrs. Lawson to Sec War (29 Apr 1840) and Heiskell 

to John Bell ( 13 Apr 184 1), both in RG 11 2, entry 2, 

11 :3 1 0 and 12:376, respecti vely; "The Requ irements," 

p. 3 17; "Review o f Forry's Statisti cal Researches," 

"Vesrem Joumal of Medicine and Surgery. 151 ser., 4 

( 184 1):27 1-72; Croghan, Army Ufe. p. 23. 

'''Ltrs, King to Miller ( 10 Feb 1838), RG 112. entry 

2,9: 152-53: W. L. Wharton et al. to SG (28 Feb 1838). 

RG 112. entry 12: ArlllY alld Navy Chronicle. p. 346. 

the 1836 to 1845 period remained imprecisely defined, however. Despite their pay, 

they d id not have the rank of field officers 

and were not entitled to th e sa lutes prescribed for such officers even though th ey 

received eq ui valent sa laries. In add ition, 

a lthough the surgeon's right to serve on a 

court-martial was indisputable, some question existed about his eligibility to serve on 

such purely administrati ve bodies as th e 

boards that decided on the disposal of serviceable property (boards of survey) or that 

managed the fisca l affairs of a post (councils of administration). The commanding 

officer of a fort was not always happy to 

have the post surgeon on such a board, but 

by 1840 the adj utant genera l had made it 

plain that although Army physicians co uld 

not preside over such bodies, they were entitled to serve on them. " 

Lawson was concerned with appea rances 

as well as with substa nce. The impression 

created by the su rgeon's uniform had long 

concerned him and he became enraged 

ove r proposed modifi cation s that suggested to him that the medical officer was 

considered in some way to be inferior to 

his brot her of the line. The surgeon genera l 

indicated that he personally wou ld rather 

wea r civilian dress than a uniform unadorned by epaulets. He claimed that their 

presence upon a medica l officer's shoulders 

would ca use him to esteem his commission 

more high ly. As a result of Lawson's efforts, 

the new surgeon's uniform of 1840 was 

complete with "Epaulettes-Gold , wi th 

solid bright crescent " and "a spread eagle 

of soli d sil ver metal to be worn by the Surgeon General only ... to be placed upon 

the epaulette strap above the wreath." The 

IJLtrs, Lawson to See War ( 18 Jul 1838) and to Par· 

ter (17 Mar 1840) and Heiskell to Sec War (4 Nov 

1841) and to W. Levely (9 Feb 1844). all in RG 11 2, 

entry 2. 9:367, 11 :247-48. 13:1 54- 57. and 14:43. 

respecti vely. 
80 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

epaulets of all were to bear "a laurel wreath 

embroidered in gold, a nd the letters 'M.S.' 

in o ld English ch arac ters within t he 

wreath,"1 8 

Lawson's readiness to fight higher authority on behalf of his subordinates undoubtedly made his fl aming pen easier to 

bear, but in some instances he fought with 

his surgeons as vigorously as he fought for 

them. As a rule, his deepest anger was directed at those who appeared to be shirking 

their duties in Florida or using illness as 

a n excuse for avoiding responsibilities. 

Even a medical officer's unfortunate choice 

of words, however, might cause a marked 

ruffling of the Lawsonian feat hers. Although Lawson had been an arrogant and 

belligerent subordinate of Lovell , he was 

very sensiti ve about the attitudes of his 

subordinates when he became surgeon general. To one surgeon whose language had 

unwittingly offended, he wrote, "When it 

suits my purposes to prefer formal charges 

against you, I shall do it without your dictation ; a nd sho uld yo u wis h to app ly 

through me to a Court of Inquiry, your language must be more respectful to me and 

towards the Secretary of War." " 

Among Lawson's more significant feuds 

with a subordinate was the one with William Beaumont, a man whose pride appears to have rivaled that of the surgeon 

general. Lawson began to resent the attentions and special considerations that Lovell 

showed Beaumont during the period of 

Beaumont's work with Alex is St. Martin. 

By the time Lawson succeeded Lovell as 

surgeon general, Beaumont had attained 

international respect and fame. The antag18Quote from Brown, Medical Depar(lIIe1ll, p. 164; 

Ltf, Lawson to Lovell (5 Oct 1824), RG 112, entry 2. 

19Quote from Ltr, Lawson to Woods (12 Oct 1840), 

RG 112, entry 2, 12:54; for Lawson's attitude toward 

Lovell , see also RG 112, Lawso n's Lc tt erbook , 

1821-1825, entry 226. esp. Ltr, 16 Oct 1825. 

onism between the two men was great. 

Each appears to have believed himself entitled to a degree of respect that the other 

was not willing to grant. Finall y, in 1839 

Beaumont requested a leave of absence 

with his replacement to be provided by the 

department at its expense. Si nce personal 

business was the stated reason for the request, Lawson denied it. Beaumont, already distressed by rumors that Lawson 

was planning to move him to a less desirable post, responded to the refusal with a 

lengthy and condescending letter of the 

kind that in variably enraged Lawso n. The 

surgeon general not only held his grou nd 

on the matter of leave but added fuel to 

the fire in September of 1839 by ordering 

Beaumont to Florida to serve on a medical 

examining board. Because Beaumont was 

no longer conducting research on St. Martin's digestion, the assignment appears to 

have been reasonable, but Beaumont, in an 

attempt to force Lawson to rescind it, submitted his resignation. To his astonishment, the surgeon ge neral accepted it, 

commenting that " if an example is not 

made of some one soon, the army will become more like a mob than a military 

Body." Beaumont then attempted to withdraw his resignation, but Lawson stood 

fast. Beaumont's long and distinguished 

Army career, one that began in the War of 

18 12 when both Beaumont and Lawson 

had first committed themselves to the care 

of the Army's sick and wounded, was at an 

end.

20 

Lawson's concerns were not limited to 

the ph ysicians in his department. He was 

also interested in the attendants who as20Quote from Uf, Lawson to Sec Wa r (16 Jan 1840), 

RG 11 2 , entr y 2, II: 188; Myer, Beal/lIIOl/f , 

pp. 241 - 45, 25 1-54,265-67; Ltrs, Lovell to AG (7 l ui 

1827) and Lawson to W illiam Beaumont (27 Mar 

1839), both in RG 112, entry 2, 4: 156 and 10:222. 

respectively. 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836-1845 81 

sisted post surgeons in their hospitals, The 

problem of obtaining good men to serve as 

hospital stewards remained from Lovell's 

period of administration, A steward was 

usually selected from the line by a surgeon, 

with the consent of the post's commanding 

officer. The Medi cal Department apparently conti nued to operate on the assumption that when it was impossible to find in 

this wayan enlisted man capable of performing in a sober, reliable, and reasonably 

intelligent man ner, the post surgeon could 

enlist a man specifica lly to serve in this 

capacity or even hire a civilian.21 

A law enacted in 1838 officially authori zed thc enlistment of yo ung men as stewards and increased their pay, At posts wi th 

more than four companies, stewards were 

paid as sergeants of ordnance; at smaller 

posts, they were paid as infantry sergeants, 

Nevertheless, many surgeons continued to 

have questions about signing on stewards, 

Thomas Mower, a surgeo n on recruiting 

duty in 1839, made an arrangement with a 

young man an xious to serve as a hospital 

steward, spec ifying that he was not to se rve 

in any other capacity, Since the enlistee had 

"rec, a collegiate education" and was both 

"a student of theology" and "of good character," Mower was eager to have him in the 

Army bu t was unsure how to interpret the 

regulations. 22 

In 1842 Congress forbade the enlistment 

or reenlistment of men to serve specifi call y 

as stewards, but surgeons continued to be 

confused, " Is it intended that the assignment of Hospital Stewards be permanent, 

or only tempora ry"? a surgeon wrote Lawson in 1844, adding, "Can a citizen who 

has enlisted solely wi th a view to perform 

21Ltr, Tho mas Mowe r. He iske ll , and Sylveste r Day 

to Lawson (30 Jul 1840), RG 112. entry 12. 

nQuotc fro m Ltr, Mower to Lawson ( 18 Feb 1839), 

RG 112, entry 12; Uf. Mower, Heiskell, and Day to 

Lawson (30 JuI 1840), RG 11 2, entry 12, 

the duties of Hospl steward be reduced to 

the ranks a nd made li able to perform military duty-more especially when the word 

soldi er has been erased and steward substituted in the enlistment?" How Lawson 

solved this problem is not known " 

The reali zation of the ex tent to which a 

good steward could lighten the medica l offi cer's burden engendered much of the interest in the character of the men chosen 

to be hospital attendants, Lawson d id not 

approve of the custom of those surgeons 

who had their stewards fill out reports and 

manage accounts, because unnecessary errors resulted, He did not, however, underestimate th e worth of stewards to th e 

Medical Department. Wishing to upgrade 

their position, in early 1840 he established 

a training school for stewards at one of the 

New York Harbor posts, apparently Fort 

Columbus, By mid- 1840 twenty young men 

of upri ght moral charac ter had bee n 

trained by an assistant surgeon, had gone 

through a four- to fi ve-month probationary 

period, and had been sent out to assist surgeons requesting their aid, In 1844 the adjutant general ruled that new orders issued 

by the commanding general of the Army, 

Lt. Gen, Winfi eld Scott, req uired th at 

stewards be taken from the line and that 

they remain attached to their companies, 

Lawson's attempts to improve the standards for hospital stewards were thereby 

negated, and the records of the period 

never again refer to the schooL" 

!JQuotc from LIT, Adam M. McLaren to Lawson 

( 14 Apr 1844), RG 11 2. entry 12; Ltrs, Heiskell to Sec 

War (8 Dec 1842), RG 11 2, entry 12; Lawson to John 

S, Griffin (II Oct 1843), RG 112, cnt ry 2, 14:439; sec 

also Ltrs, Mills to Lawson ( 12 Aug 1837), Wheaton to 

SG (4 Jan 1843), McDouga ll to Lawson ( 13 Apr 1843), 

Lawrence Sprague to Lawson ( 10 Oct 1843), Stin nccke 

to Lawson (8 May 1844), and AG to Military Storekeeper ( 15 Jun 1844), all in RG 112, entry 12; Lawson 

to Stinncckc (1 3 May 1844), RG 11 2, entry 2, 15; 143. 

~4 Ltr s, Lawson to J-Ioxon (24 Apr 1840), to Randall 

(25 Aug 1840), and to Richard 1-1 . Coolidge ( I Oct 
82 THE ARMY MEDICAL DEPARTMENT. 18 18- 1865 

THOM AS M OWER. (Co urtesy oj National Library oj Medicine.) 

Surgeons do not appear to have been as 

enthusiastic about hiring women to help in 

hospitals as they were about hiring stewards. At least one surgeon suggested replacing matrons with men. Matrons were 

the only women rou tinely found worki ng 

in Army hospitals, but the surgeon at Fo rt 

Wood, in New York Harbor, mainta ined 

that it was they who caused the greatest 

problems he ever had to face in his facility. 

They "either have children when they 

184 1), all in RG 11 2. entry 2, 11 :302 and 494 and 

13:1 15, respecti ve ly; Henderson to Lovell ( 12 May 

18 36), Heiskell to Lawson (4 Jan 1839), Russe ll to 

Lawson (15 Dec 1839), Randa ll to Lawson ( 17 May 

1840), Mower, Heiskell. and Day to Lawson (30 Jul 

1840), Wheaton to Lawson (23 Oct 184 1), Hawkins to 

Lawson (25 May 1842), Porter to Lawson (I I lUll 

1844), E. D. Townsend to C. S. Merchant (copy. 

14 Jun 1844), Porter to Lawson (2 Jul 1844), and Stei· 

ncr to Lawson (20 Jul 1848). all in RG 11 2, entry 12. 

come, or make out to get them soon after, 

which adds very materi ally to the other objections agai nst them." In list ing these 

other objecti ons, he noted that matrons 

were " lazy, sluttish, and wastefull, a nd in 

short . .. , a nuisance."25 

Lawso n does not appea r to have expressed himself on the subj ect of women 

in hospitals, but he emphasized his "d isli ke 

to any th ing li ke effemina ncy, lu xury, or 

too much convenience in a mi litary hospital." He could not "consent to make 

Gentlemel/ of common Mel/ as soon as they 

are brought into the Army." No man, in his 

opinion, was entitled to find in a military 

hosp ital an y form of luxury he could not 

provide for himself at home, and Lawson 

obviously intended that th is policy be a 

guide to those ordering supplies for these 

facilities. 26 

Nevertheless, certai n standards had to be 

maintained at the various post hospitals 

scattered abou t the nation, and many faciliti es needed upgradi ng. In 1839 Congress voted almost $70,000 for the bui ld ing 

of new hospitals, but most of this sum was 

spent injust two years. In 1843 the surgeon 

general pointed out that the coasta l forts 

still lacked no appropriate hospital fac ilities. He blamed this situati on upon those 

who believed that structures erected outside the walls of a fort would interfere with 

its defense. He poi nted out that a bui lding 

located outside the fortifications cou ld be 

burned down if hostilities ever made it advisable, but that keeping patients in the 

damp, poorly ventilated Quarters wi thin 

fort ifi cations enda nge red th eir recove ry 

and, indeed, threatened th e health of all 

those who li ved in them. 

2SQ uotes from Ltr. M onroe to Lawson ( II Aug 

1837). RG 11 2. entry 12: Ltr. Monroe to Lawson 

(24 Aug 1837), RG 11 2. entry 12. 

2"Ltr, Lawson to Russell (20 Jun 1844). RG 112. 

entry 2, 15:204. 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 83 

Despite his open dislike for " too much 

convenience," Lawson also appears to have 

been receptive to ideas for improving hospital equipment. When the secretary of war 

expressed an interest in having iron bedsteads used throughout the Army, for example, Lawson moved quickly to look into 

the matter. In the fall of 1837 he had one 

single and one double metal bedstead made 

up and sent to the War Department, confident that if these frames could be obtained at a reasonable price, the secretary 

would order them for hospitals as well as 

for barracks. The price of $15 each proved 

acceptable. Congress appropriated funds 

for the purpose, and Lawson began to buy 

bedsteads and to send them out to many 

post hospitals. By 1843 the money voted 

for this purpose had all been spent. Lawson 

noted that the new frames held up well , 

were free of insects, had a neater appearance than their wooden counterparts, and 

took up less space. He placed a second order for metal frames in 1845, using a 

slightly different, improved, and less expensive design, one for which "the parts 

will be made with such nicety and precision 

as to fit each other promiscuously."" 

Lawson was also interested in having 

some sort of ambulance developed for use 

in Florida during the Seco nd Seminole 

War. He envisioned a plain, light, twohors e wagon "o n Boston or C radl e 

springs." In this ve hi cle th e wounded 

wou ld lie upon ca nvas slings, ten to twelve 

!7First quote, ibid.; second quote, Ur, Mower to 

Lawson (23 Oct 1844), RG 11 2, entry 12; Ltrs, Lawson 

to Thomas Mower (I Sep 1837), RG 112, entry 2, 

8:476; Lawson to Leonard, to Si mpson, and to Russell 

(a ll 29 lui 1840), all in RG 11 2, entry 2, 11:432- 33; 

Heiske ll to M. Mason (24 Nov 184 1) and Lawson to 

Abadie (26 Oct 1843) and to Moses H. Grinnell 

(16 Feb 1844), all in RG 11 2, entry 2, 13:192,14:452, 

and 15:48- 49, respectively; Mower to Lawson (1 7 Apr 

1843, 23 Oct and 3 Dec 1844, and 16 Jan, 12 Mar, 

and 26 Apr 1845), all in RG 112, entry 12. 

inches above the floor, so that medi cines 

could be stored beneath them. An ambulance and a set of panni ers made of tin and 

slung across a saddle by means of a leather 

case should be provided for each battalion, 

A prototype of the desired wagon appears 

to have actually been built, but there is no 

record of its having been put into regular 

service at this time.

28 

As far as posts in the West were concerned, transportation presented a greater 

problem than purchasing, Ships came to 

grief from time to time and floods could 

delay the deli very of much-needed goods. 

Some forts appear to have been particularly 

unfortunate. In March 1845, for example, 

a packet ship loaded with supplies for Forts 

Snelling and Crawford, as well as for Forts 

Leavenworth, Atkinson, Des Moines, and 

Scott, was wrecked, and only three months 

later, when another ship, bound for New 

Orleans, met misfortune on the coast of 

Florida, the mishap deprived Fort Crawford of sixteen iron bedsteads and Fort 

Snelling of another twelve." 

Lawson was concerned about the care 

and disposal of old Medical Department 

property as well as with the purchase and 

tran sportation of the new. He was, for example, interested in the use of old bedding 

and linens. Great care should be taken, he 

beli eved, to ensure that boards of survey 

were not ca lled upon to condemn property 

that could still be made to fulfill its original 

purpose, but only a board of survey could 

co ndemn items that could no longer be 

used for their original purpose. The actual 

disposal then became the responsibility of 

the surgeo n in vo lved. Worn-out linen s 

2~ Quo e rrom Ltr, Lawson to Sec War (26 Jul 1837), 

RG 11 2, entry 2, 8:423-24; Ltr, Lawson to A. MacKay 

(17 Aug 1837), RG 11 2, entry 2, 8:458. 

~9 Ltr , Mower to Lawson (25 Mar and 13 Jun 1845) 

and Griffin to Lawson (1 Apr 1846), all in RG 11 2, 

entry 12. 
84 T HE ARMY MEDICAL DEPART MENT, 18 18- 1865 

were not, Lawson informed one surgeon, to 

be used as dishcloths or for " other household purposes," but superannuated pillowcases and sheets beyond repair were to be 

used for bandages and d ressings.'o 

Among other problems that arose in connection with the Medical Department's expenses was that of how properly to allocate 

a soldie r's commuta ti o n a ll owa nce fo r 

food, a matter that came to a head in 1841. 

The difficulty stemmed from the fact that 

the food of hospitali zed soldiers was provided by both the Subsistence and the 

Medical Departments. Should the Subsistence Department be unable to supply the 

specialized type of diet that a pati ent might 

require, the expense for his food became 

the responsibility of the Medical Department. The issue, therefore, was whether the 

monetary value of the ration normall y supplied by the Subsistence Department but 

not used for a hospitalized patient should 

be pa id out to acting medical purveyors for 

the Medical Department's use as needed 

without restriction. The alternati ves involved either using the ration allowance 

solely and specifically for the benefit of the 

individual soldier or crediting the sum to 

his unit. The surgeon general decided that 

it was illogical for a soldier to receive both 

hospital rations and the benefit of the government allowance at the same time and 

ruled that such money should go into a 

common fund fo r use by the Medi ca l 

Department. 

Problems oj Swgeons in the Field 

Except for the high morbidity in Flori da 

JOQuotc from Ltr, Lawson to Russell (20 Jun 1844), 

RG 112, entry 2, 15:203; Ltrs, Lawson to Foot (2 1 Jun 

1844), to John M. Cuyler (9 Jul 1844), to King, Simpson, and James R. Conrad ( I May 1845), and to other 

recipients, all in RG 11 2. entry 2, 15:2 10,226, 486, 

487, and 488-505. passim. 

that resulted from the Second Seminole 

Wa r, disease patterns, like the other problems facing the Medica l Department, di d 

not change materi all y in the fi rst years after 

Lawson succeeded Lovell as surgeon general. Alcoholism continued to ca use difficulties, despite Lovell's campaign aga inst 

hard liquor and reports that intemperance 

was undermining the hea lth of untold numbers of men. The Army itself provided each 

soldier with a daily gill of rum, whiskey, or 

brandy until 1838, when it substituted six 

pounds of coffee and twelve pounds of 

sugar per 100 men fo r the li quor ration. 

In the earl y 1840s, the average soldier 

serving in the northern states was reported 

sick once every 4'1> months, whereas in the 

middle and southern states he was ill once 

every 4 months. Serious epidemi cs rarely 

cha ll enged surgeo ns assigned to longestablished forts along the Canadian bo rder and the northern Atlan ti c coast, and 

they found it difficult even as late as the 

mid- 1840s to ra ise offi cial enthusiasm for 

long overdue improvements to hospitals or 

living quarters. Those ca ring for sold iers on 

the western frontiers, on the other hand, 

were often engaged in the struggle against 

disease. The combination of diarrh ea and 

dysentery, the traditional camp disease, 

a nd ma la ri a co ntinued to scou rge the 

Army. 

The number of forts in the rapidly expanding nation grew as both white and red 

men moved west of the Mississippi, but the 

conseq uences of the Indian removal policy, 

and particularly of the Second Seminole 

War, added to the burden of some post surgeons in all pa rts of the country. A few post 

hospitals far from either Flori da or the 

frontier cared for ill recruits or sheltered 

in valids returned from the southern fi ghting. One post representative of collection 

poi nts fo r recruits was Madison Barracks 

at Sackett's Harbor, New York, where the 
E 

G G 

MADISON BARRACKS H OSP ITAL, 22 April 1842. Thomas Henderson, Ass'! SlIrg. RG 112, 

ser. 12, box 301. 

surgeon was responsible for a large number 

of sick from among the unacclimated recruits. Housing there was dilapidated, and 

the post surgeon blamed the water for the 

high number of diarrhea cases. Among 

other problems afflicting both recruits and 

veterans were boils, skin infections, and 

sca bi es, as we ll as malaria, respiratory 

problems, and rheumatism." 

When no recruits were assigned to Madison Barracks for a bri ef time in 1840, the 

total number of men at the post fell well 

below 100, but by the fall of 1840, recruits 

were coming in aga in and the population 

was rising. By 1842, veterans of the Florida 

war were appea ring there as well , bringing 

with them the fevers that plagued soldiers 

JI$urgeo n's Quarte rl y Rpts. Madison Barracks 

(30 Sep 1838-30 Sep 1845), all in RG 94, enlry 634. 

in the Sou th. Within a few months of the 

end of the Second Seminole War, however, 

life at Madison Barracks was settli ng back 

into a pattern of few and ge nerally mild 

illnesses, punctuated by occasional outbreaks of sca rlet fever, which in some cases 

was severe.

32 

The facilities available for the patients of 

the Madison Ba rracks' su rgeon were, like 

so many in the North , old and inadequate. 

T hey consisted of three rooms located at 

the far end of the enlisted men's barracks. 

One room was used as a dispensary, the 

other two were used as wards. One ward 

was approx imately 400 square feet and the 

second almost twice that, but chimneys 

took up much of the space in both. As a 

JlSurgeon's Quarterly Rpts, Mad iso n Barracks 

(30 Jun 1840-30 Sep 1845), a ll in RG 94, enlry 634. 
86 TH E ARMY MEDICA L DEPARTMENT, 1818- 1865 

result, the facility could hold onl y eighteen 

beds, two or th ree of which were regularl y 

used by hospital attendants. On the basement level of this wing were two " matron's 

rooms," a "bathing room," and a "kitchen 

and eating room."33 

The post surgeon at Madison Barracks 

in 1838 emphasi zed that the rooms occupied by the sick there were never intended 

to be used as a hospital and so "of course 

[were] extremely defecti ve in arrangements 

as well as in other important particulars." 

Among the defecti ve arrangements were 

those for ventilation. Furthermore, in the 

surgeon's opinion, hospitals should also be 

entirely separate from barracks. By 1839, 

however, the constructi on of a new and 

separate hospital, bu ilt of limestone and 

designed by the Surgeon General's Office 

with modifications by the post surgeon, 

was underway. The main body of the building contained the ward for the sick, while 

a bathing room occupied one wing and a 

morgue a second. Only the site itself appears to have been criticized: it was judged 

too near a freshwat er stream and too exposed to the wind during long winters. Furthermore, a steep ravine that lay between 

the hospital and the barracks made the hospital inaccessible during the heavy snows 

characteristic of that part of the country." 

The Quartermaster's Department turned 

the new fac ility over to the surgeon in November, but some of the problems involved 

in housing the sick remai ned. Experience 

showed the new hospital at the Madison 

Barracks to be a mi xed blessing. The planks 

used for the flooring were kiln-dried and 

poorly seasoned and, as a result, shrank 

rapidly. Because the building's fireplace 

l3Quotes from Ltr, Heiskell to Lawson (23 Feb 

1839), RG 112, entry 12; Ltr. Heiskell to Lawson 

( II Nov 1838), RG 112, entry 12. 

J4Quote from Llr, Heiskell to Lawson (23 Feb 1839), 

RG 11 2, entry 12; SWlislical Report. 1839-55, p.39. 

proved inadequate for heating, stoves had 

to be used; their installation appeared to 

aggravate the problem wi th the floo rs. The 

excessive ly dry fl oo rboards ra pidl y absorbed any stains, so the post surgeon 

urged that they be painted, which he beli eved would solve all the qifficulties he 

had been experiencing wi th them. The records, unfortunately, do not reveal whether 

this step was actuall y taken H 

At many of the northern posts along the 

Atlanti c coast, damp casemates, the masonry rooms designed to contai n ca nnon, 

continued to be the only shelter avai lable 

for a ll those in the garriso n, sick or well. 

As a result, the surgeon in th e fi eld might 

be preoccupied with the effects of such accommodations upon himself and his famil y as well as with their effects upon th e 

soldiers. At Fort Hamilton in New York 

Harbor, for example, the post surgeon reported that he had spent $4,000 of his own 

money to have his personal quarters modified so as "to protect my own health and 

make myself and family comfortable a nd 

respectable." The hospital accom modations at this post were so poor that for several years pati ents were periodicall y taken 

to the new Fort COlumbus facility nearby, 

but in the summer of 1845 the Army authorized the improvement of the hospital 

casemates. Nevertheless, and despite the 

surgeon general's dislike for casemate facilities, the long-standing suggestion of the 

surgeon at Fort Hamilton that a separate 

hospital building be constructed appears to 

have been ignored. J6 

J$Ltr, Heiskell to Lawson (22 Apr 1842). RG 112, 

entry 12. 

J6Quote from Llrt Eaton to Lawson (13 Feb 1845), 

RG 11 2. entry 12; Ltrs. Eaton to Lawson (2 Jul 1842 

and 10 Jan 1843) and Mower to Dr. Ca rpent er 

(2 1 Dec 1839), all in RG 112, entry 12; for details on 

similar conditions at Ft. Adams, R. I., sec also SIll(istical Report. /839-55. p. 10, and Ltrs, lawson to Joseph G. Totten (16 Aug 1844), RG 112. entry 12. 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 87 

At Fo rt Columbus, o n G overnors Isla nd , 

the post surgeon, Joseph P. Russell , faced 

problems both with his quarte rs and with 

an influx of in valids from Flo rida. While 

Russell was serving in Flo rida earl y in the 

Second Seminole Wa r, a major from the 

Corps of Engineers took over the qu a rte rs 

usually assigned to the fort's post surgeon, 

rooms that had been modified for Russell's 

use on the orders of the Medical Department. On returning no rth in Novembe r 

1838, instead of being assigned to his usual 

qua rters o r even to those in whi ch the post 

clerk was li ving, which were o nl y slightl y 

inferio r to those of the surgeon, Russell was 

offered space he found entirely unacceptable. After Lawson appealed in his behalf 

to the secreta ry of war, urging that Russell 

be all owed to displace the clerk, the returning surgeo n appears to have made no 

furth er complaints.·\7 

A year late r, Russell wrote to the surgeon 

general of his pleasure with the new post 

hospital nearing completion at Fort Columbus, adding that he ho ped to furnish it 

with the new iron bedsteads. To this fine 

new hospital the Army shipped fifty-seven 

in valids from Tampa, Flo rida, in June 1839 

a nd e ith e r thirt y- nin e o r fo rt y-seve n 

more-the sources a re contradictory on 

this fi gure-from the Cedar Key hospital 

in 1840, by which time the hospital was 

presumably being used to train hospital 

stewards. The Cede r Key transferees a rri ved in such poor cond ition that Ru ssell 

immediately wrote Lawson, complaining 

bitterl y of the decisio n to send these men 

to his fa cility. Remov ing in valids from a 

warm climate to a cold one during the winte r was "extremely injudicious, and ill advised." Furthermo re, the vessel that ca rri ed 

.I1Ltrs, Russell to MacKay ( 10 Dec 1838) and to 

Lawson ( 10 Dec 1838) and Lawson to Sec War(23 Dec 

1838), all in RG 112, entry 12; Surgeon's Quarterly 

Rpt, Ft. Columbus (3 1 Dec 1838), RG 94, entry 634. 

them had been very uncomfo rtable, th e 

weathe r d uring the voyage " boisterous," 

and the men at times drenched by bilge 

water. By the time they reached Fort Columbus, " they presented a most pitiable 

spectacle, were gene rall y in a very filth y 

and lousy conditio n, two of them had involuntary and unconscious discha rges, and 

we r e lit e r a ll y wall ow in g in th e ir 

excrement."38 

Ru ssell protested furth er that his hospital could take only fifty patients without 

crowding and that the poo r conditio n of 

the men arri ving from Florida would be 

very bad for mo rale at a base whe re recruits 

were to be tra ined for duty in the Seminole 

wars, and would generally discourage enlistments. Any future victims of the Seminole wars, he asserted, should be sent to 

Fo rt Monroe in Virgini a or to Fort Moultrie in South Carolina, where the climate 

was better and where the re would be no 

new recruits to be horrified by the spectacle 

of what service in Flo rida could do to a 

man's health. But the Florida in valids continued to po ur in, seventy-three more from 

Cedar Key in late June 1841 and fift y-six 

from Pilatka in early July. " 

A continuing health problem that grew 

to surprising propo rtio ns at Fo rt Columbus 

afte r the first invalids arri ved from Flo rida 

was vene real disease. In December 1836 

the post surgeo n reported that 10 of the 120 

men newly ente red on his sick list in the 

past quarter were suffe ring from gono rrhea 

and 10 from syphilis (the reco rds do not 

make it possible to guess how ma ny of these 

patients might actuall y be suffering from 

JSQuotes from Ltr, Russe ll to Lawson (29 Nov 

1840), RG 112, entry 12; Ur, Russell to Lawson 

( 15 Dec 1839), RG 112, entry 12; Surgeon's Quarte rly 

Rpts, Ft . Columbus (30 Jun 1839 and 31 Dec 1840), 

both in RG 94, entry 634. 

)Q Ltr, Russell to Lawson (29 Nov 1840), RG 11 2, 

entry 12; Rpts, Russell to Lawson (22 Jun and 7 Jul 

184 1), both in RG 94, entry 634. 
88 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

both diseases). Two years later, the surgeon 

reported onl y 10 cases of venereal disease, 

but in the following June, nine days after 

the arri val of the 57 in valids from Tampa, 

the venereal disease case load figure stood 

at 14, this from a sick list totaling 433 for 

the quarter. Three months later, however, 

despite the fa ct that the total number of 

new cases of all kinds of diseases and 

wounds at that post had decreased by 67, 

59 were newly recorded victims of gonorrhea and syphilis. Russell did not suggest 

how many of these might have been Florida 

veterans who had acquired a new problem 

in the course of celebrating their return to 

c i vili zation. The ve nerea l disease rate 

slowly dropped from this high point and 

reached its more customary level several 

months later." 

To the south of the New York forts, the 

health problems that had plagued such 

posts as Fort McHenry in Maryland and 

Baton Rouge during Lovell's term as surgeon general appear to have been relieved 

before Lawson had long served in that position. Conditions at the Maryland post 

reached a nadir in the months immediately 

following Lovell's death in the fa ll of 1836, 

and the post was subseq uently abandoned 

briefly in 1837. When troops reoccupi ed it 

in 1838, the poor location and dilapidated 

condition of the old hospital inspired a 

quick start on a new one, a structure that 

greatly pleased the civilian surgeon assigned there. The retreat of malaria from 

the country's more northern areas may 

have been responsible for an improvement 

in health at the Fort McHenry garrison. Although, during the winter months, soldiers 

on guard duty who went from the overheated guard room at Fort McHenry out 

40S urgeon's Quarterly Rpts, Ft. Columbus (3 1 Dec 

1836,31 Dec 1838, and 30 Jun and 30 Sep 1839), all 

in RG 94, entry 634. 

into the cold air suffe red considerably from 

head colds (or catarrh as it was then called), 

by 1844 the men at this post appa ren tly 

considered it one of the most desirable 

assignments.

41 

At Baton Rouge, the new hospital was 

also finished in 1839, complete with brick 

walls, a much-admired system of ven tilation, and a ten-foot-wide gallery around th e 

entire structure. The fevers and digestive 

problems characteristic of sou thern posts 

continued to plague Baton Rouge, however, 

with the third quarter of the year being particularly unhealth y. In 1843, the weeks of 

the late summer and ea rly fall were unusually difficult; yellow fever struck the post 

in September when the surgeo n was already 

struggling to care for men transferred from 

Florida who were "worn out ... by Climate 

and Seve r e se r v ice-pa rti c ularl y 

Intemperance."42 

Except for the influenza epidemi c of 

1843, the health of the garrisons at such 

northwestern posts as Forts Snelling and 

Mackinac, the latter in Michigan, remained 

good once the stresses and shortages related to their establishment were past. The 

surgeo n at Fort Mackinac, however, like his 

colleague at Fort Hamilton, felt compelled 

to use his own money for improvements 

more appropriately made at the Army's expense. Although the physician paid personally to have the hospital rooms painted, 

4lSurgeon's Quarterly Rpts, Ft. McHenry (1818-45, 

esp. Rpt, 31 Mar 1845), all in RG 94, entry 634; Ltrs, 

G. C. U. Roberts to unknown reci pient (24 Dec 1836), 

Hende rson to SG ( 1837), and Robe rts to Benjamin 

King ( 10 May 1839) and ta Lawsan (30 Nav 1846), all 

in RG 112, entry 12; King to Sec Wa r (30 Jan 1838) 

and to Thompson (21 Mar 1838), both in RG 112, 

entry 2, 9:141 and 183, respecti vely; French, 1'11'0 

Wars, p.26. 

42Q uote from Surgeo n's Qua rt erl y Rpt , Baton 

Rouge (30 Sep 1843), RG 94, entry 634; Surgeon's 

Quarte rl y Rpts, Baton Rouge (1822- 45), RG 94, entry 

634; Statistical Report. 1819-39. p. 254; Statistical Repari. /839-55. pp. 147, 254. 265. 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 89 

in an attempt to start a fund to cover this 

sort of ex pense in the future, he asked each 

civilian treated in the fac ility to donate 

fifty cents to the ca use." 

Despite its grim beginnings, Fort Snelling had acquired an excellent reputation by 

1836, and the early sufferings of its garrison 

were almost forgotten. Its garden was admired for its unfailing supply of vegetables, 

and scurvy was no longer a threat. In the 

opinion of an Army inspector in 1838, "No 

soldier ought to desire to li ve better than 

they have always done at this post." The 

post surgeon could not afford to relax his 

vigilance, however. Sma llpox occasionally 

afnicted the Sioux Indians who lived near 

the fort, threatening any in the garrison 

who were not immune. After 1839, when 

alcohol became available for the first time 

in the vicinity of the post, the surgeon recorded that "The increase to our sick list 

is owing in my opinion to the introduction 

of Ardent Spirits amongst us." Many of the 

ills that came to the attention of the post 

surgeon at Fort Snelling, however, were of 

a type usually associated with long, cold 

winters. Colds and rheumatism were common , and some soldiers suffered from 

chronic bronchitis or chilblains, a painful 

engorgement of the fingers, toes, and earlobes caused by cold, damp weather. Army 

surgeo ns did not often encounter malaria 

in such a chill climate except when units 

already afnicted with this disease came to 

Fort Snelling." 

Unlike the reports of many post sur4lSurgcon's Quarterly Rpt, Ft. Mackinac (30 Sep 

1843), RG 94, entry 634; Croghan , ArlllY Life. p. 75. 

44First quote, Croghan, Army Life. p. 66; second 

quote, Surgeon's Quarterl y Rpl, FI. Snelling (30 Jun 

(839), RG 94, entry 634; Ltrs, Lawson to Jones 

( 18 Aug 1843), RG 112. entry 2, 14:275; John Emerson to Lawson (14 Dec 1838 and 26 Aug 1839), both 

in RG 112, entry 12; Jones, Citadel. p. 2 16: Surgeon's 

Quarterly RPI S, Ft. Snelling (1836-45), all in RG 94, 

entry 634. 

geons, those of George Turner at Fort Snelling se pa rat ed the numbe r of pati ents 

treated in their quarters from those treated 

in the post hospital. Turner usually hospitalized up to a third of his patients, or as 

many as eighty-six per quarter. Given the 

size of most post hospitals in relation to 

the length of their post sick lists, it is probable that most of those treated by post surgeons were ou tpatients." 

The forts located in or near the lands 

assigned to the tribes moving west from 

Florida, Alabama, and Georgia were not as 

healthy as Forts Snelling and Mackinac. 

The hea lth reco rd of Fort Gibson (located 

in Cherokee lands on the banks of the 

Grand Ri ver a long th e main emigrant 

route from St. Louis to Texas) was particularl y miserable. In the sickly season every 

man on post might be ill more than once 

in a quarter. The Army did not abandon 

Fort Gibson, however, because the secretary of war believed that its existence was 

crucial to the Cherokees' security in their 

new lands. The infantrymen who shared 

the post with a detachment of dragoons 

were still sheltered in rotting, badly ventilated barracks when Lawson became surgeon ge neral; perhaps because of the hope 

that the fort would soon be closed, authoriti es were loath to invest more money 

in its buildings. The occupants of the infantry ba rracks fell ill at a particularl y high 

rate when the wind shifted to the southwest, from the direction of the bottomlands 

between the Grand and Verdigris rivers. 

Although the dragoon quarters were sheltered from the so uthwesterly winds by a 

ridge, they were exposed to the prevailing 

winds of summer, wh ich also brought disease. During the last nine months of the 

year at Fort Gibson, malaria was the most 

4SSurgcon's Quarterly Rpts. Ft. Snelling (3 1 Mar 

1842 and 30Jun 1843), both in RG 94, entry 634. 
90 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

common illness, 700 or more cases developing in the course of a quarter. In add itio n, diarrhea increased the ga rrison's 

miseries in the summer, while in the winter, respiratory diseases posed an additional problem." 

Because the post's surgeons themselves 

also suffered from repeated attacks of disease, providing adequate medical care for 

the garrison, normall y about 500 strong, 

was difficult. The Surgeon Genera l's Office 

tried bri efly to insist that four surgeons 

could handle all the fort's health problems, 

but in 1837 authorities realized that fi ve 

wou ld be better. Despite the recogni zed 

need for at least four to five surgeons, by 

June 1838 only three medical officers were 

present at Fort Gibson. In the winter of 

1839, when there were approximately 540 

men at Fort Gibson and 236 cases of disease reported for the quarter, only two surgeons were serving at the post, with the 

health of one " fast declining" and that of 

the other scarcely better." 

In the fa ll of 1839, when over 600 cases 

of dis ease were reported durin g the 

quarter, the medical staff once again consisted of only three men. When a contract 

for a civilian physician was presented to 

~6S1alisliclll Report, 1819-39. pp. 22 1-22; Sraiisliclil 

Reports, /839-55, p. 267; Prucha, Sword. pp. 359-60; 

Surgeon's Quarterly Rpts, Ft. Gibson ( 1836- 46), all 

in RG 94, entry 634; Ltrs, Lawson to Gales and to 

Seaton (both 8 Mar 1843), both in RG 112. entry 2, 

1: 186 and 187, respectively; Wharton to King (6 lui 

1838), and to Lawson (1 3 Feb 1839), both in RG [ 12, 

ent ry 12; Francois des Montaigncs. The Plains 

cds. Nancy Alpert Mower and Don Russe ll (Norman: 

U ni versity of Oklahoma Press, 1972), PI'. 167-68. 

41Quote from Llr, Wharton to Lawson ( 13 Feb 

1839), RG 11 2, entry 12; Surgeon's Quarterl y Rpts, 

Ft. Gibson (1837-39), all in RG 94, enlry 634; Llrs, 

King to Sec War (13 Dec 1836 and 25 Mar 1837) and 

Tripier to AG (7 Oct 1837), all in RG 112, entry 2, 

8: 134 and 278 and 9: 10, respectively; Wharton to 

King (24 Jan t838), Mills 10 King (27 Jun 1838), and 

Wharton to Lawson (15 Dec 1840), all in RG 112, 

ent ry 12. 

Lawson for his approva l, however, he refused to allow the ex pense on the grou nds 

that the Regular Army surgeons already at 

the fort should be able to handle the load. 

Struggling to provide an adequate med ical 

sta ff for the troops fi gh ting the Seminoles, 

Lawson refused to understand why a ga rrison of 483 officers and men should need 

so many doctors, noting that th e 258 men 

at Fort Wayne, just sixty mil es away, made 

do with the services of only one ph ysician. 

To the secretary of war Lawson protested 

that in only eight months the commanders 

of the troops in Arkansas had spen t over 

$3,000 for pri vate physicians, in spite of 

the services of the fi ve Regular Army surgeons sent west to care for the 1,196 men 

at their four posts." 

By 1840 Lawson was will ing to adm it 

that, because of its poor location, Fort Gibson had proved for ten years to be " the 

most sickly military Post in the United 

States" and that the diseases there were 

oft en serious enough to cause death or the 

perma nent destruction of hea lth . His sympathy for the surgeons serving there, however, was limited. Typicall y, he looked for 

fault in their co nduct. He adm itted that 

assistant su rgeon Joseph H. Bailey was of 

good character, but he deplored Bailey's 

custom of spending much of his time and 

energy on his pri vate practice, principally 

in caring for Indians, thereby neglecting 

both his duties at the fort and his own 

health ." 

The surgeons at Fort G ibson were ma nning two hospitals, one for the infantry a nd 

the other for the dragoons, both of which 

"BUrs, Lawson to Sec War (1 1 Nov 1839). RG 112. 

entry 2, 11: 58-59; Wharton to Lawson (9 Jul 1839), 

RG 11 2, entry 12; Surgeon's Quarterly Rpt.. FI. Gibson (30 Sep 1839), RG 94. entry 634. 

"9Quote from Ur, Lawson to Sec War(30 Apr 1840), 

RG 11 2, entry 2. 11 :312; Ltrs, Lawson to Lewis 

(27 Aug 1840) and 10 Bailey (4 Sep 1840). bOlh in RG 

112, entry 2, 11:500 and 12: 15, respecti vely. 
LAWSON'S FIRST YEARS AS SURGEON GENERA L, 1836- 1845 9 1 

were inadequate. Because Lawson anticipated the abandonment of the post, he 

initi ally wi thheld his support from the 

campa ign of these physicians to override 

the post commander's unexpla ined opposition to the addition of two wards to the 

existi ng facilities. By May 1838, however, 

Lawson had agreed to the expansion. The 

commanding officer's consent was then obtained, and before another yea r passed, one 

of the two new wards was completed and 

the old buildings were improved'· 

One of the dragoon officers complained, 

however, that the custom of having the 

post's physicians rotate between the two 

hospita ls was not an ideal arrangement for 

the sick because the physicians never had 

the opportunity to know their pati ents as 

individuals. Presumab ly in answer to his 

complaint, sometime before the beginning 

of 1839, one surgeo n at Fort G ibson was 

assigned to work exclusively at the dragoon 

hospital. When only two medical officers 

were at the post, however, the sickness of 

either rendered this arrangement less than 

ideal, because th e pati ents of the sick physician we re then cared for by a doctor who 

was compl etely unfamiliar with their problems. Although by 1840 Lawson had apparently capitulated on the matter of hiring 

a civilian surgeon, he believed that the 

most efficient approach to providing care 

for the post's sick would be to combine the 

two hospitals in one building. His suggestion to this effect was ignored until later in 

1840, whe n man y of the dragoons appear 

to have left the post. The commanding officer then declared that the infa ntry hoswLtrs. M ills M. Mason (copy, 11 Apr 1838), Mills 

to Lawson (14 Apr 1838), and Wharton to King 

(2 1 Mar and 6 Jul 1838) and to Lawson ( 13 Feb 1839), 

all in RG 112, entry 12; King to Wharton (25 Apr 

1838) and to Mills (2 1 May 1838). both in RG 112, 

entry 2, 9:235 and 272, respectively; Dc Camp to Lov. 

ell (May 1836). RG 94, entry 634. 

pita l wou ld fun ction as a genera l hospital 

and shelter patients from all units represen ted at the post. " 

At least two of the surgeons at Fort Gibso n in the 1840s found it an appropriate 

post for further study of the use of quinine 

for ma larial fevers. Charles McCormick, 

who had developed his approach to the 

treatment of malaria wh ile he was in Florida, introduced to Fort Gibson the practice 

of treating malaria with large doses of quinine administered during the fever's paroxysm as well as during its remission. The 

intermittent fevers affecti ng the men at 

Fort Gibso n tended to return regularl y at 

seve n-day interva ls, making it possible to 

administer quinine in anticipati on of the 

attacks. Physicians discovered that by giving 10 grains of quinine twelve hours before the ex pected paroxysm and another 10 

grains six hours later, they co uld prevent 

the fever's return. They also learned that, 

for a febrile patient, 15 to 20 gra ins of quinine given as a single dose was effective , 

and its effectiveness was enhanced when it 

was repeated at four- to six-hour intervals 

thereafter, for a total of two to three days. 

Although ph ysicians might also prescribe 

bleeding or even emeti cs and cathartics, 

fortun ately for the pati ents, they fou nd that 

usually no preparation was necessa ry for 

the administration of quinine.s2 

Although the demand for quinine at Fort 

G ibson was great, a hospital steward stationed there in the 1840s stated that " to 

protect the men from malaria, the government served a gill of whiskey daily to each 

man." His commen t may have referred to 

51Ltrs, Wharton 10 Lawso n ( 12 Ma y 1837 and 

13 Feb 1839). Order, Arbuckle (no. 13,2 1 Jan 1840), 

and Ltr, W harton to Lawson (29 Jan 1840), all in RG 

112. entry 12: Ltr, Lawson to Wharton (25 Jan 1840). 

RG 112, entry 2, 1: 175. 

S!Coolidgc, "Gibson," pp. 447. 449- 50; Staristical 

Rcporl. /839-55. p. 267. 
92 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

the time when a boat bearing a new supply 

of quinine sank on the Arkansas Ri ver, 

forcing the surgeons to rely on other medications. In any event, the number of men 

requiring medical attention doubled after 

the sinking, and deaths were prevented 

only by the reservation of the small remaining supply of quinine for those most 

seriously ill. Shortly after a new shipment 

of quinine arrived at the post, the pati ent 

population was back to normal." 

In the 1830s fevers were also a common 

affliction at Fort Leavenworth, Kansas, a 

base that grew in importance as increasing 

numbers of settlers moved west and greater 

numbers of Indians from east of the Mississippi arrived in the Oklahoma Territory 

and in Arkansas to the south of this post 

and in what later became Iowa to the north. 

The size of the garrison fluctuated as expeditions to establish peaceful relations 

with and among the Indians or to escort 

settlers or traders farther west came and 

went. The problem of providing these detachments with medi cal attention was a 

difficult one, especially during the yea rs 

when so many surgeons were needed in 

Florida." 

Although the greatest consistent cause of 

disease at Fort Leavenworth was malaria, 

such disorders of the digesti ve system as 

dysentery and diarrhea were also common. 

A severe epidemic struck in the late summer of 1837, affli cting 260 men, or more 

than five times the number then suffering 

HQuote from James D. Elderkin , Biographical 

Skerches alld AllecdOles of a Soldier a/Three Wars . . .. (Det roit, 1899), p. 10; Statistical Report. /839-55, 

p. 269; Coolidge, "Gibson," p. 450; Ltr, McCormick 

to Lawson (6 Oct 1844), RG 112, entry 12. 

HWalton, George H. Sell/ine! oj the Plains: Fort 

Leavellworth and Ille American West. (Englewood 

Clirrs, N.J.: Prentice-Hall, 119731), pp. 48- 49: 

Croghan, Army Lije, pp. 10, 73; Ltrs, Macomb to Lawson ( I Apr 1838 and 3 Apr 1840), both in RG 112, 

entry 12. 

from malaria, out of a garrison whose average size numbered only 334. The 1843 

influenza epidemic also reached Fort Leavenworth, bringing 153 men to the attention 

of the surgeons in the third quarter of the 

year. Many men also suffered from wou nds 

and so-called contusions. One Fort Leavenworth surgeon, however, believed that 

most of the patients under his care could 

thank alcohol for their hea lth problems, no 

matter what their symptoms might be. He 

added to his quarterl y report of 31 December 1843 the assertion that "Nearly all the 

cases arise primarily from liquor." The surgeons' reports from Fort Leavenworth also 

hint at other vices in addition to alcoholism. In recording the discharge of a dragoon because of his "general debility," for 

example, another surgeo n later noted , 

"This man destroyed himself with vicious 

secret practices."" 

In the late 1830s, and especia lly in the 

third and fourth quarters of those years, the 

recorded number of cases of disease treated 

at Fort Leavenworth could exceed by as 

much as 80 percent the number of men in 

the garrison. Fortunately, not long after 

Lawson became surgeon general, a new 

hospital began to rise there; when complete, it was a "very capacious bri ck hospital, two stories high with every necessary 

appurtenance."" 

Because it was not always possible to assign two or more surgeons to Fort Leavenworth, on at least one occasion a hospital 

steward provided the medical care for an 

expedition leaving that post. The detachSSQuotes from Surgeon's Quarterly Rpts, Ft. Leavenworth (31 Dec 1843 and 31 Dec 1845, respectively), 

both in RG 94, entry 634. 

S6Quote from Croghan, Army Life. p. 73; SJalislical 

Report, 1819- 39. pp. 164- 65; Aurora Hunt, lvlajol' 

General James Hellry CarlelOlI. 1814- 1873: Western 

Frofllier Dragoon (Glendale, Calif.: Arthu r H. Clark 

Co. , 1959), p. 97; Surgeon's Quarterl y Rpts, FI. Leavenworth (1827-44), all in RG 94, entry 634. 
LAWSON'S FIRST YEARS AS SURGEON GENERAL, 1836- 1845 93 

ment of II officers and 200 men started 

out for the territory of the Osage Indians 

in the spring of 1838 without a physician 

because the surgeon did not believe that he 

should leave the post without a medical attendant. Two years later, shortly after a second ph ysician fina ll y arrived at Fort 

Leavenworth, the newly assigned surgeon 

left with a detachment ordered to establish 

a new post. Since his replacement had already been diverted to Florida, Fort Leavenworth was once again down to a single 

Army surgeon. " 

By 1843 a second surgeon was once again 

on duty at Fort Leavenworth, but in June 

he, too, left the post, accompanying three 

companies of dragoons escorting traders to 

Santa Fe. The physician remaining at the 

post was temporarily handicapped in his 

work by a broken bone in his right hand. 

The bone apparently healed in time, but 

since the surgeon also suffered each winter 

from a "thoracic disease," in 1844 he was 

sent to Fort Jesup, Louisiana, after he had 

requested reassignment to protect his 

health" 

Another Fort Leavenworth expedition 

departed not long after the ai li ng surgeon 

left for Louisiana. Its goals were to effect 

a reconciliation between the warring Pawnee and Sioux and to create a favorable 

impression of the white man among them 

and the other Indian tribes living near the 

S7Ltrs, Macomb to Lawson (I Apr 1838 and 3 Apr 

1840), both in RG 11 2, entry 12. 

~8Quotc from Llr, Wharton to Lawson (4 Apr 1844), 

RG [ 12, entry 12; Ltrs, ibid. (3 Jun and 17 Oct 1843), 

both in RG 112, entry 12. It is interesting to nole that 

Wharton anticipated the establishment of the Army 

Medical Museum by several decades. In a February 

1841 letter to Lawson, he suggested that medical of· 

fieers be required "to forward to you r office, such 

specimens of Morbid Anatomy as may be revealed in 

the performance of their Duty .. .. Would not a few 

years produce a cabinet of speci mens . .. alike honorable to the chief & to the members thereof?" Ltr, 

Wharton to Lawson ( 12 Feb 184 1), RG 112, entry 12. 

confluence of the Missouri and Platte ri vers. The five companies involved, accompanied by a surgeon, set out in mid-August 

of 1843 but were scarcely on their way before men began to fall ill, twelve, it would 

seem, in the first twenty-four hours alone. 

The second day out of Fort Leavenworth, 

a private "fell from his horse in convulsions, and , although the surgeon was 

promptly in attendance, died in a few minutes." Less than two weeks later, yet another private died, "of Chronic Diarrhea 

with which he had been ill almost from the 

day of our departure from the Fort." By 

the end of August, many among the officers, men, and hired teamsters were sick; 

to the victims of disease were also added 

those of accidents and carelessness, bringing the total on the surgeon's list to twentyfour. Among the injured was a private who 

shot himself in the hand early in September, "such accidents from the Carbines ... 

not [being] of unfrequent [sic] occurrence 

in the Dragoons." When the sick and injured were unable to continue the journey 

by horseback, the surgeon had them placed 

in a hospital wagon, to complete the trip 

in this uncomfortable vehicle. " 

Conclusion 

In his allempts to provide adequate medical care for the soldiers at forts like Leavenworth and Gibson, as well as for those 

at posts scallered about the country, without neglecting the men fighting in Florida, 

Lawson was severely handicapped by the 

unwillingness of Congress to face the need 

for a significant increase in the basic size 

of the Medical Department. To compensate for the inadequate number of physi-

)qc. Wharton , "The Expedition or Major Cl inon 

Wharton in 1844," Kallsas Swte Historical Society 

Transactions 16 ( 1923- 25):273, 27 5, 28 1- 82, 290, 

293 , 302, quotes rrom 275, 281 , and 290, respectively. 
94 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

cians at his disposal, Lawson drove his 

surgeons hard, raging at any subord in ate 

who showed signs of submitting to weakness or discouragement and denying leave 

to all who were not seriously ill. He encouraged his surgeons fighting to have the 

importance of their contributions to the 

Army recogni zed . He worked to lighten 

their loads where he could by attempting 

to improve the facilities where they worked 

and by initiating a training program to enable stewards to assist the medical offi cers 

more effecti vely. When all else failed, Lawson hired contract surgeons. His supply 

system, inherited from his predecessor, 

functioned well; few surgeons complained 

of significan t shortages. Although, unli ke 

Lovell, Lawson leapt at the chance to go 

into the field, the men whom he appointed 

to act for him in his office were competent, 

and the medical service did not suffer from 

his occasional absences from the surgeon 

genera l's desk. 

Up until 1846, however, the Army Medical Department as organi zed in 1818 had 

been tested only in hostiliti es against Indians, fought between small units. The 

challenge presented in 1846 by the Mexican War would draw Lawson once again 

away from his offi ce and into the field , 

where he would for the first time be in a 

position to direct personally the medica l 

care of U.S Army un its during a conventional war. 
CHAPTER 5 

The War With Mexico: 

The Taylor and Kearny Campaigns 

In the second qua rter of the nineteenth 

century, the ultimate goal of many of the 

migrants streaming west was territory then 

belonging to Mexico. In 1836 the new settl ers in Texas proclaimed their independence. Enthusiasm for the addition of the 

new Loan Star Republic to the Union was 

strong, and the annexation of Texas in February 1845 made war a lmost inevitable. In 

May of the following year Co ngress officially declared war, and the Army found 

itself facing the challenge of a major connict at the far end of long supply lines in 

a disease-ridden land.' 

Although the Army appears to have devoted surprisingly little effort in advance 

of the actual campaign to gathering information about the geography, water supplies, and other pertinent characteristi cs of 

Mexico, it adjusted to the demands of war 

with much greater ease than it had in the 

IUnlcss otherwise indicated, material in the two 

chapters on the war with Mexi co is based on Louis 

C. Duncan, "Medical History of General Scott's Campaign to the City of Mexico in 1847" and " Med ical 

History of General Zachary Taylo r's Army of Occupation in Texas and Mexico, 1845- 1847," both in MiIilm,), SlIrgeOi/ 47 ( 1920):436-70, 596-609 and 48 

(1921 ):76-1 04, respecti vely. as we ll as on Callan, Mili/or)' Laws. Brown, Medical Deparlmell/, Juslin H . 

Sm ith, The War Witlt Mexico. 2 vols. (New York: Macmillan Co., 1919), Edward D. Mansfield, The Mexican 

War . .. (New York: A. S. Barnes & Co., 1848), and 

R. S. Ripley. Tile War Willi I"texico-A Military Hislory. 2 vols. (New York: Harper & Bros., 1849). 

War of 1812. Congress modified the structure of the Army by placing brigade and 

division orga ni zations above the regimenta l level, and it undertook a controlled expansion both by adding men to ex isting 

regiments and by creating new ones. During the course of the war, another 64,000 

men serving under varying terms of enlistment in vo lunteer units joined the 30,000 

wa rtime regulars. 

Disease wrough t its usual havoc among 

these soldi ers. Volunteers, many of them 

farm boys who had never before been exposed to communicable diseases and who 

were unimpressed with the demands of 

camp sanitation, fell ill at twice the rate of 

the regulars. Some apparently had not been 

immuni zed against smallpox; as a result, 

this dreaded disease occasiona lly struck 

down sma ll numbers of volunteers, a lthough no epidemic on the scale of those 

of the American Revolution resulted, and 

the regulars, who had been vaccinated, 

were spared. Many physicians fell ill, but 

disease killed relatively few of them, especially in comparison to the mortality 

among surgeons during the struggle with 

the Seminoles in Florida. Five Regular 

Army surgeo ns and two of th ose who 

joined the Medical Department only for 

the duration of the war apparently died as 

a result of illness con tracted during or exacerbated by their service south of the Rio 
96 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

Grande, while one died of wounds. 2 

Administration of the Medical 

Department 

The fall of 1845 found Surgeon General 

Lawson eagerly anticipating war. In a letter 

to Brig. Gen. William Worth he co mplained, " It is much to be feared that the 

Mexicans intend to content themselves 

with waging a war of threats and denunciations, and that, after all their blustering, 

they will not afford our gallant offi cers 

and men recently ordered to Texas suffic ient pastime to kee p the ir blood in 

circulation,"3 

[n spite of Lawson's enthusiasm, the likelihood of war, and the growing need for 

surgeons for new posts being established in 

the West, no increases in the size of the 

Medical Department were made until after 

war was actually declared. Although three 

doctors were traditionally allowed for each 

regiment, in June 1846 Congress ordered 

the call-up of only two physicians per volunteer regiment, if there were not enough 

Regular Army physicians available to care 

for these men. The department, however, 

already too small to provide each Army 

post with a physician, was scarcely in a polThomas R. Irey. "Soldiers, Suffering, and Dying in 

the Mexican War," Journal o/Ihe West II (1972):295; 

Llrs, Heiskell to AG (4 May 1847), RG 112, entry 2, 

17:244; Henry Holt to Lawson (22 Jan 1846), RG 112, 

ent ry 12; J. J. Oswandel, NOles 0/ {IJe M exican War, 

rev. ed. (Phi ladelphia, 1885), p. 435; Stanhope BayneJones, The Evolution of Prl:'velllive Medicine ill Ihe 

United Stales Arm)" /607- /939 (Washington: Office of 

the Surgeon General, Department of the Army, 1968), 

p. 86; Porter, "Notes" 26:322; H. R. Robards, "The 

Diseases of the Army of Occupation in the Summer 

of 1846," Western Journal of Medicine and Surgery, 2d 

ser., 7 ( 1847): 187-88; William G. Proctor, "On the 

Diseases of the United States' Army on the Ri o 

Grande," Westem JO/irllal of Medicine and Surgery, 3d 

ser., 1 (1848):461-62. 

lQuote from Ltr, lawson to Will iam Wo rth ( 13 Oct 

1845), RG 112, ent ry 2, 16: 150. 

sit ion to offer care for the volunteers, who, 

therefore, had to provide for themsel ves. 

Congress did not increase the size of the 

department staff until February 1847. In 

the process of creati ng nine new regular infantry regiments and a d ragoon regiment, 

to be called up for the duration of the war, 

the legislature gave the president the power 

to appoint one surgeon and two assistant 

surgeons for each newly authori zed regular 

regiment and to name an additional two 

surgeons and twelve assistants directly to 

the regular department staff, which now totaled 11 5. T he lawmakers apparently 

wai ved the age limitation, but since they 

made no exception to the requirement that 

prospecti ve regular surgeons pass a rigorous examination and since the number 

who passed these tests continued to be low, 

months elapsed before all the new slots 

were filled. Even with the increase, the hiring of pri vate physicians both to care for 

soldiers in Mexico and to serve as post surgeons within the United States continued 

to be necessary.' 

An almost casua l provision of the legislation of February 1847 marked a milestone in the history of the U.S. Army 

Medical Department: the new legislati on 

granted surgeons and assistant surgeons the 

rank they had so long sought. Although in 

practice, under exceptional circumstances 

and on an informal basis, medical officers 

might briefl y command small numbers of 

troops, this law also specifically stated that 

doctors were not to exercise command outside the Medical Department. Si nce a law 

of August 1846 had already granted vol4l1rS, lawson to AG (6 Sep 1845), to Sec Wa r 

(30 Mar 1846), and to James A. Gregg (21 May 1846) 

and He iskell to Randall ( 10 Feb 1847), to Hunt 

(22 Feb 1847), to w.1. Michi e (19 Mar 1847), to J. P. 

Drake (8 Apr IS47), and to A. G. Howard (ISJan 

1849), a ll in RG 11 2, entry 2, 16:129, 299, and 342, 

17:200,223,378, and 4 11 , and 19:365, respectively. 
TH E WAR WITH MEXICO: TH E TAYLOR AN D KEARNY CAMPAIGNS 97 

unteer surgeons the same status as their 

regular counterpa rts, they, too, rece ived 

rank. The surgeo n general became a colonel, 'surgeons became majors, and assistant 

surgeons, captains. The signifi cance of the 

new law, however, did not become apparent 

until after the wa r' 

The responsibiliti es assigned to th e 

members of the Medical Department who 

served in Mexico included those of medical 

director and director of a general hospital, 

both positions given to senior surgeons, 

and that of purveyor. The purveyor usually 

functioned as ph ysician as well as supply 

officer. Doctors accompani ed units in the 

fi eld and the department attempted to 

place a physican aboard any troop transport destined for a long voyage, to inspect 

the vessel before depa rture, and to care for 

the troops in transit. No attempt was made, 

however, to establish guidelines for determining in ad vance who should serve in 

general hospitals and who should remain 

with the regiment. 

The caliber of the volunteer doctors sent 

to Mexico was on the whole low. Most were 

unaccustomed to military discipline and 

unfamiliar with the requirements of military medicine, parti cularly the requirement 

for sanitati on. Since they, like contract surgeons, were not required to pass qualifying 

examinations, their skills were questionable. Their personal hea lth was often poo r; 

some apparently joined the Army with the 

th ought o f restorin g th e ir health by a 

change of climate. They were profli gate in 

their use of supplies and casual about the 

required monthly reports, to the despair of 

the medical director under whom they 

served.' 

SRobinson, All Account 1 :42. 

I>Ltrs, Jarvis to Heiskell ( 16 Nov 1847) and Salterl ee 

to Lawson ( II Apr 1848), both in RG 112, entry 12; 

Lawson to Edward Bullus ( IOJul 1846) and to P. H . 

Craig (5 Aug 1846) and Heiskell to I-Icz. W illiams 

The fundamental problem continued to 

be the failure of Congress to recogni ze that 

any a rmy whose duties included the garrisoning of small posts scattered over a 

wide area required more surgeons than an 

a rmy operati ng excl usively in units of regimental size or larger. Attempts to obtain 

and keep competent hospital attendants to 

ease the burdens of Army surgeons remained futi le. The weak, the con valescent, 

the alcoholic, and the incompetent were 

left behind as attendants to care for hospital patients while their healthier and 

abler comrades marched off with their 

units. The fact that the medical staffs of 

disease-ridden volunteer regiments were 

too small to gi ve adequate care to their sick 

and oft en lacking in skill and dedication 

compli cated the shortage of regular physicians. In addition , Lawson did not make 

the most of the surgeons he had when he 

fa iled to plan in advance for the simultaneous sta ffing of both regimental and gene ral hos pit a ls. Most d e partme ntal 

physicians were overworked, and the strain 

upon them when battle or epidemic sent 

large numbers of men to hospitals was 

great. 7 

As experienced military surgeo ns could 

have predicted on the basis of their experiences in the West and in the Second Seminole War, frequent delays occurred in the 

arrival of needed items in Mexico. Shipwrecks or unex plained disappearances ru-

(2 Jan 1847), to AG (4 Mar 1847), and to Gray (6 Sep 

1847), all in RG 11 2, entry 2, 16:42 5 and 449, 17:141 

and 244- 45, and 18:5 1, respectively. 

7Bernard John Dowli ng Irwin, " Notes on the Introduction o rTent Fie ld Hospit als in War," Proceedings 

of/he FOllrth AIIII/wl J\I/eerillg oJ lhe Association of MiIirarySlirgeol/s 4 (1 894):113- 14; Ltrs, Lawson to Sec 

War (30 Ma r 1846), RG 112, entry 2, 16:299; Porter 

to Lawson (5 Jul 1846) and to M cCormick (2 5 Jun 

1847), both in RG 112, entry 12; Josiah G orgas to his 

mother, in Frank E. Vandi ver, ''The M exican War 

Experience of Josiah Gorgas," JUI/rnal of SOlllhern 

Hislory 13 ( 1947):382; Porter, " Notes" 26:31 1. 
98 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

ined the most careful planning, but even 

without mishaps, bedding and other bulky 

items proved particularl y difficult to transport. Such a shi pment might take as long 

as six weeks to reach a Mex ican port from 

New York City and another eight weeks to 

arrive at its final destination inland.' 

Although the distances in volved were 

great, Lawson urged that, whenever possible, medical purveyors send their requisitions to New York City, where the needed 

items could be bought in better quality and 

at lower prices than elsewhere. He suggested that medicines be packed for shipment in small quantities, to eliminate any 

need to open large containers when only a 

fraction of their contents was needed . He 

stockpiled medi cal supplies for both regular and volunteer units at New Orleans. Although an occasional shortage o f a 

critically important medicine such as quinine might force a surgeon to buy within 

Mex ico, medical supply officers could usually draw upon the stock of the New Orleans purveyor.' 

Surgeons in the Field 

The first units to enter combat against 

Mexican troops were those under Brig. 

8Ltrs, Lawson to De Camp and to Fi nl ey (both 

9 Dec 1846) and Hciskell to De Camp (15 Feb 1847) 

and to Charles H. Laub (10 Nov 1847), all in RG 11 2, 

ent ry 2, 17:98,99, and 206 and 18:222, respectively; 

Laub to Heiskell (5 D ec 1847) and John Frazier Head 

to Lawson (30 Oct 1846), both in RG 11 2, entry 12; 

Mower to Lawson (24 Sep 1846), in U.S. Arm y Hospital Department, New York, Lette r Copy Book, 

1846- 1854, Ms 1ll25, NLM. 

9Ltrs. Lawson to James Si mons and to Craig (both 

9 Feb 1846), to William Hammo nd (2 lUll 1846), and 

to Mower (6 )uI1 846), all in RG 112, entry 2, 16:254, 

256, 270, and 420, respecti vel y; Satte rlee to Lawson 

(27 Dec 1846 and 8 and 29 l Ull 1847), Mower to Lawson (6 Jul 1846 and 22 Mar 1847), Porter to Lawson 

(2 Jan 1847), and Henry H. Steiner to Lawson (24 Jun 

1848), all in RG 11 2, entry 12; M ower to Lawson 

(24 Sep 1846 and 9 Nov 1847), both in Ms 111 25 NLM. 

Gen. Zachary Taylor. In the summer of 

1845, anticipating a hostile response from 

Mexico to the annexation of Texas, President Polk ordered General Taylor to move 

from his station in Louisiana to a position 

nearer the border. By the end of August, 

Taylor's army was camped in the vicinit y 

of Corpus Christi, Texas. Surgeons considered the climate there to be " perfectly delicious and healthy [wi th] no possibility of 

sickness." In a short time, however, bad 

water (probably resu lting from the presence of the troops, who polluted it), extreme variations in temperature, and what 

was regarded as bad a ir bega n to take their 

toll. "The Northers ... blow with great 

force and produce an instantaneous change 

in the temperature, the thermometer fa iling 30 degrees in as many seconds," a surgeon wrote. He added that insects and 

snakes also proved to be a threat, "especially rattlesnakes whi ch are as plenty [sic] 

as blackberries." Between respiratory and 

digesti ve ills, by October " the whole a rmy 

[could] be considered a vast hospital." An 

average of 90 offi cers a nd 11 8 men out of 

every 1,000 were sick, and th e situation 

worsened in November before starting to 

improve. A disgusted Nathan Jarvis, who 

had had few complaints about Minnesota 

winters at Fo rt Snelli ng, commented: 

"Texas, its climate, . .. and people [are] all 

a humbug & not worth the cost oftaking."10 

To care for the many sick in General Taylor's command, su rgeons set up eight regIOFirst quote, Emma Jerome Blackwood, cd., To 

l'dexico With Scort: Lerters o/Capraill E. Kirby Smith 

to His Wije (Cambridge: Harvard U ni versity Press, 

19 17), p. 18; second and third quotes, Ltr, Jarvis to 

Wi ll (8 Sep 1845), in Jarvis Papers; fourth quote, Porter, "Notes" 23: 14; fifth quote, Ltr, Jarvis to Ben Jarvis (30 Nov 1845), in Jarvis Papers; sec also Porter, 

"Notes" 23: 14- 16, 18; Niles' Weekly Regisl er 68 

(30 Aug 1845):401 ; Wi lliam Seaton Henry, Campaign 

Skelches o/Ille War Will, Mexico (New York: Harper 

& Bros" 1847), p. 45. 
THE WAR WITH MEXICO: THE TAYLOR AND KEARNY CAMPAIGNS 99 

imental hospitals, each sheltered in two or 

three large hospital tents, and a general 

hospital, housed in a large frame building 

in Corpu s Christi. In the latter facility, 

those whose illness was likely to be prolonged joined the overfl ow of pati ents from 

the regimental hospitals. The medical staff 

manning these hospitals included the medical director for Taylor's force, Presley H. 

Cra ig, Jarvis as director of the general hospital, a purveyor, and thirteen more department ph ys ic ia ns. Th r ee c ivilian 

doctors were hired until more Regu lar 

Army surgeons co uld be assigned to Taylor's command . Almost immediately after 

Taylor's departure from Corpu s Christi, 

the general hospital there was moved to a 

new location on St. Joseph Island, Texas, 

a nd on 7 Nove mber 18 46 , it was 

disbanded. " 

Alth ough ne go ti a ti ons betwe en th e 

United States and Mexico fail ed in January 

1846, actual hostiliti es did not break out 

while Taylor was at Corpus Christi. In 

March President Polk ordered Taylor to 

move further south. Leaving 800 to 900 of 

the very weak and seriously ill at the general hospital under the care of two Medical 

Department physicians, Taylor established 

his men at Point Isabel on the coast of 

Texas, and inland at Fort Texas (soon to be 

renamed Fort Brown), facing the Mexican 

town of Matamoros across the Rio Grande. 

(Map 3) Although the men at Fort Texas 

were healthy when they arrived and the 

weather was good, many soon fell ill, most 

with diarrhea and dysentery. Apparentl y 

no hospital ex isted at this base in the early 

"Surgeon's Quarterly Rpt, $1. Joseph Island (7 Nov 

1846), RG 94, entry 694; Porter, "Notes" 23: 13-14; 

George Meade, Tile Life alld Lelfers o/George Gordoll 

,Heat/e. cd. George Gordon Meade, 2 va ts. (New Yo rk: 

Charles Scribner's Sons, \913),2:37, 37n; Ltr, Jarvis 

to Wi ll (8 Sep 1845), ill Jarvis Pape rs; Jarvis, "Notes" 

40:438- 39. 

weeks, but department surgeons at Point 

Isabel set up tents for a general hospital to 

shelter all the patients from Taylor's comm a nd. T his fac il it y r ema ined open 

throughout the war, and surviving records 

indicate that more substa ntial housing was 

eve ntually found for it. " 

The surgeo ns with Taylor received their 

first wo unded from the Mexican hostilities 

ea rly in May 1846, following the enemy 

bombardment of Fort Texas a nd the battles 

of Palo Alto and Resaca de la Palma. Although exact fi gures vary, it appears that 

U.S. forces lost a total of almost 50 killed 

and over 130 wounded in these battles. 

Shortly aft er the second battle, the Mexica ns abandoned Matamoros." 

For each of these two engagements, the 

twel ve surgeons accompanying the troops 

initially set up field hospitals near the battl e fi e ld . When the wounded co uld be 

moved, Craig had 48 taken to the Corpus 

Christi faci lity and the remaining 1, 123 to 

Point Isabel, where they were placed in 

tents and warehouses cleared out for the 

purpose. The facilities at Point Isabel were 

overcrowded and badl y policed, but, by the 

standards of the day, the men cared for 

there did well. One of the surgeons attributed this fact to the proximity of the town 

to the sea and its breezes, the absence of 

malari a, and th e basic good health of the 

men, the weak and sick having been left 

behind when the march began. Nevertheless, twenty died later from their injuries." 

General Taylor's concern for the welfare 

of the casualti es from the two battles of 

12Ltrs, H eiskell to Wood (Apr 1846), RG 112, entry 

2, 17:409; Hawkins to Lawson (28 Apr 1848) and 

Thomas C. Madison to Lawson ( \ Jul 1848), both in 

RG 112, entry 12; Porter, "Notes" 23: 18- 19. 

UPorter, "Notes" 23:2 1-22. 

14 I bid. , pp . 2 1-22. 33; Jarvis , "Notes" 41 

(1907): 101 ; T. B. Thorpe, Ollr Anny at MOlllerrey 

(Philadelphia: Carey & Hart, 1847), pp. 294-95; 

Henry, Campaign Skefches. p. 11 0. 
. ( 

Santa Fe 

• EI Peso 

.Chihuahu8 S8n Antonio 

• 

orpU5 ~/ '" 

THE MEXICAN WAR 

TAYLOR'S CAMPAIGN 

1846-1847 

t? 

~{/ 

o 200 

LI --~Mrr"'ie~,---" 

ARK. 

- LA:---

NRW 

Orleans 

Christi 'f 

Mis<. PR/O Alto ff Poiol '''be' 

Camargo. • ~ Brezo S8nti8go 

GULF OF MEXICO 

• CtUfslvo ... ForI Brown Monterrey 

Saltillo. • Matamoros • Buena Vists 

MAP 3 

early May was not limited to his own men. 

He ordered Mexican wounded who had 

been taken prisoner turned over to Mexican surgeons, some of whom were, in Jarvis' opinion, "very skillful surgeons and 

very agreeable men." On Taylor's orders 

Jarvis visited four or five of the hospitals 

that had been captured when the enemy 

retreated and concluded that " nothing 

could exceed the filt h & stench of their hospitals from so many wounded crowded together and I felt happy when I had ended 

my visits." Most of the 300 to 400 patients 

he saw were suffering from the effects of 

grapeshot and round shot. "Many had both 

legs and arms completely torn off. I saw 
THE WAR WITH MEX ICO: THE TAYLOR AND KEARNY CAMPAIGNS 101 

one fellow keeping the flies off by means 

of a palmetto leaf in his mouth both arms 

hav ing been torn off at the shoulder joints." 

He learned that Mexican surgeons had performed many amputations in the fie ld and 

that some of the amputees had died of 

tetanus. ' 5 

For Taylor's medical staff, the difficulties 

were just beginning. New volunteer units 

sta rted to arrive in May 1846, when U.S. 

troops were occupying the abandoned Matamoros. The rains were heavy and lasted 

into September, low-lying ground was 

flooded , " and the whole country saturated 

with water, [while] the exhalations from it 

were quickened by the heat of summer into 

persistent malaria." Mosquitoes were not 

the only creatures to pose a problem; a tarantula bit a volunteer surgeon and " the 

effect of the poison was immediate and 

alarming. So violent were his spasms, that 

the united strength of several men was required to confine him to his tent."" 

Alcoholism was a problem in Mexico as 

in the United States. One patient at Matamoros had been thrown into the guardho use whil e suffering from delirium 

tremens. While so disturbed, he borrowed 

a " thick, one-bladed pocket knife," and 

"completely excised the whole of the genital apparatus, close to the body. Flinging 

them violently into one corner of the room, 

he ve ry hero ica ll y rema rk ed-'Any 

damned fool can cut his throat, but it takes 

a soldier to cut his privates off.' " The surISFirst quote, Ltr, Jarvis to He iskell (16 Nov 1847), 

RG 112, entry 12; remaining quotes. LIT, Jarvis to Will 

(24 May 1846), in Jarvis Papers; see also Jarvis, 

"Notes" 41: 102; Porl er, "Notes" 23:2 1; and George 

Deas, "Reminiscences of the Campaign of the Rio 

Grande," Historical lv/agazille, 2d se r., 7 ( 1870):237. 

16Quotcs from Luther Giddings, Sketches 0/ {he 

Campaign ill Northern Mexico . .. (New York: George 

P. Putnam & Co .. J 853), p. 40; Ltrs, Meade to Mrs. 

Meade (3 Jun 1846), in Meade, Life alld Lellers 1 :97; 

W. W. T. Bliss to Craig (22 Jul 1846), in RG 112, 

entry 12. 

geon was able to stop the hemorrhage that 

followed this deed. The delirium tremens 

did not return, and the patient survived, 

sadder and perhaps even wiser. 11 

T he diseases in northern Mexico tended 

to be mild, but the rate of sickness, relatively low in June, increased as the summer 

progressed, especially among the volunteers. Since almost 8,000 men were serving 

under Taylor by early June, it became necessa ry to erect another hospital building at 

Point Isabel and to open yet another faci lity at Fort Brown." 

The problems that Taylor's su rgeons encountered as his force moved further into 

Mexico differed little in general outline. 

Volunteers appear to have invariably fallen 

ill in greater numbers than regulars, and 

disease was invariably a more dangerous 

foe than the enemy. Malaria ca used much 

illness, scurvy appeared from time to time, 

and measles and mumps amicted volunteer 

units, but dysentery and diarrhea caused 

more difficulties than any other ailment. 

General hospitals were established at various points through which the army passed: 

at Mier and Camargo , near th e Rio 

Grande; then at Cerralvo, where at least 

one surgeon attempted with little success 

to treat the many sick Mexican children; 

and fina lly at Monterrey. At Matamoros, 

the department also established a hospital 

whe re doctors co uld iso late sma llpox 

victims. 19 

General hospitals were located in tents 

or in whatever buildings were available, 

and because ceilings were often low, venI7E. W. H. Beck, "Case of Excision of the Whole of 

the Genital Organs," Missouri Medica/and Surgical 

JOllfll(l/3 (1847-48); 160. 

18Llr, Bli ss to Craig (22 JuI 1846), RG 112,entry 12. 

J9Surgcon's Quarterly Rpts, M icr (30 Sep 1847 and 

3 1 Mar 1848) and Camargo (30 Sep 1846), all ;n RG 

94, entry 634; S. Compton Sm ith, Chile COli Came. or 

the Camp and 'he Field (New York: Miller & Curtis, 

1857), pp. 59, 65,76-77. 
102 THE ARMY MEDICAL DEPARTM ENT, 1818- 1865 

tilation poor, and rooms crowded, disease 

could spread rapidly. Even in tents, where 

ventilation was not a problem, the death 

rate was sometimes high; one author estimated, for example, that 1,500 men died 

at Camargo. Many of these general hospitals appear to have remained open until the 

late spring of 1848, when U.S. troops finally began to leave Mexico.'o 

Taylor and his army reached Monterrey 

on 19 September 1846. After a five-day 

struggle, during which U.S. forces suffered 

120 killed and 368 wounded, the defenders 

evacuated the city. For U.S. surgeons caring for troops on the field of battle, it was 

" all blood- blood- blood!" and "a dreadful sight. .. . Particularly where death [was) 

produced by artillery and the bursting of 

shells." Initiall y, only small tents or blankets on the ground were available for the 

wounded. Jarvis, and apparently some of 

his colleagues as well, were working in 

quarry pits, no more than five feet deep 

and wide, in which Jarvis had to stoop to 

avoid being injured himself. Once, when he 

had just completed one amputation and 

was preparing to do another, some soldiers 

fleeing a Mexican sally fell into the pit, on 

top of the wounded. Fortunately, the enemy did not spot Jarvis himself, and the 

surgeon was able to continue his labor. " 

As soon as the city of Monterrey surrendered, wagons and litters began carrying 

the wounded into the city, where surgeons 

established general hospitals for each of 

three divisions. The 1st Division facility 

lay in the former home of a Mexican general, which was, unlike so many hospital 

sites, "a beautiful place, with delightful 

gardens, [and) plenty of water." The house 

itself was sma ll, but outside, " upon terraces 

lOIrey. "Soldiers," pp. 288-89. 

uQuotes from Ltc, E. K. Chamberlain to S. C. West, 

in S. Compton Sm ith, Chile COil Came. p. 90; Jarvis, 

"Notes" 39:267-68. 

of stone, hundreds of ea rthen jars were 

ranged, in which flowering bulbs opened 

their limpid-looking petals, beside the double-leafed rose, and those things were reflected into a small stream that stole along 

in its artificial canal, until it noisily poured 

into a magnificent bath."22 

Even in this idyll ic setting, maggots were 

soon growing in wounds, which had to be 

reopened to eliminate the infestation. In 

many cases, a condition then diagnosed as 

erysipelas (but which may have been hospital gangrene, another form of streptococcal infection) developed two to three days 

after surgery, causing sloughing of the involved tissue and either killing its victims 

or necessitating further amputations. Malaria appeared amon g the hospita lized 

wounded, contributing to deaths and delaying convalescence, striking soldiers in 

camp and the civilian population of the 

town as well. Suppli es of quinine gave out, 

and surgeons were forced to rely on useless 

substitutes. Blankets, bedding, and lint 

were in short supply. " Nostalgia" (homesickness) had " a powerful depressing influence" on many of the new troops and 

volunteers, prolonging their recovery." 

The shortage of physicians seemed particularly severe after the battle for Monterrey, when the wounded were added to 

the large number of sick already hospitalized. The strain on Army surgeons was 

n First quote, Porter, "Notes" 23:35; second quote, 

Thorpe, J'dollierrey. pp. 11 5- 16; Jarv is, "Notes" 

39:268. 

HQuotes from Surgeon's Quarterly Rpt. Monterrey 

(30 Sep 1846), RG 94, entry 634; Ltrs, William W. 

Mackall ( 19 Oct 1846). in William W. Mackall, A 

Son's RecollectiollsojHis Falher(New York: E. P. Out· 

ton & Co., 19 30), p. 100; Craig to Lawson (2 1 Oct 

1846) and Jarv is 10 Heiskell ( 10 Aug and 3 Oct 1847) 

and to Lawson (20 Feb 1848), all in Meade, Life alld 

Letters I: 14 5; Port er, "Notes" 25:38-39; Payne. 

"Camp Life in the Army of Occupation: Corpus 

Christi , July 1845 to March 1846." Solllhll'estem Historical Quarlerly 73 ( 1970):34 1. 
THE WAR WITH MEX ICO: THE TAYLOR AND KEARNY CAMPA IGNS 103 

great, but Lawson deni ed Taylor's request 

for more surgeons beyond the twenty already wi th his force. A soldier familiar with 

the work of the Medical Department staff 

commen ted, "Nothing can exceed the devoti on of ou r medical officers; they are literally fatigued to death." Under the stress, 

one physician suffered a mental breakdown 

fr o m w hi c h he n eve r co mpl e t e ly 

recovered.24 

After 27 September, as the surgeons acquired the buildings necessary for di vision 

hospitals at Monterrey, more patien ts from 

regi menta l facilities bega n a rri ving, a lthough it was not until I October that Jarvis believed the large hospitals were ready 

to accommodate them. When President 

Polk disapproved the armistice that Taylor 

had arranged a fter taking Monterrey, and 

the wa r resumed, Taylor sent his 2d Division south to take Saltillo, an important 

Mex ican road junction. The 2d Division 

Hospital at Monterrey was broken up, and 

patients unable to march were sent to one 

of the other two di vision hospitals, which 

had been reo rgani zed so that all volunteers 

would be in one, all regula rs in the other. " 

Supplies were scarce at Saltillo, which 

Taylor's men took without opposition. Surgeons set up another general hospital, but 

the senior surgeon was forced to bu y some 

medicines locally, until the arri val of the 

2,800 volunteers and 600 regulars of Brig. 

Gen. John E. Wool, who brought an ample 

suppl y of medicines with them from San 

Antonio, Texas. Wool and his men camped 

lI C from Henry. Campaign Sketches. p. 226; 

Surgeon's Quarte rl y Rpt, Monterrey (31 Dec 1846), 

RG 94, entry 634; Giddings, Sketches. p. 84; Ltr5, 

Craig to Lawson (20 Oct 1846) and Finley to Lawson 

( 14 D ec 1846), both in RG 11 2, entry 12; see also Ltrs 

relating to James A . Conrad (1 847-53), RG 11 2, entry 

2, vols. \8-2 1 and 23. 

HSurgeon's QU3r1 Crl y Rpts, M onterrey (31 D ec 

1846 and 30 JlIn 1848), bOlh in RG 94, enlry 634. 

nearby at Parras and becamc part of Taylor's fo rce." 

Diarrhea, a mild form of malaria, and a 

life-threatening form of measles appeared 

among Wool's men before they left Texas. 

Caring for the sick were four department 

p hysicians and vo lunt ee r surgeo ns attached to indi vidual units. Although Congress had provided for two physicians to 

accompany each volunteer regiment, even 

this ratio was not always achieved in practice; as a rule, for example, onl y one medica l officer marched with the I st Illinois 

Volunteer Regimen!." 

The disease rate among Wool's men 

dropped after an early peak, and, since 

those unable to march were left behind in 

Texas at the San Antonio hospital, the departing force that started south in the fall 

of 1846 was, for the most part, healthy. One 

gro up of vo luntee rs who had recentl y 

joined the force suffered greatly, however; 

a measles epidemi c had left many weak; 

and the change in diet was causing much 

di gesti ve d istress among the men. The 

march, "under scorching sun, and over 

plai ns covered, in many places, to the depth 

of two or three feet with water," had " disastrous effects" upon them, including respiratory diseases a nd re lapses fro m 

measles. Fo r th e remainder of Woo l's 

forces, however, the simple diet and vigorous acti vity contributed to an improvement in health, despite such dangers as the 

26Ltr. Porler to Lawson (2 Jan 1847) and Surgeon's 

Quarlerly Rpt, Salti llo (3 1 Dec 1846), both in RG 94, 

cntry 634. 

170 tto B. Enge lman, cd. and trans. "The Second 

Illinois in the Mex ican War . .. , Journal o/rite J/Iinois 

Stale J-lisrorical Sociel), 26 (1934):374; William B. Herrick, "Letters of 5 November 1846," Illinois and Indiana IHedical and Surgical Journal, n.S. , I ( 1846):5 10. 

Since Mex ican War-era physicians could diagnose 

pneumonia. it is unlikely that the deaths blamed as 

measles actually resulted from this complication of 

the disease. It is probable that the vi rus then prevalent 

was more virulent than the present-day strain. 
104 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

PAGE OF LETTER FROM NATHAN JARVIS 

To "BEN," 16 June 1847. (Courtesy of Nell' 

York Academy of Medicine.) 

wounds from the sharp leaves of the palmetto soap plant that filled one of the valleys through which they marched. The 

effect of this particular plant was " so venemous [sic) that the wounds are hardly 

curable." The march even appeared to benefit those of the ill and convalescing who 

had joined their healthi er comrades on the 

journey; a surgeon with a volunteer unit 

reported that these men recovered more 

quickly than those who stayed behind. " 

Despite the hea lth ful effects of th e 

march, at Parras a measles epidemic of unusual severity soon co nfronted Wool's 

28Quotes from Jonathan W. Buhoup, Narralil'e of 

the Celllral Division (Pittsburgh: M. P. Morse, 1847), 

pp. 86, 228; w. B. Herrick, "Remarks Upon the Or~ 

gani zation of the Med ical Department of the Army, 

and Effects of Marching and a Camp Life in Producing and Modifying Disease," !/Iinois and Indiana J\tIee/-

ieal and Surgical iOllma/4 (1847- 48):227-29, 232. 

medical staff. By December the mortality 

rate was high; one of Wool's men recorded 

" It was very seldom a man recovered after 

he had fa llen into an aggravated state of 

the disease, and we knew cases where men 

have lain down in the evening and in the 

morning have been found choked to death, 

from the measels [sic)."" 

Fortunately, Wool's men had time to recover from the measles epidemic. The armistice had ended, but General Taylor's 

unit did not see action again until late February 1847. By this time Maj. Gen. Winfield Scott had arrived in Mexico to take 

command of the effort there, siphoning off 

most of Taylor's regulars and leaving him 

with a force that was largely volunteer. 

Scott ordered Taylor to evacuate Saltillo, 

where health problems were severe, and to 

take up a defensive posture at Monterrey, 

which was regarded as among the healthiest 

cities in Mexico. Taylor, acting as if he had 

been merely adv ised to abandon his offensive, instead advanced south of Sa ltillo. Finally, on 23 February, his forces met a 

much larger army under the Mexican general Santa Ana at Buena Vista. The U.S. 

victory there cost Taylor's troops 267 killed 

and 456 wounded, casualties that numbered about half those of the enemy's.'· 

Some members of Taylor's medical staff 

had been left behind to manage the hospitals behind the lines, but four Regular 

Army physicians in addition to those who 

had marched south with Wool were present 

at Buena Vista. Spent balls caused the few 

wounds experienced by U.S. soldiers in the 

initial skirmish on 22 February, and only 

two or three men died. The next day sur29Buhoup, Narrative, p. 94. 

JOJamcs K. Polk, The Diary oj lames K. Polk . . 

cd. Milo Milton Quaifc, 4 vols. (Chicago: McClurg, 

19 10), 2:476-80; Ur, Porter to Lawson (3 Jan 1847). 

RG 112, entry 12; Rpt, John Trevitt (31 Dec 1847), 

RG 94, entry 634. 
THE WAR WITH MEXICO: THE TAYLOR AND KEARNY CAMPAIGNS 105 

geo ns and th e stewards assisti ng th em 

placed themselves "at convenient points 

near their respective regiments, ready with 

a plentiful supply of instruments, ligatures, 

bandages, splints &c" in anticipation of 

battle and were soon immersed in their 

work.]) 

Man y of th e wounded were initially 

taken either to the nearby Ranchea Buena 

Vista or to the town cathedral. Wagons 

quick ly removed the 400 to 500 U ,S. and 

Mexican wounded originally sent to the cathedral to Saltillo, often with the aid of "a 

most gallant old gentleman," a civilian 

who, surprisingl y, was "always fou nd during th e battle , whe re he co uld be of 

service." J2 

Although during the night after the battle 

all the wounded appear to have suffered 

greatly from cold, thirst, and hunger, those 

sent to the ranchea were particularly unfortunate. A volunteer surgeon working 

there noted that "those of the wounded still 

living, the d ying a nd the dead [were ] 

crowded together indescrimin ately [sic], 

... presenting a melancholy picture of suffering and distress, not easily described, 

and never to be forgotten." A former patient there remarked that " the whole fl oor 

was covered wi th wo und ed . . . . T he 

screams of agony from pain, the moans of 

the dying, the messages sent home by the 

despairing, the parting farewe lls of friends, 

the incoherent speech, the peculiar movements of the hands and fingers," all testified to the miseries of the wounded" 

llQuote from W. B. Herrick, "Surgery in the Hospitals A fter the Battle of Buena Vista," J/Iinois Medical 

and Surgical Journal 4 (\847- 48):302; James Henry 

Carl eton , BailIe of Buena Vis/{l . .. (New York: Harper 

& Bros., 1848), pp. 139, 236. 

l2Quotes from Carl eton, Dilella Vista, p. 127; H . 

Montgomery, Life of Zachary Tay/or (Auburn, N.Y.: 

J. C. Derby & Co., 1847), p. 349. 

llFirst quote, Herrick, "Surgery in the Hospitals" 

4:414- 15; second quote. French, Two Wars, pp. 8 1- 82. 

The surviving patients from the ranchea 

were moved to the cathedral as soon as possible and then, several days later, were divided up among less crowded facilities, 

each of which could hold 50 to 100 men. 

Doctors attempted to have wounded volunteers from the same regiment housed together. Officers apparently had pri vate 

quarters, but large numbers of enlisted men 

shared a common room. Mexican surgeons 

worked on their own wounded; at least half 

of their patients died, a fact a U.S. surgeon 

attributed to their "diet composed of saccharine, fatty, and other carbonaceous substances, and a life of idleness a nd 

dissipation."14 

The battle of Buena Vista marked the 

end of acti ve campaigning for the army under Zachary Taylor, although many of the 

men who had come to Mexico with him 

participated in operations conducted further south and directed at Mexico City. 

While Taylor and Wool were undertaking 

the conq uest of northeastern Mexico, however, the Army of the West, under the command of Brig. Ge n. Step hen Kearny, 

launched a second campaign, one aimed at 

the northwestern region that included the 

present-day states of New Mexico and California. In Kearny's force assembling at 

Fort Leavenworth in the spring of 1846 

were a company of dragoons, as well as artillery and infantry units, and an 860-man 

regiment of mounted volunteers led by Col. 

Alexander Doniphan. " 

J-IH errick, "Surgery in the Hospitals" 4:4 14- 15, 

quote from 418. 

l)Georgc Rutledge Gibson, Journal 0/ a Soldier VI/-

der Kearny and Doniphan. 1846-47. ed. Ralph P. Bieber (Glendale, Calif.: Arthur H . Clark Co., 1935. 

Reprint. Philadelph ia: Porcupine Press , 1974), p. 125; 

William Hemsley Emory, Liellleflalll Emory Reports. 

cd. Ross Calvi n (Albuquerque: University of New 

Mexico Press, 1951), p. 2 1; Wi lliam H . Goetzmann, 

Exploratioll and Empire (New York: Alfred A. Knopf, 

1966), p. 13 1. 
106 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

The first leg of Kearny's journey from 

Fort Leavenworth was a 50-day, 900-mile ordeal through wilderness, desert, and mountains to Santa Fe, ending in mid-August. 

By early July, "many were sick, lame, and 

exhausted," often too exhausted to continue under their own power. Although the 

Mexicans presented no opposition to their 

progress, disease, privation, and stress 

soon incapacitated many and fi lled the 

wagons being used as ambulances. Inadequate diet led in some instances to scurvy, 

good water was often hard to find, and " the 

mosquitoes came out in clouds in the intense heat of the midday sun."" 

Although it is difficult to be precise 

about the number of ph ysic ia ns with 

Kearny on the Fort Leavenworth-Santa Fe 

portion of his march, at least six accompanied him. The medical director and two 

assistant surgeons were Regular Army physicians. One of these doctors was John S. 

Griffin, who, having been replaced as post 

surgeon at Fort Leavenworth by a volunteer surgeon, accompanied Kearny the entire way to California. A doctor left at 

Bent's Fort, in what is now Colorado, with 

three invalids was apparently a volunteer. 

Two more surgeons may also have been volunteers; one of them early acquired a reputation as "both lazy and too ignorant to 

attend to the duties of his office."" 

l6Abraharn Robinson Johnston, Marcellus Ball Edwards, and Philip Gooch Ferguson, Marching With lite 

Army of the West. cd. Ralph P. Bieber (Glendale, 

Cal if.: Arthur H . Clark Co., 1936. Reprint. Philadelphia: Porcupine Press, 1974), pp. 142, 172-73, first 

quote. p. 83; Gibson, JOllrnal, pp. 129, 133-34, 143, 

152, 161 , 249, second quote, pp. 133-34; Dwight Laneclat Clarke, Stephen Watrs Kearny: Soldiero/fhe West 

(Norman: University of Okl ahoma Press, 1961), 

p. 130; Viola Lockhart Warren, " Dr. John S. G riffin's 

Mail, 1846-1853," Ctl/ijomia Historical Society Quarlerl)' 33 ( 1954):97-98, 101. 

17John ston, Edwards, and Ferguson, Marchillg, 

p. 15, quote from p. 127; Gibson, JOl/mal. p.234; 

Warren, "Griffin" 33:97- 98, 101. 

At Santa Fe, Kearny divided his force . 

Although he and 300 dragoo ns, a 14-man 

topographical team, and a few scou ts continued westward, Colonel Doni phan and 

his Missouri vo lunteers initially remained 

in what wou ld become New Mexico. They 

attempted to work at pacifying the Navajo 

Indi ans, but their ultimate goal was Chihu ahua , about 200 mil es into Mexico, 

where they were to join Wool. Although 

Doniphan's men were suffering from fevers 

and measles, after sign ing a treaty with the 

Navajo on 22 November and learning that 

the Mexicans were planning to defend EI 

Paso, on the route to Chihuahua, the colonel decided to march so uth. Moving so rapidly that there was no time for him to 

receive additiona l supplies or reinforcements, Doniphan took EI Paso at the end 

of December and then continued south. 

Word that Wool's plans had changed and 

that he wou ld not be at Chihuahua did not 

deter Doniphan. Covering as many as 50 

miles in one day through unfriendly terrain, enduring the effects of short rations 

and inadequate supplies of water, and 

threatened by snakes, scorpions, and grass 

fires, by February 1847 Doniphan and his 

men were approaching their goal. After defeating the Mexicans near Chihuahua, they 

camped at that town, awaiting further orders. On 21 May, only ten days before their 

terms of enlistment were up, orders arri ved 

for them to join Wool at Saltillo." 

J8 lrey, "Soldiers," pp. 292-93: R. Ernest Dupuy, 

The Compact History oJthe Ullited States Army. new 

and rev. ed. (New York: Hawthorn Books. 196 1), 

pp.95-96; Alexander Majors, Sel'emy Years 0 11 the 

Frofllier: Alexllllder Majors, Memoirs oj a Lifetime 011 

fhe Border. cd. Prentiss Ingraham (M inneapoli s: Ross 

& Haines, 1965), p. 90; A. B. Bender, " Frontier Defense in the Territory of New Mexico, 1846- 1853 ," 

New Mexico Hisloric(11 Review 9 ( 19 34):25 1-52; James 

A. Huston, Th e Sinews of War: Army Log istics. 

1775- 1953 (Washington: Office of the Chief of Military History. 1966), p. 146; Edward Everrett Dale. The 

Indians oj the Sowhll'est: A Cel/tury of DI..'1'e/opmelll 
THE WAR WITH MEXICO: THE TAYLOR AND KEARNY CAMPAIGNS 107 

None of Doniphan's ph ysicians was a 

Medical Depa rtment surgeon. One was an 

Ameri ca n civili an hired in Chih uahua , 

where the Mexicans had imprisoned him 

when war was declared. Although these 

doctors were probabl y unfamili ar wi th the 

demand s of military medicine, they were 

called upon to ca re for a command with a 

sick rate that approached 33 percent and a 

high deat h rate as well. Their pati ents included many with measles, fevers, and 

diarrhea. After the engagement near Chihu ahua , in wh ich Doniphan lost five 

wounded and one killed, they ca red not 

only for their own wounded, but for Mexican casualties as well. They performed a 

large number of amputations; a veteran of 

the battle noted that it was " a sight to see 

th e pile of legs and arms that have been 

amputated,"J9 

Both the men who remained at Sante Fe 

and th e vo luntee rs who ca me in after 

Kearny and Doniphan left we re often sick, 

some from malaria acquired earlier, others 

from such diseases as tonsillitis, colds, 

measles, dysentery, typhus, and " a disease 

affecting the men something li ke mumps." 

The death rate could be fi ve to eight in one 

day. Houses were converted into hospitals, 

but by the end of October 1846, when there 

were at least 2,700 men at Sante Fe with 

more still arri ving, the hospitals were full. 

Supplies were running short because of the 

difficulties in vo lved in pred ictin g how 

many vo lunteers would come in, and there 

was confu sion as to where these supplies 

should come from. The Regular Army phyUnder file United Srafes (Norman: Un iversity of Ok lahoma Press. 1949), p. 47; Gibson, JOllma/. p. 276; 

Richardson, Journal, pp. 35.37. 

J9Richardson, Journal, pp. 35, 37, quote from p. 63; 

IfCY, "Soldiers," pp. 292- 93: Adolphus Wislizenus, 

Memoir 0/ a TOllr 10 Nonhem Mexico (Albuquerque, 

N. Mcx.: Calvin Horn, 18 58); U f, James Shi elds to 

Lawson (28 Jan 1949), RG 11 2. entry 12. 

sic ian who was in charge of the general hospita l at Sante Fe, Samuel De Camp, fell ill 

hi mself. He recovered quickly, but even 

with the aid of three medical officers working directly under him, two of whom were 

Regular Army surgeons, and the physicians 

with the volunteers, De Camp was unable 

to stem the tide of illness amo ng the volunteers. On 10 November, six men died, 

and th e next day fi ve more, several from 

measles. As the weather turned colder and 

the wind rose, not all the vo lunteers could 

find adequate shelter. One noted, "A great 

mortality prevails among the troops who 

are dying from exposure and disease."'o 

Through the wi nter until earl y February 

1847, the men remaining at Santa Fe were 

occupied principally with subduing Indian 

and Mex ican rebels. The hea lth of the command remained poor; even in mid-April, 

pneumonia and other respiratory ai lments 

as well as severe cases of fever confronted 

medical officers there. The suppl y of medicines was limited through much of the 

spring, and attempts to improve the health 

of the comma nd were often frustrated. 

Many of the men preferred bread and meat 

to vegetables and fruits, and De Camp 

maintained that a " vegetable diet [was] almost unknown in New Mexico." By the 

time scurvy appea red among the men , 

many of the Missouri volunteers were a lready sick, having been in poor health 

when they started their journey to New 

Mexico, where they hoped to improve or 

even rega in their hea lth through the change 

in climate. As a result, by the time they 

reached Santa Fe, some men were in no 

condition to work. According to De Camp, 

" Man y of them have not done one day's 

4°GibsOIl , Journal. pp. 27 1, 271n, first quote, p. 244; 

Richardson, JOl/mal. p. 13, second quote, p. 37; Ltf, 

De Camp 10 Lawson (2 1 Oct 1846), RG 112, entry 12; 

Surgeon's Quart erl y Rpt, Army or the West (3 1 Dec 

1846), RG 94, entry 634. 
108 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

SAMUEL DE CAMP. (Courtesy of National 

Library of Medicine.) 

duty since they left Missouri." He urged 

that volunteers be given physical examinations before bei ng sworn into the Army, 

so that the unfit would never be in a position to receive pay. Noting, however, that 

the men from Missouri, unlike many of the 

other soldiers at Santa Fe, were accustomed to a vegetable diet, he urged that 

seeds be sent to him so he could plant a 

garden for their benefit. Whether he ever 

received his seeds is not known, but, if 

planted, the garden could not have been 

very successful; in March 1848, 79 men in 

a command of fewer than 250 volunteers 

were reported to have suffered from scurvy 

in the preceding quarter. 41 

41Quotes from Ltr, Dc Camp to Lawson (14 Apr 

1847), RG 11 2, entry 12; Ltr, Heiskell to Lawson 

(12 Mar 1847), RG J 12, entry 2, 17:266; Surgeon's 

One further venture into Mexico took 

place from Santa Fe in the spring of 1848, 

when the officer commanding in New Mexico led approximately I, I 00 regulars and 

volunteers accompanied by two surgeons 

towa rd Chihuahua. In mid-March and 

after the actual signing of the peace treaty, 

they encountered a Mexican force at Santa 

Cruz. The U.S. triumph left three of the 

victors dead and nineteen wounded. Chihuahua was reoccupied, but disease proved 

to be a devastating enemy; few were spared 

at least one episode of diarrhea, dysentery, 

respiratory infection, scurvy, or a venereal 

disease in the first quarter of 1848, before 

returning to Santa Fe." 

Kearny himself left Santa Fe for San 

Diego late in September 1846 with a force 

of mounted troops. Learning two weeks 

later that the U.S. Navy's Pacific squadron 

had already secured the principal California ports, he sent 200 dragoons and a surgeon back to Santa Fe, and with the two 

remaining companies of dragoons continued his westward journey. The two Regular 

Army surgeons who were with him apparently drew straws to determine who would 

return to Santa Fe, and Griffin won the 

right to continue on with Kearny." 

On 6 December, when Kearny's men 

were but thirty-nine miles from San Diego 

and both mules and riders were exhausted, 

a force of Californians attacked them at 

San Pasqual. Although he was now the only 

surgeon with the unit, Griffin was eager to 

share in the action. Aware that Kearny 

would not permit him to do so, he attempted to sneak forward unseen by his 

commander. When four of the enemy spotQuarterly Rpts, Army of the West (31 Mar 1847 and 

31 Mar 1848), both in RG 94, entry 634. 

42Surgco n's Quarterly Rpt , Army of the We st 

(31 Mar 1848), RG 94, entry 634. 

43Warren, "Griffin" 33:98; Goetzmann, Explora- tion, p. 134. 
THE WAR WITH MEXICO: THE TAYLOR AND KEARNY CAMPAIGNS 109 

ted him, Griffin tried to fire his doublebarreled shotgun at them, but since the 

weapon was wet, it would not discharge. 

He was forced to flee to gain the protection 

of the dragoons. Although Griffin escaped 

injury, the battle of San Pasqual left eighteen U.S. dragoo ns dead and nineteen 

wounded. Among the injured was Kearny 

him se lf, who s uffer ed two painful 

wounds. 44 

After the battle, Griffin worked late into 

the night caring for the wounded. The devices dubbed ambulances that soldiers prepared for his patients appear actually to 

have been merely buffalo-hide travois fastened between willow poles, each dragged 

behind a mule. When the expedition took 

to the road the next day, the wounded in 

the middle of the group for protection, " the 

ambulances grated on the ground, and the 

sufferings of the wounded were very distressing." Kearny himself was able to ride 

and was thus spared this agony. On the second day a ft e r the ba ttie , one of the 

wounded died, and the rest were in no condition to progress farther. Kearny sent 

three men ahead to San Diego for help. He 

ordered that the dead man, "a gallant fellow, who had,just before leaving Fort Leavenworth, married a pretty wife," be buri ed 

deep in the ground and his grave covered 

with heavy stones so that wolves would not 

dig up the body. The survivors of Kearny's 

force then settled down to wait until the 

wounded were well enough to ride; Kearny 

believed that slow-moving wagons required 

a heavier guard than he could provide. On 

10 December, shortly after Griffin had 

concluded that all but two of the injured 

were able to ride, a rescue party of 100 

sailors and 80 marines rode in from 

44Warren, "Griffin" 33; 102; Emory, Reporrs. p. 168; 

J. M. H . Hollingswort h, " Journal," California Histor· 

ical Society QlIllnerly 1 ( 1923):240. 

San Diego to escort them to safety. The 

wounded entered a Navy hospital; while 

they were there, someone stole their blankets, presumabl y the first of the many 

thefts of this type to plague the Army's sick 

in California." 

Kearny's supply train came west to Ca lifornia from Santa Fe by a more southern 

route than the general had taken. Guarded 

by a volunteer battalion of Mormons commanded by Lt . Col. Philip St. George 

Cooke, the wagon train and the surgeon 

assigned to the entire force, a volunteer 

gi ven to overdosing his patients with calomel, arrived in San Diego at the end of 

January 1847. The battalion remained a 

short time for recuperation and drill at the 

California mission at San Luis Rey, just 

north of San Diego, before being broken 

up into companies and sent to San Diego 

and Los Angeles, which had been peacefull y surrendered on 10 January. The surgeon with Cooke's force appears to have 

remained with them at San Luis Rey and 

then been reassigned to Los Angeles, while 

Griffin remained for several months at San 

Diego." 

Surgeon General Lawson announced 

early in December 1846 that the medical 

needs of the units newly arrived in California cou ld be supplied be tt er from 

St. Louis than New York. The Medical Department also shipped some supplies with 

transports taking troops to California by 

4~ mory , Reports. pp. 168, 172- 74, quotes from pp. 

171 , 173; Viola Lockhart Warren, Dragoons 01/ Trial: Los Angeles (Los Angeles: Dawson's Book Shop, 

1965), p. 2; Arthur Woodward, Lances at Sail Pascllal 

(San Francisco: California Historical Society, 1948), 

p.39. 

46Warren, "Griffin " 33:106- 08,110- 11 ; A. B. 

Bender, "Government Explorations in the Territory 

of New Mexico, 1846- 1859," Nell' ,\;Iexico Historical 

Review 9 ( 1934):4-5; Emory, Reports. pp. 182, 188; 

Frances E. Quebbeman, Medicille ill Territorial Ari~ 

zOlla (Phoenix: Arizona Historical Association, 1966), 

p.29. 
110 THE ARMY MEDICA L DEPARTMENT, 1818- 1865 

ROBERT MURRAY. (Collrlesyo/Nalional Library 0/ Medicine.) 

sea. Griffin, the first Regular Army surgeon 

to arrive in California, served as a medi cal 

purveyor, receiv ing the supplies and then 

distributing them to both volunteer and 

Regular Army physicians. He does not appear, however, to have been as methodical 

as Lawson wou ld have wished; Lawson was 

repeated ly irritated by Griffin's fai lure to 

fi le his reports on time. Moreover, when 

the surgeon received orders late in the 

spring of 1847 to report for duty to Los 

Angeles, he forgot to bring his medi cal records with him. He also appears to have forgotten to lock up the supplies he left behind 

for his successor, and, as a result, they were 

stolen. Unlucky when it came to theft, in 

November 1847 Griffin reported that a 

volunteer hospital steward had been stealing his more expensive medicines, including morphine:

n 

By the time Griffin was ordered to Los 

Angeles, significant resistance had come to 

an end in California , and Army surgeons 

were able to settle down into a peacetime 

routine. Ships brought volunteers around 

Cape Horn to the newly acquired territory; 

on one such vessel was assistant surgeon 

Robert Murray, who would become surgeon general in 1883. Like the other surgeons in Californ ia, he was soon in volved 

in treating the victims of accidents and Indians, diarrhea and typhoid. He may, li ke 

Griffin, have even treated soldiers newly 

landed from the six-month voyage around 

Cape Horn who were suffering fr o m 

scurvy.48 

Conclusion 

Surgeons who, like Griffin, served in the 

northern provinces of Mexico, faced familiar diseases of a kind to be found at 

many of the forts in the West. Nevertheless, 

because there were so few doctors in proportion to th e numb e r o f sic k and 

wounded, the stra in upo n these medi cal offi cers was great. Their principal difficulties 

in volved caring for relatively large numbers of troops on the move and in finding 

adequate shelter for those of the sick and 

wounded who were unable to march with 

their comrades. The setting for the Medical 

Department's greatest challenge, however, 

lay to the south. 

41Warren, "Griffin" 33 : 118, 120-21 , 258; Ltrs, Lawson to AG (8 Dec 1846) and Heiskell to King (2 Aug 

1847), both in RG 112, entry 2, 17:95 and 59 1, respecti vely; George Sande rson to Grimn (8 Apr 1847) 

and Griffin to Lawson ( I JUIl 1847), both in Warren, 

"Griffin" 33: 112, 118, respectively; Griffin to Lawson 

(22 Nov 1847), RG 11 2, entry 12. 

4SWarren, "Griffin" 33:252- 53, 258-59, 267. 
Chapter 6 

The War With Mexico: 

Scott's Campaign 

T he campaigns in Mexico's northern 

provinces, though successful , fail ed to 

bring that nation to her knees. As a result, 

in the autumn of 1846, Maj . Gen. Winfi eld 

Scott began planning a campaign to take 

Mexico City itself. Among his most important considerations at this time was the 

danger of yellow fever which, he was convinced, would make serious inroads into 

his force if April 1847 and the following 

months were to find him still in the mosquito-ridden coastal areas. 

Joining General Scott in New Orleans at 

the end of 1846 was his good friend Surgeon General Thomas Lawson, who, after 

several months of sniping from the sidelines at the way Taylor and his medical director were handling th e assignment of 

surgeons, had a rranged to visit that city. 

The purpose of Lawson's trip was ostensibly to supervise the establishment of a 

medical supply depot, but he quickly accepted Scott's invitation to accompany 

him on his march to Mexico. The surgeon 

general remained with the in vading force 

from December 1846 through ea rl y 1848, 

but he insisted that he was present 111 an 

advisory ca pacity only. ' 

ILtrs, Lawson to Walker (29 Aug 1846) and to Alex~ 

andcr Suter (11 Nov 1846), both in RG 112, entry 2, 

16:473 and 17:53, respecti vely; sec also the collection 

The question of why Lawson did not offi ciall y take over the duties of the medi ca l 

director for Scott's army has no obvious 

answer. He rarely usurped the prerogati ves 

of his subordinate, who was obviously in 

no position to protest encroachment. Lawson had, of course, found the management 

of medical officers and their wo rk from 

Washington during wartime a frustrating 

business at best. His refu sa l to assume 

overall responsibility for the medi cal care 

of Scott's army while in the fi eld suggests 

that he would have been happiest merely 

serving as a senior surgeon on the battlefi eld, where the excitement was great and 

th e responsibiliti es relatively uncomplicated. Available evidence indicates that 

Lawson's somewhat amb iguous position in 

Mexico, far from being helpful to his surgeons, actually caused confusion. His abse nce fr o m his d esk in Wa shin gton , 

moreover, meant that, at this crucial time, 

one of his subordinates, surgeon Henry 

Heiskell, was acting surgeo n general, making the important decisions about supply 

and the apportionment of the Medical Department's li mited number of su rgeons. 

Fortunately, Heiskell was thoroughly competent, and the department does not ap-

"Lawson Papers" fo r documents that suggest a close 

friendship between Scott and Lawson. 
• Santa Fe 

Tampico 

THE MEXICAN WAR 

SCOTT'S CAMPAIGN 

1847 

Monterrey 

• 

New 

Or/s8ns 

o 200 

Vera Cruz ~ 

• 

Mexico City 

• • Chepultepec 

-T8Cub8Y8 

Perote. 

o 

I 

{l 

Lobos Island 

Jalaps 

• 

Cerro Gordo· 

100 

Miles 

GULF 

OF 

MEXICO 

Mixc08C • 

·Sen Antonio 

·Sen Augustin 

Puebls 

• 

Plan del Rio· Vera • 

Cruz 

MAP 4 

pear to have suffered unduly from Lawson's absence from Washington, despite his 

lack of interest in his Washington office 

while he was in the fie ld.' 

2Ltr, Adam N. McLaren to Med D ir (3 Jan 1848), 

RG 94, entry 634; Lawson to G. M. Brooke (7 Dec 

1846) and Heiskelllo Drake (8 Apr 1847), 10 John C. 

Glen (18 Jun 1847), and 10 AG (7 Jul 1847), all in 

Preparing for Invasion 

Even before they set foot on Mexican 

soil, Scott's men were plagued by an assortment of diseases. The medical purRG 112 , e nlr y 2, 17 :93 , 411 , 506 , and 545 , 

respectively. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 113 

veyor at New Orleans had to work "night 

and day" to a id the men boarding transports there-"The dark cloud of disease 

hove red ove r us," a vo lunt ee r surgeo n 

wrote in describing his sea voyage to Mexico. Illness continued to strike as the troops 

landed at Tampico, a town ta ken from the 

Mexicans in the fall of 1846 by the U.S. 

Navy, and at Lobos Island, off the coast. 

(Map 4) On the island, Surgeon Richard S. 

Satterlee was running short of quinine in 

December 1846, and an outbreak of smallpox detained three companies of Pennsylva ni a vo lunteers when the ir co mrades 

departed for the assault on Vera Cruz. Mississippi volunteers, the " most lawless set of 

men" the surgeon general had ever seen, 

ran up bills with private physicians without 

authorization. J 

When two di visions from Taylor's force 

arri ved to join Scott's command at Tampi co in the summer of 1847, surgeons 

found it necessary to establish a general 

hospital to care for the sick. Like so many 

of the general hospitals established in Mexico, the Tampi co fac ility apparentl y remained in operation at least through the 

spring of 1848, at which time more than a 

thousand volunteers and a tenth as many 

regulars were stationed in that town. YelJThomas N. Love, " Remarks on Some of the Diseases Which Preva il ed in the 2d Reg. Mississippi Rines, for the First Six M onths of Its Service," New 

Orleans Medi cal and Surgical Jou rl/ a/ 5 

(1848-49);4-6, first and second quotes, 5-6; third 

quote, Llr, l awso n to Heiskell (1 1 Feb 1847), RG 112, 

entry 12; Porter, "Notes" 26:301; Llr. Scott to Butler 

(3 Jan 1847), in U.S. Wa r Depa rtmen t, Correspondellce Between the Secretary of War alld Generals Seo(/ 

and Taylor. and Between General Scali alld Mr. Trisl, 

presented to the 30th Cong., 1 SI sess., House of Representatives, as Ex. Doc. 56, p. 41; LITS, Scott to Marcy 

(28 Feb 1847 and 24 Feb 1848) and to Butler (3 Jan 

1847), all in U.S. Wa r Depa rtment, Lelfers o/General 

Winfield SCO{( alld Secrelary ,\;1al"cy Relating to flie 

Mexican War (/848) (n.p., n.d.), pp. 1-2, 41 , and 86, 

88, respectively; Oswandel, Notes, pp. 61 - 62; Lt r, Satterlee to Lawso n (27 Dec 1846), RG 112, entry 12. 

RICHARD S. SATTERLEE. (Courtesy of National Library of Medicine.) 

low fever struck in the fall of 1847, causing 

fifty-four deaths, but dysentery, di arrhea, 

and malaria were such common diseases 

that each soldier averaged almost two hospita li za ti o ns a qua rter in the so-call ed 

sickl y season, the late summer and early 

fa ll , of that year.' 

Establishing a Base: Vera Cruz 

Despite his best efforts, Scott was a 

month behind his timetable when his 6,000 

regulars and 8,000 volunteers left Tampi co 

and Lobos Island and landed near Vera 

Cru z in early March 1847. They brought 

with them tents where the approximately 

4Ltr, Hawkins to Lawson (5 Jul 1847) and Surgeon's 

Qua rterly Rpts, Tampi co (30 Jun, 30 Sep, and 31 Dec 

1847 and 31 Mar 1848), all in RG 94, entry 634. 
114 THE ARMY MEDICA L DEPARTMENT, 18 18-1865 

JOHN B. PORTER. (Collrlesy of Nalional Library of Medicine.) 

twenty physicians with Scott could care for 

their patients during the siege of that town. 

When the Mexicans there surre ndered, 

Army doctors set to work to locate more 

permanent quarters for both sick and 

healthy. They also began to deal with the 

various forms of filth that littered the city's 

streets, which they found to be broad and 

easily cleaned. Surgeon John Porter took 

over an old Franciscan convent facing the 

sea to serve as a general hospital, attracted 

by its excellent ventilation and good water 

supply. (Church and monastery buildings 

would prove to be popular choices as Army 

hospitals in Mexico.) Porter was not able, 

however, to obtain competent hospital attendants, and moving the wounded to the 

new facility, often by means of a blanket 

carried by four men, irritated wounds and 

may have caused one death. To add to Porter's troubles, many of his patients were 

afflicted with di arrh ea, but the new hospital contained neither privi es nor "chamber utensils.'" 

Because of its location, Vera Cru z became the site both of an important general 

hospital and of the principal med ica l suppl y depot for General Scott's campaign. 

The med ical purveyor there, Charles H. 

Laub, was apparentl y responsible for distributing supplies that arrived at his post 

to th e purveyors at other bases in central 

Mexi co, but the presence of the surgeo n 

general in Mexico caused him some confu sion. In the early summer of 1847, Laub 

was still submitting his reports on the rece ipt of shipments to Lawson, and since 

Lawson did not bother to forward these 

documents to Washington, the New York 

City supply officer assumed that supplies 

were going astray and conti nued to ship 

more. Laub, on the other hand, concluded 

that the arrival of goods he had not ordered 

meant that requisitions were no longer necessary. Not until August, when the true nature of the problem began to emerge, did 

Laub realize that he should be reporting 

directly to Washington both on the arrival 

of shipments and on his future needs. 6 

T he supply situation in 1847 was a lso 

complicated by the fact that more men 

were being called up tha n the Medical Department had prepared for. In urging care 

in the use of hospital stores and medicines, 

tc . "Notes" 26:302, 3 11 , 322-23. Quote from 

332; Roger G. M iller, "Yellow Jack at Vera Cruz," 

Pr%glle 10 ( 1978):48; J. F. H. Claiborne, Life and 

Correspondence o/Jolill A. QllimulII . .. , 2 vols. (New 

Yo rk: Harper & Bros., 1860), 2:232; Llrs, Lawson to 

Brooke (7 Dec 1846) and Heiskell to Finley (8 Jan 

1847), both in RG 112, entry 2, 17:93; Lawson to 

Heiskell (11 Feb 1847) and Porter to H eiskell (19 Aug 

and 3 Sep 1847), all in RG 11 2, entry 12. 

6Llrs, Laub to Lawson (20 May, 30 Jun , and 3 Aug 

1847), and Joseph J. B. W right to Lawson (25 Oct 

1847), all in RG 11 2, entry 12; Heiskell to Satterlee 

(6 Mar 1848), RG 112, entry 2, 18:467. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 115 

acting surgeon general Henry Heiskell deplored in particular the extravagance of 

volunteer surgeons; another member of the 

departmen t's staff directed the same comment at volunteer nurses and hospital attendants as wel l. Occasiona l o rders to 

suppl y medicines to teamsters and other 

employees of the Quartermaster's Department made the attempts of the Surgeon 

General's Office to predict need accurately 

all the more difficult. Unexpected ca lls for 

supplies apparently were not unu sual at 

lower levels in the chain. Purveyor Laub, 

for example, was distressed to learn in the 

fa ll of 1847 that he wou ld be responsible 

for supplying the units coming south from 

the Rio Grande area, where they had been 

serving under Genera l Taylor, since they 

were apparentl y bringing little in the way 

of supplies with them.' 

Two items that would in the fut ure be 

considered vital were not among regular 

shipments through Vera Cruz. A visiting 

civilian physician brough t ether and the apparatus to administer it to the hospitals 

and demonstrated its use, but it inspired 

no e nthusiasm. Lawso n himse lf determined that the volatility of et her and the 

fragility of the necessary equipment made 

anesthesia impractical in Mexico. Porter 

concluded that its con tinued use would 

onl y add to the toll at that hospital. He 

blamed et her for slow healing as well as for 

the excessive bleeding that had characterized a thigh amputation that he saw performed with its a id. It poisoned the blood, 

he mainta ined, and damaged muscle " contractility." He speculated also about the relationship between ether and an increase 

in hospita l gangrene (which was probably 

a streptococcal infection) and stated (inlLtrs, Heiskell to Craig (6 Sep 1847), RG 11 2, entry 

2, 18:5 1; Glen to Lawson ( I Dec 1846) and Laub to 

Lawson (29 Oct 1847), both in RG 112, entry 12. 

C HARLES H. LAUS. (Collrte;y oj National 

Library oj Medicine.) 

acc ura te ly) that hospita l gangrene had 

never ex isted before the use of anesthesia' 

Lawson had also been in vestigating the 

possibility of obtaining ambu lances, but 

even at th e time of the land ing near Vera 

Cruz, the Medical Department was still unable to provide its surgeons with any type 

of vehicle designed specifically to serve as 

an ambulance. One authority maintains 

that the department did not use this type 

Quote from J. B. Porter, "Surgery and Surgical Pa ~ 

thology: On the Effects of A nesthetic Agents in Operations for Gunshot Wounds," New York Journal 0/ 

Medicine and the Col/aleral Sciell ces, n.s., 9 

(1852):288-89; Llr, Lawson to Morton ( I Mar 1852), 

RG 112, entry 2, 22:276; Wangenstcen and Wangenstcen, Rise 0/ Surgery, p. 26; George Winston 

Smith and Charles Judah, cds., Chronicles o/Ilte Grillgas: The u.s. Army ill Ihe lV!e.\"iclllI War, 1846- 1848 

(A lbuquerque: U ni ve rsity of New Mexico Press, 

1968), Pl'. 349-50. 
116 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

of con veyance for a decade after the war. 

A soldier who was in Mexico in December 

1847, however, wrote of his trip in an " ambulance," which he described as a closed 

and very un comfortable wagon with 

springs. It seems unlikely that the vehicles 

referred to as ambulances in such contemporary documents were built to serve exclusively as such. Lawson's order for fifty 

wagons specifically designed to carry the 

wounded, apparently placed after the start 

of the war, was lost in the Quartermaster's 

Department until too late for them to be 

used in Mexico and was thus apparen tly 

never filled' 

Like the supply depot, the general hospital established at Vera Cruz was vital to 

the campaign. It remained open for the remainder of the war, caring for an average 

offrom 300 to 800 patients at a time, many 

of whom were probably destined for evacuation to New Orleans. Patients from units 

stationed nearby were sent to Vera Cruz 

when their camp had no attending surgeon 

or no accommodations for the sick. Not all 

of the hospital's occupants were soldiers; a 

few were civilian laborers, often "Irishmen, 

and very dissipated." When Scott's army 

prepared to advance beyond the coastal 

areas, the sick and wounded in regimental 

hospitals who were unable to march 

swelled the population of the general hospital; a total of more than 1,000 soldiers 

remained behind. By 17 April, when the 

9QUotc from Charles F. Hinds, ed., "Mexican War 

Journal of Leander M. Cox," Kelllllcky Historical Society Register 5S (1957):2 19; Ltrs, Harney to Tompkins 

(6 Jun 1848), in Daniel D. Tompkins correspondence 

( 1847-49), NLM; Lawson to Heiskell (II Feb 1847), 

H. L. Thistle to Scott (26 Jun 1847), and Testimonial, 

Valentine Mott, Lawrence Proudfoot. and William H. 

Van BUfen, all in RG 11 2, entry 12; Ltrs, Lawson to 

Mower (4 Dec 1846) and Heiskell to Edward Warren 

(3 May 1847), both in RG 112,entry 2, 17:86 and 434, 

respectively; Mower to Asher Robbins Eddy (18 Jan 

1847), in U.S. Hospital Department Copy Book, 

NLM. 

last of the troops left Vera Cruz, the patient 

load was so great that ph ysicians had to 

take over a Mexican military hospital, by 

then almost emptied of its Mexican patients. By July the disease rate was so high 

that some patients had to lie on blankets 

on the hospital floor. The number of attendants fluctuated from month to month, 

but at the end of April, II stewards, 2 

cooks, 4 male nurses, I ward master, and 4 

Mexican matrons were on duty at Vera 

Cruz. There, as elsewhere, the shortage of 

physicians also made itself felt, but supply 

problems, at least, were minor. 1O 

Many diseases brought patients to the 

Vera Cruz hospital, but yellow fever was 

most feared. The physician in charge concluded that yellow fever was most dangerous in summer, although it was present 

throughout the year and posed a greater 

threat to newcomers than to the native 

population, most of whom were already 

immune. Malarial fevers were also common, and dysentery-like illnesses were a 

constant threat to soldiers in such a climate. Nevertheless, General Scott believed 

that it would be safe for troops to stay in 

Vera Cruz as long as they did not associate 

with the natives and remained in the waterfront area with its breezes from the sea. He 

was confident that men assigned to the castle of San Juan de Ulloa, on an island in 

the harbor, would escape yellow fever entirely. In this notion he was sadly mistaken. 

Troops going through Vera Cruz on their 

IOPorter, "Notes" 26:31 1-12, quote from 3 12; Surgeon's Quarterly Rpt, Vera Cruz (30 Jun 1848), and 

Surgeon's Monthly Rpts, Camp Bcrgara (Apr- May 

1848) and Camp WaShington (Jun 1847 and May 

1848), all in RG 94, entry 634; J. B. Porter, "Letters," 

New Orleans Medi cal and Surgical Journal 6 

( 1849-50):52; Irwin, "Notes," pp. 11 3- 14; Miller, 

"Yellow Jack," p. 49; Ltrs, Heiskell to McCormick 

(22 Feb 1848), RG 112, entry 2, 18:450; Porter to 

M cCormick (copy, 11 Jan 1847) and E. 1-1 . Barton to 

Porter (18 Jul 1847), both in RG 112, entry 12. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN I 17 

way to or from the front often came down 

with yellow fever, as did those who, li ke 

the hospital staff or the men at the castle, 

remained in or near that city. Both volunteer and regular surgeons contracted yellow fever, and at least two died of it. " 

Physicians at Vera Cruz treated yellow 

fever with 15 to 25 grains of quinine to 

reduce the fever and baths and mustard 

plasters to equalize " temperature and the 

circulati on" and subd ue "gastric irritation." Mercurials promoted "early and free 

evacuati on of the bowels; ... five or six 

passages in as short a time as practicable" 

being co nsidered desirable to a lleviate 

stomach irritation and nausea. Cupping 

was favored over bleeding by means of 

either venesection or leeches." 

Despite the efforts of surgeons at Vera 

Cruz, legends grew up about disease and 

death there. At least one veteran of the 

Mexican War beli eved that "a great many 

deaths occurred, chiefl y among that class 

of people who neither have the means nor 

care to take pains about health-such as 

Qr. Mr.s men & soldiers-they have died 

by the hundreds of yellow fever, dysentery 

and bad wounds. Occasionally an officer is 

stricken down, but altho' all nearly have 

been sick, few have died, because they had 

had good attendance & good treatment."13 

Part of the reason for the high death rate 

at the Vera Cruz hospital lay in the fact 

"Ltrs, Scott to Marcy (5 Apr 1847), in War Department, Correspondence, p. 100; Porter to Heiskell 

(19 Sep and 8 Oct 1847), both in RG 112, entry 12; 

Porter, "Letters" 6:52; Surgeon's Quart erl y Rpts, Vera 

Cruz (3 1 Aug 1847), San Juan de Ull oa (30 Sep 1847 

and 31 Mar and 30 Jun 1848), and Surgeon's Monthly 

Rpt, San Juan de U lloa (3 1 Aug 1847), all in RG 94, 

entry 634. 

I2Porter, "Notes" 26:312-13, 326-28, and 35:352, 

quotes from 26:312- 13. 

·,1L1f, Josiah Gorgas to his mother (6 Aug 1847), in 

Frank E. Vandiver. "The Mexican War Experi ence of 

Josia h Gorgas," jOllrnal of SOIl/llem Hisfory 13 

(1947):382. 

that many patients did not come into the 

facility until they were already near death; 

some soldiers, like their predecessors in the 

Continen tal Army almost seventy-fi ve 

years earlier, apparently be li eved that 

death awaited those who entered a general 

hospital. The death rate at this facility from 

all causes among Army and nonmilitary patients from I April 1847 to 21 March 1848 

was 12 percent (775 of6,466 patients died). 

Appalling though it may appear, this rate 

compared favorably with the 15 to 20 percent mortality experienced by British 

forces during the Crimean War and the 25 

to 30 percent of the French in the same 

conflict, as estimated by Louis Duncan, 

and the 15 percent at the New Orleans 

Charity Hospital at this time." 

Compared to other causes of death at 

Vera Cruz, yellow fever did not prove to be 

as dangerous as had been fea red. From 

April through September 1847, the yellowfever season, 3,874 patients, both military 

and civilian, entered the Vera Cruz hospital, but only 402 of them had yellow fever, of whom 109 died. In contrast, almost 

a third of all those hospitalized were patients with diarrhea or dysentery, of whom 

199 died. In August, a frightening 67 percent of the victims of yellow fever died, but 

the average overall death rate from that disease duri ng the spring and summer of 1847 

did not exceed 28 percent." 

14Portcr, "Notes" 26:30 1, 311, 33 1, 332-33; Ltrs, 

Scott to Marcy (13 Feb 1847), in War Department, 

Correspondence, p. 93; Duncan, "Scott's Campaign" 

47:445; ibid. 47:459; M iller, "Yellow Jack," p. 5 I. Estimates concerning Cri mean casualty and mortalit y 

rates vary widely. In his History o/Ihe Army Medical 

Department, vol. 2. (Ed inburgh: Churchill Livingstone, 1974), p. 185, Neil Cantlie suggests that only 

I I percent of British troops hospitalized in the Crimea 

died. 

ISPortcr, "Notes" 26:326-28 and 35:352; Porter, 

" Letters" 6:57- 58; Ltrs, Porter to McCormick (II Jun 

1847) and Laub to Heiske ll (5 Ju1 1847), both in RG 

112, entry 12; Charles McCormick, "Ed itorial: Sick-
11 8 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

By the spring and summer of 1847, the 

strain on Army surgeons was taking its toll, 

both at Vera Cruz and elsewhere in Mexico. 

The civilian physicians hired to make up 

for the shortage of military doctors provided only limited relief, since they proved 

all too often to be incompetent adventurers. Although he continued at his post, Porter's health was seri ously undermined by 

the demands placed upon him. Benjamin 

Ha rney, the elde rl y surgeo n who was 

Scott's medical director, fell ill even before 

the landings at Vera Cruz. He was still so 

weak in April that one observer believed 

he was " breaking down" and predicted that 

his departure from Mexico was imminent. 

Harney found the strength to continue, 

however, until he was slightly wounded by 

a ball that struck his leg just above the ankle, causing him to relinquish his responsibilities of medical director in favor of less 

arduous duties, although he remained in 

Mexico,l6 

The Drive on Mexico City 

The strain on Scott's surgeons was unrelenting. Although the men who marched 

inland from Vera Cruz in April 1847 left 

yellow fe ver behind them, intestinal disorders followed. Many were soon "weak 

and exhausted from the effects of bad water 

and dia rrhea." Some were left by the roadside, easy prey fo r guerrillas. Even before 

his 18 April victory at Cerro Gordo, Scott 

found it necessary to order the opening of 

ness in the U.S. Army in Mexico," New Orleans Med· 

ical alld Surgical JO llnlal 4 (1847-48):14 1; Ltrt 

Heiskell to the editor of the Baltimore Sun ( 18 Oct 

1847), RG 11 2, entry 2, 18:236- 37; Statistical Repart. 

1839-55, p. 230. 

"Eba Anderson Lawton, ed., All Artillery Officer in 

the Mexican War 1846- 7: Leiters of Robert Anderson, 

Captain 3rd Artillery. U.S.A. (New York: G. P. Putnam's Sons, 19 11), pp. 37- 38. 40, 256, quote from 

p. 123. 

a temporary general hospital at Plan del 

Rio, not fa r from the Cerro Gordo pass. L7 

The battIe fo r the control of the Cerro 

Gordo pass left sixty-four U.S. soldiers 

dead. Surgeons worked twenty-four hours 

and more in the open air, caring for the 

353 wounded on 

a great plateau of table land with giant 

precipices here and towering ledges of rock 

there, standing askew as if nature, when the 

earth was cooling from a molten mass, had 

wrenched the earth asunder, grasping and 

teari ng out a huge proportion and carrying 

it away to leave a shelf where man might 

get a foothold and build his habitation. 

Scott ordered that as soon as the U.S. victory seemed assured, one wagon per regiment .and another for the cavalry gather up 

the wounded and take them to the appropriate hospitals. The decision as to which 

facility should be used for each case was 

made not by the medical director, but by 

the surgeon general himself. The wagon allotment must have been inadequate, for 

some patients were moved. by litter, but 

when darkness fell , none of the wounded 

remained on the field." 

Because the Mexicans had used old muskets firing round balls, wounds were not 

serious except for injuries caused by artillery fire . As a result, only 10 percent of the 

wounded from Cerro Gordo died. Supply 

wagons returning to Vera Cruz carried the 

less seriously hurt back with them. Although the temporary hospital at Plan del 

Rio lacked both hospital furniture and bedding, and the supply of drugs, instruments, 

and dressings was small, most patients remained at this facility for at least a short 

time. To make matters worse, two days 

110 swandel, NOles, p. 108, quote from p. 110. 

18Quote from Elderkin, Sketches, p. 63; Maria Clinton Collins, ed., "Journal of Francis Coll ins . .. ," 

Quarterly Publications a/the Historical and Philosophical Saciety o/Ohio \0 (1915):59. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 119 

after the battle, the able-bodied left the 

area. Since medical officers were attached 

to units rather than hospitals, these men 

took their doctors with them, leaving only 

one physician, a Regular Army surgeon, to 

care for 200 wounded. 

Scott's force occupied Jalapa after the 

Cerro Gordo victory, and wagons moved 

many of the wounded there from Plan del 

Rio at the end of April. As they neared the 

town, these sufferers were enveloped by 

"air ... filled with sweet fragrance of orange trees, making the entry of Jalapa more 

like the Garden of Eden." The approach 

appears to have been so dramatic that despite the jostling of the wagons and the agony of their wounds, the injured men could 

still be "amazed by the hills of the city." 

The discomfort caused the patient by being 

moved by litter is not known, but carrying 

one was apparently a depressing duty; a soldier who had been required to bear a litter 

finally vowed he would kill himself before 

he spent another day at such a task. He then 

leaned on the muzzle of his gun, pulled the 

trigger with his big toe, and brought his 

earthly sufferings to an end. " 

The Jalapa hospital was apparently located in a church or buildings attached to 

a church. It evidently lacked even the most 

essenti al equipment, and its attendants, 

like those at Vera Cruz, were men unfit for 

anything but hospital duty. As many as 

1,000 men went through this facility, and 

although one patient believed that " men 

are dying in this hospital almost co nstantly," the mortality was actually only 20 

percent. In a castle at Perote, a short distance beyond Jalapa, was a second hospital, 

19Qswandel, NOles, p. 383, first Quote, p. 140; second 

quote. Thomas D. Tennery, The Mexican War Diary 

of Thomas D. Tellllery. ed. D. E. Livingston-Little 

(Norman: University of Okl ahoma Press, 1970), p. 84; 

Surgeon's Quarterly Rpts, Jalapa (2 1 Apr and 30 Jun 

1847), both in RG 94, entry 634. 

managed by a Pennsylvania volunteer surgeon responsible to the head of the Jalapa 

facilit y. The Perote unit remained open 

through the summer, but by August the 

deaths among the 300 patients sheltered 

there were mounting. The average death 

rate was about four a day but could be as 

high as twelve. A majority of the deaths 

were blamed on diseases contracted on the 

ma rc h , most often diarr hea and 

dysentery.'o 

When Scott ordered his men forward 

once more in May, he hesitated to leave the 

sick and wounded at Jalapa, where they 

wou ld be unguarded should the enemy attempt to harrass them. Moving them, however, would also expose them to enemy 

attack and, in add ition, would furt her undermine the health of many. Scott appears 

to have finally decided to leave at Jalapa 

those too ill to withstand two days on the 

road, trusting the Mexicans to follow the 

tradition that " military hospitals are universally regarded, by civilized enemies, as 

sacred." The patients left at Jalapa remained safe until their evacuation at the 

end of June, and the facility appears to 

have reopened in the fall of 1847. Although 

"infernal fl eas and other creeping things" 

were infesting the hospital, diarrhea-like 

ailments rather than insect-borne diseases 

caused the highest percentage of deaths, at 

least among the volunteers. By June 1848, 

venereal diseases were taking a high toll; 

fo rty-six patients were suffering from gonorrhea and thirt y-th ree fro m primary 

syphilis. 2I 

lOQuotc from Tcnnery, Diary. p. 84; Oswandel, 

NOles, pp. 195,383; Surgeon's Quarterl y Rpts, Jalapa 

(2 1 Apr and 30 Jun 1847) and Ltrs, McLaren to Med 

Dir (3 Sep and 3 Dec 1847), all in RG 94, entry 634; 

Grady McWhinney and Sue McWhinney, cds., To 

Mexico With Tay/or and SCOII, 1845-1847 (Waltham, 

Mass.: Blaisdell Publishing Co., 1969), p. 158. 

21First quote, Ltr, Scott to Col Childs (3 Jun 1847), 

in War Department, Corre~pondel1ce, p. 187; second 
120 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Diarrhea "in its most fatal and destructive form" struck Scott's men when they 

reached Puebla, a town about a hundred 

miles southwest of Jalapa and located on 

a high, dry site, with a temperate climate 

and clean streets. In one regiment men 

were soon dying at the rate of two a day. 

Over 1,000 there were on sick report as of 

4 June 1847. Surgeons blamed the disease 

rate on bad food, the change in diet, poor 

cooking, the weather, and the weakened 

condition of the men. When the army left 

Puebla during the second week in August, 

2,000 men who were sick or convalescent 

stayed behind. Still others fell ill along the 

way, requiring surgeons to establish hospitals at other sites through which Scott's 

force passed on its way to Mexico City, 

while supply trains returning to Vera Cruz 

through these towns picked up invalids to 

carry them on the first leg of their trip 

home. Many who remained with the army 

were a lso suffering from diarrhea , and 

some carried their own supply of opium to 

treat themselves." 

On 18 August, Scott's surgeons set up 

another general hospital at San Augustin, 

ten miles south of Mexico City. During the 

following two days, Mexican forces killed 

137 U.S. soldiers and wounded another 

877. Despite rain and cold, at least thirtytwo surgeons, including Lawson, worked 

night and day to care for the injured. Although the wounded were soon disbursed 

among several regimental hospitals at varquote. Oswande l, Notes, p. 404; Surgeon's Monthly 

Rpt, Jalapa (3 1 Dec 1847), Surgeon's Quarterly Rpl, 

Jalapa (30 Jun 1848), and Ltrs, Mclaren to Mcd Oir 

(3 Sep and 3 Dec 1847), all in RG 94, entry 634; Ltr, 

McLaren to Heiskell (1847), RG 11 2, entry 12. 

HH. Judge Moore, SCOIl'S Campaign ill Mexico .. . (Charleston, S.c.: J. B. Nixon, 1849), p. 120, 

quote rrom pp. 118- 19; Oswandel, NOles, pp. 177,239; 

Ltf, Scott to Marcy (4 Jan 1847), in War Department, 

Correspondence, p. 188; George Ballantine, "How Far 

Shall We Charge?" in McWhinney and McWhinney, 

To Mexico, p. 158. 

ious sites in the area, the general hospital 

rema ined open to care for men stationed 

there after the main body of the army 

moved on. A facility was also opened at 

San Antonio, principally to care for the 

Mexican wounded, who apparently preferred treatment from U.S. Army 

physicians. 23 

As he approached Mexico City, Scott ordered a general hospital established at Mixcoac, where he placed the surgeon serving 

as the medical purveyor for his army in 

charge, aided by ten assistants. This faci lity 

remained in operation until after the surrender of Mexico City. A second hospital 

was established in the archbishop's palace wes t of Tacubaya, near Scott's 

headquarters. 

On 8 September, U.S. troops met the 

Mexicans at Molino del Rey. Present were 

Lawson and eleven other Medical Department surgeons, t wo of whom were 

wounded. Litters and wagons took the 

casualties from the battle to Tacubaya. One 

of the injured physicians, who had been 

shot in the head while leading troops after 

their offi cers had fa llen, died there of a 

brain abscess. A few days later, while viewing his men as they attacked the castle of 

Chapultepec, Scott realized that the Tacubaya hospital was within the range of enemy guns and ordered its occupants 

evacuated to Mixcoac. The Tacubaya facility reopened once the danger was past 

and some of the wounded from Chapultepec were moved there not long after the 

surrender of Mexico C it y on 14 

Septem berN 

l JLtr, McMillan to Lawson (6 Sep 1847), RG 112, 

entry 12; Edgar Erskine Hume, "Comment and Crit~ 

icism: Medical Officers Who Marched With the Army 

Under General Scott Upon the City of Mex ico in ~ 

gust, 1847," Military SlIrgeon 54 (1924):99- 10 1. 

24Humc, "Medical Officers" 54:99-101; Hazard 

Stevens, The Life oj Isaac Ingalls S/(Jt'ens, 2 vols. os~ 

IOn: Houghton Miffiin Co., 1901), 1:218-19. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 12 1 

The surrender of Mexico City was not 

the end of hostilities. Just as Scott's troops 

were completing their victory at the natio n's capi ta l, Mexican guerrill as were 

launching an attack on PuebIa, with its garrison of 800. Santa Ana and severa l thousand men quickly reinforced the attackers. 

Although a typhoid epidemic repo rtedl y 

struck during the siege and killed hundreds 

of the defenders in a short time, as many 

as 600 of the 1,800 patients at Puebla were 

well enough to aid in the city's defense. On 

the evening of 28 September, " the Mexicans (cowardly dogs) attacked our hospital, 

and succeeded in setting fire to the main 

gate." Even though the siege was not lifted 

fo r two weeks, the hospital was able to co ntinue in operation much as before, apparently closing only in the summer of 1848'" 

Ajier the Victory 

Despite the action at Puebl a, the active 

phase of the war was essentially over when 

U.S. forces took Mexico City. Scott's medical director, wishing to close the faciliti es 

outside th e city, quickl y sea rch ed o ut 

buildings suitable for use as di vision hospitals within Mexico City. He often chose 

convents or official palaces, but even the 

best of these were still cold, damp, dark, 

badly ventilated and, in the opinion of U.S. 

surgeons, conducive to digestive problems 

and fevers. Floors were often brick or tile. 

Since there were no chimneys, presumably 

there was no a rtifi cial hea t. Windows 

opened into a central courtyard, thereby 

limiting the ve ntilation. The real cause of 

health problems, however, lay in the character of Mexico City itself. The city in general was "exceedingly filth y" and the area 

HOswandcl, NOles. pp. 267, 34 1, 359- 60, Quote 

from p. 309; Surgeon's Quarterl y Rpt, Puebla (16 Jun 

1848), RG 94, entry 634; Moore, SCOII'S Campaign ill 

Mexico, pp. 2 12- 14, 2 17- 18. 

in wh ich one hospital was located was 

poorly drained, so that sewage remained 

near the surface. "The poor [had] no pri vies, and their excrement [was] at once deposited in th e open street, [while] the lower 

orde r of people [was] almost universally affected with li ce, and fl eas [were] the inmates of the palace as well as the hovel." 

Not surprisingly, typhoid cou ld appear 

year round, a nd many U.S. soldiers contracted it wh ile in the city." 

In Mexico City the division hospitals 

were merely collections of regimental hospitals, functioni ng under the overall supervision of a surgeon at the division level. 

Although some of the funds of each regiment intended for its sick were sent to help 

finance the division hospital, Scott also levied a tax on the city, $20,000 of which went 

to meet hospital expenses. By December 

1847 the number of patients in Mexico 

City hospitals had declined, permitting all 

to be moved into one general hospital, 

which was sheltered in several large buildings under the control of a single surgeon 

and four assistant surgeons.27 

Nevertheless, disease continued to be a 

major problem for troops in Mexico. The 

volunteers who continued to come into 

Mexico even after the end of significant 

military action often fell ill, frequen tly with 

diarrhea. A Kentucky unit was devastated 

by one ai lment after another, beginning 

with measles that affli cted the men even 

before they started out. Some had not entirely recovered from the measles when 

they boarded shi p and subseq uentl y beca me seasick. "The Sight was laughable ... . A poor fe llow would tumble over 

so sick that he could not move and vomit 

ZI>Robcrt Newton, "Medical Topography of the City 

of M exico," Nell' York Journal of Medicine and Ihe 

Collateml Sciellces, n.S. , 1 ( 1848): 298, quotes from 

302-03; Irwin, "Notes," p. 114. 

!?Lawton, Anderson, p. 3 14. 
122 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

upon himself .... The hold was full of sick 

men & the whole boat presented the most 

sickening scene." The seasickness eased in 

a day or two, but then, not long after the 

unit landed on 16 November 1847, diarrhea took over. Soldi ers too ill to march 

were left behind at the ship or at the nearest 

hospital. The sick tried many remedies to 

cure their diarrhea, including bathing their 

feet in warm water and drinking "some 

cayenne pepper tea," evidently placing little faith in professional medical advice until amateur remedies had failed. By early 

December one man was so ill with diarrhea 

that he had to be hospitalized at Jalapa. As 

the unit continued to move inland, wagons 

picked up those too sick to march, and 

more were hospitali zed, twenty being left 

at the Puebla facility. 28 

Incoming volunteer units were not the 

only ones afflicted with diarrhea. Three 

companies out often ordered to leave Mexico City for Vera Cruz and, presumably, to 

return to the Un ited States in March 1848, 

for example, were detained because of what 

was called " the diarrhea blues." Furthermore, measles and mumps apparently occasionall y a ppeared among volu nteers 

already in Mexico, and erysipelas, in addition to malaria, was reported to be "common among all the corps." In January, 

almost 4,000 of the 15,000 men in Mexico 

were sick. Thus, even though hostiliti es 

were over, as long as U.S. soldiers remained 

in Mexico, hospitals would be needed to 

shelter their sick, not only at Mexico City 

but also at Vera Cruz, Jalapa, and other 

sites where troops we re sta ti o ned or 

through which any great number of them 

might pass." 

" Hinds, "Cox" 55 (t957):35, 39, 41,46,47, 49, 213, 

214,217,218,220,226,227-28, 232, quotes from pp. 39 and 2 14, respecti vely. 

29First quot e. Oswande l, Notes, p. 509; second 

quote, Ltr, Scott to Sec War (2 Feb 1848), in War 

Surgeons ordered the evacuation of those 

who were faced with a lengthy illness or 

co n va lesce nce and those with se rious 

wounds. As a result, to their sufferings were 

added the torture of sixteen or more days 

in a wagon, tossed about from Mexico City 

and Pu ebla to Vera Cru z, whe re th ey 

boarded ships bound for New Orleans. 

Physicians accompanied them on each leg 

of this trip, but the stress of the journey 

upon men already in a weakened state increased their chances of fa lling ill. Many, 

hav ing survived their wounds, di ed of disease. Once on board ship, they too often 

lay upon the deck wi thout cover, presenting, according to Assistant Surgeon Charles 

McCormi ck, "a spectacle of the most heart 

rending distress, & extreme suffering," 

their situation made yet more depressing 

by the fact that the sick were scattered 

among the dead and dying and surrounded 

by dirt and filth .'o 

The sufferings of the invalids returning 

to the United States did not end wi th their 

arrival at New Orleans. In one instance, a 

volunteer surgeon accompanying 128 patients neglected them on board ship and 

abandoned them entirely as soon as they 

got to shore. His fa ilure to turn them over 

to anyone else allowed them to scatter 

throughout the city, so that eight were 

never found. On another occasion, a department assistant surgeon accompanying 

Department, Correspondence, p. 272; Llf, Thomas 

Marshall to Scott (3 Jan 1848), in War Department, 

Correspondence. p. 258; Po rter, "Notes" 26:329-30; 

Rpt, Scott to Sec War (6 Jan 1848), in Winfield Scott, 

Memoirs of Liew-Genera/ SCOll, LL.D., 2 vo ls. (New 

York: Sheldon & Co., 1864), 2:562-63; Israel Moses, 

"Cases or Erysipelas, Which Occurred at Soi uca, Mexico," Nell' York Journal o/Medicine and 'he Col/(l[eral 

Sciences, n .S. , 2 ( 1849): 162-63. 

JOQ uote from Ur, M cCormick to Heiskell (30 Oct 

1847), in RG 11 2, entry 12; Collins, " Journal ," p. 89; 

Karl Jack Bauer, 71,e MexiCllII War (New York: Macmillan Publishing Co., 1974), p. 32; Stevens, Stevells 

2:225. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 123 

in valids developed delirium tremens when 

the ship arri ved at New Orleans. Moreover, 

the hospital in that city was becoming overcrowded. A nea rby barracks and the buildings ofa private institution were taken over 

to shelter the casualties, but an outbreak of 

yellow fever in the summer of 1847 further 

congested the New Orleans faciliti es, which 

until the spring of 1848 could shelter an 

absolute maximum of 300 men." 

In 1847 the acting surgeon general in 

Washington urged that some patients at 

New Orleans be moved upri ver to Baton 

Rouge, where the barracks hospital was 

empty; if the barracks itself was also used, 

100 or more patients could be accommodated. Medical and hospital supplies were 

plentiful, and a good pri vate physician was 

available nearby. This hospital, however, 

was not ready for patients until September 

1847, when the preparation of 30 spaces 

was complete, and 100 more were almost 

ready for occupancy. This number, however, was insufficient to give the New Orleans fa c iliti es mu ch relief, and when 

Lawson himself returned from Mexico to 

New Orleans, he found the situation there 

as bad as ever. 32 

Such a large number of in valids continued to come in to New Orleans that by 

1848 the situation was critical. The department attempted to send as many pa31 Port e r, "Notes" 35:35 1-52 ; Lu s, Heiskell to 

McCormick (9 Nov 1847), to James McFarlane 

(12 Nov 1847). to Wr;ght (5 May 1848), and to Satterl ee (J 7 May 1848), all ;n RG 11 2, entry 2, 18:2 19 

and 226 and 19:43- 44 and 58, respecti vely; Mc- Cormick to the editor (22 Ju n 1847), in "Editorial," 

Nell' Orleans Medical alld Surgical Journal 4 

(1847-48):140; Lawson to J-J e;ske ll (II Feb 1847), 

McCormick to Heiskell (30 Oct 1847), and Wood to 

J-J e;skell ( 18 Jul 1847), all;n RG 112, entry 12. 

HLtrs, Heiskell to AG (2 Jul 1847) and to Porter 

(25 Apr 1847) and Lawson to Sec War ( 13 Mar 1848), 

all in RG 11 2, entry 2, 17:534- 35 and 18: 100 and 485, 

respecti vel y; Ltr, Wood to He iske ll ( 18 Jul 1847) and 

Statement, Lawson (26 Jan 1848), both in RG 11 2, 

entry 12. 

CJ-JARLES M CCORMICK. (Courlesy of Nalional Library of Medicine.) 

tients as possible out of the New OrleansBaton Rouge area to such posts as Jefferson 

Barracks near St. Louis. Lawson urged that 

Congress take greater heed of the problem 

Mexican War invalids posed; a new hospital should be built in New Orleans and 

specially eq uipped hospital ships sent to 

return men from Vera Cruz to New Orleans. Lawson's suggestions about hospital 

ships were evidently ignored, but by June 

1848 the Army had taken over new facilities under construction at New Orleans 

that had originally been planned as a hospital for merchant seamen. While this project remained incomplete, a general hospital 

apparently capable of taking at least 300 

patients was opened on Greenwood Island, 

near Pascagoula, Mississippi, to care for 

the sick from Mexico. Unfortunately, the 

four buildings used there were " mere 
124 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

shells, leaking in rainy weather," according 

to Porter, who was in charge of this facility. 

Proper food for the sick was hard to find, 

and the men were in very poor condition, 

suffering from diseases such as chronic dysentery, diarrhea, and even scurvy. When 

the Greenwood hospital closed in November 1848, Porter accompanied those still 

needing hospitalization back to New Orleans, despite the fact that the new hospital 

there was not actually completed until a 

month later. 33 

For some troops, New Orleans was but 

a way station. Many eventually went on to 

other posts along the coast, and especially 

to Fort Monroe, or returned to their homes. 

Some arrived at the Virginia post in fine 

health, but of the 250 on one ship, 100 

came down with yellow fever after leaving 

New Orleans. A company of artillerymen 

that had been at Vera Cruz also arrived at 

Fort Monroe with many still sick. The post 

surgeon reported that 25 of these men had 

fevers during the trip and that 9 died, "one 

with black vomit" (i.e. , yellow fever). He 

hospitalized 7 with diarrhea and placed 14 

convalescing from fevers in hospital tents 

set up about a mile from the post at a 

healthy site. As he went home by steamer, 

one veteran wrote, " my mou th is so sore 

that the least effort to masticate my food 

is very painful, and I cannot eat, .. . and 

even if I could, it wou ld be improper for 

me to do so, on account of a long continued 

diarrhea and pain in my breast and side."" 

llQuote from Ltr, Porter to Bliss (1 Nov 1848), RG 

11 2, entry 12; Porter, "Notes" 35:247-48; Ltrs, Lawson to Sec War (13 Mar 1848) and to Taylor (18 Aug 

1848), both in RG 11 2, entry 2, 18:485 and 19:172, 

respecti vely; Chase to Lawson (23 Jun 1848) and Porter to Lawson (20 Jul, 29 Nov, and 3 Dec 1848), all 

in RG 11 2, entry 12; McCormick to Lawson (10 Mar 

1848), copy in RG 11 2, entry 12. 

~First quote , Ltf, Thomas Henderson to Heiskell 

( 13 Jul 1848), RG 11 2, entry 12; second quote, Richardson, Journal, p. 86; see also Ltr, Henderson to HeisConclusion 

Of the more than 100,000 soldiers who 

had left the United States to fight in Mexico, over 1,500 had been killed in action, 

but more than 10,000 had died of disease. 

The proportion of sick to killed was better 

than that of the Revolution; in the Civil 

War, however, only two would die of disease for everyone killed in battle or dead 

from wounds. These fi gures include neither 

those who died at home as a result of disease contracted in Mexico nor those family 

members of returned soldiers who contracted dysentery or typhoid from them. 

Many a man undoubtedly suffered from 

impaired health long a fter the end of the 

war, starting the campaign " fu ll of health," 

and returning home "a sick soldier-a 

mere skeleton of a man, worn down by the 

prolonged fatigue of travelling, watching 

and toil." " 

As it was in so many wars, disease was 

the great enemy in the Mexican War-the 

rate of death from disease among the U.S. 

soldiers in Mexico was ten times that of 

civili ans at home. The surgeons of the 

Medical Department, too few to meet the 

demands made upon them, wo rking with 

inexperienced volunteer and contract surgeons and assisted by attendants who were, 

for the most part, the dregs of the Army, 

were helpless before the inroads of dysentery and other digestive ills. They were not 

as helpless as they had been, however. By 

means of vaccination they were able to stop 

outbreaks of smallpox before they became 

epidemic, and with large doses of quinine 

ke ll (24 Jul y 1848), RG 112, en try 12; Co ll in s, 

"Journal," pp. 106- 08. 

,l5Quotes from Richardson, Journal, p. 86; lrey, 

"Soldiers," pp. 285, 298; William Jay, Review 0/ fhe 

Causes and COl/sequences 0/ the Mexicall War ( 1849. 

Reprint. New York: Arno Press & The New York 

Times, 1969), p. 22 1; Bayne-Jones, Preventive Medicine, pp. 55, 86. 
THE WAR WITH MEXICO: SCOTT'S CAMPAIGN 125 

they were able to cut short the paroxysms 

of malarial fevers. Unfortunately, for practical reasons as well as because of prejudice 

and fear of the unfamiliar, they failed to 

use anesthesia on a large scale, and thus 

passed up their only real chance during the 

Mexican War to make a significant contribution to the progress of medical science. 36 

Although Army su rgeons would continue 

to be helpless against many scourges until 

progress in the state of the art of medicine 

gave them better weapons aga inst disease, 

the war with Mexico emphasized the need 

for many changes that were within the 

realm of possibility. As a result, although 

Lawson's suggestion about hospital ships 

36Edward Jarvis, "The San itary Condition of the 

Army," Ailamic lvlollllt!y 10 ( 1862):472- 73. 

appears to have been dropped, efforts to 

develop an ambulance and to make the position of hospital stewa rd permanent continued. T he Mexican War did not , 

however, lead Lawson to conclude that the 

Medica l Department should anticipate in 

peacetime the complex demands of war. As 

a result of his lack of insight, a lack many 

others shared, he fa iled to develop plans 

that might minimize the adverse effects of 

the necessary wartime influx of large numbers of inexperienced surgeons, allow for 

the need to staff both general and regimental hospitals, and meet in other ways 

the requirements of an army at war. A stubborn and unimaginative surgeon general 

had overlooked the most important and 

perhaps even the most obvious lesson of 

the Mexican War. 

CHAPTER 7 

Lawson's Last Years, 1846-1861 

Settlers and prospectors began moving 

west in large numbers after the United 

States acquired the Oregon Territory in 

1846 and the northern provinces of Mexico 

in 1848, a movement that grew still larger 

after the discovery of gold in California in 

January of that year. The federal government called upon the Army to explore 

boundaries and possible railroad routes in 

the new lands and to confront Indian and 

Mormon challenges to its authority. New 

posts also needed garrisons and the growing numbers of travelers needed the Army's 

protection. The character of the new lands 

aroused great interest in the scientific community. Surgeons assigned to Army units 

in the West were encouraged not to limit 

themselves to purely medical duties but to 

study the fauna, flora , and geology in their 

district and to record the customs of the 

inhabitants. 

During the period from 1846 to 1861 , 

tensions were building over the question of 

the extension of slavery into newly acquired lands, and secession was an ominously frequent topic of discussion. But 

contingency planning was still a thing of 

the future and neither Surgeon General 

Lawson nor any of the Army's other leaders 

seriously considered how they might meet 

the demands of a large-scale conflict. Lawson's official letters betrayed no concern 

with the problems inherent in such a war. 

Medical Department efforts continued to 

be directed almost exclusively toward 

meeting the challenges of the peacetime 

Army, and in directions essentially no different, except in magnitude, from those of 

earlier years. 

Administration 

Once the war with Mexico was won, the 

Army was again broken down into small , 

scattered units. That conflict had brought 

about few basic changes in the Medical Department. It was still not large enough to 

provide medical attendance for each garrison and detachment, despite Lawson's effort to obtain an adequate staff. Although 

he himself was brevetted brigadier general 

in May 1848, the surgeon general's campaign for increased stature for his su rgeons 

was also thwarted. Congress did, however, 

finally allow the retention in the position 

of hospital steward of any man qualified to 

handle that role. 

The law of 1847 that had allowed the 

addition of fourteen new surgeons ordered 

their dismissal at the end of hostilities. In 

July 1848, when the legislature repealed 

that requirement, it added a provision forbidding the hiring of replacements for 

those who did leave. By then, some of the 

fourteen had already departed. Only in 

March 1848 did Congress make the fourteen slots permanent, thus officially permitting the signing on of ten doctors to 

replace those who had already resigned. 

Considering the need, this increase was in-
128 TH E ARMY MEDICAL DEPARTMENT, 18 18- 1865 

significa nt. Wi th ninety-fo ur surgeo ns, 

some of whom would always be sick or incapacitated by age, the department was expected to care not onl y for men scattered 

among eighty-nine posts, some of which 

needed more than one surgeon, but also for 

soldi ers in volved in multitudinous ex peditions, both large and small, th at took 

them from their regular assignments. The 

threat of Indian ambush isolated some 

posts, making it essentially impossible to 

send a surgeon in time of emergency to a 

post o th e rw ise with o ut me di ca l 

attendance.' 

In 185 1, Congress made the Army Medical Depa rtment indirectly responsi ble for 

the medical care of the residents of the new 

Army Asylum or, as it later became known, 

the Soldiers' Home. The surgeon general 

served as a member of the Board of Commissioners. A department medical offi cer 

served as attending surgeon, his duties at 

the Soldiers' Home being above and beyond those of his regula r Army assignment 

and recompensed as the Board of Commissioners might decide. For many years, 

Assistant Surgeon Benjamin King se rved as 

secretary-treasurer of the board as well as 

a ttending ph ysician, a nd both Surgeon 

General Lawson and, after the Civil War, 

Surgeon General Joseph K. Barnes were 

very much concerned about the operations 

of this institution.' 

Lawson's campaign for a larger Medical 

I Ltrs, H eiskell to W illiam J. Worth (25 Jan 1849) 

and Lawson to AG (25 May 185 1), both in RG 11 2, 

entry 2, 19:375 and 2 1 :434, respectively. U nless otherwise indicated, all mate rial in this chapter is based on 

Brown, l\lledica/ Deparlmelll; War Department, SGO, 

Regulations/or lite Medical Deparlmelll (Washington: 

Alexander, 1850) and Regu/aliollsjor (lie Medical Deparlmellf offlle Army(Washington: A. O . P. N icholson, 

1856); and Callan, IH ililar)1 Laws. 

ul R. Goode, The United Slales Soldiers' /-lome: 

A HislOryoj/ls First Hundred Years (Privately printed, 

1975), pp. 46- 48, 54, 57, 60, 71, 86. 

Department was, therefore, a contin uing 

one. In his report of November 1855 he 

emphasized to the secretary of war that the 

number of surgeons the Army needed did 

not "depend upon the numerical force of 

the a rmy, but upon the manner in which it 

is employed; that is upon the di visions and 

subdi visions it has to undergo, and the particular service in which it is engaged." In 

1856 Congress did vote the department 4 

more surgeons and 8 more assistant surgeons, but at least one general believed that 

no fewer than 12 more surgeons and 40 

more assistants were required at this time. 

In the summer of 1860, with the nation at 

the brink of civil war, Congress granted the 

depa rtment slots for only 4 more surgeons 

and 4 more assistant surgeons. The Army 

was forced to face the oncoming holocaust 

with only 30 surgeons and 83 assistants, 

not all of whom would remain loyal to the 

Uni on] 

Because of the Medical Department's 

relati vely small size, its expenses for contract surgeons remained high, averaging 

$24,000 a year in the mid- 1850s. A civili an 

doctor hired to care for 100 or more men 

was paid $50 a month, fo r 50 to 100, $40, 

and for fewer than 50, $30, with an allowance added for any physician providing his 

own supplies and medicines. If he had to 

abandon his practice to accompany troops 

on the march, a civilian might receive as 

much as $ 100 a month. In some areas, however, nonmilitary physicians were impossible to obtain, and many soldiers did not 

trust contract surgeons. Some of these doctors, however, were young men who had 

recently passed the department's still demanding examinations and were awaiting 

JQuotc from Brown, Medical Department, p.207; 

Ltrs, McCormi ck to Lawson (29 Nov 1857) and 

Twiggs to Lawson (27 Aug 1859), both in RG 112, 

entry 12. 
LAWSON'S LAST YEARS, 1846- 186 1 

openings on the staff. The quality of their 

work, therefore, was generally good.' 

Because Lawson had few officers, he was 

unable to grant them leave except in instances of great need. This fact distressed 

him, all the more so when department finances dictated that, except for the most 

deserving cases, surgeons who succeeded in 

obtaining leave must hire and pay for their 

own replacements. Since the increases allowed in the Department's size were always 

inadequate, the problem was chronic, and 

some good men left the Army as a result' 

The officers of the Medical Department 

had official rank after February 1847, but 

the new law's significance for the surgeon's 

status within the Army was not clear. Although medical officers received housing 

and allowances on the same basis as line 

officers, those who assumed that they no 

longer had to obey commands from junior 

officers of the line or to take a back seat to 

them when serving on administrative 

boards were in for a rude awakening. Not 

long after the passage of the law, the adjutant general stated that since its implications were confusing, the old laws would 

continue to apply. Some high-ranking officers who had bitterly opposed the law 

were urging its repeal. When Surgeon, and 

now a major, Clement Finley, who would 

succeed Lawson as surgeon general, refused 

to obey an order from Bvt. Lt. Col. Braxton 

Bragg, whose regular rank was captain, he 

~Ltrs . William J. Sloan to Lawson (I Mar 1859), RG 

11 2, entry 12; Wood to Joseph B. Flint ( 14 Mar 1856) 

and Lawson to Robert Thompson (16 May 1856), both 

in RG 11 2, entry 2, 25: 193 and 269-71 , respectively. 

sLtrs, Hciskel to Jarvis ( 14 Feb 185 1) and to AG 

(30 Sep 1852), both in RG 112, entry 2, 21:383- 84 

and 22:492-93, respectively; M. L. Crimmins, ed., 

"Notes and Documents: W. G. Freeman's Report on 

the Eighth Military Department," Sollllill'eslem H istorical Quarler/), 53:207; Ltr, Maj Gen James A. Wier, 

U.S. Army (Ree) to author (4 Jan 1883), copy in historians' files, CMH. 

129 

was court-martialed and convicted. President Millard Fillmore remitted the sentence of dismissal from the service, but 

upheld the court's verdict. A second medical officer who repeated Finley's offense 

not long after was also convicted and sentenced to dismissal, but the president agai n 

remitted the sentence, this time on the 

grounds that the defendant had not heard 

of the earlier ruling.' 

The question of the role surgeons could 

play on Courts of Inquiry and similar bodies apparently also remained unresolved. 

The secretary of war ruled that a medica l 

officer could preside over such a court if 

he was the senior officer, but this ruling was 

evidently not always applied to boards of 

inspection and survey. Congress had little 

to say on the matter, and medical officers 

unhappily concl uded that, despite the 1847 

law, their status in the Army was essentiall y 

unchanged.

7 

At the time of the Mexican War, the position of hospital stewards within the Army 

also remained to be clarified. The level of 

aid that properly trained stewards rendered 

surgeons-some could perform an apothecary's duties and even conduct minor surgery-made it all the more important that 

such men be given permanent positions 

with the department. The demand for competent stewards was great. At posts where 

loLtr, Coolidge to Finley ( II Ju1 185 1), RG 11 2, entry 

2, 22:44; U.S. War Department, General Orders /851 

(Wash ington, 185 1), GO no. 5 1; Ltrs, Mower et al. to 

Lawson (24 Apr 1847), Trip1erto Lawson (6Jan 1859), 

Porter to Lawson (7 Feb 1849), and John B. Wells to 

Heiskell (26 Jul 1847) and to Marcy ( II Aug 1847), 

all in RG 112, entry 12. 

'Ltrs, Heiskell to Moore (27 Dec 1850), Coolidge 

to Wright (21 Aug 1852), and Lawson to AG (10 Oct 

1853), all in RG 11 2, entry 2, 21 :308, 22:46 1, and 

23:358, respectively; Satterlee to Lawson ( I Feb 1859) 

and White to Lawson (3 Mar (853), both in RG 11 2, 

entry 12; A. A. Woodhull, "An Inquiry Into the Military Rights and Duties of Medical Officers in the 

Land Forces," U.s. Sen'ice lvlagazine I (1864):478. 
130 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

supply depots were located, surgeons might 

ask for a second steward to serve as medical 

storekeeper. Few civilians who were qualified to perform at the highest level wou ld 

enlist, however, if they knew that they 

might be taken from Medical Department 

assignments and forced to serve as ordinary 

soldiers. Moreover, surgeons found it frustrating to train a steward from the line only 

to see him march off with his unit. On the 

other hand, having a good man taken permanently from his un it was frustrating to 

his commanding officer.' 

Finally, in 1856 and only after much urging by Lawson, Congress granted the secretary of war the authority both to appoi nt 

stewards from among men already in the 

Army and to hire competent men from the 

outside to be permanently attached to the 

Medical Department for a salary of $30 a 

month. This law also granted men who 

served as cooks and nurses extra duty pay 

in recognition of the hazardous and unpleasant nature of much of their work, a 

move the department had been unsuccessfully urging for years. 

After the passage of the 1856 law, the 

Medical Department moved cautiously to 

create what one of Lawson's assistants described as an "effi cient corps of stewards." 

Alt hough there was no longer any need to 

keep a steward at one specific post or wi th 

a particular unit, the department sti ll 

feared that moving these men abou t too 

much might cause Co ngress to have second 

thoughts. Whether the reason was caution 

or ineptness, by 1861 the department had 

not taken fu ll advantage of the opportunity 

afforded by the law of 1856 to build 

8Crimmins, "Freeman's Report," 53:207; Ltrs, Jarvis 10 Lawson ( 17 Dec 1859), Mower to Heiskell 

(16 Mar 1847), Randall to Lawson (6 Mar 1849), H. 

H . Steiner to Lawson (20 Jul 1846), and Stinnecke to 

Lawson (8 May 1844), all in RG 11 2, entry 12. 

up a corps of trained and disciplined 

stewards' 

Although Lawson needed the cooperation of Congress to deal effectively with the 

personnel problems he faced, he was to a 

large extent free to manage supply as he 

saw fit. The rapid changes that took place 

as the Army assumed expanding responsibilities made supply operations increasingly complex. Attempts to a nticipate need 

were at times frustrated by the short life of 

some posts, the long distances involved, 

and the hazards that threatened shipments 

as they moved west. The surgeon general 

continued to believe that whenever possible, purchasing should be handled in New 

York City, where prices were generally 

lower than e lsewhere . However, a year 

migh t be required for goods to reach a western fort from the East, and on the West 

Coast the telegraph was not ava ilable for 

placing supplement al orders. In consequence, the department was forced to 

permit some buying at New Orleans 

and to allow surgeons, when absolutely 

necessary, to meet specific needs on their 

ow n o r through the Quartermaster's 

Department. ' 0 

The Medical Department also began to 

establish suppl y depots at central locations 

in the West. In 1849 Fort Leavenworth became a storage site from which surgeons as 

far away as New Mexico could draw. A few 

months later, apparently when Indian dep-

'Quote rrom Llf, Wood to A. J. Ridgely (10 May 

1859), RG 11 2, entry 2, 25:524; Ltrs, Lawson to AG 

(17 Feb 1857) and Coolidge to W. T. Clarke (24 Oct 

1859), both in RG 11 2, entry 2, 27:77 and 211 , 

respectively. 

IOLtrs, J. H. Bailey to Lawson (20 Apr 1846), Wheaton to SG (13 Apr 1848), and Jarvis to SG (7 Mar 

1859), all in RG 11 2, entry 12; Heiskell to Wheaton 

(9 Jan 1849), to McDougall (22 Feb 1850), and to 

Mower (9 May 1850)and Coolidge to Charles E. Pleasants (7 Jan 1852), all in RG 11 2, entry 2, 19:353, 

20:476, and 498, and 22:2 10, respectively. 
LAWSON'S LAST YEARS, 1846-1 86 1 

redations made repeated punitive expeditions necessary in Texas, the depa rtment 

set up another warehouse at San Antonio. 

The need for a major depot there was temporary, and this facility was soon red uced 

in size and required to supply only units 

passing through. By 1855 there were also 

medical suppl y depots at Albuquerque and 

Santa Fe and at Benecia, in present-day 

California, but th e surgeon genera l remained adamant in his determination to 

have permanent forts order on a yearly basis from New York City, requisitioning 

from depots only in eme rgencies." 

The safet y of goods shipped long distances remained very uncertain; rough handling often damaged even carefull y packed 

items, and shipwrecks were a fact of life. 

In 1856 the failure of his annual shipment 

to arrive actually forced the surgeon at Fort 

Chadbourne, Texas, " to resort to the horse 

and mille medicine in the Quarter Master's 

Depot." Included in the supplies lost in 

wrecks were two consecutive shipments in 

1860 to forts in the Arkansas-Oklahoma 

area. Judging from the size of the department's orders, the concept of anesthesia 

was being accepted, but ether continued to 

be difficult to ship. One order evaporated 

during the long trip from New York to Albuquerque because of ill-fitting glass stoppers. The purveyor obtained a promise 

from the supplier to ship the anesthetic 

again, at no cost to the government if the 

Army transported the bottles. " 

IlLtrs. Heiskell to M ower (4 Jul 1849), to M cCormick (26 Jul 1849), to Wright (4 Fcb 1850), and 

to McDougall (22 Feb 1850) and Lawson to Act QMG 

(19Sep 1855), all in RG 11 2, entry 2, 20:144, 177, 

451 , and 476 and 25:37, respectivel y; Coolidge to 

M cCormick (5 Apr 186 1), Jarvis to Lawson (27 Apr 

and 10 Oct 1859). and Mills to Lawson (16 Jan 185 1), 

all in RG 11 2, entry 12. 

12Quote from Llf, E. P. Langworthy to Lawson 

(I Dec 1856), RG 112, entry 12; James O. Breeden, 

"Health of Earl y Texas: The Military Frontier," SOllfltweSlem Historical Quarterly 80 (1977):397-98; Ltrs, 

13 1 

Surgeons in California began to urge 

Lawson to permit some purchases to be 

made there. One physician maintai ned that 

the items he needed could be bought locally 

for less than the total cost, including shipment, of the same items bought in New 

York. The department's decision in January 1861 to buy the tea for Ca lifornia posts 

in San Francisco was a gesture in this direction. In add ition, theft or evaporation 

might cause bottles of wine to arri ve in California empt y. The Surgeon General's Office finall y ordered the medical director in 

San Francisco to buy twenty-four dozen 

bottles of Los Angeles wine for the use of 

West Coast posts to supplement sixty 

dozen bottles to be sent from New York 

City. The New York purveyo r initially concluded that Los Angeles wines were acceptable " for medicinal use," but by April 

186 1 it had become obvious that California 

wines did not please eastern palates; they 

were all, the San Francisco purveyor reported, either too sweet or too acid, and 

none were fit for the sick. " 

Supply problems also resulted from the 

re lative haste with which troops were 

moved about. In the spring of 185 1, for 

example, companies of the 5th Infantry began arriving at Fort Gibson from Fort 

Leavenworth on their way to Texas, but 

"entirely destitute of medical Suppli es." 

The Surgeon General's Office asked the 

Murray to Lawson (17 Feb 1854), Porter to Lawson 

(1 Sep 1858), Swirt to Lawson (30 May 1852), Satterlee to Lawson ( 16 Apr and 14 Nov 1860), and Wells 

to Montgomery (2 Mar 1852), all in RG 112, entry 12. 

IlQuote from Ltr, Satterlee to Lawson (25 Jan 1861), 

RG 112, entry 12; Ltrs, Lawson to Assl QMG (7 Aug 

1857), Wood to Satterl ee (28 Feb 1860), and C. H. 

Smith to Satterlee (23 Jan 186 1), all in RG 112, ent ry 

2, 26: 137-38 and 27:329 and 597, respecti vely: Coolidge to Lawson (9 Apr 1861), D. Camden De Leon 10 

Lawson (5 Jul 1856), Oeyer1e to Lawson (20 Apr 

1852), and Griffin 10 Lawson (10 Jul 1852), all in RG 

11 2, entry 12. 
132 THE ARMY MEDICA L DEPARTMENT, 1818- 1865 

regiment's command ing officer to order 

surgeons at the nearest post to send all th eir 

medical supplies to his unit; the surgeons 

so deprived might resu ppl y themselves 

from New Orleans. The general commanding the Milita ry Depa rtment of the West 

had apparently not been consulted in this 

situation. When he hea rd of it, he announced that the Medi cal Department's 

handling of the matter was "entirely irregular," since only he could give such orders. 

He also questioned the authority of the surgeon acting as medical director for his area 

to fun ction as other than a post surgeon; 

apparently Lawson's custom of requiring 

the senior surgeon in a military department 

to serve as medical director was not always 

recognized. In any eve nt, the general ordered that all requests for medica l suppli es 

from other posts come from or through his 

headquarters. Amidst the furor, the Texasbou nd troops were supplied from Forts 

Gibson, Towson, and Washita." 

Supply was but one of the diffi culties 

faced by Medical Department surgeons in 

the West. The shortage of adequate hospital faciliti es at new posts also presented 

problems. In 1858 at Walla Walla, Washington, for exampl e, the hospital was "a 

tempora ry thatched hovel, twelve by fourteen, with only fo ur bunks (one above the 

other), less than three feet wide." Although 

th e wo und ed res ulting from indi vidual 

skirmishes with the Indians in the West 

were usually few, ex peditions aga inst the 

Indians co uld on occasion result in more 

wou nded than there were bunks. For reasons that the surgeon appa rently did not 

understand, construction of a new facility 

I~ Fi t quote. Ltr, Wells to Madison (copy, 16 May 

185 1), and second quote, Llr, Page to Wells (20 May 

1851), both in RG 112. entry 12: Ltrs, Wells (rccipi· 

cnt's name illegible) (23 May 1851) and Wells to Lawson (21 Jun 185 1) and Order (no. 7, 19 May 185 1). 

all in RG 112, entry 12. 

to replace the dcfecti ve one at Walla Walla 

had come to a halt by 1854. The problems 

of th e medical offi cer in San Francisco at 

this time were even greater. His hospital 

building was too small for the growing 

command and in poor conditi on, and the 

surgeon general made matters worse by refusing to grant an adequate fu el suppl y for 

the summer months. Summers in northern 

Ca li fo rni a were almost as cool as the wi nters, but Lawson insisted upon allowing 

only two cord s of wood for the summer 

even though eight were needed for the 

winter. 1.5 

Surgeons also ex perienced problems getting their patients to whatever faci lities 

th ey had succeeded in establishing. As late 

as 1859, the Medi ca l Department had 

made little progress against the difficulties 

in volved in movi ng the disabled. In the fa ll 

of that year, a board of five department 

surgeons met in Washington to examine 

mod els for amb ulances. They re co mmended trials of two types, a two-wheeled 

version and a four-wheeled one that could 

carry ten men. The large r model was apparently in use at Fo rt Leavenworth by 

186 1. An attempt to have a horse litter designed for use in areas inaccessible to 

wheeled vehicles fai led. Add itiona l difficulties arose from the fact that Army offi cers tended to use ambu la nces as if they 

were ordi nary wagons. In 1860 the department was forced to emphasize that the vehicles distributed to the Army to serve as 

ambulances were not to be used for any 

other purpose." 

I~ SGO. Statistical Report 011 fhe Sickness and }\4or· 

!tIlity in 'he Army o/Ihe United States ... From Jan· 

U(lI'Y, 1855. 10 JllI/llar)'. 1860 (Wash ington: George W. 

Bowman , 1860), pp. 268-70, quote from p. 270; Ltrs, 

J. F. H ammond to Lawson ( II May, 15 Jun, and 

2 1 Aug 18 54), all in RG 112, entry 12. 

16Ltrs, Wood to Satterlee (28 Feb 1860) and to J. 

E. Johnston (2 A ug 1860), both in RG 112, entry 2, 

27:330 and 484, respecti vely; J. F. Hammond to Law-
LAWSON'S LAST YEARS, 1846- 1861 

The principal difficulties faced by the 

Medical Department as a whole in the fifteen years before the Civil War resulted 

from the refusal of Congress to grant adequate increases for the medical staff and, 

above all, from the rapidity of the nation's 

expansion. In the Far West, where the 

greatest change was taking place, the telegraph and the railroad were not available, 

and the problems faced by surgeons there 

were exaggerated by the resultant inability 

of the department to adj ust the shipment 

of supplies quickly enough to meet the 

changing demand. 

The Work of the Army Surgeon 

as a Physician 

Ultimately the problems generated by 

slow communications and transportation, 

by an understaffed department, and by the 

shortage of trained and reliable stewards 

fell upon surgeons in the fi eld, and particularly upon those in the West. In the East 

the Army doctor's duties tended to be mundane and included such chores as administering physical examinations to men 

wanting to join the Army. After the Mexican War, the department decided to look 

more closely at the health records it had 

been accumulating on would-be recruits. 

Published in the second volume of the 

department's Statistical Report, this study 

of men examined from 1849 through 1855 

recorded that 3,516 of 5,000 consecutive 

applicants in 1850 and 185 1 were foreignborn, and 2, 11 3 were from Ireland alone. 

A total of 2,675 were "from Great Britain 

and dependencies," while almost 700 came 

son (24 Feb 1855), Tripier to Wood (22 May 1860), 

and Wright to Lawson (8 Mar 186 1), all in RG 112, 

entry 12; Otis, A Report to the Surgeon General, pp. 2n, 

5,9. 

133 

from Germany. These figures no doubt refl ected the upheavals of 1848 in Europe 

and the Irish potato famine . The text 

noted, however, that in wa rtime, "The relati ve proportion of nati ve and foreign recruits [was] reversed."" 

The department's study also revealed 

that at midcentury the average would-be 

soldier weighed just under 150 pounds and 

stood between 5 feet 6'/' inches and 5 feet 

7'/' inches-regulations required a minimum height of 5 feet 5 inches. Among 

1,800 nati ve-born applicants examined for 

one part of the study, only 24 1 were at least 

6 feet tall , and the tallest hailed from Georgia. A large proportion of rejected recruits 

suffered from "varicose veins and varicocele." Many native-born men were rejected 

as " not robust, too slender," although physicians concluded that the "excess rejections" of these men resulted merely from 

their being "young men who had not arrived at the full development of their physical strength." The rejections of foreign 

recruits, on the other hand, often resulted 

from generally poor physical condition. A 

large number of "Europeans" (apparently 

an all-others type of category) was also rejected because of "Unsound and brokendown constitutions," while many English 

and Irish proved to be unacceptable because of " Intemperance and bad habits."" 

The department also classified its rejected recruits by occupation. Presumably 

most of the men who left their trades during peacetime to join the Army were not 

completely successful in civilian life. In 

some instances, poor health may have been 

to blame for their failures and therefore the 

Statistical Report fi gures may not be an ac11Quote from Statistical Report. /839-55, p.627. 

Unless otherwise indicated, all statisti cs in this hap ~ 

leT are derived from vol. 2 of the Statistical Reports. 

ISQuotcs from Statistical Report, 1839-55, p. 629. 
134 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

curate indication of the health of the civili an population. The lowest proportion 

of rejections was found in the category 

"Carpenters and workers in wood," the 

highest among laborers and farmers. Varicose veins caused rejections in all groups, 

but these tables also suggested that laborers 

suffered more than others from "lax abdominal rings," presumably a precursor of 

hernia, while farmers who had deserted 

their fields were often the victims of " imbecility" and venereal diseases, the latter 

acquired, perhaps, in the city where they 

signed up. The greatest incidence of intemperance was found among those who preferred the Army to tailoring, but "clerks, 

students, and teachers" were most often afflict ed with hemorrhoids. " 

The fact that such detailed statistics were 

gathered about those rejected by Army 

physical examinations may give the misleading impression that by this period only 

the fit were accepted for military service. 

Since no "exact, full, and uniform instructions" on how to conduct pre-induction 

physicals were distributed within the 

Army, overly eager recruiters had considerable leeway in filling their quotas. On at 

least one occasion, a line officer, angered 

by a rejection of a would-be recruit, tried 

but failed to have it reversed. Alcoholism, 

epilepsy, and psychological problems, furthermore, were undoubtedly difficult to 

spot, and accurate tests for such diseases 

as syphilis did not exist. Since physicians 

evidently believed that they could cure gonorrhea, men with this disease might be accepted if they had suffered no permanent 

physical damage. In the belief that soldiers 

"would not tolerate the mi xed breed as 

comrades," surgeons continued to reject 

I'Quotes from Statistical Repoft, /839-55, p. 630. 

those whose racial background was 

unclear. 20 

Regardless of their health when they 

signed up, recruits were exposed to many 

diseases by Army life. Fu rthermore, except 

for sma llpox, the Medical Department 

could do little to keep the soldier from contracting diseases to which he was exposed. 

All recruits were eventually vaccinated, but 

cases of small pox did occasionally occur. 

Some victims had not yet been immunized, 

or had not been properly immunized, while 

others may have lost their immunity over 

time. In 1849, when smallpox was particularly prevalent, 66 soldiers fell ill with the 

disease. Of these, 23 had been vaccinated, 

but of the 8 who died, none had ever undergone the proced ure." 

Army surgeons had by this time apparently realized that although it was often diffic ult t o obtain a potent vaccine , 

revaccination was advisable whenever soldiers were likely to be exposed to smallpox. 

The surgeon at Fort McKavett, Texas, for 

example, reimmunized most of the men at 

his post in 1857 after hearing ofa smallpox 

epidemic in San Antonio. Because of the 

difficulty of obtaini ng vaccine, he started 

by immunizing only infants and children 

who had never undergone the procedure. 

Using material taken from their lesions, he 

then vaccinated the 22-man post band. The 

20Quotes from Richard H. Coolidge, Revised Edition 

0/ Thomas Henderson's I-finis 011 the Medical Exami- na[ioIlS ... (Philadelphia: J. B. Lippincott Co., 1856), 

pp. 20, 32; Francis Paul Prucha, Broadax and BayolIet . .. (Madison: State Historical Society of Wisconsin, 1953), p. 41 ; Remarks, Maj E. W. Townsend 

(18 Sep 1858), and LIf, Randall to Lawson (26 Sep 

1858), both in RG 112, entry 12; Ltf, Bandel to his 

parents (1 7 Mar 1857), in Eugene Bandel, Frontier Life 

in the Army, /855-61 , cd. Ralph P. Bieber (Glendale, 

Calif.: Arthur Clarke Co., 1932), p. 105. 

2lltrs, Lawson to Martin N. Paine (12 Aug 1852), 

RG 11 2, ent ry 2, 22:450; W. S. King to Lawson (8 Mar 

1850) and Lafayette Guild to Lawson (22 Aug 1857), 

both in RG 11 2, entry 12. 
LAWSON'S LAST YEARS, 1846- 1861 

procedure took for all but four of this 

group, two of whom had already been vaccinated and two more of whom bore smallpox scars. With materi al obtained from 

members of the band he next vaccinated 

half of the remaining men, and with material from these, he immunized the final 

group'2 

Vaccinating the people at Fort McKavett 

in relays ensured the potency of the vaccine 

matter used after the first round. The depa rtment encouraged other surgeons to 

propagate their vacci ne similarly and also 

tried to develop an exchange system among 

its physicians. The New York purveyor experimented at this time with shipping the 

inoculum in small sealed glass tubes, but 

since these conta iners were quite fragile, 

the department generally continued to use 

vaccine crusts to ship the virus, although 

this method of shipment carried the risk 

that the material might be ineffective when 

it reached its destination." 

Although immuni zati on was not possible 

for diseases other than smallpox, the use of 

quinine could reduce malaria to the level 

of a Hvexatious" disease, even in those 

areas where mosquitoes thri ved. In Florida, for example, where fevers had caused 

such havoc during the Second Seminole 

War, a surgeon reported in 1856 that " ague 

and fever seldom affords [sic] cause for 

alarm, or even seriously excites the anxieties of the patient."" 

2lSlalisticai Report. /855-60, pp. 189-90. Unless 

otherwise indi cated. material on diseases in the Army 

is based on vols. 2 and 3 of these Statistical Reports. 

HLtrs, Heiskell to McDougall (I May 1849), to w. 

s. King (20 Aug 1849), and to Wood (27 Mar 1854), 

all in RG 112, ent ry 2, 20:33, 216 and 24:32, respective ly; Cooper to Lawson (24 Apr 1849) and Satterlee 

to Lawson (3 Nov 1857), both in RG 11 2, entry 12; 

Rpt, Coolidge, in Stalistical Report, /855-60, p. 97. 

HQuote fro m Statistical Report, /855-60, p. 149; Elkanah Babcock, A War HisfOry of the Sixth U.s. 111-

!arllry (Kansas City, Mo.: Hud son Kimberl y 

Publishing Co., 1903), pp. 66, 70-72; Esmond R. 

135 

Scurvy had long been better un derstood 

than malaria , but its cause continued to be 

partially obscured by misconception. As 

late as 1859, physicians still listed such factors as poor ventilati on, lack of exercise, 

exposure, a hot, dry climate, and boredom 

as contri buting factors. Having treated five 

cases in August and September 1857, during which time the men in his care had been 

offered dried vegetables as well as "apples, 

peaches, rice, and molasses," a surgeon in 

the West concluded that this experience 

had demonstrated that "abstinence from 

vegetable food is not, as some suppose the 

sole cause of scurvy." He ma inta ined that 

a man's physical condition and habits, especially "evil habits" in volving the use of 

the " filth y narcotic, tobacco," contributed 

to the appearance of the disease." 

When it was not deliberately supplemented with antiscorbutics, the normal 

Army diet provided little th at could have 

prevented or cured scurvy. A surgeon in 

Florida reported that men sent out on an 

exploratory expedition on 31 March 1857 

were showing signs of scurvy before their 

return to base on 21 May-and that while 

in the field they had eaten only pork, hard 

bread, and coffee. In 1854 the standard 

menu at Fort Columbus in New York Harbor was little better, except for the addition, "at rare intervals," of "one or two 

boiled potatoes." A soldier serving in the 

West in 1856 recorded a di et of a pound 

of pork or a pound and a half of beef each 

Long, "The Decli ne of Chronic Infectious Disease and 

Its Social Implications," Bulletill oJlhe History o/Melle;Ile 28 ( 1954):373. 

HQuotes fro m Statistical Report, /855-60, p.287; 

Ltrs, Heiskell to Baily (24 Mar 18 52), RG 112, entry 

2, 22:309; Wood to E. W. Johns (23 Mar 1859), in 

Statistical Report. 1855-60, p. 55; Peri n to Lawson 

(2 May 1850), RG 11 2, entry 12. It is now believed 

that such factors as st ress and smoking may indeed 

increase the body's need for vitamin C. 
136 TH E ARMY MEDICAL DEPARTM ENT, 1818- 1865 

GLOVER P ERI N . (Courlesy of National Library of Medicine.) 

day, coffee, " plenty of suga r," a little more 

than a pound of bread, and rice. Offi cers 

and their families had first cla im to vegetables grown on post, so surgeons might 

have to resort to using nati ve plants for the 

enlisted men even when the garden was 

doing well. Surgeons at less arid posts had 

long known of the virtues of wild onions, 

but Glover Perin discovered in the Southwest that cactus juice, fl avored sometimes 

with whiskey, sugar, and lemon extract to 

make it more palatable, also made a good 

antiscorbutic. In spite of th e ingenuity of 

post surgeons, among the many victims of 

scurvy in the 1849- 1854 peri od were 10 

men at the New York Harbor post, 988 in 

Texas, and 148 in Ca lifornia. " 

l6Augustus Meye rs, Tell Years in (he Ranks, U.s. 

Army(Ncw York: Stirling Press, 19 14), pp. 3, 5- 7, first 

Scurvy may not have been as common a 

co ndition as diarrhea, dysentery, respiratory ills, and alcoholism, but it was, nevertheless, a famili ar problem. By contrast, 

yellow feve r and cholera were so erratic in 

their appearance and so dangerous as to be 

capable of inspiring actual panic. Yellow 

fever continued to appear sporadi ca lly and 

without warning at cities all along the 

coast, and more regularly in the Deep 

South . Fort Brown, Texas, where it attacked 74 of the 89-man garrison and 18 

of the women and children, was but one of 

the posts where this mosquito-borne disease spread terror. At that post fear caused 

even normally sober men to drink heavily, 

and the surgeon reported that the bodies 

of ma ny of the forty-one who di ed showed 

"we ll-ma rked sympto ms o f delirium 

tremens. " 27 

Among the forts often visited by yellow 

fever was Fort Moultri e, in the harbor of 

Charleston, South Carolina. Diarrhea and 

dysentery were common there, as were various kinds of fevers, including malaria and 

dengue. Diagnosis, therefore, could be diffi cult. Although yellow fever appeared in 

Charleston in 1849 after an absence of several years, it did not reach Fort Moultrie 

until August 1850. Doctors disagreed about 

the nature of the disease at the fort, however. The post surgeon, John Porter, had 

already had more than his share of problems that summer- his hospital was ru n 

down and his steward a drunkard and a 

thi ef. Wh en Cha rl esto n surgeo ns cha llenged his concl usion that the disease they 

quote, p. 7; second quote, Bandel , Froll/ier Life, 

p. 105; Statistical Report. /839-55, p. 363; Lt rs, H. P. 

Bee to Lawson (8 Oct 1853), McCormi ck to Lawson 

( 16 May 1850), L. D. Mullawny to Lawson (5 Oct 

1853), and Perin to Lawson (2 May 1850 and 3 Jul 

185 1), all in RG 112, entry 12. 

l1Quote fro m Statistical Reporl. 1855-60, 

pp. 182-83. 
LAWSON'S LAST YEARS, 1846- 186 1 

were fighting was yellow fe ver and stated 

that it was dengue, Porter, who had become 

familiar with yellow fever in Mexico, replied that dengue was basically "a febrile, 

arthritic disease" and that he had not noted 

arthritic symptoms in his patients. He did 

entertain the idea that the disease might 

also be remittent fever. All but 10 of the 

48 officers and men, plus 43 of the women 

and children at the fort, contracted the disease before it had run its course, but the 

fact that none died indicates that the problem may not have been yellow fever" 

Yellow feve r apparently spared Fort 

Moultrie again in 185 1, but the next yea r 

33 of the I06-man garrison fell ill with it. 

The four who died were the only fatalities 

at the post during the entire year. This time 

no questions arose as to the nature of the 

epidemic, but at least Porter's luck had in 

some respects turned- his new steward 

was " always ... steady and temperate," 

and his hospital attendants were so conscientious during that desperate time that 

he was moved to urge the surgeon general 

to continue his attempt to get extra pay for 

those performing this type of work. 29 

Yellow fever returned to Fort Moultri e 

in epidemic form once again in 1858, but 

by that time Bernard M. Byrne had replaced Porter as post surgeon. Byrne may 

have been made of less stern stuff than Porter. The epidemi c apparentl y unnerved 

him, although accusa ti ons aga inst him 

were never proved. Less than a month after 

he diagnosed the first case of yellow fever, 

and after three of the sick had died, Byrne 

reported himself ill. He remained on sick 

28Llrs, Porte r to Lawson ( 11 and 26 Aug 1849, 

16 Oct 1849,2 Oct 1850, and 9 Feb 1852), all in RG 

112, entry 12; Surgeon's Quarterl y Rpl, Ft. Moultrie 

(30 Sep 1850), RG 94, entry 634. 

19Quote from Ltr, Po rte r to Lawson (26 Nov 1852 ), 

RG 11 2, ent ry 12; Surgeon's Quarterly Rpt, Ft. Moultrie (3 1 Dec t852), RG 94, entry 634. 

137 

report 32 days, an unusually long time; one 

of his yellow fever patients was able to return to duty 3 days after being hospitali zed 

and two others in 10 to II days. 

In the nine days after Byrne first became 

ill, eighteen more cases appeared a nd ten 

more victims died. A civilian physician 

from Cha rleston was asked to care for these 

men. Rumors began circulating that Byrne 

was not really ill, that he was avoiding patients for fea r of contracting yellow fever 

himself. Even after the arrival of Wi ll iam 

J. L'Engle, a Regular Army surgeo n, 

Byrne's services were still needed- the epidemic ended onl y after strik ing fo rty-nine 

men and killing twenty-eight.'· 

Although at the u rgi ng of one of the other 

officers at Fort Moultrie, Bvt. Col. J. L. 

Gardner, the post commander, took action 

against Byrne, Gard ner apparen tl y never 

doubted that Byrne was genuinely sick and 

unable to perform his duties. The Charleston physician said that, in Byrne's place, 

he too, would have treated himself, but that 

he could not substanti ate Byrne's claim of 

ill health without hav ing examined him. 

The ailing surgeon's steward praised his superior's devotion to duty and testified that 

Byrne looked ill during the time he was on 

sick report. A pri vate reported that when 

th e surgeo n r e turn ed t o dut y, " He 

seemed .. . to be a very delicate man, and 

very much reduced." L'Engle mainta ined 

that Byrne was obviously well enough to 

have cared for the sick since he had been 

caring for Mrs. Byrne, and an officer who 

had visited Byrne during his illness mai nta ined that the surgeon showed no sign of 

JOUnlcss otherwise indicated, all information on 

Byrne's ex periences a l Ft. Moultrie is based on Statistical Report. /855-60. pp. 122-23; Byrne, COllrl 

Marfial, and Surgeon's Quarterly Rpts, Ft. M oultrie 

(30 Sep and 31 Dec 1858), both in RG 94, entry 634. 
138 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

being unwell or suffering and that action 

should be taken against him." 

Byrne's reputation stood him in good 

stead at his trial and the civilian doctor 

poi nted out that Byrne had been under no 

professional obligation to care for patients 

when a Qualified physician was present to 

assume the responsibility for their welfare. 

The secretary of war approved the court's 

verdict of not guilty, but pointed out that 

the acquittal came on the ground of reasonable doubt and that t he illness of 

Byrne's wife had not absolved him of his 

responsibilities to the command. 

Yellow fever was, despite the erratic timing of its appearance, more familiar to 

many men in the Army than cholera, which 

had disappeared from the United States 

after the epidemic of 1832 had run its 

course. In 1848, however, cholera reappeared on the Nort h American conti nent, 

striking some posts repeatedly while sparing others. New York Harbor was among 

areas where this fearful disease spread terror, and 29 of the 79 who contracted it 

there died. At Kentucky's Newport Barracks, 16 of231 perished, and at Missouri's 

Jefferson Barracks and the nearby Sl. Louis 

Arsenal, 130 of 368 victims did not survive. Texas was also hard hit during this 

time, but Florida, New Mexico, and posts 

in southern California were spared." 

Cholera was soon a seasoned traveler in 

the United States. It accompanied troops 

on their way to Texas from New Orleans 

in 1848, when that city was in turmoil as 

the resu lt of simultaneous epidemics ofyellow fever and cholera. When two steamships carrying 450 soldiers set out for Port 

Lavacca, Texas, fro m a barracks four miles 

from the " doomed city" of New Orleans 

l'Quote from Byrne, COlirl IHarlial, p. 87. 

l2Ltr. Lawson to Paine ( 12 Aug 1852), RG 112, entry 2, 22:448- 49. 

on 12 December, cholera was a stowaway. 

Several days later, the men, still in "perfect 

health," debarked, with cholera still in hiding. The vibrio accompanied both those 

who remained in the town and those who 

went out to Placido Creek to camp. On 2 1 

December, the disease came out into the 

open at last, striking the men at both sites, 

appeari ng at Placido Creek after a severe 

storm had soaked the ground on which the 

men had to lie. By dawn of the 22d, 8 or 

9 men at Placido Creek and 40 at Port Lavacca were dead. By the time the epidemic 

had run its course a week later, 350 men 

and camp followers had felt its effects and 

150 lay dead ." 

In February cholera appea red at Brownsville, Texas. In March it struck at Brazos 

Santiago and Matamoros. At Camargo and 

nearby Camp Ringgold, the dread disease 

appeared early in March. Dragoons leaving 

the camp for San Antoni o by way of Laredo 

on II March took the vibrio wi th them. 

The appearance of cholera at San Antonio 

puzz led Nathan Ja rvis, for th e disease 

struck the town harder than it did other 

com muniti es even tho ugh the a lwayspresent breeze prevented miasmas and the 

town was considered one of the healthiest 

in Texas. Estimates of the number of deaths 

in San Antonio from mid-April to the first 

week in June varied from 400 to 700; 

among them was that of a major general, 

William Worth. All told, 44 soldiers died 

of cholera in southern Texas and 173 in the 

western part of that state duri ng the period 

of 1848 to 1854, after which the disease 

disappeared from the area." 

HFirst quote, Ltr, Ja rvis to Benjamin Jarvis (23 Dec 

1848), in Jarvis Papers; Jarvis, "Notes," pp. 438, 

440-4 1, second quote, p.438; Chambers, Cholera, 

p. 206; E. D . Fenner, " Report of Epidem ic Cholera 

in the City of New Orleans, 1848-49," SOl/them Medical Reports I ( 1849):135. 

)·Jarvis, "Notes," pp. 439- 4 1, 443; J. B. Wright, 

" Report on the Topography of San Antonio, and the 
LAWSON'S LAST YEARS, 1846-1 86 1 

Cholera accompanied travelers, both 

military and civilian, along all the main 

routes west in the early 1850s and even affected troops on their way to California by 

ship, but familiarity with this disease bred 

terror rather than contempt. In the summer 

of 1855, more than six years after cholera 

reappeared in the New World, the panic it 

inspired precipitated what was apparently 

a mental breakdown for the surgeon at Fort 

Riley, Kansas. Hysterical with fear for himself and his famil y, he deserted his post at 

the height of the epidemic, leaving sick and 

dying men, women, and children without 

medical attendance. Although he was convicted by court-martial and dismissed from 

the Army in January 1856, he was reinstated less than a year later and served 

creditably in the Union Army during the 

Civil War, eventually becoming Grant's 

medical director in the West. 35 

Cholera paid repeated visits to posts like 

Fort Leavenworth, through which soldiers 

and civilians, explorers and prospectors 

passed on their way along the Santa Fe and 

Oregon Trails to or from the newly acquired territories in the West. [n 1848 

traffic coming upriver from New Orleans 

brought the vibrio with it, and in 1849 the 

organism accompanied recruits from New 

York. [n the first nine months of that year, 

64 at the post became ill with cholera and 

28 died from it. [n the summer of 1850 men 

from a unit hit by cholera while at the JefEpidemic Cholera That Prevailed There in the Spring 

of 1849," Sowliem Medical Reports 1 ( 1849):4 16-17, 

429. 

3sElderkin, Sketches, pp. 97-98; Francis R. Packard, 

History of Medicine il/lhe United Siales, 2 vols. (New 

York: Hafner Publishing Co., 1963), 2:925; [George 

E. Orner, Jr.], A1I Army /-Jospira/ From Horses to Helicopters (Fort Riley, Kan., n.d.), p. \6. The story of 

cholera at Ft. Riley can be found in Perc ival Lowe's 

Five Years a Dragoon, /848- /854 (Kansas City. Mo.: 

Franklin Hudson Publishing Co., 1926). 

139 

ferson Barracks brought the disease with 

them as they traveled up the Missouri 

River. It "spread with fearfu l rapidity" 

among them, causing several deaths the 

night before thei r boat arrived at Fort 

Leavenworth. At its height the epidemic reportedly killed 4 or 5 a day, but by September it had apparently once again run its 

course in the Leavenworth area. 36 

[n 185 1 cholera struck the men of a detachment of dragoons and infantry recruits 

going through Fort Leavenworth bound for 

New Mexico, ki lling 15 of the 28 contracting it. One surgeon with these men was so 

constantly ill that he was of little use and 

remained behind when the men left the 

post in May. A second surgeon d ied along 

with 35 of his patients. [n 18 53 troops passing through the post brought chol e ra 

aga in-the Fort Leavenworth surgeon 

wrote the surgeon general that every detachment arriving at this post seemed to be 

stricken with cholera along the way. Those 

too sick to continue were bedded down in 

the three post hospitals, whose combined 

population was rarely less than 39 and was 

usually 85 or more each day. Because physicians did not always accompany detachments coming through Fort Leavenworth, 

such patients sometimes failed to recei ve 

adequate care. J7 

J6Glisan, JOllmaf. pp. 12- 13, 22, quote from p. 2 1; 

Ltrs, McDougall to Lawson (16 Jul 1849) and Mi lls 

to Lawson (3 Oct 1850), both in RG 112, entry 12; 

Surgeo n's Quarter ly Rpts, Ft. Leavenworth 

( 1846- 1848 and Mar, Jun, and Sep 1849), all in RG 

94, entry 634; Elvid Hunt, His/ory 0/ Fol'! Lem'elllIIorlh, 1827- 1927 (Fort Leavenworth, Kan.: The General Service Schools Press, 1926). p. 69; James 

Augustus Bennett. Forts and Forays . ... cds. Clinton 

E. Brooks and Frank D. Reeve (Albuquerque: ni ~ 

versity of New Mexico Press, 1948), pp. 10- 11. 

J7Chris Emmett, ForI Unioll and the Winning oflhe 

SOllthwest (Norman: University of Oklahoma, 1965), 

p. 7; Ltr, Cuyler to Lawson (24 Jun 1855), RG 11 2, 

entry 12; William Aloysius Keleher, Tllrmoil ill New 

lvlexico. /846-1868 (Santa Fe, N. Mex.: Rydal Press, 

1952), p. 129 n. 61 ; Stanley Francis Louis Crocchiola, 
140 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

In 1855, cholera returned once again to 

Fort Leavenworth with troops passing 

through, and by summer was raging at the 

Kansas post. Medical attendance remained 

inadequate for the need a nd the hospit al 

was crowded. A larger barracks was taken 

over to supplement faci lities for the sick, 

but some of the 11 5 who fell ill during the 

course of the epidemic ended up on the 

noor of an old stable that was "so infested 

with rats that they ran over the helpless sick 

in the day time." It was very hot, but the 

only drinking water ava ilable had to be 

brought in barrels from the Missouri River. 

Each man who wanted a drink dipped his 

cup into the common co ntainer. Some of 

the patients were soo n "unconscious of 

their surroundings; th eir features had 

turned to a bluish black color. Fl ies in great 

numbers swarmed around them, and settled on their open lips a nd staring eyes .... 

The doors and windows were all open, but 

the heat and stench were terrible." Some of 

the coffins of the twenty-four who died 

we re loaded with bodies in plain view of 

the sufferers. One corpse was too large for 

its container; "when his head and feet were 

in, his chest bulged up, whi ch made it necessary for one of the attendants to sit on 

the cover while it was being nailed down."" 

Sanitation at Fort Leavenworth was described as good, and the post surgeon in 

1857 reported only two problems: the diffi culty of finding sufficient water for bathing in the winter, when streams were 

frozen , and the need to find a way to drain 

laundry water away from living quarters. 

Fori Vnion (New Mexico) (n.p., 1953), p. 59; Surgeon's 

Quart e rl y Rpt, Ft. Leavenwo rth (30 Jun 185 1), 

RG 94, entry 634. 

38Mcyers, Tell Years, pp. 57- 60, quotes from pp. 58, 

59, and 60, respectively; Ltrs, Ridgely to Lawson 

(29 Apr and 14 Jun 1855), both in RG 112, entry 12; 

Surgeon's Quarterly Rpts, Ft. Leavenworth (30 Jun, 

30 Sep, and 31 Dec 1855), ali in RG 94, entry 634. 

Neve rtheless, by mod ern standards the 

management of the kitchen left something 

to be desired. In 1855, for example, a civilian working at the post, perhaps helping 

to construct the new barracks, discovered 

something odd on his d inner plate. A witness reported that "a closer examination 

disclosed a fu ll grown rodent, minus its 

hair." Whether the rodent was bald because 

of advanced age, disease, an abnormal supply of hormones, or long boiling was not 

disclosed, but the quartermaster reacted by 

hiring a new set of cooks. " 

Among th e exped iti ons leaving Fo rt 

Leavenworth for other parts of the West 

were those sent to dea l wi th recentl y settled 

Mormons in Utah, who were resisting the 

authority of the U.S. government. Planning 

for a 2,500-man expedition into Utah began in the spring of 1857. The recru its who 

joined this force just ou tside Fort Leavenworth were in poor condition, some were 

either too young or too old. "Many were 

broken down by habits of dissipation- by 

intemperance, by syphilis, by the practice 

of masturbation, & c." Health problems appa rentl y multiplied as they waited. Diarrhea was soon a common amiction and was 

blamed on diet and the climate. One surgeon specificall y mentioned "a dietetic 

cause more potent" than any other, "that 

ancient military institution, bean soup. A 

vil e concoction , prepared unde r this 

name," was served at Fort Leavenworth. 

Poison oak, "a plant which nourished in 

great luxuriance" in that area, also led to 

misery for some soldiers. "The local pain, 

heat, redness, and swelling," stated a physician, "were often considerable, accompanied by some constitutional disturbance, 

3~ Quote from Erasmus Theodore Carr, "Reminis· 

cences Concerning Fort Leavenworth in 1855-56," 

Kansas Slate H isforical Society's 1/-allsac/iolls 12 

( 1911 - 12):378; Hunt, Leavenworth, pp 98- 99, I I I. 
LAWSON'S LAST YEARS, 1846- 186 1 

especia ll y when th e scrotum wa s 

in volved."40 

The start of the march was not initially 

accompanied by any improvement in the 

health of the men bound for Mormon territory. In the first three days, problems 

caused by drunkenness, heat, and the general unfitness of the men limited progress 

to sixteen miles. When their water containers were empty, sold iers drank from 

pools of "water exceedingly filth y and nauseous from animal and vegetable decomposition" and were paid for their trouble 

with vomiting and more diarrhea. Some 

were overcome by heat and exhaustion, but 

the wagons in which they were placed were 

too high for easy loadi ng and offered a jolting ride. 4L 

In the course of their march the men encountered Pawnee Indians, among whom 

smallpox was raging, and efforts to avoid 

contact with them proved vain. Some of 

the quartermaster's men could not resist 

" the charms of filthy squaws," but their 

weakness was repaid with syphilis rather 

than smallpox. As the expedition neared 

the Platte River, problems caused by diarrhea d iminished, but the incidence of malaria increased, and in August the first case 

of scurvy appeared. By the end of the 

month, the men had marched 419 miles, 

during the course of wh ich one of the surgeons had, in addition to his other chores, 

delivered two babies, both to wives of 

soldiers. 42 

The weather was growing colde r as the 

men approached the end of their 1, 100-

mile march from Fort Leavenworth-on 8 

November the mercury reportedly fell to 

_440 F. and a strong northwest wind chilled 

40Quot es fro m Stat istical Report, 1855-60, 

pp. 28 1-83; Estimat e, Satterlee (2 Jun 1857), RG 112, 

entry 12. 

4!Quole from Statistical Report, 1855-60, p. 283. 

41Quote from ibid., p. 285. 

141 

the marrow of their bones. By December 

they had set up camp for the winte r at Fo rt 

Bridger, in today's state of Wyoming, near 

the Utah border. Wh ile awaiting the o utcome of negotiations with Brigham Young, 

surgeo ns established ho sp ita ls for their 

units in tents floored with hi des, a design 

that proved quite comfortable. Scurvy was 

apparently no longer a problem, possibl y 

because dried vegetables had been added 

to the diet, although the drying process 

probably destroyed much of the vitamin C. 

Many suffe red from frostbite, however, 

and one man lost the last joints of four toes 

to the cold." 

The knowledge that reinforcements for 

the Utah Expedition would soon be arriving from Fort Leavenworth determined the 

Mormons to seek peace in the spring of 

1858, and the men assembled to subdue 

them were, the refo re, gradually dispersed. 

Before this could happen, however, a surgeon at Fort Bridger encou ntered a new 

and mysterious form of feve r that first 

struck men who had been camped in a 

grassy valley. Within four days fifty-five of 

them were sick. Within three weeks 11 0 offi cers and men as well as a large number 

of teamsters and herders had fa llen ill. T he 

initial symptoms included an hou r or two 

of chills followed by a high fever, flushing 

of the skin, severe pain in the lower back, 

pain and cramps in the legs, a quickened 

pulse, nausea, and constipation. The eyes 

were bloodshot, and a "white, cheesy fur" 

covered the tongue, whose papillae were 

red and prominent. All symptoms disap4l1csse A. Gave, The Utah Expeditiol/, /857-1858: 

Leaers 0/ Capt. Jesse A. GOI'e. JOlh Illf. U.SA .. ed. 

Otis G. Hammond (Concord: New Hampshire Historical Society, 1928), pp. 5, II, 107, 138, 143-44, 146, 

22 1; Ltr, Wood to Med Dir (30 Nov 1859), RG 112, 

entry 2, 27:24 1; Theophi lus F. Rodenbaugh, From £,'-

erg/ade 10 Callol/ With the Second Dragoons . .. (New 

York: D . Van Nostrand, 1875), pp. 189, 19 1. 
142 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

ROBERTS BARTHOLOW. (Courtesy of Nalional Library of Medicine.) 

pea red within thirty-six hours, but in some 

cases the disease returned in a less severe 

form on the fifth day, lasting another 

twelve to eighteen hours. Only one death 

occurred at this time; the victim was a man 

who had been sick a week and paralyzed 

for two days. Mormons called the disease 

mountain fever, but it may have been what 

is today known as Colorado tick fever. 44 

Although mountain fever was apparently 

a disease Army surgeons had not encountered before, the old familiar ones like 

scurvy, alcoholism, and typhoid fever were 

also present in the area where the Mormons 

lived. In the period from 1857 to 1859, only 

4 men died from wounds and injuries in 

the Utah and Wyoming territories, but 34 

died of disease, 8 of these from typhoid. 

44Quote from Statistical Report, 1855-60, p. 305. 

Of eleven cases of scurvy, however, only 

one man died. The liquor sold by traders 

despite regulations to the contrary occasionally had particularly unfortunate effects. In at least one instance this beverage 

was compounded of alcohol, tobacco, "and 

various narcotics," and packed a kick that 

killed one man in short order and made 

many more ill." 

The Mormons as a people apparently 

fascinated non-Mormons who came to 

know them, including an Army surgeon, 

Roberts Bartholow, who stated in the third 

volume of the Statistical Report that "The 

Mormon, of all the human animals now 

walking this globe, is the most curious in 

every relation." It was, he said, 

a curious fact, that Mormonism makes its 

impress upon the countenance .. . an 

expression compounded of sensuality, cunning, suspicion, and a smirking selfconceit. The yellow, sunken, cadaverous 

visage; the greenish-colored eyes; the thick 

protuberant lips; the low forehead; the 

light, yellowish hair; the lank, angular person, constitute an appearance so characteristic of the new race, the production of 

polygamy, as to distinguish them a glance. 

He added that, even among the wealthiest 

Mormons, the infant death rate was 

high- these people believed in curing disease by "miraculous interposition" rather 

than by physicians." 

Examples of the failure of physicians to 

cure were not unusual in the middle of the 

nineteenth century, but the death of the 

Medical Department's most illustrious patient emphasized the helplessness of doctors when confronted with many of the 

diseases of that period. Despite the efforts 

Max L. Heyman, Jr., Pruden! Soldier: A Bibliography of E. R. S. Canby 1817- 1870 (Glendale. Calif.: 

Arthur H . Clark, 19 59), pp. 110- 11 , quote from 

p. I IO. 

46Quotes from Slalistical Report , 1855-60 , 

p. 30 1- 02. 
LAWSON'S LAST YEARS, 1846- 1861 

of three medical officers and a civilian colleague and at a time of considerable political turmoil, President Zachary Taylor fell 

victim to a gastrointestinal ailment in 

1850. 

Taylor became ill after spending hours in 

the sun on 4 July and then returning to the 

White House to drink quantities of cold 

beverages and eat raw fruits and vegetables. 

His doctors, summoned only after many 

hours had passed, diagnosed cholera morbus (acute gastroenteritis, not the dreaded 

Asiatic cholera), complicated in its later 

stages by remittent fever. They dosed him 

with calomel, opium, and quinine. The upand-down path of the disease led them at 

times to believe that their treatment was 

successful, but after five days of intermittent nausea, cramps, and diarrhea, and 

eventually fever as well, on the evening of 

9 July, Taylor died." 

Taylor's death may well have resulted 

from some form of food poisoning, a common enough affiiction at the time, though 

not one that ordinarily led to death. A fever 

had kept Taylor in bed for almost two 

weeks during the Second Seminole War, attacking him again during the war with 

Mexico. He may have been susceptible to 

flare-ups of malaria, especially when some 

other problem sapped his strength. Taylor's 

history of gastrointestinal problems, however, also suggests that a recurrence of amebic dysentery may have contributed to his 

demise. Like many another old soldier, he 

may have harbored not one but two parasites capable of killing him when the resilience of youth had deserted him and stress 

had rendered him especially vulnerable." 

47Holman Hamilton, Zachary Tay/or: Soldier in fhe 

White House (Indianapolis and New York: Bobbs- Merrill Co., 1951), pp. 388-93. 

Holman Hamilton, Zachary Tay/or, Soldier of lhe 

Republic (Indianapolis and New York: Bobbs-Merrill 

143 

BERNARD J. D. IRWI N. (Courtesy of Nalional Library of Medicine.) 

Surgeons as Soldiers and Scientists 

Few Army surgeons were ever privileged 

to sit at the president's bedside, but many 

cared for soldiers in campaigns against Indians in the West. One young physician 

very much involved in these efforts was Assistant Surgeon Bernard John Dowling Irwin. Irwin was both an amateur naturalist 

and the first man ever to win the congressional Medal of Honor, which was awarded 

to him in 1894 "for gallantry in action 

against hostile Chiricahua Apache Indians 

near Apache Pass, Ariz. 13th and 14th February, 186 I."" 

Co .• 194 1), pp. 36, 140, 192; Hamilton, Soldier ill fhe 

White House, p. 388. 

49Quote from B. J. D. Irwin, "The Apache Pass 

Fight," MilirarySurgeol/ 73 (1933): 197; U.S. Department of the Army. The Medal oj HOllor 0/ the United 

S({Jles Army (Washington: Government Printing Of-
144 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Irwin 's o pini o n of th e Apac he was 

scarcely better than that which his colleague held of the Mormon . His observations led him to concl ude, among other 

thi ngs, that Apache women did all the 

work, "while the dusky warrior basks in the 

sunshine, smoking his cigarito, dreaming 

over the ruthless deeds of murder and rapine" that he had infli cted on " the unfortun a te ' pa le fa ces' ." Th e r e pea t ed 

demonstration of what the Chiricahuas 

might do to palefaces unfortunate enough 

to fall into their hands apparently made 

compassion for the Apache difficult for the 

men at Fort Buchanan in present-day Arizona, seventy miles south of Tucson. In 

Irwin's account of the events of the winter 

of 1860 to 186 1, he noted that under the 

leadership of Cochise, Chiricahuas often 

ambushed small grou ps on their way to 

Mexico or California, killing the men and 

enslaving the women and children, with " ill 

treatment much worse than the most cruel 

death." He pointed out that " the highway 

leading to and from Apache Pass was dotted with the graves or stone tumuli that 

cove r th e rema in s of th e vic tims o f 

[c ochise's] treachery." Apaches, Irwin concl uded, were all a like, " treacherous, bloodthirsty, and cowardly."'· 

The events that brought Irwin the Medal 

of Honor began with the departure of 

Lt. George M. Bascom and sixty men of the 

7th Infantry, to whi ch Irwin was attached, 

from Fort Buchanan, under orders to try 

to fi nd a boy whom Cochise and his men 

had reportedly kidnapped and cattle they 

rice, 1948), pp. 6, 206. Unless otherwise indi cated, all material on Irwin's experi ences at this time is based 

on his articl e in Military SlIrgeon, pp. 197-203. 

$OFirst quote, Stafistical Report. 1855-60, p. 2 12; reM 

maining quotes, Irwin, "Apache Pass," pp. 198-99; 

Harvey Starr, "Bernard J. D. Irwin, M.D.," in The 

Westerners Brand Book, no. 13 ([Los Angeles], 1960), 

pp. 77-79, 8 1. 

had stolen from a beef contractor. After 

having been persuaded by a ci vilian he 

knew to come to camp to discuss these matters, the Indian leader managed to escape 

an attempt to deta in him there by fo rce. 

Others of his party were kept as hostages, 

but th e chi ef, und ete rred, a tt acked th e 

Overland Mail the night aft er his escape. 

Having sent a request for help through to 

Fort Buchanan, Bascom arranged a second 

parley, one that barely missed being a complete disaster. Three civilians with Bascom 

mingled with the Indians attendi ng the 

gathering and were never seen ali ve again, 

bu t a n attempt to ambush this pa rl ey 

failed. The Indians then surrounded the 

camp.SI 

Afte r Bascom's messenge r a rri ved at 

Fort Buchanan, a message was sent to the 

cavalry units at Fort Breckinri dge, 100 

miles away, requesting their support in 

helping Bascom. Desirous of bringing at 

least some aid to the lieutenant as quickly 

as possible, Irwin obtained permission, despite his supposed noncombatant status, to 

lead a small detachment directl y from Fort 

Buchanan, where there were no cavalry 

units, to Bascom's camp. In spite of the 

severe blizzard that was raging, Irwin and 

fourteen infa ntrymen set out on muleback 

toward Apache Pass. When they entered 

the pass, they encountered fi ve wagons, all 

" plundered and burned," with eight naked 

bodies fastened to the wagon wheels. The 

victims had slowly burned to death as the 

flames consumed their vehicles. Shortly 

thereafter, Irwin and his men took prisoner 

three Indi ans fo und herding stolen cattle. 

Intending to use the cattle to distract the 

besiegers as well as to supply Bascom and 

his men with beef, Irwin had the beasts 

dri ven ahead of him. With the three In-

)I Starr, " 'rwin," p. 8 1. 
LAWSON'S LAST YEARS, 1846-186 1 

dians as his captives, the surgeon made his 

way through to Bascom's camp" 

With the arrival of the cavalry from Fort 

Breckinridge a day la te r, the Indian s 

quickly disappeared. As in so many engagements with the western Indi ans, few 

men had been wounded. Although only two 

of Bascom's command had been hurt, soldiers who located Cochise's camp found 

that others had not been so fortunatevultures were tearing the flesh from the 

bodies of six white men, among them those 

of the civilians taken by the Chiricahuas at 

the time of the second meeting with Bascom. With the eight tormented bodies from 

the plundered wagon train a vivid memory, 

Irwin urged Bascom to execute six Indian 

hostages in retaliation. "The punishment," 

he admitted, "was an extreme mode of reprisal but was demanded and justified by 

the persistent acts of treachery and the 

atrocious cruelties perpetrated by the most 

cowardly and intractable tribes of savages 

infesting the territory." Irwin's insistence 

finally overcame Bascom's initial reluctance to resort to such measures, and, ten 

days later, the six Indians were hung " to 

the boughs of two stately oaks" that stood 

over the graves of their white victims. Because Irwin and Bascom "were desirous of 

making a lasting example to our treacherous foes, the bodies were allowed to remain 

suspended permanently." " 

S2Quotes from Irwin, "Apache Pass," p. 202; Starr, 

" Irwin," p.84. A report appearing three years later 

asserted that the term "non-combatant" was "convenient, but not truthful," adding that a physician 

could command troops in the absence of other commissioned officers; Woodhull, "Military Rights and 

Duties," p. 480. 

SlFirst and second quotes, Irwin, "Apache Pass," 

p. 203; remaining quotes, B. J. D. Irwin, "A Case of 

Severe Puncture Wound: Body Transfixed by a Bayonct:-Recovery," American I\-Iedical Times 4 

(1862):274. Most engagements with the Indians in the 

West in the decades befo re the Civil War were like 

this one-small, in volv ing rew men, and resulting in 

145 

Irwin's courage in action won him acclaim, and his medical duties must have 

occupied much of his time, since malaria 

posed a severe problem at Fort Buchanan 

because the post was small. But he also had 

time to pursue his interest in natural history and to keep the detailed meteorological records that the department required 

of all surgeons. Little hope may have remained that the data about climate and 

weather that he dutifully recorded and sent 

back to the surgeon general would be of 

great significance to the medical world, but 

there were valuable nonmedical uses for 

this kind of material, of which the Medical 

Department had accumulated sixty-four 

volumes by 1860. A researcher at the Navy 

Department used data from the Medical 

Department in preparing a study of storms, 

for example, and his work would serve as 

an aid to navigation. The topographical engineers responsible for assessi ng routes for 

the construction of railroads to the Pacific 

were also among those who made use of 

Medical Department data. In addition, the 

Medical Department cooperated with the 

Smithsonian Institution, which even provided some of the instruments used in recording details of the weather, in spite of 

the friction that developed between Lawson and Jo sep h Henry, head of the 

Smithsonian." 

an ave rage or barely mo re than one soldi er wounded 

pe r clash: George W. Webb, Chrollological Lisl 0/ £11-

gagemelll Belll'een fhe Regular Army 0/ the United 

States alld Various Tribes 0/ Hostile Illdialls. Which 

Occurred During the Years 1790 to 1898. IIlc/lisil'e (S1. 

Joseph, Mo.: Wing Printing & Publishing Co., 1939), 

pp. 9-23. 

Ltrs, Lawson to Jeffe rson Davis (copies, 5 Feb and 

10 May 1856), both in Joseph Henry Papers, Record 

Unit (RU) 700 1, U.S. National Museum , Sm ithsonian, Washington; Coolidge to Baird (4 Feb 1856), in 

Spencer F. Baird Papers, RU 7002; Heiske ll to Griffin 

(6 Jun 1850), Lawson to AG (25 Jun 1853), and Lawson to Henry (5 Apr 1856), all in RG 112, ent ry 2, 

21:96, 23:209, and 25:222-29, respectively; James 

Pollard Espy, First Reporl 011 J'deteorology (n.p .. n.d.), 
146 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Irwin shared his interest in natural history with many other Army medical office rs, a mo ng them th e future surgeo n 

general, William A. Hammond. By the 

time the Civil War was over, some of these 

surgeons were on their way to achieving 

enviable reputations as naturalists. With 

their aid, even before 186 1, the surgeon 

general was able to cooperate with scientists and institutions interested in obtaining spec imens of an ima ls, plants, and 

minerals. When Army physicians could not 

be spared to accompany exploring expeditions, the department hired contract surgeons, making skill as a naturalist one of 

the important qualifications for this position. Through the efforts of Assistant Secretary Spencer F. Baird, the Smithsonian 

Institution worked closely wi th the Army. 

It suppli ed surgeons with containers for 

their specimens, materials and instructions 

for preserving them, books relating to natural history, and in at least one instance, 

actually trained the natura list-p hysician 

for his work" 

One of the Army's young contract surpp. 1,2, 4; U.S. War Department. Repor! o/the Sec- retary 0/ War 011 the Several Pacific Railroad c··.xploraliolls(Washington: A . O. P. Nicholson, 1855), p. 39; 

Ashburn, Medical Deparlmem, p. 388. Henry criticized the department's work in the field of meteorology, but Professor W. E. Landsberg, University of 

Maryland Department of Meteorology. has pointed 

out that modern meteorologists regard the Army's records as ofhighcr quality because of the Army's greater 

control over its observers. 

ssUnless otherwise indicated, material on naturalists serving in the Army is based on Edgar Erskine 

Hume's Ornithologists. The paragraph is also based 

on Ltrs, Irwin to Baird (1 Sep 1857) and Hammond 

to Baird (9 May 1852), both in Registrar 1834- 1958, 

Accession Records, RU 305, Sm ithsonian; Baird to 

Irwin (9 Oct 1857). Outgoi ng Correspondence, Assistant Secretary, 1850- 1877, RU 53, 16:507; Lawson to 

Charles Sutherland (1 Aug 1853) and Heiskell to 

Byrne (1 7 May 1854), both in RG 112, entry 2, 

23:266- 67 and 24: 13, respectively; Cooper to Lawson 

(1 2 Jan 1859) and Official Orders, Jefferson Davis 

(extract, 12 Apr 185 3), both in RG 112, entry 12. 

geons with an interest in natural history 

had passed the Department's entrance exams before accompanying a survey party 

exploring possible railroad routes in the 

Northwest. George Suckley cared for the 

sick and inj ured among the men and also 

served as a naturalist, under Baird's guidance. The Smithsonian provided the necessary supplies and required that Suck ley 

collect and study zoologi cal and botanical 

specimens, familiarize himself with the Indians and their history, and make notes on 

rivers and their currents and fa lls. He initially had much time for this work because 

the men in the party were generally quite 

healthy, but his efforts to send his specimens safely back to Washington did not 

always meet with success. On at least one 

occasion, Baird was confronted by a container in which " unfortunately nearly all 

the fish were spoiled."" 

When an openi ng became available in 

December 1853, while Suckley was with 

the exploring expedition in the West, he 

joined the Medical Department and was 

sent to Fort Steilacoom in the Washington 

territory. Here he established a "good private practice" and began to invest in real 

estate. The opportunities for a naturalist 

were rich in the area and Suckley was content, but in the summer of 1854, to his dismay, the Army ordered him to Fort Dalles 

in the Oregon Territory, "a most barren 

spot." He had little time for natural history, 

for he was soon ordered to accompany a 

detachment sent "to chastise some Indians 

about 400 miles" from the fort. Despite the 

danger posed by the enemy, Suckley came 

)6Quote from Ltr, Baird to Suckley ( 17 Jan (855), 

RU 53, 10:195, Smithsonian; U.S. War Department, 

Reports of Explorations and SlIrveys . .. , 14 vols. 

(Washington: A. O. P. Nicholson. 1855), 1:64, 82, 

177- 79, 2 19-30 I; Ltrs, Baird to Suck ley (26 Nov and 

26 Dec 1853 and 3 1 Jan 1854), all in RU 53; Sucklcy 

to Baird (14 Apr 1853), RU 6999T; Isaac I. Stevens 

to Lawson (1 2 Apr 1853), RG 112, entry 12. 
LAWSON'S LAST YEARS, 1846- 186 1 

back from his six weeks in the wilds with 

"a few articles of interest."51 

At Fort Dalles, Suckley began to realize 

that he could not be happy in the Medical 

Department. His first love was natural history, and his duties as a military surgeon 

made it impossible for him to work and 

move about with the freedom he desired. 

His assignment in the West was delaying 

his work on the fina l version of the Pacific 

Railroad survey report. Baird used his influence in Washington to obtain leave for 

Suckley to travel east for a few months, but 

the surgeon was soon ordered west again. 

Suck ley spent Christmas of 1855 in Panama with troops being sent to the West 

Coast and by the end of January was at Fort 

Steilacoom accompan ying exped itions 

against the Indians in which he faced considerable personal danger as he cared for 

the sick and wounded. By the summer of 

that year Suckley was determined to leave 

the Army. He wished, however, to avoid 

having to pay his own expenses to return, 

and hoped to obtain leave to travel east and 

to resign shortly after his arrival. Again 

Baird did his best in Suckley's behalf 

through his acquaintances in the government, but to no avail. Suckley was forced 

to resign while still on the West Coast and 

by mid-November was on his way home." 

Even in the absence of hostile Indians, 

specimen hunting was not always a dangerfree occupation, as Samuel Washington 

Woodhouse, who became a prominent natS7Quotes from Suckley to Baird (22 Nov, 16 and 27 

Aug, and 16 Oct 1854), Incoming Correspondence, 

Assistant Secretary, 1850- 1878, RU 52, vo l. 71, pI. 

2:564-66. 

S8Ltrs, Baird to Suckley (Oct 1854, 15 Feb 1855, and 

15 May, 18 Apr, 21 Jun, and 16 Jul 1856), all in 

RU 53, 10:8,314, 14:11 6, 277, and 15:88-89, 131, respecti vely; Suckley to Baird (28 Dec 1854, 24 May 

1856, 23 Dec 1855 , and 2 1 Jan, 10 Feb, 9 Mar, 

16 Apr, and II Jul 1856), all in RU 52, vol. 71 , pI. 

2:567 , 580, 582, 583 , 584, 585 , 587, and 589, 

respectively. 

147 

GEORGE SUCKLEY. (Courtesy 0/ National 

Library 0/ Medicine.) 

uralist, discovered. While Woodhouse was 

serving as a contract surgeon with an expedition explori ng the Zuni and Little Colorado rivers, a rattlesnake that he was 

trying to collect bit him. Woodhouse broke 

the creature's back with a ramrod, but 

when he picked it up, he forgot to grasp it 

close to its head, and was bitten on the 

index finger of his left hand. He sucked the 

wound while his companion Quickly appli ed a tourniquet to the digit. He then 

scarifi ed the area around the wou nd and, 

as soon as he could obtain ammonia water, 

applied it to the bite. Following the recommendation of a civilian he enco untered 

on his way back to camp, he also began 

drinking whiskey in large Quantities. Despite his precautions by evening the glands 

in his armpits were sore. He then dosed 

himself with an opiate and, substituting 
148 T HE ARMY MEDICAL DEPARTM ENT, 1818- 1865 

SAMUEL W OODHOUSE. (Courtesy of Nalional Library of Medicine.) 

brandy for the whiskey, managed to remain 

drunk for fou r or fi ve hours. Throughout 

the night he continued dosing himself with 

various remedi es, including a cathartic. 

After sobering up, he removed the tou rniqu et from his fin ge r and app li ed a 

fla xseed meal poultice. Even with all this 

care, it was months before he regained the 

use of his hand. Whether because of the 

bite itself or because of the length of time 

he left the tourniquet in place, he eventually lost the nail and part of the finger. 

Although many surgeons worked as naturalists when not occupied with their patients, one young physician retained his 

unu sual youthful interest in communications a nd worked wh ile he was an Army 

surgeon to perfect a system of signaling 

wi th flags during daylight and torches at 

night. Assistant Surgeo n Albert J. Myer 

first brought his ideas to the attention of 

military authorities late in 1856, when he 

ex pounded the virtues of his system in a 

letter to Secreta ry of War Jefferson Davis. 

In 1859 the approval of an Army board led 

to fi eld tests, and in 1860 Myer was appointed signal offi cer, at which time he forma ll y r es ig n e d fro m the Medical 

Department. In 1863 Myer became the first 

head of the new Signal Corps." 

Conclusion 

Some of the younger members of the 

Medical Department showed varied talents 

as naturalists and in ventors, as surgeons, 

and as brave and sometimes harsh soldiers. 

The department itself, however, was typical 

of Army bureaus of the time, its leaders 

aging and set in their ways. During peacetime, the experience of the older men was 

a valuable asset, since the problems challenging the Medical Department in the 

years immedi ately preceding the Civil War 

were those it had always faced. Distances 

were greater and posts more numerous, but 

neither the diseases nor the needs of the 

indi vidual post or detachment had significantly changed. Furthermo re, the art of 

med icine had yet to become a science, and 

experience was no worse a guide than any 

other in the treatment of the fa miliar diseases. But the Medical Department had no 

plans for meeting the supply and evacuation problems of a major conflict, or for 

systemati ca ll y providing the physicians 

and hospitals needed to care for masses of 

casualties. And even if contingency planSqEdgar Erskine Humc. "The Foundation of American Meteorology by the United States Army Medical 

Department," Bulletill oj the Hisrory of Medicine 8 

( 1940):225-26; "Army Doctors-Pioneers and Peacemakers," 1\;1iIitar)' Medicine 126 ( 196 1 ):89 1; Paul J. 

Scheips, "Albert James Myer, An Army Doctor in 

Texas, 1854-1857," Sowhll'eslem Historical Quarterly 

82 (1978):9, 20-24. 
LAWSON'S LAST YEARS, 1846- 1861 

ning had been customary for nineteenth 

century armies, no one could have predicted the size and extent of the ordeal to 

come. Unprepared even for a minor war, 

149 

the Army Medical Department would inevitably be overwhelmed in the earli est 

months of the Civil War. 

CHAPTER 8 

The Civil War, 1861: 

Many Problems, Few Solutions 

When Confederate guns began pounding 

Fort Sumter, South Carolina, on 12 April 

186 1, undoubtedly one of the least apprehensive men behind its walls was Assistant 

Surgeon Samuel W. Crawford. Taken from 

the same mold that produced Surgeon General Thomas Lawson, Crawford was more 

soldier than physician and eager for combat in which he could take an acti ve part. 

He had led the rear guard of the unit abandoning Charleston's Fort Moultrie in Decembe r 1860 . Upo n arri ving a t Fo rt 

Sumter, across the harbor from Fort Moultri e, he had volunteered to take his turn as 

offi cer of the day. Quickly familiarizing 

himself with the problems invol ved in defending Fort Sumter, he undertook the 

command of a battery during the bombardment. (Map 5) In spite of the fact that 

he was by then responsible for the care of 

the first four Union soldi ers to be wounded 

by Confederate guns, Crawford also met 

Confederate representati ves arri ving at the 

fort on 14 April to discuss its surrender and 

conducted them to the fort's commanding 

offi cer. ' 

'Primary sources, including Crawford's own report 

and documents in the War Department's War of Rebellion volumes, indicate that, contrary to statements 

in many secondary volumes, the Confederate bombardment of Fl. Sumter did produce Union casualti es. 

Rpt , Crawford (12- 14 Apr 186 1), RG 94, entry 634, 

hereafter cited as Crawford Report; War Department, 

The time was approaching when the 

professional demands on medical officers 

in wartime would be too great to permit 

them to play part-time acti ve military roles 

as well. The care of thousands of pati ents, 

both sick and wounded, and the management of the various stages of their evacuation from battlefi eld to the hospital that 

completed their care would soon no longer 

allow a surgeon general to ride at his general's side, as Lawson had done in the war 

with Mexico, or permit a medical offi cer 

the challenge of commanding a unit in battle. At Fort Sumter, however, where the 

casualti es from the bombardment were few 

and their wounds slight, Crawford was still 

able to function successfull y as both medical and line offi cer. The first fatal injury 

at the fort came only after the surrender, 

when at final ceremonies an accidental 

The War ofllie Rebellion." A Compilalioll o/lhe Official 

Records oj fhe Uniotl and Confederate Armies (Washington: Goverment Printing Office, 1880- 190 1), ser. 

1, 1:12,20-24,62,66-67 (hereafte r cited as WOR); 

Paul E. Steiner, Physician- Generals ill 'he Civil War: 

A Sludy ill Nineleelllh Mid-Celllury Medicille (Springfi eld, III.: Charles C Thomas, 1966), pp. 41-42, 44; A. 

Doubleday, Reminiscences 0/ Forls Sumler and MoulIrie ill /860-61 (New York: Harper, 1876), pp. 146, 

166; Samuel Wylie Crawrord, The Genesis 0/ the Civil 

War: The Story 0/ Sumler /860-61 (New York: C. L. 

Webster & Co., 1887), Pi>. 430-70. Unless otherwise 

indicated, all material in this chapter is based on 

Brown, Medical Departmenl, and Callan, Military 

Laws. 
, 

; CANADA , 

Buffalo 

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MO. 

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~ I Barracks Perryville ,,I ...... "" _____ --- ~ I S ' f, ' Id KY.:-/::~ "'-J-- Rale; h 

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Pea RIdge A _ Murfreesboro I ..)".&:.....-- " 

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. \ Little Rock " , . Chattanooga c- _./' S.C. L-- - ........... 

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gl 

, 

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Cornith \ • " 

t 'Rome "- luke \ . , Charleston I A tlante "-, 

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~ I Shreveport 

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MAP 5 

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Beton' 

THE CIVIL WAR 

1861-1865 

o OOp '-, __ -="::--__ .:::1. 

Miles 

Fort Moultrie 

Fort Sumter 
TH E CIVIL WAR, 186 1: MANY PRO BLEMS, FEW SOLUTIONS 153 

ex plosion of ammunition killed one man 

and hurt several others. These men were 

quickly evacuated, one to a Charleston hospital and the others to the No rth with the 

rest of the garrison. The summer after the 

surrender, Crawford announced his intention to resign from the Medical Department to become an infantry offi cer. In this 

capacity he rose to the ra nk of brigadier 

general during the war. Even after hostilities ended, he never returned to the practice of medicine.' 

Adm inistrative Problems of the 

Medical Department 

Crawford was but one of many ph ysicians to leave th e Medical Department in 

the early months of 186 1. Of 114 doctors 

serving at the time Fort Moultri e was abandoned, 24 resigned to join Confederate 

forces and 3 more were dismissed for disloyalty. Their depa rture left the Medical 

Department with a relati vely small nucleus 

of experi enced military surgeons around 

which it had to build a huge wa rtime 

organi zation. 

Even veterans of the Mexican War, however, had no concept of the difficulties that 

would be involved in dea ling with casualties on the scale of those of the Civil War. 

Accustomed to handling the health problems of small and relati vely isolated posts, 

old-time Army surgeons had never been 

ca lled upon to develop plans for evacuating, hospitalizing, and caring for vast numbers of wounded and sick or fo r preventing 

disease in camps with populations of thousands. Because of the seniori ty system, the 

department's initi al responses to the Civil 

War were directed by " fogies," acccording 

2Steiner. Physician-Generals. p. 44; Crawford Report; Ll f, Lewis A. Edwards to Crawford ( 19 JuI1 861), 

RG 112, entry 2, 28:253. 

SA M UEL W. CRAWFORD. Cotlrte~JI oj National LibrCIIJl oj Medicine.) 

to George T. Strong, a contemporary famili ar with their work-old codgers " paralyzed by routine habits acquired in long 

dealing with an army often or fifteen thousand and utterl y unequal to their present 

work." Unable to accept the fact that their 

years of ex perience had taught them little 

that would be of value in the crisis, some 

of these "superannuated offi cers" on occasion also stood in the way of others more 

willing to innovate.' 

The Med ical Department's most superannuated offi cer at the time of Fort Sumter's surrender, Surgeo n General Thomas 

Lawson, wo uld soon no longer be contrib3QUotcs from George Templeton Strong, Diary of 

rlieCh'i/ War, /860- /865, cd. All an Ncvins(New Yo rk: 

M acmillan Co., 1962), p. 181 ; U .S. Sanitary Commission (USSC), Sanitary Memoirs o/Ihe W(lr o/the 

Rebellion (New York: H urd & Houghton, 1867). p. 43. 
154 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

CLEMENT ALEXANDER FIN LEY. (Courtesy 

of National LibrOlY of Medicine.) 

uting to the department's problems. Apparently already ill when Confederate guns 

first fired on the South Carolina fort, Lawson died of apoplexy on 15 May after fifty 

years in the Army and almost twenty-five 

as surgeon general. Unfortunately his aging 

successor, Clement A. Finley, was, as a contemporary put it, " utterly ossified and useless." Already in his sixties, Finley 

apparently had little to recommend him for 

so high a post except his forty years in the 

Army.' 

In the spring and early summer of 1861 , 

a large group of younger surgeons with no 

military experience was rapidly gathering 

to join veteran Regular Army surgeons. 

4Quote from Strong, Diary. p. \81; Ltrs, Edward to 

w. T Willard ( 15 May 1861), RG 112, entry 2, 28:65; 

Wood to AG and to Finley (both 18 May 1861), both 

in RG 112, entry 2, 28:75. 

Most of the new physicians were volunteers. Although Congress doubled the number of medical officers assigned to each of 

the forty volun teer regiments called up by 

President Lincoln in May, Surgeon General 

Finley considered one surgeon and one assistant surgeon per regiment still to be inadequate. Since state authorities often 

ignored the examination required for acceptance into the new volunteer force and 

a medical degree was not a prerequisite to 

service, the quality of the new physicians 

was as open to question as the quantity, 

and even homeopaths might be considered 

for positions as regimental surgeons.' 

In July, in the process of approving the 

President's call for troops, Congress added 

a requirement that brigades of three or four 

regiments each be organized and that the 

secretary of war assign each brigade a surgeon, who must have passed an exam "of 

practical character" administered by the 

Medical Department. The specific responsibilities of the brigade surgeon were not 

outlined at this time, leaving the medical 

director of each army or area to use his 

brigade surgeons as he wished. In practice 

the duties assigned these individuals were 

considerable, especially in view of the fact 

that many were young volunteers and at 

best familiar with Army routine only to the 

extent made possible by a few months of 

service as regimental surgeons. Those brigade surgeons who became medical directors when Regular Army medical officers 

were not available might be called upon for 

SWORt ser. 3, 1 :636; Ltrs, W. I. H. White to Joseph 

T. Howard (20 May 186 1), Wood to P. W. Ellsworth 

(20 May 1861) and to Henry H. Smith (24 May 186 1), 

Finley to Griswold ( 18 Oct 186 1), and Wood to Gov 

Kirkwood (20 Nov 186 1), all in RG 112, entry 2, 

28:82, 83, and 102, and 29:9 and 120, respective ly; 

"The Week," American Medical Times 3 (1861 ):224; 

Ltrs, J. D. S. Haslet and William Johnston to SG (both 

13 Jun 1861), both in RG 11 2, Registers of Letters 

Received, 1862, entry 10:13. 
THE CIVI L WAR, 1861: MANY PROBLEMS, FEW SOLUTIONS 155 

advice on matters affecting the command's 

health even though they were not likely to 

be aut horities on either h yg iene or 

sanitation ' 

Regular Army surgeons, however, remained the backbone of the Medical Department. Whenever possible the positions 

of medical director and medical purveyor 

were assigned to them. Regulars with years 

of experience who were serving in the West 

were called east in the summer of 186 1, 

their places to be taken by civilians. New 

regulars, both those replacing resigning 

physicians and the additional thirty for 

whom Congress called in August, were, 

however, as inexperienced as their volunteer counterparts, although their professional skills continued to be guaranteed by 

the examinations the department invariably administered to regulars. 7 

Contract surgeons, or acting assistant 

surgeons, and medical cadets were, for the 

most part, as lacking in military experience 

as volunteer and new regular surgeons. 

Contract physicians might have neither 

skill nor military background and were in 

some instances considered to be "charlatans and imposters" by their contemporari es. The creation of the position of 

medical cadet in the summer of 1861 represented a major innovation, since it made 

it possible for medical students eighteen to 

twenty-three years old to serve as dressers 

or ambul ance attendants. Up to fifty of 

these young men could be signed on at one 

Quote from Ltr, M. 1. Asch to J. Surd Peale (21 Oct 

186 1), RG 112, entry 2, 29:18; Ltrs, Wood to George 

G. Shumard (21 Jun 186 1) and Finley to U. Goldsmith (3 JulI 861), 28:183 and 2 13, respecti vely; John 

H . Brinton , Personal Memoirs o/lolm I-I. Brinton. Ma· 

jor and Slirgeon Us. V, 1861-1865 (New York: Neale 

Publishing Co., 1914), pp. 18,54, 62- 63. 

lLtrs, Wood to Finley (27 Apr 1861) and to M cCormick (6 May 186 1), both in RG 112, entry 2, 28: 14 

and 38, respectivel y. 

time and given the rank and pay of West 

Point cadets' 

To help in the care of the Army's wartime 

patients, the Medical Department needed 

a larger group of hospital attendants and 

nurses that was usually available. Like the 

Department's new physicians, many attendants were unfamiliar with the routine 

of mi li tary hospitals. Those detailed from 

the ranks might also be among the least fit 

of their units. Convalescents, who were famili ar to some degree with hospitals, were 

sometimes found to be both physically 

weak and "inhuman in their treatment of 

patients." 9 

Many women were eager to serve as 

nurses, but it was an unusual candidate 

who had been given even the briefest of 

training, since nursing schools were few. 

Surgeo n General Finley reportedl y opposed the use of civilians and particularly 

the use of women. To bring order out of 

potential chaos as far as fema le nurses were 

concerned, the Army asked the formidable 

Dorothea Dix, already well-known for her 

work with institutions for the insane, to 

serve as superintendent of female nurses 

for the Army and to screen applicants for 

nursing positions. In August, however, 

Congress effectively undermined her position by ruling that surgeons in charge of 

hospitals could hire nurses without goi ng 

through Supe rint enden t Dix. Those 

women whom Dix found acceptable were 

plain of face and dress and over thirty years 

'Quote from Brinton, lv/emoirs, pp. 65- 66; Ltrs, 

Wood to Finley (27 Apr 1861) and to McCormick 

(6 May 186 1), both in RG 112, entry 2, 28: 14 and 38, 

respectively; William Quentin Maxwell , UIU.:o/u 's 

Fifth Wheel: The Political History a/tlte Unired SWles 

Salliwry Commission (New York: Longmans, Green, 

& Co., 19 56), p. 62. 

9Quote from Mary Ashton Rice Livermore, My 

Story o/the War: II Woman's Narralil'e 0/ FOllr Years 

0/ Personal Experience (Hartford, Conn.: A. D . Worthington & Co., 1889), p. 127. 
156 THE ARMY MEDICAL DEPARTMENT, 18 18-1865 

of age. The Army forbade fema le attendants to accompany units on the march or 

to work in regimental hospitals and paid 

them 40 cents a day plus a ration each, a 

sum roughly half of that paid male civilian 

nurses hired to care for military patients.'o 

Not all Army surgeons looked forward to 

the assistance of female nurses. A medical 

journal of the day stated that fema le nurses 

were often "a useless annoyance," lacking 

the physical strength needed to he lp 

wou nded men. The article also suggested 

that its readers try to "imagine a delicate 

refined woman assisting a rough soldier to 

the close-stool, or supplying him with a 

bedpan ... " Some admitted, however, that 

when aided by orderli es or convalescents, 

female nurses could serve a useful purpose, 

si nce they were more attuned to the emotional needs of the sick and more skilled at 

Hsanitary domestic economy." I I 

In the Regular Army, the hospital steward, who before the war often added the 

role of nurse to his other duties, had by 

186 1 gained a position commanding considerable respect. Only men who could establish their competency as apothecaries 

were accepted for the required five-year enlistment. These men also served as wound 

dressers and were paid almost twice as 

much as female nurses, whose role, like that 

of all nurses, was seen as menial. Medical 

students so ught positions as stewa rds 

IO WOR, ser. 3, 1:262,308,398,42 1; Ltr, Wood to 

Cuyler (I I Dec 186 1), RG 11 2, entry 2, 29: 15; Sylvia 

G. L. Dannen and Katherine M. Jones, Our Women 

a/tile Sixties (Washington: U.S. Civil War Centennial 

Commission, 1963), p. 9; Isobel Stevenson, "Nursing 

in the Civil War," Ciba Symposia 3 ( 1941-42):92 1-22; 

Helen E. Marshall, Dorthea Dix, Forgollen Samaritull 

(Chapel Hill: Universit y of North Carolina Press, 

1937), pp. 217- 18. 

"First and second Quotes, "Duties of the Army Sur· 

geon-Females Not Suitable for Nurses," American 

Medical Times 3 (1861):30; third quote, "Female 

Nurses in Military Hospitals," American Medical 

Times 3 (1861):25. 

through whi ch they could gain experience 

in their chosen fields. In volunteer units, 

regimenta l surgeo ns fo llowed the old custom of choosing their stewards from their 

own units, one being allowed for each 

batta lion. " 

Expansion and organi zational changes 

affected the Department's fac iliti es as well 

as its personnel. The widespread network 

of post and regimental hospitals that supported the peacetime Army could never 

have been adequate to hand le the vast 

numbers of sick and wounded that wou ld 

result from the Civil War. To handle the 

overflow of patients from regimental hospitals, the Medical Department reinstituted the general hospital on a much larger 

scale than ever before. The first need for 

this institution developed in Washington, 

D.C., when more than 600 artillerymen 

and engi neers were ordered to that city in 

January and early February 1861. By the 

end of January, Lawson had ordered the 

establishment of the first genera l hospital 

to ca re for th e sick of units then in the 

capital and for any that might be sent 

through in the following weeks. With the 

advent of hostilities, the Medical Department started setting up more such faci lities 

in Washington. Medical directors in other 

areas also began to establish general hospitals to shelter those who had to be left 

behind when their units were on the move. 

Realizing that they should act ahead of actual need, directors attempted to prepare 

these facili ties before patients were actuall y 

waiting to enter them." 

12Ltrs, W. I. H. White to E. Kissler ( 14 May 186 1) 

and to J. C. Bucher (21 May 186 1), Wood to Ellsworth 

(20 May 1861), and Edwards to John S. Powell 

(21 Aug 1861), all in RG 11 2, entry 2, 28:61, 83, 

85-86, and 354, respectively. 

HLtrt Edward to Satterlee (29 Jan 186 1), RG 11 2, 

entry 2, 27:605; RG 94, Register or Hospitals, entry 

554; Constance McLaughlin Green, Washington, Vif-
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 157 

Regimental hospitals with their tents and 

eq uipment continued to accompany units 

on the march. Havi ng sent back to a general 

hospital men unable to march at the time 

the unit broke camp, the regimental surgeon cared for the wounded during and 

after battle wherever he could, sometimes 

in a rav ine or under a tree. He often established his hospital in a house near the 

battlefield and pitched his tents nearby to 

take in those the building could not accommodate. During a battIe that produced 

more casualties than regimental facilities 

could handle functioning as isolated units, 

the medical director might call for the creation of a tempo rary field hospi t a l, 

manned by regimental surgeo ns. In certain 

instances this officer also permitted the 

creation of a brigade hospital, operated under the immediate supervision of the brigade surgeon. Regarded as a consolidation 

of regimental hospitals, they were in actuality something of a hybrid between the 

regimental and general hospital, more permanent than the former but less so than 

the latter. 

Men assigned to hospital duties in regimental facilities were also expected to manage the evacuation of the wounded, a task 

they shared for a time with members of the 

regimental band. Only twenty-fi ve men 

were available in both categories in each 

regiment since the regulations permitted 

the assignment of no more than ten men 

per regiment to work as hospital attendants. The secretary of war rejected all offers from outside the federal government 

to provide ambulance compani es. Initially 

none of the men from the regiment were 

trained in the management of ambu lances 

and stretchers, and as a result an occasional 

surgeon or medical director undertook to 

lage and Capiw/, /800- 1878 (Princeton, N.J .: Princeton University Press, 1962), p. 233; WOR,scr. 3,1:23. 

drill these men so that they could perform 

their duties more effecti vely." 

Experiments before the war with various 

types of design had not led to a fi nal decision on the type of conveyance to adopt. 

As late as 27 April 1861 , the Medical Department had apparently not anticipated a 

need to order more of these vehicles despite 

complaints of shortage. Surgeons in the 

West were familiar with the four-wheeled 

variety and reported on it, but a twowheeled form, relatively untested but apparently designed by Finley, became the 

basis of the evacuation system once the war 

began. The purchase of fi ve of the lighter 

model for everyone of the heavier type was 

unfortunate, since in use the two-wheeler 

proved fragile. " 

Although evacuation and care of the 

wounded during and after battle was the 

most conspicuous responsibility of the department, the sick continued to outnumber 

the wounded and prevention of disease was 

an important consideration. The fact that 

in the early months of the war, almost anyone who wished to join the Army was permitted to do so frustrated attempts to 

maintain the Army's health. Physical examinations varied from state to state and 

in some were very lax. As a result, " feeble 

boys, toothless old men, consumpti ves, 

asthmatics, one-eyed, one-armed men, men 

with different length of legs, club-footed 

and ruptured," all might be permitted to 

I~ Maxwcll , Sal/irary Commission, p. 76; "Duties of 

Brigade Su rgeons," American Medical Times 3 

(1861 ):282-83; War Department, SGO, Medical alld 

Surgical History of the War oj the Rebellion. 2 vols. 

(Washington: Government Printing Office , 1870-88), 

I, app.: IO- 11 (hereafter cited as MSJ-/). 

"UTS, Wright to Lawson (8 Mar 186 1), RG 11 2, 

entry 12; Edward s to Robert Landreth, to A. Orvis, 

and to John M. Maisch (all 27 Apr 1861), all in RG 

112, entry 2. 28: 15; Finley to L. Thomas (2 Aug 186 1), 

RG 11 2, entry 2, 28:298; Frank H . Hamilton, II Trea· 

rise on Milirary Surgery aflll Hygiene (New York: Bal· 

liere Bros. , 1865), p. 44. 
158 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

FIN LEY AMBULANCE, FRONT VIEW, Fom 

il/ustration in Medical and Surgical 

History. 

join volunteer regiments. Many were soon 

sent home, and others " left the service 

irregularly," especially after the first battle 

of Bull Run in the summer of 1861. Only 

in August 1861 was examination by a surgeon actually required and even then the 

order was often flagrantly ignored. " 

Many recruits came from isolated areas, 

where they had never been exposed to measles and the other ordinary communicable 

diseases of childhood. In the camp where 

they were first received, as well as in the 

much larger ones to which they progressed, 

all were exposed to contagious diseases of 

many kinds. Furthermore, accustomed to 

having their clothes washed, food cooked, 

and quarters kept clean by wi ves or mothers, recruits were quite helpless when it 

16First quote, Sanitary Commission, Memoirs, p. 44; 

second quote, Llf, Finley to F. Coakley Vanderpool 

(2 Nov 1861 ), RG 11 2, entry 2, 29;65; Maxwell, Sal/' 

itary Commission, pp. 31-32; MSH I, app.:47. 

F I NLEY AMBULANC E, SIDE VI EW , F om 

iI/list ration in Medical and Surgical 

History. 

came to maintaining high standards of hygiene and sanitation in the Army. Department doctors, who compla ined that their 

own ambiguous rank and the resultant lack 

of prestige crippled their efforts to have 

line officers enforce strict rules, blamed 

this lack of hygiene and sanitation for much 

disease. Veteran soldiers, who maintained 

higher standards, also suffered from such 

diseases associated with faulty sanitation 

as typhoid, diarrhea, and dysentery. The 

sick rate of the entire army in the last six 

months of 1861 exceeded 30 percent, with 

digestive complaints the greatest source of 

illness and typhoid the principal cause of 

death. " 

In their effort to prevent the spread of 

disease, medical officers emphasized the 

dangers of overcrowding. Twenty or more 

17 MSfl I, pt. I :296-300; Brinton, Memoirs, p. 61 ; 

Maxwell, Sanitary Commission, pp. 7 1, 73: Joseph 

Janvier Woodward, Outlines 0/ fhe Chief Camp Diseases o/the United SI(l{es Armies ( 1863. Reprint. New 

York: Hafner Publishing Co., 1964), p. 9; William 

Howard Russell, My Diary, North and South. ed. 

Fletcher Pratt (Gloucester, Mass.: Pete r Smith , 1969), 

p. 196; "Sanitary Commission: Report orthe Resident 

Secretary, "Americall Medical Times 3 (1 861 ):60- 61 ; 

Strong, Diary, p. 203n. 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 159 

men often shared only 1, 100 cubic feet of 

air in the Sibley tents used as shelters in 

the first months of the war, but even in 

barracks, which were usuall y ha stily 

erected, overcrowding was a problem. Wet 

camp sites, overwork and exposure, and 

even poor blankets were also blamed for 

much illness. A civilian familiar with Army 

life maintained, however, that sending a 

soldier's pay directly to his wife or to a 

savings account wou ld significantly improve the Army's health by making it impossible for him to buy " bad pies and 

rotgut whiskey."" 

A potential cause of disease that received 

little attention early in the war was the Army's defective diet. In the summer, when 

fre sh fruits and vegetables were easy to 

find , the soldier usually had an adequate 

diet if he was stationed near a good source 

of supply or permitted to live off the land. 

Those in authority considered the basic 

Army ration to be "all sufficient for the 

men," but the potato was its only source of 

vitamin C. In the summer of 1861 , Congress passed a bill adding fresh vegetables 

or their equivalent to the diet, but the 

equi valent was apparently dried vegetables, which required long cooking to be palatable. Furthermore, transportation for an 

adequate supply of any form of vegetable 

was hard to find and commanding officers 

sometimes failed to take the need for vegetables seriously. Soups were favored as a 

way of serving meats, but th e reco mmended recipes called for hours of cooking, 

which undoubtedl y destro yed the last 

traces of this perishable vitamin in potatoes and any other vegetable that might 

find its way into the pot. Scurvy was already appearing by the end of 1861 , even 

18Quote from Strong, Diary, p. 85; Maxwell, S(wi· 

lary Commission, p. 34; Woodward , Outlilles, 

pp. 46- 47; MSH I, app.: I. 

though it takes some weeks or months 

to make its appearance in men whose suppl y of vitamin C has previousl y bee n 

adequate. " 

To care for the large numbers of both sick 

and wounded that characteri zed the Civil 

War, a far more complex system than that 

existing in peacetime was necessary to provide medicines and hospital supplies, especially since the troops were often on the 

move. New York City remained the principal supply center, but medical purveyors 

opened additional depots at appropriate 

sites over the nation, including Baltimore 

and Cairo, Illinois. Minor depots were set 

up near large camps, preferabl y near railroads or water transportation and, if possible , near a market. Field purveyo rs 

accompanied armies on the march, obtaining supplies at the nearest depot and issuing them as needed.'o 

The amount of supplies actually on hand 

when the war began was small, and the size 

of the Army was growing rapidly. The manufacture of the various items that were 

needed was time consuming. Buyers turned 

to contractors who might be interested only 

in a profit without regard to the dictates of 

patriotism. As reports came in about hospitals without either clothing or bedding 

for their patients, buyers became desperate, profiteers began to thrive, and fraud 

became common. Large amounts of cloth 

19Charlcs S. Tripier and George C. Blackburn , 

Handbook/or the Military Surgeon (Cincinnati: Robert 

Clark & Co., 1861), pp. 13- 14, quote from p. 12; Maxwell, SanilaryCommissioll, p. 58; "Duties ofthc Army 

Surgeon . .. ," "Sanitary Commission: Report of the 

Resident Secretary," and "The Week," all in American 

Medical Times 3 (1861):30 , 9 1, a nd 107- 08 , 

respectively. 

20Ltrs, Wood to Tripier (30 May 1861) and to J. H. 

Bailey ( IOJun 1861) and Edwards to J. S. Bobbs 

(180cI 186 1), all in RG 112, entry 2, 28: 11 6 and 142 

and 29:42, respectively; King to Finley (23 Aug 1861), 

RG 11 2, entry 12; MSI-I I, pt. 3:964; Huston, Sinews, 

p. 174. 
160 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

had to be purchased from abroad. Surgeons 

sometimes lacked even a complete suppl y 

of instruments, and a physician who 

wanted those of the most modern design 

might have to furnish them himself." 

Medicines were not always a problem in 

the early months of the war. Many new regiments were initially supplied by the state 

from which they came, but others had to 

draw upon the Medical Department's purveyor. When he could not contact a purchasing officer of his own department, the 

medical officer had to obtain medi cines 

through the Subsistence or the Quartermaster's Department. Many volunteer doctors further complicated the problem of 

supplying medicines by their failure to appreciate the advantages of limiting the variety bought. Some had favorite potions 

that were not to be found on the department's supply table, a document to which 

few additions were made when it was revised in the summer of 1861. Surgeon General Finley insisted that no unlisted items 

could be distributed without his personal 

approval. 22 

Slow transportation, complex ordering 

procedures, and the efforts of wellintentioned civi lians also compli cated 

medical supply. Delays forced medical officers to buy locally, and citizens added to 

the confusion by donating items that were 

not necessarily needed. Ambulances and 

many items involved in the building and 

equipping of military hospitals had to be 

obtained through the quartermaster, which 

added further complexities to the Medical 

Department's operations." 

21Ltr. Satterlee to Wood (22 May 1861), RG 11 2, 

entry 12; Huston, Sinews, pp. 179-80, 184; John Shaw 

Billings, "Medical Reminiscences of the Civil War," 

Transactions o/Ihe College 0/ Physicians of Phifadel· 

phia, 3d ser., 27 (1905):114-15. 

21Ltr. Finley to Med Dirs (11 Nov 1861), RG 112, 

entry 2, 29:95; SOs, Thomas (no. 232, 28 Apr 186 1), 

RG 112, entry 57. 

BLtrs, Wood to L. Thomas (20 May 186 1). RG 112, 

Surgeons made ingenious attempts to 

stretch the Department's resources. They 

sold the bones and fat from the meat fed 

to patients, for example, as well as stale 

bread, old newspapers, and similar items, 

and used the proceeds to buy whatever they 

believed to be of general benefit, such as 

books for the hospital's library, daily papers ~ magazines, and even musical instruments. The Medical Department received 

credit on Subsistence Department books 

for unused rations. At those hospitals 

where the produce of gardens or fish caught 

by convalescents could be added to the facility's larder, the amount in this so-called 

hospital fund could be significant. The sum 

was used to add special items to the diet, 

and at one hospital it also paid the salary 

of a professional cook whose skills resu lted 

in considerable savings to the hospital by 

eliminating waste" 

While the varied demands of the ea rly 

months of the war almost overwhelmed the 

Medical Department, many patriotic 

groups attempted to help in the care and 

feeding of Union soldiers. Their aid at first 

tended to be haphazard and inefficient, but 

not long after the war began and with Medical Department encouragement, a group 

of private citizens, one of whose leaders 

was a former Department surgeon, created 

an organization designed to coordinate efforts to aid the sick and wounded and to 

prevent disease. The U.S. Sanitary Commission was a less powerful but more pervasive version of a commission that had 

aided British soldiers during the Crimean 

War, and its work was officially approved 

entry 2, 28:78; Laub to Mclaren (II Jun 186 1), RG 

11 2, entry 12; Courtney R. Hall, "The Lessons of the 

War Between the States," in History of Americall Medicille. ed. Feli x Martin- Ibanez (New York: MD Pub· 

lications, 1959), p. 73. 

"MSH I, pI. 3:959. 
THE CIVIL WAR, 1861: MANY PROBLEMS, FEW SOLUTIONS 16 1 

by President Lincoln and his first secretary 

of war, Simon Cameron.25 

Within the War Department, opinions of 

the Sanitary Commission varied. Although 

he wished its power to be less than that of 

the British Sanitary Commission in the 

Crimea, Acting Surgeon General Robert C. 

Wood had encouraged its formation in the 

spring of 186 1. Surgeon General Finley accepted its help, although apparently with 

reluctance, but Lincoln's second secretary 

of war, Edwin Stanton, opposed it. Some 

Medical Depa rtment members believed 

that the need for supplies as perceived by 

the commission was only apparent and that 

it resulted almost entirely from the ignorance of volunteer surgeons, who asked for 

more than th ey really needed. As late as 

December 186 1, departmental opposition 

to the commission was so strong that a 

commission official was moved to comment that it was a "pity that [the] Bureau 

will neither do its official duty nor permit 

volunteers to help it without throwing filth 

at them. " 

Whether welcomed or not, the Sanitary 

Commission attempted to help the Medical Department with both advice and material aid. Its adv ice in the early months of 

the war was wide ranging. It urged more 

exacting physical exams for recruits, the 

creation of a nurse co rps, an increase in the 

rank of members of the Med ical Department, and greater attention to sanitation 

and disease prevention. It outlined a system to be used to determine the order in 

which patients were treated during and 

after battle and recommended the specific 

U WOR, ser. 3, 1:225, 258-59, 308; Strong, Diary, 

pp. xxxvii, xlviii, 150; Neil Cantlie, A Hislory oflhe 

Army Medical Depor/melll , 2 vols. (Ed inbu rgh: 

Churchill Li vingstone, 1974), 2:144-45. 

Z6Strong, Diary. p. 15, quote from p. 198; "T he Sanitary Commission," North American Review 98 

(1864): 163, 168. 

instruments and supplies a surgeon should 

take into the fi eld" 

The more tangible assistance that the 

Sanitary Commission offered the sick and 

wounded, including prisoners of war, was 

as varied as the topics on which it offered 

advice. It provided papers, pens, and volunteer scriveners to write letters for those 

unable to do so, and supplied dressing 

gowns, slippers, and reading material. It 

appealed to the public for donations of 

wine, spirits, mosquito netting, flannel, 

sheets, and ice. Its surgeons followed the 

army into the fi eld and brought with them 

ambulances, wagons loaded with stores, 

anesthetics, and surgical instruments. Its 

inspector kept watch over camp and hospital conditions. In time the Sanitary Commission eve n esta blis h e d a h osp it a l 

directory by means of which relatives could 

determine the location of any individual 

patient. It supplied quinine when Finley 

delayed his decision to order it for prophylactic use in northern Virginia . Officia ls of t he U.S. Sanitary Commission 

might provide lint for wound dressings, 

food, and even a hospital on short notice." 

The U.S. Sanitary Commission was not 

the only civilian organization of its kind 

that attempted to assist the Union Army 

with its wounded. Both the Western Sanitary Commission and the Christian Commission also operated along similar lines. 

The former was established in the summer 

of 186 1, in la rge measure at the instigation 

of Maj. Gen. John C. Fremont, and fu nctioned west of the Mississippi much as its 

counterpart, the U.S. Sanitary Commission, did in the east. Since the U.S. Sani17Maxwcll, Sanitary Commission, pp. 31- 32, 74- 75, 

114; Stevenson, "Nursing," p. 92 1; USSC, Sanitary 

Memoirs 1: 16, 24-25. 

18Maxwcll, Sanitary Commission, pp. 55. 7 1, 79, 8 1, 

295-96, 305 , 307; Ma ry Livermore , My Srory, 

pp. 131-32. 
162 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

JOHN CUYLER. (Courlesy of Nalional Library of Medicine.) 

tary Commission did not entirely restrict 

its activity to the East, there was conflict 

between the two organizations. They encountered many of the same difficulties in 

working with Army surgeo ns, some of 

whom gladly accepted their help and some 

of whom were determined to do without 

it. Although the main concern of·the Christian Commission was the spiritual welfare 

of the soldier, members of this organization 

also wrote letters, set up diet kitchens to 

provide special foods for hospital patients, 

and performed similar functions. As a result, the U.S. Sanitary Commission tended 

at times to regard the Christi an Commission as yet another riva!. " 

19Brinton, Memoirs, p. 48; Reporl to the Western 

Sanitary Commission ollihe Gelleral Military Hospitals 

o/S[, LOllis, Mo. (St. Louis, 1862), p. 4; Jacob Gi lbert 

Forman, 7'lle Western Sanitary Commission A Sketch 

Both the U.S. Sanitary Commission and 

the Medical Department broke new ground 

on a large scale in the first months of the 

Civil War. East and west of the Appalachians, medical directors were often forced 

to experiment and improvise. In each area 

of the country where there was military activity in 1861 , the medical director was 

forced to solve the problems he encountered with little, if any, assistance from the 

surgeon genera l. Despite the lack of centra l 

direction, the senior surgeon of the Medical Department for each army or area 

found it necessary to establish general facilities to shelter those whose wounds or 

diseases were likely to keep them hospita lized more than a few days, to attempt to 

systematize evacuation when his supply of 

ambulances was inadequate and his attendants untrained, and to supervise subordinates who were often inexperienced in 

military medicine. 

Care of the Sick and Wounded 

in the EaSl 

Medical directors of units serving east of 

the Appalachians found , long before year's 

end, that their relative proximity to the surgeon general gave them few, if any, advantages. Surgeon General Finley was jealous 

of his own powers and prerogatives, but his 

support of members of his department was 

ineffective. 

Perhaps the first medical director to discover how little he could rely on Finley was 

John M. Cuyler, a 27-year veteran of the 

of Its Origil/, NisfOry, Labors .. . (51. Louis: R. P. 

Studley & Co., 1864), pp. 7-8, 16-17; Jaek D. Key, 

William Alexander Hammond. M .D. (/828-1900) 

(Rochester, Minn.: Davies Printing Co., 1979), p. 19; 

Maxwell, Sanilary Commission, pp. 104, 19 1; Western 

Sanitary Commission, Report oflhe Western Sllllilllry 

Commission for the Year Eliding JUlie / , 1863 (St. 

Louis: Western San itary Commission, 1863), p. l. 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 163 

Medical Department assigned to manage 

the medical care of soldiers in the Fort 

Monroe-Newport News area of Virginia. 

Cuyler was in a very difficult situation in 

the summer of 186 1, caught between an inadequate su rgeon general and an overbearing command ing general , the arbitrary 

Maj. Gen. Benjamin Butler. When Butler 

sent some of his units on an ill-conceived 

and ill-executed operation intended to 

eliminate a Confederate battery at Big 

Bethel, Virginia, physicians with his command were already struggling wi th a measles epidemic, and a general hospital had 

been opened to ease the strain on existing 

facilities. Furthermore, Cuyler had no ambulances. After the Big Bethel effort ended 

in fi asco, Butler apparently assumed that 

Cuyler's organizati on could not provide 

care for his fifty-three wounded. He took 

over a hotel in the area, including its supply 

of bedding, and called in his family physician, Gilman Kimball, at that time a contract physician at the Army hospital in 

Annapolis, Maryland, to head the command's general hospital. In so doing, Butler 

caused the surgeon general considerable 

dismay. The Annapolis hospital was left 

without a physician when Kimball joined 

Butler, which he did agai nst Finley's expressed orders. Kimball'S arrival, accompanied by seve ra l assistants, was not 

explained to Cuyler, who acquiesced in 

Kimball's takeover of the hospital because 

he had no alternative.' o 

lORG 94, entry 544, Register of Hospitals; Ltrs, Edwards to Cuyler (1 9 Jun 186 1) and Finl ey to G. Kimbal (19Jun 1861 ), to E. D. Townsend (24Jun 1861), 

to Thomas (6 lui 186 1), and to Townsend (12 Ju1 

186 1), all in RG 11 2, entry 2, 28: 175, 175-76, 192, 

232, and 309, respecti vely; Cuyler to Finley (17 Jun, 

9 and 25 Jul, and 13 Dec 1861) and to Butler (copy, 

4 Ju\ 186 1), all in RG 11 2, entry 12; SOs, Thomas (no. 

149, 3 Jun 1861), RG 11 2, entry 57: "Camp Butler" 

and "The Week," both in AmericlllI Medical Times 3 

(1 861 ):64 and 79. and 222- 23, respective ly; WOR, ser. 

I, 2:82, 85. 

Kimball's care of his patients may have 

been adequate-no complai nt on this score 

has been found- but his departure in August 186 I revealed further evidence of his 

lack of appreciation for the way in which 

the Medical Department operated. While 

in office he had attempted to charge the 

Department for items it did not normally 

supply. After he left, Cuyler discovered that 

Kimball had also neither kept a record of 

expenditures and receipts nor collected a 

hospital fund. Despite his exasperati on 

over the entire affair, Finley apparently 

later permitted Kimball to atta in the position of brigade surgeon and to be reassigned from a position in the Western 

Department in order once again to join the 

politically powerful Butler. 31 

Unlike Cuyler, William S. King, Brig. 

Gen. Irvin McDowell's medical director in 

northern Virginia, experienced no conflicts 

with his command ing officer, but the support he received from the surgeon general 

was as weak as that given his colleague at 

Fo rt Monroe. King, a 24-year veteran of 

the Medical Department, was handicapped 

by the fact that he had arrived in Washington from New Mexico and been assigned to McDowell 's force only a few days 

before it started south toward Manassas 

and the first battle of Bull Run. A high disease rate was a lready predictab le, for 

camps were generally filthy. Latrines were 

inadequate, and the men were too unfamili ar with military life to see the need to 

use them. Seemingly undaunted, King set 

to wo rk at once to do what he could to 

prepare for the coming operation. On 16 

July, the day that McDowell's army started 

so uth, King set up a general hospital in a 

former boarding school in Alexandria and 

J I Ltrs, Finley to Butler (1 7 lui 186 1) and to T homas 

(4 and 23 Oct 186 1), all in RG 11 2, cntry 2, 28:245 

and 485 and 29:29, respecti vel y; Cuyle r to Finley ( 18 

and 2 1 Aug 186 1), both in RG 112, entry 12. 
164 THE ARMY MEDICAL DEPARTMENT, 1818-1 865 

requisitioned twenty more ambul ances. 

Finley approved the order, but his initials 

upon it did not guarantee the deli very of 

the vehicles. One of the assistant surgeons 

working in his office apparently concluded 

that, si nce the order did not bear McDowell's signature and since some ambulances had recently been deli vered to the 

general's headquarters, the new vehicles 

were not needed." 

When McDowell's 34,OOO-man army began its march, King had had no time to 

train ambulance attendants or to devise 

plans for evacuation and hospitalization. 

Apparently unaware of the serious nature 

of these omissions, King decided to stay at 

McDowell's side as much as possible in the 

belief that he could thus coordinate ambulances and "give a comprehensive supervision of officers connected with the 

medical department of the army, and see 

that the wounded were being attended to 

by the regimental officers." This approach 

had not worked particularly well for Surgeon General Lawson in the war with Mexico, and it was not li kely to prove a good 

one when appli ed to an army more than 

three times the size of General Scott's and 

to a group of physicians, most of whom 

lacked military experience of any kind. 

McDowell preferred to be at the head of 

his troops, and thus King was in a poor 

position, given the state of communications of the period, to advise his surgeons 

or coordinate their efforts. Moreover, there 

was no one below him in the medical hierarchy whose responsibility it was to supervise the work of the volunteer surgeons, 

J2RG 94, entry 544, Alexandria, Va.; 50s, Assl AG 

(no. 178, 5 lui 186 1), RG 112, entry 57; Ltrs, King to 

Finley (13 and 16 Jul 186 1), both in RG 112, entry 

12; Wood to McCormick (6 May 186 1), RG 112, entry 

2,28:38; USSC, Documents oJlhe U.s. Sanitary Commission (New York, 1866), vol. I, no. 17:3-6. 

who were unsure how to go about even such 

simple matters as ordering more suppli es." 

This lack of preparation initi all y showed 

itself during and after a skirmish at Blackburn's ford on 18 July, when an estimated 

10 Un ion soldiers were killed and another 

33 wounded, according to King, and others 

were felled by the heat- the total killed, 

wounded, and missing was later set at 83. 

Regimental surgeons gathered their patients for treatment wherever they could; 

at least one spot chosen proved too hot, and 

patients had to be moved. Troops Oeeing 

in panic and blocking the roads hindered 

evacuation from the field. King made no 

attempt to establish a hospital himself until 

he saw ambulances coming in from the 

fi eld with the wounded and the victims of 

heat exhaustion and reali zed that regimental surgeons could not handle the situation 

unaided. Troops coming through earlier, 

however, had drawn the wells dry in the 

Centreville area and the water supply at the 

hospital King's a ide had hastily set up 

there, two mil es from th e battlefield, 

proved inadequate. Physicians who were 

sometimes confused about their responsibiliti es also caused problems; one doctor 

refused until ordered to care for patients 

from units other than his own. McDowell 

failed to establish a guard for the hospital 

and mobs of soldiers wandered through the 

buildings, searching for friends and food. 

King fina lly succeeded in restoring order, 

once he left McDowell's side, but only after 

"a great amoun t of exertion." After two 

days he was able to procure ambulances to 

evacuate those who could be moved east to 

Alexandria but the seriously injured were 

left behind to be captured by the enemy." 

J3QUOIC from WOR, se r. 1,2:309; I'vtSH 1, app. :3, 

9; Ltr, King to Finley ( 16 lui 1861), RG 11 2, entry 12. 

J.JJ\4SfI I , app.: 1-5, 8, 17, quote from 2; MSH 2, pI. 

I :xxxv; WOR. ser. I, 2:305, 309, 721 ; Russell, Dianl , 

p. 2 13; S. Emma E. Edmonds, NUrse and Spy in/he 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 165 

By 20 July, the shortage of supplies was 

beginning to worry King. Twenty wagons 

with Medi cal Department supplies had 

been left behind in order not to impede the 

march, but King had req uested that more 

supplies be sent by rai l from Alexandria to 

the Fairfax station. Finley granted the request, but never made the shipment. Possibly because of Ki ng's harrassed state of 

mind, he did not anticipate a full scale battel on the 20th, and, as a result, the scenes 

enacted after the skirmish at Blackburn 's 

ford were repeated on a larger scale, with 

supplies low and ambu lances still too few. " 

Although McDowell himself heeded 

King's advice that the men no longer be 

rushed because of the heat, his officers continued to push their soldiers, and doctors 

once again found themselves caring for the 

victims of heat exhaustion. Just before the 

two armies actually clashed, King realized 

that a facility to supplement regimental 

hospitals would once more be necessary. 

He placed the new hospital in the church 

at Sudley, where water supplies were adequate. Some by ambulance and many apparently o n foot, patients soo n ca me 

pouring into the various faci lities, including those set up at King's orders at Sudley 

and Centreville, as well as the regimental 

hospitals. Apparently ne ither King nor 

anyone else made any attempt to relate the 

number of physicians at anyone hospital 

to the number of patients, who came in at 

random. Two hundred or more wounded 

eventually received treatment at Centreville and 300 of the remaining 900 were 

cared for in the Sud ley church and other 

buildings nearby. Many of the less seriously 

wounded managed to reach Washington on 

their own, while many others lay on the 

Vnioll Army (Hartford: W. S. Williams & Co., 1865), 

PP. 34-35. 

)$Ltrs, King to Finley (16 and 20 JulI 86 1), both in 

RG 112, entry 12; MSH I, app.:2. 

fi eld or in the shade of trees and bushes. 

Surgeons ge nera ll y worked where they 

pleased- those who wished to work on the 

battlefield took their saddlebags wit h them 

to care for those who had not been moved 

to shelter. 36 

After the battle, fleeing soldi ers and their 

equipment once again blocked the path of 

ambulances that were attempting to evacuate the wounded north to safety. When 

the Union flight was halted at the Potomac 

River, King returned south with ambulances, hoping that the victorious Confederates would allow him to retrieve his 

wounded still lying on the battlefield, but 

they would not. All the casualties that 

McDowell's a rmy left behind, either on the 

field or in hospitals, were taken captive. 

With them were captured a number of 

Un ion surgeons, five of whom had volunteered to remain with their patients at Sudley. The enemy permitted two Un ion 

physicians to take over a fa rmhouse and its 

outbuildings to use as a hospital although 

they had few supplies and the rebels could 

not provide them. At least one captured 

surgeon helped load Union wounded on 

trains for the long and agonizing trip to 

Richmond. Trains with wounded had low 

priority on the tracks and thus might not 

reach the Confederate capital for days, during which time those in the boxcars suffered for lack of food and ca re." 

l6Ltr, King to Thomas W. Fry (26 Jul 186 1), RG 

112, entry 12; MSH I, app.:5-8; WOR, sec 1,2:418; 

Maxwell, Sal/irar)' Commission, pp. 19-20; w. W. 

Keen, "Surgical Reminiscences of the Civil War," 

Transactions 0/ tlte College of Physicians 0/ Philadelphia, scr. 3, 27 (1905):96; William l. Sherman, Memoirs a/Generaf William T. Sherman, by Himself. 2 vols. 

(New York: D. Appleton & Co., 1875), 1:185; Louis 

C. Duncan, "The Battle of Bull Run," in The Medical 

Deparlmellf oflhe United Slales Arm)' illlhe Civil War 

(n.p., 11 912- 141). pI. 2, pp. 10-13, 17, 20. 

" Ltr, W. H. King to Finley (23 lui 1861), RG I t2, 

entry 12; MSH I, app.:4, 7-8; WOR, ser. I, 2:345, 

416,42 1. 
166 THE ARMY MEDICAL DEPARTMENT, 18 18-1865 

The custom of not classifying medical 

officers as prisoners of war, which according to military historian Louis D uncan had 

ex isted to some extent in Europe for three 

hundred years, had apparently been forgotten since Napoleon's time. Nevertheless, all the su rgeo ns who were taken 

prisoner in the aftermath of the first battle 

of Bull Run were eventually released. Confederate Brig. Gen. Pierre G. T. Beauregard 

was strongly in favor of releasing them as 

soon as possible. Some were allowed to go 

before mid-April 1862, but at least o ne was 

held captive in South Carolina for a yeaL" 

The battle of Bull Run was a great shock 

to military and medical experts alike. The 

U.S. Sanitary Commission denounced the 

lack of advance planning for the care of the 

wounded, some of whom had been left for 

long periods unattended on the fie ld. T he 

lack of a coordinated system of evacua tio n 

had also forced many who could walk to 

drag themselves back to Washington unaided. The Surgeon General's Office maintained that the number of physicians in 

attendance in the D istrict of Columbia was 

more than adequate, but beds must have 

been in short supply, since the wounded 

and their ambulances were forced to wander the streets of the city, trying to find one 

of the four general hospitals there that 

would take them in. T he new hospital at 

Alexandria was not yet entirely ready to 

receive patients; on 2 1 July it held but 26 

of the 175 it was hoped it wou ld eventually 

be able to accommodate. In the closing 

months of 186 1, however, the Medical Department was at least aware of what it was 

facing and was preparing to meet future 

18MSH I, app.:7-9; Duncan, Medica! Department, 

pI. 2, pp. 16, 18- 19. Duncan to the contrary, evidence 

exists that the English took French medical officers 

prisoner in the Napoleonic wars: Richard L. Blanco, 

Wellingtoll:S Surgeon General: Sir James McGrigor 

(Durham, N.C.: Duke University Press, 1974), p. 134. 

challenges. Large numbers of sick as well 

as wounded were a distinct possibility since 

typhoid deaths were increasing in Washington general hospitals. Fortuna tely, the 

Medical Department, realizing also that 

the poor sanitati on of many barracks in 

the city was threatening not only their 

occupants but also the entire community 

w ith disease, began urging increased 

sanitation.

39 

When Maj. Gen. George B. McClellan 

was brought in to replace McDowell , Surgeon Charles Tripier, apparently a favorite 

of old General Scott, came in to serve as 

McClellan's medical director in August 

186 1. Reported to be an "energetic, spasmodic, c rochety, genial" soul, Tripier had 

been serving in the Medical Department 

since 1830. Since he had been giving a 

course of lectures on military medicine at 

the Cincinnati Medical College, the problems in vo lv ed in caring for sick a nd 

wounded soldi ers up to 186 1 were fresh in 

his mind.'o 

Tripier was apparently not afraid of the 

task that lay ahead of him. At a time when 

sweeping changes were necessary, however, 

he was not so much an innovator as an administrator. He saw many inadequacies in 

the operations of the department in the 

a rea defended by the Army of the Potomac, 

among them defi ciencies in sanitation, hyJ9MSH I, pt. 1 :60-62, app.: 1- 9; Maxwe ll, Salliwry 

Commission. pp. 20 , 88; Ltrs, Thomas R. Shelton to 

Finley (21 Jul 1861) and King to Finley (7 Aug 1861), 

both in RG 112, entry 12; Wood to Joseph K. F. M ansfi eld (16 and 19 May 186 1) and to A. N. Mclaren 

(20 May 186 1), all in RG 11 2, entry 2, 28:70, 76, and 

77-78, respecti vely; Irwin, "Notes," p. 120 

4OQ uote rrom Strong, Diary, p. 18 1; see also L1r, 

Finley to Thomas (3 Aug 186 1), RG 112, entry 2, 

28:302; SOs, Williams (no. 25, 13 Aug 1861), RG 112, 

entry 56; Tripier and Blackburn , /-Iandbook; Eunice 

Tripier, Some NOles o//-Ier Personal Recollections (New 

York: Granon Press, 1910), PP. 127, 131. Unless ot her· 

wise indicated. all material on Tripier is based on 

MSH I, app.:44-52, and WOR, se r. 5:76- 113. 
THE CIVI L WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 167 

giene, and disease prevention; evacuati on 

and hospitalization; and the competence of 

volunteer surgeons, but attempted to deal 

with them along entirely orthodox lines. 

Many of the problems were departmental 

and more appropriately the province of the 

surgeo n ge ne ral , but Finl ey a ppa rentl y 

made no effecti ve attempt to deal with 

them.'" 

Tripier recogni zed that some of the diffi culties experienced by the Medical Department resulted from the incompetence 

of a few volunteer surgeons and the inexperience of many more. He called a board 

to examine ph ysic ia ns o f questi o nabl e 

skills and ordered that from then on such 

a board examine any med ical offi cer whose 

competence had been questi oned. Tri pier 

also decided to place his brigade surgeons 

in authority over regimental surgeons of 

their brigades. Then, by instructing the brigade surgeons about the measures he believed necessary to preserve the Army's 

health and requiring them to be responsible 

for the medical offi cers under them, he was 

able to spread his doctrines downward des pit e th e la rge numbe r o f surgeo ns 

involved. 

Tripier hoped to inculcate in his subord inates the principle of avoiding general 

hospitals whenever possi ble. Tri pier was 

aware that the general hospital was necessa ry to receive patients from an army on 

the move, but, li ke so many of th e old-time 

surgeons, including Ki ng, he retained his 

disli ke for an institution that took a patient 

far from his unit and appeared to delay his 

return to it. He also mainta ined, however, 

that " there was no authority for any hos4l Ltrs, Edwards to Byrne ( 15 and 18 Jul 186 1) and 

Fin ley to AG ( 18 Jul 1861 ), all in RG 112, entry 2, 

28:240-4 1, 249, and 250-5 1, respecti ve ly; S05, Thomas (no. 193, 19 Jul 186 1), RG 112, entry 57; 

"A rm y Hospi tals," American Medical Times 3 

( 186 1): 125. 

C HARLES T RIPLER. (Courtesy oj National 

Libraty oj Medicine.) 

pital establishment in the vicinity of di visions or brigades, that might relieve the 

hospital tents if crowded" and still keep the 

men near their units. Tripier moderated his 

nega ti ve sta nce on such fa ciliti es o nl y 

enough to allow brigade hospitals to ex ist 

as "aggregations of regimental hospitals." 

Tripier recognized that general hospitals 

were a necessary evil. He believed that the 

capi ta l's supply o f 2,000 hospita l beds 

would have to be expanded. In a report apparently written a year later he maintained 

that he had specifically urged 20,000 beds 

as a mi nimum goal and that the U.S. Sanitary Commission had been willing to settle 

for a smaller number, but a commission 

spokesman, in recalling the same debate, 

4lQUotc from MSI·( 1, app.:48, 49; Ltf, King to Finley (7 Aug 186 1), RG 112, entry 12. 
168 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

reversed the figures and maintained that it 

was Tripier who was willing to settle for 

less than 20,000. Although Tripier was apparently successful in systematizing admission to these institutions, in his attempt 

to increase the number of beds available he 

encountered frustration, much of which 

came, directly or indirectly, from Surgeon 

General Finley. 

TripleI' was concerned with the quality 

as well as the quantity of the new hospitals 

being opened to serve the Army of the Potomac. He favored creating new hospitals 

from the ground up rather than taking over 

old buildings, but designs suggested to him 

by the Sanitary Commission were so expensive that eventually he had to settle for 

only two such structures. The buildings 

that were available for his use as hospitals 

were often outstanding examples of inappropriate design: halls were narrow, provisions for toilet and bathing facilities 

woefully inadequate, cellars damp and undrained. In some instances, dirt-retaining 

carpets still lay on the floor. Ventilation 

was invariably inadequate and bad odors 

often filled the rooms. Windows were both 

too small and too few, wards were too small 

to provide the desired amount of air per 

patient, and even beds were often of poor 

quality. Not surprisingly, erysipelas appeared in some of the Washington and 

nearby Georgetown hospitals at this time." 

Finally forced to accept the fact that even 

with strong Sanitary Commission support 

he would not be able to establish a network 

of completely new military hospitals in the 

capital area, Tripier continued his search 

for buildings suitable for hospital use in 

locations both in and around the capital. 

Not long after the end of the year, his ef4l"Army Hospitals" and "The Week," both in American Medica! Times 3 ( 1861): 127-28 and 153, 

respectively. 

forts finall y brought the total number of 

beds available for military patients in the 

Washington area to 6,000. He planned to 

move patients from Washington to such 

cities as Annapolis, Baltimore, and Philadelphia as promptly as possible so as to 

keep beds in Washington free for new 

patients." 

Tripier's effo rts to open hospitals in 

nearby cities to relieve the pressure on 

those in the capital area brought him into 

open conflict with the surgeon general, not 

because of any substantive issue but rather 

because Finley apparently resented his subordinate's success and influence. The secretary of war had initially informed Finley 

that the surgeon general was directly in 

charge of general hospitals in the area of 

the Army of the Potomac, but Tripier, with 

McClellan's backing and little consideration for Finley's sensibilities, went blithely 

about his own schemes. The secretary of 

war eventually granted McClellan the right 

to proceed as he saw fit with the establishment of new hospitals, and such was TripIer's position as McClellan's medical 

director that McClellan's victory was TripIer's victory. TripleI' and Finley remained 

at odds'" 

Finley apparently kept a jealous eye on 

Tripier's work in the fa ll of 1861 , and when 

TripleI' attempted to report to him about 

his search for suitable buildings in Philadelphia to serve as general hospitals for patients moved from Washington , th e 

surgeon general flew into a rage. Cutting 

his subordinate off short, Finley charged 

that Tripier had not paid his superior the 

courtesy of notifying him of what he was 

doing in Philadelphia, that he was putting 

McClellan up to giving orders that humilHStrong, Diary. p. 186; RG 94, entry 544; Ltc, Wood 

to Kennedy (12 Sep 186 1), RG 112, entry 2, 28:429. 

W'Army Hospitals," American Medicaf Times 

(1861) 3: 128; Strong, Diary, pp. 183-84. 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 169 

iated the surgeon general, and that he was 

trying to upstage the surgeon general by 

locating more space for hospitals outside 

the District of Columbia than was needed, 

in view of Finley's own efforts in this regard. Allowing Tripier no chance to explain 

himself, Finley berated him in the presence 

ofa third party and then ordered him from 

the room. Tripier lost little time in placing 

charges against Finley, and on 6 December, 

a court-martial was called to consider the 

case. On 10 December, the surgeon general 

was charged officially with "Conduct unbecoming an officer and a gentleman" and 

"Conduct to the prej udice of good order 

and Military Discipline." The case was 

never tried, however, because Finley successfully raised the Question of whether the 

general in chief, McClellan, was empowered to dismiss a bureau chief. Finley retracted such of his la nguage as had 

offended Tripier, and the matter rested. 

Since the Sanitary Commission was by this 

point in full cry after Finley and since the 

Question of the surgeon general's competence was being debated in the public press, 

the charges placed aga inst Finley and dismissed on a technicality probably contributed to the erosion of his position. " 

Finley was not the only frustration in human form that Tripier had to endure. Volunteer help flocked to the hospitals, and 

not all of it was welcome. From Tripier's 

point of view, his hospitals were full of civilians who considered themselves better 

able than he to manage them. "Sensational 

preachers, vill age doctors, and strongminded women" all "obtruded their crude 

suggestions." Competent nurses were too 

4(>Quotes from Co urt Martial Charges ( 10 Dec 

1861), Records of the Judge Advocate General, Proceedings of Courts Martial and Courts of Inquiry. RG 

153, bod893, 11 547; SOs, Thomas (nos. 322 and 327, 

6 and 13 Dec 186 1), both in RG 112, entry 57; Strong, 

Diary, pp. 183-84, 186, 190. 

few rather than too many. Triple wished to 

have one nurse for every ten patients, but 

at the Kalorama fac ility, where contagious 

cases were isolated, for example, at one 

time only two nurses were responsible for 

106 patients. Such attendants were generally either well-trai ned lay nurses, male and 

female, or members of one or another religous order." 

Not the least of the problems that Tripier 

faced when he became medical director of 

the Army of the Potomac was that of evacuation. Since he was not responsible for the 

choice of the fragile two-wheeled ambulance and was sca rcely likely to be able to 

wean Finley away from his own design, one 

that he apparently attempted to patent, 

Tripier's complaints were la rgel y useless. 

He pointed out that 110 of the 228 twowheelers issued by the Quartermaster of 

the Army of the Potomac in the threemonth period that began July 186 1 had 

"disappeared," statistics that to him indicated "reckless use." Tripier obtained an 

order ending the practice of using ambulances as taxis. This order may have been 

obeyed, since as of 31 December 186 1, 314 

of the Finley design ambulances and 71 

four-wheelers were functioning in Washington and one two-wheeler was functioning with each regiment in the field. " 

Co nvinced of th e need for another 

method of evacuation to manage the removal of men lyi ng in areas inaccessible to 

ambulances and apparently assuming that 

Finley would do nothing about the problem, Tripier began experimenting with a litter that could be attached to the back of a 

horse or mule. The initial model he tried 

was, at 140 pounds, too heavy, but Tripier 

47Quote from Irwin, "Notes," p. 12 1; Maxwell, Sal1-

itary Commission. p. 52; "A rmy Hospitals," American 

Medical Tillles 3 (186 1): 127-28; WOR, ser. 3, 1:636. 

48Quote from MSH 1, app.:49; Maxwell, Sanitary 

Commission. p. 75; H amilton, Treatise, p. 166. 
170 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

continued to try different models in his 

search for one that could be used to replace 

the two-wheeled ambulance. Although the 

problem of the proper vehicle in which to 

transport the wounded remained, attempts 

to train attendants led to some improvement. Surgeons serving in the Poolesville, 

Maryland, area drilled their attendants in 

evacuation techniques and organized them 

by brigades to achieve greater efficiency. In 

October, McClellan ordered that all ambulance attendants take part in hour-long 

drills six times a week under the direction 

of regimental surgeons." 

Disease prevention was also one of TripIer's major concerns. Some of the diseases 

that were beginning to plague the Army of 

the Potomac were preventable by medical 

means, others by improved sanitation and 

hygiene. TripIer learned that many soldiers 

serving under McClellan had not been vaccinated against smallpox. He ordered the 

situation remedied and attempted to require that thereafter all recruits be vaccinated before they left th eir assembly 

points. Finding the results of this campaign 

not entirely satisfactory, he ordered brigade surgeons to inspect all men and to 

immunize those in need of it. His efforts 

must have been successful, for in the first 

seven months he was in office there were 

but 168 cases, most of which had already 

been contracted before the victims entered 

the Army. 

Since malaria was a major threat to the 

Army's health, TripIer was intrigued by a 

report of one of his surgeons that it could 

be prevented by the ingestion of quinine in 

whiskey. The regulations did not recognize 

this remedy, and so TripIer turned to the 

Sanitary Commission to obtain the nec-

~9 Maxwell , Sanitary Commission, p. 76; Duncan, 

"Pope's Virginia Campaign," in Medical Deparlmelll, 

pI. 3, p. 6; "Duties of Brigade Surgeons," American 

Medical Times 3 (1861):282-83; MSH I, app.:ID-11. 

essary ingredients. When the potion 

seemed successful, he managed to persuade 

Surgeon General Finley to issue it to those 

regiments most threatened by malaria . 

TripIer continued to receive favorable reports of the concoction and eventually ordered that supplies be kept on hand at all 

times. 

In yet another effort to prevent disease, 

TripIer moved to improve li ving conditions, both for hospitalized soldiers and for 

those in the field. He assigned three medical officers to serve as field hospital inspectors and urged an end to the practice 

of using tents over submerged foundations 

to shelter soldi ers in the field. He was also 

concerned with the design and heating of 

tents. Above all he urged upon surgeons 

and commanding officers alike " the paramount importance of hygienic morality."'· 

A certain amount of disease was, of 

course, inevitable. Measles, the scourge of 

new units, did not pass the Army of the 

Potomac by, and both malaria and typhoid 

appeared despite precautions. In October 

and November, among approximately 

130,000 men, almost 8,000 cases of fevers 

of all kinds developed, with 1,000 described as typhoid. Although TripIer regarded typhoid as endemic in the United 

States, he also believed that many diagnoses of typhoid were in error. In December, alarmed at the high disease rate, 

General McClellan appointed three medical officers to serve on a committee to investigate the nature of the prevai li ng 

diseases. Their conclusion was that malaria 

was taking the highest toll but that typhoid 

was definitely present. Nevertheless, al-

'OQuote from MSH I, app.:47. These were not the 

first field hospital inspectors to serve in the East, since 

at least one was apparently serving in the Hagerstown, 

Md., area earlier in the summer. It is not known, how. 

ever, whether he was appointed by Finley: Order, Asst 

AG Porter (27 Jun 1861), RG 112, entry 56. 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 17 1 

though the number of cases of disease in 

the Army of the Potomac rose from 8,000 

in July of 186 1 to greater than 35,000 in 

December, the disease rate was fa lling, 

from 45 percent in July to 30 percent in 

September and then to slightly more than 

23 percent in December. " 

TripIer and the surgeons under him were 

struggling to find ways in which the Medical Department could meet the sudden 

and overwhelming demands that the new 

conflict placed on the medical service of 

the Army of the Potomac without altering 

the department's basic structure. Though 

their efforts showed some success, they 

were handicapped in their attempts by factors beyond their immediate control. Both 

volunteer soldier and volunteer physician 

knew little as yet of the requirements of 

military life, stockpiles of supplies grew 

slowly, and, above all else, the great numbers of men joining the armed forces created ove rwhelming med ica l problems. 

Much time would be required to resolve 

these shortcomings, not only for the Army 

of the Potomac, but for all Union armies. 

Care of the Sick and Wounded 

in the West 

Military engagements to the west of the 

Appalachians took place on a smaller scale 

than the battle of Bull Run and thus, although disease took a growi ng and appalling toll, the number of wounded to be cared 

for after any si ngle battle was relati vely 

small. Even the battle of Wilson's Creek, 

Missouri, caused only two-thirds as many 

wo und ed as Bull Run . Distances were 

great, however, and the campaigns lacked 

the sharp focus of those in the East. Action 

tended to take place far from any large and 

S'MSH 1, pI. 1:30- 35 and pI. 3:364- 72; Ltr, Finley 

to AG (4 Dec 1861), RG 11 2, ent ry 2, 29:167. 

J OSEPH J. B. WRIGHT. (Courtesy 0/ National Library 0/ Medicine.) 

secure city where sufficient numbers of appropriate ho uses might be available to 

serve as general hospitals. Transportation 

became critically important and medical 

directors tended to set up general hospitals 

in cities convenient to major railroads or 

rivers. The patient load of general hospitals 

in the West was great even though some 

surgeons refrained from sending patients 

from regimental hospitals to these facilities 

until they were dying, a custom that tended 

to revive the old fear of general hospitals" 

In western Virginia and along the Ohio 

River, Union forces under McClellan and 

his successor, Brig. Gen. William S. Rosecrans, fought to uphold the independence 

of those who refused to join the eastern 

S2 lrwin. "Notes," p. 12 1; Maxwell, Sanitary Commission. p. 56. 
172 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

portion of the state in secession. In the 

spring of 186 1, the medical director for 

McClellan was Joseph J. B. Wright, to 

whom fell the responsibility for organizi ng 

the medical care of the troops in the Department of the Ohio. The regiments in the 

area were so newly called up that one of 

Wright's first duties was to provide hospital supplies for them, a task he was able 

to complete quickly with the aid of the New 

York City purveyor. Because so many of 

these men were in poor condition when 

they joined the Army, Wright anticipated 

a need for general hospitals to serve the sick 

among them and hoped to locate these facilities at several different sites, from West 

Virginia westward. 53 

Wright questioned whether the hospitals 

that sheltered disabled merchant seamen in 

Cincinnati and Pittsburgh would be worth 

using for casualties. The hospital in Cincinnati was already available to volunteer 

patients, but despite its 100 to 150 bed capacity, it held only 15 to 30 men. He finally 

decided that the rising disease rates of late 

summer and fall made reliance on regimental hospitals and the homes of patients 

who lived in the Cincinnati area unrealistic. The arrival of wounded from various 

engagements that fall made Wright's need 

all the more imperative. By October patients were pouring into Cincinnati by the 

hundreds, some from engagements in western Virginia whence they traveled much of 

the way by boat. Volunteer surgeons sent 

on many patients from Ohio who wished 

SlLtr, Wright to Finley (6 Ju1 186 1), RG 112, ent ry 

12; SOs, Thomas (no. 139, 23 May 1861), RG 11 2, 

entry 57; MSfll , app.:!3. The way in which the area 

west of the Appalachians was departmental ized 

changed as the wa r progressed. The Department of 

Western Virginia, for example. was removed from the 

Department of the Ohio in September 1861 and added 

to another department in 1862, while the Department 

of the Cumberland lasted only from August to No~ 

vember 186 1: MSH I, pI. 1:74. 

to be near their homes. Wright's staff in 

Cincinnati was too small to handle the 

heavy case load, and malingerers were turning up in significant numbers. His problems, like Tripier's, were only made worse 

by "scores, if not hundreds. of officious & 

meddle-some women, & equally officious 

men, all of whom claim to have the direction of the Hospital." Some of these busybodies were undoubtedly drawn to the hospital by vivid newspaper stories about the 

sufferings of the wou nded in poorly administered hospitals. Nevertheless, Wright 

also wrote the surgeon general of his indebtedness to the citizens of Cincinnati, 

whose charitable donations helped meet 

hospital expenses, and to that city's physicians, who donated their time to help the 

Medical Department staff. 54 

Before his reassignment to St. Louis in 

the fall of 186 1, Wright was also called 

upon to establish general hospitals near the 

battlefield in West Virginia. At Rich 

Mountain in July, for example, he set up a 

temporary field hospital in a three-story 

house and in tents pitched nearby. He also 

set up a general hospital in the town of 

Beverly, seven miles from Rich Mountain, 

both for the wounded from Rich Mountain 

and for those that came in a few days later 

from the engagement at Carrick's ford. In 

this facility, five assistant surgeons cared 

for both Union and Confederate soldiers, 

on an equal but usually separate basis. " 

Wright believed that, on the whole, his 

patients in the Department of the Ohio had 

been well cared for, despite what he apparently deemed the hopeless military ineptitude of his volunteer surgeo ns and 

~Quote from Ltf, Wright to Finley ( 15 Oct 1861), 

RG 11 2, entry 12); see also Wright to Finley (2 , 9, and 

21 Aug, 22 Sep, and 14 Oct 186 1), all in RG 11 2, entry 

12; M SH I, app.:t 4; SO, Thomas (no. 139,23 May 

1861), RG 11 2, entry 57. 

HMSH I , app.: !3, 14. 
THE CIVIL WAR, 186 1: MANY PROBLEMS, FEW SOLUTIONS 173 

Finley's failure to send him th e ambulances 

he needed. Although the men for whom he 

was responsible were fighting in a primitive 

country far from suppl y centers, and supplies were limited, no serious shortage developed, even of such difficult-to-transport 

items as anesthetics. Surgeons were appa rently able to use freely either chloroform 

or chloroform mi xed with ether and did so 

with complete success, without anesthesiarelated deaths. Wright recalled later that he 

had had " improvised ... ambulances in 

sufficient number" from " light two horse 

spring wagons" bought at McClellan's order. The evacuation of patients from Rich 

Mountain to the Beverly general hospital 

three days after the battle went well , although Wright admitted that part of the 

credit had to go to smooth roads and good 

weather." 

In the fall of 186 1, the Surgeon General's 

Office ordered the opening of yet another 

general hospital in the Department of the 

Ohio at Louisville, Kentucky, a unit that 

was to be staffed by contract physicians. 

By this time the Medical Department had 

assigned Robert Murray (who would serve 

as surgeon general from 1883 to 1886) to 

replace Wright. Murray set up his headquarters in Louisville and asked the surgeon general to appoint one of the assistant 

surgeons working in Cincinnati as medical 

director of that area so that he could fo cus 

his own efforts upon Louisville. By the end 

of November, a measles epi demi c had 

struck in that part of Kentucky and the two 

general hospitals Murray had established 

in Louisville were both crowded. Two more 

hospitals were being prepared for opening, 

and plans were underway to set up still 

more, but meanwhile 100 men were in tem-

~6 H J, app.:13, quotes from 14; MSH 2, pc 

1 :xxxv; Ltrs, Horace R. W irtz to Finley ( 19 D ec 186 1) 

and Wright to Finley ( \ Jun 186 1), both in RG 11 2, 

entry 12. 

porary rooms in the town and 400 more 

sick in camp. With 50,000 men in the fi eld 

and more coming in, the situation was not 

likely to improve. Moreover, Murray was 

hav ing diffi culty hiring contract surgeons 

at $ 100 a month, the max imum he was permitted to offer. 51 

To the west of the Department of the 

Ohio were 23,000 men who would on 25 

Jul y come under the command of Maj. 

Gen. John Charles Fremont. Until August 

there was little action in Missouri and most 

of the sick of Fremont's new command 

were cared for in regimental and post hospitals near St. Louis. Medical Director 

Samuel De Camp hastily set up the first 

general hospital in that city, located on a 

major railroad, the first week in August. 

After first accepting and then rejecting the 

sma ll e r and " miserable, filth y Ma rin e 

[merchant marine] Hospital," De Camp finally chose fo r his general hospital a new 

building with a capacity of more than 500. 

Only a few days later, Brig. Gen. Nathaniel 

Lyon and his 5,000 men left their camp 

near Springfi eld, Missouri, to attack the enemy near Wilson's Creek, and their disastrous defeat brought the first significant 

number of wounded to the hospitals of 

General Fremont's command" 

Lyon's medical system was loosely organized in the summer of 186 1, with no 

medical director to coordinate the work of 

the sixteen physicians who served within 

the command. The men who served as ambulance dri vers and attendants had received no training. Ambulances and tents 

were in short supply. The number of tyHMurray to Finley (28 Nov, I Dec, and 26 Dec 

186 1), all in RG 11 2, entry 12. 

sSQuotc from Ltf, De Cam p to Wood (25 JuI 1861), 

RG 112, entry 12; Ltrs, De Camp to Finley (2 and 

15 Aug 186 1), both in RG 11 2, entry 12; Reporl lO the 

Western Sanitary Commission, pp. 3-6; SO, Asst AG 

(no. [3, 3[ Ju[ [86[ ), RG [[2, entry 56. 
174 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

phoid and dysentery cases began increasing 

in August at about the same time that approximately forty men were wounded in a 

"smart skirmish." Lyon now ordered a volunteer doctor to establish a general hospital 

in Springfield where his headquarters was 

located, since regimental facilities could no 

longer accommodate all his sick. The doctor selected an unfinished building originally intended to serve as a courthouse and 

chose at least one other medical officer, a 

Regular Army assistant surgeon, to serve 

with him there. " 

On 9 August, Lyon ordered his command 

to leave camp near Springfield and to prepare to attack the enemy along Wilson's 

Creek. The battle the next day was fierce, 

lasting six to seven hours. In the disastrous 

defeat that ensued, Lyon himself was 

killed, and the loss in dead and wounded 

was second in 186 1 only to the casualties 

at Bull Run. But two vehicles, both " large 

spring wagons drawn by six mules," were 

available to remove the more than 700 

wounded. Those who cou ld wa lk were 

cared for in a ravine, and many of those 

who could not remained on the battlefield 

overnight. Most of the casualties were 

eventua ll y brought to Springfield , and 

about 200 joined the rest of Lyon's battered 

force in their 110-mile retreat from Springfield to Rolla, Missouri, whence they went 

by train to hospitals at St. Louis. One medical officer present at the battle of Wilson's 

Creek believed that had Lyon appointed a 

medical di rector, 90 percent of the 

wounded could have been cared for and 

evacuated before the retreat began.60 

The wounded who could not join the retreat were sheltered in the general hospital 

S9Quote from MSH I , app.:15. 

6fJMSH I , app.: 16, 17, quote from 16; From Sumler 

to Shiloh: Baules and Leaders 0/ the CiI'iI War, new 

ed. (New York: Castle Books & A. S. Barnes & Co., 

1956), p. 306. 

at Springfield, where seven Union doctors 

remained with them, but most of the men 

serving as nurses joined the retreat to 

Rolla. When Confederates took possession 

of Springfield the following day, the y 

quickly made off with the hospital supplies 

and medicines that Union forces had left 

behind for their own wounded. The enemy 

preempted all available transportation, and 

a week was needed to retrieve all Union 

wounded from the battlefield. Although 

$5,000 had been left with Union surgeons 

for the purchase of supplies and food for 

their patients, no medical supplies were 

available. Surgeons did somehow manage 

to perform many operati ons, which was 

fortunate since conditions had not been favorable for surgery at the battlefield." 

The defeat at Wilson's Creek placed an 

added burden on a hospital system already 

strained by increasing numbers of patients 

with typhoid, measles, pneumonia, and 

diarrhea, diseases that spread all the more 

rapidly because of the poor sanitation that 

characterized many of the camps in Fremont's command. Those of Lyon's casualties who had joined the retreat from 

Springfield to Rolla eventually arrived in 

St. Louis, where they were joined in time 

by the wounded who had been taken captive. A month after the defeat, the contending armies began a gradual exchange 

of wounded prisoners that was not completed until November. Taking advantage 

of the nearby railroad, surgeons sent most 

of these patients in boxcars 110 miles on 

new, unsettled, and bumpy track back to 

St. Louis, where hospitals were generally 

not highly regarded. Wounded from an engagement at Lexington, Missouri, in September also turned up at St. Louis. All 

available wards, including some in St. 

61Ltr, Edward C. Franklin to De Camp (16 Aug 

186 1), RG 11 2, entry 12; MSH I, app.: 16- 17. 
THE CIVIL WAR, 1861: MANY PROBLEMS, FEW SOLUTIONS 175 

Louis charity hospitals, took in military patients, and even the charity hospitals were 

soon fu ll to overflowing. To make matters 

worse, patients were coming in from 

crowded hospitals in other parts of Missouri and even from Cairo, Illinois, where 

the sick were too numerous for local hospitals to handle. De Camp opened a hospital for smallpox victims on an island in 

the Mississippi River and another for measles victims. He had smaller hospitals 

opened at intervals along the rail line in 

Missouri from Sedalia and Rolla to SI. 

Louis and took over a steamboat to use as 

a hospital ship. He freed beds in the city 

by sending convalescents to camps outside 

the city. The Western Sanitary Commission began outfitting railroad cars for the 

sick and provided equipment for many of 

the hospitals, supplemented Medical Department supplies, and even opened its 

own hospital in a rented five-story building, where patients were cared for by an 

Army staff.62 

By December of 1861 the condition of 

the 2,000 patients in SI. Louis hospitals 

was outraging civilian observers, who reported the deaths of fifty-six patients in 

one week. A gentleman familiar with the 

SI. Louis situation wrote the secretary of 

war that the Army's hospitals there were 

"in a miserable, dirty, filthy and disgrace/ul 

condition" and that entry into them meant 

"certain dealh." The mortality varied, of 

course-from 26 October to 2 November, 

62Gcorge Edgar Turner. Vic/or)' Rode lhe Rails: The 

Siralegic Place o/the Railroads (Indianapolis: BobbsMerrill Co., 1953), p. 297; Ltrs, De Camp to Finley 

(8 and 29 Ju1, 2 and 16 Aug, 2 Sep, 14 and 21 Oct, 

and 1 Nov 186 1), all in RG 112, entry 12; Report 10 

the Western Sanilary Commission, pp. 3- 6; Maxwell, 

Sanitary Commission, p. 105; Brinton, Memoirs, 

p. 35; Forman, Western Sanitary Commission, pp. 

8-10, 15; U.S. Sanitary Comm ission, DOCllmel1ls I, 

no. :'6:5, 9, 10, 15, no. 36:6. 46, no. 38:3; Western 

Sanitary Commission, Reparr, p. 8. 

for example, only thirty-four died. Horrible 

as the rate may have seemed, it was perhaps 

to have been expected, since only the sickest patients were likely to be sent to general 

hospitals. The mortality was not significantly worse than that in the general hospitals of the East, where 151 of the little 

more than 2,000 patients died in December. This rate was actually lower than that 

in general hospitals of the entire central 

region, where 8 percent of the patients died 

during the last month of 1861.63 

The story at many other hospitals in the 

West was much the same as that in Cincinnati and SI. Louis. Crowding was frequent and inadequate housing common, as 

could be seen at the faci lity set up in Jefferson City, Missouri, to care for 500 men 

who broke down as Fremont drove his men 

hard to make up for a string of defeats. This 

hospital was housed in an old seminary, 

two taverns, and a private home. Many 

windows were broken in these buildings, 

and some patients had to lie on the floor. 

A Sanitary Commission inspector noted 

that spittoons and chamberpots were not 

promptly emptied and that lazy and undisciplined soldiers had turned the hospital 

grounds into one large latrine. Hospitals in 

and near Cairo, Illinois, were apparently in 

better shape than many others, partially because overcrowding had been relieved by 

sending patients downriver to SI. Louis. 

The rate of malaria among the patients in 

these units was high, although, like most 

physicians before the twentieth century, 

the medical officers there did not remark 

upon any possible relationship between the 

63Quote from H. Phi ll ips to Cameron (27 Dec 1861). 

RG 112, entry 12; Ltrs, De Camp to Finley (19 Aug 

and 14 Oct 186 1), both in RG 11 2, entry 12; Forman, 

Western Sanitary Commission, pp. 13, 15; Report to 

the Western Sanitary Commission, p. 10; "Sick and 

Wounded Soldiers in S1. Louis,"Americall Medical 

Tillles 3 (1861):396; MSH 1, pt. 1:60-65, 114-19. 
176 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

JOHN H. BRINTON. (Courtesy oj National 

Library oj Medicine.) 

mosquitoes, "powerfu l and b loodthirsty ... pests, gray-backed, huge and insatiate," and the disease rate. As usual, inexperience joined ignoran ce and 

undiscipline as a major source of trouble. 

The young brigade surgeon, John Brinton, 

who set up a new hospital in Illinois at 

nearby Mound City to relieve overcrowding at the Cairo facility, commented sadly 

that, if he had had some experience before 

being called upon to establish that faci lity, 

he "could have accomplished in a few 

hours the work that cost me so many weary 

days of labor and nights of thought." 

'(Brinton, Memoirs, pp. 43-44, 50, Quotes rrom 

pp. 42 and 52, respectively. 

Conclusion 

In the West as in the East, the Medical 

Department's inability to provide prompt 

and unfailin g care for the sick and 

wounded of the Union army stemmed 

principally from two factors, bot~ beyond 

the Department's control. The frequency 

with which Union forces were defeated in 

1861 greatly complicated the management 

of medical care and evacuation, and the 

newness of warfare on the scale of the Civil 

War made it impossible for anyone to have 

adequately anticipated the scope and magnitude of the problems that would arise. 

Nevertheless, the Department did not adjust as rapidly as it might have to the new 

demands placed upon it. Surgeon General 

Finley was apparently totally unable to 

grasp the significance of the situation that 

faced him and seemed more concerned 

with maintaining his image as head of the 

Department than with designing new approaches to new problems. Medi cal Director King, too , found th e Lawsonian 

tradition hard to forget. Although King's 

successor, TripIer, was capable of a certain 

amount of innovation, he was not daring 

by nature, and abandoned the old ways 

only with reluctance. To the West, such 

men as young Brinton and the veteran 

Wright struggled to adapt to the new situation, but youthful vigor could not make 

up for inexperience, nor mature judgment 

compensate for inadequate numbers of 

hospital beds. The first eight months of the 

war were long enough for serious problems 

to develop, but not long enough for adequate solutions to be devised and carried 

out. 
CHAPTER 9 

The Civil War in 1862: 

Learning on the Job 

The horrors ex perienced by the sick and 

wounded during the first months of the 

Civil War made the need for change in 

leadership, organization, and operations of 

the Medical Department in 1862 undeniable. No truly applicable model existed to 

guide these changes, however. The Medical 

Department would have to learn through 

trial and error what was required. The 

learning process had begun in 1861 , but 

fast and imaginative learners as well as energetic leaders were still wanted. 

The first developments to influence the 

Medical Department significantl y, however, took place at a higher level. [n January 

1862 the relentless Edwin M. Stanton replaced Cameron as secretary of war. [n 

April, Congress voted to allow promotion 

on the basis of competence rather than seniority. The new bill had barely passed 

when Stanton, using Surgeon General Finley's alleged mishandling of a complaint as 

a pretext, removed the aging physician 

from office and exiled him to Boston, 

thereby triggering his resignation. At the 

urging of the U.S. Sanitary Commission, 

but against his own inclinations, Stanton 

then ~p pointed a 33-year-old assistant surgeon with barely more than eleven years of 

Army experience to be the new surgeon 

general.' 

IStrong, Diary, p. xxx ix; Maxwell, Sanitary Com~ 

Two days after appointing William Alexander Hammond surgeon general, the secretary of war called the new head of the 

Medical Department into his office. Stanton asked a casual question about the activities of the U.S. Sanitary Commission in 

a " tone and manner" Hammond recalled 

as being "offensive in the extreme," and 

then assured his subordinate that " if you 

have the enterprise, the knowledge, the intelligence, and the brains to run the Medica l Department, [ wi ll assist yo u." 

Determined not to "quietly submit to the 

insolence which [Stanton) constantly exhibited toward his subordinates," Hammond, as he later remembered it, replied: 

Mr. Secretary, ... [ am not accustomed to 

be spoken to in that manner by any person, 

and [ beg you will address me in more respectful terms .. . during my service in the 

army, [ have been thrown with gentlemen, who, no matter what our relative rank was, treated me with respect. Now that [ have 

become Surgeon-General, [ do not intent 

to exact anything less than [ did when [ was 

Assistant Surgeon, and [ will not permit 

you to speak to me in such language as you 

have just used. 

To which Stanton answered, "Then, sir, 

you can leave my office immedi ately." His 

mission, pp. 126- 27. Unless otherwise indicated, this 

chapter is based on Brown, Medical Departmelll, and 

Calian, Military Laws. 
178 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

I \ 

WILLIAM A. HAMMOND. (Courtesy oj National Library oj Medicine.) 

head thoroughly turned by the respect his 

colleagues had shown for his ability and by 

his rapid rise to high office, Hammond 

thus planted the seeds of his own destruction as surgeon general and undermined 

the success to which his ability and energy 

entitled him.2 

Hammond's earlier experiences in the 

Army foreshadowed his future as surgeon 

general. His medical research and his work 

as a naturalist while serving as an assistant 

surgeon in the West brought him to the favorable attention of prominent scientists, 

but he was unable to tolerate a life characterized by, in his words, " restra int and 

uncertainty." He resigned from the Army 

lQuotes from William A. Hammond, A Stalemellf 

of the Causes Which Led to the Dismissal of SurgeoflGeneral William A. Hammond From the Army (New 

York, 1864), p. 16. 

in 1860, using as a pretext what now appears to have been a psychosomatic illness. 

When war broke ou t, however, he was determined to take part, even though to reenter the Medical Department he had to take 

the entrance examination again and enter 

at the very bottom of the list, losi ng cred it 

for the years he had served earlier. He managed to counter Surgeon General Fi nley's 

skepticism by signing a pledge stating that 

he had not suffered from his hea rt problem 

for three years and that if it returned, he 

would resign.' 

Hammond 's work in the earliest months 

of the war demonstrated his administrative 

talents. With great energy he set up new 

hospitals and improved those already established in Pennsylvan ia, Maryland, and 

West Virginia, experimenting with a new 

system of ventilation. While doing so, he 

served under two men, Charles TripIer and 

Jonathan Lettermen, who were suffi ciently 

impressed with his abilities to serve later 

as his subordinates without apparent objection, and under Maj. Gen. George B. 

McClellan, who become convinced that 

Hammond would make a good successor 

to Finley. Hammond's success also brought 

him the enthu siastic support of the U.S. 

Sanitary Commission, but during this same 

period he managed to earn the enmity of 

Secretaries of War Cameron and Stanton 

and of Finley and Robert C. Wood, who 

seve ral times ser ved as acting surgeo n 

general.' 

lQuote from Ltf, Hammond to Baird ( 19 Apr 1860), 

RU 305 , Smithsonian; Ltf, Hammond to Baird 

(18 Oct 1860), RU 305, Smithsonian; Strong, Diary. 

pp. 185, 1850; Bonnie Ellen Blustein , "A New York 

Medical Man: William Alexander Hammond, M.D. 

(1828- 1900), Neurologist" (Ph.D. dissertation, Unive rsity of Pennsylvan ia, 1979), pp. 77-78; Hammond 

(Pledge, 18 Mar 186 1), RG I 12, entry 2, 28:84; USSC, 

Doclimellls I , no. 4 1 :29-30, 31 n. 

4Blustcin , "Hammond," pp. 75-82; Llr, Finley to 

AG (4 Mar 1862), RG 112, entry 2, 29:669; Strong, 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 179 

From the outset, the key factors in Hammond's military career were his considerable ability as a scientist, his energy and 

drive, and his unfortunate temperament. 

Even more than his administrati ve and scientific talents, his hot temper, his impulsiveness, and his "great self-confidence" 

that, in the words of friend and colleague 

S. Weir Mitchell, " led him to inconsiderate 

action," determined his fate in the Army. 

Many who knew Hammond as surgeon 

general were less charitable in their opinions than Mitchell; one remembered that, 

as head of the Medical Department, Hammond was " rarely anything but captious, 

irritable, and pompous.'" 

Just at the time Hammond came to office , Congress was acting to make major 

modifications in the structure of the Medical Department. In April 1862, it created 

the positions of medical inspector general 

and eight medical inspectors. It also revived the position of assistant surgeon genera l, a po st to which Stanton, with 

Hammond's approval, quickly named Robert Wood. Hammond later noted that Stanton had promised the position to Wood, 

subject to the surgeon general's approval, 

anticipating, Hammond believed, that he 

would react vindictively. The inspectors 

were to be chosen from among both volunteer surgeons and regulars. They were to 

be responsible for the overall management 

of military hospitals and for the inspection 

of sanitary conditions in camps where 

crowding was leading to epidemics of such 

diseases as typhoid fever and dysentery. 

Congress added to the prestige of the MedDiary, p. 187; MSfll , pt. 3:908; "The Sanitary Commiss ion," p. 175. 

lFirst and second quotes, S. Weir Mitchell, "Some 

Personal Recollections of the Civi l War," Transactiolls 

o/the College o/Physicians, 3d ser., 27 (1905):89; third 

quote, H enry C reey Yarrow, " Personal Recollections 

of Old Medi cal Officers," Military S lI rgeon 60 

( 1927):174. 

ical Department by giving the new medical 

inspector general the rank of colonel and 

the medical inspectors that of lieutenant 

colonel, and by raising the rank of the surgeon general to brigadier general.-

Congress was also aware at this time of 

the need to increase the size of the Medical 

Department. Under pressure from the Sanitary Commission it added ten surgeons, 

ten assistant surgeons, and twenty medical 

cadets to the roster in April and granted 

Hammond at the same time permission to 

appoint as many hospital stewards as he 

needed. Regimental surgeons and assistant 

surgeons were continuing to join the Army 

as part of each new regiment of volunteers 

and were serving the same terms as those 

signing up with them. But in July the legislators voted to increase the number of 

volunteer physicians serving outside the 

regimental framework as well. After changing the title of the Corps of Brigade Surgeons to Corps of Staff Surgeons, Congress 

added 40 surgeons and 120 assistant surgeons to the group, designating them surgeons and assistant surgeons of the 

volunteers. These men were to be "liable 

for detail for any professional duty the 

good of the services requires." Congress 

also gave each volunteer infantry regiment 

a second assistant surgeon and each cavalry 

regiment one surgeon and one assistant 

surgeon. It ruled that militia regiments, 

when called up, should be organized just 

as the volunteer units were.

7 

Amid these signs of progress, a new conflict began to take shape within the Deammond , Statement, p. 4; Maxwell, Sallilary 

Commission , pp. 64, 139; Blustci n, "Hammond," 

p. 78. Medical di rectors occasionall y appo inted their 

own inspectors on an informal basis, but such an appointment did not bring with it a change in rank. 

lQuote from Ltr, SGO to David L. Magruder (8 Apr 

1862). RG 112, entry 2, 30: 158; sec also LtT, SGO to 

Hammond (I JuI1862), RG 11 2, entry 2, 31 :31 1; Maxwell, Sanitary Commission, pp. 127-29, 135-37. 
180 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

partment. The ill will between Stanton on 

the one hand and Hammond and his allies 

on the Sanitary Commission on the other 

initially lay beneath the surface, but it 

emerged to interfere with the Medical Department's operations shortly after Hammond's appointment as surgeon general. 

For two months after Congress created the 

position of inspector, the secretary of war 

delayed giving his official approval to the 

surgeon general's nominees. Even then, 

Stanton accepted only four of the eight, 

substituting for the others men who were 

apparently not highly regarded by the medical profession. When Congress, recalli ng 

what appeared to be the unnecessary agonies of the sick and wounded in McClellan'S campaign of May a nd June, 

rejected Charles TripIer, McClellan's medical director, for the position of inspector 

general, Stanton named in his place former 

Brigade Surgeon Thomas Perley, a man 

who was "quite unknown to the public service and to the profession," as the editor 

of the American Medical Times put it. Despite the low caliber of the men named to 

the new positions, the lawmakers saw the 

position as important and in December 

created another eight openings for inspectors in the department. Congress also required that the inspectors assume , in 

addition to their other duties, the responsibility for examining patients in general 

hospitals and convalescent camps to determine who among them should be discharged from the Army' 

Congress also created another new position within the Medical Department, that 

of medical storekeeper. Although hospital 

8QUotc from "The Week," American Medical Times 

5 ( 1862): 11 ; see also "Sanitary Inspector in the Army," 

American Medical Times 5 ( 1862):94-95; Saul Jarcho, 

"Edwin Stanton and Ameri can Medicine," Blllletin 0/ 

lite History of Medicine 45 (1971): 155; "The Sanitary 

Commission," pp. 176-77. 

stewards were capable of compounding 

medicines under a surgeon's direction, 

Congress now authorized the secretary of 

war to hire as many as six medical storekeepers, who were to be we ll-qua lifi ed 

apothecaries or druggists and to work at a 

more responsible level than hospital stewards. They were required to be between 

twenty-fi ve and forty years of age and to 

pass an examination adm inistered by a 

board of at least three medical officers. The 

position of the medical storekeeper was 

temporary, to be eliminated at the end of 

the war, and apparently carried no rank. 

Like the medical purveyor, the storekeeper 

was expected to post bond. He apparently 

served as a captain and often acted as a 

substitute for medical purveyo r' 

Despite these newly created positions, 

physicians remained the backbone of the 

Medical Department. Alone among them, 

volunteer regimental surgeons continued 

to be examined only by state authorities. 

They were joining the Army in great numbers, as many as 1,200 in the eight months 

preceding May 1862. In July, in authorizing the increase in the number of volunteer 

staff surgeons, Congress ordered that medical officers serving at this level continue 

to be examined by a board of medical officers. The very strict examinations that 

Hammond designed for them, however, 

caused many to fail, and Stanton threatened to eliminate the examining board if 

more did not pass. Since the correlation 

between test scores and performance in the 

fi eld was apparently open to question, this 

9Hcnry N. Rittenhouse. "U.S. Army Medical Storekeepers," American Journal o!PIUlrmacy 37 ( 1865):88, 

90; Ltr, SGO to W. S. King (5 lui 1862), RG 11 2, 

entry 2, 31 :367. The Question of rank is not addressed 

in the legislation, but letters to the surgeon general 

make it apparent that medical storekeepers were ad ~ 

dressed as "captain": Ltr, Rittenhouse to SG (6 Dec 

1862). RG 11 2, Registers of Letters Received, 1862, 

entry 10, p. 447. 
THE CIVIL WAR IN 1862: LEARN ING ON T HE JOB 18 1 

threat was not as outrageous as it might 

sound. Hammond was determined, however, to improve by this means the quality 

of the ca re that the Union soldi er received. 

By the end of the year he had concluded 

that physicians taken into the regular medical service should have studied hygiene 

and military su rgery. He wrote the heads 

of medical schools to urge the introducti on 

of sllch courses into their curricula. Although he relaxed his standards somewhat 

for the examinations given volunteer surgeons, he began to work with eminent physicians in several large cities to improve the 

caliber of doctors made available to serve 

under contracL'· 

The quality of the Army's contract physicians was important, since during the 

course of the war more than 5,500 civilian 

doctors assisted the Medical Department. 

Many routinely staffed general hospitals 

while others provided help only in emergencies when it was necessary to locate 

more physicians quickly. In the last group 

were some of the nation's most prominent 

doctors. When a battle resulted in overwhelming numbers of casualties, those who 

flocked to the scene might include quacks, 

cultists, and practitioners of questionable 

ethics, men who were not under military 

discipline and who could, therefore, come 

and go as they liked, taking assignments 

that pleased them and rejecting all others. 

They often performed unnecessary operations or wrought havoc as they dug about 

for bullets. As a result of the problems experienced with doctors so casually assembled, the Medical Department decided to 

call only upon members of a reserve surIOLtrs, Hammond to G. W. Mittcnberger and to 

others (a ll 22 Dec 1862), all in RG 112, entry 2, 

33:546; Hammond to S. D. Gross (5 and 9 May 1862) 

and to Cooper ( 14 May 1862), all in RG J 12, entry 2, 

30:350, 394, and 423, respecti vely; T. M. Markoe to 

SG (19 May 1862), RG 112, entry 12. 

geons corps formed by the governors of 

various states. These gentlemen were paid 

the salary of contract surgeons and came 

in if called. They served under Medical Department orders and were required to rema in at their assigned posts at least fifteen 

days, unless officially released sooner. " 

Although, like his attempts to require 

strict examinations, Hammond's efforts to 

gai n for his medical directors a rank more 

suited to their responsibilities fai led, medical offi cers did, in theory, attain one privilege in 1862. When the war was more than 

a year old, both sides agreed that they 

would not in the future hold noncombatants, including physicians, as prisoners of 

war. Unfortunately, many months would 

pass before this understanding, never formalized, was routinely heeded. " 

The need for civili an hospital workers 

was more constant than that for civilian 

physicians and some system was required 

to guide their activities. In June 1862, the 

secretary of war issued more detailed regulations concerning civilian hospital workers than had been previously in force. 

Attendants were to serve under military 

discipline with a squad of eleven nurses assigned to serve every 100 patients. The 

chief of the squad was to report to the hospital steward. Regulations called fo r two 

male nurses for everyone fema le in general 

hospitals, but many faciliti es had yet to 

hire their first woman. " 

"GO (no. 65, 12 Jun 1863), in William Grace , 711 c? 

Army Surgeon's Mal/ual, 2d cd. (New York: Balliere 

Bros., 1865), p.47; "Volunteer Surgical Aid" and 

"The Week," both in American Medical Times 5 

(1862): 135 and ISO, respecti ve ly; Hall, "Lessons," 

pp. 76-77; William A. Hammond, " Letter to 'Gentle- men,'" BOSIOI1 M edical alld S/lrgical Journal 67 

( 1862-63):305-06. 

I2"Thc Week," American Medical Times 5 ( 1862): II ; 

GO (no. 60, 6 Jun 1862), in Grace, Manual, p. 44. 

IJGracc, Mali/wI, pp. 109, 111- 12; J. C. Stimson and 

L. C. Thompson, " Women Nurses With the Union," 

Mililary Surgeon 62 (1928):228-29. 
182 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

In the early months of 1862, the general 

hospitals in which these nurses served were 

still housed almost entirely in buildings 

originally erected for some other purpose. 

Hammond shared the U.S. Sanitary Commission's enthusiasm for the pavilion concept, having experimented with hospital 

design as a medical officer in West Virginia 

before he was appointed surgeon general. 

He had become convinced that more than 

3,000 patients could be cared for in one 

hospital if the ventilation was good. As the 

building program progressed, the Medical 

Department was able to abandon some of 

the old facilities, but the location of the 

new institutions became a political issue, 

both because communities usually wanted 

their wounded cared for nearby and because businessmen were aware of the profit 

such an institution could engender. Hospitals had also been established by states 

for their own wounded to supplement the 

Army's facilities, and the Medical Department was having so much difficulty in finding enough beds that it had no choice but 

to cooperate with the states. In June 1862, 

at the urging of state authorities who found 

them very costly to support, the Medical 

Department assumed responsibility for 

many of the state institutions. Because for 

all practical purposes these facilities remained largely under state control, many 

patients who should have rejoined their 

units were instead discharged to civilian 

life." 

The enormous numbers of sick and 

wounded flooding hospitals with the start 

of the new campaign season made it necessary to find ways to limit the size of the 

hospital population. Surgeons attempted to 

'4Blustcin, "Hammond," p. 83; Joseph R. Sm ith, 

"Hammond, The Surgeon-General," Post Graduate 15 

( 1900):628; Emory Upton, The Military Polic). a/lhe 

Ullited States (WaShington: Government Printing Office, 1917), pp. 402-05. 

weed out malingerers, but in th e confusion 

that followed a battle, this was a difficult 

task. Medical officers also urged that more 

efficient proced ures for discharging the 

chronically ill from the service be devised. 

The concept of the co nvalescent camp began to ga in popularity because such a camp 

made it possible for soldiers almost ready 

to resume their duties to remain relatively 

near the units to whi ch they would be 

returning,lS 

Hammond often visited proposed hospital sites to make sure that those chosen 

were healthy, but by the end of 1862 the 

Union Army's 150 general hospitals, scattered about the North and West and in 

some areas of the South and staffed largely 

by contract surgeons, were not achieving 

the record for healthfulness that had been 

hoped for. Although 400 stewards, 300 

ward masters, 6 ,051 male and femal e 

nurses, 3,025 laundresses, and 2,017 cooks 

served in general hospitals, many of these 

institutions were still filth y. Dirt, soiled 

dressings, and old clothing might be under 

the beds in wards that seemed clean. Bathrooms and tubs sometimes served as temporary repositories for "every uncleansed 

or unemptied chamber vessel, of soiled and 

offensive linen, and of every slop that a lazy 

nurse does not care to move." Laundries, 

kitchens, and mess rooms might be in a 

similar state, and hospital grounds could 

be littered with refuse and pri vies. Ventilati on was likely to be deficient despite 

Hammond's efforts, principally because architects valued warmth above fresh air. " 

I}Ltr, Will iam J. Sloan to Hammond, and Telg, Josiah Simpson to Ham mo nd (both 7 Jul 1862), both 

in RG 11 2, entry 12; Ltrs, Sloan to H ammond (20 Aug 

1862) and to SG (II Sep 1862), both in RG 11 2, entry 

10, p. 637; Finley to Thomas (17 Mar 1862), RG I 12, 

entry 2, 30:47-48; MSfI I, pl. 3:908. 

I~Quote from " Management of Military Hospitals," 

American 1\;lediclil Times 5 (1862):292; War Department, SGO, Alllllla/ Report, 1862. p. 6; "Locations and 
THE CIVIL WAR IN 1862: LEARN ING ON THE JOB 183 

Conditions in the Army's hospitals were 

all the more important because of the 

climbing si ck rate, more than 16 percent 

higher than it had been fo r the period of 

1845 to 1859. The death rate from disease 

had increased eve n more markedl y, from 

2.4 percent a year in the earlier peri od to 

5.0 percent from July 186 1 through June 

1862. Among the more common diseases 

was di arrhea, with over 200,000 cases recorded for the year starting July 186 1. Physicians found it diffi cult to estimate the 

number of deaths from this source, however, since diarrhea often coexisted with 

other illnesses. Measles affii cted almost 

22,000 in that period, causing 511 deaths. 

Figures for such problems as typhus, typhoid fever, mala ria, and other fe vers as 

well as for scurvy were unreli able, not only 

because one victim might have mUltiple 

diseases but also because physicians could 

not always distinguish one fever from another. Almost 24,000 cases of venerea l disease appeared, although the author of one 

journal article noted that very few patients 

came from commands where lieutenants 

were "vigilant and sober." The U.S. Sanita ry Commission blamed the Army diet for 

scur vy. O ne authorit y suggested tha t 

scurvy had become a major Army problem 

when he mainta ined that the Commission 

could best promote the Army's health " by 

resorting to measures that shall insure a 

sufficient supply of antiscorbutic vegetables and antiscorbutic care."17 

Because of the sick rate and the growing 

Appointments of O U f M ilitary Hospitals," American 

l'vledical Times 5 ( 1862):24; Blustein , " Hammond," 

p.83. 

'1First Quote, "The Hospital at Portsmouth, R.I. ," 

80s(01l M ed ical and SlIrgical JOllrnal 67 

(1862-63): 11 6; second quote, Elisha Harr is, The 

Ulliled SraleS Sallilary Commission (Boston: Crosby 

& Nichols, 1864), p.29; MSH I, pI. 3:622- 24; D. 

Hunter, "General Orders, No.5," /\lledical and Surgical Reporter 8 (1862):1 03; see also Harris, Tlte 

Vniled Stales Sanitary Commission, p. 30. 

numbers of wounded, the strain on the 

Medi cal Department's supply system increased too rapidly for Hammond to hope 

to function without the a id of the U.S. Sanitary Commission and similar agencies. 

Congress eased his work by removing some 

of the red tape that restricted the ability of 

the purveyors to keep up with demand. 

Hammond revised the supply table so that 

it continued to refl ect current usage and 

established large depots a t Baltimo re, 

Maryland; Fort Monroe, Virginia; Washington, D.C.; Cincinnati , Ohio; St. Louis, 

Missouri; and Nashville, Tennessee. Distribution in the fi eld was handled from 

fi eld depots, but buying was still handled 

principall y from New Yo rk City and Philadelphi a. Although urgent need still led to 

th e occasiona l purcha se of items th at 

proved to be poor, the difficulties he was 

experiencing in keeping up with demand 

did not keep Hammond from obtaining 

Stanton's approval of a plan to supply medicines to any famili es of volunteers that 

were totall y indigent. In Jul y Congress 

voted $ 15,000 for the purchase of artificial 

a rms and legs for both soldiers and seamen, 

and made the Army Medical Department 

responsible for determining the models to 

be used. Hammond was interested in quality as well as quantity, and his efforts to 

improve the equipment used by physicians 

in the fi eld also led to the development of 

two new designs for medical knapsacks." 

Among Hammond 's oth er successes 

were two of long-range rather than immediate significance, the establishment of the 

ISLtr, Hammo nd to Baird (29 Nov (857), RU 305; 

Blustein, "Hammond," pp. 56-57,95; Smith, "Hammond," p. 627; MSH I, pI. 3:965-66; War Department, SGO, Annllal Report, 1862, pp. 8- 9; Reasone r, 

"Medical Supply," p. 17; Llr, SGO to John Neill 

(28 Apr 1862), RG 11 2, entry 2, 30:30 I; John E. Summers to SG (23 Sep 1862), in RG 11 2, entry 10, p. 

664; Hennell Stevens, "The Medica l Purvey ing Department of the United States Arm y," American JOllr· 

nal of Pharmacy , 37 ( 1865):92- 93. 
184 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Army Medical Museum and the first steps 

toward the creation of what would become 

The Medical and Surgical HislOryofthe War 

of the Rebellion. The surgeon general was 

particularly sensitive to the possibilities for 

extending the boundaries of medical 

knowledge during such a vast conflict. 

Early in his tenure as head of the department he urged that his subordinates send 

in specimens both of human tissue and of 

the foreign bodies, such as shell fragments 

or bullets, found in wounds. He appointed 

two men to assist in collecting information 

and specimens for the history and for the 

medical museum. Although Stanton succeeded in thwarting Hammond's desire to 

create a formal medical library in association with the museum, the Surgeon General's Office continued to add to this 

collection of books on an informal basis 

until 1867 when the first librarian was 

appointed. " 

As the new chief of the Medical Department, Hammond was full of energy and 

confidence in 1862. Before he had been in 

office a month, he was going out of his way 

to express to the medical directors of major 

armies his confidence in them. He wished 

them to feel assured of his support in taking the initiative in solving the problems 

they encountered. He was obviously more 

willing to delegate authority than his two 

immediate predecessors had been and desired that his medical directors exercise 

considerable independence in determining 

their own needs without directions from 

him. Rather than control the Washington 

complex of hospitals personally, as Finley 

twice attempted to do, Hammond made 

I'>Srnith, "Hammond," pp. 625-26; Grace, Mallllal, 

p. 110; Brinton, Memoirs, pp. 169, 179; Schullian and 

Rogers, "National Library," pp. 9-10; Wyndham 

Davies Miles,A HislOryo!lhe National Libraryo!Med. 

icine (Washington: Government Printing Office, 

1982), pp. 18,29. 

Surgeon Jonathan Letterman medical director for the capital area. Realizing that 

the control of both field and general hospitals in an area or for an army might be 

too much for one man, he began to di vide 

these responsibilities, having one director, 

for example, for each of the major cities in 

the East where large numbers of ArmY patients were cared for and yet another for 

each army in the East. 20 

Care of the Sick and Wounded 

in the East 

In early 1862, a visitor inspecting General McClellan's Army of the Potomac, the 

principal army in the East, was pleased 

with what he saw. Physicians appeared to 

be both competent and hard working, 

camps were neat and orderly, drainage was 

good, and tents were warm, although their 

poor ventilation caused him some distress. 

The general hospitals serving the Army of 

the Potomac, of which there were ten in 

mid-March, needed little in the way of improvement, in his view, and he found the 

competence of the nurses, both male and 

fema le, to be particularly worthy of notice. 

In view of such reports, Medical Director 

Charles Tripier believed with some justification that his attempt to bring order into 

the medical support of the Army of the Potomac was at least partially successful. " 

In March Tripier was apparently confident of his own ability to deal with the demands of the upcoming campaign. He sent 

all the sick except for convalescents to general hospitals, a necessary move that placed 

a considerable burden upon the facilities 

l°Ltrs, Hammond to TripIer (2 May 1862) and SGO 

to McDouga ll (12 May 1862). both in RG 11 2, entry 

12,30:335 and 408, respectively. 

l' L. , "Sanitary Condition of the Army of the Potomac," and "Correspondence," both in American 

Medical Times 4 (1862):45-46 and 214, respecti ve ly. 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 185 

JONATHAN LETTERMAN (second Fom lejl, sealed), Medical Direclor, Army 0/ the POLOmac, 

AND ASSISTA NTS. (Courlesy 0/ Nalional Library 0/ Medicine.) 

in Washington and nearby communities. 

To relieve the strain, he took over the barracks left vacant as McClell an's army 

moved south. Unfortunately, much modifi cation was necessary to make these buildings suitable for this use: they were poorly 

arranged, their ventilation was haphazard, 

th e ir cei lings low. T he ir Ooors often 

showed wide cracks; they lacked appropriate space for laundry and kitchen; and their 

sites were frequently fi lthy. The two newly 

built hospitals in Washington were completed in time to assume some of the burden , but the number of pati ents was soon 

so large that tents had to be erected on the 

grounds of the new institutions to care for 

the overflow" 

The continued establishment of faciliti es 

" MSH I, app.:52 and pI. 3:908- 09, 920. 
186 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

more removed from the battlefield, including those at Philadelphia and New York, 

relieved the situation in hospitals in the 

Washington area to some degree, as did the 

creation of temporary general hospitals 

near the battlefield . The more permanent 

facilities were often quite large; New York 

institutions, according to the surgeon general's annual report of November 1862, 

held almost 5,000 patients and those of 

Philadelphia, 5,500. 23 

TripIer began laying plans for the care of 

sick and wounded in the field before 

McClellan opened his campaign against 

Richmond. He prepared instructions for 

his surgeons about the establishment of 

what he called "field depots," the organization of the medical officers to serve in 

them, the proper method of dealing with 

the wounded, and the way in which ambulances were to be divided up and used. 

A shortage of ambulances, however, interfered with the operation of TripIer's modest ambu lance corps. Although he 

repeatedly attempted to acquire more vehicles, the Quartermaster's Department 

sent him only a few, and many of these were 

two-wheelers, which TripIer regarded as 

"good for nothing." He also attempted to 

obtain all the supplies that he anticipated 

needing. Unfortunately, just when McClellan's forces were beginning their move 

by water toward the peninsula between the 

York and James rivers, Surgeon General 

Finley announced that, as ordered by the 

secretary of war on 7 April, he was resuming personal control over all general hospitals. TripIer was to leave behind his 

purveyor and some of his supplies, thus 

lJ"Army Medical [ntelligence" and "Medical Affairs," both in Americall Medical Times 4 ( 1862):360 

and 5 (1862):28, respectivel y; "The Hospital at Portsmouth R.I. ," p. 11 5; War Department, SGO, Annual 

Report, 1862, pp. 2-4; MSH I, pI. 3:908, 932-33, 935, 

989. 

starting the new campaign season with only 

part of what he needed and the hope that 

the rest would be forwarded to him from 

New York City by the time he needed it. 24 

The tendency of many regimental surgeons early in the campaign to abandon 

supplies rather than to move them exacerbated TripIer's supply problem, since the 

officers then turned to the purveyor for replacements. The tents belonging to some 

units, furthermore, were inexplicably left 

behind in Alexandria, making more difficult the establishment offield hospitals, especially since on the peninsula buildings 

suitable for hospital use were few. (Map 6) 

Pilfering and carelessness during shipment 

reduced the amount of supplies actually received, and late shipments resulting from 

the low priority given Medical Department 

supplies by the quartermaster only made 

matters worse. TripIer's request in April 

1862 that "an experienced quartermaster 

and assistant commissary of subsistence be 

attached to the command of the Chief 

Medical Officer of an army in the field" 

came to naught, and TripIer began protesting " beforehand against the Medical 

Department being held res ponsible for 

ev ils th ey have no possibl e mea ns of 

obviating."" 

During the Peninsular campaign, an extremely high rate of disease, sometimes 

called Chickahominy fever, probably either 

a combination of typhoid and malaria or 

typhoid alone, made the supply shortages 

even more critica l. TripI er determined, 

therefore, to reduce the number of patients 

for whom he was responsible at anyone 

time by evacuating them as quickly as possible. He made every effort to send both 

24Quote from MSH I, app.:63. Unless other-vise indicated, all material on Tripier's work is based on 

MSH I, app.:50-63. 

nQUOle from MS/-/ 2, pt. 3:933; sec also Maxwell, 

Sanitary Commission, p. 160. 
THE CIVIL WAR 

VIRGINIA 

o 

, 

Lynchburg • 

Denville 

• 

MAP 6 

Miles 

50 , 

• Appomattox 

---- -- PA. 

MD. 

e-----

• Winchester 

The Wilderness 

BULL RUN._ 

Man8ssas 

'0&(1 • 

~&9\ Chencellorsvill8 

Spotsylv8nia • 

atto)t 

.Apportl .,:> Harrison's 

• Fermville 

• BurkevIHe 

Bermuda Hund sCI Landing 

·City I1i1iJmSburg. • orktQwn 

Point 'e;g-8ethel 

petersburg- • Himpton 

• 

Fort Monr .. 

Norfolk • 

~.:... ---

- --- - - - N.C . 
188 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

the sick and the wounded away from the 

battle area. Because the facilities at Fort 

Monroe were limited, many wounded were 

sent north to Washington, Baltimore, and 

Annapolis, Maryland, or even further. It 

was expensive, however, to ship those with 

slight wounds or self-limiting disea ses 

north only to have to return them south 

again when they were ready to rejoin their 

units, and despite the efforts of both the 

Quartermaster's Department and the U.S. 

Sanitary Commission , few adequately 

equipped river or ocean steamers were 

available for the final leg of the journey. 

On occasion, furthermore, the water was 

so shallow that the transports could not 

come close to shore, and Tripier was forced 

to act on his own to line up whatever shallow draft vessels he could find to take his 

patients out to the steamers.'6 

The lack of discipline that characterized 

so many Union soldiers contributed to 

Tripier's problems. On one occasion at 

White House, on the Pamunkey River in 

Virginia, the 150 men assigned to pitch 

hospital tents worked so slowly that two 

days were required to erect thirty-four. On 

a number of occasions, furthermore, ablebodied soldiers eager to escape the horrors 

of the campaign swarmed aboard trains 

and steamers taking the sick and wounded 

north, displacing those entitled to evacuation. Once when Tripier insisted upon 

checking candidates for evacuation carefully, a gang of stragglers rushed aboard a 

vessel that was only half-loaded and refused to get off. Regimental officers who, 

Tripier believed, could have prevented this 

disorder did not do so. He finally decioed 

to reduce the effects of this particular prob26Ltrs, SGO to Cuyler ( II Apr 1862), Wood to M. 

C. Meigs (24 Apr 1862), and SGO to Tripier (17 Apr 

1862), all in RG 112, entry 2, 30: 189, 286, and 325, 

respectively; Tripier to Wood ( 14 Apr 1862), RG 11 2, 

entry 12; MSH I, pI. 3:75; MSH 2, pI. 3:982, 984. 

lem by retaining as many of the sick as possible in the peninsula. He ordered more 

hospital space at Yorktown and Williamsburg to house the ill from White House and 

asked for more medical officers. By midJune, only half the tents he had requested 

a month earlier had arri ved; and many of 

these co uld not be sent to Yorktown because they were needed for field hospitals 

nearer the battlefield. Tripier was t hus 

forced to use some vessels as floating hospitals and to continue the evacuation of the 

sick as well as the wounded, and with them, 

inevitably, stragglers, north by steamer. 27 

Even moving the sick and wounded as 

far as the riverbank was no easy task. Ambulances were scarce. Hospital attendants 

were increasingly busy working in hospitals. Band members were often too frightened to venture near the battlefi eld. Tripier 

had no control over trains that brought 

some of the wounded to the waterfront, and 

the enemy often cut the lines. As a result 

of these difficu lties, severely injured men 

sometimes lay for twenty-four or even 

forty-eight hours on muddy, hot battlefields before they were collected, and then 

were left waiting in the rain for hours at a 

railroad depot without shelter, food, or 

water. Since the army was often in retreat, 

the wounded who could not wa lk also faced 

the possibility of capture. 

As the situation on the peninsula deteriorated, Hammond became increasingly 

uneasy about Tripier's abi lity to deal with 

the demands placed upon the Medical Department there. In encou raging Tripier to 

act decisively on his own, the new surgeon 

general had reassured him early in May 

that all the department's resources were behind him and that he had only to let the 

department know his needs. By mid-May, 

however, Tripier was approaching frenzy. 

" Ltr, Triplerto SG (30 Apr 1862), RG 112, entry 12. 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 189 

He was trying frantica lly to acquire the necessary transportation for his patients on 

both land and water and to arrange for the 

necessary hospital faci lities and for subsistence. He pointed out to Hammond that 

the problems that took all his time and energy lay properly within the purview of the 

Quartermaster's and Subsistence Departments. He repeatedly begged Hammond 

for aid and predicted dire consequences if 

he did not receive it at once. Delays in the 

delivery of sup pli es were "producing 

frightful resu lts," he telegraphed Hammond on 18 May, while he added in another telegram the same day tha t th e 

medical staff was "all nearly exhausted."" 

Hammond obviously sympathized with 

Tripier's predicament and pushed to obtai n 

ambulances and steamers from the Quartermaster's Department and to fill other requests as rapidly as possible. His answer to 

Tripier's complaints, however, implied that 

Tripier was not doing all he could to help 

himself. He had already been granted, for 

example, the authority to do on his own 

many of the things he was now req uesting 

permission to do. In addition, he had not 

worked as closely with General McClellan 

as Hammond believed he should. The surgeon general also pointed out that Tripier 

must accept the fact that the Medical Department could not always meet all his 

needs. Hammond obtained control over 

steamers from the quartermaster in June 

and at last, presumably concluding that 

Tripier could no longer cope with the situation alone, sent two surgeons to the peninsula wit h orders to orga ni ze th e 

evacuation of the sick and the management 

28QUotcs from Tclg, Tripier to Hammond ( 18 May 

(862), RG 11 2, entry 12; Ltrs, Hammond to Tripier 

(2 and 8 May 1862), both in RG 11 2, entry 2, 30:335 

and 382, respectively; Telg, Tripier to Hammond 

(9 May 1862), RG 112, entry 12. 

of transports. He then gave Tripier specific 

instructions concerning the abandonment 

of several unhealthy hospitals and the establishment of others to replace them." 

Nevert heless, as the end of June approached, confusion ruled at White House. 

The wounded continued to arrive in great 

numbers, communications were poor and 

then finally nonexistent, few tents were 

available, and no more could be obtained. 

Patients filled the shelters and spilled out 

onto the lawn. On 28 June when the evacuation south to Harrison's Landing on the 

James River began, Tripier had to order 

more than 600 wounded abandoned to the 

enemy because he had so few ambulances, 

although he left behind surgeons who volunteered to stay with them, supplies, subsistence, and nurses. At Harrison's Landing 

in the first days of July patients lay in the 

open, without tents or shelter of any kind. 

Dysentery, diarrhea, malaria, scurvy, and 

typhoid fever raged unabated. On I July 

the rain was once again deluging the sick 

and wounded when Jonathan Letterman 

arrived fro m Washington to relieve the defeated Tripler.'o 

Although Tripier may well have done all 

he could in the situation, George Templeton Strong of the U.S. Sanitary Commission believed that he had been proved 

totally incompetent. Strong held that TripIer and his staff were entirely responsible 

for the sufferings of Union soldi ers in Virginia, and Congress apparently agreed with 

Strong. After some senators visited White 

l~ Ltr , Hammond to Tripier (19 and 22 May and 

8 Jun 1862), and to Edward Valium (17 Jun 1862), all 

in RG 11 2, entry 2, 30:467 and 493- 94, and 31:47 

and 150, respectivel y; Tripier to Hammond ( 19 and 

20 May and 1 and 6 Jun 1862, all in RG 112, entry 12. 

lOU sse, Surgical Memoirs oj the War 0/ the Rebe/~ 

/iOIl, Collected alld Published by file United Slates Sanitary Commission, 2 vols. (New York: U.S. Sanitary 

Com mission, 1870- 71), 1:276-77. 
190 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

House and saw the situation for themselves, they refu sed to confirm Tripier's 

nomination as inspector general. Hammond, however, did not openly blame TripIer. Indeed , he showed co nsid e rab le 

compassion when he learned of the Senate's action and received Tripier's request 

to be relieved. He asked his former superior 

to name the position he wanted north of 

the Potomac or along the Ohio River, and 

when Tripier asked for the post at Detroit, 

it was his. 31 

A most difficult situation had crushed a 

man of modest talent. When circumstances 

permitted him to exercise his administrative talents to their full est, Tripier functioned well. His toleration for frustration, 

however, was low, and he had little ability 

to make the best of bad conditions. In the 

Peninsular campaign he knew that if the 

requirements for ambulances, tents, transports, and supplies were not met, the consequences might be horrible. Having been 

frustrated by Finley when he attempted to 

prepare adequately for the upcoming campaign, Tripier was unable to accept the fact 

that Hammond could not at once make 

everything right. Preoccupied by his inability to prevent the disaster he knew was 

coming, Tripier failed to seize the available 

opportunities to prevent a further deterioration. Although Letterman bore no responsibility for the management of the sick 

and wounded in the peninsula, after he became familiar with the situation at Harrison's Landing, he too concluded that the 

Medical Department should not be 

blamed. Tripier was not responsible for the 

disaster; the worst that could be said, perl'Strong, Diary, pp. 222, 230. 2300; Tclg, Hammond 

to Tripier (20 Jun 1862) and Ltrs, Hammond to TripIer and to L. Thomas (both 19 Jun 1862), all in 

RG 11 2, entry 2, 31:170, 176, and 191, respectively; 

Tripier to SG ( 16 Jul 1862), RG 11 2, entry 10, p. 797. 

haps, is that he was unable to handle the 

disaster when it occurred." 

Initially when Letterman reported for 

duty, the crisis at Harrison's Landi ng demanded all his attention. Time, however, 

was on his side. The new medical director 

had to face all the frustrations resulting 

from his limited control over the steamers 

that evacuated his patients; although he 

could direct their acti vities when they were 

evacuati ng patients, he could not prevent 

their di version, even at critical moments, 

to other uses. Thus he co uld only watch 

while vessels he needed were taken over to 

move Confederate prisoners. But with the 

arrival of more transports, outfitted at 

Hammond's order to carry the sick and 

wounded, and of some of the 100 tents and 

200 ambulances that the beleaguered TripIer had vainl y urged Hammond to send, the 

situation on the James River eased. Pati ents could now be shipped to hospitals in 

the North and in the Fort Monroe area, and 

those who remained could be put under 

shelter. Letterman was then able to look 

beyond the immediate situation and to implement his plans for the future. " 

Lettermen had apparently already formulated plans to improve the efficiency of 

the Medical Department, and in this he 

had the support of both Hammond and 

McClellan. McClellan had discussed the 

possibility of devising such a scheme personally with Stanton and had received the 

permission of the secretary of war to formalize it. On 2 August, the general issued 

an order putting Letterman's formula into 

)~ Te g, Letterman to Hammond (29 Ju l 1862), 

RG I [2, entry 12. Unless otherwise indicated, all mate rial on Letterman is based on IHSJ-ll , app.:93- I04, 

and Jonathan Letterman, Medical Recollections o/lhe 

Army 0/ the Potomac (New York: D. Appleton & Co., 

(866). 

HLtr, Letterman to Hammond ( 17 Ju1 1862), 

RG 11 2, entry 12. 
THE CIVIL WAR IN 1862: LEARN ING ON THE JOB 19 1 

effect within the Army of the Potomac, although according to Letterman the printer 

did not return the order until a few days 

before the Army of the Potomac was to 

leave Harrison's Landing, thus delaying 

steps to full y implement it. On 2 1 August, 

McClellan forwarded Letterman's plan to 

Stanton for approval to put it into effect 

throughout the Union Army, but eight days 

later Stanton rejected it, noting it would 

only " increase the expenses and immobility of our army .. . without any correspondi ng advantages," an opinion Maj. 

Gen. Henry W. Halleck echoed less than 

three weeks later. As a result, just at the 

time that Letterman was beginning to move 

ahead with his plan within the Army of the 

Potomac, he learned that both the secretary 

of war and the general in chief of the Union 

Army thoroughly disapproved of it." 

Letterman's plan specified that two men 

and a driver, plus two stretchers, be on 

board each ambulance. Each regiment 

would be supplied with two light two-horse 

ambulances, and each corps another two, 

to provide evacuation from fie ld to depot. 

Four-horse vehicles carried patients back 

to field hospitals and beyond. Letterman 

called for the organization of ambu lances 

and their attendants by Army corps, with 

a captain in charge at the corps level, a first 

lieutenant at the division level, and so on 

down the line, with a sergeant directing the 

ambu lances at the regimental level. The 

ambulance corps captain, though a line officer, reported to the medical director, an 

innovation that caused less comment than 

might have been expected, in view of the 

long history of controversy concerning the 

command relationship of medical and line 

officers. Those named to man the ambulances we re neither teamsters nor band 

members, nor even hospita l attendants 

HQuote from MSH 2, pI. 3:934. 

who might be called away just when they 

were most needed. They were soldiers permanently detailed from the ranks for ambulance work. Commanders were required 

to order only " active and efficient" men to 

serve with the ambulance corps, and all the 

men of the new organization were to be 

regula rly and carefully drilled in their new 

duties. Although medical officers from 

each di vision accompanied every ambulance train, ambulance corps officers handled all administrative matters. By creating 

a permanent, disciplined, and professional 

ambulance corps, Letterman guaranteed 

more efficient evacuation and because surgeons and attendants were no longer responsible for transporting patients, better 

hospital care for the sick and wounded." 

While Letterman worked out his plans 

for the ambulance corps, the medical staff 

of the Army of Virgini a under Maj. Gen. 

John Pope faced diffi culti es simil a r to 

those that Letterman and Tripier had encountered in McClellan's Army of the Potomac. Although disease was not as great 

a problem in Pope's command as it had 

been on the peninsula and the weather remained good, problems involving evacuation overwhe lm e d th e Medi ca l 

Department during and after the Second 

Battle of Bull Run in late August. Ambulances were scarce and attendants and drivers, except for those sent from McClellan's 

army to reinforce Pope in August, untrained and undisciplined. Rail lines that 

were to have been used to evacuate the 

wou nded from the battlefield were cut, and 

the patient load became too great for the 

field hospitals of the area. Those unable to 

walk lay by the thousands on the ground 

for twenty-four and more hours unattended. While surgeons worked out the 

truce that would permit their removal, 

HMSN 2, pt. 3:933- 34, quote from p.936. 
192 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

stragglers and the slightly wou nded managed to be evacuated before their less fortunate comrades. " 

Once again, the entire system was not 

prepared for the more than 8,000 casualties 

that fl ooded in upon it. Pope's medical 

staff was too small, and the general hospitals at Alexandria were thrown into confusion in early September as casualties 

began to come in. Realizing, perhaps, from 

TripIer's experiences that it was extremely 

difficult for one man to manage medical 

care and all stages of evacuation as well, 

Hammond appointed John Brinton to the 

new position of medical director of transportation, to supervise the movement of 

the wounded to Alexandria and between 

hospitals in that city. 

During and after Second Manassas, 

Pope's medical director, Thomas McParlin, tried two new approaches to the old, 

familiar problems. In his desire to achieve 

greater efficiency in the management of 

field hospitals, McPariin attempted to take 

centralization to its ultimate conclusion by 

locating all fi eld operations in one area. But 

because a single facility could not be convenient for medical officers scattered about 

a large area, surgeons tended to render 

more care on the battlefield, and the 

amount of time they spent away from the 

central hosp it al left it undermanned. 

McParlin's attempt to improve the efficiency of medical supply by leaving the 

items he needed on the railroad cars that 

brought them and by keeping those cars on 

conveniently located sidings was thwarted. 

The cars were so overcrowded that it was 

impossible to allow any to be left standing 

for storage and the enemy could cut rail 

lines so that trains could not get through. 

l6Unless otherwise indicated, all information about 

the medical care given the Army of Virginia is based 

on Brinton, Memoirs, pp. 196-201 ; Duncan, Medical 

Depanmenr. pt. 3; and MSN 1, app.:I08- 29. 

Triggered by Lee's invasion of Maryland 

in September, the renewal of the conflict 

brought together the men who had fought 

in the previously separate forces of the 

Armies of the Potomac and of Virginia. 

Letterman was the medical director of the 

newly enlarged Army of the Potomac. Although by this point his ambulance corps 

was a month old, ambulances and medical 

supplies had to be left behind because of 

the speed with which McClellan wished to 

move. The presence of units from Pope's 

force that had not been introduced to the 

new system also kept the battles in Maryland from providing Letterman's concept 

with a true test. The medical director ordered that ambulances and supplies be sent 

on to Frederick, Maryland, as soon as they 

became available, but delivery proved to be 

exceedingly difficult because the Confederates had destroyed the railroad bridge 

over the Monocacy River near Frederick. 

All supplies sent by rail had to be unloaded 

at that point, with much confusion and delay resulting. Fortunately, ambulances began to arrive just before the Army of the 

Potomac reached Frederick, and the U.S. 

Sanitary Commission, which had its own 

means of transportation, provided invaluable help with supply." 

Discipline remained poor throughout 

the army, however, and despite Letterman's efforts, critics charged that the ambulance service at An tietam wa s 

characterized by "gross mismanagement 

and inefficiency, ... lack of system and 

control " during the battle. Ambu lance 

HLtrs, Letterman to Hammond (13 Aug and 6 Sep 

1862), both in RG 112, entry 12; Thomas T. Ellis, 

LeQl'es From the Diary of all Army Surgeon . .. (New 

York: John Bradburn, 1863), p. 300; "The Wounded 

and the Ambulances of Our Army," American Medical 

Times 5 (1862):247; Ltr, Cornelius R. Agnew (22 Sep 

1862). in U .S. Sanitary Commission, Reports, Correspondence, and Printed Matter, Ms C19, NLM 

(hereafter cited as Steiner Report). 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 193 

drivers were accused of greed and thi every, 

and some of the more than 8,000 wounded 

remained on the battlefi eld as much as 

twenty-four hours. How many of the difficulties related to the presence of the still 

untrained attendants and drivers from the 

units that formed Pope's army cannot be 

ascertained. The wounded were, in any 

event, finally evacuated to Frederick, and 

in many cases, beyond to Washington, Baltimore, and the north. 38 

His experiences with the problems of 

supply, and perhaps those of the un fortunate Tripier as well, led Letterman to conclude that 'a cha nge in the pattern of 

distribution wo uld red uce losses when 

troops were on the move. As a result, he 

decided in October that, from that time on, 

supplies would be issued by brigade and 

doled out to the indi vidual regiments as 

needed. It would thus be 'almost impossible 

for large amounts of medicines, bandages, 

and hospital stores to be casually abandoned every time a regiment moved. His 

experience in Maryland also led Letterman 

to issue general instructions to govern the 

management of a field hospital system, 

which he preferred to have organized by 

division, guaranteeing that each physician 

would know precisely what his assignment 

was. Incorporated in the orders issued at 

the end of October was the concept of having surgery performed only by the three 

best surgeons in each di vision." 

)BQuote from "The Wounded . .. ," American Medical Times 5 ( 1862):246. 

J9Cir (no. 3, 30 Oct 1862), in U.S. Army Medical 

Department Order and Letterbook of the Hospitals 

of the 2d Division, 12th Army Corps, 1863, Ms ffiSO, 

NLM. Unless otherwise indicated, all material on the 

Fredericksburg campaign is based on Gordon W. 

Jones, "The Medical History of the Frederi cksbu rg 

Campaign: Course and Significance," Theory and 

Practice ill American Medicine. ed. Gert Brieger (New 

York: Sc ience History Publications, 1976), and on 

Duncan, Medical Departmel1l. The te rminology used 

to classify hospitals during the Civil War was confused 

THOMAS A. M c PARLIN. (Courtesy oj Nalional Library oj Medicine.) 

The value of Letterman's system and the 

competence of his work under very unfavorable circumstances were most clearly 

demonstrated in the disastrous battle of 

Fredericksburg, Virg ini a, in midDecember 1862. Despite all difficulties, the 

management of the wounded during this 

engagement was one of the first Medical 

Department successes in the Civil War. 

T he attempt by McCle llan's successor, 

Maj. Gen. Ambrose E. Burnside, to defeat 

and confusing. What Tripier referred to as a field depot was directed by a surgeon. The function that had 

been performed by the regimental hospital was after 

186 1 usually handled at the brigade, the division, or 

occasionally the corps level. These fi eld hospitals resembled the old general hospitals because they took 

in patients from more than one regiment, but, unlike 

general hospitals, they were moved with the units they 

served. Some of the less permanent general hospitals 

might now be call ed evacuation hospitals. 
194 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

the Confederates was a bloody and spectacular failure, but Letterman had ready 

near the scene of the battle the tents, ambulances, and other equipment and supplies that would be needed. He had trained 

the men who were responsible for the care 

of the wounded and for their evacuation 

from the battlefield. Three ambulances, 

each with two stretchers, two attendants, 

and a driver as well as two hospital tents, 

were available for each regiment. Stretcherbearers were instructed exactly where to 

bring the wounded to meet the ambulances 

that would take them to the field hospitals. 

Despite the difficulties involved in moving casualties under fire, evacuation from 

the battlefield to field hospitals went well, 

but Letterman's management of supply 

and of the final stage of evacuation left him 

vulnerable to criticism. He did not easily 

delegate authority, and without a commissary to manage the depot, supply problems 

engendered by the unexpectedly high casualty rate grew. The Sanitary Commission 

filled the gap once more with food, blankets, warm underwear, and other items, 

and evaluated the work of the Medical Department at Fredericksburg as "admirable." Both Walt Whitman, who worked as 

a nurse with the wounded from Fredericksburg, and the new inspector general, 

Thomas Perley, were highly critical of the 

last stage of the evacuation, but neither was 

in a position to understand the problems 

Letterman faced. In addition, Perley was a 

man of dubious reputation and indebted 

for his position to Stanton, so that his criticism of the Medical Department might 

have been motivated by self interest.'o 

Letterman could not have anticipated 

that Burnside would order all of his 9,000 

4OQuote from Edmund Andress, Complete Record of 

the Surgery oj the DallIes FOllght Near Vicksburg . .. 

(Chicago: Fergus, 1863). p. 30; Maxwell, Sanitary 

Commission. p. 182; Brinton, Memoirs, pp 215, 220. 

wounded, regardless of their condition, 

moved from the Fredericksburg area; as 

medical director he had planned to keep 

the most seriously hurt where they were. 

Thus he cannot be held responsible for the 

horrors that were said to have resulted from 

journeys made on open railroad cars and 

long waits for steamers that were also devoid of accommodations for the wounded. 

Although he did anticipate problems with 

stragglers and malingerers, he was apparently unable to find guards competent 

enough to keep them from climbing aboard 

trains for a free ride to Aquia. It was these 

men, Letterman maintained, who, finding 

no shelter at Aquia, began to send up loud 

complaints about the inhumanity of the 

Medical Department. 

Although surgeons did not have to manage the evacuation of large numbers of casualties, those in charge of hospitals serving 

small units in the East faced some of the 

same problems that confronted McParlin, 

Tripier, and Letterman. The men holding 

coastal areas of the south often suffered 

from the high disease rates characteristic 

of these areas, and the surgeons with them 

could not always locate buildings easily 

adapted for use as hospitals. In western 

Maryland and Virginia, some problems experienced by the troops serving under Maj. 

Gen. Nathaniel Banks resulted from the 

fact that they apparently received little attention from the Medical Department in 

the early months of the year. Although 

much illness occurred among the men serving near Cumberland, Maryland, for example, Tripier was apparently unaware of 

their existence for some time, and supplies 

there and in the Winchester area were 

inadequate." 

" MSH I, app.:228- 29, 234-36, 243-44, 246; Ltr, 

SGO to William S. King (5 Apr 1862), RG 11 2, entry 

2, 30:145; Steiner Report, Ms C19, NLM; "Army 

Medical Intelligence," American Medical Times 4 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 195 

Care of the Sick and Wounded 

in the West 

West of the Appalachians the Medical 

Department experienced many of the same 

problems that it encountered in the East. 

For the Medical Department, the principal 

difference between the East and the West 

lay in the character of the chain of evacuation from field hospitals to general hospitals. In the East, where the navigable 

portions of the rivers ran east and west, 

patients were most often moved to the 

north or northeast from the battlefield, as 

water transportation was not always feasible. In the West, however, the existence of 

a widespread network of rivers running 

both east and west and north and south 

made it possible to rely on large-scale evacuation by water, and fluctuating loyalties 

and battle lines made rail lines especially 

vulnerable. Many of the hospital steamers 

that plied the principal rivers of the midwest could carry 200 to 600 patients or 

more. They were equipped, manned, and 

even chartered by one of the sanitary commissions or by a state organization, but 

Surgeon Genera l Hammond controlled 

their use. Because of the extensive system 

of rivers, major hospitals could be located 

at sites as widely separated as St. Louis, 

Missouri, and Cincinnati, Ohio, and could 

shelter patients from battlefields hundreds 

of miles away." 

Although in Louisville and Cincinnati 

combined, the patient load was almost 

3,500 in late 1862, the largest number 

cared for in the river cities of the midwest 

( 1862): 129; Walker DeBlois Briggs, Civil War Surgeon 

ill a Colored Regime1ll (Berke ley: University of California Press, 1860), p. 61. 

4~Telg, Hammond to McDougall (22 May 1862), 

RG 11 2, entry 2, 30:496; Forman, Western Sanitary 

Commission, pp. 42-46; Maxwe ll , Sanitary CommisSiOl/, p. 121. 

could still be found in St. Louis. Hospitals 

in the city itself in the autumn of 1862 held 

over 2,700 patients, while another 1,000 

were sheltered at the nearby Jefferson Barracks. This building, unlike those upon 

which Tripier had to rely on in Washington 

in the spring of the year, was considered 

excellent for the purpose. It had piazzas 

and shaded walks for the patients, and its 

rooms were large and well ventilated. In 

time new buildings were erected at the Jefferson Barracks, increasing its capacity by 

2,500. Benton Barracks and the marine 

hospital within the city were also taken 

over in the spring of 1862, but demand continued to exceed capacity. The Western 

Sanitary Commission deplored what it regarded as the crowding of the city's general 

hospitals, which it blamed for high death 

rates from typhoid fever and erysipelas'" 

Most of the patients in the general hospitals of the midwest came from the armies 

of Brig. Gen. Ulysses S. Grant, Maj. Gen. 

William S. Rosecrans, and Brig. Gen. Don 

Carlos Buell. Unlike McClellan in Virginia, 

Buell, headquartered in Louisville, Kentucky, appeared indifferent to the welfare 

of his sick and wounded. His regimental 

surgeons were few, averaging about three 

for every two regiments, many physicians 

having either fa llen ill or resigned. Twelve 

percent of Buell's men remained in Kentucky because they were ill when his army 

moved. His medical director, Robert Murray, was forced to establish hospitals along 

the army's li ne of march to care for the 

large numbers who fell ill along the way. 

Ambulances were so few that the sick could 

not be carried far, and the two-wheeled 

type disintegrated on the rough roads of the 

West. Bedding and medicines were scarce 

~l Forman . Weslem Sanirary Commission. pp. 45, 49, 

65-66; War Department, SGO, Alllilial Report, 1862, 

pp. 4-5; MSH I, pI. 3:907. 
196 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

and Buell begrudged the assignment of 

healthy soldiers to serve as nurses for their 

ailing comrades, so that little for the care 

and comfort of these unfortunates could be 

left behind." 

Despite Buell's lack of concern for his 

sick, Murray was able to gain his consent 

for the establishment of a convalescent 

camp for 1,000 near Elizabethtown, Kentucky, a town located along the railroad 

that connected Nashville with Louisville, 

enabling these men easily to rejoin their 

units. Murray also set up a hospital at Eli zabethtown, although whether the convalescents were used to nurse the sick there, an 

arrangement Buell favored, is not known." 

The medical director for Grant's Army 

of the Tennessee was fortunate in having a 

commander more sympathetic to the problems of the Medical Department than 

Buell, but he, too, faced high disease rates. 

Supplies were short and, because of " irregularities in the quartermaster's department .. . in the District of Ca iro," 

ambulances and hospital tents for Grant's 

army were even harder to obtain than they 

were for other armies. No buildings suitable for large hospitals were found along 

the line of march, and the army was soon 

far from its supply bases. The two-wheeled 

ambulances that composed half of the 

force's allotment once again proved too 

fragile for the uses to which they were put, 

and although each regiment apparently had 

its full quota of medical officers, even this 

number was not enough to care for men in 

malaria-ridden co untry under the prolonged stress that characterized Grant's 

44MSH I, app.:23; Ltr, Murray to Finley (22 Jan 

1862), RG 112, entry 12; usse, Sanitary Memoirs, 

p. 55; U.S. Army, Surgeon General's Office, Medi cal 

History of the Army of the Ohio and the Cumberland, 

1862, Ms C125, p. 5, NLM. 

4SUSSC, Sanitary Memoirs, p. 55; Ms e l25, pp. 1-2, 

NLM. 

campaign against Fort Henry and Fort 

Donelson." 

In the West, as in the East, the responsibility for general hospitals and that for 

fi eld hospitals were often assigned to different men. As a result, Grant's senior surgeon, James Simons, as well as the medical 

officer who sometimes acted in Simons' 

stead, John Brinton, often remained in the 

north at Cairo, Illinois, while Henry Hewit, 

a volunteer surgeon, accompanied Grant 

and served as his medical director in the 

field. Hewit sent one surgeon with each regiment into battle, ready to render whatever 

immediate care might prove necessary. The 

regimental medical officer then sent the 

wounded back to a depot where ambulances could meet them. From these depots, the wounded were taken to large 

hospitals established out of the line of fire 

in whatever buildings were available and if 

necessary in tents, Hewit's main problem 

being the lack of suitable shelter. Hewit 

also formed ambulance trains, each managed by a noncommissioned offi cer. Although his arrogance and rough manners 

alienated U.S. Sanitary Commission officers, his system, an unsophisticated version of that later devised by Letterman in 

the East, apparently worked well, even 

when snow and sleet fell upon the battlefield. Within several days of the struggle 

for Fort Donelson in February, and apparently after a period of neglect, the wounded 

were shipped by steamer to the Cumberland River and thence to general hospitals 

at Mound City, Illinois, and Paducah, Kentucky, as well as at Cincinnati, St. Louis, 

and Louisville. The troops rema ining in the 

field soon began to succumb to stress and 

disease, and those stricken with dysentery, 

46Unless otherwise indicated, all material on Fts. 

Henry and Donelson and the battle of Shiloh is based 

on MSH I, app. :23-44. 
THE CIVI L WAR IN 1862: LEARNING ON THE JOB 197 

J AMES SIMONS. (CO/lrlesy OJ Nalional Library oJ Medicine.) 

diarrhea, pneumonia, and typhoid fever 

began to join the wounded under the care 

of Hewit's medical officers." 

After the capture of Fort Donelson , 

Grant's army traveled by steamer 120 miles 

from Fort Henry to Savannah, Tennessee. 

The men were packed closely together, and 

many apparently remained on board for 

some time after their arrival at their destination. As a result of the long confinement in close quarters, a typhoid fever 

epidemic struck, and many died. Supplies 

of medicines and hospital space ran short, 

and hospital tents could not be found . Only 

one steamer was avai lable to move the sick; 

the quartermaster's men occupi ed her 

HUSSC, Documents I, no. 42:4 and 6. Simons was 

the physician who ned Ft. Riley at the time of the 

cholera epidemic in 1852. 

HENRY H EWIT. (CO/lrlesy OJ Nalional LibUllY oJ Medicine.) 

lower deck and appa rently scheduled her 

use, giving the Medical Department a low 

priority. Grant ordered Brinton to travel to 

St. Louis to see whether he could obtain 

more vessels. "After some delays," Brinton 

reported, he "succeeded in procuring other 

steamers, the first of the noble hospital 

fleet of the western waters."" 

By the time the Confederate forces attacked Grant's army at Shiloh on 6 April, 

a "prolific diarrhea that resisted obstinately the ordinary therapeutic means" 

had added to the amictions of his men. In 

combination with malaria, this ailment, 

which was blamed on the water of the Tennessee River, greatly weakened many of 

Grant's soldiers. The nature of the battle, 

<4'Quote from MSfI I , app.:29; sec also MSH 2, 

pI. 3:97 1. 
198 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

furthermore, made prompt and proper care 

of the sick and wounded extremely difficult, for in overrunning the Union camp, 

the enemy made off with the medical suppli es, stretchers, and ambulances th ey 

found there. No shelter was available to 

protect the wounded from a heavy rain, 

bedding was nonexistent, and food supplies 

were low. Nevertheless, medical officers 

made the best use of what they could find, 

while sending a "pitiful telegram" to the 

newly install ed Surgeon Genera l Hammond asking for help. The reply they received the next morning promised 10,000 

mattresses which, unlike the items requested by TripIer during the Peninsular 

campaign, "came with wonderful quickness." Grant ordered that all tents in his 

army be taken over for the use of the 

wounded, and at least one surgeon made 

wholesale use of captured tents for his patients. Hewit, as Letterman would do several months later, appointed his most 

skilled surgeons to cond uct all operations. 

Steamers, includ ing the tleet provided by 

the U.S. Sanitary Commission, aided in 

evacuation, and Hewit ordered a medical 

officer to board each vessel and to perform 

en route further surgery as needed." 

When Buell's army arrived to aid Grant 

at Shiloh, his surgeons could offer little in 

the way of medical supplies to ease the effects of the shortage. They had few of the 

needed items with them because they had 

moved so quickly. A few days after the battle, however, the supply train arrived, along 

with "constant stream of civilian surgeons, 

and sanitary commission agents, men and 

women," and a constant stream of the sick 

as well. Steamers took them off by the thousands, while three doctors at a nearby con49First quote, MSfl J, app.:29; second and third 

quotes, Brinton, Memoirs, p. 171; see also Maxwell, 

Sanitary Commission, p. 132, and Duncan, Medical 

Deparimelll, pt. 3, p. 4. 

va lescent hospital screened those who 

appeared chroni cally ill before discharging 

them from the service. The work load of 

the medical officers at Shiloh began to diminish only many days after battle.50 

The spectacle of unnecessary suffering 

brought about by the lack of tents and medical supplies at Shiloh apparently did not 

impress General Buell with the need to give 

his medical director more support. Before 

the battle of Perryville, Kentucky, on 8 October, for example, after Murray had ca refully acq uired all the supplies needed for 

each regiment, Buell ordered that everything that could not be carried in one 

wagon per brigade be left behind. Since his 

men were not allowed to bring tents with 

them, none were available for use by surgeons. The strain of the long march that 

preceded the battle was great, and illness 

took a heavy toll above and beyond that of 

the battle itself. After the contlict, Buell 

abandoned the sick, without tents, often 

without shelter of any kind, without blankets, without bedding. Suppli es that had 

been ordered were inexplicably held up by 

the quartermaster and did not arri ve for 

two weeks. Thousands were ill wi th typhoid fever, erysipelas, measles, diarrhea, 

and dysentery, and only the prompt aid of 

the U.S. Sanitary Commission prevented 

an even greater disaster. When the sick and 

wounded could be moved, they were evacuated, usually in empty wagon trains used 

by the commissary to carry stores." 

Major General William Rosecrans, who 

led the Army of the Misissippi before succeeding Buell in command of the Army of 

50Quote from Sherm an, Memoirs 1:246; Llrs, 

McDougall to Hammond (4 and 8 May 1862), both 

in RG 112, ent ry 12. 

SIUSSC. Documents I, no. 56: 1, 15. Unless other· 

wise indicated, all material concerning operations in 

the West in the fall of 1862 is based on MSH I, 

app.:242- 6S. 
THE CIVIL WAR IN 1862: LEARNING ON THE JOB 199 

the Cumberland in October, was a man 

more in Grant's mold than in Buell's. In 

Mississippi, at both the battie of Iuka on 

19 September and that of Corinth in earl y 

October, the surgeons with his army were 

well suppli ed with a ll they needed, from 

tents to ambulances. The establishment of 

hospitals was easily managed and, according to his medical director, surgeon Eben 

Swift, the wounded received prompt and 

excellent care. Oddly enough, however, 

Swift also noted, without ex planation but 

almost proudly, that patients wounded at 

Iuka received no anesthetic and that " not 

a groan or sign of pain was heard." Even 

after the battie of Murfreesboro in Tennessee in late December, when the hospitals of the right wing, their wounded, and 

their supplies were captured, when the 

ki lled and wounded eventually numbered 

about 4,000, and when several surgeons deserted, the ambulance corps "worked admirably" under the system originally set up 

by Murray, and Swift was able to provide 

"comfortable shelter for all." " 

Although the engagements west of the 

Mississippi in 1862 did not become as famous as the battles of Shiloh, Antietam, 

and Fredericksburg, two batties each resulted in at least 800 wounded. In March 

the battle of Pea Ridge in northwestern Arkansas left almost 1,000 injured, while in 

December about 800 were hurt in the struggle at nearby Prairie Grove. The surgeons 

in volved faced the same problems as their 

counterparts east of the Mississippi , Supply was particularl y difficult. The end of 

the Pacific Railroad was in Rolla, Missouri, 

240 miles from the battlefields in Arkansas, and Confederate raiders easily cut off 

suppl y wagons before they reached their 

destination. Buildings of a size adeq uate 

for hospital use were also hard to find , but 

SlQuotcs from MS/-/ I, app.:256. 

EBEN SWIFT. (Collrtesy of National Library 

of Medicine.) 

the lack of a network of deep ri vers made 

evacuation to distant general hospitals difficult. Because ambu lances and wagons 

had to use rough roads, medical officers 

preferred not to move their patients far. 

The number of casualties forced surgeons 

to rely heavily on the Western Sanitary 

Commission for hospital supplies, bedding, and clothing after both battles, but by 

late December medicines, hospital stores, 

and ambulances were plentiful. " 

Most of the casualties from the Arkansas 

battles remained west of the Mississippi, 

and at least one general hospital, near Las 

Vegas, New Mexico, was established to care 

for the wounded from military action in the 

Far West. This facility, established at a hot 

SJ Forma n , Westerll Sanita ry Commission, 

pp, 27-30, 61- 62; MS II I, app,:340- 43. 
200 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

spring a few miles from the town, served 

more as a shelter for convalescents than as 

a hospital because the seriously ill or 

wounded could not tolerate the long overland trip necessary to reach it. When a few 

casualties from beyond the Mississippi 

ended up in general hospitals of the Midwest, however, complaints arose because 

nurses were not always sent with the sick 

and wounded, and officers commanding 

units near the hospitals were thus forced to 

detail their own men to care for patients 

from other commands" 

Conclusion 

The problems of the Medical Department were much the same in both the East 

and the West, and the solutions devised to 

deal with them were generally similar. The 

immediate care and evacuation of the 

wounded from the battlefield was everywhere largely dependent upon the tide of 

battle. Patients could never be guaranteed 

speedy and efficient care, but medical directors learned much in 1862 that helped 

HSherman, Memoirs 1:274; MS/-/l. app.: 346- 47. 

them devise a more effective chain of evacuation from battlefield to general hospital. 

As line officers began to understand both 

the importance of speedy evacuation and 

efficient medical care and the nature of the 

problems facing the Medical Department, 

the significant progress already made in 

dealing with the administrative problems 

involved in evacuation would continue. 

Nevertheless, as the year came to a close, 

medical problems in the form of disease 

and infection were becoming increasingly 

insistent. The sick rate was three to five 

times that found in young civili an men because as the Army expanded, ever larger 

numbers of men were being thrown together under conditions of stress, inadequate sanitation, and poor diet. Efficiency 

required centrali zation, and the sick and 

wounded would be crowded into hospitals 

that were increasing in size. As a result, the 

growing threat of typhoid , erysipe las, 

scurvy, and other forms of disease and infection cast ahead of it an ominous shadow 

as 1862 drew to a close" 

5'Jarvis, "Sanitary Condition," p. 473. 
CHAPTER 10 

The Civil War in 1863: 

Hammond's Last Year 

The appointment in 1862 of a vigorous, 

ambitious young medical officer as surgeon 

general and his encouragement of new approaches to Medical Department problems 

held out great promise for 1863. Under the 

guidance of William Hammond the Department was already rapidly recovering 

from the initial shock inflicted by the Civil 

War's unprecedented demands and taking 

the steps necessary to evacuate and care for 

thousands of sick and wounded soldiers. 

Failing to appreciate the serious danger 

posed by his strained relationship with Secretary of War Stanton, Hammond apparently assumed that 1863 would be but the 

first full year of a long and successful career 

as surgeon general. 

Administration a/the Medical 

Department 

In spite of Hammond's confidence, the 

surgeon general's position was already beginning to deteriorate in the spring of 1863. 

Stanton was quite willing to manipulate 

events to effect the surgeon general's departure from office, and Hammond played 

into Stanton's hands by his tactless management of the explosive matter of the Army's use of calomel and tartar emetic as 

medicines. Hammond considered these 

drugs too dangerous for everyday use, but 

his removal of both from the supply table 

in May caused a great furor, despite the fact 

that he did permit special requests for 

either drug when a need could be established. At least one surgeon maintained 

that he continued to use both items as before. The clamor that Hammond's order 

caused thus seems out of proportion to the 

step taken, but the discussion of the matter 

ranged far and wide. Some agreed with the 

surgeon general and called his order "judicious, and even necessary," but many 

physicians were furious that Hammond 

would presume to tell other doctors what 

they could or could not prescribe. The potential for misuse was no excuse, they said, 

for barring tartar emetic and calomel from 

the supply table.' 

Hammond's elimination of calomel and 

tartar emetic from the supply table probably cost him supporters at a crucial time. 

His position was rapidly deteriorating as 

IQuote, " Removal of Calomel and Tartar Emetic," 

American Medical Times 6 (1863): 297; Blustein . 

" Hammond," pp. 95-97; MSH 3, pI. 1:965; M. Goldsmith , " H ow to Get Suppl ies fo r the Sick and 

Wounded of OUf Arm y," Sanitary Reporter I 

( 1863):33; "Calomel and Tartar Emetic in the Army," 

American Medical Times 6 ( 1863):299; Gert H. Bri e· 

ge r, "Therapeutic Connicts and the Ameri can Mcdi· 

cal Profession in the 1860s," Bulletin of the f1isloryo! 

Medicine 41 (1967):220-22; Llrs, Byrne to Mansfield 

(2 Mar 1863) and SGO to "Dear Sir" (12 Jun 1863), 

both in RG 112, entry 2, 34:322 and 35:199, respec· 

lively; "Circular No.6," Transactions oflhe American 

Medical Association 14 ( 1863):29-33. 
202 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

1863 came to a close, and Stanton continued to manipulate events to hasten his subordinate's demise. In the spring of the year, 

Stanton apparently refused to allow Hammond to travel west to investigate complaints about the work of the Medical 

Department there. In the summer, after appointing a commission headed by one of 

Hammond's personal enemies to investigate the department, the secretary of war 

relieved Hammond of his duties as surgeon 

general and sent him on an inspection tour 

to the South and West, a ppointing 

Joseph K. Barnes, who would be the next 

surgeon general, to act as head of the Medical Department. Barnes formed a close 

friendship with Stanton shortly after reporting for duty in Washington in mid1862 and had already received two promotions in 1863.' 

When Hammond set out on his journey 

in September, Stanton was almost ominously cordial. In early December, the Secretary of War found grounds for 

reprimanding Hammond, who responded 

not by resigning under fire, as his predecessor had done, but by asking for either a 

court-martial or a board of inquiry. He also 

asked for permission to return to Washington, where Stanton had, in Hammond's 

absence, been working to end his tenure as 

surgeon general. Stanton denied the request, but Hammond's health produced a 

solution to his problem, as it had in 1860. 

A few days before Christmas, after falling 

on the steps of a Nashville hospital and 

2Brieger, "Therapeutic Con fli cts," p. 220 n. I ; 

WOR, se r. I, 30, pI. 3:245; WOR, ser. 3, 3: 11 99; 

Strong, Diary. p. 306; James M. Phalen, Chiefs a/the 

Medical Deparrmen[ oj the Ullited Slales Army, 

1775- 1940. Army Med Bull No. 52 (Carlisle Barracks, 

Pa.: Medical Field Service School, Apr 1940), p. 48. 

Unless otherwise indicated, all material on Hammond's problems with Stanton is based on Blustein, 

"Hammond," pp. 102- 05, and Maxwell, Sal/itar)1 

Commission, pp. 234-37. 

striking his head and back, Hammond suffered a temporary paralysis of both legs below the knees, an inju ry that he used to 

justify his return to Washington, where he 

co uld more easi ly dea l with Stanton's 

attack. J 

Under the circumstances, it is not surprising that Hammond's relationship with 

Stanton continued to affect adversely some 

of the surgeon general's favorite projects. 

Even though, early in 1863, Hammond was 

completely prepared to open his postgraduate Army Medical School, for example, 

and had determined which surgeon would 

teach each course, in the early fall and after 

the briefest of inspections, Stanton refused 

to approve the start of classes. On the other 

hand, when Hammond established successful laboratories for the Medical Department as part of its purveya nce 

operations, and even Barnes, who was not 

given to praising either Hammond or Hammond's accomplishments, praised them, 

Stanton did not close them down. Although 

no attempt was made at these faciliti es to 

compound all the medicines the department used, by the end of 1863, after less 

than a year in operation, the laboratory in 

Astoria, New York, was making eightythree of the items on the supply table. With 

the aid of the laboratories, Hammond 

could stockpile drugs, thus sparing the 

Army the effects of shortages and the resultant fluctuati ons in prices. Surprisingly, 

Army laboratories neve r manufactured 

quinine, despite the fact that the process of 

making it was relatively simple and the 

variations in its price quite marked. They 

tested quinine, however, and any other 

item susceptible to adulteration. The operations of the three facilities at Astoria, 

.lSt rong, Diary, pp. 359, 394; Louis C. Duncan, "The 

Days Gone By: The Strange Case of Surgeon General 

Hammond," Military Surgeon 64 ( 1929): 109; WOR , 

scr. 1, 31 , pt.3:485. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 203 

Philadelphi a, and St. Louis resulted in a 

considerable savings for the Army during 

the course of the war from 1863 on. The 

laboratory at Philadelphia alone was credited with saving more than $75,000 from 

1863 th rough 1865 .' 

Stanton's distrust for Hammond's projects did extend to the Army Medical Museum, which he apparently convinced the 

president was merely "a mon ument to 

Ge neral Hammond ." But Ba rnes again 

foun d himse lf agree ing with the be leaguered surgeon general. Upon assuming 

the responsibilities of the head of the Medical Department in the fa ll of 1863, Barnes 

encouraged medical offi cers to continue 

sending in interesting specimens. More 

than 1,300 items had already arri ved in 

Washi ngton by 1 January 1863, and the 

Medical Department employed one man to 

serve as a water colorist and another as a 

" bone artist" to fu rther the work of the 

museum. 5 

The best proof that Hammond's difficulties stemmed more from his personality 

and conflict with Stanton than from his 

management of the Medical Department 

was Barnes' continuance of Hammond's 

policies and, with the exception of the illfated medical school, Barnes' support of 

Hammond's favo rite projects. The Medical 

Department worked without Hammond's 

hand at the helm as it had when he was 

'MSH I, pI. 3:965; Ltrs, A. K. Smith to SGO ( 14 Sep 

1863), and Barnes to Stanton ( 17 Sep 1863), both in 

RG 112, entry 12; George W. Smith, Medicines/or fhe 

Unioll Army: The United Slates Army Laboratories 

During (he Civil War (Madison, Wis.: American In· 

stitute of the History of Pharmacy, 1962), pp. 14- 15, 

37, 42, 60-6 1; Brinton, lvlemoirs, pp. 259-60. 

SFirst quote , Maxwell, S(lflitary Commission, p. 237; 

Daniel S. Lamb, "History of the Army Medical M u· 

scum," Military Surgeon 53 ( 1923):99, second quote 

from p. 98; Ltf, Earnest Goodman to J. F. Day, C. H. 

Lord, and D. H. Stri ckl and (24 Apr 1863), Ms 11350, 

NLM; Schulli"n and Roge rs, "National Library," p. 9. 

J OSEPH BARNES. (Courtesy 0/ National LibrcllY 0/ Medicine.) 

there, and the furor that would engulf him 

affected the sick and wounded very little. 

Regardless of who was at the helm, the 

major concern of the Medical Department 

was always the day-to-day care of sick and 

wounded. With soldi ers joining the Army 

by the thousands, the number of sick for 

whom the Medical Department was responsible grew rapidly. This increase was 

not unex pected, since new troops were always vulnerable, and epidemics traditionall y fo llowed their entry into mili ta ry 

service. Malaria was so common, however, 

that its occurrence was taken for granted. 

\( was generally treated in the fi eld unless 

the patient was also ill with some other disease. Possibly because those who had contracted such diseases as typhoid fever in 

earlier years had become immune, but perhaps also because of improved sanitation, 

the disease rate in the category of contin-
204 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

ued fevers was actually dropping. A breakdown of fevers into specific disease 

categories recognizable today was rendered 

particularly difficult by the invention of a 

new entity, typho-mala rial fever, which 

may have been typhoid, malaria, both, or 

neither. Yearly statistics for diarrhea and 

dysentery, still the most common afflictions, could be misleading for, unlike typhoid, they could be both chronic and 

recurrent. For this reason cumulative figures tended to exaggerate the number of 

men who were actually ill with these problems over a twelve-month period. The figure s for 1862 and 1863, however, do 

suggest a marked increase in the total number of typhoid sufferers and a significant 

upward trend in the acute form of this socalled malady. Scurvy cases were also on 

the increase, and given the nature of the 

soldiers' diet, it is entirely possible that 

many more than the figures suggest were 

suffering from subclini cal scurvy, or in 

other words, the more subtle effects of a 

vitamin C deficiency.' 

To care for those who were seriously ill 

as well as for those who had been severely 

injured, the number of general hospitals 

serving the Army increased from 151 sheltering fewer than 59,000 patients as reported in the ann ual report of 1862 to 182 

the following year, with 84,472 beds. Not 

all of the beds by any means were in use 

at all times, since many had to be available 

to accommodate thousands of new patients 

after major battles. Many of the institutions of 1862 failed to survive through 

1863; ten were closed in 1863 in Philadelphia alone as new faci lities replaced the 

old. Hammond continued to place patients 

as near their homes as possible. While 

'MSH I, pI. 1:147, 297, 452, and pI. 3:190-9 1, 193, 

199; Smith, "Typhomalarial Fever. I, .. pp. 182, 220, 

287-321. 

many hospitals were located in such maj or 

eastern cities as Philadelphia, New York, 

Boston, Baltimore, and Washington, others 

could be found throughout the Midwest, 

often along the Mississippi and its tributaries, where they could easily be reached 

by steamer. Still more were located at least 

temporarily near major battlefi elds, from 

Gettysburg, Pennsylvania, to Vicksburg, 

Mississippi.' 

Moving ever larger numbers of patients 

to hospitals made necessary a more sophisticated approach to evacuation. Much 

attention was devoted in 1863 to new designs for hospital cars, ambulances, and litters. Boards of medical officers met to 

consider these new designs, and the quartermaster general himself was invited to inspect a new railroad car. Enthusiasm for a 

prototype led to the building of more cars 

on the basis of various designs inspired by 

civilian organizations, and to their eventual use on runs to such cities as Philadelphia, Baltimore, and New York, as well as 

Harrisburg, Pennsylvania, and Louisville, 

Kentucky. A new type of ambulance, a 

four-wheeler named for Tripier that could 

carry ten men, was also developed, but its 

usefulness was limited by the fact that it 

was so heavy that four horses were required 

to pull it.' 

Keeping track of the patients who wen t 

in and out of this network of hospitals was 

difficu lt. Letterman had developed detailed forms to faci litate the submission of 

detailed reports. In practice, however, it 

1War Department, SGO, Anllllal Report, 1862, p. 5 

and 1863, p.3; WOR, ser. 3,2:389, 3:964-65; Ltrs, 

Hammond (Ind, 14 Mar 1863). RG 112 , entry 2, 

34:381 ; John Campbell to Barnes (2 Dec 1863) and 

McDouga ll 10 SG (4 Jul 1863), both in RG 11 2, 

entry 12. 

' MSH2 , pI. 3:928, 948- 49, 959- 60 n. 1, 968; " Hospital Cars," Sanitary Reporter I ( 1863):30; USSC, DocIImel1fS 2, no. 75:6; Turner, Vierory Rode the Rails, 

p. 302. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 205 

TRIPLER AMBULA NCE, FOIn il/llslralion in Medical and Surgical History. 

proved impossible to keep detailed accounts of the treatment, condition, and location of each patient from the moment he 

entered the care of an Army surgeon until 

he was discharged and to move these documents with the pati ent as he was evacuated and transferred from place to place. 

Overworked Army surgeo ns could not 

guarantee that detailed records would be 

ready to accompany the wounded when 

they were moved on short notice. A board 

that met late in 1863 to consider the problem devised a system calli ng for registers 

to be kept at each facility and turned in to 

the Surgeon General's Office, where the 

files from various institutions wou ld be 

compared to eliminate duplications' 

The word evacuation is associated pn9Brinton, Memoirs, pp. 249-52. 

marily with the wounded, but the sick continued to form th e major part of th e 

Medical Department's burden. Efforts to 

keep the unhealthy from entering the Army 

in the first place were intensified in 1863, 

and penalties were set for surgeons who 

were less than strict in this regard. Other 

approaches to the prevention of disease involved improved sanitation and hygiene 

and closer attention to the soldier's diet. 

The medi cal officer was handicapped, however, by the fact that he could only advise 

concerning the prevention of disease." 

The conviction that improper cooking, 

which usually meant frying, caused much 

'O"Responsibility o f the Arm y Surgeon," Sanitary 

Reponer I ( \863):28; U.S. Provost Marshal General, 

The Medical ParI oj fhe Filial Report Made fa fhe Secretary of War (Washington: Government Printing Office, 1866), pp. 3-4, II. 
206 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

AMBULANCE DRILL. (Courtesy 0/ Massachusetts Commandery Military Order o/the Loyal 

Legion and the u.s. Army Military History lnstitllle.) 

illness led to an attempt to make both medical and line officers responsible for culinary efforts. More worthwhile were efforts 

to guarantee that the soldier was offered an 

adequate amount of fruits and vegetables. 

Many line officers, however, failed to recognize the symptoms of scurvy or te realize 

how, even in its early stages, it could undermine the strength of their men. Because 

of their failure to understand the importance of potatoes to the health of their commands, officers sometimes casually helped 

themselves to supplies intended for the 

troops. Staff officers might thus appropriate 25 barrels out of every 100 for their 

personal use and that of their fami lies and 

servants. Since another 25 might be siphoned off at the corps level and still more 

disappear as the shipment descended 

through the di vision and brigade levels, the 

men might receive none, even when authorities at the highest levels believed thai 

the troops were adequately supplied. Hospitalized soldiers were not completely dependent upon the Commissary 

Department, which was responsible for 

supplying food to the troops in the field, 

because the Medical Department's purveyors supplied medicines as well as delicacies, 

which they continued to obtain from such 

organizations as the U.S. Sanitary 

Commission,ll 

Although otherwise few com plaints 

II H. A. Warriner, "Vegetables, Humanity, Patriot ~ 

ism" and "The Condition of the Army of the Cumberland in the Spring of 1863-The Aid Rendered by 

the Co mmission," both in Sanitary Reporter I 

(1863):92 and 2 (1864):1 53, respectively; John Ordronaux, HilliS 011 Health ill Armies/or l/ie Use of Vol- ullleer Officers (New York: D. Van Nost rand, 1863), 

p. 63; Grace, Mallua/, pp. 75-76; John Gardner Perry, 

Lellers From a Sllrgeon o/lhe Ch,jJ War (Boston: Little, 

Brown & Co., 1906), p. 129. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 207 

about suppli es deve loped during 1863 , 

problems relating to the caliber of the surgeons who worked in the Army continued. 

States still administered the exams for surgeons attached to volunteer regiments, and 

medical boards that convened to look into 

questions of competence might weed out 

two-thirds or more from among them. The 

dismissal from the service of doctors who 

were deemed unqualifi ed contributed , 

however, to a shortage of physicians at a 

time when volu nteer regiments still might 

report for duty without their fu ll complement of medical officers. Surgeons were 

also needed to serve the new black regiments being formed , but they were recruited specifically for this duty rather than 

chosen from among those a lready recruited, and few were enthusiastic about 

the assignment. They were required both 

to be graduates of orthodox medical 

schools and to submit to the scrutiny of a 

medical board, but since few came forward, 

the hospital care of blacks often devol ved 

upon stewards appointed to act as assistant 

surgeons. Black army surgeons were few 

and not always well received. " 

Nurses, like doctors, were often overworked, especially in the West, and confusion over who would pay contract nurses 

left many without wages for weeks early in 

the year. The hardships they might have to 

endure were apparently unappreciated, for 

their pay was reduced from $20. 50 a month 

to $ 13, plus a $3-a-month allowance for 

clothing. An order issued in the fall of 1863 

permitted the surgeon general to appoint 

'2"Responsibility of the Army Surgeon," Sanitary 

Reporter 1 (1863):28; Ltf, Hart to his wife (I Feb 

1863), in Correspondence and Diary, Ms CI46, NLM; 

Cir (2 Oct 1863), RG 11 2, entry 2, 36:155; Llrs, Letterman to SG (8 and 13 Jan, [ I Mar, and 21 Sep J863) 

and Israel Moses to SG (I May 1863), all in RG I t 2, 

entry 12; Briggs, Civil War Surgeon, p. 117, Benjamin 

Quarles, Tile Negro in 'he 0'1'1" War ( Boston: Little, 

Brown & Co., 1953), pp. 203- 04. 

female attendants without consulting Dorothea Oix. Although this power, which 

could be delegated to hospital directors, 

was designed for use when acute shortages 

made it desirable that appointments be 

made as rapidly as possible, it also enabled 

the department to bypass Dix at any time 

that the surgeon general desired to do so. 

The order, which also required that no 

more than one nurse be assigned to every 

thirty beds, emphasized that women nurses 

were under the exclusive control of the senior medical officer of the hospital in 

which they served and that he could assign 

them their duties as he wished and dismiss 

them for incompetence or disobedience." 

The establishment of an official organization in 1863 to manage Negro units 

would lead befo re the war's end to the enlistment of more than 186,000 blacks and 

required planning for the medical care of 

their sick and wounded. Since authorities 

apparently believed that public opinion 

would not permit the sharing of the same 

facilities by both blacks and whites, special 

hospitals had to be set aside for the use of 

this new class of recruits, and black male 

and femal e nurses were hired under contract fo r a maximum of $ 10 a month to 

work in them." 

The shortage of nurses had already led 

to use of convalescents in hospitals, but in 

1863 the Army took steps to assign those 

who were chronically ill or permanentl y 

crippled to work in these facilities. General 

'lForman , Wesfem Sanitary Commission, p. 27; 

Grace, lv/allilal. p. 86; Ltrs, C uyler to Hammond 

(20 Jan 1863), B. Choate to John Carpenter (26 Jan 

1863), and Head to Hammond (28 May 1863) and eir, 

Magruder (23 Apr 1863), all in RG 11 2, entry 12; 

"Surgeon Meylert's Letter Continued," Sanitary Re· 

pOrler 1 (1863):79. 

'4Ltrs, Magruder to SG (14 Apr 1863) and Suckley 

to SG (21 Nov 1863), and Cir, Magruder (23 Apr 

1863), all in RG 11 2, ent ry 12; "Surgeon Meylert's 

Lette r Continued," Sanitary Reporter 1 (1863):79. 
208 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

orders now required that invalids capable 

of light duties be mustered in detachments 

for work as hospital attendants, clerks, 

cooks, and guards. Many of the men so assigned were apparently the victims of 

chronic diarrhea or general weakness resUlting from wounds or disease, but occasional nurse-invalids were men who had 

deliberately injured themselves, cutting off 

their own thumbs, for example, in what 

would, with the creation of the Invalid 

Corps, prove a futile attempt to avoid further military duty. " 

Care of the Sick and Wounded 

in the East 

In early January 1863, the Army of the 

Potomac was still reeling from the disaster 

at Fredericksburg just a few weeks earlier. 

Anticipating renewed hostilities, General 

Burnside established a medical facility 

nearby at Aquia, hoping thereby to avoid 

sending his sick back to general hospitals 

when his army advanced. When heavy 

rains and flooding forced him to abandon 

his campaign, he broke up the establishment at Aquia, sent the seriously ill back 

to Washington, and set up regimental hospitals to care for those with minor ills. For 

patients who could not be cared for in these 

small facilities, Jonathan Letterman as 

Burnside's medical director formed division hospitals wherever needed within each 

corps, thus providing his medical officers 

with experience in running such 

organizations. 16 

"MSH 3, pt. 1 :28; Paul Fatcut, ed., Letters oj a Civil 

WarSllrgeon (West Lafayette, Ind.: Purdue University 

Studies, 1961), pp. 57- 58; Roberts Bartholow, A Manual 0/ Instructions for Enlisting and Discharging So/-

diers (Philadelphia: Lippincott, 1863), pp. 216- 17. 

16UnJess otherwise indicated, all material on the 

medical care given the Army of the Potomac is based 

on Letterman, Recollections. 

As they settled down near Falmouth, just 

north of Fredericksburg, in late January, 

the 120,000 men of Burnside's command 

were considered to be on active field duty 

rather than in winter camp. Since the Army 

provided them with no structures for shelter except inadequate tents, the men often 

dug shallow pits in the "wide-spreading sea 

of mud and mire," erecting log huts over 

these foundations and covering the logs 

with either tents or brush and mud. The 

Medical Department deplored this custom, 

but many regimenta l co mmanders appeared to be little concerned about the 

health and welfare of their men. Nevertheless, the sick rate among veterans initially 

held at 5 percent, and the rate for the Army 

of the Potomac as a whole, including fiftysix new regiments, was 8 percent. Letterman considered this record good under the 

circumstances, although he added that new 

recruits seemed to be suffering with unusual frequency from venereal diseases and 

hernia.17 

At the end of January, when he relieved 

Burnside, Maj. Gen. Joseph Hooker was 

much concerned with the health of his new 

command, since diarrhea, scurvy, and a fever that was probably typhoid afflicted 

many. Enlisted men were receiving very little of what Letterman considered to be the 

ample amounts of vegetables shipped to 

them. In early February, however, after 

Hooker himself expressed his determination to have the troops receive an appropriate diet, fresh bread and vegetables were 

issued. Letterman believed that the improved diet, together with better sanitation 

and greater care with cooking, was responsible for an improvement in health-by 

April the overall sick rate stood at 7 perI7Quote from Letterman, Recollections, pp. 102- 03; 

Ltr, Letterman to SG ( 15 Jan 1863), RG 112, entry J 2. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 209 

cent. The rate of diarrhea-like ills had 

dropped from 5.4 percent in February to 

3.4 percent, fevers were being encountered 

less frequently, and even the able-bodied 

were stronger and more vigorous." 

Improving the physical condition of the 

troops was but part of the preparations Letterman made for the campaign to come. 

Although an Army-wide reorgani zation 

had removed the District of COlumbia 

from the control of the commanding general of the Army of the Potomac and thus 

the general hospitals of Washington from 

the control of its medical director, Letterman's hands were still full. He soon found 

it necessary to appoint first one and then 

a second medical officer to assist him by 

acting as inspectors for the Army of the 

Potomac. In addition, he issued orders to 

each corps medical director to appoint a 

surgeon to serve as medical inspector for 

his unit. Letterman also used the winter to 

establish medical boards to examine medical officers charged with incompetence. 

Many new regiments had joined the 

Army of the Potomac since the preceding 

autumn, and in early April Letterman outlined once again how he wished the Medical Department under him to operate 

during battle. He also issued a call for a 

private from each company to report for 

ambulance duty wearing a green badge to 

identify him as a member of the ambulance 

corps and pointed out that all attendants 

below the rank of sergeant must turn in 

their arms before the start of battle. Letterman's desire to keep as many patients 

as possible in field hospitals intensified the 

need for a " regularly trained Corps of Hos18$trong, Diary. p. 321; Huston, Sinews, p. 224; Rpt. 

(filed with Ltf, Letterman to S. Williams, 4 Apr 1863), 

RG 11 2, entry 12. 

pital Attendants," but he never succeeded 

in establishing such an organization." 

Before Hooker's army started out for 

what would be known as the battle of Chancellorsville, his medical director set up tent 

hospitals along the railroad from Fredericksburg to the depot at Aquia. Here the 

wounded could remain with their comrades, at the same time providing experience in postoperative care for Hooker's 

surgeons. Organized by division , but 

grouped by corps, these facilities were, in 

his opinion, "abundantly supplied with officers, nurses, cooks, medicines, etc.," so 

abundantly, in fact, that he reportedly told 

Hammond that he did not want to have any 

civilian physicians and nurses sent to the 

field. An assistant surgeon in the Army of 

the Potomac, however, later complained 

about the lack of "trained & disciplined 

nurses." The tent hospitals were located 

near one another, so that one line officer, 

appointed at Letterman's request, could 

serve as both quartermaster and commissary for all. Since he strongly believed that 

" life in a General Hospital tends to destroy 

the good qualities of a soldier," when the 

army marched, Letterman left 8,000 sick 

behind in the tent hospital, still under the 

care of their own surgeons, rather than 

sending them back to general hospitals.'o 

Two factors, both beyond the control of 

the Medical Department, complicated the 

care of the wounded at Chancellorsville. 

19Quote from Ltr, Goodman to McNulty, Ms fBSO, 

NLM; GO (no. 13,5 Apr 1863) and Ltr, Letterman 

to "Dr." (1 2 Apr 1863), both in Ms ffi50, NLM; Duncan, "The Bloodiest Day in American History- Antietam," in Medical Depar/mem, pI. 5, p. 37; Bennett 

A. Clements, Memoir of JOllathall Lellerman, M.D. 

(New York: G. p, Putman's Sons, 1883), p. 18. 

2°First and third quotes, Letterman, Recollections, 

pp. 113 and 143, respecti vely; second quote, MSH I, 

app.:138; Clements, Memoir, pp. 13-14; Ltf, letterman to SO ( 15 Jun 1863), RG 11 2, entry 12; sec also 

Letterman, Recollections, p. 142. 
210 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

Defeat caused hospitals near the battlefield 

to be repeatedly threatened with capture 

(the enemy took and later paroled almost 

1,200 wounded). Moreover, the rapid pullback of troops forced Letterman to evacuate the wounded over the long, rough 

twenty-five miles to the corps hospitals, 

rather than use facilities closer at hand. In 

addition, evacuation was made more difficult by Hooker's orders, wh ich prevented 

many wagons, including those with medical supplies, and all but two ambulances 

per division from crossing the Rappahannock River with the units moving on Chancellorsville. No stretchers or stretcher 

bearers were permitted over the river until 

late on 30 April, by wh ich time shelling had 

forced medical officers to abandon at least 

one hospital, and patients had, of necessity, 

been carried on litters improvised from 

blankets. Ironically, in a battle where many 

hospitals with their patients often had to 

be moved, the Medical Department was 

not as well prepared as it usually was for 

evacuation, but Letterman believed that 

the moves of the hospitals were, under the 

circumstances, well managed. After the 

battle was lost, it was only with difficulty 

that he was able to move enough ambulances across the river to return casualties 

to the north bank and to the corps hospitals. The approximately 9,500 wounded 

from Chancellorsvill e then traveled by 

train along the single track to Aquia , 

whence about 2,000 went by boat to 

Washington.

2I 

The care of his patients who had been 

captured by the enemy also concerned Letterman. Nineteen physicians had been 

taken prisoner with them. Encouraged by 

General Robert E. Lee, Letterman sent 

twenty-six more medical officers and five 

l'Fatout, Letters, pp. 59- 60; MSH I, app.: 124- 26, 

128-30, 135, 137- 38. 

wagon loads of medicines, blankets, and 

hospital stores through the lines. A week 

after the battle, Lee gave his permission for 

Union ambulances to come through the 

lines to pick up Union wounded, in so 

doing sparing these men the discomforts 

and dangers of a transfer from Confederate 

to Union vehicles at some halfway point. 

All captured Union wounded were back 

within Union lines by 15 May. " 

Letterman believed that his surgeo ns 

had, on the whole, acquitted themselves 

well at Chancellors ville and pointed out 

that three had been wounded in action, two 

severely. A volunteer surgeon, however, 

maintained in a letter that "many of the 

Medical men behaved badly-ran off over 

the river in the first day's fight and never 

came back at all." Only a few lines later, 

however, he admitted that some of those 

who ran off did indeed come back, but 

added that they had consumed "the Stimulants sent over the River by the Medical 

Director for our sick." This medical officer 

may have been inclined to embroider his 

story a bit, but he was not the only one to 

raise questions about Letterman's estimate 

of the situation at Chancellorsville. Hooker 

reportedly ordered that the number of 

casualties not be revealed, and, lacking information, Stanton had Hammond send 

John Brinton to the Chancellorsville area 

with the secret mission of gathering information on the number of wounded, while 

ostensibly obtaining specimens for the 

Army Medical Museum." 

In his memoirs, Letterman reported that 

9,518 men were wounded at Chancellorsville. Given the difficulty of obtaining accurate figures under the circumstances, his 

data compares well with that reported in 

22 WOR. ser. 1,25, pI. 2:432, 465- 66. 

HFirst and second quotes, Fatout, Lellers, pp. 60 

and 64, respectively; Brinton, l\IIemoirs, pp. 233-35. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 2 11 

the War of the Rebellion collection, wh ich 

states that 9,759 officers and men were 

wounded and 1,606 killed. Brinton, however, after noting that one could safely assume four to five men wounded for every 

one killed, estimated that the total number 

of casualties was about 23,000, a figure far 

higher than that given by his contemporaries, although his memoirs do not reveal 

how he arrived at this figure. " 

By mid-June, when Army of the Potomac 

patients were on their way to facilities in 

Aquia and Washington, the able-bodied 

were marching north under Hooker, fo llowing Lee, who was invading Maryland. 

Fortunately, the health of the Army of the 

Potomac was still generally good, for the 

weather was hot and the troops were 

pushed to cover twenty-five to thirty miles 

at a time, even when this meant marching 

at night. Water was scarce, and men collapsed and died from heat and stress. By 

the time they reached Pennsylvania, they 

were " much exhausted and but illy prepared to bear up under the shock of 

wounds." Hooker, however, had decreased 

the number of wagons allowed to supply 

the Medical Department's needs. During 

the last part of this ordeal, rain turned the 

dust to mud, and supplies were often abandoned along the roadside. It was fortunate 

that following the troops were Sanitary 

Commission wagons, and that their supplies were frequently replenished along the 

way. 25 

NBrinton, lv/email's, pp. 234-35; WOR, seT. I , 25, 

pI. 1:192. 

HQuole from [Justin Duincll), Medical Report oflhe 

Second Corps al lite Baule oj Gellysburg, Ms C129 

(hereafter cited as Duinell Medical Report), NLM; 

Frederick Law Olmstead, "Preliminary Report of the 

Operations of the Sanitary Commission With the 

Arm y of the Potomac, During the Campaign of June 

and Jul y. 1863," Salliwry Reporler I ( 1863):49. Unless 

otherwise indi cated, in addition to Letterman's Rec· 

ollef/iolls, all material of the Gettysburg campaign is 

based on Duncan's "The Battle of Fredericksburg" 

Although battle was expected almost momentarily, Hooker resigned as commanding officer of the Army of the Potomac on 

28 June, to be replaced by Maj. Gen. 

George G. Meade. In his determination to 

keep open roads to his rear, Meade further 

complicated supply problems for his medical officers by issuing orders that resulted 

in hospital supply wagons being kept well 

back from the battlefield. A medical officer 

returning from Washington with supplies 

was also ordered away from the battlefield 

on 2 July. As a result of these difficulties, 

although the fighting at Gettysburg finally 

ended on 3 July, tents were not generally 

available until two days later. Most medical 

officers had to rely entirely on the small 

medicine wagons that routinely accompanied ambulances in the field. One corps 

had in some unexplained way escaped the 

restrictions placed on the rest of Meade's 

army, however, and its experiences suggest 

what could have been done had the rest of 

the army not been handicapped. Its normal 

complement of hospital supply wagons was 

allowed to accompany it from Virginia and 

none had been held back from the battlefield. Thus equipped, XII Corps medical 

officers were ab le to evacuate their 

wounded from the field , bathe, dress, and 

feed them, all within six hours of the end 

of the battle. 26 

Meade's restrictions complicated supply 

at Gettysburg, but ambu lances worked 

freely. According to Letterman, of the more 

than 14,000 wounded, none who were 

within Union lines were left on the field, 

even though the 650 officers and 3,000 

and "High Tide of the Confederacy-Gettysburg," 

both in Medical Deparlmeflf, pts. 6 and 7, respectively, 

and on MSH I , app.:141 - 47. 

!6Clements, Memoir, p. 12; William Warren Potter, 

Reminiscences of Field-Hospital Sen';ce With the Army 

a/the Polomac (Buffalo: Buffalo /v/edica/ aud Surgical 

JourI/al, October and November 1889), pp. 15-16. 
212 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

GENERAL SICKLES' LEG. (Courtesy of 

Armed Forces InslilUle of Pathology.) 

drivers and stretcher-bearers of the ambulance corps had to work under fire, five 

of its members being killed and seventeen 

wounded. In bringing out the 12,000 whom 

the ambulances could reach, eight vehicles 

were damaged and a number of horses 

either killed or wounded. Nevertheless, 

since this battle lasted three days, the work 

of the ambulance corps was not as intense 

as it had been at Antietam and no serious 

difficulties developed." 

Although the placement of supply wagons far to the rear did not affect evacuation, it added to the difficulties of medical 

17Duinell Medical Report, Ms C129, NLM; Ri chard 

H. Shryock, "A Medical Perspective on the Civil 

War," Medicine ill America: Historical Essays (Baltimore: Johns Hopkins Press, 1966), p. 91. 

officers who were trying to establish hospitals in the field. For a time after the fighting stopped they lacked an adequate supply 

of tents and were forced to use any buildings they could find . They even had to leave 

some patients out in the open, where heavy 

rains added to their sufferings. Hospitals 

were often moved; one gro.uP was nooded 

out from a low-lying area that was otherwise both safe and convenient, and others 

had to be abandoned because of enemy fire. 

Some of these facil ities apparently served 

only as clearing stations, and ambulances 

might have to move patients twice, even 

when th e original hospital was not 

abandoned.28 

The burden on Union surgeons at Gettysburg was great. Although Sanitary Commission suppl ies met their most basic 

needs until Medical Department wagons 

could arrive, medical officers were not always able to keep up with their case loads. 

Some had to work through the night and 

well into the next day. As a result of the 

strain, many fell ill at one time or another. 

Those who were captured with their patients were forced to work with few medicines or instruments after their Southern 

counterparts helped themselves to Union 

supplies. In addition, thirteen Union surgeons were wounded at Gettysburg, and 

one died as a result of his injuries. 

One severely wounded patient who did 

not lack for attention from Union surgeons 

was Maj . Gen. Daniel Sickles, who managed to separate himself from his cigar long 

enough to have his right leg amputated at 

the thigh in a field hospital at Gettysburg. 

Immediately after the surgery, the medical 

director of the III Corps and forty soldiers 

accompanied the general while he was carried on a litter to a distant railroad depot. 

The surgeon remained with him for the rest 

21Duinell Medical Report, Ms C 129. NLM. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 2 13 

of his trip to Washington, where Sickles 

recovered from his wound and his leg 

joined the growing collection at the new 

Army Medical Museum." 

In spite of the large numbers of both 

Union and Confederate wounded remaining in the Gettysburg area, Meade found it 

necessary to take most of his 650 medical 

officers with him as he started his pursuit 

of Lee on 6 July. Only 106 Union surgeons 

remained behind, an average of I for every 

150 patients. Since some of the Confederate physicians left behind with the ir 

wounded had apparently deserted their 

charges, Letterman was forced to ask Hammond to send 20 more surgeons to Pennsylvania. The strain on Union physicians 

was great. Young John Shaw Billings wrote 

his wife on 9 July that he was "covered with 

blood" and "tired out a lmost completely," 

able "only [to] say that I wish I was with 

you tonight and could lie down and sleep 

for 16 hours without stopping." He added 

that he had been "operating all day long 

and have got the chief part of the butchering done in a satisfactory manner."30 

By mid-July the surgeons Letterman had 

requested arrived. Some private physicians 

from neighboring states came to help, but 

most were of little use, preferring to operate rather than to help wherever they 

were needed . Letterman , who accompanied Meade, also asked Hammond to 

send surgeons to join the Army of the Potomac on its march, to make up for those 

left behind at Gettysburg. An additional 

forty-seven medical officers reported to 

Letterman on 9 July. 31 

29W. A. Swanberg, Sickles Ihe Incredible (New York: 

Charles Scribner's Sons, 1956), pp. 216-2 1, 405 n. 16. 

lOQuotcs from Ltf, Billings to his wife (9 lui 1863). 

in Jolm Shaw Billillgs, A Memoir, ed. Fielding H. Gar~ 

rison (New York and London: Knickerbocker Press, 

1915), p. 65; Ltr, Swift to SG (18 Jul 1863), RG 11 2, 

entry 12. 

" Ltr, Swift to SG (1 8 Jul 1863), RG 112, entry 12. 

As rapidly as possible, the Medical Department shipped its patients from Gettysburg to general hospitals in the north. 

Hammond ordered that a medical officer 

"of experience" be found to coordinate the 

evacuation. Those remaining at Gettysburg 

were from both Union and Confederate 

armies, usually amputees or those with serious wounds, As the number of patients 

dwindled, surgeons attempted to consolidate them and near the end of July opened 

a new 1,200-bed tent hospital, dubbed Letterman Hospital or Camp Letterman, for 

their use, The new facility was nea r the railroad so that patients being sent north could 

be moved to their trains by litter. Although 

the presence of individual citizens anxious 

to help the wounded added a note of confusion to the facilities at Gettysburg, the 

Sanitary Commission and other volunteer 

agencies helped staff and supply Gettysburg hospitals, including Camp Letterman, 

which remained open until 20 November. 32 

Evacuation from Gettysburg hospitals 

was initially slower than expected, since 

few ambulances remained after Meade's 

departure. Before Camp Letterman opened 

near the station and until the Sanitary 

Co mmissio n opened a ISO-bed depot, 

many patients were left lying in the open, 

exposed to the weather as they wa ited for 

a train. The train trip from Gettysburg was 

also an ordeal. The rail line was in poor 

condition, with its bridges in particularly 

bad shape. Although the department 

32Quote from Ltf, Hammond to R. Smith (9 Jul 

1863), RG 11 2, entry 12; Duinell Medical Report, Ms 

C129, NLM; Ltr, Goodman to McNulty ( 13 Aug 1864) 

and Orders, Goodman (28 JuI1863), both in Ms fB50. 

N LM; Maxwell, Sanitary Commission, pp. 2 12- 13; 

Olmsted, "Preliminary Report," p. 50; Ltr, a surgeon 

at Camp Letterman to Steine r (coPY. 21 Sep 1863), in 

Steiner Report, Ms CI9, NLM; Anna Morris Holstein, 

Three Years ill Field Hospitals oj the Army oj the Potomac (Phi lade lph ia: J. B. Lippin cott , 1867), 

pp. 43-44, 49-51. 
214 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

t 

,. -.- -..:..-

.. ~ 

tr 

:'-------- 1 ~ . 

• ~~~"':~-:;O-: --- \ '. '- .~.. ----- - , ~ . .:.. t " 

GENERAL HOSPITAL AT GETTYSBURG. (Collrtesy oj Library oj Congress.) 

placed a surgeon and attendants on every 

car that carried patients, most of the 

wounded were in boxcars belonging to returning supply trains rather than in cars 

designed especially for their comfort. Patients had only straw or hay for bedding, 

but for longer trips they were supplied with 

urinals, bedpans, water coolers, and other 

conveniences. The department eventually 

evacuated an average of 800 men a day 

from the Gettysburg area northward." 

Because of factors beyond the control of 

either Letterman or the Medical Department, the death rate among the wounded 

after Gettysburg was unusually high and 

the wounds were unusually severe, The 

men had been exhausted even before the 

battle by their long, fast march in the heat. 

After they were injured, many suffered further from exposure to the elements, even 

llFatout, Leiters, p. 70; Maxwell, Sanitary Commission, p. 2 12; Duincll Medical Report, M s C l29, 

NLM; MSH 2, pI. 3:959. 

though the wounded among both Union 

and Confederate prisoners were dressed 

and under shelter of some kind within 

twenty-four hours of the end of battle. (The 

British took ten days to reach this point 

after the battle of Waterloo,) The Medical 

Department's achievements under adverse 

conditions illustrated once more the success of Letterman's approach to the problems involved in evacuating and caring fo r 

the wounded from a large modern army, " 

The army Letterman served was large 

and moved relatively long distances by 

land. The surgeons who participated in the 

J uly 1863 attempt to take Charleston, 

South Carolina, by an attack from the 

ocean found an entirely different challenge. 

Because the troops in volved were moving 

from one island to another, the Medical 

Department had to make extensive use of 

14Duinell Medical Report, Ms C 129, NLM; S. Weir 

Mitchell, "Medical Department in the Civil War," 

Jouma! of lite American Medical AssocitltiOIl 62 

(19 14): 1447. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 2 15 

JOH N CRAVEN OPERATING during siege of Ballery Wagner. (Courtesy of MassachlisellS 

Commandery M ilitary Order of the Loyal Legion and the u.s. Army Military History 

Institute.) 

boats to transport men, ambulances, and 

suppli es. On 8 Jul y immediately after the 

attack began, John J. Craven, the volunteer 

surgeon serving as medical director for the 

expedition, loaded ambulances and tents 

on the ferry that left Folly Island, where a 

hospital had been established, for Morris 

Island, where Union forces were besieging 

Battery Wagner, and where Clara Barton 

helped care for the hospitalized. The first 

field hospital that he established on Morris 

Island had to be moved once to avoid fire 

from Fort Sumter. His patients were evacuated by ambulance across the hard sand 

to the hospital and later by ferry to the facility on Folly Island. When more than 

1,200 casualties resulted from a second attack on Battery Wagner on 18 July, Craven 

decided to move all the wounded from 

Morris Island by steamer back to hospitals 

at Hilton Head and Beaufort, South Carolina, which he did in two days with the 

help of three naval medical officers and a 

physician from the Sanitary Commission. 

When arrangements for an exchange of 

wounded prisoners were complete, Craven 

went by steamer from Morris Island back 

to Hilton Head to pick up thirty-nine 

wounded Confederate soldiers. Meeting a 

Confederate vessel in Charleston Harbor, 

he exchanged his prisoners for about half 

of the Union wounded in enemy hands, 

105 officers and men, whom he sent back 

to Hilton Head." 

))MSH 1, app.:24 1- 42; WOR , ser. 1,28, pt. 2: 10; 
216 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Among the difficulties Craven experienced while on Morris Island was insubordination. During the siege of Battery 

Wagner, a volunteer surgeon openly defied 

Craven's authority. Even after the medical 

director of the Southern Department ordered him to obey Craven, the surgeon continued to set up hospitals for his men 

wherever and whenever he chose, but 

whether disciplinary steps were ever taken 

against the miscreant is not known. During 

the rest of the summer until the enemy 

abandoned Battery Wagner in September, 

Craven also encountered both malaria and 

scurvy. In the end, however, the efforts of 

the expedition were frustrated, and as 1863 

ended Charleston remained in Confederate 

hands." 

Although reports of scurvy from Unionheld areas along the southern coastline 

were not frequent, fevers continued to be 

very common. Soldiers in the New Orleans 

area were hit hard by "swamp fever," or 

typhoid; an officer under Butler wrote of 

hearing " the screams and howls of the patients in their crazy fits " in a hospital half 

a mile from camp and noted that twothirds of his regiment were dead or hospitalized. Fortunately, Union surgeons 

were prepared to treat malaria and took the 

problems it caused in stride. The mortality 

from malarial fevers was not high in proportion to the number of cases, but in the 

late summer and early fall, as many as half 

of the soldiers in some commands were off 

duty at one time because of these fevers, 

despite some use of whiskey and quinine 

or a related drug as a prophylactic. The 

"Report on the Sanitary State of the Troops at 

Charleston," USSC Sanitary Billie/in 1 ( 1866):81; Ishbel Ross, Allgel of (he Batllejield (New York: Harper 

& Bros., 1956), p. 62. 

}6Strong, Diary. p. 350; MSH I , app.:24 1; "Report 

on the Sanitary State," USSC Sanitary Bulle/ill I 

(1866):78, 81. 

men assigned to work along the railroad 

from New Bern to Morehead City in North 

Carolina, for example, freq uently fell ill, 

and those at two stations along the line had 

to be relieved every ten days as a result. 

Each regiment in North Carolina had its 

own hospital, but the Medical Department 

established general facilities in New Bern, 

Morehead City, and Beaufort to handle serious and chronic cases and to supply medicines to a growing number of former slaves 

working for the Union, as well as for their 

families. " 

Care of lhe Sick and Wounded 

in lhe Wesl 

Just as Meade was turning back Confederate forces at Gettysburg, Grant was accepting th e surr end er of Vicksburg, 

Mississippi, after a campaign that lasted 

six months. Grant's drive on the southern 

city, however, involved many lesser engagements rather than one or two great 

battles. 

Working under Grant for this campaign 

were three Army corps, one of which, under 

Maj. Gen. William T. Sherman, set an example for the others in the management of 

the sick and wounded, while a second, under Maj. Gen. John McClernand, particularly needed to improve in this regard. 

McClernand was more of a politician than 

a soldier and, like Buell before him, tended 

to neglect his sick and wounded, leaving 

them behind without supplies or attendants and, on at least one occasion, without 

ambulances as well. Despite rough terrain 

and poor roads, the ambulance system in 

17John William DeForest, A Volul/leer's At!lIewure, 

a Union Captaill's Record ojlhe Civil War, ed. James 

H. Croushore (New Haven, Conn.: Yale Uni versity 

Press, 1946), p. 152, quotes from p. 153; M SH I, 

app.:238- 39; Ltrs, F. G. Snelling to SG (10 and 15 Jan 

1863), both in RG 112, entry 12. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 2 17 

Sherman's IV Corps, which was basically 

that created by Letterman, was so effective 

that Medical Inspector Edward Vollum 

persuaded Grant to adopt it for his entire 

army. After March 1863, therefore, Grant's 

ambulance corps was organized by division, with a commissioned officer commanding each unit at the division level, a 

noncommissioned officer in charge of each 

at the brigade level, and one driver plus two 

enlisted men assigned to each ambulance." 

Just at the time Vollum persuaded Grant 

to adopt Sherman's ambulance plan for the 

entire Army of the Tennessee, a new medical officer, Madison Mills, a Regular Army 

surgeon, arrived to replace volunteer surgeon Hewit as medical director. Hewit had 

already established a base hospital at Milliken's Bend, northwest of Vicksburg on 

the Mississippi. Now Mills created a fieldhospital system for the troops taking part 

in the campaign, one that was designed to 

accommodate Grant's desire to keep as 

many of his sick and wounded as possible 

within his department. Mills also established both convalescent camps and corps 

facilities to supplemeQ! field hospitals at 

the division level, so that only the seriously 

incapacitated would need to be taken to 

distant general faciliti es." 

Mills' work was complicated by the fact 

that various units of the Union's Army of 

the Tennessee were moving about the countryside on either side of the Mississippi 

River as Grant attempted to close in on 

Vicksburg. In some instances, Union forces 

made no attempt to hold ground previously 

taken, and any wounded not moved with 

their units found themselves within the enemy's lines. Every effort was made to keep 

)8MSH 2, pt. 3: 398; Duncan, Medical Departmelll, 

pt. 3, p. 14; Joseph E. King, "Shoulder Straps for Aes· 

culapius: The Vicksburg Campaign in 1863," Military 

SlIrgeoll 11 4 (1954):2 18-19. 

" MSH I, app.:331 ; WOR, scr. 1.24, pI. 3:128. 

FORMER SLAVE, one of the Medical Department's patients. (Courtesy oj Massachusells 

Commandery Military Order of the Loyal 

Legion and the u.s. Army Military History 

lnslilllle.) 

with the army both casualties and those 

who fell ill in increasing numbers, but eventually more than 2,000 were left behind.'o 

For an army so much on the move, the 

muddy roads and floodin g streams of 

springtime made supply difficult, and the 

carelessness of some surgeons in making 

timely requisitions made matters worse. 

The U.S. and Western Sanitary Commissions provided supplies when the government was unable to furnish them and 

continued to help in the evacuation of pa-

" WOR, ser. I, 24, pt. 3:357; MSH I, app.:334; 

USSC, Documents 2, no. 75:3. 
218 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

EDWARD VOLLUM. (Courtesy oj National 

Library oj Medicine.) 

tients, but again commanding officers were 

tempted to lighten their burdens by leaving 

regimental medical needs behind. Letterman's organization of supply by brigade 

had apparently not been adopted in 

Grant's army, but Mills personally, as medical director for the entire army, took an 

extra supply of medicines, bandages, and 

similar items with him. He supplemented 

these, where possible, by what he could 

find at drugstores in the communities 

through which the troops moved. In March 

Sherman, then on the far side of the Mississippi from Vicksburg and to the west of 

that city, was confident that his field hospitals were amply supplied. He deplored 

the spreading of rumors to the contrary. It 

may have been these very rumors, however, 

that led Hammond to seek permission to 

travel west on an inspection tour, even 

though Grant's army, once it was relatively 

stationary near Vicksburg, was easily supplied. Steamers made the round trip from 

Memphis in four to five days, and the Medical Department's needs were stockpi led at 

Young's Point, north of Vicksburg, where 

one vessel had been assigned to pick them 

up and deliver them wherever they were 

needed." 

Supply problems may have been few 

after May, but the surrender of Vicksburg 

on 4 July did not end the difficulties facing 

the Medical Department of Grant's army. 

As many as 6,000 or 7,000 Confederate 

wounded, most in very bad condition, depended on Union physicians for aid. The 

Sanitary Cor>lmission once again assisted 

the Union medical officers. A call also went 

out to the chief quartermaster for the Department of the Tennessee to assign someone at once specifically to obtain the tents 

and buildings needed for hospitals, to arrange for transportation, and to provide 

the wood, water, and other items needed 

by the Medical Department in Vicksburg. 

Men whose recovery would be prolonged 

or who would never completely recover 

from their wounds were evacuated from 

the V icksburg area after the siege. The hospitals near the city that served these patients were consolidated into one, where 

men awaiting evacuation could rece ive 

temporary care. Each regiment also had its 

own hospital, located when possible in 

buildings once used by the Confederates 

for this purpose, where those with tem-

" MSH 1, app.:330-32; WOR, ser. 1,24, pI. 3:357; 

Forman, Western Sanitary Commission, p. 77; Ltr, 

Brown to SG (comment of approx. 20 Aug 1863 by 

unknown author, 9 Aug 1863), RG 11 2, entry 12; J. 

S. Newberry, "What the U.S. Sanitary Commission 

Is Doing in the Valley of the Mississippi," Sanitary 

Reporter I (1863):1; S. B. Thrall , "A n Iowa Doctor in 

Blue: The Letters of Seneca B. Thrall, 1862- 1864," 

cd. M. Throne, Iowa Journal o/History 58 (1906): 128, 

130. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 2 19 

porary ills or slight wounds could receive 

care. 42 

At Memphis, many of the patients evacuated from Vicksburg went upriver, where 

they were joined by some of the more seriously sick and wounded from facilities 

serving Union forces fighting a successful 

campaign in Arkansas. The path of evacuation from Arkansas to Memphis was not 

as well planned as that from Vicksburg, 

however. The Arkansas evacuees' boats 

were crowded and their accommodations 

drafty and so inadequate that patients had 

to lie on the deck. In late summer the sickness and mortality rates were high in the 

20,000-man Army of the Arkansas as it 

worked its way toward Little Rock. The 

medical staff caring for those remaining 

with that army was small, and some physicians were incompetent. Supplies, which 

had to be shipped from Memphis, came in 

slowly until the very end of the year. With 

so many difficulties in volved in caring for 

patients in Arkansas, it is not surprising 

that almost 1,200 were sent to Memphis. 

To care for the patients coming from Arkansas and Vicksburg, the Medical Department in Memphis took over the largest 

and finest buildings they cou ld locate, 

many of which were hotels, until they had 

space for 5,000 beds. By summer, however, 

all these hospitals were full, and patients 

from Vicksburg were being sent to such cities as Cincinnati and St. Louis." 

WOR, ser. 1, 24, pt. 1:489-90; H. A. Warriner. 

"Department of the Tennessee," "The Rebel Sick and 

Wounded at Vicksbu rg," "Dr. Fithian's Report," and 

"Department of the Tennessee-Report of Dr. Fi· 

thian," all in Sanitary Reporter I ( 1863):45, 52, 59-60, 

and 74, respectively. 

Forman, Western Sanirar), Commission, 

pp. 69- 70: MSH I, app.:33 1: J. R. Smith, "Army of 

the Arkansas," Ms C1 26, NLM; Paul E. Ste iner, Disease ill lite Cil'i/ War-Natural Biological Warfare. 

/86/- /865 (Springfield, III.: Charles C Thomas, 1968), 

p. 30; William Fithian, "Affairs at Helena," "Letter 

MADISON MILLS. (Courtesy oj National Library oj Medicine.) 

While Grant was planning his effort 

against Vicksburg in early 1863, the Army 

of the Cumberland under Rosecrans, with 

its 4,000 wounded, was recovering from the 

battle of Murfreesboro and preparing for a 

new campaign that was not actually undertaken until the summer. Although the 

town itself, built on a rock, stank with the 

effiuvia of shallow privies as the weather 

became hotter, the hospital was reportedly 

immaculate. By spring it could boast of a 

fine garden; a visitor in early June described that facility as "one of the brightest 

spots in the Department of the Cumberland, . . . a model army hospital." Meanwhile, Rosecrans and his medical director 

From Dr. Warriner," and "Letters," all in Sanitary 

Reporter 1 (1863): 21, 62, and 63, respectively. 
220 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

used the period of inactivity to have a 

board check into the competency of his 

medical officers, some of whom proved less 

than satisfactory.44 

Rosecrans' new campaign, aimed at the 

capture of Chattanooga, a vital railroad 

junction, would try his medical officers to 

their utmost. Handicapped by mountainous terrain, vulnerable lines of communications, and an unexpected but seve re 

defeat, they were fated to see their patients 

suffer from exposure both on the battlefield 

and during evacuation, from capture by the 

enemy, and from the effects of near starvation. In May, however, the availability of 

ripe blueberries and green corn in the fields 

was accompanied by a drop in the disease 

rate from 5 percent to 4 percent, where it 

remained until after the battle of Chickamauga, despite the wet weather that plagued the army on its march." 

Rosecrans' new medical director, Glover 

Perin, believed himself adequately prepared for the campaign when each regiment was supplied with all he estimated it 

could need for three months-like Madison Mills in Grant's army, he did not 

change to a system of supply by regiment. 

Perin planned to leave items held at the 

corps level intact as a reserve. Unfortunately, in at least some instances, amounts 

allowed were insufficient for the eventual 

need. He also did not follow Letterman's 

example by consolidating small hospitals, 

'·Quote from M. L. Read, "Department of the 

Cumberland," Sanitary Reporter I ( 1863):27; WOR, 

ser. 1, 20, pt. 1 :220; USSC, Sanitary Memoirs, p. 55; 

Ltr. Lewis W. Leeds to Letterman (25 Jun 1863), RG 

112, entry 12. 

'~Read, "Cumberland," and "Condition of the 

Army," both in Sanitary Reporter I (1863):27 and 2 

(1864): 152, respectively. Unless otherwise indicated, 

material on the Army of the Cumberland is based on 

MSH I, app.:266-68. 70, and Duncan, "The Great 

Battle of the West~Chickamauga ." in Medical Depart· 

melli, pt. 8. 

and unlike Mills, apparently accepted the 

ambulance system as he found it. He personally preferred Letterman's approach, 

however, since better control could be exercised over ambulance trains by having 

commissioned officers in charge of them. 

Perin also noted that no one was detailed 

in Rosecran's army to place patients into 

the ambulances and that these vehicles 

were still under the quartermaster's control. Their number was adequate, but since 

ambulances had been often used as baggage 

wagons during the winter and spring, many 

were in poor repair just when they were 

most needed. Each regiment in the Army 

of the Cumberland was accompanied by its 

own ambulance and hospital wagons, while 

a thirty-vehicle train also moved with each 

division. 46 

Perin was also able for a time to rely on 

two specially equipped railroad cars for the 

evacuation of his wounded, but an accident 

destroyed one and damaged the other 

sometime during the spring or summer, 

forcing medical officers to evacuate their 

wounded, as many as 100 a day, in boxcars. 

Evacuation by rail, furthermore, could not 

always be relied on because of the ease with 

which lines could be cut and because a portion of the line west of Chattanooga to 

Murfreesboro ran through enemy-held 

territory." 

A network of hospitals behind the front 

lines with their field hospitals awaited 

those who fell ill or were wounded during 

Rosecrans' advance or in the battle of 

Chickamauga. The principal facilities were 

in Nashville, where a group of highly regarded general hospitals provided 3,000 

beds for soldiers and apparently more 

<l6USSC. Surgical Memoirs 1:54. 

'7"Hospital Cars-Report of Dr. Barnum" and 

"Report of Dr. Read," both in Sanitary Reporter 1 

(1863):58 and 59, respectively. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 221 

for sick and wounded former slaves who 

were working for the Army. Louisville and 

other cities offered another 12,000 spaces. 

Attempts were made in the summer of 

1863 to vacate beds in Nashville, but although more than 2,000 casualties were 

sent to Louisville and thence to facilities 

nearer their homes, still others came in 

from Rosecrans' army to take their places. 

Hospitals in Murfreesboro were also emptied of their patients, to the extent possible, 

so that they could be used for the casualties 

of the campaign. A I,SOO-bed mobile tent 

hospital was left behind in Murfreesboro, 

organized and equipped so that it could be 

moved as needed. In August it joined other 

facilities located along the Tennessee River 

and the nearby railroad that were used as 

temporary shelters for soldiers from Rosecrans' army. When possible, these hospitals 

as well as the convalescent camps that were 

located along the route were sheltered in 

buildings or in tents abandoned by the 

Confederates. 48 

When Rosecrans' men reached Chattanooga, newly abandoned by the Confederates as they evaded Union efforts to cut 

them off, Perin attempted to set up hospital 

accommodations for as many as 3,000 

men, but found space for only 500 beds in 

those buildings originally used by the enemy for the same purpose. These structures, furthermore, were far from ideal; 

many lacked both doors and windows. 

Nevertheless, Perin urged that the sick and 

wounded from Rosecrans' army be sent to 

WOR, scr. 1,23, pt. 1:4 18-19; J. P. Barnum, "The 

Hospital Train," "The Rev. Mr. Hoblitt on Nashville 

Hospitals," David Welsh, "Negro Hospital," "Hospital Cars- Report of Dr. Barnum," "Report of Rev. 

F. H. Bushnell-Louisville and New Albany Hospitals," "Report of Mr. Loomis," and "Report of Dr. 

Read," all in Sanitary Reporter 1 (1863):25-26,34,51, 

59, 77, 11 8- 19. and 141 , respectively; Ltf, Perin to G. 

Goddard (23 Feb 1863), RG 112, entry 12. 

Chattanooga before the impending battle 

so that field units would not be unnecessarily encumbered. 

In the field at Chickamauga, where Rosecrans finally met the enemy, medical office rs experienced all the difficulties 

spawned by defeat, including the necessity 

for moving hospitals and the inevitable 

capture of many of their wounded. Perin 

has been criticized for locating most of the 

division hospitals in an area far from the 

battlefield and easily cut off by the enemy. 

He has also been blamed for not moving 

these units and their occupants as promptly 

as possible when they were in danger of 

capture. The site he chose, however, was 

near a vitally needed source of water. Since 

predicting the fortunes of this battle was 

particularly difficult and the area was "undulating and thickly timbered," evacuation 

was tedious and time-consuming. As many 

as 2,500 wounded were taken captive, 

2,000 of whom had been left on the field 

on 20 September when the army fled, but 

1,700 were soon exchanged." 

At Chattanooga, the Medical Department was once again not prepared to handle the number of wou nded that flooded 

into the city. With the aid of the Sanitary 

Commission, Perin tried to find shelter for 

the 9,000 wounded. More than 200 bales 

of cotton that were discovered hidden in 

the town were rapidly converted into mattresses enough to accommodate all the additional wounded. Supplies sufficient to 

the needs of a hard campaign had not been 

accumulated, however, and food was scarce 

even before the defeat at Chickamauga, so 

that many patients arriving at the hospitals 

had nothing to eat for two days.so 

49QUotc from MSH I, app.:268; Rpts. Perin (22 Sep 

and 3 Oct 1863), both in RG 112, entry 12. 

SOMax.welJ, Sanitary Commission, p. 214; USSC, 

Sanitary Memoirs, p. 16; "Report of M . C. Read," 

Sanitary Reporter I (1863):73-74. 
222 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

After the battle, attempts were made to 

move the wounded from the Chattanooga 

area, in the belief that the city might soon 

be captured. A new tent hospital was established across the Tennessee Ri ver to the 

north, but not enough tents were available 

to shelter all of the 2,000 sent there, forcing 

surgeons to turn to use "bowers of branches 

and leaves" to protect their patients from 

the weather. Many patients were sent west 

on an exceedingly arduous trip to hospitals 

nearer Murfreesboro. In this effort, Perin 

encountered a familar problem in the perso ns of ma linge re rs a nd th e sli ghtl y 

wounded, anxious to escape further action. 

Medical officers were set to watch for them 

at the pontoon bridges across the ri ver. In 

the confusion, however, many who were 

not seriously hurt succeeded in joining the 

supply wagons that were laboring westward 

carrying the more seriously injured sixty 

miles to where the railroad to Nashville 

was still open. 51 

Despite inexplicable claims by a medical 

officer in Louisville that shipments were 

getting through to the Army of the Cumberland, there was no escaping the fact that 

Chattanooga was almost completely cut off 

from significant outside help. The ri ver 

was not navigable near the city, the railroad 

led into enemy territory, and mountain 

roads had been rendered almost impossible 

by weather and enemy raids. By October, 

many of the horses that pulled ambulances 

were so starved that they were no longer 

useful, and although the Sanitary Commission stationed agents along the roads 

used in evacuation, their aid was also limit ed by transport ati on problems. The 

wounded in the city suffered from their inadequate di et and shivered as autumn 

chills deepened and fuel became scarce. 

"Quote from MSN I , app.:288; Huston, Sinews, 

p. 233; USSC, Sal/irary Memoirs, pp. 60-6 1. 

Help was on its way, however. In late September trains began bringing Hooker with 

two corps from the Army of the Potomac 

to Bridgeport, Alabama, west of Chattanooga on the Tennessee Ri ver. In late October they finally opened the way from 

Chattanooga to the navigable part of the 

ri ver, suppli es could come th rough freely, 

and patients could be removed from the 

city without danger." 

By this point, Grant was in command of 

all forces in the West, and Sherman was on 

his way to Chattanooga from Memphis 

with two corps from the Army of the Tennessee. Sherman's men found all the food 

they needed in the countryside as they 

marched, and when they reached Chattanooga in late November, they were healthier than they had been in some time. While 

Sherman was marching west, medical officers in Chattanooga were preparing for 

the battle they knew would come, laying in 

new supplies and readying hospital buildings in anticipation of as many as 5,000 

casualties. 

During the battle to lift the siege of Chattanooga in late November, by which time 

Maj. Gen. George H. Thomas had replaced 

Rosecrans, ambulances were able to come 

closer to the battlefield than before because 

the terrain tended to shield them from enemy fire. The 60,000-man Union fo rce was 

victorious, and it was now the enemy who 

fled . Ambulance trains could function effecti vely, and there was no need to move 

field hospitals repeatedly. Tents were still 

scarce within the city, but lumber from 

nearby buildings was used to make temporary shelters and new bun ks. With few 

exceptions, all casualties were soon "comfortably housed." " 

SlUSSC, Sanitary Memoirs, pp. 16. 60- 6 1; Ur, Shumard to Hammond ( I Oct 1863), RG 11 2, entry 12. 

SlQuote from MSI1 I , app.:290. 
THE CIVIL WAR IN 1863: HAMMOND'S LAST YEAR 223 

Unfortunately, the crowding of patients, 

many still debilitated, into hospitals in 

Chattanooga led to the rapid spread of infection among them. Patients in the division hospita ls located for twenty-fi ve days 

in tents outside the city did not develop 

gangrene, even when it appeared in a large 

percentage of amputation stumps in hospitals within the city. The weather made 

evacuation inadv isable, thus precluding an 

early end to the overcrowding. It was only 

in January that tra ins could again travel to 

Nash vill e, carryi ng th e wounded from 

Chattanooga." 

Perin's organization of the Medical Department in Rosecrans' army was not as 

efficient as that of Letterman, but the basic 

reason for the suffering of the wounded 

from exposure, crowding, and deprivation 

lay not in Perin's management but rather 

in the nature of the campaign. Supply lines 

were unusually vulnerable, and the defeat 

at Chickamauga resulted in a rout and almost complete isolation. Neither the suppl y situation nor th e shortage of beds 

wou ld have been serious had medicines, 

food , and hospital stores come in freely and 

W'Report of Dr. Read ," Sanilary Reporl er 

(1 863): 142-43 ; USSC, Sanilary Memoirs, p. 6 1. 

had patients been evacuated as soon as they 

could be moved. 

Conclusion 

Although Union victori es in 1863 in 

some instances simplified the evacuation 

and immediate care of the wounded soldier, even success in battle could not eliminate difficulties caused by lack of hospital 

space, nor could Medical Department attempts to emphasize the importance of 

what the soldier ate guarantee that diet 

would recei ve the serious consideration it 

d eserved from officers command in g 

troops. The effects of underestimating casualty rates were worsened by the reluctance 

of commanding officers to complicate the 

marches and maneuvers of their armies by 

bringing along many wagons loaded with 

tents and other department suppli es. 

Large-scale prevention of contagious disease was not yet possible, and the casual 

attitudes of line offi cers at all levels undermined attempts to improve the Army's 

health through greater attention to diet. 

Further improvement in the Army's health 

and in the care of the wounded would depend upon greater cooperation between all 

those responsible either directly or indirectly for the welfare of the Union soldier. 

CHAPTER 11 

The Civil War in 1864: 

The Beginning of the End 

Under the direction of William Hammond, by 1864 an effective and more elaborate organization had replaced the simple 

structure characteristic of the Medical Department in the days of Lovell and Lawson. 

Able administrators ran the various functional and geographic divisions of the Department, and sick and wounded soldiers 

routinely moved in orderly stages from battlefield to general hospital, where a carefully organized staff, including civilian 

nurses and cooks, awaited them. The requisite medicines and supplies were usually 

available at every stage of the evacuation. 

Serious shortages or delays in the transportation of the wounded continued to occur but chiefly as the inevitable result of 

the unpredictable nature of battle, of the 

failure of commanding officers to cooperate in attempts to prevent disease, or of 

decisions made to enable an army to move 

swiftly. His very success, however, caused 

the brilliant and abrasive Hammond to become expendable and therefore vulnerable 

to the attacks of the many enemies he had 

made during the course of his short military career. 

Hammond's Trial 

Apparently never truly aware of his own 

vulnerability, Hammond was almost to the 

end convinced that a court-martial would 

find nothing of which it could convict him. 

He even pushed aside a final offer by Secretary of War Stanton to let bygones be bygones with an arrogant demand for an 

apology. Knowing that Hammond had 

both stepped on many toes and bent many 

rules, making enemies and providing them 

with the ammunition they needed to dislodge him from the position of surgeon 

general, not all of his friends shared his 

illusions as to the impregnability of his 

position.' 

Increasingly determined to remove 

Hammond, Stanton named Hammond 

foes not only to the commission that investigated the surgeon general but also to 

the court that tried him. Although Stanton's responsibility for some of the problems Hammond encountered in planning 

his defense is not clear, papers needed by 

the defense apparently disappeared mysteriously, and some of Hammond's most 

distinguished supporters, after signing a 

petition in his behalf, later inexplicably denied having done so. The resultant implication of unscrupulous conduct on the part 

of Hammond or of someone acting in his 

behalf further blackened his name.' 

IStrong, Diary, pp. 394, 476, quote from p. 394; 

Blustein, "Hammond," p. 105. 

2Blustein, "Hammond," p. 105 ; Strong, Diary, 

pp. 394, 396; Ur, Hill et al. to "Sir" (1 Jan 1864), Ms 

e l 9, NLM; "Statement of the Late Surgeon-General 
226 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

Hammond was arrested on 17 January 

1864, shortly after his return to Washington from Tennessee, and his trial began two 

days later. The most serious and damaging 

charge against him maintained that he had 

exceeded his legal authority when he purchased blankets personally rat her than 

through the medical purveyor and that the 

blankets were overpriced and of poor quality. Since Hammond was the purveyor's superior, the question of who actua ll y 

accomplished the purchase might seem 

tri vial, but the potential for graft when the 

department head purchased directly was 

not a new issue. During the American Revolution, accusations of impropriety in connection with supply led to the trial of 

William Shippen. Although in Hammond's 

case, evidence of personal profit was lacking and the questionable price and quality 

of the blankets he bought were easily explained by the existence of urgent requirements that could not otherwise be met, the 

hearts of his judges were not softened . In 

August he was found guilty on all charges. 

Sanitary Commission official George Templeton Strong maintained that the surgeon 

general was convicted of " little more than 

the technical sin of purchasing supplies too 

freely," but Hammond was dismissed from 

the Army and forbidden ever again to hold 

office in the U.S. government.' 

Among those concerned wi th the trial 

and its verdict, some supported Hammond, but no one actively defended him 

during his ordeal. Strong proclaimed Stanof the Un ited States," BoslOn Medical and SllIgical 

JOllrnal7 ( 1865):364. 

)Strong, Diary. p. 433, quote from p. 476; Blustein, 

"Hammond ," pp. 12 , 106- 07 ; Maxwell, Sanitary 

Commission, p. 240; Ltr, H enry 10 Bache (21 Aug 

1864), Incoming Corresp, A. S. Bache Papers, Smithsonian, Washington, D.C; H. C. Friend, "Abraham 

Lincoln and the Court-Martial of Surgeon-General 

William A. Hammond," Commercial Law JOllmal62 

(1957):74- 75. 

ton to be a man " whose hates are as unscrupulous as they are bitter and 

dangerous." Others, however, did not share 

Strong's indignation. One writer of a negative turn of mind accurately but rather 

unfairly pointed out that in two years Hammond had not succeeded in freeing the 

Medical Department from its reliance on 

millions of dollars of charitable donations 

or in establishing an Army-wide ambulance service, a concept opposed by General in Chief Ha ll eck. At least one of 

Hammond's contemporaries concluded 

that it was "painfully certain that the evidence fully sustained the charges presented." When Hammond succeeded in 

having the conviction reversed in 1879, it 

was on the grounds that the court was prejudiced and that evidence that had not been 

admitted cast doubt upon the verdict. Although technically Hammond was guilty of 

at least one of the charges, it seems obvious 

that he was doing what was necessary under 

the circumstances to provide the best care 

possible for the sick and wounded and that 

an impartial secretary of war would not 

have placed formal charges against him. 

Nevertheless, the net in which Hammond 

was caught was partly of his own making, 

the result not of greed but of arrogance.' 

Barnes' Administration 

Since Hammond was arrested in midJanuary, the work of the Medical Department for the entire year of 1864 was the 

responsibility of the man who in August 

would forma lly succeed him as surgeon 

general, Joseph K. Barnes. Barnes was a 

4First quote, Strong, Diary, p. 476; second quote, 

"The Case of Surgeon-General Hammond," 80Sl011 

Medical and Surgical Journal 7 1 (1865): 125; Friend, 

"Lincoln," pp. 76-78; "United States Sanitary Commission," editorial in Chicago Medical Examiner 4 

(1865):53-54; Blustein, " Hammond," pp. 109-10. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 227 

veteran of the Mexican War who had 

joined the department in 1840. Although 

he was one of the medical officers passed 

over when Hammond became surgeon general, he was by no means the department's 

senior surgeon. Because of the way in 

which he came to office, there was little 

chance that Barnes could please Hammond's supporters, but with the strong 

backing of the secretary of war and with 

the guidelines established by his hapless 

predecessor, Barnes was able to lead the 

Medical Department successfully through 

the final year and a half of the war. 

Under Barnes, most of those projects 

closely associated with Hammond, among 

them the Army Medical Museum, the history of the Medical Department during the 

Civil War, and, ironically, the Army-wide 

ambulance corps, went forward without 

further del ay. At the museum, or, in 

Barnes' words, the "National Pathological 

Cabinet," specimens were coming in rapidly. The medical illustrators Barnes hired 

for the history worked in the museum and 

also went out into the hospitals, where they 

sketched and painted illustrations of 

wounds and the effects of hospital gangrene 

and similar complications. In the summer 

of 1864, the department added a "photographic bureau" to support the efforts of 

both the museum and history, and at least 

one surgeon contributed to the department's endeavor a set of photographs he 

had made on his own initiative. Late in 

1864, experiments in photomicrography 

began at the museum, where Joseph Janvier Woodward was beginning his work 

with stains for microscopic specimens. As 

a result of these efforts, by 1864 the work 

of the museum was attracting increasing 

attention, more so, apparently, among foreign physicians than among Americans.' 

5First quote. Ltr, Barnes to Thomas Longmore 

- JOSEPH J . WOODWARD. (COurlesy oj Nalional Library oj Medicine.) 

When Congress passed the bill creating 

an Army-wide ambu lance service in March 

1864, Barnes again reaped the benefits of 

the crop that Hammond, in this instance 

with Letterman's aid, had sown. Among 

the significant features of the new legislation was the prohibition of the use of ambulances for any purpose except the 

moving of patients and, in an emergency, 

medical supplies. An officer who used an 

ambulance for any other purpose was to be 

reprimanded and, if the offense was re-

(29 Jan 1864), RG 11 2, entry 2, 37:32; Brinton, Memoirs, pp. 285- 87, second quote, p. 284; Ltf, B. F. Palmer to Barnes (8 Sep 1864), RG 112, entry 12; Otis 

Report, in Lamb, "History," p. 284; "Army Medical 

Museum," Americll" Medical Times 8 ( 1864):306; 

Robert S. Henry, 71,e Armed Forces Illstitllle of PatllOlogy: lIS First Celllliry. 1862-/962 (Washington : Office of the Surgeon General, 1964), pp. 34-39. 
228 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

peated, dismissed from the Army. Rather 

than giving each regiment a specific number of ambulances, Congress called for the 

ambulance allowance to vary with the size 

of the regiment. An infantry regiment of 

500 or more men would have three ambulances, a regiment of fewer than 200 only 

one. In addition to the vehicles assigned to 

regiments, two ambulances were to accompany each corps headquarters and two 

army wagons each division ambulance 

train. Time proved the major flaw in this 

legislation to be the inadequate number of 

ambulances.' 

The basic plan for the ambu lance corps 

was unmistakably Letterman's. The medical director of each corps was, as he had 

intended, responsible for the ambulance 

service of that corps. A captain was in direct charge of the corps' ambu lances, drivers, and attendants, and he reported to the 

medical director. A lieutenant commanded 

the ambulance corps of each division, a 

second lieutenant that of each brigade, and 

a sergeant that of each regiment. Three privates worked with each ambulance and one 

pri vate with each wagon. All men detailed 

to the ambulance corps were to be exami ned by a board of medical officers to determine their fitness. 7 

The law of March 1864 strictly forbade 

line officers to appropriate ambulances for 

their own use, but no such understanding 

existed concerning hospital ships. The matter came to a head in September when Maj. 

Gen. Benjamin F. Butler, who demonstrated a generally high-handed attitude 

toward the Medical Department, matterof-factly notified Barnes that he was temporarily taking over two hospital steamers, 

the only available vessels that would be safe 

6Lettcrman, Recollections, p. 178; WOR, se r. 3, 

4: 186·87. 

J WOR. ser. 3, 4: 186. 

for an oceango ing voyage, to return men 

from Confederate prisons in Savannah. 

Butler apparently thought he had Grant's 

approval of the move, but, upon learning 

of the takeover, Grant demanded that Butler explain his action. The secretary of war, 

unreservedly backing his new surgeon general, promptly informed Butler, " this proceeding is irregular, .. . you will please 

a bsta in from giving such orders," a nd 

added that no vessels were to be removed 

from Medical Department service without 

his prior consent. 8 

Other problems Barnes encountered in 

directing the Medical Department were 

also similar to those Hammond had faced. 

Medical offi cers continued to be frustrated 

in their efforts to preserve the soldier's 

health by improving his diet. Fresh vegetables remained scarce in the field and refe re nces to scurv y and scorbuti c taint 

remained common in the records of the period despite a slight drop in the frequency 

with which actual scurvy was reported. 

Desiccated vegetables, some of which were 

high in vitamin A, were unpopular. Although, unlike vitamin C, vitamin A could 

be stored for a relatively long period in the 

body, by 1864 the vitamin A reserves of 

some of those who had joined the Army in 

the preceding three years were apparently 

seriously depleted, and the incidence of 

night blindness, the only reliable indicator 

of a vitamin A deficiency available from 

Civil War records, was increasing. The 

campaign to deli ver more potatoes, high in 

vitamin C but relatively low in vitamin A, 

was apparently more successful than the ef8Quote from WOR. ser. 1, 42, pt. 3:4 16; WOR, ser. 

1,42, pI. 1:1024, 1064 and pI. 3:416-17, 418,432, 

480 ; Ltrs, Butler to Stanton (26 Jan 1864) and 

McDougall to D. T. Van Buren ( 19 Apr 1864), both 

in RG 11 2, entry 12. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE EN D 229 

fort to induce the men to eat other vegetables in desiccated form.' 

The probable increase in the incidence 

of a vitamin A deficiency was not representative of the overall trend in disease under Barnes. In spite of the increase in the 

number of wounded, the sick and wounded 

together numbered less than 16 percent of 

the Army's total strength, and the death 

rate was declining. In June the report for 

the preceding twelve months revealed 

300,000 fewer cases of disease among white 

troops than had been reported for the year 

ending June 1863, with the average soldier 

sick 2.2 times a year rather than the previous figure of 2.4. The year's only epidemic killed 278 soldiers when yellow fever 

struck at New Bern, North Carolina, but 

diseases associated with poor sanitation 

and hygiene, such as diarrhea and dysentery, were taking a lower toll. The decreasing incidence of typhoid fever suggests that 

many were immune to it by 1864.'0 

Adding to the complexities of the work 

of the Medical Department at this time 

were the wounds and diseases of an increasing number of black soldiers. During 

the yea r ending 30 June 1864, almost 

190,000 such cases, less than 4 percent of 

whom were suffering from wounds or other 

injuries, came to the attention of Army 

physicians. The disease rate among black 

troops in 1864 was almost twice that of 

whites, and their mortality from disease 

was four times higher. These statistics also 

indicated that while the rate of disease directly associated with poor sanitation was 

similar in troops of both races, blacks suf-

' MSI1I , pt. 1:455: WOR. se r. 1, 36, pt. 1:221,255 

and ser. 2, 4:48 1; "A Word to Aid Societies" and John 

E. Summers, "Testimony o f Lieut. Col. Summers, 

Medical Inspector, U.S.A. ," both in Sanitary Commission Bulletin 3:673- 74 and 683, respectively. 

" MSH I, pt. 1:297, 300- 301, 453, 456- 57: SGO, 

AnfIlIal Report, 1864, pp. 4- 5, and 1865, p. 6. 

fered from scurvy four times as often as 

their white counterparts, suggesti ng that 

they may have received fewer potatoes than 

the white troops. They developed night 

blindness, however, only half as often as 

whites; as relati vely new recruits, most 

probably still had adeq uate reserves of vitamin A, II 

The Army was caring for large numbers 

of newly freed blacks, not only soldiers but 

civilians as well, especially in the areas of 

such cities as Vicksburg, Mississippi, and 

Memphis, Tennessee, where the General 

Hospital for Freedmen was established for 

black civilians under the supervision of the 

medical director of the XV I Corps. Late in 

1863, the adjutant general had called for 

10 percent of the wages of employed blacks 

to be paid into a freedman's fund to aid 

their less fortunate brothers. This order allowed the Army to detail hospital stewards 

to the freedmen's hospita l, paying them 

$17 to $36 a month from the fund . Army 

surgeons also worked in these freedmen's 

institutions. With conditions in refugee 

camps poor, the death rate among blacks 

was high, and Barnes opposed burdening 

the Medical Department with the enormous expenses that involvement with the 

care of freedmen could entai l. In the summer of 1864, the adjutant general rescinded 

the order that made Medical Department 

aid possible, a decision that resulted in 

confusion and a certain amount of despair 

among the Army surgeons affected by it. 

Barnes' objection to aiding blacks, however, was presumably based on the enormity of th e challe nge rather th an any 

objection on pri nciple to aiding civilians, 

since early in the year he had shown no 

reluctance in expanding one Army smallpox hospital in Washington and opening 

" MSH I, pt. 1:300-301, 456-57, 665, 669 and pt. 

3:6; Grace, Manual, p. 171. 
230 THE ARMY MEDICAL DEPARTM ENT, 1818- 1865 

another in Alexandria in order to take in 

civilian victims of that dread disease." 

By June 1864, the 190 general hospitals 

that shelt e red most of th e sick and 

wounded soldiers, both black and white, 

had more than 120,000 beds, a figure that 

again reflected an expansion of old facilities as well as the creation of new ones. 

Included among the latter were general 

hospitals established for the exclusive use 

of officers, one in each geographical department. The Medical Department still 

tended to return general hospital patients 

to institutions near their homes, sometimes 

apparently even to civil hospitals, especially when their period of disability would 

be long and the distance involved not too 

great. A desire to enable patients to vote 

in the upcoming presidential election reinforced this tendency in the summer and 

fall. The department also paid insane asylums for temporary housing for military 

patients, but in this instance, rather than 

sending patients to hospitals near their 

homes, it moved any whose illness was 

likely to be prolonged back to Washington 

and its government-run asylum. " 

Alt hough no buildings had to be constructed to create the new offi cers' hospitals, after Jul y 1864 any new hospital 

IlLlr, D. O. McCord to SG (with notes by Barnes 

and Eaton, 15 Sep 1864), SO (no. 94, 5 Nov 1863), 

and Ltr, Charles Lee to D. O. McCord (with note by 

M cCord, 31 Oct 1864), all in RG 112, entry 12; Ltr, 

Barnes to Owen Lovejoy ( 13 Jan 1864), RG 11 2, entry 

2, 36:535; George R. Bently. A l-lisfOry oj fhe Freed· 

men 's Bureau (Philadelphia: University or Pennsyl· 

vania, 1955), pp. 26-27. 

IJ WOR, ser. 3, 4:207, 79 1; Ltrs, William C. Spencer 

to W. P. Jones (5 Jan 1864) and Barnes to Lovejoy 

(13 Jan 1864), to w. G. Sellick (30 Jun 1864), and to 

J. P. Gery ct at. (22 Nov 1864), all in RG 112, entry 

2, 36:498, 535 and 38:9 and 576- 77, respecti vely; Shumard to L. G. Burbridge (31 Ju\ 1864), Herrick to 

Provost Marshal General (2 1 Nov 1864), and McDougall to Barnes (25 and 27 Jun 1864), all in RG 

11 2, entry 12; "Army Medical Intelligence: Circular 

Letter," America" IHedical Times 8 (1 864):226- 27. 

construction that did occur had to follow 

the pav ilion pattern originally favored by 

Hammond. Ventilation was an important 

consideration in new buildings, where each 

sixty-pati ent ward had to be separate from 

the others. Even so, the number of cases of 

hospital gangrene and similar infecti ons 

was climbing and military surgeons still 

preferred to have their patients in small 

field hospitals where rates of infection were 

relati vely low." 

Stanton's willingness to support the man 

he had chosen to be surgeon general led to 

the resolution of an old problem concerning the control of general hospitals. In December and at Barnes' urging, Stanton 

ruled that general hospitals were under the 

exclusive control of the surgeon general 

and that medical officers serving in these 

facilities, whether regulars or volunteers, 

were not subject to orders from local commanding officers. Within th ese institutions, medical officers had all the authority 

of commanding officers and were to be 

obeyed as such. Stanton did note, however, 

that although members of the Veterans Reserve Corps could still be used as guards 

and attendants, doctors were under no circumstances to retain able-bodied men in 

hospitals. " 

In the fiscal year ending June 1864, the 

expense of hiring the contract doctors who 

formed most of the professional staff of 

general hospitals constituted roughly oneninth of the department's budget. The decline in the total number of patients for 

14,\l1SI1 2, pt. 3:825; Grace, Mallllal, pp. 204- 07; E. 

Andrews, G. S. Hubbard, and R. H. Gilbert, "Report 

or the Committee on Mi litary Hygiene," Transactions 

o/the America" Medical Association 15 ( 1864): 171; Armory Square l10spital Gazette (Washington: 24 Dec 

1864), p. 4. 

uGracc, Manllal, p. 103; "Surgeons in Charge or 

Hospitals as Military Commanders," American Medical Times 8 ( 1864): 175 ; Cir Ltr (31 Dec 1864), 

Ms C24, NLM . 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 23 1 

whom the Medical Department was responsible apparently led Barnes to reduce 

the number of contract physicians in January. In June, however, the medi cal director of Ba ltimore's ge ne ral ho spitals 

informed Barnes that he had hired a " large 

increase of Contract Surgeons and Nurses" 

and that $ 15,000 would be needed each 

month to pay the former and another 

$5,000 for the latter. With new casualties 

resulting from the start of the campaign 

season, Barnes was finding it difficult to 

locate an adequate number of able private 

physicians willing to take the required examination. By the end of the year, the overall shortage of physicians had become 

sufficiently severe to cause the surgeon general to mount an aggressive campaign to 

persuade former volunteer surgeons to sign 

up again and to advertise for men to fill 

openings in the regular staff as well. " 

Having concluded early in the year that 

the department had more stewards than 

necessary, by December Barnes had decided to reduce the department's expenses 

by limiting the hiring of stewards to those 

who would be serving black regiments, 

even though medical officers still experienced occasional difficulties in obtaining 

stewards when they needed them. Further 

economies were achieved by reducing the 

salaries of white femal e nurses to 40<1: a day, 

even when white male nurses and cooks 

were still being paid $24 a month. The salaries of these contract employees were not 

always paid promptly, for on at least one 

occasion Barnes was forced to complain 

16Quote from Ltf, C. C. Cox to Barnes (1 5 Jun 

1864), RG 11 2, entry 12; Ltrs, Charles Crane to Sar~ 

gent (9 Jan 1864) and C. C. Lee to J. L. Thompson 

(8 Aug 1864) and Advertisements (2 1 Sep and 29 Nov 

1864), all in RG 11 2, entry 2, 36:5 19 and 38: 11 6, 275, 

and 556- 59, respecti ve ly; Ltrs, McDougall to Barnes 

(18 and 23 Apr and 21 May 1864), all in RG 11 2, 

entry 12. 

that late payments had caused "very great 

distress and destitution amongst the 

Employees."" 

Although because of the lowered disease 

rate, the overall number of patients admitted to Army hospitals was dwind ling, 

the drive to crush Confederate resistance 

continued to produce many wounded. 

Managing supply and the network of hospitals involved was complex. In May the 

department moved the office of the assistant surgeon general, Robert C. Wood, to 

Louisville, Kentucky, where he could more 

effectively oversee the assignment of surgeons and patients and the distribution of 

supplies in that part of the country. Despite 

the demands of the war, however, Stanton 

had apparently concluded that the department's network of medical inspectors could 

handle their responsibilities without the 

aid of Sanitary Commission inspectors. He 

refused to continue allowing the commission to send its own men into the fi eld, 

enraging Sanitary Commission leader 

Strong, who maintained that " the corps of 

government inspectors [had] notoriously 

proved a nullity." 18 

The refusal to contin ue the Sanitary 

Commission's right to inspect hospitals 

and camps at the end of 1864 represented 

a general deterioration in its relationship 

with the Medical Department after Hammond lost control of the Surgeon General's 

Office. In the spring the secretary of war 

for a time even refused to issue the passes 

17Quote from Ur, Barnes to George Harrington 

(23 Sep 1864), RG 11 2, entry 2, 38:283; WOR. ser. 3, 

4:5 12; Grace, Mallual. pp. 98-99, 198, 203- 204; Stimson and Thompson, " Women Nurses," p. 230; Ltrs, 

McDougall to Barnes (7 lui 1864) and McPariin to 

Barnes (20 Jun 1864), both in RG 11 2, entry 12; Ltf, 

Crane to T. P. Drew ( 13 Jan" 1864), RG 11 2, entry 2, 

36:536. ISQuoie from Strong, Diary. p. 52 1; WOR. ser. 3, 

4:287; Ltr, Crane to J. Foster Jenkins (21 Nov 1864), 

RG 112, entry 2, 38:523. 
232 T HE ARMY MEDICAL DEPARTMENT, 1818- 1865 

commissio n represe nt ati ves needed to 

move freely in the a rea where the Army of 

the Potomac was operating, making it impossible for them to deli ver supplies during 

the battles of the Wilderness and Spotsylvania. Stanton a lso denied the Sanita ry 

Commission the right to use the adjutant 

general's records in compiling its directory 

of Army patients and their locations. The 

Sanitary Commission, like Hammond, was 

no longer completely indispensable." 

The very fact that the Medical Department could now afford to be high-handed 

in its relationship with the Sanitary Commission suggests the strength of Barnes' position. Barnes' path had been well prepared 

by Hammond, who had created the department's administrati ve framewo rk and 

had placed experienced men to function 

within it. Secretary of War Stanton was apparently quite willing to support Barnes 

against p'ractically all comers. Because of 

the drop in the disease rate, the number of 

patients was dwindling, and the only real 

stress upon the department resulted from 

th e demands of an agg ressively waged 

campaign. 

Medical Care oj Forces in Virginia 

In the sp rin g of 1864, Uni o n fo rces 

launched two major dri ves against the Confederacy, one in Virginia and the other in 

Georgia. Units in Virginia fought directly 

under Grant, now in command of the entir e U n io n Ar m y. Maj o r Ge ne r a l 

George G. Meade's Army of the Potomac 

and Maj. Gen. Ambrose E. Burnside's independent IX Corps formed a 120,000-

man force aided in the East by Butler's 

33,000-man Army of the James and by various other units. During this final year of 

'QMaxwe ll, Sanitary Commission, pp. 263, 266, 

311-13. 

the war, however, the medical care of the 

Union's principal army in northern Virginia was no longer the responsibility of 

Jonathan Letterman, who asked to be reli eved early in the year. The preparation of 

the Medical Department in the Army of the 

Potomac for the forthcoming campaign 

was, beginning in early 1864, in the hands 

of Thomas McParlin.

20 

The health of the Army of the Potomac 

at its camp along the Rapidan River during 

the fi rst months of 1864 was relati vely 

good. With the weather unusually cold, 

most of those who were sick suffered from 

respiratory infections, although venereal 

disease took a heavy toll among veterans 

returning from furlough. McParlin had the 

army vaccinated when smallpox appeared, 

and when he detected signs of scurvy in the 

form of a scorbutic ta int, he urged commissaries and medical officers to make sure 

that a proper diet was available. By I May 

he was convinced that the men were " well 

sheltered, well fed, and well clothed, refreshed by a long rest, and visits to home 

and fri ends, and full of confidence in their 

cause and in its leaders .. . as nearly perfect 

in its health, strength, and morale as it is 

possible in so large a body of troops."" 

Once the campa ign was underway, however, malaria and digestive complaints began to haunt the Army of the Potomac. 

More patients suffered from these problems than from gunshot wounds. It is likely 

that many of those with other diseases had 

ma lari a as we ll-McPariin commented 

that he had observed a periodicity, or reg2°Letterman, Recollections, p. 185. Unless other.vise 

indicated, material on the Army of the Potomac is 

based on WOR. ser. 1, 36, pI. 1:2 10-75, and MSH I, 

pI. I, app.: 148-2 11. 

llQuote from WOR, ser. I, 36, pI. 1 :2 13; Letterman, 

Recollections. pp. 183-84; Perry, Leiters. pp. 155-56; 

"Army of the Potomac," America" Medical Times 8 

( 1864):189. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 233 

ularly repeating pattern, of fever in most 

of .his sick during the campaign. The quinine doled out at sick call was undoubtedly 

vitally important to the fighting ability of 

Union forces in Virginia. 

Caring for the sick and wounded under 

McParlin at anyone time were from 500 

to 800 medical officers, among them an assistant medical director, two inspectors, 

and a medical purveyor and his assistant. 

McParlin assigned an assistant surgeon, 

John S. Billings, the principal responsibility for the collection of statistics, a challenge made more difficult by the fact that 

the medical staff was not large enough to 

guarantee the keeping of adequate records 

during those periods when battle was raging. Billings nevertheless took to his new 

assignment with enthusiasm. On 30 April 

he wrote to his wife that he was being sent 

"a barrel of whiskey .. . with which to preserve surgical specimens and immediately 

after the next battle, I expect to send 

enough pickled arms and legs to the surgeo n ge ne ral to make a mu se um of 

themselves,"22 

In April Meade named the specific surgeons who were to serve as surgeons in 

chief at the brigade and division levels, a 

move that lessened the influence of commanding officers who would otherwise 

have appoi nted their own chief surgeons. 

An average of from forty to sixty nonmedical officers served in the ambulance corps 

for the Army of the Potomac, supervising 

the work of 1,300 or more enlisted soldiers 

manning approximately 600 ambulances. 

Forty or more stewards worked in the corps 

hospitals.

23 

llQuotc from Garrison, Biflings, p. 76; Duncan, 

"The Battle of the Wilderness," in Medical Depart- ment, pt. 9, p. 18. 

llDuncan, Medical Deparlmem, pt. 9, p. 18. 

JOHN SHAW BILLINGS. (Courtesy of National Library of Medicine.) 

When McParlin first took over from Letterman, he relied upon regimental hospitals to care for those who fell ill, but in 

February he also organi zed division hospitals for the sickest of his patients. The 

organization of the division hospital in the 

Army of the Potomac varied, but a surgeon 

in chief was routinely in charge, while a 

recorder, three operating surgeons, each 

with two assistants, and a medical officer 

responsible for food and shelter worked under him. The surgeon in chief, as one of 

the most experienced physicians on the 

staff, was usually a member of the operating team at the division hospital, where 

almost all surgery was performed. With division hospitals grouped together by corps, 

this system made it easier for the corps 

medical director to contact his immediate 
234 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

subordinates. The absence of the division's 

chi ef surgeo n from the batt lefield was 

keenly felt , however, since he was needed 

to enforce discipline and order among the 

surgeons there. 

In some division hospitals during battle, 

musicians managed the pitching and striking of tents, loading and un loading of the 

wounded, carrying of water and wood, 

burying of the dead, and policing of the 

hospital area. In one such faci lity, the 350 

men and boys of the drum corps were organized into five companies, each led by a 

sergeant, and the whole commanded by a 

lieutenant. A provost's guard usually enforced discipline. 

Although McParlin had thoroughly prepared for patient care, hospitali zation, and 

evacuation, he made no attempt to provide 

cavalry units with ambulances. He believed 

that mounted men moved too fast and covered distances too great for hospital and 

ambulance trains to accompany them. 

After a cavalry engagement, surgeons appropriated nearby buildings and attempted 

to supply their patients by raids upon local 

resources. 

McPariin was not initi ally responsible 

for the condition of the Medical Department in Burnside's IX Corps, which had 

left Annapolis at the end of April in great 

haste with inadequate transport and little 

room for medical supplies. The requ isite 

number of ambu lances moved with Burnside, but many needed repairs. The ambulance organization required by th e 

legislation of March, furthermore, had not 

been full y implemented in Burnside's 

force. Most of the required stretchers were 

missing, and the civilians hired to drive the 

ambulances deserted in droves early in the 

campaign. When Grant ordered Burnside's 

corps officially added to the Army of the 

Potomac on 25 May, McPariin found that 

it was not only still badly in need of transport, but "badly supplied and organized" 

as well. 24 

Despite his careful planning, factors beyond McParlin's control threw continual 

challenges his way. Recognizing that the 

army must move swiftly, he sent a ll his sick 

and wounded as well as all property he considered unnecessary to the rear before the 

campaign started, but on 4 May Grant allowed only half the remaining ambulances 

to cross the Rapidan River with the troops. 

Since the number of these vehicles permitted to accompany the army still exceeded the lega ll y required minimum, 

Grant apparen tly did not anticipate the difficulties that resulted from his order. 

McParlin was not profligate in his use of 

ambulances and was careful not to take 

chances with those that accompanied him, 

allowing only a limited number to be exposed to fire at anyone time, but events 

proved that the number of ambulances allowed by Congress was far too small for the 

aggressive campaign Grant waged. 

During the battle of the Wilderness that 

followed the crossing of th e Rapidan, the 

removal of the disabled to ambulances 

proved unusually difficult. Dense scrub hid 

the injured, and fires raged in the dry brush 

and pine, burning or suffocating men too 

badly hurt to escape unaided, while the enemy inhibited rescue attempts by firing at 

every movement. Despite their bravery, 

stretcher-bearers were unable to remove all 

of the almost 9,000 wounded from the 

field . As many as 200 died from the effects 

of the fl ames alone. Grant could not wait 

for these casualties to be brought back to 

safety, nor for them to be removed back 

along the chain of evacuation in the usual, 

rather leisurely manner. On 7 May, Meade 

ordered all his wounded sent back to WashHQuote rrom Ltr, McParlin to Barnes (30 May 

1864), RG 112, entry 12. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 235 

ington at once. More than 300 army wagons had to join almost 500 ambulances in 

attempting to execute the command, and 

more than 1,000 men were unavoidably left 

behind. The next day, fearing that guerrillas might capture them if they went directly 

to Washington, Meade ordered that casualties be taken instead to Fredericksburg. 

Becau se of th e change of plan s t he 

wounded spent thirty hours on the road, 

and evacuation vehicles were late returning 

to pick up the casualties from the battle 

that started at Spotsylvania on 8 May." 

The ambulance corps took two weeks to 

remove all who had been left behind at the 

Wilderness. A large number died while 

waiting. Their wounds were severe, and the 

supplies left for them proved inadequate 

after stragglers came out of the woods to 

share them. Casualties returned from captivity by the Confederates were also suffering from the sa me s hortages th a t 

afflicted Lee's forces as the result of a successful Union cavalry raid that destroyed 

most of their medical supplies. 26 

Although they had not completed their 

count of the casualties from the Wilderness 

when Union and Confederate forces met 

again at Spotsylvania, after yet another day 

of battle, surgeons were struggling to care 

for over 9,000 more wounded. Few physicians remained in the field by this time, 

however, and McPariin's plans had been 

based on the ass umption that patients 

would be evacuated from field hospital to 

general hospital before many had accumulated. But large numbers were held at 

depot faciliti es at Fredericksburg because 

Confederate guerrillas had cut the rail line 

W'Fredcricksburg Correspondence," Sanitary Reparler 2 (1864): 18; U lysses S. Grant, Persollal Memoirs, cd. E. B. Long, 2 (New York: Charles L. Webster 

& Co., 1866): 290; USSC, DoclIlIlellls 2, no. 76: 1- 2. 

26Grant, Memoirs 2:227; Duncan, Medical DepaY/-

melli, pt. 9, pp. 19-20. 

to Aquia and were suspected of having 

mined the Rappahannock River. Because 

many of th e surgeons accompanying the 

wounded to Fredericksburg had to stay 

there to care for them, medical officers remaining in the fi eld were overworked and 

ex hausted." 

Both confusion and delay characteri zed 

the evacuation of the Spotsylvani a casualties because ambulances were still busy 

removing the wounded from the Wilderness. In addition, the wounded on the battlefield were too numerous for the ava ilable 

stretcher-bearers to handle. Two to four 

health y soldiers could often be seen escorting a severely wounded comrade to 

safety. Meade again ordered all available 

vehicles, regard less of type, made ready to 

remove the wounded. On 10 May the ambulances finall y returned from Fredericksburg, but both horses and attendants were 

worn out. Since renewed action was expected, Meade had ambulances and spring 

wagons (highly regarded as substitutes for 

ambu lances) retained at the front and those 

of the wounded not yet removed to Frederi cksburg sent off in returning sup ply 

wagons. 28 

The night of II May was dark and wet, 

but despite the exhaustion of men and 

beasts and the poor condition of the roads, 

the evacuation twelve miles back to Fredericksburg continued. Medical inspectors 

supervised the move of another 3,500 casualties on 12 May alone . The proportion of 

seve rely wounded among them was so high 

that fewer than a quarter of the injured 

could move themselves. Once again the 

lack of transportation prevented th e 

prompt remova l of many, and it was not 

until the 15th that 600 who had been left 

nLtr, McParlin to Barnes (10 May 1864), RG 112, 

entry 12. 

!8Grant, Memoirs 2: 290. 
236 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

behind earlier were picked up for the trip 

to Fredericksburg. The next day McParlin 

estimated that 18,500 patients had already 

gone through his fi eld hospitals" 

. On 19 May, McPariin had to order vehicles collected from other units for the use 

of newly arrived artillery regiments that 

had brought with them neither medicines 

and supplies nor transportation for their 

wounded. His surgeons assisted the artillery's medical offi cers in chosing men for 

their ambulance corps and advised them 

concerning the Medical Department's routine in caring for the sick and wounded, 

both on the march and during battle. 

The sick and wounded were not McParlin's only concern in the early weeks of 

the campaign. Malingerers by the thousands became a problem for him as they 

had been for Tripier and Letterman. Some 

appea red to have infli cted their own 

wo un ds. According to McParlin , the y 

tended to present themselves not to military surgeons but to Sanitary Commission 

doctors, who could be more easily impressed by "bloody bandages and judicious 

limping." Malingerers added to the confusion at Fredericksburg, where the establishment of a large depot hospital system 

on short notice left McParlin with no 

chance to stockpile supplies for the 26,000 

casualti es who wo uld eventu a ll y pass 

through that city.'o 

Initi ally supplies could come into Fredericksburg and patients could leave onl y 

th rough Belle Plai n, on the Potomac River. 

The harbor there was shallow and, until the 

engineers intervened, had no wharf. The 

road from Fredericksburg to Belle Plain, 

furthermore, could be attacked by guerrillas. As a result, supplies did not reach FredlQGrant, /vlemoirs 2:237; Ltrs, McParlin to Barnes 

(13 and 16 May 1864), RG 11 2, entry 12. 

lOQuote from WOR, ser. 1, 36, pt. 1:235. 

ericksburg until 10 May. The first twenty 

ambulances sent in to supplement those already with Meade's army arri ved at Belle 

Plain on the II th , when Sanitary and 

Christian Commission supplies also began 

coming in. To expedite food deli very to the 

hospitals, Meade assigned a lieutenant to 

each division facility to assume responsibility for hospital subsistence." 

In Fredericksburg enlisted patients occupied the usual churches and public buildings, although medical officers tried to 

locate the hospitals of each corps near one 

another. Wounded officers initially stayed 

in private homes where the owners cared 

for them. Facilities in Fredericksburg soon 

became crowded and infection took a 

heavy toll despite generally adeq uate ventilation and a good water supply. Near the 

end of the month, however, tents began to 

arrive, and doctors could move their patients out of doors, where infection spread 

less rapidly. At this time, the Medical Department also established an officers' hospital at Fredericksburg." 

Because medical officers were required 

both at the front and in Fredericksburg, too 

few surgeons were available to meet the 

need at either place. On 9 May, for example, only thirty physicians were caring 

for 7,000 patients in Fredericksburg. On 

8 May, therefore, Barnes put out a call to 

the surgeons general of Pennsylvania, New 

York, and Massachusetts for ten surgeons 

each for ten days' service, broadening the 

call three days later to include other states 

in a request for five more physicians each. 

J' Brinton, Memoirs. pp. 268-70; Maxwell, Sanitary 

Commission. p. 25 1; William Howell Reed, Hospital 

Life in fhe Army oj {he Potomac (Boston: William V. 

Spencer, 1866), pp. \3- 14; Ltrs, Brinton to Barnes 

(two of 10 May. one each of 11 and 12 May 1864) and 

SO ( 16 May 1864), all in RG 11 2, entry 12. 

l2Ltr, McParlin to Barnes (22 May 1864), RG 112, 

entry 12. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 237 

Among the professional men to come to 

Fredericksburg was dentist William T. G. 

'Morton, one of the developers of ether 

anesthesia, who, accordi ng to Joseph Janvier Woodward, anesthetized as many as 

100 patients a day. Although the help of 

these civilians was invaluable, they also 

contributed to the confusion because of 

their unfamiliarity with Army routine. " 

The road from Fredericksburg to Belle 

Plain was rough, the weather wet, and the 

confusion at the depot great. No facilities 

for the injured existed at Belle Plain. Since 

the wounded suffered greatly when moved 

any distance in ambulances and wagons, 

McParlin decided to keep the seriously 

wounded in Fredericksburg until the rail 

line to Aquia had been repaired and gunboats had cleared the Rappahannock. By 

14 May the situation at Belle Plain had improved, and supply was "profuse," but 

8,000 wounded remained at Fredericksburg. With the river and railroad clear, 

McParlin had all those whose condition 

would keep them out of action for more 

than a month evacuated to Washington. By 

22 May fewer than 6,000 remained in Fredericksburg facilities." 

Days before the last of the wounded left 

Fredericksburg on 28 May, Meade had ordered the next depot for the advancing 

army established downstream at Port 

Royal. On 25 May he had the sick and 

wounded still with the army sent there, 

once again using wagons to the extent possible to spare ambulances for work nearer 

the battlefield. The Medical Department, 

however, had not had time to prepare for 

})Woodward, Ollllilles, pp. 151-52; Ltrs, Barnes to 

various SGs (8, 11 , and 12 May 1864), all in RG 112, 

entry 2, 37:403, 419, and 420, respectively. 

14Quotc from Cuyler to Crane (14 May 1864), RG 

112, entry 12; Reed. Hospilal Life. pp. 15- 16, 41; Ltrs, 

Cuyler to Barnes (13 May 1864) and McPariin to 

Barnes (20 and 24 May 1864), all in RG 11 2, entry 12. 

the arrival of patients at Port Royal, and 

although it was raining when the first ones 

arrived, doctors had to leave them in their 

vehicles until the next day. Within a few 

days the army had advanced too far beyond 

Port Royal to use it as a base. On 30 May, 

even while boats were still removing patients from Port Royal, the Medical Department was beginning to set up tents at 

White House. " 

From 23 to 31 May the Army of the Potomac moved south toward Richmond and 

then east around that city toward Petersburg. Early engagements resulted in fewer 

than 2,800 injured, but in early June the 

battle of Cold Harbor accounted for almost 

7,000 wounded. In addition, many who 

were sick rather than injured also had to 

be evacuated. For more than a month, the 

men's rations had included no vegetables. 

Scurvy was appearing among soldiers already suffering from malaria and, with sanitation in the trenches poor, bowel 

complaints as well. Only after mid-June 

did shipments of the new crops of vegetables begin to arrive for Grant's men, including a large supply for the depot at 

White House. By then, however, thousands 

of the seriously ill and wounded had left 

White House for general hospitals to the 

north." 

Although surgeons returning from their 

duties at Fredericksburg eventually reli eved the shortage of physicians with the 

Army of the Potomac, transportation for 

the wounded remained inadequate, even 

after the arrival of forty-eight new ambulances and eight medicine wagons that 

lSRecd, Hospital Life. pp. 47-48; Ltrs, McParlin to 

Dalton (27 May 1864), in Edward Barry Dalton, Correspondence, Documents, and Certificates Pertaining 

to Dalton's Medical Career, 1861-72, Ms ffi29, NLM; 

Ltf, McPariin to Barnes (24 May 1864), RG 112, 

entry 12. 

l6Grant, Memoirs 2:290; WOR. seT. 1, 36, pt. I : 188. 
238 THE AR MY MEDICAL DEPART MENT, 1818- 1865 

JOHN BR INTON (center, sealed) AND H OSPITAL A TTEN DANTS al Pelersburg. (Courlesyof 

Library of Congress.) 

could a lso be used to move the sick and 

wounded. A corps from Butler's Army of 

the Jamesjoining the Army of the Potomac 

in time fo r Cold Harbor caused further di ffi culties by bringing with it only eighteen 

ambulances and no tents. Surgeons from 

another un it had to a id the doctors with 

Butler's men during the battle. Once again 

after Cold Ha rbor, because of the shortage 

of transportation, two or three able-bodied 

men co uld be seen escort ing a single 

wounded companion from the front to the 

hospital. " 

At the Wh ite House depot, surgeons attempted to load the patients from Cold 

.l1Rccd, Hospital Life, pp. 54-55. 

Harbor onto hospital boats for evacuati on 

as soon as they had recei ved emergency 

care and had been screened to eliminate 

malingerers. The Quartermaster's Department worked closely with the Medical Department in this endeavor, but casualti es 

were soon coming in as fast as they could 

be sent off. Medical offi cers shipped almost 

1,300 patients north on 2 June alone, but 

on 4 June, when they sent off a similar 

number, 1,460 still remained at the White 

House depot, and McParlin was forced to 

turn to the Sanitary Commission to supplement his nursing force. 

In mid-June, the Army of the Potomac 

resumed its movement to the sou th, and 

once again the ambulances fo llowing it 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 239 

GENERAL HOSPITAL FOR ARMY OF THE POTOMAC at City Point, Vilginia. (Collrtesy of 

MassachusellS Commandery Military Order of the Loyal Legion and the u.s. Army Militwy 

History Instilllte.) 

were soon filled with the sick, many suffering from heat stroke. By 17 June field 

hospitals sheltered almost 1,900 sick and 

wounded. By the next day, however, surgeons had established a new depot facility 

at City Point, on the south bank of the 

James northeast of Petersburg, and four 

days later White House stood abandoned. 38 

Although the siege of Petersburg eased 

the difficulties caused by the rapid movement of Grant's army, the wounded continued to come in, especially after the 

battle of the Crater on 30 June. Problems 

resulting from poor sanitation and disease 

increased. In the heat of July the disease 

lSOrder (McParlin's copy, 15 lUll 1864), RG 11 2, 

entry 12. 

rate was twice the May average of 2.3 percent. Swarms of flies led McParlin to order 

mosquito nets for his patients. When the 

weather was dry, dust filled the tents where 

the sick and wounded lay, but when it 

rained, stagnant pools became so numerous that McParlin urged greater attention 

to drainage. Approximately 40,000 new recruits unfamiliar with the necessity for sanitation reinforced Grant's force in the 

course of the campaign of 1864, a fact that 

may explain why soldiers were once again 

relieving themselves wherever they were, 

ignoring latrines. Typhoid fever as well as 

diarrhea and malaria, diseases that together caused more than half of the hospitalizations in the last six months of the 

year, became a greater danger to the Army 
240 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

of the Potomac than the Confederate soldiers besieged in Petersburg. " 

The length of the siege required modifications in the way in which hospitalization was managed. When Grant's force 

took up its position outside the city, regimental surgeons established themselves 

within several hundred yards of the 

trenches, near ambulance stations, and 

McParlin kept division hospitals in tents. 

As winter approached, however, he had 

fifty- by twenty-foot log structures erected 

to shelter his patients from the cold. Most 

of the sick remained in these division hospitals, but when they became overcrowded, 

medical officers sent some of their patients 

back by train to the depot at City Point.'o 

The City Point depot covered an area of 

several hundred acres and contained five 

corps hospitals. A hospital at Point of 

Rocks, six miles up the Appomattox River, 

apparently sheltered Butler's remaining 

sick and wounded, but one of the City 

Point facilities was set aside for the black 

troops from Butler's command. Although 

not all reports agree, in the summer these 

institutions may have been able to house 

as many as 10,000 patients, but in the 

colder months, when pavilions replaced 

many of the tents, their population was 

probably less than 6,000. Despite much initial confusion, the huge faci lity was soon 

operating smoothly, with a steam laundry 

and two steam engines keeping a 6,000-

gallon tank filled with river water for bathing and washing, while dug wells provided drinking water. A rail line went 

through the center of the depot so that patients could be taken from the cars directly 

to their beds, without the use of ambulances. Although opponents of the practice 

19Grant, Memoirs 2: 239- 89. 

<4OReed, Hospital Life, p. 94. 

pointed out that the use of convalescents 

as hospital attendants was harmful to their 

health, these men handled many of the duties at the City Point hospitals, including 

nursing and police. They apparently 

worked with great goodwill, since accounts 

of the period mention decorations put up 

by nurses and ward masters to make hospital rooms more cheerful. Blacks within 

the lines were ordered to duty as laundresses and cooks, while stragglers and suspected malingerers might also be put to 

work. Special-diet kitchens were often run 

by women who, in McPariin's opinion, 

"were of much more use [there] than when 

employed as nurses in wards."" 

Once again sending patients out and 

bringing supplies in was at first difficult. 

Piers were crowded, but temporary ponton 

wharves, including one for the Medical Department's exclusive use, were soon in 

place. Shallow draft vessels could come directly to these wharves, leaving only deep 

draft boats to be unloaded by lighter. Severely wounded patients could then be 

quickly evacuated north. McParlin stored 

medical supplies that were temporarily unneeded in barges so as to free wagons for 

other uses. Although wagon traffic kept the 

area dusty in dry weather, as soon as an 

adequate pumping system had been installed, water was available for spraying on 

the dust to lay it. During periods of rain, 

however, the entire area still became a 

quagmire. When rain fell during an attempt to move a hospital that had proved 

to be both inadequate and badly located, 

41Quote from MSU I , pt. I, app.: 165; Reed, Hospital 

Life, pp. 94- 95; Huston, Sinews, pp. 227, 230; Ade· 

laidc W. Smith, Reminiscences 0/ all Army Nurse During the Civil War (New York: Greaves Publishing Co., 

19 11). pp. 80-81 ; "City Point: From Dr. M cDonald," 

USSC, Sanitary Blilletin 2:812; GO, Butler (no. 161 , 

USSC Bull, 6 Dec 1864), RG 112, entry 12. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 24 1 

the effort became an ordeal of mired ambulances and exhausted men and horses." 

The management of the wounded was 

more than ordinarily difficult for units that 

for one reason or another temporarily left 

the immediate Petersburg area, usually in 

attempts to cut enemy supply lines. In one 

such instance, the II Corps moved to the 

north of the James River, sending its sick 

on to City Point before the move. Twenty 

ambulances followed each division of the 

corps as it marched to pick up the many 

men who became too exhausted in the July 

heat to continue on their own. Surgeons 

established a temporary hospital on the 

north bank near the ponton bridge by 

which the troops had crossed and a regular 

field hospital on the south bank, from 

which patients were taken to City Point. 

During a similar but longer-lived operation, malaria became such a problem that 

surgeons had ditches dug around hospital 

sites to improve drainage and issued whiskey and quinine prophylactically for a brief 

period. Whenever possible they took over 

houses for use as hospitals and sent the sick 

back to City Point each time a move was 

necessary. 

As the weather turned cold, medical officers with these expeditions found themselves confronting the effects of cold 

weather and exposure upon men who had 

impatiently discarded heavier clothing and 

blankets during a warm spell. When rain 

and sleet accompanied the arrival of very 

cold weather, the rate of respiratory disease 

climbed among those who were forced to 

use temporary and inadequate shelter. To 

meet the needs of units leaving the immediate vicinity of Petersburg, medical officers in one corps set up what they called 

a flying hospital, which consisted of a med-

.1Ltr, McParlin to Barnes (24 Jun 1864), RG 11 2, 

entry 12. 

icine wagon, a hospital wagon, and half the 

number of ambulances allowed each brigade involved. 

Grant's 1864 campaign took a heavy toll 

among members of the Medical Department of the Army of the Potomac, especially among the men ·of the ambulance 

corps. From I May through 31 July alone, 

one medical officer and ten men from the 

ambulance corps were killed in action. Fi ve 

surgeons, three hospital stewards, and 

sixty-five members of the ambulance corps 

were wounded in the first three months of 

the campaign in eastern Virginia. 

In striking contrast to Grant's energetic 

campaign was that of Butler and his Army 

of the James, which never got farther than 

the junction of the James and Appomattox 

ri vers despite the fact that Lee was at first 

totally unprepared to meet an attack from 

this source. Like the Army of the Potomac, 

Butler's army moved initially with a bare 

minimum of medical supplies, ambulances, and the like, leaving its sick behind 

in hospitals in the Hampton-PortsmouthFort Monroe area. A steamer served as a 

storeship and as a shelter for the wounded. 

Several other smaller vessels took casualties back to Fort Monroe as soon as they 

could be moved. One corps soon established a permanent hospital at Point of 

Rocks, and the others followed its example 

soon thereafter. Because Butler got no further than Bermuda Hundred, however, his 

medical officers never faced the problems 

with evacuation and hospitalization that 

plagued their counterparts with Grant in 

May and June. 4J 

Units fighting in western Virginia and 

Maryland experienced little success until 

they were consolidated under Maj. Gen. 

"3Ltrs, McCormick to Barnes (3, 5, I I, 18. and 

20 May 1864) and McClellan to Barnes (14 May 

1864), all in RG 112, entry 12. 
242 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

GENERAL HOSPITAL AT POINT OF ROCKS, VIRGINIA. (Courtesy o/Librmy o/Congress.) 

Phili p H. Sheridan's command. Their setbacks resulted in the capture of many of 

their wounded. Sheridan's medical director, James Ghiselin, was forced to put together a medical organization more or less 

from scratch, but using Letterman's plan 

as his guide, he successfull y created both a 

medical team and a network of hospitals. 

The surgeon general cooperated promptly 

with requests for supplies and more surgeons to man faciliti es established in Winche ster. In so doing, Barnes made it 

possible for Ghiselin to avoid the difficulties McParlin experienced during the battle 

for Spotsylvania, when his surgeons were 

spread thin trying to care fo r patients both 

in Fredericksburg and near the battlefield 

at the same time. 

Although the pattern of care and evacuation was generally similar to that of the 

forces facing Lee in eastern Virginia, the 

shortage of ambu lances here was less serious. It led to delays in retrieving the 4,000 

wounded after the battle for Winchester, 

but the use of army wagons to supplement 

ambulances enabled the latter to remain 

with the army as it advanced. Most of the 

more than 10,000 wounded from 20 August to 31 October moved smoothly and 

quickly from fie ld hospitals to depot facilities and thence by hospital train to general 

hospitals in Philadelphia, York, Wilmington, and Baltimore. In the course of caring 

for them, however, one surgeon was killed 

and three more died of their wounds, while 

two others were hurt but survived. The 

only major crisis, a temporary lack of food 

for hospitalized patients caused by Con-
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 243 

federate guerrilla activity, was quickly resolved by the commanding general's decisive action in ordering rations intended for 

troops in the field diverted to hospitals." 

Medical officers serving in Virginia in 

1864 faced a variety of challenges, most of 

which arose from the fast-paced nature of 

Grant's campaign. His rapid moves against 

Lee in the spring and early summer complicated evacuation and hospitalization 

and emphasized the need for a larger ambulance allowance for aggressi vely waged 

campaigns. The siege of Petersburg, on the 

other hand, brought with it all of the difficulties involved in keeping standards of 

sanitation high among troops camped long 

in one area. In western Virginia, the medical director of Sheridan's new army grappled with the problems that arose from the 

hasty creation of an army from a hodgepodge of units with varying standards of 

medical care. Surgeons could not meet all 

of these challenges with complete success, 

yet even in the face of partial or temporary 

failure, they managed to function in a rational, disciplined manner to limit the suffering of the sick and wounded. 

Sherman's Campaign in Georgia 

The second major campaign of 1864 was 

that led by Maj. Gen. William Tecumseh 

Sherman, under whose command three 

armies that had been fighting west of the 

Appalachians were consolidated to take Atlanta and then to push on to the coast. 

Sherman, like Grant, launched his campaign on 4 May, but the distance to be covered was great and, un like Grant, he made 

slow progress during the summer, needing 

seventy-four days to move the fi rst 100 

~~B rinton , Memoirs. pp. 293-30 1; WOR, ser. I, 43, 

pt. 2: 163; Maxwell, Sanitary Commission, pp. 269-70; 

MSH I, app.:223-26; Ltr, Campbell to Barnes (17 Oct 

1864), RG 11 2, entry 12. 

JAM ES T. GHISELIN. (Courtesy oj National 

Library oJMedicine.) 

miles. The path Sherman took lay for the 

most part along a railroad, and his medical 

officers were able to make extensive use of 

hospital trains during the first half of the 

campaign, but transportation became inc reasingly un ce rta in beca use of e nemy 

raids upon lengthening supply lines. Although his men had become skilled in the 

art of rebuilding track and bridges rapidly, 

in leaving Atlanta Sherman finally decided 

to end his reliance upon support from the 

rear. His men would live off the land as he 

moved east, and he would keep with him 

those who fell ill or were wounded after his 

departure." 

"5Unlcss othcfV(isc indi cated, all material on Sherman' s ca mpaign is based on l'vfSfI I , pt. 1, 

app.:297- 327, and Matloff, American Mililaf)' HislOry, pp. 270- 74. 
244 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

GEORGE COOPER. (COlll"lesy o/National Library 0/ Medicine.) 

When the campaign began, Sherman's 

medical officers had not had time to activate Letterman's system in its entirety. 

Field hospitals were for the most part still 

organized by brigade rather than division. 

The medical officers who were to perform 

surgical operations for the Army of the 

Cumberland, one of Sherman's three armies, were initially named by brigade, but 

in June George Cooper, the newly arrived 

medical director, adopted the division 

method of organi zation, thus making it a 

simple matter for each division's physicians to assist one another regardless of the 

units to which they were attached. The 

medical director of the Army of the Ohio, 

Henry Hewit, initially appointed a committee of surgeons at the army level to perform surgery, but he, too, eventually turned 

control over this aspect of the care of the 

wounded to his division chiefs." 

The system of Union Army hospitals 

that evolved during the summer of 1864 in 

Georgia varied to some degree from army 

to army and from place to place. As a rule, 

however, ambulances and, when necessary, 

army wagons initially evacuated patients to 

field division hospitals. If these units had 

to move on with the army before depot facilities could take in all their patients, surgeons sent the sick and wounded to mobile 

general field hospitals, and then finally to 

the depot for the train trip back to Chattanooga, 136 miles from Atlanta. Casualties were often sent beyond that city, with 

one train going 151 miles to Nashville, another the 185 miles from Nashville to 

Louisville. Hewit pointed out that his patients had to continue immediately on to 

Knoxville, which could be very hard on the 

wounded, especially if they had to change 

trains. It was desirable, however, to keep 

the Nashville and Chattanooga hospitals 

available for the newly wounded, and thus 

those who had been treated were usually 

moved on, fu rther from the battlefield. The 

casualties of the small Army of the Tennessee were for a time sent to a hospital in 

Rome, Georgia, rather than to Chattanooga. Cavalry units with Sherman, like 

those with Grant, had neither hospitals nor 

ambulance service, and their wounded had 

to enter infantry facilities or houses along 

the route of march where private families 

could be paid to care for them." 

At least one of the problems of evacuation was caused by Sherman's commanding officers who, following the time46Ltr, Perin to Barnes (6 Jan 1864), RG 112, 

entry 12. 

HLtrs, Hewit to SG (9 Mar 1864) and to Edward 

E. Potter (copy, 13 Mar 1864), both in RG 11 2, entry 

12; MSH 2, pI. 3:970-7 1. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 245 

honored custom of trying to appoint the 

weakest men to ambulance duty, ignored 

the strenuous nature of this assignment. 

Ambulances were also in a poor state of 

repair as the campaign got under way, but 

the necessary work was completed during 

the season. The animals that pulled the ambulances, howeve r, were chosen from 

among those that had almost starved to 

death at Chattanooga the previous fall and 

winter. Many had not recovered from that 

ordeal and were unfit for arduous work. 

Since forage was not easily found as supply lines lengthened, and si nce a campa ign 

many had expected to be short continued 

month after month, a substantial amount 

of supplies and equipment was left behind 

to reduce the number of animals that had 

to be fed. Nevertheless, Sherman allowed 

the Medical Department to bring an adequate supply of medicines and hospital 

needs. He also assigned an acting commissary of subsistence to the field hospital organization. Between Sherman's effort and 

those of the various volunteer commissions, the diet of the sick and wounded in 

the field was reportly as good as that of 

their counterparts hospitalized in the rear, 

and this even when ahle-bodied soldiers 

were suffering from scurvy. 

Many of the men in the fi eld with Sherman were veterans who, with the scent of 

victory in the a ir, had reenlisted. At the 

start of the campaign, they were reported 

to be in good health, but the condition of 

men who were new to the army was, as 

usual, poor. Once again, many had been 

accepted without adequate medical screening. A diet low in vitamin C and an arduous 

campaign caused scurvy to appear early 

and by June men were breaking down. At 

least one surgeon blamed the lack of vegetables for the difficulty that many men 

had withstanding the rigors of the campaign. By July definite signs of scurvy had 

appeared in an average of 20 percent of 

those in one di vision of the Army of the 

Ohio and what was described as a scorbutic 

taint was sufficiently pronounced to be 

identified in more than half of the men. 

The problem began to di.minish in importance only when green corn became edible 

in the fields. Blackberries and many vegetables ripened at the same time as corn a nd 

were probably responsibl e for th e improved health ascribed by many to corn. 

As Sherman's force moved slowly toward 

Atlanta, surgeons caring for his sick and 

wounded showed flexibi lity in their approach to the problems they encountered. 

On at least two occasions in the campaign, 

when a di vision hospital of the Army of 

the Cumberland needed help, surgeons 

from other div isions came swiftly to its aid. 

When the rail line was cut or a bridge destroyed, surgeons established temporary 

hospitals to shelter patients until the route 

back to Chattanooga had been restored. 

One such facility was located in an abandoned Confederate hospital at Ki ngston in 

Tennessee, a second at Acworth in Georgia 

after the enemy had cut a railroad bridge. 

After the bridge had been rebuilt, surgeons 

at Acworth did not wait for the arrival of 

hospital trains but shipped their patients 

west on returning freight cars. 

In late June, medical officers faced a particularly unpleasant situati on when ordered to move the casualties resulti ng from 

the battle of Kenesaw Mountain within 

twenty-four hours. Division hospitals were 

six to nine miles from the nearest depot, 

and surgeons had to use every kind of 

transport they could find, including baggage wagons, to move the 2,000 wounded 

along roads rendered virtually impassable 

by days of rain. Scurvy was by this time 

almost rampant among Sherman's men 

and proper food was apparently not yet 

available for the casualties who boarded 
246 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

the trains after the battle. The situation became all the more difficult when the trip 

took three times longer than had been anticipated, but Cooper asked the Sanitary 

Commission to aid the wounded by setting 

up rest stops at Kingston, Tennessee, and 

at Resaca and Dalton, Georgia. Not all attendants on board the train were conscientious about their duties, but physicians 

could not walk from car to car to check on 

their work while the train was moving. 

Given the hasty nature of the evacuation, 

however, the Medical Department probably could not have done better." 

As Sherman's troops drew nearer Atlanta, fi eld hospitals followed , moving finally from Marietta to Vinings Station, 

where they remai ned until Atlanta fell and 

they moved into the city itself. Even within 

Atlanta, however, these faciliti es never became fi xed. When the initial location of 

one of these hospi tals was needed for new 

fortifications, medical officers moved it 

from its original site to a less desirable one. 

Almost 6,000'were wounded in action near 

Atlanta, and at least half that number remained in Atlanta hospitals in October, 

when Confederate attacks upon the railroad leading back to Tennessee virtually 

cut Atlanta off from supplies for several 

weeks. Until the rail line could be repaired, 

food supplies were supplemented by items 

brought in by foraging parties." 

On 29 October, with the railroad finally 

repaired, Sherman sent the division field 

hospitals of his three armies back to Resaca 

in boxcars, no hospital trains being avail4lDuncan, Medical Departmelll, pt. 10, p. 12; Ex ~ 

tracts From the Report of Mrs. J. T. Horner, State 

Agent for Iowa," Sallitary Reporter 2: 131. 

49Maxwell, Sanitary Commission pp. 268-69; Duncan, Medical D eparlmelll, pt. 10, p. 14; " Letter From 

Mr. Tone," "Report of Dr. Read," and "Letters From 

Mr. Hoblit," all in Sanitary Reporter 2 ( 1864):95, 99, 

and 100- 10 1, respecti vel y. 

able. Since medicines could not be fo und 

in the countryside and Sherman planned 

to destroy the rail line behind him to prevent the enemy from using it, surgeons 

would from that point onward have to 

manage with what they could carry with 

them. Sherman took with him, therefore, 

only his fittest men, hoping to minimize 

the depletion of medical supplies by sending the weak, whose the health might fail 

under the rigors of the march, back west 

with the sick and wounded.'· 

Before leaving Atlanta, Sherman and his 

medical officers determined carefully what 

they should take with them. They allowed 

each division of 6,000 men approximately 

thirty ambu lances, a medicine wagon carrying sixteen tent flies, a month's allowance 

of the most useful medical suppli es, and 

several army wagons that could be used to 

move the packs of men who became too 

weak to carry them. Their plans proved entirely adequate, since relatively few fell ill 

on the march, and the rate of sick and 

wounded averaged only 19 per 1,000. The 

clear air and food gathered from the countryside, including berries and sweet potat oes, act u a ll y brought about an 

improvement in health. Medical officers 

examined the few who did fall ill each 

morning before breakfast and loaded those 

unable to march into ambulances. Each 

unit had its own foraging party to bring in 

food for the sick, including fresh meats, 

vegetables, fruits, and honey. Cows accompanying the march provided milk. One soldier wrote his wife that the men had "not 

li ved so well before in the army." John 

Moore, medical director for Sherman's 

command in the fall of 1864, was concerned that the medical supplies taken 

)O<'Letters From Mr. Hoblit," Sanitary Reporter 2 

( 1864):100- 101 ; E. Andrews and J. M . Woodworth, 

Tlte Primary Surgery oj Gell. Sherman's Campaigns 

(Chicago: George H. Fergus, 1866), pp. 2- 3. 
THE CIVIL WAR IN 1864: THE BEGINNING OF THE END 247 

along would not be sufficient and had arranged for a new supply to be kept ready 

for shipment to Savannah or any other site 

along the coast should it be needed. His 

concern proved unnecessary, but when Savannah surrendered on 21 December, four 

ocean-going hospital transports met Sherman 's army with suppli es for 5,000 

patients" 

Sherman's preparations for his march to 

the sea included sending Maj. Gen. George 

H. Thomas with part of the Army of the 

Cumberland back to Tennessee to protect 

Nashville, a vital supply center, from Confederate forces under Genera l John B. 

Hood. Although in late November Thomas 

still did not consider himself ready to commit his main forces against the enemy, two 

corps saw heavy action outside Nashville 

as they attempted to gain time for him. 

While Union forces dropped back first to 

Franklin and then to Nashville itself, ambulances and wagons evacuated as many as 

possible of the sick and wounded either to 

a train depot or directly to Nashville. 

Within the city, preparations for defense 

went forward, but considerable confusion 

prevailed because of the manpower shortage. Thomas gathered all available men 

into an "extemporized" unit and called in 

all surgeons in the area on leave or otherwise unassigned to serve as its medical 

staff. His medical officers scoured the city 

for ambulances. Only one corps' medical 

department was effectively organized. As 

the time for decisive action approached, its 

surgeons methodically broke up their faSlQuote from Ltr, J. R. Zearing to his wife ( 15 Dec 

1864), in Luelja Zearing Gross, "A Sketch of the Life 

of Major James Roberts Zearing, M.D. (1828- 19 11 )," 

Transactions 0/ (lie Illinois Historical Society 2 

(1921):191 ; "Report of Dr. Read" and "Letter From 

Rev. J. C. Hoblit," both in Sa'iitary Reporter 2 

(1864):130-3 1; War Department, SGO, Annllal Report, 1865, p. 3; Llr, Huntington to Barnes (7 Jan 

1865), Ms e130, NLM. 

JOH N MOORE. (Cou rl esy of Library of 

Congress.) 

cilities, moved their sick to general hospitals, and placed their amb ul ances and 

wagons by the side of the road, ready to 

move out. The director of the general hospitals in Nashville took over every building 

that could be used to house casualties until 

he had 4,000 vacant beds awaiting them. 

Just as his new patients began to arrive, 

however, so did rei nforcements in the form 

of troops from Missouri, and these units 

added to the problems facing medical officers because they were "deficient in almost everything belonging to the hospital 

department."" 

On 15 December Thomas attacked Confederate force s besieging Nashville and 

drove them beyond the Tennessee River in 

HQuote from MSfI I, pt. 1, app.:323; Brinton, 

Memoirs. p. 327. 
248 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

great confusion. By this time the weather 

was exceedingly cold, and the incidence of 

fevers, respiratory problems, rheumatism, 

and diarrhea increased among his troops. 

The wounded suffered greatly, but medical 

officers cared for them promptly in the 

field and quickly moved almost 8,000 back 

to the city. Since the railroad had been cut, 

the wounded had to use ambulances for the 

entire trip. As Thomas pursued the enemy, 

surgeons coll ected growing numbers of 

casualties in hospitals in towns along the 

way, including Franklin, where they discovered 185 survivors from the more than 

200 Union casualties of the battle of Franklin. They also found approximately 1,500 

Confederate wounded abandoned there, 

" in a lamentable condition," a state of affairs a Sanitary Commission representative 

attributed in part to " bad nourishment." 

Trai ns evacuated all the wounded from 

Franklin and other communities back to 

Nashville as soon as they were in a condition to be moved and the track had been 

repaired." 

Although as many as 3,600 beds were 

available at Chattanooga and over 800 at 

Murfreesboro and Tullahoma-among the 

cities to which Army of the Cumberland 

patients were taken-Nashville held more 

than any other. In June general hospitals 

there sheltered 6,000, of which more than 

2,000 were in tents, but by November a 

pavilion hospital for 2,000 was nearing 

completion. Among other hospitals in that 

city were an Army-run facility for smallpox 

victims and another for blacks, both soldiers and civilians. " 

HQuotes from " Report of Dr. Read," Sanitary Re· 

porter 2 (1864):1 24; "Letter from Mr. Ruggles," and 

"The Wounded at Franklin- Report of Mr. C. B. Ruggles," both in S(llliwry I?eporler 2 ( 1864): 123 and 133, 

respectively; Ltr, Cooper to Barnes ( 19 Dec 1864), RG 

112, entry 12. 

HBrinton,l\l/emoirs, p. 340; " Report of Dr. Read," 

" Report of Rev. Mr. Ingraham," and " Report of Mr. 

Many Army of the Cumberland patients 

sent to Chattanooga during Sherman's 

drive on Atlanta eventually arrived in 

Nashville, since Chattanooga facilities, inc ludin g a conva lescent camp, were 

crowded during the summer despite the use 

of tents taken from the enemy. When Nashville began to receive patients directly from 

the battlefield, however, the medical director there could not relieve the resultant 

crowding of his hospitals by sending casualties back to Chattanooga, presumably because the enemy was between the two 

cities. Chattanooga facilities were by then 

far from crowded, however, since they received no patients from Sherman after he 

left Atlanta. The city's military hospitals 

ended the year with fewer patients than 

usual, many of whom were well on their 

way to recovery. Army of the Ohio patients 

continued to go through Chattanooga. Although 2,000 remained at Knoxville at 

year's end, almost 10,000 filled general 

hospitals in Louisville, Kentucky, or the 

nearby communities of New Albany and 

Jeffersonville, Indiana" 

Trans-Mississippi Campaign 

The least fortunate part of the Union 

Army's plans for 1864 involved an illconceived expedition led by Maj. Gen. Nathaniel Banks designed to take Shreveport, 

Louisiana, and to free the Red River from 

Confederate control. The campaign was a 

Ruggl es," all in Sanitary Reporter I (1863): J 66 and 2 

(1864): 30 and 98-99, respectivel y; R. Wallace, 

"United States Hospitals at Nashville," Cillcbmati 

Lancet {lIId Observer 7 (1864):587, 590, 598. 

5s Duncan, "When Sherman Marched Down to the 

Sea," pt. 10 of Medical Deparlmem, p. 3; "Report of 

Rev. F. H. Bushnell," "Report of Rev. H . B. Hosford," 

" Report of Dr. Read," "Report of Mr. M . C. Read," 

and "Letters From Rev. H. B. Hosford," all in Sanitary 

Reporler 1 ( 1863):170 and 2 (1 864):29, 99, 124, and 

126, respecti vely. 
THE CIVIL WAR IN 1864: THE BEGINN ING OF THE END 249 

fai lure from the outset, and its failure inevitably complicated the work of medical officers. The 15,OOO-man force led by Maj. 

Gen. Frederick Steele that should have left 

Arkansas to meet the main part of the force 

under Banks at Shreveport had to turn 

back. Banks' drive north toward that city 

in early April also fell short of its goal, and 

left more than 1,600 of his men injured. 

The enemy captured almost 500 Union 

wounded, 9 medical officers, and 70 ambulances, evacuation having been seriously 

retarded by a "stampeded mass of wagons, 

artillery, infantry and cavalry." Four more 

medical officers voluntarily remained behind to help care for the captured Union 

wounded. Although su rgeons had to abandon division hospitals with little food or 

"ordinary comforts" for their occupants, 

Confederate authorities a llowed Union 

doctors to bring several loads of medical 

supplies to the casualties, whom the enemy 

commanding general agreed to parole as 

soon as they could be moved. Medical officers sent Banks' wounded on to general 

hospitals in New Orleans and Baton 

Rouge." 

The medical director who would normally have kept the records for Steele's 

force was in the East for Surgeon General 

Hammond's trial from late January to early 

May, and the records of the medical care 

for this half of the Red River force during 

April are missing. Some of the wounded 

were arriving at hospitals in Arkansas by 

the time of the medical director's return, 

however, a few at Pine Bluff and the rest 

at Little Rock. Medical officers had taken 

over private homes to house their patients 

in Little Rock but, sharing the belief of so 

many of his colleagues that such buildings 

S6QUotcs from MSH I, pI. I, app.:336. Unless otherwise indicated, material on the Red Ri ver expedition 

and action in Arkansas is based on MSH 1, pt. I , 

app.:336, 345, and on Smith, Ms C126, NLM. 

were too poorly ventilated to serve adequately as hospitals, the medical director 

ordered tents set up around the general 

hospital for the use of the wounded. Erysipelas had already appea red among them, 

however, and co nvalescence took unusually 

long. Surgeons eventually had many of the 

wo unded moved 'to northe rn hos pita ls, 

either accompan ied by a medical officer or, 

if convalescent, in small unattended groups 

on passenger vessels. 

Although the Army dropped its Red 

Ri ver campaign, Arkansas saw further action when a Union force of 6,500 men 

came through in pursuit of Confederate 

guerrillas in September. The Union general 

sent his sick, numbering more than 600, to 

the hospital at Duvals Bluff and his convalescents to a camp established for them 

in Arkansas. These new patients added to 

the strain placed upon the hospital system 

by the sick and wounded of units normally 

in the area, where the disease rates were 

high and the proportion of medical officers 

to men was low. 

Conclusion 

The campaign west of the Mississippi 

was not a failure as far as the Medical Department was concerned, despite military 

defeats, the cap tur e of ma ny of the 

wou nded and a number of medical officers, 

the loss of ambulances, and the absence of 

one of the leaders of the department in Arkansas during the first fi ve months of the 

year. Surgeons were also plagued by temporary shortages of vegetables and supplies 

caused by low water in the Arkansas River, 

unexpectedly low temperatures, and the 

destruction in a fire of quinine reserves. 

But experience with the demands of war 

had by now taught the leaders of the Medical Department in both the West and the 

East the nature of the challenges they could 
250 THE ARMY MEDICAL DEPARTMENT, 18 18-; 1865 

expect to meet, and many of their subordinates the nature of military medicine. 

Despite adversiti es, therefore, the Department was able to keep the situation in the 

West under control and to handle the difficulties encountered in the course of the 

year as well as circumstance permitted. 

The armies that would bring about the 

final defeat of the Confederacy, however, 

were fi ghting in the East. It was in Virginia 

and Georgia that medical officers were experiencing unfamiliar challenges. Grant's 

constantly moving army made a shambles 

of an evacuation system that had under 

other circumstances been adequate. The 

long and vulnerable supply lines in the 

wake of Sherman's force as it penetrated 

deep into enemy territory called for the exercise of more than ordinary ingenuity in 

anticipating and meeting medical and hospital needs. Because they had the acti ve 

support of both the surgeon general and the 

secretary of war, medical directors of the 

armies of Sherman and Grant could concentrate upon meeting these new challenges, and the members of the Medical 

Department as a whole could function effectively as a team in the final months of 

the Civil War. 
CHAPTER 12 

The End 

From January to early April 1865, the 

Civil War continued in full fury, but on 9 

April, after pushing his men close to the 

limits of their endurance, Grant forced the 

surrender of Lee's Army of Northern Virginia at Appomattox. Further south, Union 

armies took Mobile and swept through Alabama and southwestern Georgia. Sherman led his army north from Savannah 

through the Carolinas, forcing Confederate 

General Joseph Johnston to abandon the 

struggle a few days after Lincoln's assassination on 14 April. Weeks before the last 

Confederate army formally surrendered on 

26 May, the bloodiest conflict the nation 

had ever known had essentially come to an 

end. 

The Union's sick and wounded from recent campaigns had never been the only 

patients for whom the Medical Department was responsible. Thousands of Confederate soldiers in Northern prisons as 

well as a trickle of sick and wounded Union 

soldiers released from captivity in the 

South during the course of the war looked 

to Union medical officers for help. The 

campaigns of 1865 began to release Union 

prisoners of war in the thousands, and the 

health of many was shattered. Thus, even 

as it prepared to cut back its operations to 

a peacetime level, the Medical Department 

was taking on increased wartime 

obligations. 

Administration 

Other than the collection of routine reports and the coordination of the work of 

the various branches of the Medical Department, much of the administrative work 

of the Surgeon General's Office in the first 

half of 1865 continued to involve the reduction of the department's size and expenses to a peacetime level. In January 

1865 the number of general hospitals still 

operating was already three less than the 

204 that marked its peak. These installations had treated more than a mill ion white 

troops during the conflict, but by the end 

of June, after the Army began mustering 

patients out directly from hospitals, 170 

were closed. The War Department's order 

of 28 April to cut back on expenses was 

followed by the reduction of the department's small fleet of ocean-going hospital 

transports from four to one, the return of 

all its river transports to the Quartermaster's Department, the elimination of all 

hospital trains but one in the West, and the 

collection of excess medicines and hospital 

supplies for sale at public auction. Barnes 

dismissed the medical boards that had 

been examining surgeons for the wartime 

Army and ordered his purveyors to stop 

buying until all surpluses had been consumed. He began closing purveying depots, 

keeping open only seven distributing sites 
252 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

and the main depots at New York, Philadelphia, and Louisville. He started reducin g th e size o f th e d epa rtm e nt 's 

laboratories. His medical directors intensified the process of consolidating patients, 

both Union soldiers and Confederate prisoners of war, and of converting large hospitals to post faciliti es, while Barnes began 

discharging contract doctors and hospital 

attendants. The surgeon general also decided that the department could loan its 

excess bedsteads, bedding, and blankets to 

soldiers' homes. All the while, the Department was processing requests for confirmation of death from the Pension Bureau, 

averaging 5,500 a month in May.' 

Among the expenses the Medical Department could not reduce in the spring of 

1865 were those involving sick and injured 

freedmen and refugees, for although Congress voted aid to these men in March, the 

law was apparentl y not qui ckly implemented. Thus for several more months in 

1865, much of the cost of the care of such 

patients, including that incurred in hiring 

contract surgeons and nurses, continued to 

be borne by the Medical Department, with 

the understanding that it would be reimbursed, and the War Department continued to detail medical officers to assist in 

the care of the unfortunate new citizens' 

IWar Department, SGO, AlIlIllal Report, 1865 . 

pp. 2- 5; MSH I , app.:205; Brown, Medical Departmenl , pp. 244-45; Ltrs, William J. Sloan to SG (28 

and 31 Mar and 8 Apr 1865), A. K. Smith to McDougall (2 May 1865), R. Crowell to SG (17 May 

1865), Magruder to SG and Clymer to SG (both 

25 May 1865), A. J. Phelps to Wood, Sloan to SG, and 

Sloan to Alfred Henry Thurston (all 3 J May 1865), 

Abadie to SG ( 15 Jun 1865), and C. W. Ballard to SG 

(27 Jun 1865), all in RG 11 2, ent ry 12; Llf. Alexander 

N . Doughert y to Lincoln R. Stone (4 May 1865) and 

Cire LITS (2 and 5 May 1865), U.S. Army, General 

Hospital, Gallipolis, Ohio- Correspondence, orders, 

internal regulation, all in M s C24, N LM. 

lGO, AG (no. I , I Jan 1865); filed with Ltf, Hennell 

Stevens to SG (10 Jan 1865), and LITS, McCord to Lee 

(10 Jan 1865), Stevens to SG (10 Jan 1865), and 

Even with the end of the war in sight and 

much to occupy his mind, Barnes continued the department's efforts to improve the 

status of its most burdened medical officers. Less than two months before Lee's 

surrender, the War Department finally ordered the pay of medical directors increased. Medical directors of armies in the 

fie ld composed of two or more corps and 

medical directors of military departments 

whose general hospitals housed 4,000 or 

more patients were given the rank and pay 

of colonels, and those with lesser responsibilities were given the rank and pay of 

lieutenant colonels. These increases, however, were to be effective only while these 

officers bore exceptional responsibilities, 

and at least two-thirds of these positions 

were reserved for surgeons and assistant 

surgeons of the volunteers. Thus, with the 

end of the war, very few regular officers in 

the Medical Department would be entitled 

to retain ranks above major] 

Although the surgeon general's support 

and influence in Washington was invaluable, by 1865 medical directors were experienced enough to need little guidance 

from Barnes. While the surgeon general coordinated the efforts of his various subordinates, prepared the Department for a 

return to peacetime duties, and supervised 

the collection of records and specimens 

that would be used for the Medical Department's history and museum, his subordinates followed familiar routines, caring 

for their patients on the battlefield and in 

the various hospitals that sheltered the sick 

and wounded. 

Cooper to SG (27 Feb 1865), all in RG 11 2, entry 12; 

WOR, se r. 1, 47, pI. 1:492,704 and pI. 2:80, 477; 

Commission of the Bureau of Refugees, Freedmen, 

and Abandoned Lands, CirclI/ars. efc., ... Wilh Copies 

of Acts and 10ill/ Resolutions 0/ COl/gress, alld Proclamations by fhe Presidem ... (Washington, 1867), pp. 

1-3, in Freedmen's Bu reau Papers, RG 105. 

JGracc, lvlalllla/, p. 105. 
THE END 

Grant's Campaign in Northern 

Virginia 

In January 1865 the battlefield for the 

Army of the Potomac lay around Lee's besieged force at Petersburg. More than 500 

medical officers and 40 hospital stewards 

served 4 army corps, a cavalry division, 

and several independent commands, including artillery and Signal Corps units. 

More than 1,900 men and 43 officers 

formed the ambulance corps, although the 

former figure dropped to 1,600 as the campaign continued. Field hospitals housed 

2,500 patients, another 2,900 occupied the 

City Point depot hospital, and almost 

8,000 had been sent to general hospitals in 

the North. Slightly more than 22 percent 

of the soldiers of this army were sick in 

January, many of them with bowel ailments 

or fevers, usually typhoid or malaria. Respiratory problems and rheumatism were 

not uncommon. Scurvy was specifically diagnosed in only 52 patients in January, but 

at least I medical inspector blamed the severity of the diarrhea that prevailed on a 

lack of fresh vegetables caused by a shortge 

of transportation. It is highly likely that 

many men were suffering from a subclinical form of scurvy.4 

In addition to the diseases that almost 

invariably amicted armies in the Civil 

War, surgeons in the field with Union 

troops around Petersburg contended with 

diseases associated with poorly located 

camps and inadeq uate shelter or contracted by men on furlough. Around Petersburg the camp site th at military 

requirements dictated might be poorly 

drained, and shallow wells were easily con4Unless otherwise indicated, all information concerning the Armies of the Potomac and the James is 

based on MSH 1:491-92, 495, and app.:202-23. 

253 

taminated by surface water. The health of 

two V Corps divisions camped in a particularly marshy area did not improve until 

these units moved elsewhere. Circumstances also forced the men of one division to 

live several days without adequate shelter 

or blankets, and their health suffered accordingly. In mid-January men returning 

from leave added to these difficulties when 

they brought smallpox back with them. The 

mass vaccination program ordered as a result was not completed until mid-February, 

but surgeons established a smallpox hospital where they could isolate victims of 

that highly contagious disease. 

Most of the 3,000 wounded and 6,400 

who fell ill while in camp or fi eld in January and February 1865 were initially sheltered in division hospitals. Surgeons sent 

those whose recovery was not likely, as well 

as all those sick when the di vision was 

about to march, back to City Point. Should 

the number in a division hospital exceed 

its capacity, which in at least one instance 

was 100, the excess was also sent to the 

depot facility. The twenty-bed brigade artillery hospital, unlike other field hospitals, 

remained at Petersburg until the end of 

March; artillerymen falling ill or suffering 

wounds elsewhere entered the hospital of 

the division with which they were serving. 

The cavalry di vision had its own 120-bed 

hospital and ambulance corps with 26 ambulances, 3 medical wago ns, and 15 army 

wagons. 

Sick and wounded officers, however, did 

not have their own facility. Disabled officers in the fi eld often took shelter outside 

hospitals, a practice McParlin wished to 

discourage, but no rules existed to dictate 

how their expenses should be handled if 

they were hospitalized. In March McParlin 

finally sent out a circular calling for offi cers 

to meet the cost of feeding themselves and 

any servant who attended them in the hos-
254 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

FIELD HOSPITAL NEAR PETERSBURG, VIRGINIA. (Courtesy of Library of Congress.) 

pital, but forbidding the levying of any 

other charges.' 

McParlin's order meant that the depot 

hospital at City Point would shelter officers 

from both the Army of the James and the 

Army of the Potomac, since patients from 

Butler's army outside Richmond had been 

using the City Point depot as a way station, 

whence they were soon sent to the Army 

of the James hospital at Point of Rocks. 

City Point's popularity resulted in large 

measure from its easy accessibility by both 

water and rail, in the latter instance either 

directly or by means of a single change of 

trains at an intermediate station. Although 

there were some complaints of inadequate 

care, neither gangrene nor any form of ep-

' WOR, ,er. 1, 46, pI. 2:609, 616. 

idemic appeared at City Point, and those 

familiar with the conditions under which 

it had to operate regarded it highly.' 

City Point experienced staffing problems, however, once Grant's force began to 

prepare for the final stages of the campaign 

in northern Virginia, and McParlin had to 

order regimental medical officers on duty 

at the depot hospital to join their units. To 

replace them the surgeon general sent in 

contract surgeons, some recent graduates 

of the Harvard Medical School, committed 

to serve three months. The fact that contract nurses worked only in general hospitals left City Point short of attendants 

when commanding officers ordered the 

6Rpt, Proceedings of Board of Inquiry (26 Jan 

1865), RG 1i2, entry 12. 
THE END 

musicians serving as nurses to prepare to 

march. Veterans in the Reserve Corps who 

could serve in hospitals were few, and the 

need for a hospital corps was particularly 

evident. Despite the shortage of attendants, McParlin ordered the capacity of the 

City Point hospital, then variously estimated as between 5,400 and 6,000, expanded by 1,000 beds or more; one surgeon 

reported that tents were to be pitched to 

increase its overall capacity to 8,800. 

McParlin also ordered hospital transports 

readied to remove all patients destined for 

general hospitals. 7 

Union troops suffered more than 1,200 

wounded in the enemy's unsuccessful attack on Fort Stedman, outside Petersburg, 

on 25 March and captured large numbers 

of Confederate casualties as well, all of 

whom were sent to Union facilities. [n the 

hospital of a Union division not in volved 

in the defense of Union lines, Confederate 

wounded were cared for "as promptly and 

as kindly ... as our own men." These patients, quickly sent back to City Point to 

free the division hospitals to take newer 

casualties, were the first of a flood that 

would fill Union hospitals from this point 

on until Lee's surrender. 8 

Realizing that the last stage of the campaign would require the transport of many 

casualties over increasing distances back to 

City Point, McParlin had hospital cars 

placed on the military railroad. His effort 

to have the quartermaster keep a reserve 

train of ambulances available for his use 

failed, forcing him to rely entirely on vehicles that were old and much repaired and 

7Ltrs. Adam Neill McLaren to sa (6 Feb 1865), 

Charles Page to SO ( 10 Mar 1865), John Campbell to 

SO (1 7 and 30 Mar and 7 Apr 1865), and McPariin 

to SO (25 May 1865), all in RO 112, ent ry 12; WaR , ser. I, 46, pI. 2:609. 

8Grant, Memoirs 2:6 19; quote from MSfi I , 

app.:220. 

255 

wagons whose number had been substanti ally reduced. [n order that unexpected demands could be met, a 36-wagon trai n 

loaded by the medical purveyor accompanied the army as it moved, and McParlin 

ordered supplies for 10,000 to 12,000 men 

kept at City Point to meet any emergency.' 

It had been raining heavily before Grant 

began his attack on Lee on 31 March, and 

the downpour had turned the Virginia clay 

into a treacherous quagmire that rendered 

roads virtually impassable. Supplies were 

left behind to lighten wagons. Although 

stretcher-bearers moved with their commands, ambulance drivers pitched in to 

help those trying to improve the roads. Enemy action had wounded more than 1,500 

from 29 to 31 March, and delays in evacuation necessitated keeping field hospitals 

in operation even after the troops moved 

on, requiring the establishment of new facilities as the army advanced even while 

the old ones remained open in the rear. 

Surgeons had to use tents to supplement 

available buildings along the way.'o 

As Union troops moved forward after 

Lee evacuated both Richmond and Petersburg in the first days of April, McParlin 

ordered the chief medical officer of the 

City Point depot hospital to establish a su bdepot facility as far forward as the railroad 

was open. He hoped, apparently, that this 

hospital could be set up at Burkeville, or 

Burke's Station, fifty miles from Petersburg where the rail li ne to Lynchburg 

crossed that from Richmond to Danville. 

Twenty-five medical officers, 3 hospital 

stewards, and 100 attendants started out 

for the new depot with tents and food for 

2,500 wounded, but when they arrived at 

Wilson's Station on 7 April, they found 

they could go no further by rail. Whi le 

' WaR, se r. 1, 46, pI. 1:609. 

" WaR, se r. 1, 46, pI. 1:707, 843- 45. 
256 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

awaiting the completion of repairs to the 

track and its conversion to a uniform 

gauge, they set up a facility at that intermediate point. Patients from Sheridan's 

command received care at Wilson's Station, and surgeons of the IX Corps, assigned to guard the Burkeville junction, set 

up their division hospitals to accommodate 

all the wounded from units that had pushed 

beyond Burkeville in their pursuit of the 

enemy. Confederate wounded had crowded 

the Burkeville hotel, so the division hospitals were housed in private homes, warehouses, tents, and makeshift shelters. 

Foragers were sent out to find food, while 

the medical purveyor's wagons continued 

beyond Burkevill e in the wake of the 

troops. " 

As Grant drove his men in a relentless 

pursuit of the enemy, the strain took its 

toll. Hospital wagons and ambulances experienced difficu lty keeping up with the 

troops, who were covering twenty to thirty 

miles a day. Some of the ambulance horses 

were " completely used up." As ambulances 

from the IX Corps at Burkeville shuttled 

to and from the front, stretcher-bearers 

were hard pressed because of the shortage 

of vehicles in which to remove the casualties. By the time the two armies reached 

the vicinity of Appomattox, even General 

Meade was among the sick, "hardly able to 

get out of bed," as Grant recalled, although 

Meade continued to obey Grant's orders 

"with great energy." Under the stress, 

Grant himself was suffering from a persistent headache that responded neither to 

mustard plasters on his wrists and neck nor 

to mustard and hot water baths for his feet. 

Grant wrote later, however, that "the instant" he heard of Lee's readiness to surrender, he was "cured." 12 

I I Reed, Hmpilal Life, pp. 160, 168. 

I2Quotes rrom Grant, Memoirs 2:466, 482-83, 485. 

The end of the war in Virginia led to a 

gradual closing of the field and depot hospitals that had served Grant's men, including, finally, the main depot hospital at City 

Point. McParlin estimated that this facility 

had admitted more than 11 ,000 wounded 

from units under Grant from I January 

through 31 May 1865. Including the sick, 

in the first six months of 1865, over 26,000 

patients passed through City Point. Of 

these, more than 12,000 were returned directly to duty. McParlin sent those 

wounded in the last days of the campaign 

back to City Point as promptly as possible 

and after Lee's surrender continued to 

empty his field hospitals by sending 2,000 

more back. On 30 April, he ordered the 

capacity of the City Point hospital reduced 

to 2,500 beds. On 4 May the Medical Department moved the facility to Alexandria, 

and destitute former slaves apparently took 

shelter in the vacant buildings. Three 

weeks after its final move, the hospital 

closed and its remaining patients were 

transferred to general hospitals, whence 

they were eventually discharged from the 

Army." 

The Burkeville subdepot of the City 

Point hospital took in 660 sick and 192 

wounded during its existence, from 9 to 30 

April, 838 of whom went on to City Point. 

For part of this period, both the Army of 

the Potomac and the Army of the James 

camped at Burkeville, and Confederate 

wounded still occupied a hotel there, but 

many of the wounded at the facility also 

came from Farmville, where after occupying the town, Union forces had shared a 

large Confederate hospital. By II April, 

railroad cars supplied with straw for bedding were available to move 1,450 of the 

2,200 patients in the various facilities in 

1lA. W. Smith, Reminiscences, p. 47; Ltr, McParlin 

to SG ( 12 Apr 1865), RG 11 2, entry 12. 
THE END 

the Burkeville area. Two attendants accompanied each car, and medical officers rode 

every train to City Point. Another 600 patients started back on 12 April, but because 

of a transportation shortage, 150 Confederate patients remained at Burkeville. Ambulances continued arriving at this 

subdepot from field hospitals, however, so 

by the 13th, another 450 awaited transportation. On 29 April ambulances began 

moving Confederate patients from Farmville to the subdepot on the first leg of their 

journey to hospitals set up for them within 

the city of Petersburg. Small numbers of 

sick and wounded continued to arrive at 

Burkeville even after McParlin closed the 

facility and sent its supplies and hospital 

train on to City Point." 

In mid-April, with the war all but over, 

a surgeon with the Army of the Potomac 

noted that disease had become a greater 

problem than it had been when the troops 

were in action. Perhaps it was easier for 

disease to spread when the men remained 

longer in one spot and water sources were 

more likely to become contaminated with 

the organisms that cause diarrhea. The 

cases of diarrhea that McParlin was encountering, however, were markedly more 

severe than they had been. The surgeon 

blamed not only bad water but fatigue and, 

above all, the lack of vegetables. No obvious cases of scurvy confronted him except for a few in men newly returned from 

southern prisons, but these returnees, 

wherever they were, caused much anxiety 

among Army physicians, since their deprivations in the South had severely undermined their health. 

Nevertheless, the fighting was over for 

the Army of the Potomac. For the medical 

officers who accompanied it, the months 

of struggle to keep pace with an aggressive, 

I~G rant , Memoirs 2:513. 

257 

at times very fast-moving campaign that 

often left them without an adequate number of ambulances and sometimes without 

adequate fi eld facilities as well, were behind them. The war was not yet over, however, for further so uth the army of 

Confederate General Joseph Johnston still 

struggled on. 

Sherman's Campaign 

For the four Army corps of the Military 

Division of the Mississippi that would defeat Johnston, the first months of 1865 

brought a march from Savannah, Georgia, 

to Raleigh, North Carolina, during which 

the men once again lived largely off the 

land. Sherman had great confidence in the 

"quiet, industrious, and most skillful" surgeons who accompanied him, but the nature of his campaign placed a considerable 

burden upon them from the outset by once 

again requiring that what they took with 

them be strictly limited. Sherman did not 

on this occasion, however, plan to keep his 

sick with him, a nd by hav ing them 

promptly evacuated east to ports whence 

transports could move them north, he also 

limited the number of patients who would 

draw upon the supplies he brought with 

him. ls 

In Savannah, preparing for the campaign 

to come early in 1865, John Moore, medical director under Sherman, set up hospitals, staffed for the most part with 

contract surgeons, where he could leave 

those unable to march . He drew one 

month's supplies from the resources accumulated for his use by the medical purveyor at Hilton Head, South Carolina, 

apparently planning to rely heavily upon 

'SWOR, scr. 1, 47, pt. 1:17, 119; quote from 1:46. 

Unless otherwise indi cated, all material on Sherman's 

campaign is based on MSH I, app.:32 1-23. 327-29, 

337- 39. 
258 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

what his foragers could find along the way. 

He attempted in vain, however, to acquire 

new ambulances to replace the aged and 

worn vehicles that were all he had. In midJanuary Sherman and 60,000 men started 

out, but the rains that had flooded swamps 

and rivers forced the temporary abandonment of the move. While they awaited a 

change in the weather, surgeons sent those 

who fell ill back to the hospitals in Savannah and contained an incipient epidemic 

of smallpox by isolating the twenty-fi ve 

cases that appeared in a three-day period." 

Sherman's men were able to ad vance 

again early in February, and on the 17th 

the right wing entered Columbia, South 

Carolina, whi ch had been virtually abandoned by its defenders. As Confederate 

garrisons along the coast began to surrender, Union soldiers also occupied such cities as Charleston and Wilmington, North 

Carolina. Medical Director Moore noted 

that, despite the weather, an average of 

only 2 percent of the army was sick. He 

concluded that the variety and abundance 

of food gained by foraging and the absence 

of opportunities for drunkenness, as well 

as the high spirits of the men, contri buted 

to the army's health." 

The Union force paused for a few days 

when it reached Fayetteville in North Carolina on II March. Surgeons then shipped 

200 to 300 of the approximately 1,500 disabled, most of whom were sick rather than 

wounded, by river east to Wilmington, 

where the surgeon general ordered fi ve contract surgeons sent to assist in their care. 

The men remaining with Sherman were at 

this time still in good condition, according 

to that general. Relatively few had been 

16Sherm an, Memoirs 2:260; WOR , ser. 1, 4 7, 

pt. 1:439- 41 ; Ltrs, Moore to SG (30 Jan and 30 Mar 

1865), Campbell to SG (1 3 Jan 1865), and Clymer to 

SG (4 Feb 1865), all in RG 112, entry 12. 

I1 WOR, seT. 1, 47, pt. 1:440. 

wo unded, and a lth ough their wo und s 

tended to be severe, causing more deaths 

than might otherwise have been expected, 

amputees did surprisingly well after surgery, presumably because of a low rate of 

infection. When Sherman arri ved at Goldsboro, however, the disease rate had doubled. Over 3,000 of his men were ill and 

more than I, I 00 wounded as a result of 

encounters with Confederate forces. Surgeons once again sent the seriously disabled 

east to the coast, on this particular occasion 

to New Be rn , North Carolin a, where 

Barnes sent fi ve more contract surgeons to 

assist in their care. IS 

Despite the difficulties he encountered 

as Sherman's force moved north, Moore 

beli eved tha t his ca re of the sick and 

wounded was adequate. Letterman's system for managing evacuation and fi eld hospitals was proving successful. The 100 new 

ambulances that arri ved during the course 

of the campaign were, however, but onefifth of what Moore needed, and since these 

vehicles were still scarce, surgeons Qnce 

again had to rely on army wagons to evacuate their patients. Moore reported during 

March that he was experiencing no shortage of items necessary to the care and comfort of his p ati e nts, and a ft er th e 

occupation of Goldsboro at the end of the 

month, the supplies that had been awaiting 

them arrived from New Bern. He noted 

that by the 26th all the sick and wounded 

were comfortable in bunks set up in tents 

or private homes and that all patients did 

well, partly because their health was excellent when they were wounded. " 

18 WOR, ser. 1, 47, pt. I: 188, 440; Sherman, Memoirs 

2;296,298, 305; Llrs, Campbell to SG (13 Mar 1865) 

and Moore to SG (14 Mar 1865), both in RG 11 2, 

entry 12. 

'9 WOR. ser. 1, 47, pt. 1:44 1; Ltrs, Clymer to SG 

(14 Mar 1865) and Moore to SG (30 Ma r 1865), both 

in RG 11 2, ent ry 12. 
THE END 

Although Moore was happy about the 

condition of the men and Sherman himself 

described them as "saucy" despite their 

"dirty, ragged" state, the Sanitary Commission had received a contrary impression of the state of affairs. Not allowed by 

the general to come near troops in the field 

because he believed that the commission 

members favored men from their own communities, they nevertheless concluded that 

the men must be in poor physical shape. 

Since, by his own admission, Sherman had 

"gained the ill-will of the agents of the Sanitary Commission," some commission officials may have been eager to conclude the 

worst. 20 

While Sherman was leading one army 

north from Savannah, Maj. Gen. John M. 

Schofield was leading another in a successful campaign to take Wilmington, 

through which Sherman could then receive 

supplies and evacuate his sick and 

wounded by hospital transport. Apparently 

unaware of the secretary of war's firm instructions to General Butler late in 1864 

and of the issuance of general orders forbidding the removal of hospital vessels 

from Medical Department control early in 

1865, Schofield appropriated the S. R. 

Spaliiding for use as his headquarters. He 

pointed out, when taken to task, that the 

vessel had been merely "lying idle without 

a single sick or wounded man on board, .. . 

of no use but to furnishing quarters to three 

assistant surgeons, who had nothing to do 

but lounge in the steamer's cabin." He 

added that the Spaliiding could still be used 

as a hospital ship when he was aboard, and, 

indeed, was all the better suited for that 

purpose, since as his headquarters, she 

2°Sherman, Memoirs 2:306, 392, quotes from both; 

Maxwell, Saflitary Commission, pp. 280-81; WOR, 

ser. 1, 47, pt. 1:190; "Report of M. C. Read" and 

"Letter From Mr. Seymour," both in Sanitary Reporler 2 (1864): 165 and 191 , respectively. 

259 

moved up and down the river, following the 

action and thus close to the largest number 

of wounded. 21 

Schofield and troops from New Bern and 

Wilmington joined Sherman's troops before they left Goldsboro on 10 April. The 

Confederates retreated before this enlarged 

force, which was still pursuing Johnston toward Raleigh when the news of Lee's surrender arrived. The main body of 

Johnston's army no longer formed a real 

threat to Sherman's men, and in his haste 

Sherman moved ahead of a group of convalescents accompanied by twenty-three 

hospital attendants, leaving them vulnerable to an attack by guerrillas on II April, 

when all but two were captured. Sherman 

continued north despite the attempts of 

Confederate cavalry to slow him, and entered Raleigh on 13 April, where the next 

day he received a Confederate request for 

a truce. The process of finding an acceptable formula for Johnston's surrender 

proved surprisingly tedious, but word of 

the truce was sent to other units fighting 

under Sherman, and fighting in the Deep 

South came to an end. 22 

While Moore moved north with Sherman to manage the care of those wounded 

or falling ill with the army, members of the 

medical staff of the Department of the 

South struggled to care for the men left behind. Those who could no longer fight presented a considerable problem for the 

medical director, surgeon of the volunteers 

Meredith Clymer. The release or exchange 

of many former prisoners of war only 

added to his difficulties. In March, anticipating that disease might create a need for 

a temporary general hospital in Charleston, 

Clymer prepared to open one on short no-

" WOR , scr. 1,47, pI. 2:342-43, 545, 832- 33, quotc 

from 2:833; WOR , scr. 3, 4: 11 56. 

nSherman, J"Jemoirs 2:342-44, 346- 63. 
260 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

MEREDITH CLYMER. (Collrtesy of National 

Library of Medicine.) 

tice, a step he apparently was never actually 

required to take. Clymer tried to prevent 

overcrowding in his department by moving 

patients retained at Savannah north as 

soon as they could tolerate the voyage and 

transports could be obtained. He lowered 

his patient load there from 2,800 in late 

February to 800 a month later. He hoped 

that by continuing to send patients north 

he could reduce any facilities he might have 

to establish in Charleston and Savannah to 

post hospitals and concentrate future casualties at port cities further up the coast. 2l 

Contract surgeons staffed many of the 

facilities serving returning prisoners of war 

as well as the men Sherman left behind. 

HLtrs, Cuyler to SG ( 17 and 23 Mar 1865) and Clymer to SG (22 Mar and 22 Apr 1865), all in RG 112, 

entry 12. 

Clymer distrusted these physicians, however, and rejoiced in May when he discovered that the sick rate was lower than he 

had anticipated among the 4,000 who returned to Union control in Florida and that 

his earlier request for six contract surgeons 

had become unnecessary. Permitted to 

terminate their contracts after three 

months, acting assistant surgeons tended to 

head north when the sickly season began. 

Having repeatedly but apparently vainly 

urged that they be signed for six-month 

terms, Clymer could only hope to function 

without them. After the war ended, several 

assistant surgeons of the volunteers were 

assigned to the quarantine stations at such 

yellow fever-threatened ports as Charleston, Savannah, and Fernandina, Florida, 

reducing the number of physicians available to care for the new, unacclimated 

troops that were arriving in the South to 

man new posts. Although recovering patients were being discharged from the 

Army directly from hospitals, Clymer was 

forced to call again and again for contract 

surgeons to replace those who went north 

for the summer" 

Adding to Clymer's woes in the Department of the South was the fact that authorities there did not initially honor the 

law of March 1864 concerning ambulances 

and their use. For more than two months 

Clymer agitated and appealed, pointing out 

that, contrary to law and custom, the Medical Department in his area exercised no 

control over the use of ambulances. He 

cited stories of pleasure jaunts from which 

neither the line officers appropriating the 

vehicles nor the ambulances always returned safely. Only on 5 May did Maj. Gen. 

Quincy A. Gillmore, commanding in the 

Department of the South, order that all 

l4Ltrs. Clymer to SG (29 and 30 Apr, 6 and 19 May. 

and 8 and 24 Jun 1865), all in RG 11 2, entry 12. 
THE END 

~mbulances, medicine wagons, and similar 

vehicles be placed under the control of his 

medical director." 

Units under Sherman's command were 

not limited to service on the coast. Men led 

by Maj. Gen. James H. Wilson crushed the 

last significant Confederate resistance in 

Alabama and western Georgia. Fifty medical officers accompanied Wilson and his 

13,500 men through Alabama from west to 

southeast, beginning in late March. Despite 

daily marches that sometimes covered 

more than twenty-five miles, neither 

wounds nor diseases caused major losses. 

On 2 April Wilson's surgeons established 

a hospital in a church at Plantersville, 

where 2 doctors and attendants remained 

to care for 40 wounded and 18 sick while 

the command continued on to Selma. After 

Wilson launched a night assault, Confederate Lt. Gen. Nathan B. Forrest retreated 

from Selma back to Plantersville and captured the unguarded Union hospital. Forrest required the attendants and those 

patients who were only slightly wounded to 

swear not to participate further in the war 

before paroling them, but he let the surgeons care for the seriously injured without 

interference. When Forrest left Plantersville, Union medical officers brought the 

patients there south to Selma, where they 

had established corps hospitals to care for 

the 24 officers and 212 men wounded in 

taking the town. When the command resumed its march, 2 surgeons remained at 

Selma with the 68 patients who could not 

be moved, keeping with them forty days 

worth of rations and other supplies. All 

who could endure travel, however, were 

HLtes, Clymer to W. S. M. Burger (copies, 23 Feb 

and 29 Apr 1865) and to SO (29 Apr 1865) and GO, 

Gillmore (no. 56 , 5 May 1865), 311 in RG 11 2, 

entry 12. 

261 

loaded into ambulances and wagons for the 

journey to Montgomery.2. 

When Montgomery surrendered to 

Union forces on 12 April, medical officers 

entering the city were alarmed to discover 

that a smallpox epidemic was "raging furiously." Fortunately, vaccination proved 

effective for Wilson's men, and the epidemic did not spread among them. Doctors 

unloaded the wounded and placed them in 

a local hospital. Because the disabled had 

proved a serious encumbrance when 

moved with the army, Wilson now decided 

to leave 144 of them in Montgomery with 

an assistant surgeon when he continued 

east on 14 April. The di vision that went on 

to Columbus, Georgia, sustained an additional 28 wounded in capturing that city 

four days later. The taking of West Point 

the same day produced 30 more Union 

wounded. Leaving 35 patients at Columbus, Wilson moved on to take Thomaston 

on the 19th and Macon on the 20th before 

word of Sherman's armistice agreement 

with Johnson ended his campaign." 

Wilson's medical director, Surgeon 

Francis Salter, was quite pleased with the 

way his branch of the Medical Department 

had functioned during this campaign. Despite the speed with which the army 

moved, no patients were left by the roadside or cared for in makeshift shelters. 

"Regularly furnished hospitals" received 

all casualties. Although Salter had apparently been concerned about whether an 

ambulance corps could function effectively 

for cavalry units, his experience in this 

campaign led him to conclude that such an 

26Unlcss otherwise indi cated, all material on Wilson's march is based on MSfl l , app.:327-29. A report 

of 22 rather than 2 12 men wounded is probably a 

typographical error, since 35 were killed in taking 

Selma: WOR, ser. I, 49, pI. 1 :406. 

21Quote from MSN 1, app.:328-29. 
262 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

organization could be as effective for cavalry units as for infantry" 

The medical officers caring for the sick 

and wounded of the two corps that took 

Mobile on II April encountered few significant problems, despite the fact that 

Maj. Gen. Edward R. S. Canby allowed 

only a single ambulance for every 400 men 

(under the law of March 1864, a regiment 

of 500 men should have had two ambulances). He had an additional ambulance 

permanently attached to each artillery battalion, and two more for each army headquarters and each corps headquarters. 

Three wagons were to accompany each division hospital train to carry hospital tents 

and other equipment. Predi ctably, the 

number of ambulances available during the 

seige of Spanish Fort and Blakely, Alabama, guarding Mobile, proved inadequate, and once again wagons had to be 

used to carry some of the wounded." 

No deficiencies appear to have marked 

the work of Canby's ambulance corps or 

the organization and management of division hospitals, to which were allotted one 

hospital tent for every 600 men in the division. At Spanish Fort enemy fire delayed 

the removal of casualties from the field until dark each day. Their able-bodied comrades covered the wounded with rubber 

blankets, thus limiting their sufferings in 

the heavy rain. At Blakely, shells from the 

enemy gunboats forced surgeons to move 

division hospitals several times. Boats removed casualties from field hospita ls at 

both Spanish Fort and Blakely to general 

facilities in New Orleans within two or four 

days.J<l 

The ordeal that Mobile was to endure at 

the hands of the Union Army was not yet 

21QUotc from MSII I , app.:329. 

" WOR , scr. 1, 49, pI. 1:791; MSH I, app. :337-39. 

"'MSH I, app.:337- 39. 

over. Late in May ammunition stored in a 

warehouse there exploded, causing what a 

witness described as "a terrible calamitybeyond description. Acres of ground were 

covered with flames .. . . The loss of life 

[was] terrible . .. several steamers were 

torn to pieces." The hospital serving Army 

engineer units was totally destroyed, and 

the interior of the building used as a freedman's hospital was gutted. All the injured 

were initially taken into the city's hospital 

for merchant seamen, where white victims 

remained while blacks were quickly moved 

to another facility. Because the accident occurred just as regimental medical officers 

were leaving the city with their units, the 

surgeon in charge of the general hospital at 

Mobile sent out a frantic call for more physicians, and Canby ordered that all medical 

officers in the area come to the aid of the 

injured. " 

Except for those areas in which Union 

troops commanded by Grant or Sherman 

were fighting the last major battles of the 

war, Army surgeons were already beginning 

to return to their peacetime occupations. 

In Arkansas the surgeon at Helena converted the 250-bed general hospital into a 

post facility in March. At Fort Smith, 

newly reoccupied after its evacuation in 

1864, the chief health problem was apparently scurvy. The countryside had been so 

devastated that no vegetables were available locally, and guerrillas continued to 

threaten shipments coming in. A Sanitary 

Commission agent offered seeds to start a 

post garden, the Western Sanitary Commission furnished some vegetables, and the 

department's commanding officer ordered 

a special issue of vegetables to control the 

)1 WOR, ser. 1,49. pI. 2:74 1, 911-14, quote from pp. 

912- 13; Llr, Samuel Kneeland to Abadie (26 May 

1865), RG 11 2, entry 12. 
THE END 

inroads of scurvy until local crops could 

mature.32 

It was also west of the Mississippi, at 

Brownsville, Texas, that on 13 May 1865 a 

small number of Union and Confederate 

soldiers fought the last battle of the Civil 

War. Although the 26 May surrender of this 

last Confederate army formally ended the 

war, for the Medical Department a considerable challenge remained. The end of the 

conflict brought with it the release of the 

last prisoners remaining in captivity in the 

South and the beginning of the return of 

Confederate prisoners to their homes, with 

Union surgeons being responsible for the 

care of the sick and wounded in both 

groups. The apparatus of war also had to 

be dismantled, and the transformation of 

the Medical Department to a peacetime organization would not be complete for many 

months. 

Prisoners oj War 

Although the difficulties involved in 

maintaining or restoring the health of prisoners of war peaked in 1865, the challenge 

was not new. From the outset, the Medical 

Department of the Union Army had been 

responsible for the prevention of disease in 

Northern prisons, for the health of Confederate captives, and for the care of sick 

and wounded Union soldi ers returned 

through exchange or released by successful 

Union armies. Union surgeons had little to 

do, however, with the care of Northern men 

while they were in Southern prisons, since 

during most of the war, medical officers 

were not held captive, and when they were 

imprisoned, they were apparently concen-

.l2"Report of Mr. Carpenter," Sanitary Reporter 2 

(1864); 166; SGO, Sanitary Report of the Army 0/ Arkansas. 1865-66, Ms C126, NLM; U.S. Army. Medical 

Department, U.S.A. General Hospitals ill Existence, 

January 1865, Ms 81 25, NLM. 

263 

trated at Richmond rather than distributed 

among the various prisons throughout the 

South." 

In the earliest months of the war, the governments of the Union and Confederacy 

had not agreed upon the status of physicians. Medical officers taken in April 1861 

in Texas were paroled and allowed to return 

home after swearing not to care for combatants until formally exchanged. Surgeons 

on both sides were held captive for varying 

periods of time until the spring of 1862, 

when the Union War Department ordered 

all medical officers " unconditionally released ." This order was not invariabl y 

obeyed, as there were apparently some misunderstandings about it, but generally for 

a time thereafter both sides released surgeons unconditionally, allowing medical 

officers to stay with the captive wounded 

of their own armies until their captors 

cou ld provide adequate medi ca l 

attendance.

34 

In 1863, however, the state of Virginia 

claimed that a certain captured Union 

medical officer had committed crimes punishable under state law. He was, therefore, 

ineligible for return under any circumstances until he had been tried. Union authorities reacted by claiming the right to hold 

a Confederate physician hostage against 

the safe return of the Union surgeon. The 

agreement to return medical officers unconditionally collapsed completely in July 

when Confederate authorities refused to 

recognize the Union's right to hold a hostage. As a result, although it was still possible to be released by means of exchange, 

many medical officers apparently concluded that the possibility of long imprisll WOR, ser. 2, 5:953 and 6:619. 

" WOR, sor. 2, 1 :62, 73-75, 4:27, 33, 37, 39, 44, 101 - 02, 268-69, 272, and 5:164, 262, quote from 

5:262. 
264 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

onment dictated that they take fewer 

chances of being captured. 3S 

The impasse ended late in 1863, when 

finall y Confederate authorities returned 

the Union surgeon whose plight caused the 

problem, apparently still untried-his guilt 

appears highly questionable-and both 

sides ordered the release of all medical officers. Captives were by then in prisons far 

from the front, however, and their return 

proved tedious. Word that physicians were 

to be released did not always reach prisons 

in a timely fashion. In one instance, Confederate refusal to allow a flag-of-truce boat 

to carry Confederate physicians on the final leg of their journey home led to additional difficulties when Genera l Butler 

concluded that the alternative of letting 

these doctors through his lines in Virginia 

would be unsafe because they wou ld then 

"know too much." The status of hospital 

stewards caused further confusion, but in 

March 1864 the War Department ruled 

that these men were to be treated in the 

same manner as surgeons. 36 

Although they rarely cared for men held 

in Confederate prisons, Union surgeons assumed responsibility for their health when 

they returned from the South. Until Union 

armies began to occupy large areas of the 

Confederacy, only limited numbers of captives returned home, but as the war went 

on, these men presented a growing challenge to the Medical Department because 

of their numbers and their condition. Many 

were sick before they started north, and 

those who remained in captivity until the 

last months of the conflict suffered increasingly from the effects of an inadequate diet 

" WOR, se r. 2, 5:2 12 and 6:13, 18,26-27,35- 36, 

81 , 85,88-89, 157-58, 208-09, 250, 283, 335- 36, 

473-74, 762; Solon Hyde, A Captive of War (New 

York: McClure, Phillips & Co., 1900), p. 54. 

" WOR, ser. 2, 6:1078, 7:127- 28, 141 , 48 1, 491 , 710, 

853, 860-62, and 8:156, quote from 7:412-13. 

and often from the effects of exposure and 

poor sanitation as well. 

Despite a formal agreement in 1862 calling for the parole of all prisoners within 

ten days of their capture, actual exchanges 

were erratic because of squabbles concerning interpretation. Some difficulties apparently arose from the Union's lack of 

enthusiasm for a step that would renew the 

Confederacy's dwindling manpower supply 

by returning healthy prisoners. The Union 

seems to have been less reluctant to take 

part in exchanges of those "who will not 

soon be fit for service." The cartel of 1862 

called for most exchanges, whether of 

healthy or disabled men, to take place 

through the City Point area or Vicksburg, 

but wounded prisoners could also be returned directly to their units shortly after 

battle on the initiative of individual commanders involved." 

By the fall of 1863, the effects of malnutrition upon invalids returning from the 

Richmond area via City Point were pronounced. As often happened, a few of the 

disabled men sent from City Point to Annapolis hospitals died before reaching 

Maryland. Many returnees had diarrhea, 

and chronic diarrhea was the most common cause of deaths occurring soon after 

exchange, although pneumonia and debility added to the toll. Some taken at Gettysburg maintained that their wounds had 

never received medical attention. With sick 

priso ners returning in such precarious 

health, Union authorities soon realized 

that extraordinary measures would be necessary to limit suffering and the number of 

deaths. Medical officers began to accompany the vessels that picked up the returnees at City Point, and at the end of 

" WOR , scr. 2, 1:518,4:266-68, 6: 124, 129, 134, 512,523, 599, 615, 629, 995, and 7:76, 108, 215, quote 

from 7:75; Hyde, Captive, p. 51. 
I,:, 

,t" ,r 

, J '" ;' ., ,~" ,. 

CONDIT ION OF RETURNEES FROM SOUTHERN PRISONS. (Collrtesy oj Library ojCongress.) 
266 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

November 1863 the surgeon who acted as 

medical inspector of prisoners of war, Augustus M. Clark, reported that a contract 

surgeon, a contract hospital corpsman, and 

two nurses were serving on the truce ship." 

On an average run, the truce ship carried 

600 men, onl y 5 percent of whom needed 

immediate care during the 16- to 20-hour 

voyage to Annapolis, and no addition to 

her fift y-six hospital bunks was necessary. 

But when the ship carried excl usively sick 

returnees, facilities on board were inadequate, even when an add itional ten bunks 

were set up on deck. By early 1864, however, the Medical Department had succeeded in obtain ing hospital transports to 

move the sick and wounded. Sometimes, if 

the patients' condition permitted, these 

vessels took them beyond Annapolis to 

hospitals in Baltimore and Philadelphia, 

si nce even before the start of 1865, thousands of sick and wounded returnees whose 

condition was "indescribable" were almost 

overwhelming Annapolis facilities." 

In 1865, as Sherman drove north through 

the Carolinas, newly released prisoners, 

many in need of medical care, began gathering in Wilmington for transportation to 

hospitals farther north. By March 1865, 

3,700 sick former captives were crowding 

faci lities in North Caroli na. The surgeon 

general diverted medical supplies and offi cers intended for Sherman and Schofield 

to the care of the newly released prisoners. 

Quick attention and prompt transfer north 

interrupted a typhoid fever epidemic, but 

a shortage of clothing and bedding rendered th e voyage ard uo us, and th e 

"wretched condition" of many made it advisable in some instances to terminate it at 

" WOR , ser. 2, 6:446, 474- 75, 494, 593, and 1089. 

" WOR, ser. 2, 6:535, 593, and 7:69, 101 , 116 1, 

quote from 7:1 160; Ltr, McCormick to SG ( 17 Apr 

1864), RG 112, entry 12. 

Fort Monroe. A contract physician at Annapolis, where many returnees from Wilmington arri ved in the spring of 1865, 

maintained that they were being shipped 

without medical attendance, crowded, and 

" in a most horrible plight." The most desperately sick or wounded were packed in 

the hold, where the ventilation was entirely 

inadequate. The medical officer responsible for loading the ships at Wilmington, 

however, pointed out that it was impossible 

to spare a physician to accompany each 

ship and insisted that only those who appeared able to withstand the voyage were 

sent north. Prisoners had started arriving 

at Wilmington only five days after Un ion 

forces took the city, he said, but he insisted 

that, although the quartermaster general 

was initially unable to supply enough blankets and bedding for all returnees, those 

sent to Annapolis were adequately provided for.40 

The situation in wh ich sick and wounded 

prisoners returning through Vicksbu rg 

found themselves was similar to that in the 

East, and many patients died before they 

had been long in Union hands. Prisoners 

released from Andersonville were in 'particularly deplorable shape, almost all needing medical care. Exchanges were cut off 

during several months of 1863 while Grant 

was closing in on Vicksburg, but in 1865 

so many prisoners were returning that the 

city's hospitals had to be emptied of other 

patients. Surgeons sent many north to St. 

Louis and even beyond, but hospital steamers could not keep up with the demand. In 

April, the explosion of the steamer Silitana 

after it left Vicksburg killed I, I 00 returnees 

t Quote, Ltr, Cuyler to sa (23 Mar 1865), and 

second quote, Ltr, J. Simpson to sa (12 Mar 1865), 

both in RG 112, entry 12; Ltrs. Cuyler to sa (25 Mar 

1865) and Sh ippen to SG (23 Feb and 26 Mar 1865), 

all in RG 11 2, entry 12; WOR, scr. 2, 8:464- 65; War 

Department, sao, Allflllat Report, \865, p. 7. 
THE END 

and added still further to the strain on the 

evacuation system, although surgeons were 

able to send the 500 injured survivors on 

to Memphis. 41 

When caring for enemy prisoners rather 

than their own returnees, authorities in the 

North and South alike occasionally exhibited a certain vengefulness. The " Instructions for the government of armies of the 

United States in the field" issued by the 

Union in April 1863 maintained that the 

Confederate prisoner was a " public enemy," who should be " penit ent " and 

should not be coddled. Prisoners should 

not receive clothing beyond that absolutely 

necessary, regardless of whether the clothing came from the federal government or 

from friends. In 1864 Union authorities, 

including Surgeon General Barnes, General Halleck, and Secretary of War Stanton, 

agreed not to furnish able-bodied captives 

a diet any better than the one Confederate 

soldiers were receiving from their own 

army in the field. A Southern medical officer fulminated against what he took to be 

"the indifference and brutality" of the federal government, as typified by the inadequate diet, shelter, and hospital facilities 

made available to Southern prisoners of 

war.42 

Union authorities were kinder to the sick 

and wounded among their captives than to 

the able-bodied. After the battle of Gettysburg, they ordered medical officers to ensure that Confederate patients were treated 

with all the care granted Union casualties, 

41WOR, seT. 1, 48, pI. 1:2 17 and sec. 2, 8:477- 78, 

492-93 ; Benjamin Woodward, "Among the Prisoners" and "Letters From Mr. Tone," both in Sanitary 

Reporter 2 (1864): 188 and 190, respecti vely'; Ltc, 

Azpell to Wood (8 Apr 1865), RG 112, entry 12 . 

• 2WOR, seT. 2, 6:602, 7: 151, and 8: 161 , first and 

second quotes from 5:674 and third quote from 6: 102; 

J. A. Wyeth, With Sabre alld Scalpel. the Autobiography of a Soldier alld Surgeon (New York: Harpers, 

1914), pp. 286-92, fourth quote [rom p. 286; MSfll, 

app.:324-2 5. 

267 

but that they should be confined in separate faciliti es from those sheltering Union 

soldiers and receive "only such [clothing] 

as is absolutely necessary." The hospitals 

themselves, according to advice given by 

an officer responsible for prisoners of war, 

were not to be "fitted up with all the conveniences which are provided in hospitals 

for Federal soldiers," but only to be adequate " to meet all necessary wants of the 

sick ." Idea ll y, furth ermore , priso ners 

should not be hospitali zed so uth of 

Nashville." 

In spite of the restrictions placed on the 

care given Confederate prisoners and the 

accusations made by each side concerning 

the treatment of prisoners of war, some observers, both North and South, excluded 

medical officers from their diatribes. The 

same Southern physicians who wrote of 

Northern indifference and brutality noted 

that Union surgeons were compassionate. 

Speaking for the Union, General Butler informed Secretary of War Stanton in February 1864 that he had " received less 

complaint of the treatment by rebels of our 

prisoners in hospitals than elsewhere." He 

added that he had had "occasion to know, 

the treatment in the hospitals by rebels of 

our soldiers prisoners in their hands [has] 

been reasonably proper and sufficient."" 

Although the death rate among Confederate soldiers in Union hands was less than 

that of Northern soldiers in Southern institutions, more than 26,000 of 220,000 

rebel captives died during the course of the 

war. This rate of 12 percent compared favorably with the almost 18 percent characteristic of Confederate prisons, where 

22,576 of approximately 126,950 Union 

4lWOR, se T. 2, 5:676,6:98, 106, and 8:5, first quote 

from 6: 149 and second and third quotes from 7:468; 

A. W. Smith, Reminiscences, p. 133. 

44Wyeth, Wilh Sabre alld Scalpel, p. 287; WOR, ser. 

2,6:60 1, quotes from 956. 
268 THE ARMY MEDICAL DEPARTMENT, 181 8- 1865 

prisoners died, despite the fact that from 

the outset many Confederate prisoners suffered from the effects of an inadequate 

diet. Although they were sick as often and 

suffered from the same diseases as Confederate soldiers in the field, twice as many 

Confederate captives died. One authority 

suggested that it was possible that the least 

healthy were the most likely to be taken 

prisoner. Almost 6,000 deaths in Union 

prisons resulted from diarrhea and dysentery, over 5,000 from respiratory diseases, 

and just under 3,500 from smallpox, measles, erysipelas, scarlet fever, and similar 

rash-producing diseases." 

Setting the policies that governed the 

management of prisons and the hospitals 

that served them was a relatively simple 

matter, but the attitudes that lay behind 

these policies may well have contributed to 

the relatively high death rate in many of 

these institutions. Northern camps were 

hastily established at a time when large 

numbers of prisoners, many in poor health, 

were coming in. As a result, these camps 

often acquired unenviable reputations that 

challenged Army physicians, but improvements were not always immediately 

forthcoming. 

Medical inspectors and prison doctors 

attempted to prevent diseases at these 

prison camps as well as to cure them, inspecting sanitation and living conditions in 

the prisons and their hospitals and making 

recommendations for improvements. 

Worst among the institutions for which 

they were responsible was Elmira, New 

York, " a perfect pest-hole" established in 

1864, where 241 of every 1,000 prisoners 

died each year it was in operation. Diarrhea and dysentery killed almost 1,400 of 

the 12,000 men who were at one time or 

" MSH I, pI. 3:47; WOR , scr. 2, 8:948; USSC, Docwnellts I, no. 55:22. 

another imprisoned at Elmira. One factor 

contributing to the high disease rate was 

the drainage of effluent from the sinks into 

a pond within the camp's boundaries. Another was the paucity of fresh vegetables 

available in the diet. Since the vitamin C 

reserves of most of the men confined there 

were undoubtedly low, scurvy a fflict ed a 

large number, at one point as many as 

2,000 at a time." 

Conflict between the camp commander 

at Elmira, Benj amin Franklin Tracy, future 

secretary of the Navy, and the chiefmedical 

officer, a surgeon of the volunteers, contributed to the difficulties in both the camp 

and the hospital attached to it. The entire 

medical staff, which in addition to the chief 

surgeon included seven contract surgeons, 

an assistant surgeon to a militia unit, and 

a New York State National Guard assistant 

surgeon, accused Tracy of interfering in the 

management of the hospital and thereby 

making their work more difficult. Although 

the Medical Department's in vestigation of 

the prison hospital confirmed the surgeons' 

complaints, Co mmissioner General of 

Prisoners William Hoffman concluded that 

all concerned, medical staff and camp commander alike, were incompetent. Under 

Hoffman's prodding, however, Tracy improved camp drainage and pushed the 

building of better accommodations for the 

prisoners.

47 

So much illness among so many men at 

Elmira initially threatened to overwhelm 

hospital facilities regardless of what anyone 

could do. The hospital was still under con46MSH I , pt. 3:63, quote from p. 56; WOR, scr. 2, 

7:465, 1093. 

47Benjamin Franklin Cooling, Benjamin Franklin 

Tracy, Father o[ the Modem American Fighting Navy 

(Hamden, Conn .: Shoe String Press, Archon Book, 

1973), pp. 22,28-33; WOR, scr. 2, 7:878, 892, 918- 19, 

989- 90, 997, 1025, 1042- 43, 1050, 1092, 1093- 94, 

1124, 1133-34, 11 35. 
THE END 

struction when the first Confederate soldiers began arriving, and the sick among 

them had to lie on bare bunks. Straw for 

bedding and medical supplies arrived only 

after several weeks, but by October the hospital contained six new wards with an average of sixt y-t wo beds each. The 

completion of yet another ward in November allowed the abandonment of an old 

one. Construction continued until, by the 

end of the year, four more hospital buildings were approaching completion." 

Sickness was on the increase, however. 

Smallpox had broken out and, since a delay 

in the arrival of vaccine made the immediate immunization of the entire camp impossible, new cases continued to appear. By 

24 January 1865, 397 men had been sent 

to the tents hastily pitched to isolate smallpox patients, and hospital accommodation s remained in a dequ ate . Perhaps 

motivated by the need to reduce the population at Elmira, the surgeon in charge 

was less discriminating than he should have 

been in selecting patients for the 41-hour 

voyage to the exchange point, and some 

men broke down under the strain. Even so, 

the hospital remained crowded, and in February 1865 a medical inspector found 200 

patients being cared for in their quarters 

when in his opinion they should have been 

hospitalized. In mid-March the excess hospital patient load was still being cared for 

in quarters, and more than 1,700 of 6,000 

prisoners were sick. An inspector reported 

their condition as " pitiable." Only the end 

of the war and the return of warm weather 

led to significant improvement in conditions at Elmira shortly before its closing 

late in June." 

The Medical Department regarded John-

"MSH I, pI. 3:56; WOR , scr. 2, 7: 11 73,1272. 

~9MSH I, pt. 3:57, quote from p. 57; WOR, ser. 2, 

8:18 1,232. 

269 

son's Island, on the other hand, as one of 

the healthiest prisons. It opened early in 

1862 on a 360-acre island near Sandusky, 

Ohio. Drainage was excellent, the water 

good, and the diet almost ideal. Most of 

the prisoners were officers, however, and 

thus may have been in better health at the 

time of their capture than the enlisted men 

who formed the majori ty of prisoners at 

camps like Elmira. The regimental surgeon 

in charge at Johnson's Island for much of 

the time it was in operation was a Union 

physician, but he was assisted by Confederate surgeons, doctors who had been serving in the Confederate Army as line officers 

and therefore were not released. The surgeon in charge was authorized to hire contract surgeons when he needed them, but 

the isolation of the prison made finding 

civilians willing to serve for $80 a month 

difficult. so 

Medical Inspector Clark found much to 

criticize at Johnson's Island in spite of its 

wholesome location and the health record 

of its inmates. In the fall of 1863, the hospital was in need of repair and improved 

ventilation, the wards were crowded and 

badly kept, more physicians were needed, 

and the nursing, which was probably done 

by prisoners, was careless. The latrines 

were badly maintained, and some of the 

beds " in a horribly filthy condition." Even 

when improvements were made at the hospital, the camp kitchens and latrines remained filthy , policy in such matt ers 

hav ing been " left to the caprice of the prisoners themselves," and the patients' clothing was inadequate for cold weather. By 

late July 1864, although the hospital was 

well-policed and the patients were receiving good care, the prison itself had not improved. The number of sick was growing 

rapidly, principally because of diarrhea 

" WOR, scr. 2, 3: 196 and 6:827- 28; MSH I, pI. 3:54. 
270 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

UNION ARMY PRISONER OF WAR CAMP, Johnson's Island, Ohio. (Courtesy of Library of 

Congress.) 

and dysentery. Under the stress of imprisonment and disease, some prisoners developed scurvy, and the surgeon increased 

the allotment of onions to sixty pounds for 

every 100 men twice a week. Nevertheless, 

the annual sick rate of 811 per 1,000 and 

the death rate from all causes of 35.4 per 

1,000 were less than a fifth that of the second most healthy prison." 

The hea lth problems experienced at 

many of the prisons were similardiarrhea, dysentery, fevers, respiratory diseases, and occasionally scurvy. At many 

prisons, smallpox, classified as an eruptive 

fever, was a minor problem, but at Alton, 

Illinois, it was responsible for greatly in-

" WOR , se r. 2, 6:364- 66, 826-28 and 7:484-85, 

first and second quotes rrom 6:365 and 827, respecti ve ly; MSfll , pI. 3:61. 

creased disease and death rates. The fact 

that from Alton healthy prisoners were usually sent quickly to other prisons, leaving 

their sick comrades behind, contributed to 

misleading statistics, but the long-lasting 

epidemic at Alton raised the an nual sick 

rate to 10,000 per 1,000, compared to 

1,544 at Elmira. The death rate at Alton 

was also higher than that at Elmira, although dysentery and diarrhea took a 

higher toll at the New York hospital. The 

prison surgeon at Alton had believed that 

he could successfully isolate his smallpox 

patients within the prison, and by the time 

he realized he was wrong, smallpox was affli cting guards as well as inmates and was 

threatening the civilian population of the 

area as well. Despite a policy of vaccinating 

every new prisoner on arrival, the disease 

flared anew as each new group of prisoners 
THE END 

arrived, and the surgeon in charge finally 

concluded that the vaccine he was receiving from St. Louis was worthless. The medical inspector who came to the prison at 

the end of July at the request of the desperate medical officer recommended that 

a smallpox hospital be established outside 

the confines of the prison. In August, despite opposition from property owners, 

land was fina lly obtained two miles from 

the town and the surgeon general ordered 

the erection of a tent hospital. By March 

1864 Alton had only five patients with 

smallpox, and these were all con valescent. 52 

When a contagious disease appeared at 

a prison, the threat of its spread was not 

always limited to the immediate vicinity. 

Apparently unaffected prisoners were 

sometimes moved from a fort where smallpox had appeared to another or sent south 

for exchange. If they fell ill in transit with 

this highly contagious disease, they endangered the populations of the areas through 

which they moved as well as those at their 

destinations. In October 1863 the appearance of smallpox in prisoners moving toward City Point from Fort Delaware 

caused so much anxiety that delaying future exchanges from the fort seemed advisable. The disease at Fort Delaware 

apparently arrived with a prisoner from 

Camp Chase. Although no surgeon would 

permit a man obviously suffering from 

smallpox to travel, men known to be suffering from chronic diarrhea did make the 

journey south for exchange. Some had to 

be hospitalized along the route, and others 

died" 

As the end of the war drew nearer, the 

challenge to prison physicians grew. New 

prisoners poured in, especially to faci lities 

" MSH I, pI. 3:50-51 , 61-62, 67; WOR, ser. 2, 6:96- 97, 104-05, 157, 160, 179, 476, 1123, and 7:535. 

»WOR, ser. 2, 6:96, 422, 477 and 8:23 1. 

27 1 

in the more southern locations. The population at Ship Island in the Mississippi 

River was 4,000 in April, and during the 

same month that at Point Lookout, between the Potomac River and the Chesapeake Bay, rose from less than 8,000 to 

almost 12,000. The sick and dead at Point 

Lookout were particularly numerous-203 

died in April, when more than 1,700 were 

sick. By May, when nearly 1,600 left Point 

Lookout, prisoners were heading home in 

great numbers. Sick rates remained high at 

Point Lookout, however, where another 

1,800 were ill during May. Almost all detainees at Ship Island left before June, and 

prisoners departed from other camps so 

rapidly that by the end of the month relatively few remained except for those too 

sick or too weak to be moved. 54 

Men in blue or gray were not the only 

patients for whom Medical Department 

physicians were responsible during 1865. 

The chief elected officers of both Union 

and Confederacy, the one an assassin's victim, the other a defeated, harrassed, and 

ailing prisoner at Fort Monroe, received 

medical care at the hands of Army surgeons. The first doctor to come to the aid 

of Abraham Lincoln in his box at Ford's 

Theater on 14 April 1865 was 23-year-old 

Charles Leale, assistant surgeon of the volunteers. It was Leale, an ardent Lincoln admirer who apparently came to the theater 

that night only because he knew the President would be there, who determined the 

nature of Lincoln's wound. Lea1e directed 

the efforts of two other physicians, one an 

Army contract surgeon, Charles Taft. Taft 

joined him in the President's box, attempting to revive the victim by pumping his 

arms up and down, clearing his throat, and 

blowing into his mouth. The physicians repeatedly removed the clot that clogged the 

" WOR, ser. 2, 8: 173, 259, 480, 482, 493, 1001 - 02. 
272 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

HOSPITAL AND P RISONER OF WAR DEPOT at Point Lookout, Maryland. (Courtesy of 

Library of Congress.) 

wound, after having noticed that their patient's breathing and heart rate improved 

when they did so. Although they were certain almost from the outset that the injury 

would prove fatal, one of the physicians 

administered a few drops of brandy. They 

ordered that a room nearby be procured 

where the President's last hours could be 

spent and helped carry Lincoln to a nearby 

house. Leale then sent for his patient's regular physician and for Surgeon General 

Barnes. Until Barnes and Surgeon Charles 

Henry Crane, who would be Barnes' successor as surgeon general in 1882, arrived 

a short while later, Leale continued to direct the patient's care, which included the 

application of mustard plasters the length 

of his body. Barnes probed the wound 

deeply and repeatedly without encountering the bullet, and agreed with the other 

physicians gathered around the bedside 

that Lincoln could not survive his injury. 

Crane and Taft alternated holding Li ncoln's head as they waited, and Leale was 

holding his patient's hand when Barnes 

pronounced him dead shortly after seven 

in the morning of 15 April." 

The physicians responsible for the health 

of Jefferson Davis after his capture were 

also military surgeons. When Davis first arri ved at Fort Monroe on 19 May, John J. 

Craven, surgeon of the volunteers, reported 

on his health. By the time Surgeon George 

Cooper, former medical director for the 

Army of the Cumberland, assumed the 

SS Jim Bishop, The Day Lit/coIn Was Shot (New York: 

Ba ntam Books. Bantam Pathri nders, 1955), 

pp. 208- 14, 230, 256, 263-64; Charles Sabin Taft, 

Notes on Abraham Lincoln, Ms CI08, NLM; MSfl2, 

pI. 1:305- 06. 
THE END 273 

PROBE AND BULLET FRAGMENTS FROM LINCOLN'S BRAIN. (Co urtesy of Armed Forces 

Institute of Pathology.) 

responsibilities initially handled by Craven, Davis' health or lack of it was beginning to become a cause of controversy. 

During the two years he remained a prisoner, the former president of the Confederacy suffered from a variety of conditions, 

including neuralgia, boils, erysipelas, "dyspeptic symptoms," and "severe hemorrhoids." Cooper's concern for his patient's 

health and the effect of imprisonment upon 

it led the officer in charge of the prison to 

accuse the surgeon of being "entirely under 

the influence of Mr. and Mrs. Davis" and 

to refer disparagingly to Mrs. Cooper's 

Southern connections. In making this last 

comment, the commandant may not have 

reali zed that Surgeon General Barnes himself, despite his birth in Philadelphia and 

education in New England, also had ties 

with the Confederacy, for his brother had 

worked actively for the Southern cause." 

Conclusion 

In mid-1865, only Davis and a relatively 

few seriously ill soldiers and prisoners of 

war still remained to remind Medical Department surgeons of the great conflict that 

6WOR. ser. 1, 52:171 and ser. 2, 8:56, 558, 571 , 

577,71 1, 720,740, 754- 55,775, 846, 87 1, 875, 883, 

919, first, second, and third quotes from 8:846, 919, 

and 976, respecti ve ly; James M. Phalen, Chiefs, p. 47. 
274 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

had just ended. Surgeon General Barnes 

was occupied principally in preparing his 

organi zation for a return to peacetime status. The Quiet was welcome after the tumultuous last months of the war. Returning 

prisoners in fragile health had poured in. 

Grant's army in its final dri ve had moved 

so rapidly that the countryside between Petersburg and Appomattox had been strewn 

with wounded, Union and Confederate. 

Sherman had once again covered great distances with a minimum of medical supplies. Ambulances had been in short supply 

and many vehicles in poor repair. Although 

prisons were not managed with the health 

of their occupants as the main consideration, nor campaigns planned with the care 

of the wounded as the prime concern, the 

Medical Department had functioned as effectively in prisons as it had in the field 

under conditions it could not control. But 

now the war was over; it continued to exist 

only in the memory of survivors and in an 

enormous volume of records that would as 

the years went by be compiled, published, 

and studied, so that from this hideous confli ct, something worthwhile might still 

emerge. 57 

HSGO, Anflllal Report, 1865, p. 6; MSfll . app.:205; 

Brown, Medical Departmelll, pp. 244- 45. 
CHAPTER 13 

Achievements and Failures 

During the Civil War 

The Medical Department had intended 

that its detailed and copious records concerning the Union's sick and wounded 

guarantee the emergence of something of 

value to medical science as well as to the 

Army from the most frightful conflict that 

the nation had ever faced . During the struggle and the months immediately following 

it, more than 12,000 medical officersregula rs, vo lunt ee rs, and co ntractexamined ove r 25 0,000 wounds and 

treated more than 7 million cases of disease. In the course of their duties, more 

than 300 Army surgeo ns died from 

wounds, disease, or accidents.' 

In spite of their heavy case loads, many 

were able to record what they saw for posterity. The value of their observations, 

however, was to some degree negated by 

the fact that they, like their civilian counterparts, knew little of bacteria and the 

methods by which one microscopic creature could be clearly distinguished from another. Furthermore, the heavy demands 

placed on Army surgeons left little time for 

the careful consideration of the significance of what they saw. As a result, their 

observations were haphazard and often of 

little value. Since surgery was usually performed in great haste and under difficult 

'Brown, Medical Department, pp. 245-46; MSfl2 , 

pl. 3: 1, 3-4, 9 10. 

circumstances, there was also little time 

available for trying new or intricate techniques. The frightening mortality that resulted from infection obscured the possible 

achievements of new approaches to surgery. The most important progress made 

by the Medical Department during the 

Civil War involved practical matters of organization and administration and resulted 

in the creation of an effective and efficient 

medical department for the large and acti ve Union Army.' 

Disease 

In the nineteenth century, disease exacted a heavy toll when large groups of men 

were gathered closely together under conditions of stress and poor sanitation. In the 

Civil War, it killed twice as many men as 

battle. The conflict thus provided millions 

of cases of vari ous diseases for study, but 

Union surgeons, li ke their counterparts 

everywhere, were still unable to distinguish 

harmless organisms from those causing disease-the developments that would make 

this possible were yet to come.' 

2MSU 2, pI. 3: 1. 3- 4, 9 10; Phyllis Allen, " Etiological 

Theory in America Prior to the Civil War," JOllrnal 

0/ the History of Medicine and Allied Sciences 2 

(1947): 514. 

JMSH I , pt. 3: 1; Bayne-Jones, Prevellli.'e Medicine, 

p.99. 
276 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

The book devoted by the editors of the 

Medical and Surgical History oJthe War oj 

the Rebellion exclusively to the greatest 

scourge of nineteenth century armies, dysentery, illustrates both the intensity with 

which the Medical Department conducted 

its attempts to learn more about this problem and the reasons why these efforts were 

unavailing. More than 1.6 million cases of 

diarrhea and dysentery were diagnosed in 

the Union Army, and an average of 14.31 

per 1,000 mean strength died from it. A 

Union medical officer found " the prevalence of diarrhoeas among the rebel prisoners ... absolutely astonishing." But the 

gradual realization that living organisms 

might be causing this and other major 

problems would gain impetus only after the 

Civil War. Lacking the staining and culturing techniques available a few decades 

later, physicians were also unable to compile records that would enable the modern 

scientist to identify positi vely the organisms responsible for the Union Army's epidemics of dysentery. It seems probable 

that Entamoeba histolytica, Shigella, Giardia, Salmonella, and Campylobacter were 

affiicting the soldiers of 186 1- 1865. Nevertheless, fourteen years after the end of the 

war, Joseph Janvier Woodward, editor of 

the volume on dysentery and since 1864 a 

pioneer in the art of staining specimens, 

was still skeptical about the possibility that 

minuscule forms of life could be causing 

diarrhea and dysentery. He, like others of 

his contemporaries, refused to take seriouslyan 1876 publication ma inta ining that 

an ameba might be capable of causing this 

disease.' 

4Quote from "Chronic Diarrhoea at Camp Douglass," BOSIOII Medical and Surgical JOllrnal 67 

(1863):266 ; MSH I, pt. 2; USSC, Sanitary Memoirs, 

p. 291; Henry, Armed fo rces I lls/illlle, pp. 34-36; Joseph Janvier Woodward. "On the Use of Aniline in 

Histological Researches . .. ," American JOl/mal o/Ihe 

Since they did not know what was really 

causing diarrhea and dysentery, medical 

officers had little chance of devising a cure. 

Shrewd observation based on trial and error was the only hope for progress, but they 

were also handicapped by their apparent 

assumption that dysentery was a single disease. Although occasional success was reported wi th the use of ipecacuanha, which 

is effective against amebiasis, when trials 

at a Washington hospital proved disappointing, this drug was rarely used. Among 

other medicines used to treat diarrhea, opium was often mistrusted, especially after 

medical officers began to reali ze it was only 

a palliative and not a cure. Bismuth subnitrate, also somewhat effecti ve in easing 

the symptoms of dysentery, was used with 

caution because the presence of arsenic as 

an impurity was "exceedingly common." 

Strychnine, oil of turpentine, and cathartics, including mercurials and castor oil, 

were among other remedies tried without 

success. A few surgeons used lead acetate, 

but the very genuine risk of lead poisoning 

made many others reluctant to try it. Since 

malaria could cause diarrhea, quinine was 

" extensively employed," and "with a liberal hand." Although they had little control 

over the purity of the water the men drank 

in the fi eld, doctors took great care to ensure the purity of the water their dysentery 

patients consumed, preferring rainwater, 

distilled water, or boiled water, or, as a last 

resort, the addition of a little claret to whatever was available. Their efforts to treat 

dysentery and diarrhea were to no avail, 

however. Although only I in 178 dysentery 

patients died in the first year of the war, 

Medical Sciences 49 ( 1865): 106- 13. Unless otherwise 

indicated, all material on dysentery and diarrhea in 

the Un ion Army is based on MSI1 1, pI. 2. Campylobaeter has only recently been identified as a cause 

of dysentery: Jack E. Welsh and R. Clark G illett, telephone conversation with author. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 277 

by June 1865, when long campaigns, disease, and deprivation had weakened many 

soldiers, 1 in 29 was failing to survive.' 

The most effective steps taken against 

the diarrheal diseases involved sanitation. 

Without knowing precisely why, military 

experts had long realized that filth, especially when large numbers of men were 

grouped together, was associated with disease. But in an army composed largely of 

amateurs, enforcing strict standards of sanitation and hygiene posed great problems. 

When many were amicted with diarrhea, 

these problems became even more urgent, 

both in hospitals and in camps. Officers 

often ignored regulations requiring the digging of sinks for every camp. Men ignored 

trenches that were dug for this purpose, 

which were "often so badly managed that 

it was disgusting to use them." When drinking water came from shallow wells, pollution was inevitable, and typhoid as well as 

diarrhea and dysentery resulted. The need 

for improved camp sanitation inspired sanitary commissions from the beginning of 

hostilities, and with time, and perhaps as 

the men themselves began to understand 

the importance of sanitation, the number 

of diarrheal cases per 1,000 men began to 

drop, from 770 in the year ending June 

1862 to 686 three years later, and this despite the rising death rate. 6 

lMSH I, pt. 2, first Quote from p. 793, remaining 

quotes from p. 800; Woodward, Outlines, pp. 216-17, 

222, 229; Charles Beneulyn Johnson, Muskets and 

Medicine, or Army Life in the Sixties (Philadelphia: F. 

A. Davis Co., 1917), p. 162; "Subnitrate of Bis~ 

muth . .. ," American JOllrnal of the Medical Sciences 

44 (1862):213-32; USSC, Surgical Memoirs 1:304-05; 

Thomas T. Smiley, "Medical and Surgical Cases at 

Port Royal, S.c.," BoSlon Medical and Surgical JOllrnal 

67 (1863):271 

'Quote from MSH I , pt. 2:6 17; Woodward, 0111-

lines, p. 50; Maxwell, Sanilary Commission, pp. 

33-34,38; Steiner, Disease, p. 26; Reed, Hospital Life, 

p. 68; Howard D. Kramer, "Effect of the Civil War 

on the Public Health Movement," Mississippi Valley 

Historical Review 35 {I948):461; USSC, Documents I, 

Unlike dysentery, malaria no longer 

formed a serious threat to the Union Army 

as long as adequate supplies of quinine 

could be obtained. Wishing to reduce the 

amount of even temporary disability 

caused by malaria, Union surgeons continued to experiment with the prophylactic 

use of quinine, mixing the dose with whiskey to increase its attractions. It was not 

always possible, however, to obtain enough 

of both ingredients, and even when several 

times the normal dose of three to eight 

grains was administered daily, fever paroxysms might still occur. The disease was reported to return with even greater severity 

if the prophylactic doses were stopped once 

started, and prophylactic quinine never became routine. 7 

The Medical Department's interest in 

malaria extended to the question of the relative susceptibility of blacks and whites. 

Perhaps on the assumption that blacks 

were less likely to be disabled by this disease, the Army tended to send black regiments to areas with higher malaria rates. 

Although department statistics suggested 

that blacks contracted and died from malaria more frequently than whites, Charles 

Smart, editor of part three of the Medical 

no. 1:7, II and no. 5:7 and no. 46:41-42; William A. 

Hammond, A Treatise Oil Hygiene With Special Ref 

erellce to the Military Service (Philadelphia: J. B. lippincott Co., 1863), p. vii. 

'MSH I, pt. 3:77-78, 154, 167, 170- 71, 180; 8is· 

pham, Malaria, p. 136; Ltr, Moore to SO (4 Aug 1863), 

RG 112, entry 12; William H. Van Buren, "Quinine 

as a Prophylactic Against Malarial Disease," Military 

Medical alld Surgical Essays Prepared/or the u.s. San· 

itary Commission, ed. W. A. Hammond (Philadelphia: 

J. 8. Lippincott Co., 1864), pp. 96-97; "Quinine as 

a Prophylactic, American Medical Times 3 (1861):262; 

USSC, Documents I, no. 8:248; USSC, Surgical Mem· 

oirs 1:135-36. It might be noted that during World 

War II, the Medical Department found daily doses of 

0.3 g (4.6 gf.) of Quinine relatively ineffective in preventing vivax malaria in both New Guinea and West 

Africa: Havens, Jr. , In/ectious Diseases, p. 532. 
278 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

volume of the Medical and Surgical History, 

blamed this situation on the greater exposure of blacks to the disease. The death 

rate for blacks with malaria was twice that 

of whites suffering from that disease, but 

he remained convinced that blacks had a 

lesser susceptibility to malaria than whites, 

a belief that modern research has to some 

extent confirmed. 8 

Typhoid was yet another disease about 

which medical officers discovered little 

that was new during the Civil War, despite 

devastating epidemics. Although many soldiers coming from the North were exposed 

to both typhoid and malaria at essentially 

the same time, the announcement that the 

resultant collection of symptoms constituted typhomalarial fever merely added to 

the confusion. Medical officers, though 

aware of the connection between poor sanitation and typhoid, remained as much 

mystified by the disease in 1865 as in 186 1. 

The data collected in the Medical and Surgical History did, however, help Army physicians after the war to realize that water 

was indeed one so urce of typhoid 

infections' 

Smallpox was no longer the formidable 

threat it had been during the American 

Revolution, but medical officers still had 

to treat many cases, since an average of 5.5 

per 1,000 mean strength among whites and 

36.6 among blacks contracted the disease. 

It was not always possible to immunize immedi ately the thousands of volunteer 

troops who came pouring in, and doctors 

were already aware that periodic revaccination was necessary if the spread of smallpox was to be prevented. Surgeons learned 

that possible complications made it advis-

'Bi,pham, Malaria, pp. 34, 119; MSJ{ I, pI. 3: 12- 13, 

80, 85, 89, 92, 107, 109, 110- 11. 

' MSJ{ I, pI. 3:372- 73, 375, 494; Kenneth F. Maxcy, 

Preventive Medicine and Public Health, 8th ed. (New 

York: Appleton-Century-Crofts, 1956), pp. 180- 81. 

able, however, not to immunize those suffering from scurvy. They also discovered 

that vaccine could be safely preserved and 

shipped in narrow glass tubes, three inches 

or less in length, for each dose so stored. 

Because of the efforts of the Medical Department, during the autumn of 1863 and 

the winter of 1864 more people were vaccinated than had ever been immunized before in a comparable period of time. lo 

The inroads of other diseases, including 

the very prevalent respiratory infections 

that also affiicted Union soldiers, were relatively easy to appreciate, but the effects 

of a deficient diet were not. Medical officers, helpless to solve the transportation 

problems that led to the deficiency, were 

well aware that the standard ration of the 

soldier in the field was likely to lead to 

scurvy, although they were not aware that 

the soldier who refused to eat desiccated 

vegetables was also in danger of suffering 

from a lack of vitamin A. Surgeons usually 

recognized cases of scurvy at its worst, but 

the less obvious effects of subclinical 

scurvy were hard to pinpoint. As a result, 

one can only conjecture about precisely 

how much the vigor and effectiveness of 

troops in the field were affected by the 

depression and lethargy that accompanied 

the earliest stages of a vitamin C deficiency, since they could have resulted from 

or been reinforced by other health problems as well. It is difficult, too, to estimate 

to what extent a deficient diet, sometimes 

low in protein and calorie content as well 

as in vitamins, contributed to the prolongation of other ills, to the failure of injuries 

to heal, and to devastation wrought by 

"MSJ{ I, pI. 3:625- 27, 635, 638; F. G. Smith and 

Alfred Stille, "Vaccination in Armies," Military Medical alld Surgical Essays, ed. W. A. Hammond, 

pp. 148-49 , 151 - 52 ; USSC, Surgical Memoirs 

I: 137- 38, 142- 50, 162- 63, 165; USSC, Doclimellls, 

no. 9: 15, 25. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 279 

open wound infections. A Sanitary Commission official familar with the problems 

caused by scurvy commented, however, 

that "The pecuniary loss to the nation, by 

badly regulated and insufficient army ration, constitutes one of the great burdens 

of taxation now pressing upon the 

people." II 

Although the Army did what it could to 

treat the sick, many soldiers returned to 

their homes and to civilian life with their 

health permanently impaired by chronic 

disease. Usually the lingering illness involved diarrhea that, even when inactive, 

hung like the sword of Damocles over the 

veteran's head, likely to fall when' his body 

was overstressed. Many deaths from dysentery acquired during the war occurred in 

peacetime in soldiers whose health declined slowly even after they returned to 

their families. Veterans suffering from malaria acquired when they were far from 

their northern homes became a potential 

source of infection for local Anopheles mosquitoes. A study of former soldiers in Massachusetts made in the 1890s showed that 

they also suffered from such diseases as tuberculosis and rheumatism at a rate far 

greater than that of the general popUlation 

of that state. The rate of diarrhea and dysentery among veterans was almost fifty-six 

times that among the rest of the population, that of rheumatism five times, that of 

heart and circulatory problems six times 

(possibly as a legacy of streptococcal infections), and that of consumption twice. 

There was no indication, however, whether 

"USSC, Surgical Memoirs 1:51 , 88, 274, 276. 278, 

quote from 278; USSC, Documents I, no. 17:11-1 2; 

MSH I, pt. 3:68- 70, 684, 705-07, 713. Desiccated 

vegetables were prepared by cleaning and slicing, 

drying in hot air, pressing, and tben sealing in cans, 

a process likely to destroy vitamin C: E. N . Horsford, 

The Army Ration, 2d ed., rev. (New York: D. Van 

Nostrand, 1864), p. II. 

returning soldiers spread dysentery and 

diarrhea among those who had remained 

at home." 

Except for offering supportive care, doctors could do little during the Civil War to 

help those stricken with diseases other than 

malaria. Except for improved sanitation, 

they could do little to prevent diseases 

other than smallpox, but their renewed appreciation for sanitation undoubtedly contributed to a marked drop in the disease 

rate in the postwar Army as compared with 

the prewar force. Despite voluminous records, medical officers made no significant 

progress during the Civil War toward finding ways in which to' prevent or cure the 

diseases that ravaged the Union Army. " 

Injection and Wounds 

Although aware that scurvy or even a 

scorbutic taint delayed healing, medical officers were ignorant of how infections 

spread from wound to wound. As a result, 

they were initially unable' to combat the 

horrors of what now appear often to have 

been streptococcal infections. These bacteria spread through hospital wards, turning even small wounds into gaping, oozing 

pits of hospital gangrene, poisoning the 

bloodstream, and spreading the rash of erysipelas among wounded and unwounded 

alike. On the basis of the many cases they 

saw during the war, some surgeons did begin to suspect that these infections as well 

as scarlet fever, rheumatism, and some 

forms of heart disease might all be related, 

" MSH I, pI. 2:651 and pI. 3:77-78, 82; Johnson, 

Muskets and Medicine. p. 170; John S. Billings, "The 

Health of the Survivors of the War," Forum, Jan 1892, 

p.656. llKramer, "Effect of the Civil War," p. 456, 462; 

Steiner, Disease, p. 5. 
280 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

but they blamed them on miasmas or tbe 

poisons produced by decaying flesh. 14 

Medical officers could not afford to take 

these infections lightly. Some had a very 

high mortality; of 2,812 cases diagnosed as 

pyemia, a systemic infection, 2,747 were 

fatal. Surgeons recorded surprisingly few 

cases of tetanus, but much gangrene, which 

killed 45 percent of its victims and necessitated surgery that would not otherwise 

have been performed. Of the wounded afflicted with erysipelas with its spreading 

areas of swollen, em purpled skin, 41 percent died. Surgeons observed once again 

that patients in tent hospitals suffered less 

from infection than those housed indoors 

and that good ventilation reduced the infection rate. Although some theorized that 

erysipelas spread through the blood, many 

were convinced that it moved through the 

air, noting that it seemed to spread in the 

direction the wind was blowing. Case histories revealed patients who suffered first 

from one form of infection, then another, 

gangrenous wounds that healed only to be 

followed by erysipelas and then even 

pyemia." 

I'USSC, Surgical Memoirs 1:274; C. H. Cleaveland, 

«Hospital Gangrene in the U.S. Military Hospital at 

Memphis, Tenn .... Chicago Medical Journal 21 

(1864):15-16; M. Goldsmith, A Report all Hospital 

Gangrene. Erysipelas and Pyaemia. as Observed in the 

Departments of the Ohio and the Cumberland. With 

Cases Appended (Louisville: Bradley & Gilbert, 1863), 

pp. 7-8 n. 7-8, pp. 14-15,20-21 ; E. Andrews, "Diathesis: Their Surgical Relations and Effects," Transactions 0/ the American Medical Association 14 

(1863):125; Alfred North, "Report of Sixty Cases of 

Hospital Gangrene," American Medical Times 6 

(1863):258. 

"MSH I, pt. 3:663, 673; 854; MSH 2, pt. 3:32, 34, 

37,8 18; Goldsmith, Gangrene, pp. 13-14; Keen. 

"Reminiscences," pp. 104- 05; Mitchell, "Medical Department," p, 1446; Frank Hastings Hamilton, ed" 

Surgical Memoirs 0/ the War 0/ the Rebellion, 2 vols, 

(New York: Hurd & Houghton, 1870), 1:509- 10; William Thomson, "Report of Cases of Hospital Gangrene ," Chicago Medical Examiner 5 (1864):675, 

689-90; Stewart Brooks, Civil War Medicine (Springfield, Ill.: Charles C Thomas, 1966), p. 83. 

Hospital gangrene, probably caused by 

Streptococcus pyogenes, had such a rapid 

and horrible effect on wounds that it inspired both dread and strong efforts to find 

a cure . The skin around gangrenous 

wounds sloughed off, revealing flesh that 

slowly turned "reddish, greenish, purplish, 

or black," while the gray edges of the opening grew wider at the rate of half an inch 

an hour. Arteries and even bones were rapidly exposed and the stench of rotten meat 

filled the air. As his skin turned gray the 

patient's breath became sickly sweet, his 

body alternated between chills and sweats, 

and his pulse grew ever faster, ever feebler. 

So great was the fear of the spread of this 

infection that in several areas medical officers established special facilites to isolate 

its victims. 16 

Gas gangrene was not the infection that 

caused so much alarm in the military hospitals of the Civil War. Civil War records 

reveal that one of the most terrifying aspects of hospital gangrene was the rapidity 

with which it spread from patient to patient, but gas gangrene is not contagious. 

The presence of a clostridial infection cannot be ruled out, however, especially since 

the occasional mention of a sweetish odor 

from the wounds strongly suggests its presence. We know, however, that less than a 

third of all wounds become infected with 

clostridia, and only 5 percent of these actually develop gas gangrene. Gas gangrene, 

moreover, tends to appear in deep wounds, 

especially when damage to major blood 

vessels has reduced the oxygen supply to 

the muscles, a type of injury that during 

the Civil War usually led to relatively 

prompt amputation before gas gangrene 

16Quote from Cleaveland, "Gangrene," p. 5; MSH 

2, pt. 3:823 , 825-30, 843; Brinton , Memoirs, pp. 225-26; Hamilton, Treatise, pp. 570-71, 573; 

Wangen steen and Wangensteen, Rise 0/ Surgery, 

pp. 63, 394; Goldsmith, Gangrene, pp. 25, 27. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 281 

HOSPITAL GANGRENE as illustrated in the Medical and Surgical History of the War of 

the Rebellion. 

could develop in the wound. Hospital gangrene, on the other hand, actually caused 

a higher death rate when it originated in 

flesh wounds than it did in wounds accompanied by fractures." 

I1MSH 2, pt. 3:3 1,824; Wesley W. Sp ink, Infectiolis 

Diseases: Prevention and Treatment ill the Nineteemlt 

alld Twentieth Cefll llries (Minneapolis: U niversity of 

Minnesota Press, 1978), pp. 302-0 3; James F. Coupal, 

"Pathology of Gas Ga ngrene Following War 

Wounds," sec. 2 in Pathology 0/ [he Acllle Respiratory 

Diseases. and orGas Gangrene Following War WOllnds, 

vol. 12 of The Medical Deparlmefll oftlte United States 

Army in the World War (Washington: Government 

Printing Office, 1929), pp. 41 2- 14, 41 9; Rene J. Dubas and James G. Hirsh, Bacterial and MYCOlic bijections 0/ Mall, 4th ed. (Philadelphia: J. B. Lippincott 

The horror of hospital gangrene inspired 

urgent efforts during the Civil War to find 

both a preventive and a cure. Among the 

remedies used , the ha loge ns-iodine , 

chlorine, and bromine- proved to be more 

useful against hospital gangrene than nitric 

acid, which was also tried but with less 

widespread enthusiasm. Apparently finding bromine the easiest to use, surgeons began applying it to wounds and the rash of 

erysipelas, vaporizing it to disinfect the air, 

Co., 1965), pp. 553, 555; Wintrobe et aI. , Harrison's 

PrinCiples, pp. 783, 852-53. 
282 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

H OSPITAL GANGRENE as illustrated in the 

Medical and Surgical History of the War 

of the Rebellion. 

and mIxing it with glyceri ne for internal 

use, not thinking, however, to use it to sterilize instruments. One successful technique 

involved inserting bromine on wooden 

sticks into diseased tissue; another called 

for injecting bromine by hypodermic into 

healthy tissue bordering the infected area. 

These procedures could ca use so much 

pain as to req uire the use of anest hesia. 

Used in adequate strength and quantity, 

bromine prevented the spread of gangrene 

both in the individual patient and among 

patients. Although some surgeons usi ng 

bromine reported that deaths from hospital 

gangrene had been entirely eliminated, 

others remained skeptical and apparently 

regarded the approach as something of a 

fad. " 

"Wangcnstccn and Wangcnsteen, Rise of Surgery, 

Attempts to find the cause of hospital 

gangrene and other infections met with less 

success than efforts to find a cure. Microscopic studies revealed an elevated white 

blood cell count in the victims of hospital 

gangrene, but beyond that "only the ordinary bacteria which are to be observed in 

every decomposing animal substance." 

This last comment, although strange to 

modern ears, was the natural result of ignorance about the range and va riety of 

disease-causing organisms and the absence 

of stains and other techniques that wou ld 

emphasize the characteristics of cells seen 

under the microscope." 

The injuries that were the sites of such 

grim infections usually resulted not from 

bayonet or saber but from the slow-moving 

minie ball , which shattered bone and 

crushed soft tissues, carrying into the body 

bacteria-laden bits of clothing and other 

debris. A few minie balls were actually explosive and, while shattering bone still further, embedded bits of copper, lead, and 

pewter in the shredded flesh. Many victims 

bled to death on the battlefield. Even without infection, the fractures caused by the 

minie ball wou ld challenge a twentieth century orthopedist. When streptococci filled 

the wound and spread ever more widely 

beyond the injury, even amputation often 

fai led to save the victim. Thus the death 

pp. 3\8- 20, 323- 25, 507; John Brinton, "Bromide in 

H osp ital Gangrene," American Medicll! Times 6 

(1863):250; MSIl 2, pI. 3:837, 845; Goldsmilh, Gal/-

grene, pp. 29, 3 1, 32, 35, 81 - 84; Cleave land, "Gangrene," pp. 6- 7, 10; Mitchell, "Medical Department;' 

pp. 1446; Thomson, "Gangrene" 5:676, 677-78, 692; 

North, "Gangrene" 6:255; Roberts Bartholow, The 

Principles and Practice of Disinfection (Cincinnati: R. 

W. Carroll & Co., 1867), pp. 44- 47. 

" MSH 2, pI. 3:827, 832, 848-49, 862- 65, quole 

from p. 832; Wangenstecn and Wangenstecn, Rise 0/ 

Surgery. pp. 508- 09; Reed, Hospital Life, pp. 35- 36; 

Keen, "Reminiscences," pp. 103- 04; Willis G. Diffcnbaugh, " Military Surgery in the Civil War," MiliIQrjl lvledicil/e 130 (1965):491. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 283 

rate was high. Sixty-two percent of those 

with chest wounds died, as did more than 

87 percent with abdominal wounds, usually within two days of the moment when 

the bacteria-filled contents of the injured 

intestines spilled into the peritoneal cavity. 

Few surgeons would open the abdomen unless fecal material was actually oozing from 

the wound. Of the 253,142 wounds recorded in the Surgeon General's Office, 

however, most involved the extremities, 

more than 35 percent the legs and feet, and 

another 33 percent the arms and hands'o 

Confronted with so many injuries and 

imbued with the pragmatism characteristic 

of their profession, surgeons tried to test 

the effectiveness of both old methods and 

newly proposed approaches. One area of 

experimentation involved the hermetic 

sealing of chest wounds. Although this procedure gave instant relief for breathing difficulties and bleeding, it also eliminated 

the possibility of external drainage and 

thus provided no improvement in the management of infection. Many surgeons vigorously opposed its use. Another area of 

relatively intense study involved nerve injuries. Medical officers tried various forms 

of stimulation upon paralyzed patients, including electrical currents and alternating 

applications of cold and heat. Although 

" MSH 2, pI. 2:434 and pI. 3:2, 685, 702, 723; John 

Hill Brinton, "Address: Closing Exerc ises of the Session 1895-96, Army Medical School," Journal o/lhe 

American Medical Association 26 (1896):603; Duincll 

Medical Report; Frank H . Hamilton, "Lecture on 

Gunshot Wounds of the Abdomen," American Medical Times 8 (1864):230; Johnson, Muskets and Medicine, pp. 131 -32; "Scenes in Hospitals," Sanitary 

Reporter I (1863):162; " Military Medicine." MD 12, no. 6 (1 968): 130; Keen, "Reminiscences," p. 107; 

Robert L. Reid, "The British Crimean Medi cal 

Disaster- Ineptness or Inevitabil ity," Military Medicine 140 (1975):425; Dean Thomas, "The Gardiner 

Explosive Shell ," North SoUlIi Trader 2 (Jul-Aug 

1976):23-24; Robert Reyburn, Fifty Years ill/lie Practice 0/ Medicine alld Surgery, 185610 1906 (n.p., 1907), 

p. 9; DifTenbaugh, "Military Surgery," p. 492. 

55.5 percent of those with spinal injuries 

died of their wounds, in at least one instance doctors were able to keep a "nearly 

complete paraplegic" whose bladder could 

be emptied only by catheter ali ve for at 

least seventeen years" 

So great was Surgeon General Hammond's interest in nerve injuries that he 

turned an entire hospital over to S. Weir 

Mitchell, a pioneering neurologist, for the 

exclusive use of patients with nerve injuri es 

and nervous diseases. Here Mitchell , 

George R. Morehouse, and William W. 

Keen, Jr., studied the victims of phantom 

limb and nerve damage, epileptics, malingerers, and shell-shock victims (although 

"shell shock" is a term of more recent origin), men whose ills were psychological in 

origin and who usually received little attention from physicians. In one year alone 

Mitchell used 40,000 injections of morphine in his attempts to relieve the torments of his patients. He experimented 

also with hypodermic injections of atropine to ease muscle spasms. In this facility 

he took thousands of pages of notes in preparation for later publication." 

Since such a large proportion of wounds 

involved the extremities, much of the data 

collected on wartime surgery dealt with 

amputation, excision (the removal of a major portion of bone), and attempts to preserve bone essentially intact. Surgeons 

" MSfi 2, pI. 1:424.452, 497-98. 500n. 509- 11, 

618,634, and pI. I, app.:200, and pI. 3:725. 727-28, 

quote from 3:727. 

21Anna Robeson Burr, Weir Mitchell: His Life and 

Lellers (New York: Duffield & Co., 1929), pp. 104-06. 

122; Mitchell, "Recollections," pp. 9 1- 93; Ernest Earnest, S. Weir Mitchell: Novelist and Physician (Ph iladelphia: Uni ve rsity of Pennsylvania Press, 1950), 

p. 52; S. Weir Mitchell, George R. Morehouse, and 

W. W. Keen, Jr., Reflex Paralysis, Cir no. 6 (SGO, 

10 Mar 1864; New Haven, Conn .: Yale Universit y 

School of Medicine, 194 1), pp. iii- vi; S. Weir Mitchell, Injuries 0/ Nen1es and Their COIISe(Juellces (New 

York: Dover Publi cations, 1965), pp. v, xv iii-xix. 
284 T HE ARMY MEDICAL DEPARTMENT, 1818- 1865 

CASUALTIES OF BATTLE: AMPUTATED LIMBS. (CoIlrtesy of BIIrns Archive HislOric Medical 

PholOgraphs.) 

seeking to preserve a limb tried many devices to immobili ze it, but apparently distrusted casts, fea ring impaired circulation . 

Sandbags and elongated box splints limited 

motion during transportation, and several 

different kinds of splint were used in the 

hospital, including one designed by an 

Army surgeon. In cases where the fem ur, 

or thigh bone, was fractured, extension or 

traction devices were rarely used. Such 

treatment might prevent solid contact between the broken ends and thus inhibit or 

preclude healing, but without it, a leg 

tended to mend inches shorter than it had 

been and at times could be badly deformed 

as well. Other complications included abscesses and sinuses or abnormal channels 

that lasted for years and drained the patient's strength, and splinters of shattered 

bone left in the wound that continued to 

work their way to the surface, addi ng to the 

patient's lingering anguish. Some of the 

wounded thus died after years of suffering 

and slow decline. Medical officers attributed most deaths in those whose limbs they 

had tried to save to pyemia or other forms 

of systemic infection." 

" MSH 2, pI. 2:8 1 1,8 14, 841 . and pI. 3: I 79-83, 190, 

193, 198, 346n , 350, 428- 29, 568; "The Week," Amer-
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 285 

Since the treatment to be accorded fracture cases was chosen on the basis of the 

patient's condition rather than at random, 

the death rates do not necessarily reflect 

the merits of the various forms of treatment. Although there was much disagreement on the va lue of a conservative 

approach to the management of shot fractures, the mortality of patients chosen for 

conservative treatment proved less than 

that of those treated with excision or amputation. In a series of 386 men with shot 

fractures of the hip, for example, 249 of 

304, or 82 percent, treated conservatively 

died, but 53 of 55, or 96 percent, undergoing excision failed to survive, and 25 of27, 

or almost 93 percent, enduring amputation 

died. Of 2,369 victims of shot fractures of 

the shoulder, only 25.1 percent treated conservatively died, while 36.6 percent of excision patients died, as did 29.1 percent of 

the amputees.24 

The chief value of excision, with its high 

death rate, lay in the fact that it could preserve some function of the arm and, when 

the periosteum (the bone-forming connective tissue covering all bones) was preserved, doctors could hope for some bone 

regeneration. One surgeon maintained that 

he had seen the entire shaft of the tibia (the 

principal bone of the lower leg) regenerated. Even without regeneration, however, 

an arm could be surprisingly useful despite 

the removal ofa large amount of bone, and 

doctors regarded any function as better 

than none. Such removal might mean, however, that the limb would dangle loosely 

from the shoulder. Unfortunately, time 

might cause such an arm to deteriorate and 

to swell because it was dangling unsupican Medical Times 4 ( 186 1 ):268; Tripier and Blackburn, Handbook, p. 56. 

"MS}! I, pI. I, app.:311 ; MS}! 2, pI. 2:660 and 

pt. 3:65; Hamilton, Treatise, pp. 13-14; WOR, seT. 1, 

38, pI. 2:526. 

WILLIAM W. KEEN. (Courtesy oj National 

Library oj Medicine.) 

ported. In one such case, although Army 

doctors considered the result to be satisfactory, a pension examiner recommended 

amputation in 1867. Excision became less 

popular as the war went on-the chances 

for infection were great, the period of healing was long, and the results, except in the 

instances when the usefulness of a hand 

was retained, were questionable, if not actually disastrous. The death rate, furthermore, was comparable to or greater than 

that in amputations, with pyemia the chief 

danger and hemorrhage a significant 

problem's 

Although occasional reports of excessive 

enthusiasm for amputations did surface 

during the Civil War, this form of surgery 

" MSfl2, pI. 2:518, 548, 563, 611 - 12, 670, 966, 992 

and pt. 3:874-76; USSC, Papers I :5-7; "Conservative 

Surgery," American Medical Times 3 (1861):295. 
286 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

was apparently often undertaken only after 

careful consideration of the alternatives. 

Excision was generally viewed as the least 

desirable choice, however, in cases where 

there was damage to the upper leg, and 

damage to a joint was often regarded as 

necessitating amputation. The records concerning the number of amputations performed are not complete, but the figure was 

at least 30,000. The most common amputation was that of the hand or fingers, 

while the highest fata lity rate, of 83.3 percent, occurred after amputation at the hip 

joint. Surgeons discovered that amputation 

at the knee took a surprisingly high toll of 

57.2 percent, and even amputation of the 

lower arm was followed by the deaths of 

20.7 percent of those operated on. Considerable difference of opinion existed as to 

how the amputation was to be performed 

in any event, with many favoring a flap procedure that could be quickly done on the 

field and involved less danger from bleeding than the circular form of the operation. 

Some surgeons favored immediate operation, others a very brief wait until the first 

shock had worn off. The surgery itself was 

apparently a rapid procedure even though 

anesthesia was generally used. A hip amputation reportedly took two minutes, including the time needed to tie off the 

femora l artery.26 

Some surgeons were still a little wary of 

anesthesia, however, and avoided its use 

when the patient's condition was very poor. 

Few deaths were actually blamed on these 

agents, but surgeons noted the adverse effects on appetite and the nausea and vomiting that followed their use. Some 

continued to believe that anesthesia pre-

" MSH 2, pt. 2:746 and pt. 3:20,134, 339-40, 411 , 

877, 879; Hamilton, Treatise, pp. 420- 23, 426-28, 

431 , 436; Charles H. Rawson, "Visit to the Hospital 

at Springfie ld, Mo. ," American Medical Times 3 

(1861 ):364. 

vented quick healing and therefore led indirectly to increased rates of infection and 

hemorrhage. Nevertheless, by the time of 

the Civil War, most Army surgeons, even 

conservative Surgeon Genera l Thomas 

Lawson, had accepted its use." 

Anesthetics were used in at least 80,000 

cases during the Civil War. More than 76 

percent of the time the agent used was chloroform, but ether was popular in general 

hospitals, and a combination of ether and 

chloroform was used in 9.1 percent of the 

cases. A failure to use any form of anesthesia was recorded only 254 times. The 

debate over which anesthetic to use centered around the difficulties and dangers 

involved. Deaths from chloroform averaged 5.4 per 1,000 cases, those from ether 

3 per 1,000. Ether was flammable and particularly hazardous when operations were 

performed by candlelight, while chloroform caused some inexplicable deaths, although it was easy to take and even a small 

amount acted with considerable speed. 

Surgeons well aware of its dangers and its 

reputation still preferred to use this anesthetic, although they did so with care, attempting to limit the length of time it was 

administered and to ensure that an adequate amount of air was inhaled with it" 

An anesthetic, whether ether, chloroform, or a mixture of the two, was appar27Hamilton. Treatise, pp. 612, 621-22; MSH 2, 

pt. 3: 134- 35; Ms C24, p. 26, NLM; G. W. H. Kemper, 

"The Surgeons of the Civil War," Journal oj fhe I ndillna Medical Association 11 ( 1918):368; "Anesthetics 

in Military Surgery,"AmericQn National Times 3 

(1861): 151; Gross, Mallllal, p. 81. 

" MS" I, pt. I, app.:200; MSll 2, pt. 3:887-89; 

"Anesthetics," p. 151; Keen, Reminiscences, p. 109; 

William Williamson Wellington, "Modern Medicine: 

Its Need and Its Tendency," Medical Communications 

of the Massachusetts Medical Society. scr. 2, II , no. 7 

(1874): 163; Jones, "Medical History," p. 188n; J. Mason Warren, "Recent Progress in Surgery," Medical 

Communications ojthe Massachusetts Medical Society, ser.2, 10, no. 6 (1866):273. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 287 

ently usually administered by means of an 

impregnated cloth, which might have been 

rolled into a cone with an anestheticsoaked sponge at its apex, held over the 

mouth and nose. Experience taught medical officers that in the open air where so 

many amputations were performed, merely 

pouring an anesthetic on a cloth was not 

effective. Premedication, if given, might 

take the form of a dose of whiskey. As a 

rule no ill effects resulted from the inhalation of an anesthetic. On occasion, however, a patient inhaling chloroform would 

begin to make convulsive movements, and 

the veins in his neck would start to swell. 

The physician would often note that his 

patient's heart was either at the point of 

arrest or had already stopped beating. In 

such cases, respiration soon also ceased, 

and all the efforts of doctors and nurses 

were often to no avail. It was only in March 

1865, however, that the surgeon general 

was sufficiently disturbed over the problem 

of anesthesia deaths to order his surgeons 

to report on their experiences with these 

agents. 29 

In addition to anesthetics, medical officers used analgesics, including both alcohol 

and opiates, in their battle against pain. 

Alcohol was used not only to relax a patient 

before the administration of anesthetics, 

but also to serve as a vehicle for quinine. 

Some physicians, including Letterman, 

feared that this free use of alcohol could 

induce addiction or mask symptoms, but 

alcoholism did not become a significant 

problem during the Civil War. Authorities 

should perhaps have been more concerned 

about the possible overuse of opiates, since 

29Frederick E. Lente, "Sulphuric Ether as an An~ 

esthetic in Military Surgery," American Medical Times 

4 (1862):365; MSH2, pI. 3:888; 890- 91, J. H. Thomp· 

son, "Report of the Wounded at the Battle of Newbern, N.C.," American Medical Times 5 (1862):6; CiT, 

SG (Cir no. 2, 15 Mar 1865), Ms C24, NLM. 

many cases of addiction after the war were 

blamed on the free prescribing of such 

drugs during the conflict. Opium itself had 

long been prescribed for diarrhea, but during the Civil War morphine was also dusted 

in wounds or administered by hypodermic. 

Occasional mention was also made during 

this period of the use of cannabis for patients with tetanus or head injuries.'o 

The hypodermic, apparently used chiefly 

to inject morphine, was one of a few new 

devices slowly gaining in popularity in the 

Army during the Civil War. It was regarded 

to some extent as experimental. Although 

the Medical Department did have clinical 

thermometers, they were not in common 

use, and the model available was very long, 

intended for use in the armpit. Such instruments as hemostatic forceps, retractors, and dilators were not available, and 

few doctors knew how to use an ophthalmoscope or laryngoscope. Microscopes 

were few and far between. Real progress, 

however, was being made in the design of 

artificial limbs, enabling crippled soldiers 

to walk with only a limp or, with the aid 

of gloves, to conduct their lives with few 

aware that they had lost a hand or an arm. 

A relatively new development was mobility 

in the ankle of an artificial leg. A device 

developed by one firm for patients with resections of the elbow or shoulder was so 

effective that it permitted a greater reliance 

on this form of surgery as opposed to am3OWoodward, Ou/lilles, p. 170; Hall, Researches, 

p. 173; MSH I, pI. I, app.:232- 33, and pI. 3: 171, 890; 

MSH 2, pI. 1:646 and pI. 3:8 18; A. W. Smith, Reminiscences, p. 129; R. N . Barr, "Army Diseases," Ohio 

Medical and Surgical JOllmal14 (1862): 10 7-08; Letterman, Recollecliolls, p. 183; USSC, SlIrgical Memoirs 

1:13; Brooks, Civil War Medicine, p. 103; " Blue Velvet: The New Look in Drug Addiction," The Sciences 

4 ( 1964- 65):8; Barry M. Parsinen and Karen Kerner, 

"The Development of the Disease Model of Drug 

Addiction in Britain, 1870- 1926," Medical HislOry 24 

(Jul 1980):275-77. 
288 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

putation. Medical officers also developed 

considerable ingenuity in devising for 

those whose lower jaws had been torn away 

prostheses that limited drooling and made 

taking liquids possible. The actual selections of the firms to make prostheses and 

of the designs to be used was apparently 

significantly influenced by a committee of 

distinguished doctors appointed by Surgeon General Hammond. The soldier 

whose artificial limb was approved by the 

Medical Department could choose any 

limb costing $50 or less from one of several 

authorized manufacturers." 

The benefits to medical science arising 

from the Civil War are not easily established, but undoubtedly the civilian population profited from the presence of 

surgeons like S. Weir Mitchell and his colleagues who had received more training 

and experience during that conflict than 

they would otherwise have had in a lifetime. Although the records and specimens 

that would form the Medical and Surgical 

History, and the Army Medical Museum 

were of little help in improving the care of 

the sick or wounded during the struggle, 

both would be of value to future generations, just as would be the techniques in 

staining specimens for the microscope and 

JIMSH I , pt. 3:965; MSH 2, pt. 1:398; Ltrs, Brinton 

to Barnes (8 Dec 1864), RG 112, entry 12. Byrne to 

Reed and Barton (9 Apr 1863) and Edward S. Dunster 

to James W. Queen (10 Jun 1863), both in RG 11 2, 

entry 2, 34:497 and 35: 187, respectively; Keen, "Reminiscences," p. 109; w. W. Keen, "Mil itary Surgery in 

1861 and in 191 8," Anflals o/the American Academy 

0/ Political and Social Science 80 ( 1918):20; Charles R. 

Greenleaf, A Manllal for the Medical Officers 0/ the 

United SlaieS Army (Philadelphia: J. B. Lippincott 

Co., 1864), p. 25; A. W. Smith, Reminiscences, p. 189; 

Samuel D. Gross, AlIlobiography of Samuel D. Gross, 

M.D., With Sketches by His COlllemporaries, ed. by his 

sons, I (Philadelphia: George Barrie, 1887): 133-34; 

Andrews, Surgery, pp. 414- 15; James M. Minor, "Report on Artificial Limbs," Blilletin of the New York 

Academy 0/ Medicille 1 (1860- 62): 177; Henry, Armed 

Forces Institute, p. 8. 

in photomicrography pioneered in the museum late in the war'2 

Olganization and Administration 

The effect of Civil War experiences on 

the size, organization, and administration 

of the Medical Department was more pronounced than the Civil War experiences' 

effect on medical science. A more effective 

use of the department's newly huge medical staff was but one of its achievements. 

Great flexibility proved necessary to care 

for the enormous numbers of sick and 

wounded that poured in from battlefields 

and camps, both east and west. No ratio of 

surgeons to men that would be adequate 

under all circumstances could be efficiently 

established for a given unit. To deal with 

this situation, the Department departed 

from the Mexican War pattern to create 

positions for surgeons and assistant surgeons of the volunteers, who could be assigned as needed and whose qualifications 

were determined by the Medical Department. More than 500 of these physicians 

worked with a Regular Army staff numbering less than half that figure. Almost 

6,000 regimental medical officers, whose 

qualifications were initially ascertained at 

the state level, also served at one time or 

another in the Union Army. An equivalent 

number of civilian doctors unwilling or unable to join the Army worked as contract 

surgeons, either for short periods when necessity dictated or in general hospitals in 

the cities where they lived. Although a few 

Army doctors, especially in the early 

months of the war, earned unenviable reputations, the Department was apparently 

J2Henry, Armed Forces Illstillite, pp. 34-39; Anderson Hunter Dupree, Science ill the Federal Government 

(Cambridge, Mass.: Belknap Press of Harvard University, 1957), p. 129. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 289 

able to gather a medical staff that was on 

the whole highly regarded. The new type 

of organization, where regular medical officers shared their responsibilities at all levels with a large volunteer staff, was needed 

more in war than in peace, but it blazed a 

trail that would not be forgotten. 3J 

The war also served to emphasize the necessity for abandoning the customary haphazard approach to the problem of 

providing an adequate number of hospital 

attendants, nurses, clerks, and guards. Expecting to find a sufficient number of able 

and disciplined men and women to work 

in hospitals on short notice proved unreasonable. Complaints about the caliber of 

the nurses rounded up to care for military 

patients were numerous, yet by the end of 

the war, the problem remained only partially resolved. Line officers understandably resented having to leave healthy and 

competent men behind to care for the sick. 

As the war progressed and the number of 

invalids grew, the Invalid Corps significantly eased the staffing shortage, but few 

were available early in the war. Since these 

men had no training in the care of the sick, 

their usefulness was limited. Moreover, few 

women had any formal training in nursing, 

although their practical experience in caring for their families stood many in good 

stead. The obvious need for professional 

training of nurses influenced those responsible for staffing civilian hospitals after the 

war, not only to gi ve nurses the expertise 

needed but also to separate the dedicated 

from the dilettante. Of the latter, many had 

found their way to the hospitals in the guise 

of nurses during the war. 34 

nHamilton, Treatise, pp. 34-35, 38-39; USSC, Surgical Memoirs I :40; Walt Whitman, Th e Wound 

Dresser . .. (Boston: Small, Maynard & Co., 1898), 

p. 44; Mitchell, "Medical Department," p. 1448. 

HJane Stuart Woolsey, liospital Days (New York: D. 

Van Nostrand, 1868), pp. 41 , 123; MSfl1 , pt. 3:958; 

The Medical Department also introduced greater system into the management 

of field hospitals. Early in the war, surgeons 

started organizing these faci lities principally on a division basis rather than a regimental one . Medical officers also 

established small stations near the battlefield and evacuation hospitals at rail depots 

or near wharves along waterways. Tents, 

marked as hospitals by yellow flags with 

green numerals, became an increasingly 

common sight in the field, since they offered many advantages over the buildings 

that might be available near a battlefield. 

They could be pitched in an hour by someone familiar with them, and although those 

designed for hospital use could accommodate only eight patients comfortably, 

their design permitted two or more to be 

joined to serve larger numbers of wounded. 

Smaller tents could be used to shelter medical officers and medical and kitchen supplies. Surgeons found that there was less 

infection among patients sheltered in tents, 

where in good weather the walls could be 

raised to achieve perfect ventilation. An experienced Army surgeon concluded, "One 

of the most valuable lessons taught by the 

experience of the American War of 

1861 - 65 was the demonstration of the inestimable value of the tent as a hospital. " 

Unlike field hospitals, base or general 

hospitals were located almost entirely in 

buildings, although tents were occasionally 

Whitman, The Wound Dresser, pp. 42-43; Charles S. 

Tripier and Chris C. Cox, "Report of the Committee 

Appointed to Memorialize Congress in Regard to the 

M edical D epartment of the A rmy," TrallsacliollsoJllie 

American Medical Association 16 ( 1865):578; Hall, 

"Lessons," p. 93. 

JS l rwin, "Notes," p. 122, quote from p. 128; MSfl 

2, pt. 3:909- 12; Hamilton, Treatise, pp. 134, 136-37; 

Johnson, Muskets and Medicine, p. 129; Mitchell, 

"Medical Department," p. 1446; Woodward, Ollllilles, p. 11 7; "Army Medical Intelligence," Cincinnati Laneel and Observer 7 ( 1864):129. 
290 THE ARMY MEDICAL DEPARTMENT, 1818-1865 

MOWER GENERAL HOSPITAL in West Philadelphia, Pennsylvania. (Courtesy of National 

Library of Medicine.) 

used to increase their capacity. Authorities 

soon discovered that structures erected for 

some other purpose did not usually make 

good base hospitals. In a former hotel or 

barracks, no amount of purification, cleaning, and disinfecting could disguise the 

odors that spoke of inadequate ventilation. 

Maximum efficiency by a large staff, furthermore, was impossible in a badly designed building; every 1,000 patients 

required a staff of 20 wardmasters, 100 

nurses, 5 or 6 cooks, 8 to 10 assistant cooks, 

4 or 5 launderers with occasional assistants, 3 or 4 bakers, 10 to 15 men to run 

the stables and shops, 3 or 4 more men to 

manage the morgue and cemetery, lOin the 

headquarters and library, about 15 physicians, and an undetermined number of 

medical cadets, all under the command of 

a regular or volunteer medical officer." 

" MSH I, pI. 3:956-5 7; MSH 2, pI. 3:902, 908; 

As a result of the inconvenience and the 

sanitation problems involved in using existing buildings to house general hospitals, 

the Army began to design and erect structures intended from the outset for this purpose. Sma ll post facilitie s had been 

designed and built specifically to house sick 

and wounded soldiers ever since the days 

of Lovell, but the Medical Department had 

never before encountered such a pressing 

need to design very large hospitals. Experiments undertaken in its drive to create 

them contributed considerably to civilian 

medicine too. The concept of the pavilion 

hospital was later adopted by such famous 

institutions as the Johns Hopkins Hospital, 

for which John Shaw Billings, who as a 

Woodward, Outlines, p. 120; Northern M Ollfhly(no. 2, 

Dec 1864), in U.S. Armory Square General Hospital, 

Washington, D. C., Orders, Correspondence, and 

Printed Matter, 1862-1869, Ms C60, p. 19 1, NLM. 
COUNTY LINE I'IOAD 

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1'11 ,1011"11" lof'lwwu thi ~ "nd 12 I, Ihe kitchen, ~. ; 3, Knap$al4l.'I'OOIH, lJanu '1 \mrt ~N, tic.; 4, Slor(!·room .. de.; Ii, Ol'l'nliing-romn; {'~ n\\l~hH' •• 1"'1'; 7, 

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]';, 17, t'urrh tul>I j 1(', ~, L...; "' ~· <ll ,,iI e"", ,, lll d ",r rnd'~, ' lul"'i··r""m_, "1,'. 

FLOOR PLAN OF MOWER GENERAL HOSPITA L as illustrated in the Medical and Surgical 

History of the War of the Rebellion. 
292 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

I 

L 

= 

II II 

DESIGN FOR VENTILATION OF HOSPITAL 

STOVE as illustrated in tlte Medical and Surgical History of the War of the Rebellion. 

young medical officer worked on the design 

of the Army's new general hospitals, drew 

the plansn 

In the pavilion hospital, thousand of patients could be sheltered and the spread of 

infection and contaminated air limited by 

the division of patients into relati vely small 

groups, each kept separate from the others. 

Since the separation could result in administrative problems, various arrangements of the pavilions were tried to achieve 

the best combination of good ventilation 

and efficiency. On occasion, a hybrid hospital design was created by addi ng pavilions to a preexisting structure, which was 

HMitchell. "Medical Department," p. 1446; M S/-I 

I, pt. 3:896-98; Fi elding H. Garrison, An JlIlroduc:tioli 

to the History 0/ Medicine, 4th ed. (Philadelphia: W. 

B. Saunders Co., 1929), p. 669. 

used as the administration and storage 

building. Some of the earliest facilities, 

hastily erected, were of frail construction 

as well as poor design, and their walls eventually required buttressing to prevent their 

collapse. One design that proved satisfactory called for pavilions 24 to 25 feet wide 

and 12 to 14 feet high, which represented 

a 7-foot increase in width and a 4- to 6-

foot increase in height over the earliest 

models, with the length cut from 200 feet 

to 150 feet. This plan also called for ridge 

ventilation on well-spaced buildings. " 

Hospital designers believed that the ideal 

facility would consist of one-story buildings set 3 to 4 feet above ground level where 

each patient had 1,000 cubic feet of air. In 

warm weather, ventilators at the ridge of 

the roof, sheltered from the rain by a small 

roof of their own, would keep the air circulating, and open corridors would add to 

the fresh air available. Cold weather ven_ 

tilation would be achieved by closing shutters in the ridges and using a system of 

shafts that minimized the loss of the heat 

generated by stoves. 39 

Although city water and city sewers were 

available to some general hospitals, the 

problems in volved in achievi ng sanitation 

goals, already difficult when so many patients suffered from diarrhea, were in some 

instances exacerbated by water shortages 

and the need to dispose of patient waste 

without city plumbing. The Medical Department was forced to experiment with solution s t o s uc h diffi c ulti es . In a 

Wilmington, Delaware, hospital, where 

city water was available but city sewers 

were not, a long trough under the seats of 

l8Q U0 1C from Hamilton, Treatise, p. 124; MSf/ 1, 

3:920, 922, 930, 394-95; Diffenbaugh, " Military Surgery," p. 494. 

l<)Woodward, Outlines, pp. 11 5- 16, 118; MSH I, 

pt. 3:93 5, 943- 45. 952-53; Hamilton , Treatise, 

pp. 127-29; Hammond, Treatise, pp. 324- 25. 
ACHIEVEMENTS AND FAILURES DURING THE CIVI L WAR 293 

the latrine was flushed two or three times 

a day and emptied by pipe into a deep covered pit some distance from the buildings. 

When hospital effiuvia was discharged near 

the building or retained any length of time 

within it, odor became a problem, a particularly alarming one because doctors assumed that with odor came infection.'· 

As a rule, base hospitals sheltered patients suffering from every kind of disease, 

wound, and infection, but a few specialized 

facilities were beginning to appear. One 

such facility was the hospital in Philadelphia, where Mitchell, Moorehouse, and 

Keen studied patients with neurological 

and nervous problems. In 1863 the Army 

also established an eye and ear hospital in 

St. Louis, while in Nashville patients with 

erysipelas had their own facility. At Wilmington, Delaware, patients who had lost 

feet or toes to frostbite were hospitali zed 

together, and in the fall of 1862 Surgeon 

General Hammond ordered the establishment of a facility for "mutilated soldiers" 

in New York City." 

Innovative thought was as necessary in 

dealing with evacuation as it was with hospitalization. The enormity of the conflict 

made it plain early in the war that the casual approach of peacetime would not be 

adequate for the wounded and sick of 

1861- 1865. The two-wheeled ambulance 

proved too fragile and too uncomfortable 

for wide use on the battlefield. The Army 

was forced to experiment to find a conveyance that could move the wounded quickly 

from the battlefield to the nearest aid station and sturdier models to move them 

thence the longer distance to a hospital, 

hospital train, or hospital transport. Iron-

"MSH I, pI. 3;919-20, 922, 924, 928, 953. 

.IAndrews, Surgery. pp. 413- 14, Quote from p. 413; 

MSH I, pt. 3:50,665; USSC, Documellls 2, no. 87: 14; 

L1f, McDougall 10 Hammond (25 Oct 1862), RG 112, 

entry 12; Western Sanitary Commission, Report, p. II. 

RUCKER AMBULANCE as illllstrated in the 

Medical and Surgical History of the War 

of the Rebellion. 

ically, although many ambulance designs 

were tried, some of which were presented 

for approval by such Army surgeons as Finley and Tripier, the most useful one was the 

work not of a medical officer but of Brig. 

Gen. Daniel H. Rucker, a Quartermaster's 

Department officer. Mule litters of varying 

design were also tried, but without significant success. The best stretcher proved to 

be one weighing less th a n twenty-four 

pounds and designed to be carried by man 

rather than beast. 42 

The Medical Department also discovered that it was highly desirable to have 

tra ins and ships equipped specifically for 

the evacuation of the wounded. Early in the 

war, the wounded who traveled by train lay 

on straw in boxcars or, if they could manage it, sat up in passenger cars. Grad ually, 

however, with the help of charitable organi-

" MSfI 2, pI. 3:866-67,923-31,944-57; Hamilton, 

Treatise, pp. 158, 166-67; "Fl ying Hospit als," Amer· iean Medical Times 5 (1862):263; Otis, A Report 10 tlte 

Slirgeoll Gelleraf, p. 11 n; Thomas Longmore, A Treatise 011 the Trallsporl oj the Sick and Troops (London, 

1869), pp. 357-58; War Department, SGO, Report 0" 

lhe Extent and Nature of the Materials Available/or the 

Preparalioll oj a Medical and Surgical History of the 

Rebellion (Philadelphia: J. B. Lippincott Co., 1865). 

p.84. 
294 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

KITCHEN AND DISPENSARY CAR FOR HOSPITA L TRAIN, longitudinal vielV (lOp), and horizontal vielV (hollom), Army of the Potomac, as illustrated in the Medical and Surgical 

History of the War of the Rebellion. 

zations, more and more hospital cars of 

varying design and offering greater comfort 

began to appear, and in time these were 

combined into hospital trains that might 

include cars used specifically for cooking, 

dining, storage, or sleeping quarters for the 

medical staff. In Sherman's army, civilians 

hired by the Quartermaster's Department 

served as conductors and train crew, while 

enlisted men served as cooks and nurses. 

The Medical Department staff present on 

such a train usually consisted of a surgeon 

in charge, an assistant surgeon, and a hospital steward. Clearly identified by its 

bright red smokestack, engine, and tender, 

and its three red lanterns at night, the hospital train was apparently never molested 

by the enemy. The various sanitary commissions also helped outfit specially 

equipped hospital ships and provided more 

vessels of their own when necessary" 

Although the most important obstacle 

had been surmounted when the Medical 

Department recognized the simple fact 

that a formal organization, careful planning, and trained and disciplined personnel 

"MSH 2, pt. 3:959, 96 1, 964, 970-73, 977-98; John 

E. Ransom, "The Development of Ambulance Service 

in the Armies of Great Britain, the United States and 

Other Countries," Ciba Symposia 8 ( 1946):554- 59; 

Linus Pierpont Brockett and Mary C. Vaughn, Womeli's Work in lite Civil War: A Record 0/ Heroism. Paw 

triOlism alld Patience (Philadelphia: Ziegler, McCurdy 

& Co. , 1867), pp. 151 - 52; "Hospital Care-Report of 

Dr. Barnum," SUI/illiry Reporter I (1863):147; Longmore, Treatise, p. 474; Turner, Victory Rode the Rails, 

PP. 300-30 I. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 295 

U.S. ARMY HOSPITAL STEAMER, D. A. JANUARY, as illllstrated in the Medical and 

Surgical History of the War of the Rebellion. 

were necessary to successful evacuation, 

not everyone within the Army was willing 

to grant the department the control necessary to ensure its efficient operation. Letterman's struggle to have the ambulance 

corps placed under the command of medical officers succeeded in the Army of the 

Potomac only with General McClellan's 

support, and his approach was officially 

adopted throughout the Army late in the 

war. Medical Department control over hospital transport ~ was not generally conceded 

until early 1865. 

The improvements in the management 

of hospitalization and evacuation achieved 

during the course of the Civil War were 

considerable. By the end of the war, evacuation tended to be as prompt and as systematic as the military situation permitted. 

As a result, the number of regimental medical officers and attendants drawn away 

from the battlefield was minimal, and the 

need for tents and equipment for field and 

depot hospitals was limited. Although 

many patients still had to endure the heavy 

ride of Army wagons for short distances, 

increasing numbers made the major portion of their journey north or east in the 

comfort of well-appointed hospital ships or 

trains. The hospitals they stayed in along 

the way were more likely to be efficiently 

organized, and there was a better chance 

that the hospitals they reached at the end 

of their trip would be carefully designed 

and ventilated institutions where the staff 

was able to work with maximum efficiency. 

In 1865 Army surgeons remained to a 

large degree helpless in the face of disease, 

and because of the devastating infections 

they. confronted, they made little progress 

in their handling of wounds. The Medical 

Department did, however, reestablish order after a chaotic beginning and create an 

organization competent to meet the de-
296 

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THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

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Mill ' \''''eN:I.-...eII . N N X.1n ded:. o /oilnl'M. 

P P Cold. water. 

LOWER BOILER DECK OF D. A. JANUARY, as illllstrated in the Medical and Surgical 

History of the War of the Rebellion. 

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MIDDLE DECK OF D. A. JANUARY, as illustrated ill the Medical and Surgical History 

of the War of the Rebellion. 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 297 

All. )''''.Ie<'1"",."r lu>\'''''Io'C),;. DB 1I ••• f. 

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UPPER DECK OF D. A. JANUARY, as illllstrated in the Medical and Surgical History of 

the War of the Rebellion. 

f\ fit Pnoj<'<lll .. ", "r In""". deck.' o ()lI1ae. 

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CABIN DECK OF D. A. JANUARY, as ilIlistrated in the Medical and Surgical History of 

the War of the Rebellion. 
298 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

mands of a war that was waged on a scale 

never before encountered. These accomplishments were initally impossible, however, because th ose wh o shaped the 

Medical Department policies understood 

neither the unprecedented nature of the 

confli ct nor the demands it was placing 

upon them. After William Hammond inspired the department's overwhelmed 

medical officers to withstand frustration 

and adversity while he initiated new and 

determined approaches to their problems, 

there was no turning back to the old ways. 

By cooperating closely with one another, 

the very men who had been Hammond's 

undoing were able to continue successfully 

along the path he had laid out. 

Epilogue 

The creation of the Medical Department 

on a permanent basis in 1818 had farreaching consequences both for the U.S. 

Army and for medical science. Endowed by 

Congress with the responsibility for a permanent organization rather than a temporary wartime expedient, the surgeon 

general was in a position from this time 

onward to make long-range plans for the 

care of the Army's sick and wounded in war 

and peace and to direct continuing efforts 

to contribute to the sum of medical knowledge. Much depended, however, on the 

ability of the physician who served as surgeon general. 

The first man to head the Medical Department was the young and brillant Joseph Love ll , who quickly moved to 

improve the caliber of his staff and to begin 

collecting information on factors that 

might be affecti ng the Army's health. Because of Lovell's efforts, the highly trained 

and disciplined physicians who gradually 

replaced the motley crew that formed the 

department in 1818 began to regard themselves as members of a proud profession. 

The beneficial effects of this change in attitude were soon evident, for, on the whole, 

the first career military surgeons in the nation 's history worked diligently to meet the 

responsibilities placed upon them. 

The appointment of the most senior surgeons in the department rather than the 

most able as Lovell's two immediate successors did not augur well for further progress in the Medica l Department. 

Nevertheless, Thomas Lawson's enthusiasm for the department and its work led to 

the winning of rank for Army surgeons. He 

also obtained the right to enlist hospital 

stewards, continued the collection of data 

started by Lovell, and worked to develop 

an effective ambulance. Lawson grew old 

and ill in office, however, and when he 

died, the department was still unprepared 

for war. Lawson's successor, Clement Finley, while healthier than his predecessor, 

was probably less competent and came to 

office entirely because of his seniority. 

As a result, the Medical Department began to meet the challenge of the Ci viI War 

only when Finley was succeeded by a physician who was, like Lovell, both young and 

talented. Appointed surgeon general despite his lack of seniority, William Hammond built upon the small but sturdy 

foundation laid and maintained by his 

predecessors. Forcing through the changes 

in the department's organization and 

administration that were necessary to meet 

the needs of vast numbers of sick and 

wounded, with the assistance of the Department's small nucleus of Regu lar Army 

surgeons, Hammond, like his successor, 

initiated thousands of civilian physicians 

into the mysteries of their wartime duties. 

Unlike his predecessors during the Civil 

War, Joseph Barnes, who took over as surgeon general upon Hammond's disgrace, 

was regarded with great favor by Secretary 
ACHIEVEMENTS AND FAILURES DURING THE CIVIL WAR 299 

of War Stanton. He was, therefore, able to 

continue along the lines set out by Hammond with far greater ease than Hammond 

himself. During Barnes' tenure, Congress 

finally created the ambulance corps for 

which Hammond and his supporters had 

fought. In the last months of the war, 

Barnes finally gained for the Medical Department complete control of evacuation 

and the management of hospitals. The last 

Civil War surgeon general so pleased his 

superiors that he was brevetted major general in March 1865. 

Although five surgeons general directed 

the Medical Department from 1818 

through 1865, two of them were principally 

responsible for the shaping of the department's character to meet the demands 

placed upon it. Lovell professionalized the 

care that the Army's sick and wounded 

would in the future receive and, in insisting 

on regular and detailed reports on all matters that might relate to the soldier's health, 

let it be known that the Medical Department planned to playa major role in the 

world of medicine. Circumstances required 

that Hammond create the department 

anew, but even as he worked to reorder the 

structure under which the sick and 

wounded received care, he demonstrated 

his agreement with Lovell's ambition for 

the department by calling for the gathering 

of case histories and specimens from his 

surgeons. As they strove to adapt' the Medical Department's structure and operations 

to the needs of their times, both Lovell and 

Hammond blazed clear paths that their less 

talented successors could follow. 

Nevertheless, the willingness of the first 

surgeons general to take advantage of the 

department's potential for contribution to 

science and their determination to improve 

the medical care offered to the nation's soldiers did not result in major scientific discoveries. The era when c lini ca l 

observations and statistical compilations 

were the principal approach to the mysteries of human health was rapidly passing. 

As the tribulations of William Beaumont 

proved, even in peacetime the Medical Department of the 181 8- 1865 period was not 

in a position to foster ex perimental 

research. 

The department was able during this period to contribute to medical science in 

lesser, practical ways because the use of any 

remedy or treatment in relatively large 

numbers of patients by physicians working 

under the discipline of a single organization inevitably constitutes a trial of its 

worth. It was the Army's experience since 

1800 that clearly demonstrated the benefits 

of mass vaccination against sma llpox. 

Army surgeons established both the advisability and safety of using higher doses of 

quinine than those customary outside the 

South and the powers of bromine against 

infection. The Army's Civil War use of anesthetics demonstrated on a large scale the 

benefits and the relative safety of these 

agents when carefully used. 

With the acceptance of the germ theory, 

however, would come the discovery of the 

causes of typhoid, malaria, dysentery, and 

other major diseases, and the resultant development of better ways in which to prevent and treat these sco urge s. In 

comparison to these dramatic events, the 

Army's informal testing appears insignificant. As the end of the century approached, 

however, and medical science moved forward with great rapidity, medical officers 

of the U.S. Army would be in the forefront 

of many great advances. Army surgeons 

would be increasingly able to prevent and 

cure disease and infection. With new and 

better weapons, post-Civil War physicians 

would wage a more successful struggle 

against disease and infection , but they 

would never conduct a more gallant fight 

than the Army surgeons of 1818- 1865. 

Bibliography 

The National Archives in Washington, 

D.C., and the National Library of Medicine in Bethesda, Maryland, hold a majority of the manus c ripts and other 

unpublished material used in the research 

for The Army Medical Deparlmen l , 

1818-1865. As always in this series on the 

history of the Army Medical Department, 

the Records of the Office of the Surgeon 

General, Record Group (RG 112), and particularly the letters to and from the Surgeon 

General, have been invaluable. Other important material in the National Archives 

is contained in the Records of the Adjutant 

General (RG 94), the Records of the Inspector General (RG 159), the Records of 

the Judge Advocate General (RG 153), and 

the Records of the Bureau of Refugees, 

Freedmen, and Abandoned Lands (RG 

105). The National Library of Medicine 

collections include a wealth of correspondence, diaries, reports, orders, and similar 

material, both printed and unprinted, originating with the Surgeon General's Office, 

individual surgeons, individual hospitals, 

and the U.S. Sanitary Commission. 

Other repositories consulted for this 

volume include the New York Academy of 

Medicine, which holds the Nathan Jarvis 

papers, the Library of Congress, where 

there is a small collection of the papers of 

such surgeons as Benjamin King and 

Thomas Lawson, and the U.S. National 

Museum, better known as the Smithsonian 

Institution, which holds the papers that resulted from the work of various surgeons 

who gathered data and specimens for the 

Smithsonian. 

Primary Printed Sources 

Books 

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358 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

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364 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Big Bethel, Va., 163 

Billings, John Shaw, 213. 233. 290 

Black Hawk, 50 

Black Hawk War (1832).50-53 

Blackburn's ford, skirmish of, 164-65 

Blakely. Ala .• 262 

Boston, Mass., 177, 204 

Bragg, Bvt. Lt. Col. Braxton, 129 

Brazos Santiago, Mexico, 138 

Bridgeport, Ala., 222 

Brinton, John, 176, 192, 196, 197, 2 10-1 1 

Brownsville, Tex., 138, 263 

Buell. Brig. Gen. Don Carlos. 195- 96. 198-99. 216 

Buena Vista, battlc o f, 104- 05 

Bull Run 

first battle of (Manassas). 58. 163. 165-66. 171 . 174 

second Manassas, 191-92 

Burke's Station, Va., 255 

Burkeville, Va. , 255-57 

Burnside, Maj. Gen. Ambrose E. , 193-94, 208, 232, 

234 

Butler, Maj. Gen. Benjamin, 163, 216,228,232, 

238.240-4 1. 254. 259. 264.267 

Byrne, Bernard M., 137- 38 

Cairo. 11 1..159. 175-76. 196 

Calhoun. John c.. 27. 30. 33. 36 

California gold ru sh, 127 

Camargo, Mexico. 101 - 02, 138 

Cameron, Secretary o f War Simon, 16 1, 177-78 

Camp Chase, 27 1 

Camp Ringgold, Tex., 138 

Camp Townshend, Ga., 69 

Canby. Maj. Gen. Edward R. S .• 262 

Cantonment, Mo., 43-44. See also Fort Atkinson; 

Fort Snelling, Minn. 

Carrick's ford, W. Va. , battle of, 172 

Casualties 

Civil War. 164. 174. 192-94. 199. 210-15.2 19. 

221 . 223. 229. 231 . 234-37. 241-42. 244-46. 

248-49. 253. 255-56. 258. 26 1-62. 267-68. 

275 

Mexican War. 99. 102. 104. 107- 09. 11 8. 124 

Second Seminole War, 58 

Catlin, George, 49 

Cedar Key. Fla .. 62-64. 87 

Centreville, Va. , 164-65 

Cerra1vo, Mexico, 101 

Cerro Gord o, battle of, 1 18 

Chance ll orsville, Va. , battle of, 209-10 

Chapultepec, battle of, 120 

Charleston. S.c.. 71. 136-37. 153. 214- 16. 258-60 

Chattanooga. Tenn .• 220-23. 244-45. 248 

Chickahominy fever, 186 

Chickamauga, Tenn., battle of, 220-2 1, 223 

Chihuahua, Mexico, battle of, 106, 108 

Cholera. 7. 9. 11- 14. 43. 47- 48.50-52. 136. 138. 140 

Christian Commission, 161-62, 236 

Cincinnati. Ohio. 172-73. 175. 183. 195. 196.219 

Cincinnati Medical College, 166 

City Point. Va .• 239-41. 253-57. 264.271 

Civil War (1861-1865). 22-23. 146. 148. 153. 156. 

162. 176-77.20 1.25 1.253.263.276-80. 286. 

288 , 298. See also Armi es, Confederate; Armies, Union. 

Clark. Augustus M .• 266. 269 

Clymer, Meredith, 259-60 

Cochise, 144-45 

Cold Harbor, battle of, 237- 38 

Columbia. S.c.. 258 

Columbus, Ga., 261 

Congress. U.S .• 27-30. 75. 95-97. 103. 123. 127-30. 

133. 154- 55. 159. 177.179-80. 183. 189. 

227-28. 234. 252. 296-97 

Continental Army, Hospital Department, 72, 117 

Cooke. Lt. Col. Philip St. George. 109 

Coolidge, Richard, 73 

Cooper, George, 244-46, 272 

Corinth, Miss., battle of, 199 

Corps of Brigade Surgeons (Corps of Staff Surgeons), 179 

Corpus Christi, Tex., 98-99 

Craig, Presley H., 99 

Crane, Charles Henry, 272 

Crater, battle of, 239 

Craven, John J., 2 15-16, 272-73 

Crawford, Samuel W., 15 1, 15 111, 153 

Croghan, Inspector General of Army George , 31 

Cumberl and, Md., 194 

Cumberl and River, 196 

Cuyler. John M .• 162-63 

Dade, Bvt. Maj. Francis L., 57-58 

Dade massacre, 64 

Dalton, Ga., 246 

Danville, Va. , 255 

Davis, Jeffe rson 

as Confederate president, 45, 27 1-73 

as Secretary of War, 148 

De Camp. Samuel. 107-08. 173. 175 

Detroit, Mich., 50-5 1, 190 

Diarrhea, 9, 13- 14, 41 , 56, 84, 90, 92,99, 101 , 103, 

107-08. 110. 11 3- 14. 11 8-22. 136. 140. 158. 

174. 183. 189. 197-98. 204.208-09.229.239. 

248. 253.257.264 . 268-71 . 279. 287. 292. See 

also Dysentery; Casualties. 

Diet of soldier. 17. 103. 106- 08. 120. 135-36. 140. 159. 183. 200. 204-06.208.223. 228.232. 245. 

278-79. See also Scurvy. 

Diseases. 37. 41. 43. 45. 47. 57. 194.200.203. 229. 

233. 248. 253. 279 

detection, 6, 276, 282 

theories of cause and spread, 3-5, 276, 280 

treatment. 4. 6-8. 10-1 1. 13- 16. 18- 19.2 1-22. 

91. 117. 135-36. 276. 281-85 

Dix, Dorothea, 155,207 

Index 

Abadie, Eugene, 54, 56 

Abiaka (Sam Jones), 7 1 

Acworth, Ga., 245 

Albuquerque, N. Mex., 13 1 

Alcoholism, 16,38-39, 41 , 47-48,84, 88, 92, 101 , 134, 136, 140-41,287 

Alexandria, Va., 163-66, 186, 192, 230, 256 

Alton, III., 270- 71 

Ambulance corps, 186, 191 , 192- 94, 199,209, 

211-12, 216-17,227-28,233-36, 241 - 43, 253, 

261-62, 295, 297 

Ambulances, 115- 16, 132, 157, 160, 163-66, 

169-70, 172-73, 186, 188-89, 195, 204-05, 

209-13,215-17, 220, 222,226-27,233-39, 

241-49, 253, 255-58, 260-62, 274, 293. See 

also Ambulance corps; Hospitals, patients 

(1861 - 1865), evacuation; Hospitals, transports. 

America" Medical Times, 180 

American Revolution, 72, 95, 226, 278 

Andersonville prison, 266 

Anesthetics, 17-20, 125, 199,282, 287,297. See also 

Medicines. 

Chloroform, 17-19, 22, 173, 286 

ether, 17-19, 11 5, 131, 173, 237,286 

Annapolis, Md., 163, 168, 188,234,264,266 

Antietam, Md., 192, 199, 211 

Apache Pass, 143- 44 

Appomattox River, 240-41, 251, 256, 274 

Aquia, Va., 194, 208-11 , 235, 237 

Arbuckle, Col. Matthew, 47-48 

Arkansas, 73, 92, 249 

Arkansas River, 92, 249 

Armies, Confederate, 153, 165. 192, 194, 197,199, 

213- 16, 221 , 232, 235, 239,242- 43,246- 47, 

249, 25 1, 255-56, 258-59, 263, 269 

Armi es, Union 

Arkansas, 219 

Cumberland, 199,219, 220, 222, 244-45,247- 48, 

272 

James, 232, 238, 241, 254, 256 

Mississippi, 198, 257 

Ohio, 244, 248 

Potomac, 166, 168- 71, 184, 191-92, 208- 09, 211 , 213, 222, 232, 234, 237- 38, 240- 41 , 253-54, 

256-57, 295 

Tennessee, 196, 217- 18,222,244 

Virginia, 191 - 92 

Armies, Union, Corps 

Armies, Union, Corps-Continued 

II, 241 

1II, 212 

IV, 217 

V, 253 

IX, 232, 234, 256 

XII, 211 

XVI,229 

Armies, Union, Departments of 

Ohio, 172-74, 245 

South, 216, 259-60 

West, 105, 132, 163 

Army, U.S. (1818- 1860), 28, 74,78,83-84, 87, 127, 133, 146 

Black regiments, 207, 229, 240, 2.77 

in Civil War, 155-56, 158-59, 161 , 165, 176, 191, 

208,2 14,222, 229,232,235, 251 , 275,277-79, 

288 . See also Armies, Union. 

Army Medical Museum, 9311, 184, 203, 210,2 13, 

227, 252, 288 

Army Medical School, 202 

Army of Northern Virginia, 25 1 

Astoria, N.Y. , 202-03 

Atlanta, Ga., 243-46, 248 

Bailey, Joseph H., 90 

Baird, Spencer F., 146-47 

Baltimore, Md., 159, 168, 183, 188, 193,204,23 1, 

242, 266 

Banks, Maj. Gen. Nathaniel, 194,248-49 

Barnes, Joseph K., 128, 202- 03, 226- 32, 236, 242, 

251-52,258, 267, 272-74, 296-97 

Bartholow, Roberts, 142 

Barton, Clara, 2 J 5 

Bascom, Lt. George M., 144-45 

Baton Rouge, La., 39, 41- 43, 50, 52, 88, 123, 249 

Battery Wagner, 2 15- 16 

Beaufort, S.c., 215-16 

Beaumont, William, 24-25, 32-33, 41-42, 80, 297 

Beauregard, Brig. Gen. Pierre G. T., 166 

Belle Plain, Va., 236-37 

Bemrose, John, 67 

Benecia, Calif.. 131 

Benton Barracks, Mo., 195 

Bent's Fort, Colo., 106 

Bermuda Hundred, Va., 24 1 

Berzeiius, Jacob, 25 

Beverly, W. Va., 172-73 
INDEX 

Doniphan, Col. Alexander, 105-07 

Drake. Daniel, 23 

Duncan, Louis, 117, 166 

Duvals Bluff, Ark., 249 

Dysentery, 7, 14, 17,41,56,64,69, 84,92,99,10 1, 107-08, 11 3, 11 6-17, 11 9,124, 136, 143, 158, 

174, 179, 189, 196, 198, 204, 229, 239, 268, 

270, 276-77, 279. See also Casualties; Diarrhea; 

Diet of soldier; Hospitals, patients ( 1861- 1865), 

disease prevention. 

Eaton, John H .t 30 

EI Paso, Tex., 106 

Eli zabethtown. Ky., 196 

Elmira, N.Y., 268-70 

Elwes, Surgeon, 69 

Emerson, John, 45. See also Scott, Dred. 

Engineers, Corps of, 86 

Epidemic of 1832, 12- 13, 138 

Everett, Josiah, 50-5 1 

Fairfax station, Va ., 165 

Falmouth, Va., 208 

Farmville, Va., 256 

Fayetteville, N.C., 258 

Fernandina, FJa., 260 

Fevers, by type. See also Cholera; Malaria. 

dengue, II, 136-37 

hepatitis, 49 

intermittent, 8, 91 

pneumonia, 7, 9, 107, 174, 197,264 

recurrent, 64, 204 

remittent, 8-9, 48, 137, 143 

scarlet, 85, 268, 279 

typhoid, 7, 9- 11 , 43, 49, 68-69,110, 121 , 124, 

141 , 158, 166, 170, 174, 179, 183, 189,196-98, 

200, 203-04, 208, 216, 229, 239, 253, 266, 

277-78 

typho-malarial, 204, 278 

typhus, 7, 10-11 , 13, 107, 183 

yellow fever, 9, 11 - 12,37, 41 , 65,88, III, 113, 

11 6-17, 123-24,136-38,229,260 

Fillmore, Millard, 129 

Finley, Surgeon General Clement A. , 48, 52, 129, 

154-55, 157, 160-70, 173, 176-78, 184, 186, 

190, 293, 296 

conflict with Kimball, 163 

conflict with Tripier, 168-69 

Five Civilized Tribes, 53. See also Indians. 

Folly Island, S.c., 215 

Foot, Lyman, 59-60, 64 

Ford's Theater, Washington, D.C., 27 1 

Forrest, Ll. Gen. Nathan 8., 26 1 

Forry, Samuel, The Climate of Ihe United Stales and 

Its Epidemic Influences, 24 

Fort Armstrong (Rock Island), Mich., 12,51-52 

Fort Atkinson, 43, 83. See also Cantonment Missouri; Fort Snelling, Minn. 

Fort Breckinridge, Ariz., 144- 45 

Fort Bridger, Wyo., 141 

Fort Brooke, Fla., 56- 57, 60, 62-65 

Fort Brown, Tex., 101 , 136 

Fort Buchanan, Ariz., 144-45 

Fort Chadbourne, Tex., 131 

365 

Fort Columbus, N.Y. Harbor, 64, 81, 86-87, 135 

Fort Crawford , Wis., 50-5 1, 83 

Fort Dalles, Oregon Territory, 146-47 

Fort Dearborn, III., 5 1 

Fort Delaware, 27 1 

Fort Des Mo ines, Iowa, 83 

Fort Donelson, Tenn., 196-97 

Fort Drane, Fla., 64, 66-68 

Fort Gibson, Okla., 48-50, 52, 89-9 1, 93,131-32 

Fort Gratiot, 50- 51 

Fort Hamilton , New York Harbor, 38, 64, 86, 88 

Fort Harlce, Fla., 70 

Fort Henry, Tenn., 196-97 

Fort Jesup, La., 93 

Fort Jupiter, Fla., 7 1 

Fort King, Fla., 57, 65- 66 

Fort Lauderdale, Fla., 7 I 

Fort Leavenworth, Kans. , 47, 50, 83, 92-93, 

105-06, 108, 130-32, 139- 41 

Fort Mackinac, Mich., 41 - 43,5 1,88 

Fort McHenry, Md., 38-39, 41 -43, 88 

Fort Mckavett, Tex., 134-35 

Fort Marion, 65 

Fort Mellon, Fla., 64, 70 

Fort Mitchell, Ala., 53, 56, 69 

Fort Monroe, Va., 32, 50, 64, 87, 124, 163, 183, 

188, 190,241 ,266,271 -72 

Fort Monroe-Newport News region, Va. , 163 

Fort Moultrie, S.C., 87, 136-37, 151 , 153 

Fort Niagara, 50 

Fort Peyton, Fla., 70 

Fort Pierce, Fla., 70 

Fort Ril ey, Kans. , 139 

Fort Scott, 83 

Fort Severn, Md., 38 

Fort Smith, Ark., 47- 48, 262 

Fort Snelling, Minn., 43- 46, 83, 88-89, 98 

Fort Stedman, Va., 255 

Fort Steilacoom, Washington Territory, 146-47 

Fort Sumter, S.c., lSI, 153, 215 

Fort Texas (Fort Brown), 99 

Fort Towson, 132 

Fort Washita, 132 

Fort Wayne, 90 

Fort Winnebago, Wis., 50 

Fort Wood, New York Harbor, 82 

Franklin, Tenn., battle of, 247-48 

Frederick, Md., 192-93 

Fredericksburg, Va., 209, 235-37, 242 

Fredericksburg, Va., battle of, 193-94, 199,208 

Freedmen, General Hospital for, 229 

Fremont, Maj. Gen. John c., 161, 173-74, 175 

Frostbite, 141 , 293 

Gardner, Bvt. Col. J. L., 137 
366 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Garey's Ferry. Fla., 62 

Gas gangrene, 280 

Gatlin, John S., 57-58 

Georgetown, 168. See also Washington, D.C. 

. Gerhard, William Wood, 10 

Gett ysburg, Pa., battle of, 204, 211 , 213- 14, 216, 

264, 267 

Ghiseiin, James, 242-43 

G illmore, Maj . Gen. Quincy A" 260 

Goldsboro, N.C., 258-59 

Governors Island. N.Y., 77, 87 

Grand Ri ver, 89 

Grant, General U lysses S., 139, 195, 196, 199, 

216-20,222, 228, 232, 234, 237, 239-41, 243-

44, 250-5 1, 253-56, 262, 266, 274 

Greenwood Island"Miss., 123-24 

Griffi n, John S., 106, 108- 10 

Gross, Samuel, 20 

Hagerstown, Md., 170" 

Hall, Marshall, Researches Principally Relaril'e to the 

Morbid and Cllrath'e Effects of Loss oj Blood. 8 

Halleck, Maj. Gen. Henry W., 191,226,267 

Hammond, William A., 146 

ambulance corps, 191-92,227 

court-martial, 225- 26 

as Surgcon Gencral, 177-84, 188-92, 195, 198, 201 -04, 209- 10, 213, 218, 225-28, 230-32, 

249, 283, 288, 293, 296-97 

Hampton- Portsmouth-Fort Monroe area, Va ., 24 1 

Harney, Benjamin, 11 8 

Harrisburg, Pa., 204 

Harrison's Landing, Va., 189-9 1 

Harvard Medi cal School, 254 

Heilman, Col. Julius F. , 68 

Heiskell, Henry, 73, Ill , 11 5 

Helena, Ark., 262 

Henry, Joseph, 145, 14611 

Henry Clay, 50-5 1 

Hernia, 208 

Hewit, Henry, 196- 98, 2 17, 244 

Hilton Head, S.c., 215, 257 

Hoffman, William, Commissioner of Prisoners, 268 

Hood, Gene ral John B., 247 

Hooker, Maj. Gen. Joseph, 208-1 1, 222 

Hospitals (Medica l Department), 37- 38, 82- 86, 88, 

90-9 1 

black hospitals, 207 

during Civil War, 156-57, 159- 61, 163-76, 

178- 86, 188-89, 191 - 200,202, 204,207- 10, 212- 13, 215-22, 227, 229-30, 233-37,239-49, 

25 1-53, 255- 62,266,268-69, 271 , 277, 

279-80, 286, 289-93, 295 

fl ying hospital, 241 

in Mexican War, 97- 104, 107, 109, 11 3-24 

after Mexican War, 132, 139, 141 

in Second Semino le War, 63-66 

staffing of general hospitals, 290 

Hospitals, patients ( 18 18- 1860) 

Hospitals, patients ( 18 18- 1860)-Continued 

Mexican War 

amputations, 10 1- 02, 107, 115 

problem o f disease, 121-22 

thefts from wounded, 109 

Second Seminole War, care o f wounded in tempora ry forts, 66-68 

Hospitals, patients (186 1- 1865). See also Ambulances; Hospitals, transJ:Sorts; Prisoners o f War, 

Civil War. 

black troops, refugees, freedmen, 229-30, 248, 

252, 256, 262, 277-78 

disease prevention , 16 1, 170,205, 208,223, 268, 

277 

evacuation, 169-70, 188-92, 194-95, 197- 200, 

204-05, 210- 15, 218-23,225,234-35,237- 38, 

240, 242- 44, 246- 50, 255, 257-58, 260, 

266-67, 293-94 

insane asylums, 230 

treatments 

amputations, 280-88 

analgesics, 287 

artificial limbs, 287 

drug addiction, 287 

prostheses, 288 

wounds, 282-84, 295 

from mini e ball, 282-84 

hospital gangrene (erysipelas), 22, 102, 115, 

122, 168, 196, 198, 200, 227, 230, 249, 

254, 268, 279-82, 293. See also Infections. 

Hospitals, sanitation and sewage, 292- 93 

Hospitals, stove ventilation, 292 

Hospitals, transports, 174-76, 186, 188- 92, 194- 95, 

199, 215, 218, 222,234- 38, 240, 243,245, 247, 

253, 255, 257, 259-60, 262, 278, 293-95. See 

also Hospitals, patients (1 86 1- 1865), evacuation. 

hospital ships and trains, 293-95 

steamer (D.A. January), 295, 298- 99 

Hospitals, types during Civil War 

base or general, 289, 292-93 

pavilion, 290-92 

special ized, 293 

tent, 289 

Huntington, Md., 39 

Indian River, Fla., 70 

Indians, 23, 127-28, 130- 32, 143, 14511. 146. 

See also Second Seminole War, 1835- 1842. 

Apache, Chiricahua, 143- 45 

Creeks, Cherokees, Choctaws, Chickasaws, Semino les, 53-54, 56-6 1, 69-71. See a/so Five Civilized Tribes. 

Navajo, 106 

Osage, 92 

Pawnee and Comanche , 49, 93, 14 1 

Sac and Fox, 50. See also Black Hawk 

Sioux, 88, 93 
INDEX 

Infections, 22, 258, 275, 279- 84, 286, 289, 292- 93. 

See also Diseases; Hospitals, patients 

(1 86 1- 1865), treatments, wounds; Hospitals, 

sanitation and sewage. 

Influenza, 88, 92. See also Respiratory disease. 

Invalid Corps, 208, 289. See also Medical personnel, 1861- 1865 (Civil War), hospita l attendants 

and nurses. 

Irwin, Bernard John Dowling, 143-46 

luka, Miss., battle or, 199 

Jackson, Andrew, 22, 53-54 

Jalapa, Mexico, 11 9- 20, 122 

James River, 186, 189- 90,239, 241 

Jarvis, Nathan, 45-46, 98- 104, 138 

Jefferson Barracks, Mo. , 48, 50. 70, 123, 138- 39, 

195 

Jefferson City, Mo., 175 

Jeffersonville, Ind., 248 

Jesup. Maj. Gen. Thomas S., 60, 70 

Johns Hopkins Hospital, Baltimore, Md., 290 

Johnson's Island, Ohio. 269- 70 

Johnston, General Joseph, 25 1, 257, 259, 26 1 

Kaiorama, Washington, D.C., 169 

Kearney, John A., 60 

Kearny, Brig. Gen. Stephen, 105- 07 

Keen, William W., Jr., 283, 293 

Kenesaw Mountai n, battle of, 245 

Kerr, Robert, 51 

Key Biscayne, Fla., 7 1 

Key West, Fla., 57 

Kimball, G ilman, 163 

King, Benjamin, 73, 128 

King, William S., 61 , 163-65, 167, 176 

Kingston, Tenn., 245-46 

Knoxville, Tenn., 244, 248 

Laredo, Tex., 138 

Laub, Charles H., 114- 15 

Law of 1818, 29, 31 

Law of 1838, 81 

Law of 1846, 96-97 

Law of 1847, 96, 127 

Law of 1856, 130 

Law of June 1832, 30 

Law of March 1864 (Ambulance Corps), 228- 29, 

260, 262 

Lawson, Surgeon General Thomas, 16- 17,25.33, 

47- 48, 53-54, 59-63, 69, 72-76, 78-84, 87-94, 

96-98, 103, 109- 12, 11 4- 16, 120, 123, 125, 

127-32, 145, 151, 153- 54, 156, 164, 176, 225, 

286,296 

connict with Foot in Second Seminole War, 

59-60 

feud at Fort Smith, 48 

feuds, 80 

plans for ambulance in Second Seminole War, 83 

promotion of entrance exams, 78- 79 

Lawson, Surgeon General Thomas- Continued 

promotion to Surgeon General, 53-54 

property disposal, 83 

raising physicians' pay and milit ary status, 79 

requiring weather data, 77-78 

on Scott campaign in Mexico. III 

stewa rds, 8 1 

suggestion for hospital ships, 123, 125 

Lead poisoning, 15- 16, 276 

Leale, Charles, 27 1-72 

Leavenworth, Brig. Gen. Henry, 48-49 

LeBaron. Francis, 27 

Lee, Gene ral Robert E., 192,2 10- 11 , 213, 235, 

241- 43, 251-53, 255-56, 259 

L'Engle, William J., 137 

367 

Letterman, Jonathan, 10, 178, 184, 189- 94, 196, 

198, 204, 208- 11 , 213- 14, 217- 18, 220. 223, 

227-28, 232-33, 236, 242, 244, 258, 287, 295 

Letterman Hospital (Camp Letterman). 213 

Lexington, Mo., battle of, 174 

Lincoln. Abraham, 154, 161 , 251 , 27 1- 73 

Little Rock, Ark., 219, 249 

Lobos Island, Mexico, 113 

Los Angeles, Calif., 109-10, 131 

Louis, Pie rre, 8, 10 

Louisville, Ky. , 173, 195- 96, 204, 22 1- 22, 23 1,244, 

248, 252 

Lovell, Surgeon General Joseph, 16- 17, 25, 29-38, 

41 - 43,50, 52-53, 59- 60, 72, 74, 80-8 1,87- 88, 

94, 225, 290, 296-97 

connict with Lawson, 33 

encouraged research on climati c innuence on disease, 34 

examining boa rd, 3 1- 32 

financia l management, 36 

Loxahatchee Ri ver, Fla., 70 

Lynchburg, Va., 255 

Lyon, Brig. Gen. Nathani el, 173- 74 

McClellan, Maj. Gen. George B., 166, 168-73, 178, 

180, 184- 86, 189- 93, 195- 96 

McCiernand, Maj. Gen. John, 216 

McCormick, Charles, 9 1, 122 

McDowell, Brig. Gen. Irvin, 163- 66 

McParlin, Thomas, 192- 94, 232- 40, 242, 253-57 

" Mackinac boats," 70 

Mackinac Island, 33 

Macon, Ga., 261 

Madison Barracks, Sackett's Harbor, N.Y., 84- 86 

Malaria, 6- 10, 13, 37, 4 1, 43, 46-49, 53, 56, 62, 

65- 66, 84-85, 88-89, 91 - 92, 99, 101-03, 107, 

11 3, 116, 125, 135- 36, 141, 143, 145, 170, 175, 

183, 189, 197, 203, 216, 232, 237, 241, 253, 

276- 79. See also Casualties; Diseases; Hospitals, 

patients; Infect ions. 

Mari etta, Ga. , 246 

Massachusetts General Hospital, 19 

Matamoros, Mexico, 99, 101, 138 
368 THE ARMY MEDICAL DEPARTMENT, 18 18- 1865 

Meade, Maj. Gen. George G., 21 1, 213, 216, 232-37, 

256. See also Gettysburg, Pa., battle of. 

Measles, 56, 65, 101 , 103-04, 106-07, 121-22, 163, 

170, 173-75, 183, 198, 268 

Medical Department, Wa r of 18 12, 72 

Medical Department, 1818-1860, 5, 7- 8, 15, 24-28, 

30-31 , 34,36, 47,53-54, 59-60, 71-75, 78-79, 

81, 84, 87, 93-97,103, 109, 110-1 1, 114-15, 120, 124-25, 127-30, 132-34, 142, 145- 49, 153 

Apothecary Department, 27-28 

Apothecary General's Office, 36-37 

climate reports, 145 

interest in natural history, 146-48 

Northern division, 38 

Subsistence Department, 62, 84, 160, 189 

Med ical Department, 186 1- 1865 (C ivil War), 

155-56, 161-63, 167, 17 1-73, 176-80, 182-83, 

186, 190, 193-95, 197, 200, 202, 205- 06, 208-09, 

211-14,216, 218,223, 225-26, 228-32,240, 242, 249-5 1,256,259 

appeal to stale surgeons general, 236 

demobilization, 25 1- 52, 262-63 

drug laborato ries, 202-03, 251 

early deficiencies in 1861, 166-67 

enormity of problem, 153 

medical boards, 20 7, 209, 25 1 

medical inspectors, 179- 80, 209, 23 1, 235, 268, 27 1 

medical records, 204- 05, 233 

overcrowding in camps, 158-59,240 

recruit health standards, 157-58, 205, 245 

Surgeon General's cont rol of general hospitals, 230 

Medical education, pre-Civil War, 23-24 

Medical and hospital supplies, 18 18-1860 

Mexican War, 98, 114- 15 

problems afte r Mex ican Wa r, 130-32 

Second Seminole War, 6 1-63 

Medical and hospita l supplies, 1861- 1865, 159-60, 

165, 174, 183, 186, 189-90, 192-94, 196-99, 

201-02, 206, 210-1 1, 217-20, 222-23, 227, 231 , 234-36,240-41 , 245- 47, 249, 25 1,262,269,274, 

289 

Medical instruments 

dilators, 287 

hemostatic forceps, 287 

hypodermic, 7, 287 

laryngoscope, 5, 287 

microscope, 5-6, 24, 287-88 

ophthalmoscope, 4- 5, 24, 287 

retractors, 287 

stethoscope, 6, 24 

thermometer, 6, 24, 287 

Medical personnel, 18 18- 1860 

contract surgeons, 128 

hospital stewards, 129-31 

offi cal rank, 129 

pay and allowances, 30-3 1, 33, 35-36, 46 wars 

Mexican 

hospital stewards, 129 

military status or physicians, 96-97 

Medical personnel, 1818- 1860-Continued 

volunteer doctors, 97 

Second Seminole, 68-71 

Med ical personne l, 186 1-1 865 (Civil War) 

chi er med ical office r, 186 

contract surgeons and medical cadets, 155, 18 1, 

230-31, 252, 257-58, 260, 288 

doctors as prisoners or war, 165-66, 18 1, 249, 

263-64 

hospital attendants and nurses, 155-56, 169, 191 , 

207-09, 235, 252, 254, 289 

med ical sto rekeeper, 180, 180" 

pay and allowances, 156,207, 229,23 1, 252, 269 

regimental physicians, 288 

reserve surgeons corps, 181 , 255 

stewards, 23 1 

volunteer surgeons, 154, 172, 180, 207, 23 1, 288 

The Medical and Surgical History oj the War oj the 

Rebellioll. 184, 205, 227, 252, 276,278,288, 291 , 293, 295, 298- 99 

Medi cines. See also Anesthetics. 

alcohol, 7, 241 , 287 

bismuth subnitrate, 276 

bromine, 281 

calomel, 7, 13, 16, 47-48, 109, 143, 201 

cathartics, 10- 11 , 91 , 148, 276 

cocaine, 19 

codeine, 7 

colchicum, 15 

cupping, 13 

diapho retics, II 

emetics, 7, 10. 14, 91,201 

guaiacum , 15 

iod ide of potash, 15 

ipecacuanha, 276 

laudanum, 7 

lead acetate, 276 

maguey, 15 

mercuria ls, 7, II , 14- 15, 11 7, 276 

morphine, 7, 22, 110, 287. See also Hospitals, patients ( 1861 - 1865), treatments, drug addiction. 

nitri c acid, 28 1 

opium, 7, 10-1 1, 13- 15, 20, 22, 120, 143, 276, 287 

purges, 8, 14, 16 

Quinine, 6-7, 10- 11, 14, 26,61-62, 68, 91, 98,102, 

113, 117, 124, 135, 143, 161,170, 202, 216,232, 

241,249,276- 77, 287, 297 strychnine, 276 

turpentine, 15, 276 

vcnesection, 8, 2 1, 11 7 

Memphis, Tenn., 218- 19, 222, 229, 267 

Mexican War, 1846- 1848, 143, 153, 164, 227 

Indian and Mexican rebels, 10 7 

Kearny's campaign, 105-09 

Scott's campaign, 111-25 

Taylo r's campaign, 94, 98- 105 

Mexico City, Mex ico, 105, 111, 11 8, 120-22 

Micanopy, Fla., 64 

Mier, Mexico, 101 

Mill iken's Bend, Miss., 217 
INDEX 

Mills, Madison, 217-20 

Mississippi River, 175. 199-200, 204, 2 17,249 

Missouri and Platte rivers, 93 

Missouri River, 139-40 

Mitchell, S. Weir, 179, 283, 288, 293 

Mixcoac, Mexico, 120 

Mobile, Ala., 25 1, 262 

Molina del Rey, battle of, 120 

Monocacy River, 192 

Monterrey. Mexico, battle of, 101-04 

Montgomery, Ala., 261 

Moore, John, 246-47, 257-59 

Morehead City, N.C., 216 

Morehouse, George R. t 283, 293 

Mormons, 109, 127, 140-42, 144 

Morris Island, S.c., 2 15-16 

Morton, William T. G., 237 

Motte, Jacob Rhett, 56, 69-7 1 

Mound City, Ill., 176, 196 

Mountain fever (Colorado tick fever), 14 1-42 

Mower, Thomas, 50, 81 

Mower General Hospital, Philadelphia, Pa., 290-9 1 

Mullet Key. Fla., 63 

Mumps, 65, 101 , 107, 122 

Murfreesboro , Tenn., battle of, 199, 219- 22, 248 

Murray, Robert, 110, 173, 195-96, 198-99 

Myer, Albert J., 148 

Nashville, Tenn., 183, 196, 202, 220-23,244, 247-48, 

267, 293 

Navy, U.S. 

in Mexican War, 113 

Pacific Squadron, 108 

using Medical Department weather data, 145 

Nerve injuries, 283, 293. See also Hospitals, patients 

( 1861- 1865), treatments, wounds; Surgery. 

Nervous diseases, 283, 293 

New Albany, Ky., 248 

New Bern, N.C., 216, 229, 258-59 

New Orleans, 50, 83, 98, Ill , 11 3, 11 6, 122-24, 130, 

132, 138-39,2 16,249,262 

New Smyrna, Fla., 70 

New York City, 12, 28, 50, 98, 130-3 1, 159, 183, 186, 

204, 25 1, 293 

Newnansville, Fla., 69 

Newport Barracks, Ky., 138 

Night blindness, 228-29. See also Diet of soldier. 

Norfolk, Va., 33 

Ohio River, 190 

Oklahoma Territory, 73, 92 

Ophthalmia, 15 

Oregon Territory, 127 

Oregon Trail, 47, 139 

Overland Mail, 144 

Pacific railroad, 199 

Paducah, Ky., 196 

Palatka, Fla., 62, 87 

Palo Alto, battle of, 99 

Pamunkey River, Va., 188 

Paris Medical School, 5 

Parras, Mexico, 103-04 

Pea Ridge, Ark., battle of, 199 

Peacocke, Dr. James L., 78- 79 

Peninsular campaign, 186-9 1, 198 

Pension Bureau, 252 

Perin, Glover, 136, 220-23 

Perley, Thomas, 180, 194 

Perote, Mexico, 11 9 

Perryville, Ky. , 198 

369 

Petersburg, siege of, 239, 241, 243, 253, 255 

Petersburg, Va., 237, 239-40, 253, 257, 274 

Philadelphia, Pa., 168, 183, 186, 203-04, 242, 252, 

266, 273, 293 

Picolata, Fla., 63, 66 

Pine Bluff, Ark., 249 

Pittsburgh, Pa., 172 

Placido Creek, Tex., 138 

Plan del Rio, Mexico, 118- 19 

Platte River, 141 

Point Isabel, Tex. , 99, 101 

Point Lookout (in Chesapeake Bay), 27 1- 72 

Point of Rocks, Va. , 240-42, 254 

Polk, James, 98-99, 103 

Poolesville, Md., 170 

Pope, Maj. Gen. John, 191 , 193 

Po rt Lavacca, Tex., 138 

Port Royal, Va., 237 

Porter, John, 114- 15, 11 8, 124, 136-37 

Potomac River, 165, 190, 236 

Prairie Grove, Ark., battle of, 199 

Preventive medicine, pre- Civil War, 16 

Prisoners of war, Civil War 

Confederate, 251-52, 259, 263- 64, 267, 271 

Union, 257, 259, 260, 263- 71 

Puebla, Mexico, 120, 122 

Purcell, Edward, 45 

Quartermaster Department, 30, 36, 86, 115- 16, 130, 

160,186, 188- 89,238,25 1, 266, 294 

Raleigh, N.C., 257, 259 

Ranchea Buena Vista, Mexico, 105 

Rapidan River, Va. , 232, 234 

Rappahannock River, 2 10, 235, 237 

Red River, 49, 248-49 

Resaca , Ga., 246 

Resaca de la Palma, battle of, 99 

Respiratory disease, 9,15, 37,48, 65, 85,89,98, 103, 

107-08, 136, 232, 241, 248, 253, 268, 270, 278. 

See also Diseases; Fevers, by type. 

Rheumatism, 15,248, 253, 279 

Rich Mountain, W. Va., 172- 73 

Richmond, Va., 165, 186, 237, 254- 55, 263-64 

Rio Grande, 95-96, 99, IO I, 115 

Rolla, Mo. , 174, 199 

Rome, Ga., 244 

Rosecrans, Brig. Gen. William S., 17 1, 195, 198- 99, 
370 THE ARMY MEDICAL DEPARTMENT, 1818- 1865 

Rosecrans, Brig. Gen. William S.-Continued 

219-23 

Rucker, Brig. Gen. Dan iel H., 293 

Rucker ambulance, 293 

Russell, Joseph P., 87 

51. Augustine, Fla., 57, 62-64, 70-7 1. See also Fort 

Marion. 

St. John's Bluff, Fla., 74 

St. Johns River. 70, 74 

51. Joseph Island, Tex., 99 

St. Louis, Mo., 109, 172-75, 183, 195- 96,203, 219 

266, 27 1, 293 ' 

St. Louis Arsenal, Mo. , 138 

51. Marlin, Alexis, 24-25, 41, 80 

Salter, Francis, 26 1 

Saltillo, Mexico, 103- 06 

San Antonio, Tex. , 103, 120, 131, 134, 138 

San Augustin, Mexico, 120 

San Diego, Calif., 108-09 

San Francisco, Calif., 131- 32 

San Juan de Ulloa, Mexico, 116 

San Luis Rey, Calif" 109 

San Pasqual, battle of, 108 

Sanitary Commission, British, 161 

Sanitary Commission, Western, 16 1, 175. 195, 199, 

217,262 

Sanitary Commission, U.S., 160-62, 166-70, 176-80, 

182-83.188-89,192, 194, 196,198,206,21 1_13, 

215,2 17- 18, 22 1-22,226,231-32,236,238,246, 

248, 259, 262, 277, 279. See also Medical Department. 

Santa Ana, General, 104, 121 

Santa Cru z, Mexico, 108 

Santa Fe, N. Mex., 93, 106-09, 131 

Santa Fe Trail, 47, 139 

Satterlee, Richard S., 11 3 

Savannah, Ga., 228, 247, 25 1, 257-60 

Savannah, Tenn., 197 

Schofield, Maj. Gen. John M. , 259, 266 

Scott, Dred, 45 

Scott, Lt. Gen. Winfield, 50-5 1, 74, 81, 104, 111 - 14, 11 6, 118-21, 166 

Scurvy, 14, 37, 43-44, 46- 47, 62, 88, 101 , 106- 08, 

110, 124, 135-36, 141 - 42, 159, 183, 189, 200, 

204, 206, 208,2 16,228- 29, 232,237,245,253, 

257,262-63,268,270,278-79. See also Diet of soldier. 

Second Sem inole War, 1835-1842, 7, 23, 52, 54, 

57-58, 61,64,66-69, 72-74,78,83-87, 90, 95, 

97, 135, 143 

Sedali a, Mo., 175 

Selma, Ala., 26 1 

Sheldoll Thompson, 50- 5 1 

Sheridan, Maj. Gen. Philip H., 241 - 43, 256 

Sherman, Maj. Gen. William T., 2 16-18, 222, 243-46, 

248, 250- 51 , 257, 262, 266, 274, 294 

Shiloh, Tcnn., battle of, 197- 99 

Ship Island (in Mississippi River), 271 

Shippen, William, 226 

Shreveport, La., 248- 49 

S~ryock , Richard Harrison, 22 

SIbley tents, 159 

Sickles, Maj. Gen. Dani el, 212- 13 

Signal Corps, 148,253 

Simons, James, 196 

Slavery question, 127 

Small pox, 16,89, 95, 101 , 113, 124,134-35, 141 , 170, 

229, 232, 248, 253, 258, 261, 268-71, 278-79, 

297. See also Vaccination. 

Smart, Charles. 277-78 

Smithsonian Institution, 145-46 

Soldi ~rs' Home (Army Asy lum), 128 

Spamsh Fort, Ala., 262 

Spotsylvania, Va. , battle of, 232, 235. 242 

Springfield, Mo., 173-74 

S. R. Spaulding, 259 

Stanton, Edwin, 16 1, 177-80, 183, 190-9 1, 194, 

201-03,2 10, 225-26,228, 230-32,259, 267, 296, 

299. See also Hammond. William A. 

Srarisrical Repof{, 133- 34, 142 

Steele. Maj. Gen. Frederick, 249 

Steinecke, Henry, 51 

Stewart, William, 38 

Strong, George Templeton, 153, 189,226,231 

Suckley, George, 146- 47 

Sud ley, Va., 165 

SlIlrulIa, 266 

Surgery, 17-22, 193, 198, 233, 244, 258, 275, 280, 

286-87 

Swirt, Eben, 199 

Tacubaya, Mexico, 120 

Tart, Charles, 27 1 

Tampa Bay, Fla., 53, 62, 71, 87-88 

Tampi co. Mexico, I 13 

Taylor, Zachary, 45, 48, 62, 98- 105, 113, 11 5, 142-43 

Tennessee River, 197,221-22,247 

Tetanus or lockjaw, 2 1, 101 .280,287 

Texas (Loan Star Republic), 95-96, 98 

Thomas, Maj. Gen. Georgc H., 222, 247-48 

Thomaston, Ga., 261 

Tilton, James, 34 

Tracy, Benjamin Franklin, 268 

Tripier, Charles, 166-72, 176, 178, 180, 184, 186, 

. 188-92, 194- 95, 198,204,236,293 

Tnpler ambulance, 204 

Tuberculosis, 9, 48, 279. See also Respiratory disease. 

Tull ahoma, Tenn. , 248 

Turne r, George, 89 

Tuskegee, Ala., 69 

Utah Expedition, 140-4 1 

Utah and Wyoming Territories, 142 

Vaccination, 16,29, 124, 134-35, 170, 232,253, 26 1, 269- 71 , 278, 297. See also Smallpox. 

Venereal diseases, 14,87-88. 108, 11 9, 134, 140-4 1, 
INDEX 

Venereal diseases-Continued 

183, 208, 232 

Vera Cruz, Mexico, 11 3-18, 120, 122-24 

Verdigris River, 89 

Veterans Reserve Corps, 230 

Vicksburg, Miss., 229, 264, 266 

Vicksburg, Miss., battlc of, 204, 216- 19 

Vinings Station, Ga., 246 

Vellum, Edward, 217 

Volunteer Regiment, 1st Illinois, 103 

Vol usia, Fla., 64 

Walla Walla, Wash., 132 

War Department, Civil War, 161 , 260,263 

War of 181 2, 27, 34, 80, 95 

War of the Rebellion, 211 

Washington, D.C., 156, 165-66, 168-69, 183, 188, 193, 195,204,208,210- 11 , 226,230,234,237 

Waterhouse, Benjamin, 29 

Waterloo. battle of, 214 

Weather, effects of, 222-23, 237, 239-41 , 248, 258, 

262 

West Point, Ga., 26 1 

West Point, N.Y. 32, 75, 155 

West Virginia, 172 

White House, Va., 188-90,237-39 

Whitman, Walt, 194 

Wilderness, Va., battle of, 232, 234-35 

Williamsburg, Va., 188 

Wilmington, Del. , 242, 292-93 

Wilmington, N.C., 258-59, 266 

Wilson. Maj. Gen. James H. t 26 1 

Wilson's Creek, battle of, 17 1, 173-74 

Wilson's Station, Va., 255-56 

Winchester, Va., 194, 242 

With lacoochee. battle of, 66 

Wood, Robert c., 45 

as acting Surgeon General, 161, 178-79 

as Assistant Surgeon General, 23 1 

Woodhouse, Samuel Washington, 147-48 

Woodward, Joseph Janvier, 227, 237, 276 

Wool, Brig. Gen. John E., 103- 06 

371 

Worth, Maj. Gen. William J., 57, 61, 71, 96, 138 

Wright, Joseph J. B., 172-73, 176 

York, Pa. 242 

York Ri ver, 186 

Yorktown, Va., 188 

Young, Brigham, 14 1 

Young's Point, Miss., 218 

Zuni and Little Colorado rivers, 147 




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