The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.
The evolution of the nursing profession in America was accelerated by the Civil War.
Amputations were the most common surgery performed during the Civil War.
Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.
Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.
Wednesday, February 22, 2017
“In putting forth this Manual of Military Surgery for the use of Surgeons in the Confederate service, I have been led by the desire to mitigate, if possible, the horrors of war, as seen in its most frightful phase in military hospitals.”
Julian J. Chisolm
Preface to First Edition.
“When the war suddenly broke upon us, followed immediately by the blockading of our ports, all communication was cut off with Europe, which was the expected source of our surgical information. As there had been no previous demand for works on military surgery, there were none to be had in the country, and our physicians were compelled to follow the army to the battle without instruction. No work on military surgery could be purchased in the Confederate States. As military surgery, which is one of expediency, differs so much from civil practice, the want of proper information has already made itself seriously felt. In times of war, where invasion threatens, every citizen is expected to do his duty to his state. I saw no better means of showing my willingness to enlist in the cause than by preparing a manual of instruction for the use of the army, which might be the means of saving the lives and preventing the mutilation of many friends and countrymen.”
Julian J. Chisolm
Preface to First Edition.
From the outset of the war, Julian John Chisolm (1830-1903) realized that knowledge of military medicine was practically non-existent among doctors in the South. Using the knowledge gained during his time observing the treatment of soldiers wounded in the Second Italian War of Independence (1859) in Milan, Italy, Chisolm wrote and published his book, A Manual of Military Surgery: For the Use of the Surgeons in the Confederate Army With an Appendix of the Rules and Regulations of the Medical Department. First published in July 1861, the manual described how to treat specific types of wounds, construct field hospitals, and manage food, clothing, hygiene and non-surgical diseases. Later editions contained detailed illustrations showing how to perform specific procedures such as amputations. The manual became one of the most popular surgery books published by the Confederates States of America and resulted in the publication of three more editions. These later editions incorporated the knowledge gained from the battlefield to improve the treatments of gunshot wounds.
Four editions of the manual were produced during the course of the war and are now available for research use at the Waring Historical Library:
1861 edition: http://www.archive.org/details/manualofmilitarychis
1862 edition: http://www.archive.org/details/manualofmilitar00chis
1863 edition: http://jdc.jefferson.edu/milsurgcsa/
1864 edition: http://www.archive.org/details/manualofmilita00chis
“After three years of incessant and bloody warfare I have been called upon to embody, in a new edition of “The Manual of Military Surgery,” the large experience of the medical staff of our army. It has been my aim to condense, in a concise, practical form, the improvements in the treatment of gunshot wounds which have been developed during our active campaigns, and repeatedly confirmed upon thousands of wounded.”
Preface to the Third Edition.
Memorial Day, observed this year on May 28, commemorates all the men and women who have died in military service for the United States. Flags traditionally fly at half-mast from dawn until noon, and volunteers often will place an American flag on the graves of veterans.
At Saint Mary’s in Notre Dame, Indiana, we remember our deceased sisters who served as nurses in the military. This military service actually began in 1861, six months after the outbreak of the U.S. Civil War, when Holy Cross sisters responded to the request of Indiana Governor Oliver Morton to care for Indiana soldiers then serving in Kentucky. Although they had no training as nurses, six sisters, led by Mother M. Angela (Gillespie), journeyed to Paducah, Kentucky, to tend the sick and the wounded. Many more sisters followed, and others went to hospitals in Illinois, Tennessee, Missouri and Washington, D.C.
On Christmas Eve 1862, three Holy Cross sisters boarded the U.S. Navy’s first hospital ship, the Red Rover, to serve as nurses for the wounded on both sides of the war. They traveled the Mississippi River carrying sick and wounded soldiers to various military hospitals. In so doing they became what U.S. naval history today hails as the forerunners of the United States Navy Nurse Corps. Before the conflict ended, 65 of the 160 Sisters of the Holy Cross in the United States would serve in the Civil War, and another 13 sisters would serve in the Spanish-American War.
Each sister-nurse received a military pension, and the Navy honored these sisters with a special headstone placed on their graves in the congregation’s Our Lady of Peace Cemetery at Saint Mary’s.
The Sisters of the Holy Cross are among 12 congregations of religious women who are depicted on the Nuns of the Battlefield monument, erected in 1924 in Washington, D.C. The inscription reads: “To the memory and in honor of the various orders of sisters who gave their services as nurses on the battlefields and in hospitals during the Civil War. They comforted the dying, nursed the wounded, carried hope to the imprisoned, gave in His name a drink of water to the thirsty.”
Image: Novices Callista Tetteh, Grace Kitinisa and Jessica Brock stand at the headstone of Mother M. Augusta (Anderson), who served as a Navy nurse during the U.S. Civil War.
Walt Whitman was 43 and already a well-known poet in 1862 when word reached his family that his brother George, who’d enlisted in the Union army, had been wounded in a battle at Fredericksburg, Virginia. Whitman immediately left to find George, anxious to see him and discover the extent of his injuries. George, as it turned out, had only received a cheek wound, but Whitman’s experience searching for his brother among the military hospitals had left an impression on him. For the next three years—the remainder of the war and then some—Whitman, who moved to Washington DC for this purpose, visited wounded and sick soldiers almost daily in the capital’s many military hospitals.
While some people today refer to Whitman as a nurse during this time, he wasn’t anything so official. While he did help change bandages and definitely observed many bloody surgeries, his role was more that of a really dedicated and concerned frequent visitor. Funded by his part-time job at the army paymaster’s office and by generous Northern philanthropists, Whitman brought with him on his visits countless little gifts for the soldiers. He brought treats like apples, oranges, figs, crackers, fruit-flavored syrups, and ice cream, and when a soldier requested a specific food—from rice pudding to pickles—Whitman did his best to obtain it for him. Whitman also brought reading materials for the men: magazines, newspapers, and almanacs for individuals, and books to pass around the ward. He also provided the wounded with stamped envelopes and paper to write letters to their loved ones, and when they were too ill or illiterate to write themselves, he wrote the letters for them. In addition to these items, Whitman also passed out small sums of money to the soldiers, since many came to the hospital with no money in their pockets, and Whitman discovered that giving them even small amounts helped raise their spirits. At the end of the war, he estimated he had passed on thousands of dollars of philanthropists’ money to hospitalized soldiers.
But beyond these simple gifts, Whitman felt the best way he could help the wounded was with his cheerful presence. Disregarding whether the man was from North or South, Whitman went around the wards talking to the men and learning not only how they’d been injured but about their families and lives before the war as well. And when the men were too hurt to hold a conversation, Whitman would sit by their bedside and give them comfort in silence. He remarked, “I do not see that I do much good to these wounded and dying; but I cannot leave them. Once in a while some youngster holds on to me convulsively, and I do what I can for him; at any rate, stop with him and sit near him for hours, if he wishes it.” Whitman’s hospital visits lasted anywhere from a couple hours to all day or all night, if a dying soldier needed him that long. By his own estimation, Whitman “made over six hundred visits or tours, and went, as I estimate, counting all, among from eighty thousand to a hundred thousand of the wounded and sick.”
Whitman’s mission of mercy inevitably affected his writing. He wrote many poems about his own and others’ wartime experiences in a collection called Drum-Taps. Those poems captured the quiet, stalwart bravery of common soldiers and the close camaraderie they shared. He would also later compile his hastily jotted down notes and observations from his visits into a book called Specimen Days, which provides keen insight into life in Civil War hospitals and in wartime Washington DC.
Daniel Sickles, although perhaps best known as a political Civil War general whose disobedience at Gettysburg got his troops killed, is also known for a scandal before the war in which he killed his wife’s lover.
Sickles was a former lawyer of the Tammany Hall political machine who had become a Democratic representative for New York in the House of Representatives. Sickles was a womanizer and had many affairs, most famously with courtesan Fanny White, whom he took with him on his travels to England. At age 33 he courted scandal by marrying Teresa Bagioli—who was 15 and pregnant.
In 1859, when his wife was 23, Sickles discovered that she had been having an affair with 40-year-old Philip Barton Key, a family friend who was also a US district attorney and the son of composer Francis Scott Key. Sickles had apparently been ignorant of the affair until he received an anonymous letter informing him of his wife’s actions. Sickles confronted his wife and she confessed.
The next day, February 27, he saw Key walking by the house, and Sickles ran out shouting, “Key, you scoundrel, you have dishonored my home—you must die!” Sickles cornered Key, assaulting him and shooting him multiple times. Finally, Sickles shot Key point blank in the chest, killing him.
As there had been multiple witnesses, there was no doubt of Sickles’s guilt, but when his case came to trial, his lawyer (Edwin Stanton, later Lincoln’s secretary of war) blamed temporary insanity—the first time that defense had been used in trial. The trial received much attention, and the public—as well as the jury—sided with Sickles, believing that his actions and insanity were totally justified given the situation, and he was acquitted.
Interestingly, public opinion stayed on Sickles side until a few months later, when he reconciled with his wife. Having completely vilified Teresa, the public couldn’t forgive Sickles for returning to her, and they turned against him. It seemed like his political career would never recover, but then the war started and Sickles became a Union general—giving him a chance to start over.
Image 1: Daniel Sickles shooting Philip Barton Key, 1859
Image 2: Teresa Sickles
With Confederate troops looming just outside of Washington, D.C., July 1864 was an exciting and scary time to be a nurse in the city. Curator Diane Wendt shares what those daring days were like 150 years ago through the matter-of-fact diary entries of nurse Amanda Akin.
While nurse Amanda Akin's diary is more cursory than poetic, I was drawn to her account because of the proximity of her hospital to the Smithsonian, and because we share, albeit 150 years apart, this common ground. Her original diary is in the collections of the National Library of Medicine and was the centerpiece of a small exhibition I curated a few years ago.
Akin left home to work at Washington's Armory Square Hospital at age 35 and began work in April 1863. By July 1864, she was preparing to end her nursing service and return home to Quaker Hill, New York. We pick up her story on the morning of July 9, when she first heard word of the Confederate advance on Washington:
July 9, 1864. Spent morning in ward framing and changing some of the pictures, etc. Received exciting news of another raid into Maryland. An order came to have every man able to carry a musket ready to leave tomorrow. […] Sang in Miss Merrill's ward my new song, "When Johnny Comes Marching Home," and tried duets with her; then went to my ward and repeated it. The general ward master came in and brought a tenor, and we had quite a musicale.
In order to strengthen the defenses of the city, all able-bodied men were called to duty, including many of the hospitals assistants and clerks—even any patients well enough to serve. Perhaps the excitement of the call to arms inspired Akin to try out her "new song" during the evening entertainment. "When Johnny Comes Marching Home," one of the most enduring Civil War tunes, was first published in 1863, and became popular in both the North and South.
Cover of sheet music for “When Johnny Comes Marching Home” words and music by “Louis Lambert” (Patrick Sarsfield Gilmore), Boston: Henry Tolman & Co., 1863-_Project_Gutenberg_eText_21566
Cover of sheet music for "When Johnny Comes Marching Home." Words and music by "Louis Lambert" (Patrick Sarsfield Gilmore), Boston: Henry Tolman & Co., 1863.
July 11, 1864. Began my packing. Another order for men from the hospital. Found only the ward master, with ward attendants—two for the dining room and bathroom. Johnny Hegeman, my orderly, volunteered, as the orderlies were to be exempt for the present.
Armory Square Hospital had ten wards and usually one female nurse assigned to each. Akin was assigned to "Ward E." Convalescing and disabled soldiers were put to work as orderlies and ward attendants. Johnny Hegeman was serving as Akin's primary assistant—her orderly—when the call to arms came. He had joined the military service underage, but had come down with fever and landed at the hospital before his regiment reached the front. New recruits were particularly susceptible to infectious diseases including typhoid, measles, and smallpox. One can imagine that Johnny Hegeman was excited to finally have the chance to see "action."
The rebels are skirmishing before Fort Stevens, formerly Fort Massachusetts, only five miles from the city. Baltimore is in great excitement. General Lew Wallace was in command, and the fighting going on all day Saturday, but our men were obliged to fall back, as the enemy was superior in numbers. […]
A hospital ward in Washington, D.C. Library of Congress Prints and Photographs Division.
The Confederates under General Jubal Early approached Washington from the northwest. Two days before reaching Fort Stevens, they encountered General Lewis (Lew) Wallace's troops at the Battle of the Monocacy, not far from Frederick, Maryland. Although the Union was defeated, the battle slowed the Confederate advance on the city and allowed Union reinforcements time to reach Washington from the south. Wallace had borne much of the blame for Union losses at Shiloh in 1862, and his actions at Monocacy, dubbed "The Battle that Saved Washington," helped restore his reputation.
[…] After "Taps" sat on the chapel steps with Sisters Merrill and McClellan, in the moonlight. Our nerves were too over-wrought for us to separate, and we were wondering what news the morning would bring. As we were returning we were called out again to hear the band from the Sixth Corps, which passed here to-day on a forced march and returned to treat us, playing most beautiful music for a half hour. Part of the Nineteenth Corps, from New Orleans, also passed; in fact all day troops have been hurriedly massing to protect Washington.
The Confederates reached Fort Stevens on the outskirts of the city on July 11th. The fort was located north of the city on the 7th Street Pike [Georgia Avenue], the major north-south route through the city. Armory Square Hospital also sat on 7th Street, and Akin witnessed the passing of the Union reinforcements as they arrived at the Sixth Street docks to the south and marched north through the city to reach the fort. Akin’s nervousness on the evening of July 11 was indicative of the atmosphere throughout the city, as an anxious population awaited the outcome of the confrontation at the north edge of town.
Stay tuned for Part II, in which I'll continue Amanda's story.
Diane Wendt is a curator in the Division of Medicine and Science at the National Museum of American History. She has previously blogged about what it was like to survive rabies 100 years ago.
This post continues the story of Civil War nurse Amanda Akin, which began in Part I.
"July 12, 1864. The bridge over Gunpowder River, sixteen miles from Baltimore toward Philadelphia was burned. The 7.30 A.M. train yesterday was attacked, the passengers ordered out, and the train then run on to the bridge and burned. This afternoon the "extras" say a few miles of double track between this city and Baltimore were torn up, so I am a fixture for the present. […]"
General Jubal Early sent one unit of his Confederate forces around Baltimore to cut supply and communication lines that connected the Capitol to the North. Telegraph lines, track, and bridges were destroyed on the Northern Central Railway and the bridge over the Gunpowder River (near Joppa, Maryland) on the Philadelphia, Wilmington, and Baltimore Railroad was burned. This railroad is now part of Amtrak's Northeast Corridor. Until the railroads were repaired, Akin would be unable to return home.
"[…] After "Taps" went with Sisters Helen and Mac to Smithsonian, where Misses Lowell and Ware had preceded us, to see the shells from the Smithsonian Tower; but as they came down and reported only "signal lights" to be seen, we felt too weary to attempt to climb so many flights. Professor Henry's daughters came to the door and were cordial."
The familiar bugle call for "lights out" known as "Taps" had its origins during the Civil War. The top of the Smithsonian's highest tower afforded a grand view of the city of Washington and the surrounding country, although the climb proved too much for Akin and her companion on the evening of July 12th.
"July 13, 1864. The rebels have retreated, but many precious lives have been sacrificed. Major Jones of the Sixth Maine, just returned to his regiment from a furlough, was killed; his term of service would have expired in two days. […]"
By July 14, the Confederate troops had retreated to Virginia, crossing the Potomac River near White's Ford (just up river from where White's Ferry crosses today). With the threat to the city over, Akin resumed her preparations for leaving. On July 15, Akin visited Mathew Brady's gallery on Pennsylvania Avenue to purchase a picture of Abraham Lincoln and an album for her cartes-de-visite. The next day, she noted in her diary that the trains north were running again but were much too full for her to get through.
"July 16, 1864. Our ward at present is very quiet; only a few of the patients (the most severe cases) still in bed. Captain Constantine Lippe, of the 188 Pa. Vols., who would not consent to have his leg amputated, after weeks of suffering lying on his back, losing flesh and strength, as he knew he must until the crisis was passed, is now gaining. His fine physique and good health have borne the strain. […]"
Constantine Lippe was the son of Adolph Lippe, a prominent American homeopathic physician and teacher at Hahnemann Medical College in Philadelphia. Constantine was also a homeopathic physician and his "irregular" medical training probably influenced his decision to refuse amputation. Although surgeons were often accused of being too eager to amputate limbs, few other options were available to prevent fatal infections and repair shattered limbs. Lippe had received his leg wound at the battle of Cold Harbor on June 3, 1864. He continued to suffer from pain and ill health after the war, and his death in 1885 was judged to be a result of the war wound.
Akin's last entry is dated July 20, 1864. Few were left in her ward to bid her adieu except for Captain Lippe and Captain Newton May Brooks, who had been at the hospital since May after being severely wounded at the Battle of Spotsylvania:
"July 20, 1864. The day has at last arrived to bid adieu to my ward and its absorbing duties, now realizing, reluctantly, how my life has been rounded within it for eight months. So with an inexpressible regret to leave even a few whose watchful eyes and patient smiles would bid me stay, though with an unspeakable longing for home and loved ones there, have given them my hand in good fellowship, and over a glass of native wine made my good wishes to Captain Lippe, my brave Philadelphian, and Captain Brooks of the Twelfth New Jersey Volunteers. WILL I EVER RETURN?"
I do not know if Akin ever returned to Washington, nor do I know much else about the rest of her life. She married Dr. Charles W. Stearns in 1879. He had been a surgeon in the 3rd New York Infantry, but it is doubtful their paths crossed during the war. Akin was widowed in 1887, and apparently had no children. In 1909, at age 81, she published an account of her nursing experience, "The Lady Nurse of Ward E", under her married name of Amanda Akin Stearns. She died in February 1911 and is buried with her husband in Pawling, New York, the town that includes her home at Quaker Hill.
Diane Wendt is a curator in the Division of Medicine and Science at the National Museum of American History. She has previously blogged about the influenza vaccine. Want to learn more about Amanda Akin? Her book "The Lady Nurse of War E" is available online. The Smithsonian Institution Archives has other interesting resources related to the Confederate attack in July 1864.
Image: The chapel for Armory Square Hospital where Akin sat with her fellow nurses on the evening of July 11th. The nurse’s quarters were just to the left of the chapel. The capitol dome can be seen in the distance.
While most don’t immediately associate religion with war, there is no doubt that it plays a role in most, the Civil War included. The Civil War brought with it new levels of death and destruction that the government was unprepared to deal with; it didn’t have the resources to adequately care for the influx of wounded soldiers, which was painfully evident after Bull Run when the number of soldiers needing medical care was more than the hospitals could handle. In the wake of the Battle of First Bull Run, the general public as well as the government saw the need for a civilian organization to help care for and comfort wounded soldiers. On November 14, 1861, a few months after the battle, the United States Christian Commission (USCC) was created by representatives of the Young Men’s Christian Association (YMCA) to fill this void. Its headquarters were set up in Philadelphia, and a layman named George Hay Stuart was appointed to head the Commission. The Commission was made up of volunteer delegates who were unpaid, though they were reimbursed for travel costs and other expenses they acquired while in the field. These delegates would go to the field for usually only a few months, during which time they were encouraged to keep a diary; many did just that.
A diary from a delegate that spent a few months in Louisville gives us a glimpse into his everyday life. The diary was issued by the USCC and bears their stamp on the front; the first few pages detail the duties of a delegate and provide other useful information and instructions. A delegate was expected to visit hospitals, camps, and battlefields to distribute supplies and religious materials. He was also supposed to speak to the men individually as well as collectively and hold meetings of prayer. In addition, the Commission provided the delegates with supplies such as stamps, envelopes, paper, clothing, food, and coffee for distribution to the soldiers.
After the instructions section the delegate’s diary entries begin. The entries in the journal I examined date from May 18, 1864 to July 7, 1864. He was in the field for a couple of months, which is reflective of the typical length of time the Commission preferred for its volunteers. In his diary the delegate recorded the smallest details about his life such as the weather conditions and his bathing habits. In addition to this, the reader also learns what duties the delegate performed on a day-to-day basis. Much of what the delegate wrote about involved talking to the men, visiting the hospital, and distributing religious tracts. For example, on May 24 he wrote that he distributed 200 religious tracts and would have distributed more if he had the resources to do so.
In addition to handing out religious tracts, the delegate also performed many other essential tasks. There are accounts of the delegate distributing woolen shirts and cotton drawers to the men as well as envelopes, paper, and stamps. At one point he described helping a wounded soldier write home, a simple task that provided the soldier with the precious ability to communicate with his loved ones. There are other instances in the diary in which the reader can imagine the impact the delegate would have had on the soldiers. In the June 22 and 23 entries he wrote about visiting Rebel prisoners. During this visit one prisoner in particular caught his attention; a Confederate, Holliday, who was wounded and paralyzed. The delegate provided him with a shirt, despite the fact that he was a Confederate. On the 23, he wrote of the death of Holliday and lamented at “what a penalty this nation is paying for its oppressive acts.” In addition to this, the delegate spent a lot of time in the field and in the hospital, comforting and attending to the wounded. For example, on June 19 he wrote that he “prayed with a man wounded in the bowels. He died in an hour.” In this way the delegate was able to do something of which the government and the hospital staff were incapable of: sitting with and comforting a dying soldier.
In this diary we see examples of the many services the USCC provided. These services brought comfort to the soldiers and filled a void that the government was incapable of filling. The earliest forms of dog tags were provided by the Commission, something that the government was unable to do. The USCC’s distribution of religious tracts, if nothing else, provided the men with reading material that was often seriously lacking or even nonexistent in most army camps. In addition, they provided much needed support to hospitals and distributed supplies that the men needed but that the government couldn’t supply. The USCC did many other things like this, and while some may have had an aversion to the religious nature of the organization, there is no question that they provided the soldiers with simple pleasures and comforts in a time of war to which they would not have had access otherwise.
Diary of a Missionary with the U.S. Christian Commission. Civil War Vertical File Manuscripts. Special Collections/Musselman Library, Gettysburg College, Gettysburg, Pennsylvania.
Hovde, David M. “The U.S. Christian Commission’s Library and Literacy Programs for the Union Military Forces in the Civil War.” Libraries & Culture 24, no. 3 (1989): 295-316. Accessed September 10, 2016.
Katcher, Philip. “Union soldiers had a mixed verdict on the effectiveness of the U.S. Christian Commission.” America’s Civil War 15, no. 4 (September 2002): 12. Accessed September 10, 2016.
U.S. Christian Commission Dogtag. Civil War Vertical File Manuscripts. Special Collections/Musselman Library, Gettysburg College, Gettysburg, Pennsylvania.
Image: USCC headquarters in Germantown, VA. Photo via Library of Congress.