.

Civil War Hospital Ship

The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.

Evolution of Civil War Nursing

The evolution of the nursing profession in America was accelerated by the Civil War.

The Practice of Surgery

Amputations were the most common surgery performed during the Civil War.

Army Medical Museum and Library

Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.

Civil War Amputation Kit

Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.

Thursday, March 27, 2014

Organization of the Hospitals in the Department of Washington

Excerpted from: civilwardc.org
By Susan C. Lawrence

"At the outbreak of the civil war," the author of the chapter on general hospitals in "The Medical and Surgical History of the War of the Rebellion" wrote, "this country knew nothing practically of large military hospitals; indeed, most of our volunteer medical officers knew nothing of military hospitals, small or large."

In fact, most of the volunteer medical officers would have known nothing of hospitals at all unless they had practiced in a city large enough to have had one or more charity hospitals, such as New York, Boston, Philadelphia or Washington, DC. Both volunteer and newly recruited medical officers must have quickly discovered that they needed to learn something about the military as well as something about hospitals in order to work in some of the ad hoc, transitory establishments that housed the sick and wounded at the start of the war. It was the military, after all, that requisitioned space, built new hospitals, provided supplies, and needed regular, complete reports of the numbers of sick and wounded. The military imposed order (or at least tried to) on the proliferation of hospital sites, working along both military and medical chains of command.

In theory, every regiment had a hospital (a regiment was 10 companies of 100 men each). For armies on the march, these were field hospitals, with supplies carried along in wagons and set up in whatever quarters could be found or organized around ranks of tents.

For armies encamped, there were post hospitals created out of tents or wooden barracks; these were organized at the regimental or brigade (3 to 6 regiments) level. The District of Columbia hosted huge camps for mustering the troops moving through the city to form the armies operating to the south and southwest, and so had flexible camp hospitals.

As the army constructed fortifications around the District, it also established post hospitals to serve those who garrisoned the forts. Field and post hospitals served only the companies and regiments assigned to them, and were under the authority of the highest ranking military officer in the specific command. Given the number of troops needed to garrison the posts and batteries, and to be held in reserve in case of attack, these post and camp hospitals provided care for tens of thousands of soldiers. They held those too sick or injured to remain in their camp or post quarters, but not sick or injured enough to be transferred to one of the general hospitals in Alexandria, Washington or Georgetown.

General hospitals, in contrast, primarily took care of the sick and wounded left behind as troops moved out and, more importantly, to deal with the influx of sick and wounded transported in from field hospitals for longer term care than could be managed near battlefields or by soldiers on the march. General hospitals took in soldiers from any company, and so had a place outside of direct military authority. The surgeon in charge of a general hospital held an officer's rank and reported to the Medical Director of the relevant Department. Medical Directors, in turn, reported to the Surgeon General. From the very beginning of the war, however, tensions flared between the surgeons-in-charge and local officers of higher rank over who had the authority to manage the general hospitals' organization and administration. The War Department had to send out several reminders that the surgeons in charge of general hospitals followed the orders of the Surgeon General, not the orders of higher ranking military officers around them, and that they were totally in charge of all medical decisions within their institutions.

The Defenses of Washington: Organization of the Post Hospitals
The defense of the capital preoccupied Washingtonians throughout the war. How many troops and resources were needed to march against the South and how many were required to protect Washington became significant bones of contention within the army and among politicians.

General Mansfield, placed in charge of the Department of Washington at the start of the war, began construction of new defensive forts in May, 1861. In late July, the task of defending the District fell to Major General George B. McClellan. Under McClellan's authority, construction began on the series of forts, redoubts, and batteries that would eventually encircle Washington and Alexandria with sixty-eight forts and one-hundred batteries by the spring of 1864. Brigadier General James S. Wadsworth organized all of the post hospitals in March of 1862. Then, on February 2, 1863, the defenses were formally divided into two divisions of the 22nd Army Corps, one for those forts north of the Potomac (Washington) and one for those south of the river (Alexandria). Forts were manned by specific volunteer regiments, organized into three to four brigades. Clusters of forts (and redoubts and batteries) shared one or more post hospitals, with a hospital usually (but not always) found at the fort serving as brigade headquarters. In July of 1864, the brigades north of the Potomac were again reorganized, with the 1st Brigade becoming the 2nd Brigade and vice versa; the 3rd Brigade remained the 3rd Brigade.

The location of post hospitals moved according to the distribution of regiments among the various forts, as well, with more or less consistent attempts to keep them equally accessible to all of the positions they covered.

Given the capital's location, it became a major point of care for Union soldiers. Indeed, by December, 1864, the Department of Washington (twenty-four of the twenty-five general hospitals in the Department of Washington were in the District of Columbia) had more beds (21,426) in its general hospitals than any other department in the war.

The organization of the general hospitals in the District fell to the Medical Director of the region, Robert O. Abbott. At the start of the war, the military simply requisitioned the civilian city hospital (the E Street Infirmary) and the Union Hotel to serve as general hospitals when needed for the first casualties, who arrived in May of 1861.

Other sites were soon located, such as rooms in the Patent Office, but the big push to claim sites for general hospitals started in March of 1862. The general hospitals in Washington and Georgetown were loosely organized throughout the war, with no clear hierarchical structure.

In contrast, nearly all of the general hospitals located in Alexandria were grouped into three divisions on September 20, 1862. The surgeon placed in charge of all of the division hospitals supervised the surgeons responsible for each of the divisional hospitals' branches. (It must be emphasized that the divisional structure of the hospitals in Alexandria had no relation to military divisions within the army, but only represents an unfortunate use of parallel terminology.)

The Union Hotel was only the first of the buildings that the military took over to use as a hospital. Churches, schools, homes, and warehouses had crews come in to fill them with beds and to organize rooms for managing hospital functions: kitchens, stores, laundries, surgeons' rooms and, of considerable concern, water closets. Next in use were the wooden barracks abandoned by troops moving out on campaign. Commentators, both during and after the war, complained bitterly about how inappropriate such makeshift accommodations were for hospitals.

Ventilation and sanitation were the watchwords of up-to-date hospital construction in the early 1860s. By the end of the war, however, the military had constructed relatively few buildings designed from the start to be hospitals. None were built in Alexandria, for instance. Indeed, only five institutions were erected specifically as hospitals in Washington itself: Judiciary Square (built on the site of the burnt-down City Infirmary), Harewood, Armory Square, Mount Pleasant, and Lincoln general hospitals. Yet even the latter three incorporated some existing barracks buildings or tents into their plans.

All five of these general hospitals were constructed in 1862, with Judiciary Square and Mount Pleasant opening in April of 1862, Armory Square in August, Harewood in September and Lincoln in December. Their plans followed contemporary wisdom: wards, with fourteen foot ceilings, a window between each bed, and floors raised off the ground, contained 60-63 beds each. They were built as separate buildings linked by open-sided covered walkways, all in order to maximize the circulation of fresh air. In overall design intention, if not in precise detail, these hospitals presaged the requirements for purpose-built, pavilion style hospitals laid out in a War Department Circular printed on July 20, 1864, and were sent to all departments to direct the future construction of general hospitals.

As the census figures for December 17, 1864 show, 7,783 (39%) of the hospital beds in the District of Columbia were in "proper" hospitals over two and a half years into the war. These numbers do not include the number of beds found in the District's post hospitals, moreover, so there was an even lower percentage of beds in facilities designed with medical goals in mind within the District and its circle of fortifications. Most sick and wounded soldiers, in short, spent their days in makeshift accommodations, from well-appointed houses to tents in muddy fields.

The Hospitals in Space and Time
The locations of all of the District's hospitals, including all of those established as part of the defenses of Washington, even if slightly outside the District's boundaries, are displayed on our maps, in the context of the District's fortifications, churches, bawdy houses and other institutions vital to the life of a city at war. The time slider allows the user to examine the chronological arc of the hospitals' presence, and reveals how these institutions were one of the dominant features of Washington's and Alexandria's landscapes during the intense years of 1862 to early 1865. A closer examination of the hospitals that appear and disappear from May 1861, to early 1863, documents the initial use of temporary housing, particularly of churches and government buildings (the Capitol and the Patent Office), and then the shift to the large hospitals positioned in barracks or purpose-built on empty sites. When the fiercest fighting of the war moved away from Washington, some of the post hospitals and smaller general hospitals began to close. At the end of the war, hospitals closed more rapidly, with only three remaining to serve regular army needs after September of 1866. Churches and chapels all returned to being churches and chapels, re-purposed barracks hospitals were torn down, and the purpose-built hospitals, for all their up-to-date design, ceased to exist. From constant reminders of the war's presence, and its human costs, to empty spaces in the District's terrain, hospitals were, ironically, one of the most transitory of features in the District's infrastructure.


Keeping the Soldiers Warm: Civil War Women Make Quilts

From: quilting101.com

Women held a paramount role during the American Civil War. Back in the 1850s the government did not provide for the military the same way they do now and it was often up to the women to provide clothing and bedding for the soldiers. This experience alone is said to have been one of the largest forces of confidence amongst women and what propelled the push for the right to vote!

Women’s role within the war was not always received well and there were many that were not happy with their commercial patriotism which was shown through the sale of their civil war quilts at local fairs. However as times were dire and money was needed for war supplies, women continued to make quilts for sale.

Despite the money that was brought in from the quilts as the war continued it soon became obvious that there was a desperate need for bedding and clothing for all the soldiers.

Many quilts were made for both fundraising and for the soldiers’ bedding during the Civil War. A great deal of commemorative quilts were made after the war as well.

The soldiers’ quilts were generally made with basic fabrics and very simple block patterns. Time was always an issue, so the faster the quilts could be made the better.

Often the quilter would place some inspiring words in one of the blocks to give the soldier some encouragement while they were at war. Many quilts were made from the most basic, but available fabrics.

As time went on, women would often cut up two existing bed quilts and re-sew them into three or four cot quilts! Money became more scarce and women had to raise money through selling their quilts at fairs in order to afford the material for their soldier’s quilts.

However as the war progressed and money began to tighten even more the women did not have enough fabrics, materials or money to make the soldiers quilts. It has been said that a yard of calico went for around $25 towards the end of the war! Even these days that is a unreasonable amount to pay for Calico!

Men’s clothing, old blankets, feed and fertilizer sacks, wool weave, old uniforms, suits, coats, twill flannel, sleeves, pocket-flaps and pants legs were all used to make quilts!

Sometimes they used the wardrobes of the men who had died fighting in the war to make blankets for other soldiers. Many of the quilts did not have batting as it was scarce and often could not be found. The backing was generally made out of old fertilizer or feed sacks.

These types of quilts were often very roughly put together, with large chick track stitching. Their purpose was solely practical and functional with the aim to keep someone warm, and there is no beauty or skill in the finished masterpiece.

Many soldiers were buried in their quilts and as a result very few original civil war quilts have survived. As most of the quilts were made hastily and were poorly constructed, many did not survive the war. By the time the war ended it is estimated that over 250,000 quilts had been made for the union soldiers.

Illnesses and Opiates

From: nchealthandhealing.com

People remember the Civil War for its tragically high casualty rates—about 970,000 in all, or 3 percent of the population. But among soldiers, disease actually killed far more than battlefield wounds.

Many soldiers fell sick in military camps. Constant exhaustion, lack of adequate clothing, exposure to severe weather and a diet of poorly cooked food made soldiers susceptible to a host of infectious diseases. Worst of all, drinking water contaminated by open latrines caused outbreaks of typhoid fever, which caused the most fatalities.

The most common problems, though, were diarrhea and dysentery. “No matter what else a patient had,” wrote one doctor, “he had diarrhea.”

Civil War–era doctors had few effective ways to cure illness. But they knew that morphine and other opiates (drugs derived from opium) could temporarily relieve the symptoms of a wide variety of ailments. So they readily prescribed them in liberal doses. Opium, which has constipating effects, was used for diarrhea and dysentery. Doctors also prescribed it to relieve violent convulsions from malaria. Because of its effectiveness as a painkiller, opium was commonly rubbed into or sprinkled on severe wounds.

Opiates are highly addictive. As a result of their treatment, a number of Union and Confederate soldiers acquired lasting drug habits. For example, William Anderson Roberts, a private in the 14th Regiment North Carolina Troops, spent a great deal of time in military hospitals. In 1862, he wrote this to his family from Moore Hospital:

“Of all the lonesome places on earth it is a evening in a Hospital. There is a deep gloomy melancholy settling down on my mind. I have taken an Opium pill to counteract the influence of depression of spirits. Opium, that sweet restorer of man as he was before the fall. The King of all medicines. The great restorer of ease and peace to both mind and body. Thanks to the great giver of all good things for that great gift.”

Roberts survived the war and returned home at its end. But he fought his addiction to opium until his death in 1900.


The Civil War: The Origins of Veterans’ Health Care

by Jerome W. Mapp

When the Civil War ended its bloody run on April 9, 1865 at Appomattox Courthouse, Va., more than 600,000 of the 2.4 million Union and Confederate troops were either killed in combat or by disease. Thousands more would require long-term care for their mental or physical wounds of war. America’s costliest and bloodiest conflict would have a profound effect on health care for Veterans.

When the Civil War began on April 12, 1861, it is estimated America had 80,000 Veterans from previous conflicts, who were treated at a handful of Veterans homes scattered across the nation. The Civil War added more than 1.9 million Soldiers, Sailors, and Marines to the rolls.

After the war, benefits for Civil War Veterans were restricted to those Veterans who had fought on the Union side; Confederate soldiers were not legally recognized as Veterans until 1958, when they were pardoned by the U.S. Congress for taking up arms against the nation.

According to Darlene Richardson, historian for the Veterans Health Administration, pre-Civil War Veterans received long-term treatment at a handful of Soldiers and Sailors homes scattered around the country.

“One of the original homes for veterans was the Naval Asylum in Philadelphia, which was established in 1811 and officially opened in 1834, it housed sick and disabled naval officers, seamen, and Marines.” according to Richardson.

“The National Soldiers Home, established in 1851, in [northeast Washington] D.C., housed Veterans of the War With Mexico (1846-1848) until the Civil War began, when Union soldiers received care there, too.” The National Soldiers Home today is known as the Armed Forces Retirement Home (AFRH) Washington, D.C.

In the 1960s, the Naval Asylum in Philadelphia closed and a new facility known as the U.S. Naval Home was constructed in Gulfport, Miss. Congress merged operations of the U.S. Naval Home with the National Soldiers Home into one administrative unit in 1991 and the National Soldiers Home was renamed as the Armed Forces Retirement Home (AFRH). Today, both facilities house men and women of all military branches.

St. Elizabeth’s Hospital in southeast Washington, D.C., authorized in 1855, was originally called the Government Hospital for the Insane, and was actively used during the Civil War. Union and Confederate Soldiers, Sailors, and Marines, including African-American troops, were treated at the hospital. President Abraham Lincoln, a frequent visitor to the hospital, noted that the many casualties created by the war often resulted in overcrowding at the hospital. Tents were erected behind the hospital to handle the overflow of combat casualties.

In 1865, with so many Veterans needing long-term care, Lincoln appealed to Congress and the nation in his second Inaugural address, “…to care for him who shall have borne the battle, and for his widow and his orphan.” Those words later became the motto of the Veterans Administration, which became the Department of Veterans Affairs in 1989.

“Lincoln’s efforts resulted in creation of the National Asylum for Disabled Volunteer Soldiers (NHDVS) in March 1865, which established a national government home for Veterans of the Union’s volunteer forces. The National Asylum was overseen by a Board of 12 managers. Eventually there were 11 National Homes.” Richardson said. “In 1873, they [the board] renamed it the National Home for Disabled Volunteer Soldiers because the word asylum was starting to have negative connotations.”

The eleven NHDVS properties established between 1865-1930 were known as: the Eastern Branch in Togus, Maine (now Togus VA medical Center); the Northwestern Branch in Milwaukee, Wis. (now Clement J. Zablocki VA Medical Center); the Central Branch in Dayton, Ohio (now Dayton VA Medical Center); the Southern Branch in Hampton, Va. (now Hampton VA Medical Center); the Western Branch in Leavenworth, Kan. (now Dwight D. Eisenhower VA Medical Center); the Pacific Branch in West Los Angeles, Calif. (now Greater Los Angeles Healthcare system-West Los Angeles Healthcare Center); the Marion Branch in Marion, Ind. (now VA Northern Indiana Health Care system); the Danville Branch in Danville, Ill. (now VA Illiana Health Care System); the Battle Mountain Sanitarium in Hot Springs, S.D. (now VA Black Hills Health Care System); the Mountain Home Branch in Johnson City, Tenn. (now Mountain Home VA Medical Center); and the Bath Branch in Bath, N.Y. (now Bath VA Medical Center).

Initially, each home served as little more than a domiciliary (soldiers’ home) that provided medical care. Over time, the homes offered recreational activities, libraries, and church services. According to the 1900 board of manager's annual report, several homes maintained theaters, libraries, and billiard halls.

Some of the homes offered Veterans games such as dominoes, checkers, chess, backgammon, cards, boating, skating, pool, and croquet. At the homes’ theaters, Veterans were entertained with concerts, comedies, melodramas, musicals, vaudeville, and lectures.

When the Veterans Administration was established in 1930, all 11 homes, plus three newly authorized homes in St. Petersburg, Fla., Biloxi, Miss., and Roseburg, Ore., became part of VA.

Four of the original National Homes are currently under consideration for designation as National Historical Landmarks. They are: the Northwestern Branch (Milwaukee, Wis.), the Western Branch (Leavenworth, Ks.), the Mountain Home Branch (Johnson City, Tenn.) and the Battle Mountain Sanitarium (Hot Springs, S.D.).

The organization of aid to America’s Veterans has changed over the decades, but our respect and sentiment for their contributions remains the same. VA is proud to carry on America’s legacy of caring for its military Veterans.

Image: Civil War Veterans receive medical treatment at the Bath Branch of the National Soldiers Home in Bath, N.Y. VHA Historical Photo

From: va.gov



Civil War Water Filter

From: joshuasattic.com

As shown in Lord's Civil War Encyclopedia, these are the two metallic parts of a "water filter" sold privately to soldiers.

The foul, often brackish waters near large numbers of encamped men often bore highly-deadly diseases like dysentery which lead to intense, chronic diarrhea, dehydration and frequent death. In fact, more men died from disease during the Civil War than battle!

Knowing the risks of drinking water, troops were lulled into a sense of false security by purchasing these filter sets in tin cases. The soldier was supposed to place the larger filter end into the stream or pond, drawing water up through a charcoal filter by sucking on the smaller mouthpiece. A mesh tubing connected the two, but has since rotted away while it was still underground. This was located near Fredericksburg along with two others.

It is said that soldiers' eyes bugged out like frogs as they vainly tried to suck water up through these. While the concept was good, it is unfortunate that the microbes culprits were small enough to pass beyond the charcoal!!! Men died in spite of their filters.


Health and Medicine During the Civil War

by Elaine Hirsch

From 1861 to 1865, the Civil War wreaked havoc on American life. Nearly 620,000 soldiers died and an additional 412,000 were wounded. The massive amount of injuries presented new challenges in the medical field. Hospitals and clinics were overwhelmed with patients, disease was rampant and sanitation practices were no where near as sophisticated as today’s standards. Standardized medical schools did not yet exist and there were less than 100 doctors in the army at the start of the war. These factors presented unique challenges that American hospitals were not prepared to meet. The National Museum of Civil War Medicine features a collection of online videos and resources to bring to life a medical world which we cannot imagine living in today.

At the war’s onset, the Union had not yet established its own hospitals and most public hospitals at the time were rat-infested, dirty, and plagued by diseases like smallpox. Soldiers had to rely on makeshift field hospitals to heal their wounds. Later, general hospitals were established near battlefields in civilian buildings like churches, schools, houses and farms.

According to the Colonel Eli Lilly Civil War Museum, injured soldiers were threatened by more than just the pain of their wounds. Many soldiers had never been exposed to diseases like chicken pox, the mumps or measles and were therefore more susceptible to the afflictions while being treated at unsanitary hospitals. At the time, doctors did not yet understand how many diseases were spread and used contaminated instruments on patients.

Today, strict sanitation guidelines reduces the risk of spreading diseases and infection, but this knowledge was unavailable during the Civil War.

Antibiotics now save millions of lives each year but were not available in the 19th century. Doctors performed surgeries without gloves, used bare fingers to inspect wounds and simply wiped instruments clean using their aprons. Due to these practices and the infections they caused, the National Museum of Civil War Medicine calculated that over half the casualties incurred were a result of disease, not gunshots or bayonet wounds.

Medical jargon was also different during the Civil War. Doctors spoke of mania instead of insanity, lung fever instead of pneumonia and jail fever instead of typhus. Clearly, legitimate medical transcription services were not available at the time. Syphilis was simply called pox, rickets was used to describe any problem with the skeletal system and any day-long illness was called diary fever. Lead poisoning was called dropsy, circulatory problems were attributed to flux of humor and anemia was known as green sickness. These now outdated reflect the uncertainty and lack of knowledge held by the medical community at the time.

While medical technology and knowledge have certainly improved since the Civil War, the National Museum of Civil War Medicine asserts that some 19th century practices are still used during warfare today. Medical professionals working out of field hospitals are still often the first responders to emergencies and evacuating wounded soldiers is a priority now as it was then. Lessons learned during the Civil War about keeping adequate medical supplies on hand are still valid today. These lessons contributed greatly to the advancement of medical knowledge and influenced the way we now practice medicine both on war fields and in civilian hospitals.

From: teachthecivilwar.com


Civil War Medical Remedies

By Laura June Davis

While these nineteenth century remedies might not cure what ails you, they make an intriguing read.

For Dysentery
Dissolve as much table salt in pure vinegar as will ferment and work clear. When the foam is discharged cork it up in a bottle, and put it away for use. A large spoonful of this in a gill of boiling water is efficacious in cases of dysentery and colic.

Cure for the Chills
The plant, commonly called hoarhound, is said to afford a certain cure. Boil it in water, and drink freely of the tea.

Gargle for Sore Throat, Diptheria or Scarlet Fever
Mix in a common size cup of fresh milk two teaspoonfuls of pulverized charcoal and ten drops of spirits of turpentine. Soften the charcoal with a few drops of milk before putting into the cup. Gargle frequently, according to the violence of the symptoms.

To Relieve Asthama
Take the leaves of the stramonium (or Jamestown weed,) dried in the shade, saturated with a pretty strong solution of salt petre, and smoke it so as to inhale the fumes. It may strangle at first if taken too freely, but it will loosen the phlegm in the lungs. The leaves should be gathered before frost.

Simple Cure for Croup
If a child is taken with croup, apply cold water suddenly and freely to the neck and chest with a sponge or towel. The breathing will instantly be relieved, then wipe it dry, cover it up warm, and soon a quiet slumber will relieve the parent's anxiety.

For a Troublesome Cough
Take of treacle and the best white wine vinegar six tablespoonfuls each, add forty drops of laudanum, mix it well, and put into a bottle. A teaspoonful to be taken occasionally when the cough is troublesome. The mixture will be found efficacious without the laudanum in many cases.

For a Sick Headache
One teaspoonful of pulverized charcoal and one-third of a teaspoonful of soda mixed in very warm water.

Cure for a Toothache
Powdered alum will not only relieve the toothache, but prevent the decay of the tooth. Salt may advantageously be mixed with the alum.

Cure for a Burn
Wheat flour and cold water, mixed to the consistency of soft paste, is an almost instantaneous cure for a burn. Renew before the first gets dry so as to stick.

Cure for Camp Itch
Take iodide of potassium, sixty grains, lard, two ounces, mix well, and after washing the body well with warm soap suds rub the ointment over the person three times a week. In seven or eight days the acarus or itch insect will be destroyed. In this recipe the horrible effects of the old sulphur ointment are obviated.

From: civilwarmonitor.com

Health and Healing in North Carolina

From: nchealthandhealing.com

Like many other states, North Carolina had very few hospitals at the outbreak of the Civil War. Unprecedented numbers of sick and wounded soldiers created a medical crisis. The state quickly established large military hospitals in Charlotte, Fayetteville, Goldsboro, Raleigh, Salisbury, Wake Forest, Wilmington and Wilson. Smaller, temporary hospitals sprang up along railroad lines. Hotels, churches and schools also served as makeshift hospitals. And some military camps established their own for soldiers who fell ill during training.

Dr. Edmund Burke Haywood, a Confederate Army major, established the state’s first Confederate military hospital in 1861. Because of its location, it was called the State Fair Grounds Hospital. In 1864 Haywood took over the administration of the new Pettigrew Hospital and the Peace Institute (College) Hospital as well. In spite of chronic shortages of medicines, food and staff, Haywood became known for his excellent management, medical skills and compassion.

However heroic the efforts of doctors and staff, conditions in Civil War hospitals were grim and overcrowded, particularly after battles. Diseases spread rapidly, even though soldiers with contagious illnesses were separated from those who were wounded. Bug-infested bedding, an inadequate diet, depression and boredom made most soldiers eager to leave the hospitals as soon as possible.

Image: Dr. Edmund Burke Haywood

Did You Know Abraham Lincoln Advocated for People with Hearing Loss?

From: hearingaids.com

While most of us are familiar with Lincoln’s actions to emancipate the slaves, did you know he was also an advocate for people with hearing loss?

One of Lincoln’s close friends, a former U.S. Postmaster General named Amos Kendall, helped fund the school known as the Columbia Institution for the Instruction of the Deaf and Dumb and Blind. The best known action Lincoln took on behalf of the deaf (then any sort of hearing loss was lumped under term “deafness” even if the person being referred to could hear to some degree) was signing the Enabling Act on April 8, 1864. This allowed the school later known as Gallaudet College, and today as Gallaudet University, to award college degrees — becoming the first post-secondary school dedicated to the education of the hearing-impaired.

Historians theorize Lincoln became aware of the need to support those who had lost their hearing because of his advocacy on behalf of disabled Civil War veterans, several thousand of whom lost their hearing during the war due to noise-induced hearing loss (NIHL). But even before the war, while still a senator, Lincoln voted to found the Illinois School of the Deaf. Others speculate that because one of Lincoln’s children (son Tad) had a speech impediment and language delay, Lincoln understood and empathized with the struggles faced by all young people facing communication challenges.

Whatever Lincoln’s reasons for supporting those with hearing loss, he is still celebrated 146 years later during Gallaudet University’s annual “Charter Day” festivities. Today, there are approximately 32,000 people with varying degrees of hearing loss enrolled in colleges and universities around the nation thanks to opportunities stemming from Abraham Lincoln’s historic support of deaf education, giving us yet another reason to commemorate a great man on his birthday.


Civil War Hospital Leg Brace

From: joshuasattic.com

This is an utterly amazing item, showing the ingenuity and resourcefulness of Civil War period manufacturers: a wooden leg brace by maker "A. Goodwin Ashfield" which incorporates pivots, ratchets and other mechanics which allow exact positioning of an injured lower limb.

This brace pivots up and down at the knee to adjust flexion and extension of that joint, locking into place by setting the heel position upon the step-cut base. The wood (Walnut or chestnut)has been contoured to comfortably fit the lower thigh and the calf. Then, there is a heel plate that is adjusted by two large wooden turnscrews which raise the foot into dorsi-flexion or lower it into plantar (toe down) flexion.

There are remnants of canvas straps at the sides that held the leg solidly in place. These are made of the same type canvas strips of which Civil War field tourniquets were fabricated, being fixed in position by small lock-buckles. The entire assembly is set upon a base of solid wood with a T-shaped end strut for better stabilization in bed. It's a fantastic piece of workmanship meant for those men whose legs could be salvaged rather than amputated.


Three Bladed Surgeons Fleam

From: joshuasattic.com

This is an outstanding CW period 3-blade fleam, used to "let blood" from ailing patients. Before they knew about germs and infections, the theory was to let out the bad humours, toxins and poisons in the feverish person's body by draining off specific amounts of blood.

The blade tips were used to lightly cut across superficial veins, usually in the forearms. So, in essence, your doctor came to your house in a buggy, examined you, and then cut your arms with these fleams till he was satisfied you were healthier from the process. Then you were wrapped up and paid him for the service. (Then you either lived or died...)

This item has the typical construction and component shapes: a brass outer housing into which fit the pivoting steel blades. Usually there were three, but I have seen two and four-blade varieties as well. This example is beautifully hallmarked by its famous maker: Joseph Rodgers & Sons, No 6 Norfolk St. Sheffield (England)."


London-made Wingnut Tourniquet

From: joshuasattic.com

This item is an extremely high quality brass screw-type of tourniquet as was often contained in Capital Surgical Sets used in Field Hospitals. The canvas strap was tightened to draw the wad down upon an artery, thus staunching the flow of blood from a prior wound or from cuts made during surgery. Made by Evans & Co. of London.

These are sometimes excavated in battle areas and the field hospital sites to the rear. It is 3 3/4" high. Field orderlies had access to cheaper buckle-type tourniquets that quickly strapped a gushing limb dry until the victim was rushed to the rear.


Prescription Drug Abuse History

From: narcanon.org

The abuse of prescription drugs in America goes back more than a hundred years to the abuse of laudanum, a mixture of opium and alcohol. This was an early remedy for pain, sleeplessness, anxiety, coughing and diarrhea. In the 1800s, laudanum was used by doctors across the country. But it was quite addictive.

It was also part of an interesting division of addiction for people living in the 1800s. The usual laudanum addict was a Caucasian woman. Men had their own substance of addiction - alcohol. But women were not supposed to visit bars or saloons or be seen drinking so they could visit their doctors for their addictive substances. And they did, for problems with pregnancy, childbirth, menstrual cramps or emotional problems.
Morphine Use Grows

The commercial manufacture of morphine started in Germany in 1827, and the drug became the painkiller of choice during the American Civil War. While there are conflicting accounts of the degree to which morphine contributed to cases of addiction after the war was over, it has been reported that there were ten million opium pills handed out to army surgeons during the war, and that morphine was widely used for the terrible shrapnel wounds suffered by soldiers.

In fact, the doctor who invented the Coca Cola formula developed a morphine addiction during the Civil War and was looking for a solution. He added the recently-developed drug cocaine to his new drink and began to sell it at a pharmacy in Atlanta. Because there were few laws regulating the contents of foods or drugs, it was perfectly legal for him to do so.

In fact, the act of "prescribing" drugs like cocaine or morphine was essentially up to the consumer. Morphine and cocaine injection kits, complete with the newly invented syringe and a supply of the medication, were available from Sears catalogs.


Ether and Chloroform

From history.com

By the time the American Civil War broke out in 1861, both ether and chloroform had been in use for several years as methods of surgical anesthesia. Though both anesthetic agents were developed around the same time (the 1840s), chloroform soon emerged as the more widely used, as it took action faster and was non-flammable. During the Civil War, ether and particularly chloroform became indispensable tools for military doctors, who performed tens of thousands of amputations and other types of procedures for wounded Union and Confederate soldiers.

DEVELOPMENT OF ETHER
Before its development as a surgical anesthetic, ether was used throughout the history of medicine, including as a treatment for ailments such as scurvy or pulmonary inflammation. A pleasant-smelling, colorless and highly flammable liquid, ether can be vaporized into a gas that numbs pain but leaves patients conscious. In 1842,  Georgia physician Crawford Williamson Long became the first doctor to use ether as a general anesthetic during surgery, when he used it to remove a tumor from the neck of his patient James M. Venable.
In 1846, after viewing Morton's ether demonstration in Boston, the physician Oliver Wendell Holmes suggested the word "anesthesia" to describe the process of making a patient unconscious in order to free them of surgical pain; he based it on the Greek word "anaisthesis," which means insensibility or loss of sensation.

Long did not publish the results of his experiments until 1848, and by that time Boston dentist William T.G. Morton had already gained fame with the first publicly demonstrated use of ether as an effective surgical anesthetic. After watching his colleague Horace Wells unsuccessfully promote nitrous oxide as an anesthetic, Morton concentrated on the possibility of ether. On March 30, 1842, he administered it to a patient at Massachusetts General Hospital, before a surgeon removed a tumor from the patient’s jaw.

DEVELOPMENT OF CHLOROFORM
Also called trichloromethane, chloroform is prepared through the chlorination of methane gas. It was first prepared in 1831 by the American chemist Dr. Samuel Guthrie, who combined whiskey with chlorinated lime in an attempt to produce a cheap pesticide. In 1847, the Scottish physician Sir James Young Simpson first used the sweet-smelling, colorless, non-flammable liquid as an anesthetic. When administered by dripping the liquid onto a sponge or cloth held so that the patient inhaled the vapors, chloroform was seen to have narcotic effects on the central nervous system, and produced these effects relatively quickly.

On the other hand, there were higher risks associated with chloroform than with ether, and its administration required greater physician skill. There were early reports of fatalities due to chloroform, beginning with a 15-year-old girl in 1848. Skill and care were required to differentiate between an effective dose (enough to make patient insensible during surgery) and one that paralyzed the lungs, causing death. Fatalities were widely publicized, and the risks involved led some patients facing surgery to decline anesthesia and brave the pain. Still, use of chloroform spread quickly, and in 1853 it was famously administered to Britain’s Queen Victoria during the birth of her eighth child, Prince Leopold.

MILITARY USE OF ETHER AND CHLOROFORM
American military doctors began using ether as an anesthetic on the battlefield during the Mexican-American War (1846-1848), and by 1849 it was officially issued by the U.S. Army. Though many army doctors and nurses had experience with using ether by the time of the Civil War, chloroform became more popular during that conflict, due to its faster-acting nature and a large number of positive reports of its usage during the Crimean War in the 1850s. During the Civil War, chloroform was used whenever it was available to reduce the pain and trauma of amputation or other procedures.


Usage of ether and chloroform later declined after the development of safer, more effective inhalation anesthetics, and they are no longer used in surgery today. Chloroform in particular came under attack in the 20th century, and was shown to be carcinogenic by ingestion in laboratory mice and rats. It is now used mainly in the preparation of fluorocarbons, used in aerosol propellants and refrigerants; it is also found in some cough and cold medicines, dental products (including toothpaste and mouthwashes), topical liniments and other products.

Women in the Civil War: Five Nurses from St. Lawrence County

From: northnet.org

If war is a test of a nation’s civil, military and spiritual strength, then civil war - neighbor against neighbor and brother against brother - it the ultimate test of a people’s character. The American Civil War (1861-65) tore at the roots of our political and social fabric. During the War Between the States women played a number of roles.

Women from the North and the South organized at home to provide much need support for their fathers, brothers, husbands and sons far from home in the field. Local Ladies Aid Societies knitted socks, rolled bandages, sewed clothing, sent bedding and towels and food. They wrote letters, kept the family farm or local store going, and held the family together as news from the front slowly trickled in.

Some women, not content to stay at home, disguised themselves as men and enlisted in both the Union and Confederate armies. Of the 400 or so known women who enlisted and served in the ranks, many were not found out until they were wounded or became ill or were killed in battle. Some women served as spies, trading vital military information or taking messages across enemy lines.

The devastating carnage on the battlefields of the war presented other opportunities for women to serve during the war. A few women served as doctors. The best known of these is probably Mary Edwards Walker who earned a Congressional Medal Honor for her medical service. Many more women served as nurses, both in a professional capacity with training, and as private citizens, often caring for a wounded family member.

The "Angel of the Battlefield," Clara Barton, was appalled at how poorly equipped the Union Army was to supply its troops and care for its wounded. As a private citizen, she advertised for medical supplies and food, used her home as a warehouse, and enlisted the aid of her friends to distribute the supplies to battlefields in Maryland and Virginia.

Unappreciated at first, doctors and military men soon came to rely on her supplies and organizational skills. Once the government began to respond to the needs of soldiers and casualties better, Clara Barton began shifting her focus. She set up an agency to local missing soldiers, assisting families to regain contact with missing loved ones. This work eventually led her into founding the American Red Cross after a trip abroad in 1869.

The formal nurses' training service formed early in the war was the U. S. Sanitary Commission under the leadership of Dorothea Dix, who had already made a career of improving the care of mental ill people. She was able to convince many state legislatures to provide the money to move these people, often incarcerated in inhumane institutions and prisons, into state-funded special facilities with provisions for extended care. She had also been active in prison reform.

The skills and expertise she acquired as a social reformer made her an excellent choice to be the superintendent of the Union army nurses. She created and staffed infirmaries, oversaw sewing societies, stockpiled medical supplies, and recruited and trained a corps of women to be nurses. Her requirements in a nurse were strict - not too young, not too pretty, and of strict moral character.

But many more women became nurses during the Civil War because of illness or injury to a loved one serving in the line of fire. One such woman was Maria Eastman Olmstead Eldred. She was born in 1842 to William and Eunice Eastman of Pierrepont, New York. She married George Eastman early in 1863; he enlisted in the 13th NY Cavalry, leaving for Washington, DC in June. Maria gave birth to their only child on January 2, 1864. George was wounded and Maria spent nine months nursing him in Falls Church, Virginia. Her husband died on March 30, 1866 and her son Frankie died on March 16, 1868 at age 4 years. Later she married Holden Eldred, a Pierrepont farmer, and had a daughter, Nettie, who was born in 1876.

Ellon McCormick Looby was born in Ireland in 1834, immigrated to the United States as a teenager, and married another Irishman, Rody Looby, in Waddington, NY 1854. They had three sons, John (1860), William (1866) , and Richard (1870). In December 1863 Rody enlisted in the 14th NY Heavy Artillery at Potsdam and served for several months before he was wounded in the Battle of Petersburg in July 1864. When Ellon received word of her husband’s injury, she “left Norwood with my only child 4 year old in my arms and started for city point.” City Point Hospital was located near Richmond, VA. Rody was transferred to the Central Park Hospital in VA and Ellon served there as a nurse from August 1864 through the end of the war in 1865.

Alvira Beech Robinson came from Pierrepont where she was born in 1835. She married David Robinson and had three children: George (1856), Charles (1860), and Sarah (1861). Two of Alvira’s brothers, Alva and Enos, enlisted early in 1861; her husband David enlisted in the 60th NY Infantry in October 1861. David was killed at Antietam in September 1862 and she returned to work as school teacher with three small children to raise. In May 1863 Alva was shot in the leg and asked his sister to come to nurse him. She left her children with her mother and spent 2 months nursing Alva and also worked in the government printing office to defray her expenses in Washington.

She returned to West Pierrepont in August 1863. Alva came home that fall to finish his recovery and Enos left the army suffering from “the lung fever.”  Alvira undoubtedly cared for both of them, her own three children, and her mother. She continued to support herself and her family, setting up the Pierrepont post office and serving as its first postmaster in July 1876. She operated it out of her own home for 15 years until it was moved a few miles  away.

Two other women who served as nurses during the Civil war were Miss Mary A. B. Young and Mrs. Thomas Rhodes. Miss Young, the sister of Captain James Young of the 60th NY Volunteers, reportedly died of the fever “at her post in Annapolis, MD” along with fellow nurse Miss R. M. Billings in January 1865. She is buried in the Greenwood Cemetery in Morristown. Mrs. Rhodes, who died on 1893 in Fullerville, Town of Fowler was described as “a nurse in the late war” in a newspaper clipping of her death notice.

- Special thanks to Sue Longshore, Administrative Assistant, St. Lawrence County Historical Association, for the biographical details provided in this Profile.

Tuesday, March 25, 2014

The Heritage of Army Audiology (Excerpt)

By D. Scott McIlwain, AuD, Kathy Gates, AuD, Donald Ciliax, PhD

Noise-induced hearing loss has been documented as early as the 16th century, when a French surgeon, Ambroise Paré, wrote of the treatment of injuries sustained by firearms and described acoustic trauma in great detail. Even so, the protection of hearing would not be addressed for three more centuries, when the jet engine was invented and resulted in a long overdue whirlwind of policy development addressing the prevention of hearing loss.

Military conflicts have long been identified as a source of physical disability. Veterans’ benefits were first documented in this country in 1636, when money was provided to individuals disabled in the Plymouth colony's defense.

Even before World War I, military veterans were receiving compensation for hearing loss. The medical records of Union Army soldiers document that 33% had diagnosed hearing loss.

Soldiers with disabilities from their military service were guaranteed a larger pension as compensation. Even though the method of measuring an individual's hearing acuity in the late 1800s is questionable by today's standards, hearing loss was recognized by the government as a disability. The General Law of 1862 and the Disability Act of 1890 were two major legislative movements that made this possible.

From: ncbi.nlm.nih.gov


General Robert E. Lee's Probable Heart Attack in 1863

From: examiner.com

Confederate General Robert E. Lee, at age 56, was experiencing pain in his chest, back and arms in late March and early April of 1863. Several doctors diagnosed pericarditis. Pericarditis by definition, according to the Mayo Clinic, is “a swelling and irritation of the pericardium, the thin sac membrane that surrounds your heart.”

For General Lee, his doctors, Lafayette Guild and S. M. Bemiss, prescribed rest, gave him quinine and sent him into a private home near Fredericksburg, Virginia and away from the rebel camp. He was confined in bed for several weeks and was feverish. By April 16, he was back in camp, but still not feeling 100%.

Modern doctors hold the opinion that Lee suffered a heart attack. They say that doctors of the day were not familiar with angina.

How much General Lee’s illness or condition affected his performance at the upcoming battle at Gettysburg on July 1-3, 1863 is anyone’s guess. He did, however, offer his resignation within a few weeks following that battle, citing his inability to lead caused by extreme physical fatigue. That resignation obviously was not accepted.

General Lee lived until his death in October 12, 1870 following a stroke that had occurred on September 28.


Slave Medicine

From: nchealthandhealing.com

In antebellum North Carolina, ownership of slaves included the right to direct their treatment when they were sick. As they did with their own families, slaveholders usually tried to treat sick and injured slaves themselves before consulting a physician. In fact, doctors were called only for life-threatening cases. Then slaves were treated with the same medicines and therapies that whites relied on.

Health issues often brought slaves into conflict with their owners, since they held very different beliefs about the causes and treatment of illnesses. Enslaved African Americans drew upon their own healing traditions. Many distrusted the harsh therapies used by white physicians in the 1800s and concealed ailments from their owners. It was one way they could maintain a degree of control over their bodies.

When it came to health care, slave communities maintained a long tradition of self-reliance. They preferred to treat themselves or receive treatment from another slave, rather than accept the therapies of slaveholders and white physicians. So they cultivated herbs in their gardens, gathered plants in the wild and relied on the knowledge of friends and relatives. They had treatments for a wide variety of illnesses and injuries, including wounds inflicted by whippings.

With their years of experience in delivering and treating children, enslaved midwives and older women often had extensive knowledge about herbal and home remedies. Many became midwives to their mistresses and other white women as well—a valuable service for which the slave owner would be paid.

Healing traditions in slave communities were grounded in African thought. As in many cultures, sickness was attributed to spiritual and social as well as physical causes. Good health depended not only on balance within the body but also on harmonious relations with neighbors, ancestors and spirits.

Like their African ancestors, slaves generally believed that some illnesses were caused by conjure, evil spells placed by conjure doctors with special powers. Traditional wisdom held that only another conjure doctor could help. Although some slaveholders tried to suppress the superstition, conjure practices thrived among slave communities, often out of sight of whites.


Did the Civil War Create a Lot of Morphine Addicts?

By Chris

A question posed in 1999 asked, “I’ve often read that there were 500,000 morphine addicts running around after the Civil War. Is this true? If so, did narcotics have a deleterious effect on the Old West? How many cowboys were wacko on these then-legal drugs?”

According to one interesting source, the answer was… maybe:

Still, even allowing for exaggeration by drug alarmists, you have to think the Civil War had some impact. Narcotics were handed out like candy by army surgeons, who were surrounded by suffering and had few remedies to offer other than painkillers. Nearly ten million opium pills were issued to Union soldiers, along with 2.8 million ounces of other opium preparations; no doubt opium use was fairly common on the Confederate side, too. One doctor reported keeping a wad of “blue mass” (a powdered mercury compound) in one pocket and a ball of opium in the other. He’d ask soldiers, “How are your bowels?” If the answer was “open” (due to diarrhea), the soldier got opium, if “closed” (presumably because of constipation), mercury. Opiates were used to treat not just wounds but chronic campaign diseases such as diarrhea, dysentery, and malaria. Narcotics became even more popular after the war as invalided veterans sought relief from constant pain.

That said, soldiers weren't the only or even the major users of drugs, nor was drug abuse more prevalent in the Old West than in the rest of the country, as you suggest. On the contrary, casual use of hard drugs was widespread. Several surveys in the midwest in the latter 1800s found that the majority of opiate addicts were women who took drugs for neuralgia, morning sickness, or menstrual pain. Mary Chesnut, whose diary was read to haunting effect in Ken Burns’s Civil War documentary series, was a regular user. Narcotics could be found in the patent medicines of the day as well as in commonly prescribed medications like laudanum and paregoric, inexpensive opiates that could be ordered through the Sears catalog.

As we know morphine sulphate was liberally given to soldiers during the war. Post Civil War era gave birth to what was called the “Soldier’s disease.” There are sources that claim up to 400,000 veterans of the Civil War left the army with some level of addiction. After the war opiates were widely used to cure any form of ailment. Drugs were so widely used you would order them from your Sears and Roebuck catalog. However, there are no studies that were taken from 1865-1900 that would account for any significant portrayal of soldier addiction. In 1886 former Confederate soldier Dr. John Pemberton invented Coca-Cola; which contained a small amount of cocaine. Pemberton was a pharmacist and was even wounded in the Battle of Columbus.

In 1915, Jeannette Marks, first alerted the nation of the potential for as many as 400,000 post war veterans being addicted. To this day historians disagree about the impact of drug addiction after the war, with the number ranging anywhere from 45,000 to 400,000.

From: soldierstudies.org


Civil War Crutches

From: Joshuasattic.com

Crutches during the Civil War were not made with the double body struts like now. They were a long, sturdy pole of hardwood doweled-into a top piece that fit under the armpit. These could be quickly made by local woodshops or by carpenters escorting the Divisions. This one of either walnut or fine-grained oak was padded over the years with a green (or faded dark brown) heavy cloth that is sewn with heavy brown thread. It keeps the wood from digging into the flesh and irritating it with constant use... An arm could get numb, sometimes permanently, if pressure on the nerve was constant and intense. Civil War doctors were very wise about such details of care... I have not taken off the cloth-pad, as there is nothing to find under there other than the plain wood top piece. These were rarely maker-marked. It is 50" long.



About Morphine Use During the Civil War

By Susan Sosbe

Morphine, along with opium and laudanum, was widely used in the Civil War to relieve soldiers after surgical procedures were performed in field hospitals. Despite the side effects of using morphine, it is still a commonly used analgesic and is held up as a comparison for all other acute pain relievers.

Morphine was first discovered by Friedrich Wilhelm Adam Serturner when he managed to isolate the alkaloid in the opium poppy in 1805. He often experimented with his discovery on himself, noting both the benefits and the negative aspects of morphine. Although not much interest was shown in his discovery at first, chemists and physicians soon showed an interest in his findings. He received an award for the discovery of morphine in 1831.

Morphine was named after Morpheus, the Roman god of dreams. It is the active ingredient found in opium. Its use in the early stages of the Civil War consisted of using it in powder form and sprinkling it or rubbing it directly on the wound site. In later years, syringes, which had become more reliable in the 1850s, were made more readily available to surgeons in field hospitals, and it was injected into the patient's body in liquid form.

As with the use of other opiates, there was a danger of addiction and overdose in soldiers who were given morphine. It has been noted that in some hospitals during the Civil War, the medicine supplies were guarded by armed men to keep addicts from stealing. Other side effects from the use of morphine were vomiting, nausea, respiratory depression, cough suppression and sedation.

Some of the side effects of morphine were also some of the benefits during the Civil War. In addition to the relief of pain, morphine was also used for sedation of patients, allowing them to get the rest that was necessary for recovery, if they were lucky enough to avoid infection from their wounds.

With the discovery of morphine, and the overall benefits of using it to relieve pain after surgery, it became widely used in the medical profession. It was still used in the field during both World Wars. Unfortunately, it was also discovered that due to its highly addictive properties, many soldiers of the Civil War left the field as addicts. It is estimated that 400,000 Civil War soldiers became addicted. Because of this, the addiction to morphine became known as the "soldier's disease."

From: ehow.com


Anesthesia Comes of Age During the Civil War: "He's Pretty Spunky"

by Bob Shepard

The story of the use of anesthesia in the Civil War, from the very different experiences of a private and a general, according to the world’s first academic anesthesiology history unit.

Anesthesia was in its infancy when the American Civil War began in 1861. The sheer number of casualties gave surgeons on both sides the opportunity to gain experience with the first two anesthetic agents developed — sulfuric ether and chloroform — according to a paper by a University of Alabama at Birmingham anesthesiologist published in the October issue of the "Scandinavian Journal of Pain".

"As we honor the sesquicentennial, or 150th anniversary, of the Civil War, it is still widely believed that the sole anesthetic agent used was the whiskey bottle,” said Maurice S. Albin, M.D., professor in the UAB Department of Anesthesiology. “But sulfuric ether was first used in 1846, and chloroform a year later.”

The Mexican-American War in the late 1840s and the Crimean War in the mid-1850s saw the first battlefield use of these agents on a small scale. In the Civil War, Albin estimates that anesthesia was used at least 125,000 times by surgeons for both the North and South who, before the war, had limited or no experience with anesthetic agents. That number pales in comparison to the estimated 476,000 men wounded on both sides during the conflict and 620,000 killed, many of whom no doubt underwent a surgical procedure.

Albin’s paper reports on two wounded warriors, one a captured Union private and the other a celebrated Confederate general.

“These two case stories illustrate the profound improvement in surgical pain management made possible with anesthesia only 150 years ago,” said Albin. “Most surgeons and patients today have no idea what these important improvements meant to modern medicine.”

Albin, himself a World War II combat medic, tracked the story of Union Private James Winchell, a member of Berdan’s First United States Sharpshooters. Winchell was one of 3,107 Union soldiers wounded at the Battle of Gaines Mill in 1862, and one of 2,836 captured. A musket ball struck his left arm between the shoulder and elbow. His group of some 500 wounded prisoners was treated by a single surgeon, so Winchell had to wait.

Five days passed before Winchell’s shattered arm was removed, days he spent in great pain, lying under a tree shooing flies from his arm. Albin traced Winchell’s story from a book on Berdan’s Sharpshooters written by Captain C.A. Stevens, a veteran of the regiment who interviewed Winchell at a reunion in 1890. Stevens quoted Winchell’s recollection of when the surgeon finally came for him. He was one of the many who did not receive anesthesia.

“I asked if he had any chloroform or quinine or whiskey,” Winchell said to Stevens. “He said ‘no, and I have no time to dilly-dally with you.’”

Winchell was seated in a chair, and men held his shoulders as the surgeon began to cut. After removing the bone, the surgeon suggested they pause an hour to let Winchell recover.

“I refused and told them I wanted one job of it, as I was just as ready to kick the bucket then as in one hour,” Winchell told Stevens.
At this point, the surgeon and his men said of Winchell, “He’s pretty spunky. Let’s make a good job of it.”

Amazingly, Winchell survived, was exchanged and returned home. Some 30 years later, he was still alive to tell his tale. The second individual in Albin’s narrative was not as fortunate.

Lt. General Thomas “Stonewall” Jackson suffered a wound eerily similar to Winchell’s. Jackson was shot in the left arm by nervous sentries from his own army following an evening reconnaissance during the Battle of Chancellorsville. He was taken to a field hospital and attended to by Hunter Holmes McGuire, a pre-eminent surgeon in the Confederate Army who determined that amputation of the arm was necessary. Chloroform was the anesthetic used, dropped on a cloth in the shape of a cone.

Jackson is recorded as saying “what an infinite blessing” as the chloroform took effect. A team of surgeons led by McGuire performed the operation to remove his arm. It took about 50 minutes, and he was under anesthesia for just over an hour, awaking shortly after. At first Jackson seemed to make a rapid recovery, but he developed pneumonia — most likely from the arduous journey from battlefield to field hospital — and died a week later.
Albin says the science of anesthesiology has come far since those days when a general got a few drops of chloroform and a private was lauded for his spunk.

“We now routinely do complicated, lengthy operations, using a variety of anesthetic agents that are best suited for each individual patient,” said Albin. “Groundbreaking work done here at UAB and at other institutions has made remarkable progress in minimizing post-operative pain as well.”

Battlefield medicine has also made great strides in recent years. Far-forward medical teams can provide emergency and surgical care to a wounded soldier within minutes, then transport him or her to a fully equipped theater hospital nearby. UAB is home to one of the most advanced military medical teams, the U.S. Air Force SOST-SOCCET special operations team. UAB created the first academic anesthesiology history unit in the world, with the development of the David Hill Chestnut, M.D., Section on the History of Anesthesia in 2002. The section is designed to expose anesthesiology residents, fellows, faculty, medical students and the general public to the historical developments behind the progress of anesthesiology as a specialty.

From: uab.edu

They Heard the Call of Duty: Civil War Nurses

From armyheritage.org

With the onset of the American Civil War in 1861, able-bodied men on both sides of the conflict began marching to battlefields in service to their country. Women on both sides also felt a need to volunteer and contribute to the war effort. Most of these female volunteers served as nurses. Driven by the same patriotic desire as many of their male counterparts, roughly 3,300 women served as nurses for the Union Army from years 1861-1865.

These pioneers challenged existing gender roles and social norms. Many of their male colleagues believed that women did not belong in the hospitals and resented their presences. Civil War nurses overcame their objections through appeals to national pride, patriotic duty, and through hard work and dedicated service to the sick and wounded Soldiers that filled the nation’s hospitals.

Two months after the war began Secretary of War Simon Cameron appointed Dorothea Dix as Superintendent of Women Nurses for the Union. In August 1861 Congress authorized the Surgeon General to employ female nurses in Army hospitals, and to pay them $12 a month and provide them with food rations. The result was an influx of volunteers. From middle-aged widows to young bachelorettes, women volunteered to assist in hospitals and other medical establishments.

Older women typically had greater freedom to leave their homes to participate in this uncertain and dangerous profession. Apprehensive parents, fearful for their daughter’s safety, attempted to prevent their young daughters from leaving. Beside the fears about sickness, death, or other calamities, many people, including many of the doctors the nurses worked with, did not believe women belonged in a medical setting. The women faced the same challenges as their male counterparts, including the risk of communicable diseases, unsuitable medical field facilities, and various battlefield dangers. Yet thousands of women left home to become nurses, and take care of fighting servicemen.

Nurses acted as homemakers and orderlies in their wards. Soldiers viewed nurses as holistic healers because of the strong connection they drew between physical and spiritual healing. Nurses tended to the Soldier’s physical needs, but also their spiritual needs, especially among Soldiers who were not expected to survive their wounds. Numerous accounts tell of men wracked in pain that would instantly calm and be comforted by a nurse’s attentiveness, conversation, or physical contact. Nurses maintained written correspondence with Soldier’s families, and often assisted with a last letter home or death notification.

Hospital conditions and accommodations varied greatly depending on where the hospital was located and what sort of facilities existed there before the war. Regardless of the accommodations, a nurse could be assured of ghastly experiences dealing with bloody wounds and mangled limbs that would challenge even the hardiest individual’s emotional capacity.  Yet these brave women faced the fear of the unknown and the daily horrors that confronted them throughout the war. Many drew strength from the Soldiers themselves, whose constant assurances helped the nurses overcome their emotional burdens.

Over four years of war nurses provided exemplary service to the fighting forces and to the nation as a whole. They persevered through dire and unsafe conditions with selfless dedication. Brave men received attentive care and would forever remember the special women working the hospital wards all around the country during these pivotal moments in American history.

The History of Civil War Veterinarians

By James Rada

Walter Heiss may be the only person to have worn his Civil War uniform although he is not a veteran of the war.

The blue Union jacket has the gold stripes of a calvaryman. The three-up, three-down stripes identify him as a sergeant major, but in between those stripes is a horseshoe patch marking him as a veterinary surgeon.

"There isn't a record of anyone holding this position," Mr. Heiss said. And he would be one of the few people alive who would know. Mr. Heiss spent two years compiling information about Civil War veterinary medicine.

"At the beginning of the Civil War, there were 7.5 million horses in the United States and only 50 veterinarians," Mr. Heiss said. "They were all foreign born and foreign trained."

One of the few American veterinary schools, the New York College of Veterinary Surgeons, was founded in 1857. Although this is four years before the start of the war, Mr. Heiss's research found that the school's first graduating class numbered two members and didn't happen until 1867, two years after the end of the war.

This was the state of veterinary medicine at the outbreak of the Civil War. Many of the calvary battles in the war left horses with saber wounds that could have been healed if treated properly. Because no proper care existed, many of these injuries became fatalities.

Mr. Heiss, who is 80 years old, spent two years compiling everything he could find about veterinary science during the war. "I tried to chronicle all of the things I found in sequence and in context," Mr. Heiss said.

The resulting book, "Veterinary Service During the American Civil War," gathers what little was done about veterinary service during the war and puts it into context with other events during the war.

Mr. Heiss's interest in this forgotten area of Civil War history began when he and his wife moved back to Frederick from Georgia in 2000.

"I didn't know anything about the Civil War," Mr. Heiss said. "My wife and I went through the Museum (of Civil War Medicine) and as complete as it was, there was very little about veterinary medicine."

With the secession of the southern states and outbreak of war, both the Union and the Confederacy started on a massive procurement of horses. Hundreds of thousands of horses needed to be fed, sheltered, shod and equipped.

Despite the Confederacy's reputation of having superior horsemen, Mr. Heiss's research found they didn't care for their horses any better than the Union troops.

According to Fredie Steve Harris, writing in Western Horseman in 1976, the Union addressed this need and won the war. The Confederacy was unable to cope with the demand and lost.

Mr. Heiss said that, typically, a horse received 26 pounds of grain and hay a day. "At the end of the war, General Lee was writing and asking if he could just receive five pounds a day," Mr. Heiss said.

Military horses lacked good care. They were overworked and many suffered from a disease called glanders, a contagious disease that increased mucus secretions from a horse's nostrils and swelled the glands in their lower jaws.

Mr. Heiss said because of this poor care, close to 1.5 million or 20 percent of the nation's horses died during the war.

He said both the Union and Confederacy built "magnificent remount depots" that could hold up to 30,000 horses with appropriate infirmaries, haying facilities and wide open corrals.

"There were no veterinarians to work there," Mr. Heiss said. "It was like building the National Institutes of Health and not having any doctors to staff it."

He says there were people who had practical knowledge of horses, just not doctors trained in their care. Calvary units had veterinary sergeants at the beginning of the war, the position was eliminated without explanation in July 1862.

In part, the lack of veterinary surgeons was an economic one. Sergeant majors received $75 a month in pay. Farriers got $15 a month.

"So if a commanding officer could get one veterinarian or five farriers, he was well ahead to take the farriers," Mr. Heiss said. "He could get more people who could provide some medical care and do other things as well."

Mr. Heiss said that veterinary service really wasn't established in the military until 1916 when the veterinarians were first given their commissions.

Mr. Heiss's book is dedicated to the horses that died during the Civil War. While soldiers were buried in military graves, the government originally allowed salvagers to unearth the horse remains and sell the bones for a number of uses. A letter from the Quartermaster's Office in October 1865 read in part, "Having died in service he thinks they (the horses) ought to rest in peace."

"Veterinary Service During the American Civil War" can be purchased at the National Museum of Civil War Medicine, 48 E. Patrick St., Frederick, and online at Amazon.com.

From: fredericknewspost.com

Dean of The College of Pharmacy of the University of Findlay Speaks About Civil War Medicine

September 16, 2013
Written by Sarah Foltz

In August, Don Stansloski, dean of the College of Pharmacy, visited Lakeside Chatauqua, a historic Ohio community and resort, to share his knowledge of the Civil War and the impact it had on medicine in the United States.

In a uniform of a pharmacist in the Union Army, he shared interesting before-and-after facts of the war. “Essentially, I talked to them about what the north and south were like before the civil war,” Stansloski said.

Stansloski explained many aspects of the Civil War, including the industrial environment in the north where people depended on machinery, while the south depended on slavery for agriculture. In terms of health care and medicine, the north and south were very similar.

“Prescriptions were one-of, meaning that each medicine was made from scratch for each patient. One did not buy a bottle of aspirin for example. Rather the pharmacist would take a chemical and make it into a dosage form like a capsule,” said Stansloski. “The war changed everything because suddenly there were six million people in the armies that had to be cared for all at once. You could no-longer provide prescriptions one-of anymore then you could provide weapons one-of.”

During the Civil War, the general manufacturing process greatly expanded in the United States. Stansloski explains that prior to the war, there were 19,000 manufacturing plants in the south while 22,000 plants were in New York alone.

“Before the war, there were 84 places making drugs, and after the war there were 300,” said Stansloski. “Nursing did not exist in the US before the war, but it did after.”

Stansloski also shared how the world learned about infection. Even those with the best medical care possible still suffered from illness because they did not know what infection was.

Before the war, people were routinely poisoned with mercury because it was thought to follow the best medical ideas of the time.

“There was a widespread feeling that most of the bad things that happened to us were a result of our own immoral behavior or failure to have enough willpower,” said Stansloski. “People didn’t know there were infections before the war and afterwards everyone did.”

During the war, both sides used the same medical books and some of the drugs used at that time are still used today. Many drug companies were established after the war as well.

“It was a very fascinating time. 600,000 people died and about half of them died from disease,” said Stansloski.

Stansloski has shared his knowledge of Civil War medicine with several other groups and continues to enlighten others. “I do this because I’m interested and I’m able to tell the stories.”

IMAGE: Dr. Stansloski in a uniform of a Civil War pharmacist

FROM: newsroom.findlay.edu



Sunday, March 9, 2014

Dr. Charles A. Leale’s Report on the Assassination of Abraham Lincoln

By Helena Iles Papaioannou and Daniel W. Stowell

In May 2012, Helena Iles Papaioannou, a research assistant with the Papers of Abraham Lincoln, was systematically searching the Letters Received series of the Records of the Office of the Surgeon General at the National Archives in Washington, D.C. Proceeding through correspondence filed under the letter “L,” she located a twenty-two-page report by army surgeon Dr. Charles A. Leale about his role as the first physician to tend the wounded Lincoln after the president’s shooting at Ford’s Theatre on April 14, 1865. Papaioannou brought the document to the attention of the director of the Papers of Abraham Lincoln, Daniel W. Stowell. After consulting several scholars who specialize in the events surrounding the Lincoln assassination, Papaioannou and Stowell concluded that the 1865 report from Dr. Leale was generally unknown. Certainly no such report has been presented in its entirety or compared with Leale’s later account from 1867.

This 1865 report is significant because it gives us a window into Leale’s experience that is immediate and untarnished by the passage of time. In a cover letter for his 1867 written account of Lincoln’s assassination to a congressional committee, Leale stated that he had “principally copied it from (a never-published) one written by me a few hours after leaving his death bed.” We believe this 1865 report to be a copy of the account Leale wrote immediately after leaving Abraham Lincoln’s bedside. Leale rarely spoke of his actions on the night of April 14, but in 1909, the centennial of Abraham Lincoln’s birth, the Military Order of the Loyal Legion of the United States prevailed upon him to give them his memories. By then, Leale’s account was rich in sentimentality, and he had an acute sense of his own importance in the Lincoln story. His 1865 report offers a first draft of history by a man who had little time to ponder the life-changing events he had just experienced.

Dr. Charles Augustus Leale was born in March 1842, making him just twenty-three years old on April 14, 1865. Indeed, he had graduated just six weeks previously, on March 1, with a medical degree from Bellevue Hospital Medical College in New York City. Leale had, however, been around the medical profession for most of life. During the 1850s Leale’s father oversaw the United States Marine Hospital in Portland, Maine, and Leale recounted receiving his first surgical instruction at that hospital as he visited the wards. In 1860 he began attending university, where he studied chemistry and medicine. In 1863 Leale moved to New York City and began private instruction before matriculating at Bellevue. In 1864 Leale served at the U.S. army hospital in Elmira, New York, as a medical cadet, working his way up to overseeing two wards. In that position Leale tended both wounded Union soldiers and Confederate prisoners. After his graduation near the end of the Civil War, Leale became a commissioned officer in the medical department of the army and worked as the surgeon in charge of the wounded commissioned officers’ ward at the U. S. Army General Hospital in Armory Square, Washington, D.C. He held that position in April of 1865.

Charles Leale’s involvement in the events surrounding the Lincoln assassination was not entirely coincidental. A few days earlier, on April 11, Leale had been walking along Pennsylvania Avenue when his interest was piqued by crowds rushing towards the Executive Mansion. When he arrived, Lincoln was just beginning what was to be his last public address. Leale was profoundly impressed by ­Lincoln, later ­­describing his “divine appearance as he stood in the rays of light, which penetrated the windows of the White House.” When Leale heard that Lincoln would be attending the theatre on the night of April 14, 1865, he decided to do the same.
There are seven extant accounts by Leale of his experience as one of Lincoln’s final doctors. Five date from 1865, one from 1867, and one from 1909—forty-four years after the assassination.

Three of the additional 1865 accounts that have surfaced since the discovery of the report described are nearly identical copies, each in the hand of a clerk (though the handwriting indicates different clerks). None of the additional reports has been presented in its entirety nor have they received much scholarly attention. One report in addition to the one here resides at the National Archives in Washington, D.C. Originally located in the Records of the Adjutant General, it is now housed in the vault. The third and fourth 1865 reports are in the records of the United States Sanitary Commission (USSC) at the New York Public Library. The variations among the accounts are minimal. There are a very few slight word changes or added words, some punctuation differences such as ampersands used in place of “and,” commas instead of semi-colons, and variant capitalizations. The adjutant general and USSC reports both have titles, but the surgeon general report does not (other than a clerk’s note on the reverse of the final page). All of these differences can be attributed to the work of four different clerks in transcribing the reports. Other than these minor differences, the copies are identical. It is impossible, therefore, to determine the sequence of copies, whether any were made from others, or whether the clerks independently copied each from a lost original in Leale’s hand.

Leale’s other versions of Lincoln’s assassination are far more distinct from one another than are the 1865 reports. One final account from 1865 is a letter Leale wrote to his friend and fellow physician Dwight Dudley late in May of that year. His description of the events of April 14 and 15 is an abbreviated and less formal recounting that in its details is very similar to the reports he wrote in 1865 and 1867. The letter is noteworthy, however, in that Leale briefly mentions Lincoln’s funeral and also recounts attending part of the trial of John Wilkes Booth’s co-conspirators. Memorably, he describes them as a “very inferior-looking set of men.”

The 1867 report and its cover letter are addressed to Representative Benjamin F. Butler, chair of a committee in the United States House of Representatives investigating Lincoln’s assassination. For his written report to Congress, Leale drew heavily from the report he wrote in April 1865, just hours after the attack. As the annotations demonstrate, Leale made various additions to his 1867 account. In February 1909 Leale gave a speech to the Military Order of the Loyal Legion of the United States in New York City, outlining his role in caring for Lincoln after he had been shot. Leale gave this speech amidst the commemorations of the one-hundredth anniversary of Lincoln’s birth, and it was later published in pamphlet form as Lincoln’s Last Hours.

Presented below is the complete text of the copy of Leale’s 1865 report housed in the Surgeon General’s records. Notes indicate where the text differs significantly from Leale’s 1867 report to Butler’s assassination committee. Annotations provide definitions of medical terms and brief biographical information for individuals mentioned in Leale’s account.
Having been the first of our profession who arrived to the assistance of our late President, and having been requested by Mrs. Lincoln to do what I could for him I assumed the charge until the Surgeon General and Dr Stone his family physician arrived, which was about 20 minutes after we had placed him in bed in the house of Mr. Peterson opposite the theatre, and as I remained with him until his death, I humbly submit the following brief account.

I arrived at Fords Theatre about 8¼ p.m. April 14/65 and procured a seat in the dress circle about 40 feet from the Presidents Box. The play was then progressing and in a few minutes I saw the President, Mrs Lincoln, Major Rathbone and Miss Harris enter; while proceeding to the Box they were seen by the audience who cheered which was reciprocated by the President and Mrs Lincoln by a smile and bow.

The party was preceded by an attendant who after opening the door of the box and closing it after they had all entered, took a seat nearby for himself.

The theatre was well filled and the play of “Our American Cousin” progressed very pleasantly until about half past ten, when the report of a pistol was distinctly heard and about a minute after a man of low stature with black hair and eyes was seen leaping to the stage beneath, holding in his hand a drawn dagger.

While descending his heel got entangled in the American flag, which was hung in front of the box, causing him to stumble when he struck the stage, but with a single bound he regained the use of his limbs and ran to the opposite side of the stage, flourishing in his hand a drawn dagger and disappearing behind the scene.

I then heard cries that the “President had been murdered,” which were followed by those of “Kill the murderer” “Shoot him” etc, which came from different parts of the audience.

I immediately ran to the Presidents box and as soon as the door was opened was admitted and introduced to Mrs. Lincoln when she exclaimed several times, “O Doctor, do what you can for him, do what you can”! I told her we would do all that we possibly could.

When I entered the box the ladies were very much excited. Mr. Lincoln was seated in a high backed arm-chair with his head leaning towards his right side supported by Mrs. Lincoln who was weeping bitterly. Miss Harris was near her left and behind the President.

While approaching the President I sent a gentleman for brandy and another for water.

When I reached the President he was in a state of general paralysis, his eyes were closed and he was in a profoundly comatose condition, while his breathing was intermittent and exceedingly stertorous. I placed my finger on his right radial pulse but could perceive no movement of the artery. As two gentlemen now arrived, I requested them to assist me to place him in a recumbent position, and as I held his head and shoulders, while doing this my hand came in contact with a clot of blood near his left shoulder.

Supposing that he had been stabbed there I asked a gentleman to cut his coat and shirt off from that part, to enable me if possible to check the hemorrhage which I supposed took place from the subclavian artery or some of its branches.

Before they had proceeded as far as the elbow I commenced to examine his head (as no wound near the shoulder was found) and soon passed my fingers over a large firm clot of blood situated about one inch below the superior curved line of the occipital bone.

The coagula I easily removed and passed the little finger of my left hand through the perfectly smooth opening made by the ball, and found that it had entered the encephalon.

As soon as I removed my finger a slight oozing of blood followed and his breathing became more regular and less stertorous. The brandy and water now arrived and a small quantity was placed in his mouth, which passed into his stomach where it was retained.

Dr. C. F. Taft and Dr. A. F. A. King now arrived and after a moments consultation we agreed to have him removed to the nearest house, which we immediately did, the above named with others assisting.

When we arrived at the door of the box, the passage was found to be densly crowded by those who were rushing towards that part of the theatre. I called out twice “Guards clear the passage,” which was so soon done that we proceeded without a moments delay with the President and were not in the slightest interrupted until he was placed in bed in the house of Mr. Peterson, opposite the theatre, in less than 20 minutes from the time he was assassinated.

The street in front of the theatre before we had left it was filled with the excited populace, a large number of whom followed us into the house.

As soon as we arrived in the room offered to us, we placed the President in bed in a diagonal position; as the bed was too short, a part of the foot was removed to enable us to place him in a comfortable position.

The windows were opened and at my request a Captain present made all leave the room except the medical gentlemen and friends.

As soon as we placed him in bed we removed his clothes and covered him with blankets. While covering him I found his lower extremities very cold from his feet to a distance several inches above his knees.

I then sent for bottles of hot water, and hot blankets, which were applied to his lower extremities and abdomen.

Several other Physicians and Surgeons about this time arrived among whom was Dr. R. K. Stone who had been the President’s Physician since the arrival of his family in the city.

After having been introduced to Dr. Stone I asked him if he would assume charge (telling him at the time all that had been done and describing the wound,) he said that he would and approved of the treatment.

The Surgeon General and Surgeon Crane in a few minutes arrived and made an examination of the wound.

When the President was first laid in bed a slight ecchymosis was noticed on his left eyelid and the pupil of that eye was slightly dilated, while the pupil of the right eye was contracted.

About 11. p.m. the right eye began to protrude which was rapidly followed by an increase of the ecchymosis until it encircled the orbit extending above the supra orbital ridge and below the infra orbital foramen.

The wound was kept open by the Surgeon General by means of a silver probe, and as the President was placed diagonally on the bed his head was supported in its position by Surgeon Crane and Dr Taft relieving each other.

About 2 a.m. the Hospital Steward who had been sent for a Nelatons probe,arrived and examination was made by the Surgeon General, who introduced it to a distance of about 2½ inches, when it came in contact with a foreign substance, which laid across the track of the ball.

This being easily passed the probe was introduced several inches further, when it again touched a hard substance, which was at first supposed to be the ball, but as the bulb of the probe on its withdrawal did not indicate the mark of lead, it was generally thought to be another piece of loose bone.

The probe was introduced a second time and the ball was supposed to be distinctly felt by the Surgeon General, Surgeon Crane and Dr Stone.

After this second exploration nothing further was done with the wound except to keep the opening free from coagula, which if allowed to form and remain for a very short time, would produce signs of increased compression: the breathing becoming profoundly stertorous and intermittent and the pulse to be more feeble and irregular.

His pulse which was several times counted by Dr. Ford and noted by Dr King, ranged until 12 p.m. from between 40 to 64 beats per minute, and his respiration about 24 per minute, were loud and stertorous.

At 1 a.m. his pulse suddenly increasing in frequency to 100 per minute, but soon diminished gradually becoming less feeble until 2.54 a.m. when it was 48 and hardly perceptible.

At 6.40 a.m. his pulse could not be counted, it being very intermittent, two or three pulsations being felt and followed by an intermission, when not the slightest movement of the artery could be felt.

The inspirations now became very short, and the expirations very prolonged and labored accompanied by a gutteral sound.

6.50 a.m. The respirations cease for some time and all eagerly look at their watches until the profound silence is disturbed by a prolonged inspiration, which was soon followed by a sonorous expiration.

The Surgeon General now held his finger to the carotid artery, Col. Crane held his head, Dr Stone who was sitting on the bed, held his left pulse, and his right pulse was held by myself.

At 7.20 a.m. he breathed his last and “the spirit fled to God who gave it.”

During the night the room was visited by many of his friends. Mrs Lincoln with Mrs. Senator Dixon came into the room three or four times during the night.

The Presidents son Captn R. Lincoln, remained with his father during the greater part of the night.

Immediately after death had taken place, we all bowed and the Rev. Dr. Gurley supplicated to God in behalf of the bereaved family and our afflicted country.
True copy.
(signed) Charles A. Leale M. D.

Leale’s 1909 account of the events of April 14–15, 1865, is substantially different from those he wrote more than forty years earlier. By the early twentieth century, Leale had a keen sense of the importance of his role in the events of that night. Although his speech included a distinct sentimentality absent from his accounts in the 1860s, the version of events Leale presented in 1909 accords with those of his earlier accounts, with a few notable exceptions.

In 1909, Leale told a broader story of his involvement in the passion play of Lincoln’s death and burial. He described hearing Lincoln speak at the White House a few days before his death, as well as his attendance at Lincoln’s funeral and the relics he kept from that night, including his blood-stained cuffs. He also recounted the words of a wounded soldier, when learning of Lincoln’s death, “Doctor, all we have fought for is gone. Our country is destroyed, and I want to die.”

Leale also added details that are not present in his 1860s accounts. He mentioned, for example, how the other doctors present had wanted to administer more brandy and water to the President, but Leale resisted. In contrast to his description in 1865, Leale stated that “I ordered the foot of the bed to be removed. . . . Then I requested that it be broken off; as I found this could not satisfactorily be done, I had the President placed diagonally on the bed.” While Leale composed most of his 1860s report in passive voice, his 1909 speech placed him in a much more active and commanding role. For example, in 1865, Leale recounted that when Dr. Stone, the Lincoln family physician, arrived, he asked Stone to take charge of the president. By 1909 Leale stressed how late Dr. Stone arrived and made no mention of asking him to take charge. In a final example, Leale claimed to have performed a form of cardiopulmonary resuscitation on the stricken Lincoln. However, doctors did not begin performing chest compressions to stimulate the heart until the 1890s.

In 1866, Leale received an honorable discharge from the army with the rank of brevet captain. He traveled to Europe, where he studied Asiatic cholera, married in 1867, and fathered six children. He was active in philanthropic causes, serving for twenty years as trustee of the New York Institution for the Instruction of the Deaf and Dumb. Leale continued to practice medicine until his retirement in 1928 at the age of eighty-six. He maintained his affiliations with numerous medical societies until his death in 1932, sixty-seven years after the death of the president whom he could not save.

From: quod.lib.umich.edu

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