Sunday, December 6, 2015

Civil War Women Doctors

By Maggie MacLean, 4-22-13

It is unclear how many women were working as physicians in the United States before the Civil War. At that time, medical students commonly studied under an established physician and did not attend a formal medical school. Many women learned their medical skills from husbands and fathers, and then assisted the men in private practice.

During the antebellum years, an unknown number of women attended medical school dressed in male attire and went on to practice medicine, while still pretending to be men. Most women doctors served in a nursing capacity during the Civil War because they were not allowed to function as physicians.

While many male and female practitioners who graduated from unorthodox medical schools applied for admission to the Medical Corps of both armies, they were rejected. In desperation, a delegation of male homeopaths appealed directly to President Abraham Lincoln, but he would not support their application for army appointments.

Dr. Elizabeth Blackwell
When the Civil War broke out, Dr. Elizabeth Blackwell - the first woman to receive a medical degree in the United States - realized the Union Army would need a system for distributing supplies. Blackwell and her sister Dr. Emily Blackwell organized four thousand women in New York City into the Women's Central Association of Relief (WCAR), which collected and distributed blankets, food, clothing and medical supplies.

In June 1861, under orders from President Abraham Lincoln, the federal government formed a national version of the WCAR which became the United States Sanitary Commission (USSC), which oversaw nurse training, coordinated volunteer efforts and provided battlefront hospital and kitchen services. Although most of the USSC's officers and agents were men, the vast majority of its tens of thousands of volunteers were women, including Almira Fales, Eliza Porter and Katharine Prescott Wormeley.

Dr. Elizabeth Blackwell also partnered with several prominent male physicians in New York City to offer a one-month training course at Bellevue Hospital for 100 women who wanted to be nurses for the Union army. This was the first formal training for women nurses in the country. Once they completed their training, they were sent to Dorothea Dix for placement at a hospital.

Dr. Rebecca Lee Crumpler
The first African American doctor in the United States, Dr. Rebecca Lee Crumpler received her medical degree in 1864 from the New England Female Medical College. No images survive of Dr. Crumpler. What is know of her comes from the introduction to her book, a remarkable record of her achievements as a physician at a time when very few African Americans were able to gain admittance to medical college. Her Book of Medical Discourses (1883) is one of the first medical publications by an African American.

Though she did not serve with the army during the Civil War, she was active immediately after the war ended. When Richmond, Virginia surrendered to Union troops in April 1865, she went to the city to work with volunteer agencies at the contraband camp there. Crumpler believed that Richmond would be:

a proper field for real missionary work, and one that would present ample opportunities to become acquainted with the diseases of women and children. During my stay there nearly every hour was improved in that sphere of labor. The last quarter of the year 1866, I was enabled... to have access each day to a very large number of the indigent, and others of different classes, in a population of over 30,000 colored.

Crumpler joined other black physicians caring for freed slaves who would otherwise have had no access to medical care, working with the Freedmen's Bureau, and missionary and community groups, even though black physicians experienced intense racism working in the postwar South. She subsequently returned to Boston where she ran a medical practice for several years, specializing in caring for women and children.

Dr. Esther Hill Hawks and Dr. Mary Edwards Walker were among a pioneering group of medical professionals who attended orthodox medical schools and offered their services for frontline duty during the Civil War. They received a hostile reception from their male counterparts, who firmly believed that field medicine was a male environment. Undeterred, these feisty females continued to flout society's idea of a woman's place.

Dr. Esther Hill Hawks
After marrying Dr. John Milton Hawks, Esther Hill Hawks studied his medical books and decided to go to medical school. Graduating from New England Medical College for Women in 1857, she practiced in various locales with her husband. After the Sea Islands along the coast of South Carolina and the surrounding areas were occupied by Union forces, Dr. John Hawks got a job providing medical care and running a plantation set up for freed slaves.

Dr. Esther Hill Hawks - a Northerner, a teacher, a suffragist, an abolitionist and one of America's first female physicians - was the very antithesis of Southern womanhood. Nevertheless, she joined her husband and assisted him as much as the Union Army would allow, but her primary role remained primarily that of a teacher with the National Freedmen's Relief Association. During the war years she lived in and around Beaufort and Charleston, South Carolina and Jacksonville, Florida.

Dr. Hawks recorded her Civil War experiences in a diary from 1862 to 1866, in which she described the South she saw, conquered but still proud. She helped in establishing General Hospital Number 10 for black soldiers. Hawks cared for soldiers from the 54th Massachusetts Colored Infantry, the first black regiment recruited in the free states, after its famous ill-fated attempt to take Fort Wagner under Colonel Robert Gould Shaw. After the war, Hawks continued to work in the area, caring for former slaves and teaching school.

Dr. Mary Edwards Walker
When the Civil War began in earnest during the spring of 1861, Dr. Mary Edwards Walker responded by shutting down her practice, writing that she "was confident that the God of justice would not allow the war to end without its developing into a war of liberation." She set out for Washington, DC and found a city overrun with soldiers wounded during the Battle of Bull Run, and an insufficient number of medical professionals struggling to treat them.

She went straight to Secretary of War Simon Cameron and presented herself as a willing and able surgeon. Cameron found her clothing (a modified Bloomer costume) - a shortened dress atop slacks - totally absurd and would not consider commissioning a woman for any rank above nurse. However, Walker was determined to be useful, and her services were readily accepted by Dr. J.N. Green, the lone surgeon of the Indiana Hospital, a makeshift infirmary hastily set up inside the unfinished U.S. Patent Office.

Eager for Walker to be compensated, Green requested that Surgeon General Clement A. Finley formally appoint her assistant surgeon, but he refused. Entangled in a long divorce with a philandering husband who impregnated at least two patients, Walker was not a woman of means, but she returned to work, politely refusing to share Green's salary.

In 1861, the Sanitary Commission recommended amputations be conducted when a limb had serious lacerations or compound fractures, but the practice was controversial. Nearly 60 percent of leg amputations done at the knee resulted in death, while less than 20 percent survived hip-level amputations. Walker observed her colleagues senselessly amputating limbs. She wrote, "It was the last case that would ever occur if it was in my power to prevent such cruel loss of limbs."

She began surreptitiously counseling soldiers against the surgery when appropriate. Many wrote her thankful letters after the war, reporting their limbs to be fully functional. Word quickly spread about Dr. Walker's kindness to soldiers. Knowing she was bold and skilled, anxious families begged her to seek out their injured relatives, marooned near raging battles.

In an 1862 letter published in The Sibyl, Walker wrote:

"It is literally impossible for one with any force of character and humanity to remain 'in the background,' when convinced by knowledge and reason, that their mission is evidently one that will result in great good in those whose necessities demand that they have not the power to gain for themselves..."

Dr. Walker began writing endless letters requesting an official post, and received just as many refusals. Yet she continued to treat wounded soldiers, and military surgeons and generals on the ground were grateful for her help. Dr. Preston King described Walker's contributions in the aftermath of a brutal defeat at Fredericksburg which resulted in 13,000 casualties, but the secretary of war responded that there could never be a commission for her, as there was no "authority of law for making this allowance to you."

Walker designed a blue uniform for herself, replete with a green sash, the sign of a physician on the battlefield. The New York Tribune wrote in December 1862:

"Dressed in male habiliments...she carries herself amid the camp with a jaunty air of dignity well calculated to receive the sincere respect of the soldiers... She can amputate a limb with the skill of an old surgeon, and administer medicine equally as well. Strange to say that, although she has frequently applied for a permanent position in the medical corps, she has never been formally assigned to any particular duty."

Dr. Walker was now famous, and the Tribune continued to criticize the military's reluctance to recognize her efforts, asking, "If a woman is proved competent for duty, and anxious to perform it, why restrain her?" Even President Abraham Lincoln would not invite a national controversy by appointing a female physician to the Union Army, even one he knew had been acting in such capacity on nearly half a dozen battlefields.

In 1864, Lincoln wrote a carefully worded letter to Dr. Mary Edwards Walker:

"The Medical Department of the army is an organized system in the hands of men supposed to be learned in that profession and I am sure it would injure the service for me, with strong hand, to thrust among them anyone, male or female, against their consent."

After Assistant Surgeon General Robert C. Wood observed in person Walker's work during the Chickamauga Campaign, she was formally named the only female acting assistant surgeon in the United States Army and was assigned to the 52nd Ohio Volunteers, and offered a contract salary of $80 a month.

For the first time, Walker wore the sanctioned dress of a Union military surgeon. Proud of her accomplishment, she wrote, "I let my curls grow while I was in the army so that everybody would know that I was a woman." She was regularly sent on missions outside of Union lines, armed with two revolvers in her saddle, but her orders were not entirely medical in nature.

On April 10, 1864, Walker was taken prisoner as a Union spy by Confederate soldiers under General Dana Harvey Hill. Five days later, General Ulysses S. Grant ordered all women to leave Union battlefields, but by then Walker had been sent to Castle Thunder Prison in Virginia. Her reputation preceded her, and the imprisoned "female Yankee surgeon" was openly ridiculed in Virginia papers.

Both the Confederate and Union armies were desperate for physicians, and on August 12, 1863, Dr. Walker was exchanged for a male physician. She had now served as a physician at Indiana Hospital, Bull Run, Warrenton, Fredericksburg, Chickamauga, Chattanooga and Atlanta, but securing another commission required renewing the letter-writing campaign. She was finally sent to Louisville to be the head surgeon at the Female Military Prison, but the Confederate women kept there often refused her services.

Dr. Mary Edwards Walker was released back to the 52nd Ohio as a contract surgeon, but spent the rest of the war practicing at the Louisville female prison and an orphan's asylum in Tennessee. On June 15, 1865, Walker requested that her military service conclude, and the army readily granted her request. She was paid $766.16 for her wartime service. Afterward, she got a monthly pension of $8.50, later raised to $20, but still less than some widows' pensions.

Lesser Known Civil War Women Doctors
Among the women physicians who served was Dr. Orianna Moon Andrews of Virginia, who graduated from the Female Medical College of Pennsylvania in 1857. She married fellow Southerner Dr. John Summerfield Andrews in 1861 and records show that she began to serve as his nurse, but further research suggests she did considerably more than some of the medical men of the time cared to admit.

During the Civil War, Dr. Andrews devoted herself to the cause of wounded Southerners. Charlottesville, Virginia was a hospital center during the Civil War and Dr. Orianna Moon Andrews assisted in turning several University of Virginia buildings into hospital units. Her efforts were recognized by her award of a surgeon's commission as a captain in the Confederate Army – reputedly the only one given to a woman.

Dr. Chloe Annette Buckel graduated from the Female Medical College of Pennsylvania in 1856, and worked with Dr. Elizabeth Blackwell and Dr. Emily Blackwell as a physician at the New York Infirmary in New York City. She left her position there to volunteer her services and was chosen to select and train nurses for the Union army – apparently neither the North or the South wanted to employ qualified women as physicians.

In 1862 Buckel joined a company of nurses and surgeons traveling to Memphis, where she assisted in establishing hospitals in stores and warehouses. After the war, Buckel relocated to California, where she co-founded a hospital for women and children in San Francisco, and was one of the few women doctors in the state.

Dr. Sarah Ann Chadwick Clapp was appointed assistant surgeon of the 7th Illinois Volunteer Cavalry and served in that position between November 1861 and August 1862. She also served as assistant surgeon and surgeon in general hospitals in Cairo, Illinois and aboard transport ships. However, the medical examining board refused to give her an examination and she never received a commission or pay for her War work.

Governor Oliver P. Morton of Indiana appointed Dr. Mary Frame Thomas to hospital service during the Civil War, and she worked alongside her husband, a contract surgeon stationed at the Army Hospital at Nashville, Tennessee. Under this appointment Dr. Thomas served in Washington and elsewhere, and later provided special hospital service in Nashville under the direction of the United States Christian Commission, an organization that furnished supplies and medical services to Union troops.

Medical Education for Women
With the rise of the women's rights movement in the nineteenth century and greater wartime demands for their services, women's socially sanctioned role as family nursemaids evolved into greater professional opportunities and medical training.

Frustrated by the difficulty of obtaining medical and hospital training for women, Drs. Elizabeth and Emily Blackwell opened the New York Infirmary for Women and Children in 1857. This hospital and its adjacent Medical College for Women, which the Blackwells established in 1867, provided women doctors with a complete education on a par with the best medical colleges of the day. The rigorous curriculum included the first course in hygiene (public health and preventive medicine) offered anywhere in the country.

The 1870 census counted 525 trained women doctors in America - more than in the rest of the world combined. However, the large majority of these were practitioners of eclectic medicine, an officially recognized branch of North American medicine that predominantly used Native American herbs. These practitioners were eclectic in the sense that they integrated whatever worked, including herbal medicine and homeopathy. Only 137 women were enrolled in regular medical schools, and most of these were in separate women's medical colleges around the country. Women were not permitted to attend Harvard Medical School until 1945.

Image 1: Dr. Mary Edwards Walker in the male attire she so loved to wear

Image 2: Illustration of a woman doctor performing surgery



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