.

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.

Monday, November 30, 2015

Louisa Cheairs McKenny Sheppard: A Confederate Girlhood

From: ozarkscivilwar.org

Louisa Cheairs McKenny Sheppard, “Lou” or “Lulu,” was the fourth child of Talitha and E.D. McKenny. Talitha died during Louisa’s birth in 1848, and she was raised by her grandmother Louisa “Lucy” Terrell Cheairs Campbell after her father moved to Texas. Lulu was twelve when the War began, and she recalled the impact it had on Springfield.
'
The day before the Battle of Wilson’s Creek, Mother (was told) General Lyon and some of his staff (were coming) to dinner. She agreed and at once saw to the preparation of one of those dinners for which she was famous. General Lyon was a rough looking man with good manners. He sat at Mother’s right and opposite to me. During dinner he raised his wine glass to Mother, and said, “Madam, you wish us success?” “Sir,” she answered with grave dignity, “I am a Southern woman.” He looked at her with utter amazement, then said, “And you have sons in the Confederacy?” … “Four,”(she replied) and then with a sudden flash of spirit, “and I wish they were fifty and I were leading them.”…General Lyon arose and took her hand as he said, “I hope no trouble is at hand for so brave a woman.” He was killed the next day…'
Louisa Cheairs McKenny Sheppard – A Confederate Girlhood

Lucy prepared another feast in celebration of the Confederate victory; however, the festivities soon faced the reality of war as the Campbell home was converted into a hospital.

"Our house was now a hospital. I don’t know how many men we had, but there were cots and pallets everywhere, filled with Union and Confederate men, many of whom were past all aid."
Louisa Cheairs McKenny Sheppard – A Confederate Girlhood

The family’s Southern ties necessitated their flight from the Ozarks. Lucy remained in Springfield, while Lulu and others began the treacherous journey to her Uncle Jack’s plantation in Mississippi. In the spring of 1863, the Yazoo, Tallahatchie and Mississippi Rivers flooded bringing diseases and destruction to the family’s plantation. Lulu wrote of federal gunboats approaching through floating livestock carcasses, uprooted trees and buildings. Eventually the family left the plantation, and headed for Arkansas. Lulu briefly visited her father in Texas, but ultimately returned to Lucy in Arkansas. Lulu’s cousins were also stationed in Arkansas, and she commented on the condition of the men.

"The army in Arkansas was in terrible shape. They lacked for every necessity, but their most crying need was for quinine, for nearly all of them had malaria…"
Louisa Cheairs McKenny Sheppard – A Confederate Girlhood

Lucy sought to assist both the Confederate cause and her sons, as she traveled to St. Louis to procure medicine. Her son Junius, the lone Union man in the family, lived in St. Louis and helped her acquire the quinine. Lucy sewed the medicine into her petticoats, and arrived back in Arkansas in January 1865. While Lucy ventured to St. Louis, Lulu made socks, bandages, and supply “bundles” to support the army. Her efforts were honorable and courageous as supplies of all kinds were limited.

"We had not cloth of any kind, except our homespuns. …There were no shoes…We never suffered for food, though there were no luxuries. Coffee had been gone for a long time, and we used various substitutes of parched and ground grain, or squares of dried sweet potato. We had wheat flour but it was coarse and poorly ground, so that it had to be bolted through muslin cloths to make…bread or cake…. molasses sufficed for 'sweetening'."
Louisa Cheairs McKenny Sheppard – A Confederate Girlhood

Certainly, the hardships Lulu and her family faced were not nearly as difficult as those encountered by families with lesser means. Her story, however, is indicative of the resilient spirit exemplified by so many “Rebel women.” At the War’s end, Lucy was determined to return home; however, Springfield in 1865 was very different from when she left.

"(The Campbell home) was overrun with all sorts of riff-raff who had dribbled into town during the war and who had, in our absence, taken possession of the house. Of course everything was in a fearful state of dirt and disrepair. Our taxes had been paid every year by our Union friends, one of them my future father-in-law. While the Big House was being put in order, Mother lived in one of the servant’s houses… Mother had worked, as always, with all her strength, on the task of reclaiming her property, living in discomfort in that poor little house…"
Louisa Cheairs McKenny Sheppard – A Confederate Girlhood

Eventually Lucy became ill and succumbed to pneumonia. Lulu did not return to Springfield until 1869. There, she met a friend of her young uncle, and they were married within the year. Louisa Cheairs McKenny Sheppard wrote A Confederate Girlhood as a recollection of her youthful adventures and a tribute to her beloved grandmother.

Financing Volunteers and their Dependents

(text adapted from Rochester History, Vol. IX. April, 1947 Nos. 2 & 3 "Historic Origins of Rochester's Social Welfare Agencies", by Blake McKelvey)
From: libraryweb.org

Wages and Benefits
Within the first week after the attack on Fort Sumter, a Volunteer Relief Committee was established and a fund of $36,000 subscribed to aid the dependents of volunteers. Weekly benefits, ranging up to four dollars per family, were distributed in the early months from the first payments on these pledges. However, as the call for new regiments arrived and the long-range character of the war became evident, the Relief Committee was forced to recognize its inadequacy for the big task of supplementing the eleven dollar monthly wages of privates. The task was accordingly turned over to the city which continued throughout the war to pay special benefits, not exceeding two dollars a week, to the needy families of volunteers. The high point in these payments was reached in November, 1864, when 900 such families registered for assistance.

Introduction of Bounties
The community's determination to rely on volunteers introduced a new type of subsidy in the form of bounties. Private bounties appeared in the first months, and before the close of the first year the city likewise assumed this function. Starting with $100 for each enlistee in the fall of 1861, Rochester was paying $300 for each man a year later. The county took over the bounty payments for a time in 1863, but when a draft was threatened the next year, the city re-entered the field; $600 bounties were paid that fall, as well as a few private bounties ranging as high as $1,500. Although these payments were in no sense charity payments, the expenditure of an estimated $700,000, widely distributed among the 5,000 recruits raised in Rochester, considerably affected the relief problem. As most of the bounties were paid in lump sums, the recipients tended to spend them on equipment or other immediate uses, thus contributing to price inflation and reducing the real value of the weekly benefits that were to follow.

New emergency appeals, the Ladies Hospital Relief Association and the Christmas Bazaar
One tragic result of the frightful battles along the Potomac and elsewhere during the war was the multiplication of widows and orphans-a long-term problem of sober significance. Moreover, the hardships of famine sufferers in Kansas and especially those in Ireland, and the victims of a fire in Troy, stirred a response in Rochester which resulted in contributions totaling $7,000 during war years. But of course the most generous response was to the call of the Soldier's Aid Society for hospital supplies to alleviate the suffering of sick and wounded soldiers. The city's first great bazaar was held during Christmas week in 1863 for the benefit of the wounded. More than $10,000 was collected in its numerous booths, and this sum, together with the shipments of clothing, bandages and medical supplies sent off at various periods throughout the war, was placed at the disposal of the United States Sanitary Commission for use in battle areas.

Local Hospitals
It was during the war that the utility of local hospitals finally became apparent in Rochester. When the Federal Government began in 1862 to send small detachments of wounded to St. Mary's Hospital, those who had opposed the City Hospital as a useless extravagance were silenced, and its friends, led by the Female Charitable Society, were able to rush its completion at a cost of $14,000, raised largely from charitable sources. The ladies of various Protestant churches undertook to furnish the several wards with a total of 200 beds, and the hospital was finally ready for use in January, 1864. St. Mary's had meanwhile received community-wide support in its drive for funds to erect a new wing, increasing its bed capacity to 400. By May, that year, 400 wounded were receiving care in the two Rochester hospitals, and 2,000 sick and wounded soldiers were thus accommodated before the close of the Civil War.

History of AMA Ethics

From: ama-assn.org

In 1847 the American Medical Association revolutionized medicine in the United States. Members of the newly formed organization, meeting in Philadelphia as the first national professional medical organization in the world, dedicated themselves to establishing uniform standards for professional education, training, and conduct. They unanimously adopted the world's first national code of professional ethics in medicine. For the more than 160 years since, the AMA's Code of Medical Ethics has been the authoritative ethics guide for practicing physicians.

The Code articulates the enduring values of medicine as a profession. As a statement of the values to which physicians commit themselves individually and collectively, the Code is a touchstone for medicine as a professional community. It defines medicine’s integrity and the source of the profession’s authority to self-regulate.

At the same time, the Code of Medical Ethics is a living document, evolving as changes in medicine and the delivery of health care raise new questions about how the profession's core values apply in physicians' day to day practice. The Code links theory and practice, ethical principles and real world dilemmas in the care of patients.

Urology in Pre-Civil war Charleston

By Hamilton JN1, Rovner ES, Turner WR., J Urol. 2008 Aug;180(2):477-80. doi: 10.1016/j.juro.2008.04.023. Epub 2008 Jun 11.
Abstract

PURPOSE:
With a history spanning more than 3 centuries, Charleston, South Carolina was one of the initial locations of urological teaching in the southern United States. The Medical University of South Carolina was chartered in 1823 and is the oldest medical school in the South. We reviewed the historical archives of the Waring Library of the Medical University of South Carolina, specifically the history of urological practice in the city, including doctoral dissertations from medical school students regarding the teaching and practice of urology in pre-Civil War Charleston, to better understand the early development of the specialty.

MATERIALS AND METHODS:
We reviewed graduate medical student dissertations from the historical archives of the Medical University of South Carolina from 1824 to 1860. In addition, we accessed and reviewed the records of the Medical Society of South Carolina, The Charleston Medical Journal and Review, and The American Urological Association Centennial History 1902 to 2002 volumes 1 and 2.

RESULTS:
These historical documents and dissertations review in depth various medical conditions, diagnoses and treatments in pre-Civil War Charleston. Topics such as urolithiasis, urethral stricture, stone composition and hydrocele are a few of the areas considered. Review of these documents fosters insight into the evolving diagnosis and treatment of several urological conditions. Some treatments such as the use of tobacco for urinary retention have fallen out of favor, while others such as the surgical repair of vesicovaginal fistula are still practiced.

CONCLUSIONS:
The history of urology in pre-Civil War Charleston and at the Medical University of South Carolina demonstrates an advanced understanding of urological diseases and the technology designed to treat them with a distinctly European influence.

From: ncbi.nlm.nih.gov

Image: Catheters and sounds from a Tiemann Civil War military urology set

History of the American Veterinary Medical Association

From: avma.org

Correspondence among practitioners along the East Coast led to a national convention of veterinary surgeons in 1863 in New York. The first meeting was attended by 40 delegates representing seven states: New York, Massachusetts, New Jersey, Pennsylvania, Maine, Ohio and Delaware.

Elected officers included the French-trained Dr. Alexandre Liautard, who headed the American Veterinary College in New York and was a dominant voice in the profession during this period. Under the direction of Liautard, New York became the unofficial headquarters of the USVMA and the American Veterinary Review was founded to be the voice of the profession. The USVMA was renamed the American Veterinary Medical Association (AVMA) in 1898.

In 1900, Liautard returned to France and the American Veterinary Review changed its name to the Journal of the American Veterinary Medical Association (JAVMA); it featured contributions from noted veterinary practitioners in what was rapidly becoming a recognized medical profession. By 1913, the AVMA had grown to 1,650 members. Membership requirements were revised so that being a graduate of a three-year, accredited veterinary school became mandatory (prior to this, self-proclaimed practitioners could be members of the association).

Four women graduated from U.S. Veterinary schools in 1915 and began practicing.

The American Journal of Veterinary Research joined JAVMA in 1940 and the publication evolved to become the primary forum for veterinarians to publish basic and clinical research studies.

Today, the American Veterinary Medical Association has more than 86,500 members. These professionals use their skills to care for the health and well being of humans, animals, and the environment.

In addition to caring for the nation's more than 70 million dogs, 80 million cats, 11 million birds, 7 million pet horses, and millions of other companion animals, veterinarians serve in medical research, prevention of bio- and agroterrorism, and food safety and contribute greatly to scientific breakthroughs throughout the world.

Clara Barton USA: Relief Organizer/Humanitarian (December 25, 1821-April 12-1912)

FROM: civilwar.org

Born in Massachusetts in 1821, Clara Harlowe Barton was the youngest of six children. Barton supplemented her early education with practical experience, working as a clerk and book keeper for her oldest brother. She worked for several years as a teacher, even starting her own school in Bordentown, New Jersey in 1853. In 1854 she moved south to Washington, D.C. in search of a warmer climate. From 1854 to 1857 she was employed as a clerk in the Patent Office until her anti-slavery opinions made her too controversial. When she went home to New England she continued the charity works and philanthropy she had begun in Washington.


Early in 1861 Barton returned to Washington, D.C. and, when the Civil War broke out, she was one of the first volunteers to appear at the Washington Infirmary to care for wounded soldiers. After her father’s death late in 1861, Barton left the city hospitals to go among the soldiers in the field. Her presence—and the supplies she brought with her in three army wagons—was particularly welcome at the Battle of Antietam (Sharpsburg) where overworked surgeons were trying to make bandages out of corn husks. Barton organized able-bodied men to perform first aid, carry water, and prepare food for the wounded. Throughout the war, Barton and her supply wagons traveled with the Union army giving aid to Union casualties and Confederate prisoners. Some of the supplies, like the transportation, were provided by the army quartermaster in Washington, D.C., but most were purchased with donations solicited by Barton or by her own funds. (After the war she was reimbursed by Congress for her expenses.)

In 1863, Clara Barton would travel to the Union controlled coastal regions around Charleston, South Carolina. On July 14, 1863 Barton moved from Hilton Head Island to Morris Island to tend the growing number of sick and wounded soldiers - a list that would greatly expand after the failed Union assault on Fort Wagner on July 18, 1863.

Later in the Morris Island campaign, Clara Barton, working out of her tent, would seek to address the growing problem of sickness on the island by passing out fresh food and mail to the troops in the trenches.  Despite her great efforts, Barton herself would become gravely ill and would be evacuated to Hilton Head island.

"We have captured one fort - Gregg - and one charnel house - Wagner - and we have built one cemetery, Morris Island.  The thousand little sand-hills that in the pale moonlight are a thousand headstones, and the restless ocean waves that roll and breakup on the whitened beach sing an eternal requiem to the toll-worn gallant dead who sleep beside."
- Clara Barton on Morris Island

In January 1865, Barton returned to the North when her brother and nephew died. In March, President Abraham Lincoln appointed her General Correspondent for the Friends of Paroled Prisoners. Her job was to respond to anxious inquiries from the friends and relatives of missing soldiers by locating them among the prison rolls, parole rolls, or casualty lists at the camps in Annapolis, Maryland. To assist in this enormous task, Barton established the Bureau of Records of Missing Men of the Armies of the United States and published Rolls of Missing Men to be posted across the country. It was at her insistence that the anonymous graves at Andersonville prison were identified and marked.

In 1869 Clara Barton traveled to Geneva, Switzerland as a member of the International Red Cross. In 1880 the American Red Cross was established, the culmination of a decade of work by Barton. She served as the organization’s first president until 1904 and continued her tradition of philanthropy as a volunteer in Cuba during the Spanish-American War.

Clara Barton died in 1912 at the age of ninety-one.

Civil War Era Medicine

Retired physician and long-time avocational Civil War historian, Thomas Sweeney, offers the following:

The medical establishments within the U.S. Army and the nascent Confederate Army were almost totally unprepared for either the scope or duration of the conflict. The peacetime U.S. Army possessed only 113 physicians to care for more than 16,000 personnel scattered across the country. The Army’s Surgeon General, Dr. Thomas Lawson, was unable to think beyond the needs of small, frontier post hospitals. Fortunately for the Union, the Medical Department entered a new era under a relatively junior physician, Dr. William A. Hammond, on April 25, 1862. The Confederate Medical department had to begin from scratch.

Contrary to popular belief, nineteenth century military medicine was not always crude and ineffective. Lack of preparedness was the foremost problem, and it was responsible for much otherwise unnecessary suffering. The Civil War brought important advances in both organization and technique. While shortages often crippled the Confederacy’s efforts, by the end of the conflict the medical treatment available to Union soldiers was probably the best in the world. It gave sick and injured soldiers a greater opportunity of recovery than in any previous war.

With the outbreak of war civilian doctors entered the ranks of the Northern and Southern forces in large numbers. While some had served only an apprenticeship with an experienced practicing physician, formal medical education was becoming common. Diploma mills existed, but so did an increasing number of respected medical schools, such as the McDowell Medical College in St. Louis. By modern standards the curriculum in even the best schools was surprisingly brief lasting two years, with the second year being merely a repeat of the first. Not surprisingly, the quality of military surgeons differed considerably. Late in 1861 the U.S. Army Medical Department began giving examinations to weed out unqualified physicians. The Confederacy soon took similar and perhaps even more rigorous steps.

Education and peacetime practice did little to prepare physicians to treat the mass casualties of war. The border troubles labeled “Bleeding Kansas” in the Eastern press gave Missouri a reputation for violence, yet prior to the Civil War relatively few physician within the state ever treated a gunshot wound or performed more than minor surgery, much less attempted the amputation of a limb. The same was true elsewhere. Moreover, once in uniform, few military surgeons considered it to be their duty to address the basic requirements to keep the men healthy to fight, such as proper sanitation, food, and shelter. Civilian organizations, often labeled “sanitary commissions,” sprang up to address these needs, but in Missouri the dynamics of the conflict limited these to the Union side. St. Louis became the center of the regional Western Sanitary Commission, as well as the local St. Louis Ladies Union Aid Society and parallel Colored Ladies Union Aid Society.

In Union and Confederate volunteer service, and in the Missouri State Guard, regulations authorized each regiment a surgeon, an assistant surgeon, a hospital steward with the rank of sergeant major, and several enlisted men serving as orderlies. Each morning at “sick call,” the surgeons listened to soldiers’ complaints and provided treatment. The steward was responsible for supplies and medicine chests. Orderlies were jacks-of-all-trades, men who showed an interest and aptitude in nursing and were appointed by the surgeon. During combat the medical team set up a field hospital close to the action. The assistant surgeon usually manned an aid station treating wounded at the edge of the battlefield until they could be removed to the surgeon’s care at the field hospital. Near the end of 1861 the Union army began consolidating regimental hospitals into division and corps hospitals to handle larger bodies of troops more efficiently, but an Ambulance Corp was not formed until well into 1862. Prior to that wounded were brought from the field either by comrades or by musicians from the regiment’s band, if it had one.

Gunshots accounted for 94 percent of the recorded battle wounds. Injuries from artillery projectiles were less common, while bayonet and sword wounds were quite rare. The most common wounds were to the extremities, with almost equal involvement of the arms and legs. In combat involving muzzle-loading weapons, limbs often remained vulnerable even when a soldier fired from a protected position. Non-extremity wounds almost always resulted in death on the battlefield. Penetrating gunshots to the abdomen or head were about 90 percent fatal, those to the chest about 60 percent.

Contrary to myth, Civil War doctors did not perform excessive numbers of amputations because they were ignorant of, or unwilling to consider, alternatives. Doctors usually performed amputations in cases involving the penetration of a joint, a compound fracture, substantial tissue or bone destruction, or evidence of infection (gangrene). They had to consider the fact that survival rates were much greater when amputations were performed within the first twenty-four hours of injury. This was called primary amputation. Secondary amputations were performed after the 24 hour period and resulted in higher mortality and morbidity caused by bacteria having more time to enter the open wound. Surgeons were aware that the presence of foreign material such as wadding, clothing fragments, or dirt in wounds increased the likelihood complications. Tragically, it was not until just after the war ended that European physician Joseph Lister, using the work of Louis Pasteur, demonstrated the role that bacteria played in wound infection, too late to save the lives of tens of thousands of men in uniform.

One of the war’s most important advances was the popularization of anesthesia. Military surgeons employed ether and chloroform, which had first come into use at the time of the Mexican War, 1846-1848. Both drugs had drawbacks. Highly flammable ether, which took sixteen minutes to take effect, posed a danger when operations were performed by candle or lantern light. Chloroform was nonflammable and worked in about nine minutes, but improper application could result in death. During those nine minutes the patient passed through an excitable stage and might need to be restrained. The process was poorly understood by laymen observers and led to the myth that many operations were preformed without any anesthetic at all, which was rarely the case. Recovering patients received either morphine or opium, which were effective painkillers but addictive.

Although more than a thousand military engagements occurred in Missouri, disease killed over twice as many men as bullets. Infections spread rapidly in overcrowded camps. Measles, mumps, rubella, and chicken pox ran rampant, particularly among newly-enlisted soldiers from rural areas who lacked immunities from prior exposure. But even more fatalities resulted from dysentery and diarrhea contracted due to unsanitary conditions. The Western Sanitary Commission worked tirelessly throughout the war to improve conditions in camps, hospitals, and prisons. Science largely ignorant of the cause of diseases and most medications were ineffective. Malaria was the only major disease combated successfully, being treated with quinine, a drug made from the bark of the Peruvian Cinchona tree.

Because of its rail and river connections St. Louis became the most important center for military medicine west of the Appalachian Mountains. Only Washington, D.C., and Richmond, Virginia, played a greater role during the war. The process was driven by necessity. At the beginning of the war there were only two military hospitals in Missouri, one at the St. Louis Arsenal and the other at Jefferson Barracks, south of the city along the Mississippi River. These and the city’s civilian hospitals were overwhelmed by the casualties from early war battles, but before the conflict ended the city was home to fifteen military hospitals and a fleet of hospital boats serving the war effort in the Mississippi River valley.

The campaigning and fighting in the Ozarks, with its poor roads, rugged hills, and lack of adequate water and rail connections, posed particular medical challenges. Early in the war almost all sick and wounded were treated locally, often with the help of the civilian population. The impact on communities could be devastating, as the case of Springfield demonstrates. When Union forces under Nathaniel Lyon occupied the city in July 1861, they set up military hospitals in tents and buildings to accommodate their routine sick personnel. When Lyon was defeated at the nearby battle of Wilson’s Creek on August 10, 1861, the victorious Southerners occupied Springfield and shifted hundreds of casualties (Union as well as their own) to the town, taking over public spaces, churches, and private homes. Men and women came from miles around to help. O. A. Williams, a surgeon for the Missouri State Guard, wrote to John Willsen about the conditions in Springfield shortly after the Battle of Wilson’s Creek.

Headquarters, General Hospital, Missouri State Guard, Springfield, Missouri

Dear John –

I suppose ere this you have had correct information in regard to the fight so I will say nothing about it. I am not in good health – nor in very good spirits. I can see no end to this infernal war… Springfield presents rather a gloomy appearance, every house nearly has been converted into a Hospital. The wounded are generally well. There has been a great many amputations. I have taken off a good many legs and arms – until I am sick and tired… We get nothing to drink (and) little to eat… Give my love to Mary… (and) respects to… friends and tell my enemies to go to hell…

Yours fraternally,

O.A. Williams, Assistant Surgeon

Witnesses reported that the streets literally stank from the odor of wounded and dying soldiers. Weeks passed before the situation was under control. The Federal wounded that remained were eventually moved to St. Louis by rail road from Rolla. By this time smaller hospitals had been opened at intervals along the rail line in Missouri from Sedalia and Rolla to St. Louis to take care of the less severely wounded and avoid overcrowding of St. Louis Hospitals. The damage to Springfield civilian property was great; the emotional and psychological impact on families whose homes became treatment facilities is impossible to calculate. Springfield changed hands six times during the course of the conflict and was for much of the war a major Union supply depot and hospital center. By mid-war half of the homes were destroyed and more than half of the population was refugees.

The much larger Battle of Pea Ridge, fought on March 7-8, 1862, only a short distance into Arkansas from the Missouri border, was an even greater disaster. Union medical preparations were minimal, while the attacking Confederates made almost none. Although the Union forces were victorious, it proved impracticable to shift the severely wounded from the battlefield to the expanding facilities in St. Louis. There were no navigable rivers nearby, and the closest rail line to St. Louis began at Rolla, 240 miles from the battlefield. The roads to Springfield, the next best option, were severely rutted and without bridges, while guerrillas roamed the surrounding countryside. As a consequence, the closer small communities Cassville and Keitsville, Missouri, were virtually transformed into hospitals. When the news of the battle reached St. Louis the Western Sanitary Commission worked day and night packing medical supplies and shipping them as fast as possible to the scene of the crisis.

As the war in the Ozarks progressed both the military and the Western Sanitary Commission became better at averting crises by anticipating needs and stockpiling supplies at key points. One of these key points was Springfield. Large quantities of medical supplies were stockpiled in that city in anticipation of further battles in the western Ozarks. The Union victory on December 7, 1862, at Prairie Grove in northwestern Arkansas produced over 1,000 wounded, and once again poor roads and the threat of guerrillas made evacuations impracticable. On this occasion, however, Sanitary Commission agents in Springfield immediately dispatched two ambulances and stockpiled medical supplies to Fayetteville, which became the main treatment center. They sent additional supplies within ten days.

By January of 1862 St. Louis emerged as the center of military medicine not only in Missouri but also in the Mississippi River Valley. Over crowding of hospitals in St. Louis had been considerably decreased by treating less serious cases in camp and regimental hospitals and sending more serious cases to the city. Convalescing patients were also sent to camps outside of the city. St. Louis had 2,300 beds in the general hospital and 200 to 300 more in the City and Sister’s of Charity Hospitals. Separate isolation hospitals were established for smallpox patients and another for measles. During the spring of 1863 military medicine in St. Louis expanded even further. Medicines, hospital stores, dressings, bedding and clothing were being manufactured in a government facility in St. Louis. A large amphitheatre in the old fairgrounds in Benton Barracks was turned into a 2,500 bed hospital second only to the Lincoln Hospital in Washington which had a 2,575 bed capacity.

By 1864 there were military hospitals located in Jefferson City, Springfield, Kansas City Missouri, and Rolla (at the terminus of the SW branch of the Pacific R.R.) along with Tipton and Sedalia. In southeast Missouri a hospital was located at the southern terminus of the Iron Mountain RR in Ironton. Serious wounded from battle of Springfield through Price’s Raid in the fall of 1864 could be taken care of in various hospitals in Kansas City, around the Ozarks or to one of the hospitals in St. Louis. Battles in isolated areas in the Ozarks such as Newtonia (September 30, 1862 and October 28, 1864) resulted in the wounded being cared for in buildings or tent hospitals surrounding the battlefield.

As had been true for the previous two years, Missouri State Guard and Confederate forces operating within the state provided only the most basic medical services. They setup temporary makeshift hospitals in nearby structures during battles, but as they failed to control any territory permanently their serious wounded were left behind. The highly mobile Southern guerrillas and opportunistic bushwhackers who roamed the state until the very end of the war relied heavily on friendly civilians for care of their sick and wounded. The effectiveness of this care would be difficult to determine. Unfortunately, it led to retaliation upon the civilians by the Unionists.

The fortunes of war were such that the story of medical care in Missouri is really the story of the Union side. Thanks to the efforts of the federal and state governments, civilian relief organizations, and civilian volunteers, medical care in Missouri equaled that of any other state during the conflict. Although authorities were caught off guard and almost overwhelmed by events in 1861, medical care increased steadily from 1862 onwards, until by war’s end it was state of the art for that period of history.

IMAGE: Civil War Amputation Kit, the Civil War Museum at Wilson’s Creek National Battlefield.

FROM: Ozarkscivilwar.com

Peter Gaumgras: Artist (1827-1904)

By Chelsea DeLay

I. Biography
II. Chronology
III. Collections
IV. Exhibitions
V. Memberships
VI. Suggested Resources
VII. Notes

I. Biography

Born January 4, 1827, in the small town of Hamburg, Peter Baumgras was a German-born artist who later became known for his portrait and still life paintings. Baumgras first studied at the Düsseldorf Academy, and then went on to enroll at the Munich Royal Academy where he worked closely with Freidrich Kaulbach and Karl Schorn.[1] In 1853, shortly after his twenty-fifth birthday, Baumgras immigrated to the United States, settling in Syracuse, New York.

Peter Baumgras’ career as an artist launched shortly after his marriage to Mary Thomson in 1856, when the couple decided to move to Washington, D.C. Shortly after the onset of the Civil War, Baumgras enlisted in the Union Army, where he initially served as a surgical draftsman, then went on to assume the position of Assistant Professor of Drawing at the United States Naval Academy.[2] His involvement in several social clubs connected Braumgras with the most important members of Washington’s art world; he was invited to join the Literary Society of Washington and the Society of Washington Artists, and in 1859 was asked to exhibit at the Washington Art Association. The level of skill and magnificent coloring demonstrated in his still life paintings garnered the attention of the faculty at both the Columbian College (now George Washington University) and Gallaudet University, resulting in brief tenures at each institution as the resident Professor of Art.

Baumgras spent a short time in California during the early 1870s, which distinctly impacted his artistic style; Yosemite Valley (1879), his largest landscape painting, and Bighorn Sheep (1875) depict western landscapes infused with brightened colors and light. In 1877, Baumgras revisited Washington, D.C., where he once again participated in the growing art scene by contributing to the creation of the Washington Arts Club, which was founded with the intent to cultivate the fine arts and promote social interaction among its members.[3]

In 1877, Baumgras relocated permanently to Chicago, where he remained active for several years. As a faculty member at the University of Illinois he taught drawing until 1879. He also enjoyed success at the Chicago Interstate Industrial Exposition, were his works were exhibited in 1885 and 1887.[4] Upon his return to Washington in 1900, Baumgras submitted himself to be considered for a curatorial position at the Corcoran Gallery of Art, and justified his qualification by his wide range of experience and interaction with the “history of art and the leading artists of the past half-century of this country and art abroad.”[5]

The final years of Peter Baumgras’ life were spent in Chicago, where he passed away in 1904.

II. Chronology

1827 Born January 4 in Hamburg, Bavaria, Germany
1844–46 Studies at Düsseldorf Academy
1847–52 Studies at Munich Royal Academy, under Freidrich Kaulbach and Karl Schorn
1853 Immigrates to Syracuse, NY
1856 Marries Mary Thompson
1857 Moves to Washington, DC
Serves as surgical draftsman of Union Army
Assistant Professor of Drawing at US Naval Academy
Professor of Art at Columbian University (now George Washington University) and at Gallaudet University
1871–75 Travels to California, where he is employed as an artist by Louis Agassiz
1877 Founding member of The Washington Art Club and serves on the Executive Board
1877 Settles in Chicago, Illinois
Hired as Professor of Art at University of Illinois
1900 Applies for the Curatorship of the Corcoran Gallery
1904 Passes away in Chicago

III. Collections

Gallaudet University, Washington, D.C.
George Washington University, Washington, D.C.
Lincoln Museum at Ford's Theater, Washington, D.C.
McLellan Lincoln Collection of Brown University, RI
New Haven Colony Historical Society, CT
New-York Historical Society, NY
Oakland Museum, CA

VI. Exhibitions

1859–60 Washington Art Association
1868 National Academy of Design
1872, 1877 San Francisco
1897, 1898, 1900 Art Institute of Chicago
1898 Boston Art Club
1983 National Museum of American Art

V. Memberships

1877 Washington Art Club (founding member)
1901–1903 Society of Washington Artists
The Literary Society of Washington

VI. Suggested Resources

Cosentino, Andrew. The Capitol Image: Painters In Washington 1800-1915. Washington, D.C.: Smithsonian Institution Press, 1983.
Pratt, Waldo S. A Forgotten American Portrait Painter: Peter Baumgras 1827–1904. Hartford, Connecticut: Privately printed, 1937.

VII. Notes

1. Peter Falk, Who Was Who in American Art: Artists Active between 1898 and 1947 (Madison, CT: Sound View Press, 1999), 239.
2. Andrew Cosentino, The Capitol Image: Painters In Washington 1800-1915 (Washington, D.C.: Smithsonian Institution Press, 1983), 252.
3. Art Life In Washington: Records of the Columbia Historical Society, Washington, D.C. vol. 24 (Washington, D.C.: Historical Society of Washington, D.C., 1992), 174. March 26, 2012. http://www.jstor.org/stable/40067164
4. Kirsten M. Jensen, The American Salon: The Art Gallery at the Chicago Interstate Industrial Exposition, 1873–1890 (New York: City University of New York, 2007), 442.
5. Cosentino, 92.

IMAGE: Baumgras completed this watercolor while Tucker's wound was healing

FROM: questroyalfineart.com

Learn more about Civil War medical illustrators and artists at www.CivilWarRx.com.

Horse Doctors Way Back When

By Tanya Hanson, September 15, 2010

Last week something fun and wonderful happened to me, way sooner than I expected it to. The release of Redeeming Daisy, the second inspirational novella about the Martin family of Hearts Crossing Ranch. So soon on the heels of Marrying Mattie, my sensual Western Historical released two weeks ago, I found myself not only in Seventh Heaven but also realizing that both heroes, some 130 years apart,  are horse doctors. So I reckoned a trip down Vet History Lane was a good topic for today. And anybody who comments gets in a name-draw for a pdf. copy of Redeeming Daisy.

Okay. Long ago, the caretakers of the horses of the ancient Roman army were called veterinarii. The term itself derives from the Latin root for beast of burden.  The first veterinary school was founded in Lyon, France, in 1762.

But in colonial America, words like veterinarian, horse doctor, or even animal doctor weren’t part of the vocabulary. (In fact, fifty years ago or so, vet care for house pets was often considered frivolous.) For the colonists, animal disease was surrounded by mystery, superstition and ignorance—pretty much the same as for human ailments. Simple cures were largely unknown, because even physicians had little information on bacteria and anatomy.  Often a sick horse was tended by a herdsman or farrier (blacksmith) with roots, herbs, and often witchcraft.  The prevailing and unfortunate creed was—the more it hurt, the better it must heal. This mentally just breaks my heart.

By the early 1800’s, professional veterinarians, most of them graduates of the  London Veterinary College founded in 1791, began migrating to America’s cities. Without suitable veterinary schools here, young men apprenticed with these professionals and went on to become animal doctors. There were also medical doctors who used their knowledge of humans to treat animals, and other doctors who served both “man and beast.”
                                                                                         
On the frontier, most horse doctors were self-taught, like Call Hackett in Marrying Mattie. He has studied science at university level and extensively educates himself by reading treatises by such animal scientists as William Youatt. He performs necropsies when he can in a little lab he has set up in a shed on his land. Pike Martin in Redeeming Daisy is, of course, a fully accredited twenty-first century large animal vet.
                                                                       
Back in the 1800’s, books and pamphlets on horse medicine helped spread knowledge. The first surgical anesthesia upon a horse was performed in London in 1847 and helped advance animal surgery in America. Prior, surgical techniques were rarely attempted on horses: forcible restraint and terrible anguish were just not pleasant for anybody, especially the animal.  I get chills just imagining such torture on a senient creature who has no intellectual concept of  “Hey, big horsie. This is gonna hurt like a son of a gun, but it’s downright good for you.”

Dr. Isaiah Michener of Pennsylvania, whose education credentials are unknown, started a practice in 1836 and contributed many articles to Philadelphia periodicals and country newspapers. His criticism of the funds spent “to build theatres, railroads and canals” while the ravages of livestock diseases were neglected began to spread. Hence, the first veterinary association was launched in Philadelphia in 1854.

The development of veterinary schools soon followed. New York College of Veterinary Surgeons, chartered in 1857 at New York University is generally claimed to be the first veterinary college established in America. Prompted by funding from the 1862 Morrill Land Grant Act as well as concerns over post-Civil War animal disease epidemics,   Iowa State College (now University)   offered  its first animal science  class in 1872 and officially founded its veterinary school in 1879.  

By the late 19th century, a collective of institutions, agricultural organizations, and scientific periodicals united veterinarians in a common cause.  The U.S. Veterinary Medical Association was founded in 1863, later renamed American Veterinary Medical association in 1898.

One fun fact:  In 1912, Chandler, Arizona was established by and named for Dr. A.J. Chandler, a veterinarian who graduated with honors in 1882 from Montreal Veterinary College at McGill University. He left a successful practice in Detroit to come to Arizona in 1887 to set health standards for the growing cattle industry. Creating a network of canals and electric pumps to draw ground water, he transformed his ranch into a green empire in an arid land. He was able to raise enough grain and alfalfa on 300 acres to feed 2,000 head of cattle and several hundred sheep.

Dr. M. Phyllis Lose, VMD, graduated from the University of Pennsylvania Veterinary School in 1957, the first female equine vet, or horse doctor, in the United States.

FROM: petticoatsandpistols.com

Annabell (Vorse) Clark: Until the Last Man

By Sidney Dreese

During the Civil War the sick or wounded soldier who found himself in the hospital thought of it as home. The presence of female nurses made the soldiers feel better, and brought memories of mothers, sisters, and wives. The soldiers were appreciative of the kindness and care they received, and one such soldier was John B. Nicholson.

Nicholson, the young lawyer, enlisted in 1862, at Menomonee, Wisconsin, and at the end of the year had been promoted to corporal. He was assigned to Company I, First Cavalry Wisconsin Volunteers. During the Franklin and Nashville Campaign, GEN John Bell Hood, C.S.A. advanced into Tennessee, and at the Battle of Pulaski John Nicholson was wounded in 1864. A minnie ball had passed through the joint of his left shoulder and splintered the humerus bone. To receive care, he was taken to General Hospital No. 3 at Nashville, Tennessee. Through surgery his shoulder was resectioned, and he suffered with much pain and agony. Due to his wound he was in the Nashville hospital for three months, and was then transferred to a General Hospital in Milwaukee, Wisconsin, for further recovery. However, he was unable to return to service since his arm was totally disabled and was honorably discharged.

While being treated in the hospital at Nashville, he was cared for by two nurses from Lewisburg, Pennsylvania, Lida Houghton and Annabelle, “Bell,” Vorse. Nicholson wrote a letter in 1869, sent it to Lewisburg, and asked the Postmaster to forward the letter to either of the women. Vorse received it and the letter read as follows:

LADIES:-
Years have passed since I was the recipient of that kindness and attention to which I owe my life, and I presume that among the hundreds who received the same care at your hands, I have passed out of your memory. But could the scars which I bear and the remembrance of the horrid agony which I endured in the hospital and the long weary weeks of fearful anguish I passed without leaving my cot, could, I say, all this be forgotten the memory of (as it seemed to me then) your almost sainted forms as you went among the long rows of sick and wounded soldiers breathing words of cheer and comfort to the living or shedding tears over the dead and dying, and the touch of your hand on my brow when it was covered with drops wrung from me by pain almost insupportable, together with numberless acts of kindness which only a true woman can bestow. The vivid recollection of this, I repeat, must and ever will be cherished by me with as much sacredness and devout reverence as the Mohammedam has for the Prophet’s tomb. I am not weak or vain enough, however, to suppose that you still have an interest in my existence or welfare, but I have in yours, and I would much like to know what paths of life you are treading since the “clash of resounding arms: has passed away. High, honorable and noble I know that must be, for you are incapable of any other and I write hoping that should this ever reach either of you that perhaps you would not consider too much to render still heavier the weight of obligation under which I shall ever rest to you by replying. Should you so highly favor me please address Sussex, Waukesha County, Wisconsin.
The world has dealt kindly with me. I am blessed with health, strength and a fair amount of this world’s goods. My wound has thoroughly healed and my arm has almost its normal strength though it is four inches short than the other, but I fear I am wearying you.
Respectfully yours,
J. B. Nicholson

It is unknown whether Vorse replied to Nicholson, but he died in 1870 several months after writing the letter.

Bell Vorse was employed as a nurse and was attached in the summer of 1864, to the United States General Hospital No. 3 at Nashville, Tennessee. She served for about a year and was released at Nashville in the spring of 1865, and returned to Lewisburg. Many years later in 1892, she applied for a nurse’s pension due to her age and rheumatism in her hands and general debility. She received a pension of $12 per month.

Four years after the war in the spring of 1869, Bell married Dennis Clark, a successful dry goods merchant. He operated a store in Unionville, New York, and they resided in Minisink. She returned to Lewisburg after Dennis died in the summer of 1893, and then lived with her brother, Ogden.

Bell was born in 1834. Her father was a physician, and Dr. Isaac and Elizabeth Vorse lived on the corner of Market and Fourth Streets, Lewisburg, Pennsylvania. She died on September 13, 1916, and her obituary states: “The services of the deceased as a nurse during the Civil War were of exceptional fine character, so much that she was frequently highly complimented by the surgeons and others, especially by the “boys” who received treatment from her loyal and loving hands. To this may be added the fact that she was a recipient of a number of handsome medals and badges in recognition of her worth and splendid services. As a token of their regard for her, the membership of the Grand Army of Lewisburg attended her funeral in a body and accorded her a soldier’s burial including the impressive “taps”.

Nursing was hard work, and nurses cared for the sick, wounded, and dying. They also labored to provide healthy, sanitary conditions, and to keep hospitals orderly. Bell Vorse accepted the responsibilities of being a nurse, and performed the necessary required duties. Her legacy is that she indeed touched the lives of many suffering soldiers with her kindness and comfort.

FROM: sidneygarthdreese.wordpress.com

Monday, November 16, 2015

Prostitution in Civil War Nashville

By Greg Segroves, 4-3-13
 
Trivia question. What city in the United States was the first to legalize prostitution? If you answered Las Vegas Nevada you are wrong. It was Nashville Tennessee in 1863. There are many things that can reduce the effectiveness of an Army in wartime. The use of alcohol, drugs, and sexually transmitted disease. That is in any era. More soldiers died from disease in the Civil War than died from bullets. Besides sexually transmitted disease men died from poor hygiene. The poor placement of latrines near a camp. Surgeons using dirty hands while treating wounds. Because of the Civil War medical officials began to realize that disease could be prevented by changing unhealthy practices and educating troops. This ratio of deaths from disease as opposed to combat wounds changed in World War 1. In every war since more men have died from combat wounds than disease. There were 750,000 deaths from both causes in the Civil War.

In 1860 there were 207 prostitutes living in Nashville. The largest brothel housed 17 women and it was located on the river front near lower Broad & 1st Ave, or as it was called then, Front St. The average house had anywhere from one to three women. In 1860 Nashville had a population of 17,000. Five thousand of these were free blacks and slaves. When the war broke out thousands of Confederate troops passed through Nashville and then the city fell to Union Forces on 25-Feb-1862. There were as many as 100,000 troops in and around Nashville at various times. Washington D.C. and Nashville had the biggest problem with prostitution because Washington was the headquarters for the eastern armies and Nashville was the headquarters for the western armies.

There was a four block area from present day 1st Ave. to 4th Ave. called "Smoky Row" which was the "red light district". The term hooker was in use before the war but it was popularized in relation to General Joseph Hooker who had a reputation for hanging out with loose women. Nashville actually acquired the nickname as the "city of 10,000 whores' but the actual number was estimated at 1,500. The rise of sexually transmitted disease became so bad that the army's chief medical officer rounded up as many prostitutes as he could find and put them on a new steamboat called the "Idahoe". He sent them to Louisville and that city refused to take them. Then they eventually traveled to Cincinnatti where they also were not wanted. In the meantime these women trashed the steamboat. The steamboat Captain gave up and returned To Nashville. They found that the black prostitutes were picking up the slack for the missing white prostitutes. After this failed attempt a notice was issued to the prostitutes that they had until 20-Aug-1863 to be medically examined by a Army surgeon and after paying a 5.00 dollar fee they would be issued a permit to ply their trade. The new ordinance stated that they must be re-examined every 10 to 14 days. By April 30th 1864, 352 women had been licensed. Thanks to legalization only 30 of the first 999 soldiers to contract a sexually transmitted disease contracted it in Nashville.

Syphilis before the discovery of penicillin was the 19th century's version of AID's. They treated it with salts of mercury. Mercury is extremely toxic. This treatment led to the saying that "a night with Venus means a lifetime with Mercury". There were 23 military hospital's in Nashville during the war. One hospital was for soldiers suffering from STD's. One was for white prostitutes, and one was for black prostitutes. The first picture is of an era prostitute. The second is the permit issued to a Nashville prostitute and the third is believed to be the wartime hospital for white prostitutes on Second ave. near Jo Johnston . Because of the success achieved at Nashville Memphis became the second city to legalize prostitution.

From: gregsegroves.blogspot.com


Division and Corps Hospitals

From: rochestergeneral.org

The Medical Director of the Army of the Potomac, Dr. Jonathan Letterman, organized the Army into a system of Divisional hospitals in October 1862. This system of organization and management eventually spread throughout the Federal Army.

Commanded by one medical officer rather than a line officer, it consisted of four operating teams of three surgeons each and numerous medical attendants and support staff. Each hospital carried sufficient medical supplies to house and care for a typical division of 7,000-8,000 personnel. Division surgeons performed more thorough examinations and treatment of wounds and emergency surgeries. A large portion of surgeries were postponed until reaching the much larger Depot evacuation hospitals.

At the end of the day’s campaigning, each division hospital set up what was referred to as a “Ambulance hospital” that treated minor wounds and common illness’ such as sunstroke and diarrhea. Division hospitals were organized into centrally located Corps Hospitals consisting of three to four divisions.

Image 1: The Field Hospital of the 3rd Division, 2nd Corps, Army of the Potomac at Brandy Station Virginia.

Image 2:  The Field Hospital at Savage Station, Va. After the battle on June 27, 1862

Civil War Uniforms

By John Heiser, Gettysburg National Military Park

The soldier of 1863 wore a wool uniform, a belt set that included a cartridge box, cap box, bayonet and scabbard, a haversack for rations, a canteen, and a blanket roll or knapsack which contained a wool blanket, a shelter half and perhaps a rubber blanket or poncho. Inside was a change of socks, writing paper, stamps and envelopes, ink and pen, razor, toothbrush, comb and other personal items. The amount of baggage each soldier carried differed from man to man.

The southern soldier was highly regarded for traveling with a very light load basically because he did not have the extra items available to him that the northern soldier had. Southern uniforms were quite different from the northern uniforms, consisting of a short-waisted jacket and trousers made of “jean” cloth — a blend of wool and cotton threads which was very durable. Dyed by different methods, the uniforms were a variation of greys and browns. Northern soldiers called Confederates “butternuts” because of the tan-grey color of the uniforms. Vests were also worn and were often made of jean material as well. Shirts and undergarments were universally of cotton material and often sent to the soldiers from home. Southern-made shoes were of very poor quality and difficult to obtain. Union uniforms were universally of better quality because of numerous mills throughout the north that could manufacture wool cloth and the steady import of material from Europe.

The Union soldier’s blouse and trousers were wool and dyed a dark blue until 1862 when the trouser color was altered to a lighter shade of blue. The floppy-crowned forage cap, made of wool broadcloth with a leather visor, was either loved or loathed, but universally worn by most soldiers in the Army of the Potomac. Each soldier would adorn his cap with brass letters of the regiment and company to which he belonged. Beginning in 1863, corps badges were designed for the different army corps and these were universally adopted for the top of the cap. Like their Confederate counterparts, most Union soldiers disdained the itchy wool flannel army shirt for cotton shirts and undergarments sent from home.

The color of the trim on a soldier’s blue uniform told you what type of soldier he was. The infantry wore light blue trim, cavalry uniforms used yellow, and the artillery wore red. Both Union and Confederate armies used this convention. Confederate Army officers wore different colored facing on their jackets, Union soldiers wore stripes on their pants, and even some Confederate officers’ hats were these colors.

Image: This magazine illustration shows the variety of uniforms worn by Confederate soldiers. Published Aug. 17, 1861, Harper’s Weekly

From: learnnc.org

Soldiers' Food

By John Heiser, Gettysburg National Military Park

By far, the food soldiers received has been the source of more stories than any other aspect of army life. The Union soldier received a variety of edibles. The food issue, or ration, was usually meant to last three days while on active campaign and was based on the general staples of meat and bread. Meat usually came in the form of salted pork or, on rare occasions, fresh beef. Rations of pork or beef were boiled, broiled or fried over open campfires.

Army bread was a flour biscuit called hardtack, re-named “tooth-dullers,” “worm castles,” and “sheet iron crackers” by the soldiers who ate them. Hardtack could be eaten plain though most men preferred to toast them over a fire, crumble them into soups, or crumble and fry them with their pork and bacon fat in a dish called skillygalee.

Hardtack, a dry flour biscuit, made up a large portion of a soldier’s daily ration. Factories in the North baked hundreds of hardtack crackers every day, packed them in wooden crates and shipped them out by wagon or rail. If the hardtack was received soon after leaving the factory, it could be tasty and satisfying. Usually, the hardtack did not get to the soldiers until months after it had been made. By that time, they were too hard to be eaten without first being soaked in water or coffee. Sometimes they were infested with small bugs the soldiers called weevils.

Other food items included rice, peas, beans, dried fruit, potatoes, molasses, vinegar, and salt. Baked beans were a northern favorite when the time could be taken to prepare them and a cooking pot with a lid could be obtained. Coffee was a most desirable staple and some soldiers considered the issue of coffee and accompanying sugar more important than anything else. Coffee beans were distributed green so it was up to the soldiers to roast and grind them. The task for this most desirable of beverages was worth every second as former soldier John Billings recalled: “What a Godsend it seemed to us at times! How often after being completely jaded by a night march… have I had a wash, if there was water to be had, made and drunk my pint or so of coffee and felt as fresh and invigorated as if just arisen from a night’s sound sleep!”

Soldiers often grouped themselves into a “mess” to combine and share rations, often with one soldier selected as cook or split duty between he and another man. But while on active campaign, rations were usually prepared by each man to the individual’s taste. It was considered important for the men to cook the meat ration as soon as it was issued, for it could be eaten cold if activity prevented cook fires. A common campaign dinner was salted pork sliced over hardtack with coffee boiled in tin cups that each man carried.

The southern soldier’s diet was considerably different from his northern counterpart and usually in much less quantity. The average Confederate subsisted on bacon, cornmeal, molasses, peas, tobacco, vegetables and rice. They also received a coffee substitute which was not as desirable as the real coffee northerners had. Trades of tobacco for coffee were quite common throughout the war when fighting was not underway. Other items for trade or barter included newspapers, sewing needles, buttons, and currency.

From: learnnc.org

Enduring Amputation

From: learnnc.org

Walter Waightstill Lenoir to Thomas Lenoir, April 8, 1863, in the Lenoir Family Papers, Southern Historical Collection, University of North Carolina at Chapel Hill.

Dear Thomas

My leg is finished at last, and I have been using it for over a week. It is, I suppose, as good as they make ‘em,’ but it is a wretched substitute for the one that I left in Virginia. It will take me a good while to become enough accustomed to it to know how it will do, as the skin and flesh where the weight is received will have to become hardened by degrees. At present I can’t walk near as well with it as I could with the one Rufus made me; but as I learned that others had the same difficulty at first in using such legs I will not get out of heart yet. I will have to make up my mind however to take very little exercise and to do very little work, which goes hard when I think how much I ought to do. I am greatly pleased to find that I can ride with ease, though I will have to have a gentle and sure footed horse to ride in safety. I can sit, too, much more comfortably with the new leg than I could with the old one.

Your Brother
WW Lenoir

Civil War Army Hospitals

From: learnnc.org

Nearly 200,000 men lost their lives from enemy fire during the four years of the war. However, more than 400,000 soldiers were killed by an enemy that took no side — disease.

From our modern perspective, medicine during the Civil War seems primitive. Doctors received limited medical education. Most surgeons lacked familiarity with gunshot wounds. The newly-developed minie ball produced grisly wounds that were difficult to treat. The Northern and Southern medical departments were ill-prepared for removing wounded men from the battlefield and transporting them to hospitals. Systems to provide hospital care for the sick and wounded had not been developed. Blood typing, X-rays, antibiotics, and modern medical tests and procedures were nonexistent.

Open latrines, decomposing food, and unclean water were the rule in the camps. Diarrheal diseases affected nearly every soldier and killed hundreds of thousands of men. Although surgeons used ether and chloroform routinely as anesthetics, surgery was performed with unwashed hands and unclean instruments, resulting in infected wounds. The most effective drugs were the pain-killers opium and morphine, while many of the other available drugs were useless or harmful. Despite these limitations, Civil War doctors achieved some remarkable successes in treating the wounded and comforting the sick.

Popular but generally incorrect images of Civil War medicine involve surgery-amputations without anesthesia, piles of arms and legs, the surgeon as a butcher. By modern standards, wartime surgery was limited. Despite the lack of both surgical experience and sanitary conditions, the survival rate among those who underwent the knife was better than in previous wars. Amputation was not the only surgical recourse available. Surgeons also extracted bullets, operated on fractured skulls, reconstructed damaged facial structures, and removed sections of broken bones.

As bullets hit their victims, shattered bone and shredded flesh became the calling cards of the minie ball. Most of the surgeons who had come from civilian practices had little or no experience in dealing with such wounds. They quickly became aware of the surgical options: remove the limb, remove the fractured portions of bone, or clean the wound and apply a dressing. Union surgeons documented nearly 250,000 wounds from bullets, shrapnel, and other missiles. Fewer than 1,000 cases of wounds from sabers and bayonets were reported.

Walt Whitman describes a battlefield hospital:

FALMOUNT, VA., opposite Fredericksburgh, December 21, 1862. — Begin my visits among the camp hospitals in the army of the Potomac. Spend a good part of the day in a large brick mansion on the banks of the Rappahannock, used as a hospital since the battle — seems to have receiv’d only the worst cases. Out doors, at the foot of a tree, within ten yards of the front of the house, I notice a heap of amputated feet, legs, arms, hands, &c., a full load for a one-horse cart. Several dead bodies lie near, each cover’d with its brown woolen blanket. In the door-yard, towards the river, are fresh graves, mostly of officers, their names on pieces of barrel-staves or broken boards, stuck in the dirt. (Most of these bodies were subsequently taken up and transported north to their friends.) The large mansion is quite crowded upstairs and down, everything impromptu, no system, all bad enough, but I have no doubt the best that can be done; all the wounds pretty bad, some frightful, the men in their old clothes, unclean and bloody. Some of the wounded are rebel soldiers and officers, prisoners. One, a Mississippian, a captain, hit badly in leg, I talk’d with some time; he ask’d me for papers, which I gave him. (I saw him three months afterward in Washington, with his leg amputated, doing well.) I went through the rooms, downstairs and up. Some of the men were dying. I had nothing to give at that visit, but wrote a few letters to folks home, mothers, &c. Also talk’d to three or four, who seem’d most susceptible to it, and needing it.
— Walt Whitman, Specimen Days

Image: Nurses and officers of the U.S. Sanitary Commission pose under a tree in Fredericksburg, Virginia. Photograph by James Gardner, May 1864.

Annabelle Vorse Clark, Civil War Nurse

From: news.mifflinburgtelegraph.com

    The last of the nurses from Union County, Pa. found in Linda E. Snook’s book is Annabelle Vorse Clark. She was born in Lewisburg  in 1834 to Dr. Isaac Vorse and Elizabeth Reber. She attended the Institute at Lewisburg as did most of the other ladies who served from Union County in the Civil War.  She is listed there in 1856. She volunteered her service in July 1864 according to her first muster roll. She is listed as present in the U.S. General Hospital No. 3 at Nashville, Tenn. She served in this hospital until the end of the war and until all of the men were healed or sent home. She was serving in Tennessee when she was mustered out of service according to the Muster Rolls.

    Annabella met her future husband, Dennis Clark, while serving in the hospitals in Tennessee. He became a widower in 1867 and she married him in 1869 in Lewisburg. They moved to his home in Minisink, N.Y. and her mother went along. In the 1870 Census he was a wealthy farmer. Annabella raised his two children to his first wife but had none of her own. Dennis Clark died Aug. 24, 1893 and is buried in Minisink, N.Y. After he died, she returned to Lewisburg and lived there until she died Sept. 13, 1916. She was 82 years of age.

    She was one of the few nurses who received a pension for her service during the Civil War of $12 a month. The Grand Army of the Republic attended her funeral and played “Taps” which was a great honor for a Civil War nurse. The Daughters of Union Veterans at Mifflinburg has a tent named the Annabella Vorse Clark tent in recognition of her service.

History of Veterinary Medicine in Pennsylvania

From: en.wikipedia.org

Early Veterinarians in Pennsylvania
By the early 19th century, graduate veterinarians (most from London) had started to infiltrate the American cities; many of these became prominent practitioners. With the absence of veterinary schools, young men served an apprenticeship under the best of these English Veterinarians, and went on to become practitioners themselves. There were graduate medical doctors that used their knowledge to treat animals and there were some who treated “man and beast”. Most of the practitioners in the outlying areas were self-taught or not taught at all. When the process of printing became available, books on horse medicine made some contribution to the knowledge of the practitioners. In 1735, Ben Franklin advertised the reprinting of Gentleman's Pocket Ferrier which described "how to use your horse on a journey and what remedies are proper for common misfortunes that may beset him on the road."

The following quote was taken from the preface of the American Ferrier by Augustus Franklin, printed in Strasburg in 1803.

"Few subjects in the common affairs of life relating to property more immediately connects itself with the interest of individuals than an efficient knowledge of a number of means to repel such a variety of diseases as are incident to horses; and, yet, few there are who have made themselves acquainted with them, not withstanding their repeated losses, to the great injury of their circumstances – in many instances – and their excruciating suffering in their poor beasts."

This sentence and the next from the same book: "Where any surgical or medical operation is necessary for your beast, I would recommend the most mild course of it."

Individuals were pressing for scientific veterinary knowledge. The memoirs of the Philadelphia Agricultural Society, published for the first thirty years of the 19th century, contained many articles on animal diseases. Richard Peters (1770–1848), was largely responsible for this trend toward veterinary medicine at the Society meetings. He was president of the Society in 1805 and was a dominant figure promoting his pet project for many years. Peters repeatedly stressed the need for veterinary school because he realized the caliber of self-styled animal doctors. He knew that the only solution to the animal disease problem was the establishment of schools to train veterinarians.

In 1806, the Philadelphia Society offered a gold medal for “the best essay and plan for promoting veterinary knowledge.” In reply to the offer, Dr. Benjamin Rush (1746–1813), introduced a series of lectures to his medical students at the University of Pennsylvania, on Studying Diseases of Domestic Animals.

Peters and Rush were the great benefactors of veterinary medicine, then their friend, Dr. James Mease, was an early investigator of disease outbreaks. In 1793, he recognized rabies as being caused by the bite of a mad dog. In his appeal for improving veterinary medicine, Mease made this statement to the Philadelphia Agricultural Society on November 3, 1813: “The veterinary art is a practical application of scientific principles, to the preservation of the health of domestic animals, and to the cure of their diseases, in the same manner as the art of medicine applies to the health and preservation of man; and the science in which this art is grounded, and which it requires for its perfect exercise, comprise the natural history, anatomy, physiology, and pathology of those animals, together with such portions of the vegetable or mineral kingdoms as are connected with them, either in the way of ailment or remedy.”

One of Pennsylvania’s most well known veterinarians was Dr. Isaiah Michener. It is unknown how he learned veterinary medicine but he started his practice in 1836. he contributed articles to the Philadelphia and country newspapers under column titles, The Veterinarian and The Observer. He wrote: “Companies have been formed, funds obtained almost everywhere to build a theatre, construct a railroad or dig a canal … but the paramount interest of every agriculturist, the preservation of his livestock from the ravages of disease, is almost totally neglected. When will the farmer study his own business?”

Development of the Profession
By the mid-1800s, Philadelphia and other large cities of Pennsylvania had veterinarians who were scientists and practiced medicine based on the knowledge available from wizards in that area. But the vast majority of practitioners throughout the valleys of the state were inexpert and uneducated. It was decades before trained people filtered in. it would take close to a century for the graduate veterinarians to live down some of the unprofessional habits of their predecessors. It can only be said that a few were self-educated and experienced. It has been written that the armies of Europe were aware of the value of veterinary care as early as the 3rd century, but it took the United States Army until the Civil War to reach that conclusion. It was not until 1835 that the word “veterinarian” even appeared in an Army Regulation. That regulation required inspectors to see that “veterinarians perform their duties.” It took more than one hundred years after the formation of the first Regiment of Light Dragoons to really identify a “blacksmith” and a “Ferrier”. The blacksmith was held in such little regard by the Continental Congress that the Congress would not allows civilians hired by the Quartermaster to have their horses shod at government expense. “A little neglect may breed mischief: for want of a nail the shoe was lost; for want of a shoe the horse was lost; and for want of a horse the rider was lost.”- Benjamin Franklin, 1757.

Horses continued to play a greater role in the U.S. Army. Finally, one hundred and three years after the first regiment of dragoons, the following paragraph appeared in General Orders Number 36, 1879: “Hereafter appointments as veterinary surgeons will be confined to the graduates of established and reputable veterinary medicine schools and colleges.”

A charter was obtained from the Pennsylvania Legislature for the Veterinary College of Philadelphia. This was the first charter of its kind issued in the United States, but the school never graduated a student and subsequently lost any claim to being the first veterinary school. That honor has been singularly given to the New York College of Veterinary Surgeons, chartered in 1857 at New York University. The non-graduates were highly independent and unorganized, but the graduate veterinarians had the advantage of unity of purpose. Their leaders from Philadelphia and New York has met in 1863 to organize the United States Veterinary Medical Association. A few graduates in the Philadelphia area formed the Keystone Veterinary Medical Association, the first organized veterinary group in Pennsylvania, in 1882. Later, on August 22, 1883 a group of veterinarians joined to form the Pennsylvania Veterinary Medical Association. Twenty two veterinarians assembled to hear about the continuing education and legislative activities of veterinary conventions in other states and to consider formation of an association to conduct similar work in Pennsylvania. This was not the first time that Pennsylvania veterinarians had tried to organize. The very first veterinary association was launched in Philadelphia on May 7, 1854, by Robert Jennings. Perhaps the most successful of the PVMA’s educational programs is the Mid-Atlantic States Veterinary Clinic, a one-day session of “wet” demonstrations, started in York, Pennsylvania, in 1962. Alternating annually between the York Interstate Fair Grounds in Timonium, where the clinic is sponsored by the Maryland Veterinary Medical Association, the program attracts more than 400 practitioners from at least seven states.

The need for a Veterinary college in Pennsylvania was another of the issues taken up by the PVMA in its first year of existence. There were only about three hundred graduate veterinarians in the United States 1883. The importance of strong local, state and national veterinary associations was emphasized by Dr. Hoskins in a paper presented at the keystone meeting on October 11, 1892:

“The many sudden and broad changes that have characterized the doings in the world of veterinary science during the past year seem to demand at our hands stronger consideration, stronger work. It affords us an incentive that will bring to us the end of our work a rich return, when we have properly considered and disposed of the great questions that are knocking at our doors for aid in their final dispositions. It also points strongly to the need of stronger veterinary organizations. The national one must soon tend in directions and lines that will lift it entirely from the consideration of those topics which are more or less local in character…”

The keystone has the distinction of being the first veterinary association in the country to urge “a single standard of examinations in veterinary medicine.” A national board was established but it was 1955 before a standard national examination was offered. The national board of veterinary medical examiners was organized by the AVMA in 1950 with its primary objective to “elevate the standard of qualification necessary to practice by means of a comprehensive examination to be made available to licensing boards in the various states.”

Thursday, November 12, 2015

Mercury and Water: Two Civil War Surgeons of the 148th Pennsylvania Volunteers

By Marsha J. Hamilton, Professor Emeritus, The Ohio State University

On September 11, 1862, two very different physicians took a Pennsylvania Medical Review Board examination to qualify as army surgeons.  One was Dr. Uriah Q. Davis (1821-1887) of Milroy, the other was Dr. Alfred T. Hamilton (1836-1911) of Lewistown.   By an unusual coincidence, both received a copy of the same examination questions and both eventually served in the 148th Pennsylvania Volunteers.  These two civilian physicians understood the Union’s need for qualified surgeons to serve in the army, yet their approaches to medicine were radically different.  Dr. Davis was a “regular” allopathic doctor and Dr. Hamilton was a “sectarian” hydropathic or water-cure doctor.  This article will discuss some of the challenges faced by the Union Army in mustering sufficient numbers of competent surgeons to serve in regiments during the Civil War and how the recruiting of surgeons was further complicated by the bitter conflict between the regular and sectarian schools of medicine that fought for dominance in mid-nineteenth-century America.  This conflict between medical philosophies also was reflected in the personal conflict between Dr. Davis and Dr. Hamilton during their service in the 148th Pennsylvania Volunteers.

From Civilian Doctor to Military Surgeon
At the outbreak of the Civil War, no one could have predicted how long the conflict would last or the immense casualties that would be sustained by soldiers on the battlefield and in camp.  Yet it quickly became apparent that the U.S. Army Medical Department, which at the outbreak of the war was comprised of fewer than one hundred surgeons and assistant surgeons, was completely unequal to the task.1  Between 1861 and 1865, approximately seven hundred thousand men would lose their lives to wounds and disease.2  As noted in the introduction to the Medical and Surgical History of the Civil War, “A shortage of surgeons was a constant drain on everyone in the armies.  The Union forces had eleven thousand surgeons, which broke down to one medical officer per 133 men…with 2435 reported cases of trauma or sickness for every 1000 soldiers on the Union side, close personal attention to a single ill man was all but out of the question.”3

The increase in Union Army medical personnel from less than one hundred to over eleven thousand surgeons over a four-year period was monumental.  These surgeons were pulled exclusively from the civilian population, because unlike some European countries, the United States had no college for the preparation and training of military medical personnel.  According to the Roster of Regimental Surgeons and Assistant Surgeons in the U.S. Army Medical Department during the Civil War, Pennsylvania alone provided 947 surgeons and assistant surgeons attached to 179 infantry, artillery, and cavalry regiments.4  Ideally, each one thousand-man infantry regiment included one surgeon and two assistant surgeons, although in practice the number varied due to a unit’s ability to attract physicians, leaves of absence, temporary postings to other units, and losses through discharge and resignation.5  The pool of civilian candidates from which these military surgeons was drawn varied greatly in terms of education, experience, and practice of medicine.

The transition from civilian physician to army surgeon was not always a smooth one in terms of temperament, skill, experience, or level of education.  Civilian physicians in mid-nineteenth-century America had limited experience working cooperatively with other doctors unless they had worked in a hospital or poorhouse.  It must have been difficult for many doctors to function within a hierarchy where their roles as army surgeon and assistant surgeon were strictly prescribed and materia medica, the drugs and medications used to treat patients, were limited to items approved by the military. They also had to function, without additional military-specific medical training, within the confines of military discipline and bureaucracy while caring for huge numbers of soldiers suffering from exhaustion and exposure, in addition to battlefield casualties. Many civilian physicians, whose local practices had focused on obstetric cases, home and occupational injuries, and common illnesses were unprepared to deal with epidemic camp diseases and battlefield wounds.  Dr. John H. Brinton noted in his memoirs, “Our experience in the early part of the war taught us…how hard it was for a medical man who had just donned his uniform, to learn the mysteries of obtaining food from the subsistence department, or of stores and transportation from the quartermaster, how to obtain an ambulance, or to find horses, or to procure forage, how even to obtain medicines from the purveyor, and how to take care of them when received, how to draw a hospital tent, how to pitch it, how to keep it standing and comfortable for the sick.”6

Adding to the difficulties, the mid-nineteenth-century American medical community lacked consensus on the knowledge expected of all physicians and specific standards for acceptable practice of therapeutics.  It might be said that American medicine was experiencing its own civil war.

The War Between Regular and Sectarian Medicine
Regular and sectarian philosophies of medicine, based on competing views of the natural state of the human body, the causes of disease, and the therapeutics necessary to regain health, competed for the hearts and pocketbooks of patients in mid-nineteenth-century America.  In a time before germ theory, when there was a limited understanding of the value of sanitation, when bleeding was still practiced, and mercury, arsenic, antimony, strychnine, and opium were popular medicinal ingredients, regular doctors, also called allopaths or drug doctors, held some medical beliefs that dated back to antiquity.  One such belief was that two diseases could not coexist in the body and that self-limited artificial symptoms produced by drugs could displace the original illness.7  Another belief was that illness or disease could be purged from the body by using large quantities of drugs that increased the expulsion of bodily fluids.  A staple of regular allopathic medicine was mercury, often in the form of mercurous chloride, called calomel.  Mercury had been used medicinally since ancient times and was only one of a variety of drugs used to increase bodily secretions in order to purge the patient.

Regular allopathic medicine, also called “heroic” medicine, required a great deal of stamina on the part of the patient.  The often violent physical reactions to the purgatives, emetics, and caustics, the bleeding and blistering in the allopathic arsenal were seen as proof of a treatment’s effectiveness.  A regular allopathic physician accepted the premise that the patient must suffer the effects of his treatment as part of the healing process:  “…in situations where medically valid therapies were unknown, physicians developed a small number of medically invalid therapies—like bloodletting, calomel, and blisters—that produced consistent and demonstrable changes in the patient’s physiological condition.  Most regularly trained physicians used these standardized therapies almost exclusively, even though textbooks on therapeutics contained hundreds of alternatives.  One physician stated in 1849 that for many physicians the lancet, mercury, antimony or opium, are the great guns that they always fire on all occasions…whoever sends for a physician of this sort expects to be bled, blistered or vomited, or submitted to some painful or nauseous medication.”8

Patients who did not wish to subject themselves to these debilitating allopathic treatments had other options.  Sectarian schools of medicine abounded.  These alternative medical schools included homeopathy, several based on plant-derived materia medica including the botanics and Thomsonians, eclectics, and hydropathy.  These sectarian systems all agreed that the regular allopathic staples:  bleeding, blistering, purging, and dosing with mercury, arsenic, and other toxic drugs were to be avoided.  They also placed more trust than allopaths in the basic curative powers of nature, but they agreed on little else.

  In 1860, the census listed by occupation slightly over fifty-five thousand physicians.9   One study has estimated that there was one sectarian physician for every ten allopathic doctors and that nearly twenty percent of medical schools were teaching some form of sectarian therapeutics.10  The percentage of sectarian physicians may have been even higher in areas where sectarian medicine was more favored or sectarian medical schools were located, such as in the Northeast and Midwestern states.

In frontier and rural areas where the sparse population made it impossible for any type of physician to make a living, nineteenth-century Americans might live their entire lives without consulting a doctor of any type.  Midwives, local healers, bone-setters, and helpful neighbors, supplemented by popular self-help medical manuals and mail-order patent medicines, met the needs of many patients in isolated areas or of those who could not afford a visit by a professional physician.  Groups of sectarian medical practitioners rose and fell in popularity throughout the nineteenth century, each appealing to patients from different socio-economic groups or geographic areas; their prevalence based as much on their political or social philosophies as on their therapeutics.

One of the earliest forms of American sectarian medicine was botanic in nature, a successor to the “Indian” cures and traditional English and European herbal remedies transported to the new world in the seventeenth century.  Botanic healers believed that nature provided remedies for disease in the form of herbs, roots, barks, and other natural botanical substances.  It was the job of the explorer and physician to discover these native botanical remedies and their uses.  Both botanic and allopathic physicians believed that it was necessary to increase a patient’s bodily secretions to purge illness.  In practice, the difference between these competing schools could be as minor as whether a purgative or emetic was botanic or mineral in origin.

Building on this tradition of native botanic medicine, the Thomsonian medical sect rose to popularity in the 1830s.  Samuel Thomson (1769-1843), a New Hampshire farmer, developed a medical system based on botanic emetics and stimulants, rejecting all non-botanic drugs.11  The Thomsonian botanical school was unique in restricting its practitioners to a limited list of materia medica, including lobelia, peppers, ginger, and hemlock.  Although opposed to the allopathic practice of bleeding and mineral drugs, Thomsonians erroneously believed that their medicines could cause no harm because they were natural in origin.

The philosophic basis of Thomsonian medicine was that disease was caused by a reduction in body heat.  To regain health, heat must be restored and the body cleansed and invigorated.  These steps could be followed using numbered instructions and a kit of prepared remedies.  First, the stomach was cleansed using the ‘emetic herb” (lobelia or wild tobacco), which caused the patient to vomit.  The patient was then fed capsicum (cayenne powder) to raise the temperature.  The third step was to strengthen the body and provide the stimulation needed to restore the system to equilibrium.  Botanical stimulants typically included myrica (bayberry), nymphaea (pond lily), pinus canadensis (spruce), statica (marsh-rosemary), or rhus glabrum (sumac).12

As the appeal of Thomsonian medicine began to fade, the largest and most prestigious of the alternative medical sects soon replaced it.  Homeopathy, a system developed by the German physician Samuel Hahnemann (1755-1843), was based on the doctrine of “like cures like.”  Homeopaths administered minute quantities of medicines that would, in an otherwise healthy person, produce symptoms similar to those of the patient’s disease.  This was believed to correct the abnormal functioning of the body’s vital force.

Homeopathy spread rapidly following the cholera epidemics of 1848 and 1852.  Cholera patients treated with the highly-diluted homeopathic remedies survived in greater numbers than those treated with the more toxic allopathic drugs.  “It was reported that a great many orthodox practitioners were disappointed with the limited success of their own practices in the face of the cholera outbreak.  This led to what one historian described as a widespread desertion from orthodox ranks.”13  The conversion of allopathic physicians, as well as many patients, to homeopathic medicine following the cholera epidemics was viewed as a real threat to the regular medical profession, greater than any threat posed by the primarily self-educated Thomsonians.  The conversion of trained allopathic physicians to homeopathy was an admission that many educated medical practitioners lacked faith in the effectiveness of allopathic therapeutics.

Despite the increased respectability earned during the cholera outbreaks by homeopathic physicians, homeopathy was vehemently opposed by the allopathic medical community.  This prejudice was noted in a contemporary editorial entitled “A Medical Absurdity” which stated, “There is no stronger tenet in the orthodox creed than that it is better the patient should die under the old remedies than recover under the homeopathic treatment.”14  Another measure of opposition can be seen in the Fiske Award presented by the Rhode Island Medical Society.  The award was created in 1851 for the best published dissertation or essay refuting homeopathy.15

Although homeopathy was the largest of the alternative medical sects, other groups had their share of faithful practitioners and patients.  Eclectics, another medical reform movement, supported a less rigid system in which each physician could use experimentation and personal experience to identify the best course of treatment for a condition or individual patient, choosing from among any of the orthodox or alternative systems of therapeutics.  Eclectics opposed the bleeding, purging, and mercurial treatments of regular physicians, but allowed the use of animal and mineral drugs to supplement the botanic materia medica.

Another nineteenth-century medical sect was hydropathy, based on the healing properties of water, a practice pre-dating Roman times.  Vincent Priessnitz (1799-1851), a Silesian farmer, developed his own system of therapeutics using cold water to combat swelling, inflammation, and fever.  Incorporating the dietary and lifestyle reforms championed by Sylvester Graham (1794-1851), American hydropathic practitioners, also called hygienic or water-cure physicians, believed in the body’s natural ability to heal itself if given an environment of fresh air, healthy—preferably vegetarian—food, mild exercise, non-binding clothing, abstinence from alcohol and tobacco, and frequent baths and applications of cold water.  Hydropaths condemned all drugs, including botanicals, as poison.  Like other sectarian medical systems, they were adamantly opposed to the use of mercury, which ranked third, after opium and morphine, as the medicine most prescribed by allopathic doctors between 1854 and 1887, according to one study.16  Hydropaths held that pure water either internally or externally applied was the only safe and effective medicinal agent.  They believed that regular and botanical physicians were killing their patients with the toxic medicines they prescribed.  Conversely, allopathic physicians considered hydropaths, as well as homeopaths and botanical physicians, to be unscientific quacks.

Despite the mutual hostility between practitioners of these differing schools, each major mid-nineteenth-century medical philosophy was based on a coherent belief system taught by its medical educators in alternative medical schools.   Each had its own medical journals and sincerely believed that it alone held the key to health.  As such, a sharp distinction must be made between sectarian physicians and the quacks and itinerant hucksters who sold “miracle tonics” and secret-formula patent medicines.  Sectarian medical systems were not deliberately fraudulent; they were alternative philosophies of therapeutics based on differing views of health and disease.  All of these sectarian systems agreed on the core elements of anatomy and the technical aspects of surgery.17  Each system could claim successes and point to its opponents’ failures.

In addition to these practitioners schooled in their own sectarian specialties .Like other sectarian medical systems, they were adamantly opposed to the use of mercury, which ranked third, after opium and morphine, as the medicine most prescribed by allopathic doctors between 1854 and 1887, according to one study.16  Hydropaths held that pure water either internally or externally applied was the only safe and effective medicinal agent.  They believed that regular and botanical physicians were killing their patients with the toxic medicines they prescribed.  Conversely, allopathic physicians considered hydropaths, as well as homeopaths and botanical physicians, to be unscientific quacks.
  
Despite the mutual hostility between practitioners of these differing schools, each major mid-nineteenth-century medical philosophy was based on a coherent belief system taught by its medical educators in alternative medical schools.   Each had its own medical journals and sincerely believed that it alone held the key to health.  As such, a sharp distinction must be made between sectarian physicians and the quacks and itinerant hucksters who sold “miracle tonics” and secret-formula patent medicines.  Sectarian medical systems were not deliberately fraudulent; they were alternative philosophies of therapeutics based on differing views of health and disease.  All of these sectarian systems agreed on the core elements of anatomy and the technical aspects of surgery.17  Each system could claim successes and point to its opponents’ failures.

In addition to these practitioners schooled in their own sectarian specialties, there was another group practicing as “physicians,” despite a lack of any formal training or credentials.  In the period prior to the Civil War, the absence of federal and state laws restricting who could practice medicine or prescribe drugs meant that any individual could adopt the title of doctor and simply set up practice.  
This was the diverse pool of civilian physicians from which military surgeons were drawn during the Civil War.  The bitter conflict between allopathic and sectarian physicians would be replayed in the question of who could be considered qualified to serve as a military surgeon.  An equally important question was whether the unregulated system of American medical education could adequately prepare physicians for the medical demands imposed by the war.

Medical Competency and Sectarian Prejudice
Surgeons in the Union army displayed varying levels of competency, attributable not only to individual variation, but also to the mid-nineteenth-century American medical education system which lacked a standardized curriculum and required no examination of competency before the awarding of a medical degree.  Standards for entering medical school and for graduating were low.  For most allopathic and sectarian medical schools, the only criteria for acceptance of students was their ability to pay the tuition; a high school diploma was not a prerequisite at all medical colleges.  One of the main goals of the founders of the American Medical Association (AMA) in 1847 was to standardize and improve the overall quality of medical education in the United States.18  Limited progress was made prior to the Civil War, although the AMA and other groups did lobby state and local governments to prevent homeopathic, hydropathic, and other sectarian medical schools from receiving charters.19  They also worked to bar sectarian medical school graduates from practicing medicine or serving as military surgeons.

The conflict between supporters of regular allopathic medicine and alternative sectarian medicine during much of the nineteenth century was as unrelenting and bitter as the conflict between the states.  The 1847 AMA Code of Ethics prohibited its members from having professional contact with sectarian physicians in any capacity, including consultation on medical cases, stating that, “A regular medical education furnishes the only presumptive evidence of professional ability…”20

The AMA code prohibiting consultation with sectarians, and also with allopathic women physicians, was viewed by some contemporary sources as more of an attempt to protect the allopathic physicians’ own self-interest than to protect their patients.  This was particularly the case for the large number of Americans who consulted homeopathic physicians who had originally trained as allopaths.  The code stated that: “…no one can be considered as a regular practitioner, or a fit associate for consultation, whose practice is based upon an exclusive dogma, to the rejection of the accumulated experience of the profession.”21

This provision, ostensibly created to protect patients from quacks, was enforced without regard to the patient’s health or wishes.  A homeopathic and allopathic physician could not consult on a case, even if the patient requested it.  For an allopathic physician to be brought in, the sectarian physician must first be dismissed, regardless of how dire the illness or the patient’s condition.  Allopathic physicians who violated this exclusivity provision were ostracized socially and professionally, barred from membership in local and national medical associations, and excluded from lucrative consultations.22

The chilling effect the AMA provision had on cooperation or sharing of best practices between physicians of differing schools of medicine can be seen in the preface to Our Family Physician: A Thoroughly Reliable Guide to the Detection and Treatment of all Diseases…Embracing the Allopathic, Homeopathic, Hydropathic, Eclectic and Herbal Modes of Treatment.  The publisher states, “It will be observed that the name of the author is not given.  This is the explanation: He is a graduate of a medical college—a physician in regular standing in a particular school—and would at once lose his standing were it known that he had prescribed any other treatment than that practiced by his particular school...As long as such a spirit of intolerance exists, even among the more intelligent of the profession, our author cannot be blamed for withholding his name, especially as no particularly good end could be gained by its use.”23

From the time of the 1847 AMA Code of Ethics throughout the Civil War, allopathic physicians and their organizations maintained that only a regular medical education, and exclusive use of allopathic therapeutics, qualified a physician to practice.  However, even among regular medical schools, a wide variance existed in terms of admission standards, length of term of study, subjects taught, opportunities for clinical experience, the examination of students’ mastery of the subject matter, and the criteria for graduation.  For example, it was possible to obtain a regular medical degree from some colleges merely by attending lectures and having never dissected a cadaver or examined actual patients in a clinical setting.

This lack of standardized medical education in the United States had a quantifiable result as civilian physicians were sought for the Union Army.  One half of applicants taking the federal-level U.S. Army medical examination in 1860 received a failing grade due to deficiencies in their knowledge of anatomy, pathology, or clinical medicine.24   Concern by those in government over the uneven competency of incoming army surgeons at the federal level led to reviews of requirements for surgeons in the U.S. Medical Department during the early years of the war.  The Medical Department organized rigorous reviews lasting up to four days by an examining board of not less than three medical officers appointed by the U.S. Surgeon General to screen out applicants who lacked the required level of general and medical knowledge.25

This U.S. Medical Department review system did not, however, apply to the vast majority of Civil War surgeons, because they served intherapeutics, qualified a physician to practice.  However, even among regular medical schools, a wide variance existed in terms of admission standards, length of term of study, subjects taught, opportunities for clinical experience, the examination of students’ mastery of the subject matter, and the criteria for graduation.  For example, it was possible to obtain a regular medical degree from some colleges merely by attending lectures and having never dissected a cadaver or examined actual patients in a clinical setting.

This lack of standardized medical education in the United States had a quantifiable result as civilian physicians were sought for the Union Army.  One half of applicants taking the federal-level U.S. Army medical examination in 1860 received a failing grade due to deficiencies in their knowledge of anatomy, pathology, or clinical medicine.24   Concern by those in government over the uneven competency of incoming army surgeons at the federal level led to reviews of requirements for surgeons in the U.S. Medical Department during the early years of the war.  The Medical Department organized rigorous reviews lasting up to four days by an examining board of not less than three medical officers appointed by the U.S. Surgeon General to screen out applicants who lacked the required level of general and medical knowledge.25

This U.S. Medical Department review system did not, however, apply to the vast majority of Civil War surgeons, because they served in volunteer regiments organized by the states, not at the federal level.  Regimental surgeons were examined solely by state medical boards of review.26  These examinations varied by state and might include questions on non-medical topics, such as history, mathematics, or geography, in addition to therapeutics, surgery, and materia medica.27  It was the duty of the state medical boards to test physicians’ basic knowledge, character, and judgment prior to enlistment, although some states’ criteria would be lowered as the need for surgeons increased.28

Even at the federal level, there was pressure to lower standards.  Dr. John H. Brinton, President of the Medical Examining Board in Washington, D.C., supervised the examination of candidates for the position of brigade surgeons, also known as Surgeons of Volunteers.  He recollected, “A great many came before us.  Some were well prepared; some were not.  Quite a number failed to pass, until finally, we were indirectly informed by the Secretary of War, the ‘dreadful Mr. Stanton,’ that he wanted more doctors, ‘and that if we didn’t pass more, our Board would be broken up.’  So under this cogent military reasoning, our standard was lowered, and more surgeons were obtained.  I think our system of examination was not altogether perfect, for after-observation convinced me that many men who passed high in our examination did not prove very efficient military surgeons, while some who did not do so very well before us, proved themselves afterward able and satisfactory officers, professional and otherwise.”29

Brinton’s retrospective observation that success in the medical examination system was not necessarily an accurate predictor of the efficiency of military surgeons in the field is borne out by the example of the surgeons who served in the 148th Pennsylvania Volunteers.  Against this backdrop of conflicting medical philosophies and concerns about the education, qualifications, and competency of incoming army surgeons, Dr. Davis and Dr. Hamilton played out their own personal conflict.

The Surgeons of the 148th Pennsylvania Volunteers, 1862-1865
By the time the 148th Pennsylvania Volunteer infantry regiment was formed in the autumn of 1862, a well-developed examination system for physicians was in place in Pennsylvania to screen out unqualified recruits.  The 148th Pennsylvania Volunteers, part of the 2nd Corps of the Army of the Potomac, was a three-year-enlistment regiment primarily comprised of men from Centre, Clarion, Indiana, and Jefferson counties.  Its colonel was the popular James A. Beaver (1837-1914), later governor of Pennsylvania from 1887 to 1891.  The 148th had four physicians from the time of its formation until being mustered out in June, 1865: Uriah Q. Davis, Calvin P. W. Fisher, Alfred T. Hamilton, and John Wesley Allen.  Davis, Fisher, and Hamilton took the state medical examination given at Harrisburg on September 11, 1862.  Dr. Davis and Dr. Fisher were appointed as the regiment’s two assistant surgeons, but Davis, who was older, more experienced, and scored one point higher than Fisher on the exam, was rapidly promoted to surgeon on December 9, 1862 because the regiment still lacked a surgeon.

Following Davis’ promotion, Dr. Hamilton joined the regiment as the second assistant surgeon, reporting for duty on February 4, 1863.30  Dr. Fisher served only until June 12, 1863 when he was discharged on a surgeon’s certificate of disability for partial blindness caused by amaurosis, a disease of the optic nerve, which had impaired his ability to see well enough to function as a surgeon.31  Following Fisher’s departure, Davis and Hamilton were responsible for the regiment until Dr. Allen joined as assistant surgeon on May 3, 1864.  For eleven months, this regiment, involved in some of the bloodiest battles of the war, was served by two physicians, and at times by only one.

The 148th Pennsylvania Volunteers was involved in over forty skirmishes and battles between 1862 and 1865.  Major actions included Chancellorsville, Gettysburg, Mine Run, the Wilderness, Po River, Spotsylvania, Cold Harbor, the assault on Petersburg, and Deep Bottom.  Of over two thousand Union regiments, the 148th Pennsylvania Volunteers ranked fourteenth in the number of men killed in action.  Out of a total of 1339 members, twelve officers and 198 men were killed in battle or died from wounds.  An additional four officers and 183 men died from disease and accident and sixty-four died in Confederate prisons.  The regiment’s mortality rate of around 30% does not reflect their additional non-fatal casualties from wounds, accident, and disease, which were much higher.32  These figures demonstrate the heavy action seen by the 148th and the burden placed on its surgeons.  In addition to being overworked, Davis and Hamilton shared the disadvantage of disliking each other intensely.  While much of their conflict was due to personality, they were also divided by differences in medical philosophy: Davis was an allopathic physician and Hamilton was a water-cure hydropath.

The Medical Education of Dr. Davis and Dr. Hamilton
Dr. Uriah Q. Davis represented an older generation of allopathic physician.  He was forty-one years old at the time of his enlistment, older than most of the men in the regiment.33  He had trained under the preceptor system, a preparatory method popular throughout the first half of the nineteenth century whereby a young man interested in studying medicine would apprentice with a practicing physician, or preceptor, who provided on-the-job training for a fee.  For many preceptors, this system provided additional income, a source of free labor, and relief from repetitive tasks, such as grinding and preparing medicines.  The better preceptor could provide a student with access to the preceptor’s library of medical books, practical knowledge from his years of practice, and hands-on experience with house calls and minor surgeries.  The quality of medical information taught varied with the type of practice of the preceptor and his own level of knowledge and skill as a physician.  At the end of this preparatory period, the student received a letter of recommendation, then enrolled in medical school.

Mid-nineteenth-century medical schools offered a course of study that lasted anywhere from four to nine months in length.  The curriculum was presented in the form of lecture courses.  The identical course of study was repeated during a second year.  If a college was fortunate enough to be affiliated with a hospital, a student was more likely to obtain some clinical experience, where hospital patients might be examined to illustrate the symptoms of a condition or show the effects of a treatment.  Not all medical students had this opportunity to watch surgeries or work with patients.  Final exams to determine students’ knowledge of medicine were not universally required by medical schools.  After students attended lectures and paid a matriculation fee, they were awarded a medical degree.

This was the system under which Dr. Davis received his medical education.  He first read medicine with Dr. Ludwig of Limestoneville, Pennsylvania, before graduating from the respected University of Pennsylvania medical school in 1848.  Davis practiced as a physician for twelve years prior to the war, first in Lewisburg, then in Milton, Pennsylvania.34  His education and years of experience meant that Dr. Davis had a strong background for an allopathic doctor of this period.  Except for his age, Davis was a desirable applicant for the position of military surgeon.

Dr. Alfred T. Hamilton was twenty-six years old and an enthusiastic advocate of the hygienic-hydropathic school of medicine at the time of his enlistment.  He had practiced less than two years as a doctor at the Franklin Water Cure outside Winchester, Tennessee, then part-time as a water-cure physician in his hometown of Lewistown, Pennsylvania.  It is unlikely he was mentored by a regular physician preceptor prior to attending medical school.  This can be surmised from his representation of himself as an embattled sectarian “outsider” in a letter in which he wrote, “I owe my present position to none of the doctors of Lewistown as I got it in spite of them and by dint of having brains.  There are many graduated blockheads—regular graduates—who don’t like me to be where I am, but the examination silences them.”35

That Hamilton was able to pass the Pennsylvania Medical Board examination, which was designed for regular allopathic physicians, was due to his own initiative.  He was an 1858 graduate of the Hygeio-Therapeutic College of New York City headed by Dr. Russell T. Trall (1812-1877), the premier American hydropathic educator.  Trall, who had received an allopathic medical degree in 1835 from Albany Medical College,36 became a zealous convert to hydropathy after a personal health crisis.  In 1844, Trall opened his first institution in New York for the treatment of patients by the hydropathic method.37  He established the New York Hydropathic and Physiological School in 1853 in the large building that housed his water-cure establishment at 15 Laight Street by St. John’s Park in Manhatten.38  A few years later, the school was renamed the New York Hygeio-Therapeutic College, with its goal being to educate “Hygeopathic practitioners and Health-Reform lecturers.”39  An 1857 advertisement for the treatment center and college in the Water-Cure Journal boasted that, “The public rooms and halls are warmed with steam, which in winter maintains a uniform and pleasant summer temperature, without dust or smoke…In short, the proprietors are determined to spare no exertions nor expense to make this the model health institution in the world.”40  The Laight Street facility could house up to one hundred patients who provided the medical students with cases for clinical study and hands-on experience in the application of hydropathic and physiological therapeutics.

Although the college graduated students and conferred medical degrees from 1853, it did not receive a charter from the state of New York until February 4, 1857.41  Trall attributed the delay in obtaining the charter to opposition from the allopathic medical community who objected to state recognition of any sectarian medical college.  Like many sectarian medical schools, the New York Hygeio-Therapeutic College offered instruction comparable to that provided by regular medical colleges in anatomy, chemistry, medical jurisprudence (forensic medicine), obstetrics and female diseases, physiology, and surgery.  It differed from an allopathic medical school primarily in its approach to materia medica and therapeutics.  Trall’s lectures on materia medica railed against everything being taught in allopathic medical colleges; he emphasized the poisonous nature of all drugs, including botanicals, and reinforced the hydropathic prime directive to rely on the healing powers of nature and pure water.

The New York Hygeio-Therapeutic College also differed from regular steam, which in winter maintains a uniform and pleasant summer temperature, without dust or smoke…In short, the proprietors are determined to spare no exertions nor expense to make this the model health institution in the world.”40  The Laight Street facility could house up to one hundred patients who provided the medical students with cases for clinical study and hands-on experience in the application of hydropathic and physiological therapeutics.

Although the college graduated students and conferred medical degrees from 1853, it did not receive a charter from the state of New York until February 4, 1857.41  Trall attributed the delay in obtaining the charter to opposition from the allopathic medical community who objected to state recognition of any sectarian medical college.  Like many sectarian medical schools, the New York Hygeio-Therapeutic College offered instruction comparable to that provided by regular medical colleges in anatomy, chemistry, medical jurisprudence (forensic medicine), obstetrics and female diseases, physiology, and surgery.  It differed from an allopathic medical school primarily in its approach to materia medica and therapeutics.  Trall’s lectures on materia medica railed against everything being taught in allopathic medical colleges; he emphasized the poisonous nature of all drugs, including botanicals, and reinforced the hydropathic prime directive to rely on the healing powers of nature and pure water.

The New York Hygeio-Therapeutic College also differed from regular medical schools in offering courses in the mental sciences, phrenology, and speech, including vocal exercises to cure stuttering.42  With an enrollment of one hundred students, its founder could boast in 1856 that “in numbers our school already ranks as the third of the five medical schools in this city; that is to say, our class is much larger than that of the irregular Physio-Medical, and somewhat larger than the regular New York Medical College.”43  The student body was highly unorthodox in another way: of the one hundred medical students, forty-eight were women.44

Unlike most hydropathic medical students, Dr. Alfred T. Hamilton also paid to attend lectures and clinics at two prestigious allopathic institutions: Bellevue Hospital and the College of Physicians and Surgeons in New York City.  There he was exposed to some of the most prominent surgeons and anatomists of the day including Drs. Valentine Mott, James Rushmore Wood, and Alonzo Clark.  Hamilton’s lecture notes show that he readily accepted their instruction except where the topic of drugs was concerned.  His notes reflect scorn for the use of all drugs, especially mercury.  An example of this view can be seen in his journal entry for December 4, 1857: “More infants are destroyed by the pestal [sic] and mortar than Herod slew.  Scarcely a child can reach one year without being poisoned...All the quackery in the world comes from the regulars’ dispensatories.  Ninety five percent get well without doctors.”45

Despite his formal training in anatomy and regular clinical medicine that surpassed that received by graduates of many regular allopathic medical schools, Hamilton’s hydropathic beliefs would have excluded him from being commissioned as a military surgeon.  Regardless of the popularity of homeopathic, hydropathic, eclectic, and botanic medicine among the general population preceding the Civil War, state medical review boards remained firmly in the hands of allopathic physicians.  Only allopaths were allowed to take the federal or state examinations for military surgeon.  William H. Cook (1832-1899), Dean of the Physio-Medical Institute of Cincinnati, Ohio, complaining of the practice of excluding sectarian physicians, observed that “allopathic surgeons with only a few months of practice were granted commissions while reform physicians who had toiled for years to save limbs and lives were excluded from honorable service.”46

Organized attempts to increase the potential pool of military surgeons by allowing recruits from sectarian medical schools to take qualifying examinations were blocked.  The Ohio Senate passed a bill in May 1862 to abolish restrictions against non-allopathic physicians being commissioned as medical officers, but the move was met with strong opposition by allopathic supporters.47  Sectarian medical practitioners lobbied, with no effect, for state medical examinations to be the sole criteria to determine who was, and who was not qualified to serve, regardless of medical philosophy.48

Knowing this, Hamilton concealed his hydropathic background by registering for the Pennsylvania State Medical Board examination as a graduate of the “New York Medical College in 1858, having attended Bellevue Hospital Medical and Surgical Clinics for two winters.”49  Hamilton took the added precaution of enlisting in a regiment outside his native Mifflin County so that his hydropathic background would not be known, saying, “I think I can get along in duty unless some one interferes of those who know me.  But it is no one’s business now.  I passed the rigid examination of the Medical Board, and it is presumed that they ought to know who is competent.”50

Hamilton was not alone in this practice.  There are examples of other sectarian physicians obscuring their credentials and beliefs in order to take a medical board examination.51  One case was that of Dr. Edward C. Franklin (1822-1885) who, “without revealing his homeopathic bent,”52 passed an examination for federal appointment as Brigade Surgeon of Volunteers.  Franklin and his assistant, contract physician Leonard Pratt (1819-1900), were later revealed as homeopaths upon which the army medical director annulled Pratt’s contract in November, 1862.  Franklin was relieved of his duties a few days later.53

Discrimination against sectarian practitioners was viewed by some allopaths as a strong incentive for sectarian physicians to turn—or return—to medical orthodoxy in the form of heroic allopathic medicine.  In a September 1862 article in The American Medical Times, the editor stated that “it being a regulation that none but regular practitioners are eligible for examination, very many of the homœopathists have been tempted to turn heretics to their faith in the hope of obtaining positions.”54

Whether any sectarian physicians turned heretic or merely concealed their beliefs remains unknown.  It is clear Hamilton’s strong beliefs remained intact.  In an 1860 article published in the Water-Cure Journal entitled “Fanaticism,” Hamilton wrote:

“As advocates of the Water-Cure system we must expect the fate of our predecessors.  Persecution and misrepresentation are our daily experience from those who are ignorant and prejudiced against that theory which holds out health and its attendant happiness to a drug-ridden world…When individuals, or a community, wish to decry any new invention, any system that will benefit mankind, the cry of “infidel,” “fanatic,” “enthusiast,” is brought forth to oppose scientific argument—to extinguish the light of truth…We need fanatics.  The term is significant of honesty—of a noble mind…Trall and Jackson are both fanatics, but still Hygeio-Therapia is growing popular, and the almost incurable are being healed, while thousands are blessing God that they ever became acquainted with the laws of life and health as taught in the Water Cure Journal…We have adopted that fanaticism which enables us to restore health to the sick without having recourse to ‘drugs and dye stuffs,’ and as the fanatical principles and practice of Water-Cure have never failed to meet our most sanguine hopes, we ever intend to be a disciple of the truth as taught at the N.Y. Hygeio-Therapeutic College.”55

The number of sectarian physicians serving undetected in the Union Army likely will never be known due to the skill with which these physicians hid their backgrounds.  This was relatively easy to do because most medical review boards depended on self-reporting of where a physician received his medical training and asked for no documentation of a medical degree.  It is also possible that comrades-in-arms became aware of sectarian surgeons’ backgrounds, but kept the secret to themselves.  In Hamilton’s case, this can be inferred from an incident in which, “Colonel Matthews twitted me about cold water, as he did in military company once before, but it passed off pleasantly.”56  Due to the popularity of sectarian medicine in America prior to the Civil War, it is possible some soldiers might have preferred treatment by a sectarian physician, especially one who also had been certified by a state medical board of review.  Memoirs and other accounts prove that sectarian physicians did pass state qualifying examinations, something that not all allopathic physicians were able to do, and went on to serve successfully as military surgeons.

The Pennsylvania Medical Review Board Examination
The Pennsylvania Medical Review Board’s examination consisted of forty-four questions arranged under headings for surgery, anatomy and physiology, materia medica, and practice of medicine.  Different versions of the test were administered to nearly three hundred applicants at Harrisburg on September 11, 1862.  By coincidence, Davis and Hamilton received the same version of the examination. (See Appendix)

The questions assessed the physicians’ understanding of basic medical knowledge that would be required of an army surgeon: the ability to diagnose and treat pneumonia, smallpox, typhoid, and dysentery; the treatment of gunshot wounds and broken bones; how to amputate a leg; the best place to set up a camp; and how to prepare basic medicines.  Although a few medicines were mass produced by pharmaceutical companies during the Civil War, it was necessary for the physician to know how to prepare and mix ingredients for most prescriptions.  This process was assisted by referring to the Dispensatory of the United States, a massive reference volume with instructions for gathering ingredients, formulating medicines, dosages, conditions for which a medicine was prescribed, and the expected patient reaction, including countermeasures in case of overdose.  Because most medicines had to be compounded by the physician himself, a knowledge of materia medica was essential for an allopathic physician in this period.

The examination essays submitted by Davis, Hamilton, and Fisher were graded by Drs. Rutherford, Dock, and Wilson under the signature of Dr. James King, Surgeon General of Pennsylvania.  The grading scale was one to ten, with ten being the highest score possible.  In addition to technical knowledge, the graders evaluated spelling, clarity of writing, neatness, and quality of references, if any were supplied.57  An instruction letter for grading the essays stated, “The number five represents the lowest qualification worthy of any appointment.  The Board therefore recommend for the appointment of Assistant Surgeon all those having the standard marked five and upwards.  Those having seven and upwards are considered worthy of the appointment of Surgeon when in the judgment of the Surgeon General they shall have had sufficient experience in the field or previous experience in Hospital or private practice of some years.  Those having less than seven it is considered improper for promotion unless approved by another examination.”58

A grade was given for the examination as a whole.  Individual questions were not marked as correct or incorrect in the Harrisburg examinations reviewed for this article.  Grades were recorded on a grid with columns listing the recruit’s name, the initials of the board members grading the essay, the overall grade given by each reviewer, and a column averaging the reviewers’ scores.  Most passing scores fell into the five to seven range.59  Scores of nine and ten were rare among the records for the year 1862 retained in the Pennsylvania State Archives.  Whether this was due to the modest quality of applicants or the reluctance of reviewers to give higher scores is unknown.  Not all applicants passed the examination.

It is possible to compare Dr. Hamilton’s and Dr. Davis’ responses because they received identical versions of the exam.  Hamilton’s responses were weakest in the area of materia medica—understandably, because of his background as a hydropath.  In response to a question asking for the ingredients of the opium-containing Hope’s Mixture, Hamilton responded “don’t recollect” and for the purgative “compound extract of colocynth,” he replied “can’t tell.”  Davis answered both of these questions correctly.  Hamilton’s responses to questions on allopathic therapeutics were also weaker than Davis’,  including rewriting his answer on how to prevent strangury, a urological condition.  Hamilton’s initial answer, which included cold water injections, was lined out and rewritten with a less hydropathic-sounding treatment.

However, for several questions on surgery, anatomy, and physiology, Hamilton provided stronger answers.  He gave more detailed responses than Davis to the question of why gunshot wounds are slow to heal, how to treat a gunshot fracture of the humerus, and the technique for amputation of the thigh.  He also listed more factors to consider when selecting a healthy hospital or camp site.  These questions, of vital significance for a military surgeon, showed Hamilton’s strong background in anatomy, surgery, and practical hygiene.  On two questions concerning treatment of dysentery and pneumonia, Hamilton’s treatments would have been less injurious to the patient.  Davis’ reply to the question on pneumonia included the staples of allopathic medicine that were so debilitating for the patient: bleeding, calomel (mercury), cathartics to purge the bowels, and ipecac to induce vomiting.

Whenever possible, Hamilton told the examiners what he thought they wanted to hear.  His examination answers do include mention of mercury, purgatives, and other allopathic therapeutics that were anathema to his hydropathic beliefs.  This strategy was successful in hiding his hydropathic background and resulted in his being commissioned at the rank of assistant surgeon.

Dr. Hamilton received an examination score of five, the lowest passing score, but a result far better than many regular allopathic physicians who received a failing grade that day at Harrisburg.  Dr. Davis, with over twelve years experience, received a score of seven.60  Dr. Fisher, a thirty-year-old graduate of the University of Pennsylvania medical school, received a score of six.  Although these three physicians passed the Pennsylvania Medical Review Board examination, passing the exam was no guarantee of effectiveness in action or being viewed as competent by the men in the regiment in which they served.

A Clash of Men and Therapeutics
The 148th Pennsylvania Volunteers were noted for their esprit de corps.  The regiment had several officers with strong leadership skills who were well-respected.  Colonel James A. Beaver was highly popular among both officers and men, as was Chaplain William H. Stevens.61  Adjutant Joseph Muffly, himself a well-liked figure, would later compile the recollections of over seventy veterans to create a regimental history.  Accounts in Muffly’s history speak little of Dr. Davis, perhaps because it was not completed until 1904, seventeen years after Davis’ death.  There are brief allusions to Davis’ argumentative nature and his ambiguous nickname “the oldman,” despite the regiment having two men who were twenty years older than Davis.  Hamilton’s own Civil War letters paint a decidedly unflattering picture, but are undoubtedly biased by personal enmity.  In a letter of October 3, 1864 Hamilton states, “I heard that Dr. Davis and Rev. White would have quarrelled daily if it had not been for [the] Colonel.”62

Although Dr. Davis’ credentials seemed to make him the most qualified and competent of the regiment’s three surgeons, in practical terms he lacked the goodwill and communication skills possessed by his fellow officers.  This affected his ability to supervise the medical staff under his direction, as can be seen in an incident in which he accused his hospital steward Jacob B. Kreider of incorrectly preparing a prescription and had him “maliciously discharged”63 from the army.

Jacob Kreider’s court-martial records confirm that he was not experienced in the preparation of medicines.  This was not unusual.  No previous medical or pharmacy experience was required of hospital stewards, who were sometimes elected by popular vote from the general ranks of volunteers.  Kreider misunderstood the order from Dr. Davis to mix “equal parts” for a medication.  Davis had referred to equal parts of the active ingredients—opium and ipecac—
which then were to be diluted.  But Kreider mixed equal parts of all the ingredients, a mistake which could have been lethal, a point that was made at his court-martial.64  Davis would take no responsibility for any part of the misunderstanding and Kreider was sent home to Pennsylvania in disgrace in October 1863.

Hamilton felt that the fault was Davis’, not Kreider’s.  Hamilton wrote in a letter to his father, “[Davis] prepared charges of incompetency while he was incompetent himself, that is, in the specification he swore before court that our Hospital Steward was incompetent because he mixed medicines in an unscientific manner.  The truth is he ordered the Steward to mix medicine in a certain way & the order was unscientific and incorrect, thus making the blunder on the part of Davis.”65  For this and other reasons, Hamilton would later write on January 4, 1865 that, “Every Medical Officer in the Division is satisfied with Davis’ incompetency and they treat him accordingly.”66

The clash between Hamilton and Davis began long before the discharge of the hospital steward.  It had its origins in the early days of the regiment.  In the five months from the regiment’s formation until Hamilton’s arrival, when the camp and hospital were under the care of Dr. Davis, twenty-nine men had died of disease or accident.  This was a period in which the regiment was still in training and had not yet seen combat.  An outbreak of typhoid had killed and sickened many, causing Colonel Beaver to express concern over the regiment’s weakened condition.67  Beaver went on walking tours of the camp to try to determine what was causing so much illness in his new regiment.  Beaver wrote of his tours during this time: “I spent considerable time going about with Dr. Davis in visiting the sick and was impressed with his view that many men were suffering not so much from disease as from pure homesickness and, in one case which I well remember, the doctor spoke of one of our men…that he was dying, because his wife could not write a cheerful letter.”68  The belief that men could die of homesickness was echoed forty years later in the reminiscences of Lieutenant William Gemmill of the 148th, Company D, when he said, “Discouraging news from home led on to homesickness and that made men heartsick and hopeless, and that led to the hospital and in some cases to the grave.  We had something of that in our company that winter, and it didn’t do anybody any good.”69

Dr. Davis’ diagnosis of homesickness as a causative factor in disease among soldiers of the 148th Pennsylvania Volunteers was supported by texts used by military surgeons.  The Manual of Instruction for Military Surgeons on the Examination of Recruits and Discharge of Soldiers did specify that: “Nostalgia, or home-sickness, although not in itself a disease, is yet a predisposing cause to disease of a most serious character.”70  However, it was far more likely that Davis was overlooking more obvious causes: initial exposure in camp to childhood diseases, tainted food and water, uncollected refuse and animal waste, poorly located latrines and ill-maintained “sinks,” toxic allopathic medicines, and the unclean condition of the hospital.

The problem of deaths in newly formed regiments was recognized at the time.  Dr. John H. Brinton noted, “The men from the country had often not passed through the ordinary diseases of child life, and no sooner were they brought together in camps, than measles and other children’s diseases showed themselves, and spread rapidly.  The malarial influences of the rivers too, produced a most depressing effect upon men brought from higher regions, and more healthy surroundings.  Violent remittent, intermittent and low typhoid fevers invaded the camps, and many died.  The general hygiene was bad, the company and regimental officers did not know how to care for their men, and the men themselves seemed to be perfectly helpless.”71

When Dr. Hamilton arrived in camp on February 4, 1863, he immediately applied his hydropathic concepts of sanitation and cleanliness to the regiment and camp.  In this he was supported by Colonel Beaver who was deeply concerned about the condition of the camp and the health of the men.  Within six weeks, Hamilton reported: “Our Regiment was inspected today, also our Hospital.  Our Hospital was pronounced the best in the army by our inspector.  I have things fixed up pretty well.  They give me the credit, among officers & men, of having this reform.  Our Hospital was pronounced by Gen. Couch to be the worst he ever saw in his military career—that was when I first came, but now a rigid inspector says it is the best in the Army.”72   Colonel Beaver remarked on the change in a letter to his mother dated March 24, 1863, “The health of the regiment is improving and I hope soon to see a much more marked improvement.  Our Hospital is now a very nice place.”73
Despite the support of Colonel Beaver, within three months of arrival Hamilton found working under Davis to be intolerable.  In a letter dated June 6, 1863, Hamilton worried about being the regiment’s only assistant surgeon, saying, “Dr. Fisher was requested by the Corps Surgeon to resign on account of his eye sight…This will leave me in an awkward position in regard to Dr. Davis whom I hate worse than the itch.  You need not be surprised if you see me home some day, all on account of Dr. Davis.”74

Hamilton’s solution was to request a transfer.  On March 4, 1864, he wrote, “I applied to Dr. King to be transferred to another regiment on account of ill treatment by Dr. Davis but he would not transfer me.”75  Dr. James King, Surgeon General of Pennsylvania, had larger concerns than a quarrelsome regimental surgeon and his fanatically hygienic assistant surgeon.  Hamilton then decided to seek promotion in rank so that he could resign his commission as assistant surgeon with the 148th and be commissioned at the rank of surgeon with a newly-formed regiment.  He was hampered in this plan by not knowing if his examination score was sufficient to allow promotion.  Hamilton asked his father to use his influence and contacts in Harrisburg to obtain his examination score.  He was also interested in knowing how he compared to his allopathic fellow surgeons:  “If my examination placed me in any of the four higher grades, I see that I need not be reexamined for promotion…It would be a matter of great interest for me to know the grade of Merit of Drs. Davis, Fisher and myself.”76  Hamilton was never able to ascertain that his examination score was five—not high enough to allow promotion without reexamination.  Whether due to policy or red tape, the Pennsylvania Medical Review Board would not share this information, causing Hamilton much frustration for the rest of the war.  The option of reexamination was ruled out by Hamilton, who remained concerned that his hydropathic beliefs would be discovered.

Dr. Hamilton attended to the medical and surgical needs of the men of the 148th Pennsylvania Volunteers through over forty battles and skirmishes.  He was stricken with typho-malarial fever in October 1864 and hospitalized at City Point, Virginia.  Even there, Dr. Davis haunted him.  Hamilton wrote from his hospital bed on December 17, 1864, “I was told that Dr. Davis sent word to City Point Hospital that the doctors should not send me home unless on an extreme necessity, and every few days he would inquire whether I got home yet and when he found that I was still in hospital he laughed and was very much pleased because I did not get off.”77

Hamilton survived his illness and returned to the regiment, where he served until the end of the war.  When J. W. Muffly contacted survivors of the 148th to write the regimental history, Story of Our Regiment, it was Drs. Hamilton and Fisher who contributed two parts entitled “The Surgeon’s Story.”  Uriah Q. Davis had died in 1887 in an accident at a railroad crossing in Milford, Pennsylvania.  Hamilton said nothing negative about Davis in his chapter.  Hamilton’s chapter begins with a statement of that all-important qualifying credential: “My military service was preceded by an examination before the State Board of Medical Examiners…”78

Alfred T. Hamilton was a life-long proponent of hygienic living and public sanitation.  He did not practice medicine after the Civil War, except for a one-year elected term as Lewistown coroner in 1879.  It would have been impossible to continue, even had he wished to, because by 1888 it was illegal to practice medicine in Pennsylvania without a license from an accredited “regular” medical program, with a diploma and an annually renewed license on file.

Because Hamilton had a hydropathic medical degree, he would not have been eligible for a
license.  Instead, he lobbied for the building of public sewers and served as Lewistown’s first
public health officer until 1911.  He proposed the establishment of an institution supported by the
Knights of Malta for the sick, aged, and orphaned.  He worked tirelessly on its behalf until his
death in 1911.  The Malta Home opened in Granville, Pennsylvania in 1920 and was still in
operation in 2007.  A photograph of Alfred T. Hamilton is sealed in the Malta Home’s
foundation stone.

Conclusion
Drs. Davis and Hamilton were born at a time when much of medicine was based on philosophical models dating back to antiquity.  Medical diagnostic tools were primitive, germs had not yet been discovered, and the functioning of the immune system was unknown.  Yet advanced knowledge of anatomy learned through dissection allowed physicians to perform increasingly complicated surgeries successfully.

The Civil War occurred at the very beginning of the transition to “modern” medicine.  It is important not to confuse the allopathic medicine of the mid-nineteenth-century with modern medicine.  Modern medicine evolved only as a result of major scientific breakthroughs, developments in medical technology, and the integration of reforms previously promoted by sectarian practitioners.  By the time of the Civil War, a few regular physicians acknowledged the debt they owed to homeopathic theory in helping to curb the allopaths’ worst excesses in over-prescribing toxic medicines.  The sectarian physicians’ anti-venesection campaigns also undoubtedly curbed the practice of bleeding the sick.  The hydropathic movements’ insistence on washing, cleanliness and hygiene, healthful living, and urban waste dumped into water sources—issues that continue to concern Americans today.

In retrospect, each medical system was correct in some cases and very wrong in others.  Regular allopathic doctors did poison their patients with large doses of toxic medicines, but for a few diseases, those treatments did work.  For example, mercury was the only effective treatment for syphilis before the discovery of penicillin.  The allopathic error was in prescribing potentially-damaging heroic treatments for almost every condition, including those where the patient would have been better off if left to recover unaided.

Sectarian medical reformers, including hydropaths, who championed the healing powers of nature and promoted lifestyle changes paved the way for many concepts found in modern preventative medicine.  Hydropathic admonitions to eat whole wheat bread, drink water, cut down on salt, fried foods, and red meat, avoid alcohol and tobacco, and get plenty of fresh air, rest, and exercise sound very contemporary, although they were mocked by the medical establishment of the day.  Today, we better understand the mechanisms by which specific behaviors lower the risk of disease based on scientific study, whereas many nineteenth-century reformers relied as much on moral assumptions as on medical observation to come to similar conclusions.  The error of the sectarian schools was in their over-reliance on the healing power of nature and single-theory therapeutics as a universal treatment for disease.  It is also unfortunate that the animosity between the regular and sectarian schools of medicine delayed the sharing of the best features of each system.

The story of Drs. Davis and Hamilton of the 148th Pennsylvania Volunteers personified larger issues in mid-nineteenth-century American medicine including the lack of standards in medical education, the existence of sectarian schools of medicine, differences in philosophies of therapeutics, and the lack of provision for medical or leadership training for Civil War surgeons.  The training, experience, and competency of civilian physicians varied widely at the outbreak of the war.  Despite attempts by state and federal medical boards to exclude non-allopathic practitioners from serving as military surgeons, some individuals like Alfred T. Hamilton managed to conceal their sectarian medical beliefs in order to pass qualifying medical examinations and serve in volunteer regiments.  Sectarian physicians would have to wait until 1898, during the Spanish-American War, for President William McKinley to allow any physician, regardless of sectarian school, to be examined for a commission as a military surgeon based on merit alone.79

Uriah Q. Davis followed a system that believed heroic levels of intervention were required to cure illness, including removing enough blood from the patient to slow their pulse and prescribing large doses of dangerous drugs.  Alfred T. Hamilton believed in a system of preventative medicine, a temperate lifestyle, and trust in the healing powers of nature and pure water.  Records confirm that Hamilton was able to apply his hygeo-therapeutic beliefs regarding sanitation and preventative medicine paved the way for many late-nineteenth and early-twentieth-century reforms regarding inspection and quality control of drinking water, milk, meat and other foods, the building of sewers, and attempts to curb industrial pollution and his training as a hydropath to improve the health and quality of life in the regiment, while also meeting its need for a physician with basic clinical and surgical training.  Dr. Davis and Dr. Hamilton served the 148th Pennsylvania Volunteers as best they knew how, following their differing philosophies of allopathic and hydropathic therapeutics, despite personally being as incompatible as the mainstays of their respective schools of medicine—mercury and water.

APPENDIX
Pennsylvania State Medical Board Examination, 1862
Original spelling has been retained.  Readers are invited to compare the examination answers of Uriah Q. Davis (UQD) and Alfred T. Hamilton (ATH) taken September 11, 1862 at Harrisburg, Pennsylvania:

A.  SURGERY
1.   What are the symptoms of a wound of the Lung—and how would you check Pulmonary Hemorrhage?
UQD: Labored & difficult breathing, Spitting of blood, which is raised by coughing. Treatment— Bleeding, cathartics, drafts to the extremities, Sugar of lead & Opium.
ATH: Haemoptisis—coughing up of arterial blood, creaking sound in part affected.  If excessive, blood letting from arm, breathing cold air, ice water or lumps of ice.
2. How would you Trephine the Skull—and what fills up the opening made by the Trephine?
UQD: By making a crucial incision, removing the periostium, place the pin of the trephine of the cutting edge so as to secure the instrument in one position, rotate the trephine and use much caution as you approach the dura matter for fear of wounding it.  The opening fills with a fibro- cartilaginous substance.
ATH: Shave the part to [be] operated upon.  Set the pin of the Trephine so that a start can be well made, after the proper incision, then remove the center pin, continue the cutting operation until the first and second tables of the skull bone are sawed through.  Then lift up the depressed bone with the elevator.  Cover the opening with the flap and dress with adhesive plaster.  The opening is filled with coagulable lymph.
3.   What is a Hydrocele—what an Hæmatocele, and what is Varicocele?
UQD: Is a collection of serum within the tunica vaginalis testes—is a collection of blood—is an enlargement of the Spermatic vessels.
ATH: Dropsy of scrotum.  Haematocele, a tumor filled with blood.  Varicocele—enlargement of scrotal veins.
4.   Describe the circular operation for Amputation of the Thigh.
UQD: The tourniquet is first put on to arrest the flow of blood.  The operator on the outside of the left leg—and assistant takes hold of the thigh with a firm grasp and draws up the integuments & muscles.  The operator places his hand beneath the thigh and commences his incision on the inside and continues it round until he brings it to the place of commencing.  The assistant draws up the integuments still further.  The incision is then made through the muscles to the bone.  The muscle is then separated from the bone for an inch or an inch & a half.  The tractor is then put on and the bone sawn off.  The arteries lifted and the edges brought together in a straight line & fastened by adhesives straps or sutures.
ATH: Select a point for sawing the bone, below said point, about one fifth of the circumference of limb, make a circular incision, with the amputating knife, through the integuments.  Dissect the integuments and hold back with a retractor then cut through the muscles, and saw the bone, lower end of limb to be held by an assistant so as not to choke the saw or splinter the bone.  The Tourniket must first be applied over the principal femoral artery.  Close the flap, after cleansing it thoroughly with wet sponge, by the interrupted suture after ligating the femoral artery, and all others that may bleed after removing the Tourniket.  Bring the ligatures out at the lowest point so as to prevent suppuration from retained pus.  Apply the adhesive strap sufficient to sustain the flap.  Place lint between the edges of integument to prevent too sudden union.
5.   Describe the dressing usually applied to a Fracture of the Femur.
UQD: Splints are applied.  The one on the inside of the leg extending from the perineum to beyond the foot.  The other extending from the bend of the body to beyond the foot, placing a cross stick or a ratchet for extension—a pad or band extending from the perineum & fastened to the upper end of the outer splint.
ATH: Shave the leg so as to apply the adhesive strap of sufficient strength to enable me to extend the leg so as to bring the fractured ends of Femur in juxtaposition, then apply a splint from groin to knee on inside, and a long splint from pelvis to beyond the heel on outside, another splint on inside of fore leg—all to be enveloped by the roller and the unevenness to be filled up with pads. Extension must be kept up until the muscles yield and bones unite.
6.   Describe the method of reducing a Luxation of the Head of the Femur on the Dorsum Ilii.
UQD: The manipulator seizes the thigh in one hand & the leg in the other—flexes the leg on the thigh, then rotates the thigh by bringing it over the opposite thigh thence up over the abdomen & then extend the leg.
ATH: Extension and counter extension by pullies or assistants until head of Femur is brought over the ace tabulum, when it will return to its normal position.  Raise the leg upward and inward in doing this.
7.   In how many ways may Hemorrhage be arrested.
UQD: By cold applications, by compresses, by ligatures, by Styptics.
ATH: Hemorrhage may be arrested by “Garrot,” Tourniket, ligature, torsion—cautery.
8.   Name the best styptics for the arrest of Venous Oozing.
UQD: Perchloride of Iron
ATH: Per sulphate of iron, ice, Per chloride of iron.
9.   Why are Gunshot Wounds tedious in healing, and what are their chief dangers?
UQD: Because it deadens the vitality of the parts.  The parts first slough out before granulation takes place.
ATH: On account of laceration, presence of foreign bodies, liability to extensive sloughing.   Hemorrhage, tetanus & trismus and suppuration are their chief dangers.
10. How would you treat a Gunshot Fracture of the Humerus?
UQD: If there be much commination of the bone we had best amputate.
ATH: If a simple fracture bring the bones in contact by extension and counter extension, apply the splint and bandage in usual manner—if comminuted, amputation would be indicated, either at the point of election or the point of necessity.  Splint to be of wet pasteboard, or leather, bound with the roller, or simple pads and shingle splints held firmly by adhesive strap.

B.  ANATOMY AND PHYSIOLOGY
1.   How many Spinal Nerves are there, and how do they escape from the spinal canal?
UQD: Thirty two pairs & pass out between the vertebra.
ATH: 84 spinal nerves—they pass through the foramen of the vertebrae.
2. Name the bones composing the Head.
UQD:   Frontal, occipital, two parietal, two temporal, Sphenoid & ethmoid.
ATH: Occipital, frontal, two parietal, two temporal, and ossa trignetra.
3.   Describe the portions of the Intestinal Canal.
UQD:   Duodenum, jegunum & ileum, colon.
ATH: Mouth, Esophagus, Stomach, Duodenum, Jejunum, Illium, Ascending, Transverse & Descending Colon, Rectum and Anus.
4.   Name the regions of the Abdomen, and state their relative positions.
UQD: Two hypochondriums, right and left, epigastrium.  The middle portion contains the right & left lumber & the umbilicus.  The lower portion, the two iliacs & hypogastrium.
ATH: Epigastric, over stomach—Hypochondria, under the ribs—Hypogastric above and bordering on the pelvis—Right and left Illiac, over the Illiac muscles.
5.   What is the composition of the Wrist-joint?—stating its bones and ligaments.
UQD: The bones of wrist-joint are the Scaphoid lunar, cuniform & pisiform, trapezium, trapezoid, magnum & uneiform.  The ligaments are the anterior posterior lateral & anular.
ATH: Extremities of Radius and Ulna.  Scaphoid, Semilunar, Cuneiform, Pisiform, Trapesium, Trapezoides, Os magna, Uneiform, Annular ligament, transverse ligament.
6.   Describe the origin, course, and relations of the Iliac Arteries.
UQD: Commences at the bifurcation of the abdominal aorta, runs down and divides into the external & internal iliac arteries.
ATH: Illiac arteries arise at the bifurcation of the descending aorta, pass over the Iliac muscles down each side of the lumbar vertebrae, and terminate in the femoral artery and Glutens and hypogastric arterie.
7.   Where is the Thoracic Duct, and what is its function?
UQD: It is a Duct that extends along the spine receiving the chyle from the intestines and empties at the junction of the subclavical & internal jugular veins.
ATH: The Thoracic Duct arises in the duodenum and terminates in the left embelarian artery.  It carries chyle.
8.   Describe the process of Digestion.
UQD: The food is masticated mixing with the saliva, swallowed, enters the stomach meeting with the gastric juice, forms into chyme, leaves the stomach through the pyloric orifice and mixes with the bile & pancreatic secretions forming an emulsion—chyle is formed & absorbed by the lacteals.
ATH: Food is masticated by the teeth, passes into the stomach through the esophagus, mixes with the gastric juice in the stomach by means of its muscular coats, passes into the duodenum where it is mixed with bile and pancreatic juice—thence through the Ilium and Jejunum where the chyle is taken up and thrown into the Thoracic Duct and thence through the left sub clavian artery into the arterial circulation.  The foeces pass through the colon and rectum & anus.
9.   How is Respiration accomplished, and what is its object in the economy?  What part is performed by the Lungs?
UQD: By the respiratory muscles.  Its object is to oxyginate the blood. The Lungs receive the respired air, absorbes the oxygen, and throws out carbonic acid gas.
ATH: Respiration is accomplished by the contraction and relaxation of the abdominal, dorsal, and intercostals muscles and diaphragm.  The object is to purify the venous blood by exposing it to oxygen in the lungs through the capillaries.
10.   Where are the Kidneys situated?  State the name and course of their ducts, and where they empty.
UQD: The kidneys are situated at the posterior part of the lumber region.  The ureters pass down and empty into the bladder.
ATH: The kidneys are situated in the lumbar region of the back.  There are two ducts (ureturs) leading from the kidneys to the bladder and empty near its neck.  Urine is secreted from the renal arties.

C.  MATERIA MEDICA
1.   What preparation of Arsenic is most convenient for medical use?
UQD: Fowler’s Solution.
ATH: Fowler’s Solution.
2.   Write its composition and dose.
UQD: Carbonate of Pottassa, Arsenic & Sp. of Lavender.  Dose 10 drops.
ATH: Arsenic & Potassa held in solution 8 to 10 drops.
3.   What is the composition of the Compound Extract of Colocynth?
UQD: Colocynth, Alors, Scammony, Soap & Cardamon.
ATH: Can’t tell.
4.   What is the difference between Compound Extract of Colocynth and Compound Cathartic Pills?
UQD: It wants the addition of Calomel & gamboge.
ATH: Add scamony gamboge & Calomel to compound Extract of Colocynth.
5.   What Purgatives are given in very small doses?
UQD: Croton Oil, Elaterium, &c.
ATH: Drastic Purgatives.
6.   What medicines can be used as Purgatives, what as Diuretics, and what as Sudorifics?
UQD: Colocynth gamboges, Scammony, Calomel &c.—Squils Digitalis Sweet sp. of nitre—Dover’s Powder neutral mixture, effervescing drafts nitre &c.
ATH: Calomel, Croton Oil, Mandrake &c as purgatives.  Spirits of nitre, Tincture of Cantharides.   Dover’s Powders as Sudorifics & Seidlie Powder.
7.   How ought a Blister to be treated for Endermic Application?
UQD: Apply your blister, remove the cuticle, then sprinkle your madisanal substance.
ATH: The collected fluid should [be] let out by puncturing the elevated cuticle, and covered with cotton batting or flour, and be protected from pressure.  Question seems gloomy.
8.   How would you prevent Strangury, and how treat it?
UQD: By the use of tissue paper salinated with the Tincture of Camphor, Injections of laudanum & starch water.
ATH: Strangury can be prevented by injections of cold water through the urethra, and should be         treated with caustic potach applied by means of a bougie, so that the obstruction be burnt out or destroyed warm water through the urethra, and avoidance of food containing lithic acid.  Should be treated [with] small doses of diuretics and warm fomentations.
9.   Name some of the indigenous substitutes for Peruvian Bark.
UQD: Dog-wood bark and yellow willow bark.
ATH: Wild cherry bark.  Capsicum.  Dog wood bark, thorough stem tea.
10.   Name some of the indigenous Diaphoretics and Emetics.
UQD: Lobelia Sulfate Eupatorium perfoliate, Sassafras, Ipecacuanna.
ATH: Emetic, Lobelia, warm water, Old man tea.  Thyme & Sage teas.
11.   Write a prescription for a Mixture for the arrest of Diarrhœa.
UQD: Opium, Hoyd. cum oreta & Ipecacuanna.
ATH: One pint best Brandy, 20 grains Opium, ½ drachm tanin.  Table spoon full doses every hour.
12.   Write the formula for the composition of Hope’s Mixture as employed in Dysentery.
UQD: Nitric acid, laudanum & Champhor water.
ATH: Don’t recollect.

D.  PRACTICE OF MEDICINE
1.   What are your ideas of the responsibilities of an Army Surgeon?
UQD: It is a responsible situation because the life & death of his men often depends upon his skill as a Surgeon & Practitioner.
ATH: I think the responsibilities of an Army Surgeon most imminent, holding as he does the lives of patriot soldiers in his care.  An error in diagnosis, in operations, in dressings and the general medical care of the field & city hospitals may damage the patient and reputation of the surgeon.
2.   What would you desire to guard against and provide for, in the selection of a Site for a Hospital or Encampment?
UQD: I would guard against stagnant pools of water, marshy districts.  Place the Hospitals or Encampments on elevatedATH: Emetic, Lobelia, warm water, Old man tea.  Thyme & Sage teas.
11.   Write a prescription for a Mixture for the arrest of Diarrhœa.
UQD: Opium, Hoyd. cum oreta & Ipecacuanna.
ATH: One pint best Brandy, 20 grains Opium, ½ drachm tanin.  Table spoon full doses every hour.
12.   Write the formula for the composition of Hope’s Mixture as employed in Dysentery.
UQD: Nitric acid, laudanum & Champhor water.
ATH: Don’t recollect.

D.  PRACTICE OF MEDICINE
1.   What are your ideas of the responsibilities of an Army Surgeon?
UQD: It is a responsible situation because the life & death of his men often depends upon his skill as a Surgeon & Practitioner.
ATH: I think the responsibilities of an Army Surgeon most imminent, holding as he does the lives of patriot soldiers in his care.  An error in diagnosis, in operations, in dressings and the general medical care of the field & city hospitals may damage the patient and reputation of the surgeon.
2.   What would you desire to guard against and provide for, in the selection of a Site for a Hospital or Encampment?
UQD: I would guard against stagnant pools of water, marshy districts.  Place the Hospitals or Encampments on elevated ground with a clear country around & running water.
ATH: Guard against miasma, against low marshy ground, proximity to stagnant water.   Provide an elevated spot where pure air will insure sufficient ventilation.  A spot that will be out of the reach of the enemy’s guns for Hospital.  For encampment, a spot that is sufficiently inclined to drain off the rain and offal, proximity to pure drinking and bathing water.  A camp should be in an open field in preference to a woods.
3.   Describe the symptoms and treatment of Small Pox.
UQD: Fever & pain in the head & back, nausea and vomiting, chilliness, constriction of the chest with laboured breathing, soreness of throat &c.  Treatment.  Commence with a dose of Calomel & after if necessary follow it with castor oil.  Sweet sp. of nitre neutral mixture &c.  When secondary fever sets in give nourishing diet, wine, quinine &c.
ATH: Asthenic fever, pulse weak and frequent, tongue furred & rusty, florid skin terminating in eruptions, which may be confluent or distinct pustules.  Patient should have a cool well ventilated apartment, be given gentle cathartics sufficient to evacuate the bowels but not when the eruption is doing well on the surface.  The great object should be to keep the eruption out else it would be fatal.
4.   What conditions most predispose to Typhoid Fever?—and state its pathology and treatment.
UQD: An enfeeble & debilitated system caused by disease, fatigue, nursing, loss of sleep &c.  
Peyers glands become thickened, softened & ulcerated—mesenteric glands likewise.  The liver, spleen & kidneys become softened.  Treatment.  A mild cathartic, refrigerants, suck as effervescent draft.  Sweet sp. of nitre. Sp. of Mindererus.  When the skin & tongue is dry & the secretions of urine becomes less mucassalize the system.  If it does not yield, turpentine.  When the vital powers sink, beef tea, essence of beef, stimulants, quinine &c.
ATH: A scrofulous diathesis, an asthenic condition of body, constipation.  Its pathology consists of low fever, small frequent pulse, pain in cerebellum, back, limbs, cold feet, inflammation of Peyers & Bruners glands, furred tongue, often getting black, an inclination to lie still owing to prostration.   Frequent small doses of Turpentine when ulceration supervenes.  Cold applications to head, warm to feet.  Bowels free by enemas.
5.   Describe the causes, symptoms, pathology, and treatment of Pernicious Fever.
UQD: Miasmatic.  Symptoms—derangement of the digestion, respiration is laboured & suffocating, the circulation is lowered, the skin is pale, cold with a clammy sweat.  The tongue is pale and cold, breath likewise cold, tenderness in the epigastrium region.  The pulse irregular & frequent.   Treatment.  Artificial stimulant, friction with turpentine & cayenne pepper.  Stimulants internally, quinine &c.
ATH: Exposure in camp, hectic fever, low pulse, putrid condition of body.  Treatment similar to Typhoid.
6.   Describe the pathology, symptoms, and treatment of Dysentery.
UQD: It is an inflammation of the mucous membranes of the colon.  Symptoms—fever, pain over the abdomen with frequent stools with straining with bloody & slimy stools.  Treatment.  A mild cathartic.  Dover’s powder, Calomel & Sugar of lead with chalk—injections of a solution of morphine & Sugar of lead &c.
ATH: Pain, griping, tenesmus at stool, frequent evacuations, discharge of blood and mucous, sometimes of false membrane.  Fever attending pulse slow & weak.  Injections of warm water to free the bowels of crude matter, after which cool injections frequently given.  Blister on abdomen.   Opium in small doses.
7.   Describe the symptoms, causes, and treatment of Scorbutus.
UQD: Symptoms.  Languor debility, face pale &c. Sallow with a puffiness, gums swollen, spongy purple with a disposition to bleed, petrochia, a hemorragic tendency of the mucous membrane.   Cause—deficiency of vegetable matter.  Treatment.  Vegetable diet, cabbage, potatoes &c lemon juice, citric acid &c nitrate of pottassa.
ATH: Lean, cadaverous look, teeth coated as in lead poison, similar to “Burtons Line,” caused by bad, poorly cooked food, lack of vegetables.  Should have a generous diet and general hygienic care, not very conversant with the disease.
8.   What is Intussusception—what are its symptoms—what may it be confounded with, and
how would you treat it?
UQD: It is the slipping of one bowel into itself—pain over the bowels very severe, sickness of stomach, Stercoraceous vomiting.  It may be confounded with strangulated hernia.   Treatment. Warm application over the bowels, opiates.  When the [pain] diminishes give some active cathartic medicine.
ATH: Intussusception is the falling or entering of the Ilium into the Jejunum.  Rain in hypogastrium, foecal vomiting, inability to evacuate, may be confounded with colic, pressure does not relieve pain.  Fomentations to the abdomen, relaxent medicines, injections, finally operation.  Sometimes pure mercury relieves it.
9.   What are the causes of Ascites—and how would you treat it?
UQD: It is a dropsical state of the abdomen and caused by inflammation of the peritoneium—disease of the liver &c.  Treatment.  Drastic cathartics, diuretics & diaphoretics.
ATH: Improper diet, foul localities, lack of functional action of absorbents.  Preparations of iron, diuretics, &c.
10.   What are the symptoms, stages, and treatment of Pneumonia?
UQD: Pain in the chest, difficulty of breathing, cough, oppressive feeling over the chest.  The stages are congestion, red hepatisation and gray hepatisation.  Treatment.  Bleeding, cathartics, arterial sedatives such as tartar emetics &c Calomel with Dover’s powder or ipecacuanna &c.
ATH: Cough, difficulty breathing, frequent pulse.  Antiphlogistic treatment.  Blister on chest.
11.   Write a formula for a Cough Mixture.
UQD: Squills, Paragoric, liquorice, gum arabic & antimonial wine.
ATH: Pulverized licorice, gum arabic, morphia, antimonial wine.
12.   Describe the symptoms, diagnosis, and treatment of Scabies.
UQD: It commences with a papula vesicle & pustules.  We find it near the joints over the abdomen & thighs.  Treatment.  Sulphuric oint.
ATH: Itching, scratching, scabs, animal culae under cuticle.  Bathe the body with soft soap and rain water.  Sulphur & Iodide of sulphur applied externally.
________________________________________
NOTES:
The author wishes to acknowledge Sarah J. Hamilton and William L. Hamilton for their part in preserving the letters and notebook of Alfred T. Hamilton, and Lamar Richard for organizing a ceremony to place a G.A.R. marker at A. T. Hamilton’s gravesite in Lewistown, Pennsylvania in 1999.
1.  Medical and Surgical History of the Civil War.  (Wilmington, North Carolina: Broadfoot Publishing Company, 1990), iv.
2.  Medical and Surgical History of the Civil War, (n. 1), iii.
3.  Medical and Surgical History of the Civil War, (n. 1), v.
4.   Roster of Regimental Surgeons and Assistant Surgeons in the U. S. Army Medical Department during the Civil War.  (Gaithersburg, Maryland: Olde Soldier Books, 1989),  183-213.  This lists Pennsylvania regiments with the name, rank, and service dates of surgeons and assistant surgeons.
5.   Adams, George Worthington.  Doctors in Blue: The Medical History of the Union Army in the Civil War.  (Dayton, Ohio: Morningside Press, 1985), 48.
6.   Brinton, John H.  Personal Memoirs of John H. Brinton, Civil War Surgeon, 1861-1865. (Carbondale and Edwardsville: Southern Illinois University Press, 1996), 257-58.
7.   Haller, John S., Jr.  Kindly Medicine: Physio-Medicalism in America, 1836-1911.  (Kent, Ohio: Kent State University Press, 1997), 7.
8.   Rothstein, William G.  American Physicians of the Nineteenth Century: From Sects to Science.  (Baltimore: Johns Hopkins University Press, 1992), 61-62.
9.   Rothstein, American Physicians in the Nineteenth Century, (n. 8), 344.
10.  Lainie W. Rutkow and Ira M. Rutkow, “Homeopaths, Surgery, and the Civil War: Edward C. Franklin and the Struggle to Achieve Medical Pluralism in the Union Army,” Archives of Surgery, 139, no. 7 (2004): 786.  On medical schools and sectarian therapeutics see Rothstein, American Physicians, (n. 8), 287.  Table of medical school by sect, 1850-1920.
11.  Kett, Joseph F.  The Formation of the American Medical Profession: The Role of Institutions, 1780-1860. (New Haven and London: Yale University Press, 1968), 20.
12. Kaufman, Martin.  Homeopathy in America: The Rise and Fall of a Medical Heresy.   (Baltimore: Johns Hopkins Press, 1971), 19.
13. Kaufman, Homeopathy in America, (n. 12), 29.
14. Ibid., 87.
15. Ibid., 44.
16.  Michael A. Flannery, “Another House Divided: Union Medical Service and Sectarians During the Civil War,” Journal of the History of Medicine and Allied Sciences, 54 (October 1999): 503-04.
17. Rutkow and Rutkow, “Homeopaths, Surgery, and the Civil War,” (n. 10), 790.
18.   “History of Accreditation of Medical Education Programs,” Journal of the American Medical Association, 250, no.12 (September 1983): 1502.
19.  Allopathic attempts to block chartering of hydropathic medical schools are referred to by Dr. Russell T. Trall in the Water-Cure Journal and Herald of Reforms (New York: Fowler and Wells) beginning with the March 1856 issue.  An August 1858 (p. 32) article states, “Another event which looks to me like a very cheering sign is, the establishment of the Hydropathic College in New York City.  The fact that a charter was obtained for it from the New York legislature, against the powerful influence of the old-school physicians, is a cheering indication of the times.”  The Water-Cure Journal is available on microfilm as part of the American Periodical Series: 1800-1850 (Ann Arbor: UMI), reel 577.
20.  “On the Duties of Physicians in Regard to Consultation,” Article IV, Item 1.  Code of Ethics of the American Medical Association.  (Chicago: American Medical Association Press, 1847), 99-100.
21.  Code of Ethics, (n. 20), p. 100.
22.  Kaufman, Homeopathy in America, (n. 12), 53.
23.  Our Family Physician: A Thoroughly Reliable Guide to the Detection and Treatment of all Diseases…Embracing the Allopathic, Homeopathic, Hydropathic, Eclectic and Herbal Modes of Treatment.  (Chicago: J. S. Goodman & Co., 1869), iv-v.
24.  Gillett, Mary C.  The Army Medical Department, 1818-1865.  (Washington, D.C.: Center of Military History, United States Army, 1987), 23.
25.  Bollet, Alfred Jay.  Civil War Medicine: Challenges and Triumphs.  (Tucson, Arizona: Galen Press, 2002), 32.
26.  Gillett, Army Medical Department, (n. 24), 180.
27.  Anton P. Sohn, “19th-Century Academic Examinations for Physicians in the United States Army Medical Department,” cheering sign is, the establishment of the Hydropathic College in New York City.  The fact that a charter was obtained for it from the New York legislature, against the powerful influence of the old-school physicians, is a cheering indication of the times.”  The Water-Cure Journal is available on microfilm as part of the American Periodical Series: 1800-1850 (Ann Arbor: UMI), reel 577.
20.  “On the Duties of Physicians in Regard to Consultation,” Article IV, Item 1.  Code of Ethics of the American Medical Association.  (Chicago: American Medical Association Press, 1847), 99-100.
21.  Code of Ethics, (n. 20), p. 100.
22.  Kaufman, Homeopathy in America, (n. 12), 53.
23.  Our Family Physician: A Thoroughly Reliable Guide to the Detection and Treatment of all Diseases…Embracing the Allopathic, Homeopathic, Hydropathic, Eclectic and Herbal Modes of Treatment.  (Chicago: J. S. Goodman & Co., 1869), iv-v.
24.  Gillett, Mary C.  The Army Medical Department, 1818-1865.  (Washington, D.C.: Center of Military History, United States Army, 1987), 23.
25.  Bollet, Alfred Jay.  Civil War Medicine: Challenges and Triumphs.  (Tucson, Arizona: Galen Press, 2002), 32.
26.  Gillett, Army Medical Department, (n. 24), 180.
27.  Anton P. Sohn, “19th-Century Academic Examinations for Physicians in the United States Army Medical Department,” Western Journal of Medicine, 160, no. 5 (1994): 473.
28.  Medical and Surgical History of the Civil War, (n. 1), v.
29.  Brinton, Personal Memoirs, (n. 6), 173-74.
30.  Muster, service, and discharge data on the 148th P.V. can be found at the Pennsylvania State Archives, Harrisburg, in the Records of the Department of Military and Veterans’ Affairs, Record Group 19.  These include boxes: I-4377 Commission of Surgeons and Assistant Surgeons, 1862-1865 (19.164), I-4187 Commissions File Oct. 1862-May 1863 (19.14), and II-4257 Consolidated Morning Report Books of the PA Volunteers 1861-1865, Oct. 19, 1862-March 26, 1865, 148th Reg. (19.16)
31.  Letter from A. T. Hamilton to Col. John Hamilton dated March 13, 1863. All letters from Hamilton referred to in this article are unpublished and in private hands.
32.  Fox, William F.  Regimental Losses in the American Civil War 1861-1865, (Albany, NY: Albany Pub. Co., 1889).  Fox is also online at: http://www.civilwarhome.com/foxpref.htm.
33.  At 41 years old, Davis was not the oldest member of the regiment.  Colonel Beaver described two older men in Company F: “…two specially fine woodsmen who were much over age—Wash Watson and Bill Perry…must have been well onto sixty years of age.  Watson had a long white beard and Perry, although close shaven, seemed to be of equal age.”  Story of Our Regiment: A History of the 148th Pennsylvania Vols, ed. J. W. Muffly (Des Moines, Iowa: Kenyon Printing, 1904), 71.
34.  Bell, Herbert C., ed.  History of Northumberland County, Pennsylvania, (Chicago: Brown, Runk & Co., 1891), 267.
35.  Letter from A. T. Hamilton to Col. John Hamilton dated October 3, 1864.
36.  Donegan, Jane. B.  “Hydropathic Highway to Health”: Women and Water-Cure in Antebellum America.  (New York: Greenwood Press, 1986), 24.
37.  Marshall Scott Legan, “Hydropathy, or the Water-Cure,” Pseudo-Science and Society in Nineteenth-Century America, ed. Arthur Wrobel.  (Lexington: University Press of Kentucky, 1987), 81.
38.  Donegan, “Hydropathic Highway to Health,” (n. 36), 27.
39.  Advertisement.  “Water-Cure and Hydropathic Medical College,” Water-Cure Journal.  September 1856, 68.
40.  Advertisement.  “Water-Cure and Hygeio-Therapeutic College,” Water-Cure Journal.  October 1857, 91.
41.  Biennial Catalogue of the New-York Hygeio-Therapeutic College for 1856-7.  (New York:     Fowler and Wells, 1857), 10-11.
42.  Biennial Catalogue of the New-York Hygeio-Therapeutic College for 1856-7, (n. 41), 2.
43. “The Hydropathic Medical College,” Water-Cure Journal and Herald of Reforms, March 1856, 62.
44.  Biennial Catalogue of the New-York Hygeio-Therapeutic College for 1856-7, (n. 41), [3]-5.
45.  Hamilton, Alfred T.  Notebook: November 16, 1857–April 11, 1858, (Unpublished. Private collection).  Entry for December 4, 1857.
46.  Haller, Kindly Medicine, (n. 7), 69.
47.  Flannery, “Another House Divided,” (n. 16), 487.
48.  Ibid.
49.  Pennsylvania State Archives, Harrisburg.  Records of the Department of Military and Veterans’ Affairs, Record Group 19.  Reports of Examination of Candidates for Appointment as Medical Officers, 1861-1865 (19.174), Box 7-2879.  Documents include instructions to graders, grade sheets, and comments regarding exams.
50.  Letter from A.T. Hamilton to Col. John Hamilton dated February 5, 1863.
51.  Flannery, “Another House Divided,” (n. 16), 487.
52.  Rutkow and Rutkow, “Homeopaths, Surgery, and the Civil War,” (n. 10), 788.
53.  Ibid.
54. “Effects of the War Upon the Medical Profession,” The American Medical Times: Being a Weekly Series of the New York Journal of Medicine, 5 (July-December 1862): 178.
55.  A. T. Hamilton, “Fanaticism,” Water-Cure Journal, January 1860, 7.

56.  Letter from A.T. Hamilton to Col. John Hamilton dated October 3, 1864.
57.  Pennsylvania State Archives, Harrisburg.  Reports of Examination of Candidates for Appointment as Medical Officers, 1861-1865. (19.174)  Box 7-2879.
58.  Ibid.
59.  Pennsylvania State Archives, Harrisburg.  Record Group 19.  Medical Examination Theses Reports.  Folder for 1863.
60.  Pennsylvania State Archives, Harrisburg.  Record Group 19.  Medical Examination Thesis Reports. Folder for 1862.  Harrisburg, September 11, 1862.
61.  The esteem in which individuals were held is apparent when reading Story of Our Regiment, ed. J. W. Muffly, (n. 33).  Over 90 essays written by the officers and men provide one of the more compelling histories written by a Civil War regiment.
62.  Letter from A.T. Hamilton to Col. John Hamilton dated October 3, 1864.
63.  Letter from A.T. Hamilton to Col. John Hamilton dated October 25, 1863.
64.  Jacob Krider/Jacob Kreider Court Martial documents.  MM122.  National Archives. Obtained through The Index Project.
65.  Letter from A.T. Hamilton to Col. John Hamilton dated May 18, 1863.
66.  Letter from A. T. Hamilton to Col. John Hamilton dated January 4, 1865.
67.  James A. Beaver, “The Colonel’s Story,” Story of Our Regiment, ed. J. W. Muffly, (n. 33), 76-77.
68.  Ibid.
69.  William Gemmill, “The Story of Company D.  Part I,” Story of Our Regiment, ed. J. W. Muffly, (n. 33), 629.
70.  Ordronaux, John.  Hints on the Preservation of Health in Armies for the Use of Volunteer Officers and Soldiers bound with Manual of Instructions for Military Surgeons on the Examination of Recruits and Discharge of Soldiers.  (San Francisco: Norman Publishing, 1990), 63.
71. Brinton, Personal Memoirs, (n. 6), 61.
72.  Letter from A. T. Hamilton to Col. John Hamilton dated March 13, 1863.  
73.  Pennsylvania State Archives, Harrisburg.  James A. Beaver Collection.  Correspondence (6-4204).  Folder for 1863.  Letter from James A. Beaver to his Mother dated March 24, 1863.
74.  Letter from A. T. Hamilton to Col. John Hamilton dated June 6, 1863.
75.  Letter from A. T. Hamilton to Col. John Hamilton dated March 4, 1864.
76.  Letter from A. T. Hamilton to Col. John Hamilton dated April 1, 1864.
77.  Letter from A. T. Hamilton to Col. John Hamilton dated December 17, 1864.
78.  A. T. Hamilton, “The Surgeon’s Story.  Part I,” Story of Our Regiment, ed. J. W. Muffly, (n. 33), 166.
79.  Kaufman, Homeopathy in America, (n. 12), 153.

Image: figure i: Staff Officers of the 148th Pennsylvania Volunteers. Dr. Uriah Q. Davis (1821-1887) and Dr. Alfred T. Hamilton (1836-1911) appear in the middle. (Photo from "The Story of Our Regiment," 1904.)



Share

Facebook Twitter Delicious Stumbleupon Favorites