Drawing on History: A Civil War Cartoon

Hermann Faber: Medical Illustrator

By Tom Heintjes, 5-9-12

"Just as hammering one nail doesn’t make one a carpenter, so the old joke goes, neither does drawing one cartoon qualify one as a cartoonist. Hermann Faber without a doubt would not have considered himself a cartoonist, as he is now acknowledged as one of the founders of the medical-illustration profession. But the sole cartoon he produced, and later re-created, came during and as a result of American’s bloodiest period, the Civil War."
-Michael Rhode

In April 1862, Dr. William Hammond had been appointed the Union Army’s surgeon general after his predecessor, Dr. Thomas Lawson, resigned over differences with the autocratic Secretary of War Edwin M.  Stanton. Lawson had held the post since 1836, and his deputy, Dr. Clement Finley, filled in for less than a year before Hammond’s appointment. Neither man had remotely prepared the Army’s medical corps for the coming war. In May 1862 Hammond founded the Army Medical Museum, and that August he appointed Dr. John Brinton, a surgeon, as the museum’s curator and Joseph Woodward as Brinton’s assistant.

Brinton and Hammond shared a trait: They were inexhaustible in the search for improved medical knowledge. To that end, Brinton undertook the grisly but scientifically rewarding task of scouring the battlefields for specimens. (In a war that cost more than 550,000 lives, finding them was unfortunately not a problem.) He and Woodward compiled the information into the Medical and Surgical History of the War of the Rebellion, with Brinton writing the surgical material while Woodward produced the medical and disease sections. When they finished the work in the late 1880s, their research sprawled over six volumes and more than 6,000 pages. Once he began work on his section of the History, Brinton hired a staff of artists, enlisting them as hospital stewards and assigning them to military duty in the surgeon general’s office. In this capacity Hermann Faber joined the museum’s staff and produced many illustrations for the museum, mostly for Woodward’s medical section of the History.

Faber’s path to Washington, D.C., was a long and indirect one: Born in Germany on January 26, 1832, he studied illustration at the University of Giessen and emigrated to Philadelphia, where he married in 1853. He supported his family by producing anatomical illustrations until he joined Brinton and the museum in 1863.

In 1864 Brinton was abruptly relieved of his duties at the museum. Despite his medical qualifications, politics played a role in his dismissal, with several factors against him: He was a Hammond appointee, and Hammond had been court-martialed over purchasing Army blankets outside the usual channels (Stanton’s dislike of him didn’t help his case); he was a cousin of George McClellan (the discredited Union general and failed presidential candidate); and he was the proponent of a controversial and unpopular plan to retain volunteer surgeons equal in rank to the career Army surgeons after war’s end.

Faber’s sole cartoon concerned Brinton’s reassignment to normal medical duties. In his autobiography, Brinton recalls the circumstances surrounding the cartoon’s elements:

"I had been a long time in Washington, and had many friends. To some of these, I said good-bye, and to one of them, Mrs. Stephen A. Douglas, I sent a picture. I had often joked with her when officers had been sent away from Washington under the displeasure of the Secretary of War,—exiled, in fact, for the Secretary looked upon a detail to Louisville or St. Louis as a banishment, quite as in Russia they regard banishment to Siberia. Some officers took removal from Washington as a rather hard fate, but I had often told Mrs. Douglas that I was sure to be decapitated, but that when it came, like St. Denis (she, Mrs. Douglas, was a Catholic), I would lose my head with good grace. So I requested one of the artists of the Museum, Faber, a German of facile pencil, to make a pen-and-ink sketch of myself as St. Denis leaving the Museum, head in hand, for the region of the setting sun, with the bloody headman’s sword, the unfinished work of the Surgical History of the War, etc."

Brinton bestowed Faber’s resulting cartoon on Mrs. Douglas as a gift (no one knows if the original yet exists). The cartoon that today’s historian can view—the one accompanying this article—is Faber’s own re-creation of his first effort. Brinton recalled in his autobiography that Dr. Joseph K. Barnes, the new surgeon general, had heard of Faber’s cartoon and asked to see it. Woodward persuaded Faber to redraw it from memory. According to Brinton, he sensed the classically versed Woodward’s involvement in the motto Si tacuisses Philosophe mansisses (from Dante’s Inferno): “O if you had been silent, you would have then remained a philosopher.”

Barnes gave Faber’s second original to Secretary Stanton and, like its predecessor, its whereabouts are unknown.

Faber produced one other drawing of historical significance: a pencil drawing of President Abraham Lincoln’s deathbed. Lincoln had lain unconscious for several hours, and eventually died, in a boarding house across the street from Ford’s Theatre, where John Wilkes Booth assassinated him. Faber was brought into the room to sketch it immediately after Lincoln’s body had been removed. Barnes was among the doctors attending Lincoln after he was shot, and he approved Faber’s drawing for its accuracy. Of all the versions of Lincoln’s deathbed, Faber was the only one drawing from the scene. Like his St. Denis cartoon, Faber produced a second version of this work that now hangs in the Philadelphia Museum of Art.

Because of his military service, Faber was granted American citizenship on October 31, 1868. By then, he had returned to Philadelphia and resumed his career as a medical illustrator, and he instructed two of his sons in the trade. In his twilight yearshe taught medical illustration. According to one of his colleagues,the etcher J.L.G. Ferris, Faber spent these years contentedly. “He was a master of the classical line and had considerable erudition,” he said. “Affable and kindly, he was always ready to give advice to the student. He had short shrift, however, for the lazy or insincere worker.”

Toward the end of Faber’s life, America had begun to put the Civil War behind herself and began assuming a less provincial and more global perspective. When Faber died on December 10, 1913, the United States stood at the precipice of a war with Germany—Faber’s homeland.

The isolated nonmedical illustrations Faber produced were the result of great national traumas: the United States tearing itself apart and its president being slain. Though history has largely overlooked Faber, his artwork is an interesting stitch in the fabric of American history.

From: cartoonician.com

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Counting the Costs of the Civil War

By Jeffrey Allen Smith and B. Christopher Frueh, 11-7-13

While the desire to document military exploits and wars is as old as writing itself, the recording of military medical data is a relatively modern phenomenon. Although some initial attempts to chronicle the health of troops occurred in the first half of the 19th century, the first large-scale, wartime medical and behavioral health surveillance effort was conducted during the American Civil War.

This is partly a reflection on the dismal state of the medical profession before the mid-19th century. By the Civil War era, medical practice had improved markedly over the previous century, but it had yet to shake free of all the fetters of its lingering superstitions and misconceptions. For example, with the germ theory of disease still a generation away, it was commonly held that a variety of fevers and diseases, like cholera, were caused by miasma or the foul-smelling “bad” air that emanated from swamps and decomposing matter. On the other hand, medical sophistry notwithstanding, bloodletting had fallen out of fashion and belief in the prophylactic powers of cleanliness and proper hygiene were more widespread thanks in part to the hard work of Florence Nightingale during the Crimean War in bringing sanitation to British war hospitals. One ward’s mortality rate fell over 30 percent because of her efforts.

Thus, with medical advancements showing tangible results in lowering mortality rates and sickness, placing greater effort and funding into a larger systematic wartime recording of military medical data began to seem sensible, and feasible.

The United States Army Medical Department entered the Civil War understaffed and underfunded. This was partially the result of Surgeon General Thomas Lawson, an ossified War of 1812 sawbones, who infamously considered updated medical textbooks a superfluous use of funds. After Lawson died a month into the war, President Lincoln replaced him with Clement Finley, who soon ran afoul of Secretary of War Edwin Stanton in a fiery disagreement.

The choice of Finley’s replacement, William Alexander Hammond, was a stroke of good fortune for the department. Hammond, who had military experience and previously was the chair of anatomy and physiology at the University of Maryland Medical School, set about updating and modernizing the Medical Department. He is credited with increasing standards for army surgeons, reorganizing the ambulance service, founding the Army Medical Museum, expanding support to field and general hospitals and helping to establish the Army Nurse Corps.

Hammond also recognized that the medical record-keeping system for sick and wounded soldiers was “insufficient and defective” and in June 1862, barely a month into his tenure, his office announced a plan to compile the Medical and Surgical History of the Rebellion.

Still, it was not until Nov. 4, 1863, that the War Department issued General Orders No. 355, directing “Medical Directors of Armies in the field [to] forward, direct to the Surgeon General at Washington, duplicates of their reports… after every engagement.” A week later, the Surgeon General’s Office requested “all obtainable statistics and data in connection with past and future operations” and drew “particular attention” to a list of medical topics of elevated importance, the first on the list being “morale and sanitary condition of the troops.”

By January 1864, the scope and focus of the data collected expanded from the battlefield to include general hospitals. “Medical officers in charge of wards” were issued a “Register of Sick and Wounded” and a “Register of Surgical Operations” in which they kept “minutely and in detail, the particulars of all operations performed, or treated in [the] hospital.” These two registers later served as the foundation for the organizational structure of Medical and Surgical History of the Rebellion. A month later, the military began explicitly requesting medical reports for “Sick and Wounded Rebel Prisoners of War” and “White and Colored Troops.” With the inclusion of these medical reports, and a slight modification of a few others, the Surgeon General’s Office had in place a comprehensive system for tracking the medical condition of Civil War combatants by the spring of 1864.

Yet another year would pass before the office started to focus on medical reporting efficiency as well as effectiveness, but Hammond would not be around to see it. Apparently, in his zeal to modernize, Hammond fell victim to the “Calomel Rebellion.” After he banned the medicinal use of mercurial poisons like calomel, army physicians – who stood by these drugs as lifesavers – successfully ousted him from his post.

With Hammond gone, Secretary of War Stanton chose Joseph K. Barnes to serve as the fourth surgeon general in four years. Barnes studied medicine at Harvard University and the University of Pennsylvania before joining the military as an assistant surgeon in 1840. Unlike the previous surgeon generals, Stanton got along well with Barnes, and it showed in the War Department’s increased support of the Medical Department’s activities.

One of these endeavors was the organization of medical records. Bureaucratic delay, ineffectiveness and struggles to conceptualize and implement a final medical recording system notwithstanding, the unprecedented size and scope of the military medical data collected is truly impressive. Still, the struggle to organize the mountains of reports, analyze the data and effectively share it with the world would last longer than the war itself.

In June 1868, as the nation began to come to terms with the significance of the war, Congress commissioned Secretary of War Stanton to prepare for publication “five thousand copies of the First Part of the Medical and Surgical history of the Rebellion, [as] complied by the Surgeon General.”

A decade later the resulting tome, “The Medical and Surgical History of the War of Rebellion, 1861-65,” appeared, consisting of six volumes and totaling approximately 3,000 pages. Based exclusively on military and government medical records, it included statistical data on Union and colored troops broken down into a variety of subcategories. More than 100 separate tables organized by region and army group tracked 150 “diseases,” including “serpent bite,” gunshot wounds, dysentery, diabetes, “dropsy from heart disease” and even alcoholism and suicide. In addition, many of the “diseases” listed in the tables were in subsequent volumes given general descriptions, selective case studies, accounts of treatments and sometimes even illustrative photographs or color plates to further aid in contextualizing their effects on the health of the Civil War soldier.

Newspapers, photographs, diaries and soldiers’ letters all had the ability to create a visceral and real connection to the horrors and heroism of the Civil War. However, these sources could also prove selective and occasionally obscure the larger war. The “Medical and Surgical History” provides something else: an extremely detailed examination of the medical condition and toll taken on soldiers during the Civil War. Here, almost uniquely for the time, there is no euphemism, no soft focus, no attempt to diminish that cold, dispassionate arithmetic reality of the terrible cost borne by Civil War soldiers, both during the war and for decades after.

Follow Disunion at twitter.com/NYTcivilwar or join us on Facebook.

Sources: B. Christopher Frueh and Jeffrey A. Smith, “ Suicide, Alcoholism, and Psychiatric Illness Among Union Forces During the U.S. Civil War,” in the Journal of Anxiety Disorders, vol. 26 (2012).

Jeffrey Allen Smith is an assistant professor of history at the University of Hawaii, Hilo.

B. Christopher Frueh is a professor of psychology at the University of Hawaii, Hilo, a McNair Scholar, the director of research programs at the Menninger Clinic in Houston and, writing as Christopher Bartley, the author of “They Die Alone.”

From: opinionator.blog.nytimes.com

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Counting the Costs of the Civil War

By Jeffrey Allen Smith and B. Christopher Frueh, November 7, 2013

While the desire to document military exploits and wars is as old as writing itself, the recording of military medical data is a relatively modern phenomenon. Although some initial attempts to chronicle the health of troops occurred in the first half of the 19th century, the first large-scale, wartime medical and behavioral health surveillance effort was conducted during the American Civil War.

This is partly a reflection on the dismal state of the medical profession before the mid-19th century. By the Civil War era, medical practice had improved markedly over the previous century, but it had yet to shake free of all the fetters of its lingering superstitions and misconceptions. For example, with the germ theory of disease still a generation away, it was commonly held that a variety of fevers and diseases, like cholera, were caused by miasma or the foul-smelling “bad” air that emanated from swamps and decomposing matter. On the other hand, medical sophistry notwithstanding, bloodletting had fallen out of fashion and belief in the prophylactic powers of cleanliness and proper hygiene were more widespread thanks in part to the hard work of Florence Nightingale during the Crimean War in bringing sanitation to British war hospitals. One ward’s mortality rate fell over 30 percent because of her efforts.

Thus, with medical advancements showing tangible results in lowering mortality rates and sickness, placing greater effort and funding into a larger systematic wartime recording of military medical data began to seem sensible, and feasible.

The United States Army Medical Department entered the Civil War understaffed and underfunded. This was partially the result of Surgeon General Thomas Lawson, an ossified War of 1812 sawbones, who infamously considered updated medical textbooks a superfluous use of funds. After Lawson died a month into the war, President Lincoln replaced him with Clement Finley, who soon ran afoul of Secretary of War Edwin Stanton in a fiery disagreement.

The choice of Finley’s replacement, William Alexander Hammond, was a stroke of good fortune for the department. Hammond, who had military experience and previously was the chair of anatomy and physiology at the University of Maryland Medical School, set about updating and modernizing the Medical Department. He is credited with increasing standards for army surgeons, reorganizing the ambulance service, founding the Army Medical Museum, expanding support to field and general hospitals and helping to establish the Army Nurse Corps.

Hammond also recognized that the medical record-keeping system for sick and wounded soldiers was “insufficient and defective” and in June 1862, barely a month into his tenure, his office announced a plan to compile the Medical and Surgical History of the Rebellion.

Still, it was not until Nov. 4, 1863, that the War Department issued General Orders No. 355, directing “Medical Directors of Armies in the field [to] forward, direct to the Surgeon General at Washington, duplicates of their reports… after every engagement.” A week later, the Surgeon General’s Office requested “all obtainable statistics and data in connection with past and future operations” and drew “particular attention” to a list of medical topics of elevated importance, the first on the list being “morale and sanitary condition of the troops.”

By January 1864, the scope and focus of the data collected expanded from the battlefield to include general hospitals. “Medical officers in charge of wards” were issued a “Register of Sick and Wounded” and a “Register of Surgical Operations” in which they kept “minutely and in detail, the particulars of all operations performed, or treated in [the] hospital.” These two registers later served as the foundation for the organizational structure of Medical and Surgical History of the Rebellion. A month later, the military began explicitly requesting medical reports for “Sick and Wounded Rebel Prisoners of War” and “White and Colored Troops.” With the inclusion of these medical reports, and a slight modification of a few others, the Surgeon General’s Office had in place a comprehensive system for tracking the medical condition of Civil War combatants by the spring of 1864.

Yet another year would pass before the office started to focus on medical reporting efficiency as well as effectiveness, but Hammond would not be around to see it. Apparently, in his zeal to modernize, Hammond fell victim to the “Calomel Rebellion.” After he banned the medicinal use of mercurial poisons like calomel, army physicians – who stood by these drugs as lifesavers – successfully ousted him from his post.

With Hammond gone, Secretary of War Stanton chose Joseph K. Barnes to serve as the fourth surgeon general in four years. Barnes studied medicine at Harvard University and the University of Pennsylvania before joining the military as an assistant surgeon in 1840. Unlike the previous surgeon generals, Stanton got along well with Barnes, and it showed in the War Department’s increased support of the Medical Department’s activities.

One of these endeavors was the organization of medical records. Bureaucratic delay, ineffectiveness and struggles to conceptualize and implement a final medical recording system notwithstanding, the unprecedented size and scope of the military medical data collected is truly impressive. Still, the struggle to organize the mountains of reports, analyze the data and effectively share it with the world would last longer than the war itself.

In June 1868, as the nation began to come to terms with the significance of the war, Congress commissioned Secretary of War Stanton to prepare for publication “five thousand copies of the First Part of the Medical and Surgical history of the Rebellion, [as] complied by the Surgeon General.”

A decade later the resulting tome, “The Medical and Surgical History of the War of Rebellion, 1861-65,” appeared, consisting of six volumes and totaling approximately 3,000 pages. Based exclusively on military and government medical records, it included statistical data on Union and colored troops broken down into a variety of subcategories. More than 100 separate tables organized by region and army group tracked 150 “diseases,” including “serpent bite,” gunshot wounds, dysentery, diabetes, “dropsy from heart disease” and even alcoholism and suicide. In addition, many of the “diseases” listed in the tables were in subsequent volumes given general descriptions, selective case studies, accounts of treatments and sometimes even illustrative photographs or color plates to further aid in contextualizing their effects on the health of the Civil War soldier.

Newspapers, photographs, diaries and soldiers’ letters all had the ability to create a visceral and real connection to the horrors and heroism of the Civil War. However, these sources could also prove selective and occasionally obscure the larger war. The “Medical and Surgical History” provides something else: an extremely detailed examination of the medical condition and toll taken on soldiers during the Civil War. Here, almost uniquely for the time, there is no euphemism, no soft focus, no attempt to diminish that cold, dispassionate arithmetic reality of the terrible cost borne by Civil War soldiers, both during the war and for decades after.

Image: William Alexander Hammond, physician

Follow Disunion at twitter.com/NYTcivilwar or join us on Facebook.

Sources: B. Christopher Frueh and Jeffrey A. Smith, “ Suicide, Alcoholism, and Psychiatric Illness Among Union Forces During the U.S. Civil War,” in the Journal of Anxiety Disorders, vol. 26 (2012).

Jeffrey Allen Smith is an assistant professor of history at the University of Hawaii, Hilo.

B. Christopher Frueh is a professor of psychology at the University of Hawaii, Hilo, a McNair Scholar, the director of research programs at the Menninger Clinic in Houston and, writing as Christopher Bartley, the author of “They Die Alone.”

From: opinionator.blog.nytimes.com

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The Medical-Surgical History of the War of the Rebellion

Military precision proved a blessing to medical record-keeping, providing structure within the chaos. To organize, staff, stock and manage the vast hospitals, the military and the Sanitary Commission created new record-keeping systems.

Case histories were well-documented and autopsy reports were made for the future of medical education. Follow-up was extensive, and many post-surgical photographs were taken. Union Surgeon-General William Hammond improved the Army’s system for collecting and organizing medical data. Information and statistics on diseases, wounds and surgical procedures was carefully stored for future publication. This research laid the groundwork for many of the developments in medicine after the war.

The resulting six huge volumes, known as the Medical-Surgical History of the War of the Rebellion, (1861-65) were considered by the European medical community to be America’s first great contribution to academic and scientific medicine.

The Medical-Surgical History was a remarkable work. It was lauded as the greatest contribution of the era to military medicine and surgery. Records of approximately 6.5 million diagnoses of illness were recorded, substituting English names for the Latin. The Confederate Medical Department had kept similar records, retaining the Latin names, but most were destroyed in a fire in Richmond, Virginia in 1865.

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