Medical Instruments and Techniques

Information for this section was contributed by The College of Physicians of Philadelphia, in particular Jane E. Boyd, Ph.D., Wood Institute Research Associate, and Robert D. Hicks, Ph.D., Measey Chair for the History of Medicine and Director of the Mütter Museum & Historical Medical Library.

The Civil War spurred developments in medical techniques and instrumentation, particularly for surgical procedures. Cone-shaped minié bullets (minié balls) made of soft lead caused great damage to tissues and bones and the resulting wounds usually became infected. Surgeons used probes of different sorts to try to remove bullets and clean out wounds, but if these efforts were unsuccessful or if the wound was severe, more extensive surgery would be required.

Often, the only way to save a soldier’s life was amputation, cutting off the damaged limb. Another technique, used more often later in the war, was excision or resection. This removed only the injured section of the arm or leg, leaving a shortened, less functional limb.

Soldiers did not have to “bite the bullet,” as Civil War surgeons used anesthetic for virtually all amputations and for many other procedures as well. Still, amputation was a grisly procedure. Assistants were needed to administer the anesthetic (chloroform or ether, usually dropped on a cloth held over the mouth and nose), to keep the main artery closed, and to hold the limb being cut.

Though unconscious, patients would still move about, so they needed to be restrained. In field hospitals, amputations were performed in the open air rather than in the dark tents. Some soldiers witnessing these public, bloody scenes became prejudiced against surgeons, labeling them as butchers.

Medical kits included a wide range of cutting tools: knives, scalpels, bistouries (long, narrow knives for minor incisions), curettes for scraping and cleaning, and double-bladed lancets for making punctures. Tools used for amputations included tourniquets, scalpels, knives, bone saws, chain saws, sutures and bandages.

There were two main approaches to amputation procedures: the circular method and the flap method. In the first, the skin and tissue were rolled up, then pulled down and sewn closed after the limb was cut off. In the second, two long flaps of skin and tissue were cut, then folded over and sewn to form a stump. Infections after surgery, such as the condition called “hospital gangrene,” were very common, often causing the death of patients.

If the soldier survived, he could benefit from improved prosthetics. Braces of different sorts, articulated artificial legs and artificial arms outfitted with hooks and other tools were all developed to aid amputees. Amputations became rather common during the Civil War; in fact, Philadelphia’s South Street Hospital earned the nickname “Stump Hospital” due to the volume of amputee war veterans served there.

By this time, physicians had largely abandoned the so-called “heroic” methods of medical treatment, such as the blood-letting once thought to relieve inflammation. Wartime conditions called for a different sort of heroism: the courage to experiment, sometimes radically. New techniques emerged such as tracheostomies, arterial ligation, neurosurgery, and even plastic surgery to repair damaged faces. In an era before X-rays, doctors had difficulty assessing damage to the inside of the body. Serious wounds to the chest and abdomen were nearly impossible to treat and usually resulted in death. Civil War surgeons, however, had some success in repairing damaged lungs and bowels.

Thermometers were rarely used for medical purposes at the time, since they were cumbersome and body temperature was not usually studied apart from other symptoms. Hypodermic syringes for injections were also uncommon, as most medicine was taken orally. Nevertheless, doctors often used the most advanced technology of their day, even in the field—stethoscopes for listening to hearts and lungs, microscopes for examining blood and tissues and cameras for taking photographs of patients and wounds. Many of these tools were designed and made in Philadelphia, which was a major manufacturing center for precision instruments of all types.



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The Civil War: The Origins of Veterans’ Health Care

From: U.S. Department of Veterans Affairs
Va.gov

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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The Nation's First Home for Soldiers

Excerpted from: Darientimes.com, Darien, Connecticut
By Marian Castell

Fitch’s Home for Soldiers, on Noroton Avenue where the Allen-O’Neill Moderate Income Family Homes are now, was built using personal funds, by Benjamin Fitch, one year after the Battle of Gettysburg. For years it served as a shining example as the first and only home for soldiers in the U.S.

Facilities for orphans were included as the number of disabled soldiers declined, and room became available for the many children of the veterans. Due to the influx of children, the home then became the newest and most up to date school in town, and the state legislature incorporated it as Darien School District No. 5.

It was a prominent part of Darien for the next half century and served as a home, hospital and refuge for needy veterans of all wars. Blue-uniformed Civil War veterans were still a presence in town well into the 20th Century. Currently the headstones of hundreds of these veterans are visible in the state Veterans Cemetery across from the Darien police station.

Darien also has two Civil War Medal of Honor recipients buried in town. David Scofield is in the Slawson Cemetery and Oscar Peck, awarded the Medal of Honor at 14 years old, rests in the state Veterans Cemetery.

IMAGE: Many Civil War veterans made the Fitch Home for Soldiers in Darien their home after the war. It was the first such home for American veterans.

Mrs. Castell is the town historian and a member of the town Monuments & Ceremonies Commission.

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Mary Todd Lincoln at Bellevue Place

From: Abrahamlincolnonline.org

Ten years after Abraham Lincoln's assassination, a Chicago court declared his 56-year-old widow Mary insane and committed her to a mental institution. On May 20, 1875, she arrived at Bellevue Place, a private, upscale sanitarium in the Fox River Valley. Her determined efforts led to her release less than four months later, when her sister Elizabeth assumed her care in Springfield.
Robert Todd Lincoln, the president's eldest son and a practicing attorney, arranged the insanity trial after agonizing over his distressed mother's erratic behavior. He understood Illinois law, which required a jury trial for involuntary commitment to a mental institution. At 31, Robert was Mary and Abraham's only surviving child. His brother Eddie died long before the family left for Washington, Willie died in the White House, and Tad died in Chicago almost four years before the insanity trial.

In a June 1, 1875, letter to Mary's friend Sally Orne, he explained his difficult decision. "Six physicians in council informed me that by longer delay I was making myself morally responsible for some very probable tragedy, which might occur at any moment."

The Trial

Mary did not realize that a public trial awaited her, and was forcibly taken to the courthouse on May 19, 1875, by Leonard Swett, a lawyer who knew both Robert and her late husband. Isaac Arnold, a family friend who reluctantly became her defense attorney, did not contest the case, and allowed 17 witnesses to testify to her unstable condition, while not calling any witnesses of his own. During the trial, Robert testified, "I have no doubt my mother is insane. She has long been a source of great anxiety to me."

Mary's actual mental, emotional, and physical condition in 1875 is still debated by historians and clinicians. Historian Jean Baker, one of Mary's biographers, called her behavior "eccentric," said her migraine headaches had been mistaken for hallucinations, and that she had been taking large doses of chloral hydrate for insomnia. She also explained, "Rather than a progressive brain-destroying mania that required confinement, Mary Lincoln suffered from the personality disorder of narcissism."

Dr. Norbert Hirschhorn and Dr. Robert G. Feldman, on the other hand, maintain that "Symptoms imputed as insanity at her trial clearly had their origin in the organic disease of tabes dorsalis. The bizarre behavior in 1875 leading to hospitalization, with elements of acute anxiety, insomnia, and delusions, most resembles post-traumatic stress disorder, coinciding with the tenth anniversary of her husband's murder."

They believe Mary Lincoln suffered from tabes dorsalis as early as 1869 and cite symptoms of the disease in her own words and writings. They argue that Mary's health problems in the years following the trial affirm this diagnosis. "In the last decade of her life she suffered intense pain from a progressive and fatal disease, one that was misinterpreted as madness."

The trial's verdict required Mary to be committed to the State Hospital for the Insane, but allowed her to stay in a private hospital such as Bellevue Place if finances allowed it. She also could have stayed in Robert's home, but her tumultuous presence there four years earlier caused Robert's wife to leave temporarily.

Mary's case has been much debated by writers and historians. Would she have fared differently if her case had been tried years later or had a different defense attorney? In his book The Insanity File, historian Mark E. Neely, Jr. contended, "The history of the treatment of insanity in American law provides no real evidence that Mary Todd Lincoln's fate would have been different in modern times."

Mary's Stay at Bellevue Place

Patients at Bellevue Place were routinely given popular drugs of the era or physically restrained, but Mary had considerably more freedom. Jean Baker explains, "Mary Lincoln did what she had been convicted of failing to do: She lived a normal life. She visited with the superintendent's wife, took rides in her carriage, talked to the Pattersons' retarded daughter Blanche, sat on the front stairs, and wrote letters."

 Because Bellevue Place was only a 90-minute train ride from Chicago, it was convenient for Robert to visit his mother. He comforted Sally (and possibly himself) with the observation, "My mother is, I think, under as good care and as happily situated as is possible under the circumstances."

But Robert was deceived in thinking his mother was "happier in every way, in her freedom from care and excitement, than she has been in ten years." Authors Justin and Linda Turner wrote instead that "Robert, hoping for the best and meaning the best, failed to divine the turmoil in his mother's mind. Behind her subdued facade, her brain seethed with schemes to obtain her release."

With the help of lawyers James and Myra Bradwell, Mary managed to engineer a release from her indefinite confinement in record speed. Myra told a Chicago newspaper reporter, "Mary Lincoln is no more insane than I am." Mary left Bellevue Place on September 11, 1875, when she was released into the custody of Ninian and Elizabeth Edwards. On June 15, 1876, Mary was officially declared sane in a Chicago court.

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Mary Todd Lincoln: A Lunatic, or Just Grieving?

By Patricia Nugent

While President Abraham Lincoln’s legacy looms large, his wife remains a maligned, one-dimensional figure and has been considered “one of the most detested public women in American history,” according to biographer Jean H. Baker. I recently became fascinated by Mary Todd Lincoln quite by accident, when a friend gave me a book about her. And now Mary appears in a minimal supporting role in Stephen Spielberg’s new film  "Lincoln"--although in real life, Mary and Abe were partners in every sense of the word. As much as Sally Field’s portrayal attempted to humanize her, Mary’s lesser angels are all too obvious on screen as seen through that director’s lens.

Many of us know that the former First Lady was convicted of lunacy, instigated by her eldest son, Robert Todd Lincoln. She spent almost four months in an insane asylum until she was able to enlist support for a retrial, at which she was declared sane once more.

What we don’t know much about is what led to the behavior that was considered lunacy in the court of public opinion and a court of law. After extensive reading and my own writing about grief, my assessment is that Mary Todd Lincoln suffered innumerable losses in her life and had few socially acceptable means of expressing her sorrow. Such bottled-up sadness resulted in acting out behavior that was interpreted as insanity.

Mary lost her mother when she was only six. She desperately tried to please her stepmother but was rejected soundly and sent to boarding school. Upon marrying a poor country lawyer, Abraham Lincoln, she gave birth to Robert Todd, who was a cold, judgmental and unaffectionate son.

She birthed three more sons over the years, two of whom died prior to her husband’s assassination. Several of her relatives were killed fighting for the Confederacy, and her Southern family disowned her. Both sides accused her of being a traitor, leaving her with few confidantes. And she was holding her husband’s hand in Ford’s Theater when John Wilkes Booth shot him in the back of the head, exploding his brains all over her dress.

There was no provision for a pension for presidential widows, and she was soon evicted from the White House with no money and nowhere to go. She moved to a boarding house and was never again able to live with her two surviving children under one roof. Her son Tad became her constant companion until he, too, died a few years later at the age of 18. And a woman she considered her closest confidante betrayed her by writing a public expose.

Not only was there little time to grieve between incidents and duties, but women of Mary Todd Lincoln’s time were afforded little opportunity to do so. She was often shooed away from her children’s sick beds by the male doctors because she was too emotional. She was discouraged from attending the funerals, as it was considered unseemly for women to be seen grieving openly in public. (Women were expected to be the ones to give consolation, not to need consolation.) She desperately tried to stay with her dying husband, but her wailing and pleading with him not to die were unnerving to the attendants, so she was removed from the room, unable to say goodbye to the man she deeply loved.

That seems more than enough to make anyone go crazy! And while it is generally agreed that Mary was eccentric, neurotic and narcissistic, she tried to manage her grief just like so many of us. She shopped excessively, finding comfort in possessions while going deeply into debt. She sought mediums to help her communicate with those who had passed. (President Lincoln participated as well when their first son died, and Abe himself was subject to prolonged dark moods.)

She indulged in self pity and anger, enlisting anyone to listen to her tale of woe. She wore black from the time of her husband’s death until her own. She vacillated between wanting to be alone and wanting to be with friends. She couldn’t sleep and was sometimes delirious as a result. She had panic attacks and took drugs for anxiety. She became greatly despondent on the anniversaries of her loved ones’ deaths. She couldn’t face returning to Washington, D.C., where her husband had been murdered and was fearful that harm would come to her and her surviving children so she chose to live overseas for several years. And when it took too long to settle the estate, she took action unbecoming a woman by making a public case out it. She also actively and successfully campaigned for a presidential widow’s pension, again stretching the boundaries of acceptable female behavior.

As my own book illustrates, there are physical manifestations of sadness and grief as well. A study conducted at Johns Hopkins has proven that a broken heart can kill you, a condition known as stress cardiomyopathy. Neuroscience has demonstrated the neurological changes that can take place during prolonged grieving and how our emotions influence our brain function. Mary suffered migraines, backaches and a neurological condition. She sought alternative medical treatments, like spas, tonics and mineral waters.

These are very common behaviors for someone trying to bear up under sorrow. Robert claimed he sought asylum for his mother to save her any further public embarrassment, to get her out of the limelight as the crazy widow of Abraham Lincoln. Others think he was financially motivated or trying to preserve his own social standing. Whatever his motivation, it is possible that had Mary been given permission to openly grieve, a willing ear and physical comfort, the Lincoln family, and the nation as a whole, could have been spared much embarrassment.

From my work with bereavement groups, I would further clarify that prolonged sorrow does not typically cause insanity but rather can present as insanity. How many of us have forgotten to take a turn on a well-known route when preoccupied with our own emotional upheaval? How many of us might have been “put away” if we demonstrated the same supposedly irrational behaviors as Mary–such as compulsive shopping or sleeplessness or repetition of our traumatic stories? That’s why it’s so important to grieve our losses in healthy ways and not bury the sorrow deep within ourselves. And to help others do the same.

I recently gave a keynote address on grief and loss in Lexington, Ky., and so I visited Mary’s childhood home there. I sent healing energy to her, as crazy as that may sound to some.

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Civil War Stretchers

Source for this article:  "The Medical and Surgical History of the War of the Rebellion. (1861-65.)  Part III, Volume II, Chapter XV.--Transportation of the Wounded

      The first removal of the wounded from the battle-field was generally effected by means of hand litters. The number of litters issued during the war exceeded fifty thousand(1) (50,000). From the Purveyor's Office at New York, Brigadier General R. S. Satterlee reports that from April 1, 1861, to August, 1865, sixteen thousand eight hundred and seven (16,807) hand litters were issued. At the Medical Purveyor's Depot at Louisville, from November, 1863, to August, 1865, seven thousand and ninety-eight (7,098) hand stretchers were issued, and Surgeon D. L. Magruder, U. S. A., estimated that four thousand seven hundred and thirty-two (4,732) had been given out before November, 1863. The Medical Purveyor's Office at Philadelphia issued, from January, 1863, to August, 1865, five thousand five hundred and forty-eight (5,548), and the Office at New Orleans, from September, 1864, to the end of the war, eight hundred and thirty-five (835) stretchers.

  In the beginning of the war the Satterlee, or U. S. Regulation litter (FIG. 436), was supplied to the regiments. It weighed twenty-four and one-half pounds and was twenty-seven inches wide. The canvas consisted of two pieces, five feet ten inches long, sewed in the centre with a flat seam, and with a hem on either side seven and one-half inches wide, through which the poles were passed; there was an inch and a half hem on each end; on one end were three tarred rope loops to put over the pins on the cross-bar,
(1) The Records of the Property Division of the Surgeon-General's Office show that from 1861 to 1865 fifty-two thousand four hundred and eighty-nine (52,489) litters of various manufacture were purchased and issued to the troops.

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African-American Female Army and Navy Nurses

Written by: Kathryn Sheldon, former Curator Women In Military Service For America Memorial Foundation, Inc. During the Civil War, black women's services included nursing or domestic chores in medical settings, laundering and cooking for the soldiers. Indeed, as the Union Army marched through the South and large numbers of freed black men enlisted, their female family members often obtained employment with the unit. The Union Army paid black women to raise cotton on plantations for the northern government to sell. Five black nurses served under the direction of Catholic nuns aboard the Navy hospital ship Red Rover. Four of their names—Alice Kennedy, Sarah Kinno, Ellen Campbell and Betsy Young—have been recorded.  Black nurses are in the record books of both Union and Confederate hospitals. As many as 181 black nurses—both female and male—served in convalescent and US government hospitals in Maryland, Virginia, and North Carolina during the war. Susie King Taylor, Civil War nurse, cook, and laundress, was raised a slave on an island off the coast of Georgia. In April of 1861, Major General Hunter assaulted Fort Pulaski and freed all the slaves in the area, including Mrs. King. When Union officers raised the First South Carolina Volunteers (an all-black unit), Mrs. King signed on as laundress and nurse. Able to read and write, she also set up a school for black children and soldiers. Mrs. King's experiences as a black employee of the Union Army are recounted in her diary. She wrote of the unequal treatment, "The first colored troops did not receive any pay for eighteen months, and the men had to depend wholly on what they received from the commissary...their wives were obliged to support themselves and children by washing for the officers, and making cakes and pies which they sold to the boys in camp. Finally, in 1863, the government decided to give them half pay, but the men would accept none of this... They preferred rather to give their services to the state, which they did until 1864, when the government granted them full pay, with all back due pay." Susie King was never paid for her service. "I was very happy to know my efforts were successful in camp, and also felt grateful for the appreciation of my service. I gave my services willingly for four years and three months without receiving a dollar. I was glad, however, to be allowed to go with the regiment, to care for the sick and afflicted comrades." Following the war, Mrs. King established another school for freed slaves. When her husband, Sergeant Edward King of the First South Carolina Volunteers, died in 1866, she collected a widow's pension. In 1879, she married Russell Taylor. For the remainder of her life, she continued her advocacy for black Civil War troops. Immediately following the Civil War, William Cathey enlisted in the United States Regular Army in St. Louis, Missouri. William Cathey, intending to serve three years with the 38th US Infantry, was described by the recruiting officer as 5'9" with black eyes, black hair, and a black complexion. The cursory examination by an Army physician missed the fact that William was actually Cathay Williams, a woman. "William Cathey" served from November 15, 1866, until her discharge with a surgeon's certificate of disability on October 14, 1868. Despite numerous and often lengthy hospital stays during her service, her sex was not revealed until June 1891, when Cathay Williams applied for an invalid pension and disclosed her true identity. She did not receive the pension, not because she was a woman, but because her disabilities were not service related. Cathay was probably the first black woman to serve in the US Regular Army. From: womensmemorial.org Learn more about African-American Civil War nurses at www.CivilWarRx.com.

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Cathay Williams: Medical Issues of a Female Buffalo Soldier

From: Sangres.com

On November 15, 1866, Cathay Williams enlisted with the United States Regular Army in St. Louis, Missouri, for a three year tour of duty. She told the recruiting officer that she was 22 years old and a cook. She said her name was William Cathay and she was born in Independence, Missouri. She was illiterate and didn't know that her papers read "William Cathey" when she gave them to the recruiting officer. The records from the recruiting officer state that William Cathey was 5'9", black eyes, black hair, and black complexion.

An army surgeon examined her upon enlistment, and determined that the recruit was fit for duty. The exam had to be cursory, just checking for obvious and superficial impairments or abnormalities. If either the surgeon or the recruiting officer realized that William Cathey was female, well... 19th century U.S. Army regulations forbade the regular enlistment or commissioning of women.

Other than her birthplace, we know nothing of this woman prior to her enlistment in the U.S. Army. Even her age is uncertain. She might have been only 16 years old and, as do so many boys who lie about their age, she may have, too. The 1860's US Army hardly ever checked age claims, nor did they ask for proof of identity. As to why she might enlist in the Army, as a black woman in 1866 her prospects were pretty sad. But the army paid her more as a black male cook than she could have ever earned as a black female cook.

As women disguised as men had fought in the volunteer armies of the Revolution and of the Civil War, Cathay Williams may be the first to have served in the United States Regular Army in the 19th century. She is also the only documented African-American woman who served in the U.S. Army prior to the official introduction of women in 1948.

Upon enlistment, as William Cathey, she was assigned to the 38th U.S. Infantry, which had been officially established in August, 1866, as a designated, segregated African-American unit. (The 39th, 40th, and 41st Infantries were the other designated and segregated black units created that year.) The segregated African-American regiments were commanded by white officers, with the regimental headquarters of the 38th at Jefferson Barracks, Missouri.

On February 13, 1867, Company A of the 38th Infantry was officially organized, and William Cathey, along with 75 other black privates, was mustered into that company at Jefferson Barracks. However, at that time, she was in an unnamed St. Louis hospital, suffering an undocumented illness.

By April, 1867, William Cathey and Company A had marched to Fort Riley, Kansas. On the 10th of April, she went to the post hospital complaining of "itch". ("Itch" was usually scabies, eczema, lice, or a combination thereof, part the filth of camp life.) On April 30, along with 15 other privates, she was recorded as being ill in quarters. Because they were sick, all 16 privates had their pay docked 10 dollars per month for three months. She returned to duty on May 14, indicating that something other than "itch" had bothered her.

In June, 1867, the company was at Fort Harker, Kansas. On July 20, 1867, they arrived at Fort Union, New Mexico, after marching 536 miles. On September 7, Company A began the march to Fort Cummings, New Mexico, arriving October 1. They were stationed there for eight months.

From the records, it looks like she could march long distances as well as any man in her unit. When not on the march, all privates did garrison duty, drilled and trained, and went scouting for signs of hostile Native Americans. William Cathey participated in her share of their duties. There is no record that she ever engaged an enemy or saw any form of direct combat while she was enlisted.

On January 27, 1868, she was admitted to the post hospital at Fort Cummings, citing rheumatism. She returned to duty three days later. On March 20, she was again admitted to that hospital with the same complaint. Again, she returned to duty within three days.

On June 6, the company marched for Fort Bayard, New Mexico, completing the 47 mile march on the 7th. This was her last posting during her army stint. On July 13, she was admitted into the hospital at Fort Bayard, and this time was diagnosed with neuralgia (a catch-all term for any acute, intermittent pain caused by a nerve, or some part of the nervous system - which could actually be any number of symptoms from a wide range of diseases). She was gone from duty for a month. This was her last recorded medical treatment while in the Army.

During her entire military career, William Cathey was recorded as being in four different hospitals on five separate occasions, for varying amounts of time. And no one discovered that William Cathey was really Cathay Williams, am African-American woman. The fact that in five hospital visits, no one realized the sex of William Cathey raises a few questions about the quality of medical care available to the soldiers of the U.S. Army, even by 19th centuty standards, or at least to the African-American soldiers of that time. Obviously, she was never fully undressed during her hospital stays. There is no record of what kind of treatment was given to her at any of the hospitals. But whatever treatments she did receive, they obviously did not work.

On October 14, 1868, William Cathey and two other privates in Company A were discharged at Fort Bayard on a surgeon's certificate of disability. William Cathey's certificate included statements from the captain of her company and the post's assistant surgeon. The captain stated that Cathey had been under his command since May 20, 1867 "... and has been since feeble both physically and mentally, and much of the time quite unfit for duty. The origin of his infirmities is unknown to me." The surgeon stated that Cathey was of "...a feeble habit. He is continually on sick report without benefit. He is unable to do military duty.... This condition dates prior to enlistment." Despite the three-year enlistment, she served her country for just under two years.

After her discharge, she resumed wearing women's clothing and went back to being Cathay Williams. She worked as a cook for the family of a colonel in 1869 and 1870 at Fort Union. Then she went to Pueblo, Colorado and worked as a laundress for a Mr. Dunbar. In 1872, she settled permanently in Trinidad, Colorado, making her living as a laundress and part-time nurse.

In late 1889 or early 1890, she was hospitalized in Trinidad for nearly a year and a half but there's no record detailing the nature of her illness. She was indigent when she left the hospital, so in June 1891, based on her military service, she filed for an invalid pension. Her application brought out the fact that an African-American woman had served in the Regular Army.

Her original application, sworn before the local County Clerk, gave her age as 41. She stated that she was one and the same person as William Cathey who had served as a private in Company A, 38th U.S. Infantry, for just under two full years. In her application she claimed that she was suffering deafness, rheumatism and neuralgia, all of which she had contracted while in the army. She felt herself eligibile for the invalid pension because she could no longer sustain herself through manual labor. The clerk recorded her attorneys as Charles and William King of Washington, D.C., most likely "professional pension claim handlers" (the kind of creatures most of us know as "shysters").

She filed a supplemental declaration the following month in Trinidad. In the supplemental declaration, she contended that she contracted smallpox at St. Louis in October, 1868, and that she was still recovering from that disease when the Army had her swim across the Rio Grande River on the way to New Mexico. She stated that the combined effects of smallpox and exposure were what led to her deafness. Her attorneys never noticed the discrepancies of dates in the July, 1891, declaration (she swam across the Rio Grande during the march from Fort Harker to Fort Union in the summer of 1867, among other discrepancies).

On September 9, 1891, a medical doctor employed by the Pension Bureau examined Cathay Williams in Trinidad. His job was to provide a thorough examination of the patient and a complete description to the Pension Bureau of her physical condition at the time of the exam. The doctor described her that day as 5'7', 160 pounds, large, stout, and 49 years old. He said she wasn't deaf because she could hear a conversation. He also reported no physical changes in her joints, muscles, or tendons that might indicate rheumatism or neuralgia (obviously he didn't know that neuralgia was a problem of the nerves, not the muscles, making us question his competency). The doctor also reported that, on both feet, all her toes had been amputated and she could only walk with the aid of a crutch. His records provide no explanation as to how, why or when this happened. Other than the loss of her toes, the doctor stated she was in good general health. He did declare the impairment caused by the amputations permanent but his opinion as to a disability rating was "nil".

In addition to ordering her physical examination, the clerks at the Pension Bureau in charge of her case solicited information from her private doctors. Those men could not, or did not, give up any information. While it is apparent the amputations happened after her military service, those severed toes are still another unexplained incident in the life of Cathay Williams.

In February, 1892, the Pension Bureau rejected her claim for an invalid pension and notified her lawyers in April. They didn't respond until the following September. While they conceded there was no proof she acquired deafness in the line of duty, they tried to follow up on the disability of the feet and claimed she lost her toes due to 'frosted feet'. Frostbite would have qualified her for an invalid pension, if she has suffered it during her service, and if it had been recorded as happening.

The Pension Bureau rejected her claim on medical grounds, stating that no disability existed. In those days, there were five lawful grounds for denial of an invalid pension:

1. Desertion - not valid.
2. The disability existed prior to enlistment - could have been cited by the bureau, based on the surgeon's statement on her discharge certificate that the feeble condition pre-dated enlistment.
3. The disability was not due to service - also could have been cited by the bureau, as they could find no documentation of deafness, smallpox, and presumably, frostbite during her tenure in the army. And she did not claim disability due to neuralgia or rheumatism.
4. The service was not legal - The Pension Bureau could have attempted that excuse immediately, because the former soldier in question was a woman who had passed herself off as a man in order to join the army. Enlistment of women in the military was illegal.
5. No disability exists.

Perhaps the Trinidad doctor's report, which basically stated she was fine, held the most weight in the case. But Cathay Williams was disabled. She could only walk with the permanent aid of a crutch. And, for different reasons, the army itself had deemed her disabled for service in 1868. The pension clerks offered no explanation for picking the "no disability" grounds for denial of the pension. The review personnel of the Pension Bureau rubber-stamped the decision, and didn't raise any questions about the case.

The fact that the Pension Bureau chose the least defensible reason for denial, that she was not disabled, brings up the question of how fairly and how thoroughly her case was treated. She was truly disabled. She may not have been an invalid in the strictest sense of the word, but as a laundress, her ability to work and make a living was severely limited by her not being able to walk or stand without aid.

Surprisingly, the Pension Bureau never questioned her identity, and never appeared to doubt that William Cathey of the 38th Infantry and Cathay Williams of Trinidad, Colorado, were one and the same. By 1891, the Pension Bureau had already dealt with more than one woman who had disguised herself as a man and served her country during the Civil War and had come back to apply for some sort of pension. And women who applied for pensions based upon army service usually met with resistance, not just from the pension clerks, but from the army itself. Maybe a small, brief notation in Cathay Williams' pension file sums it up. In the margins, a clerk wrote that the question of identity was never raised as the claim was rejected for medical reasons. This one sentence opens the possibility that her service may have been questioned had there been no way to deny her claim on strictly medical grounds.

As we have almost no records of Cathay Williams before her military enlistment, we also have almost no records of her after her pension application was denied. She must have died somewhere between 1892 and 1900 as her name doesn't appear on the Census rolls for Trinidad from 1900. She was an improbable pioneer. Her army service was short-lived and not brilliant. She was mustered out of the army through no fault of her own - she was just "unhealthy." She was uneducated, she possibly suffered from a long-term debilitating disease (mild diabetes - which would account for the amputated toes), in lowly circumstance, and perhaps even somewhat unintelligent. What we do know about her suggests that her life was difficult. The importance of Cathay Williams' life isn't only in the recognition that she is the only documented black woman who served in the Regular Army infantry during the 19th century but that she did so against incredible odds. And she most probably wasn't trying to prove anything to anyone, she was just trying to make a living and get by in a very hard time.

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