Abraham Lincoln’s son, Robert, is Connected to Three Presidential Assassinations

By Bette Lou Higgins

Did you know that Abraham Lincoln’s son, Robert, is connected to three presidential assassinations?

Obviously, he was at the White House when his father was shot. He was Secretary of War for President Garfield and was an eyewitness to the shooting by Charles J. Guiteau on July 2, 1881. Then he was at the Pan-American Exposition in Buffalo, New York, when President McKinley was shot by Leon Czolgosz on September 6, 1901. Luckily, he was not an eyewitness to that event!

As if all that isn’t strange enough, Robert was once saved by the famous actor Edwin Booth, brother of his father’s assassin, John Wilkes Booth. Though the exact date is uncertain, apparently it was sometime in late 1863/64 in Jersey City, New Jersey. Robert was on a train platform while a group of passengers were purchasing their sleeping car places from the conductor who stood at the entrance of the car. The platform was about the height of the car floor with a narrow space between the platform and the car body. In the crowd, Robert was pressed against the car body while waiting his turn. The train began to move and he was twisted off his feet. He dropped with feet downward, into the open space. Hanging there helpless, Robert felt someone grab his coat collar and vigorously pull him up and out to to the platform. When he turned to thank his rescuer, he recognized the famous actor. However, Booth didn’t know whose life he had saved until months later when a friend happened to send him a letter to complimenting him for his heroism. Apparently, the discovery of his involvement in saving the president’s son’s life gave him some comfort after his brother had taken the life of Robert’s father.

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Dr. Jonathan Letterman

By John Tooker, MD, MBA, FACP
Excerpted from: "Antietam: Aspects of Medicine, Nursing and the Civil War"

Jonathan Letterman was a native Pennsylvanian, graduating from Jefferson Medical College in Philadelphia in 1849, soon followed by military service as a U.S. Army Medical Department Assistant Surgeon in the Seminole Indian Wars with Stonewall Jackson. Assigned to the Army of the Potomac in June 1862, Major General McClellan promoted Letterman to the post of Medical Director of the Army of the Potomac.

By September, Letterman had devised an efficient and, for the times, modern system of mass casualty management, beginning with first aid adjacent to the battlefield, removal of the wounded by an organized ambulance system to field hospitals for urgent and stabilizing treatment, such as wound closure and amputation, and then referral to general hospitals for longer term definitive management. This three-stage approach to casualty management, strengthened by effective and efficient transport, earned Letterman the title of “The Father of Battlefield Medicine”. While simple in design, the orderly and organized execution of a casualty management plan in the confusion of war, with very large numbers of casualties, was a massive undertaking.

Each battle required advance planning and marshalling of vital resources, such as skilled and trained first aid attendants near the battlefield, ambulance attendants and drivers, wagons, mules, nurses, surgeons, medical supplies, clean water, food and firewood. Communications among the cooperating parties were difficult, and, of course, the rate at which casualties were received could not be controlled. Letterman's official battle report outlines in detail the logistical challenges of providing medical support to the army.

The management of casualties was organized at the unit level—first aid at the regimental level with triage to the mobile field hospitals at the division and corps level. The ambulance corps was established by U.S. Army Special Order 147 in August of 1862, following the Seven Days Battle that ended the Peninsular Campaign in July of 1862. Letterman's model of casualty management became the standard for the Union Army by an act of Congress in March 1864. At First Manassas in 1861, with about 5,000 combined dead and injured soldiers, it took a week to get the casualties off the field. At Antietam, with about 23,000 dead and wounded, all the casualties were removed from the battlefield in 24 hours.

The mass casualty management system that Letterman devised was extensively utilized after Antietam, perhaps no better than at Gettysburg. There were more than 50,000 casualties, dead and wounded during the three day battle in early July, 1863. At the close of the battle, 22,000 wounded Union and Confederate soldiers were treated according to the Letterman model. A large general hospital, Camp Letterman General Hospital, was constructed at Gettysburg to provide care to the wounded long after the armies had moved on. Once the general hospital closed, those needing continuing hospitalization were shipped to larger hospitals in Philadelphia, Baltimore, Washington and Richmond.

Dr. Jonathan B. Letterman resigned his commission in December, 1864, completing his service to the Union Army and moved to San Francisco where he practiced medicine and served as a coroner. His memoir, Medical Recollections of the Army of the Potomac, was published in 1866. Letterman died at the young age of 48 on March 15, 1872 and was later interred in Arlington National Cemetery. The Army Hospital at the Presidio was named Letterman General Hospital in 1911, honoring the military physician who pioneered the care of battle casualties.

From: ncbi.nlm.nih.gov

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Pharmacy in the American Civil War

By G.R. Hasegawa
From: American Journal of Health-System Pharmacy

Abstract
The role of pharmacists and the process of military drug supply in the American Civil War are described. Most raw drugs used in the United States in the mid-1800s were imported. During the Civil War, imports into the North continued, but the Union blockade forced the Confederacy to obtain medicines through means such as smuggling, capture of enemy supplies, and processing of indigenous medicinal plants.

Medical supplies for Civil War troops were typically purchased by military physicians called medical purveyors and sometimes by pharmacists serving as acting medical purveyors. In the latter half of the war, U.S. Army medical laboratories, in which many pharmacists were employed, inspected purchases, repackaged supplies bought in bulk, and manufactured medicines from raw materials.

The Confederacy also had medical laboratories, which were primarily responsible for manufacturing medicines from indigenous plant material but also inspected drugs that had been smuggled into the South. At a few large Union medical depots, pharmacists called medical storekeepers assumed many of the responsibilities of medical purveyors by receiving, storing, issuing, and accounting for supplies.

Noncommissioned officers called hospital stewards assumed diverse duties that included dispensing drugs prescribed by military physicians. Although many hospital stewards were pharmacists or physicians, others had no previous pharmaceutical experience. Civilian pharmacists were employed in the medical laboratories and in military general hospitals. Pharmacists participated in nearly every aspect of military drug supply during the Civil War.

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Confederate Medical Personnel

 By DeAnne Blanton

If your Civil War-era ancestor, whether free or slave, white or black, served the Confederate army in a medical capacity, it is possible that you may find documentation of his or her role in records at the National Archives in Washington, D.C. Documentation of Confederate medical personnel is located in multiple records series of Record Group 109, War Department Collection of Confederate Records.

Record Group 109 chiefly comprises records created by the government of the Confederate States of America, with those of the Confederate War Department and army being the most voluminous. Many of these Confederate records were surrendered to or captured by Union forces during and at the end of the Civil War. Other Confederate records came into the collection during the second half of the nineteenth century through donation to, or purchase by, the federal government. This Confederate records collection remained in the custody of the U.S. War Department until transfer to the National Archives in 1938.

Prior to transfer, the Adjutant General's Office (AGO) cared for the Confederate records. The AGO reclassified Confederate record books and bound volumes into subject headings, called "chapters"; assigned numbers to the individual volumes; and added non-Confederate records to the collection, such as those created by the federal government or Union army relating to the Confederate government or military. The AGO also created reference compilations relating to individual Confederate soldiers and citizens and added these records to the larger collection of Confederate records.

Before embarking on genealogical research concerning Confederate medical personnel, one should note that records do not exist for every individual who worked in a medical capacity, military or civilian. Many records created by the Confederate States of America were deliberately destroyed by Confederate officials to avoid their falling into enemy hands. Further, untold Confederate government documents burned in the fire that broke out in Richmond, Virginia, the Confederate capital, on April 3, 1865. Additionally, extant records relating to medical personnel almost exclusively pertain to individuals who were paid for their services. It appears that the Confederate government did not document the assistance of uncompensated medical volunteers.

Confederate medical personnel mainly consisted of medical officers, civilian employees, and soldiers on detailed duty. Medical officers were surgeons and assistant surgeons in the military service. Civilian employees included hospital attendants, stewards, druggists, nurses, matrons, wardmasters, manual laborers, cooks, and laundresses. The records relating to civilian medical employees do not solely concern Caucasians. Some records relating to the medical employment of African Americans also exist. This article does not discuss detailed soldiers on medical duty because their activities are documented by compiled military service records for Confederate soldiers, which are also in the National Archives.

Medical Officers
Surgeons and assistant surgeons served with regiments, higher army commands, in specified districts, or in specific Confederate hospitals. There are three main series of bound records created by the Confederate Medical Department pertaining to medical officers. These bound volumes are all found in chapter VI, the subject designation for medical matters.

Register of appointments of medical officers, 1861-1863 (vols. 141, 143), provides the officer's name, rank, date of appointment, assignment, and remarks. The remarks mostly concern dates of promotion, resignation, furlough, transfer, or retirement, and dates and causes of death, if applicable. These volumes are arranged alphabetically by initial letter of officer's surname.List of medical officers, 1861-1864 (Vol. 142), provides name, rank, assignment, date of commission, and remarks. For example, this small, unarranged volume shows that Waddy Thompson, surgeon, served with the Twelfth Virginia Light Artillery. He was commissioned July 28, 1862, and received a thirty-day furlough from July 5, 1864.

The most complete records showing the service of Confederate surgeons and assistant surgeons are in the reference file relating to medical officers for the period 1861-1865 (entry 461). This series, compiled after the Civil War by the AGO, comprises seven archives boxes of alphabetically arranged cards showing name of officer, rank, and citations to original Confederate records, such as correspondence files or regimental and hospital records, that mention, or provide further information about, the individual. The card for assistant surgeon V. Marcellus Neal reveals that his name appears on the muster rolls of the Thirty-seventh Alabama Infantry.

Genealogists researching Virginians should note records of medical officers from Virginia, 1861-1865 (entry 31). This series, also created by the AGO, includes a consolidated handwritten list and individual cards, both arranged alphabetically by name. The list and cards provide identical information about the Virginia officers: rank, date of appointment, place or regiment where he served, and remarks, which are similar in content to those found in the previously cited bound volumes.

To gain access to records pertaining to Confederate medical officers, one need only know the name of the individual. All of the series offer proof of service, and entry 461 (described above) contains leads to other records series one might investigate for more information. None of these records, however, offer any details about the officer's daily service and experiences or his medical and family background.

Civilian Employees
Confederate medical personnel, other than medical officers, were civilian employees of the government of the Confederate States of America who mostly worked in army hospitals throughout the South. The main source of information about, and references to, hospital personnel ishospital rolls, 1861-1865 (entry 28). This series comprises thirty-six boxes of trifolded muster and payrolls. (Muster rolls were descriptive personnel lists; payrolls note the amount and date of issue of wages.) In many instances, the extant hospital rolls cite black and white workers. These rolls were created at most, but not all, hospitals within the Confederate States of America. Temporary hospitals, such as those established on the battlefield, are not usually represented.

The rolls are arranged by state, thereunder by name and/or location of hospital, thereunder roughly by year and month. The individual rolls list the full names of stewards, wardmasters, cooks, nurses, matrons, and others employed at the hospital when the roll was filled out. However, enslaved African Americans are usually only listed under their first names. The names of the slaves' owners are also listed. Additionally, the rolls cite the employees' duties or job title, wages, and the dates they were attached to the hospital.

The role for the Empire Hotel Hospital in Atlanta, Georgia, dated February 23, 1862, shows that Elizabeth Tatum was employed as a nurse at $10.00 Confederate a month; George W. Buckles was also a nurse, at $7.50 a month; William ("colored") was employed as a cook, with his $20.00 a month paid to R. Rogers; Teeny ("colored") was a laundress, with her $8.00 wages paid to L. B. Davis; S.A.R. Summerlin worked as a matron earning $18.50 a month. Many of the hospital rolls include an inspection statement. The Empire Hotel Hospital was found to be in "first rate condition."

In order to search the hospital rolls for references to a specific individual, one must know where the person may have been employed-either the name or location of the hospital. In the case of enslaved African American workers, one may need to know the name of his or her owner.

Hospital Volumes
Record books relating to medical personnel survive for some Confederate hospitals, especially the larger ones. All of these hospital volumes are located in chapter VI; none have name indexes. What follows is a list of the Confederate hospital bound records that might be useful in genealogical research, if the place of employment is known. The volumes almost exclusively pertain to white employees and officers. While they can prove that a specific individual aided the Confederate cause in a medical position, the volumes do not offer details as to the individual's daily work experiences or family background.
Record book, Fort Morgan [Alabama] Hospital, 1862-1864 (vol.5

Record book, St. Mary's [Dalton, Georgia] Hospital, 1862-1863 (Vol. 4)

Record book, Pettigrew General Hospital No. 13 [Raleigh, North Carolina], 1864-1865 (Vol. 525)

Record book, General Hospital No. 2 at Lynchburg [Virginia], 1863-1864 (Vol. 529)
Hospitals in Richmond:
Record book, General Hospital No. 4, 1863-1864 (Vol. 181)

Record book, General Hospital No. 9, 1862-1864 (Vol. 81)

Record book, General Hospital No. 13, 1862-1865 (Vol. 256)

Lists of employees, General Hospital No. 21, 1862-1864 (Vol. 13)

Record book, General Hospital No. 24, 1863-1865 (Vol. 122)

Record of employees and patients, Chimborazo Hospital,1861-1864 (Vol. 33)

Record book, Chimborazo Hospital No. 1, 1863-1864 (Vol. 448)

Record book, Chimborazo Hospital No. 2, 1864-1865 (Vol. 80)

Record book, Chirnborazo Hospital No. 3, 1862-1864 (Vol. 455 1/4

Record book, Chimborazo Hospital No. 4, 1863-1865 (Vol. 317)

Record books, Chimborazo Hospital No. 5, 1861-1863 (vols. 61 and 220)

Rosters of employees, Howard's Grove General Hospital, 1862-1864 (Vol. 342)

Requisitions for supplies and lists of employees, Howard's Grove General Hospital, 1862-1863 (Vol. 355)

Record of employees and accounts, Howard's Grove General Hospital, 1861-1865 (Vol. 191)

Letters and orders issued and received and personnel lists, Jackson Hospital, 1861-1865 (Vol. 414 1/2)
Multiple lists of matrons, Negroes (sic), and medical officers stationed at Camp Winder General Hospital in Richmond are found in lists of employees, Division No. 2, 1863-1864(Vol. 218). For example, one list shows that Mrs. S. M. Christian, aged seventy, served as chief hospital matron from June 1, 1864. The multiple lists of black employees are arranged by occupation and provide date of employment and name of owner. The lists show that Gabriel, aged seventeen, was a nurse; Blake, aged twenty-five, was a cook; and Grace, aged twenty-two, was a laundress.

Five Confederate volumes created at Richmond hospitals provide information specifically about African Americans working within the facilities. These records are:
List of colored employees, General Hospital No. 21, 1862-1863 (Vol. 14)

Lists of employees and accounts for food purchased, Chimborazo Hospital No. 1, 1862-1865 (Vol. 307)

Record book, Chimborazo Hospital No. 1, 1862-1865 (Vol. 310)

Lists of employees, Chirnborazo Hospital No. 2, 1862-1865 (Vol. 85)

Jackson Hospital, lists of employees, Division Nos. 1-4, 1863-1864 (Vol. 187)
All of these volumes are within chapter VI, and none are indexed. Volumes 310 and 85 are difficult to read, as the paper is darkened and the ink faded with age. If you suspect your African American ancestor may have been a slave or free person of color in Richmond during the period of the Civil War, the five hospital volumes cited above might be worth consulting. However, when researching slaves, one might need to know the name of the owner.

The hospital books provide the names of the slaves employed— mostly first names, but in a number of cases, surnames as well— and the full names of the respective owners. All except volume 310 list the occupation at the hospital, dates of employment, and remarks.

Occupations are mainly cooks, nurses, carpenters, and hospital attendants. While the remarks sections are usually blank, some reveal dates of discharge, transfer, or death. Volumes 307 and 187 also cite the wages slaves earned for their owners. No other information about them is given in these records. Volume 187 shows that Jim Allen, owned by G. Mears, worked as a cook in the Second Division of the hospital; Julius, owned by Samuel Bailey, was a nurse in the Third Division; Leelia Taylor, a laundress, earned twenty-five dollars a month for E. S. Maynard; and Catherine, owned by Mrs. J. N. Cooper, began working at Jackson Hospital on October 10, 1864.

Although most of the black employees listed in these five bound volumes were slaves, we can also find documentation of some free blacks employed at the hospitals. For example, in volume 85, the "list of servants employed" shows that Candace Logan, listed as free, worked as a cook for five hundred dollars a year. William Jamison and George Cox, both listed as free, worked as nurses.

Access
Researching a Southern medical officer or employee is not an easy task, but with a few clues to begin with, the records may provide the proof of their Confederate service, employment, or servitude. The Confederate records discussed herein have not been filmed as a National Archives microfilm publication. To view them at the National Archives Building in Washington, D.C., or to request further information, write to the Old Military and Civil Branch, National Archives, Washington, DC 20408.

DeAnne Blanton is an archivist in the National Archives and Records Administration's Old Military and Civil Branch. She received her M.A. in American history from Wake Forest University.

From: archives.gov

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Battlefield Medicine and Surgery at the Beginning of the Civil War

By John Tooker, MD, MBA, FACP
Excerpted from: "Antietam: Aspects of Medicine, Nursing and the Civil War"

To put the Civil War in perspective, the U.S. population at the war's beginning was about 34 million. Nearly 4 million men, more than 11 percent of the entire American population, were engaged in the war (1). Most came from rural backgrounds, lacked immunity to communicable disease and were unprepared to be concentrated in close, unsanitary quarters, making them susceptible to illnesses such as dysentery, measles, smallpox and malaria. Military surgeons had little understanding of the causes of communicable disease and most treatments were ineffective. Basic necessities, particularly in the Confederacy later in the war, such as shoes, clothing, food and clean water, were in short supply. On average, the Confederate soldier was estimated to be ill or injured about 6 times over the course of the war. The viewpoint of the average soldier is more telling than statistics. From Pvt. Alexander Hunter, Company A, 17th Virginia Infantry on arrival at Hagerstown near Sharpsburg, Maryland before the Battle of Antietam: “Another day's march brought us to Hagerstown where the cornfields and orchards furnished our meals. The situation, in a sanitary point, was deplorable. Hardly a soldier had a whole pair of shoes. Many were absolutely bare-footed, and refused to go to the rear. The ambulances were filled with the foot-sore and sick”.

Most Civil War military surgeons were graduates of unregulated two-year medical schools. At the beginning of the conflict, most had never treated a gunshot wound, and very few were experienced in evaluating and treating the injuries of war. Although general anesthesia became available in 1846, most surgeons were untrained in surgical techniques and had not performed surgery. Lister's theory of sepsis and subsequent antiseptic techniques were not applied to surgical and post-operative care until after the war. While chest, abdominal and neurological surgery were rarely possible, treatment of extremity injuries was possible and necessary. Amputation was commonly practiced and became the primary surgical skill of the Civil War battlefield surgeon. The organization of medical care in 1861 when the war began was centered on the role of individual physicians rather than systems of care designed to handle mass casualties. Both armies were shocked at the high casualty rates and unprepared for the management of these casualties.

Prior to the onset of hostilities in 1861, the Medical Department of the Union army was small, numbering only one Surgeon General, thirty Surgeons, and eighty-four Assistant Surgeons. Some of these surgeons resigned their Union commissions to join the Confederate Medical Department. By the end of the war four years later, the Union Medical Department expanded to more than 10,000 surgeons.

The Medical Department of the Confederate States of America was established in February, 1861 by the “Act for the Establishment and Organization of a General Staff for the Army of the Confederate States of America” of the Provisional Congress. The act provided for a medical department of one Surgeon General, four surgeons, and six assistant surgeons. By the end of the war, the South had about 4,000 military surgeons.

From: ncbi.nlm.nih.gov

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Civil War Cooking: What the Union Soldiers Ate

By Tori Avey, From pbs.org 

"We grab our plates and cups, and wait for no second invitation. We each get a piece of meat and a potato, a chunk of bread and a cup of coffee with a spoonful of brown sugar in it. Milk and butter we buy, or go without. We settle down, generally in groups, and the meal is soon over… We save a piece of bread for the last, with which we wipe up everything, and then eat the dish rag. Dinner and breakfast are alike, only sometimes the meat and potatoes are cut up and cooked together, which makes a really delicious stew. Supper is the same, minus the meat and potatoes."

- Lawrence VanAlstyne, Union Soldier, 128th New York Volunteer Infantry

The biggest culinary problem during the Civil War, for both the North and the South, was inexperience. Men of this time were accustomed to the women of the house, or female slaves, preparing the food. For a male army soldier, cooking was a completely foreign concept. Thrust into the bleak reality of war, soldiers were forced to adjust to a new way of life—and eating—on the battlefield.

In the early stages of the war, the Union soldiers of the North benefited from supervision by the United States Sanitary Commission. Commonly known as The Sanitary, it made the soldiers’ health and nutrition a top priority. Even before the start of the war, volunteers in The Sanitary were trained to find and distribute food to soldiers stationed in the field. They were expected to be knowledgeable in determining which foods were available during each season, and how to preserve food items for transportation and storage. It was the responsibility of The Sanitary to schedule and maintain a constant supply of food to soldiers at war.

While the Sanitary did their best to provide a reliable supply of food, that didn’t guarantee a tasty or healthy meal. Considering there were nearly 2 million soldiers in the Union army, the Sanitary did not focus on flavor nor variety. It was a large enough task to provide the basics and keep their soldiers from starving. When food deliveries were interrupted by weather delays or other challenges, soldiers were forced to forage the countryside to supplement their meager diets.

"Again we sat down beside (the campfire) for supper. It consisted of hard pilot-bread, raw pork and coffee. The coffee you probably wouldn’t recognize in New York. Boiled in an open kettle, and about the color of a brownstone front, it was nevertheless… the only warm thing we had."

- Charles Nott, Union Soldier, 16 yrs. old

At the start of the war, James M. Sanderson, a member of the Sanitary, became concerned with reports of poor food quality and preparation. Sanderson, who was also a hotel operator in New York, believed that his experience would be of value to the Union. With the help of New York Governor Edwin D. Morgan, Sanderson set out to visit soldiers in the field, in hopes of teaching them a few simple cooking techniques. He started with the camps of the 12th New York, as they were deemed “most deficient in the proper culinary knowledge.” He reportedly saw a significant change in just three days.

On July 22, 1861, just after the Union’s loss in the First Battle of Bull Run, Sanderson approached the War Department with a proposal. He asked that a “respectable minority” in each company be expertly trained in the essential basics of cooking. For every 100-man company, the skilled cook would be appointed two privates; one position would be permanent and the other would rotate among the men of the company. The skilled cook would be given the rank of “Cook Major” and receive a monthly salary of $50. It would be the Cook Major’s responsibility to ration the food, prepare it, and delegate tasks to the company cooks. Sanderson had unknowingly proposed his idea at exactly the right time. Washington was faced with the likelihood of the war lasting years, rather than months. The government was actively looking for ways to increase soldier comfort. Sanderson’s proposal reached the Military Affairs Committee of the U.S. Senate. Though they did not follow his instructions specifically, Sanderson did receive a commission—he was named Captain in the Office of the Commissary General of Subsistence from the War Department.

Around this time, Sanderson wrote the first cookbook to be distributed to the military. The book was titled: Camp Fires and Camp Cooking; or Culinary Hints for the Soldier: Including Receipt for Making Bread in the “Portable Field Oven” Furnished by the Subsistence Department. Though his grammar was questionable, Sanderson did describe several techniques, such as suspending pots over a campfire, that made cooking slightly more convenient in the battlefield.

Sanderson believed his efforts were so successful that “no man could consume his daily ration, although many waste(d) it.” This certainly was not the case, as many men still suffered from hunger, illness and death from unsanitary and poorly cooked food. Sanderson did understand the importance of cooking with well-cleaned pots and was quoted as saying, “Better wear out your pans with scouring than your stomachs with purging.”

Typical fare during the Civil War was very basic. Union soldiers were fed pork or beef, usually salted and boiled to extend the shelf life, coffee, sugar, salt, vinegar, and sometimes dried fruits and vegetables if they were in season. Hard tack, a type of biscuit made from unleavened flour and water, was commonly used to stave off hunger on both sides. After baking, hard tack was dried to increase its shelf life.

Soldiers in the field would carry rations in makeshift bags called haversacks. Made of canvas, the haversack folded around its contents, basically anything the soldiers would need to survive for a few days on their own, and was held together with buckling straps and completed with two shoulder straps.

"An army is a big thing and it takes a great many eatables and not a few drinkables to carry it along."

- Union Officer, October 1863

On her website The History Kitchen, Tori Avey explores the story behind the food – why we eat what we eat, how the recipes of different cultures have evolved, and how yesterday’s food can inspire us in the kitchen today. 

IMAGE: Dinner party outside tent, Army of the Potomac headquarters, Brandy Station, VA (Library of Congress)

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The Civil War and Nursing

By Cathryn Domrose

Vivid, dramatic images of Civil War nursing spill from history books into the American psyche: Clara Barton, her apron soaked with blood, working tirelessly beside surgeons as they amputated arms and legs. Louisa May Alcott bringing water to crying soldiers, cradling their heads in her arms, scribbling as they dictated letters home. Sally Tompkins, a captain in the Confederate army, insisting on absolute cleanliness in the hospital she ran in Richmond, Va. Dorothea Dix and Mary Ann Bickerdyke defying male surgeons and administrators to make sure their nurses and patients got the respect and resources they deserved. Phoebe Pember doing the same in the South, sometimes with the help of a pistol she kept in her pocket.

Birth of a Profession

“The Civil War launched the profession of nursing in the United States,” says Jane E. Schultz, PhD, professor of English, American studies, women’s studies and medical humanities at Indiana University-Purdue University Indianapolis, and the author of “Women at the Front: Hospital Workers in Civil War America” and “This Birth Place of Souls: The Civil War Nursing Diary of Harriet Eaton.”

The work of Civil War nurses proved that contrary to Victorian notions of the time, women could provide excellent care for men they weren't related to without damaging delicate sensibilities or reputations, say nursing and Civil War historians. It also convinced Americans in powerful places of the value of creating a trained nursing force to provide care in military and civilian hospitals. But the birth of the profession had its pangs. During the war, a diverse group of men and women cared for wounded and dying soldiers. But post-war, those exciting stories of wartime nursing heroines helped convince Americans that women were more “naturally” suited to care for the sick. Nearly eight years after the war’s end, the first American nursing schools — modeled after Florence Nightingale’s schools in England — accepted only women, almost all of them white.

“Bringing women into nursing was this great thing, but it had this price that we are still paying,” says Barbara Maling, RN, PhD, associate professor at Longwood University in Virginia, and author of many articles on Civil War nursing. Today, if someone says nurse, most people think of a woman, she says.

In the U.S. before the war, almost all nursing care was done at home. “Caring for your family when they were sick, that was part of a woman’s job,” says Sylvia Rinker, RN, PhD, professor emeritus at Lynchburg (Va.) College. But nursing outside the home, she says, “was looked down upon because it put women in contact with strange men.” When the Civil War began, most nursing duties were assigned to convalescing soldiers well enough to carry them out, and to women in religious orders whose higher calling allowed them to care for soldiers on both sides without scandal.

Influenced by Nightingale’s success in the Crimean War, the Union army added a small corps of 100 female nurses trained by Dix, already famous as a reformer and advocate for the mentally ill, and Elizabeth Blackwell, the nation’s first female physician.

Hoopskirts were banned because they caught on dressings and pulled them off the wounded men, says Rhonda Goodman, ARNP, PhD, FNP-BC, who wrote an article about women nurses in the Civil War for the Advances in Nursing Science journal. Dix’s edict, she says, “was one of the first examples of evidence-based medicine” in nursing. 

Need for Nurses Explodes

But the Civil War quickly became too large and complex for the governments on both sides to limit women willing to work for the military, historians say. “Once the war got going with a vengeance, no one effort like Dix’s could address it,” says Edward J. Halloran, RN, PhD, FAAN, associate professor at the University of North Carolina at Chapel Hill School of Nursing.

The exact number of female Civil War nurses is hard to establish. Though many historical accounts estimate 2,000 on each side, Union hospital documents show at least 21,000 women on the payroll during the war, Schultz says. Some women volunteered with aid organizations or religious groups. Others followed their husbands or brothers to the battlefields. Some, including Harriet Tubman, were freed and escaped slaves, though they were rarely called nurses, even when they cared for patients, Schultz says. “Black women were more often called laundresses or cooks than anything else,” she says.

Many women, widowed and without income, sought work as paid hospital or field camp relief workers for the Union or Confederate armies, Schultz says. Military documents and records show the paid workers vastly outnumbered the volunteers, though few wrote accounts of their work, she says. Their titles and pay varied, usually according to their race and class, with nurses at the top, receiving $12 a month, and laundresses toward the bottom, receiving around $6, she says. But the duties were essentially the same. Most hospital workers scoured floors; washed linens; bathed patients; gave out food, water and medicines; cleaned and dressed wounds; and comforted the sick and dying men. Literate women wrote and sent letters dictated to them by wounded soldiers.

Nightingale’s Influence

The war launched the popularity of Nightingale’s writings in America. Blackwell used Nightingale’s “Notes on Nursing” in her training program, and Northern nurses packed the slim volume in their carpet bags as they headed to Union hospitals. Confederate officials published Nightingale’s dietary guidelines in army hospital manuals. Nurses on both sides worked to create the sanitary environments she championed. But many also became convinced of Nightingale’s contention that nursing was the sole province of women, particularly upstanding middle-class women. “She actively promoted the division of labor,” Maling says.

Nightingale’s teachings about sanitation and the domestic chores delegated to women and slaves — cleaning, cooking, laundering, feeding — proved helpful in preventing the spread of infection and disease. “Women were already using sanitary methods without the scientific name,” Schultz says. Illnesses such as dysentery, small pox, malaria and typhoid killed more soldiers than mortal wounds. Though surgeons made great advances during the Civil War in their understanding of surgery, the medical practices of the time probably killed more people than they saved, historians say. While surgeons prescribed purges or toxic substances such as mercury for ill soldiers, nurses brought fresh water and beef tea to rehydrate and nourish them. The death rate from disease in the American Civil War was considerably lower than during the Crimean war, Halloran says. “That was all due to the sanitation efforts,” he says. 

Though women got the accolades, the vast majority of nursing care during the war was given by men, Maling says. Wounded soldiers commonly cared for their more gravely injured comrades on battlefields and in hospitals. Other men — black and white — worked as paid nurses or ward stewards. Records from the U.S. Sanitary Commission show it employed male and female nurses, Halloran says. The most famous male “nurse” probably is the poet Walt Whitman, who visited Washington hospitals as a volunteer, writing letters, bringing food and cigarettes and giving money to the young soldiers who touched his heart. Though there are accounts of soldiers grumbling about male attendants, Maling believes most men gave excellent care during the war. “I think men got a horrible rap about providing nursing care during the war,” she says. Some of the negative stories were told by women who saw nursing as their domain, she says.

The soldiers preferred female nurses because they felt as if they were being cared for by a mother, wife or sister, as they would be at home, historians say. “So much of those early Civil War duties were comforting men who were dying, and that has always been seen as a motherly trait,” Rinker says. Though some surgeons had their battles with Dix and Bickerdyke, others lavishly praised their female nurses, calling them “angels.” 

After the War

After the war, some volunteer nurses went on lecture tours and wrote books and articles describing the men’s gratitude for a woman’s touch. These accounts created a general impression that Civil War nursing had been done by mostly elite white women volunteers and obliterated the roles of black, immigrant, working class and male nurses, Maling says. “Nursing became a woman’s profession after the Civil War,” she says. “We got rid of our minorities and our men who were such a strong part of it.”

A combination of Nightingale’s work, advances in medicine, the growth of hospitals and the inspiration of Civil War nursing stories created an ideal climate for professional nursing education, Halloran says. Several years after the war ended in 1865, the president of the American Medical Association called for a women’s nursing corps based on the Nightingale model. The U.S. Sanitary Commission — which coordinated volunteer medical help for the Union during the war — lobbied for the establishment of the country’s first official nursing schools in New York, Connecticut and Massachusetts. 

Linda Richards, who had cared for her wounded Civil War veteran husband for four years, sought formal training after he died and became the country’s first nursing school graduate. Most of the women who cared for wounded soldiers during the Civil War did not train as nurses after the war ended, or, if they did, there is no record of it, historians say. Some, including Dix and Barton, took up other causes. Dix returned to advocating for the mentally ill. Barton founded the American Red Cross. Many probably returned to their homes and farms. “They had done their work,” Schultz says. But those untrained Civil War nurses — volunteers and paid, men and women, black and white — had left their mark on the profession. They provided a caring presence for their sick and dying patients that the best of nursing, with all its science and professionalism, still embodies today, Goodman says. “The whole aspect of caring is timeless.”

From: news.nurse.com.

IMAGE: Florence Nightingale

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Soldiers' Food During the Civil War

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. 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: Civilwar.com

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