A History of Hospital Ships (Excerpt)

By Milt Riske reprinted from March 1973 issue of Sea Classics

Almost as long as there have been wars fought on or near waters there have been vessels assigned to care for and move casualties.

Ancient history tells how the Romans in their exploits used special boats to remove the sick and wounded. The United States, as did other countries with navies, also found a use for such ships.

During the piracy problems with Tripoli in 1803 and 1804, Commodore Preble designated the captured ketch Intrepid as a ship with hospital duties. The Intrepid is better known, however as the ship that sneaked under the eyes of the enemy and blew up the Philadelphia held captive by the Tripolitans.

The threat of yellow fever in 1859, an epidemic brought on by seamen returning from foreign ports, instigated the first floating hospital in America. The infected sailors were turned away by the marine hospital and it was necessary to find a place to treat them. A New York physician, Dr. William Adison, recently returned from England where he had studied in the floating hospital ship Caledonian, suggested a similar vessel.

When his idea was accepted the port authorities voted funds to purchase the steamer Falcon. The engines were removed, the deck housed over, other necessary facilities installed and various changes made. Fittingly enough the name was changed to the Florence Nightingale, and a number of patients were cared for aboard her.

During the Civil War a captured sidewheel steamer named the Red Rover by its Confederate owner proved to be the U.S. Navy's first hospital ship. This was used originally as living quarters for the men manning the Confederate States' Floating Battery New Orleans. The Red Rover caught a piece of shell when the New Orleans was bombarded by the Western Gunboat Flotilla. The shell pierced her top and slanted through all her decks to the bottom. Although she leaked considerably, the ship was in no danger of sinking. She was captured by the Union gunboat Mound City and almost immediately prepared as a floating hospital for the casualties of the North.

Not long after her capture, the Red Rover became a haven for many injured men and officers of the apprehending gunboat.

In the summer of 1862 the ship was renovated by the Army Quartermaster Corps to include laundries, bathroom facilities, elevators to upper decks, operating rooms, nine waterclosets, separate kitchens for crew and patients, and gauze blinds to keep out smoke and cinders from the convalescents' berth deck.

Enough stores were taken aboard for a crew and 200 patients for three months. This included 300 tons of ice. Commander Captain Alexander M. Pennock reported to his Flag officer, "The boat is supplied with everything necessary for the restoration of health for the disabled seamen."

On June 11, 1862, she received her first patient, a seaman from the gunboat Benton, a victim of cholera.

At this time the Red Rover was really "half Army and half Navy," and it was only after the Illinois Prize Board sold her to the Navy that she could be called a Navy hospital ship. The reorganization and transfer of the Western Flotilla to the Navy helped to solidify this fact. She was commissioned in the Navy the day after Christmas, 1862.

The first vessel designated as a Naval hospital ship had a crew of twelve officers and thirty-five men, exclusive of the thirty surgeons and nurses aboard.

Not all of the nurses aboard were male. Four sisters of the Order of the Holy Cross came aboard that Christmas eve and were joined later by several other sisters and some black female nurses. Unknowingly this small group proved to be the pioneers of a Navy Nurse Corps which would be organized some fifty years later.

Not only was this fledgling hospital ship kept busy with her patients, but she was also pressed into service as a store ship carrying medical supplies, ice and provisions to the ships of the river fleet.

With the establishment of a naval hospital at Memphis, the Red Rover was relieved of some of her duties. As the war between the states drew to a close, so did the need for the Red Rover and she was removed from the service November 17, 1865. Later, stripped of her only gun and iron plate, she was sold at public auction.

From: history.navy.mil

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Women in Military Service For America Memorial

From: womensmemorial.org

During the Civil War, women on both sides of the Mason-Dixon line rose to challenge Victorian assumptions of feminine frailty and the impropriety of women in the public sphere. On the home front, northern and southern women took over households, ran family businesses, maintained farms and plantations, and provided daily care and food for their families while the men went to war. They formed aid societies or "bonnet brigades" to knit socks, and sew uniforms and flags. Women also helped organize and run public relief and sanitary commissions that gathered and distributed supplies to the armies.

Hundreds of women staffed government and regimental hospitals as nurses and matrons, and a few even worked in military hospitals as doctors. (Read about Dr. Mary Edwards Walker, the only woman ever awarded the Congressional Medal of Honor.) Some accompanied the Army as cooks and laundresses, and others disguised themselves as men and served on the battlefield. They were wounded, killed and held prisoners of war.

In the North, the War Department appointed Dorothea Dix as Superintendent of Women Nurses in 1861. Dix organized and staffed military hospitals and established firm criteria for her contract nurses and matrons.

Dix discouraged single women from nursing because of the improprieties involved in close contact with strange men and hostility to their presence. Contract nurses were required to be over 30 years old, matronly in appearance, able to pay their own way, have two letters of recommendation, wear brown or black garments and be sober and self-sacrificing. They received forty cents a day plus a ration. While 500 served under Dix, another 2,700 provided care to Civil War soldiers during the War.

In addition to her nursing services, Clara Barton began a program for locating those missing in action during the Civil War.

Others like Clara Barton, who later founded the American Red Cross, were so moved by the suffering of wounded and sick soldiers that they volunteered at Army camps and hospitals and on battlefields. A 39-year-old spinster working as a full-time copyist at the US Patent Office in Washington, DC, Barton had no formal nurses training but wanted to ease the suffering of Northern troops. Using her own money to purchase food and collecting hospital supplies, medicine and even whisky, Barton nursed Union soldiers at local military hospitals before obtaining passes to venture onto the battlefields of Marye’s Heights, the Wilderness Campaign, Hilton Head and Battery Wagner. (Read more about Clara Barton, founder of the American Red Cross.)

Catholic nuns also served as nurses for both the North and South in hospitals and aboard steamships. In the beginning, they were the only source of trained nurses—male or female, because of their education and training in 28 already-established Catholic hospitals. Nine nuns are known to have died in war service.

Women in the South did not have to leave their homes to reach the front. The war, fought in large part in the Confederacy, confronted many right on their own doorsteps. An estimated 1,000 southern women nursed in hospitals. Countless others nursed the sick and wounded who marched through their regions. They faced overwhelming difficulties because of the lack of organized relief efforts in the South and an ill-equipped Confederate government.

Freed slave women and children also followed Union armies and lived on the outskirts of camp. Some obtained employment as nurses, cooks, laundresses and personal servants to white officers. The Union army also moved many African-American women onto nearby plantations to raise cotton for the northern government to sell. Wives of black soldiers qualified for widow's pensions after the war when they “legalized” their marriages through the Union army.

Women spies often proved paramount to the development of battle strategy because they supplied information on troop movement, size and supplies, and the placement and strength of fortifications. Women sometimes traveled with information hidden in their clothing while others disguised themselves to facilitate their travel or to obtain information. When captured, they were treated as criminals rather than prisoners of war.

Women's participation in the Civil War became a catalyst for changes in women's roles in society. Successful Civil War nursing and relief work led to an increasing number of paid positions for women in these fields in the postwar period and to the opening of the first nursing schools for women in 1873. Finally, women's efforts in the Civil War established a precedent for women's inclusion in future war efforts.

Image: Unidentified Women's Volunteer Unit, Washington, DC, Civil War. National Archives (64-M-306).

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Elizabeth Thorn (1832-1907): Six Months Pregnant and Burying the Dead at Gettysburg

By Kate Kelly

Often referred to as “Angel of Gettysburg”

Stepped in to serve as cemetery caretaker since her husband was off fighting for the Union

Elizabeth Masser and Peter Thorn emigrated to the United States from Germany and were married in Gettysburg in September of 1855, the same year that the cornerstone for the local cemetery was laid.  A few months later, Peter was hired to be caretaker of what was to be called Evergreen Cemetery in Gettysburg.

An archway with interior living space for the caretaker was built as a gateway into the cemetery grounds.  Elizabeth’s parents lived on one side of the archway building; Peter and Elizabeth lived on the other. (Today there is a caretaker house built behind the arch on the right side.)

Six years later when the Civil War began (1861), the Thorns had three sons.  By 1862, Peter felt it was his duty to join the Union Army, and he enlisted with the 138th Pennsylvania Infantry, leaving the cemetery caretaking duties to Elizabeth and her father.  At the time, the cemetery was averaging about five burials per month.

War Nears

On June 26, 1863, Confederate soldiers began moving into Gettysburg. General Lee knew the northern movement would unsettle Union troops, and he was also aware his men would benefit from moving into farmlands that had not yet been picked over as they had been in Virginia.

As the Confederates arrived, the Gettysburg community had little choice but to answer their demands and feed them.

The Union Army of the Potomac was not far behind the Confederate movement.  General Howard and his men came in on the road that took them past the cemetery, so they stopped at the Evergreen gatehouse looking for a man who could familiarize them with Gettysburg.  Six months pregnant, Elizabeth Thorn stepped outside as the most capable volunteer in the household.  She accompanied one of General Howard’s men into the field, pointing out the main roadways and the lesser known local paths that the soldiers could use.

That night a Union soldier returned to the gatehouse, ordering Elizabeth to prepare dinner for the Union Generals–Howard, Sickles, and Slocum–all of whom had come to Gettysburg.  The Thorns had very little food left, having been ordered by the Confederates to give them what they could, but Elizabeth did the best she could to pull together a meal.

In return, General Howard ordered some of his men to move the family’s belongings to the cellar for safekeeping.  Elizabeth asked whether the family should leave the area, and Howard allowed that they could stay but should go to the cellar when fighting began.  He added: “When I give you orders to leave the house, don’t study about it, but go right away.”  It was understood that if the family needed to move on, they were to take nothing with them.

The next day the fighting began near Cemetery Hill, and the Thorns, along with some neighbors, took refuge in the cellar. At the conclusion of that day’s fighting, a solider arrived and told them to leave; that they should follow the main road so the soldiers would know it was them and not open fire.

Fleeing Gettysburg on Foot

The family made it to a farmhouse before nightfall, and they stopped in, hoping for food.  The house was filled with an assortment of soldiers and community people in addition to the family, and there was no more food; Elizabeth was told they could spend the night. One of the soldiers called Elizabeth over to him to show her a photograph of his children—three little boys.  He asked if Elizabeth’s three sons, 7, 5, and 2, could sleep near him for the night.  They did.

Elizabeth was among the Gettysburg citizens who set down eyewitness accounts after the siege, so we have in her words what happened to her during the next few days.  She wrote that the next day she and her father traveled back to the gatehouse to see if they could retrieve any possessions. On their arrival they found that their hogs had been killed, the windows of the house were shot out, and the trunks that had been taken to the cellar for safety had been emptied.

The house was filled with wounded men calling for water.  Outside, townspeople were beginning to deposit the dead who had been killed around town.

Elizabeth and her father realized there was nothing left to take and it was too early to return, so they walked back to gather the boys and her mother and they continued on to a larger farmhouse in order to find something to eat.  There were meager supplies at the new location, but there was enough that Elizabeth was able to pitch in to help make bread to feed the many hungry people who came through the area.

When the Fighting at Gettysburg Ended

Eliz Thorn headStarting late on July 4, General Lee began to move some of his men back to Virginia, and the family made their way back to the gatehouse.  As they arrived, they saw vast numbers of bodies had been delivered to the cemetery for burial. There were also were fifteen dead horses near the house, and nineteen others horses had died on the property nearby.  The stench of animal and human decay was overpowering.

The house itself was in shambles.  Three local women came over to help Elizabeth wash what was salvageable, and cemetery president David McConaughy came by to see Elizabeth and directed  that burials needed to move forward quickly.   He went into town to enlist volunteers, but those who came soon became overwhelmed and left—some of them too ill to continue, some of them simply repulsed by the work.  Though Elizabeth received no extra pay for her work, nor were the Thorns ever compensated for the damages incurred, Elizabeth stretched to pay some workers, but even they did not last long.

For the most part, the work was done by Elizabeth and her father, working in the heat of mid-July for as long as daylight lasted.  Ultimately, they buried 105 war casualties (91 soldiers and 14 civilians).

Despite the hard work of digging graves, Elizabeth managed to carry the baby to term, giving birth to the Thorns’ first daughter, Rose Meade (named for General Meade who commanded the Union Army of the Potomac), on November  1.

Peter Thorn returned home after Appomattox in 1865, and the family remained at Evergreen as caretakers until 1874.

In 2002 a Civil War Women’s Memorial was dedicated. The memorial is within Evergreen, near the gatehouse. The sculpture depicts Elizabeth attending to burial duties.  Her face is full of anguish, an apron covers her pregnant abdomen, and she holds a spade representing all she did.

Some refer to her as the “Angel of Gettysburg.”

If you visit Gettysburg, stop in Evergreen Cemetery and see the sculpture, and walk across the street where you can walk from monument to monument where each battlefield unit has set in marble the story of what they experienced on Cemetery Hill.  A trip into town, and a town tour, reveals that bullet holes can still be seen in local buildings, and provides a sense of the terror the townspeople had to have felt.

Kate Kelly is an engaging speaker and successful author of more than 30 nonfiction titles ranging from the bestselling Organize Yourself! to Living Safe in an Unsafe World. She has recently returned to her love of history and is writing and publishing a monthly e-letter, "American Snapshots," which she describes as "making sense of today by looking at yesterday."

From: americacomesalive.com

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Gunshot and Amputation Statistics

From: collections.countway.harvard.edu

John Hill Brinton (1832-1907), a surgeon with the United States Volunteers, compiled statistical information on gunshot wounds and amputations from reports submitted by the army hospitals to the Surgeon General’s Office.  Table no. 4 lists over 1,300 amputations performed during the months of September through December, 1862.  The Medical and Surgical History of the War of the Rebellion (1870-1888), produced by the Surgeon-General’s office, records nearly 30,000 Union soldiers undergoing amputations, with nearly 22,000 surviving.

Image: United States Surgeon-General's Office, Consolidated statement of gunshot wounds, 1863
From the collections of the Boston Medical Library

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Evergreen Cemetery, Gettysburg

From: evergreencemetery.org

The founding father of the Evergreen Cemetery, David McConaughy was a man of vision. McConaughy was the driving force in establishing Evergreen Cemetery and served as the association's president from 1854 - 1863. A year before the Battle of Gettysburg, he envisioned a Soldiers' Cemetery as part of Evergreen. At the time, only two native sons of Gettysburg had been killed during the Civil War, so there was not enough support from the community to fund the project.

When the Battle took place in July of 1863, McConaughy was in the forefront once again. Having already laid the groundwork for his concept by previously talking to the adjoining landowners, McConaughy acquired purchasing rights for the 17 acres of land north of Evergreen Cemetery. By doing so, McConaughy foiled rival lawyer David Wills' plans to purchase the land for the State of Pennsylvania. Ultimately, the Evergreen Cemetery gave the rights to the state of Pennsylvania to acquire the land with the stipulation that a fence divides the two properties.

Immediately following the battle, McConaughy began buying parcels of land with his own money to preserve the battlefield. He left the presidency of Evergreen Cemetery Association to help establish the Gettysburg Battlefield Memorial Association, for which he served as its first president for 10 years.

Peter and Elizabeth Thorn emigrated from Germany and were married on September 1, 1855; coincidentally, the same day the cornerstone was laid for the Evergreen Cemetery gatehouse. The Thorns were the first family to live in the gatehouse when Peter became Superintendent of the cemetery in 1856.

After Peter joined Co. B, 138th Pennsylvania Infantry, Elizabeth was left in charge of the cemetery and served as caretaker from 1862-1865. With the help of her elderly father, Elizabeth buried 91 soldiers in the weeks following the Battle of Gettysburg. While six months pregnant, she dug the graves in one of the rockiest regions of the cemetery. Her post-war reminiscence is one of the best known civilian accounts of the battle.

Image 1: David McConaughy

Image 2: Elizabeth Thorn, 1832 - 1907; Peter Thorn, 1826 - 1907

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Civil War Army Medical Department

From: illinois.gov

At the onset of the Civil War, the Medical Department of the U.S. Army had just 30 surgeons and 83 assistants and many of these staff people resigned and joined the Confederacy, leaving the Department with an inadequate ability to meet the crisis of the war. Regular army surgeons who had been serving in the western United States joined new, younger and inexperienced physicians and attendants in caring for wounded soldiers.

Led by a Surgeon General, the medical department was comprised of regular medical officers, volunteer surgeons, assistant surgeons, and civilian physicians who were employed under contract in general hospital wards established in the vicinity of the national capitol and large cities. Assisting the Medical Department in the care of soldiers was the U.S. Sanitary Commission, a volunteer
auxiliary service authorized by the Federal government, that provided humanitarian aid in the way of care, food, medical advice, assistance and supplies, clothing, shelter, and male and female nurses to the Union volunteer forces during the war.

Other commissions established were the Western Sanitary Commission and the Christian Commission.

The nursing profession was dominated by men who lacked specialized training and whose basic method of instruction was “learn as you go.” Women, who comprise the majority of nurses today, were considered in the Victorian era as too timid and delicate to cope with the demands of the profession. Also, their families objected to having them exposed to the intimate needs of men they were not related to.

Before the war, caring for the sick was done at home; but as the war escalated, the overwhelming numbers of men needing hospital care increased. Coming from different backgrounds and ethnicities, women who volunteered in the nursing services spent their time in hospitals dispensing medicine, attending to visitors, writing letters, distributing food and supplies, entertaining soldiers by singing, playing music, or reading to wounded soldiers.

The Civil War was fought in an era that had rudimentary knowledge of preventative medicine. Disease, not battle, caused the majority of deaths among both Union and Confederate
soldiers. Intestinal disorders including typhoid fever, diarrhea, dysentery, exposure to the elements, filthy and unsanitary camp conditions, communicable diseases (measles, mumps, scarlet fever, chicken pox), and poor diet and hygiene all contributed to the spread of disease. In addition, respiratory diseases, including influenza, bronchitis and pneumonia incapacitated and led to the deaths of thousands of soldiers.

In camp, when soldiers became mildly sick they were assigned to their quarters. Soldiers with
more serious illnesses were admitted to the camp hospital tent until they were better.

Early in the war after battle, wounded soldiers who could not walk on their own were removed from the battlefield by untrained and disorganized litter bearers. During the First Battle of Bull Run, untrained civilian ambulance and wagon drivers fled the scene leaving some wounded soldiers on the battlefield for a week.

As the war progressed, specially trained ambulance corps members transported soldiers to ambulance depots near the battle lines, and then to field hospitals where they were treated by a regimental surgeon. If an amputation was needed, patients stood a better chance of recovery if the surgery was done shortly after being wounded. Men who required serious medical attention were taken to more permanent general hospitals where they could receive extended care. However, not every soldier made it off the battlefield. Some, within reach of ambulance attendants, died from lack of care.

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Ambulance

From: collections.countway.harvard.edu

Ambulance, built at the Gov. Repair Shops, Washington, D.C., under the direction of Brevet Major General, D. H. Rucker, Quartermaster, U.S. Army.

From Reports on the extent and nature of the materials available for the preparation of a medical and surgical history of the rebellion (Philadelphia, 1865).

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Medical Education During the Civil War

(The following are the personal edited research notes of Dr. Michael Echols, the source of which may or may not be completely documented)

During the period just before the Civil War, a physician received minimal surgical  training. Nearly all the older doctors served as apprentices in lieu of formal education. Even those who had attended one of the few medical schools were poorly trained.  The perception that 'doctors' or 'surgeons' knew how to do amputations or any other kind of surgery is just wrong.  Perhaps the practicing surgeons in medical institutions were experienced at doing various procedures, but the average student who had just graduated was severely limited in surgical experience.  As the Civil War started, there were very few experienced surgeons to handle battlefield wounds.  The Union Army had to 'screen' the applicants who wanted to serve because so few were qualified.

In Europe, four-year medical schools were common, laboratory training was widespread, and a greater understanding of disease and infection existed.  Many U.S. medical students attended medical school in Scotland, England, or Europe.

The average medical student in the United States, on the other hand, trained for two years or less, received practically no clinical experience, and was given virtually no laboratory instruction. Harvard University, for instance, did not own a single stethoscope or microscope until after the war.

Until tuition was instituted in 1871 at Harvard, salaries of Medical School professors were raised through the sale of lecture tickets.

Another important point about medical students in the 1800's is how few graduated verses how many attended in a given year.  Very few actually graduated.  If you look at the current year's registered students at Albany Medical College catalogue in a given year, and then look back at how many actually graduated it is amazing how few finished and actually graduated.  The large number of students on any given year could be explained by both a high attrition rate, but also by students who wanted to refresh their knowledge since lectures were sold on a ticket basis and lecturers/doctors were paid by these tickets purchased for most of the 1800's.

From: medicalantiques.com

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