"The Most Fatal of All Acute Diseases:" Pneumonia and the Death of Stonewall Jackson

By Dr. Matthew Lively, 5-13-13

The Death of "Stonewall" Jackson.
As night fell and a full moon rose in the sky, Lieutenant General Thomas J. “Stonewall” Jackson was becoming increasingly impatient. Although he had just orchestrated one of the most successful flank attacks in military history, he wanted more.

It was May 2, 1863, and the second day of the Battle of Chancellorsville was coming to a close. The men of Jackson’s Second Corps, Army of Northern Virginia, had attacked the unsuspecting right flank of the Union army and had driven it back nearly two miles before confusion and darkness stalled the action. Anxious to continue the attack, Jackson quietly rode beyond his main battle line to scout the position. The men of the 18th North Carolina Infantry, however, were unaware that Jackson was ahead of them in the dark woods. As the general and his staff returned toward the line, the edgy soldiers mistook the riders for Federal cavalry and opened fire. Three bullets struck Jackson—two in the left arm and one in the right hand.

With Union artillery fire showering the road around them, members of Jackson’s staff desperately tried to remove him to safety. Using the woods along the side of the road for cover, the men carried Jackson on a stretcher at shoulder height to clear the tangled underbrush. Suddenly, one of the litter bearers tripped on a vine and dropped his corner of the stretcher. The abrupt tilt caused Jackson to roll off the litter and crash to the ground. The hard fall caused further damage to the artery in his injured arm, and fresh blood began flowing from the wound.

They brought Jackson by ambulance to a field hospital located one mile behind the Confederate line. Dr. Hunter Holmes McGuire, medical director of the Second Corps, arrived at the location shortly after the ambulance. Using his finger, McGuire immediately compressed the artery above the wound in Jackson’s arm, stemming the bleeding. He then rode with the general to a larger corps hospital farther to the rear. Still in shock from the loss of blood, Jackson was placed in bed and kept warm, still, and quiet. Two and a half hours later, he was deemed stable enough to undergo surgery. McGuire removed the ball from Jackson’s right hand and then amputated the left arm two inches below the shoulder.

Jackson’s initial recovery from surgery was promising. So much so, in fact, that he was transported 27 miles by wagon to an estate near Guiney Station, Virginia, the following day; the overall plan being to evacuate him by train to his home in Lexington, Virginia, for recuperation. Sadly, however, “the great and good Jackson” would never make that journey alive.

Four days after his amputation, Jackson began to experience chest pain and difficulty breathing. A close examination by McGuire would reveal the problem – pneumonia in the right lung. Despite around-the-clock medical care, Jackson’s health would slowly deteriorate over the next three days, culminating in his death on May 10, 1863.

Pneumonia was often a deadly illness in the 19th century. Sir William Osler, considered by many to be the father of modern medicine, described pneumonia in the late 1800s as “the most fatal of all acute diseases.” During the Civil War, the illness had a mortality rate of 24%, making “inflammation of the lungs and pleura” the third most common cause of death from disease during the conflict. But why?

In scientific terms, the Civil War was fought toward the end of the “Dark Ages” of medicine. Bacteria had yet to be discovered as a cause of disease and, consequently, no antibiotics existed. This lack of scientific knowledge in relation to disease transmission resulted in 19th century physicians having few, if any, useful means by which to combat infections. Without antibiotics to alter the course of a serious infection, bacteria would often enter the bloodstream and lead to the systemic—and many times fatal—condition of sepsis.

Prior to the advancement of the germ theory, the contraction of disease was believed to result from an imbalance in the natural humors, or fluids, of the body—a theory dating back to ancient Greek medicine. Treatment at the time centered on removing the excess fluid from the body that was believed to be causing the disease. Fortunately, the bleeding of patients as a treatment for diseases like pneumonia was losing favor among Civil War physicians, but other harmful therapies survived. The liberal use of cathartics, or medications to purge the gastrointestinal tract, was standard treatment at the time for most diseases, including pneumonia. Depleting an ill patient of fluids through the administration of such “medicines” undoubtedly resulted in more harm than good.

Once it was discovered that Stonewall Jackson had pneumonia, his physicians began treating him with the accepted, albeit misguided, therapies of the 19th century. He was given mercury as a laxative and antimony to induce vomiting. Cupping and blistering agents were applied to his chest to “draw” the pneumonia out of his lungs and to the surface of the skin. More appropriately, he was given opium, typically in the form of morphine, to decrease his pain and make him more comfortable.

Jackson’s physical condition and health at the time were also adversely affected by other factors. The day before his wounding, he had contracted a head “cold,” from which he was still suffering after his surgery. Additionally, Jackson had lost a large amount of blood from his injury, and he likely suffered a bruised lung when he fell from the litter. It was in this bruised lung that McGuire and the other physicians believed his pneumonia developed.

More recently, physicians reviewing Jackson’s case have, at times, questioned whether pneumonia was his actual cause of death. Some maintain instead that Jackson died of pyemia (an early term for sepsis) that came from an infected operative site. On a pathological level, Jackson did have pyemia, but the organisms that cause sepsis must have a source from which to enter the bloodstream. In the case of Stonewall Jackson, the two most likely sources were either his operative site or his pneumonia. Dr. Hunter McGuire repeatedly documented in his later writings that Jackson’s operative site never showed signs consistent with a wound infection. His course of illness was, however, consistent with the natural history of pneumonia when it is unaltered through the use of antibiotics.

So what was the cause of Jackson’s death? In medical terms, “cause of death” is defined as the “the disease or injury that initiated the train of events leading to death.” For Stonewall Jackson, the most likely conclusion—as his physicians maintained at the time—is that pneumonia was the initial disease triggering the sepsis that led to his death.

Matthew W. Lively is a Professor of Internal Medicine and Pediatrics at the West Virginia University School of Medicine. His first book, Calamity at Chancellorsville: The Wounding and Death of Confederate General Stonewall Jackson, was released by Savas Beatie LLC in May 2013.

From: civilwarmonitor.com

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St. Mary's Hospital

From: rochestergeneral.org

St Mary’s became Rochester’s first functioning hospital when it opened its doors on September 17, 1857. The first union soldiers were received at the hospital in 1862, although it would not be until March of 1863 that St. Mary’s would be officially designated a federal “Army General Hospital.” In spite of its official status, by the end of 1863, the hospital had admitted relatively few wounded soldiers most likely due to the high cost of transporting the wounded from the battlefields to western New York.

The district U.S. Surgeon and military inspector, Dr. Azel Backus, advised the Nuns at the hospital to prepare to receive a hundred soldiers in the near future but the federal authorities ordered the soldiers back to their original hospitals. Rochester’s city leaders agreed with Dr. Backus that western New York soldiers would fair better in a western New York hospital and consequently sent a local delegation to Washington in May 1864 to make their case to the U.S. Surgeon General.  Shortly after, official word was received to prepare to receive at once up to three hundred sick and wounded soldiers. On June 7, 1864, the afternoon train delivered 375 wounded soldiers to Rochester, 60 of which were sent to the Rochester City Hospital and the remaining were admitted to St. Mary’s.

In February 1865, there were 398 union soldiers under treatment at St. Mary’s. Over the course of the hospital’s military service, the hospital’s facilities and resources were often overloaded. Frequently, corridors were utilized for patients and tents were pitched on hospital grounds to accommodate the monthly influx of wounded soldiers. Many invalid soldiers came to the hospital in pitiful and desperate states of health. A number of released prisoners from the infamous Andersonville Prison made their way to St. Mary’s in a condition described as “living dead”. Most were nursed back to health “through the patient efforts of the Sisters of Charity.” Appeals to the community for food and supplies were often rewarded with generous donations.

It is difficult to accurately say how many soldiers were treated by St. Mary’s during the Civil War years. Some estimates have claimed four or five thousand patients but the remaining ledgers, evidence, and the final report by the hospital sent to Albany in December 1866 reports that there were  “soldiers treated, 2500.”

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Medicine in the Bloodiest War

By Thomas Sweeney, M.D.

The Civil War was the bloodiest war ever fought by the United States. More lives were lost in it than in all other American wars combined, from the Revolutionary War to the Korean War. The Civil War saw the death of some 618,000 souls--the Union 360,000, the Confederates, 258,000.

Disease as a Cause of Death.
The principal killer in the Civil War was not the cannon or the musket but disease; 414,000 died from disease.

The prevalence of disease and the high death rate resulted from a number of factors. A majority of soldiers were from rural areas and had not been exposed to measles and other diseases of urban living. When they did develop these diseases they did not take care of themselves and died from complications. There was ignorance of the cause and treatment of diseases on the part of both patients and physicians. Bacteriology was an underdeveloped science and little known of it outside England and Europe. Malaria and some other diseases were attributed to "bad air" or "vapors" arising out of the lowlands. "Bad humors'' in the blood were also blamed as the cause of other maladies.

Diet was deficient both in camp and in the field. Fruit, vegetables, and milk were difficult or impossible to obtain. Lack of these caused scurvy and other gastrointestinal problems. Filth contributed greatly to dysentery and other maladies that plagued the camps. Most soldiers thought only of convenience in disposing of their waste. Thus many flies accumulated to contaminate the food. Germ-spreading mosquitoes, fleas, and lice tormented the soldiers as well, even worse than the flies.

The common maladies were malaria, typhoid fever, dysentery, and measles. Pneumonia, smallpox, yellow fever, and tuberculosis were less prevalent; but all took a heavy toll of lives. The most frequent killers were typhoid and intestinal infections. Typhoid was probably responsible for one-fourth of all the deaths from disease among Civil War participants. As many soldiers died from diarrhea as from death in combat.

Medicine, the Government, and the Citizens
At the outbreak of the war, the Federal government was unprepared to meet the medical needs of the military. The personnel of the Union medical department consisted of one surgeon-general with the rank of colonel, 30 surgeons with rank of major, and 84 assistant surgeons with rank of 1 st lieutenant.

There was no hospital or ambulance corps. Nursing was performed by inexperienced soldiers, usually those recovering from illness or wounds, temporarily detailed to hospital duty. The members of the medical corps were not assigned to any particular regiment or command, but were assigned or utilized as the need arose.

Civil war hospitals were scarcely places of succor. They tended to be filthy, overcrowded and stinking. The stench was terrible, according to one surgeon. Smallpox and measles added complications. The smallpox was controllable, but the measles got out of hand. Many patients died from pneumonia caused by measles.

Dr. Charles S. Tripler was the first medical director during the Civil War. He and his organization accomplished an immense amount of work but could not cope with such a large number of casualties as occurred early in the war. During McClellan's Peninsular Campaign, for instance, confusion resulted from trying to care for the 100,000 man army involved, and tragic suffering followed.

Dr. Jonathan Letterman succeeded Tripler on July 1, 1862. He was a man of great ability who organized an ambulance corps, improved the field hospital service, and procured a greater quantity of medical supplies.

An organization called "The Sanitary Commission'' was formed in the war emergency by concerned citizens of the North to supplement the medical services of the Federal government. The Commission had its beginnings at a meeting held by the Women's Central Association of Relief in New York on April 25, 1861. Because the methods of the Commission were flexible they were able to meet emergencies well, and often brought supplies to the field days ahead of government stocks. Theirs was the main source of supply at the battles of Second Bull Run, Antietam, and Fredricksburg.

Fresh vegetables, chloroform, brandy and other stimulants, condensed milk, beef stock, bandages, surgeon's silk, and many other articles are supplied by the Western Sanitary Commission of St. Louis (not connected to the larger eastern group). It was efficient in relief and in fund raising. Workers were both male and female. During its existence the Western Sanitary Commission received about five million dollars in money and fifteen million dollars in supplies, much of it through fund-raising fairs.

No such organizations existed in the South, although there were women' s-aid societies and individuals willing to feed the hungry and nurse the sick.

A noteworthy example was Mrs. Ella K. Newsom of Arkansas, widow of a physician, who took it upon herself to work in various hospitals in the South while providing supplies with her own money. Her acts earned her the title, Florence Nightingale of the South.

Wounds and Amputation
Wounds might be divided among those to head, trunk, and limbs. Head and chest wounds were often fatal; wounds in the abdomen that involved a perforated bowel were almost always fatal.

Amputation was the common treatment for severe wounds to the limbs because of the probability of infection. If the wound had caused loss of a large amount of soft tissue, or if it involved a joint, the limb was always amputated. The same if there was a compound fracture (the bone sticking through the skin). Survival from surgery was more likely if the patient were wounded, and operated on, in places free from animal droppings and other filth. The survival rate from amputation ranged widely from about 15% to 65%.

It was usual to amputate the wounded limb as soon as possible. If it were not removed, the patient often quickly developed ared swelling, which would then drain "laudable pus." Next, a fever would follow and, in a few days, death. In short, the wound would become infected and result in fatal blood poisoning. Simply nothing was known of infection or its prevention. Not until the 1870s would there would be widespread understanding of the nature of bacteria or the causes and prevention of infection.

Not all wounded limbs were amputated. Simple fractures were set and placed in a splint. Wounds without fracture were cleaned of dead tissue and irrigated with various solutions such as potassium permanginate or dilute acid.

Major effective drugs were quinine, morphia, and other opium derivatives. Chloroform and sometimes ether were used as anesthetics. Whiskey was frequently administered to the wounded to induce "reaction." Whiskey was also mixed with quinine and administered daily to suppress malaria. Other drugs were pepsin, various emetics to induce vomiting, cathartics, iodine, and calomel. Dysentery might be treated with oil of turpentine or ipecac, though neither was very effective.

Medicine in the Civil War Ozarks
Medicine in the Ozarks during the Civil War was practiced much as it was elsewhere. Inasmuch as the Ozarks was still a frontier region, some supplies might be difficult to obtain; but both Union and Confederate armies carried supplies and physicians with them. For the most part, the Federal armies here had more supplies than the Confederates, particularly in the latter years of the war. Both sides had volunteer physicians fresh from civilian life, most of whom had no experience with the type of wounds and the massive numbers of wounded they would be forced to handle. A few were veterans of the Mexican War. During and after battles, local civilian doctors might volunteer to take immediate care of the sick and wounded.

Military physicians of both the North and the South were primarily responsible for taking care of soldiers' ailments. If a battle were imminent his responsibility was to set up a field hospital close to the battlefield, but not so close as to endanger the lives of the patients and doctors.

But at the Battle of Wilson's Creek, as a result of the Federal surprise attack, both sides cared for the wounded on the edge of the battlefield while the battle raged. Federal physicians placed their field hospital in a ravine on the north end of Bloody Hill. They did not perform surgery on the field except for the extraction of balls. They sent the wounded to nearby Springfield after bandaging because of the severity of the fight and the shifting positions of the troops.

The Federal force had only two ambulances, so after the battle every available conveyance was used to remove the wounded---baggage wagons, caissons, litters, and six-mule spring wagons. Through a flag of truce, all the wounded who could be moved were taken offbetween 11:30 a.m. and midnight the day of the fight.

Assistant Surgeon H.M. Sprague, U.S. Army, wrote subsequently that the great want in the medical department at the time of the battle was a medical director. "Had the commanding general [Lyon] designated an officer of rank as his medical director, there could have been no reason why nine-tenths of the wounded could not have been cared for and sent to General Hospital [Springfield] by the time our forces retreated." Apparently the physicians were too busy taking care of the wounded in their own immediate area to see this general problem.

In his report, Assistant Surgeon S.H. Melcher of the Fifth Missouri Volunteers wrote, "The flies were extremely troublesome after the battle, maggots forming in the wounds in less than an hour after dressing them, and also on any clothing or bedding soiled by blood or pus. The wounded left on the field in the enemies [sic] hands were swarming with maggots when brought in."

Confederate physicians set up field hospitals soon after the battle commenced. Apparently they used the Ray house and a barn or outbuilding across from the Skeggs house at the spring. Early in the battle cannon shots were fired over the Ray house, so a yellow and green hospital flag was raised on the roof to let the Federals know it was being used as a hospital.

Dr. Caleb Winfrey, a volunteer from Lone Jack, Missouri, on duty with General Price's force left a short journal describing how he went onto the battlefield and carried off the wounded in his buggy. The next day, August 11, Winfrey noted in his journal that he performed numerous operations which included multiple amputations of limbs and extractions of musket balls.

Before the battle, typhoid fever and dysentery had broken out in Springfield. General Lyon ordered Federal surgeon E.C. Francis, U.S.V. (United States Volunteer), to establish a "General Hospital" in the unfinished courthouse on the square to handle sufferers from these diseases. In addition to the General Hospital, churches, hotels, the courthouse, and many private homes were turned into hospitals and filled with the wounded from both sides.

After the battle, the Federals remained but a short time in Springfield before falling back to Rolla, carrying with them everything except medicine, hospital stores, and supplies accumulated for use in the General Hospital. General Franz Sigel ordered surgeon Phillip C. Davis, a U.S. Army physician, to stay with the wounded who were left behind.

The Confederates entered Springfield at daybreak on August 11, 1861. They appropriated what they wanted from the hospital, leaving the Federal surgeons short of supplies. They did just as the Federals had done--brought the wounded from the field in wagons, carriages, litters, merchants' wagons, and every possible conveyance in the absence of ambulances. The process took five or six days. Notations in the General Hospital's log book suggest about 412 wounded from Wilson's Creek. Added to the number already in the building, . the result was overcrowding, and more misery for all.

Dr. Winfrey wrote that on August 12, he and probably the other Confederate surgeons packed their instruments and supplies and, with the wounded, left the battlefield for Springfield. Winfrey stayed in Springfield with the wounded Confederate soldiers, amputating limbs and performing other procedures. He noted that Missouri Governor Claiborne Fox Jackson visited Springfield on September 2, but left the same day for Jefferson City. He also mentions the use of chloroform while amputating a leg. (The Federal surgeons wrote that chloroform was all they had; ether was apparently in short supply.)

During 1862 and 1863 three hospitals were in existence in Springfield: The General Hospital (unfinished courthouse), Red Top hospital and the Campbell house hospital on south Jefferson. A convalescent hospital located in the old Berry mansion at Berry Springs was called the New U.S. Hospital. This was located just north and east of Fort No. 5 (east of present Sherman Avenue at Chestnut Expressway). Springfield had thus become a large storehouse of supplies and a central hospital location for the wounded from all over southwest Missouri and northwest Arkansas. It remained so throughout the war.

Many ladies of the town volunteered their services and became hospital nurses. Civilian physicians aided in the care of the wounded in Springfield throughout the war, although little is written either of their contributions or those of lay citizens.

Dr. Beverly A. Barret was one who did leave a written account. He had moved to Springfield from Dallas County in 1858. His sympathies were for the South, but for his safety and that of his family he did not express those sympathies openly. Barret wrote of going to the battlefield after the Battle of Pea Ridge, Arkansas, some 75 miles southwest of Springfield. He went there with his brother George Barret, a Dr. E.L. Robinson, and another person after obtaining permission from the authorities to search for some of their friends whom they suspected to be among the wounded or dead. They set out on horseback; and long before they arrived at the battleground they began to see signs and effects of war: dead horses, wounded men, and here and there a corpse. Three miles from Pea Ridge they happened upon an old Federal surgeon lying in a cabin, dreadfully wounded by a cannon ball which had taken off a portion of his hip. Although both the old surgeon and the Barret party knew it to be a mortal injury, they dressed the "miserable" wound, shook hands, and went on their way. With great difficulties they found their friends and tried to assuage the suffering of the wounded as much as possible. Dr. Barret hired a sutler's wagon and one horse which he harnessed with his own horse to make a team. They loaded the wagon with the wounded and headed toward Springfield.

As a result of the battles of Pea Ridge and Prairie Grove, Arkansas, in March and December, 1862, Fayetteville also became a medical treatment center. Hospitals were hastily organized in the town as the wounded were brought in from both battles. The U.S. General Hospital, Western District of Arkansas, was established there. It consisted of the Cottage Branch Hospital, the Seminary, the "School Room," the Masonic Hall Branch, the Ward A. Smith House, and the Methodist Church Branch Hospitals.

Anticipating Confederate General Marmaduke' s attack on Springfield in January, 1863, convalescent soldiers from the hospitals were mustered to help defend the town. Organized by Dr. Melcher, the medical director of several hospitals in Springfield, it was known as the "Quinine Brigade." About 300 boys responded to the call and took up muskets, taking their place with the rest of the soldiers and civilians defending Springfield.

At the time of the Battle of Springfield, Dr. Barret resided on Booneville Street north of the town square. He heard the sounds of picket musket fire, and then cannon fire:
A cannon ball knockedoff our chimney and another hit a tree in the yard near where I was standing. For a few hours fighting was lively, everyone scared....Our house was full of friends from early morning on that memorable day until late in the evening. My wife was lying in bed with a baby boy eight days old. Most of the day I was busy taking care of the wounded of both sides. I dressed many a wound that day never inquiring which side he belonged to. Several arms and legs I amputated also. I remember well amputating the arm of a colonel with no one to assist but a Mrs. Richardson, a very timid and frail woman. It was a success.

My custom is always in amputations as well as other surgery [to] use cleanliness, warm water with Boraic of Soda in it. With my amputations I enjoy great success. I remember well in the fall of 1861 I amputated some young women's arms, from being crushed in mills from mashing sargum sticks and did not loose her [sic]. One or two amputations of the soldiers were at the shoulder joint all of whom recovered speedily. Though we blunder along good results are had in surgery, considering. Brigadier General F.B. Brown, the Federal commander in the battle, was wounded in the left ann by a musket ball. According to the account of Surgeon Melcher, the ball splintered the shaft and fractured the head of the left humerus in the upper arm. It also fractured the articulating rim of the scapula. Dr. Melcher made a V-shaped incision and removed the head and five inches of the shaft of the humerus. Upon healing, the left arm was several inches shorter than the right but still useful.

The contributions to medical care which were developed during the Civil War have been largely overlooked because the nature and quality of care administered is improperly compared to modem standards, rather than to the standards existing at the time. Major advances were achieved however, of which the following is a summary:

1. Development of a system to take care of mass casualties, including aid stations, field hospitals and general hospitals. It was the system used to manage the wounded in World War I, World War II, and the Korean War.

2. The accumulation of detailed records which, for the first time, made possible a complete military medical history. The publication of the Medical and Surgical History of the War of the Rebellion was identified in Europe as the first major academic accomplishment by U.S. medicine.

3. Pavilion-style general hospitals, well ventilated and clean, which were copied in the design of large general hospitals over the next 75 years.

4. Recognition of the importance of immediate and definitive treatment--including amputations--of wounds and fractures, optimally carried out within the first 24 hours after wounding.

5. Dawning comprehension of the importance of sanitation and hygiene to prevent disease and death in the field.

6. Introduction of female nurses to hospital care and the entrance of Catholic religious orders to the hospital business.

7. Upgrading of the education of physicians as they were introduced to new ideas and standards of care, including the prevention and treatment of infectious diseases, anesthetic agents, and new surgical techniques which rapidly advanced the overall quality of American medical practice.

8. Formation of the United States Sanitary Commission, which set the pattern for the development of the American Red Cross.

9. The development of an Ambulance Corps and a new ambulance design that would be copied around the world.

As for Springfield: After the Battle of Spring-' field, the town remained in the hands of the Federals. It was a supply depot, and its hospitals took care of wounded from both southwest Missouri and northwest Arkansas. Many federal and state volunteer physicians were assigned to Springfield for the remainder of the war. The presence of medical personnel, experienced auxiliary assistants, and medical institutions laid the foundation for Springfield's development as a major medical center in the succeeding 130 years.

Dr. Thomas Sweeney is a Springfield physician and professional collector of Civil War artifacts. He is an authority on medical aspects of the War.

From: thelibrary.org

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American Medical Association Founder, Nathan Smith Davis, M.D.

From: ama-assn.org

Born in 1817, Nathan Smith Davis founded the American Medical Association when he was just thirty years old. He received his medical training at the Medical College of Western New York and through apprenticeships with individual physicians, as was the custom in the mid-nineteenth century. He received the degree Doctor of Medicine in January 1837, just a few days past his twentieth birthday.

As a young doctor in western New York in 1844, Davis was elected to serve in the New York Medical Society, where he worked to improve medical education and licensure. A year after his election, Davis introduced a resolution endorsing the establishment of a national medical association to "elevate the standard of medical education in the United States." Though considered "impractical, if not utopian" by some, Davis and others led the establishment of the AMA in the following year, 1847.

In 1849 Davis accepted a professorship in Physiology and Pathology at Rush Medical College in Chicago. In 1858 Davis left Rush to form a new medical school, the Medical Department of Lind University, also in Chicago. In 1862 the medical school became the Chicago Medical College, and in 1892 it became the Northwestern University Medical School.

Davis served the AMA throughout his professional life, attending 47 of the first 50 annual meetings. He was elected president of the Association during the Civil War, in 1864-65; and in 1883 he was named the first editor of the Journal of the American Medical Association.

Works authored by Nathan Davis include the "History of Medical Education and Institutions in the United States, from the First Settlement of the British Colonies to the Year 1850", "History of the AMA", and the "History of the Code of Medical Ethics".  These monographs can be found in the AMA Archives digital collections.

Davis practiced until his death in 1904 at the age of 87. At least two Chicago area landmarks bear his name: Davis Street in Evanston and The Nathan Davis Elementary School located at 39th and Sacramento in Chicago.  Today, the AMA annually solicits nominations for the Dr. Nathan Davis Awards for Outstanding Government Service.  These awards, named for the founder, are recognized nationally as one of the most prestigious honors extended to elected officials and career government employees for outstanding endeavors that advance public health.

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Helen L. Gilson Osgood, Civil War Nurse (1836-1868)

From: findagrave.com

Civil War Nurse. Helen L. Gilson originally selected teaching for a profession, and she taught until 1858, when throat trouble made it impossible to continue. She then took a position as the governess to the family of Frank Fay, who was the Mayor of Chelsea, Massachusetts.

After the Union defeat at Bull Run, Helen and Fay went to Virginia to aid in treating the wounded and recovering the dead. They both devoted the next three years to traveling to the battlefields for this work. In 1864 Mayor Fay had to go to Baltimore and he directed Helen to go to Petersburg, Virginia and prepare for the expected battle.

At Petersburg over thirty black regiments were engaged, with heavy casualties. The wounded were taken to a temporary facility at City Point. A doctor would later state "It was in no sense a hospital, than a depot for wounded men".

Helen was appalled by the conditions and decided to do something about them. Without assistance she campaigned for the establishment of a hospital for the black soldiers. She was able to convince Major General Ambrose Burnside that this should be done, and the Colored Hospital Service was organized. There were a square mile of tents and hundreds of wounded blacks being cared for at the facility. The Army detailed soldiers to assist Helen at her hospital working as cooks and nurses, as well as many civilian volunteers from the north.

In temperature over one hundred degrees sickness and disease spread and Gilson soon contacted malaria, but she remained at her post until the fall of Richmond on April 2, 1865.

She left the Army and recuperated for awhile and then returned to work for Mayor Fay to assist him in operating an orphanage for three hundred black children.

She married E. Hamilton Osgood in Chelsea, Massachusetts on October 11, 1866. On April 20, 1868 she died in childbirth at Newton Corner Hospital. She apparently was too weak for childbirth due to never having fully recovered from the malaria she contacted during the war. Her child did not survive either.

Burial:
Woodlawn Cemetery and Crematory
Everett
Middlesex County
Massachusetts, USA

Created by: William Sweeney
Record added: Apr 30, 2009
Find A Grave Memorial# 36562513

Image: Helen Gilson. Gilson served throughout the war and became a beloved figure in the hospitals. Katharine Wormeley said that Gilson was "part nun, part soubrette.

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Annie Bell, Civil War Nurse

From: mifflinburgtelegraph.com

Although Annie Bell was not native of Union County, she did go to Bucknell University. She is well written about and the University at Lewisburg has much information about her.

She was born in Blair County, Pa. April 9, 1839 to Martin and Eliza Bell. She graduated from Bucknell University in 1858. She was an unpaid volunteer at Harpers Ferry, Dec. 8, 1862. She helped tend the wounded at the Battle of Antietam in Sept. 1862. She did also serve at Gettysburg and then went to Nashville, Tenn. At Gettysburg she was at the 12th Corps hospital on the George Bushman farm where there were 1,200 wounded from July 2 thru Aug. 5th of which 125 were Confederates.

Her cousin was Sarah Dysart. They remained with the 12th corps. Annie Bell spent the last part of her Gettysburg service at Camp Letterman which was established in August, 1863 and located one mile east of Gettysburg on the York Pike. The site was known as Wolf’s Woods. Over half the patients were Confederates. Annie worked in the 4th ward and completed her work at Gettysburg as the chief matron of ward 4. This company closed Nov. 20, 1863, the day after President Lincoln gave his famous address.

Annie was ordered to Nashville, Tenn. and assigned first to the U.S. Hospital No. 1 in 1863. The Battle of Chickamauga had taken place Sep. 1863 as well as the battle of Missionary Ridge, Lookout Mt. and several others that Annie Bell was faced with many dying and wounded men. The 12th Corps began as part of the Army of the Potomac and the 12th was eventually folded into the 20th corps. Annie therefore served both.

The doctors and nurses had many disagreements and Annie had one in Nashville and she resigned. The other nurses were very upset that Annie left and Annie rescinded her resignation. She served General Hospitals No. 1 and 8 in Nashville and served as chief matron in both hospitals. She served in Nashville until the end of the war and was discharged May, 1865 and returned home to Blair County.

Annie Bell married a doctor she met in the service- Dr. George Stubbs of Maine, while nursing in Nashville. She married Sep. 14, 1865 in Annie’s home in Bellwood. After the war they lived in Ohio, Philadelphia and Merion, Pa.

Annie began receiving a pension Nov. 8, 1893. She was one of the first to receive such as they began in 1892. Dr. Stubbs died in 1909 and Annie received her and his pension of each $12 a month for the rest of her life. He is buried near Philadelphia and Annie died Jan. 25, 1916 and is buried in West Laurel Hill Cemetery.

Image: Union nurse Annie Bell in Nashville

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Cancer and Bitterness: Ulysses S. Grant Nurses His Sickness

By Chris Mackowski, 7-8-15

As Ulysses S. Grant’s throat cancer continued to eat away at him through the spring of 1885, he continued to struggle with pain of another sort, too. He was, at the time, in a race to complete his memoirs before the cancer struck him down, but his backwards glance wasn’t cast toward the Civil War only. He could not forget the events of the previous May that had nearly ruined him. His business partners, Ferdinand Ward and James Fish, had swindled him, leaving him and his entire family destitute.

It was, said Grant’s editorial assistant, Adam Badeau, a “shameful story of craft and guile in all its horrible proportions. . . . The shock of battle was less tremendous, the mortal agony was less acute.”

The failure of Grant & Ward was so spectacularly colossal and so nakedly public, everyone knew about it, so Grant never tried to hide it. In fact, he spoke of it quite openly. “In his direct and simple fashion he reviewed the debacle of his fortunes without restraint,” said Century Magazine editor Robert Underwood Johnson, “showing deep feelings, even bitterness as to his betrayal by Ferdinand Ward. . . .”

“No man-of-letters could more openly have worn his heart upon his sleeve,” Johnson said.

Grant’s financial state and his terminal cancer forced him to move on from the debacle, and throwing himself into his memoirs gave him much-needed focus. But even through it all, Grant apparently nursed bitter feelings toward his former partners. Badeau—in the melodramatic fashion characteristic of his own prose—worried about the effects of Grant’s bitterness combined with the grave embarrassment of the swindle itself. “[I]t was only too plain that the mental, moral disease was killing General Grant,” Badeau later wrote; “it was the blow which had struck him to the dust and humiliated him before the world, from which he could not recover.”

Grant’s publisher and friend, Mark Twain, noted a more measured response from Grant, who “never uttered a phrase concerning Ward which an outraged child might not have uttered concerning an offending child,” Twain said. “He spoke as a man speaks who has been deeply wronged and humiliated and betrayed, but he never used a venomous expression or one of vengeful nature.”

For his part, Twain “was inwardly boiling all the time: I was scalping Ward, flaying him alive, breaking him on the wheel, pounding him to jelly, and cursing him with all the profanity known to the one language that I am acquainted with, and helping it out in times of difficulty and distress with odds and ends of profanity drawn from the two other languages of which I have a limited knowledge.”

Fish did not get quite the same venom as Ward merited. Grant later said of Fish, “He was not as bad as the other.”

Although he never truly put the hard feelings to rest, Grant did get his official last word on the matter when investigators took his official deposition on March 26. “In his testimony he spared neither Fish nor Ward,” Badeau recounted; “he felt that this was his last blow, and he dealt it hard.”

Ward was eventually sentenced to ten years in New York’s Sing Sing prison, where he served six and a half years. James Fish, sent to the prison in Auburn, New York, served four years of seven.

Grant, working desperately to finish his memoirs before the cancer finished him, never wrote of the business failure. Perhaps, as his time wound down, he realized his attention was better spent elsewhere, and he refocused his energies. “His mind was absorbed with the one subject of his military autobiography. . . ” a friend noted. “In all matters aside from his book, Grant took but a slight and passing interest.”

(For more on Grant’s final days, see Chris’s forthcoming "Grant’s Last Battle: The Story Behind the Personal Memoirs of Ulysses S. Grant")

Image: The last photo of Grant ever taken: July 20, 1885

From: From: emergingcivilwar.com

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The Roots of Southern Folk Medicine

By Phyllis D. Light, 5-26-15

Meet Phyllis at the Natural Living Expo, November 14-15 in Marlboro, MA. She will be presenting two workshops and conducting private consultations.

By the time the Pilgrims formed the English settlement known as Plymouth Colony in 1620, the South had already been explored and settled by the Spanish for almost 100 years in present day Florida. Because the Spanish, then later the French and Irish, settled there, it is no coincidence that this southern land is where our only traditional American folk medicine — other than Native American traditional medicine — developed.

The roots of Southern and Appalachian Folk Medicine are strong, deep and varied. The traditions that merged to create Southern Folk Medicine include humoral medicine, Native American plant use, healing knowledge brought from Africa by the slaves, and the folk medicine of the British Isles, especially from Scotland and Ireland.

In additional to soldiers, Spanish expeditions to the New World included healers and physicians who practiced the conventional medicine of Europe, which was based on the works of Hippocrates, Galen and Avicennia. This was known as humoral theory or Greek medicine, and held sway in medicine until the 19th century. Spanish expeditions also included botanists and naturalists to draw and describe the exotic plant and animal life of the New World, historians to chronicle the exploits and adventures of the expedition, and Moorish slaves to do the physical labor required to build a colony.

Particularly influential on the development of Southern Folk Medicine was learning from the Creek and Cherokee Indians the uses of plants for both food and medicine. First Nations people have occupied the South for more than 10,000 years. Their relationship to the land determined their survival. The importance of these healing plants cannot be overemphasized.

From 1490-1603, England was making a firm effort to rid the land of the Irish. In the early days, whole clans left Ireland to avoid either death or slavery and took their healers with them. By 1652, over 300,000 Irish men, women and children had been shipped to the Americas for labor. From the Caribbean plantations, the Irish came to the United States via the Gulf and settled in the Deep South. Later waves of free Scots-Irish arrived in ports in the Northeast and made their way down into the Appalachian Mountains during the late 1700s and early 1800s.

From northern and western Africa, people were brought to the American South and Caribbean to work the plantations. Africans who were taken or sold as slaves could not bring their medicine, their plants or their healers with them, but they could and did bring their spiritual framework, rituals and customs, and their innate intelligence.

The last strong influence on the development of Southern Folk Medicine was the Christian religion. The Spanish initially brought priests with their expeditions who believed that Native populations should be converted and brought into the fold. Later evangelical Christians from Europe followed suit with the slaves. Since the Bible was the only book many people owned, it became a reference book for daily living, a guide to good health and spiritual law.

Other influences allowed the fledgling Southern Folk Medicine tradition to develop, evolve and grow unimpeded. These included the plantation system, the Civil War and the Great Depression.

The plantation system was developed in Ireland by the British and brought to America. Each plantation was like a small fiefdom with little or no interaction with the outside world other than neighboring plantations. Here Southern Folk Medicine was used to fight illness, birth babies, take care of wounds and injuries, treat chronic illnesses and nurse children through childhood illnesses. It was the folk medicine — the only medicine — of poor whites and slaves.

The Civil War found the South in a blockade, including a medical blockade. Nothing got in and nothing got out. Regular physicians returned to using herbs as first line medicine at home and on the battlefield. Some of the most useful herb books ever found were written by Civil War physicians.

The Great Depression saw little change in the South because the people and the land were still recovering from the impact of the Civil War. Southern Folk Medicine continued to be the primary tool of mothers and physicians alike during this time of economic depression.

My Beginnings Made Me Who I Am
Growing up in a certain time period in the South meant, amongst other things, living in poverty. This was the time of President Johnson’s war on poverty and Appalachia was viewed as a third world country and ground zero in the struggle. My family could have been on a poster for the program in every sense of the word from the raggedly clothes to the animals hides stretched and tacked on the wall of the house under the front porch. But, when all is said and done, there can be no sorrow or regrets for this was my beginnings and made me who I am. It was this poverty that also helped preserve the only folk medicine, other than Native American Medicine, to develop on this soil.

My grandmother, my father’s mother Rosie, was an herbalist and midwife in a community that didn’t have a doctor nor could afford one. In general, most folks in the area knew enough about herbs to tend to the normal injuries of daily life such as aches and pains, bruises and wounds, and the general malaise that might follow childbirth or the flu. But my Granny knew about herbs as she had been taught by her mother and grandmother and on back to the Civil War. Her family was Creek Indian. My unique upbringing and the type of education I received from the long-dead relatives of my childhood is far superior to the formal education I’ve since attained.

My Granny and other Southern folk herbalists, such as Tommie Bass, viewed the earth quite differently than most people today. To them, the earth, the land, was the source of all that was good and everything we needed to stay alive. Because of the interconnectedness of people and land, we were not separate. The earth gives us food, water, shelter and medicine. If we damage the earth, then we damage ourselves. I am in awe of this simple philosophy that is at once earth-centered and practical, spiritual and mysterious.

From these old-timers, these amazing herbalists and healers of the backwoods, I learned about Southern and Appalachian Folk Medicine. It is a practical system, developed by people who lived in close harmony with the land but were ever mindful of the dangers the land could also present. Its language is land-based, filled with metaphors and similes taken from the Native American, European, and African cultures that originally settled the area.

Southern Folk Medicine Blood Types
Southern and Appalachian Folk Medicine is a constitutional system based upon assessment of blood types and elements. The blood types and elements are in pairs of opposites; once you understand one aspect of the pair, you automatically understand its opposite. There is also a range within each blood type based on excess and deficiency. When the type/element is healthy and in balance, the person has good blood. When the type/element is out of balance then there may be excess or deficiency.

The four elements — fire, water, air and earth — influence the four Southern blood types of bitter, salty, sour and sweet. Each of us is born with all four elements and types within us. It can’t be otherwise because we are the children of this earth and each of these elements is present there. Generally, one element is more outstanding than the other three and is considered the dominant constitution, although sometimes a person might have two elements that are of equal strength.

Although this may sound a bit complicated, it’s really quite sensible and easy to understand. There are no large vocabulary words to learn, because Southern Folk Medicine was conceived in the common vocabulary of its time. It developed, grew, and evolved in the common language of the settlers in America, specifically the Southern states. That means you already know the language, the vocabulary. It is inherent within you and I’m just bringing this to your attention.

Southern and Appalachian Folk Medicine is mind/body/spirit centered, dualistic in nature, and functions within a holistic framework. In addition to assessment of blood types and elements, it also explores the personality. Disease can be self-induced or originate from cold, damp, heat, dirt, pathological invaders, spiritual transgressions or magic.

In Southern Folk Medicine, the body is likened to a tree with a direct correlation between the flow of blood in the body and the flow of sap in trees. In the fall, blood begins to thicken as the weather grows cooler. It sinks downward and pulls inward to nourish, warm, and protect the vital organs during the cold winter. This is why circulation is diminished in the extremities and the hands and feet feel colder. In the spring, the blood thins and begins to rise, moving upward and outward in order to keep the internal organs cooler.

The Qualities of Healthy Blood
Blood is the most important indicator of disorder and imbalance in the body. It is the river of life, carrying nutrients and oxygen to nourish and fuel our cells. In our blood resides our genetic inheritance. Just as importantly, blood can also carry the elements and invaders producing sickness and disease. To be healthy, you must have clean or good blood, and a combination of good inheritance, environment and actions. Blood can also be affected by environmental factors, age, diet, gender and nerves, and influenced by such natural phenomena as the weather, seasons, and the moon and stars.

Blood flows in tune with nature, ebbing and flowing with the seasons. The moon also has an effect on blood much as it does the tides, causing shifts and changes in the flow with each phase of the moon. The moon is an important influence on the folk astrology used by herbalists, farmers, and midwives.

The Earth gives us food, water, shelter and medicine. If we damage the Earth, then we damage ourselves.

In the spring, impurities and pathogens that the body has been harboring over the winter can rise, causing illness in the spring. Summer or fall illnesses may also be contained over the winter when the blood is thick and then manifest in the spring when the blood begins to move again. Spring cleansing of the body is an important aspect of this healing system for moving out illness and helping thin the blood and get it ready for summer.

Blood possesses variable characteristics that can have a marked effect on health. It can be hot or cold, expressed both in temperature or qualities of these states. Blood can rise and fall, be high or low. It can be thick or thin depending not only upon season but many other factors. It can speed up or slow down. Blood can be simultaneously thick in some areas of the body and thin in others. This causes accumulation in areas of the body where the blood is thickened or congested. Blood can be clean or dirty, good or bad. Its flavors are bitter, salty, sour (acid) or sweet.

Blood qualities and flavors change continually throughout life in keeping with our actions, our environment and our attitude and spirituality. Though we may be born with a basic blood constitution (type and element), it may change and flow over the course of our lives, just as our blood does. Understanding blood is all-important — spiritually, psychologically and physically — to the study of Southern Folk Medicine. I wish there was enough space in this article to really convey all the characteristics of each element and blood type, but there’s not. Which element is prone to weight gain? Which element is flighty? Which element is most courageous? Which element can keep a secret? Which element is most prone to high blood pressure, diabetes, or rare and unusual illnesses?

Southern and Appalachian Folk Medicine is a system that developed to define, explain and remedy illnesses in a new world that was being settled by different cultures who all needed to survive in a strange, new land. It is a folk medicine that is as viable as Traditional Chinese Medicine, Ayurveda, or any folk tradition from any other land. Southern and Appalachian Folk Medicine is uniquely our own, providing cultural roots that help define us as herbalists and as a society. It is a truly unique form of healing.

Meet Phyllis at the Natural Living Expo, November 14-15 in Marlboro, MA. She will be presenting two workshops and conducting private consultations.

Phyllis D. Light is a practicing herbalist and health educator with over 30 years of herbal experience. She is traditionally trained in Southern and Appalachian Folk Medicine, beginning with her Creek/Cherokee grandmother in the deep woods of North Alabama, and continuing with her father and other Appalachian elders, including Tommie Bass. She is the director of the Appalachian Center for Natural Health in Arab, Alabama. Visit www.phyllisdlight.com.

From: spiritofchange.org

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