Civil War Hospital Ship

The U.S.S. Red Rover, a captured Confederate vessel, was refitted as a hospital ship.

Evolution of Civil War Nursing

The evolution of the nursing profession in America was accelerated by the Civil War.

The Practice of Surgery

Amputations were the most common surgery performed during the Civil War.

Army Medical Museum and Library

Surgeon-General William Hammond established The Army Medical Museum in 1862. It was the first federal medical research facility.

Civil War Amputation Kit

Many Civil War surgical instruments had handles of bone, wood or ivory. They were never sterilized.

Sunday, September 18, 2016

Lucy Seaman Bainbridge: Sister Ohio

From: edinborough.com

A VISIT TO WASHINGTON with my mother, in 1864, brought about an immediate change in my life. We were guests at a public dinner where one of the speakers told of the need of nurses at the war front--a vital need, for which there was no adequate supply. At that time our country had no trained nurses; the women who took upon themselves that duty had only their home-experience and common-sense on which to rely. I went into service with hardly that much knowledge, I was so very young.

Through the courtesy of The Outlook I am able to include here an account of my work as printed in the issue of May 28, 1919, bearing the title: Sister Ohio. A Memory of the Civil War.

The speaker at the dinner was the Ohio Military Agent, head of the Ohio Soldiers' Aid Society. He told of the terrible suffering at Fredericksburg, and continued: "The conditions are worse than in the winter of 1862, when so many dead and wounded lay along the banks of the Rappahannock and the Army of the Potomac was so sorely pressed. Without going into the causes or blunders which brought this, the fact is that by the river and in the city streets and on the floors of the houses our men are sick, wounded and suffering, helpless and dying. It is an awful condition there." Strange talk for a dinner table, but it was a time of war!

"I am here to send down a relief party to do what it can for those poor, brave boys of ours," the Military Agent went on. "In our State, furloughs have been granted so that great numbers of our young men may leave business, and the Rev. Mr. Prugh, an Ohio clergyman of good standing, will be the head of the party. There is also ready to go one efficient woman; she will arrive to-morrow, but I cannot send one woman alone.

Turning to my mother he asked: "Will you go? You have had wide experience and could give most valuable help. Can you not go down with the party? And take your daughter along--she can help."

Because of a telegram she had received informing her of sickness at home, my mother was compelled to answer that her going was impossible."But you may send my daughter," she added, "and I will go as far as Acquia Creek with her to see, whether or not, she can be of any use."

IT WAS NO GALA PARTY on that transport which took us down from Washington to meet the train from Fredericksburg. There was nothing before us but work for suffering, dying men. It was understood from the first that hardly the ordinary courtesies of social life were to be observed. If women were to go into that kind of service, they were to be ready to do fully their part, and in no sense to become a burden to the men who were so greatly needed. This was understood.

Oh, what a procession that was from train to transport! Men hobbling, limping, staggering— each man able to help lending a hand to those utterly helpless. There were few stretchers; blankets, and even sheets, were used for carrying the men who could not walk. Wounded, sick, and faint, they reeled from the railway to the friendly boat, where they gladly lay down on the hard boards. A narrow pathway was left between the feet of the two rows of men packed closely together on the floor of the transport. The few doctors were indeed busy, and very quickly used my mother's practical knowledge of nursing and medicine. In the midst of groans, creaking of machinery, and swash of the river, and no one to direct her, what could a girl do? Only this: A pail was found and filled with water; then lips were moistened, dried rags soaked with blood around the wounds wetted, and bits of old flannel shirts, made to serve as temporary bandages, eased up by the water. Water! Water! Water! How the men on that hard floor, packed closely together, craved the comfort of it on face and hands and wounds!

"Good!" said the doctor, as he hurried by. "Now make some punch--can you? We must keep these fellows alive till we get them to Washington." All through that night--long for the poor men but short to us who worked--we fought pain and death. Kneeling on the floor beside the men, one and another looked up as the comforting water or the spoonful of punch touched his lips, and said feebly, "Oh, bless ye! God bless ye!"

ON REACHING WASHINGTON, our boat was quickly emptied. The men were lifted into ambulances and sent to the hospitals, but many were laid away in quiet rest at Arlington. We made ready promptly to return for another boat-load. "I shall be very pleased if you will spare your daughter to go down to the base of supplies with our party," said the Military Agent gent, very cordially, to my mother. "All of them ask this, and Mr. Prugh, the leader, will take her under his wing." And so I went to the Front.

There was no pretty nurse's cap or white uniform to wear, but just plain, every-day clothes--a gingham dress and apron; no dainty and becoming white veil with a red cross over my forehead or on my arm. My distinguishing mark was simply a badge of red silk pinned on my left breast, on which were printed in gilt the words "Ohio Relief." Thus I went down the Potomac under the special guardianship of my leader, whom I called Father Prugh. At Port Royal on the Rappahannock, White House Landing on the Pamunkey, and, finally, at City Point, I had experiences of war which memory will never lose. How much was accomplished is a problem for the arithmetic of eternity!

The State of Ohio gave us stores of condensed milk, dried, toasted bread, crackers, sugar, canned fruits, jellies, and so forth, and our Practical State sent to each of us women a good umbrella, to be used against sun and rain. Away down within the boom--boom--boom of the cannonading, close to the Front, what could our party of untrained though willing people do? Surely, What could a mere girl really accomplish? Yet, after all, woman's work is made up of little things, and these "littles," put together, make the whole. So with that thought I worked.

Because of lack of army supplies, or because they were tied up with red tape, more poor fellows were brought wounded and helpless back from the Front than there were tents to cover them. On the grassy floor they were laid close together, with an orderly to care for them as best he could. When the tents were filled to the utmost, other men from the battle and rifle pits were left outside on the grass.

One very hot day a soldier lay with upturned face exposed to the pitiless heat of the Virginian sun. The bandages around his arm and leg were stiff and hard with blood. Was he black or white? Dirt, powder, and sunburn made it difficult to determine. Was he dead or asleep? He did not move. To inexperienced eyes he did not seem to breathe even, but water on the rags about the wounds, water on his lips, water on his face and head, had the desired effect, and his eyes slowly opened. With such material as I could find in the vicinity, a little improvised tent was put up over his head, face and neck. One of the doctors, coming hurriedly by and seeing my attempt to protect the man from the hot sun, called out, "Bully for you, Miss Ohio! I'm awfully busy, but I'll try to come back and give you a little help with that fellow. Feed him some punch."

Among the wounded men lying in one of the tents another day—men recently brought from the very Front and waiting to get to Washington—was a soldier who called out, "Say, Ohio Relief, what's your name, please? "Pointing to my badge, I replied, "There's my name." "Well, Sister Ohio," said the soldier, "I am from that State too, and the worst of it is I am hungry, and the orderly has too much to do to bother with me. What are you going to do for a fellow who wants to eat and can't feed himself?" Both arms were shot through and he was helpless. I soon found that he was ready for bread-and-milk, and liked it better than anything else. So my supplies of crackers, toasted bread, and condensed milk were put to good use. I fed my wounded Ohioan for several days, until he was carried to a Washington hospital.

Many months afterwards, this same soldier, in the uniform of a Major with his left sleeve empty, called at my home in Ohio, and said: "You see, I found out your name and who you were. So I have come to thank you and to have some bread-and-milk with you. But you won't have to feed me this time." Later, this soldier honoured me with the suggestion that I take bread-and-milk with him all his life!

Outside a tent, under the ropes which held it in place, lay a soldier-boy, groaning, and doubled-up with pain. "I'm just sorry for him, Miss Ohio," said the orderly, in a kindly voice, "but he can't be 'lowed in the tent; it's chuck full of wounded men now. He's got the cramps and he don't stay in one spot very long. He was over the other side until a few minutes ago. I'm too awful busy to 'tend to him.'' In my supplies were medicines for dysentery, and so I went to work. Careful feeding, regular medicine, a warm blanket on the grass, with the added oil of kindness, did the work, and in time the lone boy was in fair condition for the next boat-load to Washington.

When other duties to the suffering soldiers allowed a respite, Father Prugh held a short, informal service of song and cheer, in each tent. Here a girl could really help.

Frankey was a Michigan boy. Our duty was first to the men of Ohio, and after that to any one else. The lad had been terribly hurt, shot through both arms and one leg, and his wounds were full of gangrene and vermin. Frankey had lied about his age and had run away from home to enlist. He was only a boy.

"Miss Ohio," said the doctor, "that little fellow thinks he is to have a furlough and that he is to go home to his mother. But he isn't. He's going to die. Don't make him feel badly—but—oh, well, do as you like." The boy responded to every kindness and wanted "Sister Ohio" to take care of his precious possessions—green-and-yellow skein of sewing-silk taken at Fairfax Court-House, and a ring he had cut out of a nut when his leg had been hurt, but when he could still use his arm. He talked of his furlough and his mother and the Sunday School, and how glad he was that he had been in the fight. At last his mind was turned to the thought that, perhaps, he might not be able to go home to his mother; that his furlough was to be a very long one, and that in the Father's house he would meet his mother and tell her how sorry he was that he had lied. At the service that Sunday afternoon he asked that we sing his favourite hymn. It may sound a bit old-fashioned now, but the boy loved it—"There is a happy land, far, far away." He tried to join in the singing; and when we sang the hymn—"I have a Saviour in the Promised Land," he wanted us to go over it twice. Before the next boat-load was shipped to Washington, Frankey had entered into the land where there is no war. He said "good-bye" that Sunday afternoon and gave me as a token of remembrance the tiny skein of silk; the other things I was to send to his mother. "Please, Sister Ohio," he said, "you tell her I am all right inside, and you are my sister, you know. Maybe I won't be here to-morrow, so will you kiss me ‘good-bye,' 'cause my mother ain't here?" So I kissed him.

At the end of a row of men lying on the ground in one of the tents, one day, was a man so wounded that he had severe hemorrhages. "Don't waste any time on him, Miss Ohio," an orderly said. "He is a goner; he will never get to a hospital." The poor fellow knew it himself, all too well, but, as I sat by him, he said, "Will you write to my wife and tell her to make my children know that I gave my life for my country? I want my boy to know about his father. Tell them I thought of them." The story was written in full. I added a tiny lock of hair and a special message from the father to the boy who bore his name, and as I read it to the suffering man, his gratitude was expressed in a whispered "God bless you." As night came on I gave him a verse of comfort and strength from God's Word, and as I left him he said, longingly, "Sister Ohio, please come here first in the morning, and if—." At the first break of the dawn I was there, but his place on the grass was empty. A sudden severe hemorrhage—and his spirit had been released. The body had been taken away, for there was no time for delay. I hurried to the cemetery. There were so many who had died in the night, and there was so much to do for those who were suffering, that there was no time for services. But as that body was laid underground, "Sister Ohio" was kindly allowed by the man in charge to have the spade of earth held for a moment while a verse and a short prayer were repeated.

WHEN THE ARMY BASE WAS MOVED to City Point, there was much delay in the arrival of the stores and goods. There were tents, but beds and blankets did not come until later. Our food was of the simplest sort for a day or two. Johnny, a drummer boy, detailed temporarily to the Christian Commission tent near by, all unseen, rolled in a can of peaches under the edge of the canvas of our tent, and later came peeping in to say, "Well, Sister Ohio, I'm from good old Bosting, but just you count on me if you need anything." When he went back to the Front, he asked for a little piece off the side of my blue-check apron as a memento of our friendly acquaintance. Many years,—yes, very many years afterward—a bald, gray, bent man, worn and disabled, called to see me, and asked if I were Sister Ohio, and did I remember Johnny, the drummer-boy at City Point?

While it was true that at City Point we only had a tent, yet each of us had a big shawl, and there was a log for a pillow and a grassy floor to lie on. On the first night an officer came along at dusk and said: "There is a lady alone whom we want to accommodate. She has business with Headquarters. All we can do is to ask you ladies to take her in as your guest to-night." We gladly gave her a share of our log pillow, and I divided my warm shawl with her as a covering. It was dusk when she came, it was early dawn when she left. So our guest, Clara Barton, who later organized the American Red Cross, and was its first President, did not know who had been her hostess. Years afterwards, Dr. Amory Bradford, of Montclair, held a series of meetings in his church, giving one day to addresses on the work of women. There were three speakers—a lady from Boston, Clara Barton, and myself. With the permission of Dr. Bradford, I was allowed to introduce the speaker who followed me. I had never seen Clara Barton since the night we had spent together under my blanket-shawl at City Point. I told the story of the stranger who came to us that night in the tent, and then presented Miss Barton to the audience. With her cloak thrown back, showing its gay lining, the medals on her breast flashing, and her face full of light and life, she extended her hand and, clasping mine, said: "I have often wondered who the girl was who gave me a part of her pillow and warm shawl, and I have always wanted to thank her for her hospitality, and to meet her again—and now I say, God bless you." The hearty cheers of that big audience one can never forget.

My evenings at the Front were all needed for writing letters—letters to mothers, wives, and sweethearts. One very warm night as I sat at my deck, which was the top of a packing box, writing by the light of a candle, the entrance curtain of my tent was pushed back and a man, not a soldier, came in to have a social chat with my tent-mate, a widow. I was introduced; that was all. I had many letters to get off, and was not there for any social calls. Late that night, when my widow friend was out on some errand, a tap on my tent pole roused me. "Who is there?" I asked. "What is wanted?" A man's voice replied, giving his name, and making it evident that he had utterly mistaken my character and my mission. My sharp reply was followed by my taking up a hatchet with which I had opened a box, and, clanging it down upon a pile of nails which lay there, saying, with a tone and emphasis which he could understand, "The first man who crosses the threshold of this tent will be a dead man." The vile creature did not walk away, he ran—with all his might.

For the first time in all her experiences at the Front "Sister Ohio" called upon the kind services of Father Prugh and the staff of royal young men with him. That midnight caller left for Washington the next day.

Furlough-time was up for some of the party; the widow had special business to attend to in Cincinnati; and so I went to my home in Cleveland, Ohio.

During the many years which have come and gone since the days of which I am now writing, I have received a few letters. One to myself, and one to my son, are added here:

Fort Leavenworth, Kansas,
January 9, 1881.

Dear Madame: You are no doubt surprised at a letter from an old friend. I hope you have not forgotten your little soldier friend, who knew you down with the Army of the Potomac. I was of the Twentieth Massachusetts Volunteers. After that I went into the Navy and was shipwrecked. Good-by, and God bless you is the prayer of your old friend,

Johnnie Doyle.

Treasurer's Office, Trumbull County,
Warren, Ohio, September 10,1903.

November 5,1861, I enlisted in the 6th 0. V. Cav. Re-enlisted January, 1864, and on May 28, 1864, was severely wounded at Erron Church or Hawes Shop, Virginia. The Army moved, and the sick and wounded were sent to White House Landing on the Pamunkey River. Tents at the landing were put up for us soldiers, and well I remember your mother (then a young lady) with an older lady from Cincinnati, Ohio, going around among the soldiers looking for Ohio boys, as they were sent by the Ohio Relief to care first for Ohio soldiers. How well I remember boys from other States wishing they were from Ohio!

One day one of the boys from my regiment was walking around with his arm in a cling (he was wounded in the arm) and suddenly his arm began to bleed very bad. The boys called and one of our soldier nurses came and took him to the doctors who were amputating limbs. But soon the poor fellow came back, and such a look as he had when he said the doctors said he had to die, as mortification had set in and an amputation would do no good. I shall never forget that poor fellow's look. But he rapidly grew worse, and lay down upon the ground (we had no cots then) suffering very much. A doctor came in and the soldiers asked if he could not do something for him. The doctor replied: "My poor fellow, I can't do a thing for you." He soon died and was carried out for burial just as your mother came in. How she did hurry out to see if she was too late to get a lock of his hair to send to his wife and family with a letter! I wonder if she remembers it. The Army again had to move and change its base of supplies. The sick and wounded were put in transports. Another comrade and myself were put on the transport Connecticut, and your mother saw that our cots were placed side by side and she gave us a bottle of wine to keep our strength up during our trip to Washington.

Very truly yours,

J. A. Sager, Treasurer.

Military Medicine at Wilson's Creek

Wilson's Creek National Battlefield

An examination of field medical practices at the Battle of Wilson's Creek (and elsewhere in the CiviL War) gives a sense of the horrors inflicted on the common soldier during the war, as well as an understanding of the period medical techniques, procedures and equipment used by surgeons operating with the armies. Medical science at the time treated wounds and sickness with the best knowledge of the day. Most surgeons took great care to ensure the well being and survival of their patients. We should not be too quick to judge them based on modern medical practices, just as we would not expect future historians to pass judgment on the knowledge and techniques of healthcare professionals today.

Typhoid, dysentery or diarrhea, malaria, measles, sexually-transmitted diseases, pnuemonia and other ailments killed more soldiers, North and South, than musket, cannon or saber.

Of the approximately 618,000 fatalities of the Civil War, some 2/3 (approximately 414,000) were the result of disease. Typhoid, dysentery or diarrhea, malaria, measles, sexually-transmitted diseases, pneumonia and other ailments killed more soldiers, North and South, than musket, cannon or saber. Many of these ailments were due to the living conditions of the soldiers, their dietary habits and poor hygiene. Although some attempts were made to treat diseases with home remedies, surgeons also used large doses of opium, quinine, turpentine, carbonate of soda, powdered rhubarb and calomel (a mercury compound). Surgeons did not understand the concept of sterilizing their instruments and hands before an operation, and would literally spread germs from patient to patient, only stopping to wipe instruments on a dirty shirt, apron or coat, or dipping them in a bloody and stagnant bucket of water.

The most common surgical procedure of the Civil War was amputation, but only when the severity of the wound made it necessary to preserve life. Amputations were necessary when any one of three conditions prevailed: massive tissue or muscle loss, severe trauma to joints and bones, and vascular damage. A primary amputation, done within 24 hours after receiving the wound, significantly reduced infection and septicemia. Contemporary medical knowledge recognized that amputation was the best hope for a soldier's survival. Surgeons also preferred to save as much of the limb as possible, to provide the patient with a more functional arm or leg in later life. Statistics also reveal that the farther away the wound was from the trunk or torso of the body, the greater the patient's chance for survival.

The wounded soldier would be brought to the operating table, which was in some cases nothing more than a door on two saw horses, a table or even church pews - anything that would support the weight of a man and was available to the surgeon in the field. The wound would require examination to determine severity. If amputation was deemed necessary due to any of the reasons mentioned above, the surgeon would proceed. The next step was to use a general anesthetic to put the patient to sleep. Chloroform and ether were the two anesthetics available to surgeons during the war. In fact, contrary to popular belief, anesthesia had been widely used by American physicians since the 1840s.

As soon as the patient was unconscious, tourniquets or the hands of a competent assistant would be used to stop the flow of blood to the surgical site. The skin would be incised or cut with an amputating knife, then retracted or pulled back, and the muscle would be incised. The bone would be exposed and a surgical or capital saw used to sever the limb from the body. The surgeon would then ligate, or tie off, the major blood vessels with surgical silk thread, using an instrument called a tenaculum to grasp the arteries. Ligatures were often left dangling from the stump to allow for their removal later (this later removal could lead to secondary hemorrhaging, as surgeons were unable to quickly stop the flow of blood when the ligatures were pulled).

After the major bleeding was stopped, gnawing forceps and a bone file would be used to smooth the rough edges of the stump of the bone and aid in the healing process. The wound was then closed with curved needles and silk thread. The average amputation could be finished in 10-15 minutes, partly due to the fact that the surgeon had to treat many patients and had to work as quickly as he could. After the operation, the patient would then be removed from the table for post-operative care. Several different painkillers were available, including morphine and opium. Pulverized opium could be rubbed directly into the wound, or mixed with whisky to make laudanum.

From: nps.gov

Image: A patient is prepared for an amputation at Camp Letterman in Gettysburg, Pa

Deadly Diseases: A Fate Worse than Dying on the Battlefield

by Elise Stevens Wilson

Cannons blasted and bayonets tore through flesh in America’s worst war, the American Civil War. This war was gruesome for many different reasons. It tore the country apart and created divides that exist to this day.

One of the more ghastly aspects of the war concerned medical practices. Being wounded and sent to the hospital was as much a death sentence as being sent to the front lines. Medical equipment was bulky and hard to move. It was a lower priority than ammunition and food, so the doctors rarely had what they needed. At the time, people had little to no understanding of how bacteria spread so surgeon’s tools were used on multiple patients with a simple cleansing with water between uses, and wounds were packed with filthy rags that encouraged the wounds to fester. Surgeries were crude and resulted in astonishing pain as anesthesia was rarely used, and painkillers were basically non-existent. Lastly, there was a severe lack of well-trained personnel. Soldiers were grateful for the thousands of female volunteer nurses and members of the Sanitary Commission. Needless to say, the state of medicine in the Civil War was deplorable, and for many people today, unimaginable. Records clearly show that more people died of diseases than in actual battles or of field wounds.

From: gilderlehrman.org

Taking Care of Those in Need

Antietam National Battlefield, Harpers Ferry National Historical Park

In 1862, a stately brick mansion overlooking the picturesque water gap at Harpers Ferry, Virginia, was converted into "Clayton General Hospital." Long tents were pitched in the yard, and by the third week of July, this former armory paymaster's quarters housed 285 patients.

"I noticed a heap of amputated feet, legs, arms, hands, etc. -- about a load for a one-horse cart. Several dead bodies lie near, each covered with its brown woolen blanket"
Walt Whitman

Mrs. Abba A. Goddard traveled over 600 miles from Portland, Maine to care for the soldiers of her hometown's 10th Maine Infantry at Clayton. She was named "Matron of the General Hospital." Despite the limited medical services and comforts provided by the government, Goddard worked to make the hospital as comfortable as possible. Within two weeks of her arrival, she solicited donations from civilians and received seventeen boxes filled with slippers, socks, fans, pin cushions, towels, handkerchiefs and checkerboards.

The future of the soldiers under her care worried the Matron. "When I look at our host of maimed--some without an arm, some without a leg, others minus a foot--and realize their privation is life-long . . . I can hardly restrain my tears."

In early September, the hospital was closed and the patients moved to nearby Frederick, Maryland. "The cause of this sudden removal is a mystery," Goddard reported. "I am informed that some important events are about to transpire." She did not know that approximately 28,000 Confederates were marching on Harpers Ferry and that many more wounded would soon be in need of assistance.

Nearly 10,000 soldiers passed through the Frederick hospitals alone in the aftermath of the Maryland Campaign. Many of the patients who could be safely moved were quickly transferred by railroad to the large hospitals in Baltimore, Washington and Philadelphia. Many others were treated in Frederick until they recovered enough to be transferred, discharged or returned to their units.

The patients were treated by a combination of Army and civilian surgeons, volunteer female nurses, enlisted male nurses, medical cadets, cooks, and laundresses. In addition to the medical staff and employees, many private citizens helped out as they could. Supplemental food, clothing, medical supplies and various personal items were donated to the hospital and the patients by the Frederick Ladies Relief Association and other private groups.

The Poet Who was a Nurse: Walt Whitman
When the war began, poet Walt Whitman was exempt from service due to age, though two of his younger brothers joined the Union Army. Upon hearing the news of the wounding of his brother, George, in 1862, Whitman left his home in New York to care for him in Virginia. During his mission of mercy, he was overcome with sympathy for all the wounded young men he saw, many of them bound for hospitals in Washington, D.C. After George's recovery, Whitman decided to move to the Capital to care for wounded soldiers. Finding a job as a clerk in an army office, Whitman spent much of his time away from work volunteering in several of the area hospitals. Spending his pay on gifts for soldiers and volunteering his time writing letters for soldiers and changing dressings, Whitman quickly became a beloved and respected figure among the wards. Moved by the suffering of the wounded and stories of the battlefields, he scribbled poetry in his notebook as he moved among the hurt and dying. Many of these poems were included in his 1865 collection, Drum Taps.

"I noticed a heap of amputated feet, legs, arms, hands, etc. -- about a load for a one-horse cart. Several dead bodies lie near, each covered with its brown woolen blanket... The house is quite crowded; all the wounds pretty bad, some frightful, the men in their old clothes, unclean and bloody. Some of the men were dying. I had nothing to give at that night, but wrote a few letters to folks home, mothers, etc. Also talked to three or four who seemed most susceptible to it, and needing it." -Walt Whitman

Image: Sketch of a woman writing a letter for a wounded soldier

From: nps.gov

Sunday, August 14, 2016

The Monitor and the Merrimac: The Medical Aftermath

From: med.navy.mil

David goes out to meet Goliath and every man who can walk to the beach sits down there, spectators of the first ironclad battle in the world... The day is calm, the smoke hangs thick on the water. The low vessels are hidden by the smoke. They are so sure of their invulnerability they fight at arm’s length. They fight so near the shore, the flash of their guns is seen and the noise is heard of the heavy shot pounding the armor. -Surgeon Charles Martin, USN on the Battle between the Monitor and Merrimac.

What was the medical aftermath of that now legendary combat: On the Union side, three men were injured on Monitor. One was the acting master whose knee came into contact with the turret at the same instant one of Virginia’s heavy shot struck it. Knocked senseless by the impact, he regained consciousness 10 minutes later. Another seaman in the turret was knocked unconscious in a similar manner. Acting Assistant Surgeon Daniel Logue described this sailor’s injury as a concussion of the brain. His circulation remained depressed and it became necessary to administer stimulants. When the patient regained consciousness, Dr. Logue watched for a reaction and then applied cold affusion to the head. Toward the close of the action, the Confederate ironclad inflicted its last and most significant casualty—Monitor’s skipper John Worden. Following the battle, only Worden left the ship for hospitalization in Washington. The other two patients returned to duty the following day. Worden, it turned out, proved to be the only serious casualty of the battle, permanently losing the sight in one eye and incurring a disfiguring scar on his face.

On the Confederate side, Virginia’s crew did not get away unscathed. In her unequal fight with Congress, Cumberland, and Minnesota the previous day, Virginia suffered several killed or wounded. In contrast, her wooden-hulled victims suffered enormous losses. Cumberland alone lost over 100 men. Before the ship went to the bottom, all the wounded who could walk were ordered out of the cockpit; but those of the wounded who had been carried into the sick bay and on the berthdeck were so mangled that it was impossible to save them. During her engagement with Virginia the following morning, Monitor’s two 11-inch Dahlgren smoothbores did moderate damage, wounding a few aboard the Virginia but killing no one. As it turns out, the Confederates got a lucky break. Although each 11-inch Dahlgren aboard Monitor threw a shot weighing 168 pounds, Worden was under orders from the Navy Department to fire half-weight powder charges of 15 pounds for fear the guns would explode.

The United States Military Railroad

Petersburg National Battlefield
From: nps.gov

The work of the United States Military Railroad Construction Corps (U.S.M.R.R.C.C.) was instrumental in the reduction and ultimate defeat of the Confederate army defending Petersburg and Richmond, Virginia in the closing days of the American Civil War.

In the nine months of the Siege of Petersburg, 21 miles of track would be laid, 25 locomotives and more than 275 pieces of rolling stock would be used, and 2,300,000 miles would be logged on the railroad.
Photo of locomotive at Union army supply base at City Point
Locomotive "John C. Robinson" at City Point, 1864.
Library of Congress

From the waterfront at City Point just below Richmond on the James River, Gen. Ulysses S. Grant had to supply an army of more than 100,000 troops and more than 65,000 horses and mules. For so vast an army, living off the land was not an option. All food, equipment and supplies had to be shipped in from northern ports and then delivered to the battlefront eight miles from away.

Eight wharves were built to accommodate hundreds of vessels conveying war material. More than 280 buildings were constructed by the U.S.M.R.C.C. at City Point by the end of the siege. The lumber was pre-cut as per orders and then assembled once it arrived. The sleepy little village took on the appearance of a thriving, bustling port in just a few days.

As the siege progressed, Grant extended his lines around Petersburg and the United States Military Railroad (U.S.M.R.R.) followed. After every major action, with few exceptions, the railroaders received orders to investigate the terrain and chose a site suitable for a temporary rail line. In the nine months of the siege, 21 miles of track would be laid, 25 locomotives and more than 275 pieces of rolling stock would be used, and 2,300,000 miles would be logged on the railroad. The line was used to transfer thousands of troops, but the primary cargo was food, weapons, and ammunition. Wounded soldiers were eventually transported by rail to the Depot Field Hospital at City Point.

Stations were established along the railroad for distribution of supplies. Sidings were built at these stations so trains unloading would not interfere with other trains on the line. On average 18 trains made the trip from City Point to the front and back again each day and timetables were published to ensure a smooth operation.

The ultimate Union victory over the Confederate army of Robert E. Lee at Petersburg is due in large part to the well-organized operations of the U.S.M.R.C.C.

Image: Locomotive "John C. Robinson" at City Point, 1864

Medicine and Medical Practices

Antietam National Battlefield, Harpers Ferry National Historical Park, Manassas National Battlefield Park
From: nps.gov

The story of Civil War medicine is a complex one. Through the dedication, innovation and devotion of surgeons and medical support staff, the foundation for today's modern military medicine was laid.

"Humanity teaches us that a wounded and prostrate foe is not then our enemy."
Dr. Jonathan Letterman

The Traveling Medical Department
After the Battle of Antietam, both Medical Departments were faced with the daunting prospect of treating and transporting a large number of wounded men. The newly-organized Union Ambulance Corps was helpful in the evacuation of the soldiers who could be moved, and a new concept of semi-permanent field hospitals was tested for the first time. It was an experiment brought on by necessity, since there were so many soldiers with serious injuries who could not bear even the twenty mile trip to more established hospitals in Frederick.

The Confederate wounded who could not be moved were treated by the Union Medical Department, and all received the same level of care as the Union wounded, for, as Dr. Jonathan Letterman stated, "humanity teaches us that a wounded and prostrate foe is not then our enemy."

Before the Battle of Antietam, Dr. Letterman arranged for the Medical Purveyor in Baltimore to gather supplies and have them ready to be shipped where and when he asked for them. Unfortunately, the destruction of the railroad bridge at Monocacy Junction near Frederick, Maryland, delayed the supplies in reaching the field hospitals at Antietam. Also, since medical supplies were shipped by the Quartermaster Department and not the Medical Department, they were often set aside in favor of other items like ammunition and food. These delays caused Letterman great frustration, since most of the medical supplies did not arrive at the field hospitals until four days after the battle.

From his experiences at Antietam, Letterman changed the way medical supplies were distributed to the regiments. He noticed waste occurred when large amounts were given out, and the abandonment of supplies when adequate transportation could not be found. He reduced the amount of medical supplies given to a regiment at one time, thus making the system more efficient. On October 4th, 1862, the new supply system was adopted. One wagon now sufficed for the medical supplies of a regiment, plus the hospital tents and baggage of the medical staff, with one additional wagon for a brigade.

"The [new supply system was intended to] reduce the waste that took place when large supplies were at one time issued to regiments, to have a supply given them, small, but sufficient for all immediate wants, and to have these supplies easily attainable, and replenished without difficulty, when required, and without a multiplication of papers and accounts." - Dr. Jonathan Letterman

Improvements to the System
The Civil War is considered a watershed in the history of medicine. Many of the innovations implemented during the war helped to bring the practice of medicine into the modern era, including:

-Advancements in surgical procedures and the management of traumatic wounds, including specialization in plastic surgery and nerve injuries

-The establishment of an organized ambulance system with trained stretcher-bearers

-The creation of a multi-layered system of care on the battlefield that included first aid stations and field hospitals

-The use of triage to maximize the survival rate of the patients

-Widespread use of anesthesia during surgery

-The establishment of fixed-bed hospitals as long-term care facilities

-The introduction of women into the hospitals as nurses, laundresses and hospital administrators

-The organization of civilian relief agencies that worked with the military to provide supplies, clothing and food

-Improvements in orthopedic medicine and the design of prosthetics

-Documentation of wounds, illnesses and treatments with the intention of using the records as a teaching tool

The story of Civil War medicine is a complex one. Through the dedication, innovation and devotion of surgeons and medical support staff, the foundation for today's modern military medicine was laid.

Unfortunately, little was known about the psychological damage suffered by those who had experienced the horrors of war. While it was recognized that war changed people, diagnosis and treatment of the emotional impact of combat had yet to be fully understood. Some people could not cope with their experiences and were traumatized for the rest of their lives. Others found ways to overcome the mental and physical trauma and enjoyed success after the war. Veterans groups came together to help support their stricken brothers. Of great importance is the fact that what was learned during the war was shared with the world, greatly adding to the quality of health care for everyone.

Advancements in medicine made during the war allowed wounded soldiers to return to their homes and lives. Medical professionals and the compassion and service of dedicated civilians kept them alive and gave them hope. Their own strength and resilience made them heroes.

Image: Photograph of an ambulance drill

5 Pioneering Women Doctors and Nurses of the Civil War

By Jocelyn Green, 3-29-15

The truth is, all women who were doctors and nurses during the Civil War were pioneers in their field. Prior to 1861, nurses--and all but two doctors in the United States--were men. But when social reformer Dorothea Dix pointed out to President Lincoln that he had a scant 28 surgeons in the army's medical department to care for the 75,000 volunteers he'd just called for, he reluctantly conceded that women be allowed to serve as nurses. I want to introduce you to five remarkable women who blazed the trail for women in medicine.

1) Dr. Elizabeth Blackwell. An English immigrant, Dr. Blackwell was the first woman to earn a medical degree in the United States, and ran an infirmary for women and children near the slums of New York City. When the Civil War broke out, she realized the Union army needed a system for distributing supplies and organized four thousand women into the Women’s Central Association of Relief (WCAR). The WCAR grew into chapters around the county, and this body systematically collected and distributed life-saving supplies such as bandages, blankets, food, clothing and medical supplies. Blackwell also partnered with several prominent male physicians in New York City to offer a one-month training course for 100 women who wanted to be nurses for the army. This was the first formal training for women nurses in the country. Once they completed their training, they were placed at various hospitals. By July 1861, the WCAR prompted the government to form a national version—the United States Sanitary Commission. And it all started because Dr. Blackwell decided to mobilize the women of the country to help the Union.

2) Georgeanna Woolsey. At 28 years old, Georgeanna should not have been allowed to serve the army as a nurse, but she got through the application process anyway. Against her mother’s and sisters’ wishes, she was one of the 100 women trained in New York City to be a nurse. Not content to sit in a parlor and knit or scrape lint, she was eager to go where the fighting was, to get her hands dirty in a way she had never been allowed to before as a wealthy, privileged woman. Georgeanna wrote many letters and accounts of her experiences, including this:

“Some of the bravest women I have ever known were among this first company of army nurses. . . . Some of them were women of the truest refinement and culture; and day after day they quietly and patiently worked, doing, by order of the surgeon, things which not one of those gentlemen would have dared to ask of a woman whose male relative stood able and ready to defend her and report him. I have seen small white hands scrubbing floors, washing windows, and performing all menial offices. I have known women, delicately cared for at home, half fed in hospitals, hard worked day and night, and given, when sleep must be had, a wretched closet just large enough for a camp bed to stand in. I have known surgeons who purposely and ingeniously arranged these inconveniences with the avowed intention of driving away all women from their hospitals. “These annoyances could not have been endured by the nurses but for the knowledge that they were pioneers, who were, if possible, to gain standing ground for others. . ."

Georgeanna Woolsey is the inspiration for my main character in "Wedded to War". Woolsey nursed patients in seminary buildings, the U.S. Patent Office, and aboard hospital transport ships which carried wounded and sick soldiers from the swamps of the Virginia Peninsula. After the war, Georgeanna and her husband, veteran Union surgeon Dr. Francis Bacon, founded the Connecticut Training School for Nurses at New Haven Hospital.  She also published Hand Book of Nursing for Family and General Use and co-founded the Connecticut Children's Aid Society.

3) Dr. Mary Edwards Walker After volunteering as a nurse in 1861, and then as an assistant surgeon, Dr. Mary Edwards Walker earned a Union army commission for her services as surgeon in 1863. In 1864, she was captured by Confederates, suspected of espionage, and thrown into Richmond's Castle Thunder prison where she remained four months before her release. In 1865, she became the only woman ever to receive the Medal of Honor. Dr. Walker appears in Spy of Richmond. The newspaper article Mr. Kent dictates to Sophie about Dr. Walker's imprisonment is verbatim from the original story that ran in the Richmond Enquirer--including the comment about her "homely" appearance.

4) Captain Sally Tompkins Sally Louisa Tompkins founded a private hospital in Richmond, Virginia, to care for the flood of Confederate wounded. During the war, her hospital cared for 1,333 soldiers and suffered only 73 deaths, which was the lowest mortality rate of any military hospital. The Robertson hospital, named for the judge who let Sally use one of his houses, returned 94 percent of its patients to service. Eventually Confederate authorities decided to close all private hospitals, declaring that soldier patients could only be cared for at government hospitals run by a commissioned officer with at least a rank of captain. When Tompkins heard the news, she called on Jefferson Davis and asked for an exception to the new rule. Since her hospital's remarkable record spoke for itself, Davis commissioned Tompkins a Captain of Cavalry, unassigned, making Robertson Hospital an official government facility. She was the only female commissioned officer in the Confederate Army. As an unassigned officer she could remain at the hospital permanently. The military rank also allowed her to draw government rations for her patients, but she refused to be added to the army payroll.

5) Clara Barton No list of groundbreaking nurses would be complete without her. Barton was fiercely independent, a self-appointed field-nurse for the Army of the Potomac. Working on her own, beyond the structure of the Sanitary Commission and Army Medical Department, she stockpiled supplies in her small Washington flat and then drove into the Virginia countryside, and into Maryland, to disperse them among the wounded.  At General Butler's request, she cared for the soldiers in the Army of the James during the summer campaigns of 1864, as well. Her work for soldiers and their families didn't end along with the war, however. She continued her service by opening the Missing Soldiers’ Office (link is external)in Washington, D.C. to help family members find the remains of their loved ones. By 1869, she had identified 22,000 missing men and received and responded to 63,182 letters from those trying to locate their soldiers. Later, Clara brought a chapter of the International Red Cross to life in America.

*The following is excerpted from my nonfiction book, Stories of Faith and Courage from the Home Front, to explain why women had such struggles as nurses at the beginning of the war.
The clash between surgeons and women nurses which Georgeanna Woolsey described had its roots in how each group of people viewed the woman’s place in society. Americans in the mid-nineteen century commonly believed that men and women had their own separate spheres of activity. Men occupied the commercial, business and political fields. Women’s activities were relegated to home, church, women’s clubs and reform groups, and circles of female friends and relatives. But in which sphere did the hospital fall?

Normally, when someone fell ill, a doctor visited the home, examined the patient, and left the nursing care to the female relatives living in the household. Wives, sisters, daughters, and grandmothers administered medicine, dressed wounds, and saw to the patient’s recovery. The only people treated in the hospital were those who didn’t have women at home to nurse them. Once the war began, medical care for soldiers had to be systemized since the troops could not recover at home (although many wives and mothers travelled hundreds of miles to personally nurse their own wounded family members). Male doctors held that the ward was part of the military hospital, so it fell under their dominion.

Popular opinion also held that women would faint in the presence of war’s gruesome casualties, and that their innocence would be marred with exposure to the naked male body. Women nurses were convinced the hospital ward belonged in the female domain, since they were treating sick soldiers the same way they would in their own homes—and the home was unequivocally within the female sphere. More tension arose between men and women when the female nurses viewed the doctors’ advice as suggestions rather than strict orders, for at home, they had the freedom to follow or not follow the doctor’s orders as they saw fit. Over the course of the war, the surgeons and nurses came to accept and work with each other as both groups proved their mettle and shared genuine desire to save lives and speed recovery of the soldiers.

Image 1: Elizabeth Blackwell
Image 2: Georganna Woolsey
Image 3: Sally Tompkins

From: jocelyngreen.com

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