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.

Monday, April 21, 2014

Hospital for Special Surgery


In 1863, New York was a burgeoning city of 800,000. Then as now, its diverse population was marked by extremes of wealth and poverty. With little access to life-sustaining work and medical care, growing numbers of poor New Yorkers, especially the lame and deformed, had little hope of improving their lot in life.

With the philanthropic efforts of Robert M. Hartley, Dr. James A. Knight, a general practitioner from Maryland, founded a new institution to meet the needs of this unfortunate group of patients. On April 13, 1863, the Society for the Relief of the Ruptured and Crippled was incorporated in the State of New York. The Hospital, now the oldest existing orthopedic hospital in the United States, with 28 inpatient beds, was located in Dr. Knight's private residence on Second Avenue and 6th Street. It opened its doors to its first patients on May 1, 1863, in the middle of the Civil War. In its first year, 824 patients were received and treated.

It soon became clear that a larger building would be needed to accommodate the growing demand for the Hospital's services. A group of prominent New Yorkers led by John C. Green, a successful China trader, set about raising more than $200,000 for a new facility, which opened in May of 1870 on the northwest corner of 42nd Street and Lexington Avenue, the site presently occupied by the Hyatt Hotel.

The Hospital for the Ruptured and Crippled flourished under Dr. Knight's leadership. His attitude toward care emphasized sunshine and fresh air, along with diet, exercise, electrical stimulation, and gentle rehabilitation, known as Expectant Treatment. Given the frequency and severity of surgical infection at the time, Dr. Knight considered surgical treatment detrimental. With few exceptions, surgical operations were not performed during his tenure as Surgeon-in-Chief.

Study: Mental Trauma Led to Illness in Civil War Troops


Mental trauma led to physical disease among American Civil War veterans, according to a study appearing in the current issue of the "Archives of General Psychiatry" magazine. Scientists found that younger and more traumatized soldiers had much higher rates of illness later in life. Michelle Trudeau reports on the study, and how the findings could apply to today's veterans.

This is DAY TO DAY.
Now a story that never ends, that of the American Civil War. There's a new study about it appearing in the current issue of the Archives of General Psychiatry. It finds that the Civil War had affects on the physical and mental health of veterans throughout their lifetimes. Michelle Trudeau reports.

General William Tecumseh Sherman seems to have predicted the findings of this study when he famously declared, War is hell. Now research psychologist Roxanne Cohen Silver has investigated whether the degree of hellish trauma that a soldier experienced can be linked to increased health problems. She examined the military records of over 15,000 union soldiers, records which give details as to whether a soldier had been wounded or had been a prisoner of war, also the number of deaths in each combat company. During the Civil War many company members came from the same town or even family, and so tabulating deaths in each company indicates the amount of intimate violence that a soldier may have been exposed to, says Silver.

Dr. ROXANNE COHEN SILVER (Professor, UC Irvine): It would represent the numbers of dead bodies that he witnessed, dismembered bodies and dying individuals. And it also represented undoubtedly the degree of loss or bereavement that they had encountered in the war.

TRUDEAU: These 15,000 military records are kept by the National Archives, which also has each soldier's medical records.

Dr. SILVER: We obtained the medical records from the time that they discharged until they died.

TRUDEAU: Available thanks to the life-long relationship between Civil War vets and the federal government.

Dr. SILVER: In order to receive a pension after the Civil War, the veterans would have to go to pension board physicians which were military physicians. And in order to be classified as having a particular ailment, three physicians had to agree on a diagnosis. So these records are remarkably complete, remarkably thorough, and remarkably reliable.

TRUDEAU: When the researchers from the University of California Irvine matched a soldier's military record with his life-long medical records, some strong connections emerged.

Dr. SILVER: The more traumatic the experiences that the soldier encountered in the war, the more likely he was to have physical health ailments and mental health ailments.

TRUDEAU: A 50 percent greater chance of cardiovascular disease, or gastrointestinal problems, and a similar increase in mental health problems, such as depression. The horrors of war, though, had the most brutal impact on young soldiers, enlistees as young as nine years old.

Dr. SILVER: Those who were youngest when they were enlisted had a 93 percent increased risk of developing signs of physical and mental health problems.

TRUDEAU: And these youngest vets also died at a significantly younger age than vets who had been older when they enlisted. Roger Pitman, a research psychiatrist at Harvard Medical School, says he's intrigued by this finding because we know, he says, that youngsters have immature nervous systems.

Professor ROGER PITMAN (Research Psychiatrist, Harvard Medical School): Adolescents or even children who have incomplete brain development might not be able to handle the emotional stress of combat as well as persons past their adolescence where their brains are more-or-less completely developed.

TRUDEAU: The bottom line, Pitman adds, is that war has extracted similar costs from veterans of every era.

For NPR News, I'm Michelle Trudeau.

Image: Indiana Hospital for the Insane, Indianapolis, Indiana

Remembering the Women Who Served in the Civil War

By Sandra Scott

The American Civil War was the bloodiest war in American history, resulting in more than 600,000 deaths. While most people are familiar with the military leaders, they know little or nothing about the women who did their part during the fighting. All of the women of that era served on the home front, but some chose to put their lives on the line in actual battle. A good way to commemorate this year's 150th anniversary of the Civil War is by visiting one of the many sites and museums to learn about the women who answered the call of duty on both sides of the conflict.

On Nov. 30, 1864, Carrie McGavock, mistress of Carnton Plantation, was witness to the Battle of Franklin, one of the bloodiest battles of the Civil War. At the end of five hours, nearly 10,000 soldiers had been killed, most of whom fought for the Confederacy. Carnton became the largest Confederate field hospital in the area with Carrie and the rest of her family helping in a variety of ways.

Today on a tour of the pristine and beautiful plantation house it is hard to envision injured soldiers occupying every available space and body parts piled up outside the second-floor window where the operations were performed. The dead were scattered on the lawn. The floors of Carnton are still stained with the solders' blood, but most impressive is the McGavock Confederate Cemetery, now on the National Register of Historic Places.
The graves of the fallen soldiers from the Battle of Franklin were in danger of deteriorating into oblivion when Carrie, with family and friends, disinterred nearly 1,500 Confederate soldiers and reburied them on their property to create a dignified permanent resting place. Robert Hicks has immortalized Carrie McGavock in his novel "The Widow of the South."
On the Civil War Walking tour of nearby Franklin, it's possible to learn about the Petticoat Spies, so called because they secreted messages under their voluminous undergarments. At that time no gentleman would have thought of searching a lady.

The very nature of spying means that many of the Petticoat Spies have remained unknown and therefore have received no recognition. However, Sallie Carter was a staunch secessionist and the first in Franklin to fly the Confederate flag. When 25,000 Union troops occupied Franklin and the surrounding area, the courthouse became the headquarters of the provost marshal.

At 38, Sallie was twice widowed with several children, but she did her part. From the roof of her house she watched the Union activities. Then, using her wiles as an attractive female, she invited Union officers to dine in her home. Plied with a fine meal, music and plenty of whiskey, Union tongues became loose. Sallie wrote all the information on paper and stuffed it into a hollowed-out corncob stopper of a whiskey bottle.

Next she gathered food and medicine in bags that she tied around her waist so that they were hanging down around her knees and were well hidden under her hoop skirt.

 She obtained a pass and delivered her message and goods to the nearby Confederate army.

 Another story shared on the tour is that of 16-year-old Ninny Stith. When she heard that Union troops were marching from Nashville, she set fire to the bridge into Franklin.

Sarah Emma Edmonds disguised herself as a male — easier to do in those days since physical exams were not part of the induction process —and fought in several battles, including the two at Bull Run in Manassas, Va. Dressed as Frank Thompson, she enlisted in the 2nd Michigan Infantry. She first served as a field nurse, but when a friend acting as a Union spy was discovered and executed by a firing squad, she took his place.

Traveling into enemy territory she disguised herself in many ways, including using silver nitrate to dye her skin black to pass as a black man. Another time she acted as an Irish peddler. When a packet of official papers fell out of a Confederate officer's jacket, she promptly delivered it to Union generals.

Edmonds is probably the most famous of the women who soldiered dressed like a man, but so did Loretta Velasquez, who, after her husband, Harry Buford, was killed in battle, disguised herself and served in his place. There were also at least nine women who fought as men at Gettysburg.

Women have always nursed soldiers, but few women had become doctors at the time of the Civil War. In 1855, Mary E. Walker was the only female graduate of Syracuse Medical College. During the war she served as a contract surgeon, tending to sick and wounded soldiers in the field and in hospitals continuing her doctoring during her four months as a prisoner of war. She served in many different battles, including the battles of Bull Run and Fredericksburg in Virginia, and Chickamauga, Ga. Andrew Johnson awarded her the Medal of Honor in 1865 for her bravery and heroism in battle. She was the only woman to receive the medal; however, it was rescinded in 1917, along with nearly 1,000 others. It was restored by President Carter in 1977. Currently it is on display in her hometown of Oswego, N.Y.

Esther Hill Hawks, a graduate from New England Medical College for Women in 1857, was also an army physician. She was a contract surgeon and with her doctor husband joined the U.S. Colored Troops in Beaufort, S.C.

Many other women also did their part including Harriet Tubman, who led slaves to freedom and then became a spy during the war. Clara Barton, a Civil War nurse, went on to establish the American Red Cross. The women were courageous and willing to put themselves in death's way for a cause in which they believed.


Suffering in Silence: Psychological Disorders and Soldiers in the American Civil War

By Sarah A.M. Ford
Kutztown University of Pennsylvania

Did soldiers of the American Civil War suffer from post-traumatic stress disorder and other psychological disorders? It has only been several decades since mental illness attributed to war conditions was clinically recognized. Recent research has shown a strong positive correlation between war time events such as witnessing the death of comrades, friendly fire or IED explosions and post-traumatic stress disorder.

With a conflict as devastating as the American Civil War, it would be logical to hypothesize that Civil War soldiers were subjected to events that put them at risk similar to today’s soldiers. There is a strong relationship between attributing events during the Civil War and psychological affects; for instance revolutionary weaponry developments, medical procedures, psychological warfare, and hand to hand combat could have invoked psychological ailments. Data compiled from diaries and letters will affirm the presence of psychological disorders in soldiers who fought in the war. From this body of evidence, it is clear that soldiers of the American Civil War did indeed suffer from post-traumatic stress disorder and other psychological disorders.

The most common disorder that results from exposure to combat is called post-traumatic stress disorder or more commonly known as PTSD. According to the Diagnostic and Statistical Manual of Mental Disorders, there are several categories of symptoms for PTSD. The symptoms include the experience of actual harm or threats to be harmed physically and or emotionally, intrusive symptoms that include flashbacks, disturbing dreams or memories, negative changes in cognition, the avoidance of stimuli associated with the event and changes in arousal levels. In order for there to be a diagnosis, symptoms must be present for over a month and the level of stress has to be significant enough where everyday activities are negatively affected.

Another common and relatively novel disorder is Traumatic Brain Injury (TBI). This is a neurological disorder that inhibits cognitive functioning as a result of an injury to the head. Symptoms include moderate to severe amnesia, headaches, changes in personality and accumulating more sleep than normal.3 This disorder is becoming widely recognized and diagnosed more frequently in veterans today. Over 30 percent of all casualties in Operation Iraqi Freedom (OIF) and Enduring Freedom (EF) were associated with the head or neck area.

As many as ten to twenty percent of OIF/EF veterans have been diagnosed with TBI. It is plausible to assume that Civil War soldiers, who were not provided helmets, would have suffered from TBI if they experienced in injury to the head or neck region. General Anxiety Disorder and Depression are both common psychological disorders that plague many veterans today. Soldiers who experience traumatic events, such as the death of a comrade or innocent civilians, may experience depression as a result. It is logical that countless men of the Civil War era may have suffered from depression or general anxiety disorder.

The first mentions of symptoms correlated with PTSD dates back three thousand years ago; four thousand years before it would be clinically recognized. Ancient Egyptian Hieroglyphics depicted the emotions and fears soldiers felt while in combat. The Greek historian Herodotus wrote, in 480 B.C, of a Spartan soldier who was taken off the front lines due to his trembling and later took his own life in shame.

In the seventeenth century any disorder associated with depression or changes in personality was termed melancholy or nostalgia. Symptoms similar to PTSD were called Soldier’s Heart and Da Costa Syndrome during the mid and late nineteenth century.

The catalyst for the recognition of PTSD was the outbreak of World War One. The Great War had some of the worst casualties in human history as a result of revolutionary weaponry that redefined warfare. The psychological effects of this war were often seen in the returning veterans as many experienced involuntary ticks and shook unaccountably. This later would be termed Shell Shock.

While not to the extent of the First World War, The Civil War had revolutionary weapon and technological developments that negatively affected soldiers physically and mentally. This included the Minie Ball, a cylinder shape bullet that was more aerodynamic, making it more precise and effective. Instead of a round bullet that would break the bone, the Minie Ball would completely shatter it.

Another technological development that changed the world as well as warfare was the railroad. For the first time in human history, mankind would not have to rely on horses or their own two feet to transport them. This drastically changed warfare by allowing supplies and troops to move into the most remote areas at record speeds. This meant that more soldiers were exposed to significantly more carnage than past wars. A soldier was no longer confined to a specific geographical location allowing them to fight in more battles. Witnessing this novel amount of gore would have been a severe trauma that could have produced anxiety and other psychological symptoms associated with PTSD.

The Civil War is unique in that it took place during a time of great weaponry and technological developments but it was only decades shy of medical advancements that could have saved countless lives. Disease rather than bullets proved to be a significant factor in the death toll of the Civil War. For every one death in combat, there were two deaths caused by disease. The lifesaving technique of sterilization was a foreign concept to Civil War physicians and as a result thousands of soldiers succumbed to infections.

The omnipresence of decay and death of thousands of sick men only added to the carnage witnessed not only by soldiers but nurses and doctors. On a daily basis, medical teams witnessed horrific wounds, ghastly amputations and men succumbing to their injuries and illnesses. Procedures and surgeries performed by army surgeons and physicians also left Civil War veterans literally scarred for life. The survival rate for a man going into surgery was roughly eighty percent depending on the location of the wound. The fatality rate was directly related to the proximity of the injury to the core of the body.

Anesthetics, like ether and chloroform, were used for many surgeries which made the procedures much more humane.Though the fear of having to endure surgery invoked great anxiety, the fear of life after surgery was an even greater anxiety to face.

In a society that relied on physical labor for maintaining a livelihood, living without a limb meant a lifetime of unemployment. Farmers, mill workers, railroad workers or dock workers were all required to be physically able to complete the tasks required of them. An amputee could not continue working in the physical labor market. To make matters worse, majority of the men who fought in the Civil War were from lower economic classes. The socioeconomic status of an amputee would have been lowest amongst the ranks partly because there would be very few jobs that could accommodate their special needs. The anticipation of failure to provide for themselves and their families conjured major stress and anxiety.

The biological needs of humans are crucial for both physical and mental health. If humans are bereaved of biological necessities then they are at greater risk of psychological ailments. In war, especially the American Civil War, even the most basic of human essentials, such as food, water and shelter, are unavailable to soldiers putting them at an elevated risk of psychological danger.

Food supplies were frequently limited and insufficient for the amount of calories a soldier would expel. The water was often contaminated with germs making soldiers sick. Septic water is especially dangerous because it carries many diseases like cholera and dysentery. A diary entry by Union soldier Henry Tisdale implies that he got sick from drinking the water at his camp “Unwell today for diarrhea, causing me to feel weak. Think it caused by drinking too much of the aqueduct water we have here.”

Not only were the soldiers on alert for enemy attacks but also had to worry if their next drink or meal was going to make them ill. Due to the insufficient and inadequate food and water, many soldiers did not have the caloric intake needed to support straining activities. Union soldier Cornelius Platter wrote “3 mile to our right and went into camp 8 mile South East of Jonesboro at 8 oclock -- This has been the hardest days march we have had. Distance marched 22 mile.”

A malnourished soldier would have had difficulties executing long endurance orders like this and would have been pushed to the brink of exhaustion. On top of malnutrition, each soldier was subjected to the weather and its unforgiving nature. Evolutionary instinct would be to seek shelter from the elements, but this cannot be done in war. Joseph Waddell from the Indiana Volunteer Division wrote “Off early and marched to Black River a hard rain late in the evening two men killed on the road with lightning.”

Soldiers had very little protection, which would have affected their sense of safety. With unavailable resources and basic needs going unmet, these men were at an elevated risk of developing psychological disorders.

Arguably one of the most intense contributing factors to psychological effects and disorders were the prisoner of war (P.O.W) camps. Some of the most detestable incidences in the war occurred inside these camps. Psychologically, people are put in situations with numerous traumas, such as ubiquitous death, fighting and abuse, making P.O.W camps a minefield for psychological disorders.

Camps like Salisbury, Libby, Douglas and the most notorious Andersonville were overpopulated and did not have proper supplies for the number of prisoners it contained. At one point, Andersonville detained thirty-two thousand men but the original capacity was for only ten thousand men. When Sherman’s soldiers liberated Andersonville, they found some prisoners completely emaciated. At the end of the war when supplies were scarce, rations were withheld. “No rations issued yesterday to any of the prisoners and a third of all here are on the very point of starvation...”

Prisoners would fight, even kill, other prisoners for whatever they might have in their possession that could aid in their survival. “Have just seen a big fight among the prisoners; just like so many snarly dogs, cross and peevish.”

The fight to survive in hellish places like Andersonville, Libby, Salisbury and Douglas was exceedingly stressful. Witnessing the intense trauma of death on a daily basis was more than enough to produce PTSD.

A unique factor of the Civil War was that units were very often created by geographical location. A town’s entire male population, brothers, friends and neighbors, would fight together. A Union soldier from Michigan found the body of his best friend who was shot and killed. During the chaos of battle, the soldier kneeled down to clear the blood off his friend’s face, while bullets and shells exploded around him. He had lost his sense of urgency and experienced heightened arousal level, which put him in physical danger. This is an example of a soldier’s psychological state putting them at physical risk.

This psychological state would be even more compromised when a soldier fought their own kin. The famous motto of the Civil War was Brothers Fighting Brothers. Families were torn apart by this war as brothers would often fight on opposing sides. James and Alex Campbell were two brothers who fought on opposing side. When war broke out, James went to the Confederate Army with the Union Light Infantry also called the 42nd Highlanders and Alex went to the Union 79th Highlander Regiment. At the Battle of Secessionville in eighteen sixty-two, the two brothers were fighting against each other. Not only would losing the support system of a family member be stressful but the thought of intentionally killing a relative would be a severe psychological trauma that could generate PTSD.

Psychological warfare has been a vital part of combat for thousands of years. Biblical writings of Gideon portrayed of soldiers blowing horns, let out a fierce cry and breaking objects as a result the Mindianite soldiers were so beside themselves with fear that they committed suicide. (Judges 7:1-22) The Civil War was no stranger to these psychological tactics.

The phrase “Rebel Yell” originates from the Civil War and was a weapon used to instill fear in the Union soldiers. Similar to the battle cries of the Native Americans, Confederate soldiers would yell, shout or chant certain phrases or noises to invoke fear in their enemies and many times it did its job. The sounds were described anywhere from Indian whooping noises to the shrieks of a wild animal and these yells implored great fear into the Federal soldiers. “....the Union troops were startled by the most hideous of modern war cries, known as the ‘rebel yell’…This was the first time the Vermont boys had heard that fiendish sound, and it is not too much to say that they were appalled by it for a moment, and thought their time had come to be ‘wiped out.” Fear is a great weapon in combat; unfortunately this great weapon is lethal to a soldier’s psyche.

Witnessing an event is just as catastrophic to the psyche as being a victim of a trauma. Many soldiers did not have to experience combat to receive the full effect of war. Thomas Smiley, a confederate soldier, described the horrifying event that he witnessed at the Battle of Chancellorsville to his aunt. “The large brick house at Chancellorsville took fire and burnt up with about two hundred wounded Yankees who were so badly hurt that they could not move and their own soldiers did not help them any. Later in the day the woods took fire and a great many more helpless men perished.”

At the battle of Seven Pines, a Confederate soldier was horrified not by fighting but from what he heard on that day. The soldier, lying wounded on the ground, described the cries and screams for help from the Union soldiers as they lay in the ditches too wounded to move. A heavy rain came and the water had accumulated in the ditches and the wounded men were slowly starting to drown.

Stories like this would find their way back to the small towns and cities, terrifying the men who were eligible for enlistment or conscription. Joseph Waddell wrote of a young man who was sobbing because he was called up by the draft. “I heard a sound of lamentation.... A negro woman informed me that it was a soldier crying because he had to go to the war!... Several men and women stood in the street, some laughing and others denouncing the recruit”.

Severe anxiety plagued the prospective soldiers as the news of the bloodshed and atrocious fighting trickled from the battlefield to home.

The amount of hand to hand combat in the Civil War left soldiers particularly vulnerable to PTSD, depression or any battery of psychological illnesses. This is the last major American war and one of the last major wars in the world to significantly utilize hand to hand combat. After the twentieth century, the technologies gained in World War One, such as planes, bombs and machine guns, did most of the heavy labor. While linear warfare was the fighting style of choice in the Civil War, almost every battle had some form of hand to hand combat . Union Naval Officer William Ferguson testified to Major-General Hurlbut as to what he witnessed when he arrived at Fort Pillow after the massacre “[There were] Bodies with gaping wounds, some bayoneted through the eyes, some with skulls beaten through, others with hideous wounds as if their bowels had been ripped open with bowie-knives…”

This archaic style of fighting is tremendously personal and has exceedingly negative effects on a person’s psyche. To defeat the enemy, one must look into their eyes and take their life. Hand to hand combat is arguably one of the leading causes in the development of PTSD.

The evidence of psychological effects and disorders as a result of combat is clearly illustrated in the suicides of the soldiers. Numerous soldiers took their own lives rather than live to see another fight. Many men wrote home telling their loved ones about the unfortunate souls that would rather die by their own hand then fight for a chance of survival. Jacob Stouffer wrote about his friend Absolam Shetter saying, “he had been in trouble and at times in a State of despondency-this with the troubles and Excitements around us-deranged his mind and on yesterday morning ended his existence by hanging.”

Newell Gleason, a lieutenant colonel, was described as a fearless leader but had experienced nervousness and anxiety after the Atlanta Campaign. Gleason had difficulty sleeping and battled with depression. In eighteen eighty-six, Gleason committed suicide as a result of his time spent in the Union Army. A majority of the suicide victims were Confederate veterans. Besides the fact that they lost the war, the South lost twenty percent of its population. Families were torn apart by this war. Fathers and mothers lost sons, brothers lost brothers and wives lost husbands. The men that were lucky enough returned from war found their homes and lands destroyed. They lost everything. The war and its surrounding events could have thrown the soldiers into a depressive state leading to psychological ailments.

Understanding events and conditions that contribute to PTSD and psychological disorders help to create a mental picture of the soldier’s experiences. These events are correlated to psychological disorders but neither confirm or deny a conclusion. Examining individual soldiers provides insight into the effects of the war. It also makes the connection personal and the event feel real instead of words on a paper. The next three case studies are the smoking gun evidence that there were indeed psychological disorders as a result of the Civil War. More importantly, they were all real people who were once very much alive and they were all victims of something far greater than themselves.

Albert Frank was a soldier in the Union Army. At the Battle of Bermuda Hundred near Richmond, Frank was off the front line and sitting on top of a trench. He offered a drink from his canteen to a fellow soldier sitting next to him. While the soldier was taking his drink, a shell exploded and decapitated the man, covering Frank with blood and pieces of brain. Frank experienced a complete loss of cognitive functioning being unable to speak, communicate or understand his fellow soldiers. He was later found on the floor shaking and making bomb noises. The only thing he would say was “Frank is killed.”

He was taken to the Government Hospital for the Insane in Washington D.C and declared mentally insane. Witnessing such an intense trauma had affected Frank greatly. He was re-experiencing and reenacting the event and he associated himself to the trauma in a negative way saying he was the one killed. These are indicators of post-traumatic stress disorder.

Angelo Crapsey from Potter County, Pennsylvania eagerly enlisted in the Union army in 1861. Early in his military career, a sergeant in his unit committed suicide by placing his rifle between his knees and putting the muzzle in his mouth. This event would have a profound impact on Crapsey. As Crapsey started to engage in combat, his glorified perception of war began to fade away. “Rebels charged on us & we had to run, run for [our] lives…through an open field & we had showers of bullets sent after us.”

Crapsey became more withdrawn and the radiant spirit he possessed prior to the war disappeared. At the Battle of Fredericksburg Crapsey was taken prisoner and he spent time in at Libby Prison. While contained, Crapsey developed a case of lice infestation and frequently tried to rid himself of the pest even after they had subsided. After his release he fought at the bloodiest battle of the Civil War, Gettysburg. Upon his discharged, he returned back home to Pennsylvania were he experienced illusions, involuntary ticks and violent fits. On August 4, 1864, Crapsey said he was going out to hunt but instead stuck a gun in his mouth and shot himself; the same way the sergeant had done three years prior.

Major General Thomas Kane said that he “loved no one of his men more than Angelo. He came up to his ideal of the youthful patriot, a heroic American soldier.” Crapsey embodied the image of the ideal soldier and possessed a luminous spirit that was contagious. Unfortunately, he lost himself in the tremendous force that was the Civil War.

Just like the soldiers in the Great War, Angelo had experienced involuntary ticks and violent fits. World War One soldier’s ticks and fit were attributed to constant bombardment at battles like Verdun and Somme. Angelo fought at Gettysburg, the sight of the largest artillery bombardment in North American History. While the bombs never physically harmed him, they drove him to insanity. Angelo experienced a change in personality, diminished personal relationships, a loss of previous interest, flashbacks, disturbing memories, negative emotions and he associated the negative trauma to himself which created a sense of self hatred. It got to the point where Angelo could not find a way out of his own prison and the only solution was death. Angelo displayed numerous symptoms of post-traumatic stress disorder.

Dr. William Chester Minor was a surgeon in the Union Army for several years. Minor served at various battles including the Battle of the Wilderness, one of the most gruesome conflicts of the entire war. As a surgeon, Dr. Minor had seen the worst that war had to offer. He had experienced delusions and paranoid fits after the war and as a result Minor was diagnosed with soldier’s heart, an early form of PTSD.

In August of eighteen seventy-two, Minor shot and killed a man in the streets of London, England. According to his testimony, Minor claimed he had been experiencing a delusion where he was back on the battlefield and the man was an enemy soldier trying to kill him. The courts found him not guilty by reason of insanity and he was sent to Broadmoor Hospital, a notorious insane asylum in Crownthrone, England. Arguably one the most intrusive symptoms of PTSD are flashbacks. The person is experiencing an illusion or vision of the past trauma. They are essentially re-living the event allowing them to experience it all over again. Minor may have truly believed he was back on that battlefield and was fighting to preserve his life. William Minor’s incident could have been a result of post-traumatic stress disorder from his combat experience.

Did soldiers in the American Civil War suffer from psychological effects and disorders? Through revolutionary weaponry developments, horrific medical procedures, psychological warfare, and the great deal of ferocious hand to hand combat, there appears to be a great deal of evidence for psychological effects in civil war soldiers. The Crapsey, Minor and Frank case studies provide significant evidence of psychological disorders as a result of Civil War combat. With this body of evidence the question can be definitively answered; psychological disorders are present in soldiers of the Civil War as a result of combat and or its attributing factors. Without a shadow of a doubt the Civil War psychologically scarred and damaged its soldiers. Those brave men put their “sacrifices upon the altar of freedom” and endured a fate worse than death by living their lives in silent suffering. The presence of psychological effects and disorders are evident in the soldiers of the American Civil War.

Image: Government Hospital for Insane, Nurses Home, [Washington, D.C.]


Female Surgeons – Defiance in the Face of Adversity


‘A few words upon a very important aspect of this question – the right of women to compete with men in any occupation by which they can earn a livelihood. A woman has to pay like a man, she has neither mercy nor favour shown her because she is a woman, therefore she should have the same chance as a man, and the same pay if she can render as good work.  Why should not women enter the legal and medical profession…..During a four years’ sojourn in America I had the pleasure of knowing Dr Mary Walker, Dr Elizabeth Blackwell and hundreds of others who are doing the noblest work that is being done in the United States at the present time. The medical profession is one particularly adapted to women.’
Ada Campbell, Liverpool, 21st September 1891

Ada Campbell wrote the above letter, on equal rights for women in the professions, 26 years after the end of The American Civil War (1861-1865).   Nearly 1,000 women disguised themselves as men and served as soldiers during the campaign, 3,000 white women became nurses and a handful of women served as physicians.

Dr Mary Edwards Walker, Dr Elizabeth Blackwell, Dr Esther Hill Hawks and Dr Sarah Ann Chadwick Clapp were among a pioneering group of medical professionals who broke with social conventions by offering their services for frontline duty. They received a hostile reception from their male counterparts, who firmly believed that field medicine was a male environment and no place for women. Undeterred, the feisty females continued to flout the accepted norm and all 4 demonstrated defiance in the face of adversity.

Dr Blackwell (1821-1920) was the first female MD in the US, graduating from Geneva Medical College in 1849. During the War she trained the nurses that were sent to the Union Army. Dr Clapp was appointed assistant surgeon of the 7th Illinois Volunteer Cavalry and served in post between 15th November 1861 and 25th August 1862. She also served as assistant surgeon/surgeon in general hospitals in Cairo, Illinois and aboard transport ships. However, the medical examining board refused to give her an examination and she never received a commission or pay for her War work.  Dr Hawks (1833-1906) graduated from the New England Female Medical College in 1857. At the start of the War she followed her husband, John Milton Hawks a regimental doctor with the U.S. Coloured Troops, to the South Carolina Sea Islands and Florida. She treated the wounded from the attack on Fort Wagner and the Battle of Olustee.

Dr Walker (1832-1919) graduated from Syracuse Medical College in 1855. At the outbreak of War she applied for a surgeon’s contract, a request which was flatly refused by the Medical Department. She did not give-up and remained in Washington serving as a nurse in a number of camps and hospitals for Indiana troops. Whilst working at the Indiana Hospital, Washington she met Dorothea Lynde Dix. Dix had been appointed on 10th June 1861 by the Secretary of War as Superintendent of Female Nurses. She was a formidable character and insisted that her nurses were over 30 and plain, lest they should incite sexual desire in the surgeons. Dix’s nurses wore brown/black dresses, no bows, no curls, no jewelry and no hooped skirts.

Mary made repeated attempts to secure the allusive surgeon’s contract and was abused for her demands. After proving her worth during the battles of Fredericksburg (1862) and Chickamauga (1863) where she worked, unpaid, as a field surgeon, General Ambrose Burnside declared his confidence in her medical skills and recommended her for a commission. In September 1863, Major General Thomas appointed her an assistant surgeon in the Army of the Cumberland and she was assigned to the 52nd Ohio Volunteer Infantry serving in Chattanooga. Finally, in October 1864, she was officially commissioned as a Contract Surgeon and received the rank of First Lieutenant.

Although a talented and competent surgeon, Dr Walker’s temperament was described by her fellow surgeons as being cantankerous, abrasive, harassing, a professional scold and some thought her insane. Always outspoken and never afraid to challenge her colleagues and their decisions. She was appalled that the battlefield surgeons were performing amputations with such regularity and in her view many were unnecessary. She would undermine her colleagues by conspiring with the wounded soldier to challenge the Surgeon’s decision to remove a damaged limb. She was equally horrified at the heavy doses of mercuric compounds that were being given to patients.

Dr Walker was a beautiful woman, with raven hair which she kept long and curled so that no one would think that she was a man. The reason that she may have been mistaken for a man, was due to her unusual attire, for which she was famed and criticised for throughout her life. Beginning at medical school she wore bloomers, much to the disgust of her lecturers. Bloomers were the outfit of choice for radical feminists of the day and were first invented by Amelia Jenks Bloomer (1818-1894), who spearheaded the movement. When Dr Walker began her medical career she abandoned the bloomers and wore instead a modified version of male dress, a calf-length skirt worn over trousers, teamed with an Army uniform jacket. Whilst on front-line duty she would always carry 2 pistols about her person.

On 10th April 1864, following a battle, Mary had stayed behind to tend Confederate wounded upon retirement of the Union Army. She had taken a wrong turn in the camp and was captured by Confederate troops and charged with being a spy. The Confederates believed that her male attire was a deliberate attempt to don a disguise and infiltrate the encampment. She spent 4 months in prison and continued to be abused for the manner in which she dressed. Eventually in August she was exchanged for a Confederate surgeon whom the Union Army had captured. She was proud of the fact that the price on her head was that equal to a male surgeon and often boasted about it throughout her life.

In 1866, she became President of the National Dress Reform Association which urged women to discard their corsets on health grounds and adopt dress reform. The Association sought to pioneer a movement which necessitated a change of style in the dress of American women. In July 1866 she was arrested in New York for the crime of impersonating a man. The Dundee Courier & Argus reported the incident:

‘Miss Dr Mary E. Walker who indulges in the Bloomer costume, appeared one day in Broadway with a very long train of boys. A policeman arrested her, and took her before the justice in question, on charge of being dressed in the attire of a man. It was alleged that the crowd which followed Dr Mary sufficiently proved that no deception was attempted with regard to her sex. A lawyer of the Police Court declared that “any man or woman who should dress in a way that would attract attention was violating the law.” To this it was replied triumphantly that the great majority of New Yorker’s dressed for the purpose of attracting attention. We say triumphantly, for the justice decided that no case was made out against the fair physician, who thereupon returned to Broadway, where she has since appeared in her “Bloomer” at her pleasure.’

Mary always wore male dress and even in her final years, she could be seen about town wearing a wing collar, bow tie, top hat and carrying a cane. She was awarded the Medal of Honor in November 1865 for her services at the First Battle of Bull Run (Manassas).

Image: Dr. Mary Walker

Civil War Laxatives

By T.A. Wheat
Excerpted from:

At the time of the Civil War, most medical treatment was not only unhelpful but could actually be harmful.

Harsh laxatives, sometimes called "drastics," were often used and included heavy-metal salts such as mercury chloride (calomel and "Blue Mass"). Ironically, an effective treatment for chronic diarrhea—consisting of a diet limited to clear liquids and the use of opiates to slow intestinal contractions—was available and sometimes used in conjunction with other, inappropriate measures. Some surgeons appear to have learned from personal experience and gradually shifted to regimens favoring the more appropriate treatments.

Six Feet Under: Body Bags and Burial Cases

By James M. Schmidt, The Civil War News, July 2011

“In the present condition of the country, when the fatal calamities of war render it a duty incumbent on fathers, mothers, wives, sisters and brothers to seek their dead upon the battlefield and to bring home for burial the remains of their kindred, any invention which will tend to ameliorate these afflictions and assist in the performance of this sad duty is worthy of special notice.” – Scientific American, February 28, 1863

The Civil War proved to be a camp-to-grave proposition for more than 600,000 soldiers and sailors, North and South. Though the mission of military surgeons was to heal the living, they had an interest in corpses for a number of reasons, including: the postmortem examinations of dead soldiers – either from wounds or disease – allowed them to continue the study of anatomy first begun in medical school; the chemistry and biology of decomposition almost certainly appealed to their scientific minds; army regulations required a copious amount of paperwork on men who died in their care.

While innovations and inventions in the military arts have received significant attention in the Civil War literature, less attention has been paid to wartime improvements in the implements required for burial. In fact, inventors met that grim reality with dozens of improvements in coffins, caskets, biers, and embalming tools.

One of the more interesting inventions was designed for the battlefield: Dr. Thomas Holmes’ United States Patent No. 39, 291, “Improvement in Receptacles for Dead Bodies” (a rather fancy name for a “body bag,” and yet it was an invention ahead of its time). Holmes, of Washington, D.C., declared that his object was:

“…to facilitate the carrying of badly-wounded dead bodies hurriedly away that could not otherwise be quickly removed for the want of proper conveyances, or difficulty to procure boxes or coffins for removing the dead, as the boxes or coffins cannot be so easily transported or handled on the field of battle.”

The “receptacle” was made of india-rubber, oval-shaped, about six feet in length and about two and a half feet in width. The top was funnel-shaped, “so that a dead body may easily be thrust in at the top.” The bag had two handles, “so that the body can be immediately lifted up and carried off…to be transported safely to any desired place to be inclosed in a box or coffin.” A tube was attached near to the center of the bag receptacle to accommodate deodorants or preservatives, “until received by its friends to be...prepared for interment,” or embalmed.

Indeed, the very same Dr. Thomas Holmes - an 1845 graduate of the “College of Physicians and Surgeons at Columbia University,” in New York - is considered the “Father of American Embalming” for his experiments in improving the preservation of cadavers used for anatomical studies and in preparing bodies for burial. He was the premiere embalming surgeon of the Civil War era, reportedly preparing more than 4000 soldiers for burial, including the first prominent Union casualty of the war, Col. Elmer Ellsworth.

Still, not everyone could afford embalming. As Valentine Mott - one of the foremost surgeons of the era – declared:

“…in times like the present, when so many are bereft of one or more members of their family by the calamities of a horrid war . . . .the rich and the titled can afford to be embalmed, but the commoner must be pitched into the pit unheeded and unknown.”

For that reason, Mott praised the “rare inventive skill” manifested in Dr. G. W. Scollay’s “Air-Tight Deodorizing Burial Case” (U. S. Patent No. 34,700). Scollay, of St. Louis, held several patents related to undertaking. Scientific American magazine featured the case in one of its wartime issues. The long article outlined — rather graphically — the chemical and biological processes of decomposition, described the invention, and featured an engraving of the case with a fallen soldier as its occupant.

The mechanics of the innovative burial case received the approbation of the Western Sanitary Commission (which performed numerous and diligent experiments to test its utility) which appreciated the “safer, cheaper, and better method of preserving the remains of deceased persons without burial, for transportation to friends at a distance an object greatly desired by those having relations killed in battle, or dying in the military hospitals.”

The editors of Scientific American agreed, and declared, “Especially at the present time is its introduction to be desired, when desolation and grief exist in almost every home in the land.”


Huge Pewter Irrigator Syringe


This is an extremely large irrigator made out of pewter and marked on the rim "HD/US" meaning "Hospital Department/ United States." Internal leather plungers seal off the inner cavity so that liquids and gels could be forced out tip by ramming down on the wooden plunger.

This was used for larger body cavities and could even have been employed in the Veterinary Care of the Cavalry's horses (hopefully not on two species in the same day!)... Without an effective use of electricity yet during the American Civil War, equipment was literally hand-driven with elbow-grease. Thus, both suction effects and washing procedures were done with such pieces of equipment. Imagine a wounded or sick soldier's dread when seeing the physician carrying such a big metal human plunger toward you! Some might claim that staying sick was the better option!

Osteomyelitis (Bone Infection)

by Janet King, RN, BSN, CCRN

This acute inflammation and infection of a bone or bones was usually the result of some type of surgical procedure. Without aseptic and sterile techniques, cutting into the bone almost assured such a disease. In some cases this infection would become chronic with the wound "spitting out" bits of diseased bone for decades, causing much pain and suffering for the soldier - long after the war ended.

At first, the wounded soldier would complain of chills, high fever and severe pain, tenderness, swelling and redness of the skin over the affected bone(s). Eventually the condition would progress and if the patient survived he might be left with an extremely stiff joint or non-functional limb.

1860's Treatments: Quinine; liquor of potassium iodide; morphine; opium and some use of mercurial compounds. "Local treatments" such as rest of the infected part; application of cold compresses; cupping and leeches were also tried. Sometimes operations were performed to cut out the infected areas.

Modern Knowledge: Common bacteria found in cases of osteomyelitis are: streptococci and staphylococci. Today Orthopedic and Infectious Disease doctors would be very aggressive in treating such an infection. Great care is taken not to have this infection occur, as it tends to become chronic and can cause many problems and great destruction of the bone. The surgeon would first attempt to drain or "clean out" the infected area and then place the patient on long term antibiotic therapy (months to year) via the intravenous route. Careful monitoring for reoccurrence and progression of the disease would be done. Modern surgical techniques and the initial treatment of victims of trauma - i.e. gunshot wound victims - have prevented many cases of this disease.


Ivory and Brass Civil War Period Stomach/Cavity Pump


A very interesting set of old Medical equipment, contemporary to the Civil War. A brass hand-pump, connected by a weaved tubing to various custom-made ivory tips. Physicians would use this apparatus to pump out various body cavities. I suppose that most soldiers would rather face deadly double-cannister on the battlefield than to take on one of these nasty babies!!!

Contrary to our impressions, doctors were quite well-trained and sophisticated in the 1860's, going to formal Medical Schools in the east to study anatomy, physiology, pharmaceuticals, and natural curatives. They were at a crossroads between the old and new worlds of scientific knowledge. Sadly, modern doctors know nothing of herbalism or the great homeopathic philosophies.

Civil War physicians did not simply cut off legs and watch people die. They were excellent hands-on diagnosticians who cared greatly, applied dressings, did minor surgery, made their own medications. They could all set a bone, drain a boil, compose a hysteric and even deliver a baby on a buckboard if need be!

This pump-set is an uncommon accessory in its original walnut box. (No, I have NOT tested it!!!)

Andersonville Prison, Andersonville, Georgia

Andersonville, or Camp Sumter as it was known officially, held more prisoners at any given time than any of the other Confederate military prisons. It was built in early 1864 after Confederate officials decided to move the large number of Federal prisoners in and around Richmond to a place of greater security and more abundant food. During the 14 months it existed, more than 45,000 Union soldiers were confined here. Of these, almost 13,000 died from disease, poor sanitation, malnutrition, overcrowding, or exposure to the elements.

The prison pen was surrounded by a stockade of hewed pine logs that varied in height from 15 to 17 feet. The pen was enlarged in late June 1864 to enclose 261/2 acres. Sentry boxes—called “pigeon roosts” by the prisoners—stood at 90-foot intervals along the top of the stockade and there were two entrances on the west side. Inside, about 19 feet from the wall, was the “deadline,” which prisoners were forbidden to cross. The “deadline” was intended to prevent prisoners from climbing over the stockade or from tunneling under it. It was marked by a simple post and rail fence and guards had orders to shoot any prisoner who crossed the fence, or even reached over it. A branch of Sweetwater Creek, called Stockade Branch, flowed through the prison yard and was the only source of water for most of the prison.

In an emergency, eight small earthen forts around the outside of the prison could hold artillery to put down disturbances within the compound and to defend against Union cavalry attacks.
The first prisoners were brought to Andersonville in late February 1864. During the next few months, approximately 400 more arrived each day. By the end of June, 26,000 men were penned in an area originally meant for only 10,000 prisoners. The largest number held at any one time was more than 33,000 in August 1864. The Confederate government could not provide adequate housing, food, clothing or medical care to their Federal captives because of deteriorating economic conditions in the South, a poor transportation system, and the desperate need of the Confederate army for food and supplies.

These conditions, along with a breakdown of the prisoner exchange system between the North and the South, created much suffering and a high mortality rate. “There is so much filth about the camp that it is terrible trying to live here,” one prisoner, Michigan cavalryman John Ransom, confided to his diary. “With sunken eyes, blackened countenances from pitch pine smoke, rags, and disease, the men look sickening. The air reeks with nastiness.” Still another recalled, “Since the day I was born, I never saw such misery.”

When General William T. Sherman’s Union forces occupied Atlanta, Georgia on September 2, 1864, bringing Federal cavalry columns within easy striking distance of Andersonville, Confederate authorities moved most of the prisoners to other camps in South Carolina and coastal Georgia. From then until April 1865, Andersonville was operated in a smaller capacity. When the War ended, Captain Henry Wirz, the prison’s commandant, was arrested and charged with conspiring with high Confederate officials to “impair and injure the health and destroy the lives…of Federal prisoners” and “murder in violation of the laws of war.” Such a conspiracy never existed, but public anger and indignation throughout the North over the conditions at Andersonville demanded appeasement. Tried and found guilty by a military tribunal, Wirz was hanged in Washington, D.C., on November 10, 1865. Wirz was the only person executed for war crimes during the Civil War.

Andersonville prison ceased to exist when the War ended in April 1865. Some former prisoners remained in Federal service, but most returned to the civilian occupations they had before the War. During July and August 1865, Clara Barton, along with a detachment of laborers and soldiers, and former prisoner Dorence Atwater, came to Andersonville cemetery to identify and mark the graves of the Union dead. As a prisoner at Andersonville, Atwater had been assigned to record the names of deceased Union soldiers for Confederate prison officials. Fearing loss of the death records at war's end, Atwater made his own copy of the register in hopes of notifying the relatives of the more than 12,000 dead interred at Andersonville. Thanks to Atwater’s list and the Confederate death records captured at the end of the War, only 460 of the Andersonville graves had to be marked “Unknown U.S. soldier.”
—Adapted from National Park Service brochure "Andersonville"

IMAGE: The deadline that kept prisoners back from the walls of the stockade was marked by a simple fence. Prisoners who crossed the line were shot by sentries who sat in “pigeon roosts” located every 90 feet along the wall. The man in this image was shot reaching under the fence as he tried to obtain fresher water than was available downstream. (Andersonville National Historic Site)



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