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, June 29, 2015

William A. Hammond, Surgeon General

Compiled by James M. Phalen, Colonel, Medical Corps, U.S. Army retired

WILLIAM ALEXANDER HAMMOND (Aug. 28, 1828 -Jan. 5, 1900), Surgeon General, April 25, 1862 - August 18, 1864, was born at Annapolis, Md., the son of Dr. John W. and Sarah (Pinkney) Hammond, members of two old Maryland families of Anne Arundel County.  When he was about five years old the family moved to Harrisburg, Pa., where his early education was completed at a local academy.

He began the study of medicine at sixteen and at twenty was given the degree of M. D. by the medical department of the University of the City of New York.  After a year of internship in the Pennsylvania Hospital in Philadelphia, he settled in Saco, Me., for the practice of medicine.  He stayed there but a few months when he took the examination for the army medical service and was appointed as assistant surgeon on July 29, 1849.  Shortly thereafter he was sent with a body of troops to New Mexico, where during the following three years he served at nine different posts and was engaged a large part of the time in operations against the Indians.

After a sick leave spent in study in Europe he was stationed at West Point and later at Fort Meade, Florida, and Fort Riley, Kansas.  While at Fort Riley he served as medical director of a large force operating against the Sioux Indians and was medical officer with an expedition which located a road to Bridger's Pass in the Rocky Mountains.  From Fort Riley he was transferred to Fort Mackinac in Michigan.  During this first ten years of service he devoted his spare hours to physiological and botanical investigation and in 1857 he published an exhaustive essay "Experimental Research Relative to the Nutritive Value and Physiological Effects of Albumen Starch and Gum, when Singly and Exclusively Used as a Food", which was awarded the American Medical Association Prize.

His growing reputation attracted the attention of the authorities of the University of Maryland and on October 31, 1860, he resigned from the army to accept the chair of anatomy and physiology in the medical school in Baltimore.  Here he taught with marked success and practiced his profession until the outbreak of the Civil War.

As surgeon to the Baltimore Infirmary he attended the wounded men of the 6th Massachusetts Infantry, who while marching to the defense of Washington were fired upon by a Baltimore mob.  He resigned his professorship and on May 28, 1861, he reentered the army as an assistant surgeon at the foot of the list upon which he had formerly held high place.

His first Civil War service was as medical purveyor at Frederick, Md.  Later he organized the Camden Street Hospital in Baltimore and was then transferred to the command of General Rosecrans in West Virginia where he was made inspector of camps and hospitals.  His work in this field attracted the favorable attention of the Sanitary Commission, which, dissatisfied with the administration of the medical service of the army, urged the removal of the incumbent head and the appointment of Hammond in his place.  Surgeon General Finley's break with Secretary Stanton brought the opportunity, and despite strong backing for the acting Surgeon General, Colonel R.C. Wood, and a candidate put forward by Secretary Stanton, Hammond was appointed Surgeon General on April 25, 1862.  Colonel Wood failing in his greater ambition, asked for the appointment as assistant Surgeon General, which upon Hammond's approval was given him.  Shortly, however, friction developed between the two and Wood was relieved from duty in the office, though he retained the title of assistant Surgeon General until October 31, 1865.  Major Joseph R. Smith was brought into the office to fill Wood's position.  The year and a half of Hammond's actual tenure of the office was marked by an administration of high efficiency and by many important accomplishments.  These included a new and vastly enlarged supply table and the provision of hospital clothing for patients.

There was a general reorganization of boards of examiners for entrance to the corps and increased standards for applicants.  A new and complete system of hospital reports was introduced, furnishing an amount of information later invaluable in the preparation of the medical history of the war.  On May 21, 1862, he directed the organization of the Army Medical Museum and the collection of specimens and material for its exhibition.  It was during his term that the most definite program was made in the construction and equipment of military hospitals.

That he was a man of vision is evidenced by the highly constructive recommendations that he made, all of which in the fullness of time have come into realization.  He recommended the formation of a permanent hospital corps, the establishment of an army medical school, the establishment of a permanent general hospital in Washington, the autonomy of the medical department in the construction of hospitals and the transportation of supplies, and the institution of a military medical laboratory.

It was inevitable, however, that the masterful personality of Hammond would excite the disapproval of such an autocratic spirit as Secretary Stanton.  Their official and personal relations early became strained and there was constant friction in the conduct of business between the two officers.  This situation culminated in orders issued in the latter part of August 1863 relieving Hammond from charge of the Washington office and directing him to duty inspecting sanitary conditions in the Department of the South with his headquarters in New Orleans.

On Sept. 3, 1863, medical inspector general Joseph K. Barnes was placed in charge of the Surgeon General's office.  The anomalous situation in which he was placed caused General Hammond to demand the restoration of his office or trial by court-martial.  In consequence he was tried on charges and specifications alleging his involvement in irregularities incident to the purchase of medical supplies.  The prosecution was pushed with bitterness and apparent personal animosity.  It is said that the finding of the court-martial was for acquittal, but that this finding was disapproved and a reconsideration directed which resulted in a verdict of guilty and a sentence of dismissal from the army.  The dismissal took effect August 18, 1864.

Upon leaving the army Hammond found himself in straitened circumstances from the expense of his trial.  With the help of friends he was able to establish himself in practice in New York, and in a short time he became a leader in the practice and teaching of neurology, a specialty then in its infancy.  Soon after his arrival in New York he was appointed lecturer on nervous and mental diseases in the College of Physicians and Surgeons.  He resigned this position in 1867 to accept the professorship of the same subjects which bad been created for him in the faculty of Bellevue Hospital Medical College.  In 1874 he transferred to a like professorship in the medical department of the University of the City of New York.  At other times he was on the faculty of the University of Vermont at Burlington and of the Post Graduate Medical School of New York, of which he was one of the founders.

In 1878, then at the height of his success and popularity, he started a campaign for vindication of his conduct of the office of Surgeon General.  Under an act of Congress approved. March 15, 1878 (20 Stat. 511), he was restored to the army and placed upon the retired list as Surgeon General with the grade of brigadier general, without pay or allowances, on August 27, 1879.  In 1888 he moved to Washington where he established a large sanatorium for the care of cases of nervous and mental diseases.  It became necessary for him gradually to limit his professional work on account of a cardiac ailment from which he died at his Washington home on Jan. 5, 1900.  During his later years he became much interested in the therapeutic employment of animal extracts and did much to instruct the medical profession in their use.

Throughout his career Hammond was a facile writer.  While carrying the responsibilities of Surgeon General he found time to write a "Treatise on Hygiene, with Special Reference to the Military Service" (1863).  The most noteworthy of his other medical works were: "On Wakefulness: With an Introductory Chapter on the Physiology of Sleep" (1866), "Sleep and Its Derangements" (1869), "Physics and Physiology of Spiritualism" (1871), and "Insanity in its Medical Relations" (1883).  In 1871 he published his "Treatise on Diseases of the Nervous System", a well written book largely based on the lectures of Charcot.  This was announced as "the first text-book of nervous diseases in the English language."

He was also a playwrite and novelist.  For a time he was editor of the "Maryland and Virginia Journal", published in Richmond and Baltimore.  In 1867 he established the Quarterly Journal of Psychological Medicine and Medical Jurisprudence, of which he was editor until 1875.  He also cooperated (1867-1869) in the founding and editing of the "New York Medical Journal" and of the "Journal of Nervous and Mental Diseases" (1867-1883).

General Hammond was a pioneer in field of nervous and mental diseases in the United States.  American neurology began with the Civil War, from the experiences gained by Hammond, S. Weir Mitchell, and William W. Keen.  He was a dominant personality in any field he entered, attracting a following and developing active enemies.  From a certain penchant for theatrical action he could not escape entirely from a reputation for charlatanry.  Personally he was an uncommonly large man, six feet two inches in height, and of two hundred and fifty pounds weight.  He had a powerful voice, a pleasing delivery, and a flow of language which made him a popular speaker.  He was married twice: in July 1849 to Helen Nisbet, daughter of Michael Nisbet of Philadelphia, and in 1886 to Esther T. Chapin.

Sources:  H. E. Brown, Medical Department of the U. S. Army from 1775 to 1873 (1873);  P. M. Ashburn, History of the Medical Department of the U. S. Army (1929);  The Post Graduate, N. Y., May 1900;  J. E. Pilcher, Surgeon Generals of the Army (1905);  Kelly and Burrage, American Medical Biographies (1920); Dictionary of American Biography, Vol. VIII (1932).

[Extracted from "Chiefs of the Medical Department, U.S. Army 1775-1940, Biographical Sketches,"  Army Medical Bulletin, no. 52, April 1940, pp. 42-46]


Clara Barton: Heroine of Nursing and Record Keeping

Excerpted from:

“We have captured one fort—Gregg—and one charnel house—Wagner—and we have built one cemetery, Morris Island. The thousand little sandhills that in the pale moonlight are a thousand headstones, and the restless ocean waves that roll and breakup on the whitened beach sing an eternal requiem to all the toll-worn gallant dead who sleep beside.”
-Clara Barton, Morris Island

Born in Massachusetts in 1821, Clara Barton grew up to be one of the most distinguished nurses in the United States. Perhaps best known for founding the American Red Cross, Barton also played a pivotal role during the Civil War—not only as a nurse, but also as a record keeper.

Barton first came to Washington, DC in 1854, where she took a position at the US Patent Office. She worked there for three years, until her abolitionist views made her to controversial and she returned to New England. But 1861 saw her back in the capitol, and when the Civil War broke out Barton was one of the first volunteers to arrive at the Washington Infirmary.

After Barton’s father died, she left the city hospital to care for soldiers in the field. What she found here reflected the scene in battlefields all over the country. There was a dizzying shortage of medical supplies, and Barton purchased supplies with donations and her own money. (Congress would later reimburse her for these expenses.)

Barton also quickly discovered what would turn into one of the greatest challenges in the nation’s recovery: there were no processes for documenting the wounded, the dead, the buried; no protocol for notifying families if a loved one had been wounded or killed. Barton immediately set about collecting as much information as possible. She would post lists of the missing and solicit input directly from the soldiers.

The Nation Faces a New Challenge

It became readily apparent that the isolated efforts of individuals like Whitman and Barton would not be enough. In March 1865, Abraham Lincoln appointed Barton General Correspondent for the Friends of Paroled Prisoners. Her mission was to respond to inquiries from family members who were searching for loved ones. To do this, Barton sifted through all the prison rolls, hospital records, and casualty lists she could get her hands on. These documents weren’t always accurate.

Take, for instance, the case of John Shuman. He joined the Union Army in August 1862, but died of dysentery in August 1863. Shuman left behind an extensive correspondence with his family, which offers a fascinating glimpse into Civil War soldiers’ daily lives. Though the family name appears to be “Shuman” in the letters, the local census lists the family as “Shurman.” Furthermore the office responsible for removing John’s remains identified him as Shuman, but the grave marker and index at the cemetery list him as “Sherman.” The history of John’s infantry, published in 1895, calls him “John Shewman.”

Many soldiers in the war were not so lucky; they were not identified. Whitman and Barton again led the charge, independently insisting on the identification and marking of soldiers’ graves wherever they could be tracked down. Eventually it was thanks to their efforts that our national cemetery system was developed and implemented.

Barton would go on to distinguish herself as the founder of the American Red Cross and a true pioneer in the field of nursing. But her contributions during the Civil War were an equally significant accomplishment.

Anna Morris Ellis Holstein


Anna Morris Holstein may have been the last person you’d expect to see traveling with soldiers. She and her husband, William H. Holstein, were quite wealthy. But they still had a strong sense of duty. William had served in the Pennsylvania militia during Lee’s 1862 invasion. And when the couple witnessed the carnage at Antietam, they felt called to serve. Anna noted, “we have no right to the comforts of our home, while so many of the noblest of our land renounce theirs.”

The couple enlisted with the US Sanitation Commission. Anna struggled with the grisly realities of war and later admitted that she was of little use till she could gain control of her composure and stop crying. Even after she was more experienced, Anna would succumb to emotion when she received “earnest thanks” from a soldier.

After the war, publisher JB Lippincott capitalized on the hunger for war stories, first with "Hospital Sketches", then less successfully with "Notes of Hospital Life" (1864). Anna’s "Three Years in Field Hospitals of the Army of the Potomac" fit the bill to continue the trend.

Image 1: The Holsteins (center) on site at a field hospital

Image 2: Anna Morris Ellis Holstein

The Army Medical Department Civilian Corps: A Legacy of Distinguished Service

By Major Kenneth M. Koyle, AMEDD Center of History and Heritage, 9 March 2011

Civilians have played a vital role in Army medicine from the very beginning. In fact, virtually all medical functions were provided by civilians in the first few decades of the Army’s existence. The history of civilian support to the Army Medical Department (AMEDD) is an integral and inseparable component of our overall medical history.

On 27 July 1775 the Continental Congress established a medical department to provide care for the nascent Continental Army. Although it outlined a rudimentary system of care for the military, the legislation creating the medical department did not designate military rank for medical personnel, nor did it specify the correlation of the department to the larger army. This ambiguity left a corps of pseudo-civilian medical providers to carve out their own place in the Army structure, and spawned counterproductive infighting and confusion that persisted throughout the American Revolution and the subsequent War of 1812.

Despite the challenges of working in this ill-defined system, the civilian cadre of the early AMEDD made significant strides in planning and organizing battlefield medicine, preventive care, and basic logistical support for the Army. Under the purview of a Director General (antecedent of the Surgeon General), the surgeons, assistant surgeons, apothecaries, and purveyors worked tirelessly to overcome obstacles and provide the best care possible. These personnel served in a peculiar, indeterminate state—not exactly soldiers, because they had neither rank nor uniforms, but not exactly civilians, because they were subject to the rules, regulations, and restrictions of the Army. Their pay was meager and the conditions of service were arduous. According to one surgeon who served on the Canadian frontier during the War of 1812, most medical men were only willing to serve for a single year in these circumstances, and then only because of curiosity and a thirst for adventure.1

In 1818 Congress finally established a permanent Medical Department with a Surgeon General at its head, although neither he nor the surgeons and assistant surgeons under him held military rank. By 1840 the military surgeons had a standardized uniform and their pay was approaching that of the line officers. Although they were commissioned, they still held no military rank and were not entitled to salutes. This indistinct status was clarified in February 1847, when Congress granted official rank to medical personnel. From this point forward there would be a distinction between the military surgeons and their civilian colleagues, but their roles would often merge and their military functions were frequently indistinguishable.

The contract surgeon was the most prevalent manifestation of civilians serving the AMEDD in the 19th century. These civilian doctors were hired to fill shortages throughout the medical system, often with service at isolated frontier posts or other austere locations. Field commanders were authorized to hire contract surgeons as needed to provide adequate medical care for their units. Their numbers rose steadily over the ensuing years, and during the Civil War more than 5,500 civilian doctors served with the Medical Department. Many of these contract surgeons performed heroically in action with the units they supported. Perhaps the most striking example is the story of Mary Walker, a contract surgeon who served at Bull Run, Chickamauga, Richmond, and Atlanta, and spent time as a prisoner of war. In 1865 Dr. Walker became the first woman to receive the Medal of Honor, and she did it as a civilian in the Army Medical Department. To this day she remains the only female recipient of the award.


Surgeon James H. Thompson's Diary


James H. Thompson started his Civil War career as a surgeon in the 12th Maine Volunteer Infantry Regiment and was assigned in 1864 to the Point Lookout prisoner of war camp in Maryland. Thompson later served at the Soldiers’ Home and had a private practice in Milwaukee.  Among the items donated to the Milwaukee County Historical Society from this doctor was a small, worn, leather-bound journal with sixty-two colored pencil sketches of what life was like for a Confederate prisoner.

It appears that one of the Confederate prisoners (“Johnny Reb J. J. O.”) gave this journal to Thompson sometime in 1864.  Why a prisoner would do this is a bit of a mystery.  Perhaps J. J. O. trusted the doctor and knew he would take care of it.  Or maybe it was a payment of sorts for treatment that Thompson provided.  The sketches are still vibrant and crisp considering their age and offer the viewer a glimpse of the horrible conditions at Point Lookout, Maryland.  By many accounts, Point Lookout was the worst of the Union prisons for captured Confederate soldiers.  Established in 1863, it had a wall fourteen feet high that surrounded the forty acres that was meant to hold 10,000 prisoners.  Union officials typically crammed between 12,000 and 20,000 men into this barren space with no barracks to shelter the men from the heat and cold.  It will never be known for sure, but it is estimated that between 4,000 and 14,000 men died in this harsh environment.

J. J. O.’s etchings give the viewer glimpses of what the prisoner’s life was like in this camp. Depictions include men with threadbare clothing and no shoes looking for ways to supplement their meager rations.  They resort to skinning and eating rats.  Others were forced to pull discarded food out of the cookhouse slop barrel and eat it to stay alive.  Interaction between the prisoners and their African American guards are also portrayed in less than flattering sketches.  To no one’s surprise, they are often depicted as cruel masters over the Confederates.  In others, the guards are almost cartoonish who are outwitted by the white prisoners.

The artist, J. J.O., has given us a rare look at the less than glorious side of the Civil War, and the Milwaukee County Historical Society is fortunate that Dr. James H. Thompson decided to share this part of history with us.

Colonel John Shaw Billings: A Many-Sided Genius

By James M. Phalen, Colonel, U. S. Army, Retired

The Army Medical Bulletin, Number 60, January 1942: Beyond question, the name of John Shaw Billings belongs with the most outstanding among the many gifted men who have held membership in the Army Medical Corps. Though his works may not be familiar to the present generation, at the time of his retirement from the Government service he was undoubtedly the foremost medical man of this country if not of the world. Certainly no other American physician ever attained the international prominence that Billings held in his last years at the Army Medical Library.

He was born on March 12, 1838, on a farm in Cotton Township, Switzerland County, in southeastern Indiana. His father, James Billings, born at Saratoga, New York, was a descendant of William Billings, who emigrated from Taunton, England, to Lancaster, Massachusetts, about 1654. His mother, Abby Shaw, of Raynham, Massachusetts, was descended from John Howland, one of the Pilgrims of Plymouth. The family moved to Rhode Island in 1843, but five years later returned to Indiana, to Allensville, where the father became postmaster and operated a general store. At the age of fourteen, the son entered Miami University at Oxford, Ohio, where he graduated in 1857. Following some tutoring and lecturing at the university he entered the Medical College of Ohio, at Cincinnati, in the fall of 1858. When given his medical degree in 1860, he presented a thesis on The surgical treatment of epilepsy which was a creditable survey of the operations then employed and their indications. He settled in Cincinnati for the practice of surgery and was made demonstrator of anatomy at the medical school.

Talk of secession was stirring the southern states. South Carolina began the movement in December and hostilities began in April of the next year. In September 1861 Billings went to Washington for the examination for the regular corps. He was successful but no vacancy existed, so he was appointed a contract surgeon and assigned to duty in Union Hospital in Georgetown. A skillful operator at this time, he did much of the surgical work of the hospital. He developed a reputation for his surgical treatment of urethral strictures.

On April 16, 1862, he was appointed a first lieutenant, and on May 9 he was directed to take charge of the establishment and operation of Cliffburne Hospital, in an old cavalry barracks on the hills back of Georgetown. Union Hospital was abandoned and all equipment and patients moved to this new hospital. With the use of hospital tents, Billings soon had a hospital of one thousand beds.

In late August he received orders for transfer to a new general hospital in West Philadelphia, later known as Satterlee General Hospital. Before joining his new post he was married on September 3, 1862, in St. John’s Church in Georgetown, to Kate M. Stevens, daughter of the Hon. Hester L. Stevens, a former Congressman from Michigan. Billings served as executive officer at the West Philadelphia hospital until the end of March 1863, when he was ordered to the Army of the Potomac, at the time grouped around the village of Falmouth, Virginia, across the Rappahannock from Fredericksburg. Reporting to Medical Director Jonathan Letterman, he was assigned to the 11th Infantry in Sykes’ Division of Meade’s Corps. The Army, under General Hooker, was preparing for a turning movement by way of the upper fords of the Rappahannock and the Rapidan, with a holding attack upon Marye’s Heights back of Fredericksburg, to keep Lee’s army occupied at that point. This maneuver, which resulted in the battle of Chancellorsville, was begun on April 27. Meade’s Corps, crossing the rivers, took a leading part in the battle which filled the first three days of May.

Billings served with the division hospital, alternately occupied with operating upon the wounded and moving them and the hospital equipment to the rear. He speaks feelingly of the difficulties of operating a field hospital and transporting the wounded with a retreating army. The difficulties were the greater because of the alleged inadvisability of bringing the ambulance trains across the river fords. In contrast, the attack on Marye’s Heights was most efficiently served by the ambulance corps.

On May 16, Billings was transferred to the 7th Infantry in the same division. With it he accompanied the Army’s march northward, beginning on June 12, paralleling that of Lee’s army by way of the Shenandoah Valley. The Federal forces passed through Manassas, Centerville, Leesburg, Edward’s Ferry, and Frederick in Maryland. July 1 found Billings with the regiment at Hanover, Pennsylvania, and the whole Fifth Corps nearby. Word of the beginning battle of Gettysburg reached the corps that day with orders to march at once. On the morning of July 2 the Fifth Corps took over the left wing of the Union front around Round Top During the last two days of the battle, Billings operated the field hospital for his division close up behind Round Top at first, and later to the east of Rock Creek on the Baltimore Pike. Sykes’ Division sustained a loss of about thirty percent, causing days of work without end for the hospital.

Compelled to take sick leave, Billings rejoined the 7th Infantry in August, and went with the regiment to New York City for duty in connection with the draft vote. Assigned to temporary duty in McDougal Hospital at Fort Schuyler, he was later assigned to this hospital and shortly thereafter was transferred to command of DeCamp Hospital on David’s Island. Transferred from here to the Convalescent Hospital on Bedloe’s Island he was of a commission that sailed on February 5, 1864, to Haiti for the purpose of repatriating several hundred negroes who had been sent to form a colony on the Isle de Vache.

Returned to Alexandria, Virginia, on March 20, Billings asked for relief from hospital duty and assignment with the Army of the Potomac. Reporting to General Meade’s headquarters at Brandy Station, Virginia, he was assigned to duty as assistant to Medical Director Thomas A. McParlin. In this capacity he went through the Wilderness campaign and the subsequent operations up to the investment of Petersburg. On August 22, 1864, he was ordered to Washington, where was maintained a branch office of the medical director of the Army of the Potomac. He served in this office until December 27 when he was transferred to the Office of The Surgeon General. There he remained for over thirty years, until retirement in 1895.

Upon reporting, he was placed in charge “of the organization of the Veteran Reserve Corps of matters pertaining to contract physicians and to all property and disbursing accounts.”

For the next ten years his office hours were filled with the drudgery of requisitions, invoices and receipts, bills of lading, treasury allotments, and auditors’ decisions. After his office day he spent long hours over microscopy, comparative anatomy, the history of medicine, and the German language. In the field of microscopy he investigated the possible cryptogamic origin of certain cattle diseases and published his observations. In August 1868 The Surgeon General issued a circular calling for a detailed semiannual report upon the sanitary condition of his post from each station surgeon, including in the first report a description of the post itself with its buildings and surroundings. From these reports Billings compiled his Report on Barracks and Hospitals (1870) and later his Hygiene of the United States Army (1875). A tribute to his growing reputation was his assignment as a “consulting surgeon” to the Secretary of the Treasury, in 1869, to assist in the reorganization of the Marine Hospital Service. He served in this capacity until 1874. The Secretary gave great credit to Billings for the new organization based upon army standards and for its highly increased efficiency. By this time he was regarded the foremost authority on public hygiene in the country, with a further high reputation  in hospital construction.

Shortly after Billing’s detail in The Surgeon General’s Office he was given charge of the office library, with the property accountability involved. With the rapid growth of the library a clerical organization for its administration grew up in the main office in the Riggs Bank Building on Fifteenth Street and Pennsylvania Avenue, while the library collection was housed in assigned space in the Army Medical Museum, the new name given the old Ford’s Theatre on Tenth Street, under the direct charge of Doctor Thomas A. Wise.

It was not until December 1883, when Billings was appointed curator of the Army Medical Museum and librarian of The Surgeon General’s Office, that the office of the library was moved to the Tenth Street location. In the meantime, the first catalogue of the library to bear his name was issued in 1873, and in 1876 he published the Specimen Fasciculus of a Catalogue of the National Medical Library. The enthusiastic reception of this work by the medical profession of the country spurred the work on the Index Catalogue, the first volume of which appeared in 1880. In this work Billings had for his invaluable assistant Dr. Robert Fletcher, who was appointed to the library on September 1, 1876, and who continued on the editorial work of the Catalogue until shortly before his death in 1912. This is no place to speak of the monumental character of this great work, nor of its epochal influence. The first series of the Catalogue, completed in 1895, will remain a more lasting tribute to Billings’ name than any monument of stone that will be raised in his memory.

With the passing years he had been advanced to a captaincy in the Medical Corps on July 28, 1866, to major on December 2, 1876, and to Lieutenant Colonel on June 16, 1894. He had been given the brevet of lieutenant colonel on March 13, 1865, for his service in the Civil War. In these same passing years the library had grown from a few thousand volumes until it ranked with the largest in the world.

In June 1876, Billings accepted the position of medical advisor to the trustees of the Johns Hopkins Fund, the purpose of which was the erection in Baltimore of a hospital which was to be the nucleus for a medical school for the University. Skipping details, Billings drew the ground plans for the hospital, made a tour of the famous hospitals of Europe and drew up a detailed memorandum upon the proposed scope of the institution, with a discussion of its departments and services. His plans were adopted practically without change. On account of the decision to build only with the income of the fund the hospital was not completed until May 1889, at a cost of somewhat over a million and a half dollars. Billings’ official connection with this work ended in August 1889. In the meantime, he was carefully drawing plans for the proposed medical school. He was instrumental in securing for the first members of the new faculty, Dr. William H. Welch, of Norfolk, Connecticut, in 1884, and Dr. William Osler, Professor of Medicine at the University of Pennsylvania, in 1889. He had much to do with the selection of the remaining brilliant men who made up the first faculty of the Johns Hopkins Medical School. He himself lectured at the school for a number of years on the history of medicine. Billings’ connection with hospital construction began with various post hospitals of the Army, and included a cooperation in the planning for the Marine Hospital Service, for the National Soldiers’ Home, for the Memphis City Hospital, and for the Peter Bent Brigham Hospital in Boston.

Shortly after the completion of his work on the Johns Hopkins Hospital in 1889, Billings was approached with a proposal that he go to Philadelphia to become director of the hospital of the University of Pennsylvania and of a laboratory of hygiene to be constructed, and that he become professor of hygiene on the University faculty. He accepted the offer with the provision that he should remain with the Washington library until the first series of the Index Catalogue was completed. Under this arrangement, he began, early in 1890, the plans for the laboratory, and, with the 1891-92 session, began his lecture courses on hygiene and vital statistics. The laboratory was completed in February 1892.

With the first series of the Index Catalogue completed in June 1895, and with thirty-three years of service to his credit, Billings was ready to retire from the Army and carry out in full his contract with the University of Pennsylvania. His retirement effected, he moved to Philadelphia in October 1895, where, however, his incumbency of the new post was of short duration.

Prior to May 1895, there existed in New York City three large public libraries, the Astor, the Lenox, and the Tilden, each the gift of an estate to the city. At this time an agreement for consolidation was effected, the combined collections to be known as the New York Public Library. The trustees of the new foundation voted to invite Colonel Billings to accept the post of superintendent. With the consent of the university authorities he resigned his professorship to take effect on June 1, 1896, and accepted the New York position for the same date.

The plans for the library contemplated the erection of a new central building and the establishment of numerous branch lending libraries throughout the city. Colonel Billings moved to New York in September 1896, and began at once upon the plans of administration for the institution. It was not until the spring of 1897 that the site for the new building had been secured, and in the meantime Billings had made careful examinations of the plans of the leading libraries of the United States and Europe. In April 1897, he drafted a pencil sketch for the proposed building, forming the basis upon which the final plans were made and upon which the library was ultimately completed. In the meantime he was faced with the gigantic task of reclassification and recataloguing the consolidated collection of books and pamphlets. In this work he used the system of the Army Medical Library of an author catalogue for official use and an alphabetical index catalogue of both authors and subjects for public use.

In 1900 there was a further consolidation of numerous free city circulating libraries with the New York Public Library, and, in 1901, Billings conducted the negotiations with Andrew Carnegie by which the latter provided something over five million dollars to furnish sixty-five city branches of the main library.

It was not until May 1911 that the new building was opened to the public, and Colonel Billings did not long survive the completion of his cherished plans. The death of his wife on August 19, 1912, was a serious blow to him. During the last two decades of his life he was the subject of two serious surgical conditions, which brought him to the operating table a number of times. A cancer of the lip developed in 1890, which was controlled after two operations. In 1900 he was first operated upon for biliary calculus, and in 1906 the gall bladder was removed. His death on March 11, 1913, was due to pneumonia, following an operation for urinary calculus. After funeral services at St. John’s Church in Georgetown, on March 14, the remains were interred in Arlington Cemetery.

It is impossible in a few words to do justice to the qualities of Colonel Billings. He was a many-sided genius with outstanding qualifications in a number of fields. It will be wondered why this great man was apparently never considered for the post of Surgeon General of the Army. He was the recipient of great honors outside the service at the same time that men of much lesser gifts were made chiefs of the corps. Certainly it was from no lack of administrative ability. Undoubtedly the determining factor was that only shortly before his retirement did he attain a military grade which would warrant his consideration for the position of Surgeon General.

Physically he was a tall man of powerful build and commanding appearance in his prime, with a handsome head, a straight nose, and clear open blue eyes. In manner he was quiet, patient, and businesslike, with a cool detachment, and isolation of mind that gave the impression of a distant manner. When not so preoccupied he showed himself not devoid of humor and possessed of a vast amount of gentle sympathy. His detachment of mind gave him a rare ability to see things exactly as they were, in their proper proportion. Medical history will always give Colonel Billings a high place among the immortals who have practiced the profession.


Lincoln's Last Hours

By Jill L. Newmark, 4-15-15

150 years ago on April 14, 1865, Abraham Lincoln was assassinated in a crowded theater in Washington DC. On April 15th he died and an autopsy was performed. Several doctors supported Lincoln in his last hours but no medical intervention could prevent his death and bystanders could only watch and wait.

On the night of April 14, 1865, a lone assassin shot the President of the United States at point-blank range during an evening performance at Ford’s Theater in Washington, D.C.  That evening, John Wilkes Booth made his way into the theater and to the box where President Abraham Lincoln, his wife Mary Lincoln, and two guests, Major Henry Rathbone and Miss Clara Harris were enjoying a performance of Our American Cousin.  Pulling out a single-shot, derringer pistol, Booth aimed the gun, pulled the trigger and fired a bullet at the President’s head.   Many of us know the details of what occurred at Ford’s Theater that night, but what transpired after the fatal shot was fired and during the many hours before the President succumbed to his wounds?

Among the many accounts of that evening is one by physician Charles Leale, an assistant surgeon with the U.S. Army and the first physician to reach Lincoln after he was shot.  Seated in the dress circle of the theater, not far from the Presidential box, Leale heard the gunshot and saw assassin John Wilkes Booth leap to the stage snagging his spur on the draped flag.  As shouts rang out that the President had been murdered, Leale rushed from his seat to the President’s box.

“When I entered the box,” Leale recounts, “Mr. Lincoln was seated in a high-backed arm-chair with his head leaning towards his right side supported by Mrs. Lincoln who was weeping bitterly.”   Leale took charge of the President’s medical care and immediately began to assess his injuries.  He was soon joined by physicians Charles Sabin Taft and Albert F. A. King.   After consulting together about the President’s condition, the three physicians decided it was best to have Lincoln moved from the theater to the nearest house.

Under the direction of Dr. Leale, the President was carried out of the theater and taken across the street to the home and boarding house of William A. Petersen.  Carefully navigating the front steps, they entered the house and laid Lincoln down on a bed in a back room on the first floor.  Leale called for the windows to be opened for fresh air and the room cleared of all but physicians, family and friends.  Lincoln’s clothes were immediately removed and blankets used to cover his body and warm his lower extremities that had gone cold.

As the news of the fatal shooting of Lincoln spread throughout Washington, members of Lincoln’s cabinet and other government officials made their way to the Petersen house.  Gideon Welles, then Secretary of the Navy, arrived at the house along with Secretary of War Edwin Stanton.  In his diary entry for April 14th, Welles describes the scene upon his arrival, “The giant sufferer lay extended diagonally across the bed, which was not long enough for him.  He had been stripped of his clothes. His slow, full respiration lifted the clothes with each breath that he took.  His features were calm and striking.”  After about an hour’s time, “his right eye began to swell and that part of his face became discolored.”

“The President made no noise, nor attempted to speak, nor stirred a limb after he was shot nor was he conscious for one moment from that time until he died.”—Horatio Nelson Taft

Dr. Robert King Stone, Lincoln’s family physician, also arrived that evening at the request of Mrs. Lincoln.  After examining the President, Stone quickly determined that “the case was a hopeless one.”  He informed the small group of family and friends holding vigil at Lincoln’s bedside, “that the President would die; that there was no positive limit to the duration of his life; that his vital tenacity was very strong, and he would resist as long as any man could, but that death certainly would soon close the scene.”

While her husband lay dying in the backroom, a grieving Mary Lincoln remained in the front parlor room surrounded by a few friends.  She visited her husband several times during the night while their oldest son, Captain Robert Lincoln, kept a vigil by his father’s bedside.  During the evening, a distraught Mrs. Lincoln sent a messenger out to find Elizabeth Keckley, her seamstress and confidante.  Anderson R. Abbott, an African Canadian physician who served as the surgeon-in-charge at Freedmen’s Hospital in Washington, offered to escort his close friend Mrs. Keckley to the Petersen House.  Abbott described those brief but intense moments at the house, where he observed the dying President in one room “while his companion [Mary Lincoln] was lying in an adjoining room prostrate with anguish.”  Abbott would later visit the White House to view the President’s body, expressing the “great sorrow that weighed heavily upon his heart, for…the loss to the negro race in their nascent life of freedom, of the great guiding hand that now lay paralyzed in death.”

When Mary Lincoln sent a messenger to find her seamstress and confidante, Elizabeth Keckley, Keckley’s friend, Anderson R. Abbott, volunteered to escort her to the Petersen house.
Courtesy Moorland Spingarn Research Center, Howard University and Oblate Sisters of Providence Archives

During the long night and into the early morning hours, Lincoln’s friends and cabinet members came to pay their respects.   Most did not linger, but some remained steadfast including Secretary of War Edwin Stanton, Senator Charles Sumner of Massachusetts and several surgeons who had been attending to the dying President throughout the evening.  They kept a steady vigil at the President’s bedside.  At 7:22 A.M the next morning, Lincoln breathed his last breath.  The somber silence that had filled the room was broken only by the words of Secretary Stanton: “Now he belongs to the ages.”

After Lincoln died, his body was placed in a temporary coffin covered with the American flag and returned by hearse to the White House where an autopsy was conducted and funeral preparations were begun.  Many of the people outside, who had kept vigil throughout the night, found their way inside the Petersen house to catch a glimpse of the place where their beloved President had died.  On that fateful night in April 1865, a simple family owned boarding house, became the resting place for a dying President and a symbol of the pain, sacrifice and sorrow of the American Civil War.

Image 1: Charles A. Leale, M.D., the first physician to reach Lincoln after he was shot.

Image 2: Julius Ulke, a resident at the Petersen boarding house, took this photograph of the room where Lincoln died immediately after Lincoln’s body was removed.

Jill L. Newmark is an Exhibition Specialist for the Exhibition Program in the History of Medicine Division at the National Library of Medicine.


Historian Sheds Light With African American Medical Contributions

by Bobby Jones, Staff Photojournalist, 2-3-15

On Feb. 7 [2015], The Surratts House Museum hosted an education tour revealing the plight and contributions of the African American medical community during the American Civil War, entitled “Within These Walls; African American Surgeons and Nurses,” who served during the War.

Narrated by, Jill Newmark, exhibition specialist in the History of Medicine Division of the National Library of Medicine, (NLM) National Institutes of Health (NIH) Bethesda, the exhibition sheds light on the African American medical surgeons and nurses who treated the soldiers and slaves who fled to Contraband Hospital Camp of 1862 which would eventually become what is known at the Howard University Hospital in 1975.

In a capacity-filled room of Surratts House, audience members listened attentatively as Newmark revealed the history of a hospital camp that once set on swamp land in northwest Washington, D.C.

According to Newmark, the camp served thousands of escaped slaves and blacks soldiers during the American Civil War. The hospital was primarily staffed with African American surgeons and nurses.

“The story of African Americans in the Civil War is an often neglected part of Civil War history and there’s been very little that’s been written on the subject,” said Newmark, who started her research in 2008.

“Histories in Civil War medicine often overlook the participation and contributions that African Americans made in 1861 to 1865. In fact, there are few personal accounts of black surgeons, nurses or hospital workers that exist. Materials … are often hidden among the thousands of Civil War records that are contained in depositories throughout the country,” added Newmark a historian and curator.

“This presentation is about the African American men and women who served as medical personnel during the Civil War and treated civilians and black soldiers at the Contraband Hospital in Washington, D.C.”

She noted that the Army used the term contraband to describe fugitive slaves who made their way across union lines during that time to describe African American’s whose status was undefined. “So with the increasing number of contraband it caused a dilemma for the army, because they needed to help the men, women and children find food, shelter and medical care. So eventually the camp became a safe haven for the former slaves.”

Newmark described the condition, treatment, work environment, living conditions and hospital care of the patients through personal correspondence, pension records and other documents of the surgeons, nurses and medical staff. “Their voices would have been lost had it not been for these records.”

She further explained “The civilians shared the hospital with soldiers from the U.S. Colored Troops and the living conditions at the camp were poor and unhealthy due to a lack of needed supplies.”

Newmark noted when Alexander T. Augusta was appointment of the first African American surgeon-in-charge of the hospital in May 1863, it became a game changer. She noted it was the beginning of blacks fulfilling leadership roles over their white contemporaries.

“African American surgeons and assistant surgeons were commissioned as military officers or private physicians under contract with the army, and their appointments represented the first time blacks served in positions of authority at a hospital in the United States,” said Newmark. The other doctors of note included Alexander T. Augusta, Anderson R. Abbott, John H. Rapier, Jr., William P. Powell, Jr., William B. Ellis, Charles B. Purvis, and Alpheus W. Tucker. “Nurses during that period were more like care givers, than actual trained nurses,” said Newmark.

“I’ve been researching this since 2008 and I’m still finding new things,” said Newmark, who’s currently writing a book about African American Civil War soldiers.

“It’s going to take a little while longer, because I just came across some new information that might expand my book. My main goal is to get the information out there for everyone. It’s been hidden for all these years and it shouldn’t be.”

Newmark has sponsored several exhibitions at the National Library of Medicine which include, Binding wounds, Pushing Boundaries of African Americans in Civil War Medicine, African Americans: Academic Surgeons and Within These Walls; African American Surgeons and Nurses who served during the War. Among her published articles include, Face to Face with History and Opening Doors: African American Surgeons among others.

“Being that I’m in health care, and my mom was a nurse also, the history of nursing and African Americans piques my interest,” said Pamela Banks, a nurse since 1986 with Capital Caring and Hospices in Prince George’s County.

“I was particularly interested in the military pension records of the surgeons and nurses because my great, great, great grandfather was a Civil War soldier with the U.S. Colored Troop 100,” Banks added. “What I learned from this exhibit is that we mattered then and we matter now. I’m just truly happy that there is attention to the roles of African Americans, be it through Civil War onto the present.”


Celestial Sleuths Shed (Moon) Light on Death of Stonewall Jackson


One of the turning points of the U.S. Civil War occurred during the Battle of Chancellorsville, May 2, 1863, when Confederate Lieutenant General Thomas J. “Stonewall” Jackson was mistakenly shot by his own troops and later died of complications from his wounds. His death deprived Confederate commander Robert E. Lee of his most daring and trusted general two months before the fateful Battle of Gettysburg.

Almost from the day of Jackson’s wounding, historians have debated the central question: How could the soldiers of the 18th North Carolina regiment not recognize their famous general and gun him down? Now, on the 150th anniversary of the historic event, astronomer Don Olson of Texas State University and Laurie E. Jasinski, Texas State graduate and editor of The Handbook of Texas Music, Second Edition, have answered that perplexing question by looking to the moon.

Olson and Jasinski publish their findings in the May 2013 issue of Sky & Telescope magazine, on newsstands now.

The Battle of Chancellorsville is an outlier among Civil War clashes in that the fighting continued well after sunset on May 2. The Union army was in disarray after being routed by Jackson’s famous “flank attack” in the late afternoon. Jackson hoped to cut off their lines of retreat, and a bright full moon allowed the rarity of night combat to continue. Many scholars after the fact claim the night was very dark, but eyewitness accounts testify otherwise.

“The moon was shining very brightly, rendering all objects in our immediate vicinity distinct….” wrote Confederate Captain William Fitzhugh Randolph in The Confederate Veteran, December 1903. “The moon poured a flood of light upon the wide, open turnpike,”

Jackson, along with Randolph and several other staff officers, rode ahead to scout out possible routes that could be used to get between the Union army and the fords and pontoon bridges along the Rappahannock River. As the party returned from their reconnaissance expedition at approximately 9 p.m., a Confederate officer on the left wing of the 18th North Carolina regiment spotted them through the trees by the moonlight, and, mistaking the group for Union cavalry, ordered his men to open fire. Jackson was wounded by three bullets—two in his left arm and one striking his right wrist. Upon hearing of the wounds that forced the amputation of Jackson’s arm, Lee lamented, “He has lost his left arm; but I have lost my right arm.”

Image: A full Moon illuminates the scene as General A. P. Hill binds the wounds of Stonewall Jackson minutes after the fatal volley at Chancellorsville. (Robert K. Krick)

Army Medical Department Medal of Honor Recipient: Dr. Mary E. Walker

From: and

Citation: Whereas it appears from official reports that Dr. Mary E. Walker, a graduate of medicine, "has rendered valuable service to the Government, and her efforts have been earnest and untiring in a variety of ways," and that she was assigned to duty and served as an assistant surgeon in charge of female prisoners at Louisville, Ky., upon the recommendation of Major-Generals Sherman and Thomas, and faithfully served as contract surgeon in the service of the United States, and has devoted herself with much patriotic zeal to the sick and wounded soldiers, both in the field and hospitals, to the detriment of her own health, and has also endured hardships as a prisoner of war four months in a Southern prison while acting as contract surgeon; and Whereas by reason of her not being a commissioned officer in the military service, a brevet or honorary rank cannot, under existing laws, be conferred upon her; and Whereas in the opinion of the President an honorable recognition of her services and sufferings should be made: It is ordered, That a testimonial thereof shall be hereby made and given to the said Dr. Mary E. Walker, and that the usual medal of honor for meritorious services be given her.

Given under my hand in the city of Washington, D.C., this 11th day of November, A.D. 1865.

Andrew Johnson, President

(Medal rescinded 1917 along with 910 others, restored by President Carter 10 June 1977.)

Rank and organization: Contract Acting Assistant Surgeon (civilian), U. S. Army.
Places and dates: Battle of Bull Run, July 21, 1861; Patent Office Hospital, Washington, D.C., October 1861; Chattanooga, Tenn., following Battle of Chickamauga, September 1863; Prisoner of War, April 10, 1864-August 12, 1864, Richmond, Va.; Battle of Atlanta, September 1864.
Entered service at: Louisville, Ky.
Born: 26 November 1832, Oswego County, N.Y.

Date of Award: November 11, 1865
Conflict: Civil War
Branch: U.S. Army (civilian)

The Civil War broke out and Mary Walker was denied commission as a medical officer in the U.S. Army, so she volunteered despite the stigma of gender inequality. She became the first woman surgeon in the U.S. Army and served a few years as a field surgeon near the front lines of the Union. She was later appointed assistant surgeon of the 52nd Ohio Infantry.

Walker was often suspected to be a spy due to her frequent trips across Confederate lines to treat civilians, which led to her capture and imprisonment in Richmond for four months. Upon her release, Walker spent the rest of the war as a contract surgeon at a women’s prison in Louisville, Ky., and an orphan’s asylum in Tennessee.

Army Medical Department Medal of Honor Recipient: Gabriel Grant

From: and

Citation: Removed severely wounded officers and soldiers from the field while under a heavy fire from the enemy, exposing himself beyond the call of duty, thus furnishing an example of most distinguished gallantry.

Rank and organization: Surgeon, U.S. Volunteers.
Place and date: At Fair Oaks, Va., 1 June 1862.
Entered service at: New York.
Born: Newark, N.J.
Date of issue: 21 July 1897.

Prior to the Civil War, Maj. Gabriel Grant, a prominent physician from Newark, N.J., served on a special health commission to battle the cholera epidemic then spreading throughout the city. At the outbreak of the war, he joined the 2nd Infantry Regiment of New Jersey Volunteers as a surgeon, just before becoming Surgeon to the U.S. Volunteers.

Grant then joined General William French’s brigade. During the battle of Fair Oaks on June 1, 1862, he attended to the wounded on the firing line and removed fallen soldiers beyond the battle lines while exposed to heavy fire. He spent the remainder of the war in command of the United States Army Hospital at Madison, Ind., before resigning from commission in 1865.

Army Medical Department Medal of Honor Recipient: Jacob F. Raub

From: and

Citation. Discovering a flank movement by the enemy, appraised the commanding general at great peril, and though a noncombatant voluntarily participated with the troops in repelling this attack.

Rank and organization: Assistant Surgeon, 210th Pennsylvania Infantry.
Place and date: At Hatchers Run, Va., 5 February
Entered service at: Weaversville, Pa.
Born: 13 May 1840, Raubsville Northhampton County, Pa.
Date of issue: 20 April 1896.

After he achieved his degree in medicine in 1864, Jacob Raub was appointed to assistant surgeon of the 210th Pennsylvania Volunteer. As part of the board of operating surgeons of the field hospital of the 5th Army Corps, he was positioned in the rear, well out of the distance of any ensuing dangers during the battle. However, at the battle of Hatcher’s Run, Raub heard his regiment was without a surgeon, and volunteered to tend to the wounded in the middle of severe gunfire.

While administering help to the fallen, Raub spotted the enemy repositioning themselves for a surprise attack from an undefended direction. He warned the generals of the imminent attack, and picked up a musket and ammunition and gallantly joined in the fight until the engagement ended. The results could have been disastrous for Raub’s regiment if he had not spotted the attack.

Medical Historian Finds Dr. Harris

By Leah Montgomery, NC Central University, 6-30-14

Medical historian Margaret Humphreys discovered Dr. Joseph Dennis Harris in a handwritten report from the Civil War. She was looking through the United States Sanitary Commission papers during her year at the “clubhouse” — the National Humanities Center (NHC) in Research Triangle, NC.

“When I began my research, he was an unknown figure in the history of Civil War medicine,” Humphreys said. “The fact that I was able to reconstruct his life history beginning with this enigmatic reference is a tribute to the modern tools of digitization, search engines and librarians especially, in the rediscovery of minority figures. proved especially helpful.”

The historical display, "Binding Wounds, Pushing Boundaries," appears at the Medical Center Library through July 19 [2014].

Humphreys, the Josiah Charles Trent Professor of the History of Medicine and Professor of Medicine at Duke University, recently shared the story of this pioneering African-American physician in a Medical Center Library lecture as part of “Binding Wounds, Pushing Boundaries: African Americans in Civil War Medicine” an exhibition on display in the medical library through July 19.

Harris was born in North Carolina to free-colored father Jacob Harris, and mulatto mother Charlotte Dismukes Harris in 1833. At age 17, Harris and his mother migrated to Cleveland, Ohio from Fayetteville, NC.

After farming and working as a blacksmith as a young adult, Harris later studied chemistry and surgery at the Medical Department of the Western Reserve College.

From Cleveland, Harris went on to get an MD diploma from a medical college in Keokuk, Iowa.

During the Civil War, Harris was an acting assistant surgeon at Balfour Hospital in Portsmouth, VA, where he oversaw a ward of about 100 black patients, Union troops and freemen. He was later assigned to two more wards of equivalent size.

In 1865, Harris sought a commission as a Union surgeon but failed to do so due to lack of opportunity. He instead became a physician in Freedmen’s bureau hospitals in Virginia.

Humphreys’ eyes lit up as she quickly read through the papers.

In the spring of 1869, Harris was nominated for lieutenant governor of Virginia, attaining 99,600 votes. It was not enough to win however; he also failed in a bid for a US Senate seat when he received just two of the 32 state legislature votes.

Humphreys said Harris’ genuine character, relentless determination and intellectual capabilities helped to set the standard for African-American medicine.

“Harris is a person whose action in the 1850’s mattered, his actions in reconstruction mattered; (his work) is a continuum, the lives were a continuum,” said Humphreys.

Humphreys is the President of the American Association for the History of Medicine and the author of “Marrow of Tragedy: The Health Crisis of the American Civil War” (Johns Hopkins University Press, 2013), which examines the history of medicine during the American Civil War.

The six-banner traveling exhibition now on display in the library was developed by the Exhibition Program at the National Library of Medicine. It features African-American men and women who served as surgeons and nurses during the American Civil War and the impact of their service on the existing ideas of race and gender, expanding the limitations of the role of African Americans in America.

Dr. Humphreys’ presentation was co-sponsored by the Duke University Medical Center Library & Archives and the History of Medicine Collections in the David M. Rubenstein Rare Book & Manuscript Library. Margaret Humphreys MD is also a PhD historian.


Wednesday, June 24, 2015

Toward an Ambulance Corps


Soldiers wounded in July 1861 at First Bull Run had to fend for themselves because there was a "pitiful absence of provision for the wounded." Ambulance drivers were generally either impressed soldiers or wagon and hack drivers pulled from the streets of Washington, and rumors of forthcoming roundups sent drivers fleeing from the city. Surgeons reported drivers who were insubordinate or drunk or who appropriated space inside the ambulances intended for blankets and food. As to the vehicles themselves, the Army had been forced to round up commercial wagons and hacks to serve as ambulances.

Second Bull Run, the following summer, demonstrated that little had improved after a year of combat operations. Army surgeons at Centreville, Virginia, operated on casualties who lay without blankets on the bare earth. Surgeon Thomas A. McParlin, medical director of the Federal Army of Virginia, wrote that Americans should follow the lead of the Europeans. "A well-organized regularly established ambulance corps would have been a blessing." The need was felt in other theaters as well. In Missouri, Surgeon John H. Brinton reported that the lack of adequate evacuation capability had caused abandonment of the wounded. Those who were able crawled to whatever cover they could reach; many were captured.

The absence of personnel dedicated to the evacuation mission required commanders to use combat soldiers to remove the wounded from the battlefield, further reducing the Army's fighting strength. Not surprisingly, the speedy return of soldiers who left the battlefield to assist the wounded was problematic. A Confederate report echoed the universal complaint of line commanders: "If any from the ranks are drawn from the fight to carry off the wounded, they never return until the fight is over, and thus three are lost to the company instead of one wounded."

Confederate Army medical organization mirrored the Union's, as leadership of the Southern medical department was in the hands of former Union medical officers, including Confederate Surgeon General Samuel Preston Moore. While the Confederate medical manual was based on U.S. Army regulations, its field medical doctrine included the European concept of a sanitary corps with officers and soldiers designated for evacuating the wounded. Those soldiers would serve in the front lines, where "not infrequently they lose their lives in accomplishing their benevolent tasks."

A variety of ideas for an ambulance system surfaced in the Union Army. One was for an ambulance company of two lieutenants and sixty-seven soldiers for each corps, with the entire ambulance organization under command of a medical officer. A variation of that idea was an ambulance company for each division. The Sanitary Commission proposed an ambulance regiment for the Army of the Potomac.53 Some medical officers adopted partial remedies. The Army of the Potomac published an order written by Surgeon Charles S. Tripler, the medical director, detailing twenty-five soldiers per regiment as an ambulance corps under the supervision of the brigade surgeon. Tripler required the medical officers to train the medical soldiers on a daily basis and sent his medical inspectors out to check on the instruction. The inspectors also checked the number and kind of ambulances, their condition, and whether the soldiers and vehicles were employed solely in medical evacuation.54 In the West, Surgeon Brinton organized the regimental ambulances into ambulance trains, each under a noncommissioned officer "whose business it was to see that a continuous line of wagons should ply between the scene of conflict and the general hospitals."

Brig. Gen. William A. Hammond, a 34-year-old officer, replaced General Finley as surgeon general in April 1862. Hammond, at six feet, two inches in height, 250 pounds, possessing a booming voice and an aggressive and abrasive personality, was by no means a shrinking violet. Backed by the Sanitary Commission, he had been appointed by President Lincoln over Secretary of War Stanton's objections and immediately incurred the wrath of that powerful man. But at first inertia rather than hostility was Hammond's chief problem. Hammond quickly focused on the need for a coordinated evacuation and treatment capability and recommended establishment of an ambulance corps. However, Maj. Gen. Henry W. Halleck, the Army's general-in-chief, rejected the proposal, declaring that ambulances would add to the problem of large combat trains, the ever-present "tooth-to-tail" argument. Halleck also feared that the presence of medical personnel on the battlefield would spread panic among soldiers who might view them as harbingers of suffering and death. Hammond tried again in September, pleading: "I only ask that some system may be adopted." He lamented that 600 wounded soldiers still lay unattended on the battlefield of Second Bull Run, dying of starvation and neglect. His pleas were again rejected.

The surgeon general persisted, making the establishment of a permanent hospital and ambulance corps the highest priority in his annual report for 1862. He argued that it would enable the Medical Department to enlist soldiers specifically for hospital nursing duties and for the operation of field ambulances, rather than having to depend on the unreliable practice of detailing soldiers from other branches. However, he was unable to get War Department support for his proposal that year.

The Letterman Plan

That same year, however, Hammond selected Maj. Jonathan Letterman as medical director for the Army of the Potomac. What the surgeon general was blocked from doing for the Army, the 38-year-old Major Letterman was able to do for the Army's largest combat formation by putting together an ambulance corps as part of a unitary medical support system. Letterman, a veteran officer with thirteen years in the Army and field medical experience in the campaigns against the Seminole, Navajo, Apache, and Ute Nations, reported on 1 July 1862 to Maj. Gen. George McClellan in Virginia at Harrison's Landing on the James River. Here the Seven Days Battle was in progress and casualties were mounting. Letterman inherited what McClellan described as a collapsed situation: "Supplies had been almost exhausted or necessarily abandoned or destroyed, and the medical officers [were] deficient in numbers or broken down by fatigue."

Letterman, a man of "remarkable energy and ability," moved quickly to establish an integrated medical capability based on three principal elements: a coordinated system of casualty evacuation from the point of wounding back through the division rear; organization of medical logistics, including supply tables and transportation; and establishment of division field hospitals as part of the evacuation chain. Supported by his commander, he set forth his plan in Army of the Potomac General Orders 147, 2 August 1862, which placed all ambulances under the control of the medical director. Captains commanded the corps-level ambulance organization, first lieutenants commanded at the division level, second lieutenants led at the brigade level, and sergeants at the regimental level. Those ambulance officers were progenitors of present-day Medical Service Corps ground and air ambulance officers.

Letterman's use of nonphysician officers to command ambulance units represented a significant shift in Army Medical Department policy. He intended to relieve the physicians from duties that distracted them from their primary mission of patient care, especially in combat. Letterman knew that at such times the needs of the wounded "prevented any supervision [of ambulances], when supervision was, more than at any other time, required."

Another important feature of Letterman's plan was the assignment of vehicles to the direct control of the medical director. Two-patient ambulances, each with two privates and a driver, were allocated on the basis of three for each infantry regiment, two for each cavalry regiment, and one for each artillery battery. Two supply wagons were assigned to each division's ambulance corps. The use of those vehicles was strictly restricted to the Medical Department. Only medical personnel were permitted to accompany the sick and wounded to the rear, and only bona fide patients were allowed to ride in the ambulances. A Union chaplain described Letterman as "virtually a medical dictator."

Letterman implemented his plan later in the year as the Army of the Potomac fought in Virginia and then moved north into Maryland. It was only partially in place for the Battle of Antietam in September 1862, where, during twelve hours of combat, casualties from both sides rose to over 22,700. McClellan's casualties mounted to 25 percent of the soldiers who went into action. On the Union right wing, where Letterman's plan was in place, casualties were rapidly evacuated and all wounded within the Union lines were removed during the night. Casualties on the left, where the new evacuation plan was not in place, were not removed until the following night.

Full implementation of Letterman's plan occurred three months later, at Fredericksburg. There, Letterman reported that the ambulance corps had begun to evacuate the wounded after dark on 13 December and by daylight had removed all the casualties except some twenty soldiers who were within the Confederate lines. Surgeon General Hammond, visiting the Army of the Potomac, was pleased with the results; even more important, commanders began to recognize the advantages of a system that reduced straggling as it saved the wounded.

General McClellan wrote that Letterman's ambulance corps decreased the number of combat soldiers pulled from the battlefield, "one of the great desiderata for our armies." The Army of the Potomac continued to benefit from its unified medical support capability in battles after Antietam. There were 14,193 wounded Union soldiers at Gettysburg, 1-3 July 1863, yet there were no wounded left on the battlefield within Union lines by early morning the day after the battle. Letterman reported: "I know of no battlefield from which wounded men have been so speedily and so carefully removed." By the summer of 1864 the Army of the Potomac's ambulance corps numbered 800 ambulances with 66 officers and 2,600 enlisted soldiers. The medical director's central control provided the flexibility necessary to tailor the medical system to meet changing requirements. Capt. J. G. Pelton, chief of II Corps ambulances, said he could easily shift vehicles and medical soldiers throughout his corps area of operations so as to place the evacuation capability where it was most needed.

Union Army units that failed to adopt Letterman's innovations continued to experience difficulty in battlefield evacuation. Surgeon Glover Perin, upon becoming medical director of the Army of the Cumberland in February 1863, found an inefficient ambulance service. He attributed this to the absence of commissioned ambulance corps officers, the lack of attendants, and the control of ambulances by the Quartermaster Department. He adopted a modified Letterman plan, but even with that in place the Army of the Cumberland left behind an estimated twenty-five hundred of its wounded at Chickamauga in September 1863. Surgeon Thomas A. McParlin, then medical director of the Army of Virginia, received a copy of Letterman's plan and submitted it to his commander, Brig. Gen. John Pope, but there was not enough time to implement it before Second Manassas. McParlin believed that Pope's army would greatly benefit from an ambulance corps. "The lessons of experience should not be disregarded, especially in matters of such transcendant importance. At such a time, a well organized, regularly established ambulance corps would have been a blessing."

Other armies agreed. The South was never able to field an evacuation and treatment system as sophisticated as the North's, but in Europe, French Army surgeons applauded the American innovation of placing the treatment and evacuation systems under complete medical control. As knowledge of Letterman's innovation spread, European armies proceeded to adopt his system.

A by-product of these innovations was the emergence of a small cadre of junior officers who understood the problems of medical evacuation. Those ambulance corps officers were often recognized for their achievements and valor. Letterman cited Capt. J. M. Garland for outstanding service in equipping the II Corps ambulance organization and for the care and diligence with which his soldiers removed the wounded at Antietam. Surgeon Henry S. Hewitt recognized Capt. S. Windecker, 103d Ohio Volunteers, for managing the Army of the Ohio evacuation system "in the most systematic and praiseworthy manner." Windecker's leadership had enabled Hewitt to keep just one physician with each regiment, while moving the others to the field hospitals where their medical talents could be pooled.

Lt. Henry Knight was cited for his courage under fire during the Union Army's disastrous assault at Fredericksburg in 1862. Capts. W. F. Drum, B. W. Baldwin, and J. G. Pelton of the Army of the Potomac won commendations for ambulance operations that were "well and gallantly performed." Lt. Joseph C. Ayer, chief of the 1st Division ambulances, estimated that his unit evacuated nearly six hundred soldiers during Fredericksburg, and in 1863 he reported that his ambulances evacuated 1,157 casualties in the Battle of Gettysburg. Letterman commended the ambulance corps for performing in a "commendable and efficient manner" at Gettysburg, on a day in which one ambulance corps officer and four privates were killed.

On 11 March 1864, Hammond's efforts and the success of Letterman's plan, backed by petitions and lobbying efforts, resulted in congressional action that established a permanent ambulance corps. The law authorized corps commanders to detail officers and enlisted soldiers to form their ambulance organizations and provided for the examination of candidates by boards of medical officers. As one citizens' committee put it, the Army should carefully screen the officer candidates because of the special trust it placed in them, and they should "at least equal the best of the fighting-men in gallantry." The War Department implemented the law in General Orders No. 106, 16 March 1864, a directive that also gave commanders the authority to create a distinctive uniform for members of the Ambulance Corps.

Despite his success, Letterman had grown tired. In December 1863 he asked for relief from "18 months of arduous and eventful duty." He was reassigned as Medical Inspector of Hospitals, Department of the Susquehanna. General Hammond, while successful in obtaining the Ambulance Corps legislation, had become further alienated from Secretary of War Stanton. In May 1864 he was dismissed from the service by a court-martial on charges trumped up by Stanton. Letterman resigned from the service at the end of the same year. The achievements of both lived on after them.

Aged Woman Bares Secret of Youth; She was a Drummer Boy in Union Army

From: Logansport Pharos Tribune (Logansport, Indiana) Apr 11, 1921

OAKLAND, Cal. — For 58 years Mrs. Anna Glud, of this city, has nursed a romantic secret.

And then, on her 68th birthday, with a family group about her, the white haired old lady revealed the amazing story of how, at the outbreak of the civil war, she had cut her hair, donned the uniform of a Union fighter and gone to the war as Tom Hunley a drummer boy.

That she had not previously bared her secret was due partially to the fact that her family had been divided on the war issues and she waited for time to heal the wounds; partially because of a somewhat natural reluctance.

But she did not wish the secret to go to the grave with her and so the story of Tom Hunley came to light.

Two persons had known her secret — Jermiah Hunley, her father and Gen. Grant, in whose charge her father had placed her.

The Hunley’s lived in a “border” state. Two sons went with the Union forces and two with the Confederate. Then the father was called.

Father Cuts Hair.
The prospect of leaving his little girl among strangers, unprotected and uncared for, was too much, so he dressed her in the uniform of a drummer boy, cut off her hair, told her to always remember her name was “Tom,” and joined the regiment.

For two years “Tom” Hunley and “his” father served with the Union forces in the bloodiest battles of the civil war. Never once was the identity of the little “drummer boy” suspected. There came a day, however, when Jeremiah was forced to reveal the secret of his daughter’s masquerade. General Grant inspected the regiment and seeing the diminutive “drummer boy” decided “he” was too young for active service, and ordered “him” mustered out. Thereupon Jermiah told him the story of the motherless little girl. The General swore himself to secrecy and ordered “Tom” Hunley’s retention in the service.

Reminiscing, the former “Tom” Hunley said: “During all that time though many remarked that I looked more like a girl than a boy, not one soldier discovered that I was a girl. Father and I kept together so constantly that I was always protected. Had I not had his assistance at all times, I doubt that I could have stood the rigors of a soldier’s life during those two dreadful years.

Feet Red With Blood.
“Why, in a battle near Davisville, when 7000 confederates and northerners were killed, our little body of men literally had to climb over the bodies of dead soldiers in order to fight our way out. My little feet were red with blood. And when we were mustered out in the fall of 1864 there were but 17 members of our company left.”

The war over, Jermiah and “Tom” Hunley settled down in Indiana. But the rigors of war were too much for the father and in six months time he followed his wife and four sons into the Beyond, leaving his little girl, now re-attired in the dress of her sex, to continue life under the guidance of newly-made friends.

Twenty years later, General Grant died without having revealed the secret of “Tom” Hunley, and a secret it has remained until recently when Mrs. Glud revealed it.


Emerging Specialties


Outside the Union's Ambulance Corps, other specialists appeared during the Civil War. A remarkable example of hospital administration could be found on the Confederate side of the line. In Richmond, Sally Louisa Tompkins headed Robertson Hospital, which, staffed with Confederate Army physicians, had a mortality rate lower than any other in the city. Abuses by some private hospitals caused the Confederacy to pass a law restricting the treatment of Confederate soldiers to hospitals commanded by commissioned officers. Jefferson Davis desired to retain Tompkins' hospital, and thus Captain Tompkins became the only woman commissioned in the Confederate Army.

Such specialists were needed. Administrative requirements bedeviled medical officers of both sides, a situation aggravated by the rapid expansion from a small regular army to a very large, mostly volunteer, military. "Army doctors in administrative positions apparently were quite at a loss in performing the duties incident to them." They were assisted by enlisted hospital stewards, who were responsible for general administration and were superior to all other hospital noncommissioned officers, enlisted soldiers, and nurses. But seldom was there the guiding hand of an officer who understood administration and was devoted to that function alone.

Pharmacy was emerging as the accepted specialty for the compounding and dispensing of drugs. Schools of pharmacy had been established in the 1820s and the American Pharmaceutical Association formed in 1852. Civilian pharmacists were employed in the larger Army hospitals in the Civil War because, unlike the French, the Americans provided no commissions for pharmacists. The American Journal of Pharmacy criticized the lack, but there was no movement in that direction, and the argument over commissioning pharmacists would continue well into the next century.

Chiropody, performed by civilians under contract to the Army, would be incorporated into the Medical Service Corps in the next century. Isachar Zacharie, a skilled chiropodist and political opportunist, received publicity as the favored bunion cutter for Lincoln, Secretary of War Stanton, and General McClellan. Lincoln credited Zacharie as the specialist who "put me on my feet," and his fame led to calls for the creation of a chiropody corps.

The need for a medical supply system operated by members of the Medical Department was a lesson learned over and over again. Supply problems generated frequent complaints, but line officers continued to relegate medical logistics to the status of "least important in the Army." Letterman, as he had done with the ambulances, worked out an arrangement with the Army of the Potomac's quartermaster that gave him exclusive control of medical wagons. He said that it was very important to place this capability within the medical organization so as to make the medical system self-sustaining and largely independent.

Congress improved the situation on 20 May 1862, when it authorized the Medical Department to commission U.S. Army Medical Storekeepers (USAMS), a precursor of Medical Service Corps medical logistics officers. General Hammond, while pleased with the congressional action, said the number allotted was too small. The War Department appointed a selection board, limited appointments to apothecaries or druggists, and required applicants to post a $40,000 bond before entering active duty-an extraordinary sum for the day.

Hammond called the medical storekeepers "a most useful class of officers," and he expanded their duties to include medical purveying, thereby releasing physicians in those assignments to medical duties. Four of the six successful candidates were later given additional appointments as acting medical purveyors. Medical storekeepers were paid $1,750 a year, including the quarters and allowances of a first lieutenant, but no rank was assigned and by custom they were addressed variously as "captain" or "mister." Their abridged military status meant that neither they nor their families were eligible for pensions or death benefits. Congress rectified the oversight in 1867 by giving them the rank and pay of cavalry captains.

Henry N. Rittenhouse, USAMS, described his position as "one of considerable magnitude." Hennell Stevens, USAMS, said accountability was "right and thorough." George Taylor Beall, USAMS, was commissioned as a medical storekeeper in 1866 and assigned to the medical purveyor's office in Santa Fe, New Mexico. In 1875 he transferred to the St. Louis Medical Depot where he was responsible for purchasing over $1 million in medical supplies and equipment before his retirement in 1894.93 The duties of Rittenhouse, Stevens, and Beall required a knowledge of pharmaceuticals, but Rittenhouse insisted that the major prerequisite was general management skills. "Scientific knowledge is not much called into play; what is required is a thorough business knowledge, a familiarity with the various customs of ordinary business transactions, sound judgment, and intimate acquaintance with the regulations, laws, orders, and circulars of the Medical Department."

Overall, Civil War advances in the care of the sick and wounded had resulted less from improvements in medical science than from improved organization for medical support and the addition of new specialists to the Medical Department, such as the officers of the Ambulance Corps and the U.S. Army Medical Storekeepers. The war had seen the emergence of a genuine chain of evacuation, the appearance of large numbers of female nurses in the military hospitals, and the creation of the largest, most complex, best integrated military medical system the United States was to know until the twentieth century.


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