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.

Thursday, July 23, 2015

Lincoln General Hospital, Washington, D.C.


Birds eye view of Lincoln General Hospital, Washington, D.C., seen from the rear, 1865.
From Reports on the extent and nature of the materials available for the preparation of a medical and surgical history of the rebellion (Philadelphia, 1865).

The Lincoln General Hospital, a pavilion-type hospital, was active from December, 1862, until August, 1865, and located about a mile from the Capitol building in Washington.  Over 21,000 troops and prisoners were admitted over the course of the war.

The Confederacy and Coca-Cola

By Michael Climo, 6-28-14

Most everyone recognizes the soft drink Coca-Cola as one of the most prominent brands known today. But, did you know that the discovery of Coca-Cola was made by a former Confederate soldier and was unintentional? Initially it was formulated as a tonic to cure almost everything. But today Dr. John Stith Pemberton’s creation has since become one of world's most iconic and profitable brands.

John Stith Pemberton was born on January 8, 1831 in the small town of Knoxville, Georgia near Macon. At an early age his family moved to Rome where he was raised and attended school. His father, James Clifford Pemberton, was a native of North Carolina. His Uncle, Confederate General John Clifford Pemberton, is best known as the man who surrendered Vicksburg to the Union. Around the middle of 1840 John Pemberton returned to Macon and enrolled at the Reform Medical College of Georgia. He took courses in pharmacy and medicine and was trained as a steam doctor. This was a popular system devised by doctor and herbalist Samuel Thomson. The procedure relied on herbal treatments and steam baths that was believed would help patients rid themselves of disease by sweating. In 1850 at the age of 19 Pemberton received his degree. Later he acquired a more conventional pharmacy degree but the exact date and place are unknown.

In the early 1850s Pemberton launched a medical and surgical career in Rome. In 1853 he married Ann Eliza Clifford Lewis, a student at Macon's Wesleyan College, and the pair moved to Columbus, Georgia. The following year their son Charles was born. Pemberton was always looking for greater financial opportunities than those of an average small-city pharmacist. In 1855 he established a wholesale-retail business selling the raw materials for pharmaceutical remedies sold in apothecary shops and less formal retail environments like medicine shows across the South.

After the outbreak of the War Between the States, Pemberton enlisted in the Confederate Army and in May of 1862 was made a first lieutenant. He organized the Third Georgia Cavalry Battalion for the defense of Columbus and reached the rank of lieutenant colonel. Pemberton’s unit was in the line of fire when Union troops under General James Wilson attacked Columbus on Easter Sunday of 1865. Although there was an encounter later at Palmitto Ranch, Texas, and fighting even later in Alabama, the attack on Columbus, Georgia was the last large-scale battle of the war. Pemberton received a saber slash across his chest during the struggle for the 14th Street Bridge. Like many other wounded veterans, he became addicted to the morphine that was used for a pain-killer.

After the War's end and his recovery Pemberton returned home and formed a partnership with wealthy Columbus physician Austin Walker. He expanded his laboratory with the aim of devising new products and selling medicines and photography supplies. He branched out into cosmetics and found success with a perfume called Sweet Southern Bouquet. In 1869 Pemberton partnered with larger investors in Atlanta and formed the firm of Pemberton, Wilson, Taylor and Company. In 1870 he moved with his family to Atlanta and began to make a name for himself in the growing city's medical establishment, serving as a trustee of Atlanta Medical College (Now known as Emory University Medical School). Pemberton's labs were state-of-the-art and they remain in use today as a soil and crop chemical testing facility for the Georgia Department of Agriculture.

Among the successful products Pemberton launched in Atlanta in 1885 was a drink he called Pemberton's French Wine Coca. The product contained coca leaves from South America which were precursors to cocaine. Pemberton promoted the drink, which was served at pharmacy counters, as a nerve tonic, a mental aid, a headache remedy, and a cure for morphine addiction. When interviewed by an Atlanta newspaper he admitted that the concoction was based on an Italian-French product, Vin Mariani, that contained a similar wine-coca mixture. Pemberton's innovation though was to add extracts from other tropical plants like the caffeine containing kola nut produced by a genus of African trees and Damiana, a Central American shrub leaf reputed to have aphrodisiac properties.

In 1866 alcohol prohibition plans began to circulate within Atlanta's city government (it was eventually implemented but lasted only one year). Pemberton was worried that his newly popular product might soon be banned so he embarked onto more experimentation. Using a laboratory at his home on Marietta Street in Atlanta, Pemberton's French Wine Coca began to evolve into Coca-Cola. He devised an industrial sized mixing and filtering apparatus that ran from the house's second story through the floor to the ground level. Samples of his new alcohol free syrups were sent out to local pharmacies for testing with Pemberton's nephews assigned to report on customer reactions. One key breakthrough occurred when Pemberton came up with the idea to add citric acid to counteract the sweetness of the sugar based syrup.

By May of 1886 Pemberton was ready with his final formula and it was first sold in syrup form at Atlanta's Jacob Pharmacy. In the beginning it was served at the counter mixed with water to create a beverage that retailed for five cents. A pharmacy clerk who’s’ name is lost to history made a brilliant enhancement when he had the idea to use soda water in place of the normal plain water. The new Pemberton Chemical Company was formed to market his new drink and he put his son Charles in charge of production. One of his partners in the new business was the bookkeeper named Frank Robinson. He also came up with the name Coca-Cola referring to the drink's two active ingredients and created the antique script logo still in use today.

Total Coca-Cola sales for the first year of operations were only $50, a failure in Pemberton's view because he had spent $70 on supplies. But Robinson believed that exposure was all that was needed and persuaded Pemberton to devote a significant marketing budget to help popularize the new concoction. He agreed and banners, streetcar placards, and store awnings emblazoned with the message “Drink Coca-Cola” could be found all around Atlanta. Soon the product was spreading across the city and Pemberton was convinced it was on its way to national popularity.

Pemberton however did not live to reap the profits from his invention. Suffering from stomach cancer he progressively sold off two-thirds of his interest in the company to other investors, including the transplanted Northern pharmacist Asa G. Candler. In the last months of his life he dragged himself to his laboratory repeatedly in search of further improvements to the Coca-Cola formula convinced that celery extract was the key to a still more attractive taste. Pemberton died on August 16, 1888 leaving his wife in a difficult financial situation.

A struggle for control of Coca-Cola soon followed his death. The financial maneuverings that occurred were murky with rights to both the name Coca-Cola and the formula for the drink under dispute. Candler now sought to move swiftly forward to taking full control of the whole Coca-Cola operation. It has never been entirely clear how Candler wrested control of the company from Charles Pemberton and the other investors. Eventually, Charles Pemberton was found on June 23, 1894, unconscious, with a stick of opium by his side. Ten days later, Charley died at Atlanta's Grady Hospital at the age of 40.

In Charles Howard Candler's 1950 book about his father, he stated: "On August 30th {1888}, he {Asa Candler} became sole proprietor of Cola-Cola, a fact which was stated on letterheads, invoice blanks and advertising copy." With this action on August 30, 1888, Candler's sole control became technically all true. By May 1, 1889, Candler was now claiming full ownership of the Coca-Cola beverage, with a total investment outlay by Candler for the drink enterprise over the years amounting to $2,300.

The first bottling of Coca-Cola occurred in Vicksburg, Mississippi at the Biedenharn Candy Company in 1891. Its proprietor was Joseph A. Biedenharn. The original bottles Biedenharn bottles were very different from the much later hobble-skirt design now so familiar. Asa Candler was tentative at first about bottling the drink but two entrepreneurs from Chattanooga, Tennessee, Benjamin F. Thomas and Joseph B. Whitehead, proposed the idea and were so persuasive that Candler signed a contract giving them control of the procedure for only one dollar. Candler never collected his dollar, but in 1899, Chattanooga became the site of the first Coca-Cola bottling company. In 1905 fresh coca leaves were replaced by spent coca leaves, the part of the plant left over after cocaine is extracted and by the 1930s the drink was a fixture of American life.

By the time of its 50th anniversary in 1936 the soft drink had reached the status of a national icon in the USA. On July 12, 1944 the one-billionth gallon of Coca-Cola syrup was manufactured by The Coca-Cola Company. As Paul Harvey used to say, “Now you know the rest of the story.”


List of Drugs Carried in a Civil War Medical Wagon


The following list of drugs would have been carried in a Civil War medical wagon per the Medical Department regulations and Appendix A of the Supply list.

List of Drugs carried in a Civil War Medical Wagon
(See the 1861 Revised Army Supply Table list of drugs for field and hospital, which is in Latin, as are the labels for the various containers.)

acetate lead
alcoholic extract of belladonna
aromatic spirit of ammonia
aromatic sulphuric acid
bicarbonate potassa
bicarbonate soda
blistering cerate
blue mass
carbonate ammonia
castor oil
cerate of cantharides
chlorate of potassa
chlorate potassa
chlorinated solution of soda
citrate iron and quinia
citrine ointment
compound cathartic pills
compound extract of colocynth
croton oil
Dover's powder
extract of belladonna
fluid extract cinchona (aromatic)
fluid extract ginger
fluid extract ipecac
fluid extract of aconite root
fluid extract of cinchona, aromatic
fluid extract of colchicum seed
fluid extract of ginger
fluid extract of ipecac
fluid extract seneka
Fowler's solution,
fused nitrate silver
ground cayenne pepper
Hoffman's anodyne
iodide of iron
iodide of potassium
iodide polassium
mercurial ointment,
mercury with chalk
nitrate of silver (crystals)
oil of turpentine
olive oil
permanganate of potassa
pills of camphor
pills of compound extract of colocynth
pills of opium
pills of sulphate of quinia
powdered compound extract colcoynth.
powdered gum Arabic
powdered ipecac
powdered opium
powdered Rochelle salt
powdered squill
powdered subsulphate iron
powdered tartaric acid
pure chloroform
pure glycerin
purified chloroform
resin cerate
Rochelle salt, 16 oz.
simple cerate
solution chloride zinc
solution of ammonia
solution of chloride of zinc
solution of chlorinate of soda
solution of persulphate of iron.
spirit of nitrous ether
strong alcohol
stronger ether (for anaesthesia)
stronger ether
subnitrate bismuth
sulphate cinchona
sulphate magnesia
sulphate of copper
sulphate of morphia
sulphate of quinine
sulphate zinc
sweet spirit of nitre
syrup of squill
tannic acid
tartar emetic
tincture chloride of iron
tincture of opium

(Note: In 1856 Edward Robinson Squibb founded a pharmaceutical company in Brooklyn, New York, dedicated to the production of consistently pure medicines. In 1895 Squibb passed most of the responsibility for managing the firm to his sons, Charles and Edward. The company became known as E.R. Squibb & Sons.  So, any Squibb products used in the Civil War will NOT have '& Sons' on the label.)

In a Civil War Squibb pannier various anesthetics were labeled:

Chloroform was labeled: CHLOROFORMUM PURIFICATUM. (chloroform) and packaged in twelve fluid ounces

Ether was labeled: SPIRITUS AETHERIS COMPOSITUS. (compound spirits of ether) packaged in four fluid ounces) or as SPIRITUS FRUMENTI. (spirits of nitric ether) Twenty-four fluid ounces

Morphine was labeled: LIQUOR MORPHIAE SULPHATIS. (morphine sulphate solution) Sixteen grains to the fluid ounce, four fluid ounces)

Opium was labeled: PILLS OF CAMPHOR AND OPIUM. Twenty dozen; PILULAE OPII. (opium pills) Sixty dozen; PULVIS IPECAC: ET OPII. (powder of ipecac and opium) In five gram pills, thirty dozen; TINCTURA OPII. (tincture of opium; laudanum) Six fluid ounces

Image: U. S. Army Hospital Department pannier label by Squibb

Medical Schools in Existence Prior to and During the Civil War

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

The following list of medical schools were in existence prior to the Civil War and graduated doctors who ‘may’ have been the right age to have served in the Civil War as a surgeon.  There are contract surgeons (irregulars) and Union surgeons in the Army (regulars), either of which could have served in the Civil War.  Most surgeons in the War were trained during the 1840’s and 50’s.  The value of this information is that it serves to help document if a given doctor, surgeon, or officer, in fact could have served in the War.  If the school they attended is not on this list or the dates do not make sense, then it helps in the process of elimination.

1.   College of Philadelphia: The University of Pennsylvania School ,of Medicine, established 1765
2.   Jefferson Medical College of Philadelphia, established 1825
3.   Medical Department of Pennsylvania Col­lege, established 1840-61
4.   Philadelphia College of Medicine, estab­lished 1838-59
5.   Franklin Medical College, established 1846­49
6.   Pennsylvania Medical University of Philadel­phia, established 1853-61

New York
1.   King’s and Columbia Schools of Medicine, established 1767
2.   College of Physicians and Surgeons, established 1807-13
3.   Rutgers College (Queens College), established 1812-16
4.   New York University Medical College, established 1837
5.   New York School of Medicine, established 1830­33
6.   New York Hospital School of Medicine, estab­lished 1843-44
7.   Long Island College Hospital, established 1858­62
8.   Bellevue Hospital Medical College, established 1861 and later merged with N.Y.U. Medical College
9.   College of Physicians and Surgeons, Western District of New York State (Fairfield Medical College) estb. 1812-38
10. Auburn Medical School, established 1825-39
11. Geneva Medical College, established 1834-46
12. Albany Medical College, established 1838
13. University of Buffalo Department of Medicine, established 1846

1.   Medical School of Harvard, established 1782
2.   Berkshire Medical Institute of Massachusetts, established 1837-69

New Hampshire
1.   Dartmouth College, Department of Medicine, established 1797

1.   Medical Institute of Yale College, established 1802

Rhode Island
1.   Brown University Medical School, established 1811

1.   Medical School of Maine, Bowdin College, established 1820-1834

1.   Castle ton Medical College, established 1818-61
2.   University of Vermont Medical Department, established 1820
3.   Vermont Medical College, established 1827-56

1.   College of Medicine of Maryland, established 1807
2.   Washington Medical College of Baltimore, established 1826-39

District of Columbia
1.   Columbian College, Medical Department (National Medical College), established 1825
2.   Georgetown College School of Medicine, estab­lished 1851

South Carolina
1.   Medical College of South Carolina, established 1823

1.   Medical Lectures of William and Mary, estab­lished 1848-49
2.   College of Physicians of the Valley at Winches­ter, established 1825-29
3.   Winchester Medical College of Virginia, estab­lished 1847-62
4.   Medical Department University of Virginia, established 1825
5.   Medical Department of Randolf-Macon Col­lege, established 1837-54
6.   Medical Department of Hampden-Sidney College, established 1837-54
7.   Medical College of Virginia, established 1854

1.   Medical College of Georgia, established 1829
2.   Savannah Medical College, established 1852
3.   Atlanta Medical College, established 1855-98
4.   Oglethorpe Medical College, established 1856-­61

1.   Medical Department of Transylvania University, established 1816-59
2.   Louisville Medical Institute, established 1833
3.   University of Louisville Medical Department, established 1845
4.   Kentucky School of Medicine, established 1849­-1908

1.   Medical College of Ohio, established 1821
2.   Miami University Medical Department, estab­lished 1831-61
3.   Medical Department of Cincinnati College, established 1835
4.   Cincinnati College of Medicine and Surgery, established 1850
5.   Miami Medical College established 1853-57
6.   Willoughby Medical College, established 1834­45
7.   Starling Medical College, established 1848-73
8.   Cleveland Medical College - Western Reserve College, established 1843

1.   LaPorte University Medical Department, established 1843-51
2.   Indiana Central Medical College, established 1849-52
3.   Medical College of Evansville, established 1849­-54

1.   Medical College of Louisiana, established 1834
2.   Medical Department of University of Louisiana, established 1845
3.   New Orleans School of Medicine, established 1856-61

1.   Franklin Medical College, established 1842-46
2.   Medical Department of Illinois College, estab­lished 1843-48
3.   Rush Medical College, established 1843
4.   Medical Department of Lind University, estab­lished 1859
5.   Chicago Medical College, established 1864
6.   Northwestern University School of Medicine, established 1869
7.   Rock Island Medical College, established 1848­49

1.   Wisconsin Medical College, established 1854

1.      College of Physicians and Surgeons of the Iowa University, established 1850

1.   University of Michigan Medical School, estab­lished 1849

1.   Medical College of Kemper College, established 1841-47
2.   Missouri Medical College, established 1847
3.   Medical Department of the Missouri Institute of Science, established 1856
4.   Medical Department of St. Louis University, established 1842
5.   St. Louis Medical College, established 1855 then became Washington University 1899
6.   Medical Department at Franklin Medical and Literary College, established 1849
7.   St. Louis College of Medical and Natural Sci­ences, established 1855
8.   Humboldt Medical College, established 1859

1.   Memphis Medical School, established 1846-61
2.   Medical Department of the University of Nash­ville, established 1850 which became
3.   Shelby Medical College then became Medical Department of Vanderbilt University

1.   Medical College of Alabama, established 1859-­61

1.   University of Pacific Medical Department, established 1859

Image: Jefferson Medical College of Philadelphia faculty 1856, among the many famous Civil War doctors are:  Samuel D. Gross, Jacob M. Da Costa, Bartholow Roberts, Wallace, Rodgers, Pancoast,, Chapman, and others.


Navy Medicine in the Civil War


Whether victims of disease or hostile action, Sailors required treatment and much Navy medicine took place at hospitals in Chelsea, Brooklyn, Mound City, New Orleans, and Philadelphia. By the fall of 1862, Navy hospitals were filled to their utmost capacity. As a result, medical facilities at navy yards and naval stations were expanded and both civilian and Army hospitals were also treating naval patients. To remedy the situation, a major hospital expansion campaign began. Unfortunately, many of these improvements weren’t realized until the very end of the war.

Following their recapture by Union forces, the two naval hospitals in the South—Portsmouth (Va.) and Pensacola were put back into operation. In addition to the naval hospitals that had been established before the war, at least four others came on line between 1862 and 1865. These hospitals at Mound City, Ill. (1862); Memphis, Tn. (1863); New Orleans, La. (1863); and Port Royal, S.C. (1864), were located within the theater of operations of the blockading river squadrons and acted as receiving hospitals, taking patients on a short-term basis.

Image: Navy Hospital, Chelsea, Mass

Mary Ashton Rice Livermore (1820-1905): My Story of the War


"My story of the war: a woman’s narrative of four years personal experience as nurse in the Union Army…" Hartford, Conn.:   A. D. Worthington and Company, 1888.

"The story of my life: or, The sunshine and shadow of seventy years…" Hartford, Conn.: A. D. Worthington and Company, 1898.

Mary Ashton Rice Livermore, a native of Boston, Massachusetts, is one of the most well-known female figures in the Union relief movement. Before the Civil War broke out, Mary had already devoted her life to social, humanitarian and charitable causes.

In her early twenties, she worked as a family tutor on a large rural Virginia plantation. In this position, she came face to face with the injustices of slavery and became a staunch abolitionist. During these pre-war years, Mary also became known for her involvement in the temperance movement, which especially thrived after her marriage to fellow temperance supporter and Universalist minister, Daniel Parker Livermore, in 1845. Mrs. Livermore organized a juvenile temperance group, the Cold Water Army, for whom she wrote short stories and read them aloud.

In 1857, the Livermores and their three daughters moved from Massachusetts to Chicago, where Mary assisted her husband in editing the Northwest Universalist paper, The New Covenant. There, she also helped found two charities, the Home for Aged Women and the Hospital for Women and Children (American Reformers).

When the war began, many relief organizations quickly emerged in the North, and in 1861 the United States Sanitary Commission was formed to coordinate these efforts. Mary Livermore, convinced of the need for female participation in war relief, and with the support of her husband, resigned many of her former obligations and became a leader in the Northwest Sanitary Commission, a division of the U.S. Sanitary Commission. In December 1862, Livermore and her friend, Jane C. Hoge, were appointed co-directors of the Chicago office.

As a leader in the Commission, Livermore set up local Soldier’s Aid Societies in her vicinity, raised funds and medical supplies for the soldiers, lobbied for the relief effort, wrote Commission reports, and inspected hospitals. She personally delivered and coordinated the delivery of supplies to the battle fronts. During these many visits, she acted as an attentive nurse, and transported discharged, wounded soldiers to their homes. In 1863, Livermore and Hoge organized the Great Northwestern Sanitary Commission Fair, for which Mary convinced President Lincoln to donate the Emancipation Proclamation document. The fair raised nearly $100,000 for the soldiers, and it became the model for similar fund raisers in the North.

As part of her war relief work, Mary Livermore had many opportunities to speak, during which she rallied women together and encouraged them to volunteer. After the war, she applied her speaking ability to the fights for temperance and women’s suffrage, often incorporating her Civil War experiences in these orations. In 1887, she first published a detailed account of her Sanitary Commission days in My story of the war. Not only did Livermore tell her own story in this volume, but she also included details regarding the work of other Northern nurses and women volunteers. This work is a great and important primary resource on the role of women in the Union relief effort. Later in life, she published another autobiography, The story of my life, which includes additional anecdotes from her Civil War experiences.

Clara Barton (1821-1912)


In her hometown of Oxford, Massachusetts, Clara Barton began serving humanity early in life when she set up a school for the children of her father’s sawmill workers in 1836. She was only fifteen years of age (Library of North American Biographies). Departing from this position in 1851 to enhance her education, Barton attended school at the Liberal Institute of Clinton, NY for one year. Thereafter, she found herself teaching again in Bordentown, NJ from 1852 to 1854. Clara’s school in Bordentown was one of New Jersey’s first free, public schools, and its great success and growth in such a short period of time caused the local school board to hire a male principal to supervise. This action, however, upset Clara, prompting her to leave her job and teaching career behind. Her departure has been described as "a tactful, characteristic display of independence" (American Reformers). But soon, with the help of her congressman, Barton secured a job with the Patent Office in Washington in 1854, becoming the first regularly appointed female civil servant (Notable American Women). These actions from Clara’s early years show a dedication to work and a pioneering spirit.

However, Barton’s humanitarian pursuits truly began when the Civil War broke out. First she came to the aid of Union soldiers who found themselves in Washington after being attacked at Baltimore. Many were wounded and without supplies, and so Clara placed advertisements in the newspaper for medicines, bandages, food and clothing donations. Initially she used her own rooms to store the abundant contributions. Soon her service expanded and she rented a warehouse to keep supplies, which she insisted upon personally delivering to the battlefields. The War Department at first objected to a female presence on the field, but her persistence won them over, and she eventually secured army carts and mules to aid in her distribution. Barton also prepared meals for the soldiers and nursed the sick and wounded, earning the name “Angel of the Battlefield”. Only for a brief time in 1864 was she affiliated with the army in any official capacity. During this year she was head nurse with the Army of the James under General Benjamin Butler (American Reformers). Otherwise, Clara preferred to remain independent of the official United States Sanitary Commission and Dorothea Dix’s division of nurses (Notable American Women).

At the war’s end, Clara set up a missing soldier’s bureau with the approval of President Lincoln. Then from 1866 to 1868, she traveled around the northern and western parts of the United States speaking about her war experiences. In 1869, Clara went to Europe for health-related reasons and there became familiar with the International Committee of the Red Cross. This organization was formed during a convention in Geneva in 1863 and became official when the Geneva Treaty was ratified by eleven European countries in 1864. These countries agreed that in future wars, the wounded, ambulances and sanitary personnel would be neutral. Clara Barton believed strongly in the ideals of the Red Cross and joined them in the Franco-Prussian War (1870-71) relief effort (American Reformers; Notable American Women). In 1877, she began a five-year campaign to initiate an American Red Cross. Some Americans clung to the Monroe Doctrine, a policy that said the United States should stay out of foreign affairs. And also, there was a general belief amongst the American people that their country would not face a war on their own ground again (Library of North American Biographies). However, Barton overcame these obstacles by appealing to the American need for peacetime disaster relief. Not only did her campaign result in the establishment of the American Red Cross in 1881, it also convinced President Chester A. Arthur to ratify the Geneva Treaty in 1882. Her suggestion for peacetime relief, known as the “American Amendment,” was adopted by the international organization. Clara Barton became the first president of the American Red Cross, a position she held until 1904.

A copy of Barton’s important book, The Red Cross; a history of this remarkable international movement in the interest of humanity, published in 1898, is held at the Reynolds-Finley Historical Library. The story recounts the establishment of the organization in Europe and its adoption by the United States. It also gives detailed accounts of specific early American relief efforts, during the Michigan forest fires, the Mississippi and Ohio River floods, the Texas Famine, the Johnstown Flood, the Russian Famine, the Spanish-American War, and several others. In 1899, this book was reprinted under the title The Red Cross in Peace and War, and the Reynolds-Finley Library also has a copy of this book.

The Beginnings of Modern Medical Attitudes

From: Research notes of Dr. Michael  Echols

A typical physician of 1820 was likely to a regard a seventeenth century medical text as of clinical importance; but a typical physician of 1880 was very unlikely to so regard it. Inspired by the incredible success of antisepsis and anesthesia in surgery, and by the leap in medical and surgical knowledge which almost always follows a major war, many physicians born between about 1820 and 1845 saw by the 1870s little practical need to preserve the pre-antisepsis, pre-anesthesia literature, let alone enshrine it, in institutional libraries. To be sure, they did not neglect reading in the furtherance of their clinical practice, but while their fathers preferred the venerable old medical books supplemented with case reports in the journal literature, they tended to limit their reading to current state-of-the-art breakthroughs in their particular fields, as recorded in the journal literature. At first they were able to fill their professional reading needs with private journal subscriptions and book purchases, but as topics became more diverse, more narrowly circumscribed, and as the literature on these topics became more vast, the next generation of physicians (George Milbry Gould's generation) came to discover that as individuals they could not each keep up with all the current literature relevant to their respective clinical practices, and thus had to rely upon libraries whether they wanted to or not. The last third of the nineteenth century was beginning of the complex specialization in medicine which we all recognize today -- and the literature of the time, both in quantity and in orientation, accurately reflected that. The standard bibliography of nineteenth century American medicine shows only 1406 medical titles published in the 1840s, but 10378 in the 1890s. Individual finances simply could not keep up with that explosion. As Charles Perry Fisher noted during his tenure as Librarian of the College of Physicians of Philadelphia, individual physicians practicing prior to 1879, when Index Medicus first appeared, were obliged to acquire and maintain private collections of medical journals, often at great expense, only to have these gatherings of a lifetime scattered and wasted after their deaths. The increasing difficulty for physicians to maintain current professional literature collections on their own was even more pronounced in the outlying areas.

Medical books tend to be more expensive than most books. This has always been the case. Medical libraries have always been hard-pressed financially to keep their holdings comprehensive (or at least adequate) with regard to the current state of the clinical art. For example, in the July 1866 catalog of prominent Philadelphia medical publisher Henry C. Lea, prices ranged from $1.00 for small duodecimos such as a popular work on skin care to $14.00 for Joseph Maclise's Surgical Anatomy and $15.00 for the four-volume Cyclopaedia of Practical Medicine, with most of the standard texts costing in the vicinity of $4.00 to $6.00. A modern medical text may seem cheap at these prices, but not in the days when most trade books sold for less than a dollar, medical journal subscriptions typically ran between $5.00 and $10.00 per annum, and postage was figured in half-cents. Nowadays a typical medical title will cost in the hundreds and a typical medical journal subscription could cost in the thousands per annum. Unlike individual physicians, medical libraries cannot pass these costs on to their patients, but rather must simply do without or else go begging. In this regard, institutional medical library management today is no different from what it was in the nineteenth century.

There seems to have been a generation of physicians and surgeons who came of age during the Civil War or shortly thereafter, who had no interest in the preservation of the records of bygone medical eras, and who believed that the typical contents of institutional medical libraries were of little or no clinical importance. This group dominated American medical culture in the 1880s. Their attitude that medical progress did not require libraries but only modern clinical and experimental results was gradually supplanted in the 1890s under the leadership of Gould, Charles D. Spivak, and Osler, among others.

Yet medicine is a conservative profession. For example, in the nineteenth century it was a frequent conceit among the Fellows of the College of Physicians of Philadelphia that theirs was the most conservative organization in America, not necessarily in the political sense, but certainly in the cultural sense. Such conservativism can be detected in the kind of support given in the 1870s to the most prestigious medical libraries, such as the New York Academy of Medicine and the Army Medical Library (now the National Library of Medicine). These white men, mostly rich and highborn, seem to have been motivated, over against the remarkable medical and surgical progress of the Civil War and its immediate aftermath (progress in which many of them indeed participated), to protect and preserve "the way we did things," i.e., the methods, results, and curiosities of their own bygone era, the antebellum American medical world. To illustrate this point, when the new library building of the New York Academy of Medicine was dedicated in October 1879, the average age of the sixteen participants on the podium was 61 (average birth year 1818), which means that most of them were already established professionals when the Civil War broke out. The entire cost of this project was paid by subscriptions and donations, so that at the time of dedication "not a single cent of debt remained."

In contrast to this prestigious societal medical library of the 1870s strongly supported by the "Old Guard," consider a medical library which was severely neglected from the 1870s to the mid-1890s, when it was under the governance of much younger physicians, about half of whom had little or no antebellum medical or surgical experience. In 1872 the average age of the eighteen physicians on the original faculty of the Syracuse University College of Medicine was only 47 (average birth year 1825). The older faculty such as Towler and Frederick Hyde supported the library, but, with the notable exception of John Van Duyn, most of the younger faculty gave little notice to it, and even Van Duyn's interest in the library was not manifest until much later in his career.

These younger physicians were mostly of the generation that provided such breakthroughs as first allowing women into the profession. They regarded themselves as progressive and perhaps even radical, both culturally and clinically, while the older generation would offer such laments as this, in 1879: "We regret to be obliged to announce that at a meeting of a councilors held on October 1, it was voted to admit women to the Massachusetts Medical Society."

Despite the financial hardship on individual physicians who tried to maintain their own respective collections of medical literature, institutional medical libraries were generally neglected, even scorned, for much of the second half of the nineteenth century, except by a few sagacious physicians such as John Shaw Billings, Samuel Smith Purple, Joseph Meredith Toner, Charles D. Spivak, and James R. Chadwick. Throughout the nineteenth century the institutional medical library remained a low budget item. Institutional acquisition of medical books was almost entirely by gift, by swapping duplicates, or by bulk purchase of used books, almost never by deliberate purchase of specific new titles.

Some of the slack in medical acquisitions was taken up by public libraries and other non-medical institutional libraries. In the nineteenth century, many public libraries, even free libraries, had substantial medical collections. Gould, for one, vigorously advocated that public libraries should acquire medical titles. But these collections eventually dwindled, mainly because public librarians could not meet the demands of physicians in either collection development or reference service. For example, in 1875 an anonymous physician (perhaps Chadwick) argued for the creation of an easily consulted medical library in Boston, because: "Admirable as the Boston Public Library is (in some respects), it must be confessed that so far as its medical department is concerned a liberal expenditure of both time and patience is often required before the seeker can obtain, if he obtains at all, a sight of the book or journal required." This same article announced the organization of the Boston Medical Library Association in response to this perceived need.

With a few notable exceptions, e.g., the libraries of Transylvania University, Harvard University, the New York Academy of Medicine, and the Boston Medical Library Association, private institutional medical libraries in the mid- to late nineteenth century tended not to have firm financial foundations. Although libraries had grown in size, funds for acquisition tended to be inadequate, and standards of service were almost nonexistent. In 1876 Chadwick reported on the situation of medical libraries in Boston. Harvard relied upon donations of volumes and money, and was extremely well off. The Boston City Library's medical collection consisted mostly of donated volumes from Boston's sizeable community of physicians, and was quite fortunate in both the variety and completeness of its journal runs. Four other medical libraries in Boston were funded by dues or by subscription, with varying degrees of success. In 1890 E. D. Ferguson reported that the Library of the New York State Medical Association was supported entirely by members' gifts of books, journals, and money.

Demand increased for the federal government to become involved, not in financing medical libraries, but in financing a single gigantic medical library. Should such a library be an outgrowth of the Army Medical Library which Surgeon General Joseph Lovell (1788-1836) had begun, and thus be a separate entity? or should it be just a department of the Library of Congress? This debate resounded through medical circles in the late 1870s and early 1880s.

Leading the political fight for the establishment and firm Congressional support of a national medical library were not the younger physicians, readers of the current literature, but the "Old Guard," whose main agenda was the preservation of old medical literature and the honoring of the pantheon of physicians. For example, Frederick Horner, who may have had ulterior motives insofar as he lived just across the Potomac in Alexandria, Virginia, gave lip service to the "original research" favored by young physicians, but his motivation was really that of the "Old Guard": "We need a safe repository [independent of the Library of Congress] for the invaluable writings of the fathers of American medicine and surgery ... and of the glorious galaxy of living men ... [and this proposed facility should include a] hall for statuary and a gallery for portraits of eminent members of the profession ..."

Considering options of involvement of the American Medical Association, the Library of Congress, and the Medical Society of the District of Columbia, Toner was in favor of venerating the entire medical tradition, but especially the American medical tradition: "The value of books to the medical man cannot be over estimated. They are the inexhaustible fount of knowledge from which the discoveries of the day, and the accumulated experience of ages may be drawn. The physician whose studies lead him to consult early American medical literature must be painfully struck with the perishable character of our professional literature, and the meager or fragmentary collections which have been made." In 1882 Toner announced his gift of 20000 volumes to the Library of Congress.

Billings is the real hero of this era. The federal government became heavily involved in medical librarianship only during the Civil War when Billings began to pursue his vision of making the Surgeon General's library the greatest medical reference collection in the world. As early as the mid-1890s the worldwide health care community generally acknowledged that he had achieved this goal, not only through developing the collection, but also through his founding of Index Medicus in 1879 and Index Catalogue in 1880. Billings denied reports that he was the founder of the Army Medical Library, naming Lovell and Hammond as his predecessors, but acknowledged that between 1865, when he assumed office, and 1880, the holdings of that library grew from 1800 to 50000 volumes. Even as early as 1878, one physician visiting the Army Medical Library expressed sheer amazement at the breadth and depth of the collection (e.g., bound volumes of pamphlets which had belonged to Claude Bernard). He praised Billings, the administration, and ambiance of the library, which was then housed in the old Ford's Theatre, scene of the Lincoln assassination, and which was well on its way toward outgrowing these walls.

In 1876 George F. Shrady applauded one of Billings' pet projects, Index Catalogue, claiming that it would place the world's medical literature in front of those who could not travel to Washington. In 1878 Shrady expressed the strong support of the medical community for Billings' plan to create this "index, as it were, of the medical literature of the world," even at the then huge cost to the taxpayers of $25000 for 3000 copies each of the first two volumes. The medical community's praises of Congress for its creation of a national medical library and for its funding of Index Catalogue were not in short supply. By 1883 a groundswell of support for Billings' program had arisen in state medical societies and other professional medical organizations. Gross successfully offered a strongly worded resolution at the annual meeting of the Medical Society of the State of Pennsylvania urging Congress to appropriate money for "the erection of a fire-proof building to contain the library and museum of the Surgeon-General's Office," noting with regret that such a bill had already once failed to be passed. James Reeves offered a similar resolution to the Medical Society of West Virginia, which passed it unanimously.

Image: The Surgeon General's library


Civil War Subsistence Department


In 1775 the Continental Congress created a Commissary General of Stores and Provisions used to provision the Continental Army; however, few funds were allocated to feed the army. Therefore, in 1818 Congress reorganized the Quartermaster Department and provided for a Subsistence Department under a Commissary General of Subsistence.

Responsible for provisioning the Army, the Subsistence Department controlled the procurement
of all rations. When the Civil War broke out there was a staff of twelve, four of whom left to join the Confederacy.

Joseph P. Taylor headed the Department for most of the war. As Commissary General, Taylor drew
up specifications for the various foodstuffs that made up Union rations. Private contractors submitted bids based upon those specifications. The lowest bid was chosen. Bulk food supplies were then packaged and delivered to depots and warehouses in major metropolitan centers including Boston, New York, Philadelphia, Cincinnati, and St. Louis.

When foodstuffs reached their point of distribution it became the responsibility of the Quartermaster's Department to get the food to the Army’s field of operations by various methods including steamboats, barges, and railroads. Quartermasters stored food temporarily in warehouses, sheds, or out in the open until it was shipped, usually by rail, to the army's advance depots. From there, army supply wagons carried the rations to temporary depots in preparation for ultimate distribution to soldiers.

The Subsistence Department not only purchased enormous amounts of pork, coffee, and hardtack, but they also provided flour to government run bakeries where vast amounts of bread were baked each day. A soldier’s diet lacked fresh vegetables. Without the vitamin C that vegetables provide, many soldiers developed scurvy and other vitamin deficiencies. By the end of the war the U.S. Army required 3 million pounds of rations per day for its soldiers throughout the country.

Providing enough food for the Confederate Army was a considerable problem for the southern
Subsistence Department. Commissary General, Lucius B. Northrop, an inexperienced officer,
preferred to centralize all purchasing details from his office, hampering his subordinate’s ability to
buy locally. Northrop’s policy was to purchase large amounts of raw materials and transport and
store them for future distribution. Rampant inflation caused prices to escalate and the Confederacy
was forced to impress food, crops, fuel, and other commodities to support their army.

Army Hardtack Recipe
• 4 cups flour (preferably whole wheat)
• 4 teaspoons salt
• Water (about 2 cups)

Preheat oven to 375. Mix the flour and salt together in a bowl. Add just enough water (less than two cups) so that the mixture will stick together, producing a dough that won’t stick to hands, rolling pin or pan. Mix the dough by hand. Roll the dough out, shaping it roughly into a rectangle. Cut into the dough into squares about 3 x 3 inches and ½ inch thick.

After cutting the squares, press a pattern of four rows of four holes into each square, using a nail or other such object. Do not punch through the dough. The appearance you want is similar to that of a modern saltine cracker. Turn each square over and do the same thing to the other side. Place the squares on an ungreased cookie sheet in the oven and bake for 30 minutes. Turn each piece over and bake for another 30 minutes. The crackers should be slightly brown on both sides. Makes about 10 pieces.

Image 1: Clerks of the Commissary depot with boxes of hardtack. Library of Congress

Image 2: Supply wagons

U.S. Navy: Diseases of the Civil War


Even though sanitary conditions aboard ship were often superior to those ashore, and both navies probably fared better than the armies when it came to the frequency of disease, rheumatism and scurvy kept the doctors busy along with typhoid, dysentery, break bone fever, hemorrhoids, and damage done by knuckles.

In the southern climes, insect-borne malaria and yellow fever laid low many a crew. And, regardless of what they had to work with, surgeons aboard the ironclads, and indeed every vessel, had no medicine for the ills of the spirit brought on by the strain of monotony, poor food, and unhealthy living conditions which produced much longer casualty lists than did Confederate shells or mines.

Image: Sick Bay (sketch by Asst. Surg. Charles Steadman)

Dr. Mary Walker, Surgeon

By Mercedes Graf

Dr. Mary Edwards Walker is the sole woman to have been awarded the Medal of Honor. That she received this prestigious award at a time when women’s roles were strictly circumscribed makes her especially significant. Walker, born in Syracuse, NY, to “free thinking” abolitionist parents, graduated from medical school in 1855 at age 23, when only a handful of women in the country were qualified medical doctors.

When the Civil War started in 1861, Walker traveled to Washington, DC, to offer her services as a physician to the Army. Hospital commanders, however, were not ready to accept a female physician on staff. Unable to find a paying position, Walker volunteered as a doctor at Indiana Hospital in Washington, DC. The medical officer in charge of the hospital, Dr. J.N. Green, was so desperate for help that he ignored Walker’s gender. She had graduated from a medical school, he said, and that was enough for him. However, he was unable to convince his superiors to pay her a salary. Walker worked as a volunteer for as long as she could afford to do so, gaining experience in military medicine, and then went to New York City where she earned a second medical diploma.

She then returned to Washington, hoping that her new qualifications would enable her to secure a commission as a medical officer with the Army, or at least a salaried position. When she was unable to find a position in Washington she went to the front lines, where she knew her services would be needed. She worked in a volunteer capacity at Warrenton, VA, and later at Fredericksburg, VA. She labored ceaselessly, receiving only a tent and food for her efforts. Without a commission, she had no status, which meant that her opinions and suggestions met with little respect. For example, she disapproved of the frequency of amputations conducted by Army physicians, believing some of them unnecessary. This attitude irritated her colleagues and did little to help her in her quest for a commission. Dr. Mary Walker advocated dress reform for women and frequently adapted men's clothing for professional and personal comfort and utility.

Finally, in early 1864, Walker was appointed a civilian contract surgeon to the 52nd Ohio Volunteers. This regiment, at winter quarters near Chattanooga, TN, was desperate for an assistant surgeon, the previous one having just died. Part of her responsibilities entailed caring for the surrounding civilian population. Courageously, Walker traveled to wherever she was needed, paying little attention to the line between Union and Confederate territory. On April 10, she took a wrong road, encountered an enemy sentry, and immediately surrendered. She was imprisoned in Richmond, VA, at a military prison named Castle Thunder. The prison was overcrowded and dirty. Many of the inmates were sick, but the authorities would not allow Walker to doctor them. Most of the food was spoiled, and Walker became ill. She was released in a POW exchange on Aug. 12, 1864. As a result of her incarceration, she suffered vision problems that later in life prevented her from practicing medicine.

On her release from prison, Walker accepted another position under contract as an Acting Assistant Surgeon with the Army. She was assigned to the Louisville, TN, Female Prison to care for the inmates there. The prison housed Confederate women held on suspicion of spying and other anti-Union activities. Here she quickly annoyed prison officials by trying to help the inmates as much as possible. Her attitude did not make her popular with the patients, however, who disliked Walker simply because she was a woman. Women themselves believed that they should not be doctors. Fiercely trying to protect their own status as ladies, they were offended by the pants and full, knee-length tunic Walker wore to work in. Calling Walker an “anomalous creature,” they refused to trust her or take the medicines she prescribed. Many wrote letters of complaint to prison officials in Washington asking for “a man doctor or none at all.”

After the war, President Andrew Johnson granted Dr. Walker the Medal of Honor for her “untiring efforts” on behalf of the government and her “devotion and patriotic zeal to sick and wounded soldiers both in the field and in hospitals to the detriment of her own health.” Johnson’s order also mentioned the hardships Walker had endured as a prisoner of war. Walker was delighted with the medal, and wore it constantly.

In 1917, two years before Walker’s death, the Medal of Honor Board removed Walker’s name and 911 others from the list of recipients. In an attempt to make the medal more prestigious, the Board rewrote the qualifications, so that the medal would be awarded only to those who distinguished themselves “in actual combat with the enemy, by gallantry or intrepidity, at risk of life, above and beyond the call of duty.” Since Walker had not engaged in combat, she was ineligible for the medal. Walker, living on her farm in Oswego, NY, simply refused to return her medal and continued to wear it until the day she died. In 1977, the Army Board of Corrections posthumously restored the Medal of Honor to Dr. Mary Walker, stating that her acts of “distinguished gallantry, self sacrifice, patriotism, dedication and unflinching loyalty to her country despite the apparent discrimination because of her sex,” made the award of the Medal of Honor to Walker “appropriate.”

The information found in this article comes from "A Women of Honor: Dr. Mary E. Walker and the Civil War" by Mercedes Graf published in Gettysburg, PA, by Thomas Publications in 2001.

Image: Dr. Mary Walker in 1913.


Eleven-Year-Old Wins the Medal of Honor

By W.W. Minsinger, M.D., Vermont

June 25, 1862. With the Peninsula Campaign in full swing, McClellan's Army of the Potomac was just miles from Richmond. Between June 25 and July 1, Lee went on the offensive, attacking McClellan repeatedly in a series of battles known as the "Seven Days." In the Seven Days Battles the conduct of Willie Johnston, a drummer boy from St. Johnsbury, made him the youngest recipient of the Medal of Honor, the nation's highest military honor, which had only recently been created. Willie was eleven years old.

Each day Robert E. Lee's forces attacked General George McClellan's troops, and every night McClellan had his forces fall back. With soldiers fighting all day and marching all night, many discarded all their equipment to lighten their load as they retreated to Harrison's Landing and the protection of the artillery of the Federal gunboats on the James River. Willie was the only drummer in his division to come away with his instrument.

As the troops were regrouping after their retreat, a Divisional Review was set for July 4th at Harrison's Landing, and young Willie Johnston was selected by General William F. (Baldy) Smith to play for the whole division in recognition of his service in keeping his drum while others threw away their equipment. Smith also noted that fact in his report; President Lincoln learned of the story and suggested to Secretary of War Stanton that the boy be decorated. Some have speculated whether the death of his son Willie, also eleven years of age, only five months earlier influenced the President's response to the story. Willie was awarded the Medal of Honor by Stanton personally on September 16, 1863.

Willie had become a drummer boy because when Willie's father enlisted in December 1861, Willie begged to go with him, and the commanding officer agreed.

Both Willie and his father survived the war.

"Taps" Played for the First Time

It was at the same gathering at Harrison's Landing immediately after the Seven Days Battles that the bugle call "Taps" as we know it today was created.

"The music for Taps was adapted by Union General Daniel Butterfield for his brigade (Third Brigade, First Division, Fifth Army Corps, Army of the Potomac) in July, 1862. . . . General Butterfield was not pleased with the call for Extinguish Lights, feeling that the call was too formal to signal the day's end, and with the help of the brigade bugler, Oliver Willcox Norton (1839-1920), wrote Taps to honor his men while in camp at Harrison's Landing, Virginia, following the Seven Days battle. . . . The new call, sounded that night in July, 1862, soon spread to other units of the Union Army and was reportedly also used by the Confederates. Taps was made an official bugle call after the war."

Image: Drummer boy Willie Johnston


A Mystery in Manuscripts

By James Labosier, 9-25-14

Among the History of Medicine’s manuscript collections rests a small group of letters and diaries from Army Surgeon Jonathan Letterman. However, these papers, donated to the Library in 1924 by Dr. Joseph T. Smith, Jr., a Baltimore physician and Letterman’s nephew, include two diaries which Letterman did not write. There is some tantalizing evidence in the historical record which places Letterman in the proximity of the activities documented in the diaries and he almost certainly personally knew some of the persons who traveled with the diaries’ author. How they made their way into this set of documents and who actually did write them is a mystery.

Both diaries, written by the same person, detail the daily adventures, sights, and people encountered during month-long trips along the Santa Fe trail between Fort Leavenworth, Kansas and Fort Union, New Mexico in May and September of 1860. But it is clear that that person could not be Dr. Letterman—official Army records prove he was stationed elsewhere during the periods the trips took place.  It is true that by December, 1859, Jonathan Letterman was assigned to Fort Union, New Mexico as assistant surgeon. But for more than a year, he had been on detached service with General John Garland’s expedition on the Great Plains. And in January 1860, he was transferred from Fort Union to Fort Tejon, California, where he arrived on February 29, 1860.

The earlier of the two diaries begins as a group—including recruits for New Mexico regiments and 160 horses for the mounted service—depart from Fort Leavenworth on May 30, 1860. During the 37-day trek over the north fork of the Santa Fe Trail the diary’s author carefully notes the distances traveled each day and the availability of fresh water and grass for forage at each place they camped. He seems interested in the physical composition of the land, noting limestone and sandstone formations. The journey ends at Fort Union on July 5. Throughout the entire journal the author has given no overt clue to his own identity.
Official army post returns (monthly summaries of activities submitted by Army outposts to the War Department) verify that Dr. Letterman was on detached service from Fort Tejon on the Mojave river during May and June and had been since early April.

The diary’s author notes of the expedition: “Lt Pegram in command Capt. M Ferran A.Q.M.” This is likely Captain John C. McFerran, an officer from Jefferson Barracks, Missouri, who had been transferred to New Mexico. Captain McFerran was formally assigned to Fort Union and reported on July 18, thirteen days after the expedition arrived. McFerran may have been acquainted with Dr. Letterman since he had previously been assigned to Fort Union at the same time and had in fact been transferred out of Fort Union on January 5, 1860, the same day that Letterman had been transferred.  Could McFerran be the author?

Another curious fact is that an assistant surgeon, Joseph C. Bailey, had been transferred from Fort Crittenden, Utah to Fort Union in May. His whereabouts are unaccounted for during the month of June, but he reports for his assignment at Fort Union a few days after Captain McFerran.  It is not unlikely that Dr. Letterman and Dr. Bailey, both medical men, would be acquainted. Could Bailey be the author?

The second diary begins as a group numbering over 100 leaves Fort Union on September 27, 1860. Documentation from army post returns verifies that Jonathan Letterman was present at Fort Tejon during September and October. Captain McFerran again travels with the group. He had been relieved of his position at Fort Union on September 18 and reassigned to Albuquerque. Joseph C. Bailey, however, could not have been on this trip. In August he had been detached to a Comanche expedition. He returned to Fort Union on October 15, when the military party being documented was en route along the Santa Fe Trail to Fort Leavenworth.

During this trip the author implies that he is a military surgeon when he mentions visiting some of his patients. But when this dusty group reaches the walls of Fort Leavenworth 52 days later on October 29, the diary’s reader still has no clue as to the name of its author. Monthly reports from army posts in California, New Mexico, Utah, and Kansas prove that he could not have been Jonathan Letterman. We are left with the hope that an inquisitive researcher may be able to identify the author of these diaries and perhaps also tell us how they came into the possession of Dr. Letterman’s heirs. If that researcher is you, or someone you know, we invite you to share what you know about the diarist by commenting below.

Image 1: Fort Union National Monument. A wide landscape with low mountains in the background and the ruins of a large fort.

Image 2: Group of Soldiers Near the Arsenal, Fort Union.

James Labosier is Associate Curator for the Archives & Modern Manuscript in the History of Medicine Division at the National Library of Medicine.


More on Lincoln's Autopsy


"A little black mass no bigger than the end of my finger"
Dr. Edward Curtis

On April 15, 1865 at 12:10 p.m., the autopsy of President Lincoln took place in the Guest Room at the northeast corner of the second floor of the White House (currently the President's Dining Room).
Surgeon General Joseph K. Barnes and Dr. Robert Stone presided, while Dr. Joseph Janvier Woodward and Dr. Edward Curtis performed the autopsy.

The interpretation of the injury and care provided for President Lincoln are best told by those who were present.

Dr. Joseph Janvier Woodward's official autopsy report:
Surgeon General's Office
Washington City, D.C.
April 15th, 1865
Brigadier General J. K. Barnes
Surgeon General U.S.A.
I have the honor to report that in obedience to your orders and aided by Assistant Surgeon E. Curtis, U.S.A., I made in your presence at 12 o'clock this morning an autopsy on the body of President Abraham Lincoln, with the following results.

“The eyelids and surrounding parts of the face were greatly ecchymosed and the eyes somewhat protuberant from effusion of blood into the orbits.

There was a gunshot wound of the head around which the scalp was greatly thickened by hemorrhage into its tissues. The ball entered through the occipital bone about one inch to the left of the median line and just above the left lateral sinus, which it opened. It then penetrated the dura mater, passed through the left posterior lobe of the cerebrum, entered the left lateral ventricle and lodged in the white matter of the cerebrum just above the anterior portion of the left corpus striatum, where it was found.

The wounds in the occipital bone was quite smooth, circular in shape, with beveled edges. The opening through the internal table being larger than that through the external table. The track of the ball was full of clotted blood and contained several little fragments of bone with a small piece of the ball near its external orifice. The brain around the track was pultaceous and livid from capillary hemorrhage into its substance. The ventricles of the brain were full of clotted blood. A thick clot beneath the dura mater coated the right cerebral lobe.

There was a smaller clot under the dura mater of the left side. But little blood was found at the base of the brain. Both the orbital plates of the frontal bone were fractured and the fragments pushed upwards towards the brain. The dura mater over these fractures was uninjured. The orbits were gorged with blood.

I have the honor of being very respectfully
Your obedient servant.
E. J. J. Woodward
Assistant Surgeon U.S.A.

An excerpt from a letter Dr. Curtis wrote to his mother:
... Dr. Woodward and I proceeded to open the head and remove the brain down to the track of the ball. The latter had entered a little to the left of the median line at the back of the head, had passed almost directly forwards through the center of the brain and lodged. Not finding it readily, we proceeded to remove the entire brain, when, as I was lifting the latter from the cavity of the skull, suddenly the bullet dropped out through my fingers and fell, breaking the solemn silence of the room with its clatter, into an empty basin that was standing beneath. There it lay upon the white china, a little black mass no bigger than the end of my finger—dull, motionless and harmless, yet the cause of such mighty changes in the world's history as we may perhaps never realize.

Tuesday, July 21, 2015

Walt Whitman's Soldiers: Death of a Pennsylvania Soldier


Frank H. Irwin, company E, 93d Pennsylvania—died May I, ’65—My letter to his mother. —
DEAR MADAM: No doubt you and Frank’s friends have heard the sad fact of his death in hospital here, through his uncle, or the lady from Baltimore, who took his things. (I have not seen them, only heard of them visiting Frank.) I will write you a few lines—as a casual friend that sat by his death-bed.

Your son, corporal Frank H. Irwin, was wounded near fort Fisher, Virginia, March 25th, 1865—the wound was in the left knee, pretty bad. He was sent up to Washington, was receiv’d in ward C, Armory-square hospital, March 28th—the wound became worse, and on the 4th of April the leg was amputated a little above the knee—the operation was perform’d by Dr. Bliss, one of the best surgeons in the army—he did the whole operation himself—there was a good deal of bad matter gather’d—the bullet was found in the knee. For a couple of weeks afterwards he was doing pretty well. I visited and sat by him frequently, as he was fond of having me. The last ten or twelve days of April I saw that his case was critical. He previously had some fever, with cold spells. The last week in April he was much of the time flighty—but always mild and gentle.

He died first of May. The actual cause of death was pyæmia, (the absorption of the matter in the system instead of its discharge.) Frank, as far as I saw, had everything requisite in surgical treatment, nursing, &c. He had watches much of the time. He was so good and well-behaved and affectionate, I myself liked him very much. I was in the habit of coming in afternoons and sitting by him, and soothing him, and he liked to have me—liked to put his arm out and lay his hand on my knee—would keep it so a long while. Toward the last he was more restless and flighty at night—often fancied himself with his regiment—by his talk sometimes seem’d as if his feelings were hurt by being blamed by his officers for something he was entirely innocent of—said, “I never in my life was thought capable of such a thing, and never was.” At other times he would fancy himself talking as it seem’d to children or such like, his relatives I suppose, and giving them good advice; would talk to them a long while.

All the time he was out of his head not one single bad word or idea escaped him. It was remark’d that many a man’s conversation in his senses was not half as good as Frank’s delirium. He seem’d quite willing to die—he had become very weak and had suffer’d a good deal, and was perfectly resign’d, poor boy. I do not know his past life, but I feel as if it must have been good. At any rate what I saw of him here, under the most trying circumstances, with a painful wound, and among strangers, I can say that he behaved so brave, so composed, and so sweet and affectionate, it could not be surpass’d. And now like many other noble and good men, after serving his country as a soldier, he has yielded up his young life at the very outset in her service. Such things are gloomy—yet there is a text, “God doeth all things well”—the meaning of which, after due time, appears to the soul.

I thought perhaps a few words, though from a stranger, about your son, from one who was with him at the last, might be worth while—for I loved the young man, though I but saw him immediately to lose him. I am merely a friend visiting the hospitals occasionally to cheer the wounded and sick.

Image: Lower thigh bone of Corporal Frank Irwin. National Museum of Health and Medicine

The Empty Sleeve: or, the Life and Hardships of Henry H. Meacham, in the Union Army


This pamphlet is an example of postwar mendicant literature—items printed and sold for the support of their authors—and illustrate some of the hardships faced by disabled veterans in later life.

Henry H. Meacham, a former carriage-maker in Massachusetts, joined the 32nd Massachusetts Volunteers; his arm was blown off by a shell near Petersburg in June, 1864.  He printed and sold this pamphlet to make a living for himself and his ailing wife.  In this account of his war experiences, Meacham says,

"As we were standing there, a shell came through one man and then exploded, taking my right arm off, and killing four of my comrades, making five lives destroyed and one wounded.  I never expected to get home or even off the field, but I was bound to do all I could… I was at this time one mile from any surgical assistance, and walked that distance, while the blood was fast leaving me, notwithstanding I had bandaged the arm as tight as possible…. I was so weak as to be unable to walk, or hardly stand…. I had not long to wait before the surgeon came along, and at my earnest request, I was taken to the amputating room and placed on the table.  This is the last that I remember until my arm was amputated.  After I had fully come to my senses, I was conducted back to my bed on the ground, and there I remained during the night with my bloody clothes on."

The cover of the 1874 poem states, “The author of this book lost his arm in the discharge of his duties as Machinist on board the Demaly while conveying troops from Galloup’s Island to City Point, Va.”

Image: The Empty Sleeve: or, the Life and Hardships of Henry H. Meacham, in the Union Army,
(Springfield, Mass. : sold for the benefit of the author, [1869?]). Purchased for the Library of Harvard Medical School, 2005.

To Kill and To Heal: North vs. South

Excerpted from:

Despite their sharp philosophical and moral divisions over the expansion of slavery and the election of Abraham Lincoln, Northerners and Southerners actually shared some common practical background as the Civil War approached. Both sides had similar weapons and military training, as well as medical knowledge and education. They also shared a lack of preparedness for a long and costly war. Although more than 620,000 soldiers died during the Civil War, countless others were sick and wounded, yet survived. Providing appropriate medical care was a complex challenge for both sides.

While both the North and the South were inexperienced, ill-equipped and unprepared to fight a protracted war, the North had numerical and material advantages over the South before the Civil War began, including greater industrial capacity, a transportation network that integrated more than 22,000 miles of railroad track, canals and macadamized roads, and a population of 22 million
that was augmented by a steady influx of immigrants.

The South, in comparison, had only 9,000 miles of inefficient, deteriorating railroad track and an 1860 population of just over 9 million people, 38.7% of whom were slaves. In addition, the southern economy was based on agriculture (cotton, tobacco, and sugarcane) and used slave labor to produce those commodities.

Unlike plantation owners who grew cash crops, most southern farmers were subsistence-based.
With so many adult men engaged in fighting away from home, the South did not have the manpower
needed to produce sufficient foodstuffs and was unable to feed its military and civilian population
causing severe hardship. What the South lacked in resources, they hoped to obtain from Europe; but the Union blockade effectively closed southern seaports. Another disadvantage the South faced was that transportation of supplies, munitions and soldiers was inefficiently managed, and their financial and industrial infrastructure was underdeveloped. While the South had the raw ingredients necessary to support their military, the Confederates lacked the strategic organization and decisive political and military leadership to plan, coordinate and maintain the fight.

This combination of factors resulted in the Confederacy’s inability to sustain a prolonged war effort.

The Medical Library Movement


Not until the 1890s did American medical schools realize that their own well stocked and well maintained medical libraries would be essential components of the rapid modernizing of medical pedagogy which had begun in the 1870s with the shift from proprietary schools to graded instruction.

The lack of attention to medical libraries which had been the prevailing attitude not only in medical schools but throughout the entire medical community gradually evolved into a "medical library movement," a unity of the aims of both the "Old Guard" and the younger physicians in a third generation of physicians who saw the need both to protect and venerate the tradition, on the one hand, and, on the other hand, to make readily and freely available to all practitioners the widest possible sampling of the published results of current research. Gould (b. 1848), Osler (b. 1849), Frank William Marlow (b. 1858), and Spivak (b. 1861) were among this third generation that rediscovered and reinvented the medical library. They resembled their grandfathers rather than their fathers insofar as they attached importance to the contents of medical libraries; but unlike their grandfathers, and indeed more like their fathers, they regarded these contents not as curiosities, historical documents, or the hallmarks of medical tradition, but as fundamental tools of current clinical practice.

The ultimate impetus for the rebirth and growth of medical libraries in the 1890s was not the veneration of tradition, as Purple, Horner, and their cohorts had imagined, but rather the discovery that libraries are excellent means for current research. This latter view is what predominates in the medical world today. The attitude that medical libraries are research libraries rather than repositories has proved fundamental in the design, construction, and funding of medical libraries in the twentieth century.

Although there had been some pockets of American medical culture from as early as the 1870s which were enlightened about the proper role and importance of modern medical libraries, one analyst who surveyed 120 American medical schools in 1898 received reports of only 24 libraries affiliated with those schools. Clearly a crusade was needed.

Directly addressing this perceived need, Gould, Osler, and a few others in the 1890s launched a vigorous effort to encourage physicians to take seriously the published heritage of medicine as useful, not only for purposes of learning history, but even for current clinical practice, and in that spirit to bequeath their personal collections of books to medical schools and other health care institutions, especially since these institutions had few other means of acquiring books.

They and, even as early as the late 1890s, most other advocates of institutional medical libraries were making similar claims for the current practical value of "old books" and encouraging the private owners of these medical journals and books not to throw them away when they retired from clinical practice, and not to let their heirs decide what to do with them, but rather to donate them to institutions which would preserve them, not only for the use of current practitioners, but also for posterity.

Image: A doctor in his office: library, stethoscope, skull, amputation set on top of the cabinet

Bristol Civil War Hospital Finally Gets Honored

By Tom Netherland, 4-27-14

BRISTOL, Tenn. — Long dead soldiers of the Civil War and the Bristol-based Confederate hospital wherein many received care and also died warrant acknowledgement.

So goes the sentiment among the Bristol-based Sons of Confederate Veterans James Keeling Camp 52.

“It’s preserving the history and the history of Bristol,” said James Booher of the Sons of Confederate Veterans.

Therefore on Saturday afternoon members of the Sons of Confederate Veterans dedicated an historical marker in downtown Bristol to recognize the Confederate Hospital. They initially sought partial funding from the state of Tennessee, yet were rebuffed, said John “Pappy” Hawthorne of the Sons of Confederate Veterans.

“We fought a battle for over two years,” said Hawthorne. “The war wasn’t over. The state kept coming up with reasons why they couldn’t pay for the sign.”

So, Hawthorne and other members of the Sons of Confederate Veterans raised about $2,000 needed to purchase the marker.

Placed in a far corner of a lot occupied by Citizens Bank along State Street and the corner of Martin Luther King Jr. Boulevard, the marker comes about 116 years after the demise of the building that housed the hospital.

“On this site was formerly located the Bristol general Confederate Hospital,” the marker begins.
Tim Buchanan, president of the Bristol Historical Association, read and then snapped photos of the newly-placed marker.

“It’s really long in coming,” said Buchanan of the marker, “because we’ve forgotten our early Civil War history.”

Citizens Bank stands upon the spot where generations ago stood the hospital.

“It was housed in the former Exchange Hotel erected in 1858 (later known as the Nickels House),” continued the text on the marker. “The building was demolished in about 1898.”

Originally employed as a grain exchange and commission house, the large brick building was built for Joseph R. Anderson, Bristol’s founder. He soon thereafter converted it into a hotel.

“We’re in the approximate area of where the hospital was at,” said John “Pappy” Hawthorne of the Sons of Confederate Veterans and keynote speaker during the dedication.

Cars eased slowly by on State Street during the event’s proceedings. Some folks watched intently, others waved and a few honked their horns. Nary a jeer was heard.

Sun was bright, sky was blue and warmth of the day appreciated among a throng of about 30 in attendance.

“We can’t pinpoint the exact date,” Hawthorne continued, “but it was somewhere along 1862 when the Confederate government leased it as a general hospital.”

By then, multiple businesses had occupied the building during its short existence.

“Anderson never intended to operate the hotel himself,” said Bud Phillips within an article published in the Bristol Herald Courier on Oct. 17, 2010. “Instead, he leased it to Thomas W. Farley, a local school professor.”

Repurposed then rebranded, the building became the Exchange Hotel, which opened on Christmas Day 1859.

“Farley kept the hotel for perhaps a year then leased it to L.A. Womack,” Phillips wrote. “Soon afterwards, the Confederate government began to use it as a hospital.”

Geographic proximity between battlefields in the North and those in the deep South rendered the location as ideal for such a hospital.

“Bristol was mostly Confederate residents,” Buchanan said. “About 10 miles down the line, and it was mostly Union. Washington County, Tennessee as mostly Union. Kingsport was mostly Union. So, Bristol was the last bastion for the Confederacy on this line.”

Those were bloody days on the battlefields.

“Sick and wounded soldiers were brought here by train for medical and surgical treatment,” relates text upon the marker. “Bristol was approximately halfway between the battlefields of Virginia and the south.”

Translated, the hospital was placed perfectly.

“It made the hospital important,” Buchanan said.

Then as now, the rail runs alongside the site merely a few feet away.

“The railroad stopped right here,” said Jim Eller of the Sons of Confederate Veterans as he stood between the rail and the historical marker.

Indeed, the smell of creosote upon the railroad ties wafted in the wind on a breezy Saturday afternoon.

“The confederacy thought that if this line was lost, then they would lose the deep South and thus the war,” Buchanan said. “This, the railroad line, was essentially the interstate highway of the era.”
Confederate injured were thus transported from battle via the era’s “interstate highway” and to Bristol’s Confederate Hospital. They were then quickly taken to a ramp of entry at the hospital.

“Indeed, the old ramp that was long used to deliver grain to the rail side was still in place.,” Phillips wrote in an article published in the Bristol Herald Courier on Oct. 24, 2010. “Soon, many a wounded and sick soldier was brought over it — for many the last trip they ever made.”

Exact numbers of patients served and soldiers who died within the hotel, which operated from 1862 until the end of the Civil War in 1865, are not known.

“As the guys died,” Hawthorne said, “they were put on the back porch (of the hospital), loaded into a wagon that went up the dirt trail — about straight up the steep bank, to East Hill Cemetery.”
Anderson, according to Phillips, sold the building to Isaac A. Nickels on Feb. 12, 1864. The hotel reopened as the Nickels House Hotel in late 1866. Businesses including a law office, store, barbershop and saloon shared space the hotel within the building.

“The building stood vacant for a year or two and then was demolished about 1898,” Phillips wrote.
Centuries first one and then another came. Memories of the Confederate Hospital waned and then died with their beholders as generations passed by. As if cloaked in brick and mortar dementia, history of the building that witnessed countless deaths within America’s deadliest war, faded away.
As history disappears, reinterpretation that can lead to misinterpretation can appear in its place.
All parties involved with the placement of the historical marker that documents briefly Bristol’s Confederate Hospital agreed. It helps to revive historical fact.

“The Confederate history has been readapted for the times,” Buchanan said. “We need to accept the actual town history without readapting it.”

There’s no changing the most sober of all historical facts forever linked to the hospital that’s long gone. The marker establishes the site of the hospital. It underscores an era gone by. And it remembers those whose names are mostly long forgotten.

“Over 100 men who died in this hospital,” concludes the marker, “are buried in East Hill Cemetery six blocks east.”

Image: C. Phillip Kestner, Jim Eller and John "Pappy" Hawthorne pose with the historical marker dedicated to Bristol's Confederate Hospital moments after its unveiling.



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