By Tom Martin, vexillologist, purveyor of Piedmont Flag Company. (Piedmontflag.com), Winter, 2014
The first flags to indicate military hospitals were yellow. In 1861, nineteen hospitals of the Marine Hospital Service were taken over for use by the Army, and they continued to fly the yellow flag already customary for quarantined ships. (Yellow or white flags were sometimes flown at civilian homes where there was an outbreak of disease.) Despite red flags being specified in Army Regulations from 1854, yellow flags were generally, if informally, used thereafter to designate general hospitals, field hospitals, and ambulance depots (aid stations), although red and green flags were sometimes employed. (At that time green was the heraldic color of the Medical Department.) Sizes varied, and many flags had a green “H” in the middle. Ambulance flags were supposed to have a green border and not have the “H.”
“The ambulance depot, to which the wounded are carried or directed for immediate treatment, is generally established at the most convenient building nearest the field of battle. A red flag marks its place, or the way to it, to the conductors of the ambulance and to the wounded who can walk.” (US Army Revised Regulations 1861)
The Confederate States generally matched US regulations, although used red flags more. Julian Chisolm, a Confederate surgeon, noted:
"The members of the [Ambulance] Corps are designated by wearing around their caps a red band, with ambulance corps printed in conspicuous white letters.... If the body of troops about to entering into battle is a large one, with an extended line, several of those points - ambulance depots or field infirmary should be selected and marked by a suitable red flag, which designates the spot where those slightly wounded can seek surgical aid."
Another doctor noted how two Medical Department colors were useful to him:
"Very fortunately, I had on my green sash, also a red flag was on the front part of the wagon, signs of the Medical Department. ..... "
A medical staff flag was discovered by Howard Michael Madaus, possibly a brigade or regimental surgeon’s flag. Another, now at the Delaware Historical Society, was used by the ambulance officer of the 1st Division, 2nd US Army Corps. It bears a red trefoil in the center of its green-bordered white field and the initials “E&H” on the heading, referring to the manufacturer Evens & Hassall. Other ambulance and medical officers likely used similar flags.
Like hospitals, hospital trains carried red flags. Sometimes the cars would be painted red with white lettering “Hospital Train.” At night three red lanterns would be used as a signal of a hospital train.
"General Thomas accorded the fullest authority to Medical Director Cooper to select for the hospital trains the best locomotives and cars to be found among the rolling stock, and to have new cars fitted up whenever necessary, and caused to be detailed for the hospital service the most experienced conductors, engineers, and other employees of the several railway lines. Medical Director Cooper informs the reporter that the smoke-pipes of the locomotives of the hospital trains were painted of a brilliant scarlet; the exterior of the hood, and of the tender-car with water and fuel, were of the same conspicuous color, with gilt ornamentation. At night, beneath the head-light of the engine, three red lanterns were suspended in a row. These distinguishing signals were recognized by the Confederates, and the trains were never fired upon, or molested in any way. Dr. Cooper “was informed by wounded Confederate officers in Nashville, who were captured at the battle near that place, of the stringent orders given his troopers by General N. B. Forrest for the noninterference with and protection of the U. S. A. Hospital trains,” by giving them timely warning in the event of the railway being obstructed or torn up. The partizan troops of Colonel John Morgan’s command had similar instructions. It is related that on one occasion Colonel Morgan’s scouts stopped the train directed by Dr. Barnum, and having switched it off upon a siding, after enquiring if there were sufficient stores on the train for the sick and wounded, they tore up the main track, and then rifled and destroyed five supply trains that successively arrived at the point where the line was interrupted. … "
Both the U.S. Sanitary Commission and the U.S. Christian Commission used banners and flags to indicate their facilities. Sanitary Commission hospitals were typically marked by the yellow flag with a green “H”. Once the U.S. signed the Geneva Convention, the Red Cross flag was adopted. Its size and materials have varied over the years, and for different organizations, but its recognition under international law made it preferable to yellow or red.
From: history.amedd.army.mil/newsletters
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