Monday, August 24, 2015

Jonathan Letterman, (1824-1872)

"Medical Recollections of the Army of the Potomac". New York: D. Appleton & Co., 1866

On November 13, 1911, a new government hospital located near San Francisco, California was named the Letterman General Hospital in honor of the man who was responsible for reorganizing the army medical department during the Civil War and creating an effective ambulance system still used today, relatively unchanged, by modern armies. As stated by biographer Dr. G. E. Dammann, who wrote the biographical introduction to the 1994 reprint of Letterman’s Medical Recollections…, “Jonathan Letterman is the person who could be named father of medical evacuation”.

A native of Canonsburg, Pennsylvania, Letterman received an M.D. from the Jefferson Medical College in 1849 and went almost immediately into army medical service. He worked as an army surgeon in several U.S. frontiers before reporting to duty with the Army of the Potomac in 1861. In 1862, Letterman’s friend, Surgeon General Hammond, named him medical director for the Potomac division, a post he held under the command of Major-General McClellan.

Prior to Letterman’s reorganization, the U. S. Army had only a few facilities in Washington, D. C. that operated as general hospitals. Regimental hospitals that followed their units were the primary medical caregivers. There was no ambulance corps, but only litter bearers who carried the wounded from the field. These were often regimental musicians with no medical training. And ambulances were “engaged in carrying everything but wounded soldiers”. Noticing the disorganization and inefficiency of the medical corps, Letterman set out to restructure the system. He established an ambulance corps under the command of the medical director instead of regimental officers, and he made the transportation of the wounded their sole responsibility (Dammann iii). The new ambulances more than adequately proved their effectiveness, and Congress institutionalized them for all Union divisions in 1864.

As a part of Letterman’s reorganization, he also standardized medical supply wagons for each regiment and bulk supply wagons for the brigades. In addition, he consolidated the hospitals into a three-tiered system, consisting of field hospitals for immediate care of units, post hospitals for the sick and wounded of each garrison, and general hospitals that received patients from throughout the army. All these measures allowed the medical department to efficiently face the many difficult battles still ahead, and they became the basis for military medical administration for the rest of the Civil War.

In January of 1864, Letterman left the army (around the same time Hammond was replaced as Surgeon General). Shortly thereafter, he moved to San Francisco, where he served two terms as coroner and remained in that position until his death in 1872. Letterman’s memoirs as medical director during the war were published in 1866 as Medical recollections of the Army of the Potomac. Some of the original army orders and reports quoted within this book concern Letterman’s change of command order, the placement of ambulances under the medical department, and other medical reorganization and standardization orders. The Reynolds-Finley Historical Library has a first edition copy of this work.

Image: Jonathan Letterman and his staff. Letterman is seated on the left.



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