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.

Tuesday, November 29, 2016

What Can Two 19th Century Cartoons Reveal About Disease and Hysteria?

By Medicine and Science Intern Kayla Reddecliff , 12-16-14

Every few years, we read the headlines about a new, or resurgent, disease that threatens global health. Fears of transfer erupt and hysteria sets in, at least in the initial months. If someone coughs in public, I'll recoil in concern; who knows if they have this year’s contagious disease? Every stranger becomes suspect. Of course, a more rational version of myself would realize that a cough could be caused by anything.

When it comes to disease, fear of air quality and of strangers has historical roots. One of the first epidemic diseases to excite worldwide hysteria was cholera. According to Dr. Margaret Linley, cholera became "a media disease," through the explosion of widely disseminated writings and images that intensified fear of the disease. Likewise, the historian Christopher Hamlin, explains, "it was the magnitude of the reaction to it that cholera stands out as the signal disease of the 19th century." Despite its extensive media coverage, cholera was far from the greatest killer of the 19th century (compared to malaria and tuberculosis) and rarely visited western nations.

We now know that the Vibrio comma is a marine organism that spreads through infectious vomit and fecal matter (that can contaminate food, water supplies, and even linen), but cholera remained a mysterious disease throughout much of the 19th century. When it first reached Europe and North America in 1832, cholera came as a shock to 19th century sensibilities as fluids streamed uncontrollably from both ends. Dehydration turned skin a deathly blue, made eyes appear sunken, and thickened the blood. Its onset was sudden and it could kill within hours. This initial visit would kill thousands and "King Cholera" returned to western nations four more times during the century.

While researching cholera for my advisor at the museum, I found two seemingly humorous cartoons dating to the 1830s in the museum's Medicine and Science collection. These images were first loaned to the museum—when it was still the National Museum of History and Technology—in 1945 as part of a collection of European pharmaceutical artifacts from the 15th to 19th century. Both titled "Cholera Prevention Man," they depict a man covered from head to toe in protective layers in an attempt to safeguard himself from the oncoming cholera epidemic. Germ theory had not been developed, nor was the cause of cholera understood, but bodies were still in danger. Medical writings and images were internationally exchanged, as Western nations tried to find cures and explain the horrifying disease.

The first image illustrates many 19th century remedies and preventatives for cholera. Wrapped around his waist is a grey "cholera belt" (a thermal remedy primarily used by British soldiers in order to keep the body warm), while a mask and container of camphor or vinegar vapors envelope his face in an effort to neutralize any cholera miasmas that tainted the atmosphere. He stands in a doorway made of boxed medicinals (such as calomel, cayenne pepper, and laudanum) as well as other treatments for cholera: a clyster and hot water bottle (to administer enemas) and a commode. The words roughly translate to "a well stocked home to prevent cholera." However, the ghostly apparition of cholera still lurks behind the man. Desperate people stocked their “medicine cabinets” with numerous treatments and remedies from both medical men and quacks alike that ranged from sadly ineffective to wildly dangerous.

The second cartoon (published both in German and English) is a satirical comment on the effectiveness of the overabundance of protective items that were sought out as fear of the approaching cholera pandemic grew. In the English version of this cartoon, the caption warns: "By exactly following these instructions you may be certain that the cholera… will attack you first." Early theory established that cholera was not contagious because filth and overall poor sanitation that produced miasmas in the air were attributed to its cause.

Both cartoons express this miasma theory through their concern with purification and sanitation (the man has both a juniper bush and vapor mask to purify the air). Yet, in mocking the effectiveness of the protective items, the cartoon expresses a widespread uncertainty regarding cholera's contagiousness since it was known to travel along trade routes over land and sea. This uncertainty of the disease's contagiousness is reflected in the ex-mayor of New York's, Philip Hone's, personal writings on September 20, 1832, "It is stated that forty-nine thousand five hundred and sixty-nine emigrants have arrived at Quebec… a large proportion find their way into the United States destitute and friendless. They have brought the cholera this year, and they always bring wretchedness and want."

Cholera became intertwined with the anxieties over the health of the social body. Not surprisingly, poverty and immigrants seemed to attract the disease. Cholera did strike its victims disproportionally from the poor; however, in the 19th century a life of filth and ruined morality was largely seen as a personal choice, instead of a result of poverty, poor infrastructure, and a lack of resources. Both cholera and immigration influenced newly forming cities. While Western nations became increasingly involved in the global world in the 19th century, there were increased global movements of people, especially from non-Protestant and non-white backgrounds. In America, the threat of cholera was one of the biggest concerns proposed by those who supported restricted immigration. Two of the earliest International Sanitary Conferences (the predecessor to the World Health Organization) grappled with the issue of cholera's contagiousness as well as with the attempt to coordinate measures to prevent cholera's spread from India (as it was regarded to be the home of cholera) into Europe.

In Western nations, huge capital investments in water sanitation created cholera-free cities while other measures within cities began under public health movements in order to track the disease and prevent its spread. However, the stigma of filth as a cultural choice is still prevalent as countries in Africa, South Asia, and South America deal with the seventh pandemic that has been raging since the 1960s as a result of a lack of infrastructure and resources.

Kayla Reddecliff is an intern in the Medicine and Science department. One of her favorite areas of study is the history of fashion, so disease prevention costumes were a perfect fit.

Image 1: The Cholera Prevention Man. Moritz Gottlieb Saphir, Germany and England, ca., 1832. Thousands of copies of this image were produced and disseminated. Image from the museum's Medicine and Science collection.

Image 2: The Cholera Prevention Man. Wundet, Germany and England, ca., 1830s


CSS St. Philip


In the Civil War, there was steamship "Star of the West" which was used by the Confederate States Navy as "CSS Saint Philip", serving as a naval station and hospital ship.

Awards, Citations and Campaign Ribbons: Civil War Medal

Sidewheel Steamer:
Built in 1852 as the brigantine=rigged sidewheel steamer SS San Juan by Jeremiah Simonson, Greenpoint, N. Y. for $250,000
Renamed SS Star of the West, date unknown, operated passenger service between New York and California
Chartered by the Federal Government in January and April 1861 to carry reinforcements to Fort Sumter at Charleston, S.C. and to carry troops from Texas to New York
Captured by the Confederate Army steamer CSS General Rusk, 17 April 1861, off Indianola, TX.
Renamed CSS St. Philip employed by the Confederate Navy as a receiving ship at New Orleans
Sunk by Confederate forces to obstruct the channel of the Tallahatchie River, March 1863
Displacement 1,172 t.
Length 228' 4"
Beam 32' 8"
Depth of Hold 24' 6"
Draft unknown
Speed 11.5 kts
Complement unknown
two 68-pdrs
four 32-pdrs
two vertical beam steam engines

Contributed By Tommy Trampp

Image: Engraving of SS Star of the West underway with Fort Sumter Charleston S. C. in the background, circa 1860.

Disease in Arkansas during the Civil War

By David Sesser, Henderson State University, 4-5-16

Disease was a major problem among the armies serving in Arkansas during the Civil War. Large numbers of men living in close confines made the spread of illness likely. As many as 700,000 members of the military across the country lost their lives during the war, and approximately two-thirds of them died from disease.

Outbreaks of disease were common in the state even before the beginning of the war. In 1855, a yellow fever epidemic struck Helena (Phillips County), and minor outbreaks of other diseases such as cholera and typhoid were common. The lack of major centers of population and difficulty of travel, however, prevented many large-scale epidemics before the Civil War. The state had a number of doctors in the antebellum period, but, while they did undergo some training, these men were not required to obtain any formal certification or standardized education.

With the outbreak of war in 1861, thousands of men began to gather in towns across the state to create military units. The close proximity of these men made the spread of disease much easier, as many were from rural areas and had never been exposed to common illnesses such as measles. Both a lack of trained medical professionals and little understanding of how cleanliness impacted health led to large-scale outbreaks of disease during the war. Camp Nelson near Cabot (Lonoke County) housed thousands of Confederate troops from Arkansas and Texas in 1862 before being struck by a number of epidemics. Measles, mumps, typhoid, and other diseases ran through the camp, leading to the deaths of around 1,500 men, including Brigadier General Allison Nelson. The camp was soon abandoned.

Federal units were also susceptible to outbreaks of disease. After the Battle of Pea Ridge, the Army of the Southwest marched across southern Missouri and northern Arkansas in an effort to take Little Rock (Pulaski County). Unable to do so, the army instead captured Helena, which had a strategically important location along the Mississippi River. As the Federal army crowded into the town, it was joined by hundreds of newly freed slaves. The close proximity of thousands of people in the riverside location quickly led to outbreaks of disease. Many waterborne illnesses that were spread through mosquitoes swept through the army due to a lack of sanitation in the camps. Hospitals were established in the city but could not treat the growing number of sick men. Federal military surgeons were trained to handle battlefield casualties but were ill-prepared to handle the large numbers of soldiers suffering from diseases.

The large number of sick troops hampered Union operations in eastern Arkansas for the remainder of the war. In the summer of 1863, a force under the command of Major General Frederick Steele moved from Helena in an effort to capture Little Rock. In the short march from Helena to Clarendon (Monroe County) on the White River, thousands of troops fell ill from various maladies. Steele was forced to transport his sick troops to DeValls Bluff (Prairie County), where a new hospital was established. As the expedition continued, hundreds more troops became ill crossing the Grand Prairie. After Little Rock fell to the Union army, men who had fallen ill were housed at St. Johns’ College. Confederate forces left about 1,400 sick men in the city when they retreated.

As Federal forces moved across the state and created outposts at strategic locations, they were joined by countless slaves who fled their masters. By the end of the war, Pine Bluff (Jefferson County), Helena, and Little Rock all had large populations of former slaves. Union authorities struggled to provide basic services for these freedmen but were unsuccessful in preventing numerous outbreaks of disease that quickly spread through the encampments. The former slaves commonly suffered from smallpox, as well as diarrhea caused by any number of illnesses. Some estimates put the number of deaths suffered by freedmen at twenty-five percent in their first weeks in the camps. In March 1864, Quakers in Indiana sent two missionaries to Helena to establish an orphan asylum to provide for the children who had lost their parents to disease in the city. With such large numbers of sick former slaves, white troops continued to fall ill even in the face of better healthcare. Eventually, Union authorities responded to this medical crisis by establishing military farm colonies for former slaves in the Arkansas Delta. This allowed the freedmen to become self-sufficient and lowered the population inside Helena and other towns.

Men who were former slaves also enlisted into the Federal army. Stationed at Helena and other Union strongholds, these men continued to suffer from high rates of disease. This was in part due to both continued poor sanitation, as the United States Colored Troops (USCT) units often received the worst camping locations within the city, as well as resulting from a continued shortage of qualified medical professionals willing to serve in African-American units. A single general hospital operated in Helena, while the nearest medical facility for USCT soldiers was located in DeValls Bluff. Little Rock and Memphis, Tennessee, also had hospitals open to soldiers in Helena.

The large numbers of sick troops affected Union military operations and prevented commanders from continually launching large-scale operations. In Arkansas, more than 182,500 white Federal troops became infirm during the war. Only about 4,450 were directly related to wounds, accidents, and other injuries, and the remaining was from some type of illness. Some 2,348 Union men suffering from illness died in the state during the war. The number of USCT troops that became ill in the state cannot be precisely determined, but the national mortality rate for USCT troops due to disease was 148 per 1,000, compared with 88 per 1,000 for white troops.

Confederate troops continued to suffer from disease during the war, although seemingly not in as large numbers as did their Union counterparts. After the Battle of Shiloh in April 1862, the Confederate government organized a medical department in Little Rock. This organization used a medical board of local physicians to examine applicants for commissions as surgeons and assistant surgeons. This system effectively weeded out inferior doctors. A facility for the manufacture of medicines was established in Arkadelphia (Clark County).

Outbreaks of disease continued throughout the war in southwestern Arkansas after the fall of Little Rock to Union forces in 1863. Treatment of these men was often exacerbated by dwindling supplies of medical supplies. Reliable numbers on the number of Confederates who suffered from disease in the state are not available.

The end of war saw the rate of disease in the state slowly lowering. With a major reduction of troops in the state, coupled with freedmen no longer being forced to live in confined quarters, outbreaks of disease in Arkansas dropped to prewar levels.

For additional information:
Adams, George W. Doctors in Blue: The Medical History of the Union Army in the Civil War. New York: Collier Books, 1961.

Bell, Andrew. Mosquito Soldiers: Malaria, Yellow Fever, and the Course of the American Civil War. Baton Rouge: Louisiana State University Press, 2010.

Finley, Randy. “In War’s Wake: Health Care and the Arkansas Freedman, 1863–1868.” Arkansas Historical Quarterly 51 (Summer 1992): 135–163.

Foster, Gaines M. “The Limitations of Federal Health Care of Freedmen, 1862–1868.” Journal of Southern History 48 (August 1982): 349–372.

Freemon, Frank R. Gangrene and Glory: Medical Care during the American Civil War. Madison, NJ: Fairleigh Dickinson University Press, 1998.

Hacker, J. David. “A Census-Based Count of the Civil War Dead.” Civil War History 57 (December 2011): 307–348.

Kellum, Rachel M. “Surgeons of the Severed Limb: Confederate Military Medicine in Arkansas, 1863–1865.” MA thesis, Jackson College of Graduate Studies, 2014.

Pitcock, Cynthia DeHaven, and Bill J. Gurley. I Acted from Principle: The Civil War Diary of Dr. William M. McPheeters, Confederate Surgeon in the Trans-Mississippi. Fayetteville: University of Arkansas Press, 2002.

Steiner, Paul E. Disease in the Civil War: Natural Biological Warfare in 1861–1865. Springfield, IL: Charles C. Thomas, 1968.

United States Department of the Army, Office of the Surgeon General. The Medical and Surgical History of the Civil War. 12 vols. Washington DC: Government Printing Office, 1870.




Amputations were a common surgery performed in the civil war. Doctors said that it saved many more lives than it killed. Survival rate for amputations done in the first 24hrs. After an injury was very good with mortality. If they were done after the first 24hrs -mortality rate doubled to 50%. Surgeons tried to go as fast as possible. It’s generally a myth that most operations were performed without anesthesia with only a bullet to bite.

Their procedure:

1st-they cut off blood flow with a tourniquet.

2nd-after that he’d take a scalpel and slice through the outlying tissue and flesh.

3rd-Then he’d use a hacksaw-like tool called a capital saw to saw through the bone. (It had replaceable blades.)

4th-after bone and flesh was all sliced off the surgeon would take silk sutures in the north and cotton sutures in the south and sew the major arteries and veins together. This limb would be dropped on a pile that got thrown out on the platform. This would take about 15 min.

Amputation tools

Proving an amputation or surgical kit was used in the Civil War is difficult. There were two types of amputation blades, The circular blade which would more than likely be earlier then the Civil War, and the straight blade about the time of the Civil War.

Walter Reed and Armory Square: Saying Goodbye to 2 Historic D.C. Military Hospitals

By Diane Wendt, NMAH, 7-29-11

Editor's Note: This is the fourth post in a series featuring additional context about "So Much Need of Service": The Diary of a Civil War Nurse, a joint exhibition with the National Library of Medicine that documents the experiences of those who contributed to the Civil War effort, such as nurses Amanda Akin and Anna Lowell.

As I read in the papers about the closing of Walter Reed Army Medical Center, I am reminded of the closing of another military hospital in Washington, D.C., nearly 150 years ago.

From the last issue of the Armory Square Hospital Gazette, August 21, 1865:

Last Monday it was decided to close Armory Square Hospital, at once. This announcement was not wholly unexpected, vague rumors having been in circulation for a week or two past. We had hoped that our hospital would be the last to close . . .

During the last three years, thousands of our brave soldiers have been inmates of Armory Square . . . One cannot conceive of a gun-shot wound that has not been treated here. Of nearly every disease in the catalogue we have had examples. Such an opportunity for the practice of surgery, or the study of pathology and the treatment of disease, will not probably occur again soon. God grant that the stern emergency of a bloody civil war, which rendered so many asylums for our wounded and sick soldiers a necessity, may never again arise to curse with its mildew blights our native land.

We now bid adieu to Armory Square—but not without some regrets . . . Within its walls we have learned many a lesson of wisdom, of patience under suffering—of the keenest grief—of faith, forgiveness, of true manhood . . .

Armory Square Hospital was built in the second year of the Civil War on land adjacent to the Smithsonian Institution, approximately where the National Air and Space Museum stands today. The hospital is the subject of a small display showcasing the diary of a woman who served as a nurse there. Armory Square was open for only three years (1862-1865), but in that time it administered to over 13,000 wounded and sick soldiers. In addition, the hospital employed individuals from privileged backgrounds as well as newly freed slaves, and served as a temporary home for a staff of several hundred people, including surgeons, clerks, attendants, nurses, cooks, laundresses, and guards.

Diane Wendt is Associate Curator in the Division of Medicine and Science at the National Museum of American History.

Image: Interior of Ward K, Armory Square Hospital, 1865. Courtesy of Library of Congress.


Harriet Tubman USA: Underground Railroad "Conductor", Nurse, Spy, 1820/1821 - 3-10-1913


Perhaps one of the best known personalities of the Civil War, Harriet Tubman was born into slavery as Araminta Ross, on the Eastern Shore of Maryland, sometime in 1820 or 1821. As a child, Tubman was “hired out” to various masters who proved to be particularly cruel and abusive to her. As a result of a head injury caused by one of these men, she suffered from seizures and “visions” for the rest of her life, which she believed were sent from God.

In 1840, Tubman’s father was freed as a result of a stipulation in his master’s will, but continued to work for his former owner’s family. Although Tubman, her mother, and her siblings were also supposed to be freed, the law was ignored and they remained enslaved. Tubman married a free black in 1844, and changed her first name from Araminta to Harriet.

In 1849, Tubman became seriously ill with complications from her head injury, and her owner decided to sell her, but could not find a buyer. After her owner’s sudden death, the family began selling off all of the slaves. Not wanting to have her family separated, Tubman was determined to escape. A first attempt, in which Tubman was accompanied by her brothers, was aborted when they had second thoughts. Tubman decided to try again on her own, and she escaped via the Underground Railroad into Pennsylvania.

Tubman settled in Philadelphia and was able to support herself doing odd jobs. But in 1850, word came that her niece and her two children were to be sold. Tubman was determined to help, and went back to Maryland. With the assistance of her brother-in-law, Tubman was able to bring her niece and the two children back safely to Philadelphia. This was the first of many trips that Tubman would make to lead family members and others to freedom. On one expedition, Tubman contacted her husband in the hopes that he would follow her to Pennsylvania, but he had remarried and preferred to remain in Maryland.

Over the course of 11 years, Tubman rescued over 70 slaves from Maryland, and assisted 50 or 60 others in making their way to Canada. During this time, her reputation in the abolitionist community grew, and she became acquainted with Frederick Douglass and John Brown. She also moved her base of operations to Auburn, New York, closer to the Canadian border. Tubman conducted her last rescue mission in November 1861, as the Civil War enveloped the nation.

Tubman offered her services to the Union Army, and in early 1862, she went to South Carolina to provide badly needed nursing care for black soldiers and newly liberated slaves. Working with General David Hunter, Tubman also began spying and scouting missions behind Confederate lines. In June of 1863, she accompanied Colonel James Montgomery in an assault on several plantations along the Combahee River, rescuing more than 700 slaves. Her deed was celebrated in the press and she became even more famous.

With the end of the war, Tubman returned to Auburn, NY and married a Civil War veteran. Although her service in the Union Army was much publicized, she had great difficulty in getting a pension from the government, but was eventually awarded a nurse’s pension in the 1880s. She did not stay idle in her later years, taking on the cause of women’s suffrage with the same determination she had shown for abolition.

Tubman established the Harriet Tubman Home for the Aged on a property adjacent to her own. After undergoing brain surgery to try to alleviate the symptoms from the head injury that had plagued her since childhood, and being essentially penniless, Tubman was forced to move into the home herself in 1911. She died there on March 10, 1913, surrounded by family and friends. She was buried with military honors at Fort Hill Cemetery in Auburn.

Paddlewheelers And Hospital Ships


When Robert Fulton designed the first working steamboat in 1807, he probably didn't realize that his invention would lead to one of the most interesting innovations of the Civil War. Steamboats revolutionized river travel during the 1800s: for the first time, people were able to travel up and down America's mighty waterways under motorized power, rather than relying on muscle or the wind. Steamboats became the fastest and most efficient way to transport people and goods up and down the United States rivers. St. Louis, Missouri, a major port on the Mississippi River, had more than 3,000 steamboat arrivals in 1850 alone.

When the Civil War erupted, control of the country's rivers became more important than ever. Both the Confederate and Union armies had flotillas of boats they used as floating barracks, supply ships, and gunboats for fighting against artillery units.

Contrabands to Freedom
For many runaway slaves in the South, the best chance for freedom was to get on board a Union boat like Red Rover as it steamed up or down the Mississippi River. These slaves were called "contraband," and many ships hired them to serve as cabin boys, carpenters, laborers, cooks, stewards, crewman, and nurses. Working on board Red Rover had many advantages, one being the pay: the ship's records show that several chambermaids were paid$20 a month for their work. In comparison, the base pay for infantrymen in the Union army was only $13 a month.

Confederate Paddlewheelers
The Confederate paddlewheeler Red Rover was on the Mississippi River near St. Louis when it was captured by a Union gunboat. The Confederates tried to sink Red Rover to put it out of use, but the Union was able to dredge it and repair it for service. And although the Union was desperate for more gunboats to patrol the Mississippi and its tributaries, it decided to try something new with the Red Rover, the army refitted Red Rover as a floating hospital.

Transporting wounded soldiers by boat was nothing new for either army, but it was usually a pretty terrible experience for soldiers who were already paddlewheelers—pros and cons:

One reason paddlewheelers became so prevalent during the 1800s was that they were ideally suited to river travel: most paddleboats had a draft of no more than 6 or 7 feet, and some had as few as 4 feet, which meant they were able to steam up and down the wide, shallow rivers of the American West much better than any deep-hulled boats. The problem with them, however, was that their flat hulls were very difficult to maneuver if the weather or water got rough, since steering a paddlewheeler was very much like steering a giant box.

In bad shape: the boats were loud, dirty, and rarely had the supplies or personnel necessary to treat illness or injury. Transport ships usually picked up wounded soldiers at the port closest to the battle, brought them to the nearest friendly hospital, and dropped them off. Not a lot of medicine was being practiced on these ships, and the conditions were difficult.

Neither the Union nor Confederacy had ever created a complete hospital aboard a steamship before, and Red Rover was refitted with innovations never before found on a ship, all designed to help the sick and wounded. It had separate operating and amputation rooms, and the windows were covered with gauze to keep cinders and smoke from the smokestacks away from the know your slang patients. Rooms at the back of the ship had open walls to allow for better air circulation, and patients who had contagious diseases were put in these, as well as on several separate floating barges attached to the back of the ship. This helped keep the spread of very contagious diseases, such as measles and typhus, from infecting everyone on board. Red Rover also carried enough medical and food supplies for two hundred patients and the entire crew for up to three months—everything the hospital staff needed was on board, making the ship completely self-sufficient if it needed to be.

And while Red Rover was remarkable as the first complete floating hospital, what was more amazing was her crew: it consisted not only of the first women serving in the U.S. armed forces, but also the first African-American women hired by either side.

Red Rover's reputation as a hospital with conveniences, comfortable accommodations, and very caring medical staff grew quickly; so quickly, in fact, that fleet commander Charles Henry Davis had to issue an order to limit the number of patients being sent to the ship—it seemed like every sick or injured soldier wanted to be cared for on Red Rover. The order apparently didn't work all the time, since the ship's log shows that many patients came on without papers, or simply under the verbal approval of particular doctors or high-ranking officials.

Red Rover transported and cared for soldiers throughout the war, shuttling from port to port on the Mississippi River. Most of its hospital duties came to an end after the Battle of Vicksburg in 1863, which gave the Union control over most of the waterways and marked the end of most of the river action on the western front. For the rest of the war, Red Rover was primarily used to transport supplies.

Civil War Facts & Trivia

*The women who served as nurses on Red Rover are credited with officially being the first women to serve on board a naval vessel. In most accounts, the nuns who served on Red Rover are given the credit for being the first U.S. naval nurses, even though the ship's records show that the contraband women were hired outright after being welcomed on board, making them the first paid women naval employees.

*From the end of the Civil War to 1908, women were not allowed to serve in the navy.

*The majority of Red Rovers crew was African-American: at one point, black sailors and crew outnumbered white crew by two to one. It wasn't until 1865 that white crewmen outnumbered black crewmen.

Nurses and the U.S. Navy, Prior to 1908


Nursing, in the sense of bedside attendance of the sick and injured, has existed in the Navy from the first. Performed by enlisted crew members, the function was increasingly formalized during the 19th Century as part of the duties of the emerging hospital corpsman rates.

Even in the early 1800s, there was a recommendation that women be employed as Navy nurses. Nothing much came of this until the American Civil War, when Catholic Sisters of the Holy Cross served in Navy facilities and on board the pioneer hospital ship USS Red Rover in the Mississippi River area. This was part of a great endeavor by Religious and lay women during the conflict, an undertaking that led to the post-war establishment of nursing as a real profession requiring formal training -- a profession both open to and dominated by women.

During the 1898 Spanish-American War, the Navy employed a modest number of female contract nurses in its hospitals ashore and sent trained male nurses to sea on the hospital ship Solace. At the same time, the U.S. Army put women nurses on board ship, in its hospital ship Relief, and in 1901 obtained Congressional approval to establish the U.S. Army Nurse Corp (Female).

In 1902 the Navy's Surgeon-General proposed a similar arrangement for the sea service. Five years later, he reported to the Congress that "The Government supplies physicians and surgeons, splendidly equipped hospitals, and complete emergency facilities on every ship. The most serious omission in this excellent establishment is the want of that skilled nursing which civil institutions enjoy".

Image: Mother Angela Gillespie Founder of the Holy Cross Nursing Sisters. She was supervisor of the eighty Holy Cross Sisters who served as military nurses during the Civil War. Courtesy of the Sisters of the Holy Cross, 1965. U.S. Naval Historical Center Photograph.

"Heroes Come with Empty Sleeves"

By Matt Coletti,  7-20-15

Andrew Roy was 26 years old when Lieutenant Henry S. Farley lobbed the infamous first shot of the Civil War over Charleston Harbor on April 17, 1861. He answered President Lincoln's call for 75,000 volunteers by travelling north from his native Maryland and enlisting in a Pennsylvania regiment. The young man paid dearly for his zeal when he was gravely wounded at the Battle of Gaines Mill.

A private in Company F, Tenth Pennsylvania Reserves, Andrew Roy and his unit rushed forward to bolster the Union line against tenacious Confederate assaults. During the charge, he was felled by a shot that destroyed the left side of his pelvis. Roy was then captured when the field hospital he was kept in was overrun by Rebel forces a few days later. Upon returning home from a Confederate prisoner-of-war camp in Richmond, Virginia, his transition to civilian life was plagued by the wound's perpetual pain and numbness. Back home, despite holding a managerial position at a mine, Roy took weeks off from his job because of his health, relying on a disability pension for survival. Before his death in 1914, he lamented, "My lameness grows worse and the pain is more severe each year. ... My [left] foot seems dead." Doctors commented that he was, "wholly unfit to care for himself and demands constant attention."

Andrew Roy was one of over 275,000 northern soldiers wounded in the American Civil War—although he avoided amputation, unlike more than 20,000 fellow comrades who wore the Union blue. Following the death and destruction of the war, survivors faced the difficult task of finding significance in their suffering and sacrifice. Northern civilians and wounded veterans of the Federal Army offered an array of responses to the nation's anguish through ritualized commemorations in the ensuing decades. Two dominant portrayals of disabled veterans emerged: pitiful cripples and a more popular version depicting the wounded as the epitome of masculine patriotism. Scars, limps, and amputations were honorifics that symbolized the Union man's character as an individual who had sacrificed dearly to preserve the Union.

Religion helped to define public perceptions of wounded veterans, suggesting that a soldier's torment was ordained by a higher power for the national good. As Henry Palmer wrote in a handwriting competition for Federal soldiers who had lost a dominant hand:

"My right arm, as if conscious of approaching dissolution, seemingly bequeathed unto the left arm, all the properties of which it died, seized and possessed.  The seal of this Last Will and Testament was the bloodseal of amputation—Patriotism, Love and Country, and Equal Rights were the subscribing witnesses to the instrument—The body from which the arm was severed, was the Executor—In Heaven's Court, the will was proved, allowed and recorded."

Despite the misery, Union veterans attempted to demonstrate self-reliance. Perhaps the greatest example of independence was Major General Oliver Otis Howard, who rose to become the head of the Freedmen's Bureau after the war. Veterans argued that their injuries encouraged increased social and economic independence, and some used their wounds for political leverage. Lucius Fairchild, who received an amputation after being seriously wounded during the Battle of Gettysburg, won the Wisconsin gubernatorial election of 1866 and became a prominent veteran-affairs spokesperson for former members of the Federal Army. As such, scarred veterans as virtuous harbingers appeared in the popular culture for a public concerned about the profound effects of the war on wounded soldiers. "The Empty Sleeve: A Song with Chorus" by P.A. Hanaford and Reverend J.W. Dadmun of Boston, Massachusetts, was a popular sheet music written in 1866. Its chorus venerated Civil War veterans:

"Three hearty cheers for those who lost
An arm in Freedom's Fray
And bear about an empty sleeve
But a patriot's heart today."

The lyrics correlate physical sacrifice and triumphant patriotism. This righteous empty sleeve iconography was not equally bestowed, however. African American veterans went unacknowledged, and were barred from most veterans' organizations. Veteran Will Thomas, who participated in the same contest as Henry Palmer stated, "I don't expect to win a position as a clerk, that being ascribed on count of my color." Thus, at least within the confines of northern society, the physical changes that black veterans like Thomas suffered were largely ignored by the community. Listen to the song here. This post's headline also comes from the song's lyrics.

While many men spoke of their injuries in a variety of ways, many more remained silent about the nature of their wounds. While some wounded veterans celebrated personal success later in life, others endured a lifetime of hardship. Roy did not say how his wound affected his patriotism despite professing great esteem for the late Abraham Lincoln in a speech given several decades after General Robert E. Lee's surrender to General Ulysses S. Grant in Wilmer McLean's parlor. The stories circulated by thousands of northern veterans and civilians illustrated the complex post-war psyche that attempted to explain the presence of the permanently wounded soldiers who had served in "Mr. Lincoln's army."

Note: The phrase has been borrowed from the first book in Bruce Catton's trilogy chronicling the history of the Army of the Potomac.

Matt Coletti is a graduate student in the Public History Program at the University of Massachusetts Amherst. His academic interests include the public memory and contemporary collective interpretations of the American Civil War, as well as the psychological repercussions of war on individual and community life in a historical context.

Image 1: Sheet music cover with fancy geometric border and text saying "The Empty Sleeve" in ornate typeface.The sheet music, "The Empty Sleeve" created by P.A. Hanaford and Reverend J.W. Dadmun, circa 1866, in the museum's collection.

Image 2: Black and white portrait of man in military uniform with two sleeves pinned up. A carte-de-visite featuring a wounded veteran of the Union army taken some time during the 1860s. Many veterans with a visible, permanent wound would pin their shirt and/or pant sleeves together instead of opting for free artificial limbs that were considered very uncomfortable.

Hell--In Arkansas


Andrew F. Sperry, author of the 33rd Iowa Volunteer Infantry’s regimental history, gives his regiment credit for the nickname Hell-in-Arkansas. The 33rd came down the Mississippi River from Columbus, Kentucky, on the steamer John D. Perry, arriving in Helena on January 13, 1863. Sperry wrote, “About Noon on Sunday, the 13th, we reached Helena, Arkansas, which place some of the boys profanely denominated ‘Hell-in-Arkansas’– a name more intimate acquaintance, inclined to justify. . . .” The Iowa boys got off the boat in the rain and pitched their tents in a muddy abandoned garden in the middle of town.

In 1860, Helena had 1,500 residents. In the spring of 1861, four hundred men left to join the Confederate army. Some civilians fled when news of the Union army’s approach reached the city. How many residents remained in town when General Samuel Curtis arrived in Helena on July 12, 1862, with 12,000 Union troops and 2,000 Contraband following the army is unknown.. The little river port town was unprepared for such an influx.

The hell actually began before Curtis’s Union soldiers got to Helena. A number of men had been wounded in engagements with Confederates and partisans on the march through Arkansas. All were weak from weeks of fighting heat, thirst, insects and reptiles. Many became ill soon after they arrived in Helena. No matter the cause, their condition was made worse by the lack of proper hospital facilities.

In early August 1862, Dr. Charles Brackett of the 9th Illinois Cavalry wrote his wife about the hospitals in Helena “. . . by the time I had finished was thoroughly used up. It was the hottest day of the season when even the acclimated citizens kept [to] the house.” The heat in the summer months spawned insects and generated dust. Contaminated water caused diarrhea. When the rains began, the dust turned to mud.

Two accounts from the winter of 1862-63 paint a grim picture of the streets of Helena. Annie Wittenmeyer, a nurse, visited Helena in December 1862, to inspect the hospitals. A four-mule wagon was sent to take Mrs. Wittenmeyer from the dock into town. The wagon had not gone far before the mules began to sink in the mud. After a great deal of struggle, and with the help of soldiers, the mules were rescued. The wagon was abandoned and a placard placed on it that read “No Bottom.” An Indiana regiment reported a similar event in February, only they reported that “a mule and a horse drowned near the center of town.”

An Iowa soldier wrote to his father in February 1863, “There are about 30 thousand troops encamped in and around Helena, and I can say without exaggerating that there is buried forty men every day and sometimes more.” George Hammond, an inspector from the Medical Directors Office concurred. He wrote to district headquarters, “I am fully impressed with the idea that Helena is no fit place for a General Hospital and that no sick should be left here that could be moved to a more northern Hospital.” Hammond felt that all of the hospitals in Helena should be shut down and the patients sent elsewhere.

Hammond’s suggestion was ignored. A garrisoned city could not exist without a hospital. In fact, the general hospital at Helena did not close until 1866. At the time of the inspection there were four major hospitals in Helena: Hindman House, Rightor House, Convalescent Camp [on the river bank] and the Pest House/Small Pox barracks. In addition, each regiment had its own small hospital tent or building.

The July 4, 1863, Battle of Helena resulted in hundreds of casualties. The resulting wounded quickly overwhelmed the four hospitals and the medical staff. Most of the houses in town, the churches, and St. Catherine’s convent were pressed into service as hospitals. A little over a month after the battle, Anne Wittenmeyer returned to Helena to deliver medical supplies. The Baptist and Methodist churches were crowded with sick and wounded. When she inspected the hospitals she was appalled: “There were few cots in these two churches; most of the men were lying in the narrow pews, with the scant uneven cushions for their beds. The weather was extremely hot, and flies swarmed over everybody and everything. The faces of some of the men, who were too helpless to keep up a continual fight with them wereblack with swarming hungry flies.” The only drinking water had been taken from the river and was being stored in rancid pickled meat barrels. Mrs. Wittenmeyer bought ice from a boat at the dock so that the men could have cool water, if nothing else.

Wittenmeyer and her aid spent two days in Helena. “For two long days, through sun and dust, we went from hospital to hospital, till we, too, became hopeless.” She finally determined that the only way to save the men was to get them out of Helena and to the large hospital facility in Memphis. The plucky nurse hopped a northbound steamer and went from office to office until she roused a general out of his sick bed. She asked that four hospital boats be sent to Helena. She reinforced her request by mentioning that if all else failed she’d have to go to the newspapers. In the end, Wittenmeyer got her boats and the worst of the sick and wounded were taken to Memphis.

In the winter of 1864, an inspection report stated that many of the men in the 2nd, 3rd, and 4th Arkansas Infantry Regiments of African Descent and the 1st Iowa Infantry Regiment of African Descent were sick. The inspector blamed the locations of the camps, which were wet. Part of the problem was sewage seeping from the soldiers’ sinks [latrines]. In December, Dr. Charles Brackett sent a letter to Colonel Hiram Sickles, 9th Illinois, urging him to enforce regulations regarding the proper construction, maintenance and use of the sinks. Brackett wrote, “Already the camp is offensive about its outskirts from a neglect of this matter . . .” The doctor saw a real danger, because the sinks were located near the place from which the men obtained water. Ironically, Dr. Brackett died of typhoid fever in February. No doubt similar problems plagued the Arkansas and Iowa regiments cited by the inspector. The commanding officers of two of the regiments were condemned by the inspector as being unfit for command.

Charles O. Musser of the 29th Iowa reported a great deal of sickness in his regiment. He noted that only 230 out of the regiment’s 900 men were present at dress parade. “It is hard to see so many men away from home suffering and dying more for the want of care and attention than anything else. The post hospital here is full, and several steamboats are occupied for hospitals. . .” Subsequent inspections in the spring found an improvement in the general health and condition of the garrison at Helena. The inspector commended General Napoleon B. Buford, writing of his “. . . untiring energy and the able manner in which he commands.”

Incidents of illness decreased with the cool spring weather but when summer came with its oppressive heat, humidity, and insects, people began to get sick again. One inspector blamed the sickness on vaccinations, which he felt should not have been given to the men in the heat of the year. In July 1864, there were 5,556 enlisted men on duty in Helena and over 1,000 of them were reported sick.

Illness was rampant among the 6th Minnesota. The climate and lack of good sanitary conditions were probably responsible for most of the sickness. The toll Helena took on the 6th Minnesota is staggering. According to the Minnesota Adjutant General’s report, when the regiment arrived in Helena in June 1864, it was full, meaning that there were 1,000 men in the regiment. In August, only seven officers and 178 men were fit for duty. Six hundred of the Minnesotans were sent to northern hospitals.

The 6th Minnesota originally encamped in a low area on the bank of the Mississippi River. The regiment eventually moved up near the Hornor house but by then the damage had been done. It is likely that the sickness that befell the men was typhoid or another disease associated with unsanitary conditions. Malaria is another possibility.

The plight of the Minnesotans, while extreme, was hardly unique. Laundry lists of death and sickness fill the letters, diaries and regimental histories. Helena was not a healthy place. W.P. Belden, surgeon of the 6th Minnesota, summed up Hell-in-Arkansas, “. . . Helena is a city in a swamp, and is the city which the valorous Sixth helped hold through trying times, in the face of poisonous dangers a hundred fold more damaging and terrifying than the fiercest battlefield. . .”

The hell continued even after the war was over. In August 1866, two steamers left Helena for St. Louis with the officers and men of the 56th U.S. Colored Infantry aboard. By the time the two boats reached Cairo, Illinois, thirteen men on one steamer had died, and one aboard the other. Over sixty men were sick. By the time the vessels arrived in St. Louis another fifty men had died. The first army surgeon found no cholera but a second confirmed cholera on board. The soldiers were sent to the Quarantine Grounds at Jefferson Barracks. By the end of August, 175 officers and men had died. They were buried at Jefferson Barracks National Cemetery.

Image: Hindman House and Battery on Hill

Tuesday, November 22, 2016

Jane Boswell Moore and the Christian Commission


WINCHESTER, VA., August 31, 1864.
REV. J. N. M'Jilton, D. D.:

Dear Sir:--
On my return from daily distribution in Sheridan Hospital I received your kind letter, and hasten to thank you for the generous assistance and encouragement I have ever met with from you, in a task whose difficulties are known to few, and if aught from my pen can benefit the suffering, or appeal in their behalf, it shall not be wanting. Early in the spring we visited Wheeling, and collected some thirty boxes of stores and delicacies for the troops in the Valley, receiving also from Mr. Stewart a large assortment of books, leaflets, paper, &c. With these we visited General Siegel's army, near Winchester supplying the 12th West Va., the 1st Wheeling Battery, Snow's Maryland Battery, the 1st Va., the 54th Penn., 18th Conn., 34th Mass., and other regiments, with Hymn-books, papers, soldier's books, pickles, stationery, &,c. The army received marching orders before we left, and we had the satisfaction of bringing a mail of our own collection, (knapsacks and writing material having been sent to the rear) of thirteen hundred letters, some of them doubtless, the last the writers ever pen penned.

In May, by the advice of the Surgeon General, we took a large collection of stores up the James River, remaining ten weeks in the hospitals of the 10th and 18th. Corps, at Point of Rocks, on the Appomattox. After the battle of May the 20th, many of the wounded were brought here, and to not a few of these we supplied as well as others could supply, the places of mothers and sisters far away. In our little room, filled as it was with boxes, barrels, and cooking utensils, the Delegates had one delightful soldier's prayer-meeting, attended by some fifty of our patients. In the graveyard at the "Point," sleep many who were then the objects of our care. When the mine was exploded, and the disastrous charge made before Petersburg, a wide field was offered in the field hospitals of the 9th corps, within some two miles of Petersburg, and a tent being furnished us, through the kindness of the Medical Director, Dr. Prince, at General Burnside's request, we devoted ourselves more particularly to the relief of the sick and wounded of Gen. Ferrero's Division, (colored) and mostly from Maryland. The horrors of Gettysburg did not surpass those of that day-even yet I recall those woods, thickly strewn with the mangled and dying, some with arm and leg off, one with both eyes gone, some insensible, and others moaning, in an agony of pain. Only half an hour had elapsed since they had been wounded, and the war of musketry close by, sounding awfully in our ears, as halting our ambulance, Rev. Mr. Boole, of the Commission, my mother and self, made pail after pail of milk punch, and distributed it, with handkerchief's, bandages, canned peaches, wine, crackers, &c., to the sufferers. "I have not seen a lady for months," said one poor boy, who was ready to weep over the disasters of the day, "and it does seem sweet to see one in this awful place." Colored citizens of Baltimore cried to us to give them "only one cracker," and our hearts melted when the appeal was enforced by their directing our attention to the "stump" of an amputated arm, or leg. In the box there proved to be a few strap tracts, and books, and these were handed to those who could read. "Are those Testaments?" said a colored soldier, "do please give me one. I tried so hard, as I lay wounded on the field, to reach one, that had dropped from a dead soldier's pocket, but my wounds were so painful I could not crawl far enough." What a spectacle the Gospel of Peace so earnestly called for, in a spot more resembling hell than aught else on earth! As I moved in the midst of these appalling horrors, I heard many groans and prayers, one just brought from the "table" was saying with all the fervor of a departing soul, I shall never see my home again, but Lord, don't you forget me." Death reveled in their midst, and few had time to number or notice his victims. How delighted they were to know that we would bear their messages home to their native city, our much loved Baltimore.

As we hurried to and fro, a group of newly organized colored musicians, collected in the woods, and struck up, "My Maryland." We had not time then to thank them, but do it now. In this hospital we remained two weeks, ministering to their temporal wants, as well as writing letters, which most of them could not do themselves. Many of these are well worthy of publication; one with five severe wounds, wrote to his wife, "You must take things as they are. I am a soldier. Keep the faith"- and then passed away.

Through the assistance of Mr. Caton, a Delegate from Ohio, we were enabled to do much good, and the eagerness of the 30th and 39th U. S. colored regiment, in the Fourth Division, for reading and spelling books, cannot be described. They literally hungered and thirsted after instructions. And some carried books of large size through many a weary march. When I refused them to those who could not read, they looked up pleadingly, saying, "But I wants' to learn. I'se tryin all I can." Never shall I forget the words of one, brought in sun-struck, and laid on the earth, in the midst of great discomfort. I asked where his friends were, "Lady," said he, "my wife is sornewhar, and my mother is somewhar, but whar, I don't know." He seemed to feel his condition deeply; but a moment after, Jesus was mentioned. "Oh," said the poor untutored African, his eyes beaming as he spoke, "You may have all this world, but give me JESUS." And rarely have I heard such fervent, heart-felt prayers, as the man poured forth, in behalf of our distracted and bleeding land. Would that all Christians prayed thus!

Before going to the 9th Corps, the deadly malaria, so fatal in this region during the summer months, and frequent riding without regular food, from early morning until late at night, laid me on a sick bed, and I was removed at the suggestion of Dr. Pratt, of a Maine regiment, on board the hospital boat, "Matilda," lying in James river. Dr. Pratt was the Surgeon in charge, and through his care, though certainly not by his advice, I went again to the hospitals nearer Petersburg. In the 1st Maryland Dismounted Cavalry, at Deep Bottom, I found a number of sick, who preferred remaining there to being removed to Point of Rocks. They were needy and uncomfortable, and milk, tomatoes, jelly, stationery, &c., were very acceptable. The 1st, 4th, 7th and 8th Maryland regiments, we found in the "Maryland Brigade" of the Fifth Corps, and, says one, "may you be rewarded by the deep gratitude of thankful soldiers." Here, as in other Maryland regiments, we distributed Testaments, Hymn-books, papers, books, stationery, canned and dried fruits, condensed milk, handkerchiefs, &c. The 5th Maryland received Testaments and Hymnbooks very joyfully, and many of the forms that gathered round our ambulance, on that shadowless, burning plain, were so altered by exposure and hardships, that they would scarcely have been recognized at home. We could hardly refrain from tears, when in an opening in a dense wood, frequently shelled by the enemy, and on the very spot where a soldier had been killed two days before, the small remnant of the gallant 2nd and 3rd Maryland regiments, now, as one said; "a mere handful of men" surrounded us, and expressed their satisfaction drat some one from their State was looking after their interests in an especial manner. Money could not purchase the precious letters we since have received from them. "The Hymn-book you left," writes one, "has solaced many a lonely hour." "I greatly prize the Testament, especially as it was given by your hand." "We pray for you, that God may bless you, morning and night, and we thank God who put it into your heart to come among us."

Mr. Caton and myself had a narrow escape. Hearing that many of the colored soldiers from ignorance in writing, and directing, were unable to send their money safely to their friends; I offered to carry it in person, and deliver it freely, for those whose families resided in Baltimore, Some two thousand dollars, a number of watches, letters, likenesses, &c., were thus entrusted to our care, and conveyed to their friends. Some articles belonged to the fallen, and were received in tearful grief-the distress of one poor woman, whose husband had been killed, I shall never forget. One, whose arm was gone, wrote, "The night before, when I heard we was going into a fight, I went out by myself and prayed, and the only Best Friend I thought of, was the LORD."

Whilst receiving and directing the envelopes, which enclosed their payments, the Rebels opened a new and powerful battery upon us, and shell after shell whizzed through the air. We did not imagine ourselves in danger, until all at once a death-like stillness rested on the group, we in the ambulance did not see that on the ground beneath our wagon, and even under the horses, men were crouching for shelter; but we did hear the unearthly screeching of a shell, and with mute, pale faces waited for it to explode. But it passed directly over r our heads, and we were safe. Half an hour after we left, several exploded on that very spot.

We had previous received every kindness and assistance from Lieutenant General Grant, by whose special favor we were allowed to remain "Front" in General Burnside' Corps, and the anxiety thus shown by the Commander of our armies to have the wounded receive all the attention in his power, to our mind covers him with more honor than victories such as Vicksburg. By the way, the barrel of pickles furnished us through Mr. Bent, was taken in the midst, of a drenching rain, to some of General Sheridan's weary raiders as they were encamped at Haxall's Landing on James, river. The brave and chivalrous Col. Preston, of the 1st Vermont cavalry, tin cup in hand, dealt them out to his tired men, meeting our thanks with the reply, "No ladies, I feel that I cannot do too much for soldiers." And then he proposed; and they all gave three hearty cheers for their friends in Baltimore."
But a short time after, riding in the cars, I saw chronicled in the morning paper, the heavy loss of the 1st Vermont, and the death of the noble Colonel leading a charge at Coal Harbor.

Just before one of the battles of the Valley, we reached Winchester, and through the kindness of Dr. Manown, the Christian Surgeon of the Fourteenth Va., were furnished a room, &c., on Braddock street, near the West Va. or 8th Corps Hospitals. The afternoon of the 21st, we spent preparing pails of milk punch for the long trains of wounded corning in army wagons from the "Front."

Just about dark, they arrived, and we set to work supplying those on the street. It was a strange warlike scene--dark night settling over Virginia roads ; mud, cavalry and wagons-the last freighted with mangled, bleeding, but precious burdens. The night was raw and chilly, but we flitted to and fro, with flaming candles, and by the invaluable assistance of my faithful Brooklyn orderly, James Buckridge, supplied several hundreds. By and by we came to those containing the "Rebels," and the question was asked, " shall we supply them?" "Certainly," was my reply, "we have never made any distinctions, and as Christians, never shall." The sufferers had a night's ride of twenty-two miles to Martinsburg before diem. " But that punch did us a heap of good," said one, afterwards. Next night we supplied the wounded in forty seven wagons, though two of their agonized victims were dead when they arrived. The whole town seems to be full of hospitals, the Churches and many private dwellings being crowded, as well as the numerous tents of Sheridan, which, through the kindness of Capt. Mann, the courteous Quartermaster; we have been able to visit daily, and with constant supplies. In one ward is Isaac Price, of the Fifteenth Va., a soldier of thirty-eight years of age, with a wife and nine children, the eldest of whom, a lad of nineteen, is in the Tenth Va. But the greatest of calamities seems to have fallen upon him, for both his arms leave been amputated, yet he is cheerful and patient, always greeting us with a happy smile.

On the Church floor lay young Sergt. Smith, from N. J., shot through the lungs, and so agonized by the delirium of pain, that he vainly sought to tell us his father's name. What agony was in his tones as ire repeatedly exclaimed, "Oh I can't tell my father's name!" God grant that in the days of health he had made a loving friend of His heavenly Father, and went to be with him forever! "Thanks be unto God for that, I know and feel its truth!" exclaimed a Pennsylvania soldier named Jones, dying away from a destitute family, when I read to him of that fountain--

"Plunged beneath whose flood
Sinners lose all their guilty stains."

"What shall I read to you?" I asked Eli Davis, a member of the Fourteenth Va., mortally wounded. "I'm not much acquainted with books, and have no preference." But blessed be God, he was acquainted with Jesus, who revealed Himself to him as he lay there, wounded and without any outward agency, drew him to Himself. But the sweet prayer,

"Leave, oh leave me not alone,
Still support and comfort me!"

found an echo in his heart, and when I read those lines of a favorite hymn,

"We speak of the realms of the blest,
That country so bright and so fair,
And oft are its glories confessed ;
But what must it be to be there!"

his face shone, he was very near that glory, "and," said he, "I long to go! I want to go to my Jesus." For weeks Gilbert Buchanan of the Tenth Va., has been my daily care. Earnestly he desired to live; he was so young and it was hard to die without the sight of father or mother, whom I had written to come and see their dying son. Oh what a sad case his was! how sick as he was, he counted the miles and the length of the journey, and then died without the sight of a familiar face.

Every day a little package of letters, written for the sick and dying, by my mother, goes into the mail box, and what histories they reveal!

When you give a package of stationery to the Commission, dear reader, do you ever think what messages will be written upon each page? Some parent will hear of the death of the first or youngest born; some stricken wife learn that strangers cared for and closed the eyes of a dying husband, while to others tidings of safety will be gladly sent. Do not then withhold your offering.

One more incident from the many, and I close. I want to show bow a little girl's gift was bestowed, and to whom. Among some articles received by me from the Baltimore Commission, was a handsome Needle Bag, of soft red, white, and blue material, enclosing a few pieces of candy and a Carte de Visite of the giver. A note dated Gettysburg Pa., February 25th, accompanied it and read as follows

DEAR SOLDIER :-I can't do much for you, as I am a very little girl, but I think about you and pray for you too. I hope you are good and pray for yourself. When we had the battle here, I saw how you had to suffer, and I pity you. I carried things to the sick soldiers, and, if you were here, would do it for you. I send my picture that you may see how small I am. Good bye.

Perhaps Carrie thought she would never hear of her offering again. We shall see. On the Church floor lay a bright black eyed boy, named George Hill, a clear little fellow whom our good Dr. Manown carried in his arms from the wagon, the night the wounded came in. "It's a child's weight," said the Dr., as he tenderly guarded the maimed hero, " And I'm only a child," answered the clear treble voice. Where could Carrie have found a fitter recipient for her present. This is Georgie's reply:

November 5th, 1864.
DEAR LITTLE CARRIE: -- I am quite a little boy, and my name is Georgie Hill, Co. K, 13th West Virginia. I have been a soldier boy fourteen months, and was wounded in the leg with a minnie ball on the 19th of October, near Cedar creek, Va. I was carried to Newtown, and lay in a tent, and on the 20th, the Dr. took my right leg off. My father is dead, but I have a mother, three brothers and one sister in Mason Co., Va. Three of my brothers are dead, all soldiers, one died in the Mexican War, one at the siege of Vicksburg and one in the hospital at Gallapolis. Ohio. Mrs. and Miss Moore, who were at Gettysburg after the battle, are here taking care of us, and Miss Moore gave me your dear little present. She told me I must keep it as long as I live, to remember the time I lay wounded on the Church floor in Winchester, and I will. Yesterday they brought me to this hospital where the sick are all in tents, and I find mine very cold this windy day. I don't like it half so well as a house, and if I could, would not have left the warm Church. I was afraid Miss Moore would not know what tent I was in here, and so I should miss the nice things she brings round, but she found me to-day right in her ward. She got me a little puzzle box with seven pieces of wood, and if you know how, you can make squares, triangles, and funny figures. At first I could not put them all back into the box. I shall play with it when I go home, before I get my wooden lea, and am able to run round. We do suffer a great deal. One poor boy died next to me in the Church. He was in so mach pain, he could not tell where he lived nor his father's name. He was shot through the lungs and could hardly breathe. I heard him cry, "Oh I Lord help me! I can't tell my father's name! " I have not been home for fourteen months, and don't know when I shall get there. I have not heard from my mother for two months. Either she does not get my letters or I don't get hers, I don't know which. I am going to eat the candy after dinner--(I had some difficulty in convincing him of the propriety of waiting.) A lady brought me some pudding but it has lemon in it, and I don't like lemon, so I keep looking at the candy. Miss Moore asks if there is anything else I want to say. But I never wrote to you before, so you must excuse me, good bye Carrie.
Your little friend,

I hope Carrie will do more for the soldiers. I cannot close without acknowledging the kind assistance of Mr. Brackett, the Delegate from Maine, in charge of the station, who has furnished us with such articles as were at the Commission room. To Dr. Brock, also, I am indebted, as well as the suffering soldiers. May the time so soon come when we shall no more need to perform such acts of mercy! That the blessing of God may rest indeed and in truth, upon all who have aided us in our labor of Christian love, is my most earnest prayer, and upon none more than yourself.
I remain dear Sir, yours very truly,

Diagnosing the Civil War

By Margaret Humphreys, 11-11-13

Germs, not guns, were the Civil War's deadliest killer. Far from the drama on the battlefield, hundreds of thousands of young men died from infectious diseases.

Margaret Humphreys, Trent Professor of the History of Medicine, discusses the challenges of fighting infectious disease on the battlefield in her latest book "Marrow of Tragedy: The Health Crisis of the American Civil War."

Humphreys, who has also written about yellow fever and malaria outbreaks in the American South, will discuss her research at noon Tuesday, Nov. 19, in 2002 Duke Hospital.

Humphreys spoke with Ezgi Ustundag of Duke Today to discuss her research on disease and the Civil War.

Q: How did you come to take an interest in the history of infectious disease in the U.S., particularly in the South?

HUMPHREYS: It all began with picking up one book, Charles Rosenberg's monograph on cholera in the 19th Century United States.  Then it was amplified by courses on the history of medicine at my undergrad school, Notre Dame, and in graduate school.

Q: How did you research the history of infectious disease in the American Civil War for your latest book?

HUMPHREYS: My interest in the Civil War goes back to childhood, as I grew up near Fort Donelson in Tennessee and Civil War historical markers were all around me. By the time I began this book I had completed two projects on the history of disease (on yellow fever and malaria) and it was natural to put my fascination with the Civil War together with my enthusiasm for disease and its historical impact. I began the research for Marrow of Tragedy in the late 1990s, and dove into the vast literature on the Civil War by reading the papers of the United States Sanitary Commission (USSC), which are available on microfilm.

The USSC was a Red Cross-like humanitarian NGO in the North that particularly focused on the health and disease of soldiers. Other sources, aside from published books and articles, were the wonderful manuscript collections at Duke, UNC, the South Carolina State Archives, the Massachusetts Historical Society and the Museum of the Confederacy. Manuscript collections preserve letters, one-of-a-kind sources that reveal much about health and disease.

Q: What are some common misconceptions related to infectious diseases that people hold about the Civil War? How does your book address those misconceptions?

HUMPHREYS: The most common misconception about Civil War medicine in general is that they had to "bite the bullet." Wrong! Anesthesia with ether and chloroform had been introduced by 1860 and was available for operations throughout the war. They also had opium compounds.

Also common, in regard to infectious disease, is the assumption that antibiotics (20th century drugs) are necessary for survival, so that health care made no difference in the Civil War. But I found that there were degrees of good and bad health care, and understanding that led me to emphasize the factors that increase or decrease immune function in the absence of antibiotics. These factors seem mundane, but were crucial--abundant, nutritious food; cleanliness of person and environment; opportunities for sufficient rest and warmth; and hydration. You can see the difference in comparing Northern and Southern disease outcomes, as food and care were ample in the North and sorely lacking in the South.

Q: Why is the story of infectious disease in the Civil War one that the general public -- not just individuals interested in disease pathology -- should be aware of?

HUMPHREYS: I hope my readers will reconsider what matters in the sick room and the key aspects of healing. Many medical lessons were learned and applied in the Civil War that are not irrelevant to the modern day. If interested in the Civil War, I hope they can also learn to see the war as not just a glorious account of battles and victory/defeat, but as a health crisis that killed more than a million Americans and was a great tragedy for the nation.

Image: The United States Sanitary Commission helped track health and disease during the Civil War.

Samuel Preston Moore, Confederate Surgeon General


Samuel Preston Moore was born in Charleston, SC, in 1813 and graduated from the Medical College of the State of South Carolina in 1834. He moved to Little Rock, Arkansas, where he practiced briefly before being appointed assistant surgeon in the United States Army in 1835. During his time with the US Army, Moore served at posts in Florida, Iowa, Kansas, and Missouri. While serving in Texas during the Mexican War (1846-1848), Moore met Jefferson Davis, future president of the Confederacy. At the end of the Mexican War Moore returned to Missouri where he was promoted to surgeon with the rank of major in April 1849. Between 1849 and 1860, Moore served in Oregon, Texas, New York Harbor, and West Point.

When South Carolina seceded from the Union, Moore resigned his commission as surgeon in the US Army and returned to Little Rock to open a private practice. Soon after returning to Arkansas Moore began receiving requests from Jefferson Davis to join the Confederate army. In his correspondence to Moore, Davis described the deplorable conditions caused by the overwhelming number of casualties and a lack of Southern physicians trained in military medicine. Moore accepted the position of acting surgeon general on July 30, 1861 and was confirmed by the Confederate Senate in November of that same year.

Among the more notable achievements of his tenure as surgeon general was the organization of the Confederate Medical Department, the establishment of examining boards for surgeons and assistant surgeons, the construction of military hospital huts, or one-story pavilion hospitals, and the establishment of drug, hospital supplies and surgical instruments factories around the Confederacy to supply the Army's needs. Moore also directed the recruitment of Army surgeons, and commissioned two ground-breaking resources for Confederate military medicine: JJ Chisolm's Manual of Military Surgery and FP Porcher's Resources of the Southern Fields and Forests. After his service in the war, Moore settled in Richmond, Virginia where he died on May 31, 1889.

War and Prosthetics: How Veterans Fought For the Perfect Artificial Limb

By Hunter Oatman-Stanford, 10-29-12

There’s something undeniably beautiful about prosthetic limbs, designed to echo the physical grace and mechanical engineering of the human body. For most people, these objects elicit some combination of squeamish discomfort and utmost respect. But far fewer of us connect those feelings to the untold generations of battle-scarred amputees whose sacrifices made prosthetics a public priority.

“Patients even have doctors sign non-disclosure forms to protect potential patents.”
“You hate to think that war is what drives technology, but it does,” says Kevin Carroll, the Vice President of Prosthetics for Hanger, a major artificial-limb producer founded just after the Civil War. Historically, the impulse to create functional replacement limbs has grown in parallel with the number of living amputees, whose ranks ballooned following periods of military conflict, especially the American Civil War and World War I. Such episodes of violence provided the impetus for doctors and scientists to study how the human body copes with physical damage, and how we might repair it.

Today, double amputees regularly win gold medals at the Paralympics, and computer-based technologies allow replacement limbs to translate signals from the human brain into motion. But it’s been a long and violent haul from the wooden “peg-leg” days when amputees were pitied, ignored, or actually destined to die because of limited medical care.

Though amputation was one of the first recorded surgeries, mentioned in the Hippocratic treatise “On Joints” around the 4th century BC, the procedure really became a viable option after major improvements were made in blood-loss prevention during the 15th and 16th centuries. Doctors began working with ligatures to seal off individual blood vessels and eventually used tight tourniquets around entire appendages to slow blood flow.

However, amputation was still only sought for patients whose life was already at stake due to severe infection or injury, particularly because the consequences of surgery were frequently fatal anyway. “The control of a number of associated factors–blood loss, pain, and infection prevention–has been key to greatly improving the survival chances of the amputee,” says Stewart Emmens, the curator of Community Health at the Science Museum in London. “Then, as now, the procedure was often viewed as a failure of treatment.”

Physicians like Ambroise Paré, the official barber-surgeon for the Kings of France during the 16th century, noted the unfortunate effects of prevailing surgical methods and sought better ways to heal patients. Paré was especially interested in battlefield wounds, and his first published book covered techniques to treat firearm injuries, helping to expose the problems with commonly used cauterization methods.

Other advancements, like the capacity to amputate in specific locations along an appendage, also made it possible for survivors to live longer with fewer complications. But the chance for amputees to regain a sense of normalcy typically depended on the quality of artificial limbs available. Though articulated limbs were being developed around the same time, like the famous iron arm designed for Gottfried “Götz” von Berlichingen with various locking hand positions, these were exclusively made for affluent individuals.

A real breakthrough in prosthetic limb mechanics came in the form of James Potts’ “Anglesey” leg design around 1800, a style popularized by the Marquess of Anglesey after he was injured in the Battle of Waterloo in 1815 . Later dubbed “the Clapper” for the clicking sound made by its articulated parts, Potts’ creation relied on cat-gut tendons to hinge at the knee and ankle, simulating a walking motion when the toe was lifted. The design was later improved by Benjamin Palmer with his so-called “American leg,” which incorporated a heel spring in 1846 and was continuously produced through World War I.

Still, until the mid-20th century, such replacement limbs were financially inaccessible to the many working class individuals who needed them. “A Victorian agricultural laborer who lost his lower arm in an accident was probably more likely to get the local blacksmith to make a hooked prosthesis for him than to check the catalog of the nearest limb manufacturer,” says Emmens. “These were relatively expensive items, and given that any gripping, flexing, or thumb-to-finger movements would depend on a system of joints, cords, and shoulder harnesses, they were not necessarily that practical for working people either.”

Whether or not they could afford a newfangled arm or leg, amputees got on with their lives, learning to cope with their disabilities and inventing their own solutions. Some became so comfortable using temporary limb replacements that they never attempted to find a fully functioning prosthetic. Others fashioned their own devices from available materials, making necessary repairs as time went on.

In America, the major pressure to improve amputee rehabilitation came along with the Civil War, when novel firearms like the repeating rifle left around 35,000 survivors in need of new limbs. Following the war, public funds were devoted to developing and purchasing these prosthetics; in 1866, the State of Mississippi spent more than half its yearly budget providing veterans with artificial limbs. Entrepreneurs, many of them young veterans themselves, recognized the opportunity to create improved mechanical devices that would allow amputees to enjoy more normal lives.

James Edward Hanger was one of these young soldiers, an 18-year-old engineering student at Washington College who left school to join Confederate forces in a small West Virginia town. While waiting for the troops to return from a nearby village, a surprise attack by the Union army sent a cannonball ricocheting into the stable where Hanger was camped, smashing his left leg. Hours later, Hanger was discovered by the Union forces and an above-the-knee amputation was performed. The surgery became the first recorded amputation of the Civil War.

Left, one of James Hanger’s early patents from 1891 shows his novel hinged mechanism. Image courtesy Right, Samuel Decker was another veteran who developed his own mechanical arms, and later went on to become an official Doorkeeper at the U.S. House of Representatives.

While recovering at his parents’ Virginia home, Hanger worked to improve the standard-issue replacement leg he was given by the Army, a solid piece of wood that made walking difficult and noisy. Within a few months, he created a prototype that allowed for a smoother, quieter walking motion. Though the original patent is lost, Hanger’s adjustments to the generic leg style included better hinging and flexing abilities using rust-proof levers and rubber pads.

“The function of a prosthetic limb will always endow it with a certain magic few other man-made objects possess.”

Hanger immediately wrote to William Carrington, secretary of the Association for the Relief of Maimed Soldiers, to secure Carrington’s endorsement and the business of his veterans group. A few years later, the Virginia legislature created a $20,000 fund to purchase prosthetics for the state’s wounded veterans, providing even more business for Hanger. By 1890, Hanger had relocated his headquarters to Washington, D.C., and opened satellite offices in four other U.S. cities.

Despite innovators like Hanger, the best prosthetics were still out of reach for most ordinary people, whether veterans or not. These inventive devices were tailored specifically to suit specific tasks or lifestyles, like the special hand with an octave finger-spread and padded fingers created for a British concert pianist. It would require the violence of another major war to make custom limbs a reality for more amputees.

Left, this prosthetic limb was designed for a female piano player around 1895, who went on to play London’s Royal Albert Hall in 1906 using her specially designed hand. Right, this Victorian-era arm includes beautifully detailed metalwork. Images courtesy of the Science Museum / SSPL.

With the onset of World War I, the need for prosthetics escalated exponentially. As this was the first war in which industrialized weaponry like machine guns created more bodily harm than infection or disease, an extraordinary number of soldiers survived with severe injuries.

This new kind of warfare “produced new levels, new degrees of wounding,” explains Emmens. “Bodies were ripped apart by explosives; arms and legs were simply blasted off.” But countless soldiers lost their limbs through surgical intervention. “Much of the war–particularly on the Western Front–was essentially fought on well-manured farmland, and explosive weaponry could carry these highly infectious materials deep into complex, gaping wounds,” says Emmens. Amputation was frequently used in situations that normally wouldn’t require surgery, simply to avoid the threat of serious infection.

Prosthetic manufacturing boomed again, though the locus of limb development shifted overseas. In Great Britain veterans were entitled to free limbs beginning with the Napoleonic Wars of the early 19th century, yet Emmens explains that during World War I, “the existing systems of medical care were soon exposed as inadequate to deal with the sheer scale of casualties.” By the end of the war, there were an estimated 41,000 amputees in Britain alone.

Besides the overwhelming demand, shoddy fittings and unhelpful instructions meant that even available prosthetics sometimes went unused. “Many arm amputees simply stopped wearing their uncomfortable devices, put them in a cupboard somewhere, and never used them again, while some leg amputees found life easier with crutches than wearing uncomfortable, heavy prosthetic legs,” says Emmens.

This prosthetic hand was designed by Thomas Openshaw around 1916, while working as a surgeon for Queen Mary’s Hospital. The wooden hand has two fingers reinforced with a metal hook to help with daily tasks. Image courtesy the London Science Museum
This prosthetic hand was designed by Thomas Openshaw around 1916 while working as a surgeon for Queen Mary’s Hospital. Two fingers of the wooden hand are reinforced with metal hooks to help with daily tasks. Image courtesy of the Science Museum / SSPL.

In 1920, an article in The Times of London stated that “next to the loss of life, the sacrifice of a limb is the greatest sacrifice that a man can make for his country.” But the British government wasn’t prepared to assist the flood of amputees, even during the early months of the war, and several wealthy patrons quickly stepped in to establish private facilities for soldier rehabilitation. One of the most significant was Queen Mary’s Hospital, which focused on veterans who had lost limbs; this repurposed country home in southwest London soon became a global center for artificial limb design and fitting.

American manufacturers like Hanger and Rowley set up workshops at Queen Mary’s Hospital to churn out custom limbs and assist with fittings and training. Though only a handful of artificial limb designs came from England prior to the war, by 1918, several hundred British patent applications had been submitted. When the influx of new amputees finally slowed during the 1920s, manufacturers began focusing on improving their best products rather than providing as many limbs as possible.

Postwar designs incorporated a variety of recently patented innovations. In 1912, D.W. Dorrance had created a famous split-hook hand attachment for artificial arms, which allowed users to grip objects and perform daily tasks in a much easier manner. The following year, aviator and amputee Marcel Desoutter had worked with his brother Charles, an engineer, to develop a prosthetic leg made from a lightweight aluminum alloy.

“In Germany, much was made of returning wartime amputees to productivity, and industrial giants like Siemens were at the forefront of developing and introducing the means to do this,” says Emmens. Siemens designed a variety of “workers arms” which sacrificed aesthetic appeal to focus on function, designed to accommodate a range of workplace tools. Products like these led a shift away from traditional materials like wood and leather towards lighter metals and plastics.

In a 1929 article on the evolution of the artificial limb, American doctor J. Duffy Hancock wrote that “putting a cripple back to work ranks next to saving a life.” Though harsh-sounding, Hancock’s remark captures a powerful sentiment: If we save someone’s life, they should be able to live it as fully as possible. And artificial limbs provided that key, minimizing the stigma, isolation, and lifestyle limitations that often came with amputation.

Today, the power of prosthetics is more visible than ever before, particularly among young veterans recovering from injuries sustained in the Middle East. Kevin Carroll describes a recent outing with a group of veterans at a rehabilitation center in San Diego, California. “As we’re walking up the street, one of the guys climbed up on a tall ledge and jumped right off,” says Carroll. “Here’s a guy with both of his legs cut above the knee, and he comes right down on the prosthetics. Why would you want to do that? Well, because you’re a young kid and you want to continue to act like one.”

As veterans of the wars in Iraq and Afghanistan continue to flood VA hospitals across the country, their treatment helps to push prosthetic technology once again. Despite the fact that diabetes is the number one cause for limb amputation in the U.S. today, the veteran population still drives many advances in the field, as they willingly test the latest devices and generate their own ideas, too. Carroll says that some patients even have their doctors sign non-disclosure forms to protect potential patents.

Special limbs are also now created for extreme physical activities, such as specific legs tailored for sprinting versus long distance running. These products have enabled such incredible performances that sporting authorities are questioning whether professional athletes like the South African runner Oscar Pistorius, who happens to be missing both legs, may actually be given an unfair advantage.

High-performance limbs also benefit those outside the world of professional sports, as their components are adapted for ordinary prosthetics. “It reminds me of NASCAR,” Carroll says. “You see those guys racing around the track at 200 miles an hour, and in the not-too-far-away future, the technologies in their cars will be in our regular cars. It’s the same way with prosthetics, with these high-performance feet that these young men and women are pushing to the limits. Grandma may very well be walking across the floor on them next year.”

Some of the more recent prosthetic innovations include new silicone materials used to improve socket fit and energy-storing devices made from carbon-fiber composites. Carroll even worked to develop a prosthetic tail for an injured dolphin using a gel sleeve, which was modified to help human patients with fitting issues.

Possibly the most exciting advancements are those that incorporate microprocessor technologies. These tiny computers register the minute details of ordinary movements to prevent limbs from buckling and anticipate the user’s next move. “Even two years ago, to have somebody walk naturally step over step upstairs on prosthetics was difficult, a chore,” says Carroll, yet today he works with double-amputees who handle inclines easily, thanks to implanted microprocessors.

Regardless of this shifting technology, patients still develop the strong emotional connections to modern limbs they did centuries ago. The function of a prosthetic limb—to replace a part of the human body—will always endow it with a certain magic few other man-made objects possess.

“There’s an incredible bond that takes place between a person and their prosthesis,” says Carroll. “If I’m taking that prosthetic device out of the room and bringing it back to a laboratory to check it out, they’re watching it as if it’s part of their body leaving the room. They’re watching how I pick it up, how I hold it, am I being gentle with it. And it makes you realize this is their lifeline.”

Image: Top: Up through the 19th century, functional prosthetics were only available for wealthy patients, like this iron hand designed for the German imperial knight Gottfried von Berlichingen.


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