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.

Sunday, January 24, 2016

Amputations in the Civil War

(Originally published as "When Johnny Couldn't Come Marching Home: Civil War Amputations")
by Ansley Herring Wegner, Tar Heel Junior Historian Association, NC Museum of History, Fall 2008.

Unidentified soldier with amputated arm in Union uniform in front of painted backdrop showing cannon and cannonballs[Unidentified soldier with amputated arm in Union uniform in front of painted backdrop showing cannon and cannonballs]Many wounded soldiers during the Civil War (1861–1865), including those from North Carolina, had an operation called an amputation. In an amputation, a person has an arm or leg (or sometimes just a hand or foot) removed from their body because of a terrible injury or infection. Military advances before and during the Civil War meant more powerful, destructive weapons, and more devastating injuries, including shattered bones. Most American doctors, however, were unprepared to treat such terrible wounds. Their experience mostly included pulling teeth and lancing boils. They did not recognize the need for cleanliness and sanitation. Little was known about bacteria and germs. For example, bandages were used over and over, and on different people, without being cleaned.

With so many patients, doctors did not have time to do tedious surgical repairs, and many wounds that could be treated easily today became very infected. So the army medics amputated lots of arms and legs, or limbs. About three-fourths of the operations performed during the war were amputations.

These amputations were done by cutting off the limb quickly—in a circular-cut sawing motion—to keep the patient from dying of shock and pain. Remarkably, the resulting blood loss rarely caused death. Surgeons often left amputations to heal by granulation. This is a natural process by which new capillaries and thick tissue form—much like a scab—to protect the wound. When they had more time, surgeons might use the "fish-mouth" method. They would cut skin flaps (which looked like a fish’s mouth) and sew them to form a rounded stump.

Amputation Kit used by Dr. Gordon (from the County Doctor Museum)Amputation Kit. The instruments in the kit were used to amputate limbs and perform other surgical procedures. The kit includes two trephines, a variety of knives, an amputation saw, bone nippers, a tourniquet, tweezers, scissors and a hey saw. From the Country Doctor Museum, Digital Collections, East Carolina University.For soldiers who survived amputation and infection, it was natural to want an artificial, or fake, limb—both for looks and for function. An artificial arm will not provide a firm handshake, and an artificial leg will not get rid of a limp. But a prosthetic (another word used for an artificial limb) helps an amputee be less noticeable in public and offers the chance of a more regular daily life. Artificial limbs, especially legs, helped Civil War amputees get back to work to support themselves and their families. Agriculture had declined with so many soldiers away from home. After the war ended, it was important for men to return to their farms and increase production of food and money-making crops. Amputees were no different—they needed to be able to work on their farms, too.

North Carolina responded quickly to the needs of its citizens. It became the first of the former Confederate states to offer artificial limbs to amputees. The General Assembly passed a resolution in February 1866 to provide artificial legs, or an equivalent sum of money (seventy dollars) to amputees who could not use them. Because artificial arms were not considered very functional, the state did not offer them, or equivalent money (fifty dollars), until 1867. While North Carolina operated its artificial limbs program, 1,550 Confederate veterans contacted the government for help.

One Tar Heel veteran, Robert Alexander Hanna, had enlisted in the Confederate army on July 1, 1861. Two years later at Gettysburg, Pennsylvania, Hanna suffered wounds in the head and the left leg, just above the ankle joint. He suffered for about a month, with the wound oozing pus, before an amputation was done. After the war, Hanna received a wooden Jewett’s Patent Leg from the state in January 1867. According to family members, he saved that leg for special occasions, having made other artificial limbs to help him do his farmwork. (One homemade leg had a bull’s hoof for a foot!) The special care helped the Jewett’s Patent Leg last. When Hanna died in 1917 at about eighty-five years old, he had had the artificial leg for fifty years. It is a remarkable artifact—the only state-issued artificial leg on display today in North Carolina. Hanna’s wooden leg, as well as Civil War surgical equipment, may be seen at Bentonville Battlefield State Historic Site in Four Oaks.

*Ansley Herring Wegner is a research historian with the North Carolina Office of Archives and History. She is the author of Phantom Pain: North Carolina’s Artificial-Limbs Program for Confederate Veterans.

Wegner, Ansley Herring. 2004. Phantom Pain: North Carolina's Artificial-Limbs Program for Confederate Veterans. NC Office of Archives and History.

Image 1: Unidentified soldier with amputated arm in Union uniform in front of painted backdrop showing cannon and cannonballs], ca. 1861-1865.  Library of Congress Prints and Photographs Division Washington, D.C. 20540 USA http://hdl.loc.gov/loc.pnp/pp.print

Image 2: Amputation Kit. 1800-1899. From the Country Doctor Museum. Image courtesy of the Eastern North Carolina Digital Library, J.Y. Joyner Library, East Carolina University. https://digital.lib.ecu.edu/13941 (accessed May 4, 2015).

Image 3: Artificial foot that enables Limp-free walking. Patent number 16360. Issued January 1857 to Benjamin W. Jewett by the U.S. Patent Office.

From: ncpedia.org

Coffin Nails: The Tobacco Controversy in the 19th Century

From: tobacco.harpweek.com

Although a few women shared the tobacco habit in nineteenth-century America, it was overwhelming a male endeavor.  The most popular ways for American men of the time to consume tobacco were pipes, cigars, and chewing tobacco.  Snuff had largely gone out of fashion by mid-century, except for occasional sniffs by high-society youth.  Pipes were a favorite of all social classes, and varied in style from expensive, elaborately carved wood or stone to simpler, moderately-priced versions to cheap ones made of clay or corncob.  Chewing tobacco was common throughout the century in rural and urban areas alike, requiring spittoons in the cities’ public buildings.  It was popular among working class and poor Americans, but was shunned by polite society in the late-nineteenth century.
American soldiers were introduced to cigars during the Mexican War (1846-1848) and they became a fad with men in the 1850s.  Cigars ranged in price from cheap to expensive, but were associated for the rest of the century with affluence, respectability, and success in the male bastions of business, politics, and the military.  Cigars were the most exclusively male of all tobacco products, while cigarettes, in contrast, were considered unmanly until the end of the nineteenth century.  The manufacturing of cigarettes in the United States began in the early 1860s and mass production was achieved in the early 1880s.  There were two basic kinds of cigarette products:  high-end, expensive brands made of imported tobacco; and low-end, cheap brands made of domestic tobacco.

High-end cigarettes were linked with the moral decadence of Europe, the Middle East, and Latin America, where the products were both manufactured and popular.  Hand-rolled cigarettes, also made from imported tobacco, implied the user had the leisure to indulge the habit, and was not participating in his manly duty to earn a living and provide for a family.  Thus, the cigar represented the family man who gained wealth through hard work and self-sacrifice, and who respected traditional morality and authority; the cigarette symbolized the man whose inherited wealth allowed him to remain in a sort of perpetual, self-centered adolescence—unmarried, disrespectful of conventional morality and authority, and attracted to things foreign.

An article in the May 28, 1870 issue of Harper’s Weekly mocked “The Hero of a Fast Novel” (“fast” means immoral or socially improper).  He was constantly pleasure seeking, and lived in luxury by spending other people’s money or going into debt.  The cigarette was as much an identifying mark of the “fast” youth as his expensive food and wine.  “When out shooting, these gentlemen, who are ‘roughing it,’ toss the dogs foie gras and truffles, and drink delicate Burgundies to their perfumed cigarettes.”

A cartoon in the October 14, 1882 issue depicted a “Swell Struggling with the Cig’rette Poisoner.”  Like the “fast” young man, a “swell” was wealthy, self-indulgent, and egotistical.  In the cartoon, he wore evening clothes and top hat for a riotous night on the town.  His floral boutonniere may have mimicked the practice of Oscar Wilde, who toured the United States that year wearing or carrying lilies and sunflowers (that may be a lily pad in the swell’s buttonhole).  The text and image made it clear that the cartoonist considered cigarette smoking to be addictive and deadly.  The multiple cigarette “ribs” of the snake signified chain-smoking, which restricted his free will by encircling him.  According to the caption (which may have been sarcastic) he struggled (or should have struggled) against its hold on his life.  The skeletal view of the snake and the designation of cigarettes as “poison” delivered the powerful message that cigarette smoking is deadly.

Although cigarettes made with domestic tobacco had always been cheaper than those containing imported tobacco, two things lowered the price more.  The first was the drastic reduction of the federal tax on cigarette manufacturers in 1883.  Originally imposed to help pay for the Union war effort during the Civil War, two decades later Congress cut the tax by almost 29%, and manufacturers like James Buchanan “Buck” Duke of North Carolina, passed the savings along to customers.  In the February 25, 1882 issue of Harper’s Weekly, a cartoon by Thomas Nast criticized the call for the tax reduction.  The artist presented two stylishly dressed young men in a tobacco haze.  Their cigarette habit made them stupid and lazy, the opposite of the “manly air” they wanted to project.

The second important factor occurred when Duke contracted in 1883 with James Bonsack to perfect the latter’s invention for mass-producing cigarettes.  On April 30, 1884, the machine lasted an entire ten-hour shift, making 120,000 cigarettes.  The device reduced manufacturing costs and, in turn, consumer prices as it increased production and availability.  By the early 1890s, Duke had a near monopoly of the cigarette market via his American Tobacco Company (broken up by the U.S. Supreme Court in 1911).

The markets for cheap, domestic cigarettes in the late-nineteenth century were primarily boys and immigrant men from southern and eastern Europe, where the habit was common.  The low cost and convenience of cigarettes also encouraged urban working-class men to take up the practice over the next few decades.  Cigarettes could be smoked quickly while walking to and from work, on lunch breaks, and when the boss was not around.  They were also less offensive than other tobacco product to nonsmokers in the congested and rapidly growing cities of America.

These groups of cigarette smokers reinforced the stereotype that the habit was unmanly.  Boys were immature, and presumably did not have the responsibility of providing for a family (actually, some working-class boys did, at least in part).  In 1885, an editorial in The New York Times chastised men for smoking cigarettes and warned of the dangers it posed to the nation’s political survival.  “A grown man has no possible excuse for thus imitating the small boy…  The decadence of Spain began when the Spaniards adopted cigarettes and if this pernicious habit obtains among adult Americans[, then] the ruin of the Republic is close at hand…”  (The focus on Catholic Spain probably also reflected anti-Catholic sentiment among the dominant Protestant population in the United States.)

Poor and working-class men (which included most immigrants) were considered unsuccessful financially, and not socially (and sometimes, morally) respectable.  Therefore, they did not fit the middle-class ideal of American manhood in the late-nineteenth century.  A one-sentence item in the “Personal” column of the July 12, 1888 issue of Harper’s Weekly proclaimed, “Washington is proud of the fact that not one Congressman smokes cigarettes.”  It is certain, though, that many used cigars, pipes, or chewing tobacco.

The public attitude against men smoking cigarettes began to change with the Spanish-American War in 1898.  Many of the young American soldiers, particularly those from rural areas, were introduced to cigarettes as they came in contact with residents of the (former) Spanish colonies of Cuba, Puerto Rico, Guam, and the Philippines, where cigarettes were smoked by most of the population.  Although U.S. military officials approved enlisted men using pipes and chewing tobacco, they tried unsuccessfully to discourage cigarette smoking.  In fact, American sailors threatened to mutiny if deprived of cigarettes.  They had practical advantages over other tobacco products.  They could be carried easily in a uniform pocket, smoked quickly, and did not spoil in humid weather like cigars.  In cramped military quarters, particularly on long sea voyages, the milder cigarette odor would be less offensive to nonsmokers than strong cigar smoke.

At first, Harper’s Weekly presented cigarette smoking as a Spanish practice.  In the August 13, 1898 issue, at one point in a news story on a truce in the fighting in Cuba, the correspondent identified the two sides by their respective choice of tobacco:  “Meanwhile the little men in light blue [Spanish soldiers] sit calmly on the edge of their trenches and smoke cigarettes, while the big men in dark blue [American soldiers] sit on the edge of theirs and good-humoredly cast tobacco juice toward [the city of] Santiago.”  However, in the next week’s issue, in a news story on “The Taking of Guam,” the correspondent referred to American sailors aboard the U.S. transport, Australia, using cigarettes, cigars, and chewing tobacco.  The situation was similar in Puerto Rico, from where Charles L. Hofmann of Battery A, Pennsylvania Light Artillery, wrote home, “You can buy the best cigars here… and their cigarettes are good and strong.”

In the aftermath of the Spanish-American War, E. S. Martin questioned, in his “This Busy World” column from the December 24, 1898 issue of Harper’s Weekly, the presumption that cigarettes undermined “American manhood.”  Instead, he connected the habit explicitly with American servicemen, who smoked so many cigarettes in Cuba that they ran out of supplies.  He emphasized that cigarette smoking among American military personnel was simply a fact from the recent war, “which every one must recall.”  In the February 25, 1899 issue, a feature article on “Our New Possessions—Puerto Rico,” discussed the “Tobacco Culture” of the island, a new American territory after the war.  The author argued that with minor changes to cigarettes made in Puerto Rico, they would find a ready market in the United States.

The years between the Spanish-American War and America’s entry into World War I in 1917 were a period of transition for the public attitude toward men and cigarette smoking.  The notion in earlier decades that the foreign origin of high-end cigarette made the manliness and morality of male smokers suspect appears to have diminished by the late 1890s (even before the Spanish-American War).  An advertisement for the Nestor cigarette brand in the March 19, 1898 issue of Harper’s Weekly declared proudly that its product was “THE MODERN EMBODIMENT OF ANCIENT ORIENTAL LUXURIOUSNESS”:  so much for middle-class respectability and the work ethic.  A Nestor ad in the January 21, 1899 issue marketed to “smokers of refined taste” and featured a sketch of an Arab man (or perhaps a British man in Arab attire).

That there was still uncertainty, however, about cigarettes and American manhood is demonstrated in two other ads.  In the September 3, 1898 issue, the Van Bibber brand of cigarettes were called “LITTLE CIGARS,” to associate them with the unquestionably acceptable tobacco product for men.  In the February 18, 1899 issue, an illustrated ad for Lucke’s Rolls cigars stated, “They are not a smoke for boys or cigarette smokers.”  (Notice another Nestor ad at the top of the page.)  The fact that the cigar ad insulted cigarette smokers also indicates that the cigar company was experiencing competition from cigarette manufacturers.

Historians have attributed a drop in cigarette sales for a few years in the late-1890s and early-1900s primarily to the return of economic prosperity, which allowed more male smokers to afford cigars over the cheaper cigarettes.  In his “This Busy World” column from the August 19, 1899 issue of Harper’s Weekly, E. S. Martin noted that after increasing for 12 years, domestic cigarette production dropped during the previous year.  He observed, though, that the sale of luxury cigarettes had increased (evidence of the improved economy).

In the early-twentieth century, military officials continued their unsuccessful attempts at suppressing cigarette smoking.  In 1903, the Military Academy at West Point banned cigarettes (but promoted pipes) and soon court-martialed two cadets for possession.  However, the prohibition lapsed into disuse when the chief medical officer of West Point admitted in 1915 that “a large percentage” of cadets were “habitual cigarette smokers.”  Similarly, intense opposition from sailors caused the U.S. Navy to reverse a 1907 ban on cigarettes for those less than 21 years old.

By the time the United States entered World War I in 1917, cigarette smoking seems to have been widespread in the military.  The public association of cigarette smoking with the manly image of American servicemen, which had begun with the Spanish-American War in 1898, was reinforced in World War I.  The difference was that instead of military officials resisting the practice, as they had done in the earlier conflict, the U.S. military, federal government, and auxiliary associations officially approved, promoted, and distributed cigarettes among American military personnel.  Whereas cigarettes had been linked previously with moral decadence and considered a “gateway” drug for the use of stronger substances, they were now viewed as a partial substitute for bad (or worse) behavior:  alcohol was banned to servicemen, and military camps had prostitute-free zones around them.

Cigarette smoking would never again be considered unmanly, which was too bad for men.  By 1955, over half of American men smoked cigarettes.  Nine years later, the U.S. Surgeon General issued a report declaring that cigarette smoking caused cancer in men.   Today, despite a lower percentage of male cigarette smokers than in the past, lung cancer (overwhelmingly caused by smoking) is the leading cause of cancer-related deaths among American men.  The habit also increases the risk of heart disease, strokes, and other types of cancer.

Harper's Weekly References
1)  May 28, 1870, p. 343
article, “The Hero of a Fast Novel,” he smokes perfumed cigarettes
2)  October 14, 1882, p. 651, c. 3-4
cartoon, “Swell Struggling with the Cigarette Poisoner”

3)  February 25, 1882, p. 128, c. 1-2
cartoon, “A Bill To Make Idiots,” Nast, regarding proposal to lower tobacco tax; identifies smokers as “lunatic” and “idiot”

4)  July 12, 1888, p. 527, c. 3
item from “Personal” column:  “Washington is proud of the fact that not one Congressman smokes cigarettes.”

5)  August 13, 1898, p. 802-804
“The Truce,” Americans soldiers chewing tobacco, Spanish smoking cigarettes

6)  August 20, 1898, pp. 829-830, c. 1
“The Taking of Guam,” American sailors using cigars, cigarettes, and chewing tobacco

7)  December 24, 1898, p. 1263, c. 3
item in “This Busy World” column, by E. S. Martin, discusses laws against cigarettes, fear of undermining American manhood, but points out American soldiers in Cuba were smoking them

8)  February 25, 1899, pp. 193 and 196
feature article, “Our New Possessions—Puerto Rico,” discusses the “Tobacco Culture” of the island, argues that making minor changes to the cigarettes would give them a ready market in the United States

9)  March 19, 1898, p. 287, c. 1-2
ad, Nestor brand cigarette, “Oriental Luxuriousness”

10)  January 21, 1899, p. 75, c. 1-2
ad, Nestor brand cigarette, “An absolute necessity to smokers of refined taste”

11)  September 3, 1898, p. 879, c. 4
ad, marketed as “little cigars”

12)  February 18, 1899, p. 179
cigar ad, “They are not a smoke for boys or cigarette smokers.”

13)  August 19, 1899, p. 809, c. 1
item in “This Busy World” column, domestic cigarette production down, but sales of (foreign) luxury cigarettes up

Sources Consulted
Kluger, Richard, Ashes to Ashes:  America’s Hundred-Year Cigarette War, the Public Health, and the Unabashed Triumph of Philip Morris (NY:  Alfred A. Knopf, 1996)
Moyer, David, M.D., “The Tobacco Reference Guide,” http://new.globalink.org/tobacco/trg/Chapter15/table_of_contents.html

“Pennsylvania Volunteers of the Spanish-American War:  Letters Home,” http://paspanishamericanwar.com/letters/hofmann.html

Tate, Cassandra, Cigarette Wars:  The Triumph of the Little White Slaver (NY:  Oxford UP, 1999)

“Tips for Tobacco Users:  Tobacco Use During the Civil War,” http://www.shasta.com/suesgoodco/newcivilians/tobacco.htm

Slade, John, M.D., “Tobacco Epidemic: Historical Lessons,”

Civil War Battlefield Surgery

From: ehistory.osu.edu

A Description of Civil War Field Surgery
The most common Civil War surgery was the amputation. A few words about why there were so many amputations may be appropriate here. Many people have construed the Civil War surgeon to be a heartless individual or someone who was somehow incompetent and that was the reason for the great number of amputations performed. This is false. The medical director of the Army of the Potomac, Dr. Jonathan Letterman, wrote in his report after the battle of Antietam:

The surgery of these battle-fields has been pronounced butchery. Gross misrepresentations of the conduct of medical officers have been made and scattered broadcast over the country, causing deep and heart-rending anxiety to those who had friends or relatives in the army, who might at any moment require the services of a surgeon. It is not to be supposed that there were no incompetent surgeons in the army. It is certainly true that there were; but these sweeping denunciations against a class of men who will favorably compare with the military surgeons of any country, because of the incompetency and short-comings of a few, are wrong, and do injustice to a body of men who have labored faithfully and well. It is easy to magnify an existing evil until it is beyond the bounds of truth. It is equally easy to pass by the good that has been done on the other side. Some medical officers lost their lives in their devotion to duty in the battle of Antietam, and others sickened from excessive labor which they conscientiously and skillfully performed. If any objection could be urged against the surgery of those fields, it would be the efforts on the part of surgeons to practice "conservative surgery" to too great an extent.

Still the Civil War surgeon suffers from being called a butcher or some other derisive term.

The slow-moving Minie bullet used during the American Civil War caused catastophic injuries. The two minie bullets, for example, that struck John Bell Hood's leg at Chickamauga destroyed 5 inches of his upper thigh bone. This left surgeons no choice but to amputate shattered limbs. Hood's leg was removed only 4 and 1/2 inches away from his body. Hip amputations, like Hood's, had mortality rates of around 83%. The closer to the body the amputation was done, the more the increase in the wound being mortal. An upper arm amputation, as was done on Stonewall Jackson or General Oliver O. Howard (who lost his arm at Fair Oaks in 1862) had a mortality rate of about 24%.

Following is a description of a common battlefield amputation. Missing arms and legs were permanent, very visible reminders of the War. Amputees ranged from the highest ranking officers, like John B. Hood, Stonewall Jackson, and Oliver O. Howard, all the way down to the enlisted men, such as Corproal C.N. Lapham of the 1st Vermont Cavalry who lost both of his legs to a cannon ball. Hood, Jackson, Howard, and Lapham were certainly not alone in their loss, as 3 out of 4 wounds were to the extremities...in the Federal Army this led to 30,000 amputations.

The wait for treatment could be a day, maybe two and that was not out of the ordinary. When treatment was finally done on the poor soldier, it was not done antiseptically. It would only be in 1865 that Joseph Lister embarked upon the era of antiseptic surgery. Surgeons did not even perform careful handwashing before operating. The doctors wore blood splattered clothes. When something was dropped, it was simply rinsed in cool, often bloody water. They used sponges that had been used in previous cases and simply dipped in cold water before using them again on the next person.

A surgeon recalled: "We operated in old blood-stained and often pus-stained coats, we used undisinfected instruments from undisinfected plush lined cases. If a sponge (if they had sponges) or instrument fell on the floor it was washed and squeezed in a basin of water and used as if it was clean"

The injuries to be dealt with were dreadful and the fault of the soft lead Minie Ball. With the capability to kill at over 1,000 yards, this soft lead bullet caused large, gaping holes, splintered bones, and destroyed muscles, arteries and tissues beyond any possible repair. Those shot with them through the body, or the head, would not be expected to live. Almost all wounds were caused by the bullet, with canister, cannonballs, shells, and edged weapons next on the list.

The weapons (particularly the rifle) of the 1860s were far ahead of the tactics; i.e. the generals still thought to take a position you needed to go at it with the bayonet. The cylindrical lead bullet, the Minie ball, was rather large and heavy (.58 caliber usually). When it hit bone, it tended to expand. When it hit "guts" (i.e. the intestines) it tended to tear them in ways the old smoothbore musket ball did not. Since they crushed and smashed bone so badly, the doctors did not have much choice but to amputate a limb. Wounds to the stomach were almost always a death sentence.

Civil War doctors were woefully ill-prepared; of 11,000 Northern physicians, 500 had performed surgery. In the Confederacy, of 3,000, only 27. Many docs got their first introduction to surgery on the battlefield. Doctors usually did not specialize. Medical school, for many, was just 2 years (some less, few more). Surgeons reacted by adapting. They learned surgery on the job. And people died, of course, until they learned and became better... Many doctors were political appointments; there were no licensing boards in the 1860s... Army exam boards often even let in quacks.

Of the wounds recorded in the Civil War, 70%+ were to the extremities. And so, the amputation was the common operation of the Civil War surgeon.

The field hospital was hell on earth. The surgeon would stand over the operating table for hours without a let up. Men screamed in delirium, calling for loved ones, while others laid pale and quiet with the effect of shock. Only the division's best surgeons did the operating and they were called "operators". Already, they were performing a crude system of triage. The ones wounded through the head, belly, or chest were left to one side because they would most likely die. This may sound somewhat cruel or heartless, but it allowed the doctors to save precious time and to operate on those that could be saved with prompt attention.

The surgeon would wash out the wound with a cloth (in the Southern Army sponges were long exhausted) and probe the wound with his finger or a probe, looking for bits of cloth, bone, or the bullet. If the bone was broken or a major blood vessel torn, he would often decide on amputation. Later in the War, surgeons would sometimes experiment with resection, but amputation was far more common.

Deciding upon an amputation, the surgeon would administer chloroform to the patient. Hollywood's portrayal of battlefield surgery is dramatized and largely false; anesthesia was in common and widespread use during the war.... it would make more complicated and longer operations possible as the era of antiseptic surgery began in 1865 (too late for the poor Civil War soldier). With the patient insensible, the surgeon would take his scalpel and make an incision through the muscle and skin down to the bone. He would make incisions both above and below, leaving a flap of skin on one side.

Taking his bonesaw (hence Civil War slang for a doctor is a "Sawbones") he would saw through the bone until it was severed. He would then toss it into the growing pile of limbs. The operator would then tie off the arteries with either horsehair, silk, or cotton threads. The surgeon would scrape the end and edges of the bone smooth, so that they would not work back through the skin. The flap of skin left by the surgeon would be pulled across and sewed close, leaving a drainage hole. The stump would be covered perhaps with isinglass plaster, and bandaged, and the soldier set aside where he would wake up thirsty and in pain, the "Sawbones" already well onto his next case.

A good surgeon could amputate a limb in under 10 minutes. If the soldier was lucky, he would recover without one of the horrible so-called "Surgical Fevers", i.e. deadly pyemia or gangrene.

15 years after the War, surgeon George Otis cited the five principal advances of Civil War surgery: the surgeons had learned "something" about head injuries, how to deal with awful "ghastly wounds" without dismay, they had learned how to litigate arteries, information on injuries to spine and vertebrate had been "augumented," and "theory and practice" in chest wounds had been forwarded.

A little about the "Surgical Fevers". These were infections arising from the septic state of Civil War surgery. As you should have been able to see, the Civil War surgeon was interested not so much in cleanliness, but speed. As such, and not knowing anything about antiseptic surgery, fevers arose. Of these, the most deadly was probably pyemia. Pyemia means, literally, pus in the blood. It is a form of blood poisoning. Nothing seemed to halt pyemia, and it had a mortality rate of over 90%. Other surgical diseases included tetanus (with a mortality rate of 87%), erysepilas, which struck John B. Gordon's arm after he was wounded at Antietam, and osteomyelitis which is an inflammation of the bone. Also, there was something called "Hospital Gangrene". A black spot, about the size of a dime or so, would appear on the wound. Before long, it would spread through, leaving the wound an evil smelling awful mess. The Hospital Gangrene of the Civil War is an extinct disease now.

Primary amputation mortality rate: 28%
Secondary amputation mortality rate: 52%

Image: Confederate soldiers killed near the Wheatfield at Gettysburg (Library of Congress)

USCivilWar.Net wants to thank Jenny Goellnitz for compiling this information.
jgoellnitz@yahoo.com

The Imponderable ‘What-Ifs’: Did the Medical Issues of Three Confederate Generals Cause the South to Lose the War?

By Kevin R. Loughlin, MD, MBA

During the darkest days of World War II, Winston Churchill was credited as saying, “The imponderable ‘what- ifs’ accumulate”. Throughout history, imponderable what ifs have provoked the observer to consider how historical outcomes may have turned out differently. Such it is with the Civil War. It can be reasonably argued that the deaths of Albert Sidney Johnston and Stonewall Jackson and the illness of Robert E. Lee at Gettysburg irrevocably altered the course of the conflict and significantly contributed to the ultimate outcome.

At the outset of the Civil War both the North and South had strategic plans. The estimable Winfield Scott proposed the “Anaconda Plan” for the North, which would start by blockading the seacoast, then drive down the Mississippi to weaken the Confederacy to the west, and conclude with an attack through the heart of the Confederacy.

The South also had plans. Jefferson Davis favored a defensive strategy. He postulated  that a war of attrition would frustrate the better equipped Union and ultimately result in an armistice with the South and subsequent secession. An alternative Confederate strategy proposed by P.G.T. Beauregard was to attack in the western theatre and to control the river routes, first the Tennessee and Cumberland rivers and, if successful, then the Mississippi. On the eastern front, they would aim to capture Washington D.C. for both strategic and psychological proposes and then move northward into Maryland and Pennsylvania.

Albert Sidney Johnston graduated from West Point in 1826. He gained his early experience in the Texas War of Independence and the Mexican-American war. At the start of the Civil War, he was considered among the most gifted of the young generals, and Jefferson Davis placed him in charge of the Western Campaign.

Before, the battles of Fort Henry and Fort Donelson, Johnston had urged that the forts be fortified and additional  troops be assigned to their defense. However, his pleas were ignored, and Grant captured both forts in February of 1862 which delivered control of the Tennessee and Cumberland rivers to the Union. The control of these rivers emboldened the Union to move forward toward Shiloh to complete the larger goal of dominance of the western theatre.

The armies led by Johnston and Grant collided at Shiloh, Tennessee on April 6, 1862. In retrospect, this battle, more than either New Orleans or Vicksburg,  ultimately guaranteed Union control of the western theatre and the Mississippi.

Albert Sidney Johnston had repeatedly demonstrated personal valor during battle. His valor was at its zenith at Shiloh. Like many Confederate generals, he personally led the attack. On the first day of battle at the salient, Johnston was hit below the knee, probably by friendly fire, which severed his popliteal artery. At first he did not recognize the gravity of the wound, perhaps because of nerve damage that he had suffered to the same region during a duel in 1937. However, the severity of the wound quickly became clear as the blood filled his boot. The consequences of the loss of a leader like Johnston did not go unrecognized. His death was a strong blow to the Confederacy. Jefferson Davis believed that the loss of Johnston “was the turning point of our fate”. Davis would further state “Without doing injustice to the living, it may safely be asserted that our loss is irreparable; and that among the shinning host of the great and good who now cluster around the banner of our country, there exists no purer spirit, no more heroic soul, than that of the illustrious man whose death I join you in lamenting.” One can only speculate that if Johnston had survived, the South would have prevailed in the western theatre which would have caused the Union to wage war on two fronts. Such an obligation would have compromised their presence in Virginia, Maryland, and Pennsylavania.

Throughout American military history, few figures have attained the stature of Thomas J. “Stonewall” Jackson. He was born in 1824 in what is now West Virginia. He was poorly prepared academically for West Point and struggled at first, but demonstrating the resolve, hard work and determination that would be the signature of his military career, he graduated 17th out of 59 students in the class of 1846. Two of his classmates were George Pickett and George MCClellan.

Jackson served in the Mexican War and taught at the Virginia Military Institute. In 1861, when the Civil War broke out, he was put in command of several Virginia Infantry regiments by the governor of Virginia. He distinguished himself in the Battle of First Manassas where he received his nickname. This occurred when General Bernard Bee, in the midst of encouraging his men to fight on, pointed at Jackson and shouted, “Look, men, there is Jackson standing like a stone wall!” He would later be a major force at Second Manassas, Antietam, and Fredericksburg, during which he led the Second Corps of the Army of Northern Virginia under Robert E. Lee. Jackson was known for his audacity and tactical judgment in battle.

He next saw action at Chancellorsville on May 2, 1863. While returning to camp  from personal reconnaissance of  the Yankee front line, he was shot by friendly fire, twice in the left arm and once in the right hand. Members of the 18th Northern Carolina Regiment mistakenly took him for an advance party of the enemy and opened fire. As the shots occurred at dusk, he did not receive immediate medical attention and reportedly was accidentally dropped from  his stretcher twice. His left arm was seriously damaged and the next day was amputated by Hunter Holmes McGuire. Jackson lingered and died eight days later, on May 10, 1863. It has been speculated that he died of either pneumonia or pulmonary embolus, and the scenario and time frame would fit with either diagnosis, although sepsis has also been considered. Lee was devastated when informed of Jackson’s death and said, “I’m bleeding at my heart”.  Lee considered the loss of Jackson so significant that he restructured his high command. Before his death Jackson commanded the 2nd Corps of the Army of Northern Virginia and Longstreet commanded the First. However, after Stonewall’s death, Lee split the 2nd Corps in two. The original 2nd Corps was to be led by Richard S. Ewell, also known as “Old Bald Head”, and the  3rd Corps was led by Ambrose P. Hill. Longstreet remained leader of the First Corps. Neither Ewell or Hill had the battlefield boldness or judgment of Jackson, and their shortcomings contributed to the outcome at Gettysburg.

Robert E. Lee occupies a secure position in the pantheon of great modern military leaders. Historians concur that his military genius was evident throughout the war, except at Gettysburg. It has long been a point of historical interest, as to what was the cause of Lee’s apparent aberration as a strategist and tactician at Gettysburg, following so closely on the heels of his brilliant campaigns at Fredericksburg and Chancellorsville. Yes, there were factors that contributed to the defeat there other than Lee’s generalship. Certainly, the absence of his trusted cavalryman Jeb Stuart until late on July 2, 1863 was a critical element that deprived Lee of essential reconnaissance.

Lee was in apparent good health until March 1863 while when camped near the Rappahannock River, he developed sharp chest pain with radiation to his arms. His physicians diagnosed an “inflammation of the heart sac” and confined him to bed. Given the state of medical knowledge at the time, no other treatment was initiated and he apparently recovered. However, several historians have posited that heart disease, which was the cause of Lee’s death in 1870, played an important role in his performance at Gettysburg. Angina and pericarditis have both been proposed as contributing elements to what has been considered Lee’s poor strategy, particularly on July 2nd. Why was Pickett’s charge not initiated on July 2nd to reinforce Barksdale’s charge, which appeared to be heading to break through the Union lines, rather than waiting to give Pickett the order for the ill-fated offensive on July 3rd?  This question has never been adequately answered. Lee’s apparent strategic indecisiveness on the battlefield in Pennsylvania has never been satisfactorily explained, but clearly it was the seminal event that began the South’s demise.            

What if Johnston had not been killed at Shiloh? What if he had survived and helped carry out Beauregard’s proposal to attack the Union’s center in Ohio in late 1862? What  if he had been available to Lee at Gettysburg? What if Stonewall Jackson had lived to lead the 2nd Corps at Gettysburg and to support Barksdale’s change on July 2, 1863 or Pickett’s on July 3rd? What if Lee had not been distracted at Gettysburg by chest pain? What if the Confederates had prevailed at Gettysburg? What if a defeat at Gettysburg compelled the North to call an armistice and leave Southern secession in place? The answer to these questions remain unanswered. History’s only reply is silence. The imponderable ‘what- ifs’ indeed accumulate.

KEVIN R. LOUGHLIN, MD, MBA is a urologic surgeon at Brigham and Women’s Hospital in Boston and a professor of surgery at Harvard Medical School. He completed his undergraduate education at Princeton University and received his MD from New York Medical College.He also holds an MBA from Boston University and an MA(Hon) from Harvard. He is a trustee of the American Board of Urology and is a member of the board of directors of the American Urological Association and the American Association of Clinical Urologists. He is an omnivorous reader and particularly enjoys military history. He enjoys running, biking, and playing with his dogs, Finn and Lizzie.

Image: Winfield Scott's "Anaconda Plan," 1861. J.B. Elliott. Library of Congress

From: hektoeninternational.org

The "War Horse" of the Civil War

By Kathleen Golden, April 4, 2012

Recently, Steven Spielberg released War Horse, a film that is based on a young adult novel by Michael Morpurgo. It tells the story of Joey, a Thoroughbred horse, who is sold by his owner to the British Army at the start of World War I. Joey experiences the horror of that war, first as a cavalry horse for the British, and then as an ambulance puller and artillery mover for the Germans. The unique concept of the book is that the story is told from Joey’s perspective. Reading the book, it struck me that the museum has its very own “War Horse”, and that his story is equally as heroic as Joey’s. Here’s Winchester’s story, in Winchester’s voice:

“I was foaled near Grand Rapids, Michigan, late in the fall of 1859. My bloodlines are those of the famous Morgan trotter Black Hawk, whose sire was a son of the first Morgan horse, Justin Morgan. I was brought into the service by an officer of the Second Regiment Michigan Cavalry of the U.S. Army in 1862, when I was almost three years old; I was named Rienzi after the town of Rienzi in the state of Mississippi, where the regiment was stationed when I was presented to the colonel of the regiment, Philip H. Sheridan. My first impression of Sheridan? He wasn’t a very big man, which suited me just fine. I was big for a Morgan, 16 hands high and strongly built, but even so, you can run a lot faster when you’re carrying less weight. Maybe that’s why I was able to make that dash from Winchester to Cedar Creek in time to rally the troops.

That dash from Winchester to Cedar Creek happened in October 1864; before that, General Sheridan and I participated in a number of engagements, including Perryville, Stones River, Chickamauga, the Wilderness, Yellow Tavern (where that dashing Confederate cavalryman, Jeb Stuart, was killed), and Cold Harbor. I was wounded at Stones River, and again at Missionary Ridge and Fisher’s Hill, but the wounds were not serious. I maintained a level head and steady nerves through all of that. But my finest hour came on October 19, 1864, when the Confederates under Jubal Early engaged the Army of the Shenandoah at Cedar Creek. “Little Phil” and I returned from Washington, D.C. the evening before, and spent the night in Winchester, Virginia; when the sound of distant artillery could be heard at dawn the next morning, we sped off to the battlefield. Being fleet of foot, I covered the 15 mile distance in several hours, and we arrived at the battlefield around 10:30 am. We rallied the troops and repulsed the Confederate attack. Victory was ours!

I became something of a celebrity after that. The poet Thomas Buchanan Read wrote a poem entitled “Sheridan’s Ride.” My favorite stanza goes like this:

Hurrah! hurrah for Sheridan!

Hurrah! hurrah for horse and man!

And when their statues are placed on high

Under the dome of the Union sky,

The American soldier's Temple of Fame,

There, with the glorious general's name,

Be it said, in letters both bold and bright:

"Here is the steed that saved the day

By carrying Sheridan into the fight,

From Winchester--twenty miles away!"

In honor of the Union victory, my name was changed from “Rienzi” to “Winchester”. Personally, I still considered myself “Rienzi”. I was in attendance at Appomattox Courthouse on 9 April, 1865, when Confederate General Robert E. Lee formally surrendered to General Grant, and the Civil War was officially over. I retired after the war and spent my remaining years in Chicago with my master.”

Winchester (or Rienzi) died in October 1878. Sheridan had him preserved and mounted, and presented him to the Military Service Institution, Governors Island, New York, in 1879. He remained on display there until 1922, when a fire in the museum forced the Military Service Institution to transfer a number of artifacts, Winchester included, to the Smithsonian's National Museum. A ceremony was held on Saturday June 3rd, 1922, at Governors Island, where members of the Grand Army of the Republic cheered Winchester as he was ready to leave Governors Island. The event was covered by numerous newspapers.

Upon his arrival at the Smithsonian, Winchester was placed in the west gallery of the National Museum (these days known as the Arts and Industries Building). He remained there until the Museum of History and Technology opened in 1964. At that time, Winchester became a fixture in the Armed Forces Hall, where he remained in his glass case for 40 years.

In 2004, the museum opened a new exhibition on military history, “The Price of Freedom: Americans at War”. It was inconceivable that we would not include Winchester in the section on the Civil War; after all, there is some truth to the idea that he helped win the war. If Sheridan had not arrived at Cedar Creek in time to rally his troops and push the Confederates from the Shenandoah Valley, the Confederates might have gathered momentum and posed a real threat to Washington, and the war might have had a different outcome. He is on display in a case with other memorials of the war: relics from the battlefield at Gettysburg, presented to Winfield Scott Hancock in 1885; Grand Army of the Republic and Confederate Veterans badges and ribbons. Memorialization of the Civil War began shortly after the end of the war, with the formation of veterans groups on both sides. Later on, it was extended to the erection of monuments to the dead and statues of the heroes, and the creation of parks on the battlefield sites. Veterans groups, most notably the Grand Army of the Republic, began holding encampments. When Winchester died, it was in this spirit of remembrance that Sheridan had him preserved.

Kathleen Golden is an associate curator in the Division of Army Forces History.

Image: Winchester in Washington, DC, after the war

From: blog.americanhistory.si.edu

Eleanor C. "Mother" Ransom

From: findagrave.com

Birth: Dec. 18, 1815
London
Madison County
Ohio, USA
Death: Mar. 16, 1909
Los Angeles
Los Angeles County
California, USA

Civil War Nurse - Nicknamed "Mother" due to her loving care and being old enough to be the age of most of the wounded boys' mothers, Ransom was a nurse during the Civil War. Her first assignment was in a Union hospital in Tennessee and then to New Orleans were she went aboard the Government Transport Ship NORTH AMERICA to nurse wounded and sick Union soldiers during their trek back to the North by sea. The ship sank in heavy seas during a storm of the Florida coast on December 22, 1864. Of the 203 Union enlisted soldiers, mostly from Illinois and New York regiments, 194 were lost in the sinking. Ransom witnessed many of her beloved patients drown during the sinking. Ransom was placed in a lifeboat and while it was nearly swamped by the waves of the storm, she was able to make it to the ship LIBBY and rescued. She was sent to a hospital in New York City to recover from her ordeal. While there, she received visits from relatives and friends of the soldiers who were lost on the NORTH AMERICA who beseeched her to tell them if she knew of their lost loved one and/or about the storm and sinking; something she never refused to do as she felt she should try and ease the families sorrow as best she could. On July 25, 1866, a grateful Congress authorized a payment of $400 to Ransom for her wartime services aboard the NORTH AMERICA.

Ransom's parents were both Georgians by birth. She was born in Indiana (some researchers say it was in London, Madison County, Ohio). She married Stillman Ransom of Vermont on 1/19/1837 in Ripley County, Indiana.

The 1850 US Census shows the family living in Franklin Township, Ripley County, Indiana. Her husband is shown to be a farmer and Ransom is recorded as having been born in Maryland. The following family members are recorded as living in the home:
Stillman Ransom M 39 Vermont
Eleanor C Ransom F 35 Maryland
Nancy Jane Ransom F 12 Indiana
Sarah A Ransom F 10 Indiana

Her daughter Nancy Jane "Jennie" Ransom would marry twice (Walter Horace Dennison and then Civil War veteran Charles Henry Haskins). She died in Los Angeles, California, on 1/16/1881 and was buried in the Evergreen Cemetery.

In the 1900 US Census Ransom is shown to be a widow and one of many boarders in the home of a Jennie Bowlsby. Most of the boarders are young women with babies. Her obituary tells of Ransom's support for such a home and it is believed by this author that Ransom was being a "mother" and nurse to the girls at the home as well as a monetary benefactor.

Ransom was a member of the Women's Relief Corps and is mentioned in histories of that society as having been an Army nurse. Her obituary which accompanies this memorial, reported her philanthropic activities in the Los Angeles area.

Mother Ransom died at age 95. (Bio by Rick Lawrence, MSgt., USMC/USAFR (RET)


Family links:
 Children:
  Jennie Ransom Haskins (1837 - 1884)*

*Calculated relationship

Inscription:
U.S. Army Nurse

Burial:
Evergreen Cemetery
Los Angeles
Los Angeles County
California, USA
Plot: Section D

Maintained by: Rick Lawrence
Originally Created by: TLS
Record added: Aug 07, 2011
Find A Grave Memorial# 74595993

Memoir Offers Gruesome Glimpse at Civil War Surgery

By Berry Craig, September 2015

Gen. Ewell's story a reminder of how far O&P care has come.
When Confederate surgeons amputated Maj. Gen. Richard S. Ewell’s bullet-shattered left leg, they were anxious to prove to his young, soon-to-be stepson that the operation was life-saving.

“Dr. [William A.] Robertson of La. opened the leg along the track of the ball, in order to show me they were justified in taking it off – a Dr. Launer of Ala. having objected to it – but it had been plainly a necessity,” recalled Maj. Campbell Brown, 21, the general’s trusty staff officer.

Today, physicians do not generally invite relatives to watch them surgically sever a loved one’s limb. But Brown, whose wealthy widowed mother was Ewell’s first cousin, evidently went everywhere the general went, even to the operating table.

Ewell likely named Brown to his staff to curry favor with his mother, Lizinka Campbell Brown. Ewell was madly in love with her. Indeed, Richard and Lizinka ultimately married, a union that made Brown the general’s stepson.

Known for ‘bravery and generosity of spirit’
After the Civil War, Brown chronicled his experiences with Ewell in some of the bloodiest battles of America’s most lethal conflict. Terry L. Jones, PhD, a history professor at the University of Louisiana-Monroe, compiled and edited Brown’s reminiscences in a 2001 book, Campbell Brown’s Civil War: With Ewell and the Army of Northern Virginia. The volume offers a gruesome glimpse at an amputation that was typical of thousands of others in 1861-1865.

Richard’s beloved bride-to-be helped nurse him following the 1862 amputation. They were wed in 1863, though they parted when he returned to combat, fighting in the battles of Gettysburg, Pa.; The Wilderness, Spotsylvania, Va.; and Sayler’s Creek, Va.

Lizinka and “Baldy” Ewell made an odd couple, and not just because they were kissing cousins. “He was the reigning eccentric of the Army of Northern Virginia, and his men, who knew at first hand his bravery and generosity of spirit, loved him all the more for it,” wrote Larry Tagg in The Generals of Gettysburg.

Tagg said the general spoke in a “shrill, twittering lisp” and was given to “muttering odd remarks in the middle of normal conversation, such as ‘Now why do you suppose President Davis made me a major general anyway?’”

In addition, Ewell was prone to cursing “spectacularly, blisteringly” and “was so nervous and fidgety he could not sleep in a normal position, and spent nights curled around a camp stool,” according to Tagg. “He had convinced himself that he had some mysterious internal ‘disease,’ and so subsisted almost entirely on frumenty, a dish of hulled wheat boiled in milk and sweetened with sugar. A ‘compound of anomalies’ was how one friend summed him up.”

In any event, Ewell, a Washington, D.C.-born West Point graduate and Mexican-American War veteran, joined the Confederate army soon after the Civil War began in 1861.

A Proven Survivor
He had survived several battles by the time he lost his leg, and nearly his life, in fierce fighting at Groveton, Va., also known as the battle of Brawner’s Farm.

Fought on Aug. 28, 1862, the battle was a prelude to the Second Battle of Bull Run. Like the 1861 Battle of First Bull Run, Second Bull Run and Groveton were Confederate victories.

Ewell, as usual, was in the thick of the fighting, which began in late afternoon. Determined to discover the source of some worrisome Union gunfire, he dismounted from his horse and knelt on his right knee to peer through some scrubby pine trees.

A minié ball smashed his left kneecap. The bullet “pierced the joint [and] followed the leg down for some inches,” Brown wrote. “When the leg was opened, we found the kneecap split half in two — the head of the tibia knocked into several pieces.”

The slug “had followed the marrow of the bone for 6 inches breaking the bone itself into small splinters [and] finally [the ball] had split into two pieces on a sharp edge of bone,” Campbell wrote.

Ewell’s injury was typical of musket wounds in the Civil War. Bullets, round, or cone-shaped minié balls, were large — typically .54, .58 and .69 caliber – and made of soft lead. Not only did such projectiles tear gaping holes in flesh, they often splintered when they struck bones.

In any event, the battle continued past sunset, with the Union troops finally retreating.

Image: Maj. Gen. Richard S. Ewell underwent a painful amputation in the midst of a battle after being shot in the knee. Image: Library of Congress.

From: healio.com

Northern Volunteer Nurses of America’s Civil War

by Alice P. Stein

They came from the paneled drawing rooms of the nation’s great mansions, the log lean-tos of the far frontier and the chaste confines of Eastern convents. Lacking professional training but endlessly resourceful, the volunteer nurses of the Civil War labored tirelessly to bring aid and comfort to the sick and wounded soldiers on both sides of the fighting.

At the outbreak of the war, the nursing profession was in its infancy and dominated by men–women generally were considered too frail to cope with the rigors of administering to the sick. There were only about 150 hospitals in the entire country, and no formal nursing schools existed. The massive numbers of sick and wounded men who needed care during the Civil War exacerbated the lack of medical professionalization, and wartime hospital facilities, particularly early in the conflict, were primitive and disorganized. Military and societal protocol banned women from field hospitals, so most nursing duties continued to be assigned to men. Increasing numbers of casualties and the overburdening of aide facilities, however, soon broke down gender-related strictures on nursing and spurred the nation’s women into taking immediate and decisive action to help correct the situation.

Clara Barton, who later founded the American Red Cross, brought supplies and help to the battlefronts before formal relief organizations could take shape to administer such shipments. Acting entirely on her own, the Massachusetts-born Barton personally collected food, clothing and medical supplies for the hard-pressed Union Army after the Peninsula campaign in 1862. She later served in a similar capacity at other engagements.

Religious orders also responded to this new opportunity for service by sending their own trained nurses to staff field hospitals near the front. Within a few months of the war’s onset, some 600 women were serving as nurses in 12 hospitals. In all, eight Catho-lic orders sent nuns to serve in the war.

In April 1861, Dorothea Dix and a hastily assembled group of volunteer female nurses staged a march on Washington, demanding that the government recognize their desire to aid the Union’s wounded. Although not a nurse, Dix was nationally known as a crusader for enlightened care of the mentally ill, and her grandfather, Elijah Dix, had been a prominent Boston physician. Secretary of War Simon Cameron quickly named her to superintend the women nurses assigned to the U.S. Army. Cameron’s nominating citation read in part: ‘She will give at all times all necessary aid in organizing military hospitals for the care of all sick and wounded soldiers, aiding the chief surgeons by supplying nurses and substantial means for the comfort and relief of the suffering.’ Despite such responsibilities, however, neither she nor her nurses were granted military appointments.

By nature compassionate and giving, Dix was also a no-nonsense and often quirky leader. At first she required nursing applicants to be at least 30 years of age–old by the standards of the time–and ‘plain looking,’ wearing brown or black clothing with no ornaments, bows, curls, jewelry or hoops. She steadfastly denied admission to nuns or other representatives of religious sisterhoods. Despite these stringent requirements, some 2,000 women across the country laid aside their cherished jewels and laces to pass Dix’s austere muster.

As casualties mounted, Dix was forced to relax her standards, and after the First Battle of Bull Run in July 1861 she accepted anyone willing to work. Her nurses were paid 40 cents a day plus rations, housing and transportation, while male nurses received $20.50 a month plus superior benefits.

As the war dragged on, other women augmented the work of Dix’s corps and the volunteer nuns. Soldiers’ wives, residents of battlefront areas and representatives of newly formed organizations such as the U.S. Sanitary Commission all helped care for sick and wounded soldiers.

Dix operated from houses she personally rented in Washington, and she did not take off a single day during her four years of service. Her hospitality was always available to nurses and discharged servicemen who lacked shelter. Louisa May Alcott, who became ill with typhoid fever soon after entering her brief service as a nurse, gratefully recalled Dix’stealing a moment from her busy life to watch over the stranger of whom she was as thoughtfully tender as any mother.’

In her zeal to reduce suffering and death, Dix constantly prowled the hospitals. Her intolerance of hospital administrators and nurses who did not meet her exacting standards caused constant friction. Finally, in October 1863, Secretary of War Edwin Stanton transferred part of the responsibility for appointing nurses to the surgeon general and gave medical officers at each hospital jurisdiction over their own female nurses.

Dix was heartbroken but responded with a magnanimity that drew admiration from even her staunchest opponents. After she resigned at war’s end and her post was abolished, she continued to work doggedly for another 18 months, helping individual soldiers and their families deal with the stresses of recuperation. Throughout the rest of her life, Dix begged biographers to de-emphasize her Civil War years. But in 1983, long after she was dead and could not protest the well-deserved honor, she was featured on a U.S. postage stamp.

While Dix was gathering her forces in Washington, Mary Ann Bickerdyke was taking matters into her own equally dedicated hands in Galesburg, Ill. A 45-year-old juggernaut, Bickerdyke personified Dix’s ideal nurse. Before the war, she had received training in botanic and homeopathic medicine and had been engaged in private-duty nursing. Recently bereaved by the untimely death of both her husband and young daughter, she felt divinely called to spend her remaining life relieving human suffering.

On a Sunday in June 1861, Bickerdyke listened as her pastor, Edward Beecher, brother of Henry Ward Beecher and Harriet Beecher Stowe, told of the need for volunteer help in the military camps in nearby Cairo, Ill. When the congregation asked her to accompany a load of food, clothing and medical supplies to Cairo on behalf of the church, she was ready. Except for short visits, that was the last her two young sons saw of her until the end of the war.

When Bickerdyke saw the poor condition of the hospital in Cairo, she took a room in town and immediately began a determined cleanup effort that quickly spread to the other five military hospitals in the area. Although he granted her a grudging welcome at first, Dr. J.J. Woodward, a surgeon with the 22nd Illinois Infantry, later praised Bickerdyke as’strong as a man, muscles of iron, nerves of finest steel; sensitive, but self-reliant, kind and tender; seeking all for others, nothing for herself.’

Throughout the war, ‘Mother’ Bickerdyke moved from one trouble spot to another, acting on her belief that bodies healed best when they were bathed, placed in clean surroundings and fed well. She evinced a special concern for enlisted men and stopped at nothing to get supplies that would bring comfort to her ‘boys.’ She begged food from any viable source, raided government supplies–often without permission–and commandeered boxes of delicacies sent from home to healthy soldiers. Many times, when government rations were waylaid or ran out, she found a way to feed the troops. Her tireless zeal earned her the nickname ‘Cyclone in Calico.’

http://cdn.historynet.com/images/unsungsisters_1.jpg
Library of Congress
Although her strict nature earned her the unkind sobriquet ‘Dragon Dix’ from some, the rigid standards set by Dorothea Dix saved the lives of many men.
In the early period of her service, Bickerdyke held no authority other than semiofficial status granted occasionally by Union Army officers. Her manner, however, was so forthright and compelling that she was rarely questioned. When one surgeon dared to ask where she received permission to do what she was doing, Bickerdyke retorted she was given orders by ‘the Lord God Almighty. Have you anything that ranks higher than that?’ Later, she was named a Sanitary Commission agent.

In spite of her brusque and aggressive behavior, Bickerdyke gained the friendship of a few high-ranking officers, among them Generals Ulysses S. Grant and William Tecumseh Sherman. Toward the end of the war, when someone complained about Bickerdyke to Sherman, he commented that she was the only person around who outranked him, and he suggested the complainer refer the matter to President Abraham Lincoln.

On one occasion, when she was besieging Sherman at an inopportune moment, the oft-prickly general asked whether she had ever heard of insubordination. Bickerdyke responded in an equally testy manner: ‘You bet I’ve heard of it….It’s the only way I ever get anything done in this army.’

She demonstrated that point one day when troops passed one of her hospitals en route to battle at Corinth, Miss. When Bickerdyke invited the captain to halt his exhausted men so that she and her staff could feed them, he refused. As he led the men on, a deep voice cried, ‘Halt!’ The men slowed to a stop, confused. Their bewilderment was replaced with glee when a group of women led by Bickerdyke quickly served them soup and coffee and gave them bread, fruit and fresh water to take along on the march. By the time anyone realized Bickerdyke had given the spurious order to halt, all the men had been served and sent off with the only food they were to see for two days. A formal reprimand brought no firm promise of reform from the unrepentant Bickerdyke.

Major General John ‘Black Jack’ Logan also crossed paths with Bickerdyke, meeting her for the first time late one night after a battle. While lying in his tent, he observed a lone figure with a lamp crisscrossing the battlefield and sent an orderly to bring the person in for questioning. Bickerdyke explained that she could not rest until she was satisfied that no living man remained on the field. The story was picked up by the press and contributed to her folk-hero status. After that incident, Logan often confided in her, called on her to provide for his men, and ordered her to ride at his side at the Union’s gala victory parade in Washington after the Confederate surrender.

As matron of many temporary field hospitals, Mother Bickerdyke often crossed swords with surgeons and other staff members. In some cases, her complaints to superior officers brought disciplinary action; other situations she resolved in her own way. She reserved special vengeance for anyone she suspected of snitching supplies or delicacies she had set aside for the sick and wounded. Once, after repeated warnings to kitchen workers, she decided to set a trap. She cooked some peaches, secretly spiked them with a potent but harmless purgative, and left them to cool while she worked elsewhere. Soon, agonized cries from the kitchen attested that she finally had made her point.

Bickerdyke drafted anyone within reach of her voice to help with the endless labor. Healthy soldiers and camp visitors were either bribed with hot meals or badgered into service. When gentlemen from the Christian Commission came to restore wounded souls, she suggested that they would have a better chance of success if they began with wounded bodies.

Formerly active in the Underground Railroad, Bickerdyke respected blacks and often sought their help. Many contrabands cheerfully worked hard for her, and, in turn, she fought for their fair treatment and taught them skills they could use later in postwar America.

Bickerdyke was equally effective on her occasional speaking forays for the Sanitary Commission. One day toward the end of the war, she was telling the ladies of Henry Ward Beecher’s church in Brooklyn how she had bound the stumps of new amputees with old cloth bags when she had nothing better. Suddenly, she asked the startled women to rise, lift their dresses, and drop one of their many petticoats to the floor. The collected garments filled three trunks, and within a few weeks, Bickerdyke was using the petticoats to bandage the terrible sores of prisoners released from Andersonville in Georgia.

When the last Illinois man was discharged, Bickerdyke resigned from the Sanitary Commission to devote the rest of her life to her family and to charitable deeds. She died in 1901, and a sturdy freighter named for her carried on her work in the 20th century by ferrying Spam and sulfa drugs to American servicemen isolated on Pacific islands in World War II.

Another tireless champion of wounded enlisted men during the Civil War was Hannah Ropes. The daughter and sister of prominent Maine lawyers, she was over 50 when the war started. An experienced nurse, she had gained prewar recognition as a reformer and abolitionist and was acquainted with many New England political leaders. Like Dix and Bickerdyke, she believed every soldier deserved proper sanitation, good food and humanitarian treatment, and never hesitated to go to the top to obtain such creature comforts. Secretary of War Stanton personally took action against officers and stewards she found to be slovenly and incompetent.

In 1862 Ropes became the matron of the Union Hotel Hospital located in the Washington, D.C., neighborhood of Georgetown, where Louisa May Alcott also served. In her book Hospital Sketches, Alcott described Ropes’ actions as casualties arrived from the Battle of Fredericksburg: ‘The hall was full of these wrecks of humanity…and, in the midst of it all, the matron’s motherly face brought more comfort to many a poor soul, than the cordial draughts she administered, or the cheery words that welcomed all, making the hospital a home.’

In her own published diary and letters, Ropes spoke often of her particular regard for the enlisted man. In October 1862, she wrote, ‘The poor privates are my special children of the present,’ and described ‘the loss they have experienced in health, in spirits, in weakened faith in man, as well as shattered hope in themselves.’ Later, she wrote to her daughter, Alice, ‘I owe no man anything but love.’

In her final diary entry in December of that year, Ropes, writing in the third person, described the passing of one of these men: ”Thank you, madam….I must be marching on.’ So said Lewie as he passed away. Sitting on one side of him was his nurse, Miss Alcott, on the other side the matron [Ropes]….There was in the man such a calm consciousness of life, such repose in its secure strength….The matron is left alone when the breath ceases.’ A few weeks later, Ropes died of typhoid fever, the same disease that had shortened Alcott’s nursing service.

Sometimes caring for the war wounded became a family undertaking. In New York, Jane Newton Woolsey, widow of a prominent industrialist, quickly rallied her six daughters to the cause. Georgeanna (‘Georgy’), Eliza and Jane became nurses, while the others made supplies. The Woolsey home near the Brevoort House Hotel be-came a center for preparing supplies and distributing them to Union hospitals.

In 1861 Georgy Woolsey was among the first women to be accepted for nurse’s training and assigned to duty by Dorothea Dix. By September of that year, Georgy and Eliza were serving in a makeshift hospital in an unfinished government building. Georgy described how they used rough wood scaffolding for beds, with as many as six men in each one. The beds were so high that long broom handles had to be used to support them. Very sick men were given individual beds on piles of marble slabs originally intended for building construction. Until further work was done on the building, pulleys raised food and water to the ersatz hospital’s upper floors.

The three sisters served in numerous capacities, both in hospitals and on military hospital transport ships. Jane and Georgy were assistant superintendents of the U.S. Army hospital at Portsmouth Grove, R.I. The two also served at Hammond General Hospital. They were paid $12 a month and immediately returned the compensation to the surgeon-in-charge to purchase items for the patients. Eliza returned to private life when her husband, Colonel Joseph Howland, was wounded and mustered out of service.

Like Hannah Ropes, the three Woolsey women used their prominent social position to obtain prodigious amounts of supplies and other necessities for the wounded. At one point, Georgy personally delivered to the White House a letter she had written to President Lincoln, imploring him to send chaplains to the military hospitals. He promptly named seven new chaplains.

Georgy was noted for her cool demeanor, in times of emergency. Jane wrote of her: ‘There was never a critical case in the hospital on which Georgy’s intelligence was not brought to bear in some shape.’ Ever alert for ways to make patients more comfortable and their care more efficient, she kept her apron pockets filled with forks, spoons, corkscrews and other useful items. Both sisters carried notebooks in which they re-corded individual patient needs and wishes. Georgy carefully noted the names and addresses of the dying for later use in returning their possessions to their families.

Both Jane and Georgy Woolsey depicted wartime hospital life in sensitive and enduring writings. Jane’s book, Hospital Days, published in 1868, enjoyed wide readership. In it she quotes an unnamed officer’s view of the Civil War nurse: ‘She may be totally impervious to ideas of order; she may love ‘hugger-mugger’ and hand-to-mouth ways of getting at direct objects; she may hopelessly muddle the ward returns, and interchange sentiment with the most obnoxious of the stewards, but she will cheerfully sacrifice time, ease, and health to the wants or whims of a wounded man.’

After the war, Georgy Woolsey assisted in establishing the Connecticut Training School for Nurses in New Haven. She also wrote a nursing handbook that was only the second of its kind to be published in the United States. Jane and another sister, Abby, played pioneer roles in developing enlightened methods of nursing in civilian hospitals.

Among the church leaders who answered the humanitarian call during the war, none responded with more fervor or professional gifts than Mother Angela (Eliza Maria Gillespie), founder of the Sisters of the Holy Cross. The daughter of a respected Pennsylvania attorney and landowner, she numbered General Sherman, a senator, and an assortment of other leaders among her relatives. When war broke out, she was the director of St. Mary’s Academy at Notre Dame University.

Early in the conflict, when General Grant sent a plea for nurses to Indiana Governor Oliver P. Morton, Mother Angela left immediately with a group of sisters. Grant later described her to Sherman as ‘a woman of rare charm of manner, unusual ability, and exceptional executive talents.’

The sisters were first sent to Paducah, Ky., where the surgeons initially received them coolly. The doctors, however, soon came to appreciate both the useful services the women were performing and the military precision with which Mother Angela organized them.

The demoralizing hospital diet of rancid pork and stale bread was quickly replaced by rice, eggs, milk and chicken that Mother Angela procured and prepared herself. At one point, she had 60 nuns helping her care for 1,400 men at Mound City, which was regarded as the best military hospital in the country at the time.

Mother Angela employed her family connections and social skills to obtain supplies where even high-ranking military officers failed. William H. Osborn, president of the Illinois Central Railroad, gave her food, wine and free passes for wounded men who were being sent home. Asked by Secretary of War Cameron to take charge of a hospital at Cairo, she charmed representatives of various commissions and aid societies into backing her efforts. On one occasion, she entertained a weary visitor with tea brewed on her single, makeshift burner and served in a tin cup. Upon returning home, he sent her a six-burner stove and other supplies on the next train.

True to her faith, Mother Angela served Union and Confederate soldiers with equal devotion. Once, a seriously wounded Confederate officer was brought to Mound City. When word got around, an angry mob stormed the hospital, determined to drag the officer out and execute him. But Mother Angela stood over his bed and refused to leave until the Confederate had been guaranteed safe passage home. In September 1862, Mother Angela returned to St. Mary’s Academy, assured that the soldiers’ needs would be met from other sources.

Harriet Tubman was best known among the many blacks who rendered distinguished service as Civil War nurses. Famed for her courageous exploits with the Underground Railroad, she was admired by many leaders of the time, including Secretary of State William Seward and New England poet Ralph Waldo Emerson.

Early in the war, Massachusetts Governor John A. Andrew asked Tubman to help nurse in the military camps. She moved from one camp to another throughout the war, using her nursing skills and extensive knowledge of the healing properties of roots and herbs. Tubman rarely accepted the military rations that were offered to her, preferring to support herself by making baked goods and selling them in the camps. She gave any extra money to the freedmen who often sought refuge in the camps. Late in life, she was awarded a military pension, and when she died in 1913, she was given a military funeral.

A record of Civil War nursing from the black viewpoint was left by Susie King Taylor in her Reminiscences of My Life in Camp. Taylor was born a slave on the Isle of Wight near Savannah, Ga. In adolescence she learned to read and write at a clandestine school run by a free black woman. Marrying Edward King, she followed him when he joined the Union Army’s first black regiment, the 1st South Carolina Volunteers. In camp she nursed the wounded, did laundry, cooked and taught the men literacy skills.

Taylor became a protege of Clara Barton, who often took her along on hospital rounds. Taylor admired Colonel Thomas Wentworth Higginson, of the 1st South Carolina Volunteers, whom she described as ‘kind and devoted to his men’ and ‘a genial presence.’ In her book she also recalled Colonel C.T. Trowbridge. ‘He was the very first officer to take charge of black soldiers,’ she wrote. ‘We thought there was no one like him, for he was a ‘man’ among his soldiers….I shall never forget his friendship and kindness toward me….No officer in the army was ever more beloved.’

Taylor’s book is filled with details of camp hospital life. She recalled making custard of milk and turtle eggs for the wounded in a camp on Morris Island, and she described warming her tent at night with an iron frying pan full of coals from the cook shed. She noted that fleas often kept her awake all night.

Taylor served for four years and three months in Union Army hospitals without receiving either pay or a formal appointment. After the war, she was granted no government pension or recognition for her nursing services. Still, she wrote, ‘I was glad…to go with the regiment, to care for the sick and afflicted comrades.’

Taylor summed up the attitude of volunteer Civil War nurses of both races when she observed: ‘It seems strange how our aversion to seeing suffering is overcome in war,–how we are able to see the most sickening sights, such as men with their limbs blown off and mangled by the deadly shells, without a shudder, and instead of turning away, how we hurry to assist in alleviating their pain, bind up their wounds, and press the cool water to their parched lips, with feelings only of sympathy and pity.’

The nurses of the Civil War left a heritage far beyond a country’s gratitude for bodies salvaged and spirits renewed. Observing the difference they had made, both the public and the medical community finally came to recognize nursing as a legitimate profession. Women such as the Woolseys and Clara Barton translated their experience in Civil War hospitals into reforms in both nursing science and the education of nurses. As Jane Woolsey noted in Hospital Days, ‘It has been a tiresome march, but think of the results.’

Image: U.S.A.M.H.I., Carlisle Barracks, Pennsylvania, Photo by Jim Enos. A nurse prepares to spoon-feed soldiers in this photograph taken inside a Union hospital. Women also likely donated the coverlets warming the men.

This article was written by Alice P. Stein and originally appeared in the September 1999 issue of America’s Civil War.

From: history.net

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