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SAINT MARYS COLLEGE OF MARYLAND

There is No Glory for Our

Profession
The Experiences of Surgeons and Nurses in the
American Civil War

BY
MICHAEL P. WILBURN
Saint Marys Project

Dr. Gail Savage

Unpublished 2013 Michael Wilburn

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Abstract

Despite the recent scholarship in the field of Civil War medical history, many myths about the
quality of the medical care persist. Surgeons are remembered as inexperienced, callous men
interested only in gaining experience. Nurses are remembered as cheery and maternal caregivers.
By analyzing the journals, letters, and memoirs of surgeons and nurses during the American
Civil War, I provide an account of the tribulations of the medical personnel for two reasons: to
dispel the myths about them, and to provide a new emotional and psychological perspective to
Civil War medicine. The paper examines how surgeons and nurses suffered and coped during the
war, showing that many surgeons were compassionate and skilled, and that nurses endured
mental and physical exhaustion and gender discrimination. This paper adds a new chapter to the
history of emotions, history of psychological medicine, and the history of Civil War medicine by
bringing to light much that has been overshadowed by false historical memory.
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Table of Contents
Abstract ...................................................................................................................................................... i
Table of Contents ...................................................................................................................................... ii
List of Tables ............................................................................................................................................ iii
List of Figures ........................................................................................................................................... iv
Introduction .................................................................................................................................................. 1
Background ................................................................................................................................................. 13
Reactions to Service .................................................................................................................................... 36
Physical Risks............................................................................................................................................... 65
Nostalgia in Civil War Surgeons and Nurses ............................................................................................... 81
Coping ......................................................................................................................................................... 90
Conclusion ................................................................................................................................................. 103
Works Cited ........................................................................................................................................... 107
Appendix A ............................................................................................................................................ 112
Appendix B ............................................................................................................................................ 113
Appendix C ............................................................................................................................................ 114
Appendix D ............................................................................................................................................ 115
Appendix E ............................................................................................................................................ 116
Appendix F ............................................................................................................................................ 117
Appendix G ............................................................................................................................................ 118
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List of Tables
Table 1: Treatment Comparison of 60,266 Cases of Shot Wounds ...................................................... 16

Table 2: Fatalities in 8,900 Operations Employing Anesthesia ........................................................... 17

Table 3: Deaths of Union Surgeons by Cause .................................................................................... 68

Table 4: Nostalgia Cases in Whites in the Union Army ...................................................................... 85

Table 5: Nostalgia Cases among Blacks in the Union Army ................................................................ 85

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List of Figures
Figure 1: Sawbones .......................................................................................................................... 18
Figure 2: Jonathan Letterman, M.D................................................................................................... 24
Figure 3: Ambulance Drill ................................................................................................................. 25
Figure 4: Field Hospital Scene ........................................................................................................... 26
Figure 5: Hammond Hospital ............................................................................................................ 26
Figure 6: Grapeshot Wound ............................................................................................................. 28
Figure 7: Surgical Amputation Kit...................................................................................................... 29
Figure 8: Regulation Hospital Knapsack............................................................................................. 32
Figure 9: Annie Bell ......................................................................................................................... 34
Figure 10: Bodies of Confederate Dead Gathered for Burial ............................................................... 45
Figure 11: Field Day .......................................................................................................................... 46
Figure 12: Amputation Scene............................................................................................................ 48
Figure 13: Ward in the Carver General Hospital, Washington, D.C. .................................................... 54
Figure 14: Field Hospital of 3d Division 2d Army Corps ..................................................................... 56
Figure 15: Clara Barton ..................................................................................................................... 72
Figure 16: George Welch ................................................................................................................. 96
Figure 17: Sunday Morning Mass at Camp Cass ............................................................................... 100
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Introduction
The American Civil War is remembered today as the bloodiest war in American history.

The battlefields of Manassas, Antietam, and Gettysburg claimed more lives than the Second

World Wars beaches of Normandy, the islands of the Pacific, or the skies above Germany. The

accepted number of those who died during the war is placed at 620,000, though new sources are

suggesting as many as 750,000 Americans,1 civilian and soldier, died. This number exceeds the

total dead of all previous American wars and later wars until Vietnam combined. Approximately

2% of the American male population died. In addition, the Union armies suffered 281,881

wounded and for the Confederates, 194,000. Of those who died, 224,580 succumbed to disease in

the Union, and 164,000 in the Confederacy. A Union soldier had a 7% chance of dying on the

battlefield, 16% chance of being wounded, an almost 100% chance of developing a disease

(99.5% of soldiers suffered from dysentery at some point during the war). 2 For every soldier

killed by from the bullet, two died from disease.

These statistics put the sheer magnitude of death, injury, and illness during the war into

perspective. It was on a scale the Union forces and their rebelling adversaries were not prepared

for. Confederate Secretary of War, LeRoy Pope Walker predicted that when all things were said

and done, he could wipe up all the blood spilled with his handkerchief. 3 President Abraham

Lincoln called for the enlistment of 75,000 men for a term of ninety days. Union Surgeon General

Thomas Lawson was notoriously stingy and believed that spending money on books and

instruments was a waste. His successor, Clement Finley, who replaced him just before the First

1
J David Hacker. A Census-Based Count of the Civil War Dead, Civil War History 57. No. 4 (2011), 306-347.
2
Jenny Goellnitz. Statistics on the Civil War and Medicine. Ohio State.
http://ehistory.osu.edu/uscw/features/medicine/cwsurgeon/statistics.cfm;
Alfred J. Bollet. Civil War Medicine: Challenges and Triumphs. (Tucson: Galen Press, ltd., 2002) 80-90.
3
D. Jonathon White. LeRoy Pope Walker. Encyclopedia of Alabama. October, 2011.
http://www.encyclopediaofalabama.org/face/Article.jsp?id=h-1854
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Battle of Manassas (See Appendix A for timeline of major battles), decided to wait until there

were casualties before preparing for them. However, these statistics only tell a small part of the

story of suffering, a story in which the soldiers and officers were key characters.

After the first shots rang out, both sides recruited skilled, and sometimes not-so-skilled,

surgeons and nurses to treat and care for the wounded and sick. The medical departments on both

sides fumbled with the demanding responsibility of caring for the ever growing number of

patients. As the war progressed, so too did their knowledge, experience, and sophistication

improve. Town doctors accompanied their patients to the recruitment offices and became

company surgeons. Wives, daughters, and sisters who were left at home flocked to the hospitals

to provide nursing care that seemed a natural extension of their maternal responsibilities. None of

them, however, knew what to expect. Surgeons on campaign faced countless amputations and

treating relentless disease, in addition to sometimes accompanying their companies into battle.

Nurses worked long days and nights providing not only physical but also emotional care and

support to dying and healing soldiers. The medical personnel were forced to cope and adapt to the

stress of carrying out their responsibilities under conditions harshly defined by war.

Books and journals abound that record the camp life and campaigning life of the soldier.

They recount their experiences of the relentless drills, the horrible food, the twenty-mile or more

marches per day, the fear of battle, the callousness afterwards, the death of friends, the life-

changing amputations and diseases. Among these countless personal accounts of soldiers and

officers, dozens of surviving accounts record the experiences of the surgeons and nurses. While

not all of them marched into battle, their stories and perspectives on the war contribute to a more

holistic view of the way people caught up in war responded to their circumstances.
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Historiography
The driving mission of the field of Civil War medical history has been to dispel various

misconceptions about the practice of medicine during the Civil War, and in doing so, the field has

expanded from just focusing on physiological medicine to examining related issues in gender,

social, and emotional history. These misconceptions, which will be criticized in greater detail

later, have clouded the publics understanding and persisted despite the published scholarship

dispelling them. These myths include the belief that surgeons lacked anesthesia and completely

lacked effective medicine, that the armed forces suffered under an unorganized medical system,

that soldiers were subjected to treatment under inexperienced and unqualified personnel. These

myths most likely found their origin in the opening months of the war when that could be said

about battlefield medical care. But by the time the medical departments found their footing and

became well-oiled machines, the negative reputations had stuck. It was, therefore, a primary

concern of medical departments and later historians to correct this opinion.

The historical examination of Civil War medicine actually began before the war was over.

Surgeon John H. Brinton was given the task of collecting artifacts and specimens for the creation

and organization of the Army Medical Museum in 1862, later to be renamed the National

Museum of Health and Medicine. After the war, Surgeon General Joseph K. Barnes helped

compile and edit the Medical and Surgical History of the War of the Rebellion, a multi-volume

compilation of case studies, medical and surgical techniques, and general knowledge of illnesses,

conditions, and diseases. Articles and books have appeared briefly over the early and mid-

twentieth century, most notably George Adams Doctors in Blue (1952) and H. H. Cunninghams

Doctors in Gray (1958). These early works were initially written by doctors interested in medical
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history. As the field grew, academic historians began to contribute. As a result of this shift, the

historical field of Civil War medicine has grown exponentially.

The first definitive texts on Civil War medicine, Doctors in Blue by George Adams and

Doctors in Gray by H.H. Cunningham, were written to illuminate certain aspects of the Civil

War, and the medical sciences of that period4 for the general public. These works provided

narratives of progress. Adams work observed how medical care and organization progressed

from utter confusion and unreadiness in 1861 to a systematic and experienced corps, following

the reformations of Surgeons General Hammond and Barnes throughout the war. Cunninghams

book argued that the Confederate medical corps made significant contributions to medical

knowledge and procedure in the post-war years. Both works discussed the same issues in their

respective armies: medical department administration and reformation, medical ailments and care,

medical personnel and establishments. However, their works were not entirely composed of

unabated praise for the medical departments. Both authors considered the problems with infection

and a lack of knowledge of bacteriology and the toxicities of some medications. Together, they

form the first standard account of medical care during the Civil War.

The last twenty years have witnessed the largest growth of scholarship in the field of Civil

War medical history. The Society of Civil War Surgeons released the North-South Medical Times

which ran from 1990 to 1996 and was subsequently replaced by the Journal of Civil War

Medicine which is now in its sixteenth year of publication. This simple change in name also

represents the shift to a more academic approach that characterized this period. Gordon E.

Dammann M.D., who had a vast personal collection of medical artifacts from the war, along with

other scholars and medical professionals, opened the National Museum of Civil War Medicine in

4
George Adams. Doctors in Blue. (New York: Henry Schuman. 1952). xi.
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1990. The number of articles and books written and published by established academic historians

grew significantly than previously. Diaries, letters, and memoirs of surgeons and nurses from both

sides were published. Additionally, a growing interest in womens history in the late twentieth

century prompted a number of published journals and letters and books on female nurses during

the war. The period was a time growth and an era of a new understanding of Civil War medicine.

As historians continued on their quest to destroy the myths, they explored new aspects of the field

and tried to connect it to other fields.

One of the most notable works of this period is Civil War Medicine: Challenges and

Triumphs by Alfred J. Bollet, M.D. Bollets work combined Adams and Cunninghams works

into one thorough and updated volume. Bollet not only combined the subject matter of the two, he

also contributed new material and elaborated further on existing material. The book, written to

dispel the misconceptions of Civil War medicine, builds upon the notion of progress of the

medical departments on both sides. Bollet even wrote in the preface, Until I began to study the

medical history of the Civil War, I had similar negative opinions. 5 Bollet dedicated one of the

longest chapters to the reforms of Medical Director Dr. Jonathan Letterman. He provided case

studies of neurosurgery, dentistry, optometry, and plastic surgery, expressing how all of these saw

huge progress as a result of the war. Reviews in journals have praised its quality as a holistic

examination of Civil War medicine that clear[s] up many of our misconceptions. 6 The final

chapter was even titled, Re-Evaluating Civil War Medical Care: Shattering the Myths. 7 The

book detailed the reforms, politics, the various injuries, diseases and their treatments, the roles of

surgeons and nurses, civilian aid programs, and logistics. Contributing to the main mission of the

5
Bollet. Civil War Medicine. xiii.
6
Harold Ellis. Civil War Medicine: Challenges and Triumphs by Alfred J. Bollet M.D. British Medical Journal
325, no. 7356. (2002): 1.
7
Bollet. Civil War Medicine. 435.
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field, Bollet praised surgeons as caring, innovative, and dedicated, combating their misconceived

negative reputation. 8 His secondary sources include just about every book and article on the

subject, most dating from after 1960. His primary sources include personal and government

writings and publications. Bollets work is among the best in the field.

In addition to these works of the general history of Civil War medicine, several historians

have attempted to relate the field to other topics such as emotional, social, and psychological

history. Printed in 1997, Eric T. Deans book, Shook over Hell: Post-Traumatic Stress, Vietnam,

and the Civil War, offered a fresh perspective into Civil War medicine by examining the

psychological casualties of the war. Deans task, looking for evidence of PTSD, according to the

Vietnam War era standard, in a society in which it was unknown, proved difficult. Dean,

however, succeeded in providing an examination of the disorder. Dean scrutinized the cases of

soldiers at a soldiers home (a psychiatric asylum for veterans) in Indiana. His work did

succeed in showing how some veterans were psychologically affected and how the public

responded to them (that is, locking them up in an asylum). This work was quite revolutionary in

the field of Civil War medicine. It explored an entirely neglected topic and spawned interest in it,

thereby providing inspiration for a number of articles and books on psychological casualties.

Building on Deans book, James Marten surveyed the post-war lives of several soldiers

from the Great Lakes area and illustrated how their wartime experiences hindered their

reintegration into society.9 Frances Clarke and David Anderson both studied the phenomenon of

nostalgia, a clinical psychological diagnosis consisting of extreme homesickness resulting in

depression, lack of sleep, exercise, social interaction, and motivation, and in extreme cases death.

8
Ibid. 440-442.
9
James Marten. Exempt from the Ordinary Rules of Life: Researching Postwar Adjustment Problems of Union
Veterans. Journal of Civil War History 47. No. 1. 2001. 57-70.
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Using journals, letters, and the Medical and Surgical History of the War of the Rebellion, Clarke

and Anderson show the cultural importance of home, the social aspects of nostalgia and attempts

to understand and treat it. Anderson wrote:

Given the recent explosion of interest in the social history of the era and current
attention afforded to the history of medicine and the history of disability, these
questions are significant and timely ones and they have excited some interest
among historians of the Civil War, especially in a plethora of soldier studies to
have emerged within Civil War historiography since the 1980s.10

Cheryl Wells and Jane Schultz have written extensively on the social history of nursing in

the Civil War. Jane Schultz wrote on the issue of discrimination in general hospitals. Her article

studied the relationship between female nurses and their male colleagues, as well as relations

between white nurses and black nurses. She showed how black hospital workers were given the

worst jobs with little pay. Black patients were given a lower priority to white patients.11 Cheryl

Wells, however, argued the contrary in her article, Battle Time: Gender, Modernity, and

Confederate Hospitals. While in the beginning, women nurses tasks were regimented by male

staff according to an hourly clock time, as the war progressed, the biological, irregularly timed

demands of the wounded destroyed the notion of systematic clock time. Consequently, men and

women alike were subject to this new task based time. Since they were both subjected to it, she

argues that men lost their temporal authority over women and thus, hospitals became

degendered. 12 Unfortunately, her argument is not very clear. She does not show any primary

source evidence of degendering. Her whole argument hinges upon this speculated conclusion that

10
David Anderson. Dying of Nostalgia: Homesickness in the Union Army during the Civil War. The Journal of
Civil War History 56, no. 3. (2010): 248.
11
Jane Schultz, Seldom Thanked, Never Praised, and Scarcely Recognized: Gender and Racism in Civil War
Hospitals, Journal of Civil War History 48, no. 3. (2002): 220-236.
12
Chery Wells, Battle Time: Gender, Modernity, and Confederate Hospitals, Journal of Social History 35, no. 2.
(2001): 409-428.
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since all were subject to the demands of the wounded, all felt gender equality. Schultzs Union

nurses were likewise subjected the demands of the wounded, but showed no evidence of gender

equality. Regardless of their vastly different conclusions, both articles further demonstrate a

growing connection between medical history and social and gender history.

Secondary sources pertaining to the American Civil War were not the only sources

consulted for this thesis. The historiography of military psychological disorders has its origins

following the First World War. During the Great War, studies were conducted to examine a

psychological condition then known as shell shock. These studies represent the first time wartime

traumatic disorders came under any analysis. Therefore, much of our scientific and historical

understanding of Post-Traumatic Stress Disorder is built on these early studies. One of these

sources that were consulted was by authors Carol Acton and Jane Potter. They examined how

medical personnel of the First World War described and reacted to their emotional stresses of

caring for the wounded and dying.13

Despite these recent additions to the historical literature, very little has been written on the

experiences of medical personnel during the war in comparison to the voluminous accounts

written on the military aspects. Of the works written on the experiences of medical personnel, the

vast majority concerns the roles and experiences of nurses. There are, in addition to the secondary

writings, a number of published journals and letters of surgeons. Individually, these works

express only one persons experiences. Nobody has yet attempted to review a group of the

13
Carol Acton and Jane Potter. These frightful sights would work havoc with ones brain: Subjective Experience,
Trauma, and Resilience in First World War Writings by Medical Personnel. Literature and Medicine 30. No. 1.
(2012): 61-85.
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personal writings of surgeons and nurses in order to provide an analysis of personal experiences

in the medical departments.

Objective
By building upon the precedent of linking the history of medical care in the war to other

fields, this paper will connect the medical history with psychological history and the history of

emotions. Also, driven by the goal of the field, this paper will endeavor to dispel myths about the

callousness and uncaring nature of surgeons. To accomplish these objectives, this paper will

answer these questions: How did military service affect the surgeons and nurses of the American

Civil War mentally, physically, and emotionally? How did they cope with the trauma of the

service? How did the experiences of the medical personnel compare with those of the soldiers

they served? Service in the medical departments as a surgeon or nurse came with challenges. But

like their patients who understood that victory came at a price, many of these men and women

carried on their jobs despite the difficulties.

Military service affected the surgeons and nurses in a number of ways. Physically,

surgeons and nurses were exposed to disease on a regular basis, and most developed some form of

illness and some did not recover. For the surgeons and nurses operating near battlefields, the

danger of being killed, wounded, or captured was ever present. Psychologically, surgeons and

nurses were exposed to much human suffering and so they too suffered some form of stress

disorder in varying degrees. Surgeons and nurses also found themselves separated from home,

family, acquaintances, and familiar comforts. Female nurses found themselves subjected to

gender and sometimes racial discrimination. They expressed their experiences, thoughts and

emotions in their writings. They sought support from friends, family, and God. They found
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motivation in an ethical and patriotic sense of duty to their men and country. They found solace in

music and entertainment.

Sources
To answer these questions thoroughly, I perused through almost two dozen journals,

letters, and memoirs written by surgeons and nurses on both sides of the conflict. Another primary

source frequently referred to in this work is the gargantuan tome Medical and Surgical History of

the War of Rebellion. Secondary sources include the definitive Doctors in Blue and Doctors in

Gray by Adams and Cunningham, Civil War Medicine: Challenges and Triumphs by Alfred

Bollet, M.D. and a host of scholarly articles on mental health, emotional history, nursing, and

social issues.

Of the personal writings of the medical personnel, I have endeavored to select a sample

from each side and each job. However, the published writings are not wholly representative of the

surgeons and nurses. There are more published sources written by surgeons than by nurses, and

more written by Union surgeons than Confederate. The sources selected for this work were

chosen based on a few criteria. The source must have been reflective. Several journals, letters, and

memoirs were rejected because their authors merely told a day to day account of the goings-on

and less on their thoughts or reflections on these events. However, that is not to say that they were

completely dismissed, as many of them did have a few pieces of valuable data. The second

criterion was reliability. In my ranking of the sources reliability journals took the top, followed

by letters, then memoirs. Journals were often written as a way of venting, or to keep a record of

what happened or how the author felt. Many of these journals were private and thus not written

for an audience. Letters were always written to someone, and as a result, their authors may have

excluded bits of personal sentiments and feelings. Second, letter collections published just after
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the war often had a more intense focus on the military aspects and less on personal feelings and

events, the latter often being omitted from the final published collection. Memoirs ranked last as

these were often written for a paying audience, though some were merely written for friends and

family. The authors of memoirs counted on their memories, sometimes supplemented by

surviving journals and letters for details. These are biased based on the intended audience and

hindsight. However, several memoirs did have valuable things to say. The final criterion was

whether the source displayed similarities with others. Not all surgeons were affected in the same

way, or at least wrote about being affected the same way. Those sources that did not adequately

epitomize their respective categories were dismissed.

Organization
To begin, a concise examination of Civil War medical history in general will provide

context and a foundation for the argument. This first chapter will illustrate the myths; what they

are, how they were formed, and how they have persisted to today. It will then discuss the state of

the medical systems in place before the war, how unprepared they were, and how they were

forced to adapt to accommodate the scale of the war. Finally, the section will address the nature of

the duties and responsibilities of regimental and hospital surgeons and nurses, in order to provide

further context.

The second chapter will investigate the emotional reactions of the medical personnel to the

nature of their duties. It considers what kinds of experiences they were exposed to and how they

reacted to the death, injury, and illness that surrounded them on a regular basis. The third chapter

will be dedicated to the physical risks of military medical service. Many instances in the primary

sources record surgeons and nurses being killed, becoming injured or ill, dying from illness, being

captured, or coming very close to any one of these and this war-time reality requires detailed
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examination. The fourth chapter will discuss the painful feelings of nostalgia. Nostalgia as

understood during the Civil War era is quite different from our modern understanding and was a

problem felt by all. It was among the most trying psychological pains for the medical staff and

therefore will be addressed in detail. The final section will investigate the multitude of ways

surgeons and nurses managed to stave off depression and stress. It will discuss the roles religion,

patriotism, family, and friends played in motivation as well as the various methods employed to

keep their minds busy.

While the experiences of surgeons and nurses have received some attention, no one has

written any one work that focused primarily on the subject. Experiences of surgeons have been

mentioned in other works, journals have been published, experiences of nurses have received

some attention but no one has compiled all of these into one analytical overview. This paper is the

first to provide a holistic account of the experiences of all types of medical personnel, both

surgeons and nurses.

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Background
I often wondered whether, had I been confronted with the primitive system which Letterman fell heir to at
the beginning of the Civil War, I could have developed as good an organization as he did. I doubt it. There
was not a day during World War II that I did not thank God for Jonathan Letterman.
- Major General Paul Hawley, Chief Surgeon of the European Theater in the Second World War

Before we delve into the experiences of medical personnel, let us first look at the actual

state of medical care during the war. To understand their experiences, we must first understand

the system they worked in, and clear up any misconceptions that may cloud our views. Many

people today consider Civil War medical care to have been of poor quality. This, of course, is

relative. To the vantage point of the present-day medical system, one that had no comprehension

of germ theory and a lack of effective medicines would seem abysmal. To past standards in

medicine, a system that progressed in knowledge and efficiency with every year of the war would

seem impressive. This section will provide a comprehensive, yet brief analysis of the quality of

the care, as well as an overview of the responsibilities of the medical personnel, in order to give

sufficient context for the analysis that follows. The quality of the medical care was far better than

that of the previous American wars. While it was far below the standards of medical care in the

later wars, the medical system of the war did provide a solid basis for improvement. In fact, even

today the American military medical department is using the same system developed during the

Civil War, just much more improved upon.

To fully investigate the quality of the medical care during the war, we will first discuss the

many myths that have surrounded the subject. Then we will look at the story of medical care from

before to immediately after the war, observing the changes in knowledge and practice. Third, we

will closely scrutinize the quality of the care provided; from the surgeries, to the medicines

distributed, to the logistical systems. Finally, we will discuss the responsibilities of the surgeons

and nurses both on campaign and in general hospitals.

 W i l b u r n | 14

The history of Civil War medical care can be studied from two perspectives: a presentist

and a historicist perspective. The first is the most common approach used. A presentist approach

anachronistically applies modern medical understanding to the study of Civil War medicine. This

approach juxtaposes our advanced modern quality of care against the seemingly primitive care of

the nineteenth century. The historicist perspective examines Civil War medical care in its proper

context in history. Rather than comparing it to modern medicine, or applying modern standards,

the historicist point of view sees the Civil War as a transitional period in medical care. While this

perspective recognizes the progressing quality of care, it also does not disregard the failings of the

medical care. It is the historicist approach we must learn to use in studying Civil War medicine.

Myths and Misconceptions

The subject of Civil War medicine has become clouded by circulating myths and

misconceptions. Today, the subject is associated with suffering and butchery. We could attribute

such sentiments to hindsight, but these myths originated, in fact, during the war itself. What are

these myths and how were they born? Most importantly, why have they survived to this day

despite years of scholarship fighting them?

The two, most often repeated myths are those concerning amputation and anesthesia.

Amputations were the most common surgery during the Civil War. The purpose of the surgery

was to remove any limb or body part that had become injured beyond reasonable treatment so as

to prevent the spread of infection. Many believe that amputation was one of the only treatments

surgeons knew, and blame surgeons for using it too liberally. Images of piles of amputated limbs

outside of field hospitals fill soldiers diaries and letters and newspaper articles blaming surgeons

for their butchery. During his first day in camp while trying to find and visit his wounded brother,

Walt Whitman witnessed, a heap of amputated feet, legs, arms, hands, etc. a full load for one
 W i l b u r n | 15

horse cart.14 Confederate Senator of Kentucky, William E. Simm said medical officers had slain

more of our troops than all of Lincolns minions.15 On the contrary, however, amputations were

necessary. If a doctor took the chances of letting the wounded limb heal, he risked the life of the

patient should it not heal. If the doctor amputated the limb, he drastically increased the chances of

survival, but at the cost of the limb. Dr. J. J. Chisolm of the Confederate Medical Corps wrote

experience teaches us that although the wound appears trifling today, in attempting to save it [the

limb] we will sacrifice a life a few days hence. 16 The Medical Director of the Army of the

Potomac, Maj. Dr. Jonathan Letterman wrote in his memoirs, I had more ample opportunities

than anyone else to form a correct opinion of surgeries of that battle [Antietam]; and if any fault

could be found, it was that conservative surgery was practiced too much, and the knife not used

enough.17 That is not to say that amputations were never done unnecessarily. Surgeon John Perry

almost lost a leg unnecessarily after he suffered a riding accident in which his horse kicked him

and broke his leg. He received medical furlough and rode to Alexandria, Virginia in a railroad car

full of corn. Dust and dirt had accumulated on the limb giving it a black color. When he arrived at

the hospital, the doctor wanted to amputate Perrys leg, though Perry argued it was simply dirt not

gangrene. The doctor would not listen and ordered the leg removed. The night before the

operation, Perry bribed a nurse to smuggle him to a different hospital, where he got a cast and was

on his way.18

14
Walt Whitman. Walt Whitmans Civil War. Ed. Water Lowenfels. (New York: De Capo Press, 1960). 29.
15
H. S. Commager, Blue and Gray. Volume 2. (Indianapolis, IN: Bobbs-Merrill, 1950). 129-134. As quoted in Alfred
Bollet. Civil War Medicine: Challenges and Triumphs. (Tucson, AZ: Galen Press.) 436.
16
J. J. Chisolm, A Manual of Military Surgery for Use of the Surgeons in the Confederate Army. (1861. repr. Seattle:
Morningside Press, 1992), 370.
17
Jonathan Letterman, Medical Recollections of the Army of the Potomac. (1866. repr. Bedford, MA: Applewood
Books, 2008). 49.
18
John Gardner Perry. Letters from a Surgeon of the Civil War. Ed. Martha Perry. (Boston: Little, Brown, & Co.,
1906). 47-53.
 W i l b u r n | 16

The Union Army recorded nearly 30,000 amputations and, though the records do not

survive, a similar number is probable for the Confederate Army. However, there were

undoubtedly more as many were simply not recorded and this number does not include secondary

amputations and amputations after discharge.19 The table below shows the fatality rate of various

treatments employed by Union surgeons. The vast majority of wounds treated conservatively,

which is without excision or amputation, were minor, grazing gunshot wounds. Excision was the

process of removing only a portion of a limb or bone. Due to rather unsatisfactory results, this

method was not widely employed, and as we can see it also had a higher fatality rate than

amputation. Amputation was usually reserved for severe gunshot wounds and was mostly

successful.

Table 1: Treatment Comparison of 60,266 Cases of Shot Wounds20

Treatment Cases Fatality Rate Upper Extremity Fatalities Lower Extremity Fatalities
Conservative 26,467 17.9% 9.9% 26.2%
Excision 4,656 27.5% 23.8% 44.7%
Amputation 29,143 25.8% 12.6% 40.2%

The second myth that surrounds Civil War era surgery concerns the use of anesthesia.

Many historians, both those writing for a popular audience and academic scholars, have claimed

that soldiers were operated on while fully conscious, given whiskey and a bullet to bite to endure

the pain of having a limb sawed through. This myth most likely originated from soldiers whose

letters described surgeons operating on writhing, moaning men held down by assistants. What

these soldiers did not realize was that anesthesia was administered in small doses, just enough to

make a man insensible to pain, but not enough to knock him out. 21 Since these men were still

19
Bollet. Civil War Medicine. 144.
20
Ibid. 144.
21
Ibid. 2. This small dose was done for two reasons: to conserve the supplies of anesthesia, and avoid administering
too much and thus killing the patient.
 W i l b u r n | 17

semi-conscious and high on chloroform they would squirm, requiring assistants to hold them

down, and make inarticulate moaning noises, which could have been interpreted as moans of

agony.

Of the misconceptions, this next one is probably farthest from the truth. Many of the

general public believe that anesthesia was not used during surgeries. Anesthesia, successfully

demonstrated in Massachusetts General Hospital in 1846, was not widely adopted until just before

the Civil War. Union surgeons used anesthesia for any operation that would induce major pain.

Union records show that some 80,000 operations were performed with anesthesia while only 254

were not; a rate of 99.7%.22 This figure is probably slightly lower for the Confederacy due to a

shortage of anesthesia, thanks to the Union blockades.23 The anesthetics commonly used during

the war were chloroform and ether. Chloroform was used almost always in field hospitals while

ether was reserved for general hospitals. The reason being ether was flammable and it was not

prudent to use it in poorly ventilated canvas tents illuminated by candles. Deaths by overdose of

anesthesia were surprisingly low, considering the men administering them were often assistants or

handy soldiers. The liquid anesthesia was soaked into a towel or napkin. The napkin was put

inside a copper cone, which was then placed over the nose and mouth of the patient. This low

death rate may be attributed to operations being performed in the open, small doses, youth of the

patients, and brief period of use.24

Table 2: Fatalities in 8,900 Operations Employing Anesthesia25

Anesthetic Agent Cases Deaths Fatality Rate
Chloroform 6,784 37 0.5%
Ether 1,305 4 0.3%

22
J.K. Barnes. Medical and Surgical History of the War of the Rebellion. (Washington, D.C.: Government Printing
Office, 18701888): Surgical Section. Vol. 3. 887.
23
Bollet. Civil War Medicine. 78.
24
Ibid. 81.
25
Barnes. Medical and Surgical History. Surgical Section, vol. 3. 889.
 W i l b u r n | 18

Mix 811 5 0.6%

The final major myth that has endured to modern times concerns the surgeons themselves.

It is this myth that this study seeks to dispel. Surgeons are oft-remembered not for their bravery,

their sense of duty, or their service for saving the lives of the men, but as callous butchers,

indifferent to their patients, hostile and condescending to their female nurses, and sadistic in their

quest for experience. During the war surgeons were reviled and after the war, forgotten. An

editorial in the Cincinnati Lancet and Observer, chastising the population for forgetting the

surgeons, read, Our readers will not fail to have noticed that everybody connected to the army

has been thanked, excepting the surgeons The newspapers have been filled with the eulogies of

everyone except the Surgeons. The rule has been to censure them, to abuse and slander them.26

Where did surgeons gain this bad reputation? The myths about

medical care during the war certainly contributed. Surgeons were

viewed as ignorant fools who only knew how to amputate. The

nickname of sawbones was applied to surgeons for their propensity

for this surgery. Surgeons were considered sadistic and indifferent

since they, according to the people, did not use anesthesia (which they

obviously did). Many soldiers would fake illness or practice self-

mutilation in order to obtain medical furloughs. Surgeons were

Figure 1: "Saw Bones." This
cartoon is an example of
therefore forced to decide who was really sick and who was faking. contemporary feelings towards
surgeons. The caption beneath
Sometimes they made mistakes and were resented for not giving out reads: "Ho! Ho! old saw bones,
here you come, / Yes, when
the rebels whack us, / You are
medical furloughs. Soldiers thwarted in their claims about illness or always ready with your traps, /
To mangle, saw, and hack us."

26
Cincinnati Lancet and Observer. September 1863. As quoted by Bollet, Civil War Medicine. 436.
27
Bollet. Civil War Medicine. 437.
 W i l b u r n | 19

injury would slander the surgeons.

Many nurses diaries describe surgeons as callous and occasionally drunk. While

drunkenness was a common problem in the Army of the Potomac, contemporary analyses have

noted that drunkenness equally as common among physicians as among other officers.27 Nurses

and surgeons approached their tasks differently. It was the surgeons mission to save as many

lives as he could. The nurses, on the other hand, worked ceaselessly to provide comfort and

maternal care to their patients. As such there were differences between the two. Many female

nurses could not quite understand the system of triage. Triage is a treatment system in which

those who are most seriously injured but still have a chance to live are treated with the highest

priority. Those who have life-threatening injuries and are expected to die are made as comfortable

as possible and left to die. Many nurses scorned surgeons in their personal writings for ignoring

the dying men. Unlike nurses, surgeons cannot afford to become attached to any one patient, or

treat all of their patients with the attention and individuality that the nurses did. They were forced

to detach themselves from their patients in order to save as many as possible without getting too

hung up on one. This detachment, as observed by the female nurses, contributed to the myth of

the callous surgeon.

Were surgeons callous? Most certainly, many of them were, but not because they were

cruel, heartless individuals with no sense of empathy or emotion. They became callous for their

own survival. Their own mental health required them to detach themselves from their emotions

and personal feelings while conducting their surgeries. However, that is not to say these men did

not care for their patients or empathize with their sufferings. Lizabeth Roamer and Leslie

Lebowitz wrote trying to quell overwhelming emotions and maintain safety in a world perceived
 W i l b u r n | 20

as dangerous may evoke an external presentation of callousness, but, underneath this exterior, a

cauldron of intense, unmodulated, overwhelming feelings resides.28 For the surgeons,

callousness was a defense mechanism. They appeared to the nurses and patients to be emotionally

detached and uncaring. While they were probably emotionally detached, all but a few were

caring. The callousness could also be interpreted as the male surgeons merely fulfilling their

gender roles. Jane Robinett wrote, men were expected to be models of self-discipline, emotional

and intellectual discretion, characterized by the suppression of any display of emotion and a

determination not to give way to womanish wailings. Nervous collapse among males was

believed to be the result of a failure of the will.29

Female nurses also believed themselves more capable than the surgeons because they

were volunteers, not serving for pay or adhering to military duties. They served because they

genuinely cared for the patients. This rivalry served only to fuel the negative reputation surgeons

developed early in the war.

Newspaper articles abound decried the surgeons and the negative quotes remained in

memory. However, several instances of praise can be found in the sources of the time, though

they are often forgotten. Clara Barton praised the doctors. Louisa May Alcott commented on their

compassion. Fannie Beers complimented them for their self-sacrifice. Walt Whitman claimed

them to be some of the best men and hard workers.30

However, we must not get caught up in unabated praise for the surgeons. There were of

course many corrupt and inept surgeons who most certainly contributed to the bad reputation.

28
Lizabeth Roamer and Leslie Lebowitz. Chapter 29: Understanding Severe Traumatization. Mental Health and
Experts Manual. 8th edition. (Frankfort: Kentucky Department of Public Advocacy, 2005). 179.
http://apps.dpa.ky.gov/library/manuals/MentalHealthManual.pdf
29
Jane Robinett. The Narrative Shape of Traumatic Experiences. Literature and Medicine 26. no. 2. (2007): 304.
30
Ibid. 439.
 W i l b u r n | 21

Contract surgeons in the Union Army during the Peninsula Campaign of 1862 were regarded as

more a hindrance than a help and the term garnered a negative connotation.31 Many wanted to

perform only surgeries and not their assigned tasks. Hannah Ropes, the matron nurse at Union

Hospital in Georgetown, recorded in her journal that a ward physician being in his cups [drunk]

all day! And no attention given to this case.32 And on another occasion she described a head

surgeon as a thieving fiend.33 Politics of the medical departments also influenced the reputation of

surgeons. Historian Jane Schultz misleadingly wrote that most surgeons were more concerned

with rank and chain of command than about treating the patients. 34 There were surgeons who

were only interested in their own advancement, but the majority was concerned with performing

their jobs, that is, treating the wounded and sick.

Other surgeons were found guilty of conduct unbecoming, patient neglect, and

incompetence. Others were disgustingly disrespectful. Dr. George Potts, a surgeon in a black

regiment, mutilated and defaced (literally de-faced) the body of Pvt. Benjamin Anderson. He and

his assistant performed their own unlicensed post-mortem examination, cutting arteries, removing

organs, and removing and mutilating the head and replacing it with a bottle.35 Unfortunately, he

was returned to duty.36 In the famed 54th Massachusetts Regiment, Pvt. James Riley was accused

of bestiality with a mare. His court-martial, however, found him not guilty based on lack of

sufficient evidence. Surgeon Charles Briggs was not convinced and took it upon himself to punish

the soldier. He had Riley brought into his tent, bound, gagged, and stripped. He then proceeded to

31
Ibid. 30.
32
Hannah Ropes. Civil War Nurse: The Diary and Letters of Hannah Ropes. Ed. John Brumgardt. (Knoxville:
University of Tennessee Press, 1980). 119.
33
Ibid. 72.
34
Jane Schultz. Women at the Front: Hospital Workers in Civil War America. (Chapel Hill: University of North
Carolina Press, 2004). 110.
35
Thomas Lowry, Jack Welsh. Tarnished Scalpels: The Court-Martials of Fifty Union Surgeons. (Mechanicsburg,
PA: Stackpole Books, 2000). 68-69.
36
Ibid. 73.
 W i l b u r n | 22

circumcise the soldier and brand his genitalia with a hot iron. Briggs too, was sadly not court-

martialed.37 As among the troops and the officers, there were the good medical personnel and the

bad. However, it seems the memory of the bad ones have overshadowed the work of the others.

These myths have perpetrated our false memory of Civil War medical care. They have

found their way into history books, historical-fiction novels, movies, and documentaries. Tour

guides at battlefields frequently misrepresent the medical departments. Reenactors often times

unknowingly spread these myths. These myths did not just spring up from nowhere. There is in

fact some truth to them. In the early months of the war, the medical departments were wholly

unprepared.

Medical System Before and Early in the War

The First Battle of Manassas, fought on July 21, 1861, was the first major battle of the

war. Both sides were inexperienced, both armies undisciplined, and both medical departments

unprepared. The Union Surgeon General, Charles Finley, used to the small, frontier army before

the war, waited until there were actual casualties before making preparations. Hired civilian

ambulance drivers fled at the first signs of danger. Consequently, the Union wounded were forced

to walk or crawl thirty miles back to Washington, or die in the fields. In Washington, there were

no real hospitals, only quickly made makeshift hospitals in warehouses, churches, schools,

theaters, and any public building. There was hardly enough room in these so-called hospitals, so

many soldiers were forced to wait outside. The streets of Washington were filled with the stench

of pus and decaying flesh, the moans of the wounded, and the bodies of some men who could not

wait for treatment any longer and simply died. Newspapers reported neglect, purposeful cruelty,

37
Ibid. 78-79.
 W i l b u r n | 23

and savage conditions. Unfortunately, the images presented in the reports remained in memory

despite improvements.38

The first year of the Civil War was a medical disaster,39 said Bollet. He could not have

said it better. The medical departments of the belligerents were understaffed, underfunded, and

inexperienced. Before the war, there were 113 surgeons in the U.S. Army. Twenty-four joined the

Confederacy and three were discharged for disloyalty. The newly-formed Sanitary Commission, a

civilian relief organization, evaluated the pre-war surgeons to be incapacitated for all duty, and

one half were unfitted for service in the field.40 The surgeons had been alone on the frontier,

disconnected from recent medical scholarship, without access to books, and hardly any

opportunities to practice. Several regimental surgeons of the early years were also suffered ill-

repute. They were often appointed through personal connections and friendships rather than in

recognition of their competence. Though poorly educated and inexperienced surgeons could be to

blame for the failures, the biggest fault lay on the Union Surgeon Generals Office.

The medical disaster of the war was in no small part due to the incompetence of the Union

Surgeons General. The first surgeon general at the start of the war was Thomas Lawson. Despite

being eighty years old and a veteran of the War of 1812 and the Mexican War, Lawson did not

know how to manage the department. Since the majority of his service was in peacetime, he was

more concerned with saving money than with saving lives. He considered the purchase of medical

books to be unnecessary expenditure. He died May 15th, 1861. Clement Alexander Finley

replaced him. Finley shared Lawsons miserly opinions and also did not procure medical

equipment or books. The Union Army had more than doubled in size in the first year, and would
38
Ibid. 2-3.
39
Ibid. 7.
40
C.J. Still. History of the United States Sanitary Commission: Being a General Report of Its Work during the War
of the Rebellion. (New York: Hurd and Houghton, 1868). 28.
 W i l b u r n | 24

continue to grow exponentially over the course of the war. The Medical, Commissary, and

Quartermaster Departments were not used to administering to so large a force. Secretary of War

Edwin Stanton replaced Finley with William Hammond in April 1862. Hammond broke the mold

and implemented a number of reforms and cleaned out corruption. One of his best moves, though,

was appointing Jonathan Letterman as Medical Director of the Army of the Potomac.

Medical Reforms
The quality of military medical care is dependent upon two

factors: the extant of medical knowledge and technology available,

and the ability to put that knowledge and technology into practice

efficiently. Dr. Jonathan Letterman, one of the heroes of Civil War

medical care, successfully reorganized the entire medical system in

the Union Army of the Potomac and inspired further changes in the

entire Medical Department. His reforms were so revolutionary, so Figure 2: "Jonathon Letterman,
M.D." Maj. Dr. Jonathon
Letterman, Medical Director of
effective that they still serve as the basic foundation for todays the Army of the Potomac, was
responsible for a number of
Medical Department and Emergency Medical Services and they groundbreaking reforms to the
medical department. He is known
as the "Father of military and
earned him the title of Father of Modern Military and Emergency emergency medicine."

Medicine.

Dr. Jonathan Letterman was appointed as the medical director of the Army of the Potomac

in July of 1862, only a few months before the Battle of Antietam. Letterman wasted no time in

getting to work reorganizing the department. One of his first orders of business was improving the

general health in camp. In his view, The leading idea [of the Medical Department], which should

be constantly kept in view, is to strengthen the hands of the Commanding General by keeping his
 W i l b u r n | 25

army in most vigorous health.41 Since disease kills more soldiers than bullets, it was the primary

concern of the Medical Department not only to treat the wounded, though that is important, but

also to prevent illness. His reforms involved the improvement of the diet, the reorganization of

camps, such as placement of latrines and food waste. 42 His most famous reform was the

implementation of an ambulance and field hospital system to facilitate the speedy evacuation of

the wounded.

While it was days before the wounded were

picked up, or crawled off the battlefield at Manassas,

after the Battle of Antietam, September 17th, 1862, all

the wounded were off the field within twenty-four

hours. Likewise at Gettysburg, the day after the battle,

not a single wounded man was left on the field.

Figure 3. "Ambulance Drill." Here members of a
Zouave unit practice loading wounded into an
ambulance. An organized ambulance corps was one of Letterman transferred the oversight of the Ambulance
Letterman's reforms.
Corps from the Quartermaster Department to the Medical Department. The order gave the

Ambulance Corps its own officers, animals, and wagons and stipulated that the ambulances be

used for evacuation of wounded and nothing else. He placed qualified medical personnel in

command of the Corps and had the drivers regularly trained and drilled to increase efficiency on

the field. Before the reform, a wounded mans comrades would take him to the rear, meaning that

for every wounded man, two more left the firing line. 43 A similar system was adopted in the

Confederate armies under the leadership of Dr. Hunter Holmes McGuire. 44 The American

41
Letterman, Medical Recollections. 100.
42
Ibid. 25-48.
43
Bollet, Civil War Medicine. 105.
44
Ibid. 106.
 W i l b u r n | 26

ambulance system later became be the sought-after standard in the Franco-Prussian War.45 The

field hospitals organized by Letterman, evolved into the M.A.S.H. which was used to great

success in the jungles of Korea and Vietnam.

The field hospital system was another ingenious

brainchild of Letterman. Each regiment (for the

structure of the army see Appendix B) had its own

hospital in camp before the reform and communication

between field hospitals and general hospitals was poor.

Regimental field hospitals were replaced by larger, Figure 5. "Field Hospital Scene." This field hospital
at Savage Station, VA shows the horrid condtions
before Letterman's reforms. The men lie in the
improved division field hospitals. These were staffed open and a surgeon examines his patient in the
foreground.
by a surgeon-in-chief, three surgeons, nine assistant surgeons, a steward in charge of food and

supplies, and numerous conscripted enlisted soldiers to help as nurses. Field hospitals, though,

were not perfect and were plagued with problems of their own. Inadequate lighting, scarcity of

supplies, and water often times forced surgeons to stop

their work.46 Acting Assistant Surgeon J. Franklin Dyer

wrote, I performed amputations on the ground by light

of a single candle stuck in a bayonet, but had not

Figure 4. "Hammond Hospital. This is a model of efficient time to perform all that was necessary.47 Field
Hammond General Hospital which was at Point
Lookout, MD. It sat adjacent to an infamous
prison camp. hospitals only served as temporary treatment stations.

45
Ibid. 98-99.
46
Ibid. 107
47
J. Franklin Dyer. The Journal of a Civil War Surgeon. Ed. Michael B. Chesson. Lincoln: University of Nebraska
Press, 2003. 28.
 W i l b u r n | 27

Cases requiring serious treatment or recovery time were sent over hospital trains or boats to

general hospitals.

General hospitals served as the backbone of the medical departments of both sides. Before

the war started there were very few hospitals, by the wars end, America had some of the worlds

leading hospitals. In the beginning years, buildings were requisitioned as hospitals. Schools,

hotels, churches, theaters, even the U.S. Capitol Building served as hospitals for the wounded. As

the wounded grew in number and demands for better care grew insistent, buildings were

constructed to better serve their needs. The most common layout of general hospitals was the

pavilion-style. A hub in the center and wards extending outwards like spokes. These kinds of

hospitals could house up to 3,500 wounded and sick men. In the Union alone there were 431

general hospitals, with a maximum of 204 operating at any one time. Over 100,000 beds were

available to wounded and sick men of the north.48 Confederate Surgeon General Samuel Preston

Moore adopted a similar system of general hospitals, also mimicking the construction of their

northern counterparts. Around Richmond were six general hospitals holding 20,000 beds.49 More

than a million soldiers received care in Federal hospitals during the war. Of those men fewer than

10% died in the hospitals. Confederates had a similar number of men and similar mortality rates.

These general hospitals serve as one of the great medical achievements of the war.

Quality of Care: Surgeries and Disease Treatment

The quality of care during the Civil War depended on a number of factors: the disease or

injury being treated, the supplies and equipment used to treat them, and the successful distribution

of those supplies, the efficiency of treatment, and the competence of the physician. For the

average soldier, though, the procedure of care was relatively uniform. For the purposes of

48
Bollet. Civil War Medicine. 219.
49
Ibid. 224.
 W i l b u r n | 28

demonstrating the procedures of the medical system, we will follow the treatment of an imagined

wounded soldier and a sick soldier.

For the soldier on the battlefield, his greatest enemy was not the artillery shells that burst

overhead, the massive balls of canister fire, nor the bayonet of his enemy, but the ball. In

particular, the Mini ball. The Mini ball accounted for

50
75% of all battle wounds. Invented by Frenchman

Claude-Etienne Mini, it was a conical lead bullet over half

an inch in diameter (.58 to be exact) with a hollow base. As

it was fired from the rifle, the gases filled the hollow and Figure 6: "Grapeshot Wound." This is the kind
of damage grapeshot and Mine balls could do
expanded the lead skirt that gripped the rifle grooves to a body. The only treatment was
amputation.

inducing a spin on the ball. They travelled at a low velocity and at relatively low temperatures,

thus any bacteria on the bullet was not sanitized in flight. When the slow-moving, lead round

collided with flesh, it flattened on impact, much like modern hollow-point bullets. These now

deformed bullets destroyed tissue, shattered bone, and pulverized organs, and often caused

compound fractures.51 Let us assume that the regimental assistant surgeon accompanied his unit

into battle. After a soldier gets hit in the forearm and goes down, he will be taken to the rear and

examined by the regimental assistant surgeon. The assistant surgeon will apply the first dressings

and stretcher bearers will place him on an ambulance to be taken to the division field hospital. To

help with the pain along the ride, the surgeon will give the soldier an opium pill and maybe some

whiskey. The soldier will be deposited there and wait. Treatment priority was assessed according

50
Ibid. 84.
51
Compound fractures were a new wound to the battlefields of gunpowder. Muscle-powered weapons of the ancient
and medieval era, i.e. swords, axes, and clubs did not have enough power to break bone in multiple places and push
through the surface of the skin. Compound fractures were relatively rare in this period. Hippocrates often deemed
compound fractures as fatal and recommended amputation. Today, only a prolonged use of antibiotics and
reconstructive surgery can prevent a need for amputation. Ibid. 146.
 W i l b u r n | 29

to the severity of the wound (another of Lettermans changes). The patient, after being called, will

be placed on the operating table (or appropriated front door more likely) and the surgeon-in-

chief and two others would deliberate on the best method of treatment.52 In this case, it will be

amputation.

There are two methods available, round or stump amputation, and flap amputation. Stump

amputation involves cutting circularly around the limb and leaving an open stump that would heal

gradually. It was quicker and less prone to infection. The flap method, on the other hand, required

the incisions made at two angles, peeling back the flaps of skin, cutting the limb off, and then

folding the flaps over the stump. This healed more quickly, but complications like a poorly tied

ligature, stitches coming undone, or infection could arise. It also took much longer. The surgeon

in this case will decide to use the quicker, more common stump method. (For statistics on wounds

and amputations see Appendices D and E).

The assistant surgeon or conscripted help will administer the chloroform, only enough to

make the patient insensible to pain. The assistant surgeon will help hold the patient to the table.

The surgeon will apply a screw tourniquet and make an

incision, in this soldiers case above the elbow. He will cut

with a knife through the layers of skin, tissue, and muscle.

He will peel back the tissue on both sides and expose the

bone. Taking up the bonesaw, he will saw through the

Figure 7: "Ivory Handled Surgical Amputation bone in less than a minute. He will pull the flesh back over
Kit." This kit contains various knives, a screw
tourniquet, a bonesaw, a trepanner, and other
tools all necessary for a surgeon's work.
the bone. Using a curved hook, he will snag the major

52
Ibid. 162.
 W i l b u r n | 30

arteries and veins and tie them off with ligatures. He will bandage up the wound and send the

soldier back out to recover.

Since recovery for the stump method takes time, the patient will be placed on an

ambulance and taken to the nearest hospital train or ship. This will then take him to a general

hospital, where he will wait until either his wound heals, or he dies from an infection. Supposing

that the wound becomes infected, he will have to undergo a secondary amputation.53

Now let us imagine that our poor soldier has gotten hospital gangrene. While the surgeons

of the war did not fully understand germ theory, they did have an understanding of some of its

components. First, they knew to associate dirty conditions with illness and well-ventilated areas

with good health. Second, they had antiseptics; they just did not know how or why they worked.

Bromine, carbolic acid, and tincture of iodine, as well as alcohol, were used occasionally to keep

wounds from festering. However, these were not commonly used, and most likely for our poor

soldier, he caught gangrene and died a little while later.54

Suppose our soldier survived the fight and went back to camp. There he fell ill, perhaps it

was some sort of gastrointestinal disease. He would wake up in the morning feeling very ill and

would report to the surgeon at sick call. The assistant surgeon would inspect the man to make sure

he was actually sick. The Civil War surgeon had an arsenal of various drugs. However, most were

useless at best, some were harmful. To help relieve the pain, the surgeon would prescribe either

the blue pill which was mercury, or an opiate, either opium dough in a pill, or morphine. In

cases of chronic diarrhea, he might prescribe turpentine administered orally. Hopefully, our

soldiers health would improve before the drugs got him. If our soldier, though, was a victim of

53
Secondary amputation refers to any amputation done after 48 hours of receiving the wound. These often had a
much higher mortality rate of about 34.8%. Ibid. 149-153.
54
Ibid. 204.
 W i l b u r n | 31

malaria, then he had the benefit of being prescribed quinine, the powdered bark of the cinchona

tree. This drug was one of the few effective medications during the war in preventing and treating

malaria and fevers. (For statistics on disease see Appendix F).

Civil War surgeries were quite sophisticated and precise procedures for their time. An

amputation could be done in less than fifteen minutes. However, the effective medications of that

era were severely lacking. Quinine was one of the only effective drugs available. Also, thankfully,

by this time the procedures of bloodletting and cupping had been proven to be harmful or

ineffective and were rarely used, though some older physicians continued to practice them. The

Civil War was fought, as H. H. Cunningham put it in Doctors in Grey, at the very end of the

medical Middle Ages.55 The medical knowledge may have been primitive to todays standards,

but the men and women who practiced, more often than not, did the best with what they had

available. The loss of many lives can be attributed to the lack of effective medications and

understanding, but the salvation of many others is a result of the tireless efforts of the surgeons

and nurses of the war.

The Responsibilities of Surgeons

There were, during the war, many types of medical physicians (see Appendix B), but the

most numerous were the surgeons and assistant surgeons. The Union Army, out of a total of

12,000 physicians, 2,109 surgeons and 3,882 assistant surgeons were commissioned for the Union

Army, or 49.9 percent of the medical corps. The vast majority of these surgeons served in

volunteer state regiments. 5,532 civilian contractors, or acting assistant surgeons, were hired for

55
Cunningham. Doctors in Grey. 16.
 W i l b u r n | 32

the Union Army. Confederates, on the other hand employed 3,236 physicians, of which 1,242

were surgeons and 1,994 were assistant surgeons.56

The regimental surgeon had quite a job to do, more demanding, some might argue, than

that of other military officers of the same rank. As Adams says in Doctors in Blue, In the field,

the lives of regimental medical officers usually alternated between short frantic periods of

overwork and slack periods when their duties occupied them less than an hour a day. 57 The

surgeons first and foremost job was the prevention of disease. This was done mostly through

maintaining hygiene in camp and enforcing a balanced diet when possible. His next most

important task was, of course, treating the wounded and the ill. In the morning the surgeon would

hold sick call. Men from all over the regiment would come to present their maladies. The assistant

surgeons would examine the men, while the surgeon tended to the bedridden and sick. The

assistant surgeon had the power to put sick men in regimental hospital, excuse them from duty, or

prescribe them light duty. Theoretically, everyone, including the

officers and the colonel himself were subject to the surgeons

command. Those who were not sick were discharged and sent

back to the battle line. Surgeons, however, did not have the power

to send men to general hospitals, or dismiss them from service.

The men who were diagnosed as sick would line up to receive Figure 8. "Regulation Hospital
Knapsack." Assistant surgeons
usually carried this into battle to
their daily dose of medication. It was among the responsibilities provide immediate care for the
wounded.
of the surgeon to collect data on the climatic influences on

disease. This method, however, produced little, if any, new learning.

56
Ibid. 27-28.
57
Adams, Doctors in Blue. 65.
 W i l b u r n | 33

When battles started the surgeon would pick a structure or safe location to be the site of a

field hospital. The regimental hospital detail, ten men and the band (twenty-five total), would be

divided, some to the front as stretcher bearers, others to hospital as nurses. Hospital stewards took

out the medications, medical chests, and surgical supplies. The cooks put water on to boil, made

tea or coffee, and soaked bandages and sponges. The assistant surgeon, along with an orderly

carrying a medical knapsack, would join the regiment in battle. Assistant surgeons, their orderly,

and maybe a hospital steward provided the first level of first aid, such as bandaging and

administering alcohol and opium. 58 In addition to these duties, an assistant surgeon might be

required to go out on picket duty with a company in the regiment.

The hospital steward was the only man permanently assigned to assist the regimental

surgeon. He was required to know practical pharmacy, basic bandaging and wound dressing, teeth

extraction, application of leeches, and even cooking. This position was most often filled by

medical students and druggists.59

The Responsibilities of Nurses

The image of the Civil War nurse is associated with nurturing, maternal women, who

provides sweet loving care to wounded men in field and general hospitals. Unfortunately, this is

another misconception, primarily because 80% of nurses were men.

After the divisional hospitals were set up, the surgeons conscripted the help of the

musicians. Musicians, however, were not nurses. Many musicians performed dreadfully at their

ex-officio nursing duties. Scrubbing blood-soaked floors, dragging wounded men under fire,

feeding invalids were not on the top of their lists, and consequently they performed without zeal.

58
Adams. Doctors in Blue. 65-66.
59
Ibid. 67.
 W i l b u r n | 34

Some conscripted soldier-nurses were not much better. Cowardice and desertion was a problem,

along with occasional drunkenness. Some, though, did stick to their posts. Women nurses did not

generally work in the field. A few nurses especially noted for their field service include Clara

Barton, Mother Bickerdyke, and Cornelia Hancock.60

For the purposes of this section, however, we will discuss the responsibilities of female

nurses in the general hospitals, north and south. Before the war, nursing in hospitals was nearly

nonexistent. The sick were nursed at home by family. Those without a home went to institutions

(hospitals) where the only nurses were prisoners from another ward of the institution. During

the Crimean War, Florence Nightingale pioneered the creation of a military nursing service, and

illustrated a need for competent nurses, inspiring a new wave of nursing in the United States.

Female nurses often volunteered themselves independently, through Army conscription, or

through civilian relief groups like the U.S. Sanitary Commission, Christian Commission, and the

Catholic Church. Nurses wore multiple hats in the hospital wards. Their prescribed tasks included

changing the bed pans, changing the sheets, changing the mens clothes, changing the mens

dressings, feeding the men, running the special diet

kitchens, and assisting the head surgeon of the ward. They

also had a number of assumed tasks. They talked to the

men, they listened to last words and deathbed confessions,

they wrote letters to loved ones, read letters from loved Figure 9: "Annie Bell." Union nurse Annie Bell
administers medicine to wounded soldiers in
Tennessee after the Battle of Nashville.
ones, read books, provided music and entertainment,

prayed with the men, taught them how to walk on crutches, and assisted visiting families. As

Drew Gilpin Faust wrote in This Republic of Suffering: Death and the American Civil War,

60
Ibid. 69-70.
 W i l b u r n | 35

nineteenth century Americans viewed death as a ritual, in which family played the vital role of

witnessing the dying persons spiritual conditions and the all-important last words. Many dying

soldiers, however, found themselves far removed from family. Nurses frequently played this role,

standing in for kin, and recording last words for family.61

The medical care that was provided to the wounded of the war had its qualities and faults.

The system, though it started out poorly, became organized, efficient, systematic, ruthlessly

recorded, and the new world standard for delivering medical care. The procedures were

sophisticated, based off new knowledge from Renaissance anatomy and military medicine. The

surgeons and nurses were well qualified (well, most of them), compassionate, and truly dedicated

to their work. The understandings, though, of germ theory were lacking and the effective

medications available were few. H. H. Cunningham was right in saying the Civil War took place

at the very end of the medical Middle Ages.62 Civil War medical care was on the threshold

between primitive knowledge of illnesses of the old days, and the advancing systems, procedures,

and technology of the new modern age. It was in this period of medical knowledge and

understanding the surgeons and nurses were forced to work in. They managed with what they had.

61
Drew Gilpin Faust. This Republic of Suffering: Death and the American Civil War. (New York: Knopf Publishing
Inc., 2008). 11-12.
62
Cunningham. Doctors in Grey. 16.
 W i l b u r n | 36

Reactions to Service
We have shared the incommunicable experience of war; we have felt, we still feel, the passion of life to its
top. Oliver Wendell Holmes Jr.63

The physical pain is not the greatest pain suffered. William Child, Union Surgeon.64

Imagine, if you will, a Civil War battlefield. You see thousands of men maneuvering,

advancing, retreating, standing their ground, firing volleys. Shells fly over your head, exploding

in the ranks of men, creating gaps in the lines, leaving dead, mangled bodies in their wake. You

hear the whizz of bullets as they zip past your ears. Your ears ring with the shouts of officers

commanding their men, the screams and groans of the wounded. Your sight is becoming obscured

by growing clouds of smoke. The acrid sulphuric smell of gunpowder fills your nostrils.

Now imagine yourself during the days after of the battle. You walk the field of the recent

conflict, memories of dying and mutilated men fresh in your mind. You see before you hundreds,

if not thousands, of dead bodies, black and blue, bloating and oozing fluids, swarming with flies

and maggots. In camp you see the hundreds of wounded men, their gangrenous wounds festering.

Instead of the stench of gunpowder, you smell the horrid, ever-present stench of decaying and

rotting flesh. Around the division hospital, you see wounded men covering every square inch of

open ground nearby. Piles of recently amputated limbs rise to greet you. Everywhere you look,

you see suffering.

This is difficult to imagine for those of us who have enjoyed the privilege of a peaceful

life. For a surgeon of the Civil War, these scenes could be quite common. These images would be

not imagined, but a stark reality forever imprinted in their memories. For nurses, these scenes

were slightly different. Instead, they witnessed the seemingly endless supply of wounded,
63
Oliver Wendell Holmes Jr. The Soldiers Faith (Speech, Harvard University, May 30 th, 1895), University of
Virginia. http://people.virginia.edu/~mmd5f/holmesfa.htm
64
William Child. Letters from a Civil War Surgeon. Ed. Merrill Sawyer et al. (Solon, ME: Polar Bear & Co., 1995).
34.
 W i l b u r n | 37

mangled bodies imported to their hospital wards. Surgeons and nurses experienced the Civil War

in a much different way than soldiers and officers. Campaigning assistant surgeons shared, to

some degree, the battlefield experiences of the soldiers, although they did not engage in attacking

the enemy. Regimental and brigade surgeons often operated under a hail of shells. Surgeons and

nurses found themselves completely surrounded by the wounded and sick. One could say that

surgeons and nurses witnessed more suffering than soldiers. The physicians of the war witnessed

suffering through a completely different lens and consequently experienced suffering themselves.

It seems impossible that one could live through such scenes described above multiple times and

not have experienced any mental or emotional trauma or hardship.

What we call Post-Traumatic Stress Disorder (PTSD) was wholly unknown during the

American Civil War. Surely the symptoms were present in many soldiers, and we may safely

speculate in surgeons and nurses as well. However, nobody knew to make the connection between

these symptoms and a mental health condition. After the war, soldiers who showed evidence of

mental strain were said to have irritable or trotting heart. 65 PTSD was not studied as a

medical condition until the First World War. It was believed that the prevalence of artillery on

Great War battlefields, which executed shell bombardments on an unprecedented scale, created a

nervous reaction called shell shock. Doctors at the time believed the Great War was the first

war in which functional nervous diseases have constituted a medico-military problem.66 They

believed that the concussive force of detonating shells damaged the central nervous system,

resulting in neurosis. Recommended treatment consisted of hypnosis, exercise, and bedside

65
Dean. Shook Over Hell. 130.
66
Thomas Salmon, M.D. The Care and Treatment of Mental Disease and War Neurosis (Shell Shock) in the British
Army. (New York City: War Work Committee, 1917). 27.
 W i l b u r n | 38

occupations like basket weaving. 67 It is highly likely that surgeons in the Civil War noticed

symptoms in their soldiers, as there is a section in the Medical and Surgical History of the War of

the Rebellion that addresses mental diseases. It is also very likely that the surgeons and their

nurses experienced it to some degree in their war experiences. However, it was never understood

to be anything significant and as such was not treated with much scrutiny. It is difficult to

ascertain the prominence of PTSD in medical personnel as the post-war records were unavailable

and the personal writings do not provide enough data to make an accurate diagnosis.

Nonetheless, this section will analyze the ways in which surgeons and nurses mentally and

emotionally reacted to their duties, the things they witnessed, and the general difficulties of their

jobs. We will examine how surgeons and nurses felt at the beginning of their service, and then

compare that to how they felt later on. As the nature of battlefield experiences differs from the

experiences in hospitals, this section will address those separately.

Early Sentiments
Many, if not all, physicians felt feelings of enthusiasm about serving their causes.

Surgeons were eager to do what they could to either preserve the Union, or assist the cause for

independence. Women, who were forbidden from fighting in the field (though a few hundred

managed to do so secretly), were eager to provide their services as nurses. These feelings of

enthusiasm, intense patriotism, and duty would become tried later in the war as they witnessed the

reality of war and served the demands of the countless wounded.

William Watson, who signed on with the 105th Pennsylvania Volunteers at age twenty-

five, enthusiastically joined the Army of the Potomac at Washington, D.C. In his early letters to

his family he wrote about his anticipation for service. I only hope a battle will soon ensue as I

67
Ibid. 39.
 W i l b u r n | 39

should like to be present when the great and decisive engagement of the war is fought.68 Watson

would soon come to an opposite opinion after the Battle of Antietam in 1862. During the war,

Louisa May Alcott published a fictional magazine serial, Hospital Sketches, which detailed the

hospital life of Nurse Periwinkle. While fictitious, the work was largely based on Alcotts own

experiences as a nurse in the Union Hospital in Georgetown. In the story, Nurse Periwinkles

enthusiasm for service knew no bounds as she, still at home awaiting her commission, called my

dinner my rations, saluted all newcomers and ordered a dress parade. 69 Alcotts enthusiasm,

represented in Nurse Periwinkle, might possibly have been shared by many other nurses who

flocked to hospitals and the field.

While many surgeons and nurses do not explicitly write about their early enthusiasm, their

letters and journals contain several hints that they did experience it. These sources display a

positive and energetic tone in the first months of service. These tones usually, or sometimes quite

suddenly, are downgraded to a more solemn and realistic voice, representing a shift in the

authors views on war. These shifts were brought on by a number of factors: the horrors of the

battlefield, the pitiful sight of wounded, mangled men in hospitals, the fatigue of camp life and

hospital duties, to name a few.

Battlefield Experiences
The vast majority of the days of the Civil War armies were in camp or on the march. The

Union Army of the Potomac spent only forty-five days in actual battle during a period of four

years.70 Yet despite this comparatively short amount of time spent in battle, these days seemed to

have influenced those who experienced them more so than the fatigue and monotony of camp life.
68
William Watson. Letters of a Civil War Surgeon. Ed. Paul Fatout. (West Lafayette, IN: Purdue University Press,
1996). 53.
69
Louisa May Alcott. Hospital Sketches. (1863. repr. Boston: Bedford Publishing, 2004). 11.
70
Camp Life. National Museum of Civil War Medicine. 48 E. Patrick Street, Frederick, Maryland, 21705. January
14th, 2013.
 W i l b u r n | 40

What remained in the memories of those who witnessed these scenes were images of people

killed, blown apart, or slowly dying, the piles of dead, bloated bodies, the repugnant smell of

decaying flesh, and the ceaseless moans of the wounded. The real damage of war was not in the

wounds or the dead, but in the minds of the living.

For every soldier during the Civil War, battle was the test of tests. Nearly all the soldiers

that enlisted had never seen war (with the exception of the few veterans of the Mexican War and

some immigrant veterans of the Crimean War). The act of witnessing and participating in ones

first battle came to be called seeing the elephant.71 For medical personnel, to see the elephant

could be anything from actually witnessing a battle, to seeing the aftermath of wounded and dead.

Medical school or the peaceful frontier could not prepare civilian and Army surgeons for the war

that was to come. The severe gunshot and artillery wounds, the unrelenting disease and infection,

the lack of supplies and the poor conditions, working under fire, making difficult triage decisions

all presented new challenges that surgeons were forced to adapt to.

Surgeons were not immune to witnessing the horrors of the battlefield. It is difficult, as

any soldier will tell you, to describe the experiences of combat and the aftermath. There is

something to battle that cannot truly be known except only to those who experience it. Oliver

Wendell Holmes Jr. was right when he spoke of the incommunicable experience of war, and the

surgeons spoke similarly, displaying, themselves, an inability to write about true nature of their

experiences. Acting Assistant Surgeon Daniel M. Holt wrote, I cannot describe, neither can I

71
The metaphorical elephant is any emotionally overwhelming experience, either euphoric or depressing. In the
context of the Civil War, battles came to be the distressing, or adrenaline-inducing emotional experience. The phrase
is thought to have originated from the experience of literally seeing an elephant. Circuses were the only way
nineteenth century Americans had of seeing exotic animals and to see an elephant was act of great excitement.
 W i l b u r n | 41

[have you] realize what we have passed through.72 Confederate Surgeon William McPheeters

told his wife, I will not attempt to describe the scene there 200 horribly wounded. 73

Nonetheless, many attempted to portray the scenes, for some needed to express their feelings for

their own mental well-being. Spencer Glasgow Welch, a surgeon in the Confederate Army

confessed, It is useless for me to tell you of the shocking scenes I have witnessed.74 Even nurses

had difficulties writing. Cornelia Hancock, a Union nurse whose first job was at Gettysburg just

days after the battle wrote, There are no words in the English language to express the sufferings I

have witnessed today.75 Union Assistant Surgeon John Gardner Perry could find only one word

to describe battle. Hell. No other word can describe the scene.76 Confederate Nurse Cordelia

Harvey, working in Tennessee, wrote home to the Wisconsin State Journal, There are times

when the meaning of words seem to fade away; so entirely does our language fail to express the

reality. This fact I never so fully realized as when attempting to depict suffering, both mental and

physical, which I have witnessed within the last ten days.77 It is possible that medical personnel

did not describe their experiences in great detail, as it may have been too painful. Unfortunately,

traumatic events are not easily described for a variety of reasons, write Roamer and Lebowitz.

Description of these experiences is likely to evoke intolerably painful emotions and memories

that the survivor has been trying desperately (both consciously and unconsciously) to avoid.78

72
Daniel M. Holt, M.D. A Surgeons Civil War: The Letters and Journal of Daniel M. Holt, M.D. ed. James Greiner
et al. (Kent, OH: Kent State University Press, 1994). 21.
73
William McPheeters. I Acted on Principle: Dr. William McPheeters, Confederate Surgeon in the Trans-
Mississippi. Ed. Cynthia Pitcock et al. (Fayetteville: University of Arkansas Press, 2002). 151.
74
Spencer Glasgow Welch. A Confederate Surgeons Letters to His Wife. Ed. Eloise Welch Wright. (1911. Repr.
Marietta, GA: Continental Book Co., 1954). 56.
75
Cornelia Hancock. Letters of a Civil War Nurse, ed. Henrietta Jacquette. (Lincoln: University of Nebraska Press,
1998). 7.
76
John Perry. Letters from a Surgeon of the Civil War. Ed. Martha Derby Perry. (Boston: Little, Brown, & Co. 1906).
105.
77
Cordelia Harvey.
78
Roamer and Lebowitz. Understanding Severe Traumatization. 179.
 W i l b u r n | 42

What the true extent of their mental anguish was we can never know. As hard as it was to

describe it, so was it to see.

John Perry of Massachusetts volunteered his service as an Assistant Surgeon in May of

1862. On June 6th, 1863 Perry wrote to his wife about a skirmish he had the unfortunate chance to

see. On the rise where I was standing was planted a battery of very large guns; while the

Confederates were running through the chasm our men brought one of these guns to bear upon

them, throwing a shell directly in their midst. The effect was horrible, and I turned away, unable

to endure the sight.79 William Watson, who in his December 1st, 1862 letter wrote about his

anticipation of witnessing battle, wrote in another letter on the 15th. After having just lived

through the Battle of Fredericksburg, Watson wrote a very terse but powerful sentence about his

reaction to his first fight. I only trust I shall never witness another battle.80 Spencer Glasgow

Welch wrote of the Battle of Spotsylvania in May, 1864 as the most horrific battle I have ever

witnessed It was perfectly fearful. I never experienced such anxiety in my life. It was an awful

day and seemed to me as if all the Furies of Darkness had come together in combat.81

Walt Whitman, the famous poet who served as a nurse in the Union army wrote about one

episode of war in detail. An ambulance train containing about sixty men, many officers, was

ambushed by rebel guerrillas. The ambulance guards surrendered, but the rebels began killing and

mutilating their prisoners and the wounded. Whitman described, One of the officers had his feet

pinned firmly to the ground by bayonets stuck through them and thrust into the ground. 82 The

cavalry arrived and captured the rebel attackers. The next day, the nineteen rebel prisoners were

executed by shooting in the Upperville town square in Virginia. Whitman reflected:

79
Ibid. 43.
80
Watson. Letters of a Civil War Surgeon. 61.
81
Welch. A Confederate Surgeons Letters to His Wife. 96-97.
82
Whitman. Walt Whitmans Civil War. 41-43.
 W i l b u r n | 43

Multiply the above by scores, aye hundreds; verify it in all the forms that different
circumstances, individuals, places could afford; light it with every lurid passion
the wolfs, the lions lapping thirst for blood; the passionate, boiling volcanoes of
human revenge for comrades, brothers slain; with the light of burning farms and
heaps of smutting, smoldering black embers and in the human heart everywhere,
black, worse embers and you have an inkling of the war.83

Whitman also narrated in rich detail the Battle of Chancellorsville, May 12th, 1863. He described

the beautiful weather of a nice spring night, the green summer grass in the fields becoming

stained with the oozing blood of wounded and dead men. He wrote of fires igniting in the woods

and consuming all in their path, burning both the dead and the wounded that could not escape.

Men had their hair singed off, their faces and hands badly burnt. The yells of the rebels and the

Federals and the agonizing moans of the burning wounded saturated the air.84 Though, it was not

battle that affected them so much as the aftermath of battle. It is after the high of an adrenaline

rush wears off, after the terrifying shells and bullets stop flying does one really have the time and

presence of mind to ponder what happened and to see the cost of war.

The fields after a battle seem to be the most emotionally overwhelming sight for many

surgeons. Eric T. Dean wrote, While exposure to artillery fire and the sight and sounds of battle

in progress could be unnerving in the extreme, perhaps the most horrific aspect of the Civil War

experience was the scene of the battlefield after the firing had subsided.85 A landscape scarred

with shell craters, trampled mud mixed with blood, littered with dead, decaying human and horse

bodies strewn about, mangled wounded men moaning and screaming for treatment or death.

Union surgeon William Child of the 5th New Hampshire wrote, The days after the battle are a

thousand times worse than the day of the battle and the physical pain is not the greatest pain

suffered. How awful it is. You have nor can have until you see it any idea of the affairs after a

83
Ibid. 43.
84
Ibid. 45-46.
85
Dean. Shook over Hell. 66.
 W i l b u r n | 44

battleBut the poor wounded mutilated soldiers that yet have life and sensation make a most

horrid picture.86 Confederate Surgeon William McPheeters, operating in the Western theatre of

the war, survived the Battle of Jenkins Ferry. In a letter home on April 30th, 1864 he wrote:

The battlefield presented a sad picture, dead officers and men lying in all
directions, horses scattered here and there, and further on dead and wounded
Yankees. It was a dreadful sight, officers and men that a few hours before I had
seen and talked with now lying cold and ghastly on the ground War is a dreadful
thingI went to bed on the ground and tried to sleep, but could not for a long time
so violently did my heart ache.87

Another Confederate surgeon, Harvey Black, also described the aftermath saying, There is no

place I dislike so much as the vicinity of a battlefield a few days after an engagement.88 The

Battle of Antietam was particularly traumatic for Union Acting Assistant Surgeon Daniel M. Holt.

His letters to his wife display more emotional reflections than any other source read. In a letter to

his wife just after the Battle of Antietam he wrote about his first reaction to a battlefield:

Louisa, I have seen what I never once expected I should see a battle field a
field of blood and carnage a field where brother met brother where the closest
ties of consanguinity and blood are forgotten. When the evil passions of men are
let loose and the hellish deeds of cruelty are perpetrated where blind with rage
and maddened with pain, men forget their God and die blasphemers. Oh! The
terrible sight which met our eyes on the morning after the short and terrible
conflict as we marched up those rugged steps.89

Walt Whitman was traumatized by the sights of the field hospitals that surrounded him.

O heavens! what scene is this? Is this indeed humanity these butchers shambles? 90

Whitman illustrated the hospital scene, detailing men with gaping wounds, limbs blown off, all

86
Child. Letters from A Civil War Surgeon. 34.
87
McPheeters. I Acted on Principle. 151.
88
Harvey Black. The Civil War Letters of Dr. Harvey Black: A Surgeon with Stonewall Jackson. Ed. Glenn
McMullen. (Baltimore: Butternut & Blue Press, 1995). 48.
89
Holt. A Surgeons Civil War. 20.
90
Whitman. Walt Whitmans Civil War. 46.
 W i l b u r n | 45

mutilated, sickening, torn, gouged out, 91 the ferrous

odor of blood filling the atmosphere. He lamented on

the reality of war, expressing that history will never

know what war was.92

For many, one of the minds defenses in the face

Figure 10. "Antietam, MD. Bodies of Confederate of trauma is indifference and callousness. If the mind
Dead Gathered for Burial." This is but one of many
sights that were present following a battle.
reacted to every episode of trauma the same way, it

would become psychotic. By disconnecting itself from the traumatic situation, the mind can

preserve, to some degree, its own health. This numbing, Lizabeth Roamer and Leslie Lebowitz

wrote, is an effective means of managing the initial traumatic impact since it lessens (although

doesnt eliminate) emotional intensity. Many medical personnel expressed a feeling of

callousness or numbing, which often frightened them. Cornelia Hancock wrote this line on just

her second day on the job. I could stand by and see a mans head taken off I believe you get so

used to it here.93 A more jarring statement she wrote later on reads, Their screams of agony do

not make as much impression on me now as the reading of this letter will on you. 94 Holt,

himself, became callous just after Antietam. He wrote, Had any one told me a year ago that I

could look upon such horrors and feel no mental disturbances, I should not have believed them.

Yet so it is. I pass over the putrefying bodies of the deadand feel as little unconcerned as

though they were two hundred pigs. Their protruding bowels, glassy eyes, open mouths, ejecting

91
Ibid.
92
Ibid. 47.
93
Hancock. Letters of a Civil War Nurse. 15.
94
Ibid. 15.
 W i l b u r n | 46

blood and gases, the last wild expression of despair the calm resignation of life affect me not.95

John Perry wrote in a letter days after the Battle of Spotsylvania Court House:

It seems to me I am quite callous to death now, and that I could see my dearest
friend die without much feeling. This condition tells a long story which, under
other circumstances, could scarcely be imagined. During the last three weeks I
have seen probably no less than two thousand deaths, and among them those of
many dear friends. I have witnessed hundreds of men shot dead, have walked and
slept (among them, and surely I feel it possible to die myself as calmly as any.96

Holt seemed to have been especially struck by the image of dead bodies as he wrote about

them quite frequently. I have seen, stretched along in one straight line, ready for internment, at

least a thousand blackened, bloated corpses with blood and gas protruding from every orifice, and

maggots holding high carnival on their heads.97 The detailed description is evidence that this

image remained engraved in Holts memory as he later wrote to his wife. Wounded were taken

from the battlefield quite quickly by that time in the war. The dead, however, did not receive

nearly as quick a response and would consequently begin to decompose before they were buried.

Therefore the scene Holt descried would have been quite common throughout the war.

But the battlefield dead were not all that affected poor

Holt. The piles of limbs left vivid images in his mind. Every

house, for miles around, is a hospital and I have seen arms, legs,

feet and hands lying in piles rotting in the blazing heat of a

Southern sky unburied and uncared for, and still the knife went
Figure 11. "Field Day." Piles of limbs were
common sights in field hospitals. This one
is small, but some could be several feet
high.

95
Ibid. 21.
96
Perry. Letters from a Surgeon of the Civil War. 185.
97
Holt. A Surgeons Civil War. 28.
 W i l b u r n | 47

steadily at its work adding to the putrid mess.98 For many, the smell of decaying bodies left an

impression. It is awful about here now. The odor from the battlefield and the hospitals is almost

insupportable, William Child said of the smell.99 Memories of battlefields, particularly the smell,

stayed with Holt. Sad reflections followed, and the same scenes and sounds appeared to come

over me as upon the days when the ground was covered with dead and dying and the air filled

with putrid vapor arising from the decomposing bodies of men and horses.100 The battlefield

offered many horrors to the surgeons; however, some came even from within camp.

Desertion has always been a problem for every army in history. In the Union Army of the

Potomac, General Joseph Hooker estimated 85,000 officers and soldiers deserted in 1863.101 To

combat the growing figures of desertion in 1863 and 1864, execution was authorized. During an

execution, the entire division of the guilty persons was summoned to witness the sentence and the

men paraded past the dead bodies. John Gardner Perry wrote to his wife describing the scene.

All the regiments in the division are to be present, and I expect to be detailed as one of the

surgeons to examine the body after it falls. I feel too sad to write. I can bear to see hundreds shot

in battle, but everything in me recoils from seeing one shot in cold blood; if these horrible scenes

do not stop, my whole nature will change.102 One episode that deserves notice belongs to Daniel

Holt. Surgeons occasionally found themselves performing rather unpleasant duties that were

wholly unrelated to medical work. Daniel Holt wrote about one such experience.

I for the first time fully felt the dreadful effects of this cruel, wicked war. It was my
mournful duty to inform the brother of one of our men who had died, although he
had expected, and for some time tried to prepare for the event, yet when the blow

98
Ibid.
99
Child. Letters from a Civil War Surgeon. 37.
100
Holt. A Surgeons Civil War. 40.
101
David Herbert Donald, J. G. Randall, and Maria Holt. The Civil War and Reconstruction. (1969. repr. New York:
W.W. Norton & Co., 2001), 330.
102
Perry. Letters from a Surgeon of the Civil War. 100-101.
 W i l b u r n | 48

came, it was too severe. Nature gave way, and I left him a disconsolate, broken
hearted man with his companions while I continued my round. I had time to
commune with myself as I rode from post to post, and the fountain of my heart
overflowed as I found relief in tears.103
A similar incident has not been found yet any of the sources available for this study. Whether

surgeons were given charge of informing relatives and friends of a comrades death is unknown.

But what this passage represents is that for Holt, the true pain of war lay not in the physical

carnage of the battlefield, but in the emotional pain of losing loved ones. The battlefield, riddled

with dead, decaying bodies, horrid smells, and ghastly sights, and even camp with its periodic

executions account for only half of the horrors of war. The second half was the duty to which the

surgeons swore themselves to in service to their men and causes.

The medical personnel of the war carried out a myriad of duties during their services

which included inspecting the troops, distributing medicine, enforcing sanitation in camp, making

sure the troop diet was sufficient, etc. Since death by bacteria was more common than death by

bullet, preventing illness in camp was by far the most important job of the surgeon. Though, after

any battle, the treatment of battlefield wounds became the

most important job at that time. Surgery required their full

attention and commitment, despite its unpleasant nature, and

these surgeons continued to perform their surgical duties

Figure 12: "Amputation Scene. Here regardless of their distaste for it.
surgeons stage an amputation, the most
common surgery during the war.
William Watson, only twenty-five when he enlisted in 1862, had graduated from

University of Pennsylvania School of Medicine eager to put into practice the new skills he had

spent years learning. However, after his first battle, the Battle of Fredericksburg in December

103
Ibid. 63.
 W i l b u r n | 49

1862, Watson wrote I have had enough of surgery to do me for quite a number of years.104

Watson soon came to despise the very trade he dedicated his life to. He wrote in January, 1863

about dreading future engagements as they only brought on more horrific surgery. I have passed

through one hard campaign witnessed one bloody battle and had as much surgery as I desired.

So I did not care about engaging in an other drama like this.105 Amputations seemed to have had

an impact on the young surgeons mind as later letters reflected. Some days, Watson was kept

busy for hours to meet the demands of the seemingly incessant supply of wounded. Day before

yesterday, the young surgeon wrote, I performed fourteen amputations without leaving the

table. I do not exaggerate when I say I have performed at least calculation fifty amputations.106

Watson, who earlier was so eager to perform amputations and surgeries became sick of them as

the reality of war set in. Yesterday and today I have had a great deal of operating. I am pretty

well through now.107 Watson may have hated the surgeries themselves, but he most certainly did

not hate being able to serve the men and save their lives at the cost of his own comfort.

Watson was not the only surgeon to have had a negative reaction to surgery. William

McPheeters letter of May 1st, 1863 expresses a remorseful tone. In the letter he reflects on the

amputations he performed with some sadness. I never took off so many in one day before. Im

sorry that it was necessary to remove so many.108 William Child also wrote to his wife, My

work is not difficult now although very disagreeable.109 To the surgeons of the war, amputation

was a necessary evil. They did not relish the opportunity to operate; they did not celebrate the

surgeries they had completed. Amid the seemingly never-ending stream of wounded men flowing

104
Watson. Letters of a Civil War Surgeon. 61.
105
Ibid. 68.
106
Ibid. 108.
107
Ibid. 137.
108
McPheeters. I Acted on Principle. 152.
109
Child. Letters from a Civil War Surgeon. 39.
 W i l b u r n | 50

into hospitals, some surgeons felt that their efforts were all in vain. I sometimes feel so

depressed and despending [sic] when I see how utterly futile all my efforts for their comfort

are,110 wrote Daniel Holt. Comfort in this situation is used loosely as there was little comfort

to be had during the war, either in hospital or in camp.

Camp life was a trying experience, physically and mentally. It was suffered by everyone

in the armies, though surgeons, being officers, would have only slightly better conditions. Many

of the complaints that fill soldiers letters home also fill the letters of the surgeons in the field.

Exhausting marches, pitiful food, poor sleep, freezing cold and scorching heat, inactivity, and

scarcity of supplies made life just as difficult for the surgeon as for the soldier.

Weather, the environment, and location can have a strong impact on ones mind. In her

article, No Place for the Sick: Natures War on Civil War Soldier Mental and Physical Health

in the 1862 Peninsula and Shenandoah Valley Campaigns, Katheryn Meier argues that exposure

to the elements was partly responsible for low morale. The environment was linked to be the

cause of loneliness, the blues, melancholy, and nostalgia. Nostalgia and loneliness will be

discussed in greater detail later. While cold weather and restless nights do take a physical toll on

the body, they can be equally taxing on the mind. Daniel Holt found nights to be most difficult.

The worst difficulty I labor under now is sleepless and restless nights. Oh dear, how long and

tedious they appear, and how I watch for the first gray streaks of morning! When after that for an

hour I can generally get a little rest. I get mad at myself and [my darkey] because I cannot

sleep and he can sleep.111 Sleep seems to have been a very important matter on the minds of

many surgeons. J. Franklin Dyer frequently wrote about not being able to find sleep. I am

110
Holt. A Surgeons Civil War. 32.
111
Ibid. 61.
 W i l b u r n | 51

entirely exhausted having had no sleep and nothing to eat for twenty-four hours.112 It is difficult

to ascertain the extent to which a lack of sleep or insomnia had affected mentally these surgeons,

or how mental stress affected their ability to fall asleep. As we have seen in an earlier quote by

William McPheeters, the memories and stress of what he had seen kept him from sleeping. I

went to bed on the ground and tried to sleep, but could not for a long time so violently did my

heart ache.113 However, looking at our modern understanding of sleep deprivation, it may be safe

to speculate that it contributed to mood changes and depression. And vice versa, depression may

have caused a lack of sleep.

Food was also on the minds of many surgeons. William Watson wrote home to his father

and sisters about the discomforts of camp life. Pa, I assure you, he wrote, a soldiers life in

time of war is not one of ease and comfort. During the whole march we were in drenching rain.

Our rations consist of crackers and pork. For one surgeon in particular, food was of great

importance. Confederate Surgeon Spencer Glasgow Welch was often dismayed by the lack of

quality food. He complained in his letters to his wife, We have had nothing to eat but crackers

and bacon.114 His letters mention his hankering for such things as syrup, sweet potatoes, Saur-

kraut, and the like.115 When Welch was lucky enough to have a decent meal, he would write

about it in vivid detail. John Gardner Perry found a lack of food not the only thing disheartening.

Our food here is disgusting poor hard bread and brown sugar Worst of all we are even

without tobacco.116 The deprivation of such simple things as sleep, food, and, of course, tobacco

seems to have had a surprisingly larger impact than one might initially expect. But a lack of sleep

112
Dyer. The Journal of a Civil War Surgeon. 157.
113
McPheeters. I Acted on Principle. 151.
114
Welch. A Confederate Surgeons Letters to His Wife. 17.
115
Ibid. 87.
116
Perry. Letters from a Surgeon of the Civil War. 120.
 W i l b u r n | 52

and food were not the only things to demoralize surgeons and soldiers alike; a lack of activity

could be just as bad.

Inactivity in camp was quite taxing. As stated earlier, significantly more time was spent in

camp than in battle, or on active campaigning. Second, during these days of inactivity, surgeons

could complete their daily duties in the early morning then have nothing to do for the rest of the

day, exacerbating the feelings of boredom. William Watson wrote, Active campaigning in

pleasant weather is certainly more agreeable than inactive camp life. 117 Inactivity agitated the

men, making them feel restless. John Perry described, feeling somewhat restless from the

helpless inactivity.118 Inactivity would also lead soldiers and surgeons to do nothing but think

(which could sometimes be a dangerous thing). Perry later wrote of one such experience. It is

dull enough, with nothing to do and nothing new to hear. I spend hours alone in my tent thinking

of the future; questioning and answering myself.119 Idle hours could very well lead to thoughts

about home, family, and reflections on recent battles, the carnage, friends and comrades lost.

The reality of camp life was suffered by all. The enlisted man had it much rougher than

the officers. Medical personnel, being officers, enjoyed the perks their rank entitled them to.

Enlisted infantrymen could be expected to march on foot almost two dozen miles a day when on

campaign. Surgeons, if they could afford one, would have had the privilege of riding horses.

Nurses on campaign could get rides in the ambulances and contracted wagons. When it came to

food, enlisted men enjoyed the regular salted pork and hard tack, supplemented by rice or beans

and the occasional foods found while foraging or bought from sutlers. Officers and surgeons often

shared the diet, but could also expect better food on more frequent occasions. Similarly, surgeons

117
Watson. Letters from a Civil War Surgeon. 37.
118
Perry. Letters from a Surgeon of the Civil War. 65.
119
Ibid. 154.
 W i l b u r n | 53

enjoyed larger tents, though situational circumstances could force them to sleep in the open or

underneath an ambulance. Though surgeons may have had it slightly better than their men, they

were all subjected to the enduring fatigue of campaigning.

War creates many wounds. Some are treated by simply bandaging and stitching them up,

others by removing the wounded parts, still others through doses of medications and diet

regulations. But some wounds are beyond healing, others simply will never heal. Mini balls and

shell shrapnel created grotesque open compound fractures, but battle and surgery created invisible

wounds of the mind. Since many of the journals and letter compilations end with the cessation of

hostilities, it is difficult to track down the post-war lives of the surgeons who witnessed the

horrors of battlefields and field hospitals. Therefore, without knowledge of the post-war lives of

these personnel it is impossible to say if any experienced Post-Traumatic Stress Disorder (PTSD)

with any certainty. There is a possibility that surgeons experienced survivors guilt, incapable of

remembering those they saved and remembering and blaming themselves for those they could not

save. While nurses commented on the death of patients, such remarks are strangely rare or absent

in surgeons writings. Their journals and letters never mention patients dying on their operating

table, though it is almost certain to have happened. life of a Civil War surgeon was not one of

ease and comfort. They did not happily look at their patients as mere opportunities to gain

experience, or fun, challenging projects. They viewed war as a natural occurrence 120 to which

one must resign oneself and endure it. They viewed their services as necessary for their causes, a

sacrifice for the betterment of others. While they disliked battle and boredom, they found

satisfaction in serving.

120
Welch. A Confederate Surgeons Letters to His Wife. 43.
 W i l b u r n | 54

Hospital Experiences
A hospital alone shows what war is, wrote Erich

Maria Remarque in All Quiet on the Western Front. 121

Though nurses in general hospitals were far removed from

the horrors of the frontlines, they too bore witness to the

sufferings and experienced their fair share of difficulties in

treating the hundreds and thousands of wounded and
dying. Nursing in general hospitals was thankfully devoid
Figure 13: "Ward in the Carver General
Hospital, Washington, D.C." Hospital wards like
this are where many nurses volunteered the
services. Garland hangs from the ceiling to
mask the odors.

of terrorizing battles, sleeping on cold, wet ground, marching twenty miles in suffocating dust or

paralyzing mud, and most certainly devoid of inactivity. Nurses did, however, experience

physical and mental fatigue. Nurses often times became attached to their patients only to see them

die. Female nurses often report of having had strained relationships with head male surgeons of

hospital wards. Even black nurses suffered discrimination under their white colleagues. Modern

studies of nurses of the First World War revealed psychological stress and break downs as

inherent to the war nursing experience. 122 Despite these difficulties, the dedicated nurses

operating in general hospitals of both belligerents continued to serve the men under their care.

For the female nurses who had left home, many for the first time, the very sight of wars

results was thoroughly new and devastating. The first sights of war-ravaged and disease-ridden

men were daunting ones, and many initially lacked the emotional fortitude required to work

efficiently. The nurses first job was to nurse themselves mentally. As Jane Schultz wrote,

Adjusting to hospital life requires the interior and often isolated journey of an individual who,

121
Erich Maria Remarque. All Quiet on the Western Front. Reprint. (New York: Ballantine Books, 1987). 173.
122
Acton and Potter. These frightful sights would work havoc with ones brain. 64.
 W i l b u r n | 55

after grappling with the physical and psychological signs of death, might achieve the respect of

superiors and stay on or decide that the rigors were too much to endure.123

The first months on the job were always the worst as the women struggled to situate

themselves in their new environment and become accustomed to the death, the wounded, and the

demands of their jobs. Union nurse Anna Morris Holstein was forced to overcome her near-

constant urge to cry. Cornelia McDonald, a Confederate volunteer nurse, had rather a grotesque

first day when she stumbled over and fell into a pile of amputated limbs. Sarah Pryor, another

southerner, even fainted from the sights while in the midst of saying she was up to the job.124 The

first months of work were the litmus test. Those who could pay the psychotic costs of witnessing

human suffering continued to work. Those nurses who found the mental fortitude to continue

working often found pride in their work. However, they still frequently wrote about the

depressing scenes that composed their situations. Harriet Eaton, who had made it through her first

few months and later, through the war, described the mixture of feelings. The caring for our

suffering soldiers I came here for and I love the work, but there are things in connection with this

mission I little dreamed of. Perhaps I was sent here to learn patience. 125 Even six months after

her initiation into hospital life, Eaton was still affected by the job. I [cannot] describe the painful,

agonizing scenes through which we have passed.126 A year into her work, Ada Bacot expressed

her feelings, I am thourely [sic] sick of the sight of men & would gladly get away for a time of

rest, but I know these are not the right feelings and will suppress them.O my to think of getting

123
Jane Schultz. Women at the Front: Hospital Workers in Civil War America. 74.
124
Ibid. 75.
125
Harriet Eaton. This Birth Place of Souls: The Civil War Nursing Diary of Harriet Eaton. Ed. Jane E. Schultz.
(New York: Oxford University Press, 2010) 106.
126
Ibid. 222.
 W i l b u r n | 56

up early in the morning & going among men, I am so sick of the sight of them.127 However, the

sickening sights of human suffering were not the only tribulations to affect nurses. Nurses also

found themselves caught up in the complicated and intricate web of patient-caregiver

relationships, emotional, spiritual, and romantic/sexual relationships, and competitive

relationships with their fellow nurses and superiors.

On the most basic level, the patient-caregiver relationships that developed in hospitals

between the all-male patients and the handful of women workers was one of respect. The men

respected the nurses for their help, and the women respected the men for being able to endure

their suffering with little complaint. Hospital wards were akin to companies in that many thought

of them as being a close knit family and everyone a comrade. Mary Livermore wrote of her

respect for the endurance of her patients: To lie suffering in a hospital bed for months with no

companionship, no affection, utterly alone in the

midst of hundreds; sick, in pain, sore hearted, and

depressed I declare this requires more courage to

endure than face the most tragic death.128 Such feelings

were mutual as soldiers often felt and showed respect to

the nurses. Cornelia Hancock was granted a silver Figure 14: "Field hospital of 3d Division, 2d Army
Corps." This was the hospital in Brandy Station
where Cornelia Hancock spent much of her time
medal from the wounded soldiers she had served at between 1863 and 1864.

Gettysburg. It read, Miss Cornelia Hancock, presented by the wounded soldiers 3rd Division 2nd

Army Corps, Testimonial of regard for the ministrations of mercy to the wounded soldiers at

127
Ada Bacot. A Confederate Nurse: The Diary of Ada Bacot: 1860-1863. Ed. Jean V. Berlin. (Charleston: University
of South Carolina Press. 1994
128
Mary Livermore. My Story Of The War: The Civil War Memoirs Of The Famous Nurse, Relief Organizer, And
Suffragette. (New York: De Capo Press, 1995). 325.
 W i l b u r n | 57

Gettysburg - July 1863. 129 She bore this medal with her everywhere during her service,

eventually hanging it on the wall of her log hut when she was at Brandy Station Division

Hospital. She remarked about having copied the inscription every morning.130

As female nurses poured out their hearts for the men, nurturing them, caring for them,

talking and listening to them, and supporting them, they often became emotionally attached to

many of their patients. Women in nursing was initially frowned upon and contested for this very

reason. Some believed that many women merely wanted to nurse to find romance (Though, I

would hardly consider a hospital a romantic setting). Union nurse, Dorothea Dix, also known as

Dragon Dix for her strictness and high standards, opposed single women in the work force and

held very high standards for action, behavior, and dress. Many doctors also preferred Catholic

nuns, the Sisters of Charity and Sisters of Mercy, for were considered to be asexual and would not

form relationships with the men. Though, the flowers of romance still found a way to blossom in

the hearts of some of the single women who worked in the hospitals.

Cornelia Hancock wrote to her niece from the field hospitals in Gettysburg that, there are

many good-looking women here who galavant [sic] around in the evening. Hospitals were prime

places for picking up mates, she wrote, It is a capital place for that as there are very many nice

men here.131 It is speculated that Confederate nurse, Ada Bacots husband, Lt. Thomas A. G.

Clarke was a patient of hers following the Second Battle of Manassas.132 Bacot also confessed to

her diary about a crush she had on one of the surgeons. Louisa May Alcott described one patient,

blacksmith John Suhre, in a rather sexual manner. The number of budding romances leading to

129
Hancock. Letters of a Civil War Nurse. 12.
130
Ibid. 65.
132
Jean Berlin. Introduction. A Confederate Nurse: The Diary of Ada Bacot, 1860-1863. Ed. Jean Berlin.
(Charleston: University of South Carolina Press, 1994). 15.
 W i l b u r n | 58

marriage in the hospital wards between nurses and their patients, co-workers, and surgeons

alarmed Dorothea Dix.133

Ada Bacot, a young widow and a mother bereft of two children at the age of twenty-seven,

developed a romantic relationship with her coworker Dr. James McIntosh. When McIntosh took

ill in February of 1862, Ada Bacot became his exclusive nurse. I am formerly established as the

Dr.s nurse, no one else is called upon to [do] any thing for him, I am delighted he will alow [sic]

me to nurse him.134 This initial period of somewhat intimate contact may have been the spark

that lit a fire of passion in their hearts. Later in April that year, Dr. McIntosh invited Bacot on an

outing to a portrait gallery. As they were leaving, Dr. McIntosh made up his mind that we were

more than meare [sic] friends. 135 McIntosh, Bacot mentioned earlier, was currently engaged.

Though, a few months later, they appeared to have had a falling out. Curiously enough, a fellow

nurse, Esse Habersham also had a crush on McIntosh. Bacot wrote I dont know what to make of

Esse she acts very strangely, she is deeply in love with Dr. McIntosh & she knows he is engaged

I must say I feel disappointed in her, again so much for forming hasty attachments. 136 But not

all bonds formed in hospitals were romantic. Many nurses either buried their sexual desires or

channeled them into their maternal feelings. Whatever the extent or nature of their feelings were,

many nurses became attached to their patients. Those attachments, unfortunately, were often

ripped apart by the cruel, cold hands of death.

Bacot also found herself becoming attached, emotionally and spiritually to her men:

I found Montgomery very much exhausted this morning from coughing last night.
He told me he thought he would have died in the night, but that he still had hope, I

133
Schultz. Women at the Front. 94-95.
134
Bacot. A Confederate Nurse. 85.
135
Ibid. 101.
136
Ibid. 84.
 W i l b u r n | 59

tryed [sic] to make him comprehend his state told him he might die at any time &
asked if he had been trying to prepare himself for another world he said no that he
thought there was no use, that he had lived in sin so long, that now he need not try
to seek forgiveness. Oh! It is so hard to see men dieing [sic] like brutes as if they
had no Soul to save. I have tryed to talk to them & read to them, but they give me
no encouragement, some of them refuse to listen to me.137
Later, Bacot wrote about another boy she was trying to save, both body and soul. God grant his

sickness may be sanctified to him, she prayed in her diary, he thinks I trouble myself a great

deal about his diet, but if only he knew how much more I troubled about his Soul.138 In another

account she told of a soldier named Logan, by whose side she remained and told stories, talked,

and read to him. He told her he knew his fate and resigned to the will of God.139 The young

soldier asked for a minister who came and prayed for him while Bacot remembered, I was

standing by the bed weeping.140 The young soldier said his goodbyes and died.

On the other hand, not all relationships within the hospital setting were positive and

mutually beneficial. Hospitals were places rife with conflict, competition, and discrimination.

Schultz comments on the nature of class, gender, and racial interactions within hospitals. Elite

women expected to be treated as equals along class lines by the elite surgeons, but found

themselves scorned due to gender. In response, they formed relationships with lower class

soldiers. In a way, the suffering of the soldiers appealed to the nurses humanity thus contributing

to erode class boundaries in the hospitals.141 The nature of race relations depended on geography.

Northern nurses were more disposed to show as much compassion for blacks as for whites. Emily

Parsons, a nurse from Massachusetts, gave black patients a separate ward, but equal treatment.

Abby Hopper Gibbons at Point Lookouts Hammond General Hospital advocated on behalf of

137
Ibid. 116.
138
Ibid. 141.
139
Ibid. 118
140
Ibid.
141
Schultz. Women at the Front. 97-98.
 W i l b u r n | 60

blacks subjected to racial hatred. Cornelia Hancock wrote, I am willing to work for the

contrabands whenever I am not in the field Hospital, shall always give my voice to advocate their

cause.142 The relationships between white women of the north and their black patients were more

egalitarian than between white women and black women.

In reality the relations among women in hospitals, North and South, were almost always

strained. While women could dissolve or cross class and racial boundaries with their soldier

patients, they often had a much more difficult time with their female coworkers. Women workers

usually restricted their interactions to within their social class. In the South, the feelings of

resentment were often aimed downwards at the lower class. Elite nurses like Phoebe Pember

looked down upon the crude, pipe-smoking, poorly dressed nurses of the lower class. In the

North, the resentment usually flowed upwards and was aimed at the haughty elites.143

Religion also served as a boundary between hospital workers. Catholic sisters were

preferred by surgeons for their modesty, discipline, and asexuality. Protestant workers, gripped by

the virulent anti-Catholic fervor of the time, resented the nuns. For them it was a matter of pride,

seeing surgeons preferring nuns over them. They claimed nuns received special treatment and that

they were more interested in converting than healing and that their impersonal Catholic rituals left

the soldiers spiritually lacking. Lay workers, therefore, often kept out of the way and distanced

themselves from the Sisters of Charity and Sisters of Mercy.144

Women workers relationships with their male superiors and coworkers could be just as

troublesome as among themselves, though some exceptions existed. Male surgeons,

quartermasters, and stewards found their male superiority threatened by these independently

142
Hancock. Letters if a Civil War Nurse. 60.
143
Ibid. 100.
144
Ibid. 100-101.
 W i l b u r n | 61

minded women. Hospital surgeons often trivialized the contributions of the women workers. Kate

Cumming recorded that surgeons held a great prejudice against the incoming female workers.

Confederate Fannie Beers was patronized by her male superiors for her youth. Early in the war,

military surgeons remarked on the lack of military discipline of volunteer female nurses and were

unwillingly to have them in their wards. Others who would tolerate their presence, though, had no

intentions of making them their equals.145 Jane Stuart Woolseys sister Gorgeanna wrote No one

knows, who did not watch the thing from the beginning, how much unfeeling want of thought

these women nurses endured Government had decided that women should be employed, and

the army surgeons . . . determined to make their lives so unbearable that they would be forced in

self-defense to leave.146

Women workers also had difficulties being heard in the male dominated bureaucracy of

the medical departments. If surgeons misbehaved, there was often no one to punish them, and

those who witnessed the transgressions either would not report them (usually other males) or

could not report them (usually the female workers). Nurse Susan Blackford of Illinois tried to get

more food for the soldiers. She complained to the surgeons and the department. Unheeded, she

sent a petition around for the men to sign and presented it to the Illinois state government. By

taking the case out of the military and to civil authorities, she angered military officials and was

subsequently dismissed from duty. Esther Hill Hawkes tried to report a surgeon for sexual

harassment on another nurse, but the surgeon claimed drunkenness and was excused. Even if

women could report offenses, they usually went unheard. Hannah Ropes, on the other hand,

represented an exception. Luckily for Ropes, she had friends in high places; Senator Charles

145
Jane Schultz. The Inhospitable Hospital: Gender and Professionalism in Civil War Medicine. Signs 17, no. 2.
(1992): 375-376.
146
Anne L. Austin, The Woolsey Sisters of New York: A Family's Involvement in the Civil War and a New Profession
(Philadelphia: American Philosophical Society, 1971), 112-13.
 W i l b u r n | 62

Sumner (who was beaten with a cane to unconsciousness by Representative Preston Brooks on

the Senate floor in 1856), medical inspector general Thomas Perley, and even Secretary of War

Edwin Stanton. Ropes had a few differences with one head surgeon and had him transferred. Just

before he was to leave, they had a large argument, which later ended in a reconciliation and

friendship. However, he still left.147 When things went ill, Ropes found ways to petition through

her connections to get things done, though it not always worked.

There were positive interactions between surgeons and their female nurses. Many

welcomed the women nurses. They saw female nurses as a boost to patient morale. Female nurses

also kept the wards clean and hygienic. Thomas Azpell, a surgeon in St. Louis, replied to survey

Surgeon General Hammond sent out, that his five female nurses were competent and helpful.

Azpell believed that female attendants served better as morale boosters and general helpers, and

but any and all medical practices should be left to the surgeons who had training. 148 When a dying

prisoner bequeathed his savings to Surgeon John Gardner Perry, the surgeon told the dying man

that he ought to divide the whole sum among the nurses who had been so kind to him.149 His

savings, though, amounted to less than fifty cents.

In a world dominated by male superiority, women found themselves ignored and

diminished in society. For some women, hospitals served as an outlet to express social

independence and prove their qualities. Many, though, found themselves subjected to the scorn of

their male coworkers and superiors. In response, the women felt as though they needed to exert

themselves over another group in ordered to feel empowered. Black hospital workers were the

one group white women of all social classes could agree on oppressing. Blacks automatically

147
Ropes. Civil War Nurse: The Diary and Letters of Hannah Ropes. 72.
148
Schultz. Women at the Front. 125.
149
Perry. Letters from a Surgeon of the Civil War. 13.
 W i l b u r n | 63

were assigned menial, inglorious, or otherwise dangerous jobs, from laundry to nursing smallpox

patients. Blacks were also paid less than whites, if they got paid at all (a problem which affected

everyone). Black hospital workers and nurses were even often denied the title of nurse,

preferring instead to bestow upon them the title of cook or laundress. Stereotyping was quite

common; whites thinking the black workers as lazy, clumsy, and ignorant. Tensions constantly

existed between white women and black women.150

After examining the trials of nurses and surgeons, we are left wondering how these

experiences compare to those of the soldiers they served. Both the medical personnel and their

patients witnessed suffering, but through different lenses. While their experiences had differences,

there was much overlap. Both shared in the experience of battle. The soldiers not only witnessed

the horrors of the battlefields, but contributed to it, actively participating in the killing. The act of

killing was one of the greatest challenges the Civil War soldier faced. Surgeons and nurses, one

the other hand were not exposed to the necessity of taking anothers life, but the complete

opposite. Surgeons and a few nurses did, as we have seen, witness battle, but they were caught up

in the act of saving lives. The days after a battle were shared by soldiers and physicians alike but

differently. All were subjected to the overpowering stench of the dead, all bore witness to the

rows of bodies. Soldiers were often given the detail of performing the last rites of burial, surgeons

were meanwhile relegated to the hospitals, surrounded by the wounded and dying. Soldiers,

whom battle or sickness left incapacitated, likewise shared in the atmosphere of misery in the

hospitals. For the soldiers their time in the hospital was limited, ending in either cure or death.

Surgeons and nurses, on the other hand, stayed in this environment for the duration of the war.

150
Schultz. Seldom Thanked, Never Praised, and Scarcely Recognized: Gender and Racism in Civil War
Hospitals. Civil War History 48, no. 3. (2002): 221-224.
 W i l b u r n | 64

The battlefields and hospitals of the Civil War presented medical personnel with a host of

trials. Both those in the field and those in the hospital beheld the sufferings of wounded, mangled

men. The cruel savagery of war, the wanton slaughter, the dead bloating bodies, the languishing

ill, the despairing dying; these were the sights that surrounded the nurses and surgeons. Both

found difficulty in describing the indescribable. Jane Acton and Carol Potter wrote, The

conditions under which medical personnel work can have contradictory effects: they may lead to

breakdown on the one hand, but on the other, they can reinforce the need for endurance. The latter

includes a heightened sense of purpose and satisfaction in the ability to confront what is most

terrible and survive.151 It forced some men and women to quit, it spurned others to persevere. In

addition to the ghastly, grim sights of suffering, physical and mental fatigue plagued the efforts of

these men and women. These men and women fought a battle of their own. They fought infection,

combatted suffering, and contested despair. But oftentimes, they waged war with each other over

such petty issues as race, class, and gender. This not-so-friendly fire affected their efforts to treat

those who were dying. The medical war they fought against disease and wounds and the social

war that waged in hospitals were not the only wars they endured. Real bullets proved to be a very

real and dangerous threat.

151
Acton and Potter. These frightful sights would work havoc with ones brain. 76.
 W i l b u r n | 65

Physical Risks
Some Medical officers lost their lives in their devotion to duty on the battlefield of Antietam. [Their]
untimely deathsby the hands of the enemy shall not be forgotten by a grateful people; their high sense
of duty, professional ability, and unfailing courtesy will be long remembered by their comrades in the
field. Maj. Dr. Jonathan Letterman

What is often forgotten in the scholarship of Civil War history, even in the history of Civil

War medicine, are the deaths, illnesses, and injuries suffered by the medical staff. In addition to

the emotional and mental pains that came with providing medical care to the men, the medical

personnel were also faced with physical dangers. In a world before germ theory was fully

understood, the risk of contracting diseases from patients was ever present, though these brave

men and women feared not. Despite being labeled as non-combatants, surgeons and nurses still

faced physical dangers on and near battlefields. Several times surgeons faced the dilemma, in the

face of an advancing enemy, of staying behind to treat the seriously wounded and be captured, or

leaving them behind in order to continue serving the regiments later on. George Otis wrote in the

Medical and Surgical History of the War of the Rebellion, The surgical lessons of the war, like

its other good results, were only obtained at the expense of great sacrifices. The army surgeon is

not only exposed to the dangers arising from excessive fatigue, and constant contact with disease,

but to the fatalities directly incident to war.152 The surgeons and nurses, unlike the soldiers they

cared for, did not carry weapons, except for the occasional privately purchased revolver, (the

M1840 Medical Staff Sword can hardly be considered a weapon) yet still felt the dangers of war.

The medical corps suffered more casualties than any other staff corps.

152
George Otis. Medical and Surgical History of the War of Rebellion. Volume VII, xxx.
 W i l b u r n | 66

Death and Injury

There was during wartime the popular fallacy that, in time of battle, the post of the

medical officer is one of comparative safety.153 It was the duty of the Assistant Surgeon and his

orderly to accompany their regiments into battle in order to provide the first stage in battlefield

treatment. The Surgeons were required to set up Division Hospital close enough to the lines for

the convenience of the wounded, yet far enough out of range of enemy artillery, although in

practice that was difficult to achieve, as many hospitals were frequently subjected to intense

shelling. These medical officers continuously and selflessly placed their lives on the line for those

of their men. Many earned the red badge of courage for their efforts and several made the

ultimate sacrifice.

The first day of the Battle of Shiloh, fought on April 6th, 1862, was a defeat for the Union

Army. Confederate forces under the leadership of General Albert Sydney Johnson had surprise

attacked Union troops, General Ulysses S. Grant commanding, and pushed them back to the

Tennessee River. The forces in the center of the Union line, underneath Generals Prentiss and

Wallace fought ferociously in the thickest part of the fighting now known as the Hornets Nest.

Surgeon Samuel Everett, serving as the brigade surgeon on the staff of General Prentiss,

witnessed the troops retreating back towards the river. Fearing a military defeat over the loss of

his own life, Everett stood on the line and rallied the retreating troops to hold their positions. Dr.

Samuel Everett was shot and killed. He was the first Federal medical officer to be killed in action

on the battlefield.154

153
Ibid. xxxi. See Appendix F.
154
William H. Collins and Cicero F. Perry. Past and Present of the City of Quincy and Adams County, Illinois.
(Chicago: S. J. Clarke Publishing Company, 1905). 309.
 W i l b u r n | 67

Several months later on September 17th the Battle of Antietam, remembered as the

bloodiest day in American history, was fought. This battle witnessed the death of more surgeons

than any other conflict during the war. Surgeon W. J. H. White, Medical Director of the VI Corps,

was killed while setting up field hospitals. Assistant Surgeon A. A. Kendall of the 12th

Massachusetts Volunteers was killed in the fighting at Antietam as he bravely accompanied his

regiment into battle.155

Assistant Surgeon Edward Revere, 20th Massachusetts Volunteers, grandson of the patriot

Paul Revere and friend of Oliver Wendell Holmes Jr., was shot and killed as he carried a

wounded man from the battlefield. It may be mentioned, that, only a few moments before he fell,

he was observed by one of the officers of his regiment to be attending to a wounded man upon the

ground. While thus occupied, the regiment, which stood within a few feet of him, suddenly

changed front, faced to the rear, and fired a volley over his head. He continued his work without a

trembling of the hand, and not even looking up.156 As the officers coolly led their men in battle,

Revere coolly tended to the wounded in the midst of the fighting. Confederate surgeon, Dr.

Williams had, after the Battle of Harpers Ferry, fought September 12th to the 15th, 1862, stayed

behind to treat the seriously wounded men of his regiment. He fell in with an artillery battery on

his way to catch up with his regiment. The battery arrived at Antietam just in time for the battle

and immediately deployed and began firing into Union lines. However, advancing Union infantry

had claimed the lives of several of the gunners. Dr. Williams was killed as he helped man the

guns. 157 The debacle at Fredericksburg would claim the life of a surgeon. The battlefield of

155
Otis. Medical and Surgical History. Volume VII. xxx.
156
As quoted in Asst. Surgeon Edward H. R. Revere. Northern Virginia Regional Park Authority.
http://www.nvrpa.org/uploads/Files/HR%20Revere.PDF
157
Myths, Disease, Civilians, and Surgeons. Pry House Field Hospital Museum. 18906 Shepherdstown Pike,
Keedysville, MD, 21756. September 15th, 2012.
 W i l b u r n | 68

Chancellorsville would claim two more. One fell mortally wounded at Gettysburg and another at

Spotsylvania.

Table 3: Deaths of Surgeons by Cause in the Union Army

Means of Death158 Number
Killed in action 19
Killed by partisans, guerrillas, or rioters 13
Died of mortal wounds received in action 8
Died of accidents in the line of duty 9
Total 49
(For a list of the surgeons killed and wounded, see Appendix G).

Not all deaths occurred on the battlefield or in skirmishes. During the Union landings on

Roanoke Island in January, 1862 a boat carrying food and supplies was foundered off the coast in

a storm. Surgeon Frederick S. Wells dove into the water in an attempt to rescue the food for his

regiment, the 9th New Jersey Volunteers, which was famished. Wells drowned in the tempest, the

fate of the food he tried to save for his starving regiment is unknown. Wells, and several other

surgeons, placed the lives of their men above their own; the mark of a truly compassionate

physician.

Several physicians were wounded over the course of the war; some through battle and

others by accident. Though only one surgeon fell on the field at Gettysburg, five were wounded,

shot by the enemy while attending to the wounded in battle. A total of seventy-three surgeons

were recorded as wounded in battle during the war. However, the list does not include surgeons

wounded through accidents. J. Franklin Dyer, Acting Assistant Surgeon for the 19th

Massachusetts described in his journals such an event. While on the march in early September

1862, a soldier accidently discharged his rifle. Suddenly all the soldiers around thought they were

158
The number of medical personnel who died as a result of disease contracted during service is unknown. Otis
wrote, I have not space for the long list of Union surgeons who perished from disease strictly consequent upon
the nature of their avocations. (Ibid. xxx.). We can safely speculate that the list was much longer.
 W i l b u r n | 69

under attack from rebel cavalry and began firing at any horse that came near. During the panicked

frenzy four soldiers had died. Dyer wrote in his journal Dr. Hill, my assistant, was riding by my

side, with his leg shattered just below the knee by a ball.159

Assistant Surgeon John Perrys first assignment in May of 1862 was to operate in Fortress

Monroe, which served as a hospital for the wounded and sick of McClellans Peninsula

Campaign. The wounded who came to Fortress Monroe were not always Federal troops. During

the war, both sides would treat their captured prisoners and Fortress Monroe had a large number

of Confederate captives. Perry was filling up a recently vacated post in the ward. Perry wrote in a

letter to his wife dated May 18th, 1862 about the surgeon who had previously occupied that post.

I hear that the surgeon who served before me, while dressing a [Confederate] soldier's wound,

laid the knife for a moment on the bed. The man seized it and made a lunge at the doctor, but

instead of killing him, as he had intended, only ran it into his arm; whereupon the doctor instantly

shot him.160

Even nurses experienced accidents, some even life threatening. Isabella Fogg, a nurse

from Maine, fell through a hatch on a hospital ship and received life-threatening injuries. Amy

Morris Bradley barely avoided a fatal accident on her last day when the horse pulling her carriage

was spooked by a train whistle. The driver abandoned the rampant carriage, leaving the horse and

Bradley to their fates. Bradley caught the reins and stopped the horse just before going over a

forty-foot cliff. 161 Another frighteningly dangerous aspect of the job was sexual and physical

violence. Schultz argues in Women at the Front that violence was rare among white hospital

workers, but black nurses, taken as contraband of war and working in the hospitals of the Union
159
Dyer. Journal of a Civil War Surgeon. 36-37.
160
Medical personnel were never issued firearms, though they could privately purchase their own. It is curious that a
surgeon would be armed while attending to the wounded in a presumably safe hospital. Perry. Letters form a Surgeon
of the Civil War. 4.
161
Schultz. Women at the Front. 85.
 W i l b u r n | 70

armies in the Deep South, were subjected to rape and beatings. She wrote, Because soldiers

considered white women their enemies and black women their enemies property, they could

transfer their impulse to rape whites onto blacks.162 Despite being the objects of the mens

lustful desires, many blacks continued to work in the hospitals as their livelihoods depended on

it.163

Many surgeons were lucky enough to escape injury or death during battle, though they had

many close calls. These surgeons often wrote in their diaries about being shot at and being

shelled. Francis Wafer, a Canadian surgeon operating in the Union Army for academic credit, had

a close brush with death at Chancellorsville as a shell flew past his head the burning fuze slightly

singeing my left whisker as it passed. 164 Confederate Assistant Surgeon William McPheeters

accompanied his unit into the fray of combat and described the proximity of danger all around

him. But when I had been in the field for some time and seen the shower of the grape and

canister pass thick around me, hearing the whiz of the Mini ball and crash of the cannonball as it

passed, one of which took off a limb165 just over my head.166 When they were not caught in the

cross fire of fighting armies, surgeons often found themselves in the sights of enemy

sharpshooters. Union surgeon William Child wrote The rebel sharpshooters sent some dozen

balls after me yesterday.167

Artillery was mostly used as a weapon of intimidation and long-range attack. Most

artillery pieces had ranges of about one or two miles. They would hurl a several pound ball of

162
Ibid. 93.
163
Ibid.
164
Francis Wafer. A Surgeon in the Army of the Potomac. Ed. Cheryl A. Wells. (Kingston, Can: McGill-Queens
University Press, 2008). 43.
165
Probably just a tree limb.
166
McPheeters. I Acted on Principle. 38.
167
Child. Letters from a Civil War Surgeon. 33.
 W i l b u r n | 71

iron, packed with gunpowder and lead balls over the heads of advancing troops. After a set

amount of time, the shell would explode on one end overhead, showering the balls on the men.

Infantry, however, was not the only target for artillery. Occupied buildings attracted unwanted

attention from batteries, and hospitals (though technically non-combatant) often became targets.

Field hospitals in tents and in buildings, though removed from the front, often received hail

storms of shells. Surgeon William Watson wrote extensively of his experiences under fire.

Watson was forced to operate under intense shelling. He described his experiences in the

Battle of Fredericksburg in a letter to his sisters back home. He recalled the events for them:

Day before yesterday I was under the fire of shells for several hours. I was standing but a few

yards from where Genl. Baynard was shot.168 However, later on, he wrote in his letters that he

had gotten used to it. During the fight there were thousands and thousands of shell thrown. One

soon gets accustomed to them although they make a most frightful and terrific noise.169 Later in

that same letter, he wrote:

The Shell came into the woods pretty thick and all the surgeons not on duty got
out as soon as possible. I must confess I felt a little nervous at first. But knowing it
was my duty to remain until all the wounded were removed I paid no further
attention to them. They did not come any thing like as near and thick as on
Saturday. That was shelling. Generally Division Hospital is not within shot or shell
range. But on this occasion necessity compelled us to establish it on the South side
[of the Rappahannock] and as the enemy were only a mile or so of the river we
were within easy range the entire time.170
Only a few months later in May 1863, Watson survived the Battle of Chancellorsville with

many more close calls. Five to be exact. It was the most frightful shelling ever I was in

To tell the truth I was considerably frightened. It requires a good deal of courage for a

Surgeon to do his duty under such circumstances. I can say with a clear conscience I did

168
Watson. Letters of a Civil War Surgeon. 60.
169
Ibid. 66.
170
Ibid. 66-67.
 W i l b u r n | 72

mine. I dont profess to be very brave but I was always among the last to leave the

Hospital and we were compelled to skedaddle five different times. 171 One can only

imagine the focus required to operate while deadly shells explode all around. Similar

descriptions of battle and not abandoning the wounded are not rare among the works of

other physicians in the war. His account is a testimony to the bravery and courage of

military surgeons.

Harriet Eaton, a nurse in the Union Army, also described the shelling of the

hospitals in Fredericksburg. Saturday, that day of slaughter, we were as near the dreadful

scene as was permitted, near enough to have shells strike the house we were in, tearing off

splinters, one of which fell not far from the spot where Mrs. Fogg was standing. 172

Nurses, like their male associates, continued to serve in the face of adversity.

The Battle of Antietam began in the early morning of September 17th in an area

called the North Woods. As General Joseph Hookers troops attacked from these woods,

advancing south, they came under heavy fire from rebel

artillery on Nicodemus Heights and infantry, belonging to

General Thomas Stonewall Jackson, advancing out of the

West Woods to meet them. The Federal troops injured in these

opening hours were taken to a nearby farmhouse just northeast

of the battlefield. The farm belonged to Samuel Poffenberger.

Clara Barton, the Angel of the Battlefield and later the founder Figure 15: "Clara Barton." The Angel
of the Battlefield, Clara Barton
of the American Red Cross, was assisting in the care and pioneered women's role in military
and emergency medical care.

171
Ibid. 94.
172
Eaton. This Birth Place of Souls. 210.
 W i l b u r n | 73

treatment of hundreds of men. As surgeons amputated on the upper floor of the house

(which received many a stray bullet), Barton tirelessly went from soldier to soldier

administering water, bandages, and comfort. One soldier cried out to her for some water.

She stooped down and took his head in her hands and tilted a tin cup to his lips. Suddenly,

she felt something touch her sleeve and the soldier she was helping flung back out of her

hands, dead. A bullet had passed through her sleeve and into the chest of the man, killing

him instantly. As a reminder, Barton never mended the hole in her sleeve.173

Annie Etheridge was one of the very few female nurses who not only worked in

field hospitals, but also worked on the battlefield itself. Etheridge was noted for her

courage as she scoured the battlefields looking for and treating wounded men missed by

surgeons. Her dress was often pierced by bullets, wrote Mary Holland in Our Army

Nurses: Stories from Women in the Civil War, but she fortunately escaped unhurt except

for a slight wound on the left hand received at Chancellorsville. Etheridge suffered a

similar experience to that of Clara Barton when the soldier she was tending to was

literally torn to pieces by an exploding shell. 174 Juliet Opie Hopkins, nicknamed the

Florence Nightingale of the South, received two bullets to her hip at the Battle of Seven

Pines during the Peninsula Campaign and was left with a permanent limp. Elmina Spencer

also received a battle wound. A ball passed through her sciatic nerve at City Point,

Virginia. Amazingly enough, none of these nurses gave up their work, though wounded.175

Injury and death were very real threats to the medical personnel, though not nearly

as much so as to soldiers. Though, we should remember that military medicine on the

173
Stephen B. Oates. A Woman of Valor: Clara Barton and the Civil War. (New York: Free Press, 1994). 84-85.
174
Mary Holland. Our Army Nurses: Stories from Women in the Civil War. (Roseville, MN: Edinborough Press,
1998). 91.
175
Schultz. Women at the Front. 85.
 W i l b u r n | 74

battlefield, and even off, was never totally safe as many had assumed then and even now.

Long-range artillery bombardments threatened to kill surgeons, nurses, and their wounded

men. Cross fire on the field of battle and sharpshooters claimed the lives of several more.

But not all dangers that faced surgeons were in the form of a conical bullet or exploding

twelve-pound shell.

Capture
On June 17th, 1862 during the Peninsula Campaign, General George B. McClellan and

General Lee came to an agreement regarding the military status of physicians. McClellan had a

week before proposed that surgeons be considered non-combatants. Both commanding generals

issued general orders freeing enemy medical officers currently held. However, several surgeons

came to be captured during the war, and their captors did not always observe such statutes.

Throughout the course of the war, many surgeons were faced with the difficult choice of

staying behind to treat seriously wounded men in the face of an advancing enemy, or leaving

them to avoid capture and thus continue to serve their regiment. Many times they chose the

former. This placed surgeons subject to capture. Some surgeons who accompanied their regiments

into battle were also subject to capture should that regiment be forced to surrender.

Assistant Surgeon Edward H. R. Revere was captured along with his regiment at the

Battle of Balls Bluff on the shores of the Potomac on October 21st, 1861.176 After capture, he was

sent down to the tobacco warehouses in Richmond which served as a hospital, where he was

forced to treat Confederate wounded and possibly Union wounded captured along with him.

176
Dyer. Journal of a Civil War Surgeon. 7.
 W i l b u r n | 75

Surgeon Daniel Holt recorded in a letter to his wife, May 15th 1863, about having been

captured at Chancellorsville. He was ordered to move his hospital as the rebels were advancing

rapidly. Holt, however, was so wrapped up in bandaging the wounds of one soldier, that he left

his hospital too late. As he was maneuvering with his hospital staff through the woods after dark,

he became surrounded by rebels and captured. He and his men were soon relieved of all of their

property and taken under guard into the Confederate camp. Holt was allowed to treat the wounded

Federals of his regiment. The experience of a life time, he wrote, was crowded into these

eventful days: - more of actual labor more of real suffering, bodily and mentally, - more of

positive pleasure mixed up with pain in the discharge of duty.177 Holt was held prisoner for a

period of ten days. Surgeon Holt also barely escaped death while captured. A Confederate soldier,

upon seeing a Federal officer in camp, panicked, leveled his piece against Holts chest and fired.

Lucky for Holt, it was a misfire. Holt reported giving the soldier a strong chastisement.178

The dangers of being a prisoner were dependent on whose side one was fighting for.

Southerners could experience better treatment than Northerners. The Confederate Army could

barely feed and supply its own men, let alone the men of the enemy. As such, captured medical

officers, though held for a short time, could experience a lack of food, exposure to the rampant

diseases, and pitiful conditions in prison camps.

Illness
Disease was not only exclusive to prison camps, but ubiquitous in all Civil War camps and

hospitals, and even in the best kept hospitals. Several diseases, many contagious, faced surgeons

and nurses on a daily basis (See Appendix E for list of common diseases and frequency).

Surgeons at the time had very little understanding in what caused disease. Many failed to wash

177
Holt. A Surgeons Civil War. 94-95.
178
Ibid. 97.
 W i l b u r n | 76

their hands between surgeries of after handling infected wounds and patients, thus passing disease

between patients, and often incurring the diseases, themselves. Some knowingly understood the

risks involved in treating the diseased men and still undertook their duties courageously.

Surgeons were just as likely as soldiers to catch many of the common diseases while on

campaign. The majority of surgeons in the selected sources reported at one time or another

contracting fevers or diarrhea. I have, since that time, had difficulty with my bowels and am to-

day almost entirely used up, wrote Holt on September 25th, 1862.179 Later, in December of that

year, Holt caught yet another illness, this time a respiratory disease. A hard, heavy cough, with

great soreness of lungs and oppression of breathing, with feverish symptims [sic] generally,

followed me for many days.180 Holt also wrote about a fellow surgeon being sent to a general

hospital for illness.181 Daniel Holt developed tuberculosis while in the service and died shortly

after the war in 1868 as a result. Georgian surgeon Spencer Glasgow Welch reported that a

sickness kept him out of his regiment for a week.182 William McPheeters, another Confederate

surgeon, wrote of intermittent fevers plaguing him. Surgeons in the field were probably just as

likely as the soldiers themselves to contract such diseases. Surgeons in quarantine zones and

hospitals, however, faced the greatest risk.

C. Marion Dodson, of St. Michaels, Maryland, enlisted as a Surgeons Steward in the

United States Navy in March of 1864. His first assignment was aboard the U.S.S. Pocahontas

which sailed south down the cost to New Orleans. In October of that year, the U.S.S. Arkansas, a

nearby ship outside New Orleans, raised up the yellow flag, the naval sign for yellow fever

epidemic on board. Thought to be highly contagious at the time, yellow fever as it is now known
179
Ibid. 29.
180
Ibid. 61.
181
Ibid. 62.
182
Welch. A Confederate Surgeons Letters to his Wife. 56.
 W i l b u r n | 77

is transmitted via mosquitoes in tropical locales. The Medical Department knew of no cure. The

captain of the Pocahontas had asked Dodson if he would go aboard as no other surgeons were

willing. Dodson bravely agreed and immediately boarded the quarantined vessel. Thankfully,

Dodson did not contract the deadly disease.183

Others were not so lucky to escape. Hannah Ropes volunteered herself as a nurse in the

Union Hospital in Georgetown in June 1862. Ropes served as the hospitals matron and oversaw

Louisa May Alcott. Ropes service was unfortunately short, just over six months. During her

service, she caught typhoid pneumonia and died in January of 1863.184 Alcott herself developed

the disease only a few weeks after Ropes death and was sent home for a time.185 Confederate

nurse, Kate Cumming wrote in her diary on April 18th, 1862, that one her fellow nurses was

forced to leave. Mrs. Lyons left this morning for home. She was very sick; and one of the

doctors informed her, if she did not leave immediately, she would certainly die.186 Two nuns in a

hospital in Memphis became infected with smallpox and later died. Sister Consolata Conlan, a

twenty-year-old nun from Emmitsburg, Maryland died of disease at Point Lookout and was

buried on site. Oftentimes, the nursing of smallpox patients fell to black nurses. Many of these

nurses lacked immunity and consequently died. 187 Walt Whitman wrote about a nurse in

Annapolis, Miss Billings, who had taken ill and died. She was buried with military honors among

the soldiers she served and was honored with a gun salute.188

183
C. Marion Dodson. Yellow Flag: The Journal of Surgeons Steward C. Marion Dodson. Ed. Charles Albert Earp.
(Baltimore: Maryland Historical Society, 2001). 78-85.
184
Ropes. Civil War Nurse. 42.
185
Schultz. Women at the Front. 86.
186
Kate Cumming. The Journal of a Confederate Nurse. Ed. Richard Harwell. (Baton Rouge: Louisiana State
University Press, 1959). 21.
187
Schultz. Women at the Front. 87.
188
Whitman. Walt Whitmans Civil War. 116.
 W i l b u r n | 78

In some cases, it was not necessarily the diseases that did the most harm, but how the

surgeons treated themselves. A common ailment reported by surgeons in their diaries and letters

was rheumatism, or joint pain. One of the most common treatments was the blue mass or blue

pill, which was mainly comprised of the toxic element mercury. Mercury had been employed as

a pain reliever for centuries and its toxicity was widely unknown. Surgeons regularly carried a

lump of calomel (mercurous chloride) called blue mass and would simply tear off a lump and

either give it to ailing soldiers or themselves rather indiscriminately and liberally. William

McPheeters wrote I took quinine and blue mass, feeling symptoms of intermittent fever.189 In

addition to mercury, another favored pain killer was opiates, usually in the form of morphine or

opium dough. Almost 10 million opium pills were issued in the U.S. Army in addition to another

of other opiate products.190 As David Courtwright wrote in his article on opiate addiction

Another prominent type of addict is the nineteenth century physician who, owing to the ready

availability of morphine and his own fatigue or insomnia, resorted too often to the syringe.191

It is plainly evident that mercury, morphine, and opium were readily available to surgeons

in massive quantities. These surgeons distributed them among their men quite freely and for

almost every ailment. It is safe to say that they probably issued it to themselves in similar

quantities (the real damage of these drugs, though, is in the treatment of chronic illness in which

the dosage is prolonged). Surgeons privileged access to these pills combined with their liberal

prescription of it, constituted yet another danger for them. However, without access to post-war

information of surgeons, pension files, or records, I am unable to even speculate if there actually

were any cases of addiction to opiates or long-term illness due to mercury. Lastly, prolonged

189
McPheeters. I Acted on Principle. 41.
190
David Courtwright. Opiate Addiction as a Consequence of the Civil War. Civil War History 24. No. 2. 1978.
107.
191
Ibid. 111.
 W i l b u r n | 79

exposure to chloroform fumes can produce liver and kidney damage. While this was also a very

possible risk for surgeons it is impossible to say with even the remotest certainty whether any

cases of this ever happened as there is no evidence.

How did the risks military service presented differ for soldiers and their caregivers? The

soldiers of the Civil War were constantly exposed to danger in the form of bullet and bacteria.

Though often forgotten, their physicians likewise faced many of the same threats, though to a

somewhat lesser degree. Soldiers and assistant surgeons both took part in dangerous affairs of

battle. The soldier, though, stuck in formation, carrying out attacks, and defending positions, was

at greater risk of being shot. Surgeons and nurses, behind the lines in hospitals, were targets of

imprecise artillery fire. Soldiers, on the other hand, were much more likely to be killed or

wounded from slightly more accurate artillery fire. In regards to capture, soldiers suffered much

more than their physicians. Surgeons and nurses could expect to be freed, whereas soldiers would

linger and suffer from malnourishment and illness. Both though were very likely to contract

disease, though the type of disease is different. Dysentery persecuted everyone, though infectious

diseases like gangrene and staphylococcus were limited to those with open wounds. Surgeons and

nurses, not being as likely to undergo surgeries themselves, were thus less likely to contract those

diseases which plagued wounded men. However, being constantly surrounded by the more

chronic and contagious illnesses, were more likely to contract diseases like tuberculosis and

typhoid.

The position of surgeon was not one of relative safety as we have seen. Bullets, shells,

disease, and drugs threatened physicians just as they did soldiers. Surgeons and nurses, despite

being non-combatants faced the dangers of the battlefield. Surgeons and nurses in hospital wards

selflessly exposed themselves to contagious disease. They also, unfortunately, contributed to their
 W i l b u r n | 80

own physical dangers by prescribing themselves toxic drugs. Despite these dangers, though, the

physicians continued to provide their services to the wounded and sick.

 W i l b u r n | 81

Nostalgia in Civil War Surgeons and Nurses

My thoughts often, very often recur, to my dear wife and children. Oh how I long to be with them.
William McPheeters, Confederate Surgeon.192

There is no place like home. 193 These words from the popular wartime song Home!

Sweet Home! truly capture the feelings of the Civil War soldiers and officers. A longing for home

was both a blessing and a curse for those who served. Thoughts of home brought forth pleasant

memories of family and comforts far away and peacetime memories long passed. But they could

also bring on nostalgia, a debilitating longing for home that could cripple a soldier. Nostalgia and

homesickness, as for the soldiers, was a very real trial for the surgeons and nurses. This section

will explain what nostalgia is, how it affected medical personnel, and how they coped with and

managed their longing for home and family.

Importance of Home in Victorian Culture

To understand the meaning and impact nostalgia had on its victims, an understanding of

the cultural value of the home itself is vital. Home held a high level of importance in the lives and

culture of mid-nineteenth century Americans. Home was the center of the family, the center of

life, the center of ones self. Home was, before the war, where you were born, lived, and died. In

the words of historian, David Anderson, Home is, and means, so much more than any particular

place; home is a conglomeration of memories and senses, it is the knowledge and familiarity of

locale; home articulates belonging and our feelings toward its setting and surroundings proffers

comfort and assurance. 194 Home represented much more than a physical place. To it was

attached sentimental memories of childhood and family, small familiar comforts, and simple

pleasures.

192
McPheeters. I Acted on Principle. 107.
193
John Howard Payne. Home! Sweet Home! 1822.
194
David Anderson. Dying of Nostalgia: Homesickness in the Union Army during the Civil War. The Journal of
Civil War History 56, no. 3. (2010): 5.
 W i l b u r n | 82

The Civil War compelled millions of Americans to leave their homes and families to serve

their causes. The Civil War was fought in 10,000 locations by three million men, from the forests

in Tennessee and the hills at Gettysburg, to the banks of the Mississippi and the waters off the

east coast; many men who had never went more than twenty miles from home found themselves

hundreds of miles away. Soldiers left their wives and sweethearts, mothers and fathers, sisters and

brothers, and sons and daughters for what they considered a glorious cause. A week before the

First Battle of Manassas, Sullivan Ballou, an officer in the 2nd Rhode Island Infantry, wrote home

to his wife describing his love for her and his country. Sarah, my love for you is deathless, it

seems to bind me to you with mighty cables that nothing but Omnipotence could break; and yet

my love of Country comes over me like a strong wind and bears me irresistibly on with all these

chains to the battlefield.195 For some soldiers, family members went with them to war. Generals

were sometimes granted the luxury of having family in camp. Brothers, fathers, and sons often

times enlisted together. But many men still found themselves alone in a crowd, far from

everything they held dear. Being suddenly uprooted from their familiar ways of life and being

replanted in a vastly different society in a vastly different place, in even a vastly different culture,

many soldiers found the shock too unbearable and succumbed to nostalgia.

As historian Frances Clarke illustrates, the issue of nostalgia and other emotional stresses

of the Civil War have only been recently addressed in the past few decades. However, historians

have looked at nostalgia with a lens fogged up by twentieth century thought. Many saw nostalgia

simply as a Victorian precursor to Post-Traumatic Stress Disorder. However, nostalgia and war

trauma are vastly different. The focus of war trauma is on battlefield events experienced or

witnessed, whereas nostalgia is a separation from family and home creating emotional distress.

195
Sullivan Ballou. Historical Document: Sullivan Ballou Letter. PBS.
http://www.pbs.org/civilwar/war/ballou_letter.html
 W i l b u r n | 83

Nostalgia in this study must therefore be seen as the latter. This section intends to show that

nostalgia was among the many trials soldiers, as well as surgeon and nurses, dealt with off the

battlefield.196

Nostalgia as a Clinical Disorder

What exactly is nostalgia? When we hear nostalgia in our modern discourse, we assume it

to mean merely a feeling or emotion of missing something long past or out of reach. However, in

Victorian discourse, it held a much stronger meaning. Nostalgia was not only an emotion, but also

regarded as a medical ailment that in extreme cases could be fatal. When dealing with emotions in

history, one must bear in mind that the feelings themselves are transcendental and ubiquitous.

However, the perception, reception, and expression of the emotions in question change with

respects to the society and era being analyzed. Nostalgia, a term coined in 1688 by Johannes

Hofer, a Swiss doctor, literally meant a painful yearning to return home (Greek nostos meaning a

yearning to return home and algos meaning pain). It was noted chiefly in seventeenth century

Swiss mercenaries fighting for the French king. Hofer described it as, continuous vibration of

animal spirits through those fibers of the middle brain in which impressed traces of ideas of the

Fatherland still cling.197 By the nineteenth century, nostalgia grew from being a Swiss-disease

to being understood as an emotional and psychological disease that knew no distinctions or

boundaries of class, race, or region.198

Nostalgia was characterized by a deep melancholy, sadness, sleep difficulties, poor or

fluctuating appetite, heart palpitations, impaired senses, and a slow mind. In addition to reducing

motivation and basic functionality in soldiers, it also had a tendency to aggravate whatever other

196
Frances Clarke. So Lonesome I Could Die: Nostalgia and Debates over Emotional Control in the Civil War
North. Journal of Social History 41, no. 2. (2007): 254.
197
Johannes Hofer. Medical Dissertation on Nostalgia by Johannes Hofer, 1688, Trans. Carolyn Kiser Anspach.
Bulletin of the Institute of the History of Medicine 2. (1934): 384.
198
Anderson. Dying of Nostalgia, 253-256.
 W i l b u r n | 84

diseases were ailing them at the time. And in armies where disease ran rampant, nostalgia could

prove fatal.199 However, the question of how to treat nostalgia hovered perpetually in the minds of

surgeons. There were two remedies to nostalgia: keeping the soldiers constantly busy so thoughts

of home do not creep into their minds, and giving the men furloughs.200

Nostalgia did receive some mention from the Medical and Surgical History of the War of

Rebellion composed in the decade following the war. The tables presented in the massive work

show nostalgia among both blacks and whites in the Union Army. Nostalgia cases in whites rose

sharply in between 1862 and 1863 from 572 to 2057. For blacks, the table begins in 1864 where

the number is 136 and declines steadily. While 1863 had the highest number of cases reported,

1864 saw the highest number of deaths attributed to nostalgia. Another interesting statistic is that

there were 11.1 deaths per thousand cases of nostalgia among whites, compared to 47.9 deaths per

thousand cases among blacks. The actual number is lower, owing to the fewer number of blacks

in the military and their late enlistment. However, the higher mortality rate was attributed to

blacks lack of will and endurance to fight such psychological ailments. What the tables do not

show are the number of deaths whose cause was nostalgia-aggravated disease. Many who

suffered from nostalgia forsook food, exercise, sleep, and human interaction which would only

increase risk to death by disease. It is possible that many who succumbed to typhoid fever,

dysentery, pneumonia, and malaria simply lacked the will to fight it. Nor do these tables show

nostalgia in the Confederate Army. It is unknown whether such data even existed as the

Confederate medical archives were burned in the Richmond fire of 1865. It may be safe to say

that nostalgia affected both Union and Confederate to the same degree. So while these tables do

199
Clarke. So Lonesome I Could Die 253.
200
Ibid. 255.
 W i l b u r n | 85

not show us the whole picture nostalgia in the Union Army, we can at least see a small portion of

nostalgias deadly impact.

Table 4: Nostalgia Cases in Whites in the Union Army201

Year Cases Deaths Deaths per thousand
May-June, 1861 65 0 1.56
June 30, 1862 572 1 2.05
June 30, 1863 2057 12 3.35
June 30, 1864 1212 16 1.96
June 30, 1865 1110 24 1.91
June 30, 1866 197 5 1.99

Table 5: Nostalgia Cases among Blacks in the Union Army202

Year Cases Deaths Deaths per thousand
June 30, 1864 146 9 3.32
June 30, 1865 135 5 1.62
June 30, 1866 53 2 .96

Nostalgia was considered a disease, but homesickness, on the other hand, could be seen as

beneficial. An important distinction to note here is that nostalgia is merely an extreme form of

homesickness. Homesickness itself is not necessarily debilitating, but in many cases could prove

to be highly motivational. In many cases, soldiers, officers, surgeons, and nurses thought of home

to keep themselves going. Invoking memories of home could bring on mingled feelings of

pleasure and pain, but also served as a reference point, a constant in an environment of change.

Soldiers and officers kept keepsakes, mementoes, and portraits, reminding them of their families

and loved ones. They sang songs reminiscent of home, such as Home! Sweet Home! and When

Johnny Comes Marching Home.

Managing the fine balance between homesickness and nostalgia required strong willpower

and emotional control, a trait commonly attributed to manliness in the Victorian era. To think of

home, but not to dwell on it was the true test of willpower, the real trial in a soldiers life.

201
Barnes, Medical and Surgical History. Volume 1, 1:63839.
202
Ibid. Volume 1, 1:711.
 W i l b u r n | 86

Referring back to the cases among blacks and whites, the higher documented cases among blacks

was attributed to the product of slavery. Slavery diminished a persons self-control, thus rendering

them helpless in the face of nostalgia.203

Nostalgia in Medical Personnel

Having analyzed the views about nostalgia as a medical condition among the soldiers, we

now turn our attention to the medical personnel of the war. Medical personnel, like the soldiers

they cared for, likewise found themselves hundreds of miles from hearth and home. They too left

behind their husbands and wives, sons and daughters. Confederate surgeon Spencer Glasgow

Welch left his home and new family, his newlywed wife and newborn son in Georgia, to treat

men hundreds of miles away in Virginia, Maryland, and Pennsylvania. Daniel Holt left his wife in

New York to serve in the same theatre. Ada Bacot left her home in South Carolina to work in the

Confederate hospital in Charlottesville, Virginia. Like their patients and compatriots, they enlisted

often not knowing exactly what life in the Medical Corps would entail.

Homesickness was of course present in their writings, though to various degrees.

References to homesickness took the form of pining for family, comforts of home, letters and

news from the home front, and feelings of loneliness and melancholy. Thoughts of loneliness and

homesickness often set in during idle hours. In fact, surgeon John Perry likened feelings of

homesickness to being as common in this dull life as to see the stars in the sky.204

Oftentimes, surgeons wrote about feeling a particular kind of loneliness. Despite being

surrounded by hundreds of other men, surgeons reported feeling completely alone. It is a kind of

loneliness that grips the soul in the idle hours of the day, or late at night. Daniel Holt described

this kind of loneliness to his wife in almost poetic terms:

203
Clarke. So Lonesome I Could Die, 257.
204
Ibid. 164.
 W i l b u r n | 87

Upon rising in the morning with the first faint streak of day in the East, with no
fire to warm or shelter of any kind to cover you, one feels a particular sadness such
as I have never felt before. He feelsamid the din and turmoil of war, he is alone
alone as he is in the streets of a crowded city with its tens of thousands of human
faces none familiar all strange all alike none caring or thinking of you
none to heave a sigh of pity or sympathy, ache the heart ever so acutely.205

This loneliness, this feeling of separation was what could drive someone to lose all motivation.

Holt, though feeling the loneliness of nostalgia, never succumbed to its crippling power, though

many times he was tempted. John Perry similarly wrote of an experience of being lonely yet

surrounded by people. Last night the brigade band serenaded us, and our room was so filled with

generals and subordinate officers that some of us sat on the floor . . . In all this stir and excitement

I listened to the conversation about me, saying little; so much of me was far away, wishing, as I

always do wish at some times, that I were not alone.206

Frequently surgeons and nurses wrote about a desire to come home and see loved ones.

William McPheeters journal was more filled with these kinds of remarks than any other source.

Daniel Holt frequently mentioned his desire to come home. He wrote to his wife, I feel like

resigning my commission and coming home.207 However, a sense of duty to and compassion for

the welfare of his men urged him to stay. William McPheeters wrote on January 19th, 1864, The

moon shines beautifully tonight creating in me a strong desire to be at home with my family.208

The lonely, quiet hours of the night could leave men with nothing to do but think of home, which

in turn only brought on sadness. J. Franklin Dyer recorded in his diary, I hope to get home again

and live like a reasonable being once more. Not that I am played out or any thing of the kind, for

I have been at my post at all times and have done my duty, but there is a craving for home and

205
Holt. A Surgeons Civil War. 29.
206
Perry. Letters from a Surgeon of the Civil War. 29-30.
207
Holt. A Surgeons Civil War. 32.
208
McPheeters. I Acted on Principle. 99.
 W i l b u r n | 88

society.209 Only a few days away from home, John Perry felt homesick in the middle of the night

while on a south bound steamer. I have felt dazed and benumbed since my arrival here, probably

from the effort I made before leaving home to suppress all gathering emotions. On the Sound boat

I gave way, and I confess to behaving as I did when a child for the first time away from home. I

cried as I did then all night long.210 This was a homesickness powerful enough to compel a

grown man to cry.

Homesickness was exacerbated on holidays. Birthdays, anniversaries, Thanksgiving,

Christmas, and New Years Day reminded surgeons of previous years when those days were spent

in the company of loved ones in the comfort of home. For William McPheeters, Christmas Eve

was particularly painful since he had in July heard news of the death of his son. Christmas Eve

would God that I were home with my family tonight. The return of this anniversary brings sad

reflections Death has entered the home circle since last Christmas and my first born is no more;

God bless his mother and the remaining children. May they be happy though we are separated and

I a wanderer and a refugee living in a tent, but I repine not.211 Being removed from home and

family was made even more painful if death or tragedy struck the family. It made the feeling of

absence even worse. In This Republic of Suffering, Faust makes a point that the ars moriendi

(Latin for the art of dying) called for family to observe and witness a loved ones final

moments. The war forced many to be absent from the deaths of family let behind. Earlier in 1863

McPheeters wrote in his diary, The account of the death of poor George fills me with

irrepressible sadness. 212 Spencer Glasgow Welch received a letter every father dreads in

December 1863 just days after his sons second birthday. He responded to it, My appetite was

209
Dyer. The Journal of a Civil War Surgeon. 48.
210
Perry. Letters of a Surgeon of the Civil War. 21-22.
211
212
McPheeters. I Acted on Principle. 51.
 W i l b u r n | 89

gone for the death of our dear little George, together with parting from you in such deep grief,

made me sadder than I ever felt before in all my life.213 Being far from home and family wracked

surgeons and soldiers alike with loneliness, nostalgia, and grief. But through it all they managed

to persevere.

These feelings of nostalgia were felt by nearly everyone on both sides of the conflict.

However, the vast majority of them managed their feelings through various means, as they

recognized their duty to their respective causes commanded that they sacrifice their connections

to home. Nostalgia, while relatively rare in its extreme cases, was very much a real struggle for all

who served, not just the soldiers. This disease never progressed to the fatal stage in medical

personnel insofar as we know. So while no surgeon or nurse died from it, that is not to say they

did not feel the effects of nostalgia. It was felt to varying degrees by surgeons and nurses and of

the surgeons and nurses observed, each showed great control in the face of this debilitating

mindset. Loneliness, death, being far from loved ones and home comforts tempted them to give

up, but they found within them the courage to keep going, using their desires for home as a

motivator rather than a de-motivator. This should act as a testament to the bravery and courage of

the medical personnel in the war.

213
Welch. Confederate Surgeons Letters. 84.
 W i l b u r n | 90

Coping
I will take care of myself as well as I can and when I am unable to stand it any longer, some kind of hand I
hope will provide for me: at any rate, I feel confident that He who has so gently dealt with me, will
continue to shield and protect me. I have firm and unshaken confidence in my Savior. Daniel M. Holt,
Union Surgeon.214

Surgeons and nurses, as we have just seen, endured countless trials of the mind and body.

And somehow, despite these challenges, they made it through the war. What exactly was it that

kept them going through all the hell of war? From where did they draw motivation, how did they

vent their feelings, and how did they relax amidst the toils of war? These are just some of the

questions we are left asking ourselves after seeing the extent of their experiences.

The physicians methods of coping and motivation are in many respects identical to those

of the soldiers and officers. Many staved off nostalgia by writing home and found inspiration in

family. For others, a sense of duty to their country and to their men compelled them to continue.

Still others found solace in their faith. Some vented their experiences through expression in

writing journals. Several surgeons and nurses note the power of music and good company in

forgetting the war for a time. And several others, sadly, turned towards alcohol as a means of

coping.

Writing and Family

For many surgeons and nurses, the mere act of writing came to be a therapeutic and

expressive coping mechanism. These expressive writings took the form of letters, journal entries,

and even poetry. The writing allowed them to narrate the traumatic events and express their

emotional responses. Additionally, those who wrote letters to friends and family benefitted from

the supportive connection they maintained through their writing. Recently, writing as therapy has

214
Holt. A Surgeons Civil War. 33.
 W i l b u r n | 91

been studied and has been found to be beneficial not only to ones psychological well-being, but

also to physical health.

In an age before instant communication, letters served as the only means of staying

connected with friends and family back home. As such a whole culture grew up around the art of

letter-writing; a culture with its own rules, values, and etiquette laws. Letter-writing was, in a

way, a ritual. Writing home was by far one of the most common ways soldiers, surgeons, and

nurses kept their sanity and kept the feelings of nostalgia at bay. For the surgeons and nurses who

found themselves hundreds of miles from home, family, and their old way of life, letters offered a

way of connecting to these and pushing off the feelings of loneliness and despair. Letters also

acted as an expressive outlet in which the authors described traumatic events, feelings, and

reached out for support.

Letter-writing was not just a way of staying up to date with the latest goings-on in the

household or on the battlefield, but helped the writer stay connected to the family and home he

left behind. It is common to find in the letters small anecdotes and accounts of trivial events.

Within the home setting it is common for people to share their days with their families, expressing

every little thing that happened. For when people are in constant contact, these trivial experiences

are the only news. When people do not communicate for a prolonged period of time, the focus of

the communication is on big events only. Therefore, it would seem that the surgeons and nurses

write incessantly on their everyday events in an effort to make it as if they had never left, to keep

that connection as strong as it previously was.

Confederate Surgeon Spencer Glasgow Welch wrote to his wife how dearly he wanted to

hear the small stories. When you write again, tell me all the little particulars about yourself. You
 W i l b u r n | 92

do not know how much it interests me.215 Welch had not only left behind a wife, but also his

infant son, George. Being away to war robbed Welch of fulfilling his fatherly role in his sons

life. Not wanting to miss out on his son growing up and fearing a loss of connection he wrote his

wife, When you write tell me all the little particulars about George. I dreamed last night of being

at home, but thought he would have nothing to do with me and treated me like an entire

stranger.216

Surgeons and nurses wrote as often as their circumstances allowed them to. Welch and

Perry both tried to write every day or at least a few times a week but marches and battles often

interrupted or stole their free time, or left them too exhausted to write. I have not had a moment

to write for nearly a week. It has been fight, fight, fight. Every day there is a fight and every day

the hospital is filled again.217 On May 7th, 1863, following the Battle of Chancellorsville, Welch

wrote one of his shortest letters, closing it My mind and body are so worn out that I will not

write any more.218 When surgeons did write, their letters could be quite long, taking up multiple

pieces of paper. It was in these long letters, they vented about their experiences. Daniel M. Holts

letters display a large amount of emotional catharsis. His letters are filled with accounts and

reflections filled with emotions. For Holt letter-writing served as therapy. He apologized to his

wife I hope you will excuse the many senseless letters which I send you but I must let off a

surplus of gas or an explosion will result.219 William McPheeters wrote in his journal, It is a

pleasure to write to her [his wife] and would be more so if I could only write unashamedly.220

215
Welch. A Confederate Surgeons Letters to his Wife. 101.
216
Ibid. 44.
217
Perry. Letters of a Surgeon of the Civil War. 187.
218
Welch. A Confederate Surgeons Letters to his Wife. 49.
219
Holt. A Surgeons Civil War. 67
220
McPheeters. I Acted on Principle. 98.
 W i l b u r n | 93

Letters also served as a venting tool for Walt Whitman. Whitman, a famous poet, had a

strong command of the English language and in his letters to his mother, even in his private

journal entries, he demonstrate his eloquence. Whitman used this eloquence to convey and

express his deepest emotions concerning the war and the scenes that met his eyes. While many

others do not openly admit this in their writings, it is evident in the subject and voice of their

letters that they find comfort in venting in their letters.

During the Victorian Age, keeping a journal was a very common practice among men and

women alike. Some journals were large, blank books in which the authors allowed their thoughts

to flow freely onto the pages. Other journals had the dates written in and provided a few lines on

which the authors wrote a sentence or two about their day. These journals were kept for a number

of reasons. For some it was a record of their doings and role in the war. For others it served as an

expressive outlet.

Walt Whitman was a poet long before the start of the war and during his service in the

field hospitals. He composed several poems about the sights he saw and his surroundings. In the

poem A Sight in Camp in the Daybreak Grey and Dim Whitman reflected about coming across

three dead soldiers awaiting internment. The speaker of the poem lifts the blankets shrouding their

faces and ponders on the identities and lives of the men.

A sight in camp in the daybreak gray and dim, / As from my tent I emerge so
early sleepless, / As slow I walk in the cool fresh air the path near by the hospital
tent, / Three forms I see on stretchers lying, brought out there untended lying, /
Over each the blanket spread, ample brownish woolen blanket, / Gray and heavy
blanket, folding, covering all. / Curious I halt and silent stand, / Then with light
fingers I from the face of the nearest the first just lift the blanket; / Who are you
elderly man so gaunt and grim, with well-gray'd hair, and flesh all sunken about
the eyes? / Who are you my dear comrade? / Then to the second I step- and who
are you my child and darling? / Who are you sweet boy with cheeks yet looming?
/ Then to the third- a face nor child nor old, very calm, as of beautiful yellow-
 W i l b u r n | 94

white ivory; / Young man I think I know you- I think this face is the face of the
Christ himself, / Dead and divine and brother of all, and here again he lies.221

In this poem, Whitman laments over the unknown dead. The three bodies represent to Whitman,

that everyone is a victim of war; the old, the young, and those in between. Whitman was also

deeply perturbed by the unknown dead. To die unknown and forgotten was a taboo among the

people of nineteenth century America. Whitman shared this view and expressed frequently in his

poems pity and sorrow for the unknown soldier. In the poem A Twilight Song, the speaker

reflects on the unnamed dead. The poem, Whitman wrote, served as a memorial requiem for the

unknown soldiers, both North and South.

As I sit in twilight late alone by the flickering oak-flame, / Musing on long past
war scenes of the countless buried unknown soldiers, . . . You million unwrit
names all, all you dark bequest from all the war, / A special verse for you a
flash of duty long neglected your mystic roll strangely gatherd here, / Each
name recalld by me from out the darkness and deaths ashes, / Henceforth to be,
deep, deep within my heart recording, for many a future year, or North or South, /
Embalmd with love in this twilight song.222
Another of Whitmans poems suggests that the visions of the battlefield may have come to haunt

his dreams. Whitman wrote in Old War Dreams of many a face of anguish, / Of the look at

first of the mortally wounded, (of the indescribable look,) / Of the dead on their backs with arms

extended wide, / I dream, I dream, I dream.223 Whitman expressed his traumatic experiences and

his troubling emotions through his poetry. Whitman, being a nurse, saw many of the mortally

wounded, of their indescribable look. The scenes of the battlefield and the hospital composed his

dreams. Whitman found solace in his poetry.

221
Whitman. A Sight in Camp in the Daybreak Grey and Dim. Walt Whitmans Civil War. 48.
222
Ibid. 26.
223
Ibid. 325.
 W i l b u r n | 95

Writing is, in fact, therapeutic. Recent studies analyzing writing therapy have shown a

connection between expressive writing and an increase in emotional and physical health. Karen

Baikie and Kay Wilhelm compiled modern psychiatric research on the therapeutic benefits of

writing. They concluded through their research that expressive writing (defined as writing

emotionally about past traumatic experiences) resulted in better long-term psychological and

physical health. However, they noted that symptoms of distress increased marginally immediately

after writing, but subsided and gave way to better overall health in the long run. They endeavored

to discover the mechanisms of therapeutic writing and found numerous factors contributing to its

success. They wrote that merely writing about emotion responses to trauma were not as helpful as

writing about both the event and the response. In the case of the Civil War surgeons and nurses,

they wrote about both. Therefore, there is a chance that their writing was therapeutic partially due

to emotional catharsis (i.e. venting). A second mechanism was that writing removed inhibitions

which served as stressors. The authors of the article, however, claimed this was only a small

factor. A third likely mechanism was that composing a cognitive narrative of the traumatic events

helped to reorganize and structure traumatic memories, resulting in more adaptive internal

schemas.224 The authors conclude that the immediate and long-effects of expressive writing are a

complex combination of the various mechanisms.

These are, however, modern studies conducted in and out of laboratories. Therefore, we

must tread carefully in applying them to the surgeons and nurses of the past. It is impossible to

say whether their expressive writings had the positive emotional health benefits without actually

examine these long-dead medical personnel. We can only speculate that through repetitive writing

of their experiences they coped better.

224
Karen Baikie and Kay Wilhem. Emotional and Physical Health Benefits of Expressive Writing. Advances in
Psychiatric Treatment 11. (2005): 342.
 W i l b u r n | 96

What these studies do not analyze is the supportive effect of expressive writing to family

members and hearing back from them. Family was a strong motivator during the war for many a

surgeon and soldier. Just as important of writing letters was receiving them. Unfortunately during

the war, the postal services of both sides were notoriously unreliable, slow, and expensive.

Consequently, mail was often lost or delayed. Watson expressed his distress at not hearing from

home. To days mail in and no letter for me. I cant tell you how much I am disappointed. What

is the reason I dont hear from you? 225 Spencer Glasgow Welch felt a sense of relief and

satisfaction knowing his family was well and safe. He wrote to his wife that I never get

homesick in camp when I hear you and George are well.226 He later wrote I am very anxious to

get a long letter from you giving me all the news. When I can hear from you regularly and know

that you are safe and well, I feel satisfied.227

Hearing that his son was safe was a relief for Welch, and for many

other surgeons and nurses their children were sources of inspiration and

motivation. Confederate surgeon Harvey Black wrote of his family to his

wife I dont think I would be half so good a soldier if I did not have so
Figure 16: "George Welch."
many little fellows to fight for.228 Surgeon Welch told his wife, I have This was the picture of his
infant son Spencer Welch
Georges picture with me and I look at it frequently. 229 Union nurse carried with him.

Harriet Eaton so missed her child that when she received a picture, The sight of that little face

completely overcame me, and what with Franks letter, I could not help having a good crying

225
Watson. Letters of a Civil War Surgeon. 21.
226
Welch. A Confederate Surgeons Letters to his Wife. 34.
227
Ibid. 105.
228
Black. The Civil War Letters of Dr. Harvey Black. 27.
229
Welch. A Confederate Surgeons Letters to his Wife. 59.
 W i l b u r n | 97

spell. This sweet picture, I kissed it again and again. 230 William McPheeters had a similar

experience:

She gave me the photographic likenesses of my two children, dear Maggie and
Sally, and the ambrotype of my beloved wife all good. What a pleasure it is to
look upon their beloved faces. As I gaze on them, memory brings back my once
happy home and all the endearments I have left behind to engage in the glorious
cause of Southern independence. It is a pleasure to see their faces in paper and
steel as I am denied the greater pleasure of being with them, but trusting in the
goodness and mercy of God I hope ere long to be again reunited to them.231
Surgeons and nurses felt inspiration and motivation from their families, but they also found

motivation in fighting for bigger families: their country and their men.

Patriotism and Duty

A sense of duty called the men and women of the medical departments from their homes

to the battlefront far away. It was this strong notion of duty and honor so common and revered in

the Victorian era that compelled them to stay when the going got rough. As the war progressed,

things began to look bleak for both sides, especially during 1863 and 1864. When in doubt of

their cause, the surgeons and nurses turned to their very patients and the duty they owed them for

motivation.

Patriotism was a strong feeling that permeated all of nineteenth century America. Many

surgeons felt it their duty to offer their medical skills for the companies of their states. Female

nurses, unable to serve in the ranks (though a few did) took up nursing to lend their help to the

war effort. The feelings of patriotism were probably stronger in the South, as they were fighting

for independence and what they understood to be tyranny. For the Federals, the desire to preserve

the Union was the primary motivator. Confederate Surgeon Harvey Black passionately and

optimistically spoke of his new nation. With our just cause we feel that victory is sure, he
230
Eaton. This Birth Place of Souls. 106.
231
McPheeters. I Acted on Principle. 114.
 W i l b u r n | 98

proclaimed.232 In 1862, he wrote, whip them we can and whip them we will.233Even defeats did

not dampen his patriotism. When New Orleans fell he wrote it was another serious blow to us,

but one that can be recovered from.234 His undying faith served to push him through the war.

Daniel Holt was motivated largely by a sense of honor. I believe, if I know myself, that if

demanded and necessary, I am willing to die here in the discharge of duty. I am fully aware that it

is very easy to sit here and write what you are willing to do, when no danger threatens you, but

when actual jeopardy encircles you to shrink back and skulk behind anything affording shelterI

believe as I have said235 William McPheeters also shared a similar sentiment. Our cause is just

and I have no regrets for my course though it may cost me the loss of all my earthly possessions,

he wrote on Christmas Eve in 1863.236 Daniel Holt admitted that duty to his nation was one of the

many factors keeping him from resigning. Were it not that duty calls me here I think I should not

remain for pleasure or comfort.237 Ada Bacot likewise expressed similar thoughts. I am willing

to stay if I realy [sic] can be of use, I am very much troubles about it some times, I realy want to

go home very much but if duty requires me here I will sacrifice any private feeling and stay.238

For Ada Bacot, the sight of the men caused her patriotism to temporarily waiver. The

more I see of the suffering of our brave men the more wicked & unrighteous I feel the war to

be.239 Some of the surgeons and nurses began to feel a higher calling to serve than men than their

country. Holt wrote, I feel like resigning my commission and coming home: but then I think they

232
Black. The Civil War Letters of Dr. Harvey Black. 52.
233
Ibid. 33.
234
Ibid. 29.
235
Holt. A Surgeons Civil War. 83.
236
McPheeters. I Acted on Principle. 93.
237
Holt. A Surgeons Civil War. 47.
238
Bacot. A Confederate Nurse. 132.
239
Ibid.
 W i l b u r n | 99

would perhaps fare worse and it is my duty to stay.240 When looking back on their jobs, beyond

the sufferings and gory sights, looking at the work they had done, nurses and surgeons felt a sense

of pride. Daniel Holt felt joy in the work he performed for his men who needed him so

desperately. As I took the hands of our men and felt the grip of real pleasure at seeing me, I

thought how much good one man can do when so disposed and how much real comfort one poor

soul can yield anotherhere I renewed my covenant to God that I would do all in my power to

give relief, and solace the pillow of death: and it was needed.241 Harriet Eaton found satisfaction

in the work she did and the help she provided and this may have helped to continue on. I have

enjoyed myself very much in working for this Hos., she wrote, And I believe I have done the

men some good.242 Duty to their country and their men drove their efforts and gave them reason,

but when the going really got rough, when all hope seemed to vanish and their strength began to

wane, who did they turn to? God.

Religion
Most nineteenth century Americans were devoutly Protestant. Religion was practiced on a

much wider scale and much more openly than in this modern, secular age. The journal of Ada

Bacot, the letters of William McPheeters and Daniel Holt display numerous references to God and

religion and are filled with small prayers.

William McPheeters was greatly motivated and inspired by his religion. A staunch

Protestant, he found solace in attending church as often as he could. Unfortunately,

circumstances being as they were, church every Sunday was not a reality. Many weeks he pined

over not being able to attend church. It constituted an important part of his life. Sunday services

240
Holt. A Surgeons Civil War. 47.
241
Ibid. 95.
242
Eaton. This Birth Place of Souls. 95.
 W i l b u r n | 100

served as something to look forward to when they were available. It is a treat to go to church

and to worship God in these times of trouble and wickedness.243 Again he wrote, Thank God

for the Sabbath and the sanctuary.244 McPheeters, a

deeply religious man, shared his faith with his

patients. On one occasion, one of his dying patients

requested a minister, but there being none available

McPheeters read him passages from the Scriptures

Figure 17: "Sunday Morning Mass at Camp Cass." and tried to point him to the Lamb of God as best I
Religion was an important for morale during the war.
Chaplains were assigned to regiments to perform
services like this one. could.245

As we have seen earlier, Ada Bacot cared desperately for the spiritual well-being as well

as physical of the men under her care. In the case with Lt. Montgomery, she tried to save his soul

before he died, but all in vain. Religion was a major theme in her diary. As a practicing

Episcopalian, Bacot sought strength and endurance through church and prayers. Her diary is filled

with small prayers for patience. Faith in almight[y] God who has never yet forsaken the

oppressed makes me more at ease than I would otherwise be.246 Bacot credited her ability to go

nursing as divine will. She also trusted in God for the salvation of the Confederacy. I know if we

trust in God & not in our own strength that we will yet turn the enemy to flight.247 Everything

she did, every good thing that happened she thanked God. Every trial and tribulation she

acknowledged as Gods Divine Will to teach her patience and trust.

243
Ibid. 68.
244
Ibid. 80.
245
McPheeters. I Acted on Principle. 43.
246
Bacot. A Confederate Nurse. 19.
247
Ibid. 55.
 W i l b u r n | 101

Holts letters and journal similarly are filled with remarks to God, biblical references and

small prayers. The word God appears dozens of times in his journal and letters. One biblical

reference he made occurred after the death of a patient. He is borne on Angels wings to join his

God in glory. It is, and must be, hard to thus dispose of a fellow mortal, yet dust must return to

dust ashes to ashes. 248 In the same letter he makes another. A soldier claimed all the

accoutrements of a deserter, but Holt required the soldier to turn all the things over, upon which,

like the rich man who went away sorrowful when the Lord touched his riches, he turned and

grieved. 249 His journal and letters are filled with Thank God and God bless. He prayed

frequently for an end to the war and believed it his divine duty to serve the men of his regiment.

Religion, in times of difficulty, answers the great questions of life and helps one cope with

traumatic events. If one believes that bad things happen to good people for a reason, unknown to

them, and trust that in the end all things will work out for the better, it makes perseverance much

easier. But religion was not just a coping mechanism, it was a way of life; a way of life that

happened to be a coping mechanism.

All of these factors combined formed the coping mechanisms the surgeons and nurses

used to see themselves through the war. Expressive writing in the forms of letters, journals, and

poetry helped surgeons and nurses express their feelings, structure their traumatic memories, and

release their psychological inhibitions, thus allowing them to better come to terms with their

circumstances. Support and connections to their families gave them something to fight for. Letters

from home and pictures of loved ones helped to make them feel less alone, more connected, and

boosted morale. A sense of honor and duty both to their nation and to the suffering, wounded and

248
Holt. A Surgeons Civil War. 59.
249
Ibid.
 W i l b u r n | 102

sick men reminded them of their duties and drove them through their tasks. Religion and God

provided assistance when emotional and physical obstacles stood in their way. Armed with this

arsenal of coping mechanisms, the medical personnel of the war managed to continue their

service for their causes and their men.

 W i l b u r n | 103

Conclusion
The real war will never get in the books, Walt Whitman wrote ten years after the close

of the Civil War. Numerous books narrate and interpret the history of the battles, campaigns,

soldiers, generals, politicians, and social history. A few books attempt to construct the reality of

war from primary sources as seen by the participants. No book, though, can ever truly capture the

reality of war. War is a mixture of both the physical and the mental. Despite archaeological and

written evidence, no one has yet been able to describe a battle exactly as it happened. Despite the

numerous journals and letters, no one has ever been able to describe the emotions that run through

the minds of the soldiers, officers, and even the surgeons and nurses. Just as Daniel Holt wrote, I

cannot describe, neither can I [have you] realize what we have passed through,250 and as Oliver

Wendell Holmes Jr. and Walt Whitman attested to, it is impossible for us to fully know, let alone

even conceive, of the true and entire reality of war. Nevertheless, this paper has endeavored to

illuminate their experiences.

Surgeons and nurses offer a distinct and unique perspective to the Civil War. Their

journals, letters and memoirs, as we have seen, show us the war through their eyes. We see the

dangers of operating in a warzone, where death came in the form of bullet and bacteria. Through

them we see the true cost of the war. We see the extant of the human suffering. We see how it

affected them. Nonetheless, the medical personnel found ways to cope with their trauma and

persevere in their work.

The war left images and powerful memories in the minds of the surgeons and nurses who

served. Surgeons beheld the aftermaths of battle. Daniel Holt saw the carnage, the dead, the

mangled and the maimed living. William Watson wrote about the endless amputations. The

surgeons were entrusted with the task of treating the devastating wounds of war. The bloated,

250
Holt. A Surgeons Civil War. 21.
 W i l b u r n | 104

blackened bodies, the odorous smells, the piles of rotting limbs, the gory surgical procedures

troubled their thoughts. They witnessed the deaths and sufferings of hundreds of men, many of

them close comrades. But somehow they managed.

Women, who for the first time in history served as nurses on a large scale, likewise

witnessed the tragic aftermaths of battlefields and also were surrounded constantly by diseased,

wounded, and dying men. In addition, these women wage a war of their own against

discrimination from their male superiors and against each other in a battle of race and class.

Phoebe Pember spurned her lower-class coworkers while Hannah Ropes raised her voice in a

male dominated world. Despite these tribulations, however, the women of the medical department

continued to offer their services to the men of the armies.

Surgeons frequently found themselves dodging bullets and shells as the treated their men.

Assistant surgeons selflessly risked their lives to provide immediate care to the battlefield

wounded and several of them made the ultimate sacrifice. Edward Revere and forty-eight other

surgeons lost their lives serving their men. Surgeons endured heavy shelling and continued to

treat the most wounded of men despite risking capture or even death. Nurses likewise shared in

the danger of the battlefront. Some had very close calls. As we may recall, Clara Barton received

a bullet through her sleeve. Others, like Juliet Opie Hopkins who received two bullets to the hip,

were not so lucky and sustained wounds of their own. Additionally, service to the men in field

and general hospitals risked exposure to contagious diseases. These contagious diseases claimed

the lives of many surgeons and nurses.

The war also ripped the medical personnel far away from their homes and their loved

ones. They left behind wives, sons, daughters, sisters, brothers, mother and fathers. They left

behind their newly formed families to serve in the army. They left for years, some never to return.
 W i l b u r n | 105

Thoughts of home and family were frequently on the mind of Spencer Welch and John Perry.

Being separated from family also distanced them mentally from those they loved. They felt the

loneliness of being far away from the comforts of home and the love of friends and family.

These men and women found themselves facing obstacles and burdens they never

previously encountered. They experienced things they had never anticipated, even in their darkest

dreams. Yet somehow they managed. They chronicled their experiences and feelings in their

journals and letters to their families. They vented their emotions and described their traumatic

experiences through their expressive writings. Religion provided a mental and spiritual escape

and helped these men and women to overcome the burdens of their jobs. William McPheeters

found hope and comfort in his spiritual development. We can safely assume that many other

religious surgeons and nurses also found relief in their religious practices. A sense of duty to their

country and to their suffering men drove their work. Virginian Harvey Black frequently raved

about the prospects of Confederate victory. These surgeons and nurses embraced their callings

and endured their hardships to serve their nations. They treated the men of their armies and gave

hope to the men. They braved and endured their hardships for the sake of the men of the

Confederate and Union armies.

However, these brave men and women have received only a fraction of the recognition

owed to them. Female nurses have been glorified beyond what their actual numbers would

command and their male coworkers ignored. The deeds of male surgeons have not only been

forgotten, but their reputation has been slandered and falsely remembered. None of these men and

women volunteered their skills for glory, honor, and fame, for there is no glory for their

profession. Union surgeon Dr. Moses Gunn lamented over the ignored deeds of the medical

personnel:
 W i l b u r n | 106

You say that Mrs. R complains that surgeons are never alluded to after a battle.
No! why should they be? Poor benighted soul! did any one dream for a moment
that a surgeon's field had aught of glory about it? No! The glory consists of
carnage and death. The more bloody the battle, the greater the glory. A surgeon
may labor harder, must labor longer (we continued to fight three days), may
exhibit a higher grade of skill, may exercise the best feelings of our poor human
nature, may bind up many a heart as well as limb, but who so poor as to do him
honor? There is no glory for our profession. We may brave the pestilence when
all others flee; we may remain firm at our posts when death is more imminent
than it ever was on the battle field; but who sings our praise! Does the world
know who the physicians were who fell at Norfolk when yellow fever
depopulated that town? Does it know who rushed in to fill their places? And of
those who survived, can it designate one? Did they survive to receive fame? Yet
those men were braver than the bravest military leader, for theirs was a bravery
unsupported by excitement or by the hope of fame. No! there are none so poor as
to do us reverence. And, thank God, there are few of us so unsophisticated as to
expect it.251
The brave surgeons and nurses of the war surely deserve some recognition for their duty.

Few memorials exist commemorating the efforts of nurses and none exist dedicated to

surgeons. These men and women died to themselves to prevent other from dying. They

risked their well-being, even their lives to save the men who fought. Their reward was a

slandered reputation. On their shoulders was built our modern military and emergency

medicine. We owe it to them to remember their deeds and pay proper respects to their

sacrifices. And hopefully, through studying the sacrifices of the medical personnel who

served 150 years ago, we may learn to appreciate the services of those who serve the

medical needs of our armies today all over the world.

251
Jane Augustus Terry Gunn. Memorial Sketches of Dr. Moses Gunn. (Chicago: W.T. Keener, 1889). 156-157.
 W i l b u r n | 107

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 W i l b u r n | 112

Appendix A
Timeline of Major Battles in Eastern Theatre
Blue Union Victory Grey Confederate Victory White - Inconclusive

1
Fort Sumter April 12th-14th 8
6
1 First Manassas July 21st

1
Peninsula Campaign March-July
8
6
th 2 Second Manassas August 31st
Antietam September 17

Fredericksburg December 11th-15th

1 Chancellorsville April 30th-May 6th

8
Gettysburg July 1st-3rd 6
3

Wilderness May 5th-7th 1

8 Spotsylvania May 8th-21st
Cold Harbor May 31st-June 12th 6
4
Siege of Petersburg June -March

Appomattox April 9th 1

8
6
5
 W i l b u r n | 113

Appendix B

Organization of Army252
Unit Size* Commander
Company 100 men Captain
Regiment** 1,000 men Colonel
Brigade 4,000 men Brigadier General
Division 12,000 men Major General
Corps 2-4 Divisions Major General
Army 1-6 Corps Major General

*These numbers reflect the full nominal strength of a unit. Units often went into battle with half
the numbers shown. The average size of a unit halfway through the war was about 50-70% of the
strength shown above. Some units in the North were still fielded after suffering over 80%
casualties. Company F of the 81st Pennsylvania Regiment, for example, fielded at Gettysburg a
company of 1 captain, 1 first sergeant, and four privates. Though, companies this small were
extremely rare.

**Regiments were the basic fighting unit of both sides.

In the South, the command of a Corps or an Army was given to a Lieutenant General. In the
North only one man held this rank: Lieutenant General Ulysses S. Grant and he commanded the
entire Federal Army.

The term army has multiple meanings and is used loosely. The Federal Army covers every
Federal troop across the country; whereas the Army of the Potomac, for example, covers the corps
organized into a group in the locale of the Potomac River. Armies were collections of corps in a
given region. The Federal Army, for example, had ten armies named after various geographic
landmarks.

252
Bollet. Civil War Medicine. 453.
 W i l b u r n | 114

Appendix C
Military Ranks in the Union Medical Corps*

Medical Corps Designation Army Rank

Entire U.S. Army
Surgeon General Brigadier General
Assistant Surgeon General Colonel
Medical Inspector Colonel
Individual Field Armies & Regions
Medical Director of Army Colonel
Medical Director of Regional Dept. w/ Hospital Lieutenant Colonel
Medical Director of Small Region Lieutenant Colonel
Divisions
Medical Director of Division Lieutenant Colonel
Brigades
Surgeon Major
Regiments
Surgeon Major or Captain
Assistant Surgeon Captain or First Lieutenant
Acting Assistant Surgeon Civilian Contractor (Brevet First Lieutenant)

*Comparatively similar to the Confederate Medical Corps

 W i l b u r n | 115

Appendix D

Statistics on Battlefield Wounds for Union Troops

Types of Weapons and Number of Wounds Treated253

Type of Weapon Number % of Recorded Cases
Conoidal Ball (Mini Ball) 108,049 75.0%
Round Ball 16,742 12.0%
Fragment of Shell 12,520 9.0%
Pistol or Buckshot 3,008 2.0%
Grape or Canister 1,153 1.0%
Bayonet or Sabre 922 0.4%
Solid Shot 359 0.3%
Explosive Musket Ball 139 0.1%
Unknown Missile 103,829 -

Distribution of Wounds among Those Listed as Killed in Battle or Admitted to Hospitals254

Site Killed in Battle Admitted to Hospital
Trunk 51% 18%
Head or Neck 42% 11%
Lower extremities 5% 35%
Upper extremities 3% 36%

Total Cases and Fatality Rates by Location of Wounds (for cases with known outcome)255
Site Number of Cases Analyzed Fatality Rate
Spine 642 55.5%
Abdomen 8,438 48.75
Pelvis 3,159 29.7%
Chest 20,264 27.8%
Head 12,089 15.0%
Flesh wound of neck 4,895 15.0%
Lower extremities 86,413 13.8%
Flesh wound of back 12,681 6.9%
Upper extremities 87,793 6.5%
Face 9,416 5.9%

253
Bollet. Civil War Medicine. 84. Medical and Surgical History. Surgical Section, Volume III. 696.
254
Ibid. 88. Compiled from data in Medical and Surgical History. Surgical Section, Volume III. 692.
255
Ibid. 89. Compiled from data in Medical and Surgical History. Surgical Section, Volume III. 691.
 W i l b u r n | 116

Appendix E
Statistics of Amputations for Union Troops

Fatality of Amputations Based on Timing of Procedure256

Cases Fatality Rate
Total Cases Analyzed 23,762 27.3%
Surgery within 48 hours 16,238 23.9%
Surgery between 48 hours and a
month after injury 5,501 34.8%
Surgery over a month later 2,023 28.8%

Deaths from Amputation in Union Army257

Site Number of Amputations Fatality Rate
Hip Joint 66 83.3%
Knee Joint 195 57.5%
Thigh 6,369 54.2%
Lower Leg 5,523 33.2%
Shoulder Joint 866 29.1%
Ankle Joint 161 25.1%
Upper Arm 5,510 23.8%
Forearm 1,761 14.0%
Wrist Joint 69 10.4%
Elbow Joint 40 7.6%
Foot or Toe 1,519 5.7%
Hand or Finger 7,902 2.9%
Total 21,981 26.3%

256
Ibid. 152. Compiled from data in Medical and Surgical History. Surgical Section, Volume III. 879.
257
Ibid. 154. Compiled from data in Medical and Surgical History. Surgical Section, Volume III. 877.
 W i l b u r n | 117

Appendix F
Statistics on Disease in Union Troops

Incidence of Selected Diseases in White and Black Troops in Union Army258

Disease No. Cases/Year/1000 in Whites* No. Cases/Year/1000 in Blacks**
Acute Diarrhea 533.0 701.0
Intermittent Fevers 401.0 619.0
Remittent Fever 130.0 165.0
Acute Dysentery 108.0 145.0
Chronic Diarrhea 79.0 75.0
Acute Bronchitis 78.0 149.0
Acute Rheumatism 67.0 117.0
Chronic Rheumatism 51.0 86.0
Gonorrhea 42.0 33.0
Typhoid 35.0 28.0
Jaundice 33.0 35.0
Measles 32.0 65.0
Syphilis 31.0 25.0
Inflammation of lungs 29.0 113.0
Typhomalarial Fever 29.0 44.0
Tonsillitis 28.0 41.0
Mumps 23.0 86.0
Inflammation of Pleura 15.0 46.0
Anemia 10.0 19.0
Consumption 6.3 8.4
Smallpox 5.7 36.9
Scrofula 2.8 15.0
Night Blindness 2.8 11.0
Inebriation 2.2 0.1
Valvular Hear Disease 1.7 2.6
Intestinal Worms 1.6 4.5
Scurvy 1.3 66.0

* July 1, 1861 June 30, 1865

** July 1, 1863 June 30, 1865

258
Ibid. 328. Compiled from data in Medical and Surgical History. Medical Section, Volume I.
 W i l b u r n | 118

Appendix G

Excerpt from the Medical and Surgical History of the War of Rebellion: Volume VII259

The following officers of the medical staff of the regular and volunteer forces of the Union
Army were killed in action:

Surgeon SAMUEL EVERETT, U. S. V., at Shiloh, April 6th, 1862.

Surgeon W. J. H. WHITE, U. S. A., at Antietam, September 17th, 1862, while placing the field hospitals of the Sixth
Corps, of which he was medical director. (See APPENDIX, p. 100.)
Assistant Surgeon A. A. KENDALL, 12th Massachusetts Volunteers, at Antietam, September 17th, 1862. (See
APPENDIX, p. 100.)
Assistant Surgeon EDWARD H. R. REVERE, 20th Massachusetts Volunteers, at Antietam, September 17th, 1862. (See
APPENDIX, p. 100.)
Surgeon J. D. S. HASLETT, 59th Illinois Volunteers, at Perryville, October 8th, 1862.
Surgeon J. FOSTER HAVEN, 15th Massachusetts Volunteers, at Fredericksburg, December 13th, 1862. (See APPENDIX,
p. 104.)
Assistant Surgeon JOHN HURLEY, 69th New York Volunteers, April 15th, 186.3.
Surgeon CHARLES A. HARTMAN, 107th Ohio Volunteers, at Chancellorsville, May 2d, 1863.
Acting Assistant Surgeon A. HIGHBORN, at Chancellorsville, May 3d, 1863.
Surgeon E. L. WATSON, 1st California Volunteers, near Fort Craig, New Mexico, July 19th, 1863.
Surgeon J. S. WEISEK, 1st Minnesota Cavalry, near Big Mound, Dakota Territory, in a fight with Sioux Indians, July
24th, 1863.
Surgeon THOMAS JONES, 8th Pennsylvania Reserves, at Spotsylvania, May 14th, 1864.
Surgeon H. S. POTTER, 105th Illinois Volunteers, near Ackworth, Georgia, June 2d, 1864. (See APPENDIX, p. 308.)
Assistant Surgeon A. S. FRENCH, 114th Illinois Volunteers, at Gun town, June 10th, 1864.
Surgeon L. B. SMITH, 7th Minnesota Volunteers, at Tupelo, Mississippi, July 13th, 1864.
Surgeon J. C. STODDARD, 56th U. S. Colored Troops, Wallace's Ferry, Arkansas, July 26th, 1864.
Surgeon CHARLES J. LEE, 11th United States Colored Troops, near Fort Smith, Arkansas, August 24th, 1864.
Surgeon W. II. RULLSON, 9th New York Cavalry, medical director of the cavalry of the Middle Military Division, at
Smith field, Virginia, August 29th, 1864. (See APPENDIX, p. 226.)
Assistant Surgeon FREDERICK WAGNER, 3d Tennessee Cavalry, at Sulphur Branch Trestle, Alabama, September 25th,
1864.

The following officers of the medical staff, while in the discharge of their duty, were killed by
partizan troops or assassinated by guerrillas or rioters:

Surgeon H. N. GREGORY, 1st Wisconsin Cavalry, June 9th, 1862.

Assistant Surgeon F. L. HUNT, 27th Massachusetts Volunteers, November 18th, 1862.
Assistant Surgeon JARED FREE, 83d Pennsylvania Volunteers, December 10th, 1863.
Surgeon SHUBALL YORK, 54th Illinois Volunteers, Charleston, Illinois, March 28th, 1864.
Assistant Surgeon S. A. FAIRCHILD, 6th Kansas Cavalry, Stone's Farm, April 6th, 1864.
Assistant Surgeon J. A. JONES, 115th Illinois Volunteers, July 9th, 1864.
Assistant Surgeon ELI M. HEWITT, 15th U. S. Colored Troops, July 24th, 1S64.
Surgeon J. B. MOORE, 5th Tennessee Cavalry, September 5th, 1864.
Acting Assistant Surgeon F. M. OSBORNE, September 22d, 1864.
Surgeon J. B. COOVER, 6th Pennsylvania Cavalry, September 27,1864. (See APPENDIX, p. 226.)
Assistant Surgeon JOHN B. PORTER, 89th Indiana Volunteers, November 1st, 1864.

259
Otis. Medical and Surgical History. Volume III. xxx-xxxi.
 W i l b u r n | 119

Surgeon J. L. SHERK, 7th Pennsylvania Cavalry, at Bardstown, Kentucky, December 29th, 1864.
Acting Assistant Surgeon SAMUEL FAUNESTOCK, April 13th, 1864.

The following medical officers died of wounds received in action:

Assistant Surgeon S. ALEXANDER, 1st Pennsylvania Cavalry, died November 29th, of wounds received at
Drainesville, Virginia, on November 20th, 1861.
Assistant Surgeon J. E. HILL, 19th Massachusetts Volunteers, died of wounds received at Fairfax, Virginia, on
September 11th, 1862.
Assistant Surgeon W. S. MOORE, 61st Ohio Volunteers, died of wounds received at Gettysburg on July 2d, 1863.
Acting Assistant Surgeon W. B. CARY, died of wounds on January 20th, 1864.
Assistant Surgeon HEZEKIAH FISH, 15th Iowa Volunteers, died August 19th, of wounds received near Atlanta on
August 17th, 3804.
Surgeon OTTO SCHENK, 40th New York Volunteers, died on August 21st, 1864, of wounds received near Petersburg,
August 20th, 1864. (See APPENDIX, p. 175.)
Acting Assistant Surgeon EMIL OHLENSCHLAGER, died October 8th, of wounds received in action on October 8th,
1864. (See APPENDIX, p. 220.)
Surgeon THOMAS J. SHANNON, 110th Ohio Volunteers, died October 20th, of wounds received at Cedar Creek on
October 19th, 1864. (See APPENDIX, p. 226.)

The following medical officers died through accidents occurring in the line of duty:

Surgeon FREDERICK S. WELLS, 9th New Jersey Volunteers, drowned at Hatteras Inlet, January 15th, 1862, in the
courageous and perilous attempt to land to procure food and water for the famine-stricken regiment, its transport
being driven offshore in a terrific storm.
Assistant Surgeon W. M. KNOX, 78th Pennsylvania Volunteers, April 27th, 1862.
Assistant Surgeon JESSE J. THOMAS, 10th New Jersey Volunteers, May, 1862.
Assistant Surgeon CHARLES JOHNSON, 10th Tennessee Volunteers, killed by a fall, April 5, 1863.
Surgeon GEORGE HAMMOND, U. S. A., drowned in the Mississippi River, August 14th, 1863.
Assistant Surgeon W. B. WITT, 09th Indiana Volunteers, drowned at Saluria liayou, Texas, March 13th, 1864.
Assistant Surgeon S. C. FERSON, 74th Illinois Volunteers, at Varnell, October 7, 1864.
Surgeon WILLIAM K. SADLER, 19th Kentucky Volunteers, shot by a soldier, December 2d, 1864.
Assistant Surgeon A. F. MARSH, 50th Illinois Volunteers, lost at sea, on the steamer General Lyon, March 31st, 1865.

If the above sad mortuary record, proportionately larger than that of any other staff corps, is
insufficient to correct the popular fallacy that, in time of battle, the post of the medical officer is
one of comparative safety, that false impression may be removed by the following list of medical
officers wounded in action:

Surgeon J. MARCUS RICE, 25th Massachusetts Volunteers, at Roanoke Island, February 7th, 1862.
Acting Assistant Surgeon W. A. KITTREDGE, Fort Fillmore, New Mexico, June 25th, 1862. (See Appendix P. 353)
Surgeon A. A. EDMESTON, 93d New York Volunteers, at Savage's Station, June 27th, 1862.
Assistant Surgeon G. M. MCGAX, U. S. A., at Beverly Ford, Virginia, October 22d, 1863.
Assistant Surgeon W. M. NOTSON, U. S. A., at Gettysburg, July 3d, 1863.
Surgeon J. M. STEVENSON, 3d Maryland Cavalry, at Gettysburg, July 3d, 1863.
Surgeon CHARLES ALEXANDER, 16th Maine Volunteers, at Gettysburg, July 2d, 1863.
Assistant Surgeon E. B. HECKEL, 27th Pennsylvania Volunteers, at Gettysburg, July 3d, 1863.
Assistant Surgeon JOSEPH D. STEWART, 74th New York Volunteers, Gettysburg, July 2d, 1863.
Surgeon F. K. GROSS, U. 8. V., at Chiekanianga, September 19th, 1863. (See APPENDIX, p. 270.)
Surgeon J. R. WEIST, 4th Ohio Cavalry, wounded in 1863.
Assistant Surgeon A. H. LANDIS, 35th Ohio Volunteers, at Chickamauga, September 19th. 1863
Surgeon E. A. MEKRIITELD, 44th Illinois Volunteers, at Chickamauga, September 19th, 1863. (See APPENDIX, p.
277.)
 W i l b u r n | 120

Assistant Surgeon W. H. FORWOOD, U. S. A., at Brandy Station, October 8th, 1863.

Surgeon N. R. DERBY, U. S. V., on Cane River, Louisiana. April 21st, 1864. Permanently maimed and pensioned.
Assistant Surgeon ROBERT FEN WICK, 146th New York Volunteers, by a shell fragment, at the Wilderness, May 8th,
1864.
Surgeon T. E. MITCHELL, at Winchester, May 25th, 1861. {See APPENDIX, p. 230.)
Assistant Surgeon W. A. BARRY, 98th Pennsylvania Volunteers, Wilderness, May 6th. 1864.
Assistant Surgeon R. S. VICKERY, 2d Michigan Volunteers, Petersburg, July 30th, 1864. Femoral artery ligated.
Assistant Surgeon ISAAC SMITH, 26th Massachusetts Volunteers, at Opequan, September 19th, 1864. He is a
pensioner. {See Appendix, p. 226.)
Surgeon JOHN T. SCEAUCE, 11th Indiana Volunteers, at Cedar Creek, October 19th, 1864. (See APPENDIX, p. 226.
Assistant Surgeon PRESTON B. ROSE, 5th Michigan Volunteers, Hatcher's Run, October 27th, 1864 He is a
pensioner.
Assistant Surgeon C. C. V. A. CRAWFORD, 102d Pennsylvania Volunteers, Petersburg, July 12th, 1864.
Assistant Surgeon THOMAS HELM, 148th New York Volunteers, Petersburg. September, 1864.
Assistant Surgeon AUSTIN MANDEVILLE, 169th New York Volunteers, Dutch Gap, August 13th, 1864. He is a
pensioner.
Assistant Surgeon D. W. RICHARDS, 14th Pennsylvania Volunteers, June 2d, 1864.
Surgeon W. A. SMITH, 103d New York Volunteers, Suffolk, May 3d, 1863. He is a pensioner.
Assistant Surgeon SAMUEL B. SHEPARD, 7th Connecticut Volunteers, captured, June 2d, 1864.
Surgeon ISAAC WALBURN, 17th Pennsylvania Cavalry, at Beverly Ford. June 9th, 1863.
Assistant Surgeon H. T. WHITMAN, 5th Pennsylvania Volunteers, at Bethesda Church. Virginia May 30th, 1861.
Assistant Surgeon L. BARNES, 6th United States Colored Troops, explosion of magazine at Fort Fisher, January 16th,
1865-
Surgeon M. M. MANLY, 2d United States Colored Troops, at Fort Darling, Virginia, May 14th, 1864.
Assistant Surgeon G. V. R. MERRILL, 6th United States Colored Troops, at Petersburg, June, 1864-
Acting Assistant Surgeon SAMUEL H. BOONE, January 17th, 1865.
Surgeon J. T. STEWART, 64th Illinois Volunteers, Atlanta. July 19th, 1864,
Assistant Surgeon A. G. PICKET, 50th Illinois Volunteers, at Allatoona, October 5th, 1864.
Surgeon A. N. DOUGHERTY, UVS. V., Wilderness, May 6th, 1864.
Assistant Surgeon JAMES ALLEN, 89th New York Volunteers, Petersburg, September, 1864.
Assistant Surgeon O. H. ADAMS, 8th New York Cavalry, at Laey's Springs, December 21st, 1864. (See SURG. HIST. p.
2.)
Assistant Surgeon JACOB C. BARR, 1st Ohio Volunteers, Wauhatclne, Tennessee, October 29th, 1864.
Assistant Surgeon JULIUS BRAY, 25th Missouri Volunteers, at Shiloh, April 6th, 1862. .
Assistant Surgeon JAMES BROWN, 4th Tennessee Cavalry, Franklin, Tennessee, September 23(1, 1861,
Assistant Surgeon G. B. BAILEY, 9th West Virginia Cavalry, at Guyandotte, November 10th, 1861.
Assistant Surgeon CHARLES BUNCE, 59th Illinois Volunteers, July, 1864.
Assistant Surgeon A. T. C. CONNER, 9th New York Cavalry, Woodville, Virginia, May, 1864.
Assistant Surgeon D. O. CROUCH, 13th Pennsylvania Reserves, Fredericksburg. December 13th, 1862.
Surgeon J. W. GREEN, 95th Illinois Volunteers, Spanish Fort, Alabama, April 8th, 1865.
Assistant Surgeon T. GILFILLAN, 59th Massachusetts Volunteers, Petersburg, July 8th, 1864.
Assistant Surgeon JOSEPH GARDNER, 24th Kentucky Volunteers, near Atlanta, August 5th, 1864. He is a pensioner.
Assistant Surgeon C. E. GOLDSBOROUGH, 5th Maryland Volunteers, Petersburg, August 5th, 1864.
Acting Assistant Surgeon Ralph C. HUSE, January 16th, 1865.
Assistant Surgeon LEVI JEWWITT, 14th Connecticut Volunteers, Reams Station, August 28, 1864. (SEE APPENDIX, p.
173.)
Assistant Surgeon DAVID D. KENNEDY, 57th Pennsylvania Volunteers, Fredericksburg, December 13th, 1862.
Surgeon JAMES A. MORRIS, 117th New York Volunteers, Fort Fisher, January 16th, 1865.
Assistant Surgeon EDWIN W. MAGANN, 9th Indiana Cavalry, Sulphur Branch Trestle, Alabama, September 25th,
1864.
Assistant Surgeon THOMAS L. MORGAN, 10th Missouri Volunteers, April, 1864.
Assistant Surgeon PETER M. MURPHY, 134th New York Volunteers, Resaca, Georgia, May 15th, 1864.
Assistant Surgeon GEORGE A. MUNROE, 3d Rhode Island Cavalry, on a scout, November 29th, 1864.
Surgeon CHARLES NEWHAUS, 29th New York Volunteers, second Bull Run, August 29th, 1862. He is a pensioner.
Surgeon WILLIAM D. NEWELL, 28th New Jersey Volunteers, Fredericksburg, December 13th, 1862.
Surgeon FOWLER PRENTICE, 73d New York Volunteers, August, 1864.
 W i l b u r n | 121

Surgeon HENRY ROOT, 58th New York Volunteers, May, 1863.

Surgeon PETER E. SICKLER, 8th New York Cavalry, Petersburg, April, 1865.
Assistant Surgeon GEORGE R. SULLIVAN, 15th New Jersey Volunteers, Fredericksburg, May 9th, 1863.
Assistant Surgeon THOMAS S. STANWAY, 102d Illinois Volunteers, Nashville, December 22d, 1863.
Surgeon WILLIAM P. THURSTON, 1st Rhode Island Artillery, Fairfax, June 28th, 1862.
Surgeon JAMES WILSON, 99th New York Volunteers, Suffolk, April 24th, 1863.
Surgeon A. A. C. WILLIAMS, Second United States Sharpshooters, Chancellorsville, May 3d, 1863.
Surgeon ARVIN F. WHELAN, 1st- Michigan Sharpshooters, Petersburg, August 3d, 1864.
Assistant Surgeon CHARLES A. WHEELER, 12th Massachusetts Volunteers, Wilderness, May 6th. 1864.
Assistant Surgeon T. W. C. WILLIAMSON, 24th Indiana Volunteers, Champion Hills, May 16th, 1863.
Assistant Surgeon J. S. WAGGONER, 84th Pennsylvania Volunteers, in May, 1863.
Surgeon JOHN DICKSON, 111th United States Colored Troops, at Sulphur Branch Trestle, Alabama, September 25th,
1864.