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The Tangled Web Of Early Civil War Medicine

An Inept Lincoln Cabinet During

The Battle of First Manassas, 1861 and The Peninsula Campaign, 1862:

Unnecessary Deaths of Savable Men

By Kevin M. Bair

History Ph.D. Student

Liberty University

Fall 2020

HIUS 820

Introduction

During the first two years of the Lincoln administration (1861-1862), Lincoln sought ways to quickly end the war. To do this, he felt it necessary to change his top leaders, both in Washington and in the Army as he deemed it a necessity to build his winning team. The rapid change in the top positions created conflict between assorted men of power and position, antiquated men running antiquated departments, and civilian opinion on what was the best practice to care for wounded, i.e., how many men are needed for the war, how many tents and what type and kind, how many ambulances, how to evacuate the wounded ; effectively and efficiently, and other varied medical supply questions.

This paper will demonstrate how these men and their ongoing disharmony delayed any establishment of a dedicated plan to care for the wounded, thus these leaders were responsible for the unnecessary deaths of many savable men during the 1861-1862, Virginia campaigns ; The First Battle of Manassas / Bull Run, (July 21st, 1861), The Peninsula Campaign (March through July 1862) which is comprised of The Siege of Yorktown (April 5 to May 4), The Battle of Seven PinesFair Oaks, (May 31-July 1, 1862), and The Seven Days Battles (June 25-July 1862) etc. The total number of soldiers who fought during First Manassas and The Peninsula Campaign was 169,069. The number dead was 5,228, wounded, 23,824, missing,7000. As staggering as these numbers may be, disease killed more men than actual battle. [1][2][3][4][5][6]

The Evidence

The Wars initial federal leadership on medical supplies and care was conducted by the Secretary of War, Simon Cameron (March 8, 1799 – June 26, 1889), and Ninth Surgeon General, Thomas Lawson (August 29, 1789 – May 15, 1861). These men set the tone for their departments, and in particular Lawson’s management style was ingrained into departmental philosophies, that of, spend little money and make do with what you have, along with his refusal to change time-tested Army medical procedures and practices. After his death in May, these ideas were continued on with the next line of Surgeon Generals. Cameron was discharged from his position in January 1862, on charges of poor management and corruption. [7] He was replaced by Secretary of War Edwin E. Stanton (December 19, 1814 – December 24, 1869). Figure 1 is a map of the Virginia battlefields discussed.

Figure 1.The Civil War in Virginia. Gillett, The Army Medical Department 181-1865. p. 187.

Stanton, during The Peninsula Campaign, repeatedly refused Surgeon General W.A. Hammond’s request for additional ambulances. Likewise, during the August 1862, Second Battle of Manassas, Stanton turned down one of Hammond’s many requests to create a hospital and ambulance corps, stating it would involve “enormous expenses”.[8] Moreover, Interim Surgeon General Robert C. Wood (1801-1869) refused the aid of civil charity

groups such as The United States Sanitary Commission. Tenth Surgeon General Clement A. Finley (May 11, 1797 – September 8, 1879), would not order medical equipment or medical textbooks, as he believed they were a waste of money, furthermore, he would not order the needed medical supplies or bandages until after a battle had commenced,[9] which was the case at The Battle of First Manassas.

Looking Back – Pre-Lincoln Army History –

Data demonstrates the Lincoln Administration, appointed or inherited stagnant, archaic leaders with limited thoughts on the size and scope of the upcoming war. Unfortunately for Lincoln, he become heir to the Army medical department which had been fashioned by Surgeon General Lawson.

Ninth Surgeon General Thomas Lawson (1789-1861)

Figure 2. Brevet Brigadier General Thomas Lawson (1789-1861). Courtesy of Pilcher- The Surgeon Generals of the Army of the United States of America. p. 34

Thomas Lawson, a veteran of The War Of 1812 (18 June 1812 – 17 February 1815), and a former frontier army surgeon, held the position of Surgeon General since being appointed on November 30, 1836, by seventh President of the United States, Andrew Jackson (March 15, 1767 – June 8, 1845).[10]

When the rebellion started in April 1861, he was seventy-three old and in poor health.[11] He had been an Army Surgeon for fifty-five years.

Lawson entered the Navy on March 1, 1809, at the age of nineteen as a surgeon’s mate. He resigned on January 12, 1811, and immediately joined the Army. On February 8, 1811, he became a garrison surgeon’s mate. Two years later, during the War of 1812, on May 21, 1813, he was promoted to the post of surgeon of the 6th Infantry. Additionally, according to Army records, the information on how Lawson obtained his primary or medical education cannot be found. It is speculated that he may have studied in his hometown as an assistant to a medical practitioner, which was normal practice at that time.[12]

During the Mexican American War (April 25, 1846 – February 2, 1848), Lawson was appointed an advisor to General Winfield Scott (June 13, 1786 – May 29, 1866), and during the war accompany Scott from Vera Cruz to Mexico City. Furthermore, Lawson was present at the 1847, Battle of Chaultepec and the surrender of the city. [13] For his service in the Mexican War, he was promoted to Brevet of Brigadier General.[14]

In his first decade as Surgeon General, Lawson’s primary interest was the Second Seminole War (1835 to 1842), and to many he was known to be more of an “in the field”… “frontier surgeon” than an administrator, and was known not to be “enthusiastic about office work” and also to be “cantankerous.” [15][16] During the first two years of his position as Surgeon General, his lack of wanting to do administration work kept him, as much as he could get away with, in the field.

In 1836, while out fighting the Seminoles and as the medical director for the troops, he was offered the position of Surgeon General in October and on November 30th, he was sworn in. After his appointment he remained with the troops until mid-1837, only to leave again to escort the ex-president Andrew Jackson back to Jackson’s home in Tennessee. He then left Jackson’s home for Florida and the Seminole War. He remained in Florida until May of 1838. While he was away, Assistant Surgeon Benjamin King performed the duties of the Surgeon General.[17] The takeaway from history is that Lawson was not a good administrator. Mary C. Gillet, historian at the Center of Military History, Washington, D.C. remarked on Lawson,

“One of a dying breed, an army surgeon without a professional degree, he was an old soldier who had risen to his position of leadership through seniority and had remained there until youth and health deserted him.”[18]

The background on Lawson gives insight as to why the Army medical department was not prepared for a battle like the Civil War. The man was first a frontiersman and then one who practiced medicine.

Lessons on Death from the Crimean War – The Need for Ambulances.

During the Crimean War (1854-1856), newspapers reported on the poor horrid living conditions and the medical debacle of not caring for the wounded soldiers. They also reported on efforts of civilian relief agencies and nurse volunteers like Florence Nightingale (12 May 1820 – 13 August 1910) (figure 3) and 38 other English nurses who volunteered.[19]

Figure 3. Florence Nightingale Courtesy of the Library of Congress, cph 3a09175

William Howard Russell (28 March 1820 – 11 February 1907) (figure 4), a special correspondent of The Times (London), who, while at the Crimean War, he telegraphed the action back to London, giving its readers a firsthand account of the war. He wrote,

Figure 4. William H. Russell. Courtesy Library of Congress, cph.3g09183, LC-USZC4-9183

“The commonest accessories of a hospital were wanting; there was not the least attention paid to decency or cleanliness — the stench was appalling… The dead, laid out as they died, were lying side by side with the living…a spectacle beyond all imagination… for all I could observe, these men died without the least effort to save them. There they laid just as they were…”[20]

Five years later Russell would be at, and report on, The Battle of First Manassas.

During the war, each British regiment consisted of approximately 650 men, with one surgeon and three assistant surgeons, ten litters and a pack mule to carry the medical equipment, medicine, and bandages. Before the war, the British Army had specified wheeled ambulances to ship, yet when the fighting started, the British were in the action, but not with their ambulances, as their shipment had been delayed. When they finally arrived weeks later, the units came disassembled and without instructions.[21]

In 1855, for the U.S. to improve on the preparedness and technology of its Army, the U.S. Secretary of War, Jefferson Davis (figure 5), sent a delegation to the Crimean War theater. This group was comprised of Major Richard Delafield ((September 1, 1798 – November 5, 1873) figure 6), Alfred Mordecai (January 3,1804 – 23 October 1887) and Captain George B. McClellan ((December 3, 1826 – October 29, 1885) figure 7). Furthermore, Jefferson instructed the team to learn about, “The medical and hospital arrangements, both in permanent hospitals and in the field. The kind of ambulances or other means used for transporting the sick and wounded.”[22]

Figure 6. General Richard Delafield. Courtesy of The National Archives; 111-B-5268, 529372

Figure 5. Maj. Gen. Geo. B. McClellan, Courtesy Library of Congress. loc.pnp/ppmsca.33064

Figure 5. Secretary of War, Jefferson Davis loc.pnp/ppmsca.26716, LC-DIG-ppmsca-26716

The Delafield report can be found in the 36th Congress, 1st Session, Ex. Doc. No. 56. It goes into great details about the various ambulances used during the Crimean war, and is complete with detailed information on the successes and failures of each, as well as detailed drawings on ambulance types, such as, the Maltese Cart, (figure 8 ), an English Ambulance (figure 9) and the English Litter (figure 10).

Figure 9. English Ambulance, Delafield, Report on the Art of War in Europe, p.69.

Figure 8. Maltese Cart, Delafield, Reports on the Art of War in Europe, p. 72.

 

Figure 6.English Litter, Delafield, Report on the Art of War in Europe, p 73.

Delafield explained how important the ambulances were to the war. He stated, “Never before this siege was so much attention bestowed upon this branch [ambulances]of the military service”. He also refers to the power and influence of Miss Nightingale, as a “voice not to be neglected” that she had a “ power to make known…all the requirements of the medical staff, as well as being able to invoke “public sentiment.”[23] The tales of Miss Nightingale and her deeds via the press, had a profound effect on the social and moral conscious of the American society during the Civil War.

American Ambulances

During the War of Independence, on behalf of George Washington, the Continental Congress adapted and passed what was called the Doctor Shippen’s Plan, Number 23, it stated,

“That a suitable number of covered and other wagons, litters, and other necessaries for removing the sick and wounded; shall be supplied by the Quarter master, or deputy quartermaster general; and in cases of their deficiency by the director, or deputy director general.”[24]

This arrangement was used during the first two years of the Civil War, as all supplies ordered, including medical items, had to go through the Quarter Masters office. One major difference in medical care during the Revolution than in the Civil War, was the Continental Congress approved female nurses, stating, “That a matron be allowed to every hundred sick or wounded…That a nurse be allowed for every ten sick, or wounded, who shall be under the direction of the matron.”[25] It seems, the Revolutionary War soldiers had better odds of getting nursing care than the Civil War soldiers did; in the beginning of the war, there was not any type of battlefield nursing.

In 1861, the United States Army did not have any type of standardized ambulances, nor an ambulance corps solely trained to ferry the wounded off the battlefield. In fact, it was not until after the Crimea and Mexican War that the U.S. in 1859, started to entertain having some type of official wheeled ambulances for its troops. Still, after the Crimean War and with the information presented in the Delafield report on medical transports, the U.S. Army during most of the Civil War continued using and depended on ordinary makeshift wagons to carry the wounded.

Considering the information presented in the report, it is surprising that the U.S. Army did not have an official ambulance design until 1859. [26] Yet, this does not mean the Army did not think about the merits of a specialized ambulances prior to 1859, for they did, and in the 1841, General Regulations for the Army of the United States, stated,

“For the accommodation of the sick and disabled, a wagon will be attached to the rear guard, when necessary and practicable, and a surgeon will attend to give assistance, and to see that no improper persons are suffered to avail themselves of the accommodation.”[27]

Although the regulations used the term wagon and not ambulance, at least there was some provisional way to carry the sick and wounded. One of the major problems with using a common wagon was it was looked at as universal property, thus it was used as something other than what it was designated for. According to The Medical and Surgical History of the War of The Rebellion, during the Mexican American War (1846-48), ambulances were not included in their supplies, nor did they accompany the troops into Indian territories.[28]

In October of 1859, a Board of Medical Offices convened to select an acceptable ambulance design. The board consisted of Surgeons, C. A. Finley, R. S. Satterlee, C. S. Tripler, J. M. Cuyler, and Assistant Surgeon R. H. Coolidge. One of their criteria was each ambulance should carry 40 men. Some of the ones they approved were used in limited numbers during the first two years of the war. Unfortunately, they were not built in volume during that time which hindered using them at the start of the Civil War[29].

Many men designed and submitted ambulance plans; even Lawson designed an ambulance, as well as other medical men. There was the Finley (figure 11), a two-wheel ambulance designed to carry 40 men, created by future Surgeon General Clement A. Finley (1797-1879), and another 40 person two-wheel design (figure 12) by Assistant Surgeon Richard H. Coolidge (1816-1866), as well as a four-wheel design to hold eighteen and pulled by six horses. The two-wheeled Finley unit was built, and a few tried, with an estimated ratio of 1 wagon per 1000 men; unfortunately, it had dismal results in the field and was known to make the occupants sick.[30]

Figure 11. The Finley Ambulance, The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III, p. 946.

Figure 7.. The Coolidge Ambulance. The Medical and Surgical History of The War of The Rebellion, (1861-65), p. 947.

There were few authorized ambulance designs built with success, such as, the Tripler ambulance (figure 13), designed by the future Medical Director of the Army of the Potomac, surgeon Charles Tripler (January 19, 1806 – Oct. 20, 1866). This ambulance could carry 10 men. Then there was the Rosecrans or Wheeling ambulance wagon (figure 14) designed by Union General W. S. Rosecrans (September 6, 1819 – March 11, 1898) which could hold approximately 15 men.[31]

Figure 93.The Tripler Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947.

Figure 9.. The Rosecrans Ambulance, The Medical and Surgical History of The War of The Rebellion, (1861-65), p948.

These four ambulance were approved in October of 1859 by the medical board, but as mentioned not built in volume at the time. It must be remembered, initially it was not the federal government’s responsibility to supply ambulances, as each State was responsible for supplying ambulances to their regiments. And even though there were some ambulances at the start of the war, there was not an officially trained ambulance corps, the ambulances in most regiments were attended to by band members and were only for the wounded of that regiment. Most of the ambulances during the early years of the Civil War were driven by civilian teamsters and according to the firsthand account from Dr. Henry Bowditch, ambulance drivers were drunk, some broke into the hospital supplies and others refused to “help the wounded until whiskey was given,” and when the fighting started many drivers drove away with their ambulances. [32][33]

1860 Army Tents

In 1860, the United States had a peace time Army of 13,024 soldiers, of these, 1,117 were commissioned officers. The medical department was composed of “one Surgeon General, thirty Surgeons and eighty-four Assistant Surgeons.”[34] During this time, there was not an official military hospital nor an official plan to remove the wounded from the battlefield.[35] The 1860 Army’s regulations stated there was to be one Sibley tent (figure 15), which could house twelve men; one common wedge style tent which could hold six men, and three hospital tents (figure 16). They could hold eight patients each.[36] The capacity of the tents indicates each regiment could handle 78 wounded soldiers. This limited capacity suggests little thought was placed on how many men can be wounded during a major battle, nor does it seem to account for the overwhelming number of men sick from disease.

Figure 15. The Sibley Tent. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920.

Figure 10.The Hospital Tent., The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920.

Traditionally, Army medical planning focused on regimental surgeons and assistants caring for their wounded. Additionally, these regimental medical plans did not include a strategy for the removal of the wounded beyond their regimental field hospital. [37] Furthermore, during the war, regimental tents would have been filled to capacity with illnesses such as, “diarrhea, dysentery, typhus, measles, smallpox, fever, and other diseases aggravated by inadequate clothing, bad water, and poor food.”[38]

In 1862, Dr. Jonathan Lettermen (December 11, 1824 – March 15, 1872), Medical Director of the Army of the Potomac, while at Harrison’s Landing during the Peninsula Campaign, estimated the sickness within the Army of the Potomac was “at least twenty percent.” He also stated there was not a single hospital tent to be found. To treat the sick and wounded, he commandeered the Harrison House to be used as a hospital.[39] Yet, like many wars, disease was the real killer and the medical tents and homes were filled to capacity with sick and diseased men.

Grim Statistics

When the Mexican American War started, the United States was just as unprepared for war and the responsibility of caring for its wounded as the British were seven years earlier during the Crimean War. During the Mexican American War, more than 100,000 men served, and out of this there were more than seven disease related deaths to every single combat death, with the annual fatality rate of around 10 percent. During the Civil War, the overall mortality was 7.2 percent, and during the Crimean War, the British first Expeditionary Force of 25,000 men lost 18,000 over a 12-month period mostly from “dysentery, cholera, scurvy, or fevers.” This equates to a loss of 72 percent of their usable strength. During World War I, the disease death rate was 12.58 per 1000.[40][41]

Medical Training. Pre-War: Medical Thought and Training during the 1700’s and mid-1800s.

Many of the first Civil War doctors were loosely schooled in the early to mid-1800s, and these schools taught varied medical thoughts and practices. Additionally, there were varied entrance exams, as well as little or no degree or license required to become a doctor. In early medicine, doctors and patients developed personal relationships. It is fair to say that for many, a bond of trust occurred between them. This association was normally initiated by the patient, and the doctor they saw was known locally, i.e., someone in their community.

Back then, doctors were self-employed and would either come to the patient’s home or have a home office. Furthermore, depending on the doctor’s location, many had a team of medical friends or acquaintances which they could refer to if need be, i.e., a surgeon’s apprentice or an apothecary; who would mix the prescribed medicines.[42] Of course, very rural doctors had to rely on themselves to create and administer medicines, and if need be, use a family member or a neighbor to help with various types of surgeries, such as an amputation. Additionally, during this time there was not many bonified hospitals, therefore medical charities were created usually by women to help the ill get well. Moreover, these groups offered free medical care, or alternative medicines, to those who could not afford or, perhaps, did not trust, “professional” doctors.

For the most part, an individual’s medical treatments had a personal, face to face relationship with the physician. According to Dr. Thomas Percival, in his 1803, book, Medical Ethics, “The feelings and emotions of the patients, under critical circumstances, require to be known and to attended to, no less than the symptoms of their diseases.”[43] Indicating a doctor should attend to a person’s psychological needs as well as their physical medical aliment. Moreover, he makes the case that the medical profession was a divided and disjointed occupation, full of jealousies, and petty-minded tensions between physicians.[44]

Robert L. Numbers indicated in his article, The Fall and Rise of the American Medical Profession, “ by the mid-19th century…medicine for many Americans had degenerated into little more than a trade, open to all who wish to try their hand at healing.”[45] Likewise, according to the 1850, Report of the Sanitary Commission of Massachusetts, commenting on medical thought in 1836,

“There was no such thing as a legal medical police…No restriction is laid upon any one in the practice of physic, or in dealing in drugs and medicines. Any one, male or female, learned or ignorant, an honest man or a knave, can assume the name of a physician, and ” practice” upon any one, to cure or to kill, as either may happen, without accountability.”[46]

This lack of academic medical training had been a problem in the American Revolution (1775-1783) and continued in this country through the 19th century and well past the Civil War years. [47] Bonified medical schools did exist, and by 1830, there were 22 medical degree granting institutions in 13 states. In Massachusetts, degreed medical men formed medical societies, lobbied state law makers, and offered its graduates the only state sanctioned medical practitioner license. These establishments were few and had rigid entrance exams, along with a hefty price tag to attend. Because of cost and stringent requirements, people started to train elsewhere, outside the traditional channels to become doctors.

By the late 1830s, thru the 1880’s, society was beginning to rethink higher education, as there was a general “disestablishment and humbling” of higher education. During this time, technical schools with less stringent entrance policies were in demand. The previous high standards to enter college and medical schools no longer impeded students, including medical students. Many students went this route and entered technical medical schools; thus, many technical school students became part of the early Civil War doctors.

Furthermore, due to technical schools’ popularity the number of medical colleges in the United States doubled between1830-1845. This rise in diploma mills caused properly trained physicians with a bonified medical degree to complain that there were too many poorly trained doctors with many harming patients and jeopardizing the profession. [48] According to Margaret S Gordon in her article, Higher Education, and the Labor Market, the mid 1800’s deregulating of higher education created a flood of “profit-making enterprises”,

“The outcome was the rapid growth and proliferation of proprietary schools for the awarding of professional degrees. These colleges were usually profit-making enterprises established by practitioners and supported by student fees. Competition was brisk, and quite soon entry into these schools became exceedingly easy and graduation a matter of course.”

These technical school doctors became part of the new physicians initially employed during the Civil War, as “private physicians” on a short-term contracts and were not commissioned officers. Many of the newly recruited military doctors were known as Brigade Surgeons, Surgeons of the Volunteers, or Acting Assistant Surgeons.[49]

A Time for A Change; Lincoln’s General Order No.15; The Revolving Door Of “Leadership”; Surgeon Generals

In the first two years of the war, the Lincoln Administration changed staff members in key positions searching for the correct leaders to quickly win the war. The first change occurred in January 1861, when Surgeon General Larson went on a medical leave of absence and in his stead was Interim Surgeon General, Robert C. Wood (1799-1869). Lawson died on May 15, 1861, just eleven days after President Lincoln’s May 4 call for volunteers in General Order No.15, thus leaving Interim Wood in the Surgeon General position until it was filled by Clement A. Finley (May 11, 1797 – September 8, 1879), who held the position until April 14, 1862. Finley was replaced by Surgeon William A. Hammond (August 28, 1828 – January 5, 1900). Hammond held the position until August 18, 1864, when ongoing tensions between him and Secretary of War Edwin M Stanton (December 19, 1814 – December 24, 1869) caused his court marshal and removal. The position was then handed to Joseph K. Barnes, (July 21, 1817 – April 5, 1883) who maintained the role until June 30, 1882. All these men had significant bearing on the medical care of the soldiers and their personalities and education level would indicate what type of care they would give.

General Order No.15.

With the attack on Fort Sumter (April 12–13, 1861) there was an immediate need to build up the Army. Lincoln needed to switch from a peacetime Army to a battle-ready Army. This call to action was done without a master battle plan; it was a quick retaliation to Fort Sumter. In General Order 15, Lincoln stated he needed up to forty-two thousand men,

“to aid in the enforcement of the laws, and the suppression of insurrection…[with] a maximum aggregate of forty-two thousand…men…. Thirty-nine Regiments of Infantry and one Regiment of Cavalry.”[50]

These volunteer regiments were comprised of “State troops or militia” which heeded the President’s call to arms.[51] Each regiment was comprised of ten companies. The commissioned officers were appointed by the Governor of the State furnishing the regiments. The non-commissioned officers were appointed by a Captain. [52]

Each Regiment had a minimum 830 company officers and enlisted, and a maximum 1,010 officers and enlisted. Out of this number, there was: “(1) Assistant Surgeon and (1) Hospital Steward, as well as (2) Principal Musicians, and (24) Band Musicians.” Additionally, it stated, the cavalry men will “furnish their own horses and horse equipment” and the soldier who became wounded or disabled would be entitled to benefits. It also stipulated what was to be paid to the Band members.[53]

Figure 17 is the Recapitulation of GO. No. 15. outlining the Thirty-nine Regiments of Volunteers.

A close up of a receipt Description automatically generated

Figure 11. G.O. No. 15 Recapitulation. General Orders of The War Department, Embracing the Years 1861,1862 & 1863. Vol I.p.35.

Out of 42,034 men, there were 39 Assistant Surgeons and 39 Hospitals Stewards, or 1000 men for every 1 Assistant Surgeon and 1 Steward to attend to them. Furthermore, within General Order 15, there is more discussion on horses, disability benefits and pay scale for band members, than on caring for the wounded. In fact, there was no mention of transporting the wounded, or of having men designated as stretcher-bearers or ambulance staff, nor of medical wagons or ambulances.

This type of regiment configuration with little medical support was normal for the period leading up to the July 21st, 1861, First Battle of Manassas.

Prewar Excitement

According to the diary entry of New York City lawyer George Templeton Strong (figure 18), also one of the founder of The United States Sanitary Commission (figure 19), there was prewar excitement, anticipation for the new war. He stated,

Figure 12. George Templeton Strong: George Templeton Strong Diary, p.234.

Mr. Secretary Blair…thinks there is little fight, if any, in the blustering fire-eating elements of the South; its bar-room swashbucklers will collapse whenever they are resolutely met.”[54]

His May 30 and 31st entry describes a fine display of the New York 9th Regiment and the wealthy men who “joined” it.

“Afternoon, parade and review of newly arrived regiments. Garibaldi Guard, Colonel Blenker’s Germans (very promising corps both), the New York Ninth in their effective black and red uniform… Talked with Goddard and other Providence millionaires who are serving in the ranks, and saw their evening parade, which was creditable.”[55]

Not only were there millionaires marching and playing soldiers, on June 1st, he stated there was festivities near the White House,

“Walked…the grounds back of the White House, listening to the Marine Band. Loungers numerous and the crowd bright with uniforms. Firing heard in direction of Alexandria. Excitement, rumors of battle…”[56]

Figure 13. Executive Committee of the U.S. Sanitary Commission. Left to right: Dr. William Holme Van Buren, George Templeton Strong, Rev. Dr. Henry Whitney Bellows (Commission President), Dr. Cornelius R. Agnew and Prof. Wolcott Gibbs. Courtesy of the Library of Congress.

 

Soldiers Welfare – Charitable Groups

At the beginning of the Civil War, past thoughts on the horrors of the Crimean War were not far off, and sad letters sent home from sick and lonely soldiers, along with emotionally charged newspaper reports on poor camp conditions and the suffering of soldiers, prompted civilian women to organize and form charitable groups like Florence Nightingale did. These groups such as The United States Sanitary Commission (figure 19) and The United States Christian Commission[57] were created to aid and relieve the suffering of the soldiers.

These were Union supporting groups whose focus was on improving the healthcare of soldiers, better the communications between soldiers and their homes, as well as help to organize a system where part of a soldier’s paycheck could be sent home to cash strapped wives and families. Additionally, in April – May of 1861, as the war was commencing, these civilian aid groups collected and used community donated resources and money to help care for the suffering soldiers, yet were denied official access to the soldiers and since charitable groups were not endorsed by Interim Surgeon General Wood, they were not recognized as helpful.[58]

The Confederacy had their own soldier welfare groups, such as, The Ladies’ Soldiers’ Relief Society, and The Ladies’ Hospital Association.[59] Throughout the North and South, there were many welfare groups created to provide basic medical care for the tired, sick, and wounded soldiers, as their respected governments either could not, or would not, care for their medical needs.

Soon after the war started, reports were coming out on the poor sanitary living conditions, diseases, and illness within the camps. There was a social fear that “our soldiers” would suffer horrific deaths like those in the Crimean War. Men like Templeton helped form relief societies to compensate for any shortcomings the Army may have had in caring for the health and wellbeing of its solders. During this time, the newspapers were discussing camp problems, sanitation, and diseases within the troops along with the former heroic actions of Crimean volunteer nurse Florence Nightingale.

Templeton, a dedicated Christian and successful lawyer, sponsored a local regiment and joined other prominent men, Rev. Dr. Henry Whitney Bellows, paster at the All Souls Unitarian Church, New York, Dr. William Holme Van Buren of New York’s College of Physicians and Surgeons, Dr. Valentine Mott, Professor of Surgery at Bellevue Medical College, Fred L. Olmsted, and others, to combine their passion and talent with Dr. Elizabeth Blackwell of the New York Infirmary For Women to form The United States Sanitary Commission and on the 9th of June 1861, Lincoln approved their plan to care for suffering soldiers. [60] These men were movers and shakers within upper New York Society and were politically connected with access to Lincoln’s Cabinet.

On May 23, 1861, The Sanitary Commission wrote Secretary of War Cameron with an outline of the Commission’s plan to aid the Army with donated supplies and funds. Section III, of the report stated,

“The Commission would inquire into the organization of Military Hospitals, general and regimental the precise regulations and routine … Hospital supplies … the question of ambulances and field service, and of extra medical aid…” [61]

On June 9, 1861, Secretary of War Cameron writes back the Commission is

to act as “A Commission of Inquiry and Advice in respect of the Sanitary Interests of the United States Forces’ and without remuneration from the Government. The Secretary has submitted their patriotic proposal to the consideration of the President, who directs the acceptance.”[62]

Yet, being approved to be of service to the Army and becoming wholly accepted is a different matter. When the plan was finally agreed upon in June, Cameron would only let the Commission’s volunteers work with the volunteer regimental soldiers and not with the regular Army.

The First Battle of Manassas July 21, 1861

On July 17th Templeton writes

“McDowell’s column is in advance on Fairfax and Manassas Junction at last. I fear this move is premature, forced on General Scott by the newspapers. A serious check on this line would be a great disaster.”[63]

It would seem, according to Templeton, the media could and did influence and interfere with battle planning. In any case, for an Army to move ahead of its planned schedule, it is guaranteed some of the needed supplies will be left behind to expedite the troop movement, which includes leaving behind medical supplies.

Just prior to The Battle of First Manassas, there was much excitement with local regiments marching in the streets for both pride, boastfulness and recruiting purposes. The Second New-York Regiment, who according to The New York Times marched through the city, “up Lombard-street, from one deport to another were well received and cheered on many parts of the route.”[64] Between the excitement and a tinge of the unknown, many regiments hurried to the battlegrounds completely unprepared. When Manassas started, The Twenty-Seventh New York Regiment had two ambulances but not a trained ambulance staff. General Irvin McDowell had only fifty ambulance wagons for thirty-five thousand men,[65] and The Fourteenth New York headed into battle without ambulances.[66] Furthermore, it was reported the battle, which took place roughly 40 miles outside of Washington, drew “thousands” of spectators.[67] William H. Russell, reported he and his friends during the battle were resting in the shade of their buggy, and “made a feast on … sandwiches.”[68] While, Edward Pollard described, “a stream of visitors …set out from Washington, thronged with gay women and strumpets going to attend “ the Manassas Races.””[69]

Not since the War of 1812, had there been such a massive battle on American soil. This first battle was a costly battle for both sides and it indicated to the Army and to the public, this war would not be over soon and that neither of the armies were prepared for the expense, death, and chaos war brings.

Losses from the Battle of First Manassas

The Confederates had a total force of 29,188, suffered 1,582 wounded, 387 killed, with 13 missing, [70][71] while the Union Army comprised of 35,000 soldiers, 1,011 wounded, 481 killed, and 1,216 missing[72]. One of the issues with this battle was the belief it would be won quickly; it would be without a doubt the Union would win and would be over as quickly as it had started.

Medical Care During the Battle

Medical Director of the Union Army Surgeon W. S. King, under General McDowell, reported after the battle he and Assistant Surgeon Magruder, and a few others, were the only combat experienced medical officers. “Our advice and assistance were eagerly sought in relation to the details of camp life and the mode of procuring the necessary medical supplies”. Additionally he stated, pre-battle, he tried to distribute the few ambulances equally among the regiments, and decided he needed more, “I made an estimate of twenty wagons for our medical supplies, which, although approved by the commanding officer, did not result in their being sent.[73]

King was not the only one with supply problems. Surgeon H.P. Stearns U.S. Volunteers of the 1st Connecticut writes, the wounded were carried to a makeshift field hospital by “blankets fastened to poles” and he said the landscape would not allow for wheeled ambulances.[74] According to Assistant Surgeon C.C. Gray, U.S.A., who was at Manassas, and was one of the medical men at Sedley Church, the Union’s makeshift field hospital was captured and the next day was then instructed to hunt for wounded on the battlefield using a Coolidge ambulance. He writes,

“It was raining… We soon found that many must perish before we could possibly remove them… many were left on the field, and numbers doubtless died for want of timely assistance…. We suffered much for want of food, water, and blankets.”[75]

Gray’s testament is an unfortunate example of war, but it does not that help that neither side was supplied correctly before they started the war. Thus, considering this problem of supply and demand, it became clear to many, if the first battle did not end the war, then the manufacturing, gathering, and shipping supplies for the war effort is paramount, as it will not be a quick war. Moreover, by following outdated medical regimental proceeds and not ordering the needed medical supplies weeks before the fighting, many savable men died that day from lack of basic medical care.

Reality of War

The preliminary investigation into unnecessary deaths on July 21st, 1861, clearly dictates the cause of most deaths was from the lack of field medical care and ambulances. The combined number of men fighting (both sides) equated to 64,188 men. Of this number, there were 2,593 were wounded, 1,229 were missing, and 868 killed.

The medical regulations of the Confederacy stated ambulances should carry 40 men per 1000, and that a regiment should have at least, ten two-wheeled ambulances, two four-wheeled ambulances, and four two-wheeled transport carts. [76] In Confederate Hospitals on the Move…, Glenna R. Schroeder-Lien reports, these ambulances when found were unusable and lacking in quantities.[77] And like the Union, the Confederates regiments mostly relied on ordinary wagons, or “those captured from the Union.”[78] Four months after the war began, the Confederate armies medical ability “was anything but encouraging.”[79]

Doing the Math

To effectively provide adequate medical care for the 64,000 men at First Manassas, with a given ratio of 40 men per ambulance and one ambulance per 1000, it would take 1,600 ambulances plus a trained and dedicated crew to successfully remove the wounded. Of course, the 40 men per ambulance at First Manassas was a textbook wish of how it should be, yet what the armies did use was some Tripler units which had a capacity of 10, the Rosecrans, which held 15, and the two person French Cacolets which was strapped to a horse or mule. The Cacolet utilized was modeled after a French design which they used in Algeria and the Crimean These units and others were utilized throughout the war and their numbers did increase, but during the first two years of the war, the ambulance was primarily the plain old wagon.

Regardless the mode of transportation used during First Manassas, it would have taken an astronomical amount of ambulances to evacuate the wounded from the battlefield in a timely manner.[80]

The Shortage of Supplies. Why?

As discussed, ambulances and basic medical care were hard to find during the First Battle, but why was this? The records indicate that before the war there were many discussions within the Army on the need for an improved medical-ambulatory system and the data demonstrates many of the suggestions were denied by high ranking government officials. As mentioned, King never received his twenty-extra ambulances prior to the battle. In fact, those ambulances and many others were being held in Washington.

General Wadsworth stated a few days after the battle he, along with thirty-nine ambulances, went to collect the wounded and dead.[81] Though intentions were good, thirty-nine ambulances of any type, days after the fact, seems to be a dismal amount in relation to the amount of wounded.

Additionally, King, in his official report on First Manassas, stated

“In preparing for the expected battle, a limited number of ambulances which had been furnished, was distributed with great care, so as to equalize the amount of transportation among the regiments [600 to 800 men each]. I made an estimate of twenty wagons for our medical supplies, which, although approved by the commanding officer, did not result in their being sent…. As the conveyances estimated for had not been furnished, these arrangements made it impossible to transport any medical supplies except such as could be placed in the ambulances or poked into the forage wagons, and this I directed the medical officers to do.” [82]

King’s report is significant as it demonstrates even though there was pre-planning, there was also a problem with the existing supply chain, thus preventing shipment of critically needed medical supplies, which in turn caused unnecessary deaths of savable men even before the battle started. This supply problem will continue to plague the Army throughout the war but will slowly improve as the leadership changed in a few key positions.

Even if each regiment had its own ambulance, holding 10 to 20 men, after the first shots were fired it would be quickly filled. To compound this, the battles did not stop; they kept going, killing and wounding, the ambulances would have to leave the field to transport the first set of wounded and be gone for an unknown amount of time, while in its absence, more and more men would need critical medical attention.

Surgeon General Clement Finley

Two months before First Manassas, on May 22nd, The Evening Star announced that Surgeon Clement Finley (figure 20) had become the country’s tenth Surgeon General, replacing Interim Surgeon General Wood.[83] This change meant the Sanitary Commission’s prior connection with the department would need to start over. Unfortunately, it has been reported Finley, like his former boss, Lawson, had been in the military for over forty years, and was sixty-four when he became Surgeon General. He served with General Scott in the Back-Hawk War of 1832 and in Mexico, thus, like Lawson, he was a frontiersman, with a frontier scope on medicine and departmental organization. Furthermore, it was reported, he was more concerned with saving money than with suppling troops and that new medical equipment and books were a wasteful expenditure of funds. Lastly, he would not order medical supplies until after a battle started.[84] He was in the position for two months when First Manassas occurred.

Figure 14.Major General Winfield Scott. Courtesy of National Archives;529369, 111-B-5265

Figure 02. Tenth Surgeon General, Clement A. Finley (1797 –1879)

Also in May, civilian Dr. J. O. Bronson approached General Winfield Scott, (February 14, 1824 – February 9, 1886), (figure 21), on forming a dedicated ambulance corp. consisting of a, “surgeon-in-chief, with aids, nurses, and an efficient body of men to attend upon the ambulance and litters.” General Scott then sent the requested plan to Surgeon General Finley, but according to footnote 1, in The Medical and Surgical History….Ser I, Vol II, pt. III indicates, “no further action seems to have been taken” with Bronson’s plan. [85] Not only were there other individuals like Bronson who were willing to help organize an official ambulance corps, but during April and May, the Sanitary Commission had been feverishly working to get the government to recognize their organization and allow them to help supervise the sanitary conditions of the camps and provide medical aid to, and help evacuate the wounded when needed.

Templeton Strong, remarks, after dealing with both Wood, Finley, and Dr, Tripler, Medical Director of the Army of the Potomac, in his September 16th, 1861, diary entry,

“Old Finley, the head of that office, is utterly ossified and useless… Dr. Wood… His main defect is blind, fanatical loyalty to his chief, Finley… Dr. Tripler…is an energetic, spasmodic, crotchety, genial old gentleman…”

Figure 15. Fredrick Law Olmsted. Courtesy of The Papers of Frederick Law Olmsted.

These remarks came after Dr. Lamb, the Medical Purveyor the Union Medical Department was “out of bandages” and asked the Commission if they would supply him with some. Templeton noted on the department of the Surgeon General, “The fogies of that department manage it in the spirit of a village apothecary. [86]

On December 15, 1861, Secretary of the Sanitary Commission, Fred L. Olmsted (April 26, 1822 – August 28, 1903, figure 22), in replying to a previous correspondence from John M. Forbes, concerning Forbes’ remarks about Surgeon General Finley, stated his opinion of Finley,

“ …it is criminal weakness to entrust such important responsibilities as those resting on the surgeon general to a self-satisfied, supercilious, bigoted block head merely because he is the oldest of old mess-room doctors of the old frontier-guard of the country. He knows nothing and does nothing and is capable of knowing nothing and doing nothing but quibble about matters of form and precedent…”[87]

Likewise, Charlies J. Stillé, writes, in the History of the United States Sanitary Commission,

“It soon appeared that the Surgeon-General had no admiration for the Commission, it was equally clear that all the old traditions of the army conceived in a spirit which never looked beyond the wants of ten or fifteen thousand men, and for that reason, if for 110 other, wholly inapplicable to the existing emergency were to be maintained in all their vigor… his devotion to routine and his undisguised hostility to their body would render all their plans for promoting the health and efficiency of the army practically worthless.”[88]

Evidence within these claims about a non-responsive Surgeon General’s medical department, along with comments on Finley’s own inactions, further presented his and the department’s inadequacy as the months rolled on with continuation of poor, and at times, no response to requests from the field for medical equipment and supplies. This information supports Surgeon Kings statements of not receiving the 20 ambulances he ordered prior to First Manassas.

Like previous attempts to organize an official ambulance corps, in September of 1861, the Pennsylvania’s Surgeon General offered to supply a complete ambulance company (‘2 officers, 67 men, and 45 ambulances) for the Pennsylvania Reserves. Like several other requests before his, he did not get a reply from the Surgeon General or the Secretary of War.[89]

After the debacle of First Manassas, things did not improve within the supply chain or the Army’s medical department as evidenced by the poor handling of The Peninsula Campaign in March 1862. Data suggests things did not improve until Finley was removed from office on April 14, 1862, and a man 30 years younger, highly educated, and motivated, Surgeon William A. Hammond, took over the department.

For the Lincoln administration, the disaster at Manassas was an embarrassment and the negative reports within the press did not help. Manassas caused a reexamining of the top leadership in Washington as well as within the Army’s top leadership and its equally humiliated medical department. For the Sanitary Commission, the changes in the Lincoln Cabinet caused a renewed interested in their ability to provide care, as well as created new obstacles. The fallout from the failure at Manassas, and of the war in general, meant pressure was mounting on Lincoln’s administration for change. The Day after the Manassas fiasco, July 22nd, Congress backed a passed a Sanitary Commission proposal, titled, An Act to authorize the Employment of Volunteers to aid in enforcing the Laws and protecting Public Property.

This act allowed the President to call up to an additional 500,000 volunteers, “for the purpose of repelling invasion, suppressing insurrection.” Section 2, indicated, these men would be organized into regiments, which included, one surgeon and one assistant surgeon, two principal musicians, twenty-four musicians for a band, as well as one wagoner. In this Act, there are twelve detailed sections, yet within this new Act, even after Manassas, there is not a mention of additional medical supplies or ambulances.

The Act is an extension of the regimental policy that already existed. It was for more men; not an improvement in caring for the wounded, or to supply a better system. The Act added more gas to the fire, without an extinguisher. Additionally, on August 12th 1861, just weeks after the July 21st Manassas battle, the Lincoln administration made a move and Medical Director of the Army of the Potomac King was out the door and replaced by Charles S. Tripler (figure 23). Tripler, like Lawson and Finley was also a frontier army doctor, who fought in the Second Seminole War (1835-1842) as well as Mexican American War, thus was not an experienced medical officer in a war of this scale and scope.

Figure 16.Dr. Charles Stuart Tripler (January 19, 1806 – Oct. 20, 1866). Papers of Fredrick Olmsted. p.339.

On March 6, 1862, Army of the Potomac, Medical Director s Office, Surgeon Tripler noted in correspondence with Surgeon General Finley and Secretary of War Stanton, regarding his thoughts on an official Ambulance service,

“Sir, I have examined the plan of organization of an ambulance corps… However desirable a regularly organized ambulance corps may be for an army, it is too late now to raise, drill, and equip so elaborate an establishment as this for our service…”

On March 9th, both the Secretary of War and Surgeon General agreed with Tripler. [90] On March 19th, Tripler reported to Finley regarding ambulances, “Inquiries are constantly made about ambulances… if a reasonable supply of these carriages is not at the right place at the right time…the failure does not rest with the medical department.”[91]

The data present thus far indicates there was a desperate need for an official ambulance corps, as well as standardized ambulances. The medical care during The Peninsula Campaign was not any better, in fact in many ways it was worse, for there were more men, less medical supplies per man, and longer distances to travel for both supplies and medical care. And still not an official ambulance corps., nor standardized ambulances, only a few varied ambulances with varying carrying capacities which were used to evacuate the wounded from the battlefield. During this campaign, the weather was atrocious, and the dirt roads made wheeled ambulances useless. To combat this problem, the Army tested the Cacolet (figure 24).

Figure 17.French Cacolet, Medical and Surgical History of the War of the Rebellion, Vol. II. Pt. III. p. 931.

The Peninsula Campaign (March through July 1862)

During the Battle of Seven PinesFair Oaks, (May 31-July 1, 1862), the Army knew it needed more ambulances and that much of the countryside was not conducive to wheeled ones; as the muddy war torn landscape slowed or prohibited them during the varying Campaigns. Yet before this, in January 1860, the Army Medical Board decided to use horse drawn single person litters (figure 25), which unlike like the one or two person Cacolet, was dragged behind a horse.[92] In the correct setting, this useful device would work well. However, like the Cacolet, it would take hours to evacuate the wounded men from the Seven Pines battlefield, causing many to die while waiting their turn.

Figure 18. Horse Litter, Hamilton, A Treatise on Military Surgery and Hygiene. p. 162

On May 27th Colonel S. Van Vliet, the Quartermaster at the White House Landing (figure 26) on the Pamunkey River received a telegram from Lieutenant Colonel J. A. Hardie, requesting the forty Cacolets and their horses which were stored there.

Figure 19. Battle of Seven Pines, May 31, 1861

On May 31, 1862, during The Seven Pines battle, F.H. Hamilton the Medical Director of the Fourth Army Corps indicated

“eight pack-saddles, provided with a litter on one side and a cacolet on the other, were provided as a part of the ambulance outfit of that corps, and were used only on the first day of the battle, proving utterly unserviceable.” [93]

Furthermore, Hamilton indicates, the horses were not suitable to the task, and six of the Cacolets broke in service.[94]

On March 16, Mr. Kohler a salesman or Cacolet manufacturer, requested an examination of his new litters and Cacolets. Medical Director Tripler replied back to him, “there are sufficient horse litters for this Army in the possession of the Quartermaster’s Department. All we want now is horses or mules properly trained to carry them.” Moreover, Tripler, on April 25th, indicated there were more than 200 Cacolets furnished by the Quartermaster’s Department, and that General McClellan gave orders to have his horse trained to carry them, yet it is reported that this order was never carried out.[95] From June through December of 1862, the conversation over the use of Cacolets continued.

Battle of Fair Oaks – Seven Pines (May 31, 1862 – Jun 1, 1862)

On June 10th Olmsted docked at White House Landing (figure 27) and aboard the Tender Wilson Small, stated since the Battle of Fair Oaks / Seven Pines (figure 26) commenced, the Commission had received “four thousand” wounded and that half of those were transported for additional medical care, and on July 1st near Harrison’s Point he wrote, “For the wounded there is no provision: no beef—none at all…nothing yet for them to eat.” [96]

Figure 20. White House Landing. Courtesy of The Olmsted Papers, p. 335.

In October 1862, Surgeon General Hammond requested 150 mules provided with mule litters, to be sent to Dr. Letterman. Captain J. J. Dana, A. Q. M., reported, “we had no mules sufficiently well broken for the purpose… many of them, inclined to lie down, and were otherwise unruly.”[97] The correspondence from Quartermaster’s Department indicated,

“…no less than $100,000 and probably more, has been expended in an experiment which was, so far as information in this office goes, entirely unsuccessful…. All the requisitions came from the Surgeon General’s Office. It is not known to this office that these mule litters ever were used in service, and the quartermaster General believes that no wounded man was ever placed upon one of them… any further expenditure ….will be a waste of public money…”[98]

In June, Colonel Rucker advised the Quartermaster General that Koehler’s product was very high priced and “It is intricate and cumbersome in construction” therefore inferior to the French Cacolet and litter[99]. According to the Property Division of the Surgeon General’s Office, between 1861 and 1865, the Medical Department purchased and distributed 918 horse or mule litters. Moreover, the designated mules were taken for the ambulances and wagons.[100]

This method was an extremely ineffective way to extradite the wounded from the battlefield. For example, the 61st Pennsylvania of the Fourth Division during Seven Pines (figure 28), suffered 152 wounded with 68 killed, and the 5th New Hampshire had 147 wounded with 26 killed. Because we do not know if the dead were declared dead while on the field, we must include them with wounded, therefore, there were 393 wounded to be removed from the field. Of course, some could walk off.

Figure 21.Bringing wounded soldiers to the cars after the battle of Seven Pines June 3 1862 Library of Congress.* Figure 28 is a firsthand sketch of the wounded being unloaded from ambulances and putting them into rail cars at Fair Oak Station.

Note, you can see varied styles of ambulances, including some type of Cacolet in the foreground being attended two by two men.

Even if 200 men were transported off the field at the same time, there needed to be 100 mules / horses with Cacolets standing by to quickly extract the wounded. Of course, with this device the wounded must be able to be placed into the wagon, as well as sit upright while being transported. Yet, the actual battle statistics for the wounded was far more than 393.

Figure 29 is the O.R. Recapitulation of the losses suffered for the Army of the Potomac at Seven Pines showing 3,378 wounded with a total Aggregate of 5,031.[101] This is greater than the total losses from both sides during First Battle of Manassas, which was 4,690 just eleven months earlier.[102] Moreover, these are the statistics for only one of the several peninsula battles.

Figure 22. Recapitulation on The Battle of Fair Oaks. O.R. Ser. I. Vol. XI. p.764.

Even after the Battle at First Manassas and with all the time and money spent investigating Cacolets, there seems to be little practical thought on how to swiftly extradite the wounded when a large-scale battle occurs. It is obvious the long-practiced frontier medical mentality did not work with the size and scope of the Civil War.

For the most part, during The Peninsula Campaign, the men in charge of such extraction decisions were still using small scale frontier regimental thought. Yet, this was not always the case. Before the Peninsula Campaign was fought between the banks of the Pamunkey, Chickahominy and James rivers, several supply depots were established, White House Landing, Eltham’s Landing, and Cumberland Landing (figure30).

Figure 23. The Army of the Potomac at Cumberland Landing, 1862. Olmsted, Papers, p. 358

Surgeon Tripler and Olmsted, of The Sanitary Commission, had enough forethought to order medical ships to be sent to White House Landing and Harrison’s Landing before the start of the Peninsula Campaign. Even though both individuals saw the efficiency of using medical ships to care for the wounded, unfortunately, they did not cooperate in a professional manner, and their attitudes towards each other hindered the process of aiding the wounded.

Harrison’s Landing

Figure 24.Harris Landing 1862. Library of Congress

As the Army of the Potomac fought its way to capture Richmond, they had to march, fight, and camp, along the Northern banks of the James River, its tributaries, swamps, bogs, and marshes. During this period, the men camped for an extended period of time at Harrison’s Landing (figure 31), thus exposing them to a constant barrage of mosquitoes, water saturated ground, and months of varied weather; from cold spring rainy weather to hot humid rainy weather. This environment and slow arrival of supplies caused thousands of men to get sick.

On April 30, a month after the start of the campaign, the Army of the Potomac consisted of 109,335 men and officers, and out of that, 5,385 soldiers and 233 officers were sick. By July 10, there were 89,549 men in the unit, comprised of 3,834 officers with 85,715 soldiers. Out of that, there were 685 sick officers and 15,959 sick soldiers. [103] The environment was not encouraging to the health of the regiment.

Figure 32 is an office map drawn by the United States Army of The Potomac. Engineer Dept. in 1862 of the area, including, White House Landing, Harrisons Landing and others.

Map Description automatically generated

Figure 25.White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862).Courtesy of loc.gov/item/lva0000179/

 

Figure 33 titled, The Skedaddle of the Pamunkey, is a sketch of one of the landings on Pamunkey river. The image gives size and scope to the naval logistics needed to support The Peninsula Campaign.

 

Figure 26.The Skedaddle of the Pamunkey, Olmsted Papers. p. 382.

Medical Director Tripler; Meddling Village Doctors and Strong-Minded Women, and Poor Condition on the Peninsula

In his report on the medical operations of the Army of the Potomac from March 17 through July 3,1862, Tripler complains, that in preparing for the upcoming Peninsula Campaign his thirty years of medical knowledge and the running of the medical department had to endure and be challenged by “presumptuous intermeddling” from “Sensation preachers, village doctors, and strong-minded women, suddenly smitten with a more intimate knowledge” on medical matters and how to run the medical department. He goes on to recount how the “ crude suggestions” and interference was “paralyzing” to the department, as they (outsiders), tried to “quicken” the medical departments procedures thus, defeating[his] measures” which he planned to exercise “at the proper time.” [104]

He noted, by 11 March, all the supplies for each regiment was ready for deployment, shipping hospital tents, medicines, stores, a wagon to transport the supplies and the sick. Also, he stated, medical officers were given “minute directions [on] forming field depots for the wounded [along with] methods on paring…the distribution and employment of the Ambulance Corps.” [105]

Yet, in March of 1862, the Army of the Potomac did not have an official Ambulance Corps, and most regiments depended on band members as stretcher bearers. Furthermore, he indicated, the initial orders to prepare the Army of the Potomac for the upcoming campaign was expedited, thus his plans to create a medical corps d’armée had to be postponed. He wanted each regiment to be “a complete army in itself.”[106] He then discusses all the problems created by expediting the deployment, as well as listing the doctors he assigned to each corps,

  • Keeney to Sumner’s
  • Brown to Keyes
  • Milhan to Heintzelman’s
  • Magruder to McDowell’s

Additionally, he also voiced his objection that Keeney, one of his medical inspectors, was replaced by J. F. Hammond, without his being consulted. He asserted, “I cannot help complaining of the act itself as inexpedient and unjust. I remonstrated against it at the time upon principle, but without avail.”[107] To have a key member of his medical team replaced without his consent demonstrates that his superiors are questioning his management judgment. Moreover, he demonstrated his disapproval of the Sanitary Commission’s action by expressing they were generously giving out “comforts” for the “inmates” being treated in the military hospitals. Inmates, of course, are patients, i.e., wounded soldiers. He continued, these “comforts” are given out “very liberally…I had no control over these issues… they should not be given out unnecessarily …kept in reserve, [until] an emergency, such as a battle.”[108] Of course, this is exactly how his predecessor and mentor Lawson thought and acted.

Tripler also stated he met with General Van Vliet concerning the distribution of ambulances, for the upcoming campaign. Van Vliet expressed the best he could do at that time was send 36 four-wheeled units which were already mobilized and would send 86 more in the future, as well as send 140 two-wheeled units when he could. This meant, there were 402 ambulances ordered for the campaign. Tripler indicated this order was not completed until the 1st of May. [109] Thus, if the 4 wheeled unit can carry 10 each, then 122 four wheeled units could carried 488 men, while the two wheeled typically used carried 2 men, thus 140 equates to 280 men, with a total capacity of both ambulances to carry 768 wounded. Of course, these ambulances are distributed among the regiments and are not all concentrated at one battle, therefor their effectiveness becomes diminished as they are divided up. Additionally, Tripler exclaims, he was expecting 6,000 casualties from the upcoming battle at Yorktown, which would indicate he would need at least 600 four-wheeled ambulance.

These are rough estimates and the actual number of ambulances and their capacities varied, yet the records indicated the number of units employed would not suffice. Additionally, at this time, this report does not know how quickly ambulances were manufactured, therefore we do not know the replacement time when one was damaged. This could also greatly impact the survival of wounded men waiting for care on the battlefield.

Not only were ambulances a concern, so was the environmental conditional in which McClellan chose to march and camp his troops. Tripler wrote that between Warwick Courthouse to the York River, there was nothing but a “succession of swamps”, he added, the warm weather and the swamps will bring on “malarial poisoning” and that many of the wounded should be shipped North to hospitals via medical steamers. Captain Colonel Ingalls, aide-de-camp to McClellan, agreed to ship patients North from any point on the York River. At this point, Tripler contacted Interim Surgeon General Woods who agreed to this plan but insisted on changes which altered Tripler plans. Woods wanted specific injuries to be sorted and placed on corresponding ships which went to particular hospitals. Unfortunately, the mixed communications on how to treat and evacuate the wounded via the hospital ships became convoluted. To confuse things further, many states sent their doctors, female nurses, and medical supplies on their own retrofitted makeshift floating hospital ships.

Tripler reported,

“On the 19th Prof. Henry H. Smith, Surgeon General of Pennsylvania, arrived with the steamer Wm. Whildin, completely fitted up with bedding, stores, instruments, a corps of 18 surgeons and dressers, and a full complement of Sisters of Charity for nurses. He brought with also the means of embalming the bodies of the dead.”

He also reported that on the 19th, malaria and typhoid were beginning to appear in Keyes’ corps. And Keyes was the “worst on the Peninsula.” He stated, as he made arrangement to ship the sick North, the number of sick was increasing. [110]

In his report, Tripper stated he had ordered enough medical supplies and transports to care for the wounded during the entire Campaign, yet when the Army first arrived and prepared for the Battle of Yorktown, he asserted he was “flooded” with requisitions for more supplies.

He exclaimed,

“The medical officers seemed to suppose that the medical director was to furnish them with fresh supplies at every change of position, and had taken no pains to transport their stores from Washington to the Peninsula…”

He also remarked that “Liquors had very generally disappeared” … and “his” supply of stimulants was now limited and would only issue any in case of a battle.[111]

A New Surgeon General: William Alexander Hammond (1828-1900)

On April 28th, the changing door of leadership spun again, two weeks into The Siege of Yorktown, McClellan had Secretary of War Stanton replace Surgeon General Finley with William Alexander Hammond (figure 34). Hammond was picked by McClellan from a list of candidates selected by The Sanitary Commission.[112] According to James E. Pilcher, Stanton and Finley had a falling out over reported problems with Dr. John Neill, whom Finley appointed as the head of several Army hospitals located in Philadelphia and not so much as pressure from the Sanitary Commission.[113] This will not be the only Surgeon General Stanton disliked and removes.

William Hammond was thirty-one years younger that Finley, earned his M.D. in 1848. From 1849-1858, was a frontier surgeon in the Army and involved in the First Sioux War (1854, 56). In 1858, he resigned from the Army. In 1859, he became a professor of Anatomy and Physiology at the University of Maryland in Baltimore and eventually published a treatise on neurology. Although he was a frontier army doctor, he was a new breed of up and coming doctors. In 1861, after the 6th Regiment Massachusetts Volunteer Militia was attacked during the Baltimore riots, Professor Hammond decided to reenlist in the Army. In doing so, he started at the bottom of the ladder as an assistant surgeon. First, he was assigned as a medical purveyor in Frederick Maryland then went on to organize Baltimore area Army hospitals, as well as become an inspector of hospitals and camps for Maj. Gen. William S, Rosecrans. Additionally, during this time, his professionalism became known and respected by The Sanitary Commission.[114]

Figure 27.Eleventh Surgeon General: William Alexander Hammond (1828-1900). Library of Congress

According to Templeton’s diary, Hammond was “a comparatively young man of great force of character, scientific capacity, keenness of intellect, and originality of method.” His October 13th, 1861 entry, dictates,

“Dr. Hammond… Only an Assistant Surgeon, but he has had intimations from the War Department that …. he may take Dr. Finley’s place. . . . Dr. Bellows thinks well of him.” [115]

This was recorded seven months before Hammond’s April 28th, 1862 appointment as Surgeon General. This appointment was due to The Sanitary Commission, as well as the April 18, 1862: “An Act to Reorganize and Increase the Efficiency of the Medical Department of the Army[116]

The Commission’s power was quite apparent with the passing of this Act, as well as their appointment of Hammond.

Even though Hammond was agreed upon by Secretary of War Stanton, Stanton did not like Hammond.

“Well,” growled the Secretary, “the fact is the Commission wanted Hammond to be Surgeon-General and I did not. I did my best with the President and with the Military Committee of the Senate, but the Commission beat me and got Hammond appointed. I’m not used to being beaten and don’t like it, and therefore, I am hostile to the Commission.” [117]

Hammond remained in this position until August 18th, 1864, when he was relieved of duty and court marshaled for banning the standard Army medicine Calomel throughout the entire Army. Calomel contained mercury and Hammond believed it caused more harm than good. Stanton managed to get Hammond removed over this, but in 1879, President Hayes intervened and had Hammond’s Court Marshal reversed with all his Army benefits restored. It was deemed the case had been about Stanton’s personal hostility towards Hammond.[118]

The Siege of Yorktown (April 5 to May 4, 1862)

On May 2nd, The New York Times front page reported on The Siege Of Yorktown, “The Defeat of the Rebels a Foregone Conclusion” along with, “Probable Capture of the Whole Rebel Forces.” (figure 35)

Figure 28.May 2, 1862, The Siege of Yorktown, New York Times. pg. 1.

The pressure was mounting, and success was expected as the siege was coming to an end, but achieving victory was not McClellan’s only problem, the real enemy was not the Rebel Army, but sickness. During the time the Army was camped on the peninsula, the troops illness numbers were creeping up and the limited number of field hospital beds was soon filled. Out of pure necessity, on the First of May, Tripler ask the Sanitary Commission for help in transporting some of his sick to a Northern hospital. To assist Tripler, Mr. Fredrick Olmstead of the Commission, sent one of their retrofitted steamer ships, the Daniel Webster (figure36) which now represented a floating hospital, complete with 250 beds. Olmstead also suggested Tripler should procure another ship, the Ocean Queen and retrofitted it into another hospital ship, which he did.[119]

Figure 29.The Daniel Webster No. 1. Fredrick Olmstead Papers. P. 326

During the Siege, Tripler was busy requesting more hospital ships and other medical supplies. His reports indicated that during this time, he telegraphed the Surgeon General numerous times requesting new supplies as his were running out. To help fill the needs of the Army at Yorktown, the Commission placed an ad on May 8 in The New York Times, seeking donation for their floating hospital ships, which were at the Siege of Yorktown, (figure 37).

Figure 30. May 8, 1862, New York Times ad seeking supplies for floating hospital caring for the Siege of Yorktown wounded

On May 2nd Tripler indicated he expected to receive 232 sick men from Keyes’ Corps, instead he received more than 1200 sick. By May 9, there were 2000 reported sick in Yorktown, and out of that, 950 were shipped North via the ships owned by the Commission. April’s total sick was 5,618 and July’s, 16,644. There were 11,026 total sick.[120] Tripler also reported he received 28 wounded from General Stoneman, then from The Battle of Williamsburg (May 5), he received an additional 700 wounded along with 333 wounded Rebels.[121] According to Official Records, O.R., the Battle of Williamsburg had 1410 wounded.[122]

On May 7th while anchored off Yorktown, Fredrick Olmsted, aboard the Ocean Queen, writes to friend and President of the Sanitary Commission, Rev. Henry Bellows, explaining how Tripler’s assistant Greenleaf, stated he had 5000 sick which needed to be shipped out. Furthermore, Olmstead relates, many of the regimental surgeons neglected their patients frequently. They would desert their sick and head off to the battlefields, “They are mad with surgical fever.”[123]

The Peninsula Campaign and The Numbers

During The Peninsula Campaign’s five months of slogging through mosquitos and mud, there were various battles along the way each with mixed levels of troops and varied number of casualties. The scope of this paper does not include all of the battles fought during the campaign, such as The Seven Days Battle (June 25-July 1st) which was comprised of Battle of Oak Grove June 25th, Mechanicsville- June 26th, Gaines Mill- June 27th etc.., ending July 1st at Malvern Hill. These battles and others fought during the campaign contributed to an already overwhelmed Army medical department and their battle data is included in the statistics.

Between March and July, The Army of the Potomac lost 1,734 in death, 8,066 were wounded, with 6,055 missing, for a total of 15,855 battle casualties out of 114,000 troops.[124][125] In July of 1862, the Army reported, of the 106,069 soldiers, there was over 40,000 cases of illnesses.[126] The Army of Northern Virginia lost a total of 20,204, 3494 in death, 15,758 wounded, and 952 reported missing out of Lee’s 90,000 soldiers. This equates to a loss of 22 percent of Lee’s army from the start of the Seven Day’s War.[127]

The overpowering logistics of The Peninsula Campaign, with its lack of medical care, medical transports, newly conceived hospital ships, combined with mass sickness overwhelmed Medical Director Surgeon Tripler. His inability to cope with these issues caused many supplies, including medicines and ambulances, to be either not ordered or arrive extremely late. This inadequate supply train cost many men’s lives as they waited for treatment.

The information gathered does indicate that Tripler’s training as a frontier army surgeon did not, nor could not, prepare him for the medical and logistical nightmare facing him on the peninsula. Additionally, it did not help that he was not liked by many around and above him. Furthermore, the reports from Olmsted and others, including the press cause Dr. Tripler to be replaced on June 19, by Dr, Jonathan Letterman. (1824-1872) (figure 38).

Dr, Jonathan Letterman. (1824-1872)

Figure 31.. Dr, Jonathan Letterman. (1824-1872). Courtesy of the Library of Congress

Letterman, twenty years younger than Tripler, was four years older than Hammond. His father was a well-known surgeon. In 1842, Jonathan enrolled in Jefferson College, where he cofounded the fraternity Beta Theta Pi, and he joined the Philomathean Society, which was set on refining upcoming leaders by expressing the importance of writing skills, as well as conducting rhetorical debates. In order to be admitted into the college, he needed to demonstrate his knowledge of the Greek Testament, Virgil, Caesar’s Commentaries, as well as Sallust and other classics.[128] In 1845, he enrolled in Jefferson Medical School and graduated in 1849. In 1824, Jefferson Medical College was established by Dr. George McClellan, father of George B. McClellan.[129]

After graduation, Letterman decided to join the Army and soon faced the Army medical review board. After demonstrating his knowledge of physics, Latin, natural philosophy, anatomy via dissection, and his knowledge of clinical instruction, he and twenty-five other applicants, including his new boss, William Hammond, were accepted on June 29th, 1849, as U.S. Army Assistant Surgeons.[130]

He was stationed in the center of Florida at the swampy Fort Meade in 1849, Ripley Minnesota for a year, then shipped out West to Fort Defiance in Arizona.[131] Like Hammond, both were men of better education and medical training when compared to the men they replaced. Lettermen did not see any major battles with the Indians, thus had a different experience as a frontier army surgeon than his predecessors.

To invoke real long-lasting Army medical policy changes, the Army needed medical men of a different breed, men like Letterman and Hammond, who had the desire/vision, professionalism and disposition to tackle an Army ingrained in a frontier mentality. On July 1st, 1862, Letterman via Hammond, transferred to the Army of the Potomac and landed on Haxall’s Landing on the James River, and then on July 4th went to Harrison’s Landing.

Letterman, in a report, explained the conditions he found on the peninsula. He stated after the men fought and marched for seven days, they reached camp at Harrison’s Landing and were “greatly exhausted” after traveling through an area within the peninsula which was full of “pestilential swamps” engorged by the heavy rains, where malaria would soon arrive and began to adversely affect the men’s health. Furthermore, he explained, “It was impossible to obtain proper reports of the number of the sick,” and as the Army left The Seven Days Battle for camp at Harrison’s Landing they left much of their possessions behind, either by design or it was unavoidable. He stated,

“The supplies had been exhausted almost entirely or had from necessity been abandoned; the hospital tents had been almost universally abandoned or destroyed; the arrangement of the ambulances was not in such a state as to render very effective service, and the circumstances under which the army was placed required a much larger number of medical officers to perform the duties which were thrown upon that portion of the staff….”[132]

He continued explaining how he had over 12,000 men to care for, while 6,000 had already been sent away for other treatment, there were not any hospitals available and only a few walled tents. Additionally, on July 2nd and 3rd it rained; and the men lacked food, shelter, and medicine. He also stated, on July 2nd he requisitioned the Surgeon General “1,000 hospital tents and 200 ambulances”. The 7 July reply to his request was as follows,

“Have [your]ordered tents for 50,000 men sent to Harrison’s Landing. Few hospital tents on hand; more making… use of some of the wall tents sent to Harrison’s Landing… Sick and wounded are not useful at such a place as that at Harrison’s Landing.”

On July 9, he commented that General Meigs placed an order for 250 hospital tents and that the remaining 750 tents will be shipped once they were made, along with 200 ambulances. On July 18th Lettermen noted he received 750 hospital tents at Harrison’s Landing and on August 1st even more tents arrived. Also, during that time, he noted fresh food and vegetables started to arrive in “abundance” as well as fresh breads. On July 30, he informed the Surgeon General the Army of the Potomac had 12,000 sick men out of which 2000 could fight. [133] Thus, was the mess given to Letterman when he arrived.

Mr. Olmsted, The Sanitation Commission, and the Press

The Sanitary Commission placed Olmsted in a supervisory position over the Commission’s hospitals ships sent to the peninsula. He was onsite for eleven months which gave him the unique position to witness the care and wellbeing of the wounded, as well as observe the dismays of war.

It had been reported by Russell that during the Crimean War the French had an excellent ambulance system which included effectively and efficiently using hospital ships.

“the ceaseless activity of the French, the daily arrival of their steamers and the admirable completeness of all their arrangements in every detail – hospitals for the sick, bread and biscuit bakeries, waggon trains for carrying stores and baggage – every necessary and every comfort, indeed, at hand, the moment their ships came in.

Of course, this prompts the question, why did the British suffer so much during that war, and why, six years later, even after reports of successful French battlefield medical care, did the Civil War soldiers suffer so much from lack of adequate battlefield medical care?

In a series of letters and telegraphs Olmstead relates the problems with the care of the wounded and how he and others had found many wounded men in varied states of life, laying about uncared for, in the woods and on the riverbanks. On May 15, from the steamboat Wilson Small, he wrote about how they gathered, “twenty-five severely wounded men, two dying and one or two dead.” In total he assisted 240 sick and wounded men and helped placed them on the Daniel Webster.[134] Olmstead also recalled several incidents where many wounded soldiers after a long journey from the battlefield, would finally arrive for Army medical care, yet were turned away because they lacked a note from their Captain.[135]

On June 13th Olmsted writes to Bellows from the White House landing, indicating things were getting worst instead of better, and that something needs to be done in Washington. He writes,

…if these armies keep their promises to-night, tomorrow ten thousand men will bleed to death and starve to death whose lives could have been saved if proper measures had been taken…. Nobody is to blame for this but the Secy of War, but I would not like to stand in Hammond’s shoes. I don’t think his apology is a bit better than Tripler’s… Hammond must be made to do something at once to revolutionize the policy of the Medical Department.”[136]

After reading Olmsted’s report, Templeton describes his feelings about the medical care of the wounded in his June 13th diary entry, he writes that Tripler and his team are comprised of “weakness and inefficiency and imbecility” leaving,

“carloads of wounded men dumped on swampy river shores without food, medicine, or attendance; of men with fractured thighs lying neglected and forgotten forty-eight hours in two inches of water, struggling to raise themselves so as to pick the maggots from their rotting wounds and fainting after the effort”[137]

Hammond and Stanton: A Battle of Wills

During the peninsula campaign, Hammond has his own problems with Tripler and Secretary of War Stanton which surmounted with Tripler being replaced by Lettermen. On August 2nd, Lettermen’s earlier submitted plans, approved by Hammond, for an official ambulance corps within the Army of the Potomac, becomes law in General Order No. 147, thus putting in motion actions which would eventually and forever change Army ambulance care. Unfortunately, Order 147, was enacted too late to be effective at the Second Battle of Manassas (August 29, 30, 1862), but was reported to have been very successful at the Battle of Antietam (September 17, 1862).

An ambulance corp. is great, but Hammond had always felt the Army also needed an official Hospital Corps. He repeatedly writes Stanton with his plans and thoughts on why the Army needs a Hospital Corps. On August 21st, in a letter to Stanton, he wrote, there is a great need, that it is “most urgent” to establish a Hospital Corps, that during the entire war the wounded have not to be cared for properly or effectively in the field. To this, Stanton replied, on the 29th, “I can see no advantage … for a Hospital Corps … [as it would] increase expense and immobility of our army”[138]

On September 7, as the number of wounded men needing medical care from the Second Manassas kept climbing, Hammond again writes Stanton, on the necessity for ambulances and that they must get an ambulance corps up and running, he states,

“The total absence of ambulance attendants, are now working their legitimate results… Up to this date six hundred wounded still remain on the battle-field in consequence of an insufficiency of ambulances and a want of a proper system for regulating their removal in the Army of Virginia. Many have died of starvation, many more will die in consequence of exhaustion, and all have endured torments which might have been avoided.”[139]

General Halleck (January 16, 1815 – January 9, 1872), General-in-Chief of all Union forces, on September 15th, wrote Stanton needing ambulances, but then went on to explain how he was against Hammond’s plan. He stated, “It is the duty of all officers to furnish fatigue parties, properly officered, on the requisition of medical officers, for the care and removal of the wounded….” Halleck, whose words weighed heavy with Stanton stated to Hammond, “Owing to the opposition of the General-in-Chief, no further steps were taken in this direction at this time.” Instead Stanton tells Hammond to read Tripler’s ambulance plan, General Order No. 20, Sec. VI. dated Oct 3, 1861. It stated

“The hospital attendants, to the number of 10 men to a regiment, and the regimental

bands, will be assembled under the supervision of the brigade surgeons, and will be drilled one hour each day, except Sunday, by the regimental medical officers, in setting up and dismantling the hand-stretchers, litters, and ambulances…”[140]

Conclusion

During the First Battle of Manassas and The Peninsula Campaign, many wounded men died on the battlefield in want of basic medical care or ambulance transportation away from the fighting, or in many cases, just to be taken out of the inclement weather. Doctors during the Civil War did not understand the concepts later formed to create The Golden Hour, that for a trauma or emergency patient their best outcome is to receive medical care within the first 60 minutes. Yet, during the Civil War, despite the many technical school doctors, there were many well educated degreed physicians, like Lettermen and Hammond, who understood that the dirt, grime, and soggy Army camps, created the ingredients for wide-spread camp diseases, and the prolonged exposure of men to the elements while laying bleeding unattended on battlefields would eventually kill many otherwise savable men. The data revealed in July of 1862, The Army of the Potomac had 15,959 sick men out of 85,715 total, this indicating McClellan’s fighting capacity was reduced by almost 19 percent.

Armies and their disease were well discussed before the Civil War. In the Mexican American war, it was known for every single combat, there were seven disease-related deaths, and the first 12 month of the Crimean War, 1855, the British Expeditionary Forces lost 18,000 out of 25,000 to disease, a staggering 72 percent of troop combat readiness evaporated from an invisible microscopic enemy. Crimean War, London Times reporter, William Howard Russell, telegraphed back to London concerned about the huge amount of deaths to the British troops caused by disease. In one report he said, “…our army was likely to suffer severely unless instant and most energetic measures were taken… between 7,000 and 8,000 men sick, wounded… the stench was appalling… The dead, laid out as they died…a spectacle beyond all imagination”[141]

Even after the U.S. Army and the Government had read the detailed report on the Crimean War by Delafield, who wrote on the efficient medical care and ambulances used by the British and French and the deeds of Florence Nightingale during the Crimean War, the Army maintained its belief in the long-standing medical polices created by frontier soldiers / doctors such as Surgeon’s General Lawson, Wood, and Finley, and Medical Directors of the Army of the Potomac, King and Triple. All these men represented medical thoughts and practices of a bygone era, except, they were the transitional men who carried their obsolete frontier mentality into the modern American Civil War. This is the Army medical thought President Lincoln inherited and was forced to use during the first two years of the war. Coupled with his outdated Army medical staff, he also had to contend with Secretary of War Cameron, who was more interested in lining his own pockets, was demoted, and made an ambassador to Russia. Stanton, Wood, Finley, Tripler, did not take kindly to suggestions of medical improvements coming from outside of their sphere, which greatly hindered any attempts to improve the Army medical system.

Even though Letterman’s General Order No. 147 eventually became the standard in ambulance care during the war, it took two years and many deaths along with many rejected request to start an ambulance corps., as well as a hospital corps. These denials were due to political and personal reasons, which in turn, delayed any improved battle care and cost the lives of many savable men during early the early Virginia campaigns.

It is not difficult to realize the upward battle Hammond, Lettermen, The Sanitary Commission, and others who embraced the need for medical reform, had against the long-established doctrine of the frontier army which Lincoln inherited. This antiquated thinking coupled with egotistical men within Lincoln’s cabinet jockeying for key positions of power, resented being told what to do by mere army doctors, civilians, or civilian groups. It was the egos of a few key men that cost unwarranted deaths of thousands of savable men.

Bibliography

Primary

Barnes, Joseph K. Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). Washington : Goverment Printing Office, 1888.

Barnes, Joseph K. The medical and surgical history of the war of the rebellion (1861-65) Vol 1. Part 1. Washington: United States Goverment Printing, 1875.

Barnes, Joseph K. Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. II, (Washington: Government Printing Office, 1888),

Bowditch, Henery I. Abuses Of Army Ambulances. The Boston Medical And Surgical Journal Vol. 67, (10)., 1862.

Bowditch, Henery I. Army Ambulances. The Boston Medical And Surgical Journal Vol. 67 (8), 1862.

Brown, Harvey E. ed. The Medical Department of the United States Army, From 1775 to 1873. Washington D.C.: Surgron General’s Office, 1873.

Confederate States of America. War Department. Regulations for the Medical Department of the Confederate States Army. Richmond: Ritchie & Dunnavant, Printers., 1861.

Delafield, Richard, Major. Report On The Art Of War In Europe In 1854, 1855, And 1856. Washington: George W. Bowman, 1860.

Department, U.S. War. The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 10

Hamilton, Frank Hastings, M.D. A Treatise On Military Surgery And Hygiene. . New York : Balliere Brothers , 1865.

King, W. S., Surgical Director, U.S. A. Report Of Events Connected With The First Bull Run Campaign. U.S. National Library of Medicine. n.d.

Letterman, Jonathan, M.D. Medical Recollections of teh Army of the Potomac. New York: Appleton and Co., 1866.

Monroe, Alex LeB. “Letter from Surgeon Alex LeB. Monroe.” In Boston Medical and Surgical Journal Vol. 67. Aug, 1862 -Feb, 1863, by Samuel L. M.D. Abbot, 21-22. Boston: David Clapp, 1863.

Nevins, Allan. “The United States Sanitary Commission and Secretary Stanton.” Proceedings of the Massachusetts Historical Society , Oct., 1941 – May, 1944, Vol. 67., 1944: 402-419.

Numbers, Ronald, L. “The Rise And Fall of the American Medical Profession .” In The Greatest Benefit To Mankind: A Medical History of Humanity, by Roy Porter, 225. New York; London:: W.W. Norton & Company, 1997.

Olmsted, Frederick Law, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vil. 4. Defending The Union. The Civli War and the U.S. Sanitary Commission 1861-1861. Baltimore ; London: The Johns Hopkins University Press, 1986.

Olmsted, Fredrick, Law. A Collection Of The papers Of The Sanitary Commision. . Sanitary Commission No. 25. , Washington : Office Of The Sanitary Commisson, 1861.

Otis, Geroge A. Assistant Surgeon, U. S. Army Surdeon General Office. A Report to the Surgeon General on the Transport of Sick and Wounded by Pack Animals. Circular No. 9. Washington : Goverment Printing Office , 1877.

Percival, Thomas. Dr. Medical Ethics; Or A Code Of Institutes and Precepts,Adapted to The Professonal Conduct Of Physicians And Surgeons. Manchester; Strand, London: S. Russell For J. Johnson, St. Paul”s Church Yard, and R. Brickerstaff, 1803.

Pollard, Edward, A. The Lost Cause: A New Southern History of the War of the Confederates . New York : E.B. Treat and Co. , 1867.

Russell, William Howard, Nicolas Bentley, ed. In the Grip of Winter. In Russell’s Despatches from the Crimea 1854-1856, by William Howard Russell. London: Andre Deutsch, 1966.

Russell, William Howard, sir,. Mr. Russell on Bull Run. New York: G. P. Putnam, 1861

Shattuck, Lemuel, and Others. Report Of The Sanitary Commission Of Massachusetts 1850. Cambridge : Harvard University Press, 1948.

Stille, Charles. History Of The United States Sanitary Commission: Being The General Report Of Its Work During The War Of The Rebellion. New York: Hurd And Houghton, 1866.

Strong, George Templeton. The Diary of George Templeton Strong. The Civil War 1860-1865. Hew York: The Macmillan Company, 1962.

The Baltimore Sun. Brigadier General Thomas Lawson Surgeon General . The Baltimore Sun (Baltimore, Maryland) , 05 20 , 1861: 2.

The Evening Star. Items Telegraphed from Washington. Surgeon Finley... (The Evening Star, 05 22, 1861),

The Library of Congress. Jefferson Davis, Senator from Mississippi, Thirty-fifth Congress,

—. The Executive Committee of the U.S. Sanitary Commission 1860. The Library of Congress. n.d

The National Archives . Gen. Richard Delafield; The National Archives

—. Gen. Winfield S. Hancock, War Department. Office of the Chief Signal Officer.

The U.S. National Library of Medicine. Thomas Lawson. The U.S. National Library of Medicine. n.d.

The New York Times. Floating Hospitals for the wounded at the Siege of Yorktown. The New York Times (New York, New York), 05 8, 1862

—. The Siege Of Yorktown. The New York Times, 05 02, 1962: 1.

—. TheSecond New-York Regiment. The New York Times, 05 21, 1861:

The U.S. Sanitary Commission. Documents Of The U.S. Sanitary Commission. Vol. I. Numbers 1 to 60. (New York, 1866), No. 44.

United States. War Department. OliverDiefendorf, Thomas M. O’Brien,. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. New York: Derby & Millier, 1864.

United States. War Department. The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. Ser I. vol. I. (Washington, D.C.: Government Printing Office, 1881-1901), Appendix 10

United States. War Department. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. II. (Washington, D.C.: U.S. Government Printing, 1880-1901)

United States, War Deptment. Regulations for the army of the United States. New York: Haper and Brothers, 1861.

United States. War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880),

Wormeley, Katharine Prescott. The United States Sanitary Commission: A Sketch of Its Purposes And Its Work. Boston: Little, Brown And Company, 1863.

Secondary

Adams, George Worthington. Doctors in Blue: The Medical History of the Union Army in the Civil War. New York: Henry Schuman, 1952.

Bollet, Alfred Jay, M.D. Civil War Medicine Challenges and Triumphs. Tucson : Galen Press, LTD, 2002.

Browing, Judkin, and Timothy Sllver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. Journal of the Civil War Era 8, no. 3

Connell, P.A. Surgeon. Army Medical Intelligence. In Boston Medical and Surgical Journal Vol. 67., by Samuel L, M.D. ed. Abbot, 201-204. Boston: David Clapp , 1863.

Cunningham, H.H. Doctors in Gray: The Confederate Medical Service – 1958. Baton Rouge: Louisiana State University Press Kindle, 2014.

Cunningham, Horace H. Field Medical Services at the Battles of Manassas . Athens (GA) : University of Georgia Press, 2008.

Duncan, Louis C. The Medical Department of the United States Army in the Civil War. Washington, D.C.: United States Army, 1910.

Faust, Drew Glipin. This Republic of Suffering . New York: Vintage Books Div. Random House, 2008.

Fox, William F. Lt. Col. U.S.V. Regimental losses in the American Civil War, 1861-1865. Albany, N.Y. : Albany Publishing Company, 1889.

Gillett, Mary C. The Army Medical Department, 1818-1865. Washington, D.C.: U.S. Government Printing Office, 1987.

Gillett, Mary C. “Thomas Lawson , Second Surgeon General of The U . S . Army : A Character Sketch.” Prologue; Journal Of The National Archives, Spr. (14.1), 1982: 15.

Gordon, Margaret S. ed. Higher Education and the Labor Market . New York; London: McGraw-Hill Book Company, 1974.

Haller, John S. Battlefield Medicine : A History of the Military Ambulance from the Napoleonic Wars Through World War I. . Carbondale: Southern Illinois University Press, 2011.

Livermore, Thomas L. Numbers and losses in the Civil war in America, 1861-1865. Boston: Houghton, Mifflin and Company, 1901.

Lucas, Carter, ed. History of Medicine and Surgery and physicians and Surgeons of Chicago. Chicago: The Biographical Publishing Corporation , 1922.

Martin, David G. The Second Bull Run Campaign July – August 1862. Combined Books , 1997.

McGaugh, Scott. Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefiel Care. New York: Arcade Publishing , 2013.

Phalen, James M. Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. Washington D.C.: Privately Printed, 1940.

Pilcher, James Evelyn M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America : A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification. Carlisle Penn.: The Association of Military Surgeons, 1905.

Place, Ronald J. MC USA,. The Strategic Genius of Jonathan Letterman: The Relevancy of the American Civil War to Current Health Care Policy Makers. Military Medicine, Volume 180, Issue 3,, 2015, March

Porter, Roy. The Greatest Benefit To Mankind” A Medical History of Humanity. New York; London: W.W. Norton & Company, 1997.

Sears, Stephen W. To the Gates of Richmond: The Peninsula Campaign. New York: Ticknor & Fields, 1992.

Figures

Figure 1. The Civil War in Virginia. Gillett, The Army Medical Department 181-1865. p. 187. Error! Bookmark not defined.

Figure 2. Thomas Lawson (1789-1861) 4

Figure 4. General Richard Delafield. Courtesy of The National Archives; 111-B-5268, 529372 9

Figure 5.Maltese Cart, Delafield, Reports on the Art of War in Europe, p. 72. Error! Bookmark not defined.

Figure 6.English Ambulance, Delafield, Report on the Art of War in Europe, p.69. Error! Bookmark not defined.

Figure 7. English Litter, , Delafield, Report on the Art of War in Europe, p 73. Error! Bookmark not defined.

Figure 8. The Finley Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III, p. 946. Error! Bookmark not defined.

Figure 9. The Coolidge Ambulance. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947. Error! Bookmark not defined.

Figure 10.The Tripler Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947. Error! Bookmark not defined.

Figure 11. The Rosecrans Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p948. Error! Bookmark not defined.

Figure 12 The Sibley Tent. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920. Error! Bookmark not defined.

Figure 13, The Hospital Tent., The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920. Error! Bookmark not defined.

Figure 14. G.O. No. 15 Recapitulation. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I.p.35. 23

Figure 15. George Templeton Strong: George Templeton Strong Diary, p.234. Error! Bookmark not defined.

Figure 16. Executive Committee of the U.S. Sanitary Commission. Error! Bookmark not defined.

Figure 17. French Cacolet, Medical and Surgical History of the War of the Rebellion, Vol. II. Pt. III. p. 931 Error! Bookmark not defined.

Figure 18. Tenth Surgeon General, Clement A. Finley (1797 –1879) Error! Bookmark not defined.

Figure 19. Dr. Charles Stuart Triple (January 19, 1806 – Oct. 20, 1866). Papers of Fredrick Olmsted. p.339. 38

Figure 20. Horse Litter, Hamilton, A Treatise On Military Surgery And Hygiene. p. 162 Error! Bookmark not defined.

Figure 21. Battle of Seven Pines, May 31, 1861 Error! Bookmark not defined.

Figure 22. Bringing wounded soldiers to the cars after the battle of Seven Pines June 3 1862 Library of Congress. Error! Bookmark not defined.

Figure 23. Harris Landing 1862. Library of Congress Error! Bookmark not defined.

Figure 24. White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862) Error! Bookmark not defined.

Figure 25. Enlargement _ White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862) Error! Bookmark not defined.

Figure 26. Eleventh Surgeon General: William Alexander Hammond (1828-1900). Library of Congress Error! Bookmark not defined.

Figure 27. May 2, 1862, The Siege Of Yorktown, New York Times. pg. 1. Error! Bookmark not defined.

Figure 28. The Daniel Webster No. 1. Fredrick Olmstead Papers. P. 326 Error! Bookmark not defined.

Figure 29. May 8, 1862, New York Times ad seeking supplies for floating hospital caring for the Siege Of Yorktown wounded Error! Bookmark not defined.

Figure 30. Dr, Jonathan Letterman. (1824-1872) . Courtesy of the Library of Congress Error! Bookmark not defined.

  1. Stephen W. Sears, To the Gates of Richmond: The Peninsula Campaign. (New York: Ticknor & Fields, 1992), 345.
  2. Judkin Browning, Timothy Silver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. (Journal of the Civil War Era 8, no. 3, 2018), 407.
  3. Ibid. 343.
  4. David G. Martin, The Second Bull Run Campaign July – August 1862. (Combined Books, 1997) 280.
  5. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008) 61.
  6. William F. Fox, Lt. Col. U.S.V. Regimental losses in the American Civil War, 1861-1865. (Albany, N.Y.: Albany Publishing Company, 1889), 550.
  7. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),14
  8. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888), 933,34.
  9. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),14.
  10. Pilcher, James Evelyn M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America: A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification. (Carlisle Penn.: The Association of Military Surgeons, 1905),34.
  11. The Baltimore Sun. Brigadier General Thomas Lawson Surgeon General (The Baltimore Sun (Baltimore, Maryland), 05 20 , 1861), 2.
  12. James M. Phalen, Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. (Washington D.C.: Privately Printed, 1940), 33.
  13. Harvey E Brown. ed. The Medical Department of the United States Army, From 1775 to 1873. (Washington D.C.: Surgeon General’s Office, 1873),193.
  14. Ibid. 217.
  15. Mary C. Gillett, The Army Medical Department, 1818-1865. (Washington, D.C.: U.S. Government Printing Office, 1987), 73.
  16. , Mary C. Gillett, Thomas Lawson, Second Surgeon General of The U. S. Army: A Character Sketch. (Prologue; Journal Of The National Archives, Spr. (14.1), 1982),15.
  17. James M. Phalen, Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. (Washington D.C.: Privately Printed, 1940), 34.
  18. Mary C. Gillett, Thomas Lawson, Second Surgeon General of The U. S. Army: A Character Sketch. (Prologue; Journal Of The National Archives, Spr. (14.1), 1982),15.
  19. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 9.
  20. Russell, William Howard, Nicolas Bentley, ed. In the Grip of Winter. In Russell’s Dispatches from the Crimea 1854-1856, by William Howard Russell, 154. (London: Andre Deutsch, 1966),154.
  21. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 17.
  22. Richard Delafield, Major. Report on The Art Of War In Europe In 1854, 1855, And 1856. (Washington: George W. Bowman, 1860), v.
  23. Richard Delafield, Major. Report On The Art Of War In Europe In 1854, 1855, And 1856. (Washington: George W. Bowman, 1860),68.
  24. Harvey E. Brown, ed. The Medical Department of the United States Army, From 1775 to 1873. (Washington D.C.: Surgeon General’s Office), 36.
  25. Ibid. 35.
  26. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 22.
  27. War Department. General Regulations for the Army of the United States. 1841. (Washington: J. and G.S. Gideon, 1841), 71.
  28. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888),944.
  29. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 946.
  30. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 946,947.
  31. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 947.
  32. Henry I. Bowditch, Abuses Of Army Ambulances. (The Boston Medical And Surgical Journal Vol. 67, (10),1862), 204-207.
  33. Bowditch, Henry I. Army Ambulances. (The Boston Medical And Surgical Journal Vol. 67 (8), 1862), 164-166.
  34. Joseph K. Barnes, Joseph Janvier Woodward, Charles Smart, George A Otis, and D. L Huntington. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. (Washington: Gov’t Print. Off., 1870), 899.
  35. Louis C. Duncan, The Medical Department of the United States Army in the Civil War. (Washington, D.C.: United States Army, 1910), 20.
  36. Joseph K. Barnes, Joseph Janvier Woodward, Charles Smart, George A Otis, and D. L Huntington. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. (Washington: Gov’t Print. Off., 1870), 920.
  37. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 29.
  38. Ibid. 23.
  39. Jonathan Letterman, M.D. Medical Recollections of the Army of the Potomac. (New York: Appleton and Co., 1866), 8.
  40. George Worthington Adams, Doctors in Blue: The Medical History of the Union Army in the Civil War. (New York: Henry Schuman, 1952), 194,195.
  41. Ibid. 224.
  42. Roy Porter, The Greatest Benefit To Mankind: A Medical History of Humanity. (New York; London: W.W. Norton & Company, 1997), 628.
  43. Thomas Percival,. Dr. Medical Ethics; Or A Code Of Institutes and Precepts,Adapted to The Professonal Conduct Of Physicians And Surgeons. (Manchester; Strand, London: S. Russell For J. Johnson, St. Paul”s Church Yard, and R. Brickerstaff, 1803), 10.
  44. Roy Porter, The Greatest Benefit To Mankind: A Medical History of Humanity. (New York; London: W.W. Norton & Company, 1997), 628.
  45. Numbers, Ronald, L. The Rise And Fall of the American Medical Profession . In The Greatest Benefit To Mankind: A Medical History of Humanity, by Roy Porter, (New York; London:: W.W. Norton & Company, 1997), 225.
  46. Shattuck, Lemuel, and Others. Report Of The Sanitary Commission Of Massachusetts 1850. (Cambridge: Harvard University Press, 1948), 58.
  47. Ibid. 57.
  48. Gordon, Margaret S. ed. Higher Education and the Labor Market, (New York; London: McGraw-Hill Book Company, 1974), 251.
  49. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888), 900-01.
  50. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864),32.
  51. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 899.
  52. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864),32.
  53. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864), 32.
  54. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), 151.
  55. Ibid. 151,153
  56. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),153.
  57. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),13-14.
  58. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002), 12.
  59. H.H. Cunningham, Doctors in Gray: The Confederate Medical Service (Baton Rouge: Louisiana State University Press, First printing 1958. Kindle, 2014),141.
  60. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002), 458.
  61. Fredrick Law Olmsted, A Collection Of The papers Of The Sanitary Commission. Sanitary Commission No. 25, (Washington: Office Of The Sanitary Commission, 1861).11,12.
  62. Fredrick Law Olmsted, A Collection Of The papers Of The Sanitary Commission. Sanitary Commission No. 25, (Washington: Office Of The Sanitary Commission, 1861).13.
  63. Ibid. 168.
  64. The New York Times. The Second New-York Regiment. (The New York Times, 05 21, 1861),1.
  65. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 29.
  66. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008),8.
  67. Sir, William Howard Russell, Mr. Russell on Bull Run. (New York: G. P. Putnam, 1861), 14.
  68. Sir, William Howard Russell, Mr. Russell on Bull Run. (New York: G. P. Putnam, 1861), 14.
  69. Edward, A. Pollard, The Lost Cause: A New Southern History of the War of the Confederates. (New York: E.B. Treat and Co., 1867), 143.
  70. Alfred Roman, The Military Operations of General Beauregard in the War Between the States, 1861 to 1865. Vol. I. (New York: Harper and Brothers, 1884), 98.
  71. O.R. Ser 1. vol. II. 570.
  72. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser 1. vol. II. 327.
  73. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 2.
  74. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 10
  75. Ibid. Appendix 7.
  76. Confederate States of America. War Department. Regulations for the Medical Department of the Confederate States Army. (Richmond: Ritchie & Dunnavant, Printers., 1861.),57.
  77. Glenna R. Schroeder – Lein, Confederate Hospitals on the Move: Samuel H. Stout and the Army of Tennessee. (Columbia: University of South Carolina Press, 1994),127.
  78. Glenna R. Schroeder- Lein, The Encyclopedia of Civil War Medicine. (Armonk, N.Y.: Routledge, 2008),12.
  79. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008),26.
  80. War Department, United States, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Vol. II. vol. III.), 929,931.
  81. War Department, United States, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 4.
  82. W.S. King, Surgical Director U.S.A. Report Of The Events Connected With The First Bull Run Campaign. 1861.
  83. The Evening Star. Items Telegraphed from Washington. Surgeon Finley... (The Evening Star, 05 22, 1861),1.
  84. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 13,14.
  85. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 932, footnote 1.
  86. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),181.
  87. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vil. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986), 240.
  88. Charles Stillé, History Of The United States Sanitary Commission: Being The General Report Of Its Work During The War Of The Rebellion. (New York: Hurd And Houghton, 1866),101.
  89. Louis C. Duncan, The Medical Department of the United States Army in the Civil War. (Washington, D.C.: United States Army, 1910),2.
  90. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 932, footnote 1.
  91. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt .II. (Washington, D.C.: U.S. Government Printing, 1880-1901)198.
  92. Frank Hastings Hamilton, , M.D. A Treatise On Military Surgery And Hygiene. ( New York : Bailliére Brothers , 1865. 163.
  93. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 929,930.
  94. Frank Hastings Hamilton, , M.D. A Treatise On Military Surgery And Hygiene. (New York : Bailliére Brothers , 1865.162.
  95. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 930. Footnote 2.
  96. The U.S. Sanitary Commission. Documents Of The U.S. Sanitary Commission. Vol. I. Numbers 1 to 60. (New York, 1866), No. 44.p.4,5.
  97. I Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 931
  98. Ibid.931.
  99. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 930.
  100. Ibid. 931.
  101. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888),762.
  102. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol.II, (Washington: Government Printing Office, 1888),327,570.
  103. United States. War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880), 12,13.
  104. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 178.
  105. Ibid.178.
  106. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 178.
  107. Ibid. 179.
  108. 180.
  109. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 179.
  110. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 181.
  111. Ibid 183.
  112. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),19.
  113. James Evelyn Pilcher, M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America: A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification.( Carlisle Penn.: The Association of Military Surgeons, 1905), 44.
  114. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),20.
  115. Ibid. 185.
  116. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), 219.
  117. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), xxxix.
  118. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),21.
  119. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 182.
  120. United States, War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880), 13.
  121. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 184.
  122. Ibid. 450.
  123. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 320.
  124. Stephen W. Sears, To the Gates of Richmond: The Peninsula Campaign. (New York: Ticknor & Fields, 1992), 345.
  125. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Ser. I Vol. XI, pt. 2. (Washington: Government Printing Office, 1888), 24-37.
  126. Judkin Browning, Timothy Silver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. (Journal of the Civil War Era 8, no. 3, 2018), 407.
  127. Ibid. 343.
  128. Scott McGaugh, Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefield Care. (New York: Arcade Publishing, 2013.), 10.
  129. Ibid. 11,13.
  130. Scott McGaugh, Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefield Care. (New York: Arcade Publishing, 2013.),22.
  131. Ibid. 32.
  132. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. I. (Washington, D.C.: U.S. Government Printing Office, 1880-1901), 210-216.
  133. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. I. (Washington, D.C.: U.S. Government Printing Office, 1880-1901), 210-216.
  134. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 326.
  135. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 329.
  136. Ibid. 370.
  137. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),230.
  138. Joseph K Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). (Washington: Government Printing Office, 1888), 933.
  139. Ibid. 934.
  140. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). (Washington: Government Printing Office, 1888), 934,935.
  141. William Howard Russell, Nicolas Bentley, ed. “In the Grip of Winter.” In Russell’s Dispatches from the Crimea 1854-1856, by William Howard Russell, 154. London: Andre Deutsch ,1966.154,155.

The Tangled Web Of

Early Civil War Medicine

An Inept Lincoln Cabinet During

The Battle of First Manassas, 1861 and The Peninsula Campaign, 1862:

Unnecessary Deaths of Savable Men

By Kevin M. Bair

History Ph.D. Student

Liberty University

Fall 2020

HIUS 820

Introduction

During the first two years of the Lincoln administration (1861-1862), Lincoln sought ways to quickly end the war. To do this, he felt it necessary to change his top leaders, both in Washington and in the Army as he deemed it a necessity to build his winning team. The rapid change in the top positions created conflict between assorted men of power and position, antiquated men running antiquated departments, and civilian opinion on what was the best practice to care for wounded, i.e., how many men are needed for the war, how many tents and what type and kind, how many ambulances, how to evacuate the wounded ; effectively and efficiently, and other varied medical supply questions.

This paper will demonstrate how these men and their ongoing disharmony delayed any establishment of a dedicated plan to care for the wounded, thus these leaders were responsible for the unnecessary deaths of many savable men during the 1861-1862, Virginia campaigns ; The First Battle of Manassas / Bull Run, (July 21st, 1861), The Peninsula Campaign (March through July 1862) which is comprised of The Siege of Yorktown (April 5 to May 4), The Battle of Seven PinesFair Oaks, (May 31-July 1, 1862), and The Seven Days Battles (June 25-July 1862) etc. The total number of soldiers who fought during First Manassas and The Peninsula Campaign was 169,069. The number dead was 5,228, wounded, 23,824, missing,7000. As staggering as these numbers may be, disease killed more men than actual battle. [1][2][3][4][5][6]

The Evidence

The Wars initial federal leadership on medical supplies and care was conducted by the Secretary of War, Simon Cameron (March 8, 1799 – June 26, 1889), and Ninth Surgeon General, Thomas Lawson (August 29, 1789 – May 15, 1861). These men set the tone for their departments, and in particular Lawson’s management style was ingrained into departmental philosophies, that of, spend little money and make do with what you have, along with his refusal to change time-tested Army medical procedures and practices. After his death in May, these ideas were continued on with the next line of Surgeon Generals. Cameron was discharged from his position in January 1862, on charges of poor management and corruption. [7] He was replaced by Secretary of War Edwin E. Stanton (December 19, 1814 – December 24, 1869). Figure 1 is a map of the Virginia battlefields discussed.

Figure 1.The Civil War in Virginia. Gillett, The Army Medical Department 181-1865. p. 187.

Stanton, during The Peninsula Campaign, repeatedly refused Surgeon General W.A. Hammond’s request for additional ambulances. Likewise, during the August 1862, Second Battle of Manassas, Stanton turned down one of Hammond’s many requests to create a hospital and ambulance corps, stating it would involve “enormous expenses”.[8] Moreover, Interim Surgeon General Robert C. Wood (1801-1869) refused the aid of civil charity

groups such as The United States Sanitary Commission. Tenth Surgeon General Clement A. Finley (May 11, 1797 – September 8, 1879), would not order medical equipment or medical textbooks, as he believed they were a waste of money, furthermore, he would not order the needed medical supplies or bandages until after a battle had commenced,[9] which was the case at The Battle of First Manassas.

Looking Back – Pre-Lincoln Army History –

Data demonstrates the Lincoln Administration, appointed or inherited stagnant, archaic leaders with limited thoughts on the size and scope of the upcoming war. Unfortunately for Lincoln, he become heir to the Army medical department which had been fashioned by Surgeon General Lawson.

Ninth Surgeon General Thomas Lawson (1789-1861)

Figure 2. Brevet Brigadier General Thomas Lawson (1789-1861). Courtesy of Pilcher- The Surgeon Generals of the Army of the United States of America. p. 34

Thomas Lawson, a veteran of The War Of 1812 (18 June 1812 – 17 February 1815), and a former frontier army surgeon, held the position of Surgeon General since being appointed on November 30, 1836, by seventh President of the United States, Andrew Jackson (March 15, 1767 – June 8, 1845).[10]

When the rebellion started in April 1861, he was seventy-three old and in poor health.[11] He had been an Army Surgeon for fifty-five years.

Lawson entered the Navy on March 1, 1809, at the age of nineteen as a surgeon’s mate. He resigned on January 12, 1811, and immediately joined the Army. On February 8, 1811, he became a garrison surgeon’s mate. Two years later, during the War of 1812, on May 21, 1813, he was promoted to the post of surgeon of the 6th Infantry. Additionally, according to Army records, the information on how Lawson obtained his primary or medical education cannot be found. It is speculated that he may have studied in his hometown as an assistant to a medical practitioner, which was normal practice at that time.[12]

During the Mexican American War (April 25, 1846 – February 2, 1848), Lawson was appointed an advisor to General Winfield Scott (June 13, 1786 – May 29, 1866), and during the war accompany Scott from Vera Cruz to Mexico City. Furthermore, Lawson was present at the 1847, Battle of Chaultepec and the surrender of the city. [13] For his service in the Mexican War, he was promoted to Brevet of Brigadier General.[14]

In his first decade as Surgeon General, Lawson’s primary interest was the Second Seminole War (1835 to 1842), and to many he was known to be more of an “in the field”… “frontier surgeon” than an administrator, and was known not to be “enthusiastic about office work” and also to be “cantankerous.” [15][16] During the first two years of his position as Surgeon General, his lack of wanting to do administration work kept him, as much as he could get away with, in the field.

In 1836, while out fighting the Seminoles and as the medical director for the troops, he was offered the position of Surgeon General in October and on November 30th, he was sworn in. After his appointment he remained with the troops until mid-1837, only to leave again to escort the ex-president Andrew Jackson back to Jackson’s home in Tennessee. He then left Jackson’s home for Florida and the Seminole War. He remained in Florida until May of 1838. While he was away, Assistant Surgeon Benjamin King performed the duties of the Surgeon General.[17] The takeaway from history is that Lawson was not a good administrator. Mary C. Gillet, historian at the Center of Military History, Washington, D.C. remarked on Lawson,

“One of a dying breed, an army surgeon without a professional degree, he was an old soldier who had risen to his position of leadership through seniority and had remained there until youth and health deserted him.”[18]

The background on Lawson gives insight as to why the Army medical department was not prepared for a battle like the Civil War. The man was first a frontiersman and then one who practiced medicine.

Lessons on Death from the Crimean War – The Need for Ambulances.

During the Crimean War (1854-1856), newspapers reported on the poor horrid living conditions and the medical debacle of not caring for the wounded soldiers. They also reported on efforts of civilian relief agencies and nurse volunteers like Florence Nightingale (12 May 1820 – 13 August 1910) (figure 3) and 38 other English nurses who volunteered.[19]

Figure 3. Florence Nightingale Courtesy of the Library of Congress, cph 3a09175

William Howard Russell (28 March 1820 – 11 February 1907) (figure 4), a special correspondent of The Times (London), who, while at the Crimean War, he telegraphed the action back to London, giving its readers a firsthand account of the war. He wrote,

Figure 4. William H. Russell. Courtesy Library of Congress, cph.3g09183, LC-USZC4-9183

“The commonest accessories of a hospital were wanting; there was not the least attention paid to decency or cleanliness — the stench was appalling… The dead, laid out as they died, were lying side by side with the living…a spectacle beyond all imagination… for all I could observe, these men died without the least effort to save them. There they laid just as they were…”[20]

Five years later Russell would be at, and report on, The Battle of First Manassas.

During the war, each British regiment consisted of approximately 650 men, with one surgeon and three assistant surgeons, ten litters and a pack mule to carry the medical equipment, medicine, and bandages. Before the war, the British Army had specified wheeled ambulances to ship, yet when the fighting started, the British were in the action, but not with their ambulances, as their shipment had been delayed. When they finally arrived weeks later, the units came disassembled and without instructions.[21]

In 1855, for the U.S. to improve on the preparedness and technology of its Army, the U.S. Secretary of War, Jefferson Davis (figure 5), sent a delegation to the Crimean War theater. This group was comprised of Major Richard Delafield ((September 1, 1798 – November 5, 1873) figure 6), Alfred Mordecai (January 3,1804 – 23 October 1887) and Captain George B. McClellan ((December 3, 1826 – October 29, 1885) figure 7). Furthermore, Jefferson instructed the team to learn about, “The medical and hospital arrangements, both in permanent hospitals and in the field. The kind of ambulances or other means used for transporting the sick and wounded.”[22]

Figure 6. General Richard Delafield. Courtesy of The National Archives; 111-B-5268, 529372

Figure 5. Maj. Gen. Geo. B. McClellan, Courtesy Library of Congress. loc.pnp/ppmsca.33064

Figure 5. Secretary of War, Jefferson Davis loc.pnp/ppmsca.26716, LC-DIG-ppmsca-26716

The Delafield report can be found in the 36th Congress, 1st Session, Ex. Doc. No. 56. It goes into great details about the various ambulances used during the Crimean war, and is complete with detailed information on the successes and failures of each, as well as detailed drawings on ambulance types, such as, the Maltese Cart, (figure 8 ), an English Ambulance (figure 9) and the English Litter (figure 10).

Figure 9. English Ambulance, Delafield, Report on the Art of War in Europe, p.69.

Figure 8. Maltese Cart, Delafield, Reports on the Art of War in Europe, p. 72.

 

Figure 6.English Litter, Delafield, Report on the Art of War in Europe, p 73.

Delafield explained how important the ambulances were to the war. He stated, “Never before this siege was so much attention bestowed upon this branch [ambulances]of the military service”. He also refers to the power and influence of Miss Nightingale, as a “voice not to be neglected” that she had a “ power to make known…all the requirements of the medical staff, as well as being able to invoke “public sentiment.”[23] The tales of Miss Nightingale and her deeds via the press, had a profound effect on the social and moral conscious of the American society during the Civil War.

American Ambulances

During the War of Independence, on behalf of George Washington, the Continental Congress adapted and passed what was called the Doctor Shippen’s Plan, Number 23, it stated,

“That a suitable number of covered and other wagons, litters, and other necessaries for removing the sick and wounded; shall be supplied by the Quarter master, or deputy quartermaster general; and in cases of their deficiency by the director, or deputy director general.”[24]

This arrangement was used during the first two years of the Civil War, as all supplies ordered, including medical items, had to go through the Quarter Masters office. One major difference in medical care during the Revolution than in the Civil War, was the Continental Congress approved female nurses, stating, “That a matron be allowed to every hundred sick or wounded…That a nurse be allowed for every ten sick, or wounded, who shall be under the direction of the matron.”[25] It seems, the Revolutionary War soldiers had better odds of getting nursing care than the Civil War soldiers did; in the beginning of the war, there was not any type of battlefield nursing.

In 1861, the United States Army did not have any type of standardized ambulances, nor an ambulance corps solely trained to ferry the wounded off the battlefield. In fact, it was not until after the Crimea and Mexican War that the U.S. in 1859, started to entertain having some type of official wheeled ambulances for its troops. Still, after the Crimean War and with the information presented in the Delafield report on medical transports, the U.S. Army during most of the Civil War continued using and depended on ordinary makeshift wagons to carry the wounded.

Considering the information presented in the report, it is surprising that the U.S. Army did not have an official ambulance design until 1859. [26] Yet, this does not mean the Army did not think about the merits of a specialized ambulances prior to 1859, for they did, and in the 1841, General Regulations for the Army of the United States, stated,

“For the accommodation of the sick and disabled, a wagon will be attached to the rear guard, when necessary and practicable, and a surgeon will attend to give assistance, and to see that no improper persons are suffered to avail themselves of the accommodation.”[27]

Although the regulations used the term wagon and not ambulance, at least there was some provisional way to carry the sick and wounded. One of the major problems with using a common wagon was it was looked at as universal property, thus it was used as something other than what it was designated for. According to The Medical and Surgical History of the War of The Rebellion, during the Mexican American War (1846-48), ambulances were not included in their supplies, nor did they accompany the troops into Indian territories.[28]

In October of 1859, a Board of Medical Offices convened to select an acceptable ambulance design. The board consisted of Surgeons, C. A. Finley, R. S. Satterlee, C. S. Tripler, J. M. Cuyler, and Assistant Surgeon R. H. Coolidge. One of their criteria was each ambulance should carry 40 men. Some of the ones they approved were used in limited numbers during the first two years of the war. Unfortunately, they were not built in volume during that time which hindered using them at the start of the Civil War[29].

Many men designed and submitted ambulance plans; even Lawson designed an ambulance, as well as other medical men. There was the Finley (figure 11), a two-wheel ambulance designed to carry 40 men, created by future Surgeon General Clement A. Finley (1797-1879), and another 40 person two-wheel design (figure 12) by Assistant Surgeon Richard H. Coolidge (1816-1866), as well as a four-wheel design to hold eighteen and pulled by six horses. The two-wheeled Finley unit was built, and a few tried, with an estimated ratio of 1 wagon per 1000 men; unfortunately, it had dismal results in the field and was known to make the occupants sick.[30]

Figure 11. The Finley Ambulance, The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III, p. 946.

Figure 7.. The Coolidge Ambulance. The Medical and Surgical History of The War of The Rebellion, (1861-65), p. 947.

There were few authorized ambulance designs built with success, such as, the Tripler ambulance (figure 13), designed by the future Medical Director of the Army of the Potomac, surgeon Charles Tripler (January 19, 1806 – Oct. 20, 1866). This ambulance could carry 10 men. Then there was the Rosecrans or Wheeling ambulance wagon (figure 14) designed by Union General W. S. Rosecrans (September 6, 1819 – March 11, 1898) which could hold approximately 15 men.[31]

Figure 93.The Tripler Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947.

Figure 9.. The Rosecrans Ambulance, The Medical and Surgical History of The War of The Rebellion, (1861-65), p948.

These four ambulance were approved in October of 1859 by the medical board, but as mentioned not built in volume at the time. It must be remembered, initially it was not the federal government’s responsibility to supply ambulances, as each State was responsible for supplying ambulances to their regiments. And even though there were some ambulances at the start of the war, there was not an officially trained ambulance corps, the ambulances in most regiments were attended to by band members and were only for the wounded of that regiment. Most of the ambulances during the early years of the Civil War were driven by civilian teamsters and according to the firsthand account from Dr. Henry Bowditch, ambulance drivers were drunk, some broke into the hospital supplies and others refused to “help the wounded until whiskey was given,” and when the fighting started many drivers drove away with their ambulances. [32][33]

1860 Army Tents

In 1860, the United States had a peace time Army of 13,024 soldiers, of these, 1,117 were commissioned officers. The medical department was composed of “one Surgeon General, thirty Surgeons and eighty-four Assistant Surgeons.”[34] During this time, there was not an official military hospital nor an official plan to remove the wounded from the battlefield.[35] The 1860 Army’s regulations stated there was to be one Sibley tent (figure 15), which could house twelve men; one common wedge style tent which could hold six men, and three hospital tents (figure 16). They could hold eight patients each.[36] The capacity of the tents indicates each regiment could handle 78 wounded soldiers. This limited capacity suggests little thought was placed on how many men can be wounded during a major battle, nor does it seem to account for the overwhelming number of men sick from disease.

Figure 15. The Sibley Tent. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920.

Figure 10.The Hospital Tent., The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920.

Traditionally, Army medical planning focused on regimental surgeons and assistants caring for their wounded. Additionally, these regimental medical plans did not include a strategy for the removal of the wounded beyond their regimental field hospital. [37] Furthermore, during the war, regimental tents would have been filled to capacity with illnesses such as, “diarrhea, dysentery, typhus, measles, smallpox, fever, and other diseases aggravated by inadequate clothing, bad water, and poor food.”[38]

In 1862, Dr. Jonathan Lettermen (December 11, 1824 – March 15, 1872), Medical Director of the Army of the Potomac, while at Harrison’s Landing during the Peninsula Campaign, estimated the sickness within the Army of the Potomac was “at least twenty percent.” He also stated there was not a single hospital tent to be found. To treat the sick and wounded, he commandeered the Harrison House to be used as a hospital.[39] Yet, like many wars, disease was the real killer and the medical tents and homes were filled to capacity with sick and diseased men.

Grim Statistics

When the Mexican American War started, the United States was just as unprepared for war and the responsibility of caring for its wounded as the British were seven years earlier during the Crimean War. During the Mexican American War, more than 100,000 men served, and out of this there were more than seven disease related deaths to every single combat death, with the annual fatality rate of around 10 percent. During the Civil War, the overall mortality was 7.2 percent, and during the Crimean War, the British first Expeditionary Force of 25,000 men lost 18,000 over a 12-month period mostly from “dysentery, cholera, scurvy, or fevers.” This equates to a loss of 72 percent of their usable strength. During World War I, the disease death rate was 12.58 per 1000.[40][41]

Medical Training. Pre-War: Medical Thought and Training during the 1700’s and mid-1800s.

Many of the first Civil War doctors were loosely schooled in the early to mid-1800s, and these schools taught varied medical thoughts and practices. Additionally, there were varied entrance exams, as well as little or no degree or license required to become a doctor. In early medicine, doctors and patients developed personal relationships. It is fair to say that for many, a bond of trust occurred between them. This association was normally initiated by the patient, and the doctor they saw was known locally, i.e., someone in their community.

Back then, doctors were self-employed and would either come to the patient’s home or have a home office. Furthermore, depending on the doctor’s location, many had a team of medical friends or acquaintances which they could refer to if need be, i.e., a surgeon’s apprentice or an apothecary; who would mix the prescribed medicines.[42] Of course, very rural doctors had to rely on themselves to create and administer medicines, and if need be, use a family member or a neighbor to help with various types of surgeries, such as an amputation. Additionally, during this time there was not many bonified hospitals, therefore medical charities were created usually by women to help the ill get well. Moreover, these groups offered free medical care, or alternative medicines, to those who could not afford or, perhaps, did not trust, “professional” doctors.

For the most part, an individual’s medical treatments had a personal, face to face relationship with the physician. According to Dr. Thomas Percival, in his 1803, book, Medical Ethics, “The feelings and emotions of the patients, under critical circumstances, require to be known and to attended to, no less than the symptoms of their diseases.”[43] Indicating a doctor should attend to a person’s psychological needs as well as their physical medical aliment. Moreover, he makes the case that the medical profession was a divided and disjointed occupation, full of jealousies, and petty-minded tensions between physicians.[44]

Robert L. Numbers indicated in his article, The Fall and Rise of the American Medical Profession, “ by the mid-19th century…medicine for many Americans had degenerated into little more than a trade, open to all who wish to try their hand at healing.”[45] Likewise, according to the 1850, Report of the Sanitary Commission of Massachusetts, commenting on medical thought in 1836,

“There was no such thing as a legal medical police…No restriction is laid upon any one in the practice of physic, or in dealing in drugs and medicines. Any one, male or female, learned or ignorant, an honest man or a knave, can assume the name of a physician, and ” practice” upon any one, to cure or to kill, as either may happen, without accountability.”[46]

This lack of academic medical training had been a problem in the American Revolution (1775-1783) and continued in this country through the 19th century and well past the Civil War years. [47] Bonified medical schools did exist, and by 1830, there were 22 medical degree granting institutions in 13 states. In Massachusetts, degreed medical men formed medical societies, lobbied state law makers, and offered its graduates the only state sanctioned medical practitioner license. These establishments were few and had rigid entrance exams, along with a hefty price tag to attend. Because of cost and stringent requirements, people started to train elsewhere, outside the traditional channels to become doctors.

By the late 1830s, thru the 1880’s, society was beginning to rethink higher education, as there was a general “disestablishment and humbling” of higher education. During this time, technical schools with less stringent entrance policies were in demand. The previous high standards to enter college and medical schools no longer impeded students, including medical students. Many students went this route and entered technical medical schools; thus, many technical school students became part of the early Civil War doctors.

Furthermore, due to technical schools’ popularity the number of medical colleges in the United States doubled between1830-1845. This rise in diploma mills caused properly trained physicians with a bonified medical degree to complain that there were too many poorly trained doctors with many harming patients and jeopardizing the profession. [48] According to Margaret S Gordon in her article, Higher Education, and the Labor Market, the mid 1800’s deregulating of higher education created a flood of “profit-making enterprises”,

“The outcome was the rapid growth and proliferation of proprietary schools for the awarding of professional degrees. These colleges were usually profit-making enterprises established by practitioners and supported by student fees. Competition was brisk, and quite soon entry into these schools became exceedingly easy and graduation a matter of course.”

These technical school doctors became part of the new physicians initially employed during the Civil War, as “private physicians” on a short-term contracts and were not commissioned officers. Many of the newly recruited military doctors were known as Brigade Surgeons, Surgeons of the Volunteers, or Acting Assistant Surgeons.[49]

A Time for A Change; Lincoln’s General Order No.15; The Revolving Door Of “Leadership”; Surgeon Generals

In the first two years of the war, the Lincoln Administration changed staff members in key positions searching for the correct leaders to quickly win the war. The first change occurred in January 1861, when Surgeon General Larson went on a medical leave of absence and in his stead was Interim Surgeon General, Robert C. Wood (1799-1869). Lawson died on May 15, 1861, just eleven days after President Lincoln’s May 4 call for volunteers in General Order No.15, thus leaving Interim Wood in the Surgeon General position until it was filled by Clement A. Finley (May 11, 1797 – September 8, 1879), who held the position until April 14, 1862. Finley was replaced by Surgeon William A. Hammond (August 28, 1828 – January 5, 1900). Hammond held the position until August 18, 1864, when ongoing tensions between him and Secretary of War Edwin M Stanton (December 19, 1814 – December 24, 1869) caused his court marshal and removal. The position was then handed to Joseph K. Barnes, (July 21, 1817 – April 5, 1883) who maintained the role until June 30, 1882. All these men had significant bearing on the medical care of the soldiers and their personalities and education level would indicate what type of care they would give.

General Order No.15.

With the attack on Fort Sumter (April 12–13, 1861) there was an immediate need to build up the Army. Lincoln needed to switch from a peacetime Army to a battle-ready Army. This call to action was done without a master battle plan; it was a quick retaliation to Fort Sumter. In General Order 15, Lincoln stated he needed up to forty-two thousand men,

“to aid in the enforcement of the laws, and the suppression of insurrection…[with] a maximum aggregate of forty-two thousand…men…. Thirty-nine Regiments of Infantry and one Regiment of Cavalry.”[50]

These volunteer regiments were comprised of “State troops or militia” which heeded the President’s call to arms.[51] Each regiment was comprised of ten companies. The commissioned officers were appointed by the Governor of the State furnishing the regiments. The non-commissioned officers were appointed by a Captain. [52]

Each Regiment had a minimum 830 company officers and enlisted, and a maximum 1,010 officers and enlisted. Out of this number, there was: “(1) Assistant Surgeon and (1) Hospital Steward, as well as (2) Principal Musicians, and (24) Band Musicians.” Additionally, it stated, the cavalry men will “furnish their own horses and horse equipment” and the soldier who became wounded or disabled would be entitled to benefits. It also stipulated what was to be paid to the Band members.[53]

Figure 17 is the Recapitulation of GO. No. 15. outlining the Thirty-nine Regiments of Volunteers.

A close up of a receipt Description automatically generated

Figure 11. G.O. No. 15 Recapitulation. General Orders of The War Department, Embracing the Years 1861,1862 & 1863. Vol I.p.35.

Out of 42,034 men, there were 39 Assistant Surgeons and 39 Hospitals Stewards, or 1000 men for every 1 Assistant Surgeon and 1 Steward to attend to them. Furthermore, within General Order 15, there is more discussion on horses, disability benefits and pay scale for band members, than on caring for the wounded. In fact, there was no mention of transporting the wounded, or of having men designated as stretcher-bearers or ambulance staff, nor of medical wagons or ambulances.

This type of regiment configuration with little medical support was normal for the period leading up to the July 21st, 1861, First Battle of Manassas.

Prewar Excitement

According to the diary entry of New York City lawyer George Templeton Strong (figure 18), also one of the founder of The United States Sanitary Commission (figure 19), there was prewar excitement, anticipation for the new war. He stated,

Figure 12. George Templeton Strong: George Templeton Strong Diary, p.234.

Mr. Secretary Blair…thinks there is little fight, if any, in the blustering fire-eating elements of the South; its bar-room swashbucklers will collapse whenever they are resolutely met.”[54]

His May 30 and 31st entry describes a fine display of the New York 9th Regiment and the wealthy men who “joined” it.

“Afternoon, parade and review of newly arrived regiments. Garibaldi Guard, Colonel Blenker’s Germans (very promising corps both), the New York Ninth in their effective black and red uniform… Talked with Goddard and other Providence millionaires who are serving in the ranks, and saw their evening parade, which was creditable.”[55]

Not only were there millionaires marching and playing soldiers, on June 1st, he stated there was festivities near the White House,

“Walked…the grounds back of the White House, listening to the Marine Band. Loungers numerous and the crowd bright with uniforms. Firing heard in direction of Alexandria. Excitement, rumors of battle…”[56]

Figure 13. Executive Committee of the U.S. Sanitary Commission. Left to right: Dr. William Holme Van Buren, George Templeton Strong, Rev. Dr. Henry Whitney Bellows (Commission President), Dr. Cornelius R. Agnew and Prof. Wolcott Gibbs. Courtesy of the Library of Congress.

 

Soldiers Welfare – Charitable Groups

At the beginning of the Civil War, past thoughts on the horrors of the Crimean War were not far off, and sad letters sent home from sick and lonely soldiers, along with emotionally charged newspaper reports on poor camp conditions and the suffering of soldiers, prompted civilian women to organize and form charitable groups like Florence Nightingale did. These groups such as The United States Sanitary Commission (figure 19) and The United States Christian Commission[57] were created to aid and relieve the suffering of the soldiers.

These were Union supporting groups whose focus was on improving the healthcare of soldiers, better the communications between soldiers and their homes, as well as help to organize a system where part of a soldier’s paycheck could be sent home to cash strapped wives and families. Additionally, in April – May of 1861, as the war was commencing, these civilian aid groups collected and used community donated resources and money to help care for the suffering soldiers, yet were denied official access to the soldiers and since charitable groups were not endorsed by Interim Surgeon General Wood, they were not recognized as helpful.[58]

The Confederacy had their own soldier welfare groups, such as, The Ladies’ Soldiers’ Relief Society, and The Ladies’ Hospital Association.[59] Throughout the North and South, there were many welfare groups created to provide basic medical care for the tired, sick, and wounded soldiers, as their respected governments either could not, or would not, care for their medical needs.

Soon after the war started, reports were coming out on the poor sanitary living conditions, diseases, and illness within the camps. There was a social fear that “our soldiers” would suffer horrific deaths like those in the Crimean War. Men like Templeton helped form relief societies to compensate for any shortcomings the Army may have had in caring for the health and wellbeing of its solders. During this time, the newspapers were discussing camp problems, sanitation, and diseases within the troops along with the former heroic actions of Crimean volunteer nurse Florence Nightingale.

Templeton, a dedicated Christian and successful lawyer, sponsored a local regiment and joined other prominent men, Rev. Dr. Henry Whitney Bellows, paster at the All Souls Unitarian Church, New York, Dr. William Holme Van Buren of New York’s College of Physicians and Surgeons, Dr. Valentine Mott, Professor of Surgery at Bellevue Medical College, Fred L. Olmsted, and others, to combine their passion and talent with Dr. Elizabeth Blackwell of the New York Infirmary For Women to form The United States Sanitary Commission and on the 9th of June 1861, Lincoln approved their plan to care for suffering soldiers. [60] These men were movers and shakers within upper New York Society and were politically connected with access to Lincoln’s Cabinet.

On May 23, 1861, The Sanitary Commission wrote Secretary of War Cameron with an outline of the Commission’s plan to aid the Army with donated supplies and funds. Section III, of the report stated,

“The Commission would inquire into the organization of Military Hospitals, general and regimental the precise regulations and routine … Hospital supplies … the question of ambulances and field service, and of extra medical aid…” [61]

On June 9, 1861, Secretary of War Cameron writes back the Commission is

to act as “A Commission of Inquiry and Advice in respect of the Sanitary Interests of the United States Forces’ and without remuneration from the Government. The Secretary has submitted their patriotic proposal to the consideration of the President, who directs the acceptance.”[62]

Yet, being approved to be of service to the Army and becoming wholly accepted is a different matter. When the plan was finally agreed upon in June, Cameron would only let the Commission’s volunteers work with the volunteer regimental soldiers and not with the regular Army.

The First Battle of Manassas July 21, 1861

On July 17th Templeton writes

“McDowell’s column is in advance on Fairfax and Manassas Junction at last. I fear this move is premature, forced on General Scott by the newspapers. A serious check on this line would be a great disaster.”[63]

It would seem, according to Templeton, the media could and did influence and interfere with battle planning. In any case, for an Army to move ahead of its planned schedule, it is guaranteed some of the needed supplies will be left behind to expedite the troop movement, which includes leaving behind medical supplies.

Just prior to The Battle of First Manassas, there was much excitement with local regiments marching in the streets for both pride, boastfulness and recruiting purposes. The Second New-York Regiment, who according to The New York Times marched through the city, “up Lombard-street, from one deport to another were well received and cheered on many parts of the route.”[64] Between the excitement and a tinge of the unknown, many regiments hurried to the battlegrounds completely unprepared. When Manassas started, The Twenty-Seventh New York Regiment had two ambulances but not a trained ambulance staff. General Irvin McDowell had only fifty ambulance wagons for thirty-five thousand men,[65] and The Fourteenth New York headed into battle without ambulances.[66] Furthermore, it was reported the battle, which took place roughly 40 miles outside of Washington, drew “thousands” of spectators.[67] William H. Russell, reported he and his friends during the battle were resting in the shade of their buggy, and “made a feast on … sandwiches.”[68] While, Edward Pollard described, “a stream of visitors …set out from Washington, thronged with gay women and strumpets going to attend “ the Manassas Races.””[69]

Not since the War of 1812, had there been such a massive battle on American soil. This first battle was a costly battle for both sides and it indicated to the Army and to the public, this war would not be over soon and that neither of the armies were prepared for the expense, death, and chaos war brings.

Losses from the Battle of First Manassas

The Confederates had a total force of 29,188, suffered 1,582 wounded, 387 killed, with 13 missing, [70][71] while the Union Army comprised of 35,000 soldiers, 1,011 wounded, 481 killed, and 1,216 missing[72]. One of the issues with this battle was the belief it would be won quickly; it would be without a doubt the Union would win and would be over as quickly as it had started.

Medical Care During the Battle

Medical Director of the Union Army Surgeon W. S. King, under General McDowell, reported after the battle he and Assistant Surgeon Magruder, and a few others, were the only combat experienced medical officers. “Our advice and assistance were eagerly sought in relation to the details of camp life and the mode of procuring the necessary medical supplies”. Additionally he stated, pre-battle, he tried to distribute the few ambulances equally among the regiments, and decided he needed more, “I made an estimate of twenty wagons for our medical supplies, which, although approved by the commanding officer, did not result in their being sent.[73]

King was not the only one with supply problems. Surgeon H.P. Stearns U.S. Volunteers of the 1st Connecticut writes, the wounded were carried to a makeshift field hospital by “blankets fastened to poles” and he said the landscape would not allow for wheeled ambulances.[74] According to Assistant Surgeon C.C. Gray, U.S.A., who was at Manassas, and was one of the medical men at Sedley Church, the Union’s makeshift field hospital was captured and the next day was then instructed to hunt for wounded on the battlefield using a Coolidge ambulance. He writes,

“It was raining… We soon found that many must perish before we could possibly remove them… many were left on the field, and numbers doubtless died for want of timely assistance…. We suffered much for want of food, water, and blankets.”[75]

Gray’s testament is an unfortunate example of war, but it does not that help that neither side was supplied correctly before they started the war. Thus, considering this problem of supply and demand, it became clear to many, if the first battle did not end the war, then the manufacturing, gathering, and shipping supplies for the war effort is paramount, as it will not be a quick war. Moreover, by following outdated medical regimental proceeds and not ordering the needed medical supplies weeks before the fighting, many savable men died that day from lack of basic medical care.

Reality of War

The preliminary investigation into unnecessary deaths on July 21st, 1861, clearly dictates the cause of most deaths was from the lack of field medical care and ambulances. The combined number of men fighting (both sides) equated to 64,188 men. Of this number, there were 2,593 were wounded, 1,229 were missing, and 868 killed.

The medical regulations of the Confederacy stated ambulances should carry 40 men per 1000, and that a regiment should have at least, ten two-wheeled ambulances, two four-wheeled ambulances, and four two-wheeled transport carts. [76] In Confederate Hospitals on the Move…, Glenna R. Schroeder-Lien reports, these ambulances when found were unusable and lacking in quantities.[77] And like the Union, the Confederates regiments mostly relied on ordinary wagons, or “those captured from the Union.”[78] Four months after the war began, the Confederate armies medical ability “was anything but encouraging.”[79]

Doing the Math

To effectively provide adequate medical care for the 64,000 men at First Manassas, with a given ratio of 40 men per ambulance and one ambulance per 1000, it would take 1,600 ambulances plus a trained and dedicated crew to successfully remove the wounded. Of course, the 40 men per ambulance at First Manassas was a textbook wish of how it should be, yet what the armies did use was some Tripler units which had a capacity of 10, the Rosecrans, which held 15, and the two person French Cacolets which was strapped to a horse or mule. The Cacolet utilized was modeled after a French design which they used in Algeria and the Crimean These units and others were utilized throughout the war and their numbers did increase, but during the first two years of the war, the ambulance was primarily the plain old wagon.

Regardless the mode of transportation used during First Manassas, it would have taken an astronomical amount of ambulances to evacuate the wounded from the battlefield in a timely manner.[80]

The Shortage of Supplies. Why?

As discussed, ambulances and basic medical care were hard to find during the First Battle, but why was this? The records indicate that before the war there were many discussions within the Army on the need for an improved medical-ambulatory system and the data demonstrates many of the suggestions were denied by high ranking government officials. As mentioned, King never received his twenty-extra ambulances prior to the battle. In fact, those ambulances and many others were being held in Washington.

General Wadsworth stated a few days after the battle he, along with thirty-nine ambulances, went to collect the wounded and dead.[81] Though intentions were good, thirty-nine ambulances of any type, days after the fact, seems to be a dismal amount in relation to the amount of wounded.

Additionally, King, in his official report on First Manassas, stated

“In preparing for the expected battle, a limited number of ambulances which had been furnished, was distributed with great care, so as to equalize the amount of transportation among the regiments [600 to 800 men each]. I made an estimate of twenty wagons for our medical supplies, which, although approved by the commanding officer, did not result in their being sent…. As the conveyances estimated for had not been furnished, these arrangements made it impossible to transport any medical supplies except such as could be placed in the ambulances or poked into the forage wagons, and this I directed the medical officers to do.” [82]

King’s report is significant as it demonstrates even though there was pre-planning, there was also a problem with the existing supply chain, thus preventing shipment of critically needed medical supplies, which in turn caused unnecessary deaths of savable men even before the battle started. This supply problem will continue to plague the Army throughout the war but will slowly improve as the leadership changed in a few key positions.

Even if each regiment had its own ambulance, holding 10 to 20 men, after the first shots were fired it would be quickly filled. To compound this, the battles did not stop; they kept going, killing and wounding, the ambulances would have to leave the field to transport the first set of wounded and be gone for an unknown amount of time, while in its absence, more and more men would need critical medical attention.

Surgeon General Clement Finley

Two months before First Manassas, on May 22nd, The Evening Star announced that Surgeon Clement Finley (figure 20) had become the country’s tenth Surgeon General, replacing Interim Surgeon General Wood.[83] This change meant the Sanitary Commission’s prior connection with the department would need to start over. Unfortunately, it has been reported Finley, like his former boss, Lawson, had been in the military for over forty years, and was sixty-four when he became Surgeon General. He served with General Scott in the Back-Hawk War of 1832 and in Mexico, thus, like Lawson, he was a frontiersman, with a frontier scope on medicine and departmental organization. Furthermore, it was reported, he was more concerned with saving money than with suppling troops and that new medical equipment and books were a wasteful expenditure of funds. Lastly, he would not order medical supplies until after a battle started.[84] He was in the position for two months when First Manassas occurred.

Figure 14.Major General Winfield Scott. Courtesy of National Archives;529369, 111-B-5265

Figure 02. Tenth Surgeon General, Clement A. Finley (1797 –1879)

Also in May, civilian Dr. J. O. Bronson approached General Winfield Scott, (February 14, 1824 – February 9, 1886), (figure 21), on forming a dedicated ambulance corp. consisting of a, “surgeon-in-chief, with aids, nurses, and an efficient body of men to attend upon the ambulance and litters.” General Scott then sent the requested plan to Surgeon General Finley, but according to footnote 1, in The Medical and Surgical History….Ser I, Vol II, pt. III indicates, “no further action seems to have been taken” with Bronson’s plan. [85] Not only were there other individuals like Bronson who were willing to help organize an official ambulance corps, but during April and May, the Sanitary Commission had been feverishly working to get the government to recognize their organization and allow them to help supervise the sanitary conditions of the camps and provide medical aid to, and help evacuate the wounded when needed.

Templeton Strong, remarks, after dealing with both Wood, Finley, and Dr, Tripler, Medical Director of the Army of the Potomac, in his September 16th, 1861, diary entry,

“Old Finley, the head of that office, is utterly ossified and useless… Dr. Wood… His main defect is blind, fanatical loyalty to his chief, Finley… Dr. Tripler…is an energetic, spasmodic, crotchety, genial old gentleman…”

Figure 15. Fredrick Law Olmsted. Courtesy of The Papers of Frederick Law Olmsted.

These remarks came after Dr. Lamb, the Medical Purveyor the Union Medical Department was “out of bandages” and asked the Commission if they would supply him with some. Templeton noted on the department of the Surgeon General, “The fogies of that department manage it in the spirit of a village apothecary. [86]

On December 15, 1861, Secretary of the Sanitary Commission, Fred L. Olmsted (April 26, 1822 – August 28, 1903, figure 22), in replying to a previous correspondence from John M. Forbes, concerning Forbes’ remarks about Surgeon General Finley, stated his opinion of Finley,

“ …it is criminal weakness to entrust such important responsibilities as those resting on the surgeon general to a self-satisfied, supercilious, bigoted block head merely because he is the oldest of old mess-room doctors of the old frontier-guard of the country. He knows nothing and does nothing and is capable of knowing nothing and doing nothing but quibble about matters of form and precedent…”[87]

Likewise, Charlies J. Stillé, writes, in the History of the United States Sanitary Commission,

“It soon appeared that the Surgeon-General had no admiration for the Commission, it was equally clear that all the old traditions of the army conceived in a spirit which never looked beyond the wants of ten or fifteen thousand men, and for that reason, if for 110 other, wholly inapplicable to the existing emergency were to be maintained in all their vigor… his devotion to routine and his undisguised hostility to their body would render all their plans for promoting the health and efficiency of the army practically worthless.”[88]

Evidence within these claims about a non-responsive Surgeon General’s medical department, along with comments on Finley’s own inactions, further presented his and the department’s inadequacy as the months rolled on with continuation of poor, and at times, no response to requests from the field for medical equipment and supplies. This information supports Surgeon Kings statements of not receiving the 20 ambulances he ordered prior to First Manassas.

Like previous attempts to organize an official ambulance corps, in September of 1861, the Pennsylvania’s Surgeon General offered to supply a complete ambulance company (‘2 officers, 67 men, and 45 ambulances) for the Pennsylvania Reserves. Like several other requests before his, he did not get a reply from the Surgeon General or the Secretary of War.[89]

After the debacle of First Manassas, things did not improve within the supply chain or the Army’s medical department as evidenced by the poor handling of The Peninsula Campaign in March 1862. Data suggests things did not improve until Finley was removed from office on April 14, 1862, and a man 30 years younger, highly educated, and motivated, Surgeon William A. Hammond, took over the department.

For the Lincoln administration, the disaster at Manassas was an embarrassment and the negative reports within the press did not help. Manassas caused a reexamining of the top leadership in Washington as well as within the Army’s top leadership and its equally humiliated medical department. For the Sanitary Commission, the changes in the Lincoln Cabinet caused a renewed interested in their ability to provide care, as well as created new obstacles. The fallout from the failure at Manassas, and of the war in general, meant pressure was mounting on Lincoln’s administration for change. The Day after the Manassas fiasco, July 22nd, Congress backed a passed a Sanitary Commission proposal, titled, An Act to authorize the Employment of Volunteers to aid in enforcing the Laws and protecting Public Property.

This act allowed the President to call up to an additional 500,000 volunteers, “for the purpose of repelling invasion, suppressing insurrection.” Section 2, indicated, these men would be organized into regiments, which included, one surgeon and one assistant surgeon, two principal musicians, twenty-four musicians for a band, as well as one wagoner. In this Act, there are twelve detailed sections, yet within this new Act, even after Manassas, there is not a mention of additional medical supplies or ambulances.

The Act is an extension of the regimental policy that already existed. It was for more men; not an improvement in caring for the wounded, or to supply a better system. The Act added more gas to the fire, without an extinguisher. Additionally, on August 12th 1861, just weeks after the July 21st Manassas battle, the Lincoln administration made a move and Medical Director of the Army of the Potomac King was out the door and replaced by Charles S. Tripler (figure 23). Tripler, like Lawson and Finley was also a frontier army doctor, who fought in the Second Seminole War (1835-1842) as well as Mexican American War, thus was not an experienced medical officer in a war of this scale and scope.

Figure 16.Dr. Charles Stuart Tripler (January 19, 1806 – Oct. 20, 1866). Papers of Fredrick Olmsted. p.339.

On March 6, 1862, Army of the Potomac, Medical Director s Office, Surgeon Tripler noted in correspondence with Surgeon General Finley and Secretary of War Stanton, regarding his thoughts on an official Ambulance service,

“Sir, I have examined the plan of organization of an ambulance corps… However desirable a regularly organized ambulance corps may be for an army, it is too late now to raise, drill, and equip so elaborate an establishment as this for our service…”

On March 9th, both the Secretary of War and Surgeon General agreed with Tripler. [90] On March 19th, Tripler reported to Finley regarding ambulances, “Inquiries are constantly made about ambulances… if a reasonable supply of these carriages is not at the right place at the right time…the failure does not rest with the medical department.”[91]

The data present thus far indicates there was a desperate need for an official ambulance corps, as well as standardized ambulances. The medical care during The Peninsula Campaign was not any better, in fact in many ways it was worse, for there were more men, less medical supplies per man, and longer distances to travel for both supplies and medical care. And still not an official ambulance corps., nor standardized ambulances, only a few varied ambulances with varying carrying capacities which were used to evacuate the wounded from the battlefield. During this campaign, the weather was atrocious, and the dirt roads made wheeled ambulances useless. To combat this problem, the Army tested the Cacolet (figure 24).

Figure 17.French Cacolet, Medical and Surgical History of the War of the Rebellion, Vol. II. Pt. III. p. 931.

The Peninsula Campaign (March through July 1862)

During the Battle of Seven PinesFair Oaks, (May 31-July 1, 1862), the Army knew it needed more ambulances and that much of the countryside was not conducive to wheeled ones; as the muddy war torn landscape slowed or prohibited them during the varying Campaigns. Yet before this, in January 1860, the Army Medical Board decided to use horse drawn single person litters (figure 25), which unlike like the one or two person Cacolet, was dragged behind a horse.[92] In the correct setting, this useful device would work well. However, like the Cacolet, it would take hours to evacuate the wounded men from the Seven Pines battlefield, causing many to die while waiting their turn.

Figure 18. Horse Litter, Hamilton, A Treatise on Military Surgery and Hygiene. p. 162

On May 27th Colonel S. Van Vliet, the Quartermaster at the White House Landing (figure 26) on the Pamunkey River received a telegram from Lieutenant Colonel J. A. Hardie, requesting the forty Cacolets and their horses which were stored there.

Figure 19. Battle of Seven Pines, May 31, 1861

On May 31, 1862, during The Seven Pines battle, F.H. Hamilton the Medical Director of the Fourth Army Corps indicated

“eight pack-saddles, provided with a litter on one side and a cacolet on the other, were provided as a part of the ambulance outfit of that corps, and were used only on the first day of the battle, proving utterly unserviceable.” [93]

Furthermore, Hamilton indicates, the horses were not suitable to the task, and six of the Cacolets broke in service.[94]

On March 16, Mr. Kohler a salesman or Cacolet manufacturer, requested an examination of his new litters and Cacolets. Medical Director Tripler replied back to him, “there are sufficient horse litters for this Army in the possession of the Quartermaster’s Department. All we want now is horses or mules properly trained to carry them.” Moreover, Tripler, on April 25th, indicated there were more than 200 Cacolets furnished by the Quartermaster’s Department, and that General McClellan gave orders to have his horse trained to carry them, yet it is reported that this order was never carried out.[95] From June through December of 1862, the conversation over the use of Cacolets continued.

Battle of Fair Oaks – Seven Pines (May 31, 1862 – Jun 1, 1862)

On June 10th Olmsted docked at White House Landing (figure 27) and aboard the Tender Wilson Small, stated since the Battle of Fair Oaks / Seven Pines (figure 26) commenced, the Commission had received “four thousand” wounded and that half of those were transported for additional medical care, and on July 1st near Harrison’s Point he wrote, “For the wounded there is no provision: no beef—none at all…nothing yet for them to eat.” [96]

Figure 20. White House Landing. Courtesy of The Olmsted Papers, p. 335.

In October 1862, Surgeon General Hammond requested 150 mules provided with mule litters, to be sent to Dr. Letterman. Captain J. J. Dana, A. Q. M., reported, “we had no mules sufficiently well broken for the purpose… many of them, inclined to lie down, and were otherwise unruly.”[97] The correspondence from Quartermaster’s Department indicated,

“…no less than $100,000 and probably more, has been expended in an experiment which was, so far as information in this office goes, entirely unsuccessful…. All the requisitions came from the Surgeon General’s Office. It is not known to this office that these mule litters ever were used in service, and the quartermaster General believes that no wounded man was ever placed upon one of them… any further expenditure ….will be a waste of public money…”[98]

In June, Colonel Rucker advised the Quartermaster General that Koehler’s product was very high priced and “It is intricate and cumbersome in construction” therefore inferior to the French Cacolet and litter[99]. According to the Property Division of the Surgeon General’s Office, between 1861 and 1865, the Medical Department purchased and distributed 918 horse or mule litters. Moreover, the designated mules were taken for the ambulances and wagons.[100]

This method was an extremely ineffective way to extradite the wounded from the battlefield. For example, the 61st Pennsylvania of the Fourth Division during Seven Pines (figure 28), suffered 152 wounded with 68 killed, and the 5th New Hampshire had 147 wounded with 26 killed. Because we do not know if the dead were declared dead while on the field, we must include them with wounded, therefore, there were 393 wounded to be removed from the field. Of course, some could walk off.

Figure 21.Bringing wounded soldiers to the cars after the battle of Seven Pines June 3 1862 Library of Congress.* Figure 28 is a firsthand sketch of the wounded being unloaded from ambulances and putting them into rail cars at Fair Oak Station.

Note, you can see varied styles of ambulances, including some type of Cacolet in the foreground being attended two by two men.

Even if 200 men were transported off the field at the same time, there needed to be 100 mules / horses with Cacolets standing by to quickly extract the wounded. Of course, with this device the wounded must be able to be placed into the wagon, as well as sit upright while being transported. Yet, the actual battle statistics for the wounded was far more than 393.

Figure 29 is the O.R. Recapitulation of the losses suffered for the Army of the Potomac at Seven Pines showing 3,378 wounded with a total Aggregate of 5,031.[101] This is greater than the total losses from both sides during First Battle of Manassas, which was 4,690 just eleven months earlier.[102] Moreover, these are the statistics for only one of the several peninsula battles.

Figure 22. Recapitulation on The Battle of Fair Oaks. O.R. Ser. I. Vol. XI. p.764.

Even after the Battle at First Manassas and with all the time and money spent investigating Cacolets, there seems to be little practical thought on how to swiftly extradite the wounded when a large-scale battle occurs. It is obvious the long-practiced frontier medical mentality did not work with the size and scope of the Civil War.

For the most part, during The Peninsula Campaign, the men in charge of such extraction decisions were still using small scale frontier regimental thought. Yet, this was not always the case. Before the Peninsula Campaign was fought between the banks of the Pamunkey, Chickahominy and James rivers, several supply depots were established, White House Landing, Eltham’s Landing, and Cumberland Landing (figure30).

Figure 23. The Army of the Potomac at Cumberland Landing, 1862. Olmsted, Papers, p. 358

Surgeon Tripler and Olmsted, of The Sanitary Commission, had enough forethought to order medical ships to be sent to White House Landing and Harrison’s Landing before the start of the Peninsula Campaign. Even though both individuals saw the efficiency of using medical ships to care for the wounded, unfortunately, they did not cooperate in a professional manner, and their attitudes towards each other hindered the process of aiding the wounded.

Harrison’s Landing

Figure 24.Harris Landing 1862. Library of Congress

As the Army of the Potomac fought its way to capture Richmond, they had to march, fight, and camp, along the Northern banks of the James River, its tributaries, swamps, bogs, and marshes. During this period, the men camped for an extended period of time at Harrison’s Landing (figure 31), thus exposing them to a constant barrage of mosquitoes, water saturated ground, and months of varied weather; from cold spring rainy weather to hot humid rainy weather. This environment and slow arrival of supplies caused thousands of men to get sick.

On April 30, a month after the start of the campaign, the Army of the Potomac consisted of 109,335 men and officers, and out of that, 5,385 soldiers and 233 officers were sick. By July 10, there were 89,549 men in the unit, comprised of 3,834 officers with 85,715 soldiers. Out of that, there were 685 sick officers and 15,959 sick soldiers. [103] The environment was not encouraging to the health of the regiment.

Figure 32 is an office map drawn by the United States Army of The Potomac. Engineer Dept. in 1862 of the area, including, White House Landing, Harrisons Landing and others.

Map Description automatically generated

Figure 25.White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862).Courtesy of loc.gov/item/lva0000179/

 

Figure 33 titled, The Skedaddle of the Pamunkey, is a sketch of one of the landings on Pamunkey river. The image gives size and scope to the naval logistics needed to support The Peninsula Campaign.

 

Figure 26.The Skedaddle of the Pamunkey, Olmsted Papers. p. 382.

Medical Director Tripler; Meddling Village Doctors and Strong-Minded Women, and Poor Condition on the Peninsula

In his report on the medical operations of the Army of the Potomac from March 17 through July 3,1862, Tripler complains, that in preparing for the upcoming Peninsula Campaign his thirty years of medical knowledge and the running of the medical department had to endure and be challenged by “presumptuous intermeddling” from “Sensation preachers, village doctors, and strong-minded women, suddenly smitten with a more intimate knowledge” on medical matters and how to run the medical department. He goes on to recount how the “ crude suggestions” and interference was “paralyzing” to the department, as they (outsiders), tried to “quicken” the medical departments procedures thus, defeating[his] measures” which he planned to exercise “at the proper time.” [104]

He noted, by 11 March, all the supplies for each regiment was ready for deployment, shipping hospital tents, medicines, stores, a wagon to transport the supplies and the sick. Also, he stated, medical officers were given “minute directions [on] forming field depots for the wounded [along with] methods on paring…the distribution and employment of the Ambulance Corps.” [105]

Yet, in March of 1862, the Army of the Potomac did not have an official Ambulance Corps, and most regiments depended on band members as stretcher bearers. Furthermore, he indicated, the initial orders to prepare the Army of the Potomac for the upcoming campaign was expedited, thus his plans to create a medical corps d’armée had to be postponed. He wanted each regiment to be “a complete army in itself.”[106] He then discusses all the problems created by expediting the deployment, as well as listing the doctors he assigned to each corps,

  • Keeney to Sumner’s
  • Brown to Keyes
  • Milhan to Heintzelman’s
  • Magruder to McDowell’s

Additionally, he also voiced his objection that Keeney, one of his medical inspectors, was replaced by J. F. Hammond, without his being consulted. He asserted, “I cannot help complaining of the act itself as inexpedient and unjust. I remonstrated against it at the time upon principle, but without avail.”[107] To have a key member of his medical team replaced without his consent demonstrates that his superiors are questioning his management judgment. Moreover, he demonstrated his disapproval of the Sanitary Commission’s action by expressing they were generously giving out “comforts” for the “inmates” being treated in the military hospitals. Inmates, of course, are patients, i.e., wounded soldiers. He continued, these “comforts” are given out “very liberally…I had no control over these issues… they should not be given out unnecessarily …kept in reserve, [until] an emergency, such as a battle.”[108] Of course, this is exactly how his predecessor and mentor Lawson thought and acted.

Tripler also stated he met with General Van Vliet concerning the distribution of ambulances, for the upcoming campaign. Van Vliet expressed the best he could do at that time was send 36 four-wheeled units which were already mobilized and would send 86 more in the future, as well as send 140 two-wheeled units when he could. This meant, there were 402 ambulances ordered for the campaign. Tripler indicated this order was not completed until the 1st of May. [109] Thus, if the 4 wheeled unit can carry 10 each, then 122 four wheeled units could carried 488 men, while the two wheeled typically used carried 2 men, thus 140 equates to 280 men, with a total capacity of both ambulances to carry 768 wounded. Of course, these ambulances are distributed among the regiments and are not all concentrated at one battle, therefor their effectiveness becomes diminished as they are divided up. Additionally, Tripler exclaims, he was expecting 6,000 casualties from the upcoming battle at Yorktown, which would indicate he would need at least 600 four-wheeled ambulance.

These are rough estimates and the actual number of ambulances and their capacities varied, yet the records indicated the number of units employed would not suffice. Additionally, at this time, this report does not know how quickly ambulances were manufactured, therefore we do not know the replacement time when one was damaged. This could also greatly impact the survival of wounded men waiting for care on the battlefield.

Not only were ambulances a concern, so was the environmental conditional in which McClellan chose to march and camp his troops. Tripler wrote that between Warwick Courthouse to the York River, there was nothing but a “succession of swamps”, he added, the warm weather and the swamps will bring on “malarial poisoning” and that many of the wounded should be shipped North to hospitals via medical steamers. Captain Colonel Ingalls, aide-de-camp to McClellan, agreed to ship patients North from any point on the York River. At this point, Tripler contacted Interim Surgeon General Woods who agreed to this plan but insisted on changes which altered Tripler plans. Woods wanted specific injuries to be sorted and placed on corresponding ships which went to particular hospitals. Unfortunately, the mixed communications on how to treat and evacuate the wounded via the hospital ships became convoluted. To confuse things further, many states sent their doctors, female nurses, and medical supplies on their own retrofitted makeshift floating hospital ships.

Tripler reported,

“On the 19th Prof. Henry H. Smith, Surgeon General of Pennsylvania, arrived with the steamer Wm. Whildin, completely fitted up with bedding, stores, instruments, a corps of 18 surgeons and dressers, and a full complement of Sisters of Charity for nurses. He brought with also the means of embalming the bodies of the dead.”

He also reported that on the 19th, malaria and typhoid were beginning to appear in Keyes’ corps. And Keyes was the “worst on the Peninsula.” He stated, as he made arrangement to ship the sick North, the number of sick was increasing. [110]

In his report, Tripper stated he had ordered enough medical supplies and transports to care for the wounded during the entire Campaign, yet when the Army first arrived and prepared for the Battle of Yorktown, he asserted he was “flooded” with requisitions for more supplies.

He exclaimed,

“The medical officers seemed to suppose that the medical director was to furnish them with fresh supplies at every change of position, and had taken no pains to transport their stores from Washington to the Peninsula…”

He also remarked that “Liquors had very generally disappeared” … and “his” supply of stimulants was now limited and would only issue any in case of a battle.[111]

A New Surgeon General: William Alexander Hammond (1828-1900)

On April 28th, the changing door of leadership spun again, two weeks into The Siege of Yorktown, McClellan had Secretary of War Stanton replace Surgeon General Finley with William Alexander Hammond (figure 34). Hammond was picked by McClellan from a list of candidates selected by The Sanitary Commission.[112] According to James E. Pilcher, Stanton and Finley had a falling out over reported problems with Dr. John Neill, whom Finley appointed as the head of several Army hospitals located in Philadelphia and not so much as pressure from the Sanitary Commission.[113] This will not be the only Surgeon General Stanton disliked and removes.

William Hammond was thirty-one years younger that Finley, earned his M.D. in 1848. From 1849-1858, was a frontier surgeon in the Army and involved in the First Sioux War (1854, 56). In 1858, he resigned from the Army. In 1859, he became a professor of Anatomy and Physiology at the University of Maryland in Baltimore and eventually published a treatise on neurology. Although he was a frontier army doctor, he was a new breed of up and coming doctors. In 1861, after the 6th Regiment Massachusetts Volunteer Militia was attacked during the Baltimore riots, Professor Hammond decided to reenlist in the Army. In doing so, he started at the bottom of the ladder as an assistant surgeon. First, he was assigned as a medical purveyor in Frederick Maryland then went on to organize Baltimore area Army hospitals, as well as become an inspector of hospitals and camps for Maj. Gen. William S, Rosecrans. Additionally, during this time, his professionalism became known and respected by The Sanitary Commission.[114]

Figure 27.Eleventh Surgeon General: William Alexander Hammond (1828-1900). Library of Congress

According to Templeton’s diary, Hammond was “a comparatively young man of great force of character, scientific capacity, keenness of intellect, and originality of method.” His October 13th, 1861 entry, dictates,

“Dr. Hammond… Only an Assistant Surgeon, but he has had intimations from the War Department that …. he may take Dr. Finley’s place. . . . Dr. Bellows thinks well of him.” [115]

This was recorded seven months before Hammond’s April 28th, 1862 appointment as Surgeon General. This appointment was due to The Sanitary Commission, as well as the April 18, 1862: “An Act to Reorganize and Increase the Efficiency of the Medical Department of the Army[116]

The Commission’s power was quite apparent with the passing of this Act, as well as their appointment of Hammond.

Even though Hammond was agreed upon by Secretary of War Stanton, Stanton did not like Hammond.

“Well,” growled the Secretary, “the fact is the Commission wanted Hammond to be Surgeon-General and I did not. I did my best with the President and with the Military Committee of the Senate, but the Commission beat me and got Hammond appointed. I’m not used to being beaten and don’t like it, and therefore, I am hostile to the Commission.” [117]

Hammond remained in this position until August 18th, 1864, when he was relieved of duty and court marshaled for banning the standard Army medicine Calomel throughout the entire Army. Calomel contained mercury and Hammond believed it caused more harm than good. Stanton managed to get Hammond removed over this, but in 1879, President Hayes intervened and had Hammond’s Court Marshal reversed with all his Army benefits restored. It was deemed the case had been about Stanton’s personal hostility towards Hammond.[118]

The Siege of Yorktown (April 5 to May 4, 1862)

On May 2nd, The New York Times front page reported on The Siege Of Yorktown, “The Defeat of the Rebels a Foregone Conclusion” along with, “Probable Capture of the Whole Rebel Forces.” (figure 35)

Figure 28.May 2, 1862, The Siege of Yorktown, New York Times. pg. 1.

The pressure was mounting, and success was expected as the siege was coming to an end, but achieving victory was not McClellan’s only problem, the real enemy was not the Rebel Army, but sickness. During the time the Army was camped on the peninsula, the troops illness numbers were creeping up and the limited number of field hospital beds was soon filled. Out of pure necessity, on the First of May, Tripler ask the Sanitary Commission for help in transporting some of his sick to a Northern hospital. To assist Tripler, Mr. Fredrick Olmstead of the Commission, sent one of their retrofitted steamer ships, the Daniel Webster (figure36) which now represented a floating hospital, complete with 250 beds. Olmstead also suggested Tripler should procure another ship, the Ocean Queen and retrofitted it into another hospital ship, which he did.[119]

Figure 29.The Daniel Webster No. 1. Fredrick Olmstead Papers. P. 326

During the Siege, Tripler was busy requesting more hospital ships and other medical supplies. His reports indicated that during this time, he telegraphed the Surgeon General numerous times requesting new supplies as his were running out. To help fill the needs of the Army at Yorktown, the Commission placed an ad on May 8 in The New York Times, seeking donation for their floating hospital ships, which were at the Siege of Yorktown, (figure 37).

Figure 30. May 8, 1862, New York Times ad seeking supplies for floating hospital caring for the Siege of Yorktown wounded

On May 2nd Tripler indicated he expected to receive 232 sick men from Keyes’ Corps, instead he received more than 1200 sick. By May 9, there were 2000 reported sick in Yorktown, and out of that, 950 were shipped North via the ships owned by the Commission. April’s total sick was 5,618 and July’s, 16,644. There were 11,026 total sick.[120] Tripler also reported he received 28 wounded from General Stoneman, then from The Battle of Williamsburg (May 5), he received an additional 700 wounded along with 333 wounded Rebels.[121] According to Official Records, O.R., the Battle of Williamsburg had 1410 wounded.[122]

On May 7th while anchored off Yorktown, Fredrick Olmsted, aboard the Ocean Queen, writes to friend and President of the Sanitary Commission, Rev. Henry Bellows, explaining how Tripler’s assistant Greenleaf, stated he had 5000 sick which needed to be shipped out. Furthermore, Olmstead relates, many of the regimental surgeons neglected their patients frequently. They would desert their sick and head off to the battlefields, “They are mad with surgical fever.”[123]

The Peninsula Campaign and The Numbers

During The Peninsula Campaign’s five months of slogging through mosquitos and mud, there were various battles along the way each with mixed levels of troops and varied number of casualties. The scope of this paper does not include all of the battles fought during the campaign, such as The Seven Days Battle (June 25-July 1st) which was comprised of Battle of Oak Grove June 25th, Mechanicsville- June 26th, Gaines Mill- June 27th etc.., ending July 1st at Malvern Hill. These battles and others fought during the campaign contributed to an already overwhelmed Army medical department and their battle data is included in the statistics.

Between March and July, The Army of the Potomac lost 1,734 in death, 8,066 were wounded, with 6,055 missing, for a total of 15,855 battle casualties out of 114,000 troops.[124][125] In July of 1862, the Army reported, of the 106,069 soldiers, there was over 40,000 cases of illnesses.[126] The Army of Northern Virginia lost a total of 20,204, 3494 in death, 15,758 wounded, and 952 reported missing out of Lee’s 90,000 soldiers. This equates to a loss of 22 percent of Lee’s army from the start of the Seven Day’s War.[127]

The overpowering logistics of The Peninsula Campaign, with its lack of medical care, medical transports, newly conceived hospital ships, combined with mass sickness overwhelmed Medical Director Surgeon Tripler. His inability to cope with these issues caused many supplies, including medicines and ambulances, to be either not ordered or arrive extremely late. This inadequate supply train cost many men’s lives as they waited for treatment.

The information gathered does indicate that Tripler’s training as a frontier army surgeon did not, nor could not, prepare him for the medical and logistical nightmare facing him on the peninsula. Additionally, it did not help that he was not liked by many around and above him. Furthermore, the reports from Olmsted and others, including the press cause Dr. Tripler to be replaced on June 19, by Dr, Jonathan Letterman. (1824-1872) (figure 38).

Dr, Jonathan Letterman. (1824-1872)

Figure 31.. Dr, Jonathan Letterman. (1824-1872). Courtesy of the Library of Congress

Letterman, twenty years younger than Tripler, was four years older than Hammond. His father was a well-known surgeon. In 1842, Jonathan enrolled in Jefferson College, where he cofounded the fraternity Beta Theta Pi, and he joined the Philomathean Society, which was set on refining upcoming leaders by expressing the importance of writing skills, as well as conducting rhetorical debates. In order to be admitted into the college, he needed to demonstrate his knowledge of the Greek Testament, Virgil, Caesar’s Commentaries, as well as Sallust and other classics.[128] In 1845, he enrolled in Jefferson Medical School and graduated in 1849. In 1824, Jefferson Medical College was established by Dr. George McClellan, father of George B. McClellan.[129]

After graduation, Letterman decided to join the Army and soon faced the Army medical review board. After demonstrating his knowledge of physics, Latin, natural philosophy, anatomy via dissection, and his knowledge of clinical instruction, he and twenty-five other applicants, including his new boss, William Hammond, were accepted on June 29th, 1849, as U.S. Army Assistant Surgeons.[130]

He was stationed in the center of Florida at the swampy Fort Meade in 1849, Ripley Minnesota for a year, then shipped out West to Fort Defiance in Arizona.[131] Like Hammond, both were men of better education and medical training when compared to the men they replaced. Lettermen did not see any major battles with the Indians, thus had a different experience as a frontier army surgeon than his predecessors.

To invoke real long-lasting Army medical policy changes, the Army needed medical men of a different breed, men like Letterman and Hammond, who had the desire/vision, professionalism and disposition to tackle an Army ingrained in a frontier mentality. On July 1st, 1862, Letterman via Hammond, transferred to the Army of the Potomac and landed on Haxall’s Landing on the James River, and then on July 4th went to Harrison’s Landing.

Letterman, in a report, explained the conditions he found on the peninsula. He stated after the men fought and marched for seven days, they reached camp at Harrison’s Landing and were “greatly exhausted” after traveling through an area within the peninsula which was full of “pestilential swamps” engorged by the heavy rains, where malaria would soon arrive and began to adversely affect the men’s health. Furthermore, he explained, “It was impossible to obtain proper reports of the number of the sick,” and as the Army left The Seven Days Battle for camp at Harrison’s Landing they left much of their possessions behind, either by design or it was unavoidable. He stated,

“The supplies had been exhausted almost entirely or had from necessity been abandoned; the hospital tents had been almost universally abandoned or destroyed; the arrangement of the ambulances was not in such a state as to render very effective service, and the circumstances under which the army was placed required a much larger number of medical officers to perform the duties which were thrown upon that portion of the staff….”[132]

He continued explaining how he had over 12,000 men to care for, while 6,000 had already been sent away for other treatment, there were not any hospitals available and only a few walled tents. Additionally, on July 2nd and 3rd it rained; and the men lacked food, shelter, and medicine. He also stated, on July 2nd he requisitioned the Surgeon General “1,000 hospital tents and 200 ambulances”. The 7 July reply to his request was as follows,

“Have [your]ordered tents for 50,000 men sent to Harrison’s Landing. Few hospital tents on hand; more making… use of some of the wall tents sent to Harrison’s Landing… Sick and wounded are not useful at such a place as that at Harrison’s Landing.”

On July 9, he commented that General Meigs placed an order for 250 hospital tents and that the remaining 750 tents will be shipped once they were made, along with 200 ambulances. On July 18th Lettermen noted he received 750 hospital tents at Harrison’s Landing and on August 1st even more tents arrived. Also, during that time, he noted fresh food and vegetables started to arrive in “abundance” as well as fresh breads. On July 30, he informed the Surgeon General the Army of the Potomac had 12,000 sick men out of which 2000 could fight. [133] Thus, was the mess given to Letterman when he arrived.

Mr. Olmsted, The Sanitation Commission, and the Press

The Sanitary Commission placed Olmsted in a supervisory position over the Commission’s hospitals ships sent to the peninsula. He was onsite for eleven months which gave him the unique position to witness the care and wellbeing of the wounded, as well as observe the dismays of war.

It had been reported by Russell that during the Crimean War the French had an excellent ambulance system which included effectively and efficiently using hospital ships.

“the ceaseless activity of the French, the daily arrival of their steamers and the admirable completeness of all their arrangements in every detail – hospitals for the sick, bread and biscuit bakeries, waggon trains for carrying stores and baggage – every necessary and every comfort, indeed, at hand, the moment their ships came in.

Of course, this prompts the question, why did the British suffer so much during that war, and why, six years later, even after reports of successful French battlefield medical care, did the Civil War soldiers suffer so much from lack of adequate battlefield medical care?

In a series of letters and telegraphs Olmstead relates the problems with the care of the wounded and how he and others had found many wounded men in varied states of life, laying about uncared for, in the woods and on the riverbanks. On May 15, from the steamboat Wilson Small, he wrote about how they gathered, “twenty-five severely wounded men, two dying and one or two dead.” In total he assisted 240 sick and wounded men and helped placed them on the Daniel Webster.[134] Olmstead also recalled several incidents where many wounded soldiers after a long journey from the battlefield, would finally arrive for Army medical care, yet were turned away because they lacked a note from their Captain.[135]

On June 13th Olmsted writes to Bellows from the White House landing, indicating things were getting worst instead of better, and that something needs to be done in Washington. He writes,

…if these armies keep their promises to-night, tomorrow ten thousand men will bleed to death and starve to death whose lives could have been saved if proper measures had been taken…. Nobody is to blame for this but the Secy of War, but I would not like to stand in Hammond’s shoes. I don’t think his apology is a bit better than Tripler’s… Hammond must be made to do something at once to revolutionize the policy of the Medical Department.”[136]

After reading Olmsted’s report, Templeton describes his feelings about the medical care of the wounded in his June 13th diary entry, he writes that Tripler and his team are comprised of “weakness and inefficiency and imbecility” leaving,

“carloads of wounded men dumped on swampy river shores without food, medicine, or attendance; of men with fractured thighs lying neglected and forgotten forty-eight hours in two inches of water, struggling to raise themselves so as to pick the maggots from their rotting wounds and fainting after the effort”[137]

Hammond and Stanton: A Battle of Wills

During the peninsula campaign, Hammond has his own problems with Tripler and Secretary of War Stanton which surmounted with Tripler being replaced by Lettermen. On August 2nd, Lettermen’s earlier submitted plans, approved by Hammond, for an official ambulance corps within the Army of the Potomac, becomes law in General Order No. 147, thus putting in motion actions which would eventually and forever change Army ambulance care. Unfortunately, Order 147, was enacted too late to be effective at the Second Battle of Manassas (August 29, 30, 1862), but was reported to have been very successful at the Battle of Antietam (September 17, 1862).

An ambulance corp. is great, but Hammond had always felt the Army also needed an official Hospital Corps. He repeatedly writes Stanton with his plans and thoughts on why the Army needs a Hospital Corps. On August 21st, in a letter to Stanton, he wrote, there is a great need, that it is “most urgent” to establish a Hospital Corps, that during the entire war the wounded have not to be cared for properly or effectively in the field. To this, Stanton replied, on the 29th, “I can see no advantage … for a Hospital Corps … [as it would] increase expense and immobility of our army”[138]

On September 7, as the number of wounded men needing medical care from the Second Manassas kept climbing, Hammond again writes Stanton, on the necessity for ambulances and that they must get an ambulance corps up and running, he states,

“The total absence of ambulance attendants, are now working their legitimate results… Up to this date six hundred wounded still remain on the battle-field in consequence of an insufficiency of ambulances and a want of a proper system for regulating their removal in the Army of Virginia. Many have died of starvation, many more will die in consequence of exhaustion, and all have endured torments which might have been avoided.”[139]

General Halleck (January 16, 1815 – January 9, 1872), General-in-Chief of all Union forces, on September 15th, wrote Stanton needing ambulances, but then went on to explain how he was against Hammond’s plan. He stated, “It is the duty of all officers to furnish fatigue parties, properly officered, on the requisition of medical officers, for the care and removal of the wounded….” Halleck, whose words weighed heavy with Stanton stated to Hammond, “Owing to the opposition of the General-in-Chief, no further steps were taken in this direction at this time.” Instead Stanton tells Hammond to read Tripler’s ambulance plan, General Order No. 20, Sec. VI. dated Oct 3, 1861. It stated

“The hospital attendants, to the number of 10 men to a regiment, and the regimental

bands, will be assembled under the supervision of the brigade surgeons, and will be drilled one hour each day, except Sunday, by the regimental medical officers, in setting up and dismantling the hand-stretchers, litters, and ambulances…”[140]

Conclusion

During the First Battle of Manassas and The Peninsula Campaign, many wounded men died on the battlefield in want of basic medical care or ambulance transportation away from the fighting, or in many cases, just to be taken out of the inclement weather. Doctors during the Civil War did not understand the concepts later formed to create The Golden Hour, that for a trauma or emergency patient their best outcome is to receive medical care within the first 60 minutes. Yet, during the Civil War, despite the many technical school doctors, there were many well educated degreed physicians, like Lettermen and Hammond, who understood that the dirt, grime, and soggy Army camps, created the ingredients for wide-spread camp diseases, and the prolonged exposure of men to the elements while laying bleeding unattended on battlefields would eventually kill many otherwise savable men. The data revealed in July of 1862, The Army of the Potomac had 15,959 sick men out of 85,715 total, this indicating McClellan’s fighting capacity was reduced by almost 19 percent.

Armies and their disease were well discussed before the Civil War. In the Mexican American war, it was known for every single combat, there were seven disease-related deaths, and the first 12 month of the Crimean War, 1855, the British Expeditionary Forces lost 18,000 out of 25,000 to disease, a staggering 72 percent of troop combat readiness evaporated from an invisible microscopic enemy. Crimean War, London Times reporter, William Howard Russell, telegraphed back to London concerned about the huge amount of deaths to the British troops caused by disease. In one report he said, “…our army was likely to suffer severely unless instant and most energetic measures were taken… between 7,000 and 8,000 men sick, wounded… the stench was appalling… The dead, laid out as they died…a spectacle beyond all imagination”[141]

Even after the U.S. Army and the Government had read the detailed report on the Crimean War by Delafield, who wrote on the efficient medical care and ambulances used by the British and French and the deeds of Florence Nightingale during the Crimean War, the Army maintained its belief in the long-standing medical polices created by frontier soldiers / doctors such as Surgeon’s General Lawson, Wood, and Finley, and Medical Directors of the Army of the Potomac, King and Triple. All these men represented medical thoughts and practices of a bygone era, except, they were the transitional men who carried their obsolete frontier mentality into the modern American Civil War. This is the Army medical thought President Lincoln inherited and was forced to use during the first two years of the war. Coupled with his outdated Army medical staff, he also had to contend with Secretary of War Cameron, who was more interested in lining his own pockets, was demoted, and made an ambassador to Russia. Stanton, Wood, Finley, Tripler, did not take kindly to suggestions of medical improvements coming from outside of their sphere, which greatly hindered any attempts to improve the Army medical system.

Even though Letterman’s General Order No. 147 eventually became the standard in ambulance care during the war, it took two years and many deaths along with many rejected request to start an ambulance corps., as well as a hospital corps. These denials were due to political and personal reasons, which in turn, delayed any improved battle care and cost the lives of many savable men during early the early Virginia campaigns.

It is not difficult to realize the upward battle Hammond, Lettermen, The Sanitary Commission, and others who embraced the need for medical reform, had against the long-established doctrine of the frontier army which Lincoln inherited. This antiquated thinking coupled with egotistical men within Lincoln’s cabinet jockeying for key positions of power, resented being told what to do by mere army doctors, civilians, or civilian groups. It was the egos of a few key men that cost unwarranted deaths of thousands of savable men.

Bibliography

Primary

Barnes, Joseph K. Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). Washington : Goverment Printing Office, 1888.

Barnes, Joseph K. The medical and surgical history of the war of the rebellion (1861-65) Vol 1. Part 1. Washington: United States Goverment Printing, 1875.

Barnes, Joseph K. Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. II, (Washington: Government Printing Office, 1888),

Bowditch, Henery I. Abuses Of Army Ambulances. The Boston Medical And Surgical Journal Vol. 67, (10)., 1862.

Bowditch, Henery I. Army Ambulances. The Boston Medical And Surgical Journal Vol. 67 (8), 1862.

Brown, Harvey E. ed. The Medical Department of the United States Army, From 1775 to 1873. Washington D.C.: Surgron General’s Office, 1873.

Confederate States of America. War Department. Regulations for the Medical Department of the Confederate States Army. Richmond: Ritchie & Dunnavant, Printers., 1861.

Delafield, Richard, Major. Report On The Art Of War In Europe In 1854, 1855, And 1856. Washington: George W. Bowman, 1860.

Department, U.S. War. The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 10

Hamilton, Frank Hastings, M.D. A Treatise On Military Surgery And Hygiene. . New York : Balliere Brothers , 1865.

King, W. S., Surgical Director, U.S. A. Report Of Events Connected With The First Bull Run Campaign. U.S. National Library of Medicine. n.d.

Letterman, Jonathan, M.D. Medical Recollections of teh Army of the Potomac. New York: Appleton and Co., 1866.

Monroe, Alex LeB. “Letter from Surgeon Alex LeB. Monroe.” In Boston Medical and Surgical Journal Vol. 67. Aug, 1862 -Feb, 1863, by Samuel L. M.D. Abbot, 21-22. Boston: David Clapp, 1863.

Nevins, Allan. “The United States Sanitary Commission and Secretary Stanton.” Proceedings of the Massachusetts Historical Society , Oct., 1941 – May, 1944, Vol. 67., 1944: 402-419.

Numbers, Ronald, L. “The Rise And Fall of the American Medical Profession .” In The Greatest Benefit To Mankind: A Medical History of Humanity, by Roy Porter, 225. New York; London:: W.W. Norton & Company, 1997.

Olmsted, Frederick Law, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vil. 4. Defending The Union. The Civli War and the U.S. Sanitary Commission 1861-1861. Baltimore ; London: The Johns Hopkins University Press, 1986.

Olmsted, Fredrick, Law. A Collection Of The papers Of The Sanitary Commision. . Sanitary Commission No. 25. , Washington : Office Of The Sanitary Commisson, 1861.

Otis, Geroge A. Assistant Surgeon, U. S. Army Surdeon General Office. A Report to the Surgeon General on the Transport of Sick and Wounded by Pack Animals. Circular No. 9. Washington : Goverment Printing Office , 1877.

Percival, Thomas. Dr. Medical Ethics; Or A Code Of Institutes and Precepts,Adapted to The Professonal Conduct Of Physicians And Surgeons. Manchester; Strand, London: S. Russell For J. Johnson, St. Paul”s Church Yard, and R. Brickerstaff, 1803.

Pollard, Edward, A. The Lost Cause: A New Southern History of the War of the Confederates . New York : E.B. Treat and Co. , 1867.

Russell, William Howard, Nicolas Bentley, ed. In the Grip of Winter. In Russell’s Despatches from the Crimea 1854-1856, by William Howard Russell. London: Andre Deutsch, 1966.

Russell, William Howard, sir,. Mr. Russell on Bull Run. New York: G. P. Putnam, 1861

Shattuck, Lemuel, and Others. Report Of The Sanitary Commission Of Massachusetts 1850. Cambridge : Harvard University Press, 1948.

Stille, Charles. History Of The United States Sanitary Commission: Being The General Report Of Its Work During The War Of The Rebellion. New York: Hurd And Houghton, 1866.

Strong, George Templeton. The Diary of George Templeton Strong. The Civil War 1860-1865. Hew York: The Macmillan Company, 1962.

The Baltimore Sun. Brigadier General Thomas Lawson Surgeon General . The Baltimore Sun (Baltimore, Maryland) , 05 20 , 1861: 2.

The Evening Star. Items Telegraphed from Washington. Surgeon Finley... (The Evening Star, 05 22, 1861),

The Library of Congress. Jefferson Davis, Senator from Mississippi, Thirty-fifth Congress,

—. The Executive Committee of the U.S. Sanitary Commission 1860. The Library of Congress. n.d

The National Archives . Gen. Richard Delafield; The National Archives

—. Gen. Winfield S. Hancock, War Department. Office of the Chief Signal Officer.

The U.S. National Library of Medicine. Thomas Lawson. The U.S. National Library of Medicine. n.d.

The New York Times. Floating Hospitals for the wounded at the Siege of Yorktown. The New York Times (New York, New York), 05 8, 1862

—. The Siege Of Yorktown. The New York Times, 05 02, 1962: 1.

—. TheSecond New-York Regiment. The New York Times, 05 21, 1861:

The U.S. Sanitary Commission. Documents Of The U.S. Sanitary Commission. Vol. I. Numbers 1 to 60. (New York, 1866), No. 44.

United States. War Department. OliverDiefendorf, Thomas M. O’Brien,. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. New York: Derby & Millier, 1864.

United States. War Department. The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. Ser I. vol. I. (Washington, D.C.: Government Printing Office, 1881-1901), Appendix 10

United States. War Department. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. II. (Washington, D.C.: U.S. Government Printing, 1880-1901)

United States, War Deptment. Regulations for the army of the United States. New York: Haper and Brothers, 1861.

United States. War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880),

Wormeley, Katharine Prescott. The United States Sanitary Commission: A Sketch of Its Purposes And Its Work. Boston: Little, Brown And Company, 1863.

Secondary

Adams, George Worthington. Doctors in Blue: The Medical History of the Union Army in the Civil War. New York: Henry Schuman, 1952.

Bollet, Alfred Jay, M.D. Civil War Medicine Challenges and Triumphs. Tucson : Galen Press, LTD, 2002.

Browing, Judkin, and Timothy Sllver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. Journal of the Civil War Era 8, no. 3

Connell, P.A. Surgeon. Army Medical Intelligence. In Boston Medical and Surgical Journal Vol. 67., by Samuel L, M.D. ed. Abbot, 201-204. Boston: David Clapp , 1863.

Cunningham, H.H. Doctors in Gray: The Confederate Medical Service – 1958. Baton Rouge: Louisiana State University Press Kindle, 2014.

Cunningham, Horace H. Field Medical Services at the Battles of Manassas . Athens (GA) : University of Georgia Press, 2008.

Duncan, Louis C. The Medical Department of the United States Army in the Civil War. Washington, D.C.: United States Army, 1910.

Faust, Drew Glipin. This Republic of Suffering . New York: Vintage Books Div. Random House, 2008.

Fox, William F. Lt. Col. U.S.V. Regimental losses in the American Civil War, 1861-1865. Albany, N.Y. : Albany Publishing Company, 1889.

Gillett, Mary C. The Army Medical Department, 1818-1865. Washington, D.C.: U.S. Government Printing Office, 1987.

Gillett, Mary C. “Thomas Lawson , Second Surgeon General of The U . S . Army : A Character Sketch.” Prologue; Journal Of The National Archives, Spr. (14.1), 1982: 15.

Gordon, Margaret S. ed. Higher Education and the Labor Market . New York; London: McGraw-Hill Book Company, 1974.

Haller, John S. Battlefield Medicine : A History of the Military Ambulance from the Napoleonic Wars Through World War I. . Carbondale: Southern Illinois University Press, 2011.

Livermore, Thomas L. Numbers and losses in the Civil war in America, 1861-1865. Boston: Houghton, Mifflin and Company, 1901.

Lucas, Carter, ed. History of Medicine and Surgery and physicians and Surgeons of Chicago. Chicago: The Biographical Publishing Corporation , 1922.

Martin, David G. The Second Bull Run Campaign July – August 1862. Combined Books , 1997.

McGaugh, Scott. Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefiel Care. New York: Arcade Publishing , 2013.

Phalen, James M. Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. Washington D.C.: Privately Printed, 1940.

Pilcher, James Evelyn M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America : A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification. Carlisle Penn.: The Association of Military Surgeons, 1905.

Place, Ronald J. MC USA,. The Strategic Genius of Jonathan Letterman: The Relevancy of the American Civil War to Current Health Care Policy Makers. Military Medicine, Volume 180, Issue 3,, 2015, March

Porter, Roy. The Greatest Benefit To Mankind” A Medical History of Humanity. New York; London: W.W. Norton & Company, 1997.

Sears, Stephen W. To the Gates of Richmond: The Peninsula Campaign. New York: Ticknor & Fields, 1992.

Figures

Figure 1. The Civil War in Virginia. Gillett, The Army Medical Department 181-1865. p. 187. Error! Bookmark not defined.

Figure 2. Thomas Lawson (1789-1861) 4

Figure 4. General Richard Delafield. Courtesy of The National Archives; 111-B-5268, 529372 9

Figure 5.Maltese Cart, Delafield, Reports on the Art of War in Europe, p. 72. Error! Bookmark not defined.

Figure 6.English Ambulance, Delafield, Report on the Art of War in Europe, p.69. Error! Bookmark not defined.

Figure 7. English Litter, , Delafield, Report on the Art of War in Europe, p 73. Error! Bookmark not defined.

Figure 8. The Finley Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III, p. 946. Error! Bookmark not defined.

Figure 9. The Coolidge Ambulance. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947. Error! Bookmark not defined.

Figure 10.The Tripler Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p. 947. Error! Bookmark not defined.

Figure 11. The Rosecrans Ambulance, The Medical And Surgical History Of The War Of The Rebellion, (1861-65), p948. Error! Bookmark not defined.

Figure 12 The Sibley Tent. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920. Error! Bookmark not defined.

Figure 13, The Hospital Tent., The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. p. 920. Error! Bookmark not defined.

Figure 14. G.O. No. 15 Recapitulation. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I.p.35. 23

Figure 15. George Templeton Strong: George Templeton Strong Diary, p.234. Error! Bookmark not defined.

Figure 16. Executive Committee of the U.S. Sanitary Commission. Error! Bookmark not defined.

Figure 17. French Cacolet, Medical and Surgical History of the War of the Rebellion, Vol. II. Pt. III. p. 931 Error! Bookmark not defined.

Figure 18. Tenth Surgeon General, Clement A. Finley (1797 –1879) Error! Bookmark not defined.

Figure 19. Dr. Charles Stuart Triple (January 19, 1806 – Oct. 20, 1866). Papers of Fredrick Olmsted. p.339. 38

Figure 20. Horse Litter, Hamilton, A Treatise On Military Surgery And Hygiene. p. 162 Error! Bookmark not defined.

Figure 21. Battle of Seven Pines, May 31, 1861 Error! Bookmark not defined.

Figure 22. Bringing wounded soldiers to the cars after the battle of Seven Pines June 3 1862 Library of Congress. Error! Bookmark not defined.

Figure 23. Harris Landing 1862. Library of Congress Error! Bookmark not defined.

Figure 24. White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862) Error! Bookmark not defined.

Figure 25. Enlargement _ White House to Harrisons Landing. United States Army Of The Potomac. Engineer Dept. (1862) Error! Bookmark not defined.

Figure 26. Eleventh Surgeon General: William Alexander Hammond (1828-1900). Library of Congress Error! Bookmark not defined.

Figure 27. May 2, 1862, The Siege Of Yorktown, New York Times. pg. 1. Error! Bookmark not defined.

Figure 28. The Daniel Webster No. 1. Fredrick Olmstead Papers. P. 326 Error! Bookmark not defined.

Figure 29. May 8, 1862, New York Times ad seeking supplies for floating hospital caring for the Siege Of Yorktown wounded Error! Bookmark not defined.

Figure 30. Dr, Jonathan Letterman. (1824-1872) . Courtesy of the Library of Congress Error! Bookmark not defined.

  1. Stephen W. Sears, To the Gates of Richmond: The Peninsula Campaign. (New York: Ticknor & Fields, 1992), 345.
  2. Judkin Browning, Timothy Silver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. (Journal of the Civil War Era 8, no. 3, 2018), 407.
  3. Ibid. 343.
  4. David G. Martin, The Second Bull Run Campaign July – August 1862. (Combined Books, 1997) 280.
  5. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008) 61.
  6. William F. Fox, Lt. Col. U.S.V. Regimental losses in the American Civil War, 1861-1865. (Albany, N.Y.: Albany Publishing Company, 1889), 550.
  7. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),14
  8. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888), 933,34.
  9. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),14.
  10. Pilcher, James Evelyn M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America: A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification. (Carlisle Penn.: The Association of Military Surgeons, 1905),34.
  11. The Baltimore Sun. Brigadier General Thomas Lawson Surgeon General (The Baltimore Sun (Baltimore, Maryland), 05 20 , 1861), 2.
  12. James M. Phalen, Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. (Washington D.C.: Privately Printed, 1940), 33.
  13. Harvey E Brown. ed. The Medical Department of the United States Army, From 1775 to 1873. (Washington D.C.: Surgeon General’s Office, 1873),193.
  14. Ibid. 217.
  15. Mary C. Gillett, The Army Medical Department, 1818-1865. (Washington, D.C.: U.S. Government Printing Office, 1987), 73.
  16. , Mary C. Gillett, Thomas Lawson, Second Surgeon General of The U. S. Army: A Character Sketch. (Prologue; Journal Of The National Archives, Spr. (14.1), 1982),15.
  17. James M. Phalen, Chiefs of the Medical Department, United States Army, 1775-1940: biographical sketches. (Washington D.C.: Privately Printed, 1940), 34.
  18. Mary C. Gillett, Thomas Lawson, Second Surgeon General of The U. S. Army: A Character Sketch. (Prologue; Journal Of The National Archives, Spr. (14.1), 1982),15.
  19. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 9.
  20. Russell, William Howard, Nicolas Bentley, ed. In the Grip of Winter. In Russell’s Dispatches from the Crimea 1854-1856, by William Howard Russell, 154. (London: Andre Deutsch, 1966),154.
  21. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 17.
  22. Richard Delafield, Major. Report on The Art Of War In Europe In 1854, 1855, And 1856. (Washington: George W. Bowman, 1860), v.
  23. Richard Delafield, Major. Report On The Art Of War In Europe In 1854, 1855, And 1856. (Washington: George W. Bowman, 1860),68.
  24. Harvey E. Brown, ed. The Medical Department of the United States Army, From 1775 to 1873. (Washington D.C.: Surgeon General’s Office), 36.
  25. Ibid. 35.
  26. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 22.
  27. War Department. General Regulations for the Army of the United States. 1841. (Washington: J. and G.S. Gideon, 1841), 71.
  28. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888),944.
  29. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 946.
  30. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 946,947.
  31. Joseph K. Barnes, Surgeon General. The Medical and Surgical History of The War of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 947.
  32. Henry I. Bowditch, Abuses Of Army Ambulances. (The Boston Medical And Surgical Journal Vol. 67, (10),1862), 204-207.
  33. Bowditch, Henry I. Army Ambulances. (The Boston Medical And Surgical Journal Vol. 67 (8), 1862), 164-166.
  34. Joseph K. Barnes, Joseph Janvier Woodward, Charles Smart, George A Otis, and D. L Huntington. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. (Washington: Gov’t Print. Off., 1870), 899.
  35. Louis C. Duncan, The Medical Department of the United States Army in the Civil War. (Washington, D.C.: United States Army, 1910), 20.
  36. Joseph K. Barnes, Joseph Janvier Woodward, Charles Smart, George A Otis, and D. L Huntington. The Medical and Surgical History of the War of the Rebellion. (1861-65). Vol II Part III. (Washington: Gov’t Print. Off., 1870), 920.
  37. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 29.
  38. Ibid. 23.
  39. Jonathan Letterman, M.D. Medical Recollections of the Army of the Potomac. (New York: Appleton and Co., 1866), 8.
  40. George Worthington Adams, Doctors in Blue: The Medical History of the Union Army in the Civil War. (New York: Henry Schuman, 1952), 194,195.
  41. Ibid. 224.
  42. Roy Porter, The Greatest Benefit To Mankind: A Medical History of Humanity. (New York; London: W.W. Norton & Company, 1997), 628.
  43. Thomas Percival,. Dr. Medical Ethics; Or A Code Of Institutes and Precepts,Adapted to The Professonal Conduct Of Physicians And Surgeons. (Manchester; Strand, London: S. Russell For J. Johnson, St. Paul”s Church Yard, and R. Brickerstaff, 1803), 10.
  44. Roy Porter, The Greatest Benefit To Mankind: A Medical History of Humanity. (New York; London: W.W. Norton & Company, 1997), 628.
  45. Numbers, Ronald, L. The Rise And Fall of the American Medical Profession . In The Greatest Benefit To Mankind: A Medical History of Humanity, by Roy Porter, (New York; London:: W.W. Norton & Company, 1997), 225.
  46. Shattuck, Lemuel, and Others. Report Of The Sanitary Commission Of Massachusetts 1850. (Cambridge: Harvard University Press, 1948), 58.
  47. Ibid. 57.
  48. Gordon, Margaret S. ed. Higher Education and the Labor Market, (New York; London: McGraw-Hill Book Company, 1974), 251.
  49. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III. (Washington: Government Printing Office, 1888), 900-01.
  50. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864),32.
  51. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 899.
  52. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864),32.
  53. United States Dept. Of War; Oliver Diefendorf, Thomas M. O’Brien. General Orders Of The War Department, Embracing The Years 1861,1862 & 1863. Vol I. (New York: Derby & Miller, 1864), 32.
  54. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), 151.
  55. Ibid. 151,153
  56. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),153.
  57. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002),13-14.
  58. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002), 12.
  59. H.H. Cunningham, Doctors in Gray: The Confederate Medical Service (Baton Rouge: Louisiana State University Press, First printing 1958. Kindle, 2014),141.
  60. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson : Galen Press, LTD, 2002), 458.
  61. Fredrick Law Olmsted, A Collection Of The papers Of The Sanitary Commission. Sanitary Commission No. 25, (Washington: Office Of The Sanitary Commission, 1861).11,12.
  62. Fredrick Law Olmsted, A Collection Of The papers Of The Sanitary Commission. Sanitary Commission No. 25, (Washington: Office Of The Sanitary Commission, 1861).13.
  63. Ibid. 168.
  64. The New York Times. The Second New-York Regiment. (The New York Times, 05 21, 1861),1.
  65. John S. Haller, Battlefield Medicine: A History of the Military Ambulance from the Napoleonic Wars Through World War I. (Carbondale: Southern Illinois University Press, 2011), 29.
  66. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008),8.
  67. Sir, William Howard Russell, Mr. Russell on Bull Run. (New York: G. P. Putnam, 1861), 14.
  68. Sir, William Howard Russell, Mr. Russell on Bull Run. (New York: G. P. Putnam, 1861), 14.
  69. Edward, A. Pollard, The Lost Cause: A New Southern History of the War of the Confederates. (New York: E.B. Treat and Co., 1867), 143.
  70. Alfred Roman, The Military Operations of General Beauregard in the War Between the States, 1861 to 1865. Vol. I. (New York: Harper and Brothers, 1884), 98.
  71. O.R. Ser 1. vol. II. 570.
  72. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser 1. vol. II. 327.
  73. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 2.
  74. U.S. War Department, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 10
  75. Ibid. Appendix 7.
  76. Confederate States of America. War Department. Regulations for the Medical Department of the Confederate States Army. (Richmond: Ritchie & Dunnavant, Printers., 1861.),57.
  77. Glenna R. Schroeder – Lein, Confederate Hospitals on the Move: Samuel H. Stout and the Army of Tennessee. (Columbia: University of South Carolina Press, 1994),127.
  78. Glenna R. Schroeder- Lein, The Encyclopedia of Civil War Medicine. (Armonk, N.Y.: Routledge, 2008),12.
  79. Horace H. Cunningham, Field Medical Services at the Battles of Manassas. (Athens (GA): University of Georgia Press, 2008),26.
  80. War Department, United States, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Vol. II. vol. III.), 929,931.
  81. War Department, United States, The War of the Rebellion: Official Records of the Union and Confederate Armies, 128 vols. (Washington, D.C.: Government Printing Office, 1881-1901), Ser I. vol. I.), Appendix 4.
  82. W.S. King, Surgical Director U.S.A. Report Of The Events Connected With The First Bull Run Campaign. 1861.
  83. The Evening Star. Items Telegraphed from Washington. Surgeon Finley... (The Evening Star, 05 22, 1861),1.
  84. Alfred Jay Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 13,14.
  85. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 932, footnote 1.
  86. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),181.
  87. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vil. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986), 240.
  88. Charles Stillé, History Of The United States Sanitary Commission: Being The General Report Of Its Work During The War Of The Rebellion. (New York: Hurd And Houghton, 1866),101.
  89. Louis C. Duncan, The Medical Department of the United States Army in the Civil War. (Washington, D.C.: United States Army, 1910),2.
  90. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888) 932, footnote 1.
  91. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt .II. (Washington, D.C.: U.S. Government Printing, 1880-1901)198.
  92. Frank Hastings Hamilton, , M.D. A Treatise On Military Surgery And Hygiene. ( New York : Bailliére Brothers , 1865. 163.
  93. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 929,930.
  94. Frank Hastings Hamilton, , M.D. A Treatise On Military Surgery And Hygiene. (New York : Bailliére Brothers , 1865.162.
  95. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 930. Footnote 2.
  96. The U.S. Sanitary Commission. Documents Of The U.S. Sanitary Commission. Vol. I. Numbers 1 to 60. (New York, 1866), No. 44.p.4,5.
  97. I Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 931
  98. Ibid.931.
  99. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (Washington: Government Printing Office, 1888), 930.
  100. Ibid. 931.
  101. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888),762.
  102. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol.II, (Washington: Government Printing Office, 1888),327,570.
  103. United States. War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880), 12,13.
  104. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 178.
  105. Ibid.178.
  106. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 178.
  107. Ibid. 179.
  108. 180.
  109. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 179.
  110. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 181.
  111. Ibid 183.
  112. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),19.
  113. James Evelyn Pilcher, M.D., Ph.D., L.H.D. The Surgeon Generals of the Army of the United States of America: A series of biographical sketches of the senior officers of the military medical service from the American Revolution to the Philippine Pacification.( Carlisle Penn.: The Association of Military Surgeons, 1905), 44.
  114. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),20.
  115. Ibid. 185.
  116. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), 219.
  117. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962), xxxix.
  118. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002),21.
  119. Alfred Jay, Bollet, M.D. Civil War Medicine Challenges and Triumphs. (Tucson: Galen Press, LTD, 2002), 182.
  120. United States, War Records Office, et al… The War of the Rebellion: a Compilation of the Official Records of the Union And Confederate Armies. Ser I. Vol. V. (Washington: Govt. Print. Off., 1880), 13.
  121. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part I Vol. XI, (Washington: Government Printing Office, 1888), 184.
  122. Ibid. 450.
  123. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 320.
  124. Stephen W. Sears, To the Gates of Richmond: The Peninsula Campaign. (New York: Ticknor & Fields, 1992), 345.
  125. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Ser. I Vol. XI, pt. 2. (Washington: Government Printing Office, 1888), 24-37.
  126. Judkin Browning, Timothy Silver. Nature and Human Nature: Environmental Influences on the Union’s Failed Peninsula Campaign, 1862. (Journal of the Civil War Era 8, no. 3, 2018), 407.
  127. Ibid. 343.
  128. Scott McGaugh, Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefield Care. (New York: Arcade Publishing, 2013.), 10.
  129. Ibid. 11,13.
  130. Scott McGaugh, Surgeon in Blue Jonathan Letterman, the Civil War Doctor who Pioneered Battlefield Care. (New York: Arcade Publishing, 2013.),22.
  131. Ibid. 32.
  132. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. I. (Washington, D.C.: U.S. Government Printing Office, 1880-1901), 210-216.
  133. War Department, United States. The War of the Rebellion: a Compilation of the Official Records of the Union and Confederate Armies: Official records of the Union and Confederate armies. Ser. I. Vol. XI, pt. I. (Washington, D.C.: U.S. Government Printing Office, 1880-1901), 210-216.
  134. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 326.
  135. Frederick Law Olmsted, Jane Turner Censer, ed. The Papers Of Frederick Law Olmsted; Vol. 4. Defending The Union. The Civil War and the U.S. Sanitary Commission 1861-1861. (Baltimore; London: The Johns Hopkins University Press, 1986) 329.
  136. Ibid. 370.
  137. George Templeton Strong, The Diary of George Templeton Strong. The Civil War 1860-1865. (New York: The Macmillan Company, 1962),230.
  138. Joseph K Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). (Washington: Government Printing Office, 1888), 933.
  139. Ibid. 934.
  140. Joseph K. Barnes, Surgeon General. The Medical And Surgical History Of The War Of The Rebellion, (1861-65), Part II Vol III (U.S. National Library of Medicine). (Washington: Government Printing Office, 1888), 934,935.
  141. William Howard Russell, Nicolas Bentley, ed. “In the Grip of Winter.” In Russell’s Dispatches from the Crimea 1854-1856, by William Howard Russell, 154. London: Andre Deutsch ,1966.154,155.