Home : America At War : The Civil War : North And South :Casualties
Nowhere was the lack of preparation for war more painfully apparent than in the medical department. When the conflict began, the United States Army had 115 trained medical officers. Twenty-seven resigned, three to enter civilian practice and the remaining twenty-four to throw their lot with the Confederacy. Shortly after Fort Sumter was fired upon, Clement A. Finley became Surgeon General of the U.S. Army, following forty-three years of service in the Medical Department. The post was a hot seat, open to fire from politicians stung into action by relatives of the men suffering from lack of attention to wounds received in early battles. Finley lasted until early 1862, then Robert C. Wood took over in an acting capacity for a few months until the trying position was assumed by William A. Hammond. He reorganized personnel and paperwork and embarked upon a badly needed hospital building program. By autumn, 1863, Hammond had crossed swords with War Secretary Stanton and was relieved. The new Surgeon General, Joseph K. Barnes, remained in office throughout the rest of the war and later. He saw his department burgeon until it contained 10,000 medical men. Personnel changes did not haunt the South. Samuel P. Moore was appointed Surgeon General when war began and retained his post until the conflict ended. With limited facilities, Moore worked wonders. The statistics of his operations were destroyed in the great Richmond fire that marked evacuation of the Southern capital in 1865, and knowledge of the Confederate Medical Corps is therefore sparse. The top medical officers started from scratch. By the conclusion of Bull Run, it was apparent large-scale medical attention had become imperative, especially if the war lasted an appreciable length of time. Adequate hospitals, trained personnel to serve in them, and assurance of a plentiful drug supply were necessities. More important was medical attention in the field. Each of the Northern regiments had a surgeon and an assistant who traveled with the troops. Volunteer medical officers were appointed for administrative work with each division; additional surgeons became attached to brigades, corps, armies, departments, and hospitals; civilian physicians served under contract; a corps of medical cadets was appointed. Southern organization was similar to that of the North, when manpower permitted. At the war's beginning, there was no such thing as a hospital corps. Transportation and nursing for the wounded came from enlisted men, removed from their regular jobs and placed on temporary duty. There existed a pressing need for personnel whose work would serve as a connecting link between field surgeon and hospital. Surgeon General Hammond pleaded with Stanton and Halleck for an ambulance corps but was coldly turned down. It remained for individual units to create their own organizations in the field. Surgeon Jonathan Letterman, Medical Director of the Army of the Potomac, convinced McClellan of the need for first aid and transportation of the wounded. With McClellan's permission, ambulances were brought together and special personnel appointed to aid the injured and do nothing else. The system worked admirably at Antietam. By the time of Chancellorsville, ambulance men were standing by their vehicles awaiting the results of the battle. Grant took over the plan for the Army of the Tennessee. Congress eventually approved, and a standard ambulance system was established. In the Confederate Medical Department, a comparable plan existed. Transport for the wounded reached a rough efficiency but it was often of little avail to the man concerned. The Civil War occurred previous to basic medical discoveries that seem commonplace in the twentieth century. Operating on the battlefield, Union and Rebel surgeons employed practices and held beliefs that seem incredible today. Antisepsis was unknown. Wounds were probed by dirty fingers or unwashed instruments, and seldom cleaned once the bullet or shell fragment had been removed. Unclean sponges or lint, which had been created by the work of unsterilized human hands, helped absorb blood. In the field, ripped flesh was bound up with dirty handkerchiefs, portions of sweat-stained uniforms, or whatever cloth was available. Under such conditions, gangrene and tetanus were common. Army pharmacies went into the field to fill surgeons' orders. They stocked chloroform and ether, used for anesthesia, when available. Because of shortages, hundreds of operations were performed without anesthetic. Brandy or whisky sometimes substituted for the missing pain-killers. Most battlefield wounds came from rifle bullets and most rifles fired the Minie ball, a conical lead slug more than a half-inch in diameter and weighing over an ounce. The heavy projectile caused fearful damage. Mushrooming after it hit, a Minie ball smashed long bones into fragments, often making amputation necessary. Intestinal wounds, because of the tearing action of the big slug, were usually fatal. Shell fragments caused ugly injuries, tearing as they hit. Grape and canister, small balls fired in bunches from cannon, were deadly at short range. Bayonet and sword wounds were in the minority. When lead was flying on the field, regimental medical officers moved forward as near as possible to the front and established first-aid stations. Stretcher bearers went out under fire to pick up the wounded and bring them in. They received elementary attention to halt bleeding. As soon as possible, patients were taken from the first-aid stations and placed in ambulances for the trip to a field hospital. If fire was too heavy for the horse-drawn ambulance, stretcher bearers did the carrying. The litter used often had legs, which could be let down to create a temporary cot. Field hospitals were selected before combat by medical personnel, on the scene of potential action. They were houses, barns, carriage shops, stores, or even bombproof shelters built into such strongholds as Fort Fisher. Efforts were made to create crude bunks in these structures, or at least to cover the floors with clean straw. As the war progressed, tents were issued for field hospital use. Compact and portable, they were widely used. The field hospital was a receiving station in which injured men had their wounds examined in detail, when time permitted. Surgical treatment was carried out as indicated and permanent dressings replaced temporary ones. When the wounded were ready to travel, ambulances took them from their places of temporary confinement to hospital trains. Loaded aboard, they were moved to the big general hospitals in which final recovery could take place. Passenger cars, freight cars, or flatcars were used to carry the wounded, depending on availability. Near the Atlantic coast and major rivers like the Mississippi, the wounded sometimes traveled by water. Wounded soldiers who survived treatment in field hospitals, and escaped infection or disease in the process, were sent to permanent general hospitals. There they received care comparable to that extended to civilians, and were allowed to convalesce before discharge for retirement or return to their units. Women worked in permanent hospitals, but throughout the war there was a running battle of the sexes between top military men, officers of the medical corps, and feminine volunteers. Male nurses, either soldiers, wounded veterans, or civilians, were the order of the day. They and their superiors resented the distaff-side invasion. Dorothea Dix became Superintendent of Women Nurses for the Union after war began, but had to fight an uphill battle to place her charges in military hospitals. Persistence, courage, and solid determination enabled her to staff such installations as the one at Georgetown, D.C., pictured above, to the unqualified approval of its patients. The outstanding civilian welfare organization in the North, the United States Sanitary Commission, contributed male and female nurses to general hospitals. In the Confederacy, the Women's Relief Society produced volunteers to bathe, bandage, and comfort stricken soldiers. Doctors and orderlies of North and South undoubtedly made life difficult for these patriotic women. In letters and diaries, the ladies struck back. Accusations of cruelty, drunkenness, and callous indifference among medical personnel dot these personal missives. At the beginning of war, there was a serious shortage of permanent hospitals to handle casualties in any considerable number. Above and below the Mason-Dixon line, medical men converted churches, college buildings, warehouses, hotels, and residences into sanctuaries for the sick. Major cities such as Philadelphia soon became thick with permanent hospitals. Installations at army camps, such as the hospital at Jefferson Barracks, Missouri, were expanded to meet pressing needs. Urban areas near battlefields saw the greatest growth in medical facilities. By late 1864, Washington and its suburbs had twenty-five general hospitals with more than 21,000 beds. New construction was necessary. The over-all plan for general hospitals adopted in the 1860's is in use today. This called for a number of wards, constructed of wood, each to contain two rows of cots holding from forty to sixty patients. The structures were usually one story high, but sometimes had two levels. Clean, airy, easy to build, the wards could be multiplied indefinitely as the need arose. Largest of the general hospitals was Chimborazo, at Richmond, which treated 76,000 patients. The second in size was Lincoln, in Washington, where 46,000 men were cared for. Many a Civil War soldier was lowered into the grave by his comrades. Some graves were crudely marked; many were not. After major battles, and in prison camps, there were mass burials in shallow trenches, the soldiers usually unidentified. Casualty figures are uncertain. Union records, including pension data gathered by the Medical Corps, throw some light on the subject. Disappearance of Confederate documents, destroyed by fire or lost in the field, eliminated accurate statistics relating to the Southern army. The best available statements indicate more than 360,000 Union soldiers died in the war. Of these, 110,000 lost their lives as the result of battle: 67,000 being killed in action and 43,000 perishing from wounds. Over 224,000 Federal fighting men died of disease, and the remainder lost their lives through "other causes," which include accidental death, suicide, execution, and death in prison camps. For the Confederacy, one estimate reports 258,000 dead, 94,000 being killed in battle. Death from injuries was brought about by (1) gunshot wounds, (2) incised wounds from sabers, swords, and bayonets, (3) miscellaneous hurts coming from blows, falls, and like causes. Treatment of such wounds by unsanitary hands and instruments brought on infection resulting in death. Among the most shocking facts of the war was that 62 per cent of Union casualties came from disease. Many of the men who contributed to this figure never saw combat. They enlisted, went to camp or into the field, and were struck down far from enemy lines. Epidemic diseases like typhoid fever, diphtheria, and dysentery caused havoc among men living close together. Insect-borne illness, such as malaria, took its toll. And the crude preinduction medical examinations failed to root out many disease-prone men who later succumbed to pneumonia and tuberculosis.
| ||||||||||
| ||||||||||
| Links & Recommended Sites | Oneliners, Stories, etc. |
| Questions? Anything Not Work? Not Look Right? My Policy Is To Blame The Computer. |
| About The Military And Wars | Link To Us | Site Navigation | Site Map |