(Qotnell Mmoeratty Etbrary 
 
 3tt)arn, Mrui flarh 
 
 
Cornell University Library 
 UH224 1861/65 .091 
 
 olin 
 
 3 1924 030 749 588 
 
Cornell University 
 Library 
 
 The original of this book is in 
 the Cornell University Library. 
 
 There are no known copyright restrictions in 
 the United States on the use of the text. 
 
 http://www.archive.org/details/cu31924030749588 
 
THE MEDICAL DEPARTMENT OF 
 
 THE UNITED STATES ARMY 
 
 IN THE CIVIL WAR 
 
 Captain LOUIS C. DUNCAN 
 
 Medical Corps, U. S. Army 
 
Ao ^ 3^ ° 
 
T A ISLE OF CONTEXTS. 
 
 I. Preface; 
 
 II. The lliil tic of Bull Kun; 
 FIT. Pope's Virginia ( 'aiiipais'ii ; 
 
 IV Involution of the Ambulance < 'orps and Field Hospital; 
 V. Tlic Bloodiest Day in American History — Anlictam; 
 VI. The Battle of Fredericksburg; 
 VII. High Tide of the Confederacy — Cdtysburg; 
 VIII. The Creat I'.attle of the West— Chickaniaugn ; 
 IX. The Battle of the Wilderness; 
 
 X. When Sherman Marched Down to the Sea. 
 
PUFF AGE. 
 
 The story of the part played in our great Civil War l>y the 
 .Medical Department of the Army has never been told in an 
 adequate manner. 
 
 Histories of regiments, brigades, and armies; memoirs of pri- 
 vates, subordinates, and generals fill our libraries; the innumer- 
 able records of the rebellion give the last details of the battles 
 lost and won. The leaders in that great struggle have fought 
 again their battles until their lips were turned to dust. On the 
 great fields of conflict a thousand shafts tell where batteries 
 stood and battle lines held their ground amid the cannons' 
 thunder. 
 
 The work of the surgeons alone remains unrecorded. Kxcept- 
 ing what lies embalmed in those cyclopean volumes, the Medical 
 and Surgical History of the Rebellion, no one has set down the 
 modest story of their unselfish labors. Surgeon Henry E. Brown 
 wrote a brief official history of the Medical Department of the 
 Army some years ago. It has that arid, unreadable quality so 
 common in public documents, and is very unsatisfactory. 
 
 In selecting from the medical records of the war, scattered in 
 bits through hundreds of volumes, I have endeavored to sift out 
 that having true historic value. As I understand that term, 
 records have historic value only, and in proportion, as they may 
 be applied to a solution of the problems of today. So in writing 
 T have had a double object: first, to present the achievements of 
 the medical officers of the army in the great war; second, to make 
 the narrative of value to medical men of the army today. 
 
 This history should have been written by one who eould tell it 
 first hand; one who had been imbued witli and retained the 
 spirit of the war; who could say, like Aeneas, quorum omnia vidi 
 et pars fui. as Morris Schaff has written of the army of the 
 Potomac. Woodhull has given us a chapter on the last campaign 
 which causes regret that lie did not write it all. No one has 
 done the whole and the time is all but past. 
 
 Hurko was wont to condemn the proueness with which men, 
 when confronted with a difficult problem, consult their own in- 
 
<; PREFACE. 
 
 vrntinii rather tlian tin- experience of tin- past. liightly consid- 
 1'i'ivl. both are extremely useful and together they are the princi- 
 pal factors in progress. 
 
 ]>y studying the past history of any line of human action, we 
 learn what measures were successful, and just as important, 
 what failed. 
 
 Invention adapts successful measures to present conditions, 
 and, when experience fails, discovers new ones, to he in turn sub- 
 mitted to the test of experience. 
 
 The liislm-y nf the Medical Department of the I'nited States 
 Army during our great Civil War is particularly rich and valu- 
 able in experience that ma\ be applied to the tailical problems 
 of sanitary troops today. It may be safely said that sanitary 
 tactics of the battlefield did not exist in the period immediately 
 preceding the war. 
 
 A steady evolution in this work progressed, from the pitiful 
 absence of provisions for the wounded at Bull Run, to the 
 splendid organization and work of the Medical Department in 
 the great closing campaigns of the war. The system of caring 
 for the wounded, devised by Leilerman and carried out by 
 McParlin and others, was the basis of all systems now in use in 
 the great armies of the world. More than that, and contrary to 
 the common opinion, this system was developed by the spring of 
 IMif to a point which left little to be desired, and which more 
 modern devices have not materially changed. The ambulance 
 and field hospital organization that crossed the Kapidan wilh 
 (i rant's Army was in all essential features the ambulance and 
 field hospital organization that would take the field in the event 
 of war tomorrow ; and we shall be extremely fortunate if we have 
 an equipment even approaching that of the Army of the I'oiomac 
 at that time. We did not have anything like it in 1K!)H. 
 
 Students of military science have studied all the great battles, 
 not only of the Civil War but of all wars of recent and even 
 of ancient times. Napoleon's campaigns have been dissected to 
 the last detail; Marlborough has afforded valuable lessons; 
 Casar and Hannibal are not too ancient for profitable studv by 
 the line officer. The tactics of sanitary troops appear to me no 
 less worthy of studv. 
 
PREFACE. 7 
 
 If changed conditions have not rendered the campaigns of 
 Nupoleon useless to the line student, surely they have not done 
 so with tin- campaigns of the Civil War for students of sanitary 
 tactics. 
 
 How the Medical Department of the Army was developed 
 from an unorganized collection of surgeons at Bull Run into a 
 splendid, reliable, and efficient machine in 1S64 I shall attempt, 
 to relate. If the narrative proves less interesting to the reader 
 than was its unearthing from the fading records of the war to 
 me, the fault lies with the narrator, not with the subject. 
 Napier's well-known lines on his epic of the Peninsular War 
 might well he quoted. The theme — the creation of a system of 
 care for the victims of war — is worthy a more facile pen than 
 mine. 
 
 (Signed) LOCIS ('. DINCAN. 
 
THE BATTLE OF BULL BUN. 
 
 AT the outbreak of the Civil War there was in the United 
 States Army neither plan, personnel, nor equipment for col- 
 lecting the wounded from the battlefield ; caring for them in hos- 
 pital ; or transporting them to the rear. The Army was small 
 and, strange as it may seem, war was not anticipated. Even had 
 it been expected, the case would have been little different, for at 
 that time no nation had ambulance corps or field hospitals. They 
 had not yet arrived. It seems that armies were then more illy 
 provided in that regard than in the time of the First Napoleon, 
 or even earlier. It was customary to extemporize crude hospi- 
 tals or churches, mills, barns, and other unsuitable buildings in 
 the rear of the lines. The first tent hospital in a pitched battle 
 is said to have been used at Shiloh, where Surgeon Irwin took 
 possession of a regimental camp that had been abandoned and 
 converted it into a hospital. 
 
 This was no more a real field hospital than was the tent hos- 
 pital provided by Isabella at the Siege of Antequera, four hun- 
 dred years earlier. The real distinctive quality of a field hos- 
 pital is mobility. 
 
 Larrey organized real field hospitals for the Grand Army. 
 Still earlier the Army of King William in Ireland, the army that 
 fought the Battle of the Boy tie, had a fairly complete system of 
 hospitals; including base hospitals, evacuation hospital, and 
 marching (field) hospital. 
 
 This was in 1(!!)1. But the memory of these things had per- 
 ished. Although the Army in 18<il had nothing like our modern 
 field hospital, each regiment had a small hospital, provided with 
 three hospital tents and certain supplies. Hospital corps there 
 was none, but it seems each regiment had a hospital steward. 
 
 There was no ambulance corps whatever. Indeed ambulances, 
 although used by Larrey fifty years earlier, had not been adopted 
 by the United States Army. Xo ambulances were used in the 
 Mexican War, or in the later Indian campaigns on the plains. 
 In 1859 a board of medical officers examined a number of ambu- 
 lances and recommended that two be tried; but they had not been 
 adopted. Vet ambulances suddenly sprung into existence and 
 
2 MEDICAL DEPARTMENT IX THE CIVIL \\ AR. 
 
 were used in the first campaigns of the war. The States and 
 public spirited citizens were more progressive in this matter than 
 the Army. These ambulances were, however, attached to regi- 
 ments only. 
 
 The Surgeon General of Pennsylvania offered to furnish a 
 complete ambulance company ('2 officers, 67 men, and 45 ambu- 
 lances) for service with the Pennsylvania Reserves ; but the Sec- 
 retary of War took no notice of the offer. This was as late as 
 September, 1861. Surgeon Tripler, a little later, when another 
 similar offer was made, reported that all necessary and practical 
 arrangements for care of the wounded had been made, when no 
 real adequate arrangements had been made at all. They were 
 not made until Letterman became Medical Director of the Army 
 of the Potomac, July 1st, 1862. The miserable state of the 
 wounded after Second Bull Run shows what arrangements had 
 not been made up to August, 1862. Ambulance corps and field 
 hospitals were only partially organized at Antietam, and were not 
 complete until nearly three years of war had passed. 
 
 Although ambulance corps and field hospitals had been used 
 earlier, in our Civil War they were begun anew and went through 
 a course of evolution as though they had had no previous exist- 
 ence. It took one year to develop the plans and two years more 
 to put them in complete operation. 
 
 MEDICAL EQUIPMENT AND PREPARATION. 
 
 General McDowell's army numbered about 35,000 men, organ- 
 ized in five divisions ; two of which took no part in the engage- 
 ment. It is not speaking exactly to say it was organized. It was 
 not really organized and was an army in name only. The Medi- 
 cal Department was even more incomplete and inexperienced than 
 the balance of the Army, which is saying a great deal. The Medi- 
 cal Director of the Army was Surgeon \V. S. King, U. S. Army, 
 with the rank of major. In his report he complains bitterly of 
 his lack of rank, and authority to enforce his recommendations. 
 He seems to have had no conception of the duties of the chief 
 medical officer of an army. He had an assistant, Assistant Sur- 
 geon Magruder, U. S. Army. Serving with the regular regi- 
 ments there were several young assistant surgeons of the Regu- 
 lar Army, among them George M. Sternberg. 
 
THE BATTLE OF BULL RUN. 
 
 ■ iWr- 
 
•1 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Surgeon King says there were a few ambulances which were 
 distributed equitably among the regiments. It seems that there 
 were enough for one to each regiment of 600 to 800 men. An 
 estimate was made for twenty wagons to carry the medical sup- 
 plies of the army. This estimate was approved by the General 
 but the wagons never came. Each regiment had some sort of a 
 small regimental hospital ; these were the only field hospitals with 
 the army. 
 
 To make matters worse, a few days before the movement be- 
 gan, orders were issued to put the army in light marching order, 
 all baggage and stores of every kind were left behind. This made 
 it impossible to carry any medical supplies except what could be 
 carried on the ambulances and field wagons. It looks impossible, 
 but the same thing occurred again in 1898. But three ambu- 
 lances were taken to Santiago. 
 
 A sample regimental equipment was that of the First Connec- 
 ticut Volunteers, 600 to 700 men. This regiment had one two- 
 horse ambulance and two wall tents for hospital use ; no hospital 
 supplies and apparently no litters. There were no men to use 
 this equipment except the band men. 
 
 Some regiments probably had more than this, some not so 
 much. And this was the medical equipment of an army marching 
 out to immediate battle. The railroad base of the campaign was 
 at Alexandria; on the day the troops marched Chief Surgeon King 
 sent an officer to Alexandria to prepare a base hospital there. The 
 railway was open to Fairfax Station, about twelve miles from 
 Bull Run. The Army marched by the railway and parallel roads 
 a few miles north. 
 
 The army left Arlington and Alexandria on the 16th and 
 reached Centreville on the 18th. On that evening there was a 
 skirmish near Blackburn's Ford in which several were killed and 
 some forty wounded. The Medical Director's impressions of 
 this little affair are interesting. He says, "We pursued our 
 course on the road leading to the Ford and soon met the ambu- 
 lances with the dead, wounded, and disabled men. One soldier 
 had his face shot completely away; some were disabled by sun- 
 stroke and exhaustion. The ambulances were stained with blood. 
 * * * I despatched Assistant Surgeon Magruder to Centreville 
 to select suitable buildings for hospital purposes. 
 
THE BATTLE OF BULL RUN. 5 
 
 A hotel, a church, and a large dwelling were selected. An un- 
 expected difficulty was the great scarcity of water. There were 
 few wells in Centreville and these had been so exhausted by our 
 thirsty men that they were nearly all dry. Water, procured with 
 great difficulty, and placed in basins for washing the wounded, 
 was snatched up and drunk by stragglers as they passed, before 
 they could be prevented." The Medical Director also saw with 
 astonishment that a hospital established by some regiment, re- 
 fused to receive certain wounded men because they belonged to 
 other regiments. The less severely wounded were sent back to 
 Washington. The more severely wounded were kept at Centre- 
 ville, where they were captured on the 22nd. 
 
 While the Army was here, two whole days, although the enemy 
 was posted behind Bull Run but a few miles away, and a battle 
 was confidently expected, no hospital arrangements were made in 
 Centreville; no plan was made for transporting the wounded; 
 everything was left to take care of itself, haphazard. The Med- 
 ical Director telegraphed the Surgeon General for supplies for 
 the approaching battle. The Surgeon General replied that they 
 would be forwarded to Fairfax Station the following day, but 
 they never came. It was not supplies, however, that were needed 
 primarily; it was plans and organization. Had the supplies 
 reached Fairfax Station they would have availed little or nothing. 
 
 THE BATTLE. 
 
 While it is not within the scope of this article to give a com- 
 plete description of the battle, a brief review of its principal 
 features is necessary to a good understanding of the efforts of 
 the medical department and its success or failure. 
 
 The Battle of Bull Run was a political battle, forced on Gen- 
 eral McDowell by the politicians, before he was prepared and 
 against his judgment. 
 
 He had an aggregation of about 35,000 men loosely organized 
 in seven divisions. His force was largely composed of volun- 
 teers. The few militia regiments were inferior to our Guard 
 regiments of today, while the volunteers, both men and officers, 
 were entirely without experience in war, or even in peace train- 
 ing. The only reliable troops in the whole force were the eight 
 
6 MEDICAL DEPARTMENT IN THE CIVIL WAR 
 
THE BATTLE OF BULL RUN. 7 
 
 companies of regular infantry under Major Sykes. The seven 
 regular batteries seem to have been poorly handled and the few 
 troops of regular cavalry had little or no influence on the contest. 
 There was also a battalion of marines, but they were recruits and 
 ran as fast as the volunteers. There were about 28 regiments 
 engaged, most of which were from the eastern states. The aver- 
 age length of service of all the regiments was only sixty days. 
 
 The morale seems to have been on the side of the Confederates, 
 who were spoiling for a fight. That the Northern troops were not 
 quite so eager is shown by the action of a regiment of which the 
 term of enlistment expired on the day of the battle. Despite the 
 entreaties of the General this regiment marched to the rear to the 
 sound of the guns opening the fight along Bull Run. A more 
 craven action is not recorded in the whole war. 
 
 The plan of the battle was masterful and should have been 
 crowned with success. The execution was faulty. 
 
 Of the five divisions of the army one was left behind to guard 
 the railroad, which had been destroyed as far east as Fairfax 
 Station. This division may be dismissed. Miles' Division was 
 left at Centreville, with one of Tyler's brigades. This reserve 
 was never brought forward, thus leaving almost half the army 
 out of the battle. 
 
 Tyler's Division was still as large as the other divisions, hav- 
 ing three brigades left. This Division with those of Hunter and 
 Heintzelman was to fight the battle. The plan was for Hunter 
 and Heintzelman to make a wide flanking movement by the upper 
 fords and fall on the enemy's left, while Tyler was to march 
 straight ahead by the Warrenton Pike, and, when the Stone 
 Bridge should be uncovered, cross and join the left of the main 
 attack. 
 
 Everything being in readiness, orders were issued on the 20th. 
 The troops marched out to battle at 2 o'clock on the morning of 
 the 21st, a decidedly early hour, at which time, on the evidence of 
 so good an authority as Napoleon, the physical powers and moral 
 courage are at their lowest. The left wing, though having the 
 shortest distance to go, marched first. The troops of the right 
 wing were delayed by Tyler's column and did not get started 
 until 5.30. They had eight miles to march and did not pass Sud- 
 ley's Ford till long after daylight. The weather was very warm, 
 
8 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 the roads were dusty, the pace was too fast, and these civilian 
 soldiers were nearly exhausted when they reached the field. How- 
 ever, they crossed the Run and advanced along the Manassas 
 Road until they met the enemy a half mile south of Catharpin 
 Run. Howard's brigade was left behind to guard the Ford. The 
 column was deployed about nine and the enemy gradually forced 
 back. Burnside, who made the first attack, soon retired from the 
 contest and his brigade did not again return to it. 
 
 Meanwhile Tyler had reached the Stone Bridge long before; 
 his first gun was fired at 5.30. Sherman, who commanded one 
 of his brigades, found a ford above the bridge, led his troops 
 across, and joined in the fight with much resolution. Keyes also 
 crossed but kept his brigade in a friendly ravine. Schenck did 
 not cross at all. 
 
 All went well with McDowell. The enemy was driven back 
 from one position after another until about 2 o'clock he was 
 forced across the Warrenton Pike. The Stone Bridge was now 
 open but no reinforcements were brought across. Howard was 
 finally brought up, however, and the five brigades of Porter, 
 Willcox, Franklin, Sherman, and Howard were formed for the 
 decisive attack on the Confederates, strongly posted on the Henry 
 House Hill. 
 
 The struggle for this small plateau was the decisive action. 
 The Union forces had some success, but toward 4, Confederate 
 reinforcements arrived from the Shenandoah Valley and, join- 
 ing the left, flanked the Union right. 
 
 The inexperienced Union troops, exhausted by more than 
 twelve hours of marching and fighting, lost courage and retired 
 from the field; each column retreating by the road it had fol- 
 lowed in the morning. There was no efficient pursuit and the 
 retreat did not become a rout till Bull Run was past. Both 
 retreating columns came together west of Cub Run and the 
 whole army had to defile over one small bridge. Cub Run is an 
 insignificant stream, but it might as well have been a broad river, 
 in so far as all vehicles were concerned. By this time the Con- 
 federates had sent some troops of cavalry and a light battery in 
 pursuit. A few well planted shells on the Cub Run Bridge 
 blocked it and all ambulances, wagons, carriages, and even guns 
 not past this point were lost, together with a number of pris- 
 
THE BATTLE OF BULL RUN. 9 
 
 oners, wounded and otherwise. A whole battery, which had got- 
 ten thus far safely, was lost. Another battery which had been 
 with Richardson, near Blackburn's Ford, and had not been 
 across the Run, was stampeded and all its guns and caissons 
 lost. It is difficult to believe that the regulars of these two bat- 
 teries were not panic stricken as well as the volunteers. 
 
 The regular infantry maintained its organization and behaved 
 admirably throughout the whole retreat. The marines were en- 
 tirely new recruits, and in spite of the efforts of their officers, 
 broke and fled, in confusion. 
 
 An attempt was made to rally the fleeing troops at Centreville 
 that night and Miles' division made a brief stand, but they could 
 not be depended on. The whole army was panic stricken and 
 fled in the greatest disorder, never stopping till the Potomac 
 was reached. Next day there was little or no organization left. 
 
 This retreat in panic from the field would have made the 
 medical problem difficult for the most efficient medical depart- 
 ment ; as it was medical aid and care for the wounded was an- 
 nihilated. They were left to their own devices. 
 
 CARE OF THE WOUNDED. 
 
 On the morning of July 21st the Army, or a part of it, marched 
 out to battle. The two divisions of Hunter and Heintzleman 
 made a turning movement to the right, crossed Bull Run at Sud- 
 ley Ford and advanced along the road to Manassas. 
 
 When this column uncovered the Stone Bridge, Tyler was to 
 have advanced by the Warrenton Pike, making the secondary 
 attack. Of his three remaining brigades Sherman's crossed at a 
 ford above the bridge and took an important part in the contest: 
 Keyes' brigade also crossed but kept in the safe cover of friendly 
 ravines. Schenck exercised even greater discretion, he did not 
 cross at all. Ambulances followed the main column ; as the 
 accompanying batteries were unable to cross with Sherman and 
 Keyes, I take it that the ambulances were also unable to cross. 
 
 The troops that actually crossed the river and took some part 
 in the conflict were the seven brigades of Porter, Burnside, 
 Franklin, Willcox, Howard, Sherman, and Keyes; numbering 
 with five batteries and a few troops of cavalry, about 1S,500 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 men. The brigades averaged four regiments each; there being 
 28 regiments of less than 700 men. The force engaged approx- 
 imated a modern division; with another division in the rear. 
 There should have been eight field hospitals and the same num- 
 ber of ambulance companies. Of these six would have been in 
 the neighborhood of Centreville. 
 
 These six could have cared for the seriously wounded (trans- 
 portable) of the battle — about 800. Just how many ambulances 
 were with the army no one knows. It seems probable that 
 there were as many as 48, but there was no organization. 
 
 Each regiment had one or more medical officers, who followed 
 closely behind the lines. These officers attended the wounded 
 on the field, removed them in ambulances, or, when that was 
 impossible, collected them in buildings, the shade of trees, or 
 in other protected places. All the evidence at hand shows that 
 these men worked faithfully to the last, and a number volun- 
 teered to remain with the wounded where they became prisoners 
 of war. But the work was individual, every man for himself, 
 and small results were to be expected. There was regimental aid, 
 nothing more. 
 
 The Medical Director accompanied the General throughout 
 the day, galloping here and there about the field, but exercising 
 no sort of control, or even supervision over the collection and 
 care of the wounded. 
 
 In fact he followed the example of the General, who per- 
 sonally exhorted and led small bodies of troops instead of com- 
 manding the army. The Medical Director carried instruments 
 and dressings in his saddle bags and treated a number of men 
 on the field ; among others General Heintzleman, for whom he 
 extracted a bullet, while the General sat on his horse. 
 
 Accompanying the flanking column, he noticed that the day 
 was very warm and the men were exhausting themselves by 
 running, which he deprecated to the General. He thought there 
 would be a brisk skirmish and the enemy would fall back ; so he 
 took out his note book and pencil and began to make a list of 
 the dead and wounded. 
 
 He relates that he counted more than a hundred dead before 
 seeing one wounded man. This indicates that the wounded got 
 away in some manner. But the enemy did not fall back so 
 
THE BATTLE OF BULL RUN. 11 
 
 obligingly and he gave up his task of counting. Being at length 
 forced to believe that a real fight was at hand he sent Asst. 
 Surgeon Magruder to Sudley Church to "Prepare it, and if 
 necessary a couple of houses close to the church for the reception 
 of our wounded; and to send forward the ambulances as soon 
 as possible." This was the only field hospital established that 
 day. It is true that the wounded made their way to various 
 houses, but that was casual. To the Sudley Church hospital 
 were brought some 300 of the 1,124 men wounded in the battle. 
 As the ambulances had no place else to which to carry the 
 wounded they unloaded them there. A number of surgeons 
 gathered at the church casually and the wounded were cared for 
 in some way until the place was captured in the evening. 
 
 Surgeon Magruder says, "Upon taking possession of the stone 
 church I set men to work removing the seats, had the floor cov- 
 ered with blankets, buckets of water brought, instruments and 
 dressings in place, operating tables improvised, and sent men 
 to the nearby fields to procure hay for bedding. In about two 
 hours the church was filled and I was obliged to take possession 
 of three other buildings. As soon as I could get them cleaned 
 out wounded men were carried into them until they were also 
 filled. For want of other buildings many of the wounded were 
 laid under the trees in the grove around the church. Several 
 capital operations were performed before the rush of the re- 
 treating columns crowded the hospitals so completely that work 
 for the time being was suspended." 
 
 Except these wounded near Sudley Ford none appears to have 
 been removed from the field by ambulances. Some probably 
 made their way back across Bull Run and were picked up there. 
 All those who fell in the last struggle for the Henry House Hill 
 were left on the field unless able to get away by their own ef- 
 forts. Assistant Surgeon Gray, who was with the regular cav- 
 alry, says, "Few ambulances could come up and our attentions 
 consisted chiefly in conveying the injured men into the shade, 
 giving them water, extracting balls, and &." Assistant Surgeon 
 DeGraw, of the Eighth New York, says in his report, "In fol- 
 lowing the regiment to the field I entered a thicket in which lay 
 a large number of wounded with only one surgeon attending 
 them." He stopped to assist. These wounded were later taken 
 to the church and he also went there. 
 
12 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 
 ■ ; 
 
 £ 
 
THE BATTLE OF BULL RUN. 13 
 
 The Surgeon of the Fifth Massachusetts, W. W. Keen, Jr., 
 states that the drum corps of his regiment was with the am- 
 bulances in the field, and this was the only detail of men for 
 hospital purposes. Surgeon Stearns of the First Connecticut 
 says, "After the regiment had advanced about one mile I selected 
 a house to be used as a hospital and hoisted the hospital flag; I 
 gave orders to the musicians of the band, who had been detailed 
 for that purpose, to follow the regiment and bring the wounded 
 to the hospital. Water was abundant but we had no soups and 
 no food except such as was in the haversacks. The wounded 
 of other regiments were generally borne on blankets fastened to 
 poles. The wounded of my regiment were so slightly injured 
 that they walked from the field." The First Connecticut be- 
 longed to Keyes' Brigade which was so safely manoeuvred; the 
 regiment had no killed and eight wounded, presumably slightly. 
 
 Assistant Surgeon John W. Foye of the Eleventh Massa- 
 chusetts, made a report later, throwing a little light on the battle. 
 He says, "The regiment was accompanied by one ambulance 
 well provided with stimulants and surgical appliances, but with- 
 out medicines or tents. The field hospital was established about 
 a quarter of a mile from the front line when we engaged, but 
 late in the day it was three-quarters of a mile in the rear. Up 
 to two o'clock the Confederate wounded at the hospital nearly 
 equaled our own. Until that time but few wounded were brought 
 off by their comrades, but later it was not unusual to find a flesh 
 wound escorted by half a dozen able men; it is needless to say 
 they did not return to the field. * * * At three a medical 
 officer of rank visited the hospital on his way to the rear and left 
 it optional with the medical officers at the hospital to join him 
 or remain. Nearly all the surgeons left us about half-past three. 
 Three ambulances went away at that time. The only remain- 
 ing ambulance, belonging to my regiment, was captured about 
 half-past five, within a hundred yards of the hospital. 
 
 All the wounded capable of being moved had been sent off to 
 the rear. I estimate the number left at one hundred and eighty. 
 All of them fell into the hands of the enemy. I saw no excisions. 
 The major amputations, four in number, were by the circular 
 method." This regiment, numbering seven hundred and fifty 
 men, had thirteen killed and forty-five wounded. 
 
14 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 W 
 
 
 r. 
 
 *N5 
 
THH BATTLE OF BULL RUN. 15 
 
 When the Union troops fled from the field at four o'clock the 
 wounded who had not made their way to the rear were left 
 scattered over the whole terrain. Some had been gathered in 
 the few houses and barns ; there were thirty-six in the Matthews 
 House; others were in ravines, groves, and thickets; many of 
 the severely wounded lay where they fell. Some had temporary 
 aid, many had none. It must not be thought, however, that the 
 whole 1,100 wounded lay on the field. All who could possibly 
 get to the rear did so and the number of wounded that reached 
 Washington was astonishing. 
 
 Ambulances were sent out next day to pick them up and it 
 is probable that one-half of all the wounded got away from the 
 field and reached the lines at Arlington. The Confederate re- 
 ports show 550 wounded sent to Richmond as prisoners. 
 
 When the retreating column passed Sudley Church the Medi- 
 cal Director made no provision for the abandoned wounded. 
 There was some debate among the regimental surgeons there 
 but to their honor a number volunteered to remain with the 
 men entrusted to their care. The Geneva Articles were not then 
 in force and they ran the risk of being made prisoners. Those 
 who remained were Asst. Surgeons Sternberg and Gray of the 
 Regular Army, Swift, Winston, and DeGraw of the Eighth New 
 York, and Homiston and Swalm of the Fourteenth New York. 
 This was about five o'clock. 
 
 Meanwhile the column hurried on toward Washington. A 
 small force of regulars covered the rear. The Medical Director 
 naively remarks of the retreat, "I may say it was one of the 
 most unpleasant marches of the campaign." He accompanied 
 the General but lost him in the confusion of the night. Next 
 morning he "hastened" forwards to Washington to see about 
 the supplies that never came. The officers that remained at 
 Sudley Church were made prisoners. The Confederate officers 
 would not listen to their claim that they had remained behind to 
 care for the wounded voluntarily and were entitled to immunity 
 from capture. Next day they were taken to Manassas, leaving 
 the wounded without aid, but were allowed to return again to 
 care for them. On the morning of the 32nd a cold rain began 
 and the wounded were in miserable plight. 
 
 Surgeon Gray says that they collected as many as possible in 
 
1G MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 the Lewis House and outbuildings which were soon packed 
 with Union and Confederate wounded, many still remaining 
 on the field. There were no instruments, food, or blankets. 
 The wounded were gradually removed to Manassas in wagons, 
 and from there to Richmond by train. The last load left the 
 field on July 28th, just one week after the battle. The wounded 
 were transported in rough wagons and on reaching Manassas 
 were placed in freight cars, on the bare floor. They were from 
 one to two da\s on the road: neither food, water, nor medicines 
 were provided for the trip. 
 
 All this was of course not intentional but due to lack of ex- 
 perience and preparation. The Confederate wounded were doubt- 
 less treated in the same way. 
 
 Surgeon Gray was sent from Richmond to Charleston, Colum- 
 bia, and Salisbury, and was only released on July 28th, 1862. 
 
 Asst. Surgeon Sternberg was more fortunate. He says, "A 
 number of capital operations were performed at the church but 
 owing to the want of food and stimulants and unfavorable 'cir- 
 cumstances most of the cases terminated unfavorably within 
 twenty-four hours. On the following morning a cold rain be- 
 gan and continued almost without interruption for two days. 
 The church would not hold all our wounded and many were lying 
 in front of it. We made a frame about twenty by thirty feet 
 and covered it with rubber blankets, a great number of which 
 had been left on the road. * * * On Monday a small quan- 
 tity of corn meal was obtained from a nearby house and some 
 gruel made. A cup of this was given to nearly every man and 
 this was all the food we were able to obtain for them until Mon- 
 day evening, when all the medical officers were taken from Sud- 
 ley Church to Manassas. On Thursday all but three of our 
 number took a parole not to serve again during the war. Those 
 of us who refused to take the parole were shortly after allowed 
 to go out and attend to our wounded, on giving a parole not to 
 attempt to escape for five days. * * * On July 25th I was 
 sent to Centreville, where I found a number of men wounded 
 in the affair at Blackburn's Ford. They were all doing well. 
 On Sunday, my parole having expired, I made my escape from 
 Centreville and after a tedious tramp, arrived in Washington 
 the following Tuesday, footsore and weary." 
 
THE BATTLE OF BULL RUN. 17 
 
 Surgeon DeGraw relates how scarce food was at Sudley 
 Church Hospital at first. But soon the surrounding inhabitants 
 brought in soup, chickens, eggs, milk, butter, etc., so that there 
 was sufficient. 
 
 Assistant Surgeon Charles R. Greenleaf reports that he re- 
 moved about 200 wounded from the field of Bull Run to Wash- 
 ington some days after the battle. I am unable to find details 
 of these wounded but believe that they were men who had got- 
 ten away from the field and were straggling along the road to 
 Washington. 
 
 Many wounded reached Centreville during the day of the 
 battle. The Surgeon of the 31st Xew York dressed two hun- 
 dred there. All the ambulances were loaded and sent from the 
 field with the retreating troops in the evening. The rout was a 
 medley of troops, citizens, guns, wagons, ambulances, and car- 
 riages on a single road. When the bridge over Cub Run was 
 blocked all vehicles not past that point were lost. How many 
 ambulances were lost is not known. The official Confederate 
 report lists but seven as turned in. There were probably others 
 n®t turned in. If reports of eye witnesses are to be believed, 
 fleeing ambulances were filled with officers while wounded men 
 filled all the houses along the roads. The whole flight was dis- 
 graceful. 
 
 The total casualties at Bull Run were: killed 483, wounded 
 1,011, total 1,491, or about eight per cent of the force actually 
 engaged. Sherman's brigade suffered most severely, losing 328 
 men, a much larger proportion of casualties than any other 
 brigade engaged. It is remarkable that the proportion of killed 
 to wounded is almost one to two. Sherman's brigade had 109 
 killed and 208 wounded. There was a very large list of missing, 
 many of whom fled, not only to Washington, but on to New 
 York, or their homes. 
 
 An incident of this unhappy day, only slightly connected with 
 the Medical Department, has never to my knowledge been com- 
 mented on, and is worthy of notice. Dixon S. Miles, then Col- 
 onel of the Second Infantry, was in command of the Fifth 
 Division which remained as a reserve at Centreville. The Col- 
 onel was sick on that day and his doctor foolishly prescribed 
 brandy for him. By evening he was so drunk as to be unfit 
 
is MEDICAL DEP-1RTMEXT IX THE Cll 'IE N JR. 
 
 for duty; this on the evening of the l'.attle of Hull Run, when 
 the stoutest hearted needed all his faculties. 
 
 A court of inquiry was convened in November; it found that 
 the designation "drunk" was correct but recommended that no 
 further action be taken. The sequel appeared at Harper's Ferry, 
 just before the battle of Antietam ; the most disgraceful and 
 humiliating surrender of the War. If this court had recognized 
 the fact that a drunk man has no more reason to be in command 
 of troops than an insane man, the miserable affair at Harper's 
 Ferry would never have taken place. 
 
 This is not said in condemnation of Miles. I know the world- 
 wide motto, Dc mortuis nihil nisi bunkum. Poor old Miles was 
 but the victim of a bad custom, and made such restitution as he 
 could with his life. 
 
 The court, had it done its plain duty, could have prevented 
 this piece of what Upton called imbecility. They knew that he 
 was subject to imbecility. 
 
 A few days after the battle, .Medical Director King went out 
 toward Bull Run with a train of thirty-nine ambulances, in an 
 attempt to succor the wounded and if possible remove them. 
 But this effort was also doomed to failure. The ambulances 
 wandered around the country for a while, General McDowell 
 failed to secure the necessary permission from the Confederate 
 authorities, and the ambulances returned empty to Washington. 
 
 So ended the last of the futile efforts to care for the wounded 
 at Bull Run. We have already seen how they were removed to 
 Richmond as prisoners of war. 
 
 The Medical Director in closing his scanty report of the battle 
 says, "Our retreat from the ground operated like a curtain to 
 conceal from view all knowledge of the subsequent history of 
 our cases, or the results of our ministrations." A welcome cur- 
 tain that concealed or excused an almost total absence of prepara- 
 tion for or care of the wounded. 
 
 COMMENTS. 
 
 The making prisoners of medical officers at Bull Run seems 
 to have been due to the general ignorance of the laws and cus- 
 toms of war of nearly every one at that time. Immunity from 
 capture for medical officers and protection for the wounded had 
 
THE BATTLE OF BULL RUM. 19 
 
 been practiced at various times for three hundred years. It 
 was a regular custom in the time of Frederick the Great and also 
 in the Napoleonic Wars. After the fall of Napoleon everything 
 military declined and with the rest this custom fell somewhat 
 into disuse. The suffering of the wounded at Solferino in 1859 
 led directly to the Geneva Convention of 18*ii. That the cus- 
 tom was known in 1861 is shown by the clamor made by the 
 captured surgeons. On being taken to Manassas they managed 
 to make their complaints known to General Beauregard. He, 
 being conversant with the military usages of Europe, wrote a 
 letter to the Secretary of War at Richmond recommending that 
 these medical officers be set at liberty. That this was not done 
 was probably due to the civil authorities. 
 
 From the fact that fifty per cent of the wounded may possibly 
 eccape from the field unaided it is sometimes argued that trans- 
 portation need only be furnished for one-half the injured. This 
 argument is erroneous for two reasons, either of which is suffi- 
 cient for its refutation. 
 
 In the first place, the knowledge that adequate medical service 
 is at hand has for troops a marked supportive value. Still more 
 important, if aid is not at hand, many able-bodied men will leave 
 the field under the pretext of assisting the wounded. During 
 the recent war as many as six burly Russians were often seen 
 assisting one slightly wounded man to the rear. There is no 
 doubt that at Bull Run, Shiloh and other places the sight of 
 wounded straggling to the rear, and the loss of the men accom- 
 panying them contributed to the depression and defeat of the 
 troops. 
 
 These reasons are purely mercenary. There is another that 
 occupies higher ground : the volunteer soldier offers his very 
 dearest possession to his country, his blood, his limbs, possibly 
 his life. When that soldir is struck down shall his country leave 
 him on the field suffering from cold, pain, thirst, even hunger ; to 
 die perhaps, without aid, unless he can drag himself away by 
 his own painful exertions? Certainly when he gives his dearest 
 possession the country should not be niggardly, when all it can 
 give is dollars, but should supply an abundance of the best possi- 
 ble means for his succor. 
 
 The principal lesson of Bull Run is a very simple one — the 
 
20 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 value of preparedness. The wounded lying on the ground where 
 they fell, for days, in the rain, without attention, or even water 
 and food, furnished an object lesson that impressed some few 
 observers. It was not long until a beginning was made at a sys- 
 tem of better care for the wounded. A year later on the same 
 field conditions were little better. But the very misery of these 
 fields had its use; it spurred to action men in and out of the 
 army until there was created a system of satisfactory relief for 
 the wounded. 
 
 It was not alone the Union Army that suffered defeat at Bull 
 Run, some widely prevalent ideas suffered a rude shock that day. 
 One was that a collection of armed men constitutes an army; it 
 was demonstrated that a number of civil practitioners, however 
 highly qualified and patriotic they may be, do not constitute a 
 competent medical department for an army. 
 
 Unfortunately these ideas, like the army that day, were only 
 hard hit. They survived and still exist to trouble us. 
 
 \ T o previous plans, no organization, no enlisted personnel, no 
 supplies, no ambulance corps, no field hospitals, no convoys for 
 wounded, no evacuation hospitals — nothing could be expected 
 in results. It is true that all advance formations would have 
 been captured; but they would have served their purpose. Yet 
 no particular person is to blame for this miserable neglect of the 
 wounded.' The era of scientific care of the wounded had not 
 arrived. Even had our present organization been then in vogue 
 it would have made no difference. As we had no Army we 
 should of course have had no Medical and Hospital Corps. Three 
 vears had passed before the Medical Department was in a sat- 
 isfactory condition. The nation that depends on scraping up an 
 armv after war begins must take the time to do it, and in the 
 meantime will suffer. 
 
 The suffering of the wounded at Bull Run shows the natural 
 result of an inadequate Medical Department; it also by contrast 
 makes apparent the immense advance made and the excellent 
 results secured in the later campaigns when the Medical Depart- 
 ment was fully equipped, thoroughly organized, and ably ad- 
 ministered. If the work of the Medical Department at the be- 
 ginning of the war is a thing to be ashamed of, the work at the 
 close of the war is a thing to be proud of. 
 
 In spite of the scanty numbers and slight equipment of the 
 
THE BATTLE OF BULL RUN. -»1 
 
 Medical Department of the Army today, it is with a feeling of 
 comparative satisfaction that one contrasts it with the Depart- 
 ment in 1861. At that time the Medical Department was con- 
 servative to the verge of inertia. 
 
 It was not only behind the armies of Europe but it was behind 
 the public knowledge and opinion at home. Volunteer regiments 
 fresh from civil life had as good medical equipment as regular 
 regiments. Ambulance corps were urged on the army by civilians 
 long before Letterman adopted them. The first combination of 
 regimental hospitals and ambulances into brigade organizations 
 was in General Grant's volunteer army at Fort Donaldson, in 
 February, 1K63, under the management of Surgeon John H. 
 llrinton, U. S. Volunteers. The Sanitary Commission was at 
 times in advance of the Medical Department of the Army, and 
 at one time stepped in and took charge. Today, on the contrary, 
 the Medical Department may be justly called, in the political 
 phraseology of the times, progressive. It runs ahead of civil 
 progress at home and of the armies of the world abroad. 
 
 Witness the work of the Reed Hoard in making possible the 
 elimination of yellow fever; the work done at Panama; and, 
 probably more important than either, the present work of render- 
 ing the army immune to its most dangerous enemy — typhoid. In 
 this line it is ahead of all European armies and far ahead of 
 cities and other civil communities. 
 
 As to the care of the wounded on the battlefield the Medical 
 Department of the Army needs no urging from any one as to 
 adopting new devices. It is eagerly on the lookout for any new 
 scheme or method that will render the present plans ever more 
 excellent. It seeks to foresee all difficulties and provide for 
 overcoming them if possible. 
 
 The Surgeon General of the Army in lsill was no doubt a 
 worthy gentleman, he was about as much prepared for war as 
 were the people of San Francisco for an earthquake. An army, 
 in all its parts, has the same relation to the Nation that a fire 
 department has to a city. It must always be prepared for its 
 main function, and must be prepared to respond instantly, for 
 rebellions and invasions are like fires, they are much more easily 
 suppressed at the start than after they have gained headway. 
 
22 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 APPENDIX. 
 Extracts from Army Regulations, 1S(>1. 
 
 HOSPITAL ATTENDANTS. 
 
 1293. The senior medical officer will select the cooks, nurses, 
 and matrons, with the approval of the commanding officer. Cooks 
 and nurses will be taken from the privates, and will be exempt 
 from other duty, but shall attend the parades for muster, and 
 weekly inspection of their companies at the post. 
 
 121)4. * * * The allowance of hospital attendants for troops 
 in the field will be, for one company, one steward, one nurse, and 
 one cook ; for each additional company, one nurse ; and for com- 
 mand of over five companies, one additoinal cook. 
 
 1323. The Secretary of War will appoint from the enlisted 
 men of the army, or cause to be enlisted, as many competent hos- 
 pital stewards as the service may require, not to exceed one tor 
 each post. 
 
 133T. Upon the march or in battle, medical officers will habitu- 
 ally be attended by an orderly, carrying a hospital knapsack. 
 
 AMBULANCES AND TRANSPORT. 
 
 1330. The following schedule of transports for the sick and 
 wounded and for hospital supplies will be adopted for a state 
 of war with a civilized enemy : 
 
 4. For a regiment of ten companies ; two four-wheeled am- 
 bulances, ten two-wheeled ambulances, and four two- 
 wheeled transport carts; and for greater commands in 
 proportion. 
 
 TENTAGE. 
 
 1336. The following will be the allowance of tents for the 
 sick, their attendants, and hospital supplies : for ten companies ; 
 three hospital tents, one Sibley tent, and one common tent. 
 
 BATTLE SERVICE. 
 
 T35. Before the action, the Quartermaster of the division 
 makes all the necessary arrangements for the transportation of 
 
THE BATTLE OF BULL RUX. 20 
 
 the wounded. He establishes the ambulance depots in the rear, 
 and gives his assistants the necessary instructions for the service 
 of the ambulance wagons and other means of removing the 
 wounded. 
 
 730. The ambulance depot, to which the wounded are carried 
 or directed for immediate treatment, is generally established at 
 the most convenient building, nearest the field of battle. A red 
 flag marks its place, or the way to it, to the conductors of the 
 ambulances, and to the wounded who can walk. 
 
 737. The active ambulances follow the troops engaged to suc- 
 cor the wounded and remove them to the depots ; for this pur- 
 pose the conductors should always have the necessary assistants, 
 that the soldiers may have no excuse to leave the ranks for that 
 purpose. 
 
 738. The medical director of the division, after consultation 
 with the Quartermaster-General, distributes the medical officers 
 and hospital attendants at his disposal, to the depots and active 
 ambulances. * * * He will take post and render his profes- 
 sional services at the principal depot. 
 
 73!). If the enemy endanger the depot, the Quartermaster takes 
 the orders of the General to remove it or strengthen the guard. 
 
 740. The wounded in the depots and the sick are removed, as 
 soon as possible, to the hospitals that have been established by 
 the Quartermaster-General of the army on the flanks or rear of 
 the army. 
 
POPE'S VIRGINIA CAMPAIGN. 
 
 "Le soldat sait mourir pour son pays, il est habitue a I'idee d'etre frappe 
 par un balle enemie. Par contre I'esprit de sacrifice n'est suffisament de- 
 veloppi pour lui permettre de supporter des sugrances qfil judge inutiles. 
 II rapporte a ses chefs la cause de ses misereres, et la demoralization est 
 la consequence." 
 
 GENERAL SITUATION AND MOVEMENTS. 
 
 A LOST campaign will always show the medical department 
 of an army at its worst. Even with a complete, well organ- 
 ized and equipped sanitary corps, many of the wounded will be 
 left behind, and great suffering cannot be avoided. With an un- 
 trained corps, such as existed in this campaign, the fate of the 
 wounded will be much like those of the battles of the Middle 
 Ages; but without that callousness to suffering which existed 
 even among civilized peoples at that time. 
 
 The Virginia Campaign of General John Pope, in 18U2, was the 
 most unfortunate large campaign of the whole war. A miscel- 
 laneous aggregation of corps, under generals ranging from 
 mediocre to poor, or worse, marched ceaselessly and fought 
 bravely for a month. The end was miserable failure which left 
 the army within the fortifications of Washington, just where it 
 had been when the war began. All the efforts up to this time 
 had gone for nothing. One can scarcely read of it all even today 
 without a feeling of humiliation and regret that such noble efforts 
 on the part of subordinate officers and soldiers should have been 
 rendered useless by blundering generals; that all the suffering 
 and death on those fields should have accomplished nothing 
 toward ending the war; even less than nothing. 
 
 After the failure of McClellan's Peninsular Campaign it was 
 decided to withdraw his army by water to Alexandria, in order 
 to unite it with another force, to be collected in front of Wash- 
 ington. This was done during August, leaving the Confederate 
 Army free to move where it pleased. To protect Washington and 
 draw off I.ce from McClellan's embarkation, another army was 
 formed, known as the Army of Virginia. Its life was brief. 
 
•2 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 The three small armies of Sigel (formerly Fremont), Banks, 
 and McDowell were brought together above Culpeper on the last 
 of July and placed under the command of General John Pope; 
 a boaster who accomplished as much as men of his class usually 
 accomplish. The psychology of this whole campaign would make 
 an extremely interesting study. It was not neglected by Lee and 
 Jackson. They appraised Pope as they had appraised McClellan ; 
 and with accurate precision. 
 
 McClellan's army came to Alexandria in fragments. Lee 
 could not, and did not allow the two armies to unite, without first 
 striking Pope. In spite of the exhaustion and losses of the Seven 
 Days' Battle, and the danger of leaving Richmond unprotected, 
 he hurried Jackson to the Rapidan early in- August and by the 
 20th was behind the Rappahannock with his whole army, deter- 
 mined to strike Pope before McClellan should join him. This, 
 thanks to the blundering of incompetent Union generals, he was 
 able to do. 
 
 Pope's army at first consisted of three corps, each of two di- 
 visions, and numbered about 35,000 men. On August 1-1 th Reno 
 brought two divisions from Burnside's Corps at Fredericksburg, 
 giving Pope another small corps. On August 23rd Reynolds 
 joined McDowell with the fine division of Pennsylvania Reserves, 
 greatly depleted, however, at this time. A few days before 
 the great battles Porter and Heintzelman joined with two corps 
 from the Army of the Potomac. This gave Pope six small corps 
 with about 05,000 men. There was also some cavalry, probably 
 5.000 in all, which accomplished little or nothing more than kill- 
 ing their horses. It will be seen that this was not a homogeneous 
 force. It was a collection of separate corps and did not work 
 in harmony ; far different from the experienced, compact, smooth- 
 working, efficient machine it was to oppose. 
 
 Pope's duty was to defend Washington and draw off the Con- 
 federates from the James ; but his boastful proclamations almost 
 compelled him to take the offensive and march to the front. So 
 the campaign began at Cedar Mountain below Culpepper, early 
 in August. Beaten there, Pope gradually fell back along the 
 Orange & Alexandria Railway, which was his line of communi- 
 cations. As Lee and Jackson were continually attempting to 
 turn his right flank, the fighting all took place west and north 
 
POPE'S VIRGINIA CAMPAIGN. 3 
 
 of the railway. The Warrenton Pike, a few miles to the north, 
 was the main line of wagon road and on it most of the battles 
 occurred. 
 
 Banks was beaten at Cedar Mountain on the 9th and Pope fell 
 back to the Rappahannock on August 19th. On August 26th 
 that position was turned, bringing Pope back to Gainesville. On 
 the 28th he went back to Bull Run. The principal battle oc- 
 curred on the 29th and 30th, resulting in decided defeat. On the 
 31st the army was at Centreville, on September 1st at Fairfax, 
 and on the 3rd the troops were withdrawn within the fortifications 
 of Washington. Two more Corps of the Army of the Potomac 
 had joined the army on the 1st, but it was too late, the most un- 
 fortunate campaign of the war was ended. Pope's career had 
 closed. He refused to see facts, seeing only what he wanted to 
 see. The army fought well and suffered severely. The soldiers 
 bravely strove, in so far as they were able, to atone for the faults 
 of their leaders. Mad they been less brave or the leaders more 
 able, the losses would not have been so severe or the story so 
 miserable a one to tell. Repeatedly pushed into suicidal posi- 
 tions, and not knowing that they were unsupported on either side, 
 they deemed it their duty to stand, and they stood until often in 
 danger of being surrounded and captured. No more steadfast 
 fighting was seen during the war than in the wheatfield at Cedar 
 Mountain, the field of King's battle near Gainesville, and in front 
 of the railway embankment where Grover's Brigade made a 
 charge which actually merits that overworked word gallant. 
 
 MEDICAL PL*NS, ORGANIZATION AND EQUIPMENT. 
 
 Pope's army was like a scratch ball club. Various corps were 
 suddenly brought together and plunged into an active campaign 
 before they could be organized for team work. The medical de- 
 partment was like the balance, various, incomplete and not well 
 organized. 
 
 The medical director of the army was Surgeon Thomas Mc- 
 Parlin, U. S. Army, a competent man, who afterwards conducted 
 the medical department of the Army of the Potomac through its 
 greatest campaigns with eminent skill and success. In this cam- 
 paign he had clear ideas and some plans, yet the outcome was 
 largely a failure. The reasons for this will be pointed out. 
 
4 MEDICAL DEPARTMEXT IS THE CIVIL WAR. 
 
 MCFAHLIM. 
 
POPE'S VIRGINIA CAMPAIGN. o 
 
 The country from the Rapidan back to Washington is a gentle 
 rolling one with woods and cleared fields, traversed by passable 
 roads. The weather during August was generally fine though 
 excessively warm during the early weeks. Washington was the 
 base with the Orange & Alexandria Railway for the line of com- 
 munications. This road had been so often destroyed that it was 
 in poor condition and the locomotives and cars were diminutive 
 as compared with those in use today. Supplies were brought 
 forward by this line, wounded evacuated by it, and the army 
 clung to it throughout. The towns of Culpepper, Warrenton 
 and Manassas were conveniently located for temporary bases of 
 supply and hospitals. 
 
 The campaign began on the Rapidan with the supplies and 
 hospitals at Culpeper. On August 19th they were removed to 
 Bealeton Station. On the 27th they came back to Bristoe Sta- 
 tion. Here the railroad was broken, and wagons had to be used 
 to Centreville, and Fairfax Station, which was the main hospital 
 on September 1st. By September 3rd everything was back in 
 Alexandria. 
 
 Medical organization at this period of the war was crude. The 
 ambulance corps idea was new. Letterman's order was issued 
 on August 2nd, one week before Cedar Mountain. Porter's and 
 Heintzelman's corps, coming from the Army of the Potomac, had 
 their ambulance corps organized, but most of the ambulances 
 were left behind at Yorktown or Alexandria. They marched 
 out without wagon trains, some divisions without artillery, or 
 even ammunition wagons; and with field officers on foot. It is 
 hardly necessary to say that their troops had no ambulances. 
 
 As an example of what may happen, or rather will happen, in 
 war, take the case of the Regular Division (Sykes) of Fitz John 
 Porter's Corps ; which it seems should have been supplied, if any. 
 Asst. Surgeon A. A. Woodhull says, "There were no ambulances 
 with the division from the evacuation of the Peninsula until we 
 entered Maryland," that is during the entire time this corps was 
 with Pope's army. Reynolds' Division, the Pennsylvania Re- 
 serves, probably the best volunteer division that the war pro- 
 duced, also had not a single ambulance. 
 
 All the divisions were not so badly off. McParlin. says that 
 Heintzelman's divisions had a well-organized ambulance corps. 
 
6 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 In the three original corps there were no ambulance organiza- 
 tions by divisions. McParlin says that the Surgeon General sent 
 him the Letterman plan, but he had no time to put it in opera- 
 tion. He does not say that it was ordered, and it was not or- 
 dered at this time. It seems probable that the Surgeon General 
 only recommended the plan, somewhat as a trial, and shortly be- 
 fore the battles. 
 
 The three original corps had, of course, some ambulances when 
 brought together. In McDowell's corps there were supposed to 
 be three ambulances and one transport cart to each regiment. 
 Actually there were but 41 ambulances and transport carts for 
 33 regiments. The shortage was Vi\). McParlin says: "As the 
 report showed this corps to be the best supplied, the deficiencies 
 of the other corps may be imagined." Of the transport carts he 
 said, "The transport carts are useless, especially in a mountainous 
 country. They kill numbers of horses, are slow at the best, and if 
 used except for instruments and dressings will probably have to 
 be abandoned by the road." He also said that the heavy four- 
 horse ambulance was inferior to the two-horse ambulance, and 
 this was the general opinion during the war. The General Am- 
 bulance Order of 1863 prescribed the two-horse ambulance. A 
 full supply of ambulances and other stores was asked for, but 
 few of them were received. The Quartermaster at Alexandria 
 promised finally to send them on August 23rd, but the crowded 
 trains prevented them and three days later the road was broken 
 for good. The order of transportation at that time was : 1st Am- 
 munition, 2nd Rations, 3rd Forage, 4th Medical supplies. 
 
 The Ambulances were sufficient for small engagements, but 
 when the great two days' battle occurred near Bull Run, they 
 were totally inadequate, even had they been organized in di- 
 vision trains. The. Surgeon General had to be called on for 
 ambulances; he forcibly gathered up a train of hacks and ve- 
 hicles of all kinds from the streets of Washington and sent them 
 to the field to bring in the wounded. This extemporization took 
 the place of a service of the rear, which did not exist. 
 
 Letterman's field hospital plans had not yet appeared. Field 
 hospitals were to be established in houses, barns and other build- 
 ings as at Bull Run, and McParlin's idea was to establish not di- 
 vision, or even corps hospitals, but one great field hospital in the 
 
POPE'S VIRGIMA CAMPAIGN. 7 
 
 rear for the whole army. This plan failed. An army of 60,000 
 men in battle could not be served by one hospital, even with the 
 contracted lines of those days. When the battle came he es- 
 tablished his hospital on Bull Run, a central and safe place, but 
 too far away for that period, being from four to six miles from 
 the wings. Each regiment had two or three hospital tents and 
 this was the only hospital tentage with the army. 
 
 There were something like clearing hospitals that followed the 
 army ; or rather preceded it, for it was always retreating. Three 
 hundred hospital tents were held in readiness at Alexandria at 
 the beginning of the campaign, and two hundred were shipped to 
 Warrenton where they were afterwards used. McParlin did not 
 intend to retain sick and wounded in the field, or to establish any 
 general hospitals except at Alexandria. The distance to that 
 point was short and the railway convenient. He says: "The 
 railroad made our communication easy and speedy with Alex- 
 andria. I proposed to use it for transportation of wounded from 
 depots near the field. It was impossible to hazard locating, and 
 there was no time for organizing large hospitals nearer to the 
 scene of expected battle." 
 
 A wise plan would have been to set up tent hospitals at Cul- 
 peper, and later at Warrenton Junction (now Calverton). He 
 was obliged to depart from his plan, and organized hospitals at 
 Culpeper, and at Warrenton, which was rather off the main line 
 of operations. The base hospitals were at Alexandria. When 
 filled the patients were evacuated to Washington, and these 
 cleared in turn by sending them farther north. A tent hospital 
 was also set up at Falls Church. 
 
 No systematic supply scheme had yet been devised for the 
 armies. A plan somewhat out of the ordinary was tried. It did 
 not prove an entire success, but it was a definite plan. McParlin 
 says that the Surgeon General intimated that purveyors trains for 
 each army corps were not suitable for this campaign on account 
 of the increased risk of loss of supplies by that plan, but that 
 one supply depot for the whole army would be most judicious; 
 this depot to be at Alexandria. Had the army remained at Cen- 
 treville, and it would have been better there, this plan would have 
 been good. But when the army reached Culpeper McParlin soon 
 found that it was a failure ; and that it was absolutely necessary 
 
8 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 centralization. He says: "No other purveyor's depots for corps 
 (except Sigel's) were organized. I soon found, however, that 
 a small moveable depot would be necessary to furnish battle- 
 field supplies; such as instruments, anesthetics, concentrated nour- 
 ishment, cooking utensils, blankets, bedding and tents." 
 
 These supplies were secured, but instead of loading them in 
 wagons as was generally done, they were packed in box cars 
 and forwarded to Warrenton. From there they went on to 
 Culpeper for the Battle of Cedar Mountain. Afterwards these 
 cars came back to Warrenton Junction. McParlin was so pleased 
 with his railway supply train that he had two cars fitted up 
 with shelving for ready issue. This train seems to have been 
 extremely useful while it lasted. When Warrenton was evacu- 
 ated the supply trains came back toward Manassas, but Jackson 
 had destroyed the bridges about Manassas, and the trains stopped 
 at Bristoe. The army was defeated, the bridges were not repaired 
 in time to remove the trains, and they were all burned on 
 August 31st. So ended the railway supply trains. But the idea 
 was a good one and not to be condemned on account of the 
 outcome, which was not chargeable to the plan, but to the failure 
 of a campaign that was a succession of blunders, if not worse. 
 In fact these trains might have been removed, had not Pope 
 sent such urgent orders, for the bridges were repaired the same 
 night. 
 
 Aside from this source of supplies, each regiment was author- 
 ized to have three wagons for tents and medical supplies. At 
 least that is the statement made by McParlin in his official 
 report. He does not state that they actually had so many wagons 
 and it is practicatly certain that they had not. 
 
 CEDAR MOUNTAIN. 
 
 On July 16th, McDowell's Corps was at Warrenton, Sigel 
 and Banks at Sperryville, farther west. These corps had been 
 cleared of sick and wounded before leaving their former stations 
 and it was hoped that the regimental hospitals could care for 
 the ordinary sick. But there appears to have been much sick- 
 ness and it soon became necessary to have hospitals nearer than 
 Alexandria. The two hundred tents were set up at Warrenton 
 
POPE'S VIRG1XIA CAMPAIGN. 
 
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10 MEDICAL DEPARTMENT LX THE CIVIL WAR. 
 
 and churches and other buildings used in addition. By the last 
 of July enough sick had been sent back to Alexandria to fill 
 the hospitals there; so they were cleared out to make room for 
 others yet to come. There were no wounded as yet. A tent 
 hospital was also established at Falls Church about this time. 
 McParlin complained of the number of vagrant soldiers, ma- 
 lingerers, and other skulkers that would congregate about the 
 hospitals and endeavor to get to the rear; even before fighting 
 began. McDowell's Corps of 23,000 had during July an average 
 of about 1,100 constantly sick and sent 1,017 to the base hospital. 
 
 By August 8th, all the corps had moved forward to the 
 vicinity of Culpeper. The hospital at Warrenton was broken 
 up and the tents moved back to Alexandria; the supplies were 
 brought forward to Culpeper. On the morning of the 9th 
 General Banks' Corps left its camp and marched out seven 
 miles to near Cedar Mountain (Slaughter Mountain). At four 
 that afternoon, Banks rashly pushed his two divisions into a 
 determined attack on Stonewall Jackson's entire corps. No 
 engagement of the war was more fiercely contested. In this 
 battle as in all the battles of this mourful campaign, the soldiers 
 bravely did what they might to repair the mistakes of their 
 leaders. Banks placed his men in a suicidal position and they 
 were too brave to retreat ; they stood until one-third their number 
 were either killed or wounded. Finally after dark they were 
 withdrawn across the run, leaving their very badly wounded 
 behind. 
 
 This action did not begin until five and the wounded did not 
 begin to come in until dark. Field hospitals were established 
 for both divisions, in the wooded valley of Cedar Run. The 
 First Division hospital received six hundred wounded by nine 
 o'clock, dressed them without much operating, and sent them 
 on to Culpeper by ambulances and on foot. This division had 
 1,007 wounded, probably more. The Second Division hospital 
 treated about four hundrd ; there were three hundred and thirty- 
 nine reported wounded in this division. The ambulances of the 
 division disappeared and the wounded came in on foot or were 
 carried by their comrades. Colonel Donnelly, of the 28th New 
 York, came in on a horse, wounded in the lower part of the 
 abdomen; the ball lodged in the pelvis and supposed to have 
 
POPE'S VIRGINIA CAMPAIGN. 11 
 
 passed through the bladder. He was sent in to Culpeper and 
 lived seven days. The wounded in this hospital were operated 
 on before being sent to the rear. The night following the battle 
 was one of brilliant moonlight, the surgeons set up their tables 
 in the open air and worked until morning. Late in the night 
 the air turned cold and they observed that it had a bad effect 
 on the very gravely wounded, of whom there were many, the 
 battle being fought almost hand to hand. All the surgeons 
 commented on the number of wounds of the chest and abdomen. 
 
 The total loss in this battle was 314 killed, 1,445 wounded, 
 and 622 missing. As the Confederates reported but 400 prison- 
 ers there is little doubt that the remaining 200 were either 
 killed or wounded. The men of Banks Corps returned sadly to 
 their camp where the many empty tents told the story of their 
 useless sacrifice at Cedar Mountain. 
 
 During the next day (August 10th) the work in the field 
 hospitals went on, but there were many still lying on the field, 
 at the most advanced position, now occupied by the enemy. 
 These sufferers were without help until Monday. Finally on 
 the eleventh some surgeons, chaplains, and soldiers ventured 
 forward without authority to try to do something for their 
 comrades, now thirty-six hours without food or care. They 
 were not halted but by some informal arrangement were allowed 
 until two o'clock to gather up and remove the wounded, who 
 were first paroled. By night all the wounded were back in 
 Culpepper. Some of the surgeons met Jackson himself, who 
 treated them well and placed no obstacle in their way, only re- 
 minding them that they should not take advantage of their 
 opportunities for observation, and report what they saw within 
 his lines. His army was then leaving its position. 
 
 There were few tents at Culpeper, so the wounded were 
 placed temporarily in churches, hotels and other buildings, and 
 McParlin applied to the Quartermaster for a train of cars to 
 remove them to Alexandria. Next day (August 10th) he went 
 to the front, expecting the battle to be renewed. The wounded 
 being all recovered on the eleventh he returned to Culpeper, 
 and found the surgeons there so busy with the work that they 
 had forgotten the train that was waiting on the track. He placed 
 Surgeon John H. Rauch in charge of the hospitals at Culpeper, 
 
12 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 now containing some 1,500 wounded, and began evacuating them 
 to the rear. 
 
 The first train left on August 12th carrying 480 patients. 
 Each train had medical attendants, water, subsistence, straw 
 (on the floor of the cars) and necessary bedding. Thirty cases 
 with recent amputations were carried over the 70 miles of poor 
 track without mishap. These were not hospital trains, or even 
 passenger trains, but returning box and stock cars bedded with 
 straw. The conduct of these trains appears to have been so 
 excellent throughout the campaign as to have exacted no criti- 
 cism ; an unusual thing in transportation of wounded. 
 
 A small relief station was established near the depot at 
 Culpeper so that there should be no lack of care at the point 
 of transfer. It was at such points as this that patients often 
 lay for hours without care. All transportable cases were re- 
 moved by August 18th. The Alexandria hospital reports show 
 891 patients received from Cedar Mountain, out of 1,445 re- 
 ported wounded. 
 
 A temporary hospital, with the supply cars, was maintained 
 until that date. Articles of supply, including ice, were brought 
 from Alexandria as neded, but nothing permanent established, 
 for despite Pope's proclamations the army expected to retreat. 
 The management of the wounded at Cedar Mountain was ex- 
 cellent and elicited praise from the Surgeon General. 
 
 From the small skirmishes that took place from day to day 
 the wounded all came back to Culpeper; but the regimental 
 tents and supplies were with the regiments, several miles away. 
 
 The condition as to medical officers was the same; the 
 the front. The three corps at this time consisted of about 90 
 regiments and had 273 medical officers; all attached to regiments 
 and brigades except the nine medical directors of corps and 
 divisions. This faulty arrangement showed clearly the need of 
 division hospitals with separate personnel and equipment. 
 
 In Culpeper the following hospitals were in use at this time : 
 Episcopal, Baptist, Methodist and Presbyterian churches; Pied- 
 mont, Virginia, and Depot hospitals, Masonic Hall, Tobacco fac- 
 tory and an encampment near the depot. 
 
 After the fight at Cedar Mountain medical officers had to be 
 sent back from the front to serve what should have been the 
 
POPE'S VIRGIMA CAMPAIGN. 13 
 
 clearing hospitals at Culpeper, though a renewal of the contest 
 was confidently expected. This fault also was due to the lack of 
 organization in the rear. 
 McParlin says : 
 
 The experience at Culpepper also caused me to add to the purveying 
 depot of battlefield supplies a proper staff of good operating surgeons 
 and executive men ; quick to receive the wounded, to place them in trains, 
 or direct them to remain at the depot hospital; other assistants informed 
 how to procure subsistence, to have food for hundreds or thonsands cooked 
 and served at once, others to superintend the forwarding of wounded in the 
 proper manner — to accompany them if necessary — and especially to ob- 
 serve that none but proper cases were sent away. 
 
 This was in effect a clearing hospital for the whole army, the 
 first clearly conceived one of the war. It was a day's march to 
 the rear, at the head of rail transportation, was not intended to be 
 permanent, and was to be moved by rail when necessary. Mc- 
 Parlin was learning rapidly. His only great mistake was in or- 
 ganizing but one such hospital for the whole army. His outfit 
 would have sufficed possibly for one corps. There were then 
 three corps, and soon after six. 
 
 This hospital was continued throughout the campaign under 
 charge of Surgeon Rauch. Later it was held nearer the battle- 
 field and took on more of the character of a field hospital. The 
 ambulance service at this time was directed by Surgeon Jackson 
 of the 16th Pennsylvania. The ambulances ordinarily remained 
 with their regiments, but were collected and used independently 
 when necessary. This was very unsatisfactory. 
 
 McParlin says that soon after this date he received the Letter- 
 man, plan from the Surgeon General, but there was not sufficient 
 time to put it in operation. 
 
 General Reno joined the army with two divisions from Burn- 
 side's Corps at Fredericksburg on August 14th. Reno brought 
 8,000 men which more than made up for the losses at Cedar 
 Mountain and by sickness and other causes. Banks' Corps, how- 
 ever, was shortly after placed in charge of the army trains and 
 took no part in the battles which decided the campaign. 
 
 When the work at Culpeper was finished the ambulances had 
 been in use for a week; forage was scarce, the animals were be- 
 coming weak, while the brigade and regimental commanders were 
 
14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 clamoring for their return. When away from their own com- 
 mands the animals were often without feed, and the drivers with- 
 out rations. As McParlin observed in his report, a separate am- 
 bulance corps would have obviated these difficulties. 
 
 EVENTS PRECEDING THE BATTLE. 
 
 On August 18th and 19th Pope withdrew to the eastern bank of 
 the Rappahannock. Lee's whole army was approaching. The 
 wounded and sick at Culpeper were all sent to Alexandria, except 
 a few not fit for transportation. With them surgeons volunteered 
 to remain, and supplies were left. The purveyor's stores were 
 packed in six cars and sent on down the railway as far as War- 
 renton Junction (Calverton). The last train left Culpeper on the 
 night of the 19th. The army now took up a position on the left 
 bank of the Rappahannock and Bealeton Station was selected as 
 the site for the hospitals and urgent supplies. 
 
 Everything was made ready for the battle that all expected here. 
 At no other time during the campaign was the Medical Depart- 
 ment so well prepared for battle. But it was not General Lee's 
 purpose to attack. There was skirmishing at the fords resulting 
 in some 250 wounded who were easily cared for and sent to the 
 rear. 
 
 Taking counsel from his troubled experience in loading and 
 unloading stores at Culpeper, McParlin had his cars of medical 
 supplies run on a siding and issued what was needed directly from 
 the cars. 
 
 This plan was so satisfactory that he telegraphed to Alexandria, 
 directing that two cars be fitted up with shelving and fixtures con- 
 venient for issue ; to be filled with the most necessary articles ; 
 such as: medicines, instruments, dressings, stimulants, anes- 
 thetics, prepared foods, blankets, water buckets, lanterns, etc. 
 These cars were ready on the 23rd and were used until burned on 
 the 31st. He also made a last attempt to get the ambulances, 
 medicine wagons, animals and other things necessary to complete 
 his equipment, but the trains were overcrowded and he failed. 
 
 On the 22nd a small cavalry force got in the rear and struck the 
 railroad at Catletts Station, destroying, among other things, the 
 headquarters' baggage. Even the surgeons' things were not 
 spared. McParlin says with evident feeling: 
 
POPE'S VIRGINIA CAMPAIGX. 15 
 
 My office records were scattered, several valuable papers and maps lost, 
 and my servant, horse and bedding had disappeared. * * * It may be 
 conceived what sort of a life was led by us at the front. 
 
 They were destined to see worse things. 
 
 While on the line of the Rappahannock the Medical Director 
 had an unusual amount of trouble with malingerers and skulkers, 
 who thronged every hospital and tried to climb on every train 
 going to the rear. The blame for this was usually put on Sigel's 
 Dutchmen, but it probably existed in most corps. The 60th New 
 York had a virulent outbreak of typhoid, hundreds being stricken 
 in a short time. These men, with the malingerers, overran the 
 hospital at Bealeton. On August 22nd Capt. Fifield, in charge of 
 the Railway there, telegraphed McParlin : 
 
 The enormous number of complaining and sneaking men who come in 
 here claiming to be sick will take all the transportation of the road and 
 nothing will be left for the wounded. 
 
 And Surgeon Rauch sent many similar telegrams, as: "With 
 each supply train I see three or four men running away. A cav- 
 alry patrol should be ordered here to prevent and arrest them ;" 
 and, "I have just stopped a train of ambulances that was going to 
 the rear. If I had the detail of men I would have arrested several 
 drivers." And so on, many others of like tenor; showing a 
 failure of discipline throughout the army. The lack of control of 
 the ambulance drivers grew worse and worse as the campaign 
 progressed. 
 
 From the time that Pope took the line of the Rappahannock the 
 troops had no rest. There was a continual marching and counter- 
 marching. Corps marched up the river one day and down again 
 the next. The men were worn out by repeated and often unneces- 
 sary marches. Not only this, but the daily issue of new orders, 
 often immediately followed by others countermanding them, 
 showed a lack of continuity of purpose, the absence of central con- 
 trolling ideas, that soon became apparent to the body of officers 
 and even to the men. Though the army never failed to fight, and 
 up to the best standards, it was gradually becoming exhausted and 
 spiritless and steadily losing faith in its leaders. 
 
Hi MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 To add to this weakness, rations became scarce and irregular, 
 partly due to insufficient provision, partly due to complex march- 
 ing; one fault reacting on and increasing others. There are still 
 extant letters from officers complaining of the scarcity of food 
 early in the campaign. Jackson's men could live on green apples 
 and roasting ears, but our officers expected something better. 
 When the railway was broken on August 2(5th and supplies had 
 to be wagoned out, the condition was aggravated, and during the 
 closing days of the campaign the exhaustion of actual hunger was 
 added to that of fatigue and mental depression. 
 
 The Confederates doubtless marched as far and had as little to 
 eat. But their marches had a definite (and simple) aim, that 
 could be comprehended by the most ignorant soldier. As to short 
 rations, they hardly expected anything else. And at the end of 
 the campaign they too were exhausted. Jackson's invincible corps 
 marched but nine miles on September 1st. The attack was not 
 pushed with the accustomed vigor and was successfully resisted 
 by smaller numbers. 
 
 On August 25th it was learned that Jackson was moving to the 
 right, but where ? The wounded and sick were sent back to War- 
 renton Junction and the whole army began to move back slowly. 
 The Surgeon General anticipated a general engagement at this 
 time and sent out a party of high ranking medical officers from 
 Washington; but no battle took place and they returned on the 
 28th. Had they waited but a few days longer they would have 
 seen enough of battle and wounded to satisfy any reasonable 
 anticipation. 
 
 Such wounded as came in were cared for in tents at Warrenton 
 Junction, where the purveyor's cars were with plentiful supplies. 
 A temporary hospital had been established at Warrenton for the 
 60th New York and other troops in that neighborhood. This hos- 
 pital was now broken up (Aug. 27th), the furniture and patients 
 were loaded in cars and all sent to the Junction, preparatory to 
 being sent on to Alexandria. The trains were loaded and the 
 army moving on the 27th when, as McParlin says: "Extensive 
 fires appeared eastward in our rear, and it was rumored that the 
 railway was cut by the enemy." This rumor was well founded. 
 
 Jackson, leaving his trains behind, had made a remarkable 
 march of fifty-two miles, passed through Thoroughfare Gap and 
 on to Manassas without Pope's knowledge. The fires were con- 
 
POPE'S VIRGINIA CAMPAIGN. 17 
 
 suming millions of dollars worth of rations and stores in ware- 
 houses and cars at Manassas. (Jackson's corps ambulance train 
 at this time consisted of thirty wagons.) 
 
 Although Jackson held the railway there but 36 hours, he so 
 effectually destroyed the bridges over Broad Run and Bull Run 
 that no more trains got to the rear. The engineers, by hard work, 
 finished Bull Run bridge on the 31st, it was burned again the 
 same night. 
 
 All the trains were now cut off from Alexandria. On August 
 27th General Halleck sent out a brigade of New Jersey volunteers 
 to open up the railway at Manassas. This force crossed Bull Run 
 and had almost reached the Junction when it unexpectedly ran 
 into Hill's Division and was almost annihilated. The survivors 
 fled and did not stop till they reached Alexandria. 
 
 The severely wounded were doubtless left behind and fell into 
 Jackson's hands. He, in turn, was obliged to leave the worst 
 cases next day, but carried the slightly wounded on to Sudley 
 Ford where most of his prisoners were paroled. Banks' Corps 
 reached Manassas on the 28th and picked up all the wounded and 
 sick there, including some Confederates. 
 
 In the march on the 27th Hooker's Division (Heintzleman's 
 Corps) had the advance along the railway. These troops had 
 been hurried out from Alexandria a few days before. Many of 
 the field and staff officers were on foot, their horses not having 
 left Yorktown. It was observed on this march that there was 
 not the usual strife with stragglers, and it was claimed that those 
 mounted officers who had maintained that riding caused greater 
 fatigue than walking, and had heretofore been most exacting 
 with the foot-men, were now the first to fall out from exhaustion. 
 Hooker had a fight with Ewell's Division which maintained a 
 delaying rear guard action west of Bristoe. The losses amounted 
 to 250. Medical Director Milhau established a field hospital at 
 Kettle Run. This division had almost no trains or supplies but 
 had an Autenreith medicine wagon and a few ambulances with 
 headquarters. Next morning a hospital was established at Bris- 
 toe. The purveyor's cars reached Kettle Run that day and stores 
 were plentiful. 
 
 Just previous to Jackson's raid Heintzelman's and Porter's 
 Corps had marched out from Alexandria and Aquia and joined 
 the army near Warrenton, Heintzelman on the 2 1th, Porter on 
 
l,s MEDICAL DEPARTMEXT IX THE CIl'IL WAR. 
 
 the 30th. Reynolds, with the Division of Pennsylvania Reserves, 
 had joined McDowell on the 23rd. The army now numbered 
 close to T 0,000 men. 
 
 On the 27th the various corps had reached the vicinity of 
 Gainesville and points farther south as far as Bristoe, with the 
 rear extending back to Warrenton. On the 28th all moved on 
 toward Centreville, by the Warrenton Pike, the Railway and in- 
 tervening mads. On this day Banks' corps was moved along the 
 railway to guard the wagon trains of all the corps, which had 
 flocked in to Warrenton Junction. Thenceforth this corps guarded 
 trains and took no part in the battles. When the corps moved 
 eastward on this morning McDowell knew that. Lee was ap- 
 proaching Thoroughfare Gap with the balance of his army. So 
 he left Ricketts' Division to guard the Gap. Ricketts engaged the 
 enemy and detained him for three hours, but was forced to retire. 
 Surgeon N. R. Mosely, U. S. Volunteers, was medical director of 
 this division. He established a hospital in a large frame house 
 about a mile in the rear, bringing the wounded, thirty-nine in 
 number, to that point in ambulances. After the battle they were 
 loaded in an ambulance train and started toward the railway at 
 Manassas under charge of Brigade Surgeon J. T. Heard, after- 
 wards medical director of the First Army Corps. This was on 
 Thursday afternoon. 
 
 On Sunday Surgeon Mosely was at the general field hospital on 
 Bull Run. He says : 
 
 I found here Dr. Heard, who had left Gainesville with wounded, in am- 
 bulances on the 2sth. He had been unable to reach Manassas, but the 
 wounded had been faithfully cared for by him, notwithstnding they had 
 been on the road for three days and a half. 
 
 That Surgeon Heard was able to bring his ambulance train 
 through this broken country, filled with marching troops, and 
 everywhere fought over, is not less than remarkable One won- 
 ders how he fed them and what the division did for ambulances 
 during this time. 
 
 On the morning of the 28th Jackson left Manassas, marching 
 around by Bull Run, one division by Centreville, then west on the 
 Pike, to take up a position on a stony ridge running from Sudley 
 Ford to a point a little west of Groveton. Here he remained 
 throughout the battles that followed. An old railway grade along 
 his front made excellent cover. Very late that afternoon, while 
 
POPE'S VIRGINIA CAMPAIGN. 19 
 
 the Union divisions were marching eastward on a fool's errand 
 to Centreville, King's Division (McDowell's Corps) came march- 
 ing down the Warrenton Pike from Gainesville, past Jackson, and 
 all unconscious of his presence. It was sunset when the last bri- 
 gade left the town. The weary men were plodding along and had 
 almost reached Groveton when suddenly shells began exploding in 
 the midst of the column. 
 
 Poorer troops would have bolted, these were of the Iron Bri- 
 gade, now under General Gibbon. They were promptly faced to 
 the left and aided by two other regiments advanced towards the 
 woods. Five brigades of Ewell's and Taliaferro's Divisions 
 marched out to meet them. The lines halted within seventy-five 
 yards of each other and tired into each other's faces until the 
 darkness of an unusually black night ended the useless slaughter. 
 
 The old Stonewall Brigade had met the Wisconsin Iron Bri- 
 gade and on no field of the war was there a more stubborn or 
 murderous combat. "Within the Federal lines the dead and 
 wounded lay in pairs and heaps, a ghastly sight on the green turf 
 beneath the trees, or near a pathway leading from the field, where 
 in the darkness of the night many of the wounded had dragged 
 their fainting bodies. When the surgeons gathered in the 
 wounded, bits of candles and burning torches shed through the 
 gloomy forest a gloomier light." Of the six regiments nearly one- 
 half lay dead or wounded on the field. 
 
 On the other side there was evidence that the Stonewall Bri- 
 gade had at last met men worthy of its steel. 
 
 Ewell lay out in front of the railway embankment, helpless and 
 bleeding, with a ball through the knee! Taliaferro was wounded. 
 Colonel Botts of the 2nd Virginia and Colonel Neff of the 33rd 
 were dead. The Colonel of the 27th and the Majors of the 2nd 
 and 4th were wounded. The losses in the other brigades were ap- 
 palling. These were in Taliaferro's Division. The two brigades 
 of Ewell's Division had 219 killed and 539 wounded. The Union 
 loss, including missing, was about 850. Gibbons' Brigade had 133 
 killed and 539 wounded. The division commander, King, was 
 not wounded, but next day had to give up the command from ex- 
 haustion and sickness. 
 
 When the firing ceased the wounded were gathered up and the 
 brigade withdrawn to the road where the men lay down to sleep 
 with arms in their hands while the generals debated as to what to 
 
•>o MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 do. They decided to leave the Pike and continue the march by 
 way of Manassas. 
 
 All wounded that could bear transportation were loaded in am- 
 bulances ; there could have been little dressing in the darkness that 
 night. The gravely wounded were left on the ground, in charge 
 of surgeons, the report says. Alany lay where they fell, in charge 
 of no one. Fortunately in the battle of the next day the advance 
 of Reynolds' Division reached the scene of Gibbons' battle north 
 of the Pike, and the hospital south. The wounded who had re- 
 mained on the field uncared for during the night, and through the 
 conflict of the day, were recovered. 
 
 It is interesting to note the fatigue, exposure, and deprivation 
 to which men were subjected in this campaign. 
 
 The men of King's Division had marched from early morn- 
 ing on the 28th and went into battle instead of camp at 
 dark. After the conflict described above they had a little rest, 
 but at one they marched again, reaching Manassas at six next 
 morning. Here they had a little food, but before they could 
 butcher the beeves that were to feed them the order to march 
 came again. 
 
 They reached the battlefield in the afternoon and at six were 
 rushed forward at double time for a long distance, and into an as- 
 sault even more fruitless and suicidal than the one of the evening 
 before. The division made this attack alone, and only darkness 
 saved what was left of them from death or capture. The men 
 had neither dinner nor supper this day, and it is said they asked 
 for none, but silently rolled themselves in their blankets at night. 
 
 Few, if any, of the troops had rations that evening. On the 
 afternoon of the 30th King's Division was put in alongside Por- 
 ter's Corps in an attack against the railway embankment. The as- 
 sault was as obstinate as any of the war, but all in vain. Hatch, 
 now in command, was wounded ; and the lines fell back. Mc- 
 Dowell says that Gibbons' Brigade (the Iron Brigade) remained 
 on the Henry House Hill that night until the whole army had 
 crossed Bull Run, then burned the bridge and retired on Centre- 
 rille, which it could not have reached until long after midnight. 
 The division lost 892 men in the three days. 
 
 After King's fight near Groveton the division retired to Manas- 
 sas and Ricketts followed him there. By the morning of the 29th 
 the whole army was at Manassas and points farther east. 
 
POPE'S VIRGINIA CAMPAIGN. 
 
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•22 MEDICAL DEPARTMEXT IN THE CIVIL WAR. 
 
 Banks, Porter and McDowell were near Manassas, Heintzle- 
 man, Reno and Sigel near Bull Run. Pope was at Centreville. 
 
 Jackson sat tight and Longstreet was about to join hands with 
 him. 
 
 The Confederate corps were ready to unite. The Union army 
 could only claim to be between it and Washington. 
 
 Banks' Corps was near Bristoe with the trains. When the 
 medical supply cars were halted there McParlin had three-fourths 
 of the stores taken from the cars and placed in some wagons of 
 Sigel's Corps that were passing. Sigel always clung to his wagons. 
 It was said that Napoleon put his trust in heavy battalions, Sigel 
 in long wagon trains. 
 
 Medical Director Rauch with the operating surgeons, cooking 
 department and stores was sent on to Manassas. The remainder 
 of the stores were left for Banks' Corps. 
 
 When it came up Medical Director Antisell collected 480 sick 
 and wounded and placed them in cars, expecting the bridges to 
 be restored so he could send them on to Alexandria. 
 
 "McParlin often found it difficult to secure rations for the sick 
 and wounded; commissary officers refusing to issue rations ex- 
 cept to their own special commands. To remedy this fault he se- 
 cured the following order: 
 
 Headquarters Army of Virginia, 
 August 29, 1862. 
 To the various commissaries of Volunteers of the Army of Virginia: 
 
 You will each of you issue rations to hospitals in the field on surgeon's 
 requisitions or returns, no matter to what brigade, corps, or command 
 either commissary or surgeon may belong. 
 By order of Major General Pope: 
 
 E. G. Beckwith, 
 Chief Commissary of Subsistence. 
 
 FIRST DAY'S BATTLE. 
 
 On the morning of the 29th Pope prepared to move with all his 
 corps (except Banks') and attack Jacksbn, who still lay on his 
 rocky ridge behind the old railway grade. Banks remained at 
 Bristoe guarding the railway trains and the wagon trains of the 
 whole army. The other corps, heretofore moving eastward, were 
 to turn back and converge on Groveton. They were directed to 
 march around by Centreville, then turn west on the Pike, and at- 
 tack the enemy when they met him. This useless circuit delayed 
 
POPE'S I'lRGIMA CAMPAIGX. 
 
 •>3 
 
■U MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 the battle until noon. Reno advanced near Sudley Springs, 
 Heintzleman north of the Pike and Sigel south. Porter and Mc- 
 Dowell were farther south toward Manassas; McDowell marched 
 north on the Sudley Road but did not reach the field until near 
 night. Porter remained out of the fight the entire day. So of the 
 six corps but three were engaged. Jackson, on the other hand, 
 had been joined by Lee before noon, though not actually aided in 
 the fight by more than two divisions. The fighting was severe and 
 on the right some ground was gained. In the center there were 
 some desperate charges against the railway embankment, but 
 nothing was actua.lly accomplished except useless slaughter. Jack- 
 son's troops were fairly well sheltered and Pope was allowed to 
 shatter his corps against them. The loss in killed and wounded 
 was about 4,000. 
 
 Early on the morning of the 29th McParlin selected the site for 
 his main field hospital. He says : 
 
 Reconnoissance showed that the bridge (R. R.) towards Fairfax Sta- 
 tion was burned. I had to locate the depot near the bridge or ford north 
 of Bull Run (Mitchell's Ford) which was on the road from Manassas 
 to Centreville, and near the main body of the army. At the same time it 
 was accessible by a branch from Centreville to Manassas Junction. Should 
 we remain there long enough to have the bridge repaired (R. R. bridge 
 over Bull Run) we could afterwards transport supplies and wounded by 
 the railroad. 
 
 Manassas had been the headquarters, now at Centreville, and 
 Pope had plainly intimated that he contemplated moving the 
 whole army to Centreville. Unfortunately he did not do so soon 
 enough. So the hospital was naturally located at the ford on the 
 road between the two places. Yet the battle was expected to take 
 place near Groveton or Gainesville and the Warrenton Pike led 
 directly from Gainesville through Groveton to Centreville, almost 
 in an air line. It seems that the eastern bank at the Stone Bridge 
 would have been a better location for the great field hospital in 
 the battle that was to come. It involved transportation for a 
 shorter distance over a better road. 
 
 It is true that the ford is nearer the railway, but there is no 
 good road from there to the railway, east of Bull Run, except by 
 Centreville to Fairfax Station. The branch line offered some 
 prospect in advantages, but they were contingent on Pope's sue- 
 
POPE'S VIRGINIA CAMPAIGN. 25 
 
 cess, which neither his past achievements nor his present actions 
 gave promise of. 
 
 McParlin goes on to say: 
 
 "Inspector Vollum, Medical Director Rauch, and the purveying depot 
 took position immediately at the bridge, occupying a building near the 
 river, which had a well of water in the yard. There were no supplies de- 
 stroyed or left at Kettle Run, all being brought forward to the depot by 
 Dr. Rauch, or used there by Medical Director Antisell. While General 
 Banks remained at Bristoe (until Aug. list) any supplies needed were 
 drawn from the cars by wagons. 
 
 Surgeon Antisell, however, says: 
 
 When the corps left Bristoe Station the train of cars left behind with 
 quartermaster and other stores, one with purveyor's property, were set on 
 fire. 
 
 Banks burned five locomotives, one hundred and forty-seven 
 cars, and part of his trains, by Pope's orders. Most of these cars 
 had been emptied. 
 
 McParlin formed his general hospital early and the battle did 
 not begin until near two o'clock. He says: 
 
 After these dispositions were made, on the 29th, I joined headquarters 
 in front, passing through Centreville and along the Warrenton Pike, be- 
 yond Bull Run. * * * The engagement was kept up actively. Wounded 
 were brought in from the front and received the attention of the brigade 
 and corps medical officers that night. The view from the Headquarters 
 (Buck's Hill, north of the Stone House) embraced a most extended coun- 
 try, filled with troops, the lines of camp fires stretching for miles away 
 towards Thoroughfare Gap. It was confidently expected at Headquarters 
 that the enemy, if vigorously assailed before reinforcements arrived, would 
 be cut to pieces or captured. 
 
 Mut the assailing was piecemeal and reinforcements arrived be- 
 fore noon. Lee's whole army was now up. 
 
 The wounded from the day's action were numerous. I informed the 
 Surgeon General of our condition and prospects, requesting surgeons, bat- 
 tlefield supplies, and ambulances to be sent from Washington ; this by 
 courier to the nearest railway station. 
 
 When darkness fell the gathering up of the wounded from be- 
 tween the lines began. The Federal troops had made a number 
 of determined attacks, reaching positions which, from lack of 
 support, they were compelled to abandon. These assaults left 
 
26 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 many wounded up close to the opposing lines. Warren Lee Goss, 
 in his Recollections of a Private, says: 
 
 At the end of the first day's battle, August 29th, so soon as the fighting 
 ceased many sought without orders to rescue their comrades lying 
 wounded between the opposing lines. There seemed to be an understand- 
 ing between the men of both armies that such parties were not to be dis- 
 turbed in their mission of mercy. After the failure of the attempts of 
 Grover and Kearney to carry the railroad embankment the Confederates 
 followed their troops back and formed a line in the edge of the woods. 
 When the firing had died away along the darkling woods little groups of 
 men from the Union lines went stealthily about, bringing in the wounded 
 from the exposed positions. Blankets attached to poles and muskets often 
 served as stretchers to bear the wounded to the ambulances and sur- 
 geons. There was a great lack of organized effort to care for our 
 wounded. Vehicles of various kinds were pressed into service. The 
 removal went on during the entire night, and tired soldiers were roused 
 from their slumbers by the plaintive cries of comrades passing in the com- 
 fortless vehicles. 
 
 The first day ended gloomily ; thousands had been lost to no ad- 
 vantage ; the men were exhausted, rations scarce, and confidence 
 being gradually lost. Pope telegraphed that night that he had lost 
 8,000 and the enemy twice as many, that Ewell was killed, Jack- 
 son wounded, etc.. 
 
 McParlin goes on to say: 
 
 As the turnpike to Centreville was very rough, several bridges destroyed, 
 and our general depot was near the bridge (Mitchell's Ford), I insti- 
 tuted a search and found a short road running from the Centreville (War- 
 renton) turnpike, near the battlefield, directly to the general depot. I 
 sent circulars to the corps directors, informing them where the wounded 
 should be sent, and stationed some mounted men on the Pike, to direct 
 the ambulances and wounded properly. 
 
 It appears clear from this statement that McParlin had no map 
 of the region, and no idea of its geography except what he grad- 
 ually obtained by experience. It is difficult to believe that the 
 wounded were moved by the Pike nearly to Centreville, and 
 then back to the ford, but that is what was done, until he found his 
 shorter road. Pope, in his order for the battle, had directed the 
 corps from Manassas and the Fords to march by Centreville to at- 
 tack the enemy near Groveton. They were all in need of a course 
 of map study. 
 
POPE'S VIRGINIA CAMPAIGN. 
 
■>S MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 The road that McParlin found appears to have been a by-road 
 leading by the Robinson House, as shown in his map. 
 
 The distance back to the hospital was so great that the ambu- 
 lances could make but few trips, even if the wounded could be 
 reached. 
 
 McParlin's sketch map, submitted with his report, may be com- 
 pared with a correct map of the field, to determine how accurate 
 his mental picture of the ground was. 
 
 His map places the hospital at Island Ford, but his own state- 
 ment and all the other accounts locate it at the Holden House, 
 near Mitchell's Ford. 
 
SECOND DAY. 
 
 POPE should have withdrawn t6 the strong position of Centre- 
 ville on the night of the 29th, but he never saw facts, be- 
 lieved that the enemy was retreating, and next morning sent col- 
 umns to follow him up. All the corps except Banks' were put 
 into the fight on Saturday. The battle once more did not begin 
 until near noon. Jackson was again assailed without success, but 
 now Lee was ready with Longstreet's Corps, which advanced in a 
 wide turning movement south of the Pike, sweeping the Union 
 divisions back in confusion and capturing guns, flags and pris- 
 oners. 
 
 When this took place Jackson also advanced, and both the right 
 and left columns reached Bull Run. The Union center, however, 
 held fast on the old battlefield until darkness halted the Southern 
 advance. In the growing dark Pope gave the order and the whole 
 army defiled over the Stone Bridge, reaching Centreville about 
 midnight, not without some confusion. 
 
 The loss of this day was about equal to that on the first day, or 
 a little less; but as the troops were steadily beaten back, con- 
 tinually losing ground, a large proportion of the severely wounded 
 were left on the field. 
 
 McParlin says: 
 
 On the 30th the battle was renewed on our right and continued for 
 some hours. The enemy seemed to be moving to our extreme left and on 
 Manassas. 
 
 The engagement became warmer hour by hour, especially in the center 
 and near the turnpike. The ambulances had been busy all day conveying 
 wounded to Bull Run hospital depot. I had for this duty the valuable 
 services of a captain and lieutenant of the newly organized ambulance 
 corps of Heintzleman's Corps. I joined Headquarters about four o'clock, 
 observing meanwhile the ambulance and litter service around me- The 
 field for miles away, with moving troops, volleys, explosions and dust of 
 shell and shot were all in view from the high crest which we occupied 
 (Buck's Hill). 
 
 The dust of the enemy's main army train on the left, the advance of 
 our regiments, and the long line of the enemy's artillery fire from the 
 crest of the Manassas Gap Railway were very conspicuous. I believe 
 nearly 1,500 were received and fed in the depots that day. (Apparently 
 
30 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 
 ::-.^... 
 
 ter* rap 
 
 
 *j ... 
 
 
 
 M_QT\Tf{llYSkoifplDED oJt Of i bSL :Effq\GTp. 
 
 no accurate record of the number was kept.) I had made the best ar- 
 rangements which, in my judgment, I could effect with the means at my 
 disposal ; but as I looked over the scene, I felt impressed with a sense of 
 how little could be accomplished at that hour. The wide field for miles 
 resounded to the shock of two great armies. The field in front was 
 shrouded in dust and smoke. Wavering troops emerged from its folds 
 and rallied, while new combatants pressed onwards. 
 
 The tide of battle swept backwards and forwards, the crackling of 
 musketry seemed almost continuous. 
 
 Well might he feel powerless before such a scene. And with 
 troops continually falling back in such a manner even an excellent 
 
POPES VIRGINIA CAMPAIGN. 31 
 
 organization would have been largely powerless. When the re- 
 ports say that brigades and regiments "withdrew" or "fell back," 
 it should not be understood that they moved backward as if on 
 parade. Some of them stood not on the order of their going. 
 
 Fifteen hundred was not more than one-third of the number 
 wounded on the second day. Yet it taxed the capacity of the 
 general field hospital. Provisions and supplies were scanty ; it 
 was extremely difficult to find even hard tack and beef for the 
 wounded there. The supply trains were with Banks at Bristoe, 
 now cut off from the army, by the Confederates. The railroad 
 was impaired and but scant supplies were received from Alex- 
 andria. The small force of surgeons was entirely insufficient. 
 Had all the wounded been brought in this hospital would have 
 been deluged. 
 
 Surgeon Mosely says : 
 
 I took the few wounded to a spot about a mile and a half to the right of 
 the battlefield near a small stream (probable Young's Branch). At this 
 point I met several medical officers, among whom was Surgeon McParlin, 
 the Medical Director of the Army, who informed me that the wounded 
 were all to be sent to the depot hospital in the vicinity of Bull Run. At 
 his request I proceeded there for the purpose of assisting in dressing the 
 wounded. I was engaged in the hospital over Saturday night and during 
 Sunday- 
 
 The hospital was furnished with abundant supplies of hospital stores, 
 food tents, etc. Much difficulty occurred 'for want of laborers and few 
 tents were pitched. Many of the wounded were obliged to lie on the 
 ground exposed to a cold rain which fell on Saturday night and Sunday. 
 
 Surgeon C. F. H. Campbell, U. S. Vols., of Hatch's Brigade, 
 King's Division, says : 
 
 The corps of medical officers at this hospital was so small that the prin- 
 cipal labor of operating, dressing, etc., devolved upon myself and three 
 other medical officers. For three days and nights we worked almost in- 
 cessantly. The wounded were literally crowded in upon us. Our medi- 
 cal and hospital supplies proved ample. It was at this time especially that 
 the new medical wagon (Autenreith) was so thoroughly tested, and found 
 of invaluable service to us. 
 
 Twelve to fifteen hundred wounded were brought in to the Bull 
 Run hospital. All the houses on the field, the Chinn House, the 
 Lewis House, and all up to Centreville were filled with wounded; 
 but when in the growing darkness the columns defiled across the 
 
32 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Stone Bridge, several thousand remained scattered over the hills 
 and through the woods. 
 
 At six on Saturday McParlin received a telegram stating that 
 150 ambulances with 3T supply wagons had left Washington at 
 5 o'clock. Medical Inspector Coolidge, U. S. A., had been as- 
 signed to duty as principal medical officer of all troops west of the 
 Potomac. He left Washington at midnight and was at Centreville 
 by six o'clock Sunday morning. The battle was then over. 
 
 McParlin made the same mistake here that he censured his as- 
 sistants for at Culpepper ; he forgot to evacuate his wounded to the 
 rear. Up to Sunday noon not more than fifty or sixty wounded 
 had reached Fairfax Station, the nearest railway station ; and 
 they were officers and others who reached there casually. A 
 wound appears to have been sufficient authority for an officer to 
 not only leave the field, but to go on to Washington, to his home, 
 or wherever he pleased. 
 
 About 200 wounded reached Alexandria on the 29th, probably 
 from the earlier engagements. One railway train brought in 125 
 of the Warrenton patients. They had been loaded in wagons at 
 Bristoe and hauled across the break in the railway to a train at 
 Fairfax. 
 
 SUBSEQUENT EVENTS. 
 
 On Sunday morning (August 31st) all the divisions were 
 gathered on the heights of Centreville, reinforced by the Corps of 
 Sumner and Franklin from Alexandria. On that day both armies 
 were exhausted and did little. Medical Inspector Coolidge took 
 over the duties of his office at once and proceeded to immediate 
 action. He began to move the whole hospital establishment from 
 Bull Run to the nearest railway point, Fairfax Station, where 
 there were stores and empty trains returning to Alexandria. 
 Medical Inspector Vollum reported that the number of wounded 
 received was 1,200. They reached Washington that evening. As 
 the whole number of wounded was reported as 8,452, and was 
 probably greater, it appears that even after deducting all those 
 who escaped unaided there were three thousand or more wounded 
 still on the field. 
 
 Many wounded had found their way to Centreville; all the 
 buildings in the town and along the road were full of them. One 
 
POPE'S VIRGINIA CAMPAIGN. 33 
 
 hundred were in the little church. These were also to be evacu- 
 ated to the Station ; the ambulances to return. 
 
 Coolidge was unable to do anything for the wounded at Manas- 
 sas and Bristoe. However, Medical Director Antisell of Banks' 
 Corps cleared out the sick and wounded there. Banks was di- 
 rected to "remove all sick and wounded by wagons, even if it 
 necessitates the destruction of much baggage and regimental prop- 
 erty." He had been ordered to destroy all property that he 
 could not bring off, and move to Centreville, which he did on the 
 31st, burning 150 cars and 300 wagons, unnecessarily. 
 
 Surgeon Antisell tells how he found 550 wounded in a train 
 at Kettle Run (from Warrenton, and Hooker's Fight) and two 
 hundred sick (probably from McDowell's and Porter's Corps) in 
 some houses in the vicinity ; also forty sick at Bristoe. 
 
 The troops marching to battle had been obliged to leave their 
 sick on the road at every station and in almost every house. They 
 were all picked up. When Banks left Manassas he left behind 
 a few untransportable cases and 200 wounded Confederates. 
 His sick and wounded were loaded in wagons and started on to 
 Alexandria while he destroyed all the public property and 
 marched by way of Brentsville to join the army at Centreville. 
 He reported that he brought 27? wagons loaded with sick and 
 wounded into Fairfax Station on Sunday. Several hundred 
 reached Alexandria in ambulances that day. 
 
 These things being attended to, Medical Director Coolidge 
 says: 
 
 I went to General Pope and stated that I had been informed that a large 
 number of our wounded were still lyingon the battlefield and requested 
 that he would apply for a flag of truce that they might be removed. The 
 General made the application immediately. The reply was communi- 
 cated too late to proceed that night (Sunday). I, however, directed 
 Medical Director McParlin to have his ambulances ready and to procure 
 from regiments, brigades, and divisions the necessary detail of surgeons 
 and assistants ; the whole to move at six o'clock on Monday morning. 
 I also directed Surgeon Page and most of the niedical officers sent out 
 from the city to accompany him. 
 
 The train of 150 ambulances and 37 supply wagons despatched 
 by the Surgeon General at 5 o'clock Saturday evening arrived at 
 Centreville late Sunday night. Surgeon Charles Page was in 
 charge of this ambulance train. 
 
3i MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 In the later editions of the Washington papers of Saturday this 
 notice appeared : 
 
 SURGEONS AND NURSES WANTED. 
 
 There is pressing need for the services of surgeons and nurses (male) 
 to attend to the wounded of the great battles that have taken place recently. 
 We are requested by the War Department to call tor such Volunteers 
 from this point to repair at once to Alexandria, prepared to stay near the 
 scene of action for some days at least. On reaching Alexandria they will 
 find at the railroad depot provisions made for their prompt transmission 
 to point where their services may be needed. 
 
 This notice was given out by the Secretary of War, but prob- 
 ably on request of the Surgeon General. 
 
 There was a general response to the call and about a thousand 
 clerks and other civilians were at Alexandria for the train that 
 evening. They were packed in box cars and the train did not 
 leave until nine. Then the engine was weak and had to take the 
 train up every grade by sections, so that Fairfax was not reached 
 until six on Sunday morning. When this motley crew (Haupt 
 reported that many were drunk) reached Fairfax they found that 
 no provision had been made for transporting them to the field, 
 twelve to fifteen miles away. Some started forward on foot but 
 were stopped by the guard. They telegraphed to Washington 
 asking what to do and were advised to return, which they did. A 
 few stayed and soon had plenty of work, for that day the wounded 
 were removed from Bull Run to Fairfax ; where some of the vol- 
 unteers rendered real aid. 
 
 This party should at least have been placed in charge of a re- 
 liable officer, with passes and transportation from Fairfax. 
 
 The call for help also brought twelve hundred surgeons from 
 the nearby states. When they reached Washington they found 
 that their services were not needed, so they asked the War De- 
 partment for transportation back to their homes. 
 
 Chaplain Alonzo Quint of the 2nd Massachusetts was at Fair- 
 fax Station on Sunday morning and has described the scene there 
 when the wounded were being brought in from Bull Run. 
 
 I joined a long, long train of ambulances, reached Fairfax Courthouse 
 and then Fairfax Station. The sight there cannot be described. The 
 floors of cars and the roofs were covered. Acres of ground were strewn 
 with the wounded men. Train after train had gone, still the ambulances 
 
POPE'S VIRGINIA CAMPAIGN. ■>,:> 
 
 came on. All night the shriek of the whistle broke the hours of the 
 Sabbath, and morning showed loaded trains still. The wounded were as 
 well cared for as possible, lying upon hay and attended by surgeons. It 
 was sprinkling just enough to make it pleasant. Monday morning I 
 went back to the Court House and on to Alexandria. Still the long 
 trains of ambulances were on the road. The eye wearied, the heart grew 
 faint in seeing them. I was appealed to for water. * * * Every 
 ambulance then used had two kegs for water. I examined them and 
 found that in those long trains, moving a score of miles, there was not a 
 drop of water in the kegs. I am happy to say that in our division such a 
 fact would court-martial somebody. I saw no disorder. 
 
 These ambulances that the Chaplain saw were doubtless from 
 Washington, with drivers picked up from the streets. It was the 
 engineers under Haupt who, without guard, advanced to Fairfax 
 Station and brought off the wounded. 
 
 Haupt protested against sending the crowd of volunteer nurses 
 and shipped them back as soon as he could. From his dispatches 
 he appears to have had the most accurate insight and the best 
 judgment of any one concerned in the happenings of those event- 
 ful days. 
 
 On Monday Medical Director Coolidge sent all his available 
 personnel and ambulances to the battlefield. The supplies were 
 unloaded at Centreville, only a small portion being sent on in 
 ambulances. The ambulance drivers were negroes and the riff- 
 raff of the streets of Washington. When they reached the field, 
 now held by the Confederates, they were stampeded by some 
 cavalry and started pell mell for Washington. It was with diffi- 
 culty that they were restrained. The ambulances and other 
 vehicles were loaded and this train, following the Little River 
 Pike, reached Washington on Tuesday. That day's paper said: 
 "A train of five or six hundrrd wounded from Fairfax arrived 
 in Washington this morning. They were more severely wounded 
 than those arriving previously." These wounded had been left 
 on the field. The others mentioned had contrived to get away. 
 
 The first wounded to arrive in Washington were officers, who 
 were able to command transportation, by hire or otherwise. They 
 seem to have gone to hotels rather than to hospitals. General 
 Schenck, who was shot through the wrist on Saturday, reached 
 Willard's hotel at seven on Sunday morning; and a number of 
 other wounded officers came in that day; also some enlisted men 
 a little later. 
 
3<> MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 Medical Director McParlin went to the battlefield on Monday 
 and selected the peach grove at J. Dogan's house, east of Grove- 
 ton, as the most central place for collecting the wounded. 
 
 There were many wounded lying in houses along the road, but 
 he thought it better to first collect those left scattered, helpless 
 and exposed to the weather. Medical Director Guild of General 
 Lee's Army joined him and arrangements were made for parol- 
 ing. The wounded as fast as paroled were sent to Centreville. 
 Couriers were sent back for subsistence and forage, but it was 
 with great difficulty that any could be obtained. 
 
 The Surgeon General's force was working until midnight on 
 Saturday getting another force of surgeons; with wagons and 
 vehicles for bringing in the wounded. 
 
 As all available ambulances had already been sent out, the 
 Surgeon General called on the Provost Marshal to gather up 
 vehicles wherever he could find them on the streets. Mon- 
 day's Star described this action as follows: 
 
 Saturday night the military authorities commenced to impress all the 
 public hacks, wagons, etc., into service, to be used under the direction of 
 the medical director, in moving the wounded to the hospitals, and yester- 
 day large numbers of them were in service near Centerville bringing in 
 the sick and wounded. Many of the drivers, when night came on, came 
 back to the city, and this morning, with others who had escaped being 
 impressed previously, made their appearance on their stands on the 
 avenue. As soon, however, as one made its appearance, a soldier took 
 possession of the vehicle, drivers and all, and escorted them to the medical 
 director's office, where their numbers and the names of the drivers were 
 taken, and they were organized into trains. This morning all the 
 omnibuses (the old Georgetown line and the present Navy Yard line) 
 were taken possession of, and are now employed in the service of the 
 government. The Western market was the scene of some fun when the 
 seizure was made there Saturday night, the first intimation the butchers 
 and hucksters had of it, being a strong guard who surrounded the market 
 house and then made the wishes of Uncle Samuel known. Some with a 
 good grace acceded to the demand; but others, who had their pots and 
 kettles and unsold merchandise to take home, kicked against it, but it 
 was of no use, for go they must. 
 
 The absence of so many vehicles from Washington on Monday 
 made it necessary to impress other hacks and wagons for use in 
 removing patients from the incoming boats and trains to the 
 various hospitals in the city. 
 
 The story of this train of hacks is worth telling. 
 
POPE'S VIRGINIA CAMPAIGN. 
 
 37 
 
 not /' jTOr ^ 
 
 J is M^ 
 
lis MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 This train numbered two hundred vehicles and carried volun- 
 teer surgeons and nurses ; a gentleman who accompanied it has 
 related its story. Some of the hacks were such miserable old 
 vehicles that they would certainly break down on those terrible 
 roads; the horses had been in use all day and were in no condi- 
 tion to go fifty miles without feed. In one hack some good 
 Samaritan had placed a quantity of liquor for the wounded; it 
 was soon found by the drivers. 
 
 The procession started at nine Saturday night, in charge of a 
 lieutenant of the provost guard, and escorted by some cavalry. 
 The hacks rattled along amid the shouts and imprecations of the 
 drivers, already feeling the influence of stimulants. Proceeding 
 by the Aqueduct Bridge and Falls Church, the column soon broke 
 up into fragments, and the cavalry disappeared in the darkness. 
 Many hacks got off the road and found their way around by 
 Alexandria back to the city. Some of the volunteer nurses 
 induced other drivers to return. 
 
 About daybreak on Sunday Fairfax Courthouse was reached, 
 in a heavy rain. The road from here on was filled with troops, 
 artillery, wagons, ambulances, and stragglers. When the column 
 struggled up the Centreville hill there remained but sixteen of 
 the vehicles that had started. Some had broken down, the horses 
 of others had given out, many had escaped from the line and 
 returned to Washington. It was decided not to go to the battle- 
 field, there being no authority as yet. So they went to the field 
 hospital on Bull Run, loaded up with wounded there, and returned 
 to Washington on Monday. 
 
 A number of surgeons and nurses who went with the party 
 remained and were of real service. The train was a failure 
 because it had no efficient management. 
 
 The supplies from Washington had been unloaded at Centre- 
 ville, but all the ambulances and wagons were busy hauling 
 patients ; and as the Medical Department had no separate trans- 
 portation these supplies could only be taken to the field in driblets. 
 Besides they were needed at Centreville, where there were 
 wounded. 
 
 The ambulances caused endless trouble; they seem to have 
 been under no control. Those sent to Fairfax Station did not 
 return. Those coming from Washington when once loaded re- 
 
POPES VIRGINIA CAMPAIGN. 39 
 
 turned to Washington. All went off with one load of wounded 
 and disappeared, not to return. 
 
 A civilian from Washington, Horace II. Thomas, was one of 
 the volunteer nurses who succeeded in reaching Centreville and 
 accompanied the flag of truce party to the field. He says : 
 
 The Medical Director established headquarters near the Stone House 
 and divided us civilians into squads of eight, with two stretchers to each 
 ambulance; and we entered at once on the mournful task of gathering up 
 our poor fellows from the wide battlefield. This work we pursued day 
 and night with unflagging energy for the next 24 hours. Some of them 
 had lain 48 hours where they had fallen, without any attention, or any- 
 thing to eat or drink, unless they were fortunate enough to have a haver- 
 sack or canteen not quite empty. The dead were unburied and presented 
 a study of ghastly interest. Contrary to my anticipations, most of their 
 faces wore a peaceful expression. * * * I saw hardly a decent pair of 
 pantaloons, a blouse, or a pair of shoes on a dead man. * * * 
 
 Before noon of September 2nd, having filled all our ambulances and 
 other vehicles with wounded officers and soldiers, many of whom had 
 undergone the amputation of an arm or leg, we started on the return 
 trip to Washington, accompanied by 'four or five hundred slightly wounded 
 soldiers who had been paroled- 
 
 On reaching Centreville the whole party was made prisoners; 
 but allowed to go and present their case to General Jackson, who 
 was several miles away. 
 
 The General received them kindly, ordered their release, and 
 the procession reached Centreville again at three next morning. 
 At Fairfax next day they were again held up by Fitzhugh Lee, 
 who happened to be in an ill humor. By some smooth flattery 
 they secured a pass from him in his own writing. "Pass these 
 paroled prisoners, and citizens who accompany them, on their 
 way rejoicing to Washington. Fitzhugh Lee, Brigadier General, 
 Commanding." They went on by Falls Church and _ reached 
 Washington Wednesday night. 
 
 On Monday afternoon, September 1st, the Army evacuated 
 Centreville without notice to the Medical Director. In fact, 
 Coolidge says that Pope gave him misleading information. 
 During that evening the first train of ambulances from the battle- 
 field arrived; the wounded were fed, furnished with blankets, 
 and sent on their way as comfortably as possible. Next morning 
 the Confederates occupied the place. 
 
 Surgeon Coolidge wisely decided to neither send back his 
 hospital stores nor destroy them. That morning he received a 
 
40 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 requisition from McParlin for rations for 1500 men, with a note 
 describing the destitute condition of the battlefield. Application 
 was made to General Lee for permission to send ambulances and 
 supplies, but the reply as to supplies was unsatisfactory. 
 
 In all the statements regarding the care of the wounded on the 
 field it will be noticed that the reports of medical directors are 
 much more optimistic than the accounts of civilians, soldiers, 
 subordinate officers and others. As the medical director saw a 
 certain hospital, supplies were plentiful and everything satisfac- 
 tory. So it may have been to him, he really saw but little of it. 
 But to the assistant surgeon who worked there two or three 
 days and nights, or to the sanitary agent, there was lack of almost 
 everything needful, with great and unnecessary suffering of the 
 wounded. The truth lies somewhere between, but is probably 
 nearer the accounts of subordinate officers. Medical directors 
 were prone to see everything en beaux, while civilians and soldiers 
 are nutoriously given to exaggerating suffering and want. 
 
 Dr. W. W. Keen, then a medical officer, has given some of the 
 most readable reminiscences of the events following this battle. 
 
 I was sent out from Washington to Pope's Army with a large supply 
 train. My supply train was shelled for a short time from a parallel road 
 at some distance to the north of us (Ox Hill or Chantilly) by a Con- 
 federate battery, which seemed to me odd, in view of Pope's proclaimed 
 victory (of Friday). However, I finally reached Centreville (Monday 
 morning) and soon afterwards began to distribute the instruments, 
 blankets, medicines, stimulants, etc., I had brought. I had 400 dozen 
 bottles o>f whiskey, brandy, sherry, etc., 2600 blankets, 600 cases of soups 
 in cans (one of the few things then put up in cans), 800 suits of under- 
 clothes, a dozen operating cases, etc. 
 
 Before I left Washington I had been directed to be rather sparing in 
 distributing these, and I obeyed orders; but afterwards I had good 
 reason tcj regret my want of liberality, for on the third day Colonel 
 Flournoy of the Sixth Virginia Cavalry marched in and took a hand in 
 the game. 
 
 He was accompanied by one of the surgeons of Lee's army, whose name 
 unfortunately I do not remember; but I have a very vivid recollection — 
 when I gave them the key of the little smoke house in which I had stored 
 the stimulants and more valuable things — how their eyes widened and 
 their faces were wreathed in smiles as the doctor, after a rapid survey 
 of the boxes on the walls, turned to the colonel and said with an 
 expletive: "There is more good whiskey in "this little store house than 
 there is in the whole city of Richmond." (The amount of liquor supplied 
 to the Medical Department in those days was enormous.) 
 
POPE'S VIRGINIA CAMPAIGN. 41 
 
 The army left, and left me practically stranded- I was not attached 
 to any organization and nobody gave me any orders; but as I found in the 
 little church in Centreville one hundred wounded men who needed atten- 
 tion, I saw my duty well marked out All these men were severely 
 wounded, for the slightly wounded marched away with the army. Upon a 
 few mattresses, and with almost no other conveniences or comforts, the 
 men were laid in rows upon the floor. Most of them had, in fact, not 
 even a mattress, but only a little straw under them, and this in a very 
 little time, when "laudable pus" began to flow, became soiled and had to 
 be diminished daily. The bedsores which followed were something fright- 
 ful, often larger than an entire hand ; and when we add to all this the 
 secondary hemorrhages, which often soaked the floor before they could 
 be arrested, one can have an idea of the sufferings of these poor fellows, 
 and of the task of those who were caring for them. * * * 
 
 The third day after the battle (probably Monday night) I passed such 
 a night as I had never before experienced in my life. Long trains of 
 ambulances arrived, carrying wounded from the field of battle back to 
 Washington, and there were but four surgeons to look after them and 
 their .many imperious needs. Fifty poor thirsty fellows were crying for 
 water; fifty more were crying with the pain from a jolting ride of nne 
 miles over a corduroy (?) road. Most of them had had nothing to eat 
 for one, two, or three days, save what they had obtained from haversacks 
 of the dead. 
 
 Some had such horrible wounds that they could absolutely go no 
 further and must be got out and taken into the hospital. * * * I 
 took a bottle of morphine and my pocket knife (there were no hypo- 
 dermics then) and did not worry over any superfluous exactitude in 
 doling out the blessed relief which morphine brings to men in pain. All 
 this was dune in t"tal darkness, with two or three dim lanterns, in a 
 drizzling rain, and in six inches of Virginia mud. 
 
 Fortunately just as cur food was giving out, an ambulance train arrived 
 and took our patients and ourselves back to civilized conditions and 
 surgical opportunities. 
 
 On the evening of September 1st, just at darkness in a driving 
 rain, there was another fierce encounter a short distance up the 
 Little River Pike from Fairfax Courthouse. Some divisions of 
 Reno's and Heintzleman's Corps struck Stonewall Jackson's 
 advance and succeeded in halting it, though with a loss of Gen- 
 erals Kearney, Stevens, and more than a thousand killed and 
 wounded. 
 
 This night was one long remembered by everyone taking part 
 in the gloomy drama then enacted. The rain that had drizzled 
 throughout the day turned to a violent storm at dark. The 
 veterans of Jackson's Corps complained bitterly of the driving 
 
45 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 rain that spoiled their cartridges and beat them back as they 
 strove to advance through the dark and dripping forest. 
 
 An officer of Banks Corps, marching by the old Braddock 
 Road, relates how the fury of the storm almost swept the column 
 from the road; and when they reached Fairfax Station at mid- 
 night the rain had converted the low ground into marshes, in 
 which the weary, bedraggled soldiers sank to a miserable bivouac. 
 If it was so depressing physically and mentally to men still sound 
 and well what added degrees of wretchedness must it not have 
 brought to the thousands of wounded still lying scattered over 
 the battlefield; unsheltered, uncared for, alone? 
 
 Finally, on September 3rd, Medical Director Coolidge him- 
 self went to the field, where the wounded had been mostly col- 
 lected in and around houses, but some were still merely in 
 groups in the fields, with no shelter except blankets. There were 
 but two groups, of 3D each, without surgeons. Coolidge says: 
 
 After my arrival only four of our wounded were found completely 
 isolated and without attendance. (This was five days after the first day's 
 battle.) None had been absolutely without food, though the amount was 
 extremely limited. In some cases the surgeons had succeeded in pro- 
 curing a sheep or a pig and some corn meal; and in one place, the Van 
 Pelt House, they found coffee, sugar, wine, and cider, and were able 
 to procure meat. (There were 196 wounded men at the Van Pelt House.) 
 Although doubtful of the propriety of so doing, I passed the night with 
 Medical Director Guild (of General Lee's Army) at his camp on the 
 battlefield. 
 
 On Thursday (September 4th) the first train of ambulances (2nd) 
 from this city arrived on the field with fresh bread and an abundant and 
 varied supply of food and hospital stores. I immediately dispatched the 
 ambulances with provisions in every direction over the field, and to bring 
 to the central station all who were without shelter. From that moment 
 trains of ambulances, each with medicines, food and stores, arrived in 
 rapid succession. 
 
 When Surgeon Coolidge says "first train from Washington" 
 he evidently means the first train after his arrival on the field. 
 Other trains had reached the battlefield two days previously. 
 After Coolidge's arrival he sent a telegram to the Surgeon Gen- 
 eral, informing him of the situation and requesting that food, 
 forage and 300 ambulances be sent at once. The Surgeon Gen- 
 eral had no 300 ambulances to send. The Army was marching 
 into Maryland for a new campaign and Letterman was calling 
 loudly for hundreds of ambulances. 
 
POPE'S VIRGINIA CAMPAIGN. 43 
 
 Supplies were made ready and the cab-drivers were again 
 rounded up and sent to the field. It is interesting to learn just 
 what such a measure actually accomplished. Here it is: 
 
 Report of Assistant Surgeon J. J. Woodward, U. S. Army: 
 "On the afternoon of Thursday, September 4th, I was requested by 
 the Surgeon General to collect and take charge of such hacks, omnibuses 
 and other vehicles as could be collected in the City cf Washington, and to 
 proceed with them to Centreville for the relief of the wounded. The 
 vehicles having been collected by a company of cavalry, a few army 
 wagons loaded with cooked provisions and other supplies were added, 
 and we set out about 1 lo'clock Thursday night; the train consisting of 
 about one hundred hacks, forty ambulances, wagons and other vehicles. 
 We arrived at Centreville about noon next day (Friday), and having 
 been permitted to pass by the Confederate officer in command, reached 
 the orchard (at the Dogan house, east of Groveton), where most of the 
 wounded were congregated, the same afternoon. During the following 
 day (Saturday, 6th), the train was loaded with wounded, some six or 
 seven hundred in, number, and reached Washington about daybreak Sun- 
 day morning." 
 
 It appears that a train like this could be used to make one trip 
 out and back, if properly managed, but could not be depended on 
 for anything more. 
 
 An amusing incident occurred a few nights later: The hack 
 drivers, having been twice impressed for these long night rides, 
 with danger of accident and loss of business, had become nervous 
 and easily alarmed. Some wag who had a score to settle with 
 the hackmen caused it to be whispered around one evening that 
 they were about to be called out again. In a few moments the 
 stands in front of Willard's, Kirkwood's, Brown's, and the 
 National were deserted, the hacks and carriages disappearing 
 towards the suburbs in a cloud of dust, with much cracking of 
 whips and many oaths. 
 
 Surgeon B. Howard, U. S. Army, who accompanied McParlin 
 to the battlefield on Monday, does not agree with him as to the 
 wounded not being without food. He says: 
 
 A peach orchard (J. Dogan's) on the right of the turnpike was made 
 the rendezvous, whither the surgeons were directed to bring the wounded. 
 Many surgeons, however, in charge of ambulance trains, when loaded, 
 proceeded to Centreville. This caused a scarcity of ambulances and of 
 surgeons, so that operators could not get assistants and had to rely on 
 non-professional help in the most difficult operations. The battle began 
 
44 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 
 
 at 
 
POPE'S VIRGINIA CAMPAIGN. 45 
 
 on the 28th and continued until the evening of the 30th. All the wounded 
 were not brought in (to the peach orchard) until the 6th of September. 
 Some of them stated that they had received no food, drink nor assistance 
 from the time they fell until brought off by the ambulances, going a mean 
 of four and a half days without food. 
 
 On the evening of Tuesday there arose very heavy thunder storms 
 which were repeated the next two days, drenching the wounded. Of those 
 brought to the peach orchard, with few exceptions, all were submitted to 
 the necessary operations before being removed further. 
 
 On September 3rd there were about 3,000 wounded men on the field, 
 but still no food, everybody suffering from hunger, and although con- 
 stantly operating, I had only a little brandy and sugar. Shortly after a 
 train of ambulances arrived. Supplies of every sort now abounded, and 
 all the remaining wounded were conveyed in ambulances to Washington 
 on Saturday and Monday, September 6th and 8th. 
 
 Surgeon A. H. Smith, U. S. Army, of Rickett's Division, also 
 went back to the field on Monday morning. He says that the 
 ambulances, 200 in number, took but a portion of the wounded 
 and did not return until Thursday. It rained heavily just at dark 
 (on Monday), followed by a cold wind. He and Surgeon 
 Shackelford of the 94th New York went to where their brigades 
 had been engaged and collected sixty or seventy of their wounded. 
 They spent the night in carrying rails to build fires and in dis- 
 tributing soups, brandy and supplies. Next day there was no 
 food, but they happened to have tea and managed to find a camp 
 kettle. The greatest difficulty experienced by all medical men 
 was to find food and blankets. 
 
 B. B. Emery, one of the volunteer nurses, says that on Wednes- 
 day they found a group of 25 or 30 wounded who had had no 
 food or drink since Saturday, the nurses could not get a bite to 
 eat from Monday to Wednesday, and many of the wounded died 
 from starvation. Another nurse says he lived four days "on 
 corn and apples like the rebels." 
 
 The removal of wounded from the field was completed on 
 Tuesday afternoon, September Oth. The last train of ambulances 
 reached Fairfax Seminary Hospital on Wednesday Morning, 
 September 10th, with 142 wounded, twelve days after the first 
 days' fight. On the ninth a train of fifty-two ambulances went 
 out, but could not find a single wounded man. 
 
 On Saturday, September 6th, the 139th Pennsylvania Volun- 
 teers was sent to the field under a flag of truce and began bury- 
 
16 
 
 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 ing the dead. Although the Confederates had buried some, 
 there were many bodies unburied. Most of these were not 
 identified. As many persons came to the field later trying to 
 find the bodies of friends or relatives, the Washington papers 
 published a notice saying that identification was impossible. 
 
 NOTICE. 
 
 Our dead there were necessarily buried in trenches containing from one 
 to three hundred corpses each, and by persons unable to identify one of 
 them. In some few cases they were identified, a stake marked with a 
 pencil with the name of the deceased directs where his remains may be 
 found. 
 
 These things are of interest to those who think that after a 
 great battle all the minutiae of an elaborate system of identifica- 
 tion of the dead and preservation of their property may be 
 carried out. As late as September 23 a force was sent to the 
 battlefield to bury dead still lying scattered about. 
 
 While a part of the wounded were carried to Fairfax Station 
 and from there by train, the railway was a poor one and could 
 not carry all. A paper of September 2nd said : 
 
 During last night three trains of cars came into the Maryland Avenue 
 station, one loaded with wounded and two bringing sick from the Falls 
 Church hospital, which has been broken up. Arriving in' the dead of 
 night, in a pouring rain, and with many of the sufferers exposed to the 
 full fury of the storm in open cars, they had a hard time of it. 
 
 On September 4th the Surgeon General gave out the first 
 estimate of wounded, the number of which he placed at 4592. 
 He supposed that 1800 still remained on the field. Later it was 
 estimated that the number of wounded received in the hospitals 
 of Alexandria and Washington was approximately 6000. As the 
 whole number of wounded from August 27th to September 1st 
 was reported to be about 8500, the remainder must have been 
 mortal or slight wounds. 
 
 Surgeon Brinton has described how the wounded reached 
 Washington. 
 
 Those who were injured in the earlier battles were transported from 
 Fairfax Station to the metropolitan hospitals in ordinary freight cars, 
 in most cases provided with straw, and oftentimes with cots. These 
 wounded were consequently received in a condition which compared 
 most favorably with that of their less fortunate comrades, who under- 
 
POPE'S VIRGIXIA CAMPAIGX. 
 
 i 
 
 24- .>■'*& 
 
 MR. r 
 
 W 
 
 •v- - -.*■■•-•/; 
 
 r'fc 
 
 3 
 
 4' 
 
 
 *n 1' 
 
 "■•it 
 || 
 
 -I' 
 
 1 
 
 — » 
 
 X 
 
 * 
 
 fe-'' * V * ■.,■■■ L 
 
 went the tortures of exposure on the field, starvation, and subsequent 
 removal in jolting ambulances. 
 
 The horrors of transportation over twenty-five miles of rough country 
 can scarcely be described, and will never be forgotten by those whose 
 painful duty it was to witness it. 
 
 There were no "untransportable cases" on those fields. All 
 the survivors were brought away, regardless of wounds or roads. 
 It seems that under the terrible strain of those days the strongest 
 
48 MEDICAL DEPARTMENT IN THE CIVIL WAR, 
 
 men lost their judgment. The smoke of the tremendous battles 
 filled their brains, and they lost their usual faculties. The fates 
 seemed against them, and they appear now to have acted with a 
 dogged indifference to consequences. 
 
 A last glimpse of the road to the rear: On Monday morning 
 the correspondent of the New York Tribune left Alexandria for 
 the front. The army was falling back on Washington. 
 
 For the next ten miles the road was filled with the trains of every corps, 
 everywhere crowded, and frequently halting. * * * Mingled with the 
 trains was a great number of ambulances and carriages filled with 
 wounded and dying men. They had been all day long on the road, a day 
 of confinement, privation, discomfort and torture. Many must have 
 remained all night on the road; many also in wagons, which as carriages 
 for the wounded are only one degree worse than ambulances. 
 
 Some of these may have been Surgeon Heard's ambulances 
 which started from near Thoroughfare Gap on Thursday. 
 'Medical Director Coolidge concludes his report as follows: 
 
 Our wounded were collected in 21 field hospitals within an area ten 
 miles long by seven wide. It was impossible to ascertain with precision 
 the nurabi^ of wounded, but I estimate it to be four thousand (left on 
 the field). * * * I cannot close this report without commenting on 
 the conduct of the ambulance drivers. It was with greatest difficulty 
 that I could put a reasonable limit to their stealing from my commissary 
 and hospital stores. * * * Some would appropriate to their own use 
 the hospital blankets and be highly insolent when they were taken away 
 for the wounded..- 
 
 Very few would assist in placing the wounded in the ambulances ; still 
 fewer could be induced to assist in feeding them or giving them water. 
 Some were drunk, many were insubordinate, others when detected in 
 possession of stores would not 'give them up until compelled to do s» by 
 force. * * * The practice of loading ambulances with forage, camp 
 kettles, personal baggage and subsistance for the drivers needs correction. 
 * * * A wagon with stores and forage should accompany every train 
 of fifty ambulances (we now think twelve necessary) and nothing but 
 sick and wounded men and water should be put in the vehicles them- 
 selves. The service greatly needs a well-organized ambulance corps, and 
 I hope the Secretary of War will adopt the organization you have recom- 
 mended. (The Letterman plan.) 
 
 McParlin spoke in the same line : 
 
 Thousands were wounded and all the transportation at our disposal 
 was inadequate. At such a time a well organized, regularly established 
 ambulance corps would have been a blessing. * * * If the Medical 
 
POPE'S VIRGINIA CAMPAIGN. 4!) 
 
 Department must transport its wounded let it at least be done sys- 
 tematically, as in the armies of Europe. A permanent ambulance corps 
 once established can have its duties in action and at all other times denned 
 by regulations. 
 
 These reports and the many accounts of the sufferings of the 
 wounded in this battle led the Surgeon General to recommend 
 that the Letterman system be at once put in use in all the armies. 
 Unfortunately, General Halleck did not approve it for another 
 year. As the armies operating against Richmond were united, 
 this made no particular difference. 
 
 The Western armies, as a rule, already had a brigade ambulance 
 and field hospital system, and they adopted the Letterman system 
 when the campaign began the next spring. Only one battle was 
 fought in the meantime, Stone's River. 
 
 When these thousands of wounded reached Washington they 
 exceeded the hospital capacity, which was not nearly so great 
 then as it became later. New hospitals had not been built, build- 
 ings of every kind being still used for hospital purposes. A paper 
 of that time said : 
 
 This sudden arrival of so many wounded soldiers overtaxed the hos- 
 pital facilities of Washington ; some of the men brought in from Center- 
 ville, who could not gain admission to the hospitals, were taken to the 
 city hall, where they were provided with cots and blankets. Surgeon 
 Campbell, medical director in charge of this military district, issued an 
 order Sunday, August 31, published in The Star the next day, calling upon 
 all persons willing to receive convalescent soldiers into their homes from 
 the hospitals to make room for those wounded in the recent battles, 
 to notify his office of their names, etc. So great was the pressure for 
 hospital room that the prisoners in the Georgetown prison were removed 
 under guard to the old Capitol prison and central guardhouse in order 
 that the building might be used for hospital purposes. 
 
 The Patent Office had been turned' into a hospital, and even the 
 Capitol was prepared for patients. Cots were placed in the 
 rotunda, the senate and representative halls, and the corridors, 
 and wherever there was room for them. Three thousand sick 
 and wounded were sent North to make room for the new arrivals. 
 The supply of lint was about exhausted. On Saturday, August 
 30th, Surgeon General Hammond had the following notice pub- 
 lished in the evening papers : 
 
50 MEDICAL DEPARTMENT IN THE CIIIL WAR. 
 
 AN APPEAL. 
 
 To the Loyal Women and Children of the United States: 
 The supply of lint in the market is nearly exhausted. The brave 
 men wounded in the defence of their country will soon be in need of it. 
 I appeal to you to come to our aid, etc., etc. 
 
 William H. Hammond, 
 Surgeon General. 
 
 Calling on the children strikes one as unusual, but was wise. 
 A nation at war can neglect no resource. 
 
 About the same time the Provost General ordered that no 
 spirituous liquors should be sold at retail within the limits of the 
 District and that the Provost Marshal should seize and turn over 
 to the Surgeon General all liquors found in retail stores. 
 
 If some of the measures of the Surgeon General were not well 
 considered or were poorly carried out, it is certain that he was 
 resourceful and energetic in this the greatest emergency of the 
 war. 
 
 Although the cannonade at Bull Run was plainly heard in 
 Washington and many professed to smell the burning gun- 
 powder, there was no panic. 
 
 COMMENTS. 
 
 A study of the whole campaign brings out little that can be 
 held up as an example to be imitated. It shows very much to 
 be avoided, if possible. There are many who believe that such 
 conditions could not obtain and such results could not occur again 
 in our armies. I am not one of them. They can occur and would 
 occur if we should be hurried into war with a great power. 
 
 This battle took place sixteen months after the war began; 
 preparation could be made and staff departments organized much 
 more rapidly to-day, but the Franco-Prussian War was decided 
 within six weeks. Could a complete medical staff be organized 
 and equipped in six weeks, or in twelve weeks ? 
 
 In spite of the fact that this campaign was a miserable failure 
 from almost every point of view, it affords as valuable lessons as 
 any of the war. 
 
 The mistakes and shortcomings of the Medical Department, 
 the awful suffering following the battle, were a convincing object 
 lesson to the medical officers on the field, to the Surgoen General, 
 
POPE'S VIRGINIA CAMPAIGX. 51 
 
 and to everyone cognizant of them. After the lapse of fifty years 
 they remain the most terrible example in all our history of suffer- 
 ing on the battlefield. Yet there was a sufficient number of 
 medical officers, and they did their duty as they saw it, fully 
 and bravely. 
 
 The general conduct of the Medical Department was good up 
 to the great battles; at Cedar Mountain it was exceptionally 
 good. As long as the army was in camp, on the march, or even 
 engaged in minor combats, the medical service was satisfactory. 
 But the one field hospital was. only sufficient for one corps, and 
 there were six ; but one was engaged at Cedar Mountain. When 
 the great battles came and five corps were engaged it was like the 
 outbreak of fire in a Filipino village, where everyone comes run- 
 ning with whatever he can grab up, and every means is used, in 
 confusion and with little effect. 
 
 Witness the hasty sweeping up of vehicles from the streets, 
 and their departure without adequate control; the hurried 
 assembly of surgeons and nurses ; the desperate efforts to secure 
 food for the wounded ; the improvisation of hospitals in churches, 
 and even in the Capitol. These things were all done in haste, 
 without preconceived method or plan, because no adequate 
 measures had been adopted for handling the wounded from a 
 great battle. It will also be observed that they were done by the 
 Surgeon General himself, or his personal representatives. Had 
 the whole field of operations been organized this should have 
 been unnecessary. A medical officer in charge of the base would 
 have had ten thousand beds ready, with personnel and supplies. 
 Another, in charge of the short line of communications, should 
 have been prepared to transport two thousand wounded or more 
 every twenty-four hours. He would have given notice when the 
 trains were ready and when they would arrive in Alexandria or 
 Washington. 
 
 As for the service of the front, there were sufficient officers 
 had they been organized; McParlin says there were 273 in the 
 three original corps; say one to each 150 men. Each regiment 
 (about 450 men) had three surgeons, one for the firing line, as 
 was the custom, and two for the field hospitals. 
 
 This gave some twenty or t went}- five officers for each division 
 field hospital. During the latter part of the war these hospitals 
 were managed in a satisfactory manner with from twelve to 
 
52 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 fifteen officers. The corps and divisions of those days correspond 
 in numbers to the divisions and brigades of to-day. 
 
 Ambulances were inadequate in number and had little organiza- 
 tion, or even control. The manner in which the ambulance 
 drivers acted is astounding. It appears that they were mostly 
 hired drivers, which shows the value of a service corps ; and of 
 having every man with a mobile army under complete military 
 control, which is only possible when he is an enlisted soldier. 
 Furthermore, an enlisted corps of any kind develops a pride in 
 its work and a sense of loyalty to duty which the hired civilian 
 seldom has. The work of the ambulances was about as bad as it 
 could be. But sweet are the uses of adversity. No stronger 
 argument for an ambulance corps could be advanced than the 
 outrageous and despicable action of the ambulance drivers in this 
 battle. 
 
 The system of supplies was not quite so bad as the rest. The 
 railway train of reserve supplies was an excellent idea, and one 
 that will probably be adopted in the future, with an army ad- 
 vancing along a line of railway. To complete the supply system, 
 however, there should have been a small wagon train for each 
 corps, to run between the railhead and the corps camp. These 
 corps equalled our modern divisions and six wagons would have 
 been sufficient. The army was never more than a day's march 
 from the railway, seldom so far. The nearness to the base was 
 properly relied on as making the amount of supplies to be carried 
 much less than when operating at a greater distance. In the 
 Chickamauga Campaign each corps had a supply train of from 
 eleven to fourteen wagons. The Autenreith medicine wagon was 
 first thoroughly tried out in this campaign. At the beginning they 
 were top-heavy, upsetting and getting smashed on every bad 
 piece of road. This fault was remedied and by the end of the 
 operations every medical officer was praising this type of wagon 
 as a sort of Pandora's box, from which all good and necessary 
 things for the field hospital could be quickly drawn. 
 
 McParlin's system of field hospitals was not a success. One 
 great field hospital could not accommodate an army of sixty 
 thousand men in battle. Bull Run was the proper location, but 
 there should have been hospitals behind each bridge and ford, 
 particularly the Stone bridge. His general field hospital was 
 greatly deficient in personnel. The surgeons near the front, at 
 
POPE'S VIRGINIA CAMPAIGS. 53 
 
 the various advance hospitals, having been instructed to send 
 their wounded to the main hospital, doubtless did so without 
 hesitation; their establishments thus becoming dressing stations 
 rather than hospitals; but they remained at the front, leaving 
 the main hospital undermanned. The loss of the field did not 
 embarrass the work of the hospital ; rather made it simpler, for 
 the time being. 
 
 An actual clearing hospital was maintained at Culpepper, and 
 later at Warrenton. When the troops reached Bull Run McPar- 
 lin seems to have thought the army so near its base that such a 
 hospital was no longer necessary, and converted this hospital into 
 a field hospital. This was a mistake. The distance was more 
 than a day's march, practically two; and the railway was still 
 in operation. When the army was at Bull Run on August 28th, 
 and the railway broken for several miles, a clearing hospital 
 should have been immediately established at the first station east 
 of the break — Fairfax. That was the first thing Coolidge did 
 when he arrived on the 31st. It is true that the ambulances were 
 all busy at the front, but there were wagons returning, and there 
 are always hundreds who can walk. They could have been 
 directed to one point instead of scattering in all directions, and 
 taking ambulances off to Alexandria and Washington. 
 
 This clearing hospital under the circumstances would have 
 been rather nominal as a hospital ; some hay to lie on, with food 
 and attendants. The main idea should have been to get the 
 wounded to the rear, with an economical use of the insufficient 
 transportation. As it was, ambulances were going all the way to 
 the Potomac while trains were covering the same route. With a 
 clearing hospital for 1500 or 2000 at Fairfax Station and field 
 hospitals behind the fords; with ambulances held at the front 
 and railway trains utilized in the rear; a very large number of 
 the wounded could have been collected and sent to the rear before 
 the railway was abandoned — September 2nd. 
 
 In any case, hundreds of wounded must have been left on the 
 field. As Billings observed at Chancellorsville, it is one thing 
 to take up and care for wounded when the troops are successful 
 and moving forward : it is quite another thing to bring them off 
 when the troops are losing ground. Also, when troops make a 
 strong assault and penetrate the enemy's lines, only to be driven 
 out again, as was the fate of Graver's, Hatch's and other 
 
54 MEDICAL DBPARTMEXT IX THE CIVIL WAR. 
 
 brigades, many of the wounded will unavoidably be left behind. 
 The same thing occurred later at Cold Harbor, when there was 
 an excellent ambulance organization. 
 
 Neither in this nor other campaigns was any medical officer 
 assigned to the line of communications. The chief medical 
 officer at the front sent medical officers with the trains when he 
 could spare them. McParlin did have medical officers and 
 attendants with supplies at the point of entrainment, a place 
 where the wounded were only too often neglected. The railway 
 during the campaign was under the sole control of Colonel Haupt 
 of the Engineer Corps, subject only to the orders of General 
 Halleck. But for Haupt's tireless energy there would have been 
 no trains at Fairfax ; the indifferent generals at Alexandria would 
 not even furnish him a guard. 
 
 McParlin allowed his wounded to pile up at ISull Run, for- 
 getting to evacuate them; Coolidge moved the hospital to the 
 Station, but also seems to have been in no hurry to move the 
 wounded further; it was Haupt who hurried them on to Wash- 
 ington. 
 
 Manassas and Chickamauga were similar battles in many 
 respects, especially in numbers engaged, losses, and outcome. At 
 Manassas there was practically no organization, either of am- 
 bulances or field hospitals; about twice as many wounded were 
 left on the field as at Chickamauga, where natural conditions 
 were more unfavorable, but there was a fair medical organiza- 
 tion. But while at Chickamauga surgeons, attendants, tents, and 
 some supplies were left with the wounded, at Manassas they 
 were, for the most part, left helpless and alone. Not even at 
 First Bull Run were the wounded so entirely abandoned, and 
 but for the panic on that day they would have been as well 
 .cared for. 
 
 Yet no one is especially to blame. Letterman's ambulance plan 
 had just been promulgated. McParlin says there was no time to 
 put it in operation. Supply and field hospital plans were still in 
 the future. It is a satisfaction to write that this was the last 
 battle with the Medical Department working without authority 
 and in the old haphazard manner. The next great battle was to 
 see better things, and, from that time on, a steady improvement. 
 
POPE'S VIRGINIA CAMPAIGN. 55 
 
 MEDICAL OFFICERS OP THE ARMY AT MANASSAS. 
 
 Medical Director Surgeon Thomas A. McParlin, U. S. Army 
 
 Medical Inspector Surgeon Edward P. Vollum, U. S. Army 
 
 Medical Purveyor Surgeon Josiah Baxter, U. S. Army 
 
 Medical Director McDowell's Corps— Surgeon D. L. Magruder, U. S. Army 
 
 Rickett's Division Surgeon N. L,. Mosely, U. S. V. 
 
 King's Division Surgeon Peter Pineo, U. S. V. 
 
 Reynolds' Division Surgeon William King, U. S- Army 
 
 Medical Director Sigel's Corps Surgeon George Rex, U. S. V. 
 
 Schurz' Division Surgeon Hamlin, U. S. V. 
 
 Schenck's Division Surgeon J. B. Peele, U. S. V. 
 
 Medical Director Banks' Corps Surgeon Thomas Antisell, U. S. V. 
 
 Greene's Division Surgeon John H. Rauch, U. S. V. 
 
 William's Division Surgeon Artemus Chapel, U. S. V. 
 
 Medical Director Porter's Corps Surgeon R. O. Abbott, U. S. Army 
 
 Sykes' Division. .Asst Surg. W. H. Forwood, U. S. Army 
 
 Morrell's Division, 
 Medical Director Heintzelman's Corps. Surgeon John J. Milhau, U. S. Army 
 
 Hooker's Division Surgeon Thomas Sim, U. S. V. 
 
 Kearney's Division.Surgeon George L. Pancoast, U. S. V. 
 Divisions of Ninth Corps: 
 
 Reno's Division Surgeon Calvin Cutter, U. S. V. 
 
 Stevens' Division, 
 
EVOLUTION OF THE AMBULANCE CORPS AND FIELD 
 
 HOSPITAL 
 
 The question is not where they were, but which way they 
 were going. Were their faces set forward or backzvard. 
 
 Macaulev. 
 
 FOLLOWING Bull Run there was little immediate improve- 
 ment in the Medical Department of the Army. The Army 
 of the Potomac was organized; line and staff corps gen- 
 erally were placed on an adequate basis; but the Medical De- 
 partment remained much the same. The division, or even bri- 
 gade field hospital, had no existence. No such thing was con- 
 templated by Army Regulations or orders. There was a small 
 regimental personnel, providing regimental aid at the front ; there 
 were base hospitals (in old buildings) at the rear, and practically 
 nothing more. Each regiment had a surgeon, an assistant 
 surgeon, a hospital steward, an orderly for each medical officer, 
 and a few men detailed from the line to act as cooks and nurses. 
 The band was expected to assist with the wounded on the battle- 
 field, but no band ever rendered any noteworthy service in this 
 way. 
 
 The law of July 22, 1862, provided for a surgeon on the staff 
 of each brigade but gave him neither personnel nor equipment. 
 A medical director for each division had already been appointed 
 under authority of an order by the President. This personnel, 
 with regimental equipment, and such supplies as could be brought 
 up after each battle, were the only provisions for care of the 
 wounded. The regimental units gave first-aid and their ambu- 
 lances removed the wounded to hospitals established by the 
 division medical directors, or more often by themselves. These 
 hospitals were in buildings, only exceptionally in tents, before 
 Letterman's advent. The removal of the wounded from the 
 field hospitals to the rear devolved on the quartermaster, any 
 available wagons being used. 
 
 Usually in Virginia the rail or river advance base was very 
 close to the rear of the army, making evacuation of wounded 
 easy. For the Peninsular Campaign the base was at White 
 House on the Pamunkey, later it was on the James River. In 
 the West, both at Donelson and Shiloh, river steamers came 
 almost to the firing line, and evacuation of the wounded was 
 
I 
 2 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 simple. Later the Mississippi became a great highway for the 
 sick and wounded from Memphis and Yicksburg. Transporta- 
 tion by boat was recognized as being far preferable to trains 
 for wounded men. 
 
 Base hospitals were established early: in Washington, Balti- 
 more, Philadelphia, Cumberland, Frederick, Alexandria and other 
 places in the East ; and in Cincinnati, Louisville, Cairo, Mound 
 City, St. Louis and other places in the West. These hospitals 
 need no special description. At first old hotels, academies, and 
 other unused buildings were leased for hospital purposes; later 
 the Sanitary Commission entered a vigorous protest and recom- 
 mended that temporary hospitals be constructed, which was done. 
 
 It will be seen that the chief deficiencies, viewed from our 
 present standpoint, were : Transportation on the field ; mobile 
 field hospitals ; evacuation hospitals and transportation to same ; 
 and organization of the line of communications. The handling 
 of supplies also lacked system and was crude and wasteful, with- 
 out being efficient. The regimental units cared for the wounded 
 at the front, the general hospitals received them at the base, 
 between them everything was haphazard or entirely lacking. 
 Medical directors of divisions, corps and armies were appointed 
 but they had not the personnel, equipment, or even a system 
 for collecting the wounded, caring for them and evacuating them 
 to the rear. 
 
 This could not fail to be observed. It was observed, by medi- 
 cal officers of the regular army, by volunteers , and by members 
 of the Sanitary Commission and state forces, who were in many 
 cases exceedingly patriotic, enthusiastic and energetic in forward- 
 ing the war. Moreover some of these men knew that ambu- 
 lance corps had been used long before in European countries, 
 particularly in France. The Medical Department was conserva- 
 tive, but ambulance corps and field hospitals were bound to 
 appear, and they did appear. 
 
 The first use of these units of which I can find record was 
 by Surgeon H. S. Hewitt, U. S. Volunteers, at Fort Donelson, 
 in February, 1862, only seven months after Bull Run, and less 
 than a year from the beginning of the war. Surgeon Hewitt 
 was medical director of General Grant's army of green volunteers. 
 For the battle he collected all the regimental hospitals and or- 
 ganized four field hospitals for the twenty-eight regiments in 
 front of Donelson. Three of these were in local buildings but 
 the fourth was in tents — the first tent field hospital of the war. 
 
EVOLUTION OF FIELD HOSPITAL. 3 
 
 The ambulances of all the regiments were also collected by 
 brigades and organized as ambulance trains that could be used 
 systematically wherever needed, without regard to their particular 
 regiments. This Surgeon Hewitt, judged by his full, scholarly, 
 and instructive reports, was an educated man, a close observer, 
 and a logical reasoner, resourceful and energetic. He was doubt- 
 less informed as to ambulance trains and field hospitals in other 
 countries. At any rate, he was organizing them when Surgeon 
 Tripler of the regular corps was clinging to regimental hospitals 
 and rejecting ambulance corps. Tripler had served through the 
 Mexican War without so much as regimental ambulances, and 
 appears to have been a thoroughgoing conservative. 
 
 This battle of Fort Donelson is deserving of more than pass- 
 ing notice. It was the first important contest in the West and 
 was fought almost entirely by untried volunteers, as was Bull 
 Run in the East ; but the medical arrangements were so excel- 
 lent, considering the time and circumstances, as to challenge 
 admiration. The equipment was no better than at Bull Run, 
 and the personnel little different in numbers or experience. Sup- 
 plies were notable by their absence. The medical department, 
 however, had two great advantages : first, a competent, energetic 
 chief ; second, systematic plans and methods. As stated, four 
 field hospitals were established at regular intervals in rear of 
 the line of battle. The regimental medical officers were directed 
 to establish stations in covered ravines behind the lines ; all the 
 ambulances were collected in trains that ran constantly between 
 the dressing stations and field hospitals. Here was the germ of 
 our whole modern system of service at the front. 
 
 The weather, from February 13 to 16, was very severe, and 
 the wounded, 1,785 in number, suffered greatly from cold and 
 exposure. There was neither hospital bedding nor clothing; nor 
 was there any food beside the regular field ration. Straw and 
 large tarpaulins were procured from the quartermaster, thus pro- 
 viding beds and shelter. Great fires helped to maintain warmth. 
 Beeves furnished soup; hardtack and coffee completed the diet. 
 Fortunately supply steamers could come almost to the camp 
 and the wounded and sick were sent back to the Ohio River 
 within a week. This was the best and most systematic care of 
 the wounded before the advent of Letterman. 
 
 Surgeon Irwin, U. S. Volunteers, of this same army, is gen- 
 erally given the credit for the first use of a tent hospital in the 
 war. At Shiloh, two months later, he seized the tents of one 
 
4 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 of Prentice's captured regiments and converted the camp into a 
 hospital which sheltered several hundred wounded during the 
 miserable weather following the battle. By April, 1862, the 
 principal western army had reached the stage of brigade ambu- 
 lance corps and brigade field hospitals, though these were tem- 
 porary assemblages rather than permanent organizations. Strange 
 to say, there was little further progress in the western armies 
 until Letterman's system was adopted ; in Grant's army, March 
 30, 1863, and in the Army of the Cumberland soon afterward. 
 These armies were not completely equipped until the spring 
 of 1864. 
 
 In the East, after Bull Run, there were no important opera- 
 tions until McClellan began his Peninsular Campaign in April, 
 1862. For nine months there was no campaigning, and this 
 afforded ample time for organization, equipment and training. 
 
 Observers with the army were not satisfied with its medical 
 arrangements, but, on urging changes and progress, were met 
 with stiff adherence to antiquated forms and modes of action 
 outworn even for peace conditions. Again was seen an example 
 of the well-known proposition that the men who begin a war 
 do not finish it. Lord Roberts commented on the anchylosed 
 old men in India at the beginning of the great mutiny, and the 
 promptness with which they gave way to younger, more energetic, 
 and more progressive leaders. 
 
 On August 12, 1861, Surgeon Charles Tripler, U. S. Army, 
 he of the manual, became medical director of the Army of the 
 Potomac, then encamped in front of Washington and Alexandria. 
 Some of the shortcomings that he noted were : 
 
 Batteries and other small organizations had no medical officers. 
 
 There were a number of incompetent surgeons. 
 
 There was no effective system of reports. 
 
 Regimental surgeons sent patients to general hospitals on their 
 own responsibility. 
 
 A very large number of men went to these hospitals, from 
 which they were slow to return. 
 
 This state of affairs led him to affirm: "The experience of all 
 armies convinces me of the fact that the sick do much better in 
 regimental than in general hospitals, the latter being nuisances, 
 to be tolerated only because there are occasions when they are 
 absolutely necessary, — as, for instance, when the army is put in 
 motion and cannot transport its sick." 
 
 This quotation throws light on Tripler's mental habits and 
 
EVOLUTION OF FIELD HOSPITAL. 5 
 
 shows that he looked on the settled camp as the normal and 
 principal place of the army, and the march or battle as incidental 
 and unimportant. An opposite view might have led him to 
 prepare mobile organizations fitted for the field. He issued 
 three hospital tents to each regiment, thus providing for three 
 per cent of its strength. He instituted the hospital fund in the 
 volunteer organizations and was, of course, busy with sanitary 
 measures. Some peculiar minor shortcomings of the Medical 
 Department at that time he does not mention. For example, 
 no clothing was provided for patients, nor was there any arrange- 
 ment for washing hospital or patients' linen. Field hospitals 
 had no hospital fund. At Antietam, a year later, there were 
 seventy hospitals on the field and not one had a hospital fund. 
 
 The hospitals at that time consisted of the regimental tent 
 hospitals and general hospitals in Washington and Alexandria. 
 These latter were improvised in old hotels and similar buildings. 
 Tripler noted the necessity for something more, but the bands of 
 red tape were too strong. He says : "There was no authority 
 for any hospital establishment in the vicinity of the divisions 
 or brigades, that might relieve the hospital tents (regimental) 
 if crowded, or that might keep the men in the camps. It is true 
 I might have organized such establishments, but I was dependent 
 upon the provisions of Army Regulations for the necessary 
 stewards, cooks and nurses." Not much hope for this strict con- 
 structionist. It never once occurred to him that. in case of press- 
 ing military necessity he might do a thing which, while not 
 provided for by regulations, was not directly forbidden by them. 
 To him the regulations were the end and aim of all, not merely 
 a means to a greater end. Man was made for the regulations. 
 
 But there were other men who did not interpret Army Regula- 
 tions as iron bands against all progress. Tripler goes on to say : 
 "Several intelligent and zealous brigade surgeons (volunteers) 
 pressed these hospitals on my attention, and I determined, when 
 I could get the buildings, to put them in operation. I required, 
 however, that the necessary personnel should be furnished by 
 the regiments * * * and that the brigade hospitals should 
 be considered and conducted as aggregations of regimental hos- 
 pitals." A true conservative, giving way grudgingly under pres- 
 sure, and as little as possible. "Brigade hospitals were fitted up 
 for Blenker's Brigade, another in Hooker's and afterward several 
 others in Fitz John Porter's Division, and several others." These 
 hospitals seem to have been fixed hospitals, located in temporary 
 
6 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 buildings near the camps, not mobile field hospitals, but they 
 were a beginning. 
 
 Ambulance transportation also engaged Tripler's attention, and 
 in much the same indefinite manner. He partly acknowledged 
 that an ambulance corps might have some advantages, but regu- 
 lations and other obstacles effectually prevented any notable ad- 
 vance in that direction. On December 31, 1861, the Army of 
 the Potomac had 314 two-wheel ambulances and but 71 four- 
 wheel ambulances. Tripler estimated for 250 four-wheel am- 
 bulances something like one for each four hundred men. At 
 the beginning of the campaign, in April, 1S62, the army had 177 
 of the four-wheel kind; and could secure no more from the 
 Quartermaster Department. More than one-half of these were 
 lost on the Peninsula, only 74 being brought back from Fortress 
 Monroe. 
 
 Right here a few words regarding the two-wheel ambulance 
 may be interposed. The armies began the war with two-wheel 
 ambulances. They were soon condemned on every hand. I do 
 not believe that in all the reports of medical and ambulance 
 officers there is a single good word said for this type of ambu- 
 lance. No one wanted them if he could possibly get any other, 
 and before the war was one-half over, they had disappeared. 
 Later, general orders provided that only four-wheel ambulances 
 should be used. Unless all these men were mistaken the two- 
 wheel ambulance is a worthless contrivance. 
 
 Tripler says that several propositions were made by foreigners 
 to raise and command ambulance companies, but they were mere 
 repetitions of continental systems, and however promising, could 
 not, under the existing laws, be used. The Surgeon General of 
 Pennsylvania, on September 19, 1861, offered to organize a corps 
 for the troops of his state, and asked authority of the War depart- 
 ment for the same. Surgeon Tripler must be given credit for en- 
 dorsing this proposition favorably, but the Secretary of War took 
 no notice of it. 
 
 An elaborate project for an ambulance corps was submitted to 
 the Secretary by a Mr. Pfersching in March, 1862. This plan 
 embraced a company of one hundred men for each division of 
 the army. This company to have two lieutenants, and a non- 
 commissioned officer for each regiment. The company to follow 
 the army into battle and have for its chief function the carrying 
 of the wounded back to the ambulances. An ingenious device 
 proposed by Pfersching was a litter in two parts, each to be 
 
EVOLUTION OF FIELD HOSPITAL. 7 
 
 carried by one man. Some of the details of this plan were 
 faulty, but the general scheme was good for a bearer company. 
 It seems to have included no ambulances. The secretary re- 
 ferred the matter to Surgeon General Finlay, who sent it to 
 Tripler, requesting his views as to its adaptability, and with 
 regard to the question whether the use of the bands would not 
 obviate the necessity for the proposed organization. Surgeon 
 Tripler reported on March 6, 1862: 
 
 "Sir: — I have the honor to report * * * However desir- 
 able a regularly organized ambulance company may be for an 
 army, it is now too late to raise, drill, and equip so elaborate 
 an establishment. There is nothing new in the plan, nothing 
 not thought of and well weighed years ago. * * * An order 
 providing for the drilling of ten men and the band of each regi- 
 ment for ambulance service was issued on October 3. * * * 
 When that is done all necessary and practicable arrangements 
 for the transportation of our wounded will have been made. 
 I am, therefore, of the opinion that the plan of Mr. Pfersching 
 is neither needed nor available for our service at the present 
 time." (Signed) Charles E. Tripler, Surgeon, 
 
 Medical Director, Army of the Potomac. 
 
 Time soon wrote another indorsement to this remarkable 
 opinion, and one that made it far from creditable to its author. 
 The Surgeon General returned the report to the Secretary of War 
 fully endorsing the views of Surgeon Tripler. Ambulance corps 
 were not yet to be, and in consequence thousands must suffer 
 unattended for days on the battlefield, even die for want of 
 stimulants and food. It is worth while to state what the prep- 
 aration that Tripler spoke of in such a smugly confident manner 
 actually was. He says: "The only plan that appeared to be 
 within my reach (regulations always had him bound hand and 
 foot) was that adopted and established by the sixth paragraph 
 of Order No. 20." 
 
 This appears to refer to page 6, G. O. No. 30, Headquarters 
 Army of the Potomac, October 3, 1861, which was as follows: 
 
 "The hospital attendants, to the number of ten, and the regi- 
 mental bands will be assembled under the supervision of the 
 brigade surgeon, and will be drilled one hour each day, except 
 Sunday, by the regimental medical officers; in setting up and 
 dismounting the hand litters and ambulances * * * in short, 
 in everything that can render this service effective and the 
 most comfortable for the wounded who are to be transported." 
 (Signed) S. Williams, Asst. Adjt. General. 
 
8 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 Tripler says: "I could, by the plan indicated, expect to com- 
 mand about twenty-five men to a regiment to serve the ambu- 
 lances when wanted. * * * Whenever this order was obeyed 
 ( ?) the progress of the men in the drill was quite satisfactory. 
 It was at least the beginning of an ambulance corps. Perhaps 
 a distinct ambulance corps may yet be made a part of our mili- 
 tary establishment ; I am satisfied it would contribute essentially 
 to the efficiency of the hospital corps." This, his final report, 
 is dated June 30, 1802. It is apparent that a man in such a nebu- 
 lous state of mind was not to bring forth an ambulance corps. 
 
 Meanwhile events were transpiring rapidly. The Sanitary 
 Commission, one of the great moral and physical forces of the 
 war, early learned that the Medical Department must be born 
 again. The Surgeon General, Clement A. Finley, had had forty- 
 three years service and was growing old. An altercation with the 
 Secretary of War brought about his retirement and prepared the 
 way for a new regime. The Sanitary Commission stepped in 
 and dictated the appointment of William A. Hammond as Sur- 
 geon General. Hammond had then only the rank of first lieuten- 
 ant, but had eleven years' previous service, having resigned in 
 1860 to accept a position as professor in the University of Mary- 
 land. No one who ever met William A. Hammond needs to 
 be told of his immense energy and capability. He became 
 Surgeon General April 25, 1862, and there was an immediate 
 change for the better. In June, 1862, the brigade surgeons 
 became surgeons of volunteers, with the rank of major ; and were 
 eligible to all the duties and privileges of officers of the regular 
 corps, including promotion. 
 
 In July, 1862, Surgeon Tripler was succeeded in the office of 
 Medical Director of the Army of the Potomac by Surgeon 
 Jonathan Letterman. During May and June the army had been 
 fighting in the Peninsula below Richmond. The army had a 
 railway to its nearby base at the White House and during the 
 earlier minor combats the wounded were cared for without diffi- 
 culty. After the defeat at Gaines' Mills, White House was 
 necessarily abandoned, and everything moved south to the James. 
 The roads led through swamps, there were few ambulances, and 
 the wounded were largely left to their own devices. The prin- 
 cipal field hospital was at Savage's Station. There several thou- 
 sand wounded were collected from Gaines' Mills. The next 
 night the army marched away and 2500 severely wounded were 
 abandoned to the enemy. A few surgeons and scanty supplies 
 
EIOLUTJON OF FIELD HOSPITAL. 
 
 EETTERMAN. 
 
 were left, but there must have been great suffering. The Con- 
 federates had not resources for their own wounded. 
 
 The majority of the wounded from the later engagements 
 reached Harrison's Landing, coming on by wagons or in any 
 way they could, for there was no systematic transportation. 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Surgeon J. M. Hand says: "From June 28, we did not see one 
 single wagon or ambulance; they were sent in advance of the 
 column. Three-fourths of the wounded were brought along with 
 the column, the rest were left behind." There were also hun- 
 dreds of sick, almost as many as of wounded. 
 
 The press of work during the Seven Days' Battle must have 
 been tremendous and Tripler accomplished nothing more toward 
 the achievement of either ambulance corps or field hospitals. 
 
 Letterman reached the army and was placed on duty July 4, 
 1862. He found it pretty well exhausted by sickness and the 
 recent campaign. All the hospitals of the entire army were 
 cumbered with sick and wounded. The hot weather, the swampy 
 terrain, the strain of marching and fighting both day and night, 
 with lack of food and the depression of failure, all left the 
 army in a low condition. The sick seem to have been more 
 of a problem to Tripler than the wounded, and well they might. 
 In November, 1861, six per cent of the army was sick and the 
 death rate was thirty per thousand per annum. By June, 1862, 
 the ineffectives amounted to twenty per cent and the death rate 
 had gone up to fifty per thousand. The reasons that Tripler 
 gave for the failure of the Medical Department were : 
 
 1. Not enough medical officers. 
 
 2. Denial of rank and official position. 
 
 3. The idea that surgeons were "merely doctors" to be called 
 on to treat the sick, but not to institute sanitary measures. 
 
 4. Not having control of transportation. 
 
 5. Professional incompetency of some officers. 
 
 These were not the fundamental faults ; Letterman and Mc- 
 Parlin succeeded in spite of all of them; but the second, third 
 and fourth were undoubtedly serious handicaps. 
 
 When Letterman took charge, the Medical Department had 
 to be reorganized, but first the situation must be cleared up. 
 One-fourth of the army was in hospital, supplies and equip- 
 ment had been exhausted or lost, failure added to the depression 
 of fatigue, and on top of all the army was to be moved else- 
 where for another campaign. There were twenty thousand 
 sick and wounded in the hospitals at Harrison's Landing. Two 
 days before reporting for duty, Letterman had asked the Surgeon 
 General for two hundred ambulances and a thousand hospital 
 tents. On August 3, the evacuation of the sick and wounded 
 was begun and as many as five thousand were sent away in one 
 day. By August 15, the army was cleared of sick and wounded. 
 
EVOLUTION OF FIELD HOSPITAL. 11 
 
 The task of evacuating twenty thousand sick and wounded in 
 such a short time would appear to be a sufficient task, but in 
 the midst of it Letterman found time to take up the ambulance 
 problem and to carry it to a swift solution. It was not an evolu- 
 tion with him; the thing came forth at once, full-fledged and 
 complete. To be sure, he improved it later, but as first instituted, 
 it was a successful system. 
 
 Colonel Clement's monograph says that, "The events of the 
 Peninsular Campaign had given all the medical officers valuable 
 experience and insight." But Letterman took no part in that 
 campaign, he did not see the wounded left behind in the Chicka- 
 hominy swamps. When the war began he was on duty in Cali- 
 fornia. He accompanied troops to New York and soon joined 
 the Army of the Potomac, then idle in camps. In May, 1862, 
 he was made Medical Director of the Department of West Vir- 
 ginia, where he saw no active duty of importance. On June 19 
 he received his detail to the Army of the Potomac, but did not 
 reach that army until the campaign was finished and the troops 
 in the last camp. But he did devise the system, and succeeded 
 in putting it into practice in spite of all lack of authority and 
 obstructive regulations. He had the clear vision to see through 
 all the vicissitudes of a moving fighting army, the fundamental 
 organization that was necessary ; he also had the courage and en- 
 ergy to secure the fruition of his ideas in practical, working ma- 
 chinery. The conclusion is all but inevitable that his plans had 
 been worked out at leisure previously, not in the few crowded 
 days at Harrison's Landing; that he was ready and only waiting 
 for Opportunity to knock at his door. 
 
 The plans were submitted to McClellan, who as a high priest 
 of organization, could not fail to appreciate and approve them. 
 It is noteworthy that this plan was not referred to Washington, 
 where it might easily have been killed or lost, but was put in 
 force by a general order of the Army of the Potomac, dated 
 August 2, 1862. It should also not be forgotten that Letterman 
 had reported for duty only on July 4. 
 
 It cannot be claimed that Letterman originated the ambulance 
 corps idea ; his claim to distinction is that when ambulance corps 
 were indefinite and untried institutions in our armies, he, in 
 spite of the prejudice of his class, the various confused plans, 
 the seeming impossibility of introducing order and system 
 in the rear of a battle, and the lack of positive authority, per- 
 sonnel and equipment, and while busied with a thousand other 
 
12 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 problems, saw the ideal and was able to breathe into it the 
 breath of life. Others proposed ambulance corps; he made one. 
 Surgeon B. A. Vanderkief, U. S. Volunteers, submitted a plan 
 to the Surgeon General on July 15, somewhat as follows: 
 
 For each division an ambulance corps, under the Medical 
 Director, consisting of 100 men and 4 non-commissioned officers, 
 all under the command of a medical officer with the rank of 
 Surgeon (major), with an assistant with rank of Assistant 
 Surgeon. All enlisted men to be detailed from regiment and 
 receive extra pay. Of transportation there was to be: 
 
 12 four-wheel ambulances. 
 
 12 two-wheel ambulances. 
 1 ambulance loaded with medical stores. 
 4 army wagons for supplies and rations. 
 
 One feature of this plan appears superior to Letterman's, 
 that of placing in command a medical officer instead of a detailed 
 quartermaster. It was, however, probably impossible to give a 
 medical officer such actual command at that time. The one 
 ambulance load of medical supplies also appears to me to be an 
 excellent idea. 
 
 The essential features of the ambulance corps instituted by 
 McClellan's order were: 
 
 An ambulance corps for each army corps, commanded by 
 a captain. 
 
 A first lieutenant for each army division, a second lieutenant 
 for each brigade and a sergeant for each regiment. 
 
EVOLUTION OF FIELD HOSPITAL. 13 
 
 These officers and men were all detailed from the line, but 
 were under the sole control of the medical directors. The num- 
 ber of ambulances depended on the number and size of the regi- 
 ments, being three for a regiment of 500 or more, two for smaller 
 regiments, and one for a battery or similar organization. The 
 actual number was about one to 150 men; for example, the Fifth 
 Corps at Gettysburg numbered 12,509 men and had 81 ambu- 
 lances. All ambulances were taken away from the regiments. The 
 ambulances of each division were kept together in a train : these 
 division trains were sometimes combined in corps trains and 
 sometimes not. Yet the real unit was the corps. Two army 
 wagons were allowed to each division train, say 30 ambulances. 
 
 The full ambulance order is appended, namely, the order of 
 August 24, 1863. The original order of August 2, 1862, evi- 
 dently prepared in haste, was incomplete in some details. The 
 term "two-horse ambulance" means a four-wheel ambulance, 
 of a light type. The four-horse ambulance was something like 
 an army wagon. 
 
 Letterman said : "The system I devised was based upon the 
 idea that the ambulances should not be under the immediate 
 control of medical officers, whose duties, especially on the bat- 
 tlefield, would prevent any proper supervision; but that other 
 officers appointed for that purpose, should have charge of the 
 horses, harness, ambulances, etc." 
 
 Letterman's order was submitted to the Surgeon General in 
 August, and he appears to have recommended it to McParlin 
 and others. Whether or not it was recommended to the War 
 Department before the second battle of Bull Run I am unable 
 to state ; but immediately after that battle with its terrible suffer- 
 ing, exposure, and privation among the wounded, Surgeon Gen- 
 eral Hammond addressed the following letter to the Secretary 
 of War: 
 
 Surgeon General's Office, September 7, 1862. 
 
 Hon. Edwin M. Stanton, Secretary of War. 
 
 Sir: — I have the honor to ask your attention to the frightful 
 state of disorder existing in the arrangements for removing the 
 wounded from the field of battle. The scarcity of ambulances, 
 the want of organization, the drunkenness and incompetency of 
 drivers, the total absence of ambulance attendants, are now 
 working their legitimate results — results which I feel I have 
 no right to keep from the knowledge of the Department. 
 
 An ambulance corps should be organized and set in instant 
 operation. * * * Up to this date 600 wounded still remain 
 
14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 on the battlefield, in consequence of an insufficiency of ambu- 
 lances, and the want of a proper system for regulating their 
 removal in the Army of Virginia. Many have died of starva- 
 tion; many more will die in consequence of exhaustion, and 
 all have endured torments which might have been avoided. 
 
 I ask, sir, that you will give me your aid in this matter, that 
 you will interpose to prevent a recurrence of such consequences 
 as have followed the recent battles — consequences which will 
 inevitably ensue on the next important engagement if nothing is 
 done to obviate them. 
 
 I am, sir, very respectfully, 
 
 Your obedient servant, 
 William A. Hammond, Surgeon General. 
 
 This letter was returned with an indorsement by General 
 Halleck, reiterating his continued disapproval of the whole plan 
 of medical organization. The blame for this mistake is often 
 placed on Secretary Stanton. Halleck had at that time recently 
 been brought to Washington as general-in-chief and adviser to 
 the President. He could hardly be overruled on a technical 
 military point, such as that of the organization of the army. 
 
 After all, this disapproval had little real effect, as the ambu- 
 lance scheme was already operating in the Army of the Potomac. 
 It was placed in operation in the Army of the Tennessee by 
 order of General Grant on March 30, 1863. In the meantime 
 but one battle of importance had been fought, that of Stone 
 River. 
 
 The Army of the Potomac left the James River in August, 
 reaching Alexandria during the latter part of that month. A 
 portion of this army took part in Pope's unfortunate campaign, 
 and retired into Washington during the first days of September. 
 McClellan was placed in command of the now united armies 
 and Letterman was again medical director of an army of 100,000 
 men, with an opportunity, for the first time, to try out his 
 theories. It must be admitted that the trial could not be a fair 
 one. There was no time for preparation. Lee was in Mary- 
 land and the army must march at once, whether prepared or not. 
 
 To quote Letterman's own words : "The Medical Department 
 of the army was in a deplorable condition. The officers were 
 worn out by the excessive and harassing labors they had under- 
 gone with the Army of Virginia (Pope's army). A large por- 
 tion of the supplies had been left behind at Fortress Monroe, 
 and much of that brought along had been thrown away by com- 
 manding officers when on the way to join General Pope. The 
 
EVOLUTION OF FIELD HOSPITAL. 
 
 15 
 
 labor expended in fitting out the Medical Department at Harri- 
 son's Landing seemed to have been expended in vain, and it 
 required to be completely refitted before it would again be in 
 proper condition. The circumstances made this impossible. As 
 soon as the troops reached Washington, they were marched into 
 Maryland (Antietam was fought on September 17) and no time 
 was allowed medical officers to equip themselves for another 
 campaign. In a few instances the medical officers who returned 
 with the first troops procured some supplies. Some troops did 
 
 II | |ft|m' 
 
 ; ntji 
 
 \4 I / 11 1 1 ■ I 
 
 i/ofy)ittir''KHd3u r-ilU)M,)i<,d\W*,' 
 
 I 
 
 not belong to the Army of the Potomac; I could know nothing 
 of their medical department except what I learned on the way 
 to meet the enemy. The Medical Department of the entire 
 army had to be reorganized and resupplied while upon a rapid 
 march in different sections of the country, and almost in the 
 face of the enemy." 
 
 But nothing daunted Letterman. He required supplies, to be 
 prepared at Baltimore and sent on telegraphic notice. Ambu- 
 lances joined the army at various places along the line of march. 
 For example, two hundred were received at Frederick, only two 
 days before the battle at South Mountain, showing an accuracy 
 of judgment that almost amounted to prophecy. 
 
 Four days later, the great battle of Antietam, or Sharpsburg, 
 took place. Although the line of battle was six miles long, the 
 ten thousand wounded were collected promptly. On the right 
 wing, where the fighting was most severe, the wounded were 
 all cared for by two o'clock next day. On the left, where the 
 ambulance organization was not so good, the work was com- 
 pleted by evening. 
 
Hi MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 It may be said that in this battle all the wounded were col- 
 lected and placed under shelter within twenty-four hours. Hos- 
 pital facilities, however, were poor and the returns of dead and 
 wounded were in great confusion. Supplies also were very 
 unsatisfactory. 
 
 This was Letterman's first battle. On the whole, the ambu- 
 lance corps came through the bloodiest day in American history 
 with flying colors. The story as to field hospitals and supplies 
 is different. Division hospitals were not yet in existence, nor 
 was there any effective supply system. For the first few days 
 the Sanitary Commission was largely depended on for supplies. 
 
 The wounded were collected in houses, barns, sheds and under 
 anything that afforded the slightest shelter. These conditions 
 were of course unsatisfactory and would have been more so had 
 the weather been unfavorable or the enemy victorious. To col- 
 lect the wounded systematically was but one step. 
 
 While yet busy with twelve thousand wounded on the field 
 and at Frederick, Letterman attacked the problem of medical 
 supplies, and then that of field hospitals. The regiments had 
 wasted great quantities of supplies and were nearly always 
 short in time of battle. The Sanitary Commission had gone 
 on record against the regimental system ; everyone saw the evils 
 of that system but no one had been able to remedy it. Letter- 
 man instituted supply tables with definite allowances for stated 
 periods and issued these supplies to the brigade surgeons, who 
 were to give out small quantities lo the regiments as needed. 
 Brigade wagons carried the supplies. This was a marked im- 
 provement, and a step toward division supplies. The full order 
 is appended. 
 
 Letterman next gave his attention to the subject of field hos- 
 pitals. He says : 
 
 These instructions having been issued my attention was given 
 to the matter of treating the wounded on the field. As far as 
 I knew, no system of field hospitals existed in any of our 
 armies, and, convinced of the necessity for devising some meas- 
 ure by which the wounded would receive the best surgical aid 
 which the army afforded, with the least delay, my thoughts 
 naturally turned to this most important subject. On the battle- 
 field, where confusion in the medical department is most disas- 
 trous, it is most apt to occur ; and unless some arrangements 
 be adopted by which every medical officer has his station pointed 
 out, his duties defined beforehand, and his accountability strictly 
 enforced, the wounded must suffer. To remedy this want which 
 
EVOLUTION OF FIELD HOSPITAL. 17 
 
 existed, I instituted the system of field hospitals, as exhibited 
 in the following circular. 
 
 Such is the entire statement of Letterman, showing one of 
 the attributes of true greatness not always associated with it 
 by the unthinking — simplicity. 
 
 The problem was solved while the army lay about Sharpsburg, 
 and the circular establishing these hospitals was issued October 
 30, 1862. Letterman found the necessary authority, assumed 
 the responsibility, and by a single circular letter to his subordi- 
 nate medical officers inaugurated this great reform. 
 
 The main feature in this plan was that it directed the estab- 
 lishment of a field hospital for each division and provided per- 
 sonnel and equipment for the same. It, of course, abolished 
 the regimental hospital, but that institution died a lingering 
 death, not becoming entirely extinct until the spring of 1864. 
 
 The ambulance system, the scheme of supplies, and the field 
 hospital system completed the organization of the medical service 
 at the front. The actual organization and equipment of the 
 Army of the Potomac in accordance with these orders was not 
 completed until April, 1864, when that army was preparing 
 for its last Richmond campaign. The armies of the West were 
 not similarly complete in medical organization until a little later, 
 when Sherman was nearing Atlanta, in June, 1864. 
 
 Two divisions of the work for the medical department in war 
 were now complete : regimental aid, and divisional care of the 
 wounded, with the necessary transportation. The service of the 
 rear, evacuation hospitals, transport columns and the line of 
 communications generally — none of these was organized sys- 
 tematically, but was left in each case to be provided for as 
 circumstances allowed. This was, of course, generally unsatis- 
 factory. 
 
 Letterman's complete system for the front received its first 
 trial at Fredericksburg, December 13, 1862, and it worked ad- 
 mirably. The conditions were generally favorable ; there was 
 time to equip all the divisions ; the field of battle was simple 
 and circumscribed ; a railway led back to the Potomac, only a 
 few miles distant ; the army, though unsuccessful, withdrew 
 from the field leisurely and in order. The division hospitals 
 were established on the northern bank of the river, but one or 
 two hospitals of each corps engaged was taken across and main- 
 tained there for a few days. Five hundred hospital tents were 
 held in readiness at Washington. The ambulances crossed with 
 
18 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 CACOLET USt-IM. 
 
 L.C.Dunczn 
 
 the troops and the great battle was entered with confidence by 
 the medical officers. 
 
 The wounded were mostly under fire and could not be re- 
 moved until dark ; but as soon as night came, early in December, 
 the ambulances moved forward, and, in spite of occasional shots, 
 
EVOLUTION OF FIELD HOSPITAL. l'.> 
 
 all the wounded outside the enemy's pickets were brought in 
 before morning, or within twelve hours. This was a perform- 
 ance never before equalled in a great battle. The wounded, 
 more than ten thousand in number, were sheltered in tents, 
 moved to the north side of the river by the fifteenth, and by 
 December 25 all had been evacuated to Washington. Letter- 
 man desired to retain the severely wounded on the field as at 
 Antietam but General Burnside ordered them all removed with- 
 out delay, presumably for military reasons. 
 
 Fredericksburg was the first great battle in which the work 
 of the medical service at the front had been reasonably satis- 
 factory. Doctor D. W. Brink, an inspector of the Sanitary 
 Commission, said in his report: 
 
 Before closing this report I would again refer to the Medical 
 Department of the Army. The most marked improvement is 
 observable in all that pertains to the management of the wounded. 
 Instead of churches, dwellings, barns and sheds, being crowded, 
 and many remaining unsheltered, as was the case at Antietam 
 and elsewhere after great battles, ample accommodations were 
 provided in tents, with blankets and all essential stores. The 
 ambulance corps is so improved that it will, I believe, compare 
 favorably even with that of France. But above all, the organiza- 
 tion of the Medical Corps for field and hospital service is deserv- 
 ing of the highest encomiums. 
 
 For these important improvements in supplies, ambulance 
 trains and field hospitals, Letterman is almost entirely responsible. 
 The Surgeon General no doubt supported tin em. and the Secre- 
 tary of War placed no obstacles in the way of men who knew 
 clearly what they wanted, and who wanted practical things. 
 
 Fredericksburg marks the completion of the change in medical 
 management that was begun at Antietam. After ibis battle, 
 and the "Mud March," the army settled down in winter quarters 
 at Falmouth. Each division maintained its hospital, but the 
 division hospitals of each army corps were grouped together and 
 located back toward Acquia Creek. 
 
 At Chancellorsville the system worked admirably, and at 
 Gettysburg as well as possible under the circumstances. The 
 ambulance corps brought off the wounded promptly, but the 
 field hospitals, being held twenty miles in the rear, were unavail- 
 able, and the surgeons were forced to improvise hospitals of all 
 kinds, therefore the experiences of Antietam were repeated. 
 After Gettysburg there were no battles of importance in the East 
 for ten months. When Letterman left the Army, in January, 
 
20 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 1864, the ambulance system was complete as it remained to the 
 end of the war. While there was no reserve ambulance company 
 as in our present scheme, there were about twice as many men 
 and ambulances per thousand as now. The officers and men 
 were detailed from the line but were a part of the Quartermaster 
 Department. It would seem that such an arrangement would 
 have led to endless difficulties between the two departments, but 
 none is recorded, nor did anyone recommend a change. The 
 two staff departments appear to have worked together in perfect 
 harmony. 
 
 Letterman's field hospital system was inferior to his ambulance 
 
 TR/PLER fiMEULRNCE Ithl 
 
 system. When he left the service it was a loosely bound aggre- 
 gation, temporarily formed after each engagement. It had the 
 following defects : 
 
 Temporary character, only mobilized for an engagement. 
 
 Its officers were primarily officers of other organizations. 
 
 A large part of the supplies and even tentage belonged to the 
 brigades. 
 
 The enlisted personnel was too small. 
 
 The records were very poorly kept. 
 
 Another fault was that both ambulance corps and field hospitals 
 were drawn on for the service of the rear. 
 
 Later under McParlin some of these faults were remedied. 
 The status toward the end of the war is given in the chapter 
 on the Battle of the Wilderness. 
 
 Letterman retired from the Army in January, 1864, and Mc- 
 
EVOLUTION OF FIELD HOSPITAL. 21 
 
 Parlin succeeded him. The ambulance corps and field hospital 
 service under McParlin's direction reached a high degree of ex- 
 cellence. By the summer of 1864 the Medical, as well as the 
 Quartermaster, Subsistence and other staff departments of the 
 great armies of the Republic, had reached a point of perfection 
 that merit all commendation, and will repay careful study. It 
 is doubtful if any modern railway system works more smoothly 
 and successfully.' When we consider the ever changing scenes 
 and conditions, the effects of weather, the hard marches, the 
 losses of men and the exhaustion of tremendous battles; the 
 wonder is that any organization of human contrivance could stand 
 the strain; could supply such armies and could care for the 
 wrecks left in their wake. 
 
 But it was done, henceforth there were no more Bull Runs. 
 Wherever a column operated against the enemy, wherever sabers 
 flashed or musketry rattled, there were ambulances ready to take 
 up .the wounded and swiftly convey them to the waiting hos- 
 pitals in the rear. That these men did not wait for the bullets 
 to cease flying is evidenced by the names of forty medical officers 
 who died on the field of battle. Through the pines of Georgia 
 and the swamps of the Carolinas ; in the deadly thickets of the 
 Wilderness and on the fireswept flats of Cold Harbor; in the 
 last race with Meade and Sheridan ; through rain and mud ; 
 over bottomless roads and across unbridged streams, the ambu- 
 lance trains pressed on and the field hospitals were not far 
 behind. No more wounded were abandoned on the field. 
 
 By day and night, in mud and dust, in sun and storm, worked 
 the officers and men of the medical department ; without hope 
 of reward or even official recognition. Noncombatants, they had 
 not the urging of martial music nor the sweeping spirit of the 
 charge to carry them on to duty. But laboring alone in the 
 rear, often by night, and after days of exhausting toil, unseen 
 and unchronicled, faithfully they performed their task ; one 
 requiring as rare a brand of courage as that which sends men to 
 the cannon's mouth. 
 
 Of all the men who labored for the sick and wounded during 
 the great war, the name of Jonathan Letterman stands out pre- 
 eminent. His work was all but forgotten, even among the mem- 
 bers of the corps in which he belonged. As Colonel Hoff has 
 said : "With the close of the war, so rich in dearly bought ex- 
 perience, the Medical Department, apparently content to embalm 
 that experience, between the covers of its great history, returned 
 
2-2 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 to the methods of ante-bellum days." Fortunately that experi- 
 ence is again being recalled. 
 
 Letterman died with his great work unrewarded and largely 
 unrecognized. Doctor Agnew closed his report on the Battle 
 of Antietam with these words : 
 
 "I cannot close this hasty letter without expressing my sense 
 of obligation to Doctor Letterman for unusual facilities and to 
 all the surgeons with whom I came in contact, for their uniform 
 courtesy and confidence. The country should be proud of these 
 faithful men, who labor day and night to alleviate the suffering 
 of the battlefield, without hope of 'honorable mention' or a 
 'brevet' in this world ; may they have their reward in the next, 
 where the fact of having given a cup of cold water to a suffering 
 human being will be made the occasion of a never-fading record 
 and an exhaustless blessing." 
 
 APPENDIX A. 
 AMBULANCE CORPS ORDER. 
 
 Headquarters, Army of the Potomac, 
 
 August 24, 1863. 
 General Orders, ] 
 No. 85. j 
 
 The following revised regulations for the organization of the 
 Ambulance Corps, and the management of the Ambulance Trains, 
 are published for the government of all concerned, and will be strictly 
 observed: 
 
 1. The Army Corps is the unit of organization for the ambulance 
 corps, and the latter will be organized upon the basis of the Captain 
 as the commandant of the corps, one 1st Lieutenant for each divi- 
 sion, one 2d Lieutenant for each brigade, one Sergeant for each 
 regiment. 
 
 2. The Privates of this corps will consist of two men and one 
 driver to each ambulance, and one driver to each medicine wagon. 
 
 3. The two-horse ambulances only will be used, and the allow- 
 ance, until further orders, to each corps, will be upon the basis of 
 three to each regiment of infantry, two to each regiment of cavalry, 
 one to each battery of artillery, to which it will be permanently 
 attached, and two to the headquarters of each army corps, and two 
 army wagons to each division. Each ambulance will be provided 
 with two stretchers. 
 
 4. The captain is the commander of all the ambulances, medicine 
 and other wagons in the corps, under the immediate direction of the 
 Medical Director of the Army Corps to which the ambulance corps 
 belongs. He will pay special attention to the condition of the am- 
 bulances, wagons, horses, harness, etc., and see that they are at all 
 times in readiness for service; that the officers and men are properly 
 instructed in their duties, and that these duties are performed, and 
 
EVOLUTION OF FIELD HOSPITAL. 23 
 
 that the regulations for the corps are strictly adhered to by those 
 under his command. He will institute a drill in his corps, instruct- 
 ing his men in the most easy and expeditious method of putting men 
 in and taking them out of the ambulances, lifting them from the 
 ground and placing and carrying them on stretchers, in the latter 
 case observing that the front man steps off with the left foot and 
 the rear man with the right, etc.; that in all cases his men treat 
 the sick and wounded with gentleness and care; that the ambulances 
 and wagons are at all times provided with attendants, drivers, horses, 
 etc.; that the vessels for carrying water are constantly kept clean 
 and filled with fresh water; that the ambulances are not used for 
 any other purpose than that fur which they are designed and ordered. 
 Previous to a march he will receive from the Medical Director of 
 the Army Corps his orders for the distribution of the ambulances 
 for gathering up the sick and wounded previous to, and in time of, 
 action; he will receive orders from the same officer where to send 
 his ambulances, and to what point the wounded arc to be carried. 
 He will give his personal attention to the removal of the sick and 
 wounded from the field in time of action, going from place to place 
 to ascertain what may be wanted; to see that his subordinates (for 
 whose conduct he will be responsible) attend faithfully to their duties 
 in taking care of the wounded, and removing them as quickly as 
 may be found consistent with their safety to the field hospital, and 
 sec that the ambulances reach their destination. After every battle 
 he will make a report, in detail, of the operations of his corps to 
 the Medical Director of the Army Corps to which he belongs, who 
 will transmit a copy, with such remarks as he may deem proper, 
 to the Medical Director of this Army. He will give his personal 
 attention to the removal of sick when they are required to be sent 
 to general hospitals, or to such other points as may be ordered. 
 lie- will make a personal inspection, at least once a month, of every- 
 thing pertaining to the ambulance corps, a report of which will be 
 made to the Medical Director of the Corps, who will transmit a copy 
 of the report to the Medical Director of this Army. This inspection 
 will be minute and made with care, and will not supersede the constant 
 supervision which he must at all times exercise over his corps. He 
 will also make a weekly report, according to the prescribed form, 
 to the same officer, who will forward a copy to the Medical Director 
 of this Army. 
 
 5. The 1st Lieutenant assigned to the ambulance corps for a 
 division, will have complete control, under the captain of his corps 
 and the Medical Director of the Army Corps, of all ambulances, 
 medicine and other wagons, horses, etc.. and men in that portion of 
 the ambulance corps. He will be the Acting Assistant Quartermaster 
 for that portion of the corps, and will receipt and be responsible for 
 all the property belonging to it, and be held responsible for any 
 deficiency in anything appertaining thereto. He will have a traveling 
 cavalry force, a blacksmith, and a saddler, who will be under his 
 orders to enable him to keep his train in order. His supplies will be 
 drawn from the depot Quartermaster, upon requisitions approved 
 by the captain of his corps, and the Commander of the Army Corps 
 
24 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 to which he is attached. He will exercise a constant supervision 
 over his train in every particular, and keep it at all times ready for 
 service. Especially before a battle will he be careful that everything 
 be in order. The responsible duties devolving upon him in time of 
 action, render it necessary that he be active and vigilant and spare 
 no labor in their execution. He will make reports to the captain 
 of the corps, upon the forms prescribed, every Saturday morning. 
 
 6. The 2d Lieutenant will have command of the portion of the 
 ambulance corps for a brigade, and will be under the immediate 
 orders of the commander of the ambulances for a division, and the 
 injunctions in regard to care and attention and supervision prescribed 
 for the commander of the division he will exercise in that portion 
 under his command. 
 
 7. The Sergeant will conduct the drills, inspections, etc., under 
 the orders and supervision of the commander of the ambulances for a 
 brigade, be patricular in enforcing all orders he may receive from 
 his superior officer, and that the men are attentive to their duties. 
 
 The officers and non-commissioned officers will be mounted. The 
 non-commissioned officers will be armed with revolvers. 
 
 8. Two Medical Officers, and two Hospital Stewards will be 
 detailed, daily, by roster, by the Surgeon-in-Chief of Division, to ac- 
 company the ambulances for the Division, when on the march, whose 
 duties will be to attend to the sick and wounded with the ambulances, 
 and see that they are properly cared for. No man will be permitted, 
 by any line officer, to fall to the rear to ride in the ambulances, unless 
 he has written permission, from the senior Medical Officer of his 
 regiment, to do so. These passes will be carefully preserved, and 
 at the close of the march be transmitted, by the senior Medical 
 Officer with the train, with such remarks as he may deem proper, to 
 the Surgeon-in-Chief of his Division. A man who is sick or wounded, 
 who requires to be carried in an ambulance, will not be rejected, 
 should he not have the permission required; the surgeon of the regi- 
 ment who has neglected to give it, will be reported at the close of the 
 march, by the senior surgeon with the train, to the Surgeon-in-Chicf 
 of his Division. When on the march, one-half of the privates of the 
 ambulance corps, will accompany, on foot, the ambulances to which 
 they belong, to render such assistance as may be required. The re- 
 mainder will march in the rear of their respective commands, to 
 conduct, under the order of the Medical Officer, such men as may 
 be unable to proceed to the ambulances, or who may be incapable 
 of taking proper care of themselves until the ambulances come up. 
 When the case is of so serious a nature as to require it, the surgeon 
 of the regiment, or his assistant, will remain and deliver the man to 
 one of the Medical Officers with the ambulance. At all other times 
 the privates will be with their respective trains. The medicine wagons 
 will, on the march, be in their proper places, in the rear of the am- 
 bulances for each brigade. Upon ordinary marches, the ambulances 
 and wagons belonging to the train will follow immediately in the rear 
 of the division to which it is attached. Officers connected with the 
 corps must be with the train when on the march, observing that no 
 one rides in any of the ambulances except by the authority of the 
 
EVOLUTION OF FIELD HOSPITAL. 35 
 
 Medical Officers. Every necessary facility for taking care of the sick 
 and wounded upon the march will be afforded the Medical Officers 
 by the officers of the ambulance corps. 
 
 9. When in camp, the ambulances will be parked by divisions. 
 The regular roll-calls, reveille, retreat, and tattoo, will be held, at 
 which at least one commissioned officer will be present and receive 
 the reports. Stable duty will be at hours fixed by the captain of 
 the corps, and at this time, while the drivers are in attendance upon 
 their animals, the privates will be employed in keeping the ambu- 
 lances to which they belong in order, keeping the vessels for carrying 
 water filled with fresh water, and in general police duties. Should 
 it become necessary for a regimental Medical Officer to use one or 
 more ambulances for transporting sick and wounded, he will make a 
 requisition upon the commander of the ambulances for a division 
 who will comply with the requisition. In all cases when the ambu- 
 lances are used, the officers, non-commissioned officers, and men 
 belonging to them, will accompany them; should one ambulance only 
 be required, a non-commissioned officer as well as the men belonging 
 to it will accompany it. The officers of the ambulance corps will see 
 that ambulances are not used for any other purposes than that for 
 which they are designed, viz.: the transportation of sick and wounded, 
 and in urgent cases only, for medical supplies. All officers are ex- 
 pressly forbidden to use them, or require them to be used, for any 
 other purpose. When ambulances are required for the transportation 
 of sick or wounded at Division or Brigade Headquarters, they will 
 be obtained, as they are needed for this purpose, from the Division 
 train, but no ambulances belonging to this corps will be retained at 
 such Headquarters. 
 
 10. Good, serviceable horses will be used for the ambulances and 
 medicine wagons, and will not be taken for any other purpose 
 except by orders from these Headquarters. 
 
 11. This corps will be designated by Sergeants, by a green band 
 one and one-quarter inches broad around the cap, and chevrons of the 
 same material, with the point toward the shoulder, on each arm above 
 the elbow. For Privates, by a band the same as for Sergeants around 
 the cap, and a half chevron of the same material on each arm above 
 the elbow. 
 
 12. No person except the proper Medical Officers, or the officers, 
 non-commissioned officers, and privates of this corps, will be per- 
 mitted to take or accompany sick or wounded to the rear, either on 
 the march or upon the field of battle. 
 
 13. No officer or man will be selected for this service except those 
 who are active and efficient, and they will be detailed and relieved 
 by Corps Commanders only. 
 
 14. Corps Commanders will see that the foregoing regulations are 
 .carried into effect. 
 
 By Command of Major General Meade: 
 
 S. WILLIAMS, 
 Assistant Adjutant General. 
 
2ii MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 APPENDIX B. 
 
 II. 
 
 SUPPLY TABLE FOR THE MEDICAL DEPARTMENT OF THE 
 
 ARMY OF THE POTOMAC. 
 
 HEADQUARTERS ARMY OF THE POTOMAC, 
 
 Medical Director's Office, 
 
 [Circular.] September 3, 1863. 
 
 The following table of supplies for the Medical Department of 
 this Army is published, instead of the one contained in the Circular 
 from this office of October 4, 1862. 
 
 Experience has more fully shown the expediency of the manner 
 of supplying this Department, as ordered by the Circular referred to, 
 and it will be kept up. 
 
 There will be allowed, in the Army of the Potomac, the following 
 supplies to a Brigade for one month, for active field service, viz.: 
 
 One Medicine Wagon, filled. 
 
 One Medicine Chest for each Regiment, filled. 
 
 One Hospital Knapsack for each Regimental Medical Officer, filled. 
 
 Supplies in the list marked "A," which will be carried in an ordi- 
 nary Army wagon. 
 
 The Surgeon-in-Chief of each Brigade will require and receipt to 
 the Medical Purveyor for all these supplies, and will issue to the 
 senior Medical Officer of each Regiment in his Brigade the Medicine 
 Chest and Knapsacks, taking his receipt therefor. The Wagons, both 
 Medicine and Army, will be receipted for by the Ambulance Quar- 
 termaster. 
 
 The Surgeons-in-Chief of Brigades will issue to Regimental Medi- 
 cal Officers such of the supplies from the Medicine or Army Wagon 
 as may from time to time be required. These issues will be informal, 
 the Surgeons-in-Chief giving no invoices, demanding no receipts, but 
 accounting for them as expended. At the same time they will be 
 particular that no improper expenditure or wastage is permitted. 
 These officers are especially directed, when they shall have drawn the 
 monthly supply, not to divide it out among the Regiments, but only 
 to issue the articles at such times and in such quantities as they are 
 needed for use, or to keep the Medicine Chests and Knapsacks 
 supplied. 
 
 Requisitions will be made in duplicate, and in strict conformity 
 with this table; and in all cases the articles will be enumerated in the 
 order in which they occur in it. Supplies will only be issued by the 
 Medical Purveyor upon requisitions approved by Medical Directors 
 of Corps, and these officers are particularly enjoined to revise all 
 requisitions with care, that sufficient supplies may be on hand, and 
 yet that no unnecessary expenditure be permitted. As far as possible, 
 requisitions will be made but once a month, and special requisitions- 
 avoided as far as practicable. 
 
 The supply allowed will be kept up, and Medical Directors will 
 see, especially before a march or battle, that timely requisitions are 
 made, and the supplies obtained. 
 
EVOLUTION OF FIELD HOSPITAL. 27 
 
 In all ordinary cases, the amount on hand at the time the requisi- 
 tion is made, will be given, as well as the amount required, and 
 requisitions will be made only for such articles, and in such amounts, 
 as may be necessary to fill up the Brigade Supply to the amount 
 ordered to be kept on hand. 
 
 Should the welfare of the sick demand a greater amount than is 
 given by this table, or for articles which arc not allowed by it, the 
 reasons therefor must be fully and clearly stated, and the requisitions 
 approved at this office. The Medical Purveyor will keep on hand 
 only such articles as are contained in this table. 
 
 Instruments, except such as are enumerated in this table, will be 
 issued only upon requisitions approved at this office. 
 
 When articles, such as Instruments, Medicine Chests, are from 
 any cause unserviceable, they will not be turned into the Medical 
 Purveyor, unless inspected and ordered to be disposed of in accord- 
 ance with the instructions contained in General Order No. 37, Head- 
 quarters of Army of the Potomac, April 2, 1863. Whenever it becomes 
 necessary for any other cause to turn in supplies to the Medical 
 Purveyor, application, with reasons therefore will be made to this 
 office. The knapsacks will be carried in each regiment, when on the 
 march, by a hospital steward. 
 
 The above is the revised order, the original order was issued 
 October 4, 1S62. The medical purveyor referred to was in 
 charge of the reserve supplies of the whole army. 
 
 APPENDIX C. 
 
 FIELD HOSPITAL ORDER. 
 
 HEADQUARTERS ARMY OF THE POTOMAC, 
 
 Medical Director's Office, 
 
 ._. , , October 30, 1862. 
 
 [Circular.] 
 
 Sir: In order that the wounded may receive the most prompt and 
 efficient attention during and after an engagement and, that the neces- 
 sary operations may be performed by the most skillful and responsible 
 Surgeons at the earliest moment, the following instructions are issued 
 for the guidance of the Medical Staff of this Army, and Medical 
 Directors of Corps will see that they arc promptly carried into effect: 
 
 Previous to an engagement, there will be established in each Corps 
 a hospital for each Division, the position of which will be selected by 
 the Medical Director of the Corps. 
 
 The organization of the hospital will be as follows: 
 
 1st. A Surgeon, in charge; one Assistant Surgeon, to provide food 
 and shelter, etc.; one Assistant Surgeon, to keep records. 
 
 2d. Three Medical Officers, to perform operations; three Medical 
 Officers, as assistants to each of these officers. 
 
 3d. Additional Medical Officers, Hospital Stewards, and Nurses 
 of the Division. 
 
 The Surgeon in charge will have general superintendence, and be 
 responsible to the Surgeon-in-Chief of the Division for the proper 
 
28 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 administration of the hospital. The Surgeon-in-Chief of Division will 
 detail one Assistant Surgeon who will report to, and be under the 
 immediate orders of the Surgeon in charge, whose duties shall be to 
 pitch the hospital tents and provide straw, fuel, water, blankets, etc.; 
 and when houses are used, put them in proper order for the reception 
 of wounded. This Assistant Surgeon will, when the foregoing shall 
 have been accomplished, at once organize a kitchen, using for this 
 purpose the hospital mess chests and the kettles, tins, etc., in the am- 
 bulances. The supplies of beef stock and bread in the ambulances, 
 and of arrow-root, tea, etc., in the hospital wagon, will enable him to 
 prepare quickly a sufficient quantity of palatable and nourishing food. 
 All the cooks, and such of the Hospital Stewards and Nurses as may 
 be necessary, will be placed under his orders for these purposes. 
 
 He will detail another Assistant Surgeon, whose duty it shall be 
 to keep a complete record of every case brought to the hospital, giving 
 the name, rank, company, and regiment; the seat and character of 
 injury; the treatment; the operation, if any be performed; and the 
 result; which will be transmitted to the Medical Director of the Corps, 
 and by him sent to this office. 
 
 This officer will also see to the proper interment of those who die, 
 and that the grave is marked with a head-board, with the name, rank, 
 company, and regiment legibly inscribed upon it. 
 
 He will make out two "Tabular statements of wounded," which 
 the Surgeon-in-Chief of Division will transmit within thirty-six hours 
 after a battle, one to this office (by a special messenger, if necessary) 
 and the other to the Medical Director of the Corps to which the 
 hospital belongs. 
 
 There will be selected from the Division, by the Surgeon-in-Chief, 
 under the direction of the Medical Director of the Corps, three Medi- 
 cal Officers, who will be the operating staff of the hospital, upon 
 whom will rest the immediate responsibility of the performance of 
 all important operations. In all doubtful cases, they will consult to- 
 gether, and a majority of them shall decide upon the expediency and 
 character of the operation. These officers will be selected from the 
 Division without regard to rank, but solely on account of their known 
 prudence, judgment, and skill. The Surgeon-in-Chief of the Division 
 is enjoined to be especially careful in the selection of these officers, 
 choosing only those who have distinguished themselves for surgical 
 skill, sound judgment, and conscientious regard for the highest inter- 
 ests of the wounded. 
 
 There will be detailed three Medical Officers to act as assistants 
 to each one of these officers, who will report to him and act entirely 
 upder his direction. It is suggested that one of these assistants be 
 selected to administer the anaesthetic. Each operating surgeon will 
 be provided with an excellent table from the hospital wagon, and, 
 with the present organization for field hospitals, it is hoped that the 
 confusion and the delay in performing the necessary operations so 
 often existing after a battle will be avoided, and all operations here- 
 after be primary. 
 
 The remaining Medical Officers of the Division, except one to 
 each Regiment, will be ordered to the hospital to act as dressers and 
 assistants generally. Those who follow the Regiments to the field 
 
EVOLUTION OF FIELD HOSPITAL. 29 
 
 will establish themselves, each one at a temporary depot, at such a 
 distance or situation in the rear of his Regiment as will insure safety 
 to the wounded, where they will give such aid as is immediately 
 required; and they are here reminded that, whilst no personal con- 
 sideration should interfere with their duty to the wounded, the grave 
 responsibilities resting upon them render any unnecessary exposure 
 improper. 
 
 The Surgeon-in-Chief of the Division will exercise general super- 
 vision, under the Medical Director of the Corps, over the medical 
 affairs in his division. He will see that the officers are faithful in the 
 performance of their duties in the hospital and upon the field, and 
 that, by the ambulance corps, which has heretofore been so efficient, 
 the wounded are removed from the field carefully and with despatch. 
 
 Whenever his duties permit, he will give his professional services 
 at the hospital — will order to the hospital as soon as located all the 
 hospital wagons of the brigades, the hospital tents and furniture, and 
 all the hospital stewards and nurses. He will notify the Captain 
 commanding the ambulance corps, or, if this be impracticable, the 
 First Lieutenant commanding the Division ambulances, of the location 
 of the hospital. 
 
 No Medical Officer will leave the position to which he shall have 
 been assigned without permission, and any officer so doing will be 
 reported to the Medical Director of the Corps, who will report the 
 facts to this office. 
 
 The Medical Directors of Corps will apply to their Commanders 
 on the eve of a battle for the necessary guard and men for fatigue 
 duty. This guard will be particularly careful that no stragglers be 
 allowed about the hospital, using the food and comforts prepared for 
 the wounded. 
 
 No wounded will be sent away from any of these hospitals with- 
 out authority from this office. 
 
 Previous to an engagement, a detail will be made by Medical 
 Directors of Corps of a proper number of Medical Officers, who will. 
 should a retreat be found necessary, remain and take care of the 
 wounded. This detail Medical Directors will request the Corps Com- 
 manders to announce in orders. 
 
 The skilful attention shown by the Medical Officers of this Army 
 to the wounded upon the battlefields of South Mountain, Crampton's 
 Gap, and the Antietam, under trying circumstances, gives the assur- 
 ance that, with this organization, the Medical Staff of the Army of 
 the Potomac can with confidence be relied upon under all emergencies, 
 to take charge of the wounded entrusted to its care. 
 
 Very respectfully, your obedient servant, 
 
 JONA. LETTERMAN, 
 
 Medical Director. 
 
THE BLOODIEST DAY IN AMERICAN HISTORY— 
 ANTIETAM 
 
 Quelle confiance d'ailleurs, quelle cnergie ne donne pas, sur 
 le champ de bataille, a un soldat, la certitude qu'en cas de bles- 
 sures les soins les plus efficaces lui seront prodigues! 
 
 — Marshal Marmont. 
 
 THE day on which the battle of Antietam was fought has 
 been called the bloodiest day in American history. The 
 troops fought at close range and with determined obsti- 
 nacy; mostly in the open where lines stood out against the sky; 
 the rolling hills gave good play for artillery; man's instruments 
 of destruction could be used to their utmost capacity. More 
 men were killed or wounded than in any other one day in the 
 history of the republic. 
 
 General Situation and Terrain. 
 
 The general situation of the Federal Government was never 
 worse than during the first weeks of September, 1862. The army 
 had been defeated, confounded, humiliated ; it was withdrawn 
 within the defenses of Washington for safety, while the flag 
 of the Confederacy again flew almost within sight of the capitol. 
 In the West, Grant was under a cloud, Nelson had been routed 
 by Kirby Smith, and Buell was falling back to Louisville. Ex- 
 cept along the Mississippi, everything south of the Ohio and 
 Potomac seemed lost, and the armies back where they were at 
 the beginning. All the resources of the nation in manhood and 
 wealth appeared to stand for nought, and the republic, like 
 Rome after Lake Trasimene,. tottered to its foundations. It was 
 then that Walt Whitman voiced the imploring prayer of the 
 nation, "Abraham Lincoln, give us a man." But the fates vouch- 
 safed no reply; the man was battling obscurely in the West and 
 many disasters were yet in store for the much-tried army before 
 it should march to final victory. 
 
 After the Peninsula and Manassas, the southern leaders 
 might well think their army invincible and their cause on the 
 eve of complete success. Yet the Army of the Potomac never 
 
2 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 lost its morale. Despite the blunders and cruel losses of Pope's 
 campaign, that army was still ready to fight. The men of the 
 Pennsylvania Reserves, of the Regular Division of the Iron 
 Brigade, of New England and New York, might have said, like 
 the Irish after the battle of the Boyne, "Change leaders with 
 us and we'll fight you again." And they would have won, too, 
 for they had been fed, clothed, supplied and reinforced ; while 
 the Confederates would have been obliged to fight with their 
 sadly thinned ranks still more depleted by weary marching. It 
 is the crowning glory of the Army of the Potomac that in spite 
 of blunder and disaster, and of mismanagement both at Wash- 
 ington and in the field, it never lost the faith. With most great 
 armies it has been the leader that won, in spite of poor soldiers ; 
 the converse is largely true of this army. 
 
 The territory covered by the campaign is a triangle between 
 Frederick and two points on the Potomac: Washington and 
 Williamsport. The country is open, gently rolling, but rises 
 to some low mountain ridges between Frederick and the Poto- 
 mac. The actual scene of conflict was confined to a small area 
 between the Monocacy on the east, the Potomac on the south 
 and west, and the Pennsylvania line on the north. This terri- 
 tory was well settled, with good roads, prosperous villages and 
 conditions generally favorable for campaigning by a large army. 
 The people were as a rule friendly, giving food to the soldiers 
 and information to officers. The weather was fine, but warm 
 and dry at the beginning, making the roads dusty and causing 
 much straggling. 
 
 Almost everyone who has written of this campaign has told 
 how delightful to the eye was the beauty of this charming land- 
 scape. The great hills and smiling valleys were dotted over with 
 comfortable farmhouses, rich orchards and capacious barns ; 
 while between, white roads wound away to the distant hills of 
 South Mountain. Many beside the poet were moved to admi- 
 ration by the clustered spires of Frederick, green-walled by the 
 hills of Maryland. To the soldiers wearied by the sickly swamps 
 of the Chickahominy and the dreary gray woods and hills of 
 Bull Run it must have seemed a land flowing with milk and 
 honey. 
 
 Frederick was the only place of importance in the whole 
 region, but there were many thriving villages which extended 
 an open-armed welcome to the army. The place had been occu- 
 pied and had a permanent hospital of several hundred beds. 
 
ANTIETAM. 
 
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4 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 There were paved streets, water and gas supply, and the loca- 
 tion was one of the most healthful within reach of Washington. 
 
 Washington was and remained the base of the army 
 throughout all its campaign. The line of communication was 
 by the Baltimore and Ohio Railway to Baltimore, and thence to 
 Frederick ; or rather to the Monocacy River, four miles east ; 
 for the Confederates had destroyed the bridge at that point, 
 and the railway west beyond the Potomac. Transportation was 
 by wagon train until the army reached Frederick, and in part 
 until it passed South Mountain, September 14. At Frederick 
 the railway was' picked up and that point became the advance 
 base of the army. The old National Pike, from Baltimore to 
 the West, passes through Frederick, and on over the mountain 
 ranges by Middletown and Boonesboro to Hagerstown. Other 
 parallel roads run on either side, through the gaps in the moun- 
 tains, which are here about a thousand feet high, with easy 
 ascent to the passes. The distance from Washington to Freder- 
 ick is about 45 miles ; from Frederick to the Antietam, about 
 18 miles. 
 
 There was a secondary line of communication by way of 
 Baltimore, Harrisburg and Chambersburg, to Hagerstown, about 
 15 miles from Sharpsburg. After the battle this line was used 
 to a small extent for bringing up supplies and for evacuating 
 the wounded; but the line by Frederick was most direct and 
 remained the principal one. The Chesapeake and Ohio Canal 
 was also used for transportation of supplies as far as Edward's 
 Ferry. Earlier it had been used for carrying the wounded, but 
 I find no account of such use at this time. 
 
 The Army. 
 
 The army of the Antietam campaign was made up as 
 
 follows : 
 
 First Corps, Hooker (formerly McDowell) 3 divisions, 14,856 men 
 
 Second Corps, Sumner 3 divisions, 18,813 men 
 
 Fifth Corps, Porter 2 divisions, 12,930 men 
 
 Sixth Corps, Franklin 2 divisions, 12,300 men 
 
 Ninth Corps, Burnside 4 divisions, 13,879 men 
 
 Twelfth Corps, Mansfield (formerly Banks).... 2 divisions, 10,126 men 
 
 Cavalry Division, 5 brigades, 12 regiments 4,320 men 
 
 Total 87,164 men 
 
 The divisions as a rule consisted of three brigades, each of 
 four regiments, with a battery attached; but Burnside had but 
 two brigades in each of his four small divisions. There were 
 
ANTIETAM. 5 
 
 also about twelve thousand civilians with the army, in various 
 capacities. 
 
 The Third Corps (Heintzelman) and the Eleventh (Sigel) 
 were left in the defense of Washington. A division (Fourth 
 Corps) under Couch and Humphreys' division of the Fifth 
 Corps did not reach Antietam until the day after the battle. 
 With these two divisions McClellan had 100,000 men, not count- 
 ing 12,000 at Harper's Ferry and 73,000 in the defences of 
 Washington. 
 
 While McClellan had about 87,000 men for duty at Antie- 
 tam, it is doubtful if more than 50,000 men were actually 
 engaged. Porter's corps was not engaged to any extent, and 
 only one brigade of Franklin's was engaged. The cavalry also 
 may be omitted. Of the First Corps not more than 10,000 were 
 engaged; Ricketts says 3,158 in his division, Meade less than 
 3,000 in his. Allowing Doubleday 4,000, we have 10,000 in this 
 corps. The Twelfth Corps was notoriously weak; Greene's divi- 
 sion took but 2,504 men into the fight ; Williams says less than 
 7,000 in the two divisions. Burnside also made use of but 
 10,000. Sumner's corps was the strongest, with possibly 15,000 
 men on the firing line. It is a moderate estimate that 15 per 
 cent of the army was absent on account of straggling or for 
 even less excusable reasons. In the Confederate army the ab- 
 sence for these reasons was even greater, probably 20 per cent. 
 
 The loss from straggling was only a part of the shortage 
 of men on the day of battle. The tri-monthly return of Septem- 
 ber 20, 1862, after Couch and Humphreys had joined, shows: 
 
 Present for duty :,..., 89,452 
 
 Special duty, sick and in arrest 10,771 
 
 Absent, all causes 79,420 
 
 It is sometimes said that the Confederates were more strict 
 in keeping their men at the front, or their men were more patri- 
 otic. The data do not show it. A field return of the Army of 
 Northern Virginia for September 30, 1862, shows: 
 
 Present 52,790 
 
 Absent 87,143 
 
 The percentage of absentees was thus considerably greater 
 than in our own army. 
 
 General Meade, a very earnest and methodical man, made a 
 return of his corps (Hooker, wounded) on the day after the 
 battle, and again four days later, in order to get a line on the 
 number of stragglers and skulkers. The corps on September 22 
 numbered 14,509, after losing 2,500 in the two battles. Then 
 
(i MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 before the battle it should have numbered 16,500 (500 lost at 
 South Mountain) instead of the 10,000 that went into battle. 
 
 It seems that more than 5,000 were straggling. But that 
 is not all of the story by any means. The return of September 
 18 showed but 6,364 officers and men present with the colors, 
 2,000 having been killed or wounded. More than 1,500 became 
 separated from the command during the battle. Among 
 those absent were 262 officers. Remember, this corps was one 
 of the very best in the army. Meade's own divison was made 
 up of the Pennsylvania Reserves ; Doubleday's contained the 
 Iron Brigade, and others little if any inferior, as demonstrated 
 on many battlefields. 
 
 The army started with about 3,000 wagons, sufficient to 
 carry short rations and forage for seven days. McClellan stated 
 later that his army could not operate more than twenty or twen- 
 ty-five miles from the railway or canal. We then had 4,000 
 wagons and 30,000 animals. 
 
 The trains had become badly mixed during shipment by sea, 
 and some of them did not join their divisions until after the 
 battle. General Halleck testified that in November the army had 
 4,000 wagons and 907 ambulances; that there were 31,000 ani- 
 mals, of which 9,000 were used for ambulances and hospital pur- 
 poses. These latter figures appear to include hospital transpor- 
 tation at Washington as well as in the field. 
 
 It is a peculiar thing that no general of the Army of Vir- 
 ginia or of a corps had retained his command until Antietam, 
 with the single exception of Porter, and for him the axe was 
 but temporarily stayed. Hooker, however, had been promoted 
 from division to corps. Pope, McDowell, Banks, Sigel, Heintz- 
 elman had been given places of less importance; Reno was 
 killed at South Mountain. And when the army next fought at 
 Fredericksburg, another sweeping change had taken place, and 
 neither general nor any corps commander was the same as at 
 
 Antietam. _, ,. , _. 
 
 Medical Department. 
 
 The medical department of the army was improving; it too 
 had been at the lowest ebb at Manassas. On September 3 Mc- 
 Clellan assumed command of the united armies and Jonathan 
 Letterman again became medical director. His position with 
 McClellan and the Surgeon General was strong. He had brought 
 order out of chaos on the Peninsula and was now, for the first 
 time, to test his theories in actual conflict. His well-known 
 ambulance organization had been put in operation by order of 
 
ANTIETAM. 7 
 
 the general on August 2, 1862. The Army of the Potomac had 
 been partially equipped, but those corps from Pope's army (1st 
 and 12th) were still badly off, and much of the supplies of the 
 other corps had been lost or left behind. Burnside's corps (9th) 
 had belonged to neither army and was more illy fitted out than 
 any other. As the army marched very slowly, attempts were 
 made to complete its equipment while on the road, and with 
 considerable success. By the day of the battle there was a 
 reasonable supply of ambulances on hand, organized by corps 
 and divisions. Supplies were generally scanty, as no regular 
 system of furnishing supplies was then in existence, and as no 
 reserve train followed the army. The Sanitary Commission had 
 several wagon loads at hand and got up others very promptly. 
 The zealous agents of this society furnished the only reserve 
 medical supplies of the army. 
 
 Field hospitals had not yet been organized, and there was 
 no separate personnel nor equipment for them. There were 
 regimental hospitals, sometimes combined into brigade hospi- 
 tals. Before the battle Letterman directed that the hospitals be 
 formed by divisions as far as practicable. This was done to a 
 certain extent, but lack of tentage, separate personnel and 
 equipment made this extremely difficult, and in some cases im- 
 possible. 
 
 The line to the rear was by the National Pike back to 
 Frederick, and from there by train to Baltimore and Washing- 
 ton. Another line was by the pike to Hagerstown, and thence 
 by rail to Harrisburg and Philadelphia. 
 
 The main medical base was Washington, and in the vicinity 
 of that point were hospital accommodations for 20,000 men. 
 On August 31 these hospitals contained more than 11,000 pa- 
 tients. There were also extensive hospitals at Baltimore, Phila- 
 delphia and New York, and to these most of the wounded from 
 Antietam were sent. During September the hospital capacity of 
 Washington was largely increased ; the Harewood Hospital from 
 1,000 to 2,000, the Cliffburne from 1,000 to 2,000, and the 
 Douglas, Columbia, Mount Pleasant- and others in like pro- 
 portion. 
 
 The hospitals in Washington had been located in old build- 
 ings, but were now moving out to barracks and tents. When 
 the troops encamped on the hills north of the city moved over 
 into Virginia, their temporary hospitals were converted into per- 
 manent ones, and the wooden barracks taken for hospital wards. 
 
s MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 These abandoned barracks were the beginnings of most of the 
 great hospitals on Meridian Hill and elsewhere in the suburbs 
 of the city. Barrack hospitals were also constructed about this 
 time in Armory Square and Judiciary Square; but the capacity 
 of all these hospitals was not tested until Fredericksburg poured 
 in its thousands of sick and wounded soldiers. 
 
 Movements of the Army. 
 
 On September 3 the enemy was along the Potomac, from 
 Alexandria to the Chain Bridge. The Confederates were in 
 the neighborhood of Chantilly. They moved by Leesburg and 
 crossed the Potomac near the mouth of the Monocacy on the 5th 
 and 6th, entering Frederick on the 7th. There they halted a few 
 a few days, having no definite plans. On the 10th they moved 
 westward toward the Potomac. 
 
 The Federal corps began crossing the river at Aqueduct 
 Bridge on the 5th, and moved to the vicinity of Rockville. By 
 default the command fell to McClellan, and on the 7th he left 
 Washington to lead the army on a leisurely march toward Fred- 
 erick. All the corps were up except Porter's, which did not 
 leave Washington until the 12th ; one division not until the 14th. 
 The army spread out to cover a front of more than twenty 
 miles, the left following the Potomac. The march was slow. 
 Halleck testified before the Harper's Ferry Commission that it 
 was at the rate of six miles per day. As Frederick was not 
 reached until the 12th, anyone may judge of the speed for him- 
 self. Humphrey's division of 8,000 raw troops left Washington 
 on the 14th, and, although held a day at Frederick, reached 
 Keedysville on the forenoon of the 18th. 
 
 There were no complicated or unnecessary movements and 
 the slow march aided materially in bringing up much-needed 
 supplies, and in keeping the men fresh for battle. Until Fred- 
 erick was reached there appears to have been no reason for rapid 
 marching. All the troops were not up and the designs of the 
 enemy were unknown ; in fact he had none until he learned of 
 the defenceless state of Harper's Ferry. It will be seen that the 
 march naturally divides itself into two parts : first, from Rock- 
 ville to Frederick, not in contact with the enemy; second, from 
 Frederick to Antietam Creek, in contact with the enemy. 
 
 Wagon trains supplied the army from Washington until 
 Frederick was reached, and in part beyond that point. A Quar- 
 termaster depot was established on the east bank of the Mono- 
 cacy on the 13th and Frederick became the advance base of the 
 
ANT1ETAM. '.) 
 
 army. The broken Monocacy bridge seems to have been more 
 of an obstacle than would be anticpated. Theoretically it added 
 but four miles to the wagon line. Actually this broken bridge 
 was a tremendous obstacle. Supplies of all kinds piled up, con- 
 fusion reigned, trains were not returned, and at one time the 
 railway was filled with trains for ten miles ; one account says 
 almost to Baltimore. The principal cause of all this was doubt- 
 less the lack of able men at the point, to convert it into a ter- 
 minal, which would have been necessary at Frederick had the 
 road remained uninjured. This incident is chiefly useful in 
 showing how an unexpected obstacle, of comparative minor im- 
 portance, may upset a whole combination and throw everything 
 into confusion. The rebuilding of this bridge was not com- 
 pleted until Sunday, September 21, four days after the battle. 
 
 On September 10 Stonewall Jackson left Frederick for his 
 Harper's Ferry expedition, with six of the nine divisions of the 
 Confederate army. As McClellan's army had nothing to do with 
 this miserable affair, it will not be described. For every one 
 responsible it was a disgraceful thing; for the Confederates it 
 was the chief trophy of an otherwise unfruitful campaign. 
 
 McClellan remained two days at Frederick, finally moving, 
 on the 13th and 14th, against Longstreet, who was in the neigh- 
 borhood of Boonesboro and Hagerstown, and holding the gaps 
 in the mountains. He had not more than fifteen or twenty thou- 
 sand men ; McClellan had all his forces at hand, excepting 
 Humphrey's division, some ninety thousand men, all in good 
 condition and ready for a fight. In no battle except the Appo- 
 mattox campaign did the Army of the Potomac go into the fight 
 with more confidence of victory than at this time. The leisurely 
 pace was maintained, although Harper's Ferry was now in 
 gravest danger and the best opportunity of the war was pre- 
 sented for beating the Confederates in detail. 
 
 In spite of slow marching there was much straggling; this 
 was remarked by nearly all observers. Writers on the Gettys- 
 burg campaign of the following year, when the marches were 
 much longer and the weather warmer, do not speak of any great 
 amount of straggling. The natural conclusion is that it was 
 due largely to lack of discipline. General Cox, who had just 
 come from the West, was astonished. He says: "I was shocked 
 at the straggling I witnessed. The 'Roadside Brigade,' as we 
 called it, was often as numerous, by careful count, as our own 
 column marching in the middle of the road. In both the Army 
 
in MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 of the Potomac and the Army of Northern Virginia (Confed- 
 erate) the evil had become a serious one. To lessen it, after 
 Antietam, General Patrick was made Provost Marshal with a 
 strong provost guard, and retained until the end of the war." 
 
 Straggling may be in part explained by the number of raw 
 troops. The army had been greatly reduced by battles, sickness 
 and the discharge of short-term regiments. To bring it up to full 
 strength, more than twenty new regiments were added at Wash- 
 ington. For the thousands of these regiments this was the first 
 march. It was officially reported that of a Regiment of the Dis- 
 trict of Columbia Volunteers, but two men reported at Antie- 
 tam — the colonel and adjutant. On the Confederate side there 
 was even more straggling, due to long marches and insufficient 
 supplies. Many of the men were also barefoot. In both armies 
 it is probable that from 15 to 20 per cent of the men were absent 
 on the day of battle. To remedy this dangerous evil General 
 Meade suggested the death penalty, and General Lee proposed 
 practically the same punishment. 
 
 On September 14 the army, moving west across the parallel 
 ridges, met Longstreet's forces at the gaps. The First and Ninth 
 corps forced Turner's Gap on the Pike, the Sixth Corps had a 
 similar conflict at Crampton's Gap on another road, seven miles 
 south. The Confederates were overpowered at both places and 
 driven back with considerable loss, the battles extending into the 
 night. The casualties were 443 killed, 1,819 wounded. This 
 would have been a notable battle at the beginning of the war, 
 now its magnitude was overshadowed in the greater struggle to 
 come. 
 
 On the 15th, all the corps moved on a few miles to the left 
 bank of the Antietam. The 16th was wasted, and on the 17th, 
 after Lee had been given time to capture Harper's Ferry and 
 bring up all his divisions, the great battle of the campaign was 
 fought on the hills about Sharpsburg. 
 
 A careful study of the campaign will show that McClellan 
 had remarkable ability. He could organize a great army, equip 
 it and keep it well supplied ; he could move it directly to the 
 field of action, and maneuver it with skill and safety in the 
 face of the enemy; what was also of importance, he could re- 
 tain the confidence of officers and men, even in defeat. But, like 
 Du Maurier's heroine, who had all the virtues save only that 
 crowning one which gives virtue its quality, he had all the mili- 
 tary virtues except that most necessary one of all, a fighting 
 
ANTIETAM. 
 
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12 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 spirit. He lacked what the prize fighters call a fighting heart. 
 When in face of the enemy he habitually saw double, and was 
 overawed by the genius of Lee and Jackson. Ian Hamilton im- 
 agined that when the Japanese and Russians were arrayed for 
 battle on the plains of Manchuria, the spirits of the two armies 
 met and wrestled for the mastery before the clash of arms was 
 heard. So it was in this campaign, which was in the last analysis 
 a contest of minds rather than of arms. 
 
 Medical Events. 
 
 The Medical Department began the march with very inade- 
 quate equipment. As .Lettennan said, the army had to be 
 equipped and supplied while on the march and almost in face 
 of the enemy. But he was undismayed; the problem, though 
 difficult, was not to be given up, but to be faced and solved. 
 When the army marched into Maryland there were very few 
 ambulances with it. Hundreds were still in use removing the 
 wounded from Bull Run, that work not being completed until 
 September 10. All that could be scraped up were taken along, 
 and requisitions were made for others, to meet the army on the 
 march. No one could tell where it would go or when it would 
 meet the enemy. Supplies were also required, to be prepared at 
 Baltimore, and held for telegraphic notice to ship. A number of 
 ambulances were received at Rockville and two hundred at Fred- 
 erick, just before the battle of South Mountain. On October 1 
 there were 319 ambulances, with some corps not reporting. 
 
 On September 13 Letterman reached Frederick, and, recog- 
 nizing the place as the proper location, began the establishment 
 of hospitals for the wounded from the expected battles. The 
 enemy had left the place only a few days before and was still 
 east of the Potomac, as if awaiting attack. A large quantity of 
 supplies was requisitioned from Baltimore, and, but for the 
 broken bridge, there would probably have been sufficient stores 
 for the battles. As events came out, part of these stores arrived 
 at the Monocacy bridge, but no officer was there to hurry them 
 on, and there they remained. Other stores were sidetracked or 
 never left Baltimore. Could these stores have been bunched and 
 placed in charge of an energetic officer, they would have had a 
 much better chance of reaching the field. The events leading up 
 to the battle may be described in Letterman's own words : 
 
 "It appears that it was necessary to have the troops trans- 
 ported from Fortress Monroe with rapidity, as there was scarcely 
 any baggage sent with them. It resulted that the ambulances and 
 
ANTIETAM. 13 
 
 all the appurtenances were left behind, to be sent up on vessels ; 
 some of the vessels never arrived. A large portion of the medical 
 supplies were also left behind, in some cases all but the regi- 
 mental knapsack; by orders of colonels, quartermasters, and 
 others ; in some cases without the knowledge of the medical offi- 
 cers ; in others, notwithstanding their protests. 
 
 "On the 2nd of September the army came once more under 
 my control, and I found it in a most deplorable condition. The 
 officers were worn down by the labors they had in the mean- 
 while undergone; a large portion of the supplies had been left 
 at Fortress Monroe, and even much of that which they had 
 brought with them was thrown on the roadside, as I have been 
 informed by commanding officers on the way to join General 
 Pope. The labor expended at Harrison's Landing in rendering 
 the army efficient for active service seemed to have been ex- 
 pended in vain ; and before it could be in a condition to render 
 such service again it was necessary that it should be completely 
 refitted. But there was no time to do it, for as soon as the 
 troops reached the defenses of Washington they were marched 
 into Maryland, and no time could be allowed for medical officers 
 again to equip themselves. In a few instances the medical offi- 
 cers who returned with the first troops were able to obtain a 
 few supplies. 
 
 "Some corps did not belong to the Army of the Potomac; 
 of the condition of their medical supplies I could know nothing. 
 The medical department had to be, as it were, reorganized and 
 resupplied, and this had to be done while upon a rapid ( ?) 
 march over different sections of the country, and almost in face 
 of the enemy. 
 
 "Before leaving Washington I had ordered a number of 
 ambulances from Alexandria, which reached me at Rockville. 
 While at this place I directed the medical purveyor at Baltimore 
 to put up certain supplies and have them ready to send to such 
 point as I should direct. 
 
 "Upon my arrival at Frederick on September 13th direc- 
 tions were given for the establishment of hospitals at that 
 place for the reception of wounded in the anticipated bat- 
 tles ; and additional supplies, to a large amount, were ordered 
 to be sent from Baltimore at once. The Confederate troops 
 had been in this city but one day before our arrival, and almost 
 all the medical supplies had been destroyed or taken by them, 
 lust previous to our arrival in Frederick two hundred ambu- 
 lances were received from Washington, which I distributed to 
 the corps as rapidly as the movements of the troops would permit. 
 
 "The failure of the railroad company to forward supplies 
 caused serious annoyance. The railroad bridge over the Monoc- 
 
14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 acy having been destroyed by the Confederate troops, made it 
 necessary to have all the supplies removed at that point. A 
 great deal of confusion and delay was the result, which seri- 
 ously embarrassed the medical department; not from that cause 
 alone, but from the fact that the cars loaded with medical sup- 
 plies for its use were on some occasions switched off and left on 
 the side of the road to make way for other stores; and some of 
 the stores, I have been informed, never left Baltimore. 
 
 South Mountain. 
 
 "The battle of South Mountain took place on the 14th. The 
 village of Middletown, about four miles in rear of the scene of 
 action, was thoroughly examined before the battle began, to as- 
 certain its adaptability for the care of the wounded. Churches 
 and other buildings were taken as far as was considered neces- 
 sary. Houses and barns, the latter large and commodious, were 
 selected in the most sheltered places, on the right and left of 
 the field, by the medical directors of the corps engaged; where 
 the wounded were first received, and whence they were removed 
 to Middletown ; the Confederate wounded as well as our own. 
 
 "The battle lasted until some time after dark, and as soon 
 as the firing ceased I returned to Middletown, visited all the 
 hospitals, and gave such directions as were necessary. On the 
 following morning Assistant Surgeon William Thompson, 
 U. S. A., was placed in charge of all the hospitals in the village. 
 Supplies of medicines and stores were in part obtained from the 
 supplies of the army, and in part from Frederick. The task of 
 obtaining food for the wounded was one of still greater difficulty ; 
 but it was accomplished by having it brought from Frederick, 
 and by purchasing from people in the vicinity. Great kindness 
 was shown by the citizens, and especially by the ladies, to our 
 wounded, until the hospitals were broken up. 
 
 "The battle of Crampton's Gap took place at the same time 
 that the engagement at South Mountain was in progress. The 
 hospitals for the wounded were located at Burkettsville, about 
 a mile in rear of our troops. As in the village of Middletown, 
 churches and other buildings were appropriated for hospital 
 purposes. A sufficient number of surgeons were detailed by 
 Medical Director W. J. H. White of the Sixth Corps, who had 
 charge of the medical department in the action. There was but 
 short time given to prepare the hospitals in either village, as 
 the troops left Frederick and fought both battles on the same 
 day. The same difficulty existed here as at Middletown regard- 
 ing supplies and stores, and was overcome in like manner. The 
 most reliable reports that can be obtained show 1,214 wounded 
 in these two engagements ; those of the Confederate forces not 
 being engaged." 
 
ANT I ET AM. 15 
 
 The number of wounded at these battles, as determined 
 later, was 1 ,8 1 9. Letterman's estimate was but two-third* of the 
 actual number. 
 
 These preliminary engagements occupied the attention of a 
 considerable number of medical officers and required a large 
 amount of supplies, both of which were taken from the service 
 of the front, thus weakening it for the great battle to come. 
 Could a service of the rear have taken over this work, the med- 
 ical service at Antietam would have been more satisfactory. 
 Transport columns and clearing hospitals could have been used 
 had they been in existence ; they could have been brought for- 
 ward from Washington independently of the railway. The coun- 
 try was easily traversed, all the movements of the army were 
 simple and direct, much like those of a maneuver campaign. 
 Little happened by chance, events were anticipated, and the leis- 
 urely marches would have allowed the carrying out of a com- 
 plete scheme of medical service here if anywhere. 
 
 The Battle. 
 
 A brief description of the battle is necessary to an under- 
 standing of the work of the Medical Department. On Septem- 
 ber 15, the whole army advanced from the gaps of South Moun- 
 tain to the left bank of the Antietam. On the 16th, the First 
 and 12th corps were above Keedysville; the Second and Fifth 
 in the center and near that place; the Ninth was on the left, in 
 front of the lower bridge; the Sixth Corps and Couch's division 
 remained opposite Harper's Ferry ; Humphrey's division was 
 approaching Frederick, reaching there on the morning of the 
 17th. 
 
 About noon of the 16th, Hooker conducted the First Corps 
 across the upper fords and, with some fighting, took position on 
 the Joseph Poflfenberger farm, his right extending to the Ha- 
 gerstown Pike. At midnight Mansfield followed Hooker and 
 bivouacked on the John Poffenberger place, in rear of Hooker 
 and a little more to the east. The other corps remained as they 
 were. The plan was to roll up the Confederate right and then 
 attack their center and left, the plan of Bull Run. 
 
 At daylight on Wednesday morning (September 17) Hooker 
 led his men in a headlong attack down the Hagerstown Pike, 
 driving Jackson back to the West Wood, where he brought up 
 his reserves and checked Hooker's advance. Then Hood and a 
 part of D. IT. Hill's division advanced and drove Hooker back 
 
1G MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 to his original position. By seven o'clock Hooker's part was 
 done; in the meantime he was wounded and left the field. 
 
 Next Mansfield advanced over practically the same ground 
 and forced Hood back as far as the Dunker Church, this about 
 nine o'clock. There Mansfield's attack lost its impetus. Mans- 
 field was killed early in the fight. Greene's division claims to 
 have held its place in the West Wood near the Dunker Church 
 until noon. Finally all went back toward Hooker's postion, but 
 maintained the North and East woods. 
 
 Next Sumner came on the field, about ten o'clock. Moving 
 his three divisions en echelon he crossed at the fords near the 
 
 JLJA] 
 
 
 
 
 Neikirk place and advanced westward, at right angles to the 
 previous attacks. Sedgwick with the right division met with 
 little opposition until he reached the West Wood, north of the 
 Dunker Church. Here he was held in front by Hood and at- 
 tacked in flank and rear by McLaws and Walker. The division 
 was driven from the field in confusion with heavy loss. It took 
 refuge in the hills in the rear with Hooker and Mansfield. This 
 ended the battle on the right. Both sides were pretty well ex- 
 hausted. 
 
 The fight was next taken up toward the center and here 
 the principal advantage of the day was gained. When Sedgwick 
 moved off to defeat in the woods west of the Pike, French's 
 division diverged to the south and assailed the Confederate line 
 
ANTIETAM. 17 
 
 about the Roulette House. Richardson's division came up on 
 his left a little later, striking the so-called Bloody Lane. These 
 divisions drove back Anderson and D. H. Hill in confusion, cap- 
 turing flags and prisoners and taking possession of the Bloody 
 Lane. The advance reached the Pieper House near Sharpsburg 
 and victory was in sight. 
 
 But this attack was not supported and the troops fell back to 
 the Bloody Lane-Roulette House line. Towards noon Franklin's 
 Sixth Corps arrived on this part of the field, but Sumner dis- 
 suaded McClellan from making any determined use of it. The 
 battle in the center was now over. 
 
 Finally came Burnside's battle on the left. Here Burnside 
 had eight brigades, nominally 14,000 men, of whom about 10,000 
 made the fight. After several half-measure attempts, the well- 
 known Burnside's Bridge was carried by Cox's Ohioans at one 
 o'clock. At four, three divisions advanced on Sharpsburg and 
 had reached the outskirts of the village when A. P. Hill, march- 
 ing rapidly from Harper's Ferry, struck the left flank of Burn- 
 side's line and drove his whole force back near the bridge. This 
 ended the battle. On the right the North and East woods were 
 held ; in the center the Mumma-Roulette-Bloody Lane line ; on 
 the left the crossing of the Antietam had been secured. In all 
 these places the army held advantageous positions for further 
 attack. 
 
 On the 18th Couch and Humphreys came up with their divi- 
 sions, but McClellan made no attack. That night Lee withdrew 
 across the Potomac, leaving his dead and about 2,000 wounded 
 on the field. There was no more fighting of importance during 
 the campaign. The armies remained facing each other across 
 the river until November. Finally McClellan crossed and moved 
 slowly toward Warrenton. In November his dilatory course had 
 reached the limit of President Lincoln's endurance, and he was 
 removed from command. 
 
 MEDICAL SERVICE AT THE FRONT. 
 
 1. Ambulance Corps — The ambulance corps, for the first 
 time in any <, r reat battle of the war, was fairly well organized 
 at Antietam. Each division had its ambulances collected in one 
 train, commanded by an officer, and under the direction of the 
 medical director. To each ambulance two men were detailed in 
 addition to the driver. There had been some drill and instruc- 
 tion. No obstacle prevented the ambulances from reaching the 
 
18 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 field in time. The roads were good, the country, while easily 
 traversed, was yet hilly, with intervening ravines, affording shel- 
 ter for dressing stations and ambulance work. Had the field been 
 selected for a maneuver, no better one could have been found. 
 The marching and fighting probably came as near to what was 
 planned as in any other campaign of the four years. The num- 
 ber on hand I estimate at something above 300, allowing one to 
 each 175 men actually engaged. The ambulances of troops not 
 engaged were available. 
 
 The field hospitals were, as a rule, very close to the firing 
 line. Some houses at the very front — as the D. S. Miller house 
 and the Roulette house — served as hospitals. These places and 
 others were more in the nature of dressing stations on the day 
 of battle, being converted into hospitals later. The fact that there 
 were no compact division hospitals, the wounded being taken to 
 the nearest building or shelter, made the distance to be traveled 
 by ambulances less and their work easier. 
 
 The ambulances began their work early and came very far 
 to the front. On the right they advanced as far as the North 
 and East woods ; further toward the center, they reached the 
 small stream running from Dunbar's Mill to the Antietam near 
 the Neikirk place. On Burnside's front they were able to cross 
 the bridge and late in the evening worked on the right bank. 
 On the whole front they came up to points but half a mile from 
 the main battle, and three-fourths of a mile from the extreme 
 advance. While wounded were removed during the day, most 
 of this work was done during the following night and the next 
 day. Many observers noted that the ambulances did more work 
 and the litter-bearers less, during this battle, than in any pre- 
 vious conflict. 
 
 First Lieut. W Hopkins, Sixteenth N. Y., in charge of the 
 ambulance corps of Slocum's division, says : 
 
 "Most of our badly wounded were brought into the hospi- 
 tals by dark. We then began collecting the wounded Confed- 
 erates. We carried them to the field hospitals until midnight, 
 when the surgeons, overcome by exhaustion, were unable to care 
 for any more. We then collected all we could find and placed 
 them in a group, and I directed two Confederates, found hiding 
 behind the rocks, to remain with their wounded comrades, attend 
 to their wants, and keep the fires burning. At sunrise next 
 morning I went with my stretcherbearers to the camp for the 
 wounded Confederates, and found the fires burnt out, six of 
 
ANTIETAM. 19 
 
 the forty dead, and the two men gone to rejoin the Confederate 
 army." 
 
 The wounded from the right wing were all removed by two 
 o'clock on the following day. Many of these divisions had re- 
 ceived their ambulances but a week previously, and had had no 
 time for drill. The Second Corps, which had the heaviest losses, 
 had also the best ambulance organization, in charge of Captain 
 J. M. Garland. The ambulances of this corps did not stop until 
 all wounded were removed from the field. The hospitals were 
 quite close, except those of Sedgwick's division, in Keedysville. 
 
 The troops on the left (Burnside's Ninth Corps) had the 
 poorest ambulance organization ; yet all the wounded from this 
 part of the field were collected by the evening of the day follow- 
 ing the battle. It may be said that the whole field was cleared 
 within twenty-four hours. This was by far the best record made 
 in the Army of the Potomac to that time. It was commented on 
 favorably by all observers and the new ambulance corps was 
 hailed as an unqualified success. 
 
 For the wounded in advanced positions, and between the 
 lines where they could not be reached by either side, there was 
 an informal truce on the night after the battle and the next day. 
 Some few wounded remained within the enemy's lines until the 
 19th. It has been stated that a truce was asked by one or the 
 other general for this purpose, but I find no record of it. I be- 
 lieve that General Lee sent a flag of truce on the 19th, asking 
 that his surgeons left behind with the wounded be not consid- 
 ered as prisoners of war. 
 
 The ambulance corps did not collect all the wounded. Com- 
 rades, both officers and men, brought in many, at least as far as 
 the ambulances. It was a point of sentiment and honor among 
 the regiments not to allow their men to lie suffering on the field. 
 General Newton N. Curtis, then a captain in the Sixteenth New 
 York, says: 
 
 "We were on the ground over which both armies had ad- 
 vanced and retreated more than once (near the East Wood) as 
 shown by the large number of blue and gray laying where they 
 had fallen. In the twilight the resting soldiers were undis- 
 tinguishable, for passing men had spread blankets over the dead. 
 As the night advanced the Confederate pickets permitted us to 
 go near their lines to carry off those whose cries would have 
 softened the most hardened heart. I went to the front after 
 the company had bivouacked, to bring to the surgeons such men 
 as I could reach. Others of the regiment were similarly em- 
 
20 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 ployed. * * * * On the 19th we found the body of Lt.Col. 
 John L. Stelson, Fifty-ninth New York, near the most ad- 
 vanced position reached by Sedgwick ; his last order when striv- 
 ing to avert the growing confusion was, 'Rally on the colors.' " 
 
 General Newton, himself six feet seven inches in height, 
 makes the curious observation that of all the men of his regi- 
 ment, six feet or over, who went into battle, ninety-nine per cent 
 were killed or wounded. 
 
 In this battle a great variety of ambulances were used. The 
 one-horse, two-wheeled ambulance, rather aptly called "ava- 
 lanche" by the soldiers, still survived, but disappeared soon 
 afterwards. The great four-horse ambulance, a sort of converted 
 army wagon, was also in use. The army had not yet settled down 
 to the light two-horse ambulance that was generally used in the 
 latter part of the war, and was enjoined by the general ambu- 
 lance order of 1863. The ambulance work was the best work 
 that was done at the front by the medical department in this 
 battle. 
 
 Supplies and field hospitals were still in a chaotic condition, 
 as at Bull Run and on the Peninsula. 
 
 2. Supplies — Letterman telegraphed for supplies on the 
 evening of the battle and they were sent from Washington 
 promptly ; that is, they were turned over to the Quartermaster 
 department for shipment. They got as far as the Monocacy 
 Bridge, where they halted. The first of these supplies reached 
 the field on Saturday, the main portion not until later. 
 
 Dr. Agnew of the Sanitary Commission says: 
 
 "Some blame for the non-arrival of stores lies in the fact 
 that of all the forty or more surgeons sent, not one considered 
 himself charged with the function of hurrying anything forward 
 but himself ; the result being that plenty of surgeons got upon 
 the ground, but almost destitute of necessary appliances. This 
 I also attribute, not so much to want of zeal on the part of the 
 surgeons, or of ability to recognize the emergency, but to inabil- 
 ity on the part of the central bureau to command the necessary 
 transportation. 
 
 "I undertake to say that nearly every barn, and hospital, 
 and cluster of wounded over the wide extent of the late military 
 operations was receiving most essential relief from the commis- 
 sion, while the regular medical stores lay at Monocacy Bridge. 
 I solemnly affirm that great loss of life has occurred, and will 
 occur, among the wounded, as the direct result of an inability 
 on the part of the medical authorities to furnish, by rapid and 
 independent means of transportation, the medical and surgical 
 
ANTIETAM. 21 
 
 appliances needed within the two days immediately subsequent to 
 battles." 
 
 The Sanitary Commission started supplies from Washington 
 on Wednesday night and got them there two days ahead of the 
 regular supplies, because the Commission had its own transpor- 
 tation. One of the Sanitary agents says: 
 
 "On Friday we went on with stores of beef stock, stimulants, 
 and surgical dressings and visited barns and farmhouses within 
 a mile and a half of headquarters. Everywhere we were asked 
 for chloroform and opiates, instruments and bedpans, everything 
 in fact required for the wounded except the coarse food fur- 
 nished by the Commissary, and the comforts provided to the 
 extent of their ability by the inhabitants, who had been previously 
 nearly stripped by the Rebels." 
 
 Judged by the commendatory notices, the people here were 
 more generous to the sick and wounded of the army than those in 
 Pennsylvania the next year. 
 
 With the restoration of the railway bridge on Sunday, sup- 
 plies arrived in abundance, evacuation of the wounded began, 
 and there was no more complaint of a shortage of medical 
 supplies. 
 
 3. Field Hospitals — There were at Antietam no division 
 field hospitals, as we now understand them ; hospitals on wheels, 
 that can be moved rapidly and set up as well on a bare plain as 
 in a village. There were seventy-one field hospitals, all extem- 
 porized in houses, barns and other buildings which offered shel- 
 ter. At some of them the only equipment was what the surgeon 
 and his orderly carried on their persons; others had medicine 
 wagons and drew supplies from the regimental wagons. As a 
 rule there was a fair supply of medicines and dressings ; but little 
 or no clothing, bedding, tentage, food, or even cooking utensils. 
 
 The Sanitary Commission reported that this was due to three 
 causes: 1, lack of time on leaving Washington; 2, breaking of 
 the railway ; 3, lack of independent transportation for the Med- 
 ical Department. The Commission declared that if the Medical 
 Department had possessed transportation of its own, it could have 
 sent supplies direct by wagon train, instead of intrusting them 
 to the Quartermaster to be shipped by rail when they had to take 
 their chances with all other supplies. The Commission urged 
 loud and long that independent transportation be given the Med- 
 ical Department. This was done later ; each division in 1864 had 
 fourteen to eighteen wagons for field hospital and supplies, and 
 
22 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 a large reserve train carried reserve supplies for the whole army ; 
 all under control of the Medical Director. 
 
 As the army was in position (except Franklin) on the even- 
 ing of the 15th, as the marches had been slow and the roads good, 
 there was nothing to prevent the hospitals being in readiness 
 when the battle began on the 17th. Everything had proceeded in 
 a slow and leisurely manner, with only the battles on the four- 
 teenth which slightly interfered with orderly procedure. 
 
 The hospitals were mostly located on the right bank of the 
 Antietam, and very close to the battle lines. 
 
 Letterman appears to have had the confidence of McClellan 
 and to have known the proposed plan of battle, which was car- 
 ried out without change, except as the columns were checked by 
 the enemy. He says : 
 
 "As suon as the nature of the country and its resources for 
 hospital purposes could be ascertained, and when a conception 
 was formed of the nature of the anticipated battle, and the posi- 
 tions to be occupied by our troops, directions were given to the 
 corps medical directors to form their hospitals as far as possible 
 by divisions, and at such distance in rear of the line of battle as 
 to be secure from the shot and shell of the enemy ; to select the 
 houses and barns most easy of access, and such as were well 
 supplied with hay or straw, and water; and where circumstance 
 would permit, to designate barns as preferable to houses ; as 
 being at that season of the year well provided with straw, better 
 ventilated, and likely to enable the medical officers with more 
 facility to attend to a greater number of wounded; and to have 
 all the hospital supplies taken to such points as were selected. 
 These directions were generally carried into effect, and yet the 
 hospitals were not always beyond the range of the enemy's guns. 
 Very few hospital tents could be obtained, owing to the haste 
 with which the army marched from Virginia into Maryland ; 
 but the weather was such as to enable the wounded to be cared 
 for without them." 
 
 It is to be hoped that his directions were couched in shorter 
 sentences than his report. On account of the lack of tents the 
 wounded were collected in houses and barns ; before the contest 
 ended, every building between the Antietam and the Potomac 
 was filled with wounded men, while hundreds lay under straw 
 shelters, in the shade of orchards, and wherever there was shel- 
 ter or shade. 
 
 The location of the principal field hospitals is shown by divi- 
 sions on Map III. Hospitals not being compact organizations at 
 that time, it is possible only to give the locations of the principal 
 
ANT I ET AM. 
 
 23 
 
24 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 ones — the stations of the medical directors of divisions. Each 
 of these hospitals was the nucleus of a group of hospitals, occu- 
 pying all the neighboring buildings. Also the distinction between 
 dressing station and hospital was not then clear; many small 
 buildings retained their wounded for several days, a thing that 
 did not occur later. 
 
 The First Corps (Hooker) crossed at the upper fords and 
 formed for battle near the Joseph Poffenberger place. The field 
 hospitals were located at the White House (Geo. Line), the 
 Middlekauf house and the Joseph Poffenberger house, with sub- 
 divisions and branches in all the surrounding houses and barns. 
 As nearly as I can make out, these were the hospitals of Meade's, 
 Rickett's and Doubleday's divisions respectively. The White 
 House was the largest of these hospitals, caring for a thousand 
 wounded. It was the hospital of the Pennsylvania Reserves. 
 About 1,600 were treated in all these hospitals. When General 
 Hooker was wounded he was taken to the P. Pry house near 
 McClellan's headquarters. 
 
 Mansfield followed Hooker into battle. The hospitals of his 
 corps (Twelfth) were located at Smoketown for Greene's divi- 
 sion, and at the John Poffenberger house for Williams' division. 
 These hospitals were in rear of the others and received only 
 about six hundred patients. Naturally the wounded of the First 
 and Twelfth corps were greatly mixed; all these hospitals had 
 wounded from both corps, as well as from Sedgwick's division 
 of the Second Corps. 
 
 Next on the field came Sumner's large Second Corps, with 
 Sedgwick, French and Richardson in line from right to left. 
 Sedgwick's division hospitals were in Keedysville, with extensive 
 branches at Pry's house and mill, the Hammond house and other 
 places near the Upper Bridge. The hospitals of these divisions 
 do not appear to have followed the troops across the ford, but 
 to have crossed at the Upper Bridge and kept on to the west. 
 These hospitals cared for about 1,500 wounded. 
 
 The hospitals of French's division were located in and about 
 the Sam Poffenberger house. This house was in a ravine, close 
 to the front, but well sheltered from fire. This hospital shel- 
 tered 1,400, mostly in some old barns and temporary sheds of 
 rails and straw. A number of pictures of these barns and straw 
 shelters have been preserved. Many Confederate wounded were 
 also treated here. 
 
 The hospital of Richardson's division was at the house of 
 
ANTIETAM. 
 
 25 
 
 J. Hoffman, with branches in other houses near by. It sheltered 
 or attempted to shelter about 1,200 wounded. The Sanitary Com- 
 mission centered its work here and did a large portion of the 
 work of this hospital. General Richardson, when wounded, was 
 taken to the P. Pry house, where he died some weeks later. 
 
 All these hospitals show a curious tendency to drift to the 
 right, that is, to the north. Considering that the main line of 
 advance was from east to west, and the retreat would have 
 been to the east, the reason for this phenomenon is not apparent ; 
 it may have been intuitive. While it is seen now that it was 
 hardly possible for McClellan to have been defeated, it was 
 believed by the whole army at the time that the Confederates had 
 
 -"-•-'-- 
 
 superior forces. Their strength was estimated at from one to 
 two hundred thousand men. The lowest and most careful esti- 
 mate placed their forces at 97,000 men of all arms. Had such 
 been the case, defeat was not by any means improbable. Provid- 
 ing for possible defeat, it seems that only as many field hospitals 
 should have been located west of the creek as were absolutely 
 necessary. Today they would all be located east of the creek, 
 until the contest should be decided. 
 
 Franklin's corps did not come on the field until towards 
 noon and but a portion of one division was engaged. A hospital 
 was established at the house of Michael Miller; this hospital was 
 generally known as the Brick House Hospital. Dunbar's Mill 
 nearby was also used as a hospital. These hospitals cared for 
 some three hundred wounded. 
 
 General Fitz John Porter's Fifth Corps was not engaged 
 seriously. 
 
W MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 Burnside's battle was fought near the Lower Bridge and in 
 front toward Sharpsburg. The field hospitals were at the house 
 of F Rohrbach ; the house of M. Thomas, farther back toward 
 the hills, and at a place called Locust Grove, or Locust Springs, 
 on the farm of George Goeting, near Keedysville. They cared 
 for eleven hundred of the eighteen hundred wounded reported 
 from Burnside's corps ; some were cared for in Keedysville and 
 some were carried directly to Middletown and Frederick. 
 
 I do not wish lo give the idea that everything in a medical 
 way at Antietam was carried out in an orderly and satisfactory 
 manner, for this was not the case. The time for such conditions 
 and results had not yet arrived, and there is ample evidence of 
 many defects in medical matters. A Mrs. Holstein, who acted as 
 a nurse in many field hospitals, and in 1866 wrote her recollec- 
 tions of hospital life, gives rather a somber picture of Antietam. 
 She said: 
 
 "We found the wounded still scattered over the field. At 
 this time they were all under some kind of shelter. A sad want 
 of suitable food and medical supplies was still felt. Those were 
 fortunate who were in the barns, where they were sure of a little 
 hay or straw on which to rest their shattered limbs ; while many 
 lingered a few days with no other bed or pillow than a knap- 
 sack. * * * Upon one end of the piazza at Locust Grove lay 
 Lieutenant Williams of Connecticut ; for three weeks he lingered 
 here. That same piazza had been thickly strewn with the 
 wounded and dying ever since the battle. In the house were sev- 
 eral officers, all seriously wounded. In a miserable little log 
 house near the Potomac thirty men lay on the floor, ill with 
 fever. Some had a little straw but no pillows; this house was 
 the counterpart of many. The churches and half the houses in 
 Sharpsburg were crowded with our wounded troops." 
 
 Rev. I. O. Sloan of the Christian Commission, who took two 
 loads of supplies, wrote in his report: 
 
 "We arrived in Middletown on the morning of the seven- 
 teenth, here we found wounded men coming in from the battle- 
 field (on the road to Frederick), some with fingers shot off, arms 
 broken, wounded in the head, covered with blood. 
 
 "The little church in the main street was already filled with 
 our wounded, as also some of the houses opposite. * * * 
 
 "As we hurried along to where the two armies were engaged 
 we frequently had to stop and give of our supplies to the wounded 
 men whom we met in ambulances, and who lined the road, hob- 
 bling along as best they could, to find some temporary hospital. 
 
 "At Keedysville several houses were filled with wounded. 
 
ANTIETAM. 
 
 We halted at the last one, used as a hospital by Sedgwick's Divi- 
 sion. Every room in the house was filled with wounded, and 
 every spot almost in the yard. This hospital was in charge of 
 Dr. Houston, a good man who was trying to do all he could, but 
 they had as yet received no stores, and were entirely without 
 anything to eat. We gave them what we could spare. 
 
 "From the hills a little beyond here the conflict was plainly 
 visible. All day they were still bringing in wounded to this 
 place * * * * 
 
 "Nearly every farmhouse and barn in all that region was 
 made a hospital ; we visited all and left some supplies. On 
 
 itaMffi; 
 
 Shelltr for wtunM a I Anli el am 
 
 Sunday we established ourselves at the Hoffman House (hospital 
 of Richardson's Division, Sumner's Corps). 
 
 "In every spot here — the barn, the carriage house, sheds, 
 strawstacks, orchards, and indeed everywhere — were to be seen 
 wounded and dying men. * * * 
 
 "A great proportion of the sufferers were youths from six- 
 teen to twenty-one.'' 
 
 A brief but first-hand picture of the field is given in the 
 report of Dr. Cornelius R. Agnew of the Sanitary Commission: 
 
 "The wounded were mostly clustered about barns, occupying 
 the barnyards, floor and stables ; having plenty of good straw, 
 well broken by the power threshing machines. I saw fifteen 
 hundred wounded men lying upon the straw of two old barns 
 within sight of each other (probably the hospitals of French's 
 Division, Sumner's Corps). Indeed there was not a barn or 
 farmhouse, or store, or church, or schoolhouse, between Boones- 
 boro, Kcedysville, Sharpsburg, and Smoketown that was not 
 gorged with wounded — rebel and Union. 
 
 "Even the corncribs, and in many instances the cow stables, 
 and in one place the mangers were filled. Several thousand lie 
 in the open air upon straw, and all are receiving the kind serv- 
 
■2S MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 ices of the farmers' families and of the surgeons. But every- 
 thing in the way of medical supplies was deficient ; poor fellows 
 with broken and lacerated thighs had to be carried out of barns 
 into the open fields to answer to a call of nature. * * * 
 
 "Concentrated foods are also scanty; in fact everything 
 wanting that wounded men need, except a place to lie down, and 
 the attention of personally devoted surgeons." 
 
 The most notable death at Antietam was that of Major Gen- 
 eral Joseph K. Mansfield. Mansfield was sixty years old but rode 
 his horse at the head of his corps. Just as the line passed the 
 fence running from the D. S. Miller house to the East Wood, 
 he rode to the front of the Tenth Maine, believing the men to 
 be firing on Duryea's brigade and beckoning them to cease firing. 
 He halted in front of Company C and Captain Burnham pointed 
 out to him the gray coats of the enemy. The General said, "Yes, 
 you are right," and turned to the rear. A volley was fired and 
 he was hit. He tried to put his horse over the rails but the animal 
 had been severely wounded and failed. As he dismounted a gust 
 of wind blew open his coat, disclosing a wound of the body. 
 Some men of the regiment carried him back through the woods 
 (North Wood?) to the Smoketown road, where they found an 
 ambulance to convey him to a hospital. 
 
 Surgeon Thomas Antisell, Medical Director of the corps, 
 made the following brief report of Mansfield's wound and death 
 to the Surgeon General: 
 
 "General Mansfield was wounded by a rifle bullet through 
 the right breast, about 6 a. m. on the 17th, and died on the 18th at 
 8.15 a. m. Bullet entered between spine and scapula of right side 
 and passed out two inches above and to outside of right nipple, 
 between 3rd and 4th ribs. 
 
 "The wound bled at first freely from posterior wound, and 
 effusion into pleural sac augmented rapidly during the night of 
 the 17th. He died of exhaustion." 
 
 Surgeon W. J. H. White, U. S. Army, Medical Director of 
 the Sixth Corps, was killed on the field by a shot from the 
 enemy. He was the only regular medical officer killed in battle 
 during the war. Assistant Surgeon Revere of the Twentieth 
 Massachusetts and Assistant Surgeon A. A. Kendall of the Thir- 
 teenth Massachusetts were killed while accompanying their regi- 
 ments into battle. 
 
 I have endeavored to secure the personal experience of some 
 medical officer who took part in this campaign, but for most of 
 them it is now too late. General Alfred A. Woodhull, now re- 
 
ANTIETAM. -2\t 
 
 tired, was then an assistant surgeon in the regular army and 
 acting surgeon of the Second Infantry — usually in charge of 
 several regiments — of Syke's division, Fitz John Porter's corps. 
 A part of this division crossed the Antietam at the Middle 
 Bridge during the afternoon and engaged the enemy along the 
 road to Sharpsburg. Woodhull says : 
 
 "In the afternoon, I should say between 2 and 3 o'clock, the 
 Second Infantry crossed the bridge, moved into the fields on 
 the left, where there had been cavalry in the morning, and then 
 marched straight to the front toward a battery that was on the 
 sky line, not far fnom the point marked National Cemetery on 
 present day maps. The field was perfectly clear, I think it had 
 been moved, and the surface was moderately rolling with a 
 general slope toward the creek. I started out with the regiment, 
 dismounted, and as wc advanced I saw that we should draw fire 
 as we crossed a certain rise. So I purposely dropped behind, to 
 cross after the fire on that point slackened. That was success- 
 fully done. But I had hardly crossed the crest myself when I 
 saw walking along the road toward the creek Lieutenant McKee, 
 Second Infantry, apparently wounded. I crossed over to him 
 and found a triangular piece of shrapnel, about three-fourths of 
 an inch on a side, with one of its angles imbedded in the sternum. 
 He was also feeling some shock. I turned back with him, look- 
 ing for a convenient place to dress the wound, but found none 
 until we came near the bridge. * * * Approaching the bridge 
 I found a small house on the south side of the road, that had been 
 abandoned, and that I used for a dressing station — one could 
 hardly call it a hospital — and there cared for the wounded who 
 drifted back, until it was dark and after. 
 
 "No hospital site could be selected in advance, because no 
 one could possibly foresee the direction in which we might move. 
 Assistant Surgeon William R. Ramsey, who was attached to 
 the Eleventh, came there also and we worked in company. This 
 was done by both of us our own initiative. 
 
 "We were practically quite free from control, in the sense of 
 detailed direction. That was also true through the whole of 
 my service with the Army of the Potomac (until the last of 
 November, 1862). At first it depended on the lack of organiza- 
 tion, and both then and later it followed because we were regu- 
 lars. I do not say this boastfully, but I do think it was assumed 
 that, as we were intelligent men who had been carefully selected 
 and were living in an atmosphere of discipline, we could be 
 depended on to look out for the service in a matter-of-fact way ; 
 while the volunteers, even after a year's life under canvas, re- 
 quired supervision and direction, while the tendency to lack of 
 
:!o MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 control the much greater size of the respective commands and 
 the heavier sick lists, all called for official regulation. 
 
 "Thus at Second Bull Run, on the second day, when it was 
 evident that we were in for it, several of us — four, I think — rode 
 together to select of our own motion a fit place for field work. We 
 found what we thought would answer and had barely moved 
 from it, returning to our commands, when a solid shot, or an 
 unexploded shell, plumped down exactly where we had clustered 
 in consultation. One of Longstreeet's batteries, it must have been, 
 on higher ground, had espied us and paid us the compliment 
 of thinking that we were a general and his staff. We did not 
 get a common spot that day, and for myself, although with the 
 troops, and there were many wounded men, we moved from 
 point to point so rapidly that it was impossible to care for any 
 on the field. 
 
 "To go back to Antietam. If you will turn to page 634 
 (B. & L.) you will find the one-story house near the end of the 
 bridge as my station, while the ridge in the background (west) 
 represents the Rebel line that challenged us. I think that ambu- 
 lances came from the rear to the bridge and beyond and carried 
 off the portable cases, and that the work was going on all night." 
 
 Oliver Wendell Holmes, in his story "My Hunt After the 
 Captain," has left some vivid pictures of scenes following the 
 battle, and incidentally brought out the confusion that existed 
 among the wounded. His son, a captain in the Twentieth Mas- 
 sachusetts, and now a Justice of the Supreme Court, was wounded 
 in the neck in this battle. That night the elder Holmes received 
 a telegram telling him of his son's injury, and he started at once 
 for the field, accompanied by another father who had a son 
 wounded (Lt. Col. Wilder Dwight, Twentieth Massachusetts), 
 and was taking a surgeon with him. He went first to Philadel- 
 phia, but although several wounded officers had already reached 
 that place, his son was not among them. By noon of the 18th 
 he was in Baltimore, and as he proceeded toward Frederick a 
 growing company of fathers, brothers, wives and mothers was 
 found to be journeying toward that point, on the same errand 
 as himself. When he reached Frederick he found many wounded, 
 but no one could tell him anything of his son. So he procured a 
 wagon and set out for Middeltown ; along the way he first saw 
 wreckage of the battle. 
 
 "The road was filled with straggling and wounded soldiers. 
 All who could travel on foot, multitudes with slight wounds of 
 the upper limbs, the head or face — were told to take up their 
 beds and walk. Just as the battlefield sucks everything into its 
 
ANTIETAM. 
 
 :;i 
 
 red vortex for the conflict, so does it drive everything oft in long 
 divergent rays, after the fierce centripetal forces have met and 
 neutralized each other. * * * The slain of higher condition, em- 
 balmed and iron-cased, were sliding off on the railways to their 
 far homes ; the dead of the rank and file were being gathered up 
 and committed hastily to the earth. The gravely wounded were 
 being cared for hard by the scene of conflict, or pushed a little 
 way along to the neighboring villages ; while those who could 
 walk were meeting us at every step. It was a pitiable sight, truly 
 pitiable ; yet so vast, so far beyond the possibility of relief, that 
 
 GERMAN REFORMED CHURCH IN KEEDYSYILLE, USED 
 
 AS A rNION HOSPITAL. FROM A PHOTOGRAPH 
 
 TAKEN IN 1886. 
 
 many single sorrows of small dimensions have wrought upon my 
 feelings more than this great caravan of maimed pilgrims. At 
 intervals a dead horse lay by the roadside, or in the fields, un- 
 buried. Full in the middle of the road, caring little for what they 
 met, came long strings of army wagons, returning empty from 
 the front for supplies." 
 
 That evening Middletown was reached and a search made 
 of all the hospitals. The principal collection of wounded was in 
 the churches. Boards were laid over the tops of the pews ; on 
 these some straw was spread and on these the wounded lay, 
 
32 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 with little or no covering other than such scanty clothing as they 
 had on. The son was not found here either, and on Sunday 
 morning, the 21st, Dr. Holmes set out for Boonesborough and 
 Keedysville. At the latter place he found wounded by the thou- 
 sand, filling the town and all the houses in the surrounding 
 country; but no one knew anything of the captain, and he was 
 told that the only way to find him was to search every hospital 
 and house. This he did, and finally the place where the son had 
 been was found; but he had departed for Hagerstown, presum- 
 ably on his way home. So the good doctor went back around by 
 Baltimore to Harrisburg and searched the hospitals there, only 
 to find that he had not left Hagerstown. Finally on Thursday, 
 the 24th, the Captain reached Harrisburg and his father met him 
 there, six days after the battle. The wound did not prove serious. 
 The whole story is well worth reading for its pictures of the 
 times. The fact that he could determine the whereabouts of his 
 son only by going through all the hospitals, bed by bed, and 
 scanning every face, gives much information as to the keeping 
 of records. Medical inspectors, ten days after the battle, could 
 give no estimate of the casualties; the earlier lists of dead and 
 wounded came from the reports of companies and regiments, 
 not from medical officers. In this portion of the work of the 
 medical department there was room for improvement. 
 
 Burial of the Dead. 
 
 Burial of the dead was begun on the day following the battle 
 and completed by Sunday, the 21st. Details were made from the 
 various regiments, each detail gathering up the dead of its own 
 command. In this manner the sad duty was done in an orderly 
 manner, and it was possible to identify a large portion of the dead. 
 A man's own comrades would naturally take a greater interest 
 in finding his body and giving it decent burial, and in marking 
 the grave, than would strangers. The Union dead were as a rule 
 buried in separate graves, no small undertaking when the dead 
 numbered more than two thousand. When Dr. Holmes visited 
 the field on Sunday he saw no bodies, but many newly-made 
 graves. In some cases the graves were in groups which were 
 fenced in. 
 
 Confederate prisoners were employed in burying their own 
 dead, only a part of which had been interred before the retreat. 
 M,any of these were buried in great trenches, from fifty to a 
 hundred in one trench. 
 
 After the battle hundreds of northern people came to Sharps- 
 
ANTIETAM. 
 
 :rs 
 
 burg in search of dead or missing relatives or friends. The rais- 
 ing in this battle, however, were few; less than in any other great 
 battle of the war. For weeks the road to Hagerstown was a 
 continual funeral procession. Here came the father or brother 
 from Xew England, searching for his dead; here also came the 
 wife seeking the grave of her soldier husband. From the field of 
 Antietam the maimed bodies were carried back, to rest through- 
 out the ages by the homes from which they had gone out to 
 
 J- C £>/ f n f „ fl 
 
 battle for their country. It is said that more than a thousand 
 were disinterred at that time. 
 
 Medical Service of the Rear. 
 
 When the battle closed there were in round numbers ten 
 thousand wounded men at Antietam, fifteen hundred at Middle- 
 town and five hundred at Burkettsville. There were about two 
 thousand wounded Confederates at these places to be cared for, 
 making fourteen thousand in all. There were also sick, accumu- 
 lating at a rate of four or five hundred a day. By the evening of 
 the 18th they had all been collected and placed under some kind 
 of shelter. Had the army been provided with a modern sanitary 
 equipment Letterman would now — or earlier- — have called for 
 clearing hospitals and transport columns. The conditions were 
 very favorable to the work of such organizations. As he knew 
 
3i MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 nothing of these things, he had, on the evening of the battle, tele- 
 graphed to the Surgeon General, asking for one hundred sur- 
 geons and the medical supplies heretofore mentioned. Some sev- 
 enty surgeons were started next day and reached Frederick ; 
 some were stopped for work there, others were pushed on to 
 the battlefield. These surgeons and supplies took the place of 
 clearing hospitals, organized and controlled, however, by officers 
 detached from the army. Physicians and surgeons came in from 
 all parts of nearby states, even from New England; the army 
 was not engaged in further operations and remained in the vicin- 
 ity; thus there was no shortage of medical men to care for such 
 an unprecedented number of wounded. 
 
 1. Transportation — For transportation from the field to 
 Frederick, all the ambulances and spare wagons of the army 
 were used, but many hundreds of the less severely wounded went 
 on foot. The road used was the old National Pike, by way of 
 Boonesboro and Middletown ; a fairly good road at that time. 
 The massive stone bridges on this road were not destroyed by 
 the Confederates. 
 
 Provision for the journey was carefully made. Letterman 
 says: 
 
 "The removal of so large a number of wounded was no 
 small task. The journey to Frederick in ambulances was tedious 
 and tiresome, and often painful to the wounded men. It was 
 necessary that they should halt at Middletown for food and to 
 take rest; that food should always be provided at this place at 
 the proper time, and for the proper number ; that the hospitals at 
 Frederick should not be overcrowded ; that the ambulances 
 should not arrive too soon for the trains of cars at the depot 
 at Frederick, the bridge over the Monocacy having been rebuilt 
 (September 21st) ; and that the ambulance horses should not 
 be broken down by the constant labor required of them. With 
 rare exceptions this was accomplished and all the wounded whose 
 safety would not be jeopardized by the journey were sent care- 
 fully and comfortably away." 
 
 Wagons were hired from citizens for hauling medical sup- 
 plies onto the field, in order to avoid the use of ambulances for 
 that purpose. 
 
 While hundreds of wounded struggled along the road to 
 Frederick from the 14th on, the regular evacuation of the 
 wounded appears to have not begun until about the 20th. The 
 Confederates did not evacuate the field until the night of the 
 18th and the Monocacy bridge was not completed until the 21st. 
 
ANTIETAM. 
 
 35 
 
 Ambulance trains were now kept running until all but about one 
 thousand of the wounded had been removed. I am unable to 
 learn precisely how many days were required, but believe the 
 evacuation was completed by the 25th. 
 
 For those unable to bear transportation, two large tent hos- 
 pitals were constructed on the field: one at Smoketown, for 750 
 patients; and one at Locust Springs, for 450. These hospitals 
 were continued in use until the following spring — March 30, 
 1863. 
 
 A portion of the wounded were evacuated by way of Ha- 
 gerstown, to Harrisburg and Philadelphia. Dr. A. J. Smith was 
 
 
 
 Nou/eti-es Barn . 
 
 Tirld ffaspitn./tnlieHm. , 
 
 in charge of the hospitals at that point, which were in Lyceum 
 Hall, the Washington Hotel, and the Courthouse. On the 19th 
 there were 150 patients in these hospitals and 150 more had been 
 sent on to Harrisburg. They were dependent on the citizens for 
 nearly all their supplies. On September 22 General Treasurer 
 Geo. L. Strong of the Sanitary Commission was in Hagerstown 
 and found the floors of the buildings covered with wounded men, 
 with no beds or bedding. He at once advanced six hundred dol- 
 lars to Surgeon Smith with which to fit up these buildings. On 
 this date a train of 347 wounded left for Harrisburg. 
 
 One of the faults of all field and other extemporized hos- 
 
36 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 pitals at this time was lack of hospital funds. The hospital fund 
 system of the regular army had been extended to regimental 
 hospitals, but when a new hospital was organized in the field, it 
 had no fund to start with. 
 
 It is stated that of the seventy different hospitals at Antietam 
 not one had a dollar of funds. While surgeons sent to towns to 
 organize new hospitals must have been furnished with funds or 
 credit, they seem to have made purchases very sparingly. They 
 appear to have been closely restricted. 
 
 The Confederate wounded at South Mountain were moved 
 across the river to Shepherdstown as rapidly as possible, mostly 
 in rough wagons, and on foot. Ambulances were so scarce that 
 when General Hood captured a half dozen at Manassas he tried 
 to hold them for his own division and did so until placed in 
 arrest. Mary Bedenger Mitchell, a Southern woman, has given 
 an account of the wounded at Shepherdstown, from which a few 
 extracts are here inserted: 
 
 "Monday afternoon we suddenly found the wounded in our 
 streets, what seemed an endless line of wagons discharging their 
 piteous burdens. There were no preparations, no accommodations, 
 not even a courier in advance to announce their arrival. The 
 men could not be left in the streets; men ran for keys and un- 
 locked unused buildings. Hay was brought and covered with 
 blankets; on these improvised beds the sufferers were placed, 
 and the next question was how to dress their wounds. No sur- 
 geons were to be seen. A few men detailed as nurses had come 
 but they were incompetent. Our women set heartily to work ; 
 washed, bandaged, bathed and did what they could without 
 knowledge or experience. Every housekeepr ransacked her stores 
 for material for bandages. The doctors came by and by; some 
 rough surgery was done, mostly amputating. (These surgeons 
 did not impress Mrs. Mitchell favorably.) 
 
 "This was Monday, the day after the battle of South Moun- 
 tain. Next day fresh wounded poured in, and they worked all 
 day. This day would have brought despair for food, but an 
 apology for the commissary arrived ; also some additional doctors, 
 most of whom might as well have stayed away. 
 
 "On Wednesday the battle began again, this time so near 
 that the roar of artillery and the rattle of musket fire was heard 
 from dawn to dark. The wounded before had been but a pre- 
 lude. Now they came in thousands, absolutely deluging the little 
 country village. In the streets was noise, confusion, dust, throngs 
 of stragglers, horsemen, wagons blocking each other ; and a con- 
 tinual din of shouting, swearing and rumbling, in the midst of 
 which men were dying, fresh wounded arriving, surgeons am- 
 
ANTIETAM. 37 
 
 putating and women going in and out with bandages, lint, medi- 
 cines and food. The wounded continued to arrive until the 
 town was quite unable to hold all the disabled and suffering ; they 
 filled every building and overflowed into the country round. 
 Those able to travel were sent on to Winchester and other towns, 
 but their removal seemed to make no appreciable difference. 
 
 "On Thursday night we heard more than the usual sounds, 
 and in the morning we found the Confederates in full retreat. 
 General Lee crossed the Potomac under cover of darkness and 
 moved toward Kearneysville. General McClellan followed to 
 the river and began shelling the retreating army, and conse- 
 quently the town. What before was confusion grew infinitely 
 worse. The roads were thronged, the streets blocked, and the 
 wounded started off in crowds. In vain we implored tliem to 
 stay. They replied that the Yankees were crossing, the town 
 was to be burned, that we could not be made prisoners but they 
 could, that anyhow they were going— and go they did. Men 
 with cloths about their heads went hatless in the sun; men with 
 injured feet limped shoeless on the stony road ; men in ambu- 
 lances, wagons, carts, wheelbarrows, on stretchers, or supported 
 on the shoulder of some comrade — all who could crawl went, 
 and almost to certain death. They could not go far, they 
 dropped off in the country houses ; but their wounds had become 
 inflamed; erysipelas or gangrene followed and long rows of 
 nameless graves bear witness to the results." 
 
 As a matter of fact none of McClellan's troops entered Shep- 
 herdstown until September 29, when they captured and paroled 
 about six hundred wounded still remaining there, presumably 
 cases not transportable. 
 
 On September 21 General Lee, in an order directing opera- 
 tions at Winchester, said: 
 
 "Hospitals for the sick and wounded will also be provided 
 by securing neighboring barns and other suitable buildings, and 
 surgeons placed on duty with them. Surgeon Guild, Medical 
 Director, will proceed to Winchester and organize the depot." 
 
 The Confederate army moved to the vicinity of Winchester 
 during the last week of September. On October 2, in a letter to 
 Jefferson Davis, General Lee said: 
 
 "I have been endeavoring to move back to Staunton every- 
 thing captured at Harper's Ferry, together with our sick and 
 wounded." 
 
 Owing to weak transportation, the progress was very slow. 
 The distance that the Confederate wounded had to be transported 
 by wagons in this campaign — from the Potomac to Staunton — 
 was 125 miles. In the Gettysburg campaign the same route was 
 
3S MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 used, but the distance was increased by the thirty miles from 
 Gettysburg to the Potomac. 
 
 2. Advance Base Hospitals — Frederick being the rail- 
 head and advance base of the army, naturally became the location 
 of the evacuation hospitals. I call them evacuation hospitals, but 
 they were something more than that in point of duration, for 
 they were maintained for months, and not closed until the next 
 spring. If we consider an evacuation hospital as a mobile organi- 
 zation, something like a field hospital, but moving more slowly, 
 judging by Antietam we should have to alter our ideas. The 
 hospitals here did not merely shelter the wounded until they 
 could be passed on to the rear ; they received the wounded from 
 the field and cared for them until they were finally disposed of 
 by recovery, discharge for disability, death or otherwise. Long 
 before these hospitals were closed, the army had fought another 
 great battle — Fredericksburg. The personnel may have been 
 available at Chancellorsville, but the material was probably worn 
 out and of little further value. 
 
 There had been a general hospital at Frederick a year or more, 
 in some stone buildings known as "The Barracks," said to have 
 been built in the time of the ill-fated Braddock. Braddock's col- 
 umn passed through Frederiek, forerunner of many martial pro- 
 cessions witnessed by the village in these later years. In the 
 spring this had been the hospital of Banks' corps and had some 
 six or seven hundred beds. Assistant Surgeon Robert Weir, 
 U. S. Army, was in charge, with about five hundred and fifty 
 patients, when the Confederates crossed the Potomac. Learning 
 of their threatening position, he impressed vehicles and sent four 
 hundred of his patients to Chester. One hundred and fifty of 
 the worst cases were left behind ; they were captured and paroled 
 by Jackson when he entered Frederick on the 7th. When the 
 Confederates in turn evacuated the place on the 10th, they left 
 several hundred men there who were too sick to be carried fur- 
 ther. Other sick men were left along the road, four hundred, 
 according to Brinton, at Middletown. When the Union forces 
 entered Frederick this hospital was again occupied and known 
 as Hospital No. 1. Other hospitals, Nos. 2, 3, 4, 5, 6 and 7, were 
 organized in the United States Hotel, Bonsall's Academy, the 
 Lutheran and other churches, a convent and academy, a tannery, 
 schoolhouses and other buildings. The whole had a capacity of 
 3,500, which was exceeded by crowding. For example, No. 1 
 Hospital, with a capacity of 600, had 1,000, and fed 1,800, the 
 excess sleeping "somewhere." 
 
ANTIETAM. :w 
 
 Surgeon John J. Milhau, U. S. Army, was placed in charge 
 of all the hospitals, and of medical affairs generally in Frederick, 
 in which position he showed marked ability. All these hospitals 
 were organized and in operation by September 21. But when 
 the wounded began to pour into Frederick, in spite of all prepa- 
 ration, the facilities were entirely inadequate. James H. Pea- 
 body, Assistant Surgeon, U. S. V., says in his report: 
 
 "The greater number of medical officers have been sent 
 forward to the field, the work for those left in Frederick was 
 almost incessant for a few days. * * * After the battle 
 most of the wounded were hurried to Frederick, and from there 
 those but slightly wounded, after being allowed a night's rest, 
 were transferred to Baltimore and Washington. 
 
 "The hospitals in Frederick were densely crowded after the 
 battle, and every available building was used for hospital pur- 
 poses. Some of those buildings were but poorly ventilated and 
 illy adapted for this purpose ; they were given up as speedily as 
 possible. For the first five or six days, owing to crowding, it was 
 almost impossible to keep the sick and wounded supplied with 
 food and other necessaries. The greatest inconveniences to 
 which the wounded were exposed was in consequence of not 
 having an adequate number of beds to accommodate the thou- 
 sands who were pouring in ; and those but slightly wounded had 
 to lie on the floor or ground, as they preferred, until the day 
 after arrival, when they were to be transferred to Washington 
 or Baltimore. I have counted as high as 1,200 thus transferred 
 in one train. The crowding only continued for a few days, after 
 which we had ample accommodations and supplies for those 
 left." 
 
 The evacuation from Frederick appears to have begun as 
 soon as the bridge was restored, and to have been kept up con- 
 tinuously until all those to be sent away had been removed. A 
 total of 6,062 were removed by way of Frederick ; 3,329 to Wash- 
 ington; 1,356 to Baltimore, and 1,627 to Philadelphia. These 
 wounded were transported in ordinary box cars, bedded with 
 straw. 
 
 I am unable to determine what, if any, basis was used for 
 determining what patients should be held at Frederick and what 
 sent on to Baltimore. Probably none, the hospitals at Frederick 
 being filled and the remainder sent elsewhere. The statements 
 usually made are that the severely wounded were retained and 
 the slightly wounded sent on. Letterman says a large number of 
 wounded were sent from the field through Frederick to other 
 hospitals, of which no record was kept. There were many officers 
 
40 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 and others whose friends were able to spirit them away. \\ ounded 
 officers appeared in Washington as early as the 19th. 
 
 On September 23 McClellan telegraphed Halleck, saying 
 that Dr. Hitchcock and Mr. Croker were at Antietam, acting for 
 the Governor of Massachusetts, who desired the removal of the 
 more severely wounded of the regiments from that state to Bos- 
 ton, or places near their homes. 
 
 McClellan recommended that thi^ request be approved, for 
 wounded that would require thirty to forty days for recovery, 
 provided they be certified as suitable cases by the Medical Direc- 
 tor. The request was granted by General Halleck and was pre- 
 sumably carried out, at least in part. 
 
 This was a common practice with various state agents, and 
 while usually undertaken with the best of intentions, was highly 
 detrimental to the army, which thereby lost thousands of men, 
 who returned tardily if at all. In some cases it appears to have 
 been mere political tactics. 
 
 The Sanitary Commission has been blamed for such prac- 
 tices, but I believe unjustly. The efforts of that organization 
 were constantly directed to the ends of keeping the largest pos- 
 sible number of men in the field. No one who studies its endeav- 
 ors and accomplishments can for a moment believe that its aim 
 was merely humanitarian. Its first and highest aim was to aid 
 the government in prosecuting the war, and no side issues were 
 allowed to interfere with this line of action. 
 
 On September 30 there were 2,321 patients remaining in 
 the hospitals at Frederick. On September 27 five hundred hos- 
 pital tents were received and two large tent hospitals were organ- 
 ized in the suburbs of the place. Camp "A" was organized Sep- 
 tember 30 and Camp "B" October 20. Each had a capacity of a 
 thousand patients. In all the hospitals of Frederick there were 
 on duty during the month of October 62 surgeons, 22 hospital 
 stewards and 539 nurses and cooks. These hospitals received 
 3,032 patients during October, many of whom must have been 
 sick. 
 
 The army was still in the same locality, not moving away 
 until the last days of the month. On November 1 there were still 
 2,603 patients remaining. The hospitals at Middletown, Boones- 
 boro, Sharpsburg and Locust Springs were being closed during 
 this time. A sample of the work of the Frederick hospitals is 
 afforded by the following data from the records of Hospital' No. 
 
ANT1ETAM. U 
 
 5, opened September 18, 1862, and closed January 13, 1863: 
 Patients received, 1,562; died, 101; discharged S. C. D., 126; 
 remaining at close, 222. The death rate of wounded, 12 per cent, 
 is about the average for the entire war. This was the first hos- 
 pital to close, the others following during January, February and 
 March, 1863. On April 1, 1863, all remaining patients were trans- 
 ferred to Hospital No. 1, which became a permanent depot hos- 
 pital, at it had been before the battle. 
 
 At Middletown ten buildings were occupied for hospital pur- 
 poses, from the day of the battle at South Mountain. As there 
 was little bedding, straw was procured and used instead. For 
 cooking, kitchen utensils were borrowed from the inhabitants. 
 Some food was obtained from Frederick, but more by purchase. 
 Medicines and dressings were obtained in the same manner. 
 Stragglers were collected and employed as nurses, guards, for 
 fatigue, etc. Their services were generally unsatisfactory. On 
 September 16 these hospitals contained 1,084 patients, 488 hav- 
 ing been sent from the field directly to Frederick. After Antie- 
 tam, 304 wounded reached Middletown from that field. Evacu- 
 ation was begun at once and by September 23, 1,388 wounded 
 had been sent to Frederick. Of these 1,100 were sent in ambu- 
 lances and 280 went on foot. There remained 121, who were unfit 
 for transportation. I presume that the wounded were evacuated 
 from Burkettsville at the same time. There is no record of any- 
 thing like a permanent hospital at that place. On October 21 
 there were still 100 patients at Middletown. 
 
 A hospital was maintained at Boonesboro for some weeks at 
 least ; at the last of September it contained 200 patients. In 
 Sharpsburg the various churches were used as hospitals and these 
 hospitals were maintained until November. The tent hospitals at 
 Smoketown and Locust Springs have been referred to as the 
 main hospitals for transportable cases on the field. These hos- 
 pitals remained at these places until their patients were finally 
 disposed of. The Locust Springs hospital was closed on January 
 30, 1863. At that time the Smoketown hospital had 300 patients. 
 This hospital had received in all 2,723 patients, and was not 
 closed until May 20, 1863. 
 
 Of all the patients from this campaign, one-half or a little 
 more were sent away to Washington, Baltimore and Philadelphia. 
 Somewhat less than half were treated at the places above named, 
 on or near the field ; not for a few days or weeks, but until dis- 
 charged or no longer in need of treatment. The Confederate 
 
4V MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 wounded (prisoners) were transferred to Baltimore and to Fort- 
 ress Monroe when ready for exchange. 
 
 Medical Director Letterman strongly favored keeping the 
 wounded near the field when possible, bringing the hospital to 
 the wounded, instead of taking the wounded to the hospitals. 
 He said : 
 
 "Immediately after the battle, a great many citizens came 
 within our lines in order to remove their relatives and friends, 
 and in a great many instances where the life of the man de- 
 pended on his remaining at rest. Their minds were bent on 
 having their friends at home. No greater misfortune could 
 exist, and the results of this battle only added additional evi- 
 dence of the absolute necessity to wounded men of a full supply 
 of pure air, a supply which cannot be secured in the most per- 
 fectly constructed buildings. Within a few yards a marked con- 
 trast could be seen between the wounded in houses, barns and 
 in the open air. Those in houses progressed less favorably than 
 those in barns ; those in barns less favorably than those in the 
 open air ; although all were in other respects treated alike." 
 
 These statements of Letterman were true at the time, but 
 antisepsis and asepsis have made them inapplicable today. The 
 wounded should be removed to permanent hospitals, even in 
 cases like Gettysburg, where the field is in our own territory 
 and the enemy retires to a distance. In the enemy's territory 
 there are other reasons for removing the wounded from the 
 vicinity of the army. Letterman's plan of retaining the wounded 
 near the army would be a mistake today. 
 
 It was customary, and at that time an excellent custom, to 
 send several independent medical inspectors to report on the con- 
 duct of medical affairs after each battle. Inspector E. P. Vol- 
 lum made a long report on Antietam, commenting on the lack 
 of cooking utensils and food, the lack of independent transpor- 
 tation, the lack of a corps of nurses and attendants, the use of 
 stragglers for nursing, and the excellent work of the Sanitary 
 and Christian commissions in furnishing supplies. He reported 
 that hundreds of wounded were out of doors, but that this was 
 rather an advantage, the weather being fine. On September 24 
 he was unable even to estimate the number of wounded. He 
 argued that the medical department should have a train of sup- 
 plies under its own management, as did the ordnance and com- 
 missary departments. 
 
 United States Sanitary Commission. 
 
 The Sanitary Commission reached the field with supplies in 
 
ANTIETAM. 43 
 
 advance of any others, except those carried with the army, and 
 these were short in many divisions. Supplies for the medical 
 department were shipped at once by rail, but were stopped at 
 the broken bridge east of Frederick. There was no medical offi- 
 cer at that point to push them on, and they did not reach the 
 battlefield until the evening of the 20th, three days after the 
 battle. The Sanitary Commission had forwarded two small wagon 
 trains directly from Washington, before the battle, but in antici- 
 pation of it ; they reached the field on the 19th. Four other trains, 
 dispatched after receiving news of the battle, reached the field 
 as early as the regular supplies, a part earlier. The Commission 
 claimed that it had twenty-five wagon loads of supplies on the 
 ground, at Keedysville and Sharpsburg, before any of the sup- 
 plies sent by the medical department reached those places. This 
 was in part accidental and was in part due to the broken bridge ; 
 but was largely due to the fact that the Commission had inde- 
 pendent transportation, while the Medical Department was obliged 
 to turn its shipments over to the Quartermaster, where they 
 took their chances with all other supplies. 
 
 What the Commission furnished may be seen from the 
 report of its agent : "Within a week we dispatched by teams 
 from Washington alone 28,700 shirts, drawers, blankets, bed- 
 ticks, 30 barrels of bandages, 3,000 pounds of farina, 2,600 
 pounds of condensed milk, 5,000 pounds of beef stock and 
 canned meats, 3,600 bottles of wine, and several tons of lemons 
 and other fruits, crackers, tea, sugar and other hospital con- 
 veniences." 
 
 Another branch of the Commission, operating from Phila- 
 delphia and Harrisburg, by way of Hagerstown, sent agents, 
 supplies and money to the field, but they arrived a little later. 
 It is astonishing to read of the amount of alcoholic liquors fur- 
 nished by these societies. Agent W. M. Chamberlain says he 
 learned that a large invoice of stores had been sent to Cham- 
 bersburg, including eight barrels of wine, five of whiskey and 
 one large cask of brandy. When he reached Hagerstown there 
 was absolutely no wagons to be found. After a delay he suc- 
 ceeded in procuring three and started for the field with blank- 
 ets, bandages and miscellaneous stores, including a large cask 
 of whiskey and two barrels of sherry wine. It is a relief to 
 learn that, on reaching the field, all his supplies were quickly 
 exhausted except the liquor. 
 
 On September 23, one week after the battle, Frederick Law 
 
■14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Olmsted, General Secretary, wrote to President Bellows' "We 
 are sending more supplies constatnly. Four thousand sets of 
 hospital clothing will, by special train from New York, get 
 through to Frederick tomorrow, if money and energy can break- 
 through the obstructions of this embarrassed transportation." 
 
 The agent at Hagerstown, whose aid was comparatively 
 little, expended four thousand five hundred dollars at that point. 
 These agents opened storehouses at Sharpsburg and Keedys- 
 ville and filled the requisitions freely and without formalities for 
 all hospitals. Army medical officers did not hesitate to call on 
 them, indeed were only too glad to get their stores until their 
 own should arrive, and also to secure many things not on the 
 medical supply tables. 
 
 While the Sanitary Commission, like all such bodies, was 
 inclined to exaggerate its own work and importance, there can 
 be no doubt that, in this campaign, it rendered very great assist- 
 ance to the medical department ; not only on the line of com- 
 munications, where such societies are now supposed to exert 
 themselves, but even more on the actual battlefield, during the 
 first few days, when the lack of supplies was most pressing. 
 During the later campaigns not nearly so much work was done 
 at the extreme front by the Commission. 
 
 In this campaign the voluntary aid societies rendered as- 
 sistance along certain definite lines. They took little or no part 
 in collecting the wounded or in transporting them to the rear. 
 They did do a certain amount of nursing and dressing, in both 
 field and evacuation hospitals. Many small groups of wounded, 
 in separate houses or barns, were turned over entirely to the 
 Sanitary Commission agents for the time being. But their most 
 important function was to furnish supplies. By authority of 
 special passes they were often able to get to the field before the 
 regular trains. They had an abundance of money with which 
 to hire private vehicles or purchase stores in an emergency. 
 Their supplies were all but unlimited, both in variety and quan- 
 tity. They were on the field early, established issue storehouses 
 and gave out supplies freely to any medical officer calling for 
 them. They did not wait even to be called on, but peddled sup- 
 plies from one hospital to another. 
 
 The Commission also rendered valuable service at Freder- 
 ick and Hagerstown, the railheads or clearing hospitals of the 
 army. Wounded transported to such places often lay for hours 
 awaiting trains, and usually with little or no care. The aid asso- 
 
A NT I ET AM. 4=> 
 
 ciations filled these gaps admirably. They readjusted dressings, 
 furnished hot and cold drinks and suitable foods ; also blankets, 
 shelter or whatever was necessary for the comfort of the 
 wounded. 
 
 They rendered still another service by assisting in preserv- 
 ing the identity of the sick and wounded and notifying their 
 friends. This was a work that was but poorly done by the Medi- 
 cal Department at that time. Men by the hundreds were sent 
 from the field without records, or even a list of names ; only so 
 many wounded. When these men died there was often no means 
 of identifying them. The Sanitary and Christian commissions 
 undertook to prepare directories of all the hospitals and did 
 much to fill this want, but did not entirely fill it, as the thousands 
 of nameless graves testify. 
 
 Medical Officers of the Army at Antietam. 
 
 Medical Director of the Armv Surgeon Jonathan Letterman, U. S. A. 
 
 Medical Inspector Lt.-Col. Edward P. Vollum, U. S. A. 
 
 Medical Purveyor Asst. Surg. T. J. McMlllln, U. S. A 
 
 Medical Director, First Corps Surgeon J. T. Heard, U. S. V. 
 
 First Division Surgeon Peter Pineo, U. S. V. 
 
 Second division Surgeon N. R. Moselv, U. S. V. 
 
 Third division Surgeon Wm. King, U. S. A. 
 
 Medical Director, Second Corps Surgeon A. X. Dougherty, U. S. V. 
 
 First Division Surgeon .1. 11. Taylor, U. S. V. 
 
 Second division Surgeon Houston, U. S. V. 
 
 Third division Surgeon Gabriel Grant, U. S. V. 
 
 Medical Director. Fifth Corps Surgeon John McNulty, U. S. V. 
 
 First Division 
 
 Second division 
 
 Medical Director, Sixth Corps Surgeon W. J. H. White, U. S. V. 
 
 (killed) 
 Surgeon Charles O'Leary, U. S. V. 
 
 First Division 
 
 Second division 
 
 Medical Director, Ninth Corp* Surgeon W. H. Church, U. S. V. 
 
 First Division 
 
 Second division Surgeon A. T. Watson, U. S. V. 
 
 Third Division Surgeon H. W. Rivers, U. S. V. 
 
 Fourth Division Surgeon W. W. Holmes, U. S. V. 
 
 Medical Director, Twelfth Corps Surgeon Thomas Antlsell, U. S. A. 
 
 First Division Surgeon Artemus Chapel, U. S. V. 
 
 Second division Surgeon A. Ball, U. S. V. 
 
THE CAMPAIGN OF FREDERICKSBURG, DECEMBER, 1862 
 
 A route through a heavy wood, with muMed steps in the dark- 
 ness; 
 
 Our army foiled, with loss severe, and the sullen remnant re- 
 treating; 
 
 We come to an open space in the wood, and halt by a dim- 
 lighted building; 
 
 An old^ church at the crossroads — 'tis now an impromptu hos- 
 pital; 
 
 Shadows of deepest black within, just lit by candles and lanterns; 
 
 By these crowds, groups of forms, vaguely I see on the floor. 
 
 Faces, varieties, postures beyond description, most in obscurity, 
 some dead; 
 
 Surgeons operating, attendants holding lights, the smell of ether 
 and blood; 
 
 The crowd, the crowd of bloody forms of soldiers — the yard 
 also filled; 
 
 Some on the bare ground, some on planks or stretchers, some in 
 the death spasm; 
 
 An occasional scream or cry, the doctors' spirited orders or calls; 
 
 Then I hear outside the order given, "Fall in, my men. Fall in," 
 
 And I speed forth to the darkness. 
 
 Resuming marching, ever in darkness marching. 
 
 Drum Taps.— Walt Whitman. 
 
 THE battle of Antietam, September 17, 1863, was followed 
 by a long period of rest for the Army of the Potomac. Dur- 
 ing the last days of October the army crossed the river and 
 moved slowly southward toward the Rappahannock. Winter was 
 coming on and the rate of progress was so slow that it gave 
 little hope of anything being accomplished before the season 
 should render military movements impracticable. McClellan's 
 dilatory movements were finally ended by the President. While 
 the army was encamped about Warrenton, November 9, McClellan 
 was removed from command and Major General Ambrose E. 
 Burnside installed in his place. This change was received by the 
 army with misgivings. Many thought it a change for the worse. 
 which events proved it to be. 
 
 Burnside decided on an overland advance to Richmond, along 
 
2 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 the line of the Richmond, Fredericksburg and Potomac Railway, 
 and moved the army to the vicinity of Fredericksburg as a pre- 
 liminary step. His plan was to seize that point, before it could 
 be occupied in force, and, with it as a safe water base, to ad- 
 vance directly southward, as Grant did in 1864. The advance 
 corps reached Falmouth, opposite Fredericksburg, on November 
 17, but the opportunity to cross and seize the heights was lost. 
 
 Enterprise was conspicuous by its absence, now and generally 
 in this short campaign. Gradually the whole army came up and 
 encamped behind the hills on the northern river bank. For 
 three weeks it remained there, while every day the Confederate 
 army increased in numbers and their defensive works grew 
 stronger. 
 
 The army was the same that fought at Antietam, except that 
 the Twelfth Corps had been exchanged for the Third ; also there 
 was an entirely new set of generals. The organization was 
 somewhat different ; the six corps were grouped in three "Grand 
 Divisions" of two corps each, known as Right, Center and Left. 
 The Right Grand Division, under Sumner, was composed of the 
 Second and Ninth Corps. The Center Grand Division, under 
 Hooker, was composed of the Third and Fifth Corps. The 
 •Left Grand Division, under Franklin, was composed of the 
 First and Sixth Corps. These six corps were made up of 
 eighteen divisions ; the divisions as a rule had three brigades, 
 averaging a little less than five regiments to a brigade. Each 
 regiment contained rather less than four hundred men present 
 for duty. The total number of infantry regiments was about 
 256; the regular regiments were so broken up that it is difficult 
 to say how many regiments there were in the two regular bri- 
 gades of Sykes' Division (Fifth Corps). These six infantry 
 corps, with their artillery, totaled about ninety thousand men 
 for battle. There was enough of cavalry, reserve artillery, 
 engineers and special troops to make the grand total well above 
 one hundred thousand men. The organization of the army 
 was probably better than it had ever been before, but the disci- 
 pline left much to be desired, as was shown by the lack of 
 support on the part of generals, and the inexcusable looting of 
 Fredericksburg by the enlisted men. 
 
 The army reached Falmouth November 17-20, and remained 
 in camp until December 11. During this time the railway to 
 the landing at Aquia Creek (a small branch of the Potomac) 
 was reconstructed and a supply depot established at that point. 
 
CAMPAIGN OF FREDERICKSBURG. 3 
 
 This gave a very good line of communication back to Washing- 
 ton. The distance by rail to Aquia is about eleven miles ; from 
 Aquia to Washington by boat, about sixty miles; the whole 
 distance, about seventy-five miles, requiring seventeen hours' 
 time, including transfer. Roads led from the Falmouth Station 
 to the camps of the various corps. A considerable amount of 
 supplies was accumulated. Transportation was scarcely a prob- 
 lem during this campaign. Tents, clothing, rations, ammuni- 
 tion and supplies of all kinds were so abundant as to allow no 
 complaint. 
 
 The weather during the early part of December was cold and 
 stormy, causing much suffering in the camps, where shelter 
 tents were the only protection from the elements. There was 
 snow and ice in the river on December 7. The naval officers 
 on the gunboajts a few miles below feared that their vessels 
 would be frozen in. The historian of the Seventh Rhode Island 
 wrote in his diary : 
 
 "Dec. 6th. Just after ten o'clock it began to rain, but soon 
 turned to snow, which continued to fall during the night, accom- 
 panied by high winds. Wet and cold from the storm, the men 
 wrapped in their blankets, sat like Choctaws around the fires. 
 Next morning the weather was intensely cold." 
 
 But the stormy period passed and the weather at the time 
 of the battle was unusually fine for December. Some writers 
 speak of overcoats being uncomfortable; others say that the 
 morning of the battle was like a spring morning; others say that 
 the night following was not cold, and Sunday was fine and 
 balmy. While a few attempt to make out that the bodies of the 
 dead froze stiff on Saturday night, the great majority of the 
 evidence is to the contrary; especially that of the medical 
 officers. The days were unusually fine and warm ; the nights 
 were, of course, cool, but not notably cold. There was no 
 severe weather until the night of the seventeenth — four days 
 after the battle. The New York Herald reporter wrote on the 
 15th: "Weather has been clear and warm, with southerly 
 winds." 
 
 The campaign of Fredericksburg covered no extensive ter- 
 rain, only the narrow valley of the Rappahannock, with a line 
 of moderate hills or bluffs on either side. The river, some 
 three hundred yards wide, and unfordable at the town, runs 
 from northwest to southeast, with the town on the southern 
 bank. The river hugs the northern line of hills, known as 
 Stafford Heights. These heights begin at Falmouth, above the 
 
4 MEDICAL DEPARTMENT IN THE CIVIL J FAR. 
 
 FREDERICKSBURG CAMPAIGN. 
 
 SCALE Or MILES. 
 
CAMPAIGN OF FREDERICKSBURG. 5 
 
 town, and extend well below it. They are higher than the 
 highest building in Fredericksburg. Above, opposite Falmouth, 
 the valley is narrow; at the town it widens to three-fourths 
 of a mile, and is three miles wide at Massaponax Creek, 
 four miles below. The line of hills which closes the valley on 
 the southwest has various names; Taylor's Hill above, near the 
 river; Marye's Hill and Willis' Hill opposite the town; and 
 other hills further to the southeast. The area of fighting was 
 smaller than in any other great battle of the war. When the 
 conflict had ended, the dead in front of Fredericksburg might 
 have been enclosed by a square of half a mile. The battle on 
 Franklin's front took place in another limited area near the 
 lower crossing. The Confederate leaders made their line of 
 defense, not the actual river, but the line of hills that closed 
 the plain. 
 
 Fredericksburg was an old and solidly built town, with a 
 population then, as now, of about five thousand. The buildings 
 were chiefly of brick and afforded shelter from rifle fire. There 
 were a court house, orphan asylum, seminary, five churches, and 
 a number of large warehouses, that could be used for hospital 
 purposes. Steamers could come up the river as far as the 
 railway bridge — then destroyed. The wagon bridge had also 
 been broken down, but the river could be forded at a dam 
 above Falmouth,. Most of the inhabitants deserted the town, 
 but a few remained throughout the battles. Despite the tremen- 
 dous bombardment on the eleventh and the street fighting on the 
 twelfth, no one of them was killed. 
 
 On December 11 pontoon bridges were at last thrown across 
 the river, under fire, and with some two hundred killed and 
 wounded. Three bridges were laid at the town and two at 
 what was known as Franklin's Crossing, three miles below. 
 Howard's Division crossed and, after some fighting, drove the 
 Confederate sharpshooters out of the town. Several brigades 
 crossed at the lower crossing, but were withdrawn except a few 
 regiments to hold the bridges. On December 12 the First and 
 Sixth Corps crossed and took position in front of the lower 
 bridges. The Second and Ninth Corps crossed at the upper 
 bridges and took position in the town. The Center Grand 
 Division remained in reserve on the northern bank, with the 
 greater part of the artillery, which dominated the town and 
 adjacent portion of the valley. All was now ready for the 
 battle. The plan, if there was any plan, was for Franklin to 
 
6 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 make the main attack, turning the Confederates' right and roll- 
 ing up their line, when Sumner was to attack in front of the 
 town. Hooker was to send reinforcements to either wing as 
 needed. 
 
 From Stafford Heights for three weeks officers and soldiers 
 had looked down on the field. There had been no lack of time 
 for studying the ground, bringing up supplies, and making 
 every possible provision that foresight might indicate. Unfor- 
 tunately the same time had been given the enemy to prepare a 
 naturally strong position, and a deadly reception awaited any 
 attempt to storm the hills behind the town. The line of bluffs, 
 from the river on the northwest around to Massaponax Creek 
 on the southeast, was crowned with works, lined with troops, 
 and sprinkled with guns. Against this bristling line the Army 
 of the Potomac was to be thrown in a deadly frontal attack. 
 It needed no Cassandra to foresee long trains of wounded drag- 
 ging back to the river, and silent dead splotching the fireswept 
 plain. 
 
 MEDICAL PREPAREDNESS. 
 
 At Fredericksburg, for the first time in a great battle, the 
 wounded of the United States Army had adequate care and 
 treatment. Manassas had been marked by indescribable priva- 
 tion and suffering among the wounded. After that battle the 
 army was given an ambulance organization. In consequence 
 the wounded at Antietam were collected systematically and 
 promptly. No complaint was heard on that score ; but there was 
 no shelter except such as the country afforded. For several days 
 the lack of supplies was lamentable, and would have been 
 worse but for the assistance of the Sanitary Commission. Both 
 these shortcomings were remedied while the army lay at Sharps- 
 burg. Letterman's Supply Order, October 4, had greatly im- 
 proved the supply situation, though still leaving some minor 
 faults. His Field Hospital Order, October 30, had given each 
 division of the army a real, if temporary, field hospital, provided 
 with personnel, tentage and bedding, medical and surgical sup- 
 plies, rations and cooking utensils. 
 
 There was ample time to supply the whole army with every- 
 thing required, and some time for drill and practice. The Med- 
 ical Purveyor of the army, Asst. Surg. T. J. McMillan, moved 
 his depot from Knoxville (near Harper's Ferry) to Washington, 
 and then to Aquia Creek, where he maintained a large store- 
 
CAMPAIGN OF FREDERICKSBURG. 7 
 
 house, with a sub-depot at the railway station at Falmouth. The 
 medical directors were informed of these stores, and it was only 
 necessary for them to send in a simple memorandum in order to 
 secure what they needed. The field of action could be studied 
 and everything prepared before the army should cross the river 
 for action. When it did cross, on Saturday, December 13, the 
 Medical Department was prepared to collect the wounded, dress 
 and feed them, and give them shelter in hospital tents until they 
 could be removed to the rear. In no previous battle had it been 
 possible to do these things, even approximately. 
 
 Letterman says of the preparation for the battle: 
 
 "After the arrival of the army before Fredericksburg, it became 
 evident that we could not occupy the city, nor proceed farther 
 without a great battle. It became necessary to see that every- 
 thing in the medical department should be ready for any emerg- 
 ency which might arise. The principal objects to be accom- 
 plished were, that an extra amount of supplies for such an 
 occasion should be on hand and easily attainable ; that the organ- 
 ization of the ambulance corps should be carried into effect in 
 those corps which did not belong to this army when the order 
 was issued, and that it should be more perfectly put in force 
 in the others than it had been hitherto. 
 
 "Ample supplies of stimulants, medicines and anesthetics were 
 issued from New York and Washington. In addition to these 
 supplies, large quantities over and above what was required for 
 issue, of beef stock, stimulants, dressings, milk, coffee, tea, 
 blankets and underclothes were ordered and kept on hand. All 
 the Autenreith wagons that could be procured were distributed. 
 I regretted that there were not enough to supply each brigade, 
 but this I had no power to remedy. 
 
 "The required institution of field hospitals was to be attended 
 to. The details were made in each corps, the necessary blanks 
 distributed, and every step taken, as far as could be before an 
 action, to carry the instructions contained therein into effect. 
 The ambulance corps in each army corps was examined, and 
 requisitions made for such numbers as were needed to make up 
 the allowance. Horses, harness, stretchers, lanterns, and all that 
 was necessary for putting the trains in serviceable order were 
 procured, and officers were assigned and men detailed to com- 
 plete and render effective the organization. Five hundred hos- 
 pital tents were at my request ordered by Colonel Ingalls, the 
 Chief Quartermaster of the army, and kept at the depot, ready 
 at any moment for use when required. During this period fre- 
 quent interviews took place with the medical directors and other 
 
8 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 medical officers, and with the ambulance officers, and such advice 
 and instructions were given as were deemed expedient." 
 
 The basis of tentage in the division hospitals was two hos- 
 pital tents for each regiment. As these tents were capable of 
 sheltering ten men each, and the regiments averaged no more 
 than four hundred men, there was accommodation in the field 
 hospitals for five per cent of the fighting strength of the army. 
 There was also on hand a reserve of five hundred tents, provid- 
 ing for another five per cent. Taking into consideration the un- 
 usual number of slightly wounded, not requiring hospital care, 
 the supply of tents was considerably in excess of what was 
 actually needed. It was lavish, and greater than for any other 
 battle, either before or after this time. There was also straw 
 for most of the tents, but by some oversight or failure, no 
 stoves were furnished this midwinter camp. The weather was 
 fine during the battle, but rain and snow came later, and there 
 was general suffering in the hospitals and camps. There was 
 also some lack of proper hospital food, that is, of delicacies 
 suitable for the sick and severely wounded. 
 
 As to ambulances, there were enough. When Burnside took 
 command, on November 9, there were 907 ambulances. On Janu- 
 ary 1, 1863, the Chief Quartermaster reported 1,161, excluding 
 those of the corps that joined after the battle. At the time 
 of the battle there were about one thousand ambulances, allow- 
 ing one to each hundred men. Since little more than half the 
 army was seriously engaged, and an unusual proportion of the 
 wounds was slight, there could have been no possible lack of 
 ambulances. 
 
 The division hospitals were all north of the river, but arrange- 
 ments were made to take a part of the personnel and equipment 
 across the river, when the town should be gained ; the tents, 
 however, were to be left standing. This arrangement contem- 
 plated that the litterbearers should carry the wounded to dress- 
 ing stations or hospitals under the southern banks of the river ; 
 the ambulances were to cross to these stations and carry them 
 to the more permanent hospitals on the northern side of the 
 stream. 
 
 Letterman made little provision for the line to the rear. He 
 desired to retain all the seriously wounded in the hospitals near 
 Falmouth, or back toward Belle Plaine, as had been done after 
 Antietam, but this plan was vetoed by the General. A patched- 
 up railway, with a few small locomotitves and open cars, extended 
 
CAMPAIGN OF FREDERICKSBURG. 9 
 
 to the Potomac at Aquia. There were no hospital trains on 
 this line, which was only a military railway. On the river were 
 many steamers ready to carry the wounded from Aquia to 
 Washington. These steamers, with two exceptions, were ordi- 
 nary river steamers, with no special accommodations for the 
 sick, but were models of comfort as compared with jolting 
 ambulances, and open cars on a poor railway. 
 
 The base hospitals at Washington had undergone a change 
 since Second Bull Run. The hotels, halls, churches and public 
 buildings that had been crowded with sick and wounded, almost 
 from the beginning of the war, had been abandoned, or were 
 being closed as rapidly as possible. These unsuitable make- 
 shifts gave way to barrack hospitals, roomy one-story struc- 
 tures, of light construction, cheap, but capable of good ventila- 
 tion and general sanitation. The beginning was in barracks that 
 had been occupied by troops, on Meridian Hill and elsewhere in 
 the suburbs of the city. Gradually these barrack hospitals were 
 increased in capacity and new hospitals, like Carver, Harewood, 
 Armory Square, and Lincoln, were constructed and extended 
 until the hospitals of the city of Washington had a combined 
 capacity of twenty thousand patients. 
 
 Walt Whitman, whose principal occupation at that time seems 
 to have been visiting the hospitals in the role of a good Samar- 
 itan, has left in various letters bis impressions of these institu- 
 tions. About this time he wrote: 
 
 "The Government is gradually settling down to adopt the plan 
 of placing the hospitals in clusters of one-story wooden buildings, 
 with their accompanying tents and sheds for cooking and other 
 purposes. Taking all tilings into consideration, no doubt these 
 are best adapted to the purpose; better than using churches 
 and large public buildings like the Patent Office. These sheds 
 now adopted are long one-story edifices, sometimes ranged along 
 in a row, with their heads to the street, and numbered either 
 alphabetically A, V>, C, D, and so on, or Wards 1, 2, 3, etc. 
 The middle one will be marked with a flag staff, and is the 
 office of the establishment, with rooms for ward surgeons, etc. 
 One of these wards will contain sixty cots : sometimes on an 
 emergency they move them close together, and crowd in more. 
 Frequently there are tents, more comfortable than one might 
 think, whatever they may be down in the army. 
 
 "Each ward has a ward master and generally a nurse for 
 every ten or twelve patients. A ward surgeon has generally two 
 wards — although this varies. Some of the wards have a woman 
 nurse; the Armory Square wards have some very good ones. 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 There is a regular staff and a sub-staff of big and little officials. 
 Military etiquette is observed and is getting to be very stiff." 
 
 Whitman, a free lance in everything, often railed at the forms 
 and rules, but on the whole testifies to the good management 
 of the hospitals and the faithful work of the surgeons on duty 
 in them. His collection of letters, The Wound Dresser, gives 
 some vivid pictures of those hospitals. 
 
 THE BATTLE. 
 
 The battle of Fredericksburg was fought on Saturday, Decem- 
 ber 13, 1862. It consisted of two separate engagements; one, 
 the main battle, was waged in front of the town; another lesser 
 conflict took place three miles down the river. They had no 
 connection. Sumner's Right Grand Division had crossed the 
 day before and on Saturday morning was massed in the streets 
 of the town, awaiting the order to move to the attack of Marye's 
 Heights. At -the Lower Crossing, Franklin's Grand Division 
 also waited, on the sheltered ground behind the Bernard houses. 
 Hooker's Grand Division stood fast on the northern bank, ready 
 to move to either wing when needed. 
 
 Although the army had delayed for weeks, it was not moved 
 out promptly at daylight. The commander had no very defi- 
 nite plans, hesitated and delayed, as a man not quite sure of 
 himself. All writers agree that the army lacked, confidence. 
 The soldiers were in doubt, and officers in a position to know 
 what was to be attempted, were fearful as to the outcome. A 
 hesitating leader was moving a doubtful army to an all but 
 impossible task. 
 
 Finally, about noon, Franklin opened the battle. He hac) 
 six fine veteran divisions; two more from the Third Corps 
 waited across the bridge. Yet he sent but two to the attack. 
 Meade with the Pennsylvania Reserves and Gibbon with Rick- 
 ett's old division moved bravely out across the low ground, 
 passed the railway and Bowling Green Road, and disappeared 
 in the woods. A tremendous outburst of firing alone told of 
 their battle. They broke the Confederate line, took prisoners, 
 and might have achieved some real success if they had been 
 supported at the critical time. But it was the old story. Forty 
 thousand men lay idle ; these eleven thousand were allowed to 
 fight the battle alone. Not so with Jackson. He brought up 
 his reserves, attacked Meade and Gibbon on all sides, and re- 
 pulsed them with heavy loss. By 1 o'clock the battle was over. 
 
CAMPAIGN OF FREDERICKSBURG. 11 
 
 Sumner's battle was fought in a different manner. Troops 
 enough were used to insure success, had success been pos- 
 sible. The battle here began as that on the left was closing. 
 The Second Corps was to seize the heights. The columns 
 moved out by Hanover street and the streets further south. 
 Though exposed to artillery fire on emerging from the town, 
 they found some shelter after crossing the canal, where 
 lines could be formed for the attack. The hill was to be 
 assaulted by column of brigades. French's Division moved 
 first, with Kimball's brigade in advance, the other two brigades 
 following at intervals of from one hundred and fifty to two 
 hundred yards. On emerging from the swale these lines had to 
 move less than five hundred yards to reach the stone wall and 
 sunken road, but no man ever reached the wall. A cross-fire 
 of guns rent and tore the lines, but they closed up and pressed 
 on until they came within musket range, then they melted away. 
 The remnants fell back to the ravine, where they lay down and 
 waited for reinforcements. Kimball's brigade reached points 
 within twenty-five or thirty yards of the wall; or rather some 
 officers, color bearers, and other bold spirits advanced that far 
 before they fell. Andrews followed Kimball, and Palmer fol- 
 lowed Andrews, but none could pass that fatal zone of fire. 
 
 Next came Hancock's Division ; the brigades of Zook, Meagher 
 and Caldwell moved forward in order. Wave after wave of blue 
 rolled forward across the narrow plain, only to break before the 
 fire-fringed wall. Howard's Division was placed more to the 
 right, but toward evening was also moved out on the Telegraph 
 Road. Its loss was not so heavy. Meanwhile Sturgis' Division 
 of the Ninth Corps had attacked further to the left, but with 
 no more success. Later Getty's Division came up to his sup- 
 port and was partly engaged in front of the railway depot. 
 
 All these attacks having failed, the Fifth Corps was brought 
 across the river and pushed in where the Second Corps had 
 failed. Griffin advanced on the left and Humphreys on the 
 right. Humphreys, riding at the head of his division, led as 
 gallant and determined an attack as men could make. For 
 years Humphreys' men disputed with those of Kimball and 
 Hancock for the honor of leaving their dead closest to the 
 wall. All alike failed. 
 
 "The brave zeent down without disgrace, 
 Thcx leaped to ruin's red embrace." 
 
 It was Malvern Hill reversed. 
 
12 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
CAMPAIGN OF FREDERICKSBURG. 13 
 
 After dark, Syke's Regular Division, which had been held 
 behind the canal, moved out to the ravine to hold it for the 
 expected renewed attack in the morning. All the other frag- 
 ments of organizations, save Ames' brigade, were withdrawn into 
 the town. Whipple's Division of the Third Corps had been 
 posted somewhat to the right of the town to hold the line in 
 that direction. Burns' Division of the Ninth Corps was across 
 Hazel Run, maintaining a connection with Franklin's force down 
 the river. When night came the town was filled with wounded, 
 stragglers, men who had lost their regiments, and thousands of 
 weary, discouraged men. There was doubtless much demor- 
 alization that night. The pontoon bridges were maintained 
 next day and Sykes' men lay all day within a hundred yards 
 of the wall, unable to go forward or back. Burnside intended 
 tc renew the attack, but fortunately his generals dissuaded him 
 from further slaughter. That night the troops were all with- 
 drawn into the town and, the following night, in a storm of 
 wind and rain, the whole army was brought back across the river. 
 The battle was over. 
 
 Twelve hundred dead lay unburied on the plain before Fred- 
 ericksburg ; nine thousand wounded suffered in the hospitals ; 
 two thousand were prisoners or missing, never to return ; the 
 army was disheartened and the people in gloom ; such was the 
 price paid by the nation for the selection of a man for the chief 
 command because he was popular, though it must have been 
 apparent that he had little or no real military ability. 
 
 COLLECTION OF THE WOUNDED. 
 
 On the right, ambulance trains were in readiness at the 
 northern end of the bridges when the battle commenced, but 
 could not yet cross. The stretcher-bearers, usually six to a regi- 
 ment, had been sent forward and followed their regiments into 
 battle. Men began to fall before the lines emerged from the 
 town; once outside, the losses were so severe that the dead and 
 wounded actually impeded the advance of fresh lines. Many 
 were carried to the rear, but the number of litter-bearers was 
 inadequate for such losses as these. Many regiments had more 
 than a hundred wounded; some as many as Uv (11th. N. H. ) 
 and 194 (7th N. Y.). 
 
 Those nearest the town crawled away or were helped to such 
 safety as the place afforded. For those who fell far in advance, 
 though they were but a few hundred yards away, there was no 
 
14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 help until night. Every slight ravine or house was filled with 
 wounded. General Couch tells of trying to get behind the brick 
 house (Embree) and finding its rear crowded with wounded 
 men. Many were helped to the rear by their comrades. Officers 
 were quite commonly carried to the rear by their men. The 
 various regimental histories and personal narratives indicate 
 that the greater part of the wounded was removed in this 
 manner — as far as the ambulances. Litter-bearers are scarcely 
 mentioned. 
 
 When night came the real collection of the wounded began. 
 The ambulance trains moved across the river and went out onto 
 the field, while detachments from each regiment searched the 
 ground for their own comrades. Before morning practically all 
 the wounded had been brought within the town, where the vari- 
 ous corps had extemporized hospitals. Letterman says that but 
 twenty were left behind — outside the picket lines. No Confed- 
 erate report mentions any wounded taken on this part of the 
 field. The Second Corps had 3,214 wounded, the Fifth 1,669, 
 the Ninth 1,067; total, 5,950. Some few of these were wounded 
 on other days. At least 5,500 were wounded on that Saturday 
 afternoon in front of Marye's Heights. 
 
 Colonel Joshua L. Chamberlain, 20th Maine, spent the night 
 at the very front of the battlefield, where he was a witnesss of 
 the suffering endured by the wounded. By midnight he could 
 endure it no longer. He says : 
 
 "I rose at midnight, and taking our Adjutant for companion, 
 went forth to see what we could do for these forsaken suf- 
 ferers. The deep moaning sound led us to our right and rear, 
 where the fiercest of the fighting had held brave spirits too long. 
 As we advanced over the stricken field the conglomerate mono- 
 tone resolved itself into its several elements; some breathing 
 inarticulate agony ; some dear home names ; some begging for 
 a drop of water; some praying for strength to bear; some for 
 life; some for quick death. We did what we could, but how 
 little it was. Our best was but to search the canteens of the 
 dead for a draft of water for the dying; to ease the posture of 
 a broken limb; or to compress a severed artery with what little 
 skill we had been taught by our surgeons, in learning the tactics 
 of saving as well as destroying men. 
 
 "Wearied with the sense of our own insufficiency, it was a 
 relief at last to see through the murk the dusky forms of ghostly 
 ambulances gliding upon the far edge of the field, pausing here 
 and there to gather up their precious freight; and the low- 
 
CAMPAIGN OF FREDERICKSBURG. 15 
 
 hovering, half-covered lanterns, or blue gleam of a lighted match, 
 held close over a brave, calm face, to know whether it were 
 of the living or the dead." 
 
 Colonel Chamberlain's regiment was of Griffin's Division 
 (First), Fifth Corps. A few extracts from the report of the 
 ambulance corps of that division will serve as a sample of the 
 work of all the ambulance corps : 
 
 "December 11. Inspection at sunrise; teams harnessed; left 
 camp and followed ammunition trains toward front. At sunset 
 unhitched, but left teams harnessed all night. 
 
 "December 12. Hitched up at sunrise; followed ammunition 
 trains to front; unhitched at sunset. 
 
 "December 13. Hitched up at sunrise; at 2 P. M. went to 
 pontoon bridge ; at 3 :30 detached my stretcher men with 43 
 stretchers (18 regiments) and sent them across the river to the 
 field. Detailed 12 ambulances to remain on the north side of 
 the bridge and await the return of the stretcher men. The 
 stretcher men were employed until 7 P. M. in bringing the 
 wounded from the field into the city of Fredericksburg. At 7 
 the ambulances crossed the river, went onto the field, and were 
 employed all night in bringing -off wounded. I calculated that 
 about 375 were removed from the field to the town that night. 
 At 5 :30 A. M. the train recrossed the river and unhitched. (This 
 division had 665 wounded.) 
 
 "December 14. Remained quiet all day. Hitched up at sun- 
 rise and unhitched at sunset. 
 
 "December 15. Hitched up at sunrise. My train crossed 
 the river at 10 A. M., loaded with all the wounded belonging to 
 the division, and brought them back to this side, — Lt. Joseph 
 C. Ayer, 18th Mass. Inf., Chief of Ambulance Corps, 1st Divi- 
 sion, 5th Army Corps." 
 
 The work of the ambulance corps on the right was simple, 
 since all the wounded lay within a small space, on an open 
 plain. On the left, where Franklin's battle took place, the 
 wounded were scattered in the woods, fully a mile from the 
 river. The ambulances here came across the river, but most 
 of the wounded were carried to the hospitals at the Bernard 
 houses and Smithfield, all close to the Rappahannock. By the 
 next morning all were in save some two hundred who lay close 
 to or within the Confederate lines. These appear to have been 
 uncared for until the next night. General Sickles, whose divi- 
 sion occupied this front after the retirement of the First Corps, 
 says of these wounded : 
 
 "Opportunely the stretcher men from my ambulance corps 
 on going to the front for wounded skirmishers occasionally went 
 
16 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 S>> 
 
 
 ■'-■ 
 
 la 
 
 I 
 
 ■s 
 
 § 
 
CAMPAIGN OF FREDERICKSBURG. 17 
 
 to the verge of the enemy's line to get the wounded of Gibbon's 
 Division who fell on Saturday. These men were told by the 
 enemy that if our skirmishers would not fire any more on them, 
 our ambulance parties might come anywhere along or within 
 their lines and get all wounded, hundreds of whom were appeal- 
 ing for succor. This was soon after said to be confirmed by 
 General Ewell, whose division was in my front, and I directed all 
 firing along my lines to cease." 
 
 This late removal was not due to any fault of the ambulance 
 corps, but to the position of the wounded within the enemy's 
 lines. Very few wounded were made prisoners in this battle. 
 I can find record of but 23 in the Confederate reports. It 
 appears that they allowed the removal of some that might have 
 been held, but they were mostly men who would never serve in 
 the ranks again. 
 
 Among the fatalities on the 13th was that of Surgeon Samuel 
 F. Havens of the 15th Massachusetts. On account of his fear- 
 less actions at Antietam this medical officer had been detailed 
 to the Division Hospital. He begged so hard of the medical 
 director to be relieved that finally his request was granted, and 
 when his regiment came marching by in the street, he took his 
 place in the moving column with unconcealed joy. Hardly were 
 the lines formed outside the town when he was struck in the 
 leg by a piece of shell, receiving a terrible wound. The limb 
 was amputated, but he never recovered from the shock. The 
 Massachusetts regiments were either unlucky in their losses or 
 had exceptionally devoted medical officers. Assistant Surgeon 
 Kendall of the 13th Massachusetts and Assistant Surgeon Revere 
 of the 20th were botli killed at Antietam. The Kev. Arthur B. 
 Fuller, chaplain of the 16th, and a brother of Margaret Fuller, 
 was also killed by a bullet in the streets of Fredericksburg on 
 the 11th. 
 
 There have been many accounts of the suffering of the 
 wounded from cold on the night following the battle. These 
 accounts are greatly exaggerated. A surgeon of the Sixth Corps 
 said: "A kind providence favored the wounded, for the weather 
 was verv moderate. Had such weather prevailed as was experi- 
 enced before and afterwards, many of the wounded, weak and 
 exhausted from shock and loss of blood, must have perished 
 from cold during the night." We have mathematical proof that 
 there was no noticable loss of life on this account, as well as 
 that the temperature barely reached the freezing point. 
 
IS MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 Fredericksburg killed 1,284 wounded 9,600 ratio 1 .7.6 
 
 Antietam killed 2,108 wounded 9,549 ratio 1 :4.5 
 
 Atlanta killed 1,600 wounded 5,915 ratio 1 :3.6 
 
 Kenesaw Mountain. . . .killed 1.790 wounded 5,740 ratio 1 :3.2 
 
 The lowest temperature in Washington on the 13th was 32 
 degrees, on the 14th 38 degrees, and on the 15th 48 degrees 
 Fahrenheit. 
 
 Extracts from report of ambulance corps, First Division, First 
 Army Corps: 
 
 "In accordance with your directions I moved forwards on the 
 morning of the 13th to a post near the river bank and went into 
 park with the other division ambulance corps. Previous to this 
 I had despatched my stretcher bearers to their respective regi- 
 ments, each regimental squad being under charge of a sergeant, 
 and the whole under command of Lieutenant W. H. Adriance. 
 
 '"About noon I received your order for the transmission of 
 twenty two-horse ambulances to the scene of action. I imme- 
 diately despatched them under command of Lieutenant Henry 
 Knight. For his prompt execution of the order he is deserving 
 of much credit, being for some time under fire, and meeting with 
 several narrow escapes. One of his ambulances was so injured 
 by the explosion of a shell as to render it unfit for service. 
 
 "During the day the balance of my corps was ordered to the 
 division hospital, where they were loaded with wounded and 
 despatched to the general hospital. Sunday morning I returned 
 to the division hospital with ten ambulances. At the same time 
 Lieutenant Adriance was relieved by Lieutenant Kellogg, having 
 become exhausted. During Sunday and Monday we were remov- 
 ing the wounded from division hospital to general hospital. At 4 
 P M. I received the order to retreat and, loading the ambu- 
 lances with the remaining wounded, conducted them safely to 
 this side of the river. As near as I can ascertain, the number 
 of wounded conveyed by my corps was 600, many of these from 
 other divisions. — Lt. M. R. Baldwin, Chief of First Division 
 Ambulance Corps, First Army Corps." 
 
 FIELD HOSPITALS. 
 
 The night following the battle was one of the most dramatic 
 of the entire war. It appears today like some sombre scene of 
 centuries ago, some half-obscured vision of the wars of Gustavus 
 and Wallenstein. A cloudy December night shrouded every- 
 thing in gloom, from which crowded streets and ruined buildings 
 emerged momentarily at the flash of a shell, to sink again into 
 the gray of the night. Wounded, stragglers, men who had lost 
 their organizations were everywhere. Regiments maintaining 
 
CAMPAIGN OF FREDERICKSBURG. 19 
 
 their organization, but in no order, camped along the streets. 
 The hospital lights and campfires, the smoldering fires and rav- 
 aged buildings with flapping blinds, the lawless men and demor- 
 alized stragglers, the suffering and death in the hospitals, all 
 gave the sacked and gutted town a look of pandemonium, such 
 as one imagines of Magdeburg or Saragossa. 
 
 The place was crowded with wounded men ; the court house, 
 churches, schools, stores, private houses; all were lighted up, 
 and within, surgeons worked the night long. Blankets and 
 curtains were fastened over the windows next the enemy to 
 avoid attracting his fire. Behind these, by the dim light of 
 candles and lanterns, the surgeons carried on their painful but 
 necessary work. The ambulances went and came ceaselessly, 
 bringing the wounded by tens and hundreds, faster than they 
 could be cared for. The houses were filled, then the yards, and 
 rows lay on the sidewalks. For some aid came too late or was 
 useless, and soon there were growing rows of dead laid out 
 for burial. These affected no one unless a relative or comrade 
 chanced to be at hand. There was more than enough work 
 with the living, enough to make the surgeons forget the terrible 
 repulse and useless sacrifice of life. Some one has said: "The 
 sadness which prevailed throughout the whole army that night 
 can neither be described nor imagined. The surgeons were the 
 happiest of all ; they were so busy they had no time to think 
 of our terrible defeat." 
 
 RIGHT GRAND DIVISION. 
 
 The final preparations for battle were made on the 12th. 
 Letterman says of the preparation of field hospitals: 
 
 "In passing through the city on the afternoon of the 12th 
 for the purpose of examining it in regard to its adaptability for 
 hospital purposes, I found desolation everywhere visible, from 
 the effects of the bombardment of the previous day. Some 
 houses were shattered, others in ruins, others burned. The 
 court house, several churches, and other buildings were selected 
 by and under the immediate direction of the medical directors of 
 the Right and Center Grand Divisions, and medical directors of 
 the corps to be engaged. As many hospital wagons as were 
 required were sent over and the organization of each hospital was 
 commenced. So earnestly did the medical officers enter upon 
 the discharge of their duties, that before the action began on 
 December 13, the hospitals were in readiness. Mattresses and 
 beds were procured from the dwellings. These, with a limited 
 amount of straw, enabled the surgeons to have everything neces- 
 
20 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 sary to put the hospitals in order for the proper and speedy 
 treatment of the wounded. 
 
 "The wounded on the north side were left in charge of a 
 sufficient number of medical officers and attendants, with plenty 
 of medical and surgical appliances and food. All the tents were 
 left standing, and others on hand, ready for use, should they be 
 wanted." 
 
 The Second Corps began the conflict on the right, where the 
 gray plain before the town became almost blue before the sun 
 of that brief December day had set. As at Antietam, this 
 corps had the heaviest losses. The three division hospitals of 
 the corps were grouped together near the railway station and 
 west of the Phillips House. Each of the hospitals had from 
 14 to 17 medical officers with a plentiful amount of tents and 
 supplies. Howard's Second Division crossed into the town on 
 the 11th, with considerable fighting at the crossing and in the 
 streets. While leaving the tents standing where they were, the 
 medical director established another hospital at the Lacy House 
 (Chatham), which is near the site of the upper bridges. The 
 main hospital received 500 wounded, the Lacy House hospital 
 280; total, 784. The division had 718 wounded. 
 
 Early on the morning of the 12th, Hancock's (1st) Division 
 and French's (3rd) Division crossed the bridges and remained 
 in the town until the next day. Both divisions left their hos- 
 pital tents standing and sent forward surgeons with supplies, 
 to prepare temporary hospitals in the town. These extemporized 
 establishments might be called dressing stations, but all kinds 
 of operations were done in them during the three days that 
 they existed. The First Division suffered more severely than 
 any other in the whole army, having 1,584 wounded out of 
 5,006 engaged. The seventeen small regiments had nearly 100 
 wounded each. 
 
 French's Division hospital cared for about 600. The division 
 had 904 wounded. The medical officers of this hospital appro- 
 priated supplies of all kinds in the town. One surgeon relates 
 that a large quantity of ribbons was found, and as bandages 
 grew scarce these ribbons were used instead. All these hospitals 
 were brought back across the river on the 15th, and the wounded 
 were placed in the tents. 
 
 The Ninth Corps formed one-half of the Right Grand Divi- 
 sion, but for some reason, or by some chance, was only in part 
 engaged, supporting the left of the Fifth Corps. Sturgis' Divi- 
 sion (2nd) advanced near the railway depot, and, when the 
 
CAMPAIGN OF FREDERICKSBURG. 
 
 21 
 
 
 FREDERICKSBURG 
 
 //lam il ions 
 Crcs%mg 
 
 -± i ■ — ' 
 
 JVuff. 
 
 L.C.Duncan 
 
22 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Second Corps began to break, was pushed forward, against the 
 right of the stone wall. This attack failed like all the others, 
 resulting in 827 wounded. About four o'clock Getty's Division 
 (3rd) came up to the support of Sturgis. Getty's troops were 
 not all engaged and the wounded only numbered 216. The 
 First Division, under Burns, was sent across Hazel Run to hold 
 the center of the long battle line ; it was scarcely engaged, having 
 but twenty-four wounded. The whole Ninth Corps had 111 
 killed and 1,067 wounded. 
 
 All the hospitals of the Ninth Corps were located on low 
 ground north of the Phillips House. They were established 
 there on December 9, to care for the wounded from the expected 
 conflict at the river crossing. They remained in the same place 
 throughout the battles, but temporary hospitals were doubtless 
 prepared in the town as with the other corps. The three hos- 
 pitals are said to have cared for about 1,300 wounded, some of 
 whom must have belonged to other organizations. It was neces- 
 sary for all these divisions to have hospitals in the town, since 
 the bridges were so crowded that they could not be used by 
 ambulances on the day of battle. 
 
 When it was seen that the Right Grand Division could not 
 alone carry the heights, the Fifth Corps, from the Center, was 
 sent across to make the attempt. About two o'clock this corps 
 crossed the bridges and formed for the attack. At three, Griffin's 
 Division (1st) moved out on the left and Humphreys' (3rd) 
 on the right. Sykes, with the regular division, was held in 
 the edge of the town, in reserve. Griffin and Humphreys made 
 the attack, "With a spirit and efficiency scarcely ever, if ever, 
 equaled in the records of the war." But they, too, recoiled before 
 the blasting fire from the sunken road. Late in the night 
 Sykes' Division was advanced to within a short distance of the 
 wall, relieving other troops still holding their positions at the 
 front. This position was held until the following night; it 
 could not be left until dark. The corps lost in killed 206, in 
 wounded 1,669. 
 
 The hospitals of the Fifth Corps had been established very 
 close to the Falmouth railway station. Hospitals for the two 
 divisions chiefly engaged were established in the town on the 
 13th. The First Division had 733 wounded, the Third, 772. 
 Sykes' Division did not go to th.e front until the battle was over. 
 It was under a scattering fire next day and before being with- 
 drawn had 17 killed and 163 wounded. 
 
CAMPAIGN OF FREDERICKSBURG. 23 
 
 Whipple's Division of the Third Corps was posted on the right 
 of the town, but remained on the defensive, having but 92 
 wounded. The hospital was near the Phillips House and was 
 not brought across the river. 
 
 Walt Whitman made a journey to the army at Falmouth in 
 December, visiting his brother, George W. Whitman, then a 
 Captain of the 51st New York. While there he wrote a letter 
 to the New York Times, from which the following extracts 
 have been made : 
 
 "Began my visit (December 21) among the camp hospitals in 
 the Army of the Potomac under Burnside. Spent a good part 
 of the day in a large, brick mansion on the banks of the Rappa- 
 hannock immediately opposite Fredericksburg. (The Lacy 
 House, branch of hospital, Second Division, Second Corps.) 
 It is used as a hospital since the battle and seems to have re- 
 ceived only the worst cases. Out-doors, at the foot of a tree, 
 within ten yards of the front of the house, I noticed a heap of 
 amputated feet, legs, arms, hands — about a load for a one-horse 
 cart. Several dead bodies lay near, each covered with its brown 
 woolen blanket. In the dooryard, toward the river, are fresh 
 graves, mostly of officers, their names on pieces of barrel staves 
 or broken boards, stuck in the dirt. 
 
 "The house is quite crowded, everything impromptu, no sys- 
 tem ; all bad enough, but I have no doubt the best that can be 
 done ; all the wounded pretty bad, some frightful, the men in 
 their old clothes, unclean and bloody. (The Government at that 
 time supplied very little hospital clothing.) I went through the 
 rooms downstairs and up. Some of the men were dying. I had 
 nothing to give them at that visit, but wrote a few letters to 
 folks at home, mothers, etc. 
 
 "December 22-31. Am visiting the regimental, brigade and 
 division hospitals somewhat. Few at home realize that they are 
 merely tents, and sometimes very poor ones ; the wounded lying 
 on the ground, lucky if their blanket is spread on pine twigs or 
 some leaves. No cots, seldom even a mattress on the ground. 
 It is pretty cold. As to rations the army here at present seems 
 to be tolerably well supplied. Most of the regiments lodge in 
 the flimsy little shelter tents. A few have built huts of logs 
 and mud. 
 
 "Left Falmouth January, 1863, by Aquia Creek railroad and 
 so on Government steamer up the Potomac. Many wounded were 
 with us on cars and boats. The cars were just common plat- 
 form ones ; the railroad journey of ten or twelve miles was made 
 mostly before sunrise. 
 
 "Now that I have lived for eight or nine days amid such scenes 
 
S-t MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 as the camps furnish, and realize that hundreds of thousands of 
 good men are now living, and have lived for a year or more, 
 not only without any of the comforts, but with death and sick- 
 ness, and hard marching and hard fighting (and no success at 
 that), for their continual experience — really nothing we call 
 trouble seems worth talking about." 
 
 LEFT GRAND DIVISION. 
 
 The Left Grand Division crossed at the lower bridges on 
 December 12. Early in the morning the Sixth Corps crossed 
 and took position in front of the bridges. The First Corps fol- 
 lowed, moving to the front and left, that is, further down the 
 river. Bayard's cavalry brigade accompanied this division. 
 Roughly speaking, the Sixth Corps occupied the right of the 
 line, extending to Deep Run ; the First Corps occupied the left, 
 extending nearly to Massaponax Creek. The troops were on the 
 lowest plain of a gentle terrace rising from the river, from which 
 they were to advance to the wooded hills where the Confed- 
 erates were posted. 
 
 One hospital of each of these corps was pitched on the north 
 side of the river, to care for those wounded in crossing, and as 
 a sort of general hospital for the corps. That of the Se'cond 
 Division, First Corps, was at the Pollock House, in a ravine 
 behind and below the pontoon bridges. The hospital of the 
 First Division, Sixth Corps, was in the same ravine, above the 
 bridges. The remaining two hospitals of each corps were taken 
 across the river on the 12th. One report says that the constant 
 use of the bridges by troops and wagons during the battle pre- 
 cluded their use for removing the wounded. 
 
 The hospital of the First Division, First Corps (Doubleday's), 
 was established at the Forbes House on Pratt's farm, also known 
 as Smith.field. This point was directly in rear of the division 
 and about two miles from the enemy's lines. The division was 
 not actively engaged, having but 161 wounded during the battle. 
 
 The hospital of the Second Division was at the house of 
 Pollock, as stated above. An ambulance station was located 
 near the southern end of the bridge, to which the wounded were 
 directed to be conveyed by the stretcher-bearers, and thence 
 across the river and to the hospital by ambulances. This divi- 
 sion, Gibbon's, had 924 wounded. 
 
 The hospital of the Second Division (Gibbon's) was in charge 
 of Surgeon Charles J. Nordquist, 13th Massachusetts. It re- 
 ceived 819 patients, of whom 43 died, three while in ambulances. 
 
CAMPAIGN OF FREDERICKSBURG. 25 
 
 Among this number there were 67 amputations, with but two 
 deaths before the wounded were removed to Washington. There 
 were 10 amputations of the thigh, 16 of the leg, 15 of the arm, 
 five of the fore arm, and 21 of the feet, fingers and toes. 
 
 The hospital of the Third Division, Meade's Pennsylvania 
 Reserves, was temporarily pitched in a ravine above and to the 
 rear of Smithfield. It was the intention, if the attack proved 
 successful, to move this hospital further to the front. The divi- 
 sion had heavy losses, the wounded numbering 1,241. 
 
 These hospitals were ready before the battle opened. At the 
 first artillery fire, cooking commenced, and the wounded, as 
 quickly as brought in, were, if necessary, supplied with hot soup 
 and coffee. Wood and water were abundant. As many tents 
 were set up as were necessary. For several hours the wounds 
 were occasioned almost entitrely by shell fire. Shortly after 
 noon, when the two divisions advanced into the woods, wounds 
 from rifle balls became more prevalent. When this attack was 
 concluded artillery fire was kept up until dark, the position of 
 the troops remaining about the same as in the morning. As it 
 was thought that the battle would be renewed next day and the 
 position of the hospitals was subject to shell fire, they were 
 removed during the night to the north side of the river. The 
 hospital of the First Division was now established near that 
 of the Second Division ; that of the Third Division near the house 
 of Doctor Monson. The tentage of the Second and Third Divi- 
 sions was not quite sufficient and twenty extra tents were drawn 
 from the purveyor. Medical Director J. T. Heard reported 
 that 1,500 wounded were cared for in the three division hospitals 
 and safely removed to the north side of the river before morn- 
 ing. This officer, who had been in all the great battles of the 
 East, says of the medical work of the army in this battle: 
 
 "In no previous battle witnessed by me were the wounded so 
 promptly and well cared for throughout the army as at Fred- 
 ericksburg. This was due to the uniformity of action. Every 
 surgeon, hospital steward, nurse, cook and attendant was as- 
 signed to his position and knew it." 
 
 The Sixth Corps was considered a guard for the pontoon 
 bridges and remained in their immediate vicinity, taking little 
 part in the battle. General Franklin evidently did not believe 
 that the bridges could be best defended by a strong attack on 
 the enemy; at any rate more than twenty thousand men were 
 
•26 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 held out of the fight for that purpose. This fine, large corps had 
 but 329 wounded in the whole battle. 
 
 The hospital of the First Division was held on the northern 
 side of the river, as already related. The other two were 
 taken across and established at the two Bernard houses, near 
 the river. The hospital of the Second Division was at the lower 
 Bernard house, also known as Mansfield, which was the head- 
 quarters of General Franklin. General Bayard, of the cavalry, 
 was killed by a shell in the yard, showing that it was not safe 
 from artillery fire. Numerous writers have related how the 
 owner of this fine old place attempted to prevent the army from 
 intruding on his privacy, and how the discussion was ended 
 by his being marched across the river under guard. His at- 
 tempt to prevent trespass by the army was prophetic, for the 
 mansion was afterwards burned. This division had 159 wounded. 
 
 The hospital of the Third Division was at the upper Bernard 
 house, above the pontoon bridges. This division had but 47 
 wounded. 
 
 Medical Director Charles O'Leary of the Sixth Corps reported 
 that each hospital in his corps had three operating tables, with 
 the required number of operating surgeons and assistants. In- 
 struments, dressings and all necessary appliances were arranged 
 with an order, precision and convenience rarely excelled in per- 
 manent hospitals. The testimony of line officers as well as med- 
 ical officers was that the preparation quickly made presented 
 the completeness in detail belonging to long established rather 
 than extemporized field hospitals. The wounded were brought 
 without delay to the hospitals of their respective divisions. The 
 celerity with which wounded men were treated and the system 
 pervading the whole medical department, afforded the most pleas- 
 ing contrast to what had hitherto been seen during the war. 
 Perhaps the most remarkable performance of the medical de- 
 partment in this part of the field was the removal of the hos- 
 pitals with all their patients to the northern side of the river on 
 the night following the battle. After the work of the day, this 
 was a notable performance. 
 
 Surgeon George T. Stevens, of the 77th New York, gives a 
 more realistic picture of one of these hospitals than any formal 
 description can do. 
 
 "A fine stone mansion (Mansfield), of large dimensions., situ- 
 ated on the south bank of the river, and a little below the 
 bridge, was taken by the surgeons of our division (2d Division, 
 
CAMPAIGN OF FREDERICKSBURG. 27 
 
 6th Corps) for a hospital. The position was exposed to rebel 
 fire, but it was the best that could be found. Just in front of 
 it General Bayard was struck by a shell and killed almost in- 
 stantly. Others, some of whom had been previously wounded, 
 received fatal shots at the very door of the building-. The day 
 was bright and warm, as on a spring morning. The wounded 
 poured into our hospitals and well did those surgeons, who had 
 seized the stone mansion, earn that day lasting gratitude from 
 their division. Never had wounded men been so quickly or so 
 well cared for. It was the beginning of an era of organized 
 
 
 HOUSE BY THE STONE-WAI.L, IN WHICH GENERAL 
 Com! DIED. FROM A WAR-TIME PHOTOGRAPH. 
 
 labor in the medical department. The wounded were stowed 
 in every part of the great house, and in the smaller buildings 
 surrounding it ; tents furnished shelter for those unable to find 
 room in the buildings." 
 
 Two divisions of the Third Corps, the First Division (Birney's) 
 and the Second Division (Sickles') also took some part in the 
 battle on the left. At daylight on the 13th they were at the 
 lower ford, waiting to cross in support of Franklin. Birney's 
 Division crossed about noon ; Sickles' a little later. Both were 
 advanced toward the railway to hold the line formerly held by 
 
•iS MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 the First Corps. Their lines were attacked and they suffered 
 considerable loss. Birney's Division had 650 wounded, Sickles' 
 85. As the movements of these divisions could not be predicted 
 in advance their field hospitals were left in the rear. The hos- 
 pital of the First Division was at the White House, on the road 
 to Belle Plaine. It received about 1,000 wounded. The Second 
 Division hospital was at the Fitzhugh house, and cared for 
 about 300. These hospitals appear to have received some of the 
 wounded of Gibbon's and Meade's divisions. 
 
 The following extract from a Civil War letter may appear too 
 trivial for reproduction, but it is first hand evidence. C. W. 
 Bardeen was at that time a fifteen-year old boy, a fifer in the 
 First Massachusetts. The drummers and fifers were ordered to 
 the hospital after the battle. In a letter written a few days later 
 he gives his experience: 
 
 "Monday morning we were ordered back across the river to 
 the division hospital. So the drummers were put in reliefs of 
 six hours each to attend to the wounded. My relief is on at 
 dark. The following were the instructions given to me by 
 the nurse in the tent assigned to me : 'The men on the left side 
 will not require much attention. That man in the corner is 
 wounded through the temple and is- insane. You will have to hold 
 him down if he attempts to get up, and you must keep close to 
 him and keep him covered. The one next to him is crazy also. 
 Every time he wakes up you must give him some water and look 
 out that he does not get up. The one in the corner has got dys- 
 entery and will require the bedpan often. You must pay strict 
 attention to them all, and not let the crazy men get the upper 
 hand of you.' So off he went and left me alone with two crazy 
 men and six or eight wounded ones to attend to. It was a hard 
 place, but I did my duty." 
 
 We today cannot realize the difficulties under which the sur- 
 geons of these days labored. Very many of the instruments and 
 appliances of surgery have been devised since that time. For 
 example, although hemorrhage, primary and secondary, was one 
 of the most common emergencies to be coped with, there were 
 no elegant hemostatic forceps, such as we use now. A bleeding 
 vessel must be picked up with an aneurysm needle or tenaculum. 
 The difficulty of that procedure may be conceived, but that diffi- 
 culty was still farther enhanced by the lack of retractors. 
 Hypodermic syringes were unknown, such drugs as morphine 
 being doled out on the point of a knife. Clinical thermometers 
 were also yet to be. The beautiful dressings of modern surgery 
 
CAMPAIGN OF FREDERICKSBURG. 29 
 
 did not then exist. Stumps of amputated limbs were dressed 
 with a cross of lint, spread with simple cerate. From five to 
 thirty silk ligatures were left hanging from each angle of the 
 wound. When these came away hemorrhage very commonly 
 occurred. In spite of all preparation, operative procedure could 
 not but have been still more difficult in the field, and particu- 
 larly at night. 
 
 BURIAL OF TH'E DEAD. 
 
 The dead numbered 1,284, possibly a very few more. A con- 
 siderable number of these were killed in laying the bridges, in 
 the street fighting, and on the 14th. The deaths on the 13th 
 probably numbered 1,100, of which approximately 400 occurred 
 in Franklin's battle on the left, and 700 in front of Marye's 
 Heights. The greater part of those killed in the main battle, 
 and part of those on Franklin's front were left unburied when 
 the army recrossed the river on Monday night. On the next 
 day General Hooker proposed to send out a flag of truce 
 for the purpose of burying the dead, but it was disapproved 
 by Burnside. On the 16th, however, the flag was sent out and 
 on the 17th Colonel John R. Brooke of the 53rd Pennsylvania, 
 Hancock's Division, crossed the river with a large burial party, 
 made up of details from all the regiments engaged. Two days 
 were spent in collecting and burying the dead. The weather 
 being cool, the task was not so repulsive as at Antietam and 
 Gettysburg. 
 
 In his official report Colonel Brooke said: 
 
 "Those bodies nearest the works were recognized as belong- 
 ing to Kimball's brigade (French's Division) and to the regi- 
 ments of Hancock's Division. The bodies of 913 soldiers were 
 buried and five officers brought back across the river. Nearly 
 all the dead were stripped entirely naked." 
 
 Mrs. Nannie Stevens, who lived in a house near the stone 
 wall, related that on the morning after the battle the field was 
 blue, but on the morning after the Federals withdrew the field 
 was white. 
 
 Roy \V. Mason, a major in the Confederate service, observed 
 the work of this burial party. He says: 
 
 "I witnessed with pain the burial of many thousands (900) 
 Federal dead. The night before the temperature must have 
 fallen to zero (26° F.) and the bodies of the slain had frozen to 
 the ground. The ground was frozen nearly a foot deep and it 
 was necessary to use pick-axes. It was a sad sight to see these 
 
30 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 brave soldiers thrown into the trenches, without even a blanket 
 or a word of prayer, and the heavy clods thrown upon them. 
 But the most sickening sight of all was when they threw the 
 dead, some four or five hundred ( ?) into Wallace's ice house, 
 where thev were found, a hecatomb of skeletons, after the 
 war." 
 
 This account is so evidently exaggerated that one is inclined 
 to discredit the whole. Every statement that can be checked up 
 is entirely unreliable, and as comrades of all these dead men 
 buried them, it is unreasonable to think that the^ were buried in 
 quite so unfeeling a manner. Stories of frozen bodies or frozen 
 ground are fiction. The bodies were all disinterested and given 
 decent burial in 1865. 
 
 EVACUATION OF THE WOUNDED. 
 
 On December 16 the wounded were all sheltered under canvas 
 on the northern bank of the Rappahannock. Medical Director 
 Letterman desired to retain all the more severely wounded, and 
 treat them on the field, as he had done so successfully after 
 Antietam, but General Burnside directed the removal of all to 
 Washington. Chief Quartermaster Ingalls had already, on the 
 14th, telegraphed the Quartermaster General to have boats ready 
 in the river for 3,500 wounded. General Burnside, desirous of 
 repairing his badly-injured military reputation, was resolved 
 on crosssing the river at another point and again trying the for- 
 tune of battle. As a preliminary the hospitals must be cleared. 
 
 The regular evacuation began on December 16, four days after 
 the battle. As the hospitals were only brought back across the 
 river on the 15th, no time was lost. The division hospitals were 
 very close to the Falmouth railway station, excepting those of 
 Franklin's Grand Division, which were from two to three miles 
 distant. Open cars were used, generally bedded with hay or pine 
 boughs. These boughs of pine and cedar were as a rule pre- 
 ferred to hay or straw for bedding. They had one sovereign 
 virtue — they did not become infested with vermin. Some mat- 
 tresses were used for the compound fractures and other grave 
 wounds. The cars were small platform cars of the military rail- 
 way. They brought out ammunition and carried back the 
 wounded. There were no hospital cars on this road. Delays at 
 Aquia Landing were inevitable and the whole journey to Wash- 
 ington required sixteen to eighteen hours. 
 
 Although the regular evacuation began on the 16th, the first 
 boats reaching Washington on the 17th; both officers and men 
 
CAMPAIGN OF FREDERICKSBURG. 
 
 31 
 
32 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 reached that city three days earlier. The Washington Star of 
 December 15 said: 
 
 "Last night about nine, the Steamer George Weems arrived 
 at the Sixth Street Wharf, bringing 350 to 500 officers and sol- 
 diers who were wounded in the battle of Fredericksburg. Ambu- 
 lances were in attendance and the sufferers were conveyed to 
 the various hospitals. These men are not dangerously wounded, 
 but are principally such as were able to walk, and thus man- 
 aged to be first to get to the boat." 
 
 On the 16th the Steamer Wilson Small brought an additional 
 number of officers and men. The wounded brought on these 
 boats seem to have come largely on their own authority. Let- 
 terman says : 
 
 "While the battle was in progress, and after it was over, nearly 
 one thousand men, no one of whom was seriously injured, and 
 some of whom were not injured at all, jumped on the cars at 
 the station, climbed on top of them, and went to Aquia, where 
 no provision had been made for the care of the wounded. Such 
 men are those who in all battles run to the rear and raise the 
 cry of want of attention on the part of the surgeons, whom they 
 sedulously avoid, lest it be found that their wounds do not 
 prevent their returning to duty. It is almost invariably found 
 that those men who bear the burden and heat of the day, those 
 who, when slightly wounded, are eager to have their wounds 
 dressed, that they may return to the battle again ; those too whose 
 wounds are grave, do not complain of any want of care. But 
 those cowardly stragglers, who upon the slightest bruise run 
 away out of the observation of the surgeons, raise the cry, which 
 many are prone to echo." 
 
 In spite of the guards at Falmouth and Aquia a number 
 of this species of skulkers succeeded in reaching Washington. 
 The Chronicle of December 17 said: 
 
 "Several hundred soldiers have come up on the boats, some 
 of whom are sick and wounded. But the most of them are 
 neither sick nor wounded, as we are creditably informed. The 
 surgeons of the hospitals have been unable to find the wounds 
 of which they complain. The medical director of the Army 
 of the Potomac has not sent away any wounded, except a small 
 number of wounded officers." 
 
 The latter statement is correct. Evacuation began on the 
 16th, the first steamers with these wounded reaching Washing- 
 ton on the 17th. The slightly wounded were sent away first. 
 Surgeons and attendants accompanied them with the necessary 
 supplies. 
 
 In the removal of the more serious cases, such as amputations, 
 
CAMPAIGN OF FREDERICKSBURG. 33 
 
 fractures of the thigh, and penetrating wounds of the head, 
 chest and abdomen, plenty of hay was placed in the cars. Mat- 
 tresses and bedsacks were used for these cases and the patients 
 were not removed from their beds until they had reached the 
 Washington hospitals, but were carried upon them, placed on 
 stretchers, and put upon the cars ; whence they were removed 
 in the same way to the steamers, remaining undisturbed in their 
 beds until they had reached Washington. In each car there 
 was a surgeon or an attendant, provided with everything neces- 
 sary in case any accident should occur. Assistant Surgeon 
 DeWitt C. Peters conveyed about 1,500 wounded from Fred- 
 ericksburg to Washington. He says: 
 
 "The transportation was ample, but many of the cars con- 
 sisted of simple platforms without covering, and were ill- 
 adapted for transporting men badly wounded, especially in win- 
 ter ; and for this reason some of these unfortunates suffered 
 severely. Many of them had but their blankets, but at the depot 
 I found a supply belonging to the Sanitary Commission, and 
 these I appropriated. There was no straw in the cars and 
 none at hand that I could take for the purpose. At Aquia Creek 
 we were transferred to steamboats. Here again there was ample 
 room for the men, but nothing was provided for them to rest 
 on save the hard bi >ards of the deck. We were well supplied with 
 rations, nurses, and attendants. - No case terminated fatally en 
 route ; the work of the surgeons in the field had been so faith- 
 fully performed that my services were not required even to 
 arrest the slightest hemorrhage." 
 
 On December 17 a number of steamers reached Washington 
 with the advance guard of the regularly evacuated wounded, 
 some 2,800 in number. The majority of these were able to walk- 
 to the hospitals, but nearly all had bandages on their heads or 
 arms. On the 18th other boats brought 900 and a boat arrived 
 at Alexandria with others. On the 21st two steamers brought 
 400 very severely wounded. Other steamers arrived daily until 
 the 27th, when three steamers brought the last cargoes, 600 of 
 the verv worst cases. Ten days had been occupied with the 
 evacuation. As a number of those brought up were sick, no 
 accurate enumeration of the wounded evacuated can be made. 
 The number appears to have been about 6,000, not counting 
 those, possibly 1,000, who came unauthorized. 
 
 As there was a larger proportion of very slightly wounded 
 than usual, it was not necessary to send so many to the base 
 hospitals. There was no overcrowding of the Washington hos- 
 
34 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 pitals, which had at last reached a capacity sufficient for the 
 wounded of any ordinary battle. Some wounded were sent 
 farther north, but chiefly because the states were clamoring for 
 them. On December 20, an order issued by the War Depart- 
 ment, provided that all wounded officers and soldiers who so 
 desired should be sent to general hospitals in their own states. 
 Here was a point where feelings of sympathy and humanity 
 clashed with necessarily unfeeling measures ; and, as is often the 
 case, feelings got the better of reason and judgment. Yet had 
 this order specified the very seriously wounded, those who would 
 probably never return to duty, it would have satisfied both senti- 
 ment and judgment. 
 
 On the whole the evacuation was as well managed as could 
 be expected without organization of the line of communications. 
 The railway trains were bad, but regular hospital trains on this 
 temporary line were out of the question. It seems that more 
 than two hospital steamers might have been in readiness at 
 this stage of the war. The lack of an evacuation hospital at 
 Aquia was in a measure filled by the Sanitary Commission with 
 a relief station, kitchen, and attendants. The greatest suffering 
 was caused by cold, and although it must have been anticipated, 
 sufficient preparation was not made. The Sanitary Commission 
 furnished 2,700 blankets and quilts and 4,000 suits of under- 
 clothes. Stoves of a poor pattern were procured after a week's 
 delay. 
 
 VOLUNTARY AID SOCIETIES. 
 
 The Sanitary Commission received news of the battle as dark- 
 ness was ending the struggle. Next day a steamer loaded with 
 supplies, four surgeons and a number of assistants started for 
 Aquia. Previous to the battle two surgeons and several assistants 
 accompanied the army, with a supply steamer on the Potomac. 
 These gentlemen had distributed several wagon loads of sup- 
 plies on the 11th and 12th. The boat from Washington reached 
 Aquai on Monday morning and the party went forward to 
 Fredericksburg, taking two wagon loads of supplies with them. 
 The roads were so horrible, and so cumbered with trains, that 
 the party did not reach the hospitals until the next morning — 
 December 16. 
 
 They found the wounded in tents and generally comfortable, 
 except as to the cold weather. The party was divided and all 
 the hospitals visited. A store house was established and sup- 
 plies freely issued to all medical officers needing them. While the 
 
CAMPAIGN OF FREDERICKSBURG. 35 
 
 demand here was not nearly so great as at Antietam and other 
 previous battles, yet the food delicacies provided were of much 
 use, and some shortages of necessities were discovered. The 
 most useful article supplied at this time was the ordinary 
 blanket. Freezing weather on the 17th made the lack of blankets, 
 always felt after a battle, even more marked on this occasion. 
 For some reason no stoves had been provided for the hospital 
 tents, and the patients lay shivering and actually suffering from 
 cold. Hay, blankets and woolen underclothes had to repair this 
 fault. Fortunately the Commission had a good supply of blank- 
 ets and underclothing. These things were not only useful in 
 th.e tents, but also during the cold journey up the river to Wash- 
 ington. 
 
 The medical department was not able then, or later, to supply 
 a sufficient quantity of clothing for the field hospitals. Through- 
 out the war the Sanitary Commission furnished a very large 
 proportion of this clothing, and also that for many depot and 
 permanent hospitals. It was not found necessary after this 
 battle to supply medicines, liquors, surgical supplies, or any 
 great amount of food; this for the first time after any great 
 battle. These things are mentioned to show how far the medical 
 department had progressed in methodically furnishing supplies. 
 
 Assistance was rendered in placing the wounded on the cars 
 at Falmouth station, and in transferring them to the steamers 
 at Aquia. At the latter place a relief station was established 
 with shelter and a kitchen. Hot meals were served to as many 
 as 600 at one time. Another party met the boats at Washing- 
 ton with food and hot drinks. A relief station had been estab- 
 lished at the Sixth street wharf early in the war. Doctor J. H. 
 Douglas, Associate Secretary of the Commission, says in his 
 report: "Stimulants, I am happy to say, were in great abun- 
 dance among the medical purveyor's stores, so that the calls on 
 us were few. The same was generally true of food, and posi- 
 tively so of all kinds of medical articles, which had been fur- 
 nished by us at other battles. Nothing of this kind was asked 
 for. The wounded had all been placed in tents, and, under the 
 circumstances, were well cared for. Owing to the cold weather 
 an unusual amount of bedding and woolen clothing was necessary, 
 and this only did the Sanitary Commission supply." 
 
 SUBSEQUENT EVENTS. 
 
 After the battle the army went into camp back toward Aquia 
 and Belle I Maine. The weather grew rainy and cold, the flat camp 
 
36 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 ground became a muddy morass, the men were despondent, and 
 sickness increased rapidly. Desertions also were of alarming- 
 frequency. All accounts picture the condition of the army at this 
 time as most miserable. Letterman does not appear to quite such 
 advantage as a sanitarian as he does as an organizer and manager 
 in the field. It was not the age of successful sanitation. Med- 
 ical Inspector General Thomas F. Perlcy was sent to report on 
 the situation. He said: 
 
 "I do not believe that I have ever seen greater misery from 
 sickness than now exists in the Army of the Potomac." He 
 went on to condemn almost everything connected with the med- 
 ical department, and ended with condemnation of the medical 
 director: "In view of the condition of the army I am forced 
 to the conclusion that the principal medical officer is not equal 
 to his responsible station, and has failed in his duty, either from 
 having too much to do, or from neglect." In order to read this 
 report rightly it is necessary to understand the bitter feud then 
 waging between the Secretary of War and the Surgeon Gen- 
 eral — a feud to which Perley and Letterman were parties. Perley 
 had been a seeker after Letterman's place and was engaged 
 in an effort to discredit both the Surgeon General and Letterman. 
 In the end Surgeon General Hammond and Inspector Perley 
 were both forced out, but Letterman came through the contest 
 unspotted. 
 
 On January 20 General Burnside began his last effort to re- 
 trieve his lost military reputation, and there ensued the four 
 days' campaign known to history as the "Mud March." The 
 army was to cross above Fredericksburg, and make another at- 
 tempt at Lee's army. Scarcely had the long lines of infantry, 
 cavalry and artillery started upon their rapid night march when 
 a terriffic storm of rain and sleet arose, breaking up the roads 
 and making the advance impossible. Chilled and exhausted, 
 floundering through mud and water in the bitter cold of a 
 winter night, the soldiers struggled back to their cheerless camp. 
 P>ut hundreds who had escaped unharmed from a score of bat- 
 tles now fell, the victims of this miserable "Mud March." A 
 field hospital was established at Windmill Point, a few miles 
 below Aquia Landing, a city of tents arose in an old cultivated 
 field. The rain fell incessantly and the whole camp presented 
 a most wretched aspect. Thousands of weak and sick men lay 
 in the fireless tents, on the muddy ground or on beds made of 
 poles. Many died daily and it is probable that the "Mud March" 
 
CAMPAIGN OF FREDERICKSBURG. 3; 
 
 cost as many lives as the terrible battle that had shocked the 
 entire North. On January 25 General Burnside was removed 
 and Major General Joseph E. Hooker became commander of 
 the Army of the Potomac. There was also a general change of 
 corps commanders, but none of these changes affected the posi- 
 tion of the medical director. 
 
 Burnside's campaign closed the year 1862, the second year 
 of the war. It marked the end of an old era, the beginning of a 
 new one in the medical department of the United States army ; 
 the end of working without authority, the beginning of control ; 
 the end of confusion, the beginning of method and order. Here- 
 tofore the medical officers of the army had been trying to work 
 without control of their own personnel and material, to make 
 bricks without straw. Henceforth they were to have the neces- 
 sary means and authority; success or failure was to be in their 
 own hands. But two years before the medical department had 
 been no more than^a hundred or more officers, each with a more 
 or less adequate knowledge of medicine and surgery as prac- 
 ticed at that time. They might be compared to the body of 
 chaplains today, except that they did have a chief. 
 
 The army had gone through the Mexican War with little 
 more assistance from the medical department than would be 
 rendered by the average family physician, and with little better 
 results. In two years this department had become a body of two 
 thousand officers, with nearly ten thousand men under its com- 
 mand or direction ; with horsed ambulances and wagons running 
 into the thousands ; besides base hospitals with more than fifty 
 thousand beds. And, what was vastly more important, it was 
 no more simply a number of officers, but a compact organization, 
 with personnel and material, ready to take the field and suc- 
 cessfully handle ten thousand wounded men at once, as it had 
 just done at Fredericksburg. At the beginning of the war the 
 medical department had been even inferior to the army as a 
 whole, itself contemptible in the eyes of Europe and to the 
 various staff organizations. Now it could safely challenge com- 
 parison with any staff department, and was, in point of suc- 
 cessful operation, superior to the army as a whole ; and this in 
 spite of the fact that no one of its members had a military 
 education, while nineteen out of twenty of them came fresh 
 from civil life during the two years. They had, however, this 
 advantage over the mass of volunteer officers, that they were 
 
:;s MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 all graduates in their own line of work, all members of a learned 
 profession. 
 
 At Fredericksburg the wounded were handled in such a way 
 as to give no grounds for an}- important criticism. Neither the 
 numerous newspaper correspondents, the active and prying 
 agents of the Sanitary Commission, nor the most unsparing 
 critics of all — the medical journalists — could pick any noteworthy 
 flaws in Letterman's work in this great battle. This work was 
 in most respects equal to. and in some respects superior to, that 
 
 Surgeon Jameson's Headquarters, Stoneman's Station. 2nd Div., 3rd Corps, 
 at Fredericksburg. 
 
 of any other battle of the war. It might be said that the hos- 
 pitals should not have been taken across the river ; assuredly they 
 would not be taken over today. But conditions then were dif- 
 ferent. The wounded could not be brought back for some days ; 
 on account of certain infection of compound fractures many 
 amputations were made in those days ; these amputations had to 
 be made at once. Waiting two days nearly doubled the mor- 
 tality. So the operating must needs be done in Fredericksburg 
 
CAMPAIGN OF FREDERICKSBURG. 39 
 
 in spite of poor buildings and occasional shells. Since the railway 
 was so convenient and the army remained immobile, evacuation 
 hospitals were not necessary. But the failure to establish some 
 kind of a hospital or station at Aquia Landing was a neglect. 
 In spite of all precautions trains will not always connect with 
 boats on the minute. The Sanitary Commission repaired this 
 fault. The handling of the wounded on the boats also left 
 something to be desired, but, as said before, these were faults 
 of detail and were not important. The broad plans, the grand 
 tactics were excellent. As Surgeon Stevens said, it was the 
 beginning of a new era in the medical department of the army. 
 
 How the medical department appeared to operate at that time 
 may be learned from a letter of Chaplain Quint, an unsparing 
 critic, who at first condemned the ambulance corps severely. 
 About this time he wrote a letter in answer to general criticism 
 of the care of the wounded, which criticism had been very 
 common in New England. The letter is a justification of the 
 work of the medical department. Only brief extracts can be 
 quoted : 
 
 "At the head of the army is a medical director, who is vir- 
 tually a medical autocrat ; to each corps there is a medical direc- 
 tor, to each division a medical director, and the senior surgeon 
 in each brigade is acting medical director of the brigade. Now. 
 besides this there is an ambulance corps. It is under the gen- 
 eral charge of the medical director of the army. All the ambu- 
 lances were long ago taken from the regiments and put under 
 charge, not of the quartermasters, but of the medical powers. 
 Each, ambulance has its driver, permanently detailed. To our 
 brigade there are assigned some thirty-odd ambulances, six or 
 seven to a regiment. They are in charge of a lieutenant, perma- 
 nently assigned. The brigadier himself cannot take one of these 
 ambulances for a moment, so exclusively are they under medical 
 control. I had occasion to need one lately. It had to be ob- 
 tained by a requisition signed by our surgeon, and approved by 
 our brigade surgeon. Not an ambulance can be used except to 
 carry sick or wounded. I have seen these ambulances parked : 
 they were in perfect order. The men are under strict discipline. 
 As they are assigned to one duty they understand their busi- 
 ness. The medical director has entire control and the ambu- 
 lance corps is as distinct a body as the artillery. 
 
 "In case of expected movements the corps medical director 
 issues his plans, to which the corps commander orders obedi- 
 
40 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 ence. The hospital is established, one surgeon from each bri- 
 gade is detailed as operating surgeon, with four or five assist- 
 ants ; others are ordered to report for general duties. The ambu- 
 lances are stationed by personal direction of the corps medical 
 director. Ten men from each regiment have the sole duty of 
 removing the wounded from the field. They are picked men ; 
 they do no other duty, and each wears a conspicuous green badge 
 on his breast. They use the stretchers which go with every 
 ambulance, and carry the wounded to the ambulances, stationed 
 near. Now what more complete ambulance corps can exist I 
 cannot see. The only variation would be to enlist men especially 
 for the corps, instead of taking them from the regiments. They 
 now remain permanently detached and are under no regimental 
 control. Such men were so taken from our regiment, with a 
 sergeant, and to these men's care I would entrust my life. 
 
 "But how this system works is the next point. It works well. 
 Xot perfectly, for we have neither omnipotence nor perfect good- 
 ness in surgeon, ambulance driver or hospital attendant; but it 
 works better and better. It has no defects that I can see would 
 be removed if all the critics had carte blanche to devise a 
 system ; for its defects are mainly the incidents of frailty in man, 
 not in plan. Possibly I am mistaken in thinking our well-regu- 
 lated plan general. Possibly Doctor McNulty (M. D., 12th 
 Corps) and Doctor Chapel (M. D., 1st Division) are exceptions 
 in skill and sense. Possibly the splendid Twelfth Corps is as 
 much a model in hospital matters as on the field of battle. But 
 I do not believe that the other corps are far behind. I tell you, 
 anxious reader, that while your and our wounded must suffer, 
 cases of neglect are extremely rare. I bear my testimony to 
 the general skill and kindness of the surgeons. I have been 
 with many of them in bivouac where the slumber was by mo- 
 ments only ; with them as they were tenderly handling the 
 wounded ; with them to see their unselfish devotion to duty. In 
 our regiment (Second Massachusetts) one surgeon received an 
 enemy's ball, and one has just laid down his life as a sacrifice 
 to his unremitting labors." 
 
CAMPAIGN OF FREDERICKSBURG. 41 
 
 Medical Officers at Frederickburg 
 
 Medical Director of the Army Surgeon Jonathan Letterman, U. S. Army 
 
 Medical Purveyor Asst. Surg. T. J. McMillin, U. S. Army 
 
 Medical Director, Rt. Grand Division Surgeon A. N. Dougherty, U. S. V. 
 
 Second Corps a J. H. Taylor, U. S. V. 
 
 First Division " L. M. Knight, U. S. V. 
 
 Second Division " J. F. Dwyer, U. S. V. 
 
 Third Division " Grant, 7th West Virginia. 
 
 Ninth Corps " P. A. O'Connel, 28th Mass. 
 
 First Division " H. Hovet, 46th N. Y. 
 
 Second Division " A. T. Watson, U. S. V. 
 
 Third Division " M. Storrs, U. S. V. 
 
 Medical Director, Center Grand Division.. " John Moore, U. S. Army 
 
 Third Corps " Geo. L. Pancoast, U. S. V. 
 
 First Division " O. Everett, 20th Indiana 
 
 Second Division " Thomas Sim, U. S. V. 
 
 Third Division " J. Jameson, 86th N. Y. 
 
 Fifth Corps Asst. Surg. R. O. Craig, U. S. Army 
 
 First Division Surgeon J. Owen, U. S. V. 
 
 Second Division Asst. Surg. W. R. Ramsey, U. S. Army 
 
 Third Division Surgeon David McKinney, 134th Penn. 
 
 Medical Director Left Grand Division " Charles O'Leary. U. S. V. 
 
 First Corps " J. T. Heard U. S. V. 
 
 First Division " E. Shippen, U. S. V. 
 
 Second Division " C. I. Nordquist, 13th Mass. 
 
 Third Division " L. W. Reed, 1st Penn. 
 
 Sixth Corps " Charles O'Leary, U. S. V. 
 
 First Division " Geo. Burr, U. S. V. 
 
 Second Division " S. J. Allen, 4th Vermont 
 
 Third Division " S. A. Holman, 7th Mass. 
 
THE GREATEST BATTLE OF THE WAR— GETTYSBURG 
 
 THE MARCH. 
 
 THE Battle of Fredericksburg was followed during the first 
 week of May by that of Chancellorsville, which was very 
 similar, in so far as the work of the medical department 
 was concerned, but very different in the tactical action of the 
 troops. These two victories encouraged the Confederate leaders 
 to undertake another invasion of the Northern States, and this 
 time on a more bold and extensive plan than that of the year 
 before. Ewell's Corps left Fredericksburg early in June, pass- 
 ing through the Shenandoah Valley, and on into Pennsylvania. 
 Longstreet and Hill followed, crossing the Potomac at Shep- 
 herdstown and Williamsport, June 24th-25th. 
 
 The Union army started from Falmouth on June 12th, march- 
 ing first to the railway at Bealetton, and then to Manassas and 
 Fairfax. There the army remained for a week, awaiting devel- 
 opments. When it was learned that the main body of Confed- 
 erates were crossing the Potomac, the corps were put in motion 
 again, and crossed at Edwards' Ferry, June 25th-26th ; on the 
 27th and 28th they were in and around Frederick. Here General 
 Hooker was relieved by Gen. George G. Meade two days before 
 the great battle began. On the 29th and 30th the seven corps 
 were moving rather cautiously toward the Susquehanna River. 
 Ewell's Divisions were now at York and Carlisle, while Long- 
 street and Hill were about Chambersburg. On the evening of 
 the 29th Lee ordered the concentration of his army, between 
 Gettysburg and Cashtown, and next day the corps were marching 
 on Gettysburg. On the evening of the 30th the First and 
 Eleventh Corps were on the road from Emmitsburg to Gettys- 
 burg : the Third Corps was near Emmitsburg. The Headquar- 
 ters and Reserve Artillery were at Taneytown and the Second 
 Corps reached that place next morning. The Twelfth and Fifth 
 Corps were on the Baltimore Pike, at Littlestown and Union 
 Mills. The Sixth Corps was on the extreme right at Manchester. 
 Of the three cavalry divisions, Gregg was on the right at Man- 
 chester ; Buford on the left at Gettysburg; Kilpatrick in front at 
 Hanover. All these troops were within an easy day's march of 
 Gettysburg, except the Sixth Corps, which was 32 miles away. 
 No order for concentration had been given. 
 
2 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 The army now consisted of seven small corps. The grand 
 divisions of Burnside had been abolished. The Ninth Corps had 
 gone west and the Eleventh (Howard), and the Twelfth 
 (Slocum) had joined. The return of the army for June 30th 
 showed the following number of officers and men present for 
 duty and equipped : 
 
 Infantry 74,192 Artillery 7,711 
 
 Cavalry 10,192 Special troops 3,178 
 
 Total 99,795 
 
 Fox has made a very careful estimate of the number of officers 
 and men of the various organizations actually carried into action. 
 He fixes the number at 85 per cent. In addition, the largest 
 corps of the army, the Sixth Corps, was scarcely engaged. Out 
 of 16,387 men there were but 27 killed. 
 
 The march to Gettysburg was the longest and hardest march 
 ever made by the Army of the Potomac. At the beginning the 
 weather was exceedingly warm and the roads dusty. The troops, 
 unaccustomed to long marches, were pushed twenty-five and thirty 
 miles at a stretch. Night marches were common. The dust, 
 heat, and lack of water, caused much suffering. Men died of 
 heat and exhaustion on this march, but there is no record by 
 which the number may be learned. Surgeon Perry, of the 20th 
 Massachusetts, said: "On June 15th, when the march began, the 
 heat was frightful, and so many men dropped from the ranks 
 that I was incessantly engaged with the dead and dying, and 
 consequently fell farther and farther to the rear." Fifer Bar- 
 deen said in his diary : "June 12. We had to march to Beverly 
 P'ord, though it was 27 miles. Many dropped dead on the road ; 
 four in our brigade died of exhaustion." This is not accurate 
 evidence, but so many speak of these deaths that some must 
 have occurred. 
 
 During the latter part of the march there were rains every 
 day, which at least did away with the dust, but left mud instead. 
 While there was straggling on this march it was generally with 
 cause, not the needless straggling seen before Antietam. 
 Marches that lasted all day and then far into th.e night were 
 sure to leave stragglers along the road. An officer of the Third 
 Corps wrote of the last march: "July 1st. Forced march at 
 noon from Emmitsburg to Gettysburg. Soon men began to 
 stagger from the ranks, and fall by the wayside. Every piece 
 of woods through which we passed was filled with, prostrate men 
 from previous columns; and others all along the roadside, with 
 no one to care for them, lay dying, and not a few dead. Mounted 
 
GREATEST BATTLE— GETTYSBURG. 3 
 
 officers dismounted and loaded their horses with muskets and 
 equipments. Forward, forward, was the cry, and we pushed on. 
 Blankets, tents, clothing, food and equipments strewed the way, 
 and when we reached the high ground south of Gettysburg and 
 halted for the night, not over one hundred men and five officers 
 were in line. The most of them came up before morning." 
 
 The army before Gettysburg was not particularly confident, 
 but it was determined to make a good fight. All felt that they 
 were on their own soil and must win now or give up the con- 
 test. While by no means so confident as the Confederates they 
 were silently resolved to fight to the last on their own ground. 
 The spirit of the army was expressed by Colonel Patrick O'Rorke 
 of the 140th New York (a lieutenant of the regular army). Gen- 
 eral Meade had directed all commanding officers to address their 
 men before the battle. Colonel O'Rorke was no orator and made 
 a very brief speech, ending with a sentence which might well 
 have been "his epitaph, for he died that day. 
 
 "I call on the file closers to do their duty, and if there is a 
 man this day base enough to leave his company, let him die in 
 bis tracks. Shoot him down like a dog." 
 
 The line of supplies during the Gettysburg campaign was con- 
 tinually shifting, as the army marched around Washington in 
 the arc of a circle. At Falmouth it had been by the Potomac 
 River. On reaching Bealeton Station the Orange and Alexan- 
 dria Railway was used until the Potomac was crossed. The 
 Baltimore & Ohio then became the main line, with railhead at 
 Frederick. The army required 700 tons of supplies daily. On 
 July 1st this line was abandoned west of Baltimore and the 
 supply point shifted to Westminster, the terminus of a mis- 
 erable little branch railway. This was a branch of the Northern 
 Central, which had another branch to Littlestown, only ten miles 
 from Gettysburg, and another from Hanover to the town itself. 
 But these two branches had been destroyed and the road from 
 Baltimore to Westminster, twenty-five miles from Gettysburg, 
 was the nearest railway available. It was twenty-nine miles 
 long, had neither sidings nor telegraph, and the trains covered 
 the distance in five hours. As the Pike was shorter, a courier 
 service was established, and mounted couriers every hour made 
 the distance in three hours. 
 
 Colonel Haupt was put in charge and by running five trains 
 in a group was able to put through fifteen trains each way in a 
 day. With 150 cars he could carry 2,000 to 3,000 wounded daily. 
 
4 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
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GREATEST BATTLE— GETTYSBURG. 5 
 
 Haupt started gangs of men working night and day on these 
 ruined roads. He had the branch to Littlestown open by the 5th, 
 and trains in Gettysburg on the evening of the 6th. The tracks 
 were so flimsy and the management so grossly incompetent that 
 no dependence could be placed in these roads except when in 
 the hands of the military authorities. Fortunately the army had 
 a splendid supply train of 4,000 wagons and never suffered for 
 supplies. The train went to the rear on the first and did not 
 reach the army again until the 7th. It was held in the rear 
 until the Potomac was recrossed. 
 
 Baltimore, 55 miles from Gettysburg, became the base for the 
 time being. This was especially true for the medical depart- 
 ment. The greater part of the medical supplies were secured 
 from that place and after the battle the wounded were sent there 
 to be distributed to other cites further north. No wounded were 
 sent to Washington. Baltimore had general hospitals for about 
 4,000 patients, York 1,500, Chester 1,000, Annapolis 2,500, Phila- 
 delphia 10,000, and New York 5,000, with others farther north. 
 In Pennsylvania alone there were 15,000 beds. All these hos- 
 pitals had patients, but as a general rule half the beds were 
 empty. 
 
 THE BATTLE. 
 
 FIRST DAY. 
 
 On June 30th Buford's cavalry division advanced from Fair- 
 field to Gettysburg and moved out beyond the town, Gamble's 
 brigade to the west, Deven's to the north, picketing all the roads. 
 The First Corps was marching up by the Emmitsburg Road with 
 the Eleventh Corps following, and the Third Corps was not far 
 behind. These three corps formed a sort of left wing, under 
 General Reynolds. A. P. Hill's Corps was likewise advancing 
 on Gettysburg from Cashtown, while Ewell's Corps was coming 
 in from the northeast on the Carlisle Road. On the morning of 
 July 1st all these troops were marching on one point; though 
 without design of battle, collision was inevitable. 
 
 Hill's advance division, Heth's, reached Willoughby Run, two 
 miles west of the town, about 9 o'clock, and was halted by 
 Gamble's dismounted troopers. They held back Heth's skir- 
 mishers until Reynolds arrived and hurried up his infantry. 
 
 The First Corps had bivouaced on Marsh Creek, four or five 
 miles from the town. Wadsworth, leading the First Division up 
 the Emmitsburg Road, did not pass through the town, but turned 
 off at the Codori House and marched swiftly through the fields 
 
6 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
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GREATEST BATTLE— GETTYSBURG. 7 
 
 to the Seminary, and beyond toward the McPherson farm. His 
 two brigades, under Cutler and Meredith, were formed on right 
 and left of the Chambersburg Pike just as Heth was sending 
 forward the brigades of Davis and Archer. Meredith's Iron 
 Brigade, in keeping with its former reputation, made a savage 
 attack that broke Archer, taking him and many of his men pris- 
 oners, and driving the remainder beyond the Run. 
 
 North of the Pike Cutler was losing ground, until Wadsworth 
 sent one of Meredith's regiments to his aid, when Davis was 
 served much like Archer. 
 
 This ended Heth's advance for a time, and was one of the very 
 finest achievements of the Union Army during the entire war. 
 
 At the very beginning of Wadsworth's attack General Rey- 
 nolds was shot through the head and instantly killed. General 
 Doubleday took the command and the fight did not falter for an 
 instant. Heth now awaited the arrival of Pender's Division to 
 organize a new attack with his whole force, some 14,000 men. 
 Doubleday, and Howard, who had now arrived, were hurrying 
 up all the troops within reach. Rowley's Third Division arrived 
 by noon and was sent to the right of Wadsworth. Robinson's 
 Division, following, was held in reserve at the Seminary. At 1 
 o'clock the head of the Eleventh Corps was coming over Ceme- 
 tery Hill, but then Buford reported a new danger; two of Swell's 
 divisions were coming down from the northeast on the flank 
 and rear of the First Corps. Two divisions of the Eleventh 
 Corps were sent to the north of town to stay this advance, while 
 the other division was held on Cemetery Hill as a "Rallying 
 Point," a subconscious precaution against another Chancellors- 
 ville. 
 
 About 3 o'clock the battle began anew and with great vio- 
 lence. Heth and Pender with six brigades attacked the First 
 Corps in front while Rodes with four brigades attacked the right 
 flank. The six small brigades of Doubleday withstood this attack 
 with the most steadfast bravery, suffering terrible losses, but 
 inflicting still greater. At the same time General Early with 
 four brigades attacked the two divisions of Howard (four bri- 
 gades), and after an hour's fighting drove them from the field 
 in rout. Now the First Corps, which had been forced back to 
 the Seminary, being in danger of being cut off, retreated through 
 the town to Cemetery Ridge. The retreating troops of the two 
 corps crowded the streets. 
 
 Early's Division, which had no great losses, followed at the 
 
S MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 heels of the Eleventh Corps, thus coming in the rear of the First. 
 In the town about 3,600 prisoners were lost, besides many of the 
 wounded. The Iron Brigade covered the retreat, the 6th Wis- 
 consin holding the post of honor. 
 
 By 5 o'clock the remnants of the two corps were back on 
 Cemetery Hill. The Confederates did not follow. The Twelfth 
 Corps was at hand and the Third Corps was coming up. The 
 cavalry had rendered most valuable assistance in all this fighting. 
 
 In this battle, though defeated, the First Corps had done as 
 good fighting as the war produced. With six brigades it had 
 withstood twelve fully as large during the greater part of the 
 day. inflicting a greater loss in killed and wounded than it had re- 
 ceived, and taking 1,200 to 1,500 prisoners, while losing almost 
 none. l!ut when the Eleventh Corps gave way it was caught in 
 Gettysburg by still another division, Early's, and lost some 2,000 
 prisoners. When the regiments came together on the hill in the 
 evening, only 3,000 of the 9,000 of the morning remained, yet 
 but one gun and one colnr had been lost, neither taken in battle. 
 When Longstreet's men were hurrying forward that night they 
 met staff officers who had been mi the field and asked them how 
 the Yankees fought. The answer was in profane simile that gave 
 no comfort ; for the fighting that day was never excelled. 
 
 Vanderslice has made many interesting calculations as to the 
 losses in various parts of this great battle. The losses as given 
 by him are all too small, but are proportionately correct. By his 
 figures the First Corps on this day lost 3,587 in killed and 
 wounded ; while the divisions of Heth, Pender and Rodes (less 
 one brigade), opposed to it, lost 4,926. The First Corps had 
 2,173 missing, the Confederates 1,717. The total losses in this 
 part of the field were: Union 5,760, Confederate 5,643. 
 
 In the battle of the Eleventh Corps, north of Gettysburg, the 
 divisions of Schurz and Barlow lost 1,768 killed and wounded. 
 Early's Division and Doles' Brigade, opposed to them, lost but 
 856. The Eleventh Corps lost 1,427 men as prisoners and took 
 but 121. The total losses here were: Union 3,295, Confederate 
 976. The figures throw some light on the relative resistance 
 offered. 
 
 Of all the fifty-one Union brigades at Gettysburg, the Iron 
 Brigade had the heaviest loss, and the 24th Michigan of this 
 brigade had the heaviest regimental loss. One other regiment 
 had a heavier proportional loss, the First Minnesota. Two Con- 
 federate brigades had heavier losses than Meredith's, those of 
 
GREATEST BATtLE— GETTYSBURG. 9 
 
 Pettigrew and Davis, both of which opposed the Iron Brigade 
 on the first day and took part in Pickett's charge on the third 
 
 day. Their losses here were greater than in the picturesque 
 charge. 
 
 Also Heth's Division, which suffered so heavily this day, never 
 reached the Union lines with Pickett's fresh brigades on the 
 Third. 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 SECOND DAY. 
 
 On the evening of the 1st, General Meade, at Taneytown, re- 
 ceived the unwelcome news of that day's battle, with the death of 
 Reynolds and the driving back of his men. Orders were at once 
 issued setting every corps in instant motion. Throughout that 
 long moonlight night the pikes and roads leading to Gettysburg 
 were filled with thousands of marching men, plodding wearily, 
 sleepily toward the field that so many of them were to water with 
 their blood. By the York Road, the Baltimore Pike and the 
 Emmitsburg Road the silent columns pushed steadily forward, 
 while up from Taneytown dragged the heavy trains of the artil- 
 lery reserve. Though Meade was two days later than his adver- 
 sary in issuing his order for concentration, all his troops were 
 up when Longstreet was ready to attack. On the evening of the 
 1st the Twelfth and Third Corps were close at hand, but the 
 Second Corps was ten miles away, the Fifth farther, and the 
 Sixth was thirty miles from the field. By 9 next morning all 
 were in place save the Sixth, which came up in good time during 
 the afternoon. 
 
 The well known fish-hook line of the Union Army on this day 
 need not be described. The Twelfth Corps was on the right at 
 Culp's Hill ; the Eleventh Corps on the north and east faces of 
 Cemetery Hill ; the First Corps divided, on either side the 
 Eleventh. The west front of the hill was held by the Second 
 Corps, while the Third continued the line south toward the Round 
 Tops. The Fifth Corps was held in reserve near Rock Creek. 
 Toward 1 o'clock Sickles moved the Third Corps forward to the 
 Emmitsburg Road, with center at the Peach, Orchard, and left 
 obliquely to the rear. Longstreet, with the divisions of Hood and 
 McLaws, made a most determined attack on this position at 4 
 o'clock, and, after severe fighting, broke Sickles and drove him 
 back with heavy loss. The Fifth Corps was put in to relieve 
 Sickles, also portions of the Second and Twelfth. Longstreet's 
 men reached the slopes of Round Top, but were finally halted by 
 the accumulated Union brigades. When the late darkness put 
 an end to further action the Confederates held most of the ground 
 fought over, but had failed to take Little Round Top, the key of 
 the whole line. 
 
 Further north a part of Anderson's Division attacked Cemetery 
 Hill and achieved a temporary success, but were driven back 
 again. On the extreme right Johnson's Dvision attacked Culp's 
 Hill and occupied some works that had been vacated by the 
 
GREATEST BATTLE— GETTYSBURG. 11 
 
 Twelfth Corps on going to the aid of Sickles. Just at dark Hay's 
 Brigade (Early's Division) broke into a battery on East Ceme- 
 tery Hill, but was driven out again. This was the last fighting 
 of the day. When all these attacks had been checked the Battle 
 of Gettysburg was won. The great losses and the decisive action 
 took place on the second day. 
 
 The open field on the crossroad, known as the Wheatfield, was 
 the very vortex of the strife ; it was fought over backward and 
 forward by brigade after brigade, until it was almost carpeted 
 with dead and wounded. The Peach Orchard, the rocky fast- 
 nesses of the Devil's Den, the ravines of Plum Run, and the 
 slopes of Little Round Top, all were strewn with blue and gray 
 commingled; and for many of them there was no help. In this 
 fight the Confederates had the best end of the losses, as they 
 nearly always did in woods fighting. In the open fields of the 
 first day's battle the men of the First Corps had outshot them, 
 but in this rocky, wooded region they had taken advantage of 
 cover and, although confronted by both regulars and volunteers, 
 had more than balanced the score. 
 
 Vanderslice estimates the losses on the second day as follows : 
 In the whole battle on the left, including Peach Orchard, Wheat- 
 field, Round Top, etc., the Union loss in killed and wounded was 
 7,540. The Confederate loss is given at 5,366; it was probably 
 somewhat greater, but less than the other. 
 
 The Louisiana Tigers, reputed to be a most ferocious body of 
 troops, in their charge had 27 killed and 153 wounded. The total 
 Union loss this day was 1,825 killed, 8,528 wounded, 1,277 
 missing. 
 
 On the evening of July 2d nearly all of the wounded of that 
 day's fight, some 8,000 in number, were collected behind the 
 corps engaged along the Taneytown Road. Such an assemblage 
 of maimed men, in so small an area, had never been seen before. 
 An eye-witness of this spectacle, August Buell, wrote of it : 
 
 "We went down the Taneytown Road until we came to the 
 bivouac of the Sixth Corps and thence to the Baltimore Pike by 
 a cross road. The road ran close in the rear of the positions of 
 the Second, Third and Fifth Corps, which had sustained the 
 brunt of the main attack of the second day, and the whole 
 of it was literally a field hospital. Our own wounded of 
 the first day's battle had been mostly left in Gettysburg village, 
 so that during the rest of the conflict they were practi- 
 cally in the hands of the enemy, and we could not see 
 them or do anything for them. As we passed slowly along 
 
12 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
GREATEST BATTLE— GETTYSBURG. 13 
 
 the road we could see on ever)' side, in the fields and 
 around such farm buildings as had escaped the- flames, and 
 fairly lining both, sides of the road, innumerable groups of 
 wounded in all stages of misery; groaning, crying, swearing, 
 begging for water or whisky, or for food ; entreating the sur- 
 geons or attendants to come to them ; some in delirium calling 
 for friends ; some even begging some one to shoot them, to escape 
 from their present pangs ; and the whole scene fitfully lighted up 
 by the flaring lanterns of the hospital forces, or the flickering 
 campfires of rails and boards. The fields toward the front were 
 filled with the flickering lights of the stretcher parties, busy bring- 
 ing additions to the wretched mass. Meanwhile the surgeons 
 were at work as best they could in the darkness and confusion, 
 dressing wounds, administering stimulants, and all that sort of 
 thing. In the mile or so of road there must have been no less 
 than 8,000 men, of whom 1,000 no doubt died during the night. 
 No one will ever see again so much or such awful suffering, woe 
 and despair in an equal space of ground." — A. Buell. 
 
 THIRD DAY. 
 
 There were two conflicts on the third day ; also some cavalry 
 combats. The Twelfth Corps returned to their works on Culp's 
 Hill during the night to find them partly occupied by the enemy. 
 Before daylight they began an attack, which, after five hour's 
 fighting, resulted in entire success. About noon there was quiet 
 over the entire field. In the afternoon occurred Pickett's 
 Charge, which has been so often described as to need no account 
 here. A few words as to the losses may be interesting. All 
 writers dwell on the destruction that attended this assault, leaving 
 the impression that the losses were phenomenal. These great 
 losses will not bear examination. The heaviest losses in battle 
 did not occur in attacks of that kind, which were quickly made 
 and soon over with, but in the stand and fire contests like that 
 of the first day. The losses of Pettigrew's (Heth wounded) 
 Division in this charge cannot be determined, but those of Pick- 
 ett's brigades, which must have been greater, are fairly well 
 known, since these troops were not otherwise engaged : 
 
 Kemper had 58 killed and 356 wounded. 
 Garnett had 78 killed and 324 wounded. 
 Armistead had 88 killed and 460 wounded. 
 
 These brigades averaged about 1,900 men each. The 24th 
 Michigan had 79 killed and 237 wounded out of 496 engaged, 
 on the first day. The entire losses in Pickett's contest were: 
 Union killed and wounded, 2,220 ; missing, 112 : total, 2,332. Con- 
 federate killed and wounded, 3,060; missing, 2,260; total, 5,320. 
 
14 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 The entire Union loss on the third day was 483 killed, 2,012 
 wounded, and 522 missing; or 3,017 in all. 
 
 On the evening of the 3d all the Confederate troops were drawn 
 back to Seminary Ridge. During the 4th their trains were 
 started to the rear, and at night the troops followed. All the 
 wounded that could be transported, and many that could not, 
 were collected and loaded in the empty wagons, to move with the 
 trains by way of Chambersburg to the Potomac. Some six or 
 seven thousand were too severly wounded for this heroic trans- 
 portation and were left on the field, mostly collected in some 
 sort of extemporized hospitals. The Union wounded in their 
 hands were abandoned. On the night of the 4th the whole Con- 
 federate army retreated by the Fairfield and Hagerstown Road 
 toward Williamsport. General Meade had not felt strong enough 
 to attack and the retreat was only harassed by the cavalry. 
 
 The Union army remained on the ground until the 5th and 
 6th, then moved very cautiously toward Boonesboro and Fred- 
 erick. It is sometimes said that General Meade was obliged to 
 remain at Gettysburg two days in order to care for his wounded. 
 This statement sounds like an excuse. Gettysburg was Meade's 
 first battle, and a tremendous one. He had come out of it very 
 well, though several times near ruin, and all his actions were 
 those of a man not anxious for another such experience. The 
 wounded were in friendly territory. There was an army of 
 militia but a few miles away that could have cared for the 
 wounded in some manner; not very well, of course. But had 
 Grant and Sheridan been at Gettysburg they would never have 
 waited two days to care for the wounded. I feel quite sure that 
 when the whole army was eager to strike again and end the war, 
 Letterman did not ask Meade to wait two days to care for the 
 wounded. If he did he made a tremendous mistake. To destroy 
 the enemy was the first object, to care for the wounded a subor- 
 dinate one, as stated in all field regulations. 
 
 The losses in the whole battle, by days, was as follows: 
 
 First day, 847 killed, 3,989 wounded, 3,556 missing 8,402 
 
 Second day 1,825 killed, 8,528 wounded, 1,277 missing 11,630 
 
 Third day 483 killed, 2,012 wounded, 522 missing 3,017 
 
 Total 3,155 killed, 14,529 wounded, 5,365 missing. 23,041 
 
 The muster rolls show 5,091 killed or died of wounds. 
 
 AMBULANCE WORK. 
 
 The number of the ambulances with the army at this time 
 was about one thousand. They followed the troops to the field, 
 
GREATEST BATTLE— GETTYSBURG. 15 
 
 along with the ammunition wagons. Their work at Gettysburg 
 was satisfactory, and need not be described in detail. The corps 
 had reached such a stage of organization and experience as to 
 be able to cope with any ordinary situation. As the fifteen 
 thousand wounded were distributed through three days the work 
 of collecting them was not so concentrated as at Antietam. 
 
 The litter bearers followed the regiments and brought the 
 wounded back to the ambulance stations, where they were taken 
 up by the ambulances and rapidly conveyed to the hospitals. The 
 ambulance corps was ready each day when the battle began, and 
 finished its work during the following night. 
 
 On the first day ambulances were running early, from the 
 front back to the hospitals in the town. When the field was 
 lost the ambulances were filled with wounded and all brought 
 off safely. Many wounded were necessarily left behind, but 
 within the enemy's lines. The Corps engaged this day were well 
 supplied with ambulances. The Eleventh Corps had 100 ambu- 
 lances, 9 wagons, 270 men and 260 horses. 
 
 On the second day the ambulances of the Second and Fifth 
 Corps were at work early, but the greater part of the wounded 
 were collected during the night. Here, also, many wounded 
 were left behind, but next evening the ground was regained and 
 on the night of the 3d the ambulances were again busy collect- 
 ing these wounded. The wounded of the third day were easily 
 removed. By the morning of the 4th all the wounded had been 
 brought in save some out toward the McPherson farm, where the 
 enemy still lingered. The ambulances in this battle had double 
 work for a number of the hospitals, after being filled*, were re- 
 moved to other locations. They had been placed too near the 
 front. 
 
 A fair sample of the work of the ambulance corps is afforded 
 by the report of First Lieut. Joseph C. Ayer, of the First Divi- 
 sion, Fifth Corps, which is here given in a condensed form, with 
 a few explanations in parentheses: 
 
 "As soon as the division was placed in position all my stretcher 
 men, under their lieutenants and sergeants, were sent to the front 
 to follow their respective regiments; leaving one lieutenant and 
 three sergeants in charge of the train. I conducted the train to 
 a point two hundred yards in rear of the second and third bri- 
 gades, where it was rapidly loaded with severely wounded. 
 Owing to some misunderstanding there was a delay in locating 
 the division hospital and the wounded men remained in the ambu- 
 lances about an hour, when the hospital was established and the 
 
16 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 wounded unloaded. The ambulances then commenced regular 
 trips to the battlefield and were constantly at work during; the 
 night. 
 
 "As soon as all the wounded were secured, orders came to me 
 to remove all the wounded in the field hospital to one farther in 
 the rear. (The hospitals of this corps were moved on July 3d.) 
 Previous to this, seventeen ambulances from my train had been 
 ordered to report to the hospital of the Second Division, Fifth 
 Corps, where they loaded with wounded, whom they conveyed to 
 the rear. The whole of July 3d was consumed in removing the 
 hospital. At sunset the horses were unharnessed for the first 
 time in sixty hour*. 
 
 "At about 10 p. m. an order came to me to send up my whole 
 train to the front, to remove from the field the remaining' wounded 
 of the division. On reaching the field we found but one 
 wounded man of the Fifth Corps, but there being a sufficient num- 
 ber of wounded of the Third Corps, I loaded my train with them 
 and transported them to their respective hospitals. (These were 
 wounded of Sickles' Corps, left in the enemy's hands on the 2d, 
 but recovered by McCandless' advance on the evening of the 3d.) 
 
 ''The train returned to camp near sunrise on the 4th. Having 
 unhitched and fed, I hitched up again at 9 and reported to the 
 several corps and division hospitals of the army, and collected 
 as nearly as possible all wounded men of this division who had 
 been taken to other hospitals. 
 
 "On July Sth the ambulance corps received orders to move 
 and follow the division towards Emmitsburg, leaving two ambu- 
 lances and four men at the division hospital (left behind). 
 
 "I estimate the total number of wounded removed from the 
 field by the corps (First Division) to have been 560; of the Third 
 Corps, 82. There might also be added 430 transported from one 
 hospital to another, 53 for the Second Division, and 32 collected 
 from other hospitals; total, 1,157, on July 2d, 3d and 4th." 
 
 The Fifth Corps, with about thirty-five regiments, some of 
 which were batallions, had eighty-one ambulances. The wounded 
 of this corps, 1,611 in number, were scattered over the slopes of 
 Round Top and as far forward as the Wheatfield. The ambu- 
 lances went to work at 4 p. m. on the 2d, carrying the wounded to 
 the hospitals in rear of Little Round Top. At 4 next morning 
 the work was complete; thirteen hundred wounded had been 
 collected, beside some for other corps. 
 
 A very large number of wounded lay about the Wheatfield, 
 Plum Run and the Devil's Den during the night of the 2d and all 
 the following day, or until the advance of McCandless' brigade on 
 that evening cleared all this portion of the field of the enemy. 
 
GREATEST BATTLE— GETTYSBURG. 17 
 
 Gen. S. W. Crawford (Third Division, Fifth Corps) says in his 
 report: "By this charge of McCandless' Brigade the whole of 
 the ground lost on the previous day was retaken, together with 
 all of our wounded, who, mingled with the rebels, were lying 
 uncared for together. The dead of both sides lay in lines in 
 every direction, and the large number of our own men showed how 
 fierce had been the struggle and how faithfully they had con- 
 tested the field. * * * Our wounded were at once cared for, 
 and under the able and prompt management of Surgeon G. W. 
 Reed, Chief Surgeon of this Division, moved to hospitals in the 
 rear." 
 
 MEDICAL SUPPLIES. 
 
 Owing to several different causes medical supplies were in- 
 sufficient at Gettysburg. From the inaugurating of Letterman's 
 supply scheme the allowance of transportation for the medical 
 department had been one wagon to each regiment, and one to 
 each brigade, of about fifteen hundred men. This allowance had 
 proved sufficient for all ordinary needs, although it was half 
 what had been found insufficient under the old lack of system. 
 
 On June 19th, while the Headquarters was at Fairfax Court 
 House, the number of medical wagons was cut down to three for 
 each brigade. This order compelled a reduction in the amount 
 of tentage, bedding, food, etc., carried, amounting to about six 
 wagon loads to each division. For the whole army it made a 
 reduction of about one hundred medical wagons. Letterman pro- 
 tested, in vain. Failing to secure a restoration of the former 
 allowance he turned to another device. A reserve supply train 
 of twenty-five wagons was decided on. Medical Purveyor Brin- 
 ton was ordered to Washington to collect this supply train and 
 rejoin the army. I believe this was the first large train of reserve 
 supplies for the medical department in the Army of the Potomac. 
 
 Surgeon Brinton reached Frederick with his train on June 
 28th; the army had arrived the day before. On the 29th his 
 train followed the Headquarters to Taneytown. On the 30th 
 everything there stood still until word of Reynold's battle was 
 received, when all the trains were ordered to the Baltimore Pike 
 in front of Westminster, the new advance base of the army. 
 
 On June 30th General Meade had issued a preparatory circular 
 to his corps commanders providing: "Ammunition wagons and 
 ambulances will alone be permitted to accompany the troops." 
 On June 1st it was ordered that "Corps Commanders will at once 
 send to the rear all their trains, excepting ammunition wagons 
 
18 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 and ambulances, parking them between Union Mills and "West- 
 minster." On the 2d these trains were ordered still further to 
 the rear, and parked about Westminster, twenty-five miles from 
 the field. This order deprived the division hospitals of nearly all 
 their supplies during the battle. Fortunately, in most of the divi- 
 sions the special medicine wagons (Autenreith.) remained with 
 the ambulance trains, otherwise the surgeons would have been 
 helpless. These special wagons gave a moderate supply of anes- 
 thetics, dressings, drugs and instruments, which served until the 
 wagons were allowed to come up ; but tents, bedding, clothing, 
 cooking utensils and food were almost entirely lacking. 
 
 As the battlefield was soon visited by thousands a great outcry 
 against the medical department arose, on account of shortcomings 
 for which it was in no way responsible. When the battle closed 
 on the evening of July 3d Letterman requested of General Meade 
 that the hospital trains be allowed to come up, but the cautious 
 General allowed only one-half the wagons to do so. The re- 
 mainder did not arrive until the 5th. Medical Purveyor Brinton 
 arrived with his train on the evening of the 4th. The Twelfth 
 Corps in some manner escaped both the reduction in supply 
 wagons and the order sending trains to the rear. In consequence 
 the medical officers of this corps were able to shelter, dress, feed 
 and care for their wounded as well as had been done at Fred- 
 ericksburg. No other corps did anything like as well. 
 
 Letterman claimed that there were ample supplies at Gettys- 
 burg and could quote all the four or five medical inspectors that 
 visited the field, to that effect. But all the reports of the Sani- 
 tary Commission agents, and of other independent visitors, are 
 to the contrary. The enormous amount of supplies furnished by 
 the Commission, and by many other civilian bodies, seem suffi- 
 cient evidence that the medical department was not able to fur- 
 nish all the needed medical supplies. Part of the difficulty was 
 in distribution over such a widely extended territory, with such 
 limited transportation, the army moving away on the 6th, and 
 leaving but few ambulances and wagons behind. 
 
 The chief lack was as usual in tents, bedding, clothing and 
 food. Of these, the lack of food was naturally most pressing. 
 During the battle there was little to be had. On July 4th Chief 
 Commissary Clarke distributed 30,000 rations to the hospitals, 
 then containing approximately 16,000 wounded. From that time 
 on there was an ample supply of ordinary rations, but there was 
 still a want of hospital delicacies. After the retreat of the Con- 
 
GREATEST BATTLE— GETTYSBURG. 19 
 
 federate army, and when the want of supplies became known, food 
 and supplies of all kinds were poured in from the northern cities 
 and towns in enormous quantites. The supplies furnished by the 
 Sanitary and Christian Commissions will be mentioned later. It 
 was only during the first week that there was suffering on ac- 
 count of lack of supplies. One of the Sanitary Commission 
 agents said: "After this battle relief came promptly; it was on 
 our own soil and the great heart of the people was stirred to its 
 depths. All of home luxuries that could be were lavished with 
 an unsparing hand. The Government, fully equipped for the 
 contest, had medical and hospital stores abundantly supplied. 
 With its perfectly organized system and immense resources the 
 U. S. Sanitary Commission was ready to fill demands which the 
 Government could not. There was no long contiued suffering as 
 in the earlier battles." If, in the beginning, the wounded suffered 
 for lack of food and supplies, in the end they were in danger 
 from too much. 
 
 The failure of the medical department to furnish sufficient 
 supplies at the beginning was due to several causes. One was 
 the holding of the trains far in the rear. But the main cause 
 was that the number of wounded, twenty thousand, was beyond 
 its capacity. The department could handle ten thousand com- 
 fortably, and could have managed the fourteen thousand Union 
 wounded reasonably well; but the six thousand Confederate 
 wounded, all severely wounded, with the lack of trains, and with 
 railway transport cut, piled up a mass of difficulties that was 
 beyond its capacity. 
 
 It is of interest to hear how the Medical Department of the 
 Army was prepared for battle when the two armies faced each 
 other a few days later at Williamsport. Letterman, having been 
 criticized for his work at Gettysburg by Inspector Johnson, made 
 a spirited and satisfactory rejoinder, in which he stated that 
 notwithstanding the tremendous strain of the battle his depart- 
 ment was in a very short time again ready for battle. He said: 
 
 "Previous to leaving Gettysburg, on the 5th and 6th of July, 
 I had ordered supplies to be sent from Washington and Philadel- 
 phia to Frederick, to meet the wants of the medical department 
 in the event of another battle, which there was every reason to 
 suppose would occur shortly after the army left Gettysburg. 
 While at the latter place (Gettysburg) I asked the Surgeon 
 General to have fifty medical officers ready to meet me at such 
 a point as I should thereafter designate. On July 7th I desired 
 them to be sent to Frederick; late on the night of the 9th 47 of 
 
20 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 them reported. These officers were assigned to make up, as 
 far as possible, the deficiency of officers existing in consequence 
 of the large detail left at Gettysburg. Five hundred tents were 
 received and the corps supplied as far as their transportation 
 would permit, and the remainder kept in reserve. * * * 
 
 "I can state for the information of the Commanding General 
 that notwithstanding the short time in which I had to make the 
 necessary preparation, the Department was, when near Boones- 
 boro, fully prepared to take care of the wounded of another 
 battle of as great magnitude as that which the army had just 
 passed through at Gettysburg." 
 
 As the battle did not occur the hospitals were not actually 
 organized until the army reached the Rappahannock, during the 
 first week of August. 
 
 FIELD HOSPITALS. 
 
 The field hospitals were, for this period of the war, generally 
 unsatisfactory. Owing to the order sending all trains to the 
 rear, they were about on a par with those at Antietam. The 
 wounded were collected in houses, barns, groves, and in any 
 place that offered shelter or shade. While the weather during 
 the battle was fine, there were heavy rains on the 4th and 5th, 
 making shelter a necessity. The vast number of wounded made 
 it impossible to secure it for all, but the more severely wounded 
 were in general under some kind of cover. The less severely 
 wounded had to be content with shelter tents or worse, and the 
 slightly wounded had to look out for themselves. Medical In- 
 spector G. K. Johnston said in his report: 
 
 "There were some in churches, some in barns, some in tents 
 among the fruit trees, some in tents in the fields, some under 
 such shelter as a farmer would be ashamed to show for his cows. 
 Some were under blankets hung over cross-sticks, and some with- 
 out even so much shelter as that. There were some scattered 
 groups of men outside the hospitals. It sometimes appeared as 
 if an experiment had been made to see how many wounded could 
 be crowded into a given space in a house." 
 
 All the severely wounded were under some kind of cover by 
 the 4th.. The operating was not completed before a week had 
 passed, and it was as long before there was sufficient bedding. 
 The work of all the hospitals was checked when the army marched 
 away on the 6th. There were no evacuation hospitals to take 
 over the work. The tents, bedding, and most of the supplies of 
 the division hospitals, were left behind, but not enough surgeons 
 could be spared. Letterman left 106, about one for each 150 
 
GREATEST BATTLE— GETTYSBURG. 21 
 
 patients. He asked that an emergency corps of twenty surgeons 
 be sent, but intimates that they never came. Several hundred 
 medical men from the neighboring states came in and remained 
 until the rush of work was over. 
 
 Carl Schurz has left a description of the field hospitals as he 
 saw them. It is probably accurate in the main, but the surgeon 
 who held his amputating knife in his teeth was no doubt the 
 striking exception. 
 
 "Most of the operating tables were placed in the open air, 
 where the light was best, some of them partially protected against 
 the rain by tarpaulins or blankets stretched, on poles. There 
 
 ■■m^^i^H mm..* .^r^^^ ta. w— _s>mm^»^hb 
 
 Ul 'Ai " ,- , 
 
 
 
 
 
 stood the surgeons, their sleeves rolled up to their elbows, their 
 bare arms as well as their aprons smeared with blood, their 
 knives not seldom between their teeth, while they were helping a 
 patient on or off the table, or their hands otherwise occupied; 
 around them pools of blood and amputated limbs in heaps. 
 
 "Antiseptic methods were unknown at that time. As a 
 wounded man was lifted upon the table, often shrieking with 
 pain, the surgeons quickly examined the wound and resolved upon 
 cutting off the wounded limb. Some ether was administered and 
 the body put in position in a moment. The surgeon snatched 
 his knife from between his teeth, where it had been while his 
 hands were busy, wiped it once or twice across his blood-stained 
 apron, and the cutting began. The operation accomplished, th.e 
 surgeon would look around with a deep sigh and then — 'next.' 
 
 "There was a great difference in the attitude of surgeons. 
 There was a surgeon of the 16th Massachusetts who fairly 
 
22 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 levelled in operating. As soon as firing began he would roll 
 up his sleeves and await the first man to be brought in with 
 a positive appetite. Weird stories were told of operations he 
 performed when there was no chance of recovery, but unusual 
 chance for experiment. Disarticulation of the hip was said to 
 have been done when the patient was in articulo mortis, and 
 others of like condition. 
 
 "And so it went on hour after hour, while the number of 
 expectant patients hardly diminished. Now and then one of 
 the wounded men would call attention to the fact that his neigh- 
 bor lying on the ground had given up the ghost while waiting 
 his turn, and the body was quietly removed. Or, a surgeon, 
 having been long at his work, would put down his knife, exclaim- 
 ing that his hand had grown unsteady, and that this was too 
 much for human endurance — not seldom hysterical tears stream- 
 ing down his face. 
 
 "There are many who speak lightly of war as a mere heroic 
 sport. They would hardly find it in their hearts to do so had 
 they ever witnessed scenes like the above. A war brought on 
 without the most absolute necessity is the greatest and most 
 unpardonable of crimes." 
 
 An example of those remarkable operations mentioned by 
 Schurz will bear recalling. At the fight of King's Division near 
 Gainesville, before Second Bull Run, a man was brought in shot 
 in the hip. This battle began at sundown and the column had 
 been marching all day. The hospital wagon was hurried up, op- 
 erating began, and Surgeon Peter Pineo did a resection of the 
 head of the humerus. Before the Civil War this operation had 
 been done but twelve times, and in the whole war was done only 
 thirty-two times, almost always in fixed hospitals. The man was 
 left on the field and probably died in a few hours. The resected 
 bone is in the Army Medical Museum, specimen No. 71 — New 
 Xo. 98,211—84,132. 
 
 First Corps. The First Corps arrived on the field by the 
 Emmitsburg Road. The First Division, two hours in advance of 
 the others, was accompanied only by the regimental surgeons and 
 a few ambulances. There was no time for selection of hospitals ; 
 the battle opened at once and savagely. This was a division that 
 never hesitated to attack and the losses here were the heaviest 
 of the battle. The wounded were soon drifting to the rear in num- 
 bers, mostly without assistance, unless that of comrades. A sort 
 of division hospital was established at the Seminary ; it was little 
 more than a collecting place and dressing station, less than half 
 a mile behind the firing line. After the repulse of Heth's bri- 
 
GREATEST BATTLE— GETTYSBURG. 23 
 
 gades there was a lull in the battle, giving time for some attention 
 to the wounded, and they were as a rule secured. 
 
 By noon Rowley's Division was arriving, followed by the artil- 
 lery and ambulance train. Medical Director Heard says the am- 
 bulances of the corps were combined in one train, together with 
 the brigade medicine wagons. There were no hospital or supply 
 wagons, all these being held far in the rear, as already stated. 
 This ambulance train appears to have gone to the Seminary and 
 all three division hospitals were first established at that point. 
 
 On the afternoon the battle was renewed and in spite of a des- 
 perate resistance the First Corps was overpowered and driven 
 back ; first to Seminary Ridge, then through the town to Cemetery 
 Hill. The surgeons meanwhile retired to the town, establishing 
 new hospitals, in the Lutheran and Catholic Churches, the court 
 house, several warehouses near the railway and in many other 
 buildings. Some five hundred wounded were collected in these 
 buildings, but many of the most severely wounded were left 
 scattered over the field. For these there was very little care 
 during the next two days of battle. When the last resistance 
 at the Seminary was broken down all the ambulances were loaded 
 with wounded and brought off in safety. No ambulance of either 
 First or Eleventh Corps was lost. Medical Director Heard chose 
 to remain behind with his wounded and retained a number of 
 surgeons who were prisoners until the 4th. 
 
 An unfortunate accident of the street fighting that evening was 
 the death of Chaplain Howell, of the 90th Pennsylvania. He 
 had just come out of the Lutheran Church, where he had been 
 assisting with the wounded, when the Confederates came rush- 
 ing into the town. Wearing a sword he was taken for a com- 
 batant officer and called on to surrender. Instead of doing so he 
 began to expostulate against his capture and was instantly shot. 
 
 The first hospital in Gettysburg was established, not by army 
 surgeons, but by R. G. McCreary, a lawyer in that place. He 
 says: 
 
 "In the afternoon (June 30th) Buford's cavalry division en- 
 tered the town and proceeded a mile to the northwest, on the 
 Chambersburg Pike, and halted for the night. Their medical 
 officers requested accommodations for six or eight men of the 
 command, who were sick. I procured the use of the railroad 
 depot (the road was destroyed), and with a couple of assistants 
 soon had it cleaned out and twenty beds carried in, and they 
 were soon all filled with suffering men, for whom food and deli- 
 cacies were speedily supplied by families in the neighborhood." 
 
24 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Concerning the capture of the town and what then happened 
 he says: 
 
 "I ascended the housetop and found that the army was falling 
 back, and soon the rush and roar of the retreat and battle in 
 the streets banished everything else from our minds. That was 
 a terrible night; our army had been driven back, and the town 
 was full of armed enemies. 
 
 "The morning of July 2d revealed a dreadful sight — dead 
 horses and men lying about the streets, and there were none 
 to bury them. Our first care was for the multitude of wounded 
 men now suffering from want of food. I sallied forth, taking 
 care to lock the door after me. I found the bakeries were in 
 the hands of the Rebels, and not a loaf or cracker remained; 
 the butchers' cattle had been driven away or confiscated, and no 
 meat could be procured; the groceries were broken open and 
 their contents carried away, or destroyed by troops of Rebels, 
 who, like hungry wolves, roamed through the streets in search 
 of plunder. The citizens had freely distributed to our own sol- 
 diers and had little left in their houses ; but they did what they 
 could, even denying their own families in order to give some- 
 thing to the suffering men. 
 
 "In my own family we had a good supply of coffee and other 
 most useful articles ; a twelve-gallon boiler was many times re- 
 plenished and its contents carried in buckets to the different hos- 
 pitals within reach, and, with baskets of bread and other edibles, 
 distributed to the wounded. In the rear of my residence, in an 
 open lot, a Rebel commissary cut up and distributed beef to a 
 company of cavalry. My wife solicited and obtained from him 
 the beef bones left on the ground, and speedily converted them 
 into excellent soup ; until in this way probably one hundred gal- 
 lons of this nourishing food had been distributed to the different 
 hospitals. 
 
 "Our surgeons, who remained with these men and permitted 
 themselves to be taken prisoners, were greately embarrassed for 
 want of supplies, as the Rebels would not or could not supply 
 any. The ladies of the town freely devoted their linen and 
 muslin goods to supply lint and bandages, but the lack of medi- 
 cines was not so easily supplied. 
 
 "Allow me here to remark that the stories published, charging 
 the people of the town with a want of hospitality toward the 
 soldiers, are basely false. In those days of suffering I gathered 
 bread from house to house, and the last loaf and half loaf was 
 always cheerfully given. 
 
 "During the battle of the first day, when shells were shrieking 
 and bursting around the hospitals, even the women were found 
 in the midst of the wounded men as they were carried in from 
 
GREATEST BATTLE— GETTYSBURG. 25 
 
 the field ; and from that time on all through the terrible days, and 
 afterwards down to the close, in every hospital, at all times, with 
 a devotion that never flagged, or counted any sacrifice too great, 
 our noble women were found, like angels of mercy, binding up 
 wounds and administering food. Ask the many hundreds of 
 wounded men, who filled the warehouses, halls, churches, and so 
 many of the private dwellings, what they think of the hospi- 
 tality of the people of Gettysburg. 
 
 "The Rebels, though disposed to help themselves, were gen- 
 erally civil, and even respectful toward the citizens. * * * 
 
 "The officers, until Saturday, seemed entirely confident of suc- 
 cess. On Friday night the army quietly withdrew from the town 
 to Seminary Ridge, and at daylight our skirmishers drove out 
 or captured their stragglers and pickets. It was truly a joyful 
 morning to the citizens, who felt as if some dreadful incubus 
 had been removed. 
 
 "As soon as the town was cleared of the Rebel lines supplies 
 began to come in and those in the hospitals were made as com- 
 fortable as the circumstances permitted; but there were still in 
 th.e fields — the scene of the first day's fight — a large number, who 
 for two days more could not be reached, and whose suffering 
 must have been beyond description severe." 
 
 FIRST CORPS. 
 
 When the First Corps took station on Cemetery Hill new hos- 
 pitals were established, on the Baltimore Pike, east of Rock 
 Creek. The hospital of the First division was at White Church ; 
 of the Second Division at Peter Conover's house; of the Third 
 Division at the house of Jonathan Young. 
 
 These hospitals after the battle are said to have contained 2,379 
 wounded, of whom 260 were Confederates. The three divisions 
 of this corps had very heavy losses. The First Division had 1,229 
 wounded, the Second 616, the Third 1,279. The total loss was 
 666 killed, 3,231 wounded, or 3,987 out of less than 9,000 en- 
 gaged. The wounded alone amounted to 36 per cent of the 
 corps, a percentage for a large body that no medical department 
 could be exepcted to cope with. 
 
 SECOND CORPS. 
 
 On June 30th the Second Corps was at Uniontown, having 
 marched thirty miles from Monocacy Junction the previous day. 
 On the morning of July 1st the corps marched to Taneytown, 
 reaching that place before noon. At one-thirty the march was 
 
•.'(I MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 resumed — to Gettysburg. The trains were sent to Westminster, 
 the troops marched without tents, and with but few rations. On 
 reaching the neighborhood of Marsh Creek, about ten that night, 
 a halt was made, and the men bivouacked for the night. At 
 day light the march was resumed and the field reached at seven, 
 when the corps was placed in line from the Cemetery south to 
 the right of the Third Corps. 
 
 The divisions were in order from left to right. There was no 
 fighting until towards evening, when the First Division was sent 
 to aid the Third Corps. This division, Caldwell's, had heavy 
 losses ; 187 killed and 880 wounded, mostly on the second day. 
 The Second Division, Gibbon's, was engaged this day, and the 
 next day bore the brunt of Pickett's charge. Out of 3,733 men 
 engaged there were 344 killed and 1,202 wounded. The Third 
 Division, Hays', was engaged on both Second and Third but the 
 losses were not quite so heavy, being 238 killed and 987 wounded. 
 The entire Second Corps had 797 killed and 3,194 wounded; to- 
 tal 4,991. General Hancock says there were about 10,000 men 
 engaged. There were 13,056 present for duty equipped on June 
 30th and 6,130 on July 4th. The loss in killed and wounded was 
 between forty and fifty per cent, a most remarkable one for an 
 entire corps. The wounded amounted to at least twenty-four 
 per cent, and possibly thirty-two per cent of the corps, which will 
 explain why the work in the field hospitals of this corps was not 
 an entire success. 
 
 No. Wounded. No. In Hospital. 
 
 1st Div 880 846 
 
 2nd Div 1,202 843 
 
 3rd Div 987 739 
 
 Total 3,194 2,428 
 
 The total includes staff and artillery. 
 
 The hospitals of this corps were at first located in an opening 
 of the woods, along the crossroad from the Taneytown Road to 
 the Baltimore Pike, with headquarters at the Granite School- 
 house. The hospital of the First Division was at a stone barn on 
 the Taneytown Road. Other houses and barns in this vicinity 
 were used for the immediate reception of the wounded. General 
 Barksdale, of McLaw's Confederate Division, who was mortally 
 wounded late that evening, was taken to the house of J. Hum- 
 merbach, which was a hospital of the Second Corps. When 
 Colonel Willard, of the Third Division, was wounded, he was 
 taken to the house of Louis Bushman, and died there. 
 
GREATEST BATTLE— GETTYSBURG. 27 
 
 This day's battle began on the extreme left of the Union lines 
 but was gradually taken up by the Confederate troops to the 
 left, and late in the day shells began to fall about Cemetery Hill 
 and the hospitals in its rear. These locations became unsafe, so 
 they were hurriedly abandoned, and the patients removed farther 
 to the rear. • 
 
 The hospitals were all moved to the rear at evening. Surgeon 
 Peltier of the 126th New York, Third Division, says : — "I worked 
 in the hospital till three in the morning, slept an hour on the 
 ground among the wounded and was awakened by firing near at 
 hand. * * * In the afternoon we made preparations to move 
 our wounded to a less exposed position about two miles down 
 in the woods." The division hospitals were now located to- 
 gether among the trees in a bend on the west side of Rock Creek, 
 as shown in a number of maps. The location was safe and con- 
 venient, but the site was on very low ground. There was rain 
 on the fourth and still more on the fifth, overflowing the low 
 ground, and a part of the hospital. Some patients were in dan- 
 ger of drowning, scrambling out as best they could. Many were 
 left lying in the mud. From all accounts the condition of the 
 patients in this hospital was most miserable. Not from incom- 
 petence or lack of energy on the part of its medical officers, but 
 because the flood. of patients was entirely beyond their capacity. 
 
 In addition to the 2,400 Union wounded there were 952 Con- 
 federates, left behind during Pickett's attack, making a total of 
 3,400 wounded men, lying in a grove, with practically no tentage, 
 bedding, clothing, or stores ; except ordinary rations and medical 
 and surgical supplies. 
 
 When the trains came up conditions improved, but at once the 
 army marched away, leaving but thirteen medical officers to care 
 for this mass of suffering men. Medical Inspector Johnson crit- 
 icized this, as well as the lack of attendants and men for fatigue 
 work. He said requests should have been made at once for sur- 
 geons, attendants, and supplies. It was a week before all the 
 wounded were dressed and furnished with straw for beds. 
 
 Of the 3,400 wounded here 437 died, and of thirteen thigh am- 
 putations it is said that but one survived. While the hospital re- 
 mained in this low damp place in the woods there were many 
 deaths daily, but when the patients were removed to Camp Let- 
 terman the death rate fell off rapidly. The hospital was closed 
 on August Seventh. 
 
28 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Reverend Williams of the Christian Commission gives an 
 account of the Second Corps hospitals at Gettysburg which shows 
 what lack of supplies and such an enormous amount of wounded 
 leads to. It is possibly exaggerated, but the condition of this 
 hospital before the trains came up was, by all accounts, a terrible 
 one. 
 
 "In some respects the work of the Second Corps Hospital was 
 the most interesting and important. There were at least 2,500 
 wounded men (3,400) in this hospital, which was located in a 
 grove about a mile south of the Baltimore Pike, and between two 
 and three miles from town. The men were in a terrible condition. 
 They were upon the damp ground, many of them with nothing 
 under them. In this hospital there was an unusually large num- 
 ber of amputations, the amputated stumps lying directly upon 
 the ground, except when now and then elevated upon a handful 
 of straw, or a bunch of old rags. Many of the men, perhaps 
 most of them, were in want of clothing. Suitable food was not 
 to be had. The surgeons were overworked, there was an insuffi- 
 cient number of attendants — every able-bodied man that could 
 possibly be spared having accompanied the army in pursuit of 
 Lee. Into this field the Commission entered. * * * 
 
 "There were nearly or quite a thousand Rebels (952), most of 
 them severely wounded, lying on the outskirts of the hospital, 
 shrieking and continually crying for assistance. The appearance 
 of those connected with the Third Division of this corps beggars 
 description. Destitute of clothing, many of them nearly naked, 
 lying in the mud — for the sudden rise of the little stream by 
 which they had been placed rendered it impossible to avoid this — 
 cursing, praying, begging their visitors to put an end to their 
 sufferings; here one and there another laid out by himself to 
 die, these wretched men made the strongest appeal to Christian 
 sympathy and benevolence. 
 
 "This condition was soon remedied and all that could be re- 
 moved were taken to the General Hospital. Four hundred very 
 severe cases remained, of which I believe that two-thirds died." 
 
 (To be continued.) 
 
THE GREATEST BATTLE OF THE WAR— GETTYSBURG 
 
 {Concluded.') 
 
 THIRD CORPS. 
 
 ON the morning of July 1st the Third Corps was at Emmits- 
 burg. In the afternoon it marched for the battle, Birney's 
 Division first, Humphrey's following. These divisions 
 reached the field by midnight, but two brigades left behind 
 were not up until nine o'clock on the 2nd. The corps was 
 posted in front of the Taney town Road, from the left of the 
 Second Corps almost as far as Little Round Top. Shortly 
 after noon General Sickles moved the two divisions forward to 
 the Emmitsburg Road, with the center of the line at the peach 
 orchard, and the left division extending back toward the Round 
 Tops. Here they were attacked at four by two of Longstreet's 
 divisions, and after most deadly fighting finally had their lines 
 broken and were forced back. Other troops came up late in the 
 evening and they were retired to the second line, where they re- 
 mained until the battle ended. All their heavy losses occurred in 
 three or four hours on the afternoon of July 2nd. The First 
 Division (Birney) had 271 killed and 1,384 wounded. The Sec- 
 ond Division, 314 killed and 1,562 wounded. This division 
 (Humphrey's) had the heaviest loss of any division engaged, a 
 loss that alone would have accounted for a battle at the beginning 
 of the war. On June 30th the Third Corps reported 12,598 
 officers and men present for duty equipped ; on July 4th, 5,494. 
 The lotal loss in killed, wounded, and missing was 4,211. 
 
 When the battle began near the peach orchard the wounded 
 were taken to houses and barns along the Taneytown Road. 
 Adjutant Roberts of the 17th Maine (First Division), who was 
 wounded in the knee, says he was first taken to a hospital in the 
 rear, but shells soon fell there and the place was abandoned. 
 Later in the evening he was taken further back in the woods. 
 Nearly every one who wrote in those times had an exasperating,, 
 indefinite manner of mentioning "a house near the road," or "a 
 grove beside a small stream." 
 
 Surgeon J. W. Lyman of the 57th Pennsylvania was in charge 
 of the hospital of the First Division. He says that on the 2nd, 
 while the division was taking position on the left front, he rode 
 
■> MEDICAL DEPARTMENT IN THE CIVIL II' AR. 
 
 along the Taneytown Road looking for a location for the hospital. 
 Finding all the houses already taken by the Second and Eleventh 
 Corps he finally selected an old barn by the roadside. Everything 
 was in readiness when the battle began. Soon the position was 
 receiving not only shell, but also shot, and the place was aban- 
 doned for another at a large stone barn (Frank Suisher place?). 
 This position was occupied during the remainder of the day and 
 the night following, the entire force of medical officers being 
 busily engaged all night in caring for the wounded. Early on 
 the 3rd the acting medical director of the corps, Assistant Sur- 
 geon T. J. Calhoun, ordered the hospital again removed. 
 
 This last move took it across Rock Creek to an excellent 
 site on a slope, with a fine stream of running water at hand. The 
 operating tables were again set up ; all were busy that day, the 
 succeeding night, and the following day. The records show 813 
 treated in this division hospital. There were 97 operations, 53 
 being amputations, 17 of the thigh, and 11 each of the leg, arm 
 and forearm. Many slightly wounded were dressed and sent 
 away with no record. From the reports this division appears to 
 have had some supply wagons with the ambulance train. 
 
 Surgeon Thomas Sim, U. S. V., was medical director of the 
 Third corps. He left the field on the evening of the 2nd, accom- 
 panying General Sickles, who had been severely wounded, to 
 Washington. Assistant Surgeon Calhoun took his place and 
 ordered the hospitals further to the rear. The hospital of the 
 Second Division also appears to have been near the front on 
 the 2nd. An officer who visited it that evening says it was in a 
 grove and the whole grove, several acres in extent, was literally 
 crowded with wounded. When moved back next day the two 
 hospitals were brought together. They were finally located east 
 of Rock Creek, on the Schwartz farm, and southeast of the Sec- 
 ond Corps hospitals. This place is on the north bank of White's 
 Run, and 300 yards east of Rock Creek. 
 
 Only a portion of the wounded of the corps could have reached 
 the hospitals directly after the great battle of the second. The 
 troops retired from a large part of the ground on which they 
 had fought, in some cases hurriedly ; necessarily their badly 
 wounded were left behind, in the peach orchard, the wheat field 
 and the woods about the Devil's Den. These wounded were left 
 within the enemy's lines and had little care during that night and 
 the next day. On the evening of the 3rd McCandless' brigade 
 of the Fifth Corps made a spirited advance and recovered a large 
 
GREATEST BATTLE— GETTYSBURG. 3 
 
 portion of this ground. This enabled the ambulance parties to 
 go forward again and during that night and the next morning 
 these wounded were brought in, along with some Confederate 
 
 wounded. The two division hospitals are said to have cared for 
 more than two thousand wounded. 
 
 General Sickles was severely wounded on the evening of July 
 2nd, a shell smashing both bones of the leg. An amputation of 
 the thigh was made in the corps field hospital and the General 
 sent off to Washington immediately. A detail of forty soldiers 
 
4 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 carried him over the twenty-five miles of road to the railway at 
 Westminster in a litter. This expedient was thought at the time 
 to have saved the General's life, as to have been carried this dis- 
 tance in an ambulance would probably have proved fatal. 
 
 FIFTH CORPS. 
 
 The Fifth Corps left Union Springs at 4 a. m. on the morn- 
 ing of the 1st and reached Hanover late in the afternoon, but 
 had hardly made camp there when again came the order 
 to march. The corps started at six that evening and marched all 
 night, resting an hour, from three to four, only. The sternest 
 orders, involving death to anyone leaving the column without 
 permission, prevented straggling. The field was reached at six 
 next morning and the corps posted near Rock Creek, as a re- 
 serve. It remained there until called on to aid Sickles, at four in 
 the afternoon. Marching by a cross road, the Taneytown Road 
 was passed in rear of Little Round Top, and the medical officers 
 turned off there to establish their hospitals behind the sheltering 
 hills ; at the stone house of Jacob Weikert and at other places 
 along the road. The divisions marched on west as far as the 
 woods near the Trostle house, where they went into action, two 
 brigades being detached and sent to Little Round Top. All three 
 divisions were engaged, but the Third, the old division of Penn- 
 sylvania Reserves, on the extreme left, did not have such heavy 
 losses as the others. This fight on the 2nd was the main battle ; 
 nearly two-thirds of the total casualties occurred on this day. 
 
 The hospitals of the Fifth Corps were nearest of all to the 
 contested ground. In fact, they were too near ; when the Con- 
 federates reached the slopes of Little Round Top, shells fell in 
 and around the hospitals. 
 
 It is not generally known that General Samuel W. Crawford, 
 commanding the Third Division, was originally a medical officer. 
 He had served as an assistant surgeon for ten years before the 
 war. Luck placed him at Fort Sumter in 1861 and some promi- 
 nence in that affair secured his transfer to the line as major of 
 the 13th Infantry. Within a year he was a brigadier general of 
 volunteers. He was now a division commander and remained 
 such until the end of the war, reaching the rank of major general. 
 
 Surgeon Joseph Thomas of the 118th Pennsylvania has given 
 a brief account of the hospital of the First Division of this corps. 
 He says : 
 
 About eleven at night the ambulances were busy collecting and 
 
GREATEST BATTLE— GETTYSBURG. 5 
 
 carrying to the rear great loads of mangled and dying humanity. 
 The wagon trains, with tents and supplies, had not yet arrived, 
 and the wounded were deposited on the ground. The site 
 selected for the wounded of the First Division was a field in 
 rear of the Big Round Top^ a little more than half a mile from 
 its base. As they were removed from the ambulances they were 
 placed in long rows, with no reference to the nature or gravity 
 of their injuries, nor condition of rank. Friend and foe alike, 
 as they had been picked up promiscuously, were there laid side 
 by side. Soon the ambulances ceased their visits, as they had 
 gathered up all that were accessible, or could be found in the 
 darkness. There were about 250 or 300 thus collected and lying 
 upon the ground, awaiting examination by the surgeon, as soon 
 as dawn should appear to furnish light for the painful work. 
 Opiates were administered to alleviate pain and water supplied 
 to appease thirst. One of. the surgeons then rolled himself in 
 his blanket and sought a brief repose to prepare for the work 
 of the morrow. But it was futile to attempt to sleep, for the 
 horrors of the environment put this out of the question. At last 
 morning dawned and at the same time orders were received to 
 remove the wounded farther to the rear and out of range 
 of the enemy's batteries. Ambulances were brought up, the 
 wounded were again placed in them and taken to a more remote 
 place, back of Rock Creek, where tents were subsequently 
 pitched for them. In lifting them up it was found that many 
 were dead. 
 
 This first location would to-day be called a collecting station 
 or ambulance station ; it does not appear that operating, or even 
 dressing, was done there. The place was in a field, south of the 
 Jacob Weikert house, and west of the Taneytown Road. During 
 and after the battle all fences were destroyed, and while ambu- 
 lances followed the general direction of the road, they entered 
 and crossed fields freely. The road running southeast from the 
 Round Tops was the main ambulance road from the center and 
 left of the field. 
 
 Assistant Surgeon John S. Billings, U. S. Army, was on duty 
 with the Second (regular) Division of the Fifth Corps and was 
 placed in charge of the field hospital of the division, which was 
 established at the house of Jacob Weikert, back of the Round 
 Tops and on the Taneytown Road. This hospital was probably 
 as well managed as any in the army. By midnight it had received 
 150 patients. The seriously wounded were in the house, under 
 the trees and in the big barn. The slightly wounded picked their, 
 own places on the outskirts. About midnight Medical Director 
 
G MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
GREATEST BATTLE— GETTYSBURG. 7 
 
 Letterman came around and said that he had just learned that this 
 particular place would be shelled by the enemy early in the morn- 
 ing, so preparations were made to move to a safer locality. 
 
 Accordingly, the hospital was moved. But Billings' report is 
 such a complete and graphic narrative of the operations of a field 
 hospital at that time that it will bear repetition : 
 
 I accompanied my regiment until they were under fire and 
 was then ordered to repair to a large stone house and barn 
 near the base of Round Top, and there established a field hos- 
 pital. When I reached the place our skirmishers were lying 
 behind the stone walls around the house, and as I rode up a 
 small body of Rebels, about seventy-five yards off, saluted me 
 with a volley. They were captured a few minutes afterwards. 
 On entering the house I found evident traces of the hasty de- 
 parture of its inmates. A good fire was blazing in the kitchen 
 stove, a large quantity of dough was mixed up, the bakepans 
 were greased, everything was ready for me. I immediately set 
 my attendants at work baking bread and heating large boilers 
 of water. In five minutes I was joined by the other medical 
 officers detailed for the hospital. The ambulance train reported 
 fifteen minutes later, and with it three Autenreith wagons, and 
 by the time operating tables were set up and materials for dress- 
 ings arranged, the wounded began to pour in. 
 
 I performed a large number of operations, received and fed 
 750 wounded, and worked all that night without cessation. An 
 agent of the Sanitary Commission visited me in the evening and 
 furnished me with a barrel of crackers and some lemons. Of 
 stimulants, chloroform, morphine and dressings, the Autenreith 
 wagons furnished an ample supply. 
 
 On July 3d, at 7 a. m., I was ordered by Medical Director 
 Milhau to remove the hospital one mile to the rear. This was 
 done as rapidly as possible. A few shells began to drop in as 
 the first train of ambulances moved off and by eleven o'clock the 
 firing on that point was quite brisk. Little or no damage was 
 done, however, and by four o'clock all the wounded were re- 
 moved. The new site was a large grove of trees, entirely free 
 from underbrush, on the banks of a little creek, about a mile 
 from the Baltimore Pike. By means of shelter tents, ,india-rub- 
 ber blankets, etc., shelter was arranged for the worst cases, and 
 two thousand dry rations with three oxen were sent to the hos- 
 pital by Dr. Milhau in the course of the afternoon. 
 
 All that day I was employed in operating and dressing the 
 more urgent cases. The following morning (July 4th) it began 
 to rain and continued to do so for five days and nights with little 
 cessation. On the morning of the 5th the medical supply wagons 
 came up, and from them I removed all the hospital tents and 
 
8 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 flies and two mess chests. On that day the army moved. I was 
 left behind in charge of the hospital, which then contained about 
 800 wounded. Twenty men were detailed from the division as 
 assistants. I was also given two ambulances and two army 
 wagons. The ambulance train and Autenreith wagons accom- 
 panied the division. By this time Assistant Surgeon Brinton had 
 reached White Church with a special supply train and from him 
 I procured such supplies as were most needed. The greatest 
 want I experienced was tools. I had not a shovel or a pick with 
 which to construct sinks, or bury the dead, and no axes. I was 
 compelled to send a foraging party to the farmhouses, who, after 
 a day's labor, procured two shovels and an ax. Seventeen hos- 
 pital tents were pitched, and in them were placed all the most 
 severe cases, about seventy-five in number. Under the tent flies 
 I placed one hundred more patients ; the remainder were under 
 shelter tents, arranged by regiments. By means of the wagons 
 I procured abundance of clean, fresh straw, from about five 
 miles distant. Commissary stores and fresh beef were furnished 
 ad libitum. 
 
 Assistant Surgeon Bacon reported that the health of most of 
 the surgeons of this hospital became impaired by reason of the 
 excessive labor required. Of eleven surgeons on duty there eight 
 became ill or were obliged to take sick leave, including Surgeon 
 Billings. This hospital was continued in operation until Aug. 2nd. 
 
 Assistant Surgeon Howard says the hospital of the Second 
 Division was established on July 2nd at a stone house behind 
 Round Top but next day, just before noon, was removed in great 
 haste to some woods beside a creek, about two miles in the rear. 
 (Rock Creek.) 
 
 When the hospitals of the Fifth Corps were reestablished on 
 July 3rd their location was as follows, as noted by an agent of 
 the Sanitary Commission at the time : First Division, on Little's 
 farm, north of the house and south of White's Run. Second 
 Division, south of Mrs. Jesse Clapsaddle's house, across Louzy 
 Run, and one hundred rods south of White's Run. Third Divi- 
 sion, one-half mile west of Two Taverns, on Jesse Werley's farm. 
 The three hospitals are said to have sheltered about 1,400 pa- 
 tients. The wounded of the three divisions were: 594, 802 and 
 181 ; total, 1,611, including artillery loss. 
 
 SIXTH CORPS. 
 
 On the night of June 30th the Sixth Corps was on the ex- 
 treme right of the army, at Manchester, thirty-two miles 
 southeast of Gettysburg. This corps had marched one hundred 
 
GREATEST BATTLE— GETTYSBURG. 9 
 
 miles in four days, but now had a two days' rest. At nine on 
 the evening of the 1st came the order to march, but the column 
 was not under good headway until eleven. Throughout the night 
 and the next day the march was pushed, the tired soldiers urged 
 on by a succession of messengers, wounded coming to the rear, 
 and the growing sounds of battle. In spite of the heat the pace 
 was fast, yet few fell out and those only from actual exhaustion. 
 At five that evening Rock Creek was crossed, and at dark the 
 corps, the largest in the army, was placed in position behind 
 Round Top, having marched thirty-five miles. A brigade was 
 sent to the Fifth Corps and another to the Twelfth, but darkness 
 soon ended the battle. Next day the corps was the reserve of 
 the army and was not heavily engaged, the entire loss being but 
 27 killed and 185 wounded. 
 
 This corps marched to the field by the Baltimore Pike. The 
 medical officers appear to have halted before crossing Rock Creek. 
 The hospitals were established together near the house of John 
 Trostle on the eastern side of Rock Creek, below the mouth of 
 White's Run, and not far from the hospitals of the Third and 
 Fifth Corps. They are said to have cared for about 300 wounded. 
 
 Wounded were brought to the hospitals of the Second, Third, 
 Fifth and Sixth Corps by the road running from Little Round 
 Top in a southeasterly direction to Rock Creek. 
 
 ELEVENTH CORPS. 
 
 On the evening of the 30th the Eleventh Corps was in rear 
 of the First at Emmitsburg. On the morning of the 1st it 
 followed that corps toward Gettysburg. When General Rey- 
 nolds sent word back to hurry up the troops the First Divi- 
 sion continued on the same road, while the Second and Third 
 crossed to the Taneytown Road, so reaching Gettysburg over 
 Cemetery Hill. The First and Third Divisions were pushed out 
 north of the town about one o'clock, the Second was held at the 
 hill as a reserve. By three o'clock the corps had been routed and 
 all not killed or captured were back with the Second Division. 
 The two divisions had been attacked on poor ground and driven 
 back through Gettysburg with considerable loss. During the re- 
 mainder of the battle the corps had position on the northern and 
 eastern portions of the hill, but was not very heavily engaged. 
 Most of its losses occurred on the first day. The wounded in the 
 three divisions were: 677, 507 and 684; total, 1,922. 
 
 The three division hospitals were kept together and were located 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 
 id 
 
 is co 
 
 s: 5; 
 
 o -c 
 
GREATEST BATTLE— GETTYSBURG. 11 
 
 on the first day about the house of George Spangler, south of 
 Powers' Hill. The Qorps headquarters was at the Powers house 
 near by. This hospital was nearer to the front than any of the 
 others, being less than a mile from the main battle line. It was on 
 lower ground, well sheltered, and convenient to the Baltimore 
 Pike, though off it a short distance. As this corps experienced 
 most of its losses on the first day, when it was driven from the 
 field in rout, many of the wounded were left behind. An agent 
 of the Sanitary Commission reported that the commission cared 
 for more than 1,400 of the wounded of the corps. 
 
 In this corps Assistant Surgeon W S. Moore of the 61st Ohio 
 was severely wounded on July 2nd and died next day. Although 
 thirteen medical officers were wounded during the battle this was 
 the only fatality. 
 
 TWELFTH CORPS. 
 
 The Twelfth Corps marched to the field by the Baltimore 
 Pike, reaching Rock Creek late on the 1st, after the battle 
 had ended. This corps, consisting of but two divisions, 
 was posted on Culp's Hill, where it was engaged on the evening 
 of the 2nd, and morning of the 3rd. On the 2nd also a large part 
 of the corps was sent to the aid of the left wing. The men of 
 this corps saw hard fighting, but, for some unexplained reason, 
 they constructed better intrenchments than. any of the others and 
 had smaller losses. But for leaving their works on the 2nd, and 
 having to retake them again, their losses would have been still 
 less. The First Division had 406 wounded, the Second, 397. 
 
 The two division hospitals were separate but near each other. 
 They were around and north of the house of George Bushman, 
 west of Rock Creek, and on a road running south from Powers' 
 Hill to the lower crossing of the creek. There seems to have 
 been a better location for these hospitals on the Baltimore Pike, 
 east of the creek. Such a location would have placed them nearer 
 the corps, and nearer the railhead at Westminster. Their actual 
 location would have been more suitable for the Third or Fifth 
 Corps, which arrived later. It is easy to see how they might have 
 received wounded from other divisions. They are said to have 
 sheltered 1,006 Union and 125 Confederate wounded. These 
 hospitals it will be remembered had retained all their wagons and 
 brought them on the field with their ambulances. Corps Medical , 
 Director McNulty said "It is with extreme satisfaction that I 
 can assure you that it enabled me to remove the wounded from 
 
12 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 ^■'SaBIKS^ 
 
 
GREATEST BATTLE— GETTYSBURG. 13 
 
 the field, shelter, feed them and dress their wounds, within six 
 hours after the battle ended ; and to have every capital operation 
 performed within twenty- four hours after the injury was re- 
 ceived." Letterman says the same result would have obtained 
 in all the corps had the supply wagons been up. 
 
 CAVALRY DIVISION. 
 
 The two brigades of Gamble and Deven, of Buford's Cavalry 
 Division, reached Gettysburg on the afternoon of June 30th, 
 moved out beyond the town, and established pickets on all the 
 roads by which the enemy might arrive. On the morning of 
 the 1st, Gamble was west of the town along Willoughby Run 
 and Deven was covering the roads from Carlisle, Harrisburg 
 and York. The two brigades numbered about 2,200 men. 
 
 On reaching the town a hospital had been improvised by the 
 surgeons and some public spirited citizens. Next morning Heth's 
 Skirmishers struck Gamble's dismounted troopers about nine 
 o'clock and some spirited fighting ensued before Reynolds arrived 
 with the infantry. Later in the day Gamble was again engaged 
 on the extreme left. Deven's brigade performed a similar service 
 to the north of town, but with less loss. Gamble had 28 killed and 
 116 wounded; Deven, 6 killed and 38 wounded. The total num- 
 ber of wounded in what Steele calls the best day's work done by 
 cavalry during the war was 154. 
 
 Hospitals for these wounded were established in the Presby- 
 terian Church on Baltimore Street and in two nearby school- 
 houses, in charge of Surgeon Rulinson. When the town was 
 abandoned these hospitals, with those of the infantry corps, fell 
 into the hands of the Confederates. The wounded suffered for 
 care and food until the town was occupied again on the 4th. The 
 Confederates carried away no wounded but attempted to parole, 
 them. During the rain after the battle these wounded were in 
 much better plight than those in the various so-called hospitals 
 on the field. The wounded of the other cavalry divisions appear 
 to have been generally cared for in the hospitals of the infantry 
 divisions. Wounded were also cared for at Hanover, Emmits- 
 burg and other points, as a rule by civilian surgeons. 
 
 CONFEDERATE FIELD HOSPITALS. 
 
 Since the Confederate field hospitals were taken over by the 
 medical department of the army, a brief description of them will 
 be given. The Confederates left about seven thousand wounded 
 
14 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 on the field, the great majority of them being the worst cases, not 
 fit for such transportation as was available. The total number of 
 wounded prisoners at Gettysburg was 6,802. Of these about 
 1,800 were in the Union hospitals; the remaining 5,000 had been 
 collected into some sort of improvised field hospitals by their sur- 
 geons and ambulance corps. Very few remained on the battle- 
 field uncared for. The largest number in any Union hospital was 
 in that of the Second Corps, which had reaped the harvest of 
 Pickett's charge, and contained nearly one thousand of his men. 
 
 The Confederate report, made at the time, put their wounded 
 at 12,706, but it was doubtless greater. Although the medical 
 organization of the Union army was at this time superior, the esti- 
 mate of wounded was never accurate, being always too low. As 
 the Confederates evacuated the field on the night of the 4th, leav- 
 ing about 13,000 wounded and unwounded behind, they could not 
 know what prisoners were wounded and what were not. Also at 
 that time their surgeons were forbidden by orders to report slight 
 wounds not preventing duty ; this class of wounds averaged from 
 ten to fifteen per cent of the whole. There are other reasons for 
 believing that the number of wounded Confederates equaled that 
 on the other side, 14,491. But the exact number cannot possibly 
 be known. 
 
 The Confederate field hospitals were established in houses, 
 barns and dilapidated tents. Their army on this campaign carried 
 practically no tentage, not even shelter tents ; so the wounded had 
 little shelter except what could be found on the ground. The 
 rains which followed the battle and continued for several days 
 must have caused much suffering; fortunately the weather was 
 warm. Little was said of how these men were supplied with food 
 during the first few days. Probably there was little to be said. 
 The generals report that they left rations, but there were no 
 rations save what was foraged. A number of men who made this 
 campaign have stated to the writer that they drew five days' 
 rations on starting and not another ration until back in Virginia, 
 nearly one month later. After Antietam, Southern friends in the 
 vicinity brought food to the prisoners in the hospitals, but there 
 were no such friends here. The agents of the Sanitary and 
 Christian Commission were the first to visit and carry food to 
 these hospitals. But for them some of these wounded might actu- 
 ally have perished. 
 
 The Sixth Corps followed the Confederates on the Fairfield 
 
GREATEST BATTLE— GETTYSBURG. 15 
 
 (Hagerstown) Road on July 5th. Surgeon Stevens of that corps 
 says: 
 
 Every house and barn from Gettysburg to Fairfield was a 
 hospital and about most of the barns numbers of dilapidated 
 tents served to increase the accommodations for wounded. All 
 the worst cases were left in these hospitals. Never had we wit- 
 nessed such sad scenes as we were passing through. The Con- 
 federate surgeons were doing what they could for their wounded, 
 but they were destitute of medicines and surgical appliances, and 
 even food. 
 
 J. H. Douglas of the Sanitary Commission said in his report : 
 
 It appears that the aggregate wounded was 5,456, occupying 
 some twenty-four different camps. The wounds were in a large 
 proportion of cases very severe ; amputations and resections were 
 frequent. The corps of surgeons are as a body intelligent and 
 attentive. The hospitals are in barns, outbuildings and dilapi- 
 dated tents. Some few cases are in dwellings. I cannot speak 
 favorably of the camp police. Often there is a deplorable want 
 of cleanliness, especially in barns and outbuildings ; vermin and 
 putrid matter are disgustingly offensive. As fast as transporta- 
 tion can be had, those capable of being moved will be placed in 
 more comfortable quarters. 
 
 As to the camp police, there was no one to attend to it. We 
 may be sure but few able bodied men were left behind. A sur- 
 geon who was a prisoner about this time reported on his return 
 that the Confederates had an ambulance and hospital corps, made 
 up of two men from each company, but that these men were either 
 convalescents or men without shoes. 
 
 The Confederate army corps and divisions had numbers but 
 those numbers seldom served as designations, as in the Union 
 army. The names of noted commanders were used instead, as 
 Jackson's Corps, Hood's Division or Law's Brigade. The field 
 hospitals may be roughly located by divisions, but appear to have 
 been brigade hospitals grouped together. 
 
 Longstreet's Corps. Was on the extreme right of the army, 
 in front of the Round Tops. Hood's Division was on the right, 
 McLaw's next on the north. Pickett did not come up until the 
 third day, and moved from the center. 
 
 McLaw's Division. The hospitals were at Bream's Mill, or 
 Mineral Mill, on Marsh Creek, half a mile below the crossing of 
 the Hagerstown Road. McLaw reported that he left 576 wound- 
 ed, with 10 surgeons, 2 chaplains, and 70 nurses and cooks. The 
 Union records show the number here to have been about 700. 
 Men from other divisions probably made up the difference. Of 
 
10 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 these wounded 113 died. The division had 1,538 wounded, in- 
 cluding a number of officers. General Barksdale died in a Union 
 hospital : General Semmes was carried away to die. Dr. F. \Y, 
 Patterson was in charge of this hospital. 
 
 Pickett's Division. The hospitals were about the Bream 
 House and Blackhorse Tavern, on Marsh Creek. General 
 Kemper, shot through the breast, was left at Bream's Mill. There 
 were more than 1,200 wounded in this division, the majority of 
 whom were taken prisoners. Generals Garnett and Armistead 
 were killed on the field. Dr. Reeves was in charge of this hospital, 
 which contained 279 wounded. 
 
 Pickett's wounded, except those near the opposing lines, lay on 
 the field until late in the night. Lieut. Edward F. Rollins, 15th 
 Massachusetts, Gibbon's Division, speaks of these wounded in 
 the history of the regiment : 
 
 About sunset I was detailed to take fifty men and establish 
 a picket line at a rail fence beyond the Emmitsburg Pike, and 
 about midway of the plain over which Pickett had charged. As 
 this line made its way we often stumbled over dead bodies and 
 were exhorted by the wounded, "For God's sake don't step on 
 us," or to give them a drink, or turn them over. _ Though strict 
 orders had been given to pay no attention to the wounded, with 
 an explanation that the stretcher bearers would follow, still flesh 
 and blood could not refuse these offices. Arriving at the rail 
 fence we saw beyond a pile of dead and wounded, struck as 
 they exposed themselves in clambering over the fence during the 
 charge. From their lines beyond we could hear the sound of 
 chopping and driving stakes ; and this was intermingled with 
 groans and shieks of wounded men around us. At eleven o'clock 
 a detail of surgeons and assistants came out from our lines, 
 giving the wounded, as far as I could learn, not much but 
 morphine. 
 
 Hood's Division. The hospitals were on the W Plank farm, 
 about two-thirds of a mile southeast of Blackhorse Tavern, and 
 on the road leading from the Fairfield Road to the peach orchard. 
 They were directly behind the division, as were all those of Long- 
 street's Corps. There were 1,542 wounded in the division and 515 
 were left behind. Dr. Mearns was left in charge. 
 
 Ewell's Corps. Was on the Confederate left, from the town 
 to Rock Creek, and partly across the creek, and was engaged on 
 all three days. 
 
 Early's Division. Early reported but 806 wounded. But 
 little can be learned of the hospitals. The hospitals of the Louis- 
 
GREATEST BATTLE— GETTYSBURG. 17 
 
 iana Brigade (Tigers) was at a stone house 200 yards north of 
 the Chambersburg Pike. General Roy Stone of the Bucktail 
 Brigade was taken there when wounded and captured. The 
 reports of the Sanitary Commission locate Early's hospitals near 
 Blackhorse Tavern, and another report places them at the 
 Myers(?) house. But 259 wounded were left behind, in charge 
 of Dr. Gott. 
 
 Johnson's Division. The hospitals were about the W. H. 
 Monfort house, on the Hunterstown Road, about one mile east 
 of Rock Creek. When abandoned they contained 446 of the 
 1,300 wounded of this division. General Johnson says in his re- 
 port that fewer wounded were left behind hy his division than 
 by any other, which does not appear to be the case. Dr. White- 
 head was in charge of this hospital. 
 
 Rode's Division. The hospital was at the D. Shriver house, 
 about three miles northwest of Gettysburg, on the Mummasburg 
 Road, and near Willoughby Run. The Union report says that 
 800 wounded were found there. General Rodes says he left one- 
 half his wounded, which would be 760, with 4 surgeons, 6 as- 
 sistants, 97 attendants, and 10 days' rations. This division re- 
 ported (later) 1,728 wounded and 704 missing. 
 
 The wounded carried away in wagons were nearly all cap- 
 tured on the night of July 5-6, near Monterey, by Kilpatrick's 
 cavalry. Kilpatrick reported capturing 37 wagons and 15 ambu- 
 lances loaded with wounded, and several hundred on foot, more 
 than a thousand in all. On July 7th, W. B. Canfield of the 
 Christian Commission visited these hospitals and stated that but 
 one person had been there before him. Dr. Hayes was in charge. 
 
 A. P. Hill's Corps. Occupied the center of the Confederate 
 line, from the Seminary nearly to the peach orchard. It was 
 engaged chiefly on the first day, but in part on all three days 
 and had very heavy losses. 
 
 Heth's Division. The hospitals were at Pennsylvania Col- 
 lege, the Seminary and houses along the Chambersburg Pike. 
 Heth had 1,905 wounded and many missing. About one-half the 
 wounded were left behind. A Philadelphia surgeon who visited 
 the field and made some accurate observations, said there were 
 853 wounded Confederate soldiers at the College. The Union 
 reports name 693 from Heth's Division. Dr. Frazer was in 
 charge. 
 
 Pender's Division. The hospitals were on the Chambersburg 
 Pike, west of Willoughby Run. General Trimble, when wound- 
 
18 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 ed, was taken to the house of David Whistler, north of the 
 pike, which makes it appear that this place was the headquar- 
 ters of the hospitals. General Pender was severely wounded by 
 a shell in the thigh on the 2nd. He was hauled in an ambulance 
 all the way to Staunton, underwent amputation on July 18th, and 
 died next day. The division reported 1,312 wounded, and left 
 700 behind in charge of Dr. McAden. 
 
 Anderson's Division. The hospitals of this division were 
 near the house of Adam Butt, north of the Hagerstown Road, 
 and one-half mile east of Marsh Creek. The division reported 
 1,128 wounded and 840 missing, many of whom were probably 
 killed or wounded. The wounded from this division seem to 
 have been taken to Fairfield, as but 111 were left in the hospi- 
 tals on the field. Dr. Miner was in charge. 
 
 Fairfield Hospitals. When Fairfield was occupied on the 
 5th some 871 wounded were found there, in charge of Dr. Ward 
 and Dr. Wilson. These would appear to have been the wounded 
 of the first day's fight, who had been moved back thus far. This 
 is a mere conjecture. 
 
 Of the 7,000 wounded left behind, 2,500 were sent to David's 
 Island, New York; 1,100 to Chester, Pa.; a few to Harrisburg, 
 and 1,347 were retained in the Letterman hospital. Several 
 hundred slightly wounded were sent to Baltimore for exchange. 
 
 BURIAL OF THE DEAD. 
 
 The medical department appears to have had little to do with 
 this unpleasant task during the Civil War. In modern times it 
 is generally accepted that at least a supervision will be exercised 
 by the medical corps, for obvious sanitary reasons. At Gettys- 
 burg there were six thousand bodies to be buried. Some few 
 were buried during the conflict, the great majority not until 
 afterwards. Sergeant Thomas Meyer of the 148th Pennsylvania 
 First Brigade, First Division (Second Corps), has related his 
 part in the burial in the Regimental History of that regiment. 
 
 The pioneers of the 148th were sent to the field hospital, 
 behind a bluff on Rock Creek, about eleven o'clock on the night 
 of the 2nd. Here several thousand dead and wounded lay side 
 by side in long rows on the bare, wet ground. The feet of one 
 row nearly touched the heads of the next. No lights, no tents, 
 no blankets. The dead were sorted out and buried. Colonel 
 Cross of the 5th New Plampshire was one of them. By the dim 
 light of a few candles the work was done and completed by three 
 o'clock. 
 
GREATEST BATTLE— GETTYSBURG. 19 
 
 They then went to another field hospital, containing twelve 
 hundred wounded, immediately in the rear of the division 
 (First Division, Second Corps), and again began the work 
 of sorting out the dead and burying them. This was completed 
 by morning and these men rejoined their regiment. Sergeant 
 Meyer says one grave was dug and a body placed in it ; then an- 
 other grave was dug along side, the dirt from the second filling 
 the first, and so on. 
 
 This was but a small beginning. The real burial did not begin 
 until the 4th, when details were made from each brigade and 
 regiment to clear the ground in their front. The dead were then 
 collected and buried in trenches in all parts of the field. Of the 
 3,000 Union dead almost one-third were unidentified. This seems 
 a remarkable proportion in view of the place, time, and circum- 
 stances. 
 
 The dead were bUried everywhere. The whole ground around 
 Gettysburg became one vast cemetery." When they could con- 
 veniently be brought together, they were buried in clusters of 
 ten, twenty, fifty or more ; but so great was the number, and so 
 rapid the decomposition in those who had lain for days in the 
 hot sun, that many could not be removed. In gardens, fields, 
 woods, or by the roadside, wherever found lying, shallow ditches 
 were dug, the bodies placed in them, and covered as hastily as 
 possible. Rose's wheat field, McPherson's farm, and Sherfy's 
 peach orchard were points where the dead lay thickest. One 
 great trench near Rose's garden contained more than four hun- 
 dred dead Confederates. Many of the single dead merely had a 
 little earth thrown over them. Later these were exposed by the 
 rains. 
 
 The Confederates left most of their dead unburied on the field. 
 There was considerable delay in properly interring these bodies. 
 Prisoners were finally impressed into the service, great trenches 
 dug, and by the 5th all were buried save a few in inaccessible 
 places about Plum Run. Some of these were not found for 
 weeks after the battle. 
 
 The battlefield was also thickly strewn with the bodies of dead 
 horses. The artillery suffered as in no other battle. The cavalry 
 lost many and hardly a mounted officer but lost his horse. In 
 the Trostle barnyard where Bigelow's Battery was sacrificed 
 they lay thick. In a pool near where Stannard's Brigade stood 
 lay nine dead horses. After the cavalry combat on the Rummel 
 farm Mr. Rummel dragged 30 dead horses from the little lane 
 
20 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 leading to his house. It was estimated that between four and 
 five thousand horses were killed. This probably includes the 
 many wounded that had to be shot. 
 
 Shortly after the battle, when friends and relatives began to 
 arrive and seek their dead, they were struck with horror by the 
 hasty and imperfect manner of burial. After a short time the 
 opening of graves was forbidden on account of the supposed 
 danger to health. Later Governor Curtin of Pennsylvania led 
 the movement to establish a National Cemetery at Gettysburg. 
 On October 27, 1863, the work of collecting all the Union dead 
 was begun, and completed in March 1864. The contractors re- 
 ported that they had removed 3,512 bodies and opened more 
 than three thousand Confederate graves in making the neces- 
 sary identifications. The number removed includes several hun- 
 dred who died in hospitals from wounds or disease. When the 
 work was finally completed the cemetery contained 3,575 bodies, 
 of which more than 1,000 were unidentified. 
 
 The Confederate dead were exhumed shortly after the close 
 of the war and removed to Richmond. But not all were found ; 
 no road has been constructed on the battlefield without finding 
 skeletons, and in some cases trenches filled with them have been 
 encountered. 
 
 EVACUATION OF THE WOUNDED. 
 
 Gettysburg had a railway coming directly into the town, a 
 branch of the Northern Central, from Hanover. This road 
 greatly facilitated the removal of the wounded. For some rea- 
 son it was decided to remove them to hospitals in the cities, not 
 to leave them near the field as at Antietam. All the wounded 
 were to be taken away except those not fit for transportation. 
 They were mostly evacuated by this branch railway to Hanover 
 Junction, and then to Baltimore and Philadelphia. The railway 
 was poor in the beginning, its destruction by the enemy and tem- 
 porary repair did not improve it. The rolling stock was scanty 
 and all united in pronouncing the management contemptible. 
 Many inspectors noted that while every other organization in 
 the land was striving to aid the suffering soldiers this road alone 
 remained indifferent. 
 
 The bridges were repaired on the 6th and trains came to within 
 a mile of the town. The evacuation of the wounded was begun 
 on the 7th. When Inspector Vollum arrived on the evening of 
 the 8th, 1,462 had already been sent away. He found no system 
 
GREATEST BATTLE— GETTYSBURG. 21 
 
 in use. Letterman had left with the army on the 6th and the 
 evacuation was in charge of a surgeon of the 4th New York. 
 Olmstead says the wounded were brought to the railroad faster 
 than they could be taken away, and were left on the ground, ex- 
 posed to sun and rain, without attendants. When Vollum arrived 
 he found two thousand poor wretches about to pass the night 
 there without food, shelter or attendants. He notified the Sani- 
 tary Commission, which at once furnished beds, tents, a kitchen 
 and nurses. The Commission claimed to have fed every man of 
 the 16,000 that left Gettysburg, to have sheltered 1,200, and to 
 have furnished very many with clothing. 
 
 There was much difficulty in moving the wounded from the 
 field hospitals to the railway on account of the lack of ambu- 
 lances. When the army marched away Letterman directed that 
 six ambulances and four wagons from each corps be left with the 
 hospitals. It appears that but thirty in all were left. For leav- 
 ing so few ambulances to move 20,000 wounded men Letterman 
 was criticised by one inspector. But he was right; the whole 
 army expected to fight again soon, when all the ambulances would 
 be needed. It is certain that there were not enough ambulances, 
 but it should have been a simpler matter to secure them there 
 than in the field. When Inspector Cuyler arrived he required 
 and received fifty additional ambulances. 
 
 From the 7th the evacuation went on as rapidly as the poor 
 road and worse management would allow. Baggage cars bedded 
 with straw were used as a rule. The trains left for Baltimore 
 twice a day — at 10 a. m. and 5 p. m. Ambulances often arrived 
 after the trains had departed, but these patients were cared for 
 by the aid societies. Every train was in charge of a medical 
 officer and telegraphic notice was sent to its destination. Food, 
 dressings, etc., were supplied by the Sanitary Commission, the 
 medical department having none to spare from the field. The 
 XJ: S. Christian Commission maintained rest stations at Han- 
 over Junction, and at the depot in Baltimore. All the inspectors 
 gave unstinted praise to the work of these commissions. Owing 
 to the irregularity of trains hundreds of wounded often lay part 
 of a day or all night waiting for a train; but for these commis- 
 sions such men would have suffered greatly. 
 
 By July 25th 16,125 wounded had been sent away; 12,000 di- 
 rectly from Gettysburg, 2,000 by Littletown, and 2,000 by way of 
 Westminster. These were sent to Baltimore and from there dis- 
 tributed to the cities further north. Of those sent to Philadel- 
 
22 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 phia, six hundred were taken from the trains by friends along 
 the way. The average number removed daily was eight hundred. 
 There remained at Gettysburg 4,217, the greater part of whom 
 were not fit to be moved. Those considered untransportable at 
 that time were such as suffered with penetrating wounds of 
 the head, chest, abdomen and pelvis ; also compound fractures of 
 the thigh, leg and arm. The field hospitals of divisions and 
 corps were gradually closed during July and their remaining 
 wounded collected in one large tent hospital. When the army 
 marched away it was without field hospitals and these establish- 
 ments were not completely fitted out again until the army reached 
 Rappahannock Station, August 7th. A hospital was maintained 
 at the Seminary for several months but the great evacuation 
 hospital was located east of the town, alongside the York Pike, 
 in the edge of a wood still known as Hospital Wood. It was 
 placed so near the railway that ambulances would be unnecessary 
 in the final evacuation. This hospital was known as Camp Let- 
 terman, sometimes as Letterman Hospital. It was opened on 
 July 22nd and not closed until November 20, 1863. By August 
 1st practically all the remaining wounded had been transferred to 
 it, or to the Seminary. 
 
 CAMP LETTERMAN. 
 
 This Camp Letterman merits a brief description. It was located 
 within thirty rods of the railway, so that patients could be re- 
 moved to the cars on litters. It was made up of more than 400 
 hospital tents, in six double rows, ten feet apart. The tents were 
 supplied with water from wells, were heated with Sibley stoves, 
 but had no bathing facilities except the sponge bath. Ditch 
 latrines were used at some distance from the camp. Each tent 
 held from eight to ten patients, and each medical officer had 
 charge of from forty to seventy patients. Among these patients 
 were 345 with gunshot fractures of the femur. Amputation was 
 performed on 158 of these cases, with 101 deaths. The greater 
 part of the patients were later transferred to other hospitals. On 
 August 30th there were 1,600 patients and on October 18th there 
 were but 326 remaining, of whom 160 were still considered un- 
 transportable. This hospital may be said to have had at the be- 
 ginning the untransportable cases of both armies. This is a 
 larger number of such cases than were ever brought together on 
 any other field. Many such cases had ended in death before 
 the hospital was opened. Cyrus N. Chamberlain, U. S. V., 
 
GREATEST BATTLE— GETTYSBURG. 
 
 23 
 
 \?mm 
 
24 MEDICAL DEPARTMENT IX TtlE CIVIL WAR. 
 
 medical director of the Fourth Corps, was in command of the 
 Letterman Hospital during the greater part of its existence. 
 
 That the authorities at Washington were not devoid of inter- 
 est in the fate of the wounded is shown by the following tele- 
 gram : 
 
 WAR DEPARTMENT, July 3d. 
 General H. Haupt, Baltimore. 
 
 Spare no effort to send trains to bring in the wounded. If transporta- 
 tion by rail cannot be had, provide it in any other practicable mode. 
 
 Edwin M. Stanton, Secretary of War. 
 
 Haupt was then working night and day to reopen the roads 
 destroyed by Ewell. He had the road from Hanover to Harris- 
 burg open in five days, and the branch to Gettysburg in two 
 more. 
 
 REMOVAL OF CONFEDERATE WOUNDED. 
 
 During the afternoon of the 4th all the spare wagons and am- 
 bulances of the army were collected on the Chambersburg and 
 Hagerstown Pikes and loaded with the wounded. Hundreds 
 totally unfit for transportation were placed in these bare wagons. 
 A false point of honor urged them on in track of the army, 
 though to many it meant certain death. The principal train was 
 started at dark in charge of General Imboden, who has related 
 its story in Battles and Leaders of the Civil War. A few ex- 
 tracts faintly mirror its horror: 
 
 Shortly after noon the very windows of heaven seemed to 
 have opened. The storm increased in fury every moment. 
 Canvas was no protection against it, and the poor wounded, lying 
 upon the hard naked boards of the wagons, were drenched by 
 the cold rain. Horses and mules were blinded and maddened 
 by the storm, and became almost unmanageable. The roar of 
 the wind and water made it almost impossible to communicate 
 orders. 
 
 About four o'clock the head of the column was put in motion 
 and began the ascent of the mountain. After dark I set out to 
 gain the advance. The train was seventeen miles long when 
 drawn out on the road. It was moving rapidly and from every 
 wagon issued wails of agony. For hours I galloped along passing 
 to the front, and heard more — it was impossible to see — of the 
 horrors of war than I had witnessed from Bull Run up to that 
 day. In the wagons were men wounded and mutilated in every 
 conceivable way. Some had their legs shattered by a shell or 
 minie ball ; some were shot through the body ; others had arms 
 torn to shreds ; some had received a ball in the face, or a jagged 
 piece of shell had lacerated their heads. Scarcely one in a hun- 
 
GREATEST BATTLE— GETTYSBURG. 25 
 
 dred had received adequate surgical aid. Many had been with- 
 out food for thirty-six hours. Their ragged, dirty, bloody 
 clothes, all clotted and hardened with blood, were rasping the 
 tender inflamed lips of their gaping wounds. Very few of the 
 wagons had even straw in them, and all were without springs. 
 The road was rough and rocky; the jolting was enough to have 
 killed sound men. From nearly every wagon, as the horses 
 trotted on, cries and shrieks were heard. !< 
 
 Some were praying, others were uttering the most fearful 
 oaths and execrations that despair could wring from them in 
 their agony. Occasionally a wagon was passed from which 
 only low, deep moans and sobs could be heard. 
 
 No help could be rendered to any of these sufferers. On, on ; 
 we must move on. The storm continued and the darkness grew 
 fearful. There was no time even to fill a canteen of water; for 
 except the drivers, and the guards, disposed in compact bodies 
 every half mile, all were wounded and helpless in that vast 
 train of misery. It was my sad lot to pass the whole distance 
 from the rear to the head of the column, and no language can 
 convey an idea of the horrors of that most horrible of all nights. . 
 
 After a good deal of harrassing and desultory fighting along 
 the road, nearly the whole train reached Williamsport (on the 
 Potomac), a little after the middle of the next day. The dead 
 were selected from the train, for many had perished by the 
 way, and were decently buried. Straw was obtained on the 
 neighboring farms ; the wounded were removed from the wagons 
 and housed ; the citizens were all put to cooking, and the army 
 surgeons to dressing wounds. 
 
 An officer of the First Corps, then a prisoner, but paroled a 
 few days later, saw this train and said of it : "Yesterday they 
 sent their wounded, filling about five hundred wagons, ambu- 
 lances, haywagons, etc., piled thick, and followed by crowds so 
 wounded as to be able to walk on the road to Chambersburg. 
 No provision train was sent with them." No one knows how 
 many were in this train. Imboden said "thousands," probably 
 from four to five thousand. It seems there were only ambu- 
 lances for the wounded officers. 
 
 But all the wounded did not go by this train. Most of those of 
 Ewell's Corps were loaded in the division wagons and followed 
 the troops by Fairfield and Hagerstown to Williamsport. Rodes 
 in his report says that about half the wounded of his division 
 (about 800) were left behind; the remainder followed on foot 
 and in wagons and were nearly all captured. This division was 
 in the rear on the night of July 5th, when the army was crossing 
 
2G MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 the mountains west of Fairfield. Kilpatrick attacked the rear 
 guard, which was insufficient, the Michigan regiments keeping up 
 a running fight all night. Just at daylight, near the top of the 
 mountain at Monteray, the 1st West Virginia broke into the 
 train, shooting or scaring off the drivers, and stampeding the 
 teams with the wagons, many loaded with wounded, down the 
 rough mountain road. All Rodes' wagons were captured, with 
 1,360 prisoners, mostly wounded. The reports say that 300 
 wagons and 15 ambulances were captured. The ambulances con- 
 tained wounded officers, many of the wagons wounded men. 
 Other wounded men were on foot. 
 
 On the Chambersburg Road, about the same time, another part 
 of the train was captured, with more than six hundred prisoners, 
 half of whom were wounded. Probably more than 1,500 wound- 
 ed were captured, beside the numbers left at every town and 
 house along the way. The Richmond papers stated that from 
 six to eight thousand wounded were brought off, but this was 
 only a guess. It seems certain that more than half the wounded 
 were left behind; a thing which never happened to the Army of 
 the Potomac, but possibly occurred at Second Bull Run. 
 
 THE SANITARY COMMISSION AT GETTYSBURG. 
 
 When the army broke camp on the Rappahannock on June 12th 
 the hospitals were broken up and the nine thousand patients 
 shipped to Washington. The Commission supplied rest and food 
 stations at Aquia, and at the landing in Washington. Its estab- 
 lishment at Falmouth was shipped to that city but a party followed 
 the army with a wagon for each army corps. These wagons were 
 replenished at Fairfax and other points and wagons were daily 
 sent out from Washington to points along the line of march. 
 When the army reached Frederick a storehouse was established 
 there and reserve supplies were accumulated and held in readiness 
 at Harrisburg, Philadelphia and Baltimore. With the first news 
 of the battle Westminster was fixed on as the point of approach 
 and authority obtained from the War Department to ship a car 
 load of supplies daily to that point. 
 
 Two wagon loads of supplies were distributed just before the 
 battle. These wagons returned to Frederick and two others fully 
 loaded arrived on the field during Longstreet's attack on the sec- 
 ond day. They were pushed forward to the very front and the 
 stores distributed under fire. Dr. McDonald, who was chief field 
 inspector of the Commission, and in general charge during this 
 
GREATEST BATTLE— GETTYSBURG. 27 
 
 campaign, went forward by way of Emmitsburg with a wagon, 
 was captured by cavalry and carried as a prisoner to Richmond. 
 This embarrassed the work of the Commission for a time. How- 
 ever, wagons were secured and the supplies pushed forward from 
 Westminster. A field depot was established in a schoolhouse 
 from which supplies were distributed to all the hospitals. It may 
 be said here that the Sanitary Commission agents did not go 
 through, the hospitals with baskets, scattering food and supplies 
 right and left, after the fashion of the citizens generally, but 
 issued their stores to the medical officers, or gave them out by 
 their authority. After the battle began ten wagon loads of their 
 supplies reached the field before any of the regular supplies could 
 be gotten up. 
 
 In the first railway train that reached Gettysburg were two car- 
 loads of supplies for the Commission, and two more came each 
 day for a week. A storehouse was opened in the town and it 
 was soon overflowing with the abundant outpourings of those at 
 home. Each morning the wagons of the various division hospi- 
 tals were before the door and each day they went away loaded 
 with such articles as were desired. If articles needed were not on 
 hand they were telegraphed for and arrived by the next train. 
 Tons of ice, mutton, poultry, fish, vegetables, softbread, eggs, 
 butter and other substantial and delicate foods were provided. 
 Thousands of suits of underclothes, blankets, pieces of hospital 
 furniture and utensils were among the supplies furnished by the 
 Commission. 
 
 When the railway was completed into the town and the evacua- 
 tion of the wounded began a camp was established at the depot 
 with 150 beds, a shed kitchen was erected, excellent cooks secured, 
 and a most necessary link in the chain of transportation thus 
 secured. During the first ten days subsequent to the establish- 
 ment of this station more than five thousand soldiers were fed, 
 and one hundred sheltered each night. The station was continued 
 until all the transportable wounded had been removed and the 
 Letterman Hospital established. A station was then fitted up at 
 that point. 
 
 Another most necessary work done by the Commission was in 
 the Confederate hospitals, which were necessarily destitute of 
 almost everything. A special inspector visited all these hospitals 
 and reported on the number of patients, their condition, and the 
 supplies needed. The wounded in them were removed as speedily 
 as possible. In the meantime they were furnished supplies and 
 
28 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 assisted as much as possible. The Commission secured the signa- 
 tures of all the Confederate surgeons left behind to a letter ad- 
 dressed to General Lee, asking the release of Dr. McDonald and 
 those with him who were being held as prisoners of war. 
 
 At Gettysburg, as elsewhere, the Sanitary Commission under- 
 took to secure a list of names of all the inmates of hospitals. 
 These lists were forwarded to the central office in Washington, 
 where all inquiries were promptly answered. A special force of 
 workers attended to this division of the work. 
 
 Some idea of the amount of supplies sent by the Commission 
 to Gettysburg may be obtained from their statement, which shows 
 stores of all kinds amounting to a total value of $75,000. 
 
 The Christian Commission also had a storehouse in Gettysburg 
 with a small army of aids and helpers. Some 2,500 cases of 
 stores were distributed. As many as a thousand loaves of bread 
 were given out daily, contributed by the neighboring cities of 
 Pennsylvania. This Commission opened feeding stations in Get- 
 tysburg and Hanover, and also at Baltimore. 
 
 While the primary object of the Christian Commission was to 
 improve the moral and spiritual status of the soldier, it was 
 early recognized that this part of him could be most easily reached 
 through supplying his physical wants. All recognized the value of 
 this Commission in combatting drunkenness, gambling, dissipation 
 and other vices tending to the ruin of the soldier. 
 
 CONCLUSION. 
 
 The work of caring for such an unprecedented number of 
 wounded was so severe as to break down a number of the sur- 
 geons. The labor, anxiety and responsibility placed on them at 
 this time was greater than at any other battle of the war. It 
 must be remembered that these same officers had endured the pri- 
 vations and fatigues of the long, forced marches with the rest 
 of the army; that they had shared its dangers, for one medical 
 officer followed each regiment into battle; that the field hospitals 
 were often established under fire. The battle over, their labor 
 continued. While other officers might rest and renew their 
 strength, the surgeons still toiled on. The work was unending 
 both day and night, the anxiety constant, the strain both mental 
 and physical unceasing. And the recognition was nothing, except 
 the consciousness of duty well done. 
 
 In reading the scanty records of the work done by the surgeons 
 at Gettysburg and throughout the war, one cannot escape the 
 feeling of devotion to duty and of patriotism which pervaded 
 
GREATEST BATTLE— GETTYSBURG. 29 
 
 those men. It is well that they had these moral qualities for th.ey 
 received no reward. The medical director of the whole army was 
 and remained a major in rank. As for official recognition by 
 mention or otherwise, it was seldom seen. It is a discouraging 
 thought that even the memory of this devotion and patriotism 
 has all but faded into the obscurity of the past and their names 
 disappeared among men. While hundreds of marble shafts cover 
 the field of Gettysburg, while every combatant organization of the 
 United States Army there engaged has been worthily commem- 
 orated, there is neither mark nor stone to indicate that the army 
 had a medical department at that time. But this inexplicable neg- 
 lect promises to be soon remedied. 
 
 Colonel John P. Nicholson of the Battlefield Commission has 
 for a number of years contemplated the erection of suitable tab- 
 lets. Within the past year, through the efforts of Dr. S. Weir 
 Mitchell and others, this idea has been brought nearer fruition. 
 The Commission now expects to erect bronze tablets, indicating 
 the position of the hospitals and bearing the names of the prin- 
 cipal medical officers of corps and divisions. When that is done 
 Gettysburg will be the first battlefield in the world to commem- 
 orate those who in battle gave their efforts to save human life. 
 
 MEDICAL OFFICERS AT GETTYSBURG. 
 
 Medical Director, Army of the Potomac. .Surgeon Jonathan Letterman, TJ. S. A. 
 
 Medical Purveyor Surgeon J. B. Brinton, U. S. A. 
 
 Medical Director, First Corns Surgeon J. T. Heard, U. S. V. 
 
 First Division Surgeon G. W. New, 7th Indiana Inf. 
 
 Second Division Surgeon C. J. Nordquist, 83d N. Y. 
 
 Third Division Surgeon Geo. M. Ramsayl, 95th N. Y. 
 
 Medical Director, Second Corps Surgeon A. N. Dougherty, U. S. Vols. 
 
 First Division Surgeon R. C. Stiles, TJ. S. V. 
 
 Second Division Surgeon J. F. Dwyer, 19th Mass. Inf. 
 
 Third Division Surgeon Isaac Scott, 7th West Va. 
 
 Medical Director, Third Corps Surgeon Thomas Sim, U. S. V. 
 
 First Division Surgeon J. W. Lyman, 57th Penn. 
 
 Second Division Asst. Surg. J. T. Calhoun, U. S. A. 
 
 Medical Director, Fifth Corps Surgeon John J. Milhau, TJ. S. A. 
 
 First Division Surgeon Edward Shippen, TJ. S. V. 
 
 Second Division Asst. Surg. Clinton Wagner, U. S. A: 
 
 Third Division Surgeon G. W. Reed, TJ. S. V. 
 
 Medical Director, Sixth Corps Surgeon Charles O'Leary, U. S. V. 
 
 First Division Surgeon E. F. Taylor, 1st N. J. 
 
 Second Division Surgeon S. J. Allen, 4th Vermont. 
 
 Third Division Surgeon S. A. Holman, 7th Mass. Inf. 
 
 Medical Director, Eleventh Corps Surgeon C. H. F. Campbell, TJ. S. V. 
 
 First Division Surgeon B. Van Beust, TJ. S. V. 
 
 Second Division Surgeon D. G. Brinton, U. S. V. 
 
 Third Division Surgeon W. H. Thorn, TJ. S. V. 
 
 Medical Director, Twelfth Corps Surgeon John McNulty, U. S. V. 
 
 First Division Surgeon Alonzo Chapel, TJ. S. V. 
 
 Second Division Surgeon John E. Herbst, TJ. S. V. 
 
 Medical Director, Cavalry Corps Surgeon Geo. L. Pancoast, TJ. S. V. 
 
 First Division Surgeon Abner Hard, 8th 111. Cav. 
 
 Second Division Surgeon W. W. L. Philipps, U. S. V. 
 
 Third Division Surgeon Henry Capehart, 1st W. Va. Cav. 
 
 Medical Director, Artillery Reserve Surgeon M. J. Asch, TJ. S. V. 
 
 Chief Surgeon all field hospitals Surgeon Henry Janes, U. S. V. 
 
 Chief Surgeon Letterman Hospital '.Surg. C. N. Chamberlain, 10th Mass. Inf. 
 
THE GREAT BATTLE OF THE WEST, CHICKAMAUGA. 
 
 THE battle of Chickamauga was the greatest battle fought in 
 the West. On no other field west of the Alleghenies were 
 the contending forces so numerous, the contest so long and 
 deadly, or the losses so great. Moreover, the conflict took place 
 in a rugged, sparsely settled country, far from bases of supply, 
 under conditions that made the work of the Medical Department 
 extremely difficult. To render bad conditions still worse, the 
 national forces were driven from the field in a manner; nearly 
 approaching a rout. Yet the management of the wounded wa& 
 decidedly better than in the somewhat similar second battle of 
 Bull Run (fought, however, a year earlier), waged by the Army 
 of the Potomac. 
 
 THE ARMY. ; 
 
 The contest in the valley of the Chickamauga was waged for 
 the Union by the Army of the Cumberland, the only army of the 
 West that had a separate and continuous existence through the 
 greater part of the war; the only army that may be said to have 
 had a personality like that of the Army of the Potomac in the 
 
 I East. This army had been organized by General Buell at Louis- 
 ville very early in the war. It had arrived on the field at Shiloh 
 
 ' in time to turn defeat into victory ; had fought successfully at 
 
 . Luka and Corinth. In the late summer of 1862 it was in front of 
 Chattanooga, almost in the same position as we shall see it now, a 
 year later. Then it had raced across two states with Bragg for 
 the possession of Louisville, and had won the race. After a 
 
 ; drawn battle at Perryville it had occupied Nashville again, and 
 on the last day of the year 1862, once more engaged Bragg's 
 Confederate Army at Murfreesboro, or Stone's River. Defeated 
 on the first day, this army had, without help, turned defeat to 
 victory two days later, and occupied Murfreesboro. This brief 
 record is recited to show that in the Chickamauga campaign, Gen- 
 eral Rosecrans had a veteran army, an army that had marched 
 and fought all over Kentucky and Tennessee for two years with 
 the worst mark against it, a draw at Perryville. 
 
MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 After the exhausting battle at Stone's River, the Army of the 
 Cumberland remained at Murfreesboro for months ; resting, re- 
 fitting, and reorganizing for the next campaign. The battle ended 
 January 2, 1863. Despite repeated urging from Washington and 
 favorable contemporaneous campaigns east and west Rosecrans 
 
 did not move from his camp until June 24th, thus taking a period 
 of practically six months in preparation for the conquest of Chat 
 tanooga. 
 
 During this time the army was reorganized into three army 
 
THE GREAT BATTLE OF CHICKAMAUGA. 3 
 
 corps, a small reserve corps, and a cavalry corps. Thomas' 14th 
 Corps had four divisions, numbering about 25,000 men; Mc- 
 Cook's 20th Corps consisted of three divisions, 12,000 men ; Crit- 
 tenden's 21st Corps also had three divisions amounting to some 
 14,000 men; Gordon Granger's Reserve Corps was in reality a 
 division of four brigades, about 5,000 men. The Cavalry Corps 
 was made up of two divisions, five brigades, eighteen regiments 
 with three batteries attached, and in round numbers amounted to 
 10,000 men. The infantry and artillery numbered about 51,000 
 men, but this number was materially reduced by losses and by 
 the detachments of .three brigades before the battle. 
 
 There were eleven infantry divisions, with 30 brigades, 122 regi- 
 ments, and 30 attached batteries actually engaged. The total num- 
 ber of men in these organizations on the days of the battle was, as 
 nearly as can be ascertained, forty- four thousand. 
 
 The infantry regiments numbered a little less than 400 men 
 each, the cavalry rather more. 
 
 This was the number actually present and equipped for duty, 
 the number of muskets that could be put on the firing line. The 
 muster rolls of these 122 regiments contained twice this number 
 of names. 
 
 The Medical Director says that when the Army began the cam- 
 paign the sick report amounted to about 5% of the command; at 
 the time of the battle it was 4%. But this figure only shows the 
 sick present with the army. About twice this number was in the 
 hospitals in the rear, on sick furlough, or in some way absent 
 sick. 
 
 MEDICAL ORGANIZATION AND EQUIPMENT. 
 
 The Army of the Cumberland, having been in existence for two 
 years, had time to have and did have an excellent organization and 
 equipment in most respects. Surgeon Hart, who had seen service 
 with both armies, says that the medical arrangements were not on 
 an equality with those of the Army of the Potomac. Possibly not 
 in details. It was operating far from its base, in a difficult coun- 
 try, while the Army of the Potomac was always within a few 
 miles of its base with transportation lines unobstructed. 
 
 What was of more importance, the latter army was near the 
 throne — Washington. As General Johnston complained to the 
 
4 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 authorities at the Capital, their own danger was most immediate 
 and supplies were readily forthcoming. 
 
 The field hospitals were in a transitional state. Each regiment 
 had a hospital ; these were combined to form brigade hospitals, in 
 time of battle the brigade hospitals were collected to form what 
 might be called a division hospital. The material was pieced out 
 from the medical supply trains, of which each corps had one. It 
 will be seen that there was a lack of methodical organization and 
 work. There was a sufficient number of medical officers, ap- 
 parently about three hundred. Although fifty were left on the 
 battlefield there was still no lack. A peculiar thing about the medi- 
 cal officers of this army was that nearly all the division and even 
 corps surgeons were volunteer officers, and as a rule they were 
 surgeons detailed or promoted from state troops. There were 
 less than a half dozen regular medical officers in the whole army. 
 
 As to ambulances, the army was abundantly supplied, but the 
 personnel left considerable to be desired. In the beginning of the 
 war the western armies, like the eastern, had regimental ambu- 
 lances only. Later they were combined in brigades and division 
 trains; in time of battle. Finally in the spring of 18G3, division 
 ambulances were provided, but the regimental ambulances were 
 also retained. The Army of the Cumberland at the outset of this 
 campaign was provided with a train of thirty ambulances for each 
 division of from 3,500 to 5,000 men and had in addition thereto 
 one ambulance for each regiment and battery. There was a slight 
 shortage in some of the divisions but the supply as a whole was 
 ample as shown by the following table of forces and ambulances 
 at the time of battle. 
 
 14th Army Corps, 20,000 men, 181 ambulances. 
 
 20th Army Corps, 11,500 men, 105 ambulances. 
 
 21st Army Corps, 12,500 men, 121 ambulances. 
 
 Total 44,000 men, 407 ambulances. 
 
 The ratio is 1 ambulance to each 110 men. The division ambu- 
 lance trains alone contained 300 ambulances or one to each 145 
 men. These were all four wheel ambulances, carrying but two 
 recumbent patients. The Medical Director of the Army says in 
 his official report that the regimental ambulances were of little use, 
 being generally loaded with officers' baggage and other articles. It 
 
THE GREAT BATTLE OF CHICKAMAUGA. 5 
 
 CHIEKAMAUGA, 
 
 first dry. 
 
 CMWriSH SPR'tHCf' 
 
 IT. 
 L. C.JDurcen . 
 
6 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 is easy to see that they could be of little use in any case, being 
 scattered and subject to no efficient systematized control. The 
 ambulance trains were under the general control and management 
 of the Quartermaster Department and had several grave faults. 
 For example there was no ambulance corps. The drivers appear to 
 have been detailed from the line, and as to men for loading and 
 unloading the wounded, there were none; the ambulance drivers 
 had to depend on band men and others whose help was at hand, or 
 were detailed for each particular case. Another serious fault was 
 that the division ambulance trains were not in charge of commis- 
 sioned officers. For each ten ambulances there was an ambulance 
 master, who seems to have been a sort of wagon boss. The divi- 
 sion train was under charge of the division quartermaster. This 
 is one of the things that Surgeon Hart thought inferior to the 
 practice in the Army of the Potomac, as no doubt it was. But 
 this was a minor fault, a detail. The ambulances were combined 
 in division trains, they worked as division units, and they did their 
 work reasonably well. 
 
 During the battle they brought wounded off the field as long as 
 they could go on the field, only stopping when in imminent danger 
 of being captured. Even then they were all loaded with wounded 
 and escaped to Chattanooga. There was no panic as at Bull Run, 
 and many ambulances that were cut off and given up as lost made 
 their way through by-roads in the woods and came into Chatta- 
 nooga in safety. 
 
 Wounded were left behind, but chiefly on the field, and because 
 it was abandoned in rout. 
 
 Before beginning the campaign the regiments drew medical sup- 
 plies for three months and Medical Director Perrin says, "Every- 
 thing that related to preparations in the Medical Department for a 
 vigorous campaign was in readiness and as complete in appoint- 
 ment as could be desired." 
 
 The Army of the Cumberland at this time had not adopted 
 Letterman's system of brigade supplies and did not adopt it until 
 Jan. 1, 1864 ; instead there was a system of regimental and corps 
 supplies. Each regiment had a wagon load of supplies as in the 
 Army of the Potomac before October 1862. This allowance in- 
 cluded a hospital tent, and these regimental tents made up the 
 division hospital in time of battle. The regimental supplies were 
 also then drawn on. Unfortunately in one of the corps (the 20th), 
 
THE GREAT BATTLE OF CHICKAMAUGA. 7 
 
 these supplies were reduced to 500 lbs. on crossing the Tennessee 
 River and the hospital wagons taken away. This corps suffered 
 as a consequence. 
 
 In addition to the regimental supplies there was a reserve supply 
 for each corps, carried in a train of army wagons. The 14th Corps 
 had a reserve supply train of 19 six-mule wagons, the 20th Corps 
 had eleven wagons, and the 21st had fourteen. These trains car- 
 ried not only medicines and dressings but also food, clothing, 
 blankets, and hospital tents. It will be seen that a train of 11 
 to 14 wagons for a corps not so large as our modern division, 
 could carry a considerable amount of supplies. In the battle the 
 Medical Purveyor of the 20th Corps was obliged to issue hospital 
 tents to his three divisions and they were all lost. 
 
 The base of the army was at Nashville, where there were fixed 
 hospitals of about three thousand beds capacity. Further back, 
 at Louisville and other posts along the Ohio River, there were hos- 
 pitals with a total capacity of at least twelve thousand patients. 
 At Murfreesboro, the advance base, a large tent hospital of 1,500 
 beds had been organized and equipped with bedding, cots, etc. 
 This hospital was sufficiently mobile to be advanced along the 
 railway somewhat in the rear of the army. It was later brought 
 up to the Tennessee River and used there at the battle of Chicka- 
 mauga. 
 
 Stevenson and Bridgeport, on account of the peculiar configu- 
 ration of the terrain, were better situations for hospitals than 
 Chattanooga, so long as the retention of Chattanooga was not ab- 
 solutely assured. 
 
 This hospital was in actuality an evacuation hospital and was 
 so used. 
 
 The army had excellent hospital trains operating on the Nash- 
 ville and Chattanooga Railway. As the army advanced the road 
 was repaired and at the time of the battle of Chickamauga trains 
 were running as far as Bridgeport. The bridge over the Ten- 
 nessee at that point had been destroyed by the Confederates and 
 was not rebuilt until long after the battle. 
 
 THE MARCH. 
 
 After repeated urging from Washington Rosecrans finally ad- 
 vanced from Murfreesboro on June 24, 1863. The three corps 
 
8 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 marched by different roads in the general direction of Manchester 
 and Chattanooga. The Confederate Army was in position about 
 Tullahoma and this first phase of the operations is often spoken 
 of as the Tullahoma Campaign. Although when Tullahoma was 
 entered the army rested for several weeks, this was not, properly 
 speaking, a campaign. 
 
 The real objective was Chattanooga. The whole series of opera- 
 tions up to Chickamauga consisted of strategic moves for the 
 possession of certain points, rather than an effort to find and de- 
 stroy Bragg's army. 
 
 The whole should be called the Chattanooga campaign, begin- 
 ning with the advance from Murfreesboro on June 21 and ending 
 with the battle of Missionary Ridge on November 25, five months 
 later. 
 
 Shortly after the army commenced its forward movement heavy 
 rains set in, continuing almost without interruption throughout 
 the Tullahoma campaign. The miserable dirt roads leading 
 through the wooded ravines and hills of the barrens of Southeast 
 Tennessee became all but impassable. Wagons stuck fast, the 
 guns could only be moved by doubling teams, and then with the 
 greatest difficulty. Even the movements of the foot troops were 
 materially retarded by the soft glutinous soil in which the soldiers 
 sank half knee deep at every step. The men, soaked and chilled 
 by the rain, suffered terribly, and though the advance was only 
 twelve miles a day the fatigue was greater than in the race for 
 Louisville the year before, when twenty-five and twenty-seven 
 miles were covered day after day. 
 
 The rains continued and the roads became even worse as the 
 Cumberland Mountains were reached, but the army pushed stead- 
 ily forward and entered Tullahoma July 1. There had been a 
 little skirmishing, but no real engagements. The whole loss in 
 killed and wounded was less than six hundred. Despite the con- 
 tinuous downpour of rain and the atrocious roads there had been 
 no more than the ordinary amount of sickness, from ASfo to 
 5%. An accurate observer and careful writer who took part in 
 this campaign says, "During the ten days occupied in marching 
 from Murfreesboro to Winchester, not one passed without a 
 heavy shower and sometimes for twenty-four in succession 
 the rain fell incessantly. The clothing of the men was never 
 thoroughly dry and rations were at all times scanty. Many of 
 
THE GREAT BATTLE OF CHICKAMAUGA. 
 
 MOWN INC or 
 
 SECOND BAY, 
 With suitable sites for 
 hospil&ls c/tsicjnated. 
 
 SCHLC OF MILES 
 
 LY. 
 L.C. Duncan 
 
10 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 the men wore out their shoes before they had marched three days, 
 and were barefoot the rest of the time. But they kept up their 
 spirits and bore their hardships uncomplainingly." 
 
 The sick and the wounded of the first fights (Hoover's Gap, 
 June 24, and Liberty Gap, June 25), about four hundred in num- 
 ber, were sent back to the hospital at Murfreesboro, which had 
 been cleared for them. On reaching Tullahoma a number of tents 
 abandoned by the enemy were used for hospital purposes and a 
 hotel building was converted into another, with a capacity of 100 
 beds. 
 
 Having achieved the first stage of the Chattanooga campaign 
 Rosecrans now sat down at Tullahoma and remained until the 
 Washington authorities again pushed him out — August 17. 
 
 McCook's Corps was on the right at Winchester, Thomas in 
 the center at Tullahoma, and Crittenden on the left at Manchester 
 and McMinville. The Reserve Corps was back along the railway 
 and the cavalry in the front and on the flanks. 
 
 Tent hospitals had been established at all these places and one- 
 half of the large hospital at Murfreesboro was brought forward 
 to Cowan, a small station at the foot of the mountains. 
 
 On August 5, Rosecrans received a peremptory order to ad- 
 vance and on the 17th his three army corps moved forward on 
 parallel lines toward the Tennessee River. The sick and wounded 
 were all first sent to the rear and the army moved unincumbered. 
 Sheridan's division had already advanced to Stevenson and the 
 remainder of the Murfreesboro hospital was advanced to that 
 point. The army met with little opposition and by August 30 
 had reached the river. The roads were again all but impassible 
 and the march was slow. 
 
 McCook's corps crossed at Caperton's Ferry, Thomas at Bridge- 
 port and Crittenden at Shellmound. By September 4 the whole 
 army was across the river. 
 
 The great railway bridge at Bridgeport having been destroyed 
 that point became the rail-head of the column. In addition to the 
 hospital at Stevenson a smaller tent hospital was established there. 
 During all this time the railway hospital train was kept running 
 regularly and all serious cases were removed promptly to Nash- 
 ville. 
 
 The field hospitals and large tent hospitals were kept practically 
 empty, in preparation for expected combat. Supplies were brought 
 
THE GREAT BATTLE OF CHICKAMAUGA. 11 
 
 up from the rear for all these hospitals, leaving the reserve sup- 
 ply trains with the various corps intact. At Stevenson and Bridge- 
 port were now what we should call the evacuation hospitals for 
 the final advance on Chattanooga and the battle that was to follow. 
 Up to this time there had been but few casualties, but once south 
 of the river a collision with the enemy was looked for at any 
 time. 
 
 The Medical Director says, "I made every effort to familiarize 
 myself with the topographical resources of the country. As a 
 great struggle was anticipated, food for the wounded and an easy 
 way to the rear were the main points to be kept in view." These 
 were the main difficulties that were met with in the East also. It 
 was never medicine or surgical needs that were too great to be 
 met, but simple things like food, blankets, tents, ambulances, and 
 trains. These are the things that almost every medical director 
 and every medical officer found to fail from Bull Run to Appo- 
 mattox. 
 
 The hospitals on the Tennessee River were sufficient for all 
 needs until the army penetrated the gaps of Lookout Mountain. 
 Then Bragg evacuated Chattanooga and the Medical Director 
 ordered Surgeon I. Moses, U. S. V., to proceed from Murfrees- 
 boro to Chattanooga and establish a hospital of three thousand 
 beds. Supplies were also ordered forward but events moved too 
 rapidly. 
 
 Surgeon Aloses reached Chattanooga on September 18, only one 
 day before the battle began. He says, "I repaired to Chattanooga 
 and arrived on Friday, September 18, with orders from Surgeon 
 Perrin, U. S. A., to prepare beds for three thousand wounded. I 
 found scant supplies for not more than 500 beds, and buildings 
 capable of holding that number, built by Confederates and occu- 
 pied as a hospital, with about ]50 sick already in them; also a 
 large building, two stories, built by the Confederates as a re- 
 ceiving hospital, capable of holding 150. These buildings were 
 without doors or windows, and destitute of every convenience. 
 A partial supply of medicines, blankets, furniture, and dressings 
 were on hand estimated for 1,000 men, but deficient in many 
 articles. I selected several buildings which might be converted 
 into hospitals." Various buildings, hotels, lofts, churches, and 
 private buildings were selected and they were all needed before 
 the battle was over. 
 
12 MEDICAL DEPARTMENT IX THE CI] 'IL WAR. 
 
 The shortage of supplies could hardly have been avoided. It 
 would naturally be supposed that on taking Chattanooga Rose- 
 crans would halt there to refit his army, bring up supplies, receive 
 reinforcements and spend some time in preparations before again 
 proceeding deeper into the enemy's country, there to meet an 
 army still unbeaten. 
 
 But he seems to have been carried away by his own success, and 
 plunged recklessly into the valleys and mountains below Chatta- 
 nooga without the preparations that prudence would have dic- 
 tated. After Grant took command it was nearly six months be- 
 fore Sherman again took up the campaign for Atlanta, and pre- 
 vious to setting out he made careful preparations. 
 
 These things are mentioned to show why there were not proper 
 and sufficient supplies and hospitals at Chattanooga, such as one 
 would expect at the advance base of the army, and such as were 
 there in abundance before so bold a leader as Sherman undertook 
 a campaign through the mountains of northern Georgia. 
 
 After passing the Tennessee River Rosecrans had several high 
 ridges and deep valleys to cross before reaching Chattanooga : 
 Sand Mountain, Lookout Valley and Lookout Mountain. The 
 ridges were from fifteen hundred to two thousand feet high. 
 Through the main obstacle, Lookout Mountain, there were but 
 three practicable passes for an army: one near the river, Stevens 
 Gap twenty-five miles south, and a third at Valley Head, forty 
 miles south. The three corps marched for these gaps, McCook on 
 the right to Valley Head, Crittenden advanced along the river to 
 Chattanooga. On September 7 the various corps appeared at the 
 eastern outlet of these gaps and next da.y Bragg evacuated Chat- 
 tanooga, retiring southward to Lafayette and Dalton. Crittenden 
 entered Chattanooga on the 9th, left a brigade there, and pushed 
 on by Rossville toward Ringgold. The other corps had marched 
 forward and crossed still another ridge, Missionary Ridge, which 
 is not a mountain range, but a long ridge from two to four 
 hundred feet high. 
 
 By the 12th Rosecrans found that Bragg was not in retreat as 
 he had supposed, but had his army well concentrated and was ad- 
 vancing down the valley of the Chickamauga, the valley next east 
 from Missionary Ridge. Rosecrans called in his widely separated 
 corps. 
 
THE, GREAT BATTLE OF CHICKAMAUGA. 13 
 
 The weather had changed and was now extremely dry. The 
 country was almost a wilderness of rocky hills and valleys. 
 The days were warm and the thousands of marching feet ground 
 the soil into a powder that rose in clouds of choking dust. The 
 nights, however, were so cold as to make a fire comfortable. 
 
 While Rosecrans was advancing boldly into Georgia, Bragg 
 was calling aid from the whole Confederacy. Divisions were 
 brought from East Tennessee, Mississippi, and a whole corps 
 from Virginia to give him the preponderance in numbers, while 
 Rosecrans, who might easily have been reinforced from Vicks- 
 burg, remained with an inadequate force, far from his base, in 
 great danger of defeat and consequent ruin. 
 
 Bragg, now superior in numbers, advanced down the eastern 
 side of Chickamauga Creek, while Rosecrans called in his divi- 
 sions, to the western side of that stream, in the vicinity of Lee 
 and Gordon's Mills. By the morning of September 18, Bragg's 
 whole force, excepting Longstreet's corps, was ready for battle. 
 On the Union side Crittenden alone was on the field, Thomas 
 was at Pond Spring, and McCook at Stevens Gap, both hurrying 
 up. Gordon Granger was at Rossville Gap, the cavalry in front. 
 
 Map II shows the configuration of the battlefield and the lines 
 on the first day of the battle, September 19, but it does not 
 show one very important point, Chattanooga, and its relation to 
 the field. 
 
 Now Chattanooga is almost directly north from Rossville, a 
 distance of about six miles. Chattanooga was the temporary ad- 
 vance base of the army. To it the army must inevitably go in 
 case of defeat. 
 
 Looking at this map again, one sees without difficulty, that 
 the line of retreat must be along the west side of Missionary 
 Ridge from McFarland's Gap to Rossville and on north in the 
 same line to Chattanooga. The army was to fight on a line par- 
 allel to its line of communication, with its base on the left flank, 
 a perilous situation at the best. 
 
 In case of defeat the whole army must be poured through 
 McFarland's Gap, where the rugged Missionary Ridge would 
 serve as a screen and protection for a safe retreat to Chattanooga. 
 There is but one other gap in this ridge, Rossville Gap, and Gor- 
 don Granger's Reserve Corps was posted in front of this vital 
 point to guard it. 
 
14 MEDICAL DBPARTMEXT IX THE CIVIL WAR. 
 
 
 \ c/tAwri5n spRmosr 
 
THE GREAT BATTLE OF CHICKAMAUGA. 15 
 
 The location of Crawfish Springs should also be noted and 
 borne in mind ; it is about three and one-half miles from the 
 • center of the field, but on the right flank, in the enemy's country, 
 and directly away from the base at Chattanooga. 
 
 Rosecrans, Thomas, and McCook came on to the battlefield by 
 way of Crawfish Springs; an ignorant soldier might instinctively 
 feel that he would retreat in the same direction. 
 
 Crittenden came to the field from Chattanooga by Rossville 
 Gap, but moved to Lee and Gordon's Mill before the battle. 
 
 Medical Director Perrin says, "It was soon discovered that 
 the main body of the enemy was moving down the valley of the 
 Chickamauga towards Rossville. The ridge that divides the val- 
 ley of the Chickamauga from that of Chattanooga (Mission 
 Ridge) was traversed in several places by wagon roads (Mc- 
 Farland's Gap and Rossville Gap). 
 
 It was by these roads that our wounded must be conveyed to 
 the rear. The wagon road down the Chickamauga Valley was 
 nearer the base of the ridge, on the south side (east) where there 
 were few springs. As every indication pointed to a conflict on the 
 north side of the creek, our wounded were to be provided for at 
 these springs, or taken over Missionary Ridge into Chattanooga 
 Valley. 
 
 After consultation with the general commanding (Rosecrans) 
 I selected Crawfish Springs as the main depot for wounded. 
 Division hospitals for the 20th and 21st Corps, together with two 
 divisions of the 14th Corps, were accordingly established at that 
 point." 
 
 Thus of the ten division hospitals with the army (there is no 
 record of a division hospital wih the Reserve Corps) eight were 
 established at or near Crawfish Springs. 
 
 One of them, second division, Twentieth Corps, was soon re- 
 moved to a point on the Lafayette Road, probably near the Cloud 
 House, but seven out of the ten remained there throughout the 
 battle, and afterwards. 
 
 There is but one reason for locating these hospitals at this 
 point, the abundance of water. Following the rains of June and 
 July a period of drouth ensued. The roads were dusty, the 
 fields dead, and the streams dried up. The hills back of the 
 army and up to Missionary Ridge were especially destitute of 
 
16 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 water. The southern road to McFarland's Gap was known as 
 the Dry Valley Road. A pool near the Widow Glenn House was 
 known as bloody pool. Either side strove for its possession and 
 when the blue or gray was successful the men dropped at the 
 water's edge to drink, though dead men and horses lay in it before 
 their eyes. 
 
 In those days water was a prime requisite of the hospitals and 
 dressing stations. Every wound was washed if possible and the 
 simple "water dressing" took the place of our modern first 
 dressing. Then there were the ordinary needs of water for 
 drinking and cooking, always present. For no other good reason 
 could all these field hospitals have been located at Crawfish 
 Springs. 
 
 A mere glance at the map shows the line of retreat for all 
 divisions to have converged at McFarland's Gap. From there 
 the road led straight through Rossville to Chattanooga. Everyone 
 in both armies from general down to private knew that Rossville 
 Gap was a vital point. 
 
 Vet the trains were parked and seven out of ten field hospitals 
 were established at Crawfish Springs ; not only out too far on the 
 flank, but on precisely the wrong flank, and in the enemy's coun- 
 try where in case of defeat they could hardly fail to be cut off. 
 
 If on map II one should draw lines from each division to a 
 common center at McFarland's Gap and then mark points on all 
 these lines one and a half to two miles in rear of the divisions 
 he will have the ideal locations for the field hospitals. 
 
 In order to conform to topography, roads, and other natural 
 features of the terrain the actual locations would vary from the 
 ideal. But since the army was divided into two wings, each 
 with a road leading back to the gap, it seems clear that the hos- 
 pitals should have been near these roads, those of the right wing 
 somewhere near the Vittetoe House, where a division hospital 
 was actually located, and 'those on the left wing back of the 
 Lafayette Road, and north of the Snodgrass House. 
 
 The field hospitals located at the Cloud House were too far 
 out on the flank. Flanks were uncomfortable places when Joe 
 Wheeler and Forrest were around. 
 
 The various field hospitals were scattered along a line about 
 seven miles in extent, while the actual fighting line occupied not 
 
THE GREAT BATTLE OF CHICK AM AUG A. 17 
 
 more than half that distance on the first day and still less on the 
 second; on the last afternoon not more than one mile. 
 
 If on map II one should draw a line from each division to its 
 actual hospital he would have a fine crisscross of lines. It would 
 be by accident that any wounded man found a hospital of his own 
 division. Such an arrangement must invariably result in complete 
 confusion for the wounded. 
 
 In fact the mixing up of the divisions themselves is generally 
 conceded to have been a principal factor in the loss of the battle. 
 
 the battle;: first day. 
 
 The battle was opened by Thomas, near Jay's Sawmill, at 8 :30 
 Saturday morning. Bragg aimed to attack, but Thomas was 
 first. His corps had marched the whole night steadily and 
 reached the field at daylight. Crittenden had been at Lee and 
 Gordon's Mills and further north for several days. McCook was 
 below Crawfish Springs and hurried forward at the sound of 
 the guns, marching the last five miles at double time. His first 
 division (Wood) was up by noon, Davis got into the fight in time 
 to lose half his division before night, Sheridan only arrived at 
 six o'clock. Gordon Granger took post at McAfee's church and 
 remained there all day. Bragg's divisions were crossing the 
 Chickamauga at all the fords and bridges and advancing steadily 
 to the attack, which was generally met with great firmness. By 
 night, however, the whole Union line was forced back to the 
 Lafayette Road. 
 
 The ground was not unlike that of the Wilderness, hills with 
 ragged woods, ravines, and a few cleared fields enclosed with 
 rail fences. The terrain was unknown to the officers, no one 
 could know much of what was going on except in his own im- 
 mediate front. The fighting was as blind as in the Wilderness, 
 and if anything more deadly. Battle lines advanced through the 
 woods and fired on each other at close range till one or the other 
 gave way. There were few skulkers and no organization refused 
 to advance, or sought the rear, as did happen at the Wilderness. 
 When night came one-fourth of the divisions engaged were 
 killed or wounded. Several regiments lost fifty per cent of their 
 strength. 
 
 The actual battle line extended from McDonald's House to a 
 
18 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 little below Viniard's. General Rosecrans' headquarters was at 
 the Widow Glenn House. The supply trains were parked at 
 Crawfish Springs, guarded by the Cavalry. 
 
 Crittenden's Corps was first on the field. This corps reached 
 Ringgold Bridge on September 12 and was near Lee and Gordons 
 Mill on the 18th. On that day sites were selected for the three 
 division field hospital of the Corps, at a point on the Dry Valley 
 Road a mile and a half north of Crawfish Springs. 
 
 This position was directly in rear of the corps at the time, but 
 the battle began further north and continually shifted in that 
 direction. About noon of the first day Medical Director Perrin 
 ordered the hospitals moved farther to the left. The hospitals 
 of the first and second division wete packed up and moved to the 
 direct rear of the firing line, presumably near the Widow Glenn 
 House. Before night the medical director of the army ordered 
 them moved back and they were returned to their original site. 
 
 It seems that the wounded were mostly brought off the field 
 after nightfall. The first division hospital received four hundred, 
 of which three hundred belonged to the division. This division 
 was on the extreme right and nearest to Crawfish Springs. 
 
 The second division hospital reports receiving two hundred 
 wounded and many more during the night. 
 
 The third division hospital received about five hundred 
 wounded. They were from various divisions as will be easily un- 
 derstood. The ambulances of all the divisions worked till mid- 
 night and brought off practically all the wounded of the first 
 day's battle except those within the enemy's lines. The total 
 number of wounded on this day was estimated at 4,500. 
 
 In the first division of this corps a medical officer was placed 
 in charge of the ambulance train of each brigade, thus improving 
 on Letterman's arrangement and anticipating the present plan by 
 forty years. 
 
 Thomas' Fourteenth Corps, after marching all night, reached 
 the battlefield early on Saturday morning. Surgeon F. H. Gross, 
 U. S. V., was medical director of this corps. Three divisions of 
 the corps were placed in line on the left, in front of the Kelly 
 Field. The second division, Negley's, was left near Crawfish 
 Springs and later formed part of the right wing. 
 
 The hospital of the first division, Baird's, was established at 
 the Dyer House ; the best location occupied by any hospital on the 
 
THE GREAT BATTLE OF CHICKAMAUGA. 19 
 
 field. The medical director says, "A fine spring, a number of 
 outbuildings, and plenty of straw nearby rendered this a desirable 
 locality for hospital purposes." When the division fell back to the 
 line near the Kelly House, the hospital was in a reasonable dis- 
 tance, and it was on a safe road to McFarland's Gap. 
 
 The buildings were first filled with wounded, but by noon it 
 was necessary to pitch tents. 
 
 About five o'clock a column of the enemy crossed the Lafayette 
 Road and their shells fell in and around the hospital. The medical 
 director ordered the wounded removed to Crawfish Springs, but 
 the attack was quickly repulsed and the hospital remained where 
 it was. The medical director of this division says, "We received 
 more wounded from Brannan's division (3rd division, 14th 
 Corps) than from our own, as it seems the ambulance drivers of 
 that division were not informed as to the location of their divi- 
 sion hospital." The hospital of Brannon's division was away out 
 to the left at the Cloud House. Brannan's division was on the 
 extreme left at the opening of the battle but shortly after noon 
 was moved to the right of the Kelly Field, directly in front of this 
 hospital. This was the best managed as well as the best located 
 of all the hospitals. 
 
 The ambulances were kept moving all night and when the field 
 had been cleared they were started evacuating the wounded to 
 Chattanooga. About half were able to march, others were sent in 
 returning supply wagons. By Sunday morning but forty wounded 
 remained in this hospital. It may be presumed that they were 
 non-transportable. 
 
 The hospital of the second division, 14th corps, was established 
 near Crawfish Springs. The medical director of the division fol- 
 lowed it to the field and thought the hospital should be estab- 
 lished in its rear, i. e., near the Dyer House, but he was directed 
 by Medical Director Perrin to go back to Crawfish Springs and es- 
 tablish his hospital there, which he did. His own judgment was 
 better than that of his chief. He remained with the division, 
 gathering the wounded and sending them to the hospital. 
 
 The hospital of the third division, Brannan's, was, by direc- 
 tion of General Thomas, established at the Cloud House. The 
 medical director says, "There were good springs, a church, and 
 several houses." The location of this hospital was not so bad as 
 that of those near Crawfish Springs and would have been fairly 
 
20 MEDICAL DEPARTMENT IK THE CIVIL WAR. 
 
 good had the army been assured of victory. Many of the 
 wounded, not only of Brannan's, but also of Baird's, Johnson's 
 and other divisions were brought to this hospital. 
 
 By nightfall there were nearly a thousand; filling the church, 
 houses, tents ; and with hundreds more lying out of doors on the 
 ground. As many of the more severely wounded as possible 
 were dressed and fed with soup. 
 
 There was plenty of straw for bedding, but few blankets. Most 
 of the wounded had thrown away or lost their own blankets dur- 
 ing the battle. 
 
 The night was quite cold. In this hospital, as in others, the 
 wounded were arranged in rows and great fires built at their feet. 
 
 The surgeons worked nearly all night, mostly in dressing 
 wounds. Little operating was done. Operating out of doors by 
 candlelight would naturally be avoided if possible. 
 
 The hospital of the fourth division of Thomas' corps was also 
 at Crawfish Springs. When the army was driven from the field 
 next day the Medical Director and many of his surgeons remained 
 with the wounded and were captured. These surgeons were re- 
 tained on the field by the Confederates to care for the wounded 
 prisoners. Later they were taken to Atlanta and paroled. These 
 events appear to have prevented the medical director from mak- 
 ing any reports ; at least none were made. 
 
 The Twentieth Corps, McCook's, did not reach the battlefield 
 until the afternoon of the first day. This corps had a very limited 
 hospital equipment. Before crossing the Tennessee River the 
 medical equipment was ordered reduced to 500 pounds per regi- 
 ment and was actually reduced to what could be carried on four- 
 teen wagons, about five wagons to a division of 4,000 men. When 
 the corps reached the battlfield one division (Johnson's) was 
 placed on the left with Thomas, in front of the Kelly Field. The 
 other two (Davis' and Sheridan's) were placed on the right, in 
 front of the Widow Glenn house. The hospitals of these two 
 divisions, first and third, were located near Crawfish Springs. 
 The same objection holds against these hospitals as against all 
 the others but with even greater force, since when McCook came 
 on the field the lines were definitely formed and the battle was 
 being waged three to four miles further north. The medical 
 director of the first division says, "I twice selected locations for 
 a division hospital and had to abandon them." He seems to have 
 
THE GREAT BATTLE OF CHICKAMAUGA. 21 
 
 been in the rear of his division on the Lafayette Road and near 
 the tanyard. He was directed to move his wounded to Crawfish 
 Springs. He goes on to say, "With the exception of the medicine 
 wagons, the regimental supplies were reduced by general orders 
 (corps order) to 500 pounds to a regiment and this amount put 
 with other baggage and taken with the regimental transportation. 
 These supplies were not accessible when the battle came on and 
 the . edical officers had to rely on their knapsacks and such 
 articles as they had in their ambulances. The wagon trains hav- 
 ing been subsequently hurried to Chattanooga, the hospital sup- 
 plies were only obtained when the troops reached that place. I 
 sincerely hope such reduction will not be made again." 
 
 First the supplies were reduced to 500 pounds; next the regi- 
 mental medical wagons were taken away and this 500 pounds 
 loaded wherever it could be piled on a wagon ; finally the wagons 
 were sent off to Chattanooga. The corps was left with almost no 
 medical supplies as anyone could have foreseen, yet such a re- 
 duction and just such a vicious method of transporting medical 
 supplies is proposed in this year nineteen hundred and twelve. 
 
 The wounded of all hospitals near Crawfish Springs were badly 
 commingled and the records were sadly incomplete. The food 
 supply here was a grave question. The medical director quoted 
 above says: "The supply of sanitary goods, beef extracts, tea, 
 and, with five hundred pounds of fresh beef from the division 
 commissary, and some sugar, coffee, and hard bread procured 
 from the cavalry, enabled me to subsist the wounded until the 
 afternoon of the 20th." 
 
 The hospital tents had been pitched and were left behind when 
 the place was abandoned next day. 
 
 The history of the third division hospital is like that of the 
 first. The medical director says that the wounded in the two 
 days amounted to 1,500, of whom not more than 300 were treated 
 in the hospital. 
 
 The second division, 20th Corps (Johnson's), on reaching the 
 field at noon was sent to aid Thomas ; the hospital followed and 
 escaped the order to locate at the Springs. The Medical Director 
 says: "I inquired of General Johnson about the propriety of 
 establishing the hospital depot, in which he agreed after a halt a 
 mile further on." The place first selected seems to have been 
 
22 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 
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THE GREAT BATTLE OF CHICKAMAUGA. 23 
 
 well out towards Jay's Sawmill, and the hospital had to be drawn 
 back to another site on the road. I am not able to locate this 
 hospital with precision, but it must have been near the Cloud 
 House. 
 
 This hospital had two medical supply wagons. The Medical 
 Director organized the hospital and then went to the front to 
 superintend the removal of the wounded, which was chiefly done 
 at night. He says : "After three o'clock in the morning I went 
 to the front the last time, with four ambulances, and removed 
 all the wounded I could find. The work of dressing went on all 
 night, but operations were left until morning." There was no 
 light for operating, but the operations were never done, for when 
 morning came other events transpired. 
 
 Darkness ended the first day's battle. The Army of Cumber- 
 land had been outnumbered and had suffered severely, but still 
 maintained its lines covering the roads to Chattanooga. Though 
 hammered mercilessly it was in better condition than after the 
 first day's fight at Stones' River, and even from that wreck had 
 been able to pluck victory. 
 
 The loss aggregated more than five thousand and the Medical 
 Director estimated that there were four thousand five hundred 
 wounded. About four thousand of them had been collected by 
 midnight or shortly after. Work in most of the hospitals went 
 on till morning. For the surgeons of Thomas' Corps who had 
 marched all the night before this must have been especially 
 trying. 
 
 SECOND DAY'S BATTLE. 
 
 During the night and early morning the Union lines were rec- 
 tified. The left under Thomas was contracted and a line of 
 breastworks thrown up. This line on the map shows the position 
 of his troops on Sunday morning. The right wing extended 
 from the south end of these works in a southwestern direction 
 to the Widow Glenn House. 
 
 This new line was little more than two miles long but it still 
 covered the vital roads. Granger still stood in front of Rossville 
 Gap and the cavalry near Crawfish Springs. The hospitals re- 
 mained as they were. This is to me inexplicable. 
 
 The general was entirely engrossed with a desperate battle. 
 The Medical Director says nothing. 
 
24 MEDICAL DEPARTMENT IN THE CIl 1L WAR. 
 
 With the contracted lines the hospitals at Crawfish Springs 
 were farther away than ever and in more danger. On the day 
 before they were in the rear of the main line of battle; now 
 they were in front and in great danger of being cut off at any 
 time. The hospitals at the Cloud House were also in the same 
 danger, in slightly less degree. The hospital at the Dyer House 
 was too close to the firing line. That had been demonstrated the 
 previous day and yet no change had been made. However, this 
 hospital was the only one that had a passable location. That of 
 the two on the left was bad; of the seven on the right it could 
 hardly be worse. There were now five divisions on the left and 
 five on the right (see map III). The hospitals on the left should 
 have been northwest of the Snodgrass House within reach of the 
 northern road to McFarland's Gap. Those of the right wing 
 should have been on the Dry Valley Road, from the Vittetoe 
 House west. Some from the center divisions could have been 
 behind the Snodgrass House where there was shelter and a 
 private road to the rear. A line from the Vittetoe House to the 
 Snodgrass House and then north to the Brock House would 
 give the general location of all the hospitals. Today they would 
 all be behind Missionary Ridge. 
 
 On account of what looks like an unnecessary and faulty mix- 
 ing up of divisions it would have been impossible to combine the 
 division hospitals ; an excellent custom in the Army of the Po- 
 tomac. Remember that these corps were smaller than our modern 
 divisions and much less extended when in line of battle. 
 
 The second day's battle began about nine o'clock on Sunday 
 morning with an attack on the left, which was kept up till noon, 
 with no great success. However, the Confederate infantry and 
 Forrest's cavalry crossed the Lafayette Road to the north of the 
 line of works and the two field hospitals on this flank were soon 
 cut off from the main line of the army. 
 
 On the right all was quiet until midday. Then, during a gen- 
 eral shifting of divisions to send aid to the left, Longstreet burst 
 out of the woods with an overpowering column, caught the right 
 divisions moving in flank, and drove them in flight from the 
 field. Davis', Sheridan's and parts of Xegley's and Vancleave's 
 divisions were driven in rout back along the Dry Valley Road to 
 McFarland's Gap. 
 
 They rallied at the Gap but continued the retreat to Rossville 
 
THE GREAT BATTLE OF CHICKAMAUGA. 25 
 
 and took no further part in the battle. Longstreet's forces pushed 
 on for a mile behind the Vittetoe House but then turned to the 
 north to assail Thomas. Wood and Brannan were thrown back 
 at a right angle with Thomas' other divisions along the line of 
 breastworks. 
 
 The whole remaining line of battle now made a horseshoe- 
 shaped formation about Snodgrass Hill. 
 
 Here Thomas held out through the whole afternoon against 
 almost the whole of the Confederate Army. 
 
 Once his extreme right, west of Snodgrass House, was all but 
 turned, when Gordon Granger without orders marched two of his 
 brigades to the sound of the guns and arrived in time to save 
 Thomas from destruction. About five o'clock Thomas withdrew 
 through the two gaps to Rossville, where he was joined by the 
 other divisions and a new line of battle taken up. The Con- 
 federates, though victorious, were exhausted, and made no pur- 
 suit either that day or the next. On the twenty-second the army 
 fell back to Chattanooga, acknowledging defeat. 
 
 When the second day's battle began the hospitals at Crawfish 
 Springs were too far away to be of much use. But there was 
 little or no fighting on the right before noon. At any time during 
 the forenoon the hospitals might have been moved nearer the 
 field and to safer positions. No one seems to have realized that 
 they were as far from the field as was McFarland's Gap, a place 
 of perfect safety. The fate of all these hospitals will be de- 
 scribed, beginning on the left, where the battle of Sunday began. 
 
 The hospital at the Cloud house (3-14) was cut off early, cer- 
 tainly not later than ten o'clock. Most of the patients of the day 
 before were removed. Sixty of the worst cases were left with 
 most of the tents and supplies. The train of wounded that was 
 started for Chattanooga reached there with the loss of but one 
 ambulance, broken down on the road. 
 
 Medical officers were left with the wounded. This hospital was 
 again in the Union lines for a short time in the afternoon when 
 General Granger marched across from McAfee's Church, driving 
 off Forrest's cavalry, but was finally lost that evening when the 
 whole army returned to Rossville. So ends the story of this divi- 
 sion hospital. The medical director reported soon afterward that 
 a new outfit would be required before the division could take the 
 field again. Yet he had done very well for his location, in saving 
 
26 MEDICAL DEFARTMEXT IX THE CIVIL WAR. 
 
 his transportation and most of his wounded. The worst feature 
 of the case was that this division had no field hospital during the 
 remainder of the battle. 
 
 The next hospital in line was that of Johnston's division (2-20) 
 also near the Cloud house. At this hospital the work had just 
 begun on the second day when it was cut off like the other. 
 The Aledical Director had time to send all the wounded who 
 could walk back to a hill in the rear and removed as many as 
 possible of the others to the same place, by litters and ambulances. 
 The irruption of the gray lines hastened the evacuation. The Medi- 
 cal Director collected his wounded and attempted to return to 
 the hospital, but ran into the opposing lines and was made a 
 prisoner. Granger's march also released him and his hospital 
 icmporarily. He resumed the removal of the wounded to the 
 rear until evening when the Confederates took possession of the 
 wnole field and he again became prisoner. Next morning he 
 escaped and made his way to Chattanooga. All the wounded had 
 been gotten away except thirty. Four surgeons and a few men 
 were purposely left behind with the wounded and to collect 
 others. The camp and supplies were lost. The wounded on hand 
 were brought off well, but this hospital, like the other, was of little 
 use to its division on the most deadly day of the conflict. Both 
 these hospitals were cut off before ten o'clock. Their position on 
 the road to Rossville had allowed the removal of most of the 
 wounded of the fir^t day's battle ; 'but for the great battle of the 
 second day they were useless. 
 
 Let us see what happened on the right flank. The history of 
 all the seven hospitals near Crawfish Springs was much the same. 
 When Longstreet broke through the Union right at noon, all 
 these hospitals were cut off from the army. Fortunately his vic- 
 torious troops on passing the Vittetoe house turned to the right, 
 and left the trains and hospitals unmolested for a time. They 
 were safely guarded by the cavalry though separated from the 
 main body of the army. 
 
 When it was known that the right wing was driven off the 
 field the division surgeons consulted with each other and decided 
 to abandon their hospitals. All wagons of every description, and 
 ambulances, were loaded with all the wounded they could possi- 
 bly carry; all that could march were sent on ahead and the 
 whole caravan moved by a woods road back to Missionary Ridge 
 
THE GREAT BATTLE OP CHICKAMAUGA. 27 
 
26 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 and then to McFarland's Gap and Chattanooga. The cavalry 
 covered the withdrawal of these wounded and trains very suc- 
 cessfully. It appears that they might easily have been captured. 
 
 The tents as a rule were left, with a number of the more des- 
 perately wounded men. Medical officers, men, and supplies were 
 left at each hospital. The hospital of the fourth division, 14th 
 Corps (Reynolds), was captured entire with its officers. In the 
 two division hospitals of the twentieth corps there were left two 
 hundred and fifty wounded with eleven medical officers and 3,000 
 rations. The first division lost fourteen ambulances, the third 
 lost one. It will be noted that more wounded were left in the 
 more distant hospitals than in those on the left flank near Chat- 
 tanooga. The records of all these hospitals were incomplete and 
 in some all records were left behind. 
 
 All the division hospitals of the twenty-first corps (Crittenden) 
 were abandoned by two o'clock with about two hundred wounded. 
 Fourteen medical officers were detailed to remain with them. As 
 these hospitals had cared for 1,200 wounded they seem to have 
 done their work well until cut off. They were of no more use to 
 the army, but their own corps had left the field. 
 
 The hospitals of the second division brought off nearly four 
 hundred, leaving but forty behind. When the last ambulance left 
 the enemy was within a few hundred yards of the hospital. 
 
 The third division brought off all their wounded except sixty, 
 the first division left about one hundred. 
 
 We have now seen that by noon of the second day, or a little 
 later, the two hospitals on the left flank and seven on the right 
 had been entirely cut off from the army. But one remains, that 
 of Baird's division (1-14), near the Dyer house, the best located 
 of all. It will be remembered that this hospital was kept clear. 
 
 When the attack began on Sunday morning shells fell about the 
 place; by 10 o'clock it was in great danger and was at once evac- 
 uated. All the wounded except forty had been sent off during the 
 night. These, with the tents and supplies, were loaded on the 
 wagons and removed to Chattanooga. It was doubtless then 
 thought that the whole battle was lost and the army in retreat. 
 
 This was the only division hospital brought off the field entire, 
 due largely to its excellent location and in part to good manage- 
 ment. 
 
THE GREAT BATTLE OE CHICKAMAUGA. 29 
 
 The army now had not a single available hospital left on the 
 field, and the long desperate battle of the afternoon was yet to 
 come. Map III shows the field at the time with all the hospitals 
 out of reach. When the hospitals were abandoned at least half 
 the medical officers and a considerable number of ambulances re- 
 mained with the troops. Dressing stations were established and 
 the wounded cared for as well as possible with almost no supplies. 
 
 THE RETREAT TO CHATTANOOGA. 
 
 When at five in the evening the field was finally abandoned 
 some two thousand five hundred wounded were left to the enemy. 
 Not more than five hundred of these were in the field hospitals; 
 the remainder were in improvised dressing stations, but largely 
 scattered over the field where they fell. 
 
 Night found the Army of the Cumberland beaten and sadly 
 depleted but in some kind of a line of battle at Rossville, where it 
 remained all of the next day before falling back to Chattanooga. 
 It was estimated that not more than thirty-five thousand men 
 could be placed in line at that place, so heavy had been the loss. 
 
 For the wounded every vehicle was taken and started to the 
 rear; most of them reached Chattanooga Sunday night, but 
 wounded men continued to come in during all of the next day and 
 night. The ambulances were sent back as far as possible to pick 
 up those who were dragging themselves along. 
 
 Those able to march' did not stop long at Chattanooga, they 
 were sent across the river and continued on their way to Bridge- 
 port. Many of the severe ambulance cases were also sent to 
 the rear. The grave cases were retained in Chattanooga. The 
 general feeling as to the safety of the city at that time was one 
 of serious doubt, and it was desirable to get the wounded to the 
 rear as soon as possible. 
 
 The whole number of known wounded at Chickamauga was 
 9,749 ; of these about 7,500 reached Chattanooga. Every church, 
 public building, and available house was filled. Many of the in- 
 habitants had left their homes and these houses were seized for 
 the wounded. There was a shortage of supplies at first, but prob- 
 ably no real suffering on that account till later. The medical 
 supply train of the Fourteenth Corps had been brought to the 
 field from Rossville on Sunday morning, but fortunately was 
 
30 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 turned back and reached Chattanooga in safety, where the sup- 
 plies it afforded were extremely welcome. The reserve supply 
 trains of the other corps also seem to have escaped but they had 
 expended most of their supplies in equipping the field hospitals 
 which were lost. 
 
 On the twenty-second a tent hospital of fifteen hundred beds 
 was established at Stringers on the north side of the Tennessee 
 River. Surgeon Moses, who, as previously stated, had been 
 placed in charge of the hospitals at Chattanooga, says that about 
 four thousand wounded were placed in extemporized hospitals in 
 the city on the twentieth and twenty-first. 
 
 Forty surgeons from the army were on duty in these hospitals, 
 and four Confederate surgeons, attending prisoners. 
 
 All the severe cases were dressed the same night that they ar- 
 rived or the next morning, and all received food, which they had 
 not had for two days. This going without food, although much 
 deplored at the time, was in many cases a great advantage. Not 
 many operations were done on the field, very few in fact, as re- 
 lated by all the surgeons. This also was a blessing in disguise. 
 On occupying the town two hundred bales of cotton were found ; 
 they were seized and made up into mattresses, and in ten days 
 there was a mattress for every patient. 
 
 The evacuation of wounded began at once. The fear that 
 Chattanooga would have to be abandoned and the growing scar- 
 city of supplies rendered this measure imperative. The wounded 
 were sent across the river, and over forty miles of rough moun- 
 tain roads to Bridgeport, to their great detriment. Three thou- 
 sand reached that point on foot, some of whom were malingerers. 
 Within a few days steamers came up to Kelly's Ferry, ten miles 
 below the city, and thereafter the wounded were sent by steamer 
 from that point to the hospitals and trains at Bridgeport. The 
 Confederates had advanced to within a few miles of Chattanooga 
 and held the road leading back to Bridgeport on the south side of 
 the river. By November twenty-fourth, one month later, the 
 number of wounded in the general hospitals at Chattanooga had 
 been reduced to four hundred and fifty. 
 
 A week after the battle General Rosecrans made arrangements 
 to recover the wounded left on the field and the medical officers 
 held as prisoners. Many had died and some had been sent south, 
 but seventeen hundred and forty were recovered and brought 
 
THE GREAT BATTLE OF CHICKAMAUGA. 31 
 
 into Chattanooga between September twenty-ninth and October 
 second. Four medical officers were also returned. As the Union 
 forces held but fifty wounded Confederates, those recovered were 
 to be counted in future exchanges. This paroling of the wounded 
 seems to have been an exceedingly advantageous thing for the 
 Confederates, who had not the means for caring for their own 
 wounded properly. 
 
 A glimpse of the wounded that were sent south is afforded by 
 the report of Surgeon Joseph Jones of the Confederate Service, 
 printed in one of the publications of the United States Sanitary 
 Commission. 
 
 These wounded, with their fellow sufferers on the other side, 
 were sent to improvised hospitals in Dalton, Rome, Kingston, At- 
 lanta, Augusta, and other places in Georgia. Surgeon Jones says 
 of the hospitals in Augusta: 
 
 "Upon my return to Augusta the Confeedrate hospitals were 
 found crowded with wounded from the bloody field of Chicka- 
 mauga. One thousand and fifty sick and wounded soldiers, about 
 nine hundred of whom were recently wounded, were sent from 
 the battlefield to Augusta. The majority of the wounds were 
 slight and of the extremities. The battle was fought September 
 18-20th and the wounded were not received in Augusta until 
 the 26-28, or from eight to ten days after the reception of the 
 wounds. Not only were these soldiers much crowded in the cars 
 and without proper dressing and attention to their wounds dur- 
 ing the tedious journey of near three hundred miles, but many 
 of them lay out in the depot with little or no attention to their 
 wounds for from forty to eighty hours after arriving at Augusta. 
 (These were Confederate wounded.) 
 
 "The hospital accommodations were wholly inadequate to the 
 proper treatment of this number of wounded, and they were 
 crowded into houses and churches the hygienic conditions and 
 arrangements of which were defective. 
 
 "Thus the Second Georgia Hospital, with a capacity of 165, re- 
 ceived 273. The Third Georgia Hospital, with a capacity of 130, 
 received 221 (and so on). The capacity of the Presbyterian 
 Church was only 112, nevertheless 240 wounded were crowded 
 into it ; the pews were not removed, the seats were converted into 
 bunks and the wounded men laid in the pews. The capacity of 
 
32 MEDICAL DEPART M EXT IX THE CIl 1L WAR. 
 
 
 
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 o 
 
 
THE GREAT BATTLE OF CHICKAMAUGA. 33 
 
 the Catholic Church was only 50, yet it received 130 wounded. 
 
 "Hospital gangrene appeared first in the Presbyterian Church, 
 a few days after.the crowding of the wounded into it. Not a single 
 wounded soldier escaped hospital gangrene in this building. The 
 disease next appeared in the Catholic Church, and here also the 
 wounded were all attacked. And finally the wounded of the 
 Second and Third Georgia Hospitals were visited and a number 
 of cases terminated fatally." This epidemic of gangrene doubt- 
 less began in the dirty box cars that had been used in transport- 
 ing wounded for months. It was probably spread by the attend- 
 ants who went from patient to patient with the same sponge. 
 
 We have the report of Surgeon Moses that- there were five cases 
 of tetanus in the hospitals at Chattanooga, but neither erysipelas 
 nor gangrene. This seems remarkable, but the better class of sur- 
 geons during the Civil War clearly understood that gangrene 
 was violently contagious. 
 
 They isolated all cases and treated the disease with bromine 
 and the strong mineral acids. Surgeon Jones believed "That 
 hospital gangrene, smallpox, scarlatina, measles and similar 
 diseases are communicated not only by actual contact, but also 
 by the transmission of an effluvium from the original source of 
 infection through the medium of the air." 
 
 Let us return to Chattanooga. 
 
 Bragg advanced to a position on Mission Ridge and Lookout 
 Mountain and blockaded the city. Wheeler got in the rear and 
 played havoc with the supply trains running back to Bridgeport. 
 The Autumn rains came and the roads became all but impassable. 
 Rations grew scarcer and scarcer. The troops were all put on 
 half rations, and even those sometimes failed. Surgeon John 
 Moore says that for several days corn in the ear was issued as 
 bread rations. 
 
 Medical Director Perrin's report pictures the conditions at this 
 time. .'As the roads became more and more difficult by reason 
 of the rains, only those subsistence stores that were absolutely 
 essential could be brought up, and even those were soon re- 
 duced in quantity far below the standard ration. The country on 
 •the north side of the river had been gleaned of everything in the 
 way of vegetables. Every effort was made to secure for the 
 wounded enough food from the regular ration, including soft 
 bread; but in the absence of vegetables and other delicacies they 
 
U MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 exhibited but too plainly the sad evidences of deficient nutrition. 
 A want of fuel was also felt during the latter part of October 
 and November. It was very discouraging to the medical attend- 
 ants to witness the gradual but certain decline of patients who 
 should have recovered, while they felt themselves powerless to 
 apply the proper remedy." 
 
 Toward the latter part of October about fifteen hundred sick 
 and wounded were in the hospitals at Chattanooga. Starvation 
 had reduced the animals to such a point that no ambulance trans- 
 portation could be organized ; there were not even horses for the 
 guns. Things looked very dark when Grant arrived and rein- 
 forcements began to come in. Then the aspect changed. Hooker 
 opened up the cracker line to Bridgeport, supplies were brought 
 up in great quantities, and the wounded evacuated to the rear. 
 
 This line was opened on October twenty-eighth. The wounded 
 were all sent north except some two hundred of the gravest cases, 
 not suitable for transportation. The hospital across the river was 
 broken up, more permanent hospitals established in Chattanooga, 
 and preparations made for the next battle, which was now at 
 hand. Hut that is another story. 
 
 The events of Chickamauga have been narrated ; much more 
 could be written, for the reports are usually full and complete, 
 more so than for any other of the great battles of the war. I hope 
 that enough has been set down to give a tolerable idea of the vari- 
 ous elements and phases of this great battle, as seen from the 
 point of view of a medical officer. 
 
 LOSSES. 
 
 The losses at Chickamauga were, I believe, more severe in pro- 
 portion to the numbers engaged than in any other of the great bat- 
 tles of the War. This battle is unique also in that the Confederate 
 loss in killed and wounded was decidedly greater than that of the 
 Union forces, being over sixteen thousand Confederates to less 
 than twelve thousand Union. This was due to the facts that the 
 Confederates had more troops on the field and that they were the 
 attacking party, the other side fighting on the defensive, and 
 largely under some kind of cover. 
 
 The loss in the infantry was one-fourth of those engaged. And 
 there were up reserves held back as at Antietam ; save for one 
 
THE GREAT BATTLE OF CHICKAMAUGA. 35 
 
 brigade of Granger's Corps every brigade and regiment on the 
 field was engaged, and the losses of many were remarkable. 
 Steedman's reserve division in three hours lost 1,787 out of 3,900. 
 The regular brigade of Baird's Division, fighting desperately on 
 both days, lost seventy-five per cent of its strength in killed and 
 wounded. Brannan's Division, fighting mostly without cover, lost 
 1,977 in killed and wounded and had but 814 missing. Many 
 regiments lost half their strength. The Eighth Kansas, for ex- 
 ample, lost fifty-five per cent in killed and wounded, practically 
 all on the afternoon of the first day's fight. 
 
 The cavalry loss as usual was small ; forty killed and one hun- 
 dred and twenty wounded ; total, one hundred and sixty, out of 
 ten thousand present ; or about one and six-tenths per cent. 
 
 The ratio of killed to wounded is given as one to six. This in- 
 dicates that many reported as missing were either killed or mor- 
 tally wounded, which was undoubtedly the case. The killed prob- 
 ably numbered over two thousand; the wounded amounted to 
 nine thousand eight hundred. The total of killed and wounded in 
 the two days at Chickamauga amounted to about four-fifths of the 
 killed and wounded in the two days' battle in the Wilderness, 
 where the infantry and artillery engaged were quite twice as 
 numerous. 
 
 Most of the medical officers making reports commented on the 
 slight nature of the wounds. This was partly due to the fact 
 that the gravely wounded of necessity remained on the field. Yet 
 the wounds as a whole were probably not so grave as in many 
 other battles, for the reason that in the wilderness of Chicka- 
 mauga the Confederates were not able to make much use of their 
 artillery. In reading the memoirs of surgeons of the war one is 
 continually impressed with the gravity of shell wounds. These 
 were the wounds that baffled, even terrified the surgeon; the 
 wounds from which he turned away in despair. 
 
 COMMENTS. 
 
 Before criticizing the work of the Medical Department in this 
 campaign it is only just to consider the words of the Medical 
 Director, Surgeon Grover Perrin, U. S. Army. 
 
 "When it is remembered that the Battle of Chickamauga was 
 fought at a long distance from the base of supplies, in a region 
 
■M", MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 already gleaned of resources and difficult of access, that it was 
 lost, and that the army was subsequently cooped up with but one 
 outlet by a circuitous and difficult route of fifty miles in length, it 
 may be safely asserted that the obstacles to be overcome in the 
 successful care and treatment of the wounded were more formi- 
 dable in this than in any other of the great battles of the war., An 
 indulgent criticism may therefore be fairly claimed when viewing 
 the results of treatment." He might have named other adverse 
 conditions ; the army was deep in the enemy's country ; Nashville, 
 the advance base, was one hundred and fifty miles to the rear, 
 while the real base was on the Ohio River, three hundred and 
 thirty-six miles away. This distance was traversed in the greater 
 part by a single line of railway, every mile of which was at all 
 times subject to sudden interruption by raids of , Confederate 
 cavalry. The worst factor of all was that the battle was lost. 
 
 Sudden evacuation of the field must always lead to confusion, 
 with consequent suffering of the wounded. These facts should 
 tend to leniency in condemning those responsible, they should not 
 affect judgment as to faults. 
 
 Assistant Surgeon Samuel Hart, U. S. V,, who was on- duty 
 with the regular brigade and had served in the Army of the ■Po- 
 tomac, says in his report : "The hospitals had been established at 
 inconvenient distances, particularly for the left wing. I am of the 
 opinion that a less number of primary operations were performed 
 than after any engagement I have ever witnessed ; and that the 
 facilities here are not equal to those of the Army of the Potomac 
 for the prompt and efficient care of the wounded." 
 
 This criticism is eminently just, though the absence of opera- 
 tions was probably a blessing to the wounded. 
 
 The combination of regimental supplies and corps supplies was 
 faulty; the combination gf regimental hospitals to form brigade 
 hospitals, and of those to form division hospitals, was more so. 
 The ambulance organization was one of the best features of the 
 medical service ; and it had faults, as the lack of officers, and of a 
 permanent enlisted personnel. 
 
 Excellent hospital railway trains were in use and temporary 
 (evacuation) hospitals were organized along the railway as the 
 army advanced. It appears, however, that the personnel for these 
 
. THE GREAT BATTLE OF CH1CKAMAUGA. 37 
 
 hospitals was mostly taken from the marching force, instead of 
 being supplied from the rear as it should have been. 
 , The peculiar geographical- situation of Chattanooga and the 
 roundabout route by which its only northern railway entered the 
 city, made it a very difficult place to supply or from which to 
 evacuate wounded. 
 
 ., After the successful campaign for possession of the city the 
 army should have halted there and spent some time in colsoli- 
 dating its conquest, in bringing up a reserve of supplies, refitting, 
 and planning for the future, both front and rear. Rosecrans 
 halted for months at Murfreesboro and Tullahoma, places of no 
 importance, but did not delay a single day at Chattanooga. 
 
 The location of the hospitals was the glaring fault of the. medi- 
 cal service in this battle. It was at first thought that Bragg 
 would attack further up stream, near Lee and Gordon's Mills, 
 consequently the hospitals were established at Crawfish Springs, 
 not a very bad location, though the leaders seem to have not been 
 accurately oriented. But when Bragg moved further down the 
 stream the army drew farther and farther away from the hos- 
 pitals. When the battle began seven out of ten of them were 
 from three to five miles away, not to the rear but on the extreme 
 right flank of the army. There was time for a change during the 
 forenoon of the first day when there was but little fighting on the 
 right, or during the night, or again during the forenoon of Sun- 
 day when the right wing was but little engaged. 
 
 The location of these hospitals was faulty for the following 
 reasons : 
 
 1. Too many were grouped together, they should have been in 
 at least two groups and near their respective, corps. 
 , II. They were too far from the line of battle for that period. 
 
 III. They were out on a flank, and on the most exposed flank. 
 If on any flank they should have been on the left, toward the base, 
 not on the right, toward the enemy. 
 
 IV. Every patient taken to Crawfish Springs had to be hauled 
 on an average three miles to reach, that point ; then the same dis- 
 tance back on the way to Chattanooga ; thus being moved a dis- 
 tance of six miles to no advantage, but often with much injury 
 to his wounds. The idea of hauling wounded men six miles fur- 
 ther than necessary during a great battle is an outrageous one. 
 
:is MEDICAL DEPARTMEXT L\ THE CIVIL WAR. 
 
 The time required to haul these patients to Crawfish Springs 
 would have sufficed to remove them through McFarland's Gap, 
 to a perfectly safe location, and one five miles nearer Chatta- 
 nooga. 
 
 The hospitals located at Crawfish Springs on the Eighteenth 
 should have been moved during the battle. Those of the Twen- 
 tieth Corps should never have been placed there at all. When 
 this corps arrived on the field the lines of battle were drawn 
 and the roads to the rear clear and plain. 
 
 ( )nce located all the hospitals seem to have been fixed and 
 immovable, though the battle drew farther and farther away and 
 the danger of being cut off grew more and more grave. When 
 they were finally cut off at noon of the second day all of the tent- 
 age and other material was of necessity abandoned. This was 
 not so serious a thing, however, as the fact that these seven hos- 
 pitals were of no use to the army on the second day. Had they 
 been back toward McFarland's Gap, where they should have 
 been, they could have been kept cleared or nearly so ; then when 
 the disaster came at least a part of them could have been saved. 
 Some of them should have been in the rear of Snodgrass Hill, 
 where they would have been available until the whole field was 
 abandoned. 
 
 The hospitals on the left, near the Cloud House, were also 
 badly located, though not so badly as those on the right. They 
 were six miles nearer to Chattanooga and were protected to some 
 extent by Gordon (Granger's Reserve Corps. General Thomas, 
 who seems to have acted with a large degree of independence, 
 located these hospitals ; or his medical director located them with 
 his consent. When, on the night of the Nineteenth, Thomas took 
 the position along the line of breastworks, these hospitals were 
 left in an extension of that line. They should have been moved 
 further back. 
 
 Owing to their location on a direct an d short road to Chatta- 
 nooga these hospitals were able to evacuate their wounded 
 promptly, so that when they were abandoned very few were left 
 behind. But they were cut off by noon on Sunday and afforded 
 practically no service to the army on the second day. 
 
 The last, and best located of all the hospitals, was another of 
 Thomas' Corps, that of Baird's (First) Division. This hospital 
 
THE GREAT BATTLE OF CHICKAMAUGA. 39 
 
 was admirably located for the first day's battle and was kept 
 cleared of wounded. But when the lines were rearranged that 
 night the hospital should have been moved further to the rear, 
 somewhere behind the Vittetoe House. Warning had been given 
 by shells falling around it the previous day. When the Confed- 
 erate advance was«made next day it was at once in danger, but 
 owing to its good location and excellent management was able to 
 escape entire in patients and material, the only hospital on the 
 field that did so. 
 
 It should be said that the medical directors of Thomas' divi- 
 sions knew that Crawfish Springs was an improper location for 
 the hospitals. 
 
 Medical Director Marks of the First Division located his hos- 
 pital at the Dyer House as just related. Medical Director Bogue 
 of the Second Division says he was proceeding with the wagons 
 and ambulances from Lee and Gordon's Mills toward the left, 
 thinking the hospitals would be located there, when he was or- 
 dered to return to Crawfish Springs. 
 
 Medical Director Tollman of the Third Division located his 
 hospital at the Cloud House. Medical Director Herrick of the 
 Fourth Division, after his hospital had been located at the 
 Springs, attempted to move it toward the left, but was prevented 
 by the movement of troops and firing of the enemy. The inde- 
 pendence of action and good judgment shown by General Thomas 
 appear to have extended throughout his corps. 
 
 The fact that the army was practically without hospitals on the 
 second day, while two-thirds of the troops remained on the field 
 and more than half the casualties occurred, is the strongest in- 
 dictment that can be made against the location of the field hos- 
 pitals. 
 
 The evacuation of wounded from the three hospitals on the 
 center and left appears to have begun early and to have been kept 
 up, so that when these hospitals were abandoned not more than a 
 hundred wounded remained in them. From the hospitals on the 
 right the long distance to Chattanooga made the evacuation more 
 difficult and it was not so well done; when these hospitals were 
 abandoned several hundred wounded were left behind. At the 
 present day some hospitals would be held in reserve at Rossville. 
 
 The care of the wounded after reaching Chattanooga was as 
 
JO MEDICAL DEPARTMENT IX THE Cll'lL WAR. 
 
 good as could be expected under the adverse conditions prevail- 
 ing at the time. Their prompt evacuation and the establishment 
 of outdoor hospital in tents and arbors were excellent measures 
 that doubtless saved lives that would otherwise have been lost in 
 the blockade that followed. 
 
 • 
 
 MEDICAL OFFICERS, ARMY OF THE CUMBERLAND, AT CHICKAM ALGA. 
 
 Medical Director of the Army, 
 
 Surgeon Glover Perrin, U. S. Arm)-. 
 Assistant Medical Director, 
 
 Assistant Surgeon Dallas Bache, V. S. Army. 
 Medical Inspector, 
 
 Surgeon H. II. Seys, 15th Ohio Vols. 
 Medical Purveyor, 
 
 Surgeon Robert Fletcher, 1st Ohio Vols. 
 Medical Director, Fourteenth Army Corps, 
 
 Surgeon F. IT. Gross, U. S. Vols. 
 First Division, 
 
 Surgeon S. Marks, 10th Wisconsin Vol?. ■ 
 Second Division, 
 
 Surgeon R. G. Bogue, l!)th Illinois Vols. 
 Third Division, 
 
 Surgeon M. C. Tollman, 2d Minnesota Vols. 
 Fourth Division, 
 
 Surgeon O. Q. Herrick, :J4th Illinois Vols. 
 Medical Director, Twentieth Army Corps, ....-,,,.' 
 
 Surgeon Jabez Perkins, 10th Kentucky Vols. 
 First Division, 
 
 Surgeon L. D. Waterman, 39th Indiana Vols. 
 Second Division, 
 
 Surgeon Charles Schussler, 6th Indiana Vols. 
 Third Division, 
 
 Surgeon D. J. Griffiths, 2d Kentucky Vols, 
 Medical Director, Twenty-first Army Corps, 
 
 Surgeon A. J. Phelps, U. S. Vols. 
 First Division, 
 
 Surgeon W. W. Blair, .j8th Indiana Vols. 
 Second Division, 
 
 Surgeon S. G. Menzies, 1st Kentucky Vols. 
 Third Division, 
 
 Surgeon S. D. Turney, U. S. Vols. 
 Medical Director, Cavalry Corps, 
 
 Surgeon L,. A. James, 4th Ohio Cavalry. 
 
THE BATTLE OF THE WILDERNESS. 
 
 BURKE was wont to condemn the proneness with which men 
 when confronted with a difficult problem, consult their own 
 invention rather than the experience of the past. Rightly con- 
 sidered, both are extremely useful and together they are the prin- 
 cipal factors in progress. 
 
 By studying the past history of any line of human action, we 
 learn what measures were successful, and, just as important, what 
 failed. 
 
 Invention adapts successful measures to present conditions, 
 and, when experience fails, discovers new Ones, to be in turn 
 submitted to the test of experience. 
 
 The history of the Medical Department of the United States 
 Army during our great Civil War is particularly rich and val- 
 uable in experience that may be applied to the tactical problems of 
 sanitary troops today. It may be safely said that sanitary tactics 
 of the battlefield did not exist in the period immediately preced- 
 ing the war. 
 
 A steady evolution in this work progressed, from the pitiful 
 absence of provisions for the wounded at Bull Run, to the splen- 
 did organization and -work of the Medical Department in the 
 great closing campaigns of the war. The system of caring for 
 the wounded, devised by Letterman and carried out by McParlin 
 and others, was the basis of all systems now in use in the great 
 armies of the world. More than that, and contrary to the com- 
 mon opinion, this system was developed by the spring of 1864 to 
 a point which left little to be desired, and which more modern 
 devices have not materially changed. The ambulance and field 
 hospital organization that crossed the Rapidan with Grant's 
 Army was in all essential features the ambulance and field hos- 
 pital organization that would take the field in the event of war 
 tomorrow; and we shall be extremely fortunate if we have an 
 equipment even approaching that of the Army of the Potomac at 
 that time. We did not have anything like it in 1898. 
 
2 CAPTAIN LOUIS C. DUNCAN. 
 
 GENERAL SITUATION. 
 
 During the last days of April, 1864, General Grant had the 
 Army of the Potomac collected about Culpepper, facing the Rapi- 
 dan River, across which in intrenched lines lay the still formid- 
 able Army of Northern Virginia. Grant had three Infantry Corps ; 
 the Second, Fifth, and Sixth ; numbering with the artillery about 
 73,000 men. The Cavalry Corps of 12,000, and the Ninth Corps 
 of 19,000, which came up later but took little part in the conflict, 
 will not be given more than a brief notice. 
 
 A study of the sanitary tactics of the battle is much simplified 
 by considering only the three corps that really did the work. 
 
 They consisted of eleven divisions, (the Sixth having but 
 three) thirty-two brigades, about 180 regiments. A regiment 
 consisted of rather less than 400 men, a division of about 7,000. 
 Lee had about 20,000 less. Grant's objective was a position be- 
 tween Lee's army and Richmond. So the Army was shifted to 
 the left and pushed across the river into the Wilderness; with- 
 out opposition by Lee. But no man of all that great army 
 doubted that most desperate fighting would come, and soon. • 
 
 The Army had never crossed that river line except to face a 
 line of fire, and now it was lead or driven on by a silent, deter- 
 mined man whom no death list staggered, no check halted for 
 long. Death waited in the Wilderness but the Army must go on. 
 
 To prepare it for this last grapple with the Confederacy all had 
 been done that human foresight could devise ; the only fault to be 
 found with the equipment was that it was excessive. So it was 
 reduced to a minimum ; practically all tentage and baggage were 
 cast aside. 
 
 Ammunition wagons, light hospitals, and ambulances alone fol- 
 lowed the divisions across the fords at midnight on May 3d, 1864. 
 The bloody battle of tne Wilderness was to be accompanied by 
 the best care of the wounded that the world had ever seen. 
 
 When the Army of the Potomac crossed the Rapidan its 
 medical equipment was complete. Every corps had its ambulance 
 company and every division had its field hospital. That they met 
 the demands of the terrible days to come proves their sufficiency. 
 The Ambulance Corps of the Army on May 1st numbered 60 offi- 
 cers and 2,300 men. For transportation there were 609 ambu- 
 
B ATT LB OF THE WILDERNESS. 3 
 
 lances and 266 army wagons ; with 3,295 draft animals. All these 
 were in excess of the regulation allowance. 
 
 For shelter there were 294 hospital tents, holding eight patients 
 each or 2,300 patients. 
 
 Deducting the ambulances of the Cavalry Corps, it appears 
 that more than 500 ambulances crossed the river with the Army. 
 A little calculation shows that there was one ambulance for each 
 150 men. 
 
 Of these one-half followed the divisions, the other half re- 
 mained with the supply trains but was always within reach. 
 But those with the troops afforded one for 300 men while our 
 present allowance is but one to 400 men. Letterman's regulations 
 allowed three ambulances to a regiment, of 500 men or more. 
 General Sherman on the march to Atlanta, although ordering 
 every tent and trunk thrown out, allowed two ambulances to a 
 regiment (very small), and General Meigs quotes Grant as esti- 
 mating 180 ambulances for a corps of 32,000 men. The Army 
 also had an excellent field hospital equipment which will be de- 
 scribed in detail later. 
 
 The total number of medical officers on May first was 699. All 
 these numbers refer to officers and men actually present for duty, 
 and to serviceable transportation. Four hundred and thirty-thr^e 
 medical officers crossed the river with the infantry columns ; add 
 to these the sixty officers of the ambulance corps and there is one 
 sanitary officer for each 150 men. 
 
 I. ORGANIZATION OF THE MEDICAE DEPARTMENT. 
 
 Regimental Organisation. 
 
 At the beginning of the war there was no care of the wounded 
 except that afforded by regimental surgeons, ambulances, tents, 
 and supplies. The volunteers clung to their idea of regimentil 
 hospitals and only gave them up after years of effort, orders, and 
 finally law. 
 
 Gradually they gave up their hospitals, ambulances and sup- 
 plies. 
 
 The last surrender took place in the Army of the Potomac 
 when it was stripped for the final campaign to Richmond. The 
 
4 CAPTAIN LOUIS C. DUNCAN. 
 
 Rapidan was a Rubicon to regimental hospitals as well as to some 
 ether institutions. 
 
 Each regiment had by law a surgeon and an assistant surgeon. 
 
 Before an engagement these officers were drawn on to man the 
 field hospital, which had no complete permanent personnel. The 
 brigade surgeons were also detailed for this purpose. However, 
 one surgeon was required to remain with the regiment and these 
 surgeons formed the first line of aid. They gathered at sheltered 
 spots behind the firing line, by brigades in the latter years of the 
 war, and formed aid, dressing, and ambulance stations, all in one. 
 This single station was no doubt suitable for the days of short 
 range guns. These stations were from 300 to 500 yards behind 
 the firing line, at points that were under cover and could be 
 reached by ambulances. Supplies were obtained from the medi- 
 cal knapsacks of the regiments, and from the ambulances coming 
 to the stations. Regimental assitance had diminished to first aid 
 and partial collection of the wounded; but the ambulance corps 
 did most of the latter. But all the first aid given was that of the 
 regimental personnel ; the ambulance corps was in. reality a quar- 
 termaster organization, under the direction of the Medical Di- 
 rector of the Division. 
 
 Ambulance Corps Organization. 
 
 The Letterman order of August 2nd, 1862, made by McClei- 
 lan in spite of the War Department, had been reiterated by Meade 
 August 24th, 1863, and was finally enacted into law by Congress, 
 with little change, March 24th, 1864. This was the consumma- 
 tion ; a degree of comparative perfection had been reached. The 
 Ambulance Corps was complete in organization, personnel, and 
 equipment. Its officers, however, were not medical officers, but 
 line officers detailed to the Quartermaster Department; and it 
 was a part of the quartermaster transportation; but under the 
 control of the Medical Director. This feature was not ideal but 
 seems to have worked well. The principal objection is that the 
 ambulance officers could render no aid to the wounded. 
 
 The ambulance company of a corps — 20,000 to 25,000 men- 
 consisted of the following : 
 
BATTLE OF THE WILDERNESS. 5 
 
 One Captain I 
 
 One 1st Lieut, to each division 3 or 4 
 
 One 2nd Lieut, to each brigade 9 to 12 
 
 One Sergeant to each regiment 40 to 60 
 
 Three men to each ambulance 400 to 500 
 
 Two men to each wagon 6 to 8 
 
 The total is 13 to 17 officers and 500 to 600 enlisted men to a 
 corps, a little larger than our modern division. 
 The transportation was : 
 
 Two army wagons to a division 6 to 8 
 
 One to three ambulances to a regiment. 140 to 180 
 One cavalry forge to a division 3 to 4 
 
 Total, 150 to 190 vehicles to a corps; 45 to 50 to a division. 
 A typical division ambulance company was that of the First 
 Division, Second Corps, 7,000 to 8,000 men. 
 
 5 officers. 2 army wagons. 
 
 21 sergeants. 1 forge. 
 
 230 men. 45 ambulances. 
 
 Ambulances were not confined to their own divisions; the 
 commander of the ambulances of a corps could use all the ambu- 
 lances wherever needed. The ambulances were all two-horse ve- 
 hicles; they carried as many sitting patients as ours of today, 
 but; as a rule, only two reclining patients. The four litter ambu- 
 lance of General Rucker had not yet come into general use. This 
 personnel and equipment may be compared with ours of today. 
 
 Field Hospitals. 
 
 A field hospital was organized for each division (6,000 to 8,000 
 men). The personnel and equipment depended on the size of the 
 division, so it was not the same in all divisions, but was about 
 as follows: 
 
 Three permanent medical officers. 
 Thirty-six enlisted men. 
 Six to eight wagons. 
 Twenty-five hospital tents. 
 
(i CAPTAIX LOUIS C. DUXCAX. 
 
 With each division there were also a number of contract sur- 
 geons; how many, I am unable to learn. 
 
 There were about fourteen army wagons and four medicine 
 wagons of a special type to each division. Two wagons car- 
 ried the tentage, two carried cooking utensils, rations, and sup- 
 plies, and ten carried the brigade and regimental supplies; all 
 these were available for the field hospital. 
 
 When the Army crossed the Rapidan a light field hospital in 
 about six wagons followed each division; the remainder of the 
 wagons were with the great supply trains. There is no intimation 
 in any report that I have seen that these hospitals were inade- 
 quate. There was, of course, a shortage of clothing and tentage ; 
 fortunately the weather was fine throughout the battle. Many 
 of the wounded had only shelter tents for protection, and many 
 others had but the shade of the trees. 
 
 The division hospital was based on the size of the division and 
 the number of regiments in it. A good example is the hospital 
 of the First Division, Sixth Army Corps. 
 
 Four medicine wagons, Autenreith. 
 Seventeen army wagons, six-mule. 
 Twenty-four hospital tents. 
 Thirty-four attendants. 
 
 Eight wagons carried the regimental supplies (twenty regi- 
 ments) ; four the brigade supplies ; and five the field hospital. 
 The four medicine wagons were assigned to the four brigades but 
 also formed part of the field hospital. In fact, the hospital could 
 be divided into brigade sections. The Medical Director ef the 
 Army says that one of these hospitals could be set up or taken 
 down and packed in forty-five minutes. An official circular di- 
 rected: "When practicable the hospitals of the different divisions 
 should be located near together — each one, however, to be kept 
 perfectly independent and distinct in its management." The 
 division hospitals were pitched and operated in brigade sections, 
 with an operating table and a medicine wagon for each. 
 
 The Cavalry Corps had no division hospitals but had a corps 
 hospital of 22 tents, similar to the division hospitals of infantry. 
 
 This hospital, however, never accompanied the cavalry on the 
 great raids and did not accompany it in the Wilderness Cam- 
 paign. 
 
BATTLE OF THE WILDERNESS. 7 
 
 When the Cavalry Corps broke camp at Brandy Station only 
 a few ambulances were taken along, with light supplies. The 
 field hospital was packed and shipped back to Alexandria, where 
 it remained, till about May 15th, when it was forwarded to Fred- 
 ericksburg. It continued to hover around the field of operations 
 and was in reality an evacuation hospital. The Cavalry Corps 
 picked up wagons of all kinds on the march, but carried a few 
 ambulances. One of the main reliances was the ammunition 
 wagons, which, as a medical officer noted, were always emptied 
 just as they were needed. It does not appear that there were 
 many casualties among the cavalry in the Battle of the Wilder- 
 ness. 
 
 The Engineer battalions, Reserve artillery, and General Pat- 
 rick's provost guard also had their supplies, ambulances, and 
 hospital tents. 
 
 The Ninth Corps, which did not become a part of the Army 
 of the Potomac until May 25th, was very poorly provided with 
 transportation of all kinds and had almost no divisional medical 
 equipment. It was in about the same situation' as were all the 
 divisions two years earlier. 
 
 Its wounded, not many, were largely cared for by the other 
 divisions. ■ 
 
 Reserve Supplies. 
 
 In addition to the supplies carried by the divisions there was 
 an army reserve supply train of thirty-five wagons, with the 
 main supply trains. By 5 p. m. on May 5th this train was near 
 the Old Wilderness Tavern, the center of the Union lines, ready 
 to fill requisitions. The medical officer in charge of this train 
 seems to have been disappointed that after all his exertions in 
 getting his train to the front no one called on him for supplies. 
 The first day's fighting just about measured the capacity of the 
 hospitals ; the second day called for all his bedding and clothing ; 
 his general supplies were requisitioned for the great train of 
 wounded, as well as to replenish the wagons and ambulances for 
 the next conflict. There was also a considerable amount of medi- 
 cal supplies and stores carried on five wagons belonging to the 
 Sanitary Commission. These wagons carried chiefly delicacies of 
 food, clothing and bedding. 
 
8 CAPTAIN LOUIS C. DUNCAN. 
 
 The whole amount of medical supplies carried with the Army 
 was calculated to be sufficient for ordinary needs for thirty days, 
 and eight days' supplies for 20,000 wounded in addition. The 
 wounded in large numbers were to be evacuated to the rear with- 
 in eight days. 
 
 Provision was also made for sending large quantities of sup- 
 plies (bedding, clothing, dressings, medicines, and special foods), 
 from Alexandria to the evacuation hospitals. Cars stood on the 
 tracks, loaded and ready to start at a moment's notice. 
 
 The train of reserve supplies proved a necessity; the number 
 of wounded counted on — 20,000 — was far exceeded before thirty 
 days had passed. In fact, it was nearly if not quite doubled. The 
 first ten days of the campaign left more than 25,000 wounded to 
 be cared for, besides sick and some of the enemy's wounded. 
 
 Transportation of Wounded to Advanced Base 
 
 Depot hospitals had heretofore been established, sometimes on 
 or near the field, sometimes further back or at the advance 
 base. 
 
 In this campaign they had been at Brandy Station about ten 
 miles north of the Rapidan. But when the Army crossed the 
 river these hospitals were broken up and the supplies shipped to 
 Alexandria. 
 
 Still it seems to have been the intention to retain this point, or 
 Rappahannock Station, as the advance base for a time. Instead 
 of keeping medical supplies there, hospital trains were waiting 
 and a large quantity of supplies were held in readiness by the 
 Medical Supply Officer at Alexandria, but six hours to the rear. 
 From Alexandria these supplies could be quickly forwarded, 
 either to Brandy Station on the right flank of the Army, or to 
 Fredericksburg on the left. 
 
 No provision was made for tentage, however, at either place, 
 and when the wounded did reach Fredericksburg it was neces- 
 sary to utilize buildings of all kinds. From either place the 
 wounded could be readily evacuated to Washington and the 
 North. Hospital trains had been especially devised for the 
 Orange and Alexandria Railway ; these trains of twelve cars car- 
 ried from 300 to 400 patients, in comfortable bunks. Formerly 
 
BATTLE OF THE WILDERNESS. 9 
 
 the wounded had been carried in freight cars bedded with straw. 
 From Fredericksburg there was a short railway to Aquia Creek, 
 from that point fine hospital boats carried the wounded to Wash- 
 ington. The only gap in the line was that part between the field 
 hospitals and the depot (evacuation) hospitals. There were 
 stretchers and ambulances at the front, trains and boats in the 
 rear ; but for this mid section of the route there was neither per- 
 sonnel nor equipment. 
 
 Empty supply wagons and the division ambulances (improp- 
 erly) were to be used. The service proved unsatisfactory as will 
 be seen. 
 
 II. MARCH TO THE FIELD. 
 
 The movement began with the first moments of May 4th, 1864; 
 the .divisions and corps, the reserve artillery, and immense trains 
 moved out at midnight without confusion or delay and poured 
 across the river into the Wilderness. Alexander bears witness 
 that among Grant's great qualities was one of making his battles 
 come off on time. 
 
 Hancock's (Second) Corps on the left, crossing at Ely's Ford, 
 followed the Ely's Ford Road and reached Chancellorsville by 
 nine in the morning, where it went into bivouac for the rest of the 
 day. Warren's (Fifth) Corps on the right, crossing at Ger- 
 manna Ford, followed the plank road and reached Old Wilder- 
 ness Tavern in the afternoon, going into bivouac there. Sedg- 
 wick's (Sixth) Corps followed the Fifth Corps along the Ger- 
 manna Plank Road and bivouacked for the night about two miles 
 south of the FoTd. All the corps were now on one road leading 
 to the Southeast, with the Second Corps in advance and the Sixth 
 Corps in the rear. 
 
 Although the wagon trains had been reduced they still num- 
 bered more than 4,000 wagons and formed a column that on a sin- 
 gle road would have extended more than seventy miles. The 
 trains crossed on the lee side of the Army, at Culpepper Mine and 
 Ely's Fords, not being all over till the evening of the fifth. They 
 moved slowly on to Chancellorsville where they remained until 
 the eighth. 
 
 When the Army marched out at midnight each division was 
 followed by one-half its infantry ammunition train, one-half its 
 
10 CAPTAIX LOUIS C. DUXCAX. 
 
 ambulances, and a flying field hospital. The only other transporta- 
 tion was a few light spring wagons with the various headquar- 
 ters, about fifteen to each corps. The remaining ammunition 
 wagons, ambulances and hospital wagons were with the great sup- 
 ply trains, about five miles away. 
 
 This was an improvement on Gettysburg, where everything 
 was kept far in the rear. Each soldier carried fifty cartridges and 
 three days' rations. The supply trains carried ten days' rations 
 and three days' forage. 
 
 The weather was fine and the roads good ; the enemy offered no 
 opposition and the seasoned troops made the fifteen miles' march 
 without fatigue. On the evening of the fourth all were confident 
 and joyful in the bivouacs, as though Fredericksburg and Chan- 
 cellorsville had never been inscribed on their colors. But death 
 lurked in every ravine and peered from every thicket of the Wil- 
 derness. 
 
 More than two thousand of these men were to leave their bones 
 on the field, twelve thousand more were to be wounded, besides 
 three thousand missing, many of whom were killed or wounded. 
 When the Army took up the march for Spottsylvania, three days 
 later, almost one man out of every four was missing from the 
 ranks. 
 
 III. SERVICE OE THE FRONT. 
 
 Ambulance Corps. 
 
 When the battle began, about eight on the morning of the fifth, 
 the ambulance sections of all the divisions were ready for the 
 work. 
 
 The men were vigorous, the animals in good physical condition, 
 and all the material was complete. Officers and men were rested 
 and it is fortunate that they were so, for they had little rest again, 
 either day or night, for ten days. 
 
 First aid and collection of the wounded differed somewhat in 
 the different divisions ; Billings deemed the method of the Fifth 
 Corps best. Stretcher bearers followed the lines closely and 
 often displayed great heroism in carrying off the wounded. Any 
 temporary advance or lull in the combat was promptly taken ad- 
 vantage of. There was no thought of waiting till the battle was 
 over, or even until night. The bearers removed the wounded to 
 
BATTLE OF THE WILDERNESS. 11 
 
 sheltered spots called depots for wounded, or ambulance pickets, 
 from three to five hundred yards behind the firing line. There 
 was no Hospital Corps at this time, unless one should call the 
 hospital stewards a hospital corps. 
 
 The sergeants and men of the Ambulance Corps were detailed 
 rrom the line. Some hospital stewards accompanied the bearers 
 in collecting the wounded and the regimental surgeons, stewards, 
 and orderlies did the work of the aid or dressing stations. 
 
 In the Wilderness these stations could be established very 
 close to the firing line, even for that period. In the Second and 
 Sixth Corps there was a station for each brigade, in the Fifth one 
 for each regiment (about 400 men). The ambulances were col- 
 lected at an ambulance station further back; usually all the divi- 
 sion sections in one park, and near the field hospitals. Two or 
 three ambulances were kept ready at the advance station; when 
 sufficient wounded had accumulated these ambulances were 
 loaded, moved to the field hospital, unloaded, and returned to 
 the main ambulance station. Thus few ambulances were exposed 
 at one time. At the main ambulance station there was a medicine 
 wagon, and dressings were carried to the front by the ambu- 
 lances. 
 
 It was laid down that the stations were to be established at 
 points to which ambulances could come forward. 
 
 The officers of the Ambulance Corps directed the work of the 
 bearers as well as of the ambulances. Temporary dressings only 
 were applied at these stations and temporary medicines given. 
 No operations of any importance were undertaken. 
 
 In this battle the distance from the advance stations to the 
 field hospitals averaged about one and a half miles. The ambu- 
 lances followed by-roads, as a rule, leaving the main roads free 
 to troops and ammunition wagons. 
 
 The fighting began early on the fifth but was not general and 
 severe until about noon. Many wounded straggled back to the 
 hospitals. McParlin estimated this number in general as about 
 ten to twenty per cent of the whole. Of course the poorer the 
 ambulance service the larger the per cent of wounded not (ap- 
 parently) requiring transportation. With no ambulances what- 
 ever fifty per cent of the wounded would probably manage to 
 reach the field hospitals. But this number should by no means be 
 
12 CAPTAIN LOUIS C. DUNCAN. 
 
 used as a basis for estimating necessary ambulances. Many 
 wounded would injure themselves in this way; worse, a large 
 number of able-bodied men would leave the field under the pre- 
 text of assisting the wounded. 
 
 The number brought in on this day was : of the Second Corps, 
 600; of the Fifth Corps, 1,235; 0I the Sixth Corps, 1,000; total, 
 2,835. 
 
 Twice this number was brought in on the second day and 
 night. The total number of wounded cared for in the two days 
 was 8,300, as estimated by McParlin. The ambulances of the 
 Fifth and Sixth Corps traveled fifty miles on the second day, and 
 this was entirely in collecting; no wounded were sent to the 
 rear until later. It is apparent that in a battle like the Wilder- 
 ness one ambulance to 150 men was about the proper allowance. 
 Every wounded man that could be found or safely reached was 
 brought off the field promptly. A considerable number of 
 wounded were too near the enemy's pickets to be reached and 
 many could not be found in the thickets. About two hundred 
 were estimated to have perished in the fires that burned along the 
 front of the Second Corps on the afternoon of the second day. 
 Several hundred of the enemy's wounded were also brought in. 
 
 The ambulance men had little rest on these two days and 
 nights. On the 7th they found time to search the field for 
 blankets and shelter tents. They brought in over 4,000 of these 
 useful articles, sorely needed in the hospitals, where clothing and 
 shelter were the only supplies short. 
 
 The ambulances of each Army Corps acted as a unit in collect- 
 ing the wounded. Some extracts from the report of the chief 
 ambulance officer of the Fifth Corps will throw additional light 
 on ambulance work. This corps on May 1st numbered 24,423 
 officers and men, in four divisions, n brigades, 57 regiments and 
 nine batteries. 
 
 The Ambulance Corps consisted of 17 officers and about 650 
 men. 
 
 In the ambulance train there were 176 ambulances, 10 medi- 
 cine wagons, 58 army wagons, and four field forges. Of animals 
 there were 524 horses and 349 mules. During the campaign six 
 enlisted men were killed and twenty wounded; nine were taken 
 prisoners. Two horses were killed, sixteen wounded and three 
 captured. The ambulance train includes hospital wagons. 
 
BATTLE, OF THE WILDERNESS. 13 
 
 On June 1st this army corps numbered 19,321 — almost the 
 same as one of our modern divisions. The captain of the ambu- 
 lance corps may be compared with the director of ambulance 
 companies of a modern division. 
 
 * * * Report of Capt. Wm. F. Drum, 2nd Inf., Chief Ambu- 
 lance Officer, Fifth Army Corps, from May ist to June 30th, 
 1864. * * * 
 
 Headquarters, Fifth Army Corps, July 10th, 1864. 
 
 To Surgeon John J. Milhau, U. S. Army. 
 Medical Director, Fifth Corps. 
 
 Sir: I have the honor to submit a brief report of the operations of the 
 Ambulance Corps of the Fifth Army Corps, from the commencement of 
 the present campaign till June 30th, 1864. 
 
 On the march but a portion of the ambulances accompanied each divi- 
 sion, the majority with the heavy portion of the trains (hospital trains) 
 being generally ordered either in rear of the corps, or on some road that 
 would not interfere with the marching of troops. * * * A portion of 
 the hospital train was several times detached and sent to join the main 
 train of the Corps, but after each battle the whole train was brought to 
 the front. In all the battles the principal in the management of the train 
 has been the same — that is, the ambulances have been sent where they 
 were most needed without reference to any particular division. If any 
 _ of the divisions suffered much more than the others the majority of the 
 ambulances in the corps were used in transporting the wounded of that 
 division. The next day some other divisions might suffer most, in that 
 way the work was in the end about equal. 
 
 At the commencement of a battle I have generally parked my whole 
 train of ambulances (176) at some central point, under charge of an 
 officer. 
 
 I would then send a few ambulances as near as possible to the line of 
 battle of each division; * * * as fast as the ambulances at the front 
 were loaded and sent to the hospital, the officer in charge of the main 
 park would send others to take their places ; in this way placing the whole 
 train at the disposal of the division most in need. 
 
 In the disposition of the officers, I placed one in charge of the main 
 park, one or two to superintend the loading at each division, and the 
 remainder to superintend the removal of the wounded from the field to 
 the ambulances. It was also sometimes necessary to have an officer at the 
 hospital to expedite the unloading. * * * 
 
 Owing to the difficulty in procuring forage, and the severe work they 
 were subjected to, some of the teams were much reduced, and a few of 
 the animals were lost; but not an army wagon was abandoned and but 
 four ambulances. These were left on the road, having broken down and 
 there was no time or means at hand to repair them. From the time we left 
 
U CAPTAIX LOUIS C. DUXCAX. 
 
 Culpepper till after we crossed the Chickahominy not a particle of grain 
 was drawn from the Corps Quartermaster for the ambulance trains. The 
 train supplied itself when within reach of a depot, and when corn could 
 be found in the country it was seized. 
 
 In order to keep a train foraged properly it is necessary to keep two 
 wagons in each division train for the purpose of hauling forage. 
 
 * * * It also requires at least one wagon to carry the Q. M. prop- 
 erty and personal effects of the ambulance officers. * * * 
 
 During the campaign the ambulance train of the Fifth Army Corps had 
 removed over 8,000 wounded men from the field of battle to the hospital, 
 and assisted in removing the same number and over one thousand sick to 
 the depots to be sent North. * * * 
 
 W. F. Drum, Capt. and Chief Ambulance Officer, Fifth Corps. 
 
 Yet this splendid ambulance corps is never mentioned in a re- 
 port of a general officer; indeed one might read the reports of 
 line officers without knowing that the Army had either field hos- 
 pitals or ambulances. On the other hand, the report of the Medi- 
 cal Director of the Army for this period is the best and most 
 complete report made by any officer of the Army. 
 
 In 1898 Colonel Greenleaf followed the plan of these organiza- 
 tions closely, and the Fifth Army Corps had both field hospitals 
 and ambulance trains organized at Tampa. Unfortunately those 
 in control of the expedition either had forgotten the experience 
 of '61, or considered these things of lesser importance, for al! 
 wagons were left behind and all but three ambulances. So soon 
 are lessons learned in the dear school of experience forgotten. 
 
 . Field Hospitals. 
 
 On the morning of May 5th the Army was in a sort of a huge 
 column of masses along the Germanna Ford and Orange Roadi. 
 On learning that Lee's corps were pressing on from the West to 
 strike his column in flank, Grant, instead of pursuing the march, 
 faced his divisions to the right and pushed them forward one or 
 two miles in the woods to the west and south, where they formed 
 an irregular line of battle and constructed temporary intrench- 
 ments. The line of battle advanced and was pressed back as the 
 conflict rose and fell but did not vary much from this first estab- 
 lished line. It was about the right distance in front of the Ger- 
 manna Road to make it the fighting base of the Armv. Head- 
 
BATTLE OF THE WILDERNESS. 15 
 
 quarters was at the Lacy House near the Tavern, with the 
 reserves, ammunition wagons, and hospitals on or near the road. 
 I am unable to learn who located these hospitals. 
 
 The hospitals of the Second Corps were grouped together near 
 the Carpenter House, an excellent location, with running water 
 and two good ambulance roads to the front, a mile to a mile and 
 a half away. It was in advance of the main road but interfered 
 with no other hospital or troops. 
 
 The hospitals of the Fifth Corps were also grouped together, 
 near a small stream which crosses the Orange Pike one mile 
 east of the Tavern. 
 
 They were a little farther from the front than the others and 
 on the main road, being a mile directly behind the headquarters 
 of the Army. 
 
 Water was obtained from some excellent springs nearby and 
 fuel was abundant everywhere. Everything was ready at this 
 hospital an hour before the wounded began to arrive. It is 
 worthy of note that a surgeon with attendants was stationed at 
 the Tavern, to dress the wounded who might be straggling along 
 the road to the rear. Between noon and nine P. M. on the 
 fifth the hospital received, dressed, fed, and sheltered 1,235 
 wounded men. Also records were kept of all cases. One sees 
 why Billings spoke so highly of the medical work of this corps. 
 
 The Sixth Corps stretched from the right of the Fifth on 
 north to the Rapidan. It was somewhat more extended than the 
 other corps and its division hospitals were pitched separately. 
 The Hospital of the First Division was at the Spottswood House 
 on the Germanna Plank Road; that of the Second Division was 
 behind the road, on Wilderness Run, near the Woodville Mine; 
 that of the Third Division was near the Tavern. 
 
 These hospitals do not appear to have been well located ; they 
 were too near the front and that of the Third Division was on the 
 road leading to the hospitals of the Fifth Corps, which was liable 
 to mix the wounded unnecessarily. It appears that they should 
 have been located back of the Germanna Road, on roads leading 
 to Culpepper Ford. 
 
 On the evening of the Sixth when Gordon's flanking attack 
 rolled up Rickett's Division and forced it back, some shells fell 
 about the Spottswood House, but did little damage. That night 
 
16 CAPTAIN LOUIS C. DUNCAN. 
 
 all the hospitals of the Sixth Corps were removed and collected 
 near Dowdall's Tavern. By this time the battle had shifted to 
 the left and one of Sedgwick's divisions was fighting in Han- 
 cock's line. In reality the battle was over, but no one then 
 knew it. 
 
 By the morning of the seventh practically all the wounded were 
 in. The influx to the Second Corps hospitals was so great that 
 the keeping of records was impossible and a thousand or more 
 wounded were unrecorded. The heaviest fighting on the after- 
 noon of the sixth had been in this quarter; General Grant 
 termed it the hardest fighting ever seen on the continent. The 
 hospitals must have been literally swamped. No wounded were 
 evacuated to the rear ; by the morning of the seventh these eleven 
 field hospitals contained between eight and nine thousand 
 wounded. Fortunately the weather was fine and there was 'io 
 suffering from exposure. 
 
 Billings reported later that the hospitals had been at all times 
 supplied with everything necessary except bedding and clothing. 
 This was the principal shortage reported at many field hospitals 
 in many places. 
 
 The organization of a field hospital was that of Letterman : 
 
 One officer in charge. 
 
 One officer to provide food and shelter. 
 
 One officer to keep records. 
 
 Three operating surgeons. 
 
 Two or three assistants to each operator. 
 
 Total, twelve to fifteen officers. 
 
 About thirty-six attendants. 
 
 The first three only were permanent officers. The three operat- 
 ing surgeons were, as a rule, the brigade surgeons of the division. 
 They and their assistants were temporarily detailed to the hos- 
 pital before an engagement. 
 
 The majority of cases were operated on before being sent to the 
 rear, the number of primary operations being very great. The 
 amount of work done at these field hospitals is not apparent at a 
 glance. A little calculation will show it to have been enormous. 
 For example, the hospitals of the Fifth Corps attended over 1,200 
 wounded between noon and nine p. m. on the fifth. This gives 
 300 wounded for each of the four division hospitals, or 100 for 
 
BATTLE OF THE WILDERNESS. 17 
 
 each brigade section. Counting one-fourth as slightly wounded, 
 there were yet 75, allowing each man but eight minutes on the 
 operating table. 
 
 We, who today in our hospitals think four or five operative 
 cases a big day's work may have some adequate idea of the 
 amount of work required to care for seventy-five cases in nine 
 hours. It is true that there were no long tedious operations iri 
 those days. But there were many more operations — such as 
 amputations, excisions, ligations and the like. 
 
 Following this battle there were 108 excisions and 560 ampu- 
 tations. The statistics of this battle and Spottsylvania throw an 
 interesting light on the use of the bayonet. These two battles 
 are generally, and rightfully considered as the most murderous 
 of the war. The lines were very close and, more especially at 
 Spottsylvania, hand to hand. A writer in "The Photographic His- 
 tory of the War" says, "The Bayonet ended what the rifle began." 
 Surely here, if anywhere, we shall see bayonet wounds. There 
 were 16,331 wounded recorded by McParlin from these battles. 
 In all the two days' struggle in the Wilderness there were just 
 four men wounded with this weapon. Probably more than that 
 number were rendered hors du combat by being kicked by mules. 
 In the five days' struggle about Spottsylvania, including Upton's 
 charge and the long, desperate contest at the Bloody Angle, there 
 were but fourteen bayonet wounds, an entirely negligible per- 
 centage. 
 
 When all the wounded had been collected the remaining regi- 
 mental officers could also be called in to assist at the division 
 hospitals. The chaplains usually assisted in the record office. 
 About this time a commissary officer was assigned to each divi- 
 sion hospital. For dressing, nursing and such work there were 36 
 men, more or less permanently detailed. These men were taken 
 from the line. All the band men of the division were to assist at 
 the division hospital, particularly at fatigue work. They proved 
 to be of little value for this purpose, as might have been ex- 
 pected. 
 
 The success of the Ambulance Corps and Field Hospitals in 
 collecting, sheltering, feeding, and dressing the wounded was 
 truly remarkable ; and in striking contrast to the appalling results 
 of the bold and strenuous surgery of those days. 
 
IS CAPTAIX LOUIS C. DUNCAN. 
 
 The keeping of records was not entirely successful. There 
 were records of 7,300 wounded treated in the hospitals, and Mc- 
 Parlin estimated that of 1,000 more wounded no records were 
 made. It seems probable that the number unrecorded was much 
 greater than a thousand. This I should say was due to an in- 
 sufficient number of competent noncommissioned officers and 
 other enlisted men. Thirty-six to a field hospital is manifestly 
 not enough. Our present allowance is none too large. There 
 seems to have been a sufficient number of officers. 
 
 The ambulance company camped near the hospital and its men 
 assisted in pitching the tents and other work when possible. 
 
 All the work of dressing and operating was finished by the 
 evening of the seventh. That evening General Meade ordered 
 all the wounded collected in one great train and sent back to the 
 railway, and to Washington. The work of loading the wagons 
 and ambulances went on all that night. 
 
 IV. SERVICE OE THE REAR. 
 
 The weak point in the Letterman system was that there was 
 no provision for systematic removal of the wounded from field 
 hospital to the advance base at head of rail or water transporta- 
 tion. Letterman did not remain in the Service to work out this 
 last detail, and it can hardly be said to have been worked out 
 today. The expectation was that after the wounded had all been 
 collected, at least a part of the ambulances could be released, and 
 that these, with empty supply wagons returning to the base, 
 would be sufficient. In the days of McClellan and Hooker, when 
 the Army fought a battle and then rested for some months, this 
 expectation was generally realized ; though it failed signally when 
 Lee pressed McClellan day after day on the Peninsula. With 
 Grant at the head of the Army, fighting one desperate battle- 
 after another, it was bound to fail. After the Wilderness, using 
 all the ambulances and wagons that could be spared, there was 
 still not enough transportation; and that was not the only ill re- 
 sult. The ambulances that went with wounded to Fredericksburg 
 did not get back in time for the opening struggles about Spottsyl- 
 vania; and when they did get back they were stripped of their 
 supplies, and men and animals were exhausted by seven days 
 
BATTLE OF THE WILDERNESS. 19 
 
 and nights of continuous work. Also the army wagons were 
 unsuited for wounded men. 
 
 Billings says, "The greatest amount of suffering to the wounded 
 has occurred necessarily during their transit from the field to the 
 depot hospitals. Army wagons have necessarily been used, and 
 the distance traveled has usually been ten to twenty miles ; the 
 patients on several occasions remaining from 24 to 48 hours in 
 the wagons." The suffering arising from this management cannot 
 be imagined. Of the wounded in one train fourteen died on the 
 road. 
 
 On May 7th there was no fighting; that evening General 
 Meade ordered all the wounded collected in one huge train and 
 sent back to the railway, and to Washington. For this train 
 supply wagons to the enormous number of 325 were emptied and 
 turned over by the Quartermaster Department. 
 
 To these were added practically all the ambulances of the 
 Army, 488 in number. These 813 vehicles with their attendants 
 and the wounded able to march made a column seven miles long. 
 Yet with this great train more than a thousand were left behind. 
 Some of these, of course, could not bear transportation. A part 
 of them were brought in later, some were carried away to Rich- 
 mond as prisoners, very many died. 
 
 The wagons were prepared- by bedding them with boughs cov- 
 ered with shelter tents and blankets. The wounded were divided 
 into three classes : first, those able to march ; second, those able to 
 ride in wagons ; third, the severely wounded, who were carried in 
 ambulances. This tragic procession conveyed over 7,000 maimed 
 and suffering men. What an argument for peace advocates would 
 be a moving picture film of this column as it dragged along the 
 Fredericksburg Pike that day. 
 
 To care for it there were detailed 30 medical officers, 15 stew- 
 ards and 150 men. Rations, dressings, and medicines for three 
 days were supplied. The Quartermaster Department offered 
 every facility, without which the wounded could not have been 
 removed. 
 
 The loading began during the night of May 7th. The ambu- 
 lances were loaded with the worst cases and sent off first, ac- 
 companied by those able to march on foot. The train moved 
 very early on the morning of the eighth and had passed Ely's 
 Ford, when an order came to turn back and proceed to Fred- 
 
20 CAPTAIN LOUIS C. DUNCAX. 
 
 ericksburg. The Army was moving southeast toward Spottsyl- 
 vania and the temporary base had been shifted. The train of 
 wounded then moved by the Pike, escorted by two small regi- 
 ments, and reached Fredericksburg at i a. m. on the 9th; hav- 
 ing been more than thirty hours on the road. No deaths are 
 recorded. Fortunately the wounded were not loaded in a driving 
 rain and the march made through mud, darkness and storm, as 
 happened a few days later. 
 
 Meanwhile the medical supplies held ready at Alexandria (sup- 
 plies for 3,000 men for seven days) had been forwarded to Rap- 
 pahannock Station on the eighth, brought back to Alexandria on 
 the ninth, and again forwarded to Fredericksburg — or Belle Plain 
 — reaching there on the tenth, one day late. The Surgeon General 
 sent two Medical Supply Steamers direct from Washington, and 
 it is worthy of notice that these were the first supply boats of any 
 kind to reach the new base. They were at Belle Plain before any 
 wounded arrived there. 
 
 The ambulances were stripped of their supplies and started 
 back the same evening, reaching the Army again on the tenth. 
 It is hardly necessary to say that every one with them was ex- 
 hausted. The ambulances had been needed on the eighth for the 
 fighting about Todd's Tavern. In their absence the wounded 
 straggled over the country causing much confusion. But that 
 story belongs to another battle. 
 
 Fredericksburg was again converted into a hospital. All the 
 public buildings were taken and many private ones. Wounded 
 officers were billeted on families. There was a famine of sup- 
 plies at first but this was soon remedied, as seen above. The 
 wounded were grouped by corps in certain parts of the town. On 
 May 10th the supplies began to arrive from Alexandria, and with 
 them a force of surgeons. The remaining wounded from the 
 Wilderness arrived in the next four days; meanwhile another 
 stream was pouring in from Spottsylvania. 
 
 The evacuation of wounded to Washington began at once, the 
 most serious cases being sent first. The route was by road to 
 Belle Plain or by railway to Aquia Creek; from there by boat. 
 On May 20th 300 hospital tents arrived and as many as possible 
 of the wounded were removed to these tents, pitched outside 
 the town. 
 
BATTLE OF THE WILDERNESS. 21 
 
 By May 28th all the wounded had been removed ; the hospital 
 was broken up and the supplies sent to White House, the next 
 base of the Army. During the nineteen days that this hospital 
 was in existence at Fredericksburg more than 26,000 wounded 
 and sick passed through it. I believe this is the record for num- 
 bers and time. 
 
 It will be noted that no evacuation hospitals were brought for- 
 ward to the .battlefield, as at Antietam and Gettysburg. The 
 field was cleared of wounded and abandoned. This w ( as because 
 it was in the enemy's territory and unsafe. Also it was in an 
 unfavorable locality, aWay from the railroads. In order that 
 empty supply wagons could be used for the wounded it was neces- 
 sary that the evacuation hospital be at the supply base, at the 
 head of rail transportation. 
 
 COMMENTS. 
 
 Little fault can be found with the organization of the Medical 
 Department or the order specifying what parts of it should march 
 with the troops. Defects which have been remedied since were: 
 in personnel of the ambulance corps; insufficient number of per- 
 manent officers with field hospitals ; and the single aid and dress- 
 ing station combined. 
 
 The complete breaking up of the base hospital at Brandy Sta- 
 tion does not appear to have been entirely advisable. It is true 
 that Alexandria was but six hours away and that supplies were 
 sent forward promptly. In spite of a false start they reached 
 Fredericksburg but one day late. But these supplies did not in- 
 clude tentage. Had the seven thousand wounded been taken 
 to the railway as started, they would have been unloaded at the 
 station without shelter, instead of at Fredericksburg, where there 
 were plenty of buildings. Aside from the question of shelter 
 there could be no criticism. At any rate the error, if it be an 
 error, was not of the Medical Department. The base at Brandy 
 Station was abandoned by order of the general, probably to 
 avoid sparing troops to guard it. 
 
 On May 8th the Army was stripped of ambulances, and a great 
 battle beginning. There was some severe fighting that day in 
 front of Todd's Tavern, resulting in some fifteen hundred 
 wounded. McParlin says, "Slightly wounded men were strag- 
 
■>2 CAPTAIX LOUIS C. DUXCAX. 
 
 gling all over the country, in every direction except toward the 
 front. The stretcher bearers labored faithfully, but the number 
 of wounded was so large, and the distance that they had to be 
 carried was so great that the evils mentioned could not be pre- 
 vented." As a partial remedy, all the headquarters wagons of the 
 whole Army (about sixty) were seized and used as ambulances. 
 
 When the next train of wounded was made up wagons alone 
 were used ; no ambulances were allowed to leave the front. These 
 wagons were uncomfortable and insufficient in numbers. 
 
 Holding all wounded in the hospitals until the night of the 
 7th was by direction of the Commanding General. But they 
 could not have been started earlier in any event from lack of 
 transport. Could a stream of wounded have been started to the 
 rear on the afternoon of the 5th, the over-crowding of field hos- 
 pitals would have been much lessened. 
 
 The gathering of blankets and shelter tents from the field is an 
 interesting thing. It seems to have been a regular procedure in 
 this campaign, and furnished the only bedding and shelter for 
 thousands of wounded. 
 
 The Autenreith Medicine Wagon was so universally used, ap- 
 proved, and commended that one feels like prophesying that in 
 case of a great and long continued war a similar wagon would 
 again come into use. All medical officers thought it superior to 
 a heavy wagon with medicines packed in boxes. This type ot 
 wagon required no packing and unpacking. 
 
 The principal differences between the whole system of sanitary 
 tactics then and now are two. The ambulance train was then a 
 quartermaster organization. The change to a medical personnel 
 has been made recently. This places the entire management of 
 the wounded in the hands of the medical department. It leaves 
 regimental officers free for their own work ; it places the hand- 
 ling of the wounded in medical hands ; it gives a larger force to 
 draw on for the field hospitals. There is one thing yet lacking — 
 transportation. 
 
 The other great difference is, the general advance in the influ- 
 ence, authority, and prestige of the Medical Department as a 
 whole. In recent years the Medical Department has become, 
 after the line, one of the most important parts of the Army. 
 
BATTLE OF THE WILDERNESS. 
 
 23 
 
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 THE WILDERNESS CAMPAIGN, I,INES OF COMMUNICATION. 
 
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 CAPTAIN LOUIS C. DUNCAN. 
 TJELV HOSPITAL^. 
 
 ■ GerMM Jird 
 
 THE WILIlLfiNESS . 
 
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 FIELD HOSPITALS, BATTLE OF THE WILDERNESS. 
 
BATTLE OF THE WILDERNESS. 25 
 
 After all criticisms have been made it must be said that the 
 organization of the Medical Department of the Army of the Po- 
 tomac was, for the times, excellent, and that its operations during 
 the Battle of the Wilderness were in the main satisfactory. In 
 fact, one reads of the sanitary tactics of those days with amaze- 
 ment that they should have been so good ; and easily imagines that 
 he is reading of the events of today. If the reader turns to the 
 surgical records, he goes back to a distant age, and might easily 
 imagine himself reading of the surgery of the ancient Egyptians. 
 
 If, taking into consideration the advances in military science, 
 improvements in communication and transportation, and the 
 science of efficiency in labor, the Medical Department in the nexr 
 great war is proportionately as successful as was that of the 
 Army of the Potomac in 1864, it will not have to seek excuses 
 and apologies for its conduct. 
 
 But it should not be forgotten that the work done at the Wil- 
 derness was the fruit of three years' experiments, ranging from 
 dismal and total failure at Bull Run to comparative success at 
 Gettysburg. The cause of failure was lack both of system and of 
 personnel and equipment. 
 
 At present we have an admirable system. 
 
 It is to be regretted that no medical officer who took part in 
 these campaigns has put his experience in writing for the benefit 
 of those of us who have had no such opportunity. I hope it is 
 not yet too late. Such memoirs have an incalculable value. 
 
APPENDIX. 
 
 Medical officers of the Army of the Potomac, at the time of the Battle 
 of the Wilderness: 
 
 Medical Director: Surgeon Thomas A. McParlin, U. S. Army. 
 
 Assistant Medical Director : Surgeon J. F. Ghiselin, U. S. Army. 
 
 Assistant Medical Director: Asst. Surgeon J. S. Billings, U. S. Army, 
 in charge of records and statistics. 
 
 Medical Purveyor: Asst. Surgeon J. B. Brinton, U. S. Army. 
 
 Medical Director, 2nd Army Corps: Surgeon A. N. Dougherty, U. S. 
 Volunteers. 
 
 Medical Director, 5th Army Corps : Surgeon J. J. Milhau, U. S. Army. 
 
 Medical Director, 6th Army Corps: Surgeon S. A. Holman, U. S. 
 Volunteers. 
 
 Medical Director, Cavalry Corps : Surgeon R. W. Pease, U. S. Volun- 
 teers. 
 
 Surgeon in charge of Depot Hospital, Fredericksburg: Surgeon E B. 
 Dalton, U. S. Volunteers. 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 
 
 FOR the general reader the most interesting campaign of the 
 war is by common consent Sherman's famous "March to 
 the Sea." It has been embalmed in song and story until it has 
 scarcely less renown than its prototype of antiquity so graphically 
 described by Xenophon. Even the name lends itself to euphonious 
 historical literature, like Hohenlinden and Roncesvalles. While 
 it is true that this celebrated march met with practically no op- 
 position, that it was in Sherman's opinion a change of base rather 
 than a campaign, that it was mainly a problem of moving trains 
 and supplying the army, the novelty and picturesqueness of the 
 whole undertaking still make it a never-failing source of con- 
 troversy and study. However simple it looks to us now, it by 
 no means looked so simple before it had been accomplished. 
 Thomas hoped Sherman would not undertake it, Grant was in 
 doubt, and Lincoln was fearful. 
 
 Being a new thing under the sun it opened a number of prob- 
 lems, for the supply departments, the Quartermaster, the Com- 
 missary, and the Ordnance, and also for the Medical Department. 
 Heretofore all campaigns of importance had bases and lines of 
 communications; supplies could be brought up and wounded 
 shipped off to the rear as fast as they accumulated. Now an army 
 of 65,000 men was to cut loose from its base and move into the 
 enemy's country. All supplies, and what was more difficult, all 
 sick and wounded must be carried along, or left behind in the 
 neighborhood of M illen and Andersonville. 
 
 The medical problem was even more difficult than the others; 
 a considerable part of the ration and forage could be gathered 
 from the country, but medical and surgical supplies could not 
 be gathered like sweet potatoes and corn. Transportation for 
 the disabled was still more difficult, in fact, in a severe campaign 
 it would have been impossible. 
 
 Severe fighting was not within the range of reasonable prob- 
 ability; Hood was far away and Lee could spare no man from 
 Richmond. Sherman doubtless expected no great battles, but 
 probably anticipated more fighting than actually occurred. 
 
 Almost everyone considered the proposed march a grave, dif- 
 
2 MEDICAL DEPARTMEXT IX THE CI I IL WAR. 
 
 ficult, and dangerous undertaking. It proved easy to accom- 
 plish. General Cox wrote afterwards that he remembered it as 
 a gigantic outing or picknicking party. But after they are accom- 
 plished most great things look simple; in fact most great things 
 are simple. 
 
 CHATTANOOGA TO ATLANTA. 
 
 While the March to the Sea was the march from Atlanta to 
 Savannah, the campaign leading up to Atlanta is a part of the 
 same grand movement, and a review of some of its most important 
 medical features will be made. 
 
 For this campaign General Sherman had an army of one hun- 
 dred thousand men, or rather he had three armies totalling that 
 number. His forces were maintained in three separate armies, 
 somewhat after the fashion of the Germans and Japanese in later 
 days. Thomas commanded the Army of the Cumberland, three 
 corps, with sixty thousand men present for duty. McPherson 
 led the Army of the Tennessee, consisting of parts of two corps, 
 about twenty-five thousand men. A third army corps joined 
 McPherson in June. Schofield's Army of the Ohio was made 
 up of one army corps and a cavalry division, amounting to four- 
 teen thousand men. The Army of the Cumberland had an entity 
 almost from the beginning of the war; it had fought at Stone's 
 River, Chickamauga, and Chattanooga. The Army of the Ten- 
 nessee was brought from the Mississippi and had had no separate 
 existence. The Army of the Ohio had been organized the year 
 before for operations about Knoxville, and now came from that 
 place for the Atlanta campaign. 
 
 It seems a heterogenous force, but proved an efficient machine. 
 To quote the Confederate Colonel Breckenridge : "It was a 
 superb army, admirably equipped, abundantly supplied, excellently 
 led. It was veteran and had known victory. It had pushed its 
 antagonist out of Kentucky with the surrender of Donelson ; had 
 captured Tennessee, captured Vicksburg, repossessed the Mis- 
 sissippi, driven its foe over Missionary Ridge in flight. It knew 
 how to fight and was willing to fight." I believe that students 
 of tactics and strategy unite in pronouncing this campaign the 
 most scientific of the longer operations of the war. 
 
 The separate armies had separate bases at Chattanooga, Hunts- 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 3 
 
 ville, and Knoxville ; but this plan was found to be impracticable 
 and Chattanooga became the actual advance base for the united 
 armies. Nashville, one hundred and fifty miles further back, 
 was the main base, with depots at Louisville and St. Louis. All 
 supplies were brought forward from Nashville on one line of 
 railway, very poor and frequently interrupted. All sick and 
 wounded had to be evacuated in the same way, except that a part 
 of the wounded of the Army of the Ohio were sent to the nominal 
 base of that army at Knoxville. 
 
 In 1864, the Government was well provided with general or 
 base hospitals. 
 
 In the fall of that year there were hospitals in the Department 
 of the Cumberland as follows : Chattanooga, 3600 beds ; Nashville, 
 8270 beds ; Tullahoma and Murf reesboro, 830 beds ; total, 12,700 
 beds. In the Department of the Ohio there were: at Louisville, 
 3868 beds; New Albany, 1618 beds; Jeffersonville, 4262 beds; 
 Knoxville, 2057; total, 11,805. The grand total is 24,500 beds 
 and does not include many smaller hospitals at garrisoned posts. 
 After providing for all local forces there must have been beds 
 for from twelve to fifteen per cent of General Sherman's com- 
 bined armies. 
 
 In equipment the Army of the Cumberland excelled. General 
 Thomas appears to have been a great organizer. He had the best 
 supply trains, the best engineer equipment, the best ambulance 
 and hospital arrangements, the best railway and hospital trains. 
 The Army of the Ohio was less well provided with medical equip- 
 ment, but the other armies now profited by the example of the 
 Army of the Cumberland and improved their equipment as the 
 campaign progressed. At the outset the brigade hospital system 
 obtained. Medical Director George E. Cooper, U. S. A., says: 
 "Previous to entering on this campaign each brigade had a medi- 
 cine wagon and two army wagons to carry canvas and supplies 
 for a brigade field hospital. An operating staff had been de- 
 tailed and everything systematized so that during an action the 
 wounded might receive prompt and systematic attention. The 
 ambulance corps, organized under the new system (Letterman), 
 had been untried." 
 
 A peculiar feature was that the cavalry divisions, numbering 
 close to ten thousand men, were allowed no ambulances, this by 
 
4 MEDICAL DEPARTMENT IX THE CIVIL JVAR. 
 
 order of the commanding general, who instructed that men not 
 able to ride be left in houses, and authorized contracting for their 
 care at the rate of one dollar gold per day. As a matter of fact, 
 the wounded from the cavalry, not many in numbers, were cared 
 for in the infantry division hospitals. This order was a mistake. 
 For regimental medical supplies, although but three wagons were 
 allowed to a regiment, one was allotted to the Medical Depart- 
 ment. 
 
 It was the mediocre and inexperienced generals who neglected 
 adequate medical arrangements during the war. The armies of 
 the great leaders like Grant, Sherman, and Thomas, were always 
 well, almost lavishly, supplied. 
 
 For reserve supplies there was a train of thirty wagons, in 
 charge of Asst. Surgeon J. W. Craig, 10th Illinois Infantry. 
 The Sanitary Commission also kept supplies with the army, and 
 especially at the hospitals along the railway line. The division 
 hospitals were organized on the basis of ten beds to a regiment 
 of less than four hundred men. It is to be remembered that 
 the fighting strength of the three hundred odd regiments of 
 these armies seldom amounted to more than one-half the number 
 borne on the muster rolls. 
 
 The most interesting and instructive medical feature of the 
 campaign was, perhaps, the evacuation of the sick and wounded 
 to the rear, as the army advanced. For this purpose the Army 
 of the Cumberland had excellent hospital trains devised by its 
 medical director, and a great field hospital of a thousand beds, 
 which was what we should now call an evacuation, or clearing 
 hospital. There were three trains of ten to twelve hospital cars 
 each. The cars had a capacity of thirty reclining patients, and 
 this was the only class of patients that had the luxury of a hos- 
 pital car. 
 
 The car devised and perfected by Surgeon Cooper gave the 
 most general satisfaction. It was improvised from an ordinary 
 day coach, by turning two seats together and connecting them 
 by slats, on which bed sacks were placed. These lower beds 
 were for the more gravely wounded, though two patients were 
 sometimes placed in one bed. The upper berths were like 
 stretchers, suspended from the wall, and by rods from the roof. 
 The less severely wounded were placed in the upper berths. It 
 
WHBN SHERMAN MARCHED DOWN TO THE SEA. 5 
 
i; MEDICAL DEPARTMBXT IX THE CIVIL WAR. 
 
 »vas planned to have one train leave the hospital daily. This 
 would possibly have sufficed for the more severely wounded 
 and sick. 
 
 General Thomas accorded the fullest authority to Medical 
 Director Cooper to select for the hospital trains the best locomo- 
 tives and cars to be found, and to have new cars fitted up when 
 necessary. On these hospital trains the smokestacks of the loco- 
 motives were painted a brilliant scarlet; the exterior of the cabs 
 and tenders were of the same conspicuous color. 
 
 At night, beneath the headlight of the engine, three red lanterns 
 were suspended in a row. These distinguishing signals were 
 recognized by the Confederates. It is said that both Generals 
 Morgan and Forrest gave strict orders that the Federal hospital 
 trains should not be molested, and should be given timely notice 
 in case the road was destroyed. I know not how reliable these 
 statements are, but can find no record of any happenings to the 
 contrary. 
 
 As far as the records show the first official step toward or- 
 ganizing hospital trains was a letter written August 11th, 1863, 
 directing the Medical Director of the Army of the Cumberland 
 to fit up a special hospital train to run between Louisville and 
 Nashville. A hospital train was already running on the same 
 line and had been for six months or more. It was fitted up by 
 the Sanitary Commission, as were the first hospital trains in the 
 East. 
 
 The clearing hospital had tentage, bedding, and general equip- 
 ment, but no transportation. It was brought forward along the 
 railway, step by step, and cared for the sick and wounded until 
 they could be transported to the rear. It generally relieved the 
 division field hospitals in from two to five days. While the Armv 
 followed the line of the Western and Atlantic Railway in general, 
 it left this line at times to make flanking movements; notably, 
 before Resaca, and again at Dallas, where the right wing was 
 about twenty-five miles from the railway base at Kingston. 
 
 The importance of keeping a large part of the rank and file 
 of an army from drifting to the rear has been shown recently by 
 Major Munson. 
 
 The returns of Sherman's armies are for territorial divisions, 
 not for armies in the field. The returns of the Department of 
 the Cumberland for April, 1864, show the following: 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 7 
 
 Present for duty + 88,883 or. 52% 
 
 Present sick 6,501 " 4% 
 
 Total present, not for duty 17,767 " 10% 
 
 Total present 106,650 " 62% 
 
 Absent 'sick 18,885 " 11% 
 
 Total absent 64,800 " 38% 
 
 Total sick, present and absent 15% 
 
 In other words, out of each 100 men on the muster rolls, 62 
 were present and 52 were present for duty on the firing line. 
 Of the 48 not available at the crucial point, 15 were absent on 
 account of sickness and 33 from other reasons. 
 
 This campaign should have begun simultaneously with Grant's 
 advance in Virginia, but the armies had to be brought together 
 from a distance and they were not in touch with each other until 
 May 7th, the day after the Battle of the Wilderness. The advance 
 base, or rail head, was at Ringgold. 
 
 The first stand made by General Johnston was in front of 
 Dalton. 
 
 There was desultory fighting about Dalton on the 8th, 9th, 
 and 10th, in which there were no great casualties. The clearing 
 hospital was at Ringgold and remained there until Resaca was 
 gained. On May 11th the armies left the railway to make a 
 flanking movement through Snake Creek Gap and strike the road 
 in Johnston's rear at Resaca. There was fighting in front of 
 Resaca on the 13th and 14th, but the principal and successful 
 attack was made on May. 15th. 
 
 The total casualties at Dalton and Resaca were: killed, 600; 
 wounded, 3375. Many of this large proportion of wounded must 
 have been but slightly injured. General Sherman says it was not 
 necessary to send many of the wounded to the rear. The wounded 
 were cared for in the field hospitals for a few days only. The 
 railroad was repaired by the evening of the 16th and the clearing 
 hospital being brought up, took over the wounded and cared for 
 them until they could be sent back to Chattanooga, or to duty. 
 
 This clearing hospital belonged to the Army of the Cumber- 
 land. The other armies were under the necessity of improvising 
 hospitals in buildings in Resaca. Later they procured tentage 
 and equipment for tent hospitals. 
 
 One stage of the campaign was finished ; the next stage covered 
 the territory extending from Resaca to Kingston. All the armies 
 
8 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 now advanced along the railway southward, encountering very 
 little opposition. 
 
 Kingston was entered on May 20th and the troops rested there 
 three days while the railway was being repaired and supplies 
 brought up for the next step. Kingston was made a small 
 temporary depot. When the Confederates evacuated the place 
 they abandoned a hospital of 250 beds. This hospital was taken 
 possession of, increased to 750 beds, and used as a clearing hos- 
 pital until Allatoona was occupied. 
 
 The armies marched forward again on May 23rd. From 
 Kingston the railway runs eastward to Allatoona, a very strong 
 position. So the railway was left and the armies marched straight 
 south to Dallas, carrying twenty days' supplies in the wagons. 
 About this time rains began, and the country being in a state of 
 nature, it was difficult to move the trains. Dallas was reached 
 on the 25th, about twenty-five miles from the railway. Now 
 began the series of contests lasting a week and known as the 
 Battle of New Hope Church. Sherman says the soldiers called 
 the rough, wooded, roadless wilderness "Hell Hole," a not inap- 
 propriate name for a trackless wild, where blind and deadly 
 fighting was carried on for seven days without much result. 
 There were confusing attacks and counter attacks along a front 
 of six to ten miles and gloomy rainy weather made this woods 
 fighting still more dispiriting. 
 
 The fighting was not decisive, but by June 1st the left wing 
 had reached the railway in rear of Allatoona and the object of the 
 movement was gained. 
 
 The railway was repaired and the base advanced to Allatoona 
 by June 6th. The wounded in the battles about Xew Hope Church 
 and Pickett's Mills amounted to about four thousand, but as 
 these casualties were scattered over seven days the average num- 
 ber of wounded to be cared for on one day was less than six 
 hundred in the whole army. The wounded each day were con- 
 siderably less than one per cent of the entire command. Sherman 
 and Johnson were carrying on a decisive campaign with far less 
 effusion of blood than were Grant and Lee. 
 
 At Resaca the field of battle was near the railway and trans- 
 portation was simple. Here the railway was at a distance of 
 twenty to twenty-five miles, over almost no roads, and the weather 
 
ll'HBX SHERMAX MARCHED DOWN TO THE SEA. 9 
 
 ATLANTA CAMPAIGN. 
 
 SCALE OF MILESj. 
 
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 HRMY OTTHC CUMB£.KLlNt>> 
 flUMf 0(THE TENHSSSCE7 
 flR/WVOf THC OHIO.' 
 
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10 MEDICAL DHPARTMBXT IX THE CIVIL WAR. 
 
 was unfavorable. It is stated that there were 8ii0 ambulances 
 with these forces. The proportion is so large, one ambulance to 
 each one hundred and twenty men, that it is scarcely credible. 
 Those wounded in the first few days' fighting were carried back 
 to Kingston in ambulances and wagons. The following order was 
 issued : 
 
 HEADQUARTERS MlUTARY DIVISION OF THE MISSISSIPPI, 
 
 In the Field near Dallas, May 29th, 1864. 
 Major Generals McPherson and Schofield : 
 
 I am directed by the General Commanding to inform you that 
 on Tuesday next General Thomas will send to Kingston a train 
 of empty wagons, under escort of one brigade, for the purpose 
 of bringing forward supplies. General Sherman desires you 
 likewise to make up a train and send it at the same time; one 
 regiment will be sufficient guard. Send back in these wagons 
 all your sick and wounded proper to go to the rear, and have 
 your commissary and quartermaster notify the chief com- 
 missary. * * * 
 
 Instruct the officer in charge of your train to avail himself of 
 the movements of General Blair to return to your command under 
 cover. 
 
 I am with respect, yours, truly, 
 
 L. M. Dayton, Aide-de-Camp. 
 
 Those wounded in the latter days were held in the field 
 hospitals until the railroad was grasped at Ackworth when they 
 were placed in temporary hospitals established at that place. As 
 soon as the bridge over the Etowah could be rebuilt, supply trains 
 were brought up and the wounded were sent to the rear in these 
 box cars, without waiting for the hospital trains. 
 
 The rebuilding of the bridge was a large undertaking and was 
 not finished till June 11th. The clearing hospital was now brought 
 up to Big Shanty Station. The armies were supplied from 
 several stations and again moved forward. ■ General Blair's Seven- 
 teenth Corps arrived and joined the army about this time. His 
 nine thousand men made good the losses thus far sustained and 
 again raised the number of troops to one hundred thousand men. 
 
 Surgeon Cooper, who had been absent on account of an attack 
 
, IV HEX SHERMAN MARCHED DOWN TO THE SEA. 11 
 
 of malarial fever, joined the army on June 10th, at Big Shanty. 
 Up to this time Surgeon Glover Perrin, U. S. A. had been acting 
 as Medical Director of the Army of the Cumberland. Surgeon 
 Cooper found the brigade hospitals still in existence. He says: 
 "Finding that they did not work smoothly, the brigade sections, 
 were consolidated into division sections, and these placed under 
 charge of one medical officer. This consolidation was found to 
 be very much more practicable and economical, both in rations 
 and medical supplies, and in care of the wounded. The inno- 
 vation proved serviceable in every respect, particularly when 
 movements were contemplated and the sick required transporta- 
 tion to the rear; as well as during action; for instead of being 
 brought to the brigade hospitals, where often the surgeons were 
 overworked, the entire operating staff of the division was at 
 the disposal of the brigade whose loss was heaviest. The sur- 
 geons, too, had conceived the idea that their especial duty was 
 to attend to the wounded of the regiment to which they belonged, 
 or, at most, of the brigade to which they were attached. The 
 consolidation of the brigade hospitals avoided the evils resulting 
 from this idea, and all men belonging to the division were cared 
 for, regardless of the brigade to which they were attached." 
 
 During the march there had been considerable sickness, par- 
 ticularly scurvy, but this disease disappeared when the green corn 
 reached the roasting ear stage, and by the time Atlanta was 
 reached there was no scurvy in the army. 
 
 On June 1st a series of rains began which lasted almost with- 
 out intermission for two weeks. The miserable roads became 
 bottomless mud holes, the troops could move by very short 
 marches only, and the trains could scarcely be moved at all. On 
 June 18th, Sherman wrote Grant, "It is raining as though it had 
 no intention ever to stop." But the army moved slowly on. 
 On June 14th, fighting began on the Kenesaw lines and continued 
 daily until the great unsuccessful assault on June 27. This was 
 the single general frontal attack of the campaign, yet was not 
 nearly so deadly as the assaults at Spottsylvania and Cold Harbor. 
 The number of wounded to be handled in the field hospitals 
 (nineteen in number) was about 2,500. This number could have 
 been handled comfortably under ordinary circumstances. The 
 wounded were being transferred to the hospital at Big Shanty, 
 
12 MEDICAL DEPARTMEXT IN THE CIVIL WAR. 
 
 but when the attack failed, Sherman again extended to the right 
 and to do this must abandon that place. On the evening of the 
 27th, he ordered all wounded sent to the rear within twenty- 
 four hours. The field hospitals were then from six to nine miles 
 from the station and the roads were abominable. Doubtless many 
 deaths resulted from moving the desperately wounded in this 
 way. Medical Director Cooper says, "To obey this order it was 
 necessary to avail ourselves of every class of transportaiton ; 
 ambulances and baggage wagons. There were at that time nearly 
 two thousand wounded men in the hospitals of the army (Army 
 of the Cumberland) ; these had to be carried from six to nine 
 miles over roads rendered extremely rough by the rains and the 
 heavy trains. Knowing that Big Shanty would be uncovered by 
 the time named it was necessary to avail ourselves of every train 
 or box cars returning to the rear. The haste in which the trans- 
 fer was made caused, I doubt not, much suffering, and I regret 
 to say that in some cases neither proper nor sufficient food was 
 furnished the men on the way to Chattanooga. The trip oc- 
 cupied thirty-six hours or more, though the distance was not 
 more than a hundred miles. The attendants were not reliable 
 and though there was a medical officer to each train he could 
 only enter the cars when the train stopped." 
 
 To avoid these evils in the future Surgeon Cooper induced 
 the Sanitary Commission to establish rest stations at Kingston, 
 Resaca, and Dalton. The Commission promptly placed agents 
 at these places and afterwards there was no more lack of 
 food, water, or coffee. This arrangement shows the lack of 
 adequate organization along the line of communications. In 
 fact there was no organization at all. The functions ot tnis 
 division were performed by the service of the front, in so far as 
 they were performed at all. 
 
 Few of these wounded were dressed from the time of leaving 
 the field hospitals until arriving at Chattanooga, and many of 
 the wounds became affected with hospital gangrene before reach- 
 ing the rear. The Medical Director consoled himself with these 
 reflections: "I know that many complaints have been made; it 
 was, however, impossible to do better; the conveniencces were 
 few, the wounded many, and the stay-at-the-rear-faultfinding 
 patriots in excess. Everything at our command was made use 
 
IV HEN SHERMAN MARCHED DOWN TO THE SEA. 13 
 
14 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 of to mitigate the suffering of the troops, and it was only when 
 the Medical Department had no control that the wounded- were 
 subject to unnecessary suffering." 
 
 On July fourth, Johnston abandoned Kenesaw, and fell back 
 to a position about Marietta. Some slight resistance was made 
 there and at other points further back, but on July ninth, he 
 crossed the Chattahoochee River and retreated to the defences of 
 Atlanta, nine miles away. The clearing hospital was brought up 
 to Marietta, now the advance base, on July tenth, and received 
 the wounded from these small engagements north of the Chatta- 
 hoochee. The total casualties about Kenesaw Mountain and 
 Marietta were: killed, 1,790; wounded, 5,740. 
 
 On July eighteenth the army crossed the Chattahoochee, for 
 the last stage of the campaign, and the clearing hospital was 
 brought forward to Vining's Station, the first station north of 
 the river. Here it remained until the capture of Atlanta. The 
 battles at Peachtree Creek, on July SO, near Decatur, July 22nd, 
 and at Ezra Church, on the 28th, offer nothing of special interest. 
 The wounded were sent to the hospital at Vining's Station and 
 from there evacuated to the rear. 
 
 The last combat of the campaign occurred near Jonesboro, on 
 September 1st, and on September 2nd, Atlanta was entered. The 
 wounded from this battle were brought in to Atlanta three days 
 later. Large tent hospitals were now established in Atlanta for 
 all the troops except one division, which used the buildings of 
 the Atlanta Medical College. The wounded and sick were now 
 held at Atlanta except in special cases. 
 
 The losses in the battles about Atlanta were: killed, 1,600, 
 wounded 5,015. These were probably the most severe battles 
 of the four months' fighting, yet the losses do not compare with 
 those in Virginia. 
 
 The total number of wounded cared for in the hospitals of the 
 Army of the Cumberland was about 15,000, nearly the same as 
 in the single battle at Spottsylvania Courthouse. Of these, one 
 thousand died in the field hospitals, six and two-thirds per cent. 
 If we consider the desperately wounded as ten per cent of the 
 whole number it appears that two-thirds of this class died within 
 a few days, or at most a week. 
 
 Of operations there were 1,286 amputations, 302 excisions, and 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 15 
 
 790 other operations. Chloroform was reported to have been 
 used in 1,255 cases, but the Medical Director says, "This is far 
 below the actual number as it was freely used in all cases where 
 examination of wounds was to be made, and where painful 
 dressings were to be applied. In no case had any injurious effect 
 resulted from its use." 
 
 The number of sick received in the hospitals of the Army of 
 the Cumberland during the four months' campaign was 43,153. 
 Of these, 25,184 were sent to the rear, about sixty per cent. 
 The balance were treated in division and clearing hospitals until 
 returned to duty. I am unable to determine what proportion of 
 the wounded was sent to the rear, a piece of information that 
 would be of value. 
 
 The wastage of men during active campaign is shown by some 
 figures from the report of the Medical Director of the Second 
 Division, Twentieth Corps. On clearing the division of all sick 
 on May 3rd, there were present for duty, officers and men, 
 
 7,043. 
 By Sept. 1st, the division had lost: killed, 331. 
 
 wounded, 1,923. 
 sick sent to rear, 1,000. 
 
 total, 3,254 nearly 50 per 
 cent. 
 
 All the wounded were not sent to the rear; we might assume 
 that forty per cent of the wounded remained with the command, 
 leaving a net loss of about thirty-three and a third per cent, or 
 a rate of one hundred per cent per annum, a loss that would, 
 but for reinforcements, have wiped out, the army in one year. 
 
 The total losses in the combined armies for the four months 
 were: killed, 4,423; wounded, 22,822; total, 31,687. This is 
 31.6% of the whole force, much less than Grant lost in the first 
 ten days of his campaign at the same time. Since those lost 
 through sickness would more than balance the wounded that 
 returned to duty it will be seen that the wastage in the whole 
 army was equal to, if not more than, one-third. 
 
 In the South African War the wastage in the British forces 
 was at the rate of forty per cent per annum, and from the latest 
 data it was but twenty-four per cent in the Russian armies in 
 1904-5. The latter figures are in my opinion unreliable and 
 should be corrected to admit forty per cent. 
 
16 MEDICAL DBPARTMEXT IX THE CIVIL WAR. 
 
 There was a considerable amount of sickness in Sherman's 
 army during this campaign, much more than in his later cam- 
 paigns to Savannah and through the Carolinas. The number 
 constantly sick cannot well be estimated, but the admission rate 
 was about 2,000, or about double the present peace rate of the 
 army. Scurvy in a mild form was generally prevalent, caused 
 by subsisting on the restricted field ration. In July the Medical 
 Director of the Twenty-third Corps estimated that twenty per 
 cent of the men of his division were affected with this disease. 
 Typhoid also was not absent. A sad incident of the campaign 
 was the death of General Ransom, as related by General Sher- 
 man. "He was not well when we started from Atlanta, but he 
 insisted on going along with his command. His symptoms became 
 more aggravated on the march, and when we were encamped 
 near Gaylesville, I visited him, in company with Surgeon John 
 Moore, U. S. Army, who said that the case was one of typhoid 
 fever, which would probably prove fatal. A few days after, 
 viz., on the 28th, he was being carried on a litter towards Rome, 
 and as I rode from Gaylesville to Rome, I passed him by the 
 way and spoke with him, but did not then suppose he was so 
 near his end. The next day, however, his escort reached Rome, 
 bearing his dead body. The officer in charge reported that 
 shortly after I had passed, his symptoms became so much worse 
 that they stopped at a farm house by the roadside, where he died 
 that evening." The idea of a man suffering with typhoid fever 
 being carried in an ambulance for thirteen days, and until his 
 death, is a strange one. It also emphasizes the importance of en- 
 forcing general orders in the case of officers with the same 
 regularity as in the case of enlisted men. 
 
 MEDICAL OFFICERS, ATLANTA CAMPAIGN. 
 
 Medical Director of the Army, Surgeon E. D. Kittoe, U. S. 
 Army. 
 
 Medical Director, Army of the Cumberland, Surgeon Geo. E. 
 
 Cooper, U. S. Army. 
 
 Med. Director, Fourth Corps, Surg. J. Theodore Heard, U.S.V. 
 
 Fourteenth Corps, Surg. C. W. Jones, U.S.V. 
 
 Twentieth Corps, Surg. John W. Foye, 
 
 u. s. v. y 
 
 Medical Director, Army of the Tennessee, Surg. John Moore. 
 U. o. A. 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 17 
 
18 MEDICAL DEPARTMENT IN THE CIVIL WAR. 
 
 Med. Director, Fifteenth Corps, Surg. C. W. McMillen, U.S.V. 
 Sixteenth Corps, 
 
 Seventeenth Corps, Surg. J. H. Boucher, 
 U. S. V. 
 Medical Director, Army of the Ohio, Surg. H. S. Hewitt, 
 U. S. V. 
 
 Med. Director, Twenty-third Corps, Surg. Edward Shippen, 
 U. S. V. 
 Cavalry Division, Surg. A. M. Wilder, 
 U. S. V. 
 
 ATLANTA TO SAVANNAH. 
 THE ARMY. 
 
 When General Sherman left Atlanta on November 15th, 1864, 
 he led what was probably the best large army that ever marched 
 under the United States flag. He had veteran regiments and 
 tried veteran leaders. The law of the survival of the fittest had 
 here its last exemplification. 
 
 Regiments of a thousand men were now reduced to little more 
 than three hundred, but three hundred of the kind of men that 
 survive three years of war, three years of heat, cold, dust, mud, 
 fatigue, disease, wounds, and I almost said death; for they had 
 played with death and beat the game, like Kipling's crew of the 
 Bolivar, who "Euchred God Almighty's storm, bluffed the eternal 
 sea." 
 
 The weak, the inefficient, the cowardly, the infirm of purpose 
 had long since disappeared. Those who remained were vig- 
 orous, hardened veterans who could be depended on to go any- 
 where and do anything possible to be done by men. As Corse 
 had replied to the French, they were prepared for the effusion of 
 blood whenever it was convenient. They were also prepared to 
 take care of themselves and maintain their health and strength 
 under any and all conditions. 
 
 Sherman himself said, "The most extraordinary efforts had 
 been made to purge this army of non-combatants and of sick 
 men, for we knew well that there would be no place of safety 
 except with the army itself; our wagons were loaded with am- 
 munition, provisions, and forage and we could ill afford to haul 
 sick men even in the ambulances. So that all on this exhibit 
 (table of forces) may be assumed to have been able-bodied, ex- 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 19 
 
 perienced soldiers, well armed, well equipped, and provided as 
 far as human foresight could, with all the essentials of life 
 strength, and vigorous action." A knowledge of these things will 
 enable one to understand the exceptional freedom of this army 
 from disease, and will also explain in part its great superiority 
 over McClellan's forces in the Peninsular Campaign, where the 
 sick numbered 20% of the command. 
 
 The army numbered about 55,000 infantry, 5,000 cavalry, and 
 2,000 artillery; a total of 62,000 men. It consisted of four in- 
 fantry corps of about 14,000 men each ; a cavalry division of two 
 brigades, fourteen regiments; and sixteen four-gun batteries. 
 The four infantry corps were divided into 13 divisions, 36 bri- 
 gades, and about 173 regiments. The average number in an in- 
 fantry regiment was 320 men, in a brigade 1,500, and in a divi- 
 sion about 4,200. The average number in a regiment of cavalry 
 was 360, in a battery 113 men. There was one officer to each 
 22 men in the whole army. The average number of officers 
 to a regiment of ten companies was fourteen, allowing little more 
 than colonel, staff, and one officer to each company, of about 
 thirty-two men. 
 
 The medical department was fully organized in accordance 
 with the Letterman plan. 
 
 IMPEDIMENTA. 
 
 Three years of war had also taught the leaders of this army 
 that baggage and supplies are what Caesar called them, impedi- 
 menta, a necessary evil to be reduced to the lowest terms. Sher- 
 man himself had no hazy ideas on the subject. He believed that 
 tents were a luxury, for camp use only, not to be carried into the 
 field. Before beginning the Atlanta Campaign he issued General 
 Order No. 7 which, among other things, directs : "In no event 
 will tents be carried, or chests, or boxes, or trunks." "Wagons 
 must be reserved for ammunition, cooking utensils, and rations." 
 
 Officers could only take such baggage as they could carry on 
 their persons or on led horses, and were to subsist on the same 
 rations as the men. In a letter to Quartermaster General Meigs, 
 Sherman wrote, "I prefer no tents at all for marching troops, 
 * * * Soldiering, .as we have been for the past two years, with 
 such trains and impediments, has been a farce." 
 
50 MEDICAL DBPARTMEXT IX THE CIVIL WAR. 
 
 He had but one wagon for the entire headquarters of the army 
 at that time. Sherman's idea of transportation for an army 
 could hardly be improved on. It was, roughly, as follows : 
 
 1. Ammunition wagons, to carry required number of rounds. 
 
 2. Supply wagons, with twenty days' ration of hard bread, 
 sugar, coffee, salt, and a little bacon. 
 
 3. Beef, on the hoof. 
 
 •i. Supply wagons to haul a small grain ration for the animals. 
 
 An army with trains of this size could march freely. It may 
 have been overdone in some small particulars. One of the chief 
 surgeons complained that all cooking utensils were left behind 
 save only coffee pots, frying pans, and camp kettles, thereby in- 
 juring the digestion of the men. I fear he would have difficulty 
 in procuring witnesses to this alleged fact from the State of 
 Georgia. 
 
 The train that left Atlanta actually consisted of 2,500 wagons 
 and 600 ambulances. There was no army train ; each corps 
 marched on a separate road with its own trains, and was in fact 
 a complete army in itself, except for cavalry. Each corps train 
 consisted of 600 wagons at the beginning, and grew longer as 
 the march progressed. The train, including ambulances, was 
 from four to five miles long. About 20% of the wagons carried 
 ammunition ; the balance rations and a little forage. 
 
 The average number of horses and mules in the whole army 
 was 30,000. Each gun and caisson had eight horses, each wagon 
 six mules, and each ambulance two horses. The average load 
 for a six-mule wagon was 2,500 pounds. All the animals were in 
 very poor condition at the beginning of the march, but grew 
 better and better as the time passed. 
 
 The rations carried on the wagons at the beginning of the 
 march were about as follows : — 
 
 Twenty days' hard bread. 
 Forty days' sugar and coffee. 
 Eighty days' salt. 
 Forty days' beef on the hoof. 
 
 The army started with 3,476 cattle and reached 'Savannah with 
 more than 10,000, being thirty-four days between supply depots. 
 These items make up the essentials of a ration, excepting fresh 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 21 
 
22 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 vegetables, which were gathered freely from the country, sweet 
 potatoes being the most important component. Corn, wheat, and 
 later rice were gathered in large quantities ; mills along the route 
 were taken possession of and run night and day to furnish 
 flour and meal. General Sherman's order read, "The army will 
 forage freely," and it was done much more freely than he in- 
 tended. Hardly a day of the march was without its reiterated 
 order to restrain irregular looting, but the very regularity of 
 these orders shows that they were ineffective. Yet all this de- 
 struction was striking down the Confederacy, and sweet potatoes 
 and turkeys, even mules, are cheaper than blood. 
 
 MEDICAL EQUIPMENT. 
 
 Now as to medical equipment. Judging by the difficulty ex- 
 perienced today in securing transportation for medical organi- 
 zations, and by General Sherman's forcible expressions on the 
 subject of baggage, what do you suppose would be allowed by him 
 in the way of medical equipment? The natural impression 
 would be — very little. As a matter of fact General Sherman's 
 army carried about as heavy a medical equipment as our late San 
 Antonio army. When the army left Chattanooga in the Spring 
 each division (about 6,000 men) had a field hospital carried on 
 six wagons. For this campaign the number of wagons was re- 
 duced to three, with one medicine wagon. This was done chiefly 
 by cutting out the tents, taking only the tent flies. I shall enumer- 
 ate the medical equipment of a sample division ; the First Divi- 
 sion, Twentieth Army Corps. This division had a much smaller 
 equipment than the average of the army. The division con- 
 sisted of three brigades, fifteen regiments, and at the beginning 
 of the march numbered 5,289 men. 
 
 The entire train consisted of 177 wagons, of which 38 carried 
 ammunition. The division hospital was carried in three army 
 wagons and one medicine wagon. The hospital had sixteen tent 
 flies — no tents. The wagons carried a thirty days' supply of the 
 most necessary medical articles. 
 
 Each regiment had a pack mule for its medical supplies. The 
 ambulance corps was completely organized in accordance with 
 the Letterman regulation. 
 
 The division corps was commanded by a captain, with a lieu- 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 23 
 
 tenant for each of the three brigades; these officers being de- 
 tailed from the line to the Quartermaster Department for this 
 purpose. There were thirty two-horse ambulances, one for each 
 193 men. The ambulance corps numbered • about one hundred 
 men. The ambulances carried 200 pounds each of hard bread 
 and meat extracts for the hospital, and these things proved very 
 useful. 
 
 As there was an excess of ambulances at the beginning of the 
 march there is no reason why some of them should not have beers 
 loaded with supplies at the beginning, knowing that the supplies 
 would be gradually used as the ambulances became needed. 
 
 On the basis of this division one of our modern divisions; 
 would have 14 wagons and 100 ambulances, instead of 62 wagons. 
 and 48 ambulances, as at present. I believe that a happy medium 
 of 24 wagons and 60 ambulances would be better than either. 
 During the latter part of the march three additional wagons were 
 attached to each field hospital for the purpose of carrying the 
 arms and equipment of "light duty" men. The division medical 
 transportation was then measurably greater than at present. 
 
 The ambulances seem to have been kept together in one train 
 with the field hospital, but one ambulance followed each regi- 
 ment. A medical officer and a hospital steward accompanied the 
 ambulance train on the march. The chief surgeon reported 
 that the sick were plentifully supplied by the hospital men 
 foraging. Carriages were taken from the country for the use 
 of the wounded when necessary. 
 
 As to tent flies and light equipment, it is to be remembered 
 that the climate of southern Georgia is temperate even in winter. 
 It proved to be fine during nearly the whole of the march, with 
 little rain, and just cool enough to be healthful. No hardships 
 were experienced from lack of tentage or other medical sup- 
 plies usually carried with armies. The troops reached Savannah 
 in such excellent condition that General Grant was moved to 
 express his gratification on at last seeing an army that could on 
 finishing one campaign immediately begin another, without first 
 recuperating for several months. 
 
 THE MARCH. 
 
 Next to fighting, marching is perhaps the most important func- 
 tion of armies. The manner of accomplishing a great march is 
 
24 MEDICAL DEPARTMENT IX THE CIVIL WAR. 
 
 always instructive as well as interesting. It may be said in the 
 beginning that this march was hindered by no extraordinary 
 obstacles. The difficulties were chiefly three — moving the trains, 
 destroying railways, and gathering supplies. Together they re- 
 duced the rate of march to ten or twelve miles per day. But for 
 these distractions, along with road making and bridge building, 
 it seems that the army could easily have marched twenty miles 
 per day. The order of march prescribed for the Fifteenth Corps 
 at the beginning of the march was as follows : — ■ 
 
 ADVANCE GUARD. 
 
 Second Brigade, less one regiment. 
 
 One battery, without caissons, wagons, or forges. 
 
 One regiment as support to the battery. 
 
 Pioneers, with tool wagon. 
 
 Regimental wagons and ambulances of these organizations. 
 
 MAIN BODY. 
 
 First Brigade (First Division), each regiment followed by one 
 ammunition wagon, one ambulance, and one regimental supply 
 wagon. 
 
 One-half the division supply train — five wagons, infantry am- 
 munition (guarded by one regiment). 
 
 Third Brigade, wagons and ambulances as with First Brigade. 
 
 Corps Headquarters train. 
 
 Headquarters trains of division and brigades (First Division). 
 
 Ambulance and hospital train, First Division. 
 
 One-half the division supply train; remainder of ordnance 
 train (guarded by one regiment). 
 
 One regiment of Third, Brigade. 
 
 SECOND DIVISION. 
 
 First Brigade, ambulance and two wagons following each 
 regiment. 
 
 One-third of all trains. 
 Second Brigade, same order. 
 Third Brigade, same order. 
 Artillery Brigade and train. 
 
 THIRD DIVISION. 
 
 One regiment of Second BrigKlr-.. 
 Pioneer troops with tool wagon. 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 25 
 
 Remainder of Second Brigade. 
 
 Two regiments of First Brigade. 
 
 Ammunition train. 
 
 Division Headquarters train and provost guard. 
 
 Division supply train. 
 
 Ambulance and hospital train. 
 
 One regiment on flanks of trains. 
 
 Two regiments of First Brigade. 
 
 General Sherman's original order provided that one ambulance 
 should follow each regiment with the remaining ambulances 
 following the brigades. 
 
 This order was followed in some cases, but in most of the 
 divisions after providing each regiment with an ambulance, the 
 remainder were collected in a division train, usually placed near 
 the middle of the division. 
 
 The order of march is given at length in order to show the 
 place of the ambulances and hospitals in the column. 
 
 The regular day's march was fixed at a maximum of fifteen 
 miles and was more frequently not attained than exceeded. The 
 men could have easily marched farther, but the trains could not 
 keep up, especially at the beginning when the animals were in 
 very poor condition. Again it was the work of building bridges 
 or destroying railways. It was a common occurrence to assign 
 to a brigade the destruction of two miles of railway, as a be- 
 ginning of the day's work, after which the march was to be 
 made. 
 
 Sherman always claimed that the cavalry did not do this work 
 effectively and saw that his infantry left no rail untwisted. There 
 was also bridging and road work, but nothing to compare with 
 what was done in the Carolinas later. A table of the marches 
 of the Twentieth Corps shows at a glance the distances covered 
 by that part of the army. The other corps marched by different 
 roads, but on the whole made equivalent marches. 
 
 MARCHES OF THE TWENTIETH CORPS. 
 
 16 miles, weather fair 
 
 rainy 
 
 November 15th, 
 
 16 
 
 16th, 
 
 8 
 
 17th, 
 
 16 
 
 18th, 
 
 15 
 
 19th, 
 
 7 
 
 20th, 
 
 12 
 
 21st, 
 
 13 
 
MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 22nd, 
 
 15 
 
 " 
 
 weather fair 
 
 23 rd, 
 
 rested 
 
 in carnp 
 
 
 24th, 
 
 13 
 
 miles, 
 
 
 25th, 
 
 S 
 
 (t 
 
 
 26th, 
 
 12 
 
 a 
 
 
 27th, 
 
 15 
 
 a , 
 
 
 28th, 
 
 12 
 
 a 
 
 
 29th, 
 
 9 
 
 
 
 30th, 
 
 10 
 
 it 
 
 
 December 1st, 
 
 13 
 
 a 
 
 
 2nd, 
 
 11 
 
 it 
 
 
 3rd, 
 
 15 
 
 u 
 
 
 4th, 
 
 15 
 
 " 
 
 
 5th, 
 
 6 
 
 it 
 
 
 6th, 
 
 13 
 
 " 
 
 rainy 
 
 7th, 
 
 10 
 
 a 
 
 
 8th, 
 
 10 
 
 (i 
 
 weather fair 
 
 9th, 
 
 9 
 
 " 
 
 " 
 
 10th, 
 
 10 
 
 " 
 
 
 It will be seen that in the twenty-six days from the time this 
 corps left Atlanta until it arrived in front of Savannah the troops 
 had but one day's rest, and, if I remember correctly, two of the 
 divisions were busy that day. In the twenty-five marching days 
 the corps covered 293 miles, not quite twelve miles per day. 
 This looks like rather poor marching, but considering all other 
 work done is very good marching indeed. 
 
 General Sherman prescribed that the column should start at 
 seven A. M., and it frequently started earlier. He says they 
 generally got into camp by noon, but this applies mainly to the 
 leading division. The rear division, as usual, had the worst of it,. 
 often not getting into camp until long after dark and sometimes 
 not till next morning. To remedy this state of affairs, Circular 
 Xo. 14 of the Fifteenth Corps prescribed that the leading division 
 should not march over two miles per hour, allowing a rest of 
 five or ten minutes at the end of each hour. It was also prescribed 
 in army orders that the trains should have right of way on the 
 roads, the men marching at the sides of the road or in the fields if 
 necessary. The immense number of animals with the army at the 
 end of the march shows that an unusual proportion of the troops- 
 were mounted. It was a common occurrence to take advantage 
 of the crossing of a river to dismount all unauthorized riders, and 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 27 
 
 when the cavalry became short of horses the general ordered 
 800 turned over to them by the infantry. 
 
 MEDICAL ARRANGEMENTS OE THE MARCH. 
 
 General Sherman states in his Memoirs that there were about 
 six hundred ambulances with the army— one to each 103 men. 
 Each division had from thirty to forty ambulances, but it must be 
 remembered that the regiments were very small. The regiments 
 required nearly half the ambulances for regimental purposes. 
 The quota of one ambulance to a regiment was alone greater than 
 our present allowance of one to four hundred men. 
 
 The fifteen to twenty-five ambulances remaining formed the 
 ambulance train of the division. The statistics of sick and 
 wounded on the march show that the number of ambulances was 
 sufficient. 
 
 Asst. Surgeon David L. Huntington, U. S. A., Acting Medical 
 Director of the Army of the Tennessee (right wing), reported 
 that the average percentage of men unfit for duty in this half of 
 the army was 1.9. The percentage for the whole army may be 
 assumed to be the same, or approximately 1,200 men constantly 
 sick during the march. Six hundred ambulances would of course 
 carry this number easily. Considering the slightly wounded and 
 sick it would appear that not more than one-half the ambulances 
 were necessarily used. 
 
 Some of the wounded were carried considerable distances. The 
 principal fight of the march occurred near Macon on November 
 22nd. The wounded, about forty in number, were carried along 
 the remaining- 190 miles to Savannah, reaching there eighteen 
 days later. General Walcutt, the hero of this combat, was- 
 wounded in the leg and rode the balance of the way in a carriage. 
 Medical Director Moore said later: 'As far as I am informed 
 there is no case of sick or wounded men being left on the way. 
 When the army cast loose from everything in the rear, on the 
 campaign from Atlanta to Savannah, probably one of the gravest' 
 objections to it in the minds of both officers and men, was the 
 dread of being left in case of sickness, in the hands of their 
 enemies. But neither on that campaign nor on this (the Caro- 
 linas) has this fear been realized, except in the case of two men 
 from the right wing who had compound fractures of the thigh, 
 
?S MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 and were left in friendly hands in Georgia." General Sherman 
 believed, whether correctly or not, that many people in Georgia 
 were growing tired of the Confederacy and were well disposed 
 toward the United States Government. 
 
 HEALTH OF THE COMMAND. 
 
 The health of the army was excellent throughout the march, 
 as appears from the constantly sick rate of 1.!)% in the right wing, 
 which is less than half that in the United States Army today. To 
 be sure, all sick were weeded out at the beginning. That this 
 clearing out was thorough is shown by the fact that from the 
 right wing there were thus eliminated 784 men, or 2.(i'/< of that 
 army. 
 
 All external conditions of roads, terrain, climate, and season 
 were favorable. The constant movement rendered ordinary camp 
 sanitation easy and the abundance and variety of food gathered 
 from the country prevented all diseases of nutrition ; scurvy was 
 very common during the Civil War. 
 
 The constant occupation of the men no doubt contributed to 
 their health, as well as their confidence of success and good 
 spirits. 
 
 The deaths from disease were at the rate of about twelve per 
 annum per thousand ; a low rate for any time, and especially low 
 for that time. I do not believe that any large army has ever 
 had so low a rate as this either before or since. The justly 
 lauded German Army had a death rate of eighteen per thousand 
 in the Franco-Prussian War. 
 
 Certain diseases appeared but apparently did not spread. There 
 was measles in Atlanta when the march began and a case of 
 varioloid appeared on the third day. Immediately all not pro- 
 tected were vaccinated — showing that vaccine material was car- 
 ried in the medical supplies. 
 
 I can find records of very few men left behind. Two men with 
 .broken thighs were of necessity left, and Captain Norton, of the 
 10th Ohio Cavalry, having been severely wounded, was left near 
 Waynesborough, on December 4th. 
 
 General Kilpatrick left a corporal with him, bearing a note to 
 General- Wheeler. The captain died soon afterwards and Wheeler 
 returned the corporal. This amenity of war was accompanied 
 by some rather sharp correspondence. 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 29 
 
 That the general officers of the army were not unmindful of 
 the health of their men will be apparent from the following order 
 of General Osterhaus, commanding the Fifteenth Corps : 
 
 Hdqrs. Fifteenth Army Corps, 
 Opposite No. 3, Ga-., December 6, 1864. 
 Special Orders, No. 191. 
 
 I. Division commanders will proceed at once to collect all milk 
 cows in vicinity of their respective commands, and will retain 
 possession of the same until the army arrives at its destination, 
 when they will be turned over to the medical department for 
 the benefit of the sick and wounded. 
 
 II. The following are the orders for the movements of the 
 corps tomorrow, * * * 
 
 By order of Maj. Gen. P. Joseph Osterhaus. 
 
 L. F. Whitehead, 
 Adjt. General 
 
 The Medical and Surgical history of the War gives no report 
 of the Medical Director of the Army in this campaign. It does 
 give one short letter from him to the Surgeon General. I believe 
 his ability may be judged from this letter, and think it worth 
 repeating : 
 
 Atlanta, Georgia, November 10th, 1864. 
 
 Sir: I have been ordered by General Sherman to report to 
 him as medical director of the entire army under his command. 
 In three days the army will move into the interior of the State, 
 having for its objective point some important town on the Atlantic 
 seaboard. Transportation has been reduced to the minimum, 
 and in consequence, only a limited amount of supplies can be 
 carried on the march. In view of the probability of those on 
 hand being exhausted when the objective point is reached, I re- 
 spectfully suggest that three months' medical supplies for sixty 
 thousand men, as well as the fixtures for fitting up a hospital of 
 five thousand beds be held in readiness to be shipped without 
 delay, and without further requisition, to Savannah, or such 
 other point as the army may make its appearance on the sea- 
 
30 MEDICAL DEPARTMEXT IX THE CIVIL WAR. 
 
 board. Our movements will probably be learned through rebel 
 papers. 
 
 Very respectfully your obedient servant, 
 
 John Moore, 
 Surgeon, U. S. A., Medical Director, Department of 
 the Tennessee. 
 To the Surgeon General U. S. Army. 
 
 When the army reached Savannah only about one-tenth of 
 these beds were actually needed, yet their provision was an act 
 of the broadest wisdom. On reading the request for this hospital 
 and supplies the question will arise — why was Montauk Point? 
 
 COMMENTS. 
 
 For purposes of comparison, Sherman's army may be consid- 
 ered as composed of four divisions. His infantry corps were 
 almost precisely equal to our modern infantry divisions. The 
 cavalry was not attached; the artillery contingent was decidedly 
 less (about one-third) ; engineer and signal troops were mainly 
 detailed from the infantry. In spite of all orders there seem to 
 have been civilians with the army, and the hospital and ambulance 
 troops were not included in the strength as given. 
 
 If we call Sherman's corps divisions, his divisions brigades, 
 and his brigades regiments, we have a ready basis of comparison 
 with our modern army. On this basis he should have had six- 
 teen field hospitals and sixteen ambulance companies. He had 
 fourteen field hospitals. Instead of the 192 ambulances which 
 our regulations would give him, he had by his own statement 
 GOO. As he expected no severe fighting the light field hospitals 
 were sufficient, and were eminently suited to the campaign. The 
 ambulances proved ample in numbers. I am inclined to doubt 
 that the army had so many ambulances at the beginning of the 
 march, .and think that the very large number, six hundred, was 
 reached toward the end when many miscellaneous light vehicles 
 had been added to the ambulance train. The only division for 
 which accurate figures are available had not nearly so large a 
 quota of ambulances. 
 
 A thing especially notable in the medical arrangements of this 
 march is that the preparation fitted the case with remarkable 
 
WHEN SHERMAN MARCHED DOWN TO THE SEA. 31 
 
 accuracy. Flies instead of tents, hospital wagon train cut in two, 
 ambulance train largely increased, supplies carried on excess am- 
 bulances, light vehicles impressed as needed, food for the hos- 
 pitals secured by foraging; all these things bespeak a versatile 
 medical staff, that could adapt itself to circumstances, and would 
 have succeeded under any conditions, if success were humanly 
 possible. We must not forget that it was an army of picked 
 men, picked by the most impartial of all inspectors, Darwin's law. 
 
 The mental influence, the morale, must also not be overlooked. 
 In no other campaign of the war did it play such an important 
 part in contributing to the success of the Union Army. Sur- 
 geon Moore in giving reasons for the health of the command, in 
 a later report, does not, in the all too common manner, claim 
 everything for the effects of his own measures, but says: "The 
 pure air, freedom from drunkenness and other vices inseparable 
 from garrison life, but most of all the novelty and excitement of 
 ■an active campaign, on which every man knows that important re- 
 sults depend, are among the causes of better health in the field. 
 And again, the variety and abundance of food, and possibly the 
 irregular and predatory method of obtaining it, may have some- 
 thing to do with better sanitary conditions; and finally, but not 
 least important, was that they were led by a general in whom 
 they have unlimited confidence." 
 
 The thousands that dropped from the ranks during McCellan's 
 retreat through the swamps of the Chickahominy had no counter- 
 part in the swamps of the Carolinas. Not even wading swamps 
 by day and lying in the mud by night could down these iron 
 veterans. If as Napoleon said, the moral is to the physical as 
 three to one, we have here an underlying cause for the freedom 
 from disease of this army. 
 
 MEDICAL OFFICERS OF GENERAL SHERMAN'S ARMY ON THE CAM- 
 PAIGN FROM ATLANTA TO SAVANNAH. 
 
 Medical Director of the Army : 
 
 Surgeon John Moore, U. S. Army. 
 Medical Inspector: 
 
 Surgeon E. D. Kittoe, U. S. Army. 
 Medical Director, Right Wing: 
 
 Asst. Surgeon David L,. Huntington, U. S. Army. 
 
32 MEDICAL DBPARTMEXT IN THE CIVIL WAR. 
 
 M. D. 15th Corps : 
 
 Surgeon Robert Niccolls, U. S. Vols. 
 M. D. 17th Corps: 
 
 Surgeon J. H. Boucher, U. S. Vols. 
 Medical Director Left Wing: 
 M. D. 14th Corps : 
 
 Surgeon W. C. Daniels, U. S. Vols. 
 M. D. 20th Corps : 
 
 Surgeon Henry Q. Gill, U. S. Army. 
 M. D. Cavalry Division : 
 
 Surgeon B. Taylor Wise, U. S. Vols. 
 
Seaman pri3e lEeeaip. 
 
 THE COMPARATIVE MORTALITY OF DISEASE AND 
 BATTLE CASUALTIES IN THE HISTORIC WARS 
 OF THE WORLD. 
 
 By Captain LOUIS C. DUNCAN, Medical Corps. 
 
 INTRODUCTORY. 
 
 THE relation of the number of deaths caused by the enemy 
 in war to the number caused by disease is so striking as to 
 have claimed attention since statistics came into use. That 
 disease, a thing not naturally associated in the mind with war, 
 should cause more deaths than bullets, always expected, strikes 
 the mind with a peculiar force and demands an explanation. 
 Actually there is little relation between the two classes of deaths. 
 One may make a broad generalization and say that they vary 
 inversely; the rugged, hard-fighting army generally has a good 
 health report; and conversely, the sickly army is not able to meet 
 the enemy, or does not face him with the same resolution and 
 endure the same losses. Yet this rule will be often found hon- 
 ored in the breach. 
 
 In general, losses in battle depend on many things beside 
 health, and disease and death therefrom on many things other 
 than bravery. The relation between battle losses and losses from 
 disease is not per se of great importance; the important thing 
 about both is, to what extent are they dependent on avoidable 
 causes ? When disease losses are far greater than those of battle, 
 it is self evident that the greatest losses are in the preventive 
 class; while if battle losses are greater there is not so much 
 
2 DISEASE AXD BATTLE CASUALTIES. 
 
 ground for complaint, since they are expected and largely not to 
 be avoided. 
 
 As to prevention, losses from disease offer by far the most 
 promising field, since the frightful death records of past armies 
 were chiefly occasioned by infectious and preventive diseases, 
 many of which have now been entirely banished from the armies 
 of civilized nations. But battle losses are not altogether un- 
 avoidable, for they are composed of two categories : the killed 
 outright and those who die of wounds. The first are beyond 
 reach, but the second may in large proportion be saved. One 
 hundred and fifty years ago one-fourth or more of the wounded 
 died; to-day in well organized armies no more than one-sixteenth 
 die, though many are now picked up promptly who formerly 
 were left to perish on the field and counted with the dead. 
 
 A study of the two classes of mortality in war would be in- 
 teresting fur itself alone, simply to show the losses from disease 
 in contrast with the battle losses, in various wars at different 
 times in the world's history. The record of such a study, how- 
 ever, would consist largely of statistical tables, resembling a 
 nautical almanac or a table of logarithms, containing much 
 valuable information but dry and uninteresting, and not pre- 
 pared for application. 1 take it that .something more is con- 
 templated in this subject than a bare presentation of statistical 
 tables. Death losses in war are natural phenomena; they have 
 causes that are discernible, and afford lessons applicable to the 
 medico-military problems of to-day. The great captains of the 
 past often saw their armies melt away with disease and apparent 
 victory slip from their grasp; why? And, how can similar 
 disaster be prevented to-day? How and to what extent have the 
 losses in modern times been reduced, and what has brought about 
 the reduction ? These are the important questions evoked ; these 
 are the flesh and blood of the subject; the bare figures are but 
 the dry bones. 
 
 Losses in battle are of less importance to the medical man, 
 for they are largely not preventible. They form a part of the 
 subject chiefly because they serve as an exceedingly striking 
 method of presenting disease losses and contrasting those of dif- 
 ferent campaigns. But in comparing the two classes of losses 
 many people fall into a great error; they seem to imagine that 
 battle losses form a constant, a fixed value by which all disease 
 
DISEASE AND BATTLE CASUALTIES. 3 
 
 losses may be measured, forgetting that battle losses vary almost 
 as much as disease. Homer Lea fell into this pitfall and evolved 
 the ridiculously false idea that the Americans in the Spanish 
 War lost fifty-six times as many men by disease, proportion- 
 ately, as the Japanese in their recent war. He reached this most 
 absurd conclusion by calculating that the Americans lost fourteen 
 times as many men by disease as in battle ; while the Japanese lost 
 but one-fourth as many. Had the deaths from bullets been 
 precisely the same in both armies and his figures correct (and 
 they were not), his conclusion would have been just. Actually 
 it was a most simple blunder, for the disease losses of the two 
 armies were little different. 
 
 A moment's thought will convince anyone that battle losses 
 are never the same, any more than disease losses, and therefore 
 afford no solid ground for reasoning. In the Spanish War there 
 were but a few small conflicts, and less than one-tenth the army 
 was ever engaged. In the late Russian War there were frequent 
 and most sanguinary battles in which practically the entire Jap- 
 anese Army took part, not once but many times. As a matter of 
 fact, the Japanese lost ten times as many men proportionately 
 in battle as the Americans in 1898. 
 
 There is but one method of comparing losses from different 
 causes, in different places, and at different times. That is to 
 reduce all losses to a basis of 1,000 men in service one year. 
 Throughout this essay the writer has uniformly figured battle 
 losses as so many per thousand per annum, and disease losses in 
 the same manner. In this way, and only in this way, can one 
 war be logically compared with another, one age with another, 
 or one part of a given campaign with another. To be sure, dif- 
 ferent campaigns can never be accurately compared, but extreme 
 accuracy is unnecessary. The general trend of losses, the pro- 
 portion that are preventible, the influence if any of the progress 
 and utilization of sanitary science; these are the things that may 
 be deduced by comparison, and the important things. 
 
 For the purpose of this study I have thought it convenient, 
 and not illogical, to divide the history of armies into three 
 periods. First there was a Presanitary Era, lasting from the 
 earliest times to the end of the seventeenth century; second, a 
 period of Medical Organization, lasting to about 1810; and 
 third, a Sanitary Era, lasting to the present time. 
 
4 DISEASE AND BATTLE CASUALTIES. 
 
 Pre-Medical Era, to the Year 1700. 
 
 The history of the sanitary service of armies is unfortunately 
 a short one; the time since the keeping of accurate statistical 
 records of the sick and wounded began is still shorter. Of all 
 the armies that have marched the highways of the world since 
 the first armed force went out to give battle, no records of the • 
 human wrecks remain save for those of the last one and a half 
 centuries ; and no one attempted to accurately record the mortality 
 of armies until a short one hundred years ago. We shall find 
 surgeons following the armies of Greece and Rome, and in later 
 times those military expeditions known as the crusades ; surgeons 
 were apportioned to troops from early in the seventeenth century; 
 military hospitals were used a little later, and the French Army 
 had a regular medical service early in the eighteenth century; 
 but statistics, beyond rough estimates of the battle losses, were 
 practically unknown before the end of that century, about one 
 hundred years ago. 
 
 So all the years to the time of Marlborough and Turenne 
 may be passed over very quickly. As to the medical service of 
 Grecian and Roman armies it is unnecessary to speak; the ex- 
 tensive researches of Percy and Willaume have established 
 beyond a doubt that the Greeks and Romans had neither civil 
 nor military hospitals. No mention is made of anything like 
 a sanitary service by any ancient writer. The only care given 
 to the sick or wounded in those days was such as relatives or 
 companions could afford. The noble and wealthy leaders had 
 their personal surgeons; the poor soldiers, if friendless, had little 
 or no care. Lucan's lines on the brutality of Marius very justly 
 represent the background of a typical battle scene of that time : 
 
 "Nobilitas cum plebe perit : lateque vagatur 
 Ensis : et a nullo revocatum est pectore ferrum." 
 
 The modern army came into existence with the Crusades. 
 Before that time, and after the fall of the Roman Empire, there 
 had been in Europe only petty armies or large irregular hordes. 
 But after the Crusades, and more particularly after the inven- 
 tion of gunpowder, modern armies were formed and began to 
 take on the shape they bear to-day. These armies at first had 
 no medical service whatever, and no doctors or surgeons except 
 those in the service of high ranking officers : the king, nobles 
 and others. In France, until the reign of Louis XIII, there were 
 
DISEASE AND BATTLE CASUALTIES. 5 
 
 surgeons for officers but none for soldiers. When Ambroise 
 Pare came to the siege of Metz in 1575, it was as surgeon to 
 the Duke of Guise; and if any soldier received his ministra- 
 tions it was some chance favorite. For the common soldier 
 there was neither surgeon nor hospital. As De la Noue sadly 
 remarked, the only bed of the sick or dying soldier was the ditch 
 in which he might have fallen ; "leur lit d'honneur est une fosse 
 ou une harquebusade les aura renverses." 
 
 Grose says, "Immediately after a battle the meaner sort of 
 soldiers, whose wounds required considerable time to cure, were 
 dismissed with a small gift sufficient to carry them home." 
 Yet armies always had some sort of pretended doctors, even the 
 American Indian having his medicine man. The armies of the 
 Emperor Charles V, in the middle of the sixteenth century, had 
 no medical service, but were followed by a swarm of ignorant 
 empirics, charlatans and quacks, who soM at a high price elixirs, 
 balsams and even charms. When Charles the Bold of Bur- 
 gundy, the first to attach surgeons to troops instead of officers, 
 fitted out his army of 20,000 men with a surgeon to each regi- 
 ment of 800, all these surgeons were merely barbers, as related 
 by Malgaigne. The study of surgery was not introduced into 
 the universities- of France until the fourteenth century, and as 
 late as the seventeenth the surgeon was a low fellow, far inferior 
 in status to the physician. 
 
 The first surgeons supplied to the British Army were fifty- 
 seven who accompanied an expedition of 16,000 men to St. 
 Quintin in 1557. Thomas Gales, who served in this expedition 
 and afterwardsbecame a celebrated London practitioner, wrote 
 of these "surgeons" : "When I was at the wars there was a great 
 rabblement there that took upon them to be surgeons. Some 
 were sow-gelders and horse-gelders, with tinkers and cobblers." 
 These pretended surgeons, commonly known as "dog leeches," 
 used for cures such trumpery as grease, shoemakers' wax and 
 the rust of old pans, wherewith they made a noble salve. One 
 may imagine the lot of the wounded in the hands of such quacks 
 and fakers. 
 
 As to hospitals they were in no better case. Hospitals also 
 came into use at the time of the Crusades; none are mentioned 
 before 1100. But for many years, in the hands of the monks, 
 they were only sheltering places for travelers and mendicants. 
 Gradually the monks learned a little medicine from the Jews, 
 who had received it from the Arabs. These so-called hospitals 
 
6 DISEASE AND BATTLE CASUALTIES. 
 
 were not for soldiers, but later did take on the functions of mili- 
 tary hospitals. The sick soldier, when he began to receive a 
 little attention from barber surgeons, was treated in his quarters 
 — if he had any; if seriously ill he was dismissed to his home or 
 to die. 
 
 In Rymer's Foedora, among the instructions sent to Sir 
 Thomas Leighton with the English Army in Flanders, in 1593, 
 is this passage : "Where it appeareth that the one halfe or more 
 of the nomber that weare there in Paye are sick and ympotente 
 and unable to serve, it shall be considered how many of them 
 may likely be recovered in short tyme, and those to be reteyned.; 
 as for the others, whose infermities are such as there is no 
 Iykelyhood of their recovery in short tyme, order is to be given 
 to discharge the Queen of her Paye, and to return them to their 
 own country." That is, when useless they were to be cast aside. 
 Sir John Smythe, in ''Certain Discourses,'' 1590, relates how 
 these sick were returned to England : "Great numbers of such, 
 their sick and starved soldiers, by order of the Earl of Leicester,, 
 were in Flanders embarked and transported into Essex and 
 Kent, and other parts of England, to recover health; of which 
 aforesaid great numbers of miserable and pitiful ghosts, or 
 rather shadows of men, the Essex and Kentish carters can 
 testify; of which scarcely the fortieth man escaped with his 
 life." This passage, besides affording a picture of the heartless- 
 ness of the times, is one of the first to show how the sick suf- 
 fered and died in great numbers, and largely uncared for. This 
 moral darkness was at the very time when Sir Philip Sidney was 
 setting his immortal example of charity and self abnegation. 
 
 But these things were passing. The establishment of mili- 
 tary hospitals and some sort of a rudimentary medical service 
 for armies was begun as early as the latter part of the sixteenth 
 century. Pare had hospitals, and there are beautiful prints show- 
 ing him putting away the haemostatic hot irons. An ordinance 
 of Henry IV at the Siege of Amiens in 1597, considered a 
 hospital, and one was actually established by Sully. No more 
 were heard of until the time of the great Cardinal, Richelieu, 
 when hospitals were established in the rear of certain armies. 
 By this time all the cities of Europe had hospitals, and it was 
 customary to send part of the wounded to near-by cities. Ecclesi- 
 astical hospitals were utilized in the same manner. Military 
 hospitals, however, as permanent institutions, did not exist. The 
 sick and wounded were largely left to private and public charity ; 
 
DISEASE AND BATTLE CASUALTIES. 
 
 and this condition existed until near the close of the reign of 
 Louis XIV. That monarch made use of temporary hospitals in 
 the rear of his armies; Voltaire gives a glowing account of the 
 hospitals at the Siege of Lille in 1707. He also established per- 
 manent hospitals. 
 
 In England at this time the sick were generally billeted in 
 houses. Both Evelyn and Pepys speak of the wretched condi- 
 tion of the seamen wounded in the Dutch War, 1664-68, and 
 the difficulty of caring for them. For example, Pepys, October 
 5, 1665 : "To Mr. Evelyns to discourse of our confounded busi- 
 ness of prisoners and sick and wounded seamen, wherein he and 
 we are so much put out of order." Evelyn, in 1666, proposed 
 a plan for an "Infermerie," and the Merry Monarch gave it his 
 
 
 ml w%£&& 
 
 ' '■ ' . 11, ■ ,. - . I u<- r. 
 
 • Ambrose. Pare nscaroimg the jse cf cauteries in amputations • I 
 
 gracious approbation; but Evelyn sadly remarks, "I saw no 
 money." 
 
 The great Hotel Dieu and the principal communal hospitals 
 of France owe their foundation to an edict of Louis XIV, of 
 date 1693. These hospitals for years were for "poor mendi- 
 cants" and the like, not for the better or even middle classes. 
 The first permanent military hospital was the Hotel des In- 
 valides, founded by royal edict in 1674, rather as a home for 
 disabled soldiers than as a hospital for acute cases. The English 
 military hospital at Chelsea was founded in 1682; the hospital 
 for seamen at Greenwich in 1695. Other military hospitals- 
 were established on the continent, and by 1758 there were nearly 
 a hundred in France alone. They were as a rule temporary in- 
 stitutions at the bases of operations, always insufficient, and 
 
8 DISEASE AXD BATTLE CASUALTIES. 
 
 dependent for supplementary aid on the civil and ecclesiastical 
 hospitals. The medical officers of these had almost no authority, 
 the control being in the hands of a Commissary of Subsistence. 
 One may judge somewhat of the quality of the hospitals by the 
 statement that one bed always contained two patients — if not 
 more. In the Hotel Dieu six patients were sometimes crowded 
 into a bed four and one-half feet wide. 
 
 Field Hospitals, hospitals ambulantes, or ambulances, were 
 introduced by Cardinal Richelieu about 1639. The first were 
 established in towns in rear of the army; but there was also a 
 small establishment of Jesuits, with nurses and cooks, accom- 
 panying the army for the purpose of feeding and attending those 
 who did not choose to go to the hospital. This, the first real 
 field-hospital service, was composed of "six Jesuits ; viz., four 
 priests and two lay brothers ; together with a cook and five aids, 
 a surgeon and an apothecary." "The said Jesuits shall have 
 two two-wheel carts, provisions and six sheep a day. The said 
 Jesuits are particularly charged with the consciences of the sick." 
 This was an infirmary rather than a hospital; it had no tentage, 
 and the treatment must have been "in quarters." During the 
 reign of Louis XIV this small hospital service was greatly in- 
 creased and improved by the addition of surgeons, remedies, 
 instruments and appliances of every sort ; but tents were un- 
 known, likewise ambulance wagons for carrying the sick. The 
 Franciscans were at that time charged with the service of the 
 ambulances. 
 
 The French term ambulance, generally used on the continent, 
 comes from the verb ambulare, to march; and is equivalent to 
 the old English term, marching hospital, or ambulant hospital. 
 It corresponds roughly with our term, field-hospital, but in 
 Larrey's time included ambulance wagons. The English first 
 provided it with tents, about 1690. 
 
 Of the exact losses to armies from disease in the middle ages 
 we have no record. That they were greater than the battle 
 losses there can be no doubt. The average death rate of civil 
 communities was then as high as battle losses in any but the 
 most sanguinary wars. That of soldiers in home garrisons in 
 the piping time of peace as high as that which occasioned such 
 surprise and indignation in 1898. A greater proportion of men 
 in armies died in time of peace before the eighteenth century 
 than during the wars of the past fifty years; and as far as we 
 have records the peace rates have always been increased about 
 
DISEASE AND BATTLE CASUALTIES. g 
 
 five fold in time of war. Battle losses, on the contrary, while 
 probably as great in single combats, were on the whole much 
 less ; for armies waged war in a leisurely manner, usually going 
 into quarters during winter and campaigning during but six 
 months of the year. In the sixteenth century we read of the 
 Hundred Years War, and in the seventeenth of the Thirty Years 
 War, with but few great battles. No such wars occur to-day. 
 Frederick the Great waged a war for seven years; Bismarck 
 and von Moltke annihilated the military power of France in 
 seven months. No war of ancient times^ was pushed with the 
 relentless swiftness of that campaign. 
 
 Battle losses were on the whole less than now, and losses 
 from disease far greater, but no exact or even approximate fig- 
 ures can be given. Examples, however, are not wanting. 
 Passing over the not infrequent destruction of ancient armies 
 by pestilence, and the ruin of several of the Crusades by famine 
 and disease, a brief mention will be made of that terrible 
 struggle known as the Thirty Years War. This war, lasting 
 from 1618 to 1648, converted all Central Europe into a mael- 
 strom of fire, sword, famine and pestilence ; even the true plague 
 added to the horror of that time. Less than sixty battles and 
 combats of every kind were fought. In many the loss was 
 trifling; and in one of the greatest and most decisive, the Battle 
 of the. White Mountain, but a few hundred were killed. No 
 writer has ever adequately pictured the terrific effect of want, 
 suffering and disease on both people and armies during this 
 period. Army after army, magnificent in appointment, perfect 
 in discipline, heroic in valor, plunged into that vortex which 
 rejected but a few wrecks of what it had absorbed. Army after 
 army from Sweden and all the Protestant states, and from the 
 Empire and Catholic states, filled up the chasm made by battle, 
 want and disease, but chiefly by disease. More than once, when 
 two armies sat down to observe each other, they suffered far 
 more from the filth of their camps and consequent maladies 
 than if they had fought the most murderous battles. Schiller 
 notes that when the great Swedish leader comes on the field he 
 resolves to change the method of warfare, and 
 
 "the king resolves 
 To storm the camp, and lead his wasted legions, 
 Who daily fall by famine and by plague, 
 To quicker death than hunger and disease." 
 
io DISEASE AXD BATTLE CASUALTIES. 
 
 The perils of battle were less than those of a camp where the 
 army was wasting to nothing by disease. And when that valiant 
 army had fought its way from the shores of the Baltic to the 
 very gates of Vienna, and was only held in check by the fortress 
 of Brunn, disease, plague, once more appeared and accomplished 
 what all the armies of the Empire could not. Whole regiments 
 disappeared; in one case not a man was left of a large organiza- 
 tion; the general, Torstenson, was compelled to leave the field, 
 the siege was raised and the campaign lost. 
 
 Such was the unchecked course of disease in the seventeenth 
 century, subject to no law or hindrance save that of fate or 
 chance. Yet there were hopeful signs; surgeons and hospitals 
 were appearing in armies, though as yet exerting little or no 
 influence in lessening disease. That influence was to appear 
 later and it was a hopeful sign when the true plague disappeared 
 from European armies in this century. 
 
 During the ages when constant warfare and its mate, the 
 ever-present epidemic, wiped out whole peoples, the average 
 span of life was about twelve years. Since the world began 
 more lives have been sacrificed through ignorance than through 
 the combined losses of war, slavery, torture, assassination and 
 religious bigotry. The average length of life in the sixteenth 
 century was from eighteen to twenty years ; in the eighteenth it 
 was about thirty, in the nineteenth the average increased to forty, 
 and is now reckoned at from forty-five to fifty. A death-rate of 
 twenty-five per thousand in the Spanish-American War shocked 
 the country. The death rate of London in the time of Marl- 
 borough was fifty-five. 
 
 Era of Medical Organization, 1700 to 1S10. 
 
 The utilization of hospitals and the institution of" some sort 
 of field-hospitals or dispensaries was naturally accompanied by 
 a medical service. Surgeons, at first in personal attendance on 
 certain officers, were later assigned to troops, and still later or- 
 ganized into a regular corps or service. Gustavus Adolphus, 
 1630-32, was the first great general to regularly provide his 
 army with surgeons. During his campaigns in the Thirty 
 Years' War he assigned four surgeons to each regiment of one 
 to two thousand men. In England regimental surgeons date 
 from the permanent organization of regiments; that is, from 
 about 1660; but surgeons were employed irregularly much 
 
DISEASE AND BATTLE CASUALTIES. n 
 
 earlier. In France surgeons were first assigned to regiments 
 during the reign of Louis XIII. In 1620 King James provided 
 for an expeditionary force of 30,000 men, a chief surgeon for 
 each regiment of 1800, and a surgeon for each company of 150; 
 but no allotment of funds was made for either medicines or 
 hospitals. These early army surgeons were expected to furnish 
 their own medicines and treat their patients anywhere, when 
 not billeted or placed in established civil hospitals. In 1639 a 
 regimental surgeon ranked with a chaplain and received four 
 shillings a day. In Germany and Italy it was then customary 
 to allow a surgeon of some sort to each troop or company. 
 Surgeons were far more plentiful than now; but with their gen- 
 eral ignorance, lack of organization, wretched care of the sick 
 and wounded, and total lack of sanitary knowledge, their num- 
 bers in no way compensated for the usual rabble of runagate 
 surgeons and nostrum venders. 
 
 The body of surgeons did not constitute a real medical 
 service in any army before the end of the seventeenth century. 
 In France as early as 1708 the land forces had a regular medical 
 corps, numbering 196 in all, with" chief surgeons, chief physi- 
 cians, assistants and regimental surgeons. In 1746-47, under 
 the administration of Count d'Argenson, this body suddenly 
 became a complete service, with minutely systematized regula- 
 tions and a hierarchy of officials. The hospitals were divided 
 into fixed, sedentary and ambulant, and the sphere of each was 
 clearly defined by the General Regulations of January 1, 1747. 
 The operation of these hospitals was directed in great detail 
 by an order of forty-two paragraphs. There was a complete 
 medical staff for the three classes of hospitals, which correspond 
 closely to our modern base, evacuation and field-hospitals. These 
 field-hospitals, however, carried no tentage; in all the accounts, 
 descriptions, directions and regulations of French field-hospitals 
 then, there was no mention of tents. 
 
 The medical service of 1747 remained the medical service 
 of the French Army, with little essential change, until the war 
 of 1870-71. It is generally supposed that Larrey introduced 
 ambulant hospitals, but he did not originate them. Such hos- 
 pitals had existed for nearly a hundred years when he placed 
 his ambulance volante in operation in 1797. What he did was 
 to improve the existing hospital and give it light transportation. 
 Before his time the ambulance reached the field a day or two 
 after the battle ; he gave it light equipment and wagons, and had 
 
12 
 
 DISEASE AND BATTLE CASUALTIES. 
 
 it on the field when the battle began. The great defect of the 
 French Medical Service then, and even in 1870, was that it had 
 neither independence nor authority ; it was but a subordinate 
 part of the Intendance or Supply Department; it was stilled and 
 emasculated by the careful withholding of all power. 
 
 In the British Army there was, by 1700, a tolerably com- 
 plete medical service. Under the Stuarts the army, like all else, 
 fell into disorganization, but during the reign of William of 
 Orange it was whipped into shape again and became the splendid 
 force which, a few years later under Marlborough, won such 
 high renown on all the fields of Europe, from the Low Countries 
 to the Danube. After the Irish War of 1689-90 the medical 
 
 1792. 
 
 service was entirely reorganized. There was provided a surgeon 
 and assistant for each regiment, a base hospital in some town 
 in the rear, while following the army was a "marching hospital," 
 with twelve cars for carrying the sick, eight wagons for sup- 
 plies, and twenty-five tents for 200 patients. The medical 
 service of the army at that time plainly foreshadowed the service 
 of to-day. The marching hospital, however, was soon lost 
 sight of, and not seen again for nearly a hundred years. By 
 1745 the medical service was in good state for the times, as may 
 be learned by reading the admirable observations of Sir John 
 Pringle, who was Medical Inspector of the Army in Flanders 
 and on the Rhine. At that time, and until recent years, the 
 principal field-hospital was the regimental hospital. There was 
 
DISEASE AND BATTLE CASUALTIES. 13 
 
 no permanent field-hospital as in the French Army, but in the 
 Peninsular War very temporary field-hospitals were established 
 after a battle. The American Army, a natural descendant of 
 the British Army, followed the same plan to the Civil War, 
 and even throughout that war, but toward the end the field- 
 hospitals tended to become more permanent. The British 
 Service, like the American, has had the advantage from an early 
 date of a considerable degree of independence, a factor which 
 has contributed more than any other to the efficiency of both. 
 
 Yet all these contributions to the care of the sick and 
 wounded lessened mortality but little; in fact it was generally 
 believed that the hospitals increased the mortality. Pringle, 
 in enumerating the causes of mortality in war, named hospitals 
 as an important factor, and McGrigor in 18 16 quoted the pas- 
 sage approvingly. The, hospitals of Europe until the nineteenth 
 century were little more than the name indicates — shelter for 
 the helpless sick — in which they died by hundreds. In these hos- 
 pitals, where two, four, or even six patients were crowded into 
 one bed, where ventilation was unknown, and each was subject 
 to the contagions and infections of all the others, the food 
 poor and the treatment too often quackish, death was ever 
 present. Turpin de Crisse declared that he saw in the wars 
 from 1 73 1 to 1 74 1 vastly more men die in the hospitals for 
 lack of care than lose their lives in combat, and he declared, 
 "Military hospitals are an unfathomable gulf, the source of 
 their horrors appears to be inexhaustible." Hospitals were in 
 fact breeding places of disease; especially of typhus or hospital 
 fever, as well as of typhoid, dysentery as malignant as any of 
 the tropics, purulent infections, erysipelas, gangrene and a host 
 of lesser evils. Such minor discomforts as acarus and pedicu- 
 losis were ever present. Many men now living remember when 
 lying-in hospitals increased the dangers of childbirth, but few 
 realize the real role of hospitals in the presanitary era. 
 
 The relative losses in battle and by disease in this period 
 cannot in general be given ; or at all except roughly in a few 
 isolated instances. Statistics were then unknown. Every one 
 who has read Pepy's Diary will remember what difficulty he, the 
 principal accountant of the navy, had with his bookkeeping. 
 The few medico-military writers, like Pringle and Munro, con- 
 cerned themselves chiefly with observations on disease; they did 
 not and could not record the losses. General historians in all 
 ages have ignored diseases and the influence of the medical pro- 
 
i 4 DISEASE AND BATTLE CASUALTIES. 
 
 fession on civilization. For example. Motley, in his "Rise of 
 the Dutch Republic," a work of three volumes dealing with thirty 
 years of almost constant sanguinary warfare, never once alludes 
 to an army surgeon or an army hospital. Some argue from 
 this neglect that the ancient and medieval armies were hardier 
 and suffered less from disease than those of the present time, 
 and had lower death rates. Such ideas are altogether erroneous. 
 During the time of which we have reliable knowledge the mor- 
 tality of armies has irregularly but surely decreased; and there 
 is every reason to believe that death rates were never lower than 
 at the beginning of the era of sanitation, little more than one 
 hundred years ago. Soldiers before that time were less well 
 cared for in every way, the death rate of the nations was twice 
 what it is now, men were exposed to all the diseases now extant, 
 and in addition to such deadly pestilences as plague, cholera, 
 smallpox and typhus, now practically unknown in the armies of 
 civilized nations. Not only was there vastly more sickness, 
 but of the sick a much larger proportion died, from more deadly 
 diseases and from lack of care, proper treatment, and especially 
 lack of sanitary knowledge and management. Even the wounded 
 died in large numbers as compared with the present; with poor 
 surgery and little care, ordinarily one-fifth or more would die; 
 but crowded into hospitals they contracted the most malignant 
 infections and even dysentery and typhus, resulting in the death 
 of one-half or even more of their number. To-day about five 
 or six per cent, of the wounded die ; then twenty, thirty, fifty 
 or even more. The medical service at that time had become 
 organized, it had secured hospitals both in the field and at bases 
 of operations, but it had made little impress on the high mor- 
 tality rates. Why? Because as yet it only attempted to care 
 for the sick and wounded. It had not yet attempted to any 
 extent, and had not the requisite knowledge, to prevent disease. 
 
 Campaign in Ireland, 1689. 
 
 During the war of King William and James in Ireland, the 
 Duke of Schomberg landed at Bangor on August 13, 1689, with 
 an army of 14,000 regular troops, including many regiments 
 still in existence, as the Dragoon Guards and Inniskillings. 
 This army took Carrickfergus and in September marched to 
 Dundalk and went into camp there. Among the troops were 
 many recruits, the camp was low and unhealthy, food and 
 
DISEASE AND BATTLE CASUALTIES. 15 
 
 clothing were scarce, surgeons few and hospitals lacking. Sick- 
 ness of a malignant nature soon appeared and spread through- 
 out the army, which had slight means of combating it. This 
 failure was not due to the medical officers, but to Harbord, the 
 army treasurer, who afterwards acknowledged his responsibility 
 for the lack of hospitals, and stated that had he known as much 
 at the beginning of the campaign as at the end he might have 
 saved two-thirds of the men. 
 
 On account of sickness the army was unable to take the of- 
 fensive and remained in the sickly camp. In October Schom- 
 berg, who was himself attacked, wrote the King that he had 
 sent 1,000 sick to Dublin; but this only faintly represented the 
 true state of affairs. In November the rains became incessant 
 and the troops were obliged to break camp and go into winter 
 quarters. At that time nearly the whole command was sick and 
 when the army marched away it appeared to consist only of 
 the sick and those in attendance upon them. Many were so low 
 and apathetic that they did not desire to be moved; hundreds 
 died straggling along the roads and on the boats, still more after 
 reaching Belfast, where the sick were taken. 
 
 While we have no precise accounts of the losses during this 
 campaign of entire failure, Story's account of the war gives 
 some rough idea of the deaths from disease; the deaths occa- 
 sioned by the enemy were negligible. 
 
 Died at Dundalk 1700 
 
 Died en route to Belfast 870 
 
 Died in hospitals at Belfast ' 3762 
 
 Total 6332 
 
 Survivors 7700 
 
 Some of the regiments, averaging from 700 to 800 men, had 
 but 60 fit for duty. In a few months, with practically no fight- 
 ing, almost one- half the army died from disease, and the re- 
 mainder was totally unfit for the field. As Howell says, this 
 terrible loss was directly due to the foolish mistake of sending 
 into the field an army which had not been carefully prepared, 
 trained and fitted out in time of peace for what it was called 
 upon to do in time of war. 
 
 This, one of the most terrible examples of the destruction 
 of an army of which there is a record, was yet productive of 
 
1 6 DISEASE AND BATTLE CASUALTIES. 
 
 ultimate good; for, as is often the case after a shipwreck or fire 
 to-day, the horrible example spurred the authorities into an im- 
 provement of the medical service of the army. The marching 
 hospital and fixed hospital of the British Army were first put 
 on a proper basis by Royal Warrant of March, 1690. 
 
 Campaigns in Flanders, 1742 to 1748. 
 
 Sir John Pringle was one of the first to write on the diseases 
 of armies; accompanying the British forces in the Netherlands, 
 1742-48, he wrote an account of his work there, with observa- 
 tions on the diseases seen, and gave incidentally some frag- 
 mentary statistics. Writing in 1768, he regretted that neither 
 ancients nor moderns had written on the diseases of armies. 
 
 In 1742 the force in the Low Countries amounted to 14,000 
 men and the sick never exceeded 10 per cent, of the command; 
 this was double the rate at home, but was not accounted an im- 
 moderate number. At Bruges during the autumn there was 
 three times as much sickness as that mentioned, the fever was of 
 a typhoid type and more in proportion died. These fevers with 
 dysentery filled the hospitals, and now appeared that disease so 
 much dreaded, hospital fever or typhus. 
 
 In 1743 the army marched up the Rhine as far as Hanau 
 and on June 26th fought the battle of Dettingen. Soon after- 
 wards dysentery was very prevalent in a malignant form, 1500 
 being sent away within a few days. In October the army re- 
 turned to Flanders, leaving behind one-fourth its number sick 
 with dysentery and fever. Of these about one-half died, or 
 more than 10 per cent, of the army. Some idea of the malig- 
 nancy of the fever may be learned from Pringle'? statement 
 that of fourteen hospital mates all but one or two were sick 
 and five died; while the inhabitants of one village in which a 
 hospital was located nearly all died. 
 
 In 1744 there was little sickness. Pringle says not to exceed 
 300 died in this campaign; a rate of 25 per 1000 per annum, 
 which would be considered good to-day. In 1745, the year of 
 Fontenoy, the season was dry and the army healthful; at the 
 end of the campaign there were but 1000 sick, and 200 had died 
 out of an army of 20,000. All these figures are estimates and 
 doubtless too small. 
 
 In 1746 the greater part of the army was brought back to 
 England on account of the Stuart rising known as The Forty- 
 
DISEASE AND BATTLE CASUALTIES. 17 
 
 five. Some 10,000 men marched into Scotland and in April 
 fought the Battle of Culloden. During six months 2000 had 
 been in hospital and 200 died of disease. This last figure is 
 hardly credible, for in two regiments 97 were sick on landing, 
 of whom 40 died. 
 
 In 1747 an army of 12,000 men took the field in Flanders 
 and the Battle of Laffeld was fought in July. The troops were 
 sickly and about one-half the men were down with fever and 
 dysentery. During this time four battalions had been stationed 
 on the islands of South Beveland and Walcheren. These corps 
 were so sickly that at times not more than 100 men were fit for 
 duty out of 700. The Royal Battalion had but four men not 
 attacked. When these troops went into winter quarters 80 per 
 cent, of them were sick; yet at the same time Commodore 
 Mitchel's Squadron, lying between the islands, enjoyed perfect 
 health. The proportion of deaths from disease cannot be given, 
 but it all depended on fate and was unaffected by sanitary 
 arrangements. 
 
 Walcheren Expedition. 
 
 The classical example of the failure of a campaign and ruin 
 of an army by disease is that of the British expedition against 
 Antwerp in 1809. On August 1st of that year the Earl of 
 Chatham landed on the low, flat and unhealthy island of Wal- 
 cheren, in Zealand, with a Regular Army of approximately 
 42,000 men, well equipped and apparently as hopeful of success 
 as the similar small army then operating on the Spanish Penin- 
 sula. It was said that this was the largest force which up to 
 that time had ever been fitted out in England. Unfortunately 
 no study had been made of the seat of operations, and there was 
 insufficient sanitary preparation. 
 
 The landing was unopposed, and, after bombardment, Flush- 
 ing was entered on August 15th. Hospitals were established 
 in the ruined buildings of the place, and in the surrounding 
 towns where the troops were quartered. All were unhealthful, 
 the whole region being low and swampy, the water bad, and 
 the very air pestilential. Sickness promptly appeared and spread 
 with the alarming rapidity of a true plague. By August 25th. 
 there were 5000 sick in the hospitals, and the disease was be- 
 coming so prevalent and widespread as to threaten the success 
 of the undertaking, and even the existence of the army. A 
 
1 8 DISEASE AND BATTLE CASUALTIES. 
 
 council of war was held on the 27th and it was decided to 
 abandon the capture of Antwerp, the prime object of the cam- 
 paign, leave about 17,000 men to hold the island, and send the 
 remainder with the sick back to England. The sick by this time 
 numbered nearly one-fourth of the army; more than 500 had 
 already died. The troops destined for England were embarked 
 early in September and it was found that many more sick came 
 to go than had been reported. 
 
 By September 10th only 16,000 men remained, but of these 
 7000 were already sick. The deaths in September amounted to 
 52 per 1000; in October the rate rose to 62, equivalent to an 
 annual rate of 756 per 1000. These died or were sent home 
 until by November 25th there were but 6749 remaining. It was 
 finally decided to abandon the island, and on December 23d the 
 last British soldier left the place. But the disease by no means 
 ceased with the withdrawal. Some 2000 had died there; a 
 vastly greater number died after reaching England. The disease 
 continued and even spread. Many men not previously affected 
 were seized and it continued through the winter and spring. 
 By January 1st nearly 2000 more had died and the hospitals 
 where these troops were stationed were filled with sick. More- 
 over, the regiments were so filled with weak and sickly men that 
 during the next campaign in Spain they had much more sick- 
 ness than regiments that had been so fortunate as to escape 
 Walcheren. The total number of deaths was approximately 
 8,000, or 20 per cent, of the expeditionary force; of these but 
 106 were killed in battle and about 100 died of wounds. The 
 money cost of this abortive campaign was twenty million pounds, 
 on which the English people are still paying interest at the rate 
 of two million dollars a year. 
 
 A plain speaking Scotchman, writing for the Edinburgh 
 Rcriczi'. said of this expedition: "The expedition to Walcheren, 
 planned and conducted as it was, was the fruit of statistical 
 ignorance in everyone from Prime Minister to Commander-in- 
 Chief, and from him to the surgeon's mate. That ignorance any 
 Dutchman could have dispelled." It would have been easy to 
 learn from Sir John Pringle that of four battalions of British 
 troops on this very island in 1747, within a few weeks four men 
 out of five were sick. When the later expedition landed there 
 were but 85 men alive of a Dutch regiment that had come to the 
 island three years before. The average death rate of the in- 
 habitants was 32 per 1000, and the French troops along the 
 
DISEASE AND BATTLE CASUALTIES. 19 
 
 Zealand coast had lost one-third their number by death each year. 
 Napoleon was well acquainted with these details; when he 
 learned of the landing of the expedition he said : "We are re- 
 joiced to * see that the English have packed themselves in the 
 morasses of Zealand. Let them only be kept in check and the 
 fevers peculiar to that country will soon destroy them." 
 
 That this tremendous loss of life was due to unsanitary con- 
 ditions is proven, if proof were necessary, by the fact that there 
 was no more than the usual sickness in the fleet lying off the 
 coast. Sanitation on shipboard was in advance of that in the 
 land forces. This fleet numbered 35 sail of the line and 22 
 frigates and other vessels, with 174 transports; all carrying more 
 than 25,000 seamen and marines. Three cavalry regiments were 
 not landed, but remained on the transports in the Scheldt and re- 
 turned to England in September. These were unaffected by 
 epidemics and had no more than the usual sickness. A cavalry 
 regiment which was landed, the Ninth Light Dragoons, suffered 
 more than any of the other 47 except only 4. Rarely in all 
 history has ignorance and carelessness of sanitary rules led to 
 such grievous and humiliating results as in the expedition to 
 Zealand in 1809. 
 
 San Domingo, 1802. 
 
 Since armies to-day are compelled to campaign in tropical 
 climates, and unfair comparisons are frequently made between 
 the losses of such armies and those operating in cool and health- 
 ful latitudes, it will be useful to cite an example of the fate of 
 an army in the tropics in the presanitary era. 
 
 Napoleon, having decided on the conquest of San Domingo, 
 despatched a force of 20,000 men under General LeClerc to that 
 island in 1802. This force was made up of veterans and well 
 commanded, but scarcely had it landed when yellow fever ap- 
 peared and spread rapidly. The disease seems to have been even 
 more fatal than usual, and this army was swept as if by such 
 a pestilence as one reads of in legendary history. Officers and 
 soldiers perished by hundreds and thousands; 5000 had died in 
 a short time and 5000 more were sick. A reinforcement of 
 10,000 men arrived, but death was more .rapid than the ships 
 could carry them over from France. Thiers states that at least 
 15,000 perished. But 10,000 were left sound and these soon 
 succumbed to a small British force sent against them. Of 30,000 
 excellent troops scarcely any ever returned to France. 
 
LOSSES FROM DISEASE 
 IN VARIOUS WARS. 
 
 WALCHEREN EXPEDITION, J809. 
 
 2.0 in 50. 
 PENINSULAR WAR, 181 1 - 1814. 
 
 M m m m m* mum mmmm 
 
 6 In 50. 
 CRIMEAN WAR, 1854-56, ENGLISH. 
 
 hu m mi i tm m mi urn m u nm 
 
 II in 50. 
 AMERICAN CIVIL WAR 1861 - 65. 
 
 mum mnmmm ummm ummum 
 
 3 in 50. 
 
 FRANCO-PRUSSIAN, SPANISH, BOER, AND RUSSO- 
 JAPANESE WARS. 
 
 ummmumm m mmmmmmtmum 
 
 I in 50. 
 
 ttji 
 
DISEASE AND BATTLE CASUALTIES. 21 
 
 The Sanitary Era. 
 
 In the preceding pages, dealing with the care of the sick and 
 wounded, and the losses by battle and disease, the slight means 
 utilized for mitigating the sufferings of war are painfully ap- 
 parent. The terrible results of official neglect which darken the 
 pages of the history of those earlier years stamp the people in 
 general with indifference, if not brutal carelessness, concerning 
 the fate of the victims of war. When this hardness began to give 
 way to feelings of humanity, and men no longer looked on pesti- 
 lence as the inevitable manifestation of the malevolence of 
 nature, medical services were established in armies; services at 
 first lacking sufficient surgeons and doctors, attendance, sup- 
 plies, even food; and possessed of little or no influence or 
 authority. Their object was solely humanitarian; the world 
 had reached a stage of moral evolution where it could no longer 
 look without feeling on the sick soldier dying in a ditch, or the 
 maimed veteran begging from door to door. An aid to this 
 evolution was the change in the soldier himself; from a hired 
 mercenary to a patriotic defender of the State. The State 
 then prepared means' Of succor for the victims of battle; but 
 slowly learned that disease caused far more deaths than battle. 
 Frederick" the Great said fever alone cost him more men than 
 seven great battles. Still later men began to see that disease 
 was susceptible of prevention or at least of diminution, and that 
 the sanitary service was a powerful weapon for that very pur- 
 pose. Here was an entirely new view of the functions of that 
 service. 
 
 Sir John Pringle had written on prevention in 1768 and 
 made some efforts in that direction, but little was accomplished 
 before the Napoleonic Wars. Those tremendous contests lasted 
 so long that they served as great practical schools in which all 
 branches of the art and science of war made remarkable prog- 
 ress. We find the officers of the British Army much concerned 
 with sanitary affairs and making real progress. In the French 
 Army knowledge of sanitation advanced, but there was little 
 opportunity for its application; surgery and the handling of the 
 wounded were more in evidence. 
 
 The first sanitary efforts were crude and frequently fruit- 
 less of results. It was not until nearly a hundred years later 
 that the discoveries of modern bacteriology placed in the hands 
 of sanitary officers adequate knowledge and the weapons with 
 
22 DISEASE AXD BATTLE CASUALTIES 
 
 which to successfully combat the infections and contagions 
 which have heretofore caused the great mortality of field forces. 
 The birth of this idea of sanitary prevention of disease 
 marks the great turning-point in the work and success of the 
 sanitary services of armies. Instituted chiefly to care for the 
 wounded, they had no appreciable influence on the mortality of 
 campaigns ; gradually becoming organized and fitted to care for 
 the sick and wounded, they still had little effect on the death 
 rate of armies ; but with the dawn of the idea of preventing 
 disease, and conserving the strength and vitality of the army, 
 they took on for the first time a real importance, and became a 
 vital part of the forces. The sanitary officer began to take rank 
 with other staff officers. But he must prove his faith by works. 
 Unless he could actually reduce the terrible death rate of disease 
 in armies, and make camps less dangerous than battle, his claims 
 would appear pretentious and his measures of no value. 
 
 Napoleonic Wars. 
 
 These wars saw little sanitary progress in the French Army. 
 Contrary to the general opinion, the Emperor Napoleon gave 
 little or no attention to the sick and wounded. With his eye 
 ever fixed on victory ahead he cast no disquieting glance on the 
 wrecks that strewed the roads in his rear. The elan of the 
 Grand Armee never occupied itself with what was left behind; 
 le blessc on les maladcs ctait an cmbaras pour sa marche. 
 Abandonment of the wounded was the rule in his armies. Lar- 
 rey and Percy introduced the flying ambulance, but it was seldom 
 seen outside the Guard. The sick and wounded, when not aban- 
 doned, were stuffed in buildings of every sort and left to die. 
 The army depended on charity as in the days before Louis XIII. 
 Larrey, Percy, des Genettes and a few officers gained reputa- 
 tions, but for the mass of officers the imperial epoch was a 
 bloody drama which they followed without even reflecting a 
 little of its glory. They knew but the sepulchres of the Grande 
 Armee, the frightful crowded and infected hospitals, reeking 
 with blood and filth. A pamphlet of the restoration not un- 
 justly termed these so-called hospitals the sepulchres of the 
 army. But this neglect and disdain of sanitation and the sani- 
 tary service brought its own sure reward. 
 
 The Peninsular War has been often spoken of as a cancer 
 which for years steadily gnawed at the vitals of France, con- 
 
DISEASE AND BATTLE CASUALTIES. 23 
 
 suming her armies, though scarcely a battle a year was fought. 
 It has been estimated that 460,000 men perished in Spain and 
 Portugal, of whom no more than 60,000 fell in battle. 
 
 . For the Russian campaign of 1812 little preparation was 
 made and no hospital was established from Wilna to Moscow. 
 It would be mockery to call the buildings filled with wounded 
 and sick hospitals, destitute as they were of every essential 
 except shelter. Of 500,000 men- who crossed the Dnieper in 
 June scarce 20,000 recrossed in December. Some 60,000 fell 
 before the enemy; 200,000 perished in other ways during the 
 disastrous retreat from Moscow. This is hardly a fair charge 
 against disease, for amid the snows of Russia famine and cold 
 were captains of the men of death. Yet sickness was not lack- 
 ing. All the convents and public buildings along the way were 
 filled with sick, nearly all of whom died. Twenty thousand 
 died in Wilna alone, and as many in Dantzig. The lack of ade- 
 quate organization of the Intendance, including the sanitary 
 service, may be blamed for this catastrophe, which well illus- 
 trates the Roman proverb, "Saepius enim penuria quam pugna 
 consumit exercitum." 
 
 In the campaign of 1813, after Leipsic, it was disease alone 
 that dissipated the army; of a hundred thousand men who left 
 Leipsic in October but a few fragmentary battalions followed 
 the eagles across the Rhine in November. The army lay scat- 
 tered amid the villages on the route from Germany; the men 
 dying by thousands and spreading a pestilence among the in- 
 habitants. Reliable observers say the retreat from Leipsic was 
 no less ruinous than that from Moscow, although there was 
 neither cold nor famine. The utter ruin of the army was the 
 legitimate fruit of sanitary indifference and neglect of the sick 
 and wounded. 
 
 The principal campaigns of the British Army were those of 
 the Peninsula, 1808-11. From December, 1808 to June, 181 1, 
 Sir James McGrigor was at the head of the medical depart- 
 ment of these armies. Gravely impressed by what he had seen 
 in Walcheren he made determined and successful efforts to im- 
 prove the sanitary condition of the army, and especially to 
 avoid typhus in the hospitals. He also instituted accurate med- 
 ical statistics, so that for the first time the relative losses from 
 different causes might be known. This alone had a powerful 
 effect on the improvement of the condition of the army. As 
 we say to-day, he turned on the light. 
 
24 DISEASE AND BATTLE CASUALTIES. 
 
 During these two and a half years there were in all the 
 hospitals 2699 deaths from wounds and 14,269 from disease. 
 The death rates may be estimated at 42 per 1000 per annum 
 killed or died of wounds, and 118 died from disease. Disease 
 destroyed four times as many as the enemy. While McGrigor 
 says typhus was little seen, typhoid and dysentery appear to 
 have caused 11,000 of the 14,000 deaths from disease. The 
 death rate in the army at home at that time was about 15 per 
 1000 per annum. The disease death rate of the French armies 
 in Spain could not have been less than 150. 
 
 To the successful efforts of the medical officers in this war 
 its great historian Napier bears witness : 
 
 "The extraordinary exertions of the medical officers may 
 be said to have decided the day at Vittoria, for their exertions 
 undoubtedly added a full division to the strength of Welling- 
 ton's army; and without these 5000 men it is doubtful if his 
 Lordship, with his unrivalled talent, could have carried the day." 
 
 Their efforts were still much more directed to cure than to 
 prevention. It appears that about 14 per cent, of the wounded 
 died, an excellent rate for that time. Of the sick no rate can 
 be given but it was not above 10 per cent. 
 
 Russo-Turkish War, 1828-29. 
 
 During this war, of 115,000 Russians who crossed the Pruth 
 not more than 15,000 ever returned; the rest died of fevers, 
 dysentery, plague and cholera. Sanitation had lagged behind 
 in Russia and was unknown in Turkey; diseases now unseen 
 in Europe prevailed and the sick died by thousands. More than 
 one-fourth the fever patients died. Of 5500 entering the hos- 
 pitals in August, 1829, 3959 died within the month and but 
 614 ultimately recovered. During the year the Russians lost 
 at least 60,000 men by disease. Among the deaths were those 
 of 54 surgeons. This terrible record is but typical of many, 
 if not most campaigns, during the middle ages. 
 
 Mexican War, 1846-48. 
 
 During the Mexican War 100,454 men were sent to Mexico, 
 serving on an average thirteen months. The total losses were 
 1549 killed, or died of wounds; 10,986 died of disease; total, 
 12,535. 1° addition 12,252 were discharged for disability. 
 
DISEASE AND BATTLE CASUALTIES. 25 
 
 The sick averaged from 17 to 27 per cent, of the array. In 
 December, 1847, General Scott wrote: "The force at Chapul- 
 tepec fit for duty is only 6000 rank and file; the number of sick, 
 exclusive of officers, being 2041." The waste of life in this 
 war was about as great as during the Napoleonic campaigns. 
 The mortality from disease was no per 1000 per annum; the 
 battle losses, 15. Seven times as many died of disease as at the 
 hands of the enemy. 
 
 Italian Campaign, 1859. 
 
 This campaign lasted but three months. The French force 
 of 160,000 men fought two great battles in that time, making 
 the battle losses appear unusually large. Two thousand five 
 hundred and thirty-six were killed in battle and 2962 died of 
 wounds, totaling 4498 ; while but 2040 died of disease ; less than 
 half as many as by battle. The rates per thousand per annum 
 were, for battle, 112, and for disease, 51. Doubtless many died 
 of disease during the following months but the troops were at 
 once brought back to France and the losses afterwards not in- 
 cluded. Of the wounded 17.3 per cent. died. 
 
 Crimean War — English, 1854-6. 
 
 No other war so well illustrates the effects of improved 
 sanitary methods on the death rate of an army as that in the 
 Crimea. This one campaign in itself epitomizes the changes 
 wrought in the health of armies by the application of the les- 
 sons of a hundred years. When the British Army landed in 
 Turkey and advanced to the Crimea, although in a very un- 
 healthy country and subject to cholera in addition to all or- 
 dinary diseases, although without sufficient food, clothing or 
 shelter, there was almost an entire absence of sanitary control 
 of the camps. As could have been expected, the men sickened 
 and died by thousands, almost as helplessly as the followers of 
 the Crusades. The sanitary conditions were spoken- of by all 
 as frightful, and the death rolls justify the use of that ad- 
 jective. 
 
 From April 10, 1854, to June 30, 1856, 82,901 British 
 soldiers were sent to the Crimea, but during these twenty-six 
 months the average strength was only 34,559. These furnished 
 to all the hospitals 218,952 cases; of which 24,000 were 
 
26 DISEASE AND BATTLE CASUALTIES. 
 
 wounded and 194,000 were sick. There were 16,224 deaths 
 from disease, 2755 were killed and 2019 died of wounds. The 
 annual battle death rate was 69, the disease death rate reached 
 the enormous figure of 230 per 1000 per annum, more than 
 four times as great as the battle rate. In all, 300 men out of 
 each 1000 perished each year. 
 
 The winter of 1854-5 was severe, and the suffering inde- 
 scribable. At one time more men were in hospital than on duty. 
 By January the death rate was 1142, a rate that if continued 
 would have destroyed the army in ten and one-half months. 
 
 General 'Wolfe composed a song which was long a favorite 
 in the British Army. The refrain ran : 
 
 "Why, Soldier, why 
 
 Should we be melancholy boys? 
 Why, Soldier, why, 
 
 Whose business 'tis to die?" 
 
 It would have been particularly appropriate at this time, when 
 to die was indeed the principal business of the soldier; and 
 not gloriously at the head of a storming column, as Wolfe 
 fondly imagined, but miserably and to no good and in some 
 wretched hospital. 
 
 But there is a brighter side to the picture. The nation 
 learned of this suffering and death, the sanitary forces were 
 reorganized and- well supplied, clothed with authority and com- 
 manded to put an end to such conditions. By February the 
 death rate had fallen to 860, in May to 190, by autumn to 50, 
 and during the winter following it was but 16; far below the 
 battle rate of 69. During the first winter 63 men of each 
 1000 died of disease; during the second but 3.4 It was like 
 coming from the fifteenth century to the nineteenth in a few 
 months. 
 
 Of the sick about 17 per cent, died; of the wounded 16 
 per cent. 
 
 Crimea, French Army. 
 
 Bad as was the sanitary condition of the British Army in 
 the Crimea, that of the French was even worse. Affected with 
 typhoid, typhus, scurvy, dysentery and cholera, divisions were 
 reduced to fragments and regiments almost disappeared as in 
 the days of Gustavus and Wallenstein. Cholera attacked a 
 division at Varna and it disappeared as if in a whirlwind. Dur- 
 
DISEASE AND BATTLE CASUALTIES. 27 
 
 ing the first winter, of 47,800 men 18,000 died. Practically 
 one-third of all the sick died, and in addition 21 per cent, were 
 invalided. The scenes in the hospitals recalled the pictures of 
 Boccaccio. 
 
 Although 315,000 men were sent out, the average strength 
 was but 103,770. In the whole time 79,295 died of disease, or 
 one out of every four sent out. The disease death rate reached 
 the enormous figure of 341 per 1000 per year. 
 
 The battle losses were: killed, 7607; died of wounds, 8813; 
 total, 16,320. The rate is 70, about one-fifth the disease rate. 
 The general conditions may be judged by the fact that 1000 
 died following slight wounds; 830 following frostbites; and 
 4000 of scurvy. And the most discouraging thing of all is 
 that there was but little progressive improvement during the 
 war. While but 329 died of typhus during the first winter, 
 5689 died of that disease during the second. The death rate 
 of the wounded is also suggestive. Twenty-five per cent, of 
 these died, the majority not of their wounds, but of complica- 
 tions like pyemia, erysipelas and gangrene; or worse, of hos- 
 pital diseases like typhoid and typhus. 
 
 The Russians could hardly have had more than 160,000 
 men. They had 24,731 killed and 15,820 died of wounds; 
 total, 40,551. They lost 88,798 by disease. The rates are 120 
 and 263, and the proportion is 1 :2.2. Of the wounded 19.47 
 died, of the sick 22.9 per cent Russian writers, by placing their 
 average strength at 400,000, make their death rates 45 and 98, 
 manifestly too low. As the combined strength of the British 
 and French forces were less than 140,000, theirs could not 
 have been over 150,000. 
 
 American Civil War, 1861-65. 
 
 During this war, lasting from April 15, 1861, to June 30, 
 1865, the average strength of the Union armies was 806,755 
 officers and men. The total number of deaths was 359,528 
 (Fox) ; 67,058 were killed in battle and 43,012 died of wounds; 
 giving a total of 110,070 deaths from battle casualties; equiva- 
 lent to a rate of 33 per 1000 per annum. The number dying 
 of disease is estimated at 224,586, or 65 per 1000 per annum. 
 These numbers are from the latest revised statistics and are all 
 larger than those given in the M. and S. History of the War. 
 The death rate from sickness, while it appears high, was actually 
 
28 DISEASE AND BATTLE CASUALTIES. 
 
 very creditable as compared with the rates of previous wars, 
 usually waged by regular troops. While there was a great 
 deal of sickness much of it was of a mild nature. Of 6,000,000 
 cases but 200,006 died, or 3.4 per cent. The death rate in the 
 regular troops was 32; in the white volunteers, 55; and in the 
 negro troops 133 per 1000 yearly. Of the wounded 14.6 per 
 cent, died, which was the average rate at that time. About 
 two-thirds as many men died of wounds as were killed in battle. 
 Twice as many men died of disease as from battle wounds. 
 
 In addition to the deaths named there were 24,877 from 
 accidents, injuries and unknown causes. More than 250,000 
 were discharged for disability and 200,000 deserted. 
 
 In the navy, out of an average strength of about 60,000, 
 1804 were killed or died of wounds and 2627 died of disease. 
 The rates are 7.5 and 11, as compared with 30 and 60 in the 
 army. The death rate from disease was no greater than in 
 time of peace. 
 
 As to losses in the Confederate service, nothing but esti- 
 mates can be given. Complete records never existed, and many 
 of those made were destroyed near the end of the war. Dr. 
 Joseph Jones of that army estimated some 200,000 deaths, of 
 which lie believed one-fourth were caused by wounds and three- 
 fourths by disease. It is probable that one-third and two-thirds 
 would be more nearly correct. The Provost Marshal in 1866 
 estimated the battle losses at 74,550. Since then Fox has made 
 a very careful compilation of all reported losses and has fixed 
 the battle loss at 94,000, a number that may be accepted. 
 
 The disease loss is even more a matter of conjecture, for 
 there is almost no data from which to calculate. There is no 
 good reason to think it was less than twice the battle loss. 
 If so, the death rates of the Confederate armies were 47 per 
 1000 per annum lost in battle, and 94 lost by disease. Two 
 deaths from disease to one by bullets may be taken as the ratio 
 on both sides during this great war. 
 
 Russian War, 1877-78. 
 
 This war between Russia and Turkey lasted from April 24, 
 1877, to January 31, 1878, practically one year. The Russian 
 writers place their average strength at 824,000 men, which ap- 
 pears much too high. It is evident that by placing the strength 
 high the death rates will be lowered. They report that 15,567 
 
DISEASE AND BATTLE CASUALTIES. 29 
 
 men were killed in battle and 6824 died of wounds; total battle 
 losses, 22,391 ; while 81,363 died of disease. This gives a battle 
 loss rate of 25.8 and a disease death rate of 99 per 1000 per 
 annum, calling the length of the war one year. About four 
 times as many men died of disease as of wounds. Of the 
 wounded 12 per cent, died; of the sick 6.6 per cent. 
 
 Franco-Prussian War, 1870-71, German. 
 
 This war was marked by most remarkable progress in mili- 
 tary sanitation — in the German Army. The whole army was 
 made up of regular troops, splendidly organized and equipped, 
 and schooled in two preceding wars. The sanitary service was 
 like all else, complete, and worked like part of a tremendous 
 but efficient machine. And the results were even better than 
 would have been expected. Its achievements compelled admira- 
 tion, even from the French. A new record was made in the 
 contest with disease, one not bettered in any great war since. 
 
 In this war, lasting from August 1, 1870, until March 1, 
 1871, the average strength of the German Army was 723,556 
 men; 17,572 were killed "and 11,023 died of wounds; total, 
 28,595, equivalent to a rate of 55 per 1000 a year. But 12,174 
 died of disease, or 24.51 out of each 1000. One hundred years 
 earlier as many died of disease in garrison. The peace death 
 rate of the Prussian Army in 1869 was but ^.76. Eleven per 
 cent, of the wounded died and five and eight-tenths per cent, of 
 the sick. The ratio of battle losses to disease losses was 2.3 
 to 1. 
 
 French Army 
 
 The French sanitary results were as poor as the German 
 were excellent. It is a fact not altogether explained that the 
 French medical service, oldest in history and always best in 
 theory, has ever been a failure in the field. The present case is 
 not a fair example, for the army was always defeated, and gen- 
 erally driven from the field in rout, leaving the ambulance or- 
 ganizations in confusion, if not in the hands of the enemy. Yet 
 they were poorly organized and. equipped and could never com- 
 pare with those of the Germans. In the second stage of the 
 war, the stage of extemporized armies, the regular medical 
 service seems to have abdicated the field in favor of the volun- 
 teer aid societies. The results were, if possible, worse than 
 before. French writers ascribe their failure to the complete 
 
3 o DISEASE AND BATTLE CASUALTIES. 
 
 subordination of the service to the Intendance. This domina- 
 tion was doubtless bad, but the service was rickety, as was the 
 whole army. 
 
 Estimating the average strength of the army at 1,000,000 
 men, the deaths from battle casualties amount to about 67.5 
 per 1000 per annum; from disease, to 140.8. The latter rate 
 may be compared with the rate of 24.5 in the German Army 
 or with the rate- of 65 in the American Army during the Civil 
 War. The total number of deaths in the French armies was 
 138,871, but all French writers studiously avoid statistical de- 
 tails. The present writer estimates that 24,000 died in battle, 
 21,000 of wounds and 93,871 of disease and other causes. Of 
 the wounded about 15 per cent, died; of the sick at least 25 per 
 cent. The sieges and abandonment of the sick and wounded 
 in the later campaign^ account in part for these high mortality 
 rates. When the total loss was announced a cry of rage and 
 grief went up from all France, a cry that still reverberates, 
 though faintly, throughout the land. 
 
 Spanish-American War, 1898. 
 
 The average strength of the American Army in this war 
 was 211,350. Of these 862 were killed in battle and 106 died 
 of wounds; 5438 died of disease. The ratio of battle loss to 
 disease loss was 1 to 5.6. It should be remembered that but 
 one small battle was fought and not more than one-tenth of 
 the army ever saw a gun fired at the enemy. The rates, cal- 
 culated by Sternberg for one year, are, for battle, 4.6 per 
 1000; for disease, 25.73. Oi the wounded 4.6 per cent, died; 
 of the sick 8.6 per cent. Typhoid alone caused 85 per cent, 
 of all disease deaths. But for this one disease the death rate 
 would not have been above the average for peace service. 
 
 Anglo-Boer War, 1899-1901. 
 
 This war lasted 961 days, or about two and two-third years. 
 The average strength of the British Army was 208,326 men; 
 5777 were killed in battle and 2018 died of wounds; total, 7791, 
 giving a rate of 14 per 1000 per annum. Fourteen thousand 
 two hundred and ten died of disease, equivalent to a yearly rate 
 of 25.58 per 1000. Of the wounded 8.8 per cent, died; of the 
 sick but 3 per cent. The number constantly sick amounted to 
 
DISEASE AND BATTLE CASUALTIES. 31 
 
 but 2.87 per cent, of the entire force. Typhoid caused 74 per 
 cent, of all disease deaths, and with dysentery caused 87 per 
 cent. These two diseases caused all deaths in excess of the 
 usual peace rate. Twice as many died of disease as of wounds. 
 The total deaths were 39 per 1000 each year, or less than 4 
 per cent. ; but the entire wastage, including invalided, missing 
 and prisoners, was 40 per cent, annually. 
 
 Russo-Japanese War, Russian. 
 
 This was lasted from February 9, 1904, to the signing of 
 the treaty of peace, October 14, 1905. The data used is that 
 of N. Kozlovski of the Russian General Staff, except that his 
 average strength, 671,490, is too great and has been reduced to 
 540,000 officers and men. This number has been used as a 
 basis of all calculations, and the length of the war has been 
 placed at twenty months. 
 
 There were killed in battle, 25,331; died of wounds, 6127; 
 total, 31,458, or 35 per 1000 per annum. 
 
 The deaths from disease amounted to 12,198, or 13.5 per 
 1000 per annum. This is the lowest disease death rate on record 
 and is naturally under suspicion. 
 
 Of the 146,032 wounded, 6127, or 4.19 per cent. died. 
 
 Of the 358,077 sick, 12,128, or 2.7 per cent. died. 
 
 The proportion of killed to wounded was 1 to 5.7. 
 
 The ratio of battle casualties (K. & D.) to disease deaths 
 was 2.6 to 1; 31,458 to 12,128. 
 
 There were 28,358 men discharged on account of wounds, 
 or 31 per 1000 per annum. 
 
 There were 48,479 discharged on account of disease, or 53 
 per 1000 per annum. 
 
 The total discharges were 76,837, or 84 per 1000 yearly. 
 
 The total loss to the army from battle casualties (killed, 
 died and discharged) was 65.4 per 1000 annually. 
 
 The total loss from disease (died and discharged) was 66.5, 
 or practically the same as from battle. 
 
 The total loss from all causes is thus seen to be 13 1.9. 
 
 This supposes that the remaining sick and wounded recovered. 
 
 The disease death rate in the Russian home army at this 
 time was 5.75, which may be compared with 13.5, the field rate. 
 
 The number constantly sick is given as 22.9 per 1000. 
 
32 DISEASE AND BATTLE CASUALTIES. 
 
 Typhoid and dysentery caused practically one-half the deaths 
 from disease. 
 
 In the whole army 663 of each 1000 contracted disease and 
 22.4 died. 
 
 Russo-Japanese War, Japanese. 
 
 The losses of the Japanese during this war cannot be stated 
 with certainty. The figures given out by the Japanese author- 
 ities seem to the writer even less dependable than those of the 
 Russians. For the present they can only be presented, as doubt- 
 ful evidence is presented to a jury. 
 
 The Japanese are estimated by Kozlovski to have had an 
 average strength in the field of 650,000 officers and men. The 
 killed in battle numbered 47,387, while 11,425 died of wounds; 
 giving a total battle loss of 58,811 and a death rate of 54 per 
 1000 per annum. 
 
 The deaths from disease, as recently given out, and as stated 
 by Kozlovski, were 27,142, making the disease death rate ap- 
 proximately 25 per 1000 per annum. The ratio of deaths in 
 battle to deaths from disease was 2.16:1. This is an excellent 
 record but no better than that of the Germans in 1 870-1, con- 
 sidering ratios only ; and no better than that of the British and 
 Americans in their last wars, if the true ratio, the annual death 
 rate per thousand, be considered. 
 
 Of the 173,425 wounded 11,425 died, or 6.58 per cent. 
 
 Of the 333,073 sick, 27,692 died, or 6.6 per cent. 
 
 Both these rates are high for the present time, and higher 
 than the corresponding rates in the Russian Army. The propor- 
 tion of killed to wounded was 1 to 3.6, a high rate. 
 
 Surgeon Kipke in 1905 estimated that 90 per cent, of the 
 sick returned to duty and 93 per cent, of the wounded. 
 
 The Japanese report that in the navy, with a strength of 
 about 15,000 men, 496 were killed in battle, 1,445 were drowned, 
 and 1,791 wounded, of whom 117 died. If, as seems proper, 
 we include the drowned in the battle losses, they amount to 90 
 per 1000 per annum, as compared with 54 in the army. 
 
 Conclusion. 
 
 What of the future? Have the evolution of medical or- 
 ganization and the reduction of disease in armies reached their 
 limits? No. New medical discoveries, more successful applica- 
 tion of sanitary science and a more widespread diffusion of the 
 
» 
 
 DISEASE AND BATTLE CASUALTIES. 33 
 
 knowledge of the laws of health among the people promise still 
 greater achievements. If American medical men during the 
 Civil War, working largely in the dark, were able to reduce the 
 death rate from 1 10 to 65 ; if again in 1898 they reduced it from 
 65 to 25 ; if the Japanese, mere imitators, equaled this record, 
 surely a lower record will yet be reached. 
 
 The annual death rate of armies in time of peace is now 
 from 3 to 4 per 1000. The German rate, less than 3, appears 
 to be a minimum under present conditions. Until some Met- 
 schnikoff succeeds in arresting the stealing steps of age, or 
 some Carrel discovers the long sought fountain of youth, this 
 rate cannot be much improved. When the peace death rate of 
 armies was 20 the war rate often rose to 100, 200 or even more. 
 When, about 1870-1880, the peace rate fell to 5, the war rate 
 fell to 25. The disease death rate of all recent wars, except 
 the Russian war of 1877-78, has not exceeded 25-. The war 
 rate is still five times the peace rate. 
 
 An investigation of the data proves this increase to be 
 largely due to infectious diseases. As long ago as 1743 Pringle 
 blamed fever and dysentery for most of his fatal sickness. 
 McGrigor in 1811-14 accredited two-thirds of the deaths in 
 Wellington's army to these causes. In the Crimea, of 230 
 deaths per 1000 in the British Army, 210 were due to typhoid, 
 dysentery, cholera and other infectious diseases. In the Amer- 
 ican Civil War practically three-fourths of the deaths were due 
 to these infections; that is, to diseases now preventible. In 
 later wars dysentery has not been as frequent a cause of death. 
 The true plague, smallpox, cholera, typhus, hospital gangrene 
 and wound infections have practically disappeared from civil- 
 ized armies. The principal death factor in recent wars in the 
 temperate zone has been one single disease — typhoid. In the 
 Boer War 76 per cent of all deaths from disease were caused 
 by typhoid. In the Spanish-American War 85 per cent, were 
 due to this one disease. But for typhoid the death rate in these 
 two wars would have been very little greater than in time of 
 peace. This, the most important of all diseases of armies in the 
 temperate zone, now appears to be on the verge of annihilation. 
 
 But I would not infer that the disease mortality of armies 
 will soon be no greater in war than in peace. There will always 
 be exhaustion, exposure to the elements, lack of proper food 
 and clothing, crowding and other inevitable accompaniments 
 of war, which will necessarily increase the sick and death rate. 
 
34 DISEASE AND BATTLE CASUALTIES. 
 
 It is not, however, unreasonable to expect that the peace rate 
 will be no more than doubled, or under bad conditions trebled. 
 During the year 1901 the United States had an army of 65,000 
 men in the field in the tropics with a disease death rate of but 
 11.55 P er 1000. The Russians claim a similar low rate for 
 their recent war. We may expect that in future wars the death 
 rate from disease will be no more than 10 to 15 per 1000 an- 
 nually, and with favorable conditions still less. A rate of 10 
 per 1000 would be less than the battle losses in any important 
 war. And furthermore, while a loss of 10 or 15 per cent, of 
 the strength of an army weakens it perceptibly, the loss of 1 per 
 cent, in a year is negligible. It is manifest that a regular 
 standing arm}-, with every department organized and equipped 
 in advance, will have an immense advantage over an army in 
 which nine-tenths of the officers and men, and medical officers 
 as well, are inexperienced volunteers. 
 
 It may be confidently predicted that the disease death rate 
 of troops in campaign will, under reasonably favorable condi- 
 tions, be reduced to about 1 per cent, annually, or 10 per 1000, 
 which is a negligible quantity. The death rate for the wounded 
 can be reduced little more. The future ratio of deaths from 
 battle and disease will show that the application of medical and 
 sanitary science in the armies of the world has eliminated disease 
 as an important factor in dissipating the strength of armies, and 
 has relieved the barbarity of war by reducing to an absolute 
 minimum what has, until the present time, been the greatest 
 cause of suffering and death. 
 
LOSSES BY BATTLE IN WAR. 
 
 WALCHEREN 
 
 16. 
 
 PENINSULAR WAR 
 
 42. 
 
 MEXICAN WAR 
 
 I 15. 
 
 CRIMEA^RUSSIAN 
 
 ■ l20. 
 
 ENGLISH 
 
 I 70. 
 
 FRENCH 
 
 70. 
 
 CIVIL WAR 
 
 24. 
 
 1870- I, GERMAN 
 
 55. 
 
 FRENCH 
 
 67.5 
 
 RUSSIAN, 1877-8 
 
 25.8 
 
 SPANISH-AMERICAN 
 
 4.6 
 
 BOER WAR 
 
 12.5 
 
 I904-5,RUSSIAN 
 
 34.4 
 
 JAPANESE 
 
 54. 
 
LOSSES BY DISEASE IN WAR 
 
 WALCHEREN 
 
 PENINSULAR WAR 
 
 MEXICAN WAR 
 
 CRIMEAN, RUSSIAN 
 ENGLISH 
 FRENCH 
 
 CIVIL WAR 
 
 1870-71, GERMAN 
 FRENCH 
 
 RUSSIAN, 1877-78 
 
 SPANISH-AMERICAN 
 BOER WAR 
 1304-05, RUSSIAN 
 JAPANESE 
 
 332. 
 
 118. 
 
 110. 
 
 263.6 
 
 230. 
 
 341. 
 
 65. 
 
 24.5 
 
 140.8 
 
 42.99. 
 
 25.7 
 
 25.58 
 
 13.5 
 
 25. 
 
DISEASE AND BATTLE CASUALTIES. 
 
 37 
 
 War 
 
 Battle 
 Death 
 Rate 
 
 Disease 
 Rate 
 
 Ratio 
 
 Mortality 
 
 Wounds Sick 
 
 Irish, 1689 
 
 Walcheren Expedition, 1809 
 
 San Domingo, 1802. 
 
 Peninsular War, 1808-14, Br 
 
 Russo-Turk, 1828-9, Russian 
 
 Mexican, 1846-8, American 
 
 Italian, 1859, French 
 
 Crimea War, 1854-6, English 
 
 French 
 
 Russian 
 
 American Civil War, 1861-5 
 
 Confederate, estimated 
 
 Russian War, 1877-8, Russian 
 
 Spanish War, 1898, American 
 
 Franco-Prussian, 1870, German — 
 
 French 
 
 Anglo-Boer, 1899-1901, English 
 
 Russo-Japanese, 1904-5, Russian. . 
 Japanese. 
 
 42 
 
 15 
 112 
 
 69 
 70 
 120 
 33 
 47 
 
 25.8 
 4.6 
 55 
 67-5 
 
 12-5 
 
 35 
 54 
 
 450 
 200 
 500 
 118 
 500 
 no 
 
 5i 
 230 
 
 34i 
 263 
 
 65 
 94 
 99 
 
 25-7 
 24- 5 
 140 
 
 25-5 
 13-5 
 25 
 
 40 
 
 7 
 1 
 
 3 
 
 5 
 
 2.2 
 
 2 
 
 2 
 
 4 
 
 5-6 
 
 1 
 
 2 
 
 2 
 
 6.1 
 
 1 
 
 % 
 
 10 
 
 12 
 
 17-3 
 16 
 
 25 
 19 
 14.6 
 
 12 
 4.6 
 n 
 
 15 
 8.8 
 4.19 
 6.6 
 
 % 
 50 
 50 
 50 
 14 
 25 
 
 17 
 
 33 
 
 23 
 
 3 
 
 6.6 
 8.6 
 5-8 
 25 
 3 
 
 2.7 
 6.6 
 
 Authorities. 
 
 "Apercu Historique, La Guerre de 1870-1." Chenu. 
 
 "Campaign de 1870-71." Quesnoy. 
 
 "Commentaries." Turpin de Crisse. 
 
 "Dictionnaire des Sciences Medicates." Percy. 
 
 "Dictionnaire Medicale." Littre et Robin. 
 
 "Historical Magazine (Russian), 1911." Kozlovski. 
 
 "Histoire Medicale de l'Armee d'Orient." Des Genettes. 
 
 "Hygiene Militaire Comparee." Boudon. 
 
 "Le Baron Larrey." Beranger. 
 
 "Le Corps de Santee Militaire en France." Brice et Bottet. 
 
 "Medical and Surgical History of the British Army in the East. 
 Official. 
 
 "Medical and Surgical History of Rebellion." Official. 
 
 "Memoire." Willaume. 
 
 "Memoires." Larrey. 
 
 "Military Hygiene." Munson. 
 
 "Military Antiquities." Grose. 
 
 "Observations on Diseases of the Army." Sir John Pringle. 
 
 "Outlines of Military Surgery." Balingall. 
 
 "Relation de la Campaign d'Orient." Scrive. 
 
 "Report of the Secretary of War, 1848." Official. 
 
 "Report on Sanitary Condition of Br. Army." Official. 
 
 "Sanitary Lessons of the War (1898)." Sternberg. 
 
 "Sketch of Medical History of the British Army in the Peninsula. 
 Sir James McGrigor. 
 
 "Statistics of the Army (British)." Marshal. 
 
 "Statistiche Militarische Yahresberichte." Wien, 1905. 
 
 "Surgery of the War in Spain." Guthrie. 
 
 "Surgery of the War in the Crimea." McLeod. 
 
 "Tableaux Historique." Gilbert. 
 
 "Verluste der Deutschen Armeen, 1870-71." Engel.