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ACCESS TO CARE
THE MEDICAL AND SURGICAL HISTORY
WAR OF THE REBELLION
REPORTS OF MEDICAL DIRECTORS, AND OTHER DOCUMENTS
Edited, under the direction of Surgeon General JOSEPH K. BARNES, United States Army,
Assistant Surgeon J. J. WOODWARD, United States Army,
Assistant Surgeon GEORGE A. OTIS, United States Army
Washington, D.C.: 1870
CXXX. Report on the Operations of the Medical Department during the Battle of Gettysburg. By Surgeon JONATHAN LETTERMAN, U.S.A., Medical Director Army of the Potomac.
CAMP NEAR CULPEPPER C.H., VA., October 3, 1863.
GENERAL: I have the honor to submit the following report on the operations of the medical department of this army at the battle of Gettysburg, July 1, 2 and 3, 1863:
As the subject of transportation had an important bearing upon the manner in which the wounded are attended to after a battle, it is necessary to make some allusion to the manner in which this department was supplied. It is scarcely necessary to say that, if the transportation is not sufficient to enable the officers of the department to conduct it properly, the consequences must fall upon the wounded. In the autumn of 1862, I investigated the subject very carefully, with a view to the adoption of some system, instead of the irregular method which, prior to that time, was in vogue; to limit the amount necessary and to have that amount always available. The transportation allowed was one wagon to each regiment, and one to each brigade. This gave all that was required, and was not too much. It may be remarked that it was a reduction to nearly one-half that which had been in use prior to that time. This system worked well. At the battle of Chancellorsville the department had, upon the left bank of the Rappahannock, means sufficient, had it been allowed to use them, to take care of many more wounded than came under its control.
On the 19th of June, while the army was on the march from before Fredericksburg to some unknown point north of the Potomac river, the headquarters being near Fairfax Courthouse, Virginia, the transportation of the department was cut down, on an average of two wagons in a brigade, in opposition to my opinion, expressed verbally and in writing. This reduction necessitated the turning in of a large portion of the supplies, tents, etc., which were necessary for the proper
care of the wounded in the event of a battle. Three wagons were assigned to a brigade of one thousand five hundred men, doing away with regimental wagons. This method, in its practical working, is no system at all, as it is liable to constant changes, and proved to be, what I supposed at the time it would be, a failure, as it did not give the department the means necessary to conduct its operations. Headquarters left Fairfax Court-house on the 26th of June for some point as yet unknown in Maryland or Pennsylvania. On the 25th of that month, I directed Assistant Surgeon Brinton, U.S.A., to proceed to Washington and obtain the supplies I had ordered the medical purveyor to have put up, and there await orders. On the 26th, he was ordered to proceed with them to Frederick. This step was taken to obviate the want of supplies consequent upon the reduction of transportation. At this date, it was not known that the army would be near Frederick, still the risk had to be run, and the event justified the order, Dr. Brinton arriving at Frederick on the 28th of June, the day alter the arrival of headquarters there, with twenty-five army-wagon loads of such supplies as would be most required in case of a battle. The train with these supplies followed that of headquarters until we reached Taneytown. On the 1st of July, the trains were not permitted to come farther, and, on the 2d, were ordered to the rear, near Westminster. On the 1st, it was ordered that 'Corps commanders and the commander of the artillery reserve will at once send to the rear all their trains, excepting ammunition wagons and ambulances, parking them between Union Mills and Westminster.' On the 2d, these trains were ordered still further to the rear, and parked near Westminster, nearly twenty-five miles distant from the battle-field. The effect of this order was to deprive the department almost wholly of the means for taking care of the wounded until the result of the engagement of the 2d and 3d, was fully known. I do not instance the effect of this order, except to show its influence upon the department; the expediency of the order I, of course, do not pretend to question, but its effect was to deprive this department of the appliances necessary for the proper care of the wounded, without which it is as impossible to have them properly attended to as it is to fight a battle without ammunition. In most of the corps the wagons exclusively used for medicines moved with the ambulances, so that the medical officers had a sufficient supply of dressings, chloroform and such articles until the supplies came up, but the tents and other appliances which are as necessary were not available until the 5th of July. The supply of Dr. Brinton reached the field on the evening of the 4th of July. This supply, together with the supplies ordered by me on the 5th and 6th of July, gave more than was required. The reports of Dr. Brinton and Dr. Taylor show that I ordered more supplies than were used up to the 18th of July, when the hospitals were taken from under my control. Surgeon Taylor, medical inspector of this army, who was ordered, on the 29th of July, to Gettysburg, to examine into the state of affairs there, reports to me that he made 'the question of supplies a subject of special inquiry among the medical officers who had remained with the wounded during and for a month subsequent to the battle. The testimony in every instance was conclusive that at no time had there been any deficiency; but, to the contrary, that the supply furnished by the medical purveyor had been, and still continued to be, abundant.' This is, perhaps, sufficient to show that not only were supplies ordered in advance, but that they were on hand when required, notwithstanding the difficulty in consequence of the inability of the railroad to meet the requirements made upon it, until after General Haupt took charge of it on the 9th of July. I have not deemed it necessary to present any tables showing the amounts ordered and issued, considering what I have above stated sufficient to show the action of this department. The chief want was tents and other appliances for the better care of the wounded. I had an interview with the commanding general on the evening of the 3d of July, after the battle was over, to obtain permission to order up the wagons containing the tents, etc. This request he did not think expedient to grant but in part, allowing one-half of the wagons to come to the front; the remainder were brought up as soon as it was considered by him proper to permit it. To show the result of the system adopted upon my recommendation, regarding transportation and the effect of the system of field hospitals, I may here instance the hospital of the Twelfth Corps, in which the transportation was not reduced, nor the wagons sent to the rear at Gettysburg. Surgeon McNulty, medical director of that corps, reports that 'it is with extreme satisfaction that I can assure you that it enabled me to remove the wounded from 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 received.' I can, I think, safely say that such would have been the result in other corps had the same facilities been allowed; a result not to have been surpassed, if equaled, in any battle of magnitude that has ever taken place. A great difficulty always exists in having food for the wounded. By the exertions of Colonel Clarke, chief commissary, thirty thousand rations were brought up on the 4th of July and distributed to the hospitals. Some of the hospitals were supplied by the commissaries of the corps to which they belonged. Arrangements were made by Colonel Clarke to have supplies in abundance brought to Gettysburg for the wounded. He ordered them, and, if the railroad would transport them, they would he on hand.
Over six hundred and fifty medical officers are reported as present for duty at that battle. These officers were engaged assiduously, day and night, with little rest, until the 6th, and in the Second Corps, until the 7th of July, in attendance upon the wounded. The labor performed by these officers was immense. Some of them fainted from exhaustion induced by over exertion, and others became ill from the same cause. The skill and devotion shown by the medical officers of this army were worthy of all commendation; they could not be surpassed. Their conduct as officers and as professional men was admirable. Thirteen of them were wounded; one of whom, Surgeon W. S. Moore, 61st Ohio, Eleventh Corps, died on the 6th of July, from the effects of his wounds received on the 3d. The idea, very prevalent, that medical officers are not exposed to fire, is thus shown to be wholly erroneous. The greater portion of the surgical labor was performed before the army left. The time for primary operations had passed, and what remained to be done was to attend to making the men comfortable, dress their wounds and perform such secondary operations as from time to time might be necessary.
One hundred and six medical officers were left behind when the army left; no more could be left, as it was expected that another battle would, within three or four days, take place; and, in all probability, as many wounded be thrown upon our hands as at the battle of the 2d and 3d, which had just occurred. ** I asked the Surgeon General, July 7th, to send twenty medical officers to report to Surgeon H. Janes, hoping they might prove of some benefit, tinder the direction of the medical officers of this army who had been left behind. I cannot learn that they were ever sent. Dr. Janes was left in general charge of the hospitals, and, to provide against contingencies, was directed, if he could not communicate with me, to do so directly with the Surgeon General, so that be bad full power to call directly upon the Surgeon General to supply any want that
might arise. The ambulance corps throughout the army acted in the most commendable manner during those days of severe labor. Notwithstanding the great number of wounded, amounting to fourteen thousand one hundred and ninety-three, I know, from the most reliable authority and from my own observation, that not one wounded man of all that number was left on the field within our lines early on the morning of the 4th of July. A few were found after daylight beyond our farthest pickets, and these were brought in, although the ambulance men were fired upon, when engaged in this duty, by the enemy, who were within easy range. In addition to this duty, the line of battle was of such a character, resembling somewhat a horse-shoe, that it became necessary to remove the most of the hospitals further to the rear, as the enemy's fire drew nearer. This corps did not escape unhurt: one officer and four privates were killed, and seventeen wounded, while in the discharge of their duties. A number of horses were killed and wounded, and some ambulances injured. These facts will show the commendable and efficient manner in which the duties devolving upon this corps were performed, and great credit is deservedly due to the officers and men for their praiseworthy conduct. I know of no battle-field from which wounded men have been so speedily and so carefully removed, and I have every reason to feel satisfied that their duties could not have been performed better or more fearlessly.
Before the army left Gettysburg, and knowing that the wounded had been brought in from the field, six ambulances and four wagons were ordered to be left from each corps to convey the wounded from their hospitals to the railroad depot for transportation to other hospitals. From the Cavalry Corps, but four ambulances were ordered, as this corps had a number captured by the enemy at or near Hanover a few days previously. I was informed by General Ingalls that the railroad to Gettysburg would be in operation on the 6th, and upon this based my action. Had such been the case, this number would have been sufficient. As it proved that this was not in good running order for some time after that date, it would have been better to have left more ambulances. I acted, however, on the best information that could be obtained.
The number of our wounded, from the most reliable information at my command, amounted to fourteen thousand one hundred and ninety-three. The number of Confederate wounded who fell into our hands was six thousand eight hundred and two; making the total number of wounded thrown by that battle upon this department twenty thousand nine hundred and ninety-five. The wounded of the 1st of July fell into the hands of the enemy, and came under our control on the 4th of that month. Instruments and medical supplies belonging to the First and Eleventh Corps were in some instances taken from the medical officers of those corps by the enemy.
Previous to leaving Gettysburg, on the 5th and 6th of July, I ordered supplies to be sent to Frederick from Washington and Philadelphia, to meet the wants of the 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, I asked the Surgeon General to have fifty medical officers ready to meet me at such a point as I should thereafter indicate. On the 7th of July, I desired them to be sent to Frederick. Late in the night of the 9th, forty-seven of them reported. These officers were assigned to make up as far as possible the deficiency of medical officers existing in consequence of the large detail from this army left at Gettysburg. Tents were ordered by my request, and the corps supplied as far as their transportation would permit, and the remainder kept in reserve. It is not necessary to enter into the detailed list of the articles ordered and on hand ready for the anticipated battle. I have the orders in my office, and it is with pleasure that I can state, for the information of the commanding general, that, notwithstanding the short time in which I had to make the necessary preparations, this department was, when near Boonsboro', 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. It is unnecessary to do more than make an allusion to the difficulties which surrounded the department at the engagement at Gettysburg. The inadequate amount of transportation; the impossibility of having that allowed brought to the front; the cutting off our communication with Baltimore, first by way of Frederick, and then by way of Westminster; the uncertainty, even as late as the morning of July 1st, as to a battle taking place at all, and, if it did, at what point it would occur; the total inadequacy of the railroad to Gettysburg to meet the demands made upon it after the battle was over; the excessive rains which fell at that time, all conspired to render the management of the department a matter of exceeding difficulty, and yet abundance of medical supplies were on hand at all times. Rations were provided and shelter obtained as soon as the wagons were allowed to come to the front, although not as abundant as necessary, on account of the reduced transportation.
Medical officers, attendants, ambulances and wagons were left when the army started from Maryland, and the wounded well taken care of, and especially so, when we consider the circumstances under which the battle was fought, and the length and severity of the engagement. The conduct of the medical officers was admirable. Their labors not only began with the beginning of the battle, but lasted long after the battle had ended. When other officers had time to rest, they were busily at work, and not merely at work, but working earnestly and devotedly.
I have not considered it necessary to give in this report more than a very general outline of the operations of this department at that time. To enter into a detailed account of them would, I presume, be more than the commanding general would desire.
Very respectfully, your obedient servant,
J. LETTERMAN, Medical Director
Brigadier General S. WILLIAMS, Assistant Adjutant General, Army of the
CXXXI. Fourth Extract from a Narrative of his Services in the Medical Staff. By Assistant Surgeon J.T. CALHOUN, U.S. Army.
*** "From Emmettsburg, the division (2d division, Third Corps) crossed into Pennsylvania, and participated with honor and great loss in the battle of Gettysburg. It joined in the fight on the second day of the battle. About nightfall, Major General Sickles, commanding the corps, was wounded, and the medical director of the corps, Surgeon Thomas Sim, U.S.V., with my assistance, amputated the injured limb. Surgeon Sim, at the request of the General, accompanied him to the rear.
The medical care of the corps then devolved upon me. I immediately selected a new site for the hospital of the corps, that hitherto occupied having been rendered untenable by the fire of the enemy, and had our wounded, over three thousand in number; removed thither. ** During the following winter, I took every measure to put my division in the best hygienic condition. New, large, well ventilated and well warmed huts were built; the camps were thoroughly drained by a complete system of ditches, and great attention was paid to camp police. The regimental camps were inspected daily by their surgeons, who reported to the regimental commanders. The surgeon-in-chief of each brigade weekly inspected the camp of his brigade and its regimental hospitals, and reported to the brigade commander, and a surgeon was detailed daily, whose duty it was to visit the various camps of the division and their environs, and the division and regimental hospitals, and make a written report thereon to me. 'He is especially to observe the location and police of the several camps and their drainage, the cleanliness and ventilation of the quarters, the removal of offal, the number and condition of latrines, the character of the food and the manner in which it is cooked, and report if, in his opinion, the health of the command is in any way endangered. The cleanliness, ventilation and warmth of the several hospitals, the care bestowed upon the sick, the character of the food furnished them, and the attention paid them by medical officers, stewards and nurses, are likewise to be observed and reported upon.' This complete and thorough inspection system secured us a division camp as nearly perfect as it was possible to make camps in the field. We had but a very few sick, many of our regimental hospitals not containing an inmate; yet to guard against contingencies, I established a division field hospital. While a great amount of talent has been displayed in the building of general hospitals, and every effort used to make them perfect in plan and detail, but comparatively little attention has been paid to field hospitals as regards their plan. In my division field hospital each of the wards was composed of two of the regulation hospital tents, and these were arranged in two lines en echelon from the dispensary; the whole, forming a letter V, gently descending from the officers' quarters to the brook. Ditches, a foot in depth and of the width of a spade, were dug around each pair of tents and on each side of the paths, connecting them. The sinks were on either flank, and were made of barrels stink into the ground. The wash-house and cook-house were of logs covered with a canvas roof. Each ward was warmed and ventilated by a large chimney, half the width of the tent, made of stone and mud, with large, high, open fire places, capable of receiving a log four feet long. A. cedar-bough fence surrounds the grounds, to keep off the force of the wind." ***
CXXXII. Report on the Transportation of Wounded after the Battle of Gettysburg. By Medical Inspector E.P. VOLLUM, U.S. Army.
WASHINGTON, D.C., July 25, 1863.
GENERAL: I have the honor to report that, pursuant to your orders of the 7th July, I proceeded on the same day to Gettysburg, Pennsylvania, for the purpose of reporting to Medical Inspector Cuyler, U.S.A., for duty in connection with the transportation of the wounded at that place. I was detained a few hours, on the 8th, at Hanover, Pennsylvania, where I found about one hundred and fifty wounded, chiefly from Kilpatrick's cavalry, under charge of Assistant Surgeon Gardner, 1st Virginia Cavalry. They were comfortably situated in a school-house and in dwellings. The inhabitants had furnished them with bunks, bedding, dressings, untensils and food in sufficient quantity, the people in each street in the town furnishing food, delicacies, nurses, etc., two days at a time. I arrived at Gettysburg about seven P. M. on the 8th, and, in consequence of some irregularity or delay in the railroad trains, there were about two thousand slightly wounded men collected at a point a mile from town, where the trains stopped, without food, shelter or attendance for the night. Fortunately, through the agents of the Sanitary Commission, these men were all fed, and some three hundred sheltered that night. No system had as yet been adopted for the transportation of the wounded, nor had this been possible in the deranged condition of the railroad, though Surgeon J. D. Osborne, 4th New Jersey, detailed for this purpose by Surgeon H. Janes, U.S.V., in charge of the hospitals at Gettysburg, was using his best endeavors to work through the confusion and crowds of wounded with which he was surrounded, and I have to acknowledge the important services of this gentleman until the time of my departure. The railroad authorities were perplexed, and deficient in motive power and rolling stock. The bridges put up since the rebel raids proved too weak except for the lightest engines, and some for a second time were carried away by the floods. The telegraph wires were down, and the obstruction to transportation seemed insurmountable until General Haupt arrived and assumed military control of the road to Hanover Junction. We then experienced no further delays till the 18th, when an important bridge on the road to Harrisburg gave way under a cattle train, thus diverting, for the following five days, the trains that were intended for New York to Baltimore and York, Pennsylvania. Medical Inspector Cuyler arrived on the 11th, when I reported to him for duty, and, by mutual arrangement, I continued in immediate charge of the transportation of the wounded, which confined me to the railroad depot and city of Gettysburg. Every train of wounded was placed in charge of a medical officer detailed by Surgeon H. Janes. Instruments, dressings, stimulants, etc., were furnished him, and he was instructed to announce his coming by telegraph, if possible, and to report in person to the medical director at the place of his destination. Each car was filled with a sufficient quantity of hay, and, on the longer routes, water-coolers, tin cups, bed pans and urinals were placed in them, and guarded on the route by some agents of the Sanitary Commission. In some instances, these conveniencies were furnished by the medical department, but the demand for them by the hospitals often exhausted the supplies at the purveyors. Before leaving, the wounded were fed and watered by the Sanitary Commission, and often hundreds of wounded, laid over for a night or a part of a day, were attended and fed by the commission, whose agents placed them in the cars. At Hanover Junction, they were again refreshed and fed by the Christian Commission. At Baltimore, the agents of several benevolent societies distributed food bountifully to the wounded in the cars immediately on their arrival; and at Harrisburg, the Commissary Department had made arrangements for feeding any number likely to pass that way.
The following are the numbers and destinations of Union and Confederate wounded sent from Gettysburg up to thew 23d. The first one thousand four hundred and sixty-two had left before my arrival.
Wounded sent from Gettysburg to 22d instant:
Union wounded sent to Baltimore, in addition to above:
From Westminster: 2,000
From Littleton: 2,000 4,000
Total sent off: 15, 425
Deduct Confederate wounded: 3,817
Total Union wounded sent off: 11,608
Union wounded remaining on 22d instant: 1,995
Total Union wounded: 13, 503
Confederate wounded sent off: 3,817
Confederate wounded remaining on 22d instant: 2,922
Total Confederate wounded: 6,739
Grand total in our hands: 20, 342
To obtain the whole number of wounded of both sides, there must be added those of Chambersburg, Carlisle, Williamsport and Hagerstown. ** Before the arrival of Medical Inspector Cuyler, as far as my time and opportunities admitted, I endeavored to make up the deficiencies in medical supplies at Gettysburg by telegraphing to Surgeon Simpson, U.S.A., at Baltimore. In reply, he ordered liberal supplies of alcohol, solution chloride of soda, tincture of iron, creasote, nitric acid, permanganate of potassa, buckets, tin cups, stretchers, bed sacks and stationery of all kinds for ten thousand men in field hospitals. On the day after my arrival, the demand for stationery, disinfectants, iodine, tincture of iron and some other articles was so great and immediate that I purchased them in Gettysburg, and sent the bills to the quartermaster there for payment.
Very respectfully, your obedient servant,
EDW. P. VOLLUM, Medical Inspector U. S. Army
To the SURGEON GENERAL U. S. ARMY
CXX XIII. Second Extract from a Narrative of his Services in the Medical Staff. By Assistant Surgeon J.S. BILLINGS, U. S. Army.
*** "About the middle of June, the 2d division of the Fifth Corps took up its line of march, which, passing, successively, through Benson's Mills, Catlett's Station, Manassas, Centreville, Gum Spring, Aldie Gap, Leesburg, Edwards's Ferry and Frederick, terminated, so far as I was concerned, at Gettysburg, Pennsylvania on the morning of the 2d of July. On this march, all the ambulances were collected into a train, which followed immediately behind the division, and was super-intended by a medical officer detailed for the purpose. Transportation was allowed in the proportion of one wagon for the medical supplies of two regiments, and this train of wagons followed close behind the ambulances. For the approaching battle, I was detailed as surgeon in charge of the field hospital of the division, and, also, as one of the operators, my assistants being Assistant Surgeons Whittingham and Breneman, U.S.A. At this time, I was attached to the 7th Infantry, and also acted as medical officer for the 10th Infantry during the march. On the 1st of July, about four o'clock P.M., the division reached Hanover, distant about twelve miles from Gettysburg, and went into camp. Just as the tents were fairly pitched, news came of the repulse of the First Corps, and a few minutes later, we were on the road to Gettysburg. About six A.M., July 2d, the division marched into position, and formed line of battle on the right of the somewhat horse-shoe shaped line in which our army was drawn up. ** About half past three o'clock P.M., the division was brought into action, marching down a little road to the right of the large conical hill called Round Top, which was on the extreme left of the long arm of our horse-shoe like line of battle. 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 establish a field hospital. 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 further up the hill, and about seventy-five yards off, saluted me with a volley. They were captured a moment afterwards by a regiment which had passed between them and their own line. On entering the house, I found it unoccupied, and bearing evident traces of the hasty desertion of its inmates. A good fire was blazing in the kitchen stove, a large quantity of dough was mixed up, the bake-pans were greased; in short, everything was ready for use. 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 trains reported to me fifteen minutes later, having with it three Autenrieth wagons, and by the time the operating tables were set up, and materials for dressing arranged, the wounded began to pour in. I performed a large number of operations of various kinds, received and fed seven hundred and fifty 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, a few lemons, etc. Of stimulants, chloroform, morphine and materials for dressing, the Autenrieth wagons furnished an ample supply.
On July 3d, at seven o'clock A.M., I was ordered by Surgeon Milban, medical director of the corps, to remove the hospital to a point about 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 A.M., the fire on that point was quite brisk. Little or no damage was done, however, and by four o'clock P.M., all the wounded were safely removed. The new site was a grove of large trees, entirely free from underbrush, on the banks of a little creek, about half a mile from the Baltimore turnpike. By means of shelter-tents, india-rubber blankets, etc., shelter was arranged for all the worst cases, and two thousand dry rations, with three oxen, were sent to the hospital by Doctor Milban in the course of the afternoon. All of this day, I was employed in operating and in dressing the more urgent cases. The following morning, it began to rain, and continued to do so for five days and nights with very little cessation. On the morning of the 5th, the regimental medical supply wagons came up, and from them I removed all the hospital tents and tent flies, with two hospital mess chests. On this day, the division moved. I was left behind in charge of the hospital, which then contained about eight hundred wounded. Twenty men were detailed from the division to act as assistants about the hospital. I was also given two ambulances and two six-mule wagons. The ambulance train, which had up to this time been engaged in collecting the wounded of the division from the various corps hospitals to which some of them had been carried, and in hauling straw for bedding, accompanied the division, as did also the Autenrieth wagons. By this time, Assistant Surgeon Brinton had reached White church with a special medical supply train, and from him I procured such supplies as were most needed. The greatest want which I experienced was that of tools. I had not a shovel or pick with which to bury the dead or construct sinks, and no axes. I was compelled to send out a foraging party to the farm houses, who, after a day's labor, succeeded in procuring two shovels and an axe. Seventeen hospital tents were pitched, and in these were placed all the most severe cases, about seventy-five in number. Under the tent flies, I placed one hundred more patients, and the remainder were all under shelter-tents, and were arranged by regiments. By means of the wagons, I procured abundance of clean fresh straw from about five miles distance, and commissary stores and fresh beef were furnished ad libitum. Assistant Surgeons Ramsay, Whittingham, Bacon and Breneman, U.S.A., and two surgeons of volunteer regiments, whose names I cannot at this moment recall, remained with me, and through their energy and zeal the
labor of organizing the hospital was quickly completed. Especial praise
is due to Doctors Ramsay and Whittingham, whose labors were unceasing,
and from whom I received many valuable suggestions. Very few shell wounds
came under my notice at this battle, and none from round balls or buckshot.
Most of the wounds were from the conoidal ball, and a large proportion
were in the lower extremities. Of three exsections of the shoulder joint,
all were successful in so far as that the patients recovered. In one case,
I removed four and a half inches of the shaft. No cases of tetanus occurred
in this hospital. Of secondary hemorrhage there were thirteen cases up
to the 22d of July, at which time I left the hospital. Three of these cases
occurred after amputation of the thigh; in two the hemorrhage was arrested
by pressure, and, in the third, it was found necessary to open the flaps
and secure the bleeding vessel. Three cases of hemorrhage from the anterior
tibial artery occurred; two were arrested by pressure, and, in the third,
amputation was performed with a good result. In one case, the internal
maxillary was the bleeding vessel. The hemorrhage in this case was readily
controlled by pressure and persulphate of iron. Assistant Surgeon Howard,
U.S.A., left in the hospital six cases of gunshot wounds of the thorax,
all of which he had treated by hermetically sealing the orifice with collodion.
Four of these men died. What became of the other two, I do not know. In
one of these cases, I made a post mortem examination, and found an abscess
of the lung, communicating with the pleural cavity, which last was filled
with a sanio purulent fluid. Four cases of a similar nature were treated
with moist charpie. One of these died, and one was dying when I left; the
other two were, in my opinion, in a fair way to recover. Five cases of
gunshot fracture of the cranium came under my notice. Four of these involved
the occipital bone, and all were fatal. A low muttering form of delirium,
with occasional paroxysms of furious mania, was present in all from the
commencement. Two cases occurred of gunshot fracture of the femur in the
upper third. Both were treated by Smith's anterior splint, and one died.
In no case of fracture of the long bones did I attempt any formal resection,
but confined myself to removing splinters and foreign bodies, and cutting
off very sharp projecting points with the bone forceps. From my experience
in Cliffburne hospital, I am convinced that regular resections in such
cases are worse than doing nothing at all. I partially resected the elbow
joint in two cases, and the wrist in three. The wounds generally granulated
and took on a healthy appearance with great and unusual rapidity, which
fact I attributed to the following circumstances: they were in the open
air, were, many of them, exposed for the first few days to a warm rain;
they had plenty of good food, and flaxseed poultices were unknown." **
CXXXIV. Fifth Extract from Memoranda for the Surgical History of the War. By Assistant Surgeon B. HOWARD, U.S. Army.
*** "Reconnoisance in force was made across the Rappahannock on the
9th of June, 1863. The forces crossed at Kelly's and Rappahannock Fords,
and encountered the enemy at Brandy Station, when a brisk fight ensued,
confined mainly to the cavalry on both sides. The wounded were brought
to Kelly's and Rappahannock Fords as fast as possible. Those taken to the
latter place were immediately placed on the cars for Alexandria; those
arriving at Kelly's Ford were unprovided for. I immediately converted the
Mount Zion brick church near the ford into an hospital. All the wounds
were properly dressed at once, and necessary operations performed. The
wounds were mainly sabre cuts; one man had five of these. The entire force
recrossed the same evening. Next morning, all the patients were sent from
Mount Zion to Rappahannock Station, by ambulances, and shipped thence by
railroad to Alexandria. The supplies were ample. ** At the battle of Gettysburg,
the 2d division of the Fifth Corps, with the artillery brigade, got into
position on and about a ridge near little Round Top about five o'clock
P.M. of the 2d of July, and were, in a few minutes, hotly engaged. The
field hospital of the command was established at a stone house, about half
a mile to the left and a quarter of a mile to the rear of our front. Just
before noon, next day, the hospital was shelled so furiously that we removed
the wounded in great haste to some woods, beside a creek, about two miles
further to the rear. In the absence of all means of shelter, the wounded
were exposed to an exceedingly heavy rain. Supplies were sufficient; surgeons
were detailed to remain at this hospital, while the rest joined the army,
which, on the 5th of July, advanced towards Williamsport." ***
CXXXV. Third Extract from a Narrative of his Services in the Medical Staff. By Assistant Surgeon C. BACON, U.S. Army.
*** "May 27th, at my own request, I was transferred for duty to the 2d U. S. Infantry, belonging to the 2d brigade of the division. On the 3d of June, the division was advanced to protect the fords of the Rappahannock, the 2d brigade resting at Benson's Mill. On the 13th, the camp was broken up and the command moved by way of Centreville to Gum Springs, Virginia; thence, after resting a few days, to Aldie, Virginia. The second day's march, while ascending from the lowlands of the Rappahannock, was very severe, owing to the want of water and the great heat. June 15th, 16th and 17th were also excessively hot. Numbers of the men were overpowered by the heat of the sun, falling insensible from exhaustion, but no fatal cases of sunstroke occurred. The want of transportation for the sick was severely felt the first two days of the march; as a consequence, those who were too sick to march were obliged to be left on the road. Subsequently, ambulances accompanied each command of the division. On the 26th of June, the division resumed its march, proceeding by way of Leesburg, Virginia, to Frederick, Maryland. Thence it moved by way of Hanover, Pennsylvania, to Gettysburg. The regiment engaged in the battle of Gettysburg, July 2d, meeting with a loss of over seventy-five men, being about fifty-eight per centum of those engaged, including officers and men. I was not present at the engagement, having been detailed for duty at the division hospital as one of the operating staff. The action in which the division was engaged was short and destructive, placing in hospital over six hundred wounded, who were removed from the field of battle by ambulances. July 3d, the building occupied as
hospital became untenable, being immediately in the line of the fire
from the enemy's guns. It was, therefore, removed to a point some two miles
to the rear of the position of our army. This occupied much of the day,
during which the hospital was frequently under fire. ** Toward the evening
of the third day of the battle (July 3d), a heavy rain began, falling also
during the nights of the 4th and 6th, and continuing July 7th and 8th.
At an early period, the hospital tents of the division were brought up,
having, previous to the battle, been sent to the rear with the division
transportation. These, however, accommodated but a small portion of the
wounded. Preference was given to those who had sustained operations, and
to the most severely injured. The remainder were but imperfectly protected
from the rains, their shelter being only such as could be constructed by
means of shelter tents. The straw used for bedding consequently became
damp, and, the rains continuing incessantly, little opportunity was given
to dry it for several days. Under direction of the surgeon in charge, Assistant
Surgeon Billings, U.S.A., stimulants were freely distributed during this
period. So far as I know, no cases of tetanus followed this exposure, nor
had I seen tetanus ensuing from the exposure of the wounded at Chancellorsville.
The wounds presented at the battle of Gettysburg, as at Chancellorsville
and at the battles in Maryland, were principally made by the minie bullet.
** Pyaemia was frequently the result of these wounds. It was common after
our capital operations, and almost invariably proved fatal. I have notes
of but one case of erysipelas resulting in death. ** At different periods,
the minor cases and those rapidly recovering from injuries were transferred
to the military hospitals at York, Pennsylvania, Philadelphia and Baltimore.
The major operations and injuries of a complicated character were retained
until immediately preceding the breaking up of the hospital, when they
were transferred to the general hospital at Gettysburg, Pennsylvania. The
health of most of the surgeons became impaired by their duties. Of eleven
surgeons on duty at different periods during the permanent organization
of the hospital, eight were taken ill, or were absent on sick leave early
after rejoining their commands. August 2d, the division hospital was broken
up, when I rejoined my command, then lying at Rappahannock Station, on
the Orange and Alexandria railroad. I was, while on duty at Gettysburg,
seized with an inflammatory diarrhea. Continuing my duties, I became much
reduced. My illness rendered me incapable of enduring exposure to the excessive
heat of the sun, and on returning to my command, I was prostrated by a
sunstroke, which, however, left no ill effects further than increasing
my debility." ***
CXXXVI. Extract from a Report with regard to the Battle of Gettysburg. By Surgeon J.W. LYMAN, 57th Pennsylvania Volunteers.
*** At the engagement of the 2d and 3d of July, 1863, the 1st division of the Third Corps took an active part, losing heavily in killed and wounded. Early in the forenoon of the 3d, whilst the division was taking position on the extreme left of the front line of battle, I proceeded on the Taneytown road in the rear of the left of our lines to select a depot for the wounded. Finding all the more eligible houses and barns already occupied by the Second and Eleventh Corps, which had been engaged the day previous, I chose an old barn by the road side as offering the best accommodations in the immediate neighborhood, and leaving Surgeon Everts to occupy the place, returned to the command, and notified the medical officers of the locality chosen. The hospital and supply wagons were ordered up, tables prepared, and everything was in readiness when the engagement commenced. In fact, we had received a large number of wounded from the skirmishing parties sent out before the battle became general; after which, it was discovered that our position was much exposed not only to shell and shot, but to the musketry of the enemy, compelling us to abandon it, and take up a new position at a large stone barn in the direction of the Baltimore pike. We occupied this position 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 brought from the field. Early on the 3d, I received notice from the acting medical director of the corps to move the wounded of the 1st division to a place admirably selected by him for a corps hospital in the field, still further removed from danger, and where, in addition to a finely wooded and shady elope, we had a fine stream of running water. The change was soon effected, the operating staff of the division, placing their tables near each other, were constantly employed, while the remaining officers were no less busily engaged in dressing and supplying the general wants of the hundreds of wounded men who continued to increase our numbers during that day and the succeeding night. As usual, a large proportion of the graver cases of injury were the last to be brought from the field, and the cases for operation on the night of the 3d and morning of the 4th accumulated, occupying the entire operating force without intermission. From the tabular statement of wounded in the hospital of the 1st division, it appears that there were ninety-seven cases operated upon, there being no less than fifty-three amputations, seventeen of which were of the thigh, eleven of the leg, eleven of the forearm and eleven of the arm (a singular coincidence of numbers), the whole number of wounded being eight hundred and thirteen. This statement does not include the whole number of the wounded of the division, nor the full number of operations, as many slight wounds dressed on the field, as is always the case, did not come under the observation of the recorder, and many grave cases, followed by operations, fell into the hands of other surgeons, as those from other divisions fell into our hands. The whole number of wounded in the division, as shown by official reports in the office of the adjutant general of the division, was one thousand four hundred and fifty-eight, showing a discrepancy between the actual number wounded and the number recorded as receiving surgical attention in the hospitals of the division of six hundred and forty-five. I am happy to report that, notwithstanding the obstructions met with in procuring supplies from the commissary department, owing to the supplies in ambulances and supply wagons, and the energetic and faithful labor of Assistant Surgeon Albion Cobb, 4th Maine, in charge of the cooking department, the wounded of the division suffered but slight inconvenience from want of food." ***