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Chapter 3

Table of Contents

Chapter 3

THE INDIAN WARS

From 1865 until the Battle of Wounded Knee in 1890 the Army's primary responsibility was, as it had been before the Civil War, subduing the Indians who threatened white settlers and white ambitions. Most garrisons at the small and isolated forts of the West were involved only in minor guerrilla engagements that placed a premium on mobility and resulted in few casualties, and thus their post surgeons were principally occupied caring for the sick. For the physicians accompanying the few major expeditions organized to fight the Indians, caring for the troops in wild and unsettled country constituted a considerable challenge, their best efforts handicapped by the lack of a nearby hospital, by terrain that often prevented the use of wheeled vehicles for evacuation, and by acute supply problems. Supplies for men who were to be away from their base for months had to be kept to a minimum in the interests of mobility. At the same time, commanding officers had no alternative but to sacrifice mobility for days or weeks to move the sick and wounded with the expedition, since assigning a detachment to escort them back to the nearest post hospital weakened the entire force. As one officer pointed out, "In savage warfare, to leave one's wounded behind is out of the question."1

Fighting an Unorthodox Enemy

Many factors affected the way in which the Indian wars were fought, but none was as fundamental as the uncertain nature of communications. Since the headquarters of the geographical divisions and departments of the West were able to exercise only a minimum of control over their subordinate commands, the success of both soldiers and surgeons depended not only on their ability to function independently and resourcefully but also on their willingness to take great risks and endure prolonged hardships. For all of them, much of the Civil War experience proved to be irrelevant; some of it was a definite handicap. As suggested by one military historian, "The Civil War had . . . accustomed leaders and soldiers to conventional war fought according to white men's rules, and readjustment to guerrilla-style war was not easy"2

Because of the poor state of communications, neither the commanding officers of the Divisions of the Missouri and of the Pacific nor those of the subordinate departments were much involved in the decisions that governed day-to-day operations against the Indians. The commanding generals of the departments gave Army surgeons their assignments, and the departmental medical directors exercised super-


64

vision over the professional work of their subordinates, reporting monthly to the surgeon general about their performance. During the height of the Indian wars, because of the shortage of medical officers, these subordinates included contract physicians, who often had to accompany expeditions as well as to staff Western posts. Fortunately, the skills of many contract surgeons were comparable to those of career medical officers. Many had served as physicians in one capacity or another during the Civil War, while the youngest were frequently prospective medical officers, whose lack of experience was counterbalanced by their high caliber.3

Difficulties with supply, evacuation, and hospitalization, all related to poor transportation, handicapped surgeons attempting to care for the sick and wounded of units fighting Indians. Those trying to move supplies and those trying to move patients faced similar handicaps, many dictated by the nature of the warfare, communications, and the terrain. A shortage of wagons at crucial times increased the problems experienced in keeping an expedition supplied, whether with food, medicines, shelter, or litters for the sick and wounded.4

To supply posts and expeditions in areas still seriously threatened by the Indian presence, items were usually moved by water or rail as far as possible and then unloaded for transport by wagon, often under heavy guard, to those forts that were otherwise inaccessible. Expeditions picked up what they needed from the posts where they originated and, when possible, from posts along the way. Supplies were occasionally moved forward beyond the farthest posts for storage at an advance base. When troops were following a river, a steamer sometimes served as a moving depot, from which a train of pack mules could be periodically replenished. Logistics became even more complicated during the winter because of the condition of roads and trails.5

The successful pursuit of a highly mobile enemy over trails impassable to wagons required that only an absolute minimum of supplies be taken with an expedition. In addition, when troops were deep in Indian country and contact with the enemy was momentarily anticipated or when the trail was particularly rough or steep, wagons might be abandoned and everything carried on the backs of mules. The expedition's surgeons would then have to carry all their needs on their own horses or, at the most, to rely on one or two pack animals. Fortunately, in the era before antiseptic surgery, elaborate equipment was not necessary. When unexpected events brought the men to the point of starvation, the surgeons involved had to exercise more than the usual ingenuity, even though the number of wounded was usually very small.6

The Medical Department had developed no evacuation doctrine describing how the wounded should be moved in areas where trails were narrow, rough, intersected by streams and gullies, and thus impossible for wheeled vehicles to negotiate. Neither the department nor the Army provided litters with which to carry the wounded. The need for mobility often forced surgeons accompanying expeditions to abandon all but the most essential of their equipment, and as far as evacuation was concerned, they often in a very real sense lived off the land. Litters and similar devices, even if available, would not be taken with them because reasonable substitutes could be found along the way. Service in the field against the Indians convinced Assistant Surgeon General


65

MULE PULLING A TRAVOIS

Crane that somewhere in each command involved in Indian warfare were men sufficiently ingenious to meet whatever challenge they might encounter in moving the wounded. Believing that an overall policy should be developed concerning the means of evacuation to be employed when wagons could not be used, Surgeon General Barnes instructed Assistant Surgeon Otis, then a captain, to report to him how evacuation in this type of situation had been handled in the past. After examining a variety of approaches, Otis could offer nothing more specific in the way of a solution than his conviction that "uniformity in equipment" was of great importance.7

Thus left to their own devices as far as evacuation was concerned, Army surgeons relied heavily on the horse or mule litter. Each litter required the services of two animals and four soldiers, one man to lead each beast and two more to walk beside the litter to keep it from swaying, a precaution that was necessary because when the animals walked in step, the litter took up a rocking motion. The opportunity to train animals to carry litters (mules, which took smaller steps, were preferred to horses) was rare, but untrained beasts were likely to panic because of their unaccustomed burden. Each pair also needed to be matched carefully as to pace, since a faster animal in front might pull free of the harness, while a faster one in the rear would push the litter forward upon the leader. The length of poles used to construct the litter was also critical, as the animal in the rear had to be able to see the ground in front of his feet.8

A convenient alternative to the litter was, as contract surgeon Valentine T. McGilly-cuddy put it, the "travor, travois, traveau, travoise, or travail." While one end of this litter-like device was fastened to a horse or mule, the other dragged upon the ground. The travois had distinct advantages. It could be made from materials near at hand, such as branches, small trees, or the poles from captured Indian tepees (since there was no animal at the rear, the length of the poles was not critical); any pack animal (pack animals were usually mules) could be used because


66

no special training was needed; and only one beast was sufficient to move the travois and only two men to guide it, one to lead and a second to steady the patient and carry the free end over streams or rough spots. As an expedition progressed and the number of disabled increased, the pack animals seldom became available to the Army surgeons for evacuation purposes. Even though the total weight of the supplies that the mules carried was less and less over time as food was consumed by the men, they themselves were in a weakened state because of having to live on short rations, and redistributing loads to free them for use with litters was impossible because they could no long carry their usual heavy loads. While some surgeons preferred to use the litter over uneven ground, those favoring the travois pronounced it to be "well adapted for transporting the wounded over a rough country." Both litter and travois challenged physicians to experiment with improved designs that might minimize their drawbacks.9

When a hasty retreat allowed no time to construct litters or travois, surgeons were forced to improvise, placing a wounded soldier astride a horse or mule, regardless of his condition, the resultant pain, or the threat of hemorrhage. As a last resort, a patient was moved short distances seated upon the clasped arms and hands of other soldiers or carried in a blanket, with each corner held by one of his comrades. The medical director of units in the Pacific Northwest that were involved in the Modoc War, which took place in terrain where lava beds intimidated even unburdened horses, devised a litter that was borne on the back of a single mule, "something like a reclining chair," and had a carpenter make up several for his use.10

The wounded of the Indian wars could usually be taken directly to a post hospital, but occasionally facilities had to be established in the field. Tents were generally used for this purpose, although any available shelter might be pressed into use. During the Modoc War a "general field hospital" was established in the late spring and early summer of 1873 to replace a temporary facility; in this instance, structures made of "framing timber" covered with "paulins" supplemented the tents. Under most circumstances the number of sick and wounded who could not be sent back to a post hospital was very small, and what was called a field hospital was most likely a ten-bed facility at best.11

Performing surgery under such primitive conditions probably caused little difficulty for surgeons who, as Civil War veterans, were more familiar with surgery and its problems than most civilian physicians. Arrow wounds were not often encountered, however, even in the Indian wars, and thus few physicians became skilled in dealing with them. Removing an arrow from a wound without leaving its head behind required particular skill. Body fluids tended to soften the animal tendons that the Indians used to fasten the arrowhead on the shaft so that the surgeon might leave the head imbedded in the wound. Medical officer Lt. Joseph H. Bill had familiarized himself with the designs used by many different tribes and developed a technique for removing the arrow shaft and head at one time. In an article published in 1862, he pointed out that since Indians invariably placed the head either parallel to the slit in the shaft that accommodated the bow string or at right angles to it, it was easy to ascertain how the head lay without making a wide incision. One method that Bill described involved a looped wire inserted along the shaft to snare the head, making it possible to pull out both parts of the


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arrow at once. He also pointed out that when an arrowhead had embedded itself in the skull, it could be used to raise any piece of bone that it had depressed in the process, possibly eliminating the need for the surgeon to take further steps to alleviate pressure upon the brain. Indians often aimed for the navel, a broader target and one without bones to shield vital organs, but Civil War veterans knew that surgeons could do little to save men with penetrating abdominal wounds. Unless the victim were very lucky, if hemorrhage did not kill him, infection would.12

Wounds were not a major threat to soldiers serving in the West, but long grueling marches in extreme temperatures as well as severe food and water shortages could have devastating effects on their health. Disease, especially typhoid, malaria, and scurvy, was a great and often victorious enemy. Operations against the Indians in cold weather when snow covered the ground were too successful to be abandoned, but Army surgeons never found an effective treatment for the frostbite or freezing that was the possible price paid for continuing the effort. Deep gangrene and infection often resulted from cold injuries, and death was the frequent outcome. The amputation of toes or feet was common in these cases, but nonsurgical approaches were sometimes tried. On one occasion, at least, surgeons wrapped the patient's frozen feet in "cloths wet with whiskey." They dosed him internally with quinine mixed with a tincture of chloride and iron, administered three times a day, and with morphine for his pain. Two days later, when the skin began to slough from the sufferer's feet, his doctor removed the whiskey-impregnated fabric and substituted cloths soaked in lime water and olive oil, but the patient's legs continued to swell for two more days until death ended his agony.13

Supporting a Major Expedition

Army surgeons serving with the troops in the West saw action against many tribes and over a vast area, from the Southwest with its Apaches and Utes to the Northwest with its Modocs and Nez Perces. Yet no Indians put up fiercer resistance to the encroachment of the white man than those of the Northern and Southern Plains. Perhaps the most prolonged ordeal was that endured by the Army surgeons of the Bighorn-Yellowstone Expedition in 1876 on the Northern Plains. This complex campaign, part of a decade-long and increasingly intense effort to force the Sioux and the allied Cheyennes onto a reservation, involved three separate commands, all from the Division of the Missouri, that attempted to converge on the Sioux in an area roughly defined by the Yellowstone, Bighorn, and Little Bighorn Rivers and Rosebud Creek (see Map 1). Plans for this operation called for the commander of the Department of Dakota, Brig. Gen. Alfred H. Terry, who also commanded the entire expedition, to lead troops, among them Lt. Col. George A. Custer's 7th Cavalry, east from Fort Abraham Lincoln, near Bismarck, Dakota Territory. Col. John Gibbon from the Department of Dakota led a second force east following the Yellowstone River from Fort Ellis, Montana Territory. The commander of the Department of the Platte, Brig. Gen. George Crook, led a third column from Fort Fetterman, Wyoming Territory, north along the old Bozeman Trail.

The area that was the expedition's destination was exceedingly difficult to supply. Much would have to come in through Fort Buford, Dakota Territory, on the Missouri River near its confluence with the Yellowstone River, more than 1,000 miles from the nearest rail line. From Fort Buford the


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MAP 1


69

HOLMES O. PAULDING

mouth of the Powder River was 235 miles and that of the Bighorn 399 miles. The other rivers of the area could not be relied upon for the movement of supplies because they were both "shallow and uncertain."14

Evidence that Maj. William J. Sloan, medical director of the Department of Dakota, was planning for the medical aspects of the expedition is scanty. During the winter of 1876 he was incurring added expenses for medical officers, hospital stewards, and other personnel, and also for medical supplies for new posts and for field service; but whether any of these expenditures represented planning specifically for the Bighorn-Yellowstone Expedition is hard to determine. The number and quality of the surgeons seemed to concern Sloan, as well as Maj. John E. Summers, medical director of the Department of the Platte, more than supply. Sloan, who supervised the work of a dozen regular medical officers and almost twice that many contract surgeons serving more than twenty posts, urgently telegraphed the surgeon general in late April that "if Assistant Surgeon Williams could be sent back without delay, it would relieve me of much embarrassment."15

Sloan's concern was justified, for when Gibbon and 450 men left Fort Ellis on 3 April to struggle eastward through often deep snow, his entire medical staff consisted of a single physician on his first assignment as a member of the Medical Department. Although Gibbon could have signed on contract surgeons, for unspecified reasons he chose not to do so. His sole medical officer was Lt. Holmes O. Paulding, a 24-year-old physician who was apparently already showing the first signs of the heart disease that would kill him in 1883. Paulding had been the post surgeon at Fort Ellis, where the cavalry battalion for Gibbon's force had been stationed.16

From the outset Paulding encountered two of the difficulties that could confront expeditions like the one to which he had been assigned. To the threat posed by the Indians were added supply shortages and treacherous weather. Paulding could not bring with him as much of the supplies that he had collected at Fort Ellis as he wished, "not having room for any more." Infantry units joining the expedition from Fort Shaw, Montana Territory, brought him some of what he needed. Although the snow melted quickly when the sun shone, the weather was capricious. As late as June, warm sunshine alternated with heavy snow and high winds, and nights could be bitterly cold. The Indians managed to make their presence known, although at first they did not attack. Thus, until the end of May, Paulding's patients, except for a man with a broken leg, were sick rather than injured. The ambulance wagons that


70

JAMES P. KIMBALL

were carrying those too ill to march moved slowly because of the soft wet ground, and, in recalling his situation a few weeks later, Gibbon concluded that he had been "entirely devoid of any proper means for the transportation of sick or wounded." He added that his supplies should have been carried by a "well-organized pack train."17

On 23 May the Indians struck for the first time, ambushing and killing three men who had left the camp to hunt. Paulding's duties on this occasion were limited to examining mutilated bodies. Only one soldier had been scalped, but knives and gun butts had wrought havoc. Some injuries had been inflicted while the men were still alive. This horror caused the officers of Gibbon's command to reassess their vulnerability. Paulding was ordered to be prepared to douse all lights in the hospital tent in the event of a night attack unless a life depended on immediate surgery.

As the column continued forward, more minor accidents and ailments required Paulding's attention, and he was himself briefly sick. One patient, a scout who had broken his collarbone, had to be retrieved six miles from camp; the doctor noted that in this case he "expended a lot of brandy" as well as ten grains of quinine. Another patient was suffering from acute rheumatism and a third from a severe sore throat.18

On 9 June Gibbon's command met Terry's column, which had also been plagued by the weather. Even as Terry's forces gathered at Fort Lincoln, a large number was suffering from frostbite, and the deep snow delayed the arrival of many more men. Capt. James P. Kimball, who had been detached from his new assignment at Fort Brady, Michigan, to join Terry as Custer's senior medical officer, was himself delayed by a blizzard, which he later credited for saving his life by preventing him from joining Custer.19

When Terry finally started out in May, the medical director for his command was the same Capt. John W. Williams whose presence had been so urgently sought by Sloan. Williams supervised the work of five medical officers and bore the ultimate responsibility for the health of a total of 925 officers and men, 700 of them from Custer's 7th Cavalry. His supplies moved by both steamer and wagon up the Missouri and Yellowstone Rivers to a depot at the mouth of Glendive Creek, which ran into the Yellowstone River south of Fort Buford. On 1-2 June a heavy snowstorm slowed the command's progress, and thus it did not reach the Powder River until the seventh. Here a small hospital was set up to care for four men who became ill or were injured during the march.20

Upon their meeting, Terry ordered Gibbon to start up the Yellowstone River to-


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GEORGE E. LORD

ward the mouth of the Bighorn. On 18 June, after an arduous march, Gibbon again met with Terry, who had come upriver on his supply steamer, the Far West. Gibbon joined him on that vessel several days later, remaining there ostensibly "for the purpose of conferring," but Paulding insisted that Gibbon stayed because he had colic. By the twenty-fifth, and after a day of ridge-walking far from the nearest source of water, Paulding informed Terry that the men with him could go no farther without a rest. Terry apparently took his advice, but by the time the men could continue, a drenching rain was falling. Cavalry units preceded the infantry, and when the foot soldiers finally arrived at the camp, the troopers were preparing to set out again- heavy smoke had been spotted rising in the air "some miles up on the Little Horn."21

Paulding shared the general excitement that resulted from the reports that began to come in. On 26 June he joined a company sent out to scout along the bluffs. He later recorded in his diary that he had already concluded that Custer had been defeated but that his opinion was not widely held. In fact, Custer had divided his command, and all those he kept with him had been killed, among them the highly regarded Lt. George E. Lord, post surgeon at Fort Buford, who, like Paulding, had only recently been appointed to the Medical Department. Lord's body, initially unrecognized, was positively identified only after Williams noticed that one body was wearing a pair of unbleached socks, bought when he and Lord were together. Maj. Marcus H. Reno and the remainder of the 7th Cavalry were at that point sorely beset on the bluff. One of the physicians with Reno's command, contract surgeon James M. DeWolf, was also among the dead, shot once in the abdomen and six times in the head and face.

A second contract surgeon with Reno, Henry R. Porter, set up a field hospital where, using a tent as both ground cover and operating table, he amputated a private's leg. He was caring for more than fifty wounded when the Indians finally abandoned their attack with the approach of the Terry-Gibbon commands.22

Once the newly arrived force had determined that none of the men with Custer had survived, the challenge of evacuating Reno's wounded was met under Williams' watchful eye. Hand litters, mule litters, and travois were constructed to move the wounded, but even when carried by eight men, the hand litters proved slow and tedious. The litter-bearing mules were so fractious carrying their unaccustomed burdens that the wounded were terrified. Accounts of this phase of the evacuation of wounded vary, but according to Williams, whose narrative is the most detailed, the


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BENNETT A. CLEMENTS

travois proved entirely satisfactory. On 28 June mules were chosen from Custer's pack train in the belief that their exhaustion would render them tractable. Since the command had few mule litters and travois, and evacuating the wounded even just a few miles further by hand litters slowed progress, on the twenty-ninth Gibbon ordered that more mule litters and travois be made. Tepee poles, rawhide, and canvas were used to produce nineteen mule litters and ten travois, the latter adapted from an Indian design with a basket of rawhide straps suspended from the two poles. With the less seriously injured men on horseback and the remainder on travois and litters, the move to the Far West went surprisingly well. All were loaded on board and ready for their voyage back to Fort Lincoln before dawn on the morning of the thirtieth in spite of bad weather, six crossings of the Little Bighorn River, and a recalcitrant mule that knelt and dumped the amputee in his litter upon the ground.23

In the wake of the disaster both Sloan, just recently promoted to lieutenant colonel, and the surgeon general showed considerable anxiety about the future. In a telegram to Barnes, Sloan reported the catastrophe and the loss of two medical officers; asked for the immediate dispatch of a contract surgeon; and, "in view of recent events," requested the cancellation of the leave of one of his medical officers. A few days later Barnes telegraphed both Sloan and Summers to suggest that they assign both Terry and Crook a full surgeon. Summers replied that he had already ordered Maj. Bennett A. Clements, post surgeon at the St. Louis Barracks in Missouri, to join units coming to reinforce Crook. Sloan stated that although he had been waiting for the surgeon whose leave had been canceled to arrive in his department, he would send another to comply with the surgeon general's recommendation. Sloan also asked for and received permission to requisition a three-month supply of medicines for 300 men to be sent to Fort Lincoln. Determined that Summers be promptly resupplied, Barnes telegraphed the medical storekeeper responsible for filling Summers' requisition that he was not to take leave until the supplies were on their way.24

For a month Gibbon and Terry remained in the area of the mouth of the Bighorn, awaiting the arrival of Crook's command. According to Paulding, a "general Hospital [was] established by Field Orders" on 4 July. Although he gave no detail about its size or construction, this facility was described as "general" because it served men from more than one regiment. Two weeks later one of Paulding's officer patients committed suicide, shooting himself when he could no longer endure his "neuralgia and


73

CURTIS E. MUNN

nervous prostration." The weather was very hot, and both typhoid and scurvy were beginning to appear among the men. Paulding was caring for an average of thirty-five to forty cases at a time. Antiscorbutics were promised but took weeks to be delivered. He could care for so many patients satisfactorily only because of the assistance of his hospital steward, who was "acting as a medical officer."25

After moving three miles on 24 July, the Terry-Gibbon force awaited the return of Williams and the steamer from Fort Lincoln before starting out on the twenty-seventh toward the mouth of Rosebud Creek. The sick, accompanied by Williams and Porter, went by steamer. On 2 August Indians attacked men from the steamer who were attempting to retrieve forage stored at the mouth of the Powder River. Artillery fire turned back the attackers, but a scout was wounded. Although "the gallant Dr. Porter" risked his own life to care for the scout where he fell, the wounded man soon died. That same day the last of twelve companies arrived to reinforce Terry, and twenty patients were transferred to a second steamer for the journey back to Fort Lincoln.26

As long as the command remained camped along a navigable part of one of the tributaries of the Yellowstone, neither supply nor the evacuation of seriously or chronically ill patients was a major problem. On 8 August the Terry-Gibbon force left the mouth of the Rosebud, and on the tenth it finally met Crook's command. United at last, the entire Yellowstone Expedition on the eleventh "cut loose from [the] train & [went] across country," still, however, following the Yellowstone River eastward. On the seventeenth it reached the mouth of the Powder River, where thirty-four more patients boarded the steamer that had been following the march. Crook left Terry on the twenty-fourth, and on 6 September, when Terry and Gibbon reached Glendive Creek, Paulding concluded that "the expedition against hostile Sioux" had "died a natural death."27

Crook's men were also preparing for the expedition against the Sioux in the early months of 1876. Since Summers, like Sloan, did not accompany the expedition, Capt. Curtis E. Munn, newly arrived on detached service from Camp Robinson, Nebraska, was Crook's senior surgeon and medical director. Under Munn served two contract surgeons, John Ridgely and Charles R. Stephens (three physicians to care for a force twice the size of Gibbon's command, which was accompanied only by Paulding). Munn was allowed the use of four ambulance wagons and a supply wagon. The weather in early March again proved a tough adversary when Crook's men finally started north from Fort Fetterman. On one occasion the


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warmth of the sun was "in a few moments" succeeded by "snow . . . coming in from all quarters, accompanied with severe gusts of wind." The mercury in the thermometer dropped rapidly and eventually solidified, Crook recalled, "until we were having a regular blizzard." A day and a night were spent waiting out the storm before the command could continue.28

Munn had a patient in one of his ambulances almost from the outset-for four days and 84 miles, a herder wounded by the Indians journeyed with the command. The wagon train, including the ambulances, was left behind on 7 March at Crazy Woman's Fork with orders to head for the site of old Fort Reno, abandoned in August 1866. Ridgely accompanied the wounded herder and the sick to set up a field hospital there for them and for any evacuees sent back in the future. Munn continued on with his supplies, among them instruments, dressings, medicines, twenty-four blankets, a rubber bed cover, and bottles of brandy, all carried on the backs of two mules. With the ambulance wagons no longer available, he had to resort to a travois for a rider who was pinned when his horse fell on the icy path. On 16 March the command was divided once again. Now the pack train was also left behind, Stephens remaining with it and the two battalions assigned to guard it, while Munn went on with the three battalions making a night march to follow a fresh Indian trail.29

In the encounter that followed, six soldiers were wounded and four killed. Only fifteen minutes were required to construct travois out of tent poles obtained at the village from which they had driven the Indians. These devices were very effective on this occasion; Munn reported that a private with a penetrating abdominal wound was evacuated over 100 miles of rough terrain back to old Fort Reno without harm. Two more of the men who were moved on travois were suffering from severe attacks of rheumatism-whether the "rheumatism" that so often plagued members of the expedition was caused by rheumatoid arthritis or some related condition or by hemorrhaging into joints and muscles resulting from scurvy is not known. Unfortunately, all that awaited the sufferers when they reached old Fort Reno was a single tent that was wet on the inside. As the outraged Munn reported, Ridgely, an elderly physician who had served as a contract surgeon in the War with Mexico thirty years before, had spent all his time either in sleep or in "querulous controversies." Within two hours Munn had made his patients comfortable; however, since all the men had been suffering intensely from the cold and many more cases of rheumatism were developing, Crook decided not to remain at old Fort Reno but to return to Fort Fetterman to await the arrival of better weather before proceeding with his mission.30

At Fort Fetterman, Munn discovered that several cases of erysipelas had recently occupied beds in the post hospital and that the wounded there had not done well. As a Civil War veteran he knew that erysipelas, later recognized as a streptococcal infection, was highly contagious. Despite his great respect for the post surgeon he decided, therefore, to send his patients, except the herder, with Stephens, who was returning to Fort D. A. Russell, Wyoming Territory. On his way back to Camp Robinson on 30 March, Munn stopped at Fort Laramie "much exhausted." He developed "pulmonary congestion, and remained several days a patient and guest of Asst. Surgeon Hartsuff, U.S.A., the post surgeon of the Station." Although Munn finally


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JULIUS H. PATZKI

JUNIUS L. POWELL

reached Camp Robinson on 7 April, it was several more days before he was well enough to resume his duties there.31

Crook set out once again from Fort Fetterman at the end of May. His force now numbered about 1,000 soldiers, slightly more than in March, and the medical staff had been entirely replaced. His new medical director was the Fort Laramie post surgeon, Capt. Albert Hartsuff, who had been on leave when Crook's command first left Fort Fetterman. Hartsuff was assisted by Capt. Julius H. Patzki, a Regular Army surgeon and the post surgeon at Fort Fred Steele in the Wyoming Territory; by a contract surgeon, Junius L. Powell; and possibly by a third doctor, identified in only one account as Richard H. Stevens, about whom little else is known. Accompanying this force were 1,000 pack mules. On 8 June Crook again set up a supply base, this time at Goose Creek, 300 miles from the rail depot handling supplies for his expedition. Here 260 Indian scouts joined him. At Goose Creek he left his wagons and, apparently, Powell with some sick and injured. On the seventeenth, 40 miles north of Goose Creek, Crook's command encountered as many as 1,500 Indians. During the engagement that followed, the surgeons had to move the wounded often to keep them from the enemy. Dressings had to be hastily applied, and since Rosebud Creek, which Hartsuff viewed as "a miserable little stream," was 2 miles away, no water was available. The Indians killed nine soldiers and wounded eighteen before they were driven off, and another soldier accidentally shot himself with his pistol. No injuries were caused by arrows.32

No serious attempt to pursue the enemy was possible because the wounded could neither be abandoned nor dragged along at top speed. Their suffering from the pain of


76

their injuries and their loss of blood was magnified by the extreme heat and the shortage of water. Soldiers built "a rough shelter of boughs and branches" to serve as a hospital, and Hartsuff, Patzki, and Stevens, assisted by a line officer who had once attended a course of medical lectures, worked all night to ready the wounded, both soldiers and Sioux, for the return to Goose Creek. The next day, 18 June, travois and a litter were made from cottonwood and willow branches, and with thirteen of the wounded riding their own horses, the command turned south. Carried on the litter (Hartsuff maintained it was a litter, but Crook recalled that it was a travois) was Capt. Guy V. Henry, an officer who had been shot through the eye. A hardy soul, he reassured his anxious comrades that he was "bully" even after one of the mules carrying the litter shied and threw him twenty feet down a rocky incline. "Countless ravines and gullies" had to be traversed to avoid crossing deep water with the travois, but finally Crook and his men arrived back at Goose Creek. On the twenty-first, after having wagons spread with fresh grass for the wounded, a third of whom were in serious condition, Crook ordered them returned to Fort Fetterman, where they had to be sheltered in a barrack because the hospital was being renovated.33

Crook and the rest of his command remained in the Goose Creek area until Lt. Col. Wesley Merritt and ten companies of cavalry arrived on 3 August to reinforce them. Merritt's medical director, Surgeon Clements, had under him at least two contract surgeons, Robert B. Grimes, whose services Summers had specifically requested, and Edward LeCompte. Acting Assistant Surgeon McGillycuddy had apparently already joined Crook sometime in July, coming in with a supply train. Because of his seniority, Clements took over as the medical director of Crook's entire force. Two days after Merritt's arrival, Crook was again on the move, leaving his sick and wounded with a physician at Goose Creek and taking with him the remaining surgeons, seven in number if Stevens was still with Crook, and the more than 2,000 men that now formed his command. Keeping supplies to a minimum, he carried as much as he deemed absolutely necessary on 240 pack mules, two of which bore medical supplies. A few days later he joined Terry's force.34

On 23 August Crook put twenty-five of his sick on the Far West and then separated from Terry. The next day, after leaving behind his wagon train and the remainder of those too ill to march, who were watched over by hospital attendants and a guard, he started east and turned south in his search for the Sioux. Crook was confident that he was adequately prepared to bring with him any in his command who became disabled along the way The material that would be needed to make travois was loaded with other supplies on the backs of his ever-faithful mules. Since they were trained to follow in a column behind an animal equipped with a bell and since they kept up with the march whether they dragged travois or carried packs, the sick and wounded were in no danger of being left behind to the savage mercies of the Indians.35

Despite the sacrifices Crook had made to enable his command to move rapidly in pursuit of the Sioux, heavy rains slowed progress. Thus his wet and shivering men began to pay the price for his gamble in leaving so much of his supplies behind-a shortage of food. Crook telegraphed the commanding general of the Division of the Missouri, Lt. Gen. Philip H. Sheridan, to request that supplies of grain and vegetables be readied to meet them at Dead-


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wood in the Black Hills of the Dakota Territory. By 7 September no pork, bread, or coffee remained. Soldiers had to kill and eat some of their horses and mules. Depression was widespread. Men and beasts alike were in poor condition, and symptoms of scurvy were appearing. Those whose horses could no longer bear them staggered forward, their feet bleeding and their legs swollen. A member of Crook's force wrote less than two months later that he had seen "men so exhausted that they were actually insane. . . . "36

By 8 September the command's situation was desperate, and life was "almost unendurable." Crook detached 150 men and sent them out on his strongest horses to find and bring back food to the others. In their search they encountered an enemy village near Slim Buttes. At the end of the ensuing two-day struggle, which eventually involved another 250 of Crook's men, the Indians abandoned the village, leaving behind their supplies of dried meat and fruits. Surgeons cared for fifteen wounded soldiers, one of whom later died, and for Indian casualties as well. Several lodges became temporary hospitals, where surgeons amputated the leg of a seriously wounded officer. An Indian chief with a fatal abdominal wound underwent surgery without chloroform, silently, but with "the sweat of agony . . . upon his forehead." The command then resumed its trek south over ground that was wet from almost constant rain. McGillycuddy, who apparently shared the responsibility for transportation with Hartsuff, reported that nine travois and three litters were used to move the casualties from Slim Buttes south toward Deadwood, where wagons met them.37

Because captured Indian supplies, which were devoted to the sick and wounded, did not eliminate the need for food, Indian ponies became a part of the menu. Crook's men found no wood to use for fuel along the way. By 12 September some were so debilitated that they lay down upon the wet ground without shelter. When rain again began to fall, they were drenched. Mules were exhausted by their struggle to keep going in the mud, and some fell while crossing streams. Frequent soakings led to "rheumatism and kindred ills," especially among older men. Only by eating wild plums, cherries, and buffalo berries did his soldiers limit the inroads of scurvy. Crook reported with some satisfaction that by the time his men reached the Belle Fourche River, near the end of their journey, only 2.1 percent were disabled, a figure that included wounded as well as sick. Clements later reported to Summers that his supply of medicine up to that point had been "sufficient but not ample" and that he had lost no men to disease.38

An advance party had already reached Deadwood City, and on 13 September, while "breakfasting on pony steak," Crook's starving men beheld a wondrous sight: Coming toward them was a herd of cattle, followed by wagons full of flour and vegetables, and all accompanied by citizens of the various towns of the area, hurrying to welcome them. That night "everyone ate as though he never expected to see another meal, . . . and the camp for the first time in many days rang with laughter and merriment."39

Even so, the situation for Clements' patients remained difficult. Few men continued to fall ill. Their symptoms, however, had "a typhoid character." The wagons had brought only food; tents were still needed to shelter the sick and wounded, and the clothing of all the men was in poor condition. With cold and wet weather apparently on its way, Clements feared for the future


78

well-being of the men, but a supply train from Fort Fetterman arrived on 14 September, bringing medicines, blankets, and hospital tents. Crook urged that the campaign be continued, but Sheridan decided to terminate the ill-fated expedition.40

Although Clements never commented about personal hardship in his reports, he did complain bitterly to Summers in early October that line officers failed to keep medical officers informed about what they intended to do. He emphasized that he found it very difficult to plan for the care of his patients when he had no idea what the command would be doing. He clearly blamed the lack of shelter for them upon his ignorance of what might be ahead.41

Except for the 255 killed and 46 wounded in Custer's disaster at the Little Bighorn, the casualties of the Bighorn-Yellowstone Expedition had been, like those of most efforts against the Indians, quite low, 19 killed in action and 42 wounded. When Crook's command finally headed back to Fort Fetterman, it left 39 sick and wounded with Curtis Munn at Camp Robinson. "Many of them were ill," Clements noted, but within "two hours, after their arrival all were washed, cleanly clad and in bed, and had beef tea given them." The Surgeon General's Office concluded that "every medical officer" involved in this campaign had performed well "under most trying and difficult circumstances and surroundings." The effects of the ordeals, especially those of the final starvation march, would long remain with its participants. In 1886, when Clements died after a lengthy illness, his physician noted that his patient had "shared . . . hardships equally with the others, living for days on unsuitable food, from which he contracted a dyspepsia that never deserted him and to which he attributed his symptoms."42

Surgeons and Their Work

Because of its size and complexity and the time it consumed, the Bighorn-Yellowstone Expedition differed markedly from the most common operations against the Indians, and because of the disaster that befell Custer, it has gained a prominent place in history's spotlight. The physicians who endured the ordeals of that expedition were by no means the only Army surgeons to see action during the Indian wars, however. At least one saw his service less as hardship to be endured than as exhilaration to be enjoyed. Such a man was the remarkable physician who served with Capt. Henry W. Lawton and his cavalry troop in 1886, when they were chasing the enemy through the rough and blazing country along both sides of the Mexican border. Assigned to the territory of Arizona, Lawton and his men covered 2,000 miles in the summer of 1886 under conditions so arduous and at times in areas so steep that horses broke down, and the pursuit eventually had to be conducted on foot. For all those participating in this campaign, unusual strength of will, zest for adventure, and physical stamina were required, yet no Army surgeon ever enjoyed the challenge of Indian warfare more than contract surgeon Leonard Wood.43

A recent Harvard medical school graduate, Wood was among those who had been given a contract while awaiting an appointment as assistant surgeon. He had passed the Medical Department's entrance exam in spite of the board's misgivings about his "acquirements in Physics and Chemistry," but he did not thrive under the ordinary day-to-day routine and discipline of an Army post. When his command began the active pursuit of Geronimo and his Apaches, however, Wood came into his own. He eagerly vol-


79

LEONARD WOOD

unteered for field duty, and the missions he undertook were so dangerous that they earned him a Medal of Honor (and with it the resentment of many line officers) twelve years later, by which point he had acquired many influential friends.44

Neither the 120-degree heat that alternated with violent storms nor the rocky terrain fazed Wood as he rode with Lawton in pursuit of the desperate Apaches. He took every opportunity to demonstrate and test the fabric of which he was made, remaining in the saddle for incredible lengths of time and retaining his vigor and his enthusiasm while lesser men fell by the wayside. In addition to the men of his command, he cared for Mexican civilians who rarely received the attentions of a physician. In one instance, he operated on a child in an attempt to cure her cross-eyes when he was not experienced in this type of surgery and could neither provide post-operative care nor learn whether his efforts had been successful. His willingness to operate suggests more rash enthusiasm than mature judgment. Nevertheless, Wood's commanding officer was in despair over the possibility of losing his services when he became the victim of a tarantula bite that temporarily laid him low with pain, fever, and delirium in July 1886.45

Wood's prowess soon attracted the attention of Brig. Gen. Nelson A. Miles, newly appointed to command the Department of Arizona. Miles shared Wood's New England background and was impressed by his physical condition. He assigned Wood, in addition to his regular duties, the responsibility of determining whether the best white athletes could equal the endurance of Apache warriors. Wood's experience seemed the best answer to the question, since only he and the officer with whom he worked most closely lasted out


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BERNARD SEMIG

the entire campaign. By the late summer, when Geronimo finally surrendered, Wood was functioning more as a line officer than as a surgeon, having been placed in command of a detachment that was ordered to seek out escapees from Geronimo's band, a mission that failed despite Wood's best efforts.46

Few surgeons are likely to have equaled Wood's stamina, vigor, and zest, although others faced and would continue to face with similar courage challenges like those in which Wood delighted. He obviously found the life of the line officer more intriguing than that of the Army surgeon. His initial assignment, completed while he was still a contract surgeon awaiting a vacancy in the Medical Department, started him out on an unusual path, one that he was to follow during the rest of his distinguished career in the Army: Wood the physician would continue to play second fiddle to Wood the military officer. In this he differed from most of the surgeons involved in the Indian wars, who were apparently content to limit their services to those normally expected of medical officers.

Although they may not all have been as enthusiastic about the challenges they faced as Wood, Army surgeons exposed to danger in the West usually learned to live with it. Some became casual in the face of enemy fire, and the records of the period contain many stories of their heroism and level-headedness in action. In the Pacific Northwest contract surgeon Bernard Semig was severely wounded in 1873 while assigned to troops attempting to force the Modocs back onto their reservation in southern Oregon. Although hit in the shoulder, he refused to leave his patient. After he was hit again, he fell unconscious. The loss of a foot because of the second wound apparently did not keep Semig from continuing to work under contract for the Army until he was finally appointed assistant surgeon in 1874. During an 1877 campaign against the Nez Perces, who were resisting attempts to remove them from their homelands in the Wallowa Valley of Oregon, Surgeon Sternberg was forced to interrupt his caring for a patient at night; the enemy fired so constantly at his candle that he finally had to extinguish it. On the Southern Plains yet another contract surgeon, Thomas McGee, showed uncommon coolness under fire when he was applying dressings to a wound during a raid on an Arapaho village in July 1874. Spotting a warrior about to shoot a nearby soldier, McGee grabbed his patient's gun, shot the Indian, and calmly returned to his bandages.47

Modern historians have questioned the competence of these surgeons of the Indian wars, assuming that no competent physician would willingly undertake to live in


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such isolation and to function under such primitive conditions. In Frontier Regulars: The United States Army and the Indian, 1866-1891, Robert M. Utley, believing that primitive living conditions and low pay discouraged "able doctors," concluded that most Army physicians, "whether regular or contract, . . . lacked the competence of their brethren in civil life." In 1883, however, Morris J. Asch pointed out in the New York Medical Journal that although the medical officer's pay did not compare favorably with that earned by doctors practicing in large cities, it was generous when contrasted to that available to newly fledged physicians in civilian life. Medical officers also had the benefit of a steady income, even when sick, and could count on a pension of 75 percent of their salaries when they retired. Furthermore, in Asch's opinion, Regular Army surgeons on the whole were as capable as physicians anywhere in the world.48

Care of Reservation Indians

The long-term care of Indians who had given up the struggle against the white man was rarely among the Army physician's responsibilities. The reservations on which they were gathered were under the Bureau of Indian Affairs, which had agreed that the Army would play no role in their management unless the bureau requested aid. At least one medical officer, who apparently did not have the Army's approval for his care of reservation Indians, found his Army pay docked by the amount the bureau had paid him for dealing with its charges. The few Army surgeons who were assigned to care for reservation Indians did not seem to resent the responsibility and, on some occasions, seized the opportunity to study the language of their patients. But for those caring for the Indians the Army retained as prisoners, the challenge was great and the satisfaction small.49

Unlike most Indians defeated by the Army, Geronimo and those who had fought with him against Captain Lawton's force were not immediately confined to a reservation. As prisoners, they remained the responsibility of the Army rather than the Bureau of Indian Affairs. A group of about 500 Chiricahua Apaches, including women and children, were sent from the Arizona Territory, where authorities believed they would continue to foment trouble, east to Florida, where the captives had been promised a new home on a reservation. There their health remained the responsibility of Army surgeons.50

The health of Geronimo's Apaches, like that of so many Indians, whether they were the responsibility of the Army or of the Bureau of Indian Affairs, remained poor, plagued by high rates of both disease and death. Most of the Apaches defeated in 1886 were shipped to Fort Marion, at St. Augustine, although in spite of promises that they would all be kept together, a few of the men were sent to Fort Pickens, Pensacola. Forced to live crowded together under conditions characterized by poor sanitation and given an inadequate diet, those at Fort Marion began to die at a rapid rate; 22, 15 of them children, died within the first six months. By 1888 all the Florida exiles had been moved to the Mount Vernon Barracks in Alabama, where initially they had no shelter but crude huts in a low area inhabited by malaria-bearing mosquitoes. By 1890 the death rate was above 100 per 1,000. In four years 120 of these unfortunates had died. This figure included 30 of the 112 children who, despite their parents' despair, had been sent to the


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PETER J. A. CLEARY

Indian School at Carlisle, Pennsylvania, an institution that was, like other Indian schools, severely overcrowded. More than half the 79 adult males still alive were in poor health, often because of malaria.51

The Army surgeons responsible at various times for the health of the Apaches at Mount Vernon Barracks were a diverse group. The assignment was obviously not considered a desirable one for regular medical officers-two who served there were heavy drinkers, if not actual alcoholics, and another was mentally ill. Although the regulars were eager to be elsewhere, not all contract surgeons shared their opinion; one acting assistant surgeon who had served there was annoyed at having his contract canceled as not needed. All physicians assigned to care for the Apaches were to some degree frustrated by the poor health of the Indians, but not all felt compassion for their condition.52

Assistant surgeon Walter Reed, who was assigned to Mount Vernon Barracks from the summer of 1887 to 1890, was dismayed at the rapid inroads that tuberculosis, not generally recognized as a contagious disease until the end of the century, was making among the captives, its progress aided in part, he believed, by their low morale. In January 1891 his successor as post surgeon, the hard-drinking Maj. Peter J. A. Cleary, blamed the mortality on the climate, callously assuring the surgeon general that "when they are thoroughly acclimated, those left of them will be healthy." But as the months went by, the deaths continued. Cleary reported children dying from chronic dysentery, bronchopneumonia, and tuberculosis, with the latter responsible for adult deaths as well. He blamed the death of a deformed baby on deliberate poisoning, a conclusion he reached because of the tribe's reputation for destroying children with congenital deformities.53

The susceptibility of the Apaches to disease presumably resulted in part from the stress under which they lived in an area of the country that was so far from home and so strange to them and in part from a lack of previous exposure to the ailments characteristic of Florida and Alabama. Thus, in a sense, Cleary was correct-those who survived (became "thoroughly acclimated") would undoubtedly as a result thereafter have greater resistance to some of the diseases that had killed so many of their fellow tribesmen. While confirming that venereal disease was not a significant problem, a study of the health of all Indians initiated in 1903 demonstrated that tuberculosis was a particular danger to them, both on reservations and in schools off the reservations. The investigation blamed both the unhygienic surroundings in which they had to live and their poor diet.54


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In frustration at their inability to materially reduce the high death rate, physicians took to blaming the Indians themselves for it. In May 1891 Dillon J. Spotswood, a contract surgeon working under Cleary, attributed one death to "Indian medicine" and maintained that another resulted from the patient's being "tampered with by the squaws" after successful treatment for an "enormous abscess." He noted in June, however, that the death rate was dropping, a fact he attributed to the establishment of a bakery. Although the Apaches no longer had to eat the "wretched bread which [they] baked for themselves," upon which he blamed most of the cases of dysentery, deaths and disease, particularly among children, continued. Of 5 fatalities in July, Spotswood blamed 3 on "Indian poisons given as medicines" and another on "syphilitic rheumatism." Cleary, too, was now convinced that the foods the Apaches ate and the medicines with which they dosed themselves were responsible for many fatalities. Ignoring the apparent lack of milk to feed the infants, he insisted that the principal cause of infant deaths was the half-cooked meat their mothers fed them, since "the little wretches eat it with the avidity of carnivorous animals." He ordered Spotswood, as the physician directly responsible for their care, to make a regular habit of visiting their homes and trying to educate the mothers.55

Despite the efforts of both Cleary and Spotswood, in fiscal year 1891 the death rate had reached more than 142 per 1,000. When Lt. William W. Wotherspoon, the officer placed in charge of the prisoners in 1891, first visited these Apaches, he reported that they were "in filthy nakedness, clothed only in rags, with hair infected with vermin, their skin caked with accumulated filth, their houses filled with dirt and offal, sleeping on the ground in the most abominable rags, cooking and eating on the ground, treating and killing their own sick." By the spring of 1892 strict controls over hygiene and sanitation were in force. All children except the very youngest had "to be paraded once each week" so that the state of their health could be checked. All sick had to report at once to the surgeons, and the clothes of anyone who died had to be burned. A hospital was built, and the diet improved.56

Obviously proud of what he had accomplished as far as sanitation was concerned, Wotherspoon was distressed that in the summer of 1892 Spotswood's replacement, Capt. William C. Borden, considered his new charges to be filthy. The lieutenant admitted, however, that the improvement over what he had himself found a year earlier might make him see the 1892 picture as rosier than it was; the death rate had fallen to less than 110 per 1,000. Borden apparently proposed such radical improvements in sanitation that even his superior, Cleary's replacement, Maj. Curtis E. Munn, grown frail and bibulous since his days with the Bighorn-Yellowstone Expedition, questioned their practicality. Munn emphasized, for example, that it was unrealistic to expect the Indians to use earth closets even if they were provided. He noted that there was a real need for fresh milk for the two-year olds, who were too young to be adequately fed on regular rations alone.57

Despite Munn's lack of support, Borden remained much interested in the health of the Apaches. He blamed the high death rate of their children upon inadequate clothing in cold months and, above all, on an unsuitable diet after weaning. He noted that the Apaches, accustomed to the dry weather of the Southwest, preserved meat by hanging it in the sun to dry and that


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they continued to follow the same procedure in the humid climate of Alabama, where the meat rotted. Then, badly cooked by Borden's standards, it was fed both to adults and to children, whose digestive systems could not handle it in its decomposed state. He also blamed the tuberculosis rate largely on the fact that the prisoners were, contrary to their custom, living in permanent housing and that the buildings initially provided for them were poorly ventilated and constructed. Accustomed to leaving behind any filth that might have accumulated in the short period they were in one place and to burning the housing and clothing of anyone who died, Apaches allowed garbage and trash to collect in the dark dampness of their new quarters.58

By 1893 many Apache men had enlisted in the Army and, with the benefit of military inspections and discipline, were living under conditions similar to those of white soldiers. Borden noted that the village itself was now "on the crest of a hill," with "plenty of sunlight and free circulation of air. The houses are of fairly good construction, are well lighted by good-sized windows, . . . and are easily kept clean." Despite the attention and care devoted to sanitation, hygiene, and diet, diarrhea was still causing a high death rate among the Apache children in 1893, and tuberculosis continued to kill many adults. Borden, for whom tuberculosis was apparently the first concern, explained that the rate was constantly high because the disease had become well entrenched in the tribe.59

In 1894 the attempt to retain the Apaches in the East was finally abandoned, and the survivors were sent to Fort Sill, Oklahoma Territory. Here the tuberculosis contracted in Alabama was blamed for a death rate that remained high, 83 per 1,000 in 1894-1895, but in an environment more like that of their homeland, new cases of that disease were less common.60

The Last Battle

As the 1880s wore on, major expeditions and significant battles became fewer. Railroads were proliferating and telegraph lines connected Army posts, easing the Army's logistical problems and encouraging further settlement in the West. Finally, in December 1890 the white man and the Indian fought their last major engagement at Wounded Knee in South Dakota. No longer guerrilla warfare, the fight was waged on the white man's terms; the Medical Department could function much as it had in the Civil War, now with the help of the disciplined members of the new Hospital Corps drilled in the management of evacuation.61 The Army was able to move the required men and supplies by train, and troops no longer had to march endless miles, in constant danger of ambush, along trails often impassable to wheeled vehicles. The Indian this final time was surrounded, outnumbered, and totally vulnerable.62

Unrest among the Sioux at two reservations in South Dakota brought reinforcing Army units to the area in November 1890 under Miles, now a major general and the commanding officer of the Division of the Missouri. The tension was particularly great at the Pine Ridge Reservation, where by the end of the month more than 1,300 men were stationed. With the nature of any possible action relatively predictable, the medical director of the Department of the Platte, Lt. Col. Dallas Bache, could plan and organize the Medical Department's response. He sent in the tentage and equip-


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ment needed for a 25-bed hospital, a facility that was soon expanded to 60 beds to serve all the units involved in what became an effort to crush the Sioux. Surgeon Hartsuff, now a major and once again involved in a struggle against the Sioux, took charge of the field hospital, aided by an assistant surgeon, two Hospital Corps noncommissioned officers, and ten Hospital Corps privates. The two battalions that formed the 7th Cavalry brought with them two medical officers, a hospital steward, four Hospital Corps privates, and two ambulance wagons. A battalion of the 9th Cavalry arrived with a medical officer, an acting hospital steward, five Hospital Corps privates, and an ambulance wagon. Although physicians at Pine Ridge concluded that a larger contingent from the Hospital Corps would have been desirable, they also believed that the field hospital, which had been set up on the Pine Ridge Reservation, could handle about 3 percent of the command.63

The discharge of an Indian's rifle on 29 December during the Army's attempts to disarm the Sioux at their camp along Wounded Knee Creek led to violence. The Indians suffered high casualties. Their situation hopeless, the survivors were soon fleeing the melee, but the artillery stationed on high ground above the camp took a heavy toll as they fled. The Army had not expected hostilities, but the soldiers were prepared for the possibility. In their final battle, the Indians had never had a chance.

During the conflict, the value of training men for such duties as evacuating the wounded and the need to train more of them became evident. Because of the shortage of hospital corpsmen, civilians had been hired to drive the ambulance wagons. When hostilities broke out, several of these untrained men were so terrified that they fled the scene. Captain Hoff took over one of the abandoned ambulances himself, and when he encountered the men who had deserted their vehicles, "he drove them to their duty." The contrast between the conduct of these men and that of the hospital corpsmen and the company bearers proved that the Army's training was well worth the effort and expense devoted to it. One hospital steward was killed in action. Two corpsmen rescued a wounded officer during renewed action on 30 December by taking an ambulance wagon beyond the line of skirmish to retrieve him. After surgeons examined all the wounded, placing a tag with each describing his injuries, the corpsmen handled the initial dressings accordingly. They then evacuated "not only our own wounded men but wounded Indians [who] were, with great promptness and dispatch, removed and cared for in the field hospitals which were extemporized for their benefit."64

The discipline and training that the Hospital Corps provided its corpsmen stood them and the Army in good stead, but their experiences during the Battle of Wounded Knee convinced Medical Department authorities that the services they could render should be taken more seriously. Medical officers had long realized that these valuable assistants should not be forced to face the enemy unarmed, and this engagement demonstrated that regardless of the circumstances, horses should be available for corpsmen just as they were for the cavalry.65

Not all surgeons were as disciplined as the hospital corpsmen. Standing on a hill, watching the battle unfold, was Capt. Charles B. Ewing, who, according to Colonel Bache, was present "not on duty but as a spectator." When a cavalry troop galloped by, Ewing grabbed a riderless horse and sped off with the others, forgetting in


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his enthusiasm to bring his dressings with him. After fifteen minutes and three miles, he realized his mistake and turned back. By the time the day was over, Ewing had been on the field more than seven hours. Excluding his brief escapade, he spent half his time at a dressing station and the rest helping in the evacuation of the wounded and the removal of most of the dead.66

Shortly after the battle Colonel Bache told another medical officer that 29 soldiers, as well as an Indian scout, had been killed and another 30 wounded. He also estimated that as many as 115 Indians had been killed and knew that Army surgeons were caring for 8 Indian wounded in addition to 25 wounded women and children. "The slaughter of the Indians must have been sickening," Bache wrote on 1 January 1891. "It is sickening now to step through the lines of broken women and children that we have as prisoners."67

Most of the duties performed by surgeons during the battle were mundane, such as setting fractures and stopping bleeding, and required medical skill rather than military discipline. Ewing's greatest challenge involved the reattachment of the fleshy part of a nose. When he first saw this patient, an interpreter who accompanied the command's Indian scouts, the entire nose forward of the bone was "hanging by a mere shred and bleeding profusely" Several days later when Ewing removed the stitches, the damaged appendage was firmly in place. Among the patients encountered by other surgeons was an officer whose pocket watch had been fragmented and driven into his abdomen by a bullet; the pieces were removed by Surgeon Reed, now a major assigned to Fort Keogh, Montana.68

In the days that followed the battle, surgeons performed more major surgery, although Indian patients refused to submit to operations even when death was the only alternative. After waiting thirty-six hours, Ewing decided that he must amputate a shattered leg because the breaking of both tibia and fibula had damaged major blood vessels and destroyed much soft tissue below the knee. He believed that the need for surgery was so urgent that he had to proceed even when attempts to lay the dust of the dirt floor in the Sibley tent used as an operating room were only partially successful. Despite "persistent antiseptic irrigation of the stump" and free drainage from the wound, the patient died as a "result of pyemia involving staphylococcus pyogenes."69

Anticipating prolonged and fierce hostilities, medical officers had set aside a considerable amount of space in buildings in the area. Several large dormitories at the Oglalla School on the Pine Ridge Reservation were supplied with 150 beds and bedding; the executive board of the new Soldiers' Home at South Dakota's Hot Springs allotted two-thirds of the home's capacity, or 200 beds, for battle casualties; and another 40 beds awaited the sick and wounded at Forts Robinson and Niobrara in Nebraska. Army casualties received their initial care in the field hospital at Pine Ridge. Enemy wounded were also taken to the reservation, where they were sheltered in tents and a small church made available to the Indians by a group of missionaries. Once emergency care had been given, Army casualties in need of further treatment were sent back to their post hospitals as soon as they could be moved. Only two went to Fort Robinson and none to the other beds set up for the use of battle casualties. Many were carried twenty-six miles by ambulance directly from the field hospital to Rushville, where Colonel Bache had arranged to have a sleeping car with


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its beds made up waiting, and thence by train, six of them to Fort Omaha, Nebraska, and twenty-one to Fort Riley, Kansas. Of the forty-six patients in the field hospital on 4 January 1891, only eighteen remained on the fifth. These were the last wounded from Indian warfare for whom Army surgeons would ever care.70

Until the Battle of Wounded Knee, the surgeons who accompanied the Indian-fighting troops after the Civil War usually worked with small and isolated units, without the aid of a disciplined, well-trained Hospital Corps and without the benefit of the understanding of disease and infection that would come with the era of modern medicine. Just as the experiences of the Civil War were irrelevant to those of the Indian wars, so, too, were the challenges of the Indian wars irrelevant to the demands of modern large-scale warfare. Although the Medical Department had had its first significant lesson in improving the health of primitive peoples when it tried to reduce the disease and death rates among the Apaches in Alabama, the experiences of the Indian wars before 1890 prepared neither the Army nor the department for the next military struggle the nation was to face. Wounded Knee was a turning point. It was the first battle in which the Medical Department's Hospital Corps took part and the last battle of the Indian wars. It was also the last battle whose wounded did not have the care of physicians thoroughly conscious of the danger germs posed to their patients. For the Medical Department, Wounded Knee was more the last engagement of an age that had almost passed than it was the first of a new era.


NOTES

1. Quotation from War Department, [Annual] Report of the Secretary of War, 1876, 1:476 (hereafter cited as WD, ARofSW, date); Don Rickey, Jr., Forty Miles a Day on Beans and Hay, p. 272; James A. Huston, The Sinews of War, pp. 256-59; Robert M. Utley, Frontier Regulars, p. 48; Philip H. Sheridan, Record of Engagements With Hostile Indians . . . . Unless otherwise indicated, background material for this chapter is based on Russell F.Weigley, The American Way of War; idem, History of the United States Army; and Utley, Frontier Regulars.

2. Quotation from Weigley, History, p. 268; Francis P. Prucha, The Great Father, 1:544-45, 548-49; Otto L. Nelson, Jr., National Security and the General Staff, pp. 12-13; Paul A. Hutton, Phil Sheridan and His Army, p. 301.

3. AGO GO 101, 21 Aug 1882, and GO 121, 1 Jul 1865; Ltr, D. L. Magruder to SG, 4 Apr 1866, Entry 12, Record Group (RG) 112, National Archives and Records Administration (NARA), Washington, D.C. After 1882, commanding officers were urged to send only Regular Army surgeons with expeditions.

4. Huston, Sinews, p. 256; Darlis A. Miller, Soldiers and Settlers, pp. 287-88.

5. Prucha, Great Father, 1:548-49; Miller, Soldiers and Settlers, p. 300.

6. George A. Otis, A Report to the Surgeon General on the Transport of the Sick and Wounded by Pack Animals, pp. 1-3, 19-20, 23n.

7. Ibid., p. 3. See also pp. 1-2, 24, 26-28, and passim.

8. Ibid., pp. 13-15, 24-28; War Department, [Annual] Report of the Surgeon General, U.S. Army, to the Secretary of War, 1875, p. 10, 1877, pp. 11-12, 1880, pp. 10-11, 1881, p. 11, 1882, p. 10, and 1883, pp. 19-20 (hereafter cited as WD, ARofSG, date); Rickey, Beans and Hay, pp. 243-44.

9. Quotations from Otis, Report on Transport, pp-25, 22. See also pp. 17-19, 22n, 24, 26, 26n.

10. Quotation from Ltr, Henry McElderry to John Green, 30 Jun 1873, file F, Entry 624, RG 94, NARA; Ltr, Crane to McElderry, 22 Aug 1873, Entry 2, RG 112, NARA; Rickey, Beans and Hay, pp. 326-27.

11. Quotations from Ltr, H. McElderry to J. Green, 30 Jun 1873, in file F, Entry 624, RG 94, NARA; WD, ARofSG, 1892, p. 5; Otis, Report on Transport, p. 19. See Chapter 2 for a discussion of post hospitals.

12. Rickey, Beans and Hay, pp. 130, 254, 269, 272; Martha L. Sternberg, George Miller Sternberg, p. 13; Joseph H. Bill, "Notes on Arrow Wounds," pp. 367, 369-71, 374-77, 381-83, 385, 387; Frank H. Hamilton, A Treatise on Military Surgery and Hygiene, p. 526; George A. Otis, A Report of Surgical Cases Treated in the Army of the United States From 1865 to 1871, pp. 144-63; Peter D. Olch, "Medicine in the Indian Fighting Army, 1866-1890," pp. 32-41.

13. Otis, Report of Surgical Cases, p. 167.

14. WD, ARofSW, 1876, 1:309.

15. Quotation from Telg, William J. Sloan to SG, 22 Apr 1876, Entry 34, RG 112, NARA. In loc. cit., see Telgs, John E. Summers to SG, 6 and 26 Jun 1876, and, in Entry 57, AGO SO 73, 23 Apr 1875. See also Holmes O. Paulding, Surgeon's Diary With the Custer Relief Column, pp. i, 2-4, 33; John M. Carroll, ed., General Custer and the Battle of the Little Big Horn, p. 176. Except when otherwise indicated, all material on the medical care of Gibbon's column is based on Paulding, Diary.

16. Ltr, SG to Holmes O. Paulding, 10 Apr 1876, Entry 2; Ltr, Surgeon General's Office (SGO) to L. C. Gordon, 17 Apr 1876, Entry 12; and AGO SO 260, 30 Nov 1874, Entry 57. All in RG 112, NARA.

17. First quotation from Paulding, Diary, p. 3; remaining quotations from WD, ARofSW, 1876, 1:476; ibid., 1:460, 471-72.

18. Paulding, Diary, p. 17.

19. Edward S. Luce, ed., "The Diary and Letters of Dr. James M. DeWolf," p. 76; Maria B. Kimball, A Soldier Doctor of Our Army, pp. 82-84; Ltr, William J. Sloan to SG, 18 Nov 1876, H. R. Porter Papers, Entry 561, RG 94, NARA; Mil Svc Card, James P. Kimball, Entry 89, and Ltr, SG to Kimball, 27 Jan 1877, Entry 2, RG 112, NARA.

20. WD, ARofSW, 1876, 1:460-61; John S. Gray, Centennial Campaign, pp. 271-74.

21. First quotation from WD, ARofSW, 1876, 1:473; second quotation from Paulding, Diary, p. 20.

22. WD, ARofSG, 1876, p. 7; idem, ARofSW, 1876, 1:477; Augustus L. DeVoto, "A Trooper With Custer," pp. 68-71; Edward S. Petersen, "Surgeons of the Little Big Horn," pp. 41-43; Douglas D. Scott,


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Richard A. Fox, Jr., Melissa A. Connor, and Dick Harmon, Archaeological Perspectives on the Battle of the Little Bighorn, pp. 97, 99, 132-33; in Entry 561, RG 94, NARA: Ltrs, George E. Lord to SW, 8 Jul 1875, J. F. Head to J. B. Brown, n.d., and G. E. Michaelis to L. W. Lord, 29 Sep 1876, George E. Lord Papers, and also Mil Hist, James M. DeWolf, idem Papers; in RG 112, NARA: Ltr, SG to Lord, 5 Jun 1876, Entry 2, and Ltr, Geo. D. Ruggles to CO, Fort Buford, Dak.T., 21 Apr 1876, Entry 12; Gray, Centennial Campaign, pp. 274, 279.

23. Otis, Report on Transport, pp. 21, 23n2; WD, ARofSG, 1876, p. 13; idem, ARofSW, 1:474-75; Sheridan, Record of Engagements, p. 58; Carroll, Little Big Horn, p. 103.

24. Quotation from Telg, William J. Sloan to SG, 8 Jul 1876, Entry 34, RG 112, NARA. In loc. cit., see also ibid., J. E. Summers to SG, and SG to Sloan and Summers, all 17 Jul 1876; J. S. Billings to Sloan, 11 Jul 1876; and SG to Geo. T. Beall, 1 Aug 1876.

25. Quotations from Paulding, Diary, pp. 27-28; S. L. A. Marshall, Crimsoned Prairie, pp. 170-71.

26. Quotation from Rpt, Orlando H. Moore, 4 Aug 1876, in WD, ARofSW, 1876, 1:481; ibid., 1:465; Sheridan, Record of Engagements, p. 60.

27. Quotations from Paulding, Diary, p. 29; Otis, Report on Transport, p. 23n; WD, ARofSW, 1876, 1:466-67.

28. Quotation from George Crook, General George Crook, p. 191; ibid., p. 190; Herbert M. Hart, Old Forts of the Northwest, p. 146; Otis, Report on Transport, p. 19; in RG 94, NARA: Ltr, Curtis E. Munn to John E. Summers, 12 Apr 1876, file F, Entry 624, and Statement, [?] to M. Heitman, 13 Jan 1903, Reel 409, Mf1064; in RG 112, NARA: Ltr, SGO to Abram French & Co., 18 Jul 1876, Entry 12.

29. Otis, Report on Transport, pp. 18-19; Rpt Extract, Charles E. Munn, 12 April 1876, John Ridgely Papers, Entry 561, RG 94, NARA; Hart, Old Forts, p. 42.

30. Quotation from Rpt Extract, C. E. Munn, Ridgely Papers, Entry 561, RG 94, NARA; Otis, Report on Transport, p. 19; Marshall, Crimsoned Prairie, p. 126; WD, ARofSW, 1876, 1:441; idem, ARofSG, 1876, p. 12.

31. Quotations from Ltr, C. E. Munn to J. E. Summers, 12 Apr 1876, file F, Entry 624, RG 94, NARA; in loc. cit., see also Note, Munn, n.d.

32. Sources do not agree on the number of casualties, which have been reported to be as high as twenty-eight killed and fifty-six wounded. Powell would become an assistant surgeon in 1878. Quotation from Otis, Report on Transport, p. 20; Crook, Crook, pp. 194-95; Bourke, Crook, pp. 289-90, 318-19; John F. Finerty, War-path and Bivouac, p. 85; WD, ARofSW, pp. 1:308-09; in RG 94, NARA: AGO SO 17, 11 Feb 1876, and Mil Hist, Curtis E. Munn, 1876, Reels 267 and 409, Mf1064, plus Hartsuff's narrative, 1876 [?], report, 17 Jun 1876, and letter to Med Dir, Dept of Platte, 20 Jun 1876, all file F, Entry 624; in RG 112, NARA: Ltr, SG to Julius H. Patzki, 7 Dec 1876, Entry 2, and Ltr, Patzki to SG, 29 Feb 1876, Entry 12, and Mil Svc Card, Patzki, Entry 89.

33. First and third quotations from Bourke, Crook, pp. 316-17 (see also p. 319); second quotation from Crook, Crook, p. 197; Ltr, J. R. Gibson to J. E. Summers, 28 Jun 1876, Entry 12, RG 112, NARA; Otis, Report on Transport, p. 20; Marshall, Crimsoned Prairie, p. 131; Finerty, War-path, p. 85.

34. Crook, Crook, pp. 197, 200-201; Bourke, Crook, p. 345; Otis, Report on Transport, p. 23n; in Entry 561, RG 94, NARA: Ltr, Edward LeCompte to Med Dir, Dept of Platte, 30 Jul 1876, Edward LeCompte Papers, and Ltr, Robert B. Grimes to SG, Jul 1876, Robert B. Grimes Papers, and Rpt, Valentine T. McGillycuddy, 31 Jul 1876, and Ltr, idem to SG, 18 Feb 1878, Valentine T. McGillycuddy Papers; in RG 112, NARA: Ltrs, SG to Bennett A. Clements, 14 and 26 Jun 1876, Entry 2, and Telgs, J. E. Summers to SG, 6 Jun 1876, and SG to Clements, 26 Jun 1876, and to Med Dir, Dept of Platte, 27 Jun 1876, Entry 34.

35. Rpt (copy), Bennett A. Clements, 25 Sep 1876, file F, Entry 624, RG 94, NARA; WD, ARofSW, 1876, 1:467, 507-08; Ltr, Clements to J. E. Summers, 25 Sep 1876, Entry 12, RG 112, NARA.

36. Quote from Ltr, Walker S. Schuyler to his father, 1 Nov 1876, in Crook, Crook, p. 206; Rickey, Beans and Hay, pp. 262-63; Bourke, Crook, p. 366; WD, ARofSW, 1876, 1:506; Finerty, War-path, pp. 254-56, 261.

37. First quotation from Finerty, War-path, p. 278 (see also p. 300); second quotation from Charles King, Campaigning With Crook and Stories of Army Life, p. 131; Crook, Crook, pp. 206-07, 207n; WD, ARofSW, 1876, 1:506; Otis, Report on Transport, pp. 23n, 25-26; in RG 94, NARA: McGillycuddy Rpt, 30 Sep 1876, McGillycuddy Papers, Entry 561, and Clements Rpt, 25 Sep 1876, file F, Entry 624; in RG 112, NARA: Ltr, Clements to Summers, 25 Sep 1876, Entry 12.

38. First quotation from Ltr, Schuyler to his father, 1 Nov 1876, in Crook, Crook, p. 211; second quotation from Ltr, Clements to Summers, 25 Sep 1876, Entry 12, RG 112, NARA; WD, ARofSW, 1876, 1:507-09; Finerty, War-path, p. 301.


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39. First quotation from Finerty, War-path, p. 306; second quotation from Ltr, Schuyler to his father, 1 Nov 1876, in Crook, Crook, p. 209.

40. Ltrs, B. A. Clements to J. E. Summers, 7 (quotation) and 8 Oct 1876, Entry 12, RG 112, NARA.

41. Ibid., 7 Oct 1876.

42. Crook, Crook, p. 212; War Department, Adjutant General's Office, Chronological List of Actions . . . With Indians From January 1, 1866, to January, 1891 (N.p., n.d.), pp. 39-40; in RG 112, NARA: Ltrs, Charles H. Crane [?] to Curtis E. Munn, 8 Jan 1877 (first and second quotations), and to B. A. Clements, 16 Jun 1877 (third and fourth quotations), Entry 2, and Ltr, Clements to Summers, 8 Oct 1867, Entry 12; in RG 94, NARA: Ltr, Charles Page to SG, 11 Nov 1886 (fifth quotation), Bennett A. Clements Papers, Entry 561, and Mil Hist, Bennett A. Clements, Reel 409, Mfl064.

43. Hermann Hagedorn, Leonard Wood, 1:68-69, 71.

44. Quotation from Ltr, D. L. Huntington to L. Wood, 5 May 1865, Entry 2, RG 112, NARA; John M. Carroll, ed., The Medal of Honor, p. 98; Jack C. Lane, Armed Progressive, pp. 2-4.

45. Hagedorn, Wood, 1:68-69, 71-72, 76-77; Jack C. Lane, ed., Chasing Geronimo, pp. 16, 65, 69, 132-33; idem, Armed Progressive, pp. 8-11, 13-15.

46. Hagedorn, Wood, 1:108-09, 111; Lane, Armed Progressive, pp. 12-13, 17; Nelson A. Miles, Serving the Republic, p. 224.

47. Lane, Armed Progressive, p. 8; Sternberg, Sternberg, pp. 60-61; WD, ARofSG, 1875, p. 9, and 1883, pp. 35-36; Frank U. Robinson, "The Battle of Snake Mountain," pp. 96-98; Bourke, Crook, p. 76; Ltr, H. McElderry to J. Green, 30 Jun 1873, in file F, Entry 624, RG 94, NARA; George M. Kober, Reminiscences of George Martin Kober, M.D., LL.D., pp. 311-12; Ltr, Charles B. Ewing to SG, 30 May 1893, Ms C100, George Miller Sternberg Papers, National Library of Medicine (NLM), Bethesda, Md.

48. Quotation from Utley, Frontier Regulars, p. 87; Morris J. Asch, "Army Medical Service," pp. 203-04.

49. Ray H. Mattison, ed., "The Diary of Surgeon Washington Matthews, Fort Rice, D.T.," pp. 5-6; William Corbusier, Verde to San Carlos, pp. 249-50; Ltrs, Thomas F. Azpell, Entry 227, RG 112, NARA.

50. Angie Debo, Geronimo, pp. 294-95.

51. Ibid., pp. 292, 316-20; Crook, Crook, pp. 289-91; Telgs, P. H. Sheridan to G. Crook, 3 and 5 April 1886, in George Crook, Crook's Resume of Operations Against Apache Indians, 1882 to 1886, pp. 19, 21; Herbert Welsh, The Apache Prisoners at Fort Marion, St. Augustine, Florida, pp. 3-4, 6; Frank C. Lockwood, The Apache Indians, pp. 320-21; William C. Borden, "The Vital Statistics of an Apache Indian Community," p. 7; Prucha, Great Father, 2:842-44; William G. Pollard, "Structure and Stress," M.A. thesis, pp. 128, 133-34.

52. In RG 94, NARA, see documents in papers of William C. Borden and Dillon J. Spotswood, Entry 561, and in those of Peter J. A. Cleary and Curtis E. Munn, Reels 325 and 409, Mfl064.

53. Quotation from WD, ARofSG, 1892, p. 51; ibid., p. 52; Debo, Geronimo, pp. 337, 339, 342-44; William B. Bean, Walter Reed, pp. 42-45; Ltr, SG to Peter J. A. Cleary, 25 May 1890, Reel 325, Mf1064, RG 94, NARA; John Duffy, The Sanitarians, pp. 196-97; Wesley W. Spink, Infectious Diseases, p. 221.

54. Prucha, Great Father, 2:846.

55. WD, ARofSG, 1892, p. 52 (quotations), 53.

56. Quotations from ibid., pp. 54, 53; ibid., 1896, p. 92; Debo, Geronimo, p. 348; Borden, "Vital Statistics," p. 7.

57. WD, ARofSG, 1892, pp. 53-54; in RG 112, NARA: Rpt, Jos. D. Smith, 27 Jun 1892, sub: Inspection of the Medical Department, Entry 38, Mount Vernon Barracks; in RG 94, NARA: Ltr, D. J. Spotswood to SG, 12 Mar 1892, Spotswood Papers, Entry 561, and Efficiency Rpt, Curtis E. Munn, 13 Feb 1892, Munn Papers, Reel 409, Mf1064.

58. Borden, "Vital Statistics," pp. 6, 8-9.

59. Ibid., pp. 6 (quotations), 10.

60. WD, ARofSG, 1893, p. 69, and 1896, p. 92; Lockwood, Apache Indians, p. 322.

61. See Chapter 1 on the formation of the Hospital Corps and Chapter 2 on the training of its members.

62. Prucha, Great Father, pp. 560-61.

63. WD, ARofSG, 1891, pp. 37-38, 41.

64. First quotation from Ltr, James W. Forsyth to AG, 1 May 1898, Entry 561, RG 94, NARA; second quotation from WD, ARofSG, 1891, p. 12; ibid., pp. 39-41, and 1892, p. 22.

65. WD, ARofSG, 1891, pp. 40-41; in RG 112, NARA: Ltr, John van R. Hoff to SG, 13 Oct 1888, Entry 17, and SGO Cir 14, 30 Apr 1891, Entry 66.

66. Quotation from Ltr, Dallas Bache to Charles R. Greenleaf, 18 Apr 1891, Ms C91, Charles R. Greenleaf Papers, NLM. See also Charles B. Ewing, "The Wounded of the Wounded Knee Battle Field . . . ," p. 40.

67. Quotations from Ltr, Bache to Greenleaf, 31 Dec 1890, cont on 1 Jan 1891, Ms C91, NLM. See also WD, ARofSG, 1891, pp. 38, 40. The statistics on the number of wounded in Bache's letter differ from those given in the annual report, which itself contains conflicting information. According to the an-


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nual report, the Army had 31 wounded in the main battle and 8 in a later skirmish. Yet, also citing statistics from Colonel Bache's official report, the Army had 36 casualties and 30 severely injured Indians, most of them women and children. The annual report further notes that 28 Indians were taken to the hospital facilities on the Pine Ridge Reservation.

68. Ewing, "Wounded Knee," pp. 39-43 (quotation); Bean, Reed, pp. 49-50. Reed was promoted to major on 4 December 1893.

69. Ewing, "Wounded Knee," pp. 48-49 (quotations); WD, ARofSG, 1891, pp. 38-39.

70. Ewing, "Wounded Knee," p. 42; Ltr, Bache to Greenleaf, 5 Jan 1891, Ms C91, NLM.