Battle Cry of Freedom: The Civil War Era (99 page)

This wretched situation became a scandal in the Union army during the summer of 1862 and caused Surgeon-General Hammond to appoint Jonathan K. Letterman as the new medical director of the Army of the

35
. Strong,
Diary
, 239.

Potomac after the Seven Days'. This appointment brought improvement. The Sanitary Commission had long advocated the creation of a trained ambulance corps. Letterman instituted such a unit in the Army of the Potomac, from where it spread to other Union armies and was formally mandated by law in 1864. Wearing special uniforms and imbued with high morale, these noncombatant medics risked their lives to reach the wounded in the midst of battle and evacuate them as quickly as possible to surgeons' stations and field hospitals. The ambulance corps became a model for European armies down to World War I; both the Germans and French adopted the system in the Franco-Prussian War.
³⁶
The South evolved a similar "infirmary corps" in 1862 but did not institute it on the same scale. The Confederate medical service, like everything else in the southern war effort, did wonders with the resources available but did not have enough men, medicines, or ambulances to match the Union effort. This was one reason why about 18 percent of the wounded rebels died of their wounds compared with 14 percent of the wounded Yankees.
³⁷

The record of both armies in this respect, of course, was abysmal by twentieth-century standards. In the Korean War only one of every fifty wounded Americans died of his wounds; in Vietnam the proportion was one in four hundred. The Civil War soldier was eight times more likely to die of a wound and ten times more likely to die of disease than an American soldier in World War I. Indeed, twice as many Civil War soldiers died of disease as were killed and mortally wounded in combat.

36
. Adams,
Doctors in Blue
, 88.

37
. The percentage cited here for the mortality of Union wounded is based on the official report of the surgeon general used as the basis for the compilations in Fox,
Regimental Losses
, 24 and passim. No comparable data exist for the Confederacy. My estimate of 18 percent is based on fragmentary data in Fox; in Thomas L. Livermore,
Numbers and Losses in the Civil War
(Boston, 1901); in Cunningham,
Doctors in Gray
; and in Courtney R. Hall, "Confederate Medicine,"
Medical Life
, 42 (1935), 473. In addition to a less efficient stretcher and ambulance service after 1862, there were other possible reasons for the slightly higher Confederate mortality rate from battle wounds: shortages of medicine in the South; and the inadequate diet of southern soldiers, which left them less able than their Union counterparts to survive the trauma caused by wounds or surgery. To some extent the difference in death rates from wounds may have been a statistical artifact, for Confederate officers were less likely than Union officers to report minor wounds in their units, and this probably meant that a somewhat higher proportion of reported wounds in the Confederate army were serious and therefore potentially fatal.

Such a record seems at first glance to justify the conclusion shared by several historians that "the medical services represent one of the Civil War's most dismal failures."
³⁸

This appraisal echoes a good deal of opinion at the time. Newspapers and Sanitary Commission reports published horror stories about fetid hospitals, drunken surgeons, untended sick or wounded soldiers dying in agony, and the like. The reputation of many army doctors as "quacks" or "butchers" reflected the generally low repute of the medical profession. Soldiers dreaded hospitals and sometimes went to great lengths to conceal wounds or illnesses in order to avoid them. "I beleave the Doctors kills more than they cour," wrote an Alabama soldier in 1862. "Doctors haint Got half Sence." Yanks were inclined to agree. An Illinois private wrote that "our doctor knows about as much as a ten year old boy," while a Massachusetts officer pronounced his regimental surgeon "a jackass."
³⁹

Soldiers who believed they were more likely to get well outside a hospital than inside it may have been right. But this was owing more to the state of medical knowledge in general than to the particular incompetence of army doctors. The Civil War was fought at the end of the medical Middle Ages. The 1860s witnessed the dawn of a new era with the research in Europe of Louis Pasteur, Joseph Lister, and others who discovered those microscopic culprits that infected water and food and entered the bloodstream through open wounds. Within a generation the new science of bacteriology had revolutionized medicine. The discovery of the link between mosquitoes and yellow fever and malaria made possible the control of these killer diseases. Civil War doctors knew none of these things. The medical revolution came too late to benefit them. They were not aware of the exact relationship between water and typhoid, between unsterilized instruments and infection, between mosquitoes and malaria. The concept of asepsis and antisepsis in surgery had not been developed. Doctors could not conceive of antibiotics because they scarcely had a notion of biotics. Moreover, the large caliber and low muzzle velocity of Civil War rifles caused horrible wounds with the bullet usually remaining in the body rather than going through it. Surgeons knew of few ways except amputation to stop gangrene or osteomyelitis or pyemia. Stomach wounds were generally fatal because there was no known prevention of peritonitis. Chloroform and ether

38
. Peter J. Parish,
The American Civil War
(New York, 1975), 147.

39
. Wiley,
Johnny Reb
, 267; Wiley,
Billy Yank
, 131.

were used as anesthetics, but shortages especially in the South sometimes required soldiers to be dosed with whiskey and literally to bite the bullet during an operation.
⁴⁰
This was the "heroic age" of medicine in which soldiers who suffered anything from dysentery to constipation to malaria to a cold were dosed with calomel or tartar emetic or quinine or morphine or laudanum. Little wonder that many soldiers preferred to remain out of the clutches of doctors. Little wonder, also, that some became narcotics addicts.

Disease was a greater threat to the health of Civil War soldiers than enemy weapons. This had been true of every army in history. Civil War armies actually suffered comparatively less disease mortality than any previous army. While two Union or Confederate soldiers died of disease for each one killed in combat, the ratio for British soldiers in the Napoleonic and Crimean wars had been eight to one"and four to one. For the American army in the Mexican War it had been seven to one. Only by twentieth-century standards was Civil War disease mortality high. Nevertheless, despite improvement over previous wars in this respect, disease was a crippling factor in Civil War military operations. At any given time a substantial proportion of men in a regiment might be on the sicklist. Disease reduced the size of most regiments from their initial complement of a thousand men to about half that number before the regiment ever went into battle.

Sickness hit soldiers hardest in their first year. The crowding together of thousands of men from various backgrounds into a new and highly contagious disease environment had predictable results. Men (especially those from rural areas) who had never before been exposed to measles, mumps, or tonsilitis promptly came down with these childhood maladies. Though rarely fatal, these illnesses could cripple units for weeks at a time. More deadly were smallpox and erysipelas, which went through some rural regiments like a scythe. If soldiers recovered from these diseases and remained for some time at the training or base camp—where by poor sanitary practices and exposure to changeable weather they fouled their water supply, created fertile breeding grounds for bacteria, and became susceptible to deadly viruses—many of them contracted one of the three principal killer diseases of the war: diarrhea/dysentery, typhoid,

40
. The number of times when surgeons had to perform an operation without anesthetics, however, was relatively small even in the Confederacy. Stonewall Jackson's troops had captured 15,000 cases of chloroform in the Valley campaign, which helped Confederate surgeons greatly in this respect.

or pneumonia. As they marched southward in summer campaigns, many of them caught the fourth most prevalent mortal disease: malaria. A good many Union occupation troops in southern cities as well as Confederate soldiers camped near other cities—especially Richmond—experienced another soldiers' malady, venereal disease, of which there were about as many reported cases as of measles, mumps, and tonsilitis combined.
⁴¹

Disease disrupted several military operations. Lee's West Virginia campaigns of 1861 failed in part because illness incapacitated so many of his men. One reason for the abandonment of the first effort to capture Vicksburg in July 1862 was the sickness of more than half of the Union soldiers and sailors there. Beauregard's decision to abandon Corinth was influenced by illness of epidemic proportions that put more than a third of his army on the sicklist. By the time Halleck's Union army had established its occupation of Corinth in early June, a third or more of the Yankee soldiers were also ill. Nearly half of the twenty-nine Union generals came down sick during the Corinth campaign and its aftermath, including Halleck himself and John Pope with what they ruefully called the "Evacuation of Corinth" (diarrhea) and Sherman with malaria. Halleck's failure after Corinth to continue his invasion into Mississippi resulted in part from fears of even greater disease morbidity among unacclimated northern soldiers in a Deep-South summer campaign.

Illness also influenced the denouement of the Peninsula campaign in Virginia. The health of McClellan's army, already affected by the heavy rains and humid heat among the Chickahominy swamps in May and June, deteriorated further after the army's arrival at Harrison's Landing in July. Nearly a fourth of the unwounded men were sick. Scores of new cases of malaria, dysentery, and typhoid were reported every day. McClellan himself had not fully recovered from an earlier bout with dysentery. With the sickliest season of the year (August–September) coming on, the administration decided over McClellan's protest to withdraw his army from the Peninsula.

Strategic and political questions also played a part in this decision. Recognizing the drawbacks of trying to function as his own general in chief, Lincoln had called Halleck out of the West to take this post. The president had also formed a new army out of Banks's, Frémont's, and

41
. See the tabulation of diseases in the Union army in Paul E. Steiner,
Disease in the Civil War
(Springfield, Ill., 1968), 10-11.

McDowell's corps in northern Virginia and had brought John Pope east to command it. While this was going on, Congress was passing a bill to confiscate the property (including slaves) of Confederates, and Lincoln was making up his mind to issue an emancipation proclamation. The failure of McClellan's Peninsula campaign was not alone a military failure; it represented also the downfall of the limited war for limited ends that McClellan favored. From now on the North would fight not to preserve the old Union but to destroy it and build a new one on the ashes.

16
We Must Free the Slaves or Be Ourselves Subdued

I

If Robert E. Lee was unhappy with the escape of McClellan's army from destruction in the Seven Days', the southern people did not share his discontent. "The fatal blow has been dealt this 'grand army' of the North," wrote a Richmond diarist. "Lee has turned the tide, and I shall not be surprised if we have a long career of successes." Lee became the hero of the hour. No more was heard of the King of Spades or Evacuating Lee. The
Richmond Whig
proclaimed that the quiet Virginian had "amazed and confounded his detractors by the brilliancy of his genius . . . his energy and daring. He has established his reputation forever, and has entitled himself to the lasting gratitude of his country."
¹

These commentators, of course, could not foresee the profound irony of Lee's achievement. If McClellan's campaign had succeeded, the war might have ended. The Union probably would have been restored with minimal destruction in the South. Slavery would have survived in only slightly modified form, at least for a time. By defeating McClellan, Lee assured a prolongation of the war until it destroyed slavery, the Old South, and nearly everything the Confederacy was fighting for.

After the Seven Days', Union policy took a decisive turn toward total war. Northern morale initially plunged downward as far as southern

1
. Jones,
War Clerk's Diary
(Miers), 88-89; Douglas Southall Freeman,
R. E. Lee: A Biography
, 4 vols. (New York, 1934–35), II 244–45

morale ascended skyward. "The feeling of despondency here is very great," wrote a prominent Democrat from New York, while a Republican diarist recorded "the darkest day we have seen since Bull Run. . . . Things look disastrous. . . . I find it hard to maintain my lively faith in the triumph of the nation and the law." Although equally depressed, Lincoln did not falter. "I expect to maintain this contest," he informed state governors, "until successful, or till I die, or am conquered . . . or Congress or the country forsakes me."
²