Field and Temporary Hospitals
Deering J. Roberts, M.D.,
Surgeon, Confederate States Army
As the records of the Confederate hospitals were burned in the surgeon-general's office at the fall of Richmond, it is difficult at this date to write of their work. But, from the writer's own experience and the accounts of others engaged in the work, it is possible to show something of what was attempted and accomplished in the face of difficulties which seemed insurmountable.
After some preliminary hospital experience at Hot Springs, and Bath Alum Springs, Virginia, I reported, in March, 1862, to Doctor S. H. Stout, who was just beginning his invaluable services as medical director of the hospitals of the Department and Army of Tennessee. Preferring active service, I was assigned to the Twentieth Regiment, Tennessee Infantry, with which I remained until paroled, after General J. E. Johnston's surrender.
On the morning of December 1, 1864, I received orders to go to Franklin, Tennessee, and make arrangements for the wounded of General Bate's division. I did so, taking with me my hospital steward, a detail of ten men, and two wagons. I found an old carriage- and wagon-shop about sixty by one hundred feet, two stories high. It had a good roof, plenty of windows above and below, an incline leading up to the upper floor on the outside, and a good well. This I immediately placarded as " Bate's Division Hospital," and put part of the detail to work cleaning out the work-benches, old lumber, and other debris.
Further up the same street, I found an unoccupied brick store, two stories high, eighty by twenty feet, and, on the corner of the square, the Chancery Court room, about forty feet square, both of which I took possession of, and put the remainder of the detail at work cleaning out the counters, shelving, empty boxes, and barrels from the one, and the desk, or rostrum, and benches from the other, sending the wagons into the country for clean straw.
Two assistant surgeons with additional detailed men reported to me and all worked diligently, so that, by the middle of the afternoon, the buildings were fairly well cleaned. The wagons did not have to go far afield, and each floor was soon covered with clean wheat-straw ten or twelve inches deep; and before midnight all the wounded were transferred from the field-hospital.
The provisional Army of Tennessee was at first, to some extent, supplied with spring vehicles as ambulances ; but as the war progressed, hard usage and rough roads caused them to break down, and they were abandoned. Their places were supplied by ordinary wagons drawn by two mules and without springs. Staples on the sides of the body secured white-oak bows, covered with heavy cotton-duck cloth, with the name of the regiment, brigade, division, and corps painted on the sides of the white cover.
While such ambulances afforded somewhat rough riding for sick and wounded men, they were the best that could be supplied. Now and then, one or more well-built and equipped ambulances were captured; in which case it did not take long to convert the " U " into a " C," leaving the " S " and "A" painted on it in some Northern city, still on duty; but these were generally taken possession of by brigade, division, or corps headquarters, leaving the regiments to rely on the two-horse wagons.
I had kept with me my regimental medicine chest, amputating and pocket-case instrument, and the as had their own pocket instruments. The division commissary left us three days' rations of beef and meal per man, but I had no further occasion to call on our commissariat for supplies, as the good people of Franklin and vicinity brought in an abundance of everything that sick, wounded, and attendants could desire from day to day-well-cooked bread, beef, mutton, chickens, turkeys, milk, butter, eggs, and other food.
Several carpenters in my detail were put to work constructing rough bunks of such lumber as could be found, placing in them the more severely wounded. By the end of my first week's service, I had permitted about one-third of the wounded to take up their quarters in the residences of willing citizens of the town and immediate vicinity. Those who could do so were required to report at the hospital every day, or on alternate days, and one of the assistant surgeons or myself visited, from time to time, such as could not walk to the hospital. Nearly all of these " out-patients," as well as some others in my hospital, went south with Hood's battered battalions as they retreated beyond the Tennessee River in the days following December 17,1864.
In my hospital, while at Franklin, only seven men died; two from abdominal wounds, three from gunshot wounds in the head, one with amputation of thigh, and one who refused to submit to amputation - I never amputated a limb without consent of the wounded man-after the nature of his case had been fully explained to him. Despite all arguments and reasoning, this man refused amputation, was greatly depressed and despondent from the first, and died on December 23d, as I had expected, from gunshot injury to forearm, complicated by nostalgia and despondency in an old man.
Largely predominating on both sides were the wounds inflicted by the rifled musket, carrying its conical ball of an ounce or more in weight. These wounds differed in some important and very material characteristics from all gunshot wounds in preceding wars, including that with Mexico ; as well as those in our later experience with Spain, and those inflicted by the improved army-gun of the present day. The old round ball, of low velocity, caused many fractures in bones of the extremities. But it never produced such shattering, comminution, and amount of bone destruction and injury as did the heavy conical ball of increased velocity-both differing in character from the Mauser and Martini of the present day with their still greater increase of velocity-and its hardened or steel-jacketed projectile of smaller caliber, which often makes an almost clean-cut perforation, even through the shaft of a long bone.
The shattering, splintering, and splitting of a long bone by the impact of the minie or Enfield ball were, in many instances, both remarkable and frightful, and early experience taught surgeons that amputation was the only means of saving life. In the vicinity of a joint, the ends of the bone being more spongy, softer, and less brittle, the damage to the shaft of the bone was not so great, and the expedient of resection, largely resorted to and greatly developed by the surgeons, in many instances afforded a comparatively, if not perfectly, restored limb. Resections of the upper extremity afforded better results than those of the lower, although fairly good results were sometimes obtained in the case of the latter.
In some instances, I deemed it imperatively necessary to resort to a second, or even a third resection of the limb, even after the end of the bone had been sawn through, and while the patient was still under the influence of the anesthetic, the primary section furnishing the information that the bone had been shattered, splintered, or split higher up than could be ascertained at first. Conservative surgery was, I might say, almost, if not entirely, a universal principle with the Confederate surgeon; conservatism, first, as to the life of the wounded soldier, secondly, as to his future comfort and usefulness.
Conical-hall wounds in the abdomen were nearly always fatal, far more so than those produced by the round ball with lower velocity. The intestines, in the former case, were generally perforated; in the latter, they often escaped this injury by being pushed aside by the slower moving round ball fired from the smooth-bore gun. The reverse of this was the case in wounds of the chest, since the round ball bruised and lacerated a large area of lung tissue, while the more swiftly moving conical ball often produced a clean-cut wound.
On December 25, 1864, my associates and myself, with the wounded of Bate's division, were all moved to Nashville, and placed in the large building on South College Street, built in the summer of 1861 for a gun-factory, where I, as the ranking surgeon, assumed charge of the twelve hundred wounded there assembled from the battlefields of Franklin and Nashville, assisted by nine other Confederate surgeons and assistant surgeons. On January 10, 1865, all the Confederate surgeons in Nashville were relieved by Federal surgeons, and we were sent by way of Louisville, Cincinnati, Pittsburg, Philadelphia, Baltimore, Fortress Monroe, and City Point to Richmond, reaching the capital, January 28th.
Remaining three days in Richmond, I visited every morning some part of Chimborazo Hospital, and other hospitals in the city. Leaving the capital, I went to Montgomery, Alabama, having thirty days' leave, and while waiting for the Army of Tennessee en route to the Carolinas, frequently visited a hospital there in charge of Doctor John Scott, an Englishman. He had been commissioned surgeon in 1861, assigned to duty at Pensacola until it was evacuated, and subsequently was stationed in Montgomery. The hospital was in a large cotton-warehouse near the river, commodious, thoroughly clean, and well arranged in every way. He had here about two hundred and fifty patients, mostly chronic cases, two assistant surgeons, a hospital steward, a one-armed hospital clerk, about twenty convalescents as nurses, and a matron-the wife of one of the assistant surgeons.
After the battle of Chickamauga, to revert to an earlier period of the war, the Confederate wounded were treated for weeks in the field-hospitals, in the immediate vicinity of the battlefield, about one-half of the regimental surgeons and assistant surgeons remaining in charge of them until relieved by surgeons sent from the rear; while the other half of the regimental medical officers went with their commands to the vicinity of Chattanooga. Having accompanied my regiment on its advance movement, about fifteen days after the battle, I was ordered by General Bate to go to the field-hospitals and make a thorough inspection of the condition of the wounded men of his command. I do not remember to have seen, at any time, wounded men doing so well, two weeks after injury. The weather was mild and dry, and nearly all were treated in the open air. It was about five weeks before all were removed from the field-hospitals, and then fully three-fourths were convalescent or able for duty.
During the Dalton-Atlanta campaign of 1864, I was sent at different times by General Bate to make unofficial inspections of the wounded of his command at Catoosa Springs, Griffin, and Marietta, Georgia. At each place a surgeon was in charge, with other surgeons, assistant surgeons, and contract, or acting assistant surgeons under him, with a post quartermaster and commissary. The nurses and attendants consisted of enlisted men detailed for the purpose when the hospitals were first established. Later, these were ordered to their respective commands, and their places taken by convalescents.
By practical experience, during the Dalton-Atlanta campaign, the various hospitals organized at Chattanooga had become quite adept in changing position, keeping in touch with, but in the rear of, the army, occupying the towns and villages with which there was reasonable railway connection, and finally a number of them were carried over to the Mississippi at the time of Hood's last sad and disastrous advance.
The chaplains attached to regiments had the rank, emolument, and allowances of a captain of cavalry, and they not only aided in caring for the sick in camp and on the march, but were exceedingly efficient on the battlefield in many instances. As a rule, they accompanied the assistant surgeons in the immediate rear of the center of their respective commands.
The writer cannot refrain from mentioning a few of these men who were so faithful, so earnest, and so fearless in their efforts. The Reverend Charles Quintard Todd, afterward bishop of Tennessee and chancellor of the University of the South, had, previous to the war, relinquished a professorship in the Memphis Medical College to be ordained a priest in the Protestant Episcopal Church. He followed the fortunes of the First Regiment, Tennessee Volunteer Infantry, during the whole war. The Reverend J. H. McNeilly, one of the most prominent ministers of the Presbyterian Church in Nashville, never failed to be on the firing-line with the assistant surgeon in the infirmary detail. The Reverend John B. McFerrin, who stood high in the councils of the Methodist Episcopal Church, South, held a commission as chaplain, though not assigned to any particular regiment, and was of invaluable service to the medical staff. Father Blemiel, a young Irishman, served as chaplain of the consolidated Tenth and Fifteenth Tennessee regiments, and also of Slocum's battery, Washington Artillery. He was killed on the field of battle while administering the last rites of his church to a dying artilleryman.
These personal experiences will indicate the manner and method of caring for the wounded in the field or in imps. The Confederate surgeons used all of the resources at their command and their success was surprisingly great.
Source: "The Photographic History of the Civil War" Volume IV, article by Deering J. Roberts, M.D., Surgeon, Confederate States Army
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