The Civil War's chief legacy to the
Medical Department was an increase in the traditional peacetime burdens of the
Surgeon General's Office. In the years that followed the surrender at
Appomattox, the office would be asked to create both a medical museum and a
medical history, using specimens and case histories gathered during the
conflict; in response to a congressional mandate, to provide Civil War veterans
with prostheses and the information needed for pension applications; and, for a
brief period, to manage the medical care of freed slaves. As a result, for
decades after the end of the conflict, the Army's surgeon generals dealt with
war-related challenges while carrying out the department's historic mission of
guarding the Army's health.1
The Surgeon Generals
All seven of the officers who headed the
Medical Department from 1865 to 1893 were Civil War veterans. Six of them had
also served in the prewar Army and thus were familiar with many of the
difficulties their subordinates would face after the war. With their roots
firmly embedded in a period when germs were not recognized as the cause of
disease and infection, all were to varying degrees unsure of the significance of
the medical revolution then beginning to gather force across the Atlantic. They
left the task of leading their organization to a prominent position in the era
of modern medicine to the man who would become surgeon general in 1893.2
The first postwar surgeon general, Brig.
Gen. Joseph K. Barnes, came to office
in August 1864.3 A man of diplomacy and determination, Barnes was
known for his good judgment, hard work, and insight into the problems and
personalities he encountered. Assigned to Washington in May 1862, he had quickly
formed a strong friendship with Secretary of War Edwin M. Stanton. Until his
resignation from office in May 1868 as part of the power struggle that led to
President Andrew Johnson's impeachment, Stanton supported Barnes in all his
undertakings, even when they involved activating projects he had previously
disapproved. After holding office for almost eighteen years, Barnes was the
first surgeon general to whom a new law mandating retirement at sixty-four
applied. Already in poor health when he left the department in June 1882, he
died a year later.4
Death or mandatory retirement because of
age curtailed the time in office of the next six men to serve as surgeon
general. Barnes' immediate successor, Brig. Gen. Charles H. Crane, was head of
the department for only fifteen months. An obvious choice, the 57-year-old Crane
had worked
Demobilization
For both the Army and the Medical
Department, the return to peacetime size was rapid. Although the demands of
Reconstruction and the need to discourage the spread of French ambitions in
Mexico delayed total demobilization for a few months, the million wartime
volunteers of May 1865 had become 11,000 by November 1866. Few even of that
number remained after the fall of 1867. Since the war left much of the nation
convinced that large-scale conflict was for the United States a thing of the
past, Congress reduced the number of regular troops as well, from 54,000 in 1867
to 26,000 in the late 1870s, when Reconstruction came to an end.12
During the year after the Civil War ended,
much of the Medical Department's time was devoted to processing departing
medical personnel, to settling their accounts, and to closing facilities. Most
of the doctors leaving the Army by the end of 1866 were volunteers, who were
mustered out on an individual basis as soon as their services were no longer
needed. The department reduced the
number of contract surgeons to 1,997 by July 1865, to 262 a year later, and to
187 by 1870. Twelve regulars resigned
soon after the end of the war, and six more died within the year. The hospital
chaplains attached to wartime hospitals were dismissed as these facilities were
closed. With the departure of the victims of that conflict, the department
closed all general hospitals. The office of superintendent of women nurses was
also abolished in the fall of 1865, when all female nurses were discharged.13
Of the 65,000 patients in general
hospitals in June 1865, only 97 remained a year later. The rapid decrease in the
number of patients led to a corresponding decrease in the amount of medicines
and supplies needed for their care and in the number of facilities designed to
shelter them. Surgeon General Barnes was called upon to disband the ambulance
corps; to close supply depots; and to sell or otherwise dispose of hospital
transports, hospital trains, and general hospitals. Some institutions were
turned over to individual states for use as homes for wounded veterans, and
others were returned to their original owners. By the end of the fiscal year 1866 the
Medical Department had received more than four million dollars from the "sales
of old or surplus medical and hospital Property."
By the summer of 1866 only the depots at New York, Philadelphia, St. Louis, New
Orleans, San Francisco, and Washington, D.C., remained open.14
Additional information:
Inventory of
medical books from Ward "H" at N.Y. Conesus Centre Army Hospital 1865
with photos of selected items in that inventory
See these articles for much more on:
Federal Navy Medical Department during the Civil War or on the
Confederate Navy Office of Medicine and Surgery
Medical exam form
for an army recruit, 1862
The Peacetime Organization
In 1866, with the worst of the
demobilization problems resolved, Congress moved to officially establish a
peacetime Medical Department. At the outset the new organization closely
resembled the old in structure, size, and function. The new law retained the
position of surgeon general with its rank of brigadier general and that of the
assistant surgeon general with its rank of colonel. It also made custom into law
by requiring that the surgeon general be appointed from within the Medical
Department. But the responsibility for managing the purchase and distribution of
the department's supplies was no longer one that the surgeon general could
assign to any medical officer he chose. Medical purveyors were now to be
appointed by the president, subject to the Senate's approval. They would, as in
the past, be ordered to post bond. Congress also required them to remain
available for work as surgeons should the need for their services arise.
The chief medical purveyor would hold the
rank of lieutenant colonel, as would his four assistants. The wartime positions
of medical inspector general and medical inspectors were eliminated.
Congress continued at this time to
classify all other Army physicians as either surgeons, who were ranked as
majors, or assistant surgeons, who were lieutenants or captains. The legislature
kept at 60 the number who could hold the rank of major and limited the number of
assistant surgeons to 150. The total of 217 regular medical officers in the
department, while inadequate given the number of posts that needed coverage, was
an increase of 28 over the number of regulars in the Army at the end of the
Civil War. Congress required the
Medical Department to give preference in choosing new assistant surgeons to
those who had served with the Union Army as volunteers, excepting them from the
usual age limit of twenty-eight by permitting them to subtract the number of
years served in the Civil War from their actual age. The time they had served in
the Civil War was also credited to them in determining their rank. Like all
other applicants, they had to pass an entrance examination. Five medical
storekeepers-who were shortly thereafter given the official rank of
captain-remained in the department.15
Under the new organization, Army surgeons
continued to serve both in the field and in Washington. In 1872, according to a
medical officer working in the Surgeon General's Office, 3 medical officers,
including Crane, worked with Barnes in the Surgeon General's Office, with 15 or
so civilian clerks and perhaps 100 hospital stewards. In the wake of the Civil
War Barnes began officially delegating some of the responsibilities of his
office to his subordinates, establishing first a finance division-the exact date
of the establishment of this division is unclear, although the records remaining
from it date from 1873-and, in 1874, a property division, with Baxter, as chief
medical purveyor, at its head.16
Most of the professional staff were
assigned to positions outside Washington, D.C. A few medical officers functioned
as medical purveyors at medical depots, and the senior surgeon of each command
was its medical director, managing medical personnel, hiring and firing contract
surgeons and hospital stewards, and granting leave to subordinates.
The commanding officer of each military
department determined how many physicians were needed at each post and until
1892, when this responsibility was given to the secretary of war, gave them
their assignments. Those in charge of general hospitals would, should such
facilities ever be established, order supplies through the surgeon general.
Otherwise, Army surgeons sent their requisitions through their medical directors
to the medical purveyor at the designated supply depot.
Veterans also sent their requests for artificial limbs through the nearest
medical director. As necessary, medical directors were also called upon to
inspect sanitation at the various posts. Basically, however, the Medical
Department was no exception to the rule that in this period "the most minute
details" of matters "in the smallest and most distant garrisons were regulated
and handled" by the Army's bureaus from Washington.17
During Reconstruction the organization of
the Department of the South into five military districts required the naming of
five district medical directors. These officers apparently reported directly to
not only the surgeon general but also the medical director for the Department of
the South at Atlanta. Each district director was initially responsible for the
care provided the garrisons at both temporary and permanent posts. He also had
to send physicians with units leaving the South as the occupation force was
gradually reassigned.18
By 1868 the Medical Department was
expected to cover 289 garrisons, and many detachments also needed medical
attendance, among them those sent to watch over the polls in the South at
election time. To meet the challenge imposed by this requirement, Barnes
supplemented a small but elite corps of medical officers with contract
physicians (also referred to as acting assistant surgeons) as needed.19
To guarantee that this elite corps
remained elite, the Medical Department held the regular surgeons and assistant
surgeons who remained in the Army to high standards. Meeting this goal proved
difficult. Although a Medical Department position might appear to be a better
alternative to a young physician without prospects of joining a lucrative city
practice, the slow advancement and low pay that characterized the peacetime Army
had serious effects upon morale. A medical journal suggested that regular
medical officers-who, unlike their civilian counterparts, had had to pass
extensive examinations to establish and reestablish their competence-"could
surely do much better" as far as pay was concerned "in civil practice." Many
medical officers apparently agreed with the article, for while the number taking
the entrance examinations was considerable, resignations were
frequent-forty-eight medical officers resigned from 1865 to 1874.20
These exams weeded out those who did not
meet the department's standards, but for those who did pass, they also laid out
the path to be taken for improvement. In theory, at least, they required
proficiency in scientific and medical topics and in literature and history as
well. Candidates might be asked the cube and cube root of 3.6; the capitals of
such political entities as Saxony, Bavaria, and Switzerland; the principal Roman
deities, giving also the corresponding names used by the Greeks; or Newton's
first law of motion. Other questions might involve the chemistry of glassmaking,
the differences between gastric and pancreatic digestion, the pathology of
uremia, or the effects of exercise on the lungs. Weaknesses in any of the areas
of questioning were brought to the attention of those passing, who were expected
to remedy them. The proportion of those taking the examinations who passed varied widely, from as
few as one-twelfth to as many as one-third, with perhaps a fifth or more failing
to qualify for physical reasons. At least one medical officer whose military
career was successful questioned the validity of the examinations. Brig. Gen.
William H. Arthur commented years after passing his tests that many of those who
did well on them did not make good Army surgeons.21
Since no knowledge of the way in which
medicine was practiced in the Army was required to pass these exams, Surgeon
General Barnes decided that a newly commissioned assistant surgeon should
initially be assigned to one of the few posts large enough to need the services
of more than one medical officer. Here an experienced surgeon could teach the
neophyte the fundamentals of military medicine and Army routines. On some
occasions, when no opening was immediately available, the successful candidate
would be hired on contract and in that capacity sent to work with a senior
surgeon until there was an opening for him. When he became eligible for
promotion after three years, he was tested again to determine whether the
required remedial study had been done and whether he had been keeping up with
the latest developments in his profession. Those who failed this promotion exam
might, if the surgeon general believed there were extenuating circumstances, be
permitted another try, but a second failure brought a request for resignation,
with a threat of dire but unspecified steps to be taken if it were not
immediately forthcoming. Some doubt existed whether the department could legally
drop an assistant surgeon merely because he did not pass his promotion exam, but
apparently none of those who failed this test ever challenged the department's
position. In new legislation concerning the Army in 1878, Congress ruled that
those seeking to be promoted to the position of surgeon, or major, must also
pass an examination.22
The quality of the Army's contract
surgeons, on the other hand, was not so easily controlled. These physicians did
not have to take examinations, being required only to be graduates of reputable
medical schools, of good character, and in good health. Their contracts, usually
arranged by a local medical director on an annual basis and calling for a year
of service, brought them as a rule $1,200 to $1,500 a year, at a time when the
average civilian doctor was earning $1,000 a year. Because the agreement could
be canceled whenever the department determined that their services were no
longer needed, contract surgeons might be hired for the duration of a campaign
or expedition. If their work or habits proved unsatisfactory, they need not be
rehired. In the South, physicians eligible for contracts were difficult to find
because few could take the required oath that they had never voluntarily borne
arms against the government. Nevertheless, the disadvantages involved in hiring
civilian physicians who might have no military experience were counterbalanced
by the great flexibility the system gave Barnes in meeting the Army's needs.23
The passage of time did not improve
Congress' appreciation either of the Army in general or of the caliber of the
Army's regular medical officer and the nature of the demands placed upon the
Medical Department. Thus the problems engendered by low rank and inadequate
numbers remained unresolved. In 1869, when only 168 medical officers were
serving in the Army and 239 posts and innumerable detachments needed medical
attendants, the legislature, with its enthusiasm for using the Army as a police
force in the South waning, included the Medical Department among those
organizations in which no more vacancies were to be filled at any level and no
promotions made. As a result, by 1871 the department had 54 vacancies, one of
which was the position of chief medical purveyor. The number of posts to be
served had also dropped from the 1869 level, but only by 33. In reporting to the
secretary of war on these problems, Barnes pointed out that naval medical
officers held higher rank than Army surgeons, even though, in his opinion, they
performed less arduous duties.24
When Congress reorganized the staff corps
of the Army in June 1874, it was still of a mind to reduce expenses. Having
forbidden recruiting beyond 25,000 men, the legislature went on to cut the
budgets of departments supporting the Army. Although other departments also
suffered because of the economy drive, no other bureau chief, with the possible
exception of the quartermaster general, reported to the secretary of war as
serious misgivings about its effect upon personnel as did the surgeon general.
New legislation reduced the number of lieutenant colonel slots in the Medical
Department from 5 to 2 and that of majors from 60 to 50, thus effectively
preventing promotions for years to come. Congress did remove the restriction on
filling vacancies within the department and increased the rank of the chief
medical purveyor to colonel. Reductions in rank were to take place through
attrition only. The legislators also refused to allow hiring more than 75
contract surgeons and abolished vacant positions at the grades of surgeon,
medical storekeeper, and assistant medical purveyor. The only way in which
Surgeon General Barnes could now meet the need for medical officers was by
paying private physicians on a fee-for-visit basis to care for those patients
who would otherwise receive no medical care. Six months later Congress suspended
the limitation on the number of contract surgeons to be hired, but the
legislators remained unhappy with the department's use of so many.25
Civilian colleagues reacted with outrage
to the treatment accorded the Army's medical officers. The editors of the Medical Record
exclaimed that they were "in fact, astonished at [the bill's]
provisions, and thoroughly disgusted at the fact of its final passage." The
American Medical Association, to whose meetings the Army had been sending a
representative since 1850, stressed in an 1874 petition to Congress that 1 in 18
officers in the Ordnance Department was a colonel; in the Engineers, 1 in 16;
and in both the Commissary and Quartermaster's Departments, 1 in 13. But in the
Medical Department only 1 in 102 was a colonel, and an officer might serve
thirty to forty years without rising above the rank of major. In support of its
argument that the U.S. Army surgeon deserved better treatment, the petition
quoted from an address given by the famous German pathologist Rudolph Virchow
that same year: "Whoever takes in hand and examines the comprehensive
publications of the American Army Medical Staff will continually have his
astonishment excited anew by the riches of the experience which is there
recorded." The American Medical Association also emphasized that the ratio of 1
medical officer to every 200 or so men contrasted unfavorably with the 2 to 120
ratio characteristic of the British Army.26
In 1876 Congress relented somewhat
concerning promotions for medical officers, doubling the number of positions for
lieutenant colonels and adding 3 more for colonels. But it reduced the number of
openings for assistant surgeons from 150 to 125 and even slashed the
department's appropriation for the fiscal year ending 30 June 1877, forcing
drastic cuts in the number of contract surgeons and hospital stewards. When the
original number of positions was restored the following March, the department's
troubles were not at an end. After several years of dwindling appropriations,
funds for the Army for the following fiscal year were not voted until November
1877. This failure, which forced soldiers to go for many months without pay, can
be blamed at least in part on the desire of southern congressmen to encourage
the complete removal of the Army from their states. The persistent uncertainty
forced Barnes to reduce the number of contract surgeons hired. In February 1877
he urged each medical director to annul contracts whenever he could, relying
instead upon "local physicians . . . employed by the visit." He also ordered
that no leave be granted regular medical officers. Although the usual
appropriation was finally voted, difficulties caused by the shortage of
physicians remained, Barnes' pleas for more assistant surgeons having been made
in vain.27
Undaunted, Barnes continued his efforts in
behalf of the department, taking advantage, as was his custom, of the
familiarity with the ways of Washington that his years of service and his
position as long-term bureau chief had given him. In attempts to head off new
measures he considered harmful, he approached congressional leaders concerned
with the affairs of the Medical Department. Nevertheless, when age forced
Barnes' retirement in June 1882, the basic problem remained: 185 of the Army's
posts were large enough to require the services of at least one physician, but
only 183 of the 192 positions for regular medical officers in the department
were filled.28
Congress made a few minor adjustments in
the organization of the Medical Department after Barnes' departure, in 1883
downgrading the position of assistant surgeon general. The physician filling
this slot, once the only medical officer with the rank of colonel, no longer
served as the second in command in the department, but became "simply one of the
colonels in the Medical Corps." In 1892 another change gave all colonels the
title of assistant surgeon general and all lieutenant colonels that of deputy
surgeon general. Although Congress enacted no law at this time to change the way
in which medical officers were addressed, from 1890 onward the surgeon general's
annual report referred to regular medical officers by rank rather than as
surgeon or assistant surgeon.29
Such changes had no effect on the chronic
shortage of medical officers. The effects of a legal limitation on the number of
Army officers who could be retired for disability were felt more intensely with
the passage of time as the retention of an increasing number of disabled
surgeons on the active duty list blocked the appointment of replacements. By
1890 fifteen medical officers, one of whom had been disabled for thirteen years,
could not perform their duties. Seven more were in such poor health that their
usefulness to the department was limited. Fortunately, because of the constant
expansion of the railroad network in the West and the confinement of Indians to
reservations, the concentration of troops at a few large posts-the Army closed
25 percent of its posts in the period 1890-1891-was gradually reducing the
demand for post surgeons. New needs developed as requests for advice and
assistance from the National Guard increased and as medical officers were given
such added duties as teaching military hygiene at the new U.S. Infantry and
Cavalry School at Fort Leavenworth, Kansas. This latter assignment was
particularly significant because of the opportunity to impress line officers
with the importance of taking medical advice seriously.30
In February 1891 Congress finally removed
from the limited retirement list-which contained the names of officers retired
for disability or length of service rather than age-all who were more than
sixty-four years old. Because of the new openings on the limited list that
resulted, six disabled medical officers could retire almost immediately, and two
more left the department in midsummer. Surgeon General Sutherland's first annual
report recorded that only two medical officers who were permanently unable to
perform their duties remained in the department.31
The
openings produced by the new retirements seemed especially desirable to young
physicians who had just completed their professional education. As civilians
beginning their careers, few could hope to match the Army's $1,500 a year
starting salary and the 75 percent of active-duty pay medical officers could
expect when retired, whether for disability or age. Although the department did
not suffer from a shortage of applicants, traditionally many who passed the exam
were recent and untried graduates of medical school.
The opening of many positions in the
department only exacerbated a problem that had existed for decades. Barnes'
approach to the problem, an informal apprenticeship system for fledgling
assistant surgeons, was expanded by his successors to include those who were
serving as contract surgeons while awaiting assignment. Surgeon General Moore
attempted to reduce the magnitude of the problem by ordering that those with
experience "in hospital and dispensary practice" be taken into the department
first.32
The pleas for more openings for regulars
proved fruitless. Consequently, the need for large numbers of contract surgeons,
whether or not they had passed the department's examination, did not abate.
Crane pointed out that because the Army's demands fluctuated, the surgeon
general should determine the number of contract surgeons to be employed.
Nevertheless, Congress insisted on setting the limit, renewing in 1883 the
reduction of the number of contract surgeons from 125 to 75 that had been
suspended nine years earlier. From this time onward, new contract opportunities
for doctors other than those awaiting openings in the regular staff were rare,
especially as the trend toward employing larger garrisons lowered the need for
medical officers of any category. When Congress cut back the department's budget
in 1886, and further economies were necessary, the number of contract surgeons
was once again reduced. Surgeon General Moore adopted an informal policy of
limiting new contracts to those who had passed the department's entrance
examination, thus guaranteeing the Army superior contract surgeons and offering
valuable experience to future regulars. In drawing up the budget for fiscal
1893, however, Congress voted no funds for new contracts, forcing the department
to rely once again on fee-for-visit hiring. Some scientists working for the
department lost their positions as acting assistant surgeons and continued their
work as civilian employees.33
[
Note: I found the
following on another website but have not confirmed if it is totally true or
not ]: The Ambulance Department and Hospital Department were separate
departments in the U.S. Army until 1864. (General Orders No. 9 Adjutant
General's Office, War Department and Public 22-Act of Congress and General
Orders No. 106 War Department, Adjutant General's Office). The Ambulance
under the Quartermaster General and the Hospital Department under the Surgeon General, U.S.
Medical Service, War Department.
Creation of the Hospital Corps
The one significant change in the Medical
Department in the period 1865-1893 involved the effort to obtain and retain
competent enlisted men to assist medical officers in the performance of their
duties. The problem was as old as the U.S. Army itself. The tradition of
detailing the dregs of a unit to assist surgeons in their work had lasted until
five years before the start of the Civil War, when Congress made hospital
stewards permanent members of the Medical Department. After the war as before,
the legislature persisted in ignoring the argument that placing stewards in a
permanent corps would make it possible to use them more effectively.
Female nurses were not part of the
solution to this problem. No formal nursing schools existed in the United States
until 1873, and the qualifications of women willing to care for the Army's sick
and injured were not particularly high. Thus the Army, having no real reason to
hire women as nurses, employed none between the end of the Civil War and the
beginning of the Spanish American War more than thirty years later, even though
the law permitted them to be engaged at 40 cents a day for work in general
hospitals, whenever they might be established. The law also permitted women to
work in hospitals as matrons (that is, civilian housekeepers), whose chief
duties were those of laundresses, for a monthly salary of $10. Matrons were few
in number, 169 being in service as of 30 September 1887, and were hired only at
the larger posts and recruiting depots.34
By 1865 most stewards were competent men
whose assistance to surgeons included working as pharmacists, performing minor
surgery and simple dentistry, keeping records, and managing the post hospital.
Some were themselves physicians, and at least one functioned as a full-time
dentist. Nevertheless, their pay was less than half that paid their counterparts
in the U.S. Navy, and, as enlisted men, they never received the respect to which
their professional attainments might otherwise have entitled them.35
In 1874, eight years after voting to allow
the appointment of as many hospital stewards as the surgeon general believed
were needed, Congress voted to limit the number to 200. To his dismay Surgeon
General Barnes discovered that the adjutant general, who controlled personnel
procurement for the Army, could be a greater problem than the legislature.
Ignoring the law, the adjutant general limited the number the department could
hire to a significantly lower figure. In its 1878 legislation concerning
stewards, Congress divided them into three classes, with the first to be paid
$30 a month; the second, $22; and the third, $20. It also made them eligible for
the same small salary increases that other enlisted men received as rewards for
length of service or reenlistment and forbade appointing any civilian as
first-class hospital steward unless he had previously served in that position.
This new systematization in the management of Medical Department enlisted men
gained many admirers in Europe.36
Nevertheless, problems were many. Stewards
were scattered among the posts and never practiced together, and thus the Army
was still unable to train teams to move wounded from the battlefield until
hostilities started. As a result, if a war should break out, able-bodied
combatant soldiers would leave the battlefield to escort wounded comrades, just
as they had in the Civil War, possibly never to return to the conflict. Nurses
would have to be gathered and instructed in the care of the wounded after the
first of the injured had started pouring into hospitals. First-class stewards,
often capable and intelligent, were so few in number that in 1886 Surgeon
General Murray had to place restrictions on their leave. Department spokesmen
continued to urge the creation of a permanent body of "able-bodied and
intelligent men," to number approximately 2 percent of the fighting strength and
to be thoroughly trained to work as nurses, cooks, and ambulance attendants.37
At this juncture the dwindling likelihood
of further hostilities with the Indians was, according to military historian
Russell F. Weigley, encouraging "a few preparations for possible foreign war."
An entire regiment gathered to train as a unit in 1887, and the belief that the
Army should be readied for war, rather than for the work of a constabulary, was
beginning to grow. With it grew the belief that in such a force, a permanent
corps of enlisted men with centralized and systematic organization and training
should serve each staff bureau. When he became surgeon general in November 1883,
Murray began urging in his annual reports to the secretary of war that some way
be found to create such a corps for the Medical Department so that the
department's enlisted men could be trained together in the performance of their
duties. His goal was an organization of men who "shall be thoroughly instructed
and trained in all the details of hospital service, . . . thus preparing the
Department for any emergency of peace, war or epidemic."38
A few months after Murray's retirement
in
August 1886, the legislature passed a law creating the Hospital Corps, an
organization of men who could be systematically trained to function as hospital
attendants. The new corps was to be composed of hospital stewards, acting hospital stewards,
and privates, their exact numbers to be determined by the secretary of war.
First-class stewards would now be designated hospital stewards and those of the
second class, acting hospital stewards (the category of third-class hospital
steward had been abandoned in 1885). Soldiers who were not members of the
Hospital Corps could no longer be detailed to serve as nurses. Corpsmen would
perform all "hospital services in garrison and in the field" and in wartime
would manage the ambulance service as well. They would serve as wardmasters,
nurses, cooks, and assistants to others serving in these capacities, and also as
orderlies who accompanied surgeons during marches and in battle.39
In implementing the new law, the Army
tried to establish a regular upward path for those who demonstrated an aptitude
for Hospital Corps work. The plan called for four men in each company to be
selected as litter-bearers, with possible transfer to the Hospital Corps in
mind. While remaining in the line, these men would be trained in first aid and
the duties of the litter-bearer for at least four hours a month. After a minimum
of a year's experience, they could take an examination that would make them
eligible for selection as Hospital Corps privates. After a year of service and
upon the recommendation of his command's senior medical officer, a corps private
could be detailed by the surgeon general to serve as an acting hospital steward.
After a year's satisfactory service in this probationary capacity and the
passage of yet another examination, he could become a hospital steward. Previous
service in a similar capacity counted in the computation of the time required
for promotions.40
As Hoff had predicted, the Medical
Department experienced difficulty both in filling openings in the Hospital Corps
and in keeping them filled. By mid-1888, 135 of the corps' 739 positions
remained vacant. Some who had been hospital stewards before 1887 had not been
able to pass the examinations for steward in the Hospital Corps, although
considerable leeway was given to candidates who might reasonably be expected to
remedy their deficiencies by further study. Great difficulty was also
experienced in finding qualified men to serve as cooks. The ten openings for
enlistees from civilian life were restricted to graduates of schools of pharmacy
and veterans who had done Hospital Corps-type work while in the Army. Although
the corps' desertion rate of 2 percent in 1889 contrasted favorably with the
Army's average of 10.3 percent, low reenlistment rates made it difficult to keep
a trained staff. Thus, while the creation of the Hospital Corps made systematic
training possible, many problems concerning the Medical Department's enlisted
personnel remained to be solved.42
The responsibilities the Medical
Department assumed for the veterans of the Civil War, on the other hand, brought
it an enormous, persistently complex, long-lasting, and totally unfamiliar
administrative burden. In 1862, when Congress first required the Army to provide
prostheses to veterans who had held the rank of captain or below, the department
assumed the responsibility for testing, supplying, and overseeing the quality of
these items. For decades after the war ended, it continued to pay for prostheses
and for associated travel expenses. Surgeon General Barnes duly recorded that by
the end of fiscal year 1866 the department had supplied almost 4,000 legs, more
than 2,000 arms, 9 feet, 55 hands, and 125 other devices.44
Although amputees died at a faster rate
than their able-bodied comrades, the demands for prostheses did not materially
diminish. Surgeon General Murray believed that much of the failure of requests
for artificial limbs or their monetary equivalent to decrease in number should
be blamed on the deterioration in wounded limbs that made prostheses necessary
where they had not been before. Believing that a good artificial limb, if
properly cared for, could last ten years, Murray protested a congressional move
to reduce the replacement period from five to three years. He noted that since
only a small number of crippled veterans requested limbs rather than commutation
payments, "legislation . . . to secure more frequent payments seems to be, in my
opinion, of doubtful utility or propriety." Nevertheless, in March 1891 Congress
enacted the measure to which Murray had objected and added injury to insult by
failing to grant the Medical Department more money to meet the increased
expenses. The tendency to choose the payment over the limb continued. The
artificial arm was generally regarded as useless, and 98.6 percent of those
entitled to receive it chose the monetary equivalent; 78.1 percent of those
entitled to the artificial leg also preferred the money, even though the
prosthesis in this instance was helpful.46
Another reason for the failure of the
demand to fall may have been private agents who worked to stir up business among
the disabled so that they could claim 10 percent of the value of the commutation
payment. These men concealed from the veteran the fact that he could easily deal
directly with the Surgeon General's Office himself. Surgeon General Moore was
able to note in 1892 that by 1889 the campaign to eliminate the use of
intermediaries between his office and the disabled had been successful.47
The Record and Pension Division of the Surgeon General's Office, where
hospital and burial records and monthly sick and wounded reports were sent and
their data transcribed into permanent registers, was almost independent, from
the outset seemingly as much a part of the Pension Bureau as of the Medical
Department. Both the surgeon general and the secretary of war watched the
division's work closely. The staff of clerks was large, the number reaching 290
in 1883, and the sheer volume of work was impressive. In the year from July 1865
through June 1866 the department provided information in 26,589 cases to the
Pension Bureau, 8,000 to the paymaster general, 10,623 to the adjutant general,
and 4,000 to agents acting for various veterans. In that same period it also
"examined and classified" 210,027 disability discharges.51
This information was contained in 4,000
registers. Their often faded or illegibly written entries, taken from the
reports of medical officers serving in hospitals and in the field, were arranged
in the worst possible way for the purpose of verification, by date of admission
rather than alphabetically. The number of clerks and hospital stewards
conducting these searches remained inadequate, and their enthusiasm for their
work was scarcely overwhelming. As a result, a backlog of requests soon
developed. At the end of fiscal year 1870 more than 3,000 requests remained
unanswered, and by the end of the next fiscal year that figure had surpassed
9,000.52
Left behind when the new division took
over the Civil War personnel records were cards holding detailed descriptions of
men who had taken the physical examination for entrance into the Army. This
collection was valuable in identifying deserters. When post commanders reported
desertions to post surgeons, their medical officers turned the information in to
the surgeon general. Should a deserter or an undesirable then try to reenlist
under another name, the Medical Department could usually identify him by means
of the description on his card.55
Because the growing accumulation of
records from the Civil War years was of great value, its location was of
considerable importance. In December 1866 the Medical Department found space in
the former Ford's Theater, where the medical records shared the second floor
with the library, whose direction Surgeon General Barnes had placed in Billings'
capable hands in 1865. This building was to a limited degree fireproof, but the
roof was flammable and the walls were structurally weak. By the time of Barnes'
retirement, Ford's Theater was also badly overcrowded, and a movement was under
way to find still larger and safer accommodations.56
Nevertheless, only in the spring of 1885,
after much campaigning by both Surgeon General Murray and Billings, now a major,
who became head of the Library and Museum Division when it was created in 1883,57did
Congress authorize the construction of a new fireproof building. It was to be
smaller than the Medical Department wanted and "very plain and simple." Even
before the move into the new structure on what is now Independence Avenue had
been completed in early 1888, the facility was too small for the purpose for
which it had been built, and some records had to be housed elsewhere. It was,
however, definitely a safer haven than Ford's Theater, where during renovation
in 1893 the floors collapsed, killing twenty-two people and injuring three times
that number.58
State of the Art
Even before the Civil War had ended, the
era of modern medicine was already dawning across the Atlantic, and by 1893
rapid progress was being made in the struggle against disease and infection. The
age when miasmas were regarded as the cause of most sickness was rapidly coming
to an end. In France Louis Pasteur was studying the role played by microscopic
bits of living matter in the diseases of plants and animals, and in 1885 he
introduced the first successful rabies vaccine. In Germany physician Robert Koch
was developing an approach to obtaining pure bacterial cultures and refining the
procedure by means of which these cultures could be used to establish the
identity of a specific organism and the fact that it caused a specific disease.
Although he was not the first to identify Vibrio cholerae, his work with
cholera was responsible in large measure for the widespread acceptance of a
small living organism as the cause of the much-dreaded Asiatic cholera and of
its transmission through contaminated water. In England in 1867 surgeon Joseph
Lister published On the Antiseptic Principle in the Practice of Surgery,
detailing his successes in preventing the infection of surgical wounds. His
approach proved unnecessarily complex and was not quickly accepted outside
Europe; minimizing the exposure of wounds to germs by sterilizing surgical
instruments and dressings soon proved more effective than spraying the operating
room with disinfectants. Nevertheless, because of his work as well as that of
those who followed him, surgeons would be able to undertake operations of a kind
that would earlier have almost inevitably been followed by fatal infection.59
The significance of the medical revolution
that was taking place in Europe was not initially appreciated by American
physicians. More concerned with the immediate and the practical than their
European counterparts, they were skeptical about the new scientific medicine and
the germ theory. Moreover, medical education in the United States was
traditionally not the kind that would stimulate an interest in the scientific
aspects of medicine. By the time Surgeon General Sutherland retired from the
Medical Department in May 1893, however, the number of medical scientists
following in the footsteps of the pioneers was rapidly growing.60
Despite their initial lack of enthusiasm
about developments in Europe, the leaders of the Army Medical Department were
eager to use the experiences of the Civil War to advance the science of
medicine. During the conflict Barnes' predecessor, Surgeon General William A.
Hammond, had encouraged the creation of what became the Army Medical Museum to
house the legacy of the Civil War in the form of a collection of anatomical
specimens obtained from the victims of that conflict. He had also supported the
library, which became known as the Surgeon General's Library, that had been
started on a modest scale by the first surgeon general, Joseph Lovell.61
Hammond's successors attempted not only to build upon their heritage by
assigning some of their most respected medical officers to work with the
specimens and reports collected during the war but also to make the library into
a world-respected institution. Both the library and the museum would continue to
grow and to contribute to the progress of medical science. But, as the
scientific work being undertaken in Europe would demonstrate, the attempt to
uncover the mysteries of disease merely by amassing statistics and anecdotal
accounts could not succeed.62
The Surgeon General's Library, the
collection that would in 1956 become the National Library of Medicine, was
arguably the Medical Department's most valuable and lasting contribution to
medical science developed in the decades immediately following the Civil War. As
new developments in the world of medical science began to grow in number with
great rapidity, the nation's best-educated physicians came increasingly to rely
on medical libraries, particularly the Surgeon General's Library, for the
information that kept them abreast of the work of their colleagues around the
world. Much of the library's growth in size and fame resulted from the work of
Billings. Working aggressively and imaginatively to increase the library's
holdings, he made the most of the meager funds allotted that institution by
astute buying and by trading copies of the departments various publications for
the books, journals, reports, manuscripts, letters, pamphlets, and portraits he
believed it should have. By 1875 the library had copies of about 75 percent of
the available periodical literature and the largest collection of pamphlets in
the country. To classify the collection, after some experimentation, Billings
adopted a revised version of the system used by the Royal College of Physicians
in London, employing a series of 5" by 7" cards to keep track of the library's
holdings.63
Because the library's funds seemed to be
in almost constant jeopardy, Barnes and Billings had to move shrewdly to further
its interests. They arranged to have it regarded as "the medical section of the
Congressional Library" and thus as especially deserving of congressional favor.
Billings actively publicized the facility, and the number of those relying upon
its service grew rapidly, particularly among civilians. He urged physicians to
pressure Congress any time it seemed likely that it might cut the library's
funds, and he gave freely of the fruits of his own experience to advise those
managing similar institutions. A vital part of his effort involved issuing
catalogs that would inform the interested public, both in the United States and
in Europe, of the library's holdings. After Billings published a sample catalog
in 1876 and brought to bear whatever political influence he could garner,
Congress, its enthusiasm dampened by the expense involved, voted a modest sum in
February 1879 to print the first two volumes of the Index Catalogue, a
volume of which appeared each year thereafter. Despite congressional misgivings,
the publication was an instant success with the physicians it was intended to
serve. One physician called it "a monument of useful labor, a time saving
directory to medical literature, a delight and a blessing to the medical
scholar," adding, "May the Lord save Dr. Billings to finish it."64
To compensate for the inability of the
Index Catalogue to keep up with current literature, the surgeon general gave
his permission in 1879 for Billings and an associate to list the most recently
published medical literature throughout the world in a privately financed
journal, the Index Medicus: A Monthly Classified Record of the Current
Medical Literature of the World. Billings requested authors and publishers
to send him their publications for listing in the Index Medicus,
forwarding what he received to the library after they had been indexed.65
The library held copies of many books by
Medical Department authors, among them two painstakingly detailed volumes by
Billings-A Report on Barracks and Hospitals, With Descriptions of Military
Posts (Circular No. 4), published in 1870; and A Report of the Hygiene of
the United States Army, With Descriptions of Military Posts (Circular No.
8), published in 1875. In response to epidemics of two long-dreaded diseases,
cholera and yellow fever, from 1864 through 1867 Billings, with the need for
public support of the library obviously in mind, also prepared in pamphlet form
bibliographies of the library's works on those diseases. Surgeon General Barnes,
meanwhile, assigned assistant surgeon Capt. Ely McClellan to conduct a study of
cholera as ordered by Congress. The resultant report joined "A History of the
Travels of Asiatic Cholera" by McClellan and a civilian physician, a report by
Supervising Surgeon General of the Marine Hospital Service John M. Woodworth,
and Billings' full-scale bibliography of works on cholera to become The
Cholera Epidemic of 1873 in the United States, which the Surgeon General's
Office published in 1875.66
When Billings retired from the Army in
1895, the library contained more medical publications than the two next largest
medical libraries in the United States combined. It may have already become the
largest such facility in the world. Thousands of physicians benefited from its
riches. The money that Billings obtained from Congress for the library also made
it the wealthiest medical library in the world. Moreover, he established a
pattern of donations to the Surgeon General's Library, which permitted him to
add significantly to the collection and thus to increase its value to the
medical profession.
As the years passed, the museum received
from civilians an increasing number of specimens illustrating non-war injuries
and diseases. This situation met with Billings' approval, since he saw the
museum as performing a service for all doctors and believed that it should
contain items of general medical interest. To add to the collection, superfluous
items were exchanged with other museums, which were kept informed of the Medical
Department's holdings by means of catalogs and checklists. In less than fifteen
months after the medical museum opened in Ford's Theater, its exhibits drew more
than 1,400 visitors, both American and foreign, and by 1870 European authors
were illustrating their books with woodcuts made from museum photographs. The
museum's growing reputation led to its use by various organizations for their
gatherings. Exhibits sent abroad showed foreign scientists how the United States
Army handled hospitalization, evacuation, and patient care. Despite the
international reputation of the museum, congressional support was not generous
and came only in response to pleas from the surgeon general. Yet from the museum
and the activities centered there would come the American Registries of
Pathology, where thousands of cases of diseases were recorded for study, and,
after World War II, the Armed Forces Institute of Pathology.70
The principal concern of museum personnel
for many years after the end of the Civil War was transforming the mass of
surgeon's reports into the Medical Department's major publication, the Medical and Surgical History of the War of the Rebellion, which made heavy
use of museum specimens for its illustrations. The history, conceived by Surgeon
General Hammond in 1862 "to advance the science which we all have so much at
heart, and to establish landmarks which will serve to guide us in future,"
consisted of two volumes, one on medicine and the other on surgery, each of
which was divided into three parts of 700 or more pages. A 350-page appendix
containing reports of engagements, usually submitted by the medical directors
involved, was added to the medical volume. The author-editors of the volumes
were all medical officers. Woodward, an experienced pathologist, was responsible
for the first two parts of the medical volume, published in 1870 and 1879, with
the third published in 1888. The first two parts of the surgical volume were
published in 1870 and 1876, the third in 1883. The entire history was finally
completed after delays stemming both from Woodward's prolonged illness and death
and from the "pressure of current work at the Government Printing Office."71
The authors of these volumes detailed the
medical and administrative problems faced by the Medical Department during the
Civil War and the efforts made to resolve them. The illustrations, both
photographs and drawings, were of exceptionally fine quality, and the case
histories are even today a gold mine for anyone interested in learning how the
arts of medicine and surgery were practiced during the Civil War. The
discussions often contained histories of how the problems in question had been
handled for centuries, but the masses of statistics were essentially only
listings, with little analysis. The multitudinous tables merely grouped diseases
by geographic area and race. The categories into which the various ailments were
divided in the statistical tables showed that the authors still regarded vapors
and fumes from decaying matter as the most likely causes for the spread of the
diseases that traditionally posed the greatest threat to armies, among them
malaria, typhoid, typhus, dysentery, diarrhea, and even measles.
Woodward's lengthy effort to pin down the
cause of the dysentery that had devastated the Union Army was not a scientific
study in the manner of Pasteur and Koch but a history of attempts to solve the
puzzle dating from the days of the Greeks. He even attacked those who suggested
that "bacteria are in some way disease-producers" and who thus "permitted the
survival in certain quarters, of the doctrine that dysentery is thus caused."
Maj. Charles Smart, the author of the final medical volume, was more ready than
Woodward to admit the possibility that something he sometimes called a germ (a
term he used alternately with poison) might be the cause of typhoid fever, but
he obviously did not think it likely. The instruments and the techniques that
might have indisputably proven that bacteria caused the diseases and infections
of the Civil War had not been developed when Woodward and Smart made their
observations. The information their work might otherwise have revealed was
unavailable even after more sophisticated microscopes and staining techniques
had been devised. The pioneering work with wound antiseptics conducted during
the Civil War and recorded in the Medical and Surgical History had no
apparent impact on the work of Lister, which was under way before the
publication of the first volume.72
When the Medical and Surgical History
first appeared, it was greeted with enthusiasm throughout the Western World.
In praising the publications of Army medical officers in 1874, Virchow
undoubtedly had it principally in mind when he spoke of "the most extreme
exactitude of detail, a statistic careful even as to the smallest matters . . .
here united in order to collect and transmit to contemporaries and to posterity
with the utmost completeness, the knowledge purchased at so dear a price."
Hammond's hopes for the history were to a large degree frustrated, however. In
the wake of the Civil War, as James H. Cassedy noted in American Medicine and
Statistical Thinking, 1800-1860, "the laboratory effectively dominated
medical research. Statistical analysis receded, temporarily but decidedly, into
the background," to reappear only in the twentieth century, when "investigators
[had gained] the competence in higher mathematics that was needed for statistics
once again to play a major role in clinical and scientific studies." Thus, with
the passage of time the Medical and Surgical History of the War of the
Rebellion became recognized as "the world's outstanding compilation on
military medicine." Much of its value today lies in its detailed descriptions
and illustrations of the plans used for Civil War general hospitals and
ambulances, the discussions of the reasoning that led to the development of the
various designs, and the reports of various medical directors concerning some of
the major battles. The very inability of the medical officers responsible for
these volumes to add significantly to the progress of medical science is
revealing of an era that was coming to a close even as they wrote.73
The Medical Department's major official
contributions to medical science in the period 1865-1893 fell in the realm of
preserving the past for the benefit of the present and the future. The work done
in the museum and library in the 1860s and 1870s was, according to Billings in
1903, "in part merely incidental to the preparation of [the] medical and
surgical story of the war, in part for the advancement of medicine, and in part
for the pleasure of the young men engaged in it." The passage of time would
reveal that its "direct results on the science and art of medicine were not
great," even though "its indirect results have been . . . important."74
Few U.S. Army medical officers, whether
they worked in the museum or in the field, appear to have been seriously
interested in the new techniques Koch had developed. One exception was Maj.
George M. Sternberg who, impressed by Koch's work, visited the laboratory of the
German physician and briefly worked with him in 1886, when the Medical
Department sent him to Europe as the U.S. representative to the International
Sanitary Conference in Rome. Although an article written in 1883 promoting an
Army career for young physicians maintained that Army posts provided good
microscopes, some senior Army physicians still disapproved of work with this
instrument; in 1890 a medical officer working in the Surgeon General's Office
described Sternberg's work with it as of no "earthly bit of good" to the
department. Mindful of the problems that this attitude caused him, Sternberg
noted with some bitterness that he had had to pay personally for the expensive
equipment he needed to set up his own laboratory, even though "apparatus of the
same kind, purchased with government money, [had] been for two years lying idle
at the Army Medical Museum." Nevertheless, Sternberg continued his research, in
1892 giving a paper on practical accomplishments in the field of bacteriology
and his own work in the field that produced favorable comment from the highly
respected pathologist William H. Welch at Johns Hopkins.75
Although Lister's work met with much
skepticism for many years, the practical value of what he was doing was more
easily grasped than that of researchers with microscopes. Convinced after a
visit to England in 1877 that Lister's work had great merit, another young
medical officer, Capt. Alfred C. Girard, informed Surgeon General Barnes: "Be
the 'germ theory' true, or partly true, or an absolute mistake, practically it
matters not; for the present it is the best explanation we have for a most
successful method and the best guide in its use." Barnes was sufficiently
impressed by Girard's report to have it sent out to all medical officers as a
circular, but without any specific endorsement. Surgeon General Murray, in spite
of his reputedly conservative temperament, openly accepted the notion of
bacteria as a cause of infection and predicted a time when, because of Lister's
research, the world of surgery would be transformed by antisepsis. Murray's
annual report of 1884, issued when Lister's work was still not fully appreciated
in England, was the first such document to mention the use of antiseptics by
Army surgeons during or following surgery.76
By 1893 the first traces of the changes
that would profoundly affect the Medical Department in the years to come were
already evident. The formation of the Hospital Corps would make training
enlisted personnel for modern warfare easier, and post surgeons were less
isolated than they had been in 1865. But most medical officers were still
attached to small units that were scattered about the country, and the drive to
prepare the Army for modern warfare was yet in its infancy. The Medical and
Surgical History of the War of the Rebellion stood as an eloquent symbol of
the dedication and the frustrations of the medical officers who could not yet
accept germs as a cause of disease. Steeped in the older traditions and almost
overwhelmed by administrative burdens, the surgeon generals of the period
1865-1893 left the challenge of leading the department boldly toward the new era
of medical science to their successors while Army surgeons in the field
continued to practice medicine as had their predecessors for generations. Change
would come, but it would come only gradually.
FOOT
NOTES
1. War Department, [Annual]
Report of the Surgeon General, U.S. Army, to the Secretary of War, 1866, pp.
2-3 (hereafter cited as WD, ARofSG, date). The fiscal year ran from July
through June.
2. James M. Phalen, Chiefs of
the Medical Department, United States Army, 1775-1940, pp. 47-69.
3. Barnes became surgeon general
as the result of the court-martial conviction of his predecessor, the brilliant
but tactless and occasionally arrogant Brig. Gen. William A. Hammond. Although
the rank assigned to the position of surgeon general was brigadier general, on
13 March 1865 Barnes was brevetted major general because of his services in the
Civil War. See ibid., pp. 48-49.
4. Ibid., pp. 48-50; Ltr, SG to
Levi Maish, 3 Jan 1878, Entry 2, Record Group (RG) 112, National Archives and
Records Administration (NARA), Washington, D.C.; L. D. Ingersoll, A History
of the War Department of the United States. . . , pp. 233, 247 (hereafter
cited as History of WD); William Q. Maxwell, Lincoln's Fifth Wheel,
p. 318; George M. Kober, Reminiscences of George Martin Kober, M.D., LL.D.,
p. 197.
5. James E. Pilcher, The
Surgeon Generals of the Army of the United States of America, pp. 65-66;
Phalen, Chiefs, p. 52.
6. Phalen, Chiefs, pp.
62-64; Pilcher, Surgeon Generals, pp. 64, 74-76.
7. First quotation from Ltr, J.
S. Billings to Ezra M. Hunt, 13 Oct 1883, cited in Wyndham D. Miles, A
History of the National Library of Medicine, p. 161 (hereafter cited as History of NLM); second quotation from Pilcher,
Surgeon Generals, p.
68; ibid., pp. 67,69; Phalen, Chiefs, pp. 55-57; in RG 112, NARA: Ltr, Ch
Med Purveyor to SG, 3 Nov 1873, vol. 17, Entry 10, and Surgeon General's Office
(SGO) Cir 3, 21 Apr 1885, vol. 7, Entry 63.
8. Quotation from Pilcher,
Surgeon Generals, p. 70; Phalen, Chiefs, pp. 60, 63. Not long before
his death at the age of 90, Brig. Gen. Jefferson R. Kean, who joined the Medical
Department in 1884, recalled hearing that President Grover Cleveland had
selected Moore by running down the names of medical officers in the Army
Register and appointing the first one he reached for whom he had no letters
of recommendation. See Kean Interv, p. 14, in folder Interview (1950), Ms C14,
Jefferson R. Kean Papers, National Library of Medicine (NLM), Bethesda , Md.
9. Pilcher, Surgeon Generals,
pp. 74-76; Ltr, SG to F. M. Cockrell, 23 Feb 1884, Entry 2, RG 112, NARA;
[Jedediah H. Baxter], The Medical Part of the Final Report Made to the
Secretary of War by the Provost Marshal General; Samuel C. Busey, Personal Reminiscences and Recollections
. . . , pp. 303, 306-07, 308.
10. Pilcher, Surgeon Generals,
pp. 75-78; Phalen, Chiefs, pp. 63-64; William B. Bean, Walter Reed,
p. 45; Edward M. Coffman, The Old Army, p. 384.
11. First and second quotations
from Pilcher, Surgeon Generals, p. 82 (see also p. 79); third quotation
from Ltr, Jos. C. Bailey to SG, 31 May 1893, in Ms C100, George Miller Sternberg
Papers, NLM; Phalen, Chiefs, pp. 66-69; "The New Surgeon General," p. 51.
12. Coffman, Old Army, p.
218.
13. WD, ARofSG, 1865, p.
4, and 1866, pp. 7-8; in RG 112, NARA: Ltr, Charles H. Crane to C. McCormick, 18
Jul 1865, Entry 7, and Ltrs, Crane to J. W Morrison, 3 Aug 1865, to Dorothea
Dix, 11 Sep 1865, and to Henry A. Armstrong, 10 Oct 1865, and SG to Henry
Watson, 17 Mar 1870, and J. S. Billings to Samuel A. Wood, 24 Sep 1874, Entry 2.
In his capacity as assistant surgeon general, Crane relieved Barnes of much of
the routine administration of the office.
14. Quotation from WD, ARofSG,
1866, p. 1; ibid., pp. 2, 5; in RG 112, NARA: Ltr, Crane to McCormick, 18 Jul
1865, Entry 7, and Ltrs, W. C. Spencer to O. P. Morton, 16 Nov 1865, Crane to
Conrad Baker, 25 Nov 1865, Spencer to J. M. Richard, 25 Oct 1866, SG to W. W.
Corcoran, 9 Nov 1866, Entry 2, and Telg, SG to C. Baker, 17 Jan 1866, Entry 2.
15. WD, ARofSG, 1866, p.
5; War Department, Surgeon General's Office, Medical and Surgical History of
the War of the Rebellion, 2-3:901; Ltrs, Crane to D. C. Pearson, 21 Apr
1868, to S. J. P. Miller, 16 Jul 1874, and to Thomas G. Maghee, 10 Sep 1874, and
SG to J. M. Marvin, Entry 2, RG 112, NARA.
16. George M. Kober's quoted
comments, cited in Percy M. Ashburn, A History of the Medical Department of
the United States Army, p. 109 (hereafter cited as History of MD);
Preliminary Inventory of RG 112, pp. 28-29, NARA, which states that the Fi-
nance Division was in operation
"from the time of the Civil War" (p. 28).
17. Quotations from Otto L.
Nelson, Jr., National Security and the General Staff, p. 12; ibid., p.
13; Memo, J. M. Schofield to SG, 5 Oct 1892, John McA. Schofield Papers,
Manuscript Division, Library of Congress, Washington, D. C.; War Department,
Surgeon General's Office, The Surgeon General's Office, p. 224 (hereafter
cited as WD, SGO, SGO); WD, ARofSG, 1874, p. 20n. For the
responsibilities of medical directors, see, for example, in Entry 63: Instrs for
Med Dirs, 14 Sep 1874, vol. 5, and Ltrs, Crane to "Sir" [All Med Dirs], 1 Aug
1876, vol. 5, and to Med Dirs, 3 Aug 1876, vol. 5, and 6 Jan 1877, vol. 6; in
Entry 2: MD Form, 1868 (e.g., 17 Aug), and Ltrs, SG to E. L. Baker, 22 May 1877,
to Med Dir, Div of Atlantic, 6 Sep 1877, to Med Dir, Dept of Arizona, 11 Nov
1878, among many others, and to G. W. Scofield, 6 Feb 1873, and also Crane to
Med Dir, Dept of Gulf, 18 Apr and 10 Jun 1873, to Med Dir, Div of Atlantic, 24
Oct 1874, to Med Dir, Dept of Gulf, 6 Feb 1877, and to Med Dirs, Depts of South,
Gulf, Dakota, Platte, Missouri, Texas, California, Columbia, 20 Feb 1877; and in
Entry 12: Ltr, F. Branch to SG, 9 Feb 1868. All in RG 112, NARA.
18. Ltrs, John J. Milhau to SG,
18 Mar and 7 Oct 1868 and 25 Feb 1869, Thomas A. McParlin to SG, 5 May 1868,
Ebenezer Swift to SG, 13 Jun 1868 and 19 Mar 1870, James Simons to SG, 30 Aug
1868 and 24 Feb and 19 Mar 1869, Andrew K. Smith to SG, 28 Oct 1868, William J.
Sloan to SG, 11 Jun 1869, John Moore to SG, 9 Jul 1869, and to Capt L. V. Eziane
[sp ?], 20 Sep 1869, and Charles Page to SG, 25 Jul 1869. All in Entry 12, RG
112, NARA.
19. WD, ARofSG, 1868, p.
6; in RG 112, NARA: Ltrs, SG to J. D. Cameron, 16 Oct 1876, and to Levi Maish, 3
Jan 1878, Entry 2, and Ltrs, J. J. Milhau to SG, 18 Mar and 7 Oct 1868, Entry
12.
20. Quotation from "The Army
Medical Staff Bill," p. 150; Samuel L. Baker, "Physician Licensure Laws in the
United States, 1865-1915," pp. 173-74.
21. Edgar Erskine Hume,
"Admission to the Medical Department of the Army Half a Century Ago," p. 199;
Ltr, Crane to Joseph B. Brown, 30 Aug 1875, Entry 2, RG 112, NARA. Arthur was
promoted to brigadier general in the National Army on 5 August 1917.
22. Ltrs, Crane to Med Dir, Div
of Atlantic, to Med Dir, Dept of Dakota, to C. B. Byrne, all 31 Jul 1875, to J.
B. Brown, 30 Aug 1875, to E. E. Barnum, 23 Apr 1880, and to Med Dir, Dept of
Arizona, 1 Sep 1883, D. L. Huntington to Charles M. Gandy, 22 May 1883, and SG
to J. D. Cameron, 16 Oct 1876, and to A. E. Burnside, 26 Jul 1878, all Entry 2,
and SGO Cir Info, 29 Jun 1897, Entry 66. All in RG 112, NARA.
23. John Shaw Billings, A
Report on the Hygiene of the United States Army . . . , p. 106; Paul Starr,
The Social Transformation of American Medicine, pp. 84-85; in RG 112,
NARA: Ltrs, SG to G. W. Scofield, 6 Feb 1873, and Crane to H. S. Smith, 13 Jan
1876, and to Med Dirs, 4 Aug 1880, Entry 2, and Ltrs, A. K. Smith to SG, 28 Oct
1868, J.J. Milhau to SG, 25 Feb 1869, J. Simons to SG, 19 Mar 1869, Josiah
Simpson to SG, 24 Jun 1869, and J. Moore to SG, 9 Jul 1869, Entry 12.
24. Also affected by the
restriction were the Inspector General's, Quartermaster's, Adjutant General's,
Engineer, Commissary, Pay, and Ordnance Departments. See AGO GO 15, 11 Mar 1869.
See also WD, ARofSG, 1868, p. 7, 1869, p. 10, and 1871, pp. 6-7; "Army
Medical Staff Bill," p. 150.
25. James A. Tobey, The
Medical Department of the Army, p. 23; Erna Risch, Quartermaster Support
of the Army, p. 511; Robert M. Utley, Frontier Regulars, p. 15; WD,
ARofSG, 1874, pp. 20-21; Billings, Report on Hygiene, p. 106;
Ingersoll, History of WD, pp. 209, 286-87; in RG 112, NARA: Ltrs, Crane
to Sutherland, 1 Oct 1873, and SG to William Windom, 1 Jun 1878, to H. Clymer, 5
Apr 1880, and to Joseph E. Johnston, 5 Apr 1880, Entry 2, and Instrs for Med
Dirs, 14 Sep 1874, vol. 5, Entry 63.
26. First quotation from "Army
Staff Rank," p. 373 (see also pp. 13-14, 136, 374); second quotation from
American Medical Association (AMA), Petition of the American Medical
Association to the Senate and House of Representatives in Behalf of the Medical
Corps of the Army. . . , App., p. 19 (see also pp. 3-4, 11); "Army Medical
Staff Rank," p. 311; Harvey E. Brown, The Medical Department of the United
States Arrny From 1775 to 1873, p. 203; "Memorial of the American Medical
Association," p. 72.
27. Quotation from Ltr, Crane to
Med Dir, Dept of Texas, 8 Feb 1877, Entry 2, RG 112, NARA. In loc. cit., see his
similar letters to Med Dirs, Depts of Platte, Missouri, Dakota, 8 Feb 1877, as
well as those to Med Dirs, Depts of South, Gulf, Dakota, Platte, Missouri,
Texas, California, Columbia, 20 Feb 1877, to J. D. Baynes, 5 Jun 1877, and to J.
B. Downey, 7 Jul 1877; in Entry 63, see those to "Sir," 1 Aug 1876, vol. 5, to
Med Dirs, 3 Aug 1876, vol. 5, to Med Dir, 6 Jan and 25 May 1877, vol. 6, and to
Med Offs, 20 Feb 1877, vol. 6, plus SG to A. E. Burnside, 13 Jul 1878, vol. 7.
See also James E. Sefton, The United States Army and Reconstruction,
1865-1877, pp. 250-51.
28. WD, ARofSG, 1882, p.
19; Jerry M. Cooper, The Army and Civil Disorder, p. 27; in RG 112, NARA:
see, for example, Ltr, SG to A. E. Burnside,
13 Jul 1878, Vol. 7, Entry 63,
and Ltrs, SG to James A. Garfield, 2 Jul 1868, to W. Windom, 1 Jun 1878, to
Burnside, 16 and 26 Jul 1878, to J. E. Johnston, 5 Apr 1880, and to H. Clymer, 5
Apr 1880, Entry 2.
29. Although in 1890 the
legislature required promotion examinations for all Army officers below the rank
of brigadier general, the regulation was apparently not applied to the Medical
Department. Quotation from Pilcher, Surgeon Generals, p. 69; John van R.
Hoff, "Outlines of the Sanitary Organization of Some of the Great Armies of the
World," p. 513; SGO Cir Info, 29 Jun 1897, Entry 66, RG 112, NARA. On the
question of rank versus title for medical officers, the reader will note that
while Army surgeons are generally referred to as surgeon or assistant surgeon in
the 1888 and 1889 annual reports, they are consistently given their ranks in the
1890 and subsequent reports.
30. Edward M. Coffman, "The Long
Shadow of the Soldier and the State," p. 80; Utley, Frontier Regulars, p.
47; Martha L. Sternberg, George Miller Sternberg, p. 91; WD, ARofSG,
1889, pp. 14-15, and 1890, p. 12; A Military History of the U.S. Army Command
and General Staff College, Fort Leavenworth, Kansas, 1881-1963, pp. 5-7;
Timothy K. Nenninger, The Leavenworth Service Schools and the Old Army,
pp. 6-7; in RG 112, NARA: Telgs, Girard to SG, 24 Jun 1892, and C. H. Alden to
Med Dir, Dept of Dakota, 26 Jun 1892, box 13, Entry 17, and Ltr, SG to James
Laird, 20 Jul 1888, Entry 2, and Ltr, SG to SW, 15 Feb 1890, Entry 22.
31. WD, ARofSG, 1891, pp.
13-14; AGO GO 19, 26 Feb 1891, and GO 86, 26 Oct 1891 (pp. 41-43, 46-49);
Coffman, Old Army, p. 232.
32. Quotation from Ltr, SG to
Charles H. Alden, 27 Apr 1889, Entry 2, RG 112, NARA; in loc. cit., see Ltr, D.
L. Huntington to C. M. Gandy, 22 May 1883. See also Raphael P. Thian, comp., Legislative History of the General Staff of the Army of the United States . . .
From 1775 to 1901, p. 38; Morris J. Asch, "Army Medical Service," pp.
203-04; and the surgeon general's annual reports for numbers of applicants to
department.
33. AGO GO 55, 27 Jul 1883;
Ltrs, Crane to William B. Allison, 16 Jan 1883, and D. L. Huntington to C. H.
Miller, 16 Jun 1883, to Charles A. Sumner, 5 Jun 1884, to John Raymond, 8 Oct
1884, to W. E. Fisher, 22 Nov 1884, and to A. C. Mooreland, 28 Jun 1886, and SG
to F. M. Cockrell, 26 Apr 1884, to C. H. Penrose, 11 Dec 1886, to Med Dir, Dept
of Columbia, 2 Feb 1887, and to Joseph R. Smith, 17 Feb 1887, Entry 2, RG 112,
NARA; Robert S. Henry, The Armed Forces Institute of Pathology, p. 154
(hereafter cited AFIP).
34. Erwin H. Ackerknecht, A
Short History of Medicine, p. 194; AGO Cir 9, 6 Aug 1892; AGO GO 76, 16 Dec
1887; in RG 112, NARA: Ltrs, Charles R. Greenleaf to Fred C. Ainsworth, 24 Dec
1887, and to Post Surg, Davids' Island, 26 Mar 1888, Entry 2, and Ltr, Greenleaf
to Stephania Mikulewicz, 14 Mar 1890, Entry 22.
35. "The Rank and Pay of the
Hospital Stewards of the Army," pp. 670-71; Ltrs, Crane to Joseph Anderson, 21
Jun 1871, and to Med Dir, Dept of Gulf, 10 Jun 1873, Entry 2, RG 112, NARA; Paul
R. Cutright and Michael J. Brodhead, Elliott Coues, p. 107; John M.
Hyson, "William Saunders," p. 436.
36. John Shaw Billings, "Notes
on Military Medicine in Europe," pp. 236-37; AGO GO 78, 6 Jul 1874, GO 30, 9 May
1877, and GO 47,15 Mar 1881; in RG 112, NARA: Ltr, AG to SG, 19 Sep 1872, vol.
16, Entry 10, and Ltr, SGO to R. Murray, 20 Feb 1880, vol. 1, Entry 16, and Ltr,
SG to J. D. C. Atkins, 5 Feb 1877, Entry 2.
37. Quotation from WD, ARofSG,
1886, p. 35; ibid., 1885, p. 39; John van R. Hoff, "What is a Hospital Corps?,"
pp. 315-16; Junius L. Powell, "Some Observations on the Organization and
Efficiency of the Hospital Corps . . . ," pp. 330-31; Coffman, Old Army,
p. 381; AGO GO 62, 4 Jun 1885; in Entry 2, RG 112, NARA: Ltrs, D. L. Huntington
to Bernard Persh, 13 Sep 1884, to Med Dir, Div of Atlantic, 24 Sep 1884, to H.
C. Gesserer, 18 Jul 1885, to B. B. Gell, 7 Apr 1886, and to Andrew F. Peters, 22
Jun 1886, and SG to Med Dir, Dept of Arizona, et al., 21 Jun 1886, and SGO to E.
L. Bragg, 15 Jan 1887, and C. R. Greenleaf to 2d Compt, Treas Dept, 13 Jul 1889.
38. First quotation from Russell
F. Weigley, History of the United States Army, p. 290; second quotation
from WD, ARofSG, 1885, p. 39; ibid., 1886, p. 35; Graham A. Cosmas, An
Army for Empire, pp. 17-18; James L. Abrahamson, America Arms for a New
Century, p. 61; Coffman, Old Army, p. 396. The motivation for the
establishment of the Hospital Corps was not entirely identical with that for the
service corps sought by other departments (see Risch, Quartermaster Support,
pp. 561-62, 565) since the Medical Department had broken free before the Civil
War of many of the problems caused by temporary detailing of civilians and
enlisted men to serve as stewards (see Mary C. Gillett, The Army Medical
Department, 1818-1865, pp. 129-30).
39. Ltrs, D. L. Huntington to
Post Surg, Watervliet Arsenal, 5 Nov 1885, and C. R. Greenleaf to F. C.
Ainsworth, 29 Apr 1887, to Med Dirs, 7 Jan 1889,
and to 2d Compt, Treas Dept, 13
Jul 1889, and SGO Cir 1, 26 Apr 1889, Entry 2, RG 112, NARA; WD, SGO, SGO,
p. 45. Unless otherwise indicated, all material on the Hospital Corps is based
on AGO GO 56, 11 Aug 1887, from which the quotation is taken.
40. Ltrs, Charles Smart to G. W.
Miller, 8 Jun 1888, and C. R. Greenleaf to Smart, 1 Oct 1888, Entry 2; Note
[initialed CRG], 22 May 1890, Entry 22. All in RG 112, NARA.
41. First and second quotations
from Ltr, John van R. Hoff to SG, 13 Oct 1888, Entry 17; third quotation from
L.W. Crampton to Med Dir, Dept of Platte, 26 Sep 1888, Entry 17; and fourth
quotation from Ltr, SG to C. E. Hooker, 21 Jan 1889, Entry 2. All in RG 112,
NARA. In loc. cit., see Ltrs, Joseph K. Corson to Med Dir, Dept of Columbia, 8
Jul 1888, and C. Page to SG, 19 Nov 1889, Entry 17, and SG to Chair, MilAffs
Cmte, HofReps, 24 Mar 1888, Entry 2. See also Charles Sutherland, "Organization
of Hospital Corps," in Pan-American Medical Congress Transactions, 1:688;
Jack D. Foner, The United States Soldier Between Two Wars, pp. 84-92.
42. WD, ARofSG, 1888, pp.
141-42, 1889, p. 9, and 1891, pp. 10-13; Ltrs, C. R. Greenleaf to George
Dieffenbach, 1 Dec 1887, to E. P. Harrison, 6 Mar 1888, to Post Surgs, 7 Aug
1888, to William Everts, 27 Aug 1888, and to Harry J. Ramsey, 9 Sep 1889, and C.
Smart to Charles H. Swan, 27 Mar 1888, Entry 2, RG 112, NARA.
43. WD, ARofSG, 1866, pp.
2-3; Paul S. Peirce, The Freedmen's Bureau, pp. 44, 48-49, 87-89, 91-92;
Message From the President to the Two Houses of Congress at the Commencement
of the Second Session of the Fortieth Congress . . . , ed. Ben. Perley Poore
(Washington, D.C.: Government Printing Office, 1867), pp. 472, 478, 480-82, 494;
Message From the President of the United States to the Two Houses of Congress
at the Commencement of the Third Session of the Fortieth Congress, ed. Ben.
Perley Poore (Washington, D.C.: Government Printing Office, 1869), pp. 491, 499;
George R. Bentley, A History of the Freedmen's Bureau, pp. 76, 209; in RG
112, NARA: Ltr, SG to Freedmen's Hospital, Wash., D.C., 19 Jul 1872, Entry 2,
and Rpt, Samuel Jessop, 15 Jan 1869, Entry 51, Charleston, and AGO SO 435, 31
Aug 1866, and SO 266, 10 Jun 1867, Entry 57.
44. WD, ARofSG, 1866, pp.
3-4; Ltrs, Crane to J. D. W. Grady, 1 Aug 1865, and J. S. Billings to Monroe &
Gardiner, 10 May 1867, Entry 2, RG 112, NARA.
45. WD, ARofSG, 1876,
pp.4-5, 1877, p.4, 1881, pp. 4-5, and 1892, p. 7; Ltrs, Crane to Hugo Wangelin,
3 Aug 1879, and to Jay Gould, 6 Jan 1871, and SG to Com of Pensions, 15 Jun
1872, Entry 2, RG 112, NARA.
46. Quotation from Ltr, SG to
John Findlay, 22 Jan 1886, Entry 2, RG 112, NARA; WD, ARofSG, 1891, p. 6,
and 1892, p. 11.
47. WD, ARofSG, 1892, pp.
7-8, 10.
48. Among Billings' later
designs was the Johns Hopkins Hospital.
49. Fielding H. Garrison, John Shaw Billings, pp. 278-335; Miles,
History of NLM, p. 106; Paul
R. Goode, The United States Soldier's Home, pp. 28, 51, 91, 93-94, 97,
102; Constance McL. Green, Washington, p. 310; Billings, Report on
Hygiene, pp. lv-lvi; in Entry 2, RG 112, NARA: Agreement, SG and Sister
Loretta O'Reilly, 3 Dec 1868, and Ltrs, SG to Moses Kelly, 8 Aug 1868, to U.S.
Sen and HofReps, 6 Dec 1869, to Pres of Sen and Speaker of H, 10 Dec 1870, to
U.S. Sen and HofReps, 13 Dec 1872, and to Aprops Cmte, 5 Dec 1874, and Crane to
Eds, Am Encyclopedia, 10 Mar 1876.
50. WD, ARofSG, 1883, p.
15, and 1884, p. 19; Mabel E. Deutrich, Struggle for Supremacy, pp. 22,
27, 32.
51. WD, ARofSG, 1866, p.
6; ibid., 1883, p. 15, 1886, p. 5, 1887, pp. 4-5, and 1888, p. 5; Deutrich, Struggle, p. 22; in RG 112, NARA: Orders, SW to SG, 21 Jun 1873, vol. 17,
Entry 10, and Ltr, J. S. Billings to N. Van Clernam, 26 Jul 1879, Entry 2.
52. WD, ARofSG, 1870, p.
5; Deutrich, Struggle, pp. 27-28; in RG 112, NARA: Ltrs, SG to J. A.
Garfield, 2 Jul 1868 and 23 Feb 1869, and to W. Windom, 10 Feb 1877, and Ltr,
Crane to J. J. Woodward and to George A. Otis, 22 Aug 1870, Entry 8.
53. Deutrich, Struggle,
pp. 21, 26-30; in RG 112, NARA: Orders, SW to SG, 21 Jun 1873, vol. 17, Entry
10, and Ltrs, SG to J. A. Garfield, 2 Jul 1868, to H. Williams, 11 Mar 1874, to
Sol M. Merrill, 2 May 1874, to Com, IndAffs, 14 Jan 1876, to W. Windom, 10 Feb
1877, and to Div Heads (various), 9 Jun 1885, and Crane to Campbell Williams, 3
Jun 1877, to Post Surgs, 20 Jul 1881, and to Page, 25 Jul 1881, all Entry 2,
plus SGO Cir, 27 Jul 1883, and Orders, SG, 3 Aug 1883, vol. 7, Entry 63. For
more detail on this problem, see the surgeon general's annual reports for the
period.
54. WD, ARofSG, 1888, pp.
137-38, and 1889, p. 13; Deutrich, Struggle, pp. 30-34, 36-43; Ltrs, D.
L. Huntington to T. T. Carson, 29 Jun 1887, and to Robert B. Vance, 2 Feb 1887,
and Orders, SG, 25 Jun and 14 Jul 1887, Entry 2, RG 112, NARA.
55. WD, ARofSG, 1891, p.
15, and 1892, pp. 17-18; AGO Cir 6, 3 Jul 1891; SGO Cir, 9 Jul 1890, Entry 22,
RG 112, NARA.
56. WD, ARofSG, 1867, p.
4, 1880, pp. 17-18, and 1881, pp. 16-17; Miles, History of NLM, p. 28;
Henry, AFIP, pp. 54, 73-75.
57. The Library and Museum
Division was part of the Surgeon General's Office.
58. The library and museum had
initially been separate organizations. Quotation from WD, ARofSG, 1885,
p. 36; ibid., p. 35, and 1888, p. 140; AGO GO 31, 19 Mar 1885; Miles, History
of NLM, pp. 163-64, 168; Henry, AFIP, pp. 79-80; in RG 112, NARA:
Orders, SG, 28 Dec 1883, and Ltrs, D. L. Huntington to Edgar A. Means, 24 Jan
1884, and SG to William Mahone, 14 Dec 1883, to HofReps Mbrs, Conf Cmte, 12 Feb
1885, and to Chair, Sen Aprops Cmte, 1 Mar 1887, all Entry 2, plus Pamphlet,
1883, vol. 7, Entry 63.
59. John S. Chambers, The
Conquest of Cholera, pp. 335, 344, 348; Peter Baldry, The Battle Against
Bacteria, pp. 30-31, 37; Wesley W Spink, Infectious Diseases, pp.
7-8, 162, 165, 363, 428-29; Fielding H. Garrison, An Introduction to the
History of Medicine, 3d rev. ed. and enl., pp. 620-21, 623-24, 633-35.
60. Garrison, History of
Medicine, pp. 578-79; Richard H. Shryock, Medicine in America, pp.
29-31, 71; Ackerknecht, Short History, pp. 209-11; Kenneth M. Ludmerer,
Learning To Heal, pp. 4, 18, 23-26, 83-84, 119, 178, 235, 245; William G.
Rothstein, American Physicians in the Nineteenth Century, pp. 265-66,
285-94.
61. Before Joseph Lovell was
appointed surgeon general in 1818, the Army had no permanent medical service,
and although the title of surgeon general was sometimes used, it was not given
to the head of any of the temporary medical services created to meet wartime
needs. During the War of 1812 James Tilton was given the title of physician and
surgeon general.
62. James H. Cassedy "Numbering
the North's Medical Events," pp. 232-33.
63. Dorothy M. Schullian and
Frank B. Rogers, "The National Library of Medicine," p. 11; WD, ARofSG,
1872, p. 10; Ltr, Billings to William Wesley, 27 Jul 1867, Entry 2, RG 112,
NARA; John Shaw Billings, "Who Founded the National Medical Library?," p. 299;
idem, Selected Papers, pp. 4, 81; James H. Cassedy, Medicine in
America, pp. 77, 85. For a detailed discussion of post-Civil War history of
the Surgeon General's Library, see Miles, History of NLM, on which,
unless otherwise indicated, much of the material in this chapter concerning the
library is based.
64. Publication of the Index
Catalogue ceased in 1961. First quotation from Ltr, SG to Thomas Settle, 20
Aug 1872, Entry 2, RG 112, NARA; second and third quotations cited in Miles, History of NLM, p. 129. In Entry 2 above, see Ltrs, Billings to H. R.
Spoffard, 12 Feb 1872, and SG to L. M. Morrill, 9 Feb 1872, to M. Wurtz, 22 May
1872, and to John Eaton, 25 Nov 1872. See also WD, ARofSG, 1874, p. 19,
1878, pp. 17-18, 1879, p. 17, 1881, p. 16, and 1882, pp. 16-17; Billings, Papers, p. 229.
65. Billings, Papers, pp.
229-30.
66. WD, ARofSG, 1875, pp.
15-16; War Department, Surgeon General's Office, The Cholera Epidemic of 1873
in the United States; Orders and Ltr, SG to Ely McClellan, 7 May and 24 Dec
1874, Entry 2, RG 112, NARA.
67. Quotation from WD, ARofSG,
1891, p. 7; Henry, AFIP, pp. 36, 51-66; Ltr, D. L. Huntington to E. A.
Means, 24 Jan 1884, Entry 2, RG 112, NARA; Esmond R. Long, A History of
American Pathology, p. 167.
68. Quotations from Ashburn,
History of MD, p. 134; WD, SGO, Medical and Surgical History,
1-2:374.
69. Quotations from Garrison,
Billings, p. 342; ibid., pp. 152, 411; John Z. Bowers and Elizabeth P.
Purcell, eds., Advances in American Medicine, 1:347; William D. Foster,
A History of Medical Bacteriology and Immunology, p. 65.
70. The story of the museum and
its transformation into the Armed Forces Institute of Pathology is told in
detail in Henry, AFIP. See also Ltrs, SG to C. Cole, 15 May 1872, and D.
L. Huntington to L. C. Pitcher, 4 Mar 1886, Entry 2, RG 112, NARA; SGO Cir 2, 4
Apr 1867; WD, ARofSG, 1866, p. 8, 1868, p. 6, 1870, pp. 9-10, 1873, pp.
8-9, 1874, pp. 15n-16n, 1876, pp. 17-18, and 1877, pp. 12-13; George A. Otis,
"Notes on the Contributions to the Army Medical Museum by Civil Practitioners,"
p. 164; John E. Erichsen, "Impressions of American Surgery," p. 720; "Science
Schools and Museums in America," p. 290; John Shaw Billings, "On Medical
Museums," pp. 309, 311; M. C. Leikind, "Army Medical Museum and Armed Forces
Institution of Pathology in Historical Perspective," p. 75; Long, American
Pathology, p. 128.
71. First quotation from Henry,
AFIP, p. 14; second quotation from WD, ARofSG, 1886, p. 33. See
also ibid., 1888, p. 141.
72. Quotation from WD, SGO,
Medical and Surgical History, 1-2:374; ibid., 336-47, 367, 651, 653, and
1-3:500-508; George H. Daniels, ed., Nineteenth-Century American Science,
p. 177; Henry, AFIP, pp. 89-90; Owen H. Wangensteen and Sarah D.
Wangensteen, The Rise of Surgery From Empiric
Craft to Scientific
Discipline, p. 507; Cassedy, "Numbering Medical Events," pp. 232-33.
73.
First quotation from address
given by Virchow on 2 August 1874, cited in AMA, Petition, p. 19. (This
quotation from Virchow is a popular one, although rarely reproduced at length.
William G. Morgan's assumption that Virchow was specifically referring to the Medical And Surgical History is apparently a common one. But in the address
as published in "Summary," pp. 299-300, as well as in Kober, Reminiscences,
p. 224, in the AMA, Petition, p. 19, and very briefly in William G.
Morgan, "Contributions of the Medical Department of the United States Army to
the Advancement of Knowledge," p. 781, Virchow refers only to Medical Department
publications in general. Thus, since only one part of each volume of the Medical and Surgical History
had appeared by 1874 and since medical officers
were responsible for many other publications in the period 1865-1874,
it seems
likely that Virchow had more than the Medical and Surgical History in
mind when he spoke.) Second and third quotations from James H. Cassedy, American Medicine and Statistical Thinking, 1800-1860, p. 238. Fourth
quotation from Esmond R. Long, "The Army Medical Museum," p. 370. See also idem,
American Pathology, p. 129; Cassedy, Medicine in America, p. 66;
AMA, Petition, p. 20.
74. Billings, Papers, p.
264.
75. Sternberg became surgeon
general in 1893. First quotation from Ashburn, History of MD, p. 148;
second quotation from Sternberg, Sternberg, p. 88. See also ibid., pp.
67, 70-87, 91-92; John Mendinghall Gibson, Soldier in White, pp. 136-37;
Asch, "Army Medical Service," pp. 203-04; Ltr, Sternberg to SG, 27 Nov 1883, Ms
C100, NLM. In 1892 Sternberg provided a group of scientists with the details of
his work producing immunity to smallpox in calves, to include data on an
experiment that demonstrated the in vitro effects of immune serum on the vaccine
virus. See George M. Sternberg, "Practical Results of Bacteriological
Researches," pp. 68-86.
76. Quotation from SGO Cir Order
3, 20 Aug 1877, vol. 6, Entry 63, RG 112, NARA; Garrison, History of Medicine,
pp. 588-91; Phalen, Chiefs, p. 56; WD, ARofSG, 1884, p. 32, and
1885, p. 27; Gert H. Brieger, "The Development of Surgery," in Davis-Christopher Textbook of Surgery, pp. 9-10.
Be sure to read this short
article on the Truth about Civil War Surgeons by Dr. Jay Bollet
