U. S. Army Form No. 18
By Dr. Michael Echols
(The following are the personal edited research notes of Michael Echols, the source of which may or may not be completely documented)
Updated: 09/21/2016 09:08 AM
The following information regards surgical sets owned by 'contract' physicians and surgeons. The excerpts from the Medical and Surgical History of the War of Rebellion database are used to support the use of 'contract' surgeons and the existence of U. S. Army Form No. 18 which was used to pay contract physicians.
The big point to consider is whether or not contract surgeons performed surgery, and if so, did they bring their own instruments as pointed out in the yellow pages. Personally I believe contract physicians were used in an auxiliary role to maintain patients and other than the first few months of they War, were not hired to perform major surgery on any patients. Surgery or amputations were mainly performed by U. S. Army certified surgeons and assistant surgeons and you may want to read the following:
The Truth about Civil War Surgeons by Dr. Jay Bollet
More information on Civil War Contract Surgeons
The reason this information is important and needs further study is because of all the surgical sets that are floating around out there, which are claimed to have been used during the Civil War by contract surgeons. No one can prove it, but this information would certainly point toward the possibility...
A summary on the left of the facts discussed in Form 18 from the Regulations of the Medical Department of the Army. On the right, a copy of a contract signed Sept. 15, 1863, between Surgeon R. Q. Abbot and Dr. J. M. McCalla, Jr. of Washington, D.C. The last sentence in the contract states: "When instruments are furnished by the United States, the fact will be stated."
See a full copy of the Regulations on page 1 of the medical textbook collection
Click on images to enlarge
Account of Private Physician Under Contract
John Wheller, M.D., Pittsfield, N.H.
Name: John Wheeler
Cause of death: paralysis
Death date: Dec 21, 1900
Place of death: Pittsfield, NH
Birth date: 1828
Type of practice: Allopath
Practice specialities: GS General Surgery
Medical school: Berkshire Medical College, Pittsfield, 1852, (G)
Journal of the American Medical Association Citation: 36:47
John Wheeler, M. D. Was born in Barnstead, Sept.15, 1828 ; was grandson of Dr. Jewett, Sr. He fitted for college at Gilmanton Academy, and graduated at Dartmouth College in 1850, studied medicine with Dr. J. P. Jewett, of Lowell, Mass., and with C. T. Berry, of Pittsfield, N. H., attended Medical Lectures at Bowdoin, Boston, and Berkshire Medical Schools, and graduated at the latter in 1852.
He immediately succeeded Dr. Grover in Barnstead, where he has been in practice ever since, with the exception of four years at Pittsfield, and a while in the army. Many medical students, more than twenty, have pursued their studies, either a part or the whole under his direction.
Note: John Wheeler does not show up in the Roster of Surgeon's and should not, as he was a contract 'assistant surgeon'
"For services rendered as Acting Assistant Surgeon, U.S.A. at U. S. Hospital from Oct. 1st. to Oct. 5th, 1864, A. N. McLaren, Surgeon, U.S.A."
Payment to Dr. Wheeler: $117.50
"There was an obvious lack of any standard of training among surgical personnel. Medical officers on both sides of the conflict were repeatedly charged with incompetence, ignorance, inefficiency, neglect, cruelty, carelessness and drunkenness. The reasons for this are never more apparent than in the admission standards for the Medical officers in the Union army. The Army Medical Board required all surgeons to pass an oral and written test to determine their competence in the medical sciences as well as history, geography, literature, philosophy and languages. Many failed these examinations and at the instruction of the Secretary of War, the requirements were significantly lowered. Thus, the number of competent surgeons rivaled the incompetent, and those that did serve had an alarmingly disparate base of knowledge: Army surgeons lacking in the latest knowledge of medical theory and technology, and civilian volunteers lacking surgical experience. Charges of needless operations performed to perfect surgical skills, surgeons abandoning patients whose wounds proved uninteresting, and surgeons operating while intoxicated were rampant. Equally as prevalent were accusations of indignity and contempt in the treatment of civilian surgeons by regular army surgeons. In response to these conditions, Surgeon General Hammond created a “civilian-auxiliary” system in cooperation with the State’s governors. So effective was this auxiliary that following Grant’s spring campaign of 1864, not a single story of scandal surfaced."
Source of above:“Civil War Surgery: A Historical Approach”; Submitted to the Des Moines University Surgical Foundation,
August 2000, Scott S. Carpenter, DO 2003
Medical Reminiscences of the Civil War
Remarks by John S. Billings, M.D. regarding Surgeon A. N. McLaren
Read April 5, 1905
In the Fall of 1861 I went to Washington to appear before the Medical Examining Board of the Regular Army. I had graduated from a medical college after a two years' course, each year having exactly the same lectures. I had had two years' hospital experience, and I had been demonstrator of anatomy for two years, so that while I had my doubts about my passing the ordeal of the Army Medical Board, from what I had heard of its severity, still I thought that probably I should get through. I came up before the Board, and at about noon of the second day I began to feel rather comfortable and thought I was getting on very well; but by noon of the third day there was a consultation between the examiners, and they began all over again, going back to anatomy and to the beginning of things. That went on for three days more and
made me very uneasy. I did not learn the explanation of this until long afterward. When it was all over Dr. McLaren, the President of the Board, said to me that he hoped I would take service at once with him - that he could not get my commission for some time, but that I could be made a contract surgeon without delay. I agreed to this, was introduced to Surgeon-General Finley, got my contract and was told that I was especially detailed to go to the Union Hotel Hospital in Georgetown, which was under the direction of Surgeon McLaren.
HEADQUARTERS OF THE ARMY, ADJUTANT GENERAL'S OFFICE,
Washington, Dec. 6th, 1861.
SPECIAL ORDERS, No. 323.
A Board to consist of Surgeon A. N. McLAREN, U. S. A., Brigade Surgeon G. H. LYMAN, U. S. Volunteer service and Ass't Surg. M.J. ASCH, U. S. Army, is hereby instituted for the following object: To visit as many of the camps in the vicinity of Washington an they may consider necessary to obtain sufficient data to make a report to the Surgeon General on the character of the disease termed by the Medical Officers of the Brigades and Regiments "Typhoid Fever," and an far as practicable the causes of its adynamic type and whether it is to be considered an intermittent or bilious remittent fever in its inception, assuming in its course the typhoidal type or a typhoid fever primarily.
The Board will be regulated in its sessions and movements by its President so as least to interfere with the other operations of the service. The junior member will act as recorder.
BY COMMAND OF MAJ. GEN'L McCLELLAN.
(Signed) L. THOMAS, Adjutant General.
Documentation from the Medical and Surgical History database re: Army Form No. 18
CORRESPONDENCE, ORDERS, REPORTS, AND RETURNS OF THE UNION AUTHORITIES FROM JANUARY 1, 1864, TO APRIL 30, 1865
EXTRACTS FROM GENERAL REGULATIONS OF THE ARMY,
ARTICLE XLI.--Public property, money, accounts, and contracts.
1304. When it is necessary to employ a private physician as medical officer, the commanding officer may do it by written contract, conditioned as in Form 18 (Medical Regulations, U. S. Army), at a stated compensation, not to exceed $50 a month when the number of officers and men, with authorized servants and laundresses, is 100 or more; $40 when it is from 50 to 100; and $30 when it is under 50.
1305. But when he is required to abandon his own business, and give his whole time to the public service, the contract may be not to exceed $80 a month, and not to exceed $100, besides transportation in kind, to be furnished by the Quartermaster's Department, where he is required to accompany troops on marches or transports. But a private physician will not be employed to accompany troops on marches or transports, except by orders from the War Department, or in particular and urgent cases by the order of the officer directing the movement, when a particular statement of the circumstances which make it necessary will be appended to the contract.
1306. And when a private physician is required to furnish medicines, he will be allowed, besides the stipulated pay, from 25 to 50 per cent. on it, to be determined by the Surgeon-General.
1307. In all cases a duplicate of the contract will be transmitted forthwith by the commanding officer to the Surgeon-General, and the commanding officer for the time being will at once discontinue it, whenever the necessity for it ceases, or the Surgeon-General may so direct.
1308. The physician's account of pay due must be sent to the Surgeon-General for payment, vouched by the certificate of the commanding officer that it is correct and agreeable to contract, and that the services have been duly rendered. But when it cannot conveniently be submitted to the Surgeon-General from the frontier or the field, it may be paid on the order of the commanding officer, not to exceed the regulated amount, by a medical disbursing officer, or a quartermaster.
OFFICE COMMISSARY-GENERAL OF PRISONERS,
New York City, February 19, 1862.
Maj. W. S. PIERSON,
Commanding Depot of Prisoners of War, Sandusky, Ohio. MAJOR:
Yours of the 15th with Doctor Woodbridge's acceptance of the appointment of medical officer at the depot at $100 per month is just received. I send a telegram to you requesting you to employ him immediately. Make a contract with him according to Form 18, medical regulations, specifying that he is to receive the fuel and quarters of an assistant surgeon. When I return to Sandusky I will approve the contract and forward it to the Surgeon-General. If I should not return you can forward it as having been made by my order. While the men are suffering with the mumps it may be well to quarter some of them in the officers' block nearest to the gate, north side, in the inclosure.
W. HOFFMAN, Lieut. Col. Eighth Infantry, Commissary. General of Prisoners
140. Employés will be paid, at the end of each calendar month, on receipt rolls (Form 18), in duplicate, which they must sign with their own hands. One person can sign for another only by a power of attorney, a copy of which must, in each case, accompany the signature.
141. When employés are not present at the district headquarters to sign the receipt rolls, their accounts may be made out on separate vouchers. (Form 19.)
SPECIAL ORDERS No. 90.
HDQRS. DEPT. OF THE TENNESSEE,
Young's Point, La., March 31, 1863
VIII. The commanding officer of the Sixteenth Army Corps will cause to be built on one of the islands of the Mississippi somewhere between Columbus, Ky., and Memphis, Tenn., a suitable log or frame prison for the accommodation of 1,000 prisoners. The island so occupied will be garrisoned by such a force as the corps commander may deem necessary for the safe-keeping of all prisoners intrusted to them and for holding the post. One contract physician will be habitually kept to take charge of the sick in prison and more should the number requiring medical attendance make it necessary. The expense of building such structure will be defrayed by the quartermaster's department from funds received through the provost-marshal's department.
By order of Maj. Gen. U.S. Grant:
JOHN A. RAWLINS,