Confederate Navy
medicine
Author: John S. Lynch,
Msc.
Military Medicine,
Nov
1999 by
Lynch, John S
http://findarticles.com/p/articles/mi_qa3912/is_199911/ai_n8855052?tag=content;col1
The Confederate Navy's
Office of Medicine and Surgery was a small organization within the
Confederate Navy Department. The physicians, surgeon's stewards, and
nurses provided medical care to sick and injured sailors from both sides
of the conflict. The provision of health care often took place under
trying circumstances, including shortages of medicines, money, and food.
Members of the medical department served in all major and many minor
naval engagements and worked long hours treating the wounded after
battle. Many of the physicians served in the U.S. Navy before the Civil
War. Their sacrifices and achievements are lost in the maelstrom of the
larger conflict on land. This article is an effort to call attention to
their story.
One common
misperception is that during the American Civil War the two combatant
navies played only a subordinate role to the greater conflict on land.
In fact, the Federal and Confederate navies greatly affected the war at
the operational and strategic levels. General George McClellan's 1862
peninsular campaign and Benjamin Butler's Army of the James 1864
Virginian peninsula operations would have been impossible without the
support of the U.S. Navy. The Union's Mississippi Squadron was key to
denying the Mississippi River to the Confederacy and to the eventual
capture of Vicksburg. The naval blockade of the southern coastline
seriously hampered Confederate importation of war materiel and export of
"king cotton," which, of course, affected the Confederacy both
militarily and financially. The Confederate Navy also affected the
operational and strategic course of the war. Confederate Navy ironclads,
such as the Virginia and the Albemarle, kept Southern ports and rivers
safe from capture and open for blockade runners. One major contribution
to the war effort by the Confederate Navy was its handful of commerce
raiders. These ships, the most famous being the CSS Alabama, destroyed
the U.S. maritime industry by sinking merchant ships, driving up
insurance costs to prohibitive levels, and finally forcing American
cargoes into neutral ships. The U.S. merchant marine did not recover
from Confederate Navy depredations until the 20th century, Historians
primarily focus their attention on these raiders and the ironclads. As a
result, few people today know anything about the Confederate Navy's
Office of Medicine and Surgery. This article is designed to shed light
on this overlooked chapter in the history of military medicine.
Organization, Staffing,
and Budget of the Office of Medicine and Surgery:
The Confederate Navy's
Office of Medicine and Surgery (OMS) was formally instituted on March
16, 1861, when Confederate President Jefferson Davis signed the Navy
Bill into law. OMS was one of four naval bureaus. The other three were
the Office of Orders and Details (the senior bureau and essentially an
office of personnel with military judicial duties), the Office of
Ordnance and Hydrography (which dealt with weapons, ammunition, and
navigational equipment), and the Office of Provisions and Clothing
(logistics).',' OMS was tasked with establishing and operating naval
hospitals, acquiring and producing medicines, and obtaining or
fabricating medical and surgical supplies It directed medical personnel
and provided physicians for Confederate naval vessels and facilities.
OMS was a small office that supported a small navy. (The Confederate
Navy's highest personnel level was 753 commissioned officers and 4,450
enlisted men in 1864.1)
The early physician
staff was mostly drawn from former U.S. Navy physicians. In 1860, there
were 69 surgeons, 43 passed assistant surgeons, and 36 assistant
surgeons in the U.S. Navy. Thirty-eight of these men resigned or were
dismissed, representing a loss of 26% of the Federal Navy's physicians.
At least 35 of these former U.S. Navy physicians eventually served in
the Confederate Navy.' In contrast, in 1860 the U.S. Army had 30
surgeons and 83 assistant surgeons. Three surgeons and 21 assistant
surgeons resigned from the Army for the Confederacy, representing a loss
of 21% of the Army's medical officers.3 The OMS grew during the war in
response to increasing demands for medical support. The original March
16, 1861, legislation authorized OMS to have 5 surgeons and 5 assistant
surgeons. In December 1861, 30 "temporary" physicians were authorized.
The demand for additional naval medical officers was such that the
Confederate Congress passed legislation in April 1862 that increased OMS
physician levels to the following: I surgeon general, 20 surgeons, 15
passed assistant surgeons, and 30 assistant surgeons. Demand increased
further, and in 1863 President Davis was authorized to appoint as many
naval officers he deemed necessary.4 Fiftyone years after the
Confederate surrender, the Association of Medical Officers of the Army
and Navy of the Confederacy determined that there were 107 naval medical
officers who served at one time or another during the war. The 107
physicians included 26 surgeons, 13 passed assistant surgeons, 63
assistant surgeons, and 5 assistant surgeons for the war.' In addition
to physicians, OMS employed surgeon's stewards (a noncommissioned
officer rank) who aided the physicians and were required to have a
working knowledge of pharmacy and bandaging techniques and to be able to
perform minor surgery.' Nurses were also employed or detailed as needed.
Appropriations for the Confederate Navy were insignificant compared with
that for the Confederate Army. Approximately $107,000,000 (Confederate)
was appropriated for the Confederate Navy during the entire War. The
Confederate War Department, in contrast, had a total appropriation of
$2,180,700,000.4 Approximately $1,716,500 (2% of the naval
appropriations) was budgeted for the Navy's Medical Department during
the nearly 5 years of conflict. The Confederate Navy's medical
appropriations were as follows: 1861, $20,000; 1862, $61,500; 1863,
$250,000; 1864, $1,010,000; and 1865, $375,000. IA
The Chief of the Office
of Medicine and Surgery for the entire war was Dr. William Augustine
Washington Spotswood. 1,5 Spotswood, like many contemporary American
physicians, did not have a formal medical degree. He did attend the
University of Virginia's medical school but left in 1828 after
completing the first year of its 2-year program. He was commissioned as
an assistant surgeon in the U.S. Navy in December 1828. Spotswood
resigned from the U.S. Navy on January 19, 1861, while assigned to the
Pensacola Navy Yard.'-' Service Life for a Confederate Navy Medical
Officer In general terms, the Confederate Navy physician faced less
physical hardship than his Army counterpart. Many naval physicians lived
in metropolitan areas, whereas Army physicians often slept under tents.
Battle hazards were less for the naval physicians, because the ships
were idled by blockade or, if in battle, they were protected by their
duty stations being below the waterline or by ironclad bulwarks. The
risk of contracting disease was high for the Navy physician. Poorly
cooked or contaminated food could lead to diarrhea. Medical officers in
ships anchored near marshland often contracted malaria. Only four
physicians died while in service: David Llewellyn drowned in the
immediate aftermath of battle; Joseph Grafton gave his life so another
could five during a boating accident off the Brazilian coast; and George
Blacknall and Daniel Green died from natural causes or disease.4,8-10
OMS physicians, as a result of their specialized training, were classed
as limited duty officers by the Confederate Navy Department. I This
meant that they could not be used in line officer positions. Naval
medical officers were assigned to one of several general areas: land
installations, riverine or harbor defense vessels, or cruisers.
Hospital duty was
assigned to the older, seasoned surgeons because of their experience and
to assistant surgeons so that they could gain experience. It was
probably a sought-after assignment by these men, because it allowed them
to live with their families, enjoy the local economy, and live in better
conditions than their peers aboard ship. Confederate Navy hospitals were
established in Norfolk, Virginia; Richmond, Virginia; Wilmington, North
Carolina; Mobile, Alabama; Charleston, South Carolina; and Savannah,
Georgia." Additionally, several infirmaries were scattered about the
Confederacy. The largest and busiest naval hospital was the Richmond
Naval Hospital. Surgeon James F. Harrison' commanded the facility for
most of the war.' Another major facility, the Savannah hospital, was
described in 1864 by a captured Federal Navy physician: "My patients
were placed under my care at a hospital called the Savannah Naval
Hospital, under the charge of Surgeon Jeffrey, CSN. This hospital was
devoid of some of the luxuries which may be found in Northern hospitals,
but was airy and comfortable, and the patients there received every care
and comfort which the somewhat limited resources of the country
permitted. I myself was treated with gentlemanly consideration by Dr.
Jeffrey and the assistant surgeons, as well as by the numerous rebel
officers who frequently called there. We were told by the guard, to
console us, that this ration was the same as they got themselves, and I
think it likely enough that they told the truth. I know that while at
Savannah, I tabled with the rebel surgeons in the hospital, and that
during all my stay there, nearly six weeks, we had coffee never, tea
only about five or six times, butter about as often; and to the credit
of the surgeons be it said that they denied themselves the luxuries of
tea at $30 to $40 per pound, they had it furnished to our wounded, and
generally fed them better than they fed themselves."' "Surgeon Jeffrey"
was Richard W. Jeffrey, a Virginian and former U.S. Navy surgeon who had
become a Confederate Navy surgeon by February 8, 1862. He was on
"special service" between 1862 and 1863 and was assigned to the Savannah
Naval Hospital in 1864. 11 Confederate Navy hospitals admitted a total
of 1,990 patients, discharged 1,410 patients, and reported the deaths of
69 patients (a death rate of 3.5%) between October 1, 1863, and October
1, 1864 11
Assignment to the
riverine or harbor defense vessels was probably the least sought-after
duty. Often, the young assistant surgeons were sent to these vessels,
although surgeons were assigned to the larger vessels and as fleet
surgeons for the various squadrons. The crews were berthed aboard ship,
and this duty was extremely tedious because there was little activity
against the enemy. It could also be very uncomfortable if the officer
was assigned to one of the ironclads, because these vessels were
extremely hot in the summer and cold and damp in the winter. A berth in
a cruiser was the most active duty against the enemy to which a medical
officer was assigned. Passed assistant surgeons were often detailed to
these vessels. A report dated November 30, 1863, to the Secretary of the
Navy noted that 7 of the 11 passed assistant surgeons were assigned to
cruisers." The long voyages meant separation from family, but at least
there was a sense of accomplishment each time an enemy merchant ship was
taken. Service aboard a cruiser was probably very tedious for the
medical officers, because they had only medical duties. This may have
caused occasional resentment on the line officers' parts, because they
were busy with the ship's functions while the medical officer idled
about. The ship's captain could assign ad hoe duties to the physician.
On one ship, the medical officers were assigned to inspect the ship's
coal after problems were encountered with it. 14
Navy physicians were
also assigned to Army support. (Naval medical officers, like naval line
officers, concurrently held Army rank.) The Chief of OMS was a brigadier
general, fleet surgeons were considered colonels, surgeons were majors,
and assistant surgeons were captains.15 Assistant Surgeon Marcellus P.
Christian, CSN, was on such duty in 1861 when he was assigned to an Army
general hospital in Culpeper, Virginia."
Pay scales for the
naval medical officers varied with rank and sea-duty status. Fleet
surgeons earned $3,300 (Confederate) annually, surgeons between $2,200
and $3,000 depending on seniority and sea duty, and passed assistant
surgeons received $1,500 for shore duty and $1,700 for sea duty.
Assistant surgeons received between $1,050 and $1,250 depending on
seaduty status.4. ' Navy physicians earned less than their Army
counterparts (which undoubtedly caused some friction between the two
groups).
Confederate Navy Physician Uniform:
The basic regulation
uniform for the medical officer was a gray frock coat and gray trousers.
The coat had a black silk lining and two nine-button rows of Navy
buttons. The coat's shoulder straps were made of
one-and-three-eighth-inch-wide black cloth with rank-dependent devices
enclosed by a one-quarterinch-wide gold border. The uniform hat was a
gray kepi-like cap with a one-and-one-quarter-inch-wide gold hat band.
It had rank insignia placed on its front, above the band. Rank was
indicated by sleeve lace, shoulder straps, and cap insignia. The
Confederate Navy recognized three physician ranks: surgeon, passed
assistant surgeon, and assistant surgeon. Surgeons with more than 12
years of experience (service in the U.S. Navy was recognized) had two
one-half-inch strips of gold lace around the coat sleeve cuff. The
shoulder strap device was two crossed gold-embroidered olive leaf sprigs
centered and running the length of the strap. The hat insignia was three
four-tenth-inch-diameter gold-embroidered stars enclosed by a gold
wreath of olive leaves.
Surgeons with less than
12,years of experience wore one strip of one-half-inch lace around the
coat sleeve cuff. The shoulder strap device was one gold-embroidered
olive leaf sprig versus the two authorized for more than 12 years of
service. The hat insignia was two four-tenth-inch-diameter
gold-embroidered stars enclosed by a gold-embroidered wreath of olive
leaves. Passed assistant surgeons wore a strip of one-quarter-inch lace
around their coat cuffs. The passed assistant surgeon's shoulder strap
had a single gold-embroidered olive leaf at each end of the shoulder
strap. The cap device consisted of one gold-embroidered star enclosed by
a gold-embroidered olive wreath.
Assistant surgeons'
coats lacked cuff lace; instead, they wore three buttons along the cuff.
They wore the unadorned shoulder strap described above. The cap device
was a gold-embroidered olive leaf wreath. The quality of the
uniform probably varied with time and place. Those physicians serving
overseas were probably better dressed than their comrades in shore
billets in the Confederacy. There was some variation, but in general
naval medical officers kept to regulations. 17
Disease:
Navy surgeons treated a
wide range of afflictions: colds, yellow fever, malaria, pneumonia,
chilblains, diarrhea, contusions, fractures, lacerations, heat
exhaustion, sunburns, and venereal disease. 18 Malaria was the most
common illness encountered by Confederate Navy personnel."," The disease
rate was high. Confederate Navy medical reports indicated that there
were 6,122 patients treated during a 9-month period in 1863; this is a
significant number considering the highest level of personnel the
Confederate Navy had was 5,203 men in 1864 .2
The Confederacy's James
River Squadron provides an illuminating glimpse of how disease affected
the Confederate Navy. The squadron (in 1864) was composed of seven
vessels and was commanded by Commodore John K. Mitchell, CSN. On August
10, 1864, Mitchell reported that one-third of his men on each of the
squadron's ironclads were on the sick list, which also included half of
his medical officers., The high disease rate forced Mitchell to move the
squadron away from its anchorage, curtail its Army support operations,
and request replacement medical officers (which meant the loss of these
men from their normal duties). 19 Mitchell reported on August 22, 1864,
that 226 of his men were on the sick list (with 157 of them at the
Richmond Naval Hospital). One ship alone reported 61 men ill.' Many of
these James River Squadron men suffered from malaria, for the squadron
was anchored next to a marsh containing plasmodially infected
mosquitoes.
Battle Injuries:
Battle injuries treated
by Confederate Navy medical personnel included gunshot wounds, cutlass
wounds, shrapnel wounds, and bums. Confederate naval casualties for four
engagements were analyzed.' Although the casualty returns varied
considerably in detail and some were incomplete, they provide a general
idea of the combat casualties faced by the medical personnel. During the
four engagements, there were 47 Confederate naval personnel killed, 83
wounded, and 2 missing in action (see Table 111). Among the wounds noted
were 22 patients with lacerations, 7 with contusions, 4 with gunshot
wounds, 4 with bums, 2 with puncture wounds, I with a fracture, and I
with an eye injury. The anatomical distribution of the wounds was as
follows: 24% head and neck, 7% truncal, 38% lower extremities, and 31%
upper extremities. The lower percentage of chest and abdominal wounds
may be attributed to the fact that gun crews were probably crouched down
while working their guns and exposing only their heads, arms, and legs
to shells exploding on the opposite side of the gun. Mechanisms of
injury included 39% from shell explosion, 27% from blunt trauma (e.g.,
being blown down a hatch or against a bulwark by a shell blast), 21 %
from shell fragmentation or wooden splinters, and 12% from bullets.20-13
The interior of an
ironclad during battle was noisy and, in some instances, messy. Fleet
Surgeon Daniel B. Conrad described his perspective of the battle of
Mobile Bay: "You could only hear voices when spoken close to the ear,
and the reverberation was so great that bleeding at the nose was not
infrequent." He also noted the result of the transfer of force from a
large naval shell striking the exterior of the ironclad to human flesh
in contact with the ship's interior: ". .suddenly there was a dull
sounding impact, and at the same instant the men whose backs were
against the shield were split to pieces. I saw their limbs and chests,
severed and mangled, scattered about the deck, their hearts lying near
their bodies. All of the gun's crew and the Admiral were covered from
head to toe with blood, flesh, viscera.... The fragments and members of
the dead men were shoveled up, put in buckets and hammocks, and struck
below. 1114 The results of steamship boiler explosions (whether from
mechanical failure or cannon shot) were a concern to medical officers.
The CSS Chattahoochee's boilers exploded as a result of mechanical
failure in December 1863. The boiler exploded during a shift change, and
escaping steam scalded two entire shifts of the engineering staff and
put the Chattahoochee out of commission.25 A shell striking a boiler
could be catastrophic to both ship and crew. A graphic example of this
occurred during the battle of Albemarle Sound on May 5, 1864. The USS
Sassacus suffered a single strike to a boiler, which caused 20
casualties, 14 of whom were scalded by boiler steam. One man was
instantly killed by the steam, and another five died by the next day as
a result of their burns .26
OMS established a
medical laboratory and a pharmaceutical manufacturing facility in
Richmond, Virginia. Despite the pharmaceutical manufacturing plant, OMS
relied heavily on medicines run through the blockade.
References:
1.
Luraghi R: A History of the Confederate Navy. Annapolis, MD, Naval
Institute Press, 1996.
2. Coski
JM: Capitol Navy: The Men, Ships and Operations of the James River
Squadron. Campbell, CA, Savas Publishing, 1996.
3. Adams
GW: Doctors in Blue. New York, Henry Schuman. 1952.
4.
Cunningham HH: Doctors in Gray: The Confederate Medical Service, Ed 2.
Baton Rouge, Louisiana State University Press, 1960.
5.
Scharf JT: History of the Confederate States Navy. New York, Gramercy
Books, 1996.
6. W.A.W.
Spotswood card. Confederate Navy Index, Library of Virginia, Richmond.
7. Chitwood WR: Doctor Spotswood and the Confederate Navy. VA Med Mon
1976; 728-33.
8.
Report of LT Maffit. In Official Records of the Union and Confederate
Navies in the War of the Rebellion [hereafter cited as ORNI, Series 1,
Vol 2, p 657. Washington, DC, Government Printing Office, 1894 -1921.
9.
Report of Commodore Buchanan. In ORN. Series 1, Vol 7, pp 43-9.
Washington, DC, Government Printing Office, 1894 -1921.
10.
Report on the Office of Medicine and Surgery, April 28, 1864. In ORN,
Series 11, Vol 2, p 647. Washington, DC, Government Printing Office,
1894-1921.
11.
Richard W. Jeffrey card. Confederate Navy Index, Library of Virginia,
Richmond. 12. Report on the Office of Medicine and Surgery, I November,
1864. In ORN, Series 11, Vol 2, pp 758 - 61. Washington, DC, Government
Printing Office, 1894 -1921.
13.
Report on the Office of Medicine and Surgery, 30 November 1863. In ORN,
Series 11, Vol 2, pp 559-61. Washington, DC, Government Printing Office,
1894-1921.
14. Memo
to LT Maffit concerning brown coal. In ORN, Series 1. Vol 2, p 640.
Washington, DC, Government Printing Office, 1894-1921.
15. Bill
for the Reorganization of the Medical Corps of the Confederate States
Navy. In ORN, Series 11, Vol 2, pp 247-8. Washington, DC, Government
Printing Office, 1894-1921.
16.
Military records for MP Christian. National Archives and Records
Administration, Washington, DC.
17. Lord
FA, Wise A: Uniforms of the Civil War. New York, Thomas Yoseloff, 1970.
18. Langley H: A History of Medicine in the Early U.S. Navy. Baltimore,
MD, John Hopkins University Press, 1995.
19.
Report of Commodore Mitchell. In ORN, Series 1, Vol 10. pp 730-1.
Washington, DC, Government Printing Office, 1894 -1921.
20.
Report of Surgeon D. B. Phillips. In ORN, Series 1, Vol 7, p 42.
Washington, DC,
Government Printing Office, 1894-1921.
21.
Campbell RT: Gray Thunder: Exploits of the Confederate States Navy.
Shippensburg, PA, Burd Street Press, 1996.
22.
Report of Fleet Surgeon D. B. Conrad. In ORN, Series 1, Vol 21, pp
578-9. Washington, DC, Government Printing Office, 1894-1921.
23.
Report of Fleet Surgeon W. D. Harrison. In ORN, Series I, Vol 11, pp 688
-9. Washington, DC, Government Printing Office, 1894-1921.
24.
Campbell RT: Southern Thunder: Exploits of the Confederate Navy:
Shippensburg, PA, Burd Street Press, 1996.
25.
Report of LTA. McLaughlin, CSN. In ORN, Series I,Vol 17, pp 871-2.
Washington, DC, Government Printing Office, 1894-1921.
26.
Report of Acting Surgeon Edgar Holden, USN. In ORN, Series 1, Vol 9, pp
742-3. Washington, DC, Government Printing Office, 1894-1921.
27.
Phillips DB: The career of the Merrimac. Southern Bivouac 1887; March:
598608,
28.
Report of Surgeon John A Browne, USN. In ORN, Series I, Vol 3, pp 69-71.
Washington, DC, Government Printing Office, 1894-1921.
Guarantor: John S. Lynch, MSc PA-C
Contributor: John S. Lynch, MSc PA-C
American
Embassy-London, PSC 801 Box 35, FPO AE 09498-4035.
Civil War Federal
Navy Bureau of Medicine and Surgery
