Nursing and Medicine of the Civil War

On April 12, 1861 in Fort Sumter, SC Confederate troops fired the first shots of the Four Year American Civil War. After the first few battles were fought, both sides faced the realization of how they desperately needed doctors and nurses to care for the injured soldiers. (1) The first nurses were recuperating soldiers (rebel) however; their own illnesses prevented them from providing proper care or returning to full military duties. These soldiers resented being appointed hospital duty.

(2) Within thirty days after the call of 75,000 men by President Abraham Lincoln, the Women’s Central Association of New York chose 100 women to be trained by surgeons and physicians of New York as nurses in an army hospital. (3) In the South, women organized volunteer groups such as the Ladies Soldiers Relief Society and the Association for Relief of Maimed Soldiers. (2) The Union organized official Women’s Nursing Bureau. This agency attempted to organize numerous unpaid nursing volunteers and after much effort obtain regular salary for these women.

In the South, organizations assisted soldiers of their communities such as the Ladies Aid Society of Montgomery which later became the Ladies Aid Society of Alabama which provided aid to the Alabama Division of the Chimborazo Hospital. (L) At the outbreak of the war, the nursing profession was in its infancy. Men dominated over women as females were usually “too frail to cope with rigors of sick. Military and societal protocol banned women from field hospitals so duties were assigned to men.

However due to increasing casualties the gender wall was soon broke down. Many field hospitals were not available in some cities therefore; women volunteers took soldiers into their homes. As these women set up these hospitals in their homes, they cleaned wounds, performed minor surgeries, administered treatment and performed hard physical labor. The working conditions were not the greatest. The conditions were often times deplorable and infections and disease ran rampart in the wards. Cleanliness was unheard of in the civil war hospitals. Often times there

was a pungent smell of human waste, unwashed bodies and gangrenous wounds were intolerable to overpower even healthy men. The nurses would use camphor soaked cotton balls to avoid the smells. 2) The women of the households were considered “nurses” in their own rights due to tending to the sick of their own families and neighbors and this act was considered a woman’s duty. Women of the time were not allowed in medical colleges due to the medical field was considered to be the domain of men. (4) The civil war became the awakening of women in the field of medicine and helped fuel the women’s rights movements.

(5) Staffing in many of the hospitals represented all levels of southern society: wealthy white men – surgeons, middle class merchants – apothecaries, skilled workers – detailed enlisted men, respectable ladies – matrons, free blacks and hired slaves – nurses, laundresses and cooks. Female nurses came from all walks of life. (6) Confederate women were enthusiastic about volunteering for service in 1861. (7) Being a nurse in the South was not considered an acceptable profession, females were considered to be too delicate and weak. Confederate nurses made great contributions with little or no training.

(8) These women quickly dispelled the myth of Southern women being fragile and timid. In the conservative south, there was as a widespread feeling that a military hospital was no place for a lady. Elite volunteers were reserved for prized matron jobs. (9) The Confederate government formalized hiring of women in September 1862 and their pay scale ranged from $30-45 per month for chiefs, assistants and ward matrons. (10) As many as 3200 females would serve as salaried nurses and many more gave aid and relief to soldiers on a voluntary basis.

Women specifically served in three capacities: First – Vivandieres, this deriving from the Napoleon campaign, in the Civil War it lost its romanticized meaning and virtually meant any kind of military support. Many wives and daughters of the Union or Confederate volunteer regiments were involved. These women were not officially recognized by either side. Second- These women organized societies for relief such as the Sanitary Commission and third – they established relief stations which were hospitals in their homes or donated buildings.

(11) One of the first nurses to see battle injuries was Ms. Fannie Beers who described the arrival of the first 200 soldiers at a makeshift hospital “they came with some form of disease whether on foot or stretcher, barefoot or on swollen feet”. (12) The battlefront hospitals were only that of open area sites with conditions anything but sanitary, with blood, human waste and amputated limbs covering the ground. The first battle women encountered was with their selves. Only their strong religious faith steeled them against sickening sights of disease and infection.

These nurses learned to rein in their feelings and believed patients redemption hallowed their work. These early nurses were quickly educated on the rigors of war and the primitive accommodations. Hundreds of women lasted little more than a month and for those that did last the work became gratifying and their Christian mission. At the bloodiest moments of the war, nurses braved heat of moment and offered selflessly to treat injured. These ladies were much liked by the patients and were not so much nurses as mother-substitutes. Many perceived women’s arrival as an intrusion.

Others welcomed the women and acknowledged their skill as moral boosters. (13) Nursing for the sick and wounded was one way for women to prove themselves during the war. They volunteered not expecting pay, some were sent by local agencies and others followed their husbands, fathers or sons. There was a belief they would be a nuisance and get in the way. Others worried these women would lose their moral statue and become vulgar beings. (14) Poor sanitation, poorly cooked food and the open nature of the hospital caused soldiers to have severe illnesses throughout the war.

Some classifications of their illnesses were 1- Gastrointestinal, which was most common, 2- dietary deficiencies, 3- fevers, 4- pulmonary disorder, and 5- skin irritations. Small pox was a large problem. Several life threatening infections threatened wounded soldiers. Physicians, nurses and patients learned to fear early characteristics of four most feared infections: 1- Gangrene – greatest threat, 2- Erysipelas, 3- Pyemia, and 4- Tetanus. (15) The feminine touch revolutionized the care of the sick and maimed.

(e) Three distinct purposes for these nurses were first, to regulate, prepare and serve meals, second, manage physical needs of patients and distribute linens, clothing, and supplies and third, care for emotional and spiritual needs of patients such as helping them write letters home and read them letters received from home. (q) These ladies bandaged wounds, gave medicines, sang songs and wiped the sweat from brows of dying boys. (e) When the women were present, surgeons could leave domestic details to them and the hospitals were cleaner and the soldier’s hygiene was taken more seriously.

(13) Surgeons were vexed by nurse’s use of home remedies and nurses were vexed by surgeon’s dependence on whiskey. Whiskey was used in lieu of chloroform to anesthetize patients and intoxicate themselves. One famous nurse, Phoebe Yates Pember, waged war with the Chimborazo surgeons over the control of the whiskey. Liquors and other luxuries belong to the Matron’s department. One doctor stated liquor was exclusively for the use of the patients and was only to be used through a prescription with a written order. The officer of the day would order a quart of whiskey to be on hand for use during the night.

Nurses refused to let patients go under the knife if they felt amputation was unwarranted. Other than whiskey different drugs were used during this time to fight infections or pain relief. Quinine (often times called the Wonder Drug) and/or turpentine were used for malaria, while sulfur, arsenic or alkaline baths were used for skin irritations. Three very strong medications were used for pain relief, such as, Opium, Morphine or Dover’s powder. To fight off infections the nurses and doctors of the time would use whiskey, brandy or a muriated tincture of iron.

(17) Nurses would more often than not pour the whiskey and brandy into the wound to kill the germs. Chloroform was the number one anesthetic used throughout the Civil War; ether was also used as an anesthetic. Above all, Whiskey was “for whatever ails ya. ” The South had a real problem obtaining medicine after the Naval Blockade began to tighten in early 1862. Most times drugs were smuggled across state lines in trade for cotton. The Confederacy had to result to unusual methods of treatment. Astringents were often made from bearberry, marsh rosemary, sumac and white oak leaves and bark.

Tonics were made from dogwoods, persimmon trees, American Colombo’s, American gentian, hop, Georgia bark, wild cherry’s and many other trees. (18) For the treatment of gangrene, maggots were deposited onto the decaying matter or decaying flesh. One of the most effectual Civil War nurses had to be Ms. Sally Louisa Tompkins. Ms. Sally was the granddaughter of Col. John Patterson was the hero of the Battle of Monmouth of the Revolutionary War. At the beginning of the War she secured the residence of Judge John Robertson at her own expense and maintained it as a hospital.

From August 1861 to April 1865, there were 1333 admissions and only 73 deaths in her institution. Jefferson Davis named her Captain of the Confederate Service after she fought to keep her hospital open. Tompkins was the only female to be commissioned by the Army. Two months after the war ended in June 1865 the hospital closed its doors. Tompkins died on June 25, 1916 and was buried with military honors. (19) Kate Cumming was one of the most devoted nurses of the Civil War. At the beginning of the war, she collected blankets and supplies for Confederate Troops as she saw many of her childhood friends leaving for war.

The reality of the conflict was overwhelming to Cumming. She stated “Nothing that I had ever heard or read had given me the faintest idea of the horrors witnessed here. ” (20) On October 9, 1861, Surgeon General S. P. Moore ordered Dr. James Brown McCaw to organize and direct hospital which was named Chimborazo Hospital after the popular name for Virginia plateau on which it would stand. Chimborazo Hospital was the largest hospital in the South in Richmond, Va. , overlooking the James River, with 150 wards with 76,000 men treated. At the time it was the largest military facility in the world.

The hospital included a farm, a natural spring, a herd of livestock, outer buildings for preparing meals and storing food and supplies. (21) Ms. Phoebe Yates Pember was the matron of the Confederate’s largest hospital, Chimborazo Hospital. In the beginning of the war, Pember spent much of her time as an administrator, ordering supplies, supervising the meals and charging over the whiskey. As the war increased she spent more of her time caring for the wounded. After finishing her work at Chimborazo, she returned to Georgia and wrote “A Southern Women’s Story in 1879.

(22) Ms. Clara Barton, after the Battle of Bull Run, established an agency to obtain and distribute supplies to wounded soldiers. At the end of the war, she helped identify 13,000 unknown Union soldiers dead at a POW camp in Andersonville, Georgia. She launched a campaign to identify soldiers missing during the Civil War where she then published their names in newspapers and exchanged letters with veterans and soldier’s families. (23) Ms. Barton later become the founder of Red Cross which brought supplies and help to the battlefront. In April 1861, Ms.

Dorothea Dix assembled a group of volunteer nurses and staged a march on Washington. At this march they demanded the government to recognize their desire to aid Union’s wounded. This march was nationally known as the “Crusade”. Ms. Dix who was quickly appointed by the Secretary of War as the Superintendent of Nurses where she was vested with the full power to appoint army nurses in hospitals. (24) Ms. Dix was no nonsense, quirky leader. Ms. Dorothea was responsible for establishing what the nurse’s uniform was to look like, dark garments, so as not to show dirt or more importantly the blood.

These women carved a niche in nursing proving a woman’s compassion and strength need not be confined to home and family. They served their country in a time of need but in the end were ushered out gaining no recognition and no war memorials. In both armies, the greatest heroes were not those that died at the cannon’s mouth, but those who endured the lingering agonies of the sick and wounded. Civil War nurses belong in history because despite seeing blood, decaying flesh and other gruesome sights they went about their jobs in a selfless manner.

Nurses of the Civil War left a heritage far beyond the countries gratitude for bodies salvaged and spirits renewed. The story of their service and their memory will ever live in the hearts of veterans they nursed as “Angels of Mercy”. END NOTES 1) Lesli J. Favor, PhD, Women Doctors and Nurses of Civil War, (New York, The Rosen Publishing Group, Inc. ; 2004) pg 5 2) Maggie MacLean, www. civilwarwomen. com, Civil War Women, 2006 3) Mary Gardner Holland, Our Army Nurses – Stories of Women in the Civil War, (Roseville, Mn, Edinborough Press; 1998) pg. 1 4) Favor, pg. 6 5) Favor, pg. 8

6) Carol C Green, Chimborazo – The Confederacy’s Largest Hospital, (Knoxville, University of Tennessee Press,2004) pg. 19 7) Jane E. Schultz, Women at the Front – Hospital Workers in Civil War America, (Chapel Hill & London, University of North Carolina Press, 2004) pg. 17 8) Larry Eggleston, Women in the Civil War, (Jefferson, NC & London, McFarland and Co, Inc. ; 2003) pg 177 9) Schultz, pg 17 10) Schultz, pg 40 11) Michael A Flannery, Civil War Pharmacy – History of Drugs, Drug Supply and Provision and Therapeutics for the Union and Confederacy, (New York, The Haworth Press; 2004) pg 50 12) Favor, pg. 5 13) Schultz, pg 123-12414).

Female Nurses of the Civil War, www. cwnurses. tripod. com, 2002 15) Carol G. Green, Chimborazo – The Confederacy’s Largest Hospital, (University of Tennessee Press, Knoxville; 2004) pg. 120-121 16) Pember, Phoebe Yates, Southern Women’s Story, (New York, G. W. Carleton & CO. , London, 1879), pg 31 17) Green, pg. 123 18) Robert E Denney, Civil War Medicine-Care and Comfort of the Wounded, (Sterling Publishing Co, New York, 1994) pg 11 19) Favor, pg 73-81 20) Favor, pg 82-89 21) Favor, pg 23 22) Walter Sullivan, The War the Women Lived, (J. S. Sanders & Co. , Nashville, Tn, 1995) pg 63 23) Holland, pg 1.

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