Archive for December, 2012

William Starke Rosecrans and U.S. Army Medicine

December 11, 2012

I have been quiet here of late. I do have some interesting ideas for essays on the blog, but frankly, each of those ideas are still more question than answer right now.

I have decided to go ahead and discuss these ideas, with the idea of revisiting them later, as I eventually run down loose ends. the first of these has to do with medical affairs.

 

William Starke Rosecrans was an inventor and tinkerer at heart, as much as he was a soldier. This extended to all aspects of improving the soldier’s lot in life, including health care.  As early as the First Battle of Bull Run, it became obvious that the existing medical services for treating casualties were going to be an abysmal failure. The influx of masses of volunteers also created masses of sick men who had to be cared for, and the army lacked doctors, nurses, hospitals, supplies -you name it, they needed it.

Within the space of a year, two men played a huge role in not just modernizing the U.S. Army Medical Service, but revolutionizing it. These men were Dr. Jonathan A. Letterman and First Lieutenant William A. Hammond.

Letterman is the name most often associated with medical department reforms, and usually in the context of the Army of the Potomac. It was Letterman who was appointed Medical Director of that army in June, 1862, with a commission as Major. He reported to George B. McClellan, on June 19th, and set to work with a will. The Army of the Potomac was then on the Peninsula, and suffering severely from disease in that swampy, low-lying region. Letterman implemented better hospitals and helped improve the condition of the army.

Letterman’s main claim to fame, however, came later as he created what amounted to a modern system of rapid battlefield treatment and casualty evacuation. First used at Antietam, the Letterman system proved far more effective than anything that had come before. Letterman’s name is most commonly associated with Gettysburg, and the hospital complex known as Camp Letterman, out on York Road east of town.

Letterman did not accomplish all this singlehandedly, however. The man behind his success was William Hammond. Hammond, as noted, was a mere First Lieutenant in April, 1862, serving under Rosecrans in the Department of Western Virginia as a medical inspector for the department. Hammond, a former medical officer in the peacetime army who resigned to join the teaching faculty at the University of Maryland Medical School in 1860. With the war, naturally, he returned to uniform. In 1861 he was overseeing several army hospitals in Maryland, where he attracted favorable notice from the newly organized United States Sanitary Commission. This notice in turn put Hammond at odds with the existing Surgeon General of the army, Clement A. Finley, who was not in the good graces of the USSC. Hammond was consigned to West Virginia to serve under Rosecrans.

This transfer turned out to be fortuitous for Hammond, Letterman, and the tens of thousands of sick and wounded soldiers who ultimately owed their lives to Letterman’s new system.

Why? Because Letterman was already serving in West Virginia, acting as the departmental Medical Director under Rosecrans.  Letterman, Hammond and Rosecrans all shared the common traits of energy, enthusiasm, and inventiveness. Though the three men only served together for a few months in early 1862, they began the process of developing the very changes that would eventually become Letterman’s system of field dressing stations, divisional aid stations, and general hospitals. Rosecrans authorized the establishment of a new hospital at Parkersburg West Virginia, and also became involved in designing a new, lighter ambulance for field use.

The Rosecrans, or Wheeling pattern Ambulance, as it came to be known, supplanted other designs then in use, including a two-wheeled design crafted by Clement Finley.  It had four wheels instead of two, for stability, and yet was much lighter than other four-wheel carts then in use. It could be pulled by two horses, and accommodate four wounded on stretchers, or up to a dozen men seated.

In one of the most drastic rank jumps of the war, First Lieutenant Hammond was summoned back to Washington, where he discovered he was being promoted to Brigadier General and given Finley’s job as Surgeon General. The promotion came at the hands of Lincoln himself, instigated by the politicking of the Sanitary Commission, who’s ranks included a number of prominent citizens who desired nothing more than to see Finley gone.

Thus is was Hammond who in turn promoted Letterman and sent him to McClellan. When Letterman in turned asked for 1,000 tents and 200 more ambulances be sent to the Peninsula, the newly redesigned ambulance was included in the mix.

Not everything progressed smoothly, however. Hammond’s selection was opposed by Edwin M. Stanton, in part because of Hammond’s association with and enthusiastic endorsement by Rosecrans. When Rosecrans’s department was given to John C. Fremont that same spring, Rosecrans served for a time in Washington and voiced his disagreement over the way the Valley Campaign against Stonewall Jackson was being conducted, which meant Rosecrans was often criticizing Stanton’s own strategies and ideas.

In 1863, things came to a head between Hammond and Secretary Stanton, who relieved him and sent him to New Orleans, ostensibly for improper allocation of funds. Hammond demanded a court-martial, which convicted him, based on suspect evidence presented by   Stanton. Letterman also  left the army in 1864 to move on to other things. The changes wrought by both men, however, were permanent, confirmed into law by the Congress that same year.

Would Letterman and Hammond had such a profound impact on the United States Army Medical Department had they not both served together under Rosecrans in West Virginia? It’s likely they would certainly have initiated some sort of change, but how lasting would it have been? Rosecrans, however, was one of the most forward-thinking and innovative commanders in the Union army, always willing to find ways to improve things. It is typical of his leadership style that not only did Hammond and Letterman meet , but they were allowed to experiment, and as the new Ambulance design showed, Rosecrans was right there with them.

The Army of the Cumberland would fully embrace the Letterman system.  Sick and wounded were cared for at spacious hospitals in Nashville, Louisville, and New Albany Indiana; all easily accessible from the rail lines that were the army’s lifeline. Rosecrans’s interest in ambulances would extend to ordering the fitting out of hospital railcars with adaptations like rubber slings to carry stretchers, saving the men in them the agony of the jolts of the journey. Letterman’s concept of field dressing stations and divisional field hospitals was fully executed, and properly outfitted. As in other areas of innovation and improvement, forces commanded by Rosecrans were quick to embrace and fully implement these changes, something not always true in civil war armies.

After the war, the authors of The Medical and Surgical History of the War of the Rebellion (Part III, Vol. II, p. 962) would note that “it was in General George H. Thomas’s Army of the Cumberland…its long line of communications extending hundreds of miles…that the utility of railway transport in relieving the army of its disabled men was most conspicuous.”  The first of these trains was fitted out in Nashville in early 1863 by the Western Sanitary Commission, with Rosecrans’s enthusiastic support, and by the time of the Atlanta campaign three such trains were in operation. Each train consisted of about a dozen ambulance cars, and included one car fitted out as a kitchen.

I still have unanswered questions, however. How much day-to-day influence did Rosecrans actually have on these two men? How much of the hands-on process of new hospitals, new ambulances, and centralized field stations was  due to Rosecrans’s ideas, and did he discuss more comprehensive reforms with Letterman and Hammond? Existing published sources on this particular aspect of the war and the medical system are scarce, meaning that at some point, only archival research will likely produce deeper insight.  

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