William Starke Rosecrans and U.S. Army Medicine

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.  


20 Responses to “William Starke Rosecrans and U.S. Army Medicine”

  1. Christopher Coleman Says:

    Excellent essay on Rosecrans and the medical service. It sounds to me like more than a blog entry could handle however; sounds like you’ve got a book project there, if you can find a publisher. Maybe the museum of Civil War medicine could help you.

    • Dave Powell Says:


      Well, a book might be a bit much, but there’s a solid essay in there. The Rosecrans papers would need to be examined, as well as the Dept of West Virginia records at the Archives, at the very least. I saw some stuff on the Museum’s website that indicated they might have source material as well.

      • Ken Ramsey Says:

        Dave – Quite interesting. Think an essay would fit naturally in Steve Woodworth’s ongoing set of studies on the various western battles. A study like this would fit in a Stone’s River book given the emphasis on Rosecrans. Might be a way of making some specific “in action” points about the care of the wounded in that battle.

      • Dave Powell Says:

        Ken, I think there is room for an essay here, but as noted, I need to run down some details. Dave

  2. Chris Evans Says:

    Fascinating essay.

    Neat to see the Union perspective on this as the Confederate one was so well covered in the book ‘Confederate Hospitals on the Move: Samuel H. Stout and the Army of Tennessee’ by Glenna R. Schroeder-Lein.

    Behind the scenes stuff like this is always interesting. Its always a wonder they kept these huge armies in the field somehow.


  3. Don Hallstrom Says:

    Hello Dave
    You don’t need to publish this, but in the future could you give us an update on your book for SB? Is it going to be two volumes? When do you think it will be published? If it is multi-volume, I’m asssuming the volumes would be published one at a time?

    What do you think of the current trend of seeing more and more published on the western theater? Earl Hess seems to be focussed on this and there are many other authors starting to publish material? Have you heard of anything in the works that you are looking forward to?

    Regards and Happy Holidays
    Don Hallstrom

    • Dave Powell Says:

      Don, We are still projecting two volumes, with at least the first volume due out this year. Tentatively, pending Publisher approval, I hope to call it “A Mad Irregular Battle.” Since I have essentially finished both books, the second could follow relatively quickly – again, all based on publisher approval. I am reading Ear Hess’s East Tennessee volume right now, and enjoying it. I was a little disappointed that he started his narrative with Longstreet, providing only a quick overview of Burnside’s initial invasion, but still, the book is very good. As you might expect, the Union efforts to fortify Knoxville get a lot of coverage. He is also kinder to Longstreet than most historians who cover the period, pointing out the huge logistical problems Longstreet faced during the campaign, which I think has merit. Hess intends to cover Atlanta as well, I think, so I look forward to that. Dave Powell

  4. John Foskett Says:

    An excellent essay on an important subject that has gotten little to no attention. Thanks for this. There are still so many aspects of the western theater that have been ignored – a wide range of opportunities for interested scholars. My own fixation is on the glaring lack of a narrative focused on Union artillery in the western armies along the lines of Naisawald/Wise/Daniel. I know of one scholar who’s thought of this but had to abandon it in favor of other projects There’s also a dearth of unit histories, biographies, and individual battle studies pertaining to Yankee artillery out there. But I’ll certainly settle for some good material on the gunners at Chickamuaga in the forthcoming two volumes.

    • Chris Evans Says:

      Yes, Union Artillery in the Western Theater has been overlooked in book form.

      Since there has been such a dearth of it that my favorites that I can think off the top of my head is the early unit history ‘Behind the Guns: The History of Battery I, 2nd Regiment, Illinois Light Artillery’ that is still in print and the excellent ‘Chicago’s Battery Boys: The Chicago Mercantile Battery in the Civil War’s Western Theater’ by Richard Brady Williams that was put out by Savas in ’05.

      I wish there would be something along the lines of Hughes’ wonderful book on the Washington Artillery in the Army of Tennessee for a unit from the Army of the Cumberland.


  5. John Foskett Says:

    Chris: It says something that those are the only two unit histories which came to my mind, as well. The only recent addition to the library is last year’s collection of articles originally written by John C. Tidball in the 1890’s. He discusses the use of artillery at Shiloh, Stones River, and Chickamauga, as well as the usual eastern fights. There’s a lot of open ground for the right scholar to cover.

    • Chris Evans Says:

      Another artillery unit history from the Western theater I’ve recently come across and found interesting is from 1975 ‘Yankee Artillerymen: Through the Civil War With Eli Lilly’s Indiana Battery’ by John W. Rowell from UT Press.

      I recommend it but finding a copy is easier said than done.


      • Nathan Towne Says:


        There are however, quite a few contemporary unit histories. I don’t know if you have a copy of Henry M. Davidson’s “History of Battery A: First Regiment of Ohio Vol. Light Artillery,” published by the Daily Wisconsin Steam printing House in 1865. I initially got a copy for the account of the Franklin-Nashville campaign. Bat. A. 1st Ohio light served in Cpt. Lyman Bridges, IV corps artillery in the Tennessee campaign and were stationed on the re-trenchment line at Franklin.

        During the Murfreesboro campaign and the Chickamauga campaign Bat. A. 1st Ohio light was attached to August Willich’s brigade, Richard Johnson’s division, XX corps. In fact, they almost lost the entire battery at Murfreesboro to McCown’s division. He has quite of an account of the units service.

        You should get a copy if you do not already have one.

        Nathan Towne

  6. Nathan Towne Says:

    I agree with Chris, Glenna Schroeder-Lein’s books are fantastic and I would love to see more focus on the medical intricacies within the Army of the Cumberland, although a difficult topic as it is still so unexplored.

    I actually have an interesting interpretative question for you Dave, being that you are fishing around for topics for blog posts. That is an analysis of Rosecrans and Crittenden’s working relationship. I just read Larry Daniel’s new Murfreesboro study and Cozzens study from 1990 back to back and one interesting discrepancy is how Rosecrans and Crittenden’s professional and personal relationship with one another is presented. Larry Daniel presents a much more critical portrait emphasizing Crittenden’s post campaign testimony to the Commitee on the conduct of the War whereas Cozzens presents their relationship as being much more amicable.

    With William Lamers bio from 1961 the only Rosecrans biography in existence worth mentioning and no adequate study of Crittenden to speak of, I thought it may be an interesting topic for a blog post. Honestly, although I aware of Crittenden’s post Murfreesboro criticisms of Rosecrans, I always thought they had a very cordial and respectable working relationship. Daniel’s interpretation is new to me, but he presents some personal correspondence as well that is quite critical of Rosecans. Thoughts?

    • Dave Powell Says:

      Nathan, I have been struggling for some time to figure out Crittenden, and by extension, the relationship between Crittenden and Rosecrans. I think Rosecrans liked Crittenden better than Crittenden liked Rosecrans, for what it is worth. Crittenden’s military career has some highlights, and I think he did well at Chickamauga. I also find it interesting that he was offered a command under Burnside in Virginia in 1864, though that situation was not without its own complications. So far, Larry Daniel’s exploration of the topic remains the most detailed, but I would like to probe further. Dave Powell

      • Nathan Towne Says:


        Crittenden has done quite poorly in (especially modern) historiography which makes it a little bit more problematic to fully grasp him. I initially accepted the stereotype of him and McCook both being very mediocre officers who never garnered Rosecrans trust, like Thomas did, which is really unfortunate because as I have studied the Western theater much more intently over the last five or so years, I have come to really admire Crittenden. He was certainly the superior officer to McCook. His relationship with Rosecrans has really sparked my interest recently however.

        Nathan Towne

      • Nathan Towne Says:


        By the way, have you had a chance to look at the new Fanebust bio of McCook? It is a little expensive and seems to have gone largely unnoticed by the Civil War community. McCook was a complicated man and his life deserves a great treatment but I have literally seen no feedback on the book.


        Nathan Towne

      • Dave Powell Says:

        Nathan, I have only been able to look at the McCook bio on Amazon, examining footnotes, biblio, etc. The book is by McFarland’s, and I don’t have anything else by that author, so I am cautious about ordering it. I have found some books from that publisher to be pretty thin on research and writing. I did note that in the footnotes, he did not make a lot of use of the McCook papers in the library of congress, which I found somewhat odd. Dave

      • Chris Evans Says:

        I’m sure you have already read it Dave but in the great unit history ‘Mother, May You Never See the Sights I Have Seen: The Fifty-Seventh Massachusetts Veteran Volunteers in the Army of the Potomac, 1864-1865’ by Warren Wilkinson there are some tantalizing references and comments on Crittenden and his time in the Eastern Theater with the Ninth Corps.


      • Dave Powell Says:

        Chris, I haven’t seen that. I will check it out. Dave

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