Civil War Navy and Medicine
...e war began to only 208 percent and 245 volunteer officers (US Navy 112). The Confederate Navy fared even worse--only 107 medical officers served during the entire war: 26 surgeons, 13 passed assistant surgeons, 63 assistant surgeons and five "assistant surgeons for the war” (Still 55). By comparison, the Confederate Army had 3,237 medical officers, while the Union Army had more than 11,000 doctors on its payroll. In addition to the medical officers, there were also petty officers (known as surgeon's stewards) who filled the same niche as noncommissioned officers (known as hospital stewards) did in the Army. Surgeon's stewards mixed and dispensed medicines, helped surgeons during operations and assisted in tending to the patients. Their pay ranged from $25 to $40 a month, depending on their ratings. Naval hospitals also used civilian employees, such as matrons, nurses, cooks, watchmen and gardeners (Still 101). The Union Navy's medical service was officially called the Bureau of Medicine and Surgery. The bureau was established in 1842, although surgeons had been appointed for American naval vessels since the Revolution. The bureau's chief surgeon during the Civil War was William Whelan, who had been a medical officer since 1828 and chief of the bureau since 1853. Whelan served until his death in 1865. Phineas J. Horwitz, Whelan's assistant chief, took over the post on July 1, 1865. Ranking below the bureau chiefs and assistant chiefs were the fleet surgeons, who supervised all the medical officers of the squadron. They also on occasion inspected the medical officers and facilities of the ships. Communications and reports from the officers to Washington went through the fleet surgeons, who had to examine and approve all requisitions for medical supplies. They were also expected to recommend ways to prevent outbreaks of sickness and to improve the comfort of the sick and wounded. A fleet surgeon could suggest a change of climate or diet for a vessel's crew when the health of the men sufficiently interfered with their performance (US Navy 205). The post of fleet surgeon could occasionally be dangerous. Fleet Surgeon Jonathan M. Foltz served with Flag Officer David G. Farragut's vessels of the West Gulf Blockading Squadron during their operations against New Orleans. Foltz was distributing medicines to the vessels of Commander David D. Porter's mortar flotilla in April 1862 when his boat was nearly swamped by a gale. Foltz also came under fire from Confederate soldiers on shore. Once, a Rebel bullet cut the tiller ropes that Foltz was holding (Hearn 35). The Confederate Navy patterned its medical service after that of the U.S. Navy. The Confederate Navy's Office of Medicine and Surgery was run by its chief surgeon, W.A.W. Spotswood. Spotswood had been a medical officer in the old Navy from 1828 until his resignation early in 1861. One account described him as a "brawny, gray-haired six-footer, rough and ready in ways and looks, but a gentle-hearted man." The medical service of the Confederate Navy had to be built from scratch, but it was helped by one of the Union Navy's problems--the resignations of Southern naval surgeons when the war began (Still 35). Almost a quarter of the medical officers of the U.S. Navy resigned or was dismissed for suspected disloyalty in 1861. Because the U.S. Navy was scattered around the world in several different squadrons, it took months to get its vessels back into American waters. Surgeon W.D. Harrison, who was on a protracted cruise in a Federal war vessel on the coast of Africa, remained in the Federal service until his ship returned to the United States early in 1863. Harrison then resigned his commission and joined the Confederate Navy (Still 88). Sailors faced weeks or months of monotonous, uncomfortable living, often with stale or spoiled rations and foul drinking water. In one way, though, their lives were better than those of most Civil War soldiers. Because of the sailors' isolation at sea, land-based epidemics and communicable diseases did not reach them. The Confederate raider Alabama, during her nearly two years at sea, reported no deaths due to disease. Such a record for an army unit would have been quite remarkable. Alabama's surgeon, Dr. Francis L. Galt, had time to double as the vessel's paymaster during its cruise. Scurvy, once the "scourge of the sea," (US Navy 225) was no longer much of a threat for sailors. The symptoms of scurvy included, according to one old-time naval surgeon, "hemorrhages, livid spots under the skin, swollen, spongy, and inflamed gums, and general debility, not necessarily accompanied by fever” (US Navy 226). Scurvy was caused by a lack of vitamin C and was readily cured by adding "antiscorbutics" such as citrus fruits or fresh vegetables to the men's diet. There were still occasional outbreaks of scurvy in the Civil War navies, usually because of poor logistical planning for isolated vessels that had not had a chance to replenish their supplies of flesh fruits and vegetables (Pierson 8). The Civil War, however, presented the navies with new health problems during their fighting and patrolling on rivers and sounds. Freshwater assignments exposed sailors to mosquito-carried malaria and yellow fever, as well as diseases caused by drinking contaminated river water. William Maxwell Wood, the fleet surgeon of the North Atlantic Blockading Squadron, warned in 1862 that outbreaks of diarrhea, dysentery and typhoid fever were expected for the men of the James River Flotilla. Wood graphically pointed out that the James was "the only sewer of the Army of 90,000 to 100,000 men” (Quarstein 28). He recommended that the sailors drink only "condensed" water, using the boilers of the steam engines to provide pure distilled drinking water. Some steamers could derive enough drinking water simply by using a drip pipe from the safety valve. Even with such precautions, sick rates for vessels in river squadrons were much higher than those for ships operating in salt water. (Quarstein 35-36). Another new and potentially harmful environment was that of the damp, poorly ventilated ironclad gunboat. These new vessels were regarded with fear and suspicion by many of the enlisted men. Assistant surgeon Francis Minot Weld, newly transferred to the Union ironclad Nantucket, found himself besieged with crewmen afflicted with all sorts of alleged maladies. Weld realized immediately that all the men were faking their complaints in order to get transferred off the ironclad to a traditional vessel. Despite these fears and the real discomforts of serving aboard ironclads, statistics compiled by the Bureau of Medicine and Surgery showed that the crews of the ironclads had fewer health problems, lost sick days and disease deaths than those serving on traditional wooden ships (Judence 21-23). A committee of Confederate naval surgeons had several suggestions for improving the health of the crews aboard their ironclads on the James River in 1864. They were concerned to find the men sometimes "employed on boat duty without awnings, a fruitful some of fever and other sickness" and noted that the heat from the ironclads' galleys "is sufficient to render the portion of the berth decks assigned to the crew quite uninhabitable” (Still 62). The surgeons recommended that the fleet anchor at a place where the prevailing winds did not blow across marshes, that the air apparatus of the ironclads be kept open, that the men be allowed exercise on shore, and that salt and fresh provisions be served on alternate days. The sailors would have appreciated particularly their final suggestion that "the whiskey ration be issued to the men with hot coffee every morning.” (Hearn, Farragut 44). Aboard ship, the surgeon each day divided the sick into two lists. The "sick list" included only the most serious cases. Mildly sick men were put on the "binnacle list," so-called because it was deposited in a drawer in the ship's binnacle (the stand that housed the ship's compass). Men on the binnacle list were excused from duty, but they were not allowed to take up the limited airspace of the sick bay except when being examined or receiving medicine (US Navy 77-78). The ship's surgeon was also required to examine the entire crew when they boarded the vessel on a new cruise, keep detailed patient records and fill out death certificates and certificates of disability. He was responsible for seeing that the men in the sick bay were clean, properly fed and given the necessary medicines. The surgeon was also supposed to notify the captain of any threats to the health of the crew and recommend measures necessary to solve these problems, such as requiring that they be vaccinated. Additionally, he was required to examine all "bumboats," civilian vessels that sold food and drink to the sailors, and report any potential health problems (US Navy 98-99). Assistant and passed assistant surgeons helped the surgeon carry out his duties, with special emphasis on seeing to the mixture and distribution of medicine. They took over when surgeons were absent, and many served as the only medical officers on small vessels that did not rate a surgeon. Medicines and medical supplies for the Union Navy were prepared at the Naval Laboratory in New York. The Naval Laboratory had been established to serve the small prewar Navy in 1853. With only two officers and four men working in an unoccupied wing of the naval hospital at New York, the laboratory bought raw materials and made much of the medicine used for the Navy. The laboratory also shipped medical supplies for the hundreds of Union ships, as well as for the naval hospitals on land. (US Navy 46-47). Much of the medicine for the Confederate Navy was manufactured by the Medical Purveyor's Department, which was run by an apothecary named Robert Leckie. The department had only three employees, who were responsible not only for making, packing and shipping all medicine and medical supplies but also for actually taking them to distant naval hospitals. More medicine and supplies were brought in through the blockade (Still 115). Chief Surgeon Spotswood made sure that the Confederate Navy's hospitals were well-provided with clean and comfortable bedding, blankets, furniture, crockery and other items by taking advantage of auction sales and by employing an upholsterer to remodel and renovate beds. At this time, coffee was thought to have medical uses (Still 116-117). A Confederate naval surgeon's report recommended that sailors get hot coffee with their breakfast early each morning, before they began their day's work, "as a means of counteracting the effects of the damp and chilling drafts so prevalent on all freshwater courses and malarial regions at the dawn of day” (Still 82). When the Union Navy abolished the traditional liquor ration in 1862, a medical report recommended replacing whiskey with, “servings of coffee, either hot or iced, which would serve just as well as a stimulant” (US Navy 28). When a vessel went into battle, the surgeon set up a temporary operating room. Usually, the surgeon took over the wardroom, converting the officers' dining table into an operating table and the buffet into a stand to hold surgical instruments and medical supplies. One can only wonder today what such activities in the dining area did to the officers' appetites. Medical officers did not always have the luxury of time to prepare for a battle. Acting assistant surgeon W.H. Pierson was serving on USS Water Witch when that vessel, at anchor in Ossabaw Sound, Ga., was captured in a surprise attack by a raiding party of Confederate sailors and soldiers on June 3, 1864. Pierson was asleep when Rebels from several small boats rushed aboard Water Witch in the pre-dawn darkness. Awakened by the firing, Pierson had just pulled on his pants and boots when the first wounded shipmates limped into the wardroom.” Having pocket case, lint, and bandages at hand," wrote Pierson, "I dressed these wounds on the spot. Then followed a rapid succession of wounded, some of whom I attended in the wardroom, some in the cabin, and some on deck." By the time Water Witch surrendered, her crew had one man dead, two missing and 13 wounded. Pierson was assisted after the battle by a Confederate Navy medical officer, Dr. C. Wesley Thomas, whom Pierson later commended as "an honorable and gentlemanly adversary” (Pierson 57). Although medical officers did their best to help their wounded patients, no one was safe aboard a warship during a battle. Fleet Surgeon Jonathan Foltz had a narrow escape when he was operating on a patient aboard USS Hartford during the June 28, 1862, attack on Vicksburg. At 5:10 a.m., a 10-inch Columbiad shell crashed into Hartford, tore into the forward shell room and plowed through 20 empty shells. Slowed by its passage through wood and metal, the shell rolled to a stop under Foltz's operating table, where the surgeon was amputating a wounded man's leg. The shell failed to explode, and no one along its path was hurt, but Foltz was irritated when a superior officer later claimed the shell as a souvenir (US Navy 89). The men in the makeshift operating room aboard CSS Alabama during the fight with Kearsarge were not so lucky. Assistant surgeon David H. Llewellyn was operating on a wounded man in the wardroom when an 11-inch shell from Kearsarge crashed through the hull and swept away the patient and the operating table (Still 18). Wounds from enemy fire were only one problem facing naval medical officers. Shipboard life was always perilous, with the chances of a fall from the rigging or yardarms, or of being caught by a rolling hogshead or the recoil of a heavy gun. Life in the steam-powered Navy produced the new hazards of scalds and injuries from exploding boilers. Indeed, among the heaviest shipboard battle losses for the Union was the June 17, 1862, disaster that befell the gunboat Mound City on the White River near St. Charles, Ark., when a Confederate 32-pounder shot punctured the ironclad's steam chum. The scalding steam killed 82 men in the casemate, and 43 more crewmen perished by drowning or being shot by land-based sharpshooters as they attempted to escape from the ship (Still 101-103). Because conditions for the sick and wounded aboard ship were so terrible, patients who needed long-term care occasionally were sent to naval hospitals on land. Supply ships oft...