Books and Documents > The Army Medical Department 1818-1865
CHAPTER 7
Lawson`s Last Years, 1846-1861
Settlers and prospectors began moving west in large numbers after the United States acquired the Oregon Territory in 1846 and the northern provinces of Mexico in 1848, a movement that grew still larger after the discovery of gold in California in January of that year. The federal government called upon the Army to explore boundaries and possible railroad routes in the new lands and to confront Indian and Mormon challenges to its authority. New posts also needed garrisons and the growing numbers of travelers needed the Army`s protection. The character of the new lands aroused great interest in the scientific community. Surgeons assigned to Army units in the West were encouraged not to limit themselves to purely medical duties but to study the fauna, flora, and geology in their district and to record the customs of the inhabitants.
During the period from 1846 to 1861, tensions were building over the question of the extension of slavery into newly acquired lands, and secession was an ominously frequent topic of discussion. But contingency planning was still a thing of the future and neither Surgeon General Lawson nor any of the Army`s other leaders seriously considered how they might meet the demands of a large-scale conflict. Lawson`s official letters betrayed no concern with the problems inherent in such a war. Medical Department efforts continued to be directed almost exclusively toward meeting the challenges of the peacetime Army, and in directions essentially no different, except in magnitude, from those of earlier years.
Administration
Once the war with Mexico was won, the Army was again broken down into small, scattered units. That conflict had brought about few basic changes in the Medical Department. It was still not large enough to provide medical attendance for each garrison and detachment, despite Lawson`s effort to obtain an adequate staff. Although he himself was brevetted brigadier general in May 1848, the surgeon general`s campaign for increased stature for his surgeons was also thwarted. Congress did, however, finally allow the retention in the position of hospital steward of any man qualified to handle that role.
The law of 1847 that had allowed the addition of fourteen new surgeons ordered their dismissal at the end of hostilities. In July 1848, when the legislature repealed that requirement, it added a provision for bidding the hiring of replacements for those who did leave. By then, some of the fourteen had already departed. Only in March 1848 did Congress make the fourteen slots permanent, thus officially permitting the signing on often doctors to replace those who had already resigned. Considering the need, this increase was in-
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significant. With ninety-four surgeons, some of whom would always be sick or incapacitated by age, the department was expected to care not only for men scattered among eighty-nine posts, some of which needed more than one surgeon, but also for soldiers involved in multitudinous expeditions, both large and small, that took them from their regular assignments. The threat of Indian ambush isolated some posts, making it essentially impossible to send a surgeon in time of emergency to a post otherwise without medicalattendance.1
In 1851 , Congress made the Army Medical Department indirectly responsible for the medical care of the residents of the new Army Asylum or, as it later became known, the Soldiers` Home. The surgeon general served as a member of the Board of Commissioners. A department medical officer served as attending surgeon, his duties at the Soldiers` Home being above and beyond those of his regular Army assignment and recompensed as the Board of Commissioners might decide. For many years, Assistant Surgeon Benjamin King served as secretary-treasurer of the board as well as attending physician, and both Surgeon General Lawson and, after the Civil War, Surgeon General Joseph K. Barnes were very much concerned about the operations of thisinstitution.2
Lawson`s campaign for a larger Medical Department was, therefore, a continuing one. In his report of November 1855 he emphasized to the secretary of war that the number of surgeons the Army needed did not "depend upon the numerical force of the army, but upon the manner in which it is employed; that is upon the divisions and subdivisions it has to undergo, and the particular service in which it is engaged." In 1856 Congress did vote the department 4 more surgeons and 8 more assistant surgeons, but at least one general believed that no fewer than 12 more surgeons and 40 more assistants were required at this time. In the summer of 1860, with the nation at the brink of civil war, Congress granted the department slots for only 4 more surgeons and 4 more assistant surgeons. The Army was forced to face the oncoming holocaust with only 30 surgeons and 83 assistants, not all of whom would remain loyal to the Union.3
Because of the Medical Department`s relatively small size, its expenses for contract surgeons remained high, averaging $24,000 a year in the mid-1850s. A civilian doctor hired to care for 100 or more men was paid $50 a month, for 50 to 100, $40, and for fewer than 50, $30, with an allowance added for any physician providing his own supplies and medicines. If he had to abandon his practice to accompany troops on the march, a civilian might receive as much as $100 a month. In some areas, however, nonmilitary physicians were impossible to obtain, and many soldiers did not trust contract surgeons. Some of these doctors, however, were young men who had recently passed the department`s still demanding examinations and were awaiting
1Ltrs, Heiskell to William J. Worth (25 Jan 1849) and Lawson to AG (25 May 1851), both in RG 112, entry 2, 19:375 and 21:434, respectively. Unless otherwise indicated, all material in this chapter is based on Brown, Medical Department; War Department, SGO, Regulations for the Medical Department (Washington: Alexander, 1850)and Regulations for the Medical Department of the Army (Washington: A.O. P. Nicholson, 1856); and Callan, Military Laws.
2 Paul R. Goode, The United States Soldiers` Home: A History of` Its First Hundred Years (Privately printed, 1975), pp. 46-48, 54,57, 60, 71, 86.
3Quote from Brown, Medical Department, p. 207 Ltrs, McCormick to Lawson (29 Nov 1857) and Twiggs to Lawson (27 Aug 1859), both in RG112 entry 12.
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openings on the staff. The quality of their work, therefore, was generally good.4
Because Lawson had few officers, he was unable to grant them leave except in instances of great need. This fact distressed him, all the more so when department finances dictated that, except for the most deserving cases, surgeons who succeeded in obtaining leave must hire and pay for their own replacements. Since the increases allowed in the Department`s size were always inadequate, the problem was chronic, and some good men left the Army as a result.5
The officers of the Medical Department had official rank after February 1847, but the new law`s significance for the surgeon`s status within the Army was not clear. Although medical officers received housing and allowances on the same basis as line officers, those who assumed that they no longer had to obey commands from junior officers of the line or to take a backseat to them when serving on administrative boards were in for a rude awakening. Not long after the passage of the law, the adjutant general stated that since its implications were confusing, the old laws would continue to apply. Some high-ranking officers who had bitterly opposed the law were urging its repeal. When Surgeon, and now a major, Clement Finley, who would succeed Lawson as surgeon general, refused to obey an order from Bvt. Lt. Col. Braxton Bragg, whose regular rank was captain, he was court-martialed and convicted. President Millard Fillmore remitted the sentence of dismissal from the service, but upheld the court`s verdict. A second medical officer who repeated Finley`s offense not long after was also convicted and sentenced to dismissal, but the president again remitted the sentence, this time on the grounds that the defendant had not heard of the earlier ruling.6
The question of the role surgeons could play on Courts of Inquiry and similar bodies apparently also remained unresolved. The secretary of war ruled that a medical officer could preside over such a court if he was the senior officer, but this ruling was evidently not always applied to boards of inspection and survey. Congress had little to say on the matter, and medical officers unhappily concluded that, despite the 1847 law, their status in the Army was essentially unchanged.7
At the time of the Mexican War, the position of hospital stewards within the Army also remained to be clarified. The level of aid that properly trained stewards rendered surgeons-some could perform an apothecary`s duties and even conduct minor surgery-made it all the more important that such men be given permanent positions with the department. The demand for competent stewards was great. At posts where
4Ltrs, William J. Sloan to Lawson (1 Mar 1859),RG 112, entry 12; Wood to Joseph B. Flint (14 Mar 1856) and Lawson to Robert Thompson (16 May 18 56), both in RG 112, entry 2, 25:193 and 269-71, respectively.
5Ltrs, Heiskel to Jarvis (14 Feb 1851) and to AG (30 Sep 1852), both in RG 112, entry 2, 21:383-84 and 22:492-93, respectively; M. L. Crimmins, ed., "Notes and Documents: W. G. Freeman`s Report on the Eighth Military Department," Southwestern Historical Quarterly 53:207; Ltr, Maj Gen James A. Wier, U.S. Army (Ret.) to author (4 Jan 1883), copy in historians` files, CMH.
6Ltr, Coolidge to Finley (11 Jul 1851), RG 112, entry 2, 22:44;U.S. War Department, General Orders 1851 (Washington, 1851), GO no. 5 1; Ltrs, Mower et al. to Lawson (24 Apr 1847), Tripler to Lawson(6 Jan 1859), Porter to Lawson (7 Feb 1849), and John B. Wells to Heiskell(26 Jul 1847) and to Marcy (11 Aug 1847), all in RG 112, entry 12.
7Ltrs, Heiskell to Moore (27 Dec 1850), Coolidge to Wright (21 Aug 1852), and Lawson to AG (10 Oct 1853), all in RG 112, entry 2, 21:308, 22:461, and 23:358, respectively; Satterlee to Lawson (1 Feb 1859) and White to Lawson (3 Mar 1853), both in RG 112, entry 12; A. A. Woodhull, "An Inquiry Into the Military Rights and Duties of Medical Officers in the Land Forces," U.S. Service Magazine 1 (1864):478.
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supply depots were located, surgeons might ask for a second steward to serve as medical storekeeper. Few civilians who were qualified to perform at the highest level would enlist, however, if they knew that they might be taken from Medical Department assignments and forced to serve as ordinary soldiers. Moreover, surgeons found it frustrating to train a steward from the line only to see him march off with his unit. On the other hand, having a good man taken permanently from his unit was frustrating to his commandingofficer.8
Finally, in 1856 and only after much urging by Lawson, Congress granted the secretary of war the authority both to appoint stewards from among men already in the Army and to hire competent men from the outside to be permanently attached to the Medical Department for a salary of $30 a month. This law also granted men who served as cooks and nurses extra duty pay in recognition of the hazardous and unpleasant nature of much of their work, a move the department had been unsuccessfully urging for years.
After the passage of the 1856 law, the Medical Department moved cautiously to create what one of Lawson`s assistants described as an "efficient corps of stewards." Although there was no longer any need to keep a steward at one specific post or with a particular unit, the department still feared that moving these men about too much might cause Congress to have second thoughts. Whether the reason was caution or ineptness, by 1861 the department had not taken full advantage of the opportunity afforded by the law of 1856 to build up a corps of trained and disciplined stewards.9
Although Lawson needed the cooperation of Congress to deal effectively with the personnel problems he faced, he was to a large extent free to manage supply as he saw fit. The rapid changes that took place as the Army assumed expanding responsibilities made supply operations increasingly complex. Attempts to anticipate need were at times frustrated by the short life of some posts, the long distances involved, and the hazards that threatened shipments as they moved west. The surgeon general continued to believe that whenever possible, purchasing should be handled in New York City, where prices were generally lower than elsewhere. However, a year might be required for goods to reach a western fort from the East, and on the West Coast the telegraph was not available for placing supplemental orders. In consequence, the department was forced to permit some buying at New Orleans and to allow surgeons, when absolutely necessary, to meet specific needs on their own or through the Quartermaster`s Department.10
The Medical Department also began to establish supply depots at central locations in the West. In 1849 Fort Leavenworth became a storage site from which surgeons as far away as New Mexico could draw. A few months later, apparently when Indian dep-
8Crimmins, "Freeman`s Report," 53:207;Ltrs, Jarvis to Lawson (17 Dec 1859), Mower to Heiskell (16 Mar 1847),Randall to Lawson (6 Mar 1849), H. H. Steiner to Lawson (20 Jul 1846),and Stinnecke to Lawson (8 May 1844), all in RG 112, entry 12.
9Quote from Ltr, Wood to A. J. Ridgely (10 May 1859), RG 112,entry 2, 25:524; Ltrs, Lawson to AG (17 Feb 1857) and Coolidge to W. T. Clarke (24 Oct 1859), both in RG 112, entry 2, 27:77 and 211, respectively.
10Ltrs, J. H. Bailey to Lawson (20 Apr 1846), Wheaton to SG(13 Apr 1848), and Jarvis to SG (7 Mar 1859), all in RG 112, entry 12; Heiskell to Wheaton (9 Jan 1849), to McDougall (22 Feb 1850), and to Mower(9 May 1850) and Coolidge to Charles E. Pleasants (7 Jan 1852), all in RG 112, entry 2, 19:353, 20:476, and 498, and 22:210, respectively.
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redations made repeated punitive expeditions necessary in Texas, the department set up another warehouse at San Antonio. The need for a major depot there was temporary, and this facility was soon reduced in size and required to supply only units passing through. By 1855 there were also medical supply depots at Albuquerque and Santa Fe and at Benecia, in present-day California, but the surgeon general remained adamant in his determination to have permanent forts order on a yearly basis from New York City, requisitioning from depots only in emergencies.11
The safety of goods shipped long distances remained very uncertain ;rough handling often damaged even carefully packed items, and shipwrecks were a fact of life. In 1856 the failure of his annual shipment to arrive actually forced the surgeon at Fort Chadbourne, Texas, "to resort to the horse and mule medicine in the Quarter Master`s Depot." Included in the supplies lost in wrecks were two consecutive shipments in 1860 to forts in the Arkansas-Oklahoma area. Judging from the size of the department`s orders, the concept of anesthesia was being accepted, but ether continued to be difficult to ship. One order evaporated during the long trip from New York to Albuquerque because of ill-fitting glass stoppers. The purveyor obtained a promise from the supplier to ship the anesthetic again, at no cost to the government if the Army transported the bottles.12
Surgeons in California began to urge Lawson to permit some purchases to be made there. One physician maintained that the items he needed could be bought locally for less than the total cost, including shipment, of the same items bought in New York. The department`s decision in January1861 to buy the tea for California posts in San Francisco was a gesture in this direction. In addition, theft or evaporation might cause bottles of wine to arrive in California empty. The Surgeon General`s Office finally ordered the medical director in San Francisco to buy twenty-four dozen bottles of Los Angeles wine for the use of West Coast posts to supplement sixty dozen bottles to be sent from New York City. The New York purveyor initially concluded that Los Angeles wines were acceptable "for medicinal use," but by April 1861 it had become obvious that California wines did not please eastern palates; they were all, the San Francisco purveyor reported, either too sweet or too acid, and none were fit for the sick.13
Supply problems also resulted from the relative haste with which troops were moved about. In the spring of 1851, for example, companies of the 5th Infantry began arriving at Fort Gibson from Fort Leavenworth on their way to Texas, but "entirely destitute of medical Supplies." The Surgeon General`s Office asked the
11Ltrs, Heiskell to Mower (4 Jul 1849), to McCormick (26 Jul 1849), to Wright (4 Feb 1850), and to McDougall (22 Feb 1850) and Lawson to Act QMG (19 Sep 1855), all in RG 112, entry 2, 20:144,177, 451, and 476 and 25:37, respectively; Coolidge to McCormick (5 Apr 1861), Jarvis to Lawson (27 Apr and 10 Oct 1859), and Mills to Lawson (16Jan 1851), all in RG 112, entry 12.
12Quote from Ltr, E. P. Langworthy to Lawson (1 Dec 1856), RG112, entry 12; James O. Breeden, "Health of Early Texas: The Military Frontier," Southwestern Historical Quarterly 80 (1977):397-98;Ltrs, Murray to Lawson (17 Feb 1854), Porter to Lawson (1 Sep 1858), Swift to Lawson (30 May 1852), Satterlee to Lawson (16 Apr and 14 Nov 1860),and Wells to Montgomery (2 Mar 1852), all in RG 112, entry 12.
13Quote from Ltr, Satterlee to Lawson (25 Jan 1861), RG 112,entry 12; Ltrs, Lawson to Asst QMG (7 Aug 1857), Wood to Satterlee (28Feb 1860), and C. H. Smith to Satterlee (23 Jan 1861), all in RG 112, entry2, 26:137-38 and 27:329 and 597, respectively; Coolidge to Lawson (9 Apr1861), D. Camden De Leon to Lawson (5 Jul 1856). Deyerle to Lawson (20Apr 1852), and Griffin to Lawson (10 Jul 1852), all in RG 112, entry 12.
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regiment`s commanding officer to order surgeons at the nearest post to send all their medical supplies to his unit; the surgeons so deprivedmight resupply themselves from New Orleans. The general commanding the Military Department of the West had apparently not been consulted in this situation. When he heard of it, he announced that the Medical Department`s handling of the matter was "entirely irregular," since only he could give such orders. He also questioned the authority of the surgeon acting as medical director for his area to function as other than a post surgeon; apparently Lawson`s custom of requiring the senior surgeon in a military department to serve as medical director was not always recognized. In any event, the general ordered that all requests for medical supplies from other posts come from or through his headquarters. Amidst the furor, the Texas bound troops were supplied from Forts Gibson, Towson, and Washita.14
Supply was but one of the difficulties faced by Medical Department surgeons in the West. The shortage of adequate hospital facilities at new posts also presented problems. In 1858 at Walla Walla, Washington, for example, the hospital was "a temporary thatched hovel, twelve by fourteen, with only four bunks (one above the other), less than three feet wide. "Although the wounded resulting from individual skirmishes with the Indians in the West were usually few, expeditions against the Indians could on occasion result in more wounded than there were bunks. For reasons that the surgeon apparently did not understand, construction of a new facility to replace the defective one at Walla Walla had come to a halt by 1854. The problems of the medical officer in San Francisco at this time were even greater. His hospital building was too small for the growing command and in poor condition, and the surgeon general made matters worse by refusing to grant an adequate fuel supply for the summer months. Summers in northern California were almost as cool as the winters, but Lawson insisted upon allowing only two cords of wood for the summer even though eight were needed for the winter.15
Surgeons also experienced problems getting their patients to whatever facilities they had succeeded in establishing. As late as 1859, the Medical Department had made little progress against the difficulties involved inmoving the disabled. In the fall of that year, a board of five department surgeons met in Washington to examine models for ambulances. They recommended trials of two types, a two-wheeled version and a four-wheeled one that could carry ten men. The larger model was apparently in use at Fort Leavenworth by 1861. An attempt to have a horse litter designed for use in areas inaccessible to wheeled vehicles failed. Additional difficulties arose from the fact that Army officers tended to use ambulances as if they were ordinary wagons. In 1860 the department was forced to emphasize that the vehicles distributed to the Army to serve as ambulances were not to be used for any other purpose.16
14First quote, Ltr, Wells to Madison (copy, 16 May 1851), and second quote, Ltr, Page to Wells (20 May 1851), both in RG 112, entry 12; Ltrs, Wells (recipient`s name illegible) (23 May 1851)and Wells to Lawson (21 Jun 1851) and Order (no. 7, 19 May 1851), all in RG 112, entry 12.
15SGO, Statistical Report on the Sickness and Mortality in the Army of the United States ... From January, 1855, to January, 1860(Washington: George W. Bowman, 1860), pp. 268-70, quote from p. 270; Ltrs,J. F. Hammond to Lawson (11 May, 15 Jun, and 21 Aug 1854), all in RG 112,entry 12.
16Ltrs, Wood to Satterlee (28 Feb 1860) and to J. E. Johnston(2 Aug 1860), both in RG 112, entry 2, 27:330 and 484, respectively; J.F. Hammond to Lawson (24 Feb 1855), Tripler to Wood (22 May 1860), and Wright to Lawson (8 Mar 1861), all in RG 112, entry 12; Otis, A Report to the Surgeon General, pp. 2n, 5, 9.
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The principal difficulties faced by the Medical Department as a whole in the fifteen years before the Civil War resulted from the refusal of Congress to grant adequate increases for the medical staff and, above all, from the rapidity of the nation`s expansion. In the Far West, where the greatest change was taking place, the telegraph and the railroad were not available, and the problems faced by surgeons there were exaggerated by the resultant inability of the department to adjust the shipment of supplies quickly enough to meet the changing demand.
The Work of the Army Surgeon as a Physician
Ultimately the problems generated by slow communications and transportation, by an understaffed department, and by the shortage of trained and reliable stewards fell upon surgeons in the field, and particularly upon those in the West. In the East the Army doctor`s duties tended to be mundane and included such chores as administering physical examinations to men wanting to join the Army. After the Mexican War, the department decided to look more closely at the health records it had been accumulating on would-be recruits. Published in the second volume of the department`s Statistical Report, this study of men examined from 1849 through 1855 recorded that 3,516 of 5,000 consecutive applicants in 1850 and 1851 were foreign born, and 2,113 were from Ireland alone. A total of 2,675 were "from Great Britain and dependencies," while almost 700 came from Germany. These figures no doubt reflected the upheavals of 1848 in Europe and the Irish potato famine. The text noted, however, that in wartime, "The relative proportion of native and foreign recruits [was] reversed."17
The department`s study also revealed that at midcentury the average would-be soldier weighed just under 150 pounds and stood between 5 feet 6 1/2 inches and 5 feet 71/2 inches-regulations required a minimum height of 5 feet 5 inches. Among 1,800 native-born applicants examined for one part of the study, only 241 were at least 6 feet tall, and the tallest hailed from Georgia. A large proportion of rejected recruits suffered from" varicose veins and varicocele." Many native-born men were rejected as "not robust, too slender," although physicians concluded tha tthe "excess rejections" of these men resulted merely from their being "young men who had not arrived at the full development of their physical strength." The rejections of foreign recruits, on the other hand, often resulted from generally poor physical condition. A large number of "Europeans" (apparently an all-others type of category) was also rejected because of "Unsound and broken-down constitutions, "while many English and Irish proved to be unacceptable because of "Intemperance and bad habits."18
The department also classified its rejected recruits by occupation. Presumably most of the men who left their trades during peacetime to join the Army were not completely successful in civilian life. In some instances, poor health may have been to blame for their failures and therefore the Statistical Report figures may not be an ac-
17Quote from Statistical Report, 1839-55,p. 627. Unless otherwise indicated, all statistics in this chapter are derived from vol. 2 of the Statistical Reports.
18Quotes from Statistical Report, 1839-55, p. 629.
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curate indication of the health of the civilian population. The lowest proportion of rejections was found in the category "Carpenters and workers in wood," the highest among laborers and farmers. Varicose veins caused rejections in all groups, but these tables also suggested that laborers suffered more than others from "lax abdominal rings, "presumably a precursor of hernia, while farmers who had deserted their fields were often the victims of "imbecility" and venereal diseases, the latter acquired, perhaps, in the city where they signed up. The greatest incidence of intemperance was found among those who preferred the Army to tailoring, but "clerks, students, and teachers" were most often afflicted with hemorrhoids.19
The fact that such detailed statistics were gathered about those rejected by Army physical examinations may give the misleading impression that by this period only the fit were accepted for military service. Since no "exact, full, and uniform instructions" on how to conduct pre induction physicals were distributed within the Army, overly eager recruiters had considerable leeway in filling their quotas. On at least one occasion, a line officer, angered by a rejection of a would-be recruit, tried but failed to have it reversed. Alcoholism, epilepsy, and psychological problems, furthermore, were undoubtedly difficult to spot, and accurate tests for such diseases as syphilis did not exist. Since physicians evidently believed that they could cure gonorrhea, men with this disease might be accepted if they had suffered no permanent physical damage. In the belief that soldiers "would not tolerate the mixed breed as comrades," surgeons continued to reject those whose racial background was unclear.20
Regardless of their health when they signed up, recruits were exposed to many diseases by Army life. Furthermore, except for smallpox, the Medical Department could do little to keep the soldier from contracting diseases to which he was exposed. All recruits were eventually vaccinated, but cases of smallpox did occasionally occur. Some victims had not yet been immunized, or had not been properly immunized, while others may have lost their immunity over time. In 1849, when smallpox was particularly prevalent, 66 soldiers fell ill with the disease. Of these, 23 had been vaccinated, but of the8 who died, none had ever undergone the procedure.21
Army surgeons had by this time apparently realized that although it was often difficult to obtain a potent vaccine, revaccination was advisable whenever soldiers were likely to be exposed to smallpox. The surgeon at Fort McKavett, Texas, for example, reimmunized most of the men at his post in 1857 after hearing of a smallpox epidemic in San Antonio. Because of the difficulty of obtaining vaccine, he started by immunizing only infants and children who had never undergone the procedure. Using material taken from their lesions, he then vaccinated the 22-man post band. The
19Quotes from Statistical Report, 1839-55,p. 630.
20Quotes from Richard H. Coolidge, Revised Edition of Thomas Henderson`s Hints on the Medical Examinations ... (Philadelphia: J.B. Lippincott Co., 1856), pp. 20, 32; Francis Paul Prucha, Broadax and Bayonet ... (Madison: State Historical Society of Wisconsin, 1953),p. 41; Remarks, Maj E. W. Townsend (18 Sep 1858), and Ltr, Randall to Lawson(26 Sep 1858), both in RG 112, entry 12; Ltr, Bandel to his parents(17Mar 1857), in Eugene Bandel, Frontier Life in the Army, 1855-61,ed. Ralph P. Bieber (Glendale, Calif: Arthur Clarke Co., 1932), p. 105.
21Ltrs, Lawson to Martin N. Paine (12 Aug 1852), RG 112, entry2,22:450; W. S. King to Lawson (8 Mar 1850) and Lafayette Guild to Lawson(22 Aug 1857), both in RG 112, entry 12.
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procedure took for all but four of this group, two of whom had already been vaccinated and two more of whom bore smallpox scars. With material obtained from members of the band he next vaccinated half of the remaining men, and with material from these, he immunized the final group.22
Vaccinating the people at Fort McKavett in relays ensured the potency of the vaccine matter used after the first round. The department encouraged other surgeons to propagate their vaccine similarly and also tried to develop an exchange system among its physicians. The New York purveyor experimented at this time with shipping the inoculum in small sealed glass tubes, but since these containers were quite fragile, the department generally continued to use vaccine crusts to ship the virus, although this method of shipment carried the risk that the material might be ineffective when it reached its destination.23
Although immunization was not possible for diseases other than smallpox, the use of quinine could reduce malaria to the level of a "vexatious" disease, even in those areas where mosquitoes thrived. In Florida, for example, where fevers had caused such havoc during the Second Seminole War, a surgeon reported in 1856 that "ague and fever seldom affords[sic] cause for alarm, or even seriously excites the anxieties of the patient."24
Scurvy had long been better understood than malaria, but its cause continued to be partially obscured by misconception. As late as 1859, physicians still listed such factors as poor ventilation, lack of exercise, exposure, a hot, dry climate, and boredom as contributing factors. Having treated five cases in August and September 1857, during which time the men in his care had been offered dried vegetables as well as "apples, peaches, rice, and molasses," a surgeon in the West concluded that this experience had demonstrated that "abstinence from vegetable food is not, as some suppose the sole cause of scurvy." He maintained that a man`s physical condition and habits, especially "evil habits" involving the use of the "filthy narcotic, tobacco," contributed to the appearance of the disease.25
When it was not deliberately supplemented with antiscorbutics, the normal Army diet provided little that could have prevented or cured scurvy. A surgeon in Florida reported that men sent out on an exploratory expedition on 31 March 1857 were showing signs of scurvy before their return to base on 21 May-and that while in the field they had eaten only pork, hard bread, and coffee. In 1854 the standard menu at Fort Columbus in New York Harbor was little better, except for the addition, "at rare intervals," of "one or two boiled potatoes." A soldier serving in the Westin 1856 recorded a diet of a pound of pork or a pound and a half of beef each
22Statistical Report, 1855-60, pp. 189-90.Unless otherwise indicated, material on diseases in the Army is based on vols. 2 and 3 of these Statistical Reports.
23Ltrs, Heiskell to McDougall (1 May 1849), to W. S. King(20 Aug 1849), and to Wood (27 Mar 1854), all in RG 112, entry 2, 20:33,216 and 24:32, respectively; Cooper to Lawson (24 Apr 1849) and Satterlee to Lawson (3 Nov 1857), both in RG 112, entry 12; Rpt, Coolidge, in Statistical Report, 1855-60, p. 97.
24 Quote from Statistical Report, 1855-60, p. 149; Elkanah Babcock, A War History of the Sixth U.S. Infantry (Kansas City, Mo.: Hudson Kimberly Publishing Co., 1903), pp. 66, 70-72; Esmond R. Long, "The Decline of Chronic Infectious Disease and Its Social Implications, "Bulletin of the History of Medicine 28 (1954):373.
25Quotes from Statistical Report, 1855-60, p. 287; Ltrs, Heiskell to Baily (24 Mar 1852), RG 112, entry 2, 22:309; Wood to E. W. Johns (23 Mar 1859), in Statistical Report, 1855-60, p. 55; Per into Lawson (2 May 1850), RG 112, entry 12. It is now believed that such factors as stress and smoking may indeed increase the body`s need for vitamin C.
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GLOVER PERIN.(Courtesy of National Library of Medicine.)
day, coffee, "plenty of sugar," a little more than a pound of bread, and rice. Officers and their families had first claim to vegetables grown on post, so surgeons might have to resort to using native plants for the enlisted men even when the garden was doing well. Surgeons at less arid posts had long known of the virtues of wild onions, but Glover Perin discovered in the Southwest that cactus juice, flavored sometimes with whiskey, sugar, and lemon extract to make it more palatable, also made a good antiscorbutic. In spite of the ingenuity of post surgeons, among the many victims of scurvy in the 1849-1854 period were 10 men at the New York Harbor post, 988 in Texas, and 148 in California.26
Scurvy may not have been as common a condition as diarrhea, dysentery, respiratory ills, and alcoholism, but it was, nevertheless, a familiar problem. By contrast, yellow fever and cholera were so erratic in their appearance and so dangerous as to be capable of inspiring actual panic. Yellow fever continued to appear sporadically and without warning at cities all along the coast, and more regularly in the Deep South. Fort Brown, Texas, where it attacked 74 of the 89-man garrison and 18 of the women and children, was but one of the posts where this mosquito-borne disease spread terror. At that post fear caused even normally sober men to drink heavily, and the surgeon reported that the bodies of many of the forty-one who died showed "well-marked symptoms of delirium tremens."27
Among the forts often visited by yellow fever was Fort Moultrie, in the harbor of Charleston, South Carolina. Diarrhea and dysentery were common there, as were various kinds of fevers, including malaria and dengue. Diagnosis, therefore, could be difficult. Although yellow fever appeared in Charleston in 1849 after an absence of several years, it did not reach Fort Moultrie until August 1850. Doctors disagreed about the nature of the disease at the fort, however. The post surgeon, John Porter, had already had more than his share of problems that summer- his hospital was run down and his steward a drunkard and a thief. When Charleston surgeons challenged his conclusion that the disease they
26Augustus Meyers, Ten Years in the Ranks, U.S. Army (New York: Stirling Press, 1914), pp. 3, 5-7, first quote, p. 7; second quote, Bandel, Frontier Life, p. 105; Statistical Report, 1839-55, p. 363; Ltrs, H. P. Bee to Lawson (8 Oct 1853), McCormick to Lawson (16 May 1850), L. D. Mullawny to Lawson (5 Oct 1853), and Per into Lawson (2 May 1850 and 3 Jul 1851), all in RG 112, entry 12.
27Quote from Statistical Report, 1855-60, pp. 182-83.
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were fighting was yellow fever and stated that it was dengue, Porter, who had become familiar with yellow fever in Mexico, replied that dengue was basically "a febrile, arthritic disease" and that he had not noted arthritic symptoms in his patients. He did entertain the idea that the disease might also be remittent fever. All but 10 of the 48 officers and men, plus 43 of the women and children at the fort, contracted the disease before it had run its course, but the fact that none died indicates that the problem may not have been yellow fever.28
Yellow fever apparently spared Fort Moultrie again in 1851, but the next year 33 of the 106-man garrison fell ill with it. The four who died were the only fatalities at the post during the entire year. This time no questions arose as to the nature of the epidemic, but at least Porter`s luck had in some respects turned-his new steward was "always ... steady and temperate," and his hospital attendants were so conscientious during that desperate time that he was moved to urge the surgeon general to continue his attempt to get extra pay for those performing this type of work.29
Yellow fever returned to Fort Moultrie in epidemic form once again in 1858, but by that time Bernard M. Byrne had replaced Porter as post surgeon. Byrne may have been made of less stern stuff than Porter. The epidemic apparently unnerved him, although accusations against him were never proved. Less than a month after he diagnosed the first case of yellow fever, and after three of the sick had died, Byrne reported himself ill. He remained on sick report 32 days, an unusually long time; one of his yellow fever patients was able to return to duty 3 days after being hospitalized and two others in 10 to 11 days.
In the nine days after Byrne first became ill, eighteen more cases appeared and ten more victims died. A civilian physician from Charleston was asked to care for these men. Rumors began circulating that Byrne was not really ill, that he was avoiding patients for fear of contracting yellow fever himself. Even after the arrival of William J. L`Engle, a Regular Army surgeon, Byrne`s services were still needed-the epidemic ended only after striking forty-nine men and killing twenty-eight.30
Although at the urging of one of the other officers at Fort Moultrie, Bvt. Col. J. L. Gardner, the post commander, took action against Byrne, Gardner apparently never doubted that Byrne was genuinely sick and unable to perform his duties. The Charleston physician said that, in Byrne`s place, he too, would have treated himself, but that he could not substantiate Byrne`s claim of ill health without having examined him. The ailing surgeon`s steward praised his superior`s devotion to duty and testified that Byrne looked ill during the time he was on sick report. A private reported that when the surgeon returned to duty, "He seemed ... to be a very delicate man, and very much reduced." L:Engle maintained that Byrne was obviously well enough to have cared for the sick since he had been caring for Mrs. Byrne, and an officer who had visited Byrne during his illness maintained that the surgeon showed no sign of
28Ltrs, Porter to Lawson (11 and 26 Aug 1849, 16 Oct 1849, 2 Oct 1850, and 9 Feb 1852), all in RG 112, entry 12; Surgeon`s Quarterly Rpt, Ft. Moultrie (30 Sep 1850), RG 94, entry 634.
29Quote from Ltr, Porter to Lawson (26 Nov 1852), RG 112, entry 12; Surgeon`s Quarterly Rpt, Ft. Moultrie (31 Dec 1852), RG 94, entry 634.
30Unless otherwise indicated, all information on Byrne`s experiences at Ft. Moultrie is based on Statistical Report, 1855-60, pp. 122-23;Byrne, Court Martial, and Surgeon`s Quarterly Rpts, Ft. Moultrie(30 Sep and 31 Dec 1858), both in RG 94, entry 634.
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being unwell or suffering and that action should be taken against him.31
Byrne`s reputation stood him in good stead at his trial and the civilian doctor pointed out that Byrne had been under no professional obligation to care for patients when a qualified physician was present to assume the responsibility for their welfare. The secretary of war approved the court`s verdict of not guilty, but pointed out that the acquittal came on the ground of reasonable doubt and that the illness of Byrne`s wife had not absolved him of his responsibilities to the command.
Yellow fever was, despite the erratic timing of its appearance, more familiar to many men in the Army than cholera, which had disappeared from the United States after the epidemic of 1832 had run its course. In 1848,however, cholera reappeared on the North American continent, striking some posts repeatedly while sparing others. New York Harbor was among areas where this fearful disease spread terror, and 29 of the 79 who contracted it there died. At Kentucky`s Newport Barracks, 16 of 231 perished, and at Missouri`s Jefferson Barracks and the nearby St. Louis Arsenal, 130of 368 victims did not survive. Texas was also hard hit during this time, but Florida, New Mexico, and posts in southern California were spared.32
Cholera was soon a seasoned traveler in the United States. It accompanied troops on their way to Texas from New Orleans in 1848, when that city was in turmoil as the result of simultaneous epidemics of yellow fever and cholera. When two steamships carrying 450 soldiers set out for Port Lavacca, Texas, from a barracks four miles from the "doomed city" of New Orleans on 12 December, cholera was a stowaway. Several days later, the men, still in "perfect health," debarked, with cholera still in hiding. The vibrio accompanied both those who remained in the town and those who went out to Placido Creek to camp. On 21 December, the disease came out into the open at last, striking the men at both sites, appearing at Placido Creek after a severe storm had soaked the ground on which the men had to lie. By dawn of the 22d, 8 or 9 men at Placido Creek and 40at Port Lavacca were dead. By the time the epidemic had run its course a week later, 350 men and camp followers had felt its effects and 150 laydead.33
In February cholera appeared at Brownsville, Texas. In March it struck at Brazos Santiago and Matamoros. At Camargo and nearby Camp Ringgold, the dread disease appeared early in March. Dragoons leaving the camp for San Antonio by way of Laredo on 11 March took the vibrio with them. Thea ppearance of cholera at San Antonio puzzled Nathan Jarvis, for the disease struck the town harder than it did other communities even though the always present breeze prevented miasmas and the town was considered one of the healthiest in Texas. Estimates of the number of deaths in San Antonio from mid-April to the first week in June varied from 400 to 700; among them was that of a major general, William Worth. All told, 44 soldiers died of cholera in southern Texas and 173 in the western part of that state during the period of 1848 to 1854, after which the disease disappeared from the area.34
31Quote from Byrne, Court Martial, p.87.
32Ltr, Lawson to Paine (12 Aug 1852), RG 112, entry 2, 22:448-49.
33First quote, Ltr, Jarvis to Benjamin Jarvis (23 Dec 848),in Jarvis Papers; Jarvis, "Notes," pp. 438, 440-41, second quote, p. 438; Chambers, Cholera, p. 206; E. D. Fenner, "Report of Epidemic Cholera in the City of New Orleans, 1848-49," Southern Medical Reports 1 (1849):135.
34Jarvis, "Notes," pp. 439-41, 443; J. B. Wright, "Report on the Topography of San Antonio, and the Epidemic Cholera That Prevailed There in the Spring of 1849," Southern Medical Reports1 (1849): 416-17, 429.
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Cholera accompanied travelers, both military and civilian, along all the main routes west in the early 1850s and even affected troops on their way to California by ship, but familiarity with this disease bred terror rather than contempt. In the summer of 1855, more than six years after cholera reappeared in the New World, the panic it inspired precipitated what was apparently a mental breakdown for the surgeon at Fort Riley, Kansas. Hysterical with fear for himself and his family, he deserted his post at the height of the epidemic, leaving sick and dying men, women, and children without medical attendance. Although he was convicted by court-martial and dismissed from the Army in January 1856, he was reinstated less than a year later and served creditably in the Union Army during the Civil War, eventually becoming Grant`s medical director in the West.35
Cholera paid repeated visits to posts like Fort Leavenworth, through which soldiers and civilians, explorers and prospectors passed on their way along the Santa Fe and Oregon Trails to or from the newly acquired territories in the West. In 1848 traffic coming upriver from New Orleans brought the vibrio with it, and in 1849 the organism accompanied recruits from New York. In the first nine months of that year, 64 at the post became ill with cholera and 28 died from it. In the summer of 1850 men from a unit hit by cholera while at the Jefferson Barracks brought the disease with them as they traveled up the Missouri River. It "spread with fearful rapidity" among them, causing several deaths the night before their boat arrived at Fort Leavenworth. At its height the epidemic reportedly killed 4 or 5 a day, but by September it had apparently once again run its course in the Leavenworth area.36
In 1851 cholera struck the men of a detachment of dragoons and infantry recruits going through Fort Leavenworth bound for New Mexico, killing 15 of the 28 contracting it. One surgeon with these men was so constantly ill that he was of little use and remained behind when the men left the post in May. A second surgeon died along with 35 of his patients. In 1853 troops passing through the post brought cholera again-the Fort Leavenworth surgeon wrote the surgeon general that every detachment arriving at this post seemed to be stricken with cholera along the way. Those too sick to continue were bedded down in the three post hospitals, whose combined population was rarely less than 39 and was usually 85 or more each day. Because physicians did not always accompany detachments coming through Fort Leavenworth, such patients sometimes failed to receive adequate care.37
35Elderkin, Sketches, pp. 97-98; Francis R. Packard, History of Medicine in the United States, 2 vols. (New York: Hafner Publishing Co., 1963), 2:925; [George E. Omer, Jr.], An Army Hospital From Horses to Helicopters (Fort Riley, Kan., n.d.),p. 16. The story of cholera at Ft. Riley can be found in Percival Lowe`s Five Years a Dragoon, 1848-1854 (Kansas City, Mo.: Franklin Hudson Publishing Co., 1926).
36Glisan, Journal, pp. 12-13, 22, quote from p. 21; Ltrs, McDougall to Lawson (16 Jul 1849) and Mills to Lawson (3 Oct 1850), both in RG 112, entry 12; Surgeon`s Quarterly Rpts, Ft. Leavenworth (1846-1848 and Mar, Jun, and Sep 1849), all in RG 94, entry 634; Elvid Hunt, History of Fort Leavenworth, 1827-1927 (Fort Leavenworth, Kan.: The General Service Schools Press, 1926), p. 69; James Augustus Bennett, Forts and Forays ..., eds. Clinton E. Brooks and Frank D. Reeve (Albuquerque: University of New Mexico Press, 1948), pp. 10-11.
37Chris Emmett, Fort Union and the Winning of the Southwest(Norman: University of Oklahoma, 1965), p. 7; Ltr, Cuyler to Lawson (24Jun 1855), RG 112, entry 12; William Aloysius Keleher, Turmoil in New Mexico, 1846-1868 (Santa Fe, N. Mex.: Rydal Press, 1952), p. 129 n.61; Stanley Francis Louis Crocchiola, Fort Union (New Mexico) (n.p.,1953), p. 59; Surgeon`s Quarterly Rpt, Ft. Leavenworth (30 Jun 1851), RG94, entry 634.
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In 1855, cholera returned once again to Fort Leavenworth with troops passing through, and by summer was raging at the Kansas post. Medical attendance remained inadequate for the need and the hospital was crowded. A larger barracks was taken over to supplement facilities for the sick, but some of the 115 who fell ill during the course of the epidemic ended up on the floor of an old stable that was "so infested with rats that they ran over the helpless sick in the day time." It was very hot, but the only drinking water available had to be brought in barrels from the Missouri River. Each man who wanted a drink dipped his cup into the common container. Some of the patients were soon "unconscious of their surroundings; their features had turned to a bluish black color. Flies in great numbers swarmed around them, and settled on their open lips and staring eyes....The doors and windows were all open, but the heat and stench were terrible. "Some of the coffins of the twenty-four who died were loaded with bodies in plain view of the sufferers. One corpse was too large for its container; "when his head and feet were in, his chest bulged up, which made it necessary for one of the attendants to sit on the cover while it was being nailed down."38
Sanitation at Fort Leavenworth was described as good, and the post surgeon in 1857 reported only two problems: the difficulty of finding sufficient water for bathing in the winter, when streams were frozen, and the need to find a way to drain laundry water away from living quarters. Nevertheless, by modern standards the management of the kitchen left something to be desired. In 1855, for example, a civilian working at the post, perhaps helping to construct the new barracks, discovered something odd on his dinner plate. A witness reported that "a closer examination disclosed a full grown rodent, minus its hair." Whether the rodent was bald because of advanced age, disease, an abnormal supply of hormones, or long boiling was not disclosed, but the quartermaster reacted by hiring a new set of cooks.39
Among the expeditions leaving Fort Leavenworth for other parts of the West were those sent to deal with recently settled Mormons in Utah, who were resisting the authority of the U.S. government. Planning for a 2,500-manexpedition into Utah began in the spring of 1857. The recruits who joined this force just outside Fort Leavenworth were in poor condition, some were either too young or too old. "Many were broken down by habits of dissipation-by intemperance, by syphilis, by the practice of masturbation, & c. "Health problems apparently multiplied as they waited. Diarrhea was soon a common affliction and was blamed on diet and the climate. One surgeon specifically mentioned "a dietetic cause more potent" than any other, "that ancient military institution, bean soup. A vile concoction, prepared under this name," was served at Fort Leavenworth. Poison oak, "a plant which flourished in great luxuriance" in that area, also led to misery for some soldiers. "The local pain, heat, redness, and swelling," stated a physician, "were often considerable, accompanied by some constitutional disturbance,
38Meyers, Ten Years, pp. 57-60, quotes from pp. 58, 59, and 60, respectively; Ltrs, Ridgely to Lawson (29 Apr and 14 Jun 1855), both in RG 112, entry 12; Surgeon`s Quarterly Rpts, Ft. Leavenworth (30 Jun, 30 Sep, and 31 Dec 1855), all in RG 94, entry 634.
39Quote from Erasmus Theodore Carr, "Reminiscences Concerning Fort Leavenworth in 1855-56," Kansas State Historical Society`s Transactions 12 (1911-12):378; Hunt, Leavenworth, pp 98-99,111.
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especially when the scrotum was involved."40
The start of the march was not initially accompanied by any improvement in the health of the men bound for Mormon territory. In the first three days, problems caused by drunkenness, heat, and the general unfitness of the men limited progress to sixteen miles. When their water containers were empty, soldiers drank from pools of "water exceedingly filthy and nauseous from animal and vegetable decomposition" and were paid for their trouble with vomiting and more diarrhea. Some were overcome by heat and exhaustion, but the wagons in which they were placed were too high for easy loading and offered a jolting ride.41
In the course of their march the men encountered Pawnee Indians, among whom smallpox was raging, and efforts to avoid contact with them proved vain. Some of the quartermaster`s men could not resist "the charms of filthy squaws," but their weakness was repaid with syphilis rather than smallpox. As the expedition neared the Platte River, problems caused by diarrhea diminished, but the incidence of malaria increased, and in August the first case of scurvy appeared. By the end of the month, the men had marched 419 miles, during the course of which one of the surgeons had, in addition to his other chores, delivered two babies, both to wives of soldiers.42
The weather was growing colder as the men approached the end of their 1,100- mile march from Fort Leavenworth-on 8 November the mercury reportedly fell to 44° F. and a strong northwest wind chilled the marrow of their bones. By December they had set up camp for the winter at Fort Bridger, in today`s state of Wyoming, near the Utah border. While awaiting the outcome of negotiations with Brigham Young, surgeons established hospitals for their units in tents floored with hides, a design that proved quite comfortable. Scurvy was apparently no longer a problem, possibly because dried vegetables had been added to the diet, although the drying process probably destroyed much of the vitamin C. Many suffered from frostbite, however, and one man lost the last joints of four toes to the cold.43
The knowledge that reinforcements for the Utah Expedition would soon be arriving from Fort Leavenworth determined the Mormons to seek peace in the spring of 1858, and the men assembled to subdue them were, therefore, gradually dispersed. Before this could happen, however, a surgeon at Fort Bridger encountered a new and mysterious form of fever that first struck men who had been camped in a grassy valley. Within four days fifty-five of them were sick. Within three weeks 110 officers and men as well as a large number of teamsters and herders had fallen ill. The initial symptoms included an hour or two of chills followed by a high fever, flushing of the skin, severe pain in the lower back, pain and cramps in the legs, a quickened pulse, nausea, and constipation. The eyes were bloodshot, and a "white, cheesy fur" covered the tongue, whose papillae were red and prominent. All symptoms disap-
40Quotes from Statistical Report, 1855-60,pp. 281-83; Estimate, Satterlee (2 Jun 1857), RG 112, entry 12.
41Quote from Statistical Report, 1855-60, p. 283.
42Quote from ibid., p. 285.
43Jesse A. Gove, The Utah Expedition, 1857-1858: Letters of Capt. Jesse A. Gove, 10th Inf, U.S.A., ed. Otis G. Hammond (Concord: New Hampshire Historical Society, 1928), pp. 5, 11, 107, 138, 143-44, 146,221; Ltr, Wood to Med Dir (30 Nov 1859), RG 112, entry 2, 27:241; Theophilus F. Rodenbough, From Everglade to Canon With the Second Dragoons ...(New York: D. Van Nostrand, 1875), pp. 189, 191.
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ROBERTS BARTHOLOW.(Courtesy of National Library of Medicine.)
peared within thirty-six hours, but in some cases the disease returned in a less severe form on the fifth day, lasting another twelve to eighteen hours. Only one death occurred at this time; the victim was a man who had been sick a week and paralyzed for two days. Mormons called the disease mountain fever, but it may have been what is today known as Colorado tickfever.44
Although mountain fever was apparently a disease Army surgeons had not encountered before, the old familiar ones like scurvy, alcoholism, and typhoid fever were also present in the area where the Mormons lived. In the period from 1857 to 1859, only 4 men died from wounds and injuries in the Utah and Wyoming territories, but 34 died of disease, 8 of these from typhoid. Of eleven cases of scurvy, however, only one man died. The liquor sold by traders despite regulations to the contrary occasionally had particularly unfortunate effects. In at least one instance this beverage was compounded of alcohol, tobacco, "and various narcotics, "and packed a kick that killed one man in short order and made many moreill.45
The Mormons as a people apparently fascinated non-Mormons who came to know them, including an Army surgeon, Roberts Bartholow, who stated in the third volume of the Statistical Report that "The Mormon, of all the human animals now walking this globe, is the most curious in every relation." It was, he said,
a curious fact, that Mormonism makes its impress upon the countenance... an expression compounded of sensuality, cunning, suspicion, and a smirking self-conceit. The yellow, sunken, cadaverous visage; the greenish-colored eyes; the thick protuberant lips; the low forehead; the light, yellowish hair; the lank, angular person, constitute an appearance so characteristic of the new race, the production of polygamy, as to distinguish them a glance.
He added that, even among the wealthiest Mormons, the infant death rate was high-these people believed in curing disease by "miraculous interposition" rather than by physicians.46
Examples of the failure of physicians to cure were not unusual in the middle of the nineteenth century, but the death of the Medical Department`s most illustrious patient emphasized the helplessness of doctors when confronted with many of the diseases of that period. Despite the efforts
44Quote from Statistical Report, 1855-60,p. 305.
45Max L. Heyman, Jr., Prudent Soldier: A Bibliography of E. R. S. Canby 1817-1870 (Glendale, Calif.: Arthur H. Clark, 1959),pp. 110-11, quote from p. 110.
46Quotes from Statistical Report, 1855-60, p. 301-02.
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of three medical officers and a civilian colleague and at a time of considerable political turmoil, President Zachary Taylor fell victim to a gastrointestinal ailment in 1850.
Taylor became ill after spending hours in the sun on 4 July and then returning to the White House to drink quantities of cold beverages and eat raw fruits and vegetables. His doctors, summoned only after many hours had passed, diagnosed cholera morbus (acute gastroenteritis, not the dreaded Asiatic cholera), complicated in its later stages by remittent fever. They dosed him with calomel, opium, and quinine. The up and down path of the disease led them at times to believe that their treatment was successful, but after five days of intermittent nausea, cramps, and diarrhea, and eventually fever as well, on the evening of 9 July, Taylor died.47
Taylor`s death may well have resulted from some form of food poisoning, a common enough affliction at the time, though not one that ordinarily led to death. A fever had kept Taylor in bed for almost two weeks during the Second Seminole War, attacking him again during the war with Mexico. He may have been susceptible to flare-ups of malaria, especially when some other problem sapped his strength. Taylor`s history of gastrointestinal problems, however, also suggests that a recurrence of amebic dysentery may have contributed to his demise. Like many another old soldier, he may have harbored not one but two parasites capable of killing him when the resilience of youth had deserted him and stress had rendered him especiallyvulnerable.48
BERNARD J.D. IRWIN. (Courtesy of National Library of Medicine.)
Surgeons as Soldiers and Scientists
Few Army surgeons were ever privileged to sit at the president`s bedside, but many cared for soldiers in campaigns against Indians in the West. One young physician very much involved in these efforts was Assistant Surgeon Bernard John Dowling Irwin. Irwin was both an amateur naturalist and the first man ever to win the congressional Medal of Honor, which was awarded to him in 1894 "for gallantry in action against hostile Chiricahua Apache Indians near Apache Pass, Ariz. 13th and 14th February, 1861."49
47Holman Hamilton, Zachary Taylor: Soldier in the White House (Indianapolis and New York: Bobbs-Merrill Co., 1951), pp. 388-93.
48Holman Hamilton, Zachary Taylor, Soldier of the Republic(Indianapolis and New York: Bobbs-Merrill Co., 1941), pp. 36, 140, 192;Hamilton, Soldier in the White House, p. 388.
49Quote from B. J. D. Irwin, "The Apache Pass Fight, "Military Surgeon 73 (1933):197; U.S. Department of the Army, The Medal of Honor of the United States Army (Washington: Government Printing Office, 1948), pp. 6, 206. Unless otherwise indicated, all material on Irwin`s experiences at this time is based on his article in Military Surgeon, pp. 197-203.
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Irwin`s opinion of the Apache was scarcely better than that which his colleague held of the Mormon. His observations led him to conclude, among other things, that Apache women did all the work, "while the dusky warrior basks in the sunshine, smoking his cigarito, dreaming over the ruthless deeds of murder and rapine" that he had inflicted on "the unfortunate `pale faces`." The repeated demonstration of what the Chiricahuas might do to palefaces unfortunate enough to fall into their hands apparently made compassion for the Apache difficult for the men at Fort Buchanan in present-day Arizona, seventy miles south of Tucson. In Irwin`s account of the events of the winter of 1860 to 1861, he noted that under the leadership of Cochise, Chiricahuas often ambushed small groups on their way to Mexico or California, killing the men and enslaving the women and children, with "ill treatment much worse than the most cruel death." He pointed out that "the highway leading to and from Apache Pass was dotted with the graves or stone tumuli that cover the remains of the victims of [Cochise`s] treachery." Apaches, Irwin concluded, were all alike, "treacherous, blood-thirsty, and cowardly."50
The events that brought Irwin the Medal of Honor began with the departure of Lt. George M. Bascom and sixty men of the 7th Infantry, to which Irwin was attached, from Fort Buchanan, under orders to try to find a boy whom Cochise and his men had reportedly kidnapped and cattle they had stolen from a beef contractor. After having been persuaded by a civilian he knew to come to camp to discuss these matters, the Indian leader managed to escape an attempt to detain him there by force. Others of his party were kept as hostages, but the chief, undeterred, attacked the Overland Mail the night after his escape. Having sent a request for help through to Fort Buchanan, Bascom arranged a second parley, one that barely missed being a complete disaster. Three civilians with Bascom mingled with the Indians attending the gathering and were never seen alive again, but an attempt to ambush this parley failed. The Indians then surrounded the camp.51
After Bascom`s messenger arrived at Fort Buchanan, a message was sent to the cavalry units at Fort Breckinridge, 100 miles away, requesting their support in helping Bascom. Desirous of bringing at least some aid to the lieutenant as quickly as possible, Irwin obtained permission, despite his supposed noncombatant status, to lead a small detachment directly from Fort Buchanan, where there were no cavalry units, to Bascom`s camp. In spite of the severe blizzard that was raging, Irwin and fourteen infantrymen set out on muleback toward Apache Pass. When they entered the pass, they encountered five wagons, all "plundered and burned," with eight naked bodies fastened to the wagon wheels. The victims had slowly burned to death as the flames consumed their vehicles. Shortly thereafter, Irwin and his men took prisoner three Indians found herding stolen cattle. Intending to use the cattle to distract the besiegers as well as to supply Bascom and his men with beef, Irwin had the beasts driven ahead of him. With the three In-
50First quote, Statistical Report, 1855-60,p. 212; remaining quotes, Irwin, "Apache Pass," pp. 198-99; Harvey Starr, "Bernard J. D. Irwin, M.D.," in The Westerners Brand Book, no. 13 ([Los Angeles], 1960), pp. 77-79, 81.
51Starr, "Irwin," p. 81.
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dians as his captives, the surgeon made his way through to Bascom`scamp.52
With the arrival of the cavalry from Fort Breckinridge a day later, the Indians quickly disappeared. As in so many engagements with the western Indians, few men had been wounded. Although only two of Bascom`s command had been hurt, soldiers who located Cochise`s camp found that others had not been so fortunate- vultures were tearing the flesh from the bodies of six white men, among them those of the civilians taken by the Chiricahuas at the time of the second meeting with Bascom. With the eight tormented bodies from the plundered wagon train a vivid memory, Irwin urged Bascom to execute six Indian hostages in retaliation. "The punishment," he admitted, "was an extreme mode of reprisal but was demanded and justified by the persistent acts of treachery and the atrocious cruelties perpetrated by the most cowardly and intractable tribes of savages infesting the territory." Irwin`s insistence finally overcame Bascom`s initial reluctance to resort to such measures, and, ten days later, the six Indians were hung "to the boughs of two stately oaks" that stood over the graves of their white victims. Because Irwin and Bascom "were desirous of making a lasting example to our treacherous foes, the bodies were allowed to remain suspended permanently."53
Irwin`s courage in action won him acclaim, and his medical duties must have occupied much of his time, since malaria posed a severe problem at Fort Buchanan because the post was small. But he also had time to pursue his interest in natural history and to keep the detailed meteorological records that the department required of all surgeons. Little hope may have remained that the data about climate and weather that he dutifully recorded and sent back to the surgeon general would be of great significance to the medical world, but there were valuable nonmedical uses for this kind of material, of which the Medical Department had accumulated sixty-four volumes by 1860. A researcher at the Navy Department used data from the Medical Department in preparing a study of storms, for example, and his work would serve as an aid to navigation. The topographical engineers responsible for assessing routes for the construction of railroads to the Pacific were also among those who made use of Medical Department data. In addition, the Medical Department cooperated with the Smithsonian Institution, which even provided some of the instruments used in recording details of the weather, in spite of the friction that developed between Lawson and Joseph Henry, head of the Smithsonian.54
52Quotes from Irwin, "Apache Pass," p. 202; Starr, "Irwin," p. 84. A report appearing three years later asserted that the term "non-combatant" was "convenient, but not truthful," adding that a physician could command troops in the absence of other commissioned officers; Woodhull, "Military Rights and Duties," p. 480.
53First and second quotes, Irwin, "Apache Pass," p.203; remaining quotes, B. J. D. Irwin, "A Case of Severe Puncture Wound: Body Transfixed by a Bayonet:- Recovery," American Medical Times 4 (1862):274. Most engagements with the Indians in the West in the decades before the Civil War were like this one-small, involving few men, and resulting in an average of barely more than one soldier wounded per clash: George W. Webb, Chronological List of Engagement Between the Regular Army of the United States and Various Tribes of Hostile Indians, Which Occurred During the Years 1790 to 1898, Inclusive (St. Joseph, Mo.: Wing Printing & Publishing Co., 1939), pp. 9-23.
54 Ltrs, Lawson to Jefferson Davis (copies, 5 Feb and 10 May 1856), both in Joseph Henry Papers, Record Unit (RU) 7001, U.S. National Museum, Smithsonian, Washington; Coolidge to Baird (4 Feb 1856), in Spencer F. Baird Papers, RU 7002; Heiskell to Griffin (6 Jun 1850), Lawson to AG(25 Jun 1853), and Lawson to Henry (5 Apr 1856), all in RG 112, entry 2,21:96, 23:209, and 25:222-29, respectively; James Pollard Espy, First Report on Meteorology (n.p., n.d.), pp. 1, 2, 4; U.S. War Department, Report of the Secretary of War on the Several Pacific Railroad Explorations(Washington: A. O. P. Nicholson, 1855), p. 39; Ashburn, Medical Department, p. 388. Henry criticized the department`s work in the field of meteorology, but Professor W. E. Landsberg, University of Maryland Department of Meteorology, has pointed out that modern meteorologists regard the Army`s records as of higher quality because of the Army`s greater control over its observers.
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Irwin shared his interest in natural history with many other Army medical officers, among them the future surgeon general, William A. Hammond. By the time the Civil War was over, some of these surgeons were on their way to achieving enviable reputations as naturalists. With their aid, even before 1861, the surgeon general was able to cooperate with scientists and institutions interested in obtaining specimens of animals, plants, and minerals. When Army physicians could not be spared to accompany exploring expeditions, the department hired contract surgeons, making skill as a naturalist one of the important qualifications for this position. Through the efforts of Assistant Secretary Spencer F. Baird, the Smithsonian Institution worked closely with the Army. It supplied surgeons with containers for their specimens, materials and instructions for preserving them, books relating to natural history, and in at least one instance, actually trained the naturalist-physician for his work..55
One of the Army`s young contract surgeons with an interest in natural history had passed the Department`s entrance exams before accompanying a survey party exploring possible railroad routes in the Northwest. George Suckley cared for the sick and injured among the men and also served as a naturalist, under Baird`s guidance. The Smithsonian provided the necessary supplies and required that Suckley collect and study zoological and botanical specimens, familiarize himself with the Indians and their history, and make notes on rivers and their currents and falls. He initially had much time for this work because the men in the party were generally quite healthy, but his efforts to send his specimens safely back to Washington did not always meet with success. On at least one occasion, Baird was confronted by a container in which "unfortunately nearly all the fish were spoiled."56
When an opening became available in December 1853, while Suckley was with the exploring expedition in the West, he joined the Medical Department and was sent to Fort Steilacoom in the Washington territory. Here he established a "good private practice" and began to invest in real estate. The opportunities for a naturalist were rich in the area and Suckley was content, but in the summer of 1854, to his dismay, the Army ordered him to Fort Dalles in the Oregon Territory, "a most barren spot. "He had little time for natural history, for he was soon ordered to accompany a detachment sent "to chastise some Indians about 400 miles "from the fort. Despite the danger posed by the enemy, Suckley came
55Unless otherwise indicated, material on naturalists serving in the Army is based on Edgar Erskine Hume`s Ornithologists. The paragraph is also based on Ltrs, Irwin to Baird (1 Sep 1857) and Hammond to Baird (9 May 1852), both in Registrar 1834-1958, Accession Records, RU 305, Smithsonian; Baird to Irwin (9 Oct 1857), Outgoing Correspondence, Assistant Secretary, 1850-1877, RU 53, 16:507; Lawson to Charles Sutherland(1 Aug 1853) and Heiskell to Byrne (17 May 1854), both in RG 112, entry 2, 23:266-67 and 24:13, respectively; Cooper to Lawson (12 Jan 1859) and Official Orders, Jefferson Davis (extract, 12 Apr 1853), both in RG 112, entry 12.
56Quote from Ltr, Baird to Suckley (17 Jan 18 5 5), RU 53, 10:195, Smithsonian; U.S. War Department, Reports of Explorations and Surveys ....14 vols. (Washington: A. O. P. Nicholson, 1855), 1:64, 82, 177-79, 219-301;Ltrs, Baird to Suckley (26 Nov and 26 Dec 1853 and 31 Jan 1854), all in RU 53; Suckley to Baird (14 Apr 1853), RU 6999T; Isaac I. Stevens to Lawson(12 Apr 1853), RG 112, entry 12.
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back from his six weeks in the wilds with "a few articles of interest."57
At Fort Dalles, Suckley began to realize that he could not be happy in the Medical Department. His first love was natural history, and his duties as a military surgeon made it impossible for him to work and move about with the freedom he desired. His assignment in the West was delaying his work on the final version of the Pacific Railroad survey report. Baird used his influence in Washington to obtain leave for Suckley to travel east for a few months, but the surgeon was soon ordered west again. Suckley spent Christmas of 1855 in Panama with troops being sent to the West Coast and by the end of January was at Fort Steilacoom accompanying expeditions against the Indians in which he faced considerable personal danger as he cared for the sick and wounded. By the summer of that year Suckley was determined to leave the Army. He wished, however, to avoid having to pay his own expenses to return, and hoped to obtain leave to travel east and to resign shortly after his arrival. Again Baird did his best in Suckley`s behalf through his acquaintances in the government, but to no avail. Suckley was forced to resign while still on the West Coast and by mid-November was on his way home.58
GEORGE SUCKLEY.(Courtesy of National Library of Medicine.)
Even in the absence of hostile Indians, specimen hunting was not always a danger-free occupation, as Samuel Washington Woodhouse, who became a prominent naturalist, discovered. While Woodhouse was serving as a contract surgeon with an expedition exploring the Zuni and Little Colorado rivers, a rattlesnake that he was trying to collect bit him. Woodhouse broke the creature`s back with a ramrod, but when he picked it up, he forgot to grasp it close to its head, and was bitten on the index finger of his left hand. He sucked the wound while his companion quickly applied a tourniquet to the digit. He then scarified the area around the wound and, as soon as he could obtain ammonia water, applied it to the bite. Following the recommendation of a civilian he encountered on his way back to camp, he also began drinking whiskey in large quantities. Despite his precautions by evening the glands in his armpits were sore. He then dosed himself with an opiate and, substituting
57Quotes from Suckley to Baird (22 Nov, 16and 27 Aug, and 16 Oct 1854), Incoming Correspondence, Assistant Secretary,1850-1878, RU 52, vol. 71, pt. 2:564-66.
58Ltrs, Baird to Suckley (Oct 1854, 15 Feb 1855, and 15 May, 18 Apr, 21 Jun, and 16 Jul 1856), all in RU 53, 10:8, 314, 14:116, 277,and 15:88-89, 131, respectively; Suckley to Baird (28 Dec 1854, 24 May 1856, 23 Dec 1855, and 21 Jan, 10 Feb, 9 Mar, 16 Apr, and 1 Jul 1856), all in RU 5 2, vol. 7 1, pt. 2:567, 580, 582, 583, 584, 585, 587, and 589, respectively.
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SAMUEL WOODHOUSE.(Courtesy of National Library of Medicine.)
brandy for the whiskey, managed to remain drunk for four or five hours. Throughout the night he continued dosing himself with various remedies, including a cathartic. After sobering up, he removed the tourniquet from his finger and applied a flaxseed meal poultice. Even with all this care, it was months before he regained the use of his hand. Whether because of the bite itself or because of the length of time he left the tourniquet in place, he eventually lost the nail and part of the finger.
Although many surgeons worked as naturalists when not occupied with their patients, one young physician retained his unusual youthful interest in communications and worked while he was an Army surgeon to perfect a system of signaling with flags during daylight and torches at night. Assistant Surgeon Albert J. Myer first brought his ideas to the attention of military authorities late in 1856, when he expounded the virtues of his system in a letter to Secretary of War Jefferson Davis. In 1859 the approval of an Army board led to field tests, and in 1860 Myer was appointed signal officer, at which time he formally resigned from the Medical Department. In 1863Myer became the first head of the new Signal Corps.59
Conclusion
Some of the younger members of the Medical Department showed varied talents as naturalists and inventors, as surgeons, and as brave and sometimes harsh soldiers. The department itself, however, was typical of Army bureaus of the time, its leaders aging and set in their ways. During peacetime, the experience of the older men was a valuable asset, since the problems challenging the Medical Department in the years immediately preceding the Civil War were those it had always faced. Distances were greater and posts more numerous, but neither the diseases nor the needs of the individual post or detachment had significantly changed. Furthermore, the art of medicine had yet to become a science, and experience was no worse a guide than any other in the treatment of the familiar diseases. But the Medical Department had no plans for meeting the supply and evacuation problems of a major conflict, or for systematically providing the physicians and hospitals needed to care for masses of casualties. And even if contingency plan-
59Edgar Erskine Hume, "The Foundation of American Meteorology by the United States Army Medical Department, "Bulletin of the History of Medicine 8 (1940):225-26; "Army Doctors- Pioneers and Peacemakers," Military Medicine 126 (1961):891;Paul J. Scheips, "Albert James Myer, An Army Doctor in Texas, 18 54-1857," South western Historical Quarterly 82 (1978):9, 20-24.
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ning had been customary for nineteenth century armies, no one could have predicted the size and extent of the ordeal to come. Unprepared even for a minor war, the Army Medical Department would inevitably be overwhelmed in the earliest months of the Civil War.
