Chapter 9
Defeat and Final Victory, 1814 to 1815
Enemy attacks on the Baltimore-Washington area in the summer of 1814-15 made it obvious that the British posed a threat not only to the northern tier of states but also to the borders of the entire nation. Although by this time the care given the soldiers fighting in the North was beginning to show the benefits of the efforts and experience of the Medical Department`s surgeons assigned to that area, the facilities available to the regulars defending Washington and New Orleans were in some degree overwhelmed bythe sudden need to care for militia and volunteer casualties as well.
CAMPAIGN IN THE NORTH
Although the campaign season of 1814 in the Northeast began with the failure of a northward move by Maj. Gen. James Wilkinson from the Lake Champlain area, operations to the west, along the Niagara River, reflected great credit upon the American forces, in large measure because of the training given to many of the men by Brig. Gen. Winfield Scott and the leadership of General Scott and Maj. Gen. Jacob Brown. Both the Americans and the British suffered heavy losses in these engagements; the Americans, for example, lost 227 wounded in the 5 July action along the Chippewa River and more than 850 in total casualties in the 25 July Battle of Lundy`s Lane. Unfortunately, both General Brown and General Scott were wounded in the course of the summer, and in October, Maj. Gen. George Izard, who led reinforcements in from the east, ordered the Americans to withdraw from Canadian territory.1
Reinforcements for the Niagara area, however, had been taken from among the forces along Lake Champlain. The enemy quickly attempted to take advantage of the situation, but the success of American naval forces in the Battle of Plattsburg Bay and the resultant loss by the British land forces of their naval support led to the withdrawal of the British into Canada and the end of the threat of British invasion from the north.
The Burlington hospital continued to be one of the major Army facilities in this area during the last months of the war. In charge at Burlington were, first, Dr. James Mann, the surgeon with the greatest seniority in the 9th District and therefore presumably its medical director, and later, Dr. Henry Huntt, a hospital surgeon of junior status. Under their supervision at one time or another in the period January 1814 to April 1815 were more than 3,700 patients, fewer than 200 of whom died.2 (Table9)
If one can generalize from Mann`s account, the most persistent problems confronting the surgeons staffing this hospital were those caused by regimental officers and regimental physicians. Often the required records did not accompany the patients to the hospital, an omission which at times may have been deliberate. A shortage of blankets and bedding was aggravated by the failure of regimental surgeons to send the bed sacks along with the men they sent to the general hospital. Some patients, furthermore, were sent from regimental
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TABLE 9-ADMISSIONS AND DEATHSAT THE BURLINGTON GENERAL HOSPITAL, JANUARY 1814-APRIL 1815
|
Month |
Admissions |
Deaths |
|
Total |
3,707 |
184 |
|
1814 January |
180 |
7 |
|
February |
671 |
17 |
|
March |
931 |
29 |
|
April |
630 |
22 |
|
May |
151 |
17 |
|
June |
59 |
6 |
|
July |
30 |
1 |
|
August |
33 |
0 |
|
September |
729 |
31 |
|
October |
105 |
25 |
|
November |
52 |
11 |
|
December |
13 |
5 |
|
1815 January |
35 |
6 |
|
February |
56 |
3 |
|
March |
20 |
2 |
|
April |
12 |
2 |
SOURCES: Mann, Sketches, p. 144; Huntt, "Burlington," p. 179.
facilities to the general hospital only after they had reached "amoribund state." Mann was particularly angered, however, when regimental officers, often without even consulting a member of the hospital staff, informed one of his patients that if he did not return to duty at once, he would be considered a deserter. Mann believed that no officer was entitled to command a soldier to leave the hospital without a specific order to that effect from his commanding general.3
The strain placed upon the Burlington hospital increased in the late summer of 1814 after patients from Plattsburg were evacuated there in the face of the enemy advance. An estimated 650 to 815 patients arrived at the Vermont facility in open boats, "a great number of them . . .unable to walk; and some were so reduced by disease as to be unable to tell their names." A sizable majority of the men had diarrhea anddysentery4 and some developed what was diagnosed as typhus. It was noted at this time that the suffering of such of these men as had recently come in from the south seemed to be greater than that of others under these circumstances. Although the hospital itself could hold only 300 at a time, a barracks was taken over for the use of these new patients, and each man was washed and placed in a clean bed. In early September 1814, after the Battle of Plattsburg, seventy-nine more patients entered the Burlington hospital, fifty-five of whom were seriously wounded. Dysentery and diarrhea were now afflicting so many that physicians "could hardly enter a ward without seeing half a dozen on the closes tool," and care was taken to keep closes tools filled with limewater to reduce the odor.5
The men hospitalized at Plattsburg were not so fortunate as those at Burlington. In December 1813, first priority had been given here to building barracks for able-bodied soldiers and thus the hospital facilities were very disorganized when an epidemic similar to that of the previous year hit the Northern Army in the early months of 1814. As a result, some of the sick reportedly died from the cold. By the early summer of 1814, the weather and "ill-judged" troop movements were blamed for a "prodigious mortality," and by mid-August 1814, when there were 100 men in the general hospital within the Plattsburg camp, Mann was the only physician available to care for them. Another thirty patients were hospitalized in the village itself at this time under Wheaton`s management and regimental surgeons were responsible for another fifty to ninety men. By 1 September, surgeons at Plattsburg were caring for more than seven hundred men.6
Although General Izard and his men marched for Sackett`s Harbor in late August 1814, they left more than nine hundred patients and convalescents from both regimental and general hospitals behind at Plattsburg. Those still hospitalized at Plattsburg in early September were evacuated to Burlington in the face of the British ad-
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vance. Initially, however, because of the lack of adequate transportation, they were moved two and a half miles to Crab Island, where for several days Mann, aided only by a surgeon`s mate who was himself sick, cared for them as they lay on the wet ground, sheltered only by tents from the rainy weather. Finally, however, in the care of the surgeon`s mate, they were moved in large open boats the remaining twenty-five miles to Burlington.7
Although he stayed with his patients while they were on Crab Island, Mann continued in overall charge of both Army and Navy wounded from the Battle of Plattsburg and reported that while the guns were firing, surgeons were exposed to danger as they moved from one protected area to another to care for the wounded. After the battle, more than thirty major operations were performed and these with such skill that Mann could write that "the medical gentlemen of our army and navy were . . . superior to the medical gentlemen of the British navy."8
The unit at Plattsburg appears to have been reopened once the threat to the town had passed, and by the end of the year, as the war drew to an end, 174 were patients still hospitalized in regimental units and 210 in general hospitals in the Lake Champlain area, including Burlington andPlattsburg.9
In the hospital at Malone, New York, the situation had deteriorated seriously by February 1814. Two hundred patients had been sent in from the camp at nearby French Mills and every house available for the purpose in the village was taken over to shelter the total of 450 patients now hospitalized in Malone. An adequate supply of blankets, bed sacks, hospital stores, and medicines, however, could not be located. The sick were suffering so intensely from the severe weather that four of them, according to Mann, died from the cold. "Humanity," Mann commented, "shudders at the appearance of these unfortunate men." It now became necessary to send the men arriving at this hospital to other facilities, despite their "deplorable condition." Mann noted that this was not the first time the Medical Department had been overwhelmed by circumstances.10
On 9 February 1814, all the patients whose condition permitted it were moved away and the hospital at Malone was broken up. Under Mann`s supervision, more than 450 men were sent first to Plattsburg, a journey of about seventy miles, and then on to Burlington. They were moved in sleighs in small groups to avoid overtaxing the accommodations of the sparsely settled areas through which they had to pass. Twenty of those in the poorest condition, however, were left at Malone under the care of a civilian physician and were captured by the British, while six of those who attempted the journey died on the way.11
Despite the crowding at Malone in the early winter of 1814 and the reappearance of the pneumonia experienced in the North the previous winter, only twenty men of the 380 admitted in the period 1 January to 9 February 1814 died at Malone. Some of the victims of this form of pneumonia died in a very short time after the first appearance of their symptoms. Among the complications attending this illness were "swelled feet and legs; some of these were accompanied with mortifications; the consequence of long confinement and inactivity in the boats, wet and cold, during the passage of the army down Lake Ontario and the river St. Lawrence."12
The hospital located at Sackett`s Harbor, New York, remained there at least through the summer of 1814 despite dissatisfaction with the site. In the winter of 1814, the Apothecary General complained that the surgeons at this facility were wasteful, and the surgeon in charge pointed out that the 2,500 soldiers there had no regimental surgeons or mates with them and that, although hospital surgeons had taken over these re-
175
sponsibilities, more physicians were needed at Sackett`s Harbor.13
For the final two years of the war there was also a general hospital at Brownville, New York, near Sackett`s Harbor. It appears to have been closely linked with the Sackett`s Harbor unit and from January 1814 to April 1816 was under the supervision of Dr. Hosea Blood. Unfortunately, however, Blood`s report concerning deaths among the patients under his care does not break the figure down between Sackett`s Harbor and Brownville. In the period 23 October 1813 to 20 January 1814 at Sackett`s Harbor and 20 January 1814 to April 1816 at Brownville, 325 of his patients died. Tilton seems to have believed that the Brownville site was well chosen since the air and water there were good, but he urged that tents continue to be used during the summer of 1814 and that a large number of them be kept on hand to meet any eventuality, since huts should be used only in cold weather.14
A general hospital remained at Greenbush, New York, on the east bank of the Hudson, opposite Albany, as late as the earliest weeks of 1816. Little detail is available on conditions there, but the site was considered to be high enough to avoid the great danger posed by the fogs rising from the river. In the fall of 1813, a group of patients from the hospital at Lewiston, New York, had been evacuated to Greenbush, and early in 1814, two hundred to three hundred more were sent in from Buffalo. In his report of August 1814, however, Tilton listed only sixty-seven patients remaining in the Greenbush general hospital, but by 31 December 1814, the number of patients at Greenbush had again increased markedly, partly because the facility was now caring for 161 wounded British prisoners as well as 160 Americans.15
In 1814, the hospital at Williamsville, New York, did not occupy the same quarters it had used the previous year, and patients were sheltered in tents while awaiting the completion of buildings designed specifically for use as a hospital. Progress on the construction was extremely slow, however, and General Izard wrote that "the jealousy and quarrels between surgeons and the Quartermaster`s department of General Brown`s division "were to blame. In early November 1814, the new building was still "far from ready for the reception of the sick and wounded."16Some of the construction may have been complete by 26 November, for General Izard referred to the Williamsville facilities at that time as an "extensive hospital establishment," but in early November, because of the inadequacies of the facility, General Izard, following a suggestion from the hospital`s senior surgeon, ordered that as many as could tolerate the journey be senton to Greenbush. Nevertheless, almost two thousand patients were in such poor condition that they had to remain behind in the tents at Williamsville.17
There was, for a time, also a hospital set up at Buffalo in 1814 in the tents left behind when camp there was broken. The Americans wounded in July`s battle at Chippewa and some of the enemy wounded, probably those from the Battle of Lundy`s Lane, were sent to Buffalo. Among the British patients were some so badly burned in the explosion of a powder magazine that their "faces and hands were so crisped that the skin peeled off like a baked pig." Among a number of American wounded who were rowed up the Niagara River in a flat-bottomed boat to Buffalo was General Scott himself. Only those in the poorest condition were retained at Buffalo for any length of time, however, and although some difficulties were experienced in obtaining transportation, all but eighty to ninety men too seriously injured to be moved were sent eastward, apparently within a few weeks, to the facility at Williamsville. The Buffalo facility was closed on 23 December 1814.18
Because of the casual nature of some
176
"SOLDIERS WHO DIED ATTHE GENL. HOSPITAL GREENBUSH TOGETHER WITH THEIR EFFECTS."(Courtesy of National Archives.)
177
of the reports which survive from the time of the War of 1812, it is difficult to be sure of the nature of all of the hospitals serving the Army during that time. The Tilton report of 20 August 1814, for example, mentioned a return from a hospital surgeon, E. W. Bull, concerning the sick and wounded from Chippewa. It did not, however, make clear whether Bull was referring to men who became incapacitated during the battle of that name or to men hospitalized at some facility or facilities at or near Chippewa. If the former is true, however, the figures furnished Tilton by Bull (approximately 900 wounded, 300 sick) are, as Tilton commented, surprisingly high and probably included, as the Physician and Surgeon General commented, British casualties. It is difficult to believe that 300 men would fall ill as a result of one battle, and therefore it is likely that the reference was to the number of patients at a hospital. There is no record of a general hospital at Chippewa, however, but since the reporting physician was a hospital surgeon rather than a regimental surgeon, it is reasonable to assume that the Chippewa facility was a flying hospital.19
Patients at Fort Erie, which was taken from the British in July, were cared for by regimental surgeons who received high praise in the summer of 1814. The men there suffered from the high rate of illness which was to be expected in the area, but by early August, they were in better health than had been expected. Not long thereafter, however, the British began an unsuccessful five-week siege of Fort Erie, during which a strongpoint blew up just as the British were about to take possession of it. The wounded left behind by the British, their faces, in some cases, "so fearfully disfigured, that the sight of them was sickening," were carried to the American hospital. The care two surgeons and three mates gave the men entrusted to them at Fort Erie20 led the commanding general to comment upon their "active, humane, and judicious treatment of the wounded, both of the enemy and of our own."21
The final report for the Medical Department in the 9th District in the War of 1812, covering the last months of 1814, noted that in the rightwing there were 174 men remaining in regimental facilities and 210 in general hospitals, and in the Niagara area, the left wing, 365 in all facilities. In the vicinity of Sackett`s Harbor, the central division, the total number of patients reported to Tilton was 581, but he questioned the accuracy of this figure.22
In the Northwest`s 8th District, even after the departure of Maj. Gen. William Henry Harrison and approximately seven hundred regulars for the Niagara front, surgeons were unequal to the task which confronted them. The same agues and fevers which severely afflicted the civilian population in the area of Lower Sandusky, Ohio, and the country around Fort Stephenson struck at the garrisons holding the area. The physician responsible for the health of the soldiers here, Nathan Boulden, regimental surgeon for the 28th Infantry, also attempted to care for the thirty families living near the fort, even after he himself fell ill. He commented that the low-lying land was "astonishingly fruitful in the production of marsh miasmata "and that there were occasions when every member of a family was sick a the same time.23
Upon his arrival in the Northwest as hospital surgeon for the 8th District late in 1814, another Army surgeon, Adam Hays, commented that "there had been no kind of system in this district, but I shall endeavor to cleanse the Augean stable." He emphasized the shortage of hospital surgeons, pointing out that the Army would save money in the long run by sending out two good hospital mates and three garrison mates and thus eliminating the need to hire private physicians with wasteful habits.24 By
178
mid-January, however, the situation in the Northwest had deteriorated to the point where Boulden "fled for his life," after "having lost his health in the sickly region of Sandusky," and Hays was threatening to resign because of a shortage of physicians so severe that those who remained were "worn out."25
Although Tilton`s attempt to put the Army`s medical services on a systematic basis fell short of its goal and the care offered the sick and wounded in the Northwest`s 8th Military was far from the ideal in the 9th Military District where the Army had concentrated both its most skilled physicians and many of its finest military leaders, by 1814 the picture was not entirely a dark one. "Intermittent fevers, dysentery, diarrhoea and jaundice were regarded as "endemic diseases" here,26 but because of the efforts of both physicians and military leaders, the only formidable sources of disease in 1814 appeared to be new troops, "the miserable refuse of society who never had energy to demonstrate that they lived." "The mystical power of strict discipline and rigid police" which could prevent even "the demon diarrhoea" was now recognized27and utilized in both camp and hospital. The recognition of the need for order and system was already leading to improvements in the care offered the sick and wounded of the Army in the North.
In the districts of the North where there was no military action, however, few patients required the attention of Medical Department physicians. In the 2d District (Rhode Island and Connecticut), for example, at the end of 1814 thirty-five patients were reported to the Physician and Surgeon General, all of them in a regimental infirmary, while in the general hospital of the 3d District (southern New York State and adjacent New Jersey), there were but fifty-eight patients remaining at this time, twenty-two of whom were from the militia.28
CAMPAIGN IN THE SOUTH
The demands made upon the Army Medical Department in the South, where relatively few Regular Army units saw action during the War of 1812, were quite different from those encountered in the North. Unfortunately, however, few of the surgeons on the small staff in the South left records of their work, and, as a result, only fragmentary information is available on the activities of department physicians below the Mason-Dixon line.
During the War of 1812, most of the area below the Mason-Dixon line lay in the 5th, 6th, and 7th Military Districts and, after the summer of1814, in the newly created 10th Military District, which included the District of Columbia. (Map 12) At the end of 1813, there were a total of four hospital surgeons, six hospital surgeon`s mates, one garrison surgeon, and six garrison surgeon`s mates assigned to the first three of these districts. In the following year, a fifth hospital surgeon and five more hospital surgeon`s mates were added to the staff in the South, but, even so, there were fewer physicians assigned to the hospitals and garrisons of the entire South than to the northern 9th District.29
In anticipation of an enemy attack upon Washington, the 10th Military District was formed on 2 July 1814, to include the area from Baltimore south through northern Virginia, and Brig. Gen. William H. Winder was placed in command. Estimates of the number of men, both militia and regulars, vary, but the latter did not exceed 500 and may have been no more than 300. More than 93,000 militia were alerted, but the entire force at General Winder`s disposal at the time of the British landing near Benedict, Maryland, on the Patuxent River on 19 August probably did not exceed 1,700 men.
Although approximately five thousand to six thousand Americans, a large majority of
179
180
them untrained militia and volunteers, were in the vicinity of the capital by 24 August, the British won an easy victory in the Battle of Bladensburg and then moved on Washington to burn the Capitol, the White House, and other government buildings before withdrawing to their ships and reembarking on 30 August. A British attack on Baltimore in early September was defeated by militia and volunteers, without the aid of regulars except for those at Fort McHenry, where 24 of 600 regulars were wounded and 4 killed.30
Several facilities appear to have cared for the Army`s patients in the summer of 1814 in the vicinity of Washington, D.C. One Army hospital, under the direction of Dr. William Jones, who was probably a hospital surgeon`s mate at the time, was operating at a location described as Greenleaf`s Point, now the site of Fort McNair at the junction of the Potomac and Anacostia Rivers, as early as the fall of 1813. The care offered soldiers before the summer of 1814 in what would become the 10th Military District nevertheless seems to have left much to be desired and the establishment of the new district does not appear to have markedly improved it. The day before the Battle of Bladensburg, Physician and Surgeon General James Tilton complained that the district was in great disorder largely because no one was officially in charge of medical support there. He urged the appointment of a hospital surgeon to provide leadership and proposed a personal visit to the area. Although it appears that it was not until 1 October that a hospital surgeon was moved to the 10th District, within three months he was able to bring at least some order to the management of medical support in that area.31
Because of the absence of a hospital surgeon in August 1814, wounded from action in the Washington area were apparently placed under the overall supervision of Dr. Hanson Catlett, who was referred to in a House of Representatives report as "the superintending surgeon." He is listed in the official records as the regimental surgeon for the 1st Infantry32 and referred to himself as having been specifically "attached to the suite of General Winder, as staff surgeon."33 Shortly after the Battle of Bladensburg, Catlett went through the British lines to aid in the care of injured American prisoners. Two other American physicians ,at least one of whom was apparently himself also a captive, aided him here. By 2 September, the hospital Catlett had been ordered to set up on Capitol Hill was ready to take all the patients who might be sent there. When the British reembarked, they left several surgeons and their most seriously wounded behind them, and these men, too, became an American responsibility. There is no indication whether any of these prisoners were cared for in the Capitol Hill unit, which was still in operation as late as September 1814.34
In addition to the Greenleaf`s Point and Capitol Hill facilities, there was also a third military hospital in the District of Columbia. Here some of the sick and wounded, both American and British, were cared for by a prominent civilian physician, Dr. James Ewell, who was assisted by a second civilian doctor. Ewell wrote that the Acting Secretary of War had ordered a militia facility established next door to his unit. This "militia-murdering hospital" was run by a surgeon`s mate who had barely started his medical training at the time when he was appointed to care for the militia`s wounded.35
By the end of 1814, the regular troops in the 10th District were in good condition but the health of the men of the militia was reported to be suffering because of their lack of discipline. The militia`s sick were being discharged, however, and at the end of the year there were only eighty sick in regimental infirmaries and seventy in the general hospital. By January 1815, the
181
troops still in the Washington, D.C., area were again sickly and a hospital surgeon was ordered to investigate conditions in a small barracks "near the President`s Square." It was pointed out to this surgeon that the hospital at Greenleaf`s Point was not filled to capacity and could accommodate more patients than it then held.36
Although regular units were also distributed among garrisons and forts throughout the deep South, many of the operations there during the War of 1812 were, like those in the North, conducted by militia and volunteers. The men operating against the Creek Indians in the Southeast beginning in the summer of 1813 were reinforced by regulars only in February 1814 when the 600-man 39th Infantry Regiment moved from Tennessee to Fort Strother on the Coosa River in what is now northeastern Alabama. (See Map 12.)On 28 May 1814, Andrew Jackson was named major general in the Regular Army to command the 7th Military District, which included Louisiana and the Mississippi Territory and, believing that the British were planning a move in the South, the Secretary of War began concentrating troops, both regular and militia, there. By 1 July, there were reportedly more than 2,000 regulars in the 7th Military District37 and militia was being raised within Louisiana and neighboring states for the defense of that area.
General Jackson did not remain in the vicinity of New Orleans at this time but moved against West Florida with both regulars and volunteers. He did not return to New Orleans until 2 December. On 10 December, the British fleet was sighted at anchor not far from New Orleans, at a time when the only regulars there were elements of two regiments and an artillery detachment, totaling six hundred to eight hundred men or fewer.38Militia and volunteer units continued to pour in, however, and by 22 December, General Jackson had more than 2,000 men at New Orleans.
The first engagement with the British at New Orleans took place on 23 December 1814 and was followed by three more battles, on the 28th of December and the 1st and 8th of January 1815. The battle of 8 January resulted in a decisive victory over the British with only minor losses for the Americans. On the morning of 19 January, it was discovered that the British had slipped away from New Orleans, leaving behind eighty of their wounded.39Minor clashes between the British and Americans continued in the South, however, until mid-February when Congress ratified the Treaty of Ghent and brought the War of 1812 officially to a close.
Other than physicians accompanying militia and volunteer units and such of the department`s regimental medical staff as may have accompanied detachments of regulars into the 7th Military District, the medical staff in this district was composed of a single hospital surgeon, who was stationed at the general hospital at New Orleans, two hospital surgeon`s mates, whose precise locations cannot be determined, a garrison surgeon at New Orleans, and four garrison surgeon`s mates, two of whom were at Fort Stoddert, north of Mobile Bay, and a third at Natchitoches, in west central Louisiana. The location of the fourth garrison surgeon`s mate does not appear in the reports of theperiod.40
There was neither a surgeon nor a mate assigned to Fort Strother, and as late as December 1813, the 39th Infantry was without a surgeon. It is likely, therefore, that the medical care of regular units based there during two successful months of campaigning early in 1814 was provided by a regimental surgeon`s mate.41 The records of the medical care of General Jackson`s men are very sparse, however, and the few details which can be pieced together concern the hospital and physicians at New Orleans.
According to Dr. Oliver Spencer, the
183
garrison surgeon for that post, before General Wilkinson`s last nine-month command in the 7th Military District, which ended in the spring of 1813, the general hospital in the New Orleans area moved with the units it served when they left the city itself. Since that time and despite the "acknowledged insalubrity" of the location, the facility had remained within the city, which was known not only for its permeation by "poisonous exhalations" from the river and marshes but also for its "extraordinary profligacy and licentiousness."42
Even before the War of 1812, the general hospital at New Orleans was apparently located very near an Ursuline convent, the unit`s presence having been described as a "great inconvenience" for "the ladies of the convent." As early as April of 1812, it had been suggested that the hospital building and lot be given to the Ursulines in exchange for property which they owned elsewhere, but as late as mid-June of 1815, the trade had not been carried out, even though General Jackson himself was in favor of moving the facility outside the city.43
From time to time, other buildings were apparently also used to shelter Army patients near New Orleans. During the action around New Orleans on 8 January, hospital facilities were set up near the field of battle. It seems likely that a building was used rather than a tent, since the hospital surgeon, Dr. David Kerr, later stated that when the action was at its height, Louisiana`s governor Claiborne rode his horse behind the hospital, "where he was entirely shelter`d from the balls of the enemy." This unit could have been the hospital set up in late December in a mansion house outside the city, one which was so damaged by this use that, according to its owner, $550 would be required to repair it. There was a man-
184
sion known as Three Oaks in this area which served as a hospital during the defense of New Orleans. Other patients were cared for in the schoolroom of the Ursuline convent, which had been abandoned by its pupils on 23 December. Fifty beds were reportedly set up there and it seems possible that the sisters also served as nurses elsewhere.44
Kerr was the director of the New Orleans general hospital during the last months of the War of 1812 and as such was apparently also responsible for collecting the required reports from the regimental and garrison surgeons and mates in the 7th District. Kerr reported to Tilton, however, that as of 30 July 1814 he had been unable to acquire reports from the other physicians in his district, although there were forty-nine patients under his own care in the general hospital.45
References pertaining to the medical care received by the troops defending New Orleans are not always easy to interpret because of a tendency to refer to participants in the struggle by their last names only and because there were two physicians with the last name of Kerr involved. It is, therefore, not always possible to be sure from the context to which of the doctors Kerr reference is being made. By the time of the British assault on New Orleans, Spencer had resigned as garrison surgeon, but Dr. Christopher Backus, of "the Drs. Apothecary Generals department," remained in the city. A native of Louisiana, Backus had been appointed Assistant Apothecary General in August 1814. Also aiding in the care of the wounded near New Orleans was a Dr. Flood, who appears to have owned land upon which General Jackson`s line was at one time camped and who seems, like John Kerr, to have volunteered his services. Dr. Lewis Heerman was a third volunteer whose name, like that of Flood, does not appear on the rolls of the Army Medical Department.46
Because the climate was taking its customary toll, the burden on the hospital facilities in the New Orleans area in December 1814 and January 1815 was great, despite the low number of American casualties. Many contracted "pernicious fever and dysenteries" and in one month 500 men reportedly died from disease alone. Large numbers of wounded British prisoners were also the responsibility of the U.S. Army at this time. The captives were taken to New Orleans the evening of 8 January, but, since the facilities there were already filled with Americans, an appeal was made to the citizens of the city for help. Pillows, old linen for dressings, and 140 mattresses were brought forward, and many civilians volunteered to take British casualties into their homes and to care for them there until space could be found for them within the hospital. All civilian physicians in the city at this time were called upon to care for the enemy wounded. They appear to have responded without hesitation and some even left town and went out to meet the wounded to render more prompt care.47 On 8 January, General Jackson assured the British Commander that "The wounded on the field shall be sought after, and every comfort administered them until they arerecd."48
General Jackson also sent a friend who happened to be a native of New Orleans back to check on the condition of his own wounded, who were scattered about the city, but despite his concern, the death rate among the hospitalized in New Orleans in the early winter of 1815 was reported to be very high. Militia and volunteer surgeons were ordered retained in the service to care for their patients who were housed in Army hospitals. General Jackson himself was on the sick list at one time, laid low by a "serious attack of disentry . . . brought on by cold and fatigue." His cure, achieved through the efforts of "Doctor Kerr Hospital surgeon,"49undoubtedly confirmed his earlier evaluation of the care the sick and wounded received
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during and after the defense of New Orleans which had led him to conclude that "The medical staff has merited well of the country."50
In the 5th and 6th Military Districts, unlike the 7th, there were no major military operations in the last year and a half of the War of 1812, although enemy raids occurred from to time along the eastern coast. In the 5th Military District, the headquarters of the Medical Department was at Norfolk, an area which the hospital surgeon in charge found to be healthier than he had anticipated. Assigned to Norfolk in 1814 were the district`s only hospital surgeon, two hospital surgeon`s mates, and a garrison surgeon`s mate. There was also a garrison surgeon`s mate at nearby Fort Nelson.51
When the hospital surgeon at Norfolk reported to Tilton in the summer of 1814, there were but forty-three patients in his general hospital and 618 in the "regimental infirmary." Elsewhere within the district, however, there seems to have been much confusion. The Deputy Quartermaster General in Richmond, Joseph Wheaton, maintained that he was forced to act as physician, superintendent, and manager of hospitals in Richmond from1 January 1814 to 19 November 181752 because "there was no hospital or medical department, nor even a United States physician at Richmond" to care for the many sick who, after their discharge from the Army, went through Richmond on their way from Norfolk. He had personally taken the initiative, arranged to obtain the use of a building for a hospital, signed on a surgeon`s mate, and appointed nurses. He apparently also supervised the care of patients from the militia units in the area.53
The troops in the Carolinas and Georgia were served by a relatively large medical staff, which as of 29 December 1813 included, on paper, three hospital surgeons, three hospital mates, and two garrison mates. Tilton appears to have had as little success in extracting reports from this district as he had in many others.54
The last year of the War of 1812 illustrated in the North the improvements in the care of the sick and wounded which could result from the effort and planning of experienced physicians when they were given adequate time and resources. Hospitals there were clean and efficiently managed and there is no evidence that in the North they became the hotbeds of infection which they had been in the Revolutionary War. In the South, where a high rate of disease was to be expected but where relatively few regular troops were stationed, the situation was quite different. Since casualties here were few among American regulars, any unusual strain upon the department`s physicians resulted largely from the wounded militia, volunteer, and enemy troops entrusted to their care.
