Sunday, January 27, 2013

Cholera, Typhoid, Amputation...


When I started writing blog entries about the Representatives who fought during the Maryland Campaign, I had Socrates Norton Sherman at the top of my list and planned on writing about him first. I figured finding information on him would be quite easy since he was a doctor and even has his name on the regiment’s monument. Ha! Wrong! Sherman has been the most elusive Representative and it took several months and a few dozen emails to finally locate something more than just a tiny bio about him in the Congressional Biographical Directory.
Sherman was born on July 22, 1801 in Barre, Vermont. He attended Mount Castleton Medical College and graduated in 1824. He moved to Ogdensburg, NY in 1825 and practiced medicine. In June 1832, a cholera epidemic broke out in Canada. New York Governor Enos Throop passed the “Public Health Act” and imposed quarantines along the NY/Canada border. However, within two weeks of the reported Canadian cholera cases, Ogdensburg had its first reported case. During this epidemic, Sherman was the health officer for Ogdensburg. The nature of the illness was not understood at that time so Sherman treated the sick as best he could and recorded all cases of those infected.(1)

In 1860 Sherman was elected as a Representative to the 37th Congress. While yet serving in Congress, he responded to Lincoln’s initial call for troops and entered the military as the Surgeon for the 34th NY on June 15, 1861. Sherman accompanied the 34th NY to Washington DC in July 1861 and remained at the city’s hospitals until August 1861. On September 30, 1861 Sherman wrote about his experience with the 34th NY---
“Reached Washington July 6 and went into camp on Kalorama Heights. There it remained until the 30th, when the sick were ordered to the Georgetown hospital and the regiment to Seneca Mills, Md., where it arrived on August 2. While encamped at Kalorama the diseases were almost exclusively diarrhea and rheumatism, but since it occupied its present location there have been superadded intermittent and remittent fevers, which in a few cases have assumed a typhoid type. I was detained at Washington and did not rejoin my regiment until August 11, when I found it encamped in the Seneca bottom, half a mile from the Potomac. Immediately the camp was removed to an elevation half a mile from and one hundred and fifty feet above the creek and about the same distance from and height about the Potomac. All possible attention has been paid to police regulations. The location is airy and descends in all directions. The water from a spring adjacent is both pure and abundant. The rations furnished are sufficient in quantity and of unexceptionable quality. Ardent spirits are excluded. Among the duties assigned the regiment is that of guarding the river for four miles above and below the camp; this has required the constant services of two companies, with generally four on picket on the banks of the river or the tow-path of the canal. Chills and fever have resulted, but only among those doing guard duty on the river; and of those attacked few fail of a rapid recovery when quinine is liberally used and strict confinement to camp enjoined. As the frosts of autumn approach the number of attacks decrease and the recoveries are more speedy.”(2)
Around this time, Jonathan Letterman designed a new medical system that Sherman would be a part of at Antietam. Treating the wounded during and after a battle was an absolute chaotic nightmare. Men died because they could not be removed from the field in a timely fashion. After observing this tragedy during the Spring/Summer 1862, Letterman stated “the subject of the ambulances became, after the health of the troops, a matter of importance. No system anywhere had been devised for their management. They were under control both of Medical officers and Quartermasters, and, as a natural consequence, little care was exercised over them by either. They could not be depended upon for efficient service in time of action or upon a march...[thus] it was necessary, nevertheless, to devise such a system as would render most available the materials upon the spot without waiting for the arrival.”(3)
In August 1862, Letterman released orders which created an ambulance corps and field hospitals. Dr Potter summed up Letterman’s orders---
“Each division hospital was to organize a staff, consisting of one surgeon in charge; one assistant surgeon as recorder; one assistant surgeon to provide food and shelter; three medical officers to perform operations, each operator to have three assistants; and additional medical officers, according to necessity, to attend the wards, dress the wounds, etc. There was also a chief hospital steward, one chief cook, one ward master, and a few nurses attached to the permanent organization.”
“The ambulances were organized into division trains with a first lieutenant in command and second lieutenants from each brigade as assistants; the entire trains from each corps being commanded by a captain attached to the corps commander’s  staff. A sufficient number of enlisted men were detailed from the ranks to properly man the trains of each division, in the proportion of two men and a driver to each ambulance, and a mounted sergeant from each regiment. A medicine wagon, properly supplied with stimulants, dressings, and medicines for each brigade, also formed a part of the division field-hospital equipment. Each division was provided with a saddler, blacksmith, and a traveling forge, to keep the train in order; and each ambulance was supplied with stretchers, buckets, kettles, lanterns, beef stock, bed-sacks, and kitchen utensils.”(4)
On September 2 McClellan’s Army of the Potomac fell under the medical direction of Letterman. The army was in a wretched condition as the medical officers were exhausted and most supplies had been left at Harrison’s Landing, VA. Pope’s Army of Virginia was not in any better condition having just been whipped at Second Manassas. The two armies met and merged in Washington and within days were quickly turned back out to chase after Lee in Maryland. As a result, the medical officers had no time to replenish their instruments and medicine supplies before they embarked on another campaign. Letterman lamented “the Medical Department of the entire Army had to be reorganized and resupplied while upon a rapid march in different sections of the country, and almost in the face of the enemy.”(5)
When the Army of the Potomac reached Frederick, MD on September 12, Letterman found the Confederates had already cleaned out all medical supplies. Even with this dire setback, Letterman arranged for hospitals to be made in Frederick and ordered supplies from Baltimore. Unfortunately, the suppliers could not meet Letterman’s needs fast enough due to the ruined condition of the railroads between Baltimore and Frederick. To make ends meet, supplies were taken off the rail cars four miles from Frederick and brought into the city by wagons and carts. Incredibly, some rail cars were put off to the side to make room for other cars and the medical supplies contained within were not discovered until much later while other rail cars simply never left Baltimore.(6)
On September 13, the day before the battle of South Mountain, Letterman selected houses and barns in Middletown to be used as hospitals. Sure enough, after the battle the wounded flooded into the area. The ambulances went up the mountain and brought the wounded back down.(7)
On the 15th Letterman passed through Keedysville and began a search for places that could be used as hospitals for the next battle shaping up along Antietam Creek. He had a general idea of McClellan’s battle plan and examined the terrain for ideal spots that were both safe and located near water. He said “the resources of the country for hospital purposes was ascertained as speedily as possible, and, when an idea was given of the nature of the battle, and the positions to be occupied by our troops, instructions were issued to Medical Directors of Corps to form their hospitals, as nearly as possible, by divisions, and at such a distance in the rear of the line of battle as to be secure from the shot and shell of the enemy---to select the houses and barns most easy of access---and, when circumstances permitted, to choose barns well provided with hay and straw, as preferable to houses, since they were better ventilated, and enabled Medical officers to attend a greater number of wounded---to place the wounded in the open air near the barns, rather than in badly-constructed houses---and to have the medical supplies taken to the points indicated.”(8)
Potter further elaborated on the details of hospital preparation when he explained that when battle was looming, the Medical Director of each corps located the site of division hospitals with an eye to safety and access to water. The hospital also needed to be an easy place for the wounded to be brought to. Once the site was chosen, the ambulance wagons pulled up and unloaded. Prior to receiving the first victims of battle, tents were pitched, buckets filled, tables and instruments laid out. Also, the hospital flag was raised and markers were placed along a route from the battlefield to the hospital so those in need wouldn’t get lost.(9)

Hoffman Farm

Hoffman Barn
Closer to the action, on the edge of the battlefield, was located an advance ambulance team with basic items. This team usually worked for a single brigade but on occasion for two if the brigades were small enough. The men of this team quickly determined if a wound could be treated by them at the “field depot” or if the person needed a hospital. Once at the hospital, the recorder made an entry of the wounded soldier (name, rank, company, regiment, nature of the wound, any other notables) and passed the soldier either to a dresser (of wounds) or the operating staff. The recorder would then add to the entry the course of treatment, the outcome of treatment, and daily reports. The daily reports were collected and sent to the Medical Director of the corps who then sent the reports to the Medical Director of the army. Hopefully, any patterns of success or failure would show up in these reports.(10)
This recording system was in use during the Maryland Campaign and in The Medical and Surgical History of the War of Rebellion, five entries were patients of Sherman’s at Antietam. Although full case studies are not provided, it seems Sherman was a competent surgeon since four out of five lived. His patients were---
1.      J Egan, 2nd NY Militia, amputation of right femur, died September 25, 1862.
2.      J Bowers, 69th PA, amputation of right femur, discharged May 15, 1863.
3.      C Ford, 106th PA, amputation of right femur, discharged December 10, 1863.
4.      CF Gage, 15th MA, amputation of left leg, discharged December 10, 1863.
5.      TG Smith, 107th NY, amputation of right leg, discharged December 6, 1862.
All patients were treated at the Susan Hoffman farm on Keedysville Road so it can be assumed that was Sherman’s location during the battle. This hospital provided aid to over 800 Union soldiers, primarily from the II Corps. From the above listings, four out of five soldiers were from the II Corps, as was Sherman, and the fifth was from the XII Corps.(11)
Dr Holt from the 121st NY wrote three entries in his diary that described what it was like to be a doctor in the days and weeks after the battle (Going Out for a Fight entry describes his South Mountain and Antietam experiences)---
On September 25---the soldiers “sleep in the open air. A few brush and boughs thrown over a frame of poles is all they have for shelter. Our hospital is such a structure. When it rains, the water comes down upon the men just the same as if they were in the open air. The consequence is, that sickness is greatly upon the increase...we have one hundred and fifty on the sick list...unless a change takes place soon, deaths will be as frequent as the most cruel enemy wish. We are lacking medicines...”
On October 2- “Surgeon’s Call is sounded and from one hundred and fifty to two hundred patients present themselves for treatment. The time required to attend all this consumes two or three hours and then the hospital has to be visited and those sick in quarters:---that means, those who are too unwell to come up to call, but who are not sick enough to go into the barn which we have taken possession of for a hospital. We have to make from twenty-five to thirty of these calls daily, seeing that the medicines prescribed are faithfully given and that the condition of men are comfortable, &---the diet of the sick in bed is also to be looked to--- Sanitary condition of the camp must be attended to, and a general supervision of the health of the men made and reported.”
On October 15- “Nothing upon or about me indicates a civilian. Everything is warlike:---guns, swords, bayonets, flags, drums, tents and indeed all the eye rests upon is unlike home. I am at this time sitting upon a canister of black tea, with a surgical case upon my lap for a table, writing this amid almost momentary interruption. Someone comes for an excuse from duty---another for relief from guard---another does not feel well enough to attend battalion drill---still another prays for excuse from dress parade, and others want still want their discharge papers made out and sent home. This is all competent for the Surgeon, and these calls are as frequent as every few moments in the day.”(12)
Even after the battle there was still the vexing problem of getting supplies from Baltimore to the battlefield. Any and all supplies in Frederick were needed at the Antietam hospitals. Luckily, at no time did the Medical Corps run dry. With the establishment of the Sharpsburg depot by the Sanitary Commission, supplies were continually replenished through the middle of October. Wagons unloaded at the depot and from there the goods were distributed among the battlefield hospitals. Since Letterman had such a difficult time getting supplies from Baltimore, the Commission was able to distribute supplies donated to it in the Medical Department’s stead. Typically, the route was from Philadelphia-Hagerstown-Sharpsburg. The Commission donated generously to every hospital within three miles of the battlefield regardless of where the soldier was from.  The Inspector of the Sanitary Commission, Lewis H Steiner, proudly wrote in his report that “I am pleased to state that the true relation of the Sanitary Commission to the Medical Department was fully recognized and appreciated as a body designed to supplement and not supplant the regular operations of the Army [as] the medical officers of the Army united with our officers in the proper disposal of our supplies.”(13)
Steiner also realized that the Sharpsburg depot was a huge success and quickly considered “an institution.” He sought ways to make it a permanent part of the Army’s medical operation. Furthermore, Steiner envisioned a future permanent partnership with the military Medical Department in a role where the Sanitary Commission hoped “to supply the want by details made from the private practitioners of our large cities...[as] demands for aid of this kind have been responded to by a rush of professional volunteers...[so that] a certain number of experienced surgeons, who would be willing to respond to such calls, and in whom the utmost reliance might be placed by the medical officers.”(14)
Letterman, too, was busy after the campaign ended. On October 4, he issued a medical supply chart for field service. Each brigade was allowed one full hospital wagon, one medicine chest per regiment, a hospital knapsack for each regimental Medical officer, designated supplies to be transported by a four-horse wagon. The brigade Surgeon was responsible for all supply receipts, issuing supplies to regiment Medical officers, and keeping the keys to the medicine chest!!!(15)
Overall, Letterman was happy with the results of the ambulance system he implemented prior to the campaign. In his 1866 Medical Recollections, Letterman wrote “it will be perceived that the ambulance system, with that of supplies and of field hospitals, were ordered as essentials of that new organization from which, I earnestly hoped, the wounded and sick would receive more careful attendance and more skillful treatment...[and] all the arrangements that time permitted to carry out the instructions contained in the system I had established; and with the hearty cooperation given me by the ablest Medical officers of the Army, I felt, in the event of a battle, this Department would be better able than ever, to discharge the duties devolving upon it.”(16)
On March 6, 1863 Sherman left the 34th NY. He was discharged for promotion and served with the US Volunteers Medical Staff until October 7, 1865. This staff consisted of surgeons who were above the regimental surgeons and who usually served in hospitals or were in charge of brigades. Sherman spent the time between 1863-1865 as the Surgeon-In-Charge at Grafton Hospital in West Virginia. He served only one term in Congress and never ran for reelection. After the war he returned to Ogdensburg and continued practicing medicine until he died on February 1, 1873.

1. Newsletter No. 45 June 2009.
2. The Medical and Surgical History of the War of the Rebellion, GPO 1870-88, Vol 1 Part 3 Pg 360-361.
3. Medical Recollections of the Army of the Potomac by Jonathan Letterman, 1866. Pg 22-23.
4. Reminiscences of Field-Hospital Service with the Army of the Potomac by William W Potter MD, 1889. Pg 9-10.
5. Letterman Pg 33-34.
6. Letterman Pg 35.
7. Letterman Pg 36.
8. Letterman Pg 39.
9. Potter Pg 10.
10. Potter Pg 11.
11. The Medical and Surgical History of the War of the Rebellion, GPO 1870-88, Vol 2 Part 3 Pgs 246, 248, 259, 516, 533.
Historic American Buildings Society, Hoffman Farm, HABS No. MD-961, 1991, Martha Wagner.
12. A Surgeon’s Civil War: The Letters and Diary of Daniel M Holt, MD by James M Greiner, 1994. Pgs 29-32, 37.
13. Letterman Pg 40-41.
Report of Lewis H Steiner, Inspector of the Sanitary Commission, Containing a Diary kept During the Rebel Occupation of Frederick, MD, 1862. Pgs 35-36.
14. Steiner Pg 38.
15. Letterman Pg 52-55.
16. Letterman Pg 63-64.

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