The essential reference about a surprisingly well-organized medical department
Despite the many obstacles it had to overcome—including a naval blockade, lack of a strong industrial base, and personnel unaccustomed to military life—the Richmond-based Confederate Army Medical Department developed into a robust organization that nimbly adapted to changing circumstances. In the first book to address the topic, Guy R. Hasegawa describes the organization and management of the Confederate army’s medical department. At its head was Surgeon General Samuel Preston Moore, a talented multitasker with the organizational know-how to put in place qualified medical personnel to care for sick and wounded Confederate soldiers.
Hasegawa investigates how political considerations, personalities, and, as the war progressed, the diminishing availability of human and material resources influenced decision-making in the medical department. Amazingly, the surgeon general’s office managed not only to provide care but also to offer educational opportunities to its personnel and collect medical and surgical data for future use, regardless of constant and growing difficulties.
During and after the war, the medical department of the Confederate army was consistently praised as being admirably organized and efficient. Although the department was unable to match its Union counterpart in manpower and supplies, Moore’s intelligent management enabled it to help maintain the fighting strength of the Confederate army.
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Guy R. Hasegawa, a retired pharmacist and editor, is the author of Villainous Compounds: Chemical Weapons and the American Civil War and Mending Broken Soldiers: The Union and Confederate Programs to Supply Artificial Limbs.
Preface
When former Confederate surgeon Francis Peyre Porcher addressed a gathering of wartime colleagues in 1899, he paid tribute to the late Samuel Preston Moore, a fellow South Carolinian who had served for most of the Civil War as the Confederate army’s surgeon general. In citing Moore’s creation of “the matchless organization of the medical department of the Confederate army,” Porcher echoed a view expressed consistently by other former Southern medical officers—that the Confederate Medical Department was extraordinarily well arranged and owed its efficiency to Moore.
Given the many disadvantages faced by the South during the Civil War, it is remarkable that the Confederate army was able to survive as long as it did against an opponent that had the upper hand in manpower and materiel. One factor having a profound effect on any army is its health, so the Medical Department of the Confederate army merits study not only for its efficiency but also because what it did was so important.
For the general reader, learning about Confederate military medicine should start with H. H. Cunningham’s Doctors in Gray, first published in 1958 and still the standard introduction to the topic. Cunningham presented a wide view of Confederate medicine, from actions taken in the Confederate capital to maladies suffered by common soldiers in the field. His decision to provide a panorama prevented him from delving deeply into any particular aspect of Confederate military medicine, so while he described decisions made in the Surgeon General’s Office (SGO), he stopped short of giving readers an inside view of the operation.
My aim in Matchless Organization is to explore the Medical Department as an organization and the SGO as its administrative core. By describing the setting in which the Medical Department operated, I hope to provide enough context to allow readers to understand the otherwise confusing actions taken by the department or imposed on it by other government entities. Matchless Organization offers information from sources not used by other historians (e.g., records of the secretary of war and adjutant and inspector general, letters from the SGO to members of Congress, amnesty records) and documents its references fully, which Doctors in Gray—because of unfortunate publication decisions—does not. Even the most avid of Civil War enthusiasts may find some unfamiliar facts in Matchless Organization and be enabled to research them further. Matchless Organization centers on Richmond not only because that city housed the SGO but because management decisions concerning the Medical Department had the greatest influence there. Compliance with orders emanating from the capital tended to diminish with distance from Richmond, and forming conclusions about activities west of the Mississippi River presents challenges because of the scarcity of relevant records about that region of the Confederacy.
I have not attempted in Matchless Organization to cover Confederate naval medicine or to explore in detail every aspect of Confederate army medicine. Although there have been studies of Confederate general hospitals—the excellent Confederate Hospitals on the Move, by Glenna Schroeder-Lein, for example—enough original records survive to support more research into that topic and others, such as the army’s medical purveying operations. Matchless Organization covers the middle ground between very specific studies and the wide-ranging Doctors in Gray.
Samuel Preston Moore, who took command of the Medical Department in July 1861, plays the most prominent role in this book. Although several articles have been written about Moore, a full-length biography has not, most probably because no researcher has found enough information about him to fill a book. Matchless Organization is not a biography but describes Moore’s actions as surgeon general and examines the factors that steered his decisions.
Moore’s job required that he be a master of multitasking. Many things were happening simultaneously and influencing each other, and he had to eschew a tunnel-vision approach in favor of one that considered all related factors. One could truly appreciate his position only by being there and living it in real time. Since that is impossible, I have organized topics thematically and, within those themes, presented events roughly in chronological order. This approach, which comes with the caveat that Moore’s considerations were complex and interconnected, necessitates some redundancy and cross-referencing, which I hope readers will find more helpful than distracting. Other personalities also played vital and sometimes multiple roles. Appendix A is offered to assist readers in keeping the people and their positions straight.
Many of the records kept at the SGO were scattered at the end of the war or destroyed by the fire that consumed much of Richmond in early April 1865. However, records survive from Richmond facilities that were outside of the fire zone and from medical personnel, hospitals, and offices dispersed throughout the South. Relatively few truly explanatory documents—such as reports by Moore to the president or secretary of war—are available to help elucidate the thinking behind various actions. Many documents examined for this book are letters, and even in the rare cases in which complete exchanges are available, proper interpretation requires an appreciation of the relevant context. Matchless Organization contains some educated guesses, but I have based them on the best information available and identified speculation as such.
I am grateful to the many individuals who assisted with this project. Among the most helpful, I must single out F. Terry Hambrecht, MD, who has been a mentor from the start of my Civil War research more than twenty years ago and encouraged me to write this book. Terry has, with Jodi Koste of the Medical College of Virginia, been compiling an unpublished register of physicians who served the Confederacy in a medical capacity; information from that source, freely shared by Terry, has been highly valuable. Terry also provided his painstakingly created transcriptions, also unpublished, of wartime letterbooks containing communications of Confederate surgeon J. J. Chisolm and other medical officers. Terry, an expert on Confederate medicine, acted as a sounding board as I developed this book, and he reviewed its manuscript. He was the obvious choice to write the foreword.
Important assistance also came from Jonathan O’Neal, MD, a long-time student of Confederate medicine, who shared his knowledge of Confederate general hospitals, provided documents and photographs from his collection, and commented on the book manuscript. Debra Chisolm Ruehlman generously shared copies of correspondence involving her ancestor J. J. Chisolm and allowed the use of his wartime photograph. Ray Nichols graciously provided his transcriptions of National Archives records of Confederate medical purveyors; his generosity spared me from untold hours of tedium. Numerous librarians and archivists, particularly at the National Archives, patiently aided me in retrieving records. Susan Hoffius of the Waring Historical Library, Medical University of South Carolina, and Rosemary Spellman of the Library Services Center, Sheridan Libraries, Johns Hopkins University, merit special thanks for their assistance. Sylvia Frank Rodrigue, executive editor for Southern Illinois University Press, once again helped me navigate the publication process and gave expert advice on how to improve the manuscript.
Finally, I could not...
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