Creating Confederate Medicine
AT THE EXACT MOMENT THAT DR. IRWIN WAS fighting Cochise at Apache Pass, the representatives of the seceded states were meeting in Montgomery, Alabama, to form a new government. The Provisional Congress of the Confederate States of America established the general military staff of the new nation on 26 February 1861. The new military organization contained a Medical Department, consisting of a surgeon general, four surgeons, and six assistant surgeons. The new regulations stipulated that the surgeon general would hold a rank equivalent to colonel and would be paid $250 per month. Each surgeon was paid $162 per month; each assistant surgeon received $110 per month. These regulations were identical to those of the old U.S. Army.
The kernel of the new medical department of the Confederacy consisted of military physicians with experience in the U.S. Army, an organization now called simply the Old Army. Some physicians, such as David C. DeLeon, joined the Confederate Army immediately, even taking all available U.S. Army medical supplies with them. Other U.S. Army physicians from the South chose to leave military life altogether. Samuel P. Moore entered private practice in Little Rock, Arkansas. Lafayette Guild was promoted to the rank of surgeon by the U.S. Army; this new rank required that he again take the oath of allegiance to the United States. He could not take the oath, so he was dropped from the army rolls on 1 July 1861. He also “went South” to join the new Provisional Army of the Confederate States.
The Confederacy made its first medical error on 6 March 1861. The Provisional Congress organized the new Confederate Army, using the regulations of the old U.S. Army as a guide. Unfortunately, the copyist let his eye wander and left out the medical officers. The U.S. regulations are given below; the Confederate regulations were exactly the same except that the words in italics were missing:
Each regiment of infantry shall consist of one
colonel, one lieutenant-colonel, one major, one
surgeon, one assistant surgeon, and ten compa-
nies. Each company shall consist of one captain,
one first lieutenant, two second lieutenants, four
corporals, two musicians, and 90 privates.
According to official army regulations, no regiment would have any medical officers. The entire Confederate Army would contain only eleven doctors, all working in the surgeon general's office. Most authorities who raised regiments, however, conformed more to tradition than to regulations and included regimental doctors. Many young physicians entered the ranks as privates, hoping to defend their new nation with arms; they often found themselves pressed into service as regimental surgeons because the Confederacy needed their medical skills more than their military ones.1
The Confederate government, overwhelmed with the unprecedented task of creating itself, was slow to form the headquarters of the army medical department. In his report to President Jefferson Davis, submitted on 27 April 1861, Secretary of War Leroy Walker had to admit that “the medical department of the Regular Army has not yet been organized, chiefly from