Lincoln Finds a Surgeon General
MANY WERE INJURED IN THE RIOT. ON 19 APRIL the 6th Massachusetts Infantry Regiment, while marching through Baltimore to reinforce the capital, was set upon by a proSouthern mob. The injured were taken to the infirmary of the medical department of the University of Maryland, where they were treated by the civilian doctors on duty, Edward Warren and William A. Hammond. Hammond, who had ten years experience as a doctor with the U.S. Army, examined Private Sumner H. Needham. A rioter had struck Needham upon the head with a brick. Hammond determined that the unfortunate recruit had bled into his brain; he undertook the very risky operation of trephination, the drilling of a hole in the skull, in order to relieve the pressure caused by the hematoma. Needham did not improve following the operation and he died a few hours later.1
On 15 May 1861 the surgeon general of the U.S. Army, Thomas Lawson, died of natural causes at his home in Norfolk, Virginia. During his long tenure as chief of U.S. Army medicine, Colonel Lawson had accomplished many things. He had increased the collection of medical books for the Surgeon General's Office; he had obtained officer status for physicians; he had accompanied General Winfield Scott's expedition to Mexico City during the Mexican War. But Lawson proved most successful when he squeezed everything possible from the minuscule budgets allotted to the medical section of the peacetime army. “Finery and furbelows,” he declared, “cannot he tolerated in field hospitals or other sick stations.”2 Lawson was respected for his long service to the U.S. Army; the flag flew at half-mast for one day in all U.S. military posts and all officers of the army wore a badge of mourning for thirty days in his remembrance.
The next most senior medical officer, Clement A. Finley, succeeded him. Like Lawson, Finley had spent many years trying to manage with limited resources and did not fully grasp the magnitude of the problems facing the army after the South had fired on Fort Sumter. He reported with pride that for the fiscal year ending 30 June 1861 the Medical Bureau had actually spent less than it had been allocated.3
Just three weeks later, on 21 July 1861, the first major battle of the War found the medical service, like the rest of the United States Army, unprepared. The Battle of Bull Run shocked the North by showing that an armed mob does not make an army. The battle also demonstrated that a group of village practitioners, gathered together to help wounded soldiers, does not make a military medical organization4
The physicians of the volunteer regiments had been appointed by state authorities and had no military experience. Some individuals who were officially regimental surgeons and assistant surgeons were not even doctors. Medical student William W. Keen was asked by his mentor John H. Brinton, a brigade surgeon, to act as assistant surgeon of the 5th Massachusetts, replacing a man named Smith who had been appointed by state authorities. Keen tried to decline the appointment; he argued that he was only a medical student who knew little about medicine and nothing about military medicine. “That is quite true,” re-