Maggots and Minié Balls
DURING THE WINTER OF 1861 TO 1862, BOTH THE Union and Confederate armies settled in and prepared for a very long war. Sharing the same medical and military backgrounds, the two nations built quite similar systems to handle their sick and wounded soldiers. The doctors, the enlisted personnel, the female nurses, and a various assortment of civilian volunteers made up the medical infrastructure of both great armies.
With certain exceptions, two physicians were assigned to each regiment. They bore the official rank of surgeon and assistant surgeon, even though they might or might not have any real experience with surgical operations. Each regiment had an additional individual assigned to medical functions, the hospital steward, an enlisted man equal in rank to a sergeant. Despite some confusion in the first year of the War, the hospital steward was not a servant for the doctors; he was part of the regiment and reported to the regimental commander, not directly to the doctor.
Sick call was held each day, usually in the morning. Any soldier who felt ill lined up to be evaluated by the assistant surgeon. The doctor listened to the soldier's symptoms and performed a brief examination. The artist Winslow Homer observed a doctor examining a young soldier by looking at his tongue. In the painting, the hospital steward records the doctor's diagnosis for the regimental report. Most complaints were trivial: headache, joint aches, constipation, loose bowels. Some soldiers suffered from significant chronic disabilities and were medically discharged from the army.
Sick call could be quite boring, both for the soldier-patients and for the medical personnel.
One of the soldier's major symptoms concerned his bowels. One physician kept opium in one pocket and mercury compound in the other. Regardless of the soldier's main complaint, the doctor asked: “How are your bowels?” If they were too loose, he gave the opium; if the soldier was constipated, he received a pinch of the mercury compound.
Some soldiers developed illnesses that interfered with their abilities to carry out their usual military functions. Treatment was undertaken and the soldier was given limited duty. The illness producing this temporary disability was recorded by the hospital steward, as observed by Winslow Homer. The number of illnesses per month were calculated and a report was forwarded to the next highest physician in the chain of command, usually the brigade surgeon. Sick reports were collated and eventually made it to the medical director of the field army or the military department. These reports reached Washington or Richmond, where higher medical authorities could detect trends in illnesses. Both the Union and Confederate medical authorities used the British Farr system for the classification of disease.1
The physician carried a medical bag, often brought from home. At the beginning of the War the surgical tools in the doctor's bag were his personal property. The hospital steward carried a medical knapsack. In these were medicines and equipment supplied by the government. Each regimental knapsack was supposed to contain both chloroform and ether