Medicine at Sea
MEDICAL CARE IN THE UNION AND CONFEDERATE navies presented special problems. Some actions that were routine on land could be difficult at sea. The naval doctor who tried to set a dislocated shoulder during a gale had to deal with the roll and pitch of the ship as well as the dislocation of the limb.
Naval medicine did not classify illness by the system developed by William Farr of England and used by the medical services of both Northern and Southern armies. Rather, both navies used a special system of disease nomenclature devised particularly for the U.S. Navy in 1857.1 Medical care for the sailors of the naval forces was administratively separate from army medicine.
Most ships of the U.S. Navy had one or two medical officers aboard. The next level of medical command was the fleet surgeon of the squadron to which the ship was assigned. The fleet surgeon was analogous in position to the medical director of a field army. He gave advice to the fleet commander regarding medical matters. For example, the fleet surgeon of the East Gulf Blockading Squadron recommended in 1862 that the major outfitting port at Key West be closed because yellow fever was infecting all the ships that stopped there; the advice was not taken.2 The fleet surgeon, on the staff of the officer commanding the squadron, reported to William Whelan, who was the senior doctor in the U.S. Navy, holding the title of chief of the bureau of medicine and surgery.3 Dr. Whelan reported directly to Secretary of the Navy Gideon Welles.
In the smaller Confederate States Navy, the senior doctor on each ship or at each naval station sent his medical reports directly to William A. W. Spotswood, the chief of the bureau of medicine and surgery, who reported to Secretary of the Navy Stephen Mallory. Several surgeons from the old U.S. Navy, such as Spotswood, went South with their states. With few Confederate ships, they were assigned to naval headquarters in Richmond, where they chaffed, waiting for a position where they could help the Confederacy.
The two senior naval medical officers, Whelan and Spotswood, were analogous in position to Hammond and Moore. Both were in their late fifties during most of the War, being born in 1806 and 1808. They had learned their medicine by apprenticeship; neither had graduated from a medical school. Both had spent many years at sea in the old U.S. Navy. The term “old salt” often came to the minds of men meeting these rough and ready medical sailor.4
Naval surgeons, like their army counterparts, looked upon the treatment of wounded as their most exciting duty. Sea engagements could be bloody affairs. In land battles, the courageous commander orders his troops forward; if the casualties are too great the troops may falter and stop, or even retreat, on their own initiative. At sea, the courageous commander who brings his ship alongside the enemy vessel brings the sailors and marines with him. They cannot retreat; they must stand toeto-toe with their enemy until one or the other ship breaks off the action and flees, surrenders, or sinks. A medical officer below decks in a wooden ship is not really a noncombatant; shells pass through the wooden barriers bring-