Did Medical Care Make a Difference?
MOST SOUTHERNERS IMMEDIATELY AFTER THE conflict and most historians since have claimed that the South stood no chance of victory in this great War Between the States. A leading history textbook states that “the North's military potential was so overwhelming that she should have been able to achieve a speedy victory.”1 The population of the Northern states produced a potential for a two-to-one superiority in troops, and the industrial differential superiority was many times greater.
A simple comparison of resources, however, fails to note the different national goals of the two antagonists. The South wanted to become an independent nation, not to subdue the federal government and occupy the Northern states. The Confederacy had merely to survive until the North tired of the conflict. To win the War, the North needed to crush its opponent completely. The North required all its superior resources and needed to apply them efficiently. Even with overwhelming advantages in material and organization, the North experienced several moments when the course of events could have proceeded down a different road.2
In his thorough review of the conflict, James McPherson provides the clearest analysis of this point. “Most attempts to explain southern defeat or northern victory,” he argues, “lack the dimension of contingency-the recognition that at numerous critical points during the war, things might have gone altogether differently.”3 McPherson lists five special periods of contingency, when a different outcome on the battlefield might have changed the entire course of the War. Two of these are times when medical care was important: the campaigns in Vicksburg and in northern Georgia. The present work claims that Northern medical care was superior to Southern in these two campaigns, that this superiority made a difference in the outcome of each campaign, and that a reversal of either campaign could potentially have changed the outcome of the War.
Table 33 examines the health of Union field armies at several points during the War. The Army of the Potomac, as it huddled around Harrison's Landing after the failure of the Peninsula campaign, was greatly debilitated. Forty percent of its soldiers were unable to carry out their military duties. Only 4.2 percent of these were disabled because of wounds. The remainder were ill with a variety of diseases, especially malaria and diarrhea. The physical deterioration of the Army of the Potomac on the Peninsula was a major failure of the Union medical arm.
The Army of the Potomac never again had this great a proportion of its troops on the sick list. After Gettysburg, about a quarter of the troops of the Army of the Potomac were disabled, but 42 percent of these were in the hospital because of their wounds, not because of illness. After the great bloodletting of May 1864, 30 percent of the troops of the Army of the Potomac were disabled, but almost two out of three of these were wounded. There was not much the Union medical department could do to maintain the health of an army so chewed up by combat.
The Army of the Gulf invading Louisiana and Arkansas in 1864 had about a quarter of