One of the biggest
problems I confront on a regular basis is dealers or individuals saying they
own a surgical set of someone who served as a surgeon during the Civil War.
Okay, but there were basically three kinds of Union 'surgeons' during the War:
Regular Army
surgeons, State Militia surgeons and Civilian 'contract' surgeons on both
sides. We need to define who and what these three groups did during the War. To be fair, there were
also
medical school teaching surgeons and private surgeons who volunteered during
the War who were among the most competent surgeons on record. Many of those
surgeon's also served on both sides during the War as army officers.
There is an excellent reference by Dr.
Jay Bollet, Civil War Medicine:
Challenges and Triumphs, which is a well documented book where he makes
the point that contract surgeons were relegated to working in the rear area
hospitals changing dressings and attending to the general health of
patients, not doing complicated, amputations, or field surgery. The
qualified surgeons were admitted to the Union and Confederate Armies and
reviewed for their competence or lack there of, and eliminated from doing
surgery if they did not pass muster. The point here is contract surgeons were not in the field or
rear hospitals using their surgery kits to amputate limbs or resect
fragments from bullet fractured bones. It just didn't happen often if
at all.
The real surgeons were in the regular Army on both sides, were supplied by the Army with Army
owned and purchased surgical sets, not the sets found in some closet one hundred
plus years after the fact, no matter how much some collectors or families
would like to romance that idea.
Contract surgeons are a
major source of problems in relating any existing or pre-existing surgical
set to the Civil War. Everyone wants to think their surgery set was a
part of the Civil War. But the surgery performed during the Civil War
is greatly misunderstood or exaggerated. A part of those
misconceptions is the misunderstood role of the 'contract' surgeons.
During the early days of
the War, there were only 200 medical officers in the Union Army and some of
those left to join the Confederate Army and form the medical service for the
Confederacy. Of those remaining only a very few had any experience
doing actual major surgery necessary for treating battle wounds. Until the
Union could recruit and verify the abilities of new surgeons, they used
'contract' surgeons who may never have actually done any surgery other than
minor procedures. These 'contract' surgeons were paid by the day, and came and
went as needed in areas where battles took place. They would have been
the local doctors who came to help. (Yes, they would have brought and
used their own surgery sets) During this time (pre-1861) it was
rare for any kind of major surgery to be performed unless it was thought to
be the absolutely last resort.
Another kind of surgeon
was those who served in state volunteer militias, which were organizations
from the colonial period. These militia groups may have had a surgeon,
who brought his own instruments, and they were mustered into the Regular
Army.
There were a few teaching centers at
medical hospitals where major surgery was done, but it was not even part of the
teaching experience for most medical students. (That said, there are
many medical textbooks which show and teach extensive invasive surgery as
practiced in teaching hospitals in both America and Europe in 1850 and
earlier. But, most of this type of disease oriented surgery was not
necessary in the field of battle during the War. What they needed were
doctors who could do triage surgery to correct or sew up battle damage and
treat disease which spread among the troops.) Most American medical students only went to medical school
for two years and then generally worked as an apprentice afterwards.
Physician/surgeons in major cities like New York, Boston, or Philadelphia,
would have had extensive surgical experience, but not by the type of doctor found across much of rural America at the time of the
Civil War. If you wish to read more on this area of medical surgical
history, there is a fine book about medical schools prior to the Civil War:
"Medical Education Before the
Civil War", by Wm. F. Norwood.
If you have any doubt about the
expertise of surgeons just prior to the Civil Was, all you need to do is
thumb through Henry Smith's or Gross's volume I & 2 of 'A System of
Surgery'. Either medical text will quiet any fears you may have about
the ability of the qualified surgeon's entering the Army on either side
since the vast majority of the surgeons on both sides were educated in the
North prior to the War.
Below: Taken from A
History of the Army Medical Department: Civil War Medicine 1861-1865 by
Mary C. Gilletty
"The quality of
the Army's
contract physicians was important, since during the course of the
war more than 5,500 civilian doctors assisted the Medical Department. Many
routinely staffed general hospitals while others provided help only in
emergencies when it was necessary to locate more physicians quickly. In the
last group were some of the nation's most prominent doctors. When a battle
resulted in overwhelming numbers of casualties, those who flocked to the
scene might include quacks, cultists, and practitioners of questionable
ethics, men who were not under military discipline and who could, therefore,
come and go as they liked, taking assignments that pleased them and
rejecting all others. They often performed unnecessary operations or wrought
havoc as they dug about for bullets.
As a result of the problems experienced
with doctors so casually assembled, the Union Army Medical Department decided to call
only upon members of a reserve surgeons corps formed by the governors of
various states. These gentlemen were paid the salary of contract surgeons
and came in if called. They served under Medical Department orders and were
required to remain at their assigned posts at least fifteen days, unless
officially released sooner."
Civil War Surgery: The
truth about what surgeons did and did not do during the War
(Source
of the following: "The
Medical and Surgical History of the War of the Rebellion. (1861-65.) Part
III, Volume II, Chapter XIV.--The Medical Staff and Materia Chirugica")
"Beside the medical
officers of the regular and volunteer staff, and the medical officers of
regiments, there was a class designated as Acting Assistant Surgeons,
who were private physicians, uncommissioned, serving under contract to do duty
with the forces in the field or in general hospitals. This class was very
large and embraced in its number some of the most eminent surgeons and
physicians of the country. The Medical Cadets were generally young men,
students of medicine, who were assigned to duty in general hospitals as
dressers and assistants. The Medical Department was still further increased
by a number of Hospital Stewards, who were enlisted as needed, and who
performed the duties of druggists, clerks, and storekeepers."
Account of Private Physician Under Contract
John Wheller, M.D., Pittsfield, N.H.
 Name: John Wheeler
Cause of death: paralysis
Death date: Dec 21, 1900
Place of death: Pittsfield, NH
Birth date: 1828
Type of practice: Allopath
Practice specialities: GS General Surgery
Medical school: Berkshire Medical College, Pittsfield, 1852,
(G)
Journal of the American Medical Association Citation: 36:47
John Wheeler, M. D. Was born in Barnstead, Sept.15, 1828 ;
was grandson of Dr. Jewett, Sr. He fitted for college at
Gilmanton Academy, and graduated at Dartmouth College in
1850, studied medicine with Dr. J. P. Jewett, of Lowell,
Mass., and with C. T. Berry, of Pittsfield, N. H., attended
Medical Lectures at Bowdoin, Boston, and Berkshire Medical
Schools, and graduated at the latter in 1852.
He immediately succeeded Dr. Grover in Barnstead, where he
has been in practice ever since, with the exception of four
years at Pittsfield, and a while in the army. Many
medical students, more than twenty, have pursued
their studies, either a part or the whole under his
direction.
John Wheeler does not show up in the
Roster of Surgeon's and should not, as he was a contract 'assistant surgeon' |
"For services rendered as Acting
Assistant Surgeon, U.S.A. at U. S. Hospital from Oct. 1st.
to Oct. 5th, 1864, Signed by: A. N. McLaren, Surgeon,
U.S.A."
Payment: $117.50
Medical Reminiscences of the Civil War
Remarks by John S. Billings, M.D. regarding
Surgeon A. N. McLaren
Read April 5, 1905
In the Fall of 1861 I went to Washington
to appear before the Medical Examining Board of the Regular Army. I had graduated from a
medical college after a two years' course, each year having exactly the same lectures. I had
had two years' hospital experience, and I had been demonstrator of anatomy for two years, so
that while I had my doubts about my passing the ordeal of the Army Medical Board, from
what I had heard of its severity, still I thought that probably I should get through. I came up
before the Board, and at about noon of the second day I began to feel rather comfortable and
thought I was getting on very well; but by noon of
the third day there was a consultation
between the examiners, and they began all over again, going back to anatomy and to the beginning
of things. That went on for three days more and made me very uneasy. I did not learn the
explanation of this until long afterward. When it was all over Dr. McLaren, the President of
the Board, said to me that he hoped I would take service at once with him - that he could
not get my commission for some time, but that I could be made a contract surgeon without delay.
I agreed to this, was introduced to Surgeon-General Finley, got my contract and was
told that I was especially detailed to go to the Union
Hotel Hospital in Georgetown, which was
under the direction of Surgeon McLaren.
There was an obvious lack of
any standard of training among surgical personnel. Medical officers on both
sides of the conflict were repeatedly charged with incompetence, ignorance,
inefficiency, neglect, cruelty, carelessness and drunkenness. The reasons for
this are never more apparent than in the admission standards for the Medical
officers in the Union army. The Army Medical Board required all surgeons to
pass an oral and written test to determine their competence in the medical
sciences as well as history, geography, literature, philosophy and languages.
Many failed these examinations and at the instruction of the Secretary of War,
the requirements were significantly lowered. Thus, the number of competent
surgeons rivaled the incompetent, and those that did serve had an alarmingly
disparate base of knowledge: Army surgeons lacking in the latest knowledge of
medical theory and technology, and civilian volunteers lacking surgical
experience. Charges of needless operations performed to perfect surgical
skills, surgeons abandoning patients whose wounds proved uninteresting, and
surgeons operating while intoxicated were rampant. Equally as prevalent were
accusations of indignity and contempt in the treatment of civilian surgeons by
regular army surgeons. In response to these conditions, Surgeon General
Hammond created a “civilian-auxiliary” system in cooperation with the State’s
governors. So effective was this auxiliary that following Grant’s spring
campaign of 1864, not a single story of scandal surfaced.
Source of above:
“Civil War Surgery: A Historical Approach”;
Submitted to the Des Moines University Surgical Foundation,
August 2000, Scott S. Carpenter, DO 2003
"During
the years of the war the organization of the Regular Staff had been
increased so as to number one Surgeon General, one Assistant Surgeon
General, one Medical Inspector General, sixteen Medical Inspectors, and
one hundred and seventy Surgeons and Assistant Surgeons; there had been
appointed five hundred and forty-seven (547) Surgeons and Assistant
Surgeons of Volunteers; there were mustered into service between April,
1861, and the close of the war, two thousand one hundred and nine
(2,109) regimental Surgeons, three thousand eight hundred and eighty-two
(3,882) regimental Assistant Surgeons. During the same period there were
employed eighty-five (85) Acting Staff Surgeons and five thousand five
hundred and thirty-two Acting Assistant Surgeons."
As the War progressed, it
quickly became apparent many of the doctors were not competent to do any
kind of surgery, so the Surgeon General's Office developed testing
procedures and 'boards' for admitting surgeons to the Army Medical Department and further
qualified those who had varying degrees of skill to actually do the day to
day surgery on the troops. As the more qualified doctors were
recruited and processed the less qualified doctors and especially the
'contract' doctors were relegated to the rear areas to tend to the troops in
ways that we would expect skilled nurses to do today.
See this from the Medical
and Surgical History:
Article on
Gettysburg by Surg. Letterman about useless civilian doctors
It is essential for you
to understand how little major surgical experience existed prior to the War
pre-1860. Surgery we take for granted today just did not exist other
than in major teaching hospitals if at all.
Medicine was primitive at best by today's standards in most areas of the
country. For all the amputation sets made, it was a rare surgery and
often done by inexperienced doctors who had never done one before. Not
all doctors were trained the same as there were no national standards.
(See medical education
and the Civil War)
As the War progressed,
the more skilled surgeons and assistant surgeons were moved forward into the
field. Assistant surgeons triaged in the forward areas and the full
surgeons operated behind the lines on the more seriously wounded. As
soon as possible the post surgical and seriously wounded would be
transported to field hospitals for continued care and this would
have been where 'contract' doctors would have been employed. It would
not have been in the field with a saw in knife in hand as some would like to
believe. Only the most
experienced surgeons were doing amputations or complicated surgery.
So, the odds of a surgery
set belonging to a 'contract' surgeon being used during the War is pretty
slim. Perhaps a pocket surgical kit, but not a large complicated set. Contract surgeons were not in the Army, they were hired hands to
help in the rear areas and they were not hired to do major surgery.
And anything where cutting was involved was 'major'. Most likely a
pocket roll-up surgical kit was the most any doctor ever needed given the
minor nature of the 'surgery' they did. Certainly only the most
experienced doctors/surgeons drew an amputation knife or bone saw.
The surgery sets used by
the Regular uniformed Union surgeons were bought and paid for by the Union Army. They
were not the personal property of the surgeon (thus no name on the brass
plate) and were maintained by
assistants, not the surgeons. (The excepetion to this statement would
be related to the early years of the War when State Volunteer Militia
surgeons brought their own instruments.) Surgeons didn't walk around with large
and heavy sets. These were transported by wagon and set up by
assistants in field or rear area hospitals, which were merely tents in more
protected areas behind the lines. Some well meaning local doctor may
have given a hand or observed at times, but more than likely the uniformed
Army surgeons ruled the scene and kept total control of the situation.
Being a military surgeon was serious business and not to be taken lightly by
allowing some unknown visiting doctor to take over or do a major operation
with a limited use surgery set he brought along for the day.
All this said, there is a
directive in the 1863 SGO Army Surgeon's Manual which specifically states
that 'contract' surgeons who are issued instruments shall have their pay
debited for the cost of the instruments, which would lead one to assume the
contract surgeon's would then own the instruments they drew from medical
stores.
See a copy of this
directive on
instruments and contract surgeons.
There may have been European
and English sets used by northern doctors who served in the early days of
the War as 'contract' surgeons after local battles. The Union and certainly the Confederate contract surgeon's may have (and the emphasis
is on 'May have") brought their existing sets
or pocket kits with them. The source of
these sets would have been both European, English, and American in origin.
The trick is proving they were actually owned by the doctor and the set
existed before or during the War. This is extremely difficult,
but not impossible.
A few more thoughts about
'provenance' supported sets. Just because someone shows up with a lot
of written information about a great set, you have to prove the set belonged
to the owner/surgeon. The set has to be from the right time frame, and
to be something the owner 'could' have owned. This boils down to
documenting the dates of manufacture, the source of the set, then connecting
the set to the owner during the Civil War. (See an example of such a
set owned by a Regular Union surgeon who was mustered into the Regular
Army from a State Volunteer Militia.)
One of the big problems
with European sets is dating the set to a specific time frame because there
is almost no information available about specific European or English sets, with which you can date the sets to five or ten year
time frames. There are a couple of books on European and English
topics (Bennion, Kickup), but nothing to match Edmonson's work on American
sets.
Methods to research and
identify Civil War surgeons (You will need exceptional luck to
find information on any contract surgeon as they were not regular army
surgeons and the majority are either poorly or undocumented.)
Be sure to read this short
article on the Truth about Civil War Surgeons by Dr. Jay Bollet
Additional
information
on contract surgeons and U. S. Army 'Form 18'
used to pay private physicians during the War
Research notes of:
Dr. Michael Echols
Ft. Myers, Florida
