Field Organization of the
Medical Department, 1862
(Edited
by Dr. Echols)
In 1861 there were already in the army
2,109 regimental surgeons 3,652 assistant surgeons and in the hospitals
scattered through the country 5,500 acting assistant surgeons by degrees
things took shape.
(The Medical Department in
the Civil War, by
Silas Weir Mitchell)
The Union medical services were organized into seven
categories:
1. Surgeons and
Assistant Surgeons of the United States Army. This was the regular
Medical Corps and consisted of men in the service when the war began.
The War began with only 90 medical officers.
2. Surgeons and
Assistant Surgeons of Volunteers. These were former "brigade surgeons"
created by Congress to supplement the work of the regular staff surgeons.
A total of 547 commissions were issued.
3. Regimental Surgeons
and Assistant Surgeons, commissioned by state governors rather than congress
or the President. There were 2,109 Surgeons and 3,882 Assistant
Surgeons. (Note: these are the best documented surgeons and a list of
their names is found in the "List of Battles and Roster of Regimental
Surgeons")
4. Acting Assistant
Surgeons, United States Army. These physicians were known as the
'contract' surgeons. They held no commission but received pay as first
lieutenants. There were a total of 5,532 Acting Assistant Surgeons; most
of which worked in the general hospitals in the North. They also
continued their civilian practice at the same time. (Note: of all the so
called "Civil War" surgeons, this group is the most difficult to identify.
Without personal correspondence or other documents, it is very difficult to
pinpoint any contract surgeon as being a 'Civil War' surgeon. Ownership
of a given surgery set can help by dating that set via the makers address
during the War.)
5. Medical officers of
the Veterans Corps.
6. Acting Staff
Surgeons.
7. Surgeons and
Assistant Surgeons of the Colored Troops, who received presidential
commissions. They were assigned to the Black troops
Field Organization of the Union Medical Department in
1862
O.R.-- SERIES I--VOLUME XIX/1 [S# 27]
Operations in Northern Virginia, West Virginia, Maryland and
Pennsylvania.--September 3-November 14, 1862.
No. 4.--Report of Surg. Jonathan Letterman, U. S. A., Medical Director
CIRCULAR. ] HEADQUARTERS ARMY OF THE POTOMAC,
Medical Director's Office, October 30, 1862.
SIR: In order that the wounded may receive the most prompt and efficient
attention during and after an engagement, and that the necessary
operations may be performed by the
most skillful and responsible surgeons at the earliest moment,
the following instructions are issued for the guidance of the medical
staff of this army, and medical directors of corps will see that they
are promptly carried into effect:
Previous to an engagement there will be established in each corps a
hospital for each division, the position of which will he selected by
the medical director of the corps.
The organization of the hospital will
be as follows:
1st. A surgeon in charge; one assistant surgeon to provide food and
shelter; one assistant surgeon to keep the records.
2d. Three medical officers to perform operations; three medical officers
as assistants to each of these officers.
3d. Additional medical officers, hospital stewards, nurses of the
division.
The surgeon in charge will have general superintendence and be
responsible to the surgeon-in-chief of the division for the proper
administration of the hospital. The surgeon-in-chief of a division will
detail one assistant surgeon, who will report to and be under the
immediate orders of the surgeon in charge, whose duties shall be to
pitch the hospital tents and provide straw, fuel, water, blankets, &c.,
and, when houses are used, put them in proper order for the reception of
wounded. This assistant surgeon will, when the foregoing shall have been
accomplished, at once organize a kitchen, using for this purpose the
hospital mess chests and the kettles, tins, in the ambulances. The
supplies of beef stock and bread in the ambulances, and of arrowroot,
tea, in the hospital wagon, will enable him to prepare quickly a
sufficient quantity of palatable and nourishing food. All the cooks, and
such of the hospital stewards and nurses as may be necessary, will be
placed under his orders for these purposes.
He will detail another assistant
surgeon, whose duty it shall be to keep a complete record of every case
brought to the hospital, giving the name, rank, company, and regiment;
the seat and character of injury; the treatment; the operation, if any
be performed, and the result, which will be transmitted to the medical
director of the corps and by him sent to this office.
This officer will also see to the proper interment of those who die, and
that the grave is marked with a head-beard with the name, rank, company,
and regiment legibly inscribed upon it.
He will make out two tabular statements of wounded, which the
surgeon-in-chief of division will transmit within thirty-six hours after
a battle, one to this office (by a special messenger, if necessary) and
the other to the medical director of the corps to which the hospital
belongs.
There will be selected from
the division by the surgeon-in-chief, under the direction of the medical
director of the corps, three medical officers, who will be the operating
staff of the hospital, upon whom will rest the immediate responsibility
of the performance of all important operations. In all doubtful cases
they will consult together, and a majority of them shall decide upon the
expediency and character of the operation. These officers will be
selected from the division without regard to rank, but solely on account
of their known prudence, judgment, and skill. The surgeon-in-chief of
the division is enjoined to be especially careful in the selection of
these officers, choosing only those who have distinguished themselves
for surgical skill, sound judgment, and conscientious regard for the
highest interests of the wounded.
There will be detailed three
medical officers to act as assistants to each one of these officers, who
will report to him and act entirely under his direction. It is suggested
that one of the assistants be selected to administer the anaesthetic.
Each operating surgeon will be provided with an excellent table from the
hospital wagon, and, with the present organization for field hospitals,
it is hoped that the confusion and the delay in performing the necessary
operations so often existing after a battle will be avoided, and all
operations hereafter be primary.
The remaining medical officers of the division, except one to each
regiment, will be ordered to the hospitals to act as dressers and
assistants generally. Those who follow the regiments to the field will
establish themselves, each one at a temporary depot, at such a distance
or situation in the rear of his regiment as will insure safety to the
wound, d, where they will give such aid as is immediately required; and
they are here reminded that, whilst no personal consideration should
interfere with their duty to the wounded, the grave responsibilities
resting upon them render any unnecessary exposure improper.
The surgeon-in-chief of the division will exercise general supervision,
under the medical director of the corps, over the medical affairs in his
division. He will see that the officers are faithful in the performance
of their duties in the hospital and upon the field, and that by the
ambulance corps, which has heretofore been so efficient, the wounded are
removed from the field carefully and with dispatch.
Whenever his duties permit, he will give his professional services at
the hospital, will order to the hospital as soon as located all the
hospital wagons of the brigades, the hospital tents and furniture, and
all the hospital stewards and nurses. He will notify the captain
commanding the ambulance corps, or, if this be impracticable, the first
lieutenant commanding the division ambulances, of the location of the
hospital.
No medical officer will leave the position to which he shall have been
assigned without permission, and any officer so doing will be reported
to the medical director of the corps, who will report the facts to this
office.
The medical directors of corps will apply to their commanders on the eve
of a battle for the necessary guard and men for fatigue duty. This guard
will be particularly careful that no stragglers be allowed about the
hospital, using the food and comforts prepared for the wounded.
Very respectfully, your obedient servant,
JONA. LETTERMAN, Surgeon