The Surgeons of Gettysburg
 By Joel Rubenstein, M.D.

The medical aspects of the great Civil War battle at Gettysburg are an often overlooked subject. Although countless books and articles have been written about generals, weapons, and tactics, a description of the surgeons who cared for the wounded is also an important topic.

Based on today's standards, the medical care provided by both sides appeared crude and inefficient. Yet, many lives were saved, innovations were implemented, and valuable lessons were learned during the Civil War. Surgery was performed using anesthesia such as chloroform; however, there were no antibiotics and antisepsis techniques were not widely being used or appreciated by the general medical community. Despite this, 3 out of 4 amputees actually survived and the business of prosthetics boomed after the war.. Sadly, if a man was wounded in the chest or abdomen, he had a less than 10% chance for survival.

Treating the wounded was not only humanitarian, but a logistical necessity for both Confederate and Union armies. A wounded man could not fight, and the men and resources utilized to help the wounded were a drain on an army. On the positive side, if a wounded man could be healed quickly he could return to active service.

The medical corps of both armies were fairly well organized with a large number of surgeons and men assisting as nurses, litter bearers, and ambulance drivers. Jonathan Letterman, Medical Director of the AOP (Army of the Potomac), had reorganized the Union army medical corps. Ambulance service, medical officers, and hospitals were assigned to specific brigades and divisions. Each division medical director established a field hospital in the rear of his division. Each field hospital had 3 surgeons, and 3 nonsurgical medical officers to assist. Each regiment had a medical officer plus an assistant. The Union army had about 650 medical officers and over 1,000 ambulances. The Union Eleventh Corps ambulance train consisted of 100 ambulances, 9 medical wagons, 270 men, and 260 horses. There were a variety of different types of ambulances employed. Two-wheeled Finlev and 4-wheeled Triplers were common. Sometimes, ordinary supply wagons were used, which was common in the Confederate medical corps.

The Confederate medical corps was organized in a similar fashion. There were probably about 400 Confederate medical officers in the ANV (Army of Northern Virginia). However, a lack of medical instruments, medicines, and ambulances greatly hampered the care provided.

The civilian population also played a major role in caring fat the wounded of both sides. Although many people fled or refused to help the wounded, there are many examples of civilians feeding and caring for the wounded during and after the fighting ended. Many of the wounded stayed in private homes for several weeks and received excellent care.

The effort to treat the wounded at Gettysburg was a massive undertaking that merits a closer look. However, before describing the medical care, the stage must be set. The Confederate Army of Northern VA. 85,000 strong and commanded by Robert E Lee, had marched over 200 miles from Fredericksburg , VA through the Shenandoah Valley, and into PA end of June, 1863. The Union Army of the Potomac, 100,000 strong and commanded by Joseph Hooker had also moved northward to stay between Lee's army and Washington. During this movement, Union cavalry had tried to intercept the Confederate army at the Blue Ridge Mountain passes, but were unsuccessful. General George Meade replaced Hooker on June 28, and moved his 7 corps north and west to intercept Lee.

The important roads in this area that connected Hagerstown, Frederick, Baltimore, and Harrisburg all intersected in a small town called Gettysburg. The region was a hilly, sparsely populated area consisting of forests and farms. The town of Gettysburg had a population of 2,500, mostly German descent, and worked as farmers and shop owners. They hated the Confederate soldiers and merely disliked the Union soldiers who disrupted and endangered their lives.

On July 1, both Lee and Meade tried to consolidate their forces, which had been spread out over large distances. Lee's army was separated while trying to capture supplies and seize key cities like York and Harrisburg. Meade's army was also divided, trying to protect Washington and Baltimore and to locate Lee's army.

It is interesting to note the important roads and railroads utilized by these armies. These same roads and railroads became critical for moving the wounded and supplies after the fighting began. The railroad spur that served Gettysburg was destroyed along with several bridges by the Confederate army.

The following descriptions of field hospitals and medical care are not an attempt to be comprehensive. Instead, the following events and observations are representative of the variety of difficulties and suffering experienced by the wounded men and the people who cared for them. It is sad that so many young men died or were maimed. In addition to the thousands of ordinary soldiers, hundreds of officers who led their men fell in large numbers, including many colonels and generals. Many of these officers were not regular army and included civilian leaders like lawyers, politicians, businessmen, and schoolteachers. The deaths of so may men of great potential were losses for the future felt by the people of the U. S., as they tried to recover from the terrible war.

The Fighting Begins

On July 1, Confederate soldiers under General Heth literally bumped into Union cavalry under General Buford just west of Gettysburg. Infantry brigades and artillery arrived at Gettysburg at different times throughout the day as the fighting intensified in an arc north and west of town. The Confederate brigades approached from the north and east, while the Union brigades came from the south and west. Both sides fought heroically all day, but culminated in a Union retreat to the high hills, called Culp's Hill and Cemetery Hill, just south of Gettysburg. Casualties were high in the Union First and Eleventh Corps, including the death of General John Reynolds, the commander of the First Corps. Almost 9,000 total Union men were killed, wounded, and missing with a total of about 4,300 wounded. The wounded were initially placed in several large buildings plus some private homes in town; however, when the Union army was forced out of town, many wounded were left behind. A few Union surgeons remained with the wounded, but most of the surgeons reestablished field hospitals behind the hills along the Taneytown Rd. and the Baltimore Pike.

The Lutheran Theological Seminary consisted of several buildings on a ridge just west of Gettysburg. Surgeon George w. New, 7th Indiana Infantry, wrote, "I was surgeon in chief of 1st Div, First Corps and opened the first hospital for the wounded, the Lutheran Theological Seminary. But as our forces were compelled to fall back, leaving a few medical officers there, I went back into the town, took possession of several large rooms, halls, hotels." (CV, p6) Dr. Robert Loughran, 83rd NY Infantry was captured on July 1, continued to care for the wounded and then placed in charge of the Seminary Hospital for 7 weeks. Hundreds of wounded Union and Confederate wounded were cared for here, including Confederate officers General Isaac Trimble and Henry K. Douglas.

The Trinity German Reformed Church, a 2-story brick building was located near the town square. Union wounded were brought there from the Eleventh Corps on the first day of fighting. Dr. Abraham Stout, assist. Surgeon of the 153rd PA Infantry cared for many wounded here. A wounded man, Reuben Ruch wrote, "I found the (church) full . . ...I should call it a slaughter house. There must have been 10 to 12 amputation tables in (one) room . . ...they were all busy. The doctors had their sleeves rolled up to their shoulders and were covered in blood." (CV, p13)

The St. Francis Xavier Roman Catholic Church was a large brick building just south of the town square. Lt. Colonel Henry S. Huidekoper, 15th PA Infantry was wounded in the arm on the first day at McPherson Farm and was cared for here. He wrote, "About 6 o'clock ...I went to the (operating) table... I took some chloroform What I next remember was my saying, You took my arm off; did you doctor? He was Dr. Quinan, surgeon of my regiment. The night was a horrible one. All night long I heard from downstairs, moans, groans, shrieks, and yells from the wounded and suffering soldiers." The colonel recovered well enough to be transferred out on July 9. (CV, pl6). Dr. Quinan remained at the church until July 22 caring for as many as 200 wounded.

The David Wills House is just one example of a home in Gettysburg that cared for the wounded. The 3-story house is famous for being the place where President Lincoln stayed overnight on Nov 18, 1863 (the Gettysburg Address speech was given the next day). A Captain Francis Jones, 149th PA was fortunate to have been from the same hometown, Norristown, PA, as Mrs. Wills. He wrote that he had been wounded in the leg on July l and spent 4 days in McPherson's barn. On July 6, Mrs. Wills sent an ambulance, which brought him to her home. General Winfield Hancock and many other wounded were also cared for here. (CV, p33)

The Confederate casualties were also heavy in the divisions of Heth, Pender, and Rodes. About 5,600 total were killed, wounded or missing. About 4,000 wounded were taken to farmhouses, barns, or woods behind their lines. Most of Heth and Pander's wounded were located along the Chambersburg Pike. R.odes' wounded were treated around Oak Ridge and the road on the north side of town.

The Edward McPherson Farm, located on the west side of town, was one of the first field hospitals used by both Union and Confederate wounded on the first day. On July 2, Lt. R. B. Beath, 88th PA Infantry, was there as a medical attendant and wrote, " . . ...found it full of bleeding and mangled soldiers in a most distressed and sickening condition, without a surgeon . . ...many in some cases, glued to the floor by the blood flowing from their gaping wounds." (CV, p5)

The College Edifice of Gettysburg College, called Pennsylvania College in 1863, was a large 4-story building. About 600 wounded Confederate were cared for here. Four Sisters of Charity cared for the wounded, and each morning they found 8-10 bodies at the entrance waiting to be buried. (CV, p30)

The David Schriver Farm was located 2112 miles NW of Gettysburg on the Mummasburg Rd. Mr. Schriver wrote, "(My) farm was occupied by the rebel army and was held by them until July 5 . . ...they established a hospital in and about the home and barn and they had a large number of wounded men there; this hospital was continued after the rebel retreat for about (five) weeks by the Union authorities." (CV, p129) Capt. Duncan wrote in his book that General Rodes reported leaving half of his wounded behind at this farm, 760 wounded, with 4 surgeons. 6 assistants, 97 attendants, and 10 days rations. (D, p259)

Many Confederate field hospitals were located west of Gettysburg, where the streams called Willoughby's Run and Marsh Creek intersected the Chambersburg Pike and the Hagerstown Rd. One of the first hospitals was the Samuel Lohr Farm, on Chambersburg Pike, about 1/4 mile north of Marsh Creek This hospital cared for hundreds of wounded from Heth and Pender's divisions on the first day. There are several eyewitness reports about this hospital. Surgeon Spencer Welch, 13th SC wrote, "When I arrived at the hospital, my ears were greeted as usual at such time with the moans and cries of the wounded. I went to work and did not pretend to rest until the next morning after daylight." (CV, p136)

More fighting, July 2

On July 2, the Confederate aggressively attacked the Union left flank. The Union Third Corps under General Sickles and Fifth Corps, under General Sykes bravely defended the Peach Orchard, the Wheatfield, and Little Round Top with heavy losses. About 1,800 were killed, over 8,000 wounded and taken to field hospitals just west of the Taneytown Rd. Many of the Union wounded were left behind when their positions were taken by the Confederate forces. Aid stations, where brave medical officers gave first aid, were often very close to the fighting. One example of this is Z. B. Adams, surgeon of the 3rd Mass, 1st Div., Fifth Corps. He cared for several wounded men at an aid station, which was briefly located behind some boulders at the edge of the Wheatfield. The surgeon had to abandon many of the seriously wounded when the position was overrun by the Confederate on July 2. Today, a plaque marks the spot at the Gettysburg battlefield. (CV, p60)

Several hospitals were established on farms near the front lines of the Union army. One example is the Jacob Hummelbaugh Farm, just west of the Taneytown Rd, which was a hospital for the Second and Third Corps. Surgeon Alfred Hamilton reported that he cared for many wounded on July 2 and 3, including Confederate General Barksdale who was mortally wounded during Pickett's Charge. (CV, p64)

The Michael Frey Farm just east of the Taneytown Rd. was also temporarily used by the Second and Third Corps for more than 300 wounded. James Houghton, 4th Michigan, carried his wounded Capt. to this house on the afternoon of July 2. He wrote, "The wounded were lying on the ground in rows across the yard . . ...the surgeons were busily at work probing for bullets and amputating limbs." The chief of ambulances for the Second Corps, Thomas Livermore, established an ambulance collecting point here on July 2. (CV, p66)

Several Union field hospitals were placed at farms farther away from the front lines. Some were established on July 1 or 2, and some were moved on July 3 when Confederate artillery shells were landing too close. The Twelfth Corps established a hospital at the George Bushman Farm, located about 2 miles south of town and near the Baltimore Pike. Many wounded Confederate were taken to Union hospitals on July 2 and 3. Confederate Capt. Decimus et Ultimus Barziza, 4th Texas was wounded on July 2 and wrote, "I was taken to the field hospital of the Twelfth Army Corps . . ...Our wounded were generally well treated, and we were put side by side with the enemy's. The surgeons, with sleeves rolled up and blood to the elbows, were continually employed in amputating limbs. The red, human blood ran in streams from under the operating tables, and huge piles of arms and legs, withered and horrible to behold, were mute evidences of the fierceness of the strife." (CV, p103)

The Second and Third Corps moved their hospitals to the Jacob Schwartz Farm on Jul), 3. The Second Corps hospital cared for a total of 2,300 Union wounded and about 1,000 Confederate wounded were taken here, which was near the Rock Creek, just south of the Baltimore Pike. Another 800 wounded were also placed here for the Third Corps hospital. These hospitals had many of the worse cases and worse conditions.

On the night of July 4, Confederate Lt. John Dooley was taken there and wrote, "This is a horrid night, cold and wet and rainy. Groans and shrieks and maniacal ravings; bitter sobs, and heavy sighs, piteous cries; horrid oaths, despair; the death rattle; darkness, death.." (CV, p93) About 500 men died over the next few week, and surgery was continuous for many days during and after the battle.

Surgeon William Watson, 105th PA wrote letters about his activities at the Third Corps hospital. He worked there for several weeks and performed many amputations. He personally recorded more than 50 amputations in just the first couple of days there. Watson wrote on July 9, "We have 800 wounded in our division hospital and only 8 medical officers to attend them. I will turn my attention to wounded Rebels. There are about 100 of them in a barn near us in a most distressing condition Dr. Hildreth, surgeon in charge of the Corps hospital. thinks we will remain about 8 or 10 days longer." (CV, p 101) The wounded that were still waiting for operations were in serious risk. Delay in proper treatment meant more suffering, more chance for infections like gangrene and sepsis, and more deaths. The Second Corps hospital statistics indicated that 1 /9 of the Union wounded died and 1/5 of the Confederate died. (P, p70)

The Confederate attack on the Union left was led by Gen. Longstreet's Corps. Two of his 3 divisions suffered the most casualties when they attacked the Union positions along the Emmitsburg Rd. About 1,000 were killed and over 4,000 wounded at the Peach Orchard, Wheatfield, Devil's Den, and Little Round Top. The Union forces were pushed back about a mile but remained in control of excellent defensive positions, including the Little Round Top. Many of the Confederate wounded were captured or remained in the fields for a day or two.

Most of the wounded men from Hood and McLaws' divisions were taken to field hospitals to the west of town as mentioned earlier. The wounded were spread out over several farms and fields, but there were a couple of large hospitals established by the Confederate surgeons. The John Edward Plank Farm, located on the Marsh Creek, was the location for Hood's Division. Captain Duncan reported 1,542 wounded, leaving behind 515 men. (D, p258) There are several descriptions of this hospital. Elizabeth Plank, who lived there, wrote, "Now it was not long before all the beds were filled with the wounded, and the floor covered in the halls, on the porches, in the out buildings, on the barn floor and every place wounded men . . ...Many limbs and arms were amputated and their wounds dressed . . ...These wounded soldiers were left at this hospital 5 or 6 weeks after the fight. Every morning they buried their dead in shallow graves in the orchard. "(C V, p 143)

Many of McLaws' wounded were cared for at a hospital established at Francis Bream's Black Horse Tavern and Farm, which was located where the Marsh Creek crossed the, Hagerstown Rd. Surgeon Simon Baruch. Kershaw's Brigade, wrote about July 2, "All day and night the work continued at the field hospital, and throughout the following day also the wounded came pouring in, many on foot, among them several captured Union soldiers, on two of whom I operated. The field hospital contained now 222 seriously wounded men, 10 orderlies, and 3 surgeons." He was captured by the Union army on July 4, continued to work there for 6 weeks. (CV, p145) General McLaws reported that his division had a total of 1,538 wounded and left behind 576 wounded with 10 surgeons and 70 attendants. (D, p257) One interesting historical incident concerned the Confederate doctors after their service at Gettysburg. Dr. Baruch and many other Confederate doctors were imprisoned in Baltimore for several months before they were eventually freed.

Another Confederate surgeon, Aristides Montiero of Longstreet's Corps wrote, "The wounded appeared to be everywhere. They lay on blankets or on the bare ground; some were waiting their turn at the operating tables. A few screamed in their delirium, calling for their wives, sweethearts, or mothers. At the operating section, makeshift tables had been hastily set up. Some were made of doors laid across barrels. The surgeons (looked like) butchers, with their blood-spattered white shirts and navy trousers. To one side lay a pile of amputated, mangled limbs, stacked like cordwood." He also wrote that surgeons, '` . . ...cutting and sawing through skin, muscle, and bone, then cauterizing the stump with a searing hot iron, not ligating or tying the arteries. "(CV, p145) He left July 4 with the Confederate army.

On July 3, the major fighting occurred in front of the Cemetery Ridge, where Pickett's Division lost half of his 6,000 men. Pickett was part of a large frontal attack aimed at the Union center, which failed. Pickett's Division suffered more than 200 killed, about 1,200 wounded, and thousands of prisoners, including about 1,000 of the wounded. The Union losses included about 1,500 wounded in the Union Second Corps. The majority of these wounded soldiers of both sides ended up at the Second Corps hospitals previously described.

Aftermath

Following Pickett's Charge , General Lee decided to retreat back to Virginia. No fighting occurred on July 4: however, Lee waited until the night and left with over 5,000 wounded in his wagons. More than a thousand wounded men lay in between the two armies for a day or two. The heat of July was replaced by heavy rains for the next several days. Some men likely drowned, while flooding and mud added to the miserable conditions of the wounded in barns, woods, and fields. The final tally of carnage was 7,000 dead men, 5,000 dead horses and mules, 26,000 wounded men, with about 21,000 wounded in Gettysburg

The primary goals in the first few days were consolidation of the wounded and transportation of supplies. The Union wounded were carried from the fields to the hospitals and operated on first. The Confederate wounded were eventually found and received fairly good treatment. At least medical supplies and food were abundant after the first few chaotic days. Many of the railroads leading to Gettysburg and nearby towns had been destroyed. Herman Haupt the transportation chief , organized repairs and had trains reaching the Rock Creek by July 6, and fully repaired by July 10. Medical supplies like tents, bandages, medicines, and food were scarce for a few days. General Meade had ordered most of the supply wagons to stay behind in Westminister, about 30 miles away. Most of these wagons did not arrive until July 5. A second tragedy was the decision by General Meade, with the support of Dr. Letterman, to move his army on July 6 and take most of the doctors and medical supplies with him. Out of 650 Union doctors, only 106 were left in Gettysburg. Also, only 30 out of 1,000 ambulances were left behind. Oddly, even though no major battle was fought during the next several weeks, no ambulances, medical officers, or supplies were ever sent back to Gettysburg by the AOP.

Dr. Henry Janes, a surgeon from the 3rd Vermont Volunteers, was put in charge of all hospitals in the Gettysburg area. He had about 250 doctors to assist him, which included 106 Union army doctors, about 50 doctors contracted by the War Dept., 30 Confederate doctors, and about 75 volunteer civilian doctors. (C, p1)

Most of the supplies for Gettysburg came from the nearby major cities like Baltimore, Washington, and Philadelphia. The War Dept. and the Sanitary Commission, funded by private donations sent tons of medical supplies and food. In fact, wagons from the Sanitary Comm. arrived as early as July 2.

Transportation of the wounded out of Gettysburg was very important. By July 14, 9,800 Union and 1,500 Confederate wounded had been sent to hospitals in other cities like York, Baltimore, Phil, and New York. (P, p123)

One of many important decisions by Dr. Janes was the establishment of a large hospital for long term care of the wounded. Camp Letterman opened on July 22 on the Wolf Farm. The location was a mile, northeast of town, and close to the railroad. It had 400 tents, each with 12 beds. Union and Confederate men shared the same tents and were cared for by 40 surgeons. About 4,000 men received care here and many of these severely wounded men died, as evidenced by the 1,200 graves in the cemetery behind this hospital. This hospital was not officially closed until Nov 19th, the day of Lincoln's Gettysburg address.

Surgeon Bushrod James wrote a fitting conclusion for this article. "No written nor expressed language could ever picture the field of Gettysburg! Blood! Blood! and tattered flesh! Shattered bones and mangled forms almost without the semblance of human beings! faces torn and bruised and lacerated...,. groans and cries, screams, and curses, moans and grinding teeth! And the horrible silence of torture beyond all expression those weeks of sickening work, when the cut of the knife and the rasp of the saw grated on my overtaxed
nerves. "(CV, p. xv of the summary)

Bibliography:

(Many of the quotes were from the original sources such as letters and diaries. I list here the books where I found the quotes.)

C= Coco, Gregory. A Strange and Blighted Land. Thomas Publications, 1995.

CV = Coco, Gregory. A Vast Sea of Misery. Thomas Publications, 1988.

D = Duncan, Louis. The Medical Department of the US Army.

P = Patterson, Gerard. Debris of Battle. Stackpole Books, 1997.