THE 
Army Surgeons. 
BY 
Frank H. Hamilton, M. D. 
Reprinted from the Buffalo Medical and Surgical Journal. 
i . 
B U F F ALO: 
The Times Co., Limited, Printers, 191 Main St, 
18S6. THE 
Army Surgeons. 
BY 
Frank H. Hamilton, M. D. 
Reprinted from the Buffalo Medical and Surgical Journal, 
BUFFALO: 
The Times Co., Limited, Printers, 191 Main St. 
xBB6. The Army Surgeons 
New York, 43 W. 32c! St., January 1, 1886. 
Editors Buffalo Medical and Surgical Journal: 
The enclosed manuscript was written, as you will see, on the 
“field” in 1862, twenty-three years ago. As it would have 
been manifestly improper to have published it while I remained 
in the army, I sent it to Mrs. Hamilton, with instructions to keep 
it until I authorized its publication. It has remained in her 
charge ever since, and has only been brought to my notice 
recently, and since her decease. 
It now seems to me, although the provocations under which 
it was written have long been forgotten, that it might be proper 
to publish it, in view of the facts that the criticisms remain in 
print and may be recalled by some one, and that no one has, so 
far as I know, taken the pains to answer them, lam influenced 
now to offer them to you, because there is just now a period of 
revival of reminiscences of the war, but in which only officers of 
the line appear conspicuously as men who rendered to their 
country great public service. 
Harrison’s Landing, Va., July 30, 1862. \ 
Gen’l Keyes’ Headquarters, f 
We have listened for some time patiently to the censures 
laid upon the medical corps of the army, trusting that time and 
occasion would furnish a vindication. The censures to which 
we refer have seldom a direct personal application, but are 
usually in general terms, implicating all, or nearly all, who are 
now serving in the various portions of the U. S. Army, whether 
regular, volunteer or contract surgeons. 4 
THE ARMY SURGEONS. 
The writer proposes to reply briefly, but as specifically as 
the general nature of the charges and criticisms will permit. 
The medical officers attached to the regular army have all 
been subjected to an examination as to their moral, physical and 
professional qualifications prior to admission, notoriously severe, 
and in all respects equal to that of those officers who have been 
graduated at West Point or at Annapolis. In no country in 
Europe is the test more rigid. In England it is much less rigid. 
Volunteer surgeons, or surgeons attached to the volunteer 
army, have been subjected to similar tests, differing more or less 
in standard in the different States of the Union; but in no case 
which has come to our knowledge, has these examinations been 
omitted. 
Contract surgeons have all been examined by an army medi- 
cal board, as have also Brigade surgeons; the board in the 
latter case being composed of some of the ablest regular army 
officers. 
At first, and for many months after the war began, no officer 
of the volunteer service not of the medical profession was, in a 
single instance, subjected to an examination of any kind, nor, in 
general, were any testimonials required as to intellectual or 
moral qualifications. 
These facts alone must establish a presumption that the 
medical officers of the army are as well qualified for the per- 
formance of their duties as the officers of the other departments; 
but there is one other fact, not yet stated, and which is entitled 
to consideration. The duties to which surgeons are called, are 
not new to them. There is nothing in the experience of a camp, 
except the mere routine of business transactions,, to which they 
have not been previously trained and accustomed. The diplomas 
alone, conferring the degree of doctor in medicine, might be 
justly regarded as testimony on this point; but, in addition to 
this, a very large proportion of these gentlemen have been 
several years engaged in active private practice, or have been in 
charge of hospitals. Most of the brigade surgeons were taken THE ARMY SURGEONS. 
5 
from the highest ranks of the profession, and are men whose 
social position at home was eminently respectable. 
The presumption, therefore, is established in our favor, and 
we might properly decline any further argument until the 
charges are more specifically made; but, from respect to the 
public, who, remote from the scene of our labors, look alone to 
the press for a confirmation or denial of these criminations, we 
shall enter upon our own defense. 
Where have surgeons failed of their duty? On the field of 
battle ? We have been on the field, or near enough to observe 
the conduct of the surgeons attached to the various regiments 
engaged, sufficiently often to say that in this respect they have 
seldom done less than their duty. We have seen them under 
fire, deliberately dressing the wounds of soldiers, administering 
to them nourishment, stimulants and water. We have seen 
them going forward with the litter-bearers to the very field ol 
conflict, and assisting the men to carry off the wounded. 
In many instances during the present war, surgeons, in the 
performance of these and similar duties, have been wounded, 
and some have died from the wounds thus received. 
If others have met with examples of surgeons who have 
deserted their posts at such a time, it has not occurred to us, 
after a pretty long experience, to see them; while, in the same 
experience, it has occurred to us to see scores of men and 
officers, belonging to the fighting portion of the army, file past 
the depots which we had established to the rear, and whom, 
since they were not wounded, we had no occasion to detain in 
places not yet beyond the reach of bullets. 
Have surgeons neglected their duties on the field after the 
battle has closed ? Not to our knowledge. On the contrary, 
they have labored night and day, for one, two and three suc- 
cessive days, without sleep, without rest, and sometimes almost 
without food, until, from sheer exhaustion, they have been com- 
pelled to desist. After a battle, the surgeon is usually left alone 
to do his work. His nurses, cooks and servants are gone. His 6 
THE ARMY SURGEONS. 
wounded are in deserted houses, in barns or upon the open 
field. He has often no lights, no seats, no beds, no tables, no 
cooking utensils, no food or stimulants. Everything almost has 
to be improvised. No commissary has ever been known, of his 
own instance, to bring supplies of food, or quartermaster, of his 
own instance, to furnish conveyance. We have to this day 
never found at hand a commissary or quartermaster immediately 
before, immediately after, or during a battle. We have repeat- 
edly been obliged to leave our appropriate work and go a long 
distance in pursuit of a commissary, and, when found, we have 
been obliged to return without the food necessary to save our 
men from famine, because no transport could be obtained to 
convey the provisions. 
In long and forced marches, both in the advance and in the 
retreat, surgeons have done constantly all that lay in their 
power to help along the disabled, and to provide for those who 
must be left. It is no part of a surgeon’s duty to transport the 
sick. This duty, by regulation, belongs to the quartermaster, 
but in a very large majority of cases, where troops are suddenly 
ordered to move, surgeons find it necessary to attend to this 
themselves; but the means of transportation are seldom equal 
to the demand. The army regulations declare that the following 
schedule of transports for the sick and wounded, and for hospital 
supplies, will be adopted for a state of war with a civilized 
enemy: “ For a regiment of ten companies, two four-wheeled 
ambulances, ten two-wheeled ambulances and four two-wheeled 
transport carts;” or transportation for about forty men to each 
regiment, it being estimated that about this proportion of men 
will be too ill to march; while the fact is, that in that portion of 
the army to which we are at present attached, there is not, and 
there has not been for a long time, one ambulance to a regiment; 
or, to state it in round numbers, where transportation ought to 
have been supplied for 2,000 men, there has been actually trans- 
portation for only 200. 
Transportation carts for hospital stores, hospital tents, etc., THE ARMY SURGEONS. 
7 
have been supplied in the proportion of not more than one to 
two regiments. 
It is a common practice, moreover, to turn over to the 
hospital department, for the ambulances and transports, the 
poorest horses, and in some instances, regimental, brigade and 
division quartermasters, having received with the ambulances 
good horses, have selected the best and exchanged them with 
other departments of the service for inferior horses; so that one 
seldom sees before an ambulance sound horses, unless the horses 
have been furnished by the State from which the regiment came. 
From all these facts, and not from any fault or negligence of the 
surgeon, it results, that hospital tents, with blankets, cots, medi- 
cines, and other hospital supplies, are often left behind; some 
of which have been finally recovered, but most of which 
have been utterly lost, at least, to the regiments to which they 
belonged. Ambulances sent forward to recover the wounded 
and bring them to the rear, are abandoned in the road, the horses 
having balked, or becoming stalled in the mud: sick, wounded 
and weary men straggle and are left by the roadside. 
On the day following, a heavy-forced march the surgeon is 
notified that sick men, belonging to the command, are reported 
to have been left several miles in the rear without food or water. 
The company officers, whose duty it is to prevent straggling, 
have permitted these men one by one to fall out, for the good 
reason that it was found impossible for them to keep up. 
The surgeon, or his assistant, must, in addition to the perform- 
ance of his other duties, ride back ten or fifteen miles, and pro- 
vide for them as well as he can; and it is not improbable that 
instead of finding only one squad of such disabled men, he will 
find three or four at different points of the road who have crawled 
under some old shed, or other similar shelter, sick, exhausted, 
without blankets or food, and utterly helpless. 
The health of the troops has always an intimate relation 
with the sanitary police of the camp. No one understands this 
better than a medical man, for the relations between health, 8 
THE ARMY SURGE,ONS. 
cleanliness, and purity of air, constitute a large portion of his 
study and education ; but it is not in the power of any regimental 
surgeon t6 enforce camp police without the approval and co- 
operation oft he commanding officers, especially of the colonel. 
We do not think any person can fully appreciate the difficulty 
under which the surgeon labors in this respect, until he has had 
personal experience. He has no authority to command, except as 
in some instances the commanding officer invests him with such 
authority. He can only suggest; but he may suggest and 
report until doomsday, yet, unless the colonel issues the order, 
not a street will be cleaned, not a tent will be struck, not a trench 
or sink will be dug. We have seen encampments in a most 
perfect condition of police, where the surgeons have acknowl- 
edged to us that they never in any way interfered with it—the 
colonels had themselves establish their rules, and their company 
officers had by daily inspections and personal attentions, carried 
out the letter and spirit of the orders—while in other instances, 
and these examples we are bound to say are the most frequent, we 
have seen encampments badly policed,where intelligent surgeons, 
of neat and systematic habits, have labored zealously for many 
months, but whose efforts were rendered completely ineffective 
from the indifference and want of support on the part of the 
colonel. 
Field surgery has been made the subject of unfriendly criti- 
cism by those who have been permitted to see our patients after 
the lapse of several days; yet intelligent medical men never, or 
very seldom, venture to judge of the propriety of an operation, 
or of the skill exercised in its execution by the condition of the 
patient, or of his wound at this period. The best-made stumps 
may ulcerate, slough and open, the skin and muscles may 
retract and expose the bones from faults of the constitution, 
from the severity of the shock attending the accident, from 
exposure to heat or cold, from rude jolting over rough roads, 
or from rude handling on the part of those who move them from 
place to place. THE ARMY SURGEONS. 
9 
The neatest dressings may become disarranged and soiled; 
and in hot climates, where wounds cannot be sufficiently pro- 
tected, magots will obtrude their disgusting presence in spite of 
the utmost diligence of the surgeon and his attendants. 
If, however, it could be clearly shown that there was a good 
deal of bad surgery in army practice—that operations are not 
always judiciously timed, or skillfully made, or the wounds 
neatly dressed; does it justify the severity of the judgment 
sometimes given in these cases ? Have any of these gentlemen 
who find it so easy, and who feel it so much their duty to point 
out our errors ever made an amputation “ under fire?” It is no 
uncommon thing for a surgeon on the field to be compelled to 
change his position once or twice during an operation, on 
account of a change in the direction or range of the shots. 
Such interruptions, together with the urgency of the claims 
of other wounded men lying about, render it necessary to 
decide quickly, and, no doubt, sometimes injudiciously, and to 
execute rapidly. 
In short, while we are no apologists for the surgeon who 
neglects his duties, or performs them unskillfully through ignor- 
ance, or who, from any cause or in any degree, fails of doing 
all that can reasonably be demanded of him, we protest against 
ill-grounded, uncharitable and wholesale criminations of a corps 
of officers who have thus far in this war performed their duties, 
we believe, as faithfully and as skillfully as any other corps in 
the army, yet for whom there are but few of those incentives to 
good conduct which are placed before other officers of the line 
and staff. A surgeon may be commended by his commanding 
officer for diligence and bravery in the discharge of his appro- 
priate duties, and occasionally this has been done; yet not, we 
think, as often as the commendation has been merited; but in no 
case has there been placed before him the incentive of promo- 
tion, In the medical department of the U. S. Army, there is 
provision for one brigadier-general, one colonel, and eight lieu- 
tenant-colonels. Only ten medical men can ever rise above the 10 
THE ARMY SURGEONS. 
rank of major, while, in the other departments of the service, 
provision is made for over 2,000 who shall rank above major. 
Surgeons may be called to offices of additional trust and respon- 
sibility, involving usually additional expense, but their rank and 
pay must remain the same. 
To the above, I wish to add a few supplementary remarks : 
According to the report of the surgeon-general, (Medical 
and Surgical History of the War of the Rebellion, 1861-65, Sur- 
gical Volume, Part 1., pages 30-32 of Appendix,) including the 
period from the beginning of the war to 1865, 28 medical officers 
were killed, or died of wounds received in action, thirteen 
were killed by partisan troops, guerrillas, etc., nine died of 
wounds received in the line of duty, and seventy-three were 
wounded in action, but recovered. 
This report was made up in 1865, or so as to include the 
year 1865, but it was not published until 1870, and it is prob- 
able, therefore, that the pension rolls, with other and later sources 
of information, would considerably increase the number of those 
who died of fatal injuries. 
I have not been able to find in the surgeon-general’s reports 
a statement as to how many medical officers died of disease 
contracted in service, but I have in ray possession a memo- 
randum, dated December 6, 1869, to the effect that Dr. Wood- 
ward gave the number of those medical officers who died of 
disease as 385, including four who died in prison. 
From what I have seen in the medical journals and else- 
where, I presume an equal number of medical men were killed 
and died of diseases in the Confederate Army. 
Yours truly, 
Frank H, Hamilton.