Echoes of Navy Medicine's Past: The Civil War (1861-1865)
Wednesday, December 14, 2011
Echoes of Navy Medicine’s Past
Part II: The Civil War (1861-1865)
By Jan Herman and Mr. Grog
LEGENDARY BATTLE OF THE IRONCLADS: USS MONITOR vs. CSS VIRGINIA
“David goes out to meet Goliath and every man who can walk to the beach
sits down there, spectators of the first ironclad battle in the world...
The day is calm, the smoke hangs thick on the water. The low vessels are
hidden by the smoke. They are so sure of their invulnerability they
fight at arm’s length. They fight so near the shore, the flash of their
guns is seen and the noise is heard of the heavy shot pounding the
This is how U.S. Navy physician Charles Martin described the legendary
fight between the ironclads USS
Monitor and CSS Virginia. What made the Civil War at sea different from
what came before is indeed that image—the first seemingly unequal duel
of the ironclads—the Yankee cheese box on a raft versus the slope-sided,
After all, the once U.S. Navy sloop of war had just hours before set
Congress afire, rammed and
sank the Cumberland, and
run Minnesota aground. The following day she was headed out to
finish off the grounded vessel when
Monitor, her low-freeboard decks nearly awash, popped into
view and saved the day, fighting
Virginia to a draw.
AFTERMATH OF BATTLE OF THE MONITOR vs. VIRGINIA
What was the medical aftermath of that now legendary combat: On the
Union side, three men were injured on
Monitor. One was the acting
master whose knee came into contact with the turret at the same instant
one of Virginia’s heavy
shot struck it. Knocked senseless by the impact, he regained
consciousness 10 minutes later. Another seaman in the turret was knocked
unconscious in a similar manner. Acting Assistant Surgeon Daniel Logue
described this sailor’s injury as a concussion of the brain. His
circulation remained depressed and it became necessary to administer
stimulants. When the patient regained consciousness, Dr. Logue watched
for a reaction and then applied cold affusion to the head.
THE ONLY CASUALTY OF THE IRONCLAD ACTION
Toward the close of the action, the Confederate ironclad inflicted its
last and most significant casualty—Monitor’s skipper John Worden. LT S.
Dana Green, Monitor’s executive officer described the event:
“Soon, after noon, a shell from the enemy’s gun, the muzzle not ten
yards distant, struck the forward side of the pilot house directly in
the sight hole or slit and exploded, cracking the second iron log and
partly lifting the top, leaving an opening. Worden was standing
immediately behind this spot and received in his face the force of the
blow which partly stunned him and filling his eyes with powder, utterly
“[Sent for], I found him standing at the foot of the ladder leading to
the pilot house. He was a ghastly sight with his eyes closed and the
blood apparently rushing from every pore in the upper part of his face.
He directed me to take command. I assisted in leading him to a sofa in
his cabin. Dr. Logue examined his eyes, succeeded in removing tiny
scales of iron and a small quantity of paint, and then made cold
applications to his eyes.”
Following the battle, only Worden left the ship for hospitalization in
Washington. The other two patients returned to duty the following day.
Worden, it turned out, proved to be the only serious casualty of the
battle, permanently losing the sight in one eye and incurring a
disfiguring scar on his face.
VIRGINIA CREW--SEVERAL LOSSES
On the Confederate side, Virginia’s
crew did not get away unscathed. In her unequal fight with
Minnesota the previous day,
several killed or wounded. In contrast, her wooden-hulled victims
suffered enormous losses. Cumberland
alone lost over 100 men. Before the ship went to the bottom,
all the wounded who could walk were ordered out of the cockpit; but
those of the wounded who had been carried into the sick bay and on the
berthdeck were so mangled that it was impossible to save them. So
recalled her acting commander. During her engagement with
Virginia the following
morning, Monitor’s two 11-inch Dahlgren smoothbores did moderate damage,
wounding a few aboard the Virginia
but killing no one. As it turns out, the Confederates got a
lucky break. Although each 11-inch Dahlgren aboard
Monitor threw a shot
weighing 168 pounds, Worden was under orders from the Navy Department to
fire half-weight powder charges of 15 pounds for fear the guns would
GREAT IRONCLAD BATTLE ENDS
If this first great combat between the ironclads ended in a draw, war at
sea had changed forever and with it the practice of naval medicine. What
made the naval environment different from the Civil War battlefield was
the advent of the ironclad ship. John Ericsson’s
Monitor employed the new
technology, incorporating many technical advances for the time including
forced ventilation of living spaces, a protected anchor which could be
raised and lowered without it or the crew being exposed to enemy fire,
and a protected pilothouse.
DANGER WITHIN THE IRONCLADS--MANY HAZARDS FOR CREWS
Nevertheless, the new technology of iron and steam introduced brand-new
hazards—exploding boilers, scalding with live steam, burn injuries, and
primary and secondary wounds resulting from large caliber, rifled naval
guns. Ironclad vessels also introduced environmental and occupational
concerns for sailors aggravated by badly ventilated and hell-hot engine
rooms. It is estimated that a typical low ranking coal heaver aboard a
poorly ventilated ironclad routinely endured temperatures approaching
130 degrees F. In fact, aboard
Monitor in summer, temperatures of 125 degrees were recorded
on the berth deck and 150 degrees in the galley. One cannot
underestimate the utility of awnings in deflecting the sun from
Almost everyone has experienced opening the door of an automobile after
the vehicle has been baking in the summer sun all afternoon. Those
freshly scrubbed teak decks on World War I and World War II era
battleships were not designed for aesthetics. They insulated steel decks
and made living conditions somewhat bearable in the days before air
conditioning. One can only imagine then, the plight of the typical Civil
War ironclad sailor stationed on an inland river of the deep south or in
the vicinity of the besieged Charleston, SC. Add the oppressive humidity
of July or August and now one can begin to understand the life of an
DANGER OF WATER IN HEAVY SEAS
There were other hazards to be endured. With only inches of freeboard,
many ironclads of both navies were literally only inches from disaster.
One has only to contemplate Monitor’s
ill-starred voyage to Hampton Roads even before her fight with ex-Merrimack.
Only one day out of New York, she encountered a storm which soon had
heavy seas cascading over her deck, washing out turret caulking,
flooding her berth deck, disabling her blowers, and nearly extinguishing
her boiler fires. Her paymaster recalled what the ironclad’s fight for
survival meant for her crew.
“Turning to go down from the turret I met one of our engineers coming up
the steps, pale, black, wet and staggering along gasping for breath. He
asked me for brandy and I turned to go down and get him some and met the
sailors dragging up the fireman and other engineers apparently lifeless.
I got down as soon as possible and found the whole between decks filled
with steam and gas and smoke; the sailors were rushing up stifled with
gas. I found when I reached the berth deck that it came from the engine
room, the door of which was open. As I went to shut it one of our
sailors said he believed that one of the engineers was still in there—no
time was to be lost, though by this time almost suffocated myself, I
rushed in over heaps of coal and ashes and fortunately found the man
lying insensible. One of the sailors who had followed me helped pull him
out and close the door.”
This nightmare would be played out again—fatally—at the end of the year
when Monitor’s pumps
failed to stem the incoming seas and John Ericsson’s ironclad pioneer
plunged to the bottom off Cape Hatteras with the loss of several
HAZARDS OF ON-BOARD FUEL & CARBON-MONOXIDE
Even the fuel that fired an ironclad’s boilers was a threat. Coal, while
not a new fuel used by the Navy, had the potential of becoming a silent
killer. Fossil fuels require proper ventilation and this concept was not
yet adequately understood by Civil War engineers. Untold casualties,
some fatal, occurred when crewmen either loaded wet bituminous coal in
below-deck bunkers or bilge water contaminated the fuel. Both the
Mississippi Squadron and the South Atlantic Blockading Squadron reported
a number of cases of sailors being discovered either dead or unconscious
below deck. The more fortunate were revived when exposed to the fresh
air. Besides unconsciousness, surgeons described their patients as being
cyanotic—blueness of the skin caused by oxygen starvation with foreheads
and eyelids markedly swollen. Similar cases reported aboard a coal-fired
ship in 1913 recognized the problem as carbon monoxide poisoning. Wet,
unventilated coal produces high levels of that dangerous gas.
SEA-WARFARE METHODS CHANGED WITH IRONCLADS
Indeed, there were significant differences in warfare once ironclads
came into their own. Naval guns up to the middle of the nineteenth
century had an effective range of only about a mile and a half. These
were the smoothbores throwing balls weighing 24 and 32 pounds. The
strategy therefore called for close-in fighting terminated by boarding
parties and hand-to-hand combat.
DIFFERENCES (FROM WOODEN SHIPS) AND WOUNDS ON THE IRONCLAD SHIP
There were many differences between wounds sustained in battle on the
old wooden ships and those encountered aboard ironclads. Shots striking
wooden vessels tended to throw about splinters which, as secondary
projectiles, caused many of the wounds. Burns were uncommon. In yardarm
engagements and during the hand-to-hand fighting resulting from boarding
an enemy’s vessel, many wounds were caused by small arms, cutlasses,
bayonets, and pikes.
In ironclad fighting, splinters might be fewer, but burns and fragment
wounds became commonplace. The so-called protected environment an
ironclad warship provided was illusory. If anything, it offered fatal
hazards the crew of a wooden ship rarely experienced. Take the example
of the monitor Nahant.
Engaged in Samuel Du Pont’s attack on the Charleston forts in April
1863, shellfire from the forts slammed against her pilot house and
turret with such velocity that broken bolts ricocheted about her pilot
house like bullets, killing one man and injuring two others, including
"GARBAGE CAN" EFFECT PROJECTILES STRIKING THE IRONCLAD SHEETING
Iron shot weighing over 150 pounds were now common, making the 24- and
32-pound size thrown by earlier guns seem quite puny in comparison.
What’s more, a newer generation of rifled guns that could pulverize
masonry forts could do worse to those enclosed within an iron-sheathed
hull. What resulted was the “garbage can” effect. Imagine yourself
encased in a typical galvanized steel garbage pail or a 55-gallon steel
oil drum, ears unprotected, and then having your antagonists hurling
50-pound cement blocks against your cocoon, one per second. With blood
dripping from nose and ears, crewmen were sometimes driven mad under the
barrage of both rifled and unrifled artillery impacting against iron
armor. And if not driven mad, many sailors had their eardrums ruptured
or, at very least, suffered temporary or permanent deafness. Civil War
sailors frequently described ringing in the ears or tinnitus. With noise
levels aboard Civil War ironclads routinely exceeding 130 decibels, one
can only conjecture what kind of hearing damage resulted among these
warriors. For comparison, a modern F-18 jet engine produces about 125
decibels of noise. The noise on the flight deck of a modern aircraft
carrier during flight operations routinely exceeds that level. And these
crews have available hearing protection. One can only imagine the degree
of hearing loss suffered by Civil War sailors.
MEDICAL CONCERNS IN THE NAVY- PHYSICAL AND MENTAL
As similar as the practice of medicine may have been for both Army and
Navy physicians--certainly in the treatment of battle injuries--the
marine environment offered some very unique circumstances. Sailors on
blockade duty experienced little battle and much boredom. Off Cape Fear,
NC, a sailor in the blockading squadron wrote home to his mother that
she should get some notion of blockade duty if she would go to the roof
on a hot summer day, talk to a half dozen degenerates, descend to the
basement, drink tepid water full of iron rust, climb to the roof again,
and repeat the process at intervals until she was fagged out. Then go to
bed with everything shut tight.
Needless to say, under these conditions, the psychological health of
sailors was often in question. “Give me a discharge and let me go home,”
a distraught coal-heaver begged his skipper after months of duty outside
of Charleston. “I am a poor, weak, miserable, nervous, half crazy boy.
Everything jarred upon my delicate nerves.”
And this routine was accompanied by an unbroken diet of moldy beans,
stale biscuits, and sour pork. To ease the monotony or perhaps to
anesthetize themselves from reality, mess crews specialized in the
manufacture of outlaw whiskey distilled from almost any substance that
fermented in the southern heat. Commanding officers and medical officers
assigned to the James River Flotilla complained a great deal of the lack
of fresh provisions and vegetables. Following a July 1862 inspection,
Fleet Surgeon of the North Atlantic Squadron, Dr. James Wood,
recommended that vessels be furnished with fresh provisions twice a
week. His report on his inspection also contained a recommendation for
improving the water supply used in the vessels. He said that the “turbid
and objectionable” river water used tended to produce diarrhea. He saw
no reason for continuing to use impure river water, since steam vessels
could condense more pure water than their crews needed.
Even though sanitary conditions aboard ship were often superior to those
ashore, and both navies probably fared better than the armies when it
came to the frequency of disease, rheumatism and scurvy kept the doctors
busy along with typhoid, dysentery, break bone fever, hemorrhoids, and
damage done by knuckles. In the southern climes, insect-borne malaria
and yellow fever laid low many a crew. And, regardless of what they had
to work with, surgeons aboard the ironclads, and indeed every vessel,
had no medicine for the ills of the spirit brought on by the strain of
monotony, poor food, and unhealthy living conditions which produced much
longer casualty lists than did Confederate shells or mines.
The ironclad navy of the Civil War was neither all wood nor all iron.
Nevertheless, it represented the first, halting steps into the modern
age. Even though many of the hulls were still wood with but a veneer of
iron, such vessels as Monitor and the vessels it spawned would soon
become commonplace. The age of sail was over and had been since
Virginia fought their
legendary duel in 1862. It was a new navy in 1865, even though
hard-bitten conservatives in Washington had been loathe to trade
traditional wooden hulls and canvas for an all-iron fleet. By the late
1870s and certainly by the turn of the twentieth century that fact was a
reality. Medical planners and health care providers would now have to
face squarely the realities Civil War surgeons had already encountered
during their war. The new steel ships now carried rifled, breach-loading
artillery. What their muzzle-loading predecessors had inflicted upon
human flesh and bone had already been demonstrated. Traumatic
amputations, penetrating fragment wounds, and horrific burns had become
commonplace during that war. In the post- Civil War environment, these
wounds would increase exponentially as would new kinds of injuries
merely hinted at during the Civil War—primary and secondary blast
injuries, scalded skin and flesh caused by ruptured steam pipes and
boilers, toxic smoke inhalation—the products of fire below decks. The
problems first encountered during the war of the ironclads would now
have to be dealt with aboard ships of the all-steel, all-steam navy.
Whether victims of disease or hostile action, sailors required treatment
and much Navy medicine took place in the three existing hospitals at
Chelsea, Brooklyn, and Philadelphia. By the fall of 1862, all three were
filled to their utmost capacity. As a result, medical facilities at navy
yards and naval stations were expanded and both civilian and Army
hospitals were also treating naval patients. To remedy the situation, a
major hospital expansion campaign began. Unfortunately, many of these
improvements weren’t realized until the very end of the war.
ADDITIONAL HOSPITAL SHIPS ADDED
Following their recapture by Union forces, the two naval hospitals in
the South--Portsmouth and Pensacola were put back into operation. In
addition to the naval hospitals that had been established before the
war, at least four others came on line between 1862 and 1865. These
hospitals at Mound City, IL (1862); Memphis, TN (1863); New Orleans, LA
(1863); and Port Royal, SC (1864), were located within the theater of
operations of the blockading river squadrons and acted as receiving
hospitals, taking patients on a short-term basis.
RED ROVER- FIRST NAVY HOSPITAL SHIP
Ironically, one of the medical stations that could perform long-term
care was not stationary at all. In 1862, Union forces captured a
Confederate side-wheeler, Red Rover.
Under the order of the Naval Fleet Surgeon, the ship was converted into
what can be considered the Navy’s first hospital ship (however, there is
evidence that Navy ships used during the Tripolitan Wars were used as
floating hospitals). According to a Navy General Order of June 1862,
“only those patients are to be sent to the hospital boat who it is to be
expected to be sick for some time, and whose cases may require more
quiet and better attention and accommodation than on board the vessels
to which they belong.”
Regardless, Red Rover
was something of a naval anomaly. The vessel had a laundry; an elevator
that could transport the sick from lower to upper decks; an amputation
room; nine water closets; an icebox to store fresh food; and gauze
blinds to keep flies, mosquitoes, cinders, and smoke from “annoying” the
patients. It was also the first ship to have a staff of female nurses
trained in the medical arts.
WOMEN "NAVY NURSE CORPS"
On Christmas Eve, 1862, Sisters of the Order of the Holy Cross of St.
Mary’s of Notre Dame in South Bend, IN, reported aboard the medical
vessel to care for sick and wounded seamen. One hundred years later, the
Navy helped to honor these women at a ceremony on the campus of Notre
Dame as true pioneers of the Navy Nurse Corps.
MEDICAL CORPS SUFFERS CASUALTIES, HONOR IN MEDICAL CREWS
From 1862 until 1865, the medical staff on-board
Red Rover cared for 2,450 casualties, including 300 wounded
Confederates. In roughly the same time period, Navy shore facilities
handled more than 31,000 patients, with 990 treated in 1864 alone, a
record for a four-year conflict. However, the conflict was not without
other distinctions. The war took a heavy toll on the Navy Medical Corps,
killing 33 surgeons including Assistant Surgeon William Longshaw, Jr.,
who was acknowledged by Secretary of the Navy Gideon Welles and RADM
John Dahlgren for gallant behavior for his action on 15 November 1863
when he, under heavy fire, volunteered to retrieve the monitor Lehigh
which had run aground. In January 1865, Dr. Longshaw was killed in an
assault on Fort Fisher, NC, while binding the wounds of a dying man. His
heroism under fire encapsulates Navy medicine’s real Civil War legacy.
A . . .
With the Navy vessels
changing to ironclad, read the article and describe the "new" dangers
concerning the ships, called "Garbage Cans." Make a computer
presentation or poster illustrating and describing these dangers.
B . . .
Describe the most
common medical problems that sailors got on-board an ironclad.
These can be related to hearing, mental and physical. Make a
presentation or a poster to illustrate or describe your findings.
C . . .
USS Red Rover became the first Navy Hospital ship. Read
the article and describe what kind of ship the Red Rover was, how it was
set up to be a hospital, how large was the crew including medical
personnel, and where it did its' work. Conclude this order with
making a listing and short description (name, physical characteristics
of the ship, size of crew and where it was stationed) for three other
ships added to the hospital naval fleet.
D . . .
Read about the
medical corps, nurses corps, and the dangers of being a nurse or doctor.
What kind of injuries and illnesses were these professional always in
threat of getting?
Reading the article,
who was the doctor awarded for bravery in-action by Secretary Welles and
Read Admiral Dahlgren? What did this doctor do? What role did
women play on hospital ships? Read the article find who the women
were that helped on the hospital ships. Make a computer
presentation or a poster to illustrate and describe medical care on the
hospital ships, and on-board the ironclads or other ships.
E . . .
Go to the section on
NAVY MEDICAL PROCEDURES
and make a list with descriptons of medical procedures. Present
your results in a presentation or poster.
Check the U.S. Navy Civil War Sesquicentennial Blog Site for a Series of
Use "New Technologies
of the Civil War" for Information
You can record your answers in a Navy Form each
part of the activity.
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