Empty Sleeves: Amputation in the Civil War South by Brian Craig Miller (review)

“It was all over but the empty sleeves and wooden legs,” wrote a Civil War veteran from Georgia about the end of the war (117). As Brian Craig Miller argues in this deeply researched and briskly written book, however, the Confederate surrender was more of a beginning than an ending for the men who had lost an arm or a leg fighting for the Confederacy.

The accepted number of men in both the Union and Confederate armies who survived amputations is sixty thousand, although Miller argues that the absence of records makes it impossible to say with any certainty how many Confederates actually experienced the trauma he describes in this account of the archetypal sacrifices of soldiers during the Civil War. Moreover, the importance of Confederate amputees transcends their actual numbers, as Miller uses the process of amputation to explore several facets of the war and its aftermath in the South, including notions of masculinity, the practice of medicine in the Confederate army, gender relations, post-traumatic stress, as well as postwar commemoration of and government programs for veterans.

The five chapters address, in roughly chronological order, the key elements of what could be called the “amputation experience.” Chapter 1 includes blood-drenched descriptions of amputations on and off the battlefield. But Miller’s most important contribution is to note that Confederate surgeons became more conservative and more effective in their approach to amputations as the war went on. Chapter 2 frames amputation as a test of manhood; although many of Miller’s examples seem familiar—in fact, many are familiar, in that the author draws on the experiences of several well-known amputees—his application of the idea of agency to soldiers’ acceptance of or resistance to amputation raises such choices beyond simple courage or stubbornness. Instead, they reveal a more substantial reflection on self-image in a society shaped by others’ perceptions of one’s physical capacities. Chapter 3 addresses women’s responses on several levels, from disgust and courage when called upon to nurse injured men to concern and admiration, and from worrying over family finances to embracing the greater responsibilities that fell on their shoulders.

Chapter 4 shows, in a particularly sensitive way, the many situations in which amputees were forced to adjust to dependence and disability in their new lives. A surprising number—enough so that the one-armed or one-legged politician became something of a stereotype—used their injuries as an equivalent to the Radical Republican “bloody shirt” to campaign successfully for state offices and Congress. Finally, chapter 5 chronicles the excruciatingly slow adoption of programs to aid amputees in the hard-pressed former Confederate states. Along the way Miller corrects the frequently cited but exaggerated notion that Mississippi and other states devoted huge chunks of their budgets to buying prosthetic limbs and reveals surprising levels of resistance to spending public money—especially for pensions—on Confederate veterans. Appendices sampling the number of amputees and pension “ratings” for various disabilities in several states offer a practical ending.

Each of Miller’s chapters adds to our knowledge of this awful, fascinating subject. The book does have limitations, however. The heartfelt epilogue, which tries to place the amputees produced by the United States’ recent wars in a larger context, misfires. While earnest, it does not add to our understanding of Civil War amputees. More important, because it is necessarily based on a small sample of men and women, the evidence is unavoidably anecdotal. Miller is a little light in his discussion on masculinity, although his commonsense arguments about the way amputation affected men’s self-images and their relationships with women are certainly plausible. In addition, the case is not made clearly enough as to why amputation was different enough from all the other ways that the war disabled soldiers—disease, psychological trauma, other wounds that required treatment for the rest of the victims’ lives—to...