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Marrow of Tragedy

The Health Crisis of the American Civil War

Margaret Humphreys

Publication Year: 2013

The Civil War was the greatest health disaster the United States has ever experienced, killing more than a million Americans and leaving many others invalided or grieving. Poorly prepared to care for wounded and sick soldiers as the war began, Union and Confederate governments scrambled to provide doctoring and nursing, supplies, and shelter for those felled by warfare or disease. During the war soldiers suffered from measles, dysentery, and pneumonia and needed both preventive and curative food and medicine. Family members—especially women—and governments mounted organized support efforts, while army doctors learned to standardize medical thought and practice. Resources in the north helped return soldiers to battle, while Confederate soldiers suffered hunger and other privations and healed more slowly, when they healed at all. In telling the stories of soldiers, families, physicians, nurses, and administrators, historian Margaret Humphreys concludes that medical science was not as limited at the beginning of the war as has been portrayed. Medicine and public health clearly advanced during the war—and continued to do so after military hostilities ceased.

Published by: The Johns Hopkins University Press

Series: Johns Hopkins Biographies of Disease


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pp. 1-7


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pp. vii-viii

List of Illustrations

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pp. ix-x

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pp. xi-xiv

To properly thank all of those who have contributed to this book, I’d have to begin with the Brownie Scout leaders who took me to Fort Donelson in the second grade and continue from there. Raised in the South by a mother from Minnesota, I have long realized that the war was the key event in American history and that sooner or later I would have to engage it professionally. ...

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Introduction: Call and Response

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pp. 1-19

The American Civil War was the greatest health disaster that this country has ever experienced, killing more than a million Americans and leaving many others invalided or grieving.1 It does not seem to have occurred to the leadership on either side that the war would produce casualties and that the gathering of men in great camps would provide a field day for infectious diseases. ...

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1. Understanding Civil War Medicine

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pp. 20-47

For the men and boys who signed on to fight in the Civil War, the world changed remarkably. No longer at work in their usual trade or at school studying under the teacher’s rule, they were instead cast into a new world of marching, tenting, and shooting. They left a domestic world where each of the sexes had its assigned tasks, ...

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2. Women, War, and Medicine

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pp. 48-75

At the top of anyone’s list of “Famous Women in the Civil War” is Clara Barton, who organized battlefield relief stations, visited Andersonville after the war to identify the dead and notify families, and in the 1880s established the American Red Cross. So when she told a Memorial Day audience in 1888 that at the end of the Civil War, ...

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3. Infectious Disease in the Civil War

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pp. 76-102

One of the most remarkable changes in medical thought in the nineteenth century was in the understanding of infectious diseases. At the start of the century, most physicians in Europe and America would have agreed that the fevers (a nebulous category marked by the symptom of high temperature) were caused by inhaling the foul odors that arose from various forms of filth. ...

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4. Connecting Home to Hospital and Camp: The Work of the USSC

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pp. 103-130

In the war fever that followed the firing on Fort Sumter and President Abraham Lincoln’s call for troops, men rushed to volunteer while women and men not of fighting frame rushed to support the war effort in other ways. In the North, the U.S. Sanitary Commission was born amid this wave of “excited benevolence of the country towards the army.”1 ...

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5. The Sanitary Commission and Its Critics

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pp. 131-151

If the U.S. Sanitary Commission was so great, why did so many contemporaries attack it? The record of the USSC during the Civil War was one of sustained benevolence and significant reform. Why, then, did the agency spend so much effort during the four years of its existence defending its record and actions? ...

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6. The Union’s General Hospital

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pp. 152-183

In 1876 Philadelphia hosted the Centennial International Exhibition, ostensibly to celebrate the one-hundredth birthday of the Declaration of Independence but actually to showcase the industrial and agricultural prowess of the United States. Attracting some 10 million visitors (at a time when the U.S. population was 46 million), ...

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7. Medicine for a New Nation

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pp. 184-207

Confederate medical leaders struggled with the same challenges as their Union counterparts, but they also embraced the opportunities offered by the war to create a new medical system for their nascent country, one that would rival the North’s and encompass the best features of contemporary medicine.1 ...

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8. Confederate Medicine: Disease, Wounds, and Shortages

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pp. 208-242

While Samuel Preston Moore imagined his southern medical Renaissance in Richmond, the day-to-day reality of the Confederate hospital was one of frequent and widespread shortages that affected every aspect of medical care for soldiers as the war went forward. Hospital beds, medical supplies, surgical instruments, ...

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9. Mitigating the Horrors of War

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pp. 243-270

In May 1864 Union physicians had reason to become personally aware of the shortages of food and other supplies in the Confederacy. During a limited exchange of prisoners of war, a ghastly parade of “living skeletons” disembarked from boats that had ferried them from Belle Isle prison in Richmond. ...

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10. A Public Health Legacy

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pp. 271-289

Elisha Harris probably would not have phrased it this way, but he and the cause he held most dear had a very good war. In the 1850s Harris had been frustrated by failures to institute sanitary reforms in the United States. Through his work with the USSC during the war, however, he saw the goals of sanitation broadcast nationwide, ...

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11. Medicine in Postwar America

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pp. 290-309

How did the war influence medicine in postwar America? Chapter 10 considered how understandings of the causation and prevention of infectious disease directly affected public health. This chapter follows other threads of the narrative into the world of postwar medicine, exploring influence, change, and sometimes stasis. ...

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pp. 310-312

Imagine that on July 21, 1861, there you stand, an observer near Manassas Junction, Virginia. Out of the smoke and noise staggers a man, clutching his arm, calling out in pain as blood drips onto his boots. He falls on the bare ground at your feet. What can you do for him? Tear up your petticoat to make a tourniquet to stop the bleeding? ...


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pp. 313-372


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pp. 373-385

E-ISBN-13: 9781421410005
E-ISBN-10: 1421410001
Print-ISBN-13: 9781421409993
Print-ISBN-10: 1421409992

Page Count: 408
Illustrations: 19 halftones
Publication Year: 2013

Series Title: Johns Hopkins Biographies of Disease