Nature's Civil War: Common Soldiers and the Environment in 1862 Virginia

3. Soldiers and Official Military Health Care

65 3 Soldiers and Official Military Health Care Before the war, common soldiers could scarcely have imagined the sprawling , alien medical systems that would be constructed by the United States and the Confederacy. Properly supporting soldier health necessitated the consideration of supply lines and camp sanitation, sick call and diagnostic procedures in the ranks, treatment at regimental and remote hospitals, and rehabilitation. Because of the division of labor in military bureaucracy, not all these elements were under the purview of the two sides’ Medical Departments. The health systems of the Union and Confederacy involved the Quartermaster and Commissary Departments, commanding generals , military and medical officers, the presidents, and, in the case of the United States, the civilians of the U.S. Sanitary Commission—composed of elite social and medical reformers, middle-class male and female reformers , and average Northerners at home. Meanwhile, Union and Confederate civilians scrutinized medical progress and commented upon it in the newspapers, pushing for changes that might preserve the health of their loved ones. It is no surprise, then, that this complex network of individuals quarreled over power, conflicting medical theories, and varying obligations . Further, even the brightest, most forward-thinking health care workers only dimly comprehended environmental management, disease prevention, and medical treatment. Even so, institutional obstacles were more crippling to health care in 1862 than were individuals. These factors involved a shortage of staff, supplies, and hospitals and the painfully gradual nature of reform endemic to democracies. Despite the complex tangle of problems, both Medical Departments were able to institute reform programs that would improve soldier health over time, if not drastically 66 / Soldiers and Official Military Health Care during the 1862 Peninsula and Shenandoah Valley campaigns; however, in the first year and a half of war, taking responsibility for one’s own body was not only an accepted cultural convention, it was vital to survival. Increased contact with the unfamiliar did not lead soldiers to heightened confidence in science or trust in the Medical Departments in 1862; quite the contrary.1 Common soldiers often criticized and sometimes rejected a system of care they found ineffectual, impersonal, and even condemnatory given the class differences with some of their caretakers. They leveled their harshest critiques at surgeons, assistant surgeons, hospital stewards, nurses, and military officers.2 In return, common soldiers were often viewed as low-class, undisciplined volunteers in need of guidance by the enlightened middle and upper classes. To a certain extent, the opinion was justifiable. Officers were supposed to regulate and train their troops not only to prepare them for combat, but also to preserve their health. And yet middle-class paternalism spread beyond securing army efficiency to enforcing a code of expected behavior, evident particularly in the newspapers . This feedback loop increased estrangement between soldiers and civilians. SOLDIERS ASSESS THE OFFICIAL NETWORK OF CARE “Against entering an hospital, there usually exists in the mind of the soldier a strong repugnance, even a manifest horror. Nor is this, by any means, an unnatural feeling,” wrote Union chaplain A. M. Stewart.3 Though Stewart believed he was speaking on behalf of the common soldier, and in some sense he was, his comments better reflected his middle-class origins. According to Stewart’s parameters for proper behavior, soldiers should fear hospitals, because “too often they are cold, heartless places, to which, even when sick, the soldier is carried with great reluctance. As a consequence, the good soldier is wont to resist and stave off an approaching disease as long as possible, by a performance of ordinary duties.” As historian Frances Clarke’s War Stories has elucidated, forbearing in one’s pain earned a man cultural clout in a society coping with mass suffering.4 Indeed, as Stewart wrote, “When finally forced to yield, the bravest and strongest usually gives up altogether,—lie down in the cheerless, homeless tent, draw up their blanket over their head, and almost refuse to move, until forced away by command of an officer.”5 Here Stewart elaborated that the respectable soldier, in an embrace of striking individualism, would refuse altogether to succumb to army medical infrastructures unless compelled by direct order. The fact that Stewart had class-specific expectations for Soldiers and Official Military Health Care / 67 the men’s behavior does not mean he lacked genuine compassion. It fell to chaplains to spiritually comfort soldiers, and in doing so many grew terribly impressed by the hardships soldiers...