Two Confederate Hospitals and Their Patients, Atlanta to Opelika (review)

The medical history of the American Civil War has, in the last few years, become popular again. Statistics of the northern side of the war, of the sick, the wounded, the dead, have been available since the publication of The Medical and Surgical History of the War of the Rebellion in the later decades of the nineteenth century. Because so many of the records of the Confederacy went up in the flames of Richmond in April 1865, the Confederate medical story has had more gaps. Yet there are some good caches of records, and one of them supplies the data for this book.

The medical director of the Army of Tennessee, Dr. Samuel H. Stout (1822–1903), carefully preserved 1,500 pounds of hospital records in the hope of producing for the South what the Surgeon General's office of the Union Army produced for the North. Before his death Stout wrote some articles, but he never obtained the necessary funding to allow him to write a more complete history. For a time after his death his daughters preserved the records, but then slowly dispersed them; the bulk is now at the University of Texas in Austin and at Emory University in Atlanta.

It is the extensive records of two of the many hospitals that Stout supervised that form the basis of this book. Founded as a single hospital on the Atlanta fairgrounds in 1862, they were divided into Fairground No. 1 and No. 2 early in the next year. They received many of the wounded at the battle of Chickamauga in 1863. As Sherman approached Atlanta in 1864, Stout ordered the hospitals moved to other Georgia towns, and eventually to Mississippi and Alabama. It is the records of 18,905 patients in these two hospitals that Jack Welsh has analyzed in print and on an enclosed CD-ROM. The result is full of medical information, but it is not a narrative of the medical care received in the two hospitals and is therefore not easy reading. For the narrative history of Stout's work, Glenna Schroeder-Lein's Confederate Hospitals on the Move (1994) is still the place to go.

Welsh's focus is on the nearly nineteen thousand admissions, 16,269 of whom received specific diagnoses, with a total of 213 different diagnostic designations. He has also traced the final disposition of 17,120 patients. As one would expect, intestinal disease and pulmonary problems predominated. Surprisingly, there were only 675 deaths recorded. Unfortunately there is virtually no mention of surgery, although 4,380 were listed as wounded or injured. It is true, as Welsh points out in a very good concluding chapter on comparisons with other hospitals (both North and South), that many of the seriously wounded were treated near the battlefields or died of their injuries before they could be shipped to hospitals in the rear.

It seems fair to say that Dr. Welsh excels in compiling information, as witnessed by two previous books about the medical histories of Union and Confederate generals. In this one, too, he has included brief biographical sketches of fifty-three of the surgeons who served in one of the Fairground Hospitals. Although the military doctors were referred to as "surgeon," many of them spent most or all of their time taking care of the sick or the wounded who so frequently developed infections. This book provides an interesting sample of patients, and Welsh's description and analysis give us a richer and more precise understanding of the work of the doctors and the suffering of their patients.