Gangrene and Glory: Medical Care during the American Civil War (review)

Frank R. Freemon. Gangrene and Glory: Medical Care during the American Civil War. Madison, N.J.: Fairleigh Dickinson University Press; London: Associated University Presses, 1998. 254 pp. Ill. $52.50.

In this book Dr. Freemon, with a skillful use of words, allows us to envision the day-to-day care of wounded soldiers. The visual effect of the title is followed in the preface by a description of what a hospital must have smelled like. He likens the smell to that of a freezer that has failed while you were on vacation: as you reach the front door you get a faint whiff of this putrid smell, which becomes ever stronger as you proceed toward the freezer. He touches our emotions as well, with a description of the suffering of the Confederate wounded during the retreat from Gettysburg that is especially poignant.

Freemon makes the case that the Union medical system was perhaps more successful than its Southern counterpart in returning wounded and sick soldiers to combat duty. He emphasizes with statistics that Grant's success in the Vicksburg campaign, Sherman's in northern Georgia, and the failure of the Union to take Arkansas and Louisiana were related to the success of the respective medical services in maintaining the health and fitness of their armies. In the Vicksburg campaign one-half of the Confederate forces were ill, whereas only 25 percent of the Union troops were ill. The battle in northern Georgia, resulting in the fall of Atlanta, witnessed the collapse of the Southern medical system, so that very few sick or wounded soldiers were returned to combat. In Louisiana and Arkansas, malaria crippled the Union forces; it was the only area of campaign in which quinine was not readily available for Union troops.

With the obvious pride of a physician, Dr. Freemon relates that through all this misery the depth of commitment of physicians to their duty was great. Physicians of both sides mingled on the battlefield to care for their respective wounded. Grant, in his campaign to the east of Vicksburg, cut loose from all his supplies and left his wounded on the field, knowing full well that Confederate physicians would care for them. Lee left six thousand Confederate wounded at Gettysburg College, with Confederate physicians continually resupplied by the United States Sanitary Commission and nursed by the Sisters of Charity. After Stonewall Jackson's successful valley campaign, where a number of Union physicians were captured, Jackson's personal physician, as well as other physicians in the Confederacy, successfully petitioned him to grant the Winchester Accord--to treat physicians as noncombatants and release them. This principle rapidly spread throughout both armies: physicians and chaplains were noncombatants and could succor the wounded without fearing capture.

Freemon also points out that the American Medical Association, during the Civil War, listed in its program the missing representatives of the Southern states as though they were only temporarily absent. Following the war, Confederate physicians served the AMA as president--including Hunter Holmes McGuire, Jackson's physician, who personally arranged the Winchester Accord. Thus, these physicians who had personally witnessed the horrific consequences of combat, and had labored to overcome the inadequacies of their respective medical systems, came together in an effective way to help heal the wounds of national division.

This is a well-written book covering the many problems faced by the medical services of the Union and the Confederacy. It should find a place in the library of all serious Civil War students.

Thomas T. Provost
Johns Hopkins University

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