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Bulletin of the History of Medicine 78.1 (2004) 229-230

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Cynthia DeHaven Pitcock and Bill J. Gurley, eds. I Acted from Principle: The Civil War Diary of Dr. William M. McPheeters, Confederate Surgeon in the Trans-Mississippi. The Civil War in the West. Fayetteville: University of Arkansas Press, 2002. xvi + 423 pp. Ill. $34.95 (1-55728-725-2).

This Civil War diary of a surgeon who served the Confederacy for three long years with the army that fought on the western side of the Mississippi River is part of a series intended to promote interest in a neglected area of the war. What emerges is a vivid picture of the trials faced by the Confederates as they persisted to the end of the war. Despite the inevitability of the outcome, they continued to have faith in their cause, unwilling to believe they would not prevail.

Dr. William M. McPheeters typified that unwavering commitment to the Southern cause. Born in North Carolina and educated in medicine at the University of Pennsylvania, he settled in St. Louis, Missouri, where he prospered and eventually became one of the leading physicians of the city. He was a professor at St. Louis University and an editor of the St. Louis Medical and Surgical Journal, and he served on the Board of Health. He owned no slaves, though slavery in Missouri was legal.

When the Civil War began, Missouri, one of the border states, was hotly contested by the North and the South. McPheeters deeply resented the Federal troops who gained control of the city, and he thoroughly opposed Lincoln's determination to prevent secession from the Union. He refused to sign an oath of allegiance to the government of the United States, and after a year of harassment by Federal officials, which included confiscation of his property and a brief imprisonment, he escaped to Richmond. There, he was commissioned a surgeon in the Confederate army and assigned to service with Missouri troops then serving in Mississippi. Within five months his commander was transferred to the Confederate Department of the Trans-Mississippi and McPheeters was stationed in Little Rock, Arkansas. When Little Rock fell to the Union army his division moved west and south. Eventually the war took him through Arkansas, western Louisiana, Texas, and the Indian Territory. There was even a futile foray into Missouri.

McPheeters provided medical care to soldiers who were often sick with fevers and intestinal ailments when not facing battle, and who suffered horrible wounds when they encountered the enemy. He also had many patients among the noncombatants living in the surrounding area, and some of the officers' wives who accompanied their husbands. Remarkably, he remained healthy throughout the war, except for a brief malarial episode and occasional dysentery.

To the bitter end, McPheeters believed it was his duty to fight for the independence of the Confederacy, and for civil and religious liberty threatened by Northern domination. These beliefs were buttressed by his staunchly Presbyterian religious convictions, which included a God whose will determines man's fate. At the end of the war he returned to St. Louis, where he resumed his medical practice and was widely esteemed by his colleagues and associates.

Much of the diary describes the tedium of army life, which McPheeters [End Page 229] relieved by reading serious literature, often of a religious nature, and by socializing among the upper class in the areas where he was stationed. There is little here of special interest to a medical historian, although the book is worthwhile as the biography of an interesting man and as an aspect of Civil War studies. In his diary entries, McPheeters does not diagnose the diseases he encounters, nor does he describe medical treatment. As for surgery, it is a familiar story of amputations without anesthesia or antisepsis. For readers interested in the organization of the Confederate medical department, the diary offers few insights but the Appendix presents official reports written by McPheeters regarding the inspection of...


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