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  • The North vs. the South:Conditions at Civil War Hospitals
  • Barbra Mann Wall (bio), Kathleen Rogers (bio), and Ann Kutney-Lee (bio)

The American Civil War resulted in the death of nearly one million Americans (Hacker 348). At the beginning of the war, both Union and Confederate medical departments entered the conflict unprepared. Initially, care was provided in existing buildings such as schools, churches, almshouses, hotels, and homes; but as the war progressed, the armies constructed new hospitals. Poor diet, lack of ventilation, inadequate clothing, exposure, and unsanitary conditions all contributed to high rates of disease and poor patient survival rates. Yet some hospitals—on both sides of the Mason-Dixon Line—had remarkably better outcomes than others. In this article, we provide explanations for these healthcare differences. We also examine the critical role that nurses played in achieving the best success rates for patients. Clearly, though, many factors affected soldiers’ health, including a hospital’s location, patient acuity, and the availability of supplies.

Our essay focuses on selected hospitals in both the North and South, and we use the Daughters of Charity as our primary group of nurses. This Roman Catholic religious community is especially relevant to our study since the sisters worked in both Northern and Southern hospitals, and their efforts help us to compare and contrast large military hospitals from Richmond, Virginia, and Philadelphia, Pennsylvania. We examine other hospitals as well, including Robertson Hospital in Richmond, which was famous for its low mortality rates and privately established and administered by a remarkable individual, Sally Louisa Tompkins (1833-1916). We have relied on primary sources from the College of Physicians in Philadelphia, the Provincial Archives of the Daughters of Charity in Emmitsburg, Maryland, the Museum of the Confederacy and Virginia Historical Society in Richmond, and the Civil War Richmond online research project. These various archives house [End Page 37] letters, diaries, newspapers, and hospital records central to our inquiry. Our work also was informed heavily by the memoir of Phoebe Yates Pember (1823-1913)—chief matron of the Second Division at Chimborazo Hospital in Richmond—and the diary of Mary Boykin Chesnut (1823-1886). These two works, well-known to historians of Southern and Civil War history, provide invaluable insights into daily life at the Richmond hospitals during the war.

Nurses included men as convalescent soldiers; women and men slaves or escaped slaves; free blacks; and women members of aid societies, the US Army, religious congregations, and various plantation and farmers’ families. A key group of women nurses in the Civil War included the Daughters of Charity—established in America by Elizabeth Ann Seton in Emmitsburg, Maryland, in 1809. This congregation was founded in 1633 in France by Saints Vincent de Paul and Louise de Marillac to work among the sick poor. De Paul’s 1655 Common Rules of the Congregation of the Mission stipulated that in any war, the sisters were not to prefer one side or the other. Accordingly, during the Civil War, the Daughters of Charity’s religious superior, Father J. Francis Burlando, wrote a letter to the sisters on September 15, 1861, directing them to “refrain from uttering Political sentiment. . . . They have no Enemy but pride and the evil spirit—North, South, East or West are alike to them; every afflicted member of society is their friend and an object of their Solicitude. . . . ” (qtd. in McNeil 404). Thus, the Daughters of Charity worked in both Northern and Southern hospitals. In sum, more than 600 Catholic sisters worked as nurses during the war, but the largest number were by far the Daughters of Charity: 232 nursed at one time or another in general hospitals, in field hospitals, and on hospital ships (Jolly 83). They also nursed on the battlefields at Antietam and Boonsboro, Maryland, and Vicksburg, Mississippi, and worked on hospital ships up and down the Mississippi River, the Potomac, and in the Chesapeake Bay, plus rode with the ambulance corps at Manassas, Virginia, and Harpers’ Ferry, West Virginia. In addition to Philadelphia and Richmond, the Daughters served at hospitals in several other locations, including Washington, DC, and St. Louis, Missouri. The Daughters were also present in Gettysburg, Pennsylvania, which was only about fifteen miles...