Intensely Human: The Health of the Black Soldier in the American Civil War

4 Medical Care

c h a p t e r f o u r Medical Care Even by the standards of the time, African American regiments received decidedly second-class medical care. Like the wag’s complaint that the food was terrible and there was not enough of it, for these men there were too few doctors, and many of them lacked compassion and skill. In the best of circumstances, physicians served as vocal patient advocates, protesting inadequate supplies, granting sick leave to weakened men, calling on the U.S. Sanitary Commission for extra food and clothing, and rigidly enforcing contemporary standards of hospital cleanliness and wound care. The mediocre physician ascribed high mortality rates to di¤erences inherent in the black body and spirit, and drank the medicinal whiskey stores while minimally serving his black patients. At his worst, the surgeon was cruel, capricious, and dismissive of the needs of the men under his supposed care. In the hospitals run by surgeons of the latter stamp, the patients received inadequate food and endured filthy conditions . While nurses sometimes took up the cause of the African American hospitalized patient, most of the caregivers tending black men were too weak socially to e¤ect needed reforms. Although it is diªcult to quantify the impact of inadequate medical care on the high rates of disease and death among black regiments, the evidence indicates that poor care was an important factor in these outcomes. Recruiting Doctors for the Black Regiments Few black regiments ever had their full complement of medical attendants . Oªcial policy dictated that each regiment should have one surgeon and two assistant surgeons. Yet by the summer of 1863, when the big push to form black regiments began, the U.S. Army had already consumed the available medical manpower. Some men were eager for promotion from assistant to full surgeon and were willing to transfer to a black regiment to acquire that rank. Charles Edward Briggs applied for a position with the 54th Massachusetts (the Glory regiment). “I think it is desirable that I should have the major strap of Surgeon, before the war is over.” He was happy to serve with the black regiment, as “I have been favorable to negro regiments from the beginning, and have no recantation to make if I obtain a position in one.”1 No doubt other physicians took the opportunity of some 138 newly created surgeon positions to garner the promotion in rank and pay. But all too often there were not enough applicants, and the small available pool was comprised of men who had been unable to get a commission elsewhere due to their poor qualifications. The surgeon general set up screening boards specifically for medical appointments to black regiments and claimed that the men had to meet the same requirements as those for white regiments, but there seems little doubt that, in practice, standards were lower.2 Historian Paul Steiner has charted the medical staªng of the 65th U.S. Colored Infantry in detail. This regiment never had the expected medical sta¤ of three doctors, rarely had two physicians well for duty at any given time, and for several weeks had none at all. Gathered in St. Louis during the winter of 1863–64, the regiment’s first surgeon was mustered in on 9 January 1864. He had graduated from a St. Louis medical college only a few months before; that he entered as a full surgeon with so little experience was a sign of how desperate the colored regiments were to commission anyone with formal medical training. This man developed an incapacitating hernia and left the regiment that summer. A second physician joined on 4 April 1864, and was dead a month later of diarrhea. A third arrived in August, quickly sickened, and left in November. A fourth came a couple of weeks later and lasted until the following August 1865.3 The 1st U.S. Colored Infantry Regiment had similar troubles maintaining its quota of physicians. The first appointee refused to come south when the regiment was ordered there. The second found he disliked the duty and neglected it until he was fired. Then a private in the company claimed to have some medical knowledge, so he was appointed surgeon. It subsequently happened that his self-appraisal was not borne out by 58 Intensely Human events, and his principal reason for wanting the position was its...