Book Review! Civil War Medicine: Matchless Organization
Guy Hasegawa's book on the Confederate Medical Department.
Title: Matchless Organization: The Confederate Army Medical Department (Carbondale: Southern Illinois Press, 2021) by Guy Hasegawa.
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About the author of Matchless Organization:
Dr. Guy Hasegawa has a science and medical background. He has a Doctor of Pharmacy from UC-San Francisco. Dr. Hasegawa has worked as a pharmacist in Ann Arbor also teaching pharmacy at the University of Michigan. He currently works for the American Society of Health-System Pharmacists in Maryland, editing the American Journal of Health-System Pharmacy. Dr. Hasegawa has also worked as a National Museum of Civil War Medicine board member. He has written several books on Civil War Medicine, including Years of Change and Suffering: Modern Perspectives on Civil War Medicine, The Confederate Navy Medical Corps: Organization, Personnel and Actions, Mending Broken Soldiers: The Union and Confederate Programs to Supply Artificial Limbs, and Villainous Compounds: Chemical Weapons and the American Civil War.
Review:
Dr. Hasegawa’s book should be the new definitive overview of the Confederate Army Medical Department. Books on this topic have been sparse over the last 60 years. For that time period, H.H. Cunningham’s Doctors in Gray: The Confederate Medical Service stood as the authoritative source on the Confederacy’s medical department.
Cunningham’s book was first published in 1958 by the Louisiana State University Press. This was around the beginning of Civil War Medicine as an area of academic interest. Cunningham was inspired by George Worthington Adams’ 1952 book Doctors in Blue: The Medical History of the Union Arm in the Civil War. The pair of books established a foundation to work with; now, there was room for an addition.
Well, I’m sure we’re all aware, but a lot can change in the course of 70 years. This is especially true when it comes to the study of history. While Cunningham certainly deserves respect, there is room for a new authoritative book on the Confederate Medical Department, a topic that needed a refresher with new perspectives.
The book is a great overview of the medical department. He covers the major figures of men like Surgeon General Samuel Moore, other members of the Surgeon General’s Office, Medical Directors, Medical Purveyors, Inspectors, and politicians. For a medical department that had little to work with, Hasegawa answers the necessary questions, such as how they got supplies. How did they modernize their medical department? What effect did the young political establishment have on the medical department?
I first walked away with an appreciation for how well the Confederate Army Medical Department was organized. Samuel Moore put men in place throughout the Confederacy to direct medical supplies where needed. General Hospitals were established using state-of-the-art ideas. The Confederacy had high standards for their doctors, later requiring examinations and medical degrees for their surgeons. Moore’s department pushed surgeons to contribute to medical science by accumulating reports and data to later be published.
Really, the Confederate Medical Department’s story almost identically mirrors the Union Army Medical Department.
The Confederacy was forced to draw in doctors from the civilian world, and many were inadequately prepared or qualified for the task ahead. The CSA lacked hospitals, ambulances, surgical supplies, surgeons, and experience. Only a tiny portion of Moore’s surgeons were Antebellum regular army veterans.
There was a vicious learning curve as bad surgeons were weeded out, but competent surgeons still learned to advance their skills the hard way. They had to learn about surgical complications, how to properly treat sick and wounded soldiers, the pros and cons of surgery, the best practices for operating military hospitals, and more.
Field medical services, like their Union counterparts, evolved over time. As early battles left men without medical treatment or means of evacuation, this was remedied. While the solution was not as immaculate as the Union’s development of specialized ambulance corps, the requisition of Quartermaster and regimental equipment wagons had to suffice for the Confederacy. Wounded soldiers were treated as emergency cases near the field, and many were sent back to established hospitals for treatment of convalescence.
The Confederacy did have some unique challenges. The lack of southern medical schools made training new doctors difficult. Only 5 of the 15 pre-war southern medical schools still graduated students after 1861.
The Confederate Medical Department was forced to make due while under the Union blockade and with lacking industrial resources. Before the war, most medicine was imported from abroad or shipped from the North. Confederate ports were blockaded, and Samuel Moore was forced to create drug manufacturers of his own to supply his medical department. The Union itself ended up being a top supplier for Confederate medical supplies as they were smuggled through in exchange of Confederate cotton and other items. Confederate cotton was the bargaining chip needed to buy supplies in Europe, but jamming a ship full still had the added challenge of slipping past the Union blockades.
Medical books, manuals, and journals were in short supply. With changing medical science surrounding ideas like hygiene, hospital construction, surgery, pharmacy, and other sciences, new books were in constant demand. Printing and distribution was an expensive task, and the lack of authoritative manuals forced the Confederacy to improvise. Pre-war and Northern books were reprinted, but the cost was astronomical.
Probably one of the most amazing feats came from attempts to lean on local means for supplying the army. Francis Peyre Porcher was instructed by Moore to create an exhaustive book on local plants and their medicinal uses. The book Resource of the Southern Fields and Forests, Medical, Economical, and Agricultural was over 600 pages thick and filled with plants for any ailment surgeons dealt with.
Probably most infuriating to read about in Hasegawa’s book was the sluggish political undermining of any needed improvements to the department. Moore desperately needed a mobile ambulance corps, and several proposed changes were constantly denied for political or regulatory reasons. For a nation founded as a breakaway from restrictive government, the Confederacy was mired in the same bureaucratic slog that affected their Union counterparts.
Moore constantly struggled to get the help he needed. Jefferson Davis never wanted to approve the expansion of allowed surgeons. Improvements to field hospitals, ambulance corps, or field organizations seemed to get caught up in Congress and never passed. Meanwhile, while Congress slowed everything down, the war continued, and the number of wounded men piled up. Individual states had to intervene in the administration and building of general hospitals for their own until the Confederate government finally moved things along.
Hasegawa’s book is not going to bog you down. It is a fascinating read and something medical and Civil War medical historians, enthusiasts, and readers have needed since Cunningham’s book was published decades ago! Check it out using the links above.