Vol. 22 No. 4- April 2009

Volume 22, No. 3
Editor: Stephen L. Seftenberg
Website: www.CivilWarRoundTablePalmBeach.org

Colonel Jack Travis will present an in-depth study on the five flags of the Confederacy. He will explain why men on both sides fought and died for their flags. Come hear the Rebel Yell and see the Bonnie Blue flag.

President's Message

If your dues are not paid by the end of the April meeting, this will be the last newsletter that you will receive and you will not be included in the 2009 directory. Your dues pay for our meeting expenses and donations.  There are openings for speakers. If you would like to give a program, please let me know.  Remember to sign up for refreshments at the meeting. Cash donations are also appreciate for the forage fund.  It is with regret that I have to say that Stuart Robinson passed away in February. We extend our condolences to his family.

Gerridine La Rovere, President

Program: Wednesday, March 11, 2009

Member Camille Granda introduced us to Patrick Romayne Cleburne. Cleburne was born in Ireland. Orphaned at 15, he failed entrance exams at Trinity Medical College; enlisted in the 43rd Regiment of the English army where he rose to the rank of corporal. He purchased his discharge; emigrated to Helena, Arkansas, where he became a pharmacist and a lawyer, and became a US citizen in 1860. He went with the South solely out of affection for his neighbors. He was elected captain of the Yell Rifles; seized the US arsenal at Little Rock in 1861; his unit was added to the 1st (later renamed the 15th) Arkansas Infantry Regiment; he was elected Colonel and on March 4, 1862, Brig. General. His motto: Duty Points the Way. Fought at Shiloh, Richmond, Kentucky (where he was wounded in the face); promoted to command a Division in Arkansas; at Stone River, his troops advanced 3 miles; promoted to Major General 12/13/62. Led a night assault at Chickamauga and fought rear guard actions at Missionary Ridge and at Ringold Gap, Georgia that saved the Confederate Army from disaster. His ability to utilize terrain to advantage and to hold ground led to his nickname, "the Stonewall of the West." Federal troops dreaded seeing his blue flag on the battlefield. He felt that "slavery was not the sole reason for the war, only a pretext for centralized government." His recommendation to draft and emancipate blacks as soldiers in the army led to a fierce backlash in the South. He soldiered on: outnumbered 4-to-l, he blocked Sherman at Chattanooga and harassed Sherman’s advance through Georgia. Sent to Kentucky, he was killed leading an ill-conceived attack he opposed at Franklin, Kentucky on November 30, 1864, and was buried there (his remains were later moved to Helena). Cleburne, a brilliant leader, served under less competent generals and as a result got less attention than he deserved. Sadly, he became engaged in 1864 but was killed before he could marry.

March book review:

Member Ed Lewis discussed James McPherson’s new book, Trial By War: Abraham Lincoln as Commander-in-Chief. McPherson, who won a Pulitzer Prize for his Battle Cry For Freedom, focused on Lincoln’s growth as military Commander-in-Chief. Few Presidents have acted as Commander-in-Chief, leaving battlefield strategy and tactics to the generals and admirals, and in the beginning Lincoln (whose only military experience was two months in the Blackhawk War) followed the same pattern. Once faced with war, however, he read many books. He stumbled in the early months and made many "bad" appointments (out of the mediocre group he could chose from until "stars" developed). While his generals viewed the war as to conquer territory, Lincoln’s native genius led him to see that the Confederate armies had to be utterly defeated if the Union was to be preserved. He quickly saw the advantages the telegraph and the railroad gave the Union forces and often slept at the War Department telegraph office. As his confidence grew, his advice and orders to his generals became more sophisticated. A similar earlier book is T. H. Williams, Lincoln and His Generals (1952). Lincoln finally found generals, such as Grant, Sherman, Sheridan, who were aggressive and smart. Lewis recommended reading both these books.

March program

Member Marsha Sonnenblick’s lavishly illustrated lecture, US Medical Service Through Five Wars, used the device of taking one young man and giving him a similar wound in each war. First is Robert Forbes, in 1856, a 14-year old farm boy living in York, Pennsylvania and an avid reader. At that time, Jefferson Davis, the US Secretary of War, sent a committee (including McClellan) to study the English medical service as well as English and Russian military tactics in the Crimean War. The Civil War was fought in the last stages of medieval medicine – American medical schools were a joke: it took no qualification (except the ability to pay the fee) to attend or to graduate. The US Army had about 100 surgeons, few of whom were qualified. Drs. William Hammond and Jonathan Letterman served in the West. During the war, over 11,000 surgeons were used by the North (compared to about 3,000 by the South). Many doctors, many of whom had never done an operation, rushed to join the army. The first part of Mrs. Sonnenblick’s talk is limited to the Army of the Potomac in the early stages of the war. Forbes joined the 39th Pennsylvania Regiment in June 1861.

A "minie" ball could go through several bodies and become easily infected. Most wounds as a result led to amputation (by the end of the war, 50,000 plus amputations were performed!). The "surgeon" sharpened his implements on his shoe, wiped it off on his long coat, and never washed his hands. 95% of surgeries used a light does of chloroform, which the South had little of (in one incident, Phil Sheridan provided Confederate doctors chloroform so they could operate on Confederate soldiers captured by his troops). Mortality rates varied by the location of the amputation: hands and fingers (26%), shoulder (30%), upper arm (24%).

Forbes was wounded in the leg but laid out on the battlefield for three days before being brought to the medical tent. He was in shock and his wound was infected. The surgeon botched the amputation. Forbes was sent to Washington, DC, but died 30 days after he was wounded. Another soldier wrote: "A rebel ball shattered my right knee. I lay for two days and when I was finally taken in, my accommodations were meager: no chamber pot (which made diarrhea hard to handle) and no heat (at least the cold weather reduced the maggots!). A nurse wrote in her diary, a wounded soldier recovered from pneumonia and diphtheria but died anyway. Frederick Law Olmstead wrote to his wife: 2 or 3 soldiers accompanied 200 wounded soldiers on the train -- no straw, "festering" and "awful stench" (called "patriotic smell!). Olmstead was moved to instigate the creation of the Sanitary Commission. In 1862, typhoid was rampant (victims included Stephen Douglas and President Lincoln’s son) and caused two-thirds of all deaths. The dead were embalmed by private entrepreneurs ($7 for a soldier and $13 for an officer).

Antietam marked the first battle at which an organized ambulance service was in effect. Still, as one New York reporter wrote: hundreds of wounded lie on the floor of one hospital – long lines of wagons pull up – surgeons are covered with blood. Hospitals were often staffed by untrained convalescents, some too weak to handle their duties. The doctors too often treat female nurses like "dirt."

Until Secretary of War Stanton got rid of him, Dr. William A. Hammond, as Chief of the Union Medical system, reformed the Army’s hospital and transportation systems. He appointed Dr. Jonathan Letterman as

Medical Director of the Army of the Potomac. Under Letterman only doctors with surgical experience could perform surgery. This was the beginning of medical specialization and the Army’s level of medical competence grew tremendously under Letterman. He designed supply wagons organized so supplies could be quickly and easily located. Each doctor was supplied with a "Squibb Pannier," a smaller box with a variety of medical supplies. Letterman took ambulances away from the Quartermaster Corps, launched a "triage" system (I: soon to die; II: needs immediate attention; and III: can wait) still used today.

"Hospitals improved throughout the war. The initial dressing station was usually a tent, barn, church or private home, where triage and primary surgery (within 48 hours) was often performed. Surgeons on both sides learned that their patients fared better when surgery was performed outdoors rather than indoors, due to improved lighting and ventilation. Efficiency was gained by building larger hospitals and by creating ward systems, still in use in some settings, separating patients by injuries or disease. A growing realization that ‘bad air’ and unclean conditions might increase infection led to clean, well-ventilated hospitals. However, direct transmission of bacteria through instruments and dressing materials went unrecognized.

Our hero, William Forbes, a cousin of Robert, was not wounded until 1864. An officer, he was shot in the leg at the battle of Spotsylvania Court House in Wilderness campaign. He was picked up and taken promptly to a front line hospital tent and then to a hospital in the rear where his leg was amputated. He was then evacuated by train to a Washington, DC hospital, or he could have been taken by hospital ship. He would have been treated by competent doctors and Roman Catholic nuns acting as nurses. In some cases, Afro-American women acted as nurses. Hammond redesigned Army hospitals in an arc for efficiency and fresh air. Each ward had different kinds of wounded. Each had ventilation and plumbing. Bromine stopped gangrene. Congress in its infinite wisdom failed to appropriate funds for severely wounded soldiers who were discharged. After all, they could no longer fight!

The Confederate Army had its own geniuses: James Hangar designed an artificial leg with a movable knee. Hangar Co., the company he started after the war, is still in business. Designing and making artificial limbs (legs, arms, hands) was a big business after the war. Our hero, Forbes, fitted with an artificial leg, learned to walk and marched in many Grand Army of the Republic parades. He married in 1869, had six children, and died in 1920.

Forbes’ son, William II, fought in the Spanish-American War. However, despite numerous advances in medical science, the Army Medical Service failed to further modernize its organization or treatment between the wars, except for one thing: the hospital ships returning wounded soldiers and sailors had antiseptic operating rooms.

William’s grandson, William III, enlisted in the AEF in World War I. "Luckily" he was wounded by shrapnel above his knee and not gassed. There were hospitals near the front lines and the hospital trains carrying the wounded had operating rooms. There were forward X-Ray units and gas-driven ambulance trucks. William became a lawyer, married, had three children, became a state legislator and died in 1975.

William’s great-grandson, William IV, graduated from law school before serving 2 1/2 years in the jungles of the South Pacific. In 1944, he landed with MacArthur on Leyte. Medical corpsmen served alongside their comrades. They had blood and penicillin. The Geneva Convention, adopted after WWI, was supposed to protect corpsmen from being shot. The Germans mostly honored this, but the Japanese made them special targets, so corpsmen stopped wearing red arm bands. The Army put hospital wards and operating rooms underground (see picture at right). It flew wounded soldiers in specially-designed cargo planes (still four bunks on each side of an aisle, just like the Civil War trains, however). Field hospitals were established. The one in Manila was located in the cathedral. Fully-equipped hospital trains and ships were used. Blood transfusions were common, although typing was not as accurate as it has become. William IV recovered quickly from his wounded leg, which was saved, and after the war practiced law, married, joined the VFW and died in 1997.

Marsha did not treat the Korean War separately since only five years separated the end of WWII and the beginning of the Korean War. However, innovations included "MASH" units: "The MASH unit was conceived by Michael E. DeBakey and other surgical consultants as the ‘mobile auxiliary surgical hospital.’ It was an alternative to the system of portable surgical hospitals, field hospitals, and general hospitals used during World War II. It was designed to get experienced personnel closer to the front, so that the wounded could be treated sooner and with greater success. Casualties were first treated at the point of injury through buddy aid, then routed through a battalion aid station for emergency stabilizing surgery, and finally routed to the MASH for the most extensive treatment. This proved to be highly successful; it was noted that during the Korean War, a seriously wounded soldier that made it to a MASH unit alive had a 97% chance of survival once he received treatment." The unit was later renamed as the "Medical Army Surgical Hospital." [Editor’s note: Quote from Mobile Army Surgical Hospital, Wikipedia, the free encyclopedia.]

In Vietnam, William Forbes V, was hit by a "bouncing betty" mine that nearly severed his right leg above the knee. Front line medics put him on a medical helicopter which took him to a MASH unit and from there to a field hospital in Vietnam, then to Japan and then to the Philippine Islands. He recovered but walked thereafter with a slight limp. In Vietnam, 70.6% of casualties came from disease, 15.6% from "nonbattle" wounds (traffic accidents, fights, etc.) and only 17% from actual battle wounds.

In Desert Storm, William Forbes VI lost his leg to an "IED" ("improvised explosive device") and was equipped with a remote controlled leg. He was immediately placed in a battlefield ambulance armored like a tank because of IEDs and reached a forward aid station within 60 minutes. From there he went to a Combat Support Unit and then a "Level 4" hospital in Kuwait or Spain or Germany. After extensive treatment, his final destination was either Walter Reed Hospital, Washington DC or the big hospital in San Antonio, Texas. Unfortunately he also suffered traumatic brain damage in the explosion, which left him with memory loss, mood swings, etc. We are still searching for solutions to these injuries. Marsha bemoaned the callous lack of support for our wounded men and women, citing the scandal at Walter Reed Hospital as an example. Marsha left us with this sobering thought: Many more soldiers survive their wounds due to superb equipment (kevlar jackets and helmets, armored vehicles) and advanced medical treatment, but their wounds are much more severe than in other wars as a result. America will have an increasingly expensive job on its hands to care for them. She was somewhat pessimistic about the outcome.

Marsha provided us with a chart showing the relationship between battle wounds and battle deaths:

Last changed: 06/26/11

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