On Independence Day in 1863, a Saturday, it was raining in Gettysburg, Pennsylvania, as burial details and medical officers took account of the recent battle. Some 50,000 men had fallen in three days, 8,000 of them killed outright and the rest in need of medical attention. Civilians working independently or under the auspices of the US Sanitary Commission, a relief organization established in 1861 to lend a hand to the Army Medical Department, poured into town as overtaxed surgeons worked around the clock and local citizens came up for air. By Sunday, with so many bodies left to bury and 3,000 horse carcasses littering the roads and fields, relief workers arriving from Washington, Philadelphia, and Baltimore could smell decay from miles away and recorded their revulsion at the stench.
The prospect of providing timely aid to so many was daunting. No one had anticipated this many casualties, and the medical corps was ill prepared. The germ theory was not yet widely understood, so few surgeons practiced antisepsis, which meant that patients with fair chances of recovery sometimes contracted blood poisoning or gangrene and died. Anesthesia, on the other hand, was routinely administered to those undergoing painful procedures. Gettysburg surgeons handed out opium pills to men awaiting amputations, and when morphine and chloroform were in short supply, whiskey substituted. Advances in medicine were slow to come, despite the overwhelming availability of military bodies presenting themselves to practitioners. Competition among medical sects and disagreements about licensure created professional mistrust, which served neither patients nor practitioners well. Even though Britain had begun to train nurses in 1860 in the wake of the Crimean War, nurses in the United States did not begin to professionalize until 1870, and most of those detailed to nurse during the war—convalescent men and middle-aged women—had little training other than what domestic life had taught them.
By the summer of 1863, the surgeon generals’ offices of both the Union and the Confederacy had learned a great deal about triage and the rapid deployment of critical medical services. Though he was satisfied that the Union ambulance service had succeeded in removing 12,000 soldiers from the Gettysburg field by July 4—a significant improvement over the chaotic evacuations of 1861 and 1862—Army of the Potomac Medical Director Jonathan Letterman still lacked shelter tents and supplies to distribute among the thousands of men laid out on stretchers. Rebel wounded left behind in the retreat needed immediate attention as well, but too few Confederate medical officers had stayed behind, and Letterman was soon ordered to move on, leaving only about a hundred Union surgeons to clean up the mess. Men and women from the Sanitary Commission started to arrive on the 4th while local women, like Sallie Myers, and those attached to regiments, like Amanda Farnham, who had marched thirty miles with the 6th Corps, had witnessed the entire conflict. Charlotte McKay of Massachusetts rode atop forage in an army wagon and found the 2nd Corps hospital in the Jacob Schwartz farmhouse, where she fed double amputees and swatted the flies and mosquitos bedeviling convalescents. Already 800 Union and 300 Confederate soldiers were scattered about the house and the grounds, some under a stand of apple trees. Mary Morris Husband of Pennsylvania, an ample woman of 43 and a veteran of Antietam’s Smoketown Hospital, secured a ride to town on General Meade’s mail wagon and started cooking for men in the 3rd Corps hospital. In the absence of stoves, such women slung iron cauldrons over campfires to make soup, distributed fresh clothing, and dressed minor wounds. Altogether the Commission spent $75,000 at Gettysburg in the month of July—equal to approximately $100 million in today’s dollars.
Gathering equipment, livestock, and wounded men in haste, Lee’s Army of Northern Virginia retreated south toward Emmitsburg, Maryland, with the object of reaching the Potomac. Yankee artillery and cavalry pursued the nineteen-mile-long train of Confederates and inflicted further damage. Coming in the opposite direction was a band of thirteen sisters of charity from Emmitsburg, who described a harrowing journey of dodging corpses in a carriage with blood-spattered wheels. The sisters were from an order known for its nursing mission. Once in Gettysburg, they took up residence in McClennen’s Hotel and went to work in the courthouse, the churches, and the local college, dressing the wounds of men from both armies who had not already landed in one of the several corps hospitals ringing the town. On her way out to soldiers who had not yet found shelter, Sister Camilla O’Keefe noticed a sign in the woods that read, “17,000 wounded down this way.” Here she and her band encountered men, whose wounds were crawling with maggots, lying on the ground; both the nuns and their charges battled lice.
Many surgeons expressed gratitude for the services of female volunteers, even those whom Army Nursing Superintendent Dorothea Dix had barred from the environs on account of their youth. The tireless proponent for the reform of mental illness ultimately appointed more than 3,000 women as nurses during the war, but Surgeon General William Hammond would circumvent her authority less than three months after Gettysburg by encouraging surgeons to appoint their own female staff. Given the press of sick and wounded, it was surely more practical to put surgeons in charge of hiring, and more than 20,000 Union women ultimately provided domestic and medical relief during the war with at least 10,000 Southern women, many of them slaves, providing the same services.
One of those whom Dix turned back was 23-year-old Cornelia Hancock of New Jersey, who tagged along with her surgeon brother-in-law, flouting Dix’s injunction; her first glimpse of Gettysburg was a pile of amputated arms and legs. Given her Quaker background, it is surprising how quickly Hancock acclimated: “You will think,” she told her mother in her third week as nurse, “it is a short time for me to get used to things.” Anxious to allay family disapproval, she wrote to another, “I am better than I am at home. I feel so good when I wake up in the morning.” Sophronia Bucklin, a seamstress from Auburn, New York, also in her twenties, was similarly barred but to no avail. Upon arrival, Bucklin encountered a line of stretchers a mile and a half long, with rain pelting those awaiting their turn with the surgeons. Passing the night on a bare iron bedstead, she “fished up” her shoes with the handle of her umbrella in the morning and learned “how much, which at home we call necessary, can be lopped off, and we still be satisfied.” Nursing Southern soldiers was not easy for her. She saw weaknesses of character, as did Emily Bliss Souder of Baltimore, who branded the rebels crybabies. Imperious in their observations of the enemy, Union nurses like Georgeanna Woolsey, a blue-blooded New Yorker with six siblings in the war effort, still insisted that relief workers treated Northerners and Southerners alike—with sympathy and delicacy—and that the men’s weakened state fostered a surprising spirit of conciliatory brotherhood in hospital tents.
With so much work to be done, few medical officers worried about the scores of women who came to town in the second week, hauling baskets of food and bedding. But there were those like Franklin Dyer, surgeon of the 19th Massachusetts assigned to the 2nd Corps, who wanted the women to disappear, presumably because they disrupted surgical focus. Dyer observed that six months earlier at Fredericksburg, a colleague had told him that the famed Clara Barton “plagued me so that I had to get her out of the cook house and put one of my own men in charge.” Like other sleep-deprived surgeons, Dyer’s patience was fraying and he found no solace in the high prices that the people of Gettysburg were charging for food from their larders. Prejudices aside, there was little anyone could do to prevent civilians—some who wanted to help and others who wanted to gawk—from flooding the town.
At the start of each day, stewards set out vials of chloroform and morphine sulfide, anticipating the amputations that would begin as soon as ambulances could deliver up their harvest of wounded flesh. Confederate Surgeon Simon Baruch of the 3rd South Carolina Battalion used whatever came to hand for operations in the field: wagon tailgates, wooden doors spanning barrels, even a church communion table. After the Confederate retreat on July 3 left him to fend for hundreds of wounded Rebels on his own, he was the grateful recipient of Union mules and a wagonload of medicinal and commissary goods sent by Jonathan Letterman—an indication that medical cooperation sometimes trumped political partisanship. Throughout the three days of the battle, field surgeons were forced to move their dressing stations to keep up with the fluctuating line of fire while more experienced practitioners operated in houses and barns impressed by corps medical officers. Wounded men were sometimes caught in the crossfire, and medical staff were wounded and killed by stray bullets or shrapnel. When Pennsylvania hospital steward Spencer Bonsall’s horse was shot out from under him, the thousand-pound animal collapsed on top of him, causing a lengthy hospitalization. Assistant Surgeon Morgan Baldwin of the 32nd Massachusetts reported that on July 2 alone, his medical unit was compelled to move three times. At the last place, a soldier with exposed intestines begged him for help, but the man would die in several hours and Baldwin’s superior berated him for wasting his time on a dead man. Later that night, as he returned to the Weikert farmhouse to assist with amputations, he witnessed hogs on the loose, feeding on the deceased. It was not a good day.
In the days following the battle, vendors selling coffins and offering passage to relatives who had come to find their soldiers’ bodies descended upon the town, increasing stress for medical staff and relief workers who were suffering from physical as well as emotional fatigue. Northern civilians attempted to secure information concerning the whereabouts of their loved ones’ graves, and some 1,500 of them succeeded in getting their boys disinterred and transported back home. Others searched in vain or arrived too late for parting words, despite the Sanitary Commission’s efforts to make available the location of the wounded. Southerners, if they ventured to Gettysburg at all, were advised to avoid the notice of vengeful Northern citizens. One of these, Margaret Bissell, upon coming to bury her husband, discovered that he had been interred en masse in a trench of more than a hundred bodies.
By early August, Camp Letterman—a fully supplied tent hospital—had been established on the outskirts of Gettysburg, and the men who remained in temporary corps hospitals were transferred to the new facility to die in some cases of secondary infections and subsequent amputations or to recover. Joshua Lawrence Chamberlain of Maine, one of the lucky ones and a rhetoric professor at Bowdoin College, led the regiment credited with stopping Confederate forces at Little Round Top, and went on, despite a bullet to the foot, to become governor of Maine. As a young member of the medical corps remarked on July 3, “A surgeon could get more experience here in one night than he could get back home in years.” Inevitably the horrific aftermath of the Battle of Gettysburg made Americans beg for closure. Even if it provided abundant living material for surgeons-in-training and advanced the science of evacuation, it did not spare caregivers trauma, despite what pundits claimed was a glorious turn in Union fortunes. If anyone had foreseen the casualties that were to come as a result of fighting in 1864, then those same caregivers might have understood that Gettysburg merely prepared them for worse.
 Unpublished narrative of Sister Camilla O’Keefe, St. Joseph’s Archives, Emmitsburg, Maryland.
 Cornelia Hancock to her mother, July 26, 1863; and Cornelia Hancock to her sister, August 6, 1863, in Letters of a Civil War Nurse: Cornelia Hancock, 1863–1865, ed. Henrietta Stratton Jaquette (Lincoln: University of Nebraska, 1998), 15.
 Sophronia Bucklin, In Hospital and Camp: A Woman’s Record of Thrilling Incidents among the Wounded in the Late War (Philadelphia: John E Potter, 1869), 145.
 J. Franklin Dyer, The Journal of a Civil War Surgeon, ed. Michael B. Chesson (Lincoln: University of Nebraska, 2003), xxiv.
 Clyde Kernek, Field Surgeon at Gettysburg: A Memorial Account of the Medical Unit of the 32nd Massachusetts Regiment (Indianapolis: Guild Press, 1993), 68.
Jane E. Schultz is a professor of English and an adjunct professor of American Studies, Women's Studies, and Medical Humanities at Indiana University-Purdue University Indianapolis. She is the author of Women at the Front: Hospital Workers in Civil War America (2004).
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