The Civil War was a turning point in the history of medicine. It brought about new discoveries and innovations, which led to a revolution in the field.

The civil war medicine north vs south was a revolution in medical practices. It allowed for the first time to treat patients with anesthesia, surgery, and hospitalization.

During the Civil War, Frederick, Maryland, became the epicenter of monumental advances in military medicine.

In late January 1863, Union soldier Stephen Bogardus Jr. wrote to his local newspaper, “When we first arrived here, the streets, on a beautiful day, were crowded with convalescent injured men.”

In early December 1862, his regiment, the Maryland-based Purnell Legion, was sent to defend the vital railhead and road junction at Frederick, Maryland—a noncombat duty.

When Bogardus arrived at Frederick, he wrote of the many injured men he saw all around the town of 8,000 people.

In his letter to the Poughkeepsie Daily Eagle, he added, “The bandaged head, the empty sleeve, and the stump of a leg, told a story louder than words could express.” “Those who dismissed patriotism as a meaningless phrase should have seen some of the people I’ve met.”

The soldiers Bogardus saw in the streets of Frederick were only a handful of the thousands still recovering from severe wounds and diseases sustained during the brutal battles of September 1862. Over 20,000 American troops were wounded in the chaotic fighting atop South Mountain and near Antietam Creek.

Many ended up in improvised hospital wards in Frederick’s government buildings, churches, schools, and hotels.

In the fall of 1862, Frederick underwent a remarkable change. Almost all commerce had come to a stop in the usually thriving market community of local farmers and manufacturers. Since the Army of Northern Virginia marched into town in early September, life in Frederick had been disturbed.

After a nearly week-long occupation, the Army of the Potomac was called from Washington, D.C. On September 12, the Union troops will take Frederick.

Major Jonathan Letterman, the Army of the Potomac’s 37-year-old medical director, arrived among the Union force’s officer corps.

As the troops advanced into Maryland, Letterman had a tremendous job. More than 80,000 troops’ health was in his and his department’s hands.


Despite not being a West Point alumnus, Letterman spent the most of his career in the United States Army, beginning in 1849. (Courtesy of the Library of Congress)

Letterman ordered “the construction of hospitals…for the reception of injured in the expected battles” when he reached Frederick on September 13.

The order to pre-stage medical supplies and men before to the start of combat was groundbreaking, and it signaled the start of a series of additional bold moves Letterman would make as commander of the Army of the Potomac’s medical wing.

In reality, the major had started a comprehensive reorganization of the army’s medical department.

He oversaw the reorganization of battlefield medical evacuation from the moment soldiers were wounded on the front lines, to the care they received at field hospitals, and then to more established medical facilities away from the battlefield in communities like Frederick, in what became known as “The Letterman Plan.”

Letterman took control of the army’s ambulances and transported them to the Medical Department as part of his new system, and he arranged training for stretcher-bearers and ambulance drivers. He also implemented a new division-level field hospital system, ensuring that sufficient medical supplies and staff were available to treat the injured.

Letterman’s first field test of his new medical systems was to take place in Frederick, some 25 miles east of Sharpsburg. Significant amounts of beds, bandages, anesthesia, and other medical needs started arriving shortly after Letterman gave his instructions to turn it into a hospital city.

The morning of September 16, tailor Jacob Engelbrecht wrote, “All the churches (or almost so) in Frederick have been seized for hospitals for the injured which are to be brought to town.”

According to Engelbrecht and other locals, the first injured from the Battle of South Mountain on September 14 came in Frederick on September 17th in Army ambulances.

Engelbrecht observed 25 ambulances arriving with injured people and noted that the churches-turned-hospitals were quickly filling up.

The battle at Antietam on September 17 only added to the duration of the ambulance trains en route to Frederick. Letterman recognized the many problems that needed to be addressed in his post-action report:

All of the city’s accessible buildings (six in all) were seized at once as hospitals for our own soldiers and any enemy troops who may fall into our hands. These were put together in a hurry…

Beds, bedding, dressings, supplies, food, and cooking preparations were arranged, and surgeons, stewards, chefs, and nurses were detailed and sent for. This was a lot of work, but it got done, and it was done quickly and effectively.

Sergeant Henry Tisdale of the 35th Massachusetts Infantry was one of the first patients to come from the battle in Maryland. At the Battle of South Mountain, Tisdale was hit in the left leg by a Minié ball.

Tisdale made his way to a Union field hospital after his experience on the hill and was one of hundreds transported to Frederick by ambulance.

A lady recalled these childhood memories decades later, saying, “I vividly recollect standing on Market Street… and how we used to watch the carts arrive in Frederick with the injured for us to care for.

As the wagon wheels pounded through the streets, so much blood flowed from the backs of the carts and fell on the dirt road that the mud became red.”

The Medical Revolution During The Civil War Downtown Frederick as shown in a Harper’s Weekly sketch. The Evangelical Lutheran Church’s twin towers may be seen. (Source: Harper’s Weekly)

Tisdale and others in his condition were taken to the Evangelical Lutheran Church on East Church Street, where they were treated in a makeshift hospital ward. Later, Tisdale recounted what he saw inside:

The tops of the pews were covered with a rough wood floor. We were given free folding iron bedsteads with mattresses, clean white sheets, pillows, blankets, and clean underwear, as well as medical dressing gowns and slippers.

The people came in twice a day with a variety of delicacies, cordials, and other refreshments for our convenience. The inside of the church was beautifully decorated, properly aired, and our position was as nice and comfortable as it could be.

According to Letterman, on September 30, Frederick’s temporary hospital wards had more than 2,321 patients, and 3,032 patients were in two tent hospitals built up on the city’s outskirts, with 62 surgeons, 15 medical cadets, 22 hospital stewards, 539 nurses, and 127 chefs on duty.

Letterman’s medical revolution brought significant improvements to the town’s inhabitants’ lives. On September 23, Engelbrecht wrote in his journal, “Town in turmoil.” “All day and half of the night, our small city is a hive of activity as carts, ambulances, and other vehicles transport injured, medical supplies, and hospital supplies.”

While some people watched the ruckus that had suddenly engulfed their neighborhood, others acted quickly.

Mrs. J.A. Bantz, president of the city’s Ladies’ Union Relief Association, wrote, “As a vast number of sick and wounded are now in our midst requiring immediate relief,” “we would urgently entreat one and all of the friends of the cause, to renew their diligence and forward whatever they can…as our brave soldiers’ wants should be promptly attended to.”

Southern supporters also stepped forward to help injured Confederates being treated in the city’s numerous hospitals. Catherine Markell went to them many times, keeping track of her trips in her journal and lamenting the deaths of troops due to wounds, illness, or sickness.

She went to Mount Olivet Cemetery after visiting the Lutheran Church Hospital on Church Street on November 24. She wrote solemnly, “[P]laced flowers on the graves of our CSA friends who are buried there.”

Despite the dismal circumstances when the weather turned chilly in October and November, Frederick locals were praised for their courageous efforts in helping the injured in the city that the Philadelphia Inquirer now refers to as “one huge hospital.”

A Baltimore preacher was one among many who lavished praise on Fredericktonians, writing, “the people of that city have covered themselves with a glory far beyond that of military victors, by their great charity.”

The Medical Revolution During The Civil War Confederates sent this card to express their gratitude for their assistance. (The National Museum of Civil War Medicine provided this image.)

Frederick citizens had to contend with the loudness of injured troops, the illegal activities of those convalescing soldiers who were mobile enough to attend the city’s beer halls, and the ever-present Union military presence during this time.

One Pennsylvania soldier wrote in his journal, “Everything from the omnipresence of the army is tinted with blue.” “The walkway is clogged with officers and privates.” Because of the military and hospital intrusions into civilian life, daily activity in the town came to a stop for months.

Between September 1862 and January 1863, U.S. Army doctors treated almost 8,000 patients in Frederick’s hospitals, effectively tripling the city’s population.

The life-saving treatment provided in the city’s schools, churches, hotels, and private houses would not have been possible without the help of local people who, despite the horrors of war, nursed the injured and gathered supplies.

In early 1863, the city’s wounded were taken from public places and sent to general hospitals in surrounding towns for additional treatment—the next stage in Letterman’s system of care.

Many of those who were treated, including Confederates, would remember the help of townspeople who volunteered at their bedsides for the rest of their lives.

Letterman’s efforts, as well as those of the doctors and the brave citizens of Frederick, were instrumental in changing medical treatment and creating the modern-day emergency evacuation system.

The National Museum of Civil War Medicine invites visitors to learn about the town’s important role in the creation of today’s critical systems.

Jake Wynn is the Director of Interpretation of the Clara Barton Missing Soldiers Office and the National Museum of Civil War Medicine. The Education Coordinator of the National Museum of Civil War Medicine is John Lustrea.

The civil war medicine primary sources is a collection of letters, diaries, and memoirs from the Civil War. These documents provide insight into how doctors and nurses treated patients during the Civil War.

Frequently Asked Questions

How was the medical care during the Civil War?

The medical care during the Civil War was poor. There were no doctors, and hospitals were not built until the late 1800s.

What were some medical advances during the Civil War?

The Civil War was a time of many medical advances, including the discovery of anesthesia and the development of vaccines.

What was the importance of medicine during the Civil War?

The importance of medicine during the Civil War was to help heal and save lives. Medicine also helped with sanitation, hygiene, and public health.

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