U.S. Ambulance Corps

History

Early in the American Civil War, no organized system of battlefield evacuation existed. Regimental bands men were ordered to transport the wounded creating a muddled system where wounded men could suffer on the battlefield for over a week. There was no overall plan for evacuation and hospitalization of casualties. There was no unity, a lack of equipment, and facilities or integrated system of support. Ambulance drivers were generally either pressured soldiers or wagon and hack drivers pulled from the streets of Washington DC. Surgeons reported drivers who were insubordinate, drunk or who appropriated space inside the ambulances intended for blankets and food. As to the vehicles themselves, the Army had been forced to round up commercial wagons and hacks to serve as ambulances.

In Missouri, Surgeon John H. Brinton reported that the lack of adequate evacuation capability had caused abandonment of the wounded. Those who were able crawled to whatever cover they could reach; many were captured.

The absence of personnel dedicated to the evacuations required commanders to use combat soldiers to remove the wounded from the battlefield, further reducing the Army's fighting strength. A Confederate report echoed the universal complaint of line commanders: "If any from the ranks are drawn from the fight to carry off the wounded, they never return until the fight is over, and thus three are lost to the company instead of one wounded."

Surgeon Thomas A. McParlin, medical director of the Federal Army of Virginia, wrote that Americans should follow the lead of the Europeans. "A well-organized regularly established ambulance corps would have been a blessing."

The horror of the unnecessary suffering of injured soldiers compelled officers to improve frontline medical provisions.

A variety of ideas for an ambulance system surfaced in the Union Army. One was for an ambulance company of two lieutenants and sixty-seven soldiers for each corps, with the entire ambulance organization under command of a medical officer. A variation of that idea was an ambulance company for each division. The Sanitary Commission proposed an ambulance regiment for the Army of the Potomac.. Jonathan Letterman, medical director of the Army of the Potomac, established an integrated medical capability based on three principal elements: a coordinated system of casualty evacuation from the point of wounding back through the division rear; organization of medical logistics, including supply tables and transportation; and establishment of division field hospitals as part of the evacuation chain

Jonathan Letterman

On August 2, 1862, under the instruction of Jonathan Letterman, the Medical Director of the Army of the Potomac, General George B. McClellan issued General Orders 147 and created the United States Army’s first full-time, dedicated Ambulance Corps. These orders determined the structure, training and role of the service; and were a blueprint for the creation of subsequent Ambulance Corps later in the war. His plan placed all ambulances under the control of the medical director. Captains commanded the corps-level ambulance organization, first lieutenants commanded at the division level, second lieutenants led at the brigade level, and sergeants at the regimental level .

Civil War Ambulance at Fort Scott

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Letterman's use of non-physician officers to command ambulance units represented a significant shift in Army Medical Department policy. His intent was to relieve the physicians from duties that distracted them from their primary mission of patient care. Another important feature of Letterman's plan was the assignment of vehicles to the direct control of the medical director. Two-patient ambulances, each with two privates and a driver, were allocated on the basis of three for each infantry regiment, two for each cavalry regiment, and one for each artillery battery. Two supply wagons were assigned to each division's ambulance corps. Only medical personnel were permitted to accompany the sick and wounded to the rear, and only patients were allowed to ride in the ambulances. This instigated a major improvement in battlefield medicine.

U.S. Ambulance Corps field training. Photograph by William F. Browne

In the Army of the Potomac, the Ambulance Corps soon demonstrated its worth as they fought in Virginia and then moved north into Maryland. It was only partially in place for the Battle of Antietam in September 1862, where, during twelve hours of combat, casualties from both sides rose to over 22,700. McClellan's casualties mounted to 25 percent of the soldiers who went into action. On the Union right wing, where Letterman's plan was in place, casualties were rapidly evacuated and all wounded within the Union lines were removed during the night. Casualties on the left, where the new evacuation plan was not in place, were not removed until the following night. Nevertheless, despite its success, the service received hostility from the military.

Full implementation of Letterman's plan occurred three months later, at Fredericksburg. There, Letterman reported that the ambulance corps had begun to evacuate the wounded after dark on 13 December and by daylight had removed all the casualties except some twenty soldiers who were within the Confederate lines. Surgeon General Hammond, visiting the Army of the Potomac, was pleased with the results. General McClellan wrote that Letterman's ambulance corps decreased the number of combat soldiers pulled from the battlefield, "one of the great requirements for our armies." The Army of the Potomac continued to benefit from its unified medical support capability in battles after Antietam. There were 14,193 wounded Union soldiers at Gettysburg, 1-3 July 1863, yet there were no wounded left on the battlefield within Union lines by early morning the day after the battle. Letterman reported: "I know of no battlefield from which wounded men have been so speedily and so carefully removed." By the summer of 1864 the Army of the Potomac's ambulance corps numbered 800 ambulances with 66 officers and 2,600 enlisted soldiers .

Union Army units that failed to adopt Letterman's innovations continued to experience difficulty in battlefield evacuation. Surgeon Glover Perin, upon becoming medical director of the Army of the Cumberland in February 1863, found an inefficient ambulance service. He attributed this to the absence of commissioned ambulance corps officers, the lack of attendants, and the control of ambulances by the Quartermaster Department. He adopted a modified Letterman plan, but even with that in place the Army of the Cumberland left behind an estimated twenty-five hundred of its wounded at Chickamauga in September 1863.

Surgeon Thomas A. McParlin, then medical director of the Army of Virginia, received a copy of Letterman's plan and submitted it to his commander, Brig. Gen. John Pope, but there was not enough time to implement it before Second Manassas. McParlin believed that Pope's army would greatly benefit from an ambulance corps. "The lessons of experience should not be disregarded, especially in matters of such transcendant importance. At such a time, a well organized, regularly established ambulance corps would have been a blessing."

On 11 March 1864, Hammond's efforts and the success of Letterman's plan, backed by petitions and lobbying efforts, resulted in congressional action that established a permanent ambulance corps. The law authorized corps commanders to detail officers and enlisted soldiers to form their ambulance organizations and provided for the examination of candidates by boards of medical officers. As one citizens' committee put it, the Army should carefully screen the officer candidates because of the special trust it placed in them, and they should "at least equal the best of the fighting-men in gallantry."The War Department implemented the law in General Orders No. 106, 16 March 1864, a directive that also gave commanders the authority to create a distinctive uniform for members of the Ambulance Corps.

Following the civil war the medical Department, like the rest of the Army, declined in numbers. The special laws that had been passed for the prosecution of the Civil War expired when the war ended, and along with them the wartime structure of the Ambulance Corps, the general hospitals, and the hospital transports and trains disappeared. The Medical Department forfeited the progress it had made toward establishing commissioned officers in medical administrative specialties. The law that created the Ambulance Corps expired in 1866.

Bibliography

Brooks, Stewart (1966). Civil War Medicine. Charles C. Thomas Publisher.

Brinton, John (1914). Personal Memoirs of John H. Brinton, Major and Surgeon, U.S.V. 1861-1865. New York: Neale.

Clements, Bennett Augustine (1883). Memoir of Jonathan Letterman. Palala Press.

Chisholm, Julian (1861). A Manual of Military Surgery for the Use of Surgeons in the Confederate Army.

Ginn, Richard (1997). The History of the U.S. Army Medical Service Corps. United States Army.

Letterman, Jonathan (1866). Medical Recollections of the Army of the Potomac.

Livermore, Thomas L. (1901). Number and losses in the civil war in America 1861-65. Mifflin and Co.

Medical and Surgical History of the War of the Rebellion Part 1 Volume 1. 1870.

Medical and Surgical History of the War of the Rebellion Part 3 Volume 2. 1883.

Sears, Stephen W. (1983). Landscape Turned Red. New York: Ticknor and Fields.

See also

• United States Sanitary Commission

Sources

• Wagner, Margaret. The American Civil War: 365 Days. Abrams, New York, in association with the Library of Congress.
• Purcell, Peter N.; Hummel, Robert P. (1992). "Samuel Preston Moore: Surgeon-general of the confederacy". The American Journal of Surgery. 164 (4): 361–5. doi:10.1016/S0002-9610(05)80905-5. PMID 1415944.