Faces of the Civil War Wounded

by Blair Rogers & Michael Rhode

Draft chapters by Michael Rhode, 5/31/1997.

Unpublished as such.

2

The Army Medical Museum

Like much of the rest of the country, the Army Medical Department was unprepared

when the war began on April 12, 1861. As J.J. Chisolm wrote in his preface to the Confederate

Manual of Military Surgery, "Most of those who now compose the surgical staff were general

practitioners whose country circuit gave them but little surgery, and very seldom presented a

gunshot wound. Moreover, as our country had been enjoying an uninterrupted state of peace, the

collecting of large bodies of men, and retaining them in health, or the hygiene of armies had been

a study without an object, and therefore without interest". (Chisolm, p. iii) America's last major

war had been the much smaller conflict with Mexico thirteen years earlier which began in 1846

and lasted until 1848. As a result, most doctors, whether career military officers or

newly-enlisted civilians, had almost no experience with gunshot wounds, especially those made

by the newly-developed Minié ball. Minié had developed a conical bullet that came out of a

rifled barrel; this high-speed bullet caused a significantly worse wound than the older soft lead

ball. (MSHWR, Surgical III, p. 694)

Although, contrary to popular belief, physicians did use anesthesia during the war,

medicine had not yet made the great advances now taken for granted. Since germ theory did not

exist, bacteria and viruses were not recognized as the cause of disease. Anti-sepsis would not be

practiced until the decade after the war. Blood typing did not exist and so transfusions were

extremely rare. William Roentgen would not discover x-rays for another 30 years. Penicillin and

antibiotics were 80 years in the future. Medical education was extremely simplistic, and the

familiar modern hospital-based training would not be instituted until after the turn of the century.

Amputation was a common treatment for a wound of a limb, although surgeons tried excision

(removal of the damaged bone) more frequently - sometimes causing more problems than if they

had amputated. The Department had no ambulance corps. It was not until the second year of the

war that Dr. Jonathan Letterman developed a standard procedure for removing the wounded

from the battlefield. To address some of these problems, William Alexander Hammond and John

Hill Brinton created the Army Medical Museum.

By the end of the spring of 1862, Surgeon General William Hammond's plans for revising

the Union Army's Medical Department were beginning to get underway. Secretary of War

Stanton had not liked Hammond's aged predecessor, Clement Finley, and had forced him to

retire. Hammond had then been appointed, regardless of seniority, to head the Medical

Department on April 25, 1862. His appointment was due to the Sanitary Commission's pressure

on Stanton for an younger, energetic Surgeon General who could revitalize the department.

(Gillett, p. 177, Lamb, p. 1)

Hammond was born on August 28, 1828. He earned his medical degree at age twenty

from the University of the City of New York. He joined the Army Medical Department in 1849

and served for ten years at various Western posts. He had begun to make a name for himself

with publications such as "Experimental Research Relative to the Nutritive Value and

Physiological Effects of Albumin, Starch and Gum, When Singly and Exclusively Used as a

Food," which won the American Medical Associations's 1857 prize. In 1860, Hammond resigned

from the Army to teach at the University of Maryland's medical school. He re-enlisted when the

war broke out and was promoted to the highest office in the Medical Department.

Hammond used himself as an experimental subject in his 1857 article, including this

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description: "28 1/2 years of age, 6 feet 2 inches in height, and measure 38 1/2 inches around the

most prominent part of the chest. My weight during the last three years has ranged from 215 to

230 pounds. My habit of body is rather full, temperament sanguinonervous. I am of sedentary

habits, rarely taking much physical exercise, unless with some specific object in view other than

exercise. I have never indulged freely in alcoholic liquors and very seldom use them now:

tobacco I do not use in any form.” (Hammond in Drayton, p. 559) What is lacking in the physical

description is a feeling for the man. Hammond's personality, more than anything else, would

eventually lead to his downfall. Two days after being appointed by Stanton, Hammond was

telling him "I am not accustomed to be spoken to in that manner by any person, and I beg you

will address me in more respectful terms...during my service in the army, I have been thrown

with gentlemen, who, no matter what our relative rank was, treated me with respect. Now that I

have become Surgeon-General, I do not intend to exact anything less than I did when I was

Assistant Surgeon, and I will not permit you to speak to me in such language as you have just

used.” (Hammond, quoted in Gillett, p. 177)

At the height of his authority in May of 1862, the newly appointed Hammond had begun

making changes in the Medical Department. Most importantly for the study of medicine and

eventually its history, Hammond committed the resources of the Department to forming a

museum, which would use its collections and the records of the Surgeon General's Office to

compile a medical history of the war. Only a few weeks after taking over the Medical

Department, Hammond established the Army Medical Museum, the first federal medical research

facility. By creating the Museum, Hammond essentially began government-funded medical

research which is now seen as such a basic part of the role of government. As Dr. J. J.

Woodward, whom Hammond assigned to the Museum, pointed out years after the war:

The establishment of the Army Medical Museum was undoubtedly

suggested by a most pressing need experienced at the

commencement of the late war. There were at that time but

few persons in the United States who had any experience

whatever of military surgery, and there was no place in he

country to which the surgeon about to devote himself to the

military service could turn for definite information or

guidance beyond what he could obtain from foreign works. It

was natural that conscientious men, many of whom had never

seen a gunshot fracture in their lives, should feel a grave

regret that there was no place where, before assuming their

new responsibilities, they could obtain a more realistic

knowledge of the details of military surgery than they could

possibly gather from books and pictures alone.” (Woodward,

Lippincott, p. 241)

Hammond issued several orders to implement his ideas. These were published in the form

of "circular letters" which were intended to be passed through the Department until everyone had

seen them. In Circular No. 2, issued on May 21, 1862, Hammond specifically stated "Medical

Directors will furnish one copy of this circular to every medical officer in the department in

4

which they are serving." (Henry p. 12) This circular established the Museum, stating:

As it is proposed to establish in Washington, an Army

Medical Museum,1 Medical officers are directed diligently

to collect, and to forward to the office of the Surgeon

General, all specimens of morbid anatomy, surgical or

medical, which may be regarded as valuable; together with

projectiles and foreign bodies removed, and such other

matters as may prove of interest in the study of military

medicine or surgery.

These objects should be accompanied by short

explanatory notes.

Each specimen in the collection will have appended

the name of the medical officer by whom it was prepared.

Shortly after the initial circular letter was issued, Hammond recalled John Hill Brinton

from duty on the western battlefields. Brinton's orders were extremely laconic, telling him only to

report to Washington for special duty. (Brinton p. 166). Brinton arrived hoping to receive one of

the newly-created medical inspectorships, a job for which he felt well-qualified. Instead, he was

assigned to the examining board for surgeons, placed in charge of the Museum, and told to

prepare the surgical history of the war. Hammond's Circular No. 5, issued on June 9th, formally

created The Medical and Surgical History of the War of the Rebellion and placed the

responsibility for accomplishing it on Brinton and Dr. J.J. Woodward. Brinton was assigned the

Surgical part and Woodward the Medical.

Brinton, before meeting Hammond and being assigned to the joint projects of creating a

museum and medical history, had already been collecting a "quantity of shot, shell and projectile,

broken and mutilated weapons and preparations of gunshot wounds" (Brinton p. 167-8) for future

lectures. On August 1st, Hammond issued an order to Brinton enabling him to begin

requisitioning similar specimens from Army surgeons who had collected them for their personal

use prior to the establishment of the Museum.

Brinton was well-suited to the task. Born and raised in Philadelphia, he was thirty years

old when assigned to create the Museum. He had received his medical degree from Jefferson

Medical College in 1852 and a master's degree from the University of Pennsylvania a year later.

After a year of study in Paris and Vienna, the centers of medical education at that time, he

returned to practice in Philadelphia. He taught surgery at Jefferson Medical College until the

outbreak of the war. Enlisting as a volunteer surgeon, Brinton served in the West with Grant

and Sheridan before transferring to Washington to work on the Museum. (Haller, preface)

1 The name "Army Medical Museum" would become the Museum's formal name, but it was also referred to

in orders from this time as the Military Medical Museum or the Pathological Museum.

Brinton's colleague, Joseph Javier Woodward, had been assigned to the Surgeon

General's Office on May 19. (Lamb, p. 2) Woodward was also from Philadelphia, where he was

born on October 30, 1833. He received his medical degree from the University of Pennsylvania

5

in 1853 and, like Brinton, a master's degree afterwards. He began practicing medicine in

Philadelphia and, until the outbreak of the war, conducted research and published several papers

on cancer. He joined the Army on August 5, 1861, serving as an assistant surgeon with the Army

of the Potomac until he was recalled to Washington to organize several hospitals. After a term

spent in charge of the Patent Office Hospital, he was assigned to the Medical Museum.

(Hemmeter, p. 644-5) Woodward, as memorialized by Surgeon General R. Murray, was "of a

sensitive, highly strung, nervous organization." Murray also described him as:

Endowed with a retentive memory and of untiring industry,

he acquired a vast store of information which he held

available for use at will; fluent of speech, he took delight

in the expression of his views and opinions both in social

converse and in the arena of scientific debate.

His fund of knowledge, his strong convictions, his

tenacity of opinion and his quick perception made him a

controversialist of no low order. (Murray, p. 2)

The Museum's first home was in Brinton's room in the Surgeon General's Office.

Thirty-four years later, Brinton would recall "the beginning of the Museum in August, 1862 was

very modest, consisting of three dried and varnished specimens placed on the little shelf above

the ink stand on the desk of the recently appointed curator. These were duly inspected and

admired by the office officials and for a while, as a novelty, they had numerous visitors from

the surgeons on duty in and around the city. 'How is the Museum?' was the joking question of the

day." (Brinton 1896, p. 601) Dr. George Otis, Brinton's successor, wrote in 1876 that, in addition

to the three specimens, other objects typical of a medical facility such as wax models, were also

in the offices. (Otis, 1876 checklist, p. 3)

Other people besides Brinton and Wooodward helped establish the Museum. Frederick

Schafhirt, a German-trained anatomist, was hired in 1862 to prepare bones for the collection. He

had worked for Joseph Leidy at the University of Pennsylvania and "was adept in preparing and

mounting specimens for a museum.” (Brinton, p. 182) At various times, Schafhirt's two sons,

Adolph and Ernst, assisted him. (Henry, p. 22) He remained with the Museum until his death in

1880. Dr. William Moss initially aided Brinton as an assistant curator, taking responsibility for

the first Catalogue of the Army Medical Museum and much of the daily functioning of the

Museum. Moss was with the Museum from 1863 until 1864 when he left the Army. (Lamb, p. 9,

11, 23) Dr. Brinton Stone, one of Brinton's former students, replaced him. (Lamb, p. 26-7) Dr.

Edward Curtis joined the staff on April 13, 1864. Curtis did much of the Museum's work in

microscopy and performed President Lincoln's autopsy. Curtis stayed with the Museum he left

the Army in 1870. (Lamb, p. 27, 57) Daniel S. Lamb, who was with the Museum for sixty-five

years, joined the staff as a hospital steward on November 3, 1865. Lamb, a native of

Philadelphia, was born in 1843 and enlisted in the Army at age eighteen. He spent the war

serving in military hospitals. After joining the Museum, he earned his medical degree from

Georgetown University. Lamb became the staff pathologist and essentially ran the Museum from

1883 until the entry of America into World War I in 1917. On his death in 1929, he left his body

to the Museum. (Cobb) Many other men in various functions contributed to the work of the

Museum.

6

With an order on August 1, 1862, Hammond increased his personal support for Brinton.

In addition to collecting new specimens, Hammond ordered him to collect specimens that had

already been saved in military hospitals by interested surgeons for their own use, much as

Brinton had done himself in the West. Hammond directed Brinton:

to collect and properly arrange in the "Military Medical

Museum" all specimens of morbid anatomy, both medical and

surgical, which may have accumulated since the commencement

of the Rebellion in the various U.S. hospitals or which may

have been retained by any of the Medical officers of the

Army. You will also take efficient measures for the

procuring hereafter of all specimens of surgical and medical

interest that shall be afforded in the practice of the

different hospitals. Should any medical officer of the Army

decline or neglect to furnish such preparations for the

Museum, you will report the name of such officer to this

office.” (Brinton p. 180-1)

Notwithstanding this order, Brinton apparently kept his own specimens as he referred to having

them when he wrote his autobiography in 1891.

In those Memoirs, written for his family and not published until after his death, Brinton

revealed his thoughts on being assigned to work on the Museum:

The order of August 1st, to me, was the first step towards

really putting this notion of an Army Museum (sic) into

shape, and was a most welcome duty. My whole heart was in

the Museum and I felt that if the officers in the field and

those in charge of hospitals, could only be fairly

interested, its growth would be rapid as the future good of

such a grand national cabinet would be immense. By it the

results of the surgery of this war would be preserved for

all time, and the education of future generations of

military surgeons would be greatly assisted." (Brinton, p. 181)

Brinton began collecting by writing to doctors at hospitals throughout the country asking

them to send specimens to the new Museum. He also traveled to the Eastern battlefields, meeting

surgeons and collecting specimens. Brinton described the type of material and how it was

collected for the Museum:

First of all, the man had to be shot, or injured, to be

taken to the hospital for examination, and in a case for

operation, to be operated upon. If all this were taking

place in a city hospital, or a permanent general hospital,

the bones of a part removed would usually be partially

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cleaned, and then with a wooden tag and carved number

attached, would be packed away in a keg, containing alcohol,

whiskey, or sometimes salt and water. Then, when a

sufficient number of specimens had accumulated, the keg

would be sent to Washington and turned over to the Army

Museum, where the preparations of the specimens would be

finished, so that they could take their place upon the

shelves. The memoranda or histories of these specimens

would in the meantime have been forwarded to the Surgeon-

General's Office, and after having been fitted to objects

and their truthfulness assured, would be entered in the

books of Histories of Specimens, preserved in the museum,

and under the care of the Assistant Curator. (Brinton p. 186)

Brinton also collected personally on the battlefield. When he heard of a battle close to

Washington he would ride out and assist in the surgery and, at the same time, show the surgeons

what type of specimens he was looking for. Beyond that, he had other ways to get specimens.

"Many and many a putrid heap [of amputated limbs] have I had dug out of trenches where they

had been buried...", he recalled. (Brinton, p. 187) He and Moss were once confronted by a soldier

who discovered his amputated limb in the Museum and demanded it back. Brinton asked the

soldier how long he had enlisted for and was told for the duration of the war. He then told the

soldier to come back when the war was over. At another time, after hearing of a "remarkable

injury of a lower extremity" in a buried soldier, he met with the soldier's friends and "dwelt upon

the glory of a patriot having part of his body at least under the special guard of his country... My

arguments were conclusive; the comrades of the dead soldier solemnly decided that I should have

that bone for the good of the country, and in a body they marched out and dug up the body."

(Brinton, p. 190-1)

Brinton, like everyone ever assigned to the Museum, had multiple duties. He was Medical

Director of Transportation for Alexandria, Virginia, in August, 1862, when the war raged close

to Washington. (Brinton 195-200) Brinton was frequently sent to battlefields to determine what

had happened on the field. He recalled, "Not infrequently, I received important verbal orders, the

execution of which was the prime object of my being sent, as where, with an apparent

"specimen" order, I was instructed to find out the loss after a battle, the extent of which a general

commanding was not always desirous should reach the ears of a Secretary of War.” (Brinton, p.

203-4) Brinton's frequent absences from Washington probably meant that work on the medical

history proceeded more slowly than did specimen collecting.

Congress supported the new Museum, providing $5,000 a year to run it. (Lamb, p. 20)

Moss compiled the first Catalogue of the Museum which Brinton forwarded to the Surgeon

General on January 1, 1863. The Catalogue was simply a numerical list of the specimens in the

Museum. Brinton pointed out that information was still needed on many specimens:

As the value of all pathological preparations depends, to a

great extent, upon the completeness of their history,

strenuous efforts have been made to procure an accurate

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surgical and medical account of every case from which a

specimen has been taken. I regret to state that, in many

instances, the desired success has not been obtained. In

order that this evil may, as far as possible be remedied,

the number of every specimen in the Catalogue for which a

sufficient history has been received has been marked with an

asterisk. For all others, neither history nor description

have as yet been furnished. It is hoped that medical

officers, recognizing the objects contributed by them, will

exert themselves at once to remedy this deficiency.

(Brinton, Catalogue, p. 3)

Brinton used the Catalogue to increase interest in and contributions to the Museum. He stated in

his memoirs, "Very many specimens I had brought [to the Museum] from the battle-fields,

collected by myself. These I put into the first catalogue, assigning them to such medical officers,

as I could call to mind, and especially to those whom I knew to be lukewarm in Museum

interests. The effect of the procedure was good.” (Brinton p. 188)

Brinton acquired the Museum's third home, "Mr. Corcoran's School House" on H Street,

to hold the new Museum. In the fall of 1863, the Museum moved to its new location. Exhibited

to medical professionals were some of the 3,500 specimens collected. (Lamb, p. 19-20) When

Museum founder Surgeon General Hammond was court martialed on trumped-up political

charges in 1864, Brinton convinced Hammond's successor, Joseph Barnes, to keep the Museum

open. Barnes, another Philadelphia native and University of Pennsylvania graduate, was born in

1817. He joined the Army and served in the war with Mexico. During the Civil War, he was

Medical Director of several armies until becoming the Surgeon General. Barnes oversaw the

Museum until he retired in 1882. (Kelly, p. 63; Gillett, p. 201-3, 225-227)

Later in 1864, Brinton was relieved of duty at the Museum. He thought his transfer due to

any of three reasons: he was an appointee of Hammond, a cousin of McClellan, and the

proponent of a plan to bring in volunteer surgeons equal to the regular army ones at the close of

the war. He was assigned to normal medical duties and returned to Philadelphia to practice

medicine after the war ended. Brinton maintained a sense of humor about his transfer. He had

Hermann Faber, a Museum artist, draw him as "St. Denis leaving the Museum, head in hand, for

the region of the setting sun, with the bloody headman's sword, the unfinished work of the

Surgical History of the War, etc.” After a request by Barnes, Woodward had Faber make a copy

from memory and photographs of it were given to the new Surgeon General and much of his

staff. (Brinton p. 307-314)

Dr. George Alexander Otis replaced Brinton as curator. Otis served in the Museum for

seventeen years until his early death at age fifty in 1881. Under his direction, the second, much

larger Catalogue of the Army Medical Museum and the Medical and Surgical History of the War

of the Rebellion were published, as well as many shorter monographs. Otis was described by

Woodward as, "Hesitating, often embarrassed in his manner in ordinary conversation, especially

with strangers, he became eloquent when warmed by the discussion of any topic in which he took

interest.” Born in Boston on November 12, 1830, Otis lost his father before his first birthday. He

and his mother returned to her native Virginia. Undistinguished at Princeton, Otis preferred to

9

read French literature instead of the assigned material. Returning to Virginia, he privately studied

in Richmond and received his medical degree from the University of Pennsylvania in April,

1851. He spent the rest of that year and the next studying in Paris.2 There, Napoleon III's coup

d'etat gave him the opportunity to begin a first-hand study of military medicine. He returned to

Virginia in spring 1852 and the next year began the Virginia Medical and Surgical Journal.

The Journal, in competition with the older Stethoscope, was not a financial success. Otis sold a

partial interest to Dr. James McCaw3 and moved to Springfield, Massachusetts, but maintained

his connection with the Journal as corresponding editor. Otis enlisted as a surgeon in the 27th

Massachusetts Volunteers to participate in the war. (Kelly, p. 867-9) He moved over to the

regular Army as the war continued and joined the Museum staff as Brinton's assistant on July 22,

1864. On October 3, Otis replaced Brinton as Curator. (Lamb, p. 29, 31) (Within the split nature

of the Museum with its medical and surgical division, Otis and Woodward seem to have run their

sections of the Museum and written their sections of the History mostly independent of each

other. Since they worked together for seventeen years, their arrangement must have been

successful and in fact, Woodward was the executor of Otis' will.)

When the war ended, the Museum still had to fulfill its mission of creating a medical and

surgical history. Congress continued to fund the Museum to complete this task. By 1866, less

than a year after the war's conclusion, the Museum had expanded its scope of collecting. Otis

wrote to Dr. G. McCook congratulating him on his "successful case of ovariotomy" and

requesting "Unless you have decided on some other disposition of the pathological specimen, we

should be glad to mount it for the Army Medical Museum, which is no longer confined to

illustrations of military surgery but embraces the whole field of pathology.” (Otis to Cook, March

24, 1866)

Interest in the Museum continued to grow. As Hammond and Brinton had expected,

surgeons were eager to see their name in print as donors to the Museum. Otis wrote to Dr. Henry

Lyster in May 1866 acknowledging, "I am sensible that there was ground for complaint on the

part of the field surgeons that the specimens which they forwarded to the Army Medical Museum

were not always accredited to them. It is true that specimens often reached the Museum with very

insufficient memoranda, yet it cannot be denied that there was sometimes gross carelessness on

the part of those employed at the Museum.” Otis promised to credit Lyster while continuing to

look for the specimens that he had contributed. (Otis to Lyster, May 11, 1866) However, the

Museum was never intended to be a comprehensive collection of every limb amputated during

the war. In addition to contributions from military surgeons, Otis hoped to cooperate and trade

with other museums to build his collection. He wrote to Dr. Bache, curator of Philadelphia's

Mütter Museum, informing him "...that there are duplicate preparations illustrating gunshot

wounds at the Army Medical Museum, and that it is the wish of the Surgeon General to institute

a liberal system of exchanges with other museums of Surgery and Pathology.” (Otis to Bache,

February 23, 1866)

2 Hammond, Brinton and Otis were all educated in Europe, the center of medicine in the nineteenth century. They

were well-suited to establish a medical museum.

3 McCaw later became known for his organization of Chimbarozo Hospital in Richmond for the Confederacy.

10

The growing Museum required more space. The government purchased and renovated

Ford's Theatre for the Museum. The building also housed the Surgeon General's Library and the

Records and Pension division of the Surgeon General's Office. The move to Ford's Theatre in

December 1866 permitted the Museum to expand its range of interests. Otis wrote to Dr. William

Forwood, the surgeon at Fort Riley, Kansas, explaining the new situation: "We have removed the

Museum, as well as the Records Division of the S.G.O. to the large fire-proof building on Tenth

Street, remodelled by the Quartermasters' from the old Ford's Theatre structure, and have now an

abundance of room and are anxious that the Medical Officers at distant posts should send us

contributions of Indian weapons, and of specimens of

comparative anatomy.” (Otis to Forwood, January 4, 1867)

The Museum's Ford's Theatre location was described in Appletons' Journal:

Entering the building -- the front of which has been changed but little, while the

interior has been completely remodelled and altered, to suit the purposes for

which it is now used -- from the street, the visitor ascends a massive iron

staircase, on the walls of which are mounted, in black-walnut frames, sketches

and plans of the battle-fields of Gettysburg, Antietam, and other of the hard-

contested fields of our civil war...

Upon entering the large hall in the third story, with its long rows of glass cases,

in which are exhibited to the glance of the curious the prepared specimens of anatomy

and osteology, one is first made aware of the character of the collection by the

peculiarly prevalent odor of carbolic acid, which is placed, enclosed in small phials, in

all the cases, to assist in preserving the specimens. The hall is well lighted by a

skylight above and windows at the ends; in the ceiling...arranged, artistically, half a

dozen flags and standards belonging to various ambulances during the war; and on the

wall, over some of the cases, are arranged swords [and weapons] of the regulation

patterns, Union and Confederate. Models of ambulances, stretchers and hospital-tents

have a place on the top [of exhibit cases].

It is, indeed, not such a collection as the timid would care to visit at midnight...

Fancy the pale moonlight lighting...with a bluish tinge, the blanched skeletons

and grinning skulls... The thought is not a comforting one, and those fancies

would not be calculated, at such a time, to inspire... But in broad daylight...

with the noise and traffic of the street outside, and the hum and murmur of

numerous clerks and attendants inside, even those of timid proclivities do not

then hesitate to inspect closely and with curiosity the objects which, twelve hours later,

when the building is dark and deserted, they would scarce care to approach. (

Appleton's, March 1, 1873)

The Museum reached an agreement with the Smithsonian Institution over the collection

of American Indian material two years later. Professor Joseph Henry, head of the Smithsonian,

proposed to Barnes:

On the return of the exploring Expedition under

Admiral, then Capt. Wilkes, the government established a

11

National Museum consisting of specimens of Natural History

and Ethnology, which it subsequently placed in charge of the

Smithsonian Institution, with authority to increase the

collection by exchange and otherwise. The Government having

since established an Army Medical Museum to be composed of

specimens to illustrate the various branches of science

connected with anatomy, physiology, medicine and surgery,

and also a Museum in charge of the Department of Agriculture

to consist of articles intended principally to illustrate

the economical resources of the country, it is important

that these establishments should be in harmonious

cooperation in order that the collections of the Government

in the city of Washington may be complementary to each

other, or in other words, each as perfect as possible in

definite lines.

With this view I address you at present in regard to an

exchange of specimens which are now in possession of the

Army Medical Museum, relative to Indian Archaeology and

Anthropology, for specimens to human and comparative Anatomy

in the Smithsonian Institution. The specimens referred to

as now in our possession consist of a series of skulls which

I am informed will be required for the preparation of a

monograph, under your direction, of the crania of North

America. Those for which we propose to make an exchange and

which are in the Medical Museum, consist of a collection of

objects illustrative of the manners, customs and arts of the

Indians of this continent. (Henry to Barnes, January 14,

1869, quoted in Lamb, p. 52-3)

This agreement would set the collecting policies of the Museum for the rest of the century with

the Smithsonian transferring human remains to the Museum and the Museum sending cultural

artifacts in return.

Opened to the public on April 16, 1867, the Museum drew around 6000 visitors by the

end of the year. (Lamb, p. 43-4) By 1874, over 2600 people visited some months. (Parker to Otis,

April 30, 1874) The standard hours for the Museum to be open, at least on Saturday, were 10 am

to 2 pm. During the first years, the staff of the Museum worked from 9 am until 3 pm, Monday

through Saturday; in January 1867 an hour was added to the end of the day. (Otis to Crane,

January 17, 1874; Lamb p. 43) Even before opening to the general public, the Museum was

known enough for Dr. S. Weir Mitchell's fictional story, "The Case of George Dedlow," to

appear in the Atlantic Monthly in July 1866. Mitchell's Dedlow, who had lost both his legs during

the war, was contacted by spirits during a seance. The spirits proved to be his amputated limbs,

preserved in the Medical Museum. "A strange sense of wonder filled me, and, to the amazement

of every one, I arose, and, staggering a little, walked across the room on limbs invisible to them

or me. It was no wonder I staggered, for, as I briefly reflected, my legs had been nine months in

12

the strongest alcohol.” (Mitchell) Undoubtedly, readers of the story would have wished to visit

the Museum to look for Dedlow's (fictional) limbs.

Woodward and Otis both oversaw large offices responsible for the medical records of the

war. Otis was in charge of the Division of Surgical Records while Woodward headed the Record

and Pension Division. Woodward described the divisions in 1873:

The first floor of the main building being nearly on a

level with the street, the visitor who glances through the

windows as he approaches the principle entrance is often

struck with the number of busy clerks he sees seated at

their desks or carrying record-books and papers about the

room. This floor, however, has nothing to do with the

museum. It is occupied by the record and pension division

of the surgeon-general's office. Here are filed the records

of the numerous military hospitals which existed during the

war, together with the monthly sick-reports received from

our armies during the rebellion, and those which still

continue to be forwarded monthly from the several military

posts. There are about sixteen thousand folio volumes of

hospital books, and several tons of sick-reports and

miscellaneous papers, all systematically filed in such a

manner as to permit ready access. To this branch of the

surgeon-general's office the commissioner of pensions

applies for official evidence of the cause of death or

nature of disability in almost all pension cases before

finally acting upon them. Similar information is also

continually asked for by the adjutant-general of the army

and other officials. Altogether, about two hundred thousand

applications from these sources have been responded to since

the war, and fresh cases are still received for

investigation at the rate of about fifteen hundred a month.

To facilitate these inquiries, the names of the dead, so far

as ascertained, have been indexed in a series of

alphabetical registers, which now contain very nearly three

hundred thousand names. About two hundred thousand

discharges for disability have been indexed in a similar

series of registers.

The second floor of the building is chiefly occupied by

the division comprising the surgical records of the surgeon-

general's office. Here are filed the reports made during

the war with regard to the wounded and those who had

undergone surgical operations, and from these a series of

record-books have been compiled, in which are entered the

histories of over two hundred thousand wounds and nearly

13

forty thousand surgical operations. These have been

arranged according to the nature of the wounds or

operations; amputations of the thigh, for example, being

entered in one set of books, amputations of the arm in

another, and so forth. These books are therefore available

for the preparation of the surgical history of the war.

Meanwhile, they have done good service by preventing frauds

in the matter of furnishing artificial limbs to disabled

soldiers, for which large sums of money have been

appropriated by Congress and ordered to be expended under

the direction of the surgeon-general. (Woodward,

Lippincott, p. 234)

The Surgeon General's library shared the second floor of the building with the Division of

Surgical Records.

Both Otis and Woodward complained of the workload of the Museum, the History and

the other duties they were assigned. Otis served on a board redesigning the standard Army

ambulance. Woodward accomplished much pioneering work in microscopy and

photomicroscopy during these years, introducing in America the use of aniline dyes to stain

microscopic specimens. For the Secretary of the Treasury and the National Academy of Sciences,

he investigated the content of wool fabrics for adulteration. In 1876, he was responsible for the

Medical Department's exhibit at the Centennial Exposition in Philadelphia.

Otis wrote to the Surgeon General asking to hire Dr. John Stearns as an assistant:

In endeavoring to carry out the Surgeon General's

instructions to prepare for the press with the greatest

rapidity consistent with accuracy the remaining portions of

the Surgical History, and at the same time to keep up the

current business of the Division of Surgical Records and of

the Anatomical and Surgical branches of the Museum, I find

my time engrossed with multifarious details to such a

degree, that I am unable to [do] that careful study and

reflections upon the general conclusions that the reader

will naturally expect to be deduced from the vast

accumulation of facts in the Surgical History. (Otis to

Crane, March 6, 1874)

Woodward had similar problems, especially with the Record and Pension Division. Woodward

estimated that 106 clerks were necessary to do the work of checking pensions and the other

duties of the division, including keeping meteorological records for Army posts. Woodward

supervised only 68 clerks. The Commissioner of Pensions complained about the slow rate that

information on pensioner's wounds were reported to his office from the Army, but would not

detail any men to Woodward. (Woodward to Barnes, Oct 26, 1875; Woodward to Crane,

December 4, 1875) Both Otis and Woodward suffered from ill-health and early deaths, possibly

14

directly related to their workload.

Through its publications and its contact with the medical profession, the Museum

functioned as a clearinghouse for information learned during the war. Woodward pointed out

other roles for the Museum in 1871:

...Specimens bearing upon disputed points or upon

subjects incompletely understood accumulate and increase in

number year after year, with carefully recorded histories of

the cases, until series are formed that serve for

comparison, and for a more exhaustive study of the questions

involved, which not unfrequently (sic) decides the dispute

or solves the difficulty.

The connection between the results of such studies and

the choice of the best method of treatment is perhaps most

obvious in surgery. For example: any intelligent person who

examines the unequalled series of over four hundred and

fifty specimens of gunshot fractures of the thigh-bone

preserved in the museum will have little difficulty

realizing their importance in connection with the vexed

question of amputation for this injury. He will only need

to examine a few of the specimens from cases in which

injudicious efforts were made to save limbs, and life was

lost after protracted suffering for months or years, to

understand the duty of preserving these mute witnesses. If

he happens to remember the grave differences of opinion

existing among our military surgeons during the late war as

to the proper cases for this operation, and the efforts made

in certain quarters to compel a false conservatism in all

cases and at all hazards, he cannot but feel thankful that

the results of that dreadful experience exist in a tangible

form for future guidance. Many similar examples might be

readily cited from the surgical domain.

On the medical side, although the connection between

morbid anatomy and the treatment of disease is less easily

understood by the non-professional mind, it is none the less

intimate. Our modes of treatment are so bound up with our

notions as to the nature of the affections with which we

deal, and those notions are so dependent upon the state of

our knowledge of morbid anatomy, that improved methods of

dealing with disease have in the past invariably followed

every advance in this knowledge, whether in the direction of

establishing firmly the connection of symptoms with

anatomical alterations, or in the direction of that better

acquaintance with the nature of the alterations themselves

15

which is attained only by the aid of the microscope...

Another use of pathological museums is too important to

be overlooked. They serve as valuable aids in enabling new

generations of medical men to identify with certainty the

descriptions of their predecessors, and thus to utilize

their experience. (Woodward, Lippincott, p. 240-1)

Otis stayed with the Museum through a stroke in 1877 until his death on February 23,

1881. He continued working on Museum projects even after the stroke made him an invalid.

Woodward, already in poor health, broke his leg on New Year's Day, 1881. That summer,

Woodward was one of President Garfield's doctors. Garfield died several months after being

shot, with his physicians having been unable to help him. (Lamb, p. 77-83) Woodward, now

elected President of the American Medical Association, was "prostrated with nervous depression

and hypochondria, and was taken to Europe in the hope that rest and change of scene would

restore him. He returned after some months without having found the benefit hoped for, and it

soon became necessary to place him in the asylum where he ... died.” (Cox, p. 254) Woodward

passed away on August 17, 1884, at age fifty-one. (Heaton, p. 537) In October 1883, Barnes'

successor Surgeon General C.H. Crane died and Robert Murray became the head of the Medical

Department. Murray combined the Museum and the Surgeon General's Library into a single

Museum and Library Division under John Shaw Billings. At the same time, efforts began to

acquire a new building for the new Division. Congress provided land and money for a new

building in 1885. In 1887, the Museum and Library moved to their new home on the National

Mall at Independence Avenue and Seventh Street, SW. The Record and Pension Division,

formerly under Woodward, was transferred to the Adjutant General's Office in 1889. (Pacheli, p.

2) The Museum was fortunate to be out of Ford's Theatre; it was subsequently occupied by the

clerks of the Division, of whom twenty-two were killed and sixty-three injured when the interior

collapsed in 1893. (Miles, p. 162-8)

16

CHAPTER:

The Medical & Surgical History of the War of the Rebellion

The records collected by the Museum during the war, and indeed the entire idea of the

Museum, were to produce the Medical and Surgical History of the War of the Rebellion.1 This

was not the first time that a medical history of a war had been written; the British had produced a

book on their medical experiences in the Crimea, and a similar account by the French was in

preparation when America's war began. (Circ. 6, p. 2) However, the American Civil War was of

a different order of magnitude and so was its History. The six-volume set attempted to discuss

every aspect of military medicine encountered during the Civil War. The massive bureaucracy

and organization of the North was replicated in a smaller scale in the Surgeon General's Office.

Hammond, brought in to replace the superannuated Finley and shake up the hidebound

Department, created his own, far larger, bureaucracy with its own policies, forms and regulations.

Reports were revised time and again to ensure the clear flow of knowledge back to Washington.

A large, sometimes stultifying, bureaucracy was the only way the History could ever be done. By

the time it was done, both editions of the six volumes apparently cost well over $100,000.

(Woodward to Crane, July 29, 1875.) The plates for the second editions of the second and third

Medical volumes alone cost $29,510.

This giant undertaking, a triumph of medical research which eventually took twenty-three

years and over 6,000 pages to complete and weighed fifty-six pounds, first was assigned by

Surgeon General William Hammond to Museum curators John Hill Brinton and Dr. J.J.

Woodward. Brinton had the responsibility to compile the Surgical section and Woodward the

Medical section2. When Brinton left the Museum, George Otis took over the Surgical section.

Both Otis and Woodward had been recommended for their assignments by Assistant Surgeon

General Crane. (Hemmeter, p. 647) Barnes and Crane's support for the project never flagged as

the years went by. Accounts were solicited from surgeons and doctors, including Confederates,

and the records of the Pension Office were heavily utilized to follow up cases. Museum

specimens were photographed; engravings, lithographs and photomechanical prints were made to

illustrate the text. Books, photographs, specimens, equipment - all were purchased although not

at the rate the authors would have preferred.

Both Otis and Woodward brought an immense learning to the project, surveying all that

was known on a subject before drawing any conclusions. Woodward wrote, "In view of the

many errors of fact scattered through the text-books, some of which have been repeated for ages

by authors copying from each other, I early resolved that, so far as possible, I would cite no

authority not before me when I wrote; and that, for the convenience of subsequent students, I

would in every case give not only the name of the author but the edition and page to which each

citation referred.” (History, Medical II, p. iv)

1Hereafter referred to in the text as the History. Cited in notes as MSHWR, Medical or Surgical Vol. #.

2The terms Surgical and Medical were used in a way that is slightly archaic today; to put it simply, Surgical

cases required surgery and were often the results of an injury while Medical cases were the result of a disease.

Otis and Woodward traced diseases through history. Woodward asked Otis, "Will you do

17

me the very great favor to request one of the distinguished French Physicians with whom you

have the honor to correspond, to obtain for me at the Bibliotheque Nationale of Paris a textual

copy of that part of the Greek Manuscript of AEtius which corresponds with the heading and first

sentence of ... the Latin translation of J. Cornarius, Basel Ed. of 1532...” Woodward wished to

ensure the two translations he had were both from the original Greek document on diarrhea.

(Woodward to Otis, December 27, 1875) The books collected to fulfill this need to review

directly all known information on a subject, formed the foundation, under John Shaw Billings'

direction, of the National Library of Medicine. A product of the nineteenth century's philosophy

of natural history, the History is a systematic, statistical compilation of the types of injuries and

diseases a military surgeon could expect to treat, along with discussions of and examples of

treatments. It was not a textbook but rather a reference book, a compendium of experience. Since

the History itself was a distillation of millions of pages of medical information, its creation and a

few points of interest, rather than the contents of each volume, will be reviewed here.

On June 9, 1862, the History was publicly announced to the Medical Department.

Hammond's Circular No. 5 (see fig ) assigned the writing of the History to Woodward and

Brinton and requested many types of information from medical officers. To promote

compliance, the announcement promised to put one's name in print for the ages.

Charged with writing the History, while also creating the Medical Museum, both

Woodward and Brinton had their own ideas on how to proceed. Woodward began looking at

statistics, publishing Circular No. 15: Sickness and Mortality of the Army during the first year of

the War, an eight-page survey, on September 8, 1863. Brinton soon published his statistical

survey, Circular No. 9: Consolidated Statement of Gunshot Wounds and then proceeded to

ignore the cold, dry numbers and solicited descriptive battlefield reports.

Brinton envisioned the surgical history as a chronological one, following the war, battle

by battle. In the first Surgical volume, Otis described Brinton's plan:

In the preparation of the surgical portion of the Medical

and Surgical History of the War of the Rebellion, it was at

first proposed to treat the surgery in connection with the

military operations in the several battles and campaigns.

... After giving a general account of a campaign,

enumerating the troops engaged, the mode of transporting the

injured, and the available hospital accommodations, the

wounds and operations of each engagement were discussed, the

reports of medical directors, and all other reliable sources

of information being brought into requisition. Among these

were observations personally made in the base and field

hospitals of the armies of the Potomac and of the West,

after the great battles, where much valuable surgical

material was collected, including admirable illustrations of

the graver injuries, pathological specimens, and a series of

excellent surgical drawings.” (MSHWR, Surgical I, p. xiii)

In a letter to Surgeon Alonzo J. Phelps, based in Nashville (a city precariously held by the

18

North), Brinton delineated his needs. He wanted to know everything related to surgery that

occurred at a battle:

I to-day had an opportunity of examining your "Casualty

report" of the battle of Murfreesboro. As you perhaps know,

I have been directed by the Surgeon General to prepare the

Surgical history of the War. I am exceedingly desirous of

obtaining a good Surgical account of the above mentioned

battle. Have you time Doctor to prepare such an account?

If you have, I should be glad to receive it, and I will see

that due credit be given you in the forthcoming history.

The chief points to be noticed, are number of killed and

wounded, character of missile used by the Enemy, the

Surgical appliances at hand in the battle-field, general

character of wounds, -- Hospitals Ambulances, what was done

with the wounded, Erysipelas or Tetanus, if either were

subsequently prevalent, Resections, Amputations, Names of

Operators. In fact Doctor a full account of the battle as

looked at by a Practical Military Surgeon from his own point

of view. I sincerely trust that you will have leisure to

write something. If you have, may I ask you to furnish me

with the name of some one, whom you may think capable of

doing this important Subject justice... (Brinton to Phelps,

February 9, 1863).

Phelps' detailed report was abstracted in the first Medical volume's appendix.

Brinton was dutiful in requesting information from the field, even when he would rather

have been at the battle himself. He wrote to his comrade Surgeon H.S. Heust, who was with

Grant, requesting information on the Union victory at Vicksburg:

My dear Heust:

I want some of these days to know all about the great

Vicksburg battle. I envy you your position. If you have

force enough, can you not direct some young assistant

Surgeon to keep notes (Surgically) of what is going on --

what hospitals are established +c -- + what have been your

arrangements in your glorious sequence of victories. The

enclosed blanks will be suggestive. I know you will not

think me annoying, in asking you now, in the midst of what I

know are arduous labors, -- But I have learned, that, unless

this information is collected on the field, it is apt to be

lost -- + I, if no one else, am sure to be the loser. Kind

remembrances to all my friends, + to the best General of

them all. (Brinton to Heust, June 6, 1863)

19

In keeping with his plan to track surgery in the war through each battle, Brinton needed

maps of the battlefields. "A great desideratum is a map of the locality with the position of the

hospital correctly laid down. This I could have engraved and inserted in the Book," he wrote to

Surgeon John Craven who had reported on skirmishes on Morris Island, South Carolina. (Brinton

to Craven, August 22, 1863) In later years, Brinton felt that he did not get enough credit for his

initial work on the surgical portion. In his autobiography, he wrote:

By the way, I may add that this map [of Antietam] and nearly

all the other field hospital maps, etc., of great battles in

that book, except the extreme southern campaigns, were

prepared under my direction when stationed in the Surgeon-

General's office in Washington. The were modified and

reduced by an artist named [Pohlers], from the topographical

maps, and the position of the hospitals I usually had

located by any medical inspectors or other medical officers,

who might know the ground well. My name does not appear in

any of this work, but it was designed by me, and much of

it executed under my direct superintendence. Some was done

by my successor after my departure from Washington.

(Brinton, p. 206)

The maps were published, along with the field reports solicited by Brinton, in the appendix of the

first Medical volume. They were credited to Woodward and Otis; Brinton's name was not

mentioned although Otis credited him in the opening paragraph of the first Surgical volume.

Brinton encountered difficulties in gathering information to research bullet wounds. He

found reports coming into the Museum listed gunshot wounds without accompanying

information such as part of the body wounded or results of surgery. Another problem was

patients being counted as new cases each time they were transferred from hospital to hospital.

(Brinton 249-50) Brinton was forced to state, "The inadequacy of the entries in the ...monthly

report of sick and wounded was early acknowledged, and it was officially declared that previous

to September, 1862, 'the surgical statistics of the war were absolutely worthless,' and that 'the

only information procurable is such as can be derived from the examination of a mass of reports,

all of which present merely certain figures under the vague and unsatisfactory heading, Vulnus

sclopeticum [gunshot wound]." (Brinton, Consolidated Statements of Gunshot Wounds, quoted

in MSHWR, Surgical I, p. xxv) New forms, reports and registers were designed in late 1863 by

a special board of medical officers. A small register was given to officers to use in the field. Two

larger ones, one for information on the sick and wounded and one for surgical operations, were

used in hospitals with new quarterly report forms. The new information, as well as specimens,

arrived in the Museum to be processed by doctors and clerks for use in the History. (Circular 6,

p. 3-6)

Specimens were preserved in alcohol seized by the Provost Marshal for the Museum.

Brinton recalled:

...an enormous amount of alcoholic beverages was poured into

20

the Museum, everything from champagne to the commonest

rum. Our side lot was piled with kegs, bottles, demijohns

and cases, to say nothing of an infinite variety of tins,

made so as to fit unperceived on the body, and thus permit

the wearer to smuggle liquor into camp. ... When the whisky

was strong enough for preservative purposes, [Schafhert]

kept it in the package; when it was not, it went into the

still. This under Schafhert's watchful care, ran

incessantly, and furnished the Museum with a large amount of

very fair alcohol, not only for putting up our specimens,

but for furnishing the various depots in the Army where

fresh specimens were being collected, so that they could be

kept from decomposition, and reach the Museum in good

condition.

When Brinton discovered that the Museum's whiskey was being tapped en route, he added tartar

emetic to a barrel. He got a report of many vomiting railroad employees and had no more

problem with losses. Brinton also used confiscated cherry brandy to smooth his travels on the

road; he traded kegs with the 5th Cavalry in exchange for the use of their horses when traveling.

(Brinton, p. 191-3) War-time supplies of alcohol were still preserving new Museum specimens

ten years later. (Woodward to Tyson, March 10, 1876)

Woodward, like Brinton, had problems gathering information. Soon after he was placed

in charge of the Division of Medical Records, Woodward realized that the then-current forms

with spaces for 143 diseases worked fine during peace but were inadequate in war. In July, 1862,

a board consisting of Woodward, Brinton, Surgeon Lewis A. Edwards and Assistant Surgeon

M.J. Asch met in Washington to revise the Army's sick reports. The reports were changed from

quarterly to monthly, and then forwarded directly to the Surgeon General from each unit without

being edited or consolidated by the Medical Directors of the individual Armies. At the same

time, the board modified the Classification of Diseases. The board selected the classification

system devised in 1855 by England's Dr. William Farr and (with some modifications, such as

leaving out diseases of women) recommended it to the Surgeon General. A section of the

classification scheme, barely comprehensible now, sharply shows the limits of nineteenth-century

understanding of disease:

The class Zymotic diseases is intended to embrace epidemic,

endemic, or contagious affections, supposed to be induced by

some specific body, or by anomalies in the quantity or

quality of the food. The order Miasmatic diseases includes

affections believed to be due to various atmospheric

influences, such as the products of vegetable and animal

decomposition, specific emanations from the human body in a

state of disease, and the so-called marsh miasms. The order

Enthetic diseases includes those disorders which are

transmitted by the inoculation of morbid matters. The order

21

Dietic diseases includes those which are caused by errors in

the quantity and quality of the food. (MSHWR, Med I, p.

xviii-xix)

Miasmas, vague unhealthy influences, were supposed to be floating through the air, infecting

soldiers. Mosquitos and other disease carriers would not be suspected for years after the war

ended.

When Otis succeeded Brinton as curator of the Medical Museum, he also became

responsible for the Surgical section of the History. Before the close of the war, Otis realized that

Brinton's plan to write a surgical history of each battle would not work due to the sheer amount

of information being received. "During that year [1864] there were no less than two thousand

skirmishes, actions, or battles, and to have given a correct analysis of the casualties from the

returns from the field and base hospitals would have been impossible.” Instead, Otis decided to

arrange the Surgical volumes by type of wound and region of the body. The battlefield reports

that Brinton had already collected would be an appendix to the first Medical book. He promoted

his new plan in the Museum's first major post-war publication, Circular No. 6: Reports on the

Extent and Nature of the Materials available for the preparation of a Medical and Surgical

History of the Rebellion.3 (MSHWR, intro, p. xiiv)

3Hereafter cited as Circular 6.

Otis and Woodward published Circular No. 6, heavily illustrated with woodcuts and

lithographs, on November 1, 1865. The Circular became the blueprint for the History. In keeping

with the planned format of the History, Otis wrote the Surgical report while Woodward produced

the Medical one. The book, which it certainly is at 166 pages, purports to be a report to Surgeon

General Barnes from Otis, "in response to your inquiries relative to the nature, extent, and value

of the surgical data that have accumulated in the department of your office under my charge."

(Circular 6, p.1) Barnes knew very well what Otis and Woodward were doing, especially in light

of the considerable financial costs of the project. Circular 6 was even published by the noted

medical printer J.B. Lippincott of Philadelphia. The first edition of 5,000 copies cost well over

$6,000. When Lippincott raised the issue of selling copies of the book, Otis replied, "I am

directed by the Surgeon General to acknowledge your communication of the 22nd inst. and to

instruct you to refer all applicants for copies of Circular No. 6, S.G.O. 1865, to this office. The

Surgeon General does not entertain favorably the proposition to supply demands from

booksellers, but decides that all issues must be made gratuitously from this office.” (Otis to

Lippincott & Co, February 24, 1866) Circular 6 was aimed at the medical officers of the Army,

to whom it was distributed freely, to encourage their continued enthusiasm for, and participation

in, the projected History. Otis wrote to a prospective contributor, "In reply to your

communication I would state that Circular No. 6, S.G.O. 1865, is distributed to all medical

officers who rendered faithful service during the late war and who have notified this office of

their P.O. addresses... It is proposed to distribute future publications relative to the medical and

surgical history of the war to those medical men who have contributed or who shall contribute to

the material from which such publications may be compiled." (Otis to Roberts, May 11, 1866).

Much of the expense of such free publications was made possible by the transfer to the Museum

22

of slush funds from the closing hospitals. (Lamb, p. 37) The fund from Lovell General Hospital

of Portsmouth Grove, Rhode Island, alone was $9,952.83. (Otis to Samuel Ramsey, December 4,

1865) On the other hand, the hospitals in Nashville, Tennessee, only produced $226.25 (Otis to

George Cooper, December 8, 1865).

Both Woodward and Otis wrote extensive introductions on their materials and methods

before presenting specific examples of information available for the History. Otis began his

report by discussing the types and quality of the data available to him:

The materials in the office relating to the surgery of the

late war consist of the reports of the medical officers

engaged in it, and of illustrations of these reports in the

shape of pathological specimens, drawings and models. The

documentary data are of three kinds; first, the numerical

returns, in which the number alone of the different forms of

wounds, accidents, injuries, and surgical diseases is given;

secondly, what might be called the nominal returns, in which

are furnished the name and military description of each

patient, and the particulars of the case, with more or less

of detail; and thirdly, the miscellaneous reports... In the

third class are included the reports of medical directors

of armies in regard to the operations of the Medical

Department, and the succor given to the wounded; reports and

dissertations on new methods and modes of treatment, and

modifications of surgical apparatus and appliances;

pathological researches on morbid processes pertaining to

surgery, as hospital gangrene, osteomyelitis, pyaemia, and

the like; plans for ambulance organization, and the

transportation of the wounded by land and water. (Circular

6, p. 1-2)

"The extent of these materials is simply enormous," Otis continued. By comparison with the

British and French experience in the Crimea, where the combined armies had suffered 653

gunshot fractures of the femur, over 5,000 such cases were reported to Otis. Otis recognized and

explained the value of this material, saying:

It may be emphatically said that they throw much light

on some of the great moot points in surgery; that they

comprise on some subjects, as, for example, on the question

of the propriety of excising the head of the femur for

injury, fuller data than are now extant in the entire range

of surgical literature; and that it may be hoped, without

temerity, that they include the elements for the solution of

many grave surgical problems. (Circular 6, p. 3)

23

Otis laid out Circular 6 the way he anticipated organizing the History. He covered wounds of the

body, starting with the head and working down. He then examined surgical treatments such as

excision and amputation. A brief overview of the medical department staff was followed by a

review of the medical resources, including transportation, available to the surgeons. Otis

optimistically ended his report,

In conclusion, it has been estimated that it will be

possible, by judicious condensation, to include in one large

quarto volume the statistics of the graver injuries, as

fractures of the extremities and wounds implicating the

joints or great cavities, and of the major surgical

operations they have involved, the individual cases, their

progress and results, being concisely recorded; while a

second quarto volume could comprise numerical tables of the

less serious injuries, an historical summary, and a

discussion of the lessons derived from the statistical

records of the war. (Circular 6, p. 88)

In fact, none of these estimates were accurate, and Otis' plan for the Surgical history was much

altered when it began appearing. An additional 600-page volume proved necessary to cover the

topic adequately.

Woodward's report to Barnes followed much the same pattern as Otis's. He listed the

available material that he would be using:

The matter collected is partly statistical, partly

pathological. The first category embraces the medical

statistics of the several armies and general hospitals. The

second consists of a number of memoirs and reports by

medical officers on the causes, symptoms and treatment of

the more important camp diseases, of numerous histories of

cases and autopsies, of the fine series of medical and

microscopical specimens in the Army Medical Museum, and of

the results of the pathological studies conducted under my

direction of the basis of these collections. In addition,

there are a large number of descriptions and plans of

general hospitals, of reports on hospital organization, and

some other miscellaneous matters. (Circular 6, p. 89)

Woodward's statistical work led him to conclude that fewer troops died from disease in the

Union Army than during any previous war, but that the mortality rate for soldiers due to disease

was more than five times higher than expected for a similar group of men during peacetime. The

rate of deaths due to disease was also far higher than that from injuries. Facts like these enabled

Woodward to state unequivocally the value of the History:

24

Such a publication, therefore, becomes one of the most

important duties of the Medical Department of the army; a

duty the evasion or neglect of which would be a grave crime

against the army of the United States, and against every

American citizen who, in future wars, volunteers in the

defence (sic) of his country." (Circular 6, p. 90)

Woodward's primary interest for his first volume lay in statistics. He defended his data

against criticism of two types. Diagnostic errors would be eliminated by combining similar

diseases that might have been confused by doctors. Diseases of the eye would all be put together

under "ophthalmia" to highlight the most important fact -- disease of the eye occurred at a certain

rate in the Army. Errors of negligence were a bit more difficult for Woodward to address.

Woodward answered these critics, saying the reports during the war to the Surgeon General

"contain internal evidence of the care with which they were prepared, and, it is believed, will

compare favorably with any other set of statistical papers in existence.” It was true that some

reports were never made, were lost or were badly done, but in light of the sheer mass of

information, in Woodward's view, they became statistically insignificant.

Woodward, like Otis, organized the Circular as he would the History. He discussed the

mortality rate of the Army and statistically examined the disease rate. He previewed the Medical

and Microscopical sections, the two Museum sections under his care, relating details of

individual cases. A full color lithograph by F. Moras after artwork by Hermann Faber was

included; plates by this team would be published in the third Medical volume twenty-three years

later. Woodward closed with a discussion of the design of hospitals during the war. He included

lithographs that were not reproduced in the History such as a "Birds Eye View of Lincoln

General Hospital."

Woodward's projections for his volumes were more accurate than Otis':

In conclusion, I may express the opinion that, with the

utmost brevity and care, it may be hoped to digest the

material above sketched, not including surgical cases, into

three quarto volumes... The prominent subjects in these

volumes would be the medical statistics of the several

armies, with the principal facts in their medical histories;

the medical statistics of the several general hospitals,

with descriptions of their construction and administration,

illustrated by a sufficient number of ground plans and

perspective views to give a just idea of them; and lastly,

an account of the causes, history, symptoms, pathology, and

treatment of the principal diseases of the troops, based

upon statistical facts, contributed papers, histories of

cases and autopsies, and observations made in the medical

and microscopical sections of the Museum. ... Of the

subjects thus indicated, about one-half of the statistical

matter is compiled, and most of the material required for

25

the remaining portion of the work is collected, and can be

prepared for the press with reasonable rapidity. (Circular 6, p. 166)

Woodward correctly estimated that three volumes would be necessary while Otis only planned

for two of the final three; neither, however, would live long enough to see the work completed.

Circular 6 proved to be extremely popular. Two months after it was printed, Dr. Lemuel

Dale, a contributor to the Museum, was writing to Otis to find out how he could receive a copy of

the History, wondering whether he could request one before it was completed. Fortunately for

Dale, Otis told him that he could request one at any time provided he specified where and when

he had been in the Medical Department and what data he had provided to the Surgeon General's

Office (Otis to Dale, January 12, 1867). On February 9, 1866, four months after it was printed,

Otis requested a bid from Lippincott for a second edition of 2,500 copies. No substantial changes

were to be made. "With the exception of the correction of typographical errors, the second

edition must be in every respect uniform with the first," were his instructions. (Otis to Lippincott,

February 9, 1866) Otis negotiated with Lippincott over the price of the second edition; he was

willing to pay $1.28 per copy for a total cost of $3200, not $3475 as Lippincott had requested

(Otis to Lippincott, February 15, 1866). Circular 6 was the last volume that Lippincott, who had

printed forms and books for the Museum through the war, would handle; in the future, Museum

publications were usually done by the Government Printing Office.

For the next five years, the two men continued working on the first book in each of their

respective specialties. Otis pointed out to inquirers, "The Medico-chirurgical history of the

British Army in the Crimea was not published, if you recollect till 1858, while the French

statistics on the same subject only saw the light a few months ago." (Otis to Lyster, September

25, 1865; the Crimean war was from 1853-1856) Assistant Surgeons like Woodhull and Curtis

helped produce catalogs of the three collections in 1866 and 1867, with brief descriptions of

cases that could be expanded on and woodblock illustrations that could be reused for the History.

Before much research work on Museum specimens could be done, a cataloging system

was needed to arrange the Museum's vast number of specimens in a logical order. During the

war, Woodward and Brinton had divided the Museum's collection into three sections: Surgical

(Section I), Medical (Section II), and Microscopical (Section III). Items in each section were

numbered consecutively starting at 1. The Surgical Section contained material related to surgical

operations, including skeletal specimens, wet tissue, bullets, photographs and plaster casts. The

Medical Section contained specimens of various diseases which were not treated surgically.

These include specimens of typhoid fever, swamp fever, tuberculosis, and especially diarrhea and

dysentery. The Microscopical Section consisted of prepared microscopic tissue sections and

photographs taken of them.

By the end of 1865, it was apparent that these sections would have to be expanded.

Human Anatomy (Section IV) and Miscellaneous (Section VI) sections were placed under Otis.

The Human Anatomy Section contained samples of normal, not pathological, human anatomy.

The Miscellaneous Section held equipment such as medical kits, models, and anthropological

artifacts. Woodward dealt with Comparative Anatomy (Section V) which had veterinary

specimens, normal and pathological. (Lamb, p. 38). In the following decade, the Surgical and

Medical Sections were merged into one Pathological Section.

Once a specimen, photograph, or object was placed in one of these sections, it was then

26

assigned to a particular pathology category. These categories were developed by Museum doctors

and reflected contemporary medical knowledge. The specimen, photograph, or object was then

assigned a unique identification number. The first Catalogue of the Army Medical Museum,

compiled by assistant curator William Moss under Brinton's direction, was published on January

1, 1863. The Catalogue was "offered simply as a numerical list of the objects in the Army

Medical Museum. No attempt has as yet been made to classify the various injuries, nor has any

description of the preparations been entered upon. Such a work must be deferred for the future. It

will then be found to demand volumes. The labor of the present hour is simply to collect and to

preserve -- the study must be made hereafter.” (Brinton, Catalogue, p. 3-4)

Three catalogues, corresponding to the three main sections of the Museum, were

published soon after Circular 6. These catalogues were listings of the Museum's collections,

arranged for the most part by body section. The Government Printing Office published the first

catalogue in 1866. The Catalogue of the Surgical Section of the United States Army Medical

Museum, credited to Alfred A. Woodhull, was worked on by Woodhull, Otis and John Shaw

Billings. (Otis to Lyster, May 11, 1866) Otis did not like Woodhull's work. He wrote to a

correspondent who had complained about a lack of credit, Woodhull "no longer consulted me

as to the compilation and adapted many arrangements of which I much disapproved. Among

these was the practice of referring specimens to the commissioned officer of the hospital from

which they were sent.” Otis planned to correct Woodhull's work in a second edition of the

Catalogue, but it was never redone. (Otis to L. K. Baldwin, April 4, 1876) Woodward's

Catalogue of the Medical Section of the United States Army Medical Museum and Curtis'

Catalogue of the Microscopical Section of the United States Army Medical Museum followed

in 1867. All three catalogues included short description of each specimen, the name of the patient

who provided the specimen, where he was wounded, his doctor's name and other facts of the

case. This information could be expanded for the Museum's other publications.

An extraordinarily complex numbering system, which varied slightly for each section,

was adopted for each catalogue. It was designed to combine specimen identification numbers and

types of objects with pathology categories. The specimen's unique number was preceded by a

Roman numeral code, pertaining to a particular pathological category. For instance, "XXVI,

4629 A 3 101" refers to one photograph of a "group of officers who had undergone amputation

for gunshot injury.” In this case XXVI corresponds to the twenty-sixth category of objects

relating to surgery, namely "Photographs, drawings and maps," and 4629 is the unique

consecutive item number. 'A' means "the Army Medical Museum Series of Photographs". '3' is

the third volume of photographs taken at the Museum. 101 indicates that this photograph

number 101 within a consecutive numbering series. Photographic collections eventually began to

receive names reflective of their content. Our example "XXVI, 4629 A 3 101" became Surgical

Photograph 101 (SP 101).

This system was far too cumbersome to maintain given the rapid rate of acquisition of

specimens and objects, especially since it was necessary to refer back to a catalogue. Specimens

were tracked and referred to by their Section number instead of the larger cataloging system. This

inability to devise a pathological cataloguing system plagued the Museum and other medical

professionals well into the twentieth century. (Lamb, p. 126-135)

Other duties and publications intervened with the work on the History. Woodward spent

time researching the cholera epidemic of 1866, producing Circular No. 5: Report on Epidemic

27

Cholera in the Army of the United States During the Year 1866 in 1867. His format for this was

very similar to that of Circular 6. He gave a brief history of the epidemic (out of 12,780 men in

the Army, 2,708 caught the disease and 1,207 died), followed by statistical tables and excerpts

from field reports on the disease. The circular ends with an interesting report on disinfectants

from Dr. B.F. Craig of the Surgeon General's Office. Craig concluded that disinfectants such as

bleach, alcohol, and chlorine were effective in checking the disease. Unfortunately, he also

thought, "The theory of the mode of propagation of cholera which is the most widely received

and has in its favor the greatest amount of evidence is that the virus4 is not eliminated as such

from the bodies of cholera patients, but that it is formed in their discharges by some specific

process of decomposition, a process which is supposed to go on only in alkaline fluids.” (Circular

5, p. 63-65) Woodward concluded and clearly stated that there was no good treatment for the

disease. After using epidemiology to pinpoint the two centers and subsequent spread of the

epidemic, Woodward lamented that, "As to the question of therapeutic agencies, it cannot be said

that any new light has been shed upon the existing obscurity of the subject by the army

experience.” He then recommended that attention be instead focused on 'hygienic precautions'

such as Craig discussed and T.A. McParlin's recommendation on "the efficacy of the use of pure

drinking water in arresting the spread of the disease, even after it has made its appearance."

(Circular 5, p. xvi-xviii) He returned to the subject the following year with Circular No. 1:

Report on Epidemic Cholera and Yellow Fever in the Army of the United States During the Year

1867.

4 'Virus' is used in its older meaning of a "specific agent of an infectious disease", and not its modern meaning,

"a group of microbes which with exceptions are capable of passing through fine filters that retain most bacteria,

and are incapable of growth or reproduction apart from living cells.” (Steadman p. 1559) Modern virology was not

established until the end of the nineteenth century in the great expansion of laboratory medicine.

Woodward also did much important research in microscopy during these years, research

which contributed to his understanding of the diseases he would be writing on in the History.

Otis, an excellent surgeon, continued to publish on topics of interest to him that could be used in

the History. In July 1867, Circular No. 7: A Report on Amputations at the Hip-Joint in Military

Surgery was published. Otis was much interested in this rare operation, in which the entire leg

was removed. He could eventually fully document fifty cases. He had sent letters imploring

acquaintances, "Can you not hear among your rebel friends of any unreported amputations at the

hip-joint? We have thirty on record. The Confederates but two - I have a third not yet in print.

Try and put me on the track of some new cases.” (Otis to W.F. Smith, January 21, 1867). Otis

stated his rationale for his monographs clearly, "It may reasonably be hoped that the analysis of

large numbers of surgical cases, due attention being paid to essential particulars, must result in

the establishment of rules for the performance of operations more nearly approaching scientific

method and accuracy than those that now prevail, and in the selection of proper cases for

operation at the stages and under the circumstances most conducive to success." (Circular 7, p. 6;

italics added) For Otis, the Civil War was a great learning experience which would become a

greater teaching experience. He also wrote a small companion publication Drawings,

Photographs and Lithographs illustrating the histories of seven survivors of the operation of

amputation at the hip joint, during the War of the Rebellion, together with abstracts of the seven

28

successful cases. (Lamb, p. 46)

Otis produced another monograph, Circular No. 2: A Report on Excisions of the Head of

the Femur for Gunshot Injury in January 1869. Unlike amputations, in excisions only the

damaged portion of the bone --in this case the head of the femur-- is removed, with the aim of

leaving a partially-functioning limb. Otis felt "it must be admitted that this report comprizes (sic)

the elements for solving the grave problem of the appropriate treatment of gunshot injuries

involving the hip-joint." (Circular 2, p. 6) He responded to critics of his previous publication,

who had questioned his classification of the importance of time elapsed before surgery, saying,

"If a study of the histories of over twenty thousand major amputations, and of more than four

thousand excisions of the larger joints, performed during the late war, may permit me to speak

authoritatively on this point, I would say that no doctrine in military surgery is supported by more

ample evidence than that which teaches that in operations for traumatic causes, there is a wide

difference in the results of those performed immediately after the reception of the injury, those

performed during the existence of inflammatory action, and those done after the symptomatic

fever and inflammatory symptoms have abated.” (Circular 2, p. 6) Otis continued defending his

arrangement for years, writing in 1870, "Dr. Taylor's classification may be excellent for the

British army, with its corps of trained medical officers; it could not have been advantageously

introduced in our service, chiefly attended by surgeons hastily called from civil life." (MSHWR,

Surgical I, p. xxvi) Indeed, many of the medical problems of the Civil War arose from the lack of

a large, well-trained medical force.

For the femur excision report, Otis had assembled the artistic team he preferred to work

with. J. Bien had produced the lithographs and H.H. Nichols had produced the woodcuts over the

preceding five years. The amount of people working on such a large task was never very big. The

maximum staff Otis had working on the project was "one medical officer, one clerk, and sixteen

hospital stewards, occasionally aided by one acting assistant surgeon." (MSHWR, Surg I, p. xxvi)

The following year saw the publication of the initial parts in both the Medical and

Surgical volumes of the History. Unfortunately an odd system was adopted: Woodward's book

was designated Part I, Volume I Medical History, and Otis' work became Part II, Volume I

Surgical History; for the sake of convenience they will be referred to here as first Medical, first

Surgical, et cetera.

Barnes credited Secretary of War Stanton with promoting the publication to Congress; on

June 8, 1868, Congress appropriated money and authorized the Government Printing Office to

print five thousand copies of each volume. Work began on March 3, 1869, and by November

1870 the books were completely done. Barnes, in his ornate style, states, "Through the

liberality of the Government, in its beneficent pension laws, it has been found practicable to

obtain accurate histories of many thousand wounded or mutilated men for years subsequent to

their discharge from service. As in the official returns of the casualties of the French and English

Armies in the Crimean War, the cases were dropped when the men were invalided, pensioned, or

discharged from service, this information was considered peculiarly desirable.” Barnes' point,

that these volumes were the first long-term follow-ups of surgical cases, sets the stage for the

development of modern medical studies conducted on groups over a period of years. Otis

concurred with Barnes, stating, "Much important and otherwise unattainable information

regarding the ulterior consequences of the more important and rare injuries has been collected by

private correspondence with invalided soldiers and their surgical advisers. More than fifteen

29

hundred cases have been examined in this way.” Otis also credited the "former medical officers

of the Confederate army" for providing much information. He was also able to use Confederate

hospital records that had been captured by the Union. Occasionally, Otis would even advertise in

newspapers for information on specific cases. But the lion's share of information came from

pension records. "[T]he principal sources from which the remote results of wounds, injuries, and

operations were ascertained, were the reports of pension examiners, and communications from

the surgeons general and adjutants general of States.” (MSHWR, Surg I, p. xix)

Otis had changed the format and content of his volumes in the five years since Circular 6

was published. The volumes were not arranged into one volume of graver injuries and one

volume of lesser injuries, followed by a historical summary and a discussion of lessons learned.

Nor were cases of injuries discussed followed by a separate discussion of treatments as in

Circular 6. Instead, "As nearly as practicable, the wounds and injuries and surgical disease of

each region of the body have been arranged together, as the simplest and most natural order that

could be adopted. The most interesting clinical histories have been printed in full, or in abstracts

including the attainable essential details, and the remaining cases, or sometimes the whole

number of cases of the class, are set forth in tabular statements.” In other words, each area of the

body would have its wounds described and treatments discussed. Otis opened his book with a

daily chronological summary of the battles and engagements the Army fought. Then he examined

wounds of the upper body. Due to space limitations, in the first Surgical volume only the head,

face, spine, and chest were included.

Whenever possible, the clinical histories were credited to the doctor who had treated the

patient, preferably in his own words. Otis could not quote every bit of information he received.

He wrote to R.G. Jennings, the Secretary of the State Medical Society of Arkansas, "You will

readily understand that it is impossible for me to furnish even a synopsis of all individual cases in

the immense number of surgical facts reported to this office. I am compelled to select, and am

expected to select those instances that convey the most original information. I feel sure,

therefore, that you will approve my course in referring the reader to the volumes in which your

important case was published.” (Otis to Jennings, April 28, 1876)

After the information was presented, Otis discussed it, drawing conclusions and pointing

out relevant facts. He was still planning to finish the Surgical section of the History in two

volumes, but had been forced to move the 'Wounds and Injuries of the Head and Trunk' to the

second Surgical volume due to space considerations. (MSHWR, Surg I, p. XXXII) Otis' volume

was heavily illustrated with woodblock engravings, lithographs and chromolithographs of

patients and specimens.

While compiling his research, Otis considered the lessons of the war still useful:

That the experience acquired during the war should have

added largely to every subject connected with military

surgery was not to be anticipated. But it may be safely

asserted that, in many directions, it has advanced the

boundaries of our knowledge. ... [W]hile, before the war,

there were few surgeons who chose to undertake operations on

the great vessels [the arteries in the neck], there are now

thousands who know well when and how a great artery shall be

30

tied. ... Without further illustration, we may claim that

the additions to surgical knowledge acquired in the war are

of real and practical value.” (MSHWR, surg I, p. xxix)

Therefore, while "we must perhaps be content to wait until some genius as sublime as Newton's

shall explain the laws of life by a generalization as simple and perfect as the law of gravitation,

before the physiological sciences shall be recognized among the strictly exact sciences," Otis was

confident that the study of the war wounded would advance medical science. (MSHWR, Surg I,

p. xxix)

Woodward, in contrast with Otis, continued his plan of doing a volume "consist[ing] of a

series of statistical tables presenting a summary view of the facts embodied in the monthly

reports made to the Surgeon General with regard to the Sickness of the Army, the Deaths, and the

Discharges from service on surgeon's certificate of disability.” He could do so because, unlike a

surgical case that could take years for the final resolution of the injury, most medical cases ended

relatively quickly. "The writer regrets greatly the necessity of publishing first these dry and

severe details, in which it can hardly be expected the general medical reader will be able to take

much interest. This course was rendered imperative, however, by the fact that in the subsequent

volumes it will frequently be necessary to refer to statistical considerations, which could not be

accurately done until the tabulations of the present volume were complete; and the tabulations

having been completed, it appeared a duty to place them as soon as possible at the disposal of the

other students of this subject, throughout the world.” By doing the statistical work first,

Woodward was able to report the primary cause of death in the Union Army was diarrhea and

dysentery. As a result, he would concentrate the whole of the second Medical volume on those

diseases (although he had planned to discuss all types of disease in the second volume and save a

'somewhat detailed account of the General Hospital System' for the third volume). (MSHWR,

Med I, p. XIII, xlii, xliii, xxiv) Woodward did not use any illustrations in his first volume

except for charts and graphs.

In his statistics, Woodward included the fiscal year following the war, ending on June 30,

1866, "because, although after the close of the war the great volunteer army was disbanded

with unprecedented rapidity, the unsettled state of the country rendered it necessary to keep a

certain number of volunteer troops in service for some time after the cessation of actual

hostilities, and it was thought that tables showing the sickness and mortality from disease during

the year of peace following the war would be valuable for comparison with the diseases and

deaths of similar bodies of troops in the same regions during the period of active operations."

(MSHWR, Med I, p. xx)

Woodward split his statistics to show the differences between 'White' and 'Colored'

troops. His justification was a humanitarian one:

The propriety of endeavoring to present separately such

facts as it has been possible to collect, with regard to the

sickness and mortality of Colored Soldiers, would appear too

obvious to require extended remark in this place. Aside

from all considerations of a scientific or historical

nature, motives of humanity would seem to dictate that the

31

statistics should be presented in the form most likely to

render them serviceable as a contribution to our knowledge

of the influence of race-peculiarities of disease. These

motives acquire, if possible, additional importance from the

fact that several thousand Colored Men still continue to

form a part of the United States Army. (MSHWR, Med I,

p.xiii)

Woodward, in true scientific spirit, would have preferred to compare more groups than

just 'White' and 'Colored':

Many other interesting subdivisions suggested themselves,

such as the comparisons between the Regular and Volunteer

troops, between Officers and Men, between Infantry,

Artillery, and Cavalry, and between soldiers of American and

those of Foreign birth. All attempts at such subdivision

were, however, reluctantly abandoned, as involving a degree

of labor for which there was no adequate clerical force and

which would have required a system of returns entirely

different from those in use at the breaking out of the war

or those which it was afterwards thought practicable to

adopt. For the same reason it was deemed inadvisable to

attempt to prepare for publication the separate regimental

returns which have served as a basis for the present tables.

In extent and costliness such a publication would have

exceeded all reasonable limits. (MSHWR, Med I, p. xxii)

Woodward's volume closed with a 365-page appendix of the battlefield reports and maps

sent in by the doctors during the war. These are the reports and maps that Brinton had planned to

use in his surgical history. Woodward and Otis compiled and edited them, observing "either a

chronological or geographical sequence in the arrangement of the documents, in order to

approximate a connected narrative.” (MSHWR, Med I, "Note by the editors")

Writing during a memorializing age when much of Washington was being filled with

statues of war heroes, Barnes hoped, "In carrying out the intentions of Congress, it has been my

earnest endeavor to make this Medical and Surgical History of the War, not only a contribution

to science, but an enduring monument to the self-sacrificing zeal and professional ability of the

Volunteer and Regular Medical Staff; and the unparalleled liberality of our Government, which

provided so amply for the care of its sick and wounded soldiers." (Barnes, Prefatory, MSHWR v.

1) It seems that his wish came true; in 1875, Congress authorized the printing of another five

thousand copies of the History, reserving four thousand for its own use and giving only one

thousand to the Surgeon General. (MSHWR, Surg I, 2nd ed., Memorandum, p. 2). This

distribution system was not the best. Dr. A. T. Bartlett, a contributor to the Museum, contacted

Otis for a copy of the History. Otis "referred him to his representative Mr. Morrison, but as he

apprehended, being a republican, his application was unsuccessful.” Otis recommended adding

32

him to the Surgeon General's distribution list. (Otis to Crane, June 5, 1876) Surprisingly, extra

copies of the second edition were still in stock in the Surgeon General's Library during World

War II. (Miles, p. 286)

The second Surgical book came out in 1876, six years after the first volume and eleven

years after the end of the war. The same year Woodward was promoted to full Surgeon, thirteen

years after being appointed Assistant Surgeon. (Woodward to Thomas M. Vincent, July 29,

1876) The rest of the History had been authorized by Congress in June, 1872, but Otis and his

staff were unable to complete the remaining 1800 pages in the two years for which they had

appropriations. Congress renewed their appropriation in June, 1875, with provisions made for a

second edition, which was printed at the same time as the first. Six presses ran for four weeks at

the Government Printing Office in early 1876 to print both editions. (Otis to Crane, February 26,

1876). Woodblock engravings, lithographs, chromolithographs (colored lithographs), and

woodburytype and heliotype photomechanical prints were all utilized to illustrate the book, as

they would be in the third surgical and second and third medical volumes. Continuing his survey

of war wounds by body area, Otis covered injuries of the abdomen, pelvis, back and upper

extremities (arms and hands) in this book. The amazing scope of the book can be seen from the

88,741 cases of wounds of the upper extremities reviewed, 817 of them in detail. (MSHWR,

Surg II, p. III)

When President Abraham Lincoln was assassinated, Museum doctors performed his

autopsy. Contributing to the knowledge of head wounds, Otis gave Lincoln a semi-anonymous

entry in the History:

Another case of alleged fracture by contre-coup of both

orbital plates of the frontal by the transmitted shock from

the perforation of the occipital by a pistol ball, has been

much commented on:

Case. --A. L-----, aged 56 years, was shot in the head,

at Washington, on the evening of April 14th, 1865, by a

large round ball, from a Derringer pistol, in the hands

of an assassin... (MSHWR, Surg I, p. 305-6)

Otis devoted over a full page of small type to Lincoln's injury and autopsy.

Woodward followed Otis by three years and put his second book out in 1879, "with much

labor and after serious interruptions" such as the Centennial Exposition. Woodward's lecture at

the fair revealed how he was able to do so many tasks:

The process [photomicroscopy] by which the photographs I am

about to exhibit were prepared, was, as most of you are

aware, brought to its present state of perfection by my own

original investigations. A complete misconception exists in

certain quarters as to the time I am able to devote to work

of this class. It has been simply my amusement -- my

relaxation from the daily routine and toil of the other

33

labors which I have outlined to you to-night. For years all

the work of this kind I have been able to accomplish has

been done on Sundays and holidays. (Woodward, 1876, p. 22)

The topic of diarrhea and dysentery had proven larger than he had expected in 1870. The

"alvine fluxes," as Woodward referred to them, took up the entire volume, forcing him to move

to a third book the rest of the diseases that affected the army. Woodward felt that the discussion

of the rest of the diseases, the camp fevers and scurvy among others, would not be discussed as

exhaustively as the fluxes which caused 1,739,735 illnesses with 44,558 deaths in the Union

Army alone. (Hemmeter, p. 640) Woodward's 314-page exploration of the pathology and

almost 200-page discussion of treatments, including local bloodletting, antimony, castor oil,

opium, alum, arsenic, and enemas, are a massive statement of medical knowledge at the time of

the war. (MSHWR, Surg II, p. iii-x)

Woodward labored, as had every physician before him, under the difficulty of not

knowing what caused disease:

Undoubtedly, the chief reason why our best preventive

measures fall so far short of our needs is because we have

so little exact knowledge of the causes of disease. I know

it is fashionable for certain sanitarians to talk flippantly

in public addresses, as if we knew all about these causes,

and I am often moved by scorn and pity at the complacency

with which they utter their platitudes.” (Woodward to

Bowditch, January 19, 1876)

When neither Woodward nor Otis survived to complete the final volumes in their series,

the Surgeon General was forced to find replacements for them. Upon Otis' death in 1881, his

third volume was finished by Dr. David L. Huntington, who replaced him as Curator of the

Museum. Another University of Pennsylvania graduate, he had served during the war with Grant

and Sherman. After the war, he served at various posts and was in charge of the Soldier's Home

in Washington from 1875 until 1880. (Kelly, p. 581) Huntington completed the volume, much of

which was probably already done, in 1883. Huntington said, "no change in, or deviation from, the

original plan has been attempted; that, so far as known, his [Otis] wishes and intentions with

regard to the arrangement and development of the History have been scrupulously regarded.”

Huntington was helped by the Museum's chief clerk, C.J. Meyers, who had been assisting on the

History since its beginning. As Otis had desired, the third book covered the lower extremities, the

legs and feet. Sections on bullets, operations and treatments, surgical tools, surgical diseases, and

anesthetics were included. The section on anesthetics contained the interesting conclusion that

ether and chloroform "were used in no less than eighty thousand (80,000) instances.” (MSHWR,

Surg III, p. 887) The book ended with a 'brief historical sketch of the Medical Staff' explaining

how the Army's system was modified for the war. The final part, with some of the engravings

dating from Circular 6, is a comprehensive overview of the large-scale evacuation of the

wounded that was first practiced during the Civil War. Huntington, echoing Barnes' wish of

thirteen years earlier, said, "It is hoped that its short-comings may not seriously impair or detract

34

from the beauty and harmony of the masterpiece, which must remain a living monument to the

intelligent industry, perseverance, and professional learning of the late Surgeon GEORGE A.

OTIS.” (MSHWR, Surg II, p. iii-iv)

Woodward died on Sunday, August 17, 1884, after a series of illnesses. He was

succeeded in his work by Dr. Charles Smart, another veteran of the war. Smart had not wanted

the assignment. "In July, 1883, the late Surgeon General CRANE expressed to me his desire that

I should undertake the Third Part of the work; and, in view of my reluctance to assume this

heavy responsibility, he gave me to understand that his wish in this instance was intended to

carry the weight of an order.” Crane imposed no conditions on the contents of the book except

that the plates that Woodward and Faber had begun working on so long ago were to be used.

Smart adhered to Woodward's original plan for the third volume published in 1888. He used

most of the volume to discuss fevers such as malaria, typhoid, typhus, measles, smallpox, scarlet

fever, yellow fever and mumps. All of these were considered the 'miasmatic fevers.' Miasmas

were thought to be emanations from the toxic ground that caused diseases. Smart continued the

historic error of grouping diseases by their clinical effect on the body as these diseases have little

in common. After the fevers, Smart looked at other diseases common to armies, such as scurvy,

consumption (tuberculosis), and pneumonia. A short chapter included perennial military

problems such as nostalgia (depression due to homesickness), army itch (an ill-defined skin

disease), alcoholism and venereal disease.5 The book closed with the valuable, and even then

historic, discussion of general hospitals that Woodward had worked on twenty-three years earlier

in Circular 6. This final volume brought to a close the Museum's main interest in the Civil War,

an ending underscored by the Museum's move into a new building near the Smithsonian Castle.

It is difficult to say how useful the History was. Some dismissed it as a "mere compilation

of other people's writings.” (Henry p. 89, quoting the Washington Sunday Herald, April 1, 1883)

But there was enough interest in the set to require a second edition even before the first had been

distributed. Although Woodward felt that more attention was paid to their work in Europe than

America, contemporary reviews of the volumes were favorable. The Philadelphia Medical Times

had a typical response, "We think that a just pride will be felt by the American medical

profession, and indeed by our countrymen generally, in these admirable volumes.” George

Shrady's editorial in the Medical Record concluded:

These documents illustrate the real medical history of the

war. They are most interesting and valuable historical

records, and indicate a high degree of intelligence, not

alone professional, but administrative, military, and

comprehensive. They show that the profession of the

country, whether trained in the army, in metropolitan

centres, or sparsely and recently settled districts, was

5 The rate for white troops was 8.2% versus 8.7% before the war. The rate for colored troops was considerably

lower at 3.38% for syphilis and 4.39% for gonorrhea. (MSHWR, Medical III, p. 891)

capable of grasping and dealing with the great emergency in

which the country found itself suddenly involved. They

35

breathe the purest spirit of humanity irrespective of

politics, and reveal a high degree of cultivation of both

mind and heart. They indicate a degree of medical culture

beyond what we are apt to acknowledge in our periodical

onslaughts on the medical colleges. More than this, they

display the acute practical common-sense of the American

mind which often rises to the level of genius. The war

developed first-class soldiers, and first-class military

surgeons, out of what, at first sight, and to a European,

would have seemed the most unpromising and even hopeless

material. (Curatorial Records: Notices of AMM publications)

Only two slightly critical reviews are preserved in the Museum (which did keep critical notices).

One British reviewer, possibly from The Lancet, thought "Dr. Otis criticises (sic) with some little

asperity certain statements made by Professor Longmore..." The North Western Medical and

Surgical Journal felt "both volumes are as handsome as they are valuable, except the bindings

which are only worthy of a cheap novel.” (Curatorial Records: Notices of AMM Publications)

Although Otis frequently referred to himself as the editor of his volumes, this simplistic

view does not acknowledge the massive amount of information digested and the great knowledge

that both Otis and Woodward brought to their task. Woodward and Otis were writing just at the

dawn of a great revolution in medical thought and can hardly be held accountable for not

foreseeing the basic tools and principles of modern medicine. No one could have predicted the

x-ray. Woodward certainly laid some of the foundations for pathology and histology in his work,

while Otis clearly showed that a conservative approach to surgery aided the patient. The careful

and extensive research that he and Otis did, reviewing literally everything written on a topic,

would never be equalled again and is certainly not possible now. The great pathologist Rudolf

Virchow said of the History:

Whoever takes up and reads the extensive publications of the

American medical staff will be constantly astonished at the

wealth of experience therein found. The greatest exactness

in detail, careful statistics even in the smallest matters,

and a scholarly statement embracing all sides of medical

experience are here united, in order to preserve and

transmit to contemporaries and posterity in the greatest

possible completeness, the knowledge purchased at so vast an

expense. (Henry p. 90)

William Gerry Morgan, president-elect of the American Medical Association, wrote in

1930 that the History "is still a valuable source of information for the physician whether in the

military service or in civil practice.” (Morgan, p. 781) Dr. John C. Hemmeter, author of Diseases

of the Intestines, surveyed Woodward's work on the second medical volume in 1923. Hemmeter

concedes that Woodward did not realize that bacteria caused dysentery and diarrhea, but points

out that neither did anyone else in the 204 years that passed between Leuwenhoeck's sight of

36

bacteria through a microscope and Woodward's publication of his work. Hemmeter continues,

"In America, it was largely due to Surgeon General Geo. Miller Sternberg (1838-1915) and to J.J.

Woodward that American medical schools were led to accept the great importance of

bacteriology as an absolutely necessary science for the understanding of diseases. ...J.J.

Woodward deserves the credit for his diligent and penetrating research into the bacteriological

literature of the world of his day, for the direct applications of this science to the causation and

treatment of intestinal diseases.” (Hemmeter, p. 639) Victor C. Vaughn, author of Epidemiology

and Public Health, wrote to Hemmeter, "I do not think that you can say anything too eulogistic of

Woodward. He certainly was far ahead of his time and the 'Medical and Surgical History of the

War of the Rebellion' is a monument to his learning and industry.” (Hemmeter, p. 643-4)

Certainly the philosophy of the History survived, even though its exact format -- a survey

of the entirety of medical literature and discussion of hundreds of individual soldier's cases --

became less possible and less necessary. The Surgeon General's Office produced the

fifteen-volume Medical Department of the United States Army in the World War. The Army's

Center for Military History produced the large series Medical Department U.S. Army World War

II and individual volumes on specific medical aspects of both the Korean and Vietnam wars. The

Textbook of Military Medicine series, currently being produced by the Surgeon General's Office,

mostly draws lessons from the Vietnam War, but displays its lineage by including information on

gunshot wounds abstracted from the History. The History, intended as a reference work and a

monument, succeeded as both and remains a unique history, even now that advances in medicine

and surgery have made much of its hard-won knowledge obsolete.

37

CHAPTER: Photography and other Medical Illustration

Medical illustration includes photographs, engravings, drawings, or paintings designed to

demonstrate facets of medicine. During wartime, weapons produced wounds generally unseen by

civilian practitioners; medical illustration could display the wound and show the methods used to

treat it. During the Civil War, medical art remained popular even though the recently-developed

medium of photography could produce a "truer" image. Daguerre invented photography in 1839

and by the time of the Civil War, it had become a useful tool instead of a curiosity. Yet it had

limitations. The best method, a collodion process which used silver nitrate suspended in

cellulose that had been dissolved in ether, could not tolerate motion or depict color. The heavy

glass plates that were used as negatives had to be individually sensitized with collodion just

before use, exposed for several seconds, and then immediately developed. Camera equipment

was bulky and expensive. Additionally, "early photographs of diseased organs proved

disappointing. Although photography could represent the relative sizes and shapes of

pathological specimens, the detail in the pictures was indecipherable. This was because

photography did not imitate the conventions which lithographers and engravers employed to

distinguish the textures and colors of pathological specimens -- cross hatching, for example. (Fox

& Lawrence, p. 24) Notwithstanding the difficulties with photography, its use for medical

subjects was becoming popular in the years prior to the war. (Burns) The Museum would use all

modes of medical illustration but began by employing artists.

Brinton, after being assigned his section of the History, gathered artists for his

staff in Washington. He had them enlisted as hospital stewards and assigned to duty in the

Surgeon General's office. Brinton recalled, "The supply of artists in Washington available for my

purposes was not very great. The only person I could at first lay my hands on was a German

artist, who had been on topographical duty in the War Department (his name was Pohlers),

excellent in his line, but not capable of drawing and coloring from the human figure.” Although

he did do some surgical drawings, Pohlers primarily worked on the maps which Brinton needed

for the first volume of the History. Brinton's major artist was Edward Stauch, "who had enlisted,

tempted by the bounty [money paid to volunteers], or to avoid the draft, and had immediately

been detailed on this special duty as water colorist at the Surgeon-General's Office." (Brinton, p.

231). Brinton thought highly of Stauch's work, if not of Stauch personally:

E. Stauch was a German water-colorist. His work was very

fine, and his coloring exquisite. He came to me in the

early part of 1863, or the end of 1862. He accompanied me

in several visits to the army in the field, and frequently

visited the hospitals with me, especially to make pictures

and sketches of the hospital gangrene cases, occurring in

our troops sent north and exchanged from the Southern

prisons. ... He was a most excellent artist, and when in a

good humor, or well satisfied, could, and would, work well,

and with tolerable rapidity. Like so many artists, however,

he was capricious and irritable, and when these fits were on

him, he could not be depended on. When I took him with me

38

to the army, I always took great care of his bed and food,

far more than I did of my own. I worked with him thus. I

first selected the patients to be pictured on the field or

in the hospital. Then the point of injury, say the wounds

of entrance, were carefully painted by Stauch in oil. Next

a pencil outline sketch was taken of the general locality.

This work he did with great rapidity, and then when he

reached Washington again, the beautiful pictures you will

see in the Surgical History were elaborated. (Brinton, p.

285-6)

Unfortunately, Stauch did not survive the war. He died on a trip home to Philadelphia after

successfully sketching wounds at the siege of Petersburg, Virginia. Brinton, who had gone to

Philadelphia to find Stauch, thought his illness "probably of some nervous type, the result of

exposure or of mental disturbance.” (Brinton, p. 287-8) Stauch's death left a hole in the

Museum's ability to produce medical illustrations, a hole both Brinton and Otis deplored. Otis,

crediting Stauch's work years after his death, wrote, "The gifted artist, Mr. STAUCH, whose

services, Surgeon Brinton had fortunately secured, after preparing many water-color drawings of

recent injuries, at the field hospitals, died from pernicious fever contracted before Petersburg,

without completing the exquisite studies of embolism, cranial abscess, false aneurism,

osteomyelitis, and gangrene, which he had drawn from dissections made at the Museum.”

(MSHWR, Surg I, p. xxviii)

Hermann Faber was the Museum's other main artist. Faber, a trained artist who emigrated

to America from Germany, has been described with his sons as "the founders of medical

illustration as a profession in this country.” He did many illustrations for the Museum, mostly for

Woodward's Medical History. After the war, he moved to Philadelphia and continued his career

as a medical illustrator along with two of his sons. (Ars Medica, p. 2-10) Faber also made a

pencil drawing of Lincoln's deathbed. He sketched the room in the Petersen house where the

President died immediately after the body was removed. Barnes, who was among the doctors

attending the dying president, approved the drawing for accuracy. Of the many artistic versions

of Lincoln's deathbed, Faber was the only artist actually drawing from the scene. (Henry, p.

44-5)

Stauch and Faber were the two main artists for the Museum, but others like Pohlers were

sometimes employed. Peter Baumgras joined the staff around March, 1865. (Otis to Blanchard

and Mohun, March 2, 1865) Baumgras seems to have been given Stauch's duties of drawing in

the field. On January 20, 1866, Otis asked Assistant Surgeon General Crane to send him to

Alexandria, Virginia. The curator's "object in sending Mr. Baumgras to Alexandria is to obtain a

drawing of Dr. Bentley's successful hip-joint amputation." (Otis to Crane, January 20, 1866)

Baumgras also travelled to a New Jersey hospital to illustrate Eben Smith's case of amputation at

the hip for Otis.1 Louis Bagger noted Faber's earlier illustration of Smith when visiting the

Museum:

1 An unidentified artists' drawing was photographed and published as Surgical Photograph #29. Baumgras'

drawing, showing Smith with a cigar, has never been published.

39

There is on the wall, in the northwest corner of the room, a

small gallery of watercolor paintings, mounted in frames,

which illustrate peculiarly dangerous and difficult surgical

operations that have been performed successfully. Among

these is one, the picture of a young man, a mere boy of

eighteen or nineteen, resting on a couch after amputation at

the hip-joint. It is a beautiful face, almost perfect in

its contour, with hazel eyes, and long, wavy, brown hair;

but there is such an expression in the eyes and features as

tells -- oh, what a tale! -- of suffering, long and

patiently borne. The left arm is placed under the head,

while the fingers of the right clasp the palm-leaf fan with

which the patient has been seeking to impart coolness to his

fevered cheeks. That pale, youthful face, with the large

brown eyes, sank deep into my memory; only one other face

have I seen, a painting, also, that possessed for me the

same fascination -- that of Guido's "Beatrice Cenci.”

(Bagger, p. 296)

William Schultze was on duty in Baltimore when Otis heard he was a 'competent

draughtsman and colorist' and requested his transfer to the Museum in September, 1865. (Otis to

Crane, September 13, 1865)

Artwork was sometimes donated to the Museum. Dr. Daniel S. Young, Surgeon of the

21st Ohio Volunteers, sent in copies of artwork that he had sketched of some of his patients.

These 32 pieces were in pencil with pastel colors. Young had intended to produce his own

medical history of the war. Several chapters illustrated with his work were published in the

Cincinnati Journal of Medicine in 1866 and he had advertised Field Observations in Surgery

with forty lithographic plates. Upon hearing about the Surgeon General's major effort, Young

decided to donate his work instead. Otis wrote to Young upon receipt of the sketches, saying,

"The value of the histories of these cases is greatly diminished by the omission of the names and

military designations of the patients. It is impossible to decide whether or not the cases are

already recorded on the registers of this office. Is it not practicable for you to supply this

deficiency?” (Otis to Young, April 16, 1866) Otis returned to the need to identify the patients in

June of 1866, inquiring, "Can you supply the names of these patients?, if so, they will be of much

value in completing the histories of these cases.” (Otis to Young, June 15, 1866). Young

probably did not know the names of the wounded men and did not provide Otis with the

information. A few other donations of artwork were listed in the Surgical Catalogue, but far more

photographs were given to the Museum.

Documentary, portrait, clinical (patients displaying their medical problem), gross

(removed pathological specimens), and microscopic photographs were all used by the Museum.

Several large photographic collections were created during or soon after the war,

including the Contributed, Surgical, Medical, Microscopical and Anatomical, which loosely

paralleled the arrangement of the Museum. Staff photographers were kept constantly employed.

40

Their work was distributed as photographs and also engraved for publications.

Brinton began the photographic work that became such an important part of the Museum.

In early 1863, he was requesting photographs be taken for the Museum. He wrote to Thomas

McParlin, "[The Surgeon General] directs that Photograph representations be taken of all cases of

interest to accompany this report [on hospital gangrene.] The expenses of such photography

will be defrayed out of the sum arising from the sale of rags, etc., etc., as reported on hand by you

in a previous communication.” (Brinton to T.A. McParlin, February 9, 1863) Brinton claimed

that the Museum had a "full photographic outfit" around January, 1863, (Brinton, p. 188) but Otis

continued to purchase the things necessary to set up a good photographic studio. In July, 1865, he

reported to the Surgeon General, "About the same period [in November 1864] a commodious

photograph gallery was erected in the yard of the Museum by the Quartermaster's department,

and supplied with water, baths, screens, shelving, etc. A few articles of furniture were procured

from the Medical Purveyor. A sufficient amount of apparatus of high order of excellence, as is

believed, was purchased from the Museum fund at a cost of about $1200.00." (Lamb, p. 35) All

of the equipment and supplies were ordered from major New York and Philadelphia suppliers.

Wilson & Hood, James A. Queen & Co. and John H. Simmons of Philadelphia, and E. & H.T.

Anthony & Co. and Holmes, Booth & Haydens of New York received orders from the Museum

in the 1860's. Otis also ordered directly from J.H. Dallmeyer of London, purchasing "a pair of

[carte-de-visite] tubes with the camera so arranged as to take four pictures by means of a

repeating back.” (Otis to Dallmeyer, September 5, 1866) Wilson & Hood supplied a 'posing

chair' requested by Museum photographer William Bell in June, 1865, perhaps the same one that

appears in so many of the Museum's photographs. (Otis to Wilson & Hood, June 13, 1865)

Otis also was willing to purchase books and journals on photography. On June 5, 1866,

he ordered from Wilson & Hood a subscription to the British Journal of Photography, beginning

from the past January. A subscription to the Philadelphia Photographer as well as Photographic

Mosaics and Newman's Manual of Harmonious Coloring were ordered from Benerman &

Wilson of Philadelphia on January 27, 1865. He asked Lippincott & Co. to procure Towler's

Silver Sunbeam 4th ed., Hardwick's Photographic Chemistry, Towler's American Photographic

Almanac 1864 and 1865, M.A. Root's The Camera and the Pencil, and Photographic News. (Otis

to Washburne, October 25, 1865)

A description of the Museum's studio behind the Corcoran school house building was

published in the Philadelphia Photographer in 1866:

A nicely arranged and convenient atelier adjoins the Museum,

and all the conveniences of a well-regulated, first-rate

gallery are there... [T]he principal work of the

photographer is to photograph shattered bones, broken

skulls, and living subjects, before and after surgical

operations have been performed on them. Of course, all

these subjects were created by the war. In most cases the

fatal ball is plainly visible in the bone that it had caused

to be shattered and broken.... These bones are photographed

principally to aid the engraver in making wood-cuts for the

illustrations of works upon army surgery. We were shown

41

some photographs of the wounded, before and after operations

had been performed on them, and certainly photography is the

only medium by which surgery could so plainly make known its

handiwork. We saw a picture of one poor fellow as he came

from the field, with his face almost torn asunder by a

shell. After surgery had exercised its skill upon him, he

was again photographed, and looked much better than any one

could be expected to look with his lower jaw gone. (quoted

in Keith, p. 160)

The studio was vacated soon after the description appeared when the Museum moved to Ford's

Theatre. Notwithstanding the kind description of the gallery, Bell was probably glad to move. A

burglary of $496 worth of equipment including a Voightlander portrait combination lens, two

carte-de-visite lenses and a card camera box occurred on March 20, 1866. No real precautions

were taken before the theft, Woodhull wrote because, "The building itself is so slight in

construction that the only adequate protection would be a watchman [who would have to be

detailed from the Museum's daytime staff]. Either lock could be readily removed, a door broken

down, or with little labor or risk a section of the floor might be cut out.” (Woodhull to Otis,

March 22, 1866) Later that year, on the night of Monday, September 24, a fire broke out,

apparently from "a wooden box of ashes of waste silvered albumen paper, of rags, sticks, etc, of

all waste in short supposed to contain any residue of salts of silver, on the floor at the northwest

corner of the room, at the locality at which the fire originated.... The fire was discovered a little

after eleven o'clock. A negro woman living in the house adjacent to the grounds of the Museum

gave the alarm. She testifies that she knocked at the door of the Museum for five minutes before

the watchman came and that he was then partially undressed and appeared to be very sleepy.” In

spite of continuing problems such as a lack of water buckets, the fire was put out without any

damage to equipment. (Otis to Barnes, September 28, 1866)

The Museum moved to Ford's Theatre in November and December 1866 after Lincoln's

assassination when Ford could no longer attract an audience. Ford's Theatre also housed the

Surgeon General's Library2 and the Records & Pensions Division which worked closely with the

Interior Department's Bureau of Pensions. (Lamb, p. 41) The pension records were used by Otis

and his staff to compile the Medical and Surgical History, and sharing the same building meant

other opportunities as well. Ex-soldiers needing information from the Army for their pension

request came to the building where Museum doctors asked them to have their photograph taken.

In the first Surgical volume of the History, Otis acknowledged, "The numerous survivors of

grave wounds and mutilations who have visited Washington to prosecute their pension claims, or

to solicit places under Government, or to obtain orders for artificial limbs, generally visit the

Army Medical Museum, and the writer has thus had the opportunity of personally examining

such cases, and of preparing six quarto volumes of photographs of the more remarkable

examples. The Museum also possesses fourteen quarto volumes of contributed photographs, and

2Now the National Library of Medicine located on the National Institutes of Health campus in Bethesda,

Maryland, just outside of Washington.

42

a vast number of card-size pictures, indexed and classified, but not bound.” (MSHWR, Surg I, p.

xiix-xix)

Museum photographers primarily photographed specimens and sick and wounded

soldiers for use in Museum publications. The photographers commonly enlisted for a three year

term in the Army, much like the artists had done, and were assigned to the Museum as hospital

stewards. The standard size of negatives used at the Museum was 10 x 12" and Otis preferred to

buy 20 x 24" glass plates which could be cut in half without any excess. (Otis to John H.

Simmons, September 19, 1865) The negatives were extremely heavy, being made with 1/4"

thick glass. These had to be individually sensitized with collodion and silver salts, then exposed

while still wet and developed. Many of them have clear areas in the corners where the

photographer held the plate while spreading the developing solution. Years later, George G.

Rockwood, a Civil War photographer, described the difficult process of making a negative in the

field, which was similar to the studio work:

First, all the plain glass plates in various sizes, usually

8 x 10, had to be carefully cleaned and carried in dust-

proof boxes. When ready for action, the plate was carefully

coated with 'collodion' which carried in solution the

'excitants' -- bromide and iodide of potassium, or ammonia,

or cadmium. Collodion is made by the solution of gun-cotton

in about equal parts of sulphuric (sic) ether and 95-proof

alcohol. The salts above mentioned are then added, making

the collodion a vehicle for obtaining the sensitive surface

on the glass plate. The coating of plates was a delicate

operation even in the ordinary well-organized studio. After

coating the plate with collodion and letting the ether and

alcohol evaporate to just the right degree of 'stickiness,'

it was lowered carefully into a deep 'bath holder' which

contained a solution of nitrate of silver about 60 degrees

for quick field work. This operation created the sensitive

condition of the plate, and had to be done in total darkness

except subdued yellow light. When properly coated (from

three to five minutes) the plate was put into a 'slide' or

'holder' and exposed to the action of the light in the

camera. When exposed, it was returned to the darkroom and

developed. (Horan, p. 41)

After a negative was made, it could be printed onto albumen paper by exposure to sunlight.

Brinton had Hospital Steward Wills assigned to do the Museum's photography. With the

essentially free (to the Museum) labor of the stewards and the apparently simple nature of

photography, Brinton was able to tell J.S. Bereher of Harrisburg, Pennsylvania's Barnete &

Weldon that "no photographic artist is required at this office" at the same time he was looking for

a replacement for Stauch. (Brinton to Bereher, September 19, 1864) Hospital Steward Wills was

assisted by Private Real Bradley of the 2nd Battalion Veteran Reserve Corps of unassigned men.

43

Bradley was recommended to Otis as a 'practical photographer.' (Otis to Barnes, October 8,

1864) Otis seems to have assigned more value to the position of 'photographic artist' than

Brinton did. Most of the Army Medical Museum's early photographic work was done by William

Bell in the Museum's studios. Bell joined the Museum staff, reenlisting in the Army as a hospital

steward, on February 22, 1865.3 A professional photographer in civilian life, Bell replaced

Wills as the main photographer in the Museum while Wills stayed as his assistant. (Lamb, 33,

35) Bell, a Philadelphian, might have been recommended to Otis by Constant Guillion, the

president of the Philadelphia Photographic Society.4 Otis had written to Guillion, requesting

advice on the purchase of camera equipment as Otis felt much of the equipment he purchased

was defective. (Otis to Guillion, December 13, 1864) Otis undoubtedly needed Bell; two weeks

earlier, Otis had had to turn to L. W. Walker, the Treasury Department photographer, to test a

camera that he had ordered for $182.00. (Otis to Holmes, Booth and Haydens, February 9, 1865)

Bell, born in Liverpool, England, was described as being 5' 7 1/2" tall with a ruddy

complexion, blue eyes and brown hair on his discharge in 1868. He had served in the Mexican

War with the 6th Louisiana Regiment, U.S. Volunteers. After the war, he moved to Philadelphia

and worked as a daguerreotypist. In 1862, he again enlisted in the Army, this time in the 1st

Pennsylvania Volunteers, fighting at Antietam and Gettysburg.

Other hospital stewards were assigned to assist Bell in the photograph gallery. G.O.

Brown joined the staff on November 2, 1865. (Lamb, p. 37) In March 1866, Thomas Heavers

worked in the gallery at laborious duties which precluded him being a night watchman.

(Woodhull to Otis, March 22, 1966) Frank Langley resumed his duties under Bell on March 30,

1866. (Otis to Langley, March 30, 1866)

3 Although Brinton says in his biography, "In the latter part of the summer [or 1864], a photographic bureau was

added to the Museum, and I had to see to engaging the proper artists and outfit. I succeeded after much trouble in

procuring an excellent artist, named Bell...” p. 284.

4 Unfortunately letters arriving in the Museum have been missing since at least 1917. Lamb labored under the

same difficulty in producing his History. Lamb p. 144.

In addition to photographing specimens and wounded veterans who visited the Museum,

Bell did other photographic work, little of which has been credited to him. Bell, and later Ward,

took dozens of portraits of notable Washington personalities and visitors. Bell photographed

General Seth Williams at the Medical Museum. Otis recalled, "The picture was taken at the

Army Medical Museum, and a few prints were prepared, after which the negative was sent to

Brady, from whom a number of General Williams' friends have procured copies of the

photograph. The negative is still in the keeping of Mr. M.P. Brady, (Brady & Co) 352 Penna

Avenue, Washington, D.C.” (Otis to George E. Hastings, June 15, 1866) The negative, taken

with a carte de visite camera, actually had four images of Williams on the plate. Broken in half,

one section remains in the Medical Museum while the other is in the National Archives credited

to Brady. In 1865, Bell and Dr. Reed Bontecou, a proponent of medical photography, roamed

Virginia battlefields taking photographs including stereographs of the Wilderness battlefield. One

hundred and twenty-one negatives of the Wilderness were taken, although 21 were missing by

1874; they had not been printed since Bell's departure from the Museum in 1868. (Otis to Keen,

March 8, 1879; Otis to Bontecou, October 8, 1866; Parker to Otis, February 9, 1874, none are

44

still in the Museum) Bell took stereograph negatives of the Spotsylvania battlefield. Otis wrote to

Billings in 1873:

I send you thirty nine (39) of the stereo prints made by

Bell in the Spotsylvania region which are all that are on

hand. There are about sixty (60) other negatives and I have

directed Parker [the Museum clerk] to have duplicate prints

made from them, when the printer can find time and these you

can use for exchange. It will be necessary to have a new

set of labels printed as the supply of the old and very

incorrect ones prepared by Bell is exhausted.” (Otis to

Billings, December 16, 1873)

The Museum also printed 1,500 carte-de-visite photographs of three of Lincoln's

assassins, John Wilkes Booth, David Herold, and John Surratt, to be mounted on a reward poster

in April 1865. (Henry, p. 46-8) Bell copied drawings for General Rucker, perhaps of the

ambulance Rucker designed, and was told to "also print, and send to General Rucker one copy of

the large picture of the Hon. Secretary of War," implying that the Museum, like the Brady studio,

took portraits. (Otis to Bell, July 2, 1866) Bell also took pictures for Quartermaster General

Montgomery Meigs, a noted amateur photographer and connoisseur. Otis wrote to Meigs, "I am

instructed by the Surgeon General to send you, with his compliments, the accompanying

photograph which was recently taken by Mr. Bell of the Army Medical Museum with a

six-and-a-half inch Dallmeyer triplet lens. It is thought to be a good representation of one of the

most celebrated monuments of your service as an engineer.” (Otis to Meigs, September 25, 1866)

Meigs, called "the medium's most important official patron during the war," ordered the taking

of many photographs for his department during the war. (Davis, p. 162-165). The subject of the

photograph is almost certainly the U.S. Capitol building, which Bell and Treasury Department

photographer L.W. Walker photographed on September 12. The photograph was published in

July 1867's Philadelphia Photographer. (Pitts, p. 26-7) Meigs may have been familiar with

Bell's work earlier as Otis had sent him a portfolio of photographs from the Museum in June,

1865 (Otis to Meigs, June 24, 1865) Bell also did small jobs for other government agencies such

as photographing crania for the Smithsonian Institution. (Otis to Gill, January 11, 1866)

When his second term of enlistment lapsed on February 22, 1868, Bell returned to

Philadelphia and opened the Bell & Silver photographic studio. He continued working for the

Museum, writing to Otis on May 28, 1868, soon after leaving the Museum, "I express today to

the Army Medical Museum, Negatives and Prints of 'Durkins' Case... the Quality of the

Negatives and Prints will I feel assured equal any done while under your Orders in Washington."5

In an undated letter to Otis, Bell said "While there [at the Philadelphia Pennsylvania Hospital]

endeavored to see if there was anything that would be of value to the Museum but saw nothing...”

5 The picture was published as Surgical Photograph #194. Otis' text for the photograph claims that Durkins

visited the Museum to have his picture taken. This seems unlikely in light of the ornate mirror and rug in the

picture.

45

(Both letters; AMM correspondence: photography) Bell continued working for the Army and

went with Lieutenant Wheeler's expedition to the West in 1872. He returned to Philadelphia in

1875 and was the photographer for the Pennsylvania Railroad until once again joining an official

expedition, this one to Patagonia in 1882 to photograph "The Transit of Venus" across the face of

the sun. Bell did early work in designing a dry plate negative, making photography far easier,

safer and cheaper. He died in Philadelphia in January, 1910. (Bell collection)

Bell was replaced in the Museum by E.J. Ward although a "Mr. Rice" had taken at least

two photographs in the Museum in April 1871. (Curatorial Records: AMM Collection Logbooks,

Box 18, MM 8800, p. 7) Ward, "a photographer of Washington" had accompanied Curtis on a

scientific expedition in the summer of 1869 and may have been hired based on that experience.

(Curtis, p. 123) Ward, like Bell, experimented with using dry plates which did not needing

coating with collodion immediately prior to use. Ward worked with the technique in 1876 when

it was first publicized in England. Woodward want to use it for his photomicroscopical work, but

apparently Ward could not make it work. (Woodward to Col. H. Stuart Wortley, January 31,

1876)

Ward photographed Museum specimens and visiting patients throughout the 1870s. Henri

Rouseau, a former French marine, was photographed by Ward. "On the morning of September

29, 1874, when Dr. Otis was on his way to the office, he saw him singing in front of a beer

saloon, and he sent a messenger out for him and had his photograph taken, gave him two dollars

for his trouble.” (MM 8800, SP 351) Ward was a prolific photographer. He shot 255 specimens

with 229 prints made in November 1873. Four months later in April 1874, he made 253

specimen photographs, two Surgical Photographs, five prints on wood and 558 albumen prints.

(Parker to Otis, December 1, 1873; Parker to Otis, April 30, 1874)

As a result of the abilities of Bell and Ward, many of the Museum's photographs, even as

the patient displays his horrific wound, look similar to Matthew Brady's portraiture; this is

perhaps not surprising since some of Bell's photographs have been attributed to Brady. While the

photographs were made for scientific study, as professional photographers, Bell and Ward used

the styles and conventions they were familiar with. (Nordstrom, p. 6) An example of the portrait

style can be seen in Major General Barnum's pose (SP 93, see fig ). At the same sitting, a true

portrait of Barnum was taken. (Woodward 3881B) The photographs look very similar, as "when

picturing the sick, the earliest photographers employed the conventions used in making ordinary

portraits.” The photograph from Barnum's pension file (see fig) shows how odd early clinical

photographs could look when taken by a photographer who did not use the same portrait

conventions as the Museum photographers. This photographer seemed to view Barnum as a

freak. (Fox & Lawrence, p. 5-13, 25) Other conventions of the time are disturbing now; Otis

published a photograph of Jesse Smith (SP 185), a sixteen-year old African-American cattle

drover, with a removed fragment from his skull, as a mounted Museum specimen, balanced on

his head. Smith's pose contrasts strongly with Julius Fabry's dignified pose, (SP 276) his removed

femur resting on a table alongside his chair. Fabry's reamputation at the hip (a second amputation

was performed when the bone became infected due to the first one) was a difficult operation with

only nine previous successes, and one that Otis appeared proud of accomplishing successfully.

Otis took so much interest in the four surviving pensioners still alive in 1875 that he asked Dr.

Crane "if it would be proper for me to prepare a statement of the facts in the cases of these four

(or five) pensioners, on which the Surgeon General might predicate a special recommendation in

46

their behalf, or if there is any other suitable mode in which I could promote their wishes.” (Otis

to Crane, ...., 1875)

By far the most common photograph taken by the Museum were of specimens in a

carte-de-visite size. This popular French size for photographs swept America just prior to the

war. Matching the size of the engravings to be made for the History, Museum photographers took

thousands of these pictures. The "Card Photos" were mounted in large albums, arranged by

section of the body, in the Museum.

The "Contributed Photographs" collection, as it came to be known, consisted of

photographs donated or contributed to the Museum. Photographs arriving during and after the

war were usually added to the Surgical Section and numbered like the bones were. Many

photographs were sent by doctors who wished to see their cases included in the History. Doctors

such as Reed Bontecou of Harewood Hospital in Washington, J.C. McKee of Lincoln General

Hospital in Washington (who also provided surplus photographic equipment after the Museum's

burglary), and J.H. Armsby of Ira Harris General Hospital in Albany, New York, contributed

dozens of photographs at the end of the war. They received photographs from the Museum in

exchange. Most of the photographs given to the Museum were albumen prints, but infrequently a

tintype (a photograph printed on thin metal) was donated. (Otis to Lyster, May 11, 1866)

Tintypes were never as popular as other photographs. (Welling, p. 117) Their dark background

made medical subjects harder to see and reproduce in print.

Otis frequently wrote to surgeons requesting a photograph of a specific case which he

would then have engraved for the History. He also wrote to patients asking them to have their

wound photographed. Otis wrote to Charles Lapham, who had been with Co. K of the 1st

Vermont Cavalry:

The interesting report of your case, which is recorded

in this office, leads me to desire to possess if possible, a

photograph which shall farther illustrate it. The Surgeon

General possesses photographs of a number of the very rare

cases in which patients have survived after the very grave

mutilation of the removal of both thighs, and has instructed

me to request you to have a photograph prepared, the expense

to be defrayed by this office.

It would be well to have two pictures taken: one

representing the stumps, the other the appearance with

artificial limbs attached.

The photographer might take two or three prints of each

to be retained by you, and then should forward the

negatives, carefully packed to this office, by express,

enclosing at the same time the bill for his services.

I enclose copies of a photograph of the size desired.

(Otis to Lapham, May 25, 1865)

Lapham had the work done and two photographs were added to the collection.

Otis commissioned physicians such as E.D. Hudson of New York City to take

47

photographs for him. Writing to Hudson, Otis said "I am anxious to obtain photographs of double

amputations of the thigh or leg and of other cases of unusual interest, and am willing to pay for

such. I hereby authorize you to have photographs taken of cases of especial interest. As near as

may be they should be uniform in size with those taken at the Army Medical Museum, of some

of which you have copies.” In the same letter, Otis sent a list of soldiers who had survived the

operation of the excision of their humerus. Hudson, a maker of prosthetics, undoubtedly

appreciated Otis' fulfilling his request for the names. Otis and Hudson's arrangements to look out

for each others interests, resulted in striking photographs such as the two of Columbus Rush, a

young Confederate from Georgia who lost both legs. (Otis to Hudson, February 7, 1866) Otis and

Hudson cooperated so closely that Hudson was able to display his prosthetics in the Medical

Department's exhibit at the Centennial fair. (Otis to Hudson, March 8, 1876)

For many years, these photographs received a Surgical Section number and were bound in

volumes labeled Photographs of Surgical Cases. (Otis to Washburne, April 4, 1866) The

photographs donated to the Museum were often rephototographed to be included in the Surgical

Photograph series. Roland Ward's plastic surgery after the destruction of his lower jaw (SP

167-170, 186) is an example. Columbus Rush's photograph, in which he demonstrates his

Hudson-made artificial legs, was copied and sent out as part of the series. Otis also purchased

photographs from studios, buying "two dozen of the war views for the Museum" from E. & H.T.

Anthony & Co. (Otis to Anthony, September 25, 1865)

Contributors of photographs like Hudson also used the pictures themselves. Dr. Gurdon

Buck is particularly noteworthy for his use of photographs. He had engravings made of "before

and after" photographs for his 1876 text on plastic surgery, Contributions to Reparative Surgery.

In the engravings, Buck used drawn lines to explain his operation. Buck deposited a set of his

photographs in the Army Medical Museum soon after the end of the war. (Rogers)

About 1876, as photographs of many sizes and from many people continued to arrive, the

collection was removed from the Surgical Section and named the Contributed Photographs. Otis

no longer had the photographs bound in albums. All of the photographs were renumbered from

the beginning in red ink with the identifying "Cont. Photo." or the initials "C.P."6 Some of the

best photographs were copied in the Museum and published as part of the Surgical Photograph

series. Others were engraved for the History. Some photographs almost certainly taken by the

Museum such as the one of Neil Wicks, probably by Bell,7 were added to the collection after the

original negatives disappeared. Unfortunately, many photographs were given away by Daniel

Lamb in 1915 including scores to Reed Bontecou's son.

6 These abbreviations never stood for "contract photograph" as has been surmised by earlier authors.

7 The photograph is listed in a logbook of Museum stereographs (MM 8797), p. 20, Curatorial Records: AMM

Collection Logbooks, Box 18.

48

Otis had 8 x 10" photographs taken of interesting surgical cases or specimens throughout

his tenure at the Museum. There were 400 Surgical Photographs8 published in eight volumes

between 1865 and 1882. They were also known as the Photographic Series, especially in

contemporary Museum correspondence, but as more series were created this term proved

inadequate. Most of these photographs were taken at the Army Medical Museum in the 1860s

and 1870s to illustrate interesting surgical operations or difficulties. Bell took approximately the

first 200 and Ward the remainder. The photographs usually show either a damaged bone or a

soldier showing his wound. As the war receded into the past, the pictures began including

civilians and women. The very last pictures are long-term follow-ups of specimens from two

soldiers eighteen and twelve years after they were wounded during the war. Following a patient

over the course of years is common now, but was rarely done before the Civil War. The

continuing publication of the pictures seventeen years after the war ended shows that they were

still useful. Some of the photographs were engraved to illustrate cases in the Medical and

Surgical History. Some were distributed individually when requested. A small catalogue, Army

Medical Museum Photographic Series, listing 109 photographs, was published in 1865. The

photographs were also bound in volumes of 50 to make an eight-volume set titled Photographs

of Surgical Cases and Specimens. The first volume of 50 photographs was printed in an edition

of 40 sets which were distributed to Medical Directors in the Union Army. (Lamb, p. 35) Otis

"hoped, that by distributing to Department and Army Headquarters, a series of illustrations of the

choicest specimens of the Museum, that the collection may be made more generally useful to

medical officers, and that their interest in it will be augmented - that they will see what has

already been effected, principally by their zeal and what yet remains to be supplied by their

exertions.” (Otis to Sloan, March 18, 1865). The first two volumes in the series were ready to be

sent to the Universal Exposition at Paris of 1867 by the end of the year. (Otis to J.C. Derby,

December 13, 1865) By January 1869, volumes one through four, containing photographs 1

through 200, were being made available to interested parties, including the College of Physicians

of Philadelphia and the Royal College of Surgeons in Dublin, Ireland (Lamb, p. 52; Curatorial

Records: AMM Collection Logbooks, Box 19, MM8795).

8 Although a logbook compiled by Lamb lists a number 401, a shot wound of Johnson's face. Another logbook

lists the photograph of John C. Johnston as SP 377, taken at the Museum on May 26, 1884 by Mr. C. Trought. SP

377 was published as a photograph of Private Francis Ahearn. Curatorial Records: AMM Collection Logbooks,

Box 18, MM 8646, p. 213; MM 8800 377 entry.

In 1871, the first five volumes were formally published as Photographs of Surgical Cases

and Specimens taken at the Army Medical Museum. A separate companion volume "Histories of

296 surgical photographs prepared at the Army Medical Museum, 1866-1871" was published as

well. (Lamb, p. 61) Volume six was ready for the Centennial in 1876. The final volume had

apparently been published by late 1882 to complete the set, with the photographs after number

375 selected by Huntington. At the end of the series, Huntington included five photographs (SP

385-389) of President Garfield's spine. Garfield had been shot by Charles Guiteau, a disgruntled

office-seeker, on July 2, 1881. The President survived in pain at the New Jersey shore until

September 19th. He was attended by Barnes and Woodward among others. Garfield was never

properly treated for his wound because his doctors, lacking x-ray technology, could not find the

49

bullet. Only months after the President died, Huntington published photographs of his vertebrae

showing the bullet's actual location, which probably helped to settle some of the controversy

surrounding Garfield's treatment. One also wonders if the Museum included five prints, more

than almost any other case, due to the celebrity of the patient and the notoriety of the

assassination. After his hanging, Guiteau's skeleton joined the President's vertebrae at the

Museum.

Garfield was not the first famous politician to have a Surgical Photograph taken. An

image of General Daniel Sickles's shattered tibia and fibula was published years earlier. Sickles,

renowned and notorious for his actions at Gettysburg, had presented his amputated leg to the

Museum and frequently brought visitors to see it. With the publication of the photograph in

1864, the flamboyant Sickles could have had a wider audience for his heroism, much to his

satisfaction, one would suppose. Sickles also sat for a portrait, conspicuously not showing his

stump. Selections of Surgical Photographs were also bound as Photographs of Cases of

Consolidated Gunshot Fractures of the Femur by George Otis.9 This version was exhibited at

the 1876 Centennial Exhibition and includes a listing of the 59 photographs in a table of

contents. All of the cases were successful cases of excision or resection surgery as opposed to

amputation. Only two copies of are still extant, and since it is not mentioned in Woodward's list

of Otis's publications, it must have had a very small circulation.

Glass negatives are of course fragile; in some photographs with the same number, the

pose is varied or completely different, presumably printed from a different negative when the

first glass plate was broken. Similarly, on some soldiers, fig leaves have been discreetly placed to

cover their genitals. This seems to have been done for the Centennial Exhibition when the

pictures would be available to anyone at the fair to examine. "A full set of the publications of the

Surgeon General's Office" was sent by Woodward for the Exhibition. (Woodward to Lyford,

August 2, 1875) The work was probably done the previous summer:

I have the honor to report that many of the negatives

of the Surgical Photograph Series, prepared during the past

ten years, have become damaged, either by cracking of the

films through age, or by scratches or defacements from

careless handling. The prints, in many cases, are

consequently such as I dislike to issue as work of the

office.

Unhappily this observation applies especially to the

photographs of consolidated shot fractures of the femur,

many of which were originally bad, being enlargements from

card pictures, many of them prepared at hospitals or country

towns by amateurs inexpert in their art.

It is the opinion of Mr. Ward, that most of the defects

may be obviated by retouching the negatives. There are over

9 The photographs are SP 45, 46, 47, 48, 49, 50, 55, 64, 67, 68, 69, 71, 72, 73, 76, 83, 84, 85, 89, 90, 91, 92,

106, 107, 111, 114, 115, 116, 117, 118, 119, 128, 129, 130, 131, 139, 140, 141, 142, 151, 152, 153, 156, 157, 158,

161, 178, 179, 187, 194, 235, 236, 246, 265, 266, 273, 296, 302, 308. SP 64 is placed out of order behind SP 76.

50

two hundred of the regular series that require this. Mr.

Miller, an expert in this business, some of whose work you

have seen from time to time, offered to restore the whole

series for two hundred dollars ($200.00). With the

additional negatives requiring repair, it is estimated that

the work can be done for two hundred and fifty dollars

($250.00). All along I have had repairs made by some of the

clerks who have facility in using water-colors, but it seems

best now to have a thorough restoration and revision of the

whole series. I think the cost will be amply repaid by the

contributions to the Library that Dr. Billings can obtain in

exchange for the Photographs.

For several years, I have had comparatively few prints

prepared. Now the photograph room has been thoroughly

repaired. The negatives have been cleaned, classified and

rearranged, and everything is so systematized, that the work

can be pushed on expeditiously and economically. I hope

therefore that you will approve of the necessary outlay to

put the negatives in order. (Otis to Barnes, July 15,

1875).

The letter was endorsed "Approved by order of the Surgeon General.” Otis had done something

similar years earlier; he had a lithographer cover the soldier's genitals when a plate for the

History was being made. (Otis to Rosenthal, January 11, 1867) A very few soldiers, like Jonathan

Wallace, are actually wearing a real leaves in the pictures; most appear resigned to their nudity.

The mounts also were changed and labelled "International Exposition Philadelphia, 1876.”

Some earlier users of these photographs have been confused by the fact that individual

photographs were distributed and frequently bound in albums with other photographs or in the

wrong order. It is worth noting that the collection does consist of a fixed number of 400

photographs. The photographs run consecutively and are always of the same individual, although

the pose or view might vary if a negative was broken and replaced by a new one.

Otis wrote 375 labels for the Surgical Photographs and Huntington completed the last 25.

Otis's labels on the reverse of the photographs are packed with information. The number of the

photograph was usually on both the mount and the label. Early printings listed the number as

Photographic Series, but as has been noted, this is the same as the Surgical Photograph number.

Each picture was given a title that concisely summed up the information to follow. These titles

were frequently printed in order and bound in the front of the volume to aid the user in finding

cases of interest such as amputations. After the title, the patient was identified, usually by

name, rank, company, regiment and state. Modern notions of privacy due in clinical situations

had not yet become established, although some soldiers were only identified by initials. The

particulars of the case, including the battle the soldier fell in, were summarized with proper credit

given to the doctors concerned in the case. The Museum's Surgical Section number was

mentioned if a specimen from the case ever arrived in the Museum. A History citation was given

if it was available. Since the photographs were usually taken years before the case was written

51

for the History, frequently there is no cross-reference.

Many other photographs were taken at the Museum in the years following the Civil War,

but these do not show men with their wounds. Instead they are of pathological material, much

like the Surgical Photographs of bones. A small run of Medical Series photographs, consisting of

pictures of colons removed from dead soldiers, were made for Woodward's research. These were

probably first taken by Bell, with some definitely done by Ward. The pictures are of colons

suspended in glass jars full of preserving alcohol. Woodward used the photographs in his second

volume of the History on the "alvine fluxes" or dysentery and diarrhea where they were

photomechanically reproduced as woodburytypes or heliotypes. Each photograph had a printed

label on the reverse giving information about the soldier's illness and describing the pathology.

He also distributed individual copies when requested and collected a small volume of them as

Camp Fever and Camp Dysentery.

Otis' Anatomical Series photographs compared skulls of aboriginal people throughout the

world. This work stemmed from the arrangement with the Smithsonian Institution, under which

the Army Medical Museum became the government's home for human anthropological remains

while the Smithsonian handled cultural remains. Otis had plans for a larger publication which he

referred to as a catalogue of the craniological collection. (Otis to Joseph Barnard Davis, March

11, 1874) He may have intended a publication similar to the Surgical Photographs, since the

format of the pictures was much the same with an extensive label on the back of the mount. He

began compiling a checklist of the specimens which was published for the 1876 Centennial.

Congress was not interested in funding this project, and most of the photographs and remains

were given to the Smithsonian some years after Otis's death.

Woodward, initially assisted by Curtis, also took thousands of Microscopical Series

photographs in which he experimented with photomicrographs using sunlight, artificial lights and

specialized stains. Woodward created masterful photomicrographs while using an entire

darkened room as his camera. The lens was a microscope in a window, with a heliograph

focusing sunlight though the slide and microscope. The image was projected onto a glass plate

negative mounted in a wood box, two to four feet from the microscope. Woodward discussed his

technique in detail in several reports. Some of these photographs were reproduced in the second

Medical volume of the History as engravings or woodburytypes. Woodward, ever the

perfectionist, was quite concerned that he, not Curtis, get the credit for taking the photographs.

He wrote:

I found, as every investigator will find, that the only way

to get the results I desired was to take the photographs

myself. ... My mode of work is to employ a dark-room man

(of course) but I handle the microscope, get the image on

the screen, regulate the exposure, and in short, take the

picture. The dark-room man is a convenience to me, (not a

necessity.) I save time and patience by using him. But any

dark-room man will answer my purpose, who can do clean map

copying, whether he ever saw a microscope before or not;

while no dark-room man can take my place, unless he

understands the use of the microscope and the structure of

52

the tissues as well as I do. I make this explanation not in

the way of reclamation for credit deserved but not received

-- for this I care nothing -- but because I hear of

continual disappointment on the part of medical gentlemen

who endeavor to get results similar to those I obtain,

without correctly understanding how I really get them.

(Woodward to Austin Flint, December 20, 1875)

Curtis, accompanied by E. J. Ward, hospital steward A. E. Le Merle, "a practical

photographer of long experience," and Private M. S. Brennan, traveled to Des Moines, Iowa, in

July of 1869 to photograph the total eclipse of the sun. This expedition was led by Commodore

B.F. Sands of the U.S. Naval Observatory in Washington. The four men took 119 negatives

during the two hours of the eclipse. Curtis discussed their methods in great detail, including the

formula for collodion that Le Merle prepared, in Sands' published report. (Curtis in Sands, p.

123-128)

Illustrations based on photographs became increasingly popular in the years following the

war. The Philadelphia Photographer noted in 1875, "It is difficult to go into a bookstore now

without seeing serious works illustrated by means of one or more of the various photomechanical

processes.” (Welling, p. 235) The Medical Museum was no exception and used many techniques

including photoengravings, woodburytypes, heliotypes, lithographs and chromolithographs to

illustrate the History.

Engravings were made from photographs taken of museum specimens to illustrate the

History, the Catalogue and other publications of the Museum. This was by far the most common

way the Museum published its photographs. When Circular 6 was published soon after the war,

the Museum had two staff engravers, probably hospital stewards. The specimens in the Museum

were already being photographed for the engravers. (Circ 6, p. 7)

Henry H. Nichols was hired as a wood-engraver for $100 a month, soon after the end of

the war. He had been working in the Museum as a private in the Veteran Reserve Corps until he

was discharged. (Otis to Barnes, July 21, 1865; Otis to Nichols, July 31, 1865). The following

year Nichols seems to have recommended Ephraim M. Wells to Otis. (Otis to Wells, November

21, 1866) Otis sent him two photographs to copy in pencil on Bristol Board to test his work.

Wells, "a draughtsman of unusual merit, now employed in the New York Central Railroad Car

Shops," was hired as a "draughtsman for wood engraving" for $125 per month, "to be paid from

the funds appropriated at the last session of Congress for the preparation of a medical and

surgical history of the war." (Otis To Barnes, December 24, 1866) The following year, Otis

recommended that Wells and Nichols receive a proposed twenty percent raise, but not the

colored laborers who were receiving $40 per month. (Otis to Barnes, April 30, 1867) The artists

were obviously valued; eight years later, Acting Assistant Surgeon Lamb requested a raise from

$100 to $125 per month, just matching the draughtsman's 1866 salary. (Woodward to Surgeon

General, June 12, 1875)

Nichols was responsible for making wood engravings to be used for photoengraving. In

1875, Harper's published R.W. Bowker's description of the process:

The engraver has upon his table a smooth block of boxwood,

53

upon whose surface appears, reversed, the drawing or a

photograph from the picture which he is to reproduce.

Modern photography has been able to coat the wood with a

sensitive film which takes an exact photograph, reversed, of

a picture to be copied, leaving the picture itself as a

guide to the engraver. This is a double gain, and most

artists now draw directly on paper in wash or body color, in

preference to drawing backward on the wood itself, a design

which the engraver's tool must destroy as he interprets it.

The block is placed upon a cushion on the engraver's table,

and between the block and his eye is a magnifying-glass

supported from a frame, through which the eye directs and

follows the hand. Thus equipped, the engraver uses

otherwise only the simplest tools -- gravers of well-

tempered steel, sharpened occasionally on a whetstone near

at hand, and sometimes the multiple graver or "tint tool,"

which has a cutting series like a comb, and cuts parallel

furrows. This last is seldom used by the best men. Line by

line, with exquisite patience, the engraver pursues his

wonderful work, in whose highest reach there is no secret

beyond the eye careful to see, the hand deft to cut, the

artistic judgement which dictates the right kind, direction,

and width of line to interpret the artist's feeling. The

graver cuts away the furrows in the wood, leaving ridges

which are to be the lines of the print, so that a magnified

wood block is simply a carefully ploughed field. (Welling,

p. 235).

The Museum could not achieve the technique of printing a photograph on wood for its early

publications such as Circular 6. In June, 1866, Otis wrote to William Washburne of Lippincott &

Co. requesting advice on photoengraving:

Can you do me the favor to enquire of the wood

engravers in Philadelphia what process they find most

available for securing photographic impressions on wood

blocks. I have tried a great variety of plans, using black

coatings and making ambrotypes on the block, and white

coatings on which, after silvering, the object is printed

from a negative in the usual way. But all my results are

unsatisfactory to the engravers, and practically I am

compelled to continue to use photographic prints on albumen

paper, which are subsequently traced and transferred by

draughtsmen on the wood blocks.

I know that Sears and others in New York have a simple

54

method of photographing directly on the wood; but I cannot

find out from any one here, nor from any of the books on

photography what the method is.

If you could get the merest hint from the engravers, we

could follow up the clue and perfect the process.

I don't expect to get better pictures by photographing

on wood directly; but the profession will perhaps be better

satisfied of the exact fidelity of the illustrations, if

this plan is adopted. (Otis to Washburn, June 19, 1866)

Even in 1874, few photographs were printed directly on wood in the Museum; most were still

being drawn by the draughtsman for the engraver. In April 1874, only five photographs were

made on wood by Ward, while forty-one drawings and fifty engravings were done. (Parker to

Otis, April 30, 1874)

Nichols and Wells' work was still considered technically excellent. Otis had tried

contracting some of the work to Lippincott and Co., but:

The critics here do not esteem the work equal to that

done by our own engravers. It is fine and delicate, but

does not represent the texture of the unbroken and fractured

or necrosed surfaces of bone as accurately as is done by the

engraver (sic) who work steadily on this particular branch.

Such at least is the verdict of the artists and officers

here, who are perhaps not impartial judges. I think in

future I shall have the mechanical drawing done in Phila.,

and the pathological illustrations illustrated here. (Otis

to Washburn, May 23, 1866)

After Wells completed the image's transfer and Nichols finished his engraving, the wood block

was sent to Philadelphia or New York to be electrotyped. The wood block engraving was

pressed in wax and then copper or nickel was electrolyzed to cover the wax and produce the

electrotype printing plate. The electrotype block, which could be set in with the type for the book

to be printed, was easier and cheaper to use than lithographs or photomechanical prints, which

had to be individually printed and then bound into the typeset pages. It could also be reused; for

the Catalogue, Otis sent Woodhull ninety-one electrotypes that had previously been made for

other Museum publications. (Otis to Woodhull, October 18, 1866) With 150 electrotypes to be

used in the catalogue, reusing three-fifths from earlier publications made for significant savings,

important to the always cash-strapped Museum. When the first Surgical volume was reprinted in

1875, Otis reported "The electrotyper at the Congressional Printers Office assures me that the

electrotypes will hold good for another edition of 5000 copies, and, indeed, Captain Brian,

Foreman at that Office, thinks that they will be good for 50,000 impressions. (Otis to Barnes,

April 7, 1875) Charles Sears of New York did most of the electrotyping for the Museum in the

years following the war. Otis, protecting the Museum's budget, paid 90 cents per block with 5

cents to finish each block instead of the 95 cents with 50 cents for finishing that Sears requested.

55

(Otis to Sears, December 8, 1865) The woodblocks and electrotypes had to be carefully printed to

make the illustration work best. Otis made this point to the superintendent of the Printing Office.

He reported to Barnes that he had written to Superintendent Clapp, stating, "I would like

occasion to say, that many of these wood-cuts are prepared from photographs made in country

villages, or other out of the way localities, and that while it is difficult to obtain acceptable

draughtings and engravings on wood, it is impossible, after the work is carved and electrotyped,

to get satisfactory results, unless great pains (sic) is taken in the printing." (Otis to Barnes, March

31, 1875) Woodward's delicate pictures of microscopic views could not be wood-engraved

electrotypes. A. E. Lent of Philadelphia engraved them directly on steel. (Woodward to Billings,

September 18, 1875)

Nichols was discharged from the Museum at the end of March 1874, "hereafter to be

employed only by the piece," and Otis began a search for a new engraver. (Otis to Barnes, March

25, 1874) He offered the job, still paying $100 per month, to Mary Jacob of the Cooper Institute

of New York City. In a curious third person letter Otis wrote:

At the suggestion of Miss McLaiw, Dr. Otis takes the liberty

of writing to Miss Jacob, with reference to the execution of

wood engraving for the Surgeon General's Office.... He is

authorized to employ a wood engraver at a salary of one

hundred dollars a month, and also to contract for

additional work as it may be required. The position of

engraver was vacated at the end of March, and is now offered

to Miss Jacob, should she be willing to come immediately to

Washington and assume the duties. These consist in

engraving woodblocks, on which the drawings are prepared,

for six hours daily, (from nine to three) Sundays and

holidays excepted. An annual leave of absence of thirty

days is also allowed, without curtailment of pay. The

engraver is at liberty to do additional work, at the market

rate of compensation, out of office hours, and the engravers

previously employed have thus largely increased their

compensation. (Otis to Jacob, April 2, 1874)

Jacob did not take the job of engraver, which was abolished in July in favor of contracting

by the piece. Otis still wished her to come to Washington, writing, "As I have informed you

heretofore, it is impracticable to send the blocks and specimens away from the Museum. Though

the office of Engraver has been abolished since July 1st, yet the appropriation for the Med. and

Surg. History, and its requirements in the way of wood-engraving are such, that I think I am safe

in assuring you steady employment with equal renumeration to that you received as engraver.”

(Otis to Jacob, September 26, 1874) When Jacobs did not move to Washington, Otis continued

searching for a local engraver or one who would move to Washington. He wrote to Miss C.A.

Powell, "Some very well executed proofs of wood engravings from you were brought to this

office to-day, and I would respectfully inform you that such work is much required here; and, that

if it is practicable for you to come to Washington, I think steady employment in wood engraving

56

could be furnished you." (Otis to Powell, December 4, 1874)

Lithography was the Museum's initial choice for reproducing artwork and photographs in

publications. In a letter to Toudy & Co., an inquiring contractor, Otis discussed the Museum's

lithography needs:

The work consists chiefly of drawing on stone

chromolithographic plates, 8 1/4 by 6 6/10 inches,

representing pathological subjects, which commonly require

from six to ten stones, and printing these plates in

editions of five thousand copies. There are also similar

plates printed in black and white, and a few maps and plans

to be executed by transferring upon stone from steel plates

that have been prepared here.

All of the plates are of the dimensions above given and

are to be printed in editions of 5000 [later expanded to

10,000 for the second edition].

No form for estimates is furnished by this office.

Those making offers estimate: 1st, for drawing a plate

on stone; 2nd, for printing 5000 copies, exclusive of the

paper, which is provided by this office, in order to secure

uniformity in the plates. (Otis to H.J. Toudy & Co, June

17, 1867)

Many lithographers were used by the Museum, although Toudy was told, "The specimens

enclosed in your letter are of a character of work which would not be at all satisfactory to this

office.” John Cassin of Bowen & Co. in Philadelphia did two-color chromolithographs for

Circular 6 at a rate of no more than $150 per 1000 prints. (Otis to Cassin, November 3, 1866)

Thomas Sinclair of Philadelphia did the lithographs for the circular. Sinclair & Son and Julius

Bien of New York city did most of the chromolithograph plates for the Surgical volumes. (Otis to

Sinclair, January 26, 1876) The Bufford Brothers of New York did plate twenty-four in the third

Surgical volume. Huntington probably commissioned them, since the plate did not have the

standardized style Otis preferred.

L.N. Rosenthal corresponded about doing chromolithographs for Circular No. 7. Otis

sent instructions to Rosenthal to do one based on a lithograph in Circular 6 with some additional

artwork done to modify the original and guide the coloring. Otis sent instructions and two

now-lost drawings to him. Otis's revealed how the lithographs could be altered from a strict

representation of reality:

I sent you yesterday a copy of Circular No. 6, S.G.O. 1865,

which contains a lithograph of the case of Kelly. In the

chromo-lithograph which you have undertaken to prepare for

me, I wish the drawing of the lithograph in Circular No. 6,

to be followed except as regards the arrangements of the

drapery or blanket about the genitals. I wish the latter to

57

be concealed as in the water-colored drawing marked (A). In

drawing the head you may modify the features, being: the

guided by the water-colored drawing marked "B.” I wish you

to follow the color of the water-colored drawing "A," except

in regard to the hair and complexion for which the drawing

"B" will be your guide. (Otis to Rosenthal, January 11, 1867)

Rosenthal did the lithograph, but James Kelly was represented by a woodcut in the History.

Changes were made when lithographs or chromolithographs were based on photographs

as well. In a letter to Julius Bien, a New York lithographer, Otis tells him, "I send you by to-days

mail a drawing in water-color and a photograph of the same subject, to be reproduced in

chromo-lithography as soon as it can be done consistently with thoroughly good and faithful

execution of the work. The alterations which we verbally discussed can be made in the coloring

and accessories, but the man's features, and especially the appearance of the stump must be

faithfully copied.” (Otis to Bien, January 11, 1867) Bien had to modify some photographs

extensively for the lithograph. Otis wrote to Bien, "I regret very much that the photograph is so

badly illuminated, that the details of the stump are almost irrecognizable (sic). But I could

procure nothing better... [Y]ou will insert your own draughtsman's name as the delineator.” The

two-color lithograph of Private Vick was published in Circular 7; in the History, an engraving

'from a photograph' was published instead. (Otis to Bien, May 22, 1867; History, Surg III, p. 157)

Otis was an exacting taskmaster, frequently requiring modifications in the

chromolithographs. He wished them to be exact in a medical sense with correct coloration of

tissue and injuries, but he had aesthetic requirements as well. Rosenthal was told "I find the flesh

tints too highly colored, the face especially too florid. The man had been confined to a hospital

for more than a year and was probably pale and less fleshy than would be inferred from your

representation of his remaining leg. The gray of the cap and jacket has too much blue in it. You

must give the regular pepper and salt dirty Confederate gray. In the stump you should follow the

drawing sent you quite closely. Do not omit the eight dots which represent the scars of the

punctures through which the stitches passed.” (Otis to Rosenthal, April 11, 1867) (See figure

page 53)

Otis was willing to countenance extensive modifications of the original work to get a

good print. F. Moras of Philadelphia, who did most of Woodward's chromolithographs in the

History, was asked to do a print for Otis' Circular 7 and later reprinting in the History:

By this mail I send you a photograph and colored sketch

of a patient exhibiting the results of a successful

amputation at the hip-joint. I wish to have a

chromolithograph prepared of this case to illustrate a

circular about to be issued by this office...

The photograph is poor, being enlarged from a carte de

visite, and the colored sketch is execrable both in drawing

and color. But they were the best pictures I could get of

the case.

If possible, I wish to engage you to have a presentable

58

drawing made from the photograph and water-color picture.

What I chiefly wish to illustrate is the appearance

of the cicatrix and stump. The painter has rendered the

appearance of the healed wound tolerably well, though his

tints are bricky. He has dislocated the right ankle and

knee by turning the foot out too far, and has immensely

exaggerated the size of the face. Please to have an outline

prepared for me of such a sketch as you would be pleased to

have published over your name. Put some accessory such as

your taste suggests in place of the unsightly table, and

modify the dreadful formal floor. Leave out the gilt watch

chain and substitute something for the particolored neck-

tie. The vest must be of army blue. The background seems

to me well enough. I like the arrangement of the shirt in

the aquarelle better than in the photograph, though in the

former it is brought down rather too low on the stump. With

the aid of the photograph I have confidence that your artist

can give a correct anatomical drawing, and I trust that he

will also produce a pleasing chromo-lithograph... (Otis to

Moras, January 25, 1867)

Otis bought a lithographic press in January 1866 for $185. (Otis to Barnes, December 29,

1866) Perhaps he was getting frustrated by trying to get dozens of lithographs done to his

satisfaction though the mails or looking to save money. He might also have feared that the

Museum's work would be pirated, for he wrote to his lithographers, "It is understood that in this

and future work entrusted to you by this office you will take every precaution to prevent parties

unconnected with the office from seeing the original illustrations or proofs, and, in fact, regard

the work as confidential.” (Otis to Moras, January 25, 1867) Writing to S.C. Duval a few days

after purchasing the press, he said, "I have submitted your proposition to supervise the work to

the Surgeon General and have been instructed by him to enquire what monthly compensation you

would expect for such service.” (Otis to Duval, January 3, 1867) Otis decided that Duval was not

the man for the work after all, writing to P.S. Duval, Son & Co., in March 1867:

I would not be willing to insert prints from these

plates in the official publications of the government. As I

do not think it probable that the defects can be remedied, I

should prefer to pay for the trouble you have already had,

and suffer the plates to be rubbed out, than to make further

experiments. If you, however, are confident that you can

still make these plates acceptable, I will not insist on

their abandonment.

I object first that all three proofs are palpably

retouched and worked up after printing. This defect is

fundamental. I like the backgrounds in all the proofs, and

59

desire no alteration in that respect.

I pointed out to your artist my objections in detail to

the first two proofs. The third is somewhat better; but

still the drawing does not conform to the original, which,

in this case was hardly susceptible of amendment. Your

artist has seen fit to alter the anatomy of the dresser's

hand, and has not, in my opinion improved it. In depicting

the gangrenous sore he has lost entirely the wet tow

appearance of the mortified cellular tissue and has

neglected many of the little details in the colors of the

sore which in Stauch's drawing gave such a natural

appearance to the ulcer. The effects of texture which

should have been obtained by printing, he has sought to get

from washing with gum and colors.

The Surgeon General has instructed me to decline the

proposition of the younger Mr. Duval to undertake the

supervision of the lithographic work here at a compensation

of one hundred and fifty dollars a month. (Otis to P.S.

Duval, Son & Co., March 14, 1867)

The lithograph press was sold in January, 1869, never having been used for some reason. (Lamb,

p. 52)

For the second edition of the first Surgical volume and the second and third Surgical

volumes, Otis had most of the chromolithographs done by Thomas Sinclair. Bien, described by

Otis in 1867 as "the best lithographer we employ," could not meet Sinclair's prices. (Otis to

Sinclair & Son, August 17, 1874; Otis to Fauntleroy, May 22, 1867; Otis to Bien, September 19,

1874) Bien and Sinclair were the only lithographers Otis used after the first edition of the first

Surgical volume. He wrote to the Surgeon General that "I can learn of no other lithographers

willing and competent to undertake the work.” (Otis to Barnes, June 21, 1874) Sinclair and Son

were paid $1,080 for 10,200 copies of a chromolithograph for the Second surgical books. (Otis to

Sinclair and Son, July 7, 1875) Woodward had his chromolithographs done by F. Moras. The

colors were supervised on contract by Hermann Faber, who had done the original artwork a

decade earlier while at the Museum. (Woodward to Moras, July 3, 1875)

For the second book in both the Medical and Surgical series, Otis and Woodward began

using woodburytype photomechanical prints in place of black and white lithographs. The

woodburytype looks extraordinarily like a photograph, tipped-in on the page. Walter B.

Woodbury patented the process in 1864. A positive gelatin relief was printed from a collodion

negative and hardened by exposure to light followed by an alum bath. The relief was dried and

placed in a hydraulic press with a lead plate to form a lead mold. The lead mold was filled with a

colored gelatin, which was used as the 'ink' for the photograph, and pressed on paper. When the

gelatin cooled, it glued to the paper and a print was formed. After hardening in the alum bath, the

print was trimmed and tipped onto a mount. It could then be bound into a book. The prints were

described as "the finest pictures ... perfect in light and shade, of exquisite tone and brilliancy, and

leaving nothing desirable but color to make complete pictures." (Welling, p. 202) John Carbutt

60

bought the American rights to the process. In Philadelphia, he established the American

Photo-Relief Printing Company, and in 1871, he was able to begin printing. (Welling, p. 204)

Carbutt began working for the Museum that year, printing a plate for Woodward's Report to the

Surgeon General of the United States Army on an Improved Method of Photographing

Histological Preparations by Sunlight. (Woodward to Barnes, March 4, 1875)

The Museum, instead of sending Carbutt the original glass plate negatives, made the

positive gelatin relief and shipped that. Otis wrote,

"I shall send you on Monday the

gelatine films of specimens 2749, and of 4170. These are

designed for photo-relief prints to be numbered respectively

Plates XIX and XLIV of the Second part of the Surgical

History. Congress having directed a second edition of this

work, the Surgeon General instructs me to order ten thousand

two hundred (10,200) instead of five thousand one hundred (5,100)."

(Otis to John Carbutt, Sept 12, 1874)

Like the lithographers, Carbutt printed the plate page titles, tipped-in the photograph and

returned a completed page for binding by the printers. Surprisingly enough the cost for a

reproduction as either a lithograph or a woodburytype was about the same. Otis said, "By either

method the editions would cost about three hundred and fifty dollars for five thousand and a little

less than double that amount for ten thousand copies.” (Otis to Barnes, November 24, 1874) Otis

preferred to use woodburytypes, writing to Carbutt, "...I have regarded this process as most

valuable for scientific illustrations, and have wished to largely avail of it.” (Otis to Carbutt,

February 15, 1875)

Unfortunately, in early 1875, Woodward began finding problems with his prints:

In examining the edition of No. 820 I find the film has

parted from the paper on several of the plates, which I

return for your information. I have several times talked to

you of the possibility of this accident, and you have always

assured me that you had taken such precautions in the method

you are now using that it would not occur. I am free to

admit that the proof returned a few days ago and these few

prints are the only ones I have seen behave thus as yet; my

portfolio of proof copies of the several plates has been

quite roughly handled, and nothing of the kind has happened.

Can it be that freezing while the plates were still damp has

done it, or has something else gone wrong? (Woodward to

Carbutt, January 25, 1875)

Several weeks later, Woodward wrote to Carbutt again about the problem:

I have just completed the examination of the last box of the

61

plates of 820. I regret to say that I find about two

hundred of the plates peeled, quite like those I returned to

you a short time ago. Worse than that, of those which

appeared perfect, I find that very little handling will

loosen the film so that I am full of uneasiness with regard

to the usefulness of the edition of this plate. I shall be

compelled to call the attention of the Surgeon General to

the matter, which I shall do to-morrow. The box of No. 124

has not yet arrived, I await it with anxiety. I cannot deny

that the full confidence which I had placed in the

permanence of these plates is somewhat rudely shaken by

this untoward event.” (Woodward to Carbutt, February 10,

1875)

Two days later, Woodward wrote to James R. Osgood and Co., who had offered a

competing process, the Heliotype, to the Museum the previous summer. He stated:

Your letter of July 21st addressed to the Surgeon General,

enclosing [a] circular of your heliotype process, was handed

to me by the Assistant-Surgeon General at the time, but it

did not seem likely that we should require it.

Circumstances have, however, arisen which may make us wish

to employ your process for some contemplated work, and I

write therefore to ask you to send me, to lay before the

Surgeon General, a few samples to illustrate your success in

reproducing photographic portraits from life, or photographs

of landscapes, or scientific objects. (Woodward to Osgood &

Co, February 12, 1875)

The same day, after writing to Osgood, Woodward wrote to Carbutt:

I laid this matter before the Surgeon General yesterday. He

was, of course, greatly surprised and annoyed, and will not

authorize the commencement of any more plates unless this

matter can be explained in such a manner as to guarantee the

safety not only of the future, but of past work. For it

must be admitted that the clean manner in which the gelatin

film separates in these prints, and the apparent want of any

incorporation of the ink with the face of the paper, is

calculated to make us uneasy about the permanence even of

those plates heretofore completed for our work, which as yet

appear to be all right, and suggests the possibility that

they may sooner or late crumble away from the paper.”

(Woodward to Carbutt, February 12, 1875)

62

Woodward found problems with the next two plates that Carbutt shipped. He began

writing to others who were using the process in their publications, wondering if they had similar

problems. (Woodward to Carbutt, February 13, 1875; Woodward to Count Pourtales, February

16, 1875) Otis discovered similar problems with his prints. (Otis to Carbutt, February 15, 1875)

Carbutt sent new sample prints to Woodward, who was able to peel them from the mount as well.

Woodward also found earlier prints dating back to 1871 were cracking. "I cannot avoid asking

whether this is to be their ultimate fate; whether sooner or later, perhaps within a few years after

the book goes out, the plates will not begin to break up, and whether, under the circumstances, it

is profitable for us to go any further in this direction,” Woodward wondered. "At the same time

these plates so faithfully represent the several subjects that I am loth to come hastily to the

conclusion that we must abandon them for the second edition, and therefore I shall await any

explanations you can offer before coming to a positive determination.” (Woodward to Carbutt,

February 20, 1875) The same day, Woodward sent photographs of the intestines in the Medical

Series to Osgood & Co., asking if they could do the work and at what price. (Woodward to

Osgood, February 20, 1875)

On March 4th, Woodward reported on the situation to Dr. Barnes, recounting the

difficulties with the plates received from December through February. He stated after meeting

with Carbutt in Philadelphia:

...Mr Carbutt seems to think their condition due to the

disturbing influence of the late unusually cold weather

while they were being made, claims to have introduced such

modifications in the process as will secure that future

plates shall be fully equal to those formerly supplied, and

expresses a willingness to replace free of charge all those

which ultimately prove unserviceable. I gather, however,

that his pecuniary ability to fulfil this offer, even if no

other plates should spoil that the boxes above mentioned,

will depend upon his continuing to receive work from this

office.

I regret to say, moreover, that the inquiries I have

made have increased the uncertainty first suggested to my

mind by this accident, as to the permanency even of those

Woodburytype plates which, when first prepared, appeared

perfectly satisfactory. I have observed in a number of the

oldest of Mr. Carbutt's plates which I have examined since

the accident two forms of destructive changes: in some of

them portions of the film of moderate size have separated

either spontaneously or on slight handling, while in others

great numbers of fine cracks have formed, resembling on a

small scale those seen in old oil paintings, and in such

prints, on a little handling, minute morsels of the film

chip off. I have observed both these accidents in a few of

63

the earlier plates prepared for the Medical history, and in

a few sample prints procured from Mr. Carbutt (prior to any

order being given to him for this office) which were

perfectly free from these defects at the time they were

first received and for a year or more subsequently.

Insignificant as the number of such spoiled prints appear to

be, they lead me to believe that molecular changes in the

gelatine film of these prints mag go on after they are dry,

and make me fear that even those prints which now, several

years after their preparation, appear perfectly sound are

not secure against future destructive changes.

I need not say how much I regret to arrive at this

conclusion, for the Woodburytype plates thus far prepared

for our work by Mr. Carbutt, give a more faithful and

accurate representation of the pathological specimens

selected than could be obtained by any other method with

which I am acquainted. It is only just to state that a

portfolio in which a single proof from each edition hitherto

prepared for the Medical history was placed when first

received lies on a table near my desk, and that although

these proofs have been much handled, not one shows as yet

any signs of deterioration....

Mr. Carbutt expresses himself as hopeful that the great

majority of the prints already made, which are now in good

condition, will remain permanently so, and endeavors to

explain the act that a certain number have spoiled, on the

hypothesis of accidental imperfections in the original

preparation of these individual prints which are not shown

by the rest of the edition. I have every confidence in his

sincerity and good faith, but fear, in view of all the

circumstances above reported, that he may prove mistaken.

(Woodward to Barnes, March 4, 1875)

Four days later, Woodward wrote to Carbutt that he had "received official instructions to the

following effect: 'The Surgeon General directs that no more orders be given to Mr. Carbutt for

execution, by ourself or Assistant Surgeon Otis, until the "Surgeon General may so direct" which

of course implies the indefinite postponement of any further work from us.” (Woodward to

Carbutt, March 8, 1875)

The first editions of the History were illustrated mostly with the woodburytypes, but the

second had many of them replaced. The second Surgical volume (1876), second Medical volume

(1879), third Surgical volume (1883) and third Medical volume (1888) all have some tipped-in

woodburytype prints since Woodward and Otis had purchased enough of some of the plates for

both editions.

Since the work was designed as a "monument" to the medical staff, the Museum hired

64

James R. Osgood & Co. to make heliotypes for some prints and substituted lithographs for

others. The heliotype, or collotype as it was usually known, was another photomechanical

process. The process used a glass sheet covered with gelatin which was then hardened. A second,

photographically-sensitized gelatin layer was then painted over the first. The gelatin was exposed

by a negative and developed in cool water and glycerine. The unexposed, and therefore

unhardened by light, areas, absorbed water and stayed moist. The hardened areas had become

water repellent by exposure to light and so did not absorb water. Lithographic ink, which stuck to

the hardened areas but not the moist ones, was then put on the plate for printing. The plate could

be varnished to give it a photographic appearance, but this was not done for the History.

Heliotypes reversed the images, but Woodward thought "this will not injure their truthfulness.”

(Woodward to Hayes, December 29, 1875)

Osgood worked mostly with Woodward, making prints of colons for the second and third

Medical volumes. Otis and Huntington used their remaining stock of woodburytypes and then

replaced them with lithographs by Sinclair and Son. Otis contracted with Osgood for heliotypes

at $274.00 per 5100 but was not pleased with the quality. (Otis to Osgood, October 13, 1875;

February 23, 1876) He had most of the illustrations for the second and third Surgical done by

Bien and Sinclair. Woodward used the process extensively for the second and third Medical

books.

As with the woodburytypes, the Museum did not always send original negatives but

instead began the work of making the photomechanical print especially when the negative was a

precious photomicroscopic one. Woodward, recovering from the loss of the Woodbury process,

wrote:

I send to-day by express a transferred negative of a

microscopic subject for the Medical History of the War, of

which I would like you to prepare a proof. If approved, the

edition will be 5100 copies. One edition of the same number

of copies of this plate has already been printed by the

Woodburytype process, and of this I send you herewith a

print. I think your method gives a better result for this

subject. By the Woodbury method I was limited in the width

of the picture; but as it is different in your method, I

would like the mask cut so as to allow all of the negative

to print except the indistinct edges. (Woodward to Osgood,

July 7, 1875)

Photography, more than any other form of illustration, made the Museum's publications

possible. Less than two hundred pieces of artwork were made for the History, while thousands of

photographs were used. Photographs were not directly reproduced though; halftone illustrations

were not invented until 1880 and did not become common until after 1890. (Welling, p. 263-4)

The photographs of specimens and soldiers still had to be interpreted by the engraver or

lithographer. Color was only possible when an artist's work was reproduced via lithography, and

the nature of some of the medical illustration required it. By using all of the techniques of

medical illustration, the Museum's staff produced a monumental work.

65

Acknowledgements

My wife, Cathy Hunter; Joan Redding, Assistant Archivist who edited my manuscript time and

again; colleagues Adrianne Noe, Paul Sledzik, Alan Hawk, Robert Goler; Robert Montgomery;

NARA staff Connie Potter & Bill Lind, NPG Mary Panzer, NMAH Helena Wright, Museum

volunteers Peggy Garner & Marcy Leverenz, Dan Bennett, NLM Stephen Greenberg, photohist

list

66

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