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Johnathan Letterman |
On March 19, 1865 the home of John and Amy Harper was commandeered by the XIV Corps of the Union Army and used as a field hospital. During the three days of the Battle of Bentonville the Harpers witnessed the result of Jonathan Letterman’s innovative work on how medical care was practiced from the battlefield to the field hospital.
Letterman was born on December 11, 1824 in Can-onsburg, Pennsylvania. Following in his father’s footsteps, Letterman became a surgeon after graduating from Jefferson Medical College in 1849. After medical school, Letterman would spend the next fifteen years as a U.S. Army surgeon. Letterman served as the Medical Director of the Army of the Potomac from June 1862 until the end of 1863. During his tenure, Letterman oversaw medical care at many of the Civil War’s most vital battles such as Antietam and Gettysburg.
Prior to Letterman’s appointment, medical care on the battlefield was rather unorganized and inefficient. The appointment of Letterman led to several innovations in battlefield medical care leading to what historians refer to as “The Letterman Plan.” These improvements aimed to handle the task of caring for the mass casu-alties from the battlefield and standardizing medical procedures.
One of the first and most vital improvements that Letter-man made was establishing an organized ambulance corps. Prior to Letterman’s plan, ambulances were under the authority of the Quartermaster and their primary purpose was to haul supplies to the battle line. Only when empty would the wagons be used to cart off wounded men. In the heat of battle it was common for the wagons to be in constant use, thus making them unavailable for medical purposes. With the help of General George B. McClellan, Letterman was able to assign all ambulances to the sole purpose of removing the wounded from the battlefield. Even if the wagons were empty, they could only be used for their assigned purpose.
Letterman also standardized battlefield medicine and procedure. Before Letterman’s improvements, doctors brought their own supplies and medicine that they used in civilian life. Letterman established a standardization of these tools and supplies. This allowed a doctor to go to any medical supply wagon and find exactly what he needs in its proper location. Field hospitals were to be established before any anticipated engagements. The locations of the hospitals are determined by the Medical Director of each corps.
To make field hospitals more efficient, Letterman formally introduced the triage system in the U.S. Army. Rather than treating the wounded on a first come, first serve basis, the triage system organized the men based upon the severity of their wounds. This responsibility lied with medical officers referred to as “dressers.” The wounded would be placed into one of three categories. Priority one were men who had serious yet treatable injuries. Second priority was given to men who had received less serious wounds. Soldiers who were considered mortally wounded (wounds to the head or the abdomen) were the lowest priority.
Letterman continued to serve in the Union army after his tenure as Medical Director ended, but resigned in December of 1864 with the rank of Major. He later moved to San Francisco where he served as coroner from 1867 until his death in 1872. In just a year and a half, Letterman changed the way medical care was practiced during war. This standard was practiced by the United States military through WWII.
Sources
Civil War Trails, “Jonathan Letterman.” Accessed September 11, 2013. http://www.civilwar.org/education/history/biographies/jonathan-letterman.html
Freemon, Frank R., Gangrene and Glory; Medical Care During the Civil War. Chicago: University of Illinois Press, 1998.
McGraugh, Scott, Surgeon in Blue; Jonathan Letterman, the Civil War Doctor Who Pioneered Battlefield Care. New York: Arcade Publishing, 2013.
Wiley, Bell Irvin. The Life of Billy Yank. Baton Rouge: Louisiana State University Press, 2008.