“They Did Not Seem to Respect It Much”: Insignia and Medical Evacuation

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Kyle Dalton

Originally published in 2020 in the Surgeon’s Call, Volume 25, No.1

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The Civil War created a massive humanitarian crisis by the sheer scale of wounding and death. Mass casualty events were distressingly common throughout the conflict. These previously unimaginable catastrophes required adaptation both on the ground and in military medical administration to treat the wounded. Among the most important of these challenges was removing the wounded in a timely and safe manner from active battlegrounds.
Figure 1: Unknown Ambulance Corps soldier. NMCWM collection (L3.2000.004)

Figure 1: Unknown Ambulance Corps soldier. NMCWM collection (L3.2000.004)

Both Confederate and Union medical professionals developed a myriad of evacuation systems. Dr. Jonathan Letterman, Medical Director for the Army of the Potomac, was the most successful in systematizing the approach to medical evacuation, but his system was not universal, even within his own command. Something so simple as naming the system in use was a source of disagreement: Confederate military personnel vacillated between the terms “infirmary corps” and “ambulance corps.” The confusing collection of sometimes competing medical evacuation systems and units North and South are evidenced by the disparate methods of identifying insignia that the stretcher bearers and ambulance drivers wore on the battlefield. These mixed messages sent by a lack of systematized insignia contributed to the high casualty rate among stretcher bearers.
Figure 2: Private Bruce Shipman, 76th New York, Co. K. Courtesy of the U.S Army Heritage and Education Center

Figure 2: Private Bruce Shipman, 76th New York, Co. K. Courtesy of the U.S Army Heritage and Education Center

The best documented insignia type among Union stretcher bearers and ambulance drivers was the green stripe and chevron instituted by Dr. Letterman. In his Special Order No. 147 creating the Ambulance Corps, Letterman detailed precisely what the enlisted man should wear:

The uniform for this corps is: For privates, a green band 2 inches broad around the cap, a green half chevron 2 inches broad on each arm above the elbow, and to be armed with revolvers; non-commissioned officers to wear the same band around the cap as a private, chevrons 2 inches broad and green, with the point toward the shoulder, on each arm above the elbow.[i]

Two years later, using Letterman’s system as a guide, General George Thomas ordered his Army of the Cumberland to wear green bands around their caps and arms.[ii] Photographic evidence bears out the use of the green stripe and chevron by soldiers of the ambulance corps. In the collection of the National Museum of Civil War Medicine is a remarkably rare example of this uniform in an original portrait of an unidentified Ambulance Corps soldier. A similar portrait of Private Bruce Shipman of the 76th New York Infantry is in the U.S. Army Heritage and Education Center collection.
Figure 3: Unidentified Ambulance Corps sergeant. Sold on eBay, presumably in private collection

Figure 3: Unidentified Ambulance Corps sergeant. Sold on eBay, presumably in private collection

In two separate photographs by Timothy O’Sullivan in the collection of the Library of Congress, some of the Ambulance Corps men of the Engineer Corps are also wearing the stripe. By ordering the use of green insignia, Letterman was likely tapping into an existing method of identification. In May 1862, fully three months before Letterman’s Special Orders No. 147, The Chicago Daily Tribune reported that musicians were to join “the ambulance corps,” and that “They are designated by a green badge.” [iii] Green was the color of medical professionals in the Union Army, where both surgeons of all ranks and hospital stewards wore green insignia per regulations that pre-dated the Civil War.
Figure 4: Detail with potential ambulance corps corporal from “Winter Quarters, troops with row of cabins,” Brady album, p. 128, 1861–65. Courtesy of the Metropolitan Museum of Art

Figure 4: Detail with potential ambulance corps corporal from “Winter Quarters, troops with row of cabins,” Brady album, p. 128, 1861–65. Courtesy of the Metropolitan Museum of Art

Unfortunately for Letterman’s system, green was not the only traditional color of medical professionals in the military. At the start of the war, the regulations of the United States Army dictated that ambulance depots be designated with “a red flag [which] marks its place, or the way to it, to the conductors of the ambulances and to the wounded who can walk.”[iv] This regulation was lifted verbatim by the Confederacy in its Regulations for the Army of the Confederate States[v] and often repeated in orders given by Confederate commanders throughout the war.
Figure 5A and 5B: Details from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train,” Timothy H. O’Sullivan. Courtesy of the Library of Congress

Figure 5A and 5B: Details from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train,” Timothy H. O’Sullivan. Courtesy of the Library of Congress

Red is a bright color that draws attention. It made sense, then, that some would adopt red as the color of the stretcher bearers and ambulance drivers, much in the same way the Red Cross does today. In December 1862 orders to the XVIII Corps of the Army of the James it was dictated that “the uniform or distinctive badge of [ambulance men of] this corps shall be, for private and noncommissioned officers, a broad red band around the cap with a knot upon the right side, and a red band, one inch wide, above the elbow of each arm.”[vi] Less formal was the insignia remembered by Devalan S. Miller, a drummer boy in the 35th New York Infantry: “[The surgeon] proceeded to tear up some red flannel in small strips which he tied around our right arms, explaining that this was a badge the enemy would respect when we were caring for the wounded.”[vii]
Figure 5A and 5B: Details from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train,” Timothy H. O’Sullivan. Courtesy of the Library of Congress

Figure 5A and 5B: Details from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train,” Timothy H. O’Sullivan. Courtesy of the Library of Congress

Red also appears to have been the color of choice for the Confederate ambulance men. English observer Lieutenant Colonel James Fremantle wrote that on the march to Gettysburg “in the rear of each regiment were from twenty to thirty Negro slaves, and a certain number of unarmed men carrying stretchers and wearing in their hats the red badges of the “ambulance corps.”[viii] The volunteer Richmond Committee for Our Wounded, sometimes styled the Richmond Ambulance Corps, wore hat and arm bands of pink (or possibly red faded to pink over the years), two of which survive in the collection of the American Civil War Museum.[ix] Confederate surgeon John J. Chisholm wrote in 1862 that “the members of this corps are designated by wearing around their caps a red band with ambulance corps printed in conspicuous white letters.”[x] In both the collections of the American Civil War Museum and the National Museum of Civil War Medicine are fraying examples of these badges.[xi]
Figure 6: Ambulance Corps Badge. NMCWM collection (L 2012.016.009)

Figure 6: Ambulance Corps Badge. NMCWM collection (L 2012.016.009)

The Union army eventually veered away from red as a color of medical care. This was due in part to the fact that red flags, especially in conditions without breeze or wind, were difficult to distinguish from regimental flags. These could prove to be a target for enemy artillery that mistakenly believed the hospitals and ambulance depots to be enemy combatant positions. Similarly, red arm and hat bands were very similar to those worn by the artillery of both Union and Confederate forces and may have brought similarly unwarranted enemy fire.
Figure 7: Detail of Union ambulance corps soldiers from “The Rebel Dodge to Cover the Retreat into Virginia. Flag of Truce to Look After the Wounded,” Alfred R. Waud, September 1862. Courtesy of the Library of Congress

Figure 7: Detail of Union ambulance corps soldiers from “The Rebel Dodge to Cover the Retreat into Virginia. Flag of Truce to Look After the Wounded,” Alfred R. Waud, September 1862. Courtesy of the Library of Congress

In addition to red and green, stretcher bearers sometimes wore white. Just as the green and red insignia were extensions of military medical traditions, so too was white. White flags had long been (and continue to be) the symbol of neutrality. Alfred R. Waud illustrated the meeting of Confederate and Union ambulance corps soldiers in the wake of Antietam and clearly displayed the white armbands of the North, and cap badges of the South.
Figure 8: Detail of Confederate ambulance corps soldiers from “The Rebel Dodge to Cover the Retreat into Virginia. Flag of Truce to Look After the Wounded,” Alfred R. Waud, September 1862. Courtesy of the Library of Congress

Figure 8: Detail of Confederate ambulance corps soldiers from “The Rebel Dodge to Cover the Retreat into Virginia. Flag of Truce to Look After the Wounded,” Alfred R. Waud, September 1862. Courtesy of the Library of Congress

General Grant endorsed white insignia for the Department of the Tennessee on March 30, 1863, with General Orders No. 22, in which he ordered that “enlisted men detailed to the ambulances…will wear a white badge on the left arm above the elbow.”[xii] As late as the Battle of Cold Harbor in 1864, drummer boy George T. Ulmer assigned “to the stretcher corps” wore a “little white cloth…around our arms.”[xiii] A Confederate soldier fighting in Arkansas wrote home “The ‘Hospital Badge’ in a fight is a white rag tied around the arm. Our Infirmary Corps all wore these white rags and are secure from capture.”[xiv]
Detail from Virginia, City Point. Park of Army Wagons, July 1863, LoC

Figure 9: Detail from “Virginia, City Point. Park of Army Wagons,” published July 1863. Courtesy of the Library of Congress

At least as common as white, red, or green was a lack of any insignia. At times this was because soldiers who were not detailed to the Ambulance Corps were nonetheless required by an emergency to take up stretchers and assist their fallen comrades. Outer garments were not required to bear the insignia of the ambulance corps, and soldiers may have covered up their designation to keep warm, which may be the case in the below 1863 photograph of ambulance drivers at City Point, VA.
Figure 10: Detail from “Wounded Escaping from the Burning Woods of the Wilderness,” Alfred R. Waud, May 5-7, 1864. Courtesy of the Library of Congress

Figure 10: Detail from “Wounded Escaping from the Burning Woods of the Wilderness,” Alfred R. Waud, May 5-7, 1864. Courtesy of the Library of Congress

Many photographs and illustrations show Ambulance Corps stretcher bearers and drivers wearing the uniform of the unit which they served absent any insignia designating them as medical non-combatants.
Figure 11: Detail from “Unknown location. Zouave ambulance crew demonstrating removal of wounded soldiers from the field; another view.” Courtesy of the Library of Congress

Figure 11: Detail from “Unknown location. Zouave ambulance crew demonstrating removal of wounded soldiers from the field; another view.” Courtesy of the Library of Congress

There are many possible reasons that ambulance corpsmen would have ignored regulations regarding insignia. For some, the duty itself rendered them self-evidently non-combatant and so insignia did not seem necessary. Surgeon Francis M. Wafer of the 108th New York Infantry wrote “the stretcher bearers’ vocation is always known by the model of carrying the stretcher on the fields, that is carried open when empty looking when far away like a long & narrow white flag, if clean.” [xv]
Figure 12: Detail from “Removing wounded, Fredericksburg, Va. 57th N.Y. Ambulance Corps.” Courtesy of the Library of Congress

Figure 12: Detail from “Removing wounded, Fredericksburg, Va. 57th N.Y. Ambulance Corps.” Courtesy of the Library of Congress

Soldiers assigned to the Ambulance Corps did not stop being soldiers in their original units. In his orders describing the use of Ambulance Corps badges for the 2nd Corps of the Army of Northern Virginia, Confederate surgeon Hunter Holmes Maguire required that the badges be returned by the attendants after the battle. A.P. Hill’s order of June 24, 1862, establishing an infirmary corps for his division made no specifications for any insignia.[xvi] The most famous image of a Civil War ambulance shows men in Zouave uniforms without any Ambulance Corps insignia.[xvii]
Figure 13: Detail from “Ambulance of the 6th Corps,” Matthew Brady. Courtesy of the National Archives and Records Administration

Figure 13: Detail from “Ambulance of the 6th Corps,” Matthew Brady. Courtesy of the National Archives and Records Administration

Many soldiers continued to wear the corps badges and uniforms of the regiments to which they belonged. Regimental or corps insignia was not restricted to uniforms alone. Numerous surviving photographs show ambulance wagons bearing the insignia of their unit. In the collection of the Gettysburg National Military Park is an ambulance flag emblazoned with the 2nd Corps, 1st Division emblem, an addition not authorized in Letterman’s orders.
Figure 14: Detail from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train; another view,” Timothy H. O'Sullivan, November 1862-April 1863. Courtesy of the Library of Congress

Figure 14: Detail from “Falmouth, Va. Men and wagons of the Engineer Corps ambulance train; another view,” Timothy H. O’Sullivan, November 1862-April 1863. Courtesy of the Library of Congress

By displaying the insignia of their original units, rather than those of the ambulance corps or Hospital Department, soldiers assigned after beginning their service as warriors visibly displayed their loyalty to the comrades they had served beside before bearing the wounded.
Figure 15: Detail of V Corps ambulance in “Massaponax Church, Va. Council of War Gen. Ulysses S. Grant examining map held by Gen. George G. Meade,” Timothy O'Sullivan, May 21, 1864. Courtesy of the Library of Congress

Figure 15: Detail of V Corps ambulance in “Massaponax Church, Va. Council of War Gen. Ulysses S. Grant examining map held by Gen. George G. Meade,” Timothy O’Sullivan, May 21, 1864. Courtesy of the Library of Congress

Altogether, this meant that Ambulance Corps stretcher bearers and drivers were probably difficult to distinguish. Whether wearing badges, arm bands, chevrons, or hat bands of green, red, or white, or no insignia at all, there was a great deal of confusion in designating ambulance corpsmen of the Union and Confederate armies. This certainly contributed to the high casualty rates of stretcher bearers.
Figure 16: Ambulance Flag. Courtesy of the National Park Service, Gettysburg National Military Park

Figure 16: Ambulance Flag. Courtesy of the National Park Service, Gettysburg National Military Park

Unable to distinguish Ambulance Corps soldiers from those bearing arms, some stretcher bearers must have been gunned down by mistake. In the collection of Don Troiani is a unique rectangular red patch bordered with green. This ambulance corps insignia is seen nowhere else in regulations or other surviving examples. Accompanying the small badge is a note by Andrew C. Brigham, who served as a musician in the 4th Massachusetts Infantry. He wrote “They did not seem to respect it much.”[xviii]

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About the Author

Kyle Dalton is the Membership and Development Coordinator at the NMCWM. H He has worked in museums across the nation for over fifteen years as an educator and public historian. A graduate of the Catholic University of America, Kyle received the Zeender Prize for his thesis “Active and Efficient” examining the role of veterans in the Ambulance Corps of the Civil War. In his spare time, Kyle writes and maintains the website BritishTars.com, where he explores the lives of common sailors in the eighteenth century through primary sources.

Endnotes

[i] Letterman, Jonathan, Medical Recollections of the Army of the Potomac, New York: D. Appleton and Company, 1866, reprinted Bedford, Mass.: Applewood Books, 14-15. [ii] Whipple, Assistant Adjutant General Wm. D., by command of Major General Geo. H. Thomas, Head-Quarters Department of the Cumberland, Chattanooga, Tenn., January 1, 1864, General Orders No. 1, in General Orders, Department of the Cumberland, 1864, Nashville: Government Printing Office, 1865, page 6. Thomas ordered that the bands on hats and arms be 1 ¼ inches broad, a reduction from the 2 inches required by Letterman. [iii] “From Gen. Halleck’s Left,” Chicago Daily Tribune, May 22, 1862, page 1, column 3. [iv] Revised United States Army Regulations, 1861. With an Appendix Containing the Changes and Laws Affecting Army Regulations And Articles of War to June 25, 1863, Washington: Government Printing Office, 1863, page 106, accessed via Google Books, July 23, 2019, <https://books.google.com/books?id=HpksAAAAIAAJ>. [v] Regulations for the army of the Confederate States, 1863, Richmond: J.W. Randolph, 1863, page 73. [vi] Eighteenth Corps, Army of the James, Department of the South, December 30, 1862, quoted in Katcher, Phillip, American Civil War Armies (3): Specialist Troops, Oxford: Osprey Publishing: 1986, via Google Books, accessed July 23, 2019, <https://books.google.com/books?id=B3uHCwAAQBAJ>. [vii] Miller, Delevan S., Drum Taps in Dixie: Memories of a Drummer Boy, 1861-1865, Watertown, N.Y.: Hungerford-Holbrook Co., 1905, page 84, Library of Congress via HathiTrust Digital Library, accessed July 26, 2019, <https://babel.hathitrust.org/cgi/pt?id=loc.ark:/13960/t4vh5s45f&view=2up&seq=4>. [viii] Fremantle, James, The Fremantle Diary: A Journal of the Confederacy, Arthur Lord editor, eBook: Burford Books, 2001. [ix] Armbands, 0985.13.00921 and 0985.13.01735, American Civil War Museum, accessed July 23, 2019, <https://moconfederacy.pastperfectonline.com/webobject/E5EF01AF-CE84-49E1-A666-501797613560>. [x] Chisolm, John Julian, A Manual of Military Surgery: For the Use of Surgeons in the Confederate States Army, Columbia: Evans and Cogswell, 1864, page 114, via National Library of Medicine, accessed July 29, 2019, <https://collections.nlm.nih.gov/catalog/nlm:nlmuid-66730780R-bk>. [xi] Patch, Military, 1990.009.00001, American Civil War Museum, accessed July 23, 2019, <https://moconfederacy.pastperfectonline.com/webobject/3A00C5CE-863B-4A52-9EF0-088932620604>. [xii] General Ulysses S. Grant, General Orders No. 22, Department of the Tennessee in Medical and Surgical History of the War of the Rebellion, Volume III, Part II, Washington: Government Printing Office, 1883, page 938. [xiii] Ulmer, George T., Adventures and Reminiscences of a Volunteer, or a Drummer Boy from Maine, Grand Army of the Republic, 1892, page 40. [xiv] Letter from “Camp on Bayou Metre” dated July 28, 1863, quoted in I Do Wish This Cruel War Was Over: First-Person Accounts of Civil War Arkansas from the Arkansas Historical Quarterly, Mark K. Christ, Patrick G. Williams editors, Fayetteville: University of Arkansas Press: 2014, page 137. [xv] Wafer, Francis M., A Surgeon in the Army of the Potomac, Cheryl A. Wells editor, Montreal: McGill-Queen’s University Press, 2008, page 52. [xvi] Hill, A.P., Headquarters Light Division, General Orders No. -, June 24, 1862, in The War of the Rebellion: A Compilation of the Official Records of the Union and Confederate Armies, Series I, Volume XI, Part III, Washington: Government Printing Office, 1883, page 616. [xvii] Given the bayonets and cap boxes the Zouaves are wearing, it is quite possible that they were not ambulance corpsmen at all. [xviii] Brigham, A.C., “Piece of Flannel worn as a badge when serving in Ambulance Corps. Presented by A.C. Brigham ‘they did not seem to respect it much,'” textile, Military and Historical Image Bank, Don Troiani, accessed June 6, 2019, <http://www.historicalimagebank.com/gallery/v/album02/album22/album72/CWm30d_Early_Ambulance_Corps_badge.jpg.html>.