Seven Hospital Stewards
William T. Campbell, Ed.D., RN
Originally published in December 2013 in the Surgeon’s Call, Volume 18, No. 2
In an attempt to gain insight into the roles and responsibilities of the Hospital Steward this researcher has been able to locate seven first person or primary sources by and about Hospital Stewards in addition to Woodward’s official manual. These sources, which are all available in print today, give us a glimpse into the lives of these individuals during the Civil War. These books were written by the Hospital Steward himself post-war or were edited by others using journals, diaries, and/or letters written by the Hospital Steward during the war years. Primary sources often allow us to see what the individuals are doing especially if their performance differs from the official manual.
John Roper (2001) edited and wrote verbatim from the diaries of John Samuel Apperson, 1st Virginia Brigade or “Stonewall Brigade.” Apperson described compounding and administering medications, organizing and inventory of supplies, dressing wounds, and administering anesthesia. He also talked about seeing patients independently, diagnosing and treating, vaccinating for smallpox, collecting tissue samples, extracting teeth, performing autopsies and triage, attending the wounded, practicing percussion and auscultation, and being an apprentice to a surgeon. At one time he went into the community to do minor surgery on a child’s neck and open an abscess. On other occasions he was doing surgery on gunshot wounds, amputating fingers, amputating below the knee, and removing a ball from a foot (excision rather than amputation). In reference to the nurses he stated “…staying up to see that the nurses gave every attention necessary.” After the war Apperson would continue in health care to become a physician and open Virginia’s first mental asylum.
Charles Earp (2002) edited and wrote verbatim from the journal of C. Marion Dodson. Dodson served as a Union Navy Steward aboard the USS Pocahontas, USS Arkansas, and USS Hollyhock. He describes his duties from a clerk to compounding prescriptions, but in addition he states he was also involved in diagnosis, treatment, minor surgery, administering chloroform, dentistry and prescribing medications. He volunteered to serve under a Yellow Flag (quarantined for Yellow Fever) on board a ship where the surgeon was ill and he was the sole provider. In addition he served on a second ship where he was also the sole provider, having no surgeon on board for an extended period of time and then with an ill surgeon who was unable to perform his duties. He also mentions nurses and states he had a male nurse detailed to assist him. Originally from St. Michaels, MD, he became a physician after the war with a practice in Baltimore, MD, and later retired back to St. Michaels.
Michael Flannery and Katherine Oomens (2007) edited and wrote verbatim from the journal of Spencer Bonsall, 81st Pennsylvania Infantry. Bonsall comments in his journal on compounding many prescriptions daily, opening boxes and examining stock “enough for a small drug store,” and dressing wounds. He also listed autopsies as one of his responsibilities. In reference to supervisory duties with nurses he stated that he took five nurses up to the Lacy House (Fredericksburg, VA) with orders to open a hospital. His military career ended a few months later at Gettysburg, PA.
Solon Hyde (1900) wrote a book about his own experiences as a Hospital Steward with the 17th Ohio Infantry during the early war years and more interestingly about his later war years serving as a Hospital Steward while being a POW. He was a prisoner in three different Confederate POW camps. At Pemberton POW camp, he took care of sick POW’s and was in charge of a hospital ward. At Danville POW camp, he worked as a Hospital Steward. At Andersonville, he was in the hospital outside the gates where he was in charge of the dispensary, was dispensing to civilians and families, was allowed to go out into the countryside to collect herbs, and on one occasion left to visit some lady friends! He not only survived Andersonville, but stated that he returned after the war with Clara Barton to help identify the thousands of unknown graves. He dedicated his book to Clara Barton.
Charles Beneulyn Johnson (1917) wrote a book about his experiences as a Hospital Steward with the 77th and 130th Illinois Infantry. He was one of the relatively few Hospital Stewards that left healthcare and returned to active duty only to retire his musket and return again to field hospital duty. His book is interesting in that as it was written 45 years post-war he contrasts the Civil War-era care he saw and delivered to what should have been done based on the current (1917) knowledge of medicine. He describes and discusses medical care, medicines, surgery, and nurses. One practice he describes is assigning numbers to favorite prescriptions. The surgeon ordered them by number and he compounded and administered them by number. He had no experience as a druggist or chemist, but was an educated man and apprenticed under the previous Hospital Steward. His book is a very descriptive narrative of the medical care that he saw the Surgeons deliver, but contains little detail of what he personally was doing as a Hospital Steward other than assisting at Sick Call. He briefly mentions nurses and matrons and at one point states that he personally “nursed” and cared for a patient with typhoid.
John Michael Priest (1995) edited and wrote verbatim from the many letters to his wife and the diary of John N. Henry, 49th New York Volunteers. John Henry served first as a nurse and later became a Hospital Steward. He stated that he was ordering and obtaining supplies and assisting the surgeon with sick call. Henry also stated that he set up a hospital and a smallpox hospital, was called out to see sick patients independently, and was called out to see a patient in an emergency. As for supervisory duties he said “…the charge of the inside of the hospital…over 50 men in my Supervision.” In relation to the importance of his position he stated “…any other person could leave (on furlough) better than I could…”
Alan West (2010) edited and wrote verbatim from 230 letters and the diary of Daniel McKinley Martin, 2nd Virginia Infantry and 5th West Virginia Cavalry. Martin discussed examining soldiers with the surgeon, making up pills and dispensing to the sick, setting up and maintaining a dispensary, cleaning compounding equipment and surgical instruments, and attending the wants of the wounded. He also referred to himself as the “tooth puller.” He stated he “vaccinated (for smallpox) perhaps 100 of our regiment today” and on another occasion mentioned “…how many operations I assisted with the doctor in performing I can’t tell…” For a period of time the surgeon went to Baltimore and Martin was “the only surgeon left with the regiment…I have to prescribe and dispense the medicines…” During his time on the march and in the field he was constantly prescribing, advising, and instructing his wife and daughter on health issues long-distance by mail.
After reviewing the primary sources it is obvious that the roles and responsibilities of the Hospital Steward far exceeded those that Woodward penned in his official manual. It could be that an individual overstepped his role, but yet some of the same themes appear from different Stewards. The reader sees mention of diagnosis, treatments, prescribing medications, administering vaccinations, performing minor surgery and suturing, and administering anesthesia. The most important repeated theme is autonomy or practicing independently. This theme of autonomy is repeated throughout the primary sources in a military environment or setting that was anything but autonomous. If one were to compare the Hospital Steward’s roles, responsibilities, duties, and skills along with his level of autonomy to modern day health care, a similar individual can be identified. Those individuals are Advanced Practice Nurses (APN), either Nurse Practitioners (NP) or Certified Registered Nurse Anesthetists (CRNA), and Physician’s Assistants (PA). These modern healthcare providers diagnose, treat, prescribe, administer immunizations, perform minor surgery, suture, and administer anesthesia with varying levels of autonomy, and in some cases independently, depending on site and state regulations. While Woodward identified the Hospital Steward as a combination of pharmacist and hospital administrator and nursing supervisor, based on primary sources one could add to the list the first APN/NP/CRNA/PA. He really was a “workhorse” and the list continues to grow.
Want to learn more? Read Meet the Hospital Steward
Learn more in this interview with Dr. William Campbell, the article’s author
Earp, Charles (Ed.). (2002). Yellow Flag: The Civil War Journal of Surgeon’s Steward C. Marion Dodson. (Charles Albert Earp, ed.). Baltimore: Maryland Historical Society. (Original journal entries written 1864-65).
Flannery, Michael, and Oomens, Katherine. (2007). Well Satisfied with my Position: The Civil War Journal of Spencer Bonsall. Carbondale, IL: Southern Illinois University Press.
Gillett, Mary. (1987). The Army Medical Department 1818-1865. Washington DC: Center of Military History, United States Army.
Hyde, Solon. (1996). A Captive of War. Shippensburg, PA: Burd Street Press. (Originally published: 1900, New York: McClure, Phillips & Co.).
Johnson, Charles Beneulyn. (1917). Muskets and Medicine or Army Life in the Sixties. Philadelphia: F. A. Davis.
Letterman, Jonathan. (1866). Medical Recollections of the Army of the Potomac. New York: D. Appleton & Co. (Reprinted).
Moore, Samuel Preston. (1992). Regulations for the Army of the Confederate States. (New introduction by Ira M. Rutkow.) San Francisco: Norman Publishing. (Original work published 1862, Richmond: Randolph).
Priest, John Michael. (1995). Turn them Out to Die Like a Mule: The Civil War Letters of Hospital Steward John N. Henry, 49th New York, 1961- 1865. Leesburg, VA: Gauley Mount Press. (Original letters and diary 1861-1865).
Roper, John (Ed.). (2001). Repairing the March of Mars: The Civil War Diaries of John Samuel Apperson, Hospital Steward of the Stonewall Brigade, 1861-1865. (Jason Clayman, Peter Gretz, and John Herbert Roper, Trans.). Macon, GA: Mercer University Press. (Original letters 1861-65).
West, Alan I. (2010). Remember Me: Civil War Letters Home from a Hospital Steward 1862-1864 Daniel McKinley Martin. Chicora, PA: Mechling Bookbindery.
Woodward, J. J. (1991). The Hospital Steward’s Manual: For the Instruction of Hospital Stewards, Ward Masters, and Attendants in their Several Duties. (New introduction by Ira M. Rutkow.) San Francisco: Norman Publishing. (Original work published 1862, Philadelphia: Lippincott).
About the Author
Dr. Campbell is an Associate Professor and RN Coordinator at Salisbury University in Salisbury, MD. He has been with the faculty of the Department of Nursing at SU for fifteen years and has been a Registered Nurse (RN) for 31 years. He teaches undergraduate nursing courses in pediatrics, pharmacology, and health assessment. Dr. Campbell attended Philadelphia College of Pharmacy & Science, completed undergraduate degrees in biology, psychology, and nursing at the University of Delaware, a masters degree in family nursing at Salisbury University as a clinical specialist, and his doctor of education in educational leadership at the University of Delaware. He is a member and docent of the NMCWM, and spends much of his free time reading, researching, and speaking as a living history interpreter on topics of Civil War era medicine and nursing.