Looking Back: The father of battlefield medicine
Courtesy of the descendants of Dr. Jonathan Letterman
Dr. Jonathan Letterman with a patient
Courtesy of Washington County Historical Society
Dr. Jonathan Letterman with his staff
Courtesy of Washington County Historical Society
Dr. Jonathan Letterman
Those who have traveled the Civil War battlefield sites have undoubtedly heard the stories of horrific injuries sustained by soldiers.
You would have been told about soldiers lying on the battlefield calling out and waiting for someone to carry them to safety. Sometimes it was days that they would wait.
Many soldiers, who might have been saved if gotten to quickly, would die where they fell due to dehydration or exposure. Most likely you have heard the stories of soldiers being given a shot of whiskey and a bullet to bite on as they had limbs amputated. Or been told of those limbs then being thrown outside the medical tent onto an ever-growing mountain of body parts.
These stories paint a very grim picture of surgery during the Civil War. One surgeon during this period, upon beginning his service in the Army of the Potomac, also saw these conditions and made it his mission to develop a solution to the problem.
Dr. Jonathan Letterman was born in Canonsburg on December 11, 1824. His father was a prominent surgeon in the area and made sure his son received a proper education during his childhood.
Letterman would go on to attend Jefferson College, graduating in 1845. Shortly after graduation, Letterman entered Jefferson Medical College in Philadelphia.
He decided to pursue a career as a military surgeon and entered the Army immediately following his graduation from medical school in 1849. Serving as an assistant surgeon in the Army Medical Department, he would take part in several military campaigns against Native American tribes throughout the country over the next 10 years.
With the outbreak of the Civil War, Letterman was assigned to the Army of the Potomac as a surgeon, but by June 1862 had been promoted to medical director of the Army of the Potomac.
Following the battle of Second Manassas, Letterman was appalled by the fact that it took more than eight days to fully remove the wounded from the battlefield. He saw issues not only with organization, but also the efficiency of the medical department.
One of the first changes Letterman implemented was the organization of a separate ambulance corps.
Before Letterman took over, it was the responsibility of the soldiers fighting to remove their own wounded comrades from the battlefield and get them to the nearest aid station or hospital. This method resulted in a high casualty rate, which was unacceptable to Letterman.
He instituted a separate ambulance corps made up of officers and enlisted men to remove the wounded from the battlefield using two- or four-wheeled carts. This newly developed ambulance corps laid the groundwork for the ambulance services used in the modern Army.
Letterman’s methods were tested during the Battle of Antietam, where the new ambulance corps removed more than 23,000 wounded soldiers, both Confederate and Union, from the battlefield within 24 hours.
Letterman would expand on this by developing a more detailed evacuation system. First, there would be a field dressing station near the fighting that could apply dressing.
Letterman’s second change was locating a field hospital in a nearby barn or house where further treatment or emergency surgery could be performed; it was in these settings that “triage” procedures became instituted.
Lastly, Letterman called for establishing regional hospitals that were away from the battlefields that could provide long-term treatment. This system was tested at the Battles of Fredericksburg and Gettysburg. In both instances, Letterman’s system was a success – accounting for several thousands soldiers’ lives being saved that previously would have been lost.
In March 1864, the U.S. Congress adopted Letterman’s system as official practice for the Army.
In December of that year, Letterman resigned from the Army and moved with his wife, Mary Lee, to San Francisco. There, he would serve as coroner until his death.
Mary passed in 1867, and following her death, Letterman would suffer from several illnesses and bouts of depression. He followed Mary Lee in death March 15, 1872. He was buried in Arlington Cemetery with the following inscription on his gravestone: A man “who brought order and efficiency in to the Medical Service and who was the originator of modern methods of medical organization in armies.”
Letterman’s legacy lived on long after his death when the Army named the hospital at the Presidio in San Francisco the Letterman General Hospital.
The hospital came under the ownership of the National Park Service when the site was decommissioned by the Army. The building itself was demolished in 2002, and in 2005, Lucasfilm opened the Letterman Digital Arts Center on the site of the former hospital.
Katie West is the former curator for Washington County Historical Society.