PDF Marrow of Tragedy: The Health Crisis of the American Civil War by Margaret Humphreys in History

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9 of 9 people found the following review helpful. Review of Margaret Humphreys; Marrow of Tragedy: The Health Crisis of the American Civil WarBy A J Hawk[...]The past couple decades have seen the publication of a number of books documenting Civil War medicine. The classics are George Worthington Adams Doctors in Blue published in 1966 and H.H. Cunningham's Doctors in Gray published in 1958. The Society of Civil War Surgeons ; founded in 1980; publishes a quarterly journal for its membership of scholars and reenactors. There are at least a dozen books currently in print covering various aspects of the topic. More recent comprehensive treatments; Frank R. Freemon’s Gangrene and Glory: Medical Care during the American Civil War; published in 2001; and Alfred Jay Bollet’s Civil War Medicine: Challenges and Triumphs; published in 2002; beg the question whether another book is necessary or redundant.Margaret Humphreys promises a gendered approach to Civil War medicine; exploring of how masculine and feminine behaviors and attitudes affected the structure of medical care. The author wisely used this approach as her muse or point of departure and was not heavy handed in its application in subsequent chapters. While most authors of this topic focus primarily on military medicine performed within the combat zone; Humphreys focuses on medical care in the general hospitals established in major towns and cities throughout the country. The book is a study of how the Army Medical Department and concerned civilians adapted and created institutions; such as hospitals and nongovernmental organizations; to deal with an unexpectedly large number of sick and wounded men.As one would expect from a book that promises a gendered approach; the author explores the role of women as nurses; physicians and social workers. She objectively describes their success as well as their limitations. Most women physicians of the period had minimal surgical knowledge and were more likely trained at less conventional medical colleges; and; even if you factor out gender; were unlikely to be accepted in the Medical Department as surgeons. Only three female physicians served in the U.S. Army during the war; two as nurses with only Mary Walker serving as a Contract Surgeon . One woman doctor practiced briefly as physician for the Confederate Army. Female physicians did find more success; and ultimately acceptance by both the lay public and their professional colleagues; in civilian communities facing a shortage of doctors. Many women served as nurses during the war on both sides. However; this book is more than a women’s history of the Civil War.The first chapter summarizes the state of the art of medical practice in 1860. The next chapter describes the influx of women transferred their traditional role of taking care of the sick in homes into the newly established hospitals and; by extension; the army. The third chapter discusses the impact of infectious disease during the Civil War.The fourth and fifth chapters describe the establishment; purpose and evolution of the U.S. Sanitary Commission; precursor to the American Red Cross. Chapter nine describes the Sanitary Commission’s attempts to provide relief to enemy prisoners of war. The commission’s role evolved from training surgeons about camp hygiene and providing medical supplies to mitigating the horrors of war. The author describes an organization torn between its humanitarian impulses as it tries; with mixed success; to improve the conditions of confederate prisoners of war; who endured Andersonville-like conditions; and its duty to the northern cause; where it struggled with whether it should publically criticize conditions in northern prisoner of war camps. These three chapters provide one of the best analysis of the evolving role of the Sanitary Commission found in the literature.In Chapter six; the author uses Satterlee General Hospital as a case study in describing the workings of rear echelon medical care. She explains how novel the concept of a hospital was at the beginning of the war; since most of the sick were treated in the home; by doctors making house calls and nursed by their sisters; mothers or wives. She provides a detailed account of the hospital; including physician; nurse and patient perspectives on life at the hospital.In chapters seven and eight; the author turns her attention development of medical institutions in the Confederacy. The polity of the south was decentralized as was healthcare; “The benevolent impulses of the south remained on a states’-rights basis. While the USSC (Sanitary Commission) decried this attitude – condemning the woman who walked past a Wisconsin bed to tend to an Illinois one – and saw as being in concert with the very roots of the rebellion; the southern woman who tended the wounded had no difficulty in choosing to help only “our boys.” Without a national organization such as the USSC to organize and stream benevolence to hospitals where it was needed most; confederate women’s relief work remained resolutely local. If women traveled to Virginia to nurse; they headed for hospitals in their states; they likewise channeled food; clothing; and other support to the men of their state regiments.”In chapters ten and eleven; the author explores the legacy of the war in medicine and public health. Physicians attributed disease to contagion; where disease is spread by physical contact. She argues that the concepts of sanitation and organization that were disseminated during the war led to widespread application in cities and towns after the war in hospital hygiene and public health campaigns.However; the author moves onto shaky ground when she argues the countermeasures against contagion prepared for the acceptance of the germ theory of disease. Her argument is nuanced. She describes that contagion theory used terminology later used to describe processes of infection by microorganisms; but recognizes that the two theories represent radically different concepts. She notes that the evidence supporting the argument is not clear cut. The difficulty she faces in making that case is an anecdote; where an American surgeon proudly proclaims that better hygiene in American hospitals; a result of the application of sanitary principles learned during the war; led to a lower mortality rate; making Listerian methods unnecessary. Her understanding of the nuance of the issue hampers her ability to make the case.However; the main point of the book is to explore the development of an American healthcare system during crisis. In that; Margaret Humpherys makes a valuable contribution to the literature of Civil War medicine and the history of medicine by sharply focusing on rear echelon military healthcare. She adroitly uses primary and secondary sources to make her explain the significance of such innovations as the development of hospitals; non-governmental organizations; nurses; social workers and improved sanitation. This book shines a bright light on previously unexplored aspects of the War and belongs on the bookshelf of anyone interested in the impact of the war on American society.1 of 8 people found the following review helpful. Excellent review of a neglected sad time in medicine in the USBy daniel gottoviThis was a sad episode in American medical history. Not surprising in light of the feelings about people with dark skin at that time even among the educated political and military leadership.4 of 5 people found the following review helpful. Public Health During A The Time Of A Brothers' WarBy Civil War LibrarianMargaret Humphrey’s Marrow of Tragedy: The Health Crisis of the American Civil War (2013) consolidates the scholarship of the past two decades and reviews the material from the perspective of society-wide public health issues. Many Americans during the mid-19th century were accustomed to healing and recovering in a Victorian home sickroom visited by a doctor and attended to by a mother or sister. Home cooked food; served to a sick or injured person lying in clean bed occupying a room with ventilation were the essential elements of regaining personal health. Public hospitals and asylums were used by the poor; travelers; or sailors.For those who fought it; the Civil War “was less about heroism and more about the daily grind of disease; hunger; death and disability.” [2] Marrow of Tragedy: The Health Crisis of the American Civil War describes a humanitarian revolution that came to grips with the Victorian elites’ cultural understanding of the virtues of honor and heroism; manliness and military service. Within the past two years; an estimate of the war’s death toll rose from 625;000 to more than 750;000 and counting civilians nearly 800;000. Roughly two thirds of military deaths were brought about through disease and approximately 56;000 soldiers died in prison camps during the conflict. It is estimated that 60;000 men lost limbs in the war. Margaret Humphreys understands the Civil War to be the greatest public health disaster in the nation’s lifetime.Humphreys finds that during wartime the role of women in medicine expanded during debates over the causation and prevention of infectious diseases; the re-design of hospitals; and the limits of proximity that women could approach the battlefields. In the course of several chapters; Humphreys presents how the benevolent Unitarianism of the U.S. Sanitary Commission challenged the brutally of civil war. Both the Federal and Confederate hospital systems are described and women’s participation in them. Prisoner of war camps; the debate over the Geneva Convention and the newly drafted Lieber Code are described as challenges and opportunities for the U.S. Sanitary Commission and its volunteers.Humphrey sustains a gendered approach throughout Marrow of Tragedy; she describes this focus as following LeeAnn Whites’ and Nina Silber’s constructions of language; and notions understood by both Northerners and Southerners. The author describes the “perceptions of what behaviors and attitudes were masculine or feminine” and how these perceptions affected the structure and conduct of medical care. There are elements in the discussion that may press her gendered approach forward a bit too far. Humphreys sides with one historian who describes antebellum military doctors as “somewhat feminized” due to the fact that medicine carried “the feminine message of cleanliness; nutrition; and the proper care of the sick.” [15] Possibly cleanliness; nutrition and proper care are not fully male or female attributes; but characteristics of humankind altogether.Conversely; Humphreys’ gendered approach does elucidate the mid-19th century Victorian sentiments which were embraced by the social elites within the professional and political classes; if not all Americans. She sees the home front as containing “women who were not allowed to enlist in the armies” but who could encroach “into military space through the medium of hospitals; relief work; and other forms of medical care” including the U.S. Sanitary Commission. [18] The author places Marrow of Tragedy within the current trend of war and society studies ‘that emphasize the connections between social organization; political institutions and military” activities. Humphreys views the U.S. Sanitary Commission as essentially connecting the home front to the military camps and hospitals. The volunteer organization; though organized and supervised principally by males; significantly depended upon females’ voluntary service. Bedding; clothing; literature; food and medical supplies were gathered by women who organized donation campaigns and sewing circles.The U.S. Christian Commission [USCC] receives three slight mentions. The dual missions of the USCC included were nursing on battlefields and in hospitals and aiding in the spiritual formation of the soldiers. During the course of the war 5;000 USCC delegates served in hospitals and camps; $6 million were raised including $3 million in supplies. Immediately after the Battle of Gettysburg; a USCC medical warehouse was located on the town’s square. Better covered are the Roman Catholic nursing sisters. Humphreys notes that 617 Catholic sisters served both sides. Nearly 15% of this total served at Satterlee Hospital in Philadelphia.Humphreys concludes Marrow of Tragedy with two chapters on the public health legacy and medicine in post-war era. The war “energized and educated physicians and the ruling classes to improve the health of the American population through sanitary measures.” [288] The USSC vision of a national public health policy was not sustained; though the military model of medical efficiency was. The transformation and dissemination of the germ theory is discussed in Marrow of Tragedy. Humphrey notes that two decades after the war; the germ theory was readily embraced in Europe but was still very much suspect in the United States. Candice Millard’s work on the Garfield assassination; Destiny of the Republic: A Tale of Madness; Medicine and the Murder of a President; makes this clear.In Marrow of Tragedy Humphreys offers a graceful narrative style. The organization of the chapters will satisfy the general reader and the academic. Chapters contain an introduction; three to five subdivisions and a conclusion. The book carries extensive bibliographic notes and a detailed index. Humphrey’s work accomplishes several tasks. It puts mid-19th century health care through a prism of military concerns; civilian responses to war; medical science and women’s empowerment. It offers clear and concise depictions of individuals and their vendettas; such as military officers embracing or not tolerating civilian efforts. Marrow Of Tragedy: The Health Crisis Of the American Civil War presents a compelling story of Americans; civilian and military; struggling together to do acts of mercy and create better environments during an era of brother against brother bloodshed.Author of Review: Rea Andrew Redd is the Director of Eberly Library; Waynesburg University and the author of The Gettysburg Campaign Study Guide; Volume 1 (2012).Copyright © 1999- 2014 Civil War Book Review. All rights reserved.Full Text Source: Civil War Book Review Issue: Winter 2014 [Louisiana State University]Posted by Rea Andrew Redd at 3:41 PM