Matchless Organization: The Confederate Army Medical Department by Guy R. Hasegawa. Southern Illinois University Press, 2021. Paper, IBSN: 978-0-8093-3829-0. $26.50.
In Matchless Organization, Guy R. Hasegawa offers a clear, detailed, and thorough history of the Confederacy’s military medical organization. The book is largely procedural, walking the reader through the organization of the department and the various steps its leadership took in the attempt to get it, and keep it, running.
In 1861, when the seceding states began the task of building a government and military from the ground up, the need for a military medical organization was apparent. Three surgeons and twenty-three assistant surgeons resigned from the federal army and offered their services to the organizing southern army. In February 1861, the Medical Department of the Confederate Army was officially established and, after some staff shuffling, was settled into the hands of Surgeon General Samuel Preston Moore. Moore had long experience in military medicine, first entering the U.S. Army in 1835; he also had a good Southern pedigree, with a medical degree from the Medical College of the State of South Carolina. Hasegawa traces the work that Moore did to try to build a functioning medical department from the ground up: finding ways to import medical supplies around blockades, making sure that hospitals ran efficiently, and vetting incoming medical staff to ensure a skilled and educated department.
The department was continuously beset with problems, much of it the fault of Confederate leadership. For example, legislation to appoint medical officers to each regiment and create an infirmary corps was vetoed by Jefferson Davis in the fall of 1862; Davis asked the Confederate Congress to make small clarifications to the bill. The legislation was reintroduced and revised the following spring, only to languish without a vote. Surgeon General Moore was forced to use improvised workarounds to get his infirmary corps.
Supplies were also a constant problem. Most medical goods, from medicines to surgical instruments, were imported through or made in the North, so the department was forced to think creatively about how to get necessary supplies around the blockade. For instance, in 1863, Moore and his medical purveyor, George Blackie, purchased 2,000 bales of cotton, which they shipped to Europe through Bermuda and used to trade for medical supplies. This created an almost absurd process. One order for a shipment of quinine and medicine was sent to British traders in Nassau, who took it to New York City for fulfillment. The supplies were shipped back to Nassau and, finally, nearly a month later, were delivered to Richmond, all under the British flag (64).
In the federal army, the medical department found ways to advance medical science by meticulously collecting materia medica and to augment manpower through the creation of the Invalid Corps. The Confederate medical department tried to do the same, but as with everything else, was hampered by inflation, dwindling manpower, and general disorganization. A medical journal, founded in 1864, lost money as inflation drove up production costs. Collected medical records burned when members of the government evacuated Richmond. An invalid corps was created in the winter of 1864, but the book does not make clear what it was used for or how large it was.
In recent years, there has been a new wave of research into the medical history of the Civil War era, with texts such as Shauna Devine’s Learning from the Wounded examining the military medical profession from a variety of angles. Despite this recent interest, the Confederate medical department has been largely understudied. With the classic study of the topic (H. H. Cunningham’s Doctors in Gray: The Confederate Medical Service) dating to 1958, this new text provides a welcome new perspective. While most recent studies on Civil War medicine offer broader analysis and contextualization, Hasegawa sticks to an administrative history. It’s clear that Hasegawa has set out to write the authoritative text on the subject, marshalling more sources than Cunningham was able to access and including valuable appendices and detailed notes. The result is an eminently useful book, one that I know I will reach for when writing a class lecture. But it also left me wanting more. Hasegawa is a booster, convinced that the organization is worthy of praise. In the book’s final paragraph, he writes that, “in light of conditions under which it operated, it is fair to characterize the Confederate Medical Department’s performance as above any reasonable expectation and eminently worthy of study” (183). I completely agree that the Confederate medical department is worthy of study, but Hasegawa doesn’t go much further than giving us an introduction to the organization. I wanted analysis of the economic strife and political failings that held the department back, as one example, and desperately wanted to know more about the handful of women who worked in the Surgeon General’s office. Nevertheless, this is a welcome addition to the scholarship on Civil War medicine.
Sarah Handley-Cousins is clinical assistant professor of history and associate director of the Center for Disability Studies at the University at Buffalo. She is the author of Bodies in Blue: Disability in the Civil War North.