At the beginning of the Civil War it was assumed that it would only take place for 90 days or less. There would be one big battle and the South would go its own way. With that in mind, the responsibility for caring for the sick and wounded would be left to the civilian population of the Confederacy until the government would decide that it needed to take control.

After the Battle of Manassas, the Confederate Capitol of Richmond became one large hospital as wounded and dying men were housed in temporary hospitals in private buildings.

Warehouses, private homes, and churches were all used to house the invalids. As the war dragged on, the realization dawned on both the military and civilian population that they needed to step up and plan assistance for the brave soldiers.

In South Carolina, the United Daughters of the Confederacy started to organize Southern women in that state starting on July 21, 1861.

While the Confederate Medical Department had been organized in February, 1861, there were only about 50 medical officers in the corps. These were former U.S. Army and Navy personnel.

One of the officers, at the age of 22, was put in charge of a battalion of 500 infantry with only the assistance of a hospital steward.

It was not until December, 1862, that the Confederate government started to consolidate the hundreds of interim hospitals.

How did these men get served until this consolidation took place?

Aid associations of southern women made medical supplies, established hospitals and treated casualties.

Many of these organizations started within churches and with ministers of the South.

There were more people attending church on any Sunday than actually voted in the election of 1860. An example of this is Kate Cumming from Mobile, Alabama. She volunteered for the Army of Tennessee after she listened to an address by the Rev. Benjamin M. Miller of St. John’s Church. Of the 30 women who volunteered, only three remained after the Battle of Shiloh.

Many of these women volunteered because of their religious convictions, seeing this work as a way to instill religious principle into the soldiers under her supervision.

Other women saw this service to the sick as a way to fulfill their patriotic duty to the Confederacy.

These ladies aid societies usually started as gatherings of local women that later became formal groups.

Unlike those of the North, they did not form into a more “national” group until later in the war. There were over 1,000 of these organizations at one time in existence.

These women pooled their resources and divided the labors of the group. Supplies of spinning wheels, looms, and sewing machines were shared. The organizations could collect more funds than if they were locals or individuals seeking funds. The organizations tended to be organized around state or counties within a state. Unfortunately, this resulted in an unequal distribution of supplies.

Mary Chestnut, wife of Confederate Senator James Chestnut from South Carolina, observed this in the Richmond “State Run” hospitals.

The South Carolina Hospital Association received funds from both Governor Francis Pickens and conducted a fair to raise money for the “medical care of our soldiers.” Funding for the Societies came from cash donations, fund raising events such as bazaars or plays, and donations from families. This was so critical in 1861, as the Confederate Congress only allocated $50,000 for the establishment and support of military hospitals.

The first hospital established in Greenville, SC, was organized by the Soldiers Relief Society of Greenville.

The hospital was established in the local Male Academy (school). Some of these hospitals were established by medical emergencies. One such was at Columbia, SC, in September, 1861.

A measles outbreak resulted in the town collecting cots, bedding, and other supplies at the local fairgrounds.

Once the Union blockade tightened its grip on the South, the medical department was forced to look at indigenous plants and home remedies for medical “cures.” The ladies aid societies not only started medicinal gardens, they searched the meadows and forests for these indigenous substitutes.

Many of the aid societies also established small wayside hospitals at train stations.

These temporary hospitals treated the sick and wounded on their way to general hospitals.

It also assisted the furloughed wounded soldiers who were trying to get home to recover from their illness or wounds. The ladies of Abbeville, South Carolina set up one of these in 1865.

Two ladies met each train that came in and cared for those who could not be transported further. The Wayside Hospital at Columbia, SC treated over 75,000 soldiers during the war.

Some of these organizations even communicated with each other. The Ladies Aid Societies of Eutawville and Charleston, SC actually kept copies of their communications.

They made requests for certain items from each other, trading items at critical times. An example was the request of the Charleston Society that obtained 139 shirts from the Eutawville Society. The Fairfield Society sent $100.00 to the Charleston Society to help with the treatment of the wounded in August, 1863. These women were incredible in their efforts.

The Ladies Auxiliary of Black Oak, Mississippi made as many as 1,000 pieces of clothing within a three week period.

When stoves for hospitals were of short supply because of the blockade, the Ladies Relief Society of Fairfield, SC bought a stove for the Columbia Hospital so the sick and wounded could remain warm.

In September, 1862, the Confederate Medical Service took over the control of all hospitals in which soldiers were treated. This was done through the “Act to better Provide for the Sick and Wounded of the Army in Hospitals” that was approved on September 27, 1862.

The act was issued as General Order No. 93 to the military by the Adjutant and Inspector General’s Office on November 22, 1862.

This act limited the ladies aid societies and volunteer organizations from administering, provisioning, and staffing of the hospitals of the Confederacy.

The hospitals continued to look the other way when they could not purchase necessary items and still acquired them from the aid societies when necessary.

Many of these local or state hospitals that were taken over lacked sufficient ventilation and systems to dispose of sewage. Many of them were in low lying areas and were very disorganized.

Once they were taken over by the government, many small state hospitals were closed in favor of pavilion plan hospitals that were built.

These were detached wards, usually single story, that housed 50 soldiers. This also “solved the problem of visitors.”

There were too many visitors as well as curiosity seekers and relatives at all hours in the hospitals run by the ladies’ aid societies.

Some of these people were providing foodstuffs that were not on the medical diets of those patients.

After reorganization, Dr. Samuel Stout of the Army of Tennessee found that the death rate dropped 3% in one month in his hospitals.

He credited the drop in mortality to better organization of the hospital, greater control of the patient’s diet, better ventilation of the wards, and improved control of the sewage disposal.

This resulted in fewer warehouses, stores, churches, courthouses, hotels, meeting halls, schools, and unoccupied homes being used for the sick and wounded.

After November, 1862, some of the women in the associations still continued to provide vital support to the hospitals through the Confederacy. Some of these women even became matrons in these consolidated hospitals under the employment of the Confederate Medical Department.

Until next Month

Your Obt. Servant

Surgeon T.T. Steinbach

Army of Tennessee Field Hospital (CSA)