On February 28, 1827, the Baltimore & Ohio Railroad became the first U.S. railway chartered for commercial transport of passengers and freight.

There were skeptics who doubted that a steam engine could work along steep, winding grades, but the Tom Thumb, designed by Peter Cooper, put an end to their doubts. Investors hoped a railroad would allow Baltimore, the second largest U.S. city at the time, to compete with New York for western trade.

The first railroad track in the United States was only 13 miles long, but it caused a lot of excitement when it opened in 1830.

Although the usefulness of the railroads for the army logistical support started in 1861, the idea of using them to move the wounded away from the battlefield did not start at the beginning of the war.

The first use of railroads to evacuate soldiers was during the Crimean War of 1854-56.

The three month Italian War of 1859 had over 89,000 casualties of the French, Italian and opposing Austrian armies were evacuated in unmodified passenger trains from overcrowded hospitals after the battles.

The railroads were used to move casualties away from field hospitals to rear hospitals where they could receive better care.

In 1861, the United States had more than 30,000 miles of railroads while the South had only 8,000 miles.

They were immediately used for shipping men and material to the front lines.

It quickly became obvious that railroad junctions were important strategic targets. General McClellan wrote to Lincoln, “it cannot be ignored that the construction of railroads has introduced a new and very important element into war by the great facilities thus given for concentrating at particular positions large masses of troops from remote sections, and by creating new strategic points and lines of operations.”

During the first six months of the war, the U.S. Army dealt with railroads in a chaotic manner. Army rail movements were not coordinated. Field units frequently used boxcars as warehouses.

Finally on January 31, 1862, President Lincoln signed into law a bill granting the United States government the authority to centralize the administration of the nation’s railroads and to commandeer specific rail lines as necessary.

Secretary of War William Stanton appointed Colonel Daniel C. McCallum as superintendent of the U.S. Military Railroad and Colonel Hermann Haupt as Chief of Construction. Both men had experience in railroad operations and were able to rebuild and organize them into a system that would win the war.

Supplying the Army was a monumental task. In 1862, the daily resupply requirement for the Army of the Potomac was 191.7 tons of rations, 411.9 tons of forage for animals, 63.9 tons of small arms ammunition, and additional artillery ammunition, replacement clothing and equipment, or medical supplies. The first priority for shipment of supplies was rations, followed by forage, ammunition, and then finally, medical supplies.

Medical evacuation by rail by the medical department quickly became accepted practice. The use of empty railcars returning from battlefields provided the ideal way to evacuate soldiers. The first hospital trains used the floors of the boxcars that were padded with straw, pine branches and whatever blankets were available.

These cars were very uncomfortable for the wounded, especially those with broken bones. Soldiers had the swaying, jarring, and jolting, riding on uneven rails. Ventilation in these closed cars was non-existent.

Katherine Wormeley, a Sanitary Nurse, described the cars; “the worst cases are put inside the covered cars …They arrive a festering mass of dead and living together.”

In June, 1862, Dr. Elisha Harris, U.S. Sanitary Commission, rode on one of the improvised hospital trains and witnessed the suffering caused by the jostling motion of the car.

During the trip, Harris sketched out a system for hanging the stretchers with India rubber rings for shock absorbers. By October, 1862, Philadelphia, Wilmington, and Baltimore railroad was the first company to outfit and donate a hospital car configured to Harris’s specifications.

Fourteen cars were built and ten were put in service on various long routes, while the remaining four were on the rail line connecting hospitals in Louisville, Kentucky and Nashville, Tennessee with General Grant’s Army of the Tennessee.

These railcars reduced the travel time from Louisville to Nashville to 24 hours. You can see these cars in the February 27, 1864 issue of Harper’s Weekly that depicts the interior of a Union hospital car during the American Civil War. (http://railroads.unl.edu/documents/view_document.php?id=rail.str.0217) Soldiers described the ride as just as comfortable as the beds of a hospital.

The Harris car made it possible to also have dedicated medical attendants to go from car to car while the train was in motion checking on the patients.

This was not possible in converted freight cars. The moving train did make treatment of the patients difficult. This new design did allow for the same stretcher that carried a wounded soldier off the battlefield to be used to transport him on the railcar simplifying the loading and unloading of patient.


It is not clear who ordered the first medical evacuation by rail during the Civil War, which occurred after the battle of Wilson’s Creek on August 10, 1861. U.S. Army was forced to leave its wounded soldiers to be captured by Confederate forces.

The wounded were paroled and placed under the care of Assistant Surgeon S. H. Melcher, Fifth Missouri Volunteers, comfortable. During October, he sent one hundred and fifty of these patients to Rolla, (Missouri). On November 11th he started with the remaining wounded, all of whom arrived safely in St. Louis on November 19th.

Men recovering from gunshot wounds traveled over one hundred miles along a dirt road from the battlefield to Rolla, where they were loaded onto bare floors of boxcars and shipped an additional one-hundred and ten miles of unsettled railroad tracks to the general hospital in St. Louis.


Assistant Surgeon DeWitt Peters, who had been detailed by Letterman to convey 1,500 wounded soldiers to Washington, DC, described the journey, “The transportation from Falmouth to Aquia Creek was ample, but many of the cars consisted of simple platforms without covering, and were ill adapted for transporting men badly wounded, especially in midwinter; and, for this reason, some of the unfortunate suffered much.

Many of them had lost their blankets, but at the depot I found a supply belonging to the Sanitary Commission. The time occupied in making the journey to Washington was seventeen hours.” 6,000 wounded were evacuated without any fatalities.


The largest evacuation of the wounded by rail occurred after the Battle of Gettysburg. Improvised hospital trains transported 11,425 wounded soldiers from the battlefields of Gettysburg, Pennsylvania to general hospitals in Baltimore, Maryland, York, Pennsylvania, and New York City within fifteen days.

The journey for the wounded began at a Sanitary Commission hospital located at a railroad depot, described by Katherine Wormeley.

“During the battle all the wounded were gathered into field hospitals, ...from which those who were able to be removed to a distance were brought to the railroad depot, where…large tents (were) erected for their reception and refreshment during the interval of the departure of trains morning and evening.”

When Medical Inspector Edward P. Vollum arrived at the Gettysburg railroad depot five days after the battle, he found two thousand wounded men awaiting transportation. Once General Haupt arrived and assumed military control of the railroad to Hanover Junction, we then experienced no further. Usually two trains ran each day, one in the morning and one in the afternoon. On July 9, over two thousand soldiers were sent to Baltimore and on July 12, the next busiest day, 1,219 soldiers were transported to Baltimore on three different trains. On the other days, the daily number of soldiers shipped to the rear ranged from 300 to 800.

This transportation effort required the medical department, the quartermaster’s corps, and various civilian relief agencies to focus together their efforts. The train of wounded were placed in charge of a medical officer. Instruments, dressings, and stimulants were furnished him, and he was instructed to announce his coming by telegraph, if possible, and report to the Medical Director at the place of his destination. Each car was filled with a sufficient quantity of hay, and, on longer routes, water coolers, tin cups, bedpans and urinals were placed in them, and guarded on the route by some agents of the Sanitary Commission. Before leaving Gettysburg, the wounded were fed and watered by Sanitary Commission staff. At Hanover Junction, they were rewatered and fed by the Christian Commission staff. Once they arrived in a city like Baltimore, the benevolent societies distributed food to the wounded. The army at Harrisburg, through the commissary department fed any wounded passing though that city.

These hospital trains moved at a slow rate of speed displaying a yellow hospital flag near the engine and had painted on the side of the cars, “U.S. Hospital Train.” At night, beneath the headlight of the engine, three red lanterns were suspended in a row to indicate that this was a hospital train that must be given safe passage.

Until next month

Your Obt. Servant

Surgeon Trevor Steinbach

17th Corps Field Hospital