A New York Times reporter observed, “Great complaint is made in regard to the conduct of the volunteer surgeons, who recklessly amputate the limbs of the wounded, and leave them destitute of the care needed for their recovery. Many operations are performed without judgment, and in a totally unjustifiable manner, frequently hastening the death of the patient.” Another doctor, James Oliver, of the 21st Massachusetts Volunteer Infantry, recorded a converse opinion: “I had an opportunity to watch the result of gunshot wounds to know how severe a wound must be to require amputation. Came to the conclusion that too many cases were left to nature and the knife was not used enough after a battle.”

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Some amputations were botched. Samuel Watson of the 118th Pennsylvania Volunteers was shot in his left leg at the Battle of Shepherdstown on September 20, a follow-up action to the main fight on the 17th, and the leg was amputated below the knee on the 21st. Dr. E.M. McDowell of the U.S. Volunteers, working in Sharpsburg’s German Reformed Church, took off the limb. McDowell wrote in his case book on October 11 that Watson “must die unless the whole [leg] is removed by an operation above the knee and I have become sick of amputating thighs secondarily.” McDowell was sadly correct, Watson died on October 14.

The conditions of the various field hospitals did not help ensure a high survival rate. Thousands of injured gasped and groaned in breeding grounds of infection that contributed to many deaths. Many hospitals were set up in barns or houses, and wounded could also be found in churches, stores, sheds, carriage houses, corncribs, stables and mangers, in the open air under tents, or simply laid out on haystacks, in fields and orchards.

Animal manure and its attendant flies and other insects, the lack of ventilation and of sufficient light and the fact that many men lay almost on top of each other in filthy blood-caked uniforms accelerated the spread of disease. Many eventually died from typhoid fever, diarrhea or diphtheria rather than from their wounds. Those scourges also spread to and killed many local citizens.

The deplorable conditions of the Antietam hospitals inspired a government investigation, which took place in November. Assistant Medical Inspector W.R. Mosely found that intolerable conditions still existed. After he toured the hospital in Sharpsburg’s St. Paul’s Methodist Episcopal Church, he reported, “All the churches used for hospitals in Sharpsburg are in a dilapidated condition, and filthy, and unfit for the purpose for which they are used. This is especially the case with the Episcopal Church…there is not a window in the building and no means of ventilation except by removing…part of the canvas which occupies the place of glass and sash in the window frame. The interior of this place presents a spectacle of misery and poverty.”

At the Smoketown hospital, the longest-lasting of all the Union hospitals, he found that “The medi­cines are on the grounds, and tables, boxes, etc. without order or regularity. There is want of attention to the police of the wards and camp. Dirt and garbage are accumulated in large quantities….” Mosely was more pleased by the Locust Spring hospital, the largest hospital on the Union left. He declared it a model operation, noting there were 24 tents each heated with a stone fireplace and all of the bedding “straw in good sacks, with sheets, quilts, and blankets placed on bedsteads.”

In all hospitals, good and bad, wounded men suffered agonizing days. A Rebel bullet shattered the right knee of Jonathan Stowe of the 15th Massachusetts Volunteers during action at the West Woods. Stowe lay on the field for two days before being taken to the Susan Hoffman farm along the Keedysville Road for treatment. On September 20, he unwittingly began documenting his own demise as he awaited surgery: “Many must lose their arms or legs but they do not murmur. What sensation—used chloroform, hope to have no bad effects. There are some dozen or more stumps near me.”

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