Civil War ambulance at Wilson's Creek
Ambulances such as this one were vital to transporting the wounded to better care, but were in short supply at early battles during the war. (Wilson’s Creek National Battlefield)
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On August 11, 1861, Philip C. Davis, a U.S. Army surgeon, looked at the mayhem around him in Springfield, Mo., and saw the wretched result of civil war. “The churches, hotels, court house, and nearly all of the private dwellings were filled with wounded of both sides,” he wrote. The previous day, a battle had raged along the banks of nearby Wilson’s Creek, resulting in 1,800 wounded and more than 550 dead between U.S. and Confederate forces. For many of the wounded, their sad ordeal had only just begun.

Wilson’s Creek was the first major battle west of the Mississippi. In the war’s early days, Federal soldiers had sparred with the Missouri State Guard, a secessionist militia unit, for control of the strategically important state. With access to both the Missouri and Mississippi rivers, a Federal arsenal in St. Louis, and vast natural resources and manpower, it was vital to the Union cause that Missouri not fall under Confederate control.

Starting in May, Union forces commanded by Brig. Gen. Nathaniel Lyon began securing most of Missouri. By mid-July, Lyon’s men had outmaneuvered the Missouri State Guard to the state’s southwest corner, near Springfield, and felt a decisive victory there would give Lyon the full control he desired.

Lyon’s 5,000-man force, however, faced sudden outbreaks of typhoid fever and dysentery—all too common early in the war, with large numbers of soldiers gathered together for the first time and many never before exposed to epidemic diseases such as smallpox or measles. The number of sick quickly outpaced the army’s available hospital accommodations and the unfinished courthouse in Springfield was designated for the overflow. Davis was assigned to care for the sick and would end up stationed there for months caring for the eventual Wilson’s Creek wounded.

As the armies prepared to fight near Springfield, the lack of ambulances began to concern the medical departments. Each army had only a handful available, and they weren’t yet organized into an official ambulance corps. Both generals had plans to surprise each other the morning of August 10, 1861, but rain the night before postponed the Confederate movement. Southern soldiers awoke at 5 a.m. to the sound of gunfire around them. The Battle of Wilson’s Creek had begun.

Neither side had a medical director to organize the casualty response. Direction from higher ranking medical officers could have saved many lives. As it was, when the shooting started, individual surgeons sprang into action as they saw fit. Assistant Surgeons Havilah Mowry Sprague and E.L. Patee of the 1st Kansas set up a field dressing station in a ravine behind the northern portion of the Union line, near where the National Park’s visitor center stands today. In addition to being sheltered in the ravine, they chose the location because there was an offshoot of Wilson’s Creek that passed through the low spot providing plenty of water. The sheltered nature of the area made it a logical place for wounded to seek shelter when leaving the front line. The wounded who could walk went there for stabilizing medical care.

Civil War surgeon Havilah Sprague
Havilah Sprague was one of several Union surgeons who had to handle increasing casualties on their own. (American Civil War Surgical Antiques)

Surgeon W.H. White of the 1st Iowa was also on the field, tending to wounded on a slope in rear of his regiment. Few, if any, operations were done at these dressing stations. Rather, wounds would be stabilized by stopping the bleeding and performing triage. With few ambulances available, medical personnel prioritized those to be sent farther behind the lines to more established hospitals, like the one at the courthouse.

By midday, Lyon was dead and the Federals had been driven from the field. On August 11, they began a retreat to St. Louis, bringing 200 wounded along and leaving Springfield—and other wounded—to the enemy. Surgeon E.C. Franklin was left in charge of the remaining 500–600 Union wounded. He was helped by Davis, surgeon S.D. Smith, and assistant surgeon Samuel H. Melcher.

Not long after the Federals departed, Confederate forces arrived and set up their own hospitals. According to surviving records, Confederate medical personnel seized most of the Federal medical supplies for their own wounded, leaving the Union surgeons with only a small quantity of supplies. Franklin was forced to purchase necessary medicine, spending $5,000 for the purpose. Between the armies and the local merchants in a relatively rural area, there surprisingly was no lack of medical supplies. Surgeons reported having plenty of chloroform for anesthesia, splints for setting broken bones, and calomel, opium, and other vital medicines.

In addition to caring for the wounded already filling every available space in Springfield, the Federal surgeons focused on providing care to the Union soldiers still on the field desperately awaiting help. It took five to six days to recover all the wounded Union soldiers who faced that predicament—due mostly to the lack of ambulances.

The extensive time it took to bring the wounded in from the field had dire consequences for those left behind. Melcher reported that the wounded brought in from the field were “swarming with maggots.” Insects were a nuisance in the hospital, too. “The flies were exceedingly troublesome after the battle, maggots forming in the wounds in less than an hour after dressing them, and also upon any clothing or bedding soiled by blood or pus,” wrote Melcher, who ultimately rid himself and his patients of these pests by sprinkling calomel (a mercury-based medication) on the open wound.

This article first appeared in America’s Civil War magazine

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If there were any lessons to be learned from Wilson’s Creek, they were the importance of a well-trained ambulance corps and medical leadership. Assistant Surgeon Sprague complained about the lack of an appointed medical director within the Federal forces operating in Missouri. “The regiments had no community of action or feeling,” Sprague wrote. “Had the commanding general designated an officer of rank as his medical director, there could have been no reason why nine-tenths of the wounded could not have been cared for and sent to general hospital by the time our forces retreated.”

As the war progressed, medical evacuation and leadership improved dramatically. The medical personnel’s experience at Wilson’s Creek was clear evidence about the importance of having ambulances and a medical director in place. But then again, such failed responses would occur frequently in the war’s chaotic first year.

Once all the soldiers had been retrieved from the battlefield, the days slipped into weeks for exhausted Union surgeons. On September 7, Franklin left to rejoin the main Union force at St. Louis (a journey of more than 200 miles), presumably with patients who were recovered enough to move. On September 20, Smith and Davis left Springfield with about 50 patients, leaving Melcher with the remaining 209 sick and wounded. Throughout October, he sent 150 on their way to St. Louis. Finally, on November 11, Melcher took the remaining wounded via wagon train to St. Louis, arriving on November 19.

The medical response to the Battle of Wilson’s Creek was finally over. It took more than three months, illustrating perfectly that the bloody consequences of a Civil War battle lingered long after the guns fell silent and the armies moved on to new battlefields. 

John Lustrea is the Director of Education at the National Museum of Civil War Medicine.

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