If there’s a little known hero of the Civil War, it has to be Dr. Jonathan Letterman. I was reminded of that recently when the founder of the National Museum of Civil War Medicine, Dr. Gordon Dammann, gave a lecture on Dr. Letterman and his Letterman Plan. Maybe you’ve never heard Dr. Letterman’s name before, but your life has probably been affected by his work. The Letterman Plan, which is a system for treating and evacuating casualties from battlefields, is the basis for many aspects of our modern military medicine, emergency medicine, and even disaster relief.
At the start of the Civil War, there was no set procedure for removing wounded soldiers from the battlefields. In some cases, the wounded were left on the battlefield for over a week, which meant that many of the men, who might have been saved, died from their wounds or from exposure. While the army did have ambulances which could transport the wounded soldiers, the ambulances were under the control of the Quartermaster Department which procured and distributed most of the supplies for the army. As you might imagine, the ambulances were not always the top priority in this system! In fact, there were instances in which ambulances were appropriated to carry other supplies, or even personal items.
In 1862, just a few months prior to the Battle of Antietam, Major Jonathan Letterman was named the Medical Director of the Union Army of the Potomac. His first step toward revamping the medical system was to establish a separate Ambulance Corps. He gave control of the army ambulances to the officers of the ambulance corps, he distributed ambulances to each regiment, he had enlisted men trained to serve as ambulance drivers and stretcher bearers, and he had the use of ambulance wagons for any non-medical uses forbidden.
Letterman also reorganized the system of medical treatment and field evacuation. He applied a triage system in which the wounded were treated based on the severity of their wounds instead of the order they arrived. He also established aid stations on the battlefields, where medical officers could stabilize the wounded soldiers and arrange for their transportation to a field hospital. The field hospitals were located near the battlefields. It was here that the soldiers received additional treatment, including emergency surgery if needed. If more long-term treatment was required, the wounded were transported to the larger, more permanent hospitals which were usually located in the cities.
The Battle of Antietam, the bloodiest single day in American history, was the first real test of Major Letterman’s new system. It was a success. Even when faced with over 23,000 casualties, his plan ensured that all of the wounded were removed from the battlefield within 48 hours, which undoubtedly saved many lives. He continued to make changes and improvements, and in 1864 his plan was made official by an Act of Congress.
I’ll leave you with a quote from the NMCWM’s own website: Major General Paul Hawley, Chief Surgeon of the European Theater in the Second World War, said of Letterman, “I often wondered whether, had I been confronted with the primitive system which Letterman fell heir to at the beginning of the Civil War, I could have developed as good an organization as he did. I doubt it. There was not a day during World War II that I did not thank God for Jonathan Letterman.”
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