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Data Collecting during the U.S. Civil War, 1861-1865
Like the Crimean War, the U.S. Civil War (1861-1865) was a huge conflict for the times, involving millions of combatants, and new transportation and communication technologies. Sanitation was a challenge from the start, as thousands of new recruits flooded into army camps, where water supplies and drainage might or might not be adequate, and diseases could easily spread. The new recruits came from all regions of the country, often rural areas where they hadn’t encountered the contagious diseases more common in cities, such as measles. Unused to army life, many of them had had little practice with tasks such as preparing basic meals, keeping clothing and quarters clean, and proper disposal of waste, including use of latrines. Crowding and poor sanitation in the camps (and sometimes poor nutrition as well) made disease almost inevitable, and many new soldiers suffered and sometimes died, especially from typhoid and dysentery, before they ever saw combat. As in the Crimean conflict, the army’s medical resources were initially overwhelmed by the vast numbers of wounded troops needing care after major battles. Ambulance and rail transport was inadequate; hospitals, hastily set up in whatever buildings were available, were crowded, understaffed and filthy.
William Hammond, Army Surgeon General from 1862 through 1863, directed a wide-ranging reorganization of the Union Army’s medical department. Among his many reforms were increased data collection from medical officers in the field and in military hospitals. In one of his most significant initiatives (Circular No. 2), Hammond ordered senior medical officers to include detailed case histories in their monthly reports of the sick and wounded. For each case of illness, medical officers would report its character and symptoms, the treatment planned and given, and remarks on camp conditions (quality of food, shelter, ventilation, location, and sanitation). For surgical treatments of fractures and gunshots, surgeons would provide details about the date, situation, character, and direction of the wounds. For amputations, Hammond wanted a history of the original injury, the character of the operation, time, place, and results. Results of any post-mortem dissections would also be submitted. Although conditions sometimes became chaotic during the war’s first year (as the two sides struggled to rapidly expand their forces and keep them organized) medical data gathering became an integral part of every medical officer’s job, and helped commanders understand the relative strength of their forces and possible threats to their health. Records of numbers of sick men had been kept previously, but Civil War army surgeons were required to provide more specific details.
Civilian physicians, reformers, and public health experts also became involved in data collection, monitoring army sanitation and the general health of the Union forces through the United States Sanitary Commission (USSC), an aid organization chartered by President Lincoln at the war’s outset. These citizens—particularly nurses, sanitary reformers and charity workers—were an important adjunct to the military’s medical operation during the Civil War, though their presence was not always welcomed by army medical officers. Sanitary reformers, physicians, and many women’s charity groups were well aware of the medical disasters of the Crimean War and the role of good sanitary regimens, adequate supplies, and trained nursing in saving lives there, and hoped to apply the lessons of that war to their own. Florence Nightingale’s work and writings had inspired thousands of middle and upper-class women to aid their hospitalized soldiers by serving as nurses or pursuing related charity work. When the Civil War started several groups, in New York and elsewhere, began organizing to promote women as nurses, provide food, clothing and hospital supplies, and raise funding for other relief efforts. The USSC quickly emerged as an umbrella organization for these initiatives.
The USSC developed a wide-ranging network, coordinating donations of funds, goods, and services, to supply army camps and hospitals throughout the war. USSC workers helped the government set up hospitals, with attention to creating an environment as homelike as possible. They assisted the Medical Department in transporting the sick and wounded from field hospitals to general hospitals. They maintained supply depots around the country so that supplies could be rushed to army surgeons after battles. The USSC also worked to monitor conditions in the regimental camps and hospitals, sending out experienced physicians to do sanitary inspections. Armed with a long list of questions about the soldiers’ food, shelter arrangements, latrines and medical care, the inspectors noted shortcomings and advised the regimental officers.
The vast scale of the Civil War made it essential to collect data on millions of American men, starting with recruitment exams, and extending to their health in camp, their wounds and treatment, and their recovery or death. The Provost-Marshal-General’s Office managed recruiting for the Union forces during the last two years of the Civil War (1863-1865), standardizing the medical exams and making other improvements to ensure better fitness in new troops. This process generated over a million detailed medical records. For scientific and public health-minded leaders, both in the army and in the USSC, the huge pool of data also presented an opportunity to assess the general state of health in American males under the age of 40, the prevalence of various conditions and diseases—especially those that disqualified a recruit for military service--and how these varied according to ethnicity, region of origin, and occupation. Following the war, the data were compiled and analyzed to provide a valuable statistical profile (Volume 1 and Volume 2) of the physical and medical condition of American men.
Data gathered during the army’s recruitment exams also became the focus of anthropometric research done by the USSC. In these studies, which measured height, weight, chest circumference, lung capacity, and other dimensions, investigators hoped to learn more about which physical characteristics and body types were typical for men of certain classes, occupations, ethnicities, and so on. By sorting the recruits into “types” and “races” based on physical dimensions, they thought, it might be possible to determine which were best suited for military service—and which were liabilities.
The anthropometric research and the medical "profiles" also grew from the investigators' interest in determining the "ideal" human form; this had many implications for contemporary theories regarding ethnicity, and what "races" could be considered "superior." This wasn’t just a black vs. white question; in fact, the researchers devoted much more attention to the differences between the different European "stocks"--English/Scots/Irish, Scandinavian, Germanic, French, Italian, Slavic, etc.
Over fifty years later, following World War I, army medical historians would use the Civil War studies done by the Provost Marshal General’s Office and the USSC as templates for their own analysis of draft records, citing the scope and quality of those studies, and their long-term historical value.