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"Overworked, Undermanned and Indispensable: Hospital Stewards in the Civil War" by William Cambell, Ed.D RN
The final and often most valuable member of the medical staff was the hospital steward. These individuals were essentially pharmacists, a title the army adopted 40 years after the war. Chronically undermanned and always overworked, regulations called for one steward per general hospital. A second man was assigned if there were more than 150 beds and a third if the hospital numbered 400 or more beds.
Qualified stewards did not come easy. Candidates were often found among the ranks of druggists who labored in civilian apothecary shops. They compounded prescriptions and even made drugs from raw materials using the iconic mortar and pestle. They were chemists rather than those who simply filled prescriptions from larger bottles of manufactured pills.
The first authority and primary reference on hospital stewards was published in 1863 as
The Hospital Steward's Manual: For the Instruction of Hospital Stewards, Ward Masters, and Attendants in their Several Duties. Thanks John Hartwell CWT!) Author Joseph J. Woodward, an assistant surgeon in the U.S. Army, wrote it following a suggestion by the army's Surgeon General, William A. Hammond.
They "must have…sufficient knowledge of…pharmacy to take charge of the dispensary, acquainted with minor surgery, …application of bandages and dressings, extraction of teeth, application of cups and leeches, …knowledge of cooking." Woodward's
Manual suggested that candidates be "18-35 years old, able-bodied, free of disease, honest and upright," of "good intelligence, having a knowledge of English, able to spell and write correctly," and "industrious, patient, and good tempered." There was a competitive exam to be taken. Stewards were screened for previous medicinal experience. A history of having worked as a druggist, chemist, or apothecary clerk in civilian life added a huge plus.
This hospital steward displays the distinctive chevron on his sleeves and the wide stripe of a non-commissioned officer on his trousers. The cap has the proper insignia of a laurel wreath with "US" in the center, not "MS."Carte de visite by E.H. Clark of Great Barrington, Mass. Steven Karnes Collection.
After the exam, interviews, and a review of references, the Secretary of War had to approve the appointment. With the process successfully completed, the hospital steward became a non-commissioned officer. Woodward explained that the position was equal to an ordnance sergeant and next in rank after first sergeant. The appointment was permanent for the duration of the war and the steward could not be returned to regular duty—they were part of the Medical Department or Hospital Department. This certainly benefitted the hospital's medical staff, as the men who gained experience would be retained, unlike male nurses.
1. The distinctive cloth insignia was the half chevron of caduceus and snakes worn on the upper sleeves, not to be confused with the nurse which according to Woodward was to wear the same chevron on the lower left sleeve.
2. The dress or ceremonial sword was the non-commissioned officer's sword, not the medical staff sword carried by surgeons.
3. The dress sash was to be of red worsted wool, not the red or crimson silk sash of the artillery branch and not the green silk sash of the surgeons.
4. Dress hats could be adorned with a feather or plume, an eagle pin on the right side, a gold laurel wreath on the front with a silver US, and a green and buff hat cord. The pin was to be US, not MS, which was reserved for medical staff use only.
5. The undress uniform, for fatigue purposes or hospital work, included the blouse or sack coat with the same half chevron on the upper sleeves. The pants were sky blue enlisted infantry trousers with a one-and-a-half inch wide crimson stripe down the outer seams. The red/crimson stripe (and wool sash) signaled the wearer was a non-commissioned officer, not a member of the artillery branch. A three-quarter inch wide crimson stripe would also designate a non-commissioned officer, but represented a corporal. A hospital steward would never hold this rank.
6. The undress cap was the enlisted man's regulation forage cap.
The roles and responsibilities of the hospital steward varied depending on his duty location. In the hospital and acting as the pharmacist, he compounded (measured, weighed, mixed, rolled, cut, polished) prescriptions as written in the prescription book by the surgeons, rather than just filling them from a bulk supply. He also verified that the medication was actually administered although he was usually not the person who gave it. A nurse usually performed that duty, although Mary Gillett in
The Army Medical Department 1818-1865 observed "…the Hospital Steward who before the war often added the role of nurse to his other duties…"
Ralph D. Parsons, left, wears the four-button sack coat, or fatigue coat, of the hospital steward complete with chevron. Parsons began his service in 1861 as a private in the 4th Illinois Cavalry and received a promotion to hospital steward in February 1864. He mustered out nine months later.Carte de visite by an anonymous photographer. Steven Karnes Collection.
Woodward explained that the hospital steward supervised male nurses but not the female nurses. He stated: "Enlisted men are under the orders of the surgeon…look up to [him] as their commanding officer… [and] are also under the orders of the hospital steward, to all whose lawful commands they must yield prompt obedience." The supervisory role similarly echoed in the South, where the regulations for the Confederate Medical Department noted that "the cooks and nurses are under the orders of the stewards."
Medical personnel were not immune to becoming battlefield casualties. Their numbers include Hospital Steward Perry W. Bahl of Company C, 16th Ohio Infantry, who suffered a wound at Port Gibson, Miss. The most frequent cause of death for medical workers—and others in the military—was disease. Carte de visite by Harvey's New York Photographic Gallery in New Orleans. Author's Collection.
In the fall of 1862, Algernon Marble Squier of the 9th Vermont Infantry remained with sick and wounded soldiers at Harpers Ferry, Va., when the Union garrison surrendered to Confederates commanded by Maj. Gen. Thomas J. "Stonewall" Jackson. After a formal exchange, he returned to active duty as a hospital steward. He transferred to the regular army in 1865 and continued his service in the same capacity. He graduated from Georgetown Medical College in 1867 and joined the ranks of contract surgeons employed by the U.S. Army. In July 1867, while on his first assignment, Squier was credited with saving the lives of 36 soldiers from the 18th Kansas Cavalry who had contracted cholera en route from Fort Harker to Fort Larned, Kansas. Unfortunately he also became ill with cholera and succumbed to the disease. Carte de visite by Charles Allen of Claremont, N.H. Ronald S. Coddington Collection.
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