Margaret Humphrey’s Marrow of Tragedy: The Health Crisis of the American Civil War,
reviewed by Malkah Schack
Marrow of Tragedy (2013) is a comprehensive look at medicine and health during the American Civil War. Humphreys has brought together a vast around of research to produce this well-rounded narrative of the Civil War. Through the 300 or so pages that carry the bulk of the writing, she creates an easy to read, well researched, and a brief breakdown of the role that medicine and public health had during the war. These are not only the actual medications used but also the roles of doctors, surgeons, women, and patients in helping and or hindering the process of healing. Later in the review, I will examine, in a little more detail the various aspects of the book that make it stand out as an essential book for understanding the Civil War.
Humphreys is also of the class of scholars that consider themselves “new military historians.” This perspective “seeks among other goals to address the broad category of ‘war and society’” (Humpherys 18). This aspect of scholarship focuses, not only the various theaters of war but also on the homefront, the social groups, the diverse backgrounds of the soldiers, women, other minorities and their multiple roles on both the homefront and the battleground. Through this lens, Humphreys successfully maneuvers and explains the functions that diseases, epidemics, medicines, surgeries, organizations attached to volunteerism and public health (exemplified in the U.S Sanitary Commission), and women, had in shaping the war and its result. This book is essential to a complete understanding of the Civil War.
The opening chapter of the book is called “Understanding Civil War Medicine,” in it, Humphreys summarizes the quick learning that both sides had to do at the beginning of the war. She also introduces the language that the reader will need to be familiar with throughout the rest of the narrative. In this chapter and the following, she introduces the guiding themes that she will revisit again and again over the course of the book. These include the various kinds of hospitals and their uses, the role of volunteer organizations such as the U.S. Sanitary Commission (in the north), the desire for femininity in the hospitals (first without women and later with them), and the advancements in medicine and its effect on the diseased and wounded during and after the Civil War.
The first theme, the kinds of hospitals and their uses, comes into play everywhere. The field hospital was used near the place of battle and was very limited to the space and amount of doctors, surgeons and later nurses that were on hand. It was the place that the wounded were put during the course of, or right after a battle. It was often disorganized and crowded until the wounded could be shipped off to a general hospital. These hospitals housed men of any regiment or division and served as places of convalescence and recovery. The final kind of hospital was the pavilion hospital. It was created popularized by Florence Nightingale’s book Notes on Hospitals (1859) and laid out a plan for large airy wards, good water and lots of light. The Union mastered the art of the hospital and the men that were physically able to return to battle after having been in those hospitals were far more fit than their Confederate foes. Humphreys is very precise in writing that the south did not have the funding, the human resources, or the volunteerism, to maintain their hospitals, especially later in the war.
The second and third theme, the use of volunteer organizations, and the role of women and feminity are distinctly tied together. The volunteer organization that is mainly held up as an example is the U.S. Sanitary Commission (USSC). The USSC began as a meeting of concerned women that slowly turned into a male lead volunteer organization. They did much good for the troops, that is not a question. They gave out food and clothes to those who couldn’t afford it, the supported national pension bills for veterans, and they helped to make general hospitals and field hospitals more organized and sanitary. However, the USSC also had various scandals around their organization. These included not providing enough smallpox vaccine, trying to overthrow the Surgeon General and getting into a generally intense rivalry with the Western Sanitary Commission that did very similar work. Humphreys also praises and condemns the USSC for finally getting women into hospitals, but also erasing them from the leadership of the organization, and not paying the tens of thousands of women that labored over various projects for the cause.
Separately from their role in organizations, Humphreys also examines women and femininity within the context of the Civil War. At the beginning of the war, women, although eager to join and to do their part, were not permitted to, primarily, because it was feared that it would take from them the delicateness of their gender. Instead, the hospital and field hospital had to provide the “femininity” without the women, officers had to school their men in hygiene, and recovering men had to nurse sicker or more wounded men. As the war progressed the need for women to fill these jobs increased in both the north and south, more men were wounded, sick or dead and the USSC, in the north, began to help by organizing women to volunteer in hospitals. Some women even showed up on the front lines to assist physicians in field hospitals. Still, many women were barred from practicing as physicians, even if they had the schooling and women were also not allowed to perform amputations or other surgeries. Humphreys is evident in the fact that this involvement in the war helped to further and fuel the feminist and suffragette movements after the war.
The final theme in the book is the advancement of medicine and the effect these developments had on medicine in the post-war years. Humphreys first establishes what doctors were dealing with in the 1860s during the war. These diseases included smallpox, measles, yellow fever, and cholera. They were also dealing with large and small wounds and amputations. Humphreys goes through the various treatments that men went through for these diseases, as well as the proper process of amputation and the treatment of gangrene. She also has an entire chapter on Confederate medicine. They were an inferior army that was always in need of more men, and their hospitals were inadequate in returning healthy men to the front. Many of the hospitals were not stable; they had to be continually moved in accord with where the battle was. They also had inconsistent medical supplies because of the blockade that had been set up by the Union. They had smuggled shipments through the siege, and that was less than reliable. The Confederates had a far inferior system in place than their northern counterparts.
In the last chapter of the book, Humphreys describes the influence of the Civil War on post-war America (Humphreys 290). She lists four significant lasting effects. The first was that men returning home were “vectors of disease” (Humphreys 291), they all carried many of the diseases and infections that they had contracted during the war and were then able to pass them on to wives, sweethearts, and children. The second is that the war did not bring very many actual changes to medicine, but it did change the way that people treated the sick in hospitals, and it brought about a concern around public health. The third is that surgeons began to get a real foothold in the medical field. The final effect is the advancement in germ theory. The men that witnessed the paths of infectious diseases during the war and use these moments and experiences as teachers. Humphreys concludes the book on this note: the Civil War helped to prepare people for the transformation of medicine during the move toward the 20th century and modernity.
The critical reception of this book was very positive. Jane Schultz, who is quoted much time throughout the book, stated in her review: “ In a well-balanced eleven-chapter narrative that traces the history of war-related diseases, surgical advances, and the inequitable ground of medical resources, Humphreys moves far beyond the conventional imagery that readers have associated with war carnage” (Shultz 905). She is not the only one that found the book interesting and well-rounded. Michael Flannery wrote: “ Overall, the book has high production values and makes one of the most important contributions to our understanding of that so-called third army of the Civil War—disease—and the efforts of those on both sides of the Mason–Dixon to fight it” (Flannery 149). These are glowingly positive reviews. Some things were criticized, like footnotes and illustrations, but the reviewers themselves said that it was nitpicking.
I felt that the book was very well rounded and gave a thorough and comprehensive look at the various components of Civil War medicine. The main strength that Humphreys has is her ability to pack a large amount of information into a small book that is readable and easy to follow. I felt that her weakness was, as the reviewers said, that there, not enough illustrations or photographs, but of course, this is just nitpicking.
Although Humphreys states that the war itself did not have much effect on the newer medicine at the time, the Civil War was a catalyst for change. It can be seen that just like the war still has a hold on the socio-political soul of the U.S. so do the innovations in medicine during the Civil War have on the history of medicine overall. The Civil War is essential for understanding the post-war developments in public health, cures, and treatments.
It is clear that Humphreys’ Marrow of Tragedy is an important book in the canon of the history of medicine during the Civil War. Her thorough research and understanding of the themes that she highlights in the book are instrumental for any medical historian and are interesting to those who would like to understand the subject itself. The themes that she highlights: the hospital, the women, the organization, and the advancement of medicine all work together to form a whole narrative of both the North and South during the war. She has used the testaments of ‘new history’ to her advantage, and this book will undoubtedly remain not only in the canon of medical history but also in the understanding of the entire picture of the American Civil War.
Yankee Doodle went to town
Smallpox is awful. There’s really no other way to say it. The victim experiences fever, vomiting (sometime black vomit), aching pains, and small sores that burst and create pit like scars. Back in the 1770’s and prior to then people very often died, especially because conditions were unsanitary and bleeding was a very common practice.
American History - After Class 