Record-keeping for the wounded

[Hank Trent]

Been trying to research when the paperwork first began for wounded men. I first thought it would begin at the most forward location, variously called the ambulance depot, dressing station or aid station, before the wounded were removed to a field hospital. But strangely enough, I can find no evidence that paperwork was done there. The first examples, given in the steward's manuals for both US and CS, seem to be for field hospitals.

For men who fall out on the march "if he is sent to the wagons, he should be furnished with a written permit for that privilege," according to Trippler's Handbook for the Military Surgeon. But his description of the ambulance depot notes no such paperwork for men wounded in battle. Hospital knapsacks for the field could contain lead pencils and note paper, but I've not seen any specific forms listed.

So my question is, has anyone run across either US or CS original examples, instructions, diary/memoir accounts, or anything to indicate that ambulance drivers or medical personnel at dressing stations or ambulance depots were keeping paperwork on the men being treated and/or transported, before they reached the field hospitals?

Also, looking at it from the other direction, how were field officers first hearing about the number of casualties in their ranks during/after an engagement? I'm guessing it was from reports of roll calls of the men remaining, rather than reports from the ambulance depots of wounded men arriving, but again, is there evidence of field officers receiving reports from ambulance personnel or medical officers on the field of casualties before they reached the field hospitals?

Hank Trent
hanktrent@voyager.net

[1stMaine]

Re: Record-keeping for the wounded

Hank,

I am also of the opinion that little, if any, actual paperwork was used at the field dressing station. The main reason for them being there was to simply stabilise the wounded and prepare them for evacuation to the Division Hospital, where, in fact, all of the main record keeping comes into play.

It is, of course, possible that some assistant surgeons kept records to be forwarded with the patients, but that cannot be ascertained with any certainty. I would suspect that, at most, he had some sort of journal to keep track of numbers and types of wounds, what army, etc, but anything more than that I haven't seen records for.

The paper and pencil, I suspect, is for prescriptions for the steward to make up, and perhaps a note saying that corporal such and such, the bearer of this note, has been given 3grains of opium (or whatever) at such and such a time, etc. A warning for the next doctor in line, etc.

That same paper might also be used to give a slip to a man falling out, or to grant permission to ride in the ambulance, etc, when a man fell out from a long march. However, many doctors had a special pad a pre-printed forms, or chits, for the same thing, and they are mentioned from time to time in memoirs, letters, etc.

I have attached a couple images of one hospital form. I include the original, but I cannot upload the copy I made for use in the field. I'll try and convert it to a JPG and upload in a bit. I have used it to record my initial treatment at a field dressing station, placing the card with the injured upon the litter for the next physician in line to treat him. However, I suspect that it was more appropriate for use at an actual Division Hospital than at an aide station.

Sadly, this is one area where documentation of procedures is slowly being teased out, but in small amounts, and that irregularly.

Respects,

[JohnTaylorCW]

Re: Record-keeping for the wounded

Mike Schaffer mentions in "School of the Clerk" that in Kautz's Company Clerk, Sick Books are kept by the Company. There is also a "Return of Killed, Wounded and Missing." (Form 21).

Just in case you're unaware, there are two books you might be interested in:

"One Surgeon’s Private War"
(Doctor William Potter of the 49th and 57th New York.)
Priest, John Michael ed. White Mane Publishing 1996

and

"Turn Them Out to Die like a Mule"
The civil war letters of Hospital Stewart John N. Henry, 49th New York 1861-1865
Priest, John Michael Gauley Mount Press, 1995

I don't have my copies handy, they're currently on the other side of the world, but Henry's comments, for example, seemed to demonstrate that men were often kept with the regiment , at least while it was stationary.

Hope this is at least slighty helpful.

[1stMaine]

Re: Record-keeping for the wounded

John,

Yes indeed, Most men preferred to atay with their regiment or battery, etc. That was usuaully possible, except in the most extreme cases, when the unit was "en bivouac".

What Hank and I (and several others, actually) are trying to determine was what, if any, records were kept at the field dressing station. Allow me to digress here. When action was imminent, the Division medical Officer selected a site for the Division Hospital, and set up shop, as it were. Virtually all of the regiment's own medical staffs were relocated to the Division Hospital, and assigned various positions in dealing with the wounded. Some set up the camps, others did the clerical work, still others ran the field kitchen, another the pharmacy, etc.

A few, usually assistant surgeons, along with medical orderlies carrying a medical knapsack, were sent out to the field to establish what was often referred to as a "field dressing station". The assignment for these men was to be a forward aid station where the wounded would either come to, or be brought to, for immidiate, or "first" aid. At the FDS, they would be sorted out by severity of wounds (later known as triage), be stabilsed, and given such treatment as was available for initial bandaging, splinting, sutures, and treatment for shock and pain. from there, they were loaded onto ambulances to be taken to the Division Hospitalm where the real treament of their injuries would begin.

Our problem is in locatin what, if any, records were used at the FDS, and to date, there seems to be little or none prescribed. their are MANY forms, books, etc, required to be kept up, etc, at the Division level and above, and the various regimental surgeons are also required to maintain a set of 5 books, plus various reports as well.

However, the FDS seems to be a seperate case, and i suspect that little, if any, records beyond perhaps basic numbers treated were kept by those working there.

Respects,

[Hank Trent]

Re: Record-keeping for the wounded

Mike Schaffer mentions in "School of the Clerk" that in Kautz's Company Clerk, Sick Books are kept by the Company.

Yes, from the medical side also, I can find forms for ongoing illness, like a surgeon's morning report, diet tables, and so forth. Though those seem to be for situations where the patient is at a hospital or is receiving ongoing care on the march or in light duty situations.

There is also a "Return of Killed, Wounded and Missing." (Form 21).

That's interesting. Is there any information where the data was coming from? I mean, who was actually finding the dead bodies on the field and identifying them and writing that down, who was listing the names of the wounded lying on the field or in the hospital and writing that down and sorting it by regiment and company, etc.?

I don't have my copies handy, they're currently on the other side of the world, but Henry's comments, for example, seemed to demonstrate that men were often kept with the regiment , at least while it was stationary.

What I'm picturing is a situation where there's a battle, and an aid station is established as close to the field as possible. Medical personnel (ambulance drivers, stretcher bearers, assistant surgeon and orderly with hospital knapsack, etc.) go out onto the field and do initial care and transportation of the wounded back to that point, or the wounded wander in. Then the wounded who can't return to the line are transported back to a field hospital a mile or more behind the lines where the higher-ranking surgeons and more personnel are waiting.

It's the standard thing portrayed at reenactments, except the wounded stop reenacting about the time they'd be transported from that forward station to the field hospital, and so the situation is cut short there, and the field hospital isn't portrayed because there are no more wounded many hours after the battle.

I'm trying to find information on any paperwork that was done within the usual time and space reenacted. What Tim Kindred said is pretty much what I'm finding also.

Hank Trent
hanktrent@voyager.net

[ephraim_zook]

Re: Record-keeping for the wounded

"Also, looking at it from the other direction, how were field officers first hearing about the number of casualties in their ranks during/after an engagement? I'm guessing it was from reports of roll calls of the men remaining, rather than reports from the ambulance depots of wounded men arriving, but again, is there evidence of field officers receiving reports from ambulance personnel or medical officers on the field of casualties before they reached the field hospitals?"

Hank,

I don't like to speculate without some kind of firm knowledge behind me, but let me throw this out: In looking at several during-the-war company rosters, I've noticed men listed as having deserted, only to show up again in subsequent rosters as having "returned from hospital", or "in hospital at x____sburg". It seems to me that companies had to account for every man somehow; if no one saw a man go down and his body wasn't found after the battle, he may have been presumed to have deserted until documentation saying otherwise went from the hospital back down the line to the company.

Ron Myzie

[1stMaine]

Re: Record-keeping for the wounded

Hank,

Ron has a good point. At this period of time there was no distinction between desertion and AWOL. If you weren't present at roll call, and no one knew where you were, you were a deserter.

Form 21 is usally pretty accurate, because in MOST cases, as long as the unit wasn't broken or over-run, someone usually saw casualties fall, killed outright, etc. The file closers would have seen them falling out of ranks, for certain, and unless the unit was pushed back, thus forced to leave it's wounded behind, in most cases they would be accounted for within a reasonable period of time.

Respects,

[DougCooper]

Re: Record-keeping for the wounded

Logically, the post battle roll call was a real contributory exercise as each company solicited from every survivor the status of the missing as to KIA, wounded, captured and missing. I am wondering at what point a commander declares a man "deserted" rather than missing...I cannot recall ever seeing that category listed on any casualty report at any level. It may in fact be that until discovered alive and unwounded (in the hospital, etc) a soldier remained missing, and officially declaring a soldier a deserter becomes the function of an entity way higher than a regiment - maybe an AG job? it would useful to hunt down the deserter classification procedures.

Obviously deserting to the enemy in a static position would be obvious and would be passed up the chain, but after a battle, not so unless an eye witness account is available. Even then it might simply be more convenient to list the soldier as "captured."

On dressing station papework - agree that if there are any forward battle area medical records from dressing stations, I would guess they are quite rare and would have traveled with the soldier himself or the ambulance driver. But it may be that the nature of CW battle wounds and the rudimentary treatment available would have required no descriptive paperwork as the wounds were obvious. Triage sorting was the activity and diagnosis in writing might have been seen as time consuming and not necessary. When an ambulance load of wounded arrived at the hospital, the sorting was performed again and real treatment began, including charts, etc. One thing that might have taken place would be a verbal status briefing to the ambulance driver or accompanying medical steward (if available) on each patient, and perhaps said driver or steward might have taken notes?

But...recall that many, perhaps most casualty reports submitted up the chain list the nature of the wound (leg severely, hand slightly, etc) so that info was written down somewhere and transcribed onto the Form 21 or the Official Report. Did these come from the hospital back to the unit listing the status of the wounded soldier or were they a compilation of survivor reports, or both? Maybe there was a form that was kept at the dressing station and forwarded to the unit on the status as the soldier was processed....something like "Pvt John Doe, 82nd NY, wounded in arm, severely, transferred to 2nd Corps hospital"...? Another input might have come from the survivors who were sent back to the hospitals to check on the wounded - and there are a number of diary and letter entries on this activity.

good stuff here. Noah, you out there?

[Hank Trent]

Re: Record-keeping for the wounded

But...recall that many, perhaps most casualty reports submitted up the chain list the nature of the wound (leg severely, hand slightly, etc) so that info was written down somewhere and transcribed onto the Form 21 or the Official Report. Did these come from the hospital back to the unit listing the status of the wounded soldier or were they a compilation of survivor reports, or both?

In the CS regulations for the medical department (and I'm betting the US regulations were similar), "The senior medical officer of each hospital, post, regiment, or detachment, will keep the following records, and deliver them to his successor: A register of patients (Form 11); a prescription and diet book (Form 12); a case book; copies of his requisitions, returns of property, and reports of sick and wounded; and an order and letter book, in which will be transmitted all orders and letters relating to his duties." That's from http://docsouth.unc.edu/imls/regulat...gulations.html Additionally, a card like Tim Kindred scanned would have information about specific wounds.

Unfortunately, I can't find that the regulations say 1) when and where those forms should be forwarded to someone outside the hospital, if they were, and 2) what happened in the more chaotic atmosphere of a battle, compared to even a field hospital, let alone a garrison hospital or general hospital.

Hank Trent
hanktrent@voyager.net