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From Field Hospital to Lunatic Asylum: 19th Century
       Medicine as experienced by two men
             from Southwest Virginia…
        Harvey Black and John S. Apperson
Pursuing a medical career –
before, during and after the chaos of the Civil War
          • Dr. Harvey Black (1827-1888)
         • Dr. John S. Apperson (1837-1908)
Two historians, Glenn McMullen and Jack Roper, have
published letters and diaries, revealing amazing details about
the experiences of doctors and medics during the Civil War


                     The Civil War Letters of Dr. Harvey Black,
                     by Glenn L. McMullen

                     Repairing the March of Mars, the Civil War Diaries
                     of John S. Apperson, by John Herbert Roper
Other historians have drawn from these sources to glean
information about medical practices. Perhaps you’ve heard of
                          this one…

                                        Bud Robertson
First, a biographical sketch of Harvey Black…
from Tending the Wounded, by Glenn L. McMullen
• Harvey Black was born in 1827 in…
  Blacksburg, founded in 1798 by his
  grandfather John and granduncle
  William Black… The second of twelve
  children…, young Harvey grew up as
  a farmer’s son. In 1845, at eighteen,
  he became an apprentice to a local
  doctor, and in 1847 volunteered to
  serve…[in] the Mexican War…as a
  hospital steward… He returned and
  enrolled at the University of
  Virginia’s medical school and
  received a degree in 1849.
Biographical sketch of John Apperson
         from Tending the Wounded, by Glenn McMullen


• Apperson was born in Orange
  County, Virginia, in 1837. He
  grew up in an area known as
  the Wilderness, reaching into
  both Orange and Spotsylvania
  counties, but sought a career
  elsewhere. He moved to Smyth
  County in southwestern Virginia
  in 1859, where he, as did Black
  before him, became an
  apprentice to a local doctor.
Soon after the war began…

• …Apperson enlisted in the Smyth Blues,
  organized as Company D of the 4th Virginia
  Regiment. Black had enlisted and briefly
  served in the 5th Virginia before obtaining a
  transfer to the 4th as regimental surgeon.
  He named Apperson as one of the
  regimental hospital stewards.
About the 4th Virginia…

•   Raised from the counties of
    Rockbridge, Montgomery, Smyth,
    Grayson, Pulaski, and Wythe, the 4th
    Virginia was part of the First
    Brigade of Virginia, then
    commanded by former Virginia
    Military Institute professor Thomas
    J. Jackson. In time the unit became
    known as the Stonewall Brigade, of
    which the 4th Virginia was one of the
    most stalwart regiments. It fought
    hard, and the regiment’s casualty
    lists reflected this. In many battle,
    its casualties exceeded those of any
    other regiments in the brigade.
Battle of First Manassas

•   By midday the casualties
    started coming. “the first
    man wounded in our
    regiment,” Apperson wrote,
    “was struck in the mouth by
    a fragment of a bomb. He
    came out and we
    commenced dressing the
    wound, but before we had
    done anything others were
    brought out, and being
    desperately hurt we left him
    to attend to them.”
Witnessing his first amputation…

•   The field hospitals were the
    scene of most amputations,
    and Harvey Black must have
    performed hundreds of
    them. It was at Manassas
    that Apperson witnessed his
    first amputation, one that
    Dr. Black performed. As he
    confided to his diary, “my
    ideas were not very far from
    right.”
From another source…The Horrors of the Wilderness,
    by Augustus Brown, captain In the 4th New York Heavy Artillery

•    Under three large “tent flies,” the center one the largest of all, stood three
     heavy wooden tables, around which were grouped a number of surgeons and
     their assistants, the former bare headed and clad in long linen dusters
     reaching nearly to the ground, which were covered with blood from top to
     bottom and had the arms cut off or rolled to the shoulders. The stretcher
     bearers deposited their ghastly freight side by side in a winrow on the ground
     in front of the table…
Horrors of the Wilderness, cont.
•   …some of the surgeons administered an
    anesthetic to the groaning and writhing
    patient, exposed his wound and passed
    him to the center table…in a very few
    moments an arm or a leg or some other
    portion of the subject’s anatomy was
    flung in a pile of similar fragments
    behind the hospital, which was then
    more than six feet wide and three feet
    high, and what remained of the man was
    passed on to the third table, where other
    surgeons finished the bandaging,
    resuscitated him and posted him off with
    others in an ambulance. Heaven forbid
    that I should ever again witness such a
    sight!
Remember M.A.S.H.? Imagine the Civil War with
       helicopters…or cell phones…
Treating the Federal Soldiers at Fredericksburg
  (passages from the next slides are from McMullen’s
           article in the Virginia Cavalcade)
• Among the wounded cared for by Confederate surgeons at
  Fredericksburg were a number of Union soldiers. Treating
  wounded Federals must have been especially difficult for
  Harvey Black, for he fully expected to find his wife’s brother,
  Lewis Kent, whose unit was then part of Ambrose Burnside’s
  army that had been repulsed with such horrific losses. As to
  his Northern relatives serving in the Union army, Black lived
  with a contradiction. On the one hand, he asserted the
  superiority of Southern fighting men, yet he also tried to
  assure his wife that her brother faced no inordinate dangers
  fighting on the other side.
Creation of a field hospital

• Dr. Hunter Holmes McGuire, medical director of the Army of
  Northern Virginia’s Second Corps, created a field hospital to
  serve the entire corps. He named Harvey Black as surgeon in
  charge, with Apperson assigned to keeping the records. Less
  temporary and better equipped than the regimental hospitals
  quickly erected during battles, but more mobile than the far-
  larger, more permanent general hospitals, the Second Corps
  field hospital was an attempt to provide better emergency
  care for the wounded during battles.
Between engagements…

• Between engagements, the field hospital functioned as a
  receiving hospital for patients recuperating from wounds or
  illnesses. The unit included six surgeons and seventy-five
  ambulances - as well as a dozen milk cows. Located originally
  at Guiney’s Station, south of Fredericksburg, the field hospital
  followed the corps during campaigns and went into action
  during battles.
Diseases…

• During the lulls between engagements, the field hospital’s
  surgeons and stewards combated diseases, diseases so
  prevalent that for every Confederate soldier who died of
  wounds, another two died of illness.
• “Some thirty-eight of our regiment had to march to the rear,”
  he wrote,” and a dilapidated set they were. Rheumatic
  patients, and those affected with bronchial diseases,
  diarrhea, dysentery, and almost all other diseases had some
  victims.”
• The next day Apperson commented that :if Old Nick had paid
  us a visit this morning there could have been little more of a
  stir than there was. The variola case has been examined by
  Drs. Black, Walls, and Sayers – all pronounce it to be
  genuine.”
Quarantine – Outbreak of smallpox

• The medical staff quickly set about vaccinating those not
  already inoculated and quarantined the smallpox patient.
  Apperson wrote that the man’s food was set down fifty yards
  away from him and that he was not even allowed to send
  letters to his family. “I do not suppose,” Apperson
  commented, “that Robinson Crusoe was more exiled of felt
  worse than the young man in quarantine.”
Medical Education

• During the period between Fredericksburg and
  Chancellorsville, Apperson suggested to his fellow hospital
  stewards that they initiate a formal course of study. He
  succeeded in setting up nightly lectures by the surgeons on
  various branches of medicine, followed by readings and brief
  examinations. Harvey Black, as surgeon in charge, gave the
  opening lecture.
Field hospital at Chancellorsville

• An unsettling experience…John Apperson had grown up in the
  Wilderness area, not far from the now-clamorous scene. As
  the fighting began, Apperson searched for a suitable location
  to set up the hospital. Suddenly he passed a building he had
  seen before – the old school house where he “had studied the
  rudiments of spelling and arithmetic almost eighteen years
  ago. My feelings were such that I could not discuss them.”
• There the staff established the hospital near a gully where
  Apperson remembered playing “gully keeper” as a child.
  While still distracted by his thoughts of his childhood
  innocence, he wrote, “the wounded commenced coming in
  and we began to work.”
About Stonewall Jackson’s injury…

• While Black did not record the scene, Apperson wrote that
  some of the medical stewards were sitting around a fire late
  that night, enjoying a few moments of leisure after an
  exhausting day’s work, when “one of the boys remarked
  jestingly that a tent had been set up for General Jackson, that
  he had fought so well that we could afford to give him one.
  Another said he was wounded. Several of us laughed at the
  idea of Jackson being wounded – knowing that he had
  escaped in so many hard-fought battles.”
Morale


• After the vast slaughter of Chancellorsville and the loss of
  Jackson, the tone of Harvey Black’s letters and John
  Apperson’s diary become noticeably less enthusiastic, less
  sure of the South’s ultimate victory. A somberness and
  fatigue began to permeate their writing.
• Increasingly the two men began to focus their attention on
  what life after the war might be.
Privation – Letters from Mary Black

• Privation became commonplace for Mary Black. She
  commented in her letters on her attempts to procure meat,
  coffee, or flour, and to find shoes for her children. Most of
  these attempts met with mixed success or outright failure. In
  his own letters, Harvey Black frequently remarked on his own
  inability to keep his family clothed and fed, even according to
  the “Confederate fashion.”
Wondering if the war would ever end

• At one point in the spring of 1862, Harvey Black had written
  his wife that there never was a war but this one that ended at
  some time, and this will do so too.” His war dragged on for
  another three years – until April 1865 with the surrender T
  Appomattox Court House. Black and Apperson were there
  together at the war’s end, just as they had at First Manassas
  at the war’s beginning.
After the war
• Harvey Black resumed his medical practice in Blacksburg
• 1872 – Won election as president of the Medical Society of
  Virginia
• Helped found the V. A. & M. College and became first rector –
  1872.
• 1876 – superintendent of Easter Lunatic Asylum –
  Williamsburg
• 1887 – first superintendent of the Southwester Lunatic
  Asylum in Marion Virginia
• Black named Dr. Apperson to be his assistant physician
• 1888 – Dr. Black died at age sixty-one.
From steward to doctor…
• Apperson… attended the University of Virginia’s medical
  school, graduating in 1867, and returned to Smyth County to
  practice as a country doctor. In 1868 he married a Smyth
  County native, Ellen Victoria Hull, with whom he raised a
  family of seven children.
• 1887 – Ellen Victoria Hull died (complication of anemia)
• 1888 – Dr. Black died; Dr. Apperson decided to leave the
  Asylum
• 1889 – Dr. Apperson married Lizzie Black, daughter of Harvey
  Black, and they had four children
Ellen Victoria Hull Apperson (seated)
Another group photograph taken at the Asylum
Dr. Apperson’s photograph




               The man seated at this desk
               Is actually Dr. Robert Preston –
               an embarrassing mistake
               indeed…. (see previous slide –
               Dr. Preston is at the top of the
               stairs (#6)…
Elizabeth Black Apperson and her four children
                   (c. 1896)
From doctor to businessman

• After their marriage, Apperson
  became a businessman and
  publicist for Virginia’s industrial
  development and in 1892 was the
  state’s representative to the
  World’s Columbia Exposition in
  Chicago.
• Other ventures:
• Staley’s Creek Manganese and iron
  Company
• Marion and Rye Valley Railroad
Scenes around Blacksburg
Alexander Black’s store
Questions and comments?

• Another quote from the Apperson diary…when one of the
  doctors asked Harvey Black how may of his sons he planned
  to make doctors, Apperson recorded…
• “Dr Black said none of them unless they wanted to be, for he
  did not believe that anyone would become proficient in
  medicine if they were compelled to adopt it against their will,
  and spoke of the little incidents that change a man’s feelings.
  How a very insignificant occurrence might cause a child to
  determine his course, and follow it with diligence, or on the
  other hand, when a child’s antipathies are set against a
  profession, an attempt to make him follow it would be
  ruinous to him in future life.”

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From field hospital_to_lunatic_asylum(1)

  • 1. From Field Hospital to Lunatic Asylum: 19th Century Medicine as experienced by two men from Southwest Virginia… Harvey Black and John S. Apperson
  • 2. Pursuing a medical career – before, during and after the chaos of the Civil War • Dr. Harvey Black (1827-1888) • Dr. John S. Apperson (1837-1908)
  • 3. Two historians, Glenn McMullen and Jack Roper, have published letters and diaries, revealing amazing details about the experiences of doctors and medics during the Civil War The Civil War Letters of Dr. Harvey Black, by Glenn L. McMullen Repairing the March of Mars, the Civil War Diaries of John S. Apperson, by John Herbert Roper
  • 4. Other historians have drawn from these sources to glean information about medical practices. Perhaps you’ve heard of this one… Bud Robertson
  • 5. First, a biographical sketch of Harvey Black… from Tending the Wounded, by Glenn L. McMullen • Harvey Black was born in 1827 in… Blacksburg, founded in 1798 by his grandfather John and granduncle William Black… The second of twelve children…, young Harvey grew up as a farmer’s son. In 1845, at eighteen, he became an apprentice to a local doctor, and in 1847 volunteered to serve…[in] the Mexican War…as a hospital steward… He returned and enrolled at the University of Virginia’s medical school and received a degree in 1849.
  • 6. Biographical sketch of John Apperson from Tending the Wounded, by Glenn McMullen • Apperson was born in Orange County, Virginia, in 1837. He grew up in an area known as the Wilderness, reaching into both Orange and Spotsylvania counties, but sought a career elsewhere. He moved to Smyth County in southwestern Virginia in 1859, where he, as did Black before him, became an apprentice to a local doctor.
  • 7. Soon after the war began… • …Apperson enlisted in the Smyth Blues, organized as Company D of the 4th Virginia Regiment. Black had enlisted and briefly served in the 5th Virginia before obtaining a transfer to the 4th as regimental surgeon. He named Apperson as one of the regimental hospital stewards.
  • 8. About the 4th Virginia… • Raised from the counties of Rockbridge, Montgomery, Smyth, Grayson, Pulaski, and Wythe, the 4th Virginia was part of the First Brigade of Virginia, then commanded by former Virginia Military Institute professor Thomas J. Jackson. In time the unit became known as the Stonewall Brigade, of which the 4th Virginia was one of the most stalwart regiments. It fought hard, and the regiment’s casualty lists reflected this. In many battle, its casualties exceeded those of any other regiments in the brigade.
  • 9. Battle of First Manassas • By midday the casualties started coming. “the first man wounded in our regiment,” Apperson wrote, “was struck in the mouth by a fragment of a bomb. He came out and we commenced dressing the wound, but before we had done anything others were brought out, and being desperately hurt we left him to attend to them.”
  • 10. Witnessing his first amputation… • The field hospitals were the scene of most amputations, and Harvey Black must have performed hundreds of them. It was at Manassas that Apperson witnessed his first amputation, one that Dr. Black performed. As he confided to his diary, “my ideas were not very far from right.”
  • 11. From another source…The Horrors of the Wilderness, by Augustus Brown, captain In the 4th New York Heavy Artillery • Under three large “tent flies,” the center one the largest of all, stood three heavy wooden tables, around which were grouped a number of surgeons and their assistants, the former bare headed and clad in long linen dusters reaching nearly to the ground, which were covered with blood from top to bottom and had the arms cut off or rolled to the shoulders. The stretcher bearers deposited their ghastly freight side by side in a winrow on the ground in front of the table…
  • 12. Horrors of the Wilderness, cont. • …some of the surgeons administered an anesthetic to the groaning and writhing patient, exposed his wound and passed him to the center table…in a very few moments an arm or a leg or some other portion of the subject’s anatomy was flung in a pile of similar fragments behind the hospital, which was then more than six feet wide and three feet high, and what remained of the man was passed on to the third table, where other surgeons finished the bandaging, resuscitated him and posted him off with others in an ambulance. Heaven forbid that I should ever again witness such a sight!
  • 13. Remember M.A.S.H.? Imagine the Civil War with helicopters…or cell phones…
  • 14. Treating the Federal Soldiers at Fredericksburg (passages from the next slides are from McMullen’s article in the Virginia Cavalcade) • Among the wounded cared for by Confederate surgeons at Fredericksburg were a number of Union soldiers. Treating wounded Federals must have been especially difficult for Harvey Black, for he fully expected to find his wife’s brother, Lewis Kent, whose unit was then part of Ambrose Burnside’s army that had been repulsed with such horrific losses. As to his Northern relatives serving in the Union army, Black lived with a contradiction. On the one hand, he asserted the superiority of Southern fighting men, yet he also tried to assure his wife that her brother faced no inordinate dangers fighting on the other side.
  • 15. Creation of a field hospital • Dr. Hunter Holmes McGuire, medical director of the Army of Northern Virginia’s Second Corps, created a field hospital to serve the entire corps. He named Harvey Black as surgeon in charge, with Apperson assigned to keeping the records. Less temporary and better equipped than the regimental hospitals quickly erected during battles, but more mobile than the far- larger, more permanent general hospitals, the Second Corps field hospital was an attempt to provide better emergency care for the wounded during battles.
  • 16. Between engagements… • Between engagements, the field hospital functioned as a receiving hospital for patients recuperating from wounds or illnesses. The unit included six surgeons and seventy-five ambulances - as well as a dozen milk cows. Located originally at Guiney’s Station, south of Fredericksburg, the field hospital followed the corps during campaigns and went into action during battles.
  • 17. Diseases… • During the lulls between engagements, the field hospital’s surgeons and stewards combated diseases, diseases so prevalent that for every Confederate soldier who died of wounds, another two died of illness. • “Some thirty-eight of our regiment had to march to the rear,” he wrote,” and a dilapidated set they were. Rheumatic patients, and those affected with bronchial diseases, diarrhea, dysentery, and almost all other diseases had some victims.” • The next day Apperson commented that :if Old Nick had paid us a visit this morning there could have been little more of a stir than there was. The variola case has been examined by Drs. Black, Walls, and Sayers – all pronounce it to be genuine.”
  • 18. Quarantine – Outbreak of smallpox • The medical staff quickly set about vaccinating those not already inoculated and quarantined the smallpox patient. Apperson wrote that the man’s food was set down fifty yards away from him and that he was not even allowed to send letters to his family. “I do not suppose,” Apperson commented, “that Robinson Crusoe was more exiled of felt worse than the young man in quarantine.”
  • 19. Medical Education • During the period between Fredericksburg and Chancellorsville, Apperson suggested to his fellow hospital stewards that they initiate a formal course of study. He succeeded in setting up nightly lectures by the surgeons on various branches of medicine, followed by readings and brief examinations. Harvey Black, as surgeon in charge, gave the opening lecture.
  • 20. Field hospital at Chancellorsville • An unsettling experience…John Apperson had grown up in the Wilderness area, not far from the now-clamorous scene. As the fighting began, Apperson searched for a suitable location to set up the hospital. Suddenly he passed a building he had seen before – the old school house where he “had studied the rudiments of spelling and arithmetic almost eighteen years ago. My feelings were such that I could not discuss them.” • There the staff established the hospital near a gully where Apperson remembered playing “gully keeper” as a child. While still distracted by his thoughts of his childhood innocence, he wrote, “the wounded commenced coming in and we began to work.”
  • 21. About Stonewall Jackson’s injury… • While Black did not record the scene, Apperson wrote that some of the medical stewards were sitting around a fire late that night, enjoying a few moments of leisure after an exhausting day’s work, when “one of the boys remarked jestingly that a tent had been set up for General Jackson, that he had fought so well that we could afford to give him one. Another said he was wounded. Several of us laughed at the idea of Jackson being wounded – knowing that he had escaped in so many hard-fought battles.”
  • 22. Morale • After the vast slaughter of Chancellorsville and the loss of Jackson, the tone of Harvey Black’s letters and John Apperson’s diary become noticeably less enthusiastic, less sure of the South’s ultimate victory. A somberness and fatigue began to permeate their writing. • Increasingly the two men began to focus their attention on what life after the war might be.
  • 23. Privation – Letters from Mary Black • Privation became commonplace for Mary Black. She commented in her letters on her attempts to procure meat, coffee, or flour, and to find shoes for her children. Most of these attempts met with mixed success or outright failure. In his own letters, Harvey Black frequently remarked on his own inability to keep his family clothed and fed, even according to the “Confederate fashion.”
  • 24. Wondering if the war would ever end • At one point in the spring of 1862, Harvey Black had written his wife that there never was a war but this one that ended at some time, and this will do so too.” His war dragged on for another three years – until April 1865 with the surrender T Appomattox Court House. Black and Apperson were there together at the war’s end, just as they had at First Manassas at the war’s beginning.
  • 25. After the war • Harvey Black resumed his medical practice in Blacksburg • 1872 – Won election as president of the Medical Society of Virginia • Helped found the V. A. & M. College and became first rector – 1872. • 1876 – superintendent of Easter Lunatic Asylum – Williamsburg • 1887 – first superintendent of the Southwester Lunatic Asylum in Marion Virginia • Black named Dr. Apperson to be his assistant physician • 1888 – Dr. Black died at age sixty-one.
  • 26. From steward to doctor… • Apperson… attended the University of Virginia’s medical school, graduating in 1867, and returned to Smyth County to practice as a country doctor. In 1868 he married a Smyth County native, Ellen Victoria Hull, with whom he raised a family of seven children. • 1887 – Ellen Victoria Hull died (complication of anemia) • 1888 – Dr. Black died; Dr. Apperson decided to leave the Asylum • 1889 – Dr. Apperson married Lizzie Black, daughter of Harvey Black, and they had four children
  • 27. Ellen Victoria Hull Apperson (seated)
  • 28. Another group photograph taken at the Asylum
  • 29. Dr. Apperson’s photograph The man seated at this desk Is actually Dr. Robert Preston – an embarrassing mistake indeed…. (see previous slide – Dr. Preston is at the top of the stairs (#6)…
  • 30. Elizabeth Black Apperson and her four children (c. 1896)
  • 31. From doctor to businessman • After their marriage, Apperson became a businessman and publicist for Virginia’s industrial development and in 1892 was the state’s representative to the World’s Columbia Exposition in Chicago. • Other ventures: • Staley’s Creek Manganese and iron Company • Marion and Rye Valley Railroad
  • 34. Questions and comments? • Another quote from the Apperson diary…when one of the doctors asked Harvey Black how may of his sons he planned to make doctors, Apperson recorded… • “Dr Black said none of them unless they wanted to be, for he did not believe that anyone would become proficient in medicine if they were compelled to adopt it against their will, and spoke of the little incidents that change a man’s feelings. How a very insignificant occurrence might cause a child to determine his course, and follow it with diligence, or on the other hand, when a child’s antipathies are set against a profession, an attempt to make him follow it would be ruinous to him in future life.”