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.”