An engraving of a covered wagon pulled by a team of 4 horses.

Following the Rear: Travails of the Union Army’s Ambulance Corps

Circulating Now welcomes guest blogger Benjamin Forrest, a fourth year medical student at the University of Birmingham, United Kingdom. He has just completed an intercalated degree programme in the History of Medicine which saw him travel to archives and libraries in the United States. Today, he explores the Union Army’s Ambulance Corps during the Civil War drawing on first hand accounts in NLM manuscript collections.

Early in the American Civil War, no organised system of battlefield evacuation existed. Regimental bandsmen were ordered to transport the wounded; the outcome was a muddled system where wounded men could suffer on the battlefield for over a week. The horror of the unnecessary suffering of injured soldiers compelled officers to improve frontline medical provisions.

An engraved portrait of a white man with a full beard in a military uniform.
Jonathan Letterman in The Medical Department of the United States Army in the Civil War by Louis C. Duncan, Carlisle Barracks, PA: Medical Field Service School, 1931
National Library of Medicine #14120240R

On August 2, 1862, under the instruction of Jonathan Letterman, the Medical Director of the Army of the Potomac,  General George B. McClellan issued General Orders 147 and created the United States Army’s first full-time, dedicated Ambulance Corps. These orders determined the structure, training and role of the service; and crucially, they were a blueprint for the creation of subsequent Ambulance Corps later in the war. This instigated a major improvement in battlefield medicine. However, the new service challenged contemporary ideas concerning wartime humanitarianism, suffering and military authority. So, the corps was often met with hostility and neglect from the rest of the army.

In the Army of the Potomac, the Ambulance Corps soon demonstrated its worth. At the Battle of Antietam on September 17, 1862, all the Union wounded were evacuated from the battlefield within twenty-four hours. Nevertheless, despite its success, the service received hostility from the military.

Stereograph card showing members of the Ambulance Corps carrying wounded soldiers on stretchers to the horse drawn ambulance in the field.
The Ambulance Corps, ca. 1865
Although the Ambulance Corps was dedicated and full-time, training was limited. The staged photograph above shows ambulance-men practicing loading ambulances. However, this was a rare occurrence. Division Ambulance Corps Commander Lieutenant W. H. Whyte says that only new recruits were drilled, on two consecutive days, for a total of around six hours. Generally, ambulance-men learned on the job.
Library of Congress #2011660482

First, the service was opposed due to the supposition that it restricted the military’s authority and activity, as officers surrendered power to medics. This point of contention resulted in a physical relegation of the Ambulance Corps. In his diary of 1864, now in the manuscript collections of the National Library of Medicine, Lieutenant W.H. Whyte repeatedly notes that, during the Battle of the Wilderness on May 5-7, his ambulances were neglected and left to follow the rear of the army’s wagon train.

Diary of Lieutenant W.H. Whyte, 1864
Drilling of new recruits is mentioned on Thursday April 14th and Friday April 15th 1864.
National Library of Medicine #100938705

Captain Elliot Pierce, in his letter-book now held at the National Archives and Records Administration, reported a similar experience on May 3, 1863; the army’s wagons blocked roads and prevented his ambulances from supplying medical assistance to engaged troops. However, most strikingly, Pierce believed that many military officers did not even know the Ambulance Corps existed. Early Civil War medical historian Louis Duncan claims the service is ‘never mentioned in the report of a general officer’—meaning one could read all these reports and never learn that the Union Army even possessed an Ambulance Corps. So, the service was not only actively opposed by officers who knew of its existence, but was also neglected entirely by others who had no knowledge of it altogether.

Men holding carpentry tools stand outside a building with wagons.
Workmen in front of the Ambulance Shop in Washington, D.C. ca. 1865
The ambulance wagons and horses of the Ambulance Corps were also neglected greatly. They were often in a state of terrible disrepair. The photograph above displays an ambulance workshop that tended to the service’s equipment. However, access to vital repairs was often inadequate, so much so that Captain Pierce was unable even to acquire paint for the most basic maintenance of his wagons.
Library of Congress #2018667013

Second, besides being held in contempt for its infringement upon military authority, the Ambulance Corps was shunned due to the belief that it was ineffective and staffed by slackers. Thomas McParlin, Letterman’s successor as Medical Director of the Army of the Potomac, said the Ambulance Corps did not always follow advancing troops into battle as they should have. However, because of the military’s neglect, as described by Whyte and Pierce, ambulance-men often struggled to perform their role effectively. Furthermore, an event from stretcher-bearer Private Heyward Emmell’s diary (held by the Madison Historical Society in New Jersey, a transcribed copy is available at NLM) demonstrates that ad hoc skirmishing meant ambulance-men could not be aware of all ensuing clashes. On October 15, 1863, Emmell records that he and his fellow stretcher-bearers were cooking dinner when a mêlée began nearby. Nevertheless, they rushed into action, even attempting a dangerous shortcut that drew Confederate gunfire, and joined the engaged soldiers. Emmell’s account shows that ambulance-men were often unfairly labelled slackers; instead, they were willing to put themselves in danger to perform their role.

An engraving of a covered wagon pulled by a team of 4 horses.
1861 Ambulance in The Medical Department of the United States Army in the Civil War by Louis C. Duncan, Carlisle Barracks, PA: Medical Field Service School, 1931
National Library of Medicine #14120240R

The Union Ambulance Corps’ efficacy saved countless soldiers the agony of days languishing on the battlefield. In the words of Louis Duncan, ‘[it was] the best care of the wounded the world had ever seen’. And yet it was not appreciated by the American military fully during the war. Nevertheless, the system set a new precedent for humanitarianism on the battlefield and has formed the backbone of American military medicine during every conflict since.


  1. enjoyed your blog post on Ambulance Corps of Army of Potomac. Part of what you see as indifference is probably better thought of as command and control limitations, the staff process we take for granted in modern armies is nascent in the Civil War, so coordination of logistics, operations and medical support was haphazard at best. The other suggestion you make that calls out for more study is the tie to the growing humanitarianism and the questions many people had about how much one could civilize or humanize war. The initial discussions in Geneva, that were contemporary with the US Civil War, are still being developed and debated while good people try to implement them in a very varied world. Please continue the good work you have begun

    1. Here at the National Museum of Civil War Medicine, I have been conducting just such research into the links between the ambulance corps and humanitarianism.

      Beginning in 1863, the US Army followed the Lieber Code, but the Confederacy had no universally administered equivalent. The articles of the Lieber Code were sometimes too broad to be applied humanely, and not universally enforced throughout Union forces.The US was not a signatory to the first Geneva Convention, and the Confederacy (as an unrecognized state) was not invited.

      More importantly for the study of the Ambulance Corps (and the Confederate equivalents), stretcher bearers do not appear to have been considered non-combatants. Targeting them was considered socially disgraceful, but there were no official repercussions that I have yet discovered. Anecdotally, in the case of a Confederate guerrilla captured after intentionally wounding a Union stretcher bearer and surrendering, there is no record of any consequences official or unofficial. The private was even exchanged back to the Confederacy in 1864.

      This all goes to your latter point that the lines were still being drawn. It was indeed a varied world full of mass casualty events and war crimes, and the protection of soldiers employed as stretcher bearers does not appear to have yet been a high priority.

      1. Thank you for your comment and apologies for the delay in getting back to you. I agree that the Lieber Code was rather vague and there was no formal recognition of the ambulance-men as non-combatants. Thank you for sharing the case of the Confederate prisoner.

        In my own research, I have come across many cases of stretcher-bearers being taken prisoner that go against both the Lieber Code’s recommendations on the treatment of medical staff and the Winchester Accords. Interestingly, according to General Orders Number 147 – Section 14, ambulance-men were meant to be armed with revolvers, arming them perhaps inhibiting them from adopting a non-combatant identity. However, in reading both diaries and officers’ reports, I have not come across any evidence that stretcher-bearers ever used their revolvers, or that they even carried or possessed one in the first place. One conclusion I drew from this, and other evidence, was that by acting like non-combatants, they were treated as such. Thus, Union ambulance-men adopted a collective identity that straddled the roles of both a soldier and a humanitarian.

    2. Thank you for your comment and apologies for the delay in getting back to you; I have been away touring France. I agree that it will have been challenging logistically for military officers to have kept tabs on the entire army and the medical department’s matters. However, my idea that the officers’ attitude may have erred more towards indifference or antagonism comes from the work of Civil War medical historian Scott McGaugh and my supposition that the Ambulance Corps was too large in size to be ignored easily. McGaugh says that there were 1000 ambulances at Gettysburg (1 per 100 men) and, with three men attached to each ambulance, there will have been 3000 ambulance-men in total (around 3% of the Union Army’s strength). But again, as you have said, due to its size, it will have been a great challenge to have organised effectively by today’s standards.

      I also agree that this is an area with potential for further exciting research into early humanitarianism and ‘rules of war’. Additionally, some of what I have written in my response to Kyle Dalton below (and his original comment) may be relevant to this discussion.

  2. I have enjoyed reading this article and comments. I am writing a book about my great-great uncle, Louis C. Duncan, M.D. One of his drawings is in your article and you also mention him. He wrote “The Medical Department of the United States Army in the Civil War” as well as another book and articles. A lot of the drawings in the books were done by him. We distant nieces have found his life fascinating. He was from Meriden, Kansas, served in the Kansas Volunteer Infantry during the Spanish-American War, and later joined the Army as an assistant surgeon, and reached the rank of Colonel. Thank you for letting me share a bit about my ancestor!

    1. Linda, thank you for sharing your family’s story. It’s nice to know that some of your great-great uncle’s work is preserved at the National Library of Medicine. Good luck with your book!

  3. After first serving some 18 months as a Private in the 125th Illinois Infantry, my 2nd Great-Grandfather Eli M. Hewitt received a commission and served as an Assistant Surgeon in the 15th USCT from March 1864 until his murder by Confederate guerillas on July 24, 1864. I address his death here since it occurred as an ambush of him and his ambulance and driver as they travelled alone from his detachment at Springfield, TN, to Nashville. I came across this blog as I was attempting to learn more about the ambulances and their horse teams. The official regimental report states that after taking him and his driver down a lane and killing them, the ambulance was burned and the team also killed. This made me wonder why the horses would be killed. Perhaps there were two reasons… they were older, work horses not fit for cavalry or raiders, and that they may have been clearly branded as U.S. Army property?

    A second related story is that, while still in the 125th Illinois, records state he spent time assisting in the care of casualties. The following is also found for January 5, 1863, at Bowling Green, KY. Joel D. Morse, Acting Surgeon of the 1st Brigade, 7th Division, sent a letter to the Brigade Commander, Colonel D. McCook, recommending that Eli be sent to Louisville, Kentucky, to bring up the brigade’s medical supplies which had been left there with the Medical Purveyor. The recommendation states, “Mr. Hewitt is recommended as a trusty energetic man, acquainted with business matters, and is at present a convalescent, unfit for active duty as a soldier.” The order was eventually issued even though it was forwarded one additional level for approval. Such is an indication that medical supplies did not travel at anywhere near the speed of the troops.

    Your input is greatly appreciated.

    1. Thank you for your comment and sharing about your great-great-grandfather.

      On the note of horses, I cannot say specifically whether older or less fit horses were detailed to the ambulance corps, as I never came across any comments on the state of the horses (which may have meant they were adequate since I read a lot of complaints about the condition of the ambulanes themselves!).

      Yes, the speed at which medical supplies were transported was slow and ambulances and medicines were ‘following the rear’. Eli being sent to collect supplies personally would not have been unusual. The head medical officer for an Ambulance Corps detachment was responsible for ordering and collecting his own provisions, and ambulance-men and their ambulanes would be used to collect them.

      Thanks again for your input, and I hope this helps you understand a little more about what Eli would have been involved in.

  4. Although General McClennan initiated the Ambulance Corps because he issued the General Order 147, it was Dr. Jonathan Letterman who actually re-organized an shabbily existing one, and instigated the concept of triage. In the United States, Letterman is known today as the “Father of Battlefield Medicine” For more information, I refer you to —
    Techniques of Civil War medical innovator Jonathan Letterman still used today

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