The Rise of Rail-Power in War and Conquest, 1833-1914

by Edwin A. Pratt

Large numbers of sick or wounded were conveyed by rail under one or other of these conditions, and the work was done with great expedition. Between the morning of June 12 and the evening of June 14, 1863, over 9,000 wounded, victims of the Federal disaster at Chancellorsville, were taken by the single-track Aquia Creek railroad from Aquia Creek to Washington. Many even of the severely wounded declared they had suffered no inconvenience from the journey. After the battle of Gettysburg, July 1-3, 1863, more than 15,000 wounded had been sent by rail from the field hospitals to Baltimore, New York, Harrisburg or Philadelphia by July 22. An even more rapid distribution was effected after the battles of the Wilderness and Spottsylvania when, with a few exceptions, the transfer to the hospitals in the cities mentioned was effected in the course of a few days. Following on the battle of Olustree (February 20, 1864), the serious cases were removed on the Mobile Railway by freight cars bedded with pine boughs, palmetto leaves and a small quantity of straw, each patient having a blanket, in addition.

As an improvement on these methods of transport, the plan was adopted of fixing rows of upright wooden posts, connecting floor and ceiling, on each side of a car as supports for two or three tiers of rough wooden bunks, a central gangway through the car being left. In this way the available space in the car was much better utilised than with the straw-on-floor system. Next, in place of the bunks, came an arrangement by which the stretchers whereon the patients lay could be securely lashed to the uprights; while this was followed, in turn, by the insertion of wooden pegs into the uprights and the placing on them of large and strong india-rubber rings into which the handles of the stretchers could readily be slipped, and so suspended. The first car so arranged came into use in March, 1863.

Meanwhile the Philadelphia Railroad Company had, at the end of 1862, fitted up an ambulance car on the principle of a sleeping car, but so planned that the stretchers on which the sufferers lay could be made to slide in or out of the wooden supports. This particular car was capable of accommodating fifty-one patients, in addition to a seat at each end for an attendant. Other innovations introduced on the car were (1) a stove at which soups could be warmed or tea made; (2) a water tank, and (3) a locker.

What the introducers of these improvements mainly prided themselves upon was the fact that the patient could remain, throughout the entire journey from field hospital to destination, on the stretcher he had been placed on at the start. The adoption of this principle necessitated, however, uniformity in the dimensions of the stretchers in order that these could always be accommodated on the ambulance-car fittings.

The next important development was reached when the ambulance car, run in connection with ordinary trains, and used for exceptionally severe cases, was succeeded by the ambulance train. Here came further innovations, the nine or ten "ward-cars," of which such a train mainly consisted in the Eastern States, being supplemented by others fitted up as dispensary and store-room, kitchen, and quarters for surgeon, attendants, and staff of train, besides carrying all necessary appliances and provisions for the journey.

What was now specially aimed at was to make the train as close an approach to an actual hospital on wheels as circumstances would permit. "At present," wrote the Medical Director of the Department of Washington, "the sick and wounded are transferred in cars ill-adapted for the purpose and with difficulty spared from the other pressing demands; and lives are lost on the route not infrequently which, in all probability, might be saved by a more comfortable and easy method of transportation." The train he caused to be constructed consisted of ten ward-cars, one car for the surgeon and attendants, one as a dispensary and store-room, and one as a kitchen, etc. The ward-cars, arranged on an improved principle, each accommodated thirty recumbent and twenty or thirty seated patients. The train was to run regularly on the Orange and Alexandria Railroad between the theatre of war and the base hospitals at Alexandria and Washington. It was either to supplement or to supersede the freight cars with their bedding of straw, hay or leaves. If only from the point of view of the inadequate supply of rolling stock, a car fitted up to accommodate fifty or sixty patients offered an obvious advantage, in the speedy removal and distribution of sick and wounded, over a car, without fittings, in which the floor space alone could be utilised.

Several complete trains of the type stated were soon running on the Orange and Alexandria Railroad, within the Union lines, and the hospital train thus became an established institution in modern warfare.

It was, however, in connection with the chief army in the West, the Army of the Cumberland, operating under General George H. Thomas, that the useful purposes which could be served by hospital trains became most conspicuous.

The need for them in the West was even greater than in the East, because the distances to be covered were greater and lay, also, to a considerable extent, in enemy country.

In the fall of 1863 and the winter of 1864, as narrated in the "Medical and Surgical History of the War of the Rebellion," the chief army of the West was concentrated principally along the line of railroads leading from Nashville, Tennessee, to the South-west, viâ Chattanooga, Tenn., and onwards towards Atlanta, Georgia. At the outset the sick and wounded who could travel in ordinary passenger cars to points in the North were so taken. Severe cases had to remain in the nearest available hospital depôt. In addition to the discomfort suffered by the former in having to travel in cars not suited to invalids, they were liable to frequent and prolonged delays on the single-track lines by reason of the constant passing of supply trains proceeding to the front; and not unfrequently the detentions were at points where nothing could be obtained for feeding the sufferers or making them comfortable, while even if rations could be drawn the train afforded no means of cooking them. So it was resolved to have a train which would be the equivalent of an ambulating, self-contained hospital, capable of carrying both recumbent and sitting-up patients and supplying all their wants on the journey.