Civil War Nashville: Hospitals & Healing

In an attempt to frame this study, we find ourselves at the eve of the Civil War. Following the election of President Abraham Lincoln, and an intense political and social battle between states of the North and the South, South Carolina secedes from the Union in December of 1860. The state is soon followed by Mississippi, Louisiana, Florida, Georgia, Alabama, and Texas. Following the crisis at Fort Sumter, Virginia, North Carolina, and Tennessee, the home of Nashville, join the Confederacy. Over the next few years, Nashville would become a key battle site as Union troops moved in to take the city and assert their control over the South until they eventually found victory (Hulette 2021).

After the Union took control of Nashville, the city became the Army’s base of operations in the Western Theatre. The fact that it was the only southern state capital in Union hands combined with its geographical significance made the possession of Nashville a crucial point in the latter half of the war. For these reasons, Northern troops established numerous fortifications and hospitals surrounding the Cumberland River awaiting the inevitable Confederate attempt to retake the city. On December 15-16, 1864, the Battle of Nashville occurred, and the resulting Union victory effectively ended the South’s hope in the Western Theatre. The Union troops led by General George Thomas defeated Confederates under General John Bell Hood (ibid).

According to the Journal of American History, the Civil War exceeds every other major conflict in military deaths since the creation of our county, with over 618,000 casualties. This massive loss of American life represented not just an intense wave of death within the country in just four years, but also the first time many Americans had witnessed a fight in their own backyards, let alone a fight between those who once both considered themselves "Americans." The critical number of wounded and dead at every battle and campaign during the war led to an enormous need for medical attention, surgical improvement, and burial arrangement.

Focusing on these core needs, one finds themself at the intersection of them all: the hospital. Whether it be a tent set up on a battle field, or a more permanent structure, many Civil War soldiers (from both sides) would find themself in need of hospital care during the war, and many would see to the end their lives within one. Surgeons, generalized physicians, and nurses played an integral role in mitigating that massive statistic of casualties, but given the times and the course of the war, only so much could truly be done or expected of them. By mapping and inherently acknowledging the role of these individuals and their hospital communities in the war, we can more accurately track the lived experiences of those in Nashville in late 1864 and on.

Until now, no known map exists that documents both permanent and semi-permanent field hospitals from the Battle of Nashville and the overall federal occupation of the city. In an interview with Jim Kay, the current president of the Battle of Nashville Trust, he expressed this importance of this project and his excitement for its completion, given that so many descendants of the Civil War and those who are simply interested in its study tend to ask about these specific hospitals.

By highlighting life inside of these sites of healing, and how that healing came about, was adapted, and advanced, we can learn from the history of Civil War Nashville and preserve it, virtually, forever. We want to be clear that we do not honor the Civil War or the Confederacy, but to forego the significant role it played on medicine and healing for American (and international) wars from its occurrence on would be incompatible with the task of keeping history.

We introduce a map of known hospitals of Nashville from 1864 to 1865, as well as in depth stories on each of these locations, the people who worked within them and were treated at them, and the research that took place because of them.

The geographic data for this map was collected in April of 2021 within Davidson County by the authors of this project and utilized the ESRI ArcGIS Data Collector app to capture, down to 30 ft, an accurate geographic depiction of each individual site.

Please explore the hospitals of Civil War Nashville by clicking on them, and find available photos and information from the historic record (TSLA, LOC).

These points are plotted onto a contemporary map of Nashville from the Civil War, known as the Poe map, which was geo-referenced onto a modern day snapshot of Nashville for the most accurate depiction. See below for a "swipe" between 1860s Nashville and today.

Nurses, one of the few roles that women were able to assume during the Civil War, played an integral role in the saving of both Confederate and Union lives in Nashville. They often worked alongside men or on their own, facing many of the horrors of the war head first. Nurses like Clara Barton in the Eastern theatre, the founder of the American Red Cross, were the first to notice good hygienic practices during war and seek them out, even if they did not recognize them as exactly that.

We had the chance to interview Jake Wynn, the Director Interpretation at the National Museum of Civil War Medicine, and hear about his work. He focused on the "cascade effect" of nursing, seen in their advice and its implementation, throughout the Civil War. His work focuses on the Eastern Theatre, but his advice was influential in our search for information beyond the obvious, to root out the health experiences of those often overlooked or ignored in the historical record. While this research is important and clearly has benefits for understanding the roles of persons beyond soldiers, it needs expansion, and here we try to add to this body of knowledge.

Mary Jewett Telford served as a nurse in Hospital No. 8, but her journey to Civil War-era Nashville is of particular interest to those with a passion and sense of duty. Born in Seneca, NY, and raised in an abolitionist Kentucky family, her age barred her from joining the United States Sanitary Commission despite her strong urge to serve. After endless begging, she was able to have this opportunity due to the political connections of her father, who was friends with the governor of Michigan. Upon arrival at Hospital No. 8, Telford was only the only female staff member for most of its functional existence.

On July 8, 1864, she married Union soldier Jacob Telford of the 15th Indiana Infantry. Mary and Jacob met after the Battle of Stones River, during which Jacob had been severely wounded. Shortly before the wedding, Mary resigned from nursing, but her one-year career is well-documented and thrust her into the spotlight.

In the writings of Elvira J. Powers, she is referenced below as "Miss J,"

After the war, she was active in the Women’s Relief Corps and the Women’s Board of Missions. For many famed Civil War nurses, involvement in these organizations propelled influential careers in politics and social advocacy.

Telford later ran for the office of Lieutenant Governor of Colorado in 1894 with the nomination of the Prohibition Party. A staunch supporter of women’s suffrage and temperance, she argued that the two issues should be addressed together. The newspaper she published, Challenger, was an outlet favorable to these causes.

Telford passed away at the age of 67 in Hinsdale, IL. One of Mary’s friends credited her military experience for much of her later success in life prior to her death, stating:

Not only did the Civil War, and the subsequent construction of several hospitals within the city, lead to opportunities for women as nurses; early medical research using the same scientific methods and observations we acclaim today took place within the bounds of Nashville and nearby battle sites. These reports and other forms of medical observation led to direct, actionable change, seen in both the increase of sanitation within hospitals for the military as well as legislative implementation and policy adaptation to a war-torn reality.

The Civil War catalyzed the advancement of many modern medical practices, including an innovative method for treating gangrene, a relatively common but harmful form of infection. Hospital gangrene represented a common enemy for medical professionals within or near a battlefield: basically, it was rampant, generalized infection, common after soldiers trudged in from the field or received amputations without any form of sterilization or sanitation.

Dr. Middleton Goldsmith observed patients in the Union ranks (the Army of the Ohio and the Army of the Cumberland), attempting to treat them with bromine. This treatment involved both topical application and targeted injection to heal the wounds and prevent damaging infections. In 1863, Dr. Goldsmith published a deeply influential work entitled A Report on Hospital Gangrene, Erysipelas and Pyemia as Observed in the Departments of the Ohio and the Cumberland, with Cases Appended. According to the official surgical documentation from the war, 45.6% of all gangrene cases resulted in death. However, as outlined in his study, under three percent of those who received Goldsmith’s bromine treatment passed away.

His study was so rigorously undertaken and documented that future researchers could confidently conclude that his bromine treatment was truly effective. As amateur scholars of this field of research, we reached out to a modern surgical pathologist and Civil War buff, who acclaimed this kind of research as integral to the future of medicine.

Unfortunately for most soldiers, infection within the bounds of the hospital in the form of gangrene was not the only concern. As men flocked to battle areas such as Nashville, a common pattern presented: a significant increase in cases of venereal disease, or what we today call sexually-transmitted infections (STIs). The pattern continues on into nearly every war following the Civil War, but Nashville specifically remains a highlight in this long history. While many may guess Vegas when thinking of the first city in the United States to legalize prostitution, it was actually Civil War-era Nashville, in an attempt to mitigate the powerful issue of syphilis and other STIs.

Hospital no. 11, also known as Pest House, sprung up as the main hospital for treatment of males with venereal diseases in Nashville like the man below.

Thinking back to the very first photo in this story map, there was also a hospital simply for prostitutes (Hospital no. 15) within Nashville during the Civil War. By engaging in legalization and some forms of market control, as well as ensuring that the working women were healthy (and infection-free), Nashville officials increased the safety of soldiers and prostitutes in their relations. The percentage of men in Nashville with STIs fell from 40% to 4% (Hulette 2021). Further, this action reflects a level of foresight and acceptance of reality quite uncommon in that time period; certainly, these legislative changes were not permanent, and demonization of these women still occurred, but nonetheless this example serves to show just how impactful disease can be to one community, and all of society.

Overall, mapping and understanding the role of each hospital in Civil War-era Nashville provides not only a glimpse into a significant moment of history, but a better understanding of life during the Civil War in the Western Theatre. As a tipping point in the war as a whole, Nashville remains integral to the study of the Civil War, and it allows us to better connect the true, lived experiences of those fighting on both sides with the broader conclusions of the war in general.