Review of Reid, ed. - "RECOLLECTIONS OF A CIVIL WAR MEDICAL CADET: Burt Green Wilder"

[Recollections of a Civil War Medical Cadet: Burt Green Wilder edited by Richard M. Reid (Kent State University Press, 2017). Hardcover, map, photos, illustrations, appendices, notes, index. 158 pp. ISBN:978-1-60635-328-8. $29.95]

The position of medical cadet was created by Congress in 1861 in response to volunteer army mass mobilization and the sudden need to treat vast numbers of sick and wounded soldiers. Directly assigned to an army surgeon, a cadet's primary purpose was to dress wounds in army general hospitals and, while in the field, serve as an ambulance attendant. The term of service was set at one year, and medical cadets were accorded officer-equivalent rank and pay level equal to that of West Point cadets. While some medical education background was required by law, the urgent need for hospital attendants combined with the predictable shortage of qualified candidates led to the acceptance of individuals with no prior medical training. One of these promising yet entirely inexperienced inductees was Bostonian college graduate Burt Green Wilder. His outstanding memoir of his time spent as a medical cadet at an army general hospital in Washington, D.C. was recently published by Kent State University Press under the title Recollections of a Civil War Medical Cadet (edited by Richard Reid^*).

In the summer of 1862, Burt Green Wilder had just completed a degree in anatomy and physiology at Harvard's Lawrence Scientific School. Faced with the decision of either joining the army or trying to make use of his scientific background in the medical service, he chose the latter and applied for a medical cadet position. Glowing faculty recommendations convinced hard-pressed authorities to waive the medical training requirement, and Wilder was duly appointed (along with his friend James Adams) medical cadet at Washington's Judiciary Square Hospital.

Wilder used his retirement years to write prolifically about many different aspects of his life and career. He started composing his cadet memoir in 1910. Wilder used his letters to then fiance Sarah Nichols as the basis of the memoir, but he didn't stop there. In order to both enhance his narrative and fill in various gaps, he incorporated wider research from a number of other sources, including friend and cadet colleague James Adams's diary. Excising all personal material, the result is a remarkably intimate and detailed account of the duties of a medical cadet serving at an army general hospital. In addition to being deeply informative, the memoir is composed in a lively and frequently charming manner that is a pleasure to read.

Helped along by his anatomical and scientific background, Wilder learned his medical functions quickly and his competence made him highly regarded by army surgeons and patients alike. Initial duties were similar to those of today's hospital nursing staff, but Wilder also proved to be very adept at administering surgical anesthetic and even conducted autopsies under physician supervision. He prepared specimens for the Army Medical Museum, and his exceptionally well-written case histories brought him to the attention of the planners of the Medical and Surgical History. Indeed, as his memoir demonstrates, Wilder had many interesting personal interactions with prominent Civil War medical figures like Dr. John Brinton and Surgeon General William Hammond.

In addition to being a highly useful historical record of the role of medical cadet in the army medical service, Wilder's memoir is an equally important contribution to the history of the Judiciary Square Hospital. Along with his personal portraits of various staff members, Wilder's remarkably detailed firsthand descriptions of the physical layout of the hospital, its patient care, and its day-to-day operation are invaluable.

Wilder's unpublished manuscript also includes a large number of interesting appendices. Some were written in defense of the operation of Judiciary Square Hospital, which came under fire later from Walt Whitman and others. Other topics in the appendix section include staff bios, supporting documents of all kinds, case studies, and other interesting ephemera from Wilder's cadet service.

In addition to assembling a continuous narrative, Wilder also extensively annotated all of the collected material contained in his memoir. These later notes are integrated into the main text but helpfully separated from the contemporary material by parentheses (and the text within italicized by Reid). Wilder's post-retirement notes offer factual correctives and much in the way of additional information. Perhaps most interesting are the commentaries on the differences between 1860s medical care and that of the early twentieth century. While expressing some bemusement at mid-18th century ignorance of antiseptic and aseptic technique, Wilder's memoir does confirm the employment of some elements of progressive care at the hospital. The younger staff, including Wilder, opposed the old guard's general use of mercury preparations, and Wilder's writing also discusses the testing of bromine solutions at Judiciary Square for wound care, noting the treatment's beneficial effect on gangrene prevention.

Editor Richard Reid contributes a fine introduction to the volume. In addition to providing background information on Wilder's life, career, and manuscript preparation, the lengthy introduction also explores the scholarly utility of Wilder's memoir in a variety of contexts. In the end, Reid makes a very strong case for the value of Wilder's manuscript. The editor also added his own annotations to the main text. These are mostly biographical in nature, but others consist of brief introductions to select appendices.

Recollections of a Civil War Medical Cadet is an important contribution to the literature of Civil War medicine on several levels. In no other book is the practical role of medical cadet explored in such a comprehensive manner. Wilder's memoir also constitutes an unusually rich record of the daily operation of a Civil War general hospital from a unique perspective. Wilder's writings additionally offer abundant confirmation of the emergence during the war of a new emphasis on innovative scientific principles, a trend that would accelerate real advances in American medical practices. This volume is highly recommended.



* - Reid has published Wilder documents before. Like many medical cadets, Wilder did not complete his full term of service, leaving Judiciary Square after ten months for a coveted post as assistant surgeon with the 55th Massachusetts. See Reid's Practicing Medicine in a Black Regiment: The Civil War Diary of Burt G. Wilder, 55th Massachusetts (UMass Press, 2010) for thorough coverage of Wilder's post-cadet Civil War career.