Review - "North Carolina's Confederate Hospitals 1861-1863, Volume I" by Wade Sokolosky

[North Carolina's Confederate Hospitals 1861-1863, Volume I by Wade Sokolosky (Fox Run Publishing, 2022). Hardcover, 6 maps, photographs, illustrations, tables, footnotes, appendix section, bibliography, index. Pages main/total:vi,180/243. ISBN:978-1-945602-23-8. $32.95]

Scholarship published over the past few decades has dramatically improved our understanding of the professionalism, compassion, scientific curiosity, and innovative drive displayed by many practitioners of Civil War military medicine. What effect this revisionist work has had on the wider reading public's generally dim view of the army physician is anyone's guess. Hopefully, the popular stereotype of the Civil War surgeon only too happy to ply his patients with blue mass and cut off an injured limb at the drop of a hat are long gone. A more accurate picture of Civil War military hospitals has also matured over time. A notable new contribution to that expanding literature is Wade Sokolosky's North Carolina's Confederate Hospitals 1861-1863, Volume I.

At its heart, Sokolosky's book is an organizational history of the military hospital system in North Carolina. The early sections present, through both synthesis and the author's own considerable primary source research, a state-level picture of an evolving bureaucracy that was both informed by and frequently clashed with the national-level management system documented so well in Guy Hasegawa's recent book Matchless Organization: The Confederate Army Medical Department (2020, SIU Press) [review]. The tireless activities of many physicians, from state Surgeon General to hospital directors, are explored in the book, as are the roles of female matrons, nurses, and volunteers. As indicated by the author, the experiences of black hospital attendants, who served in sizable numbers according to hospital rolls, cannot be revealed in detail due to source limitations.

A major theme of the book is how the state's logistical apparatus and military events, particularly the latter, shaped the establishment, location, and scale of North Carolina's military hospital system. With the entire coastline threatened by Union army and naval forces in 1861-62, a corresponding influx of defenders led to the establishment of a number of general hospitals in vulnerable forward positions. The startling success of the 1862 Burnside Expedition forced relocation inland, but the need to be tied to railroads also placed those facilities in the path of subsequent infantry and cavalry raids launched from the Union Army's recently seized coastal bases. Proximity to the Virginia front and the bloody escalation of the fighting there also forced an expansion of North Carolina hospital capacity.

Where documentation exists, physical descriptions of the hospitals, their capacity, their staff, and their local sources of support (or, in some cases, opposition) are also conveyed in the book. In addition to the state's system of general hospitals, the more controversial wayside hospitals are also discussed at length. Meant to handle convalescents, visiting family, and transient patients, wayside hospitals proved effective, but critics still saw them as a waste of resources. In contrast to general hospitals, wayside hospitals in North Carolina were more often able to maintain state and private management.

As Sokolosky abundantly demonstrates, management of the hospital system in North Carolina during this period mirrored many other aspects of the Confederate war effort in that it was subjected to frequent and often intense States Rights versus centralization clashes. With North Carolina governor Vance being one of the most ardent defenders of state prerogatives, that tug and pull between Richmond and Raleigh was present at all levels of medical department leadership and management. Who should manage, supply, and fund general hospitals in North Carolina was an ongoing subject of debate. As the war progressed, however, the forces of centralized integration gathered momentum, and by December 1863 the Confederate Medical Department was in charge of all of North Carolina's general hospitals and the majority of its wayside hospitals.

With fresh data and insights drawn from extensive original research, Wade Sokolosky's North Carolina's Confederate Hospitals, 1861-1863 provides us with the first comprehensive history of the personnel, organization, and management of military hospitals in the Old North State during the first half of the Civil War. The quality of this study certainly heightens the anticipation level for the second and final volume, which will document further expansion of Confederate hospitals in the more central part of the state and explain how the great military events of 1865 (e.g. Sherman's Carolinas Campaign and the fall of Wilmington) pushed the entire system to the point of collapse.