National Historic Site Kansas
The post surgeon was more then just the doctor for the post. He was a valued advisor to the post commander - responsible for keeping the post and its inhabitants as healthy and fit for duty as possible. He was responsible for examining new recruits to judge their state of health and had very strict guidelines for rejecting men. Men could be rejected if they had missing fingers or toes, or if their sight or hearing was impaired. They were rejected if they had what was felt to be contagious skin infections. Special attention was given to trying to keep out habitual drunkards. Bad breath is also cited as being a reason for rejection-not a bad idea considering that the bunks were built for two and also noting that bad breath can denote chronic pulmonary conditions, chronic tonsillitis, or chronic alcoholism.
The surgeon would have sick call in the morning and great care was made to keep any malingering to a minimum. The sickest of the men would be placed in the hospital for intensive therapy, while the less sick would simply be confined to the barracks, while treated.
The post surgeon or regimental surgeon was also the scientist. He was responsible for recording weather data-specifically; temperature, wind direction and force, rain, and snow fall. This was done four times a day: before dawn, 9:00 a.m., 3:00 p.m., and 9:00 p.m. He also recorded data regarding the flora and fauna (vegetation and animal life) both around the post and on expeditions into rarely visited regions. Many were also keen observers of the different Indian tribes. An example is a report from Fort Scott in the 1850's showing how the ravages of measles, chickenpox, and alcohol had decimated the Osage Tribe native to this area.
The Army Medical department of the 1840s was small. It was made up of a Surgeon General, nine or ten surgeons, and forty to fifty assistant surgeons. The surgeons made the equivalent of a major's pay, assistant surgeons with five years of service made a captain's pay, and the less experienced assistant surgeons made the same as a first lieutenant. This amounted to between fifty and sixty dollars per month.
An examination was given to physicians wishing to join the Army. It covered anatomy, physiology, surgery, pharmacology, and obstetrics. Although we have rather extensive records of the diseases and afflictions that were treated here, we do not have any medical records of obstetrical deliveries. We know that many babies were delivered, but because the wives were not officially part of the army, they were not included in the official records.
Military service was quite valuable to the physician since he was exposed to many more cases of disease in a shorter length of time, than was the civilian physician of his day. Between 1842 and 1849 there were 3,034 medical cases treated at Fort Scott. There were 1717 cases of malarial fever treated here during that time.
The arrival of a new medical officer usually resulted in an increase at "sick call," as the chronically ill and malingerers tried out the new doctor. The number of cases might increase by as much as 40 percent until the new medical officer had a chance to familiarize himself with his men. A young and inexperienced doctor was particularly at a disadvantage.
The hospital staff consisted of a surgeon, a steward, a wardmaster, nurses, a cook, and a matron.
The surgeon's duties included overseeing all of the hospital personnel, make morning and evening visits through the hospital, keeping the proper records such as the case book, prescription book and the diet book as well as a diary of the weather. He was also responsible for the care of the dispensary, instruments, and the proper distribution and administration of medicines prescribed. Other duties included keeping a correct account of all expenditures and filling out the monthly, quarterly, and semi-annual reports.
As the post surgeon he was allowed to select his own wardmaster, steward, nurse, and matron. The wardmaster, steward, and nurse were all soldiers selected from the companies stationed at the post.
Duties of the wardmaster included admitting patients into the hospital, recording all personal property of the patient, and taking care of the patient's clothing. Care of each person's clothing involved cleaning, numbering, and labelling with name, rank, and company. The wardmaster made sure there was enough bedding, cooking utensils, etc., in the hospital. He also took inventory of everything in use once a week and reported everything missing, worn out, or destroyed.
The wardmaster was also responsible for keeping the kitchen, wards, furniture, and cooking utensils clean. The wardmaster would call roll of the wards at sunrise and sunset and report any absentees. He was responsible for the cleanliness of the patients and attendants. He made sure every patient was washed and had his hair combed every morning. He would see to it that the patients were shaved 3 times a week when their case would permit.
Another duty of the wardmaster was to sweep and sand the floors before the morning visit of the surgeon. He would also make sure the close stools and spit boxess were clean, as well as the (bed) pans. He was to air the bedding and change the straw once a month. If a patient died, the straw would be burned and bed and bedding cleaned. An orderly often assisted the wardmaster in the performance of these duties.
The cooks (if any), nurses (soldiers from the post who had no medical training) , and attendants or orderlies were under his immediate direction and were subject to his orders.
Duties of a steward were mainly clerical. He was responsible for recording all hospital-related supplies which were received. This included hospital stores, furniture, and supplies purchased for the use of patients. He also kept a roster of the nurses and attendants and would make out returns for rations used by the hospital each month. The steward also issued the hospital stores and the supplies to the nurses and cooks, recording each item. Any supplies the wardmaster needed such as bedding, furniture, and cooking utensils were issued by the steward. He was in charge of the order and neatness of the storeroom and allowed no one to enter the room.