CHAPTER II
Background and Beginnings
In May 1862, the United States had been at war with the Confederate States for a year and a month. After early defeats at Bull Run and Wilson's Creek, the course of the war had been marked by great victories and wide conquests. In the western theater, Fort Donelson had fallen to "Unconditional Surrender" Grant, Nashville had been occupied by Buell, the battle of Shiloh had resulted in victory for the Union, the great port of New Orleans had been taken by Farragut. In the East, the mountain counties of western Virginia had been detached from the Old Dominion, the defenses of the North Carolina sounds had been breached, the deep water harbor of Port Royal in South Carolina had been occupied to provide a safe base for the blockaders of the Atlantic ports, and, most conspicuous of all, General McClellan's mighty Army of the Potomac had advanced up the Virginia Peninsula, pushing the Confederate defenders back almost into the outskirts of Richmond itself.
For the Union, the war had gone well in its first year, but it had been at a cost in suffering and death from wounds and disease at which the people were appalled. The Nation had gone to war in traditional hip-hip-hurrah fashion, with little regard for the visible dangers of the battlefield and even less regard for the invisible but more deadly dangers of the diseases that lurked in the unclean camps.
Indeed, even if there had been a more realistic appreciation of these risks and dangers, there was not in the existing state of medical knowledge and military organization a great deal that could be done about them. Though anesthesia had been introduced in America some 15 years earlier, methods were still crude, and it was used with considerable misgiving. Bacteria were known to exist but had not yet been accepted as a cause of disease. Antiseptic surgery was still in the future, and asepsis was not yet even an ideal to be sought. The occurrence of pus in wounds or as a result of surgery was looked upon as part of the process of healing, a necessary suppuration.
