Dr. Jonathan Letterman’s Guidelines For Health and Nutrition in Civil War Camps

Dr. Jonathan Letterman

Dr. Jonathan Letterman is remembered for developing the ambulance and field hospital services for the Union Army, but as medical director for the Army of the Potomac, he also recommended policies to improve the general health and well being of the army. Letterman became medical director in the summer of 1862, while the Army of the Potomac was in the midst of the Peninsula Campaign with its huge casualty lists.

At the end of the campaign in July, the army was encamped at Harrison’s Landing on the James River. The wounded were being shipped out to hospitals in the north; while that was going on Letterman recalled:

the troops began to feel the effects of miasmatic and other influences, as evidenced in the prevalence of malarial fevers of a typhoid type, diarrhea, and scurvy. My attention was then directed to the most expeditious method of improving the health of the army. The means considered proper for adaption (some of which had already been enforced with great benefit), were set forth in a communication I addressed, of the 18th of July, to Brigadier General S. Williams, Assistant Adjutant-General.

At the time, germ theory was still being studied as a cause of disease, and there were no antibiotics. But cleanliness, proper nutrition, and clean drinking water were understood to have positive health effects by more and more physicians. Letterman offered his suggestions in his July 18th letter to General George McClellan’s Adjutant General Seth Williams:

Headquarters Army of the Potomac,
Medical Director’s Office,
Camp near Harrison’s Landing, Va., July 18, 1862.

General: I have the honor to submit the following extract from a report of the sick and wounded in this army, taken from the latest reports made to this office by the medical directors of corps, and to present to you certain suggestions for removing the causes of disease and improving the general condition of the men.

Dr. Jonathan Letterman and Staff

The diseases prevailing in our own army are generally of a mild type and are not increasing; their chief causes are, in my opinion, the want of proper food (and that improperly prepared), exposure to the malaria of swamps and the inclemencies of the weather, excessive fatigue and want of natural rest, combined with great excitement of several days’ duration and the exhaustion consequent thereon. I would recommend, to remedy these evils, that food, with an abundance of fresh vegetables, shelter, rest, with a moderate amount of exercise, be given all the troops, and general and personal police be enforced. To accomplish this, I would suggest that an abundant supply of fresh onions and potatoes be used by the troops daily for a fortnight and thereafter at least twice a week, cost what they may; that the desiccated vegetables, dried apples or peaches, and pickles be used thrice a week ; that a supply of fresh bread, by floating ovens or other methods, be distributed at least three times a week; that the food be prepared by companies and not by squads, and that there be two men detailed from each company as permanent cooks, to be governed in making the soups and cooking by the inclosed directions ; that wells be dug as deep as the water will permit. That the troops be provided with tents, or other shelter, to protect them from the sun and rain, which shall be raised daily and struck once a week and placed upon new ground; the tentes d’abri also to be placed over new ground once a week; that the men be required to cut pine tops, spread them thickly in their tents, and not sleep on the ground; that camps be formed not in the woods, but a short distance from them, where a free circulation of pure air can be procured, and where the ground has been exposed to the sun and air to such an extent as to vitiate the noxious exhalations from damp ground, saturated with the emanations from the human body and from the decaying vegetation. Sleep during the day will not compensate for the loss of it at night; that not more than two drills per day be had, one in the morning from 6.15 to 7, and one in the evening from 6.30 to 7.15; that the men be allowed to sleep until sunrise, and that they have their breakfast as soon as they rise; this, with the labor required for policing, will be sufficient during the present season. That when troops are to march they should have breakfast, if only a cup of coffee, before starting, and alter their arrival in camp each man be given a gill of whisky in a canteen three-fourths filled with water. I would also recommend that the strictest attention be paid to policing, general and special; that all the troops be compelled to bathe once a week—a regiment at a time, if possible, being marched to the river from a brigade one hour after sunrise or an hour and a half before sunset—to remain in the water fifteen minutes; that sinks be dug and used, 6 inches of earth being thrown into them daily, and when filled to within 2 feet of the surface new sinks be dug and the old ones filled up; that holes be dug at each company kitchen for the refuse matter and filled in like manner; that the entire grounds of each regiment be thoroughly policed every day, and the refuse matter, including that from stables and wagon yards, buried 2 feet below the surface or burned; that dead animals and the blood and offal from slaughtered animals be not merely covered with a layer of earth, but buried at least 4 feet in the ground; that the spaces between regiments be kept policed, and no nuisance whatever be allowed anywhere within the limits of this army, and that regimental commanders be held strictly accountable that this most important matter is attended to. I think if these suggestions be carried into effect that we may with reason expect the health of this army to be in as good a state as that of any army in the field.

Very respectfully, your obedient servant,

JONATHAN LETTERMAN,
Surgeon and Medical Director, Army of the Potomac.

Brig. Gen. S. Williams, U. S. A.,
Assistant Adjutant-General.

“Sinks” was the term used for latrine at that time.

Gen. FitzJohn Porter and Staff at Harrison’s Landing August 1862

Letterman also offered his detailed recommendations for cooking in camp. Union soldiers were in theory given generous rations, but in reality that wasn’t always the case, especially while on active campaigning when supply lines might be disrupted. The quality varied a great deal as well. Letterman was a big proponent of soup for the troops.

Directions for cooking in camp.

The importance of soup as a diet for troops is not sufficiently apprehended except by veteran soldiers, those of experience in the field. It cannot be too highly esteemed, and should be used to a much greater extent than it is. Bean soup, when properly made, is one of the best that can be used; when improperly made, one of the worst. The beans must be washed, steeped in water overnight, put on the fire at reveille, and boiled slowly for six hours; a piece of pork, say one ration for three men, put in three hours before dinner; this, eaten with a little pepper and vinegar, makes a wholesome and palatable dish. The cooking is everything; if not well done, it is positively injurious; if well done, it is wholesome. The great principle in making soup is that it must be boiled slowly and for a long time; it cannot be boiled too much. In making beef soup all the bones should be used, together with half rations of beef, rice, and desiccated and fresh vegetables, with salt and pepper; the desiccated vegetables should be steeped in water for two hours, and boiled with the soup for three hours; the rice should be added, after having been washed half an hour before the soup is served; the beef must first be put in cold water, and the soup kept at a low boil for five hours. Beef should not in any case be used for cooking until cold. Hard bread will be more palatable and more easy of digestion if placed in the ashes until thoroughly heated; it can also be improved by breaking it in pieces an inch or two square and soaking it thoroughly in warm water, then placing it in a frying-pan with a few slices of pork and cooked for five minutes, stirring it, that all may be cooked alike. Such portions of beef as are not used in making soup should be cut in pieces about the size of a hen’s egg, with half a ration of potatoes and a small -sized onion cut in slices to one man, and half a ration of desiccated vegetables previously soaked in cold water for an hour, with a few small pieces of pork, adding salt and pepper, with water sufficient to cover well the ingredients, and stewed slowly for three hours, will make an excellent dish. Beef that is not used thus should be cooked on coals or held before them on a stick or fork, and no salt or pepper put on until cooked; the salt put on before cooking only assists in abstracting the juices of the meat and in making it dry and hard when cooked. The secret in using the desiccated vegetables is in having them thoroughly cooked. The want of this has given rise to a prejudice against them which is unfounded; it is the fault of the cooking, and not of the vegetables. Pork should be boiled three hours, having been previously soaked in water, to abstract the salt, for three hours, the water being changed twice in that time; when cold and cut in slices, with a piece of bread and a slice of onion, it makes an excellent lunch; cut in slices and toasted over coals it is sweet and good. Coffee should be roasted over a slow fire, constantly stirring it until it becomes of a chestnut-brown color, and not burnt, as is so commonly done. It should be boiled for twenty minutes, set one side, sweetened, well stirred, and a little cold water added to cause the grounds to settle. Cabbage is more wholesome when cut in shreds and eaten with a little vinegar, pepper, and salt, than when cooked. All fried meats are unwholesome; they should be boiled or broiled.

JONATHAN LETTERMAN,
Surgeon and Medical Director, Army of the Potomac.

Army of the Potomac at Harrison’s Landing VA 1862

McClellan was on board with Letterman’s recommendations, and put them into effect in issuing General Orders No. 150 in August.

Sources:

Hardtack and Coffee or the Unwritten Story of Army Life by John D. Billings

The Life of Billy Yank: The Common Soldier of the Union by Bell Irvin Wiley

Medical Recollections of the Army of the Potomac by Jonathon Letterman

Official Records of the Union and Confederate Armies in the War of the Rebellion Series I, Volume 11, Part 3