Ring the fire bell: the incredible story of an Iowa Civil War medical center, September 27, 2018

- [Donna Hirst] So this is the History of Medicine Society and we have monthly lectures through the academic year and if you're interested in being on the mailing list, to find out what lectures are coming up or special events that we have, there's a sign up sheet right at the end of this ledge. Along the wall here are pictures from Dr. Driscoll's talk and so you might want to walk by and just kind of get oriented. He may talk about some of those. In the back of the room, we are having a book signing and you can purchase Dr. Driscoll's book. We're selling it for $15, a bargain, and they're all signed. So you might want to consider that. Charles Driscoll received his BA degree and his medical degree from the University of Iowa. He did his family medicine residency at Ball State University. He attended the US Air Force Flight Medical School and then had a private practice in Red Oak from 1976 to 1978. He served as a professor and head of the Family Practice department at the University of Iowa College of Medicine from 1978 to 1994. He resumed private practice in West Branch but then left for the University of Virginia as Residency Director and Geriatric Fellowship Director. Dr. Driscoll has edited Medical Aspects of Human Sexuality, the Female Patient, and the Iowa Family Physician. He's been on the boards of Archives of Family Medicine and Patient Care and was the editor-in-chief for Resident and Staff Physician Journal. He's been a past president of the Iowa Academy of Family Physicians and a past chair of the Accreditation Council of Graduate Medical Education Review Committee for Family Medicine Education. In parallel, Dr. Driscoll has been a historian. With four ancestors serving in the Civil War, he is a live member of the Sons of Union Veterans of the Civil War, where he served as a past commander. He has been an educator of 18th and 19th century medicine. He is a charter member of the National Museum of Civil War Medicine and has had the opportunity to act in two Civil War movies. - [Dr. Charles Driscoll] Nobody's called from Hollywood yet. - [Donna Hirst] I'm very pleased to introduce Dr. Charles Driscoll who will be sharing information about the Iowa Civil War Medical Center. - [Dr. Charles Driscoll] Thank you. You may all be in trouble 'cause you punched my button of Civil War medicine and we may have to send out for dinner. So my spouse, Jean, is sitting in the front row and my editor, Dick Caplan, is sitting in the front row. He's going to use the red pencil on anything I say and Jean's going to cut the time off when it's time. So I don't want to waste any time but it's so good to see friends and faces in the and thank you for the invitation to come and speak. As Donna said, my passion has become history of Civil War medicine. I live in Virginia. You can not drive 500 yards without seeing a historical marker. And every town has its claim to fame, the battle of. So we do have the Battle of Lynchburg and if you want to come and visit us, we'll be glad to host you and show you around. You're looking at an engraving from the New York Times, 1960, and this is Keokuk, Iowa as it appeared then with the steamboats and the levee and here's the city. You're standing in Illinois from this view and looking across the river at Keokuk. I want to remind you that at this time, that was the northern most navigable waters of the Mississippi. The Des Moines and the Mississippi came together, there was a rapids there, and the draft was only two and a half feet above the rapids, so no steamboats could get through there. So they would offload here in Keokuk. They put it on a train, run it up 15, 30 miles, offload, put it back on a steamboat and be able to take it on north. So if any of you are here from Davenport and Keokuk said oh yes, we had steamboats. Yes you did but they never passed Keokuk to get up there. Why am I going to tell you this story? Well, I just have one word about that. It's a darn good story. I grew up in Keokuk. I knew nothing about this when I was there. There was no publicity. I knew we had a national cemetery because I lived two blocks away from it and I played in the national cemetery. I remember that very well but I knew nothing of the history. And it wasn't until I got here as a medical student and one day should have been studying or perhaps in class but couldn't concentrate so I went up to the top of the tower and there was an attic up there. And in the attic there were old instruments and beds and cots and lamps and I started to look at a box and it said medical instruments, Keokuk, Iowa. And it suddenly dawned on me, they were talking about my Keokuk, Iowa. So I looked at these instruments and started to study it up a little bit and then I got busy and I never got back to it until I retired in 2012 and five years later, I had a book out on it. And so I hope you will enjoy hearing some of the history of Iowa. How many Iowans do we have here? Okay, a lot, then I should just be able to give a quiz and you'll know all the answers. What was the year of the Great Flood? No, only Vic remembers that it was back in 1851. How 'about the worst tornado that ever hit Iowa? Anybody know that? Okay, so you Iowans have a little bit to study up on. Well, it's a good story. Keokuk is full of characters, good and bad. It was US General Hospital number one. It was the 17th largest hospital out of 190 US military hospitals. That in and of itself gives it some significance, I think. We need to learn its whole story. It's in pieces everywhere you look, so I tried to pull the pieces together. Over 10,000 people were treated there and there were 8,000 citizens, just so you know. And can you imagine dropping a boatload of 300 people in the midst of 8,000 citizens and say take care of them. And then the next day, another boat arrives with another 250 and then the next day, another boat arrives with another 300? You probably would have to really scramble. I don't think we could do it today with all the resources we have. Keokuk sent a lot of people to the war. Many of them didn't come back. Others came back broken. There were 10,500 soldiers treated in three and a half years. Iowa sent the most men per capita of any other state in the Union, so we're talking about a significant loss of a generation of young Iowa men that went to war and didn't come back. And the other significance I want to share with you is that Lincoln created a national cemetery system and Keokuk was one of the first among the first dozen national cemeteries that he created. So that's why I want you to know the story. Okay. It's sort of like studying the Bible. If you read a piece of scripture and you don't know the context, you don't know anything at all. You just know what the pretty words say. So we got to have context and then we'll study about Keokuk. So here's the context. This is Chief Keokuk. He was chief of the Sauk and Fox tribe. He was a diplomat. He never took over anything by war, he was a negotiator. He was such a negotiator that they had him in Washington DC testifying before Congress and he gave land and ceded land to the federal government. His land was right across the Illinois river from where all the Black Hawk War took place. So his land was given over and that was where Keokuk was. Iowa was a territory in 1938. We're not very old, if you think about it. He had settled about 10 or 15 miles above Keokuk and called the area where they settled Puck-e-she-tuck. Puck-e-she-tuck was his language for the Medicine Ground. So you could see we're already building a medical heritage in Keokuk. Most of the whites who arrived, the first whites were Marquette and Joliet and they came in the 1600s, about 1673, and they got as far down as Keokuk but the whole state of Iowa was prairie at that time and there were no whites settled here. In 1838 when it became a territory, there were probably only 50,000 people in the state of Iowa, the whole state. And so most everybody arrived after 1842. Why then? Well, that was when the Indian uprisings in Illinois and the Black Hawk War got settled and it was much safer to migrate across. There are no bridges, by the way. There are no bridges until after the Civil War. They started a bridge, they had a bridge, but a steamboat ran into the bridge. It was up in Davenport, I believe, and completely wrecked it. And then the war broke out and they needed every ounce of steel that they could for rails and cannons. And so there was never a bridge until after the Civil War. Iowa became a state on the 28th of December in 1846. So at that point in time, I have to show you a little bit about what it looked like. But I need to also tell you about this guy because this story has so many strange connections to it, it's just, you can't make this up. It's truth. And does anybody know who, whoops, I'm sorry. Back we go. Does anybody know who that is? Jean knows. That is Robert E. Lee. And Robert E. Lee came to Keokuk in 1837 and this was about what Keokuk looked like in 1837. And it's kind of stylized but the Des Moines river is down here and this is the Mississippi going through. And he was trying to figure out how he could get boats up the river, so he studied it for a period of time and decided that there was no earthly way that you could get steamboats up the Mississippi River. So after he lived in Keokuk for a little while, he left and I'm sure that you all know that Robert E. Lee became important in the Civil War times. Now what was going on at the time that Keokuk became a major medical center? Well, in Missouri, they were having a little squabble with Kansas. You may remember the Bloody Kansas, the Kansas Missouri Wars and that went on because they were a slave state and Iowa was not. And so they didn't like us very much and we didn't like them very much. There were lots of boundary disputes. During the Civil War, it had pretty much been settled. The boundary became fixed when Iowa became a state and then in 1847, it became its present shape. But the first proposal was that our state wouldn't look like this. And it was carving out a part of the Wisconsin territory, the Nebraska territory's over here, and Missouri had laid claim to this. So this was very fertile ground, those hills, those of you who are from Western Iowa, and they were going to an annex this to Missouri. That battle went on until January 1st, 1848. Some other things happened to make Iowa a particularly proud and ready state to enter the Union. Number one, there was an anti-slavery push in Iowa. Some of you may have gone through the Freedom Trail, which starts down in Kansas, works its way up into Western Iowa and comes, basically comes across Interstate 80, through Iowa City, up to Springdale and into Chicago and that's the underground railway to get slaves out of captivity. Is that me? No. I thought my time was up. Iowans fought against slavery and they were very much of a help to John Brown and his group as they were bringing slaves across the state. Now I mentioned a few of these things but how in the world did Iowa ever survive the Great Iowa Floods, 1851? And you can see a picture of Des Moines. It had crested at 22 feet over flood stage at that point. The problem with it was there was no water control, no dams, so the water just went everywhere and unfortunately, most people survived by subsistence farming and their crops were wiped out and their fields were unable to be tilled. And they just picked up and moved, so we lost a lot of population out of the state in 1851. Then in 1857, the Sioux Uprising in Okeboji. There were 40 men and women and children that were slaughtered up in the northwest corner of the state. And now we had two conflicts going on. We had the Sioux and that conflict stayed right through the Civil War and we had the conflict of the Missouri border ruffians that were trying to incur up into Iowa. And then in June of 1860, the worst tornado that ever hit Iowa went through and look at the damage that it did. 200 people died. It was traveling at 66 miles an hour, they said, and it traveled 590 miles, wiped out 200 citizens and $745,000 lost in homes. Remember, the homes are miles apart. Iowa's not settled and so it was devastating. So you kind of wonder how Iowa ever got up on its feet and got back in the game. And here's an interesting connection. I'm sure that you all recognize this guy up here. But does anybody recognize this? That was only 15 miles away from here. Tom Novak and I practiced very close to it. That's Springdale and that's the Maxon Home and there was a Quaker settlement there. And the Quakers were particularly strong in their belief about the abolition of slavery. So strong that they let John Brown come and set up a military camp and drill. So all of the training for Harper's Ferry took place in Iowa not very far from here. Now, if you're going to go up there and look for this place, there's nothing left, okay. But this is the fella who owned the house, John William Maxon, I think it was, and this is John Brown. So he takes a group of men and goes east to Harper's Ferry to raid the arsenal. And he takes these Iowa boys with him. He had six Iowa men included. And these two are Barkley and Edwin Coppet and the one that's the oldest over here, he was hanged side by side with John Brown. And at the point of Harper's Ferry, he could have stopped and changed the whole Civil War because who led the counter attack against Harper's Ferry? Anybody remember their history? Robert E. Lee. And Edwin had his gun sighted on Robert E. Lee through the arsenal, was about to fire, and somebody knocked his gun away. And then Robert E. Lee said oh, I'm too close, I've got to get back. And he left. He moved to the back and there wasn't another shot. But he could have killed him at that point. Now, the other one, he escaped, never gets to trial. They've chased him up into Canada and back down to Springdale in Iowa and he finally ends up dying as a lieutenant in the Union army in a train wreck over in Nebraska. Like I said, can't make this stuff up. So now let's look at Keokuk and it's medical practice because that's really what we want to learn something about. Were they doctors or were they butchers? Everyone thinks they might have been butchers. They were not. They were, this is not a pun, cutting edge medicine of their day. Because there was no germ theory, there were no antibiotics, there were no tetanus boosters. There were no x-rays. They basically had to observe what happened to their patients and try to make an intervention that saved a life. They weren't interested in making a prosthetic hip or a prosthetic knee, they were interested in saving a life. So amputation, was it done too frequently? There's an argument in the literature that it probably wasn't done frequently enough. That if people had allowed the surgeons to carry through, many people including my great grandfather said no, you can't amputate, but if they had amputated, they might have been alive today. No nursing schools. I'm sorry? - [Female 1] Not today. - [Dr. Charles Driscoll] Oh. I don't know where you're at, I'm back here in 1861. My today is, okay. There's no knowledge of public health. They had to figure that out. They had to figure out that you don't put the latrine next to the drinking water. They had to figure out that you don't fight a battle on a field that has had cattle on it because the incidence of tetanus goes way up. So, you know, animal manure is where you can expect tetanus to come from. So they basically cut down forests and had their battle back and forth across that. No medical sub-specialties. A lot of sectarianism. There were hydrotherapists and electrotherapists and herbalists, and you know, good conventional therapies. And so they all got inducted into the Civil War as doctors. They all became. And so there was no standard for medical training back then. You could become a doctor by just attaching yourself to another physician, you became an indentured servant for a couple of years. You did all the messy stuff. You cleaned up the vomit, you changed the dressings, you did all that and then when the doctor decided that it was time for you to be a doctor, he would release you and give you your papers. So that's the way the majority of doctors were trained. And so they all took up some kind of niche in the medical practice. But there were legitimate doctors. Now there's no medical licensure so how do you know? How do you know? They just present a piece of paper. And remember that medical school at this time was two years of lectures, so it was like the theory of medicine. Usually it was the same set of lectures presented every year so you had to sit through it twice and then you had to be precepted for a couple years and then you took your exam. Well, your sitting in the great great grandchild of this building because this is the first medical building west of the Mississippi in Iowa. And it's actually the first one from Iowa on west until you get out to California. So this building was built in Keokuk in 1849 and it had to move to Keokuk because of a problem. Does anybody know what the problem is? Okay, well just ponder that for a minute. Why would a town say you're not our medical school anymore, get out of here, go somewhere else? 1849 to 1858, and this building also served as a pest house, a house of pestilence where all the small pox cases and everything were taken during the Civil War. So it was still in operation. It burned in 1863. But it was the grandest building and it was described in the New York newspapers and everybody bragged about it. Here's a graduate. I love to see faces. I love to put faces on all of this talk. So here's an actual graduate from that medical school and he was in the Union army. You see his got his Doctorem in Arte Medica degree from Universitatas Iowaensis. Latin for doctor of medicine, University of Iowa. And that was February 25th, 1857. He became an assistant surgeon. He joined the Indiana Volunteers and he died of disease during the Civil War. Okay, has anybody figured out why you'd run a medical school out of town? Because you had to obtain dissection material somewhere and people didn't want their bodies donated and so you had to go to the cemetery after midnight and obtain your dissection material. I'd like to just read for you, if I may, a personal account from Dr. Kababs, who's an 1852 graduate of the College of Physicians and Surgeons and he practiced for 50 years in Pella, Iowa. And this is what he said. We had a great deal of difficulty getting dissecting material, arrangements were made to obtain some from St. Louis but either the college authorities there, St. Louis had a medical school. They weren't going to share their resources with us. Or others got wind of it or prevented it, the sexton from filling his contract with Keokuk. But yet, through great trouble and some danger, we secured the very much desired article. My preceptor did not think a man fit for a surgeon unless he had the nerve to obtain his necessary materials. It's a little easier nowadays. In 1858, that school closed and they built a brand new school. And these pictures are all over there on the wall and you can take a closer look at them. But this was the new building. Had a nationally renowned faculty and they really did. They published in all the major journals. They were presidents of the medical societies. They had sub-specialties after the war that they became presidents of, ob-gyn was one of them. So they were nationally known men and women. I'm sorry, they were nationally known men. There were no women on the faculty. But Iowa was one of the first schools to allow qualified women and blacks to enter medical school and enter medical training. And we'll see a couple of those as we go through. It was a school that was far ahead of its time. Microscopy, dissection, and the big thing was, and Dr. Gallon, you'll appreciate this, bedside teaching. That's where the bedside teaching where they went and made rounds at the wards and stood at the bedside and discussed the case. And that's something that started here and wasn't being used in other medical schools. And the faculty, there was a six to one ratio. So there was one faculty for every six students. Some of the medical schools were one to 150. So I think they got much better training with hands-on one-on-one experiences. They also published the first medical journal west of the Mississippi, the Iowa Chirurgical Journal. So that started up in 1853 and it went through the Civil War. And here's just one of the advertisements up here. And here's an actual degree from the medical school. And it gives you sort of the years of study and I won't read that to you but I'll give you a second to see. If you were a medical student back in this day, this is what you'd have to do. And here they are in their microscopy lab. They had, when they started, they had one microscope and that was phenomenal. That'd be like getting the first electron microscope at the University of Iowa. So they had this microscope and then more money and more microscopes and more teaching. So these are the things that they did. And they actually used anesthesia for all of their surgeries right after it was discovered. So from about 1847 on, they were using anesthesia in Iowa in the medical schools. And here's the rundown of all the medical schools. This is the University of Iowa College of Medicine. This was the University of Iowa College of Medicine. This became the University of College of Medicine. These two schools, one of them was the Keokuk College of Medicine and the other was the Iowa Medical College and they were, in their time, the University of Iowa College of Medicine. Didn't move here until 1870. And when it moved here, it was located on the bottom level of Old South Hall, and I've indicated where the capital building was located. So from its earliest days until 1870, it was located in Keokuk. And then, why change? Were they not doing a good job of producing graduates? No, that was not the issue. The issue was the legislature passed a bill that said you can not have separate campuses. You have to have all of your facilities and everything on the same campus, so they moved it. Now we're going to talk about the war in Keokuk. And if I'm correct, it's 6:00 and I have until 6:30, is that right, Donna? Okay. So I'm about there. You all recognize this fella. He was living in Keokuk before the Civil War. His mother lived and died there. His brother, Orion, operated a book store and a publishing store and that's where he learned to publish and he wrote his ever first article in Keokuk, Iowa. Another claim to fame. And that's what he said in his book Life on the Mississippi. Okay, so how did we get embroiled in all this? This is today. Pretty peaceful, pretty calm. But this is the Des Moines river you're looking at and on one side is Missouri and on the other side is Iowa. And this gentleman is Colonel David Moore. Colonel Moore was the commander of the unit that my great grandfather served in. I have to spend a little time talking about him. But this was the only bullets that fell in Iowa. So this is as far as the Civil War got to actually involving bloodshed in Iowa. Okay, I'm going to bore all of you who don't care about battles. So he's the commander, he has 500 Union troops. And the opposite side, the Confederate side, we've got Judge Green who has a militia and he's got 2000 and three canons. Hmm, a little bit of a mismatch here. So what happened? Well, Green was harassing, this is Scotland County and this is, I forgot the name of that county. If anybody knows, help me. But these two Missouri counties, and here's Keokuk right here. There's a rail line that goes here. And here's Croton, which is a ghost town. But Croton was the arsenal. That was the armory where all of the guns and local ammunition were stored. So this train basically just ran back and forth to supply Keokuk and the arsenal. So Colonel Moore, who's in blue here, he hears that Green is harassing citizens, running them out of their homes. So he goes over at Etna, there's a battle, and he repels them. Sometimes brain is better than brawn. And he took off. He harassed them and he took off and he went back up here to Athens, Missouri. So this is the battle of Athens we're talking about. If you've never been there, this was the northern most battle that took place west of the Mississippi. And he digs in and entrenches with his 200 men now. He's lost some of them, not to the battle, but they had to go home. They had to go home to protect their homes. So he's now got 200 men and Green hears that he's up there and chases him up to Athens. So he digs in. This guy is firing his cannons. The cannonballs are going everywhere. Whoops. There's no excuse. This house, you can see that hole right there next to the door, that was the cannonball. It went through the house, across the river, and landed in Iowa. That's as close we came to getting in the war. Okay. And what he didn't count on was that the men in Keokuk came up the train, got across the river, set up across the river so he comes up here to chase Colonel Moore, Colonel Moore's dug in defensively and the sharpshooters are all lined up over here. So about 250 men defeated a force of 2000. And he turned and hightailed it back across the Fox River. So that was the famous battle that really got Keokuk's ire up and they decided by golly, we're not going to put up with this, we're going to form militias. And they appealed to the governor and the governor said well, Keokuk's a good place because we can get our men over to Keokuk by train and then we'll send them down the river, so that's what happened. Here we have Keokuk, right here. And here we have the Mississippi River. And all of the battles that took place here and all of the battles that took place over here, everything west of the Appalachians, that theater, this is US hospital number one for that theater. So they all were brought over here, loaded on steamboat, taken up the river. Why not go somewhere else? Why not go to St. Louis? There's the Jefferson Barracks. Well, the governor was a secessionist and he kept harassing Jefferson Barracks and sending Confederate troops in there and it wasn't safe, they couldn't have men rehabilitating in an area where their lives were still in danger. So Keokuk, because of its shipping industry and the steamboats, it ended up being the place where all the patients were brought. It also ended up being the place where all of the soldiers from Minnesota, Dakotas, Iowa, they all funneled down, they were brought down to Keokuk and they were trained in Keokuk and they did disembark from Keokuk to the battlefields in the south. Okay, this is a picture, a photograph, of the Third Iowa Volunteer and they trained at Camp Ellsworth. Camp Ellsworth was the first military facility in Iowa and it was in Keokuk and they trained up to 1000 men at a time. This was about two miles north of the main part of the city. But there were three other camps, very interesting camps. So this group of men was from the Third Iowa and this is what Lieutenant Colonel John Scott said this army looked quite different than our own men, recorded a soldier from New York. They all wore large hats instead of caps, were carelessly dressed, both officers and men marched in a very irregular way, seeming not to care to keep closed up and in regular order. They were a large fine type of men, all westerners. It was easy to see that any serious time they would close up and be there. As they passed by, we viewed their line and a good deal of friendly chafing was done. They expressed their opinion that we were tin soldiers and said oh look at those little caps. Where are your paper collars? Oh how clean you do look. Do you have soap? This was Camp Lincoln. Camp Lincoln was, are there any Keokukians in here? There's one, okay. 18th and Orleans Street, that's where this one was. Now, the interesting camp was located, I have to back up one. That would have been Camp Halleck, camp over there. That Camp was located in downtown Keokuk with a brewery on one side and two saloons on the other. Does anybody see a problem with that? Double guard all around the camp to keep the boys under control and that didn't really work either. The very first place that patients were deposited, and this was from the battle of Athens, was the College of Medicine. They had 250 beds in their infirmary so they started taking patients to there first. This picture right here came up doing some research here in Iowa City and I went to the Historical Society and they let us back in the back bowels of the Historical Society and said here, paw around over here and see what you can find. And I found this picture and on the back of it, it said Keokuk Medical School. And it said photo by, who was it? Photo by, ah, I can't remember. Dr. So-and-so. And so I took it out and I said can I get a copy of this, said we don't know, we've never seen that photo before. So I had to write to Des Moines and send the photo to them and they said well, we don't know about that photo. It's not in our files, it's not in the archives. So I discovered this photo for them. And they allowed me to have a copy of the photo. Now this is an actual physical exam but not a physical exam during the first two years of the war. This was probably at least 18, the latter part of 1862, after they found out that examining somebody fully clothed allowed people with gigantic hernias, women who wanted to pose as men, people who were missing some body parts, people who had large livers and hearts that were irregular. You know, if you could sign the paper and you were over 18, and let me tell you how that happens. You take a piece of paper, you write the number 18, you put it in your shoe, and you go up to the recruiter and say I want to join and he says are you over 18. And he didn't lie, he said yes, I'm over 18. Okay, you're in. But they did examine for one thing. They examine to make sure you had all your fingers. And does anybody know the duration of 4F? Any military people in here? You're right, absolutely. If you didn't have your four front teeth, you're unfit for service because you had to bite the paper off the cartridge, dump the powder in your musket and ram it home. So if you were 4F, now that has stuck all the way to today, so any kind of medical disability is 4F. How 'about government red tape? It came out of the Civil War. That is a medical record and if you wanted to get somebody's medical records, they were all bound up in red tape and you had to take the tape off and get it out, so. We owe a lot of those inventions to the Civil War. So how did it become the Medical Center of the Department of the Northwest? See this article down here and this is what it says. It says the fire bell will be rung on the arrival of the steamer with the wounded and persons prepared to render assistance will attend the signal. That was April 19th, 1862 and Keokuk had already been in the business of taking care of the war since 1861 because they didn't wait for the order or for the fire bell to ring. They had formed the Ladies Aid Society. All of these troops that were going out were given blankets, they were given materials to take care of them on the battlefield and they went out and rode the battlefields and found out what they needed, what kinds of food they could supply. And so they were heavily invested in the war even before there was any kind of official order for them to do it. Here's some more from the Gate City. I won't read it but you can kind of get a flavor for what was going on here. So the big thing that happened in early April was the Battle of Shiloh and Fort Donaldson. And all of those battles, all of the wounded were transferred eventually up river. So that's where the big influx of patients started and this was in 1862 to '63 was the high water mark of treatment there and then in '64, '65, things began to wane. There's the Jeannie Deans, that's what she looked like. Side wheeler. Remember that there were 200 and some men on it. I don't think you could walk on the deck without stepping on somebody. Now here is the first, one thing you have to understand is that during the Civil War, if you were a hospital, you weren't a single building. It's just like today's campus. We're a university hospital but we're not on, we're spread out. So there were five or six buildings that took part as the hospital. In Lynchburg where I live now, it was the second largest hospital in the Confederacy. There were 32 different warehouses, factory buildings, homes that were designated hospitals and incorporated in that medical care system. So here's where the first patients landed. And I thought you might be interested in the internal diagram. Those of you who are medically trained, here is the amphitheater for surgical demonstrations and lectures. So they just basically took over all of that space and made cots and beds in there. The second part of the hospital was the Estes House. And the Estes unit was an old hotel. It was built in 1857 and never completed because of economic hard times in 1858. And so the finishing of the building didn't occur until the Civil War and the town's citizens got this building ready to be a hospital by finishing the fourth floor of the hospital. They completely plastered the walls and put stoves in and everything. It's a very unique building. It was a quote marvel of its time because it was built as a hollow square. If you could look at it in an aerial view, you'd see that there's a big tube looking structure that runs down in that courtyard in the hollow square. And so there's a room on the outside and room on the inside and on every floor, there's a little catwalk that goes to that tube, which is the privy. So they had a modern privy system set up in this building and they all went in to the center and rain water rushed it out and if they didn't have the rain flushing it out then they had to haul it up to the top of the privy and dump it from the river. That was the second building that was put into use. This is the one that saw the most traffic. They had more patients go through Estes Hospital than any other unit. Here's another unit. Look how elegant these buildings were. They just basically said oh, you have a hotel. Well, it's a hospital now. See you later. And they kicked everybody out, took over the hotel. This was the Leighton House. And this was the Simpson House. And that's Rice Hall, which was later the Masonic Hall. They took that over. And had 150 beds in there. A little bit crowded. Now this will strain your eyes a bit, but you really need to see this. This is the campus and these buildings that I just showed you are starred here. So this is the medical campus. Right in here where that blue star is, that's where the camp that's located between the tavern and the brewery is. So quite interesting things happened. And here's just a close up view of it. This was a drawing that was made, I think it was made in 1858, but they were able to label it. Okay, we're going to take a look here at a few people, a few faces, and we're not going to spend a lot of time with them but I need you to know that this guy, John or Joseph, he goes by either, Hughes. He was the first legitimate dean of the medical school. There was another dean by the name of Dean Sanford and he got everybody so ticked off that they ran him out of the college and he started his own medical school somewhere else. But Dr. Hughes took over and he was really a personable man, he was a manager, he understood medicine, he was an authority in ear, nose, and throat surgery. And he was the Iowa Surgeon General during the Civil War. He was the first director of this hospital system until the military took it over. And he was quite a figure. His son, must have studied under Dr. Sanford because after Dr. Hughes died and his son took over, everything went to hell in a hand basket and the school folded, so. I think that this is the guy who is our medical giant that those of us who were trained here at the University of Iowa, we stood on this guy's shoulders. Dr. Morse K Taylor, he was a surgeon. He was with the regular army. He had fought in the Mexican War and now he's being pushed to be the commander of this military hospital system. He arrives on the scene. You can see where that could upset Dr. Hughes. He's a very gracious man. He said oh welcome, come, tell me what you want us to do. So they worked as partners. And that was hard because Dr. Morse Taylor was known for his curmudgeonly behavior. Not many people got along with him, but Dr. Hughes did and they were great colleagues. And they did well. He also became a teacher. He taught physiology and pathology at Keokuk College of Physicians and Surgeons. Now he had the daily responsibility of sending a report to his superior officers. Okay, you think you got paperwork problems today? He had to report on how all of these activities proceeded during the day. He had to make out prescriptions for all medications for all patients under his care. This could have been as many as 3000 patients at one time. That was the peak. And he had to have diet assignments to every patient. Well, that wasn't too hard. There was full diet, for those who were well. It's basically convalescing. There was half diet for those people who looked like they were going to recover. And there was low diet for those people where they had to be fed, basically. But he had to report on all this stuff. This is a somewhat of a local hero also. He became head of the Davenport Relief Committee and he was a friend of Annie Wittenmyer and we'll tell you a little bit about her in just a bit. He went into the battlefields and he studied what was going on out on the battlefield and he came back and contributed a lot of information that helped organize the delivery of supplies and medicines and so forth. He was the assistant regimental surgeon in the 13th Iowa and they drafted him to come back to Keokuk. So at the peak time, October '62 to June '63, he was serving as one of the physicians. There's a whole book written about him and his, I've met his grandson. His grandson is a lawyer in Minnesota. This is one of the few blacks that went through but he was born a free black in 18, can't see that, 33. He attended Keokuk Medical College. He had gone to school in two other places and they took his money and allowed him to attend lectures and then they told him he was not qualified to graduate because he was black. So he found his way to Keokuk. He took the one year course. They said you don't need to take another one, you're qualified, he became an assistant surgeon in the US Army. He took care of the contraband. The contraband were the blacks who followed the troops. So if there was a big battle and there were blacks that were emancipated but because of the battle then they were afraid to stay where they were and they followed the troops and those were contraband and he took care of the contraband hospital. Unfortunately, he became demented and died in Washington DC. This guy, I got this picture from a fellow in Keokuk who happened to have his calling card. And this is a picture of this doctor who left his calling card. And he was at the university. And interesting afterlife. Some of these doctors, as soon as they have their experience with the Civil War, they said that's it. I'm not going to do this anymore. And they quit. And he quit and he went, after the war, into Arkansas. He became fascinated with cotton farming and he started the Thomas-Fordyce Manufacturing plant which anybody who's a farmer will know Thomas Fordyce's name. And he invented the cotton processing materials and they said that he was a leading genius after Eli Whitney and the cotton mill industry. Another interesting connection to our forebearers. And here's a woman who graduated. Her story goes like this. She followed her husband from Northern Iowa down to Keokuk, he enlisted. They found, during his physical exam, that he had a heart defect. They were now listening to hearts and they said he could not go into battle. But you could become a hospital nurse. Most of the nurses back then were military men. And so he was then stationed at Keokuk in the hospital and his wife, who had a wanderlust, said well I can go. I'll go. And so she went to the battlefield and served as a nurse or a matron to all the battles in Missouri and Arkansas. And she came back, she was assigned as a matron of the Simpson House. She was Dr. Hughes' personal nurse and he let her attend lectures so that by 1870, she graduated and got her medical degree. She sat for the medical exam and passed it and she became an herbalist physician. Okay, we're not going to spend a lot of time here 'cause I'm getting short on time and I want to try to end as promised. So we've got some faces. I'm just going to flash some faces by you. These are real people. These are what they looked like and these are the experiences that they had, so read fast. And these people, this was General Samuel Curtis. He was a hero during the war by his leadership and he won the Battle of Pea Ridge in Arkansas and the Battle of Westport in Kansas City and he became a commander of the army of the southwest. After the war, he was then responsible for Indian territory. This is Samuel Freeman Miller who practiced law in Iowa. He was a good friend of President Lincoln. He was strongly abolitionist. Lincoln recognized his expertise. Now this guy started out as a physician in Kentucky and he became discouraged because he said all we do is go around and pass poisons out to people and let them heal on their own. Sounds a little familiar. But he then gave up medicine, became a lawyer, and lived in Keokuk and Abraham Lincoln appointed him to the United States Supreme Court. And he was an Associate Justice in the Court until he died in 1890. Everybody wanted to make a buck. We've already talked about this guy. But what I want you to do is I want you to read this story 'cause you'll die laughing, it's hilarious. He spent two weeks as a Confederate and he said I almost had down, he said I had 50% of it down. I knew as much about retreating as anybody else knew. Tom Clagett, he was the newspaper editor and the governor of Indiana spoke at the Atheneum, which is a big theater and he gave this talk pro-Union. Clagett was known as a copperhead. Copperheads were people who were dangerous. They could spread sedition and so he always had the secessionist viewpoint whereas the Daily Gate City had the Union viewpoint. And one day this governor gave a talk there and then Clagett, in his newspaper the next day, made disparaging remarks about the Union and about the governor and so 150 of the wounded men from Estes House got up, found their pistols, went down there, tore up his presses. The Union army tried to stop it and the provost marshal had 12 men and there were 150 men and they were all armed and he said well, I can see that you're done with what you're going to do so if everybody will disperse, but he let them finish tearing up and they tore up the presses and took them down and dumped them in the Mississippi River. Now this guy is an infamous person. He was a lawyer in Keokuk. The war broke out and he just suddenly disappeared. He disappeared so quickly that he left his Bible and 150 books in his office. And he went somewhere. Well, he was the son of the Winder that was head of all of the prisons in Richmond and the prisons were getting overpopulated and they said you got to build us a new prison. So he went south and he went down to around Americus, Georgia and there was a railhead down there. There were 12 people living there and the name of the railhead was Andersonville. And he became the architect and designer of Andersonville Prison. So after the war, they hung the supervisor of the prison. They would have hung his, this guy's father, but he died, conveniently, of a heart attack before he was able to finish trial. And they imprisoned him and as he had testimony that there were several Union officers that said this is the only guy who treated us with any respect. And so he was then freed from prison. But Keokuk wouldn't let go. They're going to try him again. So the US Federal Court tried him but he was no where to be found. They couldn't get him to come back and stand trial so they took his Bible and put it in a chair and that was the defendant. So the defendant was One Holy Bible and the Bible was convicted of treason and then they allowed all of his library to be sold. Annie Wittenmyer sound familiar? You've probably heard that name. People say that she was the Clara Martin of the West. She did so much for the Union cause. Just in a brief summary of what she did, she was a matron at the hospital. She felt that the soldiers were coming in and that they were in such poor condition that something had to be done out in the field. She went out in the field. She went from battlefield to battlefield. Remember the Shiloh battle. She was actually on the Shiloh battlefield, bullets, cannonballs all around her and she had a bucket of soup and she was going from wounded to wounded offering them water and soup. And then she stared collecting materials and she shipped them down on the boats. She even had a hospital ship designed. It was the DA January and they ran that ship up and down the Mississippi. She did so much and Lincoln said do not obstruct her because women were not appreciated during the Civil War. And if she'd walk on a base, a general would say get her off, get her off. Lincoln said she can have anything she wants, any materials, and go anywhere she wants. And he gave her a pass to the railroads that was a lifetime pass. And the other good thing that she did was that she started the Women's Christian Temperance Unit and she was the president, first president of that. She started diet kitchens. She found her brother dying in a hospital being fed greasy bacon, coffee, and hardtack. I don't know if any of you have seen hardtack, but it's actually as hard as Dick's cane. You break a tooth on it. So they had to soak it in grease in order to soften it up and that's what he was being fed and he was dying. And she fed him vegetables and sauerkraut and citrus. Vitamin C. We know now vitamin C is instrumental in healing. He recovered. And she did this. She started the very first orphans home and it was started in Farmington, Iowa. She started a second one in Cedar Falls and then a third one in Davenport. And there were over 3000 Civil War orphans cared for under her care. One of them was Billy Sunday, who's father died and mother couldn't take care of him and she put him in the orphanage and Billy Sunday was a famous baseball player and then he became the evangelist that we know. And that's her. And she also won pensions for the female matrons and nurses during the Civil War. Now I've got about five minutes left and I realize I'm three minutes over so if you will indulge me for five more minutes, I promise you I'll get done. Keokuk's National Cemetery, one of 12 that were commissioned by President Lincoln. And in 1912, they put this monument up, but there are about 2000 burials there. And they also moved a lot of soldiers to there. For example, Fort Des Moines where the military burials around Fort Des Moines were all moved to the Keokuk National Cemetery. There was a fort in North Dakota, they were all moved. So they're there. There are about 11 Confederates that are also there who died in the hospital as prisoners of war. And we come to the end, the final tribute. I don't have any way of making you cry except to just tell you that this is tear jerker. They had the GAR, the Grand Army of the Republic and every year after the Civil War, they wanted to get back with their comrades, they wanted to share stories. They still do that today. You get two Vietnam vets together and it's like okay, I'm out of here. But they were always meeting and they met one year in Keokuk in 1926. And they paraded, they always had a big parade and they would push the older ones or the wounded ones in wheelchairs and they would carry some and they would have wagons and they would march and they all came down and somebody in the very first rank recognized the Estes House as the hospital that he had spent a long time recuperating in. And they called the parade halt, they all did a right face and they all saluted the hospital. And that happened every company after that that stopped and saluted the old hospital. And that was its swan song. It was torn down. This is the cornerstone, it's in the National Cemetery. Notice that inside the cornerstone, there's this niche, what does that look like? Looks like a bottle 'cause it was a quart of the finest wine they could find that was in the cornerstone. And as they tore down the building, somebody raided the cornerstone and got the bottle out. Nobody took responsibility. Well, thank you for allowing me just a few extra minutes. I wanted you to hear the story. Those of us who are physicians and we went to the University of Iowa, this is our history. This is the legacy that was left to us to continue. Those of us who are nurses, those of us who are social workers, this is all got started during the Civil War and if you know a little bit about medicine, little bit about history, I think that, it's an appreciation that you'll get for what sacrifice these people made. If you have any questions, I'll be glad to take them. Some of the slides that I had of the buildings, if you want to take a closer look at them, are over there on the ledge.