Although Rutkow's depiction of Civil War medicine does not focus on nurses, he does make some valuable points about Civil War nurses. On page 168 he reminds the reader that no programs in nursing education existed in the country at the time, and although some Catholic orders did train nuns as nurses, the training was not of the "Nightingale School" ie cleanliness, diet, drainage, light, quite and warmth and adequate ventilation; but rather caring for patient's emotional needs, providing clean clothing and linen and regulating what the patient could eat. This is the first book I've read that discusses in detail the type of training received by nursing sisters. It also discusses the Catholic church's initial reaction to the nun's nursing for the Army which was unfavorable. The book also contains an excellent discussion of why Victorians found the idea of women nurses so unpleasant, and discusses the contributions of such nurses as Hannah Ropes and Lousia May Alcott. The author explains more about the background and character of Hannah Ropes than one can get from her diary (which we have) and also does a great job explaining the motivations of Dorothea Dix. The story of Dix's attempts to hire only middle-aged, plain women is well known, what is not known was why. Initially Army doctors objected strenuously to almost all the women nurses, criticizing some for laziness and other for working too hard and insisting on cleanliness. The real problem of course was that few doctors wanted the women there at all! The only women, Dix believed, who could get along with doctors were "women of bad character" because these became the doctor's mistresses! Thus she began to insist on plain women...

Did I miss something, or did the end of the Civil War not mean that the country was reunited? For a book purporting to be an account of American medicine during the Civil War, it is unfortunately only a documentation of Union medical development during that era. Exactly ONE Confederate case--that of Stonewall Jackson's agonizing death after what should have been a survivable wound--is mentioned, and that only fleetingly. The author clearly spent much time at the Army Medical Museum*--I must get up there some day and visit Dan Sickles's pickled leg--would it have killed him to have gone one hundred miles down the road to visit the medical museum on the site of Richmond's Chimborazo hospital? I was interested to discover if Chimborazo, the largest Confederate hospital, really did serve as the model for pavilion hospitals on both sides of the conflict, and I was hoping to find out how the Confederate medical staff coped with medical shortages due to the blockade, or how they dealt with the continual insistence from fundraisers that money and material donated go only to the wounded from an earmarked state. And didn't the Confederacy start the first proto-MASH units, too? I would have liked to have read about that, as well. Alas, my curiosity remained unsatisfied. For a book entitled "Blue" AND "Gray", this lapse was inexcusable.

Harrumph. Well, as a history of Union medical practices, this book isn't bad. Rutkow writes with some verve; his thumbnail sketches on the querulous and paranoid Stanton, the imperious Hammond, and the energetic man-of-all talents Olmstead are especially good. Even more gripping are his accounts of the slow deaths of several soldiers whose excised wounds ended up in the specimen jars at Walter Reed; these are particularly difficult for a modern reader to follow, as the great advances in bacteriology came just a few years too late for these hapless men. And I enjoyed the accounts of the backstabbing amongst the paper-shufflers. There's a bit too much of that, however, as the author circles back (and circles back) to his obvious greatest interest, the establishment of the Union Ambulance Corps, and the turf struggles between the Quartermaster Department (to whom it originally belonged, when the department belatedly decided the Union Army needed one) and the Surgeon General and Dr. Letterman, who were of the opinion that said department was too lackadaisical by half. Indeed, the author would have been better to have organized his book in strict chronological order, or to have picked an area of medicine (nursing, surgery, etc.) for each chapter, as that would have cut down on much redundancy. It is still a fascinating look at an era when man's technological ability to wield destruction outstripped his capability to cure it.

* While writing this review, I spoke to someone whose husband works at the now renamed National Museum of Health and Medicine; she believes the museum, relocated in Silver Spring, is inferior to the old one near Walter Reed as the display area is somewhat diminished, and many of the preserved medical specimens have been tucked away. The moral: always visit when you can. ( )