Major De Sessa

Major Paul De Sessa, Cmdg. 1629 Banbury Court Fayetteville, NC 28304 (910)-485-8862 pdesessa@nc.rr.com

Brig Gen Jeff Stepp

The Carolina Legion Hospital is a component of the Carolina Legion reenacting organization commanded by Brig Gen Jeff Stepp. The Carolina Legion website can be found at: http://www.carolinalegion.org

Medical staff relaxing between battles in front of the hospital tent

Treating wounded at the original Oakgrove Planation used as a hospital by the Confederacy during the Battle of Averasboro

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Click on images for hospital duties and biographical data

Sgt. Matt DeSessa Hospital Steward	Cpl. Paul Peeples Ambulance Corps	Major Chuck Hodges Regimental Surgeon
Major Paul De Sessa Brigade Surgeon	Pvt. Paul Sechrest  Ambulance Corps	Pvt. Brian Fassnacht Ambulance Corps

The Carolina Legion Brigade Field Hospital is an authentic recreation of the medical facilities made available by the CSA Medical Department to the infantry regiments in the Confederate Army.

The typical field hospital comprised one or more tents (14'x14' and 11' high) for use as a hospital and dispensary; and a large tent fly for use as an operating theater. The "hospital" compound also included living tents for the medical officers, Hospital Steward, cooks and ambulance corps troops.

A large number of wagons and horses provided transportation for the hospital and its personnel. Due to the logistic problems associated with moving such a large endeavor by wagon, the field hospital often was not immediately available during and after a battle and surgeons had to rely on what they and their stewards carried on their backs.

A regimental surgeon with the rank of major or captain commanded the hospital. He was accompanied by two assistant surgeons (captains and/or lieutenants) and a hospital steward. The steward was responsible for supervising the cooks, washer women, nurses and ambulance corps personnel. He also maintained all stocks, administered the pharmacy, accomplished all relocations and assisted during anesthesia and surgery.

A field hospital provided sick call for regimental troops in garrison and on the march. Medical cases provided the overwhelming majority of patients at a regimental hospital. Surgical cases occurred mostly during and after battles. Three times more soldiers died of diarrhea and dysentery than from battle wounds! Camp fevers were caused by mixing rural soldiers, often without exposure to childhood diseases, with urban soldiers who were carriers of communicable diseases. The resulting "childhood diseases" were fatal to between 10 and 20 percent of those affected. Only small pox had an effective vaccine, and this was often done in an incompetent manner.

Hospital staff also assisted the Regimental Commander in promoting policies that ensured good camp sanitation and troop health. Water contamination from latrines known as "sinks" was almost universal, and seldom suspected unless the water was visibly turbid. This resulted in high rates of fecal dysentery. Infections and dysentery were attributed to inhaling the vapors of decaying organic matter, called "miasms". The prevalence of the theory of miasmic vapors explains the CW preoccupation with fresh air and pavilion style hospitals. Surgeons preferred to operate "under canvas" because of the fresh air inherent therein.

Malaria, (Latin for "bad air") was understood to occur nears swamps. When troops were removed from the swamps, rates of malaria decreased. The infection was believed caused by miasmic vapors from decaying organic matter in the swamps. The vector of mosquito transmission was unknown. "Malaria is caused by a parasite that is transmitted from one human to another by the bite of infected Anopheles mosquitoes. In humans, the parasites (called sporozoites) migrate to the liver where they mature and release another form, the merozoites. These enter the bloodstream and infect the red blood cells." - A.D.A.M.

During battle, the regimental hospital sent an assistant surgeon and the ambulance corps forward to evacuate and treat battlefield injuries. The regimental hospital itself would be collocated with other regiment hospitals to form a brigade or division level surgical area to treat the most seriously injured.

Field hospitals performed a myriad of surgical procedures under general anesthesia including bullet extractions, amputations of arms and legs, reducing skull fractures (including rudimentary brain surgery), setting and splinting of broken bones, maxilofacial surgery, plastic surgery, an occasional urological procedure, an occasional abdominal debridement and a very rare thoracic debridement.

Although antiseptic techniques were yet developed, and surgeons often inadvertently cross contaminated their patients, the overall mortality rate was less than 30%. While this figure is very high by today's standards, there is no doubt that they saved many more patients than they killed, a miraculous feat given the primitive state of medical technology of their day.