Born in Canonsburg, Pennsylvania, Jonathan Letterman followed his father’s profession and became a doctor. During the American Civil War, he instituted several crucial medical procedures to efficiently remove battlefield casualties, immediately assess their condition and provide short- and long-term care, saving thousands of lives in the process. After the war, Letterman moved to San Francisco, California, where he practiced medicine and served as coroner. He died on March 15, 1872.
Early Life and Military Service
Jonathan Letterman was born in Canonsburg, Pennsylvania, on December 11, 1824. The son of a surgeon, Letterman followed in his father’s footsteps. He graduated from Jefferson Medical College in 1849, assuming the rank of assistant surgeon in the Army Medical Department that same year. From 1849 to 1861, he served in several military campaigns against Native American tribes in Florida, Minnesota, New Mexico and California.
Field Doctor in the Civil War
At the outbreak of the Civil War, Jonathan Letterman was assigned to the Army of the Potomac and was soon named medical director of the entire army, rising to the rank of major. Upon his first assignment, Letterman recognized that the typical field soldier was suffering from a number of health conditions, scurvy being one of them. He successfully addressed this problem by introducing fresh vegetables into their diet. But addressing the problems of battlefield casualties wasn’t going to be so easy.
During Civil War battles, Letterman and his fellow doctors had to deal with casualty levels far greater than expected. As an example, the Second Battle of Bull Run (Second Manassas, August 28–30, 1862) produced nearly as many U.S. casualties as the entire Revolutionary War. This was due, in part, to the combination of improved weaponry and outdated battle tactics. Another problem was the appalling inefficiency in dealing with casualties. Wounded men were left to fend for themselves unless carried off by a fellow soldier. Oftentimes, they would lie for days on the battlefield to suffer from exposure and thirst. It took more than a week to remove the wounded from the Second Bull Run battlefield.
Major Improvements in Medical Procedures
Jonathan Letterman made several changes to reduce the number of deaths after a battle. First, he established an ambulance corps with trained stretcher bearers to pick up the wounded and bring them to hospital clinics. He also instituted a triage system with prioritized treatment based on the degree of a soldier’s injury and likelihood of survival. Letterman developed a three-stage process for treating soldiers after evacuation with a field-dressing station next to the battlefield to quickly dress wounds and stop bleeding; a field hospital close by, usually in homes or barns, where emergency surgery could be performed; and a large hospital located away from the battlefield that would provide long-term treatment.
Proof of the effectiveness of these methods was made evident just two weeks after their implementation. The Battle of Antietam (Sharpsburg, September 17, 1862) is considered the bloodiest single-day battle in American history. There were more than 23,000 casualties, 12,000 of them Union soldiers. Under Letterman’s command, medical personnel were able to remove all wounded Union troops from the field within 24 hours, probably saving thousands of lives.
During the remainder of the war, Jonathan Letterman served for a brief period as Inspector of Hospitals for the U.S. Army and then resigned in December 1864. He moved to San Francisco, where he continued to practice medicine and was elected coroner from 1867 to 1872. Upon the death of his wife, Letterman became severely depressed and died of intestinal disease on May 15, 1872, at age 47. He was buried at Arlington National Cemetery. In 1911, the Army hospital at the Presidio in San Francisco was named in his honor.
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