Nursing in the military was traditionally done by male soldiers. Shortly after the Revolutionary War began in 1775, a request was made by General Horatio Gates for a woman to care for his wounded soldiers. General George Washington asked Congress to provide nurses to attend the sick and matrons to supervise the nurses.
In July, 1775, a plan was created that provided one nurse for every 10 patients and one matron for every 100 wounded or sick soldiers. This was the first instance of some sort of organized nursing system in the military involving the word “matron.” The Congress allowed a salary of $2 per month for these nurses; matrons were allotted $4 per month. To provide a means of caring for sick soldiers, the Congress also authorized the formation of hospitals.
The army preferred female nurses, not only because women were better at caring for the sick, but also because every woman nursing meant that one more man was freed to fight on the battlefield. But women were not always eager to volunteer for nursing duty. Washington blamed the low compensation rate for the shortage of nurses. In 1776, Congress increased nurses’ pay to $4 a month, and a year later to $8 a month, while surgeons and apothecaries were paid $40 per month.
During the War of 1812 (1812-1815), women were employed as military nurses, just as they had been during the American Revolution. Soldiers’ wives and townswomen near the battlefields were frequently hired by military hospitals to serve as nurses. Commodore Stephen Decatur’s ship’s log reveals the names Mary Allen and Mary Marshall, who worked as nurses on board Decatur’s ship, United States, on May 10, 1813. They were still on board when the ship sailed on May 24, 1813.
Mary Ann Cole served the American Army as a hospital matron during the siege of Fort Erie, Ontario from July to October of 1814. During her service 1,800 Americans were killed or wounded. As the Americans inside the fort were mercilessly bombarded by the British , Mary Ann performed her matron duties caring for those sick in the hospital, preparing their meals, dispensing medications, and keeping the medical records for the regimental surgeon.
The women who were allowed to remain in the military encampments during the War of 1812 were chosen by a lottery system. Only six wives were allowed in camp for every one hundred soldiers. The women were then employed as nurses, seamstresses and maids. If a woman’s husband died she had three to six months to grieve, and then she had to find a new husband or was told leave the camp.
The outbreak of the Civil War created an immediate need for capable nurses to care for the enormous number of sick and wounded. About 20,000 women and men served as nurses in both the North and the South. The extraordinary service rendered by Civil War nurses provided the rationale for future “experiments” in setting up training programs for nursing women.
The position of matron was more important and prestigious in the Confederacy than in the Union. It was legally established by legislation passed on November 25, 1862. Each hospital was to have two chief matrons to supervise the entire “domestic economy” of the hospital. They were to be paid no more than $40 per month and provided with a place to lodge and rations. There were also two Assistant Matrons in charge of the laundry and patients’ clothing at a salary of $35 per month. Finally, there two ward Matrons for each ward of 100 patients, who made sure that each patient received suitable bedding, food and medicine, who were paid $30 per month. Nurses (male or female), cooks, and ward masters were paid only $25 per month.
Hospital personnel lists in Richmond Hospitals indicate that there were seven matrons hired prior to the passage of the bill by the Confederate Congress in 1862. There are also morning reports from Williamsburg in 1861 showing the position of an appointed matron in a hospital at that location. Perhaps the Confederate law only formalized the position for its pay and for its status in the Confederate medical system.
Why did Confederate women take on this role in hospitals? There are three reasons that have been theorized. First, some women did this to escape households and gain independence from their family. Second, patriotism and a desire to contribute to their new country’s cause led others to this position. Finally, some sought employment because they needed the income. Leading their families while their men were fighting in the field, some needed the income to cover food and lodging, especially if they were a refugee in a city of the South, like Richmond. Others were widows with no other sources of income during the war.
The “legal” position of matron evidently was more important and prestigious for the Confederates. Although some people objected to matrons, as they did to the presence of women in hospitals in any capacity, patients generally seem to have benefitted from matrons’ care. In practice, the number of matrons depended upon the size of the hospital and the willingness of the doctor in charge to appoint them. Their duties also varied, involving many kinds of hands-on hospital work in addition to their supervisory roles. Matrons often cooked for patients on special diets, making toddies or eggnog, in order to appeal to delicate appetites. Matrons sometimes fed the patients as well.
Southern women also took on even more public responsibilities working in military hospitals and worked as both nurses and matrons, who, in addition to regular nursing duties, essentially took responsibility for the day-to-day operations of the hospitals. Matrons and nurses filled in the gaps, attending to tasks that male doctors could not afford the time to do. In addition to seeing to the physical care of the wounded, they also assisted with emotional support so necessary for promoting wellness with patients. These duties really reflected the Southern perception that women are naturally more caring than men. This new acknowledgment that women’s skills were valuable beyond the Southern home was just as important in women’s progression in the nursing field after the war.
Southern Matrons provided that critical Victorian “good death” as they sat with the dying and wrote to patients’ families to inform them of the location their deceased loved ones so they could be “brought home.” These women worked long hours, in some cases from 4:00 a.m. until midnight. Many Matrons became ill from exhaustion and disease, and had to leave the hospital either short term or permanently to recuperate their personal health.
Among the most famous of the Confederate matrons were Phoebe Pember, at Chimborazo Hospital No. 2 in Richmond, and Ella Newsom, Fannie Beers, and Kate Cumming, who worked at various locations with the Army of Tennessee. An estimated 15,000 soldiers were under Pember’s direct supervision in the 150 wards she managed. Pember, Beers, and Cumming later wrote books about their experiences which are available on Google Books.
The Matron washed, dressed, and fed patients, wrote letters, read to patients, helped patients to endure boring convalescence and did other duties as required, including cooking and laundry. They were responsible for all weekly records of hospital property under a Matron’s control. What little data that exists indicates that many of the hospitals also had their following titled matrons. Jackson Hospital in Richmond had a Chief Matron of the Culinary Department and a Chief Matron of the Linen Department. The Chief Matron of the Linen Dept. was also in charge of the bath house at the hospital. She made sure that the surgeon’s orders for either a hot or cold bath were carried out. She also had to make sure that the bath facility was kept clean. There were also Assistant Matrons to a Chief Matron. Wards had Matrons that most often gave direct patient care. Matrons were also heads of Division Hospitals at Chimborazo Hospital in Richmond, VA.
Dr. A.G. Lane at Winder Hospital (Richmond, VA) established a policy allowing only female personnel, referred to as matrons, to dispense whiskey. His reason was simple: “I know well that it is the custom with many medical officers . . . when they draw their monthly supplies of liquor, to call their regimental officers to drink it up.” Violation of Dr. Lane’s regulation meant the guilty officer’s immediate transfer to the field. This rule apparently kept the liquor supply firmly in the hands of the matrons.
Sick and wounded Union prisoners were given the same treatment and care as Confederate troops, by government order. Mrs. Annie E. Johns, matron of the hospital in Danville, Virginia, is mentioned in this regard. When in the Confederate retreat her hospital was moved further South, Mrs. Johns elected to remain behind with a group of seriously ill Union prisoners, until their care could be assumed by the Union medical officers.
Mary Boykin Chestnut was a regular visitor in Richmond hospitals. In her book Diary from Dixie, she describes one day’s activities: “Oh! Such a day! Since I wrote this morning I have been with Mrs. Randolph to all the hospitals. I can never again shut out of view the sights I saw there of human misery. … There is enough to think about now, God knows … with the long rows of ill men on cots, ill with typhoid fever, of every human ailment; on dinner tables for eating and drinking, wounds being dressed; all the horrors to be taken in at one glance.”
Phoebe Yates Pember, a Confederate Division Hospital Matron at Chimborazo in Richmond, once wrote of a patient who was brought in after his ankle had been crushed by a train. She described how after his ankle was set, the man was still in agonizing pain, and upon further investigation, Pember discovered that the patient’s bandaged leg was perfectly healthy and that the other leg was “swollen, inflamed and purple.” The surgeon was so intoxicated that he had set the wrong ankle. Soon after, fever set in, and the patient died.
In March of 1908, the Virginia legislature finally passed “an act pensioning matrons.” This bill acknowledged the service of Virginia women who had served as matrons in a Confederate Hospital for at least a year. They were then qualified to receive a pension of $40.00 per year from the State of Virginia. They were not allowed to also collect from the State of Virginia a widow’s pension from a Confederate soldier at the same time. There were actually 17 women who received a pension under this legislation.
President Jefferson Davis stated it best, “The only department that was not demoralized was the Hospital Department that was well in hand and doing efficient service until the end of the war.”
Until next time.
Your Obedient Servant.
Maj. T.T. Steinbach, Confederate Surgeon