Health and Healing in North Carolina - An Interactive Timeline

The Civil War

1861 - Institutional Event

Like many other states, North Carolina had very few hospitals at the outbreak of the Civil War. Unprecedented numbers of sick and wounded soldiers created a medical crisis. The state quickly established large military hospitals in Charlotte, Fayetteville, Goldsboro, Raleigh, Salisbury, Wake Forest, Wilmington and Wilson. Smaller, temporary hospitals sprang up along railroad lines. Hotels, churches and schools also served as makeshift hospitals. And some military camps established their own for soldiers who fell ill during training.

Dr. Edmund Burke Haywood, a Confederate Army major, established the state’s first Confederate military hospital in 1861. Because of its location, it was called the State Fair Grounds Hospital. In 1864 Haywood took over the administration of the new Pettigrew Hospital and the Peace Institute (College) Hospital as well. In spite of chronic shortages of medicines, food and staff, Haywood became known for his excellent management, medical skills and compassion.

However heroic the efforts of doctors and staff, conditions in Civil War hospitals were grim and overcrowded, particularly after battles. Diseases spread rapidly, even though soldiers with contagious illnesses were separated from those who were wounded. Bug-infested bedding, an inadequate diet, depression and boredom made most soldiers eager to leave the hospitals as soon as possible.


A recreation of a typical Civil War hospital. Beds were often dirty and bug-infested.


Dr. Edmund Burke Haywood (1825-1894) established the first Confederate hospitals in North Carolina.

A Crisis in Medical Supplies

When the Civil War began, the Federal government declared medical supplies contraband, or illegal for sale to the Confederacy. The Union set up a naval blockade to prevent vessels from entering and leaving Southern ports. This forced North Carolina to rely on privately owned blockade runners and state ships to import surgical tools and medicines from Europe.

Soon Wilmington became one of the most important ports in the Confederacy. But during the last two years of the war, the Federal blockade tightened. Fewer and fewer supply ships managed to reach their destinations.

Unable to import enough medical supplies to treat their own soldiers, civilians and captured Union soldiers, the South began manufacturing more and more medicines from its own native plants. Nine pharmaceutical laboratories were opened, including two in North Carolina, in Charlotte and Lincolnton. The Lincolnton lab grew poppies for opium and collected medicinal plants from as far away as Asheville, Statesville and Wilkesboro. Citizens were asked to support the war effort by providing plants and bottles for medicines.


1862 advertisement from the Charlotte Medical Purveyor’s Department, offering cash for wild plants and bottles.

Illnesses and opiates

People remember the Civil War for its tragically high casualty rates—about 970,000 in all, or 3 percent of the population. But among soldiers, disease actually killed far more than battlefield wounds.

Many soldiers fell sick in military camps. Constant exhaustion, lack of adequate clothing, exposure to severe weather and a diet of poorly cooked food made soldiers susceptible to a host of infectious diseases. Worst of all, drinking water contaminated by open latrines caused outbreaks of typhoid fever, which caused the most fatalities.

The most common problems, though, were diarrhea and dysentery. “No matter what else a patient had,” wrote one doctor, “he had diarrhea.”

Civil War–era doctors had few effective ways to cure illness. But they knew that morphine and other opiates (drugs derived from opium) could temporarily relieve the symptoms of a wide variety of ailments. So they readily prescribed them in liberal doses. Opium, which has constipating effects, was used for diarrhea and dysentery. Doctors also prescribed it to relieve violent convulsions from malaria. Because of its effectiveness as a painkiller, opium was commonly rubbed into or sprinkled on severe wounds.

Opiates are highly addictive. As a result of their treatment, a number of Union and Confederate soldiers acquired lasting drug habits. For example, William Anderson Roberts, a private in the 14th Regiment North Carolina Troops, spent a great deal of time in military hospitals. In 1862, he wrote this to his family from Moore Hospital:

“Of all the lonesome places on earth it is a evening in a Hospital. There is a deep gloomy melancholy settling down on my mind. I have taken an Opium pill to counteract the influence of depression of spirits. Opium, that sweet restorer of man as he was before the fall. The King of all medicines. The great restorer of ease and peace to both mind and body. Thanks to the great giver of all good things for that great gift.”

Roberts survived the war and returned home at its end. But he fought his addiction to opium until his death in 1900.


Constant exhaustion, lack of adequate clothing, exposure to severe weather and a diet of poorly cooked food made soldiers susceptible to a host of infectious diseases.

Soldiers' Stories

The terrible conditions in Confederate military hospitals were vividly described in soldiers’ letters to and from their families at home.

John Quincy Adams, Corporal, Company D, 26th Regiment North Carolina Troops
Wake County native John Adams volunteered for the Confederate army in 1861 at age 24. While his regiment camped at Camp Burgwyn, he and many other men fell sick with measles and fever. Adams entered an army hospital in New Bern and was captured when the city fell to Union forces in 1862. Nine days later he died in the hospital of typhoid fever. Listen to letters Adams wrote to his family describing his illness and treatment. The final letter was sent to inform the family of Adams’s death.

Isaac Lefevers, Sergeant, Company K, 46th Regiment North Carolina Troops
A potter and farmer in Catawba County, Isaac Lefevers volunteered for the Confederate army at age 30 in 1862. When his regiment moved to Richmond from Goldsboro, Lefevers remained behind for at least a month in the Christian Palace Hospital in Goldsboro. He recovered, returned to his regiment and was wounded several times in battle. Finally, he died of wounds in a Richmond hospital in 1864. In his letters home, Lefevers describes his sickness, the hospital conditions and his love for his wife and children.


Recreation of a common Confederate hospital scene: a lonely soldier writing a letter.

The Horrors of Civil War Surgery

Soft lead bullets caused most Civil War battle wounds, often leaving broken and splintered bones and large, ragged holes in the body. If a soldier was shot in the head, chest or stomach, his chances for survival were slim.

Because of the extensive damage to bone and muscle tissue, wounded arms and legs often had to be amputated—as quickly as possible to minimize suffering and loss of blood. Like Northern doctors, Confederate physicians used ether and chloroform to anesthetize patients for surgery. But when supplies ran out, they operated without anesthesia. Not surprisingly, many soldiers feared surgery more than death itself.

Unaware of how infections develop, doctors operated without washing hands or sterilizing tools. They rinsed wounds with water contaminated by the pus and blood of other patients. In fact, infected wounds were so common that physicians thought pus was a necessary part of the healing process. Even when an operation went well, some patients died of tetanus, blood poisoning or gangrene afterward.


Surgical tools used by Dr. Newsom Jones Pittman of Tarboro, believed to have served in the North Carolina infantry brigade.