The Confederate medical laboratories.

Abstract: During the Civil War, the scarcity and expense of imported drugs forced the Confederate Army to establish several medical laboratories to manufacture drugs for military use. The laboratories produced medicines from indigenous plants and also made non-plant-based drugs. The Confederate Surgeon General and the Chief Purveyor in Richmond, VA, coordinated activities of most of the laboratories. The laboratories employed talented and resourceful personnel and manufactured a large volume and wide variety of drugs, the most useful of which included ether, chloroform, and opiates. The pharmaceutical quality of the laboratories' output was evidently uneven. Empirical testing in military hospitals helped determine the clinical value of indigenous remedies. The Confederate medical laboratories participated in a coordinated effort to supply the Army with substitutes for drugs whose availability was curtailed or uncertain.

Key Words: Confederate States of America, drug manufacturing, history of medicine

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During the Civil War, the South faced the major challenge of supplying its troops with medicines. The Union naval blockade interfered with the importation of drugs like quinine, vital for the prevention and treatment of malaria and derived from the bark of trees (cinchona) not found in the southern states. Goods made their way into the South via blockade-running ships, through commerce and smuggling across enemy lines, and by the capture of Union military supplies. Such routes were unreliable, and blockade running in particular became more difficult as the war progressed. Furthermore, the South had no preexisting large-scale pharmaceutical industry, so even drugs like ether and chloroform, whose production required no ingredients of foreign origin, were not being made in large amounts. Thus, the Confederate Army established facilities, most often called medical laboratories, to manufacture for military use what necessary drugs they could and to use indigenous resources in producing substitutes for medications that could not be made or procured in adequate amounts. The few published descriptions of these important facilities have been sketchy, (1-4) and original source material about the laboratories has been thought to be practically non-existent. (1) However, a considerable, albeit incomplete, body of primary information about the Army facilities does exist and allows an overall view of them to be formed.

Origin and Location of the Confederate Medical Laboratories

It is unclear when the concept of establishing Army drug manufactories arose, and the incompleteness of records makes it impossible to determine the laboratories' exact operational dates. The first laboratory appears to have opened in Richmond, VA, by late January 1862. (5) In March 1862, the Confederate Surgeon General's Office published a pamphlet on the collection and medicinal use of native plants. (6) Surgeon General Samuel Preston Moore (7) included the pamphlet with a circular the next month directing medical purveyors (medical officers charged with procuring and issuing medical supplies) to collect the listed plants so that they could be processed into medicines. Other laboratories probably started manufacturing drugs in mid-1862 to mid-1863. They were located at Columbia, SC; (8) Arkadelphia, AR (9), (10) (later Tyler, TX (11), (12) ); Atlanta (13) (later Augusta, GA (12) ) and Macon, GA; (14) Charlotte (15) and Lincolnton, NC; (16) and Mobile (17) and Montgomery, AL. (18) Additional laboratories may have operated at Little Rock, AR, (19), (20) and Jackson, MS. (21)

Administration and Personnel

Except for the facilities west of the Mississippi River during the latter half of the war, overall responsibility for the Army laboratories rested with Surgeon General Moore in Richmond. Beginning in April 1862, Surgeon Edward W. Johns, medical purveyor for Richmond, was authorized to issue orders as Chief Purveyor to medical purveyors concerning the movement of supplies; (22) after February 1863, Moore assumed that responsibility. (23)

Because of its remoteness from Richmond, the portion of the Confederacy west of the Mississippi developed its own command structure. (24) Although Richmond was still communicating with Medical Purveyor Charles O. Curtman of the Arkadelphia laboratory in April 1863, (25) the surrender of Vicksburg, MS, in July 1863 gave control of the river to Union forces and compelled the facility to move to Tyler, TX. (11), (12) Operations at Tyler began around September 1863 under Surgeon-in-Charge William R. Johnston, (20), (26) who reported to the chief of the medical bureau of the Confederate Trans-Mississippi Department rather than to Surgeon General Moore. (24)

Individual laboratories were typically associated with a medical purveying depot and directed by the depot's medical purveyor, but there were exceptions. The Lincolnton laboratory, apparently a stand-alone operation, was directed by Surgeon-in-Charge A. Snowden Piggot (16) (Fig. 1); functions for that facility that required the authority of a medical purveyor were apparently handled by James T. Johnson, medical purveyor and director of the Charlotte laboratory and depot, some 30 miles away. (27), (28) A similar relationship evidently existed between Surgeon-in-Charge Johnston (26) of the Tyler laboratory and Medical Purveyor Howard Smith at Houston, TX. The medical laboratory at Arkadelphia was associated with the ordnance works there. (10) The Little Rock arsenal had a laboratory under Surgeon-in-Charge Johnston, but it is unclear whether it manufactured drugs. (19), (20)

Pharmaceutical operations were carried out by various personnel, including surgeons (military physicians), hospital stewards (noncommissioned officers with medical duties), (29) civilian pharmacists, and civilian chemists. Many had qualifications suited to the laboratories. Surgeon-in-Charge Piggot of the Lincolnton laboratory had a special interest in metallurgy and chemistry and had previously served the Confederacy at a smelting facility (30) and an acid-production plant. (31) The Columbia laboratory and purveying depot were directed by Medical Purveyor J.J. Chisolm (8) (Fig. 2), a physician particularly knowledgeable about military surgery and material medica. Pharmaceutical operations there were conducted under physician-naturalist Joseph LeConte, (32) scientist-minister James Woodrow, (33-35) and (possibly) physician-scientist St. Julien Ravenel. (34), (35) The Mobile laboratory employed Army surgeon and botanist F.J.B. Rohmel (36) and pharmacist-botanist Charles T. Mohr. (37) Private Charles P. Sengstack, Jr., a "practical druggist of the Philadelphia school of several years experience," worked at the Richmond laboratory, (5), (38) and the Macon laboratory employed chief chemist James Stewart, graduate of a New York pharmacy school and former employee of the United States Army's medical purveying department. (39)

[ILLUSTRATION OMITTED]

Talented scientists occasionally offered their services to the laboratories. For example, Professor J.M. Safford, former geologist for Tennessee, applied through Brigadier General Alexander P. Stewart (40) to Surgeon General Moore for a position in a laboratory, and his request was supported by Lieutenant General Leonidas Polk and Tennessee Governor Isham G. Harris. (41) The Surgeon General and laboratory directors tried to protect skilled workers, who were apparently quite rare, from conscription. (42), (43)

Soldiers deemed unfit for combat were assigned to the laboratories for guard and other duty. (44), (45) Couriers escorted medical supplies to and from the laboratories. (46) Civilians working at the laboratories included "free men of color." (47)

[ILLUSTRATION OMITTED]

Raw Materials

The use of indigenous medicinal resources was given high priority and reflected the Confederacy's desire to make itself more self-sufficient. It did not signal a departure from mainstream medical practice but instead a pragmatic attempt to find workable substitutes for medicines that were difficult or expensive to procure. The indigenous species used by the Confederacy were recognized in the United States Dispensatory, (48) the standard drug reference of the time, as having medicinal value. Many (eg, elm, wild cherry, Virginia snakeroot, castor oil plant) were, in fact, used in standard-issue medicines (ie, agents in the Army's standard supply tables), and those that were not were nonetheless familiar to physicians, pharmacists, and the public. "It is not desirable that the list of [indigenous remedies] be multiplied," said Surgeon General Moore. (49) "It is more important that a moderate number of the more valuable should be selected and these prepared for use promptly and properly." Not all indigenous remedies were prepared from plants. Cantharis vittata (the potato fly) was collected as a substitute for Cantharis vesicatoria (Spanish fly), which was used in blistering plasters. (50)

Medical purveyors responded to Surgeon General Moore's orders to collect indigenous plants (7) by publishing handbills and newspaper announcements (Fig. 3) offering payment to citizens for delivery of the listed species. Purveyors were directed to share their advertisements and prices with each other and with Chief Purveyor Johns's office (51) and to hire agents to collect the plants and encourage citizens to help. (52) In some instances, Moore (53) or Johns (54) set maximum prices for indigenous materials, which sometimes frustrated purveyors. Medical Purveyor William H. Prioleau, (54) director of the Macon laboratory, agreed to pay citizens 75cents/lb for Pinckneya pubens (Georgia bark, native to southern Georgia) only to be told by Johns in Richmond to pay no more than 30cents/lb. "I do not think," Prioleau complained to Johns, "prices of these articles can be safely fixed where they are not to be found."

Citizens were encouraged to cultivate medicinal plants, most notably the opium poppy. (55) Surgeon-in-Charge Piggot directed the planting of poppies near his Lincolnton laboratory (56) and paid local growers to cultivate the flowers. (57) Sorghum (58) and flax (57) were cultivated near that facility, and the Surgeon General hoped to have black mustard grown there as well. (56) All these plants had medicinal applications.

Purveyors occasionally found minerals or chemicals that could be used in the laboratories. Medical Purveyor George S. Blackie (59) of the Atlanta laboratory informed Surgeon General Moore of a "large deposit of black oxide of manganese of extreme purity" at a mine. He offered to procure the material, which he intended to use in the manufacture of chloroform and other medicines, and share it with other purveyors. Blackie (60) also noted that the Confederate Nitre and Mining Bureau was destroying large quantities of sulphate of potassa--which could be used medicinally by itself and as a constituent of other remedies--during the manufacture of nitre (potassium nitrate, a vital ingredient of black powder). He obtained approval to collect the sulphate of potassa for use by the medical department.

Employees at the medical laboratories inspected drugs that found their way into the South to determine their usefulness. The inspections often revealed serious problems. Chemist Mohr at the Mobile laboratory reported that French quinine, one of the goods delivered by blockade runners, was "highly adulterated." (37) Drugs smuggled from the North were necessarily disguised, and this, said Mohr, resulted in "mix-ups between quinine sulfate and morphine sulfate, which often led to harm in the hospitals."

Drug Processing

Grinding indigenous plants was often a prelude to further manufacturing steps and was also desirable because it reduced the bulk of the plant material and facilitated its transport. Grinding machinery, however, was not always readily available. One week before Medical Purveyor Prioleau reported his Macon laboratory ready for operation, he was authorized to pay a civilian to pulverize raw materials. (61) In February 1863, Medical Purveyor Chisolm (62) at Columbia was grinding drugs for his Atlanta-based colleague Blackie; grinding equipment was also present at the Mobile (37) and Lincolnton laboratories. (63)

Among the equipment obtained early in laboratory operations were large-capacity vessels and heating devices. Prioleau (64) reported ordering six 100-gallon "evaporating apparatus," Chisolm (65) had a series of copper kettles for boiling, and the Charlotte laboratory had a steam engine and pharmaceutical furnace. (15) The Mobile laboratory had equipment for "steam distillation, and for the extraction of high-grade alcohol from corn whiskey." (37) Surgeon-in-Charge Johnston (26) at the Tyler laboratory wished to produce castor oil and requested permission to impress from a local resident an iron screw and its appurtenances, which were apparently needed to construct a press. Surgeon-in-Charge Piggot (66) at Lincolnton asked for assistance from Richmond's Tredegar Iron Works in constructing leaden chambers for acid production, from the Charlotte Navy yard in fabricating a system of copper tubing for his laboratory, (67) and from the central ordnance laboratory in Macon in supplying "chemical apparatus." (68)

It was generally desirable to process plant material into preparations that, in Medical Purveyor Prioleau's words, would "retain the full properties of the plant at the same time taking up as little room in the Regimental [medicine] chest and the Patients stomach as possible." (69) A solvent was typically added to pulverized plant parts to extract the active constituents; the resulting solution was an infusion or decoction (depending on the temperature of the operation) if the solvent was water, or a tincture if the solvent was alcohol. (48) The crude solution was usually heated to evaporate at least some of the fluid. A solid end product was called an extract or solid extract. The long application of high heat required to produce a solid extract could degrade active components, so heating times and temperature were reduced for some preparations, and the result was a somewhat concentrated solution called a fluid extract.

Chisolm (70) recommended equipping a laboratory and staffing it with specialists (recruited from England and Germany, if necessary) to extract the alkaloids from indigenous plants. Isolating plants' active components as pure substances--as quinine was isolated from cinchona--would make it easier to evaluate a medicine's clinical effects and to standardize dosage. Prioleau (71) had chemists working on P. pubens, but attempts "to procure a crystallizable alkaloid" failed. There is no evidence that any Confederate laboratory succeeded in isolating active alkaloids from native plants. Table 1 shows the indigenous remedies produced or collected at various laboratories. (18), (36), (72-85)

In addition to indigenous remedies, the laboratories also produced non-plant-based medicines (sometimes called "chemicals") that were in the Army's standard supply tables. (86) In the Macon laboratory, the ability to prepare these chemicals followed the initiation of plant-processing operations. (87) In February 1863, Medical Purveyor William H. Anderson (18) reported that his Montgomery laboratory was making solution of ammonia, sulphuric ether, and chloroform, and by July of the same year, the Columbia laboratory was prepared to make mercurialpill mass (blue mass), mercurial ointment, and spirit of nitric ether. (88) Table 2 shows the chemicals and other standard-issue medicines, some of which incorporated indigenous plants, prepared at the laboratories. (10), (18), (36), (59), (63), (72), (73), (75), (78-80), (89)

Coordination of Laboratory Activities

Logistics

To a large degree, the scope and extent of production in individual laboratories were governed by the availability of raw materials, equipment, and personnel. Surgeon General Moore and Chief Purveyor Johns, however, used reports from laboratory directors on the quantities of collected indigenous materials to set priorities for further collection and for production of medicines. Johns, (90) for example, noted that relatively more poplar than dogwood and willow bark was being collected and ordered that the three species be collected in equal amounts as they were typically combined in a tincture for the treatment of malaria. Moore (91) ordered Medical Purveyor Prioleau to collect large quantities of P. pubens, because it had promise as a substitute for quinine and grew in Prioleau's district. Medical purveyors were also directed to stop accumulating the most easily collected plants and start concentrating on some of the rarer and more valuable species. (92)

When Richmond learned that the Columbia facility was ready to manufacture certain standard-issue medicines, it directed medical purveyors elsewhere to order those preparations from that depot and stop purchasing them on the open market. (88) Laboratory directors communicated among themselves and offered each other supplies and their own services. Chisolm (93) purchased a large quantity of filter paper and asked whether the Richmond laboratory required any. Medical Purveyor Anderson (18) of the Montgomery laboratory offered to make certain preparations for Medical Purveyor Blackie, his counterpart at Atlanta, if Blackie could supply him with the necessary raw materials. Richmond routinely ordered laboratory directors to send raw or finished materials to their colleagues Moore, (94) for example, ordered Blackie to send 40,000 pounds of indigenous plants to Prioleau for processing and directed Prioleau to send Blackie 50 pounds of extract of P. pubens. (95)

Specifications for Indigenous Formulations

Instructions for the preparation of standard-issue medicines and some indigenous-plant formulations were in popular compendia of the time. Medical Purveyor Chisolm (65) at Columbia informed Chief Purveyor Johns that, unless notified otherwise, he would consider the United States Dispensatory (48) to be the standard reference for such instructions. Laboratories could occasionally--as was the case for ointment of Phytolacca decandra (poke root) (96) --find formulation instructions in Resources of the Southern Fields and Forests, a book written by Surgeon F.P. Porcher (97) under orders of the Surgeon General. Laboratories had to devise their own preparations and procedures as well. Surgeon Rohmer (36) at the Mobile laboratory, for example, recorded formulas that did not appear in the standard references or in instructions from the Surgeon General's Office. Chemist James Stewart of the Macon laboratory also developed his own formulations and was requested by Medical Purveyor Prioleau (98) to standardize tinctures such that a dose would be 1 to 2 fluid drams. In one instance, Richmond expressed its priority in selecting formulations. Chief Purveyor Johns (99) told Medical Purveyor Prioleau to "prepare the extracts in solid or fluid form as may be most expedient, or rather, most easily made." Johns (100) ordered that indigenous preparations be labeled with the drug name, medicinal properties, and dosage.

The indigenous formulations approved for issue were enumerated in an 1863 supply table of indigenous remedies. (101) Some formulations manufactured at the laboratories apparently varied from the approved ones, for Surgeon General Moore (102) reminded medical purveyors that "an article ... specified as 'Fluid Extract' is not to be made into 'Tincture,' or a 'Solid Extract' into 'Fluid Extract' &c, but the Supply Table is to be followed throughout." On the other hand, Moore authorized the laboratories to collect certain indigenous plant species that did not appear on the list. (85), (103)

Evaluation of Pharmaceutical Quality

Laboratory directors were ordered to submit to Richmond samples of preparations made at their facilities along with the formulas used. (13), (104) Estimates of the pharmaceutical quality of the medicines were inconsistent. A newspaper reporter asserted that articles produced by the Columbia laboratory compared "favorably with the best English and French preparations of similar character" in "neatness of preparation and general 'getting up.'" (105) Chief Purveyor Johns (104) told Medical Purveyor Prioleau that specimens of tinctures made at the Macon laboratory "seemed to be good but a little muddy." Surgeon General Moore (106) said that samples from the Macon laboratory appeared to be of good quality, but an inspection of the Macon purveying depot identified numerous problems. Barks, said inspector Edward N. Covey, (107) "were not very well ground," and extracts were "generally burnt and totally unfit for issue." The extracts were problematic, suggested Covey, because evaporation was performed over a hot-water bath. Evaporation was ideally conducted in vacuo, in which a partial vacuum over the heated solution allowed lower temperatures and shorter evaporation times; (48) this apparatus was apparently not used at Macon. One Confederate surgeon noted that the products of the laboratories were "in many directions, not surpassingly excellent" and recalled wryly that the elemental mercury in laboratory-produced mercurial-pill mass quickly "seceded" from the other constituents of the preparation and "settled by itself at the bottom of the holder." (108)

Evaluation of Clinical Value

Medical Purveyor Prioleau was ordered to have "a few judicious and reliable Medical officers" test his indigenous preparations in Army hospitals and report on their therapeutic value. (109) Samples of the preparations were sent to Richmond for the same purpose. Reports of the effectiveness of the preparations are anecdotal. Medical Purveyor Anderson (18) of the Montgomery laboratory called fluid extract of blackberry "a capital astringent in dysentery and diarrhea," extract of podophyllum "a safe and thorough purge," and extract of dogwood "a good substitute for quinine." One surgeon reported from Florida that the indigenous preparations were useful as tonics (mild stimulants) but "proved to be of no service" in relieving "malignant" fevers (probably malaria). (110)

Fate of the Laboratories

Surgeon General Moore reported in February 1863 that he had ordered the discontinuation of the laboratory in Mobile; (17) the reason for its closing is unknown. In early June 1863, Moore (21) acknowledged Medical Purveyor Richard Potts's loss of indigenous plants at Jackson, MS, where Potts had been stationed. Moore instructed Potts to have his "employees who were engaged in the manufacture of indigenous remedies" report to the directors of the Mobile and Montgomery purveying depots. If there was a laboratory at Jackson, it was probably destroyed when Potts's office was burned in mid-May by Union troops or by Confederates evacuating the city. (111) Not only did Union advances force relocation of the Arkadelphia laboratory--and its possible companion facility at Little Rock--to Tyler, similar pressure prompted the Atlanta laboratory to move to Augusta, GA, between June (95) and October 1864. (12)

As Union troops approached in February 1865, Medical Purveyor Chisolm (112) distributed some stock from the Columbia laboratory to hospitals, removed other supplies by train, and had the remainder, particularly "stimuli" (medicinal alcohol) destroyed. Chisolm kept his evacuated stores in Greenville, SC, (113) and sent portions to Charlotte and Lincolnton. (112), (114) On April 21, 1865, Surgeon General Moore, (113) who had relocated to Augusta, GA, ordered Chisolm to forward him various supplies. Chisolm could send only 10 of the 200 ounces of quinine that Moore wanted but was able to supply all the silver nitrate (187 pounds), chloroform (250 pounds), and mercurial-pill mass (193 pounds) specified. In June 1865, Chisolm (115) turned over to a Union officer "all machinery, injured by fire formerly used at the Confederate States laboratory & Distillery located at the Fair Grounds on the outskirts of the town of Columbia" along with about 80 pounds of gum opium and 340 ounces of morphine.

Surgeon-in-Charge Piggot at Lincolnton was paroled at the end of the war. (116) He was allowed to return to his home in Baltimore, MD, and to "have, retain, & dispose of as his own private property one gray gelding branded 'U.S.' the same having been received by him from the U.S. Forces in exchange for one taken by the same from him." (117)

What happened to the other laboratories is unknown. There is no evidence that any continued operations after the war.

Contributions of the Laboratories

The laboratories produced a great volume of medicines. In a single quarter, for example, the Columbia laboratory manufactured 2,005 pounds of mercurial-pill mass, a year's supply according to standard tables, for 501 general hospitals, each treating 200 sick, or for 501 regiments. (78), (86) During another quarter, the Macon laboratory had enough Liriodendron tulipifera (tulip tree) powder on hand or in preparation for 1.7 million doses. (79), (101) The Macon facility issued enough P. pubens powder during one quarter for some 30,000 doses. (75), (101) The variety of manufactured preparations was also considerable and, given the incompleteness of available records, probably wider than that shown in Tables 1 and 2.

Whether those preparations were clinically beneficial is less certain. By today's standards, only a few drugs used during the Civil War were effective. Ether, chloroform, quinine, and the opiates were probably the most valuable, so the Confederate laboratories, which produced all of these but quinine, probably helped soldiers when those preparations were of adequate quality. Many other medications used during the war, including indigenous remedies produced by the Confederate laboratories, elicited responses (eg, emesis, diaphoresis, defecation) thought then to be helpful but generally recognized now as offering, at best, only some symptomatic relief. They did little to cure or markedly relieve the major ills of Civil War soldiers--infectious diseases, nutritional deficiencies, and battlefield wounds.

The laboratories were considered in some instances to be cost-saving operations. The Montgomery facility was reported to produce medicines at costs enough below market prices to save the government at least $300 a day; the laboratory's equipment was said to have cost no more than $1,000. (118) Such economy was evident when Surgeon General Moore (119) told Medical Purveyor Prioleau not to pay a civilian $19 per gallon of castor oil. Moore knew that a bushel of unhulled castor beans could be purchased for $7 and would yield 3 to 4 gallons of oil when processed in a laboratory. Whether the cost of producing medicines at the laboratories was generally lower than market prices cannot be determined from available documents, but the question may have been of little practical import, because many standard-issue drugs were often unavailable at any price or available only in quantities insufficient to supply the army. The extent to which the laboratories were able to keep up with requisitions from the field and hospitals is also unknown.

Questions of operational efficiency aside, the men associated with the laboratories displayed impressive energy and skill. Laboratory directors and chemists, who included some of the best medical and scientific minds of the time (eg, J.J. Chisolm, Joseph LeConte, A. Snowden Piggot, Charles T. Mohr), exhibited resourcefulness in obtaining and using the necessary raw materials, equipment, and personnel under difficult circumstances.

The Army was not the only organization in the Confederacy to establish medical laboratories. A single Navy medical laboratory, in Richmond, reportedly manufactured numerous standard-issue medicines at a cost considerably lower than what was being paid for products delivered by blockade runners. (120) Records of supplies issued to Confederate Navy vessels and hospitals suggest that indigenous preparations were not widely used in that branch of the military. William A.W. Spotswood, (120) Chief of the Bureau of Medicine and Surgery for the Confederate Navy, credited pharmacist Robert Lecky for important contributions to the facility's success. Otherwise, little information has been found about the Navy laboratory. Other official medical manufactories included distilleries directed by or under contract to the Army medical department and laboratories in Louisiana that manufactured medicines for civilian use in that state. (121)

Conclusion

Drug manufacturing by the Confederate medical laboratories was undertaken to make the South more self-sufficient and to supply substitutes for medicines whose continued availability could not be ensured. A coordinated effort that employed talented and resourceful personnel resulted in the production for the Army of standard-issue preparations as well as medicines made from materials indigenous to the South.

                      WANTED.

The Medical Purveyor's Department, Charlotte, N. C.,
is in need of the following articles for the use of the
Army, for which the annexed prices will be paid:

          ROOTS, HERBS AND BARKS.

Seneka Snake root                       per lb 60 cts
Puccoon or Blood root                          40 "
Wild Cherry bark                               30 "
Indian Turnip                                  20 "
American Ipecac--root                          $1 00
Blooming Spurge--root                          50 cts
Indian Physic--root                            25 "
Indian Tobacco                                 25 "
Black Snake root                               50 "
Poke root                                      10 "
Cranesbill,                                    20 "
Blackberry root                                20 "
American Gentian                               20 "
Dogwood bark                                   25 "
Fever Root                                     20 "
American Hellehore root                        20 "
Peppermint leaves                              25 "
Skunk Cabbage--root                            20 "
Jamestown Weed--seed and leaves                20 "
Hemlock leaves                                 20 "
Hemlock seed                                   50 "
Wintergreen, or Partridge Berry                50 "
Horsemint                                      20 "
Sassafras--bark of root                        20 "
Sassafras pith                                 $5 00
Ginseng root                                   50 cts
Sarsaparilla root                              75 "
Lavender--leaves and stem                      20 "
Flaxseed                            per bushel $2 00
White Oak bark                          per lb 20 cts
Meadow Sweet                                   25 "
American Columbo root                          50 "
Willow bark                                    20 "
Tulip tree bark or White Poplar                20 "
Persimmon--bark from root                      20 "
Centaury herb                                  20 "
Boneset                                        20 "
Butterfly Weed, or Plouriay Root               30 "
Dandelion root                                 30 "
Hops                                           $1 00
Wild Senna                                     50 cts
May Apple, or Mandrake                         75 "
Butternut--inner bark of root                  50 "
Henbane--leaves and seed                       75 "
Barberry leaves                                50 "
Fleabane                                       25 "
Scotch Broom--tops of stems                    50 "
Pink Root                                      50 "
Worm Seed                                      25 "
Calamus                                        25 "
Wild Ginger, or Canada Snake Root              50 "
Queen's Root                                   50 "
Slippery Elm                                   30 "
Red Pepper                                     $1 00
Anise seed                                     50 cts
Spear Mint                                     25 "
Bitter Sweet, or Woody Nightshade              50 "

                BOTTLES AND VIALS.

Quart Champaigne Bottles                    $1 25 per doz.
Pint " "                                       75 "
Quart Wine (claret) "                        1 00 "
Pint " "                                       75 "
Quart Castor Oil "                             75 "
Porter "                                       75 "
8 oz. Vials                                    75 "
6 and 4 oz. Vials                              60 "
1 and 2 oz. Vials                              50 "

To be delivered in any quantity at the N. C. Military Institute, or to
Drs. Duffy and Arendell, Medical Purveyor's Agents, who will visit the
various towns in this State,                          M. HOWARD,
                                     Surgeon and Medical Purveyor.
   Garlotte, N. C., July 22, 1862 lm

Table 1. Indigenous remedies prepared or collected at Confederate
medical laboratories (18), (36), (72-85)

Issued or ready for issue (a)          Hyoscyamus niger (henbane),
                                       tincture (b)

   Aralia spinosa (Angelica tree),     Juglans cinerea (butternut),
   bark (b)                            solid extract (b)

   Aristolochia serpentaria (Virginia   Juniper communis (juniper),
   snakeroot), root (b)                 berries (b)

   Asarum canadense (wild ginger)       Lappa minor (burdock), root
                                        (b)

    Root (b)                            Laurus nobilis (bayberry),
                                        berries (b)

    Powder (b)                          Laurus sassafras (sassafras)

    Fluid extract (b)                      Bark (b)

    Solid extract (b)                      Pith (b)

Capsicum (cayenne pepper)               Liquidambar styraciflua (sweet
                                        gum), bark (b)

  Pod (b)                               Liriodendron tulipifera (tulip
                                        tree)

  Tincture (b)                             Bark (b)

Cassia marilandica (American senna),       Powder (b)
leaves (b)

Chenopodium anthelminticum (wormseed),     Tincture (b)
seeds (b)

Cimicifuga racemosa (black snakeroot),  Lobelia inflata (lobelia),
root (b)                                tincture (b)

Cornus florida (dogwood)                Marrubium vulgare (horehound),
                                        leaves (b)

  Bark (b)                              Mentha viridis (spearmint),
                                        leaves (b)

  Fluid extract (b)                     Panax quinquefolium (ginseng),
                                        powder (e)

  Solid extract (b), (c)                Phytolacca decandra (poke
                                        root)

  Compound infusion (b)                   Powder (b)

  Compound tincture (b-d)                 Ointment (b)

  Compound fluid extract (d), (e)       Pinckneya pubens (Georgia
                                        bark)

  Compound solid extract (b)              Bark (b)

Cucurbita citrullus (watermelon), seed    Powder (b)
(b)

Datura stramonium (Jamestown weed),       Solid extract (b)
solid

  extract (b), (e)                      Podophyllum peltatum (may
                                        apple)

Diospyros virginiana (persimmon)          Rhizome (b)

  Bark (b)                                Solid extract (b), (c), (e),
                                           (f)

  Tincture (b)                          Polygala senega (seneka
                                        snakeroot), root (b)

Eupatorium perfoliatum (boneset),       Prunus virginiana (wild
leaves (b)                              cherry)

Gelseminum sempervirens (yellow           Bark (b)
jasmine)

  Root (b)                                Syrup (c), (e), (f)

  Tincture (b)                            Solid extract (b), (e)

Gentiana catebaei (American gentian)    Quercus alba (white oak)

  Solid extract (b)                       Bark (b)

  Compound tincture (f)                   Powder (b)

Gillenia trifoliata (Indian physic),    Rhus glabrum (sumach), berries
powder (b), (e)                         (b)

Humulus lupulus (hops)                  Rubus villosus (blackberry)

  Strobiles (b)                          Root (b)

  Tincture (b), (e)                      Fluid extract (c), (d)

Hydrastis canadensis (yellowroot),       Solid extract (b), (f)
root (b)

Issued or ready for issue (a)           Rumex crispus (yellow dock),
                                        root (b)

   Aralia spinosa (Angelica tree),      Salix alba (white willow),
bark (b)                                bark (b)

   Aristolochia serpentaria (Virginia   Salvia officianalis (sage),
snakeroot), root (b)                    leaves (b)

   Asarum canadense (wild ginger)       Sanguinaria canadensis
                                        (puccoon)

  Root (b)                                Rhizome (b)

  Powder (b)                              Tincture (b)

  Fluid extract (b)                     Sesamum indicum (benne plant),
                                        leaves (b)

  Solid extract (b)                     Smilax sarsaparailla
                                        (sarsaparilla)

Capsicum (cayenne pepper)                 Solid extract (f)

  Pod (b)                                 Compound fluid extract (d)

  Tincture (b)                          Spigelia marilandica
                                        (pinkroot), compound fluid

Cassia marilandica (American senna),     extract (e)
leaves (b)

Chenopodium anthelminticum (wormseed),  Stillingia sylvatica (queen's
seeds (b)                               root)

Cimicifuga racemosa (black snakeroot),     Root (b)
root (b)

Cornus florida (dogwood)                   Tincture (b)

  Bark (b)                                 Solid extract (b)

  Fluid extract (b)                     Xanthoxylum fraxineum (prickly
                                        ash)

  Solid extract (b), (c)                  Tincture (d)

  Compound infusion (b)                   Fluid extract (d)

  Compound tincture (b-d)               Collected (g)

  Compound fluid extract (d), (e)         Acorus calamus (calamus),
                                          rhizome (b), (e)

  Compound solid extract (b)              Apocynum androsaemifolium
                                          (dog's bane), root (b)

Cucurbita citrullus (watermelon), seed    Arum tryphillum (wake
(b)                                       robin), corm (b)

Datura stramonium (Jamestown weed),       Chimaphila umbellata
solid                                     (pipsisseway), leaves (b)

  extract (b), (e)                        Cunila mariana (American
                                          dittany), leaves (b)

Diospyros virginiana (persimmon)          Gaultheria procumbens
                                          (partridge berry), berries (b)

  Bark (b)                                Geranium maculatum
                                          (cranesbill), rhizome (b)

  Tincture (b)                            Iris versicolor (blue flag),
                                          rhizome (b)

Eupatorium perfoliatum (boneset),         Monarda punctata
leaves (b)                                (horsemint), leaves (b)

Gelseminum sempervirens (yellow           Quercus rubra (red oak),
jasmine)                                  bark (e)

  Root (b)                                Richardsonia scabra (white
                                          ipecacuanha), root (d)

  Tincture (b)                            Rubus trivialis (dewberry),
                                          root (e)

Gentiana catebaei (American gentian)      Solanum dulcamara
                                          (bittersweet), stalks (b)

  Solid extract (b)                       Spiraea tomentosa
                                          (hardhack), root (b)

  Compound tincture (f)                   Symplocarpus foetidus (skunk
                                          cabbage), root (b)

Gillenia trifoliata (Indian physic),      Uva ursi (bearberry), leaves
powder (b), (e)                           (b)

Humulus lupulus (hops)

  Strobiles (b)

  Tincture (b), (e)

Hydrastis canadensis (yellowroot),
root (b)

(a) Dosage forms follow names of plants. For some species, plant parts
(eg., root, bark, leaves, seeds) could be issued in crude form.
(b) Prepared or collected at the Macon laboratory.
(c) Montgomery.
(d) Mobile.
(e) Columbia.
(f) Tyler.
(g) Does not include remedies issued or ready for issue at any
laboratory.

Table 2. Standard-issue drugs prepared at Confederate medical
laboratories (10), (18), (36), (59), (63), (72), (73), (75), (78-80),
(89), (a)

Acetic acid (b)                           Mercurial ointment (b), (c)

Alcohol (b), (c)                          Mercurial pills (b)

Ammonia (b)                               Mercury with chalk (b)

Aromatic sulphuric acid (c), (d)          Mild chloride of mercury (f)

Camphorated tincture of opium (c-e)       Muriate of ammonia (b)

Castor oil (e), (f)                       Muriatic acid (h)

Cerate of carbonate of zinc (d)           Nitrate of silver in
                                          crystals (b)

Cerate of Spanish flies (c), (d)          Nitric acid (b)

Chloroform (b), (g-i)                     Ointment of nitrate of
                                          mercury (d)

Compound cathartic pills (b), (c)         Ointment of Spanish flies
                                          (c)

Compound spirit of lavender (d), (e)      Opiate pills of lead (c)

Compound tincture of columbo (c)          Pills of opium (b), (e)

Compound tincture of Peruvian bark (c)    Pills of opium and camphor
                                          (b), (e)

Extract of colocynth (c)                  Pinkroot (e), (j)

Fluid extract of buchu (j)                Powder of cayenne pepper
                                          (e), (j)


Fluid extract of cubebs (d)               Powder of elm bark (e), (j)

Fluid extract of ginger (c), (d)          Powder of gum arabic (b)

Fluid extract of sarsaparilla (e), (g),   Powder of ipecacuanha and
(j)                                       opium (b), (e)

Fluid extract of senna (c)                Powder of mustard (c), (e)

Fluid extract of wild cherry bark (d),    Prepared chalk (b)
(e)

Fused nitrate of silver (b)               Resin cerate (c), (d)

Iodide of mercury (b)                     Simple cerate (b-d)

Acetic acid (b)                           Solution of ammonia (b), (g)

Alcohol (b), (c)                          Solution of arsenite of
                                          potassa (b-d)

Ammonia (b)                               Solution of chlorinated soda
                                          (b), (h)

Aromatic sulphuric acid (c), (d)          Solution of iodide of iron
                                          (c)

Camphorated tincture of opium (c-e)       Spirit of nitric ether
                                          (b-d), (f), (g)

Castor oil (e), (f)                       Sulphate of iron (b)

Cerate of carbonate of zinc (d)           Sulphuric acid (b), (i)

Cerate of Spanish flies (c), (d)          Sulphuric ether (b)

Chloroform (b), (g-i)                     Syrup of ipepacuanha (c)

Compound cathartic pills (b), (c)         Syrup of squill (b), (c),
                                          (g)

Compound spirit of lavender (d), (e)      Tincture of catechu (b), (c)

Compound tincture of columbo (c)          Tincture of chloride of iron
                                          (c), (g)

Compound tincture of Peruvian bark (c)    Tincture of colchicum seed
                                          (b)

Extract of colocynth (c)                  Tincture of colchicum root
                                          (c)

Fluid extract of buchu (j)                Tincture of cubebs (c)

Fluid extract of cubebs (d)               Tincture of foxglove (c)

Fluid extract of ginger (c), (d)          Tincture of iodine (b)

Fluid extract of sarsaparilla (e), (g),   Tincture of opium (c-e)
(j)

Fluid extract of senna (c)                Tincture of tolu (c)

Fluid extract of wild cherry bark (d),    Tincture of valerian (b)
(e)

Fused nitrate of silver (b)               Vinegar of squill (b), (c)

Iodide of mercury (b)                     Virginia snakeroot (e), (j)

(a) Many other conventional medications were issued from or on hand at
the laboratories, but records do not indicate that they were prepared
there.
(b) Prepared at the Columbia laboratory.
(c) Tyler.
(d) Mobile.
(e) Contains ingredient indigenous to or cultivated in the South.
(f) Arkadelphia.
(g) Montgomery.
(h) Atlanta.
(i) Lincolnton.
(j) Macon.

Acknowledgments

We gratefully acknowledge the assistance of the Piggot family, Debra Chisolm Ruehlman, and James R. Chandler.

Accepted November 25, 2002.

References

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(2.) Cunningham HH. Doctors in Gray: The Confederate Medical Service. Baton Rouge, Louisiana State University Press, 1960, ed 2, pp 146-148.

(3.) Crowell LA Jr. Confederate laboratory for preparation of medicines near Lincolnton. South Med Surg 1933;95:343-344.

(4.) Hasegawa GR. Pharmacy in the American Civil War. Am J Health Syst Pharm 2000;57:475-489.

(5.) Johns EW. Commutation of rations for Sengstack CP (1 Mar 1862). Record group 109 (War Department Collection of Confederate Records, hereafter RG 109), microfilm M324 (compiled service records of Confederate soldiers who served from Virginia; hereafter M324), roll 360 (file for Sengstack, Charles P, 1st Virginia Infantry, Company E), National Archives, Washington, DC (hereafter NA).

(6.) General Directions for Collecting and Drying Medicinal Substances of the Vegetable Kingdom. List and Descriptions of Indigenous Plants, etc; Their Medicinal Properties; Forms of Administration and Doses. Richmond, VA, Surgeon General's Office, 1862.

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(38.) Sengstack CP to unidentified addressee (23 Jul 1863). RG 109, M324, roll 360 (file for Sengstack, Charles P, 1st Virginia Infantry, Company E), NA.

(39.) Prioleau WH to Moore SP (7 Nov 1862). RG 109, ch 6, vol 627 (letters and telegrams sent, Medical Purveyor's Office, Macon, GA, Depot, 1862-63), NA.

(40.) Stewart AP to Moore SP (13 Mar 1863). Piggot papers.

(41.) Harris IG to Moore SP (15 Mar 1863). Piggot papers.

(42.) Moore SP to Breckinridge JC (9 Feb 1865). OR, ser 4, vol 3, pp 1073-1076.

(43.) Prioleau WH to Secretary of War (11 Dec 1862). RG 109, ch 6, vol 627, NA.

(44.) Special orders, no 61, para 7, Adjutant and Inspector General's Office (extract, 14 Mar 1864). RG 109, ch 6, vol 135, NA.

(45.) Moore SP to Prioleau WH (6 Apr 1864). RG 109, ch 6, vol 628 (letters and telegrams received, Medical Purveyor's Office, Macon, GA, 1863-1865), NA.

(46.) Chisolm JJ to Prioleau WH (13 Jun 1862). Chisolm letters.

(47.) Akers JA. Enrolling office order (20 Apr 1864). RG 109, ch 6, vol 135, NA.

(48.) Wood GB, Bache F. The Dispensatory of the United States of America. Philadelphia, J.B. Lippincott, 1858, ed 11.

(49.) Moore SP to Prioleau WH (16 Sept 1862). RG 109, ch 6, vol 566 (letters, telegrams, and orders received, Medical Purveyor's Office, Savannah, GA, Depot 1862), NA.

(50.) Moore SP. Circular (23 Apr 1863). RG 109, ch 6, vol 135, NA.

(51.) Johns EW. Circular no 13 (22 Aug 1862). RG 109, ch 6, vol 135, NA.

(52.) Johns EW. Circular (12 Apr 1862). RG 109, ch 6, vol 6 (Letters, telegrams, orders, and circulars received, Medical Purveyor's Office, Savannah, GA, March-June 1862), NA.

(53.) Moore SP to Prioleau WH (19 Jun 1863). RG 109, ch 6, vol 740, pt 1, NA.

(54.) Prioleau WH to Johns EW (18 Aug 1862). RG 109, ch 6, vol 572 (Letters sent, Medical Purveyor's Office, Savannah, GA, Depot 1862), NA.

(55.) Moore SP. Circular (19 Mar 1863). OR, ser 4, vol 2, p 442.

(56.) Moore SP to Potts R (26 Oct 1863). RG 109, ch 6, vol 740, pt 2, NA.

(57.) Beckwith TS to Piggot AS (5 May 1863). Piggot papers.

(58.) Piggot AS to Lawton AR (30 Jul 1864). Piggot papers.

(59.) Blackie GS to Moore SP (10 Jul 1863). RG 109, ch 6, vol 750, NA.

(60.) Blackie GS to Moore SP (27 Jun 1863). RG 109, ch 6, vol 750, NA.

(61.) Moore SP to Prioleau WH (24 Oct 1862). RG 109, ch 6, vol 566, NA.

(62.) Chisolm JJ to Blackie GS (5 Feb 1863). RG 109, ch 6, vol 750, NA.

(63.) Piggot AS to Brown TL (22 Feb 1865). Piggot papers.

(64.) Prioleau WH to Moore SP (24 Sept 1862). RG 109, ch 6, vol 572, NA.

(65.) Chisolm JJ to Johns EW (2 Oct 1862). Chisolm letters.

(66.) Piggot AS to Moore SP (10 Jul 1863). Piggot papers.

(67.) Piggot AS to Mallory SR (21 Oct 1863). Piggot papers.

(68.) Mallet JW to Piggot AS (3 Aug 1863). Piggot papers.

(69.) Prioleau WH to Moore SP (23 Dec 1862). RG 109, ch 6, vol 627, NA.

(70.) Chisolm JJ to Johns EW (4 Aug 1862). Chisolm letters.

(71.) Prioleau WH to Moore SP (27 Apr 1863). RG 109, ch 6, vol 627, NA.

(72.) Bond JB to Haden JM (15 Jun 1864). RG 109, M331, roll 27 (file of Bond, John B, Surgeon), NA.

(73.) Johnston WR. Report of operations CS chemical laboratory Tyler, Texas (23 Jun 1864). RG 109, M331, roll 142 (file for Johnston WR, Assistant Surgeon), NA.

(74.) Moore SP to Prioleau WH (25 Jul 1864). RG 109, ch 6, vol 628, NA.

(75.) Abstract of medical and hospital property issued at Macon, Georgia, in the quarter ending on the 31st day of December 1864 by Surg WH Prioleau, Medical Purveyor. RG 109, ch 6, vol 621 (Abstracts of medical and hospital property issued, Medical Purveyor's Office, Savannah and Macon, GA, 1862-1865), NA.

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(77.) Invoice of supplies, Walker Hospital, Columbus, Ga (26 Sept 1864). RG 109, ch 6, vol 578 (Invoices of hospital and medical supplies, Medical Purveyor's Office, Macon, GA, Depot, 1864-1865), NA.

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(79.) On hand Feb 29th 1864. RG 109, ch 6, vol 565 (Inventories of packages shipped and medications on hand, Medical Purveyor's Office, Macon, GA, Depot, 1862-1864), NA.

(80.) Stock of indigenous remedies on hand July 31st 1863. RG 109, ch 6, vol 565, NA.

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(82.) Moore SP to Prioleau WH (9 Jul 1864). RG 109, ch 6, vol 628, NA.

(83.) Prioleau WH to Johns EW (15 Aug 1862). RG 109, ch 6, vol 572, NA.

(84.) Chisolm JJ to Johns EW (17 Aug 1862). Chisolm letters.

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RELATED ARTICLE: Key Points

* The Confederate medical laboratories produced drugs for troops because many medicines were difficult or expensive to obtain.

* Many drugs produced by the laboratories were derived from indigenous plants.

* Among the most valuable medications produced by the laboratories were ether, chloroform, and opiates.

* The Confederate Surgeon General and the Chief Purveyor coordinated the activities of the laboratories.

* The laboratories employed talented and resourceful personnel.

Guy R. Hasegawa, PHARMD, and F. Terry Hambrecht, MD

From the Publications and Drug Information Systems Office, American Society of Health-System Pharmacists, Bethesda, MD, and the National Museum of Civil War Medicine, Frederick, MD.

Reprint requests to Guy R. Hasegawa, PharmD, American Society of Health-System Pharmacists, 7272 Wisconsin Avenue, Bethesda, MD 20814. Email: [e-mail]

Copyright [c] 2003 by The Southern Medical Association

0038-4348/03/9612-1221