This article first appeared in the summer 1975 issue of the VMI Alumni Review. Dr. Smith was, in 1975, a practicing physician who became interested in analyzing the medical care given to Jackson. The results of his research were presented in this article.
At 9:00 PM Saturday, May 2nd, 1863 Jackson was wounded at the battle of Chancellorsville . He was shot through the left upper arm just beneath the shoulder. The humerus was fractured--the brachial artery was injured. He bled profusely. A second bullet entered the lateral left upper forearm and exited diagonally from the medial lower third of the forearm. A third bullet struck his right hand fracturing the second and third metacarpal bones and lodged beneath the skin on the back of his hand. He arrived at the Field Hospital near Wilderness Tavern) where Dr. Henry Black had prepared a warm tent for him. After a two mile ride in an ambulance with Major Crutchfield his condition from hemorrhage and pain had produced such shock that Dr. McGuire was prevented from adequately examining his wound. He was given sedation, kept warm and by 2:00 AM (5/3/63) his condition had so improved that Dr. McGuire examined his wounded left shoulder region and told him that his arm might have to be amputated. General Jackson agreed. Dr. McGuire then had Dr. Coleman anesthetize him with chloroform and upon examining his wound under anesthesia decided amputation was necessary and performed the surgery. His left arm was amputated at 2:00 AM Sunday, May 3rd, in a Field Hospital, two inches below the shoulder, after the bullet beneath the skin on the back of his right hand was removed. The Anesthetist was Dr. Coleman--he was given chloroform. he surgeon was Dr. Hunter McGuire. An Internist, Dr. Black, followed his heart; Dr. Wells, First Assistant, tied the arteries; and Captain Smith held the lights. The bullet was first removed from his right hand to see the type of ball. Confederates used a round ball from a smooth bore musket. Federals did not use smooth bore guns. This was proof that he had been wounded by his own men (18th N. C. Regiment). The operation was a standard type of circular amputation. This was the accepted treatment at that time for an injury at this site, of this magnitude. One half hour after the operation he was given a cup of coffee.
At 3:30 AM, one and one-half hours after amputation, Pendleton, his Assistant Adjutant General called and told him General Hill had been wounded and the troops were in great disorder and that General Stuart who had taken command had sent him to report to General Jackson and ask his advice. Dr. McGuire, at first, refused to permit the interview, but Pendleton said the fate of the Army was at stake and Dr. McGuire relented. As Pendleton entered Jackson's tent, he said, "I am glad to see you. I thought you had been killed." Pendleton gave General Jackson Stuart's message. He asked many rapid questions, became quiet, obviously concentrating and thinking. His nostrils dilated, his eyes flashed, then his face relaxed and he said, "I don't know--I can't tell--say to General Stuart to just do what he thinks best."
Jackson turned to Captain James Smith (a theology student--ordained and preached in Richmond--taught some of my Richmond friends' Sunday School!) and asked if he was there at the operation. When he answered affirmatively, he asked if he had said anything under the chloroform. Smith assured him "No." Then Jackson said "I have always thought it wrong to administer chloroform in cases where there is a probability of immediate death," but, he continued "It was the most delightful physical sensation I ever experienced. I seem to remember the most delightful music that ever greeted my ears, but I should dislike above all things to enter eternity in such a condition." Captain Smith told him he should sleep. He then slept until 9:00 AM Sunday. He awoke to the sound of the Federal guns to the east in the field works against which he had last night ordered Hill's troops to attack.
With Jackson wounded General Hill was the senior officer on the field and assumed command. When General Hill was wounded, Rodes next in seniority assumed command. There had been confusion in the ranking of commanders. What happened is not clear. Eventually Assistant Adjutant General Pendleton sent Captain R.H.T. Adams of General Hill's staff to Stuart--five miles away toward Ely's Ford asking him to return immediately and take command of the 2nd Corps. This procedure was irregular. Stuart was senior to Rodes, but Army regulations said nothing concerning a Cavalry Commander becoming a Corps Commander. General Stuart reported that--"Captain Adams of Hill's staff reached and informed me only of the urgent demand to come and take command as quickly as possible." Rodes reported, "I was informed after hearing of Jackson's being wounded that Hill had been wounded and disabled and that the command of the Corps devolved on me. Thereupon I got in touch with General Heth then commanding General Hill's division, and with General Colston had ordered them to renew the attack in the morning. The troops were not in condition to continue a night attack. About midnight the Federals made a feeble attack on their right. It was easily repulsed. Shortly thereafter, Major General Jeb Stuart arrived and assumed command. I yielded to General Stuart because I thought General Jackson or General Hill had instructed Major Pendleton to place him in command--not because I thought he was entitled to the command, nor was I unwilling to assume command having already given orders for an advance in the morning.
Jackson had no part in these events. The conclusion seems to be that General Hill made this decision and Pendleton dispatched one of General Hill's staff to notify General Stuart. Whether Pendleton suggested Stuart to Hill, no one knows.
Stuart's responsibilities were many. He had never commanded an infantry brigade, division or corps and was forced to take command of a Corps between midnight and daybreak during a lull in a terrific conflict. He had no idea of the progress of the Corps during the day nor did he know Jackson's plans and further he was unfamiliar with the topography and could not locate any one of Jackson's staff except Pendleton. His first move was to send Pendleton to Jackson for information and advice.
Simultaneously, Captain Wilbourn riding to General Lee with the news of Jackson's wounds, reached him about 3:00 AM Sunday. He was awakened and told of Jackson being wounded. As they sat on General Lee's blankets under a pine tree, General Lee moaned and wept as Wilbourn related the details. General Lee stopped him. Wilbourn told General Lee of the shift in the command from Jackson to Hill to Rodes to Stuart. He acquiesced. General Lee then wrote a note to General Stuart and handed it to Wilbourn to deliver. He stated, "those people must be prosecuted with utmost vigor--the enemy given no time to rally." He stressed uniting the two wings of the army. He said nothing of Jackson's intent to drive to the north of Chancellorsville in the direction of the road to the Rapidan and Rappahannock to prevent the Federals from reaching the U. S. Ford.
At 3:30 AM Sunday, Hotchkiss arrived bringing General Lee more information. General Lee would not talk of Jackson's wounding. He sent General Stuart a second note by Hotchkiss stressing the importance of his pressing to the right to unite the two corps. He said nothing about starting for the U. S. Ford Road. General Stuart began riding the lines during the night, brought the divisions into position and placed A. P. Hill's Division in the lead early Sunday, the 3rd, and launched a headlong attack against the Federal Field fortification. As he rode the line driving straight for Fairview which was crowned with guns and girdled by entrenched infantry protected by protruding tree branches, the fighting was desperate and with heavy losses and much confusion. General Stuart with Sweeney's banjo accompaniment, as he rode by the troops sang, "Old Joe Hooker won't you come out of the Wilderness."
Hooker had ordered a hill, Hazel Grove, abandoned. (Stuart saw its importance from which Fairview could be shelled.) General E.P. Alexander, immediately placed guns there and began to enfilade another adjacent hill, Fairview. Before the end of the 3rd, General Anderson and General McLaw's Divisions with General Lee in command had joined their left to the right of the 2nd Corps (General Hill's troops) and established a continuous line.
At 11:30 AM, General Lee received a note from General Jackson telling him he had been wounded and that General Hill was in command. Turning to his aide Colonel Marshall, General Lee dictated his famous letter to General Jackson. The original of this letter is in the Rare Book Room of Tulane University in New Orleans. I have held and read it. It is written on a small sheet of ordinary coarse, blue ruled, tablet paper, signed R.E. Lee, General.
May 3, 1863
General Thomas J. Jackson, Commanding Corps
General: I have just received your note, informing me that you were wounded--I cannot express my regret at the occurrence. Could I have directed events, I should have chosen for the good of the country to be disable in your stead.
I congratulate you upon the victory, which is due to your skill and energy.
Very respectfully, your obedient servant
R.E. Lee, General.
When Captain Smith read this to General Jackson he replied, "General Lee is very kind, but he should give the praise to God."
On Sunday May 3rd, Jackson had awakened at 9:00 AM, twelve hours after being wounded, seven hours after amputation--and was making a good immediate recovery. He was free of pain, cheerful and doing well. He took a little nourishment. His mind began to function quickly. He ordered Captain Smith to stay with him and Captain Morrison (Mrs. Jackson's brother) to go Richmond and inform Mrs. Jackson of his amputation and accompany her back to him. The remainder of the staff he ordered to return to their duties with the Corps. He dictated a note to General Lee which reached him at 11:30 AM as he was watching flames destroy the Chancellor House. About 10:00 AM, eight hours after his amputation, his right side began to pain. He asked Dr. McGuire to look at it. He saw no bruise or abrasion or any external evidence of injury. His lungs were performing normally. Cold cloths were applied locally. By Sunday at 8:00 PM his pain was gone. Dr. McGuire thought his discomfort was caused from striking his side when the litter fell. Did he then suffer an intra-abdominal injury?
Reverend Lacy, the 2nd Corps Chaplain, came in during the morning (Sunday). He looked at Jackson's stump and exclaimed,"Oh General, what a calamity." Jackson would have none of that. He wanted to rationalize the loss of his arm in terms of his understanding the relations of a true believer to his God. He insisted he was not depressed or unhappy. He was certain that the Heavenly Father had designed the affliction of the loss of his arm for his own good. He felt in this or the future world to come he would discover that what seems like a calamity was actually a blessing. He told Reverend Lacy he felt that so strongly that if he had the power to replace his arm he would not do so unless he knew the replacing was the Will of God.
He said to Chaplain Lacy, "You never saw one more contented than I am today." Reverend Lacy asked what happened? Jackson told him. He said at the moment the litter fell he experienced exquisite pain. Where? Arm--abdomen or both? It seemed a moment of death --and he knew perfect peace in the thought that he was approaching his Heavenly Father and could do so without fear. Jackson said, "It has been a precious experience for me that I was brought face to face with death and found all well." Jackson doubted whether anyone who had not made his peace with God would have the same experience. Dr. McGuire ordered the conversation stopped.
Captain Kyd Douglas came to the Field Hospital and gave news of the Stonewall Brigade to Captain Smith who relayed it to General Jackson who brightened with each report of bravery, shook his head from side to side and uttered, "Good-Good." He told Dr. McGuire, "The men of that Brigade will be some day favored to say to their children, I was one of the Stonewall Brigade." Captain Smith told him of General Paxton's death. The commander of the brigade said that he had had a strong premonition he would be killed. He gave instructions if this occurred and had read calmly and devoutly from the New Testament shortly before going into battle. Jackson replied, "That's good, that's good."
In the afternoon, General Lee send a message to move Jackson to Guinea Station as soon as his condition permitted. He would be spared if the Federals swooped around from Ely's Ford on the Rapidan. General Lee had sent troops to prevent that movement. Dr. McGuire told Jackson of General Lee's message to move him. He replied, "If the enemy does come, I am not afraid of them. I have always been kind to their wounded and I am sure they will be kind to me." If he did move to guinea Station, he did not want Dr. McGuire to go with him. There had been so many complaints about wounded generals taking surgeons off with them. Jackson knew the Thomas Coleman Chandlers at Guinea Station, in whose home he would stay and hoped after a few days of rest he could continue to Ashland (12 miles from Richmond) and on to Lexington. General Lee sent a second urgent message. Dr. McGuire should move General Jackson Tuesday morning and go with him. Jackson replied, "General Lee has always been kind to me and I thank him." This order resulted from news General Lee had while he was nearing the burning Chancellor House that General Sedgwick at Fredericksburg with the 6th Corps had stormed and taken Marye's Heights, General Early was retreating South and General Sedgwick was advancing upon his rear from Fredericksburg.
On Monday, the 4th, about 8:00 AM, Jackson left the Field Hospital in an ambulance on a mattress accompanied by Dr. McGuire. Major Crutchfield was also in the ambulance. They traveled 27 miles on rough roads which Major Hotchkiss had attempted to clear of wagons and obstructions. The teamsters resented having to give way to an ambulance until they heard who was in it. They arrived at the Chandler House about 8:00 PM. Dr. McGuire put General Jackson in the office building not connected with the house, as there was an officer with Erysipelas in the main house. He had tea and bread, then slept long and quietly. The route leading southwest to Todd's Tavern and on to Spotsylvania and Guinea Station was the same route Grant later took to Spotsylvania in 1864. During the journey Jackson felt well and was talkative, remarking that Hooker's plan was a good one, but he made a mistake when he sent his cavalry away. That error permitted Hooker to be outflanked without the movement being discovered. Jackson said he considered his flanking movement the greatest one of his life. He had planned to cut the Federal forces off from U. S. Ford, take a position between them and the Rappahannock and force them to attack him. "My men," he said, "sometimes fail to drive the enemy from a position, but the enemy always fails to drive us away."
On Tuesday, May 5th, the third day after his amputation, Jackson awakened refreshed. Dr. McGuire said his wounds were doing well. Healing was occurring by first intention to some extent in the stump and the rest of the wound was healthy granulations. The hand wound was not painful and the discharge from it was healthy. A short light splint had been placed on the right hand. He asked Dr. McGuire, "From the appearance of my wounds, how long will I be kept from the field?" He said to Captain Smith, "Many would regard my wounds as a great misfortune, I regard them as one of the blessings of my life." Captain Smith said, "All things work together for the good of those that love God." "Yes" Jackson replied, "that's it, that's it." He ate heartily and was cheerful throughout the day.
Tuesday, the 5th and Wednesday, the 6th, there were no marked changes in his condition. On Tuesday he sent for Reverend Lacy who arrived at 10:00 in the morning and asked him to read from the Bible and pray by his bed. He asked Reverend Lacy to come each morning at 10:00 o'clock. Jackson told Reverend Lacy. he was willing to die, but his time, he believed, had not yet come and His Heavenly Father still had work for him to do in the defense of his country and he would be spared until that was completed. Christianity, he said, made a man better in any lawful calling. It helped make a better general. Religion calmed a general's perplexities at a critical hour in battle, moderated his anxieties, steadied his judgment, preserved him from exaggerated and rash conclusions. He thought of religious relationships when he washed and dressed himself and ate. He said, the Bible furnished rules for everything.
He asked Captain Smith, a student of Theology, "Can you tell me where the Bible gives generals a model for their official report of battles?" Smith replied, he had never consulted the Bible for such. The General said, "There are such and excellent models, too. For instance, Joshua's battle with the Amalekites (Exodus 17:8-16). There you have one. It has clearness, brevity, fairness, modesty and it traces victory to its right source, the blessing of God." While Dr. McGuire was dressing him, Jackson asked him whether people whose body afflictions had been healed by Jesus would ever suffer again from the same affliction. Dr. McGuire did not answer. Jackson thought for a while, then exclaimed, "Oh, for infinite powers!"
As Hotchkiss left that day, he said goodbye to Jackson who asked him to present his regards to General Lee, who in the meantime, had stopped Sedgwick in his rear at Salem Church with McLaws and Anderson reinforcing Early and forced him across the Rappahannock River at Bank's Ford.
General Hooker retreated during a drenching rain the night of May 5-6 as General Lee prepared to assault his trenches. He got away without General Lee knowing it with all of his equipment. The planned attack of the night of Wednesday, May 6th, was abandoned. Jackson did not know this. To him Wednesday the 6th, was an uneventful day. He seemed to be holding his own. Reverend Lacy came at 10:00 in the morning and with Smith there was more religious talk. He asked Captain Smith, "What were the headquarters of Christianity after the crucifixion?" Captain Smith replied, "The centers of influence were at first Jerusalem, then Antioch, Iconium, Rome and Alexandria." Jackson interrupted and asked why he replied, "centers of influence"--"is not headquarters a better term?" Captain Smith continued, after looking inquiringly at McGuire for approval or disapproval and continued that the apostles were directed by seeming divine providence to plant churches in these cities. Jackson then said to Smith, "I wish you would get the map and show me exactly where Iconium was." Smith said there was no map available. "Yes sir," Jackson said, "You are right, I left it on a shelf on the desk" and he concluded, "I wish you would examine into this matter and report to me."
By Wednesday night, the 6th, the fourth day after amputation, Dr. McGuire was exhausted. Reverend Lacy rode to General Lee and requested for Dr. McGuire that Dr. S. B. Morrison, the Chief Surgeon General of Early's Division be sent to Guinea to be with General Jackson. Dr. Morrison was Mrs. Jackson's brother and the General knew him well.
Dr. McGuire did not record any change in Jackson's condition on this day, but Dabney recorded from Lacy in his biography that Mrs. Jackson requested he write, that on that day, the fourth day after amputation Wednesday, May 6th, the bright promise of his recovery began to be overcast. Pain and restlessness gradually increased. He resorted again to his favorite remedy, wet towels and anodynes to soothe his pain. This report was not from Dr. McGuire.
During the night of May 6-7 (Wednesday-Thursday) the fifth day after amputation a striking change occurred. Jackson awakened about 1:00 AM. He was nauseous and had pain. He would not awaken Dr. McGuire who was asleep on a cot in his room. Jackson ordered his servant Jim to put wet towels on his abdomen. Cold cloths did no good, nausea continued and pain in his right side added to his nausea. He suffered doggedly thru the night and finally called Dr. McGuire about daylight who stated, "I found him suffering, great pain." Examination revealed pleuro-pneumonia of his right side. The consultant, Dr. Morrison agreed, and attributed it to the fall of the litter, as did Jackson. Dr. McGuire stated, "The disease came on too soon after the application of the wet towels for them to have caused it. The nausea might have been the result of the inflammation already begun." Contusion of the lung with extravasation of blood in his chest occasioned by his fall and shock and loss of blood prevented ill effects until reaction had been well established and inflammation ensued. Pneumonia, so soon after amputation, was clinically obvious Thursday, May 7th, the fifth day after amputation and his doctors directed their efforts toward this new enemy. They treated his crippling pain with mercury, antimony and opium.
On Thursday, the 7th, Mrs. Anna Jackson and Baby Julia arrived. She was five months old and still nursing. Anna had been told of his wounding on May 3rd. Captain Joseph Morrison had been sent by Jackson to get her. He reached Richmond on May 3rd, but Stoneman's raiders (before Richmond) made travel too dangerous for her to leave before May 7th.
Captain Smith met Mrs. Jackson and told her that her husband was doing "pretty well." She knew from his voice that Jackson was not well. General Paxton's coffin was being exhumed, just outside Jackson's quarters. Mrs. Jackson heard the digging, was told what it was and it upset her greatly.
She noted her husband's flushed cheeks, fever, and oppressed breathing which benumbed his senses. Just eight days before she had left him in robust health at Yerby's. He was not under opiates and did not recognize that she was at his bedside. He had to be aroused to speak to her and soon nodded off. His condition had changed rapidly and was approaching a toxic crisis.
Mrs. Jackson made a lemonade for Captain Smith to give Jackson. He said it was too sweet. He aroused to note Anna's anxiety and said, "My darling, you must cheer up and not wear such a long face. I love cheerfulness and brightness in the sick room." When he awoke from a stupor he said, "My darling, you are very much loved. You are one of the most precious wives in this world. I know you would give your life for me, but I am perfectly resigned. Do not be sad. I hope I may recover. Pray for me, but always remember in your prayers to use the petition, 'Thy Will be done'."
Mrs. Jackson stated from the time she reached him he was too ill to notice or talk very much and lay most of the time in a semiconscious state only recognizing those about him as his consciousness momentarily returned.
Dr. Morrison came at 2:00 PM. When Jackson saw him he said "An old familiar face!" Dr. McGuire summoned Dr. David Tucker from Richmond, who had much experience with pneumonia, as a consultant.
Thursday, the 7th, in the afternoon. Jackson became better and those about him again had hopes of his recovery.
Friday, May 8th, the sixth day after amputation was cool. Dr. McGuire dressed his stump in the presence of Dr. Breckenridge and Captain Smith. he wound discharge had lessened. The process of healing continued. Dr. McGuire stated, pain in his right side had disappeared but he breathed with great difficulty and complained of exhaustion and labored inspiration. Fever and restlessness increased. He was growing weaker. His words were disjointed. In his delirium he said, "Tell Major Hawks to send provisions forward for his men. Order A. P. Hill to prepare for action. Pass the infantry to the front. Major Pendleton, send in and see if there is higher ground back of Chancellorsville. I must find out if there is high ground there between Chancellorsville and the River. Push the columns. Hasten the columns. Pendleton you take charge of that. Where is Pendleton? ell him to push up the columns." Then silence. Quick breathing and a lapse into coma. Dr. Morrison told him he feared he would not recover, to which Jackson replied. "I am not afraid to die. I am willing to abide by the Will of my Heavenly Father. I am persuaded the almighty has yet a work for me to perform."
On Saturday, May 9th, the seventh day after amputation, there was marked deterioration of his strength. Dr. Tucker after examining him said there was nothing he could do for him. Jackson said to Dr.McGuire, "I see from the number of doctors here you think my condition is serious, but I thank God, if it is His Will, I am ready to go."
In the afternoon, Jackson aroused and asked for Reverend Lacy. He could barely talk as his breathing was so labored. He told Lacy he should not stay with him Sunday, but as planned, he should return to the Corps for his regular Sunday services. Dr. McGuire stated he had no pain that day. Although his breathing was less difficult, obviously he was weakening hourly and becoming more toxic. Jackson told his wife he was suffering too much to listen to her read psalms to him. Then he said, "We must never refuse that --get the Bible and read them." Jackson obviously was more tired as the Day ended. He asked her to sing to him and asked in a whisper that she sing--"Show Pity, Lord"--Isaac Watts' hymn based on the fifty-first psalm. She read the psalm as follows at his bedside--
Have mercy upon me, oh God, according to Thy loving kindness
According to Thy tender mercies blot out my transgressions
Purge me with Hyssop and I shall be clean
Wash me.and I shall be whiter than snow
Create in me a clean heart, Oh God and renew a right spirit in me
Then Mrs. Jackson and her brother, Dr Joseph Morrison, sang Watts' words
"Show pity, Lord--Oh Lord forgive;
Let a repenting rebel live:
Are not Thy mercies large and free?
May not a sinner trust in thee?"
The song quieted him. His night was bad. He tossed feverishly and could not sleep and requested continuous wet cloths on his forehead. He was delirious, weaker and whimpered disjointed words, mentioned officers, but most of the time remained unconscious.
On Sunday, May 10th, the eighth day after amputation, Dr. Morrison told Anna, General Jackson would not live long. Mrs. Jackson said he should know it. In the early morning, Anna said to The General that he would soon be in Heaven. She said, "Do you not feel willing to acquiesce in God's allotment, if He will you go today?" With great difficulty he replied, "I prefer it." Anna told him that "Before this day closes,you will be with the Blessed Savior in his glory." Jackson said, "I will be an infinite gainer to be translated." He was unconscious all the morning. General Lee and Reverend Lacy prayed for him and General Lee formally urged officers and the entire Corps to gather at the regular Sunday religious services and pray for Jackson and give thanks for the victory at Chancellorsville.
As Sunday continued, Jackson was weakening. His exhaustion was rapidly increasing. Anna asked if he realized before sunset he would be with his savior. He answered, "Oh no, you are frightened my child, death is not so near. I may yet get well." Anna fell across his bed and wept and told him his doctors said there was no hope. Jackson asked for Dr. McGuire and said to him, "Doctor, Anna informs me that you have told her that I am to die today." Dr. McGuire replied, "That is so." Jackson looked at the ceiling and said, "Very good. very good, it is all right." Anna asked him,"Should I return with Julia to Father's North Carolina home?" Jackson replied, "You have a good kind father, but no one is so kind and good as your heavenly Father." Anna asked, "Where do you want to be buried?" His mind was cloudy. He said Charlotte or Charlottesville. Anna knew neither place meant much to him. This reply puzzled her. Anna asked, "Lexington?" Jackson said, "Yes, in Lexington in my own plot." Mrs. Hodge who had accompanied Mrs. Jackson from Richmond then brought five month old Julia in. Jackson's face lit up with a smile. Julia was placed on his bed. Jackson said, "Little darling-sweet one" as she smiled, he fell back into unconsciousness.
At 1:00 PM Pendleton arrived. Jackson asked, "Who is preaching at Headquarters today?" Pendleton told him and said, "The whole army is praying for you, General." He replied, "Thank God, they are very kind." With almost the last of his strength Jackson said, "It is the Lord's Day, my wish is fulfilled. have always desired to die on Sunday."
At 1:30 PM, Dr. McGuire noted momentary consciousness and told him he had but two hours to live. Jackson whispered, "Very good. it's all right." He declined brandy and water and said, "It will only delay my departure and do no good. I want to preserve my mind to the last." Dr. McGuire states his mind began to fail and wander. He talked as if giving commands on the battlefield--then he was at the mess table talking to his staff--now with his wife and child--now at prayers with his military family. A few moments before he died he ordered A. P. Hill to prepare for action. "Pass the infantry to the front rapidly. Tell Major Hawks"--then stopped. Presently he smiled and said with apparent relief, "Let us cross over the river and rest under the shade of the trees" and then seemingly in peace he died.
There is nothing in this little arbeit that is not in print. I culled from all that has been written about Jackson that I could find that I thought might be relevant to my purpose. The cause of Jackson's death is medically unknown except for Dr. McGuire's diagnosis of pleuro-pneumonia (an 1863 medical term). Dr. McGuire's recitation of Jackson's symptoms is not completely diagnostic in modern medical parlance. He lost whatever records he had when he lost his ambulance containing the records as he fled up the Valley with Early, ahead of Sheridan.
Sometime ago a colleague-friend challenged McGuire's diagnosis and suggested his pulmonary pathology was the result of an embolus (a clot) from the vein at the amputation site lodging in his lung. I have tried to collect everything that Jackson said and those in his attendance have recorded in an attempt to make a clinical study from a historical recitation. It is an unusual and difficult medical problem. I sent this essay around to ten friends of mine--surgeons in charge of departments in Medical Schools. It elicited a surprising amount of interest and discussion. The opinion of almost all of these was that Jackson had some intra-abdominal pathology--i.e. below his diaphragm which either precipitated or was concomitant with his pulmonary pathology which might have been terminal and not primary. Only one distinguished surgeon, a midwesterner transferred to a Southern School admitted he knew little or nothing about Jackson. The opinions were not unanimous and concerned his gall bladder, duodenum, pancreas and physiology of renal dysfunction associated with trauma (acute kidney pathology).
This is a fascinating medical problem. There was no autopsy and the true answers will never be known. Could Jackson have been saved? Today I would say very very probably "yes," but then he neither could nor was saved. However, nothing more could be done for him at that time than was done. What a momentous moment and future was involved in this one medical situation-- and so on--Lincoln, Franz Joseph, Garfield, McKinley, Kennedy, etc. A never ceasing fascinating subject. How valuable can a single life be? Do we all move in a pattern which has pre-fixed our destiny?