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Figure 1.
Lieutenant General James Longstreet in 1863.

Lieutenant General James Longstreet in 1863.

Figure 2.
The Wilderness, site of a major battle 1 year before, was some of the roughest countryside in Virginia.

The Wilderness, site of a major battle 1 year before, was some of the roughest countryside in Virginia.

Figure 3.
Robert E. Lee hoped to trap the Union army while it was on the march and mired in the confines of the Wilderness. The battle opened with LTG James Longstreet 44.8 km away.

Robert E. Lee hoped to trap the Union army while it was on the march and mired in the confines of the Wilderness. The battle opened with LTG James Longstreet 44.8 km away.

Figure 4.
The attack on Union GEN Winfield Scott Hancock's left flank ordered by LTG James Longstreet.

The attack on Union GEN Winfield Scott Hancock's left flank ordered by LTG James Longstreet.

Figure 5.
Lieutenant General James Longstreet's mounted party, obscured by dense brush and smoke, moved eastward between separated regiments of Confederate BG William Mahone's brigade.

Lieutenant General James Longstreet's mounted party, obscured by dense brush and smoke, moved eastward between separated regiments of Confederate BG William Mahone's brigade.

Figure 6.
John Syng Dorsey Cullen, MD, the First Corps' medical director. Courtesy of the Museum of the Confederacy, Richmond, Va.

John Syng Dorsey Cullen, MD, the First Corps' medical director. Courtesy of the Museum of the Confederacy, Richmond, Va.

Figure 7.
Simulated magnetic resonance imaging scan (top) and diagram (bottom) showing the oblique passage of the bullet through LTG James Longstreet's neck and shoulder.

Simulated magnetic resonance imaging scan (top) and diagram (bottom) showing the oblique passage of the bullet through LTG James Longstreet's neck and shoulder.

Figure 8.
The slightly upward trajectory of the bullet from posterior to anterior.

The slightly upward trajectory of the bullet from posterior to anterior.

Figure 9.
Lieutenant General James Longstreet in 1872, his paralyzed right arm tucked in his coat.

Lieutenant General James Longstreet in 1872, his paralyzed right arm tucked in his coat.

1.
Longstreet  J From Manassas to Appomattox. 2nd ed. New York, NY Da Capo Press Inc1992;
2.
Eckenrode  HJConrad  B James Longstreet: Lee's Warhorse. 2nd ed. Chapel Hill The University of North Carolina Press1986;
3.
Wert  JD General James Longstreet: The Confederacy's Most Controversial Soldier.  New York, NY Touchstone1993;
4.
Porter  H Campaigning With Grant.  New York, NY Da Capo Press Inc1986;
5.
Lowry  D No Turning Back: The Beginning of the End of the Civil War: March-June 1864.  New York, NY Hippocrene Books Inc1992;
6.
Steere  E The Wilderness Campaign.  Mechanicsburg, Pa Stackpole Books1960;
7.
Rhea  GC The Battle of the Wilderness May 5-6, 1864.  Baton Rouge Louisiana State University Press1994;
8.
Gallagher  GW The Wilderness Campaign.  Chapel Hill The University of North Carolina Press1997;
9.
Sorrel  GM Recollections of a Confederate Staff Officer.  New York, NY Konecky & Konecky1994;
10.
Dawson  FW Not Available Wiley  BJed.Reminiscences of Confederate Service 1861-1865. Baton Rouge Louisiana State University Press1980;
11.
Layton  TR Stonewall Jackson's wounds. J Am Coll Surg. 1996;183514- 524
12.
Blanton  WB Medicine in Virginia in the Nineteenth Century.  Richmond, Va Garrett & Massie Inc1933;
13.
Stiles  R Four Years Under Marse Robert. 2nd ed. Marietta, Ga Bellum Editions1995;
14.
US War Department, The War of the Rebellion: A Compilation of the Official Records of the Union and Confederate Armies. 130 volumes Washington, DC US Government Printing Office1880-1901;Vol LI (pt 2 suppl) 893
15.
Dammann  G Pictorial Encyclopedia of Civil War Medical Instruments and Equipment. 8th ed. Missoula, Mont Pictorial Histories Publishing Co1993;
16.
Hamilton  FH A Treatise on Military Surgery and Hygiene.  New York, NY Bailliere Bros1865;
17.
Blackford  SLed. Letters From Lee's Army: On Memories of Life in and out of the Army in Virginia During the War Between the States.  New York, NY AS Barnes & Co1962;
18.
Welsh  JD Medical Histories of Confederate Generals.  Kent, Ohio Kent State University Press1995;
Citations 0
Original Article
March 2000

The Cervical Wound of General James Longstreet

Author Affiliations

From Medical City Dallas, Dallas, Tex.

Arch Otolaryngol Head Neck Surg. 2000;126(3):353-359. doi:10.1001/archotol.126.3.353
Abstract

Background  Lieutenant General James Longstreet was arguably the finest corps commander on either side during the Civil War. He was severely wounded at the Battle of the Wilderness in Virginia on May 6, 1864, after a successful flank attack that nearly routed the Union army.

Design  A thorough review of the firsthand accounts of the events leading up to and following Longstreet's wounding was made. In addition, all articles listed in the medical literature describing Longstreet's care and numerous recent texts and articles about Longstreet have been researched.

Results  After being wounded on May 6, Longstreet received appropriate care by John Syng Dorsey Cullen, MD. Cullen controlled the hemorrhage from Longstreet's wound, helped evacuate him from the battlefield, and diligently cared for him during his convalescence.

Conclusions  Longstreet was wounded by "friendly fire." The bullet's trajectory and the location of the gunshot wound suggest a posterior wound of entry rather than an anterior one as has been previously assumed.

CONFEDERATE LTG James Longstreet was arguably the finest corps commander on either side during the Civil War. He was severely wounded by "friendly fire" at the Battle of the Wilderness in Virginia on May 6, 1864. While Robert E. Lee commanded the army of northern Virginia, no officer was closer to him and no officer's views did Lee value more than those of Longstreet.

Born in South Carolina but raised in northeastern Georgia, Longstreet was called "Pete" because of his Dutch ancestry. He entered the US Military Academy in the class of 1842. Fifty-six cadets would graduate in this class, Longstreet ranking 54th. His disciplinary record was not much better than his academic standing. He was a large man, 6'2" (186 cm) tall, and (in his Civil War years) he weighed about 220 lbs (99 kg). "I had more interest in horsemanship, sword exercise and the outside game of foot-ball than in the academic courses,"1(p15) he wrote.

He found his best friend among the class of 1843, an Ohioan, Ulysses S. Grant.

During the Mexican War in a frontal attack at Chapultepec on September 13, 1847, Longstreet was hit in the thigh with a musket ball as he led the charge carrying the regimental flag. As he fell, he passed the colors to 1LT George E. Pickett, who carried the standard over the wall and to victory.2 Pickett led the infamous and suicidal "charge" ordered by Lee and reluctantly carried out by Longstreet at Gettysburg, Pa, on July 3, 1863.

Longstreet returned to the United States from Mexico and married Marie Louise Garland, daughter of his former brigade commander, COL John Garland. Louise gave birth to 10 children, only 5 of whom lived to adulthood. In 1862, during a 6-day period, 3 of the 4 Longstreet children, Mary Anne, James, and Gus, died of scarlet fever in Richmond, Va. Only 13-year-old Garland survived.3

With the outbreak of the Civil War, MAJ Longstreet resigned his commission in the US army and was commissioned a brigadier general of infantry in the army of the Confederacy. He was ordered to Manassas Junction in northern Virginia. For the next 4 years, he fought in nearly every major campaign in the eastern theater and in 2 major campaigns in the west (Figure 1). When Lee surrendered to Grant at Appomattox, Va, on April 9, 1865, Longstreet was a lieutenant general, the senior subordinate officer in the army.1(ppvii-xiii)

In March 1864, Grant was promoted to lieutenant general and made the new federal commander in chief. The first match between Lee and Grant was to be the Battle of the Wilderness, fought on May 5 and 6, 1864. Grant was a relative unknown and perhaps Lee underestimated him. Longstreet, Lee's First Corps commander, certainly did not. "That man," Longstreet warned, "will fight us every day and every hour till the end of the war."4(pp46,47)

The Wilderness was some of the roughest countryside in Virginia—an approximately 70-mile wide by 30-mile long (112 × 48-km) stretch of second growth timber, briers, thick underbrush, and brackish water all but impenetrable (Figure 2).5 In the days before smokeless powder, a single volley, much less a pitched battle, would prevent a soldier from seeing anything beyond the end of his rifle. Only one really good road crossed the area: the Orange Turnpike.

On May 5, 1864, Union GEN Winfield Scott Hancock's corps drove LTG Ambrose P. Hill's men back almost to Lee's headquarters. Longstreet's corps arrived just in time on Orange Plank Road, having marched a remarkable 28 miles (44.8 km) in 1 day. The Union forces were driven back almost to their starting point (Figure 3).

Lee's chief engineer, BG Martin L. Smith, told Longstreet about an unfinished railroad bed not shown on any local maps, which led directly past the Union flank.6 This was too good an opportunity to miss. A flanking attack was ordered by Longstreet (Figure 4). Three brigades led by LTC Moxley Sorrel attacked Hancock's left flank. Organized Union resistance was nonexistent. Hancock said to Longstreet after the war, "You rolled me up like a wet blanket."1(p568)

Sorrel, riding back to give Longstreet the good news, found his commander riding east on Orange Plank Road. Longstreet was leading a mounted party and was planning another attack that would hopefully drive the Union army back across the Rapidan River. At the head of the party with Longstreet was GEN Micah Jenkins. Jenkins' troops were dressed in new uniforms made of cloth "so gray as to be almost black."7(p369)

Making their way back to Orange Plank Road after the attack, the members of Confederate BG William Mahone's 12th Virginia on the right end of the line found their way blocked by a brush fire (Figure 5). They detoured to the east around the fire, reaching the road well away from the other regiments in the brigade. Officers of the 12th Virginia realized that their regiment alone had crossed the road. They then turned south and moved back toward the road. The other 4 regiments (6th, 16th, 41st, and 61st Virginia) of Mahone's brigade were lying down or kneeling between 31.5 and 67.5 m south of the road and facing north.8

Longstreet's party advancing to the east unwittingly passed between the 2 separate parts of Mahone's brigade, which obliquely faced each other across the narrow road. Through the dense growth and the smoke, the 12th Virginia saw mounted troops in dark uniforms and fired at the indistinct forms. The remainder of the brigade south of the road, assuming this was the enemy, returned the fire.

Brigadier General Joseph B. Kershaw saw Jenkins' brigade kneel and level their rifles to fire. He rode forward and screamed, "Friends!"1(p564)

The damage was done. Jenkins, struck in the temple, never regained consciousness. Several others riding with Longstreet were killed or wounded. Sorrel recalled, "[Longstreet] was a heavy man . . . but he was actually lifted straight up and came down hard. The lead-torn coat, the orifice close to the right shoulder pointed to the passage of the heavy bullet of those days."9(p243) Longstreet felt "a severe shock from the Minie ball passing through my throat and right shoulder . . . and my right arm dropped to my side."1(p564) He tried to continue to ride, but his staff, seeing him wobble in the saddle and about to fall, lifted him to the ground and sat him against a tree.

Longstreet was accidentally shot by his own men only 4.8 km from the spot where Stonewall Jackson was mortally wounded by friendly fire 1 year before.

Francis Dawson, a British volunteer, rode to the rear to find a physician, "giving the sad news to the first surgeon I could find."10(p115) He gave his horse to John Syng Dorsey Cullen, MD (Figure 6), the First Corps' medical director. Cullen rapidly rode to the front. The general was choking on his own blood. Cullen worked to stop the hemorrhage, probably by direct pressure. Longstreet, a bloody froth bubbling at his mouth and throat, was preoccupied with the battle. In a rasping, whispery voice, he ordered MG Charles W. Field to "assume command of the corps [and] press the enemy."7(p371)

Cullen was able to stop the bleeding. Longstreet was lifted onto a litter and soon placed in an ambulance, constantly under Cullen's care.

Cullen was a graduate of the Medical Department of the University of Virginia, Charlottesville. After the war, he eventually succeeded Hunter Holmes McGuire, MD (the surgeon who attended Jackson),11 in the chair of surgery at the Medical College of Virginia, Richmond, and was made dean in 1886.12

Longstreet left his grief-stricken men, and the somber procession traveled east toward the Confederate hospital tents at Parker's Store. Robert Stiles, an artillery officer, rode up to the ambulance and looked in. He described the general as being quite pale.

They had taken off Longstreet's hat and coat and boots. I noticed with reverent admiration how spotless white his socks and his fine gauze undervest, save where the black-red gore from his breast and shoulder had stained it. . . . Then he moved his unwounded arm and with his thumb and two fingers carefully lifted the saturated undershirt from his chest and heaved a deep sigh.13(p247)

Obviously, laundry soap and the time to use it was a rare commodity in the Confederate army.

At Parker's Store, Drs Cullen, Barksdale, Wood, and Guild probed the wound. They concluded it was "not necessarily" fatal.14(p893)

The treatment of gunshot wounds at that time was fairly straightforward. The bullet and any foreign debris were to be extracted with forceps, after their location was determined by probing. Major blood vessels would have to be sutured, and the wound bandaged. Abdominal and chest wounds were usually fatal, and no treatment was given. To locate the bullet, probing with the finger was preferred. "With the use of the finger came a degree of touch that was lost with the use of the probe."15(p4) If digital probing was unable to reach the bullet, a metal probe was used. "The Nealton probe, the most favored, had a small ball of polished porcelain at its tip and could establish whether the foreign body was lead or bone."16(p184) Obviously neither of these procedures was pleasant for the patient, especially when repeated by several surgeons.

At the time of the Battle of the Wilderness, the predominant weapon for both sides was a .58-caliber rifle of the Springfield type, which fired a minié ball weighing 505 grains. From a 32-inch (81.3-cm) barrel, the muzzle velocity of such bullets was from 725 ft/s (217.5 m/s), to 1395 ft/s (418.5 m/s), depending on the powder charge. It could be fired accurately at 200 to 250 yards (180 to 225 m), and a skilled rifleman could fire 4 shots per minute. It is likely that Longstreet was wounded by a weapon of this type.

Longstreet, those with him when he was wounded, and most historians are of the opinion that the wound of entry was located anteriorly. Given the trajectory of the bullet, slightly upward from posterior to anterior, it is more likely the cervical wound was an exit wound or Longstreet would have had to have been leaning far forward in the saddle when shot, which is unlikely.

The bullet entered the right side of the general's back just along the medial border of the scapula. It traveled in an anterior-superior direction and angled medially, transecting the right brachial plexus and the right recurrent laryngeal nerve. It then passed through the right lobe of the thyroid gland and the right anterolateral wall of the trachea, exiting almost in the midline (Figure 7).

This trajectory would account for the paralysis of Longstreet's right arm and his weak, breathy voice, both of which persisted for the rest of his life. The tracheal wound explains the "bloody froth" that issued from his mouth and neck.

Differentiating entry wounds from exit wounds can be quite complex, as seen in the Hearings Before the President's Commission on the Assassination of President Kennedy, published 100 years later.

Most of Mahone's brigade (4 regiments) was lying down or kneeling on the south side of the road, resting from the attack on Hancock's left flank. They fired from this position at the 1 regiment to the northeast, with Longstreet's party in between. A posterior entry wound with a slightly upward trajectory is not only feasible but likely (Figure 8).

The attack planned by Longstreet before he was carried from the field never materialized.

On May 7, 1864, Longstreet was placed in an ambulance bound for Orange Court House (a village in Virginia). Accompanying him were Cullen and staffers Osman Latrobe, Andrew Dunn, Thomas J. Goree (also wounded), John Fairfax, and Erasmus Taylor.7 At noon, they stopped at a house and requisitioned whiskey, ice, and sugar. Mint likely grew along the roadside. Taylor made juleps, which were consumed by the patient and his escort of southern gentlemen, making the journey more pleasurable. Dunn became so intoxicated that he fell off his horse. Latrobe shouted some good-natured insults. "Dunn cursed him for all the damned fools that had ever been," Taylor recalled, "Latrobe and I being convulsed with laughter."7(p450)

They spent the night at Meadow Farm, the Taylor home near Orange County. In the morning, they boarded a train for Charlottesville, Va, staying at the home of Mrs Charles Blackford.3 Mrs Blackford noted, "He [Longstreet] is very feeble and nervous and suffers much from his wound. He sheds tears on the slightest provocation and apologizes for it. He says he does not see why a bullet going through a man's shoulder should make a baby of him."17(p261)

From Charlottesville, Longstreet traveled by train to Lynchburg, Va. Cullen remained with him and was assisted in his treatment of the general by 2 surgeons from one of the nearby Confederate hospitals. Longstreet was forced to make several moves during his convalescence because of the presence of Union cavalry raiding nearby. In July, the general and his family left Virginia for Georgia. His wounds had healed, but his right arm remained paralyzed. His voice, which once could be heard all along the lines, was gone. He was barely able to speak above a whisper.

Lee and Longstreet corresponded periodically while Longstreet was recovering. In a letter dated August 29, 1864, Lee cautioned Longstreet not to become impatient with the slow but steady progress he was making. "Do not let Sherman capture you, and I will endeavor to hold Grant till you come." Longstreet, using his left hand for writing, had in a previous letter apologized to his commander. Lee replied, "We shall not object to your chirography, so you must practise it often, and let me hear of your progress and well-doing."1(pp639,640)

In October, Longstreet was concerned about his physical limitations but returned to the army. Sorrel said, "Following the advice of his doctor he was forever pulling at the disabled arm to bring back its life and action."9(p274)

As Lee left to meet with Grant at the Appomattox courthouse on April 9, 1865, Longstreet told him, "General, if he does not give us good terms, come back and let us fight it out."3(p403) Grant was indeed generous, and the war ended in the parlor of the McLean house in Virginia.

When Grant saw Longstreet, he smiled, grabbed both his hands, and then embraced him. "After passing a few remarks [he] offered a cigar, which was gratefully received."1(p630) Longstreet left Appomattox with his horse, $100 in his pocket, a paralyzed right arm, and his voice reduced to a hoarse whisper (Figure 9).

The general was the center of postwar controversy as a result of his criticism of Lee's tactics at Gettysburg and his acceptance of patronage from his old friend, now President Grant. He wrote: "Bad as was being shot at by some of our own troops in the Battle of the Wilderness—that was an honest mistake, one of the accidents of the war. Being shot at, since the war, by many officers, was worse."1(p568)

In December 1903, Longstreet traveled to Chicago, Ill, where he underwent "x-ray treatment for a cancerous right eye."18(p144)

While visiting his daughter in Gainesville, Ga, he contracted pneumonia and died on January 2, 1904, after a profuse hemorrhage. He was buried at Gainesville in the Alta Vista Cemetery, the last survivor of the Confederate high command. Some Confederate organizations refused to send flowers to the funeral.2

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Article Information

Accepted for publication December 3, 1999.

Presented at the annual meeting of the American Head and Neck Society, Palm Desert, Calif, April 26, 1999.

Reprints: Robert M. Steckler, MD, Medical City Dallas, 7777 Forest Lane, Building C, Suite 208, Dallas, TX 75230.

References
1.
Longstreet  J From Manassas to Appomattox. 2nd ed. New York, NY Da Capo Press Inc1992;
2.
Eckenrode  HJConrad  B James Longstreet: Lee's Warhorse. 2nd ed. Chapel Hill The University of North Carolina Press1986;
3.
Wert  JD General James Longstreet: The Confederacy's Most Controversial Soldier.  New York, NY Touchstone1993;
4.
Porter  H Campaigning With Grant.  New York, NY Da Capo Press Inc1986;
5.
Lowry  D No Turning Back: The Beginning of the End of the Civil War: March-June 1864.  New York, NY Hippocrene Books Inc1992;
6.
Steere  E The Wilderness Campaign.  Mechanicsburg, Pa Stackpole Books1960;
7.
Rhea  GC The Battle of the Wilderness May 5-6, 1864.  Baton Rouge Louisiana State University Press1994;
8.
Gallagher  GW The Wilderness Campaign.  Chapel Hill The University of North Carolina Press1997;
9.
Sorrel  GM Recollections of a Confederate Staff Officer.  New York, NY Konecky & Konecky1994;
10.
Dawson  FW Not Available Wiley  BJed.Reminiscences of Confederate Service 1861-1865. Baton Rouge Louisiana State University Press1980;
11.
Layton  TR Stonewall Jackson's wounds. J Am Coll Surg. 1996;183514- 524
12.
Blanton  WB Medicine in Virginia in the Nineteenth Century.  Richmond, Va Garrett & Massie Inc1933;
13.
Stiles  R Four Years Under Marse Robert. 2nd ed. Marietta, Ga Bellum Editions1995;
14.
US War Department, The War of the Rebellion: A Compilation of the Official Records of the Union and Confederate Armies. 130 volumes Washington, DC US Government Printing Office1880-1901;Vol LI (pt 2 suppl) 893
15.
Dammann  G Pictorial Encyclopedia of Civil War Medical Instruments and Equipment. 8th ed. Missoula, Mont Pictorial Histories Publishing Co1993;
16.
Hamilton  FH A Treatise on Military Surgery and Hygiene.  New York, NY Bailliere Bros1865;
17.
Blackford  SLed. Letters From Lee's Army: On Memories of Life in and out of the Army in Virginia During the War Between the States.  New York, NY AS Barnes & Co1962;
18.
Welsh  JD Medical Histories of Confederate Generals.  Kent, Ohio Kent State University Press1995;
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