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Morphine & take it, see if I will not be happier. … If it shortens my life, it will be an end most devoutly wished.”56

These mutterings of disloyalty came mostly from Confederate women who stayed put; a far darker kind of misery awaited those who tried to turn refugee. As early as 1862, Federal invasions of northern Virginia and Tennessee were dislodging large numbers of Southerners, mostly women whose men had left for the army and who feared the unlovely rule of Yankee occupiers, and mostly those with slaves who feared that their slaves could not be relied upon anywhere near the Northern armies. Over the course of the war, nearly 250,000 Southerners fled from the battle zones to areas deeper within the Confederacy. Taken together with the flight of blacks in the other direction and with the three million men sucked up into the whirlwind of the armies as they crossed state after state and river after river, the Civil War produced a demographic disruption all across the eastern half of North America that had no equal in the American memory.57

Nor did the problems stop once Southerners had gotten away to a reasonable distance from the Yankee invaders. Once removed, refugee planters who had dragged their slaves along with them had no work for the slaves to do and no income from cotton planting to feed them. In order to earn money from their slaves, refugee planters hired them out in record numbers to public and private war industries, as teamsters, ironworkers, and even β€œnitre diggers.” This, in turn, only further destabilized the slave work regimen. As slaves moved out of the plantation environment and into the wider boundaries of urban employment for cash, the old systems of supervision broke down, while wartime conditions made it impossible to develop a new work system to absorb the sudden influx of industrial slaves.58

Even without the excess baggage of slaves, Southern women refugees found the incessant string of moves from one unfamiliar place to another, or from one increasingly reluctant brace of relatives to another, to be a counsel of despair. The longer the war rolled on, the more all trace of Southern civic life disappeared, as individual survival became the paramount concern. Sarah Morgan and her family fled Baton Rouge under a barrage of Union shells to seek refuge on a plantation near Port Hudson; when the war came up to Port Hudson, they fled again to Lake Pontchartrain, and then finally into occupied New Orleans, where Sarah was sheltered under the roof of her Unionist half-brother. β€œGive me my home, my old home once more,” she lamented, in what could have been the words of every Confederate woman tossed in the tornado of destruction and disappointed expectations for their own womanhood. β€œO my home, my home! I could learn to be a woman there, and a true one, too. Who will teach me now?”59

As the war forced women into new and unaccustomed roles, it simultaneously undermined women’s notions of their reliance on men, and introduced them to new views of their own capacities. This was particularly true for women who stepped into the void created by the army medical services’ miserable unpreparedness for handling the frightful casualties of Civil War battlefields. Women had been assigned to so many domestic roles related to caregiving that it required only the shortfall in male medical personnel before women began to volunteer themselves as nurses, and in a few cases, such as that of Union army surgeon Mary Walker, as doctors. Before the 1850s, army medicine, like the army itself, had been the preserve of male doctors and male nurses, and women could scarcely find opportunity for medical education in the United States, much less an opening for medical practice.60

The work of Florence Nightingale during the Crimean War had cracked that particular wall of gender separation down to its foundations, and Nightingale became the stepping-stone for a small number of American women to open up military nursing to women volunteers. Not surprisingly, female nurses were at first not welcomed by the doddering army medical establishments. β€œThere is scarcely a day passes that I do not hear some derogatory remarks about the ladies who are in hospitals, until I think, if there is any credit due them at all, it is for the moral courage they have in braving public opinion,” wrote Kate Cumming in 1863. But the administrative record soon carved out by Dorothea Dix as the superintendent of army nurses in the North, by Captain Sally Tomkins and her Richmond hospital, and by U.S. Sanitary Commission nurses on the Federal hospital ships on the western rivers soon dampened the carping. Tompkins, the sister of a Confederate colonel, opened her own private hospital for 1,330 Confederate soldiers in Richmond and managed to evade bureaucratic efforts to incorporate her hospital into the army hospital system by obtaining a captain’s commission from Jefferson Davis. She was β€œoriginal, old fashioned and tireless in well doing,” recalled Thomas De Leon, β€œβ€¦ as simple as a child and as resolute as a veteran.”61

What was far more discouraging to women nurses was the appalling slaughter churned up by battle, and the dirt and incompetence that pervaded the army medical services. When Cornelia Hancock and a group of army nurses caught up with the Army of the Potomac at Fredericksburg in 1864, they walked into an abandoned church that the army had converted into a hospital. There β€œthe scene beggared all description.” The two male surgeons with them β€œwere paralyzed by what they saw,” Hancock wrote home, for β€œrain had poured in through the bullet-riddled roofs of the churches until our wounded lay in pools of water made bloody by their seriously wounded condition.” Louisa May Alcott, who nursed briefly in a military hospital in Georgetown before falling dangerously ill, described her hospital as a β€œperfect pestilence-box… cold, damp, dirty, full of vile odors from wounds, kitchens, wash rooms, & stables.” By the end of the war, only 3,200 women had

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