The Death of A.P. Hill

On the morning of April 2, 1865, 143 years ago yesterday, A.P. Hill was shot and killed by a member of the Union Sixth Corps as he tried to rally his broken lines at Petersburg.

Hill’s death was notable for the fact that it was so well-documented.  Much of A.P. Hill’s life is difficult to piece together.  A dearth of letters (one hopes the proverbial shoe box full of letters in some forgotten closet will yet turn up to shed light on, say, what exactly Hill did at Gettysburg) exists not only for Hill himself, but also for many of his men and officers.  Of the original commanders of the six brigades in A.P. Hill’s Light Division, only Edward Thomas¹ and Charles Field survived the War.  Neither wrote much of consequence about Hill or the Light Division.  Hill’s commanders managed for the most part to keep themselves out of the unseemly post-war feuds that caused many other Southern officers to pick up their pens.  The only seeming positive for understanding Hill is that at least D.S. Freeman had access to Colonel William Palmer, Hill’s long-lived chief of staff. ²

A.P. Hill’s death, however, was extremely well documented and written about.  The best source remains The Southern Historical Society Papers.  Writing for the Baltimore American, James P. Matthews contacted both Cpl. John W. Mauk of the 138th Pennsylvania (the shooter)³ and Hill’s trusted courier George Tucker.

Tucker, after having paid a proper eulogy to his chief noting simply that “we loved him”, recalled the events leading up to the fatal event by beginning by describing Hill’s actions the night prior.

During the entire winter of 1864-’65 General Hill was an invalid, and was absent in Richmond on a sick leave from about March 20th, returning to his command upon being advised of the operations on the right beyond Hatcher’s Run. April 1, accompanied by his staff and couriers, he spent in the saddle from early morning until about 9 P.M., returning at night along the works held by his corps as far as those in front of Fort Gregg, where the General halted a considerable time. He passed only a few words with his staff party or those very, very few in the trenches there. He seemed lost in contemplation of the immediate position, at which the Confederate line had become so terribly stretched that it broke that very night, letting in a deluge of the enemy, who, only partly checked by the wonderful defense of Fort Gregg, next morning flooded the country. We then returned to corps headquarters, which were at Indiana, on an extension of Washington street, Petersburg, and immediately adjoining “The Model Farm,” on the east. General Hill retired to Venable’s cottage, just across the road and within fifty yards of his camp, having had there, during the winter, his wife and two young children.

About midnight the cannonading in front of Petersburg, which had begun at nightfall, became very heavy, increasing as the hours went by. Colonel Palmer, Chief of Staff, woke Major Starke, Acting Adjutant General, and requested him to find out the cause and effect of the prolonged firing. This was between 2 and 3 o’clock on the morning of April 2. Major Starke returned before daylight and reported “that the enemy had part of our line near the Rives’ salient, and that matters looked critical on the lines in front of the city.” This he communicated to General Hill at Venable’s.

Tucker then began to recount the morning Hill was shot:

Before sunrise General Hill came over and asked Colonel Palmer if he had any report from Generals Wilcox and Heth, whose divisions on the right extended from the front of Fort Gregg to and beyond Burgess’s Mill, on Hatcher’s Run. The Colonel told him that he had heard nothing from them, and had nothing further to report beyond Major Starke’s statement.

The General then passed on to his tent, and a few minutes later the Colonel, noticing his colored servant, Charles, leading the General’s saddled horse to his sent, ran to him just as he was mounting and asked permission to accompany him. He told the Colonel no, and desired him to wake up the staff, get everything in readiness and have the headquarters’ wagons hitched up. He added that he was going to General Lee’s, and would take Sergeant Tucker and two couriers, and that as soon as he could have an interview with General Lee, he would return.

General Hill then rode to the couriers’ quarters and found me in the act of grooming my horse. (I did not then have the slightest intimation of what had taken place since our return from the lines the night before.) He directed me to follow him with two couriers immediately to General Lee’s headquarters. He then rode off rapidly. It was our custom, in critical times, to have, during the night, two of the couriers’ horses always saddled. I called to Kirkpatrick and Jenkins, the couriers next in turn, to follow the General as quickly as possible. I saddled up at once and followed them. Kirkpatrick and Jenkins arrived at General Lee’s together, only a few minutes after General Hill, who at once directed Kirkpatrick to ride rapidly back to our quarters (I met him on the road, going at full speed) and tell Colonel Palmer to follow him to the right, and the others of the staff, and couriers, must rally the men on the right. This was the first information received at corps headquarters that our right had given way. General Hill them rode, attended only by Jenkins to the front gate of General Lee’s headquarters (Turnbull House, on the Cox road, nearly one and a half miles westerly from General Hill’s), where I met them. We went directly across the road into the opposite field, and riding due south a short distance the General drew rein, and for a few moments used his field glass, which, in my still profound ignorance of what had happened, struck me as exceedingly queer. We then rode on in the same direction down a declivity toward a small branch running eastward to Old Town Creek, and a quarter of a mile from General Lee’s. We had gone little more than half this distance, when we suddenly came upon two of the enemy’s armed infantrymen. Jenkins and myself, who, up to this time, rode immediately behind the General, were instantly upon them, when, at the demand, “surrender,” they laid down their guns. Turning to the General, I asked what should be done with the prisoners? He said: Jenkins, take them to General Lee.” Jenkins started back with his men, and we rode on.

Though not invited, I was at the General’s side, and my attention having now been aroused and looking carefully ahead and around I saw a lot of people in and about the old log hut winter quarters of General Mahone’s division, situated to the right of Whitworth House and on top of the hill beyond the branch we were approaching. Now as I knew that those quarters had been vacant since about March 15th by the transfer of Mahone to north of the Appomattox, and feeling that it was the enemy’s troops in possession, with nothing looking like a Confederate anywhere, I remarked, pointing to the old camp: “General, what troops are those?” He quickly replied: “The enemy’s.” Proceeding still further and General Hill making no further remark, I became so impressed with the great risk he was running that I made bold to say: “Please excuse me, General, but where are you going?” He answered: “Sergeant, I must go to the right as quicly as possible.” Then, pointing southwest he said: “We will go up this side of the branch to the woods, which will cover us until reaching the field in rear of General Heth’s quarters, I hope to find the road clear at General Heth’s.”

From that time on I kept slightly ahead of the General. I had kept a Colt’s army pistol drawn since the affair of the Federal stragglers. We then made the branch, becoming obscured from the enemy, and crossing the Bowdtoin (not “Boydtown,” as some writers have called it) plank road, soon made the woods, which were kept for about a mile, in which distance we did not see a single person, and emerged into the field opposite General Heth’s, at a point two miles due southwest from General Lee’s headquarters, at the Turnbull House, and at right angles with the Bowdtoin plank road, at the “Harman” House, which was distant half a mile. When going through the woods, the only words between General Hill and myself, except a few relating to the route, were by himself. He called my attention and said: “Sergeant, should anything happen to me you must go back to General Lee and report it.”

We came into the field near its corner, at the foot of a small declivity, rising which I could plainly see that the road was full of troops of some kind. The General, raising his field glass, said: “They are there.” I understood perfectly that he meant the enemy, and asked: “Which way now, General?” He pointed to that side of the woods parallel to the Bowdtoin plank road, about one hundred yards down hill from where our horses stood, saying: “We must keep on to the right.” I spurred ahead, and we had made two thirds of the distance, and coming to a walk, looked intently into the woods, at the immediate edge of which were several large trees. I saw what appeared to be six or eight Federals, two of whom, being some distance in advance of the rest, who halted some forty of fifty yards from the field, ran quickly forward to the cover of one of the large trees, and, one above the other on the same side, leveled their guns.

I looked around to General Hill. He said: “We must take them,” at the same time drawing, for the first time that day, his Colt’s navy pistol. I said: “Stay there, I’ll take them.” By this time we were within twenty yards of the two behind the tree and getting closer every moment. I shouted: “If you fire, you’ll be swept to hell! Our men are here — surrender!” When General Hill was at my side calling “surrender,” now within ten yards of the men covering us with their muskets (the upper one the General, the lower one myself), the lower soldier let the stock of his gun down from his shoulder, but recovered quickly as his comrade spoke to him (I only saw his lips move) and both fired. Throwing out my right hand (he was on that side) toward the General, I caught the bridle of his horse, and, wheeling to the left, turned in the saddle and saw my General on the ground, with his limbs extended, motionless.

Mauk recalled his role in events a bit more succinctly, but very similarly to Tucker:

Just as we entered the swamp we saw two men on horseback coming from the direction of Petersburg, who had the appearance of officers. They advanced until they came to the men on the hill; they then turned and rode toward us. We had just entered the swamp, when they advanced with cocked revolvers in their hands, which were leveled at us. Seeing a large oak tree close to the road, we took it for protection against any movement they would be likely to make. Seemingly by direction of his superior, one of the rebel officers remained behind. The other advanced with his revolver pointed at us, and demanded our surrender, saying, “Surrender, or I will shoot you. A body of troops are advancing on our left (i.e., from the direction of Petersburg), and you will have to surrender, anyway!” The officer still advanced and peremptorily demanded, “Surrender your arms.” I said “I could not see it,” and said to Comrade Wolford, “Let us shoot them.”

We immediately raised our guns and fired, I bringing my man from his saddle.

Mauk stated he did not know the name of the officer who he killed until General Horatio Wright told him it was General A.P. Hill.  Mauk also noted that he ran into men from the 5th Alabama — Hill’s headquarters guard — who brought off the body.  Tucker had followed Hill’s directions, switched to Hill’s faster horse (almost certainly Hill’s gray charger Champ), and rode directly to Lee’s headquarters where he explained what happened to first members of Hill’s staff (including Palmer), then to General Longstreet, and finally to Lee himself.

As Walter Taylor put it, “Thus terminated the career of one of the most brilliant and successful leaders in the Southern Army. From the day he crossed the Chickahominy at Mechanicsville, in June, 1862, and opened the attack on the army under General McClellan, to the day of his death, he was a constant and reliable support to General Lee in the operations of his army.”

(Shameless self-promotion time.  If you would like to learn more about A.P. Hill, you can go to my website about him, And Then A.P. Hill Came Up.  The full-text versions of the accounts and information about Hill’s death is contained in the Last Campaign section of the biography.)

1. Technically, Thomas took command from J.R. Anderson, who commanded the brigade during the Seven Days. [↩]
2. For those interested in Gettysburg, unfortunately Palmer was hors de combat — he was still recovering from a dislocated shoulder sustained in a fall from his horse in the same barrage that mortally wounded Jackson at Chancellorsville.  One should wonder if the loss of his trusted chief of staff had some effect on Hill at Gettysburg.  Imagine Longstreet without Sorrel or Ewell without Sandie Pendelton, for example. [↩]
3. Mauk was from Bedford, Pennsylvania.  It was noted that “never boasted of the act which brought his name into the official report of the commander of the division in which he served, but he had no hesitation in telling the thrilling story when it became the subject of special inquiry.” [↩]

why the interest in A.P. Hill

A question via email that has been asked numerous times.  Why the interest in A.P. Hill? 

One of the first books I read about the Civil War was D.S. Freeman’s classic three volume set Lee’s Lieutenants.  For those not familiar with this masterwork, following his four volume Pulitzer prize winning biography of Robert E. Lee, Freeman set about writing a history of the Army of Northern Virginia’s high command.  The trilogy proceeds in chronological order from the first days of the War all the way to the very end at Appomattox.  Lee’s various generals — from Longstreet to Jackson to Stuart to Gordon — all make appearances and are given roles in the drama.

It is here I first encountered A.P. Hill.  Most of Lee’s generals can be distilled down to a word or a phrase or a nickname.  For example, Longstreet is Lee’s “War Horse” — reliable, dependable, solid.  Jackson can be summed up as the “eccentric genius” — difficult, yet brilliant.  Stuart is the cavalier — the superb horseman, the Knight of the Golden Spurs.

A.P. Hill had a nickname too.  Friends and family referred to him as “Powell” and his nickname during the War was “Little Powell.”  Nevertheless, that nickname only suggests a slightness of stature.  It doesn’t give a clue or key to the man like “Old War Horse” or “Old Blue Light” or “Marble Man” or “Tige.”

Hill came across to me as a sort of shadowy character.  He clearly had a volcanic temper that would erupt when he felt he had been slighted.  His fascinating personal “battle” first with Longstreet, then with Stonewall Jackson reflects that.  On the other hand, Hill was well loved by his men.  A courier remembered that “of all the generals, only A.P. Hill never failed, even during the heat of battle, to have a kindly word and perhaps a little joke for the couriers.”

As a general, Hill could be brilliant.   His career was marked by several successes — the highest among them arriving in the nick of time at Sharpsburg.  Yet to counterbalance those brilliant days, Hill had his share of bad days — the most notable being the disaster at Bristoe Station.

I came to the study of the War in the mid 1990s, one of the many people who had their interest in Civil War history ignited by the movie Gettysburg.  (Gettysburg was, of course,  not one of Hill’s better battles.)  While some people may have found their interest passed quickly, mine didn’t.  The more I read about the Civil War, the more I wanted to know.  I became entranced by the period and wanted to know everything I could.  And it was the people who intrigued me the most.  It was as if the War was a grand tragedy written by a great mind like Shakespeare, with this colorful cast of characters — rouges and villains, heroes and idols.  Yet, it was all real, it had all really happened.  You could even travel to Gettysburg and walk over the same ground that Meade and Lee had ridden over.  You could stand on Cemetery Ridge and even crouch behind the stonewall and imagine what it was like to see Pickett’s and Pettigew’s men emerge from the tree line on July 3.

I had a healthy interest in battlefield tactics, and to this day enjoy poring over maps and trying to figure out which regiment was where, how a brigade ended up where it was, of principles of war.  I like to picture battle lines in my head.  But what really captured my imagination was trying to understand the people.  How did men face fire like that and not run?  What was it really like to be there?

In 1997, I signed on to the internet for the first time and discovered there was much out there already about the Civil War.  By that time, I had developed an interest in A.P. Hill.  For whatever reason, I found that I liked this shadowy character who wore a red shirt into battle, dared to pick fights with Longstreet and Jackson, was unquestionably very brave, yet was also significantly flawed.  While there was quite a bit out on the internet about the War, I found there was precious little about A.P. Hill in the new world.

Back before everyone could have a blog and broadcast their thoughts to the world, we had websites.  Websites were also fairly easy to set up and run (though not as easy as a blog), and like blogs you could pretty much publish anything you wanted about any topic.  That said, most websites weren’t personal thought collections like many blogs or little blurbs about what the author is thinking about at any given time.  Rather, they were topical.  I thought it would be neat to give Hill a big, interesting website.  Maybe he had been forgotten, or mostly forgotten anyway, in the books, but I decided that would not be in the new electronic age.

And so I started reading about Hill and then writing about him.  The more I learned, the more I wanted to know. At first, I was more interested in Hill as a general.  But the more I learned about him, the more I wanted to know him as a person.

I wanted Hill to have a nice looking website.  So I learned first HTML, then XHTML, then CSS so I could have a decent looking website.  I studied web design a little bit.  I scanned in pictures and I kept on reading anything I could find with even just a passing reference to Hill.

My site started out small, then grew into a behemoth.  When my dad bought me a copy of the Official Records on CD-Rom, I painstakingly added the reports of not only Hill, but all his subordinates to my site.  When I received a copy of the Southern Historical Society Papers, I again carefully combed through looking for interesting articles about Hill or the men who served under him.

As an internet subject for someone’s first real history project, Hill turned out to be a good subject.  There is a good amount of information available about him, but not an insurmountable amount.   He also had enough paradoxes about him that even people who might not otherwise be interested in history could find Hill an intriguing and interesting fellow.

By the time I graduated from college in 2002, my website was mainly complete, though I still add to it from time to time when I find something interesting or read something interesting about Hill.

And so in that roundabout way, I return to the question — why A.P. Hill?  I could have picked any character — after all, there was no website about John Sedgwick or John Gordon or even of Winfield Scott Hancock.  I think I picked A.P. Hill because he was an interesting person.  Not because he was the War’s best general.  He was not.  Not because he was the War’s worst general.  He was not.  Not because he was saintly.  Hill was not.  Rather, I picked him because he human.  I liked the balance between good and bad qualities.  Human beings are not all good or all bad.  Well, at least most of us aren’t.  Most of us are a mixture of both flaws and good qualities.  In the words of Nietzsche we are “Human, All Too Human.”

Hill was definitely human.  And, I think that’s why he still interests me even today.

Fog and Gray and Rain

Sorting through pictures today on my hard-drive; a few favorites of the Gettysburg battlefield in the rain and fog.  Seemed appropriate for a very gray February day.

Image of Cowan’s New York Battery near the Angle in the rain.  Taken in December 2007. Visible beyond the cannon is the Codori Barn.

(These are far from my best pictures in most cases, but they have a certain dark and forlorn beauty that I can appreciate and I hope you enjoy them too.  The field takes on a ghostly appearance in the fog and rain.)

Set one, from upper left.  The Codori Farm from the Wheatfield Road, rain beaded like droplets of sweat on the bust of Patrick O’Rourke on Little Round Top, Warren in the fog on Little Round Top, view towards newly cleared Devil’s Den from the 140th New York monument

 

Set two, from upper left. The Bushman farm from Seminary Ridge near the position of the Texas Brigade, Meade at the Angle, the Trostle Barn, view of the Peach Orchard in the rain from the Longstreet tower.

 

Set three from upper left. The 155th Pennsylvania Zouaves on Little Round Top, Culp’s Hill near position of the 123rd New York, the Masonic Monument - Armistead hands his effects to Capt. Bingham of Hancock’s staff, the High Water Mark Monument at the Angle.

Set four from upper left. Personal favorite series — shots of the Bushman and Slyder farms taken from South Confederate Avenue along Seminary Ridge.

Set four from upper left. Detail of the 2nd New York Cavalry horsehead, the Pennsylvania monument from the Emmitsburg Road, the 44th New York castle on Little Round Top, the Peace Light Monument.

The February 6 Triumvirate

In lieu of the usual monument post today (most of which are related to the Army of the Potomac), I decided to take a brief break and turn my attention to the Army of Northern Virginia.

History is full of odd and interesting coincidences. One of the more interesting that you may not be aware of is that three stellar, young Army of Northern Virginia generals were born in successive years on this date in history (February 6th).

Interestingly, this illustrious trio represented four Confederate states (Georgia, Alabama, North Carolina, and Virginia). There was one civilian soldier and two professionals (both graduates of the West Point class of 1854). Two were killed in the Civil War; one rose to become a prominent post-war politician.

They are in order of birth:

General John B. Gordon was born on February 6, 1832 in Upson County, Georgia. He was a lawyer and engaged in mining operations prior to the War. Gordon rose from the colonelcy of an Alabama regiment to eventually command of the illustrious Second Corps. He survived a terrible series of wounds at Sharpsburg and commanded the last attack by the Army of Northern Virginia at Fort Stedman. Ramrod straight and imposing on the field of strife, one of Gordon’s admiring men would exclaim that to see Gordon on the battlefield would put fight into a whipped chicken. Of the illustrious triumvirate, Gordon was the only one to survive the War. He served his state for years as a senator and as a governor. Gordon died in January 1904.

“He was,” Union General John Sedgwick said, “the greatest cavalryman foaled in America.” James Ewell Brown Stuart — “Jeb” — was born on February 6, 1833. He was the quintessential cavalier of the War. A professional soldier, he would rise to command of the Army of Northern Virginia’s cavalry and arguably become the best cavalryman of the Civil War. Even if you don’t think Stuart worthy of that lofty title, it is indisputable that he was one of the most flashy and iconic of all the generals of not only the Confederacy, but of the entire Civil War. Stuart — the eyes and ears of Lee’s Army of Northern Virginia — was mortally wounded at the battle of Yellow Tavern in May 1864 and died the following day. Among his last words on the battlefield were the entreaty to his men: “I’d rather die than be whipped.” ¹

When Robert E. Lee ticked off the loss of his “best men” in a letter in the fall of 1863, the name William Dorsey Pender was prominent. Pender was born on February 6, 1834, making him the youngest of the three Army of Northern Virginia generals who celebrated their birthday on February 6th. Pender was a professional soldier (West Point class of 1854 ² — same class as Stuart) with a knack for getting wounded. Rising up through the ranks of A.P. Hill’s storied Light Division, Pender was Hill’s choice to take over that command. Hill even went so far as to make certain Pender received command of the Light Division over Henry Heth, who was technically the senior and one of Hill’s dearest friends. Pious, brave to the point of flaw, and an excellent soldier marked for potential higher command, Pender was mortally wounded in command of the Light Division at Gettysburg. One of his officers summed him up thusly: “He was one of the coolest, most self-possessed and one of the most absolutely fearless men under fire I ever knew.”

(Other famous people born on February 6 include the greatest baseball player of all time, Babe Ruth. I give the Babe the title of the greatest because not only could he hit, he could also pitch. There is no one quite like him in the game.)

There you have it — three stellar young generals of the Army of Northern Virginia, all born in three consecutive years on February 6th.

1. Ironically, Stuart and Sedgwick, the beloved commander of the Union VI Corps, died within days of each other. [↩]
2. The class of 1854 produced 11 generals; of these 11, 6 were killed in battle, including five for the Confederacy. [↩]

A Brief History of Mr. Hodgkin and His Horrible Disease

(I am sticking this in the Civil War category, although it has almost nothing to do with the Civil War. It’s very much a history related post, however.)

There seems to be something a bit ironic about a student of history being diagnosed with a type of cancer with as long and as interesting a history as Hodgkin’s Disease. Being a history buff afflicted with this particular malignancy, I thought it might be interesting to give … drum roll … a brief history of both Dr. Hodgkin and his horrible disease.

(You know, my first interest was medical school — maybe you’ve seen my website on Civil War medicine. But desire and interest and actual talent are different things, so I ended up a lawyer. Still anatomy in particular fascinates me so I enjoyed flipping through some of the really disgusting pictures I found on the web that Hodgkin included in his books.)

Dr. Thomas Hodgkin

Hodgkin’s Disease is one of the best known medical eponyms. The fellow who’s name got attached to this relatively rare¹ cancer especially known for attacking younger people² was named Thomas Hodgkin. Hodgkin was born in to a Quaker family in Middlesex, England on August 17, 1798. In 1819, he entered medical school at St. Thomas’s and Guy’s Medical School (affiliated today with King’s College in London). In 1823, he earned his M.D. Two years later, Dr. Hodgkin was appointed lecturer in morbid anatomy and curator of the Pathology Museum at Guy’s Hospital Medical School.

Physically, Hodgkin was dark haired, with a slight and wiry build. He had a hot temper, but was greatly appreciated as a lecturer. Hodgkin’s passion seems to have been pathology. In 1829, Hodgkin published a work that became a classic in pathology, The Morbid Anatomy of Serous and Mucous Membranes. This work focused on unexpected intra-thoracic and intra-abdominal tumors and how cancer spread.

In 1832, Dr. Hodgkin described the disease that now bears his name in a paper entitled On Some Morbid Appearances of the Absorbent Glands and Spleen. The paper was published in the journal of the Medical and Chirurgical Society in London. The disease would be rediscovered in 1865 — right as the Civil War ended — by Dr. Samuel Wilks who recognized Hodgkin’s work and named the disease after him in a paper entitled Cases of enlargement of the lymphatic glands and spleen, (or, Hodgkin’s disease) with remarks.

Hodgkin was one of the early advocates of preventive medicine, publishing On the Means of Promoting and Preserving Health in 1841.

Although the most brilliant pathologist of his day, Hodgkin was an abject failure in business. After staying up all night caring for a very rich patient, Hodgkin received a blank check for his work. He filled in the blank with 10 pounds, then added insult to injury by saying that the patient didn’t seem to be able to afford more. Many of his friends were reluctant to ask him to consult on their cases because he would refuse to charge them.

Hodgkin was a social progressive. He opposed slavery, advocated for reforms in medical education, and founded the the British and Foreign Aborigines Protection Society. His liberal views along with his hot temper made him enemies in the medical profession.

Dr. Hodgkin died of a terrible illness sadly familiar to many Civil War soldiers — dysentery — on April 5, 1866 in Jaffa, Palestine. His grave reads: “Here rests the body of Thomas Hodgkin M.D. of Bedford Square, London. A man distinguished alike for scientific attainments, medical skills and self-sacrificing philanthropy.”

Hodgkin’s Disease - The Early Years

Dr. Hodgkin was the first to note that Hodgkin’s Disease seemed to form in the intra-thoracic region and would spread through contiguous lymph node chains. He also noted that involvement of the spleen seemed a symptom of advanced disease.

Dr. Hodgkin also recognized that the “father of microscopical anatomy,” Marcelle Malpighi published the first actual recorded description of Hodgkin’s disease in his paper De viscerum structuru exercitatio anatomica in the year 1666. Hodgkin’s Disease was not the first cancer discovered,³ but it was among the first and one of the first to be accurately described.

Hodgkin only examined his disease grossly; he did not undertake to use the primitive microscopes of the day to explore the tissue further. As previously mentioned, a year before his death, Dr. Wilks assigned Hodgkin’s name to the disease. Hodgkin’s Disease proved to be interesting because it was difficult to classify — was it an infection? a cancer? an inflammatory process? The disease additionally attracted much attention and infamy due to it’s frequency in young adults.

Several pathologists who followed Hodgkin and Wilks did examine biopsies of Hodgkin’s Disease under the microscope, but it was Dorthy Reed (1874-1964), a fellow at Johns Hopkins, who first classified the unusual giant cells unique to Hodgkin’s Disease. Dr. Reed failed to recognize that they represented a neoplasm, however, thinking they were inflammatory. The unique giant cells that make up Hodgkin’s Disease are today known as Reed-Sternberg cells (Dr. Carl Sternberg (1872-1935) had also done work describing them independently in Germany in 1898).

Pathologists were eventually able to tie the giant Reed-Sternberg cells⁴ to the malignant process. Hodgkin’s Disease is a cancer,⁵ sometimes called Hodgkin’s Lymphoma. ⁶

Reed-Sternberg cells are interesting because they only make up 1 to 2% of a Hodgkin’s Disease tumor. Hodgkin’s Disease is the only malignancy where the size of the masses aren’t a result of the number of cancerous cells. ⁷ (This is one reason why there is so much inflammation with Hodgkin’s Disease and often scar tissue).

In 1925, Hodgkin’s Disease, Non-Hodgkin’s Lymphoma, and the leukemias were finally differentiated officially as different diseases.

Hodgkin’s Disease: The First Curable Cancer

Although early pathologists did not recognize that Hodgkin’s Disease was a malignancy, it’s ability to kill was well known. Ninety percent of people with Hodgkin’s Disease would die within three years time; almost all would die within five years.

Through the early 20th century, doctors experimented with using radiation to try and control Hodgkin’s Disease. They had limited success. They began to then experiment with nitrogen mustard. Now my military readers are probably asking mustard? Isn’t that the stuff that was so terrible and killed so many in WWI? Yes. Ironically, the development of the nitrogen mustard drug used in Hodgkin’s disease stemmed from the use of mustard compounds during World War I and from a terrible explosion during World War II in Bari, Italy that exposed servicemen to toxic effects. The Bari incident showed that nitrogen mustard could cause suppression of the bone marrow and of the lymphatic system. By the mid-1940s, doctors were beginning to control Hodgkin’s Disease and shrink the tumors.

The big breakthrough came in the middle 1960s. By 1964, doctors had come up with a combination chemotherapy regimen that utilized the mustard known as MOPP. MOPP consists of cyclophosphamide, vincristine, methotrexate, and prednisone.

The current staging system was also set up by the mid-1960s. The Ann Arbor Staging for Lymphomas also applies to Hodgkin’s Disease. Stage is closely associated with prognosis. The stages for lymphoma are:

• Stage I indicates that the cancer is located in a single region, usually one lymph node and the surrounding area. Stage I often will not have outward symptoms.
• Stage II indicates that the cancer is located in two separate regions, an affected lymph node or organ within the lymphatic system and a second affected area, and that both affected areas are confined to one side of the diaphragm - that is, both are above the diaphragm, or both are below the diaphragm.
• Stage III indicates that the cancer has spread to both sides of the diaphragm, including one organ or area near the lymph nodes or the spleen.
• Stage IV indicates diffuse or disseminated involvement of one or more extralymphatic organs, including any involvement of the liver, bone marrow, or nodular involvement of the lungs.

To this letters are often appended:

• A or B: the absence of constitutional (B-type) symptoms is denoted by adding an “A” to the stage; the presence is denoted by adding a “B” to the stage. The B symptoms include night sweats, fevers, and weight loss of 10% of more. Many symptoms associated with Hodgkin’s Disease (itching, pain on drinking alcohol) are not official B-symptoms.
• E: is used if the disease is “extranodal” or has spread from lymph nodes to adjacent tissue.
• X: is used if the largest deposit is >10 cm large (”bulky disease”), or whether the mediastinum is wider than 1/3 of the chest on x-ray.
• S: is used if the disease has spread to the spleen.

(So if you assigned your author all the different letters that applied to her case, she would have Stage III-AEXS Hodgkin’s Disease.)

By the way there are also four known sub-types of Classical Hodgkin’s Disease:

• lymphocyte predominance (approximately 5% of cases)
• nodular sclerosis (approximately 70%)
• mixed cellularity (approximately 20%)
• lymphocyte depletion (5%)

(Your author had the NS sub-type.)

By 1967, the results from MOPP were coming in and they were astounding: an 81% complete remission rate. In 1968, Adriamycin ⁸ became available for the first-time and in 1972 Dacarbazine ⁹ was approved for use. Because MOPP caused severe side effects (including sterility and severe suppression of the bone marrow leading to secondary leukemias), in 1972-73 a group from Italy led by Bonadonna came up with the current “gold standard” for Hodgkin’s Disease: ABVD Chemotherapy. ABVD combined a vinca-alkaloid known as Vinblastine ¹⁰ (similar to Vincristine in MOPP), an anti-tumor antibiotic called Bleomycin, and Adriamycin, and Dacarbazine. In head to head trials, ABVD proved not only less toxic, but also provided superior rates of cure.

The last major step in treating Hodgkin’s Disease came in 1992 when a German group came up with a new regimen for highest risk patients known as BEACOPP. Along with the Stanford V regimen (a combination chemotherapy and radiation regimen), these two treatments are now sometimes used in place of ABVD in advanced disease.

With modern chemotherapy, sometimes combined with radiation to areas of disease, about 80% of patients with Hodgkin’s Disease can today be cured.

As you would expect, Hodgkin’s Disease is still an evolving field, especially in terms of treating patients who have relapsed disease. Much of the work currently involves effective treatments for Hodgkin’s Disease that reoccurs despite first-line therapies. Also, there has been focus on trying to predict which patients are most likely to relapse. The use of radiation remains an issue as does attempting to lessen the toxicities from chemotherapy.

A Few Famous Hodgkin’s Disease Survivors You’ve Probably heard of

• Paul Allen
• Mario Lemieux
• Arlen Specter
• and a host of wonderful people you’ve never heard of, but are just as important, and just as valuable

So there you have it — a brief history of Dr. Hodgkin and his disease.¹¹

1. The incidence of Hodgkin’s Disease is about 3 cases per 100,000 people per year, and it accounts for less than 1 percent of all cases of cancer in the United States. The American Cancer Society states: “The American Cancer Society estimates that in 2007 there will be about 8,190 new cases of Hodgkin disease in this country. And about 1,070 people will die of the disease. Because of better treatment, death rates have fallen by more than 60% since the early 1970s.” [↩]
2. Hodgkin’s has a biomodal distribution; it is most often seen in people aged 15 to 34 or over the age of 60. In young adults, it is the most common kind of cancer. [↩]
3. Cancer is an ancient disease. Bone remains of mummies have revealed growths suggestive of bone cancer. The Edwin Smith Papyrus found in Egypt that dates back to 1600 BC actually describes 8 cases of tumors or ulcers of the breast that were treated by cauterization, with a tool called “the fire drill.” The writing explains that there was, “no treatment.” [↩]
4. R-S cells are the major thing that differentiate Hodgkin’s Disease from non-Hodgkin’s Lymphoma. The R-S cell is very large and often has more than one large nuclei. [↩]
5. Hippocrates used the terms carcinos and carcinoma to describe non-ulcer forming and ulcer-forming tumors. He used the word that referred to a crab because crab the disease often presented with finger-like spreading projections from a cancer called to mind the shape of a crab. [↩]
6. A lymphoma is a cancer of the lymphatic system, a set of interconnected organs and tissues that helps the body fight diseases and infections. There are two major types, the much more common Non-Hodgkin’s Lymphomas and Hodgkin’s Disease. Connected along the thin network of vessels of the lymph system are groups of small, bean shaped and sized organs called lymph nodes. Lymph nodes are found in the neck, chest, armpits, abdomen, and groin. The lymphatic system also includes the tonsils, thymus, spleen, and bone marrow. [↩]
7. Most of the Hodgkin’s Disease mass consists of benign inflammatory cells including small T lymphocytes, histiocytes, plasma cells, eosinophils, and neutrophils. The inflammation is produced by cytokines which are in turn produced by the tumor cells. [↩]
8. Adriamycin is the red drug. It is used for many different kinds of cancers. It’s generic name is doxorubicin. Adriamycin is in the class of chemo drugs known as Anthracyclines. [↩]
9. Dacarbazine is also known by it’s brand name, DTIC. Dacarbazine is an alkylating antineoplastic agent. It is used mainly now for Hodgkin’s Disease and for certain kinds of melanoma. [↩]
10. Vinblastine is a mitotic inhibitor. It derives from the perwinkle plant. [↩]
11. The World Health Organization in 2001 tried to officially name Hodgkin’s Disease, Hodgkin’s Lymphoma. Personally, I think Hodgkin’s Disease sounds better and my doc uses the term “Disease”, so I am going to keep referring to it as Hodgkin’s Disease. [↩]

understanding history

Harry Smeltzer has a website and blog about Civil War history in general, and the battle of Manassas in particular, called Bull Runnings. The topic of whether history should be presented in narrative format is popular right now and Harry has a good post today about that topic. In the post Harry asks whether “web projects, perhaps, [can] be something more than alternatives to traditional print narratives: can they somehow be more illustrative of the fragmented, chaotic nature of events, military or otherwise, and so provide a better understanding of what happened than traditional narrative?”

I think web projects can be. But even the best web project cannot address the problem of conveying what it was really like to be there.

A web project can go further than the traditional narrative history book in that a web project has at least the potential to be multimedia which in turn appeals to multiple senses; there is also the opportunity to build large archives and collections of different types of descriptions to create a more complete picture of a topic. For example, a website on a battle can include narrative descriptions of the fighting, maps of troop movements, maps depicting topography, photographs of the battlefield past and present. There can be paintings or depictions of art in other form. It can include descriptions from women, old men, children, fighting men, and generals — all each conveying a different part of the experience. Music from the period, the sounds of battle, could also be included. Books cannot convey sound and most are limited in what they can present in the way of photographs and maps. A good website can gather all of these things in one place. Furthermore, there’s more opportunity in a web project to have different authors.

(Not to say books should be replaced by websites. But I do think the electronic medium has a lot of potential to create a more complete version of history.)

But no multimedia presentation and no book no matter how detailed can convey what it was really like. Historians, like it or not, are constrained in part by the medium — the English language can only go so far in it’s descriptiveness. The brain can only absorb and process so much at any given time.

Part of the problem is history is the craft of describing human life and affairs, and life is in and of itself a sensory experience. Words can try to describe things we sense — what a man’s face looks like, what a battlefield smelled like, what a Whitworth projectile heading overhead sounded like, how the ground rises and falls — but unless you experience those things for yourself, you really don’t understand. Further complicating matters is the fact that people perceive things differently. Sure, there is usually a common thread, but reality is different for each of us. Asked to describe the same exact event, we’ll all come up with slightly different ways to do so, maybe even widely divergent ways. How we will describe the event in part is based upon our own past experiences, but probably also has something to do simply with the fact that we’re all biologically wired somewhat differently.

Take the example of chemo for cancer treatment. Most of you out there have not ever experienced first-hand what it is like to do chemo. I can tell you that no matter how much you try to understand what it is like to undergo chemo, you cannot understand unless you’ve been through it yourself. I can try to convey to you what it is like, but my reality and your reality are different. Think of trying to describe to someone who has never heard one what a saxophone sounds like — you have points of reference to use to try and describe it, but until you have experienced it yourself, you cannot say you really know or understand.

I think that is what the chaos of battle is like. We can try to understand it, but really never cannot because we have not experienced it the same way they experienced it. Historians try to describe it, but can only go so far.

The more ways you can sense history — touch it, experience it for yourself — I think the closer you can get. But you never are going to know what it actually was like to be there, unless you were there. Even then, you cannot ever have the full picture.

Since none of us are witnesses, we’re also limited by having to make sense of what we’re given by the historical record. The historical record has it’s problems. Go back to trying to describe the same event and coming up with different stories to describe it. We may sense it differently, but there is more to it than that. Our descriptions also may vary depending on what we’re trying to convey. Do we want sympathy? Do we want someone to believe us and not someone else? Is there something to be gained if our version of what happened is believed over another? This can impact what we emphasize when we tell our own version of what happened. It can lead us to consciously or unconsciously distort the record.

Historians, in the end, are a lot like attorneys, really. I think that’s the reason you find so many lawyers writing history or interested in history. As attorneys, we are given a set of facts — all filtered through the eyes of witnesses with different experiences who may have differing motivations for how they tell the story of what happened. They may all be telling the truth, or at least think they are telling the truth (though of course some will lie and the attorney will have to try and sort fact from fiction which is in and of itself sometimes impossible). An attorney takes these “facts” and then cobbles them together to create a story to be told in a brief, or to the judge, or to the jury. The attorney creates a story to explain reality. In the end, isn’t that really what a historian does — gather evidence and tell a story? Of course, we like to think that historians don’t have reason to give the story a certain “spin,” whereas the lawyer obviously tries to tell the story in a way that most benefits the client. But is there such a thing as a totally unbiased historian? I don’t think there is.

Just some thoughts bouncing in my head, as Harry put it. Although I don’t think there are any answers to some of these problems, I think that mulling over them and understanding that they exist is a good thing.

Mrs. A.P. Hill

A number of women had the opportunity to become Mrs. A.P. Hill, most notably the future Mrs. George McClellan and the future Mrs. G.K. Warren.

But Hill’s heart eventually went to a woman by the name of Kitty Morgan McClung.  If you don’t know much about A.P. Hill, you probably know little about his beloved wife, the woman Powell called “Dolly.”

Not long after he lost the hand of the future Mrs. George McClellan, Hill was back out attending parties in Washington.  Apparently, he was of somewhat delicate health even prior to the Civil War and as such he had been assigned to duty with the Coast Survey in the capital.  At one of these Washington parties, Hill met a young widow named Kitty Morgan McClung.

She was a Kentuckian, the sister of future Confederate cavalry general John Hunt Morgan; Kentucky was a border state and divided sympathies were common, but the Morgan family was thoroughly Confederate in allegiance with another sister marrying yet another Rebel cavalry general named Basil Duke.  In 1855, Kitty married a cousin from St. Louis named Calvin McClung.  He died suddenly soon after, however, and Kitty found herself at a young age a widow.  It was in this capacity that the 23-year old met A.P. Hill.

At this point in his life, Hill was not worn down and haggard from illness; he was a slim, dashing soldier with a red mustache and a charming manner that easily won over the opposite sex.  Hill was smitten by the lovely young widow from Kentucky.

Hill seems to have often poured out his deepest thoughts and feelings to his favorite sister Lucy.  He wrote her that, “I can reach you and you can reach me easily, that in case either of us be married, we can surely attend the other. Look out for mine at any time! You know I am so constituted, that to be in love with some one is as necessary to me as my dinner, and there is now a little siren who has thrown her net around me, and I know not how soon I may cry, ‘Pecavvi!’ and yield up my right to flirt with whom I please.”  Kitty, Powell noted, “is a sensible little beauty, and if the spasm will stay in me long enough, and she will say ‘yes,’ why I don’t believe I could do better.”  To his old friend McClellan, Hill opined that Kitty was “gentle and amiable, yet lovely, and sufficiently good looking for me;” he felt his old friend would “like her, and when you come to know her, say that I have done well.”  He closed the letter with an invite to the wedding, to be held at the Morgan family home in Lexington.

Kitty and Powell married on July 18, 1859.  Kitty wore a silk wedding dress; Hill wore his blue lieutenant’s dress uniform.

To Hill, Kitty was forever “Dolly.”  This was the nickname Kitty was given by a black servant charged with caring for the Morgan children.  He was proud of her musical talents.  She possessed the same sense of charm that Hill did, and the couple made friends easily in Washington society.

Undoubtedly, she must have known of Hill’s “youthful indiscretion,” for she knew of his other affairs.  Powell wrote Lucy to not “tease Dolly about Miss Wilson and my other affair.”  The other affair could only have been the infamous affair with “Miss Nelly” — that affair ended abruptly when Mrs. Marcy let out word that Powell had contracted a venereal disease at West Point.

When Hill resigned his commission to cast his lot with Virginia, Dolly dutifully followed him.  What her thoughts at the time were are uncertain, but she probably enjoyed being the wife of a successful Confederate general.  When their Culpeper home became untenable, Dolly attached herself to the Army.  General Scales noted, “Mrs. Hill is not satisfied with remaining here after all the ladies had been ordered away & all the other had left, but said she had no home & she might as well make Orange her home as any where else.”

Unlike Mrs. R.S. Ewell, Dolly apparently did not interfere with military affairs or with the staff of the Light Division or the Third Corps.

But she followed her husband closely.  She would roll her jewelry and other valuables into her chesnut hair for safekeeping and set out with the Army.  Sometimes she followed too closely and apparently she was a spunky woman with a nose for adventure.  According to legend, one night Dolly learned that cavalry general Philip Sheridan was expected in a hotel not far from Confederate lines. Dolly snuck into enemy territory in hopes of picking up useful military information. But, she quickly became an object of suspicion and had to flee with shots ringing out behind her.

The couple had four children, all girls.  Two of these daughters lived till adulthood; one was born after her father was killed at Petersburg.  Dolly and the Hill children were popular with General Lee.  In a letter, Dolly noted that Lee “comes very frequently to see me. He is the greatest and best man on earth, brought me the last time some delicious apples.”  J. William Jones recalled a story about Lee and Lucy Hill

In calling one day in Petersburg upon the accomplished lady of the gallant and lamented General A. P. Hill, his bright little girl met him at the door and exclaimed, with that familiarity which the kind-hearted old hero had taught her: ” O General Lee, here is ‘ Bobby Lee ‘ (holding up a puppy): ” do kiss him.” The general pretended to do so, and the little creature was delighted.

Lucy Lee Hill, one of his two daughters who survived to adulthood, had been christened with Lee as the godfather during the winter of 1863.

Dolly and Powell spent the night of April 1, 1865 together.  On the morning of April 2, Hill parted from his wife and rode out to attempt and rally his lines that were broken beyond possibility of repair.  Soon thereafter, he was shot through the heart and instantly killed.

Dolly was seven months pregnant.  Lee entrusted Hill’s trusted chief of staff, Colonel William Palmer, to tell Dolly the terrible news.  She was engaged in small household tasks and singing.  When she saw Palmer, she threw up her hands in anguish and cried, “The General is dead! You would not be here if he had not been killed!” Palmer tried to temper his news that he didn’t know if Hill was indeed dead or not only that he had been shot, but a few minutes later soldiers came back carrying his lifeless body. Members of his 5th Alabama Regiment had gone out and recovered Hill’s body. When his gauntlets were removed, Dolly noted how conspicuous his wedding ring looked on his mangled hand.  For two days she rode next to his body as first an attempt was made to bury him in Richmond’s Hollywood Cemetery, then as the body was transfered to Chesterfield for burial in a family cemetery.

It was probably this final experience that embittered Dolly towards the Confederacy and “The Lost Cause.” ¹  She did not participate in post-war activities, although she did give permission for Hill’s body to be buried underneath the statue it now reposes under in Richmond.  She never again went by the name Dolly after Hill’s death.  Not content to wear black for the rest of her life (like Mrs. Jeb Stuart, for example), she remarried in 1870, this time to a doctor, but again outlived her husband.

Despite her dislike for the “Lost Cause,” Mrs. A.P. Hill was among the longest lived of the Confederate generals widows.  She died on March 20, 1920 in Lexington, Kentucky.  She is buried there as “K. Forsyth” — under the surname of her final husband.

1. Dolly was also no doubt broken by the death of her brother John Hunt Morgan as well. [↩]

the cadiz turtle snaps

I reached the Gettysburg Campaign in re-reading Freeman’s classic Lee’s Lieutenants and decided to take a break and re-read parts of Sears’ book on Gettysburg.

Which got me thinking about the campaign and specifically Meade’s handling of the retreat from Gettysburg. This isn’t a reflection on Sears or Freeman; it is just reading about Gettysburg and working on the Monument Project that led to this rambling.

Customary warning that I’m a Meade defender, a Meade champion if you will. ¹

In his farewell address to the Army of the Potomac, Meade wrote:

It is unnecessary to enumerate here all that has occurred in these two eventful years, from the grand and decisive Battle of Gettysburg, the turning point of the war, to the surrender of the Army of Northern Virginia at Appomattox Court House. Suffice it to say that history will do you justice, a grateful country will honor the living, cherish and support the disabled, and sincerely mourn the dead.

History has largely rehabilitated Meade’s reputation and done him justice. Once sullied by Sickles and his Historicus crew, most historians now give Meade more credit than just bumbling and stumbling his way into victory against Lee.

(There still is an obsession with finding out why the South lost at Gettysburg, however, as though it could not simply be that for three days in July Meade and his crew out-fought Lee and his. As Pickett put it so succinctly, the Yankees did have something to do with it. In this way, the Army of the Potomac has not really been given complete justice.)

In doing the monument studies and looking individually at each of the regimental commanders in the Army of the Potomac, you can’t help but get struck by just how badly beaten up Meade’s Army was in terms of it’s officer corps. Critics of Meade who feel he should attack Meade should actually consider what Meade had to work with.

It is true the Army of Northern Virginia was badly beaten up too, but at least Lee retained his three corps commanders. Meade lost Reynolds, Hancock, and Sickles — the former two probably his two best corps commanders; the latter maybe his worst but in-arguably one of his most aggressive. He was left with “Tardy George” Sykes, Henry “Slow Come,” “Uh Oh” Howard, Sedgwick (probably the best of the bunch but utterly cautious), and Pleasanton (the most aggressive one left; he was destined to be eventually sacked). Of his arguably best fighting units — the First, Second, Sixth, and Fifth Corps — the 1st was effectively destroyed, the Second was badly injured and left under the command of the rather forgetable William Hays, and the Fifth had suffered significant casualties. Only the Sixth remained in-tact, but it was under the command of one of the most cautious generals in the Army (and considering we’re discussing the AOP, that is saying something!).

Meade was supposed to coordinate his Army to attack, yet look at the loss in officers in the Army of the Potomac at brigade and regiment level. With no time to reorganize, much of Meade’s Army was left under the command of captains and sometimes even lieutenants. Not exactly an effective fighting force. Plus, some regiments of 9-month men continued to be mustered out as July ended.

Considering how badly broken his officer corps was, it was a wonder Meade was able to organize and mount any type of a pursuit, let alone destroy Lee’s Army.

This is a consideration I’m sure others have voiced, but I don’t think gets enough play in evaluating Meade.

1. Not to the extent I am an A.P. Hill champion, of course. I just have always, for whatever reason, liked Meade. [↩]

monstrous fine

I am rethinking my prior post where I confessed to devouring an entire bag of potato chips. After all, I do not want to go down in history like Irvin McDowell.¹ A subordinate officer recalled of this rather large Union general:

At dinner he was such a Gargantuan feeder and so absorbed in the dishes before him that he had but little time for conversation. While he drank neither wine nor spirits, he fairly gobbled the larger part of every dish within reach, and wound up with an entire watermelon, which he said was “monstrous fine!”

When Sherman was planing to engage in “total war” against the Confederacy, don’t you just have to wonder if he at least considered just setting a hungry McDowell loose in the Confederate heartland to eat until his heart’s content?

Certainly, that would have quickly starved the Confederacy into submission.²

1. Given my luck, all I would be remembered for is my ability to eat potato chips. Perish the thought. [↩]
2. McDowell’s appetite was so impressive, I even named my favorite angelfish after him. That fish could EASILY eat any other fish under the table. Unfortunately, telling the gender of angelfish is not easy; one day, Irvin laid eggs and became Irvina. [↩]

13 down, 3 to go

I managed to just squeak through treatment number 13. It was the worst treatment since the first, mainly because of severe anticipatory nausea and a terrible attack of acid reflux. And that’s all I am going to say about it.

I thankfully have only three chemo sessions left to go.

And, for those wondering, no, Robert Krick did not mess up my PET scan. Other than a high SUV of 6.2 throughout my skelton, my PET was clean. My chest masses seem to have disappeared. My spleen is still enlarged, although even that is shrinking. Other than the spleen and the high SUV in the marrow which we are near certain is being caused by the marrow being thrown into overdrive by Aransep, Neulasta, and chemo itself, I would be “normal.”

This is all good stuff, I just wish chemo would not be so difficult and that I could get some sort of hold on this crazy anticipatory nausea stuff.