Preparing massive armies for large-scale combat engagements involved every single person and department, from providing ammunition to troops to delivering orders to and from commands. Besides the jobs that assisted in achieving strategic and tactical victories on the battlefield, the most important, and laborious, role in both the Federal and Confederate armies was care of the wounded. Influxes of thousands of wounded troops, ranging from bruises to full amputation of limbs, were needing immediate medical care. These surgeons were responsible for dispensing medications to conducting surgical operations to dressing wounds. It was all on their shoulders to save the lives of their comrades.
J. Julian Chisholm was one such surgeon who not only experienced preparing the hospitals for battle, but he also wrote the manual of instructions to teach future surgeons. Born in 1830 in Charleston, South Carolina, J. Julian Chisholm excelled in his career in medicine, as a physician and professor. When the war broke out in April 1861, Dr. Chisholm was operating his own surgical hospital in his hometown and was immediately recruited by the Confederacy for service in the Medical Corps.
By 1864, when he published his last edition of The Manual of Military Surgery, he had cared for the wounded at Fort Sumter, opened one of the Confederacy’s first general hospitals, established a medical purveyor’s office, and started a medical laboratory in Columbia. He understood nearly all aspects of operating a military medical corps by the time he wrote his manual. From experience in tending to the combat wounded to supplying medicines and equipment to surgeons, Chisholm wrote a section in his manual regarding the duties of surgeons on the battlefield.
“The surgeon on the battlefield must participate in the dangers, without the stimulation of the conflict; he requires, therefore, a double proportion of courage to sustain him in the trying part which he has to perform. Upon the even of a battle, the regimental surgeon has much to do to prepare facilities for the treatment of the wounded. “
Specifically, there were many supplies these surgeons had to gather prior to a battle to assist the wounded: instruments, anesthetics, water, astringents, and treats. These items are gathered to immediately care for the soldiers:
“He must see that the hospital stores are brought up with the ammunition wagons — as the articles for treating the wounded and saving the life of comrades are fully as important as those for the destruction of the enemy. He examines his stores, and satifies himself that nothing which will be required for the wounded has been omitted or forgotten. He examines his instruments, his supply of bandages, lint, india-rubber cloth, oiled silk, or waxed cloth, etc […] He sees that chloroform and opium, or morphine, the chief source of comfort to the wounded, are at hand in sufficient quantity. Water he has not overlooked […] He should be well supplied with astringents. He should also have a moderate supply of brandy to revive those exhausted from hemorrhage, oil to grease their wounds, and a little tea, sugar, and such medical comforts as will refresh and support the wounded.”
To move about where and when needed, surgeons needed to keep items with him. The “hospital knapsack” was a convenient way to keep what the surgeon needed on the go at all times. Chisholm writes extensively on the hospital knapsack, shown below: 
1. Julian John Chisholm, A Manual of Military Surgery, for the Use of Surgeons in the Confederate States Army (Columbia, SC: Evans and Cogswell, 1864).
2. Ibid., 133.
3. Ibid., 133-134.
4. Ibid., 136.