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Annals of Workers Comp: Origins of the Ambulance
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Annals of Workers Comp: Origins of the Ambulance

The next time you hear the siren of an ambulance, think of Edward Dalton. He was born in Lowell MA in 1834, the son and grandson of physicians. He became a medical administrator during the civil war, but he was no ordinary administrator. Stepping into a situation where infection and disease killed far more soldiers than bullets, he recognized the need to remove the wounded from the battlefield and treat them in reasonably sanitary conditions. His largest hospital on the James River comprised 1,200 tents across 200+ acres, where he treated nearly seventy thousand soldiers for battle wounds, dysentery, pneumonia and other problems. Talk about logistical challenges!

This vast medical support infrastructure would be useless if the wounded were unable to get to it. Beginning with the bloody battle at Antietam, the Union army developed an ambulance corps of a thousand horse-drawn wagons, known as "gut-busters" for their excruciatingly painful ride.

City Emergencies

After the war, Dalton went to work for Bellevue Hospital in New York City. Recognizing the same urgency needed in treating the acutely ill and injured in the city, he implemented a "rapid response" system that used police wagons to transport people to Bellevue. Then he worked with Abbot-Downing Company, a New Hampshire manufacturer of stagecoaches, to design a light yet sturdy horse-drawn vehicle large enough for a driver, a surgeon and two patients lying down (or eight sitting up). A foot pedal connected to a bell cleared the roadways. The vehicle contained a couple of stretchers, a cabinet stocked with whiskey and bandages, a stomach pump for the poisoned and suicidal and a straightjacket for the unruly.

The last of the horses used to pull the Bellevue wagons were retired in 1924. Fast forward a few decades and you have the modern ambulance.

For all his brilliant skills, Edward Dalton lived a star-crossed life. His only child died in 1868 and his wife died in childbirth the following year. Plagued by chest pain and a hacking cough (likely TB), Dalton moved to California, where he died alone in 1872, age 37. Few today even know his name or his formidable contribution to health care. May we all be counted among those who do.

Source: Bellevue: Three Centuries of Medicine and Mayhem at America's Most Storied Hospital, by David Oshinsky. A wonderful book, highly recommended!  Photo: Bellevue Hospital Ambulance, New York Times, 1895, Wikimedia public domain - The Byron Collection / Museum of the City of New York.

Jon Coppelman
Senior Workers Comp Consultant

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