When Lt. Col. George Armstrong Custer's 7th Cavalry executed its movement up Rosebud Creek to the Little Bighorn River in late June 1876, it was supported by a medical staff of three physicians. The senior man and the only commissioned US Army doctor was 1st Lt. George Edwin Lord, the Assistant Surgeon to the regiment. He was supported by Dr. James Madison DeWolf and Dr. Henry Rinaldo Porter, both contract surgeons hired specifically for the campaign. During the combat on the afternoon of 25 June 1876 along the Little Bighorn, Lord was killed with Custer's five-company battalion; DeWolf died during the retreat of Maj. Marcus Reno's three-company battalion from its abortive attack on the southern end of the Indian villages. This left Henry Porter as the only physician available to treat the many wounded for some forty-eight hours.

Historians have paid relatively little attention to the US Army's preventive medicine, battlefield medical treatment, and care for ill and injured,[1] although recent scholarship is beginning to remedy this omission. Joan Stevenson's biography of Doctor Porter comprehensively assesses how contract surgeons were hired and administered by the Army, and how medical support was provided throughout the Indian War. She focuses on Porter's actions during the Great Sioux War and particularly at the Battle of Little Bighorn, 25–27 June 1876.

Stevenson, an independent scholar (PhD Stanford), begins and ends her biography with Porter's dramatic testimony at Marcus Reno's court martial at the Palmer House Hotel in Chicago in January 1879. Appropriately so, for this appearance first brought Porter's name and his contributions at Little Bighorn to the public's attention. The second chapter, "The Starting of a Young M.D.," treats in detail the Army's supplementation of its meager medical staff by the hiring of contract surgeons (a procedure it still employs today). It reviews Porter's medical education and his extensive experience as a contract doctor during Maj. Gen. George Crook's 1872–73 campaigns against the Apache Indians in the Arizona territory.

The majority of the book—seven of its eleven chapters—concerns Porter's participation as an Acting Assistant Surgeon with the 7th Cavalry in the 1876 campaign. At the time, Porter, although young for a surgeon, was already an accomplished horseman, devoted hunter, and experienced campaigner. He was both active and vigorous. By contrast, Doctor Lord suffered poor health and illness throughout the campaign. When Custer organized his regiment into three battalions on the morning of 25 July, Porter offered to relieve Lord so that the older, ailing man could remain in the rear with the baggage train. Knowing combat was imminent and as the regiment's senior surgeon, Lord insisted on staying with Custer and his battalion. He thereby inadvertently saved Porter's life while losing his own. Porter accompanied Reno's attack on the southern portion of the large Indian villages west of the Little Bighorn.

Stevenson devotes a full, meticulously detailed chapter to Porter's part in Reno's assault. Rarely can biographers track so precisely the movements and activities of a single individual on a battlefield. We read here of Porter's treatment of a wounded soldier with a pocket medical kit directly behind the skirmish line and his desperate retreat from the battlefield. Entirely focused on his medical duties, he escaped the closing Indian trap only because he was warned by scout "Lonesome" Charlie Reynolds, who was killed shortly thereafter. Porter had gone unarmed to the battlefield, having actually turned down a weapon offered by Major Reno, a decision he rued as he ran the Indian gauntlet, barely making it across the river and up the bluffs. Only his fine horse and superb riding skills saved him from DeWolf's fate.

Two chapters (6 and 7), the heart of the volume, describe events at Porter's field hospital, located in a shallow depression at the center of the defensive configuration set up by Reno and Capt. Frederick Benteen. Individual casualties, the nature and severity of their injuries, and Porter's assessment and treatment of the wounded are thoroughly discussed, as are the challenging medical conditions and complications that confronted him. He was assisted only by untrained soldiers—his medical orderlies had been killed in the afternoon retreat—and had to cope with a lack of medical supplies, water, and rations, while his patients were exposed to dreadful heat and Indian gunfire. For three days, he was the sole caregiver for nearly sixty wounded soldiers and two wounded Indian scouts. Only on the afternoon of 27 June did another contract surgeon, Dr. Holmes Offley Paulding, in Gen. John Gibbon's column, reach Porter to relieve him.[2] Although he was fully involved in treating the mounting casualties, Porter still found time to locate the body of his friend Doctor DeWolf together with many personal items that he subsequently sent to DeWolf's widow.[3]

Stevenson dedicates two chapters to the evacuation of the wounded to the Yellowstone River and their travel aboard the steamboat Far West to a more permanent medical facility at Fort Abraham Lincoln. Porter was entirely responsible for the care and treatment of the men throughout this transfer, since Paulding had returned to the column being led by Colonel Gibbon and Gen. Alfred Terry. In fact, Porter accompanied the 7th Cavalry casualties during their whole trip back east. That only three men—all of them critically wounded—died during this lengthy and difficult journey speaks volumes about his excellent medical skills and committed care. Another chapter concerns Porter's court martial appearance, Major Reno's attorney's attempts to challenge his testimony, and the descriptions by various reporters of his demeanor on the witness stand. The final chapter discusses Porter's leadership in establishing the US Army's Association of Acting Surgeons. This organization comprised contract surgeons like Porter who believed their many services had been inadequately appreciated and recognized by the nation.

The chief value of the biography lies in the extensive information it offers on the establishment of the Army Surgeon system, the role of contract surgeons in augmenting the badly undermanned Army medical staff, and the operation itself of the contract system. Also valuable is the exhaustive discussion of medical knowledge and practices in 1876, particularly concerning avoidance and treatment of infection, which was not then well understood. The methods used by physicians like Porter to treat battlefield wounds have rarely been addressed by historians, which makes Stevenson's careful medical assessment particularly fascinating and novel. She describes the types of amputations Porter performed even under the difficult conditions immediately after the battle. Some may find her technical medical discussions distastefully explicit and gory, but such a degree of graphic detail is necessary to medical accuracy.

Porter has been the subject of another recent biography, by L.G. Walker, Jr.[4] However, it recounts the story of his entire life, stressing his contributions as a founding father and early civic leader in Bismarck, North Dakota. Walker also delves at length into Porter's personal and family life, and worldwide travels between 1893 and his death in 1903. He devotes only six pages to Little Bighorn, fifteen to the rest of the Sioux War, and eight to Porter's court martial appearance. Thus, Stevenson's biography nicely complements rather than reiterates the material in Walker's work; it will be preferred by those with a strong interest in military history.

The book contains full reference notes, a bibliography, an index, and an epilogue summarizing the lives of featured individuals. It is liberally illustrated with photographs, including several of handwritten documents by Porter and the surgical pocket case and amputation kit he used at Little Bighorn. The only serious deficiency is the lack of either an overall campaign map or any serviceable individual battlefield maps.

This well-written, lively, detailed, precise, and exhaustively researched study makes a valuable contribution both to the history of Little Bighorn and to our understanding of the role of Army surgeons throughout the Indian Wars period. One only wishes Stevenson had expanded her work to provide still more information on the roles, responsibilities, procedures, medicines, and medical techniques of Army surgeons in the latter half of the nineteenth century. This minor critique notwithstanding, she has certainly produced a engrossing biography that will interest all students of the Battle of Little Bighorn, the 7th Cavalry, the Indian Wars, and the US Army of the period.