The Civil War saw the first United States military decorations. The Navy Medal of Honor arose from a public resolution signed into law by President Lincoln on 21 December 1861. It authorized the preparation of 200 medals of honor to promote the efficiency of the Navy. It was followed by a joint resolution of Congress on the same day which approved the design and defined requirement eligibility of the potential recipients. The Army Medal of Honor was established by a joint resolution of Congress, July 12, 1862 with an effective date; of April 15, 1861. The Medal of Honor was originally only to be presented to enlisted men for heroic service in the United States Army. However, as the war continued the award of a Medal of Honor was extended to include Army officers.
Union Officers began creating unit doctors as early as1862 when the officers of General Kearny's division ordered a gold medal after the General's death to commemorate serving under his command. The next Division commander ordered a bronze cross for award to enlisted men of the division. Other private medals were the Gilmore Medal stuck by General Gilmore for his troops around Charleston, SC and the Butler Medal for colored troops in the Battle of Newmarket Heights in 1864. Most of these were paid for by the commanders and had limited use.
Following the Civil War, there was an absolute explosion of veterans commemorative medals, reunion medals and badges. The Grand Army of the Republic reunion medals began to so closely resembble the Medal of Honor that Congress was historically forced to change the Medal of Honor and to patent its new design. (See page 58 for example.)
In 1905 President Roosevelt authorized campaign students retroactive to the Civil War. The Civil War Campaign Medal (Army) was issued for any federal army service between April 15, 1861 an April 9, 1865 (with extended service in the state of Texas through August 20, 1866). The Navy and Marine Corps were also authorized Civil War Campaign Medals, with each service having a different design on the reverse of the medal. The original Army campaign medal had a red, white and blue ribbon which was changed in 1913 to match the Navy and Marine Corps Civil War Medal blue and gray ribbon design.
Confederate soldiers only received recognition from the hands of the United Daughters of the Confederacy who designed and stuck a handsome Southern Cross of Honor. The design is a Maltese Cross with the battle flag of the Confederate forces on the face, surrounded by a reef of laurel with the inscription, "United Daughters of the Confederacy to the UCV" The reverse of the cross has the Latin motto of the Confederate States' "Deo Vindice" (God our Vindicator) with the dates 1861-1865. On the four arms of the cross are the words "Southern Cross of Honor". Beginning in 1900 approximately 80,000 crosses were awarded, with the last Cross of Honor presented posthumously in 1959 to Confederate Rear Admiral and Brigadier General Raphael Semmes.