Permanent and General hospitals
1865—a Presbyterian church turned into a hospital with 41 beds, at Nashville|
A photograph which helps to explain the national pension roll: carver hospital in Washington, September, 1864
The figure farthest to the right, with the white cross on his breast, was recognized as his own portrait, a generation after the war, by Henry W. Knight, of Company B, Seventh Maine Volunteers, one of the veterans associated with the preparation of this Photographic history.
The cross is the corps badge of the Sixth Corps.
The man on his right is Cephas McKelvey, of the Eleventh Pennsylvania Volunteers, who was wounded in the arm. Both men were convalescent.
The personnel of these hospitals consisted of the surgeon in command, assisted by an executive and professional staff, and with the necessary number of stewards, clerks, attendants, cooks, laundry workers, guards, etc. Nursing and similar work was either done by details of soldiers from the line of the army or by civilians hired or volunteering for such duty.
the guard, necessary for the maintenance of order restraint of convalescent
patients and the protection of property, was usually composed of convalescent patients and members of the Veteran Reserve Corps.
The surgeon in command of a general hospital had full military control over all persons and property connected with his institution, reported directly to the War Department and surgeon-general and received his orders therefrom.
He usually had one or more assistants.
The medical staff ordinarily numbered about one to each seventy-five patients.
A medical officer of the day, detailed by roster, was always on duty, performing routine duties in relation to the proper management of the hospital and responding to any emergency in professional, administrative, or disciplinary matters.
The ward surgeons had duties almost exclusively professional and similar to those performed by the resident physicians of civil hospitals.
Two women are sitting by one of the cots.|
General S. P. Heintzelman and friends at the headquarters of the convalescent camp in Alexandria
The photographs on these two pages tell their own pathetic story—the story not of the wounded and suffering soldiers, but of their thrice-suffering womenkind.
To this convalescent Camp in Alexandria came the anxious wives and mothers, sweethearts and sisters to find their soldiers whom they had perhaps not seen for months or years.
The mourning of the woman on the veranda tells the tale of a soldier-boy that is gone.
Perhaps she has come to bring the aid and comfort to others which she was denied the privilege of lavishing on her brother or son. The quaint costumes of the time are very well illustrated in this photograph.
Then a woman apparently put on a cap at forty, sometimes before.
the little girls wear such
voluminous draperies that one wonders how they could get about at all. These were the days of the hoopskirt and the polonaise.
In the photograph to the right they have removed their quaint small hats, and look less like premature little women.
The little boys, in their ‘cunning’ Kate Greenaway costumes on the left-hand page, have evidently just come up to get into the photograph.
The officer lounging in the chair has turned his profile to the camera.
A great change in the type of women's faces can be seen since that time.
Women have changed more than men. The change is deeper than mere dress, and involves also her outlook upon the world.
But she is as ready as ever to relieve distress and suffering in war.|
Though the writer was never on the staff of a general hospital, he visited a large number of them, knew personally many medical officers assigned to duty in them, and was familiar with their general plan of operation.
The most valuable information concerning them, however, is to be found in a remarkable series of addresses and papers published in the Southern practitioner,
many of which had been delivered before the Association of Medical Officers
of the Army and Navy of the Confederacy
This series is an invaluable mine of information, and from it most of the facts given in the following pages are drawn.
It must be remembered, of course, that the men from whom I quote, whose writings are abstracted, or whose success is described, were among the most distinguished officers of the service.
Added to professional skill they possessed executive and administrative ability which would have won success under any circumstances.
That all the Confederate
hospitals were so successful, either upon the medical or upon the administrative side, is, of course, improbable.
The problem confronting the Medical Department and the manner in which it was met is thus stated by the surgeon-general
, Doctor Samuel Preston Moore
The only building in Richmond adapted to hospital purposes, the almshouse (a large brick building, well suited, capable of accommodating say five hundred patients), had been converted into a hospital,
Hospital ward in convalescent Camp at Alexandria
This is where thousands of fortunate soldiers got well from their wounds.
When the regiments marched away to the front, their barracks and other available buildings were turned into improvised hospitals.
Where the intended capacity was exceeded, tent wards were often pitched to supply the deficiency.
Generally, however, other buildings were taken over to provide for the surplus wounded.
These offshoots themselves were frequently forced to enlarge and, for facility of administration, were detached from the parent institution.
For instance, in the middle of December, 1864, there were sixteen such institutions within the corporate limits of the city of Washington alone, and a total of twenty-five, with an aggregate bed capacity of 21,426, almost within cannon-shot of the Capitol.
On this same date there were 187 general hospitals in operation, scattered all over the country from New England to New Orleans and from the Missouri to the Atlantic, and having the enormous total capacity of 118,057 beds, of which but 34,648 were then vacant.|
and occupied by the wounded prisoners of the Northern army from the battle just mentioned [Manassas]. The Confederate wounded from the same battle were treated in private houses, in small, unoccupied wooden buildings, and small tobacco-factories improvised as hospitals.
There were serious objections to this method of treatment of the sick and wounded, the principal being the liability of spreading contagious diseases among the inhabitants of the city; the aggregation of so many patients in the necessarily large wards of the factories, thereby contaminating the buildings, rendering them unfit for occupancy; and the impossibility of supplying by these means the further demands of the service.
To meet, as far as practicable, these requirements, the plan was adopted of erecting buildings, each one to be a ward and separate, of undressed planks set upright, calculated for thirty-two beds, with streets running each way, say thirty feet wide.
From fifteen to twenty of such wards constituted a division, three or more divisions making a general hospital.
Each division was separate and distinct, having all the appliances of a hospital, but under control and supervision of the surgeon in charge of the general hospital.
There were five of these hospitals in the suburbs of Richmond, erected in 1861.
At a rough estimate, twenty thousand patients were at one time treated at these general hospitals.
The plan proved to be excellent, and the temporary hospital buildings in the city were abandoned as soon as practicable, the larger factories only being retained and used.
This segregation of the sick and wounded was highly beneficial.
If the condition of a ward, from whatever cause, required its abandonment, it was done without trouble or much cost to the Government.
It may be stated that cases of hospital gangrene were, as a rule, removed from wards and treated in tents, with decided benefit.
General hospitals, on this plan, were established whenever and wherever deemed necessary.
This was sometimes attended with delay; for the Medical Department, instead of being an independent bureau, building and furnishing hospitals, had to depend entirely upon the Quartermaster's and Commissary departments.
Hence, much delay was experienced in obtaining proper hospital accommodations, and in such cases blame was attached to the medical bureau, which it never deserved.1
Doctor John R. Gildersleeve
, when president of the Association of Medical Officers
of the Army and Navy of the Confederacy
, in 1904, delivered an interesting address upon Chimborazo Hospital, Richmond
When the necessity for larger hospital accommodations became evident, SurgeonGen-eral Moore
, after consultation with Doctor James B. McCaw
, of Richmond
, chose Chimborazo Hill, on the outskirts of Richmond
, as a site for the new hospital, and Doctor McCaw
was placed in charge.
Some of the buildings were opened early in 1862, and before the end of the war one hundred and fifty wards had been constructed.
They were usually commodious buildings, one hundred feet long, thirty feet wide, and one story high, each ward having a capacity of from forty to sixty patients.
The buildings were separated by alleys and streets, and the hospital presented the appearance of a town of considerable size.
Five divisions were created, each in charge of a surgeon with the necessary assistants.
These divisions were arranged, as far as possible, upon the basis of States.
So far as possible troops from the same State were assigned to one division, and were attended by surgeons and attendants from that State.
The celebrated farm, ‘Tree Hill,’ was loaned to the hospital by Mr. Franklin Stearns
, and afforded pasturage for a large number of cows and several hundred goats.
The meat of young kids was found to be much relished by the soldiers.
‘The hospital trading canal-boat, Chimborazo
, with Lawrence Lotier
in command, plied between Richmond
, and Lexington
, bartering cotton yarn
and shoes for provisions.
This was only one of the hospital's many resources.’
An additional fact is that the hospital never drew fifty dollars from the Confederate States
Government but relied solely upon the money received from commutation of rations.
The total number of patients received and treated at Chimborazo Hospital amounted to seventy-six thousand (out of this number about
Officers and nurses at seminary hospital, Georgetown, April 1, 1865
The two neat nurses in the window, with their old-fashioned black mittens, may be held responsible for the bird-cage hanging by the door.
Neither they nor the chubby little boy sitting on the sidewalk in the foreground suggest war; yet this is a scene of April, 1865, before Lee's surrender.
It is well-nigh impossible for a man surrounded by the sights and sounds and scents of every-day civilian life to realize what a touch of femininity meant to a sick soldier far from home after four years of rough campaigning.
A chaplain was attached to most of these hospitals; his duties, besides those of a spiritual nature, having to do with correspondence with friends and relatives, supervision over the postal service, reading-room, library, amusements, etc. There was often much trouble in securing adequate nursing attendance, both in respect to the number and character of the personnel.
There were female nurses at many hospitals; some were Sisters of Charity, and representatives of women's aid societies often took turns in nursing and assisting in the diet and linen-rooms.
The sick were fed from the regular ration, or from articles purchased with the savings made on the unconsumed portions.
The latter fund was in some cases scarcely sufficient.|
seventeen thousand were wounded soldiers). . . . It was the first military hospital in point of size in this country and in the world, the next largest hospital in this country being the Lincoln in Washington, D. C., which represented a total number of forty-six thousand patients; and the next largest in the world at large was the Scutari Hospital in the Crimea, which represented a total of thirty to forty thousand patients.
The percentage of deaths at Chimborazo was a fraction over nine per cent.2
Doctor Alexander G. Lane
, surgeon in charge of the Winder Hospital
, from its organization in April, 1862, until the evacuation of Richmond
, has told in an interesting way of the organization of that institution.
The grounds covered one hundred and twenty-five acres, and the hospital, composed of six divisions, had a capacity of forty-eight hundred patients.
A dairy was organized, an ice-house was built, and there were large gardens, worked by convalescents, on the hospital grounds.
Here, as at the Chimborazo Hospital
, it was sometimes difficult to secure food suitable for the sick, and therefore Doctor Lane
had two canal-boats constructed, which made regular trips up the Kanawha Canal
, bringing back whatever supplies could be found in the country nearer the mountains, as yet undrained by the demands of the armies.
The bakery had a capacity somewhat larger than was necessary for the hospital, and at times baked, by contract, a part of the bread for the prisoners in Belle Isle
From a series of articles prepared by Doctor Samuel H. Stout
, Medical Director
of the Army of Tennessee, we learn that the change of climate caused much sickness among the troops drawn from the Gulf
States to Tennessee
during the winter of 1861-62, and that only by the greatest exertions was Medical Director Yandell
able to provide for the care of the sick.
Most of these were sent to
, and there Doctor Stout
himself, before his promotion, was placed in charge of the Gordon Hospital
, formerly an old warehouse.
This hospital had been in charge of a committee of ladies who had employed civilian physicians to attend the sick, and the hospital attendants were not under military discipline.
Through the exercise of considerable tact, Doctor Stout
reorganized the hospital and brought it under military rule without offending the sensibilities of the ladies.
was an excellent business man and required frequent statements from the commissary of the amount of money due the hospitals from commutation of rations, and the fund thus obtained was used liberally for the benefit of his patients, procuring for them articles of food to be had in the market.
When chickens, butter, and eggs were not brought to the hospital in sufficient quantities, he sent out wagon-loads of cotton yarn
purchased from the factories, and exchanged it for the much needed delicacies.
After his promotion to the office of medical director, Doctor Stout
was particularly insistent that real coffee should be served the patients in the hospitals under his control, and sent subordinates to Wilmington
to purchase it from the blockade-runners.
A bakery was established at every hospital, and the saving thus made inured to the benefit of the hospital fund.
He even went so far as to purchase at Chattanooga
a printing outfit on which the numerous blanks needed for the use of the various hospitals were prepared.
This was placed under the charge of privates detailed for the purpose and soon became a source of income.
Seeds were bought for gardens, and, when the number of convalescents was not sufficient to work them, labor was paid from the hospital fund.
Cows, horses, and wagons were purchased whenever needed, without waiting for the formal approval of the surgeon-general
. ‘I thought that economy of
expenditure was not to be considered urgent.
The great undertaking was to find the materials needed.’
, Doctor Stout
caused hospitals to be constructed upon an entirely new plan, which he maintained was far superior to that followed in the building of the Chimborazo Hospital
, and which ‘was evidently an imitation of the models of such buildings long in use in the Federal
His objections to the plan of Chimborazo
were that its width afforded space for more than two rows of bunks and that, when windows and doors were necessarily closed on account of the weather, ventilation through the roof was not sufficient.
He thus describes the new plan:
The pavilion wards erected under my direction, were of such width that only two rows of bunks could be arranged or accommodated in them.
The bunks were placed crosswise of the room, the head of each being from one and a half to two feet from the side wall.
Thus, an aisle or vacant space of from eight to ten feet in width was left in the middle of the ward throughout its entire length.
Sometimes the wards were built one above another.
Near the floor, and just under the ceiling overhead, were longitudinal openings with sliding shutters, one foot in width, that could be closed or opened at the will of the surgeon in charge.
Overhead, in the ceiling, were also openings with sliding shutters, and latticed structures on the comb and in the gables, which were opened or closed as occasion required.3
also provided a general register at his headquarters for all the hospitals under his direction.
The surgeon in charge of every hospital was required to send daily any changes in his register.
These were entered upon the general register, and it was therefore possible to find the whereabouts or the fate of any patient in a few seconds.
In addition to the general hospitals established for the treatment of patients until they were convalescent, ‘wayside’ hospitals were established at every important junction-point.
A Federal officer wounded at pine mountain, Georgia—August, 1864
This unusual photograph of an officer still on crutches, emaciated and suffering, was taken in August, 1864, near Pulpit Rock, Lookout Mountain, Tennessee.
It is reproduced here through the courtesy of the officer himself—Major (later Colonel) L. R. Stegman, associated with the editors in the preparation of this work.
In June, 1864, during Sherman's march to Atlanta, he was shot in the thigh, the shot fracturing the bone.
Major Stegman was in command of the Hundred and Second New York, which was attached to the twentieth corps of the Army of the Cumberland.
A wound of this character disabled the victim for many months.
Colonel Stegman's companion in the photograph is Lieutenant Donner, of an Ohio regiment, also wounded in the thigh and using a cane for support.|
In these were treated soldiers taken suddenly ill, convalescents who had overestimated their strength, and wounded whose condition forbade further travel.
Some of the general hospitals established received high praise from Federal sources.
For example, the lamented Doctor Stanford E. Chaille
, of New Orleans, in a private letter written just before his death, tells of the capture of himself and his hospital at Macon, Georgia
, by Wilson
's cavalry, and goes on to say that he ‘was treated by General Wilson
's medical director with marked consideration and to many favors, . . . and he urged me to continue in charge, on Federal pay, retaining my Confederate inmates, and admitting to separate wards Federal sick and wounded.
My feelings were then too bitter to accept his generous offer.’
At the beginning of the war, many private hospitals were established wherever troops were stationed for any length of time.
These were generally under the control of a committee of women anxious to do something for the good of the cause, and under the charge of a citizen-surgeon of their own selection.
The nursing was almost exclusively volunteer, but rations were furnished in some cases by the Confederate Government.
Many of these were well conducted and did good service, particularly during that period before the general hospitals were built and the medical staff thoroughly organized.
When the Medical Department became able to take care of all the sick and wounded, it seemed best, for obvious reasons, that all sick and wounded should be brought under direct supervision of the Medical Department, and a majority of the private hospitals were discontinued.
One of them, however, established in Richmond
just after the first battle of Manassas
) by Miss Sally L. Tompkins
, deserves mention.
Doctor William Berrien Burroughs
says of this hospital:
Ten days after the battle, on July 30, 1861, entirely at her own expense she opened the Robertson Hospital (corner of Main and Third streets) which continued its mission of mercy to July 13, 1865.
This Confederate hospital over fourteen hundred soldiers were nursed and received the best of attention.
Private hospitals became so numerous that a law was passed that they be discontinued, and no hospital was allowed except those in charge of a commissioned officer with a rank not lower than that of captain, that being the rank of an assistant surgeon.
When this law was being executed and the ambulances were at the hospital door, Miss Sally remonstrated.
The Secretary of War was consulted but said he was powerless and that President Davis was the only man that could annul the order.
Her hospital register was shown the President.
The death-rate was very small.
The number of men returned to the army was very large; in fact, her hospital record of deaths was lower than, and her record of soldiers returned to their commands was greater than, that of any other hospital in Richmond. . . . On receipt of this information the President commissioned her captain.4
Though the germ theories of Lister
and Pasteur had not yet been advanced, mention has already been made of some instances of accidental asepsis.
From necessity or experience, surgeons in the hospitals sometimes adopted methods which prevented infection of wounds, so common in all surgery at that time.
For example, Doctor C. H. Tebault
One blessing we enjoyed, due to the blockade, was the absence of sponges, clean rags being substituted for them with telling advantage.
These rags could be thoroughly washed, as was done, and used over and over again.
It is next to impossible, easily, if possible at all, to wash an infected sponge.
This fact and the unstinted use of a plentiful supply of pure well or spring water, and the pure condition of the air of the hospitals, . . . were not without their wholesome effect.
On the other hand, Doctor J. J. Terrell
, in connection with his service at General Hospital No. 1
, Lynchburg, Virginia
, in 1863, began to treat cases with dried-lint dressing to exclude air from the wound, ‘not upon a germ theory, which was then unknown, but upon the theory of oxygen and moisture causing decomposition.’
Armory square hospital—where Lincoln walked among the flowers
Perhaps it was because of President Lincoln's habit of visiting the Armory Square Hospital in Washington that so much care has been bestowed upon the flowers.
The walks are straight and even, and the scene, except for the ambulance standing near the curved walk, seems one of peace and not of war. The Capitol rises majestic in the background, and to the left is the little chapel attached to the hospital.
Earnest people entered there to send up a prayer for the soldiers who were wounded in the cause of their country.|
There was no central organization controlling the women nurses as in the North
, but there was seldom any lack of feminine attention in the permanent hospitals.
The greater part of the service was rendered entirely without remuneration, and, if paid for, the amount was trifling.
The women of the South
considered it a privilege to act as nurses and hospital attendants.
So many were they and such valuable services did they render, that it is almost an injustice to mention the few and omit the names of hundreds.
Miss Emily Mason
, niece of James M. Mason
, Confederate commissioner to England
, was the matron of one of the divisions of the Winder Hospital
, while Miss Mary L. Pettigrew
, sister of General Pettigrew
, served in the same capacity, first at Raleigh
, and then at Chimborazo
Mrs. Archibald Cary
did effective service at Winder
, where she was assisted by her daughter, later Mrs. Burton N. Harrison
The daughters of General Lee
, Mrs. G. W. Randolph
, and many others were frequent visitors to the Richmond hospitals
, where they read to the convalescents, wrote letters for them, and fed them.
Mrs. Felicia Grundy Porter
, of Nashville
, gave freely of her time and means; Mrs. Gilmer
, of Pulaski, Tennessee
, served as nurse and matron at various hospitals; Mrs. Ella Newsom
, a wealthy young widow, left her home in Arkansas
with a number of her own servants and went to the seat of war in the West
, serving first at Memphis
, then at Belmont
, Bowling Green
, and Chattanooga
Nor must the work of the Roman Catholic
sisterhoods be neglected.
The nursing in some of the hospitals was entirely under their charge.
At others, they worked with nurses appointed by the surgeons, or with volunteers.
Every city or town containing a convent had in the inmates willing workers, who went where sickness and suffering were found.