Bowers, Russell V. "A Confederate General Hospital: Chimborazo Post (1862-1865)." The Scarab, Medical College of Virginia alumni magazine. November 1962.
The Confederate medical history of Chimborazo Hospital located east of Richmond, Virginia, in Henrico County, has been neglected. It wasn't included in the General Index of the "Official Records," but fortunately the Confederate records of this hospital are now in the National Archives. These rare documents of some 168 manuscript volumes give some insight into Confederate hospital care and management. The best medical and surgical care of the sick and wounded is exhibited. It is a challenge to the medical-history scholar.
The Confederate medical department was organized from scratch. The individual states offered their state guard and militia for the embryonic 36,000-man army—the medical service was started from former U. S. Army surgeons, professors, and instructors from Northern and Southern medical school faculties, private practitioners, and many who had never been to medical school but had served an apprenticeship in the office of an established physician.
All Southern medical colleges were closed for the duration of the war, with the exception of the state institution, the Medical College of Virginia, in Richmond, which usually ran only one session a year. Other students had to take their training on the battlefields or in the hospitals, such as Chimborazo, Howards Grove, MCV, and other local hospitals.
The U. S. Army medical corps was not very well prepared either. It consisted of only 98 surgeons and assistant surgeons. Medical supply had only 20 clinical thermometers and didn't acquire an archromatic microscope until 1863. Laryngoscopes, ophthalmoscopes, and stethoscopes were barely known in the U. S. Army. Hypodermic syringes were seldom used.
In the Peninsula Campaign in the spring of 1862, almost 5,000 wounded were brought into a Union field hospital where there was only one surgeon and five hospital stewards to care for them. These were lean days for men and materials.
In the spring of 1862, the Confederate Army, under General Joseph E. Johnston, was encamped in Northern Virginia's March, red mud, only twenty miles from Washington. The Federal forces were moving in, and some 9,000 sick and wounded men had to be evacuated before the Confederate Army could be moved to the Peninsula to join General John B. Magruder's hard-pressed defenders of Richmond.
The newly-appointed Surgeon General of the Confederate Army, Dr. Samuel Preston Moore, had his hands full in the Confederate capital. There were only 2,500 beds available. In this moment of great emergency, Dr. Moore called upon Dr. James B. McCaw, professor of chemistry and pharmacy, Medical College of Virginia, to provide hospital care, independent from the army, for these evacuees. This distinguished, magnetic, thirty-nine-year-old gentleman had a great passion for work and order and a genuine genius for getting things done. He was to be the man of the hour.
At once, he selected the land on Chimborazo plateau, just cast of the city line for the site. It was no doubt named long before by some international traveler, probably because of its likeness to the extinct volcano in the Andes of Central Equador that could be seen from many miles at sea. Here was a natural forty-acre site, overlooking the James River basin. It was about a mile from Academy Square where the MCV Egyptian building and hospital were located. Ironically, looking down the James River, less than ten miles away, was the site of the first hospital established by the Jamestown English on the North American continent, The University College and Hospital at Henricopolis, long asleep in the massacre of 1622.
Soon, about 150, well-constructed, naturally ventilated, whitewashed wooden buildings were erected. Each ward measured 100 by 30 feet, was one story, had 10 windows, and accommodated 40-60 bed patients. These dimensions allowed for two rows of cots on each side of a center aisle and a centrally located stove. In addition to these buildings, there were 100 Sibley tents, quartering 8-10 soldiers or convalescent patients. This all provided a bed capacity of nearly 7,000. The buildings were separated from each other by wide streets which were clean and orderly. Dug wells were sanitarily located at the ends of the streets. There was a sewage disposal system. The atmosphere was of a newly-erected town, functioning independently as most towns do.
A large private house, north of the hospital, was made medical headquarters. It was occupied by Medical Commandant McCaw and the chief surgeons of the five new divisions, with their clerical forces.
Captain Thomas E. Ferrell and 30 soldiers were stationed on the grounds to maintain law and order. The guardhouse and five dead houses were located just north of the hospital grounds. Oak-wood Cemetery was three-quarters of a mile to the northeast. It was a small country cemetery but in the next three years was to receive 16,000 Confederate dead.
The inactive tobacco factories, nearby, furnished boilers, which were used in making soup in the soup houses. The large supply of seasoned wood used in making tobacco boxes, etc., were fashioned into beds and other furniture. Local churches donated their pew cushions for mattresses. The tobacco warehouse workers were put to work doing manual labor, serving in kitchens and wards, and cultivating the hospital farm which was located on "Tree Hill." Here were pastured several hundred cows and up to 500 goats. The bakery was enormous, sometimes 10,000 loaves were baked daily. Soap was made out of the grease from the soup houses. A brewery produced 400 kegs of beer at a time, which were stored in caves at the bottom of the plateau and also in five large ice houses.
To procure fresh vegetables, poultry, eggs, and other necessities, there was the canal boat, Chimborazo, which tied up at the foot of the hill. It bartered between Richmond, Lynchburg and Lexington, under command of the canny skipper, Captain Lawrence Lottier.
Alcoholic stimulants were the most popular drugs by choice of the Confederacy. Nearly $4,000,000 or 20% of the 1865 Army medical department appropriations were for this drug. The law provided that spirituous liquors required by hospitals should be entrusted to the matrons. They no doubt encountered considerable opposition when they entered into what was regarded as domain reserved for males. At the Medical College of Virginia hospital, this drug seemed to be under the dean's lock and key.
The Table of Organization (1862) for Chimborazo Hospital was as follows:
* indicates an alunmus of MCV, () after name, year of graduation, X first name, an assumption.
Surgeon James B. McCaw, Commandant and Medical Director in Chief
Surgeon Peter F. Browne (Accomac, Virginia)
* James C. Watson (1855)
* John G. Trevillian (1861)
J. Prosser Harrison
George W. Alsop
W. H. Pugh
John C. Baylor
* Charles A. Board
* Landon A. Woodson (1860)
Samuel C. Smith
* J. R. Gildersleeve (Acting) (1864)
Surgeon Stephen E. Habersham
Third Division—North Carolina
Surgeon E. Harvie Smith
Surgeon William A. Davis
Fifth Division—South Carolina
Surgeon E. M. Seabrook
The medical examining board, composed of division surgeons, passed on questions of furloughs and discharges. Other staff members were, John H. Claiborne, commissary; Colonel A. S. Buford, quartermaster; Paine and Kent, commission merchants. Mrs. Dr. Minge was chief matron. The Rev. Mr. Patterson, a native of Greece, was chaplain.
Besides those mentioned, the hospital contained an endless horde of stewards, clerks, cooks, bakers, brew masters, carpenters, shoemakers, ward-inspectors, ambulance drivers, apothecarists, dentists, and medical students.
One matron wrote, "I am living out at Chimborazo Hospital in a whitewashed board house through the planks of which I can see the stars and the snow too. It is divided into three parts: the first my parlor and chamber in one. The second my kitchen and the third my Laundry. . . . I have little sliding windows like the cabin of a ship, and when it rains I put my straw mattress in the center of the room as it comes through the planks. (The matrons received $45 a month and $15 for communication.)
The Medical College of Virginia oriented itself to wartime conditions and shortened its sessions to one or two classes each year. The faculty of eight, including Dr. McCaw, trained approximately 400 students during the war. There was a close relationship between the Confederate medical department and the Medical College of Virginia. Surgeon General Moore stated in meeting the needs of the service for medical officers, "a certain number of young gentlemen were annually appointed hospital stewards, with the privilege of attending lectures at the Medical College of Virginia, and on graduation, letters of invitation were issued them for examination for appointment in the Corps." It was in this sense that the College was a training school for future Confederate medical officers.
Physicians of the period were experts in clinical observation. Actually, they knew little about the cause of disease. Their treatments were almost entirely empiric and symptomatic. Almost none of the great discoveries that marked the beginning of modern medicine had been made until after the 1860's. Medicine of that day bears a closer resemblance to medieval medicine than it does to the 1960's.
In the absence of knowledge, for example, of the causes of putrefaction which followed most serious wounds, the surgeons of the 1860's followed the 17th century surgeon, Richard Wiseman—primary amputations in serious wounds of the extremities as soon as possible after wounding. Field hospitals were busy mainly with amputations, usually done under chloroform anesthesia. The preferred technique was the guillotine operation. The flap technique was too time consuming on the battlefield and seemed to result in more serious infection. The Southern surgeons, due to necessity, cleansed their operative wounds with rags and lint that had been cleaned, boiled, and ironed. Horsehair sutures were boiled to make them more pliant. No one, apparently, had time to write this up, but the Southern surgeons had empirically discovered asepsis.
In 1864, after two years of operation, Chimborazo Hospital had admitted 47,-176 patients and in the next year this figure would swell to 76,000, of which 17,000 were battle casualties. Seven thousand soldiers died at the hospital. The overall death rate was only 9%, which was remarkable for that period.
During the Seven Days Battle around Richmond in the summer of 1862, there were performed in all of the Richmond hospitals:
Leg 132 43%
Thigh 172 59%
Forearm 45 13%
Arm 192 28%
Resection of a joint 17 35%
Ligations 17 64%
To be wounded in this war meant to be dead or an amputee. Nearly 80% of all wounds reported were of extremities; and interestingly enough, the principal weapon of the war, one by which 80% of all wounds were produced, was a single-shot, muzzle-loading rifle in the hands of foot soldiers.
If a soldier was retired from the service, he could apply for the new Confederate Veterans GI Bill,
"Adjutant and Inspector Generals Office
Richmond, Virginia, November 21, 1864
General Order #84
III, Paragraph XIII, General Order No. 34 (current series), is amended to allow all retired soldiers, who may enter any university, college or school, to draw their rations in kind at the nearest post.
S. Cooper A & I General"
To improve their professional mind, the always busy medical men published in January, 1864, the first issue of the Confederate States Surgical and Medical Journal. The editor was the energetic commandant of Chimborazo Hospital, Dr. McCaw. The journal was the only one of the Confederacy, and appeared only fourteen times. In these issues were six scientific reports from the Chimborazo Hospital staff, which provide an excellent cross section of the best Confederate medicine and surgery.
"Case of Tetanus—Recovery" —W. A. Davis
"Report of Cases of Gun-shot Fracture of Femur Treated without Operative Procedure, Chimborazo Hospital"—W. A. Davis, S. F. Habersham, and F. M. Seabrook
"Ligature of the Right Subelavian Artery"—P. F. Browne
"Report of Cases of Compound Comminuted Fracture of Femur"—E. H. Smith
"Eleven Cases of Compound Fracture of Cranium of Gun-shot Wound Treated at Chimborazo Hospital" (Probably by Editor McCaw)
"Gun-shot Wound of the Chest Treated by Hermetically Sealing"—P. F. Browne
After several years of war, the besieged Capitol of the Confederacy showed intensification of suffering. Famine stricken faces with pitious, scared smiles were common on the city streets. One hospital nurse said the federal prisoners may in some instances been starved in the South, we cannot deny the truth of the charge-but we starved with them-we had so little to share with any.
Private Charles A. Douglas wrote to his wife Caroline in Campbell County, Virginia:
"2nd, March 1864
"I'm in Chimborazo Hospital. I find this place not a pleasant one by any means. Very little to eat and that of the roughest and coursest sort and not half enough wood to keep a comfortable fire. Candles are worth $6.00 in Richmond..."
Some complained very little and were anxious to get back to the front. The pocket diary of Pvt. John Bell Vencent, 41st Va. Inf., Co. E, reveals;
"May 30, '64, Left the army for Hospital quite sick. Took the car (train) at Meadowbridge (road). Arrived in Richmond at 10 o'clock P.M. and sent to Seabrook Hospital.
"May 31-June 9th, '64, Transferred to Chimborazo Hospital and remained until 9th June. Left Chimborazo Hospital for the Army. Arrived in Richmond during the day.
"June 10th '64, Left Richmond for the Army. Marched down Meadowbridge Road and then to Mechanicsville from there to Gaines Mill and joined the Army.
"June 11th '64, Headquarters at Watt's House. Division in line of Battle. Continuous firing in the skirmish lines."
As with any hospital, Chimborazo had its share of malingerers, better known as "hospital rats." An interesting case is the letter from Georgia. Surgeon Stephen F. Habersham in charge of Chimborazo Hospital #2 to Brig. General John M. Winder, December 1862. "In compliance with your verbal order to me yesterday, I have ordered Dennis Fitzgerald (Co. K 20th Ga. Regt.) to report to you this morning. He has been in this Hospital since its organization and has made constant applications for a discharge-he has many complaints, none of which are real and finding it impossible to keep him from his bottle, I returned him yesterday as fit for duty."
The Georgian matron of hospital #2, Phoebe Yates Pember, writes of the returned P.W.'s from the Federal Prison, Point Lookout, Maryland. "One among them lingered in patience the usual three days that appeared to be their allotted space of life on their return. He was a Marylander", (Richard Hammond Key, grandson of Francis Barton Key (Francis Scott Key), author of 'Star Spangled Banner'). . . . presenting the same bluish, bloodless appearance common to them all. Hoping that there would be some chance of his rallying, I gave him judicious nursing and good brandy. Every precaution was taken, but the third day fever supervened and the little life left waned rapidly!" He "begged that he might be buried apart from the crowd in some spot where those who knew and cared for him might find him some day, and quietly slept himself to death that night. "The next morning was the memorable 29th September, 1864, when the enemy made a desperate and successful attack, taking Fort Harrison, holding it and placing Richmond in jeopardy for four hours. The alarm bells summoned the citizens together, and the shops being closed to allow those who kept them to join the city guards, there were no means of buying a coffin, or getting a hearse. It was against the rules to keep a body beyond a certain time on the hospital grounds, so little time was to be lost if I intended keeping my promise to the dead.
"I summoned a convalescent carpenter from one of the wards, made him knock together a rough coffin from some loose boards, and taking the seats out of my ambulance had it, with the body enclosed, put in. My driver was at his post with the guards, so taking the reins and kneeling in the little space at the side of the coffin I started for Hollywood cemetery, a distance of five miles.
"The enemy were then in sight, and from every elevated point the masses of maneuvering soldiers and flash of the enemys' cannon could be distinguished.
Only stopping as I passed through the city to buy a piece of ground from the old cemetery agent, I reached Hollywood by twelve o'clock. Near the burying ground I met the Rev. Mr. McCabe, requested his presence and assistance, and we stood side by side while the sexton dug his grave. The rain was pouring in torrents, while the clergyman repeated the Episcopal burying service from memory. Besides ourselves there (were) but two poor women . . . Catholics, who passing casually, dropped upon their knees. undeterred by the rain, and paid their humble tribute of respect to the dead. "He had all the honors of a soldier's burial paid to him unconsciously, for the cannon roared and the musketry rattled, mingling with the thunder and lightning of Heaven's artillery. The sexton held his hat over the small piece of paper on which I inscribed his name and birthplace (to be put on his headboard) to protect it from the rain, and with a saddened heart for the solitary grave we left behind I drove back to the city."
Hospital life was soon to come to an end and there was deep sadness associated with the transfer of Chimborazo Hospital to the blue-coated Federal troops under General Godfrey Weitzel. As they tramped through the medical headquarters building, the Commandant and Medical Director James B. McCaw's and his staff's tour of duty came to an end.
The Richmond News Leader (1-9-1909) best reported his achievements: "when we consider the size of this great military hospital, the number of soldiers admitted, treated, furloughed, discharged and buried, its successful work for nearly four years, the perfect discipline, order and harmony that existed from its establishment to its close, the immense amount of work done, the difficulties always attending the securing of supplies for such a large body of invalids, especially towards the closing days of the Confederacy, and the comparatively low mortality, we can not but accord to Dr. James B. McCaw, its medical director and commandant the highest praise."
The medical students, alumni, and faculty of the Medical College of Virginia played a major role in the medical and military history of the War Between the States. This medical heritage of our alumni continued by service in the McGuire Units, Toul, France, 1918; Base Hospital #45, Rabat, French Morocco to Naples and Ban, Italy, 1942-45; and in the recent Korean War. The College's medical history of the past, in time of war as well as peace, is a proud one.
15% wounded died in Civil War
8% wounded died in World War I
4% wounded died in World War II
2% wounded died in Korean War