Bowers, Russell V. "A Confederate General Hospital: Chimborazo Post (1862-1865)." The Scarab, Medical College of Virginia alumni magazine. November 1962.

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

First Division—Virginia
Surgeon Peter F. Browne (Accomac, Virginia)
Assistant Surgeons
George Ross
* James C. Watson (1855)
* John G. Trevillian (1861)
J. Prosser Harrison
George W. Alsop
W. H. Pugh
John C. Baylor
X Charles A. Board
X Landon A. Woodson (1860)
Samuel C. Smith
* J. R. Gildersleeve (Acting) (1864)

Second Division—Georgia
Surgeon Stephen E. Habersham

Third Division—North Carolina
Surgeon E. Harvie Smith

Fourth Division—Alabama
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: