Hume, Edgar Erskine. "Chimborazo Hospital, Confederate States Army, America's
Largest Military Hospital" Virginia Medical Monthly (July 1934), pp.
189-195.
CHIMBORAZO HOSPITAL
CONFEDERATE STATES ARMY—
AMERICA’S LARGEST MILITARY HOSPITAL*
By MAJOR EDGAR ERSKINE HUME, M.C., U. S.
Army
(With two illustrations)
THE honor of speaking on
this historic occasion is one which any Southern man would
appreciate. It is also to me a privilege because, a military surgeon
myself, I am at present the librarian of the Army Medical Library in
Washington, the largest medical library in the world, an institution
which from 1904 to 1913 was directed by Brigadier-General Walter
Drew McCaw, the distinguished son of the founder of the Chimborazo
Hospital. As it fell to my lot during the World War to have charge
of the hospitals of the United States Army in the Italian War Zone,
I know something of what it means to conduct an institution of this
kind, though under the conditions of the World War with no shortage
of supplies, equipment, or personnel, I can sense only at a most
respectful distance, the difficulties under which the Chimborazo
Hospital functioned so efficiently.
The site of the Chimborazo Hospital, here on an elevated
plateau above Jeemses River, as I am sure most of its inmates called it,
was well chosen. It was separated from the city of Richmond by Bloody Run Creek,
significant name given it by the Indians in Colonial days. It came into being in
1862 when General Joseph E. Johnston reported to the War Department that with
the enemy’s move in force on Bull Run, some nine thousand men would have to be
sent back to Richmond. The distinguished Surgeon General of the Confederate
States Army, Dr. Samuel Preston Moore, a former officer of the regular United
States Army, knew to whom to turn in the emergency. He went at once to see Dr.
James Brown McCaw, one of the most noted of Richmond’s physicians. Dr. McCaw was
already in his country’s service, having early in the war joined a company of
cavalry. But a greater duty lay before him, and unhesitatingly he assumed the
great task.
He selected the site, and with almost unbelievable speed,
the hospital was made ready to receive patients. At the time of General
Johnston’s warning to the Surgeon General, that officer had only 2500 beds
at his disposal. To he ready to receive 9000 and probably many more patients
within a brief period required great skill in administration and
organization. Surgeon General Moore and Surgeon McCaw had these qualities.
Work began immediately, and 150 wooden buildings were completed. These were,
of course, not all set up at once, but, as is usual in war time
construction, as fast as needed and as fast as materials and workmen could
be supplied. It must not he supposed that the entire construction of the
Chimborazo Hospital was completed in a few days’ time. The buildings had in
many eases merely to be remodeled, for they had been constructed as winter
quarters for the Army of Northern Virginia, but the enemy’s drive on
Richmond forced the Confederate Army to fight the winter out at Manassas.
The buildings measured approximately 100 feet in length by
30 feet in width. They were of one story, seven feet in height. Each
building had ten windows. From forty to sixty patients were accommodated in
each building.
Not only were the buildings themselves airy, but they were
not placed too near together, and ample space for drives and walks was
allowed. Realizing the necessity for proper ventilation, the Commandant
ordered an allowance of approximately 800 to 1000 cubic feet of air space
per patient, and that attendants and others be not permitted to sleep in the
wards, for they would in that way have reduced the amount of fresh air
available to each patient. The prevailing breeze from the Southwest from the
nearby woodlands was always a source of comfort. This regulation is exactly
what we required in the World War during the epidemic of influenza.
In addition to the 150 hospital buildings, the post
included 100 Sibley tents in which eight to ten convalescent men could be
quartered. These tents were spread upon the slope of the hill.
"The hospital," wrote Surgeon John R. Gildersleeve,
C.S.A., "presented the appearance of a large town, imposing and attractive,
with its alignment of buildings kept whitened with lime, streets and alleys
always clean, and with its situation on such an elevated point, it commanded
a grand, magnificent, and pleasing view of the surrounding country for many
miles." In the first week two thousand patients were received, and in two
weeks’ time there were in all four thousand.
The site was well chosen and had an ample supply of good
water. There was natural drainage on the east, south and west. There were
five large ice houses, Russian bath houses, and adequate provision for the
disposal of wastes. Dr. McCaw profited by the hard lessons learned in the
first year of the war when there was general confusion and the belief that
the war would he of brief duration. He stressed the importance of
cleanliness and that the mental attitude of the patient had much to do with
his recovery.
The Secretary of War saw the desirability of having the
Chimborazo Hospital function as a unit, free from the usual army routine. To
accomplish this, he made the institution and its grounds an independent army
post, with Surgeon McCaw as Commandant. An officer of the line and thirty
men were stationed there to assist him in maintaining discipline. There
being no precedent for such a military post, the Secretary of War was
somewhat perplexed about a suitable name for the station itself and title
for its commanding officer, who was not an officer of the regular
Confederate States Army. At Dr. McCaw’s suggestion the institution was given
the name Chimborazo from that of the hill where it stood, and its
director, Surgeon McCaw, called Commandant and Medical
Director-in-Chief. Dr. McCaw held this position during the whole
existence of the hospital.
The Chimborazo Hospital, or, as we should in modern
military terms call it, ‘‘The Chimborazo Hospital Centre,’’ was built and
operated not only in accordance with the best medical opinion of that day,
but it will hear comparison with large military hospital centres even of the
World War.
The hospital centre, using the modern term, consisted of
five separate hospitals or divisions, thirty wards or buildings to each. A
Surgeon was in charge of each of the five divisions, with Assistant Surgeons
or Acting Assistant Surgeons in charge of the several wards or buildings.
When the wounded were first brought in, soldiers were assigned to vacant
beds without regard to their homes or their military organizations. Later
separate divisions were appropriated to men from different sections of the
country. Schedules showing where patients from different states were
quartered were published in the Richmond newspapers. This made it possible
for State and private organizations to send supplies to their men and
supplement those received from the Government. This organization of the
hospital upon a geographical basis proved an effective means of keeping up
morale. Many of the wounded and ill men were thus treated by their regular
family physicians or others of whom they had heard or known. The value of
this system in a provisional government with slender resources must be
realized.
In the conduct of the Chimborazo Hospital the director
bore in mind the fact, often overlooked by Northern historians, that the
number of men of the upper classes of the South serving in the ranks was
great. The division of the hospital into wards and larger units for those of
each local community was appreciated by such men.
There is something inspiring about a military hospital.
Any hospital demands our respect as an institution dedicated to the relief
of suffering, to the restoration to health, to the demonstration of highest
Christian ideals. But a military hospital is more. Here are treated not only
those who have fallen victims to disease such as might occur at any place
and at any time, but also those who have been but recently in the best of
health but who suddenly have been stricken down by a man-made agent of
destruction. They have of their own accord gone to the scene of danger borne
along by idealism, by love of country, by unselfishness. In a military
hospital the patients are all men—mostly young men, and in this lies the
most heartbreaking cruelty of war. Schiller has said Der Krieg
verschlingt die Besten—War engulfs the best. And so it seems, though in
the words of the Spartan, "The arrow would be of great price if it
distinguished brave men from cowards." The best of the land arc offered on
the altar of patriotism, and even in a hospital as admirably conducted as
the Chimborazo Hospital, many cannot recover. They die; they pass on to the
great beyond, endowed with the grateful -love of the nation which bore them.
But they have something more. They are endowed with immortal youth. No
matter how long parents live, their boy who has made the supreme sacrifice
will never grow old to them. Had he and they lived together for a few
decades, the youth would have become an old man. But once he has given his
life for his country, he passes from the Realm over which Time holds sway,
and he knows not decay nor decline. He enters Eternity and remains forever a
youth.
As soon as the hospitals were opened, the large tobacco
factories of the Grants, Mayos, and others were secured, their trade being
practically at an end for the period of the war. The great boilers from
these factories were effectively used in making soup in the kitchens. The
factory workers were employed in the construction not only of the hospital
buildings but also furniture and other equipment for them. There being, at
least at first, no shortage of seasoned wood, for the tobacco factories had
a large supply intended for the making of crates and packing cases,
serviceable beds and other articles were made by the carpenters.
The patriotic Mr. Franklin Stearns lent the hospital his
celebrated farm Tree Hill for the pasturage of 200 cows and 300 to
500 goats. The latter supplied kid venison, a meat popular with the
patients. A large bakery was kept in almost constant operation, having the
capacity of 7000 to 10,000 loaves daily, though even this quantity proved
insufficient to insure one loaf per man per day. The grease from the "soup
houses" was saved and lye brought through the blockade when possible, so
that soap could be made. Beer was made on a large scale. As much as 400 kegs
were brewed at a time, and stored in the caves or cellars at the eastern end
of the hill.
To us who witnessed the expenditure of enormous sums of
money in the construction and maintenance of military hospitals during the
World War, it is a source of wonder and of admiration to read that no funds
were drawn from the Confederate States Government for the conduct of the
Chimborazo Hospital. The institution was entirely maintained by the
commutation of rations. It had its own subsistence department, and possessed
a canal boat, the Chimborazo, which under the command of Lawrence
Lottier, plied between Richmond, Lynchburg, and Lexington, bartering yarn,
shoes, etc., for provisions. This was but one of the many resources of the
hospital. At the close of the war the Confederate Government owed the
hospital $300,000 which Mr. Memminger, the Secretary of the Treasury of the
Confederate States, agreed to pay in gold on March 29, 1865. On April 3, the
city surrendered.
At the time of the War between the States the Chimborazo
Hospital was the first military hospital in point of size in the world. The
second largest was the Lincoln Hospital in Washington. The total
number of patients received and treated in the Chimborazo Hospital was
76,000, of whom 17,000 were wounded soldiers. The Lincoln Hospital reported
a total number of 46,000 patients. The Scutari Hospital in the
Crimean War was the largest prior to the War of 1861-5. It reported a total
of 30,000 to 40,000 patients.
The enormous work of the Chimborazo Hospital may be
realized somewhat in the light of the experience of the United States Army
in the World War. The Justice Hospital Centre at Toul, France, which was the
largest in the American Expeditionary Forces treated in all 67,866 patients
up to the time of its closing at the end of March, 1919. It is interesting
to recall that one of the eight base hospitals constituting this centre, was
Base Hospital No. 45, organized at the Medical College of Virginia and
commanded by Lieutenant-Colonel Stuart McGuire, U.S.A., son of Surgeon
Hunter Holmes McGuire, C.S.A. of General Jackson's staff.
Even though we consider the shorter time of America’s
participation in the World War, we must likewise remember the enormously
increased killing and wounding power of modern weapons and also the ravages
of the pandemic of influenza. Truly great was Chimborazo, to this day
America’s largest military hospital.
Because of the destruction by fire in 1865 of the records
of the Surgeon General’s Office, we cannot give the names of all of the
medical officers, averaging forty-five in number, who labored for the relief
of their countrymen at the Chimborazo, nor of the devoted nurses and the
forty-five matrons whose skill and untiring energy made its success
possible. We can give only the names of the chiefs:
Commandant and Medical Director-in-Chief:
Surgeon James Brown McCaw;
In charge of the first division (Virginia): Surgeon P. F. Browne of Accomac,
Virginia;
In charge of the Second Division (Georgia): Surgeon S. E. Habersham of
Augusta, Georgia;
In charge of the Third Division (North Carolina): Surgeon E. Harvie Smith;
In charge of the Fourth Division (Alabama) : Surgeon S. N. Davis;
In charge of the Fifth Division (South Carolina): Surgeon E. M. Seabrook of
Charleston;
Chief Matron: Mrs. Minge (wife of a physician)
Commissary: John Herbert Claiborne;
Quartermaster: Colonel A. S. Buford;
Chaplain: Rev. Mr. Patterson.
There were in all two apothecaries, one clerk, and one
general ward-master or assistant steward. Each division had a chief matron
with three or four assistants.
"The duty of the matron," wrote Surgeon S. E. Habersham,
in charge of the Second Division, "was to superintend the preparation of all
the diet for the sick not convalescent, and supply it upon the requisitions
furnished by the assistant surgeon of each ward; to take charge of the
laundry department, and see that the wards were supplied with clean bedding,
etc.’’ These women rendered most valuable services.
The task of feeding the large group of patients has been
graphically told by Mrs. Phoebe Yates Pember, one of the matrons at the
Chimborazo Hospital. The men were fed from the general kitchen with special
provision for the preparation of special diets for about six hundred
patients in need of such care. These patients were fed from the ‘‘matron’s
diet list,’’ as it was called. The ones who were in the most dangerous
condition were fed from the matron’s own kitchen. As supplies became more
and more scarce by the summer of 1864, the men in the ranks were always
hungry. Fighting men had to be denied in order that their stricken comrades
might be fed. The hospital matrons had a most difficult task to be just to
all. No articles of food were wasted, and Mrs. Pember even gives a recipe
for cooking rats, which she says she learned from men who had had
experience. Fortunately the patients in the Chimborazo Hospital never had to
be fed on such delicacies.
The conduct of the Chimborazo Hospital may fairly be
called one of more noteworthy achievements in military medicine in America‘s
history. When we consider its size, the number of soldiers admitted as
patients, its successful work for four years, its excellent discipline, the
tremendous difficulties that had to be overcome in the procurement of
supplies, especially towards the closing days of the Confederacy, the
comparatively low mortality (slightly over 9 per cent), we must recognize
its director as a genius of first rank.
Despite the loss of so many of the Confederate medical
records in the fire in Richmond in 1865, Surgeon S. E. Habersham of Augusta
has left us some valuable statistics of the Chimborazo Hospital for the
period October 10, 1861 to November 1, 1863. By divisions we have the name
of the disease or injury, number treated, and the number of deaths. As we
read today the names of the maladies, we realize the advancements in medical
science, for many of the terms used are all but unknown now. Dr. Habersham
concludes that the most serious diseases were: Adynamic fevers, sloughing
phagedaena, phagedaena gangrenosa, pyaemia, erysipelas, and the
neuralgic affections following continued fever.
Dr. McCaw, the director of the hospital, demonstrated the
truth of Osler's dictum: "Work is the master word in medicine." "Towering
physically and mentally above his associates," says one of his admirers,
"princely Dr. James B. McCaw, sweet, gentle, tender and true, and brave,
generous and loyal, he was just, honorable, and upright, an exemplar worthy
of emulation."
He came of a family of physicians. The first of his name,
Dr. James McCaw of Newton-Stewart, Wigtonshire, Scotland, came to live at
Norfolk, Virginia, in 1771, practicing surgery. He was commissioned a
Captain by Lord Dunmore and was present at the Battle of the Bridge.
But like some others who remained loyal to the Mother Country in the
American War of Independence, his house was plundered and destroyed by
revolutionists, and he was compelled, with his family, to take refuge on
board a British ship in Chesapeake Bay. He took his family to Scotland but
returned to America and died in New York, still in British hands, in 1778.
His son was Dr. James Drew McCaw, born in Virginia,
apprentice in surgery to Benjamin Bell of Edinburgh, where he received his
M.D. in 1792, and returned to Virginia to practice his profession until his
death in 1846. He had two sons who were physicians, Dr. William Reid McCaw
and Dr. David McCaw. The former of these was the father of Surgeon James
Brown McCaw, the Commandant of the Chimborazo Hospital.
Surgeon James Brown McCaw was born in Richmond on July 12,
1823; studied under Dr. Valentine Mott who first successfully ligated the
Innominate Artery; graduated a Doctor of Medicine at the University of the
City of New York in 1844 and practiced his profession in Richmond for
fifty-seven years, retiring in 1901. He was for twelve years, ending in
1872, Professor of Chemistry in the Medical College of Virginia, and for the
next sixteen years was Professor of the Practice of Medicine and Dean of
that institution. From 1853 to 1861 he was editor of the Virginia Medical
and Surgical Journal. From 1864 to 1865 he was editor of the Confederate
States Medical and Surgical Journal, the only medical journal in the South
during this period, fourteen issues having appeared in all. In April 1871 he
became one of the editors of the Virginia Clinical Record. He wrote many
medical papers on many subjects, publishing them chiefly in the journals
which he edited. A lover of music, he was President of the Mozart Society of
Richmond, and was a charter member of the Medical Society of Virginia
(1870). He was called "A typical Virginia gentleman of the old school, and
the beloved physician of three generations." He must have had what President
Eliot of Harvard called "the durable satisfactions of life." As three of his
sons became physicians, Dr. Walter Drew McCaw, Dr. James Henry McCaw and Dr.
David McCaw, they represent the fifth generation of this distinguished
medical family, while Dr. James McCaw Thompkins of Richmond represents the
sixth generation. Dr. Walter Drew McCaw became a military surgeon himself,
rising after a long career of usefulness to the rank of Brigadier-General.
He was Chief Surgeon of the American Expeditionary Forces and of course had
under his direction the many large hospitals established by the United
States Army overseas. His citation for the Distinguished Service Medal
states that ‘‘as Chief Surgeon of the American Expeditionary Forces, he
maintained the splendid efficiency of that department at a critical time and
solved each new problem presented with wisdom and marked ability." His
father’s mantle descended upon him indeed.
Surgeon J. R. Gildersleeve, C.S.A., a member of the staff
of the Chimborazo Hospital, has left an interesting account of the
circumstances surrounding the surrender of the Chimborazo Hospital when
Richmond was occupied in 1865:
General Godfrey Weitzel’s brigade of the Federal army was
in the van of the advancing army. The General rode up the hill, and when he
came through the post he was received by our whole corps of officers in full
dress uniform. Dr. Alexander Mott [of New York, Surgeon of Volunteers],
chief medical director of the staff of General Weitzel, exclaimed:
"Ain’t that old Jim McCaw ?"
"Yes," said Dr. McCaw, "And don’t you want a drink?"
Mott’s answer was, ‘‘Yes,’’ and he added, ‘‘the General
will take one too, if you will ask him." The invitation was duly extended
and accepted.
General Weitzel gave a free pass to the Commandant of the
Chimborazo Hospital for himself and all of his officers, and ordered that
all Confederate patients in the hospital be taken care of under all
circumstances. Surgeon Gildersleeve tells us that the General even offered
to place the Commandant in the general service of the United States, so that
he might issue requisitions, etc., and have them honored in the same way as
those of any other Medical Director in the United States Army. General Lee
not having surrendered, Dr. McCaw respectfully declined this generous offer,
but voluntarily continued to perform all of the duties incident to the
position that he held.
Thus with scant medical supplies, for they were contraband
of war, and poor facilities, the Chimborazo Hospital had been administered
for three years with outstanding success and with a remarkable ratio of
recoveries. It was at last turned over to the Federal troops in perfect
working order, and they were not slow in giving credit where credit was due.
Dr. McCaw knew how to thwart fear and engender courage. He
had the deep religious feelings which characterized the leaders of the
Southern cause, and without a knowledge of which it is impossible to
understand the war. ‘‘A soldier without religion,’’ said a Prussian officer,
who knows the Confederate as well as the Prussian Army, ‘‘is an instrument
without value.’’ Even the rank and file were in full accord with the great
principles of the war, and were sustained by the abiding conviction of the
justice of the cause.
"No one can bring a tribute of words into the presence of
great deeds, or try with them to embellish the memory of any inspiring
achievement, without feeling and leaving with others a sense of their
insufficiency" (Oliver Wendell Holmes). We cannot do more than to mark the
place where this great instrument of mercy stood, where a group of faithful
men and women of our South did their utmost to repair war’s broken victims,
where in so doing they enabled many of the men to return to their commands
and strike yet other blows in defense of their invaded country.
Nor Mars his sword nor war’s quick
fire shall burn
The living record of your memory.
‘Gainst death and all-oblivious enmity
Shall you pace forth: your praise shall still find room
Even in the eyes of all posterity.
Shakespeare,
Sonnets, LV.
BIBLIOGRAPHY
Ashburn, P. M.: James Brown McCaw, Dict. of
Amer. Biogr. 11:575-576.
Garrison, F. H.: Dr. James Brown McCaw,
Old Dominion
J. of Med. and Surg., 1906-7, 5:65.
Gildersleeve, John R.: History of
Chimborazo Hospital, Richmond, Va., and its Medical Officers During
1861-1865, Fe. Med. Semi-monthly, 1904-5, 9:148-154. also in
Southern Hist. Papers, Richmond, 1908, 30:86-94.
Habersham, S. E.: Observations upon the
Statistics of Chimborazo Hospital with Some Remarks upon the Treatment of
Various Diseases During the Recent Civil War, Nashville, Tenn., 1866, pp.
15.
McCaw, James B.: Of Chimborazo Park
(newspaper clipping circa August 17, 1897), in Confederate Museum, Richmond.
Stout, S. H.: Some Facts of the History of
the Organization of the Medical Service of the Confederate Armies and
Hospitals, Southern Practitioner, Nashville, 1903, 25:91-98; 517-526.
Tebault, C. H.: Hospitals of the
Confederacy, Southern Practitioner,
Nashville, 1902, 24:499-509.
(Obituary)—Trans. Med. Soc. of
Va., 1906, 37:305.
(Personal communications from Brig. Gen.
Walter D. McCaw, U.S.A.)
* This address was
to have been delivered by the author on May 26, 1934, at the unveiling of the
bronze tablet marking the site of the Chimborazo Hospital. On account of illness
in his family the author could not be present so that the manuscript was read by
Dr. Greer Baughman of Richmond. Miss Sally Archer Anderson, President of the
Confederate Memorial Literary Society, presided, and Mrs. Littleton Fitzgerald,
chairman of the sites committee, presented Dr. Baughman. The marker was received
on behalf of the city of Richmond by Colonel R. Keith Compton, director of
public works. Mrs. Dabney H. Maury, daughter of Dr. James
B. McCaw, Commandant of the Chimborazo Hospital, unveiled the tablet
which was covered with a battle flag and a hospital flag of the Confederate
States Army captured during the war, and returned to Virginia by act of
Congress.
The tablet, attached to a waterworn
boulder on Chimborazo Hill, is inscribed:
ON THIS HILL STOOD
CHIMBORAZO HOSPITAL
1862-1865
ESTABLISHED BY
SURGEON GENERAL S. P. MOORE, C.S.A.
DIRECTED BY DR. JAMES B. McCAW
AT THAT TIME IT WAS THE
LARGEST MILITARY HOSPITAL IN THE WORLD
IT CONSISTED OF 150 BUILDINGS AND 100 TENTS
AND CARED FOR 76,000 PATIENTS WITH A
MORTALITY OF LESS THAN 10 PER CENT
THIS TABLET IS PLACED BY THE
CONFEDERATE MEMORIAL LITERARY SOCIETY
*Published also in The Virginia
Medical Monthly The Virginia Medical
Monthly for 1934
