Monday, September 9, 2013

From Post Hospitals to General Hospitals


Before the Civil War, post hospitals cared for seriously sick and wounded soldiers, while those with milder cases were simply confined to their tents. This system proved adequate for meeting the medical needs of small stationary units of armed forces. At the beginning of the war, regimental hospitals served the needs of the assembling troops, and division or brigade hospitals were created by combining regimental facilities. The first new military hospitals of the war—the East Street Infirmary and the Union Hotel—opened in Washington, D.C., in May 1861. Nearby private homes, adapted to create wards, service, and administrative areas, provided supplementary facilities. After Bull Run, in July 1861, when it became clear that the war would be long and require large scale movement of troops, the army had to develop a new system quickly to receive the most seriously wounded cases sent from the field hospitals or left behind when troops moved off to pursue the Confederate army. The first of many general hospitals opened in Alexandria, Virginia, followed by hospitals in Baltimore, at the U.S. Naval Academy at Annapolis, and the grounds of the Agricultural Society of Frederick, Maryland. In June 1861, the Christian Hospital in Philadelphia became the most remote military establishment of the Union army.

As the war dragged on, the army expanded the number and locations of military hospitals. According to the six-volume Medical and Surgical History of the War of the Rebellion, published serially by the Surgeon General between 1870 and 1888:

"North of Philadelphia, there were but few extemporized hospitals. Factory buildings were occupied in Newark, N.J. A three-story cabinet factory contained most of the hospital beds in Elmira, N.Y. Contracts were made at Rochester and Buffalo with the civil hospitals at 50 to 75 cents daily per bed. The Mason hospital in Boston, Mass. was a private residence, given up rent-free by its owner."

The U.S. government set up a few military hospitals south of Washington. In the western states, it created hospitals by converting or adapting asylums, orphanages, factories, hotels, schools, and warehouses. By the war’s end the army had created 192 general hospitals in its 16 military departments. Twenty-five hospitals were in the Department of the East, including three in Vermont. The surgeon general’s report, so rich in detail about the dimensions, capacity, treatment, and facilities at these general hospitals, offers few dates, so it is difficult to confirm Governor Holbrook’s claim for the priority of the Brattleboro General

It is clear, however, that the context for establishing these remote facilities was the growing realization that preexisting arrangements were inadequate for treating the large number of men who came out of battle wounded or physically and mentally broken down, as well as the many who contracted debilitating and contagious illnesses in the military camps themselves, where sanitary conditions were poor and diseases spread rapidly. In fact, during the Civil War, death from disease accounted for two-thirds of all military fatalities, while only one-third of the deaths were directly attributed to battle wounds, overwhelmingly bullet wounds. If a soldier survived the first few days following a battle injury, he was threatened by a host of secondary potential killers—diseases such as chronic diarrhea, typhoid, and malaria—if he had been lucky enough to escape them in routine camp life. Thus, by the time Holbrook and Phelps made their proposal to Lincoln and Stanton for remote hospitals, the need for additional facilities had become acute and the army had already begun to accommodate that need.

Although Holbrook’s account claims that the Brattleboro mustering grounds became the first remote general hospital, the Marine Hospital in Burlington was already receiving sick and wounded from the war seven months before the governor presented his proposal to Lincoln and Stanton.

According to the report of the surgeon general of Vermont, the hospital “was opened by the State of Vermont under the direction of Governor Holbrook” on May 5, 1862, when it received its first patients, and “transferred to and organized by the United States Government” on July 1, 1862.

The physician in charge of the facility was Dr. S. W. Thayer, surgeon general of Vermont. Originally built between 1856 and 1858 with a congressional appropriation of $39,000—a political patronage reward for Judge David Smalley, head of the Vermont Democratic Party—the Italianate-style brick building with a spacious verandah sat two miles south of the village of Burlington on ten acres of land off Shelburne Road. According to an account in Abby Hemenway’s Vermont Historical Gazetteer, the building commanded “a fine view of the lake and village. . . . It is 2 stories high, with a basement; built very thoroughly, with ample and convenient rooms for the use intended.”

A reporter from the Burlington Free Press described it as “a substantial and expensive affair. The rooms are high and airy, furnished with marble mantels, with closets and bath rooms attached to each ward on both floors, and every convenience in the way of store rooms, cases of shelves and drawers, &c. for the safe and orderly keeping of the quantities of clothing and hospital supplies in constant demand. . . . The wounded are all within the Hospital building. A few of the sick . . . are in a wooden portable house, and in the tents, which are provided with floors and stoves, and are entirely comfortable.”

Renamed the General Hospital in April 1863 then Baxter General Hospital in September 1864, in honor of Vermont Congressman Portus Baxter, the facility treated a total of 2,406 men before the U.S. Army closed it in July 1865 and transferred its remaining patients to a temporary post hospital elsewhere in Burlington or to Sloan General Hospital in Montpelier.

Vermont’s third military hospital opened in Montpelier in June 1864. Named in honor of W. J. Sloan, U.S. medical inspector for the Department of the East, the facility accommodated 500 patients, hospital staff, and a company of Vermont Reserve Corps, who served as hospital guards. On April 25, 1864, Governor Smith turned over the buildings to the U.S. War Department and in mid-June the first 300 patients arrived


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