Commentary on Medicine, Army of the Confederate States of America

By Dr. Jack E. Butterworth, 3-25-2014.

In September of 1864 General Sherman entered Atlanta pushing all civilians out of the city. He burned all buildings not suitable for military use. General Jubal Early, in the Shenandoah Valley, was outnumbered by General Sheridan’s forces causing a retreating action by the Confederates. General Lee in the Richmond area was short on food and supplies with an approaching Northern Army. General Hood in the western arena had a deficiency of troops and both he and President Davis, after appraisal of the situation, were at a loss for optimism. The outlook for the Confederate Army was indeed grim.

Nevertheless, the September 1864 issue of the Confederate Medical and Surgical Journal was published. The Journal (C.S.M.S.J.) was edited by Dr. Samuel Preston Moore (1813-1889), the Surgeon General of the Confederate States of America.1 Moore had been trained as a military surgeon in the US Army in 1835 and he continued to serve as a Surgeon until 1861. During the Mexican–American War, Moore became friends with Col. Jefferson Davis, the future Confederate President. Moore resigned his commission as a U.S. Army surgeon on February 25, 1861 and returned to his medical practice in Little Rock, Arkansas. Davis appointed Moore to the position of Surgeon-General of the Confederate States Army Medical Department on March 16, 1861.

Dr. William D. Sharpe wrote in the Bulletin of the New York Academy of Medicine that, “The level of material in the (Confederate Medical and Surgical) Journal is high, at least as high as that of any of its American contemporaries, although pressures on space are evident in a sometimes excessively terse style.”

Doctors Peter N. Purcell and Robert P. Hummel Jr. writing about Moore in the American Journal of Surgery described his (Moore’s) career as CSA Surgeon General:

 “He reformed the mediocre medical corps by raising recruiting standards and improving treatment protocols and by placing the most capable surgeons in positions of authority. He improved the ambulance corps and directed the construction of many new hospitals for Confederate casualties. He was directly responsible for the barracks hospital design, which is still used today. He established the Confederate States Medical and Surgical Journal and directed a successful effort to develop substitutes for scarce pharmaceuticals from the indigenous flora of the South. He founded the Association of Army and Navy Surgeons of the Confederate States of America. With skill and dedication, Dr. Moore transformed the medical corps into one of the most effective departments of the Confederate military and was responsible for saving thousands of lives on the battlefield.”
The average Confederate surgeon had received approximately two years of formal training at the time of the War. They were mostly volunteers from the civilian sector of medicine and not primarily military men. Such a Journal was therefore of great value to such surgeons in advancing their ability to manage the magnitude of war wounds they received.  The 1864 issue of the Journal contains medical and surgical conditions pertinent to the War and the times. Detailed articles on tetanus, manufacturing of artificial limbs, treatment of gangrene, and the case presentation and management of an aneurysm of the femoral artery caused by buckshot wounding of a deserter shot by a militiaman were features of the 1864 edition.

 The details of the health of the patients describing the incident of their illness or wounding are most revealing in their descriptions of the personal nature of the War. From them we learn first-hand of the extent of war wounds and illness as well as the degree of treatment available at that time in history.

  One example of such detailed description is that of a 37 yr old male who was engaged in the battle of Secessionville at James Island SC, on 16 June 1862.

 “While standing in a small house and in the act of taking a cartridge from a box, a Minie ball passed through a 3 inch pine wall board and struck him in the ‘fleshy part of the forearm between the ulna and radius splintering them but not causing complete fracture’.” This wound led to suppuration (drainage of pus) and infection. Subsequently the man developed symptoms of Tetanus with the severe generalized symptoms of that complication.1

Tetanus was described by Hippocrates as early as 400 BC and was found to result from ‘wounds’ at that early date. It was predicted in Colonial American times that if a patient survived the fourth day, which was unusual, he was most likely to live. The condition presented dramatic signs of ‘locked jaw’ or spasm of the Masseter(jaw) muscles and ‘opisthotonus’  which is extreme spasm of the muscles of the back causing the patient to rest with only his head and heels touching the floor while he exhibited the spasms.

Undoubtedly in this case at James Island, the ‘Minie ball’ carried bacteria from the pine wood to enter the wound. Additionally there was loss of circulation associated with necrosis(death) of tissue. Laudanum(tincture of opium) was used copiously for treatment when available for symptom relief and relaxation of the tetanic spasms.

 In “Doctors in Gray”, H.H. Cunningham describes the differences in wound trauma as small weapon munitions progressed from the round ball to the Minie ball and higher velocity shells. The ‘round ball’ small arms wound was most prominent early in the War. Cunningham notes that “ .. in 1863 the Army of Northern Virginia alone reported 27,206 cases that were hospitalized as a result of wounds”. This projectile caused significant bone fracture as well as soft tissue destruction.  Unfortunately because an injured soldier was considered to be a greater cost to the opposing army than one killed, it became more common for the armies to include a large number of ‘buckshot’ in their cartridges. On the Olive Drab website it is noted that, “ In the American Revolution, Gen. George Washington encouraged his troops to load their muskets with “buck and ball,” a load consisting of one standard musket ball and three to six buckshot, to increase the probability of a hit.”  This cartridge load caused multiple wounds and “ of 110 Confederate wounded treated in a Union hospital during the fighting around Atlanta, for example, many had from three to five wounds and the soldier with a single wound was the exception”. General Patrick R. Cleburne “ …was hit with 49 bullets at Franklin ..”.This use of buckshot greatly increased the wounded who required care by their units.

The introduction of the “Minnie Ball”, conical in shape, heavier than the old round ball, and of increased velocity fired from a rifled barrel, created even greater wounding than the round ball. Deering J. Roberts, a Surgeon in the Army of Tennessee stated. “ The shattering, splintering, and splitting of a long bone by the impact of the minie or Enfield ball were, in many instances both remarkable and frightful, and early experience taught surgeons that amputation [to avoid infection] was the only means of saving life”. 2

The ‘frightful findings” of all wounds increased the presence of infection which was not understood until later in the century. Tetanus, the streptococcal infection called erysipelas, and gangrene were the scourge of wounds. Undoubtedly what we now call ‘sepsis’ (generalized circulatory involvement) was the final complement to the pathogenesis of the war wound. It is difficult for many of us to realize that until the 20th cn bacteria and viruses as the causative agents of infection was not accepted. In the mid 19th cn Ignaz Semmelweis found that ‘hand washing’ reduced puerperal sepsis in his clinic in Hungary. He did not know why it did so but he understood that a process existed that reduced morbidity.  He was not only ignored for his success in reducing mortality his obstetrical clinics but was actually censored for differing with the medical opinions of his day.
 Antibiotics only came into use in WWII. During the War Between the States there was no understanding of the process by which ‘infections’ developed or were transferred from one patient to another. Even little use of antiseptic solutions was offered. Dr Middleton Goldsmith was a surgeon in the Union army stationed at Jeffersonville army hospital who focused on the treatment of gas gangrene. He wrote a classic book titled: A Report on Hospital Gangrene 1863.3 He believed it (gangrene) was caused by a miasm (a vaporous exhalation formerly believed to cause disease, Merriam –Webster) or poisonous substances that occurred on putrefied flesh.4  This actually was most often due to the anaerobic bacteria, Clostridium species, it was later proved. This complication remains a most dangerous condition in wounds today.

[2002 report] Clostridium perfringens gas gangrene is, without a doubt, the most fulminant necrotizing infection that affects humans. In victims of traumatic injury, the infection can become well established in as little as 6-8 h, and the destruction of adjacent healthy muscle can progress several inches per hour despite appropriate antibiotic coverage. Shock and organ failure are present in 50% of patients and, among these, 40% die. Despite modern medical advances and intensive-care regimens, radical amputation remains the single best life-saving treatment. Clinics of Infect Dis. 2002 Sep 1;35 (Suppl 1):S93-S100.

Treatment for tetanus, erysipelas and gangrene was largely symptomatic. While Joseph Lister had used phenol for antisepsis, the practice was not well established at the time of the War.  Wound cleansing, surgical drainage, dressing changes, and nutrition were widely employed. Amputation was the most prominent surgical procedure performed by confederate surgeons. The less experienced surgeons often left insufficient tissue to cover the stump of the extremity leaving the bone exposed. This encouraged the further danger of osteomyelitis.

 Soaks and washes were used as well as iodine, tannic acid solutions, and camphorated oil. “ … one Confederate surgeon, C.J. Clark of the Third Alabama Hospital in the capital, concluded that they(the solutions) were responsible for much of the erysipelas in the Richman hospitals during the second year of the war and (he) championed the use of warm water dressings”.2

Such was the status of diagnosis and treatment of war related conditions in the mid nineteenth century America. Understanding the medical knowledge of the era and the degree of the conditions presented allows us to better assimilate the truly outstanding magnitude of the concerns facing the medical men of the Confederacy. In addition to the horrendous degree of wounding, both in wound intensity and volume of cases, the general deficiencies of food, clothing, shoes, and sleep compounded the obstacles for the medical sections of each detachment. We can be proud of how our forefathers met these difficulties and served their patients in this time of war.

While the Confederate Army Medical Department was small in size compared to that of the United States army, it was composed of dedicated individuals at the headquarters and field unit level. Dr. Hunter McGuire is perhaps the best known physician of his era and served as medical director for “Stonewall” Jackson’s fabled 2nd Corps. He was the physician who treated Jackson following his wounding at Chancellorsville. As a surgeon, physician, educator, writer, and southern gentleman he excelled beyond comparison. Dr. McGuire himself expressed admiration for the Confederate surgeon in this address to the Southern Surgical and Gynaecological Association, at their Meeting held in Nashville, Tenn., November 13, 1889.

…”And now of the Confederate surgeon let me say a word. How can I express, in adequate terms, my admiration for him! He possessed virtues peculiarly his own. Coming from civil life, it was wonderful to see how rapidly he adapted himself to the discipline of the army and conformed to the requirements of military life. The hardships he endured and the privations to which he was subjected soon transformed him from a novice to a veteran, and I can say, with truth, that before the war ended some of the best military surgeons in the world could be found in the Confederate army.”5

Dr. McGuire went on to describe how the Confederate Surgeon was pressed to devise methods of treating the wounded without adequate supplies or instruments. They used pine sticks for probing gunshot wounds and eating forks were bent to be used as periosteal elevators in skull fractures. They frequently harvested herbs from the forests in which they had grown up to be used for medications. Their ingenuity was motivated by the absence of medical instruments and supplies but they prevailed despite the state of their profession in war. In addition to medical ability the Confederate medical personnel displayed bravery in the face of cannon, gunfire, and bayonet, often taking great personal risks to administer their craft.

While the written history of the War Between the States is focused naturally on military aspects such as the strategies of the generals, bravery of the soldiers, and instruments of war itself, the medical component also has a history worthy of recording. This article serves as an introduction to that aspect and lists only a small portion of the concerns of the Medical Department and the Surgeons of the Confederate States Army. Hopefully it will serve to create interest for further investigation by today’s Southerners interested in understanding the complete story of our ancestors who participated in this conflict.

Dr. Jack E. Butterworth

References
Paperless Archives.com; BACM Research; BAMC Research paperless archives.com.   (The September issue of the Journal is available through the BAMC Research on disc for a $ 10.00 fee.)
Doctors in Gray, The Confederate Medical Service,  H.H Cunningham, 1958.
A Report on Hospital Gangrene, 1863, Dr. Middleton Goldsmith, Bradley and Gilbert Louisville, 1863.
Hospital Gangrene During The Civil War – Civil War Medicine,  Dr. Scott Watson
Between the States: Tennessee/ Virginia During the Civil War.  (The Overmountain Press, 1997,  V.N. “Bud”  Phillips.)
Address in Southern Historical Society Papers. Vol. XVII., Richmond, Va., January-December. 1889. “Progress of Medicine in the South.” Dr. Hunter Holmes McGuire, MD.

From: southernhistorians.org

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Private William McCarter of the Irish Brigade Hospitalized After Fredericksburg

By Patrick Young, Esq., 1-4-13

Private William McCarter was badly wounded during the Irish Brigade’s disastrous attack on the stone wall during the Battle of Fredericksburg in Virginia. He lay bleeding on the field for hours before nightfall made possible his still-dangerous escape to the rear.

The Northern army had a medical corps consisting of doctors and assistants, but most of the wounded were brought off the field by members of their own regiments who went back to try to collect friends. These Union soldiers would often pass by other wounded men, reserving their aid for men of their own units alone. McCarter was helped by two Irish Brigade comrades who recognized him in the dark. They put him on a horse-drawn ambulance. The ambulance was overloaded with twelve men when it took off to try to find medical care. The men were offered no first aid and two of them died before the vehicle reached the city of Fredericksburg, a short ways away.

When McCarter got to Fredericksburg, Union soldiers were wandering about aimlessly in the streets. Some broke into houses and looted them. A number were getting drunk on whiskey they had stolen. McCarter was dropped off at a house that served as a make-shift hospital. More than fifty “mangled victims” of the fighting were in the one room. The men did not see a doctor until the next morning. By then, a wounded man lying near McCarter had died.

A severely overworked doctor was finally able to see McCarter. He dug the bullet out of the soldier’s shoulder, but first he had to cut away much of McCarter’s uniform to get at his wound. When McCarter had to evacuate north by foot the next day, he did so with his wounded arm naked and exposed to December’s cold. He and thousands of other wounded men walked to a rail depot where they waited hours without shelter for a train to take them north. “[T]he wounded men crouched and huddled together and…some of them died from the exposure,” he recalled.

McCarter next went to a makeshift hospital made up of a collection of tents. There was so much blood and so many severed body parts that he later described it as looking like a “village of butcher shops.”  The surgical tent left a lasting impression:

Lying around were cases of ugly looking surgical tools, including the saw and the knife. In the back end of each tent a hole was made. Through it amputated arms or legs were thrown out upon the ground outside.

When trains finally arrived, the wounded rushed to get on. There was no order to the loading and the healthier men shoved aside the severely wounded. “It was simply every man for himself,” McCarter wrote, “I saw three men killed by falling under the car wheels as a locomotive began to move.” When McCarter was finally evacuated he was taken by a four hour train ride to Aquia Creek. Along the way, nine of McCarter’s wounded comrades died.

McCarter and hundreds of other wounded men on the train were taken off and hauled onto a steamship that was to take them to Washington. Few comforts were provided the suffering men and McCarter was forced to rest on the cold floor of the ship, when an unexpected source of comfort came to him. A woman, a Catholic nun, a Sister of Mercy comforted him, fed him and found him a warm place to sleep. This was McCarter’s first experience with these women, many of whom were immigrants like himself.

As he soon found out, the Sisters of Mercy had volunteered to take over the care of the men on the ship. McCarter remembered that during the trip they did “everything in their power to alleviate the terrible sufferings of the cargo of our wounded, sick and dying soldiers.” Over the coming weeks he would be cared for by many Sisters of Mercy. Their ministrations would be offered to native-born and immigrant soldiers alike of all religious backgrounds.  In coming articles, we’ll look at how these immigrant religious women helped create the nursing profession in the United States and changed attitudes about women in medicine.

Image: Field hospital at Savage’s Station in 1862.

From: longislandwins.com

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Confederate Hospitals

Original entry by Glenna R. Schroeder-Lein, Abraham Lincoln Presidential Library, Springfield, Illinois, 09/09/2010. Last edited by NGE Staff on 08/01/2016

During the Civil War (1861-65), Confederate military medical authorities established general hospitals behind the lines in at least thirty-nine cities and towns in Georgia, though many of them remained at a particular location for only a short time.

There were two types of hospitals during the Civil War. Field hospitals accompanied the armies, treating the sick and wounded first before sending those needing lengthier care to the general hospitals behind the lines, often at some distance from the front. Each general hospital had a staff, preferably of a size appropriate to its bed capacity. This staff included surgeons and assistant surgeons, a steward (manager and pharmacist), ward masters (supervisors), nurses, female matrons (domestic supervisors), cooks, and laundresses. Many staff members were soldiers, with a few white civilians, numerous hired or impressed slaves, and a minority of women. One of the women who worked as a matron in several Georgia hospitals was Kate Cumming, who kept a journal of her experiences, which was later published.

Savannah had a hospital early in the war, and general hospitals were established in Atlanta early in 1862, although little is known about the general hospitals in Georgia before they were incorporated into the Army of Tennessee system directed by Samuel H. Stout. A Tennessean and an excellent administrator, Stout had been in charge of the hospitals in Chattanooga. Beginning in August 1862, he became supervisor of the Army of Tennessee hospitals at Tunnel Hill, Ringgold, and Dalton, as well as those hospitals that would later be established between Chattanooga and Atlanta. By December 1862 the Atlanta hospitals were under Stout's control as well.

The hospitals in Georgia served sick and wounded soldiers who had fallen on battlefields outside the state. With the fall of Nashville, Tennessee, in February 1862, there were few "safe" places for hospitals behind the lines in Tennessee north of Chattanooga. (There were a couple of hospitals at various times in Knoxville.) Because they were accessible by railroad, the hospitals in Atlanta and northwest Georgia took in soldiers able to travel by train who had been evacuated from field hospitals to the north.

There was little military activity in Georgia until the late summer of 1863, when the Army of Tennessee under Braxton Bragg retreated through Tennessee to Chattanooga and then evacuated that city. Stout had to relocate his hospitals from Chattanooga, as well as from seven or eight vulnerable towns in north Georgia, to towns south and west of Atlanta. Stout had already developed a plan to mobilize his hospitals if needed. The patients would be transported to a hospital that was not moving. Then the staff would pack bedding, supplies, and other equipment and move to a preselected location, where they would set up the hospital again in local buildings or in tents.
Stout had established certain criteria for hospital sites. The town had to be on a railroad because trains were the quickest and most comfortable way to transport large numbers of patients. It also needed to have plenty of water and wood, appropriate buildings with empty land for hospital expansion, and adequate food available in the area. The town should also be some distance from battlefields and the risk of raids.

Unlike the general hospitals of Virginia, which stayed in one place, the Army of Tennessee hospitals went through waves of movement due to military conditions. Most hospital movements occurred in the summer of 1863, before the Battle of Chickamauga; around December 1863, after the Battle of Chattanooga; during the Atlanta campaign in the summer of 1864; and during and after John Bell Hood's Tennessee campaign in the fall and winter of 1864.

During the Atlanta campaign, especially, hospitals were continually relocating, even into Alabama, to avoid raiders from Union general William T. Sherman's army. At its peak during the summer of 1864, Stout's hospital system had at least fifty hospitals in nineteen Georgia towns, but locations changed frequently. In the fall of 1864 the hospitals tried to follow Hood into Tennessee, but due to deteriorating and indirect transportation routes, most were waylaid in Alabama or Mississippi and never provided any help to the sick and wounded.

After they returned from the Tennessee campaign, Stout's hospitals were reestablished in as many as ten Georgia locations, but they were very short on supplies. Although some of the hospitals were ordered to Charlotte, North Carolina, in April 1865, they were unable to go because of transportation collapse. Instead, most hospitals surrendered when captured by Union forces, though some continued to serve needy soldiers traveling home.

Army of Tennessee hospitals were located at one time or another in each of the following Georgia cities and towns: Adairsville, Albany, Americus, Athens, Atlanta, Augusta, Barnesville, Calhoun, Cassville, Catoosa Springs, Cherokee Springs, Columbus, Covington, Cuthbert, Dalton, Eatonton, Forsyth, Fort Gaines, Fort Valley, Geneva, Greensboro, Griffin, Kingston, LaGrange, Macon, Madison, Marietta, Milledgeville, Milner, Newnan, Palmetto, Resaca, Ringgold, Rome, Thomaston, Tunnel Hill, Vineville, and West Point.

Image 1: Macon City Hall, constructed in 1837, was used as a field hospital during the Civil War and served as the temporary state capitol during the final months of the war. This photograph of the building was taken in 1894.

Image 2: The Gordon-Lee Mansion in Chickamauga, built by prominent resident James Gordon, was completed in 1847 and later served as a hospital during the Civil War. The property was subsequently purchased by James Lee and remained in the Lee family until 1974. Today the home is open to the public as a bed and breakfast.

From: georgiaencyclopedia.org

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Columbus DaVega and The Floating Hospital

From: waring.library.musc.edu

One of the few South Carolina physicians with battlefield experience was MCSSC alumnus, Dr. Columbus DaVega, who was born in Charleston on December 23, 1830. After graduating from the Medical College of the State of South Carolina in 1852, he traveled to Europe where he was recruited to serve as a field surgeon with the Russian Army in the Crimean War (1853-1856). At the end of that war, he returned to Charleston and entered private practice.

During the Civil War, DaVega designed and served as surgeon on a hospital attached to a floating battery built to attack Fort Sumter from the water. The hospital was a one-story wooden structure outfitted with ten beds and medical supplies to treat soldiers wounded aboard the battery. In 1863, when Federal troops began their bombardment of Charleston, Dr. DaVega left for Columbia where he continued his medical practice. He died in Charleston on July 14, 1882 and is buried in the Jewish Cemetery on Coming Street.

Image 1: Columbus DaVega, M.D., n.d.

Image 2: The Floating Battery at Charleston, S.C.

Image 3: Interior of the Hospital

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History of the South Carolina Department of Mental Health

From: state.sc.us

From the establishment of the South Carolina State Hospital over 175 years ago, to the beginning of community mental health services in the 1920's, to the evolution of a complex mental health care delivery system, South Carolina has achieved an impressive record in its efforts to meet the needs of its mentally ill citizens.

As far back as 1694 the Lord Proprietors of the Carolinas decreed that the indigent mentally ill should be cared for locally at public expense.  In 1751 the colonial government similarly recognized the mental health needs of slaves.  In 1762 the Fellowship Society of Charleston established an infirmary for the mentally ill.  But it was not until the 1800s that the mental health movement received legislative attention at the state level.

According to legend, when Colonel Samuel Farrow, a member of the House of Representatives from Spartanburg County, traveled to Columbia to attend sessions of the legislature, he noticed a woman who was mentally distressed and apparently without adequate care.  Her poor condition made an impact on him and spurred him on to engage the support of Major William Crafts, a brilliant orator and a member of the Senate from Charleston County.

The two men worked zealously to sensitize their fellow lawmakers to the needs of the mentally ill, and on December 20, 1821, the South Carolina State Legislature passed a statute-at-large approving $30,000 to build the S.C. Lunatic Asylum and school for the deaf and dumb. This legislation made South Carolina the second state in the nation (after Virginia) to provide funds for the care and treatment of people with mental illnesses.

Robert Mills, a renowned architect, was chosen to design the new S.C. Lunatic Asylum.  In 1822 the cornerstone was laid for the Mills Building, which took six years to complete.  The building's many innovations included fire-proof ceilings, a central heating system, and one of the country's first roof gardens.  South Carolina's asylum was one of the first in the nation built expressly for the mentally ill and funded by a state government.

Citizens were wary of sending their loved ones to the asylum, and so, it was not until December 12, 1828, that the first patient was admitted. A young woman from Barnwell County, she was accompanied by her mother who worked as a matron while her daughter was a patient at the hospital.

The hospital admitted patients wealthy enough to pay for their own care, as well as the middle class and paupers. Although a few blacks, mostly slaves, were admitted during the first 20 years, they were not officially permitted until 1848.

Despite its innovative architecture, many problems arose within a few years after the asylum opened.  Complaints ranged from narrow halls and staircases and small activity rooms to flooding on the ground floor.  Another issue was expansion of the asylum grounds.

By the 1850s, the average patient paid $250 annually. A separate room and eating area cost another $100. Paupers were admitted for an annual fee of $135, which was billed to the patient's home district. As more paupers were admitted, it became harder to collect fees, and the asylum grew more dependent on state funding.  Due to the large number of people being admitted land was needed for new buildings and for patient recreation and gardens.  Some asylum leaders believed the institution should be moved to the country.  Largely because the legislature was unwilling to fund a new complex, it remained at the original location.  Land was purchased next to the complex, and more buildings were erected.  The headquarters for the South Carolina Department of Mental Health remain on these grounds even today.

Men and women were housed separately, originally on different floors, but later in separate buildings. When a new building was completed in 1858, male patients moved into it, and the women remained in the Mills Building. Despite the new building, the asylum reached its capacity of 192 by 1860. Many families preferred to care for their mentally ill relatives at home, while others wanted them closer to home even if it were in the county jail or the poor house. Only after the state assumed direct responsibility for all mentally ill in 1871 did county jails readily give up their patients.

During the Civil War, funding problems grew worse. Dr. John W. Parker, the superintendent, opposed a plan to turn his complex into a prisoner-of-war camp. Although the Confederate Army did not get the asylum, the grounds were used as a prison camp for Union officers from October 1864 to February 1865.

Despite worsening conditions late in the war, the asylum became a refuge for many Columbia residents when the city burned during Union General William T. Sherman's occupation in February 1865. With dwindling provisions, Parker did his best to provide for his patients and for the destitute citizens.

Like the rest of the South, the asylum struggled to survive in the aftermath of the war. Despite the lack of funds, the superintendent accepted more patients and often used his own money to provide them with food and other necessities.

J.F. Ensor, a Maryland native and former Union Army surgeon, became superintendent in 1870 and tried hard to find adequate funds for the institution. Several citizens from around the state contributed, and he received a $10,000 subscription from some Philadelphia Quakers, which helped repair the buildings. More than once, when local businesses could no longer give him credit, Ensor supplemented the institution's meager budgets with his own funds.

As the population grew, it became virtually impossible to treat patients.  The asylum became largely a dormitory to house the mentally ill.

In 1870 Ensor reported that the rundown asylum rooms "were mere cells of chink in the wall, dark and illy ventilated" and that there was not an adequate means of diagnosing patients.  These problems were solved to the best of his ability.  By 1874 Ensor had added central heating, plumbing, new furniture, pianos and books.

While Ensor made some strides in providing for patient's physical needs, overcrowding remained a problem.  This accelerated when the state government assumed the cost of patient care from the counties in 1871.

With slavery abolished, African-Americans became a larger part of the asylum's population. The admission of blacks not only added to the patient population, but led to another problem-providing separate facilities for the races. Temporary structures built before 1860 for blacks desperately needed replacement. Facilities for whites also were overcrowded.

While trying to accommodate this population increase, Ensor was forced to cut staff to have funds to buy food and meet other needs.  Sometimes this was not enough.   Even though the state was now required to pay for patient care, some asylum residents were sent home if they had no money to pay for their care.  Nevertheless, the population increased from 245 in 1870 to more than 300 by the time Ensor resigned seven years later.

Notable changes before 1900 included the founding in 1892 of a nursing school, which did not close until 1950, and changing the hospital's name in 1896 to the S.C. State Hospital for the Insane.

Although hospital finances became more stable in the 1880s, the legislature instructed the superintendent to economize wherever he could.  While most states were increasing their annual per capita spending, South Carolina was reducing hers.  The cost for each patient in 1877 had been $202.  It was reduced to $140 by 1888.  Nine years later, the per capita rate had fallen to $107.80, one of the lowest in the nation.

Image 1: The original drawings of the S.C. Lunatic Asylum, designed by Robert Mills, the United States' first native-born architect.

Image 2: This drawing of Camp Asylum was done by a prisoner, one of the 500 Union
officers imprisoned in the camp from October 1864 to February 1865.

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Chimborazo Hospital: Largest Military Hospital in the World

By Maggie MacLean, 10-10-15

Chimborazo Hospital in Richmond, Virginia essentially functioned as a village, complete with bathhouse, soap factory, morgues, and a bakery. Phoebe Yates Pember was one of the first women to serve as a hospital matron during the Civil War. Her memoirs describe in vivid detail her experiences as one of the first women to enter the previously all-male field of medicine in the Confederacy.

A Hospital on a Hill
Several million men went off to war in the early 1860s. They fell sick with disease and died from battle wounds by the hundreds of thousands. The Confederate government was not prepared for the sudden burden of caring for so many men. Hundreds of hospitals sprang up in the Confederate States, particularly in Richmond, where five railroads converged and close to many of the war's battles.

On May 29, 1861, Confederate President Jefferson Davis arrived in Richmond. In June 1861, street cleaners and unemployed free blacks were put to work building the three lines of defense around Richmond. The interior line consisted of a series of forts; in the middle line, earthworks were constructed in a five-mile radius from the capitol building, with intermittent installations of artillery batteries; the outer line was a set of simple trenches that soldiers could quickly occupy if the city were threatened.

Essentially, there were three types of fortification surrounding the city – artillery batteries strategically placed to maximize the effectiveness against approaching troops, forts to house more artillery along with soldiers and supplies, and. They were made almost entirely of earth and wood, which is why you often see old photos of fortifications almost completely barren of any nearby trees.

During the summer of 1861, newly-enlisted Confederate troops inundated Richmond. The undeveloped forty-acre plateau in the city's east end, known as Chimborazo Hill, was selected as a camp for soldiers. In late September and early October 1861, a workforce of slaves began erecting permanent winter quarters on the site. Plans called for soldiers' barracks, officers' quarters, three hospitals, and a large bake house.

The newly appointed Surgeon General of the Confederacy, Samuel Moore, soon recognized that Richmond's ability to care for the army's sick and wounded was sorely lacking. Many soldiers had died that previous summer because of the crowded conditions in the hotels, warehouses, stores, and private homes that had been used as makeshift hospitals. With many structures already in place on Chimborazo Hill, Moore decided to use the barracks as the beginnings of a hospital. He placed prominent Richmond physician, Dr. James B. McCaw, in command with the rank of surgeon-in-chief.

The nearly complete winter quarters - which measured about eighty feet by twenty-eight feet - were converted into patient wards. The walls were composed of two-inch-thick boards nailed to a simple vertical frame, and then a coat of whitewash inside and out. The workers covered the roofs with shingles and the floors with wood planks. Three doors and ten windows ran along each side for access and ventilation. There was a woodstove to fend off the cold, and a candle to show the way for the night shift of physicians.

Construction began in the autumn of 1861, and the complex grew to include ninety hospital wards, which were divided into five hospitals that could accomodate 3,600 patients at one time. In addition to the patient wards, Dr. McCaw's crew built kitchens, five ice houses, a large stable, a guard house, a chapel, five mortuaries, and various shops, bringing the total number of buildings to nearly 150. Wide avenues separated the rows of buildings to provide fresh air, which Dr. McCaw believed necessary for a speedy recovery.

With the buildings arranged in this fashion, Chimborazo became the first pavilion-style hospital in America. An assistant surgeon described the scene:

"The hospitals presented the appearance of a large town, imposing and attractive, with its alignment of buildings kept whitened with lime, streets and alleys clean … The buildings were separated from each other by wide alleys or streets, ample spaces for drives or walks, and a wide street around the entire camp or hospital."

Slaves at Chimborazo
In addition to the workforce of slaves who constructed the hospital buildings, Chimborazo relied on the slaves of local plantation owners to fill positions such as cooks and laundresses. Hundreds of African Americans, mostly enslaved males, served as nurses at Chimborazo Hospital. Slaves working at Chimborazo moved from a private to a public work environment and worked alongside free blacks, which must have been somewhat liberating.

Dr. James McCaw recognized early on the necessity of employing blacks for the hospital's own survival:

"I have at this time only two hundred and fifty-six cooks and nurses [slaves] in my Hospitals, to take care of nearly 4,000 sick soldiers ... it will be entirely impossible to continue the hospital without them."

Patient Care
Dr. McCaw first had to organize the massive facility. Contract surgeons were hired as needed, and civilian doctors occasionally volunteered their services. McCaw purchased hospital rations from local suppliers, and for the good of his patients, he established a large vegetable garden and a herd of hundreds of goats and milk cows a nearby farm.

In the summer of 1862, the constant dread that must have niggled at the mind of every person employed there came to pass. Wounded from the Seven Days' Battles filled the hospital beyond capacity. To accommodate the overflow, hospital workers set up Sibley tents, which housed eight to ten soldiers per tent, and the hospital continued to function as before.

The level of medical care within Chimborazo Hosptial varied greatly. Many accounts praised the doctors and the care provided by the female matrons. However, some patients complained that sufficient food was sometimes unavailable and some wards were poorly supervised. Some eyewitnesses went so far as to pronounce the medical staff negligent and the environment filthy and foul-smelling. However, the system worked. Throughout its existence, Chimborazo had a mortality rate of about nine percent; the best-staffed Union hospitals achieved only ten percent.

The Matron Law
On September 27, 1862, Confederate President Davis signed into law "an act to better provide for the sick and wounded of the Army in hospitals." The law provided that each hospital could employ two chief matrons at salaries not to exceed forty dollars per month to "exercise a superintendence over the entire domestic economy of the hospital." Each facility could hire two assistant matrons "to superintend the laundry, to take charge of the clothing of the sick, [and] the bedding of the hospital, to see that they are kept clean and neat." These women received compensation up to thirty-five dollars per month. Each ward could employ two ward matrons for salaries of thirty dollars per month whose duties were:

"to prepare the beds and bedding of their respective wards, to see that they are kept clean and in order, that the food or diet for the sick was carefully prepared and furnished to them, the medicine administered, and that all patients requiring careful nursing are attended to."

For the rest of the war, white Southern women managed Confederate hospitals as matrons. Those who filled these positions had to be blessed with the stamina to endure physical and mental hardships and the will to defy conventional ideas about their proper role in southern society. In addition to their salaries, all matrons received rations and suitable lodging. Matrons were not nurses. Most Civil War nurses in Confederate hospitals were hired slaves, free blacks, or convalescent soldiers. Matrons were almost always white women.

Phoebe Yates Pember
In her book Mothers of Invention: Women of the Slaveholding South in the American Civil War, Drew Gilpin Faust states that only a few "exceptional women" dedicated their lives to work as hospital matrons. Phoebe Yates Pember was one of the first women to serve as a hospital matron, and she served in that position at the largest military hospital in the world: Chimborazo. Pember's memoirs describe the difficulties she encountered as one of the first women to enter the all-male field of medicine.

Pember was born into a prosperous and socially prominent Jewish family in Charleston, South Carolina who later moved to Georgia. When her husband of five years died of tuberculosis in Boston on July 9, 1861, Pember joined her family, who had left the coastal city of Savannah for the supposedly safer town of Marietta, Georgia; they would spend the rest of the war as refugees.

In late 1862, Pember received a letter from her friend Mary Elizabeth Adams Pope Randolph, wife of the Confederate secretary of war. Randolph was active in the Richmond Ladies Association, which organized relief efforts for Confederate soldiers. Randolph offered Pember a position as chief matron of Chimborazo Hospital's Second Division, one of five hospital divisions. It was "rather a startling proposition to a woman used to all the comforts of luxurious life," Pember later wrote in her memoirs, but she reported for duty at the age of 39.

While working at the hospital, Pember not only dealt with the pain and suffering of her patients, but also with shortages of medicine, food and equipment. In addition, she dealt with doctors as well as a society that criticized women for working in hospitals, to which she responded:

In the midst of suffering and death, hoping with those almost beyond hope in this world; praying by the bedside of the lonely and heart stricken; closing the eyes of the boys hardly old enough to realize man's sorrows, much less suffer man's fierce hate, a woman must soar beyond the conventional modesty considered correct under different circumstances.

Pember made sure that the orders of surgeons were performed properly, and that the medical and dietary needs of her patients were fulfilled. As the war progressed, casualties multiplied and Phoebe's duties increased. She continually washed and dressed minor wounds and prepared the most difficult cases for the surgeons. She eventually found some respite from her duties by renting a room in town, to which she returned every night.

By the end of the Civil War, 76,000 patients had received medical care at Chimborazo; 15,000 of those were under Phoebe Pember's supervision in the 150 wards she managed. She remained at Chimborazo until the facility was taken over by Federal authorities and her last patients were discharged. At the end of the war, she wrote, "I found myself with a box full of Confederate money and a silver ten-cent piece." She spent the 10 cents on a box of matches and five coconut cakes.

Phoebe Pember then returned to Savannah, where she maintained her elite social status, and traveled in the United States and Europe. In 1879, her memoirs A Southern Woman's Story: Life in Confederate Richmond was published. It is considered a pioneering resource in women's history. During her last years she lived with her niece, Fanny Phillips Hill in Pittsburgh, Pennsylvania, where she died on March 4, 1913 of breast cancer.

Fall of Richmond
Because Richmond never endured a direct attack, Chimborazo operated safely throughout the Civil War. However, on April 2, 1865, Union forces penetrated Confederate defensive lines around Petersburg, twenty-three miles south of Richmond. When General Robert E. Lee's Army of Northern Virginia retreated to the west, Richmond was no longer protected and had to be evacuated. Those of Chimborazo's patients who were able began leaving on their own, while the staff and those too sick or injured to travel waited for the arrival of Union troops. Dr. McCaw surrendered the hospital to a group of Union surgeons on April 3, 1865. Soon after, ambulances began delivering Union patients, who were placed in separate wards away from the Confederates.

Freedmen's Bureau School at Chimborazo
By the early summer of 1865, patients had been removed from a section of the hospital, which was then designated as classrooms for a Freedmen's Bureau school. Two months after the fall of Richmond, the village on Chimborazo Hill was providing a home as well as an education for thousands of former slaves. Quaker societies like the New York Friends' Association supported the school, and they sent white Quaker women from the northeast to serve as teachers. Almost 200 newly-freed slaves enrolled in an afternoon session, and by fall their number had increased to 345.

The Freedmen's Bureau was a federal agency established to assist freed slaves in finding education and employment. They also used the former barracks and other buildings to house the flood of African American refugees pouring into Richmond. One ward was inhabited by 1,500 ex-slaves, some of whom were employed by Union authorities to begin cleaning up the city.

Sometime after 1869, the Freedmen's Bureau school at Chimborazo closed its doors, probably due to the ratification of the new Virginia Constitution, which required a public school system for all Virginia children. According to the Richmond Public Schools, in 1869, rooms were rented nearby to educate African American children. In 1881, a new school building was constructed, which eventually became today’s George Mason Elementary School.

The buildings at Chimborazo disappeared quickly after that. Local residents, desperate for firewood, tore down the hospital wards and burned them in their fireplaces and stoves.

In 1874, when the city purchased Chimborazo Hill to be used as a park, few buildings remained. In 1909, a United States Weather Bureau Station was constructed on the site. In 1959 the National Park Service acquired six acres of Chimborazo Hill, including the weather station building, which now serves as a visitor center for Richmond National Battlefield Park and the Chimborazo Medical Museum. The museum offers a great deal of information about the famous hospital, other hospitals in Civil War Richmond, and the practice of medicine in the 1860s.

Image 1: Image: Chimborazo Hospital in Richmond, Virginia. A man with a crutch looks out upon the long white buildings of Chimborazo Hospital on the hill above in a photograph taken just after the city had fallen to Union forces in April 1865.

Image 2: Freedmen's Bureau Classroom at Chimborazo School for Slaves

From: civilwarwomenblog.com

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Reunion of the Class of 1865: Captain Sally Tompkins

By Autumn Reinhardt Simpson, Local Records Archival Assistant, 11-17-10

Love and respect for one remarkable woman drew Civil War veterans from across the United States to Richmond during the summer of 1896. The occasion was a reunion of soldiers who spent time in the care of Captain Sally Tompkins and the staff at the Robertson Hospital.

 The Robertson Hospital Reunion Register dated 30 June 1896. The usual practice was to segregate the Confederate sick and wounded by state of origin. Patients often received sympathetic treatment from citizens of their home state. The diarist Mary Chestnut recorded  that when she expressed the desire to provide aid for wounded fellow South Carolinians Tompkins rebuked her saying, “I never ask where the sick and wounded come from.”

The hospital reunion register, recently cataloged here at the Library of Virginia, records the names, signatures and, occasionally, military units of former soldiers who attended a patient reunion during the Grand Confederate Reunion of 1896. Some wives’ names are also listed. The attendees came from at least nine states, from as far away as New York and Texas, further testimony to the respect and love that soldiers on both sides felt for the care Tompkins bestowed on all. Their admiration was not one-sided; Tompkins paid for the party herself, renting a house and providing food and drink for the entire company.

Tompkins was the only female commissioned officer in the Confederate army. She was born 9 November 1833 in Poplar Grove, Mathews County, Virginia. She moved to Richmond following the death of her father before the Civil War and used her considerable inheritance to open a private hospital at the outbreak of the war in April 1861. It stood at the corner of 3rd and Main Streets at the home of Judge John Robertson, thus giving the facility its name. Tompkins expected her patients to be treated as guests and she made the hospital as much like a private home as possible by providing excellent meals and keeping out as many hospital trappings as feasible.

In all, the hospital treated 1,333 soldiers from its opening until the last patients were discharged on 13 June 1865. Only 73 deaths were recorded at Robertson Hospital during its existence, a figure often attributed to Tompkins’s tireless work ethic and strict standards of cleanliness.

 When Confederate medical authorities decided to reorganize the hospital system to relieve Richmond’s overcrowding, Surgeon General Dr. Samuel Preston Moore closed most of the small private hospitals in Richmond except for Tompkins’s Robertson Hospital since it accepted no government funds, passed inspections, and had a high recovery rate.  A page from the register shows signatures and current residences of attendees. Another page shows that veterans traveled from several states and at least one identified his military unit. The stained glass window memorializing Capt. Sally Tompkins at St. James's Episcopal Church in Richmond.

The popular story is that when orders were given to the effect that all military hospitals must be run only by military personnel, Jefferson Davis appointed Tompkins a captain of cavalry to ensure that she continued to run the hospital. However, she received her commission on 9 September 1861; the Confederate government began its innovative hospital reorganization program and closed most private hospitals in Richmond to relieve overcrowding in the city after that time. Secondary sources are not all in agreement about the exact details of these events.

Sally Tompkins was buried in Mathews County with full military honors after her death on 25 July 1916, in Richmond. The Robertson Hospital Reunion Register is available for viewing on microfilm [Mathews County (Va.) Reel 56].

Image: The Robertson Hospital Reunion Register dated 30 June 1896.

From: virginiamemory.com

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“Captain Sally”

By Reed Alvord of Hamilton, New York, October 1998

NAME: Sally Louisa Tompkins
DATES: 1833 to 1916
ALLEGIANCE: Confederate
HIGHEST RANK: Captain
UNIT: N/A
SERVICE RECORD: Opened Robertson Hospital in Richmond, Virginia, on August 1, 1861. Commissioned captain of cavalry on September 9, 1861. Ceased operating the hospital on June 13, 1865.

Born into a wealthy and altruistic family in coastal Mathews County, Virginia, in 1833, Sally Louisa Tompkins was destined for a life of philanthropy. After moving to Richmond, Tompkins spent much of her time and a considerable portion of her fortune assisting causes she considered worthy. With the onset of civil war, she labored tirelessly on the behalf of the South’s wounded soldiers, and for this she became the first and only woman to receive an officer’s commission in the Confederate army.

After the First Battle of Manassas in July 1861 left northern Virginia littered with wounded, the fledgling Confederate government pleaded with its citizens to open their homes to the wounded. Tompkins was among the first to respond. She sought help from her friend, Judge Robertson of the Circuit Court of Richmond and Henrico County, and he offered her his home at the corner of Third and Main Streets in Richmond. At her own expense, Tompkins transformed the house into a hospital, naming it in honor of the generous judge. Tompkins’s keen eye for detail and her obsession with cleanliness made Robertson Hospital, which opened on August 1, one of the South’s most vital institutions, and Confederate authorities hurried their most desperate cases to her.

Tompkins’s reputation grew, and soon wounded Rebel soldiers, calling her “the little lady with the milk-white hands,” begged to be sent to her hospital. Soldiers of all ranks proposed marriage to her. She turned them all down, saying, “Poor fellows, they are not yet well of their fevers.” She never married.

Only a few weeks after the hospital opened, President Jefferson Davis placed all Southern hospitals under the control of the Confederate Medical Department. In recognition of Tompkins’s service, Davis commissioned her a captain of cavalry on September 9. Flattered, Tompkins refused all pay but accepted the rank because it enabled her to obtain supplies far more easily than she would have as a civilian. Her patients soon gave her the affectionate nickname “Captain Sally.”

Tompkins worked exhaustively until the hospital closed on June 13, 1865, two months after Union soldiers had occupied the Confederate capital. In four years as chief, Tompkins had admitted 1,333 patients, losing just 73 of them, a remarkable 94.5 percent survival rate. After the war, Tompkins’s continued philanthropy wiped out her fortune and compelled her to enter Richmond’s Home for Confederate Women. She died in 1916 and was buried with full military honors at Kingston Church in Mathews County. Years later, two chapters of the United Daughters of the Confederacy were named for her, the Confederacy’s only woman officer.

From: historynet.com

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Sally Tompkins: Devoted Confederate Nurse

From: historynet.com

Although they had no formal nursing directors, the Southern armies relied on women to succor their wounded just as the Northern armies did. Sally Tompkins administered one of the larger hospitals for the treatment of Confederate casualties. The daughter of Christopher Tompkins, a wealthy businessman and politician, she established a reputation as a philanthropist and nurse in Richmond, Va., where she and her family were living when the war began.

Following the First Battle of Manassas, a prominent Richmond judge named John Robertson offered his home as a military hospital and put Tompkins in charge of the operation. Although other private hospitals in Richmond that served the wounded were shut down to make way for larger military facilities, Tompkins obtained permission to carry on.

Confederate President Jefferson Davis gave Tompkins the rank of captain in the cavalry in September 1861, making her the first woman in the country to hold a military rank during wartime. In lieu of military wages, she received food, medicine and other supplies for the men. She ran her hospital with military discipline, Christian fervor and a fanatic insistence on sanitation. Of 1,333 patients admitted, only 73 died. Because of this success, some of the most grievously injured Army of Northern Virginia troops were sent to her hospital.

After the war, Tompkins remained single. She continued to take an interest in the welfare of Southern veterans until her death in 1916 at age 83, when she was buried with full military honors.

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John Wornall House Museum

From: civilwaronthewesternborder.org

Built in 1858, the John Wornall House Museum is a unique Kansas City landmark and a significant educational institution. As only one of five remaining Kansas City Antebellum homes, this magnificent Greek Revival structure is listed on the National Historic Register. Most famous for its use as a field hospital for both sides during the Civil War’s Battle of Westport, the Museum also tells the stories of domestic life, culture, traditions, and key economic developments in the mid-to-late 19th century. The home remained in the Wornall family until 1964 whereupon the Jackson County Historical Society meticulously restored the home to its 1858 grandeur. Since opening its doors in 1972, the John Wornall House Museum has become synonymous with tradition, prestigious, and bringing history to life.

In 2011, the John Wornall House and the Alexander Majors House merged to form The Wornall/Majors House Museums, a nonprofit organization with a mission to “engage our community by bringing history to life through innovative, hands-on programs and experiences.” The Museums boast an impressive record of achievement, reaching thousands of visitors and program participants annually with an operating budget of nearly $300,000. Each historic House features hands-on tours, including popular “ghost” tours and Holiday festivities. Field trips by dozens of local schools introduce thousands of students to history and what it means to them. The grounds of both Houses are filled with children’s laughter during sold-out summer camp sessions and often bustle with activity as history buffs and educators reenact the lives of Civil War soldiers and civilians. Concerts and readings by regional authors and reenactors round out the Houses’ programs. For information about the hours, summer camp, or upcoming programs and events, please visit www.wornallhouse.org.

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The Confederate Hospital in Bristol

From: visitbristoltnva.org

Bristol was a divided area when the Civil War began.  However, during the years that followed, Bristol became a confederate stronghold.  Although Bristol didn’t experience any battles, it served as a crucial point for soldiers in the area during the war.

The train depots located in Bristol were a stopping point for many soldiers traveling to the Deep South or northern Virginia.  During the years of the war, both train depots were burned down.  One occurrence was in December 1864 during (Union General) Stoneman’s Expedition into Southwest Virginia.

In the later years of the war, the trains bought soldiers to Bristol for medical attention.  The Exchange Hotel, which once stood in historic downtown Bristol, served as an Army hospital for the Confederacy.  The local residents made sure the hospital was supplied with food, medicine, bandages and fuel until the end of the war.  Many recuperating soldiers were placed in private homes when the hospital began to overflow with patients.

For the soldiers who didn’t make it, they were placed in the East Hill Cemetery.  A special section is dedicated to those who served.  Although most are confederate soldiers, union soldiers can also be found.

Built in 1920, the Confederate Soldier Monument was erected to honor those that fought for the Confederate Army from Tennessee and Virginia.  Today the monument can be found at Cumberland Square Park off of Cumberland Street.

 Among the many confederate and union soldiers that served from Bristol, was confederate Colonel John S. Mosby, who moved to Bristol with his wife in 1857.  During the war, Mosby was deemed the “Gray Ghost” because of his quick raids on Union strongholds and ability to vanish before being captured.

Bristol has many stories from the Civil War times.  Several that can be heard on the self-guided historic downtown walking tour.

Image: Confederate dead, East Hill cemetery, Bristol Tn

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A Confederate Hospital in Fredericksburg, and The Women Mobilize–1861

From: npsfrsp.wordpress.com 12-26-11

A tobacco factory would seem an unlikely place for a military hospital, but during the exceedingly polite Confederate presence in Fredericksburg during the first year of the war there were few other options. (The Union army used churches, stores, hotels, homes, and the courthouse–none of which were accessible to those bent on politeness in 1861). We don’t know the circumstances that led the Confederate army to take over the tobacco factory of Alexander Gibbs and his partner John F. Alexander (there is no record, for example, of the Confederates leasing the building or of their commandeering it), but by late June of 1861, as the landscape around Fredericksburg filled with spanking new Confederate troops (including some from Tennessee and Arkansas), Gibbs’s and Alexander’s tobacco factory on Prussia street held upwards of 150 sick Confederate soldiers.  Betty Herndon Maury recorded on June 26:

"The sick suffer a great deal for want of proper medical attendance and good nursing.  Many of the soldiers are laid on the floor when brought in, and are not touched, or their cases looked into, for twenty-four hours.  One or two died when no one was near them; they were found cold and stiff several hours afterwards.  The other night at ten o’clock, when one of the ladies left, there was not a soul in the house besides the sick men.  Every one in town has been interested in them."

The wretched conditions at the hospital soon spurred the community to action.  Two days after Maury’s gloomy assessment, the Fredericksburg News reported:

“The Ladies of Fredericksburg have organized a regular system for attending to the sick soldiers of our Hospital. Six ladies are in attendance constantly,whose office it is to superintend in various departments, and it is earnestly recommended to all who are desirous of aiding in this good work to act in connection with the committee of six ladies who will always be found in attendance.”

The rotations through the hospital did not last long, apparently, for soon local residents opted for the more expedient solution of simply taking the sick soldiers into their homes (though at least one local doctor protested the solution).  “I never saw anything like the spirit here!”, exclaimed Mrs. Maury. ” The women give up the greater part of their time to nursing the sick or sewing for the soldiers.  And it is the same case throughout the South.”

Despite the efforts of local women, dozens of Confederate soldiers died in the early months of the war. Town Council eventually set aside an area in the Potter’s Field (where the former Maury School stands today) for their burial.  Over the last several years, there has been a wrangle over the location of a memorial to these Confederate dead, which you can read about here.

The Alexander and Gibbs tobacco factory was the product of perhaps Fredericksburg’s youngest rising business combination.  John B. Alexander was just 25 years old at the outset of the war, and was one of Fredericksburg’s earliest enlistees-eventually becoming an officer in the 55th Virginia. Alexander Gibbs was just 30. They opened their business just before the war. Fredericksburg slave John Washington was among seven slaves hired by Alexander and Gibbs in 1860, and he left a vivid account of his time here–a time he remembered fondly.

"January 1st 1860 I went to live with Mr Alexander & Gibbs tobbacco manifacturers where I, in a month or two, learned the art of preparing tobacco for the mill. We were all “tasked” twist from 66 1/8 to 100 lbs per day. All the work we could do over the task we got paid for which was our own money not our masters. In this way some of us could make $3.00 or 4 extra in a week.

 "The factory weeks began on Saturday and ended on Friday when the Books were posted and all the men that had over work were paid promply on Saturday. But if any one failed to have completed his task the lash would be generally resorted to. In a Tobbacco Factory the “Twisters” generally have one or two boys, sometimes women for stemming the tobacco to be “twisted”. The Factory is kept very clean and warmed in winter from early morning till late at night could be heard  the noise of the machinery and singing of the hands in one incessant hum. In a Tobacco Factory some of the finest singing known to the colored race could frequently be heard — I was only permmitted to live one year in consequence of the threatening positions of the Southern States the firm of Alexander & Gibbs suspended operation. This year in the Factory was to me more like “Freedom” than any I had known since I was a very small boy. We began work at 7 oclock in the morning, stoped from 1 to 2 oclock for dinner, stoped work at 6 p.m. If we chose to make extra work we began at any hour before 7 and worked some times till 9 p.m. The se[ce]ssion of South South Carolina, and the threatened close of business between the North and South caused the suspension of work in this factory early in December 1860."

No vestige of the original building survives.  Sometime late in the 19th Century, Alexander and Gibbs’s place was torn down, replaced by another industrial building that is today fashioned Lafayette Square.  

Image 1: Alexander & Gibbs Tobacco Factory Confederate Hospital, 1861

Image 2: Betty Herndon Maury

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Jackson Street Hospital in Augusta, Georgia

By Tim Talbott, 2-11-2014

When it comes to primary sources few things catch me by surprise anymore. However, looking through the May 1860 issue of the Southern Cultivator, an antebellum agricultural publication produced in Augusta, Georgia, I came across an advertisement for the Jackson Street Hospital in Augusta.  That, of course, is not the surprising part; the surprising part is that the advertisement claimed this medical facility was a "SURGICAL INFIRMARY FOR NEGROES."

Immediately, I thought that this hospital was not solely for free people of color. Perhaps they treated free people of color, but why would a hospital for free blacks advertise in a planter's journal? It appears to me that this hospital was mainly for the treatment, rehabilitation, and cure of afflicted enslaved individuals. Is that not fascinating?

The ad strikes me as particularly intriguing because of some of the language that is included in it. First, the opening sentence clearly states that this hospital "is an acknowledged advantage to the Patient, the Owner, and the attending Physician." It clearly states the word "owner," which, of course, means it was for slaves. Secondly, it states that the hospital was established due to the "great need in the State of Georgia, and in the adjoining States." This phrase is strengthened by the next one. That is, that the infirmary "was established, ten year ago" just "for such a purpose." Now, if the Jackson Street Hospital was not proving successful and was being underutilized it is doubtful that it would have existed for a decade. Owners apparently saw the hospital beneficial and effective in the treatment of their slaves.

The ad also makes note that it is located near the town's railroad depot so owners could seemingly send their sick, diseased or worn out enslaved workers via train to be treated. Hospital amenities are enumerated as well: "rooms are furnished with proper bedding and accommodations; and Hot, Cold shower Baths, are at all times, convenient on each floor of the building." Mentioned also is the attending staff of "Resident Physician, and both Male and Female nurses" that are "in constant attendance, and every effort made to render the patients comfortable."

Patients were received by locomotive, as mentioned above, or by steamboat. And, it only cost $10 per month for room, board, and nursing per patient. To give a comparison, in 1860, field slaves often were rented for about $10 per month.

I wasn't able to find much information on the named doctors, Henry F. Campbell and Robert Campbell, but I did find that they were brothers. The 1860 census shows Henry as a 36 year old physician with a wife named Sarah and a daughter in the household. Robert is listed as a 34 year old physician with wife Caroline and six children. Henry was worth $25,000 in real estate (likely the value of the hospital building) and $5,000 in personal property. Robert owned $8,500 in real estate and an amazing $20,900 in personal property. I was not able to find out if the brothers were slaveholders.

One source, a book on Augusta's history and published in 1890, claimed Jackson Street Hospital had 50 beds and an auditorium for clinical lectures. The book mentioned in common Lost Cause terms that "its [the hospital's] ample patronage and support well vindicated the kindness and humanity of the Southern people, in the care and attention they were willing to secure, at liberal cost, for the sick and afflicted among their dependents."  On one level I see what the author was saying here, and it certainly fits well with the paternalistic label that some owners reveled in. But on the other hand it appears, too, that owners were likely seeking to heal and cure their slaves for another motive - that is to get more labor from them. This source says that the Jackson Street Hospital operated until after the Civil War when Freedmen's Bureau hospitals took over, "supported out of the public funds."

This article also states that Dr. Henry F. Campbell was educated at the Medical College of Georgia, graduating in 1842. During the Civil War Dr.Campbell apparently secured a position as an army doctor and served in the hospital that attended to Georgia soldiers in Richmond, Virginia. After the war he served on the faculty of the New Orleans School of Medicine and also worked at Charity Hospital. Later he returned to teach at the University of Georgia. He also published numerous articles on various medical issues.

In all of my reading on slavery I had never heard of a hospital that advertised in a planter's magazine. I often had read that owners went to great expense paying for the heath care of their enslaved populations, and why wouldn't they, being such a valuable investment. But that health care usually involved a local doctor making house calls at the slave quarters to attend to sick or diseased slaves or assist in a difficult birthing. The idea of an actual slave hospital is something that is totally new to me, but this evidence proves that regardless of owners' motive - benevolent or otherwise - the health of some masters' slave work force was important enough to go great expense and effort.

From: randomthoughtsonhistory.blogspot.com

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