St. Elizabeths Hospital in the Civil War
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St. Elizabeths Hospital in Washington, D.C., originally was known as the Government Hospital for the Insane. It was established through the Civil and Diplomatic Appropriation Act of 1852, and admitted its first patients in 1855. Dorothea Dix, its founder and the leading mental health reformer of the 19th century, wrote the law that articulated the hospital’s mission “to provide the most humane care and enlightened curative treatment of the insane of the Army, Navy and the District of Columbia.”
Located on a hill in southeast Washington, D.C., overlooking the Anacostia and Potomac rivers, it offers a panoramic view of the city. St. Elizabeths was built as a 250-bed hospital. Thomas Walter, Architect of the Capitol Building (1851-1865), drafted the architectural plans for Center Building. In 1852, on the recommendation of Dorothea Dix, Charles H. Nichols, M.D., was appointed as the first Superintendent of the hospital. He was responsible for the building and administration of the hospital. It was built in three phases– west wing, east wing and the center building last. These wings became three distinct hospitals, each headed by a different physician.
On October 10, 1861, in the early days of the Civil War, the United States Congress authorized temporary use of the unfinished east wing as a 250-bed general hospital for the sick and wounded soldiers of the Union Army. The West Lodge for African American men was converted into a 60-bed general and quarantine hospital for the sailors of the Potomac and Chesapeake fleets.
In 1862, an artificial limb manufacturing shop (patented by B.W. Jewett) was set up to fit amputees with artificial limbs. Amputees from neighboring hospitals were transferred to St. Elizabeths Hospital to fit the prostheses free of charge. Soldiers stayed at the hospital until their wounds healed and they learned to use their artificial limbs. During this period, a portion of the hospital’s farm was converted into a cavalry depot and an encampment for a marine company.
Overcrowding was inevitable during the war. Tents were placed on the ground for the convalescent patients. President Lincoln frequently visited the hospital to see the sick and wounded soldiers, and a room was reserved for his overnight stays. During the fall of 1862, General Joseph Hooker was wounded at the Battle of Antietam and admitted to the hospital. Dr. Nichols and his wife personally cared for him. Dr. Nichols, a volunteer Surgeon for the St. Elizabeths Army General Hospital, would often ride out to major battlefields around the Washington, D.C. area to treat casualties. Approximately one-fourth of St. Elizabeths’ male employees divided their time between the battlefields and the hospital. The patients stepped in to assist in providing hospital services.
During the Civil War, the wounded soldiers were reluctant to write home that they were being treated at the “Government Hospital for the Insane.” They began referring to the asylum as the St. Elizabeths Hospital after the colonial name of the tract of land where the hospital was located. Congress officially changed the hospital’s name in 1916.
The Government Hospital for the Insane was the first and the only federal mental health facility in the United States at that time. Soldiers were referred there for treatment after they were thoroughly evaluated for malingering and deception. The way for a Union soldier to get discharged based on mental disability was through Government Hospital for the Insane. The admissions and discharges were controlled and authorized by the Adjutant General’s Office. However, not all Union soldiers were treated at St. Elizabeths. Dr. Nichols observed that most of these cases had both mental and bodily diseases. After the war, the Army and Navy general hospitals were closed, and the artificial limb manufacturing shop was dismantled. But the hospital continued to care for the mentally ill Civil War veterans.
Following the Civil War, there was an increase in the number of mentally ill veterans. On July 13, 1866, Congress passed an act that permitted the Government Hospital for the Insane to admit all men who had served as Union soldiers in the Civil War and were found insane within three years of discharge by reasons of continuation of mental illness, relapses after recovery, or mental illness relating to military service. The hospital gradually received veterans from all parts of the United States. Many of these former soldiers were chronically ill and required custodial care. To relieve congestion and overcrowding, the hospital continued to construct new buildings. The Dawes* extension to Center Building was built in 1871 to house 100 males. In 1872, another wing named Garfield* was added. In 1878, Atkins* Hall was built. The hospital’s expansion continued with the 1880 construction of the Relief Building to house 250 chronic male patients.
In 1882, Congress passed legislation directing transfer of insane persons from the National Home of Disabled Volunteer Soldiers to St. Elizabeths. The following year, the Home Building was built to accommodate 150 patients, 450 patients soon occupied it. The veterans were now elderly, disabled and in poor health. To separate the military prisoners and criminally insane, Howard Hall was built in 1887. Between 1898-1899, four Allison** Buildings were constructed to care for infirm and bed-ridden Civil War Veterans. The hospital always maintained high standards in caring for the Civil War soldiers. As stated by Dr. Nichols, “the patriotic sacrifices of the military patients will always entitle them to our best endeavors to promote their comfort and their restoration to health.”
St. Elizabeths Hospital has two cemeteries where soldiers from the Civil War are interred. The Civil War cemetery on the west side of the grounds has approximately 500 graves. White and African American soldiers from the Union army and soldiers of the Confederacy are interspersed throughout the cemetery. Many of the stone markers are worn, cracked, or broken. Some have been destroyed. The cemetery is in a poor condition. On the east side of the hospital grounds is another cemetery for Civil War veterans. Records listing names, ranks and the branch of service of the soldiers are maintained at the National Archive and Records Association. St Elizabths is still in use as a psychiatric facility to this day.
* Buildings were named after Henry L. Dawes, Republican Massachusetts, Chairman of House Committee on Appropriations from 1869 to 1871; James A. Garfield, Republican Ohio, Chairman of House Committee on Appropriations from 1871 to 1875; and John D. C. Atkins, Democrat Tennessee, Chairman of House Committee on Appropriations from 1877 to 1881.
** Buildings were named after William B. Allison, Republican Iowa, Chairman of the Senate Appropriations Committee from 1881 to 1893 and 1895 to 1908.
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