- The Washington Times - Friday, June 3, 2005

The first shots of the American Civil War sparked a significant need for hospitals to tend the wounded — and cemeteries to bury the dead.

As the war progressed and casualties increased, the need for hospitals far exceeded federal capabilities. Thus, injured soldiers often were treated at impromptu locations.

Washington’s St. Elizabeths Hospital, the first federal mental hospital in the United States, was one of the sites chosen to provide for the recovery of the sick and injured. Established six years before the war by Dorothea Dix, it had as its primary mission “to provide the most humane care and enlightened curative treatment of the insane of the Army, Navy and the District of Columbia,” the Journal of Civil War Medicine said in a recent issue.

St. Elizabeths not only fulfilled its initial goals but also subsequently added medical and surgical care, established a prostheses-manufacturing shop and provided space for two military cemeteries.


Originally known as the Government Hospital for the Insane, the 250-bed facility was established through the Civil and Diplomatic Appropriation Act of Congress in 1852. Ground was broken for the first building in 1852, and in 1855, the first patients were admitted.

The institution was placed under the Department of the Interior. Dr. Charles H. Nichols, appointed by President Millard Fillmore as its first superintendent, served from 1852 to 1877. In addition to handling daily operations, Dr. Nichols was responsible for the construction of the buildings.

The hospital was laid out in three sections. The west wing was erected first, followed by the east wing, then by the center administration building, which was later called the Center Building. Two separate buildings established to care for the “colored insane” were the West Lodge for men, constructed in 1856, and the East Lodge for women, built in 1861.

The hospital’s physical arrangement was based on the recognized standard for asylum and mental health treatment at that time. The Center Building “represented the collegiate gothic style with a castle-like appearance,” the Journal of Civil War Medicine said.

Military role

The Civil War began on April 12, 1861, as Confederates fired on Fort Sumter, S.C. Within six months, there was a dire need for hospital facilities in the Washington area to care for the wounded.

St. Elizabeths was suitable for military purposes for a number of reasons. Its impressive acreage already held several buildings intended to care for the disabled. Also, its location on a prominent hill in Southeast was ideal for Signal Corps operations.

In response, Congress authorized military use of various buildings and other space there. The unfinished east wing was temporarily approved as a 250-bed general hospital for sick and wounded soldiers.

The “colored” men’s West Lodge was converted into a 60-bed general and quarantine hospital for sailors of the Potomac and Chesapeake fleets. In addition to the Government Hospital for the Insane, two distinct military hospital divisions were created, one for the Navy and another for the Army.

A famous patient

St. Elizabeths Navy General and Quarantine Hospital received its first patient June 28, 1861, and closed Oct. 1, 1866. The daily roll of 20 to 50 patients included many servicemen from the Washington Navy Yard. Seamen admissions included those from the USS Anacostia, Freedom, Minnesota, Pawnee, Pensacola, Pocahontas, Relief, Resolute, Savannah, Sonoma and Yankee, and the revenue cutter service.

The Union Army General Hospital officially opened at St. Elizabeths on Nov. 21, 1861, and closed May 31, 1864. The first patient at this facility was Francis W. Carney, a drummer with the 4th Regiment, Excelsior Brigade, Company I.

Gen. Joseph Hooker, wounded at the Battle of Antietam, was treated there in autumn 1862. This hospital division had its largest number of admissions during the first 14 months of activity. During its 3 years of operation, 1,890 patients were admitted. Confederate soldiers also were treated there.

A new name

The Minie ball, the prevailing ammunition used during the war, was so devastating that battlefield and hospital amputations often were necessary. To aid amputation patients, an artificial-limb manufacturing shop was opened by B.W. Jewett in 1863 and operated under the Army General Hospital. Patients from St. Elizabeths, as well as neighboring hospitals, were fitted and taught to use their prostheses free of charge.

Overcrowding was inevitable, and tents often were used for convalescing patients. The hospital’s male civilian employees divided their time between the battlefield and the hospital, and patients volunteered to assist in providing hospital services.

Wounded soldiers were reluctant to write home that they were being treated at the Government Hospital for the Insane, so they began referring to the asylum as St. Elizabeths Hospital, after the Colonial name for the tract of land where the hospital was located. In 1916, Congress changed the hospital’s name.

Unique cemeteries

St. Elizabeths Hospital’s grounds contain three known burial areas, one for patients and two for military-related personnel. These cemeteries are unique in a number of ways.

At the time these cemeteries were established, the prevailing burial policies dictated that racial separation be maintained. Within most cemeteries, it was not unusual to have blacks’ graves separated from other interments by a fence, a hedge or even a ravine. This policy was not maintained at St. Elizabeths, where black and white, along with Union and Confederate, rest side by side.

The patient interment area, on the hospital’s East Campus, may date to as early as 1855, but this is unconfirmed. Few gravestones mark the area, situated northeast of today’s John Howard Pavilion. The total number of burials here is unknown, but countless grave-shaped depressions are evident in the ground.

Worn headstones

Military burials took place on the hospital’s West Campus, on a hillside that slopes down toward Interstate 295 and overlooks the Potomac River. This location perhaps was the hospital’s initial military cemetery. Union and Confederate casualties lie here, as do civilian “indigents.”

Burial sites are marked by military-type grave markers. With few exceptions, the markers are inscribed with the grave number and the soldier’s name, rank and unit. In addition, the markers for black soldiers regularly have a C (for colored) or USCT (United States Colored Troops) inscribed at the top of the stone.

The gravestones of Pvt. Thomas Jackson, Company A, and of Pvt. Evans Covington, Company E, two black soldiers from the well-known 54th Massachusetts Infantry, are marked in the latter fashion.

Buried here are soldiers from 198 companies and 21 states. Most markers are worn with age, and many are damaged or missing. In 1982, 225 stones remained, but the area may have contained as many as 500 graves. A stone wall bearing a memorial plaque protects the entrance.

Other wars

Other military burials took place on the east side of the hospital’s campus, generally south of the patient interment area. The dead are identified by standard military-type markers.

The first two rows of this extensive area are readily identified as Civil War-related burials. The remaining sites mark the graves of those who fought in other wars and campaigns. For instance, the headstone above the remains of William Shields says, “Negro Scouts Seminole War.” Many others represent casualties of the Spanish-American War and of World War I.

The grounds of St. Elizabeths Hospital, a National Historic Landmark District, are divided by a major thoroughfare into a West Campus and an East Campus. The federal government deeded the East Campus to the D.C. government in the mid-1980s. Patient care has been reduced and is confined to the East Campus.

Paul E. Sluby Sr. is a local historian and genealogist who has written a number of books on cemeteries and churches.

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