The city was flooded with casualties after the first battle of Manassas, quickly overwhelming the existing hospitals. Wounded were treated in any space available - hotels, private homes, even barns. Realizing that a long war and thousands more casualties lay ahead, Southern leaders ordered the construction of five general hospitals in Richmond to treat the military's injured and ill. The National Park Service Visitor Center now stands on the site of the most famous of those institutions -- the "hospital on the hill," Chimborazo.
According to local legend, the name "Chimborazo" comes from a volcano in Ecuador. A Richmonder who had visited South America compared that volcano with this hill, one of the largest in the area, and the name became widely used in the city. Chimborazo hill was an excellent site for a medical facility for several reasons. Its location near the James River was convenient for the transportation of supplies on the Kanawha canal. Fresh water was readily available from natural springs, plus dug wells and steep slopes on three sides of the hill afforded good drainage.
Opened in October of 1861, the hospital covered over forty acres and operated between 75 and 80 wards grouped into five separate divisions Each ward was a hut made of whitewashed pine boards that housed up to forty patients, giving the entire hospital a capacity of over 3,000. Every division had its own laundry, kitchen and bathhouse, and a central bakery and dairy serviced the entire facility, making Chimborazo one of the Confederacy's best-equipped hospitals as well as one of the largest. Directly outside the grounds were the J.D. Goodman brewery and the city's Oakwood Cemetery.
More than 76,000 Confederate sick and wounded were treated here. Chimborazo had a patient mortality rate of 20 percent; dismal by today's standards, but quite good in terms of nineteenth century medicine, before the days of antibiotics, antiseptic surgery and widespread understanding of germ theory. Indeed, it was viewed by Confederate leaders as one of the finest hospitals their new nation possessed.
Chimborazo hospital was innovative, pioneering several new techniques in medicine. Its use of separate wards allowed patients to be grouped together by state - a forerunner of the ward system in modern hospitals.
In 1862, faced with a shortage of hospital staff, the Confederate government authorized the hiring of females as matrons and ward attendants. Phoebe Pember, author of A Southern Woman's Story was one of several women who worked in the wards of Chimborazo. "The service of these ladies," said one surgeon, "added very materially to the comfort of the sick" and marked one of the earliest full-scale entries by women into a profession they soon dominated -- nursing.
Chimborazo's greatest asset was its chief surgeon, Dr James McCaw. A professor at the Medical College of Virginia before the war, McCaw proved to be an exceptional administrator. As with the rest of the South, Chimborazo was continually plagued with supply shortages. The ravages of war on the countryside and the general inefficiency of the Confederate Quartermaster Department combined to prevent the hospital from getting needed supplies. Some wards had to be closed because of a lack of straw used to make mattresses, and the shortages of basic foodstuffs (salt, coffee, meat, flour) forced the hospital bakery to close in the winter of 1864-1865.
Dr. McCaw ably managed his available resources, much to Chimborazo's benefit. He rented land near the hospital to pasture cows and grow a garden, providing his patients with a small but steady stream of fresh vegetables, cheese and milk When soap was scarce, Chimborazo made its own, using grease from the hospital kitchens. McCaw even purchased two canal boats to speed the shipment of foodstuffs from outlying farms. Through his efforts, the "hospital on the hill" was able to fill many of its own needs and continue functioning.
Chimborazo hospital was not a wonderful sight to behold. With insufficient soap or staff for cleaning, the wards were constantly "littered with piles of dirty rags, blood and water." In the summer, the heat made the odor and the flies almost unbearable. Yet, it must be remembered that this hospital faced a monumental task and significant problems with accomplishing that task.
Under the leadership of Dr. McCaw, Chimborazo overcame most of its difficulties and provided the Confederacy with valuable service, an achievement which one author wrote, "may fairly be called one of the most noteworthy achievements in military medicine in American history."
