During our country's early history, the federal military forces were considered to be a field army. Congress believed there was no need for any permanent barracks or hospital buildings. In time of war temporary hospitals could be established in churches, barns or other abandoned buildings. The United States was not alone in this practice for most European Armies did not provide any medical care for soldiers until about 1850. The sick and wounded were either sent home to recuperate or unceremoniously dumped on the local community until they recuperated.
In the United States there were only a few military hospitals and those were poorly staffed and relied on the individuals to provide most of their own care. During the American Revolution 12 soldiers died from disease for each killed in combat. The ratio dropped to seven to one during the Mexican War and the Civil War resulted in three disease-related deaths for each one caused by enemy action. We must also remember that this was before doctors associated germs with disease. It was not unusual for doctors to operate on infected wounds in dirty buildings with contaminated hands and instruments. In 1809, over 1,000 soldiers died near New Orleans because of inadequate housing and medical attention. Many army posts were isolated and in unhealthy areas. The appropriations for the seacoast fortifications made no provisions for hospitals. The sick were usually placed in damp casemates or some temporary shelters established by the post commander. As with most forts, no hospital was constructed at Fort Washington until the Civil War.
After the first fort was destroyed, workmen were sent to Digges Point to erect new batteries in case the British fleet decided to return. The garrison returned and lived in temporary quarters until the barracks was completed in the fort. Quartermaster returns show that fuel, straw and food were issued for use in a hospital. Some unknown building was being used as a sick ward, a pharmacy and as quarters for hospital stewards and cooks. William Harrington was paid $30.00 for 66 2/3-days service as hospital steward to sick laborers in July of 1820.
The 1821 Army Regulations were the first to place emphasis on cleanliness of barracks and bunks but does not mention hospitals. At Fort Washington, the enlisted barracks were competed in 1824. Prior to that time, the troops occupied a building outside the fort. After the troops moved into the new barracks the hospital remained outside the fort.
Captain Thomas Childs indicated that the hospital was separate from the fort in a letter to Brigadier General Jessup on February 19, 1827. "The repairs required for the hospital are absolutely necessary in order that the sick may be at least as comfortable as the miserable building called a hospital will allow in its present state, the floors are inundated when it rains." The hospital was in poor condition. The use of the word "inundated" might indicate that the building probably had a ground level floor and was setting in a low area.
The government only owned the land occupied by the fort. Daniel Carrol represented Thomas Digges in negotiations to sell additional land to the government. In a letter to James Barbour, in April 1827, he wrote "...and that the houses of the officers, artificers, Hospital Department, and all others of any consequences, connected with the establishment are built also on his (Mr. Digges) land, contiguous to and adjourning the fort..."