Chimborazo: The Confederacy's Largest Hospital

Chimborazo: The Confederacy's Largest Hospital * Carol C. Green * Knoxville: University of Tennessee Press, 2004 * xii, 200 pp. * $29.95

For many, the words "Civil War hospital" conjure up distinctive images of battlefield survivors crowded around makeshift hospital tents waiting for harried, overworked surgeons to dress their wounds or amputate shattered limbs. Yet field hospitals made up only a small portion of Civil War medicine, and Carol C. Green's Chimborazo: The Confederacy's Largest Hospital corrects this historical myopia and sheds new light on an oft-neglected topic. Green argues that the protracted care administered in Civil War hospitals in general, and at Chimborazo in particular, positively affected nineteenth-century notions of medical treatment in large institutional settings.

Green's work describes Chimborazo Hospital from its organization in October 1861 to its closing in the late spring of 1865, and individual chapters focus on the institution's medical officers, staff, patients, supplies, and medical treatment. A major theme throughout the book is the idea that Chimborazo was an innovative medical facility, both in the large, pavilion-style structure of the hospital complex and in the methods used by medical officers to treat patients. The author persuasively argues that Chimborazo's surgeon-in-chief, Dr. James B. McCaw, deserves most of the praise for his institution's success. According to Green, McCaw was an energetic, caring administrator who sometimes disregarded the directives of Surgeon General Samuel Preston Moore in order to promote his patients' comfort. Realizing that contented patients were easier to manage than hungry ones, McCaw used the hospital fund advantageously and responded promptly to patient complaints. He also encouraged the development of collegial relationships among medical officers, which further improved patient care.

In addition to the able leadership of McCaw, Green asserts that several factors coalesced to make Chimborazo the flagship institution of the Confederate hospital program. Its location just outside Richmond offered the advantages of well-trained physicians from the Medical College of Virginia and easy access to supplies and medicines from locally based Quartermaster and Commissary Department agents. Chimborazo's close proximity to major battles and campaigns in the eastern theater of the war might at first seem disadvantageous, because sick and wounded soldiers often taxed the staff's ability to care effectively for them. Yet Green insightfully argues that medical officers gained valuable knowledge from treating thousands of patients and concludes that, over time, patients benefited because doctors honed their diagnostic and treatment skills.

The book's main shortcoming, however, lies in one of Green's stated purposes: to construct "a picture of life at Chimborazo Hospital" (p. viii). The author points out that both staff and patients represented all levels of southern society, from upper-class physicians and elite matrons to enslaved and free African American nurses, cooks, and laundresses. Yet the main players in Green's story are McCaw and Phoebe Yates Pember, a Chimborazo matron who published her postwar memoirs as A Southern Woman's Story. Although Green offers some analysis of life at Chimborazo from the patients' perspective, most are quoted from secondary sources. This work would have benefited from more archival research. For example, the postwar memoirs of William Eustace Trahern (incorrectly identified in the text as "Traher") and wartime letters written by Charles Achilles Douglas-both patients at Chimborazo-are in the Virginia Historical Society's collections, to name just two examples. To be fair, Green did consult over 100 volumes of official Chimborazo Hospital records, a daunting task indeed. Yet without these "unofficial" voices, the picture of life at Chimborazo remains somewhat incomplete.

Reviewed by Nancy Schurr, adjunct professor of history at Chattanooga State Technical Community College. She completed her dissertation, "Inside the Confederate Hospital: Community and Conflict during the Civil War," at the University of Tennessee, Knoxville, under the direction of Stephen V. Ash.

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