Civil War Profiles: Tilton General Hospital, a haven for Civil War casualties

Based on recent research, University of Minnesota Associate Professor J. David Hacker has determined that the death toll from wounds and illnesses during our nation’s conflict from 1861 to 1865 was upwards of 750,000. Beyond that appalling statistic, the Civil War Trust’s casualty figures lists 620,000 men wounded on the battlefield and a larger number stricken with a variety of sicknesses who required hospitalization.

Dr. Allen G. Schiek’s “Hospitals and Surgery,” relates that, early in the war, military hospitals were “converted factories, warehouses, and even railroad stations.” Increasing demand, however, generated a boom in the construction of medical facilities throughout the North and South.

By war’s end, federal general hospitals numbered more than 200, with enough beds to accommodate 137,000 patients. The Confederates were not far behind, with more than 150 such hospitals.

Dr. Alfred Jay Bollet’s study titled “Civil War Medicine: Challenges and Triumphs,” which is considered the “bible” on this subject, states that more than a million soldiers received care during the war. Hospitals had to provide patients with food, medicines, clothing and sanitation, as well as medical and nursing care. They even developed methods for “rehabilitation” of those recovering from disabling wounds and illnesses.

By 1862, the Union army adopted a standard type of hospital and constructed them from Vermont in the North to Louisiana in the South — from Kansas in the West to Delaware in the East. Confederate hospitals were primarily located in Virginia, North Carolina, Georgia and Alabama.

The largest of all was Chimborazo Hospital, located near Richmond, with surgeon James B. McCaw — a prominent Richmond physician — in charge. It spread over 40 acres and consisted of 150 wards that could accommodate 8,000 patients. Like a small city, it had a bakery that produced 10,000 loaves of bread a day, a soap factory, ice houses and a brewery for medicinal purposes, and published a newspaper.

The primary Civil War hospital in Delaware was Tilton General in Wilmington, named for Delawarean Dr. James Tilton, the first Surgeon General of the U.S. Army, from 1813 to 1815. Small in comparison to some of the more massive federal installations, Tilton nonetheless could accommodate 350 patients.

The building was constructed of brick, three stories high, and had six wooden wards running parallel to each other, projecting from a wide corridor. Tents erected on the grounds increased the hospital’s capacity.

More common, however, were the “pavilion-style, single-story wards that formed either a grid or an arc that fanned out from a central administrative facility.” These wards usually contained about 60 beds and had many windows, to permit maximum ventilation — a practice Florence Nightingale reportedly originated during the Crimean War in the 1850s.

Tilton was in operation for two years. Its staff consisted of surgeon E.J. Gailey, along with a number of doctors, including Robert P. Johnson, who served as executive officer.

Typically, in these army hospitals, there were no female nurses until later in the war. Instead, convalescent patients took care of the sick and wounded.

A Delawarean named Cyrus Forwood was a patient at Tilton General. A 25-year-old farmer from Brandywine Hundred in New Castle County when he enlisted, Forwood served with the 2nd Delaware Regiment.

On July 3, 1863, during the Battle of Gettysburg, Cyrus sustained a thigh wound. Casualties such as this were usually administered first aid at stations near the battlefield before being removed to the brigade hospital, a mile or two behind the lines.

By July 11, Forwood, having progressed sufficiently, was sent to Wilmington by railroad and admitted into Tilton General for treatment. Fortunately, Cyrus’ wound did not cause him to lose his leg. Nonetheless, his recovery was protracted, delaying his return to duty for two months (

Another soldier who benefited from care at Tilton General was Charles Knox from Schroon Lake, N.Y. The Augusta Chronicle of Aug. 18, 2011, described the fate of Knox, who enlisted in the Union Army, was captured in Virginia and was sent to Camp Lawton — a Confederate prison near Augusta, Ga. Confronted with Lt. Gen. William T. Sherman’s army advancing through Georgia in 1864, the rebels transferred the Camp Lawton prisoners to the infamous death pen at Andersonville, Ga.

Mercifully, Knox survived this ordeal and gained his release near war’s end. The U.S. Army transported him to Tilton General Hospital in Wilmington, where, receiving quality care, he was able to recuperate and return to his family in New York.

For wounded soldiers or those who contracted illnesses during the Civil War, Union and Confederate authorities created havens for their comfort and care — thereby saving many thousands of lives that would have otherwise been lost.

To learn more, visit the National Museum of Civil War Medicine in Frederick, Md. Their website is at, or call (301) 695-1864 for information.

Thomas J. Ryan is a Civil War historian, speaker and author of “Essays on Delaware during the Civil War: A Political, Military and Social Perspective.” Contact him at