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The Civil War: The Origins of Veterans’ Health Care

Old photo of a hospital room with soldiers and beds

Civil War Veterans receive medical treatment at the Bath Branch of the National Soldiers Home in Bath, N.Y. VHA Historical Photo

by Jerome W. Mapp, VA Staff Writer

When the Civil War ended its bloody run on April 9, 1865 at Appomattox Courthouse, Va., more than 600,000 of the 2.4 million Union and Confederate troops were either killed in combat or by disease. Thousands more would require long-term care for their mental or physical wounds of war. America’s costliest and bloodiest conflict would have a profound effect on health care for Veterans.

When the Civil War began on April 12, 1861, it is estimated America had 80,000 Veterans from previous conflicts, who were treated at a handful of Veterans homes scattered across the nation. The Civil War added more than 1.9 million Soldiers, Sailors, and Marines to the rolls.

After the war, benefits for Civil War Veterans were restricted to those Veterans who had fought on the Union side; Confederate soldiers were not legally recognized as Veterans until 1958, when they were pardoned by the U.S. Congress for taking up arms against the nation.

According to Darlene Richardson, historian for the Veterans Health Administration, pre-Civil War Veterans received long-term treatment at a handful of Soldiers and Sailors homes scattered around the country.

weathered illustration of hospital buildings and hills

A detail of the Eastern Branch of the National Soldiers Home in Togus, Maine. The home today is the Togus VA Medical Center. VHA Historical Photo

“One of the original homes for Veterans was the Naval Asylum in Philadelphia, which was established in 1811 and officially opened in 1834, it housed sick and disabled naval officers, seamen, and Marines.” according to Richardson.

“The National Soldiers Home, established in 1851, in [northeast Washington] D.C., housed Veterans of the War With Mexico (1846-1848) until the Civil War began, when Union soldiers received care there, too.” The National Soldiers Home today is known as the Armed Forces Retirement Home (AFRH) Washington, D.C.

In the 1960s, the Naval Asylum in Philadelphia closed and a new facility known as the U.S. Naval Home was constructed in Gulfport, Miss. Congress merged operations of the U.S. Naval Home with the National Soldiers Home into one administrative unit in 1991 and the National Soldiers Home was renamed as the Armed Forces Retirement Home (AFRH). Today, both facilities house men and women of all military branches.

St. Elizabeth’s Hospital in southeast Washington, D.C., authorized in 1855, was originally called the Government Hospital for the Insane, and was actively used during the Civil War. Union and Confederate Soldiers, Sailors, and Marines, including African-American troops, were treated at the hospital. President Abraham Lincoln, a frequent visitor to the hospital, noted that the many casualties created by the war often resulted in overcrowding at the hospital. Tents were erected behind the hospital to handle the overflow of combat casualties.

Old photograph of a hospital building

The Western Branch of the National Soldiers Home in Leavenworth, Kansas as it looked shortly after the Civil War. Today, the home is the Dwight D. Eisenhower VA Medical Center. VHA Historical Photo

In 1865, with so many Veterans needing long-term care, Lincoln appealed to Congress and the nation in his second Inaugural address, “…to care for him who shall have borne the battle, and for his widow and his orphan.” Those words later became the motto of the Veterans Administration, which became the Department of Veterans Affairs in 1989.

“Lincoln’s efforts resulted in creation of the National Asylum for Disabled Volunteer Soldiers (NHDVS) in March 1865, which established a national government home for Veterans of the Union’s volunteer forces. The National Asylum was overseen by a Board of 12 managers. Eventually there were 11 National Homes.” Richardson said. “In 1873, they [the board] renamed it the National Home for Disabled Volunteer Soldiers because the word asylum was starting to have negative connotations.”

The eleven NHDVS properties established between 1865-1930 were known as: the Eastern Branch in Togus, Maine (now Togus VA Medical Center); the Northwestern Branch in Milwaukee, Wis. (now Clement J. Zablocki VA Medical Center); the Central Branch in Dayton, Ohio (now Dayton VA Medical Center); the Southern Branch in Hampton, Va. (now Hampton VA Medical Center); the Western Branch in Leavenworth, Kan. (now Dwight D. Eisenhower VA Medical Center); the Pacific Branch in West Los Angeles, Calif. (now Greater Los Angeles Healthcare System-West Los Angeles Healthcare Center); the Marion Branch in Marion, Ind. (now VA Northern Indiana Health Care System); the Danville Branch in Danville, Ill. (now VA Illiana Health Care System); the Battle Mountain Sanitarium in Hot Springs, S.D. (now VA Black Hills Health Care System); the Mountain Home Branch in Johnson City, Tenn. (now Mountain Home VA Medical Center); and the Bath Branch in Bath, N.Y. (now Bath VA Medical Center).

Old photo of a hospital building surrounded by snow

The Danville Branch of the National Soldiers Home in Illinois is today the VA Illiana Health Care System, Danville. VHA Historical Photo

Initially, each home served as little more than a domiciliary (soldiers’ home) that provided medical care. Over time, the homes offered recreational activities, libraries, and church services. According to the 1900 board of manager's annual report, several homes maintained theaters, libraries, and billiard halls.

Some of the homes offered Veterans games such as dominoes, checkers, chess, backgammon, cards, boating, skating, pool, and croquet. At the homes’ theaters, Veterans were entertained with concerts, comedies, melodramas, musicals, vaudeville, and lectures.

When the Veterans Administration was established in 1930, all 11 homes, plus three newly authorized homes in St. Petersburg, Fla., Biloxi, Miss., and Roseburg, Ore., became part of VA.

Four of the original National Homes are currently under consideration for designation as National Historical Landmarks. They are: the Northwestern Branch (Milwaukee, Wis.), the Western Branch (Leavenworth, Ks.), the Mountain Home Branch (Johnson City, Tenn.) and the Battle Mountain Sanitarium (Hot Springs, S.D.).

The organization of aid to America’s Veterans has changed over the decades, but our respect and sentiment for their contributions remains the same. VA is proud to carry on America’s legacy of caring for its military Veterans.

Related Link:
  National Homes for Volunteer Soldiers