Few American armies have been more humbled by the reality of war than the Army of the Potomac during its summer 1862 march up the Peninsula from Fort Monroe to Richmond.
When its blue-clad legions landed at Old Point Comfort in March, it was the largest army the Western Hemisphere had ever seen — and its advance with 121,500 men, 14,592 horses and mules and 1,224 wagons on Confederate-held Yorktown was described by a British military observer as "the stride of a giant."
But beginning with the May 5 Battle of Williamsburg — and continuing in clash after clash during the struggle for Richmond — the grim ferocity of the rifled musket and .58-caliber Minie ball exacted a toll no one expected. Still more crippling was the fearful number stricken by typhoid, dysentery, malaria and Chickahominy fever, which swept through the Union ranks so relentlessly that the camps of the sick and wounded swelled to 20,000 soldiers.
So dire was this unprecedented medical crisis that Maj. Gen. George B. McClellan plead for help, spawning a fleet of hospital ships that evacuated the sprawling wards on the Pamunkey River first — and then the epic expanses of tents at Harrison's Landing on the James River.
When that flood overflowed the hospitals to the north in early August, the steamers ferried thousands to the east bank of the Hampton River, where hundreds of carpenters labored to complete the vast triangle of wards that soon boasted the second largest number of beds in the North's hospital system.
"The army simply wasn't equipped to deal with such huge numbers of wounded and sick soldiers — and it was quickly overwhelmed," says Dennis Mroczkowski, former director of Fort Monroe's Casemate Museum.
"But it responded in a very short time with a huge hospital and a huge staff that could handle thousands of patients. The hospital at Hampton was a very busy place — and it was very impressive."
So large was the tract of land taken up by the hospital at its height that it stretched from the grounds of today's Veterans Affairs Medical Center to the far side of adjacent Hampton University.
Dozens of buildings housed some 3,500 beds, and a small city of hospital tents pushed that capacity to 5,000 patients. Horse-drawn ambulance cars weaved between these structures, connecting them to the busy Old Point Comfort wharves through a narrow-gauge railway.
Nearly every week the New York Times reported the names of the men who died there, while the American Medical Times described the conditions in the wards and the newest treatments. Illustrations appeared in both Harper's and Leslie's weekly newspapers, while Harper's New Monthly devoted 18 pages to an in-depth feature.
"People have forgotten how large and important this hospital was," says J. Michael Cobb, curator of the Hampton History Museum.
"And when Grant crossed the James River and began the siege of Petersburg in 1864, its location so close to the field of battle made it even more crucial."
Despite its later significance, the Hampton hospital got its start in the small 4-ward clinic that served the garrison of 350 men defending Fort Monroe at the start of the war.
Within days of Virginia's secession, however, the number of troops stationed there grew nearly 10-fold, raising the number of sickbeds needed so quickly that doctors commandeered the Hygeia Hotel and transformed its famous dining room into a surgical ward.
As the Federal presence swelled, so did the need for more hospital space, leading the army to fill the abandoned halls of the 4-story Chesapeake Female Seminary with 500 more stricken soldiers.
That meant the two largest buildings in the region had been seized and repurposed in a desperate response to the unending stream of sick soldiers, Cobb says. But the situation only grew worse with the ferocious Battle of Williamsburg and the campaign that followed.
By early July 1862, the American Medical Times reported the Hampton "hospitals filled to overflowing with the sick and wounded from the battlefields about Richmond."
Though construction had started on a huge new "pavilion hospital" made up of more than two dozen large detached wards, the workmen couldn't keep pace with the deluge that poured in as the army abandoned Harrison's Landing in August.
"Near the end, the Hampton hospital was like the drain for the whole campaign," says Terry Reimer, director of research for the National Museum of Civil War Medicine in Maryland.
"The Union was evacuating the sick and wounded as fast as it could. It was just insane."
Just how overwhelming can be seen in the reports of Army of the Potomac medical director Jonathan Letterman, who moved patients to Hampton by the thousands.
Yet despite his complaints about the hospital's unfinished state, it was still far better than the field hospitals left behind.
"For several days…the hospital steamers, with their little crimson flags flying from the masts, were at the upper dock," Harper's Weekly reported.
"A large number (of the patients) were convalescing, so that they walked to the hospitals... It was a touching and sympathetic sight, with forms and faces indicative of disease, some with fans, and most with staffs in their hands, they slowly walked along, like pilgrims to the promised land."
Within days, most of the 3,000 new patients were housed in either the new wood-frame wards or one of hundreds of tents, paving the way for a complex that became one of the Union's largest and most well-developed hospitals.
In addition to the fruits and vegetables provided by a 100-acre garden, Hampton boasted running hot water, a 3,000-volume library and its own letterhead stationary in addition to the most modern treatments of battlefield trauma and camp diseases.
Nevertheless, its proximity to the front filled its wards with the most severe cases, including those too sick or injured to be moved north in what was a constant shuffle of patients. Amputees abounded, resulting in the construction of a ghastly Gangrene Camp, while every new battle brought ships filled with the most seriously ill and injured.
"To see a large steamer crowded with them, lying upon their narrow couches, with bleeding wounds, shattered bones, amputated limbs, and parched tongues, was enough to move the compassion and rouse the sympathies of the hardest heart," a chaplain reported.
Then there was the constant procession of the dead spawned by the hospital's grim struggle.
Letter after letter sent home by patients, doctors and chaplains describes the constant sound of Hampton's musicians as they honored the fallen.
"They are dying off very fast in the hospitals," wrote Pvt. Milton McJinkin of the 85th Pennsylvania Infantry a month after the Peninsula Campaign folded.
"Almost all hours of the day you hear the muffled drums and the dead march and the salutes fired over the graves of the departed."