St. Elizabeths Hospital in Washington, DC, originally known as the Government Hospital for the Insane, was established through the Civil and Diplomatic Appropriation Act of 1852.  Dorothea Dix, its founder and the leading mental health reformer of the 19th century, wrote the law that articulated the hospital’s mission “to provide the most humane care and enlightened curative treatment of the insane of the Army, Navy and the District of Columbia.” 

SEH was built as a 250-bed hospital.  Thomas U. Walters, architect of the Capitol Building, drafted the plans for Center Building.  Upon Dix’s recommendation, Charles H. Nichols, MD, was appointed the first Superintendent of the hospital by President Millard Fillmore in 1852 and served until 1877. He was responsible for the construction and operation of the hospital. Center Building was built in three phases: west wing, east wing, and the center administrative section last. 

The facility was soon split into three distinct hospitals shortly after the outbreak of the Civil War.  On October 10, 1861, Congress authorized temporary use of the unfinished east wing as a 250-bed general hospital for sick and wounded soldiers of the Union Army.  West Lodge, for “colored insane males,” was converted into a 60-bed general and quarantine hospital for sailors of the Potomac and Chesapeake Fleets, and the patients from West Lodge were relocated to another building.

In 1863, an artificial limb manufacturing shop (patented by B.W. Jewett) opened to fit amputees with prostheses. Soldiers stayed until their wounds healed and they learned to use their artificial limbs. During this period, a portion of the hospital’s farm was converted to a Cavalry Depot and encampment for a Marine Company.  

During the Civil War, wounded soldiers were reluctant to write home that they were being treated at the “Government Hospital for the Insane.” They began referring to the asylum as the St. Elizabeths, the colonial name of the tract of land. Congress officially changed the hospital’s name in 1916.

President Abraham Lincoln frequently visited soldiers at the hospitals. Overcrowding was inevitable during the war. Tents were erected behind Center Building to house convalescing soldiers. 

Dr. Nichols, a volunteer surgeon for the St. Elizabeths Army General Hospital, often rode out to major battlefields around the DC area to treat casualties. He was introduced as one of General McDowell’s staff at the First Battle of Bull Run.  Approximately one-fourth of St. Elizabeths’ male employees divided their time between the battlefields and hospital and patients stepped in to help provide hospital services.

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