Fort Porter and the U.S. Medical Corps.

World War One began in 1914 with the assassination of Archduke Franz Ferdinand of Austria-Hungary and had been raging in Europe, Africa, Asia, the Pacific Islands, and the Middle East. After four years of war, rising civilian casualties, and the sinking of U.S. merchant vessels, President Wilson appealed to Congress, asking for "a war to end all wars". On April 6, 1917, the U.S. Congress approved a resolution declaring war on Germany.

With the declaration of war, the citizenry of Buffalo was mobilized as the U.S. adopted the use of total war. Multiple regiments were mustered in and around the city. New factories were built, like the Curtiss plant, located on Elmwood Ave that constructed airplane parts while others shifted their work to help the war effort like the Pierce Arrow Motor Car Company making trucks for the army.

At the University of Buffalo and Canisius College students organized into student armies so that they could be prepared should they enter service. While school children helped in any way they could, whether that be knitting or helping gather food. The Red Cross volunteers prepared bandages, sewed and knitted clothes. From 1917 to 1919 there were four Liberty Bond drives and parades around the city to raise funds for the troop and war effort.

"During June, July, and August, 1917, all New York State Candidates, except those from New York City, were examined at Fort Porter for the 2nd Officers' Training Camp. ... During that summer, the people of Buffalo were greatly interested in the idea of organizing a Hospital Unit consisting wholly of local men." ³⁹  The unit was organized by the American Red Cross, Greater Buffalo Chapter and the Buffalo General Hospital. After training for three months the unit was activated on August 21, 1917. It numbered 28 Doctors, 75 Nurses, and 153 enlisted men. The unit finally got deployed on November 21, 1917, after a few canceled orders over the months. ⁴⁰  

Private Hourigan in the book History of Buffalo and Erie County 1914-1919: Buffalo and Erie County in the World War details the journey of the unit:

"A small crowd followed, mostly relatives, who had waited all day to see them off. Amid tears, smiles, and kisses from the loved ones they were leaving behind, the train pulled out at 8.20 P.M. They had no idea of the whereabouts of their destination." ⁴¹ 

Arriving in New Jersey, the following morning, the unit was met by, The Red Cross who served them food, drink, and cigarettes. The Red Cross nurses of their unit who had been waiting on Ellis Island for a few weeks before the arrival of the Buffalo's hospital unit joined them on their voyage as they left New York Harbor aboard the troopship, Carpathia, Cunard Lines at 12:15 P.M. November 22. ⁴³ 

"At last our turn came to board the troopship, our names were called, and as we went up the gangplank we each got a card with our bunk number on it, also a meal card. The boys were all excited, knowing by this time that we were bound for somewhere in France."  ⁴⁴ 

After a 17 day voyage that passed through Halifax (Nov. 26th), the unit got to Liverpool, England, (Dec. 8) where they took a train to Winchester, where they spent 5 days before going to Southampton where they took a boat to France. ⁴⁶ 

"The crossing of the Channel at that time was done at night on account of the sub warfare. So we left Southampton after dark.[Dec. 11] About midnight some Boche planes were flying over the Channel to make a raid somewhere in England. All the searchlights were turned on them from the forts and the boats guarding the waters between France and England. Their anti-aircraft guns also put up a wonderful barrage. While this was taking place our destroyers, two of which we had guarding us while crossing, made an awful noise blowing their sirens and making circles around our boat. I inquired what the trouble was, and found that a sub was in the vicinity. The boat returned to Southampton and we made the trip in safety the following night.[Dec. 12]" ⁴⁷ 

After landing in Havre, France the unit traveled for six days before reaching Vittel, France on December 19. ⁴⁸  Arriving at Vittel, France in the Vosges Mountains in the Lorraine Sector, the unit was just 40 miles from the front. ⁴⁹  Seven hotels and other buildings, villas, and cottages in Vittel made up Base Hospital No. 23. The Continental, Terminus, Angleterre, Nouvel, La Providence, Lorraine, and Joan d'Arc Hotels were used as hospital buildings. ⁵⁰  Le Casino was used as the barracks for enlisted men while Officers and Nurses stayed in hotels, cottages, and villas. ⁵¹ 

The outfit was supposed to be 500 beds but after a few months the capacity was over 3,000. There were two surgical hospitals with a capacity of 1,200, two medical hospitals with a capacity of 1,500, one contagious hospital with a capacity of 300, one officers hospital with a capacity of 250, and a nursing hospital with a capacity of 150. All of the buildings were in a bad state and it took almost three months to get them habitable with beds and other hospital materials not arriving until February. ⁵⁹ 

When Base Hospital 23 first began taking in patient accounts vary, with the Fort Porter Reporter claiming that "The first patients arrived at Vittel on Jan. 1, 1918. These consisted of gas and surgical cases. In the middle of February, cases began to come in by the hundreds. In a few weeks the hospital was caring for nearly 2600 patients, men from all the allied armies, but mostly French and Americans." ⁶⁰ 

Pvt. Hourigan the source for Buffalo's Part in the War claims the hospitals did not see their first patients until March, ⁶¹  but Nurse Elsie Blanche Augustine's earliest mention of treating patients was in her February 12 diary entry:

"On duty at 5 but no patients until 8:30. 23 were admitted. Feel as tho' I have a new lease of life -- to think of being able to do something for the [?] blesses -- 9 stretcher cases -- all nationalities, Belgium, French, Madagascan, Chinese, Arabian..." ⁶² 

However, "after August, 1918, the wards contained only Americans." ⁶³  Private Hourigan recalls that this happened "when the commandant of the hospital centre received orders to evacuate all Allied soldiers but Americans, and thereafter to care for Americans only. This happened because Americans began coming over more rapidly and the 1st and 2nd American Division moved to the Lorraine Front" ⁶⁴ 

According to Private Hourigan "The hospitals didn't get overcrowded until the St. Mihiel drive." ⁷¹  The offensive of St. Mihiel was the first battle with the newly formed American First Army under the U.S. command of General John Pershing. All previous battles involving the American Expeditionary Force had been under French or British leadership. The attack took place from the 12-16 of September 1918, and involved over half a million Americans and 110,000 Frenchmen. ⁷²  The offensive was a pincer maneuver of Germans withdrawing from the town of St. Mihiel that they had held for nearly four years. ⁷³  At the end of fighting the allied forces had routed the Germans who had lost 2,300 men with another 16,000 captured and the Americans suffered 7,000 casualties ⁷⁴  with about 4,437 killed or missing in action. ⁷⁵ 

Private Hourigan recalls that their

"Center being nearest to the Lorraine front, was made an evacuation hospital during the St. Mihiel drive. The Red Cross did wonderful work among the wounded boys. They visited the hospital every day, gave them everything they needed, and entertained them in every way....The hallways were fitted up with cots and the capacity of each hospital was far exceeded. The operating rooms were busy day and night, ambulances and Red Cross trains were coming in at all hours. The suffering of wounded men was intense but they seemed to think nothing of their wounds, smoked cigarettes and 'kidded' one another over their injuries; at the same time, many of those men had arms or legs shot to pieces. As fast as patients could possibly be moved they were sent to base hospitals farther back." ⁷⁶ 

Blanche Augustine indicates in her September 13, 1918 diary entry that they also treated "quite a number of Germans." ⁷⁷ 

According to the Fort Porter Reporter "All the surgeons and most of the enlisted men [of Base Hospital 23] had active duty in evacuation and field hospital work" ⁸⁴ 

Private Hourigan again recalls that "our loss of patients was very small, due to the excellent treatment given them by our skilled doctors and nurses. It was sad when we lost some of our own unit. The first one we lost was our beloved adjutant, Capt. Burroughs. The boys missed him very much. Whenever they got into trouble, a little trip to the adjutant's office, and everything was easy for them. We used to call him 'Dad.'" ⁸⁵  Captain Burroughs died September 17, 1918, of pneumonia following influenza. ⁸⁶ 

After the Battle of St. Mihiel and the following Meuse-Argonne offensive, the number of patients began to dwindle as the war came to a close. On November 11, 1918, the Armistice was signed and the war was ended. With the war over the number of patients continued to fall until February 6, 1919, when Blanche Augustine recalled "Our buildings are being closed today and we cease to be a base. All records are sent in and we await orders." ⁸⁸  By the end of the war "Base hospital 23 handled close to 15,000 patients" ⁸⁹ 

On March 11 the unit left Vittel and on March 13, arrived in La Baule, France where they stayed until April 4th when they departed for Brest and Camp Kerhoun. Two days later they boarded the Kaiserin Augustine Victoria, the first German liner taken over by the Americans and on April 8 left France. ⁹¹ 

Here we look at a few members of Base Hospital 23 and get a brief summary of their backgrounds and their time in France.

A graduate from the University of Buffalo Medical School in 1895. He enlisted in the National Guard on Nov 1, 1894 at the age of 21 while still at UB. Upon graduation, he transferred to the Hospital Corps. of the 74th Regiment in 1896. He spent a year as a resident physician at Erie County Hospital and was house surgeon at the Fitch Accident Hospital of Buffalo for two years. Then in 1898, he was deployed to Cuba during the Spanish-American War where he was commissioned from an Assistant Examiner to an Assistant Surgeon. ⁹⁴ 

After the Spanish American War Dr. Clinton "began a private practice in Buffalo as a general surgeon. He also served as assistant surgeon of the 65th Regiment of the National Guard, with the rank of Captain, and was surgeon for the Pennsylvania Railroad Company." ⁹⁵  He was also "appointed to the faculty of the U.B. Medical School in 1900, he taught surgery to several thousand students, many of whom have since achieved distinction in the field. In June 1931 he succeeded the late Dr. McGuire as professor of surgery and head of the surgery department. He also became a professor in the Dental school and after his retirement was made emeritus professor in both divisions. ⁹⁶ 

During the summer of 1917 the people of Buffalo became interested in creating a Hospital Unit consisting of Buffalonians. On August 20, 1917 Marshall Clinton was called into service as a Major MD, and on August 21 initially under his command as director of surgical service, Base Hospital No. 23 was mobilized at Fort Porter.

Deployed to Vitell with the rest of his Base Hospital 23, he was later sent to the front in February 1918 in the Vosges mountains and served in evacuation hospitals 1 and 2, where he was the head of a surgical team. ^97-98  That Summer, on July 3, 1918 he was promoted to Lieutenant Colonel, ⁹⁹  and was cited by General Pershing for "exceptionally meritorious and conspicuous services." ¹⁰⁰  Then he was detailed to general headquarters in the Argonne in September. He became surgical consultant with the 35th division at Gerardmer and was with the A.E.F. First army at Sorelly. In November 1918, he was a surgical consultant to the Second Army at Toul and became commanding officer of Base Hospital 23. During his service he received a Purple Heart ^101-102  and was honorably discharged on March 1, 1919. ¹⁰³ 

After returning from France in 1919 he became "chief consulting surgeon at Children's Hospital and Buffalo City Hospital. He was attending surgeon at Buffalo General Hospital and its predecessor the Buffalo Hospital, and had previously served in a similar capacity at the Sisters of Charity and Erie County hospitals. He was a fellow of the American College of Surgeons, the American Surgical Society, and a member of the Erie County Medical Society, the Buffalo Academy of Medicine, the New York State and American Medical Associations, the American Association of Military Surgeons and the Saturn Club."  ¹⁰⁴ 

A graduate from the University of Buffalo Medical School in 1911 and a family member to other prominent Buffalo doctors, including Professor Irving W. Potter (Uncle) a clinical instructor of Obstetrics at UB, and Dr. Milton G. Potter (Cousin). ¹⁰⁵  Hugh registered for the draft on June 5, 1917, and was placed in the Medical Corps Reserves as a Lieutenant as part of Base Hospital No. 23. and was deployed to Vitell, France. ¹⁰⁶ 

"In April 1918, he was detached from it [(base hospital 23)] and ordered to the Verdun sector with the 2nd division of marines and regulars. He experienced much action with various divisions and finally returned to hospital 23 in December 1918." ¹⁰⁷ 

In 1918, Lt. McDowell was awarded the Silver Star Medal for gallantry in action. ¹⁰⁸  The Silver Star Medal is the third-highest military decoration for valor in combat. The Silver Star Medal is awarded for singular acts of valor or heroism over a brief period ¹⁰⁹ , such as one or two days of a battle. Based on the proximity of his unit and the time he was awarded the medal it can be reasonably inferred that he received this medal for his contributions during the St. Mithiel or Meuse Argonne Offensives.

After the war, Hugh returned to Buffalo and became a prominent obstetrician. He worked as an attending physician at Millard Fillmore Hospital and an associate attending physician at Buffalo General Hospital. Member of the Obstetrical and Gynecological Society. He was a trustee on the council of the Buffalo Academy of Medicine from 1938 until his death in 1951. He was also a member of many other professional associations such as the American Medical Association, the New York State Medical Society, the Erie County Medical Society, and the Buffalo Obstetrical and Gynecological Society,  ¹¹⁰ 

Elsie who preferred to go by Blanche was born on a farm in Wainfleet Township, Ontario Canada in 1885. She moved to Buffalo, New York to become a nurse, graduating from the Buffalo Homeopathic Hospital Training School for Nurses, as part of the class of 1914. Blanche joined the American Army Corp of Nurses and was attached to the Base Hospital 23 unit. ¹¹⁴ 

She met up with the unit after being stationed at Ellis Island in 1917 and when deployed she spent most of her time stationed with Base Hospital 23 in Vittel, France, though she traveled around France when needed and for a few weeks in the summer of 1918 was sent to New York City's Base Hospital 9 in Chateauroux, France. As a nurse, Blanche was treated akin to an officer and was forbidden to interact with enlisted men outside of professional duty and was housed in buildings reserved for nurses and officers. ¹¹⁵ 

At the end of the war, like others in military service, she was given a Victory Medal, now known as the World War One Victory Medal. ¹¹⁶  Blanche's medal has an Army Service Clasp for non-combative service that denotes where she served attached to her ribbon.

After the war "Blanche did more private duty nursing after return[ing] from France. Some papers indicated she may have gone back to Europe to escort wounded soldiers home but we have no formal knowledge of this -- ...She was formally discharged in 1925. ... She worked in obstetrics for a year in Akron Ohio ... and did private duty nursing again in Buffalo where she met her husband in 1928. ... They moved back to Long Beach, Ontario... [and] became the unofficial nurse for the Long Beach community."  ¹¹⁷ 

Fort Porter officially became home of General Hospital No.4 on November 10, 1917, when Base Hospital 23 was deployed. The Fort changed over from a mustering and training ground to a U.S. General Hospital. The hospital was meant to treat wounded, sick, and unwell soldiers coming back from Europe but after a few months began to admit psychiatric patients and before long the hospital was specializing in psychiatric care although medical and surgical cases were still treated at the hospital.

"The total number of admissions for the first year was 1062 and the number of discharges was 835... Extensive alterations had been made to the barracks building to fit it for the proper care of psychiatric patients. The old squad-rooms were made into wards and apparatus for treatment of such cases were installed. In caring for the patients all available means, of a surgical, medical and hydrotherapeutic nature, were used in order to improve their condition and hasten their recovery. The doctors assigned here to treat these patients were men who had had from ten to fifteen years' experience in State Hospitals caring for psychiatric cases. Besides the medical officers and the experienced attendants, there was a very efficient staff of nurses of the Army Nurses Corps, and Army Reserve Nurse Corps." ¹²³ 

 When U.S. General Hospital No. 4 opened in November of 1917 it treated general medical and minor surgical cases. However, soon after accepting its first psych patient in February of 1918 the hospital became specialized in treating psych patients. ¹²⁷  The types of cases being treated at the hospital are often referred to as neuro-psychopathic, nervous, or shell shock cases. Shell shock was a term "coined in 1915 by medical officer Charles Myers. At the time it was believed to result from a physical injury to the nervous system during a heavy bombardment or shell attack, later it became evident that men who had not been exposed directly to such fire were just as traumatised." ¹²⁸  As a modern diagnosis this disorder is known as a type of post-traumatic stress disorder.

This condition was one that hundreds of thousands of soldiers suffered from during World War One. "The first cases Myers described exhibited a range of perceptual abnormalities, such as loss of impaired hearing, sight and sensation, along with other common physical symptoms, such as tremor, loss of balance, headache and fatigue. He concluded that these were psychological rather than physical casualties, and believed that the symptoms were overt manifestations of repressed trauma." ¹²⁹ 

In the March 21, 1919 issue of the Fort Porter Reporter, one of the station's weekly newspapers describes in an article the staff, the conditions of the wards, and treatments used to treat patients:

"To treat these patients, a carefully picked class of men and women were enlisted into the army to care for these poor unfortunate soldiers. Psychiatric specialists and male and female nurses experienced in the treatment of such cases in civil life joined the ranks of the army and put themselves at the disposal of our government to help cure these men. ...at present time there are approximately 270 patients in the hospital and 193 enlisted men in the medical corps and 25 Medical Officers to care for them. There are also 30 nurses and 9 reconstruction Aides in the Hospital. In the treatment of these stricken soldiers, first of all comes the extreme cleanliness of the wards. The beds are kept thoroughly clean. The linen is changed twice a week and oftener, if necessary. ... The wards are well heated and ventilated at all times. The patients are bathed and clothing is changed twice a week. Barbers trained in handling nervous patients are kept busy shaving the patient and cutting their hair. - Medical Officers and constantly going thru the wards looking after the patients’ condition and are always on the alert to see that they are comfortable. Patients are put to bed for the slightest ailment and the nurse in charge instructed to pay close attention to them for symptoms. The nurse in charge of the ward keeps a careful record of each and every patient. ... . The treatment of patients consists largely of quiet surroundings, fresh air, a physical culture of exercises, and walks out in the open air. In some wards men are provided with uniforms of  fatigue suits and any who wish to work are given light duties for a few hours every day." ¹³⁰ 

At General Hospital No. 4. occupational work for the patients was introduced October 2, 1918, by Reconstruction aides under the leadership of Head Aide Miss Alma L. Whitney. The idea behind the reconstruction program implemented by the U.S. Surgeon General was to have aides:

"go into the general and base hospitals and furnish occupation for them; not with the idea that they will later earn a livelihood by what they learn while convalescing, but rather that the occupation will give their bodies and minds employment so they will dwell less on their condition. ... [Reconstruction work at General Hospital No. 4 consisted of] basket making, knitting, crocheting, making hot-dish mats, knotted belts, bags and hammocks, rug-making, drawing, toymaking and chair-caning." ¹³¹ 

With the success of the reconstruction work and at the request of the patients a vocational training program was developed by the Reconstruction Aides in the late-Spring, early-Summer of 1919. The Library at Fort Porter which was maintained by the American Library Association had hundreds of volumes of fiction and magazines for the patients but upon request of those at the fort they developed a collection of technical books. "Automobiles, electricity, business, engineering, printing and carpentry are just a few of the subjects covered." ¹³⁵  For any books that were lacking the fort had forged a relationship with the head of the Buffalo Public Library and were able to "draw upon the reserve shelves of the school department for any book which may be needed immediately." ¹³⁶ 

In the later stages, the Reconstruction Department had expanded, and by August 1st, 1919:

"This branch is now in a position to teach carpentry thoroughly, as it is equipped with two of the latest model work benches, all kinds of tools imaginable and so arranged that quite a number of men can work at a time. At one end of the tent are several drawing tables for mechanical drawing and here can be seen students at work, busily engaged learning the art. Further down the aisle in the tent is a brand new mimeograph machine that the department is using to do their own work in mimeographing as they have numerous reports that must be made out every day and at the same time teaching the use of this machine to the patients. In one corner is seen a late model jig saw and on this the men are bust cutting out different shape objects in wood that are later used for other work that is in progress. This department has also started a branch in journalism and so far we have enrolled quite a number of students, including several cartoonists who have volunteered their services for our post paper and shortly we will print some of their work to demonstrate their progress. Any patients that are interested in any of these branches can get any information they desire from any of the Reconstruction Aides on duty, as we will be glad to enroll any patients and endeavor to give them instructions in any line of work that they are best fitted for." ¹³⁸ 

Daily life at Fort Porter, U.S. General Hospital No. 4, was reported by hospital newspapers the Trench & Camp (October- December, 1918) and the Fort Porter Reporter (January-October, 1919). They informed the reader about the status of the war, the city, happenings around the Fort (events, sports, discharges, transfers, etc.), and in some cases the lives of people at the Fort and those who used to be stationed there.

Much of what was being done at Fort Porter was trying to keep the patients in a happy and pleasant environment. In History of Buffalo and Erie County: 1914-1919 Sweeney says that "The post orchestra and the Commission on Training Camp Activities furnished a musical program throughout the wards daily. Two vaudeville programs were given by professional talent from the theaters in the city each week so that there was plenty of entertainment. The patients were given daily exercise and daily walks in the vicinity of the Fort." ¹⁴²  In addition to events held at the Fort, there were also regularly scheduled events like dances and concerts held at music halls, Knights of Columbus halls, and auditoriums around the city often as benefits to help the men at the Fort.

Other events that happened at Fort Porter to keep the men in high spirits were the participation and spectating of sports. While Fort Porter had a baseball team and a football team they also regularly held smaller sports tournaments among the patients (pool and track & field). In the Summer trips to the beach were also a special treat for the patients to get off base and enjoy the sun.

While there were many events at the Fort for the mental well-being of the patients there were also other parts of life that were not as about mental-hygiene but rather the sanitation of the Fort itself.

One of the largest fears of the U.S. Army in camps and hospitals was the spread of pestilence among their ranks through the spread of insects. When the war ended in November of 1918 focus changed from fighting the Germans to fighting pests. And, with the defeat of their enemy one can see how quickly rhetoric changed, no longer characterizing threats to the U.S. forces as "Huns" or "Jerry" but instead opting for Bolsheviks. Often seeing play on words like "Flysheviks" or "Flysheviki" as can be seen in the June 20, 1919 political cartoon of the Fort Porter Reporter (right). These two things were among the perceived greatest threats to the United States moving forward. However, another threat that proved to be perhaps the greatest concern to the camp, and the U.S. Army in general, however, was the Spanish Flu.

While the treating of its neuro-psychiatric patients was the primary focus of U.S. General Hospital No. 4 with the outbreak of Spanish Influenza in 1918, the patients of the hospital were too at risk of the most deadly pandemic since the Black Death in the 14th century.

The Spanish-Influenza Pandemic began in 1918 and roughly lasted until 1920. "World War I claimed an estimated 16 million lives. The influenza pandemic that swept the world in 1918 killed an estimated 50 million people. One fifth of the world's population was attacked by this deadly virus. Within months, it had killed more people than any other illness in recorded history." ¹⁴⁶  This flu, a strain of the H1N1 was especially deadly to those under the age of 5, ages 20 through 40, and over 65. ¹⁴⁷  The 20-40 age range being prime military age the men of the Fort were especially susceptible to the disease. With no known way to effectively treat the disease, ways to treat and mitigate its spread were inconsistent throughout the world and the United States. Quarantines were recommended, masking mandates and ineffective vaccines were being rolled out and General Hospital No. 4 was no exception.

In the October 10, 1918 issue of the Trench and Camp it describes some of the precautions used to deal with the pandemic at Fort Porter:

“Although the men stationed at Fort Porter have not been quarantined for Spanish Influenza, the utmost precautions are being taken to prevent the spread of the disease at this point. All men of the post have been inoculated twice against the plague, and each day the men are sprayed through the nose and throat. Major Brownrigg called the members of the post together at noon on Friday, October 4, and instructed them in regard to the best methods of preventing the spread of the disease by personal cleanliness. The officers of the post have pledged themselves to do all in their power to prevent the disease from spreading. ¹⁵¹  ... ’Flu’ Masks Now in Vogue at Fort Porter – To Prevent the spread of Spanish influenza, all members of the command stationed at Fort Porter have been supplied with masks. When the masks were given out most of the fellows took the whole thing as a joke. It was not long, however, before the seriousness of the matter was realized. The masks are worn at all times, except when eating.” ¹⁵² 

While Spanish Flu continued to be a concern for those at the Fort, by 1919 they seemingly were not as concerned given the lack of it being mentioned in their weekly newspaper.

When the armistice was signed in November 1918, the soldiers stationed at General Hospital No.4 like most of the soldiers throughout the army were anxious to be discharged and to get back to their lives before the war.

However, because of the continued need to keep treating patients returning from overseas medical personnel were not being given their discharge orders. The government had no means to immediately replace all of the doctors, nurses, and aides that were seeking immediate discharge and needed to roll out the discharges gradually. ¹⁵⁴  This upset many at the Fort especially as they were continually told that they should re-enlist in the army throughout the Spring and Summer of 1919.

However, by July the number of remaining patients around the country had been shrinking and there was no longer a need for all hospitals to stay open. It was decided that medical personnel could begin mustering out by the end of September, and in the August 15 issue of the Fort Porter Reporter those at the Fort were informed that they would be closed down in the fall. ¹⁵⁵ 

After two years of the establishment of the hospital, General Hospital No.4 transferred its final patients in October and closed its doors on November 9, 1919. Its remaining patients were transferred to the remaining U.S. General Hospitals and the men at the Fort were mustered out of service or transferred to new posts.