THE MILITARY SURGEON, VOLUME 31 (JULY 1912)
Memoir of Alexander Henry Hoff.*
[18 December 1822-19 August 1876]
ALEXANDER HENRY HOFF, Bvt. Col., U. S. Volunteers, Captain, Medical Corps, U. S. A., in whose memory the memorial medal was founded, was born in Philadelphia, Pa., December 18th, 1822.
The family of which he was scion settled in Somerset County, New Jersey, during the early Colonial period. His father was the Rev. Brogan Hoff, a graduate of Rutgers College, and a• minister of the Dutch Reformed Church; his mother, Caroline Clay, of an old Delaware family.
Alexander passed his childhood and youth in his native city, received his education there and took his degree in medicine at the Jefferson Medical School with the class of 1843; Professor J. K. Mitchell, the father of Dr. Weir Mitchell, being his preceptor.
Upon graduation in medicine, Dr. Hoff was appointed interne in Blockley Hospital and later became house physician. During this period he acted as demonstrator of anatomy at Jefferson. Even then he had a decided leaning towards things military and passed his examination for appointment in the Medical Corps of the Army, but his father so vigorously opposed his entering the service that he declined the appointment.
Dr. Hoff settled in New York State and soon established an extensive practice, but his interest in military matters continued. He was for a number of years examining surgeon of recruits at Albany, and in 1854-56 was Surgeon General of the State. He married a daughter of the late General John S. Van Rensselaer.
Deeply imbued with the principles of the Republican party, a lover of his profession and with his military tendencies, it is not to be wondered at that he was among the very first to offer his professional services to the country in 1861. He was assigned
The following memoir of his father was read by Colonel John Van R. Hoff, U. S. A. (retired), at the graduating exercises of the Army Medical School, May 31st, 1912.
As Surgeon of the 3rd N. Y. Vols. and soon had his baptism by fire at the affair at Big Bethel, where a lantern was shot from his hand.
In August, 1861, Dr. Hoff was commissioned Brigade Surgeon of Volunteers, and during that war filled many positions of trust and responsibility. He was the director of the fleet of floating hospitals on the Mississippi river and the originator of the modern hospital ship.
So incessantly was he occupied that he had little time to record his extensive professional experience, but such records as are available bear witness to the fact that he was abreast of the best professional thought of that day.
Reporting on the sick received aboard the hospital steamer D. A. January in October, 1862, he said: “Most of them are suffering with diseases of the intestinal tract; however, in the last two loads there has been more intermittent and remittent fever, complicated with flux. Whether this is a necessary complication, caused by the influences of climate, or depends upon mistreatment, is a matter of much importance. The history of the cases, so far as they can be obtained, points strongly to the treatment as a considerable factor.” Surgeon Hoff held that the excessive use of mercurial preparations under field service conditions, resulting in the salivation of 50 per cent of the cases, was unjustifiable, particularly as no apparent good followed in cases which, with their discontinuance, often yielded to proper diet alone. Speaking of prophylaxis of malaria he reported: “I cannot say that I am in favor of the whiskey ration even as a vehicle for the administration of sulphate of cinchona.” His report on the misuse of mecurials [mercurials] was largely instrumental in having these remedies stricken from the field supply table.
Dr. Hoff's predilection was towards surgery, but his views were conservative. For example, he contended that the then accepted practice that gun shot fracture of the humerus with wound of the brachial artery imperatively demanded amputation, was not justified and warmly advocated attempts to save the limb.
Regarding primary amputation at the hip joint for gun shot injury he thus expressed himself: “Out of more than a hundred thousand sick and wounded soldiers transferred under my direction while connected with the hospital transportation department, no case of the kind came under my observation, and of the seventeen thousand transported on the hospital steamer D. A. January, under my immediate supervision, I saw no such case. * * *. The day after the battle of Shiloh I had occasion to make several amputations at the upper third of the thigh, just below the trochanter. These cases were all transferred to the general hospitals at St. Louis and were apparently doing well four days after the operation, but, I think they all ultimately died.
I received very few patients on board the hospital transports who had undergone amputation very high up in the thigh, and among the large number of applicants for artificial limbs who came under my observation while stationed in New York City upper third stumps were great rarities. I am inclined to think that not more than ten in a hundred, if as many, survive amputation in the upper third.” Based upon his observation and experience, Dr. Hoff believed that the results of primary amputations lower down did not encourage us to expect much from amputation at the hip joint, a far more formidable operation.
His conclusions were justified by the statistics of the Civil War; but how different the story today. I saw six cases in which amputation had been done at the hip joint, in a single Russian hospital, during the war in Manchuria, all of whom were well on towards recovery.
The history of the hospital boats on the Mississippi river forms a very interesting chapter in Surgeon Hoff’s military record, which is set forth all too briefly in the Medical and Surgical History of the Civil War.
In the beginning there were no boats at the disposition of the Medical Department. In order to clear the front of even a single sick or wounded soldier, it was necessary to apply to the Quartermaster of the Army. This official, naturally, gave preference to his immediate duties and the demands of his own department in the way of transportation; so, even when a boat was secured and partly filled with sick and wounded, it was frequently delayed until the demands of other departments were complied with. The necessities of the ill and injured, at that period of the war, says its medical historian, were apparently of secondary consideration, and the medical officer who exerted himself in their behalf, alike in the interests of humanity as well as military efficiency, was regarded as seeking a personal favor. Surgeon Hoff was the active factor in resolving this situation. His cry for more means of transportation for the sick and its control by the Medical Department was finally heeded.
In 1864 the subject of this memoir was transferred to New York City as Medical Director of Transportation, where he had charge of the receipt and distribution of the sick transferred from field and other hospitals east of the Alleghanies. Utilizing the experience gained in the West, he planned and supervised the arrangement of the ocean steamer J. K. Barnes, the first ship built in this country for hospital purposes, solely.
Nor were his duties here devoid of personal danger, for the attitude of some of the “people” at that period was not kindly towards soldiers, even though sick or wounded.
During the unloading of a hospital boat at one of the city wharves the sick were set upon by the rabble. Surgeon Hoff, who was supervising the debarkation, went to the rescue and got into the midst of a desperate fight, which left him with a broken leg.
March 1st, 1866, he was honorably mustered out of the Volunteer army and given the brevet of Colonel for faithful and meritorious service.
His taste for military life, which had manifested itself in the beginning of his professional career and became fixed by his experience during the Civil War, led him to renounce the brilliant prospect that civil practice offered and he determined to remain in the Army. After an examination which placed him fourth in the very large class of that date, he was commissioned Assistant Surgeon, U. S. Army, with rank of Captain, May 14th, 1867.
He accompanied the first troops sent to Sitka after the purchase of Alaska from Russia, was assigned as Medical Director and served there two years, then two years in San Francisco Harbor, and in 1872 was assigned to duty at Governor’s Island, N. Y. In 1874 he was detailed as recorder of the Medical Examining Board and remained on this duty until he died, August 19th, 1876.
He was modest to self effacement, faithful to his duties as physician and soldier, seeking only the reward of service to humanity embodied in the commendation, “Well done, good and faithful servant.” May Colonel Hoff’s example be to you all an emulation, stimulating you to higher effort and greater result in the service of your country and humanity.