Asploro Journal of Biomedical and Clinical Case Reports
ISSN: 2582-0370
Article Type: Review Article
DOI: 10.36502/2023/ASJBCCR.6323
Asp Biomed Clin Case Rep. 2023 Oct 16;6(3):241-47

The Spanish Hospital in Cayey in the Latter Part of the 19th Century

Joseph Orlando Prewitt Díaz1iD*, James J. Prewitt2
1Director, Center for Psychosocial Solutions, Annandale, VA, USA
2Chief Warrant Officer Five, Ret, Inductee, U.S. Army, Military Intelligence, Hall of Fame, Ft. Huachuca, AZ, USA

Corresponding Author: Joseph Orlando Prewitt Díaz, PhD ORCID iD
Address: Director, Center for Psychosocial Solutions, Annandale, VA, USA.
Received date: 28 September 2023; Accepted date: 09 October 2023; Published date: 16 October 2023

Citation: Prewitt Díaz JO, Prewitt JJ. The Spanish Hospital in Cayey in the Latter Part of the 19th Century. Asp Biomed Clin Case Rep. 2023 Oct 16;6(3):241-47.

Copyright © 2023 Prewitt Díaz JO, Prewitt JJ. This is an open-access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium provided the original work is properly cited.

Keywords: Spanish-American War, Spanish Military Hospital, Cayey, Puerto Rico, Tropical Diseases, Military Medicine


This paper provides a detailed historical account of the Spanish Miliary Hospital in Cayey, Puerto Rico during the latter part of the 19th century, focusing on its role during the Spanish-American War and its impact on public health in Puerto Rico. The paper is divided into ten sections, each highlighting the development, growth, and function of the hospital during the Spanish American War and concludes with a look at the hospital today. Overall, this paper provides a comprehensive historical account of the Spanish Hospital in Cayey in Puerto Rican history, shedding light on its role in military medicine and public health during the Spanish-American War in the Central Mountain Region of Puerto Rico.


This paper is a first-hand account of sorts, of two boys, one of whom was born in Henry Barracks, who spend their infancy and early teen age years listening to the stories of their father and grandfather. Among their favorite stories were when sitting in the Hospital Hill at sunset, and hearing the story about the Americans coming down the Guayama road, their cannons pointing at the center of town.

The occupation of the Spanish Military Forces of Puerto Rico required constant care of the troops who became ill because of tropical diseases, as well as occupational hazards. With the threat of United States interventions in the Caribbean islands such medical facilities were essential to the troops’ well-being. As the United States took over Puerto Rico, it began sanitary and relief efforts, highlighting the importance of the Spanish Hospital in Cayey, as part of the process of transforming the island through humanitarian and educational projects [1].


The Spanish-American War was relatively short authorized by the Secretary of War on July 18, 1898 [1]. The President directed, the War Department to send ships of war sufficient in number to allow General Miles to land in Puerto Rico and remain there as long as needed. On August 8, General Brooke was ordered to move “rapidly but cautiously” to Cayey. The reason for taking Cayey was to isolate the Spanish position in Aibonito. Reconnaissance on that day led to an engagement with Spanish troops entrenched north on the road to Cayey, aa battle ensued and the American troops [1]. The importance of Cayey, was its location at the crossroads between southwest, and northeast. This key position assured Gen. Brooke’s victory.

The initial landing took place on 25 July 1898, and the armistice ended hostilities on 12 August of the same year. Unfortunately, 3,500 reinforcements from the United States brought typhoid when they joined the troops already taking Ponce. Eventually, 17,000 men from the I, II, and IV Corps served on in Puerto Rico under General Miles, reinforcements having landed at such varied sites as Guayama, Ponce, and Arroyo. When the fighting ended, only four of Miles` force had been killed and forty wounded, few of them seriously [2].

The Spanish Hospital in Cayey received casualties from both sides in the days following the invasion. Thirty-six American soldiers, and 132 Spanish soldiers were treated at the hospital in those four days [3]. In addition, the Spanish Hospital was overloaded with weather borne diseases. Due to heavy and frequent rains malaria, influenza, and gastrointestinal, as well as glandular congestions of the digestive system. had become more widespread those days [4].

Soon after the war ended, in October 21, 1898, all Spanish troops were on their way back home to Spain [5].

An adequate number of medical officers and hospital corpsmen were present at each of the minor engagements that characterized the campaign. In one instance, however, the grounding of a transport near Ponce hampered the work of the medical staff of I Corps units that landed at Arroyo on 2 August. As a result, neither the many hospital corpsmen nor the animals used to pull Medical Department wagons rejoined the rest of their unit for more than a week, significantly delaying the unloading of the reserve division hospital and its equipment.

Familiar diseases afflicted troops in Puerto Rico. Investigation confirmed that typhoid had been imported from the United States. However, it was also endemic in Puerto Rico, and the debilitating effect of the Island’s malaria was prevalent.

The Army of Occupation takes over the Spanish Military Hospital in Cayey

Colonel Greenleaf suggested that the men of one particularly debilitated unit be sent to the mountains to regain their health and strength. At first, the disease rate continued to climb-300 remained. As the campaign ended, the number of new typhoid cases decreased. Still, various digestive problems were increasing, and malaria remained a significant problem for the Army of Occupation.

As a result of the Treaty of Paris signed on 18 August 1898, Puerto Rico was ceded to the United States as a spoils of war. The Spanish empire had collapsed. The Spanish soldiers returned to their barracks in Cayey. They remained in quarters until they were repatriated to Spain on 15 October 1898 [5].

This captured real estate comprised 15 acres of land on a hill east of Cayey. From that vantage point, all activities of the town could have monitored. The main building in the installation was 320 feet by 30 feet and was the largest building in the region. It housed the Surgeon General, Red Cross Doctors and Nurses, Medical Officers, and a 112-bed hospital (see Fig-1).

The Spanish Hospital in Cayey in the Latter Part of the 19th Century
Map of The Spanish Hospital– Hospital Hill in Cayey. The map presents the exact locations with coordinates. The Hospital Building (B#1) is 30 feet by 320 feet. Source: Line of Original Reservation G.O 97 A.G.O. July 7, 1903. Department of the Navy (1915). Map showing boundary lines of the original Spanish Reservation and the present reservation February 7, 1903: Washington, D.C.: Bureau of Yards & Docks, Department of the Navy

The most prominent building (the Hospital) was at the top of the hill [6]. Northeast of the hospital was the kitchen and a squad room with a capacity of 20 men (probably cooks and orderlies). On the hospital’s access road, two wooden quarters accommodated NCOs and two cavalry companies. At the bottom of the hill was the Headquarters and guardhouse [7]. In 1899, the San Cipriano hurricane destroyed the barracks. A new hospital was built on the bricks of the Spanish hospital. The American soldiers were repatriated in 1901. The 2nd Battalion of the Puerto Rico Volunteer Infantry took over the Barracks on 23 February 1901. Four companies (E, F, G, and H) were assigned to Camp Henry (two infantry and two mounted).

The Spanish Military Hospital in Cayey

The main Spanish military post in Puerto Rico was in San Juan, including the Spanish Military Hospital, which became Fort Brooke Army Hospital after the occupation. Spanish military bases were in the towns of Aibonito, Aguadilla, Cayey, Mayaguez, and Ponce. Each of these bases had a Spanish Hospital to address the war-related injuries of soldiers and Puerto Rican volunteers. In Cayey, a Spanish Military Hospital managed specific tropical diseases contracted by the troops, as well as other medical emergencies [8].

This mechanical drawing (See Fig-1) represents the exact location of the Spanish Hospital in Cayey, P.R. The most prominent building (Hospital) was located at the top of the hill, known as Hospital Hill by the locals.

Northeast of the hospital was the kitchen and a squad room with a capacity of 20 men (probably cooks and orderlies). Three smaller buildings in the same area accommodated the following: 1) the plumbers and a tin smith; 2) the Q.M. barracks with a capacity for 17 men; 3) Q.M. storehouse; 4) Q.M. shops (26); 5) an oil house with a capacity of 5000 gallons. On the hospital’s access road, two wooden quarters accommodated NCOs and two cavalry companies. At the bottom of the hill was the Headquarters and guardhouse [2] (Fig-2).

The Spanish Hospital in Cayey in the Latter Part of the 19th Century
Camp Henry, Cayey, Puerto Rico Circa 1903. (Duncan, 1910). Post and Reservation Map of Henry Barracks, P.R. Library of Congress. G-30-11-2-Mil Sta-PR. The former Spanish hospital was located on 15 acres of land on a hill east of Cayey. The main building in the installation was 320 feet by 30 feet and was the largest building in the region. It housed the Surgeon General, Officers, and a 112-bed hospital

Military Medicine in the Spanish Empire

Puerto Rico’s history during the Spanish Empire from 1493 to 1898 and the ensuing colonial governments have demonstrated how social processes associated with colonialism—such as extractive economies, forms of unequal citizenship, and extreme labor exploitation- impacted its citizens’ public health. Military Medicine and public health combined to cure tropical diseases identified in the Spanish soldiers and the population.

The 19th century Spanish Military health services encountered several tropical diseases such as malaria, dysentery, anemia, and hookworm among the Puerto Rican population. In addition, many cows were infected with the T.B. bacterium. The bacterium was passed through the milk, resulting in many deaths across socio-economic borders as all families were affected [9].

Military health and maritime public health became the two branches of medicine with a genuinely imperial dimension in Spain during the colonial period in Puerto Rico. Maritime public health was practiced in San Juan, while the military Public Health was practiced in other Spanish Military installations. The Military Hospital in Cayey served all the inland public health needs on the Island [10]. (Military health refers to medical, surgical, and pharmacological services for the members of the Spanish Army and its affiliated Volunteer Units).

Under the General Director were placed the Chiefs of the military health districts the empire was divided into, which corresponded to the territories of the General Captaincies. In 1846, Puerto Rico became the 16th Military Health District of the Spanish Empire. The thirty doctors in Puerto Rico came from Catalonia and were long-term career officers [10]. This cadre would serve the medical needs of Spanish soldiers who, upon their arrival to the Island, came in contact with a host of tropical diseases such as smallpox, typhoid, Pneumonia, dysentery, hookworms, and/or syphilis.

Role of a Spanish Military Hospital in Cayey

By 1898, physicians knew how wounds became infected, and the precautions necessary to prevent wound infection were quickly taken. The Spanish Military Hospital in Cayey had a laboratory and an X-ray machine. In addition, the template climate of the Central Mountain region offered a favorable environment for convalescence and recovery.

The wounded invariably did well despite many inexperienced physicians, difficult terrain, filth, and a shortage of suitable shelter for hospitals. The role of the Spanish Hospital in Cayey was to treat and research new ways to address and cure tropical diseases. An understanding of how typhoid fever, malaria, and yellow fever were spread was the necessary first step to eliminating the high toll these diseases traditionally took, and the profession was only on the brink of that understanding. In the care of wounds, the war with Spain represented a new era in medicine [11] (see Fig-3).

The Spanish Hospital in Cayey in the Latter Part of the 19th Century
The Spanish Hospital located in Hospital Hill overlooked the valley of Cayey. Most of the patients before the American Invasion were suffering from Spanish soldiers suffering tropical diseases. They were quarantined before being repatriated. The last Spanish soldiers left this location on October 21, 1898

As soon as Cayey had been taken, the general hospital was taken over for U.S. patients in the former Spanish military facility, moving out its forty-four Spanish occupants. Several soldiers, Red Cross doctors, and nurses were detailed to care for the sick in this new facility [12,13]. By mid-August 1898, the Spanish Hospital in Cayey had evolved into an American Field Hospital, in the post that would later be named Henry Barracks [14].

The short-lived hostilities of the Spanish-American War taught a hard lesson about the dangers of going to war without adequate preparation. Had the enemy been a more able foe, the result for the Medical Department and the Army as a whole would obviously have been far more tragic. Not surprisingly, therefore, those concerned with the ability of the United States to defend its new role as a world power after 1898 pushed to reorganize both the Army and its Medical Department so that involvement in modern warfare would not spell disaster.

Hurricane San Ciriaco

On 8 August 1899, Hurricane San Ciriaco attacked Puerto Rico with winds upward of 100 mph. It destroyed the wooden buildings of the Spanish Military Hospital in Cayey. A few months after, the United States assumed control of the Island in the Spanish-American War in 1898. The combined land occupied by the Spanish Military Hospital became a part of Camp Henry.


During the Spanish colonial period, which spanned from 1493 to 1898, The Spanish colonial authorities maintained a military presence in Puerto Rico to protect its interests, suppress uprisings, and defend against foreign attacks. This network of garrisons included the establishment of a Spanish Army camp located on key terrain on the northeast outskirts of the town. From that vantage point, the Spanish soldiers could monitor the entire town of Cayey and control the crossroads from Guayama to the capital, San Juan.

The strategic location of the garrison could account for its value to defenders and invaders. However, a significant aspect of the installation was a hospital building located on the hill’s highest point. From a functional standpoint, the hospital was an important medical facility in the region for treating tropical diseases and occupational injuries related to soldiering. From a psychological point of view, the hospital building was seen by every person in the town of Cayey. It represented the might of the Spanish Government to the locals.

The actual location of the Spanish Army (and later the U.S. Army 1898-1963) garrison in Cayey is being lost to history. The location where the hospital building once stood is used as a parking lot. A few foundations of some of the buildings can still be found but are unrecognizable. It is painful to realize that for a society that prides itself on its Spanish roots, no effort has been made by Historical Societies or local, state, or federal governments to recognize the location with a marker to teach current and future generations of the impact and sacrifices of the soldiers (Spanish and American) serving in places like the Cayey garrison had in the community.

Conflict of Interest

The authors have read and approved the final version of the manuscript. The authors have no conflicts of interest to declare.


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