Each pavilion is three stories tall, three bays wide, and rises above a raised full-story basement.

It operated under the direction of Dr. Charles Bell Gibson, the head of surgical department at the Medical College of Virginia.

Many casualties from the battles of First and Second Manassas, Ball's Bluff, the Seven Days, Fredericksburg, and Chancellorsville were treated here.

In December 1864, it became the home of the Virginia Military Institute, after that campus had been burned by Union troops under the command of Gen. David Hunter.

The institute and its cadets occupied the building until the fall of Richmond to Union forces in April 1865.