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Construction of the Old Naval Hospital began in 1864 in response to the critical need for hospital care during the Civil War, but the building was not completed until 1866, after the war was over. The Navy Department created the 50-bed facility to serve "seamen serving on the Potomac River and its tributaries" and as a permanent alternative to various temporary facilities, most notably at St. Elizabeth's across the Anacostia. It’s the oldest documented naval hospital in Washington and was the first institution of its kind specifically designed on a large enough scale to serve for an extended period of time.