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After the Confederate retreat, the Union retook control
of Frederick, and Dr. Milhau worked to setup hospital
facilities for the immense number of sick and wounded
men. He oversaw the setting up of hospital sites in
twenty-seven buildings and two camps within a matter
of days and had them running by September 21 just four
days after Antietam as detailed in “One Vast Hospital:
The Civil War Hospital Sites in Frederick, Maryland after
Antietam” by Terry Reimer (printed copy included in the
file). The hospitals tended to thousands of men with
horrific wounds. The Minie balls used in Civil War rifle-
muskets lever more devastating wounds than the round
balls of earlier conflicts, often shattering bones leading
to amputations.
Dr. Milhau was made Medical Director of Frederick,
Maryland, which also covered Hagerstown. The office
was abolished in January of 1863 as the need was
reduced, and he later served as Medical Director of
the V Army Corps and was relieved from the field due
to illness from exposure on November 20, 1864. He
returned to New York City where he examined new
recruits and was also one of the surgeons in charge
of the Central Park Hospital. After the assassination
of President Lincoln, Dr. Milhau was a guard of honor
and protected the president’s body. He remained with
the Army after the war and was stationed in the South
during Reconstruction as the Medical Director of the
Third Military District in the Department of the South. He
is noted as having been the only surgeon who remained
to care for the inmates during the cholera outbreak at
Hart’s Island, New York, and received a brevet promotion
to brigadier general in recognition of his service.
He resigned on October 1, 1876, after his father’s
death and took over the family estate and married in
1878 and had one son. Like his father, Dr. Milhau was
involved in numerous civic organizations, including as
a member the County Medical Society of the New York
Academy of Medicine and the Society for the Relief of
Widows and Orphans of Medical Men, as one of the
State Commissioners of Charity, and as secretary of the
Emigrant Industrial Savings Bank. He was a member
of multiple military orders, including as Treasurer in
Chief of the Loyal Legion, and marched directly behind
the hearse during President Ulysses S. Grant’s funeral
precession in 1885. After he died on May 8, 1891, at
the family home at No. 41 Lafayette Place, he was
remembered as a man who gave up his birthright as
a French count to serve in the U.S. Military. His funeral
included a battalion from the U.S. Army stationed at
Governor’s Island as well as numerous generals and
officers, and he was buried in his family’s plot in the
Calvary Cemetery alongside his wife. The Medical
Record’s obituary closed: “Dr. Milhau ranked as one of
the best surgeons of the war, was a judicious operator,
a keen diagnostician, and an officer of great executive
ability. He was singularly approachable, as affable as
he was firm, and during the whole term of his military
service never lost the confidence of his superiors in rank
or the devotion of his subordinates. He always did his
whole duty quietly, unostentatiously, and effectively.”