(c5i ||||;|||i|||l|i|ill||t :!?!'!■!:; Book -i_A„e":::u rificiCTis iai5 iLmi?iTt. iz -p-^ afeo ite^essarr. fr T2eir of tie :: r? '"h»T the Coirniji^DX :-"J 5. st^HTC xi- psj Imx moSsriif eaiB- ^ . . . ^e lif ciiiserraiiDiu nieL. ea,ii passfssed of sjiecliil i:-: '_-~i'ii;C'ri5.. lt-: -i.-i nudss. A lis: ff liifcr seTsral cases tri-.riri-sT, zrjm pcsiiMtt far mnrf rt£mEiieri:nre ThnTi liat nuw osnrjiiE'i i~ litenL £3ig iaxi; mideratsB •tbeir id c»f n?. TuiiifSt 7L xb* ssrice Cif iiif _ . :_:i_— J sion. Is'o one is now employed on this 23 81 50 44 100 100 100 The following table shows the ratio of sick men per thousand in regiments which had been supplied respectivqly with india- rubber blankets ; wooden tent-floors ; straw^, fir boughs, or cedar boughs ; and in those which have been sleeping on the bare ground. The data are taken from the returns of 120 regiments, and chiefly in November. Recimknts si,i:eimn(j ox — Wood India rubber Bare ground Straw or fir boujihs Entire Number of Regiments. Those in We.stern Virginia excluded 61.5 60.9 69.3 45.8 // 21 As the forces in Western Virginia ^vcre, as a rule, unprovided Avith rubber blankets, and as they have suffered special hard- ships in other respects, they are excluded from the comparison in the second column. As rubber blankets had not, at the time the data were collect- ed, been issued by Government, it is probable that the regiments furnished Avith them had also been better {)rovided for than usual in other respects, and that those sleeping on the bare ground ivere generally at a greater distance from the supply- depots than the others, and consequently not as well provided for in other respects. A limited examination of the diseases of the army indicates that the largest proportion of those of typhoid type occur with regiments sleeping on rubber blankets, the least with those on straw or boughs ; the largest proportion of catarrhal, with regi- ments on wooden floors, the least with those on the giound ; the largest of rheumatism, with those on wood, the smallest with those on straw or boughs ; the largest of malarial, with those on the ground, the least with those on straw or boughs. As had been presumed by tlie Commission, it has been proved that the best bed for soldiers in camp, can, with a little skill, be formed from fir or cedar spray, whenever it can be obtained in sufficient quantity. The Inspectors have from the outset been instructed to advise its use whenever practicable. It should be frequently removed and burned, after a thorough cleansing of the tent floor, the tents being struck for the pui'pose. Experienced officers generally object to the board floors in tents. They are thought to be more damp than the ground itself and they offer an opportunity for the collection of rubbish and dirt, and make them dilhcult of removal. 22 Privies. — Privies had been established in all the camps in- spected, except those of two or three regiments recently mus- tered in. In eighty (80) per cent, of tlie camps, they are reported to be properly arranged and kept in proper order, no oflensive odor drifting from them. In twenty (20) per cent., proper attention was not given to them, and the health of the men was more or less seriously endangered in consequence. In sixty-eight (68) per cent, of the camps, the men seemed to be eflFectively restricted to the use of privies. In thirty-two (32) ])er cent., the proper prohil)ition was found by the inspectors not to be strictly enforced. In thirty-five (35) per cent., the men were allowed, at least at niglit, to urinate Avithin the camp limits. Night buckets, which are regularly provided, one for each tent, in the British service, are nowhere in use. The Commission does not think it desirable that they should be added to the camp furniture, believing that their cleaning would be too frequently neglected. Disposition of Offal. — In seventy-seven (77) per cent, of the volunteer camps, slops, refuse, and offal are systematically re- moved to a distance from camp by a daily detail of men. In twenty-three (23) per cent., this duty was performed iri-eg- ularly, or very imperfectly. In nineteen of these twenty-three camps, the inspectors found odors of decay and putrefaction per- cef)tiblo in and about the tents and streets. StdJih's. — Stables are sometimes found actually within the camps, and quite frequently within half the distance prescribed by the Regulations. In rather more than fifty (50) per cent, of tlie camps, the iiianiirc and litter of the horses are allowed to accumulate for an /;t inuofiiiite period. In tlie rest, this source of" diinger is removed to a distance, or burnt, once a week, or ot'tencr. Camp Police, in general. — Of the camps inspected, five (5) per cent. Avere in admirable order, forty-five per cent, fairly clean, and well policed. The condition of twenty-six (26) per cent. was negligent and slovenly, and that of twenty-four (24) per cent, decidedly bad, filthy, and dangerous. In those camps which are lefi'rred to as in a neglected and positively bad condition, some or all of the following sources of danger to the health of the men were found to exist, viz : drains wanting or clogged up, and retentive of stagnant water ; the canip streets and spaces between the tents littered with I'efuse food and other rubbish, sometimes in an oftensive state of decomposition ; slops deposited in pits within tlie camp limits, or thrown out broadcast ; heaps of manure and offal close to the camp, and the privies neglected. In about two-thirds of the camj)s, the streets were found fairly clean, but in only about one-third were the edges of tents, the spaces between thetn, and the camp drains, entirely free from litter and rubbish. On the whole, a very marked and gratifying improvement in the custom of the volunteer regiments in respect of camp police has occurred during the summer. Faults in this respect, which were at one time generally regarded as unworthy of the attention of regimental officers, are now considered disgraceful, and the number of camps in which officers and men take pride in main- taining an exact and severe camp police, is i-apidly increasing. Clotliing. — The shirts used by the men were found to be of poor quality in twenty-six (2(j) per cent, of the regiments examined. In seventy-four (74) per cent., they were of the Keg- ulatioii quality. In iiiiiety-i'our (94) per cent., the men had been provided with two shirts each. In f(jur and a-lialf (4^) per cent., they had but one each, and in the remainder only a part Avere properly supplied. A want in this and other articles of clothing frequently arises from the fact that the men have sold or bartered away a part of what they have received. In nothing are the volunteer officers more remiss of their duty than in that of ascertaining such deficiencies, and in making them good upon a charge against the pay of those who are responsible for them. A proper overstock of clothing is seldom kept in regiments for this purpose. Officers have often been known to degrade themselves, their Government, and their commands, by begging for supplies of clothing, as a charity, which their men were abundantly able to pay for, and which it was their duty to obtain for them, and make them pay for. £]ighty-two (82) per cent of the regiments were well supplied with overcoats, and seven (7) percent, partly so. In eleven (11) per cent, there were none at the time of the inspection. In only three (3) per cent, of the regiments were the overcoats of poor quality. Seventy-five (75) per cent, of the i-egiments were pro- vided with good clotli body coats ; the remainder with flannel sack coats or cloth jackets. Of two hundred regiments, all were provided with pantaloons — one hundred and seventy-five sufficiently, eight indifferently, sev- enteen very poorly. Men have been frequently seen during the summer on duty and on parade in their drawers alone. In sevent^'-five (75) per cent, of tlie regiments, one good blanket had been issued to each soldier. In twenty (20) per M cent., two hud been })rovide(l ; these being, however, in inost cases, of inferior quality. In five (5) per cent..the men h:id never all received each a blanket. Deficiencies in the regulation allowance of clothing, noted in October, have since been genorallj made good. Whore they have not, it is in nearly every case owing to the ignorance, negligence, or knavery of regimental and company officers. There are ample supplies of all necessary articles of clothing, in- cluding gloves and socks, in the principal depots, from which all wants still existing can be supplied at short notice upon the re- quisitions of the proper officers. Never, probably, v»^as so large an army as well supplied at a similar period of a great war. CleanlineBS. — In about eighty (hOj per cent, of the regiments, the officers claimed that they gave systematic attention to the per- sonal cleanliness of the men ; but in very few instances — almost none — is this attention vfhat it should be. The Avashing of the feet is very rarely enforced as a military duty, and in not more thon six per cent, of the regiments did the inspectors believe, from per- sonal observation, that the officers strictly enforcsMl the Army Regulations in respect of washing the head and neck. In eighty per cent, of the regiments, the officers reported that the men washed their shirts at least weekly. In the remainder the want of a change was sometimes given as a reason for this neglect. In 90 per cent, the officers professed to comply with the Army Regulations in regard to the removal of dirt from their woolen clothing ; but, from observation, it is obvious that this is very rarely done in a thorough manner. The volunteer army is more unsoldierlike in respect to matters of this kind, and its improvement luis been slower in them than in any other. Tlint scrupulous nicety and exactness in the care 2G of articles of dress and equipment, wiiicli gives so much occupa- tion to regular soldiers, and which is not only important to be observed for the sake of their health, but as presenting the surest evidence of a high condition of discipline and efficiency in all other respects, is, as yet, entirely unknown. A proper military inspec- tion scarcely ever occurs in a volunteer regiment. Recently, the inspectors of the Commission have been required to return answers to the question : " Are officers and soldiers on duty alloived to ivear " their coats partially buttoned, or to follow jj^^'sonal inclination in " matters proper to be made uniform and regular f In nearly seventy-five (75) per cent., officers, when advised with on this point, confessed that very little attention was paid to such mat- ters, and in most instances could not understand the object of the inquiry, thus showing that they had not a proper apprecia- tion of the value of uniformity, of their own duties, or of the trouble that would be saved them in their duties by a strict en- forcement of the intention of the Regulations in this respect. A chief advantage of the uniform of military bodies is, the facility it affords for keeping their equipments in serviceable order. When every man is expected to appear, in all matters of dress, the exact counterpart of every other man, the attention of the officer is arrested by a very slight neglect of proper care of his equipment on the part of any individual. On the prin- ciple of the proverb, " A stitch in time saves nine," it is easier and cheaper, for both officer and private, that no day passes without every stitch of clothing, every strap, buckle, and button being put in the best possible condition. In European armies, every man is required to be provided with, and constantly carry about him, not only articles necessary for the repair of his cloth- ing, belts, &c., but conveniences for cleaning both his person and clothing ; as, for instance, a switch or cat for whipping dust to the surface of clotii, and a brush to remove it ; oil, emery, whiting, blacking and bnislies, for straps, shoes, and buttons. 27 In the British army, every private is furnisheil with a tooth brush, which he is required to show in his knapsack at the Sun- day morning inspection. The economy of this regulation may be inferred from the prevalence of toothache and swollen faces in our camps. Among volunteers it is somewhat rarely that men are found provided with the few articles which are essential to an eco- nomical care of their clothing ; still more unfrequently are they found possessed of those which are requisite to the maintenance of health in crowded camps and quarters. This want also stands directly in the way of the development of that esprit du corps, which is as essential to military efficiency as to health, and is the only reason which can be assigned for the greater difficulty which the inspectors Inive found in inducing a marked improvement in this direction, than in any other. It seems desirable, therefore, that such articles should be made a part of the Government supplies, and that every man should be required to show that he has them properly stowed in his knapsack, at each Sunday morning inspection — new issues from the quartermaster being made to supply losses in the same manner as of clothing, the value of all beyond the yearly allow- ance being deducted from the monthly pay of those making this necessary. Slovenliness is our most characteristic national vice. Frontier necessities and costly labor account in a measure for this. The indirect influence exerted upon all parts of the country by a pe- culiar local system of labor explains more. The city of Wash- ington illustrates the vice and the penalty that is paid for it. Structures designed in themselves to be commensurate with and typical of the moral grandeur of a great republic, are offences against good taste, like precious stones on dirty hnnds, when seen from out of the unmitigated shabbiness and filth of the unsewered, unpaved, unpoliced streets of a collocation of the 28 houses ops, have become convinced that the first sanitary law in camp and among soldiers is military discipline ; and that unless this is vigorously asserted and enforced, it is useless to attempt and impossible to effect, by any secondary means, the great end they propose — which is the health and happiness of the army. "'-Resolved, That looking only to the health and comfort of the troops, it is our profound conviction that any special relaxa- tion of military discipline in favor of volunteer troops, based either upon their supposed unwillingness or inability to endure it, or upon the alleged expectation of the public, is a fallacious policy, and fraught with peril to the lives of the men and the success of the national cause; and that, speaking in the name of the families and the communities from which the volunteers come, and in the name of humanity and religion, we implore that the most thorough system of military discipline be carried out with the officers and men of the volunteer force, as the first and es- sential condition of their health, comfort, and morality. ^" Besolved, That the health and comfort, and efficiency of the men, is mainly dependent on the uninterrupted presence, the personal watchfulness, and the rigid authority of the regimental and company officers ; and that all the great defects, whether in the commissariat or in the police of camps, are radically due to the absence of officers from their posts, and to the laxity of the discipline to which they are themselves accustomed — a laxity which would never be tolerated amona; regulars, and which, while tolerated among our soldiers, will make our force a crowd of armed men rather than an army. " Resolved, That it is the public conviction of this Commis- sion, that the soldiers themselves, in their pai}iful experience of the want of leaders and protectors, would heartily welcome a rigid discipline exerted over their officers and themselves ; that the public would hail .with joy the inauguration of a decisive, prompt, and rigid rule, extending alike to officei's and men ; and that any despondency or doubt connected with our military and iKitional prospects, or with the health and security of our troops, wouhl (lisa|)pear with the first indications of rigid oi'der enforced with impartial authorit}^ throughout the whole army." Tiie opinion is often expressed by professional soldiers that an effectively disciplined army can never be made of volunteers, and that as undisciplined men can only be used in w'ar in limited numbers, chieflj to preserve the fighting force from excessive fatigue, it is a waste of the public resources to keep a large volun- teer foi-ce in the field. Many volunteers express, in effect, their acquiescence in this view, when they say, '' You cannot expect volunteers to be as particular as regulars" — an answer constantly given to the suggestions of the Inspectors, when they find a regi- ment the condition of wdiich is in all respects disgraceful to its officers. To the consideration that this war is to be waged against volunteers, the reply of those Avho believe that only a large army of regulars can prosecute it to a successful end, is, that undisciplined forces are much better adapted for defensive than for offensive operations, and that volunteers can never be pushed to the heart of the rebellion, liowever they may hack at its extremities. This view is habitually sustained by those whose position entitles their judgment to be regarded with respect, and the question whether volunteers can be effectivel}' disciplined thus becomes a serious one for the nation, and may be thought to give an importance to the information obtained by the Com- mission, aside from its sanitary bearing. Discipline is a habit of prompt and exact obedience under cer- tain authority. Being a habit, it cannot be taken on, except by a more or less rapid process of acquirement. So long as progress is being made, a satisfactory state of discipline is not only to be thought yet possible of attainment, hut it may be probable. Tliero have been a few regiments of volunteers in which no progress in discipline during a considerable period could be ob- (T/ served. Special causes were obvious in every such case, and they wore notoriously exceptional in character. There is no room for doubt tliat in a hirgc majority of the volunteer regi- ments there has bfonfrom month to month a perceptible advance in discipline. This is true not only of those regiments which have been com- manded by officers educated at West Point, but of those the commanders of which six months ago had never had a sword or musket in their hands, never read a militai-y book, never saw a, company of soldiers. It is true not only of regiments of voluntcoi s the officers of which were selected by the War Department or by Gov^ernors, but of tliose which elected their officers. It can- not even be said tliat a very marked difference in the progress of these different classes is to be observed. The advantage of educated and appointed officers over elected civilians is clearly manifest only in the fact that the former liave in no case — as far as known to the Commission — allowed their regiments to fall into the rare, exceptional, excessively demoralized condition before referred to. Regiments of volunteers havinc; an unusual strength of West Point officers have in all cases been found in a fair state of discipline, so that if an order with reference to matters of camp-police was given at the suggestion of an Inspector of the Commission, it could be assumed that it would not be neglected. But this has been equally true of many regiments whose officers were taken from civil life and elected. It cannot of course be concluded that military education and experience is of no value, nor that there are no disadvantages attending the election of officers. But it may be fairly concluded that a special military education is not at all necessary to ade- quate appreciation of the value of discipline or to the enforcement of discipline. There is, indeed, room for doubt if the conviction which prevails with regular officers of tlie difficulty of enforcing discipline with volunteers, and their consccjuent hesitation and 38 endeavors to accommodate tlicii- habits to the supposed necessity for moderation in the exercise of authority in dealing with vol- unteers, is not a greater hindrance to their progress in discipline than the inexperience of the officers chosen from among civilians. The di.«a(lvantage of the latter is certainly less, and the pro- gress of their commands in discipline greater, compared with that of regulars and with volunteers commanded by regulars, than tlie Commission, influenced by the judgment of experienced military advisers, had been led to expect. In not a few cases where tlie officers of a regiment appeared at the outset peculiarly incompetent, (juite careless of discipline and incapable of estab- lishing it, after a few months a very decided improvement has been observed. To account for this, it is only necessary to reflect that the habit of command grows, as well as the habit of obedience, and that if an officer does not habitually perform his proper duties, and see tiiat the orders whicdi, in the performance of his duties, it is neces- sary he should give, are carried out, discomfort is sure to result both to iiimself and to his command. Sucii officers, however jiop- ular they may have lieen when elected, soon become aware that the accidents, privations, and discomforts to which their men, through their neglect, are subject, are bringing ridicule, con- tempt, and hatred upon themselves, and they are thus drivftn to resign, or they fall into practices which cannot be overlooked by higher authority, and which lead to their dismissal, or they yield more and more to the habit of military authority, and will giadually learn that the simplest and easiest, and most popular course, is that of the most complete discipline. Thus, throughout the volunteer aiiny, the Commission has ..f late l)eeii gratified to find the habit slowlv formino- and stremnh- euing, the general absence of which in July seemed to involve the greatest danger to health. Commiseration for what are erroneously considered technical ^r :.;) offenders. ;iti!;e, with- out positive injury to himself. What is not sent home, is nearly certain to be laid out in unwholesome food (pies and the like) or more unwholesome drink, to the damage of his health and the diminution of his efficiency, to the cost of Government. As a general rule, the regimental pay day is immediately followed by an enlarged sick list, and a more populous guard-house. It is confidently'' believed, that if fifty per cent, of that portion of the soldiers' p;iy which he spends in camp were thrown into 4:3 the Potomac, he woukl, on the whole, be the gainer, the only loser being the sutler and the peddler. ^Moreover, the neglect to I'cmit the soldier's pay often leaves his family dependent on public or private charity. There is danger of a great pauper class being thus created, especially in our large cities ; and the existence of this class, always most un- desirable, will be peculiarly mischievous at the present critical peiiod by increasing local taxtition and gimeral distress, weak- ening the national resources, and wearying the people of the i)rcs- ent just and necessary war. The disposition among our soldiers to remit the largest part of their pay should, therefore, be gladly encouraged and aided in every way by Government, nor ^>hould there be \\\\^ hesitation in incurring any reasonable expenditure which will confirm and strengthen so gratifying a characteristic. Qualifications of Surgeons. — The qualifications of Regimental Surgeons, in respect of education and experience, cannot, as a general rule, be ascertained by direct inquiry. The Inspectors, however, are usually able to form a decided opinion on tliis point, by conversation, and by observing the mode in which the surgeon's duties are performed. They report the Surgeons of one hundred and seventy-six (170) out of two hundred (200) regiments in question, sufficiently well qualified ; four (4) incompetent ; thirteen (13) of doubtful competence; and as to seven (7) regiments, the point is not re- ported upon, owing to the absence of the surgeon from his post, or to some other reason. One hundred and twenty-nine (129) of these Regimental Sur- geons are reported as not only competent, but as having discharged their duties with creditable energy and earnestness; twenty-five (25) to have done so with tolerable attentivencss ; nineteen (19) to have been ncfjliffont and inert; of the surgeons of twciitv- seven (27) regiments, no distinct opinion is expressed. 44 Camp Hospitals. — The arratigement. equipment, and supplies of the Regimental Hospitals are reported to have been in one hundred and five (10;")) of the regiments, good; fifty-two (")2) indifferent or tolerable; twenty-six (20) bad. In thirteen (13) regiments, no hospital whatever had been or- ganized. As to four, there is no report. The folh>wing table shows the aii-a;reirate sircnirlh of the two liundieil regiments under consideration. The iiuuiIkms sick in hospitals and in quarters ; the projjortion sirk in hospitals and ([uarters to every 1000 strength, and to cvoy 1000 cases on the siek list: Of 200 regimentrt Lift visited previous to Nnveni- Aggregate iiniii btr. 1801. bei> PRESENT 8TI1E.V(5TH ON SICK LIST. Strength when luustered.. Strength when inspected.. On sick list at the time of inspection. . Sick ill General Hospiial Kegimental Ho.xjiital " (Quarter-- Proporiion to I'ripcirtion to every l.liOi). i every l,i 00. i7i;. (;;■;'.) 17(;,042 i ction 12,841 78 1,(100 2,756 2,1)78 7,112 16 17 -HI 215 "8 1 554 i^esumc'.-— The table on the following l)age presents a resume of the statements which have been given as to the condition of two hundred ,1-egiments. The returns of all inspections are re- duced to a similar, exact, and concise form, and tlie precise con- dition of each regiment, of each biigade, of each division, of each department, and of the volunteers from each State, in all the particulars indicated, is separately tabulated at the oflice of the Commission. The causes of special disease niay thus, sometimes, be deitionstraicd in a monuiit. z.^ o Co ^ 45 >3 S r: ST t S 5 a-i:.k=E=. J llfilllf^lil Cl .-: CO -T •* -T U5 1- 05 o — Ci r3 o £222 oooooooo ^ _r X > — ''• c. £ > rs c •3 2 1-; ■A t; to =^-="s 46 MORTALITY, DISEASES, AND CASUALTIES. Extent and General Character of Disease. — In the army of the Potomac, the average constant number of sick, per one thousand (1,000) men, has been sixty-three (03;) in the department of AVestern Virginia, one hundred and sixty-t\Y0 (102;) in the Val- ley of the Mississippi, one hundred and sixteen (HO.) The average constant number of sick during the months of August, September, and October, in the regiments east and west, so far as visited, has been seventy-seven (77) per thousand. In this number all relieved from duty, from any sort of physical indisposition, however slight, are included. At this rate, in order to secure a constantly active force of three hundred thousand men, (300,000) the nation must maintain in the field an army of about three hundred and twenty-five thousand, (325,000.) The number of sick varies in different regiments from one- third of one (.33) per cent, to forty-nine (49) percent. 4- The average length of time lost for active duty, in each case of sickness reported, has been a little more tlian five days, (5.18.) The health of the volunteers of the army of the Potomac has been slightly better than that indicated by the returns respecting the health of the regular army, during the past year. The average health of the whole volunteer force in the field has been inferior to that of the regulars. The average number of men constantly sick in the regiments from several of the States respectively, is nearly as follows : 47 New York, (per thousand strong,) - - - - oo Pennsylvania, " " . . - _ ,^7 Massachusetts, " '• .... o2 Connecticut, " '* . . . . 49 A^ermont, " " - . - - 88 Maine, " " - - - - Vl\ New Jersey, " " . . . - oG Wisconsin, " " - - - - 76 Indiana, " " . ... 42 Michigan, " " . - . 76 Illinois, " " ... - 156 Ohio, " " ... - 1<)2 Data derived from reginjients of States not included in the above list are too limited to be of use. The forces from Ohio and some other States have been, to a considerable extent, subject to unusual privations and exposure, during the campaign among the mountains of Western Virginia. A similar remark applies to those of Illinois in Missouri. There is reason to think that the most sickness has occurred where regiments, raised in far northern and highland districts, have been removed to lowland, fluvial, and seaboard districts ; those, for instance, from Maine and A^ermont, the ridge counties of New York, and from Minnesota, being more subject to distinct disease, as well as to demoralization, or ill-defined nostalgia, than others in the army of the Potomac. The healthi- est regiments, physically and morally, have been those from the seaboards, as of New Hampshire, Massachusetts, Rhode Island, Connecticut and New Jersey ; those from Rhode Island being probably the most fortunate in this respect, which fact, liowever, is chiefly due to their superior discipline early in the campaign. It is difficult to compare the rate of sickness of foreign armies with that of the volunteers, because it is uncertain what degree of sickness in them places a man upon the sick list. Our volun- 48 teer surgeons are, uruloubtedly, very accommodating in this re- spect, probably more so tlian the surgeons of the regular army or of foreign armies. It has happened in more than one instance that upon an order to advance against the enemy being given, every man of a regiment then on the sick list immediately re- ported himself well, was discharged, and shouldered his musket in the line of battle. It is probable that at least one-half those returned as sick by the surgeons of volunteers would do the same, under similar circumstances ; that proportion being excused from duty on account of a cold in the head, severe fatigue, or a slight indigestion. In the whole British army, in time of peace, 6.5 per cent, of the force otherwise available, is reported constantly "in hospital." Of the British army in the Peninsula under the Duke of Wellington, 1808-1814, 21 per cent, (or 9,300 of an average force of 44,500 men) was constantly '• sick in hospital." The number of sick ranged from 9 to 33 per cent, of the whole force at different periods. ^4^hese rates were exceeded in the British army of the Crimea. To maintain 100 effective soldiers in the field, it there became necessary to provide for 2(3.6 sick men. The annual rate of mortality was 8 per cent, by wounds, and 20 per cent, by disease. The annual rate of mortality in the British army, at home and in time of peace, was from 1.1 to 2 per cent, in the ten years pre- ceding 1847. The average mortality of the army of the Potomac has been, during the summer, at the rate of 3A- per cent., (allowance being made for those who die after their discharge, from causes con- nected with army life.) Imperfect data received from the West indicate a considerably larger rate for the whole arm3^ ; prob- ably it will not be far from 5 per cent, if sweeping epidemics should be escaped. XT Mortality IVoiii disease, in tlie Royal Navy of Great Britain, is 140 per cent, greater in time of war than of peace ; rising from an annual rate of 15 or IG to one of 37 or o8 per 1,000 strength. The principal increase of the deaths in the navy, in time of war, is from disease; the amount of increase from casualties hcing com- monly quite inconsiderahlo. The following statement exhibits a classification of the cases of disease in the volunteer army during a portion of the cam- paign, showing, also, the per centage of casualties of all kinds (wounds, accidents, &c.) for the same period, compared with like returns from the army of the Crimea, from April 10, 1854, to June 30, 1850 : Arniy of the Ami}' of Ariiiyof the CiiiiiCH, Votoniao. the WcHt. Ap 10, '.■)4, to June ol', 18CC.. Zymotic disease. (per cent, .) - 61.1 7G.4 G9.8 Constitutional, - 1.2 .() .5 Local, a - 30.7 17.3 15.G Developmental, a - 3.4 3.5 .1 A'iolence, a - 3.G 2.2 14.0 All cases - 100.0 100.0 100.0 Two most important facts appear on the face of this table : first, the immense disproportion between cases of disease and of violence, fully justifying all that has been asserted as to the loss an army in the field must expect to sustain from these causes respectively ; and, secondly, the great excess of zymotic diseases, nearly all of which are, in a greater or less degree, prevcntible by proper precautions. For instance, typhus can be almost certainly averted by systematic attention to cleanliness and ventilation, small- pox by vaccination, and malarious diso.ises (intermittent fever, (fee.) by quinine. It seems apparent, therefore, that it is within the power of Government, either by the action of the War De- 4 parriucnt or liy legislation, to eiif'oi'ce niU's tlmt will most mate- rially (liininisli the Avaste of efficiency by disease, and the conse- .a "^■S. ALL CASES : 15,439 j 12,215 27,054 SPECIFIED CASES 15,439 12,087 27,520 (Classes.) Zymotic Diseases 9,437 Constitutional Diseases 193 Local Diseases 4,737 Developjiental Diseases 520 Violence 552 228 18,005 77 270 080 0,823 427 947 209 821 (Orders.) Miasmatic EiUhcUc. . Dietic I'arasilic. . 1 ] Diathetic. . 2 I Tubercular Nervous System Organs of Circulation jRe.fpiratori/ Organs Digestive Organs 1, Urinarij Organs Generative Organs Organs of Locomotion 149 Integumentary System 037 8,821 9,005 17,886 551 132 683 53 30 83 12 1 13 86 25 111 107 52 159 1.122 270 1,398 51 9 60 817 270 1,098 1,767 1,237 2,994 107 33 140 97 ■*3 120 Z05 Not occurring in the army Diseases of Nutrition Accident and ) Battle I ■• Homicide Suicide Punishment and 'xecuticn 520 551 {^' 427 268 1 170 842 Causes not specified. 947 819 1 1 128 ^J i)ii DLSKASES AND CASUAI/l'lHS— Coiitinue.l. Diseases, etc. NUMBER OF CASES TREATKI). (Diseases.) CLASS I.— Zymotic. Order 1. — Miasmatic. Small-Pox.... Varioloid Measles Scarlet fever Uiun^y Mumps Influenza Catarrh Opiitlialmia Typhoid fever Typhus Congestive fever... Continued fever Erysipelas Carbuncle Dysentery Diarrhoea Cholera morbus Cholera Asiatica.... Intermittent fever. Remittent fever Yellow fever Rheumatism All other fevers Order 2. — Enthetic. Gonorrhoea Syphilis Bubo Stricture of urethra. Cachexia Order 3. — Dielic. Scurvy Alcholism 224 183 127 17 626 97 156 1 81 618 3,667 2-59 1 1,178 639 720 190 308 159 54 29 1 4 49 Orker 4. — Parasitic Worms 482 1 20 54 171 140 131 14 18 ?P 16 4 527 3,362 2,868 839 163 193 63 57 6 3 3 21 9 12 706 1 203 181 17 797 237 287 15 18 39 68 85 1,145 7,029 282 1 4,046 1,478 883 383 '.71 60 25 58 13 OG 1)1SI:AS1::S ANI) ("ASUALTILS— Continued. Diseases, etc. NUMBER OF CASES TUSATED. CLASS II. — Constitutional. Ordkr 1. — Dialhedc. II Gout Lumbago Anasarca Cancer All other diseases of this order. OuBKK 2. — Tubercular. II 2 j Scrofula I Phthisis, (cotiKumption of lungs) I Iltcmoptj'feis Aua>mia Ill CLASS III.— LocAi,. Order 1. — Nervous Si/stem. Apoplex}' Headache liifi immation of Brain Chorea, (St. Vitus' dance) Epilepsy Sun stroke Spinal irritation Slania Melancholy Neuralgia Paralysis Nyctalopia Hemeralopia Retinitis, (inflammation of retina Iritis Amaurosis Cataract Earache Otitis, (inflammation of ear) Otorrhoea, (discharge from ear).. Deafness Delirium tremens Nostalgia, (home sickness) Toothache Tetanus All other diseases of this order.. . 14 51 21 21 19 6 19 11 15 281 51 1 92 10 21 70 32 30 3 - •) 29 7 30 31 7 38 9 _ 9 8 3 7 5 12 120 73 193 4 1 5 1 _ ] _ 1 1 97 _ 97 5 1 6 _ 1 1 4 4 105 6 111 67 8 75 75 1 76 10 2 12 12 8 20 1^-^ 73 258 o •1 r.4 29 93 ^^/ 57 DISEASES AND CASUALTIES— Continued. Diseases, etc. CLASS IIL — Local — Continued. Order 2. — Organs of Circulation. Aneurism Angina pectoris Carditis Endocarditis Pericarditis Inflammation of Vein Varix Htematocele All other diseases of the organs of circulation Ordkr 3. — Jiespiratori/ Organs. Asthma Bronchitis acute " chronic Laryngitis Pleurisy Pneumonia, (inflammation of lungs).. Hydrothorax Epistaxis, (bleeding at the nose) All other diseases of respiratory organs Order 4. — Digestive Organs. Constipation Colic Dyspepsia Enteritis, (inflammation of bowels).. Gastritis, (inflammation of stomach) Hiematemesis Inflammation of liver, acute " " chronic Fistula Jaundice Peritoniiis Splenitis, (inflammation of spleen)... Hernia Haemorrhoids Prolapsus ani Ascites Other diseases of digestive organs... NUMBER OF CASES TREATED. 20 ;}50 (55 22 112 45 17tj 3 140 14 2 2!t 41 47 629 505 1,134 834 82 416 158 19 177 19 2 21 39 18 57 8 2 10 38 218 256 32 42 74 35 _ 35 33 50 83 15 _ 15 2 30 32 97 9 106 141 33 174 12 _ 12 1 _ 1 1G4 227 391 4 9 2 3 1 23 IG 490 79 24 141 86 27 223 58 1>1SEASES and casualties— Continued. o 5 () , 7 8 Diseases, etc. ndmiser of cases treated. 00 <1 III CLASS III.— Local— Continued. Order 5. — Urinary Organs. Calculus Inflammation of bladder 10 6 6 1 ^ 23 25 19 11 1 5 10 8 1 8 10 7 Diabetes 6 Enuresis 12 Ischuria et Dysuria 33 Inflammation of kidney Ulcus penis non syphiliticum 33 20 Other diseases, of the urinary organs... Order (i. — Generative Organit. Varicocele 19 HI 27 63 2 5 2 19 2 29 Orchitis 82 ■ Sarcocele 2 Hydrocele 7 • Order 7. — Organs of Locomotion. Hydrarthrus I!T 17 13 4 3 112 2 1 24 19 Anchylosis 13 Exostosis 5 Necrosis 3 Other diseases of this order i Order 8. — Integumentary System. Abscess 136 ITT 133 51 79 6 63 20 116 50 7 - 239 78 184 Whitlow, or felon 85 Phelgmon 83 Ulcer 166 Tumor Other diseases of the integumentary system 317 IV ( 4 CLASS IV. — Developmental. )rder 1-3.— (Not applicable to the Army. ) Order 4. — Diseases of Nutrition. Atrophy and debility [ 520 427 947 59 DISEASES AND CASUALTIES— Continued. ^o H P O Diseases, etc. NUMBER OF CASES TREATED. CO < S o <1 Army of the West. Aggregate. V 1 4 5 CLASS v.— Violence. 20 5 I 135 15 1 21 51 84 23 50 6 60 79 5 2 102 1 14 33 24 8 18 5 36 14 25 5 3 237 Fracture Frost 21 35 84 Lacerated or contused wound 108 31 68 Poison Wound by incision 11 9(i Bite of Serpent _ 93 SOICIDE V - 1 1 Punishment and Execution V 1 - 1 - 128 128 On the next page is a table by which the distribution, accord- ing to Statistical Classes, of the diseases and casualties of the same portion of the forces of the United States (1861) may be compared with those of the British army when in the Crimea. 60 Number of Diseases and Casualties of each Class and Order to 1,000 cases treated. m •< u P ca o DlSE.\SE8, ETC. o o o a a ii < s (I < 1000 "5 "o Eh Army of the Crimea, April 10, 1854, (0 June 30, 1856. ALL SPECIFIED CASES 1000 1000 1000 T 1 2 3 4 1 2 1 2 3 4 5 6 7 8 4 1 2 3 4 5 Zymotic Diseases 611 12 307 34 36 764 6 173 35 22 678 10 248 34 30 698 TT Constitutional Diseases 5 TTT Local Diseases 156 TV Developmental Diseases 1 V Violence 140 I (Orders.) Miasmatic 571 36 3 1 750 11 3 650 25 3 673 Enthelic Dietic 23 9 Parasitic t II Diathetic 5 7 2 4 4 6 3 Tubercular ') Nervous System III 73 3 53 114 7 6 10 41 23 1 23 102 8 2 2 17 51 2 40 109 5 4 6 31 25 Organs of Circulation 2 Respiratory Organs 16 JJii/estive Ori/ans 29 Urinary Organs 1 Generative Organs Organs of Locomotion 1 Integumentary Si/stem 82 Diseases of Nutrition IV 34 35 34 1 Accident and ) V 36 22 30 t 114 Battle i Homicide Suicide 11 f Punishment and "1 { Execution j Note. — This table maybe read thu.s : Of every 1000 cases of disease and casualty occurring in the army of flie Potomac, Oil were of the class called the Zymotic, (comprising epidemic, endemic, and contagious diseases.) 571 of these Zymotic diseases were of the Miasmatic order. S / 61 Tendencies of Disease. — Diseases of a malarial type, \vliiL'h till recently have most given occasion for anxiety, are noAv be- ginning somewhat to decline. On the other hand, there is a slight but appreciable increase in cases of disease appropriate to the winter months, as severe colds, inflammations, pulmonary affections, and acute rheumatism. Typhus. — To this must unfortunately be added a decided in- crease of typhus fever. This term is used to indicate not the typhoidal aspect occasionally assumed by other forms of disease, but the formidable and infectious disorder, known, according to the conditions that produce it, as "camp fever," "ship fever," " hospital fever," &c. Its appearance is traceable to the natural disposition of soldiers to shut themselves up in their tents or huts as much and as closely as possible in cold weather. In many camps they have already been allowed to commence a system of suicide by excavating the ground within their lodgings, and throwing up banks of eartli against their -walls or curtains. This practice, which, as is well known, occasioned a great loss of life in the British army during the Crimean war, should be at once forbidden, and full ventilation of tents at night made compul- sory, even at some real or imaginary expense of comfort. The Inspectors of the Commission are unable to act with adequate eflfect against this danger. An extensive outbreak of typhus would be exceedingly demoralizing as well as destructive, and it would be better that double or triple the usual allowance of blankets and of flannel shirts should be distributed to the men in camps, even if the issue should be left behind or thrown away at the first movement, than they should be indulged in their dis- position to burrow or seal themselves in their lodgings. Measles and Small- P 02% — Measles and small-pox are also com- mon, the latter sufficiently so to justify uneasiness. Inspectors 62 of the Commission have been called upon by regimental surgeons almost daily during the last month, for a supply of vaccine virus, the reason assigned by them being that it could not be obtained from the jNledical Bureau. The supply at Washington, under the control of the medical authorities, was reported to be en- tirely exhausted on the 6th inst. There has been no general re-vaccination in the army, and many regiments are now in serious danger from this disease. The Commission has constantly urged the importance of atten- tion to this subject, and has been partially able to supply the existing deficiency, by purchasing and issuing to regimental sur- geons the vaccine matter they stated themselves unable to ob- tain from the regular sources. Its organization and means are, of course, not sufficient to comprehend the whole array. It has, however, provided for the vaccination of more than twenty thou- sand men. ' Most cases of small-pox that have occurred in the army of the Potomac are attributed by the regimental surgeons to the ab- sence of means for a proper isolation of the sick. Small-pox patients have been conveyed to general hospital in the ambu- lances and on the cushions used by the sick and wounded generall}'. What is still more unfortunate, all cases of erup- tive disease have hitherto been accommodated in one special hospital. In this hospital, overcrowded* and most imperfectly * The overcrowded condition of the hospital has frequeutly led to the dis- charge of patients before their convalescence was established While tliis re- port is preparing, the following statement is made by an inspector, in connec- tion with his return for a New York regiment: " I observed the funeral of a soldier in progress, and asking for a history of his case, received the following statement from the colonel and sur- geon : A few days previous he had been sent to the hospital for eruptive dis- eases at ' Kalorama.' He was, when sent, in the early stages of measles. On the evening of the day thereafter, to the surprise of the surgeon, he reap- peared in camp, in an exhausted and distressed condition. He said that he h- ' 3t provided with bedding and supplies of every description, all cases of eruptive disorders have been placed in close juxtaposition and without adequate precautions against the communication of small-pox to patients under treatment for other diseases. As a natural consequence of this oversight, several instances have occurred during the last two months in which patients dis- charged from this hospital cured of measles, &c., have, on rejoin- ing their regiments, been attacked with small-pox, apparently contracted in hospital, and have communicated it to their com- rades. The following cases of small-pox have been reported to the Commission by the surgeons of the respective regiments, as directly traceable to this cause, viz : In the 8th regiment Maine Volunteers 7 8th " New Jersey " 3 1st " New York Artillery 3 Harris's Light Cavalry 2 7th regiment Wisconsin Volunteers 9 19th Indiana Volunteers 5 And it is to be feared that the list could be enlarged by special inquiry. The disease has been communicated to the 4th Pennsylvania cavalry by one of these regiments encamped near it. Of the nine men belonged to the Wisconsin regiment, three have died, and the same number of the Indiana regiment. In the 8th regiment of Maine Volunteers, the disease communicated to them broke out when they were on the eve of their depar- been discharged from the hospital, and, in the evening of a December day, obliged to walk back to his regiment. lie was immediately taken to the regi- mental hospital, and assiduously attended upon. But notwithstanding all efforts to save his life, he died during the same night from bronchial and laryn- geal congestion consequent upon exhaustion and exposure." t>4 ture from Annapolis for Port Royal, and the most serious mischief was only prevented by the energetic action of Dr. Cooper, the Medical Director of that expedition, who instantly transferred all who had been in any way exposed to infection from camp to the navy yard. Nevertheless, the 21st Massa- chusetts regiment, then engaged in guard duty at the navy yard, was infected, and up to the 28th November, twenty-five cases of variolous disease had occurred among the troops at Annapolis, five of which proved fatal. The 8th Maine did not entirely escape the disease even after leaving all supposed to be infected behind. The last arrival from Port Royal brings news of the death of one member of that regiment, and of three deaths in the Michigan 8th from varioloid. MILITARY HOSPITALS. At the close of the October session of the Commission it was un- derstood that Government would at once commence the erection of two cheap temporary model hospitals at Washington, in con- formity with plans carefully prepared by a committee of the medical members of the Commission, and approved by it as em- bodying the latest results of sanitary science. These plans have been formally approved by the Quartermaster General, the Commander in Chief, and the Medical Director of the army of the Potomac, and the ground for the example buildings has been staked out. But their erection is not yet commenced. As the Commission believe that a large amount of hospital space of the character provided for in these plans is urgently demanded from considerations of economy as well as of humanity, it is hoped that there will be no unnecessary delay in their completion and equipment. Defects in present Hospital Arranf/e/nents. — Tlu* dt-fects and sources of mischief in the general hospitals at and around "Wash- ington and elsewhere, which have been under consideration by the Commission at each of its sessions, and against which it has repeatedly remonstrated, continue without material change. An unfortunate personal difficulty between two medical officers of high position is believed to stand in the way of the measures necessar}'^ to bring these establishments up to anything approach- ing the lowest standard that would be tolerated in any civil hos- pititl. No fact in sanitary science is better established than this, that old buildings, such as hotels, academies, store-houses, ikc, are, from their want of systematic ventilation and other reasons, most unfit to be used as hospitals on any large scale, and that, even in inclement weather, tents or the rudest shanties are preferable. During warm weather, while every door and window is kept open, especially if the buildings are newly occupied, the evil is less felt ; but in the winter months, when doors and windows are sure to be kept closely shut, it is almost certain to show itself in the form of hospital fever, erysipelas, and other formidable diseases, and in the general depression and tedious convalescence of those patients who escape them. The Commission has formally ap- plied to the Meilical Bureau to take steps to improve the venti- lation of these buildings occupied as hospitals near Washington. Some steps have been taken to this end, but they are reported by the Inspectors of the Commission to be inadequate. Complaint is made by officers of the Medical Bureau that regi- mental surgeons are tardy in sending their sick to general hos- pitals — that they are often detained in regimental hospitals till past cure. A large portion of the mortality in general hospitals is thought to be accounted for by this alleged fact. This tardiness is in many cases to be explained by the feeling 5 6»J of discouragement frequently expressed by regimental surgeons ill regard to general hospitals. Men sent to these establishments when laboring under the severest forms of disease are reported to have been frequently turned from their doors, after a long and tedious journey, and sent back to their regiments, because the hospital was full, or because there was some formal defect in their papers. In some instances, such men have spent the night in an ambulance at the hospital door. Relations between General and Regimental Hospitals. — It is manifest that the relations between general and regimental hos- pitals, and between the surgeons of regiments and those in charge of general hospitals, are in an unsettled condition, which practi- cally leads to great suffering and the loss of many lives. Technical Difficulties in the Hospital System. — Mere technical defects and irregularities in the permits for admission to general hospitals, and also in the requisitions of regimental surgeons for their medicines and other supplies, are the daily cause of much mischief, and of what seems most unnecessary suffering. This will be best illustrated by a statement of a single case which happens to be reported by the surgeon interested while this portion of the report is in preparation. It is by no means of peculiar or unusual hardship, and is merely a specimen of hundreds in which the Commission has been appealed to for relief. A volunteer surgeon, whose regiment is encamped at a distance of several miles from the depot of military supplies for his divis- ion, and who has in his hospital a large number of sick requiring his constant personal attention, applies to the proper officer for a hospital stove. Ilis requisition is in all respects regular, except that he has forgotten or neglected to get it countersigned by the ^^/ general ocunnandiiig his bi-ii!;;i(le. It is, therefore, haiideil back to him for correction. He returns to cauip. After spendinj^; at least another day in pursuit of this officer, he succeeds in findint]; him, in getting access to him, in gaining his attention, and obtaining his approval and the required signature. lie devotes another day to another expedition to headquarters with his wagon for the transportation of the stove, and presents his re- quisition as amended. The name of the brigadier general appended to it is well known. But the requisition is still defec- tive. The general has hastily subscribed his name in the proper place upon the printed blank, but has neglected to append his title. For this reason, as the surgeon is given to understand, the stove cannot be issued, and he goes back to camp w'ithout it to spend two or three days more in pursuit of tjie general. Whether the sick men in this regiment sustained serious harm or any harm from the absence of the surgeon, or for want of the stove, it is needless to inquire. They certainly may have suffered fatally. Unless the surgeon considered a stove necessary for them, it is to be presumed he Avould not have taken all this trouble to procure one. But many analogous cases have been reported to the Commission, in which hospital patients were in imminent danger from like delays, and in which the Commission has sup- plied from its own stores the few dollars' worth of necessaries required to save them. There is little room for doubt that many lives have already been lost from mere technical and formal obstacles to their pres- ervation. It is respectfully submitted that some remedy should be applied to this evil. The inevitable consumption of life in military hospitals is sufficiently appalling without any in- crease from merely artificial difficulties. Official forms luid rules are indispensable to the Medical Bureau and Quartermaster's Department, as to every other department of Government, and all -who hold official relations with either, are in duty bound, as rapidly as possible, to inform themselves as to the details of its system, and govern themselves accordingly. But if tliis system be not adapted to the new order of things, and to the wants of the volunteer army — a question on which it is not intended to express an opinion — it seems plain that the system should be changed. If the regulations to which surgeons must conform before they can obtain medicines for their patients be too complex and elaborate for the comprehension of the average volunteer surgeon, without military education or experience, the interests of half a million volunteer soldiers require that these regulations be re- vised and simplified, even at some little expense of official pre- cision, and of checks against waste and improvidence. If, on the other hand, these regulations be in fact fairly within the comprehension of any man of ordinary capacity Avho will take the trouble to study them attentively and learn his duty, volunteer sui'geons should be expected and requested to comply with them, and any failures to do so, in matters involving the health or comfort of their patients, should subject them to mili- tary discijiline. A more liberal discretionary power should also be expressly vested in the Medical Bureau, in directors of hospitals,and in cer- tain easily accessible officers of the Quartermaster's Department, to waive strict technical accuracy in requisitions for hospital supplies and in hospital permits, whenever they are satisfied that the interests of the service will suff'er no substantial detriment. MEDICAL AND SURGICAL SERVICE OF THE ARMY. Regular Service. — Admission to the medical staff of the regular army is attained through a successful examination by a board of G9 army surgeons appointed by the Surgeon General on the order of the Secretary of War. The candidates approved by the board are entitled to appointment as assistant surgeons in the order of merit as vacancies occur. The test of fitness imposed by these army boards of examination has hitherto been a thorough one, and has secured to the service young men of more tlian average ability, who only need encouragement to advance in professional attainments, in order to maintain an eminent position as scientific physicians. Unfortunately this encouragement is not affoi'ded them. The policy of the Government has not heretofore been such as to develop a high degree of professional acquirement. The assist- ant surgeon, as soon as he is commissioned, has generally been sent to a distant frontier, where he serves for several years as physician at a small military post, the garrison of which rarely consists of more than two companies, often of one of only ninety men. As soon as convenient after five j'ears' service, he has, after a short furlough, been submitted to examination for the grade of suro;eon, which terminatinrr in his favor, he is trans- ferred to another frontier post, where he again passes several years without an opportunity of visiting any seat of medical learning, or of renewing by dissection, as he only can at a medical centre, his familiarity w^ith practical anatomy. During most of this time his experience is, in many instances, limited to a small amount yearly of indigenous disease, and a few trifling accidents, and he is thus practically unfitted for ])rofessional responsibilities of a wider range. The administrative duties of his office tend, at the same time, to interfere with the proper exercise of the higher scientific duties of his profession, and the careful preparation of a de- tailed monthly report often gets to be considered more creditable than the prevention, by professional foresight, of an epidemic. Thus the army surgeon, by the time he reaches middle life, is 70 in danger of becoming a mere routinest, mindfal rather of the forms of business than of scientific advancement. It is highly creditable to the medical corps of the army that this tendency of the system has been so well resisted by many of its nccomj3lished members, and yet that such is its tendency can hardl}' l)e denied. But the evil is not without remedy. The head of the Medical Bureau should be allowed to permit the surgeon, after stated periods of service, to devote a few' months at some centre of medical instruction, where, by association with the learned and the progressive of his profession, his own ambition would be stimulated, and his professional knowledge extended. The Brit- ish Government thus systematically detaches its medical officers from duty, that they may refresh and extend their knowledge by attendance on lectures, and by resorting to other means of instruction. Other branches of the service have the stimulus to improve- ment, and the opportunity of securing it afforded by occasional furloughs, for the purpose of studying the art of war. The country has not forgotten the late military commission to Europe, the experience of which must have greatly enhanced the resources of its present commanding general. Was an army surgeon ever sent to Paris or Vienna to add to his scientific knowledge ? The tendency of all work as a matter of routine is to dwarf the intel- lect and unfit it for broader views. Hence the greater need of occasional special culture. Beside the reasons which humanity urges in favor of securing the highest efficiency to the medical corps, there exists a claim to consideration in the fact, that, unlike the officers of the purely military arm of the service, who have been educated by Government at its Military Academy, the medical officers have educated themselves in an expensive learned profession. The service could hardly fail to be benefited also by a reorgan- 71 izatiori which should create a body of'inspeclor.s-geiK'ial, selected from the army surgeons, with increased assimilated rank, whose business it should be to inspect tlie condition of all camps, hos- pitals, barracks, stores, and supplies, and keep the head of the bureau constantly informed as to the sanitary condition of the army, and the provision for its needs, each season and station frequently having its special wants. This feature of organiza- tion, the necessity for which is recognized in every European army, seems necessary to conform the medical department to the purely military departments of the service, thorough inspection being elsewhere the stimulus to efficiency, the remedy for neglect, and the only means by which abuses will be removed. This function of inspectors-general is now blended with that of medi- cal directors, who, being administrative officers on the staff of the commanding general, cannot command time for the thorough and close examination which, as experts, the inspectors-general should be required to make. More frequent reports, made up of other than purely statisti- cal matter, embracing reflections and investigations, as well as records of cases, would, if called for by authority, and circulated in and out of the army, furnish a valuable stimulus to the laud- able ambition of the army surgeon. Volunteer Service. — The surgeons of the volunteer army have been received, with its other officers and its privates, from civil life, either with or without examination. Where examination has been had, it has varied in degree, from the rigid tests imposed on candidates by the State examining board of Vermont, to a care- less weighing of merit by which the imperfectly qualified im- postor has not been found wanting. In most instances the colonel has nominated the surgeon, who has afterward been con- firmed by the Governor of the State, with the approval of an examining board. Practically, the result is better than could have been exported. Abuut sevcu-cightlis (7-8ths) of the sur- geons and their assistants — and this is about the proportion who have undergone examination — seem to the inspectors of the Commission to be fairly qualified for their duties. There are notable exceptions, however, to this general rule of competence. Two surgeons confessed that, until they were sup- plied with instruments by the Government, they had never seen an amputating knife. But the average grade of qualification, founded on both scientific attainment and practical experience, is reasonably high. The fairly qualified sui'geon is attached to his regiment, which has reached the column of the army of which it is to form a part. What facilities are his in the administration of his oflSce ? Hav- ing overcome the difficulties in the way of securing hospital tents for his sick, and recovered from his vexation at being denied one- fourth of the articles of medicine and of furniture, for which he had made requisition in conformity to the supply table, he endeavors, as best he may, to execute his trust. Shall he treat the sick as far as possible in the regimental hospital in camp? He often finds himself cut off from the use of medicines on which he has been accustomed to rely, (they are not mentioned in the supply table for field service,) and cannot obtain others, whose importance is recognized, in sufficient quantities from the medical purveyor. Ilis instruments are often very poor; not at all fit for the uses for which they were designed. He finds the regi- mental quartermaster and the brigade commissary, both un- willing to be bankers for the Government, when he asks them to purchase, on account of his hospital fund, which from the savings of his rations lie has accumulated on paper, such nutritious food as he may require for his sick. Often for that purpose no funds are available. 71^ 3'/ Shall he nut thoii send all hut tin; li'^hllv side to iieDeral lio.s- pital ? It is, perliap:, not the best place for tlicm. The fever patients will not be benefited by tlie ride of six or eight miles in a jolting ambulance, and the}' cannot have, in the old public house or the narrow rooms of seminaries, now misnamed hos- pitals, the free ventilation so essential to them, which the regi- mental li()S|)ital tent afl'ords. Ijiit to secure to them more promjjt supplies of appropriate medicine, and more varied and suitable food, and to avoid em- barrassing the rapid movement of the regiment liable to be ordered forward, he applies to the medical director for a permit which shall admit his dozen most sick men to the general hospital, in the nearest town. That he sometimes meets delay in securino; it, is not strange when re^rard is had to the amount of accommodation in the general hospitals and the numbers al- ready there, together with the number in camps ill enough to require the surgeon's advice, and to be nursed in the hospital tent. By the statistics gathered by the Commission, it appears that nineteen men in each thousand enlisted are on an average constantly sick in regimental hospital. Could one (^[uarter of that number find place in the general hospitals on the Potomac, for instance, in addition to their present population ? As tlie character of the regimental hospital must vary accord- ing to the mobility of the regiment, the season, the locality, the prevalent diseases, the proximity to available general hos- pitals, etc., a larger discretionary power should be accorded to the surgeon. The facility of adaptation to varying circum- stances is an essential feature of a good hospital system. The mutual relations of the surgeon and his assistant need to be more clearly defined. The surgeon is at loss, moreover, as to his relation to the snr2:con of brigack-, Avliom he finds on the staff of the brigadier general. The authority of that officer is very imperfectly defined, and he n.ay often claim more than would be readily conceded. To make the medical and surgical service of the volunteer army as efficient as the country has a right to expect it to be, there seems to be required a uniform and thorough examination of candidates for the post of surgeon and assistant surgeon, by a central board of United States army surgeons, if need be. This is the more important from the practical difficulty encoun- tered in getting rid of incompetent surgeons. It is not an un- known thing for a board summoned to test the qualifications of a medical officer known to be unfit for the discharge of his duties, to report him as qualified, after which only a court martial can separate him from the service, and this he can easily avoid. More ample provision should be made for the sick, both in camp and town hospitals. The supply table for the former should bo revised. It is submitted, indeed, that the entire medical supply table for post, field, and general hospitals ought to be carefully exam- ined and revised by a competent board ; and that, if it be found in any respect below the requirements of the latest and most enlightened medical science, it should be brought fully up to that standard. Surgeons of both the regular and volunteer forces constantly apply to the Commission for medicines and surgical and other appliances which they deem necessary for their patients, but wliich they cannot obtain through official channels. Argu- ment is unnecessary that our soldiers, when suffering from wounds received, or disease contracted, in the national service, are en- titled to expect from the nation the benefit of everything that the highest medical and surfjical science can jrive them. 3$ 75 Transportation. — Transportation for the jNIedical Dcpaitineiit of the army is at present very deficient, irregular, and bad of its kind, and shouhl be improved and systematized. Instances have been credibly reported to the Commission, in which sick antl dying men have been packed together in cars and canal boats, and detained for liours on their way, in a manner that (unless it arose from unavoidable accident) can only be characterized as shocking and inhuman. The Government two-wheeled ambu- lance, whether considered as a conveyance for the sick and wounded, or as a transport wagon, is too bad to be continued. In its place several additional four-wheeled ambulances should be given to each regiment, three or four horse-litters of the form shown in Delafield's report on European armies, figures 75 to 78, pending some better invention, and a supply of pack-mules with hampers ; as wagons will often be impeded, broken, and rendered impracticable, in the rough roads, gullies, streams, and sloughs, constantly met in our Southern States. These articles should, of course, be the exclusive property of the Medical Department, and a considerable proportion of the transportation belonging to the medical service of each com- mand should be kept near the stationary or moving depot of the Medical Purveyor of the Corps d'Armde, in order that requisi- tions, by courier or telegraph, may be immediately filled and despatched. (See Appendix : ""^ Ambulance.") VOLUNTEER HOSPITAL, AND OTHER SUPPLIES. The Commission did not, at first, contemplate furnishing hos- pital and other supplies to the army on any large scale, bur con- fined Itself mainly to the duties of " inquiry and advice" assigned it by the Secretary of War. It could not refrain, however, with- out doing violence to the human sympathies of its members. 76 from supplying some few of the more pressing wants which they saw existing in the military hospitals of Washington and else- where. The absence of any hospital fund already referred to made these wants remediless, except by the Commission, or more properly, by the generous and patriotic people of tlie loynl States, Avhom the Commission represents as their agent and al- moner. The Commission tiius found itself in a manner obli";ed to overstep its strict duty, and was induced to employ a number of experienced young men as hospital dressers ; to provide for the washing of the clothing of patients and of the hospital bed- ding, bandages, and towels; to purchase water-beds for patients who had undergone amputation, and whose surgeons certified that they could not recover without them ; to provide nurses possessed of skill for the handling of badly-fractured limbs; to engage the services of barbers to be constantly employed in the hospi- tals ; to supply, from time to time, some small amount of stim- ulants, and medicines, and surgical appliances to surgeons who were unable to obtain them from the Medical Bureau, either from their own excusable ignorance of official forms, or because the stock at the disposal of the Bureau was exhausted ; to provide some means of recreation for men with tedious wounds, and convalescents ; to furnish letter paper, envelopes, pens, ink, and postage stamps, or obtain franks, for those wishing to commu- nicate with their friends, or with the friends of more feeble comrades, etc., etc. The distribution of stores, clothing, bedding, ic, to the hos- pitals, and occasionally and on special emergencies (as after the engagement at " Ball's Bluff") to soldiers in the field, has now become a recognized function of the Coinmission. It assumed it with the less reluctance, that some central aejencv was indis- pensable to prevent a distressing wnste of the supplies -which the h>y;il women of the country were diligently providing for the army. Soldiers of one regiment were found to be over supplied, and throwing away the surplus or bartering it for liquor, while the hospital of some neighboring regiment was without bed:?, and its patients without a change of clothing.* The Commission has, therefore, for some months past held itself ready to receive and to distribute where most required, among the soldiers of every portion of the army, all supplies, especially of hospital stores, which might be forwarded to its depots by the liumanc and charitable societies that are working for the army in every northern city, town, and village. These supplies have been forw%arded to it in large ((uantity. The Quartermaster General having advertised for blankets from the private stocks of citizens, and having become acquainted with the method of action adopted by the Commission, has also directed that all blankets which shall thus be obtained by his agents shall be placed in the stores of the Commission, for gra- tuitous distribution, where found to be needed by the sick. Depots of the Commission. — The principal depots of stores for the Commission are in New York, (under charge of the " Woman's Central Relief Association," of New York ;) at Bos- * As this is being written, word is received from the quartermaster of the Second Regiment New Hampshire Volunteers, that he has three or four tons of hospital stores which have been presented to the regiment, but of which it has no need, and which he finds it impossible to transport. As the regiment is or- dered to move, he desires the Commission to relieve him of them. On the same day an urgent request has been received from several other regiments of the same division for much needed supplies. Si.x days after tlic Commission bad, by its agents, conveyed to the wounded at the battle of Ball's Bluff three wagon loads of comforts, the lirst box arrived, sent bv friends at homo for their relief. ton, at Providence, R. 1. ; at Philadelphia; at Cincinnati; Cleve- land, and Culumbus, Oiiio ; at Wheeling, Va. : at Louieville ; at Chicago; at Cairo; at St. Louis, and at Washiugton. Freight. — The freight on these supplies has been in many cases necessarily paid by the Commission. This source of ex- pense, however, will be diminished by the liberality of the direc- tors of most of the principal railroad lines, on which supplies consigned to the Commission will hereafter be conveyed at re- duced rates. Amount of Sup/dieg DUtrlhuted. — The demand for articles of clothing and protection for the sick has naturally increased during the past month, but the means placed by the community at the disposal of the Commission has enabled its Inspectors to keep pace with this increase. Thirty-four thousand four hun- dred and eighty-one articles of hospital clothing were distributed from the Washington depot alone during the month of Novem- ber, besides a large bulk of unclassified articles. The supplies thus distributed from the Washington depot have been issued to one hundred and thirt\'-six hospitals ; twenty of which were general, and one hundred and sixteen regimental. The average number of articles supplied to each was a litte more than two hundred. About one thousand are now daily distributed from the same depot, and their value in money is not less than five hundred dollars. At the Cleveland depot sixty-nine thousand articles have been received since its organization; and fiftj-oue thousand, besides several tons of articles of hospital diet, have been already issued from it to the army of the West, at various points. From the Wheeling depot, four thousand eight hundred and fourteen articles of bedding and clothing, alone, have been dis- tributed. Accurate returns have nut yet been i-eceived IVum other depots, but there can be little doubt that the value of supplies issued to the army, by agents of the Commission, during November, amounted, at a very moderate estimate, to the sum of forty thousand dollars. System of Distribution. — It is the duty of the Commission to prevent, as far as possible, the sacrifice of human life to matters of form and considerations of accuracy of accounts. Its method of distribution is as thorough and exact as can be maintained con- sistently Avith this duty. This department of its business has so greatly increased of late that it has been difficult to enlarge its clerical organization uith corresponding rapidity. Vouchers signed by the surgeon, or his assistant, of every regiment or hospital aided, and counter- signed by an inspector of the Commission, who has ascertained that the articles supplied are actually needed, have been f)btained, however, for every dollar's worth issued at all the depots di- rectly controlled by the Commission. Caution is exercised in the distribution of the gifts of the people, chiefly in the following particulars : 1. That they should be as fairly- divided as is practicable — those most needy being most liberally dealt with ; 2. That no officer shall be unnecessarily relieved from an ex- isting responsibity to secure for all dependent on him all the supplies which it is his right and duty to demand directly of Government. Reserve Stock of Supplies. — The reserve of stores at the disposal of the Commission is still smaller tlian it shouM be. The demand caused by the comparatively trifling engagement 80 at Kail's Bluff exliaustcMl its supply of various articles urgently require'!, and obliged it to purchase what was still needed in the shops of Washington. Had this battle been followed up by a general advance, or had a general engagement on the Potomac taken place, it is morally certain that many hundred, if not thousand men would have perished for the want of hospital sup- plies and medicines. Neither Government, nor the Commission, nor the shops of Washington, could have furnished one quarter part of Avhat would have been required, especially if a national victory had thrown the enemy's wounded on the hands of the Gov- ernment. It is true that Government could have telegraphed to Baltimore, Philadelphia, and New York for additional supplies ; but these could not probably have been obtained in considerable quantity for several days ; and if only forty-eight hours elapsed before their receipt, hundreds of wounded men would have died from mere want of medicine, bedding, and bandages. Insufficiency/ of Government Supplies on hand. — The Corami.s- sion feels that the duty assigned it by the AVar Department re- quires it to })rotest, as it has already protested, against the grossly inadequate provision for the contingency of a general ac- tion which, certainly existed during the summer and autumn, and which it believes still to exist. To illustrate the extent of this deficiency, it is only necessary to say that the Medical Bureau was obliged to call on the Com- mission to supply lint and bandages for a few wounded men brought into hospital after one of the petty skirmishes that oc- curred in September last. The possibility of an engagement on our own soil at any moment, between two armies of one hundred and fifty or two hundred thousand men each, is so strange a novelty that we naturally fail to appreciate its inevitable consequences, and tho 81 irMiiien^o ainuunt of huinati suffering whicli must follow it. Tli« battle of Bull Rua has not taught us the lesson, because most of our woiiutled were then left on the field. Few of the morn serious cases reaehed our hospitals. We must remember that the experience of foreign armies shows that, after a well-contested battle on this scale, we must count on having, at the very least, frotu twenty to thirty thousand men crying to us for relief fiom agony. Supplies for Men in the field. — The Commission lias, by circu- lars and advertisements, given the widest publicity to the need of hospital supplies at all its dei)ots, specifying particularly the nature, dimensions, form, &c., of the articles especially needed ; and, as has already been stated, this appeal has been most gen- erously answered. It has had under consideration the expedi- ency of making a like call on the loyal women of the country for e.xtra clothing for men in the field. After advisement with the Quartermaster General, this has been thought inexpedient, except (to a limited extent) in the West, where delays and irregu- larities of transportation may retard the supj)ly through the regular channels of Government. Our soldiers are far better paid than those of any European army, and wherever these extra articles of clothing can be obtained throuf]jh their regimental quartermasters, their value being deducted from the soldier's pay, it is in the highest degree unfavorable to the development of true military habits, that th^y should seem to be furnished them as a kind of charity. The Commission, however, is in constant receipt, at Washing- ton and elsewhere, of considerable supplies of this class, which it distributes in cases of emergency. (See Appendix: Volunteer Army Supplies.) SiJ SPECIAL RELIEF TO VOLrNTEERS IX IRREfiULAR CIRCUMSTAXCES. The attempt has been made to smldenly stretch a system •lesigned to supply the Avaiits of a well-organized aimy of less than twenty thousand men under thoroughly-trained officers, to make it sufficient for the wants of six hundred thousand civilians rushing together in arms, all at once, with no officers acquainted with the forms of administrative duty for an army, but only leading men from among themselves, and of their own selection, to take the duty of officers in that system. Tlie population of a large town has been all at once set down here and there, in various parts of the country retired from the grand routes of communication, and from all adequate avenues for the supply of their subsistence. Rogues and traitors have seen their opftor- tunity in this state of things. Fools and indolent men have been swept, in the many eddies of the grand purpose which formed the central current, into places where great wisdom, activity, and energy would have failed to meet every pressing need. That men everywhere, throughout these wonderful multitudes, are daily suffering from the ignorance, neglect, mistakes, and impositions of their officers and of each other, is a matter of course. The agents of the Commission, limited in numbers, and sorely limited in means, have yet been able, in ways innumerable, and in many which cannot even be alluded to by a general indication of their character, to administer some measure of assistance and relief in many thousands of these cases. A brief description of one of the more systematic methods in which the Commission has thus more than justified all the hopes of a beneficent result which were entcitained :it its orjranizaiion, is all that can be attempted in this report. 88 The main purpose had in view, in the a<^enc_)' rclerrril tt), lias been to lessen the lianlships to which the ignorance of the sick volunteers and their officers, of the forms and methods of Govern- ment, make them subject while in the city of Washington, and to provide for certain wants of the volunteers, when detacheil from their regiments, for which the Government arrangements had been inadequate, and which the regular inspectors of the Com- mission, in their visits to camps and hospitals, could not attend to. Practically, the chief duty has been — First. To supply to the sick men of the regiments arriving in Washington such medicines, food, and care as it was impossible for them to receive, in the midst of the confusion, and with the lack of facilities, of their own officers. Second. To furnish suitable food, lodging, care, and assistance to men discharged from the general hospitals, or from their regi- ments, but who arc often delayed for a number of days in the city before they obtain their papers and pay. Third. To give assistance and information, and secure trans- portation to men who arrive at the railroad station in small numbers, and want to find and join their regiments. Some of these arc men accidentally left behind ; some are men who have been detained by order for a few days at hospitals in Phila- delphia or Baltimore. The building near the railroad station, occupied by this agency, is furnished ihe Commission by Government. From its occupation for this purpose on the 9th of August^ last, up to the 9ih of December instant, four thousand and forty nights' lodg- ings have been furnished to seventeen hundred and ninety soldiers, mostly laboring more or less under disease, who would, if without this resource, have been obliged to sleep on the fioor of the re- ception house or in places of great exposure. Many have re- fi4 mained in it several dnys, receiving meflical caic fiuiii a plivsiciati of the city, employed by tlie Commission. This has been done ut an aggregate expense of about fifteen hundred dollars. This agency also aids soldiers passing through tiie city "n their return to tlieir regiments from general hospitals, or passing through the city on sick leave, and in various ways that cannot be classified under any general head, but which have certainly prevented a large amount of sickness and suffering. This will be best illiistiated by extracts from two reports made to the Commission Iiy the Inspector in charj^i- of this agency. "When the regiments, whose sick men we had cfiarge of, went to camps, they usually carried their sick with them, unless the men seemed too feeble to go : in which case we saw that the men were taken to a general hospital, or else we kept them in charge a few days longer, until the regimental hospital couhl be put into a comfortable condition. " Sometimes the sick of a regiment just arrived occupied a sepa- rate passenger car, and remained in the car until the regiment moved; in that case we supplied them with tea and coffee and needed refreshments in the car. "Often the surgeon of the legiment had no medicine at hand for the sick, it being locked up in his chest, which could not be reached in the baggage car. In that case we obtained for him such medicines as immediate needs required. " When we found men from general or regimental hospitals wait- ing to get their discharge papers filled out, and for tlieir pay, we took them in charge, sheltered and fed them, and if they needed help, we rendered it. " When we found men who were too weak to bear the fatigue of going with their papers, we took charge of tlx' papers ourselves, had them filled up, obtained the signature of the men to blank receipts for money due to them by Government, and thus, by consent of the paymaster, received the money, and paid it over to the men. This privilege couhi only be granted in cases of absolute ii'^ce>-^ity. " When we found men seeking their regiments, we ilirected them, (from a record of the location of the various regiments kindly 4^ 85 furnished us by General Williams ;) if they needed money, Ave gave it to tliem ; if they were wonk, obtained an order for an ambulance, or an army wagon, or a railroad pass, by which they were sent to their respective stations. '• In many cases, men who were discharged left their regimental hospitals sadly in need of clean garments, especially shirts, stock- ing, and drawers. In such cases, before they started for home, we made the men clean and comfortable. " When "we found men at the reception buildings in need of medical treatment, but not sick enough to be sent to the general hospital, we called in a physician, unless their own surgeon could be obtained. "It is not the plan to consider this, in any sense, a hospital, but only as a place where the weak can rest and be cared for, and the sick remain awhile until they are otherwise provided lor, and also where those returning home, who have n(^ chiim ujion hospital, or camp, or station-house, may be sheltered if obliged to remain near the station more than six hours. Therefore, as a general thing, men will remain in the house but one, two, or three days at any given time." ''Within the past three weeks, we had a new class, viz: men belonging to regiments moving from Washington to Annapolis for special service. A number of cases have occurred where the regiments have struck their tents and marched to the railroad station, bringing all their sick with them in ambulances, expect- ing to take the cars at once; but they were detained there waiting sometimes for twenty-four hours. In such cases we have immedi- ately received the sick into the house : and there they remained until the train which was to take them was ready to start. Some nights we had as many as twenty such from one regiment, who otherwise (though just removed from a regimental hospital) would have been obliged to have slept on the floor of the recep- tion-house, or else in the army wagons and ambulances. Many of these were men who needed all the care we could give them." * * * * ^: -Jfi * "Sept. 11th. There were last night in the "Soldiers' Home," as we now call it, twenty-five men resting. Among them were a number of Berdan's Sharpshooters ; none of them were sick enough to go to a hospital, but some of them will doubtless be saved from serious illness by two or three days of rest and care. These men represent a large class of soldiers now arriving, who come in companies of fifties or hundreds, not yet organized into regiments, and therefore having no surgeon with them. To such we feel that we can be of especial service." 86 " Anw. 12, p. m. ; at 6J o'clock, thirty men arrive, belonnring to the Wisconsin 5th, in charge of a sergeant. lie left them immediately to go to he:i(lqu;irtcrs to get wagons to transport them to their camp. They were men sent on from the hospital at Baltimore. They had no provision for supper. We supplied them, and at 9^ o'clock they were packed into the wagons which had arrived. Had I seen the sergeant beforehand, he would gladly have let them rest for the night in the reception-house. Meantime, at about 8 o'clock, thirteen men and one woman, of the Wisconsin 6th, arrived from Baltimore hospital, witliout any one in charge of them. They had been merely told to go to Washington, and join their regiment. We gave them supper, made them comfortable for the night, and after breakfast they were taken to their encampment." Dr. Grymes, the physician to the Home, in his report, dated October 10th, says : " I have professionally treated over 400 soldiers since tlie opening of the house — some of them very sick. I have sent 36 to the general hospitals from the Home, and others from the depot. I have given medicine to many who were directed to call for advice. I have furnished medicines to various regimental surgeons arriving at the station-house; and, wlicnever ttie oppor- tunity has occurred, have conversed and advise 00 Compensation of Services for Inspection 3,480 36 Travelling Expenses of Commissioners 1,640 1-i Office Expenses, Including Services 1,036 24 Printing and Stationery --. 1,823 96 Postage 397 19 Telegrams 90 29 Freight 888 66 Soldiers' Home, at Washington l,19o 00 General Hospital 2,392 74 Regimental Hospital 572 59 Store House Expenses at Washington 660 83 • §16,256 98 THE MEMBERS OF THE COMMISSION. Of the gentlemen named as Commissioners, in your order dated June 9th, 1861, the folloAving accepted the duty assigned them, and have continued active members of the Commission, viz: The Rev. Henry W. Bellows, D. D., New York. Prof. A. D. Baciie, LL. D., Washington. Elisha Harris, M. D., New York. George W. Cullum, U. S. A., Washington. Alexander E. Suiras, U. S. A., '' Robert C. Wood, M. D., U. S. A., William II. Van Bi jien. M, D., New York. WoLCOTT GiBBS, M. D., New York. Samuel G. Howe, M. D., Boston. Cornelius R. Agnew, M. D., New York. J. S. Newberry, M. D., Cleveland. The Commission, under jour authority, has since added to its number by the addition of the following members, viz : George T. Strong, New York. Horace Binney, Jr., Philadelphia. The Right Rev. Thos. M. Clark, D. D., Providence, R. T. The Hon. Joseph Holt, Kentucky. Francis Burnett, Cincinnati. The Hon. Mark Skinner, Chicago. Frederick Law Olmsted, New Y'ork. It has also appointed about four hundred "associate members" from every part of the loyal States, including many gentlemen accomplished in sanitary science, whose counsel and assistance has been found of great value. Through these associate mem- bers, auxiliary organizations have been established in our prin- cipal cities, which have rendered material service to the Commis- sion, in supplying it with funds, in stimulating the supply of hospital material, and in the preparation of medical and surgical papers. An expression is due of the obligations which the Commission is under, to the Major-General Commanding; the Quarter- master General, and to the Medical Director of the Army of the Potomac, for valuable advice in its deliberations. Thanks are due, also, to nearly all the agents of (iovernment, who have at any time had it in their power to aid the work of the Commission. In the various regiments of volunteers which have been inspected, the number of officers from which the Com- 92 mission has received information is about seven tlionsand. With a single exception, they have answered enquiries and received suggestions, in matters of their duty, with entire courtesy and frankness. The fact illustrates a distinguishing characteiistic of this Republican Army. IMPORTANCE OF MILITARY HYGIENE. The experience and observation of the last five months, has only strengthened the original conviction of the Commission, of the immense practical importance to the nation, in a merely economical point of view, of a thorough system of military hygiene, and of increased [)recaations against the occurrence of disease. Such precautions can hardly be said to form part of our present system. The army medical staif are charged with the cure of disease; its prevention forms a most subordinate inanch of their duties, if, indeed, it be distinctly recognized as belonging to them. The views of the Commission on this subject are clearly em- bodied in the following extracts from a Report on Army Medical Statistics presented to the British House of Commons, (printed June. 1861): "Reports exhibiting the results of extensive observations over a wide field will serve to measure the influences of each known cause on health, and will probably lead to the discovery of now causes, both of impaired and of vigorous life. They will every year contain new contributions to the science of healtli, in which the w'hole nation is concerned. The report will be the means of improving the health of the army. They will contribute to di- minish the army's sickness, which is attended with expense ns well as suffering; foi- a sick army is the worst extravagance in which a nation can indulge. Thiough the wane of information, whicli rhese reports \\\\\ supply, the exact amount of sickness in the army is not known ; but according to past experience, it may inferred that at least thirteeyi iIiou.so)i(J officers and men of the ^y 93 present force are habitually in the hospitals, so that to have an available strength of OHt? liundred and eiijhtij-itcvcn thousand, the country has to maintain two-Jnindred thousand of all arms. The thhteen thousand sick men in the hospitals cost as much as thir- teen thousand men under arms. Here is a -wide margin for economy. "If the statistical reports help the Secretary of State for war to reduce largely the sickness of the army in peace and in war, they will, it is plain, save thousands of pounds annually in the estimates. At the same time they will effect a still moie impoi'- tant saving : for they will save the lives of our soldiers. "If soldiers die in battle by hundreds, they die of disease in hospitals by thousands. " The economy of life resulting directly from the information which statistical returns supply, has been already strikingly exemplified in Jamaica, where, by a better choice of stations and sanitary arrangements, the mortality has been reduced from 13 (in 1817-1830) to 6 per cent, per annum (in 1837-1855) on the strength. " The sickness in the field may be reduced by carefully selecting men; by letting the men when it is practicable, breathe purer air ; by selecting the healthiest sites available for camps ; by raising the men in their tents from the ground ; by supplying them with purer water ; by better arrangements for cleanliness, clothing, and the supply of food, and by better medical arrange- ments. "A certain amount of insalubrity will nevertheless remain. "As we have shown that the excessive sickness of the army in- volves a large amount of expense, it is evident that the diminu- tion of that sickness will effect a great saving in peace and an enormous saving in war. For sick men are not only a loss but an incumbrance to an army. Their numbers are negative quan- tities. The expense of recruiting and of invaliding soldiers would be reduced by reducing the rates of mortality. Fewer men would be required, and recruits would more readily join a healthy army. The existence of an army in the highest state of efficiency would give additional security to the country without increasing the cost; the liability to an attack Avould be lessened; war woidd be waged with more chances of success, and would sooner be brought to a close by such an army tlian by an :irmy • 94 suffering from diseases which have hitherto infested our barracks and campjj." Tiie object had in view by the Commission can be effectually accomplished only by the direct action of Government, through officers who can order, where the Commission can only advise. The cause our armies have to defend is alone dearer to the peo- ple than are those who have to suffer in its defence. The strength and mobility of the array cannot be sacrificed to the care of its sick and wounded. The sick and wounded should be sacrificed unflinchingly, to every unavoidable, military necessity ; but all the more should they be supplied with whatever mitigation of suffer- ing military necessities leave possible. And these should be fur- nished them, not as if a hard master were driving a bargain with them — as in the commutation of a board contract — but as if the love and pity of mothers, wives, sweethearts, and sisters, were exercised with the far-seeing providence, boldness, ingen- uity, tact and industry of true military generalship — Surgeon- Generalship. The duty of guarding against the defeat of our armies by dis- ease, needs to be undertaken as earnestly, as vigilantly, with as liberal a policy, and with as resolute a determination, as any other military duty. To secure this result, the Commission is convinced tliat a higher place needs to be accorded the medical staff in the or- ganization of the army. Its relations with all departments and all ranks, as well as with the Government itself, needs to be more intimate, confidential, and influential. Whatever and whoever stands in the way of this, the Com- mission wants put out of the way. But if an impression prevails 4^r in any quarter that the members of the Commission, in tlieir devotion to this purpose, have been over-zealous, or snuglit, individually or collectively, to bring it about by action not absolutely within their assigned duty, or that they have used any indirect or unworthy means therefor, that impression is without the smallest foundation in truth. Whoever seeks to promulgate it, narrows to a personal issue a question of the broadest hu- manity, and is Avithout provocation or excuse for so doing, in any action of the Commission, The one point which controls the Commission is just this : a simple desire and resolute determination to secure for the men who have enlisted in this war that care Avhich it is the will and the duty of the nation to give them. That care is their right, and, in the Government or out of it, it must be given them, let who will stand in the way. The Commission has no fear that its motives will be miscon- strued, or its words perverted. In the life-struggle of a nation, soft speaking of real dangers and over-considerateness is a crime. Whether the great tide of the spirit of war which now sub- merges our land shall be allowed to quietly subside, or whether the struggle in which we are preparing to engage shall continue so long as to establish in us the habits of thought and of life of a military nation, matters little. It matters much that, whatever betide us, we remain true to the central idea of our nation's life ; that our army be one with our people, and that we accept whatever the Almighty sets before us as our duty, courageously, patiently, and with mutual helpfulness. The members of the Commission, deeply grateful for the hon- ored confidence which has constituted it so important an artery 96 of the people's love to the people's army, desire nothing so much as that by a sufficient enlargement and invigoration of the proper departments, they may be relieved of the duties which they have undertaken. While, however, their beloved Government can, with advan- tage, continue to accept such services as by the aid of the pub- lic liberality they are able to offer, they renew their assurances of the devoted good will with which they remain at its disposal. By order of the Commission : FRED. LAW OLMSTED, General Secretary. APPEXDIX. I. OFFICERS OF THE SANITARY COMMISSION. President, the Rev. II. W. Bellow.s. D D Vice President, Prof. A. D. Bacme, LL D Treasurer, Geo. T. Strong. General Secretary, Fred. Law Olmsted. Associate Secretary, J. S. Newderrt, M.' D. " J- FosTKR Jenkins, M. D. ^ " " J- H. Doi:gla8, M. D. Assistant Secretary, A. J. Bloou. Actuari/, E. B. Elliott. II. STAFF OF INSPECTION. J. Foster Jenkins, M. D., Associate Secretary Lewis H. Steiner, M. D., Sanilari/ Inspector. UOKDO.V WiNSLOW, D. D., Gko. L. .Vndrew, M. D., w,m. m. chambkrlain, m. d. , Georoe A. Blake, M. D., RiiBERT Ware, M. D., IIexrv K. Oliver, M. D., J. S. Newberry, M. D., Associate Secretary Godfrey Aigner, M. D., Sanitarij Inspector. C. S. Griswold, M. D., <' .. A. N. Read, M. D., " << W. M. Prentice, M. D., " << west of the Mississippi. J. II. Douglas, M. D., Associate Secretary Prof. Henry A. Warriner, M. D., Sanitary Inspector. inspectors engaged in special duty. Fred'k N. Knapp, Henry B. Rhoers, Robert Collyiou, Thos. B. DkWalden, J. B. Clark, W. S. Wood. 98 • III. EXAMPLE. Owing to the insignificant number of onr regular army, and to the fact that a large part of it has been conbfantly eugnged in scouting duties in tl'e wilderness, the aspect of the tidy, well set-up, alert, thoroughly trained soldier, so familiar to all Europeans, is almost unknown to the native Ameri- can. Of military administration, and especially of saiiitary duties, our officers have rarely seen anything, even rarely read or heard anytliing, before they be- come responsible for executing them. Information ab"ut them is to be olitnined from certain parngrai hs of military brevity scattered among al'ove si.xteea hundred sections of the general llcgulolinns for the Army, and frMii observation of those a little more advanced in experience. Hence the exceeding value of a good example in establishing a standard of attainment. It was precisely the same in the revolutionary war, and it was then, not tintil the Inspector General took a company of one hundred and twenty men, and by giving it his almost un- divided personal attention for some time, personally inspecting each man twice a day, and was thus able to set before the Contii ental officers an example of real excellence, tliat the army began to assume an ethcient character for offensive operations. "In a fortnight," writes Fteuben, "my company knew erfectly how to bear arms, had a wilihuy air," &.c. "1 had my company of guards ex- actly as I wished them to be. They were well-dressed, their arms clean and in good order, and iheir general appearance quite respectable." * * " It afforded a new and agreeable sight for the young officers and soldiers." " Having gained my point, I dispersed my apostles, the inspectors and my doctrine was eagerly embraced." This was in December, 1777 — a year aiid-a-half after the war opened. In the ReguJutionx for the Continental army the police, sanitary, .and adminis- trative duties of officers are tar more thoroughly delinfd than in the present Reyidntions, and, if they were rei'arded, the Continental army toward the close of the war, at least, must have had a much more creditable appearance than our present army, and been less in danger of camp epidemics. See Kappas SCenben. IV. SOME NOTES OF AN INSPECTION OF A PART OF THE FORCES ENGAGED IN THE BATTLE OF BULL RUN. As soon as practicable after the battle of Bull's Run, a series of seventy-five enquiries was prepared, intended to elicit information as to the condition of the troops before, during, and after the engagement, ai d as to the dettcis in the moOe of providing for the necessities of the army which had been munifested iu the series of movements which were connected with it. These questions were placed in the hands of the seven inspectors of the Commission, who weie then employed in visiting the regiments which had been engaged, for the purpose of ascertaining and administering to their wants, and ihey were instructed to obtain aitswers to them, wliich would represent as nearly as pos^ible the knowl- edge and judgment of the most intelligent officers and surgeons of these regi- ments with whom ihey were able to confer. Tlie returns received coinpri-e iibout two thousand items of evidence with ref- erence to the history of the buttle, and have a certain value o'herwi^e than from a meilical or sauitJiry ( oint of view. Tlie largest [tart of them were collected by physicians and examiners of lite insurance companies, accustomed lo aa exact and searching method of inquiry. <^~/'/ 99 Portions of each of the twelve hrigafles under the c.ommnndof Major General McDowell, at the time of the general advance of July lU, were visited by the in- spectors. Tlie entire niimher of bodies of troops visited was thirty. Of tlie twelve brigades coraprit^ing the army of the Potomac, seven only crossed the stream known as Bull Run, on the occasion of the engagement of Sunday, July the :21st, and took any active part in the main action with the enemy. Certain regiments that crossed the stream and took important part in the action of the Hist, (as, for instance, the G9th and the 71st New York State ]\[ilitin,) were removed from Washington to be mustered out of service so soon after the battle, that no reports were obtained from them. (Joncerniug several of tlie regiments visited, replies were obtained to the entire scries of seventy-five questions proposed ; concerning others, replies were ob'ained to hut a portion of the series — the defect being due in some instances to neglect on the part of inspectors, in others, to inability on the part of the regiuuntal officers consulted to give the information desired. Skirmish of the 18th. — Of twenty-nine bodies of soldiers visited, four were actively engaged in the "demonstration" of the 18th of July, (Thursday,) at Blackhurn's Ford, (across the Bull Run,) three others were engaged, but not actively, and twenty-two were not engaged.* Engagement of the 2\xt. — Of the same twenty-nine bodies of troops, twenty were actively engaged in the battle of the 21st of July, (Sunday,) seven were engaged, but not actively, and two were not engaged. Camp Guard. — The average number left as camp guard at the time of the general advance, previous to the engagements of the 18th and 21st, from each of nineteen regiments reporting on this point, was sixty-eight, (more exactly, G8.2.) From ten of the twenty nine regiments visited, no report was made as to the number so left. The smallest number so left behind by any regiment was thirteen ; the largest number s© left, one hundred and fifty. Strength of Regiments. — The average number of troops that marched for the batt'e fitdd at tlie time of the general advance, from each of twenty regiments reporting on this point, was (as stated by their officers) eight hundred and two ;t nioe of the twenty nine bodies of troops visited not reporting. The smallest number so marching was six hundred, the largest number nine hun- dred and fifty-one. Last Meal. — The last meal before the battle of the 2l8t, of sixteen of the twenty nine regiments, was on tiie evening of the day before; that is, on the evening of the 20th. Six regiments had a regular breakfast early (that is, before 2^ o'clock) on tlie morning of the day of the battle ; two regiments break- fasted at six, and the battiiion of United Stales infantry is reported to have enjoyed a regular meal in the woods about eleven a. m. The time of the last regular meal of three regiments is not reported, but there is reason for stating it to have been about G a. m. First Movement on the 2\st. — The troops, except those in the reserve, were aroused from sleep between the hours of one and two o'clock on the morning of the battle of July the 21st, ihe march being ordered to commence with some at two, with others at half-past two. J *Tlie thirtieth t)Ofly, previously referred to, was Blenker's Brigade. which alsownsnot engsped and which is for tlie present disregarded, because the teturus from it are more imperfect than the uverape. f Thirt i* believed to be somewliat over estimated. I Those regiments which breakfasted at six wore of tbo roBcrv^. 100 The Commissariat — The troops hadheen supplied at about 3 p. m., on the 16th of July, with three days' rations in tlieir haversacks, "which should have lasted them to the afternoon of the 19th." [See report of Captain Ciark, Commissary of Subsistence.] And again, in a circular from headquarters, dated at Centre- ville, July 20th, 18G1, an equal distribution of the subsistence stores on hand was required to be immediately made to the different companies of each division. In accordance with the last-mentioned order, " 100, 000 complete rations were received by the army at and in the vicinity of Centreville — sufiicient for its sub- sistence five days." (Hence there appears to have been a short interval unpro- vided for. ) According to the reports made to the in.«pectors, few companies complied fully with these orders; twenty-six of the twenty-nine regiments visited took at least a partial supply, say from one to three days' rations, under the former order ; two regiments, it is said, taking " no supply," depending for food upon "forage." An insufficient supply in one case was accounted for by the state- ment that " they had no expectation of being called to march ;" (that is, therefore did not obey the order.) In several instances it is ttated tliat the supply of three days' rations taken by the troops was " exhausted before the close of the second day ;" that is, the rations were wasted. Tliese confeessions of neglect or improvidence on the part of the volunteeis are confirmed by the report of Commissary Clarke, in which it is stated that after the distribution had been properly made to the several divisions, he (Captain Clarke) knew "of several instances in which subsistence stores remained in possession of division and brigade commissaries, and of others in which provisions were left on the ground of the encampments on the morning of the 21st of July." Distance Marched before the Battle. — The distance marched to the field of battle on the morning of the 21st by those who became actively engaged, varied from four to twelve miles; of those in the vicinity of the field but not actively engaged, the distance generally was from two to four miles, (Richardson's brig- ade remaining in the position it held on the 20th, menacing the enemy at Blackburn's Ford.) Double-Quick. — The portion of this march to the battle field which was at double-quick, was, in the case of fifteen of the regiments, from one and one-half to three miles — generally from two and a half to three miles ; in the case of thirteen of the regiments there was no portion of the march at double- quick. During the battle a few of the companies, and but a few, moved at double-quick for one or two miles. It seemed to be generally considered by the volunteers that their strength was unnecessarily and injuiiiciously wasted by the extent of the double-quick advance. To a certain extent this appears to be true, yet the result could hardly have been affected by it if the men had been in tolerable condition. Degree of Vigor at Commencement of Battle. — As to the physical condition of the troops on reaching the field of battle, it is reported that eight of the regi- ments visited were in " fair,'" " excellent," " good," " best" condition ; That in eight others " the meu were somewhat exhausted," " partially ex- hausted," evidently suflfering;" That in twelve of the regiments visited, the troops were said to he " much ex- hausted," " generally fatigued," "many considerably exhausted :" in six of the regiments from one to twenty were "giving out," " giving completely out," &c., one or two instances of " sun stroke" being specified. In eight regiments none " gavo out" before the battle ; in from nine to eleven regiments some gave out before the battle ; and concerning the remaining regi- ments there is no report. (There was was an evident disposition to regard the exhausted physical condi- tion of the men as a chief cause of the defeat.) ^/ 101 Cauus of Exhaustion before the Battle. — As to the causes assigned for the ex- haustion, it apjicai'S that of the regiments visited, it was stated that three had not sutlered at all from fatigue or heat, or want of food or drink or sleep ; in seven- tem of the regiments "fatigue" was assigned as a cause of exliaustion ; in eleven the march at "double-quick"' was specified as peculiarly fatiguing; in eight of the seventeen the esliauslion is attributed more to the double-quick than to want of food and drink ; in sixteen of the regiments waut of fO( d was assigned as a cause of exhaustion; in eleven want of drink was assigned as a cause ; and in a few cases, the exbuustiou was attributed, in part at least, to want of sleep, and to a bivouac of three or four nights in tbe open\air, with icsuih- cient clothing, as was the case with the Fire Zouaves, who left their blankets and rubber cloths in c^imp. So much as to the condition and movement of the troops before the battle. Time in the Battle. — The time during which the troops taking part in the battle of the 21st were actively engaged (pu^hing_ forward the enemy, or being tempo- rarily on retreat, after first coming under fire,) appears to have varied from twenty-five minutes to six hours, being in most cases fruni five to six hours. To the regiments most actively engaged the time was thought to be much shorter than actually elapsed, the five or six hours in which they were engaged seeming to the men, as they state, scarcely one hour. The time duriijg which men stood under tire without being aciively engaged themselves is, on the other hand, found to be over-estimated by them. Degree of Vigor during the Battle. — It is claimed that in eight of the twenty- nine regiments visited, there were no symptoms of exhaustion manifest during the battle ; that in eight there was evident sufi'ering and fatigue evinced by men lagging behind, and by companies breaking up, especially after double-quick, few or none giving conjpletely out ; that in ten regiments, many (in some in- stances stated as liigii as one-fourth or one-tbiid of the number constituting the regiment,) gave completely out, "some few dropping down in convulsions," or sutfering from " sun stroke." The evidences of exhaustion in other regi- ments are not assigned. Causes of Exhatistion during the Battle. — In explanation of the alleged excessive exhaustion of tbe men toward the close of the battle, the dfhcers consulted in twenty-six of the twenty-nine regiments referred to, attribute it to fatigue and heat, twenty-one to lack of food and drink. All the reports which assigned iu- Butficiency of fVud and drink as a cause, also as.signed excessive fatigue. Six of tiiem assign fatigue, and especially the march at double-quick, as the main cause of the exhaustion which was manifest during and just tifter the battle. Cause of Retreat. — The proximate cause of tlie retreat is variously assigned — to the attack of fresh reserves of the enemy upon our right — to the rapid and apparently wild return of tbe caissons for ammunition — to the appearance of a retreat of our cavalry, who were thought by some to be riding over our own in- fantry, the rear guard, at the same time, mistaking them for fccssion cavalry, &c. Certain moi e organic causes of the defeat are frequently stated. By some tlie defeat is attributed to the condition of the men, exhausted by excessive fatigue, and by want of sufficient food, drink, and sleep ; by others, to a "leelirg." on the approach of the fresh reserves of the enemy, "of the total inadequacy of a small force to compete with superior numbers supported by masked batteries." By others the defeat is attributed to "causes involving the wb(de command ;" " not due to previous exposure and fatigue, but to the bad conduct of the battle on tbe part of the leaders." By others (regulars) the defeat is attributed to "inefficiency of volutileers ;" by one (German) to "bad Strategy and want of discipline." Through all the regiments there appears to have prevailed the false idea of the vast superiority in point of numbers possessed by the enemy, together witli 102 a_lnck of cnnfiflence in the Tnilitnry ekill of the lemlprs of the nrmy of the Un'on, as compnrel with thiit of the l.jideis nn the p ivt of t'le rebels; ul^o combiuecl to a Cort.iiii exieut with a Jreud of meeting an iuvisib'.e foe. Oljicers Leaving their Commands. — In thirteen of the regiments the otficnrs are sai'l not to have been much separated from their commands, except iu the case of woundtd officers; in eleven resiimeiits it appe'irs that the officers were, to a considerable extent, separated from their commtnid-*, the regiments being "much scattered," " badly disorganized," "broken into fr.igments," ihe men being, in certain cases, "left entirely to themselves." Concerning five of the regiments vi-ited. no iiifovmatiun was givi n on this point. (The above report is that of the officers tliemselves in most cases. ^ Throwing aicai/ of Arms and Equipments. — Of the twenty-nine bodies vi>ited, tweuty-two threw away or laid aside bbnikets and 'laversacks before engaging in battle. Some placed them in a pi'e under guard, others threw them aside carc'essly, either Itofore arriving on the field, wiiile approaching it at double- quick, or immediately before engaging with the enemy. Three regiments threw oft' tlieir blaidsets during the battle, and the march at double-quiek on the battle field ; one regiment threw aside blankets only, retaining haversncks ; and three only of the twenty -nine hidies of troops visited retained possession of their blankets and haversacks during the engagement. During the retreat, it appears from Ihe reports of the inspectors that the men of ten regiments did not throw away any of their arms or accoutrements ; that the men of nine regiments did throw away portions, no report being made rela- tive to the course of the retnaiiiing fen regiments. There is no reason to believe that these latter averaged better indiscipline than the former, and it is probable that there was some loss of arms in, at lea«t, half of them. Colonel Keyes, of 1st brigade, 1st divi.'^ion, reports that his brigade bivouaced on the night of the 23d near Fort Corcoran, "every man with liis firelock." The number of muskets thrown away during the retreat was stated, in some cases, to be about fifty ; generally' the number is not mentioned. [A considera- ble portion of one regiment arc reported to have exchanged their smooth-bore muskets for those of a superior kind left behind by regiments prece'ling."] The blankets and haversacks of many of the regiments, e-^pecially of those actively engiged in the confiict of the 21st.. were lost, being left on the field of battle wherever they were deposited before theengagement. A sm:ill num- ber of the regiirients, and a few individuals and companies in each rpiriment, possessed themselves again of their blankets and haversacks, it is stated, before leaving the field. Overcoats do not appear to have been so generally lost, as many of the regi- ments left their c^mps at th" time of the general advanc^, (July 10,) equipped in "light marching order," that is, with blankets, haversacks, and canteens, leaving overcoats in their camps. Certain of the regiments, as, for instance, the Conneclicnt regiments and the 2d Elaine regiment, in the briga le under the effi- cient commatui of Cd. Iv'yc-i. recovered much property of other regiments, in- cluding arms and otlier equipments thrown aside in flight, and also including the abandoned tetits and camp equipage of two regiments, (of another brigade.) this latter property being secured by his troops during the continued ('.renching rain of Ihe 22d. Companies in certain other regiments (as in the Massachusetts 1st) halted on retreat, and picked up blanke's, camp kettles, &c., which they found thrown aside on the road. (The loss of blankets at this time led in cer- tain regiments to a good deal of subsequent sickness and increased demorali- zation. ) Bad Arms. — One regiment complained of the bad condition of their smooth- bore muskets, (the altered muskets of 1840,) nipples breaking, cartridges too small. So as to drop in, or too large, so as to require to be forced in by pres- sing thernmrod against trees, &c., &c. This complaint does not seem to have been general, witli certain regiments the smooth bores working efficiently. ^~i- 10:', Distance Travelleil. — The distance traveled by the several regiments on the night of tlic retreat varied from twenty to thirty-live miles, frencvtilly it whs about twenty-aeven. The average distance of the day's advance and retreat, iacluding movements on the field, was about forty-four miles. riii/slcal Condition after the Retreat. — Tiie next morning, (the -2d,) according to the almost universal report, there were few, if any, able men in the int'anti-y. 151i!cided demoralization. V. .AMi'.ri.iNC!':. It is well known that the means of transi)ort:ition which regiments of ditl'er- cnt States have lu-ought to the seat of war with them, provideil by liie care and forethought, and paid for by the pecuniary liberality of the State or district supplying these troops, have, on their ai-nval at Washington, been withdrawn from "them, and turue-l into the common stock. To the corps d'armt'-e, whose position, in the front of operations, renders tlieni liable to the various contingen- cies of war. a very limited supply of means of transportation for the sick and wounded has been provided, far less in many cases than their original property. Since this report was prepared, the first important skirmish in the army of the Totomac for some months has occurred, lu all previous engagements it is notorious that the ambulance arrangements have proved, to the Ir.st degree, inadequate, and imperfect. Many lives were lost at Ball's Blutl', for instance, in consei|uence of this, and more woidd have been, had not a volunteer surgeon, without authority, compelled men to assist him in his iluties, by drawing his revolver and shooting at the first who refused to obey his orders. Since then the Medical Director has issued orders, excellent in spirit, for the training of a small number of ambulance attendants in each regiment, and it was hoped that we might be spared renewed occasion of shame for ne- glect to care for wounded men. In the all'air at Drainsville, December liOth, i)rd's brigade took to the field its whole ambulance provision, consisting of nine covered spring carts, in which but eigliteen men could well bo carried at once. The engagement took place twelve miles from where a " division hospital" — an anomaly in the service, unprovided for in the llegulations or Supply Tables — had been permitted to be established. Some sixty sufi'ering men were got hack to this hospital. But, although we had in this case driven tlie enemy in confusion from the field, for lack of ambulances, we were obliged to leave all but three of his wounded, (thought to be larger in number than our own,) on the ground wlicre they fell, at the'beginning of a December night. 'i-treat. Tliey then whc-li-d stcuiily inlo (■(liuiiiii, and iii:iiclicd in good onlcr. until the road was • ibstriicted l)y overtiirned waj;ons. HiTe they wore badly broken up by a cinnonade, scattered «nd ilisorganized. but afterwards, havin;; mainly collected at Centreville, ret'ornieil iiiid marched tlie same ni'.:lit. under such of their otlicers as remained alive, to and tlirough Washington to a liositiou several miles to the novtliward— a post of danger— where they at once re.sumed regular lamp duties. When visited by the innpoctor, a few main- tain the inheritance of our father.'^. Blankets worn in the Revolution, and others taken in the last war with England, heir-loom linen, with groat-gr> Q"i!S IN P>i;i<(;k.\, N. •!., 14//i of ,/uli/, 1780. AI.vDA.M : I have received with much pleasure — but not till last night — your favor of the 4th, specifying the anu)unt of the subscriptions already collected f()r the use of the American Sf)ldiery. This fresh nuirk of the patriotism of the Ladies entitles them to the highest applause of their country. It is impossible for the army not to feel a superior gratitude on such an instance of goodness. If I am ha))py in having the con- currence of the Ladies, 1 would propose the purchasing uf coarse linen, to be made into shirts, with the wliole amount of their subscription. A shirt extra- onlinary to the soldier will be of more service to him than any other thing tliat could be procured him : while it is not intended to, nor shall, exclude him from the usual supply which he draws frum the public ^~^ !(»■ This nppenrs to mc to be tlio best mode for its applicalioii, provided it is approved of Ity the Ladies. I am happy to