my duties, though a Protestant myself, I do not hesitate to declare that in my opinion the latter are far preferable to the former, being better disciplined, more discreet and judicious, and more reliable. In the arrangement of the hospitals it might be judicious to assign one section to the Sisters of Charity and the other to the Protestant nurses.

Male nurses are most readily obtained by detail from the troops. There are many men in the ranks who are the subjects of infirmities, disqualifying them for the active duties of the field, who could be usefully employed as nurses in the hospitals. Numbers have been enlisted with hernia and cirsocele, and are being discharged on account of these, who would be very capable of doing the duties of nurses.

3. Pian for the extension of hospital accommodations at Washington, D. C.-I assume that this army will number 200,000 men, of whom 30,000 will garrison Washington and its defenses, and 170,000 will be mobilized. We had on the 18th September 84,778, of whom 6,007 were reported sick; this is a little in excess of 6 per cent. of the whole force. The sanitary condition of the army has been constantly improving for the last six weeks. The ratio of sick is increased by the condition of a few corps. Some of the regiments arrived with large sick reports; others have suffered from being encamped in unhealthy locations; but even these are improving, and I am confident we shall not have to leave in hospital more than five per cent. when the grand army is put in motion. This would require 8,500 beds for the 170,000. We have now 1,163 beds, exclusive of the eruptive-fever hospital, leaving 7,337 to be provided for. I have not estimated for the sick of the garrison of Washington, as they can be taken care of in their field hospitals. Many of those left sick in the general hospitals would be able in a short time to serve in the works in case of an attack upon Washington, and they might be considered as forming a part of the garrison to be left; so that we estimate that the whole complement of 170,000 will be put in motion.

If the 170,000 should fight anywhere within seventy-two hours' transportation of Washington, I should recommend that the wounded be sent back to this city. If we have a well-contested series of battles within that time of Washington we may have 56,666 casualties. The Army of Mexico left Pueblo 10,500 strong, and the killed and wounded in the valley exceeded 3,000. We have no right to rely upon a less proportionate loss, though no one expects it to occur.

The proportion of the killed to the whole loss is a difficult problem to investigate. We are yet to experience the destructive power of rifled muskets and cannon. I do not know how well the enemy may be supplied with either, or how well they may be able to serve them if they have them. We used to estimate the proportion of the killed with the old weapons to be 25 per cent. of the whole loss. It has been estimated since the introduction of the new arms that that proportion is now inverted-i. e., that of 100 casualties 75 will now be fatal. I think that extravagant. But let us estimate one-half of the loss as likely to require hospital accommodation, and we shall then want 28,333 beds for the wounded, making, with the sick, a grand total of 35,670.

Now, the General knows his own plans and I am ignorant of them. It may be the great battle may be fought nearer Fort Monroe than Washington, or nearer Richmond than either. Our hospitals at Washington in either case would be to a great extent unavailable. I cannot, therefore, make more than an approximate estimate of what will be required here. From the data I have adduced the General can form a better judgment than myself. I think, however, assuming 200,000 as

the strength of the army, that 10 per cent., or 20,000 men, ought to be provided for in the hospitals.

But 20,000 patients will require 2,000 nurses, 666 cooks, and 1,000 matrons; 200 medical officers, and as many stewards and ward-masters, will also be required. The number of cooks may be reduced materially, but the number of matrons cannot, as I include the laundresses under that head. I think 300 cooks will be sufficient. Whatever extent of hospital establishment may be determined upon finally may find its administrative force adjusted by this scale. For the medical officers required as internes, I rely upon the States that have appointed medical boards of examiners. They must be employed by contract. The commissioned medical officers of the army or volunteers cannot supply the necessary force.

The buildings for this establishment will necessarily be large and expensive, but I am satisfied the demands of economy and humanity will be met by the adoption of the plans herewith submitted. All experience has shown that dwelling-houses, hotels, and the like are unfit for military hospitals. It is impossible to ventilate them properly, and their interior is always so arranged that, while there is great waste of space, the sick are always crowded, and at the same time a larger number of surgeons, cooks, stewards, &c., are required for their administration than in the well-arranged hospitals that modern science and experience have devised. The single-floor pavilion hospital is the one that now unites the opinions of the scientific and humane throughout the world in its favor. Such a plan has been prepared by an architect under the supervision of the Sanitary Commission, and is herewith submitted. This is a design for one building, and is calculated to accommodate 200 patients, with the necessary administrative force. It will require 100 of these buildings for the number of patients I have supposed we shall have. The accompanying memoir of the Sanitary Commission contains the specifications for the building.*

Under ordinary circumstances I would not undertake to modify this plan in any way. It meets my views fully as it stands. But as I think we may save both time and money in the construction by some modifications, I would suggest―

1. That the buildings should rest upon timber instead of masonry supports.

2. That the wards should be but 12 instead of 14 feet high. This will give each man 1,260 cubic feet, an ample space, considering the excellent arrangements for ventilation in the plan.

3. The upper windows in the plan may be dispensed with if we make the other windows 8 feet high, and reaching from within 1 foot of the ceiling to 3 feet of the floor. The upper sash should let down. The lower sash may be made "French fashion," or to lift, but it should be furnished with a lock, so that it could not be opened without the orders of the surgeon.

4. The administration building may be reduced in size by omitting two of the 14 by 20 rooms on each floor. The remaining rooms will be sufficient for the necessary personnel of the building. For sites for these buildings I propose to occupy the grounds of Mr. Stone on Fourteenth street, opposite Columbian College. He has two lots, one of 87 acres, the other of 40, both of which he has placed at the disposal of the Government for this purpose. The grounds lie well, are well drained, and well supplied with excellent water. There are three springs upon

* Not found.

the place, at present furnished with pumps, and as many more may readily be sunk as the necessities of the buildings may require. These lots will afford room for about one-fourth of the proposed buildings. We have a lease of 100 acres at Kalorama. This land is similarly circumstanced with that of Mr. Stone as to its general features and the water supply. It will afford room for 20 buildings. We shall want about 250 acres more for the remaining buildings. There is plenty of unoccupied land upon the heights about Washington that might be procured for this purpose. I apprehend the Quartermaster's Department will find little difficulty in effecting leases of as much as will be required.

There will thus be some three or four large hospital towns at some distance from each other. Each assemblage of buildings or hospital section will require one experienced, active, and energetic surgeon of the Army as superintendent; one assistant commissary of subsistence, and one assistant quartermaster at least will be required, and perhaps more. The guards can be furnished by the troops occupying this military position. They should be required to enforce the orders of the chief surgeon.

There being no fund within the control of the Medical Department from which suitable hospital clothing can be furnished for the inmates of this establishment, we must rely for a time upon the contributions of the Sanitary Commission for that purpose, and I am happy to say they are now taking measures to meet this demand. But it is reasonable to suppose that the time during which they will be called upon to supply this want will be limited; for the hospital fund, well managed, ought to be sufficient in the course of two months to provide all necessary comforts for the sick.

Very respectfully, your obedient servant,

CHAS. S. TRIPLER,

Surgeon and Medical Director Army of the Potomac.

Brig. Gen. S. WILLIAMS,

Assistant Adjutant-General, Army of the Potomac.

[Appendix I.]

HEADQUARTERS ARMY OF THE POTOMAC,

Medical Director's Office, October 29, 1861. GENERAL: I have the honor to report that, in obedience to the orders of Major-General McClellan, I proceeded to Annapolis, Baltimore, Philadelphia, and New York for the purpose of making arrangements for the sick of the Army of the Potomac. I wished, if possible, to evacuate all the hospitals upon the Potomac, at Annapolis, and Baltimore upon Philadelphia and New York, and also to ascertain how much hospital accommodation could be depended upon at Annapolis and Baltimore. At Annapolis a portion only of the public buildings is at present occupied for hospital purposes. I would recommend that all the buildings at that point should be fitted up as hospitals, and the establishment could then accommodate 1,200 patients. At Baltimore there are two hotels and three dwelling-houses now occupied. These buildings can receive in cold weather, when windows and doors are to be kept closed, but 310 patients. The rents paid for them amount to $12,900. At such an extravagant rate I did not think it advisable to negotiate for any extension of hospital accommodation in Baltimore.

I then proceeded to Philadelphia and made inquiries for buildings suitable for our purposes. Several large and small buildings were

suggested to me as available. I estimated for about 4,000 beds as likely to be wanted in Philadelphia and New York, and therefore, after procuring the assistance of the quartermaster and some of my professional friends in looking up convenient buildings, I went to New York to see what could be done there. In that city I was unable to accomplish anything. After several days' delay, I could only procure one offer, and that was to accommodate 250 men in the New York Hospital at $5 per week each. This I considered altogether too high. The commissioners of emigration have six buildings on Staten Island, capable of accommodating 125 men each, that they have placed at the disposal of the governor of the State for barracks for volunteers. These buildings the quartermaster-general of the State told me we might occupy, provided the United States would put up rough board barracks for the accommodation of the volunteers. I did not think it best to accept this offer. If we are to build, it would be better to build here than there. It would be both hazardous to the men and expensive to the Treasury to send patients to Staten Island. It would involve the increased cost of transportation from Philadelphia to New York and back in each case, and the additional cost of a steamer to convey the men from the depot at Jersey City to the island. The distance of the island from the city also would create great difficulty in subsisting the men there. For these reasons I felt obliged to give up the idea of availing ourselves of any assistance from New York. Upon my return to Philadelphia I visited, examined, and requested the quartermaster to hire the following buildings and to fit them up for hospitals:

1st. The National Hall, on Market, below Thirteenth street. It will accommodate 350 patients. The rent is $425 per month.

2d. The Reading Railroad Depot, corner of Broad and Arch streets. It will accommodate 400 patients. The rent is $1,750 per annum.

3d. A paper factory, corner of Twenty-second and Wood streets. Will accommodate 275 patients. Rent not ascertained.

4th. The State Arsenal. Will accommodate 350 patients. For this I think no rent will be demanded. It is under the control of General Patterson, who told me he would write to the governor on the subject, and that I might rely upon having it.

5th. A silk factory, corner of Twenty-second and South streets. will accommodate 160 patients. Rent, $150 per month.

It

6th. The Summit House. It will accommodate 100 patients. Rent, $150 per month.

In addition to these accommodations, we are offered 150 beds at St. Joseph's Hospital, and 150 at the Pennsylvania Hospital, at $3.50 per week each. This, after a careful calculation, I find to be about what it costs to furnish any hospital accommodation to our men. The sum asked includes everything-medicines, stores, fuel, lights, medical attendance, &c. I therefore earnestly recommend that these offers be accepted immediately. We can avail ourselves of them at once, to relieve our crowded hospitals in Washington.

This gives a total accommodation of 1,935 beds. When prepared, this will just about relieve the present general hospitals on the Potomac, in Annapolis, and Baltimore. The rents are very reasonable, averaging about $9 per man per annum, whereas in Baltimore the average is more than $40.

To carry out these plans the authority of the Quartermaster-General for hiring the buildings and making the necessary improvements is required. I respectfully ask that it may be obtained.

For the bedding, furniture, and medical attendance the action of the

Surgeon-General will be necessary. It was my intention to ask for the appointment of Dr. John Neill, of Philadelphia, as brigade surgeon, and to place him in charge of the whole Philadelphia establishment, giving him for assistants a suitable number of young physicians, to be employed by contract. These can be procured in Philadelphia at $50 per month each. The economy and efficiency of the whole arrangement I hope will be perceived.

*

Very respectfully, your obedient servant,

CHAS. S. TRIPLER,

Surgeon and Medical Director Army of the Potomac.

General S. WILLIAMS,

Assistant Adjutant-General, Army of the Potomac.

[Appendix K.]

HEADQUARTERS ARMY OF THE POTOMAC,

Medical Director's Office, January 28, 1862.

GENERAL: In obedience to instructions in your letter of January 21 I have the honor to submit the following report:

Having the reports of the inspectors of hospitals as to the sanitary condition of nearly all the divisions of the army in this vicinity, showing their conditions at periods varying from December 5 to the present date, and having also the weekly reports of the brigade surgeons of nearly all the brigades up to January 18, for the purpose of laying before the general what I conceive to be the true state of the hospitals of this army, I hasten to present this letter in anticipation of the completion of all the inspections ordered. The importance of the subject seems to me to demand this, in order to allay unnecessary apprehensions and to afford an opportunity for correcting certain existing irregularities, as well as to offer suggestions as to the means of preventing as far as practicable any increase of disease during the winter and spring.

I am able from the reports in my hands to compare the true sick lists in brigades with those sent in to the Adjutant-General's Office. Among the brigades to which my attention was directed are the following. I arrange them in tabular form, to show how widely the reports of the briga surgeons differ from those in the table appended to your letter:

The above are sufficient for my present purpose, which is to show