March, when preparing to take the field, 132 men of that regiment were reported unfit for duty.

Another cause of disease was the heavy details for labor in the field works and the severe nature of the labor; another, the exposure incident to picket duty. Regular officers and soldiers know how to make themselves comfortable on picket duty; volunteers do not. The 'frequent alarms in some portions of our lines were considered by some of the medical officers as a cause of disease. This was particularly the case in front of some of the Vermont troops in Brooks' brigade. It is possible this may have had an unfavorable effect upon men predisposed to disease from other causes.

The principal causes of disease, however, in our camps were the same that we have always to deplore and find it so difficult to remedy, simply because citizens suddenly called to the field cannot comprehend that men in masses require the attention of their officers to enforce certain hygienic conditions without which health cannot be preserved. The individual man at home finds his meals well cooked and punctually served, his bed made, his quarters policed and ventilated, his clothing washed and kept in order without any agency of his own, and without his ever having bestowed a thought upon the matter. The officer in ninety-nine cases in a hundred has given no more reflection than the private to these important subjects. When the necessity for looking after these things is forced upon his attention, he is at a loss how to proceed. Too frequently he lacks the moral courage and the energy to make his men do what neither he nor they stipulated for or understood when they entered the service. To bad cooking, bad police, bad ventilation of tents, inattention to personal cleanliness, and unneces sarily irregular habits we are to attribute the greater proportion of the diseases that actually occurred in the army.

My attention was given to these evils from the beginning. By precept and by orders the necessity and the methods of correcting them were urged upon the commanders and the medical officers of the several regiments. When the brigade surgeons were assigned, the first paragraph of the order defining their duties impressed the paramount importance of hygienic morality upon their consciences, and no occasion was let slip by me of urging upon both commanders and surgeons their obligations in this respect. Some of the regimental surgeons I know faithfully performed this duty. Copies of reports made to their commanding officers, creditable alike to their intelligence and their zeal, were sent to me. The attention of commanding officers is earnestly called in these reports to the drainage of their camps, the clothing and cleanliness of their men, to the situation of their sinks, and the like. One surgeon reports that he cannot strike the tents as I had enjoined, because they were too old, and urges his colonel to get new ones, if possible.

The prophylactic use of quinine and whisky having been suggested as a means of preventing malarial disease, I determined to try its efficacy. There being no warrant for such an issue in the Regulations of the Army, I procured a small quantity from the Sanitary Commission. and received favorable reports of its effects. Upon representing this to the Surgeon-General, I was authorized to issue it in reasonable quantities to regiments whose condition seemed most to demand it. I required reports as to the effect. These reports were generally favorable; so much so, that I was induced to keep it constantly on hand afterwards in the purveyor's store. The surgeon of the Cameron Dragoons reported that by its use he had reduced his sick report from 126

to 74 in two weeks. The surgeon of the Sixty-second Pennsylvania reported equally favorably, and stated that two companies of the regi ment who had used it faithfully for two weeks presented a sick report of only four men. Much prejudice and aversion, however, had to be overcome in inducing the men to take it, and I scarcely think it would have been practicable to have forced it upon the whole army. Fortunately there was no necessity for this.

In order to secure some comforts for the sick in the regimental hospitals I attempted to show the surgeons how to create and to use a hospital fund. The regimental commissaries strenuously opposed this, on account of the inconvenience to themselves. The first paragraphi of General Orders, No. 9, Army of the Potomac, September 9, 1861, however, enjoined this upon them as a duty, and in the course of some four or five months we succeeded in getting the system pretty generally established.

As cold weather came on I judged it necessary to make some provision for warming the tents. A very ingenious plan having been proposed by Brigade Surgeon McRuer, which had received the approval of General Heintzelman and other officers of experience, I directed Dr. McRuer to visit every division of the army, and to construct one of his furnaces for a model. This duty he performed. Some of course were found to object to it, but it was generally well received and found to contribute much to the comfort of the men. Some, however, still used the Crimean pit, and others succeeded in getting stoves. A cheap and convenient stove, and one readily transported, the make of Mr. Hainsworth, of Newport, Ky., was introduced into the army and found to answer well. It was the general understanding that the army was not to go into winter quarters, and therefore I did not recommend the housing of the men until the middle of January, 1862; but in December, 1861, learning that some of the regiments were excavating pits in the ground and covering them with their tents, I hastened to object strenuously to this plan. I suggested inclosures of rails or palisades some three feet high, to be roofed over with the tents. The excava tions could not be kept dry or well ventilated, and certainly would not be kept in good police; all of which objections would be obviated by the above-ground inclosure. This plan was adopted in a number of camps I visited, and they presented an air of comfort that was very gratifying. Later in the season I recommended the Chester hut, with roof ventila tion, as used so successfully at Balaklava.

Protection of the men against the contagion of small-pox of course received constant attention. While the Army of the Potomac was in process of organization small-pox was prevailing rather extensively in several of the districts from which the troops were being drawn. It was unsafe to travel without protection over any railway in the country. The city of Washington was infected, as I knew from the number of applica tions made to me by the authorities for the use of our small-pox ambu lances to convey city patients to the pest-house. An eruptive-fever hospital had been established before I took charge of the army. Under the excellent arrangements made in that establishment by Dr. Thomas, the surgeon in charge, but little risk was incurred of the propagation of the disease to the camps. Orders were issued and reiterated for the vaccination of all volunteers unprotected. I also recommended that an order should be published requiring that all recruits for the Army of the Potomac should be vaccinated before they were put en route from their rendezvous, and that they should be carefully inspected as to this immediately upon their arrival. Not satisfied with what had been done, I

asked for and obtained another order, in December, 1861, requiring the division and brigade commanders to cause the brigade surgeons to reinspect all the men, vaccinating such as were still unprotected, and to report the results to me. At this late period most of the brigades were found to have some men unprotected; in a few the number was serious. In Slocum's brigade there were 1,500, in Blenker's 1,250, and in Sickles' 750. Crusts were furnished and the vaccination completed. As the result, small-pox, though rife in the community, never gained any foothold in the army. A sporadic case would occasionally occur, sometimes in the most unaccountable way. There are individuals so susceptible, that neither vaccination nor a former attack of small-pox secures them against the disease. An alarming report of the dangers to which the army was exposed from the system adopted at the hospital, having been made by the Sanitary Commission, with suggestions of some few modifications to suit their views, I inquired into the statistics of the disease in our army up to that time, and found that in seven months we had had but 168 cases, the majority of whom were ill with the disease when they reached Washington. I adopted such of the suggestions of the Commission as were not already in use, but with no perceptible effect. In fact, the precautions always adopted had made the cases, considered in reference to the size of the army, too insignificant to give the least uneasiness to any one at all informed on the subject.

I had always been solicitous to get possession of a few experienced regular medical officers, to be employed as inspectors of the field hospitals, through whom I might be assured that the measures devised for the preservation of the health of the men were faithfully and intelligently carried out. This was accomplished at last. In the middle of November, 1861, two officers were assigned to me for that purpose and some weeks afterwards a third. I prepared instructions for them and set them at work at once. (See Appendix C.) These inspections extended from Budd's Ferry to Cumberland. They included Lander's division at Cumberland and Burnside's expedition fitting out at Annapolis. From the reports made by these officers I was enabled to correct many errors in hygiene, as well as to improve the discipline of my department and to keep it always in readiness for an advance. All faults in police, cooking, clothing, location of camps, &c., were promptly reported by me to the Adjutant-General, and by him as promptly ordered to be corrected.

I come now to speak of the regimental and brigade hospitals. The Regulations of the Army recognized only regimental and general hospitals. The regimental hospitals in the field were established in tents or in such buildings as might chance to be within the limits or in the immediate vicinity of each camp. The general hospitals available for the Army of the Potomac were the few old hotels or other similar buildings occupied as hospitals in the cities of Alexandria, Washington, George. town, and a small portion of the Naval Academy building at Annapolis. There was no authority for any hospital establishments in the vicinity of the divisions or brigades that might relieve the hospital tents if crowded or that might keep the men near their camps, so that they could be readily returned to duty when sufficiently recovered. It is true I might have authorized such establishments, but I was dependent upon the provisions of the regulations for the necessary stewards, cooks, and nurses for the service. Several intelligent and zealous brigade surgeons pressed these hospitals upon my attention. Their advantages were obvious, and I determined, when I could get the buildings, to put them in operation. I required, however, that the necessary personnel

should be furnished from the regimental details authorized by the regu lations, and that the brigade hospitals should be considered and conducted as aggregations of the regimental hospitals; that their stewards, &c., should be mustered on the regimental rolls. In this way a number of them were organized and served. Brigade Surgeon Suckley organized one for Kearny's brigade near Alexandria, another was fitted up for Blenker's brigade at Hunter's Chapel, another in Hooker's division at Budd's Ferry, afterwards others in Fitz-John Porter's division, and several more. A very nice building was put up at Poolesville for Stone's command, upon plans furnished by Brigade Surgeon Crosby and approved by yourself.

About the 1st of February, 1862, my attention was called by General Williams to the condition of Lander's division at Cumberland. This was the first intimation I had had that there were any troops there. I sent one of my inspectors immediately to examine into the facts, with authority to provide at once for their necessities, to hire buildings, or to put up hospital huts if required.

On the 5th of February Brigade Surgeon Suckley was assigned to Lander's division, and instructed to use every exertion to put things in order. He was informed that the condition of the sick in that division was represented as scandalous, and that no effort must be spared to reform it. On the 8th I received the report of the inspector. It confirmed all that had been reported as to the shocking state of affairs. The regi ments composing the command were scattered in all directions for some 40 miles over the hills. The sick, numbering 1,200, were abandoned in the city of Cumberland, and were in a wretched condition. They were "quartered in close, compact, ill-ventilated rooms, where the police is bad, food badly cooked and improperly served out; men of different regiments reeling and staggering through the streets with fevers, seeking shelter and medical attendance." The inspector had succeeded in getting comfortable and roomy quarters for 500 of the sick at the time of his report, had employed a number of women in making bed-sacks, and had contracted for some hundred bunks.

Dr. Suckley was in position on the 7th. On the 9th he had collected 1,079 of the sick; on the 11th he had 1,400. He found things in the town in a wretched condition; no discipline, no system. The commissary had no funds. There were nineteen regiments of infantry, besides cavalry and artillery, in the division. On the 18th he asked authority to build two shanties, to contain 50 patients each. This was immediately granted. On the 20th he had succeeded in making things more comfortable, had procured eight Sisters of Charity for nurses, had classified his patients, and had provided proper medical attendance. He reported also that the mortality and the gravity of disease were diminishing. He had received authority to build as many shanties as were necessary.

Measures were taken by me upon receipt of these reports to provide instantly for all the necessities of the case. I applied to the Commissary-General to place funds in the hand of the commissary. On the 19th Colonel Taylor informed me he had sent $5,000. I ordered a supply of ambulances to be forwarded, loaded with bedding, from Baltimore. Medical and hospital stores were also forwarded by myself as well as the Surgeon-General. March 3 I received a telegram from the railroad agent at Wheeling, informing me that 149 boxes of hospital stores would be at Cumberland the next day. There was no more trouble with that establishment. The brigade and field hospitals of the Army of the Potomac were at last organized and in working order.

The next subject I shall glance at is that of ambulance transportation. Previously to this war the Army of the United States had never been supplied with carriages expressly designed for the transportation of the sick and wounded. A board assembled by the Secretary of War some two years before the rebellion had adopted a four-wheeled carriage and two models of two-wheeled carriages for experiment. The four wheeled carriage had been tested upon the plains in an expedition to New Mexico, and had been favorably reported upon by the medical officer in charge of it. The two-wheeled carriages, though a few bad been built, had never been tried. Some doubts were entertained as to their suitableness for their purposes, but they were adopted and recommended as the best for "badly-wounded men." Experience, however, has shown that they are utterly unfit for any such purpose. When the present exigencies came upon us, the Quartermaster's Department lost no time in having the carriages built as rapidly as possible. They were of course ordered in the proportions recominended by the boardi. e., 5 two-wheeled to 1 four-wheeled. The two-wheeled were the basis of the system-a most unfortunate decision. It was my duty, however, to supply the Army of the Potomac with as many of these carriages as would suffice for probable necessities if they could be had. A considerable number of the two-wheeled had already been accumulated in Washington before my arrival and had been distributed to the several camps. I found them in general use as pleasure carriages for idlers and accommodation cabs for conveying officers and men from their camps to the city of Washington. A large number of them had already been broken down in this service. This was immediately stopped. An order was promulgated directing all ambulances, with the exception of 1 two-wheeled to each regiment, to be turned in to the Quartermaster's Department in Washington, and the use of that one was strictly limited to the service for which it was intended. We were enabled by this means to find out what we had and to keep most of them in order.

October 5, 1861, the depot quartermaster reported 109 two-wheeled and 12 four-wheeled ambulances in use, and 224 two-wheeled and 38 four-wheeled not in use. The unphilosophical idea of a two-wheeled being an easier carriage than a four-wheeled had been exaggerated in providing the vehicles. The quartermaster had issued 228 two-wheeled since July 1; 119 of these carriages had disappeared in a little more than three months, showing both how recklessly they had been used and how incapable they were of standing the hard work of our campaigns. December 31, 1861, there were in Washington 314 two-wheeled and 71 four-wheeled ambulances. Each regiment had its own twowheeled in addition to these.

The two-wheeled carriages being so generally condemned, I endeavored to have a number of cacolets collected to replace them in the Army of the Potomac. The Quartermaster-General had already procured some of them, made after the French model. They weigh 140 pounds. I thought this too heavy, and that their weight might be materially reduced without compromising their strength or durability. This I recommended to be done. Several other models were presented to me afterwards that were much lighter, and I requested the Quartermaster's Department to procure a limited number of 2 of them. I thought I had secured 200 altogether for our army, but I received but 40, and most of these not until we had reached the Chickahominy. As early as August 21, 1861, I requested the Quartermaster-General to introduce these litters in the proportion of 1 to a regiment. On the 8th of