markable. Thus, the Second Rhode Island had but .45 per cent. sick, the Seventh Massachusetts 1.99, the Ninety-eighth Pennsylvania 1.21, the First Long Island 1.46, and the mean of Keyes' division was but 3.29. During this time, so far as rumor was concerned, the Army of the Potomac was being decimated by disease every month. The reports from the regimental headquarters were only less erroneous than rumor. The statistics I have given are from the weekly and monthly reports of medical officers. It was ascertained to be the general habit of the captains to report every man sick who found it convenient to report himself so. The difference between these reports and the facts is illustrated in my letter to General Williams of January 28, 1862, a copy of which is appended, marked K. I append also a report in relation to that subject made to the Surgeon General of the Army January 4, 1862 (L). During this period there were frequent skirmishes, giving a number of wounded men. Two affairs of importance took place: On the 21st of October, 1861, the battle of Ball's Bluff, and on the 20th of December, General Ord's affair at Dranesville. In the former, 280 men were reported wounded; in the latter, 34. Of the wounds at Ball's Bluff 93 were in the head and face-a very large proportion-showing the accuracy of fire of the enemy, as well as the skill with which they availed themselves of the advantage they possessed on that occasion. This concludes the first period. I hope to resume the subject and to report upon the second period in a few days. Very respectfully, your obedient servant, CHAS. S. TRIPLER, Maj. Gen. GEORGE B. MCCLELLAN, U. S. Army. GENERAL ORDERS, } [Appendix A.] HDQRS. ARMY OF THE POTOMAC, No. 20. Washington, October 3, 1861. The following regulations respecting the duties of brigade surgeons are published for the government of all concerned: I. The brigade surgeons will frequently inspect the police, cooking, clothing, and cleanliness of the camps and men in their respective brigades; the position and condition of the sinks, the drainage of the camp grounds, the ventilation of the tents, &c.; making written reports to the brigade commanders whenever, in their opinion, any errors in these respects require correction, and sending duplicates of these reports to the medical director of the army. II. They will see that the medicines, hospital stores, instruments, and dressings of the several regimental surgeons are kept constantly sufficient in quantity in good order, and always ready for active service. III. They will collect from the several regimental surgeons and transmit every Saturday morning to the medical director a copy of their morning report made to the commanding officer of their regiment, and will accompany these with remarks showing the character of the principal diseases prevailing. IV. They will promptly report to the medical director all changes in station or location of themselves or of any of the medical officers in their brigades, with the number, date, and authority of the order by which such changes were made. V. They will inspect carefully all men receiving certificates of disability for discharge, and if they approve, they will countersign such certificates. VI. The hospital attendants, to the number of 10 men to a regiment, and the regimental bands, will be assembled under the supervision of the brigade surgeons, and will be drilled one hour each day, except Sunday, by the regimental medical officers, in setting up and dismantling the hand-stretchers, litters, and ambulances; in handling men carefully; placing them upon the litters and ambulance beds; putting them into the ambulances, taking them out, &c.; carrying men upon the handstretchers (observing that the leading bearer steps off with the left foot and the rear bearer with the right); in short, in everything that can render this service effective and the most comfortable for the wounded who are to be transported. VII. Brigade surgeons will see that the orders of the commanding general in relation to the uses to which ambulances are to be applied are strictly obeyed, and they will report promptly to the brigade commanders all infractions of these orders. VIII. Whenever a skirmish or affair of outposts occurs in which any portion of their brigades is engaged, they will see that the ambulances and stretchers, properly manned with the drilled men, are in immediate attendance to bring off the wounded, and that the regimental medical officers are at their posts, with their instruments, dressings, and hospital knapsacks in complete order and ready for immediate use, so that no delay may occur in rendering the necessary surgical aid to the wounded. IX. They will report in writing to the medical director, within twentyfour hours after any affair with the enemy, the name, rank, and regiment of each of the wounded, the nature and situation of the wound, and the surgical means adopted in the case. X. Brigade surgeons will be held responsible that the hospital service in their brigades is kept constantly effective and in readiness for any emergency. No remissness in this respect will be tolerated or overlooked. By command of Major-General McClellan: S. WILLIAMS, Assistant Adjutant-General. NOTE. The medical director desires that exsection of the shoulder and elbow joint shall be resorted to in preference to amputation in all cases offering a reasonable hope of success, and that Pirigoff's operation at the ankle should be preferred to Chopart's or to amputation above the ankle, in cases that might admit of a choice. GENERAL ORders Į S [Appendix B.] HDQRS. ARMY OF THE POTOMAC, No. 9. I. The attention of brigade and regimental commissaries of subsistence and of officers acting as such is directed to paragraphs 20, 21, and 22, Subsistence Regulations, or paragraphs 1073, 1074, and 1075, Army Regulations, 1857. Subsistence officers must make issues to the hospital, and keep the accounts of the hospital funds in strict conformity with the requirements of the regulations cited. II. All changes of station of medical officers are to be promptly reported to the medical director at these headquarters, and the authority given by which the change was made. III. Leaves of absence to medical officers are prohibited, unless granted at these headquarters. IV. Patients will not be sent from the regimental to the general hospitals without the authority of the medical director. Applications for this authority must be made in writing, specifying the names and diseases of the patients, and be handed in to the office of the medical director between the hours of 9 and 10 a. m. V. When a soldier is sent to general hospital, his company commander shall certify and send with him his descriptive list and account of pay and clothing. VI. Male nurses and cooks for general hospitals are to be detailed from the privates of the army, regular and volunteer. The allowance will be 1 nurse to 10 patients, and 1 cook to 30. Where women are employed, the number of men to be called for will not exceed the number sufficient to make up the whole force to the allowance above authorized. Hired nurses and cooks will be forthwith discharged. VII. Men reported at the general hospitals for duty will be sent by the surgeons in charge to the office of the medical director at 10 a. m. for the passes necessary for them to rejoin their regiments. VIII. Medical officers joining this army for duty, with or without troops, will report promptly to the medical director in person. If with troops, they will report the number of men, the state of their supplies, and ambulance transportation. IX. Ambulances will not be used for any other than the specific purpose for which they are designed, viz, the transportation of the sick and wounded, except by the written authority of the brigade commander, the medical director of the army, and the quartermasters in charge of them in the city of Washington. The provost-marshal is directed to see that the provisions of this order are carried out, and will arrest every officer and confine every private and non-commissioned officer who is found violating it. X. All Government ambulances now in possession of regiments or separate corps will be turned in to the chief quartermaster, with the exception of 1 two-wheeled ambulance to each regiment. One twowheeled transport cart will be allowed to each general hospital for the conveyance of marketing and hospital stores. XI. The reveille will not be beaten until after sunrise, and hot coffee will be issued to the troops immediately after reveille roll-call, as a preventive of the effects of malaria. By command of Major-General McClellan : [Appendix C.] S. WILLIAMS, Assistant Adjutant-General. HEADQUARTERS ARMY OF THE POTOMAC, Medical Director's Office, Washington, November 25, 1861. The inspectors of hospitals assigned to duty with the Army of the Potomac will proceed to the camps of such divisions of the army as they may be directed to visit from time to time, and will institute careful and rigid inspections as to the following points: I. Whether there is a brigade surgeon on duty with the brigade; what is his name and date of commission; whether he is active, competent, and attentive to his duties; whether the duties assigned to brigade surgeons in General Orders, No. 20, are fully comprehended and faithfully carried out. II. Whether each regiment in any brigade is provided with a surgeon and assistant surgeon; what are their names, dates of commission, and dates of mustering in; whether they are present and for duty with their regiments; if absent, by what authority, for what reasons, and how long. III. The number of hospital tents; how many have been received, and from what source; whether they are used for the sick; if diverted to any other use, by what authority this was done; whether the hospital tents are properly located, sufficiently warmed and ventilated, furnished with bunks and bedding, and kept in good police. IV. Whether there is a competent hospital steward and a sufficient number of hospital attendants; whether these men are well selected, and attentive to their duties. V. How many men are sick in hospital; how many in quarters! What are the prevailing diseases in each? VI. Whether there is a brigade hospital; if so, how is it situated; how served; stewards, attendants, &c. What kind of building is it? Is it comfortable, in good repair, and sufficiently provided with bunks and bedding? Can it be advantageously dispensed with? Should any of the patients be sent to the general hospitals? How many patients does it contain, and what are the diseases? Is the building sufficiently ventilated and warmed? VII. What is the condition of medicines, hospital stores, instruments, and dressings? Are they sufficient to enable the regiment to take the field? If deficient, in what respect? Has any record been kept of the supply received? Have they been judiciously and faithfully used? VIII. Has the hospital fund been kept in accordance with paragraph 1, General Orders, No. 9; if not, who is responsible for the neglect? IX. How many and what kind of ambulances are on hand; what is their condition; from what source were they received? Is their use strictly confined to the transportation of the sick and the ambulance drills; if not, who is to blame? X. Are the records of the hospitals properly kept? Do the surgeons send in their weekly reports to the brigade surgeons for the medical director? XI. What is the condition of the camp? Is it well located; if not, can its location be advantageously changed? Is it well drained and well policed? Are the tents in good order and well ventilated? XII. Are the men well clothed? Are their persons kept clean? XIII. How is the cooking done? Are the messes inspected, and by whom? Are the provisions good? XIV. Are the men's sinks properly located and attended to? XV. What means are resorted to for warming the camps and are they effective? XVI. What is the strength of the regiments? XVII. What is the general sanitary condition of the regiment? How many would have to be sent to the general hospitals if the regiment were ordered to march? Upon all these points a systematic report will be made to the medical director immediately after each inspection. Where the inspectors perceive hygienic errors to exist, they will call the attention of the proper authority to them at once, and state in the report of the inspection that they have done so. The inspectors will also examine the medical officers upon their duties, to ascertain whether they understand them, taking the regulations as their guide. They will instruct the medical officers in their duties, being careful to correct any errors they may have imbibed, and to point out to them the scope and correct manner of performing their duties. The surgeon's call should be beaten in the presence of the inspector, to enable him to judge whether the men understand it, whether the men attending it correspond with the official reports, and whether they are judiciously treated. The inspectors will also institute an inquiry into the cases of the men who are recommended for discharge. The number of certificates sent to headquarters indicates either great facility in granting these discharges or great carelessness in the inspection of the men at the time of their enlistment. It is the desire of the general that a thorough medical inspection of the army be made as speedily as possible, that no possible deficiency may exist in the medical department when it advances upon the enemy, and to this end he commands all officers, of whatever rank, to afford to the inspectors of hospitals every facility in conducting their inspections. CHAS. S. TRIPLER, Surgeon and Medical Director Army of the Potomac. [Appendix D.] HEADQUARTERS ARMY OF THE POTOMAC, Medical Director's Office, January 7, 1862. GENERAL: In reference to the letter of Brigade Surgeon Stocker, inclosing requisitions for ambulances and transport carts furnished by the State of Pennsylvania for McCall's brigade, I have the honor to report that the quartermaster in charge of these carriages informs me he has receipted to Lieutenant-Colonel Crosman for all that have arrived here up to December 31, 1861. I am further informed upon inquiry that he has no transport carts on hand. Upon the inspection of General McCall's division by Dr. Milhau, inspector of hospitals, on the 5th of December, they had 22 two-wheeled and 2 four-wheeled ambulances and 1 transport cart. Four of the two-wheeled are reported broken at this date, but as fifteen days elapsed before they were wanted, they must have been repaired if proper attention was given to their condition. There have been reported to me 34 men wounded in General Ord's late action. I suppose this to be correct, as the brigade surgeons are required by General Orders, No. 20, of 1861, to report to me within twenty-four hours after an action the names, &c., of the wounded, and I have always found General McCall's brigade surgeons very punctual in the performance of their duties. There was then in General McCall's camp sufficient transportation for the wounded. Why it was not sent to the battle-field I don't know. We have at this point 48 four-wheeled ambulances in use and 23 in depot, and 84 two-wheeled in use and 230 in depot. Of the fourwheeled we want 20 here constantly. That will leave 28 for distribution, if it should be decided upon. But it has been the policy to withdraw these carriages from distribution to the camps in this vicinity, because in case of an action in front they can be readily sent in a few hours to any point or points where they may be required and in suitable numbers to different points. If distributed, those on the extreme right might be wanted on the extreme left or the reverse, and thus delay would be incurred in commanding them; whereas if kept here a telegram or a mounted orderly would put them in their proper position in a few hours. Again, if distributed, for want of shelter and want of care they would inevitably get out of order in a short time. I am confirmed in this opinion by Dr. Stocker's letter. With all his care he reports them as being uncomfortable for 7 R R-VOL V |