U. S. SANITARY COMMISSION. RULES FOR PRESERVING THE HEALTH OF THE SOLDIER. FOCKTII EDITION. The members of the Sanitary Commission order- ed by the President of the United States, and act- ing under the direction of the Secretary of War, in cooperation with the Army Medical Bureau, to secure by all possible means the health and effi- ciency of our troops now in the field, and to prevent unnecessary disease and suffering, do most earnestly and affectionately request their brethren of the vol- unteers and militia to adopt and carry out the fol- lowing "Rules for preserving the health of the soloier." They are derived from the highest authority and the largest experience of military and medical men, and it is believed that, if followed with the intelligence and honesty of purpose which char- acterize the American soldier, they will save the 2 lives of thousands of brave men who would be otherwise lost to the service of their countrv. They are addressed alike to officers and privates, inasmuch as the hitler arc liable lo promotion, and upon their officers devolves the responsibility of securing their health, safety, and comfort. They will be found in no instance to conflict with the " Army Regulations," by which all ranks are gov- erned, and with which every good soldier should bo familiar. 1. It is absolutely necessary, for the sake of humanity and the efficiency of the army, that every man laboring under any physical infirmity which is liable to unfit him forbearing without injury the fatigues and hardships of a soldier's life in the field, should be promptly discharged from the service by his commanding officer on a surgeon's certificate of disability. (Army Regulations, par. 1.'/.), 107, and 1134, 1135, 113S.) It is the duty of every good soldier who is con- scious of any such disease or detect, which may have been overlooked on inspection, to report him- self to the surgeon for advice. In case of discharge, means arc provided for his prompt payment and conveyance t■> his homo. 3 2. Every officer and soldier should be carefully vaccinated with fresh vaccine matter, unless already marked by small-pox; and in all cases where there is any doubt as to the success of the operation it should be repeated at once. " Good vaccine matter will be kept on hand by timely requisition on the Surgeon General." (Gen- eral Regulations, par. 1105, 1131.) .Medical officers are earnestly advised to make themselves familiar with the " Revised Regulations for the Medical Department of the Army," a copy of which should be obtained by application to the Surgeon General. They will thus learn the proper modes of securing supplies of medicines, instru- ments, and hospital stores, and rules for official con- duct under all circumstances. 4. The articles of food composing the rations issued by the United States Commissary Depart- ment have been proved, by sound experience, to be those best calculated for the food of the soldier. The amount allowed for each man is greater in quantity than the similar allowance for any Euro- pean soldier. If he understands his duties aiid 4 manages well, any commissary of subsistence can save from 15 to 30 percent, out of the rations fur- nished by Government, and with the money thus saved, fresh vegetables, butter, milk, &<•., may be procured. 5. When the surgeon considers it " necessary for the health of the troops, the commanding officer, on his recommendation, may order issues of fresh vegetables, pickled onions, saur kraut, or molasses, with an extra quantity of rice and vinegar." (Army Regulations, par. 107!).) Desiccated vegetables and dried apples may bo obtained on similar authority. 6. "When the rations furnished for the troops are damaged, or in any way unfit for use, the Army Regulations require the commanding officer to ap- point a " Board of Survey," composed of compe- tent officers, by which they may he condemned; in which case, good provisions are issued in their stead. (Tar. 926.) .7. Soldiers should always cat at regular hours, as far as the exigencies of service permit. Neglect of regular hours for meals tends to disorder the digestion, and to invite diarrhoea. 5 8. Each company should have its regularly de- tailed cook and assistant, who should always, on a march, be allowed to ride in one of the wagons, when practicable, inasmuch as their services are more necessary for the health of the men than in the ranks, and they are often required to cook at night the rations for the next day, whilst the men are sleeping. The men should always willingly procure wood and water for the cooks, whether detailed for such service or otherwise. 9. " Bread and soup are the great items of a soldier's diet in every situation : to make them well is therefore an essential part of his instruction. Those great scourges of a camp life, the scurvy and diarrhoea, more frequently result from a want of skill in cooking than from the badness of the ration, or from any other cause whatever. Officers in command, and more immediately, regimental offi- cers, will therefore give a strict attention to this vital branch of interior economy." ("Winfield Scott.) 10. The best mode of cooking fresh meat is to make a stew of it, with the addition of such vege- 6 tables as can be obtained. It may also be boiled; but roasting, broiling, or frying, in camp, are waste- ful and unhealthy modes of cooking. 11. "In camp or barracks the company officers must visit the kitchen daily, and inspect the kettles. * * * The commanding officer of the post or regiment "will make frequent inspections of the kitchens and masses. * * * The greatest care will be observed in washing and scouring the cook- ing utensils : those made of brass or copper should be lined with tin. * * * The bread must be thoroughly baked, and not eaten until it is cold. The soup must be boiled at least five hours, and the vegetables always cooked sufficiently to be per- fectly soft and digestible." (Regulations, par. Ill, 112, 113.) Medical officers should frequently ex- amine the articles of food issued to the men, inspect and taste it when cooked, and scrutinize the good- ness of the cooking, and the condition, as to safety and cleanliness, of cooking utensils. 12. Spirits should only bo issued to the men after unusual exertion, fatigue, or exposure, and on the discretion of the surgeon. 7 Those men who drink spirits habitually, or who commit excess in its use, are the first to fail when strength and endurance are required, and they arc less likely to recover from wounds afld injuries. 13. Water should be always drank in modera- tion, esjiecially wdien the body is heated. The excessive thirst which follows violent exertion, or loss of blood, is unnatural, and is not quenched by large and repeated draughts; on the contrary, these are liable to do harm by causing bowel complaints. Experience teaches the old soldier that the less he drinks when on a march the better, and that he suffers less in the end by controlling the desire to drink, however urgent. 14. There is no more frequent source of disease, in camp life, than inattention to the calls of nature. Habitual neglect of nature's wants will certainly lead to disease and suffering. A trench should always be dug, and provided with a pole, supported by uprights, at a properly-selected spot at a mod- erate distance from camp, as soon as the locality of the latter has been determined upon; one should be provided for the officers and another for the men. 8 The strictest discipline in regard to the perform- ance of these duties is absolutely essential to health, as well as to decency. Men should never be allowed to void their excrement elsewhere than in the reg- ularly-established sinks. In a well-regulated camp the sinks arc visited daily by a police party, and a layer of earth thrown in, and lime and other disin- fecting agents employed to prevent them from be- coming offensive and unhealthy. It is the duty of the surgeon to call the attention of the commanding officer to any neglect of this important item of camp police, and also to see that the shambles, where the cattle are slaughtered, are not allowed to become offensive, and that all offal is promptly buried at a sufficient distance from camp, and covered by at least four feet of earth. (Regulations, par. 505, 513.) 15. Except when impossible for military reasons, the site of a camp should be selected for the dry- ness of its soil, its proximity to fresh voter of good quality, and shelter from high winds. It should be on a slight declivity, in order to facilitate drain- age, and not in the vicinity of swamps or stagnant water. 9 A trench, at least eight inches deep, should be dug around each tent, to secure dryness, and these should lead into other and deeper main drains or gutters, by which the water will be conducted away from the tents. 16. Sleeping upon the damp ground causes dys- entery and fevers. A tarpaulin or India rubber cloth is a good protection; straw or hay is desira- ble, when fresh and frequently renewed; fresh hemlock, pine, or cedar boughs make a healthy bed. When occupied for any time, a flooring of planks should be secured for the tents, if possible, but this must be taken up, and the earth exposed to the sum, at least every week. 17. The tents for the men should be placed as far from each other as the " Regulations " and the dimensions of the camp permit, (never less than two paces;) crowding is always injurious to health, (Regulations, p. 508.) No refuse, slops, or excre- ment should be allowed to be deposited in the trenches for drainage around the tents. Each tent should be thoroughly swept out daily, and the ma- terials used for beddiug aired and sunned, if possi- 10 bio; the canvas should be raised freely at its base, and it sho aid be kept open as much as possible during tho day-ti au\ in dry weather, in order to secure ventilatiou, for tents are liable to become very uidiealthy if not constantly and thoroughly aired. Five ventilation should also be secured at night, by opening and raising the base of the tent to as great an extent as tin; weather will permit. 18. The crOAvding of men in tents for sleeping is highly injurious to health, and will always be pre- vented by a commanding officer who is anxious for the welfare of his men. Experience has proved that sleeping beneath simple sheds of canvas, or even in the open air, is less dangerous to health than overcrowding in tents. No more than five men should ever be allowed to sleep in a common army tent of the kind most commonly in use. 19. The men should sleep in their shirts and drawers, removing the shoes, stockings, and outer clothing, except when absolutely impracticable. Sleeping in the clothes is never so refresliing, and is absolutely unhealthy. 11 20. The men should never be allowed to sleep in wet clothing, or under a wet blanket, if it can be possibly avoided; and, after being wetted, all articles of clothing and blankets should be thor- oughly dried and sunned before being used. After a thorough wetting there is no serious danger as long as the body is kept in motion; but the wet clothes should be replaced by dry shirt and drawers before sleeping; otherwise there is danger of taking cold, and of other grave forms of disease. If the men are deficient in the necessary supply of clothing for a change, the surgeon should report the fact to the commanding officer. 21. Camp fires should be allowed whenever ad- missible ; they are useful for purifying the air, for preventing annoyance from insects, for drying clothing, and for. security against chilliness during the night. 22. The underclothing should be washed and thoroughly dried once a week. The men should bathe, or wash the whole body with water, at least once a week, and oftener when practicable, but the feet should be bathed daily, and the stockings washed whenever soiled. 12 23. The. hair and beard should be closely crop- ped. If vermin make their appearance, apply promptly to the surgeon for means to destroy them. Extra soap may be procured on recommendation of the surgeon. It is the immediate duty of non-conunissioned officers in command of squads to see that these, and all other precautions required for the health of the men, are strictly carried out under the orders of the company and medical officers. 24. When bowel complaints are prevalent, be especially observant of the rules for preserving health, and apply to the surgeon for a flannel ban- dage to be worn constantly around the belly. 25. It is wise and prudent, when ague and fevers are prevalent, that every man should take a dose of quinine bitters at least once in twenty-four hours. This will surely serve as a safeguard against an attack of disease; it has been practiced in Florida and elsewhere with undoubted benefit. 26. The men should not be overdrillcd. It is likely to beget disgust for drill, and to defeat its object. Three drills a day, of one hour each, for squads, and a proportionate length of time, when 13 sufficiently advanced, for battalion drill, is more profitable than double the time similarly occupied. Drilling before breakfast is always injurious, espe- cially in malarious districts. 27. When practicable, amusements, sports, and gymnastic exercises should be favored amongst the men, such as running, leaping, wrestling, fencing, bayonet exercise, cricket, base-ball, foot-ball, quoits, &c, &c. 28. On a march take especial care of the feet. Bathe them every night before sleeping, not in the morning. Select a shoe of stout, soft leather, with a broad sole, and low heel. Prefer woolen socks. If the feet begin to chafe, rub the socks with common soap where they come in contact with the sore places. 29. An old soldier drinks and eats as little as possible whilst marching. The recruit, on the con- trary, is continually munching the contents of his haversack, and using his canteen; it is a bad habit, and causes more suffering in the end. 30. The commencement of the day's march shoidd be prompt. Nothing tires the men so much as hang- ing around a camp, waiting for the word to start. 14 31. It is a great comfort to the men to halt for ten or fifteen minutes at the end of the first half hour; many, aLout this time, require to attend to the calls of nature. After this there should be a halt of ten or fifteen minutes at the end of every hour, with a rest of twenty minutes in the middle of the day for lunch. A longer halt than this stiffens the men and ivndei-3 subsequent marching difficult. The bestride is to get through the day's march, and rest in camp, if possible, by two o'clock, p. m. 32. The best pace to adopt, in marching, is from 90 to 100 steps (of 28 inches each) to the minute; this will give a rate of fro.n 2\ to 2'\ miles to the hour. In continuous marches, the leading companies should b.3 altoriiatel c ich day, as it is always less fatiguing to be in advance. 33. At the close of a day's march every man should bathe his feet, and wash his stockings, and get his meal before lying down to rest, removing and changing the under clothing, if wet. 31. Whenever, on a march, facilities of transpor- tation are available, it is wise to allow the men to 15 put their knapsacks into the wagons. This is an immense saving of strength, especially to troops unaccustomed to marching. When there is liability to attack, and AArhcn the troops are going into battle, this measure is partic- ularly recommended, as themen, under these circum- stances, are liable to lose their knapsacks, over- coats, and blankets. 35. In action, the proper position in which to place a wrounded or fainting man is flat upon his back, with the head very slightly raised. 36. The most urgent want of a Avounded man is water; if a canteen or cup is not at hand, bring it in a hat or any aA'ailable vessel. 37. As a rule, cuts, even Avhen extensive, are less dangerous to life than they seem; the contrary is true of bayonet and bullet wounds. 38. Whenever blood is flowing freely from a wound by spirts or jets, there is immediate danger, and, if the Avound is situated in one of the limbs, a stout handkerchief or band should be promptly tied loosely around it, hstwr.cn the wov:vJ and the heart; 16 a drumstick, bayonet, ramrod, or jack-knife is t<> be then inserted between the skin and the bandag and tAvisted around until the strangulation of tl limb stops the flow of blood, and it should be hi 1 thus until the surgeon arrives. In a less urgent case, or where the wound ; differently situated, pressure applied directly to it surface, and kept up steadily, will often save life. 39. Wounded men should always be handle with extreme care, especially if bones are broken. The medical assistants arc always provided with spirits and anodynes. 40. It is by no means necessary that bullets should ahvays be extracted; they often remain in the body, and do little or no harm—much less, in fact, than might be done in attempts to remove them. Washington7, July 12, 1861. W. II. VAN BUREN, M. D. Adopted and approved by the Commission at a meeting held at Washington, July 12, 1861. FRED. LAW OLMSTED, General Secretary