SANITARY COMMISSION,
            No. 36.
REPORT
ON THE
CONDITION OF THE  TROOPS,
AND THE
OPERATIONS OF THE SANITARY COMMISSION
IN THE
VALLEY OF THE MISSISSIPPI,
FOR THE THREE MONTHS ENDING NOVEMBER 30th, 1S61.
BY J. S. NEWBERRY, M. D.,
       Associate Secretary.
           CLEVELAND:
FAIRBANKS, BENEDICT & CO., PRINTERS, HERALD OFFICE.
              1861. 
 
SANITARY   COMMISSION,
                 No.  36.
                  REPORT
                        ON THE

CONDITION OF THE  TROOPS,
                        AND THE

  OPERATIONS OF THE  SANITARY COMMISSION
                        IN THE
 VALLEY OF  THE  MISSISSIPPI,
       FOR THE THREE MONTHS ENDING NOVEMBER 30th, 1861.
        BY  J.  S.  NEWBERRY,  M.  D.,
                    Associate Secretary.

  Since the publication of my former Report, the aspects of our
field of  labor  in the Valley of the  Mississippi have materially
changed.  The number of  enlisted men in camp and field in that
area now reaches the large  figure  of 250,000.   As a natural
consequence, the investigation into the  sanitary condition of this
immense force, and the effort to supply the wants from which they
have suffered,  have  draAvn largely upon  my energies  and the-
material means at my command.  I am happy to be able to state
that such drafts have but  rarely been protested; no considerable-
number of troops, for whose health and comfort I have been in any
degree responsible, have been wholly neglected; nor has any appeal
for assistance in any case been refused, nor waited long  for a full
and satisfactory response.  To accomplish this task my own labor has;
been necessarily somewhat  severe; I have been compelled to travel
over ten thousand miles in the  service of the  Commission, and
in my  brief intervals of rest have  been burdened with a large* 
2
and  constantly increasing correspondence.  To do in a manner at
all satisfactory the sanitary work Avhich has been crowding upon
the Commission in the Western States, it has seemed  indispensable
to increase our corps of  agents;  I  have, therefore, employed two
additional inspectors, who  have occupied themselves with investi-
gating and supplying the wants of the troops now rapidly gathering
into  Kentucky; and  have established, and  brought into successful
operation, a depot of supplies in Western Virginia.   I  have also
the  pleasure of acknowledging  my indebtedness to  the  earnest,
systematic and most efficient aid of a large number of our associate
members, and  of auxiliary Ladies' Aid  Societies, without whose
assistance but a small portion of  the work  done could have been
accomplished.  Our acknowledgments are also due to the railroad,
steamboat and express lines, who have, with feAV exceptions, gener-
ously offered to transport supplies  free, or at  greatly diminished
rates.   In some instances, also, they have  granted free passes to
our agents, and have thus spared us  a heavy drain upon our limited
pecuniary resources.   Through all these agencies a system of sani-
tary measures has been inaugurated, which has already  prevented
and  alleviated much suffering, and, it is not too much to say, has
saved many lives; a system which  promises in the future to add
greatly  to the health, comfoit and efficiency of our troops, and thus
to accomplish, to a good degree, the objects for which the Commission
was  organized.
   The details of what has been done  and Avhat remains to do for
the welfare  of  the soldier in the different divisions of our western
army, will be given under the different heads where the condition
and wants of the troops in the several departments are specifically
noted;  but  a few facts in regard to the general  condition of the
troops in the Valley  of the Mississippi, and the causes which have
had a general  bearing on their health and comfort,  deserve to be
first mentioned.
   On comparing the condition of  the troops which have come
under my observation, with that  observed  at  the time of making
my former Report, it may be stated that, while exhibiting in many
respects a different  phase, their average health has on the whole
not  materially changed.  With  the  advance  of the season, and
their experience in camp life, important modifications have taken
place in the diseases from which they have suffered.  The diarrhoea 
3
at one time so prevalent in all the camps, and the various effects of
malarious poison which gave a distinct phase  to the  nosology of
our armies  early in  the season, have diminished  in  a  marked
degree ; while with the approach  of the colder weather of autumn,
the cases of typhoid fever, perhaps no more numerous, have become
more  grave; measles and small pox, which for a time  had some-
what  abated their virulence, are  now  more frequent and severe •
and  rheumatism  has assumed  an important  place in the list of
diseases with which our  troops  are affected.  On the whole, the
percentage of sick is but little greater than during the summer,
yet I  think it will be found to hold good, as a general rule, that the
mortality has sensibly increased.  This  is doubtless  due  to the
combined operation of several causes.  The multitudinous cases of
trivial  diseases,  occurring  among  all newly-enlisted  men,  and
incidental to the change from civil to military life, no longer swell
the sick list and fill the hospitals; and the more  frequent, but less
severe forms of  malarious disease—ague and chill fever—have
been  succeeded by the rarer, but  more  grave, malarious dysenteries
and bilious  remittent fevers; while the eruptive diseases,  as they
are so prone to do, have multiplied in number and increased in
virulence with the approach  of cold weather.  This increase in the
number of cases of grave and fatal diseases among troops now more
experienced  in camp life, better equipped than at first, subject to
at  least partial sanitary inspection and instruction,  and in the
enjoyment of a large and liberal bounty from the Sanitary Com-
mission and a generous public,  by which their  comfort and, as  a
consequence,  their  health  have been without  question  greatly
increased, will perhaps excite surprise  and concern in many minds;
and  the question Avill  naturally arise: Why is  it?   Doubtless  a
portion of the prevalent sickness and  mortality are due to natural
and inevitable causes, incident to  the change of season, and affecting
alike those enjoying the comforts of home and those exposed to the
hardships of Gamps; there can be no question, however, that a very
large number of the cases of death and grave disease in our western
Armies  are due  to removable  causes;  which  should therefore
become matters of  anxious  concern and earnest,  immediate effort.
   In this category of causes I would include unnecessary exposure
to wet and  cold.  The consequences following such exposure have
been mainly entailed by insufficient protection against the inclem- 
4
encies of the weather, such as defective tents, blankets too few and
of inferior quality, uniforms of too light material, overcoats wholly
wanting or  far too pervious to  both cold  and  rain.  And here  I
may be permitted to remark that I cannot hut anticipate the gravest
consequences from the  inadequacy of the protection  afforded by
their  clothing and bedding, such, and so much as now furnished
to troops soon to encounter all the severities of our arctic Avinter.
It is my earnest conviction that few of  our volunteers will be  so
located  as  to  geographical  position, or so protected in winter
quarters, as to escape great suffering and serious disease, while
guarded from the effects of cold only by their uniforms and a single
blanket each.   If it be determined that military necessity limits
the transportation, and therefore restricts the bedding and clothing
of the soldier to the present regulation standard, it is none the less
a sad necessity, from which the gravest  evils must follow.   I am
confident that few of  our troops can endure the rigors of a winter
campaign with less than  at  least two good blankets each and  a
more  liberal supply of winter  underclothing, socks and mittens,
than even the most favored now enjoy.   And I cannot but believe
that the humane, the Avise and  prudent, both among army officers
and civilians,  will strain  every  nerve to secure to our soldiers  as
nearly an adequate protection  against this great and  impending
evil as. the circumstances of the case will possibly permit.
   It must be  borne  in mind, in this connection that all efforts  to
compensate  the soldier for inadequate clothing and bedding, by
raising  the temperature in barracks or tents by stoves, or by care-
fully preventing the ingress or egress of air, will be a fruitful cause
of the gravest forms of disease incident to camp life;  and will be
productive of  even greater evils than excessive  cold.
   The truth of this statement is so apparent as scarcely to require
an argument;  a  highly-heated  sleeping apartment, exposing the
occupants to all the many and  most serious consequences of great
and  sudden alternations of temperature;. Avhile in  closely-shut
quarters, the  men are deprived of the " breath of life," and  are
poisoned by their own exhalations.
   I should,  perhaps, mention here that the troops  bow in service
in the Valley  of the Mississippi  are, with few exceptions, provided
with uniforms, overcoats and blankets of fair quality, though few
come  up to the regulation standard in point of weight and  dura- 
                               5

bility of material.  The exceptions  to which  I  have referred are
regiments which at the date of Dec. 1st were not yet supplied with
overcoats, or which had only very inferior blankets.  The instances
of this kind which have come under my  observation, or have been
reported by our inspectors, are fortunately few; but few as they
are, they exhibit  such incompetence or inhumanity on the part of
those in authority as should  make  them the objects of universal
execration.
 '  Some of the regiments in my field of  operation have been pro-
vided with the India rubber overcoat, but  I  believe it has added
little to the comfort of the soldier, and has been generally con-
demned.  The India rubber blanket, on the other hand, has been
as generally approved.
v   Passing over the evils' consequent upon the neglect or incompe-
tence of officers—unfortunately not unknown, nor unfrequent  in
any division of any army—I  am compelled to speak of  the  forced
marches made by  some of our troops in the West as a most fruitful
source of disease, and one of the most potent influences which have
operated to increase the percentage of  sickness and mortality to
which I have already referred as matter of grave concern. Without
raising the question of  military necessity, the obvious consequence
of such severe and unusual duty cannot  be ignored; and I think I
am safe in saying that the disproportionate number of sick reported
in the Valley of the Kanawha—173 to  a regiment—and the still
greater percentage in  Eastern Kentucky, are the legitimate and
necessary consequence  of  the hardships incident to the  forced
marches made by  the divisions in these districts.
   I cannot refrain from also enumerating among the causes  gener-
ally affecting "the  health and  efficiency of  the troops, the unfortu-
nate relation  which exists between the  sutlers and  men in many
regiments; by which they are not only permitted, but often induced,
to expend their earnings for food and drinks in such a way as  to
injure both health and  morals.  It would  seem that there was a
call for more  stringent  measures prohibiting the  sale  in camp of
articles destructive to health or productive of demoralization.   I
have failed  to perceive any good reason why the sutler should  be
permitted to collect his dues at the pay table; or why, unless more
rigidly restricted  in his functions, he should be  protected from
competition, and be raised above the common chances of trade. 
6
      GENERAL CONDITION OF THE HOSPITALS.

  The character and condition of the hospitals in which the sick of
the western armies  are  treated, are fully  given in the reports
which follow.   I may say, however, in passing, that hospital service
in the West has assumed  a new aspect since the presentation  of my
last report. Then the general hospital was almost unknoAvn, and
the regimental  hospital, usually constructed of boards, small, open
and airy, free from infection and uncontaminated by the emanations
from  the  kitchen or privy, impeding in no respect  the  curative
influences of nature's agents, left little  to be desired as regards a
habitation for the sick.   As a consequence, the wards of no  model
hospital in the world could afford a more favorable  exhibition of
those cases of disease prone to become grave where a confined and
vitiated atmosphere is substituted for the sunlight and pure air of
heaven.   With the advance of the season the regimental hospitals
Avere  deprived  of many of  their  advantages, and the general
hospitals which had  sprung into existence were overcrowded with
the increasing number of the sick.  These were usually old  build-
ings, constructed for  other purposes, ill adapted to the wants of the
surgeon and  often  inflexible to any reforms he  was  disposed to
institute.   As a consequence, they are inconvenient,  ill ventilated,
wanting a full  supply of pure water, and destitute of commodious
and sufficient bath rooms and privies.  They also have been, and
are still, as a general rule, overstocked with patients; without an
adequate  supply of beds, bedding and  hospital clothing; and not
often furnished with a sufficient  number of intelligent and faithful
nurses.   There is, therefore, and must long be, much to be desired
in the condition of the general hospitals throughout  the West, and
there must continue to be  both  sickness and mortality as a conse-
quence  of their imperfection.   It gives me  pleasure, however, to
testify to  the earnestness and efficiency of the Medical Directors of
the different departments under whose control  they  are.   In most
instances they are doing all in their power to ameliorate  the con-
dition of  the sick under their charge.   They have  received  Avith
cordiality the proffered assistance of the Sanitary Commission, and
have accepted  gratefully the large amount of  hospital stores thus
placed  at their disposal.  By the free use of  the resources of the
 government and the liberal donations of the people, the  hospitals 
7
of Wheeling, Louisville, Cairo and  St.  Louis, by far  the most
important ones in the West, have been furnished with  nearly all
things necessary to the comfort and well being of  the sick, and in
all  from which I have any reports, the amendment of condition is
steadily progressing.   Here, as at the East, a radical and general
difficulty has been experienced in keeping a hospital  in  proper
condition, from the impossibility, by  means now in use,  of having
the hospital bedding and clothing promptly and thoroughly washed
as it becomes soiled, so thnt the sick may be always cleanly, sightly
and comfortable.  How this desirable end can be accomplished, I
am  not at present prepared to  say, but where it is now achieved it
certainly evinces unusual energy and virtue on the part of surgeons
and nurses.
                  WESTERN  VIRGINIA.

  The condition of the  troops in camp and hospital in Western
Virginia,  has been in some important respects modified since the
publication  of  my former report.  The  number and per centage
of sick  has very  largely increased,  while the  means  employed
for   their care,  both by the  Government and by  the Sanitary
Commission, have  been  sensibly augmented, the number of hos-
pitals multiplied,  their  condition much  imnroved,  and a  great
quantity of hospital  stores supplied  to them.  The causes  of this
prevalence of disease in a country proverbially  healthful, are, I
think, unmistakable,  easily pointed out, and for the most  part
connected Avith the  unusual hardships to which  our troops have
been exposed.   These hardships have been due  to the nature of
the topographical features of the country, the severity of the duty
imposed upon too small  a force, to heavy rains, floods in the rivers,
which induced great suffering, and the early approach  of winter,
for  which our troops  were not fully prepared.
  That  portion  of Virginia occupied by our  forces, includes the
summits, passes, western slopes and foot-hills, of the mountains,
and the plateau country bordering the Ohio and  Kanawha.  This
latter region, once nearly level  and  smooth, has  been deeply cut
by the draining streams, which run in narrow valleys  of excavation
Beveral hundred feet in depth.  These form the channels of com-
munication,  and when traversed by  troops, it has been  necessary
that the flank companies of regiments, and the flank regiments  of 
8
columns, should  cover the broken and thickly-Avooded hill-sides in
their progress;  thus meeting with almost inconceivable obstacles,
which  greatly tried their  powers of endurance-.  The  geological
sub-structure of the whole country is that of the Coal measures, the
water  excellent, the drainage free, the  air pure  and salubrious.
Yet in face of all these  advantages, the military necessities con-
nected  with the  occupation of  a long frontier  by  a force  in
numbers about half what was desirable for the purpose ;  the forced
marches; the difficulties in the way of the transportation of needed
supplies, and excessive rains, have entailed sufferings not experi-
rienced  by  any other division of our  army.  Add  to this,  an
inadequate supply of clothing, and we have ample cause for the
prevalence of disease.
  In the valley  of the Kanawha  the  sufferings  and sickness  have
been greatly aggravated  by the many sad  consequences  of a
remarkable  flood by which it was  inundated  in October.  The
effect of this and other misfortunes on the health of the troops was
such that at November  1st,  out  of a force of aborat 12,000  men,
2,038 were on the sick  list.
  Since  my last report, our inspector, Dr. Griswold,  has visited
all the camps and hospitals in Western Virginia with the exception
of those at  Cheat Mountain.   The large force  at this  point has
recently been much reduced, but he is  now  on his Avay to  visit
those remaining, who have established themselves  in winter quar-
ters.   The results of his inspection,  are given in the following
extracts from his general report  to me,—the  detailed inspection
returns  having  been forwarded  to  the Secretary.
  " I left Cleveland, Ohio, Sept. 20th, and arriving in this city,  I
procured the store 105£ Main St., by the aid  of Gov. Pierpoint,
from  Mr. Thomas Hornbrook, the oAvner, for an office for the
Commission, and depot for Hospital Stores.   No charge  is to be
made for rent until such time  as it may be rented to the advantage
of the owner.
  On the 24th ultimo I proceeded to Grafton and inspected the
camp of the 7th  Va. Regiment there stationed,  the report of which
I send you herewith.  The hospital at Grafton I found improved in
many respects, especially in neatness and order.  The building waa 
9
being completed,  but the delay  in  the receipt  of  lumber had
prevented the accomplishment of some of the improvements I had
recommended on a former visit.  The  large number of sick still
crowding  this hospital from  surrounding outposts, together with
the near approach of the  inclement season, induced me to recom-
mend the construction of barracks immediately adjacent to  the
main building suitable for a dining room, wash room, and quarters
for the surgeon  and  assistants.  The  reasons  for making these
additions  to  the hospital being given  to Gen. Kelly,  he approved
of the measure, and orders were  given for their construction at the
earliest  possible  date.  A matron and one female  nurse had been
engaged in  this  hospital, and  Avere  rendering valuable service.
Patients expressed much pleasure  in having females in attendance
upon them.   Dr.  John  D. M.  Carr still occupies  the post  of
surgeon.  He was originally called by Major  Oak.es to  act as
Assistant  Surgeon of the 1st  Va. Regiment, before the organiza-
tion of the  government of Western Virginia,  and  afterwards
assigned to this post.

              POST HOSPITAL AT CLARKSBURGH,  VA.

                    Inspected Sept. 24th, 1861.
   Charles R. Winne, Ass't Surgeon U. S. A., has been appointed
to  this  post  since my visit  in  August  last.  Two large private
dwellings are occupied  for the  hospital, situated  about one mile
apart, and Avell adapted to the Avants of the service;  one being at
the  eastern  and the other at the western extremity of the fown,
convenient for the reception of the sick and wounded from either
direction.   At the date of my inspection, there were 122 sick and
wounded in hospital.  Average admissions per month, 90.   Preva-
lent diseases were typhoid fever,  remittent do., chronic rheuma-
tism, dysentery,  diarrhoea, and occasionally a case of intermittent.
The hospital  buildings Avere  kept in good  order;  the wards Avell
ventilated, and strict  police regulations  enforced.  At the western
building a matron was employed,  and perfect order and neatness
maintained.   A  requisition for medical supplies had been made on
the  Medical  Director, Dr. Wright of Cincinnati,  but  not  yet
received.  There was but a small  quantity of medicines, and  no
instruments on hand. 
10
  The regimental hospital of the 3d Va. Regiment at this place,
was being closed up by direction of Dr. Horace  R. Wirtz, Ass't
Surgeon U. S. A., of Gen. Rosecrans' staff.  The convalescent sick
were  being discharged, and  the principal  amount  of medical
supplies placed in the hands of the post quartermaster; the balance
being forwarded  to the regimental surgeon.   No report was for-
warded to the Medical Director.

                post hospital gallipolis,  o.

                    (Inspected Sept. 29, 1861.)

  I found the hospital at this place in charge of Dr. T. F. Gabriel,
commissioned surgeon by the Governor of Ohio.  The  number  of
sick in hospital Avas 129, occupying  two  small, illy-constructed
houses, altogether  unsuited for  the  purpose. The rooms  were
small, windows mostly immovable, and hence ventilation impossi-
ble.   I found on  a wharf boat 37 discharged  sick who had  come
down the KanaAvha the day previous, separated from their surgeon,
without passes to go further, or rations.  I  caused them to be fed
from the  hotel with coffee, soup and crackers early in the morning,
before visiting the  hospital.
  Under these circumstances, I advised that ample hospital accom-
modations  be  immediately secured.   On inArestigation, I learned
that barracks  could not be erected within four or six Aveeks; and
that the  only building in  town suitable for the purpose, was the
Union School House, containing eight  large rooms.  A  meeting  of
the School Board  was convened at 3 o'clock P. M.,  that day, and
on  presenting  the  subject to   them  in such manner  as the case
seemed  to warrant, a  voluntary consent  was obtained for the
occupancy of the  building for  hospital purposes, and before night
the sick  from the Avharf-boat were removed to it.  Dr. Robison,
Brigade  Surgeon of Gen. Cox's staff, arrived that evening, and
afterwards afforded essential aid to Dr. Gabriel in the re-organi-
zation of the hospital.
  The number of deaths  at this  hospital  since  July  19th, have
been six.   Since Sept. 1st, fresh vegetables  have been supplied by
the post  commissary; previous to that date the loyal  citizens  of
Gallipolis had  contributed largely for the comfort of the  sick.
The hospital having no stove but a sheet-iron one, the citizens had 
11
organized a committee of ladies to cook the  rations daily at their
several  homes.  The  only hospital bedding in use had been con-
tributed by  the citizens, and  from surrounding towns.   Fresh
beef Avas  now supplied  four days  in  the week.   Milk was also
furnished in sufficient quantity.
  No hospital  stores,  nor medicines, nor instruments had been
supplied from the  Medical Director.  Purchases of medicines had
been  made from a village  druggist, by order of a commanding
officer.  I advised that requisitions  for these supplies be immedi-
ately made on the Medical Director at Cincinnati.
  The active co-operation of the citizens of Gallipolis in surrend-
ering their  school building  for  a  hospital,  and  in  furnishing
subsistence  and bedding for the sick,  is worthy of the highest
commendation.
            post hospital at  parkersburgh, va.
                    (Inspected October 1, 1861.)
  This hospital is situated about one mile east of the centre  of the
city of  Parkersburgh,  on an  elevated site well  suited for the
purpose.   It is tolerably clean, Avell ventilated,  and apparently
well disciplined.  Dr. Albert  P. Wheeler, a citizen physician,
is acting  as  surgeon  under an appointment by Gov. Pierpoint,
Dr. John T.  Wharton, Assistant.  Some distrust of the compe-
tency of  the  surgeon  has  been  entertained,  on  the  ground  of
intemperate habits, but I could learn of no abuse from that  cause.
A good  supply of medicines was  obtained by  requisition  on the
Medical Director,  Dr.  Wright of Cincinnati,  while the hospital
was in charge of Dr. Barr, Surgeon 36th Regiment 0. V.
  The hospital  is Avell supplied with fresh meat and vegetables
from  the hospital fund; also milk, butter, and other necessaries  of
subsistence.
  The number of sick in hospital, 38.  Treated  the  last month,
109.  Deaths, 1.

        HOSPITAL FOR DISABLED SOLDIERS, WHEELING, VA.
                  (Inspected October 12th, 1861.)
  The arrangement for the treatment of disabled soldiers,  was
made by Maj. Oakes, in this city, prior to the  organization  of the
government of Western Virginia.  Dr. Logan,  a respectable drug- 
12
gist, was authorized to  act as Post Surgeon, and  a contract was
made Avith the Catholic hospital in charge of the Sisters of Mercy,
to receive and attend to the sick  at $3,50 each per  week.  Dr.
Logan employs a physician to attend the patients,  whether at his
OAvn cost or at the expense of the Government, I have been unable
to learn.   The medicines are supplied from Dr. Logan's store.
  In my inspection of the Catholic Hospital, I could not learn the
number of soldiers that  have been treated there.  I Avas informed
however, that as many as thirty had been in at a  time, but now
reduced to sixteen.   But three deaths are said to have  occurred.
The treatment in hospital, in food and attention, I  have no doubt
has been good.

    CAMPS  AND  HOSPITALS IN THE VALLEY OF THE KANAWHA.

  *   *  *   I reached the head-quarters of Brigadier General W.
8.  Rosecrans,  commander of the  army of Western  Virginia,
October 22d.  The camp of Gen. Rosecrans is situated tAvo  miles
east or south-east of Gauley Bridge, and on NeAv River, the union
of which with  Gauley  River,  forms  the Kanawha.  The ascent
from  the ferry which crosses the mouth of the Gauley River,  is
about 500 feet.  The road leads along the left bank of New River
beneath over-hanging cliffs one  and two  hundred feet high,  for  a
quarter of a mile, and then rapidly ascends in a tortuous course.
The camp is known as  " Tompkins' Farm," the owner, of that
name, being a colonel in the rebel service on the opposite side of
New River.
  The camp is neatly laid out, on a gentle slope descending south-
east,  and directly  in front of Tompkins' house, which is guarded
against eroilations, and  its inmates, four children and  attendants,
protected by order  of the General.   I  was happy  to find  myself
recognized from a former . official interview, and  treated with all
the consideration due the Commission.  The Quartermaster, Capt.
C. M. Gouldjng, afforded me every facility I could ask in trans-
port to the distant camps.
  From the  returns accompanying this, you will learn  the general
and relative situations  of  all the brigades and  isolated camps
inspected.   That of Gen. Benham,  embracing  the 10th,  12th and
13th Regiments, 0. V., is reported  under the best  police manage-
ment  This is  due, measureably, to Gen, Benham's personal care 
                              13

for his regiments, and also the efficient attendance of Dr. Geo. G.
Shumard, Brigade  Surgeon.  The  large  amount  of  sickness in
these regiments, is referable to the severity of the service they have
endured, thus  over-balancing  the  advantages  of strict sanitary
police.
  My attention was often called to the fact that this portion of the
army is supplied with coffee  in  the sack, in witnessing the process
of roasting  and  grinding  or  pounding in camp.  The  roasting is
usually done in  the camp  kettle, by which means it is  often
rendered perfectly inodorous, or in other words, it is burned black.
The  pounding is done in the  same vessel, often with the butt of the
musket.  Of course, coffee prepared in this way makes not only an
innutritious  beverage, but  it  is absolutely  injurious.  If coffee
could be properly roasted  and ground without sophistication, and
packed in twelve-pound tin cans, or tin pails with bails and covers,
the  Government  would make a vast saving  in many ways, Avhile
the army would derive a great benefit from its use.  Put up in the
manner  last specified, an article of  great convenience in  camp
would be supplied.
  The employment of a non-combatant  cook for each company of
men seems to warrant, in  the volunteer service, the serious consid-
eration of the Government.  Some regulation should be introduced
to secure the provision of better-prepared food for the  army.  The
abuses in this particular have unquestionably been among the great
sources from Avhich  so much sickness has fallen upon our troops.
  There are thirteen buildings occupied as hospitals in this column
of the army.  Excepting one at Point Pleasant, one at Charleston,
and  perhaps one at  Gauley,  all the others are altogether unfit for
the  occupation of the sick.   Most  of them are merely log tene-
ments, some without  glazed windows or means of  heating.  The
rick, in some instances, lie upon loose straw upon the floor.   Above
Gauley, none had cots or bunks, but  in some instances, rude bed-
steads  had  been found and  used.   In several regiments  the sick
were treatad in tents altogether.  The  Assistant  Surgeon of the
12th Regiment, 0. V., had constructed bunks of split timber, using
barrel  staves for bottom slats.  He  had also farmed an  earth flue
which  served to warm and dry  the  air in the tent, and the seven
patients he had under treatment, were seemingly the best provided
for of  any above Gauley.  A continued rain, however, would have 
14
 materially  changed  the appearance  of  his  hospital.   The  skill
 exhibited  in providing for  his sick,  with the perfect  order and
 neatness, was highly creditable.   The reasons given for  the accu-
 mulation of  so  large  a number of sick, were the difficulty  of
 transporting  them over the rough roads, and that there were  no
 post hospitals accessible to which they could be sent.
            u. s. military hospital, wheeling, va.
   You are aware that I have been organizing a hospital  here.  A
 telegraph  came on to the Quartermaster and  to  me from General
 Rosecrans, through  Dr. Wirtz, ordering a hospital to be  organ-
 ized here, capable of  holding four or five  hundred.  The Quarter-
 master returned  a dispatch to send on the sick, without consulting
 me, and then delivered the dispatch  to me.  I had no alternative ;
 a battle at Gauley was imminent, communication was cut off,  and
 I felt that I must obey the order, not only  as a duty to the General
 commanding, but from every consideration of humanity and justice.
 I immediately set myself  at  work, and  last Wednesday got  a
 building  on Water street;  to-day  I  have a hospital  with  285
 patients all bedded and in  the most comfortable  condition.   The
 sick require the  close attendance of two surgeons, and my time  is
 constantly occupied from 5 A. M. to  11 and 12 P. M.   To  be sure
 I have gotten over the  worst of it, but there  is  no one  here yet
 who can make a requisition  by authority.  I  have written to Dr.
 Wirtz, and expect relief soon  if a surgeon can  be  spared from
 above.  I received 105  more men from a boat this morning, kept
 them separate from those previously  in hospital, and had them all
 bathed and  the sickest put regularly to bed by 3 P. M.   To-night
 the hospital is as cheerful as a large hotel."
  At a later date Dr.  G. writes:
  " I remain, as yet, the chief head of  the hospital   *     *    *
 I have ten female nurses and ten males.   Without the women  I
 would not undertake the control.  The  three ladies from Cleveland
 are rendering excellent service and were  in good time   I supply
 the destitute with shirts, drawers and socks from the stores of the
 Sanitary Commission.   Three hundred beds are furnished wholly
or in part.   I have 261 in hospital,  have returned to  duty 21
transfer to  Covington, Kentucky, 23 to-morrow,  and by first boat'
send 48 back to duty.   Deaths 3, 
15
  Since the date of my last report, the depot of hospital stores has
been carefully and well managed by Mr. Fracker, and has greatly
increased in efficiency.  The number of articles  of bedding and
clothing received up to this date is 10,770, the number distributed,
4,814.
                            OHIO.

  Ohio has now about 80,000 infantry, 6,000 cavalry, and several
batteries of artillery,  in the field or in camp.   Of these, however,
nearly all have left the limits of the State, and are included among
those whose condition has received the attention of our inspectors
in the different departments of the army to Avhich they have been
sent.   As  a general  rule, they have  left  the  State  in excellent
sanitary condition and, particularly those more recently recruited,
well appointed and commanded by officers of ability and experience.
To this rule, hoAvever, so creditable to the authorities, there have
been some glaring, I  may say, shameful exceptions.  Even so late
as the 25th November, I saw one  regiment which had  been up to
that  time on duty in Western Virginia, not  yet provided Avith
overcoats; and when, on their arrival at Cincinnati, en route for
Kentucky, overcoats were offered  them, they were of a quality so
inferior that they were indignantly rejected.  It is  but just to state,
however, that the State authorities have labored most ardently and
earnestly to  secure the proper equipment  of her troops, and for
their umvearied  efforts  and  general success,  are worthy of all
honor.
  Every exertion  has been  made to  provide  each regiment with
surgeons fully qualified for their duties, and all that a competent
examining board could do to secure this end has been done.  The
examination of candidates has been thorough and  trying; and the
appointments from those who have  passed the  ordeal just and
judicious.  A large  number of these surgeons have, as  I know,
received the more important documents of the Commission and are
fully impressed with  the  necessity of the  observance  of  sanitary
laws in camp life.  Most of  the regiments still remaining within
the State have been inspected by our associate members, and their
sanitary condition  as reported by them is  in the highest degree
satisfactory.
  Since my last report, Branch Commissions composed of Associate 
16
members have been formed in Cleveland, Columbus and Cincinnati,
which promise to be efficient auxiliaries in  the work of  the  Com-
mission.
  At Cleveland, through the intervention of the Branch Commission,
a portion of the Marine Hcspital has been  opened for the reception
of such enlisted men, or those discharged  from disability, as may
be in need of assistance other than that furnished  by the military
authorities.  The wards set apart for this purpose have been neatly
furnished by the ladies  of the Aid Society, and  every possible
provision  made for the  comfort of such as are entitled to the aid
thus afforded.   The number  of  cases requiring  assistance has
already been considerable, and it is evident that the opening of such
a hospital Avill supply what has been a realAVant in Northern Ohio.
  At Columbus the Branch Commission  is composed of earnest,
intelligent and influential men, Avho have already initiated  an
efficient system of sanitary measures in behalf  of  the troops sta-
tioned  at Camp Chase.  They will also  prove active co-laborers in
the general Avork  of the Commission.
  At Cincinnati our Branch Commission includes many of her best
known and most philanthropic citizens.  Its President is R. W.
Burnett, Esq., now a full  member of the  Commission.   By the
request of the Cincinnati Branch, I was  present at its organization,
and  can testify to the intelligence and  zeal with which they have
begun their labors.   Much had  previously been done for the relief
of the  soldiers by Dr. MussEY  and other  Associates, with the co-
operation of the benevolent ladies of the city, in securing the
opening of the Marine Hospital, bringing the sick soldiers  from
Camp Dennison, and gratuitously, though most faithfully providing
for all  their wants.  More recently, however, the care of this hos-
pital has  been assumed by the War Department, and it has  been
filled to repletion by the sick brought down from  the  Kanawha.
Having received a commission  as Brigade  Surgeon, Dr. Mussey
still remains in charge.
  I should also mention among the good works of the Cincinnatians,
the formation of a Citizens' Relief Association, by whom  large
quantities of clothing and stores were collected and disbursed, by a
committee appointed for that purpose, among the troops in Western
Virginia.   A most interesting report of  the visit of this committee
to Virginia has been published since their return. 
17
  Perhaps the most important exhibition of  public benevolence on
the part of the citizens of Ohio yet remains to be noticed.   I allude
to the organization and  most efficient  labors of  the Soldiers' Aid
Societies, composed  of patriotic  women who have devoted them-
selves with astonishing success to the preparation of hospital stores,
bedding,  clothing and  edibles for the volunteers  in  the various
divisions  of  the Army of the West.  Through their agency a vast
amount of good  has been  accomplished, suffering relieved, and
undoubtedly, life preserved.   Of these societies the more important
are: that at Columbus, made auxiliary to  the  Commission  by a
recent vote,  and that at Cleveland, which has been  in  operation
since April last.  With the workings of  the latter Society I  have
been personally and constantly conversant.  As these are fully  set
forth in the report of the Society—published as Document No. 37 by
by the Commission,—I  need here only refer to the subject to say
that by but one other similar organization in the country has  more
material  aid been rendered to  the cause of humanity in the present
war, and  in  none  more zeal  and self-devotion, or more skill and
energy displayed in the performance of a self-imposed task.   By
this efficient auxiliary of  our Commission, over 69,000 articles of
bedding,  clothing, etc., have been collected and prepared, and over
40,000 distributed  to  meet the  real  and  pressing wants of our
soldiers.
                         KENTUCKY.

  Since the  publication of my last Report Kentucky  has-been
opened as a  new field for the operations of the Commission; one too
important to be neglected ; one, indeed, where the demand  upon
the intervention of the Commission has been so urgent  as to require
the  employment of all  the  resources it  could  command for that
district.
  After months passed  in a vain effort to  maintain  a position of
neutrality, in a struggle not only of paramount but vital import-
ance to every State and section of our country, Kentucky at last
hurst the shackles  that the enemies both of her prosperity and
of the Government had forced upon her, and came out boldly and
fully for  the  Union; raised  her quota of troops and supplies, and
invoked the  aid  of her  sister  States in her efforts to punish the
treason of her own  disloyal citizens, ..and .to...repel the encroach-
                2 
18
ments of the Southern rebels invading her territory.  Her cry for
help was promptly answered; large  numbers of troops from Ohio,
Indiana, Illinois and Pennsylvania hurried to her rescue, and again
the "Dark and bloody ground " became the seat of war.
  Receiving sad accounts of the destitution and  suffering, particu-
larly  of the  hastily, and  as yet  imperfectly equipped  Kentucky
troops, and the loyal men of Tennessee who had been driven from
their  homes  by the rebel  forces, I felt it to be my duty to go to
their  relief.  I therefore went to Kentucky in  the  latter part of
October, taking with me  two experienced  surgeons, Drs. W.  M.
Prentice and A. N. Read, both of Ohio.
  We were most cordially greeted on  our  arrival by the Rev. J.
H.  Heywood, who had been since June an Associate member of
the Commission.  A meeting was at once  called  at  his house,
where a local  Commission was organized,  composed of men well
known for their intelligence and  patriotism throughout the West.
A depot was  immediately established, the cooperation of the loyal
ladies of Louisville  secured, and a  course  of  usefulness entered
upon which has been continued with unabated ardor  and constantly
increasing success up to the present time.
  Though but  incidental  to the  subject matter of  this Report, I
cannot  refrain from  expressing  my admiration for  the  fervent
loyalty  exhibited  both in actions and words  by  the many  dis-
tinguished citizens  of  Ketucky  which it was my  pleasure to
meet.   In their patriotic devotion the greatest sacrifices have been
cheerfully made, and the strongest ties of nature and affection un-
hesitatingly severed.  The virtues of these noble men and women,
burnished by the bitterest trials humanity can  suffer, shine with a
lustre which  must be seen to be appreciated.   My visit to Ken-
tucky has been the saddest and yet most hope-inspiring episode of
my experience  in this fratricidal war,  and  I am sure I shall  be
pardoned for  thus alluding to the instances of  lofty self-consecra-
tion which I  have witnessed.
  At  my instance the  energies of the  Louisville Commission and
the ladies cooperating with them,  were  first  directed to the supply
of the pressing wants of  the  Tennessee and Kentucky troops, of
warm and comfortable clothing; promising, as I did, to supply all
needed  hospital stores from the ample resources of the Soldiers'
Aid Society of  Cleveland, unreservedly placed  at my disposal.   I 
19
found the medical directorship of the department of the Cumber-
land in the able hands of Dr. Rob. Murray, U. S. A., a gentleman
of large views, fully alive to his responsibilities, but heavily bur-
dened with his cares and duties.   By him we were cordially re-
ceived, and  our proffered aid  gratefully accepted.   On his requi-
sition and that of the President of the  Louisville Commission, Dr.
T. S. Bell,  over two thousand sets of hospital bedding and cloth-
ing were at once forwarded to this point by the  Cleveland Aid
Society.  The hospitals  in Louisville  were at this time  greatly
crowded by the  sick  rapidly concentrating there from the differ-
ent columns of Gen. Sherman's command; were defective in many
particulars, and wanting in many things essential to the well-being
of their inmates.  A portion of these wants were  supplied by the
means already detailed, and the necessary changes and expansions
of the hospital  system  were  being as rapidly and thoroughly
effected by the Medical Director as  could  be  done with the means
at his command.  There, as elsewhere at the West, the entire  ab-
sence of buildings well adapted to  hospital purposes must forbid
the hope that the general hospitals can ever be all that could be
desired.
   On acquainting myself with the  distribution of the troops in
Kentucky, Dr. Read  was sent to examine into the condition and
wants  of those stationed on the line  of the  Nashville Railroad,
south from  Louisville, and such as were located  along the Ohio,
west from Louisville and east of Paducah.   Dr. Prentice mean-
while, was requested to inspect the columns of Gen. Thomas, south
from  Lexington,  and that of  Gen.  Nelson, in the valley of the
Licking.  From these gentlemen requisitions were received from
time to time for the supply of wants detected in  the camps and
hospitals which they visited.   These requisitions  were promptly
filled, and  during the month  of November more than a hundred
boxes of hospital stores were  forwarded to Kentucky from Cleve-
land alone; and in addition large contributions were made by the
patriotic ladies of Columbus, 0., and Detroit, Mich.  Dr. Read fin-
ished his round of inspection in about  three  weeks, forwarded de-
tailed reports of twenty-four  regiments,  and a summary of his
observations, from which I give the following extracts :
   " As  you requested, I have inspected  the U. S. troops in the
Western Department .-of the Cumberland.        *      *       * 
20
  " In making  these  inspection  returns, it gives  me  pleasure to
Btate  to you that I have been  received everywhere kindly and
courteously.
  Brig. General McCook gave me an  introduction to his Brigade
Surgeons, Drs. Meylet and Chambers, Avho entered cordially into
the objects  of  my mission,  and  so far as they could find time
accompanied me in my inspections at Camp Nevin ;  and otherwise
rendered me all the aid in their power.
  They expressed themselves as being  greatly aided in their duties
by my visit, from my efforts  to co-operate with them in a common
object.
  Gens. Johnson, Wood, Rosseau and  Neigle, of Camp Nevin, and
Gen. Hazzard, of Camp Holman, furnished me with an attendant
to each of the regiments in their respective brigades, and " furthered
the inquiries and objects of my mission to the utmost of their ability."
  The officers  and the  Medical Staff  of  the  regiments visited
received  me as one who was  working  with them for a common
object.
  The manner of my examinations was as  follows: after an intro-
duction to the commanding officer and the Surgeons, I asked that,
if it would in no respect interfere with military duties, the Captains
of the companies might be called, and that I might  be introduced
to them.  After the introduction, I stated to them, in few words,
the object of my visit, and asked them to go Avith me to the tents
of their respective  companies—then to return and listen to the
questions I, was required to answer.
   They were always courteous, and usually showed a commendable
desire to learn their duties more  perfectly.  They often asked me
for a copy  of  the inspection returns, that they  might have the
benefit of the suggestions made by those questions.
   After  asking and answering  those which  had  reference more
particularly to the duties of the Captains,  I thanked them for the
kind manner in which they had given me aid, and detained them
no longer.
   I then with the  Surgeons  visited the sink,  the hospital, the
sutler's stores, and Commissary Department.
   Returning to the Colonel's tent  (unless, as was  frequently the
case, he.accompanied me in these visits), I made to him and to the
 Surgeons such suggestions as seemed necessary. 
21
  As the result of these visits of inspection, I will  give you some
of the  special characteristics of  each regiment, where I  found
anything  of  interest, which may not  be found  in my printed
reports.
                       ------  Regiment.
  I  found camp streets, tents,  spaces between tents, drains, and
edges of the  tents, filthy.  Refuse slops were buried in trenches!
but the trenches were nearly filled, before the dirt was filled in.
  The men were  undisciplined.  The horses  tied very near the
tents, and their dung not  removed.   The cooking  bad; the men
dirty.   In short,  by want of cleanliness and attention  to the
requirements of civilized life, the men were in danger of losing all
self-respect.
  But I am glad to be able to add to this  unpleasant statement of
affairs, that I passed through the camp some  days after—that I
again saw the Colonel, the Surgeon and one of the Captains, who
represented that they were making improvements, and assured  me
they would continue to do so.   I can  add my testimony to theirs
that there was a decided improvement since my visit.
                   Sixth Indiana Regiment,
  This was  in excellent condition.   The  Colonel is  a gentleman
and a soldier, alive and active  in  his  duties.   The Surgeon,  Dr.
Chas. S. Schussler, is eminently well qualified,-and devotes him-
self untiringly to his duties.  Guided by science, he is saving many
lives by taking those  precautions necessary to prevent sickness.
Means  were used to promote cheerfulness, and the men were in
good spirits.
  The  streets  of the camp  are beautifully  turnpiked and  Avell
drained.  The tents are  struck or raised  from the bottom often.
The slops are carefully disposed of, so as not to  be  in the least
offensive, the men clean,  their clothing well washed.  The sink
was on the leeward side of  the camp, in  the  woods, at a  proper
distance, neither too far nor too near.   A  nice walk was cut to it
through the woods, trees cut close to the ground, and felled in
such a  manner as to make even a beautiful fence  on each side of
the  walk.
  Most of the companies  have  built  log houses,  with fire-places
and chimneys, for kitchens, well  adapted for the use designed. 
22
But two men were so sick but that they would join their regiment
were an order  given  to march—one of these disabled by an acci-
dental wound,  the other sick with fever.
                      ------ Regiment.
  Tents crowded, only one foot apart in the rows.  Men had not
each two shirts;  blankets  very poor; scraps of food between the
tents; sink sometimes used.  Men would obtain ardent spirits,
and were sent to the  guard-house in consequence of intoxication—
were  allowed  access  to pedlars, from whom they obtained pies,
cakes and fruits, to their injury.
       ******

                Thirty-Second Indiana Regiment.
  Col. Willjck's German regiment, after recruiting commenced,
in twelve  days  were mustered into service.  The men are well
disciplined and cleanly; police of the camp excellent.   The Sur-
geon  assured  me that the men, as a rnle, wash their  feet, face,
neck  and hands once a day, and bathe once a week.
  A regimental  fund has  besn established after this manner: the
regiment has one-half the  profits of the sutler.
  A shoemaker and  a tailor are attached to each company.  The
men drink moderately of lager beer, and draw one pint of whiskey
each morning  for every twelve men.
                     ------Ohio Regiment.
  Were furnished with poor, very light blankets.   Nine of them
had no overcoats.  The body coat was a light summer blouse—
pants of the same quality.  Men cooked by mess, poorly;. bread
hard, old, poor.
                     ■■'      Ohio Regiment.
   Camp in fair condition, men in good health, hut had no over-
 coats, and no  body coats but a light blouse.
                Thirty-Fourth Illinois Regiment.
   Health  unusually good—the medical  staff  very efficient.  The
 regiment had been  systematically vaccinated—the only one  I
 found that had  been.  The camp and men were unusually cleanly
 —sink  in excellent condition.  The dung made by the horses was
 removed, so  as not to he  in the least offensive.   The hospital* in 
23
excellent condition, had comfortable beds, (the only one I  found
Avhich  had,)  and a  supply of delicacies and  cordials.  It  was
almost a luxury to be sick there compared with most regimental
hospitals.
                  ------ Indiana Regiment.
  Was  encamped  on a low bottom-land, the surface  dry,  but
unfavorable for drainage; the tents crowded  in  the rows; too
many men  in a  tent; the police of the camp not as good as the
average ; and although  there was not  a greater number sick than
in many other  camps,  the  sickness was  more severe, 'and  was
increasing.   In looking  for the cause, we could not find it  in the
water used, in the cooking, nor in the  police of the camp; but on
digging, at from one to two feet, in all parts of the camp, we found
water.  The  dampness  was  such, that it would gather in large
drops upon the lower side of  the rubber blankets used by the  men
while  sleeping. The Surgeons of  the  regiment,  with Brigade
Surgeons Mylert and Chambers, united with me in a request to
Gen.  McCook,  that,  if practicable,  the regiment might be moved.
The General  received the request very cordially, and immediately
ordered the removal to  drier, higher, and better-aired grounds.  I
have no doubt but by this the  men will be greatly benefitted and
many lives saved.
        *******

Seventy-Seventh, Seventy-Eighth and Seventy-Ninth Pennsylvania
                          Regiments.
In  good health and well supplied with everything but  bread.
They were,  mostly, drawing flour instead  of  bread,  and were
using flap-jacks—flour mixed with water and fried in grease ;  this,
if continued, must produce sickness.
                  Ninth Michigan Regiment.
  Men suffering severely from measles.  They were exhausted by
hard Avork in the rain and loss of sleep on their march to  camp;
and I have no doubt but the severity,  if not  the number, of cases
was  increased by that  cause.  300 were sick in hospital, being in
different houses, with bad ventilation, no beds, and no means of
changing the clothing  worn in  camp.  (Wants  since fully  sup-
plied.—N.) 
24
                       ------Regiment.
  Camp unclean ; been occupied but a week or ten days;  expect-
ing to move soon. The sink used but a little more than the ground
in the vicinity, from which there is a gentle slope to a small stream
of surface water some few yards distant, from which  all  the Avater
used in camp is obtained.   It would be hardly extravagant to say
that the sink was the fountain-head of the  stream.  The  men com-
plained, and had the promise of moving to a better location.

                  ------Indiana Regiment.
  Police good.   Cooking done  by Company cooks, three cooks to
each Company, changing one every two weeks; cooking done bet-
ter than usual.   Measels have been prevalent, but most have  now
had them and are convalescent.

                 Nineteenth Illinois Regiment.

  W. Bogue, the Surgeon, and also the Assistant Surgeon, are  both
well qualified for their duties.  The troops are in good  condition,
encamped on the side of a hill,  the Colonel's tent being at the top,
overlooking the encampment.^ Natural drainage so good that  very
little artificial was necessary.  The sick in the  hospital Avere well
cared for, and although two  were very sick they would probably
recover.   The boys  had taken possession of the Elisabethtown
Democrat, a  secesh  paper, and in  its place were publishing the
Zouave Gazette, a paper of  "decided Union tendencies."
  During the three weeks I Avas engaged in this inspection, I vis-
ited twenty-four regiments, two companies of artillery, three parts
of regiments of infantry and two companies of cavalry.   The  most
important results of  the inspection are :
   1st. Calling the attention of  the troops to the necessity of a bet-
    system of camp police.
   2d.  Endeavoring to secure better cooking of food and  making of
coffee, substituting for the wasteful and unhealthy but too common
mode of cooking by frying, the better mode of stewing  or making
soups.
   3d. Calling the attention of the surgeons to the importance of
systematic vaccination, which they seemed to feel, and which they
promised to attend to  as soon as they could obtain the virus. 
25
  4th. Urging  the  men, through  the  captains of  companies, to
greater cleanliness, both of their tents and persons.
  There seems  to be difficulties in the way of general bathing, or
washing the body, in cold weather.
  5th. Securing the  removal of the Thirtieth and Thirty-Ninth
Indiana Regiments from unhealthy to more healthy camps.
  6th. An additional stimulus was given  to all  in authority to
attain to a more thorough police of the camps.
  This was evinced by the interest manifested by all in command
in the object of my visit, and especially by an  order  issued by
Brigadier-General Wood to each regiment in his command, calling
their attention to the  importance of the subject and requiring its
better performance.
  Before closing this Report, I would remark that the soldiers suf-
fer from what they find at the Sutlers'.   They spend their money
tor  much that  injures them.   The medical men whom I met were
decidedly of this opinion, as  were also many of the commanding
officers.  Can anything be done to prevent this source  of disease
and waste  of money, at the same  time  the soldier to be supplied
with the few articles needed, such as stationery and tobacco ?"
  Dr.  Prentice found the troops  in his district  much  scattered,
difficult of access, and in constant motion.  Up to  the present time
no detailed report of their condition has reached me, though I have
received several requisitions  for hospital stores, which have been
filled,  and  letters attesting his earnestness and success.
  The forced marches performed by the columns of Gens. Nelson
and Thomas have been peculiarly severe and trying, and by their
influence  the  number of sick in each  command' was suddenly
doubled.  While I  will  not  pretend to  pass judgment upon the
military necessity in each  case, I am constrained to say that only
the most urgent need could justify the infliction of so much suffer-
ing, disease and death upon our troops.
  Through the agency of Dr. P. and the exertion of Dr. Bell, of
Louisville, a society for the relief of the wants of the troops has
been  organized  at Lexington, Avhere Dr. P. was  most kindly re-
ceived, and in many Avays aided in the  performance of his duties.
To  Dr. Chipley, the  Superintendent of  the Insane Asylum, and
Mr. James Harper, the Agent of Adams Express, he reports him-
self under peculiar obligations. 
26
  In a letter just received, Dr: Prentice says :
  " I give you the folloAving list of hospitals which I have visited,
and the larger part of which  I have furnished with bedding and
clothing  received from Soldiers' Aid Societies in Ohio and Ken-
tucky :
    Frankfort__________   60 Patients,  furnished supplies.
    Lexington_________220    do.       do.      do.
    Nicholasville______   30     do.        do.      do.
    Camp Dick Robinson  200     do.        do.      do.
    Brick Church______100     do.        do,      do.
    Lancaster_________   30     do.        do.      do.
    Crab Orchard______440     do.        do.      do.
    London------____620     do.        do.      do. in part.
    Mt.  Vernon  ______   72     do.        do.      do.
    Stanford----------   49     do.        do.      do.
    Danville--------    185     do.       do.      do.
    Baptist Church-----   42     do.       do.      do.
    Lebanon__________  320     do.       do.      do.
    New Haven_______   93     do.       do.      do.
    Louisville_________1000     do.       do.      do. in part.
  The greater portion of  the sick were in badly ventilated build-
 ings.   I have made it a point  to visit every  part of each, and give
my personal attention to  the sinks, Avater,  cooking arrangements,
cleanliness  of the patients, clothing  and bedding,  police  of the
hospital,  &c; when in tents, the drainage, &c.  The latter, together
with the sinks for hospital patients, have been much neglected.   I
am happy to say  that on the second visit made, there was usually
a decided change for the better.
  One fruitful source of sickness among the soldiers, is the  want
of ventilation of the tents; among those I have inspected,  the wedge
tent predominating.   I have  recommended the officers to attend
in person to the ventilation at night, also the airing them as often
as twice  a week,  and I am happy to say the report of the surgeon,
Avhere this has been done, shows the sickness and mortality to have
decreased.
  At Lebanon and Springfield I found nine cases of small pox, and
I have urged upon the surgeons of regiments the necessity of gene-
ral vaccination, but the difficulty in procuring vaccine matter  for
so many regiments, has prevented, in many cases, its being done.
 I sent to friends in Ohio and procured some, and at this date, most
 of those in  Gen.  Thomas' division bave  been, or are being vaccin-
 ated.   The  Medical  Director has been unable to procure one-half 
27
that was needed."  (I have since supplied large quantities to Ken-
tucky.—N)
  With the number of troops now occupying Kentucky, and with
the probability that this will be the scene of active operations du-
ring the winter, it seems to me desirable that two  good inspectors
should be  constantly employed in  this field.   By this  means, and
the efficient measures of relief at our command, we may confidently
anticipate that the istances of destitution and suffering, hitherto so
common, may be Avholly prevented or made extremely rare.

                          ILLINOIS.
  In Illinois, I have the  pleasure of reporting a general and  most
enthusiastic devotion to the cause of the Government in the present
war; the enlistment and  generally thorough equipment of  over
50,000 troops; the most  careful scrutiny into the qualifications of
Surgeons by an excellent Medical Board; and an efficient and well-
organized system of  co-operation with the Sanitary Commission in
the work for  which it was created.  A large number of the troops
of this  State have been inspected  by myself, either in their camps
of instruction or in the field,  and I can bear testimony to the care
Avhich has supervised their organization arid  equipment, their
admirable  physique,  good behavior,  and soldierly bearing.   The
excellent sanitary condition of those at Camp Butler, near Spring-
field, under the medical care of Dr. Lord, merits special notice,
and reflects  great credit  on  his thoroughness.   During  the  two
months preceding my visit, in a force of five thousand men, there
had been  but three  deaths from  disease, and an average of less
than thirty cases  in hospital.   It is but just to state, also, that the
good condition of these  troops  is in a great measure due to the
assiduous attention to their wants by Oapt. Pitcher, U. S. A., an
energetic, experienced and enlightened officer, for a long time in
command of  this  camp.
  At Chicago a Branch Commission has  been formed, composed of
earnest, philanthropic  men, who have already given evidence of
their energy by the organization of a complete system for the sup-
ply of the wants of the soldiers; have established a depot; issued
an  appeal  to  the public; have  collected and distributed a large
amount of hospital  stores; and have  sent  committees  of their
number to inspect  the camps  and  hospitals at Paducah,. Cairo, 
28
Bird's Point, St. Louis, and other places in the interior of Missouri.
The  report of one of these committees  has been authorized as a
document of  our  Commission, and affords  conclusive evidence of
the zeal and  intelligence of  the  authors.  I was present at the
organization  of the  Chicago  Commission, and have  subsequently
been an eye-witness  of the  working of their  system, and bear
cheerful testimony to the Avisdom  and activity which have charac-
terized their operations.  Of this Commission, Hon. Mark Skinner
is President, E. W. Blatchford Corresponding,  and H. E.  Seelye
Recording Secretary.
  The  condition of the  troops in the vicinity of Cairo is so fully
described in  the   report  of  Messrs. Patton and Isham, of the
Chicago Branch Commission,  and in that prepared  by Dr. Aig-
ner, hereAvith  given, that nothing more remains for me to say
upon that subject.   Of the operations of  the Sanitary Commission
at this  point, I will  say briefly that  Dr. A. has continued during
the three months passed, the  important  and  acceptable duties to
which  I havre alluded in my former report.  Through his agency
much has been done to improve the sanitary condition of the forces
stationed in this vicinity,  both  by the exercise  of his well-earned
influence and  the distribution of  a very large amount of hospital
stores,  received from Chicago, Cleveland, and the Woman's Central
Association of New  York.  In the performance  of  his duties as
Sanitary Inspector, Dr. A. has enjoyed the cordial sympathy and
efficient aid of Gen. U. S. Grant,  of whose intelligent appreciation
of his  mission and unvarying kindness he speaks in  the strongest
terms.   With Drs. Simmons  and  Taggart, U. S. A., the Medical
Director and  Purveyor, his relations have  always been of a most
friendly character, and   from  these  gentlemen  he  has  met a
spirit of hearty co-operation which has rendered their intercourse
agreeable, and materially facilitated a thorough performance of the
duties  of each.
                  DR.  AIGNERS REPORT.

  " Being about to bring my labors as Camp and Hospital Inspector
of the Sanitary Commission in this Department, to a close, after a
service of three months, I transmit you the following synopsis of
my observation as recorded in my detailed inspection returns.
  Such a review cannot fail to present many defects in regard to 
29
completeness  and accuracy  of statistics, from  the nature of the
case, and the short-comings of the observer.  The  different bodies
of troops inspected  being scattered over a  large  extent of terri-
tory, their condition had  to be investigated  at different, periods of
time,  and their constant changes in location and number, as well
as their very progress from  the state of inexperienced organiza-
tions of raw recruits, to well-disciplined corps of an effective army,
make a statement Avhich was perfectly correct as to the condition
of a regiment several weeks ago, appear false or unjust if we apply
it to its actual state to-day.   Keeping these difficulties and dis-
turbing influences in mind, I shall attempt to give you a descrip-
tion of the average condition  of the volunteer forces which it has
been my duty to inspect from the beginning of August to the end
of October, referring you to my special returns for details recorded
at given days and places.

   1.—Description and General Character of Troops Inspected.
   The troops  inspected by me, are stationed in Cairo and  Mound
City,  111., Bird's  Point and Cape Girardeau, Mo.,  Fort Holt and
Paducah, Ky., in the south-east division of  the Department of the
West.   The bodies inspected are, twenty-three regiments of infant-
ry, a regiment and several detached companies of cavalry, (fifteen
altogether) and ten  companies of  artillery, forming two divisions
under  Gens.  U.  S. Grant and  Chas. F.  Smith,  or seven brigades
under  Gens.  McClernand, Paine, L. Wallace, and Cols. Cook,
Oglesby, Wm.  H. Wallace  and  Plummer.   All these troops,
with the exception of two regiments of  infantry each,  from *lVIis-
souri, Indiana and IoAva, are recruited in Illinois, forming one-half
the troops furnished by that State, actually in the field.   The
predominating nativity is American, only a few regiments contain-
ing a considerable quota of Germans ; for instance the 9th Illinois,
while the foreign element in the rest is insignificrntly small, if we
except some cavalry  and artillery companies.  The 7th, 8th,  9th,
10th, 11th and I2th  Illinois, and the 7th Indiana,  Avere originally
three-months  regiments,  nearly all the  officers  and  many of the
men re-enlisting for the war after the expiration of their first term.
The others were organized and  mustered'into  U. S. service for
three years,  at different periods of time, from May to  September.
The 7th, 8th, 9th, 10th, ilth, 12th, 18th and 22d Illinois, and'four 
30
companies  of  artillery and cavalry, Avere already here when I
arrived ; the others came  from different camps  of instruction in
their respective states, or active service in Missouri, by a more or
less direct route.   The present strength of the  whole, is in the
neighborhood of 19,000 men; considerably higher than the aggre-
gate of all  regiments and detached companies at  the time of  their
being mustered in.
                 2.—Character of Camp Sites.
  The camp sites were in all cases selected by the commanders of
the respective divisions  or brigades, military considerations out-
weighing all others in most instances.   " Military necessity" was
also the frequent excuse for the  otherwise  unwarrantable practice
of making  a newly-arrived regiment occupy the  site just vacated
by one ordered off—a practice which led to some bad consequences
in a sauitary point of view, with several  regiments encamped  on
Bird's Point (18th, 20th and  22d.) Excepting the camps of the
7th Illinois and  11th Missouri  at Cape  Girardeau, I found those
of all  regiments on level ground,  on tha banks of the Mississippi
and Ohio, or between the levees at Cairo;  more or less unfavora-
ble for surface drainage;  unshaded, except those  at Paducah, and
one (11th 111.) at Bird's Point;  sheltered from the  prevailing winds
except two at  Fort Holt, and one (11th Mo.) at  Cape Girardeau;
with a soil and sub-soil of  sand and clay mixed in uarious propor-
tions,  easily permeable to water, (except to a certain degree,  40th
111. and 7th Ind. at Paducah,)  but unfortunately, all exposed  in
a high degree  to the poison of malaria.   A glance at  the annexed
synopsis  of the  consolidated reports of sick and wounded, will
show you the consequences  of this exposure.  As you have investi-
gated personally the character of soil and climate  in those portions
of the Ohio and Mississippi Valleys, I need not mention the local
conditions ot malaria,  in this short and hurried review.

           3.—Arrangement and Condition of Camps.
  I found the camps arranged mainly in accordance with the army
regulation, wherever  the  locality  and  the .circumstances would
permit it.  The tetits were, on  an average,  nine yards apart in the
roAvs,  the artificial drainage systematic and complete, (except 7th
Iowa,  8th  Mo.,  23d  Indiana,  18th, 22d, 40th and 41st 111.) with 
31
straight  drains  averaging four inches in depth and six in width,
around tents,  deeper and wider mains,  kept tolerably clean,  but
rarely with a good  outlet.   I  found the  tent floors  almost always
very dry, even after heavy  rains; a good feature, less due to sys-
tematic drainage and other care, than to the above-mentioned very
porous nature of  the  soil.  In many instances, the commanding
officers told me that their men were taught to drain their tents by
an inundating  shower.  Necessity is the best, though not always
the mildest and cheapest  teacher of sanitary measures, as of so
many other things.  Camp  streets,  edges of, and  spaces between
tents very clean in most regiments, except 8th and 11th Mo., 2d and
7th Iowa, 18th, 22d, 40th and 41st 111., at different periods of time.
     4.—Tents,  their Character,  Ventilation and Management.
  The two Missouri, 8th and  11th Illinois regiments are provided
with a large number of Fremont tents, the.  7th 111. Avith Avail, and
the 41st  111. with English or oval tents; the  rest are, for the men, a
small  Avedge tent,  furnished by their respective states, of various
sizes, but invariably too small for the number of men crowded into
them,  and of inferior material.  Commissioned  and  non-commis-
sioned officers in all the regiments, use mostly the wall,  some the
Sibley or  Fremont, but none  the  wedge tent.  I  look  upon this
description of tent (wedge) and  its  almost universal use for  the
men as the more unfortunate because the rule for striking the tents
for the purposes of ventilation and  cleaning, is still not frequently
enough practiced by most regiments.  The  skirts of the wall, Fre-
mont and Sibley tents  can be raised so easily that the  men will do
it of their own accord, and  this practice  furnishes a tolerably good
substitute  for striking the tents, as far as airing and' drying of the
floors is concerned.  The wedge tent does not admit of it, and this
defect, together with  its insufficient size, ought to condemn its use
altogether.  The usual average of men  to  a 7x9x7 wedge  tent  is
five.  The care of the ventilation of tents at nights, is left in almost
all cases to the  men.  During the last week of  October the troops
around Cairo received orders to construct barracks  of logs  and
boards, for winter quarters, and three regiments have moved  into
the old huts in Camp  Defiance, formerly occupied by the 8th. 9th
and  10th 111.   The 9th and 10th 111. have been under tents only a
short time. 
32
                  5.—Bedding a7id Clothing.
  During August and  September the men of almost all  the  regi-
ments slept on the bare ground, straAV or hay being  scarce, and
lumber not to be had, on account of  Avant of funds in the hands of
the Quartermaster.  With the cool weather of October came a great
demand for these articles, but  the supply was insufficient;  and in
many regiments the men suffered from cold during the night.   The
great majority of the men  have two shirts and  one  blanket;  very
few can make a change of clothing at night.  The very poor blankets
furnished  to most regiments at first, have nearly in all given place
to more serviceable ones ; but even these are inferior in Aveight and
texture compared Avith the regular  U. S. A. blankets.  With very
few exceptions, all companies are provided with light-blue overcoats
of good quality.   The quality of the uniform coats and troAvsers is
very fair, although the  neAv are  not in  all instances an improvement
over the old ones.  The 7th Indiana, 7th, 8th, 9th, 10th, 11th, 12th,
18th, and  22d Illinois, with some artillery companies, Avear gray,
the rest blue uniforms.  In the cut of the body coats great variations
have  been indulged.   From the immense  number  of photograph
and  ambrotype  likenesses Avhich the "boys" have made of them-
selves when they receive  their  uniforms, I  conclude  that they take
considerable pride in them, at least  as long as they are new; but I
am sorry  to  see that  only few volunteers understand  the great
military art of making an old uniform appear as neat as a new  one.
The removal of  dust from their clothing is a Aveekly, not a daily,
practice with most men, the inspection for that purpose being made
too rarely and negligently by regimental and company commanders.
The underclothing is regularly washed once a Aveek in all regiments.
                   6.— Personal Cleanliness.
  During the warm weather the men bathed and washed frequently,
the facilities for ablution in this Department being unsurpassed.
In very feAV regiments,  however, was a regular practice and inspec-
tion by officers instituted  to that effect.   The washing of the feet is
not regularly looked after by the commissioned or non-commissioned
officers of  any regimeht.   Body lice have  troubled but  very few
men ; fleas, on the contrary, have been, and still  are a scourge of all
our  camps.  On  the whole, the volunteers keep their persons as
clean as the generality of people in the localities they come from. 
33
                   7.^—Cleanliness of  Camps.
  The camps present generally a very clean appearance as far ;aS
the streets between the tents are concerned.   The rules  in  regard
to 'the daily collection and burial of kitchen and mess refuse, horse
dung, etc., are not strictly kept by any regiments Avith the  excep-
tion of perhaps two or three.  The privies are all at a proper dis-
tance from camps, and properly constructed, but the great difficulty
is to make all the men go there and nowhere  else at all times.   In
three or four regiments the  men are prevented from easing  them-
selves elsewhere by the guards, and rigidly punished for  any viola-
tion of this regulation; but  the territory surrounding the camps of
all  others presents many evidences of gross neglect of camp police,
and gives mamy a regiment, otherwise well  reputed, a  bad odor.
Separate  officers' sinks I have frequently heard  spoken of, but I
must confess that I never saw one except in  some buildings which
served  as head-quarters to some commander.   The  horses and
mules are almost invariably kept too near the camps, and the daily
removal of their dung is a myth dreamed of only by the  authors.
of the army regulations and the  Sanitary Commission Inspectors.
                 8-.=-=- Water, Source and  Quality.
  All regiments  in Cairo, Mound City, Fort Holt and Birds Point
drink Ohio or Mississippi water;  in Cape Girardeau and Paducah,
well  or spring water is used by most regiments.  The Avater of
some of the latter is deemed unwholesome by some surgeons, but I
am  not aAvare of any scientific  investigations of the qualities of the-
Water procured from them having been made.  The free  use of ice,
which was very liberally furnished to all the troops during the hot
season, has, in my opinion, had more to do with the prevalence of
certain diseases in July, August and September, than any unwhole-
some  character of the water used as a drink.
                   9.—Rations and Choking.
  The requisitions for the rations as® in all regiments made by the
captains, who, in  many companies, mess with the men, and then,
of course, examine and taste the food'for the latter.  Even where
this is not the case, I have never heard any complaints by the men
regarding the quantity or quality of the rations.   Instead of want
there is waste in many cases,  Noav and then the men will grumble
                  3 
34
 at the uniformity of their meals, which they try to vary by pur-
 chasing pies or fruit out of their private purse ; but even this fault-
 finding is disappearing  gradually, as the several companies learn
 how to save and trade off their surplus rations for articles of fa»od
 not furnished  by government.  I can state from personal inquiry
 and observation, that every well man in this force gets fresh meat
 three times and fresh vegetables twice if not oftener, a week, while
 he has his choice between fresh and hard bread, every day.   This
 has  been the  case, not during the entire period of  the  war,  but
 during nearly the  whole of my stay here, and consequently the
 monthly reports of surgeons have a steady diminution of scurvy
 •until September, Avhen Ave  find only one man in 9,000  afflicted
 with that scourge  of armies.  The cooking is done, Avith very fevr
 exceptions, on 'the unbroken ground, but in all regiments I found
 the ingenuity  of soldiers at  work constructing hearths out of rail-
 road iron,  stones, logs,  &c, facilitating the operations of  cooks.
 Nearly one-half of all the companies have permanent cooks,  and
 the principle of rotation in  office is gradually dying out as  far as
 that of cook  is concerned.  How is the food generally cooked ?
 Very fairly,.for men who are  satisfied or have to be satisfied with
 such materials as the Government furnishes.   There are many men
 and women ' who would  not eat it unless dying from, starvation;
 but these people are fortunately not soldiers ;  while many a  labor-
 ing man's family would regard the common diet of our volunteers
 as a holiday feast.   I have enjoyed many a soldier's-dinner with
relish, except  their coffee, which is uniformly bad (when made)
 and such dainties as crackers fried in fat of pork, or cakes made of
 ■flour and water,  dainties which the men will persist in preparing
■ and eating in  spite of the  remonstrances of their surgeons  and
 officers.  The  bread is baked by contract bakers, or got from town
 bakeries in trade for rations ; it is, as a  rule,  very  good.   The use
 of tea instead of coffee, is gaining ground in most  regiments, by
 the efforts of surgeons.

                     10.—Company Fund.

  I have found very few captains who had a clear  idea  of such an
 arrangement, and even now, the number of companies in which it
 has been established, is very small. 
35
                            11.—Sutlers.
     All regiments have sutlers with the exception of two, appointed
  by the colonels, (except in the 8th 111.)  The prices of articles sold
> by them are fixed by a council of administration in about one-half
  of all the regiments.  I met about a dozen of regimental staff offi-
  cers who heard of such a council for the  first time, when I asked
  them if there was such an institution in their regiments.
                         12.—Intoxication.
     The sale  of ardent spirits is now prohibited in all the camps by
  general orders; formerly, some sutlers were  allowed to sell them
  to the men, with  a permission  from their captain.  The habit  of
  getting them  out  of camp, has been pretty  effectually broken by
  general orders, closing all  the bars in Cairo,  Paducah,  &c.   These
  orders came very  timely,  as all  the regiments are being paid off,
  and  the temptation of spending money in drink seems  to be much
  stronger among the men  than  one  might  suppose from the asser-
  tions of regimental and company commanders in relation  to the
  temperate  habits of their men.   The number of men sent  to the
  guard-house is very small in all regiments, and intoxication is the
  cause in most  instances.   I frequently had to express my astonish-
  ment at the small  numbers given as the average of arrests.   I am,
  however, not yet prepared to decide whether this startling fact is
  due to the excellent  discipline and subordination of the men, or to
  excessive mildness of the  officers, many of whom are decidedly
  more fond of popularity with the men and their friends at  home,
  than  of  rigid  discipline.   Pedlars of eatables, and of  non-intoxi-
  cating drinks,  are allowed access to the men in most camps.  I
  have  endeavored,  and  I believe successfully in most instances,  to
  introduce the  principle of inspecting their articles before  giving
  them permission to sell, into nearly all the camps.
                     13,—Absences from Camp.
    Officers and men are kept strictly in camp,  e'xcept when on duty
  or leave of absence, and the number of such leaves does not  exceed
  on an average, four to a company.
                         14.—Recreation.
    The spirits of the men  are excellent, as a general thing,  but as
  to the means of keeping them ia that state, they are left entirely 
36
to their own  resources.  Bands of music,  all  of very primitive
skill in execution, are found in most regiments.  The other means,
hoAvever, usually  resorted to by civilized society,  to  cheer  up
depressed spirits, are used either not at all, or at least not system- ,»
atically.
                     15.—Benefit Societies.
  The  spirit  of benevolence  and  mutual  assistance manifested
itself, up to this time, only in individuals, and has  not yet assumed
the form of an organization  in  any body of this command.   The
delayed payment of the troops has  offered me very few opportuni-
ties to judge of the saving propensities of our regiments  here, but
I understand  that  Adams Express Co. has  transmitted  since the
first pay-day,  to the friends  whom  the soldiers left behind them,
small sums of  money, varying from  fifteen to fifty dollars, in such
numbers that the total amounts to fully one-half the  aggregate
paid to all the soldiers here.   It is  believed that two-thirds of the
men send home at least half their pay.  The allotment  system is
favorably received by all officers to  whom I mentioned it, but has,
as yet, not been practically carried  out.

                        16.—Discipline.
  The general discipline of the  troops  under my observation,  is
slowly but steadily improving.  The " armed mob " is being trans-
formed into an efficient  army, although an eye accustomed to the
looks of well educated and drilled soldiers, would still find many
faults  and deficiencies.   Our officers are as far removed from a
punctilious enforcement  of the outward signs of military discipline,
as the men from their ready and constant  observation.  The rol-
licking independence of these youthful spirits, is too strong for the
straight jacket of any martinet.
  I have seen brigade parading but  not  manceuvering, in this
department; the  batallion  drill  of most regiments  is creditable,
and what is still better, our troops have been victorious in all
conflicts with the enemy in which they were engaged.
             17.—Medical Inspection on Enlistment.
  All  the regiments, except  those  organized in  Missouri,  have
uudergone a medical inspection  before entering  the U. S. service,
hy surgeons employed for that  purpose by their respective State 
37
 governments;  but it was not thorough, and the subsequent inspec-
 tions by the regimental surgeons were in almost all cases conducted
 with similar  negligence.  This explains the occurrence of very
 numerous applications for discharge on account of disability not
 acquired in the service—applications granted only in a small pro-
 portion, for fear of reducing the strength of regiments.  From my
 own observations in camps and hospitals, I must come to the con-
 clusion that one-tenth of all  the  men would  be rejected  on a
 thorough  and  rigid examination.   Up to this  date, (Nov.  1st)
 re-vaccination after enlistment has not been systematically prac-
 tised in a single regiment.
                      18.—Medical Officers.
   All the regimental  medical  officers, excepting those of the 8th
 and 11th  Missouri,  7th and  23d Indiana, 30th and 31st Illinois
 Regiments, have undergone  an examination  by Medical Boards
 appointed by their respective governments  for that purpose.   All
 hold  their commissions from the State  Governors, except  those of
 the two Missouri Regiments.   Most of them have practised in the
 locality where  the  regiment was  recruited,  and  are,  doubtless,
 considered  very good "family doctors" in  their neighborhood.
 The number of thoroughly educated, well qualified and experienced
 Surgeons  among them is, hoAvever,  very small, judging from  their
previous history as  given by themselves, and from what I  have
 seen of, or heard from them in my personal  intercourse Avith them.
 As they  are, with  few  exceptions, the very men to Avhom the
 volunteers would  have applied for assistance in cases of  sickness
 or accident at home, the Government will certainly not be blamed
 by the officers  and men for  employing them as their  medical
 attendants in the  field, no matter what the  value of their services
 may be when judged by the absolute standard of true science.

                19.—Hospitals, Ambulances,  <£c.
  The whole  force described  in Sect.  1, has three general and
twenty-six regimental or corps hospitals.   The general  hospitals
are: one at Cairo, one at Mound City, and one at Paducah.  Of the
last I shall not speak, as it was just being organized at the time of
my visit to the regiments stationed at that place, and has since
been moved from the old Marine Hospital  building into the Court 
38
House, the interior of  which I have not seen.  Brigade Surgeon
Hewitt, the acting Medical Director of the Paducah Division, has
the superintendence of this hospital, at which six Sisters of Charity
act as nurses.
  The general hospital  at Mound City, the largest  and  most
important of the three, is located in a row of twelve brick buildings
of equal size and construction, excepting the first and last, which
form projecting wings; with separate entrances, and no communi-
cation but the newly-constructed wooden balconies in the  rear,
leading to the privies.   The buildings  are three stories  high, with
one room on each floor, 20x75x14, originally intended  for stores.
The twro upper rooms are or will be  used  as wards;  the loAver
for administration or store rooms, &c.   At  present only eight of
these wards are furnished with beds, containing  three hundred
patients.  I say, purposely, furnished with beds, because I saw no
other furniture in them, besides a few camp stools.   Capt. Hawkins,
U. S. A., lately arrived here to superintend the Quartermaster and
Commissary Departments, proceeded to procure everything that his
Departments can furnish to a hospital.  If he keeps this promise,
his arrival will have been a perfect God-send to the medical  officers,
patients and attendants of this hospital, which, from Oct. 1  to Nov.
1, received more than five hundred patients, but not a single article
necessary to the comfort of its patients or the convenience of their
attendants, from the Government besides beds, bedding, cooking
and mess utensils, articles of food and drugs; not even a single
candlestick  could be procured.  This destitution is due to either
the poverty or negligence of the Quartermaster's Department.   A
large quantity of hospital clothing has  been sent to the hospital by
the ladies of New York and Cleveland, through the agency of the
Sanitary Commission.  Brig. Surgeon Franklin and three assist-
ants have at present charge of this hospital.   The general hospital
at Cairo—a new three-story brick building, originally intended for
hospital purposes, and of sufficient dimensions to hold one hundred
and twenty patients—is supplied Avith everything that is absolutely
necessary, and as many comforts as may be reasonably expected in
a military hospital, including donations from the Soldiers' Aid
Society in  Cleveland, and others.   The  number of  patients  at
present under treatment  ranges  from  seventy-five to one hundred
men. 
39
  Of the regimental hospitals, seven are in tents (on  Bird's Point
and  at Fort Holt), the rest in frame  buildings at Cairo, Mound
City, Cape  Girardeau and Paducah; the latter tolerably well suited
for such a purpose in summer, but not in cold weather, being badly
ventilated, and having no proper heating apparatus.  Each hospital
has the proper number of detailed men allowed by the regulations
as nurses;  only ten  have female nurses of Miss Dix's Corps.   The
supply of  medicines and  instruments  is  as liberal  as  the  most
energetic activity and  foresight of a Medical Purveyor can make
it;  that  of sheets,  hospital dresses,  &c,  still deficient in many
regiments.   The U. S.  A. Hospital  Department has supplied a
large number of sheets, bed ticks, pillow ticks  and cases, blankets
(over 2,000) ;  and the  following articles have been distributed by
myself to the hospitals as gifts of patriotic Ladies' Societies: sheets
680, shirts 902, drawers 290, pillows  55,  pillow ticks 90, pillow
cases 456, towels  333, handkerchiefs  168, bed gowns 24, woolen
socks 150,  soft shoes 42, pads 13, bed  ticks 25, two boxes of lint
and bandages, &c.   Jellies and other delicacies are greatly needed
in all the  hospitals, the previous donations of  these articles being
completely exhausted.   Two ambulances  for the Avhole  force and
an  average of two stretchers for each regiment make  up the
apparatus  for  field  service; it is, therefore, no  wonder that the
drilling of the Ambulance Corps has not yet begun in any regiment
or brigade.
                    20.—Prevailing Diseases.

  The prevailing  diseases  during July,  August and September,
were diarrhoea and  dysentery, malarious  fevers and  measles; in
October, malarious  fevers, measles, catarrhal  and rheumatic  affec-
tions.  In August, 310  were sent to general hospital; in September,
603 ;  in October, about  800.   The total of sick men (taking the
regiments  from which complete monthly reports are in my posses-
sion, as a basis of calculation) was in July 2,939, in August 5,820,
in September 9,150, and  in October 8,900;  the  differences being
explained  partially  by fluctuations in  the strength of the force,
partially by the absolute increase in the amount of sickness.   The
number of serious cases in the regimental hospitals is very great.
Most regiments have hospital  accommodations for an average of.
forty patients.  Surgeons and  men are equally averse to availing 
40
themselves of the advantages (?) of the general hospitals;  and as a
rule,  only those  cases  which  cannot be  accommodated in  the
regimental hospital, on account of its being croAvded with patients,
are transferred to general hospital.  In some regiments it has been
the policy of the Surgeons to rid themselves of cases threatening a
fatal  result; hence the great  mortality in general  hospitals  as
compared with the regimental; and  hence again an increased
aversion of the men  against the former.   That this policy has
increased the cost of our Hospital Department enormously, cannot
be denied; but I am inclined to the opinion that it has led to some
good  results, of which I may speak hereafter.   As  soon as the
regiments take the field,  it  will, of  course, have  to be totally
abandoned.   The contagious or  infectious  diseases were  measles,
mumps, and  a few  cases of  typhus.   If Ave except  measles, the
proper precautions were taken to prevent their spreading.
  I have examined the complete morning  reports of eight regi-
ments  for  July, August and  September, from which the  daily
average of sickness (new cases) appear as follows :  July 12, August
15,  September 20, to  a regiment of 900 men.   The differences
between individual regiments are, however, very great.   In August,
for instance, we find the mean ratio of sickness in  the
    Eleventh Illinois Regiment_____________  29 per cent.
Ninth
Twelfth
Seventh
Eighth
Twenty-second
Eighteenth
 33
 33
 37
 47
 63
143
  Even taking  into consideration the fact that the first five regi-
ments were during that month composed of old  three-month men
and newly-arrived recruits, Avhile all the men of  the 22d and 18th
were just passing through the third  month of  their service, the
most dangerous to  the health of the soldier,  according to the
experience  of Army Surgeons, Ave cannot help  looking for some
other cause or causes of such glaring differences; and Ave find  them,
not in differences of  diet, drink, or locality, but in  the different
observance  of the rules of camp police and military hygiene.   1 h
11th and 12th, standing among  the healthiest  of the list, were
encamped on Bird's Point, like the 18th and 22d, on four or five
hundred yards removed from the entrenchments, within which the
e 
41
latter were cooped  up, using  the  same food and drink; but the
camp police and  sanitary discipline of these regiments differed  as
widely a's the relatiA7e amount of sickness  among their men.   In
the same month (August) Ave  had a total  absolute increase of 884
cases of sickness over those in July, although the number of the
force diminished from 7,227 to 6,103 during the same  period;
while these two regiments (18th and 22d) alone show in their
monthly reports an increase of 874 cases  in August over those  in
July, or only ten less than the increase in the whole force during
the same period !   These figures,  compared with the  description I
gave of the camps of these typical regiments in my detailed
returns, speak volumes  for the value of sanitary science to army
men.
   An examination of the Surgeons'  reports from these and some
other regiments, shows the following ratios of sickness and mor-
tality among them:
                                     July.      August.   September.
Taken sick of the whole force,.....    40.66  p. c.  62.73 p. c. 61.06 p. c.
Died of the whole force, ) including j   0.249       0.377      0.470
  "   "   sick,.......[accidents,}   0.612       0.601      0.770
  "   "   whole force, ) excluding j   0.152       0.295      0.418
      "   sick,.......[accidents,!   0.372       0.473      0.734
   The rapid rise in the mortality among the sick with exclusion of
accidents, from 47 to 83 in 10,000, from  August to September, is
due  to  the  greater  prevalence of  typhoid,  typhus and  severe
malarious fevers.   The October reports will  shoAv a still greater
increase.
   I could point out a great many more interesting facts embodied
in thes*e reports, were I not  afraid to  make this revieAV too lengthy
for your perusal.  I send you a consolidated abstract of them for
your own use.
   The general health of  the  troops was improving in October, as
far as  the mere number of cases of sickness  is concerned; the
severity of their character was, however,  increasing.

               21.—Preventive Duly of Surgeons.
  The number of Surgeons who fully  understood their responsibity
as health officers to the regiments is very small, judging, not from
the answers to questions 168-172 of my returns, but from the facts
connected with their duties as such before my eyes.   The adoption 
42
of Gen. McClellan's orders in reference to the duties of Brigade
Surgeons,  by Gens. Grant and  Smith, and  the  arrival of four
active  and intelligent officers of that grade, will, I believe, make
up now for any deficiencies  of  the  Surgical Staff in this respect.
Drilling before breakfast had  been abandoned in  most instances,
and  is  prohibited now altogether  by an order from Gen. Grant.
The average number of hours the men are on drill daily is five.

                22.—Arms and Accoutrements.

  With the exception of six regiments, provided with rifles and
rifled muskets, all the infantry force is armed with the old smooth-
bore musket, pronounced to be bad, and detested by nearly all the
men.   The weight of  the knapsacks  for heavy marching order is
limited in almost all the regiments to  twenty-five pounds.  The
cartridge boxes are sustained by shoulder straps.
  In conclusion, I have to express my thanks  to  nearly all  the
commanders of divisions, brigades  and regiments, and  the  great
majority  of  the Medical  Staff, for many acts of courtesy and
Araluable assistance in the discharge of my duties, but especially to
Gen. U. S. Grant, commanding U. S. forces in  the S. E. Depart-
ment of Missouri, &c, Dr. James Simmons, Medical Director, and
Dr. J. P. Taggart, Medical  Purveyor at Cairo, who have treated
me throughout my stay here with the kindest consideration.
                                        P.  AIGNER, M. D.
   Cairo, III, Nov. 2, 1861.

  In the probability that a large force will be located at this point
during the  winter,  and  that military  operations will here  be
rather increased  than diminished, I would  suggest that the work
of the Sanitary Commission should be placed on a somewhat more
permanent foundation by the establishment of a depot of supplies
to which recourse may be had in any emergency, and where the
drafts of the Inspector may be honored at sight.  Such  an ar-
rangement would involve but a trifling expense to the Commission,
and would materially increase its efficiency at this point. 
43
                          MISSOURI.
   A  vast  amount  of extraneous aid  has  been rendered  to the
 Government in the care of the sick among the troops in Missouri
 within three months past.  During that time, Dr. Buel, agent of
 the Commission, has continued to reside in St. Louis, has inspected
 many camps  in  the  vicinity of the  city and farther  westward,
 and has distributed to those wanting them,  a large aggregate of
 hospital supplies, forwarded to him from  Chicago, Detroit, Cleve-
 land and New York.   The Rev. Robert Colyer has also rendered
 most  efficient aid  to the Commission by devoting  a number of
 weeks to visiting the camps in the interior of  the State, and in the
 care of the sick in St. Louis.
   The " Western Sanitary Commission,"  under the authority of
 Gen.  Fremont about three months since, commenced the establish-
 ment in St. Louis  of hospitals for the reception of such sick as
 might be transported  thither from the columns advancing south-
 west  and west.   Latterly their self-imposed  duties  have  largely
 increased, and in cooperation with the medical authorities of the
 army, they have  provided most comfortable quarters for about
 2500 sick,  their hospitals  being  now nearly  full.  The  appended
 report upon these  hospitals,  made  November 20th,  by Dr. Buel,
 will give some idea of their  extent,  capacity and completeness;
 it was  my  privilege, soon after the  commencement of their op-
 erations, to  meet  the  Commission, and  examine the provisions
 they had made and were then  making, for the accommodation of
 the sick.  The evidence of their intelligence,  industry and philan-
 thropy, as  furnished  by the  hospitals established under  their
 supervision, were then in the highest  degree gratifying to me, and
 as more fully exhibited in their present condition, entitles them to
 the gratitude and respect of the whole country.  The arduous and
 gratuitous  labors of  the Western Sanitary Commission, in  the
 establishment  and care of the hospitals in  St. Louis, have necessa-
rily engrosssd  most of their time and attention, and the inspection
of camps, and the prevention of disease among the troops west of
the Mississippi, which, in their generous self-devotion, they at one
time  assumed, has  proved to be beyond  their power.  In  these
circumstances, it has been determined to extend  into Missouri the
same  thorough system  of sanitary measures now being carried out
through all the other  divisions of our army.   An Associate Secre- 
                               44

 tary and an experienced Inspector have therefore been sent to St.
 Louis, who will,  in  cooperation with the  Western Sanitary Com-
 mission, in the  shortest  time  possible,  investigate  fully  the
 condition  and wants  of  the troops in Missouri, and promptly
 supply all  needed material aid from our abundant stores.

  REPORT  ON THE  MILITARY HOSPITALS OF ST. LOUIS, MO.,
                      November  20, 1861.
   " The military  hospitals of St. Louis,  consist of three large hos-
 pitals, one receiving house, one measles  hospital, one small pox do.
 and one small hospital at Benton Barracks.
   The first I shall mention, is that in order of time first opened, in
 a new building  constructed  as a House of Refuge  for Juvenile
 Delinquents, but  never occupied for that purpose.   It stands upon
 an elevated piece of ground, about four miles southward of the
 city, and about a mile west of the river;  is admirably adapted to
 hospital purposes, as much so as if expressly constructed for that
 use ; contains  six  large and lofty wards well lighted and ventilated,
 about one hundred feet by sixty, capable of comfortably accommo-
 dating about eighty patients each.   There are other smaller wards,
 making, in the aggregate, room for six hundred beds.   The person-
 nel of  the  hospital consists of the Medical Staff, one  Surgeon-in-
 chief, Dr. Bailey, U. S. A., and five assistants, who are mostly, I
 believe,  from  civil life, one apothecary and assistant,  one  clerk,
 eight stewards, eight ward masters,  thirty-one male  nurses, four-
 teen female do.,  besides cooks, laundresses and laborers,  whose
 number  varies with the number  of patients  in the  house.  The
 female nurses  are  Sisters of Charity, and from personal observation
 as well as the testimony of the patients, I am satisfied that they
perform their duties with great kindness, zeal and assiduity.  The
whole aspect of the hospital presents an air of neatness and com-
fort, and I  am satisfied that the patients are as comfortable and as
well cared  for  as  the inmates of any large  hospital in the  world.
The most  prevalent  and  fatal  diseases are  typhoid fevers and
dysentery.   The  greatest number of deaths  are  from  the first-
mentioned  disease.  I did not learn the  exact number.  There are
but few surgical cases at present.
  The second hospital in the order of opening, is that on the corner
of Fifth  and  Chestnut streets, in the  heart  of the  city.  This 
45
building contains five  stories  besides the basement, having two
fronts of about eighty feet each.  It was designed for stores, offices
and apartments, contains a very large number of rooms, none of
which are of very large size, the largest number of beds in any
one being about twenty-five.  This has its advantages and disad-
vantages.  Large Avards are more easily ventilated, smaller ones
give a  more  perfect classification.  The building has been well
fitted  with baths,  water-closets  and heating  apparatus.  It is
thoroughly warmed  and  ventilated  throughout.  The  present
number of patients is 450, number of beds, 550.
   Personnel.—Medical Staff, Surgeon-in-Chief, Dr. Hodgins of St.
Louis,  six assistants, all  from civil life,  two apothecaries,  male
nurses 50,  female do. 13, ward masters 5, cooks 6, laborers 27.
   In this  hospital  the female  nurses  are Protestant women, and
appear to  be  fully  equal  in the discharge of their  duties,  to the
Catholic Sisters at the House  of  Refuge.  The  remarks made in
reference to the comfort  and  cleanliness at that institution, are
equally applicable  to this.   They are all that  could be  desired.
This hospital  contains more surgical  cases, many of the wounded
from Springfield and Lexington having been brought here.   Many
cases of severe injury, Avhich seemed nearly hopeless, are noAV in a
fair wray of recovery Avithout loss of limb.
   The third and last of the larger hospitals, is  on  Fourth  street,
near its northern termination.   The building is  of the same style
and description as that on Fifth street;  somewhat larger, having
six hundred beds, and at present four  hundred and sixty patients.
The number of physicians, nurses and attendants is about the same.
All the arrangements are in the same style  of neatness and com-
fort.
   Measles Hospital, corner O'Fallon Street and Franklin Avenue,
one  hundred  and fifty beds, all  occupied.  Medical  attendants,
two;  nurses and other attendants, same relative  numbers as in the
large establishments.
   Small Pox  Hospital, beds fifty, patients five.
   Small Hospital adjoining Benton Barracks, designed to receive
such cases  as  occur among  the soldiers there.  Beds one hundred
and  thirty, all occupied ;  medical  attendants, two;  nurses and
other attendants, same proportion as the others.
   Receiving House, situated immediately adjoining the R. R. Depot 
46
 of  the  Western  and  Southwestern Railroads,  connecting  with
 Jefferson City, Rolla, &c, over which most of the patients arrive.
 The trains come  in mostly at a late hour  of the evening.  The
 object of  this building is  to make  the  patients comfortable for
 night immediately on  their arrival.  It has one hundred and
 twenty beds, medical attendants, nurses, cooks and cooking facil-
 ities, so that every new-comer  can be furnished with a  warm
 supper.  In the morning they are sent in ambulances, and distrib-
 uted among the different establishments  according to the diseases
 under which they are  suffering, or Avherever  there is most  room.
 As a connecting link between this and the other hospitals in this
 city, and points in the  interior to which the sick  and  Avounded are
 sent, they have railroad ambulances or  hospital cars, filled Avith
 beds, berths and blankets, provided with cooking stoves each, and
 one or two nurses, so that the patients are made perfectly comfort-
 able, provided with warm food and drinks, and thus  make the
 transit with slight fatigue and inconvenience.
  It will  thus be seen  that the system  of Military  Hospitals in
 St. Louis is very extensive and complete.  It is also economical,
 the expense per man being but the trifling sum of $5.00 per month
 in addition to his  rations.   Probably  this  amount is far more than
 saved to the Government, by the  shorter time  spent, where the
 facilities for recovery are so great, setting aside Avhat  is due to
 humanity  and the patriotism of our brave volunteers.
  These arrangements  have all  been made  under  a voluntary
committee of prominent and Avell-known  citizens, the  most  active
 of whom  are  the Rev. Dr.  Eliot,  Dr.  Johnson and  James C.
Yeatman, Esq., who have given  themselves to this labor of love
with a zeal and devotion worthy of all praise.
                                WM.  P.  BUELL,  M. D.,
                                    Inspector U. S. San. Com.
  Total number of beds,    2,200.
                  patients, 1,600, 
47
    INDIANA, MICHIGAN, WISCONSIN  AND IOWA.
  It will be noticed that in the preceding pages no mention has been
made of the operations of the Sanitary Commission in these States,
but it must not be inferred from this omission that nothing has been
done among all this warm-hearted and loyal people for the great
cause in which Ave are engaged; but there are no troops permanently
stationed in any of these States,  nor has the efficient aid which we
are receiving from this source yet crystallized into such a definite
form as to be  satisfactorily reported.  I am happy to  be able  to
say, however, that in  all  these States we have  influential and
patriotic Associate members,  who are  doing and will do good work
for the sick soldiers; and Ladies' Aid  Societies, which are forward-
ing quantities of hospital stores  to be  distributed  by our agents in
Western Virginia, Kentucky and Missouri.  Among those to whom
we are  specially indebted for favors of this kind, should be men-
tioned Mrs. Geo. Dufpield, of Detroit, Rev. H. A. Reid and Mrs.
L. P. Harvey, of Wisconsin, who have been most active and useful
in distributing supplies furnished by the ladies of their  respective
States.
  To give a resume, then, of the condition and wants of the troops
in the Valley of the Mississippi, and the duty done and to be done
by the Sanitary Commission, we have  to congratulate ourselves,
first, upon the  marked  amelioration of the sanitary condition of
both camps and hospitals since  my last report;  second, on the
general  high character of the medical  officers having the care of
the troops, most of them having passed a searching examination by
a competent Board appointed by the  Governors of the States in
which the regiments were recruited;  third, upon  the uniformly
friendly  relations  and hearty co-operation  existing between the
medical and military officers of .the different departments with the
Sanitary Commission and its agents, with a general  high apprecia-
tion of the importance of its aims, and  approval  of its methods;
fourth, on the active and efficient  co-operation of  a large  number
of Associate members of  the Commission, who have formed Branch
Commissions in the principal cities, which, by their earnest efforts
and their moral influence, are affording most important aid in our
work: fifth, upon the organization of a number of Auxiliary Ladies' 
48
Soldiers' Aid Societies, Avho are busily engaged in the preparation
of hospital stores, whose bounty so liberally bestowed has alleviated
much suffering, saved  many lives, and  enabled us to  accomplish
good which it would have  been  impossible to effect without their
aid;  sixth, on  the liberality  of the managers  of railroad  and
steamboat lines and express companies, who have, by the transpor-
tation of stores free, or at diminished rates, greatly added to  our
means of usefulness.
  On the other hand, we  have to deplore the continued operation
of avoidable  causes  of suffering and disease which call  for  our
warmest sympathy and most  earnest efforts, and which  will, in
the future, task  our  energies to  the utmost,  and exhaust  all  our
resources in their removal.
  While the present percentage of sickness and mortality Continues
among our volunteers,  we, as  a  people, stand convicted  of inhu-
manity, and  bad  economy, a wastefulness  of  the doubly vital
element on the present Avar, human life.  We  can never  consist-
ently suspend our labors till this  charge can be truthfully denied
                 Respectfully submitted.
                              J.  S. NEWBERRY, M. D,
                                            Assoc. Secretary,