10. Are not all such considerations reducible to these?

a. The physical quality of the men sent;

b. The nature of their food and cooking;

c. The quality of their clothing, outfit, and camp habits. Their climate; their necessary exposure; their liability to malarious, contagious, or camp diseases, cannot be changed. But cannot the percentage of illness and loss be reduced to its minimum, as well as the general efficiency of the army be raised to its maximum,

1st. By more rigid medical examination of recruits, and all men placed in new regiments? Is not the laxity great at present? Next, by sending back all those who have gone, who, on a re-examination at Washington, are seen to be physically incompetent to the trial before them, supplying their places by fresh men, carefully selected?

2d. Is not the cooking of the regular and volunteer corps capable of a vast practical improvement?

a. What are the present usual regulations or customs in this matter? How is food prepared? and by whom?

Might not cooks of adequate skill, previously tested, or even carefully prepared here, be sent, one with each company, by orders from head-quarters? And would not this diminish, by several per cent, the sickness of the men?

b. Are the surgeons and officers sufficiently attentive to precautionary hygiene? Do they inspect the food, the dress, the sleeping arrangements, the marching preparations, in respect of shoes, head-covering, and other matters? And might not new orders in this direction from the Secretary of War have a great efficacy?

Is there a sufficient and competent medical force usually sent with the regiments? and how are medical volunteers likely to understand military hygiene?

Finally, would not proper cooks sent with the army be better than nurses sent after it, and an adequate attention given to inspection of recruits and hygiene be even more efficient and useful than any amount of remedy?

11. Will any quantity of excellent advice to recruits and volunteers, or any amount of receipt-books and cooking-apparatus, be of practical use, unless made compulsory by actual

enforcement from head-quarters or the Secretary of War? And how can their attention be best secured?

To these numerous questions the Medical Purveyor returned the kindest and most patient verbal answers. It was, however, perfectly obvious, that, while, as a warm patriot and a gallant man, he rejoiced in the enthusiastic uprising of the women of the land, as a member of the Medical Staff and a Medical Purveyor of the United States Army, he regarded their solicitude as very much exaggerated, and their proffer of aid as mostly superfluous. He assured their committee that the government was ready and willing to supply everything the soldiers needed or could need; that the Medical Department was fully aroused to its duties, and perfectly competent to them; and that it would be an uncalled-for confession of delinquency and poverty to admit that the army needed, or would need, anything that the government and the Medical Department were not able and willing to furnish. Not, however, completely to slacken the milk of human kindness in the women's breasts, it was thought expedient to indulge them with the opportunity of supplying a short list of articles,* until the public anxiety should calm down by discovering the admirable and thorough organization and efficiency of the Medical Department. The writer remembers, as if it were yesterday, the glow of national pride with which he heard the honest old soldier unfold the resources of the government, the zeal and humanity of the Medical Department, the admirable adequacy of its efforts in the Mexican war; and recalls the settled convictions with which he left the presence of this experienced medical officer, that the haste of the humane had outrun their knowledge and their judgment, and that it was his own duty at once to allay wasteful activity by publishing fully the results of his satisfactory conference with the representative of the Medical Bureau in New York! There is not the least reason to question that the Medical Purveyor's judg ment was as sound as the wholly untried future on which our

"Dressing-gowns; night-shirts; flannel under-clothing in general; drawers (made loose); socks; slippers; flannel bandages for the abdomen, one yard long, eight inches wide."

country was then entering allowed any man's to be; that he exhibited only a true ésprit de corps in the ground he took, which was as honest as it was faithful. It is recorded here, only because it was the first instance of a feeling with which afterwards the Sanitary Commission had continually to strive,

an honest and proper feeling in the Medical Department, which, however, just as honest and just as proper a feeling in the public has been obliged to withstand, qualify, and correct.

Notwithstanding the cold water thus dashed in the face of the Woman's Central Association, in the first warmth of its being, and the distrust awakened in the minds of its very founders as to the necessity of its existence, matters had gone too far to be immediately dropped. The seventh article of the Constitution had made it incumbent on the Executive Committee to establish direct relations with the central authorities of the Medical Staff"; and, accordingly, after inviting the Board of Physicians and Surgeons of the hospitals of New York, which had been recently organized for similar loyal purposes, and the "New York Medical Association for furnishing Hospital Supplies," to join the "Woman's Central," in a delegation to Washington, a committee, consisting of Dr. W. H. Van Buren, Dr. Elisha Harris, Dr. Jacob Harsen, and Rev. Dr. Bellows, repaired to the national capital to confer with the medical authorities and the War Department in regard to the whole subject of volunteer aid to the army. A few days' study, on the ground, of the condition of the troops arriving at Washington, the character and military training of the officers and surgeons accompanying them, and an observation of the immense pressure on the War Department and on the Medical Bureau, satisfied the committee that our army was expanding with a rapidity which made the existing machinery in any department labor and strain, as would a small engine, built only to work a river steamboat, if transferred to an ocean vessel. They found every bureau overwhelmed with work, and embarrassed by the prodigious though natural ignorance of the swarms of young and inexperienced officers, who neither knew what was wanted, nor how to supply the wants when they discovered them. Regiments arriving at Washington, after thirty-six hours passed in cattle-cars with insufficient

food and without sleep, were kept standing in the street from twelve to eighteen hours longer, because their colonel or quartermaster did not know how to make a requisition for food or quarters. Surgeons did not ask for medicines in terms that the Medical Bureau could recognize, or if they did, it took, at the very least, a fortnight to get the requisition filled. The Purveyor's store-rooms, to the Committee's view, presented an ominous vacancy, and the total aspect of the Medical Bureau was that of dignified routine and a Rip Van Winkle sleepiness, which alarmed them indescribably for the medical prospects of the army. There was nothing peculiar, remarkable, or specially blameworthy in this state of things. The Medical Bureau had been for years one of the best-ordered bureaus in the government. Its business since the Mexican war had been very slight, and was well done. In that war its duties had not exceeded its abilities and resources. It did not expect to prove otherwise than wholly equal to any emergencies likely to arise now. A mighty war, not at all recognized in its growing proportions, had broken out. Those most engaged in meeting the immediate pressure, had least opportunity to study the future necessities it would create. Officials, whether in the civil, military, or medical service, seemed, in proportion to the length of their services and their education in technical routine, to be least aware of the new bottles which would be required to hold the new wine, least expectant of the vast strain that was to be put on the government machinery, and of the necessity of immediately strengthening and enlarging it, manning it with new and more vigorous officials, and working it on a broader and more generous plan. And yet there were reasons for great care in this urgently called for reform. The Cabinet officers, new in their places, could not dispense with the experience and routine knowledge of the old heads of bureaus; nor could they, without alarm and anxiety, see even the inadequate machinery of the government tampered with by zeal and patriotism. They had to stand for order and method amid the convulsions and freshets of the time; and there can be no doubt that the reluctance with which all changes have since been effected at Washington the official vis VOL. XCVIII. - - No. 202.

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inertia has been of the utmost benefit, considering the strength and ignorance, the impatient zeal, and often precipitate patriotism, which have so constantly sought to revolutionize bureaus and departments.

The Committee had the great advantage of the judgment of one of its members, who had for five years been not only a member of the Medical Staff, U. S. A., but who had served for two years in the Medical Bureau itself. To a thorough acquaintance with the routine of the department he added sixteen years' experience in civil practice, where he had attained an enviable, not to say an unrivalled position; - to zeal he added knowledge; to humanity, judgment; to aspiration, patience. The weight of his professional character, both in the Medical Staff and in the profession at large, proved not only of invaluable service at the inauguration of the Sanitary Commission, but has been, in all medical questions ever since, the guiding and decisive influence. It is not too much to say, that without him the Sanitary Commission would have lacked its medical balance-wheel, if not its medical mainspring.*

The longer the Committee conferred with the Medical Bureau, the more it watched the operations of the War Department, the closer its observation of the men arriving and of the camps about Washington, the more deeply and anxiously convinced it became, that neither the government, the War Department, the Bureau, the army, nor the people, fully understood the Herculean nature of the business we had entered upon, or were half prepared to meet the necessities which, in a few weeks or months, would be pressing crushingly upon them. Discovering the extreme difficulty of obtaining accurate information, even from the government itself, perplexed and embarrassed by the suddenness and extent of the war on its hands, the futility of any attempts to carry out the plans of the benevolent associations whose delegates they were, without a much larger kind of machinery and a much more extensive system than had been contemplated in any of their organizations, the idea of a "Sanitary Commission," with an office and resident staff at Washington, presented itself to the Com

*Professor W. H. Van Buren, M. D.