HAVE WE THE BEST POSSIBLE AMBULANCE SYSTEM 1 REPRINTED FROM THE CHRISTIAN EXAMINER, January, 1864. PUBLISHED, FOR GRATUITOUS DISTRIBUTION, BY THE COMMITTEE OF CITIZENS WHO HAVE IN CHARGE THE SENDING OF PETI- TIONS TO CONGRESS FOR THE ESTABLISHMENT OF A THOROUGH AND UNIFORM AMBULANCE SYSTEM IN THE ARMIES OF THE REPUBLIC. BOSTON: WALKER, WISE, AND COMPANY, 245 Washington Street. 1864. LIBRARY OF THE PRUDENTIAL INS. CO. OF AMERICA NEWARK, N. J. STATISTICIAN'S DEPARTMENT Section_________________________ Subject_________________________ Date%ecd._____________________ Acknowledged__________________ Indexed________________________ Presented to the Statistical Division, Surgeon-General's Library, United States Army Washington, D. C. BY The Prudential Insurance Co. of America Newark, New Jersey HAVE WE THE BEST POSSIBLE AMBULANCE SYSTEM 1 REPRINTED FROM THE CHRISTIAN EXAMINER, January, 1864. PUBLISHED, FOR GRATUITOUS DISTRIBUTION, BY THE COMMITTEE OF CITIZENS WHO HAVE IN CHARGE THE SENDING OF PETI- TIONS TO CONGRESS FOR THE ESTABLISHMENT OF A THOROUGH AND UNIFORM AMBULANCE SYSTEM IN THE ARMIES OF THE REPUBLIC. BOSTON: WALKER, WrISE, AND COMPANY, 245 Washington Street. 1864. University Press: Welch, Biqelow, and Company Cambridge. PREFATORY REMARKS. The Committee of Citizens having in charge the sending of petitions to Congress to establish a uniform Ambulance System for all the armies of the Republic have great pleasure in pre- senting to the public the following article from that excellent periodical, the Christian Examiner. It was written by a son of Harvard, who, from high patriotic feeling, volunteered as a private in a Massachusetts regiment, and served as such for several months, until honorably dis- charged, in consequence of shattered health caused by expos- ures in the service. Having suffered for the want of a proper ambulance system, his words, as tho'se of a personal expe- rience, as it were, ought to have weight with our people. The Committee regret to find, that, since the Hon. Henry Wilson introduced his bill into the Senate, many suppose that nothing further need be done about sending petitions to Con- gress. On the contrary, now is the precise time to send them. Continue to send them during the whole of the present session of Congress, or until that body acts definitely upon the subject, and establishes an Ambulance System for the whole of the armies, and commensurate with the demands of modern civil- ization. Let it be remembered that the Military Committee, to whom Mr. Wilson's Bill has been referred, have twice de- feated a bill referred in like manner to them. We have no certainty that the same fate may not befall that now presented 4 by the honorable Chairman of that Committee. Let us con- sider nothing accomplished until all is well done. If any judgment can be formed of the items of Mr. Wilson's bill from the meagre telegraphic despatches given of it, it is a vast gain upon the present want of system everywhere save in the Army of the Potomac. It in fact establishes, by law, for all the armies, the present system now thoroughly acted on by the Potomac Army alone. This is an immense step in the right direction, and the Committee hail it with delight. If this bill passes, every General will thereafter be compelled to see that his men are not left for days without proper care, as has, at times, heretofore happened. ^ But if we refer to the operation of the Ambulance Depart- ment of the Army of the Potomac at the great battle of Get- tysburg, we shall find that the Ambulance Corps arrangement was wofully deficient, in some particulars, on that occasion. It brought the wounded with comparative skill from the battle- field, and then left them exposed to the rain or a July sun, and without food, twenty-four hours. Fortunately for them, that most noble offspring of this century, that culmination of modern civilization and humanity, the United States Sanitary Commission, foreseeing that something of the kind would hap- pen, had made provision for the emergency, and, after these twenty-four miserable hours, was enabled, out of the ample provision poured liberally from the hearts of the nation, to meet that emergency, and to give comfort, clothing, and food to our wounded heroes. What has happened once may hap- pen again. If the government cannot, by its own officials, provide against such an event, perhaps it might do so by allowing this Commission to take up the work. In fact, is it not true that these two great agencies are now comple- ments of one another, and must, from the necessities of the case, continue to be so during the existence of this war? If these two powerful agencies, viz. the government acting 5 through the Ambulance System, and the Sanitary Commission by its various resources, could have been, before the battle of Gettysburg, placed in such intimate relations with one another, that, at the moment one had finished its specific duties, the other would have been prepared to take upon itself the great and responsible duty of caring for these wounded soldiers, all would have been done that in the nature of the case could have been accomplished, and the twenty-four hours of suffer- ing been prevented. To meet this obvious want of complete harmony between these two agencies, it seems as if only a little tact and mutual forbearance were needed. It would seem as if a law could be devised whereby this volunteer power could, for the time being, become the agent of the government for the relief and trans- portation of the wounded. This could be done without in the least derogating from strict military discipline. Wounded men are worse than useless in the army, and surely it would be good policy and economy on the part of the government to allow the Commission to aid in the care of them; — in fact, for the time being, and under strict military rule, to become the agents of the military authorities, in the same way that many other non-military men are now engaged in the transportation of material and men. If the Sanitary Commission had a set of officers properly graded, and the chief in command were in im- mediate personal relations with the Commander-in-Chief, any arrangements necessary could be easily carried out. It is to be hoped that in any bill prbposed something may be introduced, looking to the possibility of these two mighty powers, viz. the government and the volunteer association of the people, being thus united. As a powerful, though indirect, confirmation of these general views, the Committee would refer to the remarks on pages 47 to 52 inclusive of document marked 69, U. S. Sanitary Commission. None but a prejudiced mind can deny the cogent arguments there used, which bear upon this whole question. « 6 The Committee throw out these suggestions in the hope that they will, at least, prompt others to consider whether such a desirable result cannot be obtained. One of the arguments that may be brought against this proposition is, that, from the very nature of the Commission, and any body like it, it may die at any moment. It may be urged that it depends simply upon the volunteer offerings of the people, and it would be impossible to provide by law for such a union. The Com- mittee would answer, — The Sanitary Commission sprang into life to meet the necessities of the case, viz. the demands of modern civilization acting on the heart of man. Its ideal cannot die; and hereafter, in all wars urged on this continent, similar, though less extensive, associations must arise. Still further, if we may judge from recent action by the Inter- national Congress at Geneva, similar subjects are to be dis- cussed in Europe. As we have taught the nations much on the arts of war, we surely can suggest to them some im- provements in the amenities of war. In conclusion, the Committee hope that Congress will do something towards improving the inter-belligerent code of law, and will declare that surgeons and their assistants, the men of an ambulance corps, while dressed in their specific uniforms, and actually engaged in their humane purpose of relieving the wounded and burying the dead, should not be the mark for the enemy's sharpshooters, nor, if taken prisoners should they be held as prisoners of war, but released as men on parole, inviolate in their persons, their personal property, and the implements necessarily incident to their occupation. OUR AMBULANCE SYSTEM. 1. Traite de Chirurgie d'Armee. Par L. Legouest. Paris. 1863. 2. Code des Officiers de Saute de VArmee de Terre. Par P. A. Didiot. Paris. 1863. 3. Systeme des Ambulances des Armies Frangaise et Anglaise. Par M. Boudin. Paris. 1855. 4. Report on the Art of War in Europe, in 1854-56. By Major Delafield, U. S. A. Washington. 1861. 5. Revised United States Army Regulations. By Authority of the War Department. Philadelphia. 1862. The subject of our Ambulance System is one which is very near to all of us. The lives of our nearest and dearest may at any moment depend upon the perfect working of the minutest part of its machinery. It is with a purpose of comparing our ambulance system with the systems of the English and French that we have looked over the volumes which stand as sponsors at the head of our article. We think that we have found in them some materials which may aid us in forming an opinion upon the question, which presses upon us at the present time, " Have we the best possible ambulance sys- tem ? " It is because this inquiry belongs as truly to Chris- tian charity as it does to military economics, that it claims room here. We have been unable to trace the use of ambulances for the conveyance of wounded from the battle-field farther back than the time of the French Revolution, or rather of those gigantic wars which followed it. The germ of the present system existed, as the French claim, so long ago as the tenth century, and the times of Leo VI.; but however that may be, 8 it needed the humanizing influenes of sixteen Christian cen- turies, the military instincts of Napoleon, and the genius of such surgeons as Percy and Larrey to bring it to anything like maturity. The French previously to the time of Napoleon, and the English even so late as the commencement of the Cri- mean war, appear to have depended upon chance or the wagons of the quartermaster for the removal of their wounded. It will thus be seen, that the ambulance is a modern invention, a matter of to-day's experiment, not of history. Three patterns of four-wheeled ambulances, for ten, seven, and eight wounded men respectively, were used and tested by the English in the Crimea, together with two patterns of two-wheeled ambulances, for seven and two respectively. A general description of the plan of one of these ambulances must suffice us. In the ambulance for ten, the body of the wagon is divided lengthwise by one perpendicular and one horizontal partition, making four compartments of a size to admit a stretcher and its occupant. Sides and partitions are all of open work, secur- ing ventilation. The stretcher used consisted of " two wooden frames, the lower one with handles carrying an upper one secured at one end with a hinge, and rising slightly towards the other, retained in the inclined position by india-rubber springs encased with spiral steel cases. The bottom of the stretcher is formed of leather, and stuffed at the elevated end to form a pillow. Rollers are attached to the under part of the lower frame, to facilitate its being shoved in the ambulance-wagon from the rear." If, then, you wafer two letters together at one end, place a piece of india-rubber between them at the other end, imagine a wounded man on the inclined plane thus produced, and trundle the whole on imaginary rollers into a post-office de- livery box, you will get some idea of the way in which the most desperately wounded are placed in the ambulance. The forward part of the wagon has fore and aft seats for six men sitting back to back. The four-wheeled ambulance in use in the United States is in external appearance a cross between an ice-cart and an omnibus. It has a step behind, and two seats running length- wise like an omnibus, which seats may be folded up out of 9 way, in whole or in part, and stretchers introduced ; or, by lifting two hanging leaves, these seats may be made into a cushioned platform, covering the whole bottom of the car. Our two-wheeled ambulances look like milk-carts, balanced on two wheels, with very long shafts. They have no honey- combed arrangement behind, but are simply enclosures of so much space, on wheels, in which stretchers can be placed. They are drawn by one horse, and have not an enviable repu- tation. We have never ridden in a two-wheeled ambulance, and therefore say reputation ; as to the four-wheeled ambu- lances, we shall speak from experience. We cannot go through our ambulances, point by point, and say how or why or whether they are inferior to the ambulances used by the Allies; but we can speak of some points of infe- riority which, even if they seem unimportant, are so obvious, that, if the subject of the construction of our ambulances had ever received the attention it deserves, they could not have been overlooked. If our ambulances have springs at all, — it would be difficult to convince one who has ridden in them that they have, — they have not such springs as fit them for the carrying of wounded men over rough military roads. The fact is, that they are made from the cart, not the carriage, point of view. Perhaps such springs as are used in our best carriages might not be equal to the service imposed upon an ambulance, but that some improvement upon the present state of things cannot be had is not to be believed. Let our carriage-smiths understand that a spring is needed, not too elastic nor too stiff, strong, yet not unpliant, and it will be forthcoming. Even if the ambulances last longer when of the coarsest make, it is better that wrecks of ambulances should strew Virginia from end to end, than that one of our wounded brothers should bleed his life out through reopened wounds, — wounds reopened by the cruel jolting of a'car which should be prouder of its burden, and bear it more gently, than ever car which bore triumphing general. In the latest form of ambulance adopted by the English, the body of the vehicle was " slung or suspended by four coils of India-rubber cord," this being a late result of European ex- perience. It would be gratifying to know that it had been at 2 10 least tried in this country. We cannot say positively that it has not. . * The stretchers used by us are two poles, with canvas stretched between, and with a cross-piece at either end, and legs which can be folded up on occasion. The stretcher used by&the Allies has been already described; it is easy to see its advantages over ours. Instead of being lifted in or shoved gratingly along the floor, the wounded man is rolled in with- out shock; if the springs of the ambulance are stiff, still the jar is broken by the springs of the stretcher; if the ambulance is ascending a hill, the sufferer is kept nearly on a level by the inclination of its bed; his head, propped by a pillow, is not allowed to hang down without support, or rest uneasily on the same level with his body. In our particular ambulance there was a bag of oats which was used as a pillow; but, as it was needed at least once during the night for other purposes, and as the sacking had given way in the middle, so that we were half on and half through it, like reluctant jelly half forced through a strainer, our one night on an ambulance-stretcher was not rendered luxurious even by the oats. Oats, moreover, may not always be attainable for such a use, and, on the whole, we are decidedly in favor of a pillow. Another point of superiority of the ambulances of the Eng- lish seems to be their rack for fire-arms and accoutrements. In our own service the musket and equipments are not allowed to be carried in the ambulance at all, or must be laid on the floor. We were not allowed to bring musket or equipments into the ambulance ; they were put into some other part of the train, the train got separated, and we never saw them again. Now, one use at least of the ambulance is to carry to the front men who are unable to march from temporary illness or other cause, and men without their muskets and accoutrements are of no use. Again, an ambulance train may be attacked. In the account of Ifte campaign of Gettysburg, by a British officer, in the September " Blackwood," he mentions that, upon an alarm of cavalry, the men jumped from an ambulance near him with their arms, ready to defend it. It would appear from this, that the Rebels must have some such arrangement as that of the English for the convenient transportation of the arms of the 11 wounded with their owners. The unwillingness of a good soldier to part with his arms is in itself a reason for keeping them with him. Water is furnished in our ambulances conveniently and abundantly, if the drivers do their duty in filling the vessels provided. It would seem that, as the ambulances have to carry both sick and wounded, and over long distances, some means should also be at hand for nourishing them. A man who has lain on the battle-field several days is very likely to have lost or exhausted his rations; and, more than that, to be in such a state of exhaustion from fasting, and perhaps loss of blood, as to be unable to eat a soldier's ordinary hard fare, if he had it. It is well known that many operations and many diseases prove fatal, which would not be so were it not for the state of exhaustion in which the sufferer comes to the sur- geon's hands. It is our belief that, if materials for a broth, or other light nutriment, with means of preparing it, were carried with the ambulance, and used by discreet hands, many lives might be saved. Though many improvements were made by the Allies in their ambulances, four-wheeled and two-wheeled, during the war, and though they attained, as it seems to us, far more sat- isfactory results than we have done, yet the greatest improve- ment of all seems to have been the giving them up in pa^rt or altogether, and substituting pack-mules, with chairs or litters. It is of course of the utmost importance to bring speedy succor to the wounded. They must be sought out where they lie, and while the fight is going on. The ground fought over is often, and indeed very generally, such as no wheeled vehicle could pass over, even if it were not covered with wounded and dead ;«the ambulance, moreover, being a large object, would be apt to attract the enemy's fire. The mule satisfies all requirements. He can pass over the roughest ground or through woods, avoiding the dead o» wounded in his path; is low and small, and of a grayish color, which fades undistinguishably into almost any background at a little dis- tance ; his step is gentle, and without jar; he can travel side by side with baggage and ammunition trains, for he does not need the whole road to himself, and, if a jam 12 occurs, he can make a detour. And all this is not theory, but the experience of the Crimea. Each mule carried two men, a litter or a chair being attached to the pack-saddle on either side. According to the French method, the chair or litter, furnished with legs, was set upon the ground, the wounded man placed in it, and the whole then lifted, and the litter or chair attached to the saddle by hooks. The litter consisted of a centre-piece bolted or hooked to the pack-saddle, a piece hinged to this, and opening towards the tail, to support the head, which could be fixed at any angle desired, and a similar piece, with a foot-board opening towards the head, the whole arranged so that it could be folded up against the ani- mal when not in use. The whole arrangement (two litters, with mattresses, and water-proof awnings, like buggy-tops, over the men's heads) weighed ,one hundred and forty-two pounds. One driver was allowed to two mules. Major Delafield, to whose Report on the Art of War in Europe we shall often refer, says of the system of mule-ambu- lances for the. wounded, that one hundred and sixteen chairs and litters " sufficed to transport all the wounded from the sanguinary battle-field of Inkermann in a very short time after the action terminated, proving very satisfactorily that they combined greater advantages than any previous arrangement," and he recommends them for use in our service. This recom- mendation has never, to the best of our knowledge, been acted upon, though wood and swamp, mountain and ravine, are such constant features of our battle-fields as to make far more imperious for us than for the Allies the need of such a means of transport. Of course the system of mule carriage would not entirely supersede wheeled ambulances. Where the wounded have to be transported great distances, wheeled am- bulances would be required. The two systems fay into each other wonderfully well; the ambulance may be left in a shel- tered spot near the battle-field, as an ambulance depot to which the wounded shall be brought, and where they may be cared for, and the mules attached to this very ambulance may be engaged in bringing in the wounded from the immediate battle-field. The French have an arrangement which suggests this. Their ambulance — which is rather a moving hospital 13 than a carriage for the transportation of the wounded — is separable into two parts, like a gun-carriage ; and on approach- ing the battle-ground the rear part is left with a part of the surgeons and attendants as a depot, or sort of field-hospital, and the forward part (a light caisson with medical supplies), with those of the surgeons and attendants detailed for the service, goes forward to carry succor to the wounded on the field itself. If the ambulances of the Allies are better than our own, it is either because they have better surgeons, better mechani- cians, or more humane generals than we, — or it is because public attention was directed to the subject, and enforced reform. The latter seems to have been the case in England at least. Major Delafield speaks of Miss Nightingale as "the foundation of power, from which all the new arrangements and appliances emanated. Not that she contrived, devised, or was aware of what machines were best suited for these purposes. Within sight of the hostile cannon, &c, this good lady could well see, and had the power to make known in a voice not to be neglected, all the re- quirements of the medical staff. Coming from such a source, public sentiment enforced attention and compliance with her representations and requests." We believe that the influence of public opinion is as neces- sary to produce needed reform in this department in the United States as in England. Without any disrespect to the govern- ment, and making all allowance for its difficulties, we do not think it has been so active in the premises as to make the suggestions of public opinion unnecessary and impertinent. What are the signs of activity ? Commissions, investigations, reports, treatises, experiments, legislation. The French espe- cially have made this subject a matter of the most careful and thorough investigation. The number of ambulances in pro- portion to the number of men, in general, and in particular classes of warfare, their construction, the articles proper to be carried in them, — all these questions have been treated and solved as scientific problems. In this country we see very little of this. The Report of the Secretary of War for 1862-63 mentions, that, of several models tried, one has proved the best, and that ambulances are now 14 making after this model: no description of the model, no state- ment of the reasons for adopting it. The Army Regulations, in the last edition of 1861, prescribe the number of ambulances to a regiment, &c, and that they shall be made according to a model to be furnished the Quartermaster's Department by the Surgeon-General; and, further, allows the use of horse-litters, the litters to be similar to the stretchers before described. Not a word about the litters used and proved in the Crimea. Whether the Surgeon-General, among his other duties, found time to pre- pare a model for the Quartermaster's Department, we do not know, but there is nothing of it in his Report. This is all the record we have been able to find of action by the government upon this first branch of the subject. Let us pass to the second. The best ambulance is of no avail if in the hands of cowardly, ignorant, inefficient, or unfeeling men, and the best way of raising, organizing, and disciplining the men who are to have charge of the ambulance, the personnel of the ambulance-train, is even more of a desideraturn than the best model for the ambulance itself. To understand this branch of our ambulance system, it is necessary to understand something of the gradations of au- thority in our constituted military rulers. Congress has by the Constitution the supreme power to make rules and regulations for the government of the army.' The President has a like but subordinate power as Commander-in- Chief. The analogy between the relation of the War Depart- ment to the President, and that of a chief of staff to his general, if not perfect, is still striking, as is also the analogy between the relations of the War Department to the several departments of the Adjutant-General, Quartermaster-General, Surgeon-Gen- eral, &c, and the relation of a chief of staff to the other staff officers. All these departments speak with the authority of the President, ancLfor all the armies of the Union. The commander of an army in the field has supreme power as to matters not already regulated by Congress, or the President, acting either personally or by one of the departments, and not withdrawn from his jurisdiction by them. If Congress, then, has not legislated upon the matter of an ambulance system, nor the v 15 President regulated it, that system is under the exclusive con- trol of the commanding general of each army in the field, and a uniform system throughout the United States is impossible. How is it as matter of fact ? Congress is silent. The President, through the army regu- lations, prescribes that "before the action" the division quar- termaster shall make "all the necessary arrangements for the transportation of the wounded," and give his " assistants the necessary instructions for the service of the ambulance-wag- ons, and other means of removing the wounded." " The medical director of the division, after consultation with the Quartermaster-General, distributes the medical officers and hospital attendants at his disposal to the depots and active am- bulances. He will send officers and attendants, when practi- cable, to the active ambulances," &c, &c. These are the principal provisions bearing upon the subject. Three things will here be noted. First, it is left in considerable uncertainty whether it is the general in command, or his division quartermasters, or his medical inspectors of division, or all three jointly, who are charged with, and responsible for, the transportation of the wounded ; but it is entirely certain that each general, or army, and probably each division quartermaster, may have just such a system, or no system, as he likes. Second, there is no provision for any attendants perma- nently attached to the ambulances ; the quartermaster is to furnish attendants upon the eve of an engagement from the employees of his department, who have enough to do at such a time without attending to ambulances. Third, so far as any system is found here at all, it is the system so strongly condemned byMajor Delafield's Report in these words : " The details and requirements of this branch of the service should not constitute a part of the general trans- port service of the army, as has been the case in our service. No person can so well preserve the efficiency of the surgical and medical apparatus, as he who best knows its uses." As to the first point, the dangers of a divided responsibility can hardly be exaggerated. If it is considered that the gen- eral in command is alone responsible, still the disadvantages 16 of having different systems in different armies are very great. All our generals are not equally humane, or equally compe- tent to decide upon such a matter. One system must be best, and that one should be prescribed for the whole army. As to the second point, the chances of ambulances being well served by men appointed for the occasion, from an already severely tasked'department, are infinitesimally small. As to both the second and third points, it is perhaps unnecessary to say more than that the system worked so badly that it was found neces- sary to reform it. This was done first by General McClellan in the army of the Potomac, and afterwards by other generals in other armies. The system adopted has been that of a permanent detail of officers and men from regiments, to form an Ambulance Corps. This is unquestionably a great improvement over the old sys- tem. Is it the best system possible ? Two objections at once occur: —first, the men being taken from the regiments in the field, those regiments are just so much weakened; second, the men detailed, in all probability, will be the most worthless men in the regiment. Again, offi- cers and men alike are detailed without knowledge, or any means of knowledge, except experience, as to the duties re- quired of them ; and even if the officers were acquainted with their duties, there being no officer of any kind permanently attached to each ambulance, the driver and his assistant, if he have one, are practically autocrats, irresponsible rulers over an insulated realm. We have neither space nor inclination to enumerate in- stances of the bad working of this system, but have confined ourselves to what seemed reasons why it was not likely to work well. A bill passed the national House of Representatives at its last session, intended to remedy the defects of the present system, and to provide a uniform system for the whole country. The method proposed was recruiting especially for the Ambu- lance Corps, instruction of the recruits in their duties, and the gradual substitution of these men and officers for those now detailed. The old regiments would have thus gradually recovered the men who had been detailed, obviating the first 17 objection to the present system. It seems to us that the second objection would also have been obviated, and that a better set of men might have been obtained, more interested in their duties, since they voluntarily assumed them, — better fitted for their duties, since selected by the officers who were to com- mand them, and not by officers who were to lose them from their commands. Instruction being provided for, the third objection also falls to the ground. The bill failed in the Senate. Whether this bill should have been passed or not, we have no opinion, as we are not familiar with its details; but that some such bill should pass, we are convinced. •Whatever method is adopted for procuring the men, we do not believe any system will succeed which does not provide for a practical and minute supervision of the men in charge of the ambulances, and for the punishment of the negligent and cowardly, and the promotion and reward of the brave and efficient. For this purpose, as well as for the proper care of the wounded in transitu, we believe it to be necessary that there should be medical officers connected with the ambulance corps, with gradations of rank similar to those of the admin* istrative officers now attached to it, and that one or more medical officers, commissioned or non-commissioned, should be permanently attached to each ambulance. We are strength- ened in this belief by the practice of the Allies. The English system was a " brigade of hospital conveyance," for two divisions of the army of six regiments each; the whole train was under the exclusive control of the staff-surgeon of the division, " none of the wagons, carts, horses, or drivers being subject to the orders of any other department, except with the authority of the general of division, who best knew when to break up or sacrifice any part of his entire means of transport." This arrangement is emphatically approved by Major Delafield. The personnel of this train, of about 27 wagons, consisted of 5 non-commissioned officers and 69 drivers. These drivers were, as nearly as we can ascertain, old discharged soldiers enlisted and trained for this special service. Nothing is said of medical officers attached to each ambulance. 3 18 In the French ambulance corps medical officers of different grades are attached to each ambulance, and the attendants are nurses (infirmiers), and trained of course, and we presume enlisted for that special service. But the ambulances of the French, at the present time, are, as we have stated, rather hos- pitals than means of transport for the wounded, and the nurses (infirmiers') are not numerous enough to attend to the trans- portation of the wounded, on mule-litters or otherwise, to the ambulance depot, from the field itself. This want is deplored, and a regular corps for this special purpose suggested as a remedy in the latest French publications on the subject. Letus*think for an instant what a negative answer to the question, " Have we the best possible ambulance system ?" means. It means this. Our brave soldiers are suffering, with- out complaint, unnecessary agony. Our husbands, fathers, brothers, and sons are dying when they might live. The simple facts are so eloquent, that any attempt to strengthen their pleading would be worse than vain. If there is only a reasonable doubt whether improvement is possible, it is the duty of Congress to settle that doubt, and of the people to call ■upon it to do so. This is a sacred duty which the people owe to their soldiers, — not to strangers, but to those who have gone out from their own homes and firesides, — a duty, and a debt, neglect of which is not merely unjust and ungrateful, but is infamous. $