\ SANITARY COMMISSION. c. RULES FOR reserving tjre peahfe of % Jiflftutr. [fifth edition.] The members of the Sanitary Commission ordered by the President of the United States, and acting under the direc- tion of the Secretary of War, in co-operation with the Army Medical Bureau, to secure by all possible means the health and efficiency of our troops now in the field, and to prevent unnecessary disease and suffering, do most earnestly and affectionately request their brethren of the volunteers and militia to adopt and carry out the following "Rules foe preserving the health of the soldier." They are de- rived from the highest authority and the largest experience of military and medical men, and it is believed that, if fol- lowed with the intelligence and honesty of purpose which characterize the American soldier, they will save/the lives of thousands of brave men who would be otherwise lost to the service of their country. They are addressed alike to officers and. privates, inasmuch as the latter are liable to promotion, and upon their officers devolves the responsibility of securing their health, safety, and comfort. They will be found in no instance to conflict with the "Army Regulations," by which all ranks are gov- 0 erned, and with which every good soldier should be familiar. 1. It is absolutely necessary, for the sake of humanity and the efficiency of the army, that every man laboring under any physical infirmity which is liable to unfit him for bear- ing without injury the fatigues and hardships of a soldier's life in the field, should be promptly discharged from the service by his commanding officer on a surgeon's certificate of disability. (Army Regulations, par. 159-167, and 1134, 1135, 1138.) It is the duty of every good soldier who is conscious of any such disease or defect, which may have been overlooked von inspection, to report himself to the surgeon for advice. In case of discharge, means are provided for his prompt payment and conveyance to his home. 2. Every officer and soldier should be carefully vaccinated with fresh vaccine matter, unless already marked, by small- pox; and in all cases where there is any doubt as to the success of the operation it should be repeated at once. " Good vaccine matter will be kept on hand by timely re- quisition on the Surgeon General." (General Regulations, par, 1105, 1134.) N3. Medical officers are earnestly advised to make them- selves familiar with the " Revised Regulations for the Medical De- partment of the Army," a copy of which should be obtained by application to the Surgeon General. They will thus learnNtfie proper modes of securing supplies of medicines, instruments, and hospital stores, and rules for official con- duct under &U circumstances. 4. The articled of food composing the rations issued by the United States \Commissary Department have been proved, by sound experience, to be those best calculated for the food of the soldier. Nv The amount allowed for e&ch man is greater in quantity than the similar allowance for any European soldier. If he understands his duties and managesNvell, any commissary of _......_____X 3 subsistence can save from 15 to 30 per cent, out of the rations furnished by Government, and with the money thus saved, fresh vegetables, butter, milk, &e., may be procured. 5. "When the surgeon considers it "necessary for the health of the troops, the commanding officer, on his recommenda- tion, may order issues of fresh vegetables, pickled onions, saur kraut, or molasses, with an extra quantity of rice and vinegar," (Army Regulations, par. 1079.) Desiccated vegetables and dried apples may be obtained on similar authority. 6. When the rations furnished for the troops are damaged, or in any way unfit for use, the Army Regulations require the commanding officer to appoint a "Board of Survey," composed of competent officers, by which they may be con- demned; in which case, good provisions are issued in their stead. (Par. 926.) 7. Soldiers should always eat at regular hours, as far as the exigencies of service permit. Neglect of regular hours for meals tends to disorder the digestion, and to invite diarrhoea. 8. Each company should have its regularly detailed cook and assistant, who should always, on a march, be allowed to ride in one of the wagons, when practicable, inasmuch as their services are more necessary for the health of the men than in the ranks, and they are often required to cook at night the rations for the next day, whilst the men are sleeping. The men should always willingly procure wood and water for the cooks, whether detailed for such service or otherwise. 9. "Bread and soup are the great items of a soldier's diet in every situation: to make them well is therefore an essen- tial part of his instruction. Those great scourges of a camp life, the scurvy and diarrhoea, more frequently result from a want of skill in cooking than from the badness of the ration, 4 or from any other cause whatever. Officers in command, and more immediately, regimental officers, will therefore give a strict attention to this vital branch of interior econ- omy." (Winfield Scott.) 10. The best mode of cooking fresh meat is to make a stew of it, with the addition of such vegetables as can be ob- tained. It may also be boiled; but roasting, boiling, or frying, in camp, are wasteful and unhealthy modes of cooking. 11. " In camp or barracks the company officers must visit the kitchen daily, and inspect the kettles. * * * The commanding officer of the post or regiment will make frequent inspections of the kitchens and messes. * * * The greatest care will be observed in washing and scouring the cooking utensils: those made of brass or copper should be lined with tin. * * * The bread must be thoroughly baked, and not eaten until it is cold. The soup must be boiled at least five hours, and the vegetables always cooked sufficiently to be perfectly soft and digestible." (Regulations, par. Ill, 112, 113.) Medical officers should frequently ex- amine the articles of food issued to the men, inspect and taste it when cooked, and scrutinize the goodness of the cooking, and the condition, as to safety aud cleanliness, of cooking utensils. 12. Spirits should only be issued to the men after unusual exertion, fatigue, or exposure, and on the discretion of the surgeon. Those men who drink spirits habitually, or who commit excess in its use, are the first to fail when strength and en- durance are required, and they are less likely to recover from wounds and injuries. 13. Water should be always drank in moderation, espe- cially when the body is heated. The excessive thirst which follows violent exertion, or loss of blood, is unnatural, and is 5 not quenched by large and repeated draughts; on the con- trary, these are liable to do barm by causing bowel com- plaints. Experience teaches the old soldier that the less be drinks when on a march the better, and that he suffers less in the end by controlling the desire to drink, however urgent. 14. There is no more frequent source of disease, in camp life, than inattention to the calls of nature. Habitual neglect 7 o of nature's wants will certainly lead to disease and suffering. A trench should always be dug and provided with a pole, supported by uprights, at a properly-selected spot at a mod- erate distance from camp, as soon as the locality of the latter has been determined upon ; one should be provided for the officers and another for the men. The strictest discipline in regard to the performance of these duties is absolutely essential to health, as well as to decency. Men should never be allowed to void their excrement elsewhere than in the regularly-established sinks. In a well-regulated camp the sinks are visited daily by a police party, and a layer of earth thrown in, and lime and other disinfecting agents employed to prevent them from becoming offensive and unhealthy. It is the duty of the surgeon to call the attention of the com- manding officer to any neglect of this important item of camp police, and also to see that the shambles, where the cattle are slaughtered, are not allowed to become offensive, and that all offal is promptly buried at a sufficient distance from camp, and covered by at least four feet of earth. (Re- gulations, par. 505, 513.) 15. Except when impossible for military reasons, the site of a camp should be selected for the dryness of its soil, its proximity to fresh water of good quality, and shelter from high winds. It should be on a slight declivity, in order to facili- tate drainage, and not in the vicinity of swamps or stagnant water. A trench, at least eight inches deep, should be dug around each tent, to secure dryness, and these should lead into other ('. and deeper main drains or gutters, by which the water will be conducted away from the tents. 16. Sleeping upon the damp ground causes dysentery and fevers. A tarpaulin or India rubber cloth is a good protec- tion; straw or hay is desirable, when fresh and frequently renewed; fresh hemlock, pine, or cedar boughs make a healthy bed. When occupied for any time, a flooring of planks should be secured for the tents, if possible, but this must be taken up, and the earth exposed to the sun, at least every week. 17. The tents for the men should be placed as far from each other as the "Regulations " and the dimensions of the camp permit, (never less than two paces ;) crowding is always injurious to health, (Regulations, p. 508.) No refuse, slops, or excrement, should be allowed to be deposited in the trenches for drainage around the tents. Each tent should be thoroughly swept out daily, and the materials used for bedding aired and sunned, if possible; the canvass should be raised freely at its base, and it should be kept open as much as possible during the day-time, in dry weather, in order to secure ventilation, for tents are liable to become very unhealthy if not constantly and thoroughly aired. Free ventilation should also be secured at night, by open- ing and raising the base of the tent to as great an extent as the weather will permit. 18. The crowding of men in tents for sleeping is highly injurious to health, and will always be prevented by a com- manding officer who is anxious for the welfare of his men. Experience has proved that sleeping beneath simple sheds of canvas, or even in the open air, is less dangerous to health than overcrowding in tents. No more than five men should ever be allowed to sleep in a common army tent, of the kind most commonly in use. 19. The men should sleep in their shirts and drawers, re- 7 moving the shoes, stockings, and outer clothing, except when absolutely impracticable. Sleeping in the clothes is never so refreshing, and is absolutely unhealthy. 20. The men should never be allowed to sleep in wet clothing, or under a wet blanket, if it can be possibly avoid- ed; and, after being wetted, all articles of clothing and blankets should be thoroughly dried and sunned before being used. After a thorough wetting, there is no serious danger as long as the body is kept in motion ; but the wet clothes should be replaced by dry shirt and drawers before sleeping; otherwise there is danger of taking cold, and of other grave forms of disease. If the men are deficient in the necessary supply of clothing for a change, the surgeon should report the fact to the commanding officer. 21. Camp fires should be allowed whenever admissible; they are useful for purifying the air, for preventing annoy- ance from insects, for drying clothing, and for security against chilliness during the night. 22. The underclothing should be washed and thoroughly dried once a week. The men should bathe, or wash the whole body with water, at least once a week, and oftener when practicable, but the feet should be bathed daily, and the stockings wash- ed whenever soiled. 23. The hair and beard should be closely cropped. If vermin make their appearance, apply promptly to the sur- geon for means to destroy them. Extra soap may be pro- cured on recommendation of the surgeon. It is the immediate duty of non-commissioned officers in command of squads to see that these, and all other precau- tions required for the health of the men, are strictly carried out under the orders of the company and medical officers. 24. When bowel complaints are prevalent, be especially 8 observant of the rules for preserving bealtb, and apply to the surgeon for a flannel bandage to be worn constantly around the belly. 25. It is wise and prudent, when ague and fevers are prevalent, that every man should take a dose of quinine bitters at least once in twenty-four hours. This will surely serve as a safeguard against an attack of disease; it lias been practiced in Florida and elsewhere with undoubted benefit. 26. The men should not be overdrilled. It is likely to beget disgust for drill, and to defeat its object. Three drills a day, of one hour each, for squads, and a proportionate length of time, when sufficiently advanced, for battalion drill, is more profitable than double the time similarly occu- pied. Drilling before breakfast is always injurious, especi- ally in malarious districts. 27. When practicable, amusements, sports, and gymnastic exercises should be favored am<5ngst the men; such as run- ning, leaping, wrestling, fencing, bayonet exercise, cricket, base-ball, foot-ball, quoits, &c, &c. 28. On a march take especial care of the feet. Bathe them every night before sleeping, not in the morning. Select a shoe of stout, soft leather, with a broad sole, and low heel. Prefer woolen socks. If the feet begin to chafe, rub the socks with common soap where they come in contact with the sore places. 29. An old soldier drinks and eats as little as possible whilst marching. The recruit, on the contrary, is continu- ally munching the contents of bis haversack, and using his canteen; it is a bad habit, and causes more suffering in the end. 30. The commencement of the day's march should be prompt. Nothing tires the men so much as hanging around a camp, waiting for the word to start. 9 31. It is a great comfort to the men to halt for ten or fif- teen minutes at the end of the first half hour; many, about this time, require to attend to the calls of nature. After this there should be a bait of ten or fifteen minutes at the end of every hour, with a rest of twenty minutes in the middle of the day for lunch. A longer halt than this stiffens the men and' renders subsequent marching difficult. The best rule is to get through the day's march, and rest in camp, if possible, by two o'clock p. in. 32. The best pace to adopt in marching, is from 90 to 100 steps (of 28 inches each) to the minute; this will give a rate of from 2| to 2| miles to the hour. In continuous marches, the leading companies should be alternated each day, as it is always less fatiguing to be in advance. 33. At the close of a day's march every man should bathe his feet, and wash his stockings, and get his meal before lying down to rest, removing and changing the under cloth- ing, if wet. 34. Whenever, on a march, facilities of transportation are available, it is wise to allow the men to put their knapsacks into the wagons. This is an immense saving of strength, especially to troops unaccustomed to marching. When there is liability to attack, and when the troops are going into battle, this measure is particularly recommended, as the men, under these circumstances, are liable to lose their knapsacks, overcoats, and blankets, 35. In action, the proper position in which to place a wounded or fainting man is flat upon his back, with the bead rery slightly raised. 36. The most urgent want of a wounded man is water; if a canteen or cup is not at hand, bring it in a bat or any available vessel. in 37. As a role, cuts, even when extensive, are less danger- ous to life than they seem; the contrary is true of bayonet and bullet wounds. 38. Whenever blood is flowing freely from a wound bv spirts or jets, there is immediate danger; and, if the wound is situated in one of the limbs, a stout handkerchief or band should be promptly tied loosely around it, bet/can. the irovnd and the Inart; a drumstick, bayonet, ramrod, or jack-knife is to be then inserted between the skin and the bandage, and twisted around until the strangulation of the limb stops the flow of blood, and it should be held thus until the surgeon arrives. In a less urgent ease, or where the wound is differently situated, pressure applied directly to its surface, and kept up steadily, will often save life. 39. Wounded men should always be bandied with extreme care, especially if bones are broken. The medical assistants are always provided with spirits and anodynes. 40. It is by no means necessary that bullets should always be extracted; they often remain in the body, and do little or no barm—much less, in fact, than might be done in attempts to remove them. Washington, Jidy 12, 1861. W. 1L VAN BUREN, M. D. Adopted and approved by the Commission at a meeting held at Washington, July 12, 1861. FRED. LAW OLMSTED, (icyiCT'il Secretary. SANITARY COMMISSION. c.