SANITARY   COMMISSION.
              No. 172.
 RULES  FOR PRESERVING THE HEALTH  OF  THE
                      SOLDIER.
                      [second 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 Avith the Army
 Medical  Bureau, to secure by all possible means the health
 and efficiency of our troops noAv in the field, and to prevent
 unnecessary disease and  suffering, do  most earnestly and
 affectionately request their brethren of the  volunteer and
 militia to adopt and carry out the following '' Rules for pre-
 serving the health of the soldier."  They are derived from the
 highest authority and the largest experience of military and
 medical men, and it is believed that, if folloAved Avith the
 intelligence and honesty of purpose Avhich characterize the
 American soldier, they Avill  sa\"e the lives of thousands of
 brave men who Avould be  otherAvise 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  Avhich  all  ranks are
governed, and Avith 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 Avhich is liable to unfit him for
bearing Avithout  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 Avho is conscious of
any such disease or defect,  Avhich may have been overlooked
on 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
Avith fresh A*accine matter,  unless already marked by small-
pox; and, in all  cases Avhere  there is any doubt as to the
success of the operation, it should be repeated at once.
   "Good vaccine matter  Avill be kept on  hand by timely
requisition on the Surgeon General."   (General Regulation?.
par. 1105, 1134.)

   3. Medical officers are  earnestly advised to make them-
selves familiar with the  "Revised Regulations for  the Medical
Department of the Army,'' a copy of which should be obtained
by application to the Surgeon General.  They Avill thus learn
the proper modes of securing  supplies of medicines, instru-
ments,  and hospital stores,  and  rules for official conduct
under all circumstances.

   4.  The articles 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.
   The  amount alloAved for each man is greater  in quantity 
o
than the similar alloAvance for any European soldier.  If he
understands his duties and manages Avell,  any Commissary
of Subsistence can save from 15 to 30 per  cent, out of the
rations  furnished  by Government, and  Avith the  money
thus saved, fresh \regetables, butter,  milk,  <fec,  may be
procured.

  5. When the surgeon  considers it  " necessary for  the
health of the troops, the commanding officer,  on bis recom-
mendation, may order  issues  of  fresh  vegetables,  pickled
onions,  saur  kraut, or molasses,  Avitk  an extra quantity of
rice and vinegar.7'   (Army Regulations, paragraph 1079.)
  Desiccated vegetables and dried  apples may be obtained
on similar authority.

  6. When the rations furnished for  the  troops are dam-
aged, or in any Avay unfit for use, the  Army Regulations
require the  commanding officer to appoint  a "Board of
Survey," composed of  competent  officers, by Avhich the}'
may be  condemned; in Avhich 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.

  S. Each  company  should have its regularly detailed cook
and  assistant, avIio  should always,  on  a march, be  alloAved
to ride in  one of the Avagons, Avhen practicable, inasmuch
as their  services are more necessary for the health of the
men than in the ranks,  and they are often  required to cobk
at night the  rations for the next day, Avhilst the men  are 
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sleeping.  The men should always willingly procure wood
and water for  the  cooks, whether detailed for such service
or otherAvise.

  9. "Bread  and  soup are the great items of a soldier's
diet in  every  situation: to make them well  is therefore an
essential part  of his instruction.   Those  great scourges of
a camp life,  the survy and diarrhoea, more frequently result
from a Avant of skill in cooking than from  the badness of
the ration, 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 economy."  (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
obtained.   It  may also be boiled ; but roasting,  broiling,
or frying, in  camp, are Avasteful  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  Avill  be observed in washing and scouring
the cooking utensils; those made of brass or copper should
be lined Avith 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."   (Regu-
lations, par. Ill,  112, 113.)   Medical officers  should  fre-
 quently examine  the  articles of  food  issued  to  the men,
inspect and taste it when cooked,  and scrutinize the good- 
5
ness of the cooking, and  the  condition, as to safety and
cleanliness,  of cooking utensils.

  12. Spirits should only be issued to the men after unusua
exertion, fatigue, or exposure,  and on the discretion of the
surgeon.
  Those men Avho drink spirits habitually,  or  Avho commit
excess in its  use. are  the first to fail when strength and
endurance are required,  and  they are  less likely to recover
from Avounds and injuries.

  13. Water  should  be  ahvays  drank  in  moderation,
especially when the  body is heated.   The excessive thirst
which folloAvs A'iolent exertion or loss of blood is unnatural,
and is not quenched by large and repeated draughts; on
the contrary, these are liable to do harm by causing boAvel
complaints.   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,
hoAvever urgent.

  14. There is no more frequent source of  disease in  camp
life than inattention to the calls of nature.  Habitual neglect
of nature's Avants Avill certainly lead to disease and suffering.
A trench should  always  be dug and provided Avith 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 Avell as to  decency.  Men
should never be allowed to void their excrement elseAvhere
than in the regularly established sinks.   In a well  regulated 
(I
camp the sinks are visited daily by  a  police party, and a
layer of earth throAvn 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 commanding  officer to any neglect of this
important item of camp  police, and also  to see that the
shambles, Avhere the cattle are slaughtered, are not alloAved
to become offensive, and that  all offal is promptly buried at
a  sufficient  distance  from camp,  and  covered by at least
four feet of earth.  (Regulations, par. 505, 513.)

   15. Except Avhen 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
ifinds.  It should be on a slight declivity, in order to facili-
tate drainage, and not in the vicinity of SAvamps 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 main drains or  gutters, by AA7hich the Avater will
be conducted aAvay from the tents.

   16. Sleeping  upon damp ground causes  dysentery and
fevers.   A tarpaulin or India  rubber cloth is a good  pro-
tection;  straw or hay are desirable, Avhen fresh and  fre-
quently  reneAved; 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 Aveek.

   17. The tents for the men should  be placed as far from
each other as the "Regulations" and the dimensions of the 
t
camp permit,  (never less than  tAvo  paces ;)  crowding  is
always  injurious to  health.—(Regulations,  p.  508.)   No
refuse, slops, or excrement should be alloAved to be deposited
in the trenches for drainage  around the tents.   Each tent
should  be thoroughly SAvept out daily, and the materials
used for bedding aired and sunned, if possible; the canvas
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 Aveather Avill permit.

   18. The crowding of men  in tents for sleeping is highly
injurious to health, and Avill always be prevented by a com-
manding officer Avho is anxious for the Avelfare 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 over-croAvding in tents.
   No  more than five men should  ever be  alloAved to sleep
in a common army tent of the kind most commonly in use.

   19.  The men  should sleep in their shirts and draAvers,
removing  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  alloAAred  to sleep in wet
clothing or under a Avet blanket, if it can be possibly avoided;
and after being Avetted all articles of clothing and blankets
should be  thoroughly dried and sunned before being used. 
8
After a thorough Avetting 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 draAvers before sleeping, other-
Avise 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.

  20.  Camp fires should be alloAved Avbenever 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 Avashed and thoroughly
dried once a Aveek.
  The men should bathe, or Avash the whole body with
water, at least once a Aveek, and oftener Avhen  practicable,
but the feet should  be  bathed  daily, and the  stockings
Avashed Avhenever 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
observant of the rules for  preserving health, and apply to
the surgeon for  a flannel bandage to be Avorn  constantly
around the belly. 
9
   25.  It is wise and  prudent, Avhen  ague and fevers  arc
prevalent,  that  every man should take  a  dose of quinine
bitters at least once in twenty-four hours.  This will surely
serve  as a safeguard against an attack of disease ; it has
been practiced in Florida and  elsewhere with undoubted
benefit.

   26.  The  men should  not be over-drilled.  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 propor-
tionate length  of time,  Avhen  sufficiently advanced,  for
battalion  drill,  is  more profitable than double the time
similarly occupied.

   27.  When practicable, amusements, sports, and gymnastic
exercises  should be faA'ored amongst the men, such as run-
ning, leaping, Avrestling, 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, Avith a broad sole and
Ioav heel.
   Prefer Avoolen socks.  If the feet begin to chafe, rub  the
socks Avith common  soap Avhere 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  con-
tinually munching the contents of his haversack,  and using
his canteen; it is a bad habit, and causes more suffering in
the end. 
10
  30. The commencement of the day's march  should  be
prompt.  Nothing tires the men so much as hanging around
a camp, Avaiting for the Avord to start.

  31. It is a great comfort to  the  men to halt  for ten or
fifteen minutes at the end of the iirst half hour; many, about
this time, require  to attend to  the  calls of nature.   After
this there should be a  halt of ten or fifteen minutes at the
end of every  hour,  Avith a rest of  tAventy 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 tAvo o'clock, p. m.

  32.  The best  pace to  adopt,  in marching, is from 90 to
100 steps (of 28  inches each) to the minute; this will give a
rate of from 2-£ to  2| miles to the hour.
  In continuous  marches, the leading companies  should be
alternated each day, as it is ahvays less fatiguing to be in
advance.

  33.  At the close of a day's march every man should bathe
his  feet,  and Avash  his stockings, and  get  bis  meal  before
lying  down to  rest,  removing and changing the  under
clothing, if Avet.

  34.  Whenever, on a  march, facilities of transportation are
available, it is Avise to alloAv the men to put their knapsacks
into the  Avagons;  this is an immense  saving  of strength,
especially to troops unaccustomed to marching.
  When  there is liability to attack, and when the  troops are
yroing into battle, this measure is particularly recommended, 
11
as the  men, under  these circumstances, are liable  to  lose
their knapsacks, overcoats, and blankets.

  35. In action, the  proper position  in Avhich to place a
wounded or  fainting man is  flat upon his back, with the
head very slightly raised.

  36. The most urgent want of  a  wounded man  is Avater:
if a  canteen  or cup is not at  hand bring it in a hat or any
available vessel.

  37. As a rule, cuts, even Avhen extensive, are less danger-
ous to life than they seem; the contrary is  true of bayonet
and bullet Avounds.

  38. Whenever blood  is flowing'  freely from a-Avound by
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, between the wound
and  the heart; a drumstick, bayonet,  ramrod,  or jack-knife
is to be then  inserted betAveen the skin and the bandage,
and tAvisted around until the strangulation of the limb stops
the floAv of  blood,  and it  should  be held thus  until the
surgeon arrives.
  In  a less  urgent  case, or Avhere the Avound is differently
situated, pressure  applied directly to  its surface, and kept
up steadily, Avill often save life.

  39. Wounded men should  always  be  bandied Avith ex-
treme  care, especially if  bones are broken.   The medical
assistants arc always provided Avith spirits and anodynes. 
12
  40. It  is by  no means necessary that  a bullet should
ahvays be extracted;  the}r often remain in the body, and
do little or no harm, much less,  in fact, than might be done
in attempts to remove them.
  Washington, July 13, 1861.
                        W. H. VAN  BUREN, M.  D.

  Adopted and approved by the Commission at the meeting
held at Washington, July 12,  1861.
                Henry W.  Bellows,
                Prof. A. D. Bache,
                Elisha Harris, M. D.,
                George W. Cullum,  U. S. Army,
                Alexander E. Shiras, U. S. Army,
                Robert C. Wood, M.  D., U. S. Army,
                William H. Van Buren, M. D.,
                WOLCOTT GlBBS,  M. D.,
                Samuel G.  Hoave, M.  D.,
                Cornelius  R.  Agneav, M. D.,
                J. S. Newberry, M. D.,
                George T.  Strong,
                Fred. Law Olmsted,
                                   Commissioners.