SANITAKY COMMISSION. No. 65. DEPARTMENT OF SPECIAL INSPECTION OF €\)t (Drnral hospitals of % %xxq. —■ «•► ■—. SECOND REPORT TO THE COMMITTEE, BY HENRY G. CLARK, M. D., INSPBCTOR-IN-CHIEF. WASHINGTON, JANUARY 31st, 1863. WASHINGTON: McGILL & WITHEROW, PRINTERS 1863. gUparinmtt of Sijjmal Inspection of (©crural hospitals, Washington, Jan. 21, 1863. To Wm. H. Van Buren, M. D., W0LC0TT GlBBS, M. D., C. R. Agnew, M. D., Medical Committee, U. S. Sanitary Commission : The undersigned respectfully reports: That the inspection with which he has been entrusted has progressed favorably. Since the last report eighteen Inspectors have been or are now on terms of service; as follows, viz : Dr. Wm. W. Morland,. Dr. James Ayer,......... Dr. S. Conant Foster,. Dr. S. O. Vanderpool,. Dr. David B. Reid,..... Dr. S. Pollak,............. Dr. C. E. Buckingham,. Dr. George H. Gay,.... Dr. William E; Coale, Dr. S. Weir Mitchell, Dr. G. R. Morehouse,.. Prof. J. W. Draper,..... .District of Columbia. u a a a a a .St. Louis, Louisville, etc. .Chicago, Keokuk, etc. .District of Louisville. a a " Nashville. " Harrisburg. Annapolis and Frederick. 4 Dr. E. Krackowizer,...........District of Philadelphia. Prof. Alden March,............ " New York. Prof. A. Jacobi,................. " New England. Dr. C. A. Terry,................Port Royal and Newberne. Prof. Z. Pitcher,................District of Memphis. Prof. S. G. Armor,............. " Reports have been received from the following gentlemen, viz: On the hospitals at— Louisville, by Dr. Joshua B. Flint. Baltimore, Dr. Edmond Fowler. Philadelphia, Drs. A. A. Gould and R. M. Hodges. Fortress Monroe, etc., Drs. Minot and Abbot. District of Louisville, Drs. Buckingham and Gay. " Nashville, Dr. W. E. Coale. " Columbia, Drs. Morland, Foster, and Ayer ; and they are herewith transmitted. They exhibit the faithful industry and intelligence of the Inspectors ; and several of them, especially those from New York, by Dr. WinslowLewis; Philadelphia, by Drs. Hodges and Gould ; Nashville, by Dr. W. E. Coale ; the District of Louisville, by Drs. Gay and Buckingham; and Fortress Monroe, by Drs. Minot and Abbot: an exactness of detail, and an elaborate completeness, which leave nothing to be desired. Considering the circumstances under which these gentlemen have been called to serve, we may congratulate the Commission certainly on its success in this. One of the Inspectors, Dr. Buckingham, writes to the General Secretary as follows : " The fact is, that both Gay and myself were pretty well used up. The papers (reports) which we sent can give no adequate account of the labor to one who is not accustomed to the work." This remark can be fully 5 appreciated by many of our inspectors on this special service, who have undertaken, amid the fatigues and inconveniences of travel, at its close, to reduce to order and put into writing the notes and various experiences and observations of the day. Although the Inspectors report great defects in some of the hospitals of the Southwest, from the difficulty of obtaining suitable buildings in all cases; from the too small number of attendants, and from the embarrassments of transportation in localities so near to the seat of hostilities, and where so many of the inhabitants are disloyal, or luke- warm; their testimony is uniform as to their very cordial reception by the medical directors and the hospital surgeons, who seem not to have lost their equanimity under many trying circumstances, or to have been discouraged by the obstacles and embarrasments abounding in a district in the very focus of the war, and but just relieved from a state of siege, with a very large number of sick and wounded sud- denly thrust upon them; and which would have appalled or paralysed men who were less devoted, less capable, or less courageous than they, but which were proved to be only the stimuli needed to bring into active operation all their best sentiments and energies. A few extracts from these reports will best illustrate these statements. They are taken from many others equally per- tinent. Dr. Minot says: " As the result of our tour of in- spection we are much gratified at being able to say, that we have found, on the whole, the hospitals we have visited in a most creditable condition." " We were uniformly received with courtesy, and the utmost freedom of inquiry and exa- mination was accorded to us. Feeling that our inspection was, to some extent, a matter of sufferance, we wish to put 6 on record our acknowledgments of the gentlemanly and hospitable treatment that we met with everywhere." Dr. Coale, speaking of one of the hospitals in his circuit, says : " I must acknowledge how much I am indebted to the surgeon-in-charge for his carefulness, fulness, and minuteness in furnishing me with the required information, and his genial courtesy in doing it;" and of several other medical officers : " These gentlemen offered me every facility in their power for prosecuting my enquiries, and my relations with them were most pleasant and cordial." As to the difficulties to be encountered and overcome, the following will give us some idea : " Water has to be brought a mile and a half, from the river." "The washing cannot be done for the amount allowed by Government." " The medical men are much too few in number, and far too much overworked." " The most urgent and instant want, not only of the places I have officially visited, but* of eveiy military station in the West where I have been, is—Hospitals. This want was pressed upon me very forcibly, not only by my own obser- vations, but by officers and soldiers, and not less by civilians. Many and bitter were the comparisons made by these several classes of our people upon the different treatment of tho East and the West; and I. could not deny the justice of their complaints that, while hundreds of thousands of dollars had been spent for hospitals, with all the best means and appli- ances to boot, for ameliorating the condition of the sick and wounded soldiers in the East, not one cent had been dis- tributed for a proper hospital West of the Allegheny moun- tains."* "In looking back at those pages devoted to what * Since this was written, orders have been issued for the construction of a very large hospital at Nashville, on the plan of the " Chestnut Hill," at Philadelphia. I found at Bowling Green, it will be at once seen that I have not described a single hospital, or a house which could readily be converted into one." The most suitable building at Louisville, the State Blind Asylum, is thus spoken of by Drs. Buckingham and Gay: " This large four story building, with a high basement, on high open ground by itself, and furnished with every conveni- ence for a hospital, the best adapted in eveiw respect of any building yet seen, has just been vacated by order of the Secretary of War." "It seems wrong that this magnificent building, with all the conveniences for at least four hundred men, which the Government has already spent so much money to protect, and for which damages to the amount of $40,000 have already been claimed, should be abandoned, when it is evident that no damage has been done. Four- teen or fifteen persons, now elsewhere well accommodated, ought not to be permitted to exclude thousands whose comfort and safety can no otherwise be provided for."* To show how bravely these discouraging circumstances are met by the medical men, I extract the following passages from the previous report :f " The surgeon J of Hospitals Nos. 2 and 3 (Nashville) had established himself writh his patients in two college buildings, which, with the grounds, had until within eight days been a camp for a brigade of cavalry, the horses of which had been even stabled in the buildings. In that tirne he had policed off 280 loads of manure from the houses and grounds, and deposited them a half mile distant; had thoroughly cleansed the buildings; had brought the water (laying pipes) from a quarter of a mile distant; had * MS. Reports, fol. XIII, No. 38. f MS. Reports, fol. XV, No. 3. X Dr. Kelly, Assistant Surgeon 1st Wisconsin. 8 found, down in the city, the steam boiler and apparatus used to heat the brick building, brought it up and erected it, much with his own hands; had built two large brick bake- ovens; had built a soup-house, and set up a soup-boiler in it to make all the soup for the two buildings; had built a decent covered privy, 100 feet long; had had all the 455 bedt filled with hay: and all this without a requisition, (for that would have been useless,) foraging for all the material— a necessary step in the condition of Nashville at that time. Surely I never saw more energy and ingenuity crowned by a consummate amount of executive abilities, and all covered under a close garb of modesty." One other case at Hospital No. 2, Bowling Green: " The cook was a German, who took great interest in his office, and, under direction of the Surgeon,* made up, with great ingenuity, out of scant and imperfect materials, fancy messes, puddings, &c, for the men. The doctor had erected by his convalescents a bake-house, where excellent bread was baked. The iron oven used was made for field purposes, and struck me as being very excellent. I saw nothing like it in the Army of the Potomac. I ought to add, in justice to Dr. S., that he personally retook this on the battle field after it had been captured by the Confederates, who had tried to render it useless by firing shot through it. Where the Surgeon had control of the grounds in the vicinity, they were thoroughly policed, and the sinks were provided for, as regards hygiene and decency." f Considering the West, especially the Southwest, a very important field, and having received no report from Dr. Flint of Louisville, who had been there inspecting '- Selby- t MS. Reports, fol. XV, No. 2. J under the appointment of the Committee, I detailed, on the first of December, to that region, and to the Nashville district, three very competent Inspectors; and to their reports, from which I have extracted above, I especially refer. 1 have already arranged for another inspection at these points during the ensuing month. I have, in accordance with the announced policy of the Committee, felt obliged to prefer Eastern Inspectors for this purpose; and have also, for the same reason, invited our Western brethren to inspect at the East. Experience, and the information I have derived from these reports, and from personal interviews with the writers, as well as from the note of the Western Secretary, which your Chairman was good enough to transmit to me, have satisfied me fully of the wisdom of this arrangement. I have, therefore, taken great pains to send into this field, and shall continue to do so, gentlemen from this part of the country, whose general intelligence, weight of character and loyalty, ought to make them anywhere and everywhere welcome. We hope, therefore, that this mutual interchange of the Special Inspectors of the General Hospitals of the Army will not only prove mutually agreeable, but that it will tend to foster that true spirit of national loyalty to the Govern- ment, which, laying aside personal and local prejudices, should count all men as its friends who in this most effective way have rallied to its support; and that our brethren at the West will not, on that account, receive with the less cordiality those who, like the Magi of old, shall have come to them, with their good gifts and the frankincense of good fellow- ship, from the direction of the rising sun. The District of New Orleans is the only one which will not be under inspection during the next two or three weeks, 10 This omission is less to be regretted from the fact that, under the energetic administration of the general lately in command of that department, its sanitary condition has been so well maintained that the numberof sick there is not very large. I have the offer of an excellent Inspector for that district in the month of April. Having found that many of the Inspectors prefer to visit in company, I have, when I have been able to do so, made that arraugement for them ; and I am certain that the con- joined observations of two Inspectors for a fortnight are often more satisfactory, for many reasons, than those of a single inspector, for a longer comparative period. I am happy to be able to say that the knowledge of the confidential nature of our reports; the certainty that any grounds of complaint stated in them will be made known, first of all, to the head of the medical department, and by him to those whom they most concern; that our whole desire is to aid aud not to embarrass the surgeons in charge ; to improve and not to criticise the hospitals; have beeu suf- ficient to make our path of duty so far, not only one of present satisfaction, but one which gives promise of perma- nent future good. Respectfully submitted: HENRY G. CLARK, Jnspertar-in- Chief.