SANITARY COMMISSION.

No. 43.

New York Agency of the U. S. Sanitary )

Commission, 498 Broadway, v

July 21st, 1862. )

To the President of the United States :

Sir, — Three hundred thousand raw recruits are about to be called into the field. It is impossible for the U. S. Sanitary Commission to contemplate this momentous fact without a pro- found feeling of its obligation to lend Government whatever aid and counsel its peculiar experience may enable it to offer as to the safest and best method of getting these men into the field and keeping them there in the most serviceable condition and with the highest attainable economy of life and health. After studying for fifteen months the sanitary interests of our great army, we have arrived at definite conclusions as to mea- sures necessary to protect these new levies against certain of the dangers that threaten them, and it is our plain duty, as a " Commission of inquiry and advice iu regard to the Sanitary " interests of the United States Forces," to submit these con- clusions, most respectfully, to the consideration of yourself, their Commander-in-Chief.

The careless and superficial medical inspection of recruits made at least twenty-five per cent, of the volunteer army raised last year, not only utterly useless, but a positive encumbrance and embarrassment, filling our Hospitals with invalids and the whole country with exaggerated notions of the dangers of war that now seriously retard the recruiting of the new levies we

so urgently need. The wise and humane regulations of the United States Army that require a minute and searching in- vestigation of the physical condition of every recruit, were during the spring and summer of 1861 criminally disregarded by Inspecting Officers. In twenty-nine per cent, of the regi- ments mustered into service during that period there had been no pretence even of a thorough inspection. Few regiments have thus far taken the field that did not include among their rank and file many boys of from fourteen to sixteen, — men with hernia, varicose veins, consumption, and other diseases, wholly unfitting them for duty, and which could not have escaped the eye of a competent Medical Officer — and others with constitutions broken by intemperance or disease, or long past the age of military service. Each of these men cost the nation a certain amount of money, amounting in the aggregate to millions of dollars. Not one of them was able, however well disposed, to endure a week's hardship or render the nation a dollar's worth of effective service in the field. Some regiments left ten per cent, of their men in hospitals on the road, before they reached the seat of war. !N"o national crisis can excuse the recruiting of such material. It increases for a time the strength of the army on paper, but diminishes its actual effici- ency. It is a mere source of weakness, demoralization, and wasteful expense, and of manifold mischief to the army and to the National cause. The frequent spectacle of immature youth and men of diseased or enfeebled constitutions returning to their homes shattered and broken down after a month of camp-life destructive to themselves and useless to the country, has de- pressed the military spirit and confidence of the People. How can we escape a repetition of this manifest evil except by a more vigilant and thorough inspection of our new levies? And how can such inspection be secured ? We respectfully submit that no new recruits should be ac-

cepted until they have been examined by Medical Officers of the United States Army, entirely without personal interest in the filling up of any regiment. And these medical men should have had some experience in the hardships and expos- ures of military life. No one, in short, should be allowed to serve as a Medical Inspector of recruits, who has not passed a regular Army Board named by the Surgeon-General him- self, and convened at some one of the great centres of medical science.

A large percentage of the disease and weakness of our armies up to this time, (in other words the waste of many millions of our national resources,) has been due to the inexperience of Medical and Military Officers alike, as to the peculiar dangers and exposures that surround the soldier in camp and on the march, and which render the money the nation has ex- pended in putting him into the field, a far more precarious investment than it would be, were he kept under strict subjec- tion to Sanitary Laws. The liability of soldiers to disease should be far less than it is. It would be so were they required to observe the laws of health. They and their officers, and the People and the Government, have thus far too generally overlooked those laws. But the last twelve months have taught the Army and the People the immense importance of Sanitary science in war. Our school has been costly, but it has already taught us much. For the last three months thousands and thousands of wan and wasted forms brought North by railroad, and on Hospital transports, stricken by no rebel bullet, but by far deadlier enemies of the Nation-mal- arial fever and camp-dysentery-have been impressing on the People the lesson the Sanitary Commission has been endeavor- in- to teach ever since the war began, viz, that our soldiers we're in far greater danger from disease than from the violence

of their enemies — and that we lose ten men uselessly by pre- ventable disease, for every man destroyed by the enemy.

We have been learning rapidly during the past year. If we have learned anything, it has been that it was a mistake to keep the Regular Army and the Volunteer Army separate. Had the Regulars been from the first intermingled with the Volun- teers, they would have leavened the whole lump with their ex- perience of camp-police, discipline, subordination, and the Sanitary conditions of military life. We should have no Bull Run panic to blush for. Our little Regular Army diffused among the Volunteers of last year, would within three months have brought them up to its own standard of discipline and efficiency.

As it is, the greatest efforts have been required to inspire officers and men with a sense of the nature and importance of sanitary laws, and with the practical application of hygienic principles to their tents, their camps, their persons, and their habits and food. In this work, the Sanitary Commission, through its professional experts, has labored methodically, and with marked success. But it cannot contemplate the needless renewal of its painful experience, without warning Government that the loss of life by debility, disease, and immaturity — ten times that by our bloodiest battles — is wholly unnecessary ; that of every ten men lost by the army during the past year, nine have been needlessly wasted ; that by proper medical inspec- tion of recruits, the material of disease can be reduced to the lowest possible sum ; and then, by a proper distribution of the raw recruits among the regiments already formed, and of all new officers among existing regiments, we may at once com- municate all that is most important in the sanitary experi- ence of our veteran army to the new levy of 300,000 men and thus save them from seventy-five per cent, of the mortality to which they will otherwise be inevitably exposed.

From a sanitary point of view, tlie urgency of this policy is clear. If all the 300.000 men now to be recruited, were recruited without a single new regiment being formed, it would save the country, sooner or later, thousands of lives, and mil- lions of dollars. We should get a far better class of men. They would have a thorough medical inspection, and every man would soon cease to be a raw recruit when absorbed into a veteran regiment. Thus all our year's costly experience would be saved, and the perils of ignorance, inexperience, and crudity be avoided.

This process, too, is that by which our present army can be most rapidly reinforced, since the men raised might be sent to the field as fast as they were collected, and digested into the body of the army, day by day, without delay, and without sensibly diluting its discipline. Whereas, raised by regiments, as at present, with officers and men equally raw, they must be kept in camps of instruction till the pressing want of their ser- vices has gone by, or the opportunity of their usefulness is lost. If it be said that the stimulus to recruiting will be taken away if the aspirations of new officers are repressed, we do not hesitate to meet that alternative by saying, that it would meet the wants of the country, and the views of an enlightened public sentiment better, to draft the whole 300,000 men, with a distinct understanding that they were to fill out the skeleton regiments to which the army of veterans has become reduced, than to have them raised, without drafting, by a volunteer pro- cess to which raw officers and unskilled medical men would communicate their own ignorance and inadequacy.

Although it is purely on sanitary grounds that we urge this plea, it would be easy to show that military and political wis- dom are in exact harmony with sanitary requirements in favor- ing such a plan. But we do not venture beyond our own

sphere to urge considerations of which others are so much better judges.

If Government will call on the Medical Department of the Army for its official judgment on this grave and urgent question, we feel no doubt that these views will be abundantly confirmed, and more forcibly argued. We have the honor to be,

With great respect,

Your obedient servants,

Henry W. Bellows,

W. H. Van Btjren, M.D.,

C. K. Agnew, M.D.,

WOLCOTT GlBBS, M.D.,

Fredk. Law Olmsted, Geo. T. Strong, Exec. Committee of the

U. S. Sanitary Commission.

[Note.]

The following is an extract from a Report to the Sanitary Commission, by its actuary, Mr. E. B. Elliott, which is now in press :

" Since one hundred and four (104.4) out of every thousand men (officers and pnvates together) in the entire army, is the constant proportion of sick, it follows, that, to secure in the field a constant force of five hundred thousand (500,000) effective (or healthy and able) men, the nation must constantly maintain, in hospitals or elsewhere, an additional force of fifty eight thousand (58,000) sick men, making the entire force maintained both sick and effective, to consist of five hundred and fifty-eight thou- sand (558,000) men; four per cent, or 22,000 of this entire force

would be commissioned officers, and ninety-six per cent., or 536,000 enlisted men. And since to supply continuous losses in the ranks of the enlisted men, other than losses from expiration of service, requires recruits at the annual rate of 229 per 1,000 enlisted men, it follows, that to keep the ranks of these 536,000 enlisted men constantly full, will require annually 123,000 recruits; 29,000 of these recruits being demanded to supply the annual loss occasioned by death ; 54,000, the loss arising from discharged from service, mainly from disability ; 27,000 for excess of desertions over returns of deserters to duty; 7,000 missing in action, not subsequently otherwise accounted for, and 6,000, the loss from other causes.

" To repeat — assuming the returns of the period from the 1st of June, 1861, to the 1st of March, 1862, as the basis of calculation, it follows, that to secure in the field a constant force of 500,000 effective men, the nation must not only maintain 58,000 sick men, but it must also recruit the ranks of the enlisted portion of these forces with new material, at the rate of 123,000 per annum, so long as the war shall last ; a rate somewhat ex- ceeding 10,000 recruits per month. Of these 123,000 annual recruits, 83,000 are to supply losses by death and discharges from service, (ex- clusive of discharges for expiration of its term) ; 34,000 for desertions and missing in action, (not returned or otherwise accounted for) ; and 6,000 to supply other losses specified and unspecified.

" The five hundred thousand (500,000) effective men are equivalent in number to the number of men in 573 regiments of the average numerical strength, (that is 872 men each) ; and the 58,000 sick equivalent to 67 regiments of average numerical strength; the entire force of 558,000 men to be maintained being equivalent to 640 regiments of average strength."