Chas. S. Tripler to S. Williams, January 28, 1862
Medical Director’s Office, January 28, 1862.
GENERAL:
lu obedience to instructions in your letter of January 21 I have the honor to submit the following report:
Having the reports of the inspectors of hospitals as to the sanitary condition of nearly all the divisions of the army in this vicinity, showing their conditions at periods varying from December 5 to the present date, and having also the weekly reports of the brigade surgeons of nearly all the brigades up to January 18, for the purpose of laying before the general what I conceive to be the true state of the hospitals of this army, I hasten to present this letter in anticipation of the completion of all the inspections ordered. The importance of the subject seems to me to demand this, in order to allay unnecessary apprehensions and to afford an opportunity for correcting certain existing irregularities, as well as to offer suggestions as to the means of preventing as far as practicable any increase of disease during the winter and spring.
Iam able from the reports in my hands to compare the true sick lists in brigades with those sent in to the Adjutant-General’s Office. Among the brigades to which my attention was directed are the following. LI arrange them in tabular form, to show how widely the reports of the brigade surgeons differ from those in the table appended to your letter :
t . o gs H Ls gus B Ba Brigades. E g 22 Date. gh Sg RH oo S sa d o8 A Per cent. Per oo : A i VUURCTNONIE eee ie ee A O OO pU de 14. 34 6. January Howard EE asd oben ic eMe MERE uU N Mi CN 12. 44 9.3 Januar 18 Richardson’s.-.:….–.-.-2-2…-.–0202.-..2.–. saeco snes Ie mre cA 11, 19 6.7 January 18 JAMESON Ses ia Shas ota data Do heureuse sp src ein es 10. 95 6.4 January 18 iy Ip Bic es miM re a een 9.6 6.3 January 11 Morell: anal euet ate Seen a a ms. e secre 9.17 3.4 January 18 Hancock Baena wea dd is en a = aoe 17.1 10.9 January 18 IBTOOES Mo aa al ells a lo e 29.75 14.52 January 11 A AS acer EE aie ee ct o NO MET 9. 36 5.82 January 11 O O A seems M m ceu. c eie ei s mure gem ede 11.8 5.9 January 18 PPalmersbe a cR Me eleme e E. sate a= ce dare 12. 56 6.5 January 22 Sykes! see jon teas io Se r e eme eee ae aada ae Eai eer em mctu 9. 95 6.5 January
The above are sufficient for my present purpose, which is to show
that numbers of men are reported sick by their captains who are not . found upon the reports of the medical officers of their regiments. The true number of the sick is large enough to give-me much concern, but Iam unwilling it should be represented to be larger than it really is through the careless manner in which company reports are too frequently made out. Considering the season of the year and the unfavorable state of the weather it cannot.be disputed that this is the most healthy army the world has ever seen. The general health of the whole force is rather improving than deteriorating ; still, certain corps. -are at a stand-still, while others are sadly falling off.
IT have observed in several instances that regiments after arriving here speedily exhibited a wretched sanitary condition. The maximum, however, was soon reached, and they have steadily improved until their sick lists would compare favorably with the rest. This might be accounted for by acclimation, by gradual improvement in discipline and police, by becoming better acquainted with the wants of a soldier in – camp, and with the ineans of meeting those wants. But other troops, and those, too, from particular sections of country, have not improved. The Vermont regiments in Brooks’ brigade are examples of this. They give us the largest ratio of sick of all the troops in this army, and that ratio has not essentially varied for the last three months. They suffered in the first place from measles. In this they simply shared the lot of allirregular troops. Since then they have beer and are the subjects of fevers (remittent and typhoid). S
The inspector of hospitals (Surgeon Keeney) reports the police of all these regiments as good, their clothing good, their tents good, with the exception of the Second and Third Regiments, and, strange to say, those two regiments are in decidedly the best sanitary condition. The locations of the camps of the Fifth and Sixth are reported as bad, but that of the Third is also bad. The soil is clay; the face of the country rolling, but presenting many plains sufficiently extensive for camps. These plains have been selected, and in consequence the difficulties of drainage, always great in a clay soil, have been increased.
While writing I have received another weekly report from the Vermont brigade, which shows a large increase of sick over that of the preceding week. The Berdan Sharpshooters are also in a bad sanitary
condition, and not improving. Their camp, however, is badly located. :
I shall visit this brigade personally. .
We have now successfully passed through the season of malarious . fevers. The sanitary arrangements of this army have been successful . in warding off the diseases of summer and autumn. We are now called upon to guard against those of winter and spring. The principal dis- eases we have to fear are typhus and typhoid fevers and pneumonia. These diseases prevail in this district during the present and approaching season. Already a number of cases have occurred, some of which have been fatal. These diseases arise from foul air, bad clothing, imperfect shelter, exposure to cold and wet, imperfectly-drained and badlypoliced camps, &e. The indispensable conditions for securing the health of men in the field are good shelter, good clothing, good food, and good water, dry camp grounds, and an abundant supply of pure air.”
For the shelter of nur men we are to choose between tents and huts. There are clusters of buildings at several places within our limits that might be occupied by our troops, but having been erected for a different purpose, they are in nowise adapted to this. They are ill-constructed, ill-ventilated, too crowded, and generally out of position. I should prefer, if it is practicable, the “Chester hut,” as used at Balaklava, .
~~ Guar. XIV] GENERAL REPORTS.
the plans for which will be found in the Report of the English Sanitary
Commission. These huts, with the independent roof ventilation, were
found well adapted for hospitals as well as quarters, and the results of their employment were altogether satisfactory; but it will take time to erect them, and our necessities seem to be too pressing to admit of this delay. They might, however, be put up to some extent in the worst of our camping grounds, if military necessity requires that our men shall be kept in those positions.
Next to these huts I would invite attention again to the plan of improving our tents that I recommended in mine of the 11th December last, and perhaps in other letters, i. e., to build a pen of logs and slabs the size of the base of the tent, some 3 feet high, and then to secure the tent upon this fora roof. This plan is now in use in several camps, and wherever it has been adopted it has been found to contribute very much to the comfort of the men. In some of the camps the pit has been dug, as in the Crimea, and the tent placed over that. This I condemned emphatically in the letter alluded to, and I repeat it, it is totally inadmissible. I should add to what I said before that in my opinion board floors should be furnished to all the tents and fresh straw or hay for the men to sleep upon. These tents must not be overcrowded. This is the tendency of all armies, and is a pernicious practice. The ventilation of tents, again, is a more difficult matter than is generally supposed. This should be secured by windows, as they are termed, in the tent, and by frequently opening the tent doors or keeping them open during the day.
Most of the subsoil upon the Potomac is of clay. Thisis particularly so in the camps presenting the largest sick reports, and therefore the greater attention is required tobe paid to its drainage. I donot believe such a soil can be sufficiently will drained in a wet season to enable us to dispense with floors to the tents, but to secure as good a drainage as practicable I would recommend each company ground should be surrounded by a ditch not less than 12 inches deep at its shallowest parts; this ditch to be 4 feet from the outside border of the tents, and to be laid out and dug under the superintendence of a competent engineer; otherwise it will be imperfectly done, and be productive of more harm than good. Supplementary ditches a few inches in depth should also surround the tents, and be carefully conducted into the main ditch. I would further suggest that the floors of the tents should be raised some three inches from the ground ; that lime or charcoal should be strewed over the surface of the ground, and then the floor laid without pinning, that it may be readily taken up and the ground under it
oliced. ; Pure air cannot exist without good police. To secure this as much as possible I recommend that all impurities collected in the camps and all other impurities shall be buried not less than 12 inches below the surface. In cavalry camps the manure must be got rid of iu some way, or the men will get sick. Camping grounds long occupied seem frequently to get saturated with putrescent exhalations that engender and aggravate disease. A change of ground will often be found to
arrest or diminish an endemie for a while until a new saturation of the
new soil sets it in motion again. This was exemplified in Brooks’ brigade. A change of camp seemed to have checked the endemic in one of his worst regiments. Gradually, however, it reappeared.
The camping ground of Berdan Sharpshooters 1 think should be changed on this principle, as well as that its drainage is bad. This regiment is suffering from measles, and lately severe lung complications
have accompanied the disease. A fresh and a dry camp, therefore, is in my opinion decidedly necessary for the command. If asuitable ground is selected and the tents put up in the way I have suggested, I should look for favorable results.
Allow me to insert here what I have omitted in its proper place, that the tent foundations should not be permitted to be banked up with dirt. You can never have a dry soil under the tent floors where this practice obtains. A
I respectfully recommend an immediate change of the camping grounds of all the brigades that show an undue proportion of sick ; that these grounds shall be selected upon proper principles in relation to their drainage capabilities, their exposure to storms, and the vicinity of marshes; that they shall be ditched in the mode I have pointed out, and that the;tents shall be fitted up as I have suggested.
The food of our men is now good, and they are gradually improving in their cooking. We have no pernicious dysenteries or diarrheas in our camps. The clothing of the men is generally good. I do not think: any deficiency in this respect has anything to do with the fevers that scourge our Vermont troops. If it were practicable, it would be desirable that our men should be furnished “with the high water-proof boots, that their feet and legs might be kept dry when compelled to walk through the deep mud of the Virginia side of the Potomac.
I recommended in September that hot coffee should be issued to the men immediately after reveille. This was enjoined in general orders. I doubt whether itis now observed, but I think it important, and it should be reiterated. Picket duty is very severe at this season. The tente d’abris, if not used, might be used much to the comfort of the men exposed. I would give a whisky ration twice a day to men thus exposed, and they certainly should be furnished with the long boots I have suggested.
A. little contrivance might provide them a comparatively dry bivouac. India-rubber blankets to spread upon the ground would be advisable. lthink if we do all this, or as much of it as is possible, we shall have done all we can to secure the health of our men. Ido not expect it will meet the whole difficulty in the Vermont cases, but it will go far to alleviate it. I believe there is a nostalgic element in those regiments affecting them unfavorably. This we cannot remedy, except in so far as it may be aggravated by the spectacle of so many of their comrades being sick and dying. We shall diminish disease by the course I have pointed: out, and this will react favorably upon the other men. The proeess of aeclimation has been more tedious in these troops than in any others. lt does, however, progress. Most of the sickness in these regiments occurs among the reeruits, and those regiments which have been longest here are the best off. All this in encouraging.
While upon this subject, I ask leave to suggest that it is advisable to forbid soldiers coming into the cities of Washington or Georgetown unless upon duty with written orders. Small-pox is quite prevalent in these cities, and I have reason to believe that the cases that have occurred of late among our men have originated from exposure in town. Vaccination has been pushed as actively as possible among our troops, : but still cases of this disease do occur. Men have become its subjects `
who have been vaccinated and revaccinated very recently. Such occurrences set all calculations at defiance, and I know no other means of preventing them than keeping our men out of the way of infection altogether. I also earnestly recommend that all recruits intended for this army shall be revaccinated before they leave the rendezvous where they
Char. XIV.) GENERAL REPORTS. 111 are enlisted to join their regiments. Hundreds of recruits have joined this army lately who have never been vaccinated. It is notoriously unsafe to travel over any railroad in the country at the present day unprotected. ;
The brigade of General Hamilton is in General Banks’ division. As soon as the inspection of the few remaining commands in this vicinity is completed an inspector will be sent to that brigade.
I have written this report before I am able to communicate all the information required in your instructions, because the exigency seemed urgent. The inspections will be pressed forward, and the results communicated as rapidly as possible. i
Very respectfully, your obedient servant,
Surgeon and Medical Director Army of the Potomac.
Assistant Adjutant-General, Army of the Potomac.
[Appendix L.]