Report of Surg. Jonathan Letterman, U. S. Army,
Medical Director Army of the Potomac, of operations from July 4 to September 2.
THE PENINSULAR CAMPAIGN, VIRGINIA

March 17-September 2, 1862.
O.R.-- SERIES I--VOLUME XI/1 [S# 12]

HEADQUARTERS ARMY OF THE POTOMAC,
Med. Director's Office, Camp near Falmouth, Va., Mar. 1, 1863.

Brig. Gen. S. WILLIAMS,
Assistant Adjutant-General, Army of the Potomac.

        GENERAL: In compliance with the directions contained in your communication of January 20, 1863, I have the honor to submit the following report of the operations of the medical department of this army from July 4, 1862, to November 7, 1862, viz:
        In obedience to orders from the War Department, dated June 23, 1862, I reported on the 1st day of July following to General McClellan at Haxall's Landing, on the James River, for duty as medical director of the Army of the Potomac, and after the arrival of the army at Harrison's Landing was placed on duty as such on the 4th day of that month.
        I attempted on the 28th of the previous month to report to the commanding general from the White House on the Pamunkey River, but was prevented from doing so by the movements of the army, and was compelled to proceed by way of Fortress Monroe and the James River to his headquarters. The change which was taking place in the position of the army when I left the White House rendered it necessary that the medical supplies and the transports for the wounded and sick should also be sent up the James River to meet the wants of the army. Upon inquiry, not ascertaining that any orders had been issued in the case, I assumed the authority, and directed Assistant Surgeon Alexander, U. S. Army, the medical purveyor, and Assistant Surgeon Dunster, U.S. Army, the medical director of transportation, to proceed up that river with their supplies and vessels with all possible dispatch. They reached Harrison's Landing in time to be of the greatest service.
        The army when it reached Harrison's Landing was greatly exhausted. The malaria from the borders of the Chickahominy and from the swamps throughout the Peninsula to which it had been so freely exposed now began to manifest its baneful effects upon the health of the men. In addition to this the troops, just previous to their arrival at this point, had been marching and fighting for seven days and nights in a country abounding in pestilential swamps and traversed by streams greatly swollen by the heavy rains, which made that region almost a Sarbonean bog. The labors of the troops had been excessive, the excitement intense. They were called upon to subsist upon a scanty supply of food, and but little time even to prepare the meager allowance. They had little time for sleep, and even when the chance presented itself it was to lie in the rain and mud, with the expectation of being called to arms at any moment. The marching and fighting in such a country, with such weather, with lack of food, want of rest, great excitement, and the depression necessarily consequent upon it, could not have other than the effect of greatly increasing the numbers of sick in the army after it reached Harrison's Landing.
        Scurvy had made its appearance before its arrival there, the seeds of which had doubtless been planted some months previously, and was due not merely to the want of vegetables, but also to exposure to cold and wet, working and sleeping En the mud and rain, and to the inexperience of these troops in taking proper care of themselves under difficult circumstances. This disease is not to be dreaded merely by the numbers it sends upon the reports of sick. It goes much further, and the causes which give rise to it undermine the strength, depress the spirits, take away the energy, courage, and elasticity of those who do not report themselves sick, and who yet are not well. They do not feel sick, and yet their energy, their powers of endurance, and their willingness to undergo hardship are in a great degree gone, and they know not why. In this way it had affected the fighting powers of the army, and much more than was indicated by the numbers it had sent upon the reports of sick.
        All these influences were not without their effect upon the medical officers as well as upon the rest of the army. A number of them became sick from the exposure and privations to which they had been subjected, and those who did not succumb entirely to these influences were worn-out by the excessive labor required of them during the campaign upon the Peninsula, and especially by the labor incident to the battles immediately preceding the arrival of the army at Harrison's Landing.
        The nature of the military operations unavoidably placed the medical department, when the army reached this point, in a condition far from being satisfactory. The supplies had been exhausted almost entirely or had from necessity been abandoned; the hospital tents had been almost universally abandoned or destroyed; the arrangement of the ambulances was not in such a state as to render very effective service, and the circumstances under which the army was placed required a much larger number of medical officers to perform the duties which were thrown upon that portion of the staff.
        It was impossible to obtain proper reports of the number of the sick in the army when it reached Harrison's Landing, nor had the causes just referred to produced their full effects. After about 6,000 had been sent away on the transports 12,795 remained. The data on which to base the precise percentage of sick and wounded could not be obtained at this date, but from the most careful estimate which I could make in the absence of positive data the sickness amounted to at least twenty per cent.
        On the 1st of July I directed the Harrison house to be taken and used as a hospital, as it was the only available building for the purpose in that vicinity, although entirely inadequate to meet the wants of the army. Only a few wall tents could be obtained at that time with which to enlarge the capacity of the hospital. No hospital tents could be procured.
        The rain began to fall heavily early on the morning of the 2d, and continued with little interruption until the evening of the 3d. A few wounded came to the hospital on the 1st and on the 2d, and thereafter for several days they came in great numbers. Relays of medical officers were required to work day and night, and continued to work faithfully until all the wounded who desired assistance had received it. The absence of tents prevented shelter being provided, and the vast majority, being slightly wounded, were obliged to find protection from the rain as best they could, the more serious cases being kept in the building. The labors of the medical officers were excessive, but no relaxation was given until all who required treatment had received it. The greatest difficulty experienced at this time was providing proper food, which very many needed much more than any medical or surgical aid. Very soon large caldrons and supplies of beef stock were obtained from the medical purveyor and hard bread from the commissary department, by means of which an excellent soup was prepared and freely issued, relays of cooks being at first employed night and day. This hospital was afterwards sufficiently enlarged by hospital tents to contain 1,200 patients, and when the army left Harrison's Landing the tents were removed to Craney Island, near Fortress Monroe, and a hospital established there by Surgeon Stocker, U.S. Volunteers, who conducted the removal and the re-establishment of the hospital speedily and well.
        The transports for the sick and wounded, except those that had been sent North from the Pamunkey River, reached the army on the 2d of July. These vessels were fitted up with beds, bedding, medicines, hospital stores, food, with many delicacies, and with arrangements for their preparation-- everything, indeed, that was necessary for the comfort and well-being of the wounded and sick. Surgeons, stewards, and nurses were assigned to their respective boats, and remained with them wherever they went. I doubt if ever vessels have been so completely fitted up for the transportation of sick and wounded of an army as these vessels had been by the orders of the Surgeon-General.
        The shipment of the wounded and sick began on the 2d of July in the rain, and was continued day and night until a very large number had been sent away. The want of shelter and proper accommodations at that time at Harrison's Landing rendered it necessary to send away many who under more favorable circumstances would not have been sent out of the army. The weather was so inclement and the mud so excessive that there was an evident disposition on the part of medical officers to look leniently upon any case of sickness or of wounds which presented itself. Had they not been sent on board they must have remained out in the rain and mud, without shelter and without proper food. On the 15th of July about 7,000 had been sent to Fortress Monroe and North. This number having been sent away a large number still remained, and during the first week whilst the shipment was in progress the troops were feeling seriously the effects of the late campaign. The deadly malaria was now producing its full effects, and, together with the want of proper food and the exposure to the rains which had fallen so continuously, and the fatigues endured, was now being fully manifested in the prevalence of malarial fevers of a typhoid type, diarrheas, and scurvy. Whilst the shipment of wounded and sick was going on, and as soon as the pressing necessities of the first few days were provided for, my attention was given to ascertain the most expeditious method of improving the health of the army. The results of the investigations made and the means considered proper for adoption (many of which had been enforced before it was written, the good effects of which were daily apparent) in the case were set forth in a communication I transmitted to you on the 18th of July. An extract from this communication was published to the army in orders, and from this extract I quote the following, in order to recall to your mind the views which I then had the honor of submitting for the consideration of the commanding general, viz:

        The diseases prevailing in our army are generally of a mild type and are not increasing. Their chief causes are, in my opinion, the want of proper food (and that improperly prepared), exposure to the malaria of swamps and the inclemencies of the weather, excessive fatigue, and want of natural rest, combined with great excitement of several days' duration, and the exhaustion consequent thereon. I would recommend, to remedy these evils, that food, with abundance of fresh vegetables, shelter, rest, with a moderate amount of exercise, be given all the troops, and general and personal police be enforced. To accomplish this I would suggest that an abundant supply of fresh onions and potatoes be used by the troops daily for a fortnight and thereafter at least twice a week, cost what they may; that the desiccated vegetables, dried apples or peaches, and pickles be used thrice a week; that a supply of fresh bread, by floating ovens or other methods, be distributed at least three times a week; that the food be prepared by companies and not by squads, and that there be two men detailed from each company as permanent cooks, to be governed in making the soups and cooking by the inclosed directions; that wells be dug as deep as the water will permit; that the troops be provided with tents or other shelter to protect them from the sun and rain, which shall be raised daily and struck once a week and placed upon new ground; the tentes d'abris also to be placed over new ground once a week; that the men be required to cut pine tops, spread them thickly in their tents, and not sleep on the ground; that camps be formed not in the woods but at a short distance from them, where a free circulation of pure air can be procured, and where the ground has been exposed to the sun and air to such an extent as to vitiate the noxious exhalations from damp ground saturated with emanations from the human body and from the decaying vegetation. Sleep during the day will not compensate for the loss of it at night, and I suggest that as far as possible the troops be allowed the natural time for rest; that not more than two drills per day be had, one in the morning from 6.15 to 7 and one in the evening from 6.30 to 7.15; that the men be allowed to sleep until sunrise, and that they have their breakfast as soon as they rise. This, with the labor required for policing, will be sufficient during the present season. That when troops march they should have breakfast (if only a cup of coffee) before starting, and after their arrival in camp each man be given a gill of whisky in a canteen three-fourths filled with water. I would also recommend that the strictest attention be paid to policing, general and special; that all the troops be compelled to bathe once a week, a regiment at a time, if possible, being marched to the river, from a brigade, one hour after sunrise or an hour and a half before sunset, to remain in the water fifteen minutes; that sinks be dug and used, 6 inches of earth being thrown into them daily, and when filled to within 2 feet of the surface new sinks to be dug and the old ones filled up; that holes be dug at each company kitchen for the refuse matter and filled in like manner; that the entire grounds of each regiment be thoroughly policed every day, and the refuse matter, including that from stables and wagon-yards, be buried 2 feet below the surface or burned; that dead animals and the blood and offal from slaughtered animals be not merely covered with a layer of earth, but buried at least 4 feet under ground; that the spaces between regiments be kept policed, and no nuisance whatever be allowed anywhere within the limits of this army, and that regimental commanders be held strictly accountable that this most important matter is attended to. I think if these suggestions be carried into effect that we may with reason expect the health of this army to be in as good a state as that of any army in the field.
        Every effort is being made by the commissary and quartermaster's departments to provide such articles as I have mentioned belonging to their departments.

        This extract will, perhaps, be sufficient to explain the views entertained by me on this subject, so vital to the army and to the country. After about 7,000 sick and wounded had been sent away there remained 12,975, making a total of nearly 20,000. The greater portion of the army reached Harrison's Landing on the 2d of July. On that day I addressed a letter to the Surgeon-General, asking that 1,000 hospital tents and 200 ambulances might speedily be sent for the use of the army. I felt convinced that great destitution in tents would be found to exist and that many ambulances had been lost, and that it would be necessary to have both of these articles replaced. The tents I considered would be especially needed to shelter the wounded and sick, whom it would be desirable to keep with the army. No one thing so much disheartens troops and causes homesickness among those who are well as sending sick to hospitals outside of the army to which they belong. Such was the experience of the armies in the Crimea, and such is the experience of all armies.
        On the 7th of July the following communication was sent to me from Washington by the quartermaster General:

        You were this day telegraphed as follows, viz: Have ordered tents for 50,000 men sent to Harrison's Landing. Few hospital tents on hand; more making. For the present I advise the use of some of the wall tents lately shipped to Harrison's Landing. But why not send your sick and wounded at once to Fort Monroe, to be transferred to a healthier place? Sick and wounded are not useful at such a place as that at Harrison's Landing.

        On the 9th of July General Meigs informed me that he had ordered 200 ambulances from Philadelphia and 250 hospital tents from Washington to Fortress Monroe, saying "the remaining 750 hospital tents will be forwarded as soon as made." Three hundred hospital tents reached Harrison's Landing on the 18th of July. On the 1st of August I was informed that "a large number had arrived, together with a number of ambulances." The tents, as far as they were needed, were used for the accommodation of the sick. The ambulances were distributed before we left.
        Before the communication to you of July 18 was written the existence of scurvy attracted my serious consideration, and upon consultation with Colonel Clarke, the chief commissary of the army, large supplies of potatoes, onions, cabbage, tomatoes, squash, and beets and fresh bread were ordered by him. The first arrival of anti-scorbutics was on the 7th of July; potatoes and onions arrived on the 20th, and thereafter the supplies were so abundant that potatoes, onions, and cabbage rotted at the wharf for want of some one to take them away. The fresh bread was eagerly sought for by the men, as they loathed the hard bread, which they had used for so many weeks. This loathing was no affectation, for this bread is difficult to masticate, is dry and insipid, absorbs all the secretions poured into the mouth and stomach, and leaves none for the digestion of other portions of the food. The craving for fresh bread was founded in reason, and was not a mere whim. In addition to these vegetables and fresh bread procured by the commissary department, 1,500 boxes of fresh lemons were issued by the medical purveyor to the various hospitals and to the troops. The beneficial effects of this treatment soon became perceptible on the health of the men, and when we left Harrison's Landing scurvy had disappeared from the Army of the Potomac.
        While the army remained at this place supplies of every kind appertaining to the medical department were abundant and large amounts were issued; as it was found necessary to resupply almost the entire army. Ice was freely and almost continuously supplied by the medical purveyor to the general and regimental hospitals and to the transports.
        The recommendations contained in the extract taken from my communication to you of July 18, which I have quoted were ordered to be carried into effect by the commanding general. The subject of police throughout the army, I may here state, was called to your attention in a note addressed to you on the 12th of July. Inspections were made frequently by medical officers in the different corps, by officers sent upon this duty from the medical director's office, and by myself, to see that the instructions just alluded to were enforced. The duty was laborious, and especially so during the excessive heat in July and August. These inspections were purposely made irregularly, both as regards time and commands. The beneficial effects of the orders and the inspections were very evident in the improvement of the various camps and regimental hospitals. In a few regiments the sickness increased; in some others it remained nearly stationary, and in others it decreased one-half. On the whole, the health of the army was improving. On the 30th of July I informed the Surgeon-General that the number of sick in the army was about 12,000, 2,000 of whom could take the field. The cases became less severe and were manageable, more readily yielded to treatment, and continued so until the army evacuated Harrison's Landing.
        It is impossible to convey in writing to any one not mingling with the troops a true idea of the improvement which took place in the health of the troops while we were encamped at that place. The number reported sick on the regimental returns cannot by any means be taken as the true condition of the health of the army upon its arrival there. It does not give the real amount of its effective fighting strength. The want of proper nourishment, the poisonous exhalations from the streams and swamps of the Peninsula, the labor undergone, and the anxiety felt had undermined the strength and withered the spirits of a great many who were apparently well. The effective strength of the army when it reached Harrison's Landing and for some time thereafter was less than the returns would indicate. And then, on the other hand, there are many ways in which improved health manifests itself that cannot be adequately described. There was so much in the appearance, in the life and vivacity exhibited by the men in the slightest actions, even in the tone of the voice, which conveyed to one's mind the impression of health and spirits, of recovered tenacity of mind and body, of the presence of vigorous and manly courage, an impression which to be understood must be felt-- it cannot be told. The real strength of the army when it left Harrison's Landing was greater than the large number at that time sent on the transports for the sick would lead you to suppose.
        It was agreeable to notice that the measures adopted for the improvement of the health of the troops were so ably and so cordially seconded by the medical directors of corps, that by their exertions and that of the officers under them encouraging results were brought about, and that they were so able and so willing to assist in restoring the health and re-establishing the vigor of the Army of the Potomac. Time showed that those who were not sick were well, that the spirits of the troops had risen, and that the army when it left Harrison's Landing was in a better condition by far than when it reached that place, and that there was every evidence to "expect the health of this army to be in as good a state as that of any army in the field."
        From the 15th of July the transports for the sick were chiefly employed in bringing over wounded and sick exchanged prisoners from Richmond and carrying them to the Northern cities, principally to Baltimore, Philadelphia, and New York. They were almost wholly occupied in this duty until the 3d of August, at which time the last were received at City Point. Shortly after communication was opened with the Confederate authorities; large supplies of fresh lemons, brandy, lint, &c., were, by direction of the general commanding, sent to City Point, to be turned over to them for the use of the wounded, but would not be received by them, and were returned. As the general commanding visited the vessels as they returned from that place loaded with our wounded and sick, he will, doubtless, remember the pains taken to have these men in every respect well cared for. I inspected every vessel before it was allowed to leave for the North, that I might be certain that everything was done, and done properly, that was necessary for the welfare of those on board. Three thousand eight hundred and forty-five sick and wounded were thus transported.
        After this time a portion of these transports, which had been while North taken from their legitimate use, were occupied in carrying exchanged Confederate prisoners from the North to City Point. On the return of these boats from this service to Harrison's Landing they were found to be excessively filthy, and required a great deal of labor to render them again suitable for the transportation of the sick. The use of these vessels in this way embarrassed me. On the 6th of August I informed the Surgeon-General by telegraph that--

        I sent away yesterday 700 sick from the army. My boats are in use with the Confederate prisoners. If my boats are thus interfered with by the authorities beyond this army, I hope I shall not be held accountable if the sick of this army are not properly sent away.

        On the 3d of August the shipment of the sick from the army commenced, and was carried on as rapidly as the transportation could be obtained. It will be perceived from what I have just said that I had at my disposal only a portion of the boats set apart for that purpose, and the hospitals I had drawn plans for, and which the commanding general had directed the chief quartermaster to procure, were not allowed.
        These two things alone embarrassed me much.
        The following extract from a letter I addressed to the Surgeon-General will show to some extent the difficulties in the way of the rapid shipment of the sick under which I labored on the 13th of August:

        I left on the 10th of August 150 hospital tents at Fort Monroe to be pitched near the Mill Creek hospital, and to-day have had '200 more sent from here, and have sent Assistant Surgeon McMillan to superintend putting them in order, and have sent Assistant Surgeon McClellan to superintend the hospital near Camp Hamilton. The tardiness exhibited at Fort Monroe in the erection of that hospital has been a serious annoyance. From the appearance of things at Point Lookout I shall be surprised if the hospital there is finished before the 1st day of November proximo. From this state of things and from the fact of the hospitals which were sent for by Lieutenant-Colonel Ingalls, chief quartermaster of this army, some time since, the plans for which were drawn up by me, and which were ordered to be carried into effect by General McClellan, having been refused, as I am informed, by General Halleck, I have been more seriously embarrassed. These buildings were to have been erected about this time at such point as I should have selected, and would have contained about 3,000 sick, and this army would be able to move. Some of the sick transports have been used for other purposes, carrying Confederate prisoners and General Burnside's troops and loaded with supplies. All this has caused serious delay in removing the sick from this point, and have been circumstances over which no one here has any control.

        Colonel Ingalls made every effort in his power to aid in removing the sick, and placed at different times boats temporarily at my disposal for this purpose, amounting in all to ten. Some of these could make but one trip; others made more, and carried in all, from the 9th to the night of the 15th of August, 5,945 men; 1,908 were sent away before the 9th on the regular transports. The total number sent away consequent upon the movement of the army was 14,159. The largest number of boats was obtained on the 15th, and on that day and night 5,629 were sent away. This fact will, I think, lead the commanding general to believe that the medical department was not idle. The delay arising from the use of the transports for purposes other than that for which they were designed it was impossible for me to avoid, and at the same time was the cause of another serious evil-- the want of time to have the cases to be sent away properly examined. From this cause many were taken on board who should not have been received. Many cases were sent from regiments which had marched by colonels or captains, without the knowledge of the medical officers, from negligence or favoritism, who were fully able to do the duty required of them, and under the circumstances it became necessary to send them on the boats. This state of things could have been prevented had the medical department full control of its vessels when the preparations were commenced to ship the sick.
        The delay occasioned by the causes I have alluded to rendered the case at last an emergency, under the pressure of which it was impossible to have every case thoroughly examined. There are always numbers of skulkers and worthless men in the army who are on the watch for an opportunity to escape duty, and these are always the cases which require the most careful examination; and these are the men who raise the cry of the inhumanity, want of attention, and cruelty of surgeons, which is so frequently taken up and echoed and re-echoed from one end of the country to the other. Out of 3,000 cases examined upon our arrival at Fortress Monroe 600 were fit for duty and ordered to their regiments. When the time and the means are considered it will, I think, be conceded that seldom have so large a number been transported without accident and without suffering. A careful and attentive medical officer was placed on each boat with medical supplies sufficient for use. Credit is very deservedly due to Dr. Dunster and the medical officers of the vessels for the manner in which this large number was transported and provided for. The labor was great.
        The supplies appertaining to the medical department were, owing to the excellent manner in which the purveying was performed by Assistant Surgeon Alexander, in every way abundant while at Harrison's Landing, and when the army left that place it was, so far as the medical department was concerned, fully, I might almost say elegantly, equipped with all that was requisite for another campaign.
        The subject of the ambulances, after the health of the troops, became a matter of importance. Medical officers and quartermasters had charge of them, and as a natural consequence little care was exercised over them, and they could not be depended upon during an action or on a march. It became necessary to institute some system for their management-- such that they should not be under the immediate control of medical officers, whose duties, especially on the day of battle, prevented any supervision when supervision was more than at any other time required. It seemed to me necessary that whilst medical officers should not have the care of the horses, harness, &c., belonging to the ambulances, the system should be such as to enable them at all times to procure them with facility when wanted for the purposes for which they were designed, and to be kept under the general control of the medical department. Neither the kind nor the number of ambulances required were in the army at that time, but it nevertheless was necessary to devise a system that would render as available as possible the material upon the spot, particularly as the army might move at any time, and not wait for the arrival of such as had been asked for, only a portion of which ever came. In order to inaugurate a system which would make the best of the materials on hand and accomplish the objects just referred to, the following order was written and published by direction of the commanding general:

GENERAL ORDERS No. 147.

HEADQUARTERS ARMY OF THE POTOMAC;
Camp near Harrison's Landing, Va., August 2,1862.

        The following regulations for the organization of the ambulance corps and the management of ambulance trains are published for the information and government of all concerned. Commanders of army corps will see that they are carried into effect without delay:

1. The ambulance corps will be organized on the basis of a captain to each army corps as the commandant of the ambulance corps, a first lieutenant for a division, second lieutenant for a brigade, and a sergeant for each regiment.

2. The allowance of ambulances and transport carts will be 1 transport cart, 1 four-horse and 2 two-horse ambulances for a regiment; 1 two-horse ambulance for each battery of artillery, and 2 two-horse ambulances for the headquarters of each army corps. Each ambulance will be provided with two stretchers.

3. The privates of the ambulance corps will consist of two men and a driver to each ambulance and one driver to each transport cart.

4. The captain is the commander of all the ambulances and transport carts in the army corps, under the direction of the medical director. He will pay special attention to the condition of the ambulances, horses, harness, &c., requiring daily inspections to be made by the commanders of division ambulances, and reports thereof to be made to him by these officers. He will make a personal inspection once a week of all the ambulances, transport carts, horses, harness, &c., whether they have been used for any other purpose than the transportation of the sick and wounded and medical supplies; reports of which will be transmitted through the medical director of the army corps to the medical director of the army every Sunday morning. He will institute a drill in his corps, instructing his men in the most easy and expeditious method of putting men in and taking them out of the ambulance, taking men from the ground and placing and carrying them on stretchers, observing that the front man steps off with the left, foot and the rear man with the right, &c. He will be especially careful that the ambulance and transport carts are at all times in order, provided with attendants, drivers, horses, &c., and the kegs rinsed and filled daily with fresh water, that he may be able to move at any moment. Previous to and in time of action he will receive from the medical director of the army corps his orders for the distribution of the ambulances and the points to which he will carry the wounded, using the light two-horse ambulances for bringing men from the field and the four-horse ones for carrying those already attended to farther to the rear, if the medical director considers it necessary. He will give his personal attention to the removal of the sick and wounded from the field and to and from the hospitals, going from point to point to ascertain what may be wanted, and to see that his subordinates (for whose conduct he will be responsible) at tend to their duties in taking care of the wounded, treating them with gentleness and care, and removing them as quickly as possible to the places pointed out, and that the ambulances reach their destination. He will make a full and detailed report after every action and march of the operations of the ambulance corps.

5. The first lieutenant assigned to the ambulance corps of a division will have complete control, under the commander of the whole corps and the medical director, of all the ambulances, transport carts, ambulance horses, &c., in the division. He will be the acting assistant quartermaster for the division ambulance corps, and will receipt and be responsible for the property belonging to it, and be held responsible for any deficiency in ambulances, transport carts, horses, harness, &c., pertaining to the ambulance corps of the division. He will have a traveling cavalry forge, a blacksmith, and a saddler, who will be under his orders, to enable him to keep his train in order. He will receive a daily inspection report of all the ambulances, horses, &c., under his charge from the officers in charge of brigade ambulance corps, will see that the subordinates attend strictly to their duties at all times, and will inspect the corps under his charge once a week; a report of which inspection he will transmit to the commander of the ambulance corps.

6. The second lieutenant in command of the ambulances of a brigade will be under the immediate orders of the commander of the ambulance corps for the division and have superintendence of the ambulance corps for the brigade.

7. The sergeant in charge of the ambulance corps for a regiment will conduct the drills, inspection, &c., under the orders of the commander of the brigade ambulance corps, and will be particular in enforcing rigidly all orders he may receive from his superior officers. The officers and non-commissioned officers of this corps will be mounted.

8. The detail for this corps will be made with care by commanders of army corps, and no officer or man will be selected for this duty except those known to be active and efficient, and no man will be relieved except by orders from these headquarters. Should any officer or man detailed for this duty be found not fitted for it, representations of the fact will be made by the medical director of the army corps to the medical director of this army.

9. Two medical officers from the reserve corps of surgeons of each division, and a hospital steward, who will be with the medicine wagon, will be detailed by the medical director of the army corps to accompany the ambulance train when on the march, the train of each division being kept together, and will see that the sick and wounded are properly attended to. A medicine wagon will accompany each train.

10. The officers connected with the corps must be with the trains on a march, observing that no one rides in the ambulances without the authority of the medical officers, except in urgent cases; but men must not be allowed to suffer, and the officers will, when the medical officers cannot be found, use a sound discretion in this matter, and be especially careful that the men and drivers are in their proper places. The place for the ambulances is in front of all wagon trains.

11. When in camp, the ambulances, transport carts, and ambulance corps will be parked with the brigade, under the supervision of the commander of the corps for the brigade. They will he used, on the requisition of the regimental medical officers, transmitted to the commander of the brigade ambulance corps, for transporting the sick to various points and procuring medical supplies, and for nothing else. The noncommissioned officer in charge will always accompany the ambulances or transport carts when on this or any other duty, and he will be held responsible that they are used for none other than their legitimate purposes. Should any officer infringe upon this order regarding the uses of ambulances, &c., he will be reported by the officer in charge to the commander of the train, all the particulars being given.

12. The officer in charge of a train will at once remove anything not legitimate, and if there be not room for it in the baggage wagons of the regiment will leave it on the road. Any attempt by a superior officer to prevent him from doing his duty in this or any other instance he will promptly report to the medical director of the army corps, who will lay the matter before the commander of that corps. The latter will at the earliest possible moment place the officer offending in arrest for trial for disobedience of orders.

13. Good serviceable horses will be used for the ambulances and transport carts, and will not be taken for any other purpose except by orders from these headquarters.

14. The uniform for this corps is: For privates, a green band 2 inches broad around the cap, a green half chevron 2 inches broad on each arm above the elbow, and to be armed with revolvers; non-commissioned officers to wear the same band around the cap as a private, chevrons 2 inches broad and green, with the point toward the shoulder, on each arm above the elbow.

15. No person will be allowed to carry from the field any wounded or sick except this corps.

16. The commanders of the ambulance corps on being detailed will report without delay to the medical director at these headquarters for instructions. All division, brigade, or regimental quartermasters having any ambulances, transport carts, ambulance horses, or harness, &c., in their possession will turn them in at once to the commander of the division ambulance corps.

By command of Major-General McClellan:

S. WILLIAMS,
Assistant Adjutant-General.

        Owing to the delay in receiving the printed copies the enforcement of the order was prevented until within a few days previous to the evacuation of Harrison's Landing. As soon as they were received steps were at once taken to have the order carried into effect. The system being new and so radically different from any hitherto in vogue no little labor was required to put it in operation. As only a few days elapsed between the distribution of the order and our leaving Harrison's Landing there were many details that could not be attended to. However, imperfectly as the order was carried into effect on the march from that place to Yorktown and Fortress Monroe, during which it was first tried and from the cordial approval of the medical directors of corps who alluded to the subject after our arrival in Washington in the early part of September, I felt convinced the system would work well. The contrast exhibited during the battles fought by General Pope in Virginia in the latter part of August between the action of the ambulances belonging to the Army of the Potomac, a few of which were able to reach the battle-fields, and those of corps in which the system ordered by General McClellan did not exist, I have been informed was very striking in favor of the former. At the battle of Fredericksburg, which took place on the 13th of December, 1862, this system, I may be allowed to say, was for the first time properly put in operation, and owing to the nature of that engagement severely tested. It worked very satisfactorily, not only to me, but also in the opinion of the general officers in command; all the wounded being brought from the field the same night, although the battle lasted until after dark, except those between the lines.
        While at Harrison's Landing, everything having been done that was considered necessary and that time permitted to place the medical department on a proper footing for active service, little was required of me during our march to Fortress Monroe, nor did anything occur in the medical department worthy of mention. Upon our arrival there steps were immediately taken to have the well men who had unavoidably been allowed to go on the transports to Fortress Monroe separated from those unable to perform their duties, and sent to their regiments.
        Whilst the army was at Harrison's Landing the hospitals at Point Lookout, Fortress Monroe, and its immediate vicinity, Portsmouth, and Newport News were within the jurisdiction of the Army of the Potomac, and all of them I visited. On the 1st of August there were in these hospitals 1,820 patients. During that month, including the hospital at Craney Island, to which I have already alluded, they received 5,191: making a total of 7,011. Of these 716 were returned to duty, 101 discharged, 4 sent on furlough, 9 deserted, 218 (paroled prisoners) sent to Annapolis, and 84 died, leaving under treatment 5,879 on the 31st of August. In these hospitals and camps 66 surgeons, 12 medical cadets, 12 hospital stewards, 537 nurses, and 126 cooks were on duty during the month of August.
        The army had to be transported by water from this place North. All the vessels that could be obtained (the transports fitted up for the sick, as well as others) were required by the quartermaster's department for this object. It appeared that it was necessary to have the troops transported with rapidity, as they were sent with scarcely any baggage. From this it resulted that the ambulances and all their appurtenances were left behind, to be sent up as vessels could be spared for the purpose. Some of the vessels never arrived. A large portion of the medical supplies were also left behind-- in some cases everything but the hospital knapsack-- by orders of colonels of regiments, regimental quartermasters, and others; in some cases without the knowledge of the medical officers, in others notwithstanding their protest. For such acts as these medical officers have been severely censured, and they were censured afterward for not having the very supplies which had been left behind in this manner.
        From the date of the embarkation of the troops at Fort Monroe up to the time when the general was placed in command of the defenses of Washington I know personally but little of the medical department of the Army of the Potomac. It was not under my control.

Very respectfully, your obedient servant,
JONATHAN LETTERMAN,
Surgeon, U. S. Army, and Medical Director Army of the Potomac.

Source: "Official Records of the War of the Rebellion"

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