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REPORT OF LIEUT. COL. A. C. GIRARD, UNITED STATES VOLUNTEERS, CHIEF
SURGEON SECOND ARMY CORPS
Dated October 21, 1898
I was ordered to report to Maj. Gen. William M. Graham, commanding Second
Army Corps, on the 19th of May, 1898, at Camp Alger, Va. I received the order on the 20th, and proceeded the same day to Camp Alger-a point 7-miles from Washington, D. C.-in the State of Virginia, the nearest site of the camp being 2 miles from the railroad, and extending eventually 2 miles farther toward the Potomac.
On reaching the camp I found that the corps commander had not yet arrived, and reported to Major-General Guenther, commander of the First Division. He, however, had no knowledge of the corps organization. I remained in camp the only officer of the general staff, and the next morning, on the arrival of the adjutant-general of the First Division, I ascertained that a number of regiments were in camp; that they were coming in with every train, generally without previous announcement, and camped where they saw fit.
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I inquired about the water supply, and was informed that there were supposed to be a number of fine springs on the place, which was a water shed for the city of Alexandria. I succeeded in obtaining the services of Lieutenant Ames, of the Sixth Massachusetts, as engineer, and, accompanied by the proprietor of the place. I started out to locate these springs, the engineer noting them on a map. I found the tract of land which was supposed to be occupied by the troops to be composed of woods, with open places of from 20 to 100 acres each. The country was uninhabited, with the exception of two homesteads, and only a few fields were cultivated. A large number of springs could be found all over the grounds. Their capacity, however, was small and evidently insufficient for a large command for any length of time. In addition to these springs there were two wells at the homesteads, which were said to give an abundance of water. I at once repaired to division headquarters and recommended that these springs be placed under guard to prevent the defiling of the ground in the vicinity, and that an engineer officer be supplied with a sufficient force to excavate these springs into sink-barrels, in order to utilize them to the best advantage. The quantity of water soon proved insufficient for the increasing number of the troops, and great complaints were made of its scarcity. I was in great doubt as to what my duty was in the premises.
The camp had been selected by the War Department, which must have been fully apprised of its facilities for water supply; and considerations of which I could have no knowledge were, in my opinion, the reasons for the selection of this ground. I therefore deemed it my duty not to impede the Government by entering a formal protest. but to make the best of the situation, hoping that the stay of the troops would be but temporary, and that meanwhile the water supply might prove sufficient. In order to increase the quantity of water available, I recommended that details be ordered to gather the water at the springs during the night, and, as very soon the question of purity became a burning one, I recommended the water to be boiled by the detail and supplied the troops in barrels at the company streets. An order to that effect was issued by the commanding general, but very imperfectly carried out-partly for the lack of barrels, partly for the lack of utensils for boiling the water, and partly from indifference.
I had at the same time made recommendations for the proper care of the privies and their disinfection, which were ordered carried out; but the orders were obeyed in a very indifferent manner, the regimental surgeons proving particularly indifferent to the care of the privies.
I found the cooking done in a very careless and unskillful manner and recommended simple cooking regulations, which were ordered, but never enforced.
While attempting to have the sanitary condition of the camp regulated I was forced into making provisions for the care of the sick of the command. I had understood that you had requested the governors of the several States to provide the regiments with their equipments at the expense of the General Government, but found that this request had either not been complied with at all, or, by the lack of judgment of the medical officers as to the quantity needed by these large commands, had been so inefficiently complied with that there was a great lack of medical supplies, some regiments having a large number of sick without tentage or medicines to take care of them, and I was compelled to establish at once a division hospital, the supplies for which I obtained by calling in all the medical supplies of the command on an order from the commanding general This gave me time to obtain the most necessary medicines before the first supply was exhausted, and I obtained everything needful. Naturally I incurred the ill will of those regimental surgeons who had come well supplied with the regimental hospitals and who could not realize the situation. The supply of medicines, however, of all was very limited, but the wants could be met by frequent issues in small quantities.
Not knowing the intentions of the Government with regard to the command, I used the most strenuous exertions to equip the hospitals for the field, and succeeded in providing three brigades with a complete outfit, which were detached for service in Cuba or Porto Rico. I had to do this again by depriving sonic of the well-equipped regiments which were to remain in camp of their equipment, which, however, had to be replaced as soon as possible. The medical and surgical chests and orderly pouches, which required special preparation, were very slow forthcoming, as the troops which were first destined for Cuba had to be supplied first, as I was informed.
I had no intimation until late in the summer that Alger was to be a camp of instruction, and that the troops were not destined to take the field immediately. The camps of the regiments at first were badly laid out, the tents crowded, the
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privies too close to the camps, but gradually the matter was remedied, and whenever I found that the health of a regiment was deteriorating I caused the regiment to be removed to a new site.
As early as the 3d of June I recommended individual covering of fecal matter in the privies. This was generally disregarded until the commencement of August, when, on my recommendation, an order was issued enforcing this necessary sanitary measure, and since that time, by close watching, it has been the rule of this camp.
Shortly after the fact had become plain that the water supply from the springs would not be sufficient for this command drive wells were commenced and the work continued day and night until every regiment was furnished with a pump. These wells were, on an average, 120 feet deep, and driven through clay until they reached shale rock, in which the water supply lay, and then driven still further into the solid rock. In this manner no subsoil water could reach the water supply. The water from these wells was analyzed in your laboratory and found pure excepting two instances, which revealed organic matter. These wells, although completed, were at once condemned.
About the middle of July the Second Division of the corps was suddenly ordered one night to start on the march to Thoroughfare Gap, Va., at 7 o*clock the next morning, leaving their tents standing and taking only shelter tents. Very hasty and imperfect provisions were made for the supply of the troops with food, causing much complaint and no doubt sickness. This command was unfortunate in encountering very severe rain storms on its march, and ordinary sanitary precautions were then ignored, as I was informed. I was not with that command.
The First Division was moved from its camp site to one where there was more
space at Dunn Loring as fast as wells could be driven. On the 14th day of August it was decided to move this command to Middletown, Pa., to which place I accompanied the commanding general in a train preceding the troops. I drove with him over the Young*s farms, which had been selected by the commission from the War Department, of which Deputy Surg. Gen. Charles Smart was a member, and found that the most level camp sites were in the valley of the Susquehanna, too close to the river, and I recommended that no locations be chosen below the second bench, which necessitated the camp to be spread out over a number of miles, on account of the broken condition of the grounds.
The water supply here also was precarious, the Quartermaster Department having had a well driven which gave about 50,000 gallons in twenty-four hours. The plan was to pump this water into tanks, and thence to distribute it by pipes over the camps. The troops arrived, however, before this water supply could be completed. Fortunately a pure limestone spring was found within convenient distance, and the water supply of the town of Middletown was available. All three sources of water supply were chemically examined in a laboratory, which I had established in one of the division hospitals in this camp, and found pure. For several weeks the water had to be hauled in barrels to the different camps, and every possible precaution was recommended by me to insure its delivery in a pure condition. In order to guard against any possible contamination affecting the health of the troops I caused a set of Maignen and Berkefeld filters to be issued to each company with orders to detail a special man for the care of the filters and one of the junior medical officers in each regiment to superintend the work. This duty was omitted or carelessly performed, like most of the sanitary duties of the volunteer officers. Some regiments did not even unpack the filters; others used only the Maignen. Still, a gradual improvement in the care of the filters took place by the appointment, on my recommendation, of an inspector. My object was not so much to purify the water, as the supply was pure, but to educate the troops in the use of the filters and to insure a sufficient supply of them for each command as experience would teach me to find necessary.
Every possible sanitary precaution was recommended by me to improve the health of the command, which had severely suffered from typhoid fever, of which I will speak hereafter. Orders were not only issued but carried out, and compliance was watched by the commanding general, corps, division, and brigade inspectors, sanitary inspectors, and by myself.
The composition of the command entirely changed after the troops reached Camp Meade, some regiments of the corps not even arriving at this camp, but being sent to their States from Camp Alger to be mustered out. In their place came 12 regiments from various parts of the country, most of which had been in regimental camps and were ignorant of the sanitary regulations carried out in this command, and had generally ignored sanitary rules and thereby added to the number of sick in the command. It is impossible in this r?sum? to refer to each
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particular sanitary recommendation, but a copy of every one has been appended to this report with a carefully prepared index, so that the sanitary history of this command can be better followed up by reading these letters than by lucre description. [These letters and recommendations are too voluminous to be printed in this place.]
Every sanitary recommendation made by me was made the subject of an order by the commanding general, and in order to insure prompt action and no delay from pressure of other administrative business, I supplied, in nearly every instance, the Adjutant-General`s Office with the necessary copies in the form of an order, until we came to this camp.
The health of the command-Soon after the arrival of the troops at Camp Alger cases of typhoid fever developed. At first they could be ascribed to well-defined outside infection. They wore at once removed to Fort Myer, which was about 10 miles distant, first by ambulances, later on the trolley line, on which two hospital cars had been equipped. After these original cases, which had clearly received their infection before their arrival in camp, others occurred more and more frequently after a perfectly pure water supply had been provided for the camp. The number of those actually taken sick with typhoid fever could never be accurately ascertained. As soon as a man showed indications of typhoid fever in division hospital he was removed to Fort Myer before an accurate diagnosis could be made. Many men who felt ill obtained furloughs and proceeded to their homes, where they were taken with the fever. It was evident, however, that the number was steadily increasing, and that it was absolutely impossible to hedge in the cause of the infection. By the careless and filthy habits of the men the woods surrounding the camps became generally the receptacle of fecal matter. Sentinels who were placed to prevent this use of the surroundings of the camp failed to report their comrades, and I do not believe that in a single instance an arrest took place for this cause, which was one of the principal ones of the infection of the camp.
In spite of the fairly sufficient water supply of the pumps, the men, in violation of orders, would go to the so-called springs and quench their thirst. The heavy rains had washed the fecal matter into these water courses, and thus infected them. There were hundreds of these springs in all sorts of hidden places in the woods, and it was a physical impossibility to place them under guard. There is no doubt that the indifference of the officers in looking after this matter is largely responsible for the great amount of typhoid fever.
As another source of the disease, I would indicate the probability that the wells in the farm houses surrounding the grounds were more or less infected. I was credibly informed that every fall a number of typhoid cases, particularly in Washington, occur among people who had made these farm houses their summer resorts. The same applies to the water supply of the wells of Dunn Loring and East Falls Church, where several companies were stationed to control the undisciplined mob of volunteers which composed the command.
Another source which could he but imperfectly controlled was the reception by many soldiers of boxes of all sorts of food from home, which either caused indigestion and thereby liability to disease, or actual infection. Another source were the venders of ice cream, sandwiches, pies, cakes, and every possible indigestible food, which the soldiers purchased principally because it was prohibited. Orders issued to suppress this trade on my recommendation could not be carried out, because the venders established their stands on land 60 feet each side of the public roads, which the proprietor had reserved for himself. The only possible measure was to station sentinels at each booth to prevent the men trading there, but these sentinels were no more efficient than those who were supposed to watch the surroundings of the camp from contamination by fecal matter.
After I had sent about 200 cases of supposed typhoid to Fort Myer, it was found that preparations for the reception of this class of sick had not progressed rapidly enough, and orders were issued to me by your office to discontinue sending typhoid cases to Fort Myer for one week. This was at a time when the disease had become general, and I received your authority to take care of the typhoid cases in camp, as their transportation to Fort Myer after a certain stage of the disease was detrimental to their recovery. By this time I had accumulated a sufficient amount of tentage and appliances to care for all the sick of the command, which did not exceed 600 at the worst stage. On its arriving in the vicinity of Manassas, the Second Division found itself encumbered with a small number of incipient typhoid cases, and on being asked for instructions I telegraphed to establish a field hospital at the most convenient place, and Bristow was selected by the commanding general. The command from Bristow proceeded to Thoroughfare Gap, and the typhoid cases from that place were sent back to Bristow. On the arrival of the command at this place it appeared for a time that the infection had been shaken off by the command, but very soon the hospitals became filled again, especially when the Fifteenth Minnesota, the Thirty-fifth Michigan, and the Two hundred
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and third New York arrived. The Fifteenth Minnesota had left one-third of their command sick in the hospitals of St. Paul and Minneapolis. The Thirty-fifth Michigan came from an infected camp, and the Two hundred and third New York had had several hundred cases before coming here. Every possible precaution, that will be seen from the appended recommendations, was taken by inc within the means at my command to prevent the spread of the infection. I failed to secure one very important agent by the refusal of the Quartermaster Department to supply a portable engine and steam disinfecting apparatus, which I believe would have been of inestimable value.
As soon as I found that the hospitals were filled to their utmost capacity, I accepted, with the consent of the commanding general, the hospitality offered by the city hospitals of Philadelphia, Harrisburg, Reading, Lancaster, Norristown. West Chester, Pottsville. Pottstown, Lebanon, York, and Columbia, partly to relieve the engorged condition of the hospitals, partly to remove the infection from the camp to places where it could be handled better than it could be with the crude appliances of the field. At that time, I also was offered by you the use of the field hospital of the Associate Society of the Red Cross of Philadelphia, which I made part of the Second Division hospital, for the reception of such typhoid cases as became too sick for transportation by rail and the seriousness of their condition was realized. The Red Cross Society furnished female nursing and the care received by the patients from these skilled attendants was far superior to any which could be given in any of the field hospitals by the untrained men of the Hospital Corps.
As a r?sum?, I desire to state that the appearance of typhoid fever in this command was a natural result of the gathering together in crowded camps of untrained soldiers with ignorant officers, and that a careful review of the past convinces me that no feasible measure to prevent the spread of the disease was left untried, and that every recommendation possible under the circumstances was made by me.
Division hospitals-As mentioned above, I was compelled by the force of circumstances, in order to provide for the sick of those regiments which had come without any medical equipment, to establish division hospitals. They were crude affairs at first. The men who assisted me were details from a few regiments, whose colonels or medical officers were public spirited enough to assist me in my efforts to have the sick cared for. I had to rely on details made from the regimental medical officers, and found them, as a rule, fault-finding, disinclined to incommode themselves for the welfare of the sick, and unable to adapt themselves to the peculiar circumstances, besides being hostile to a measure which appeared to be an infringement upon what in their militia notions they regarded their rights. They have not learned yet to consider themselves part of an army, and each regiment and each State was for itself.
As I found it impossible to obtain a hospital corps for the camp, I had to resort to the transfers from the regiments and met with innumerable obstacles. The medical officers did not inform the men of the terms of the transfer; if transfers were insisted on they palmed off on the medical department the most undesirable element in the companies, men whom the captains wanted to get rid of, although they certified on the transfer papers to the efficiency of these men. The result was that the medical service in the hospitals was very unsatisfactory.
In the early days of our service at Camp Alger I made no effort to provide for the hospital commodities which were enumerated on the supply tables, as I was then under the impression that we were preparing for actual war and that it would not be to the best interests of the sick for them to become accustomed to conveniences which could not be carried into the field. For this reason I made no effort to provide the beds with sheets and pillowcases, as they were articles which could not be carried into the field, and after being carried they would only become an incumbrance, for the lack of facilities for washing.
As soon as I learned that Camp Alger was to be only a camp for instruction, I obtained a large number of articles desirable for the care of the sick which usually do not belong to the equipment of a field hospital. At no time was the medical service satisfactory until I received your consent for the employment of contract surgeons, who, as a rule, were not appointed like the volunteer surgeons as a reward of political preferment; but, knowing that their stay in the service depended on their usefulness and zeal, they devoted their best efforts to the welfare of the sick.
I had a fund intrusted to my care by you to meet extraordinary demands, and this enabled the hospitals to provide the sick from the very start with the necessary food, independent of that furnished by the ration. Owing to the lack of ability of managing the allowance made by the Government on the part of the surgeons and the wastefulness of the cooks, the expenses which for milk and eggs alone I had to meet in one of the division hospitals amounted to over $300 in one
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month. The ice was paid for through the generosity of the National Relief Commission, and was unlimited.
At the very outset of the camp I had established a supply depot for the corps, and in this manner succeeded in having on hand a stock of medicines from which division hospitals were supplied; and at no time was there an absolute insufficiency, although at times there was a scarcity. I can attribute this only to wanton waste, which I could not locate, but which I tried to prevent wherever possible by stringent regulations.
The first hospital established on the grounds was the First Division hospital. I was compelled to place it in an undesirable location, as I desired to have it in the vicinity of the only available well and within reasonable distance of the troops which it was to supply with shelter for the sick. I had it soon placed on a more desirable ground, but at no time was the hospital under sufficiently competent charge to effect what I thought it ought to accomplish. The main reason for this was the apathy of the officers in charge and the indifference of the men composing the hospital corps.
When the Second Division was organized I was fortunate enough to secure the services of Maj. F. C. Stunkard, surgeon of the One hundred and fifty-ninth Indiana, who had assisted me in establishing the First Division hospital, and had thereby acquired some knowledge of matters of administration. I placed him in charge of the Second Division hospital, and by his personal magnetism he succeeded in bringing about a friendly feeling among the colonels and the medical officers of a number of regiments, thereby enabling me to secure the transfer of a more desirable class of men; and the hospital, even after Major Stunkard returned to his regiment. retained its higher grade of efficiency.
On being notified that the Second Division was to make its march to Thoroughfare Gap, I prepared a complete brigade hospital and had it sent with that division, expecting to supply any deficiencies, as they were to remain on the line of the railroad.
As mentioned above, I had to establish the hospital at Bristow, and in order not to deplete the brigade hospital of the Second Division I sent the supplies for that hospital by ambulances across country, not willing to trust to the delays of the railroad, and in that manner completely equipped it. Having received information that the Second Division continued its march from Thoroughfare Gap to Middletown, Pa., I transferred all the sick and the necessary tentage and supplies from the Second Division hospital, which had remained standing in camp, with 300 sick, to the First Division hospital, and completed, as far as I could, another brigade hospital, which, with the brigade hospital that accompanied the Second Division, could supply these troops with sufficient facilities for the care of the sick. These orders were changed, however, and the whole move was to be made by rail. I therefore telegraphed to have 50 additional tents meet us at Middletown, and with the equipment of the Second Division hospital sent the hospital force of that hospital on the second train to Middletown, and as soon as a suitable place could be secured established a hospital in advance of the arrival of any of the troops. I then caused the corps reserve ambulance company, of whom about 100 had accompanied headquarters, to establish a hospital in readiness for the First Division. The organization of the First Division hospital on the departure of the troops from Dunn Loring was left standing under the charge of the best officers I could find, and after disposing of the sick, was with the personnel moved to this camp.
The Hospital Corps-The difficulty of obtaining a sufficient number of men from the regiments to give 2 per cent of the force allowed for the Hospital Corps and the impediments thrown in my way were so great that the commanding general determined to stop all transfers and to send out a recruiting party to fill up the Hospital Corps. I was fortunate in gaining the good will of the colonel of one of the Ohio regiments, who, not understanding the system of the division hospitals at first, had been very hostile to any transfers or the detail of his officers in the division hospitals. He not only offered me a full quota of the hospital detail of his regiment, but also sent an officer with a party of noncommissioned officers to recruit desirable men in southern Ohio. In this manner in a very short time I not only succeeded in filling the quota of the divisions, but also in organizing a full corps reserve company, and had at least then the men necessary for the service. The inability of medical officers to grasp the company organization and its papers and lack of mental force or training to control the men led finally to my requesting authority to place one of the officers of the line, who are allowed as quartermasters in the division hospitals, in command of the Hospital Corps companies, and gradually matters became systematized. The reserve company was of the greatest use to me, since from it I supplied 25 nurses to the general hospital at Fort Myer, 75 to the hospital at Bristow, and still had enough left to organize the second section of the First Division hospital at this place. As soon
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as I obtained its personnel I started regular mounted drills, litter exercises, and general instructions in first aid and nursing, and hoped in this manner to supply the divisions with well-trained men and call in those that needed instruction. The move to Camp Meade, however, frustrated this design. When the order for muster out came, more than one-half of the Hospital Corps left with their regiments, under an agreement which I had to make in order to get any men at all that should any of their regiments be mustered out they would return home with them. Fortunately here again the reserve corps stepped in, and by dividing it between the two hospitals I succeeded in retaining a sufficient number of men who by that time had become very well trained to perform the service in the hospitals with the aid of detailed men from the regiments under General Order No. 126. I then applied for the detail of an officer of the Fifteenth Minnesota to recruit the hospital corps in Minneapolis, and am now getting recruits and hope to fill the corps to its full quota before starting for the South.
On arrival in Augusta, I propose to reorganize the reserve company and, if circumstances permit, turn it into a training school, from which to replenish losses in the division hospitals or transfer men thence to the school.
I desire to add the following conclusions and recommendations as further results of my experience in the performance of my duties as chief surgeon of the Second Army Corps:
First. Regimental medical officers and hospital stewards: I believe that this method of supplying volunteer troops with medical attendants should be done away with, as it has been abandoned for many years in the Regular Army. Instead of the medical officers being selected for their superior aptitude, they have been relics of the National Guard service, in which, as it is known, these offices are filled with men, by the colonels, regardless of professional standing, generally for personal reasons of political preferment. The medical officers in this manner are too much dependent on their colonels, who, instead of looking upon them as medical advisers, consider them only ornamental additions to their staff. This cripples the independence which a medical officer ought to have of his commanding officer, and makes him useless as a sanitary adviser with an ignorant or opinionated colonel. I have also found that the medical officers were so wedded to their regiments that any duty outside of the regiments, either of a sanitary nature or in division hospitals, was resented by them as an imposition.
The hospital stewards of the regiments were fully equal to the medical officers in their regimental adhesions, and proved, as a rule, useless in division hospitals. In the regiments many of them did the real professional work, as they were physicians, while the administrative work in hospitals was new to them, and they worked at a disadvantage. I would recommend that regimental surgeons therefore be abolished, and that some measures be taken to obtain a reliable medical corps for the volunteer service, even at a sudden call like the one of the war with Spain.
Second. Much of the enmity displayed against the division-hospital system was due to the belief of the regimental medical officers that I was introducing notions of my own into the administration of the medical service. It seems very desirable that a carefully prepared code of regulations be worked out and printed for the field-hospital service in the style of those of foreign armies, thus not only bringing about uniformity in methods, but a possibility for the medical officers of inferior rank to become acquainted, by study, with the administration of the Medical Department.
Third. It was very fortunate that I was authorized to increase the small number of acting hospital stewards allowed in the organizing order, and recommended that such an increase be made permanent, on the same basis as noncommissioned officers are appointed for the troops of the line. I found that since I received this authority, and the men knew that they had something to gain by good behavior, and the stewards something to lose by incompetency, I obtained much better service than ever before.
Fourth. One of the principal sources of infection in the command is the fecal matter, and a permanent system for the disposal of this question in the field appears very desirable, and the equipment necessary for the purpose should form part of the regimental baggage. It should therefore be of imperishable material, easily kept clean and easily transported, and I believe that the best method is to provide each company with two cast-iron troughs, on cast-iron wheels, the front axle on a pivot. These troughs should be about 10 feet long and have a circular opening with a cast-iron cover, opening downward, 1 foot in diameter at the bottom. They should have two movable lids, one supplied with four holes, the other as a cover to prevent unsightly appearance in the removal of the trough.
Fifth. The question of water supply for the troops in camp and on the march should also receive serious and permanent consideration. I believe that one or more water carts should form part of every regimental equipment, to carry
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the water to the camps where hydrants are not available, and to make a suitable water supply accessible to the men on the march. I believe that this necessary article of diet should be issued to the troops with the same care as the components of the ration. In this manner only can the proper sanitary supervision be carried out. If necessary, a system of filtration could be connected with these carts.
Sixth. As a considerable part of the army will hereafter be stationed in subtropical countries where pure water supply can not always be obtained, a nest of boilers in a box, supplied with hinge lids and hasps, should form part of the equipment of every company, to render the boiling of water possible. As the nest of boilers can be utilized for the carriage of sugar and coffee and similar components of the ration, it is believed that it will not be left behind like other more complicated apparatus, and will always be carried with the cooking outfit; consequently remain with the troops.
Seventh. Contract surgeons: The position of the contract surgeons is an anomalous one. They are civilians performing the duty of officers, and have the rights of neither, if it suits the commanding general to deny them. The method of employing this useful class of officers in the Navy seems to offer a remedy, as there they obtain the warrant from the Secretary and form part of the establishment. They would in this manner also be more secure against arbitrary dismissal, and, as in the Medical Department of the Navy, a list of qualified men examined by the medical board could be appropriately kept on file in the Department, from which. in case of necessity, the proper men could be recommended to the Secretary of War for warrant. They would in this manner become eligible to the military orders which perpetuate the associations of the wars, and no doubt would add to the inducement for a suitable class of men to present themselves for admission to the rolls.
Eighth. Division and brigade surgeons: The division surgeons of this corps are men of high professional standing and status in the National Guard service, but absolutely ignorant of administrative work in the Army. I therefore recommend that only trained medical officers be in the future made eligible for the high offices in the Medical Department, and in this manner the War Department will be relieved of the political pressure which brought about the selection of men who were not suited for these positions.
The brigade surgeons should likewise be trained medical officers, as their duties, as a rule, call them to duty in division hospitals. Their name, brigade surgeon, appears to be a misnomer, and has caused in this corps frequent attempts on the part of brigade commanders to have these officers attached to their staff, where they occupied more ornamental than useful positions.
I believe that the system of the war of the rebellion of appointing surgeons and assistant surgeons, United States Volunteers, throughout the service would meet the requirements of the Volunteer Army better than that which now provides for officers performing duty under the misnomer of brigade surgeons.
For duty in the colonies which have passed into the possession of the United States, medical officers of the Regular Army should receive at least one grade increased rank, in order to enable them to better meet the expenses of keeping two households, and to make them equal in rank to brigade surgeons or whatever the title may be of the superior medical officer, with the proviso that where officers of equal rank serve together the medical officers of the Regular Army, irrespective of the date of appointment, shall be considered the seniors.
I trust that in considering this report you will bear in mind that my duties with this corps were entirely of an administrative character, and as I had to follow up and supervise duties which usually are performed as a matter of course by medical officers of inferior rank, I was less able than I would have been under other circumstances to closely observe the etiology of epidemics or to make observations of a clinical or purely professional character.
