I have, as you know, been making a collection of books and printed papers that relate to matters with which the Sanitary Commission of 1861 was concerned. I wish to put this Collection in a safe place, where it will be available when any emergency comes making reference to it desirable for public interests. You have led me to think that it would be an acceptable addition to the Library of the Massachusetts Commandery of the Loyal Legion. This letter is written, partly that the request, which I ask you to make in my behalf, for leave to so dispose of it, may be considered with some knowledge of its contents, and partly to supply an introduction that will aid a discriminating search of it.

I shall append hereto a list that will serve as a Table of Contents of the Collection, the title or a brief description of each separate publication being [265]given, with a reference to the volume and the place in the volume where it will be found. The number of volumes is twenty-five; the number of separate publications, four hundred and fifty-five.

The first volume contains the General History of the Commission, by Commissioner Charles J. Stille, LL. D., (Professor of History and Literature, University of Pennsylvania). Nearly all the rest of the Collection may be regarded as a series of documents, extending, exemplifying and illustrating Dr. Stillé’s text. In most cases, they supply the original typography of papers cited, quoted or summarized by Dr. Stillé. A few are added, either because they are of a supplementary character, or because they throw additional light upon the state of Sanitary, Medical or Surgical Science at, or shortly after, the period of the War.

To aid a search of the Collection, such as may be desirable to be made quickly in the pursuit of a purpose kindred to that which led to the formation of the Commission of 1861, I have gathered in the volume lettered K, numerous papers adapted to bring rapidly under view the preparatory and initial proceedings of the Commission; the basis of its authority and its legal status and methods; together with a selection of illustrations of the system of instruction, accountability and discipline of its executive service, and of the class of means used to affect favorably to its purposes the convictions respectively of the people, of the Government, and of the officers and men of the army and navy. In another volume, L, are brought together many papers more particularly adapted to show the working of various secondary departments of the Commission’s business, for which, as the war went on, occasion gradually appeared. A third, M, contains pamphlets issued during the war, explanatory of the Commission’s work. In a fourth, N, illustrations are supplied of the organization, the methods and the animating spirit of the Commission’s Branches, and of thousands of societies composed mostly of women, that were contributive, through these Branches, to the Commission. Volume J contains twenty short original treatises issued by the Commission to regimental surgeons, each on a particular professional duty to which they were likely to be called in a campaign, but with which civil practice, and, especially, rural civil practice, would not, in many cases, have made them familiar. Each of these treatises was an offering to the national cause, made at the solicitation of the Commission, by a recognized authority on its special subject; the series of authors having included the most eminent surgeons and medical specialists of the country. The titles of the fourteen other volumes, given in the appended table, sufficiently indicate the character of their contents.

The first question which one having occasion to examine this Collection will be likely to ask, is:—

What was the use of this institution, and by what means and methods did it become of that use?

The purpose of what is next to be here said will be to save the enquirer, [266]searching the Collection for an answer to this question, from wasting time in following the wrong trails.

During the war, the Commission was most widely known to the public as an agency through which, in emergencies after battles, the medical departments of the army and navy were usefully reinforced, especially in respect to nursing and supplies of household comforts for the wounded. The natural presumption that this was the most important part of its business will have been unintentionally perpetuated by admirable narratives, written by some of those honorably serving in these trying emergencies. Therefore it will be best to state that this was never intended to be and never was the leading use of the organization.

The primary aim of its founders may best be explained by referring to the fact that the loss of life in modern wars, even of the most enlightened and best prepared nations, has been much greater from preventable disease than from fatalities of battle. In the Crimean war, the French and English lost four times as many men by disease as by wounds; the Turks, Sardinians and Russians a still larger proportion. The French, in their invasion and occupation of Algiers, lost thirteen times as many by disease as by wounds. In our invation of Mexico, seven men died from disease to one from injuries in battle.

The larger the sick list of an army or of a fleet, the less able, on an average, are the men who have not been classed as sick, for any trial of their strength and endurance; the less, therefore, is the actual strength of the nominally effective force. The above figures, consequently, represent much less than the actual loss of strength from disease. With reference to the cruelty of war, the suffering that comes from diseases is nearly always much greater than the suffering that results from battles.

It was consideration of facts of this class that led to the formation of the Sanitary Commission of 1861. Its first and leading business was that of obtaining reports of examinations by its own confidential inspectors, of the manner in which our forces in the field were taken care of, in respect to matters of health and morale, by the officers in command of them and by those of the Commissary, Quartermaster and Surgical Departments; giving such advice for bettering their condition as could be offered judiciously through these inspectors while in the field; analyzing and consolidating the reports of its inspectors and drawing deductions from them; laying these deductions before the President and Congress and the War and Navy Departments; securing attention to them, and by personal efforts, promoting the passage of laws and the adoption of regulations and usages such as the Commission could show grounds for believing to be desirable.

It may be allowed me here to observe that there is an element of weakness in a forming army of American volunteers that seemed not to be [267]appreciated at army head-quarters in 1861. Had it been, special instructions would, I think, have been issued, and pains otherwise taken to more rapidly bring it to an end and to lessen its bad results. I more than once ventured to inquire if nothing could be done for this purpose, but was always answered that only through experience of painful effects could the needful lessons be taught. As a civilian, I still modestly permit myself to suspect that perfect military wisdom would not have held to this conclusion. In the early summer of 1861, few company officers knew much more of their duties than they had learned in the militia service in time of peace. In this they had been taught hardly anything that could not be put in practice in the drill-room, on a parade ground, or in the streets of a town. When a regiment was sent to the field, its captains were not only unpracticed in all that class of duties which are implied in the precept that “a captain should be the father of his company,” but often most averse to learning them. There were regiments that were exceptional in this respect. Those from Massachusetts were generally so in a greater or less degree, but no others as distinguishedly as those from Rhode Island. This was due, as we understand, to the provident care of General Burnside. It was recorded that after the instructive disaster of Bull Run, the camps of no other regiments were found, the next day, to be in as good order as those of Rhode Island. In none was the ordinary routine of camp life resumed as quickly, and with as little disturbance or evidence of demoralization.

In a communication to our Executive Committee in 1861, I named one regiment as being more unfortunate in respect to the manner in which its officers regarded their administrative and paternal duties, than any other that had at the time been visited. Our inspectors had reported that its men were worn down with excessively prolonged and fatiguing drills; the officers appeared to suppose that their duties began and ended with the drill; the full supplies to which the regiment was entitled were not obtained; much of its food was no more than half cooked; none of it well prepared; none cleanly served; the camp was not drained, parts of it were filthy, and, except when under drill, a lack of system, good order and discipline, was everywhere apparent. I had called on the regimental surgeon, and he had confirmed the reports of our inspector as to the habits of the officers. With the permission of the Colonel, a conference had been had with the captains as a body. They were informed that the sick list of the regiment had been nearly twice as large as that of several other regiments camped on no better ground; their attention was called to clauses of the Army Regulations which they appeared to have overlooked, and they were persuasively urged to zealously comply with them. They received this counsel smilingly, but their real sentiment was evidently expressed by one who said, with a joking air, that he certainly had not been led to suppose that he was commissioned to look after pots and kettles, and by another who said that he did not volunteer to run a hotel, or to do the work of a housekeeper, for his company. If this was what the Government wanted, it would be welcome to his resignation. When this regiment was first taken into action, the men were [268]depressed with a long and unnecessary fast, and by a hard march; many had fallen out, and it no sooner came under fire than “it all went to pieces.” This was the last engagement in which it had part. A few months afterwards I asked its Brigade Commander about its condition, and he answered that it was good for nothing, and nothing good could be made of it. A little later, being greatly reduced by disease and desertion, without having lost a single man, I believe, in action, it was disbanded, and the men distributed among other regiments.

It was, at the outset, a common opinion among military officers, that the power given by President Lincoln to the Sanitary Commission to employ civilians in the inspection of posts and camps of forces near the enemy would have various unfortunate results, and, early in the war, much evidence appeared that such apprehension had not been unreasonable. Whether the difficulties to be overcome could be surmounted, was a question partly of the instructions under which the Commission’s agents would act, but mainly of the ability of the Commission to obtain the services of men, who, otherwise capable, would submit to discipline, and could be depended on to be governed strictly by their instructions; to exercise all necessary discretion, and to maintain good temper and unprovoking manners under the trials to which they would be subject.

The inquiry for such men was so successful that I do not think that in all the war a single inspector of the United States Sanitary Commission was even so much as charged, formally, individually and specifically, with a misuse of his privileges; with conveying information that should have been withheld; with offensive officiousness; or with undue zeal in any respect. This statement is made because, for a time, reports conflicting with it, often appeared in the newspapers. It was, for nearly three years, a part of my special business to have such reports traced back, as far as possible, to their starting-point. In every case in which this was done successfully, it appeared that the person rightly accused had been wrongly assumed to be in the service of the Commission. Gradually, it came to be recognized that the authorized agents of the Commission were even more punctilious than military officers themselves in respect for military order, etiquette and discipline, and that, on the whole, their presence in the camps was the reverse of disturbing. After various crises in the second and third years of the war, General Grant, General Meade, General Rosecrans, with many officers of less reknown, spontaneously gave public testimony to this effect. The Medical Director of the Army of the Potomac, in response to an inquiry, telegraphed: “It gives no trouble. There is no interference.” The Medical Inspector of the same army: “We could not get on without it.”

I cannot refer to these favors without adding that if the question were asked where we found, from the first, the heartiest sympathy, the greatest readiness to accept our co-operation and to give us facilities for accomplishing our purposes, the answer would be, from the Quartermaster’s Department. The hospitality of no other single man was worth as much to our undertaking as that of Major-General M. C. Meigs.

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It may be added that, from the Commission’s point of view, nothing in the conduct of the War appeared as excellently done as the work of keeping the army provisioned and otherwise supplied. The weakness, above stated, of a newly raised volunteer force, in respect to this class of military labors, gradually disappeared, and it is doubtful if the world has ever seen as large, complex, and often exigent, and precipitant, a piece of business managed as energetically, efficiently, honestly and successfully, as that for which the Quarter-Master and Commissary Departments of the army were responsible.

Touching the success of the Commission in its primary and most important purpose as above explained, it would never have been gained but for the personal fitness of some of its members. Of those distinguished in this respect I will name only four, who are already dead: Bache, Van Buren, Harris, Agnew.

Doctor Bache was a West Pointer, and all the old army men, whose good will it was so necessary and, for a time, so difficult to gain, were proud that the Academy had sent out one who took the rank that he did among the leading men of Science in the world. With the blood of Benjamin Franklin in his veins; bred a soldier; Chief of the Coast Survey; first President of the National Academy of Science; thorough, judicial, learned, wise, conservative, persuasive; long a resident of the Capital; eminent in its lettered society, and familiar with its legislative and administrative customs; no man’s opinion had more weight with the older members of Congress, or with those who stood between Congress and the army and navy; no man’s counsel was of more value.

Doctor Van Buren had been a surgeon of the regular army in the Florida War, and a messmate and tried friend of many of its older officers. In civil practice he had earned a position in which he was looked up to by the younger men of his profession, both in the army and out of the army, with a degree of deference that hardly any other man commanded.

Doctor Harris had been Health Officer, in trying periods, of the port of New York, and an active member of the National Quarantine Commission. In these capacities and otherwise he had had an uncommon experience in dealing, in a large way, with certain forms of disease, and in the handling of sick and wounded men.

Doctor Agnew, a man in whose mind activity and caution were unusually combined, had probably had more intelligent interest in means of preventing and restricting disease, and in following all recent substantial advances of Sanitary Science, than any other man in the country of equal professional standing.

Perhaps the best work of the Commission in this division of its duty was rendered in the course of personal conversations, often dinner-table conversations, on the one hand with the President and his Cabinet, with members of Congress and with Governors of States; on the other, with officers of the higher grades of the army and navy. Among the Commissioners there were several who were able, both in social intercourse and in more formal deliverances, to array facts, present arguments and press convictions in a rarely [270]effective manner. Eminent among these stood Dr. Bellows, the President of the Commission, but there were others, not so markedly eloquent, fluent or graceful, who were able on occasion to second him in a manner that made their few words greatly telling. Judge Skinner of Chicago was one; Dr. Howe of Boston another. (I still name only the dead.)

In the nature of the case, the best work of the Commission in this respect is unrecorded, but of what it was chiefly aiming to accomplish, much may be learned from various papers in Volume K. Of its methods of gaining the information upon which its advice was mainly based, some idea may be gathered from an examination of the printed instructions to its inspectors and the printed forms for routine returns from them, to be found in the same volume. Valuable compilations in a condensed tabular form from these returns will be found in volume B of the collection, edited by Dr. Gould of Cambridge. That a man of Dr. Gould’s scientific standing and occupation should have undertaken the great labor of preparing this volume is conclusive evidence of the value of the data supplied by the returns.

In what I have thus far written of the Inspection Service of the Commission, I have had in mind only what was called the Field Service. A few words must be given to its department of General Hospital Inspection.

One of the most lamentable incidents of nearly all great wars has been the dreadful condition into which General Hospitals at times fell through insufficient and unsuitable structures used for housing them; through inadequate supplies, and through the weakness, and the demoralization largely due to that weakness, of the medical service and attendance. Nothing in the history of the British army during the Crimean War was more shocking, for instance, than the condition of its General Hospitals before the measures of improvement were taken with which the name of Florence Nightingale is associated.

As necessity came for greatly multiplying and enlarging our General Hospitals, the Sanitary Commission organized a special corps of inspectors to maintain constant watchfulness of them. It was composed of sixty physicians of unusual reputation, drawn from active civil practice and volunteering each for a limited period of service. This corps was under the command of Doctor Henry G. Clark of Boston, and successive reports of its operations will be found in Volume L of the Collection.

But the question will be asked:—

Was the leading purpose of the Commission, as it has been above stated, so far successfully pursued as to be of much value to the nation?

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The first thing to be said in answer to this question is that the proportion of men dying from disease during the war, instead of being more than four to one of those dying of injuries received in battle, as in the Crimean War, or as seven to one with our army in Mexico, was but two to one. What was due to the Commission’s labors, and what to other causes, cannot, of course, be discriminated. But I testify from personal observation, and from statements repeatedly made by regimental surgeons, that, simply through the direct efforts of the Commission’s inspectors, a decided reduction of the sick-rate of regiments often followed their visits, and that this reduction was accompanied by an obvious gain in the spirits and vigor of entire commands; by a gain, consequently, in their fighting strength. I think it certain that, partly in this way, still more by stirring up a lively and intelligent interest in the sanitary duties of officers and yet more through information and advice given at various army headquarters; given to Committees of Congress and to Chiefs of Departments and Bureaux, the preventive work of the Commission was equivalent in effect to an addition of many thousand men to our fighting force.

I have mentioned one ground of apprehension that for a time made some of our military authorities look askance at the Commission. There was another which, though of less importance, should be referred to.

Early in the war, it was apprehended that the Commission would be aiming to enforce a degree of care of all sick and wounded men which, looking to military success, would be unadvisable in an active campaign. And there was often afterwards an appearance of morbid sentiment that helped to sustain this apprehension. Numerous stories of the excessive and misdirected tenderness of volunteer nurses went about, also, and the Sanitary Commission had to take a good deal more than its fair share of the amusement they provoked. What was the fact? I can best answer, perhaps, by reciting instructions given by myself, early in 1861, to all our agents in the field: “The strength and mobility of the army cannot be sacrificed to the care of its sick and wounded. The sick and wounded should be sacrificed unflinchingly to every unavoidable military necessity; but, all the more they should be supplied with whatever mitigation of suffering military necessities leave possible.”

The spirit of this precept was, with, possibly, some rare temporary exceptions, lived up to in all the business of the Commission.

I have said that the preventive work of the Commission was, from the day it was organized, regarded as a more important part of its duty than that of providing for the sick and wounded. A service of the Commission, which, in my judgment, proved to be of yet greater importance and which is yet less understood by the public, remains to be mentioned.

From an early period of the war, the Commission was in communication with most firesides of the loyal States. Its means to this end were elaborately organized, first through its Branches, in the management of which, [272]suitably to the purpose, always by women, a very high degree of efficiency was manifested; second, through thousands of societies of women, subordinate to the Branches. By the second year of the war, few women in the loyal States, except those living in parts of towns chiefly inhabited by people of foreign birth, had not been brought into direct relation with some one of these societies, and through it with the Commission. Thus it occurred that a constant flow of information and of influence, backward and forward, was established, through the Commission, between the seat of government and between every army, every detachment, every squadron and every gunboat, and the remotest households of the loyal States.

Through thoughtfully contrived methods, the character of which has been thus suggested, the Commission established for itself the power, incidentally to the regular correspondence it maintained about supplies for the wounded, to spread true reports and counteract false reports; to encourage or to restrain currents of public sentiment, and, at times, to give legislators and officers of government better information than they could obtain from any other source, of the manner in which the heart of the people was affected by successive events. Leading members of Congress were habitual visitors of the Commission’s office in Washington, seeking less to know what had been heard from the front, than to feel the popular pulse.

This power of the Commission was exercised with reserve, and with little publicity, but never timidly or with uncertain or vacillating purpose. No one, looking now at the evidence presented in the papers of this Collection, will doubt that, on the whole, it was used discreetly and effectively.

With regard to this department of the Commission’s work, three points are to be specially noted,—first, that influence was brought systematically to bear against all sectional, jealous, querulous and conditional support of the war, and in sustenance of a broad, whole-hearted and magnanimous national patriotism; second, that the Commission sought to make all good citizens realize that nothing else was of equal importance to the health, the comfort and the efficiency of a fighting force, with its discipline; third, that the Commission began early and continued steadily to nourish the conviction that the war was to be a long, a costly and a bloody war, and that success was only to be hoped for as a result of great and sorrowful sacrifices, and of systematic, long-continued, courageous and self-denying efforts.

As the best illustration of the Commission’s work in this last particular, attention may be advised to the pamphlet entitled “How A Free People Conduct a Long War,” No. 10 of Volume M, of the present Collection. This pamphlet, written by a member of the Commission (Prof. Stillé), was systematically placed in the hands of some of the more influential men and women of nearly every school district in the loyal States. Its effect, in promoting the growth of a spirit of dogged determination in place of a feverish fervor, with its dangers of relapse and reaction, I believe to have been of incalculable value. [273]The Commission did much, in all its enormous direct and indirect correspondence, to develop and sustain this spirit.

There was a series of agencies of the Sanitary Commission, of the organization, methods and operation of which illustrative papers will be found chiefly in Volume L, of the Collection, that were highly useful as means for the alleviation of hardships, but, I believe, even more useful through the strength they indirectly added to our fighting force by lifting men under depressing circumstances; checking a tendency, under such circumstances, to despondency, and in some cases to desertion; hastening and confirming convalescence, preventing the nursing of grievances, and cultivating trust in the Government, and in the people back of the Government.

Chief among these I place that which, under the name of Special Relief Stations, was devised and superintended by that good and wise man, Frederick Newman Knapp, whose funeral at Plymouth last year was attended by a detachment of our Commandery and by hundreds of old soldiers, officers and privates, not a few coming from a distance, in testimony of their gratitude for kindnesses received directly from his hands during the war.

I transcribe a brief statement written by Mr. Knapp, showing something of the sort of work that was done at these Relief Stations, which were established in most of our large towns, one at each base of army operations, and one at each main point of transhipment of reinforcements.

The work of a Relief Station, wrote Mr. Knapp, is—

“1. To supply to the sick men of newly-arriving regiments such medicines, food and care, as it is impossible for them to receive in the midst of the confusion of arrival, and with the unavoidable lack of facilities, from their own officers. The men to be thus aided are those who are not so sick as to have a claim upon a general hospital, but who yet need immediate care to guard them against serious sickness.

“2. To furnish suitable food, lodging, care and assistance to men who are honorably discharged from service, sent from general hospitals, or from their regiments; but who are often delayed a day or more,—sometimes many days,—before they can obtain their papers and pay.

“3. To communicate with distant regiments in behalf of discharged men, whose certificates of disability, or descriptive lists on which to draw their pay, prove to be defective; the invalid soldiers meantime being cared for, and not exposed to the fatigue and risk of going in person to their regiments to have their papers corrected.

“4. To act as the unpaid agent, or attorney, of discharged soldiers who are too feeble, or too utterly disabled, to present their own claims at the paymaster’s office.

“5. To look into the condition of discharged men who assume to be without means to pay the expense of going to their homes, and to furnish the necessary means, where the man is found to be true, and the need real.

“6. To secure to disabled soldiers railway tickets at reduced rates; and, through an agent at the railway station, to see that these men are not robbed or imposed upon by sharpers.

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“7. To see that all men who are discharged and paid off, at once leave the city for their homes; or in cases where they have been induced to remain behind, to endeavor to rescue them, and see them started with through tickets to their own towns.

“8. To make reasonably clean and comfortable, before they leave the city, such discharged men as are deficient in cleanliness and clothes.

“9. To be prepared to meet at once with food or other aid, such immediate necessities as arise when sick men arrive in large numbers from battlefields, or distant hospitals.

“10. To keep a watchful eye upon all soldiers who are out of hospitals, yet not in service, and give information to the proper authorities of such soldiers as seem endeavoring to avoid duty.”

To the above functions of the Special Relief Service there came to be added, at most of its stations in our large cities, a great deal of organized and systematic looking after soldiers’ families, not for the purpose of providing for them in the way of charity by drawing upon the Commission’s funds, but chiefly by obtaining needed information for them; giving them sound advice and, in cases of need, putting them in the way of getting help from other sources. Necessity for charitable outlays in these cases was met by special local collections. In the city of New York, a single society acting in systematic co-operation with the Commission, expended six million dollars thus raised by special subscription for the purpose, in caring for soldiers and soldiers’ families.

Another of the agencies to which I have referred was that called the Hospital Directory of the Sanitary Commission, by means of which the place where, among thousands greatly scattered, every sick and wounded man lay, could be quickly learned by his friends at home, together with the address of a surgeon or chaplain, nurse or Commission Agent, through whom special information about him could be obtained, and if desirable, correspondence with him carried on.

Another was the Sanitary Commission Claim Agency, by which the claims for pay of any soldier or sailor could be examined, put in proper form, testimony obtained and compiled to sustain them, and the pay due drawn and remitted, all without expense to him or his family.

Another was the Sanitary Commission system of agencies by which discharged, maimed soldiers and sailors were helped to find remunerative employment suited to their condition.

About the occasion for each of these agencies; their organization, rules and methods of proceeding, and the work they did, original papers will be found in the Collection, chiefly in Volume L.

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There were other ways in which the Commission served as a medium of communication between the people in their homes and the people in the army and navy, of which no record will be found. One such, as an indication of their general spirit, I will mention.

The agents of the Commission were instructed always and everywhere to facilitate correspondence between the fighting men and their families and friends. Those at the front, as well as those at the hospitals and relief stations, were furnished with paper and stamped wrappers for this purpose, and they often took verbal messages to be put in writing and sent. These especially from wounded men, of course, but often from active men, also. I remember walking with one of our inspectors displaying the Commission’s badge, along the rear of a line of men who, after a long, hot, dusty march, had just hastily thrown up a slight defensive work of fence rails, stumps, fallen timber and brushwood; and I recall the strained faces I saw as one man after another turned, and without leaving his place, asked to have an address taken with a brief message. In one case, what was said was this, and generally it was something nearly equivalent:—

“Tell her that I sent my love. That’s all. You know, Sanitary, if I should get knocked out to-day, it would be some comfort to her to have got just that word from me.”

In carrying forward and back such scraps of comfort, by means of all its varied and widely scattered agencies, the Sanitary Commission helped, no one can say how much, to keep men and women in heart to fight out the weary war.

Those who, when the need of such an institution again comes, are to first take up the burden of it, are advised to bear well in mind that the ability of the Sanitary Commission to accomplish what it did, depended on its securing the services, early in the war, of trusty men, of suitable qualifications for certain clearly defined and limited duties, and in holding them, even more strictly than those of the army and navy themselves were held, to respect the letter and the spirit of army and navy regulations. So far as battle-field relief; so far as any temporary, volunteer emergency service, was valuable, it was so greatly because those engaged in it, men and women, were duly influenced, led and restrained by this earlier and more thoroughly disciplined skeleton force, composed almost entirely of physicians and liberally educated men, most of them, for one reason or another, disqualified for serving in the ranks.

I am, dear Colonel Rand,

Faithfully yours,