Rules for Preserving the Health of the Soldier

By Frederick N. Knap, special relief agent.

“SUNDAY EVENING, December 1, 1861. – The 8^th Regiment of New York Cavalry arrived last night, with a large number of men sick with the measles; some very sick. Forty were brought up here in the night, and nine more this morning. Just at daybreak one of them died; he was too far gone when brought here in the night to allow medical skill to be of any avail. His body to-day has been embalmed, to be sent to his friends. Ambulances have been obtained, and twenty-two of the men most seriously sick have been sent to the general hospital. A few days of care and rest will be all that the others need. There are seventy-one in the Hone to-night.”

“SUNDAY, December 15. – There were but thirty-five here last night; it is comparatively quiet to-day; all will be glad to rest; it has been a busy week; last Sunday there were nearly sixty here; many of the men to-day are writing letters home. We send from this house, upon average, about thirty-five letters per day to the post office. Two or three of the men have gone to the church near by. To-day Dr. Grymes has taken an ambulance and been himself with Williams out to his regiment, to consult with the surgeon there who may know more about his case; but it is decided best to bring Williams back again; his disease seems to be nothing but homesickness with general debility. He is a mere boy, of about eighteen, from a New Jersey regiment; he has been here since December 5. He evidently struggles to be manly and brave, but this homesickness has become a real disease, which masters him. We have thus frequent opportunity here in the Home to make note of what in the general excitement is almost unavoidably overlooked, and which yet it is worth while to have borne in mind while we are seeking to aid and strengthen our soldiers-namely, what a vast amount there is in the hearts of these soldiers of personal sacrifice, daily struggle to put down anxious feelings which might enervate the man, tender thoughts of home checked in their utterance, and hope silently waiting. The sum and the costliness of all this can never be estimated, and will never be recorded; yet, taken in the aggregate in the camps of these five hundred thousand men who have left their Northern and Western homes, the total is immense.”

“DECEMBER 25, (Christmas.) – The large room has been cleared out, and long tables spread, and a Christmas dinner prepared for all who happened to be here to-day. There were about sixty seated at the tables, and although some of the men were not able to taste what was spread before them, they were all able, as the face of each man showed, to share in the feeling which passed from one to another as they thought of Christmas days at home. And these thoughts of home did not make them weaker, but stronger for enduring hardships, as was manifest from the calm, earnest manner in which they responded to the few words spoken to them, telling them to bear in mind that Christmas day had but half its meaning until we had a country where, literally, freedom, justice, right laws, and all Christian principles were absolute in their control, and inaugurated by the will of the people.

            “I cannot but note the example here, in a small way, of what may be seen and ought to be felt working, in an immense way, all through our army, viz: the effect of bringing together into personal contact, men from all of the different parts of the land, blending their thoughts and interests and sympathies in common. For instance, as I took pains to record, we had to-day at our Christmas dinner men from Michigan, Pennsylvania, Maine, Wisconsin, Vermont, Massachusetts, New York, Rhode Island, New Jersey, New Hampshire, Indiana, and Maryland. To-night there are sixty-one men in the Home.”

Report of a Preliminary Survey of the Camps of a portion of the Volunteer Forces near Washington.

TENTS.

            The most common tent is a poor affair, being similar in form to the French tent d’abri, but without its advantage of portability. The common wall-tent is also largely used, and is much better. During the day the walls are triced up, and the tent is well ventilated; but at night, if the walls are lifted, or the flaps opened, the drift of the dew-laden wind across the men sleeping on the ground is felt to be severely cold. In most cases, therefore- the officers paying, apparently, no attention to the matter- the tents are closed as tightly as possible at night, and are crowded full of sleepers, six to eight and sometimes ten men being found in each. Of course they breathe a most vitiated atmosphere. Those who are most sensitive to this are sometimes forced out of the tent; and in a camp visited at night, the Secretary discovered that many men were sleeping on the ground, without any protection from dew or malarious influences….

SINKS.

            In most cases the only sink is merely a straight trench, some thirty feet long unprovided with a pole or rail; the edges are filthy, and the stench exceedingly offensive; the easy expedient of daily turning fresh earth into the trench being often neglected. In one case, men with diarrhea complained that they had been made sick to vomiting by the incomplete arrangement and filthy condition of the sink. Often the sink is too near the camp. In many regiments the discipline is so lax that the men avoid the use of the sinks, and the whole neighborhood is rendered filthy and pestilential. From the ammoniacal odor frequently perceptible in some camps, it is obvious that the men are allowed to void their urine, during the night, at least, wherever convenient.

PERSONAL CLEANLINESS.

            In but few cases are the soldiers obliged to regard any rules of personal cleanliness. Their clothing is shamefully dirty, and they are often lousy. Although access is easily had to running water, but few instances are known where any part of the force is daily marched, as a part of the camp routine, to bathe. A careful daily inspection of the state of the men’s clothing is probably made in few, if any, regiments. Whatever good qualities they possess in other respects, so far from being good soldiers in this, which has been long held the elementary condition of good soldiers, our volunteers are, in many cases, really much dirtier than it can be believed they have been accustomed to be in their civil life; and it is obvious that neither they nor their officers comprehend in the slightest their duty in this particular, nor the danger and inconvenience they are bringing upon themselves by its neglect. The clothing of the men from top to toe is almost daily saturated with sweat and packed with dust, and to all appearance, no attempt is generally made to remove this, even superficially…

By J.S. Newberry, M.D., Associate Secretary.

            ….On comparing the condition of the troops which have come under my observation, with that observed at the time of making my former Report, it may be stated that, while exhibiting in many respects a different phase, their average health has on the whole not materially changed. With the advance of the season, and their experience in camp life, important modifications have taken place in the diseases from which they have suffered. The diarrhea, at one time so prevalent in all the camps, and the various effects of malarious poison which gave a distinct phase to the nosology of our armies early in the season, have diminished in a marked degree; while with the approach of the colder weather of autumn, the cases of typhoid fever, perhaps no more numerous, have become more grave; measles and small pox, which for a time had somewhat abated their virulence, are now more frequent and severe; and rheumatism has assumed an important place in the list of diseases with which our troops are affected. On the whole, the percentage of sick is but little  greater than during the summer, yet I think it will be found to hold good, as a general rule, that the mortality has sensibly increased. This is doubtless due to the combined operation of several causes. The multitudinous cases of trivial diseases, occurring among all newly-enlisted men, and incidental to the change from civil to military life, no longer swell the sick list and fill the hospitals; and the more frequent, but less sever forms of malarious disease – ague and chill fever- have been succeeded by the rarer, but more grave, malarious dysenteries and bilious remittent fevers; while the eruptive diseases, as they are so prone to do, have multiplied in number and increased in virulence with the approach of cold weather. This increase in the number of cases of grave and fatal diseases among troops now more experienced in camp life, better equipped than at first, subject to at least partial sanitary inspection and instruction, and in the enjoyment of a large and liberal bounty from the Sanitary Commission and a generous public, by which their comfort and, as a consequence, their health have been without question greatly increased, will perhaps excite surprise and concern in many minds; and the question will naturally arise: Why is it? Doubtless a portion of the prevalent sickness and mortality are due to natural and inevitable causes, incident to the change of season, and affecting alike those enjoying the comforts of home and those exposed to the hardships of camps; there can be no question, however, that a very large number of the cases of death and grave disease in our western Armies are due to removable causes; which should therefore become matters of anxious concern and earnest, immediate effort.

            In this category of causes I would include unnecessary exposure to wet and cold. The consequences following such exposure have been mainly entailed by insufficient protection against the inclemencies of the weather, such as defective tents, blankets too few and of inferior quality, uniforms of too light material, overcoats wholly wanting or far too pervious to both cold and rain. And here I may be permitted to remark that I cannot but anticipate the gravest consequences from the inadequacy of the protection afforded by their clothing and bedding, such, and so much as now furnished to troops soon to encounter all the severities of our arctic winter. It is my earnest conviction that few of our volunteers will be so located as to geographical position, or so protected in winter quarters, as to escape great suffering and serious disease, while guarded from the effects of cold only by their uniforms and a single blanket each…

KENTUCKY.

-Regiment.

            I found camp streets, tents, spaces between tents, drains, and edges of the tents, filthy. Refuse slops were buried in trenches; but the trenches were nearly filled, before the dirt was filled in.

            The men were undisciplined. The horses tied very near the tents, and their dung not removed. The cooking bad; the men dirty. In short, by want of cleanliness and attention to the requirements of civilized life, the men were in danger of losing all self-respect.

Sixth Indiana Regiment.

            This was in excellent condition. The Colonel is a gentleman and a soldier, alive and active in his duties. The Surgeon, Dr. CHAS. S. SCHUSSLER, is eminently well qualified, and devoted himself untiringly to his duties. Guided by science, he is saving many lives by taking those precautions necessary to prevent sickness. Means were used to promote cheerfulness, and the men were in good spirits.

            The streets of the camp are beautifully turnpike and well drained. The tents are struck or raised from the bottom often. The slops are carefully disposed of, so as not to be in the least offensive, the men clean, their clothing well washed. The sink was on the leeward side of camp, in the woods, at a proper distance, neither too far nor too near. A nice walk was cut to it through the woods, trees cut close to the ground, and felled in such a manner as to make even a beautiful fence on each side of the walk.

            Most of the companies have built log houses, with fire-places and chimneys, for kitchens, well adapted for the use designed. But two men were so sick but that they would join their regiment were an order given to march- one of these disabled by an accidental wound, the other sick with fever.

Thirty- Fourth Illinois Regiment.

            Health unusually good- the medical staff very efficient. The regiment had been systematically vaccinated- the only one I found that had been. The camp and men were unusually cleanly – sink in excellent condition. The dung made by horses was removed, so as not to be in the least offensive. The hospital, in excellent condition, had comfortable beds, (the only one I found which had,) and a supply of delicacies and cordials. It was almost a luxury to be sick there compared with most regimental hospitals.

Ninth Michigan Regiment.

            Men suffering severely from measles. They were exhausted by hard work in the rain and loss of sleep on their march to camp; and I have no doubt but the severity, if not the number, of cases was increased by that cause. 300 were sick in hospital, being in different houses, with bad ventilation, no beds, and no means of changing the clothing worn in camp. (Wants since fully supplied. – N.)

-Regiment.

Camp unclean; been occupied but a week or ten days; expecting to move soon. The sink used but a little more than the ground in the vicinity, from which there is a gentle slope to a small stream of surface water some few yards distant, from which all the water used in the camp is obtained. It would be hardly extravagant to say that the sink was the fountain-head of the stream. The men complained, and had the promise of moving to a better location.

2. Every officer and soldier should be carefully vaccinated with fresh vaccine matter, unless already marked by smallpox; and, in all cases where there is any doubt as to the success of the operation, it should be repeated at once…

7. Soldiers should always eat at regular hours, as far as the exigencies of service permit. Neglect of regular hours for meals tends to disorder the digestion, and to invite diarrhea.

8. Each company should have its regularly detailed cook and assistant, who should always, on a march, be allowed to ride in one of the wagons, when practicable, inasmuch as their services are more necessary for the health of the men than in the ranks, and they are often required to cook at night the rations for the next day, whilst the men are sleeping. The men should always willingly procure wood and water for the cooks, whether detailed for such services or otherwise.

9. “Bread and soup are the great items of a soldier’s diet in every situation: to make them well is therefore an essential part of this instruction. Those great scourges of a camp life, the survy and diarrhea, more frequently result from a want of skill in cooking than from the badness of the ration, or from any other cause whatever. Officers in command, and, more immediately, regimental officers, will therefore give a strict attention to this vital branch of interior economy.” (Winfield Scott.)…

12. Spirits should only be issued to the men after unusual exertion, fatigue, or exposure, and on the discretion of the surgeon.

Those men who drink spirits habitually, or who commit excess in its use, and the first to fail when strength and endurance are required, and they are less likely to recover from wounds and injuries.

13. Water should be always drank in moderation, especially when the body is heated. The excessive thirst which follows violent exertion or loss of blood is unnatural, and is not quenched by large and repeated draughts; on the contrary, these are liable to do harm by causing bowel complaints. Experience teaches the old soldier that the less he drinks when on a march the better, and that he suffers less in the end by controlling the desire to drink, however urgent…

16. Sleeping upon damp ground causes dysentery and fevers. A tarpaulin or India rubber cloth is a good protection; straw or hay are desirable, when fresh and frequently renewed; fresh hemlock, pine, or cedar boughs make a healthy bed. When occupied for any time, a flooring of planks should be secured for the tents, if possible, but this must be taken up, and the earth exposed to the sun, at least every week…

18. The crowding of men in tents for sleeping is highly injurious to health, and will always be prevented by a commanding officer who is anxious for the welfare of his men. Experience has proved that sleeping beneath simple sheds of canvas, or even in the open air, is less dangerous to health than over-crowding in tents.

No more than five men should ever be allowed to sleep in a common army tent of the kind most commonly in use…

26. The men should not be over-drilled. It is likely to beget disgust for drill, and to defeat its object. Three drills a day, of one hour each, for squads, and a proportionate length of time, when sufficiently advanced, for battalion drill, is more profitable than double the time similarly occupied.

27. When practicable, amusements, sports, and gymnastic exercises should be favored amongst the men, such as running, leaping, wrestling, fencing, bayonet exercise, cricket, base-ball, foot-ball, quoits, &c., &c.

28. On a march take special care of the feet. Bathe them every night before sleeping, not in the morning. Select a shoe of stout, soft leather, with a broad sole and low heel.

Prefer woolen socks. If the feet begin to chafe, rub the socks with common soap where they come in contact with the sore places…

31. It is a great comfort to the men to halt for ten or fifteen minutes at the end of the first half hour; many, about this time, require to attend to the calls of nature. After this there should be a halt of ten or fifteen minutes at the end of every hour, with a rest of twenty minutes in the middle of the day for lunch. A longer halt than this stiffens the men and renders subsequent marching difficult. The best rule is, to get through the day’s march, and rest in camp, if possible, by two o’ clock, p.m.

32. The best pace to adopt, in marching, is from 90 to 100 steps (of 28 inches each) to the minute; this will give a rate of from 2 ½ to 2 ¾ miles to the hour.

In continuous marches, the leading companies should be alternated each day, as it is always less fatiguing to be in advance…

35. In action, the proper position in which to place a wounded or fainting man is flat upon his back, with the head very slightly raised.

36. The most urgent want of a wounded man is water; if a canteen or cup is not at hand bring it in a hat or any available vessel.

37. As a rule, cuts, even when extensive, are less dangerous to life than they seem; the contrary is true of bayonet and bullet wounds.

38. Whenever blood is flowing freely from a wound be spirits or jets, there is immediate danger, and, if the wound is situated in one of the limbs, a stout handkerchief or band should be promptly tied loosely around it, between the wound and the heart; a drumstick, bayonet, ramrod, or jack-knife is to be then inserted between the skin and the bandage, and twisted round until the strangulation of the limb stops the flow of blood, and it should be held thus until the surgeon arrives.

In a less urgent case, or where the wound is differently situated, pressure applied directly to its surface, and kept up steadily, will often save life.

39. Wounded men should always be handled with extreme care, especially if bones are broken. The medical assistants are always provided with spirits and anodynes.

40. It is by no means necessary that a bullet should always be extracted; they often remain in the body, and do little or no harm, much less, in fact, than might be done in attempts to remove them.

WASHINGTON, July 13, 1861.

                                              W.H. VAN BUREN, M.D.