Civil War Facts
Medicine
Civil War medicine was in a time before the doctors even knew much about bacteriology and were ignorant of what caused disease. Doctors during the Civil War for the most part had two years of medical school, though some pursued higher amounts. Most surgeons had never treated a gun shot wound, many had never performed surgery. Medical boards let in many doctors who were not qualified. Yet, for the most part the Civil War doctor , as understaffed, sometimes underqualified, and very usually under supplied as he was, did the best he could, exploring through the so-called "medical middle ages." Some 10,000 surgeons served in the Union and about 4,000 served the Confederacy.
Little was known about what caused disease, how to stop it from spreading, or how to cure it. Surgical techniques ranged from the barbaric to the barely competent. The patients were cared for by a woefully underqualifled, understaffed, and undersupplied medical corps. Working against incredible odds, the medical corps increased in size, improved its techniques, and gained a greater understanding of medicine and disease throughout the war.
It was the tragedy of the era that medical knowledge of the 1860's had not yet encompassed the use of sterile dressings, antiseptics and antiseptic surgery, and the realization of sanitation and hygiene was still inadequate and many died as a result from diseases such as typhoid or dysentery. In particular, relatively simple intestinal complaints such as dysentery and diarrhea claimed many lives.
Diarrhea and dysentery alone claimed more men than did battle wounds. The soldier also faced outbreaks of measles, small pox, malaria, pneumonia, or camp itch. Malaria was brought on by usually camping in damp areas (that were conductive to breeding mosquitos) while camp itch was caused by insects or a skin disease.
One of the reasons for the high rates of disease was the slipshod recruiting process that allowed underage or overage men and those in noticeably poor health to join the armies on both sides, especially in the first year of the war. By late 1862, some 200,000 recruits originally accepted for service were judged physically unfit and discharged, either because they had fallen ill or because a routine examination revealed their frail condition.
Those who survived their wounds and surgeries still had the high risk of infection. While most surgeons were aware of a relationship between cleanliness and low infection rates, they did not know how to sterilize their equipment. Due to a frequent shortage of water, surgeons often went days without washing their hands or instruments, thereby passing germs from one patient to another as he treated them. The resulting vicious infections, commonly known as "surgical fevers," are believed to have been caused largely by Staphylococcus aureus and Streptococcus pyogenes, bacterial cells which generate pus, destroy tissue, and release deadly toxins into the bloodstream. Gangrene, the rotting away of flesh caused by the obstruction of blood flow, was also common after surgery.
Many unqualified recruits entered the Army and diseases weeded out those who should have been excluded by physical exams. There was no knowledge of the causes of disease. Rural area troops were crowded together for the first time with large numbers of other individuals and got diseases from which they had no immunity. Neglect of camp hygiene was a common problem as well. Ignorance of camp sanitation and little knowledge about how disease was carried led to a sort of "trial and error" system.
Both Armies faced problems with mosquitos and lice. Exposure turned many cases of normal colds into pneumonia and other complicated ailments. Pneumonia was the third leading killer disease of the war, after typhoid and dysentery. A lack of shoes and proper clothing further complicated the problem, especially in the Confederacy. The soldier's diet was somewhere between barely palatable to absolutely awful. It was estimated that 995 of 1,000 Union troops eventually contracted chronic diarrhea or dysentery; Confederates suffered similarly. Disease particularly ran rampant in the prisons, as many of these conditions that led to disease were very much present.
To halt the spread of disease, the doctors used many cures. For bowel complaints, open bowels were treated with a plug of opium. Closed bowels were treated with "blue mass" ( a mixture of mercury and chalk.) For scurvy, doctors prescribed green vegetables. Respiratory problems, such as pneumonia and bronchitis, were treated with dosing of opium or sometimes quinine and muster plasters. Sometimes bleeding was also used. Malaria could be treated with quinine, or sometimes even turpentine if quinine was not available. Camp itch could be treated by ridding the body of the pests or with poke-root solution. Whiskey and other forms of alcohol also were used to treat wounds and disease.
The medicines brought in to try and halt diseases were manufactured in the North for the most part; the Southerners had to deal with running the Union blockade. On occasion, vital medicines were smuggled into the South, sewn into the petticoats of ladies sympathetic to the Southern cause. The South also had some manufacturing capabilities and worked with herbal remedies. However, many of the Southern medical supplies came from captured Union stores.
Battlefield surgery was also at best archaic when held against the modern standard. Doctors often took over houses, churches, schools, even barns for hospitals. The field hospital was located near the front lines (sometimes only a mile behind the lines) and was marked with with a yellow flag with a green "H".
Anesthesia's first recorded use was in 1846, making it still in it's infancy at the time of the war. Anesthesia was almost always, as a rule, used in surgery, in fact, there were 800,000 cases of it's use. Chloroform was used about 75% of the time. Of 8,900 cases of use of anesthesia, only 43 deaths were attributed to the anesthetic, a remarkable mortality rate of just 0.4%. Anesthesia was usually administered by the open-drop technique.
The anesthetic was applied to a cloth held over the patient's mouth and nose and was withdrawn after the patient was unconscious. A good capable surgeon could amputate a limb in 10 minutes.
Lack of water and time meant they did not wash off hands or instruments. Bloody fingers often were used as probes and bloody knives used as scalpels. Doctors operated in pus and blood stained coats. Everything about surgery was septic.
Blood poisoning, sepsis, or Pyemia (meaning literally pus in the blood) were common and often very deadly. Surgical fevers also could develop, as could gangrene. One witness described surgery as such: "Tables about breast high had been erected upon which the screaming victims were having legs and arms cut off. The surgeons and their assistants, stripped to the waist and bespattered with blood, stood around, some holding the poor fellows while others, armed with long, bloody knives and saws, cut and sawed away with frightful rapidity, throwing the mangled limbs on a pile nearby as soon as removed." About 75% of amputees did survive.
As the lists of the maimed grew, both North and South built "general" military hospitals. These hospitals were usually located in big cities. They were usually single storied, of wood construction, and well-ventilated and heated. The largest of these hospitals was Chimbarazo in Richmond, Virginia. By the end of the War, Chimbarazo had 150 wards and was capable of housing a total of 4,500 patients. Some 76,000 soldiers were treated at this hospital.
There were some advances, mainly in the field of military medicine. Jonathan Letterman revolutionized the Ambulance Corps system. With the use of anesthesia, more complicated surgeries could be performed. Better and more complete records were kept during this period than they had been before.
The medical field was not yet capable of dealing with the disease and the massive injuries caused by the minnie bullet and by the outmoded tactics practiced by the generals who had learned about war in the Napoleonic Age.
SURGERY/AMPUTATION
Many soldiers construed the Civil War surgeon to be a heartless indivdual or who was somehow incompetent and that was the reason for the great number of amputations performed.
The surgeon suffers from being called a butcher or some other derisive term. The slow-moving Minnie bullet used during the war caused catastophic injuries. Missing arms and legs were permemant, visible reminders of the war. Three out of four wounds were to the extremities. In the Union Army, this led to 30,000 amputations.
The wait for treatment could be a day or two, depending on how long a battle lasted. When treatment was finally administered, it was not done antiseptically. Careful hand washing by the surgeon was not even done, and the doctors wore blood splattered clothes. When an instument was dropped, it was simply rinsed in cool, often bloody, water. Sponges that had been used in previous cases were simply dipped in cold water before using them again on the next person.
A surgeon recalled: "We operated in old blood-stained and often pus-stained coats, we used undisinfected instruments from undisinfected plush lined cases. If a sponge or instrument fell on the floor, it was washed and squeezed in a basin of water and used as if it was clean" The injuries to be dealt with were dreadful and the fault of the soft lead Minnie Ball. With the capability to kill at over 1,000 yards, this soft lead bullet caused large, gaping holes, splintered bones, and destroyed muscles, arteries and tissues beyond any possible repair.
Those shot with them through the body, or the head, would not be expected to live. Almost all wounds were caused by the bullet, with canister, cannonballs, shells, and edged weapons.
The cynlidrical lead Minnie ball was rather large and heavy. When it hit bone, it tended to expand. When it hit the intestines or other soft tissue, it tended to tear them in ways the old smoothbore musket ball didn't do. The bullet crushed and smashed bone so badly, the doctors didn't have much choice but to amputate a limb. Wounds to the stomach almost always ended in death.
Doctors were woefully ill-prepared. Of 11,000 Union physicans, 500 had performed surgery before. In the Confederacy, of 3,000, only 27 had performed surgery before. Many doctors got their first introduction to surgery on the battlefield. Doctors usually didn't have a specialty.
Medical school, for many, was just 2 years of study. Many had to learn to do surgery on the job in the most hellish conditions. While most surgeons were competent, many doctors were no more than political appointments because there were no liscencing boards in the 1860's. Army exam boards often even let in "questionable" doctors.
The field hospital surgeon would stand over the operating table for hours. Only the division's best surgeons did the operating and they were called "operators".
Already, they were performing a crude system of triage. The ones wounded through the head, stomach, or chest were left to one side because they would most likely die. This allowed the doctors to not waste precious time and to save those that could be saved with prompt attention.
The surgeon would wash out the wound with a cloth and probe the wound with his finger, or a probe perhaps, looking for bits of cloth, bone, or the bullet. If the bone was broken or a major blood vessel torn, he would often decide on amputation. Later in the War, surgeons would sometimes experiment with resection, but far more common was amputation.
Deciding upon an amputation, the surgeon would adminster chloroform to the patient. Anesthesia was in common and widespread use during the war. It would make more complicated and longer operations possible as the era of antiseptic surgery was embarked.
The surgeon would make incisions both above and below, leaving a flap of skin on one side. Taking his bonesaw he would saw through the bone until it was severed. With the patient insensible, the surgeon would take his scapel and make an incision through the muscle and skin down to the bone.
He would then tie off the arteries with either horsehair, silk, or cotton threads. The surgeon would scrape the end and edges of the bone smooth, so that they would not work back through the skin. The flap of skin left by the surgeon would be pulled across and sewed close, leaving a drainage hole. The stump would be covered and bandaged, and the soldier set aside. A good surgeon could amputate a limb in under 10 minutes
Surgeon George Otis cited the five prinicpal advances of surgery 15 years after the war ended. The surgeons had learned something about head injuries, how to deal with "ghastly wounds" without dismay, how to litigate arteries, information on injuries to spine and vertebrate had been "augumented", and "theory and practice" in chest wounds had been forwarded.
"Surgical Fevers" were infections arising from the septic state of surgery. The surgeon was not so interested in cleanlieness, but in speed. As such, and not knowing anything about antiseptic surgery, fevers arose. The most deadly fever was probably pyemia, a form of blood poisioning. Nothing seemed to halt pyemia, and it had a moratality rate of over 90%. Other surgical diseases included tetanus, erysepilas, and osteomyelitis (which is an inflammation of the bone). Also, "Hospital Gangrene" was a black spot, about the size of a dime or so, that would appear on the wound. Before long, it would spread throughout, leaving the wound a smelling awful mess.
- Primary amputation mortality rate: 28%
- Secondary amputation rate: 52%
DENTISTRY
The dental profession had gained some standing during the two decades that preceded the Civil War. In the Confederate states, there were about 500 dentists. Jefferson Davis, while serving as Secretary of War under Pierce, was an advocate for a dentistry corps. Perhaps this is why the Confederate Army had a dental program, while a similar idea by the Union Army was rejected by the War department.
Soldiers tended to neglect basic care of their teeth. Toothbrushes were somewhat scarce and the average diet left a lot to be desired. Dental operations usually also cost more than the common private soldier could afford.
Many soldiers, by the way, were turned down if they lacked six opposing upper and lower front teeth to bite off the end of the powder cartridges used with the muzzle loading rifles of the times.
Dentists were usually accorded the rank of hospital steward, though according to one source, they also could be full surgeons with all the pay and benefits of a surgeon. Confederate Medical Director William A. Carrington commented that dentists "plugged, cleaned, and extracted teeth", in addition to "adjusting fractures of the jaw and operating on the mouth".
Dentist Dr. James B. Bean of Atlanta made significant contributions to the treatment of fractured maxillary bones. Bean used an interdental splint made of vulcanized india rubber that had cup shaped indentations for the teeth. Bean's splint was a great success and he was sent to Richmond where his splint was used for treatment at a ward of the Receiving and Way Hospital.
The act of conscripting dentists in January of 1864 gave the Confederate soldier at least that small advantage over the Union soldier. All attempts at the Union Dentistry corps were turned down.
REGIMENTAL HOSPITAL
In the field, the Regimental Hospital department was allowed 2 small tents for the officers, medicines, etc. Another small tent was used for the kitchen department and supplies, and a larger tent for the sick. The hospital tent was about 14 feet square and was capable of containing 8 cots with as many patients.
In the field, there were almost never any sheets and pillow cases, but many made use of army blankets. In warm weather, the walls of the tent were raised, making it more pleasant for the patients.
The policy was to send those who were not likely to recover quickly to the base hospitals, though this was not always to the patient's best interests. These larger hospitals were oftentimes centers of infection of one kind or another, especially hospital gangrene.
During a campaign, the stock of medicines was necessarily limited to standard remedies, among which could be named opium, morphine, Dover's powder, quinine, rhubarb, Rochelle salts, castor oil, sugar of lead, tannin, sulphate of copper, sulphate of zinc, camphor, tincture of opium, tincture of iron, tincture opii, camphorate, syrup of squills, simple syrup, alcohol, whiskey, brandy, port wine, sherry wine, etc. Upon going into camp, where patients were likely to remain for a few days, these articles were unpacked and put on temporary shelves. When marching orders came, the medicines were packed in boxes.
Practically all the medicines were administered in powder form or in the liquid state. The result was that most powders were stirred in water and swallowed. The bromides, sulfonal, trional and similar soporifices and sedatives, had not come in use. Asafetida, valerian, and opium and its derivatives were used to relieve nervousness and induce sleep.
Among the surgical supplies were chloroform, ether, brandy, aromatic spirits of ammonia, bandages, adhesive plaster, needles, silk thread for ligatures, etc. While all the instruments were washed in water and wiped dry to keep from rusting, such an idea as making them aseptic never entered the head of the most advanced surgeon.
There was an emergency case, about the size of a soldier's knapsack, intended to be carried on an attendant's back like a knapsack. In this emergency case were bandages, adhesive plaster, needles, artery forceps, scalpels, spirits of ammonia, brandy, chloroform, ether, etc. This emergency case, or hospital knapsack, was always taken with the regiment when the firing-line was about to be approached, and where the First Assistant Surgeon was in charge and was ready to treat the wounded.
This first aid never went further than staunching bleeding vessels and applying temporary dressings. After the initial care, the wounded were taken to an ambulance, and driven to the field hospital in the rear. At the field hospital, the patient was cared for by the surgeons and nurses. The wounds were examined and dressed.
Hospital men were detailed from the regiment to serve in the several capacities of nurses, cooks, and ambulance drivers, etc. Service of this kind was known as "special duty."
U.S. SANITARY COMMISSION
The Sanitary Commission's origin may be traced to a meeting of women held in New York, April 25, 1861. Out of this grew the Women's Central Association of Relief. Plan after plan was suggested, only to be discarded by the leaders. Finally, Dr. Henry W. Bellows, a church pastor in New York, advised them to find out first what the Government would and could do, and then to attempt to do only those things which the general Government felt itself unable to do.
Accompanied by several other men deeply interested in the problem, he went to Washington to study the situation. The idea of the Sanitary Commission was a natural outgrowth of what they saw, but the plan at first met with little favor. The medical corps was indifferent if not actually hostile; the War Department was in opposition; President Lincoln feared that it would be a " fifth wheel to the coach." But finally the acting surgeon-general was won over and recommended the appointment of " a commission of inquiry and advice in respect to the sanitary interests of the United States forces," to act with the medical bureau. The committee was invited to put into a definite form the powers desired, and suggested that an unpaid commission be appointed for the following purposes:
"To inquire into the recruiting service in the various States and by advice to bring them to a common standard; second, to inquire into the subjects of diet, clothing, cooks, camping grounds, in fact everything connected with the prevention of disease among volunteer soldiers not accustomed to the rigid regulations of the regular troops; and third, to discover methods by which private and unofficial interest and money might supplement the appropriations of the Government. "
The plan was approved and, on June 9, Henry W. Bellows, D.D.; Professor A. D. Bache, LL.D.; Professor Jeffries Wyman, M.D.; Professor Wolcott Gibbs, M.D.; W. H. Van Buren, M.D.; Samuel G. Howe, M.D.; R. C. Wood, surgeon of the United States Army; G. W. Cullum, United States Army, and Alexander E. Sbiras, United States Army, were appointed by the Secretary of War, and his action was approved by the President the same month. The Government promised to provide a room in Washington for their use. The men at first appointed soon added others to their number, and as the movement spread over the country additional members were appointed until there were 21 commissioners. Frederick Law Olmsted, the distinguished landscape architect, was chosen general secretary while Dr. Bellows naturally became president. A general circular asking for contributions amounting to $50,000 for the remaining 6 months of the year 1861 was issued on June 22d, which amount was considered sufficient to continue the work of inquiry and advice for that period.
Upon the authority thus given, an examination of the condition of the troops both in the East and in the West was undertaken by several members of the commission, with the result that unsanitary conditions were found almost everywhere. At once, provision was made for the employment of expert physicians as inspectors of camps. Though the commission could pay only moderate salaries, it was found possible to secure inspectors of an unusually high type, many of whom resigned more remunerative positions to take up the work of the commission. Minute instructions were issued to them. They must not enter a camp without the approval of the superior officers, which was usually given as a matter of course. In their examination they were instructed to consider the location of the camp, its drainage, ventilation of tents or quarters, the quality of the rations, the methods of cooking, the general cleanliness of the camp and of the men. Wherever any of these fell short of a satisfactory standard, they were instructed to suggest tactfully to the commanding officers the points of deficiency and also to send their reports to the commission.
Their reports contained an immense number of physiological and hygienic facts, which were tabulated by the actuaries of the commission and digested by the physicians employed for the purpose. The effects of these inspections were almost invariably good. When a commanding officer once had his attention called to defects in the location of the camp or in drainage or in police, he was usually unlikely to make the same mistakes in the future, and every regiment in which sanitary and hygienic conditions were satisfactory was an example to the regiments with which it might be brigaded in the future.
Through the inspectors, 18 short treatises prepared by committees of eminent medical men were distributed to the regimental surgeons and the commanding officers. Since these surgeons had been almost wholly drawn from civil life and as the Medical Department had not issued any such treatises to them, these little books were of inestimable value.
The ideas of the members of the commission, which included some of the best-known physicians in the country as well as men of affairs, were large. The members of the Sanitary Commission felt that only a young man was capable of making the organization effective, and they were successful in so influencing public opinion that a bill was passed destroying to a large extent the system of promotion by seniority and allowing the appointment of William A. Hammond as surgeon-general.
The third phase, that of relief, began with the care of the fugitives of the battle of Bull Run. Many regiments had been scattered, and the men came pouring into Washington, separated from their officers and surgeons, and but for the work of the commission, much more suffering would have resulted. Relief was also sent to the wounded after the battles at Edwards' Ferry, Ball's Bluff, and Dranesville.
The collection of supplies in kind was left largely to the branches, which were made almost entirely independent of the parent organization. In all of these women were prominent. The Women's Central Relief Association of New York was the first one recognized, though the branch in northern Ohio was the first association of women organized. The chief branches in the East were those in New York, Boston, Buffalo, and Philadelphia. There were other branches at Cincinnati, Louisville, Chicago, Troy, Detroit, and elsewhere. Far-off California sent a large contribution in money. These branches were best able to deal with local conditions, as through them were collected such diverse articles as quilts, blankets, pin-cushions, butter, eggs, sauerkraut, cider, chickens, and many other things. The standard set by the branch for the local-aid societies was " a box a month for the soldiers."
At first, there was much difficulty in establishing the principle of universality of relief. A community was willing to send a box to its own company or to its own regiment, but was less enthusiastic over the question of sending articles to men whom it bad never seen. But after it had been shown that, on account of the frequent changes in the position of troops, thousands of such boxes lay in the express offices undelivered until their contents were often spoiled, the wisdom of the provision of a general-relief fund which should send aid wherever needed, came to be recognized.
One great difficulty to be overcome was the widespread belief in some sections that the soldiers did not get the contents of the boxes sent them. Rigid investigation disproved the existence of any considerable misapplication of stores, but the rumor was stubborn, and was believed by many whose zeal naturally was relaxed.
The commission proved its value during the Peninsula Campaign of 1862. The transfer of troops to this new and somewhat malarious country soon brought on an amount of sickness with which the Governmental agencies were unable to deal. With the approval of the medical bureau, the commission applied for the use of a number of transports, then lying idle. The Secretary of War ordered boats with a capacity of one thousand persons to be detailed to the commission, which in turn agreed to take care of that number of sick and wounded. The Daniel Webster, assigned to the commission April 25, 1862, was refitted as a hospital and reached the York River on April 30, with the General Secretary, Mr. Olmsted, and a number of surgeons and nurses.
Other ships were detailed, though great inconvenience was suffered from the fact that several were recalled to the transport service, even when they had a load of sick and wounded, who, of course, had to be transferred at the cost, sometimes, of considerable suffering. At the same time, agents of the commission were near the front with the soldiers, offering such relief as was in their power. Undoubtedly hundreds of lives were saved during this campaign by the efficient work of the commission.
During this campaign, another branch of the commission's activity developed. So many letters inquiring about sick, wounded, or dead soldiers were received that a hospital directory was begun, and before the 1st of April, 1863, this directory included the names of the sick and wounded soldiers in every general hospital. At the second battle of Bull Run the supplies sent forward by the surgeon-general were captured by the Confederates, and but for those furnished by the Sanitary Commission, the suffering would have been truly frightful. The work was continued at Antietam, where the supplies were brought to the field two days ahead of those of the Medical Department. The commission was also the main dependence after the battle of Fredericksburg, and not until the battle of Chancellorsville were the supplies of the Medical Department on the battlefield plentiful and accessible.
In the West, an organization in St. Louis, known as the Western Sanitary Commission, though having no connection with the larger body, was very efficient in the work of relief. It established and equipped hospitals, and was able to supply them. Many valuable contributions, however, were sent from the East. The Chicago, or Northwestern branch, also rendered valuable service. Scurvy was prevented by rushing carloads of fresh vegetables to Vicksburg and to the Army of the Cumberland.
After the reorganization of the medical bureau and the resulting increase in efficiency, the work of the commission became, as mentioned above, largely supplementary. And yet, to the end of the war, with every corps was a wagon carrying, among its supplies, chloroform, brandy, and other stimulants; condensed milk, beef-stock, bandages, surgeon's silk, and other articles of pressing need.
A telegram from the inspector or relief agent on the spot to the nearest branch, demanding articles of food or of clothing, was almost sure to be promptly answered, while Government supplies were to be procured only on requisition, and necessarily passing through several bands, were sometimes much delayed. With the resulting lessening of the burden upon the energies of the commission, its activity was much broadened.
A " home " was established in Washington, D.C. to give food and lodging and proper care to discharged soldiers. Those in charge were always ready to help soldiers to correct defective papers, to act as agents for those too feeble to present their claims at the pension office or to the paymaster, and to protect them from sharpers and the like. Lodges were established near the railway stations to give temporary shelter. Two nurses' homes were established, but these were largely used as temporary shelter for mothers or wives seeking their wounded sons or husbands.
In the West, a home was established by the Chicago branch at Cairo, Illinois, which was one of the main gateways through which soldiers passed, going toward or returning from the army. Rations were issued by the Government, and the building was furnished for the most part by the commission which assumed the management. It was, in effect, a free hotel for soldiers, and thousands were looked after and kept from harmful associations. Later it was much enlarged by order of General Grant, who instructed the officer commanding the post to construct suitable buildings. Much of the money raised by the Sanitary Commission was by means of fairs, some of which became national events, and lasted for weeks. During its existence, the Sanitary Commission received $4,924,480.99 in money and the value of $15,000,000 in supplies.
No such well-organized instrumentality as the Sanitary Commission existed in the South. There were many women's aid societies, and some of those in the seaport towns performed valuable services. The one in Charleston devoted its energies largely to procuring through the blockade the much needed stimulants and medicines. In Wilmington, much work of the same sort was accomplished. In every town through which soldiers passed, the women were always ready to feed the hungry and nurse the sick without formal invitation.
There were few organized convalescent homes, but their place was taken by almost the universal custom of private families taking convalescent soldiers to their homes. In Richmond, the so-called ambulance committee was very efficient in proportion to its scanty means, but the needs were so great, and the scarcity of men and money so discouraging, that it did not work so like a well-oiled machine as did the Sanitary Commission. Bibles and tracts were distributed by various organizations, and an attempt to furnish other reading matter was made.
Another organization which did good work among the Northern soldiers was the United States Christian Commission, organized by the Young Men's Christian Association. Its purpose was primarily to improve the morals of the soldiers and, incidentally, their physical condition. It distributed thousands of Bibles, millions of copies of religious books, and many millions of religious newspapers and tracts. In addition, it bought many copies of the better class of magazines and sent them to the soldiers. In the permanent camps, free reading rooms were established, and in a number of these State newspapers were kept on file. Writing materials and postage stamps were furnished free to the soldiers, and the agents never ceased to urge the men to write home and to send a considerable part of their pay. This commission set up a number of coffee-wagons in competition with the sutlers, many of whom sold liquor, and also established " special diet-kitchens," where needed, for the sick and convalescent. The commission estimated that it had expended in money and in supplies more than six and a quarter million dollars.
