RANCE and Prussia had signed the Treaty of Geneva in 1864. During the two years that followed, this treaty, for the amelioration of the condition of wounded soldiers, had been accepted by nearly all the Governments of Europe, and national relief societies had been organized in each State in accordance with its terms

The Austro-Prussian War of 1866 afforded to several of these societies the first opportunity for active work. The character and value of the services rendered to sick and wounded soldiers by voluntary associations during that war, I have myself endeavoured to show in a work entitled "Sanitary Institutions during the Austro-Prussian Conflict." The experience gained during the war of 1866 was moreover of great service to the voluntary societies. The field within which their action might be beneficial was more clearly marked out, and their position as institutions of public utility definitively established. In certain States the organization of the societies was modified and improved---in all it was invigorated and strengthened

The great war of 1870-71 was a fearful contest between the two wealthy and powerful nations which had first given in their adhesion to the Treaty of Geneva, and in which the principle of creating popular aid for the wounded in war had been most generally accepted, and the organization of the relief societies was most complete. The circumstances under which the action of these societies was then tested were not only rich in opportunities of usefulness, but seemed to offer the most favourable conditions for the practice of voluntary relief in behalf of the victims of battle-fields. During the war the popular sympathy for the wounded was intense, and the liveliest interest was taken in the movements and operations of the French and German societies. Since the close of the war the friends of charity and beneficence in every quarter of the world have been anxious to learn, to the fullest extent, the character of their services and the practical results of their labours

Conscious, therefore, of the desirableness as well as the utility of assembling the facts concerning the action of the volunteer relief societies during this war, so classified that they might be easily compared, and so presented that they might clearly teach the lessons to be derived from them, I proposed before the close of the war to prepare a full and complete history of the labours of these societies. Such a work, however, could not be written until data covering a very wide field of operations had been collected, nor before the reports of the principal associations had been made public. The difficulties in the way of obtaining from official sources the necessary information have made it impossible for me to finish this work within the time originally proposed

While, however, the relief societies founded upon the Treaty of Geneva were national in their organization, as also in their more immediate and specific purposes, they were the representatives of a common cause, and were closely affiliated in action as well as in sympathy

The Franco-German War of 1870-71, in opening out a vast and comparatively new field for organized patriotic benevolence, offered also the first great occasion for the exercise of international sympathy and assistance. The occasion was not unheeded. If armies were never before more abundantly supplied by national voluntary effort---never before in human history have belligerents received from foreign and neutral States such generous aid. The action of the French and German societies for battle-field relief was largely sustained by foreign contributions, and the sufferings incident to the war assuaged by the liberalities of aliens. Foreign charities, however, were generally distributed through local organizations, and lost their national character in the process of distribution

The American International Sanitary Committee of Paris was formed almost immediately after the declaration of war in 1870, for the purpose of being a direct agent of American charity in behalf of the victims of the war. It was, moreover, the only foreign association created for the general succour of the wounded that succeeded in preserving throughout the war, on belligerent territory, a complete independence in the direction of its operations and in the immediate distribution of its assistance. The committee began its labours by organizing an ambulance, or field hospital, at Paris

Few organizations for the relief of the wounded during the late war, acquired a more noble celebrity than the American ambulance. As an expression of international goodwill, it at the time secured for itself the gratitude of the French people. As an expression of earnest personal effort, of the courage and generous devotion of compatriots, it cannot soon be forgotten by Americans. As an expression of modern sanitary science, however, it has been chiefly valued, and probably will be longest remembered, by all.(1) Its mission was significant-its work was one of usefulness. To commemorate, therefore, the services of those who laboured in the American ambulance, or contributed to its success, and to preserve a record of its acts and methods, are duties equally imposed

This volume contains the history of that ambulance

It was my original intention to publish it together with, and as a part of, my general history of voluntary effort in behalf of the sick and wounded during the late war. The causes mentioned have held in abeyance the publication of that work. But as most of the material which appears in this volume has been a long time ready for the press, it has not seemed to me expedient to retain it any longer. I accordingly now issue the "History of the American Ambulance," complete, in a single volume, which will form also the first volume of my general history of "Sanitary Associations during the Franco-German War of 1870-1871."

I have endeavoured to present in it a clear statement of the purposes of the American International Sanitary Committee, of the difficulties they encountered, of the labours they accomplished, and of the successes which finally crowned their undertaking. The admirable reports of the gentlemen who were especially entrusted with the administrative and executive work of the Committee---treating upon those subjects which are more particularly scientific and technical---complete the history of the ambulance

The report prepared by Dr. Edward A. Crane is an exhaustive essay in which the writer has not only stated the essential facts connected with the material organization of the American ambulance, but has discussed at length the principles in accordance with which army hospitals have been, and should be, established, and the general character and qualities of temporary and portable shelter

The surgical and medical histories of the ambulance will be read, I believe, with great interest by that portion of the public to which they are now more particularly addressed. Dr. Swinburne's cases are fully and concisely stated, as are also the peculiar difficulties under which he contended while treating them. Dr. Johnson's report, if brief, is nevertheless instructive

In presenting this volume to the world I shall solicit a generous criticism not only in my own behalf, but in behalf of those who have laboured with me in its preparation. Verbal errors, and mistakes even in fact, may doubtless be found. These, as every one knows, are more or less unavoidable, especially in a work, parts of which have been edited for absent writers, and all of which has been hurried through the press in the midst of numerous personal pre-occupations. I believe, however, that while the special subject of the volume may commend it to the favour of many, the facts it presents in connection with the general history of army hospitals will render it a valuable contribution to the medico-military literature of the day

PARIS, Avenue de l'Impératrice, No. 41. July 11th, 1873.

AN ACCOUNT OF THE FORMATION OF THE AMERICAN INTERNATIONAL SANITARY COMMITTEE OF PARIS TOGETHER WITH THE HISTORY OF THE AMERICAN AMBULANCE MOTIVE for issuing a call for a meeting of American citizens resident in Paris on the 18th of July, 1870 A statement of the object of the meeting Resolution passed, committee appointed, appeal to citizens of the United States Letters of the secretary to the president of the "American Association for the Relief of the Misery of Battlefields" Letter received in reply by the secretary Purport of this letter---remarkable for certain misconceptions Reply of Dr. Elisha Harris to a letter addressed to him by the committee Prompt and generous action of the United States Government contrasted with the indifference of the American Association Efforts of the committee to obtain funds and carry, out its programme Attempt made to organize a "Ladies' Branch Committee" The work undertaken by the committee gradually assumes a definite form Faults of the French ambulance system The committee determines to retain its independence and to find a suitable locality for the establishment of its hospital Not easy to find such a locality Discussion of the question, "Shall we go or shall we stay?" The question put to a vote Opinion thereon of Col. James McKaye The divergence of opinion how settled The committee proceed to the organization of an ambulance in Paris The 4th of September The Empress finds a temporary refuge in the house of the president of the committee, who subsequently conducts Her Majesty to England Effect upon the committee of the sudden and unexplained absence of both president and secretary Scandalous imputations as to the motives of the president's mysterious departure Action of the committee restored to its former vigour A long absence from Paris not anticipated by the president Causes which rendered such an absence finally necessary Unavailing efforts made by the president to guarantee the Paris ambulance against any crippling of its energies through lack of funds Resolutions passed by the Paris committee in the attempt to enlist the sympathy of their countrymen in their work Letter from the secretary to Dr. Elisha Harris Straitened pecuniary circumstances of the committee Letter addressed by Dr. Elisha Harris to the president Appeal prepared for publication in the American press Pecuniary history of the American ambulance Certain characteristics of the ambulance Gratuitous character of the services rendered Visitors at the ambulance One of the most eminently popular of the properties of the American ambulance Patients treated with a success which rendered evident the superiority of the system pursued Aim which the organizers of the ambulance had mainly in view completely attained What was said of the ambulance corps by the " Electeur Libre" What was said of the ambulance corps by "Le Réveil" What was said of the ambulance corps by " L'Univers" The ambulance the subject of a special notice The ambulance gives the best results in the curing of wounds The ambulance the object of numerous official visits The Archbishop of Paris visits the ambulance The ambulance as described by the "Constitutionnel" "A Visit to the American Ambulance," from the "Official Journal" of the French Republic "Le National" gives its opinion of the American ambulance "La Liberté" pronounces everything to have been in the most perfect order M. Gustave Lafarge writes about "L'Ambulance américaine" Fifty or one hundred encampments after the manner of the American ambulance advised by "La Défense Nationale" "That ambulance where the fewest wounded die."---"La Patrie" The general value of medical and scientific notices in popular French journals The opinions of the physicians and surgeons of Paris What M. Francisque Sarcey writes about the American ambulance What Dr. Dusart says about the ambulance What the "Gazette Médicale" reports of the prompt and efficient services of the corps of aids-volunteer What Dr. de Ranse thought of the ambulance How the "Union Médicale" speaks of the ambulance The opinion of M. Gustave Monsnereau Why the American ambulance merits the special attention of the public and of the press, as stated by the "Gazette Hebdomadaire de Médecine et de Chirurgie" Opinions of M. Nélaton and Baron Larrey The committee greatly indebted to the medical gentlemen of Paris for constant kindly encouragement The system employed for heating the tents attracts great attention Paper prepared by M. Charles Joly upon the subjet Communication thereon addressed to the secretary by M. Delpierre Plans and sketches of all the details prepared by General Morin for the "Conservatoire des Arts et Métiers " An account of the waggons used by the transport corps of the ambulance The model subsequently adopted by the French Société de Secours aux Blessés The French Government adopts the stretcher used by the transport corps of the ambulance The American ambulance largely instrumental in popularizing the use of oakum as a substitute for charpie General Wolf, the Intendant-General of the Army of the Defence, recognizes the services rendered by the American ambulance The letter addressed to the committee by Alfred Doucet An article which appeared in "La Vérité" Honours conferred by the French Government upon persons for services rendered at the American ambulance The committee under great obligations to the Government for the uniform kindness and courtesy of all its agents The success of the ambulance largely owing to the personal interest taken in the work by each member of the corps The services rendered by the members of the committee Dr. Swinburne and his surgical staff Of the captains of the squads for the transport service---Mr. Joseph K. Riggs M. Ranzi M. Rillet, Messrs. Gunther and Dreyer, and Majors Hutton and O'Flinn Of the ladies who served in the ambulance Miss Bewick, Mrs. McFarlane, Mrs. Koch, Miss Chandon, the Marquise de Bethisy, Mrs. Conklin and the Misses Castri A remarkable fact concerning all these ladies Letter addressed to the Queen of Prussia Letter received in reply from Her Majesty Communication from the Central Committee for the care of the wounded of the German Army Visit of the president to the seat of military operations in Eastern France Organization of the "Society for Clothing the French Prisoners" The labours of the president in this special field only a part of the general work upon which the American International Sanitary- Committee originally proposed to enter   REPORT ON THE ORGANIZATION OF THE AMERICAN AMBULANCE PART I ON THE ESTABLISHMENT OF ARMY HOSPITALS LETTER to Dr. Thomas W. Evans Silence of the most ancient records with regard to the care extended to the sick and wounded of armies The earliest allusions to army surgeons in Greek writings Statement of Herodotus (note) Silence of Greek writers concerning measures to succour the wounded. Statement of Diodorus Siculus (note) Equal silence of Latin writers upon the same subject Subjects which have usually not interested historical writers, modern as well as ancient (note) Passages cited to show that care was sometimes given to the sick and wounded in Roman armies Official position of the Medici in the military hierarchy (note) Popular charity among the Romans in behalf of the victims of war; instances in which it is said to have been exhibited A remarkable example of voluntary effort in behalf of the wounded Claims of sick and wounded soldiers upon the State practically unrecognized Hospitals of all kinds unknown to the Romans A passage in Velleius Paterculus (note) Sickness rates in Greek and Roman armies; reasons why they may have been low An ingenious suggestion (note) The slaughter on ancient battle-fields. Character of the wounds received in battle Reasons why an ambulance service was less needed in ancient than in modern times Physicians and surgeons under the Byzantine Empire No mention made of hospitals before the eleventh century Care of the sick among the ancient Hindoos (note) Xenodochia Primary object of the establishment of hospitals in Europe Hospitals for the sick Special hospitals for the sick and wounded during the crusades Care taken of the sick poor in the middle ages (note) Hospitals without physicians---maintained by the clergy as a source of revenue and profit Scandals arising from the mismanagement of these institutions Le droit d'oblat The beneficence of the middle ages Measures adopted during the middle ages to secure immediate assistance for those wounded in battle The armies of the crusaders unattended by physicians and surgeons The practice of surgery held in general disrepute Care taken of the sick soldiers in camp during the fifteenth and sixteenth centuries Army surgeons in France until the reign of Louis XIII Army surgeons in Germany in the time of Charles V English army medical and surgical service in the fifteenth century The expedition to St. Quintin Instructions to Sir Thomas Leighton Medical and surgical science during the middle ages One of the causes which retarded the efficient organization of the health service in European armies (note) The medical department---a result of the establishment of permanent armies The first military hospitals established in Europe Le siège de velours (note) Ordonnance authorizing these hospitals Hospital service during the reign of Louis XIV Royal edict of 1662 The Hôtels-Dieu and communal hospital establishments of France The Hôtel des Invalides French military hospitals during the early part of the eighteenth century Permanent military hospitals in the middle of the eighteenth century Defective management of these hospitals The Hôtels-Dieu at Paris during the eighteenth century (note) Suppression of the permanent military hospitals in France in 1788 Re-organization of French military hospitals in 1793 Establishment of permanent military hospitals in England How the sick in English armies had been taken care of previously to the creation of these hospitals Evelyn's project for the establishment of an "infermerie" English permanent military hospitals during the eighteenth century Cost of constructing permanent military hospitals in France in the eighteenth century Character of the buildings The hospital at Lille General plan of these establishments The material organization of the civil hospitals or Hôtels-Dieu Their limited capacity Ecclesiastical character of the foundations The monastic infirmary (note) Light and ventilation little regarded in the construction of monastic hospitals Administration of permanent military hospitals in France Administration of civil hospitals in France Radical vice in the administration of French hospitals Surgeons-major of camps and armies first recognized in the French service in the reign of Louis XIII Regimental surgeons in the Swedish army Regimental surgeons in the English army Qualifications and duties of a military surgeon in the reign of Queen Elizabeth Clowes' opinion of his professional contemporaries Provisions made for an army of 30,000 men in 1620 Number of surgeons attached to armies during the sixteenth and seventeenth centuries (note) First reference to the ambulance or field temporary hospital Article in the "Ordonnance" of January, 1629 Establishment of 1638 The field hospital service during the reign of Louis XIV Personnel of the field service according to the royal edict of January, 1708 Military hospitals first established by the French Service de Santé during the reign of Louis XV "Instruction" prepared by D'Argenson in 1746 "Order" issued by Marshal de Belle-Isle in 1759 Former organization of corps for field service Organization of the Service de Santé since 1792 (note) French ambulance system scarcely improved since the beginning of the century Personal composition of an ambulance organized by the French Société de Secours aux Blessés in 1870 Impracticability of the organization Re-organization adopted in October, 1870 Its defects Field service of the British army from 1750 to 1815 More importance attached to the duties of the army medical officer Over-sensitiveness of the medical profession in matters relating to military rank (note) Medical officer better educated Medical and surgical stores more abundantly furnished Control of the army medical service Personal composition of the British army medical service before the Crimean War Influence of more enlightened views upon sanitary subjects The regimental hospital The general hospital Special hospitals for the wounded Dispositions for the field service now observed in the British army Principal defect of the English organization The convalescent hospital Medical field service in the United States army Act of Congress passed in March, 1804 English, French, and American organizations compared Decree of the French Minister of War of January 4th, 1871 The initiation of a much-needed reform Radical difference between the French and the English and American organizations Dependence of the medical service upon the quarter-master's department Functions of the officier de santé and of the intendant officially defined Ordonnance issued May 3rd, 1832 The diet list and medicines limited to certain formulæ Personal independence of the surgeon subject to the assumptions of the intendant Result of these restrictions and assumptions Rôle of the French sanitary associations Poverty of the Service de Santé with regard to the material means for hospitalizing the sick Qualifications of the Société de Secours aux Blessés for the direction of the ambulance service of an army Offers of the society Consequences of the false position it occupied History of the eighth ambulance History of the first ambulance History of the second ambulance History of other ambulances Results of the assumption of this society to direct the field ambulance service Selfish motives which prompted the opening of ambulances Little popular interest shown for the sick The rôle of the doctor The name Société de Secours aux Blessés unfortunate Evidence of the inefficiency of the volunteer system as applied in France Inferences from the facts stated How the offer of the Société de Secours aux Blessés came to be accepted Who was responsible for the confusion in the administration of the health service Basis on which the French army hospital service was established during the late war Necessity of official and personal responsibility The true province of voluntary effort misconceived by the French society Causes which led to the formation of the United States Sanitary Commission One of the glories of the United States Sanitary Commission Purpose for which the army medical service has been created If inefficient, the cause should be ascertained and removed The mission of volunteer associations for the relief of the misery of battlefields   MOST remarkable facts in the history of the hospitalization of sick and wounded soldiers Reforms in army sanitation to be obtained only by the united efforts of many inquirers Question whose solution appeared to the American International Sanitary Committee most important   MILITARY hospitals Sedentary hospitals Ambulant hospitals Hospitals established from reasons of convenience The primary idea to be attached to the word hospital The object to be accomplished in building a hospital An accepted fact of sanitary science Mortality rates in the first hospitals for the sick The suppression of hospitals advocated A curious fact State of things in the early military hospitals Causes to which the mortality existing in hospitals was attributed A fact which could not escape notice That air once respired was unfit for respiration---a fact not generally known Earliest recognitions of the importance of pure air History of ventilation in France Different plans for obtaining a fresh air supply suggested during the eighteenth century Too much importance ascribed to cubic space Ventilation---its principal object Why crowded habitations are unhealthy The salubrity of all hospitals to be estimated by the degree of atmospheric purity maintained within them   PLANS adopted in the construction of permanent military hospitals Military hospital at Vincennes Military hospital at Bayonne The chief faults of nearly all permanent hospitals Objects to be kept in view in constructing a hospital Hospitals not to be erected as monuments of architectural skill Temporary hospitals indispensable in time of war Principal reason for the construction of temporary establishments for the sick of armies The idea of barrack hospitals a modern one (note) The earliest wise conclusions concerning the relative fitness of buildings to serve as hospitals The Crimean experience and its results General character of the sedentary hospitals recently especially constructed to receive the sick of armies The American ward-pavilion A ridiculous statement (note) The English model hospital-barrack Crimean huts Experimental barrack erected by Dr. Esse in 1867 at Berlin German barrack hospitals during the Franco-German War Prussian ward-barrack for thirty patients Süvern's mixture (note) Minden barracks French barrack hospitals Barracks of the Luxembourg and of the Garden of Plants Barrack hospital at Passy Barrack hospital constructed by the Société de Secours aux Blessés Barrack hospital at Metz Characteristics of the German barrack hospitals One of the chief faults of the typical American pavilion The use of paper in converting summer barracks into winter hospitals   MIXED hospitals respond only partially to the necessities of an active army Means should exist for creating hospital accommodation within the army itself Defective condition of the ambulance service in European armies A want especially felt in each army Sick and wounded soldiers crowded together in such buildings as chance offers Consequences of the practice Proof that no systematic effort has been made to procure suitable shelter for the sick and wounded of active armies Why we find no accounts of the kind of shelter employed for the ambulances. The employment of public and private buildings for ambulance purposes possesses certain advantages Its disadvantages Larrey's account of the condition of the wounded after the battle of Eylau Gama's account Gama's account of the character of the hospitals during the Russian campaign Evacuation of the wounded, and its consequences Vaidy's proposition Suffering in the Crimean War from a want of shelter Forced evacuations of the wounded Hospitals at Solferino Hospitals at Langensalza Field hospitals during the late war Hospitals at Sedan Hospitals at Metz Hospitals in the army of the Loire Object of the citations Is it not possible to improve the hospitalization of active armies? Objections to the employment of portable shelter Economic motive to the employment of such shelter Claims of the soldiers to profit by our science Want often wastes an army more than fighting A certain number of tent-hospitals should be established in each army Advantages which they possess Pure air of more consequence than shelter itself Illustrations of the influence of the open air upon the sick Tents afford all the shelter necessary A great evil for which a remedy must be found Dr. Sutherland's opinion Baron Larrey's opinion The transportation of the sick and wounded Its advantages Its disadvantages Classes of sick and wounded not transportable German system of evacuating battle-fields Disastrous consequences of hurried evacuations Opinion of Dr. John A. Lidell The remedy   PART II ON TENTS AND TENT-BARRACKS MOTIVES which induced the writer to treat these subjects at length in his report TENTS used in the earliest ages Tents now used among primitive and nomadic tribes Tents used by the English during the Peninsular campaign First real improvements in the construction of temporary shelter Tents of the Israelites Arab tents Tents used within the walls of cities The use of tents in the East, in the summer Tents upon wheels An Oriental story (note) Atkinson's description of a Kirgis yourt     TENTS at the siege of Troy Tents in Persian camps The word σκηνὴ (note) Xenophon's allusions to the use of tents in the Greek armies Splendid tents---their origin A description from Athenæus Time when tents were adopted in the Roman army Qualities of early Roman tents Allusions to Roman tents by Livy Tabernaculum and tentorium (note) Cæsar's account of the shelter used by his troops Allusion to Roman tents by other writers Camp shelter among the Germans and Gauls Carthaginian encampments The use of cabins in Roman armies Roman winter quarters The bas-reliefs on the column of Trajan Tabernacula---huts Difference between the tabernaculum and the tentorium The tentorium---tent The papilio---pavilion The prœtorium (note) Why certain tents were called papiliones Difference between papilio and tentorium (note) Covering employed for the papilio Woven stuff not mentioned as a covering for Roman tents before the second century The conopeum (note) Weaving an Eastern art Roman commerce with the East---a probable result Form of the papilio A mistake explained (note) Splendid tents not used by the Romans Interior arrangement of the Roman soldier's tent   THE use of tents in the armies of the Eastern Empire The use of tents among the Goths and Huns Tents in the armies of the Merovingian and Carlovingian kings Tents among the Anglo-Saxons Tents in the armies of the Crusaders Camp of King Edward II Froissart's allusions to the use of tents Statements of French chroniclers Huts preferred in sieges Troops occasionally encamped in tents Tents used by the Hungarians and Tartars Remarkable accounts of Spanish camps and camp life Tent-making a special service in armies Ostentatious rivalry among the knights of the middle ages Camp before Grenada The splendid camp equipage of Charles the Bold Magnificence of Philip the Hardy The splendid tent of Conradine The "Field of Cloth of Gold" The tent of Nadir Shah An encampment in the time of the Sultan Mahomet IV Love of display during the middle ages Brilliant effects of colour in mediaeval encampments Tent of a French knight of the fourteenth century Means existing in the middle ages for magnificent displays Existing customs derived from the usages of mediæeval camp life   AMBROISE PARE'S sketch of the imperial encampment before Metz Disposition of a German camp according to Fronsperger Hungarian encampment at the close of the sixteenth century Camps of Maurice of Nassau Use of tents at Oppenheim Camps regularly laid out before the use of tents became general Use of tents in the Imperial armies Tents in the Levant Old Turkish conical tent The Turkish marquee Turkish camping material Tents first issued to the troops of modern armies Use of "baraques and hutts " in English armies Lodgings provided for the household of Henry VIII. (note) Soldiers' quarters in the time of Elizabeth Soldiers' quarters in 1649 What Orrery says of the hutting of troops What Evelyn says of the camp at Hounslow Soldiers' tents in the Prussian service The cannonière The tente d'ancien modèle German tents anterior to the reign of Frederick the Great Wedge-tents Chinese tents The cortine The marquee Origin of the word marquee (note) Tents rarely employed during the winter months Colombier's observations concerning encampments Use of tents under the First Empire Use of tents in the English army Use of tents in the United States army Use of tents during the Franco-German War Interior of tents, how furnished Floor-cloth Criticisms Observations of Jourdan Le Comte and Colombier Instructions of Frederick the Great (note)   TENTS as a means of hospitalizing the sick Sick treated in their quarters by the Greeks Sick treated in their quarters by the Romans The valetudinarium Contubernales (note) Reported establishment of a tent-hospital in the sixteenth century Fray Antonio Agapida (note) Subject of hospitalizing the sick of armies little thought about in the sixteenth and seventeenth centuries A passage from Bombelles Infrequent references to tents by medico-military writers Munro one of the earliest writers who refer to the use of tents for hospital purposes M. Bégue de Presle's allusion to tents Tents first recommended in the organization of hospitals Decree of the French Government Terms of the decree seldom acted upon Larrey's allusions to tents Tent-hospitals in the British service   CAUSES for differences in the construction of tents Why the roof of the Western tent has a sharp pitch Why Turkish tents are flat-roofed Material of which modern tent coverings have been made Classification of tents proposed by MM. Lévy and Boisseau The classification of tents difficult   THE British "marquee" The British "bell-tent" Edgington's "three-poled tent" Major Rhodes' tents Turner's tent Shelter-tents in the British army Shelter-tents used in ancient times Account of the use of shelter-tents by the Scots in 1547 French account of the origin of the tente-abri The French tente-abri Tentes-abri of MM. Waldéjo and Barbe The shelter-tent cannot be dispensed with The French tente nouveau modèle The French tente elliptique The French tente conique The French marquise The French tente de conseil du nouveau modèle "Surgeons' tent" of the Société de Secours aux Blessés Model tent of M. de Moulnier Model tent of M. Couette The manteau d'armes (note) Tents now in use in the Turkish army The Prussian "troop-tent " The Prussian " hospital tent " A model Prussian "hospital tent" Prussian "field hospital tent for twelve beds" Prussian "tent for the treatment of contagious diseases" Austrian and Italian "long tent" Capt. Theurekauf's tent Austrian "marching-tent" Italian "shelter-teat" Italian "conical tent" Russian tents United States " wedge-tent" United States "shelter-tent" The "half-faced camp" A Comanche "lodge" The "Sibley tent " United States "hospital tent" Certain advantages of the "fly" The American "hospital tent " a component part of a large tent or pavilion Some of the defects of this tent Le Fort's tent Le Fort's modified field hospital tent Le Fort's tent as modified by the Sociéte de Secours aux Blessés   THE coverings of modern tents French Government tent canvas English Government tent canvas Austrian Government tent canvas Certain characteristics of flax tissues United States Government tent canvas Italian Government tent canvas Certain characteristics of cotton tissues The respective merits of cotton and linen tissues How tents are destroyed Wear from ordinary use and handling Damage from exposure to the weather Damage from mildew Preservative preparations Process of the house Husson Of the greater strength of linen tissues The question of cost Cost of raw flax and of raw cotton in the French market Waste in the manufacture of flax Waste in the conversion of cotton into tent-duck Prices of linen and cotton tent tissues in different countries A conclusion Relative merits and demerits of tissues of cotton and flax as tent coverings Greater permeability of linen tissues Linen tents hotter in the summer and colder in the winter than those of cotton Results of the hygrometricity of linen Relative capacity of tissues to hold water by interposition Linen canvas easily saturated Shrinkage of linen tissues An objection made to the use of cotton canvas Conclusion   THE qualities a hospital tent should possess Importance of using the best materials in the construction of hospital tents On the choice of a location for a tent A location under trees objectionable Points to be observed in pitching a tent   TENT-barracks Their principal advantage; Their principal disadvantages An opinion of competent judges Tent-barracks used during the Austro-Prussian War of 1866 The tent-barracks of the ambulance at St. Cloud The tent-barrack of the Hospital Cochin The tent-barrack of the Charity Hospital at Berlin Tent-barracks of two kinds or types The expedient plan Points to be observed in constructing a tent for a special service Defects of the tent-barrack of the Hospital Cochin Tent designed by Dr. Thomas W. Evans   PART III ON THE SPECIAL ORGANIZATION OF THE AMERICAN AMBULANCE A LAW of sanitary science Opinions entertained by the American International Sanitary Committee Resolutions passed Development of the original plan   THE first impression of the visitor The tents Furniture Tent-barracks Pavilion No. 7 Pavilion No. 8 Pavilion No. 10 Other constructions The American ambulance, how composed Essentially a sedentary ambulance   THE American ambulance represented a new system The tent-hospital at Varna The use of tent-hospitals limited to the summer months The opinion in France upon this subject Recent European opinion upon this subject English opinion upon this subject Conclusions derived from the use of tents as hospitals during the late war Conclusions of MM. Demoget and Brossard Opinion of M. Grellois Report of M. Leplat Conclusions of M. Grellois Tent ambulances of the Société de Secours aux Blessés The practice among the Germans during the late war Statement of Captain Galton Statement of Miss Lees The "Woolwich ambulance" Hospital tents in the United States army Attempts to treat the wounded under tents in the winter American opinion concerning tent-hospitals   THE use of tent-hospitals not limited to the summer months The results of our experiment Results obtained at Varna Opinions of Quesnay and Pirogoff Statement of Kraus Statement of Dr. Hammond Results obtained by Boerwindt Remarks of Chantreuil Facts to be considered in comparing results Statistics vitiated by evacuations from one hospital to another Statistics of the ambulance at the "Corps Législatif" Statistics of the American ambulance Results obtained at the ambulance "Rothschild" Results obtained at the ambulance in the École des Ponts et Chaussées Results obtained in other ambulances at Paris Results obtained by the "first ambulance" at Metz Results obtained in the civil hospital at Strasbourg Results obtained in the ambulance of the "Petit Séminaire " at Strasbourg Statement of Dr. Gordon Recoveries most frequent in the American ambulance   WHY tent-hospitals furnish the most satisfactory results The sanitary influence of light Conditions under which the wounded were treated at the American ambulance   SANITARY state of Paris Causes of the great mortality existing during the siege Quality of the bread issued Suffering from want of food less than generally supposed How Paris was able to feed its population for five months or more (note) A tabular statement of the deaths in Paris Remarkable exemption of certain classes from disease The mortality from small-pox The influence of cold weather upon the mortality rates Incident mentioned by Dr. Gordon (note) Diseases of the respiratory organs Typhoid fever Diarrhoea and dysentery Influence of the sanitary state of Paris upon the wounded Mortuary statistics of the siege (note) Mortality table Temperature table Location---character of the grounds The tents---how arranged Tent-barracks Lighting Furniture. iron bedsteads System for warming and ventilating the tents The general practice in camps Custom prevalent during the eighteenth century Difficulties of heating tents Methods of warming tents at different times suggested The fireplace and chimney How to warm tents---a difficult problem A solution suggested A practice in the English army before Sebastopol The "California stove" A method of applying the system A second method of applying the system The arrangement adopted at the American ambulance Statement of M. Bréhan Statement of M. Joly Report of M. Cottard A difficulty---its cause and its remedies How uniformity of temperature was obtained How the rate of the heat supply was regulated Another advantage of the system The relation between heating and ventilation Natural ventilation Artificial ventilation Inefficiency of mechanical devices The evil of draughts The cheminée d 'appel The tents at the American ambulance ventilated by natural forces Canvas full of natural openings Why the air in tents becomes close How the air escapes from a tent Outlets and inlets should be numerous Important condition in the ventilation of tents "How do you know your tents are well ventilated? Conclusion Cost of the apparatus Water supply Amount of water distributed in Paris in August and December, 1870 The composition of Seine water Quality of Seine water Kitchen Wine room. Provision store Linen room Store room Knapsack room Operating room Dormitory Transport service Baths Sinks Latrines Trenches Fresh earth as a deodorant and disinfectant Cabinets Urinals Importance of separating the urinal from the cabinet A grave abuse How it can be prevented Cabinets d'aisance a source of specific disease Latrines how policed Dead-house   TRANSPORTABILITY an important point in constructing an ambulance Special advantage possessed by an ambulant hospital Our tents subjected to an unusual test The question of cost Cost of a tent-hospital containing fifty beds Cost of permanent constructions Conclusion   ON THE SURGICAL HISTORY OF THE AMERICAN AMBULANCE INTRODUCTION   RÉSUMÉ of the general treatment of wounds in the ambulance General surgical treatment of compound fractures Injuries which necessitate amputation Fractures of the shaft or joints which are to be treated by conservation The transportation of the wounded The treatment of fractures by extension and counter-extension   GENERAL facts in the surgical history of the ambulance Table of fractures Fractures of the thigh Case 3 Case 4 Case 134 Report of the Surgeon-General of the United States Report of Professor Legouest Conclusions Amputations of the thigh Case 5 Case 9 Case 23 Excisions, amputations, and conservations of the shoulder-joint Case 32 Case 56 Case 166 Shoulder-joint operations Fractures of the tibia and fibula Case 36 Case 244 Fractures of the arm Case 130 Case 225 Case 31 Case 18 Case 115 Case 14 Fractures of the tarsus and ankle-joint Case 41 Case 45 Fractures of the scapula Case 43 Case 6 Fractures of the carpus Case 191 Case 29 Fractures of the maxillaries Case 62 Case 65 Case 73 Case 129 Case 145 Case 179 Case 200 Wounds of the abdomen Case 239 Penetrating wounds of the chest Case 13 Case 55 Case 64 Case 68 Wounds of the nerves Case 108 Case 128   HISTORY of each surgical case which terminated fatally Case 7 Case 8 Case 10 Case 53 Case 54 Case 58 Case 59 Case 63 Case 72 Case 82 Case 83 Case 85 Case 96 Case 105 Case 106 Case 109 Case 116 Case 117 Case 120 Case 122 Case 126 Case 127 Case 131 Case 132 Case 133 Case 135 Case 147 Case 148 Case 150 Case 153 Case 155 Case 156 Case 162 Case 164 Case 168 Case 169 Case 178 Case 184 Case 188 Case 189 Case 204 Case 205 Case 222 Case 223 Case 229 Case 240   SPECIAL points Causes influencing the surgical results Cause of erysipelas, &e Conditions existing at the American ambulance Case 106 Opinion of Mr. Erichsen upon blood-poisoning Did anyone treated at the ambulance suffer from blood- or pus-poisoning? Origin and character of the conditions observed   THE medical and surgical staff Conclusion   TABLE of surgical cases admitted to the American ambulance   ON THE MEDICAL HISTORY OF THE AMERICAN AMBULANCE CONDITIONS influencing the public health Temporary immunity from disease Later history of the ambulance Conclusions   TABLE of medical cases admitted to the American ambulance   APPENDIX LIST of the persons who served in the American ambulance   PLATES I. Ground-plan of the ambulance II. A pavilion, showing the system of heating, &c III. A pavilion viewed in section, and without the fly IV. Supplement to Plate III V. A pavilion viewed from above VI. Supplement to Plate V VII. Front view of a pavilion. VIII. Sectional front view IX. Sectional view of the trench tent-cords and keys X. Dr. Evans' hospital-tent