THOMAS W. EVANS, M.D.,
REPORT ON INSTRUMENTS, etc.
PARIS UNIVERSAL EXPOSITION, 1867.

 

PART III.

AMBULANCE AND SANITARY MATERIEL.

AMBULANCE SERVICE OF ARMIES---TRANSPORTATION OF THE WOUNDED ---TRANSPORTATION OF MEDICINES AND SUPPLIES---HOSPITALS; TENTS; MODELS AND PLANS; FURNITURE---SURGICAL INSTRUMENTS AND APPARATUS---SANITARY SUPPLIES---MISCELLANEOUS---HOSPITAL TENTS---HISTORICAL.

AMBULANCE SERVICE OF ARMIES.

The exhibit made at the Exposition of the material connected with the ambulance service of armies is particularly complete and interesting. Governments and Sociétés de Secours, stimulated by a generous rivalry, or actuated by the purer purpose of contributing something which might serve to ameliorate the condition of the wounded and the suffering, have united their efforts in the service of a common and humane cause.

In the American department this material has not only been well represented, but surpasses, both in value and extent, any similar collection in the Exposition.

That this most gratifying result has been reached must be ascribed to some extent to the action of the Medical Bureau at Washington, a representative selection of the most important materiel in its possession having been carefully prepared by Surgeon General Barnes, and forwarded to Paris. It is to be regretted, however, that this valuable official contribution, disconnected at the commencement from everything of the same class, whether coming from the United States or elsewhere --- and itself broken up and scattered over various portions of the palace and the park---has been so greatly overlooked and unappreciated.

As perhaps was to have been expected, almost nothing has been sent by inventors or private individuals. It was in anticipation of this---and impressed with the importance of having a creditable exhibition in a department which to me had long possessed a peculiar and absorbing interest, and to which I felt confident the United States, after a recent and extensive experience, could furnish most important contributions---that I proposed to form the collection which bears my name.

If the idea, as time passed, reached a fuller development and was ultimately crowned with more of success and honor than I had at first hoped for, it must be attributed less to any personal effort of my own than to the largeness of the field, the richness of the materials, and the revival again in the memories of men of those glorious charities which---through the long and weary years of a desolating war, unfaltering from first to last---were ever present with the American soldier, in summer and in winter, on the rivers and by the sea, on the battlefield and in prison, in victory and in defeat.

The Grand Prix d'Honneur awarded to the collection, as representing the work of the United States Sanitary Commission, was the highest expression of estimation which it was possible for the Imperial Commission to give, but it can furnish a very imperfect idea of the value of the collection itself, or the great influence which it has had and will have both morally and materially upon the hospital service of European armies. The practicability of admitting upon the battlefield volunteer aid, of securing for the sick and wounded a more generous treatment, of realizing in a large measure those humane sentiments which so distinctively characterize our civilization, have received from it a new and forcible expression.

Placed with the ambulance materiel of nearly the whole world under the flag of the Société de Secours aux Blessés. Militaires, it has been made during the past summer the subject of a most serious and exhausting study; and it is with no little feeling of national pride that I have seen American ambulances, medicine wagons, tents, plans for military hospitals; in fact, those things most essential to the sanitary service, subjected to the severest tests, and finally acknowledged and accepted as in principle the best of their kind.

The number of different articles exhibited in this section of Class 11 is so great that simple descriptions of each would fill a space many times larger than I have assigned for my whole report. It will therefore be only possible for me to name the articles exhibited, presenting such general descriptions and observations as may seem necessary in view of important principles or special merits, at the end of each category, which for the sake of convenience I have constructed, although perhaps somewhat arbitrarily.

TRANSPORTATION OF THE WOUNDED.

1. Ambulance, Wheeling; Surgeon General Barnes.
2. Ambulance, Bucker; Surgeon General Barnes.
3 Ambulance, Wheeling, improved.
Ambulance, Perot; Evans collection.
4 Ambulance, Bucker Brainard; Evans collection.
5 Ambulance, Howard; Evans collection.
6 Ambulance, Philadelphia Fire Company; Evans collection.
7 Ambulance, Evans; Evans collection.
1 Model of railway ambulance or hospital car, Harris; Evans collection.
1 Horse litter, 'Woodcock; Evans collection.
1 Wheeled hand-litter; Surgeon General Barnes.
2 Combined wheeled litter and fracture bed, Langer; Evans collection.
1 hand litter, United States Army; Surgeon General Barnes.
2 Hand litters; United States Army; Evans collection.
3 Hand litters, Howard; Evans collection.
4 Hand litters, Stevens and Son; Evans collection.
5 Hand litters, Railway ambulance; Evans collection.
6 Hand litters, Evans; Evans collection.

That the American ambulances are superior to all others exhibited has been generally conceded by the most competent European critics.

Their principal merit is lightness, the heaviest weighing hot over 1,300 lbs., while the average weight of European two-horse ambulances is about 2,000 lbs.

That lightness is not incompatible with sufficient strength is clearly demonstrated by the condition of the Wheeling ambulance exhibited by Surgeon General Barnes, it having borne the brunt of a long campaign with but little apparent injury.

Another excellence common to all the American ambulances is to be found in their covering of enamelled cloth or cotton duck, which, adding but little to the weight of the carriage, is sufficiently impermeable to rain, and renders a free and abundant supply of air always possible. Nearly all the European ambulances have wooden sides, ends and tops; in a word, are closed omnibuses.

The chief objection urged against all the American ambulances, except No. 7, is the difficulty of turning them, on account of the height of the forward wheels. This objection is one more apparent in Europe than in the United States, where an easy draught seems to be more readily obtained by increasing the height of the wheels, than by diminishing the badness of the roads. Still the objection is unquestionably a valid one.

Of the ambulances coming from the United States, the one made by Dr. Benjamin Howard, of New York, has been most highly commended. It has received an honorable mention from the Imperial Commission, and a silver medal (the highest prize awarded) from the special jury appointed by the Société de Secours aux Blessés..

Howard's ambulance is designed to carry two persons recumbent and two sitting, or eight sitting, besides the driver.

The mattresses to be used as stretchers slide easily into the carriage on rollers secured to a frame-work supported by interior and lateral springs. The seats also rest on the same frame-work.

The ambulances constructed on the Bucker plan are capable of carrying four men recumbent. Whether the interior arrangement employed in these ambulances for the transportation of four recumbent be approved or not, it is unquestionable that the end sought is a most desirable one. Where but two men can be carried in an ambulance lying down, the waste of force in wagons, horses and men, must always be great. In most European armies it is actually enormous, since always, except on well-constructed roads, three or four horses are needed for each ambulance.

Locati, of Turin, has endeavored to remedy this difficulty, and exhibits an ambulance used in the Tyrol during the recent Austro-Italian war, which can carry five lying down, but the wagon, aside from being too complicated for general use, defeats its own end by being so heavy as to require the use of four or more horses.

Ambulance No. 7 (the Evans ambulance) was constructed with the purpose of uniting a possible capacity for four recumbent, with lightness, easiness of movement, facility of loading and unloading, and simplicity. It was however not finished until the last of August, so late as to be even hors de concours in the competition for the special prizes offered for the best ambulances by the Société de Secours aux Blessés.. Nevertheless such were its considered merits, that the jury of the society saw fit to award to it a second prize of 500 francs, accompanied with an expression of regret that they were unable, in view of the fixed condition of the concours, to award to it the first prize.

This ambulance can carry ten persons seated, besides the driver and one or two attendants, or four lying down and two seated, besides the driver and one or two attendants. The seats can be used each as a mattress upon the floor of the wagon, the iron wheels with which they are furnished resting, when in position, upon springs beneath the floor. The object was to place these supplementary springs, first, out of the way; secondly, when once fixed, they would be secured against accidents. For the upper tier four rings of caoutchouc are attached, in front and rear, to the sides of the wagon, 2 feet 9 inches from the floor; two rings to an upright in the centre of the wagon immediately behind the seat of the driver, and two rings to a hook which may be dropped from the rear centre. By means of this arrangement, so very simple as scarcely to be observed unless special attention is directed to it, two ordinary French, English or American stretchers can be suspended whenever necessary, and two additional wounded transported in the most comfortable manner.

This ambulance weighing about 1,300 pounds is slightly heavier than the other American ambulances. The forward wheels turn readily under the body of the wagon. The top is covered with enamelled cloth, and folding seats are placed at the rear end outside for one or two attendants. It is furnished with a double tank for ice and water, and with a box for a few necessary supplies. Two stretchers are carried over head inside, and a supplementary one outside.

The model hospital car, made in accordance with specifications furnished by Dr. Elisha Harris, of New York, is one of the most beautiful and attractive objects in the American exhibition. Built on a scale of one-fourth, it shows in detail exteriorly the construction of an ordinary American passenger car, and interiorly the special arrangement, couches, dispensary, wine closet, water closet, systems of ventilation, heating, &c., made for the comfortable transportation of the sick and wounded.

This model has been greatly admired by military surgeons, and although the plan cannot be readily adopted in Europe, owing to the peculiar construction of most European railway carriages, it has occasioned much interesting discussion relating to the subject of railway transportation.

The Prussian government has very recently even directed a carriage to be constructed on the same plan.

The model was recompensed by a bronze medal from the Imperial Commission, and a silver medal from the Société de Secours au Blessés.

Horse litters and wheeled hand litters were never much used in our army. A few of the former, either obtained in France or made on the French pattern, were issued early in the war, but were soon abandoned as not only inconvenient but unnecessary. The litter proposed by Woodcock of New York is much lighter than the French litter, but scarcely as comfortable.

Wheeled hand litters or barrows have long been employed on the continent, particularly in Germany, for the transport of the sick. Towards the close of our war, Neuss, of Berlin, sent a number of these litters to the United States, but they arrived too late to be of much service except as models. The use of wheeled hand-litters even in Europe, where populations are dense and the roads generally excellent, must always be exceedingly limited as compared with the use of the simple civière or stretcher, and yet it is curious as well as interesting to observe that the welfare and comfort of the wounded are at present regarded as of such paramount importance, that while but two or three new stretchers have been sent to the Exhibition of the Société de Secours aux Blessés., more than 20 different varieties of wheeled litters can be seen there.

Of the two American specimens I can only say that the first, essentially a copy of the Neuss litter and without the least merit of originality, is a good litter; while the second, entirely original with the inventor whose name it bears, is, as far as I have been able to comprehend it, entirely worthless.

The stretchers exhibited are all simple hand litters, and differ little from those in common use in the French and English armies. I consider the United States army pattern with the jointed yoke-piece equal if not superior to any. Howard's stretcher is a proposed improvement on one of the English models.

TRANSPORTATION OF MEDICINES AND SUPPLIES.

1. Medicine wagon; Surgeon General Barnes.
2. Medicine wagon, Autenreith; Evans collection.
3. Medicine wagon, Perot; Evans collection.
1. Coffee wagon, Dunton; Evans collection.
1. Medicine pannier (2), United States army; Surgeon General Barnes.
2. Medicine pannier, United States army; Evans collection.
3. Medicine pannier, Perot; Evans collection.
4. Medicine pannier, Dunton; Evans collection.
1. Hospital knapsack, Dunton; Evans collection.
2. Hospital knapsack, Perot; Evans collection.
1. Packsaddle, United States army, old pattern; Evans collection.
2. Packsaddle, United States army, new pattern, Evans collection.
1. Canteen, United States army, soldiers'; Evans collection.
2. Canteen, United States army, officers'; Evans collection.
3. Canteen, Confederate States army; Evans collection.

Medicine wagons Nos. 1 and 2 are designed rather for the transportation of medical stores in bulk than for dispensing; No. 3 rather as a dispensing wagon than for reserved supplies; all are light and well made, and greatly superior to the European fourgons. No. 3 is remarkable not only for the elegance of its construction, but for the very ingenious and effective systems employed to prevent the breaking of bottles; these being secured against fracture, either by the employment of springs upon which they rest, or by placing them in paper boxes, thickened at each extremity by bands which receive all concussions. This wagon received a silver medal from the Société de Secours aux Blessés..

To Mr. Dunton, of Philadelphia, belongs the credit of having invented a coffee-wagon, the only sample of a cuisine ambulante at the Exposition, excepting perhaps the cuisine of Dr. Roth, (English.) Pinner, of New York, has sent photographs, and Dr. Abel, of Vienna, has submitted the plans of a more complete kitchen. Still it is questionable to what extent these really interesting inventions may prove of practical utility except possibly in the service of volunteer associations.

Dunton’s pannier, more expensive than several, is certainly one of the best exhibited. The bottles in this pannier are of block tin, internal and external surfaces of tin, between which is placed a thin lamina of wood. The bottles are light and strong, well secured at the mouth, and square in form. This pannier received a silver medal from the Société de Secours aux Blessés..

The knapsack of Perot is a slightly modified copy of the English "Field Companion." Mr. Dunton's is quite equal to any of the fifteen I have examined, and is entirely original both in form and mode of suspension. Of the 16 canteens exhibited I prefer the French and United States regulation patterns, between which there is little difference; each holds about a quart, is of tin, and furnished with a woollen jacket; I can see, however, no advantage in the cotton suspension band of the United States canteen which can compensate for its slovenliness. For hospital or sanitary purposes, the "officers'" pattern is preferable; it is divided into two sections, each holding about a quart, is concave upon its inner surface, and, like the soldiers', is made of tin covered.

HOSPITALS; TENTS, MODELS, AND PLANS; FURNITURE.

1. Hospital tents, Wall, United States army (2); Evans collection.
2. Hospital tent, umbrella, Richardson; Evans collection.
1. Model of Lincoln hospital at Washington; Surgeon General Barnes.
2. Model of a pavilion of Lincoln hospital at Washington; Surgeon General Barnes.
3. Section of a pavilion, showing a system of ventilation, &c.; Surgeon General Barnes.
4. Diagram of Lincoln hospital; Surgeon General Barnes.
5. Model of United States general hospital at West Philadelphia; Evans collection.
6. Diagram (ground plan) of United States general hospital at West Philadelphia; Evans collection.
7. Model of United States general hospital at Chestnut Hill, Philadelphia; Evans collection.
8. Lithographic view of United States general hospital at Chestnut Hill, Philadelphia; Evans collection.
9. Model of a pavilion of United States general hospital at Chestnut Hill, Philadelphia; Evans collection.
10. Model of a log barrack hospital, City Point, Virginia; Evans collection.
11. Lithograph United States hospital steamer Elm City; Evans collection.
12. Model illustrating a mode of heating a tent hospital; Evans collection.

1. Hospital bedstead, (iron;) Surgeon General Barnes.
2. Hospital mattresses; Surgeon General Barnes.
3. Hospital clothing, blankets, &c.; Surgeon General Barnes.
4. Hospital tables; Surgeon General Barnes.
5. Hospital bedstead, (iron;) Evans collection.
6. Invalid bedstead, (Crosby;) Evans collection.
7. Invalid mattresses; Evans. collection.
8. Hospital clothing, blanket, &c.; Evans collection.
9. Water bed; Evans collection.
10. Bed table, (Stevens;) Evans collection.
11. Head rest, (Stevens;) Evans collection.
12. Camp chairs, stools, &c.; Evans collection.
13. Hospital mess chest, (Perot;) Evans collection.
14. One hospital bed, furnished; Evans collection.
15. Bed and pillow, (Pettiteau;) Evans collection.

But five different hospital tents are to be seen at the Exposition, or rather but four, as the tent used for hospital purposes in the French army is the common tente conique.

Of these four, the United States regulation (wall) tent is generally admitted to best realize the most important principles of construction: impermeability, convenience of form, ventilation, facility of pitching and striking, solidity, transportability, simplicity. Its really distinctive feature is the "fly." This has been unsuccessfully imitated in the Prussian tent, which I may also add is too large to be secure. The English marquee tent is an excellent one, but being double, one tent within another, is costly and difficult to transport. By the employment of the "fly," a sufficient degree of impermeability is obtained without an excessive increase of weight and cost. The ventilation of the English tent is admirable, and I would suggest the introduction into our own regulation tent of the sliding ventilator employed in the inner tent of the English marquee.

Umbrella tent, possessing many excellences, seems to me too complicated for field use.

Both American tents are made of cotton duck. The European tents are all of linen canvas. I prefer the former material it is denser, less permeable to rain, and sufficiently durable.

The pavilion system of barrack hospitals so extensively and successfully used during our war, is well illustrated in the several models and plans exhibited. As to the superiority of this system over all others for the special purpose for which it was intended, there is at present but one opinion among military surgeons. Whether in Europe it can ever be as extensively employed as with us is doubtful. The duration of our war, the absence of public buildings, and the abundance of lumber, made it possible for us to give a most astonishing development to principles previously accepted, though less from experience than from theoretical considerations.

The method of ventilating commonly adopted in these hospitals (Leeds) has been regarded with peculiar favor; as have also many of the details connected more particularly with the administration.

Among the articles of furniture most worthy of notice is the iron bedstead generally used in our hospitals. Its lightness, the elasticity and strength of the slats, its compactness and cheapness, render it superior to any hospital bedstead I have examined: its only possible fault, a want of solidity, is a fault of execution rather than of principle.

SURGICAL INSTRUMENTS AND APPARATUS.

1. Field operating sets, (2,) Tiemann; Surgeon General Barnes.
2. Special operating sets, (4;) Surgeon General Barnes.
3. Trephining set; Surgeon General Barnes.
4. Pocket set; Surgeon General Barnes.
5. Field operating sets, (2,) Hernstein; Surgeon General Barnes.
6. Pocket operating sets; Surgeon General Barnes.
7. Field operating, Tiemann; Evans collection.
8. Minor operating, Tiemann; Evans collection.
9. Pocket operating, Tiemann; Evans collection.
10. Five trays of miscellaneous surgical instruments, Tiemann; Evans collection.
11. Instruments for the administration of ether, Lente; Evans collection.
12. Apparatus for the production and administration of nitrous oxide gas, Colton; Evans collection.
13. Set of splints, Day; Evans collection.
14. Set of splints, Winsted, Connecticut; Evans collection.
15. Fracture apparatus, Buck; Evans collection.
16. Instruments and preparation illustrating a mode of operating in compound fractures, Howard; Evans collection.
17. Artificial limbs and apparatus for exsections and resection, Hudson; Evans collection.
18. Field operating table, Perot; Evans collection.
19. Field operating table, Autenreith; Evans collection.

While the official field operating sets lave contained nearly all the instruments generally required by the regimental or staff surgeon, I believe a desirable end would be accomplished by adding to each set a small capital operating set or trousse, which might be carried in the medical knapsack or elsewhere. Very beautiful samples of these trousses are to be found in some of the French or Italian knapsacks. The one proposed by Professor Esmark, of Kiel, is the most compact, and can be carried easily in the pocket. Mr. Tiemann has sent a small case, (Tray No. 5,) which might be used in this way, but the system of employing but one handle for several blades, which the case is chiefly intended to illustrate, is open to many and serious objections.

The surgical instruments exhibited by the establishments of Messrs. Tiemann and Hernstein are equal in elegance and finish to any exhibited by the most celebrated European makers. "In execution nothing more could be desired."[NOTE: Report of Professor Gurlt.] The display is an exceedingly fine one, and is alike creditable, to the manufacturers and the country. Mr. Tiemann is the recipient of a silver medal from the Imperial Commission.

The light wooden splints of Day, Winsted & Co. are novelties in Europe, and have been examined with much interest, as have also the instruments for the better administration of ether, and for the production and administration of nitrous oxide gas. The dangers resulting from the indiscriminate use of chloroform are daily more generally recognized by European surgeons, and earnest efforts are now being made to discover either safer methods of administration, or new and less dangerous anæsthetic agents.

The number of artificial limbs exhibited is not great, but the selections were well made. The American limbs are generally more highly finished than those made in Europe; the price also, it must be stated, is considerably greater. Dr. Hudson has received from the Imperial Commission a bronze medal for the limbs sent by him, which have been particularly admired, and are in execution unquestionably the most remarkable in the Exposition.

SANITARY SUPPLIES---EVANS COLLECTION.

Clothing.---Blankets, bed-quilts, bed-sacks, cushions, drawers, handkerchiefs, mittens sheets shirts dressing gowns socks slippers towels &c.

Food.---Apple butter, barley, beef, (dried,) beef stock, (Martinez,) broma, (Baker's,) cabbage, (pickled,) canned fruits, corned meats, corned vegetables, catsup, cheese, chocolate, (Baker's,) cocoa, (Borden's,) coffee extract, (Borden's,) condensed milk, (Borden's,) dried sweet corn, popcorn, crackers and biscuits, dried fruits, eggs desiccated, (Lamont's,) flavoring extracts, (Woodruff's,) farina, (Hecker's,) flaxseed, groats, hickory-nuts, hominy, Iceland moss, jellies, julienne soup, lemonade condensed, lemon extract, lemons, limejuice, macaroni, maizena, (Duryea's,) molasses, mustard, nutmegs, oatmeal, oranges, oysters pickled, pickles, potatoes, prunes, rice, sago, sardines, spices assorted, sugar, tapioca, tea, tobacco, (Gail and Ax,) vegetables desiccated, vermicelli, yeast powder, ale and porter, (McPherson and Donald Smith,) blackberry brandy, brandy, (F. S. Cozzens,) cider-champagne, (J. Kierman,) ginger extract, (Frederick Brown,) Jamaica rum, (F. S. Cozzens,) raspberry vinegar, sirup, whiskey, (F. S. Cozzens,) domestic wines, (F. S. Cozzens,) foreign wines, (F. S. Cozzens,) &c.

Miscellaneous.---Adhesive plaster, alcohol, bandages, baskets, brooms, brushes, buckets, buttons, candlesticks, combs, chairs, coffee-pots, cologne, comforts, cotton batting, crutches, envelopes for letters, eyeshades, pens, feeding cups, feeding tubes, games, lanterns, letter paper, lint, oakum, oil-silk, pens, paper bags, pins, pipes, sponges, spit cups, yarn, &c.

The collection of sanitary supplies is one of peculiar interest as a material indication of the direction of popular philanthropy during our war. The liberal provision of the government had secured an unusually abundant supply of medicines, surgical appliances, and all the more important stores pertaining to the hospital department.

The object of volunteer aid was to furnish those things which are most likely to be needed in pressing exigencies, certain articles of hospital clothing and food, or those supplies which, perhaps not absolutely indispensable, might contribute greatly to the comfort of the sick and the welfare of the army.

Samples of nearly everything contributed by the people to the soldier are here to be seen. The home-made blankets and counterpanes, hospital wrappers, caps and slippers, the curious little comfort-bags filled with note paper, stamped envelopes, hymn books, combs, brushes, needles, thread, tape, buttons, &c., bearing with them, perhaps, some woman's word of hope and encouragement---all, the simple, silent but eloquent witnesses of a noble work of loyalty, love, and charity most worthily accomplished. Probably no articles in this class have been examined with more curious interest or elicited more admiration than these. Not only have they shown precisely what the American people did do for their army, but they have shown what other people can do. As is the case with most good works, the agency of the Sanitary Commission has been felt beyond the circle of those necessities which first created it, and its influence in widening the domain of human interest and sympathy has been not less apparent and important than the material service which it has rendered.

Among the articles of diet the preparations of canned food occupy a prominent rank, whether considered in view of their intrinsic value or the immense demand for them in the general cuisine of the army. The meats, vegetables, and fruits put up in this way were usually of good quality and cheap, as were also the jellies and preserves. Some of these articles, such as green corn, cranberries, okra, &c., are almost entirely unknown in Europe, while in a large number of cases the preparation only is new as an article of commerce. Still, most of these things can be found in foreign, particularly in English markets, as well prepared, sometimes better than in our own. Borden's condensed milk, and extract of coffee with milk, particularly the former, are so well known to the American public as to little need the sanction of European favor. The English and continental preparations of milk have generally been inferior in quality, or at least have never become popular. Less than a year since a company in Switzerland commenced the manufacture of milk on Borden's principle. Our own European navy is now chiefly supplied from this establishment, and the rapidly increasing demand for the milk has completely assured the success of the enterprise. The extract of beef, recently prepared by the same manufacturer, Borden, is of remarkable excellence. It has generally been regarded here by those who have carefully examined it as superior to the somewhat celebrated extractum carnis of Liebig, and as the best concentrated extract of meat now known. Its introduction into the sanitary service of European armies has been strongly urged.[NOTE: Report of Baron Munday.]

A silver medal was awarded to Mr. Borden for this preparation by the Société de Secours aux Blessés..

Duryea's maizena, Lamont's desiccated eggs, and several other strictly American preparations have also been highly commended.

MISCELLANEOUS.

1. Umbrella tent, officer's; Richardson; Evans collection.
2. Umbrella tent, officer's; Walton; Evans collection.
3. Life-boat; Evans collection.
4. Samples of clothing issued by the United States government to infantry soldiers; Evans collection.
5. Cavalry stirrups; Evans collection.
6. Sanitary Commission tool case; Evans collection.
7. Sanitary Commission mess kit; Evans collection.
8. Officer's mess chest; Perot; Evans collection.
9. Field mess chest; Perot; Evans collection.
10. Mess pannier; Dunton; Evans collection.
11. Platform scales; Fairbanks; Evans collection.
12. Balances; Evans collection.
13. Anthropometer; Evans collection.
14. Spirometer; Evans collection.
15. American combined knife and fork; Evans collection.
16. Spike candlesticks; Evans collection.

A much more complete exhibit of the clothing issued by the government (luring the war has been made in another class. The mess utensils are of no special interest. Nos. 11, 12, 13, 14 are instruments used by inspectors of the Sanitary Commission, while conducting observations to determine the weight, strength, physical development, &e., of soldiers recruited in different sections of the country, or representing different elements of population or social condition.

HOSPITAL TENTS.

Hospital tents should be impermeable to rain, convenient in form, capable of being well ventilated, of being easily pitched and struck; simple in construction, light, compact when ready for transportation, and, withal, sufficiently secure when pitched.

In order that the first requisite, impermeability, may be properly secured, every hospital tent should have a double roof or "fly." This principle has been observed in the construction of the English, Prussian, and American regulation tents, which are also what are termed "wall tents"---that is, are made with sloping roofs and perpendicular sides. This form is preferable to the "conical" or wedge not only in view of its being better adapted to receive the protection of an upper roof or "fly," but from the greater ease with which the interior space is utilized. The objections against these tents are, that they are more likely to be blown down by heavy winds than either the conical or wedge tents; and that they compel the employment of an additional number of poles and guys. Experience shows, however, that, unless too large, they are sufficiently secure; and the burden upon transportation can hardly be regarded as considerable, in view of the limited nature of the ambulance service and the special and important objects to be gained.

In the French army no tent is used especially by the ambulance service---the ordinary "tente conique," for sixteen foot soldiers, being the one generally employed for this purpose. The diameter of this tent is 5.70 metres, its height 3.25 metres; weight 72.14 kilograms, and cost 237 francs. It is made of linen canvas, is supported by a single centre pole, and is guyed out by short cords. Its extreme diameter from picket to picket is 6.50 metres. The bottom of the tent is furnished with a curtain 0.36 metre in breadth, which can be raised for purposes of ventilation, while a permanent opening in the top permits the escape of foul air.

This tent possesses almost all the essential requisites of a service tent, although the material is too loose in texture, and not sufficiently impermeable; as an hospital tent, however, we cannot approve it; it is inconvenient in form not only for the patient but also for the surgeon and the attendants.

The Prussian tent exhibited, is an oblong wall tent 13.33 metres long, 6.65 metres large, 4.33 metres high, with side walls 1.50 metre high. It is supported upon a tubular iron frame, and made steady with guys. It has a double roof, and a curtain at each extremity which drops from the roof to the ground, cutting off a space between itself and the end wall 1.30 inch in width. In the roof are two circular openings for ventilation. The material of which it is made is linen canvas of fair quality, cost 1,300 francs. The Prussian tent is too large for easy handling and transportation; it offers, also, too extensive a surface to the wind, as it cannot be made sufficiently secure without employing a frame-work undesirably complicated and heavy. Although a double roof or "fly" is used in this tent, its principal advantages have been lost by retaining it in close apposition with the roof of the tent itself.

The English hospital marquee is a double tent; the inner tent is 28 feet long, 15 feet wide, and 12 feet high, with a cubic space of 2,596 feet. The lower part is elliptical, with straight walls 5 feet in height; the upper part is in the form of a triangular prism and two half cones. The tent is suspended by bands front a ridge-pole 14 feet long, supported by three upright poles each 14 feet in length, and each in two sections, and is guyed out by cords. The outer tent, entirely covering the inner tent, rests upon the ridge-pole and is retained in its place by guys. The average distance between the two tents is about two feet. The walls of both tents are in section, and hook upon the roofs entirely around the sides and ends. Upon each side of the roof of the inner tent is a sliding ventilator, which corresponds with a hooded opening in the outer roof.

The material of which the tent is made is linen canvas of good quality. Cost and weight unknown. This tent is, undoubtedly, excellently adapted for hospital purposes. It is convenient in form, impermeable, capable of being easily and thoroughly ventilated, and is scenic when pitched. The objections to it are its cost and weight; two entire tents serving but for one. Inasmuch as the outer, larger and more expensive tent serves but an accessory and secondary purpose, we must regard the construction of this tent, notwithstanding its evident excellencies, as radically faulty.

The "umbrella" tent made by Mr. Richardson, of Philadelphia, and exhibited for the United States Sanitary Commission, is a large circular tent 6 metres high, and 7.88 metres in diameter at the base; supported by a central pole made in two sections, and by arm pieces radiating from the centre, which, by a hoisting apparatus, spread the tent out something after the manner of an umbrella. The roof is stayed by short cords, from the insertions of which a curtain, 0.61 metre in breadth, drops perpendicularly to the ground. The material employed in the construction is cotton duck; cost 700 francs. This tent possesses certain merits. It is well ventilated at the sides and top; can be readily pitched and struck; its form when packed is well adapted to transportation, and the interior is spacious and convenient. No special provisions have been taken, however, to make it impermeable to rain, and the complications of its construction are too considerable. Small props are liable to be broken, joints are likely to get out of order, and in the field it is not always easy to supply the one or repair the other.

The hospital tent exhibited for the United States Sanitary Commission, and generally employed by the United States government during the late civil war, is 14 feet in length, 15 in width, and 11 feet (centre) in height, with side walls 4-1/2 feet high. It is intended to accommodate eight patients. The tent is supported by two poles and a ridge-pole, each made in two sections. One end is furnished with a lapel so as to admit of two or more tents being joined and thrown into one, with a continuous covering or roof.

Each tent is also furnished with a "fly" or extra covering, which, resting upon the ridge pole, and elevated several inches above the roof proper, entirely covers it.

The material employed in the construction of this tent is closely-woven cotton duck, and the cost of each tent about 300 francs.

The advantages possessed by this tent are its simplicity, cheapness, square form and perpendicular walls; the almost entire impermeability of the material employed in its construction; and, finally, the "fly," which, while it is an additional security against rain and humidity, is also an effective defence against solar heat, the space between the two roofs being open to a free ventilation. Again, the "fly" being movable, it can, during dry and pleasant weather, readily be advanced in front of the tent, thus increasing to a considerable extent the amount of shelter furnished. In this tent no special arrangement has been made for roof ventilation. This is perhaps a fault; one, however, which can be easily remedied should ventilation from the ends be at any the apparently insufficient or defective.

This American (regulation) tent certainly possesses in construction great merits, while the material of which it is made (cotton duck) is less permeable and less expensive than linen. Whether it may prove sufficiently durable in all climates to be economically employed, is a question which can only be determined by experience.

HISTORICAL.

1. Histoire de la Commission Sanitaire des Etats-Unis; Evans; Evans collection.

2. Discourse of Rev. Dr. Bellows, president of the Sanitary Commission; Evans collection.

3. Reply to the question why the Sanitary Commission needs so much money; Knapp; Evans collection.

4. Memorial of the Great Central Fair; C. J. Stillé; Evans collection.

5. Military Statistics; Elliot; Evans collection.

6. Tribute Book; Goodrich Evans collection.

7. Medical and Surgical Essays; Hammond; Evans collection.

8. Three Weeks at Gettysburg; Evans collection.

9. History of the United States Sanitary Commission; C. J. Stillé; Evans collection.

10. A Brief History of the United States Sanitary Commission; Evans collection.

11. Essais sur la Chirurgie et la Médicine Militaire, Translation; Evans; Evans collection.

12. Les Institutions Sanitaires pendant le conflit Austro-Prussien-Italien; Evans; Evans collection.

13. Charts, Diagrams, &e., of the United States Sanitary Commission; Evans collection.

14. Photographs of Places Made Memorable by the War; Evans collection.

15. Guerre d'Amérique; Evans collection.

16. Groups (5) in terre cuite; Rogers; Evans collection.

17. Lithographs of the Bazaars of the Sanitary Commission in Philadelphia; Evans collection.

18. Photographs of Pinner's ambulance; Kitchen; Evans collection.

19. Autographs of 19,108 persons who have undergone surgical operations under the influence of nitrous oxide gas; Colton; Evans collection.

20. Picture frame made by a wounded soldier; Evans collection.

21. Tribute to the Lathes of New York; Dusseldorf artists; Evans collection.

22. The Wounded Soldier; Carl Hubner; Evans collection.

23. Frame enclosing photographs, medals, &c., of the United States Sanitary Commission; Evans collection.

24. De la Découverte du Caoutchouc Vulcanisé et de la Priorité de son Application à la Chirurgie Civile et Militaire; Evans; Evans collection.

25. Treatise on Military Surgery; Hamilton; Evans collection.

26. Army Regulations, (United States;) Evans collection.

27. Various publications of or pertaining to the United States Sanitary Commission; Evans collection.

28. Circular No. 6, Surgeon General's office; Evans collection.

29. Micro-photographs; John Dean; Evans collection.

30. Sanitary Commission mail-bag of the Army of the Potomac; Evans collection.

31. Flags of the United States Sanitary Commission; Evans collection.

32. Rubber rings used in one of the United States Sanitary Commission hospital cars; Evans collection.

33. Photographs and micro-photographs of objects in the Army Medical Museum at Washington; Surgeon General Barnes.

34. Various reports and publications of or pertaining to the United States Christian Commission; Evans collection.

35. Loan library United States Christian Commission; Evans collection.

36. Flags of the United States Christian Commission: Evans collection.

37. Knapsack of a field delegate of the United States Christian Commission; Evans collection.

The history and literature of our hospital service is well represented by books, diagrams, photographs, &c. If perhaps a less striking, it presents a completer record of the means employed for the relief of the sick and wounded than is elsewhere shown. "The History of the Sanitary Commission," "The Tribute Book," and "Woman's Work," are the imperishable records of earnest effort, of generous sacrifice, of heroic fortitude and devotion. From them we may learn the loyalty of both the army and the people to the government, the close relation of the army to the people, and the keen appreciation by the people of the special dangers, sufferings, and necessities which were to be encountered and borne by the newly-made soldier. From them we may discover the sources of that inspiration which, to diminish these evils, created in a few weeks a vast machinery covering the country with a net-work of branches, having their subordinate centres of charity in every village and hamlet, and maintained for more than four years with unabated efficiency the most extensive, as well as the most successful, philanthropic work ever before undertaken.

From Circular No. 6 and the remarkable photographs sent from the office of the Surgeon General, we learn something of the organization of the medical staff; of the wide field of its operations, and of the appreciation by the medical bureau of the immense collection of statistical, surgical, and pathological material with which its offices were filled at the close of the war.

It certainly is to be regretted that a more complete exhibit was not made of the general orders and circulars from time to time issued relating to the medical staff; as well as of the various returns or forms in use. With a clearer understanding of the organization and services of the medical staff; of the reasons for the modifications and changes which it was ultimately found necessary or expedient to adopt in it, of the absolute data sought, in regimental and hospital, medical and surgical statistics, the world would have been better satisfied to wait for conclusions and results whose value is now in danger of being impaired by a somewhat slow process of evolution. Enough, however, has been shown to indicate the remarkable fidelity with which these medical records have been made and preserved, and their really incalculable value in the solution of some of the most important questions of the present time, and it is earnestly to be hoped that our government may accord to the medical bureau every encouragement and facility necessary to their speedy preparation for publication; a publication as essential to the reputation of our country as imperatively demanded in the general interest of sanitary science.

The reports and publications of the Christian Commission indicate the character and extent of the moral and religions influences brought to bear upon the soldier, and the earnest efforts made to check the vices and counteract the demoralization peculiar to camp life. We have here a sample of those "loan librairies" furnished by hundreds to hospitals, regiments, and ships, not filled wholly with sermons and religions tracts, but composed principally of books of travel, history, and science. No better illustration could have been furnished than this of the average intellectual tastes of our soldiers and sailors.

The little parchment "identifier," "to be worn in battle under the shirt, with a blank on one side for the name of the soldier, and on the other for the address of father, mother, or sister, is a touching instance of tender forethought.

How many sad yet pleasant memories of the camp are called up by those modest placards headed "Soldier's writing table; sit down and write a few words home; if you have no postage stamps, leave your letter in the box, we will stamp and mail it." Had we not seen these things with our own eyes, we should have been half inclined to doubt the possibility of all this goodness.

If war is a scourge and a desolation, it is not always an unmixed evil. If the baser passions of our nature are unloosed, our forgotten virtues too are aroused from their dead slumbers, and, all the purer and brighter and more conspicuous amidst the general darkness and gloom, repeat to us the story of our fall, and again assure us that we are still the children of a Divine Father who will finally receive us into that kingdom where all is charity and peace.

In concluding this report I can only regret my inability to render it more complete, a better representation of our exhibit at the Exposition, and a fuller summary of the results of studies which have extended over a much wider field. Still, however desirable it might have been to have considered this special section of Class 11 from an international point of view, and to have instituted a comparative criticism of the articles exhibited by different governments, such was not the purpose of the present report. The undertaking was too vast, and on. the whole perhaps of doubtful utility.

Many of the methods employed in the hospital service, as well as many of the most important principles involved in the construction of hospital material, will always be determined by social, climatic, topographical, or other local considerations. While most of the hospital material exhibited by the different States of Europe has been well devised with reference to the special end to be accomplished, as we have already stated, much of our own material is equal and some certainly superior to that shown by any other nation. Still, while we have every reason to feel gratified with the results of the Exhibition, as they may regard this portion of our subject; it may be well to remember that there is little which may not be improved, often even by adopting principles employed in models in themselves inferior. We may sometimes teach; it is always possible to learn; and if others have profited by the study of this rare assemblage from all quarters of the globe of the most approved material of the ambulance service, the benefit should have been to us no less. If our merits have at times been recognized, we have had occasion more than once to confess our faults, and admit with all the world the many practical difficulties which must always interfere with the full accomplishment of our wishes in behalf of the wounded on the field of battle.


Part Four

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