FOR THE CAMPAIGN IN VIRGINIA.

Terms of Service.

The Sanitary Commission, being itself under military authority, in order to meet its responsibilities, must require of all persons who engage in the hospital service of the army under its direction, that they place themselves, for the time being, entirely at its disposal.

Those who volunteer their services gratuitously being supposed to do so fully and in good faith, no distinction can be known between them and those who may be paid for their services, it being understood that these services, in both cases, once engaged or accepted, are to be claimed equally of right by the Commission.

Administration.

An agent of administration for the Commission will be appointed for each hospital vessel, who will be regarded by those on board as responsible for her fittings and supplies.

Wards.

Each vessel will be divided into hospital wards, designed each for the accommodation of from fifty to one hundred and fifty patients. In case of convalescents, a larger number will be properly included in a ward.

Surgeons.

A surgeon in charge will be appointed to each vessel, who will be responsible for the reception, classification, and distribution of patients in the wards. He will sign any necessary official medical reports of the vessel. Each ward will be placed under the especial charge of one surgeon, and, if practicable, there will be a surgeon for each ward.

Assistants to Surgeons.

An assistant to the surgeon (with the title of Ward-master) is to be constantly on duty in each ward. Under instructions from the surgeon of the ward, he will superintend and be responsible for the entire treatment of the patients of the ward, during the hours in which he is appointed to be on duty.

Nurses.

Two or more nurses are to be constantly on duty in each ward. They will perform any and all duties necessary in the care of the patients, under instructions from the surgeons received through the ward-masters.

Dispensary.

A dispensary will be established on each vessel, and one or more apothecaries will be placed in charge of it. They will be responsible for the medical stores, and for their proper compounding and issue upon requisitions of the surgeons through the ward-masters.

These will be in charge of ladies, who will issue to ward-masters or nurses, or themselves administer and dispense, under proper control of the surgeons, special diet and drink, and articles of bed and personal clothing for the patients.

Watches.

Ward-masters and nurses, and all who have part in duty of a constant character, will be divided into two watches, which will be on duty alternately, as follows:—

1.	From	7 A. M. to	1 P. M.	A
2.	"	1 P. M. to	4 P. M.	B	(dog watch.)
3.	"	4 P. M. to	7 P. M.	A	" "
4.	"	7 P. M. to	1 A. M.	B
5.	"	1 A. M. to	7 A. M.	A
6.	"	7 A. M. to	1 P. M.	B	(second day.)

Time of Meals.

BREAKFAST.
One watch at	6.40	A. M.	(being then off duty.)
The other at	7	A. M.	" "
DINNER.
One watch at	12.30	P. M.	" "
The other at	1.15	P. M.	" "
TEA.
One watch at	6.40	P. M.	" "
The other at	7	P. M.	" "

House Diet.

When practicable, the house diet will be served at tables to such patients as are able to come to them. When not practicable to arrange tables, such patients as may be designated by the surgeons will be divided into squads of forty, and a squad-master appointed to each, who will receive and distribute to the rest the prepared diet, as may be found most convenient. Patients not able to leave their beds will not be included in these squads, but house diet will be served to them by the nurses of their wards, if ordered by the surgeon.

Special Diet.

The surgeons will ascertain from the administrative agent, or from the ladies, what articles of diet are available on the vessel, and in their morning rounds direct what choice shall be made from these for the diet of each patient, for whom the house diet would not be suitable, during the succeeding twenty-four hours. The ward-master on duty at the hour for surgeons' morning rounds will, in regular order, be on duty at each meal-time during the following twenty-four hours, and will consequently be able to direct the entire diet of each patient from verbal instructions. He should, as soon as possible, notify the proper person (no rule in this respect being practicable for all vessels) of the quantity of each article of special diet which will be required at each meal in his ward, and at the proper time should (if necessary) send the nurses for it, and see it properly distributed.

Surgeons' Rounds.

Surgeons' rounds should commence at 9 A. M., and at 6 P. M. The ward-master on duty will closely attend the surgeon, and receive his instructions as he passes through his ward. The ward-master off duty may also attend the surgeon at this time, for the benefit of receiving instructions directly. The surgeon may make this a duty, otherwise it will be optional.

All Hands.

In receiving and discharging patients, or in any emergency which makes it necessary, ward-masters and nurses may be required to do duty in their watches off. In cleaning, fitting, or repairing the vessel for hospital purposes, they will act under orders of the administrative agent.

Receiving and Distributing Patients.

Before patients are taken on board, the vessel should be properly moored or placed, gangways or other means of entrance arranged, and, if possible, all duties completed, for the time being, in the performance of which the crew of the vessel are required. The surgeon, who should have previously informed himself of the character of the accommodations for patients in all parts of each ward, should detail a sufficient number of guides and bearers to convey the patients, and of all necessary attendants at the gangway, and within the wards. These should remove their boots, and each squad of bearers should be instructed that all orders will be given them by their guide alone, and that no one else is to speak aloud while carrying a patient, or passing through the wards. All persons not having a specified duty to perform in receiving patients, should be put where they will not be in the way or disturb the patients, but where they can be readily called on if the force engaged is found insufficient.

As each patient is brought on board, he will be examined by the surgeon in charge, who will direct where he shall be taken; at the same time notes will be taken, as follows:—

The administrative agent will, at the same time, cause a corresponding number to be placed on the effects of the patient, which he will take care of, to be returned to the patient on his leaving the vessel. If practicable, the patients may, before being taken to their berths or cots, be washed and supplied with clean clothing.

It will not usually be in the power of the surgeon in charge to select patients for his vessel. It may, however, be proper for him to protest against taking patients whose illness is not of a sufficiently serious character to warrant their withdrawal from the seat of war, or those for whose cases there is less suitable provision on the vessel than in the hospitals they are leaving, or those already in a dying condition, whose end will have been accelerated or whose suffering aggravated by their removal; also, when going to sea, against taking cases of compound fracture of the lower extremities.

The simplest possible arrangements should be made for the diet of patients which will be consistent with their proper treatment.

At the outset, the cook may be ordered to prepare daily for breakfast, to be ready at 7 A. M., ten gallons of tea and fifteen loaves of bread in slices, with butter, for every hundred patients on board; for dinner, ten gallons of beef-stew made with vegetables, and fifteen loaves of bread, for every hundred patients on board; for tea, the same as for breakfast.

Orders for special diet should, as far as possible, be confined to beef-tea, arrow-root or farina gruel, milk-porridge, and milk-punch.

Quantities of each of these articles, except the punch, may be prepared by the cook once a day, and delivered to the matron, under whose care they should be warmed in portions over spirit-lamps, as required at any time during the day or night.

As a general rule, for each hundred patients on board, there should be prepared, for twenty-four hours,—

2½	gallons of beef-tea,
4	gallons of gruel,
½	gallon of milk-porridge.

Where the patients are chiefly suffering from illness, especially if from fevers, the above quantities will be found larger than is necessary. Where a large proportion of them are severely wounded, they may need to be slightly increased.

By estimating the quantity of each article which will be required for the twenty-four hours, as thus instructed, the surgeon in charge will find it best to give his orders to the cook for everything at once, one day in advance.

If the quantities ordered prove too small, the deficiency can be made good by the matron with crackers, tea, canned meats, or meat essence, &c., in the pantry; it being best, if possible, to avoid any call upon the cook or the ship's kitchen for this purpose.

If the quantities prove too large for one day, the saving can be used the next. Whether too large or too small, a proper modification can be readily made in the order to the cook for the remainder of the trip. The surgeon in charge will in this way be relieved of the necessity of giving further consideration to this department of administration, which, if not thus simplified, will be found to be a source of much trouble and anxiety, greatly withdrawing his attention from surgical and medical duties proper. Associated surgeons should be careful to make no demands for diet, inconsistent with this arrangement.

Milk-punch is best made with cold water in the pantry. This and all other cold drinks can be made under the superintendence of the matron, without any call upon the cook. The cook should, however, be required to keep a supply, as large as convenient, of hot water, constantly ready to meet any demand from a surgeon or the matron.