Statement showing the amount remaining in the hands of each of the disbursing officers of the Pay department, and unac- ,854,04 605,762 07 2,248,284 40 2,854,046 47 2,191,817 87 PAYMASTER GENERAL'S OFFICE, October 30, 1843. N. TOWSON, P. M. G. No. 5. REPORT OF THE SURGEON GENERAL. SURGEON GENERAL'S OFFICE, October 31, 1843. SIR: In obedience to your circular of the 26th of September, I have the honor to lay before you a statement of the fiscal transactions and a report upon the operations generally of the Medical department of the army. The amount of the appropriation for the medical and hospital department remaining on the 30th of September, 1842— In the hands of disbursing agents $2,999 94 In the Treasury of the United States 18,240 85 And the amount appropriated by the act of Congress approved the 1st of March, 1843 Also, this sum, paid to Boyd Reilly, by order of the Secretary of War, under an act of Congress of 3d March, 1843, for his patent right to a bathing apparatus 2,500 00 And by disbursing agents, for medical and hospital supplies, meteoro The medical supplies for the army have been furnished to all the military posts, by the medical purveyor at New York, with the utmost regularity and promptitude, and the articles provided have been of the best quality, and withal were purchased at the lowest possible cost. Under the present method of supplying medical stores to the army, and the system of responsibility for the expenditure of the same, which was established a number of years ago, and which is now rigidly enforced, the expenses of the department have been brought down to the lowest possible. standard compatible with a just liberality on the part of the Government. During the last four or five years, the average cost of the medical supplies has been about $2 60 per man per year; for the last twelve months, $2 22 per man. Below this amount we cannot go without abridging the sick of some of the necessary comforts; but with this sum we have heretofore provided all the essential articles of medical stores, and we can continue to furnish every comfort and convenience which the officer or the enlisted soldier can reasonably expect or rightfully claim of the Government. The returns of public property, embracing statements of purchases, expenditures, &c., required from the different military hospitals, were regularly rendered; and as these papers exhibited in detail every article of sup ply received, and satisfactorily accounted for all expenditures of the same, the accounts of the medical officers have been settled in this office up to the 30th of June, the close of the last fiscal year. The number of cases of indisposition which have been under treatment in the army during the last twelve months (see report marked A) was 27,734; 26,820 of which occurred within the past year, 914 being cases that remained of the preceding year. Of the whole number of sick, 26,513 have been restored to duty, 309 have been discharged the service, 18 have deserted, and 160 have diedleaving, on the 30th of September, 726 still on the sick report. The mean strength of the army for the last twelve months has been about 9,863; and, as the number of sick during the same period was 27,734, and the aggregate of deaths was 160, it will appear that the proportion of cases of indisposition to the number of men in service was as 28 to 1, or 281 per cent.; the ratio of deaths to the number of men as 1 to 61, or a fraction less than 1 per cent.; and the proportion of deaths to the number of cases treated, as 1 to 173-27, or 57 1 per cent. A medical board, for the examination of assistant surgeons for promotion, and of applicants for appointment to the medical staff of the army, was convened in the city of New York on the 1st of July last. Before this board, one assistant surgeon presented himself for examination, and, having been found qualified, he was recommended for promotion. From among the applicants for appointment, twenty-four were invited to the examination, fourteen of whom only reported to the board, ten having declined, or failed to present themselves for examination. Of those who reported to the board, three afterwards withdrew without an examination, one was objected to on account of physical disqualifications, and ten were examined; and of these last, four were approved and recommended for appointment. In conformity with the will of Congress, expressed and implied, an additional number of barometers have been purchased and placed at the prominent positions in our country, and the medical officers have been required to give all the attention to meteorology practicable, compatible with their duty to the sick and other higher obligations to the Government; so that, in addition to the thermometrical and other meteorological observations which have been heretofore received from the different military posts, we shall be able to report barometrical observations also from most of the important stations in the United States. From the report and accompanying charts of Mr. Espy, the meteorologist, here with presented, (B,) it will be seen that he has been zealously engaged in prosecuting his investigations into the various phenomena accompanying storms, with the view of demonstrating the laws by which the whole are governed. From data derived from observations taken in every section of the United States, Mr. Espy has, with very great labor, framed these maps, exhibiting to the eye, as he says, "the progress of storms through the United States from west to east, accompanied always with a depression of the barometer, and strong winds on each side blowing towards the line of least pressure," &c. Charts like these he contemplates preparing quarterly throughout the year, should Congress deem it expedient to sanction the proceeding; and, as the work assigned him will not be complete, nor the result of his obser vations and investigations so clearly and satisfactorily illustrated without these exhibits of barometrical curves, &c., I respectfully recommend the projét to the favorable consideration of those whose province it is to foster the undertaking. I deem it to be my duty to call the attention of the Department of War and of Congress to the fact, that, at many of the forts on the seaboard, no proper buildings have been erected for the accommodation of the sick of the garrison. As a general rule, in the absence of all accommodations outside of the walls, some of the casemates of the fort are allotted to the purposes of a hospital, where, in addition to the want of privacy and deficiency of ventilation and of light, the sick are constantly annoyed by the tramping of the other men, and the clangor of their arms within the area of the fort, and frequently shocked by the thunder of the cannon and the rattling of the battlements over their heads. In further illustration of my views on this subject, I beg leave to give here a transcript of my report, made on a late occasion, touching the propriety and the necessity of having distinct buildings for hospitals erected near our permanent fortifications: "Whether the Engineer department estimates for funds with which to construct buildings for hospitals, or Congress, in their appropriations for fortifica tions, contemplate the erection of suitable permanent hospital establishments, 1 know not; but whatever may have been the practice or the opinions heretofore prevailing on this subject, it is a matter, in my humble judgment, deserving of the serious consideration of the Department of War. I hold that an appropriation of money for the building of fixed fortifications, or a permanent military work, provides not only for the construction of the walls of the fort and the batteries, but also for the erection of barracks, hospitals, and other indispensable accommodations for the men, sick and well, who are to occupy the post and serve the batteries. "A military work without barracks, hospital, storehouses, &c., is incomplete. A fortification without these essential appurtenances is a mere battery-a work of inferior character, it seems to me, to those contemplated generally in the appropriation acts of Congress. "As the officers of engineers are the persons who plan and superintend the construction of our permanent fortifications, they understand best the several points of offence and defence, and can better adapt the accommoda tions for the men to the size and figure of the work than any other agents of the Government. And as under a general contract for erecting a fortress, embracing barracks, hospitals, and other appurtenances, as well as the fortifications proper, better terms can be obtained than by a special agreement afterwards for the construction of the necessary accommodations for the officers and men, there cannot be a doubt as to the propriety of having the whole work done according to one original design, and under the control of one and the same department. "The present seems to be an opportune time for me to give an expression of an opinion, also, touching another matter involving the health and efficiency of the men who are to garrison our fortifications. It is a question, and one which has never been satisfactorily decided, whether the casemates of a fort can be, with propriety, assigned exclusively as the quarters, &c., for the officers and men who are to occupy the work in time of peace. "As a professional man, I have no hesitation in saying that, in general, casemated rooms cannot be occupied as quarters with the same prospe health and comfort, that distinct buildings within the area of the for outside the work, can afford. "Were it possible to construct casemates so that they could be kept and preserved also in a uniform temperature, military propriety, as wel economy, would seem to require that so much space within a garri should not remain unappropriated. But, as our experience proves 1 casemated rooms are invariably damp, and with a temperature of air v different, in summer and in winter, from the external atmosphere, it m be conceded that they are not, on the score of humanity or of econo even, (having reference to the sickness and permanent invaliding of men,) suitable quarters for troops. "Casemates, like the batteries of a fort, are intended for the purposes war. They will give shelter and protection to the temporarily increas force of the garrison during the presence of an enemy; and men, under the circumstances, will readily submit to the necessities of the case. Until t time of need, however, I think it will be good policy to let the casema remain bare walls, for the protection from the weather of spare cannon a other implements of war, reserving the money, that would otherwise be e pended in fitting up these places as quarters, for the erection of disti buildings for the accommodation of the officers and men who are to garris the fort." The objection to having barracks, hospitals, &c., erected outside the wa of our forts is, as I understand, that they destroy the military appearance the place, and, by masking the rear battery, interfere with the fire from guns on the line of defence. This may be a valid objection with the scientific engineer, whose laud ble pride it must be to display the fortress which he has erected in all i strength and grandeur of appearance. I, however, whose province it is! suggest measures conservative of health in the army, and whose duty it i too, to advocate the cause of the sick and invalided soldier, cannot b brought to subscribe to the wisdom of a policy which would withhold fro the officers and men who are to occupy these forts the ordinary comfort and abridge them of the accommodations essential to their health, unde the supposition that some time or other, perhaps in the hundredth year, th work may be attacked, and the use of all the guns required, unencumbere with a hospital or other buildings outside of the fortification. Barracks hospitals, &c., distinct from the walls of the fort, (and which can be built a as little expense, I apprehend, as fitting up casemates for quarters,) will give accommodation and comfort to the garrison for forty or fifty years; and should, eventually, one or two of our many works of defence be besieged or stormed by an enemy, why, the buildings that mask the guns or cover the assailants may be readily burnt down, or battered down by our own |