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On April 29, 1861, at a meeting of a great concourse of women in the Cooper Institute, New York City, a movement was initiated which led to the organization of the United States Sanitary Commission.

As first formulated, the plan looked to an organization with full powers to establish for the benefit of the Army a preventive, hygienic and sanitary service, this under or independent of the Medical Bureau, as might be deemed most expedient.

To secure recognition from the War Department, the promoters of the movement laid their proposal before the Surgeon General in Washington, but received no encouragement.

It was well known to all and was called to the attention of the Secretary of War and the Surgeon General, that when the British Government, a few years before, learned of the dreadful mortality of the British Army in the Crimea, the most radical and previously unheard of measures were taken to remedy the situation.

For hospital reform and supervision Miss Florence Nightingale was sent to Scutari by the British Secretary of State for War with the most ample power to call upon the military authorities for any assistance she required and to adapt the administration of the hospitals to her plans in conformity with her orders. Miss Vightingale stated, what the official returns confirm, that during the first seven months of the campaign before Sebastopol, the British Army suffered a mortality at the rate of sixty per cent per annum. Other most radical steps for reform were taken, these consisting in placing the military authorities, so far as respected preventive measures and sanitation generally, under a civil commission of three British sanitarians.

The Secretary of State for War, in his instructions to those experts, said:

It is important that you be deeply impressed with the necessity of not resting content with the giving of an order, but that you see instantly, by yourselves or by your agents, to the commencement of the work and to its superintendence day by day until it is finished.

Those who initiated the organization of the United States Sanitary Commission were familiar with the facts respecting this British Commission, whose report was dated December 1, 1856. They sought to secure from the Government at Washington similar plenary powers for supervision and intervention respecting preventive measures touching sanitation.

The Surgeon General and the other military authorities repelled the idea of their own subordination in respect to any military matter to a committee of civilians; the Sanitary Commission had to accept the role of a body invited to inquire into matters affecting health and to advise with the Medical Bureau relating thereto.

The official designation of the organization was A Commission of Inquiry and Advice in respect of the Sanitary Interests of the United States Forces. The War Department order 1 notes that it was issued at the instance and in pursuance of the suggestion of the Army Medical Bureau and that the Commission was to exist at the pleasure of the Government, unless dissolved by its own action.

The persons to compose the directorate, which included the head of the Medical Bureau and two other military officers, were designated by the Secretary of: War. He required that the inquiries of the Commission be directed to the principles and practices connected with the inspection of recruits and other enlisted men; to means of preserving and restoring the health and securing the general comfort of the troops; to the sanitary condition of the volunteers; to the proper provision of cooks, nurses and hospitals; and to other subjects of like nature.

The Commission immediately organized, chose a president, vicepresident, secretary and treasurer, increased its personnel to twelve, and, on the 13th of May, 1861, submitted for the action of the Secretary of War a "plan of organization "2 in which were set forth in some detail the powers and responsibilities of the organization. This was approved by the War Department the same day.

1 Printed in SUPPLEMENT to this JOURNAL, p. 229. 2 Printed in SUPPLEMENT to this JOURNAL, p. 230.

The two papers together, the order and the plan, constitute what may be called the Constitution of the Sanitary Commission.

Under the first branch of their responsibility -- inquiry — the information sought was to cover the wants of the troops under the heads, what must be, what is, and what ought to be their condition.

In respect to the other branch -- advice - the Commission was to prepare plans, undertake to secure their approval and enforcement by the military authorities, and their support by the benevolence of the public, - in short, to aid the Medical Bureau without displacing it or in any manner infringing upon its rights and duties.

A comparison of the measures adopted at Geneva in 1863 and recommended to the signatory powers for acceptance (see below) with those adopted by the Government of the United States in 1865 will show that there was no substantial difference so far as concerned results to be secured. The single motive actuating both the Geneva Conference and the United States Sanitary Commission was to devise a plan and means for aiding the medical services of the armies in campaign. At Geneva much was said about succor of the wounded and nothing about the general health and comfort of the troops. At Washington the succor of the wounded, although not specially referred to, was covered by the phrase "preserving and restoring the health and comfort of the forces." At Geneva it was proposed that all those connected with the medical services wear distinguishing marks or badges. At Washington there was no such proposal at the outset, but before the war was ended the helpers of the sick and wounded at the front and in the hospitals were wearing distinguishing marks. The delegates at Geneva asked that the nations confer upon the army sanitary services and their helpers the privilege of neutrality. This was asking for what both belligerents in the Civil War in America had more than a year before the meeting at Geneva already conceded as respected medical officers and other non-combatants taken prisoners. From and after the spring of 1862 all doctors and chaplains held as prisoners of war by the Union or Confederate forces, as well as those liberated on parole. were released. General Beauregard appears to have been

3 Par. IV, G. 0. No. 60, June 6, 1862, for the Union Army, and par. II and III, G. 0. No. 45, June 26. 1862, for the Confederate Army.

the first to propose this humane treatment of physicians, April 13, 1862, and General Bragg, the same for chaplains, June 16, 1862.

As early as the eighteenth century in European wars surgeons and chaplains, on exchange of prisoners, were commonly released without equivalents or ransom. *

The international usage in this regard is stated by Lieber in his “" « Instructions " 5 as follows:

The enemy's chaplains, officers of the medical staff, apothecaries, hospital nurses, and servants, if they fall into the hands of the American Army, are not prisoners of war, unless the commander has reasons to retain them.

This was published to the Union Army several months before the Geneva Conference met and more than a year before the International Congress convened.

It thus appears that the rules prescribed at the Geneva Congress, conferring the privilege of neutrality upon the sanitary or medical personnel and their attachés, was but the declaration of a status for this class of noncombatants that was in general harmony with many European precedents and strictly in accord with the American practice announced more than two years previously.

Thus America, in 1861, created a volunteer agency for war relief and this was soon developed into a powerful and efficient organization for safeguarding the health and succoring the sick and wounded in war.

After its efficiency had been demonstrated the Geneva Congress formulated rules of international law to the same end. The sole original feature of the Convention of 1864 is found in the requirement that those engaged in relieving suffering of the troops

4 See Hall Int. Law, 1:422, who cites Moser IX, II:255 and 260; De Martens, Rec. VI:498-III:306; Precis p. 276; Dumont VII, 1:231-Kluber 247; Heffter p. 126. Wellington Despatches, VII:591.

5 G. 0. 100, War Department, April 24, 1863, “ Instructions for the Government of Armies in the Field.” This work of Dr. Francis Lieber is the earliest formal exposition of the international laws of war that was published in any lan. guage. As issued by the War Department the monograph had the approval of a board, appointed by the Secretary of War, consisting of Dr. Lieber, the author, and Major-Generals Cadwalader, Aitchcock, Martindale, and Hartsuff of the Army.

as well as the hospitals for the sick and wounded, and their means of conveyance display a distinguishing mark — the Red Cross.

It is generally understood that the proposal to inake the Greek Red Cross a universal badge of neutrality for those engaged in the succor of the wounded in war originated with the First International Conference that met in Geneva in October, 1863. The meeting was called by the Genevese Society of Public Utility,% whose interest in the movement was brought about by M. Henri Dunant, the author of a pamphlet published in 1860, entitled Un Sourenir de Solferino. The author vividly portrayed the suffering of the wounded during the Italian campaign of 1859; showed how painfully inadequate were the means of relief controlled by the military commanders; urged the formation in each country of a permanent society for the succor of the wounded in war, the services of its benevolent volunteer personnel to be accepted as supplementing the efforts of the overworked official achninistrative staff; proposed that a condition of neutrality and freedom from capture by the enemy should attach to the official and nonofficial, regular and volunteer personnel of the medical services of the belligerent armies; and expressed the hope that some of the great military powers might accept these proposals by formal compact and so secure their recognition by the civilized world as governing in war.

The official reports of the first Geneva Conference and contempo raneous publications established the accuracy of the proposition that the idea of a distinctive and universal badge for the sanitary personnel serving with the armies and a recognition of their neutrality was proposed, discussed and adopted at the First International Conference. These proceedings were reported October 29, 1863, and immediately thereafter published to the world.

The result of the deliberations at Geneva, as respected volunteer aid for the wounded, was expressed in ten resolutions, in substance proposing the creation in all countries of committees and subcommittees of volunteers to aid the army medical services in the

• See Project of Declarations, prepared by the Society, in SUPPLEMENT to this JOURNAL, p. 235.

7 SUPPLEMENT to this JOURNAL, p. 236.

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