PLAN FOR CONDUCTING THE Hospital Department of the United States.

PHILADELPHIA:

Printed by DAVID C. CLAYPOOLE Printer to the Honourable the Congress.

IN CONGRESS, SEPTEMBER 30, 1780.

Plan for Conducting the Hospital Department.

WHEREAS the regulations for conducting the affairs of the general hospital are in many respects defective; and it is necessary that the same be revised and amended; in order that the sick and wounded may be properly provided for and attended, and the business of the hospitals conducted with regularity and oeconomy: therefore

Resolved, That there be one director of the military hospitals, who shall have the general direction and superintendance of all the hospitals to the northward of North-Carolina: that, within the aforesaid limits, there be three chief hospital physicians, who shall also be surgeons; one chief physician, who shall also be surgeon to each separate army; fifteen hospital physicians, who shall also be surgeons; twenty surgeons mates for the hospitals; one purveyor, with assistants; one apothecary, one assistant apothecary; and to each hospital a steward, matron, orderly men and nurses, as heretofore:

That the director, or in his absence one of the chief hospital physicians, be impowered and required, with the advice and consent of the commander in chief, or commander of a separate army, to establish and regulate such a number of hospitals, at proper places, for the reception of the sick and wounded of the army, as may be found necessary:

That the director be authorized and instructed to enjoin the several chief hospital physicians, and other officers of the hospitals under his superintendance, to attend at such posts or stations as he may judge proper, and also to attend and perform such duties, at any post or place, as a change of the position of the army or other circumstances may from time to time make necessary, and shall be required by the commander in chief; and that, in case of any dispute concerning their seniority or precedence, the director shall determine the same in the first instance, the party supposing himself aggrieved being at liberty to appeal for redress to the medical committee.

That, in time of action, and on any other emergency, when the regimental surgeons are not sufficient in number to attend properly to the sick and wounded, that they cannot be removed to the hospitals; the director, or in his absence the nearest chief hospital physician, be impowered and required, upon request of the chief physician and surgeon of the army, to send from the hospitals under his care, to the assistance of such sick and wounded, as many surgeons as can possibly be spared from the necessary business of the hospitals:

(4) That the director, or in his absence two of the chief hospital physicians, shall make out and deliver, from time to time, to the purveyor, proper estimates of hospital stores, medicines, instruments, dressings, and such other articles as may be judged necessary for the use of the hospitals: also direct the apothecary of his assistant to prepare and deliver medicines, instruments, dressings, and other articles in his possession, to the hospitals and surgeons of the army and navy, as he or they may judge necessary:

That the director authorize and instruct the purveyor and apothecary to supply, for the use of the regimental surgeons, such medicines and refreshments as may be proper for the relief of the sick and wounded, before their removal to a general hospital, and to be dispensed under the care and at the direction of the chief physician of the army:

That the director, or in his absence the chief hospital physicians respectively, be impowered, occasionally to employ second mates, when the numbers of the sick shall increase so as to make it necessary, and to discharge them as soon as the circumstances of the sick will admit:

That the director, or in his absence the chief hospital physician respectively shall appoint a ward-master for each hospital, to receive the spare regimental arms, accoutrements and cloathing of each soldier admitted therein, keeping entries of and giving receipts for every article received, which, when the soldier shall be discharged, shall be accounted for by the said ward master with the commanding officer of the regiment to which such soldier belonged, or the officer directed to take charge of the convalescents from the said hospital; or in case of the death of the soldier, shall be accounted for with and delivered to the quartermaster of the regiment to which the said soldier belonged: and the ward master shall receive and be accountable for the hospital cloathing, and perform such other services as the chief hospital physician shall direct:

That the director shall make returns of all the sick and wounded in the hospitals, once every month, to the medical committee, together with the names and ranks of all the officers and others employed in the several hospitals:

That the director be required to employ such parts of his time, as may be spared from the duties before pointed out to him, in visiting and prescribing for the sick and wounded of the hospitals; and that he pay particular attention to the conduct of the several officers in the hospital department, and arrest, suspend and bring to trial, all delinquents within the same:

That the duty of the chief hospital physicians shall be, to do and perform all the duties herein before enjoined them to do in the absence of the director; to receive and obey the order of the director, made and delivered to them in writing, to superintend the practice of physick and surgery in the hospitals, put under their particular care by the director, or which, by the order of the commander in chief or the commander of a separate army, may be by them established; to see that the hospital physicians and other officers attending the same do their duty; and make monthly returns to the director of the state and 0004 (5) number of the sick and wounded in the hospitals under their care; and also make returns to the director and to the medical committee of all delinquent officers, in order that they may be speedily removed or punished; and to take measures that all such sick and wounded as are recovered and fit for duty be delivered weekly to the officer of the guard, to be conducted to the army: when present at any hospital to issue orders to the proper offices for supplying them with necessaries: and generally, in the absence of the director, to superintend and controul the business of such hospitals, suspend delinquent and remove unnecessary non-commissioned officers, making report to the director: and, when in their power, to attend and perform or direct all capital operations:

That the hospital physicians shall take charge of such particular hospitals as may be assigned them by the director; they shall obey the orders of the director, or in his absence of the chief hospital physician: they shall have power to suspend officers under them, and to confine other persons serving in the hospitals under their charge, for negligence or ill behaviour, until the matter be regularly enquired into: they shall diligently attend to the cases of the sick and wounded of the hospitals under their care, administering at all times proper relief as far as may be in their power: they shall respectively give orders under their hands to the assistant purveyor or stewart at the hospital, for the issuing provisions and stores, as well as for the procuring any other small articles that the exigencies of the hospital may require, and which the store is not provided with, having always a strict regard to oeconomy, as well as the welfare of the sick then to be provided for: they shall make weekly returns to the nearest chief hospital physician of the state of the hospitals under their respective care.

The mates shall each take charge of and attend the patients assigned them, and perform such other duties as shall be directed by the director, chief physicians and surgeons, or other physicians and surgeons.

The chief physician and surgeon of the army shall be subject to the orders and controul of the director: his duty shall be to superintend the regimental surgeons and their mates, and to see that they do their duty to hear all complaints against the said regimental surgeons and mates, and make report of them to the director, or in his absence to the commander in chief or commanding officer of a separate army, that they may be brought to trial by court-martial for misbehaviour; to draw for and receive from the purveyor a suitable number of large strong tents, beds, bedding and hospital stores, and from the apothecary or his assistant proper medicines, for such sick and wounded persons as cannot be removed to the general hospital with safety or may be rendered fit for duty in a short time. He shall also see that the sick and wounded, while under his care, are properly attended and provided for, and conveyed, when fit to be removed, to the general hospital; for which last purpose he shall be supplied by the quarter master general with a proper number of convenient waggons and drivers; he shall have a steward, which he is to appoint, to receive and properly dispense such articles of diet and refreshments as shall be procured for the sick; and also shall appoint such a number of nurses and orderly men as may be 0005 (6) necessary for the attendance of the sick and wounded under his care. He shall cause daily returns to be made to him of all the sick and wounded which have been removed to the hospitals, all that remain in the hospital tents, all that are become fit for duty, all that are convalescent, and all who may have died, specifying the particular maladies under which the sick and wounded labour; and shall make a monthly return thereof to the director, who shall add it to his general hospital returns, to be transmitted monthly to the medical committee:

That whenever any regimental surgeon or mate shall be absent from his regiment, without leave from the chief physician and surgeon, or commander of the army where his duty lies, the said chief physician and surgeon shall have power to remove such surgeon or mate, and forthwith appoint another in his stead:

That the purveyor provide, or cause to be provided, all hospital stores, medicines, instruments, dressings, utensils, and such other articles as shall be prescribed by the written order of the director, or two of the chief hospital physicians, and deliver, or cause the same to be delivered, upon written order, under the hand of the director, a chief hospital physician, or one of the hospital physicians, having the charge of a particular hospital or of the chief physician and surgeon of the army, which, with receipts thereon for delivery of the same, shall be his sufficient vouchers. He shall be allowed a clerk, and as many store keepers as occasion may require and the director shall approve of. He shall also pay the salaries of the officers, and all other expences of the hospitals. He shall render his accounts every three months to the board of treasury for settlement, and make application for money to the medical committee, before whom he shall lay estimates of articles necessary, which shall previously have been approved and signed by the director or two of the chief hospital physicians; at the same time he shall render to them an account of the expenditure of the last sum of money advanced to him: and the said medical committee shall lay such estimates before Congress, with their opinion thereon:

That the assistant purveyor shall procure such supplies, and do and perform such parts of the purveyor's duty, as by him shall be particularly assigned to him:

That the apothecary and his assistants receive, prepare and deliver medicines, instruments and dressings, and such other articles of his department, to the hospitals and army, on orders, in writing from the director or either of the chief hospital physicians or chief physicians and surgeons, of the army: and that he be allowed as many mates as occasion may require, and the director shall approve of:

That the director, or in his absence the chief hospital physician, shall appoint a steward for each hospital, whose duty it shall be to purchase vegetables and other small articles, under the direction of the purveyor, and to receive hospital stores from the purveyor, and provisions from the commissary general, and issue the same, for the use of the sick and wounded, agreeable to the order of the physician and surgeon attending such hospital; the steward to account with the purveyor for all such issues:

(7) That the director, or in his absence the chief hospital physicians, appoint a proper number of matrons, nurses, and others, necessary for the regular management of the hospitals, and fix and ascertain their pay, not exceeding the sums heretofore allowed, and point out and prescribe their particular duties and employments in writing, which they are enjoined to observe and obey:

That the director, with two chief hospital physicians, be impowered to fix the pay of second mates, and of such clerks, storekeepers, and other persons as may occasionally be employed; and also make such regulations, and point out and enjoin in writing such further particular duties for the several officers in the hospital department, as they may judge necessary for the regular management of the same; which duties shall always be consistent with and in no wise contradictory to any of the duties herein before particularly enumerated, and which being reported to and approved of by the medical committee, shall thereupon become obligatory to all those concerned:

That the quartermaster general furnish the hospital department, from time to time, as occasion may require, with such a number of horses and waggons as may be necessary for removing the sick and wounded, and for transporting the hospital stores: but that no other horses than those belonging to the officers of the department, for which forage may be herein allowed, be kept separately and at the expence of the department:

That no person concerned in trade, on his own account, shall be suffered to act as an officer in the hospital or medical department of the army:

That no officer or other person in the hospital department, except the sick or wounded, be permitted to use any of the stores provided for the sick:

That the director, chief hospital physicians, the chief physicians and surgeons of the army, physicians and surgeons, purveyor, apothecary, assistant purveyor and assistant apothecary, be appointed and commissioned by Congress: the regimental surgeons and mates to be appointed as heretofore:

That the director, with the advice and concurrence of two of the chief hospital physicians, appoint all hospital mates; which appointments shall be certified by warrants under the hand of the director; in which appointments no persons shall be admitted under the age of twenty-one years:

That all the officers in the hospital or medical department, shall be subjected to trial by courts-martial for all offences, in the same manner as officers of the line of the army.

RESOLVED , That the Pay and Establishment of the Officers of the Hospital Department, and Medical Staff, be as follows; Director, 150 dollars per month, 2 rations for himself, and 1 for his servant per day, and forage for 2 horses; Chief physicians and surgeons 140 dollars per month, 2 rations of the army and hospitals per day, and forage for each 2 horses; Purveyor and apothecary, each 130 dollars per month; Physicians and surgeons 120 dollars per month; of the hospitals, each day, and forage for 1 horse; Assistant purveyors and apothecaries, each 75 dollars per month; 0007 (8) Regimental surgeons, each 65 dollars per month, 1 ration per day, and forage for 1 horse; Surgeons mates in the hospitals, 50 dollars per month, 1 ration per day; Surgeons mates in the army, 45 dollars per month, 1 ration per day; Steward for each hospital, 35 dollars per month, 1 ration per day; Ward-master for each hospital, 25 dollars per month, 1 ration per day:

RESOLVED, That none of the aforesaid officers, or other persons employed in any of the hospitals, be entitled to rations of provision or forage when on furlough.

RESOLVED, That the chief physician of the army be allowed a two horse covered waggon for transporting his baggage:

That the several officers above mentioned shall receive their pay in the new currency, emitted pursuant to a resolution of Congress of the eighteenth day of March last; and that they be allowed and paid at the rate of five dollars of said currency per month for every retained ration; and shall each be entitled annually to draw cloathing from the stores and the cloathier general, in the same manner and under the same regulations as are established for officers of the line by a resolution of Congress of the 25th of November, 1779:

That the returns for cloathing for officers in the medical staff (regimental surgeons and their mates, who are to draw with the regimental staff, excepted,) be signed by the director or one of the chief hospital physicians; and such cloathing shall be delivered either by the cloathier general or any sub cloathier in the state in which the officer to receive cloathing shall reside, in the same manner as is provided in the cases of other staff officers not taken from the line:

That the several officers whose pay is established as above (except the stewards and ward masters) shall, at the end of the war, be entitled to a certain provision of land, in the proportion following viz.

The director to have the same quantity as a brigadier general; Chief physician and purveyor the same as a colonel; Physicians and surgeons and apothecary the same as a lieutenant colonel; Regimental surgeons and assistants to the purveyor and apothecary the same as a major; Hospital and regimental surgeons mates the same as a captain:

That the former arrangement of the hospital department, and all resolutions heretofore passed touching the same, so far as they are inconsistent with the foregoing, be repealed, excepting that the hospitals in the southern department, from North Carolina to Georgia, inclusive, be continued under the same regulations as heretofore, until the farther order of Congress.

Extract from the minutes, CHARLES THOMSON, Secretary.