HEADQUARTERS ARMY OF THE POTOMAC,
Medical Director's Office, Washington, September 20, 1861.

SIR: Your duplicate report, which was very properly made, has been received. The brigade commander will no doubt issue the proper orders to correct the evils which you represent. In relation to your complaint that the colonel of the Thirty-third Pennsylvania Volunteers does not recognize your official relations to him, I have to say that those relations depend upon your commission from the President of the United States and not upon the recognition or non-recognition of any individual officer under the President's command.

Very respectfully, your obedient servant,

CHAS. S. TRIPLER,

Medical Director Army of the Potomac.

Brigade Surgeon PRINCE, Graham's Brigade.

I had thus established a hierarchy, which, though imperfect, enabled me to keep myself tolerably well informed of the condition of the medical department of the army. The irregularities prevailing in relation to the sending of men to the general hospitals and discharging them therefrom were corrected by paragraphs 4 to 9 of General Orders, Numbers 9, Army of Potomac, September 9, 1861. (See Appendix B.)

In suggesting this order I had also another object in view, to control and to diminish as far as possible the number of men sent from the regimental to the general hospitals. The experience of all armies has shown, and my personal observation has convinced me of the fact, that the sick do much better in these regimental than in the general hospitals. I consider general hospitals general nuisances, to be tolerated only because there are occasions when they are absolutely necessary, as, for instance, when an army is put in motion and cannot transport its sick. It is a singular fact, but one as to which I believe all military surgeons of experience will agree with me, that the sick report of a regiment under ordinary circumstances is a constant quantity; that after a regiment has been in the field a month that quantity will be ascertained, and that if the regimental hospital is evacuated in a short time, it will be found to contain again its habitual number of inmates; so that we may have as many successive crops of sick as we choose by repeating the process of evacuating the regimental upon the general hospitals. A leading object with me was to keep up the fighting force to its maximum, and therefore, as well as for the more speedy recovery of the men themselves, I discouraged the practice of sending them to the general hospitals. If I had permitted the practice I found existing to continue - that of sending men promiscuously and without restraint to the general hospitals - the only limit to the number and extent of these would have been what was required to contain the whole army. I stopped it, and thus kept a healthy army in the field.

Having thus established some order and system in the personnel of the medical department and some method in instructing the officers in their duties, my attention was turned to the means of keeping them supplied with medicines, instruments, stores, & c. In this I met with many difficulties. The volunteer medical officers being many of them country doctors, accustomed to a village nostrum practice, could not readily change their habits and accommodate themselves to the rigid system of the army in regard to their supplies. To meet this difficulty I attempted within reasonable limits to disregard supply tables, and to give the surgeons articles of medicine and hospital stores to suit even their caprices, if in my judgment such articles could be of any avail in the treatment of disease. In this effort I first felt the inconvenience of being in Washington. The medical purveyor was bound by the regulations, and although my order ought to have been sufficient to have relieved him from all responsibility, still, to be perfectly safe, he would.