The hospital is in excellent condition and the patients look clean and comfortable. The smallpox hospital is overcrowded at present, but this will soon be obviated, for the disease is rapidly on the decrease. Each ward is provided with a bath-room for the patients and containing all the necessary appliances. The smallpox hospital is located too near the general hospital, nearly adjoining it, but this the limits of the island render necessary. Additional materials for vaccination should be obtained and every man on reaching the island vaccinated. This is the only sure means of effectually eradicating the disease.

I have to report that in my opinion this post is an utterly unfit location for a prison, much more for a hospital. Lying so low, its level being some six feet below high tide, it is impossible to properly drain it or to prevent its surface being constantly marshy and wet. The island is traversed by ditches connecting with the main ditch encircling the island, and with the moat round the fort, and intended to be constantly full of water, changing with the tide. The moat is in process of repair, and during this the water is partially shut off, rendering the ditches partially dry. From the stagnant mud and partially stagnant water in these a constant, and in some cases a most offensive, effluvia is constantly given off, rendering the atmosphere in a high degree unhealthy. Some of these ditches run directly underneath the barracks. The influence of such an atmosphere on a large number of men congregated together, and whose vital powers are depressed, as those of prisoners naturally are, cannot but be most injurious.

I would respectfully suggest that at this as at other posts where prisoners are confined some system of labor be devised, light it may be, but still sufficient to occupy their minds and bodies, and thus obviate the depressing influence which confinement and want of occupation necessarily exercise. I am convinced that if this were done the general condition of the prisoners would be much improved and the numbers on the sick-list rapidly diminished.

In many of the prisoners which I have visited I have heard the men begging for work as a means of passing away time, and at Camp Douglas, where many of the prisoners were employed on the sewer and in erecting the new fence around the camp, these were by far the most cheerful and presented the best appearance. At every post I think that by some judiciously advised plan sufficient work could be found for all the prisoners to answer this purpose, if enforced by the commanding officer. At present I am convinced that idleness and ennui are more pregnant sources of disease than any other to be found in our various prisons.

Respectfully submitted.

A. M. CLARK,

Surgeon and Acting Medical Inspector Prisoners of War.

HEADQUARTERS DEPARTMENT OF THE MISSOURI,
Saint Louis, Mo., November 13, 1863.

Lieutenant Colonel J. O. BREATHED,

Provost-Marshal-General Dept. of the Missouri, Saint Louis, Mo.:

COLONEL: The major-general commanding the department directs that you give orders to the officers in charge of the military prisons in this city that the selling of fruit through the grates of the prisons, and all intercourse or communication of any kind whatever between prisoners