The United States Sanitary Commission

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Beginnings. In April 1861 the Lady Managers of the New York Infirmary for Women and Children, the first hospital run for and by women, formed the Woman’s Central Relief Association to train nurses and send them, as well as food and clothing, to Union army hospitals. The organization attracted a sizable group of wealthy female reformers, along with a small cadre of male leaders. Out of it emerged the Commission of In-quiry and Advice in Respect of the Sanitary Interests of the United States Forces, or the United States Sanitary Commission. The venture was modeled after the British Sanitary Commission, which had been created during the Crimean War to promote cleaner, healthier hospital conditions.

Official Recognition of the Sanitary Commission. The creation of the United States Sanitary Commission

attracted the interest of men and women in the medical field, and on 15 May 1861 a delegation of male physicians traveled to Washington, D.C., to secure presidential approval for their plan. The Army Medical Bureau, the official medical agency of the Union army, viewed the delegation as a threat to its powers; the head of the bureau, the surgeon general, also questioned the use of female nurses. The delegation persisted in its efforts, however, meeting with Secretary of War Simon Cameron and President Abraham Lincoln. Lincoln initially hesitated to support the commission, calling it a “fifth wheel to the coach,” but on 13 June he signed a bill officially establishing the U.S. Sanitary Commission as an investigatory and advisory board.

Functions of the Sanitary Commission. Although women composed the majority of Sanitary Commission volunteers, male leaders determined the direction and ultimate goals of the organization. Henry Bellows, a Unitarian minister, was the president of the commission; Alexander Dallas Bache, professor of natural philosophy and chemistry at the University of Pennsylvania, was vice president; and the landscape architect Frederick Law Olmsted and the lawyer George Templeton Strong served as officers. The commission employed about five hundred agents, mostly men, to distribute medical supplies in army camps and hospitals and to teach sanitan procedures to soldiers; it also relied on volunteer support By 1863 about seven thousand local affiliates existed physicians and prominent businessmen usually served a officers of these organizations, but women made up the majority of the volunteer force. The affiliates raised money by holding bazaars and “sanitary fairs” and sen volunteer nurses and food, clothing, medicine, and othe supplies to camps and hospitals. They also offered food and lodging to soldiers traveling to or from the front.

Reform in the Army. The Army Medical Bureau, which had opposed the creation of the Sanitary Commission, refused to cooperate with it, prompting the commission to lobby the government for changes in the bureau. The commission especially criticized the Medical Bureau’s seniority system, which kept younger, more-progressive doctors from becoming leaders. With the prodding of the Sanitary Commission, Congress in May 1862 passed a bill that eliminated the seniority system and allowed the surgeon general to appoint inspectors to reform the medical system. Lincoln appointed a new surgeon general, William Alexander Hammond. Younger and more reform minded than his predecessor, Hammond worked closely with the Sanitary Commission to produce a more efficient and hygienic army medical system.

Criticism of the Sanitary Commission. While the commission served an important philanthropic need, the motives of its leaders were not entirely humanitarian. Commissioners insisted on strict military discipline and order, sometimes to the detriment of sick or wounded soldiers. Staff surgeons who did not follow required procedures when requesting medicine, for instance, were often denied lifesaving drugs. The Sanitary Commission also prohibited volunteers from delivering supplies, medical or otherwise, to hospitalized soldiers: only hired agents could distribute provisions.

The Christian Commission. One of the most vocal critics of Sanitary Commission policies was the Christian Commission, a volunteer organization formed to provide religious and humanitarian services to Northern soldiers. Leaders of the Christian Commission were especially critical of the Sanitary Commission’s insistence that only paid agents work in the hospitals and that these agents deal mainly with doctors rather than with sick or wounded soldiers. Christian Commission volunteers, by contrast, worked directly with soldiers whenever they could, in an attempt to “enhance the value of both gifts and services bv kind words to the soldier as a man, not a

machine.” Directors of the Sanitary Commission responded by portraying the Christian Commission as sentimental and undisciplined; board member Charles Stille asserted that the rival organization had no use for “ideas of fitness, practical usefulness, efficiency, or of anything else essential to the success of the object in view.”

Impact of the U.S. Sanitary Commission. The U.S. Sanitary Commission played a major role in mobilizing civilian support for Union war aims. It also represented the largest volunteer effort to that time in the United States. Its emphasis on discipline and efficiency reflected a greater change in American society as a whole: whereas prewar reform efforts had taken the form of individual acts of benevolence, the Sanitary Commission was a large, bureaucratic organization. Like the executives of large corporations, commission leaders based their decisions on scientific theories of management. The commission, along with the army, also helped to bring about the professionalization of nursing: in July 1862 Surgeon General Hammond ordered that at least one-third of army nurses be women, and over the course of the war more than three thousand women worked as paid army nurses; more than two thousand others served as volunteers or paid agents of the Sanitary Commission. The Sanitary Commission also stimulated awareness of the necessity for more-hygienic practices in American medicine. Postwar social reformers, many of whom had worked with the commission, pushed for improved sanitary conditions in hospitals and for the professional training of nurses. Organizations such as the American Public Health Association, established in 1872, and the American Red Cross, founded in 1881 by Clara Barton, also reflected this emphasis.