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History of The United States Sanitary Commission

The United States Sanitary Commission (USSC), 1861-1879, was a civilian organization authorized by the United States government to provide medical and sanitary assistance to the Union volunteer forces during the United States Civil War (1861-1865). As the USSC broadened the scope of its work during the war, Regular troops, sailors and others also benefited from its services.

The USSC's roots lay in the collaborative efforts of New York City's civic leaders, medical community and, particularly, the Woman's Central Association of Relief, to channel the public's outpouring of support and concern for the troops in ways most useful to the government and the military at the start of the war in April 1861.


A delegation to Washington in May 1861 representing these groups led to the appointment of “A Commission of Inquiry and Advice in respect of the Sanitary Interests of the United States Forces” to work in collaboration with the War Department and Medical Bureau, as ordered by the Secretary of War on June 9, 1861, and approved by President Lincoln on June 13. The Sanitary Commission was empowered to inquire and advise as to matters concerning the inspection of recruits, the health and sanitary condition of the volunteer forces, their general comfort and efficiency, the provision of cooks, nurses and hospitals, and “other subjects of like nature.” The Commission received further endorsement by order of the U.S. Army Surgeon General on June 15.


The USSC did not receive funding from the federal government. Its work was supported by donations of cash and supplies from supporters at home and abroad. Insurance companies were solicited. Soldiers’ aid societies collected supplies and funds, and Sanitary Fairs were held in major metropolitan areas. Substantial funds were raised by Western states and territories, notably California. Donations were also received from supporters around the world.


It was a guiding principle of the USSC that it should work only to supplement, not supplant or compete with, the work of the government, while supporting Army discipline. The Commission began its work investigating the condition of the troops. Its members formed committees concerned with camp and hospital inspections, collection of statistics, and preparation of reports on sanitary practice, the preparation of food, and the quality of supplies. In the early months of its investigations, the Sanitary Commission looked carefully at the lessons of the Crimean War, when British forces lost many men to disease caused by unsanitary conditions.


The Standing Committee relied on an enforced system of regional and functional reporting, largely through the general secretary, to maintain control and communication, and to formulate policy. The number of employees on the Commission’s roster varied from roughly one hundred fifty to several hundred, the average number being about three hundred. While some men and women, at all levels of service, preferred to work on a volunteer basis, as a rule officers and employees received salaries as a matter of policy to ensure accountability and consistency in the work force. As Charles J. Stillé wrote in his History of the United States Sanitary Commission (1866, p. 258), their work was “too full of toil, drudgery and repulsive reality,” especially in the field, to be sustained solely by volunteer workers. The exposure to disease and/or incessant overwork resulted in death or serious illness for a number of men and women associated with the USSC, including both paid and volunteer workers.

USSC sanitary and relief work in the field was generally administered in geographical departments roughly resembling the jurisdictions of U.S. military departments or districts, such as the USSC’s Department of the Gulf. USSC superintendents of such departments were often inspectors with medical backgrounds, supported by relief agents and other staff; inspectors often carried out relief work. USSC department heads reported to the general secretary and worked closely with associate secretaries. Staff members were also assigned to accompany particular Armies in the field, carrying out inspection and relief duties.


The central administration was supported by the work of its branch offices. The USSC provided hospital supplies, clothing and food contributed by aid societies and individual citizens, which were channeled geographically through large branch offices across the Union to major USSC supply depots. Additional supplies were purchased as necessary. The branches were semi-independent regional offices with their own administration under the direction of the USSC. It was believed that donations and supplies could more effectively be raised through local efforts, and distributed more efficiently according to need by a central bureaucracy in official communication with the government.

USSC Members at Fredricksburg Virginia

The central administration was supported by the work of its branch offices. The USSC provided hospital supplies, clothing and food contributed by aid

Special relief services aimed to reduce unnecessary suffering among servicemen who found themselves in “irregular circumstances” or whose needs, for various reasons, fell outside the compass of ordinary government provisions or responsibilities. The Special Relief Department, established in 1861 by Frederick N. Knapp, ran a network of soldiers’ homes and lodges, usually at transit points, which provided food and shelter to sick, wounded or exhausted soldiers, many of them furloughed, discharged and disabled. Special relief staff assisted soldiers with health needs, contacted families in case of sickness or death, resolved problems relating to their military papers, and helped soldiers, sailors and their families file pay and other claims with the government. Similar services were provided by relief agents at large convalescent camps. Special relief work was also carried out by some branches.


The USSC established the Hospital Directory in 1862 to collect and record information concerning the location of sick and wounded soldiers in U.S. Army general hospitals, and to provide that information to the public. Its four offices in Washington, DC; Louisville, KY; Philadelphia, PA, and New York, NY also gathered information from other hospitals and locations, and searched for soldiers who had lost contact with family and friends. Hospital patient data was also used by the Statistical Bureau to monitor the general health and relative strength of the Army. It worked closely with the Special Relief Department.


Assisting soldiers and their families, without charge, to fill out the proper government forms to obtain back pay, pensions, bounty and naval prize monies became an increasingly important part of the USSC’s special relief work. In 1864, it formed the United States Sanitary Commission Army and Navy Claim Agency in Washington, D.C. to better organize its services. Local claim agencies such as the Protective War Claim Association of the State of New York, located in New York City, and the Protective War Claim and Pension Agency, located in Philadelphia, were part of the USSC network of local agents forwarding claims to the central claim office in Washington for processing with the government.


United States Sanitary Commission at Gettysburg


Additionally, the USSC worked with the military to improve transportation of the sick and wounded. It staffed hospital steamers and other ships, some provided by the Quartermaster General, to transport the wounded. It developed special railway cars and ambulances, and used refrigerated rail transport to bring fresh food to Army hospitals. The USSC created several large ‘hospital gardens’ during the war to provide fresh vegetables for patients and for troops in the field, to battle the spread of scurvy. When the war ended in April 1865, the USSC continued much needed relief work with returning prisoners of war, discharged soldiers, and those remaining in hospitals. By July, branches were bringing their work to a close. Active relief work related to the war ceased officially on October 1, 1865, although some tasks continued past that date

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