From William A. Carrington CSR (M331): Orders on sanitation for General Hospital #21, dated 11/12/1862.
Richmond, 213 Main St. Nov. 12th 1862
Asst Surgeon Coleman in charge Genl Hosl No. 21
You will please take steps to have your privies and urinals put in perfect order and kept cleanly and well disinfected by chemicals, the mixture of Coal tar and Plaster of Paris being sufficient. Keep the yards well policed. Additional means must be taken for the cleanliness of your patients and their clothing - See that every man (whose condition will permit it) be well washed over his whole person & that his clothes & bed clothes be frequently changed to ensure their being cleanly - If you have not hospital clothes enough to keep them neat & clean, at once make a requisition for more which will be approved and forwarded.
You will also use additional care to ensure that the floors should be frequently swept - the walls &c when discoloured whitewashed and the wards frequently ventilated by the windows being let down from the tops &c - also that the times of eating and the hour for lowering & putting out lights be as regular as possible. It is better to scour the floors with sand than to wash them. Please see that the diet be improved in quality as much as the rations issued and Hospital fund will allow and that additional care be used in preparing it, so that it may be most digestible and acceptable.
These additional precautions are rendered necessary by the existence of a contagious disease in your Hospital if in any case vaccination has not been performed let it at once be attended to - You will until further notice receive no more patients neither will you return to duty, furlough, transfer or discharge any one. I will in a short time visit your Hospital again officially to see the results of these additional Hygienic measures.
Your Obedient Servant
Wm A. Carrington
Surgeon & Inspector of Hospls.