From the National Archives, RG 109, Ch. 6, Vol. 416, "Letters Sent, Medical Director's Office, 1862-63." p. 16-19
213 Main St., Richmond, Dec. 24th/62
Surg. T. H. Willliams
I have the honour to report that I have this day inspected Bellevue Hospital, in obedience to your order of this date. I would respectfully refer you to reports No. 13 and 15 relating to the organization and administration of this Hospl, and to orders relating to its administration, which will show the peculiar relations that it holds to the Government.
I could enumerate as advantage for this Hospl its quiet salubrious position, an office, reception room, kitchen, dining room, laundry, well fitted privies, wide passages, convenient staircases, large and numerous windows, grate(?) in each room, several portions opening into a large secluded well shaded yard; an apothecary shop and bath room with hot and cold water taken to each part of the house. That there are 1 Surgeon, 1 Asst. Surg., 1 Steward, 4 Nurses, (1 as a clerk) who are paid by the Government, and a matron and 8 other employees, paid by the Hospl as attendants for 40 patients; a larger No. of attendants than allowed by Par. 45 Med. Regulations.
The Hospital consists of a basement and 2 floors, each of which consists passage, and on each side a row of rooms, which are arranged with from 3 to 8 beds in each, 48 beds in all. 4 Rooms, (an Office, apothecary shop, & 2 for [page break] attendants' quarters), are not for the accommodation of patients. The rooms are not of high pitch and I have to report that they are most of them over crowded, (??? with an allowance of 500 sq feet of floor to each patient). The floors, walls, windows, ward utensils, spittoons &c) are not scrupulously cleaned; especially is the wood work discolored and disfigured by long accumulation of dirt.
The bedding was entirely insufficient and dirty: the mattresses, some of hair and some of straw, were not properly changed or aired, the Surgeon saying he could not procure straw. He has made a requisition for bedding on the Med. Purveyor, which under the present orders will not be allowed.
The dress of the patients seemed uncleanly and disordered, there being no Hospl clothing to supply them while in the Hospital. The Medical Attendance is sufficient.
A requisition has been made and filled for medicines & Hospital stores, of which there seemed to be an abundance. One Med. Officer to 40 wounded is the allowance fixed by Surgn. Genl. S. P. Moore. Among the wounded I found dressings neatly and skillfully applied. There was only one case of Erysipelas (from wound of the face), no gangrene in the Hospital and I am convinced from the reputation Surgeon Bolton has for skill and fidelity as a Surgeon, that gangrene could not have taken place from unskillful pressure by bandages or otherwise, and that the gangrene reported, will be found on investigation to be caused by neglect of the patient or to the natural result of the wound of some principal nerve or blood vessel.
Compared with many of the Military Hospitals of this City for private soldiers, this is more crowded, less comfortable, and lacks that scrupulous cleanliness of beds, bedding and clothing, and that military exactness and order, which characterizes them.
The rent of the building is $500 per annum, less than $10.00 per week, the sum charged each patient per week. It was occupied before the war as a Hospl for sick negroes principally, [page break] and in to the house, in beds, bedding, Hospl furniture, kitchen furniture, &c, I see no evidence of any but a very inconsiderable outlay, as before mentioned, not sufficient to ensure health, cleanliness and comfort.
Surgeon Bolton, who is the Surgeon in charge, owns and manages the Hospital for his own benefit. He is assigned to attend Officers in private quarters, and reports 262 other Officers in private quarters. Surgeon Lyons has also been appointed to assist him in this duty. The recommendations in Report No. 15, were carried out, and the 3 private pay Hospls have had all private soldiers and non-Commissioned Officers removed.
The Medical College can accommodate 50 Officers and has only 15, St. Francis De Sales ahs a capacity for 80 privates and should accommodate 40 Officers.
The Med. College has diminished its capacity by ½ and allowing the same space for each, Bellevue could only accommodate 25 Officers.
All of the Hospitals of this City have had Officers as inmates, charging them from $1.00 to $2.00 per diem for rations consumed &c. The Louisiana has separate quarters for about 20, and the Gen Hospl No. 16 for about 12.
Some time since an Order emanated from the Medical Director's Office, directing the Hospital to receive no more officers, and orders were given at the receiving and distributing Hospl and to the Superintendent of transportation, to transport all officers to the above 3 Hospls; but in the exigency following the battle of Fredericksburg, Officers were allowed to enter the Hospls of their own status, and a considerable no have done so. Allowing 1000 men to a regiment and there being 40 Cos & staff officers to each Regt for the 8678 men now in Hospitals in Richmond, there should be 575 sick and wounded officers, supposing there are sick and wounded in the same proportion as the men.
It is found on a fair trial that the 3 Hospls above mentioned are insufficient; other accommodations will have to be provided for them, either by setting aside some large Hospl for them, or a ward in a No. of Hospls for each State [page break]
Your Obt. Servt
Wm. A. Carrington
Surg. & Inspr. Of Hospls.
Special report on the condition and management of Bellevue Hospital, and its relations to the Government.