At the headquarters of an army there should be a chief surgeon, an aide-de-camp to the commanding general, with the same rank as the chief of the other departments of the staff. This officer, being charged with the administration of the medical department, should be authorized to give orders in the name of the commanding general in relation to all matters connected with the health of the army; the supervision of certificates of disability for discharge, pension certificates, applications for leave of absence for ill-health, sanitary suggestions, and regulating the establishing and furnishing of hospitals, and the like. He should have one aide at least for each corps d’armée of which the army is composed. For such an army as the Army of the  Potomac he will require at least three clerks, one of whom should be a competent hospital steward. This assistance is necessary for recording correspondence, making the reports required at headquarters and at Washington, and for dispensing medicines at the headquarters. An assistant quartermaster and an assistant commissary of subsistence are absolutely necessary to the chief surgeon. These officers, holding official relations to their respective departments, can so much more readily command and furnish the supplies in possession of those departments than a medical officer, who has to make requisitions for what be wants upon a quartermaster or commissary already overwhelmed with business. I am surprised it had never been thought of until I brought it to the notice of the present Surgeon-General while we were at Yorktown. If I had had these officers on the Peninsula I could have fitted up and supplied our hospital ships and stationary hospitals with comparatively little trouble or delay. I could have kept the ambulance trains more in hand, could have known more about them, and could have taken much better care of them. The advantages of such an arrangement are too obvious to require to be urged upon a military man.
For each corps d’armée of which an army is composed a chief surgeon should be placed upon the staff of the commander of the corps. He should have an assistant and a clerk. If the corps is more than 25,000 strong, he should have two assistants. He should have also an acting assistant quartermaster and commissary. This officer will take charge of the ambulance and supply trains, and when temporary hospital arrangements are to be made for the corps he will provide the tents and buildings, and will see to the drawing and placing in position of the necessary subsistence. While we were on the Peninsula I knew in two instances the valuable time of a medical officer wasted in the effort to get from commissaries subsistence for which his patients were suffering, and for which he had an order from headquarters. This officer would take charge of the hospital train upon a march, see that the wagons were not misapplied, distribute them to the brigades and regiments upon their arrival in camp, muster, pay, and subsist the teamsters, forage the horses, &c.
The guard for the hospital train would be the Ambulance Corps if a regular ambulance corps is authorized, or the drilled hospital attendants if we are compelled to use them upon the plan adopted in Washington. In the latter case we might by this means hope to keep these men together. They could not very well be removed and their places supplied by uninstructed men or not at all, at the caprice of colonels.
The chief surgeon of the army should have on his staff one experienced medical officer of the army for each corps d’armée, to be kept constantly employed in sanitary inspections. It is in the field we want these officers, and where, in my view, their duties are all-important. No medical man of less than ten years military training is, in my opinion, competent to perform these duties in the field. Any intelligent physician can inspect the police of a city hospital. One inspector cannot do justice to more than 25,000 men. This I know from experience.
The chief surgeon of the army, the chief surgeon of the corps, and the inspectors should constitute a council of health, and should assemble weekly if practicable, examine the medical reports, the reports of the inspectors, &c., deliberate upon all matters pertaining to the health of the army, and submit through the chief surgeon to the commanding general the result of their deliberations.
Batteries having no regimental organization, or at least not acting  together as regiments, should have an adequate medical force. I should recommend one surgeon as administrative officer for each eight batteries, and one assistant surgeon for each battery. An army in the field must have its general supply train or transports for hospital supplies. Amedical purveyor or storekeeper will be in charge of these stores. To get supplies from the purveyor’s store to the troops I found very perplexing, both in Washington and on the Peninsula. Now, by having an assistant quartermaster attached to the chief surgeon of each corps, with the hospital train under his charge, this difficulty is at once obviated.
The hospital train for a large army should consist of two four-wheeled ambulances, four cacolets (or horse-litters), one ordinary baggage wagon for medicines, stores, tents, and cooking apparatus to each regiment. Instruments, medicines, and dressings for daily use should be transported in panniers or the hospital knapsacks. The reserve supplies in the baggage wagon should be packed in cases of uniform size, exactly fitted to the wagon-box, numbered, and the contents of each marked upon it. The French transport system is admirable, and could be readily adapted to our service.
I cannot close this report without expressing my appreciation of the conspicuous services of Surgs. J. F. Hammond, J. B. Brown, and J. J. Milhau, the medical directors of Sumner’s, Keyes’, and Heintzelman’s corps; Surg. R. H. Alexander, medical purveyor; Surg. A. K. Smith and assist. Surgs. E. McClellan and C. R. Greenleaf, my own aides. I think I am justified in asserting that there was no duty these others were called upon to perform that was not well and promptly done; that their zeal never faltered, their ability never failed. If my department was conducted to your satisfaction the efforts of these gentlemen contributed most essentially to that result. Among the volunteer medical officers, in my opinion Brigade Surgeons Lyman, Crosby, Baxter, Bently, and Dougherty deserve special notice for ability and efficiency.
I am, general, very respectfully, your obedient servant,
CHS. S. TRIPLER,
Surgeon, U. S. Army, Medical Director Army of the Potomac.
Maj. Gen. GEORGE B. MCCLELLAN,
U. S. Army, Commanding General Army of the Potomac.
Official Records of the Rebellion: Volume Eleven, Chapter 23, Part 1: Peninsular Campaign: Reports, pp.194-196
web page Rickard, J (25 October 2006), http://www.historyofwar.org/sources/acw/officialrecords/vol011chap023part1/00010_12.html