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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 wrapped up its war relief operations in the fall of 1865. At that time it established an Historical Bureau to collect, arrange, and preserve its records, which would also serve as a documentary resource for planned publications on historical and scientific topics. Some special relief operations, such as the running of employment bureaus and homes for disabled soldiers and sailors, continued until early 1866. The USSC’s Army and Navy Claim Agency, which helped soldiers, sailors, and their family members to file pension and other claims with the government without charge, ceased accepting new claims as of January 1, 1866. Its agents continued to process existing applications until approximately 1870. The Statistical Bureau prepared monograph reports on its findings through 1868. Also during this period, USSC officers and former associates established the American Association for the Relief of the Misery of Battle Fields (1866-1870). By 1872, the USSC’s Historical Bureau and General Secretary had completed two arrangements of its records, which had been collected or submitted on a rolling basis. The Sanitary Commission remained relatively dormant until 1878, when its Standing Committee authorized a third and final arrangement of its records, and a complete statement of its financial accounts from 1861-1878. USSC President Henry W. Bellows officially brought its work to a close on January 7, 1879.

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 commission was named the United States Sanitary Commission and officers were elected from among its members. Reverend Henry W. Bellows, a Unitarian minister and vice-president of the Woman’s Central Association of Relief, served as president, with Alexander Dallas Bache serving as vice-president, and George Templeton Strong as treasurer. Frederick Law Olmsted was hired as general secretary and appointed a member of the Commission. 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 commissioners, who formed what was initially described as an executive board or legislative council, met on a quarterly basis throughout the war to review submitted reports and to set general policy. The board usually met in Washington, D.C. Once military actions began and sanitary and relief work spread across great geographical distances, the committee structure was gradually replaced by an executive administrative structure.

The demands of the war soon required more frequent decision-making. This led to the creation of the Standing Committee, which met on a nearly-daily basis in New York City where most of its members resided. The Standing Committee initially consisted of five commissioners who retained their position for the entire war: Henry W. Bellows, George Templeton Strong, William H. Van Buren, M.D., Cornelius R. Agnew, M.D., and Wolcott Gibbs. Charles J. Stillé of Philadelphia joined the Standing Committee in 1864. Their decisions were implemented and informed by the general secretary, who in turn worked with the associate secretary of the East (Eastern Department), based in Washington, D.C., and the associate secretary of the West (Western Department), based in Louisville, Kentucky. Van Buren, Agnew and Gibbs also formed the USSC’s Medical Committee. They directed inquiries and projects on medical, surgical, sanitary and other scientific topics, including the publication of professional papers during and after the war. Committee members also engaged in USSC efforts to modernize and reform the Army Medical Bureau in the early years of the war. USSC commissioner Elisha Harris, M.D., worked closely with them.

The general secretary and the associate secretary of the East were located at the USSC’s Washington headquarters at 244 F Street. In early September 1863, Olmsted resigned as general secretary, and was replaced by J. Foster Jenkins, who served in that position until the spring of 1865. The USSC implemented further executive restructuring in October 1863, following Olmsted’s departure.

John S. Newberry, M.D. was associate secretary of the West throughout the war. (The Western Department should not be confused with the Western Sanitary Commission, an independent organization that declined to join the USSC. Its headquarters was located in St. Louis, Missouri.) Associate secretaries were responsible for the general supervision of regional staff, agencies, supply depots, and relief services in their geographical territory. They made sure the supply needs of inspectors and relief agents serving with the Armies in the field were met, and often coordinated USSC operations at major battles. Louisville and Washington were also the location of the USSC’s two largest supply depots. Associate secretaries were supported by an assistant secretary and other staff. In the fall of 1863, a third associate secretary position was created for a chief of inspection (held by John H. Douglas), who set the responsibilities of inspectors and handled general matters of “inquiry and advice.” An additional assistant secretary was based at the USSC’s New York Office.

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. There were also branches located in London, England and Paris, France. Women’s branches such as the Woman’s Central Association of Relief, the New England Women’s Auxiliary Association and the Pennsylvania Women’s Branch worked closely with the USSC offices in their cities – the New York Office, the Philadelphia Agency, and the Executive Committee of Boston Associates. The term “branch” was sometimes used to refer to the collective activities of a city, such as the “Boston Branch.” The USSC in its entirety was essentially a federal system.

The USSC’s circulars, broadsides, pamphlets and publications such as the Sanitary Reporter (in the West) and the Sanitary Bulletin (in the East) were vitally important in keeping the public aware and supportive of its work. Canvassing agents traveled throughout the country giving lectures to promote the USSC and raise funds. The USSC published medical and surgical essays on topics such as scurvy, dysentery, and amputation for free distribution to military medical personnel. The USSC made use of photography during and after the war to support and document its work.

The collection of statistics was instrumental to the USSC’s work from its inception. USSC inspectors conducted camp and hospital inspections, reporting their findings according to specially prepared questionnaires. They also collected information on the physical condition and social background of volunteer soldiers. This information was submitted to the USSC’s Statistical Bureau which compiled abstracts from the data to make recommendations for sanitary policy and other studies. The Statistical Bureau was headed by first by E.B. Elliott, and later by Benjamin A. Gould. It reported to the general secretary and later worked closely with the chief of inspection. The scope of the USSC’s work grew and its structure evolved as the scale of the war increased. In addition to its promotion of preventative measures to support the health of the forces, USSC staff engaged in several types of complementary relief work. General relief addressed the supplementary supply needs of hospitals, camps, and troops (often referred to as "field relief" in war zones). Battlefield relief consisted of transporting and providing extra medical supplies at times of battle, caring for the wounded on the field and other tasks. Individual relief (supplies or other assistance) was offered according to a serviceman’s or civilian’s circumstances, at staff discretion. Often the lines between these categories blurred. Out of this work, and in addition to it, grew the USSC’s Field Relief Corps (1863), and the Auxiliary Relief Corps (1864), created to provide more flexibility and responsiveness to the needs of the Army, as the Army’s medical and quartermaster staff developed their own organizational standards. The USSC carried out its work with attention to Army protocols and discipline.

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.

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.

The post-war years of the USSC saw continued activity. Branches continued to tie up loose ends and to prepare their records for shipment to the USSC’s Historical Bureau. The Historical Bureau (1865-1868) was established in New York City to arrange, catalog, and preserve the records for future use by the public, and to aid in the preparation of several planned histories of the USSC’s war work. The Medical Committee, under the direction of Elisha Harris, M.D., collected documentation for histories of war-time medical, surgical, and sanitary practice, while others worked on histories of statistical, special relief, and other USSC activities. In 1867, upon the death of Alexander Dallas Bache, the Standing Committee elected Cornelius R. Agnew as Vice President. At the same time John S. Newberry was elected to the Standing Committee, joining the Medical Committee as well.

The USSC Army and Navy Claim Agency and the Protective War Claim agencies in New York and Philadelphia stopped accepting new claims as of January 1,1866, but continued working on pending cases and brought most work to a close by 1870. Their records were among the last to be received by the Sanitary Commission. Also during this period, USSC officers and former associates such as Henry W. Bellows and Frederick Law Olmsted established the American Association for the Relief of the Misery of Battle Fields (1866-1870) as the first American branch of the Comité International de Secours aux Militaires Blessés, later known as the Red Cross. The records of the Association are found in the records of the United States Sanitary Commission.

John S. Blatchford, general secretary from 1865, remained actively engaged through the early 1870s in supervising the collection and arrangement of records and the publication of USSC works, and handling any pending business under the direction of the Standing Committee, which held its final meeting in 1878. Henry W. Bellows, president of the USSC since 1861, officially brought its affairs to a close on 7 January 1879 with the formal transfer of its records to the Astor Library, where they had been stored since 1868.