river. I have given preparatory orders for the establishment of receiving hospitals on the Orange and Alexandria Railroad.
Culpeper Court-House will be one of the first to be organized, provided, of course, the army continues its movement in that direction. Gordonsville will be the most eligible position for a purveying depot, and Surgeon [W. H.] Geddings has received the necessary instructions. The Central and Orange Railroads will be our direct line of communication.
In the event of the movement in anticipation, I respectfully ask that ambulance trains (railroad trains) be established and equipped on that line of road similarly to those in use upon the Fredericksburg road, with medical officers, nurses, and all conveniences necessary for the comfort and safe conveyance of the sick and wounded to general hospitals.
It is the intention to send no more sick to Richmond, if suitable accommodations can be provided for them elsewhere. The difficulty of connecting at Hanover Junction with the Central train going west, together with the impracticability of keeping the sick at that point, has rendered it impossible to direct their conveyance from Richmond.
Gordonsville will be the point of distribution, and the hospital department at that post should be prepared for the temporary accommodation of several thousand sick and wounded, particularly if an engagement takes place on the Upper Rappahannock or along the railroad to Alexandria.
I am not informed as to the extent of hospital accommodations at Gordonsville, and do not believe it would be advisable to establish a large permanent hospital there; yet the necessities of the case may demand temporary preparations at that point of great magnitude. Charlottesville, Staunton, Lynchburg, Danville, Farmville, &c., I think might afford ample accommodation. I inclose a circular* which I have just issued. It is simply a condensation of orders previously issued from your office and from mine.
I find it necessary to reiterate orders every few months, or they become obsolete, or rather they are disregarded. Sixteen of the severely wounded, who could not be removed far from the battle-field of Chancellorsville, will be sent to Richmond to-morrow. Thirty will remain at Ellwood hospital, yet in no condition to be moved. I regret to report to you that some of the stumps from amputations will require supplementary operations. Ordinarily the amputations were well done, and I can only attribute the necessity for further surgical interference to the application of improper dressing or no dressing at all, and to sloughing. However, it may be that the bad appearance of these stumps could not have been avoided. Among those still remaining in the hospital are quite a number of fractures of the femur, some in the upper third, reported as doing well.
If I go to Culpeper, I will take the hospitals in my route, and report to you more particularly their condition. Skirmishing with the enemy continues, and I am unable to inform you what the general has in contemplation. I will telegraph to you, if possible, should anything of great importance transpire.
I am, very respectfully, your obedient servant,
Surgeon and Medical Director, Army of Northern Virginia.