Medl Director E. S. Gaillard,

I have the honor to report that on the 2^nd inst I inspected the prison hospitals in the city of Richmond 1^st at Castle Thunder (Cary near 19^th St.). I found about 70 patients in a garret room 40 ft. by 80 of low pitch & very imperfect ventilation. The capacity of the room (from these causes) was 32 patients. There was no bath room, linen room or Hosl Clothing. The beds and bedding were filthy & the clothing & persons of the patients in the same conditions. Most of the patients were stragglers & privates with irregular furloughs arrested on charge of desertion –

The same rations are served to the sick as to other patients & no Hospital fund exists or has been accounted for.

No medl officer was found, but I am informed that Contract physician Hammond attends daily. The acting Hospl Steward is an officer of the prison detailed for the purpose by Capt. G. W. Alexander A.P.M.

The patients will shortly be removed to the Libby Prison Hosl now being whitewashed preparatory to their removal.

I recommend that they be removed to Genl Hosp no. 10 when facilities exist for isolating them from the other patients; & that one of the floors of that institution have one or more sentinels to effect this purpose, & to prevent the escape of prisoners. The majority of them are not criminals, probably none of them have been tried & there is no reason why they should be compounded with the prisoners of war in Libby Prison.

2^nd I next visited the Hospitals attached to the prison for "prisoners of war." In the Libby Prison there are 3 floors each 40 by 70 ft. The building is owned by L. Libby & the amt. of rent is not known.

Palmer & Atkinsons late tobacco factory (in the vicinity) of the same size & capacity is also used as a hospital. The pitch is not too low & the ventilation by windows is sufficient exept on 1^st floor of Palmer’s Hosl where the machinery still remains & circulation is obstructed by an overhanging shed.

With strict attention to cleanliness of person & bedding & good order 60 patients might be accomodated on each floor. 360 to the 2 buildings. The two buildings constitute one Hosl under charge of Act. Asst. Surgeon Barham, P.A.C.S – Contract Physician Coggin also attends & visits the wards 2er daily. Several U.S. Medl Officers assist in attending to the sick & wounded – but no Confederate surgeon was present. There was an apothecary & clerk, but they could not exhibit to me the Hospl Records (if such exist) ___ register, cash books, order & letter book, muster roll – monthly & quarterly reports & copies of registration – A quarterly report of sick & wounded & a quarterly return of property for the quarter ending Sept. 30^th is now due in which the Surgeon in charge of each hospl will account for the medl instrument, Hospl stores, furniture, & receipted for by him & to them I refer you.

There is no bath room in either building. The privies communicate with the wards & are badly constructed & in bad condition. The bedding, persons of patients, and floors are filthy & disgusting & there is a general absence of order.

The kitchen is cleanly & well managed – the rations well cooked & savory & the cooks less in no. than allowed by the regulations.

No nurses are employed or detailed but volunteers from the prisoners. Two meals are given daily at regular times, no difference being made in the rations of the sick & well & none commuted for Hosl fund as vegetables & anti-scurbutics (?) have been bought by the A. M. of the prisons on special requisition by the surgeon in charge.

Private Barke 18^th Va Regt. Detailed for duty in subsistence department was act. Hospl Steward by order of Capt. Warner Commissary of prisons. No gas was used in either hospital building. I requested by letter a report of the Surg. in ch. On some subjects I could not otherwise get information concerning, & will append his reply to this report. Seventy officers & men of the City Batn are constantly on duty as guard & sentinels.

The inmates of the Hosls. Are our disarmed and frequently disabled enemies, a respect for the opinion of foreign nations, humanity, chivalry & christianity & even policy would make it eminently desirable that

1. That additional means to promote health & prevent contagion be observed. (Regulation 27)
2. That regulations necessary for the good order & comfort of a Military Hosl. be composed, conspicuously displayed, & rigidly enforced. (Regulation 28)
3. That a Confederate Medl officer be required to be constantly in attendance at this Hosl. & that unless expressly desired in individual cases all aid from the Enemy’s Surgeons be dispensed with, for to my knowledge they have repeatedly made it an excuse for accusing our government with violation of the agreement not to hold or consider Surgeons as Prisoners.
4. That a sufficient corps of Hosl attendants be organized, employed or detailed.
5. And to attain all these objects more certainly that the Hosl be separated (?) as much as possible from the prison proper, established as one of the Gen. Hosls of this City & placed under charge of a Medl officer with the rank of Surgeon who has demonstrated his executive talent by his experience in organizing & conducting a Military Hospital.

Very Respectfully, Your Obdt Servt,

Surgeon Wm. A. Carrington P.A.C.S.