_Hospital, Carthage, December 13._—I should have written to you sooner had I not fallen ill, being confined to bed, and generally weak. . . . It verily pains me to see what goes on every day in this hospital, which I selected for special observations. In the first place, the services, medical, pharmaceutical, and administrative, are perfectly independent of each other. The duties of the medical men are, of course, confined to writing prescriptions for food and drugs, and the druggists execute the orders as to the latter without the chief of the medical staff having the slightest wish to say a word to them. The administrative officer is the supreme manager of the nurses, and also supplies the provisions and superintends the _materiel_ and distribution of food. Something may be contrary to the interests of the patients; the food may be badly cooked, the hours of the meals irregular; through negligence or incompetency, the steward may have omitted to make certain purchases prescribed by the doctor and indispensable to some patient; the attendants may neglect or not perform different little duties often of immense importance in particular circumstances; yet the doctor cannot make a reflection on the steward. This official is perfectly independent; he is generally a man of limited experience and education, who had hitherto been a petty military officer, as in the case of our large hospitals, and only enjoys the rank of captain, whereas the chief doctor is assimilated to that of colonel. The doctor’s only recourse, when the service is perfectly intolerable, is to the commissariat officer, who is placed above all three services. Here, at Carthage, as it happens, the administrative service is conducted in a deplorable manner. The attendants shamefully neglect their duties. Patients often remain for a whole day without receiving their medicine; they are often made to swallow it all at once. A convalescent from typhoid fever procured, nobody knows how, supplementary victuals, which he concealed under his mattress, and died of indigestion. Another needed help to move from his bed; the attendant was away; he was obliged to go alone; he fell, and I found him lying on the sand, for most of the patients are under tents, without boards or mats, a point to which I shall revert. “Can the service in time of war be as good as in time of peace?” is the attendant’s reply to a remonstrance. At what a war; and at Carthage, too! The chief medical man complains, let us say to the commissariat officer. If the latter says anything to the steward, which does not necessarily follow, the latter is furious, and thenceforth he is at daggers drawn with the chief doctor. All the attendants of course side with the steward, as they are involved in the blame. Every opportunity is taken of giving annoyance to the doctor, and in the end the sufferer again is the unfortunate patient, whom the attendants, stewards, and commissariat officer all