Orders customarily went to the lowest bidders, with a careful review in Washington of all prices named in contracts. The inspection of material was an important phase of the work. This inspection was handled through the New York Medical Supply Depot, which called in as assistants the United States Board of Customs Appraisers at New York City. That corps of men had had long years of experience in inspecting and determining the value of surgical supplies, as most of these supplies in the past had come through the customhouse from foreign countries. The inspection of drugs was handled by the Medical Department's laboratories, the Army Medical School, and by the Bureau of Standards, which rendered valuable assistance in examining and testing samples. In addition the Medical Department maintained a corps of inspectors to travel from one factory to another, keeping in close touch with the progress and assisting in procuring raw materials and expediting deliveries.

The medical supplies were divided under the following classifications:

The New York depot was intrusted with the purchase of miscellaneous hospital equipment and dental and X-ray supplies. The St. Louis depot purchased the veterinary supplies, and the field medical supply depot at Washington purchased the laboratory and field supplies. The motor ambulance supply depot, established at Louisville, Ky., purchased ambulances and ambulance spare parts. Appreciating the necessity for a certain amount of cooperation where the purchase of conflicting articles by the various depots was concerned, the general purchasing office of the Medical Department was organized at Washington. This purchasing office bought all surgical dressings, surgical instruments, and medicines and such items as were used in the field, post, veterinary, and dental stations.

In connection with the production of surgical instruments in this country it was necessary for the Medical Department to educate in the manufacture of these instruments certain concerns which had been engaged in the production of similar devices. Men skilled in the manufacture of instruments, with long years of experience, were sent to these factories to work out with the forces there satisfactory processes. It was necessary to recruit toolmakers, jewelers, and cutlery manufacturers in order to build up a sufficient supply of forged and finished instruments.

Surgical needles, for instance, had never been made in this country, but had all been obtained in England. As a war measure the British Government placed this item on its list of restricted exports. After long and continued effort the general purchasing office developed American sources of supply of needles with remarkable success.

In one month we shipped 65 tons of surgical instruments to France. A few of the principal instruments, quantities purchased, and the prices paid were as follows:

Average cost, each.
1,301,476 hæmostatic forceps$1.04
284,600 tissue forceps.59
348,500 minor operating knives.57
225,000 probes.047
309,548 surgical scissors.741
2,102 general operating cases159.55
3,400 small operating cases45.30
10,000 instrument cases for officers' belts5.28
300,000 enlisted men's belt cases1.35

Each general operating case contains more than 50 instruments and the small operating case more than 30 instruments, and in these two items alone are more than 207,000 forgings, practically all handwork.

The quantity of surgical dressings used in peace times was relatively small, so that the sources for supplying this material had to be increased enormously. To do this the Government went out into the cotton goods industry and induced such concerns as curtain makers and manufacturers of waists and white goods to make bandages for surgical uses. The Government obtained the raw material, gray gauze, and turned it over to the various manufacturers for bleaching, cutting, sterilizing, and packing in the necessary cartons.