Following the attack on Fort Sumter that occurred on April 12th 1861, Dr. Henry W. Bellows, the founder of the United States Sanitary Commission, met in New York city with a large group of influential women of the city who were concerned with the health and well being of the Union troops called upon to squash the southern rebellion. From the start the women of the relief agencies under the sanitary commission met with indifference and even some hostility from the army medical establishment. The army bureau felt that in due time the Commissions enthusiasm would wane and the Army Medical could proceed as they had in the past. Indifferent, lacking in organization skills. With the medical departments main endeavor, had been up to this time handling minor medical problems from the skirmishes with the Indians of the west. On June 9th 1861 Simon Cameron, Secretary of War authorized the appointment of the commission members. Lincoln signed the order on June 13 1861. By June 16th a general order went out to all medical officers of the army and volunteers to "render every facility for such objects to give the Commission admission when on visits of inspections, regimental and general. Afterwards, Camerons’ order was reaffirmed by Edward Stanton who succeeded him as Secretary of War.

Three days after Simon Cameron had signed the order establishing the Commission, Dr. Henry Bellows was elected president of the United States Sanitary Commission. He served on the commission from 1861 until 1878 the deactivated date for the commission. The board of the sanitary commission met once every 6 weeks in Washington. Later on they met quarterly, leaving day to day operations to Fredrick Olmsted. These quarterly meetings usually lasted 4 to 5 days. Eventually the day to day operation of the sanitary commission became so huge that standing committees were formed that met daily in New York. The Commission appointed a chief sanitary inspector for each division of the Union Army. The employees in the field were paid because it was felt that more efficient people could be recruited. Salaries ranged from $ 5000.00 annually for the general secretary, down to about $ 2.00 a day and subsistence for those in the relief services. On June 21 1861 a general appeal was sent out to the citizens of the north telling of the aims of the Commission and seeking their help. Following the Battle of Bull Run on July 18 1861,it became apparent to the surgeon general that there was a need for an overall plan to handle the sick and wounded. Soldiers wounded on the battlefield had been left to die of thirst or starvation, if not from there battle wounds. Other soldiers deserted the battle under the pretense of helping to remove the wounded. Several comrades would be required to carry a wounded soldier to the rear. These same comrades might encounter difficulty in finding there way back to the front.