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7

Bureau Refugees, Freedmen and A. Lands.
Office Chief Medical Officer State Va
Richmond Va May 11" 1866.

Circular.
Instructions were issued sometime since, that no medical services, should by ordered by any officer of the Bureau R.F. and A. Lands, except from Medical Officer of the Bureau, unless in cases of extreme necessity,- and that, if the necessity is likely to exist for more than a few days, report of the same, shall immediately be made to the Chief Medical Officer Bureau RF & AL. State Va. and the continuance of the service shall be subject to the approval or disapproval of this officer. These instructions have not been followed in all cases, which makes it necessary to again to say,- that hereafter, where they are not regarded, accounts for services rendered will not be approved by the Chief  Medical Officer, or paid by the Bureau.

Attention is called to the fact that the charges of Private Physicians who [[strikethrough]]se[[/strikethrough]] have been employed in these cases by officers of the Bureau, are in most cases, unreasonable. It cannot be expected by Physicians, that the Bureau will pay for visits to these indigent persons, who should be provided for by the 

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