The only attachment authorized to the medal was the silver citation star, awarded for meritorious or heroic conduct. The silver citation star was the predecessor of the Silver Star and was awarded to eleven soldiers between 1865 and 1891. As originally issued, the medal had a solid red ribbon. In 1917 two black stripes were added to the ribbon. The reason for this change is that the ribbon of the Indian Campaign Medal was easily confused with the ribbon of the French Legion of Honor which also had a solid red ribbon.