Kitabı oku: «The Atlantic Monthly, Volume 10, No. 60, October, 1862», sayfa 11

SANITARY CONDITION OF THE ARMY

The power and efficiency of an army consist in the amount of the power and efficiency of its elements, in the health, strength, and energy of its members. No army can be strong, however numerous its soldiers, if they are weak; nor is it completely strong, unless every member is in full vigor. The weakness of any part, however small, diminishes, to that extent, the force of the whole; and the increase of power in any part adds so much to the total strength.

In order, then, to have a strong and effective army, it is necessary not only to have a sufficient number of men, but that each one of these should have in himself the greatest amount of force, the fullest health and energy the human body can present.

This is usually regarded in the original creation of an army. The soldiers are picked men. None but those of perfect form, complete in all their organization and functions, and free from every defect or disease, are intended to be admitted. The general community, in civil life, includes not only the strong and healthy, but also the defective, the weak, and the sick, the blind, the halt, the consumptive, the rheumatic, the immature in childhood, and the exhausted and decrepit in age.

In the enlistment of recruits, the candidates for the army are rigidly examined, and none are admitted except such as appear to be mentally and physically sound and perfect. Hence, many who offer their services to the Government are rejected, and sometimes the proportion accepted is very small.

In Great Britain and Ireland, during the twenty years from 1832 to 1851 inclusive, 305,897 applied for admission into the British army. Of these, 97,457, or 32 per cent., were rejected, and only 208,440, or 68 per cent., were accepted.²

In France, during thirteen years, 1831 to 1843 inclusive, 2,280,540 were offered for examination as candidates for the army. Of these, 182,664, being too short, though perhaps otherwise in possession of all the requisites of health, were not examined, leaving 2,097,876, who were considered as candidates for examination. Of these, 680,560, or 32.5 per cent, were rejected on account of physical unfitness, and only 1,417,316, or 67.5 per cent., were allowed to join the army.³

The men who ordinarily offer for the American army, in time of peace, are of still inferior grade, as to health and strength. In the year 1852, at the several recruiting-stations, 16,114 presented themselves for enlistment, and 10,945, or 67.9 per cent., were rejected, for reasons not connected with health:—

All of these may have been in good health.

Of the remainder, 5,169, who were subjects of further inquiry, 2,443 were rejected for reasons connected with their physical or mental condition:—

Only 2,726 were accepted, being 52.7 per cent, of those who were examined, and less than 17 per cent., or about one-sixth, of all who offered themselves as candidates for the army, in that year.⁴

In time of peace, the character of the men who desire to become soldiers differs with the degree of public prosperity. When business is good, most men obtain employment in the more desirable and profitable avocations of civil life. Then a larger proportion of those who are willing to enter the army are unfitted, by their habits or their health, for the occupations of peace, and go to the rendezvous only as a last resort, to obtain their bread. But when business falters, a larger and a better class are thrown out of work, and are glad to enter the service of the country by bearing arms. The year 1852 was one of prosperity, and affords, therefore, no indication of the class and character of men who are willing to enlist in the average years. The Government Reports state that in some other years 6,383 were accepted and 3,617 rejected out of 10,000 that offered to enlist. But in time of war, when the country is endangered, and men have a higher motive for entering its service than mere employment and wages, those of a better class both as to character and health flock to the army; and in the present war, the army is composed, in great degree, of men of the highest personal character and social position, who leave the most desirable and lucrative employments to serve their country as soldiers.

As, then, the army excludes, or intends to exclude, from its ranks all the defective, weak, and sick, it begins with a much higher average of health and vigor, a greater power of action, of endurance, and of resisting the causes of disease, than the mass of men of the same ages in civil life. It is composed of men in the fulness of strength and efficiency. This is the vital machinery with which Governments propose to do their martial work; and the amount of vital force which belongs to these living machines, severally and collectively, is the capital with which they intend to accomplish their purposes. Every wise Government begins the business of war with a good capital of life, a large quantity of vital force in its army. So far they do well; but more is necessary. This complete and fitting preparation alone is not sufficient to carry on the martial process through weeks and months of labor and privation. Not only must the living machinery of bone and flesh be well selected, but its force must be sustained, it must be kept in the most effective condition and in the best and most available working order. For this there are two established conditions, that admit of no variation nor neglect: first, a sufficient supply of suitable nutriment, and faithful regard to all the laws of health; and, second, the due appropriation of the vital force that is thus from day to day created.

A due supply of appropriate food and of pure air, sufficient protection and cleansing of the surface, moderate labor and refreshing rest, are the necessary conditions of health, and cannot be disregarded, in the least degree, without a loss of force. The privation of even a single meal, or the use of food that is hard of digestion or innutritious, and the loss of any of the needful sleep, are followed by a corresponding loss of effective power, as surely as the slackened fire in the furnace is followed by lessened steam and power in the engine.

Whosoever, then, wishes to sustain his own forces or those of his laborers with the least cost, and use them with the greatest effect, must take Nature on her own terms. It is vain to try to evade or alter her conditions. The Kingdom of Heaven is not divided against itself. It makes no compromises, not even for the necessities of nations. It will not consent that any one, even the least, of its laws shall be set aside, to advance any other, however important. Each single law stands by itself, and exacts complete obedience to its own requirements: it gives its own rewards and inflicts its own punishments. The stomach will not digest tough and hard or old salted meats, or heavy bread, without demanding and receiving a great and perhaps an almost exhausting proportion of the nervous energies. The nutritive organs will not create vigorous muscles and effective limbs, unless the blood is constantly and appropriately recruited. The lungs will not decarbonize and purify the blood with foul air, that has been breathed over and over and lost its oxygen. However noble or holy the purpose for which human power is to be used, it will not be created, except according to the established conditions. The strength of the warrior in battle cannot be sustained, except in the appointed way, even though the fate of all humanity depend on his exertions.

Nature keeps an exact account with all her children, and gives power in proportion to their fulfilment of her conditions. She measures out and sustains vital force according to the kind and fitness of the raw material provided for her. When we deal liberally with her, she deals liberally with us. For everything we give to her she makes a just return. The stomach, the nutrient arteries, the lungs, have no love, no patriotism, no pity; but they are perfectly honest. The healthy digestive organs will extract and pay over to the blood-vessels just so much of the nutritive elements as the food we eat contains in an extractible form, and no more; and for this purpose they will demand and take just so much of the nervous energy as may be needed. The nutrient arteries will convert into living flesh just so much of the nutritive elements as the digestive organs give them, and no more. The lungs will send out from the body as many of the atoms of exhausted and dead flesh as the oxygen we give them will convert into carbonic acid and water, and this is all they can do. In these matters, the vital organs are as honest and as faithful as the boiler, that gives forth steam in the exact ratio of the heat which the burning fuel evolves and the fitness of the water that is supplied to it; and neither can be persuaded to do otherwise. The living machine of bone and flesh and the dead machine of iron prepare their forces according to the means they have, not according to the ulterior purpose to which those forces are to be applied. They do this alike for all. They do it as well for the sinner as for the saint,—as well for the traitorous Secessionist striving to destroy his country as for the patriot endeavoring to sustain it.

In neither case is it a matter of will, but of necessity. The amount of power to be generated in both living and dead machines is simply a question of quality and quantity of provision for the purpose. So much food, air, protection given produce so much strength. A proposition to reduce the amount of either of these necessarily involves the proposition to reduce the available force. Whoever determines to eat or give his men less or poorer food, or impure air, practically determines to do less work. In all this management of the human body, we are sure to get what we pay for, and we are equally sure not to get what we do not pay for.

All Governments have tried, and are now, in various degrees, trying, the experiment of privation in their armies. The soldier cannot carry with him the usual means and comforts of home. He must give these up the moment he enters the martial ranks, and reduce his apparatus of living to the smallest possible quantity. He must generally limit himself to a portable house, kitchen, cooking-apparatus, and wardrobe, and to an entire privation of furniture, and sometimes submit to a complete destitution of everything except the provision he may carry in his haversack and the blanket he can carry on his back. When stationary, he commonly sleeps in barracks; but he spends most of his time in the field and sleeps in tents. Occasionally he is compelled to sleep in the open air, without any covering but his blanket, and to cook in an extemporized kitchen, which he may make of a few stones piled together or of a hole in the earth, with only a kettle, that he carries on his back, for cooking-apparatus. In all cases and conditions, whether in fort or in field, in barrack, tent, or open air, he is limited to the smallest artificial habitation, the least amount of furniture and conveniences, the cheapest and most compact food, and the rudest cookery. He is, therefore, never so well protected against the elements, nor, when sleeping under cover, so well supplied with air for respiration, as he is at home. Moreover, when lodging abroad, he cannot take his choice of places; he is liable, from the necessities of war, to encamp in wet and malarious spots, and to be exposed to chills and miasms of unhealthy districts. He is necessarily exposed to weather of every kind,—to cold, to rains, to storms; and when wet, he has not the means of warming himself, nor of drying or changing his clothing. His life, though under martial discipline, is irregular. At times, he has to undergo severe and protracted labors, forced marches, and the violent and long-continued struggles of combat; at other times, he has not exercise sufficient for health. His food is irregularly served. He is sometimes short of provisions, and compelled to pass whole days in abstinence or on shore allowance. Occasionally he cannot obtain even water to drink, through hours of thirsty toil. No Government nor managers of war have ever yet been able to make exact and unfailing provision for the wants and necessities of their armies, as men usually do for themselves and their families at home.

SUPPOSED DANGERS TO THE SOLDIER

From the earliest recorded periods of the world, men have gone forth to war, for the purpose of destroying or overcoming their enemies, and with the chance of being themselves destroyed or overthrown. Public authorities have generally taken account of the number of their own men who have been wounded and killed in battle, and of the casualties in the opposing armies. Gunpowder and steel, and the manifold weapons, instruments, and means of destruction in the hands of the enemy are commonly considered as the principal, if not the only sources of danger to the soldier, and ground of anxiety to his friends; and the nation reckons its losses in war by the number of those who were wounded and killed in battle. But the suffering and waste of life, apart from the combat, the sickness, the depreciation of vital force, the withering of constitutional energy, and the mortality in camp and fortress, in barrack, tent, and hospital, have not usually been the subjects of such careful observation, nor the grounds of fear to the soldier and of anxiety to those who are interested in his safety. Consequently, until within the present century, comparatively little attention has been given to the dangers that hang over the army out of the battle-field, and but little provision has been made, by the combatants or their rulers, to obviate or relieve them. No Government in former times, and few in later years, have taken and published complete accounts of the diseases of their armies, and of the deaths that followed in consequence. Some such records have been made and printed, but these are mostly fragmentary and partial, and on the authority of individuals, officers, surgeons, scholars, and philanthropists.

It must not be forgotten that the army is originally composed of picked men, while the general community includes not only the imperfect, diseased, and weak that belong to itself, but also those who are rejected from the army. If, then, the conditions, circumstances, and habits of both were equally favorable, there would be less sickness and a lower rate of mortality among the soldiers than among men of the same ages at home. But if in the army there should be found more sickness and death than in the community at home, or even an equal amount, it is manifestly chargeable to the presence of more deteriorating and destructive influences in the military than in civil life.

SICKNESS AND MORTALITY IN CIVIL LIFE

The amount of sickness among the people at home is not generally recognized, still less is it carefully measured and recorded. But the experience and calculations of the Friendly Societies of Great Britain, and of other associations for Health-Assurance there and elsewhere, afford sufficient data for determining the proportion of time lost in sickness by men of various ages. These Friendly Societies are composed mainly of men of the working-classes, from which most of the soldiers of the British army are drawn.

According to the calculations and tables of Mr. Ansel, in his work on "Friendly Societies," the men of the army-ages, from 20 to 40, in the working-classes, lose, on an average, five days and six-tenths of a day by sickness in each year, which will make one and a half per cent, of the males of this age and class constantly sick. Mr. Neison's calculations and tables, in his "Contributions to Vital Statistics," make this average somewhat over seven days' yearly sickness, and one and ninety-two hundredths of one per cent, constantly sick. These were the bases of the rates adopted by the Health-Assurance companies in New England, and their experience shows that the amount of sickness in these Northern States is about the same as, if not somewhat greater than, that in Great Britain, among any definite number of men.

The rate of mortality is more easily ascertained, and is generally calculated and determined in civilized nations. This rate, among all classes of males, between 20 and 40 years old, in England and Wales, is .92 per cent.: that is, 92 will die out of 10,000 men of these ages, on an average, in each year; but in the healthiest districts the rate is only 77 in 10,000. The mortality among the males of Massachusetts, of the same ages, according to Mr. Elliott's calculations, is 1.11 per cent, or 111 in 10,000. This maybe safely assumed as the rate of mortality in all New England. That of the Southern States is somewhat greater.

These rates of sickness and death—one and a half or one and ninety-two hundredths per cent, constantly sick, and seventy-seven to one hundred and eleven dying, in each year, among ten thousand living—may be considered as the proportion of males, of the army-ages, that should be constantly taken away from active labor and business by illness, and that should be annually lost by death. Whether at home, amidst the usually favorable circumstances and the average comforts, or in the army, under privation and exposure, men of these ages may be presumed to be necessarily subject to this amount, at least, of loss of vital force and life. And these rates may be adopted as the standard of comparison of the sanitary influences of civil and military life.

SICKNESS AND MORTALITY OF THE ARMY IN PEACE

Soldiers are subject to different influences and exposures, and their waste and loss of life differ, in peace and war. In peace they are mostly stationary, at posts, forts, and in cantonments. They generally live in barracks, with fixed habits and sufficient means of subsistence. They have their regular supplies of food and clothing and labor, and are protected from the elements, heat, cold, and storms. They are seldom or never subjected to privation or excessive fatigue. But in war they are in the field, and sleep in tents which are generally too full and often densely crowded. Sometimes they sleep in huts, and occasionally in the open air. They are liable to exposures, hardships, and privations, to uncertain supplies of food and bad cookery.

The report of the commission appointed by the British Government to inquire into the sanitary condition, of the army shows a remarkable and unexpected degree of mortality among the troops stationed at home under the most favorable circumstances, as well as among those abroad. The Foot-Guards are the very élite of the whole army; they are the most perfect of the faultless in form and in health. They are the pets of the Government and the people. They are stationed at London and Windsor, and lodged in magnificent barracks, apparently ample for their accommodation. They are clothed and fed with extraordinary care, and are supposed to have every means of health. And yet their record shows a sad difference between their rate of mortality and that of men of the same ages in civil life. A similar excess of mortality was found to exist among all the home-army, which includes many thousand soldiers, stationed in various towns and places throughout the kingdom.

The following table exhibits the annual mortality in these classes.⁵

Through the fifteen years from 1839 to 1853 inclusive, the annual mortality of all the army, excepting the artillery, engineers, and West India and colonial corps, was 330 among 10,000 living; while that among the same number of males of the army-ages, in all England and Wales, was 92, and in the healthiest districts only 77.⁶

There is no official account at hand of the general mortality in the Russian army on the peace-establishment; yet, according to Boudin, in one portion, consisting of 192,834 men, 144,352 had been sick, and 7,541, or 38 per 1,000, died in one year.⁷

The Prussian army, with an average of 150,582 men, lost by death, during the ten years 1829 to 1838, 1,975 in each year, which is at the rate of 13 per 1,000 living.⁸

The mortality of the Piedmontese army, from 1834 to 1843 inclusive, was 158 in 10,000, while that of the males at home was 92 in the same number living.

From 1775 to 1791, seventeen years, the mortality among the cavalry was 181, and among the infantry 349, out of 10,000 living; but in the ten years from 1834 to 1843 these rates were only 108 and 215.⁹

Colored troops are employed by the British Government in all their colonies and possessions in tropical climates. The mortality of these soldiers is known, and also that of the colored male civilians in the East Indies and in the West-India Islands and South-American Provinces. In four of these, the rate of mortality is higher among the male slaves than among the colored soldiers; but in all the others, this rate is higher in the army. In all the West-Indian and South-American possessions of Great Britain, the average rate of deaths is 25 per cent, greater among the black troops than among the black males of all ages on the plantations and in the towns. The soldiers are of the healthier ages, 20 to 40, but the civilians include both the young and the old: if these could be excluded, and the comparison made between soldiers and laborers of the same ages, the difference in favor of civil pursuits would appear much greater.

Throughout the world, where the armies of Great Britain are stationed or serve, the death-rate is greater among the troops than among civilians of the same races and ages, except among the colored troops in Tobago, Montserrat, Antigua, and Granada in America, and among the Sepoys in the East Indies.¹⁰

In the army of the United States, during the period from 1840 to 1854, not including the two years of the Mexican War, there was an average of 9,278 men, or an aggregate of 120,622 years of service, equal to so many men serving one year. Among these and during this period, there were 342,107 cases of sickness reported by the surgeons, and 3,416 deaths from disease, showing a rate of mortality of 2.83 per cent., or two and a half times as great as that among the males of Massachusetts of the army-ages, and three times as great as that in England and Wales. The attacks of sickness average almost three for each man in each year. This is manifestly more than that which falls upon men of these ages at home.¹¹