Kitabı oku: «The Atlantic Monthly, Volume 10, No. 60, October, 1862», sayfa 12

SICKNESS AND MORTALITY OF THE ARMY IN WAR

Thus far the sickness and mortality of the army in time of peace only has been considered. The experience of war tells a more painful story of the dangers of the men engaged in it. Sir John Pringle states, that, in the British armies that were sent to the Low Countries and Germany, in the years 1743 to 1747, a great amount of sickness and mortality prevailed. He says, that, besides those who were suffering from wounds, "at some periods more than one-fifth of the army were in the hospitals." "One regiment had over one-half of its men sick." "In July and August, 1743, one-half of the army had the dysentery." "In 1747, four battalions," of 715 men each, "at South Beveland and Walcheren, both in field and in quarters, were so very sickly, that, at the height of the epidemic, some of these corps had but one hundred men fit for duty; six-sevenths of their numbers were sick."¹² "At the end of the campaign the Royal Battalion had but four men who had not been ill." And "when these corps went into winter-quarters, their sick, in proportion to their men fit for duty, were nearly as four to one."¹³ In 1748, dysentery prevailed. "In one regiment of 500 men, 150 were sick at the end of five weeks; 200 were sick after two months; and at the end of the campaign, they had in all but thirty who had never been ill." "In Johnson's regiment sometimes one-half were sick; and in the Scotch Fusileers 300 were ill at one time."¹⁴

The British army in Egypt, in 1801, had from 103 to 261 and an average of 182 sick in each thousand; and the French army had an average of 125 in 1,000, or one-eighth of the whole, on the sick-list.¹⁵

In July, 1809, the British Government sent another army, of 39,219 men, to the Netherlands. They were stationed at Walcheren, which was the principal seat of the sickness and suffering of their predecessors, sixty or seventy years before. Fever and dysentery attacked this second army as they had the first, and with a similar virulence and destructiveness. In two months after landing,

In ninety-seven days 12,867 were sent home sick; and on the 22d of October there were only 4,000 effective men left fit for duty out of this army of about 40,000 healthy men, who had left England within less than four months. On the 1st of February of the next year, there were 11,513 on the sick-list, and 15,570 had been lost or disabled. Between January 1st and June of the same year, (1810,) 36,500 were admitted to the hospitals, and 8,000, or more than 20 per cent., died, which is equal to an annual rate of 48 per cent, mortality.

The British army in Spain and Portugal suffered greatly through the Peninsular War, from 1808 to 1814. During the whole of that period, there was a constant average of 209 per 1,000 on the sick-list, and the proportion was sometimes swelled to 330 per 1,000. Through the forty-one months ending May 25th, 1814, with an average of 61,511 men, there was an average of 13,815 in the hospitals, which is 22.5 per cent.; of these only one-fifteenth, or 1.5 per cent. of the whole army, were laid up on account of injuries in battle, and 21 per cent. were disabled by diseases. From these causes 24,930 died, which is an annual average of 7,296, or a rate of 11.8 per cent, mortality.¹⁶

No better authority can be adduced, for the condition of men engaged in the actual service of war, than Lord Wellington. On the 14th of November, 1809, he wrote from his army in Spain to Lord Liverpool, then at the head of the British Government,—"In all times and places the sick-list of the army amounts to ten per cent of all."¹⁷ He seemed to consider this the lowest attainable rate of sickness, and he hoped to be able to reduce that of his own army to it: this is more than five times as great as the rate of sickness among male civilians of the army-ages. The sickness in Lord Wellington's army, at the moment of writing this despatch, was fifteen per cent., or seven and a half times as great as that at home.

In the same Peninsular War, there was of the sick in the French army a constant average of 136 per 1,000 in Spain, and 146 per 1,000 in Portugal. Mr. Edmonds says, that, just before the Battle of Talavera, the French army consisted of 275,000 men, of whom 61,000, or 22.2 per cent., were sick.¹⁸ Lord Wellington wrote, Sept. 19, 1809, that the French army of 225,000 men had 30,000 to 40,000 sick, which is 13.3 to 17.7 per cent. The French army in Portugal had at one time 64 per 1,000, and at another 235 per 1,000, and an average of 146 per 1,000, in the hospitals through the war.

The British army that fought the Battle of Waterloo, in 1815, had an average of 60,992 men, through the campaign of four months, June to September; of these, there was an average of 7,909, or 12.9 per cent., in the hospitals.¹⁹

The British legion that went to Spain in 1836 consisted of 7,000 men. Of these, 5,000, or 71 per cent., were admitted into the hospitals in three and a half months, and 1,223 died in six months. This is equal to an annual rate of almost two and a half, 2.44, attacks for each man, and of 34.9 per cent. mortality.²⁰

"Of 115,000 Russians who invaded Turkey in 1828 and 1829, only 10,000 or 15,000 ever repassed the Pruth. The rest died there of intermittent fevers, dysenteries, and plague." "From May, 1828, to February, 1829, 210,108 patients were admitted into the general and regimental hospitals." "In October, 1828, 20,000 entered the general hospitals." "The sickness was very fatal." "More than a quarter of the fever-patients died." "5,509 entered the hospitals, and of these, 3,959 died in August, 1829, and only 614 ultimately recovered." "At Brailow the plague attacked 1,200 and destroyed 774." "Dysentery was equally fatal." "In the march across the Balkan, 1,000 men died of diarrhoea, fever, and scurvy." "In Bulgaria, during July, 37,000 men were taken sick." "At Adrianople a vast barrack was taken for a hospital, and in three days 1,616 patients were admitted. On the first of September there were 3,666, and on the 15th, 4,646 patients in the house. This was one-quarter of all the disposable force at that station." "In October, 1,300 died of dysentery; and at the end of the month there were 4,700 in the hospitals." "In the whole army the loss to the Russians in the year 1829 was at least 60,000 men."²¹

CRIMEAN WAR

In 1854, twenty-five years after this fatal experience of the Russian army in Bulgaria, the British Government sent an army to the same province, where the men were exposed to the same diseases and suffered a similar depreciation of vital force in sickness and death. For two years and more they struggled with these destructive influences in their own camps, in Bulgaria and the Crimea, with the usual result of such exposures in waste of life. From April 10, 1854, to June 30, 1856, 82,901 British soldiers were sent to the Black Sea and its coasts; and through these twenty-six and two-thirds months the British army had an average of 34,559 men engaged in that "War in the East" with Russia. From these there were furnished to the general and regimental, the stationary and movable hospitals 218,952 cases: 24,084, or 11 per cent, of these patients were wounded or injured in battle, and 194,868, or 89 per cent, suffered from the diseases of the camp. This is equal to an annual average of two and a half attacks of sickness for each man. The published reports give an analysis of only 162,123 of these cases of disease. Of these, 110,673, or 68 per cent., were of the zymotic class,—fevers, dysenteries, scurvy, etc., which are generally supposed to be due to exposure and privation, and other causes which are subject to human control. During the two years ending with March, 1856, 16,224 died of diseases, of which 14,476 were of the zymotic or preventable class, 2,755 were killed in battle, and 2,019 died of wounds and injuries received in battle. The annual rate of mortality, from all diseases, was 23 per cent; from zymotic diseases, 21 per cent.; from battle, 6.9 per cent. The rate of sickness and mortality varied exceedingly in different months. In April, May, and June, 1854, the deaths were at the annual rate of 8.7 per 1,000; in July, 159 per 1,000; in August and September, 310 per 1,000; in December, this rate again rose and reached 679 per 1,000; and in January, 1855, owing to the great exposures, hardships, and privations in the siege, and the very imperfect means of sustenance and protection, the mortality increased to the enormous rate of 1,142 per 1,000, so that, if it had continued unabated, it would have destroyed the whole army in ten and a half months.²²

AMERICAN ARMY, 1812 TO 1814

We need not go abroad to find proofs of the waste of life in military camps. Our own army, in the war with Great Britain in 1812–14, suffered, as the European armies have done, by sickness and death, far beyond men in civil occupations. There are no comprehensive reports, published by the Government, of the sanitary condition and history of the army on the Northern frontier during that war. But the partial and fragmentary statements of Dr. Mann, in his "Medical Sketches," and the occasional and apparently incidental allusions to the diseases and deaths by the commanding officers, in their letters and despatches to the Secretary of War, show that sickness was sometimes fearfully prevalent and fatal among our soldiers. Dr. Mann says: "One regiment on the frontier, at one time, counted 900 strong, but was reduced, by a total want of a good police, to less than 200 fit for duty." "At one period more than 340 were in the hospitals, and, in addition to this, a large number were reported sick in camp."²³ "The aggregate of the army at Fort George and its dependencies was about 5,000. From an estimate of the number sick in the general and regimental hospitals, it was my persuasion that but little more than half of the army was capable of duty, at one period, during the summer months"²⁴ of 1813. "During the month of August more than one-third of the soldiers were on the sick-reports."²⁵ Dr. Mann quotes Dr. Lovell, another army-surgeon, who says, in the autumn of 1813: "A morning report, now before me, gives 75 sick, out of a corps of 160. The several regiments of the army, in their reports, exhibit a proportional number unfit for duty."²⁶ Dr. Mann states that "the troops at Burlington, Vt., in the winter of 1812–13, did not number over 1,600, and the deaths did not exceed 200, from the last of November to the last of February."²⁷ But Dr. Gallup says: "The whole number of deaths is said to be not less than 700 to 800 in four months," and "the number of soldiers stationed at this encampment [Burlington] was about 2,500 to 2,800."²⁸ According to Dr. Mann's statement, the mortality was at the annual rate of 50 per cent.; and according to that of Dr. Gallup, it was at the rate of 75 to 96 per cent. This is nearly equal to the severest mortality in the Crimea.

General William H. Harrison, writing to the Secretary of War from the borders of Lake Erie, Aug. 29, 1813, says: "You can form some estimate of the deadly effects of the immense body of stagnant water with which the vicinity of the lake abounds, from the state of the troops at Sandusky. Upwards of 90 are this morning reported sick, out of about 220." This is a rate of over 40 per cent. "Those at Fort Meigs are not much better."²⁹

General Wilkinson wrote from Fort George, Sept. 16, 1813: "We count, on paper, 4,600, and could show 3,400 combatants"; that is, 25 per cent, and more are sick. "The enemy, from the best information we have, have about 3,000 on paper, of whom 1,400," or 46.6 per cent., "are sick."³⁰

MEXICAN WAR

There was a similar waste of life among our troops in the Mexican War. There is no published record of the number of the sick, nor of their diseases. But the letters of General Scott and General Taylor to the Secretary of War show that the loss of effective force in our army was at times very great by sickness in that war.

General Scott wrote:—

"Puebla, July 25, 1847.

"May 30, the number of sick here was 1,017, of effectives 5,820."

"Since the arrival of General Pillow, we have effectives (rank and file) 8,061, sick 2,215, beside 87 officers under the latter head."³¹

Again:—

"Mexico, Dec. 5,1847.

"The force at Chapultepec fit for duty is only about 6,000, rank and file; the number of sick, exclusive of officers, being 2,041."³²

According to these statements, the proportions of the sick were 17.4 to 27.4 and 24.7 per cent of all in these corps at the times specified.

General Taylor wrote:—

"Camp near Monterey, July 27,1847.

"Great sickness and mortality have prevailed among the volunteer troops in front of Saltillo."³³

August 10th, he said, that "nearly 23 per cent, of the force present was disabled by disease."

The official reports show only the number that died, but make no distinction as to causes of death, except to separate the deaths from wounds received in battle from those from other causes.

During that war, 100,454 men were sent to Mexico from the United States. They were enlisted for various periods, but served, on an average, thirteen months and one day each, making a total of 109,104 years of military service rendered by our soldiers in that war. The total loss of these men was 1,549 killed in battle or died of wounds, 10,986 died from diseases, making 12,535 deaths. Besides these, 12,252 were discharged for disability. The mortality from disease was almost equal to the annual rate of 11 per cent., which is about ten times as great as that of men in ordinary civil life at home.

SICKNESS IN THE PRESENT UNION ARMY

There are not as yet, and for a long time there cannot be, any full Government reports of the amount and kind of sickness in the present army of the United States. But the excellent reports of the inquiries of the Sanitary Commission give much important and trustworthy information in respect to these matters. Most of the encampments of all the corps have been examined by their inspectors; and their returns show, that the average number sick, during the seven months ending with February last, was, among the troops who were recruited in New England 74.6, among those from the Middle States 56.6, and, during six months ending with January, among those from the Western States 104.3, in 1,000 men. From an examination of 217 regiments, during two months ending the middle of February, the rate of sickness among the troops in the Eastern Sanitary Department was 74, in the Central Department, Western Virginia and Ohio, 90, and in the Western, 107, in 1,000 men. The average of all these regiments was 90 in 1,000. The highest rate in Eastern Virginia was 281 per 1,000, in the Fifth Vermont; and the lowest, 9, in the Seventh Massachusetts. In the Central Department the highest was 260, in the Forty-First Ohio; and the lowest, 17, in the Sixth Ohio. In the Western Department the highest was 340, in the Forty-Second Illinois; and the lowest, 15, in the Thirty-Sixth Illinois.

On the 22d of February, the number of men sick in each 1,000, in the several divisions of the Army of the Potomac, was ascertained to be,—

Keyes's,                  30.3

Sedgwick's,               32.0

Hooker's,                 43.7

McCall's                  44.4

Banks's,                  45.0

Porter's,                 46.4

Blenker's,                47.7

McDowell's,               48.2

Heintzelman's             49.0

Franklin's                54.1

Dix's,                    71.8

United States Regulars,   76.0

Sumner's,                 77.5

Smiths's,                 81.6

Casey's                   87.6³⁴

Probably there has been more sickness in all the armies, as they have gone farther southward and the warm season has advanced. This would naturally be expected, and the fear is strengthened by the occasional reports in the newspapers. Still, taking the trustworthy reports herein given, it is manifest that our Union army is one of the healthiest on record; and yet their rate of sickness is from three to five times as great as that of civilians of their own ages at home. Unquestionably, this better condition of our men is due to the better intelligence of the age and of our people,—especially in respect to the dangers of the field and the necessity of proper provision on the part of the Government and of self-care on the part of the men,—to the wisdom, labors, and comprehensive watchfulness of the Sanitary Commission, and to the universal sympathy of the men and women of the land, who have given their souls, their hands, and their money to the work of lessening the discomforts and alleviating the sufferings of the Army of Freedom.

OTHER LIGHTER AND UNRECORDED SICKNESS

The records and reports of the sickness in the army do not include all the depreciations and curtailments of life and strength among the soldiers, nor all the losses of effective force which the Government suffers through them, on account of disease and debility. These records contain, at best, only such ailments as are of sufficient importance to come under the observation of the surgeon. But there are manifold lighter physical disturbances, which, though they neither prostrate the patient, nor even cause him to go to the hospital, yet none the less certainly unfit him for labor and duty. Of the regiment referred to by Dr. Mann, and already adduced in this article, in which 700 were unable to attend to duty, 340 were in the hospital under the surgeon's care, and 360 were ill in camp. It is probable that a similar, though smaller, discrepancy often exists between the surgeon's records and the absentees from parades, guard-duty, etc.

It is improbable, and even impossible, that complete records and reports should always be made of all who are sick and unfit for duty, or even of all who come under the surgeon's care. Sir John Hall, principal Medical Officer of the British army in the Crimea, says that there were "218,952 admissions into hospital."³⁵ "The general return, showing the primary admissions into the hospitals of the army in the East, from the 10th April, 1854, to the 30th June, 1856, gives only 162,123 cases of all kinds."³⁶ But another Government Report states the admissions to be 162,073.³⁷ Miss Nightingale says, "There was, at first, no system of registration for general hospitals, for all were burdened with work beyond their strength."³⁸ Dr. Mann says, that, in the War of 1812, "no sick-records were found in the hospital at Burlington," one of the largest depositories of the sick then in the country. "The hospital-records on the Niagara were under no order."³⁹ It could hardly have been otherwise. The regimental hospitals then, as frequently must be the case in war, were merely extemporized shelters, not conveniences. They were churches, houses, barns, shops, sheds, or any building that happened to be within reach, or huts, cabins, or tents suddenly created for the purpose. In these all the surgeons' time, energy, and resources were expended in making their patients comfortable, in defending them from cold and storm, or from suffering in their crowded rooms or shanties. They were obliged to devote all their strength to taking care of the present. They could take little account of the past, and were often unable to make any record for the future. They could not do this for those under their own immediate eye in the hospital; much less could they do it for those who remained in their tents, and needed little or no medical attention, but only rest. Moreover, the exposures and labors of the campaign sometimes diminish the number and force of the surgeons as well as of the men, and reduce their strength at the very moment when the greatest demand is made for their exertions. Dr. Mann says, "The sick in the hospital were between six and seven hundred, and there were only three surgeons present for duty." "Of seven surgeons attached to the hospital department, one died, three were absent by reason of indisposition, and the other three were sick."⁴⁰ Fifty-four surgeons died in the Russian army in Turkey in the summer of 1828. "At Brailow, the pestilence spared neither surgeons nor nurses."⁴¹ Sir John Hall says, "The medical officers got sick, a great number went away, and we were embarrassed." "Thirty per cent. were sometimes sick and absent" from their posts in the Crimea.⁴² Seventy surgeons died in the French army in the same war. It is not reasonable, then, to suppose that all or nearly all the cases of sickness, whether in hospital or in camp, can be recorded, especially at times when they are the most abundant.

Nor do the cases of sickness of every sort, grave and light, recorded and unrecorded, include all the depressions of vital energy and all the suspensions and loss of effective force in the army. Whenever any general cause of depression weighs upon a body of men, as fatigue, cold, storm, privation of food, or malaria, it vitiates the power of all, in various degrees and with various results; the weak and susceptible are sickened, and all lose some force and are less able to labor and attend to duty. No account is taken, none can be taken, of this discount of the general force of the army; yet it is none the less a loss of strength, and an impediment to the execution of the purposes of the Government.