Kitabı oku: «The Atlantic Monthly, Volume 10, No. 60, October, 1862», sayfa 14
WANT OF SANITARY PREPARATIONS FOR WAR
There are, and have been, faults—grievous, destructive, and costly faults—in all connected with armies, from the Governments at the head, down through all grades of officers, to the men in the ranks: they are faults of theory and faults of practice,—of plan in those who direct, and of self-management in those whose whole duty is to obey. The root of this is the failure to fully understand and count the cost, and to prepare to meet it as men generally do in the management of their common affairs. In civil life, when prudent men intend to effect any purpose by the aid of motive power, whether of water, steam, horse, or other kind, they carefully consider the means of generating that power, and the best and safest ways of applying and expending it. They include this in their plans, and make provision accordingly. Precisely determining the extent of the purpose they design to effect, and the amount of force that is and will be needed, they make their arrangements to provide or generate and maintain so much as long as they intend to do the work. During the whole process, they carefully guard and treasure it up and allow none to be wasted or applied to any other than the appointed purpose. But in the use and management of the vital machines, the human bodies, by which the purposes of war are to be accomplished, nations are less wise. There are few, perhaps no records of any Government, which, in creating, maintaining and operating with an army, has, at and during the same time, created and established the never-failing means of keeping the machinery of war in the best working order, by sustaining the health and force of the men in unfailing fulness.
War is carried on by a partnership between the Government and soldiers, to which the Government contributes money and directing skill, and assumes the responsibility of management, and the soldiers contribute their vital force. In the operation of this joint concern, both the money of the nation and the lives of the men are put at risk. Although, by the terms of the contract, the Government is presumed to expend its money and the soldiers' vital force to the extent that may be necessary to effect the objects of the association, it has no right to do this for any other purpose or on any other condition. It may send the men to battle, where they may lose in wounds or in death a part or all that they have contributed; but it has no right, by any negligence or folly on its own part or in its agents, to expend any of the soldiers' health or strength in hunger, nakedness, foul air, miasma, or disease. There is a received glory attached to wounds, and even to death, received in a struggle with the enemies of one's country, and this is offered as a part of the compensation to the warrior for the risk that he runs; but there is no glory in sickness or death from typhus, cholera, or dysentery, and no compensation of this kind comes to those who suffer or perish from these, in camp or military hospital.
DIFFERENCE BETWEEN CIVIL AND MILITARY LIFE
Military life, with the labors, exposures, and circumstances of war, differs widely from civil life. The social and domestic machinery of home spontaneously brings within the reach of families the things that are needful for their sustenance, comfortable for their enjoyment, and favorable to their health. But this self-acting machinery follows not the soldier through his campaigns. Everything he needs or enjoys is to be a matter of special thought, and obtained with a special effort and often with difficulty. Much that was very comfortable and salutary in civil life must be given up in the camp. The government is the purveyor for and the manager of the army; it undertakes to provide and care for, to sustain and nourish the men. But, with all its wisdom, power, and means, it is not equal to the thousand or thousands of housekeepers that cared and provided for these men when at home; and certainly it does not, and probably cannot, perform these domestic offices as well and as profitably for the soldiers as their natural providers did. Nevertheless, the Government is the sole provider for the army, and assumes the main responsibility of the physical condition of its members.
Starting with the very common belief that the human body has an indefinite power of endurance, or, if it suffer from disease, or fall in death, it is from causes beyond man's control,—seeing, also, that it is impossible to carry the common means of sustaining life into the camp, Governments seem willing to try the experiment of requiring their men to do the hard work of war without a certain, full supply of sustenance. They expect from the army the largest expenditure of force, but sometimes give it the smallest means and poorest conditions of recuperating it.
The business of war is not constant and permanent, like the pursuits of peace. It therefore comes to most managers as a new and unfamiliar work, to which they can bring little or no acquaintance from experience. They enter upon untried ground with imperfect knowledge of its responsibilities and dangers, and inadequate conceptions of the materials and powers with which they are to operate. They therefore make many and some very grave mistakes, every one of which, in its due proportion, is doubly paid for in drafts on the nation's treasury and on the soldiers' vital capital, neither of which is ever dishonored.
Military life is equally new to the soldier, for which none of his previous education or experience has fitted him. He has had his mother, wife, sister, or other housekeeper, trained and appointed for the purpose, to look after his nutrition, his clothing, his personal comfort, and, consequently, his health. These do not come without thought and labor. The domestic administration of the household and the care of its members require as much talent, intelligence, and discipline as any of the ordinary occupations of men. Throughout the civilized world, this responsibility and the labor necessary for its fulfilment absorb a large portion of the mental and physical power of women.
When the new recruit enters the army, he leaves all this care and protection behind, but finds no substitute, no compensation for his loss in his new position. The Government supposes either that this is all unnecessary, or that the man in arms has an inspired capacity or an instinctive aptitude for self-care as well as for labor, and that he can generate and sustain physical force as well as expend it. But he is no more fitted for this, by his previous training and habits, than his mother and wife are for making shoes or building houses by theirs. Nevertheless he is thrown upon his own resources to do what he may for himself. The army-regulations of the United States say, "Soldiers are expected to preserve, distribute, and cook their own subsistence"; and most other Governments require the same of their men. Washing, mending, sweeping, all manner of cleansing, arrangement and care of whatever pertains to clothing and housekeeping, come under the same law of prescription or necessity. The soldier must do these things, or they will be left undone. He who has never arranged, cared for, or cooked his own or any other food, who has never washed, mended, or swept, is expected to understand and required to do these for himself, or suffer the consequences of neglect.
The want of knowledge and training for these purposes makes the soldier a bad cook, as well as an indiscreet, negligent, and often a slovenly self-manager, and consequently his nutrition and his personal and domestic habits are neither so healthy nor so invigorating as those of men in civil life; and the Government neither thinks of this deficiency nor provides for it by furnishing instruction in regard to this new responsibility and these new duties, nor does it exercise a rigid watchfulness over his habits to compel them to be as good and as healthy as they may be.
MUCH SICKNESS DUE TO ERRORS OF GOVERNMENT
Whatever may be the excess of sickness and mortality among soldiers over those among civilians, it is manifest that a great portion is due to preventable causes; and it is equally manifest that a large part of these are owing to the negligence of the Government or its agents, the officers in command or the men themselves, in regard to encampments, tents, clothing, food, labors, exposures, etc.
The places of encampment are usually selected for strategic purposes, or military convenience, and the soldiers are exposed to the endemic influences, whatever they may be. In some localities these influences are perfectly salubrious; in others they are intensely destructive. Malaria and miasms offer to the unpractised eye of the military officer no perceptible signs of their presence. The camp is liable to be pitched and the men required to sleep in malarious spots, or on the damp earth, or over a wet subsoil, exposed to noisome and dangerous exhalations from which disease may arise. Pringle says, that, in 1798, the regiment which had 52 per cent, sick in two months, and 94 per cent, sick in one season, "were cantoned on marshes whence noxious exhalations emanated."51 "Another regiment encamped where meadows had been flowed all winter and just drained, and half the men became sick." Lord Wellington wrote, August 11, 1811, "Very recently, the officer commanding a brigade encamped in one of the most unwholesome situations, and every man of them is sick."52 One of our regiments encamped at Worcester, Massachusetts, on the Agricultural Society's grounds, where the upper soil was not dry and the subsoil was wet. The men slept in tents on the ground, consequently there were thirty to forty cases of disordered bowels a day. The surgeon caused the tents to be floored, and the disease was mitigated. The Eleventh Massachusetts Regiment were encamped on a wet soil at Budd's Ferry, in Maryland. In a week, thirty cases of fever appeared. Dr. Russell, the surgeon, ordered the camp to be removed to a dry field, and the tents to be floored with brush; no new cases of fever appeared afterward. Moltka says that "the Russian army which suffered so terribly and fatally in 1828 and 1829 was badly clothed and badly nourished, and in no way protected against the climate of the Danubian Provinces, and especially of Bulgaria, where the temperature varies from 58° in the day to 29° at night, and where the falling dew is like a fine and penetrating rain."53
Lord Wellington was a sagacious observer and a bold speaker. His despatches to his Government frequently mention, the errors of those who should provide for the army, and the consequent sufferings of the soldiers. November 14, 1809, he says, "In the English army of 30,000 men, 6,000 are sick." "Want of proper food increases sickness." "With nothing but water for drink, with meat, but no salt, and bread very rarely for a month, and no other food; consequently, few, if any, were not affected with dysentery." Again he writes, "Men cannot perform the labors of soldiers without food. Three of General Park's brigade died of famine yesterday, on their march; and above a hundred and fifty have fallen out from weakness, many of whom must have died from the same cause." August 9, 1809, he wrote to Lord Castlereagh, "No troops can serve to any good purpose, unless they are regularly fed. It is an error to suppose that a Spaniard, or any man or animal of any country, can make an exertion without food." In February, 1811, he wrote, "The Portuguese army of 43,000 or 44,000 men has about 9,000 sick, which is rather more than a fifth. This is caused by want of proper and regular food, and of money to purchase hospital-stores. If this be continued, the whole army will be down, or must be disbanded."
The British army in Spain suffered from want of clothing as well as of food. The Duke, who did not intend to be misunderstood, nor believe that this was without somebody's fault, wrote, November 3, 1810, to General Pane, "I wish it were in my power to give you well-clothed troops or hang those who ought to have given them clothing."
The diaries of the medical officers in the Crimean army, quoted in the "Medical and Surgical History" of that war, already referred to, are full of similar complaints, and these are supported by Dr. Lyons's "Pathological Report." One says, "Some of the camps were very injudiciously chosen." "The men were very much weakened," "unable to undergo any fatigue," even "to carry their knapsacks." "At Balaklava, they built their huts on a very unhealthy site." Sir John Hall, Inspector-General of Hospitals, referring to this, said, "I protested against it, in the strongest way I could, but without effect; and the consequence was that shortly after the men had spotted fever."54 Dr. Hanbury says: "November, 1854. Health of the army rapidly deteriorated from defective diet, harassing duties, hardships, privations, and exposures to the inclement season." "Cholera increased; cold, wet, innutritious and irritating diet produced dysentery, congestion and disorganization of the mucous membrane of the bowels, and scurvy." January, 1855, he says, "Fever and bowel affections indicated morbid action; scurvy and gangrene indicated privation and exposures."
The surgeon of the Thirty-Fourth Regiment writes: "November, 1854. Cholera broke out. It rained constantly. Troops had no other protection from the damp ground than a single wet blanket." "Without warm clothing, on short allowance of provisions, in want of fuel." "The sanitary condition of the regiment deteriorated rapidly: 56 per cent. of the men admitted to the hospital."
Forty-First Regiment, November and December. "No respite from severe duties; weather cold and wet; clothing ill-adapted for such climate and service; disease rapidly increased; 70 per cent. of the men in the hospital in two months."
Thirty-Third Regiment, December, 1854. "Cold and wet weather, coupled with insufficient food, fuel, and clothing, and severe and arduous duties, all combined to keep up the sickness; 48.8 per cent. admitted to the hospital in this month."
Twentieth Regiment. "The impoverished condition of the blood, dependent on long use of improper diet, exposure to wet and cold, and want of sufficient clothing and rest, had become evident." "Scurvy, diarrhoea, frost-bite, and ulceration of the feet followed."
First Regiment. "December, 1854. Scarcely a soldier in perfect health, from sleeping on damp ground, in wet clothing, and no change of dress; cooking the worst; field-hospital over-crowded." "January, 1855. Type of disease becoming more unequivocally the result of bad feeding, exposure, and other hardships."
Thirtieth Regiment. "Duties and employments extremely severe; exposure protracted; no means of personal cleanliness; clothing infested with vermin; since Nov. 14, short allowance of meat, and, on some days, of biscuit, sometimes no sugar, once no rice; food sometimes spoiled in cooking; tents leaked; floors and bedding wet; sanitary efficiency deteriorated in a decided manner."
These quotations are but samples of hundreds, perhaps thousands, of similar statements, showing the immediate connection between privations, exposures, and hardships, and depression of life and abundant disease.
Dr. Sutherland went through all the camps, and makes similar statements. "The damp, unventilated, and undrained huts, in some parts of the camp, produced consequences similar to those in cellar-dwellings at home,"—that is, typhus and typhoid diseases. "The half-buried huts of the Sardinian camp furnished a large proportion of fever cases among their occupants," "That beautiful village of Balaklava was allowed to become a hot-bed of pestilence, so that fever, dysentery, and cholera, in it and its vicinity and on the ships in the harbor, were abundant." "Filth, manure, offal, dead carcasses, had been allowed to accumulate to such an extent, that we found, on our arrival, in March, 1855, it would have required the labor of three hundred men to remove the local causes of disease before the warm weather set in."55 General Airey said: "The French General Canrobert came to me, complaining of the condition in which his men were. He said 'they were dying in the mud.'"56
Dr. Bryce, one of the army-surgeons in that war, says, in his book: "The British army was exhausted by overwork and the deficiency of everything that would sustain health and strength."
When the soldier, overcome by these morbific influences, became sick, and was taken to the hospital, he was still compelled to suffer, and often sank under, the privation of those comforts and means of restoration which the sick at home usually enjoy.
Dr. Sutherland says: "The hospitals at Scutari were magnificent buildings, apparently admirably adapted to their purpose; but, when carefully examined, they were found to be little better than pest-houses."57
Under direction of the Sanitary Commission, the hospitals were cleansed and ventilated, and the patients allowed more room. In the first three weeks of these improvements, the mortality from diseases fell to one-half; in the second three weeks, to one-third; in the third, to one-fifth; and in the fourth and fifth periods, to one-tenth of that which prevailed be before they were begun.58
The reform was carried through the whole army, camp and barracks, Government supplies, and soldiers' habits and exposures; and the mortality from diseases, which had been at the annual rate of 114 per cent. in January, and 83 per cent. in February, fell to 19 per cent. in April and May, 5 per cent. in the autumn, and 1.6 per cent. in the winter following.59
The exposures, privations, and sufferings of our own army in the last war with Great Britain, heart-rending even at this distance of time, were sufficient to account for much of the terrible sickness and mortality that prostrated and destroyed the men. They were at times in want of food, clothing, and tents; and yet, in the new and unsettled country, in the wilderness and forest, they performed great labors. "Long and unremitting exposures to wet, cold, and fatigue, with a diet which, under existing circumstances, could not prove nutritious, exhausted the vital principle, and diarrhoea and typhus fever supervened. The production of animal putrefaction and excrementitious materials were also sources of these diseases. Armies always accumulate these noxious principles about their encampments in a few days, when attention is not called to their daily removal."60 Feeble, and destitute of clothing and provisions, they invaded Canada at the end of the autumn in 1813. "During the whole of October and part of November, most of them were subjected to excessive fatigues, and exposed in open boats on the lake, when it rained almost every day." "On the 14th of November the weather became intensely cold, and remained so all winter. In addition to their great fatigue, most of them lost their extra clothing and blankets on their march and in the battle of the 11th. Even the sick had no covering but tents until January. Provisions were scarce, and of a bad quality. Under these circumstances, sickness and mortality were very great." "Nearly one-half of the army," 47 per cent., "were unfit for duty."61
"Through the following winter, the want of necessaries for the support of the enfeebled and wretched soldier was most severely felt. The poor subsistence which bread of the worst quality afforded was almost the only support which could be had for seven weeks." "The sickness, deaths, and distress at French Mills excited much alarm. This great mortality had obvious causes for its existence." "Predispositions to sickness, the effects of obvious causes, the comfortless condition of men exposed to cold, wanting the common necessaries of life to support them in their exhausted states." Dr. Lovell adds: "It was impossible for the sick to be restored with nothing to subsist upon except damaged bread."62 Among the causes of the abundant sickness, in March, along the Niagara frontier, given by the surgeons, were "severe duty during the inclement weather, exposure on the lake in open transports, bad bread made of damaged flour, either not nutritious or absolutely deleterious, bad water impregnated with the product of vegetable putrefaction, and the effluvia from materials of animal production with which the air was replete."63 "The array, in consequence of its stationary position, suffered from diseases aggravated by filth accumulated in its vicinity." "The clothing was not sufficient to protect the men on the northern frontier, and even this short allowance failed to reach them in due season."64 "The woollen garments have not been issued until the warm weather of summer commenced, when winter finds them either naked or clad in their summer dresses, perishing with cold."65
The camps were sometimes in malarious districts. "At Fort George and the vicinity, the troops were exposed to intense heat during the day and to cold and chilly atmosphere at night." "The diseases consequent to this exposure, typhus and intermittent fever, dysentery and diarrhoea," and "but little more than half of the men were fit for duty."66
Gen. Scott wrote from Mexico, February 14, 1848: "The army is also suffering from the want of necessary clothing. The new troops are as destitute as the others. They were first told that they should find abundant supplies at New Orleans, next at Vera Cruz, and finally here."67
There is ever a danger of the sensibilities and perceptive faculties becoming blunted by exposure to and familiarity with offensive effluvia. "The General repeatedly called the attention of the officers at Fort George to the filthy state and foul effluvia of their camp, but they perceived no offensive odor; their olfactories had lost their acuteness, and failed to warn them of the noisome gases that pervaded the atmosphere."68 If the officers fail of their duty as housekeepers to see that everything in the camp and tents is clean and healthy, the men fall into negligent habits, and become dirty and sick. It was the "total want of good police" that reduced the regiment already referred to from 900 to 200 fit for duty. On the other hand, "The regiment of artillery, always subject to correct discipline, with quarters and encampments always in the best state, and the men mostly neat and clean, suffered less by disease than any on the northern frontier. Their better health may be much imputed to cleanliness."69
Itch and lice, the natural progeny of negligence and uncleanness, often find their home in the army. Pringle, more than a hundred years ago, said that "itch was the most general distemper among soldiers." Personal and household vermin seem to have an instinctive apprehension of the homes that are prepared for them, and flock to the families and dwellings where washing and sweeping are not the paramount law and unfailing habit. They are found in the houses and on the bodies of the filthy and negligent everywhere. They especially delight in living with those who rarely change their body-linen and bedding. They were carried into and established themselves in the new barracks of Camp Cameron in Cambridge, Massachusetts; but they are never found in the Boston House of Correction, which receives its recruits from the filthiest dens of iniquity, because the energetic master enforces thorough cleansing on every new-comer, and continues it so long as he remains.
The camps and police of the present Union army, though better than the average of others and far above some, are yet not in as healthy condition as they might be. The Report of the Sanitary Commission to the Secretary of War, December, 1861, says: "Of the camps inspected, 5 per cent, were in admirable order, 45 per cent, fairly clean and well policed. The condition of 26 per cent, was negligent and slovenly, and that of 21 per cent, decidedly bad, filthy, and dangerous." 70 The same Report adds: "On the whole, a very marked and gratifying improvement has occurred during the summer." And that improvement has been going on ever since. Yet the description of a camp at Grafton, Virginia, in March, shows that there a very bad and dangerous state of things existed at that time, and "one-seventh of the regiment was sick and unfit for duty"; but the bold and clear report of Dr. Hammond of the United States Army produced a decided and favorable change, and "the regiment has now less than the average amount of sickness." 71
The hospitals of the army are mostly buildings erected for other purposes, and not fitted for their present use; and the sudden influx of a large military population, with its usual amount of sickness, has often crowded these receptacles of the suffering soldiers. For want of experience on the part of the officers, surgeons, nurses, and men, in the management of such establishments, they are sometimes in very bad and unhealthy condition. In Cumberland, Maryland, fifteen buildings were occupied by about five hundred patients. These buildings had been warehouses, hotels, etc., with few or none of the conveniences for the sick. They were densely crowded; in some the men were "lying on the floor as thickly as they could be packed." One room with 960 feet of air contained four patients. Dr. Hammond's description of the eighty-three rooms and the condition of the patients in them seems to justify the terms he frequently uses. "Halls very dirty." "Rooms dismal and badly ventilated." "Utmost confusion appears to exist about each hospital; consequently, duties are neglected, and a state of the most disgusting want of cleanliness exists." 72 Happily, the wise and generous suggestions of the surgeon were carried out, and with the best results. This hospital was an exception; but it shows the need of intelligent watchfulness on the part of the Government.
