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.