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.
Crowded Quarters.
It is to be expected that the soldier's dwelling, his tent and barrack,
will be reduced to the lowest endurable dimensions in the campaign, for
there is a seeming necessity for this economy of room; but in garrisons,
stations, and cantonments, and even in encampments in, time of peace,
this necessity ceases, and there is a power at least, if not a
disposition, to give a more liberal supply of house--and lodging-room to
the army, and a better opportunity for rest and recuperation. In common
dwelling-houses, under favorable circumstances, each sleeper is usually
allowed from 500 to 1,000 cubic feet of space: a chamber fifteen or
sixteen feet square and eight feet high, with 1,800 to 2,048 feet of
air, is considered a good lodging-room for two persons. This gives 900
to 1,024 feet of air for each. The prudent always have some means of
admitting fresh air, or some way for the foul air to escape, by an open
window, or an opening into the chimney, or both. If such a room be
occupied by three lodgers, it is crowded, and the air becomes
perceptibly foul in the night. Sometimes more are allowed to sleep
within a room of this size; but it is a matter of necessity, or of lower
sensibility, and is not healthy. They do not find sufficient oxygen to
purify or decarbonize their blood through the night; they consequently
are not refreshed, nor invigorated and fully prepared for the labors of
the following day.
No nation has made this liberal and proper provision of lodging-room for
its sleeping soldiers in peace or in war, in garrison or in the
encampment.
The British army-regulations formerly allowed 400 to 500 cubic feet for
each soldier in barracks in temperate climates, and 480 to 600 in
tropical climates. The new regulations allow 600 feet in temperate
climates.[73] But the 356 barracks at the various military stations in
Great Britain and Ireland give the soldiers much less breathing-room
than the more recent regulations require. Of these,
3 allow 100 to 200 feet for each man.
27 " 200 to 300 " "
123 " 300 to 400 " "
125 " 400 to 500 " "
59 " 500 to 600 " "
19 " 600 to 800 " " [74]
The French Government allows 444 feet for each infantry soldier, and 518
feet for each man in the cavalry.
The British soldiers, at these home-stations, have less breathing-space
and are subject to more foulness of air than the people of England in
civil life; and the natural consequence was discovered by the
investigation of the Military Sanitary Commission, that consumption and
other diseases of the lungs were much more prevalent and fatal among
these soldiers, who were originally possessed of perfect constitutions
and health, than among the people at large. The mortality from
consumption and other diseases of the respiratory organs, among the
Household Cavalry, the Queen's Body-Guard, and the most perfectly formed
men in the kingdom, was 25 per cent., among the Dragoon Guards 59 per
cent., among the Infantry of the Line 115 per cent., and among the
Foot-Guards 172 per cent. greater than it was among the males of the
same ages throughout England and Wales, and consumption was the
prevailing cause of death.
The huts of the British army are of various sizes, holding from
twenty-five to seventy-two men, and allowing from 146 to 165 cubic feet
for each. The "Portsmouth hut" is the favorite. It is twenty-seven feet
long, fifteen feet wide, walls six feet, and ridge twelve feet high.
This holds twenty-five men, and allows 146 feet of air to each man. All
these huts have windows, and most of them are ventilated through
openings under the eaves or just below the ridge, and some through both.
Some of the temporary barracks erected at Newport News, Virginia, are
one hundred feet long, twenty-two feet wide, and twelve and a half feet
high at the ridge, and accommodate seventy-six men, giving each 360 feet
of air. Some are larger, and allow more space; others allow less; in one
each man has only 169 feet of breathing-space. All these buildings are
well supplied with windows, which serve also for ventilators.
In forts, the garrisons are usually more liberally supplied with
sleeping-room, yet, on emergencies, they are densely crowded. At Fort
Warren, in Boston Harbor, two regiments were temporarily stationed, in
the summer of 1861. There was one large barrack divided into some large
and many small rooms, and there was the usual supply of rooms in the
casemates. There was one range of rooms in the barrack, each sixteen
feet six inches long, seven feet four inches high, and varying in width
from ten feet eight inches to thirteen feet two inches. In most of these
rooms, including two of the narrowest, twelve men slept. They had from
105 to 119 feet of air for each one. There was a large window in each
room, which was opened at night, and might have served for healthy
ventilation, except that there was an accumulation of disgusting filth
within a few feet of the building, on that side, sending forth offensive
and noisome effluvia, and rendering it doubtful which was the most
disagreeable and dangerous, the foul air within or the foul atmosphere
without. In two of the casemate-rooms, holding sixty and seventy-five
men respectively, each man had 144 and 180 feet of air. At Fort
Independence, in the same harbor, a battalion was stationed, and slept
in thirteen casemate-rooms, where the men had from 150 to 297 feet of
air. All the casemate-rooms, being in the thick walls, and covered with
earth, in both forts, were cold and damp, and many of them were kept
comfortable only by fires, even in June.
The ten new barracks at Camp Cameron, in Cambridge, when full, according
to the plan, give each soldier 202 feet of air for respiration; but in
August last, when densely filled, as some of them were, the proportion
of air for each man was reduced to 120 feet. The doors and windows were
left open at night, however, and obviated in some degree the evil
effects of the crowding.