DISEASE
If the rules of health set forth in the foregoing chapter are carefully
observed, the soldier will be doing the best he can to keep his body
fit. He will be building up a reserve of strength that will stand
him in good stead should the germs of disease find entrance into his
body. But there are times when, in spite of all our precautions,
these little microbes get the upper hand, and a long struggle against
them begins. The disease that has been responsible for the death of
armies of soldiers is ENTERIC or TYPHOID fever. During the campaign
in South Africa the British lost more men through the ravages of this
disease than through bullets and shells. But during the present war
there have been comparatively few cases of enteric, and the number
that have proved fatal is very small. For this result we have to
thank the medical profession that has given so much study and care
to the perfection of a method of combating this disease. The secret
has been found to lie in the inoculation of the soldier with small
doses of the disease itself till he becomes comparatively immune to
it. Inoculation was not made compulsory in the first armies that were
raised in England after war broke out, but it was made compulsory for
men who desired to become members of the British Expeditionary Force
in France. Most men gladly accepted this medical boon and subjected
themselves to this simple and painless operation. But there were
others who objected, sometimes through fear of the pain, and sometimes
through what they termed "conscientious objections." Anti-Inoculation
Societies got busy and spread their wretched literature throughout the
camps and made men thoroughly afraid, both of the operation and of its
results. To meet this the War Office issued through the papers and by
pamphlets, information from the medical authorities as to the wonderful
results that had already been achieved. They were able to prove beyond
all dispute, that of the men who caught the infection in France,
practically all of those who had been inoculated recovered--their
cases being light--while those who had not been inoculated became easy
victims to the disease. As the war has progressed these figures have
been amplified till now there can be no question that the use of
"Inoculation" has made this dread disease a thing to be feared less
than the measles.
[Illustration: FIGURE 9:
Finished trench showing parapet and parados; firing step of earth;
flooring; and shelter dugout under parados.]
Officers adopted different methods in counteracting the teaching of
those who tried to keep the soldiers from submitting. Some of them
argued with the men and told them of the wonderful results that had
been achieved. Others warned their men that they would be left behind
when the battalion went to France. For my own part I adopted the method
of sending for the medical men whose business it was to administer
the "dose." When they were all prepared I marched in my men from some
light fatigue work in which they had been engaged, told them to take
off their coats and roll up their sleeves, and three at a time they
appeared before the waiting surgeons. The business was over in no time.
I marched them off to a place where I could talk to them and then
acquainted them with the advantages of inoculation. The announcement
of forty-eight hours' freedom from drill for the whole company to
let their arms limber up put the few that were disgruntled into good
spirits again, and I was able to report to the O. C. that 100 per cent
of my men were willing to be inoculated--and had been inoculated! So
little did any of them suffer from its effects that they readily lined
up in ten days time when they were to receive the second dose. At
intervals of two or three months in France the operation was repeated
and I never had a single man on the sick list from enteric!
Now, while inoculation is excellent and should be insisted on in all
armies, both for the sake of the individual soldier and of those who
associate with him, every possible precaution should be taken by the
soldier even after this has been done. All water for drinking should
be looked upon with suspicion. Never take any chances for the sake
of getting a hasty drink. Many communities have water supplies that
are admirable and when military operations are carried on there, the
difficulties disappear. On the other hand many places have the most
abominable water supply systems. Where we were in France, the country
was very flat, and consequently the drainage poor. The buildings that
housed the human beings and the cattle and pigs on the farms were as a
rule all built around a "midden" into which flowed all the refuse. In
many cases the family water supply, a well, was dug within three feet
of this cesspool, so that the drainage from the latter was almost sure
to reach the former. This is "asking for" enteric, and some men fell
victims to it before they could be made to realise the danger. The best
rule to follow, as we all soon learned, was to get our drinking water
exclusively from the army water wagons, for there the water had been
treated and the danger lessened. At times we could not get to the water
carts and a certain degree of risk had to be run.
[Illustration: FIGURE 10:
Machine gun position with heavy overhead cover.]
Not only with water has the greatest care to be taken, but also with
food. Flies are notorious carriers of disease, and consequently
soldiers must see to it that no food is left uncovered. Nor should
food ever be placed near latrines or any place where there is decaying
matter.
With universal inoculation, and with a careful following of these
simple rules laid down, the ancient scourge of the army loses much
of its terror. The task of combating it lies mainly with the medical
and sanitary staff, though the common soldier must also play his part
of carefulness. Some men carried small sterilisers with them. This
practice is not to be recommended for it is very difficult to keep
these little utensils clean, and then they themselves become harmful.
Tabloid sterilisers I have found to be effective in an emergency.
Those who have followed the history of the war will remember how the
Serbian Army was threatened with extinction through the deadly disease
called TYPHUS. There is no doubt that the army and most of the civil
population would have been wiped out had it not been for the timely
assistance that that brave little nation received from medical men and
women throughout the world, notably America. Many of these brave souls
made the final great sacrifice in their endeavour to stamp out this
disease. Then again its horrors have been more recently brought to our
notice through the revelations of the conditions at Wittenberg Camp
in Germany. The story that Captain Vidal and Major Priestly, Officers
of the Royal Army Medical Corps, had to tell of their living death in
that awful internment camp, brought home to the British people and
then to the world, the frightfulness of that disease, as well as the
inhumanity of certain German medical officials. Fortunately, typhus has
been little known in Western Europe, and it is possible that soldiers
in this country will never know its ravages. But all the same it is
as well to be prepared for it, and to know the methods of preventing
its outbreak. It is a disease that is carried by flees and lice and
consequently the most that can be said in a work of this kind is to
recommend the greatest pains in the removal of these creatures from
the body should they ever take up their residence there. I refer the
reader to the chapter on "Vermin" for methods of combating "Lice."
DYSENTERY, ENTERITIS, and COLITIS. These names are applied to various
kinds and grades of stomach troubles, between which it is difficult for
the common soldier to differentiate, and which show themselves with
most distressing effects. They come, usually, from drinking bad water
or eating bad food. Even with the greatest care that the Commissariat
could take, there were occasions when food unfit for human consumption
was served to the troops. In the trenches it was not to be wondered at
that we were stricken with these diseases, for the flies that infested
the trenches and lived on the dead bodies there, favoured us with many
visits at food time and poisoned the latter for us. There is no way
that I know of to prevent it, and the sufferer will be well advised to
report to the medical officer for skilled treatment. Cases of dysentery
were not very frequent in France, but they were in Gallipoli where the
food supply left much to be desired.
TETANUS is a disease that is brought about by infection which enters
the system through a wound. In the early part of the war it occurred
only too frequently till, in this case also, the skill of the medical
profession provided us with a serum to combat it. The universal
practice now is to inoculate with anti-tetanic serum just as soon as
possible after a wound has been received. By this means tetanus, like
enteric, is rapidly ceasing to be regarded as a menace.
I have no intention of exhausting the whole category of diseases to
which man--and therefore the soldier--is heir, but simply to touch upon
those that are most likely to occur in a campaign. The foregoing list
includes, I believe, all the most likely, but to them I should like to
add these two--SMALLPOX and CHOLERA. To deal first with smallpox, we
can say, fortunately, that it is rare. This is due in large part to the
almost universal provision of vaccination, which should be insisted
upon in an army. Cholera is of rare occurrence, and nothing can be done
to ward it off except to follow carefully the ordinary rules of health
and sanitation. Should it, unfortunately, break out, the army must
place itself unreservedly in the hands of medical authorities who are
especially qualified to deal with it.
There is one other disease that has made its effects felt on almost
every army, and which it has been found impossible to thoroughly
eliminate. The hands of those who would lessen its influence are to a
great extent tied, because in the past, the only method that has been
permissible to eliminate venereal disease has been what I shall call
"the Moral method"--the appeal to morality and the intelligence of the
individual soldier. We have used this excellent and praiseworthy method
for generations, but it has never been found capable of eradicating the
evil. Some other means, from an army point of view, has obviously to be
resorted to. But even to discuss the matter, one runs the risk of being
ruled out of court by those who will admit none but the aforementioned
"moral argument."
When the first Expeditionary Force went to France, the late Lord
Kitchener, then Secretary of State for War, issued an appeal to the
men, in which he besought them to be on their guard against two of
the evils that lessen the efficiency of soldiers--wine and women. The
men who fell victims to wine or whiskey or other forms of alcoholic
intemperance, were punished, first of all with imprisonment, and then,
when it was seen that this penalty did not meet the case, the death
penalty was imposed for such as became intoxicated when at their post
of duty. Obviously the army cannot afford to have as its guardians
men who cannot keep sober. Those who fell victims to loose women and
contracted venereal diseases--and it is beyond a doubt that most of
the women who follow an army are diseased--had to be withdrawn from
their positions and sent back to the bases to hospitals. Every man,
therefore, who violated Lord Kitchener's advice, was playing into
the hands of the enemy to this extent that he was taking the risk of
contracting a disease which would rob the army of his services. My
own Colonel used not to mince words on this subject but used to say
that such men might just as well go over to the enemy at once. But
with every kind of pleading and threat on the part of officers, it was
found that there were men who disregarded their advice. A soldier's pay
automatically stops under these circumstances, and at first it was the
custom to acquaint his family with the fact that he had been sent to
such and such a hospital, and the people of England soon got to know
the purpose of these hospitals, and many a home suffered shame from
the indiscretions of the men who represented them in France. When the
Australian troops were quartered near Cairo--than which there are few
more immoral cities in the world--venereal cases were frequent, in
spite of the admonitions of the combatant officers and of the medical
staff. What was to be done? Every effort was made to restrain the men
and keep them out of the notorious red light district, but case after
case of the disease turned up. Eventually some of the medical men
hit upon the scheme of establishing at the entrance to the various
camps, tents to which men could go on their return from the city.
In those tents there was a representative of the Army Medical Corps
equipped with all the latest appliances in the form of prophylactics,
and these were administered without charge and without question, even
as to name, to all who sought this method of protecting themselves
after acts of indiscretion. The result was very gratifying from the
medical standpoint, for the number of those who contracted the disease
rapidly declined and the efficiency of the army was maintained at a
correspondingly high standard. Of course a protest was immediately
entered by those who were particularly interested in the morals of
the men, and the charge was made that it was putting a premium on
immorality. For my own part, interested in both of these matters, I
have come to the conclusion that the old methods have failed, and that
I would rather have an army immoral and well than an army immoral
and diseased. As human nature is constituted at present I can see no
alternative, though I believe it to be our bounden duty to continue to
urge the need of self-restraint. I do not fear that these words will
be taken to cast a slur upon any army, for those of us who are not
blind are perfectly aware that the same kind of immorality exists among
civilian populations as in armies. For those men who shall read these
words of mine I would with all the force at my command urge the close
following of the precepts of Lord Kitchener.
[Illustration: FIGURE 11:
Simple entanglements made of barbed wire and rough posts.]
A kindred problem with which the authorities sometimes have to deal
is that of "unnatural men." Records of the German Army before the war
contained many examples of this most revolting form of perversion. In
the British Armies that were raised at the outbreak of the war, several
cases occurred, the offenders being punished with terms of imprisonment
varying from seven to fifteen years with hard labour--much too lenient.
The whole problem is most difficult to deal with, and any one who
attempts to deal with it risks public censure. Yet the problem must
be faced, nevertheless, and the sooner we apply sane methods to
its solution, the better. Of course views will differ as to what
constitutes sane methods, but I am convinced from my own experience
with soldiers that the method outlined above is a good one. We must
not, however, fail to emphasise the dangers that men run. They must
be taught the folly of it. We must make it plain to them that it is
not worth the candle to run the risk of contracting the most horrible
diseases that even our advanced medical science can never cure with
certainty, for the sake of a brief gratification. A man's whole life
may be ruined; his innocent children afflicted with a loathsome
disease; his wife made to endure years of physical and mental torment
as the price of that foolish act. Were this book a moral treatise I
should spend time in driving this point home with more force. But as
the object I desire to achieve is to show men how they can become
soldiers and remain fit, it must suffice to say again that the surest
way to lay up misery for yourself, to render yourself unfit to remain
at your soldier tasks and thus increase the odds of the enemy against
your side is to run the risk of venereal disease through contact with
women.