FEVER IN THE ARMY
The most serious and threatening feature of the situation at Santiago
after the capture of the city was the ill health of the army. In less
than a month after it began its Cuban campaign the Fifth Army-Corps was
virtually _hors de combat_. On Friday, July 22, I made a long march
around the right wing from a point near the head of the bay to the
Siboney road, and had an opportunity to see what the condition of the
troops was in that part of our line. I do not think that more than fifty
per cent. of them were fit for any kind of active duty, and if they had
been ordered to march back to Siboney between sunrise and dark, or to
move a distance of ten miles up into the hills, I doubt whether even
forty per cent. of them would have reached their destination. There were
more than a thousand sick in General Kent's division alone, and a
surgeon from the First Division hospital--the only field-hospital of the
Fifth Army-Corps--told me that a conservative estimate of the number of
sick in the army as a whole would be about five thousand. Of course the
greater part of these sick men were not in the hospitals. I saw hundreds
of them dragging themselves about the camps with languid steps, or lying
in their little dog-kennel tents on the ground; but all of them ought to
have been in hospitals, and would have been had our hospital space and
facilities been adequate. Inasmuch, however, as our hospital
accommodations were everywhere deplorably inadequate, and inasmuch as
our surgeons sent to the yellow-fever camps many patients who were
suffering merely from malarial fever, a majority of our sick soldiers
remained in their own tents, from necessity or from choice, and received
only such care as their comrades could give them.
Yellow fever and calenture broke out among the troops in camp around
Santiago about the same time that they appeared in Siboney. Calenture
soon became epidemic, and in less than a fortnight there were thousands
of cases, and nearly one half of the army was unfit for active service,
if not completely disabled.
The questions naturally arise, Was this state of affairs inevitable, or
might it have been foreseen as a possibility and averted? Is the climate
of eastern Cuba in the rainy season so deadly that Northern troops
cannot be subjected to it for a month without losing half their
effective force from sickness, or was the sickness due to other and
preventable causes? In trying to answer these questions I shall say not
what I think, nor what I suppose, nor what I have reason to believe, but
what I actually know, from personal observation and from the testimony
of competent and trustworthy witnesses. I was three different times at
the front, spent a week in the field-hospital of the Fifth Army-Corps,
and saw for myself how our soldiers ate, drank, slept, worked, and
suffered. I shall try not to exaggerate anything, but, on the other
hand, I shall not suppress or conceal anything, or smooth anything over.
Poultney Bigelow was accused of being unpatriotic, disloyal, and even
seditious because he told what I am now convinced was the truth about
the state of affairs at Tampa; but it seems to me that when the lives of
American soldiers are at stake it is a good deal more patriotic and far
more in accordance with the duty of a good citizen to tell a
disagreeable and unwelcome truth that may lead to a reform than it is to
conceal the truth and pretend that everything is all right when it is
not all right.
The truth, briefly stated, is that, owing to bad management, lack of
foresight, and the almost complete breakdown of the commissary and
medical departments of the army, our soldiers in Cuba suffered greater
hardships and privations, in certain ways, than were ever before endured
by an American army in the field. They were not half equipped, nor half
fed, nor half cared for when they were wounded or sick; they had to
sleep in dog-kennel shelter-tents, which afforded little or no
protection from tropical rains; they had to cook in coffee-cups and old
tomato-cans because they had no camp-kettles; they never had a change of
underclothing after they landed; they were forced to drink brook-water
that was full of disease-germs because they had no suitable vessels in
which to boil it or keep it after it had been boiled; they lived a large
part of the time on hard bread and bacon, without beans, rice, or any of
the other articles which go to make up the full army ration; and when
wounded they had to wait hours for surgical aid, and then, half dead
from pain and exhaustion, they lay all night on the water-soaked ground,
without shelter, blanket, pillow, food, or attendance. To suppose that
an army will keep well and maintain its efficiency under such conditions
is as unreasonable and absurd as to suppose that a man will thrive and
grow fat in the stockaded log pen of a Turkish quarantine. It cannot be
fairly urged in explanation of the sickness in the army that it was due
to the deadliness of the Cuban climate and was therefore what policies
of marine insurance call an "act of God." The Cuban climate played its
part, of course, but it was a subordinate part. The chief and primary
cause of the soldiers' ill health was neglect, due, as I said before, to
bad management, lack of foresight, and the almost complete breakdown of
the army's commissary and medical departments. If there be any fact
that should have been well known, and doubtless was well known, to the
higher administrative officers of the Fifth Army-Corps, it is the fact
that if soldiers sleep on the ground in Cuba without proper shelter and
drink unboiled water from the brooks they are almost certain to contract
malarial fever; and yet twelve or fifteen thousand men were sent into
the woods and chaparral between Siboney and Santiago without hammocks or
wall-tents, and without any vessel larger than a coffee-cup in which to
boil water. I can hardly hint at the impurities and the decaying organic
matter that I have seen washed down into the brooks by the almost daily
rains which fall in that part of Cuba in mid-summer, and yet it was the
unboiled water from these polluted brooks that the soldiers had to
drink. One captain whom I know took away the canteens from all the men
in his company, kept them under guard, and tried to force his command to
boil in their tin coffee-cups all the water that they drank; but he was
soon compelled to give up the plan as utterly impracticable. In all the
time that I spent at the front I did not see a single camp-kettle in use
among the soldiers, and there were very few even among officers. Late in
July the men of the Thirty-fourth Michigan were bringing every day in
their canteens, from a distance of two miles, all the water required for
regimental use. They had nothing else to carry it in, nothing else to
keep it in after they got it to camp, and nothing bigger than a tin cup
in which to boil it or make coffee.
In the matter of tents and clothing the equipment of the soldiers was
equally deficient. Dog-kennel shelter-tents will not keep out a tropical
rain, and when the men got wet they had to stay wet for lack of a spare
suit of underclothes. The officers fared little better than the men. A
young lieutenant whom I met in Santiago after the surrender told me
that he had not had a change of underclothing in twenty-seven days. The
baggage of all the officers was left on board of the transports when the
army disembarked, and little, if any, of it was ever carried to the
front.
Nothing, perhaps, is more important, so far as its influence upon health
is concerned, than food, and the rations of General Shafter's army were
deficient in quantity and unsatisfactory in quality from the very first.
With a few exceptions, the soldiers had nothing but hard bread and bacon
after they left the transports at Siboney, and short rations at that. A
general of brigade who has had wide and varied experience in many parts
of the United States, and whose name is well and favorably known in New
York, said to me in the latter part of July: "The whole army is
suffering from malnutrition. The soldiers don't get enough to eat, and
what they do get is not sufficiently varied and is not adapted to this
climate. A soldier can live on hardtack and bacon for a while, even in
the tropics, but he finally sickens of them and craves oatmeal, rice,
hominy, fresh vegetables, and dried fruits. He gets none of these
things; he has come to loathe hard bread and bacon three times a day,
and he consequently eats very little and isn't adequately nourished.
Nothing would do more to promote the health of the men than a change of
diet."
A sufficient proof that the soldiers were often hungry is furnished by
the fact that men detailed from the companies frequently marched from
the front to Siboney and back (from eighteen to twenty-five miles, over
a bad road), in order to get such additional supplies, particularly in
the shape of canned vegetables, as they could carry in their hands and
haversacks or transport on a rude, improvised stretcher. Officers and
men from Colonel Roosevelt's Rough Riders repeatedly came into Siboney
in this way on foot, and once or twice with a mule or a horse, and
begged food from the Red Cross for their sick and sickening comrades in
their camp at the front.
It is not hard to understand why soldiers contracted malarial fever in a
country like Cuba, when they were imperfectly sheltered, inadequately
equipped, insufficiently fed and clothed, forced to sleep on the ground,
and compelled to drink unboiled water from contaminated brooks. But
there was another reason for the epidemic character and wide prevalence
of the calenture from which the army suffered, and that was exposure to
exhalations from the malarious, freshly turned earth of the rifle-pits
and trenches. All pioneers who have broken virgin soil with a plow in a
warm, damp, wooded country will remember that for a considerable time
thereafter they suffered from various forms of remittent and
intermittent fever. Our soldiers around Santiago had a similar
experience. The unexpected strength and fighting capacity shown by the
Spaniards in the first day's battle, and their counter-attack upon our
lines on the night of the following day, led our troops to intrench
themselves by digging rifle-pits and constructing rude bomb-proofs as
places of refuge from shrapnel. During the armistice these intrenchments
were greatly extended and strengthened, and before Santiago surrendered
they stretched along our whole front for a distance of several miles. In
or near these rifle-pits and trenches our men worked, stood guard, or
slept, for a period of more than two weeks, and the exhalations from the
freshly turned earth, acting upon organisms already weakened by
hardships and privations, brought about an epidemic of calenture upon
the most extensive scale.
By August 3 the condition of the army had become so alarming that its
general officers drew up and sent to General Shafter the following
letter:
We, the undersigned officers, commanding the various brigades,
divisions, etc., of the army of occupation in Cuba, are of the
unanimous opinion that this army should be at once taken out of
the island of Cuba and sent to some point on the northern sea-coast
of the United States; that it can be done without danger to the
people of the United States; that yellow fever in the army at
present is not epidemic; that there are only a few sporadic cases,
but that the army, is disabled by malarial fever, to the extent
that its efficiency is destroyed, and that it is in a condition to
be practically entirely destroyed by an epidemic of yellow fever,
which is sure to come in the near future.
We know from the reports of competent officers and from personal
observation that the army is unable to move into the interior, and
that there are no facilities for such a move if attempted, and that
it could not be attempted until too late. Moreover, the best
medical authorities of the island say that with our present
equipment we could not live in the interior during the rainy season
without losses from malarial fever, which is almost as deadly as
yellow fever.
This army must be moved at once or perish. As the army can be
safely moved now, the persons responsible for preventing such a
move will be responsible for the unnecessary loss of many thousands
of lives.
Our opinions are the result of careful personal observation, and
they are also based on the unanimous opinion of our medical
officers with the army, and who understand the situation
absolutely.
This letter was signed by Generals Kent, Bates, Chaffee, Sumner, Ludlow,
Ames, and Wood, and Colonel Roosevelt.
In view of such a state of affairs as that disclosed by this letter
there was, of course, only one thing to be done. The War Department
decided to remove the Fifth Army-Corps at once from Cuba, and before the
middle of August a large part of General Shatter's command was on its
way to Montauk Point.
As a result, I presume, of sleeping without shelter from the heavy dew
in the field-hospital at the front, and over-exerting myself by walking
around the lines of the army in the blazing sunshine of midday, I was
finally prostrated with illness myself. At three o'clock on the night
of Tuesday, July 26, I awoke in a chill, and before morning I had all
the symptoms of calenture, with a temperature of 104.
Calenture, or Cuban malarial fever, comes on rather suddenly with a
chill of greater or less severity and a violent headache. The
temperature frequently rises to 105, and the fever, instead of being
intermittent, runs continuously with little, if any, diurnal variation.
If the attack is not a very severe one the headache gradually subsides;
the temperature falls to 102 or 103, and in the course of three or four
days the disease begins to yield to treatment. In some cases the fever
is interrupted by a second chill, followed by another rise of
temperature; but, as a rule, there is only one chill, and the fever,
after running from four days to a week, gradually abates. The treatment
most favored in Santiago consists of the administration of a large dose
of sulphate of magnesia at the outset, followed up with quinine and
calomel, or perhaps quinine and sulphur. The patient is not allowed to
take any nourishment while the fever lasts, and if he keeps quiet,
avoids sudden changes of temperature, and does not fret, he generally
recovers in a week or ten days. He suffers from languor and prostration,
however, for a fortnight or more, and if he overeats, moves about in the
sunshine, or exposes himself to the night air, he is liable to have
another chill, with a relapse, in which the fever is higher and more
obstinate, perhaps, than at first. Under ordinary circumstances the
fever is not dangerous, and the worst thing about it is the wretched,
half-dead, half-alive condition in which it leaves one. My attack was
not a very severe one, and in the course of ten days I was able to walk
about again; but the first time I went out into the sunshine I had a
relapse, which reduced me to such a state of weakness and helplessness
that I could no longer care for myself, and had either to leave the
country or go into one of the crowded Santiago hospitals and run the
risk of being sent as a "suspect" to the yellow-fever camp near Siboney.
Upon the advice of Dr. Egan, I decided to take the first steamer for New
York, and sailed from Santiago on August 12, after a Cuban campaign of
only seven weeks.